Meeting adequate intake for dietary calcium without dairy foods in adolescents aged 9 to 18 years (National Health and Nutrition Examination Survey 2001-2002)

BACKGROUND: In the United States, >50% of dietary calcium is provided by milk and milk products. Calcium intakes in the United States are inadequate for many children, and a large proportion do not drink milk or consume dairy products. However, no studies have addressed whether dairy-free diets can provide adequate calcium while meeting other nutrient recommendations. OBJECTIVE: To determine the highest calcium intake for adolescents obtained from dairy-free diets, and to examine the relationship between intakes of calcium-fortified foods, using citrus juice as an example, and maximal calcium intakes. DESIGN: In the National Health and Nutrition Examination Survey 2001 to 2002, 65 females and 62 males, aged 9 to 18 years, reported no intake of dairy. We used linear programming to generate diets with maximal calcium intake, while meeting Dietary Reference Intakes for a set of nutrients, limiting energy and fat intakes, and not selecting food quantities exceeding amounts usually eaten in the population. RESULTS: With food use and energy and fat constraints, diets formulated by linear programming provided 1,150 and 1,411 mg/day of calcium for girls and boys, respectively. With the Dietary Reference Intakes constraints, these decreased to 869 and 1,160 mg/day. When we introduced 1.5 servings of fortified juice to the diets, the highest calcium intake increased to 1,302 mg/day for girls and to 1,640 mg/day for boys. CONCLUSIONS: Adequate intake for calcium cannot be met with dairy-free diets while meeting other nutrient recommendations. To meet the adequate intake for calcium without large changes in dietary patterns, calcium-fortified foods are needed. In addition, greater physical activity and responsible sunlight exposure should be encouraged to promote vitamin D adequacy.     

Intake of Dairy Products in Relation to Periodontitis in Older Danish Adults

This cross-sectional study investigates whether calcium intakes from dairy and non-dairy sources, and absolute intakes of various dairy products, are associated with periodontitis. The calcium intake (mg/day) of 135 older Danish adults was estimated by a diet history interview and divided into dairy and non-dairy calcium. Dairy food intake (g/day) was classified into four groups: milk, cheese, fermented foods and other foods. Periodontitis was defined as the number of teeth with attachment loss ≥3 mm. Intakes of total dairy calcium (Incidence-rate ratio (IRR) = 0.97; p = 0.021), calcium from milk (IRR = 0.97; p = 0.025) and fermented foods (IRR = 0.96; p = 0.03) were inversely and significantly associated with periodontitis after adjustment for age, gender, education, sucrose intake, alcohol consumption, smoking, physical activity, vitamin D intake, heart disease, visits to the dentist, use of dental floss and bleeding on probing, but non-dairy calcium, calcium from cheese and other types of dairy food intakes were not. Total dairy foods (IRR = 0.96; p = 0.003), milk (IRR = 0.96; p = 0.028) and fermented foods intakes (IRR = 0.97; p = 0.029) were associated with reduced risk of periodontitis, but cheese and other dairy foods intakes were not. These results suggest that dairy calcium, particularly from milk and fermented products, may protect against periodontitis. Prospective studies are required to confirm these findings.     

An Investigation into the Association between DNA Damage and Dietary Fatty Acid in Men with Prostate Cancer

Prostate cancer is a growing problem in New Zealand and worldwide, as populations adopt a Western style dietary pattern. In particular, dietary fat is believed to be associated with oxidative stress, which in turn may be associated with cancer risk and development. In addition, DNA damage is associated with the risk of various cancers, and is regarded as an ideal biomarker for the assessment of the influence of foods on cancer. In the study presented here, 20 men with prostate cancer adhered to a modified Mediterranean style diet for three months. Dietary records, blood fatty acid levels, prostate specific antigen, C-reactive protein and DNA damage were assessed pre- and post-intervention. DNA damage was inversely correlated with dietary adherence (p = 0.013) and whole blood monounsaturated fatty acids (p = 0.009) and oleic acid (p = 0.020). DNA damage was positively correlated with the intake of dairy products (p = 0.043), red meat (p = 0.007) and whole blood omega-6 polyunsaturated fatty acids (p = 0.015). Both the source and type of dietary fat changed significantly over the course of the dietary intervention. Levels of DNA damage were correlated with various dietary fat sources and types of dietary fat.     

Older Adults Need Guidance to Meet Nutritional Recommendations

Objective: The purpose of this study was to compare the diet of healthy, free-living senior volunteers to the dietary reference intakes (DRIs) and Food Guide Pyramid recommendations.

