Evaluation of dietary intake in children and college students with and without attention-deficit/hyperactivity disorder

Objectives: To evaluate dietary intake among individuals with and without attention-deficit hyperactivity disorder (ADHD), to evaluate the likelihood that those with ADHD have inadequate intakes.

Methods: Children, 7–12 years old, with (n?=?23) and without (n?=?22) ADHD, and college students, 18–25 years old, with (n?=?21) and without (n?=?30) ADHD comprised the samples. Children’s dietary intake was assessed by a registered dietitian using 24-hour recalls over 3 days. College students kept a detailed food record over three days. Dietary information for both groups was entered into the Nutrition Data Systems for Research database, and output was analyzed using SAS 9.4. Nutrient analyses included the Healthy Eating Index-2010, Micronutrient Index (as a measure of overall micronutrient intake), and individual amino acids necessary for neurotransmission. Logistic regression was used to model the association of nutrient intake with ADHD. Models were adjusted for age, sex, IQ (or GPA), and energy intake (or total protein intake) as appropriate. Significance was evaluated at P?=?0.05, and using the Benjamini–Hochberg corrected P-value for multiple comparisons.

Results: No evidence existed for reduced nutrient intake among those with ADHD compared to controls in either age group. Across both groups, inadequate intakes of vitamin D and potassium were reported in 95% of participants. Children largely met nutrient intake guidelines, while college students failed to meet these guidelines for nine nutrients. In regards to amino acid intake in children, an increased likelihood of having ADHD was associated with higher consumption of aspartate, OR?=?12.61 (P?=?0.01) and glycine OR?=?11.60 (P?=?0.05); and a reduced likelihood of ADHD with higher intakes of glutamate, OR?=?0.34 (P?=?0.03). Among young adults, none of the amino acids were significantly associated with ADHD, though glycine and tryptophan approached significance.

Discussion: Results fail to support the hypothesis that ADHD is driven solely by dietary micronutrient inadequacy. However, amino acids associated with neurotransmission, specifically those affecting glutamatergic neurotransmission, differed by ADHD status in children. Amino acids did not reliably vary among college students. Future larger scale studies are needed to further examine whether or not dietary intake of amino acids may be a modulating factor in ADHD.     

Head and Neck Cancer Patients Do Not Meet Recommended Intakes of Micronutrients without Consuming Fortified Products

This study assessed dietary and micronutrient intakes of head and neck cancer (HNC) patients at key points in the disease trajectory and evaluated the contribution of oral nutritional supplements (ONS) to micronutrient intake. HNC patients (n = 114) completed a three-day dietary record and a tool to assess Nutrition Impact Scores (NIS) at baseline, post-treatment, and follow-up. Foods were classified into food categories. Micronutrient, protein, and energy intakes were compared to European Society for Parenteral and Enteral Nutrition guidelines for cancer patients. The majority of patients did not meet recommended dietary intakes for vitamins D, E, C, folate, and magnesium at any study time point. Relative to baseline, the proportion of calories from milk, soup, and ONS significantly increased at post-treatment, while grain, meat, potato, baked dessert, and oil and sugar decreased (P < 0.03). At all study time points, patients categorized as high ONS consumers (>15% of total daily calories from ONS) had higher intakes of micronutrients (P < 0.003). They also had a higher NIS (P = 0.006) and experienced greater weight loss (P < 0.04) during the study, despite having similar energy intake to patients consuming <15% kcal from ONS. Fortification of usually consumed foods to improve micronutrient intake among cancer patients should be evaluated.     

The Association between the Macronutrient Content of Maternal Diet and the Adequacy of Micronutrients during Pregnancy in the Women and Their Children’s Health (WATCH) Study

Nutrition during pregnancy can induce alterations in offspring phenotype. Maternal ratio of protein to non-protein (P:NP) energy has been linked to variations in offspring body composition and adult risk of metabolic disease. This study describes the dietary patterns of pregnant women by tertiles of the P:NP ratio and compares diet to Australian recommendations. Data are from 179 Australian women enrolled in the Women and Their Children’s Health Study. Diet was assessed using a validated 74-item food frequency questionnaire. Food group servings and nutrient intakes were compared to the Australian Guide to Healthy Eating and Australian Nutrient Reference Values. Higher maternal P:NP tertile was positively associated with calcium (P = 0.003), zinc (P = 0.001) and servings of dairy (P = 0.001) and meat (P = 0.001) food groups, and inversely associated with the energy dense, nutrient poor non-core (P = 0.003) food group. Micronutrient intakes were optimized with intermediate protein (18%E–20%E), intermediate fat (28%E–30%E) and intermediate carbohydrate (50%E–54%E) intakes, as indicated in tertile two. Results suggest a moderate protein intake may support pregnant women to consume the largest variety of nutrients across all food groups.     

