Dietary shortcomings in children on a gluten‐free diet

Background: Coeliac disease (CD), or permanent gluten intolerance, is one of the most common chronic food‐related diseases among children in Europe and the USA. The treatment is lifelong gluten‐free diet (GFD) (i.e. the exclusion of wheat, rye and barley from the diet, which are important sources particularly of iron, dietary fibre and vitamin B). The present study aimed to evaluate dietary intakes of energy and nutrients in children and adolescents on GFD and compare these with intake of comparable age groups on a normal diet as well as current recommendations. Methods: Thirty children, 4–17 years of age with confirmed CD and on GFD were agreed to participate in this study at the Department of Pediatrics, Umeå University Hospital. Weight and height were used to calculate individual energy requirement according to Nordic Nutrition Recommendations 2004 (NNR‐04). Dietary intake was assessed using 5‐day food records and household measures were used for quantities. Twenty‐five children completed their dietary record. Results: Thirteen of the 25 children did not meet the recommended energy intake and the dietary intakes were inadequate regarding quality of macronutrients and quantity of minerals and vitamins. The mean intakes of sucrose and saturated fatty acids were above and the intakes of dietary fibre, vitamin D, magnesium and selenium below the NNR‐04. High intakes of sucrose and saturated fat and a low intake of dietary fibre were also noted in a previous national survey on healthy children on a normal diet. The nutrient density of vitamin D, riboflavin, niacin, thiamine, magnesium and selenium were lower among CD children than healthy children but, for iron and calcium, it was higher in CD children. Conclusions: Children on GFD appear to follow the same trends as healthy children on a normal diet, with high intakes of saturated fat and sucrose and low intakes of dietary fibre, vitamin D and magnesium compared to recommendations.     

Evaluation of a Quantitative Food Frequency Questionnaire for 5-Year-Old Children in an Asian Population

BackgroundFood frequency questionnaires (FFQs) are often used to assess dietary intakes due to their ability to assess intake over extended periods, their low respondent burden, and their cost-effectiveness. A quantitative FFQ that includes locally appropriate food items for 5-year-old children in a multiethnic Asian population was developed, but its validity has not previously been evaluated.ObjectiveTo evaluate the relative validity of a newly developed FFQ as a dietary assessment tool for 5-year-old children in a multiethnic Asian population.DesignThe 112 –food item FFQ was administered by trained interviewers to caregivers of children. Frequency of food items consumed in the previous month and portion size information were collected. The FFQs were evaluated against 3-day nonweighed diet records (DRs) completed by caregivers.Participants/settingThe dietary data of 361 children aged 5 years from the Growing Up in Singapore Towards Healthy Outcomes mother-offspring cohort were collected in 2015-2016.Main outcome measuresNutrients of interest included energy, macronutrients, fiber, cholesterol, vitamin A, beta carotene, calcium, and iron, calculated from the FFQs and DRs.Statistical analyses performedNutrient intakes according to FFQs in relation to DRs were assessed using Pearson’s correlation, Lin’s concordance, Bland-Altman plots, quintile joint classification, and Cohen’s κ statistics.ResultsThe highest energy-adjusted correlation (Pearson’s r=0.71) and concordance (Lin’s concordance=0.69) were observed for calcium. Fiber, saturated fat, polyunsaturated fatty acids (PUFA), cholesterol, and iron also showed correlation coefficients and concordance of at least 0.40. Bland-Altman plots suggested no substantial bias across ranges of intakes for the nutrients with correlations and concordance of 0.40 or above. Quintiles joint classification showed substantial agreement for calcium (κ=0.66), and moderate agreement for iron, fiber, saturated fat, polyunsaturated fat, and beta carotene (κ=0.59, 0.54, 0.49, 0.44, 0.43, respectively).ConclusionsThe newly developed FFQ is in reasonable agreement with DR for estimating intakes of calcium, fiber, saturated fat, PUFA, cholesterol, and iron. In addition, the FFQ is able to classify children according to quintiles of nutrient intakes, with moderate to substantial quintile agreements between FFQ and DR for calcium, iron, fiber, saturated fat, PUFA, and beta carotene. To assess the remaining nutrients, DR method is recommended instead of the FFQ.     