Methods: This study was a cross-sectional assessment of dietary habits, as measured using a standardized food frequency questionnaire, among 1740 healthy Southwestern U.S. adults, aged 51 to 85 years. Assessment of independently-living volunteers to chemoprevention trials provides an efficient mechanism to profile typical dietary habits among the older adult population.

Results: Daily estimated macronutrient intakes exceeded recommended proportions of protein and fat. In contrast, more than 60% of this senior population reported dietary vitamin D, vitamin E, folate and calcium intakes below estimated average requirements (EAR). Based on the Food Guide Pyramid recommendations, fewer than 10% of the older adults consumed the recommended daily dairy and grain servings. More females than males consumed recommended vegetable (49% versus 40%) and fruit (53% versus 48%) servings (p < 0.05). More males consumed recommended grain (11% versus 7%) and protein (78% versus 73%) servings (p < 0.05) than females.

Conclusions: Mean micronutrient intakes compared well with DRIs, although fewer than one-half of these older adults consumed recommended levels for vitamin D, vitamin E, folate, and calcium or daily food servings of dairy, grains, vegetables or fruits. Since the beneficial aspects of foods are not limited to essential nutrients, nutrition recommendations to older adults may be improved by emphasizing daily servings of nutrient-dense choices within the Food Pyramid.     

Food and nutrient intake of Irish community-dwelling elderly subjects: Who is at nutritional risk?

Objectives: To assess the dietary intakes of Irish community-dwelling elderly individuals, participating in the ELDERMET project. Design: Cross-sectional study. Setting: Cork city and county region of southern Ireland. Participants: Two hundred and eight (94 males, 114 females) community-dwelling subjects aged 64-93 yrs. Measurements: Dietary intake was assessed using a validated semi-quantitative food frequency questionnaire (FFQ). Anthropometric data were recorded. Nutritional status was assessed using the Mini Nutritional Assessment (MNA). Results: A high rate of overweight/obesity was observed in this population group. Consumption of energy-dense, low-nutrient foods was excessive among this population group. Older elderly subjects (≥75 yrs) consumed significantly (P<0.01) more desserts/sweets than younger elderly (64–74 yrs). Intakes of dietary fat and saturated fat were high while dairy food consumption was inadequate in both males and females. Elderly females typically had a more nutrient-dense diet than males. A considerable proportion of subjects, particularly males, had inadequate intakes of calcium, magnesium, vitamin D, folate, zinc and vitamin C. Conclusion: The data indicate that the diet of Irish community-dwelling elderly individuals is suboptimal with respect to nutrient intake, and excessive in terms of fat intake, with implications for the health status of this population group. Reductions in dietary fat and increased low fat dairy food intakes are recommended for the prevention of diet-related disease in older persons. In addition, strategies to improve a number of sub-optimal micronutrient intakes need to be developed and implemented, particularly among elderly males.     

Effects of dairy food supplements on bone mineral density in teenage girls

Summary Background Bone mineral density (BMD) is largely genetically determined and this influence is most powerful in the period of rapid skeletal development in childhood and late adolescence but environmental factors such as exercise and dietary calcium intake may influence up to 20%. Aims of the study The aims of the study were to examine healthy late adolescent females for the effects and benefits of a high calcium intake from dairy product foods on bone mineral density, body composition, lipids and biochemistry. The secondary aim is determine whether a high intake of dairy product foods in the diet is acceptable for this age group long term. Methods Ninety-one teenage girls who participated in a two-year randomised controlled study on the effect of dairy food supplementation on dietary patterns, body composition and bone density in post-pubertal teenage girls were approached one year after the cessation of the study to determine the effects of the cessation of dairy supplements on bone mineral density, dietary habits, biochemical markers, body composition and blood lipids. Bone mineral density and bone mineral content were assessed at the hip, spine and total body. Anthropometric data were collected, and exercise, Tanner, dietary assessment, preference and compliance questionnaires were administered. Lipid profiles, hydroxyproline excretion and urinary calcium and sodium excretion measurements were performed. Results There were no significant differences between the 2 groups for height, weight, lean and fat mass. The supplemented group had significantly higher calcium, phosphorus and protein intake during the supplementation period (p<0.001). No differences were seen between the groups 12 months after supplementation finished. There were no significant differences in exercise level, preference or acceptability of dairy products or in the lipids and bone markers between baseline the end of supplementation and 1 year follow-up. There was a significant increase in trochanter (4.6%), lumbar spine (1.5%) and femoral neck (4.8%) BMD (p<0.05) in the high calcium group at the end of supplementation. There was an increase in bone mineral content at the trochanter (p<0.05) and lumbar spine; however the latter was not statistically significant, in the high calcium group at the end of supplementation. There was no difference in vertebral height or width at any stage of the study, indicating no influence on bone size. Conclusions In this 3 year study (2 years of supplementation, 1 year follow-up), teenage girls, aged 15–18 years, were able to significantly increase their BMD at the trochanter, femoral neck and lumbar spine when supplemented with dairy product foods to a mean calcium intake of 1160 mg/d. There was also an effect seen on the BMC particularly at the trochanter and to a lesser extent at the lumbar spine. The dietary calcium intake achieved did not adversely affect body weight, fat and lean mass or blood lipid profiles. Twelve months after the supplementation finished the girls had returned to their baseline diet, indicating self-selection of a high dairy product diet may be hard to achieve. Received: 5 June 2000, Accepted: 5 September 2000     