Formulation of practical advice for reducing dietary fat intakes in unemployed in Dublin

Patterns of food and nutrient intake in a sample of 97 adults in a region of Dublin with chronically high unemployment were examined. Food intake (g/10 MJ/day) of the upper and lower quartiles of intakes of selected nutrients were compared. Quartiles of fat intake were expressed as percentage energy from fat or as g/day. In both cases, but most notably in the former, the intake of table sugar was inversely related to the intake of fat. Again irrespective of the mode of expression, the high-fat diets were characterised by high intakes of spreadable fats. The high intakes of sugar seen with low intake of fat (g/day or percentage energy) were not associated with an absolute diminution of macronutrient (excluding sugar or energy) intake or of micronutrient intake.     

The diet quality of adult women participating in a behavioural weight‐loss programme

Background: Diet quality plays an important role in health and has been shown to impact the risk of heart disease and certain cancers. The present study aimed to examine baseline and 16‐week follow‐up levels of energy intake, energy density and diet quality, as measured by the Healthy Eating Index 2005 (HEI‐2005), in overweight and obese women participating in a behavioural weight‐loss programme. Methods: Sixty‐six women [mean (SD) age 48.6 (10.8) years; body mass index 31.8 (3.7) kg m^?2; 92% Caucasian] completed dietary measures at baseline and follow‐up. All participants received a 16‐week Internet Behavioural weight‐loss programme based on the core of the Diabetes Prevention Program. Dietary intake was measured using the 2005 Block food frequency questionnaire. Diet quality was calculated using the HEI‐2005. Paired t‐tests were used to determine changes over time. Results: There was a reduction in reported energy intake [7.867 (3.232) MJ versus 5.748 (1.775) MJ, P < 0.001] over the 16 weeks. Participants had an increase in diet quality [HEI score = 53.9 (9.9) versus 57.4 (10.6), P = 0.002] as well as a reduction in energy density [0.0088 (0.0021) MJ g^?1 to 0.0080 (0.0021) MJ g^?1 (P = 0.002)]. All micronutrient intakes decreased over the 16 weeks. Conclusions: Participation in a 16‐week behavioural weight‐loss programme significantly improved diet quality and reduced dietary energy density and energy intake in adult women. However, despite the overall increase in diet quality score, there were deficiencies in key micronutrients in the diets of most women at the conclusion of the 16‐week study.     

Fat content of the diet among pre-school children in Britain; relationship with food and nutrient intakes

OBJECTIVE: To investigate the relationship between the percentage of energy from fat and food and nutrient intakes at 18 and 43 months of age. DESIGN: Diet was assessed using a 3 day unweighed food record. The children were divided into quartiles of fat intake as a percentage of energy (QFI), and food and nutrient intakes in the different QFIs were compared. SUBJECTS: A total of 1026 children at 18 months and 863 children at 43 months, taking part in the Avon Longitudinal Study of Pregnancy and Childhood, participated. RESULTS: At 18 months the mean (s.d.) fat intake was 31.2 (2.8) % of energy in the lowest QFI and 43.1 (2.2) % in the highest. Energy intake increased slightly with increasing QFI. The percentage of energy derived from total sugar, and in particular non-milk extrinsic sugar fell as QFI increased, as did the ratio of polyunsaturated to saturated fatty acids. Intakes of retinol equivalents and zinc increased significantly with increasing QFI, while intakes of iron and most water soluble vitamins fell. There was a particularly marked fall in vitamin C intake as fat intake increased, from 11.8 mg/MJ in the lowest QFI, to 6.0 mg/MJ in the highest (P<0.001). Consumption of whole milk increased substantially with percentage energy from fat, from 51 g/MJ in the lowest QFI to 116 g/MJ in the highest (P<0.001), while consumption of fruit and fruit juice fell. The results obtained at 43 months were very similar. CONCLUSIONS: The chances of a suboptimal intake of zinc and retinol were higher at lower fat intakes. However, intakes of the fat-soluble vitamins E and D were unrelated to fat intake and intakes of iron and vitamin C fell as fat intakes increased. Some suggestions for improving diet in this age group have been given. SPONSOR: University of Bristol.     

