Food intake and inflammation in European children: the IDEFICS study

Purpose

This cross-sectional study assesses the relationship between consumption frequencies of food items and high-sensitivity C-reactive protein (hs-CRP) in European children.

Methods

Out of the baseline sample (N = 16.228) of the IDEFICS study, 6.403 children (1.315 boys aged 2 to <6, 1.908 boys aged 6 to <10, 1.204 girls aged 2 to <6 and 1.976 girls aged 6 to <10 years) had hs-CRP measured and the Children’s Eating Habits Questionnaire filled, including a food frequency questionnaire. Logistic regression adjusted for body mass index z-score, education of the mother, breast-feeding and self-reported hours of physical activity in a sport club per week was conducted.

Results

Mean frequency intake of raw vegetable was lower in boys (p = 0.022 in young and p = 0.020 in old) and older girls (p = 0.026) with high hs-CRP concentration, while in younger girls (p = 0.008) the same occurred with the cooked vegetables. The probability of having higher hs-CRP concentration was significantly associated with having low consumption frequency of vegetables (p = 0.004 in older boys, raw vegetables; and p = 0.0032 in younger girls, cooked vegetables). Also, honey/jam intake decreased the probability of having higher concentration of hs-CRP, whereas soft drinks with sugar, mayonnaise and cereals milled increased this probability.

Conclusions

Out of all food items associated with hs-CRP, frequency intake of vegetables presented more associations across all the analysis. Findings suggest that a high-frequency intake of vegetables is inversely related to an inflammatory status in children. More studies are needed to assess the association between diet and inflammation.

     

Dietary sources of free sugars in the diet of European children: the IDEFICS Study

European Journal of Nutrition - To report dietary free sugars consumption and their different types and food sources in European children. The present study is based on the IDEFICS study, a...     

Prospective associations between dietary patterns and high sensitivity C-reactive protein in European children: the IDEFICS study

Purpose

This prospective study explores high sensitivity C-reactive protein (hs-CRP) levels in relation to dietary patterns at two time points in European children.

Methods

Out of the baseline sample of the IDEFICS study (n?=?16,228), 4020 children, aged 2–9 years at baseline, with available hs-CRP levels and valid data from a food frequency questionnaire (FFQ) at baseline (T0) and 2 years later (T1) were included. K-means clustering algorithm based on the similarities between relative food consumption frequencies of the FFQ was applied. hs-CRP was dichotomized according to sex-specific cutoff points. Multilevel logistic regression was performed to assess the relationship between dietary patterns and hs-CRP adjusting for covariates.

Results

Three consistent dietary patterns were found at T0 and T1: ‘animal protein and refined carbohydrate’, ‘sweet and processed’ and ‘healthy’. Children allocated to the ‘protein’ and ‘sweet and processed’ clusters at both time points had significantly higher odds of being in the highest category of hs-CRP (OR 1.47; 95% CI 1.03–2.09 for ‘animal protein and refined carbohydrate’ and OR 1.44; 95% CI 1.08–1.92 for ‘sweet and processed’) compared to the ‘healthy’ cluster. The odds remained significantly higher for the ‘sweet and processed’ pattern (OR 1.39; 95% CI 1.05–1.84) when covariates were included.

Conclusions

A dietary pattern characterized by frequent consumption of sugar and processed products and infrequent consumption of vegetables and fruits over time was independently related with inflammation in European children. Efforts to improve the quality of the diet in childhood may prevent future diseases related with chronic inflammation.