Combining food records with in-depth probing interviews improves quality of dietary intake reporting in a group of South Asian women

Objective: To investigate if the addition of an in‐depth interview focused on cultural dietary practices could improve the quality of dietary data from food records among South Asian women in New Zealand. Methods: Cross‐sectional data were collected from 134 South Asian women (≥20 years), living in Auckland. Dietary data were collected using four‐day food records. Nutritional analysis revealed 33.6% under‐reporting of energy intakes. All women were recalled for an in‐depth probing interview focused on culture‐specific foods and dietary practices. Results: The interview revealed extensive use of dairy products and plant oils. The nutrient content of the food record alone and the food record plus interview were compared; median energy intakes were 6,852 kJ vs 7,246 kJ (p<0.001); under‐reporting decreased by 14.2%, and total fat and protein intakes (g/day) increased (p<0.001). Estimates of poly‐ and mono‐unsaturated fatty acids increased significantly (p<0.001) due to greater use of plant oils due to greater use of plant oils replacing saturated fatty acid‐rich fats in food preparation. A significant increase (17%) (p<0.001) in calcium intake reflects the higher dairy intake identified with the interview. Conclusion: The addition of an in‐depth probing interview to a four‐day food record enhanced food intake reporting. Self‐reported dietary assessments in immigrant population groups require quality control for accuracy. Implications: Methods to ensure high‐quality dietary data are essential to assess health outcomes and to inform public health interventions, especially in immigrant populations.     

Extrinsic and intrinsic regulation of DOR/TP53INP2 expression in mice: effects of dietary fat content, tissue type and sex in adipose and muscle tissues

Background

A growing body of research suggests that regular consumption of dairy foods may counteract obesity and other components of the metabolic syndrome. However, human intervention trials are lacking. We aimed to determine the cardiometabolic health effects of increasing the consumption of reduced fat dairy foods in adults with habitually low dairy intakes in the absence of energy restriction.

Methods

An intervention trial was undertaken in 61 overweight or obese adults who were randomly assigned to a high dairy diet (HD, 4 serves of reduced fat dairy/day) or a low dairy control diet (LD, ??1 serve/day) for 6 months then crossed over to the alternate diet for a further 6 months. A range of anthropometric and cardiometabolic parameters including body composition, metabolic rate, blood lipids, blood pressure and arterial compliance were assessed at the end of each diet phase.

Results

Total energy intake was 1120 kJ/day higher during the HD phase, resulting in slight weight gain during this period. However, there were no significant differences between HD and LD in absolute measures of waist circumference, body weight, fat mass or any other cardiometabolic parameter.

Conclusion

Recommended intakes of reduced fat dairy products may be incorporated into the diet of overweight adults without adversely affecting markers of cardiometabolic health.

Trial Registration

The trial was registered with the Australia and New Zealand Clinical Trials Registry (ACTRN12608000538347) on 24th October, 2008.     

Women's diet quality in the UK

Women's diets are of interest as they not only impact on wellbeing and risk of chronic disease in women themselves, but also influence pregnancy outcomes and infant health. UK dietary surveys show that, while some improvements have occurred, intakes of key micronutrients, particularly iron, vitamin D, calcium and folate remain below recommended levels. Women's diets are also too high in saturated fat and salt, and low in fibre, oily fish and fruits and vegetables. Evidence suggests that certain chronic conditions are influenced by dietary components, e.g. inadequate calcium and vitamin D intakes reduce bone density, salt and saturated fat increase cardiovascular disease risk, excessive alcohol intakes increase cancer risk, low intakes of long chain n‐3 fatty acids may adversely affect fetal development and mental health, while adequate folic acid reduces the risk of birth defects. Focused health initiatives are needed to improve diet quality in women, particularly school‐aged girls, women planning a pregnancy, those living in areas of deprivation and elderly women. Vitamin and mineral supplements, and fortified foods may have a role to play alongside dietary improvements in helping women to achieve optimal diet quality.     