Micronutrient dilution associated with added sugar intake in elderly black South African women

OBJECTIVES: To investigate the association between added sugar and macronutrient and micronutrient intakes, and to assess whether added sugar intake is related to biochemical indices of nutritional status, Mini-Nutritional Assessment (MNA) score, body mass index (BMI) and performance on physical function tests. DESIGN: A cross-sectional, analytical study. SETTING AND SUBJECTS: Convenient sample of 285 institutionalised and community-dwelling black South African men and women aged 60+ y. METHODS: An interviewer-administered 24-h dietary recall and MNA were performed. Serum albumin, vitamin B12, ferritin, cholesterol, haemoglobin, red blood cell (RBC) folate and plasma vitamin C were measured. Handgrip strength, BMI, 'sit-to-stand' and 'get-up-and-go' tests were measured. Outcome variables were analysed according to tertiles of added sugar, in grams and as a percentage of total energy (% E). RESULTS: In each tertile of sugar intake, mean MNA score fell in the 'at-risk' classification. In women, energy, protein, % E protein, fibre, thiamin, riboflavin, niacin, vitamin B6, folate, pantothenic acid, biotin, vitamin C, calcium, iron, magnesium, phosphorus, zinc, copper and selenium intake were significantly lowest in subjects in the highest % E sugar tertile. In men, no differences were found for micronutrient intake according to tertiles of total added sugar or % E added sugar. Physical function declined with increasing sugar intake, and suboptimal RBC folate and plasma ascorbic acid status was associated with increasing sugar intake (in women). No relationship was found between added sugar intake and the very high prevalence (65%) of obesity in women. CONCLUSION: A nutrient-diluting effect of added sugars intake was demonstrated in elderly black South African women. Further studies in this population are required in order to develop food-based dietary guidelines, which include messages on added sugar intake.     

Consumption and sources of sugars in the diets of British schoolchildren: are high-sugar diets nutritionally inferior?

Data files of the food intakes of 2705 schoolchildren surveyed in 1983 (DoH, 1989a) were reanalysed to provide an estimate of the total intake of sugars and major sources of sugars in the diet. The relationships between intake of sugars, nutrients and nutrient density were examined by comparing between tertiles, firstly of total sugars (g/day) and subsequently of percentage energy from sugars. The results are presented separately for boys and girls in two age-groups (10–11 years and 14–15 years). The estimated mean intake of sugars (123 g/day, s.d. 42 g) was equivalent to 23% of dietary energy. Major sources were confectionery (18%), table sugar (16%), cakes and biscuits (13%), milk (10%), soft drinks (9%) and puddings (9%). Nutrient intakes were not significantly lower, and indeed were often higher, in those groups consuming most sugars, by either method of defining tertiles. Energy intake appeared to be the major influence on intakes of nutrients. Nutrient densities (mg or μg/MJ) showed different trends: vitamin A, vitamin C and thiamin concentrations were similar across all tertiles, while those for calcium and riboflavin tended to rise with increasing sugars intake and those for iron and nicotinic acid tended to fall, although not all of these differences were significant in all age/sex groups at the 1% level. There was a significant reciprocal (inverse) relationship between sugars and percentage energy from fat. Iron intakes were low in girls, irrespective of consumption of sugars. These data therefore provide little support for the ‘empty calorie’ hypothesis Schoolchildren with low energy intakes in combination with high proportional intakes of sugar may constitute a theoretical at-risk group, particularly with regard to iron intake. However, because the possibility cannot be excluded that habitual food intake may be underrepresented in dietary records, further investigation of such groups by methods incorporating clinical/biochemical assessments are warranted.     