Food consumption and nutrition of regional tribes of India†

Systematic investigations of food availability, dietary patterns, nutritional levels, were initiated among aboriginal tribes in different regions in India. These studies also compared nutritional intakes to the physiological requirement of the groups as well as the influence of respective dietaries on physique, working efficiency and growth of children. The 31 tribes investigated were located in the North‐Eastern Frontier, Eastern India, the Central region, Southern states and Andaman and Nicobar islands. Samples of food and homely brewed alcoholic beverages collected during the investigation were analysed for nutrient content.

The investigations provided considerable information on living conditions. A comparative study of family size, total food intakes, supplies of food energy, proteins, minerals and vitamins as well as correlations between dietary patterns and growth of children and Korperfulle index of body build revealed that 14 tribes (47 percent) were well fed and in satisfactory nutritional status, eight (23 percent) were underfed and deficient in many nutrients. Nine tribes (30 percent) lived in utmost poverty and were grossly deficient in all the nutrients and were in a state of physical degeneration and nutritional depletion. This may also be the reason for the degeneration, depletion and ultimate extinction of many regional tribes of India.     

Fortified Foods Are Major Contributors to Nutrient Intakes in Diets of US Children and Adolescents

BackgroundEven in an era of obesity and dietary excess, numerous shortfall micronutrients have been identified in the diets of US children and adolescents. To help tailor strategies for meeting recommendations, it is important to know what foods contribute greatly to micronutrient intakes. Data are lacking on specific contributions made by added nutrients.ObjectiveOur aims were to examine the impact of fortification on nutrient adequacy and excess among US children and adolescents and to rank food sources of added nutrient intake and compare rankings with those based on total nutrient intake from foods.Design and statistical analysesData were from 7,250 respondents 2 to 18 years old in the National Health and Nutrition Examination Survey 2003-2006. Datasets were developed that distinguished nutrient sources: intrinsic nutrients in foods; added nutrients in foods; foods (intrinsic plus added nutrients); and total diet (foods plus supplements). The National Cancer Institute method was used to determine usual intakes of micronutrients by source. The impact of fortification on the percentages of children having intakes less than the Estimated Average Requirement and more than the Upper Tolerable Intake Level was assessed by comparing intakes from intrinsic nutrients to intakes from intrinsic plus added nutrients. Specific food sources of micronutrients were determined as sample-weighted mean intakes of total and added nutrients contributed from 56 food groupings. The percentage of intake from each grouping was determined separately for total and added nutrients.ResultsWithout added nutrients, a high percentage of all children/adolescents had inadequate intakes of numerous micronutrients, with the greatest inadequacy among older girls. Fortification reduced the percentage less than the Estimated Average Requirement for many, although not all, micronutrients without resulting in excessive intakes. Data demonstrated the powerful influence of fortification on food-source rankings.ConclusionsKnowledge about nutrient intakes and sources can help put dietary advice into a practical context. Continued monitoring of top food sources of nutrients and nutrient contributions from fortification will be important.     

Fat intake in children with autism spectrum disorder in the Mediterranean region (Valencia,Spain)

Objective: Children with autism spectrum disorder (ASD) have been found to have alterations in dietary fat intake and fat quality. The fat intakes of the foods consumed by children with and without ASD were compared, and the deficiency and excess of these nutrients were examined.

Methods: In a matched case–control study, 3-day food diaries were completed by 105 children with ASD and 495 typically developing (TD) 6- to 9-year-old children in Valencia (Spain). We used the probabilistic approach and estimated average requirement cut-point to evaluate the risk of inadequate nutrients intakes. These were compared between groups and with Spanish recommendations using linear and logistic regression, respectively.

Results: Groups did not differ significantly in age, total dietary intake, Healthy Eating Index, or food variety score. Children with ASD had lower saturated fatty acids (SFAs) and ω-3 polyunsaturated fatty acids (PUFAs) intakes, but their total PUFAs and (PUFAs?+?monounsaturated fatty acids (MUFAs)/SFAs, PUFAs/SFAs intakes and ω-6/ω-3 ratios were higher than TD children. The total fat and cholesterol intakes of both groups were slightly above Spanish recommendations. Both groups had low ω-6 intakes, very low ω-3 intakes, and high ω-6/ω-3 ratios.