No effects of low and high consumption of dairy products and calcium supplements on body composition and serum lipids in Puerto Rican obese adults

Objective

Epidemiologic studies have shown that a high calcium intake is related to lower body weight, fat, and serum lipids in obese individuals. However, clinical studies have shown inconclusive results. The present study was conducted to determine if dairy or calcium supplementation alters body composition or serum lipids in Puerto Rican obese adults without dietary energy restriction or exercise.

Methods

A 21-wk randomized clinical trial was conducted in 30 obese adults, aged 21-50 y, with usual calcium intakes <700 mg/d. Subjects were randomly assigned to the following: high dairy (∼1300 mg/d of calcium from dairy products by substituting foods); high calcium (∼1300 mg/d of calcium; ∼700 mg/d from diet and 600 mg/d from a supplement); or placebo. Subjects were asked to continue their established dietary intake (except for the high dairy group) and their physical activity during the study. Body weight was measured monthly; body fat, bone, and serum lipids (total cholesterol, high-density lipoprotein, low-density lipoprotein, and triacylglycerol) were measured at baseline and at 21 wk. Pairwise differences in study endpoints among the groups were assessed using ANOVA and post-hoc analysis.

Results

Grand mean calcium intake was 1200 ± 370 (median 1187) mg/d in the high dairy group, 1171 ± 265 (median 1165) mg/d in the high calcium group, and 668 ± 273 (median 691) mg/d in the control group, which was significantly lower compared to the two treatment groups (P < 0.001). There were no significant group effects in any of the outcome variables.

Conclusion

A high dairy or calcium diet alone did not alter body composition or serum lipids profile in a sample of Puerto Rican obese adults.     

Concern about cholesterol and its association with diet in a group of healthy elderly

The association between diet and degree of concern about dietary cholesterol was examined in a group of 244 healthy elderly persons. Specifically, it was thought that a concern about cholesterol might result in diets that exclude essential nutrients, such as calcium and vitamin D, that are found in foods that also contain cholesterol. 70% of this group indicated a concern about dietary cholesterol; 18% were “very concerned”. Over half of these elderly thought that dietary cholesterol contributed to heart disease, atherosclerosis and high blood pressure. Many indicated that they were restricting their intake of certain foods because of cholesterol. This response was strongly associated with degree of concern about cholesterol. It was found that those who were concerned about cholesterol had lower intakes of cholesterol, total fat, saturated fat and total calories, and greater intakes of vitamin D. However, no other significant associations with diet were found.     

Increased consumption of dairy foods and protein during diet- and exercise-induced weight loss promotes fat mass loss and lean mass gain in overweight and obese premenopausal women

Weight loss can have substantial health benefits for overweight or obese persons; however, the ratio of fat:lean tissue loss may be more important. We aimed to determine how daily exercise (resistance and/or aerobic) and a hypoenergetic diet varying in protein and calcium content from dairy foods would affect the composition of weight lost in otherwise healthy, premenopausal, overweight, and obese women. Ninety participants were randomized to 3 groups (n = 30/group): high protein, high dairy (HPHD), adequate protein, medium dairy (APMD), and adequate protein, low dairy (APLD) differing in the quantity of total dietary protein and dairy food-source protein consumed: 30 and 15%, 15 and 7.5%, or 15 and <2% of energy, respectively. Body composition was measured by DXA at 0, 8, and 16 wk and MRI (n = 39) to assess visceral adipose tissue (VAT) volume at 0 and 16 wk. All groups lost body weight (P < 0.05) and fat (P < 0.01); however, fat loss during wk 8-16 was greater in the HPHD group than in the APMD and APLD groups (P < 0.05). The HPHD group gained lean tissue with a greater increase during 8-16 wk than the APMD group, which maintained lean mass and the APLD group, which lost lean mass (P < 0.05). The HPHD group also lost more VAT as assessed by MRI (P < 0.05) and trunk fat as assessed by DXA (P < 0.005) than the APLD group. The reduction in VAT in all groups was correlated with intakes of calcium (r = 0.40; P < 0.05) and protein (r = 0.32; P < 0.05). Therefore, diet- and exercise-induced weight loss with higher protein and increased dairy product intakes promotes more favorable body composition changes in women characterized by greater total and visceral fat loss and lean mass gain.     