Effect of high levels of intense sweetener intake in insulin dependent diabetics on the ratio of dietary sugar to fat: a case-control study

OBJECTIVE: To examine the influence of intense sweetener consumption on nutrient intakes in insulin dependent diabetics compared to controls. DESIGN: Case-control food consumption survey. SETTING: Dietary data were collected from individuals in Ireland between 1998 and 1999. SUBJECTS: Diabetics were recruited through diabetic outpatient departments of St. James's Hospital Dublin. Controls were friends of the patients or staff/students of Trinity College and University College Dublin. Of the 171 diabetics contacted, 122 agreed to participate (70% response rate) and 119 completed the study. INTERVENTIONS: In all, 3-day food diaries were used to collect the food consumption data. MAIN OUTCOME MEASURES: Fat--sugar seesaw, intense sweetness. RESULTS: Patients had significantly higher % energy from starch, lower % energy from sugars and a high intake of fibre compared to controls. In both groups, there was an inverse relationship between % energy from fat and % en from sugar, with the diabetics at the lower level of sugar intake. A score of intense sweetness intakes was computed and across tertiles of this score, there were no significant effects on macronutrient intakes. CONCLUSION: The fat-sugar seesaw present in the diabetic group was at a lower level compared to the control group. A high intake of intense sweeteners does not have a detrimental effect on macronutrient and micronutrient intakes.     

Energy Intake,Profile, and Dietary Sources in the Spanish Population: Findings of the ANIBES Study

Energy intake, and the foods and beverages contributing to that, are considered key to understanding the high obesity prevalence worldwide. The relative contributions of energy intake and expenditure to the obesity epidemic, however, remain poorly defined in Spain. The purpose of this study was to contribute to updating data of dietary energy intake and its main sources from food and beverages, according to gender and age. These data were derived from the ANIBES (“Anthropometry, Intake, and Energy Balance in Spain”) study, a cross-sectional study of a nationally representative sample of the Spanish population (from 9–75 years old). A three-day dietary record, collected by means of a tablet device, was used to obtain information about food and beverage consumption and leftovers. The final sample comprised 2009 individuals (1,013 men, 996 women). The observed mean dietary energy intake was 7.6 ± 2.11 MJ/day (8.2 ± 2.22 MJ/day for men and 6.9 ± 1.79 MJ/day for women). The highest intakes were observed among adolescents aged 13–17 years (8.4 MJ/day), followed by children 9–12 years (8.2 ± 1.80 MJ/day), adults aged 18–64 (7.6 ± 2.14 MJ/day) and older adults aged 65–75 years (6.8 ± 1.88 MJ/day). Cereals or grains (27.4%), meats and derivatives (15.2%), oils and fats (12.3%), and milk and dairy products (11.8%) contributed most to daily energy intake. Energy contributions from non-alcoholic beverages (3.9%), fish and shellfish (3.6%), sugars and sweets (3.3%) and alcoholic beverages (2.6%) were moderate to minor. Contributions to caloric profile were 16.8%E from proteins; 41.1%E from carbohydrates, including 1.4%E from fiber; 38.5%E from fats; and 1.9%E from alcohol intake. We can conclude that energy intake is decreasing in the Spanish population. A variety of food and beverage groups contribute to energy intake; however, it is necessary to reinforce efforts for better adherence to the traditional Mediterranean diet.     

The Gustaf Study: Repeated, Telephone-Administered 24-hour Dietary Recalls of Obese and Normal-Weight Men — Energy and Macronutrient Intake and Distribution Over the Days of The Week