Conclusion: Further research is required to clarify associations between ASD symptomatology, fat-eating patterns and health status.     

Dietary macro- and micronutrient intakes of nonsupplemented pre- and postmenopausal women with a perspective on menopause-associated diseases.

OBJECTIVES: To assess the dietary intakes and diet quality of menopausal women relative to premenopausal women, and to determine whether their diets are compatible with reducing risks of cardiovascular disease (CVD) and osteoporosis. DESIGN: Cross-sectional study using 3-day food records and anthropometric measurements. Subjects Thirty apparently healthy, nonoestrogen using and nonsupplemented women menopausal since 3-5 years and 30 well-matched premenopausal women. Outcome measures Nutrient intakes, diet nutrient density, body mass index (BMI), waist circumference, waist-to-hip ratio and serum oestradiol. RESULTS: Energy intake and body weight of pre- and postmenopausal women were comparable. Their BMI, waist circumference and waist-to-hip ratios were within healthy ranges. The diet of postmenopausal women was compatible (less total lipids and saturated fatty acids; more fibres, antioxidant vitamins and potassium) with North American nutritional recommendations linked to cardiovascular health. Their dietary iron intakes exceeded their reduced physiological need, which may jeopardize their cardiovascular system. Their calcium and vitamin D intakes were far below recommendations for healthy bones. Five other nutrients were also suboptimal. Phosphorus intake (high in both groups) correlated with dietary proteins, sulphur amino acids and calcium. CONCLUSIONS: The diet of the postmenopausal women studied were more compatible with national nutritional recommendations than that of premenopausal controls. However, these postmenopausal women, not taking hormone replacement therapy (HRT) and having inadequate dietary calcium and vitamin D intakes, may be at increased risk of osteoporotic fracture later in life. More studies on CVD risk inherent to body iron accumulation involving a large number of postmenopausal women are warranted before planning public health measures regarding dietary iron intake.     

孕中期妇女营养状况及影响因素调查

目的:了解孕妇的膳食摄入与营养状况,提出合理的建议,改善孕妇的营养状况,促进胎儿的正常发育。方法:选择前来银川市妇幼保健院进行膳食咨询的孕妇作为调查对象,采用24 h回顾法进行膳食调查,对每个调查对象的食物的摄入种类和量进行询问、记录,利用食物成分表计算出每人每日营养素的平均摄入量。并对影响因素进行显著性分析。结果:孕中期妇女大多数营养素能满足需要,但是钙、锌、维生素B1仍然摄入不足,分别达到RNI的74.36%、81.15%、79.33%。三大营养素的供能比例基本合理,而三餐能量比摄入不合理,零食占三餐的能量比较高达34.80%。文化程度与能量、蛋白质、维生素B2、钙有显著性差异。结论:孕中期妇女大多数营养素的摄入能满足需要,仍然有少数营养素不能满足需要,而且膳食结构不太合理。因此为保障孕妇的营养,使孕妇处于最佳的生理状态,建议加强孕妇摄食的科学指导,引导孕妇合理选择食物,改善不合理的饮食习惯。     

A probabilistic intake model to estimate the impact of reformulation by the food industry among Irish consumers

Abstract

This project quantified the impact that voluntary reformulation efforts of the food industry had on the Irish population’s nutrient intake. Nutrient composition data on reformulated products were collected from 14 major food companies for two years, 2005 and 2012. Probabilistic intake assessments were performed using the Irish national food consumption surveys as dietary intake data. The nutrient data were weighted by market shares replacing existing food composition data for these products. The reformulation efforts assessed, significantly reduced mean energy intakes by up to 12?kcal/d (adults), 15?kcal/d (teens), 19?kcal/d (children) and 9?kcal/d (pre-schoolers). Mean daily fat intakes were reduced by up to 1.3?g/d, 1.3?g/d, 0.9?g/d and 0.6?g/d, saturated fat intakes by up to 1.7?g/d, 2.3?g/d, 1.8?g/d and 1?g/d, sugar intakes by up to 1?g/d, 2?g/d, 3.5?g/d and 1?g/d and sodium intakes by up to 0.6?g/d, 0.5?g/d, 0.2?g/d, 0.3?g/d for adults, teenagers, children and pre-school children, respectively. This model enables to assess the impact of industry reformulation amongst Irish consumers’ nutrient intakes, using consumption, food composition and market share data.     