Nutrient contributions of dairy foods in the United States, Continuing Survey of Food Intakes by Individuals, 1994-1996, 1998

OBJECTIVE: This study was designed to quantify the impact of dairy foods on nutrient intakes in the United States. SUBJECTS: Data were from 17959 respondents to the 1994-1996, 1998 Continuing Survey of Food Intakes by Individuals (CSFII).Statistical analyses Nutrient intakes were quantified by quartile of dairy food intake. Also, dairy intakes were compared in people who met vs did not meet intake recommendations for select nutrients. Finally, the direct contribution of dairy foods/ingredients to calcium and lipid intakes was determined. SAS and SUDAAN software were used. Data were weighted. Energy intake was a covariable in regression models. RESULTS: Intake of all micronutrients examined, except vitamin C, was higher with increasing quartile of total dairy and milk intake, controlling for energy intake. Calcium was the only micronutrient positively associated with cheese intake. Fat intake either did not differ or was lower among people in quartile 2, 3, or 4 vs quartile 1 of total dairy and milk intake, whereas fat was higher as quartile of cheese intake increased. Dietary cholesterol was lower as intakes of any of the dairy categories increased; the opposite was true for saturated fat. Dairy foods/ingredients directly contributed an average of 51% of dietary calcium, 19% of total fat, 32% of saturated fat, and 22% of cholesterol. CONCLUSIONS: Total dairy and milk intakes were associated with higher micronutrient intakes without adverse impact on fat or dietary cholesterol. Results reinforce the strong nutritional profile of dairy-rich diets, although results with saturated fat and with cheese suggest that it would be useful to modify product composition and/or eating patterns to optimize nutritional contributions of dairy products.     

The Association Between Index of Nutritional Quality (INQ) and Glioma and Evaluation of Nutrient Intakes of These Patients: A Case-Control Study

Introduction: Glioma is the most common adult brain tumors. Dietary factors may play a role in the etiology of glioma. The Index of Nutritional Quality (INQ) provides a general overview for the nutrient content of a food or a diet. This study aimed to investigate the association between INQ and glioma and nutrient intakes. Material and methods: This study was included 128 patients and 256 controls. Dietary intakes of the subjects were evaluated by a food frequency questionnaire (FFQ) and FFQ-derived dietary data were used to calculate INQ scores. Logistic regression was used to calculate the odds ratios and 95% confidence intervals. Results: Cases had higher intake of total fat, saturated fatty acid (SFA), meats, hydrogenated oils and controls had higher intake of monounsaturated fatty acid, polyunsaturated fatty acid, calcium, dairy, fruits, and nuts. Only the INQ of vitamin C, vitamin E, calcium, and fiber are higher in controls. An inverse association was observed between glioma and INQ of calcium, vitamin E, vitamin C, and fiber. Conclusion: The results of this study propose a healthy diet such as high intake of vitamins C and E, calcium, fiber, food groups like fruits and vegetables, and low-fat milk and nuts; and low consumption of total fat, SFA, and red meat may be protective against glioma.     

Patterns of Egg Consumption Can Help Contribute to Nutrient Recommendations and Are Associated with Diet Quality and Shortfall Nutrient Intakes

Limited data are available on how eggs are consumed in the typical American eating pattern and the contribution to usual intakes, diet quality and in meeting recommendations. The objectives of the present analysis included identifying how eggs are consumed within U.S. dietary patterns and how these patterns are associated with the usual intakes of shortfall nutrients and diet quality (Healthy Eating Index 2015) using data from the combined National Health and Nutrition Examination Survey (NHANES) from 2001–2016. An additional objective included assessing the differences between egg consumers and egg non-consumers in nutrient intakes and nutrient adequacy. Several egg-containing dietary patterns were identified, and two egg patterns were associated with a greater diet quality compared to a no egg pattern (p < 0.0001). Most egg patterns identified were similar in diet quality scores when compared to the no egg pattern; however, the two egg patterns had lower diet quality scores. Egg consumption combined with a greater intake of total protein foods, seafood and plant protein, total vegetables, total fruit, whole fruit, whole grains and dairy foods, and a lower intake of refined grains and added sugars contributed to an improved diet quality, supporting that no one food is responsible for a healthy dietary pattern. Egg consumers demonstrated significantly higher intakes of dietary fiber, calcium, magnesium, potassium, total choline, vitamin A, vitamin C, vitamin D and vitamin E when compared to egg non-consumers. A comparison of egg consumers and egg non-consumers found egg consumers had significantly less percentages of the population below the EAR for calcium, iron, magnesium, vitamin A, vitamin C and vitamin E. Similarly, the percentage of the population above the recommendations for potassium and choline were greater for egg consumers vs. egg non-consumers. In egg consumers, 24.4% of the population was above the AI for dietary choline when compared to 4.3% of egg non-consumers (p < 0.0001). Findings from the present analysis demonstrate that eggs and egg-containing foods can be an important part of a healthy dietary pattern when balanced accordingly with other nutrient-dense foods.     