Objective A dietary survey of obese and control men was conducted through 24-hour dietary recalls administered by telephone at 12 times selected randomly over a period of 3 months. Energy and macronutrient intake and distribution were studied for all days of the week.Subjects Eighty-six obese men, 20 to 60 years old, body mass index (BMI)= 37.7±4.4 (mean±standard deviation) from the waiting list of the outpatient clinic and 61 normal-weight (BMI= 23.0±1.9), age-matched men selected randomly from the Stockholm County Census Bureau.Main outcome measures Energy and macronutrient intake, intakes by energy tertiles, and distribution over the days of the week.Statistical analyses Nonparametric tests were used because of skewed distribution of most food data.Results A median daily energy intake of 2,700 kcal was found in both groups. The obese men reported a higher protein (P<.001) and a lower alcohol (P<.001) intake than the control subjects. Both groups reported a maximum intake of energy and macronutrients on Saturdays. When separated into tertiles according to reported energy intake, the obese men in tertile 3 reported a higher intake from fat (% energy, P<.001) and a lower intake from protein (P<.01) compared with men in tertile 1. Normal-weight men in tertile 3 reported a higher intake from fat (% energy, P<.01) compared with men in tertile 1.Conclusions When reported energy intake was compared with calculated total daily energy expenditure, there was a greater discrepancy in the obese group than in the control group. The normal-weight men may have had a special interest in food and health, and this group may not reflect the population at large. J Am Diet Assoc. 1996; 96:686–692.     

Associations between fat,sugar and other macronutrient intakes in the National Diet and Nutrition Survey

Observational studies show an inverse relationship between fat and sugar within diets, described as the ‘fat‐sugar seesaw’. It has been suggested however, that this is a consequence of expressing macronutrient intakes as percentages of energy intake rather than by the dietary choices made by individuals. To test this we examined the associations between macronutrient intakes in the diets of adults (n = 1724) participating in the UK National Diet and Nutrition Survey (NDNS) and within the same adults across different days of the week. Pearson's correlations were calculated between the macronutrient intakes from fat, total sugar, intrinsic sugars, non‐milk extrinsic sugars (NMES), non‐sugar carbohydrate, protein and alcohol. Energy intakes relative to estimated basal metabolic rate (BMR) were calculated to partially account for differences in energy requirements. Pearson's correlations also examined associations between the same macronutrients in foods from the Nutrient Databank (ND), used to analyse dietary intakes in the NDNS. Correlations between fat and sugar(s) were calculated in five ways: (i) percentage energy between individuals; (ii) amount (g) between individuals; (iii) amount (g) relative to BMR between individuals; (iv) within individuals over seven days; and (v) between food items in the ND. Negative correlations were obtained between mean daily percentage energy intakes of fat and, total sugars, NMES and intrinsic sugars (all P < 0.001). However, when mean daily macronutrient intakes were expressed in weight (g)/day, these were all positively correlated (all P < 0.001). Mean estimated correlations between macronutrient intakes (g/day) for each individual across the days of the week were also positive, indicating a lack of fat‐sugar seesaw effect. Within the ND, the correlation between fat and total sugar (g/100g of food) was weakly positive (P = 0.006). Only when examining the correlation between fat and sugar(s) between individuals in percentage terms (% energy) was the fat‐sugar seesaw evident; in all other methods the correlations between fat and sugar(s) were positive. Examination of the effects of using percentage energy values to describe the macronutrient composition demonstrated that the fat‐sugar seesaw is only an inevitable mathematical consequence, rather than the result of dietary choice. Comparing diet composition in percentage terms alone can therefore be misleading. It is only when examined as absolute values (weight), as well as percentage contributions to energy, that the interrelationships between macronutrients can be studied fully.     

Detailed Dietary Assessment in Patients with Inoperable Tumors: Potential Deficits for Nutrition Care Plans

Advanced cancer often results in reduced dietary intake; however, data on actual intake at the time of diagnosis are limited. In the present study, a detailed dietary intake assessment was performed in patients with metastatic lung and upper gastrointestinal cancer, before initiation of systemic therapy. Basic demographics and performance status (PS) were recorded. Nutritional status was evaluated through anthropometry, Mini Nutritional Assessment (MNA), and 3 nonconsecutive 24-hour dietary recalls. Of the 84 patients enrolled, 61.4% were protein, energy, or protein–energy undernourished, regardless of body mass index (BMI) or MNA category. No differences in energy, macronutrients, and micronutrients intakes across BMI categories were recorded. Very low consumption of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), irrespective of energy intake, tumor site, BMI category, or PS was found. Suboptimal micronutrients intakes were recorded even in well-nourished and overweight/obese patients. Patients with adequate PS and better MNA score reported significantly higher intake of certain macro- and micronutrients (all P < 0.05). Most patients exhibited reduced dietary intake in terms of energy, macronutrient, and micronutrient. Very low EPA and DHA intake was recorded for the whole sample, whereas micronutrient suboptimal intakes were also prevalent in well-nourished or overweight patients. All the above should be taken into account during patients' nutritional care.     