Potential impact of the Choices Programme on nutrient intakes in the Dutch population

In May 2006, the Choices Programme was launched in The Netherlands – products can qualify for a health stamp by meeting pre‐set nutritional criteria. Currently, more than 120 partners in food manufacturing, retail and catering have joined the initiative. There is an increasing recognition and appreciation of the health stamp by consumers. Moreover, the initiative has given a clear incentive to participating companies to reformulate products to give them a healthier profile. The objective of the present study is to assess the potential effect on nutrient intakes in the Dutch population after replacing normally consumed foods in diets with foods that are eligible to carry a Choices stamp. Usual nutrient intakes were calculated using deterministic modelling with the Monte Carlo risk assessment model. Inputs for the modelling were food intakes (Dutch Food Consumption Survey 2003) and composition of foods from the Dutch food composition database. For a selection of nutrients, three scenarios were calculated and compared: (1) nutrient intakes ‘as measured’, based on the original Dutch Food Consumption Survey data; (2) replacement of all non‐complying foods, where possible, with a food complying with the Choices criteria; and, because this could lead to a decreased energy intake, (3) same as (2) but nutrient intakes corrected for the difference in energy content between the original and the replacement food. Calculations of usual intake distributions showed that energy intakes were reduced by 15% by replacing normally consumed foods with foods carrying the Choices stamp. Intakes of nutrients with a maximal intake limit were also reduced (between ?23% for sodium and ?63% for trans fatty acids). Intakes of nutrients with a minimal intake limit increased (between +5% for folic acid and +28% for fibre), except for carbohydrate (?16%) and unsaturated fatty acids (polyunsaturated fatty acids ?1% and monounsaturated fatty acids ?28%). When the data were corrected for energy intake, the difference was still apparent, but smaller for the nutrients with maximal intake limits and larger for most of the nutrients with minimal intake limits, except for carbohydrate and unsaturated fatty acids. From the results, it can be concluded, based on data from the Dutch Food Consumption Survey 2003, that replacing normally consumed foods in the diet with foods that carry the Choices health stamp can potentially lead to substantial improvements in nutrient intakes. These results demonstrate the potential positive impact of the Choices Programme on nutrient intakes in the Dutch population.     

Findings from the latest National Diet and Nutrition Survey

The National Diet and Nutrition Survey (NDNS) of adults aged 19-64 years, carried out in 2000-1, is part of the NDNS programme, a series of cross-sectional surveys aiming to provide detailed quantitative information on the diet, nutritional status and related characteristics of the British population. The programme is split into four surveys of different population age-groups, conducted at approximately three-yearly intervals. In the survey of adults food consumption data were collected from 1724 respondents using a 7 d weighed-intake dietary record. Other components included: height, weight, waist and hip circumference and blood pressure measurements; a 24 h urine sample; a blood sample; a record of physical activity. Results have been published in four volumes covering food consumption, energy and macronutrient intakes, micronutrient intakes and nutritional status, including physical measurements and physical activity. The results have shown that, based on a comparison of nutrient intakes with the UK dietary reference values, adults in Britain are generally getting sufficient nutrients from their diets. However, younger adults (particularly women) and those in lower socio-economic groups are more likely to have low micronutrient intakes and lower levels of some nutritional status indices. The proportion of food energy derived from total fat has fallen since the last survey of this age-group in 1986-7 and is close to the dietary reference value, while the proportion of energy derived from saturated fatty acids and non-milk extrinsic sugars exceeds the dietary reference values. The prevalence of overweight and obesity has increased since 1986-7 and physical activity levels are low.     

Food and nutrient intakes of a population sample of 7-year-old children in the south-west of England in 1999/2000 – what difference does gender make?