Dietary fiber and nutrient density are inversely associated with the metabolic syndrome in US adolescents

Background

There is no consensus as to whether low dietary intakes of saturated fat or cholesterol, or high intakes of dietary fiber are related to a lower prevalence of metabolic syndrome (MetS) in adolescent children.

Objective

To determine whether a fiber-rich diet as measured by a fiber index (grams fiber/1,000 kcal) is associated with lower rates of MetS among adolescents vs a diet low in saturated fat or cholesterol as measured by a saturated fat index (grams saturated fat/1,000 kcal) and a cholesterol index (milligrams cholesterol/1,000 kcal), respectively.

Design/participants/setting

Cross-sectional analysis of 12- to 19-year-old boys and girls (N=2,128) who participated in the National Health and Nutrition Examination Survey 1999-2002.

Outcomes and statistical analyses

The prevalence of MetS (abnormal values of three or more of the following: waist circumference, blood pressure, fasting serum high-density lipoprotein cholesterol, triglycerides, and glucose) was compared across quintiles of the dietary indexes (fiber index, saturated fat index, and cholesterol index) derived from 24-hour recalls. χ² tests determined the prevalence across dietary quintiles, and multivariate logistic regression evaluated the association of the dietary indexes with MetS. Weighted analyses were used controlling for sex, age, ethnicity, and family income. Significance was set at P≤0.05.

Results

The overall prevalence of MetS was 6.4% (n=138). There was a graded inverse association between the fiber index and MetS (P<0.001) with a threefold difference between the lowest and highest quintiles (9.2% vs 3.1%). Each quintile increase in the fiber index was associated with a ∼20% decrease in MetS (adjusted odds ratio 0.83, 95% confidence interval 0.68-1.00; P≤0.043). Neither the saturated fat index (P=0.87) nor the cholesterol index (P=0.22) was significantly associated with MetS.

Conclusions

Higher intakes of dietary fiber, but not low intakes of saturated fat or cholesterol are related to the MetS in adolescents. These findings suggest that to reduce the risks for MetS in adolescents, it is more important to emphasize a paradigm that promotes the inclusion of fiber-rich, nutrient-dense, plant-based foods vs what foods to restrict or exclude as is commonly done when the focus is on total fat, cholesterol, or saturated fat intake.     

Calcium and dairy products inhibit weight and fat regain during ad libitum consumption following energy restriction in Ap2-agouti transgenic mice

We demonstrated previously that dietary calcium suppression of calcitriol reduces adipocyte Ca(2+), suppresses lipogenesis, and increases lipid utilization during energy restriction. Notably, dairy calcium sources exert markedly greater effects. To determine the effects of dietary calcium and dairy products on energy partitioning during subsequent refeeding, we induced obesity in aP2-agouti transgenic mice with a high-fat/high-sucrose diet, then restricted energy intake from a high-calcium (1.3%) diet for 6 wk to induce fat loss, and then provided free access to a low-calcium (0.4%) diet or to high-calcium (1.3%) diets that utilized either calcium-fortified foods or dairy products (milk or yogurt) for 6 wk. Refeeding the low-calcium diet caused the regain of all weight and fat, whereas all high-calcium diets reduced fat gain by 55% (P < 0.01). All high-calcium diets stimulated adipose tissue uncoupling protein (UCP)2 and skeletal muscle UCP3 expression (P < 0.001) and slightly increased core temperature (P = 0.136), but only the dairy-based diets elicited a marked (>10-fold, P < 0.001) increase in skeletal muscle peroxisome proliferator-activated receptor-alpha expression. All 3 high-calcium diets produced significant increases in lipolysis, decreases in fatty acid synthase expression and activity, and reduced fat regain (P < 0.03), but the 2 dairy-containing high-calcium diets exerted significantly greater effects on regain (P < 0.01). Thus, high-Ca diets elicit a shift in energy partitioning and reduction of weight gain during refeeding, with dairy Ca sources exerting markedly greater effects.     