     

Associations between early body mass index trajectories and later metabolic risk factors in European children: the IDEFICS study

Faster growth seems to be a common factor in several hypotheses relating early life exposures to subsequent health. This study aims to investigate the association between body mass index (BMI) trajectories during infancy/childhood and later metabolic risk in order to identify sensitive periods of growth affecting health. In a first step, BMI trajectories of 3301 European children that participated in the multi-centre Identification and Prevention of Dietary and Lifestyle-induced Health Effects in Children and Infants (IDEFICS) study were modelled using linear-spline mixed-effects models. The estimated random coefficients indicating initial subject-specific BMI and rates of change in BMI over time were used as exposure variables in a second step and related to a metabolic syndrome (MetS) score and its single components based on conditional regression models (mean age at outcome assessment: 8.5 years). All exposures under investigation, i.e. BMI at birth, rates of BMI change during infancy (0 to <9 months), early childhood (9 months to <6 years) and later childhood (≥6 years) as well as current BMI z-score were significantly associated with the later MetS score. Associations were strongest for the rate of BMI change in early childhood (1.78 [1.66; 1.90]; β estimate and 99 % confidence interval) and current BMI z-score (1.16 [0.96; 1.38]) and less pronounced for BMI at birth (0.62 [0.47; 0.78]). Results slightly differed with regard to the single metabolic factors. Starting from birth rapid BMI growth, especially in the time window of 9 months to <6 years, is significantly related to later metabolic risk in children. Much of the associations of early BMI growth may further be mediated through the effects on subsequent BMI growth.     

Nutrient intakes in relation to style of breakfast and taste preferences.

Style of breakfast (western- or Japanese-style) and taste preferences were associated with various diseases in some epidemiological studies in Japan. To evaluate what are measured by asking these dietary behaviors, we administered semiquantitative food frequency questionnaire (SFFQ) and asked style of breakfast and taste preferences to a subsample of residents in Takayama City, Gifu, Japan. Style of breakfast and total diet were studied in a random sample of 346 residents. There were no statistically significant differences in the nutrient intakes estimated from SFFQ between those with western- and Japanese-style of breakfast except for crude fiber. Taste preferences were asked to 555 men and 1,130 women who attended a health check-up program in the community. Salt intakes were slightly higher (< 3%) in those who had a favor for salty food than the others in both sexes. Fat or carbohydrate intake was similar between those stratified by preference for greasy or sweet foods. The data suggest that western-style of breakfast is not associated with western diet, in general, i.e., high-calorie and high-fat diet. Intakes of salt, fat, or carbohydrate appear to be unrelated to preferences for salty, greasy or sweet foods, respectively.     

Development of taste and food preferences in children

PURPOSE OF REVIEW: There are concerns about the rising incidence of obesity in children and their acceptance of healthy foods. Many factors affect children's food acceptance, the most salient are those enabling early exposure to culturally appropriate foods in the weaning or pre-weaning period. Parents, however, have always observed individual differences in children's willingness to take new foods. This review looks at studies that encompass both exposure to and genetic determinants of food acceptance. RECENT FINDINGS: Children's willingness to take new foods and accept specific foods has strong-to-moderate heritability. This inherited willingness is moderated by cultural differences in early exposure to both the taste and texture of foods, giving rise to different patterns of food acceptance. Breast-feeding not only confers an advantage in food and taste acceptance but may also give rise to a preference for highly palatable 'junk food'. Modelling and flavour-conditioning may also contribute to food acceptance, whereas coaxing a child to eat may impact negatively on the intake of food. Children of obese mothers, however, react to prompting by overeating rather than food refusal. This may indicate another area where food acceptance is genetically determined. SUMMARY: Health intervention programmes that aim to promote a healthy diet in children should start at the weaning and, to a lesser extent, the pre-weaning stage, and target maternal diet for optimal effectiveness.     

Prevalence of negative life events and chronic adversities in European pre- and primary-school children: results from the IDEFICS study

Background

Children are not always recognized as being susceptible to stress, although childhood stressors may originate from multiple events in their everyday surroundings with negative effects on children’s health.

Methods

As there is a lack of large-scale, European prevalence data on childhood adversities, this study presents the prevalence of (1) negative life events and (2) familial and social adversities in 4637 European pre- and primary-school children (4–11 years old), using a parentally-reported questionnaire embedded in the IDEFICS project (‘Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS’).

Results

The following findings were observed: (1) Certain adversities occur only rarely, while others are very regular (i.e. parental divorce); (2) A large percentage of children is shielded from stressors, while a small group of children is exposed to multiple, accumulating adversities; (3) The prevalence of childhood adversity is influenced by geographical location (e.g. north versus south), age group and sex; (4) Childhood adversities are associated and co-occur, resulting in potential cumulative childhood stress.