Objectives To describe the diet of schoolchildren aged 7 years, and identify gender differences in food and nutrient intakes. Subjects A cohort of children resident in the south-west of England in 1999/2000. Methods Diet was assessed using three 1-day unweighed food diaries. Nutrient intakes were compared with dietary reference values for this age group, and with children aged 7–10 years in the British National Diet and Nutrition Survey. Food and nutrient intakes were contrasted between boys and girls. Results Median nutrient intakes exceeded the reference nutrient intake (RNI) for most nutrients. Median intakes of iron and zinc were below the RNI. Median sodium intake was greater than the maximum set by the Scientific Advisory Committee on Nutrition. The mean energy intake for boys and girls, respectively, were 7.3 and 6.8 MJ, this is below the estimated average requirement. The percentage of energy from fat was 35.3% for boys and 36.1% for girls. Boys had higher iron intakes than girls, even after adjustment for energy intake. There were differences in the types of foods eaten between boys and girls; girls ate more fruit and vegetables (P = 0.001) and boys ate more breakfast cereals (P = 0.016). Conclusions The dietary intakes of these 7-year-old children were adequate for most nutrients. However, a reduction in the sodium content of the diet would be advantageous. Fruit and vegetable consumption should be encouraged particularly among boys.     

Food-based dietary guidelines--the Austrian perspective

Presently, no national dietary guidelines--neither food- nor nutrient-based--exist for Austria. Usually, the recommendations of the German Society of Nutrition are used instead. The determination of national characteristics of nutritional behaviour and food consumption can reveal starting-points for the improvement of nutritional status in Austria. Seven-day weighed records (children and adolescents, n = 2.173) and 24-h-recalls (adults, n = 2.488) were used for the evaluation of nutrient intake and food consumption. For a sub-sample of children and adolescents, results from laboratory assessment of biomarkers were also available (n = 1.400). Based on fat intake, the age groups were divided into low fat intake (less than 25th percentile = 28-34% fat energy) and high-fat eaters (greater than 75th percentile = 38-45% fat energy). Approximately 75% of the Austrian population have fat intakes above 30% of energy intake, older age groups having a higher prevalence of high fat intakes. Intakes of saturated fatty acids reach 40-46% of total fat. The usual intake of dietary fibre in the Austrian population is between 17-21 g/d; some individuals are able to achieve the recommended intakes for dietary fibre, but do not represent a significant majority of the population. The mean intakes of fruits are clearly higher in children and adolescents (10% of total food intake) than in adults (2-6%). Differences in the intake of selected nutrients in foods between low and high fat consumers, unexpectedly, did not result in different plasma concentrations of cholesterol, nor did it result in differences in fat soluble vitamins. Therefore, one of the primary dietary guidelines for Austria should be the reduction of fat consumption, which is also associated with increasing intakes of fruits and vegetables, increasing intakes of dietary fibre and decreasing intakes of cholesterol.     

低体重患儿膳食营养调查

目的 调查评价低体重患儿的膳食结构和饮食营养状况,以便提出膳食建议并为营养教育提供依据.方法 采用简化的食物频率询问法对普儿病房142名3～6岁低体重患儿进行膳食调查,并以中国居民膳食营养素参考摄入量(DRIs)为标准,评价膳食能量和各营养素摄入情况.结果 142名低体重息儿各营养素摄入量未达80%推荐摄入量/适宜摄入量(RNI/AI)的有:维生素A为69.2%,碳水化合物为63.3%,维生素C为61.1%,热能为58.8%,钙为54.9%.有34.8%患儿粮谷类提供的能量不到40%.结论 低体重患儿膳食结构不合理,粮谷类和蔬菜类食物的摄入量严重不足,导致患儿能量不足、维生索A、维生素C及钙缺乏.     