Predictors of nutritional adequacy in mother-toddler dyads from rural families with limited incomes

OBJECTIVE: To predict the mean adequacy ratio (MAR) scores of mothers and toddlers from intakes of fruits, vegetables, and dairy group foods and being seated during mealtimes. DESIGN/SUBJECTS: This was a regression analysis of cross-sectional data of the diet quality and being seated during mealtimes of 100 rural mother-toddler dyads from limited-income families using two 24-hour dietary recalls. Children were 11 to 25 months of age and at or below 100% of the poverty index. MEASURES OF OUTCOME: Dietary quality for mothers and toddlers was assessed using a MAR score for eight different nutrients (vitamin A, vitamin C, vitamin D, folate, calcium, zinc, iron, and magnesium), and a score of 85 or above was considered nutritionally adequate. The main food groups of interest were servings from the fruits, vegetables, and dairy group foods. Mealtime sitting behavior was the percentage of times the toddler remained seated while eating. RESULTS: Servings of fruits, vegetables, and dairy foods predicted 0.62 of the variance in the mother's MAR score, whereas vegetable and dairy intakes along with being seated while eating indicated nutritional adequacy for toddlers. Mothers with low MAR scores were most likely to have toddlers with poor diets, although few toddlers had poor diet quality. CONCLUSIONS: Adequate intakes of dairy, vegetables, and whole fruits along with being seated while eating could be quick assessment tools to screen toddlers for nutritional risk. Mothers with poor diet quality were likely to have toddlers with poor diets; low intakes of fruits, vegetables, and dairy foods were markers for poor diet quality in mothers.     

Older adults need guidance to meet nutritional recommendations

OBJECTIVE: The purpose of this study was to compare the diet of healthy, free-living senior volunteers to the dietary reference intakes (DRIs) and Food Guide Pyramid recommendations. METHODS: This study was a cross-sectional assessment of dietary habits, as measured using a standardized food frequency questionnaire, among 1,740 healthy Southwestern U.S. adults, aged 51 to 85 years. Assessment of independently-living volunteers to chemoprevention trials provides an efficient mechanism to profile typical dietary habits among the older adult population. RESULTS: Daily estimated macronutrient intakes exceeded recommended proportions of protein and fat. In contrast, more than 60% of this senior population reported dietary vitamin D, vitamin E, folate and calcium intakes below estimated average requirements (EAR). Based on the Food Guide Pyramid recommendations, fewer than 10% of the older adults consumed the recommended daily dairy and grain servings. More females than males consumed recommended vegetable (49% versus 40%) and fruit (53% versus 48%) servings (p < 0.05). More males consumed recommended grain (11% versus 7%) and protein (78% versus 73%) servings (p < 0.05) than females. CONCLUSIONS: Mean micronutrient intakes compared well with DRIs, although fewer than one-half of these older adults consumed recommended levels for vitamin D, vitamin E, folate, and calcium or daily food servings of dairy, grains, vegetables or fruits. Since the beneficial aspects of foods are not limited to essential nutrients, nutrition recommendations to older adults may be improved by emphasizing daily servings of nutrient-dense choices within the Food Pyramid.     