Impact of Adopting Lower-Fat Food Choices on Energy and Nutrient Intakes of American Adults

Objective To evaluate the energy and nutrient intake of free-living men and women who choose foods consistent with different fat-reduction strategies.Design For each year of the Continuing Survey of Food Intake by Individuals from 1989 through 1991, food codes were used to sort respondents by type of milk; type of meats; and type of cheese, yogurt, salad dressing, cake, and pudding (ie, full-fat or fat-modified products) consumed.Subjects A nationally representative sample of 3,313 men and 3,763 women who completed 3-day intake records and consumed either a reduced-fat or full-fat food from at least 1 of the 3 fat-reduction strategy categories.Statistical analysis performed Analysis of variance with the Scheffé test was used to analyze differences in energy and nutrient intake between exclusive users, mixed users, and nonusers of each strategy or combined strategies.Results Regardless of fat-reduction strategy, men and women who used them reported significantly lower intakes of total fat (up to 18 g lower), saturated fat (up to 12 g lower), cholesterol (up to 75 ing lower) and energy compared with nonusers. Exclusive users of single strategies met or approached recommendations of the National Cholesterol Education Program for total fat, saturated fat, and cholesterol intake; micronutrient intake varied depending on the strategy used. Skim milk users had the most favorable micronutrient intake, whereas lean meat users reported inadequate intake of zinc (men 6396 and women 59% of the Recommended Dietary Allowances [RDAs]) and female users of fat-modified products reported inadequate intakes of vitamin E (64% of RDA) and zinc (65% of RDA). Multiple-strategy users achieved National Cholesterol Education Program goals and reported adequate micronutrient intakes and significantly lower energy intake. Mixed users of fat-modified products compared with nonusers of any fat-modified products had adequate micronutrient intake and lower intakes of total fat (32% vs 36% of energy for men and 32% vs 35% of energy for women) and saturated fat (11% vs 13% of energy for men and 11% vs 12% of energy for women). In addition, nonusers of any fat-modified strategy had the highest cholesterol and energy intake and the lowest intake of. many micrbnutrients.Applications A variety of fat-reduction strategies can be implemented to reduce energy, total fat, saturated fat, and cholesterol intake. Some of the strategies were associated with an inadequate micronutrient intake, so additional dietary guidance is needed to ensure that all nutrient requirements are met. Furthermore, people who do not use any fat-reduction strategy or those who exclusively use lean meats or fat-modified products would benefit from understanding how to balance their food choices. J Am Diet Assoc. 1999;99:177–183.     

Adults with and without type 1 diabetes have similar energy and macronutrient intakes: an analysis from the Australian Health Survey 2011-2013

The aim of this study was to describe and compare the mean usual dietary intakes of adults with type 1 diabetes (T1D) and without diabetes living in Australia. Our hypothesis was that adults with T1D have similar dietary intake profiles to adults without diabetes. Data from the National Nutrition and Physical Activity Survey 2011-2012, which formed part of the Australian Health Survey 2011–13, were used and participants ≥18 years of age with T1D and without diabetes were included in the analyses. T1D status was assigned to participants who reported a diabetes diagnosis at age <25 years and still had diabetes at the time of survey completion. Mean usual intakes of energy, macronutrients and carbohydrate-rich food groups, measured by 24-hour recall, were compared between groups using Analysis of Covariance after adjustment for age, sex, socioeconomic status, smoking status and body mass index. The number of adults classified with T1D and without diabetes was n = 43 and n = 8844, respectively. The T1D group had a mean energy intake (%E) of 7873 kJ/day with 45%E from carbohydrates (213 g/day), 31%E from fats (67 g/day) and 20%E from proteins (88 g/day). There were no significant differences in energy or macronutrient intakes between groups (P ≥ .07), except individuals with T1D reported higher intakes of whole grains and high fiber cereals, after multivariable adjustment (2.4 vs 1.7 serves/day; P = .02). In conclusion, adults with and without T1D had similar reported energy and macronutrient intake profiles that are consistent with current dietary recommendations for T1D management and healthy eating guidelines for the general population.     