Conclusions

This study demonstrated the importance of not only studying traumatic events but also of focusing on the early familial and social environment in childhood stress research and indicated the importance of recording or monitoring childhood adversities.

     

Assessment of diet, physical activity and biological, social and environmental factors in a multi-centre European project on diet- and lifestyle-related disorders in children (IDEFICS)

Obesity is a major public health problem in developed countries. We present a European project, called Identification and Prevention of Dietary and Lifestyle-induced Health Effects in Children and Infants (IDEFICS), that focuses on diet- and lifestyle-related diseases in children. This paper outlines methodological aspects and means of quality control in IDEFICS. IDEFICS will use a multicentre survey design of a population-based cohort of about 17,000 2- to 10-year-old children in nine European countries (Belgium, Cyprus, Estonia, Germany, Greece, Hungary, Italy, Spain and Sweden). The project will investigate the impact of dietary factors such as food intake and food preferences, lifestyle factors such as physical activity, psychosocial factors and genetic factors on the development of obesity and other selected diet- and lifestyle-related disorders. An intervention study will be set up in pre-school and primary school settings in eight of the survey centres. Standardised survey instruments will be designed during the first phase of the project and applied in the surveys by all centres. Standard operation procedures (SOPs) will be developed, as well as a plan for training the personnel involved in the surveys. These activities will be accompanied by a quality control strategy that will encompass the evaluation of process and result quality throughout the project. IDEFICS will develop comparable Europe-wide health indicators and instruments for data collection among young children. Establishment of a new European cohort within IDEFICS will provide a unique opportunity to document the development of the obesity epidemic in the current generation of young Europeans and investigate the impact of primary prevention in European children populations.     

The relation of drinking and smoking habits to diet: the Lipid Research Clinics Prevalence Study

The relation of cigarette smoking and alcohol use to diet was examined in a general population of adults ages 20-59 years enrolled in the Lipid Research Clinics (LRC) Prevalence Study. There was a positive association between cigarette and alcohol use, but little relation between these habits and the nutrient intake. The total energy from food was about the same whether or not a person drank or smoked; alcohol was simply added to food intake. However, persons who drank received slightly less of their food energy from carbohydrate than persons who did not drink and persons who smoked received slightly more of their food energy from fat than did nonsmokers. Both persons who drank and persons who smoked weighed less than would be expected from their total energy intake. While these relationships were similar for men and women, among women they were stronger for those using gonadal hormones than among those not using these hormones.     

Perceptions of and preferences for sweet taste in uremic children

Uremic children have low energy intakes, with little appetite for sweet foods. Likewise, sucrose-rich diets are poorly accepted by uremic rats, which suggests that uremia causes a relative aversion for sucrose. Hemodialyzed children (no. = 39, mean age = 160 mo) and healthy controls (no. = 25, mean age = 122 mo) were compared for perception of sweet taste intensity in two familiar foods (soft white cheese and apple sauce) and for preference for sweetness. The food stimuli were prepared in five sucrose concentrations: 1%, 5%, 10%, 15%, and 20% for cheese; 10%, 20%, 30%, 40%, and 60% for apple sauce. Children were presented with pairs of stimuli of adjacent concentrations and asked, in a forced choice, to identify the sweeter stimulus and to express their preferences. The hemodialyzed children made more mistakes (19%) than the controls (5%) when asked to rank sweetness in the soft cheese (i.e., with low concentrations). Both groups made an equal number of mistakes when asked to rank sweetness in the apple sauce. Preferences for sweetness were markedly different. In cheese, the highest sucrose concentration was preferred by 21.9% of the hemodialyzed children vs 41% of the controls. The lowest sucrose concentration was selected by 15.6% of the hemodialyzed children vs 4.6% of the controls. Similar preference trends were observed for apple sauce. We conclude that abnormally low preferences for sweet foods can contribute to insufficient caloric intake in uremic children.     