The contribution of yogurt to nutrient intakes across the life course

Yogurt is a nutrient‐dense food within the milk and dairy products food group. The nutritional content of yogurt varies depending on the processing method and ingredients used. Like milk, it is a good source of protein and calcium, and can be a source of iodine, potassium, phosphorus and the B vitamins – riboflavin (B₂) and vitamin B₁₂ (depending on type). Some yogurt products are also fortified with vitamin D. The nutritional value of dairy products (milk, cheese and yogurt) and the importance of the nutrients they provide for bone health are well recognised. These foods are collected together as one of the four main food groups within the UK's eatwell plate model that illustrates a healthy, balanced diet. Studies exploring the nutritional and health attributes of yogurt are limited but some research has suggested benefits in relation to bone mineral content, weight management, type 2 diabetes and metabolic profile. Yogurt consumption has also been associated with diet quality. The aim of this paper is to use national survey data to examine yogurt consumption in the UK and consider its contribution to nutrient intakes at different life stages within the context of nutritional challenges in each age group. The contribution of yogurt to energy and nutrient intakes across the life course was calculated via secondary analysis of data from the Diet and Nutrition Survey of Infants and Young Children (2011) and the National Diet and Nutrition Survey (2008/2009–2010/2011). The products categorised within the ‘yogurt group’ included all yogurt, fromage frais and dairy desserts, and fortified products. Comparisons were also made between specific sub‐categories of yogurt, namely ‘yogurt’, ‘fromage frais’ and ‘dairy desserts’. Nutrients included in the analyses were energy; the macronutrients; micronutrients that yogurt can be defined as a ‘source of’; micronutrients that may be of concern in the UK population; and vitamin D for fortified products. A simple dietary modelling exercise was also undertaken to investigate the potential impact of including an additional pot of yogurt per day on the nutrient intakes of adolescents. Children aged 3 years and under had the highest intakes of yogurt [mean intake 43.8 g/day (SD 39.7 g) in 4–18 month‐olds; 46.7 g/day (SD 39.1 g) in 1.5–3 year‐olds], and adolescents (11–18 years) consumed the least [21 g/day (SD 38.0 g)]. In adults, highest mean consumption [35.7 g/day (SD 55.0 g)] was during middle age (50–64 years), equivalent to less than a third of a standard 125 g pot. Around 80% of young children (aged 3 years and under) but only a third of teenagers and young adults had consumed any yogurt product during the survey period of 4 days. Average yogurt consumption was twice as high in women as men among older adults (65 years and over), while gender differences in consumption were less apparent in children. Fromage frais and fortified yogurt products were most commonly consumed by younger children, as were dairy desserts in those aged 4–18 years. Among adults, yogurt per se was most commonly consumed. Children aged 4–10 years exhibited the most variety in the types of yogurt consumed. Low‐fat yogurt (including those with added fruit, nuts and cereals) was the most commonly consumed yogurt type when all ages were combined. More than a third of all yogurt products consumed by children aged 3 years and under were fortified, compared with 18% in those aged 4–10 years. During adulthood, the consumption of fortified products was negligible. The yogurt group made a useful contribution to micronutrient intakes in children aged 4 months to 10 years, particularly vitamin B₁₂ (4–18 months: 7.6%; 1.5–3 years: 5.3%; 4–10 years: 3.8%), riboflavin (7.8%, 6.9%, and 5.7%, respectively), calcium (9.5%, 8.2%, and 5.9%, respectively), iodine (7.2%, 7.6%, and 7%, respectively) and phosphorus (8.1%, 6.3%, and 4.3%, respectively). It also provided 3.9% of the total intake of vitamin D in those aged 4–18 months and 10.5% in those aged 1.5–3 years. Although the contribution to total dietary energy intake was low (4.9% at 4–18 months and 4.2% at 1.5–3 years), yogurt contributed a high proportion of non‐milk extrinsic sugars (NMES) to the diets of young children (22.7% and 11.1% in 4–18 months and 1.5–3 years, respectively). However, the total NMES intake was comparatively low in children aged 4–18 months (6.7% total energy), and 11.6% in 1.5–3 year‐olds (compared to 15.3% total energy in children aged 11–18 years in this survey). As children aged, the contribution of yogurt (all categories combined) to micronutrient intake, as well as to NMES, decreased, reflecting the increasing amounts and variety of foods in the diet. Yogurt made a small contribution to energy and macronutrient intakes during adulthood, with the greatest proportions mostly in the older age group (65 years and over) (energy: 1.7%; fat: 1.3%; saturated fatty acids: 2.1%; NMES: 4%). As intake was higher among women, yogurt made a greater contribution to their micronutrient intakes compared with men, providing >5% of the reference nutrient intakes (RNIs) for phosphorus, iodine, calcium, vitamin B₁₂ and riboflavin. Simple dietary modelling was carried out to investigate the hypothetical change in mean nutrient intakes among adolescents aged 11–14 and 15–18 years, if they were all to add an extra 125 g pot of low‐fat fruit yogurt to their current diet. This showed an increase in average intake, as a percentage of the RNI, for several micronutrients for which there is some evidence of low intakes in this age group, notably calcium in boys and girls (11–18 years) and iodine in girls (11–18 years). Although some benefits for micronutrient intakes were noted, such advice would impact on energy and macronutrient intakes (including NMES), and would need to be given in the context of the wider diet (e.g. as ‘swaps’ for less nutrient‐dense foods). In conclusion, yogurt makes a small but valuable contribution to nutrient intakes in the UK, particularly in young children. Among adolescents, the addition of a low‐fat yogurt would help meet recommended intakes for several micronutrients, particularly calcium and iodine, which are of concern in some teenage diets. Advice to replace some types of snacks and desserts, particularly those high in fat and sugars and low in micronutrients, with a pot of yogurt or similar dairy product may improve the nutrient density of their diet.