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 and nutrient intakes of primary school children: a comparison of school meals and packed lunches

Background New school meal standards are currently being phased in by the government in an attempt to improve the nutritional composition of school food. However, no standards are applied to packed lunches. The present study aimed to compare the food and nutrient intakes of primary school children eating a school meal with those taking a packed lunch. Methods A sample of 120 children, aged 6–11 years, was observed once at a lunch time and all items consumed were recorded. Nutrient analysis was performed, and differences in nutrient intake between those children consuming packed lunches and school meals were determined. Results Mean energy and protein intakes were similar. The amount of energy provided by starchy carbohydrate was also similar but, compared with school meals, packed lunches provided twice as much energy from sugar (P < 0.001). School meals on average provided more energy from fat (P < 0.001), but intakes of saturated fat were lower in the school meals group (P = 0.021). Packed lunches provided more sodium (P < 0.001), calcium (P < 0.001) and iron (P = 0.016) than the school meals. Very few packed lunches contained vegetables, and fruit intake was particularly low for those having a school meal. Conclusions Children taking a packed lunch to school were consuming approximately double the amount of sugar and 50% more sodium and saturated fat in their midday meal compared with those having a school lunch. However packed lunches were providing children with more calcium, iron and fruit.     

Development of a Diet Quality Index with Special Reference to Micronutrient Adequacy for Adolescent Girls Consuming a Lacto-Vegetarian Diet

Recent dietary guidelines emphasize micronutrient sufficiency by giving importance to consumption of whole grains and a variety of fruits and vegetables. The objective of this study was to identify a measure of micronutrient quality of diets in adolescent girls consuming a lacto-vegetarian diet. Data were collected on the nutritional status of 630 schoolgirls (ages 10 to 16 years) from Pune city, India, in a cross-sectional survey during 2006-2007. Dietary intakes were assessed by 24-hour recall on 3 nonconsecutive days. Nutrient intakes were calculated from the Indian nutritive value databases. Micronutrient adequacy was expressed as a ratio of observed intake to reference intake. An Adolescent Micronutrient Quality Index (AMQI) was formulated using the Indian and the recent US dietary guidelines. Fasting blood samples were analyzed for plasma levels of vitamin C, beta carotene, and zinc. The average energy intake of the majority of the girls was below the Indian recommended dietary intakes, whereas micronutrient intakes were 50% to 70% lower than recommended dietary intakes. The mean AMQI score was 41.5±9.4. The age of subjects as well as mother's education and occupation were significantly associated with the AMQI. The AMQI was correlated with nutrient intakes and the ratio of observed intake to reference intake (P<0.01) after controlling for energy intake and sociodemographic factors. Higher AMQI scores were associated with higher concentrations of plasma vitamin C (r=0.26), beta carotene (r=0.34), and zinc (r=0.12). The AMQI is a useful measure of the dietary adequacy and micronutrient quality of the diets of adolescent girls consuming lacto-vegetarian diets.     

High Intake of Nonmilk Extrinsic Sugars Is Associated With Protein and Micronutrient Dilution in Home-Dwelling and Institutionalized Older People

Background

High dietary sugar intake may compromise protein and micronutrient intakes in people with low energy intakes. The results of micronutrient dilution studies in older people have been few and conflicting. We examined the nutritional status and nutrient intakes associated with nonmilk extrinsic sugars (NMES) intakes in older people representing a broad spectrum of both healthy and vulnerable older populations.

Energy and Nutrient Intake of Tongan Adults Estimated by 24-Hour Recall: The Importance of Local Food Items

Tongan adults show one of the highest prevalences of obesity in the world. The present study aims to estimate Tongans' energy and nutrient intakes and food sources using a 24-hour recall survey for 14 days targeting 15 men and 19 women. The mean (SD) daily energy intake was 12.2 (2.3) MJ for men and 10.6 (2.2) MJ for women. Imported foods accounted for about half of their energy and macronutrient intakes, but for much less of their micronutrients. Some local food items, specifically pork, kava, and sea hare, contributed significantly to their vitamin, Fe, and Ca intakes, respectively. These findings suggest that heavy reliance on imported foods can lead not only to a high prevalence of obesity, but also to micronutrient deficiencies.