超重肥胖与儿童哮喘及哮喘样症状相关性分析

目的探讨超重与肥胖对儿童哮喘及哮喘样症状的影响效应。方法采用整群随机抽样方法随机抽取沈阳市5所小学和10所幼儿园,采用国际统一标准问卷ATS调查表对所选学校的所有学生的呼吸系统疾病及症状进行调查,并进行体格测量。结果本次共调查儿童5 096人,超重、肥胖患病率分别10.73%和9.93%。肥胖儿童哮喘患病率(11.41%)高于正常体重儿童患病水平(6.11%),且超重肥胖对女性儿童哮喘及哮喘样症状的影响更加明显。多因素分析结果显示,与正常体重儿童相比,无家族易感史和有家族易感史的儿童患有哮喘的危险性分别增加了80%(OR=1.80,95%CI=1.15～2.96)和113%(OR=2.13,95%CI=1.12～3.15);进一步分析结果显示超重肥胖与家族易感史对儿童哮喘的交互效应并无统计学意义(P>0.05)。结论超重肥胖可显著增加儿童患有哮喘及哮喘样症状的风险,且女性儿童受到的影响较大。     

Inherited taste sensitivity to 6-n-propylthiouracil in diet and body weight in children

OBJECTIVE: Negative associations between the inherited ability to taste the bitter compound 6-n-propylthiouracil (PROP) and preference for fat and body weight have been observed in adults. This study tested the relationships among the ability to taste PROP, reported food intake, and body weight in young children. RESEARCH METHODS AND PROCEDURES: Fifty-three 4- to 5-year-old children were classified as tasters (N = 35) or nontasters (N = 18) of PROP using a standard screening solution. Anthropometric measures were taken in the laboratory. Mothers completed questionnaires to assess their child's food intake and their own dieting behaviors. RESULTS: Nontaster boys had higher weight-for-height percentiles than taster boys (77th vs. 56th percentile, respectively), but the relationship was opposite for girls (p < or = 0.05). Nontasters reportedly consumed a higher percentage of their daily energy from protein (p < or = 0.01), mainly as high-fat meat products. Tasters reportedly consumed a higher percentage of their daily energy from sugars (p < or = 0.05), mainly in the form of brownies, doughnuts, cookies, soft drinks, and juice drinks. There were no differences between tasters and nontasters for reported intake of grains, fruits, vegetables, dairy products, or discretionary fats. DISCUSSION: This study is the first, to our knowledge, to report weight differences in children as a function of their PROP status. Genetic taste factors seem to play a role in the development of dietary patterns and weight differences in young children, but the nature of these relationships may vary with gender.     

Physical activity,adiposity and urbanization level in children: results for the Italian cohort of the IDEFICS study

Objectives

While there is extensive evidence about the influence of environmental factors on adult obesity, fewer studies have assessed how the environment influences body fat in children. This cross-sectional study investigated the distribution of adiposity indices according to urbanization level and patterns of physical activity among children in the Italian cohort of the IDEFICS study.

Methods

The sample included 1673 preschool and school-aged children (mean age 6.1 years, standard deviation 1.7) living in rural (n = 579), suburban (n = 442) and urban (n = 652) areas. Anthropometric measures were taken and questionnaires were used to assess children's lifestyles, including patterns of physical activity.

Results

Children who lived in rural areas spent significantly more time in outdoor activities but participated in less structured physical activity compared with children living in suburban and urban areas. Adiposity estimated by the sum of skinfold thickness increased linearly from rural to urban areas, with results for suburban areas showing intermediate values.

Conclusions

The data show that geographical environmental factors influence patterns of physical activity and body fat in children. In particular, the results suggest an association between the time spent in unstructured outdoor activities and the degree of adiposity in schoolchildren. These results may have implications for public health, including efforts to increase freely available playgrounds as an effective measure to counteract the obesity epidemic in children.     