Contributions of Early Care and Education Programs to Diet Quality in Children Aged 3 to 4 Years in Central North Carolina

BackgroundParents and early care and education (ECE) are the key influencers of young children’s diets, but there is limited information about how each contribute to children’s overall diet quality.ObjectiveThis study aimed to determine what proportion of children’s dietary intake occurs within the ECE setting and whether diet quality is higher at ECE centers and, consequently, on weekdays than weekends.DesignThis cross-sectional analysis of a larger cluster randomized controlled trial used multiple 24-hour dietary intakes measured through a combination of the Dietary Observation in Child Care protocol and parent-reported food diaries.Participants/settingParticipants (N=840) included children aged 3 to 4 years enrolled in ECE centers in central North Carolina for whom 24-hour dietary intake was captured via observation of meals and snacks consumed at ECE and parent-report of all remaining meals and snacks. Data were collected from 2015 to 2016.Main outcome measuresDiet quality at ECE and elsewhere was evaluated using the Healthy Eating Index 2015.Statistical analyses performedMixed-effects models were used to determine differences in mean Healthy Eating Index 2015 component and total scores. Models were adjusted for children’s age and sex and accounted for clustering within ECE centers and families.ResultsChildren consumed approximately 40% of daily energy, nutrients, and food groups at ECE centers. The mean total Healthy Eating Index 2015 score was higher for foods and beverages consumed at ECE centers (58.3±0.6) than elsewhere (52.5±0.6) (P<0.0001). The mean total Healthy Eating Index 2015 score was also higher on weekdays (58.5±0.5) than on weekends (51.3±0.5) (P<0.0001).ConclusionsChildren consume a majority of dietary intake away from ECE centers. Overall, diet quality is low, but the quality of foods consumed by children at ECE centers is higher than that consumed elsewhere. ECE centers remain an important source of nutrition and further investigation is warranted to identify ways to support both ECE centers and families to provide healthier eating environments.     

湖北省城乡孕妇膳食营养状况调查分析

目的:查明湖北省部分地区孕妇膳食营养现状,为制定符合湖北省实际情况的干预策略和措施提供参考。方法:抽取到医院进行产前检查的湖北省城乡孕妇进行问卷调查,采集孕妇血样测定营养生化指标,并采用t检验和χ2检验等方法对数据进行统计分析。结果:孕妇膳食结构以植物性食物为主,各类食物摄入量较丰富。农村孕妇奶类的摄入远远低于城市孕妇,粮谷类、蔬菜类的摄入较城市高,城市孕妇的水果类、大豆类、畜禽肉类、鱼虾蟹贝类食物摄入量高于农村孕妇。能量和各营养素平均摄入量总体达到RNI或AI的要求,但在部分孕妇中仍存在能量和营养素摄入明显不足的情况。营养生化指标中血清锌缺乏率最高(51.52%),尤其是农村地区。孕妇贫血患病率为35.50%,农村(50.74%)显著高于城市(13.68%)(χ2=33.5333,P<0.0001)。结论:湖北省孕妇膳食结构中食物种类多样,城市孕妇各类食物摄取都比较充足,农村孕妇膳食摄入和营养状况仍存在相对较多的问题。     

The relationship between household income and dietary intakes of 1-10 year old urban Malaysian

BACKGROUND/OBJECTIVES

Diet plays an important role in growth and development of children. However, dietary intakes of children living in either rural or urban areas can be influenced by household income. This cross-sectional study examined energy, nutrient and food group intakes of 749 urban children (1-10 years old) by household income status.

SUBJECTS/METHODS

Children''s dietary intakes were obtained using food recall and record for two days. Diet adequacy was assessed based on recommended intakes of energy and nutrients and food group servings.

RESULTS

For toddlers, all nutrients except dietary fiber (5.5 g) exceeded recommended intakes. Among older children (preschoolers and school children), calcium (548 mg, 435 mg) and dietary fiber (7.4 g, 9.4 g) did not meet recommendations while percentage of energy from total fat and saturated fats exceeded 30% and 10%, respectively. The mean sodium intakes of preschoolers (1,684 mg) and school children (2,000 mg) were relatively high. Toddlers in all income groups had similar energy and nutrient intakes and percentages meeting the recommended intakes. However, low income older children had lowest intakes of energy (P < 0.05) and most nutrients (P < 0.05) and highest proportions that did not meet recommended energy and nutrient intakes. For all food groups, except milk and dairy products, all age groups had mean intakes below the recommended servings. Compared to middle and high income groups, low income preschoolers had the lowest mean intake of fruits (0.07 serving), meat/poultry (0.78 serving) and milk/dairy products (1.14 serving) while low income toddlers and school children had the least mean intake of fruits (0.09 serving) and milk/dairy products (0.54 serving), respectively.