Television watching and some eating habits of 6-14-year-old children in Amsterdam, the Netherlands; a cross-sectional study

OBJECTIVE: To describe the time spent by children between the ages of 6-14 years watching television during a weekday and to examine associated factors. DESIGN: Cross-sectional questionnaire study. METHOD: Data were collected during a vaccination campaign against meningococci C in Amsterdam in September 2002. From a sample of 2910 parents of 6-14-year-old children 1775 agreed to participate in the study. Socio-demographic characteristics and data on television viewing the previous day, the presence of a television in the child's bedroom and on eating habits were collected by short interviews. RESULTS: In total 1587 children were included in the analyses, 805 boys and 782 girls. In total 40.1% of the boys and 36.5% of the girls had watched television for > or = 2 h during the previous day. Among the children < or = 10 years 28.7% had a television in their bedroom, among children > 10 years this was 45.7%. Age (> 10 years), ethnicity (notably Surinam origin) and having a television in the bedroom was related to spending more time watching television. Having parents with a high socioeconomic status (SES) was associated with less television viewing than having parents with a lower SES. Children who had not eaten fresh fruit or who had visited a snackbar the previous day had been watching television for > or = 2 h more often than children who had eaten fresh fruit (p < 0.001) or who had not visited a snackbar (p < 0.05). CONCLUSION: Children spent a lot of time watching television. In view of the relation between television viewing and overweight this is an alarming development. Possibilities for the prevention of overweight by reducing television viewing must be investigated.     

The relation between overweight and subjective health according to age, social class, slimming behavior and smoking habits in Dutch adults

Subjective health status was assessed in relation to overweight by administering a list of 51 health complaints to adult men and women who were either chronically overweight as defined by Body Mass Index (BMI) or not overweight, in a continuous morbidity registration in four general practices during the period 1967-83. Responses were received from 455 men (182 overweight) and 790 women (386 overweight), ages 26-66 years. Response rate (71 per cent) and age distribution (mean age 48) were similar in overweight and non-overweight groups of both sexes. BMI was correlated with the total number of complaints in women (r = 0.15) but not in men (r = 0.07). Multiple regression analysis revealed, however, that age was an effect modifier in this relation, there being a negative association between BMI and subjective health in younger men and a positive association in older men, whereas in women the association between BMI and subjective health was much more pronounced at younger ages than at older ages. In addition, current smoking habits and social class (in men and women) and reported slimming behavior (in women) had an independent relation to the total number of health complaints. BMI was also related to specific complaints and groups of complaints, particularly in women.     

Selenium in diet, blood, and toenails in relation to breast cancer: a case-control study

The association between breast cancer and selenium, measured in the diet, plasma, erythrocytes, and toenails, was investigated in a case-control study in the Netherlands during 1985-1987. Dietary selenium intake was assessed by a structured dietary history technique among 133 breast cancer cases and 238 population controls. Absolute and energy-adjusted selenium intake and selenium concentrations in plasma, erythrocytes, and toenails were similar in cases and controls. The multivariate adjusted odds ratios of breast cancer for subjects in the lowest quartile compared with the highest quartile were 1.6 (95% confidence interval (CI) 0.8-3.4) for dietary selenium, 2.0 (95% CI 0.9-4.4) for plasma selenium, 0.9 (95% CI 0.4-1.9) for erythrocyte selenium, and 1.1 (95% CI 0.6-2.1) for toenail selenium. No statistically significant trend was observed in the odds ratios for any of the four indicators of selenium. These results do not suggest a substantial association between selenium and breast cancer for both short- and long-term markers of selenium status.     

Television viewing and exposure to food-related commercials among European school children, associations with fruit and vegetable intake: a cross sectional study

Background  

Fruit and vegetable intake is low among European children and exposure to TV is negatively associated with the intake of fruit and vegetables. The aim of the present study was to explore exposure to food commercials on TV in nine European countries. Associations between such exposure and intake of fruit and vegetables and possible mediating effects of attitudes toward and liking of fruit and vegetables were assessed.     

Physical activity, overweight and central adiposity in Swedish children and adolescents: the European Youth Heart Study

Background  

The aim of this work was to study the associations of physical activity (PA) and other factors predisposing to overweight, with overweight and central adiposity in children and adolescents.