CONCLUSION

Low socioeconomic status, as indicated by low household income, could limit access to adequate diets, particularly for older children. Parents and caregivers may need dietary guidance to ensure adequate quantity and quality of home food supply and foster healthy eating habits in children.     

Food and nutrient intakes of a population sample of 7-year-old children in the south-west of England in 1999/2000 - what difference does gender make?

OBJECTIVES: To describe the diet of schoolchildren aged 7 years, and identify gender differences in food and nutrient intakes. SUBJECTS: A cohort of children resident in the south-west of England in 1999/2000. METHODS: Diet was assessed using three 1-day unweighed food diaries. Nutrient intakes were compared with dietary reference values for this age group, and with children aged 7-10 years in the British National Diet and Nutrition Survey. Food and nutrient intakes were contrasted between boys and girls. RESULTS: Median nutrient intakes exceeded the reference nutrient intake (RNI) for most nutrients. Median intakes of iron and zinc were below the RNI. Median sodium intake was greater than the maximum set by the Scientific Advisory Committee on Nutrition. The mean energy intake for boys and girls, respectively, were 7.3 and 6.8 MJ, this is below the estimated average requirement. The percentage of energy from fat was 35.3% for boys and 36.1% for girls. Boys had higher iron intakes than girls, even after adjustment for energy intake. There were differences in the types of foods eaten between boys and girls; girls ate more fruit and vegetables (P = 0.001) and boys ate more breakfast cereals (P = 0.016). CONCLUSIONS: The dietary intakes of these 7-year-old children were adequate for most nutrients. However, a reduction in the sodium content of the diet would be advantageous. Fruit and vegetable consumption should be encouraged particularly among boys.     

四川农村贫困地区儿童膳食营养状况评价

目的了解四川农村儿童膳食营养状况,为农村儿童营养干预提供依据。方法随机抽取四川省某县3个乡514名3～10岁农村儿童为研究对象,采用24h膳食回顾法和食物频率法进行膳食调查,并以中国居民膳食营养素参考摄入量（DRIs）为标准,评价膳食能量和各营养素摄入状况。结果调查对象膳食以粮谷类、蔬菜水果类为主;能量达到80%RNI者占18.5%,碳水化合物、脂肪和蛋白质的供能比分别为67.2%,20.4%和12.4%;蛋白质达到80%RNI者占11.7%,钙和铁摄入量达到80%AI值者分别为0.9%和36.2%。锌和视黄醇摄入量达到EAR值的儿童分别为12.4%和17.9%,铁和视黄醇均主要来源于植物性食物。结论四川农村儿童膳食结构不合理,能量和各种营养素摄入普遍不足。     

Gluten and casein free diets in autism: a study of the effects on food choice and nutrition

Background There is growing interest in possible dietary involvement in the aetiology and treatment of Autistic Spectrum Disorders (ASD). Research has focused on the physiological and behavioural effects of dietary change but has not examined the effect of exclusion diets on nutritional intake. Aims The aim of this study was to examine whether the removal of major dietary staples placed children with autism at risk of nutrient deficiency and compares their food choice with ASD children not following gluten and/or casein free diets. Methods A postal questionnaire was sent to parents of children aged 3–16 years, diagnosed with ASD belonging to the National Autistic Society in Leicestershire and southern Derbyshire. Detailed dietary information and a 3‐day food diary were collected. The sample size was small: those using gluten/casein free diets (n = 8) and those not following diet (n = 29). Results Nutrient intakes fell below the Lower Reference Nutrient Intake (LRNI) in 12 children (32%) for zinc, calcium, iron, vitamin A, vitamin B12 and riboflavin in the nondiet group and four children (50%) for zinc and calcium in the diet group. Fruit and vegetable intakes were higher and cereal, bread and potato consumption were lower in those children using gluten and/or casein free diets. Conclusion No significant differences in the energy, protein and micronutrient intakes were found between the two groups of children. A longitudinal prospective study is suggested to examine whether differences in food choice are the result of dietary intervention or the prerequisite for the successful application of diet in this special group of children.