Dietary patterns and nutrient intakes of 7-year-old children taking part in an atherosclerosis prevention project in Finland

OBJECTIVE: To evaluate the dietary patterns of 7-year-old children participating in an atherosclerosis prevention project and the relationship of those dietary patterns to nutrient intakes and serum cholesterol values. DESIGN: In the randomized, prospective Special Turku Coronary Risk Factor Intervention Project (STRIP) 1,062 children were randomly assigned to an intervention group (n=540; low-saturated fat, low-cholesterol diet) or to a control group (n=522; unrestricted diet) at 7 months of age. SUBJECTS/SETTINGS: The intervention families received, at 6-month intervals, individualized counseling that focused on the known environmental atherosclerosis risk factors and aimed at reducing children's saturated fat and cholesterol intake. Nutrition counseling was targeted at the child but, because of the young age of the children, was given to the parents. When children were 7 years old, food and nutrient intakes of 307 intervention and 323 control children were studied using 4-day food records. STATISTICAL ANALYSES PERFORMED: K-means cluster analysis was used to classify children into 4 groups on the basis of similarity of food intake. Differences in nutrient intakes and serum lipid concentrations between children in the 4 food intake clusters were evaluated using Tukey's multiple comparison test. RESULTS: Intervention children dominated the bread, skim milk, and margarine cluster and the cereals, rice, and pasta cluster whereas the 1.5%-fat milk and butter cluster included mainly control children. Saturated fat intake was nearest to the recommendations, that is 11.7% and 11.9% of energy, in the bread, skim milk, and margarine cluster and the cereals, rice, and pasta cluster, respectively. Children in the bread, skim milk, and margarine cluster had 20% to 27% higher fiber intakes (P<.001) whereas children in the sugar and sweets cluster had markedly higher sugar intakes than children in other clusters (P<.001). Serum cholesterol concentrations were lower in those clusters with high dietary ratios of polyunsaturated to saturated fat. CONCLUSION: Detailed and repeated dietary counseling of parents, starting when children are aged 7 months, that aims at decreasing children's exposure to known nutrition risk factors for coronary heart disease modifies children's food patterns and nutrient intakes toward expected values.     

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.     

Dietary practices of high school teachers of nutrition

To examine the application of nutrition knowledge in a sample of nutrition educators, we investigated the dietary practices of 71 high school health and home economics teachers who were currently teaching nutrition. They kept four-day food records and filled out food-frequency questionnaires. Group means of female teachers met or exceeded the Recommended Dietary Allowances (RDAs) for seven of the eight nutrients investigated; mean iron intake was 66% of the RDA. Group means of males met the RDAs for the nutrients investigated except thiamin, which had a mean of 89% of the RDA. Teachers' diets were more nutrient dense for calcium, vitamin A, and ascorbic acid than were the diets of adults surveyed in the Health and Nutrition Examination Survey I (HANES I) and the Nationwide Food Consumption Survey (NFCS). Except for iron for females, inadequate intakes of individual teachers generally were related to low caloric intakes. Teachers incorporated many current dietary recommendations in their personal praices, such as eating several servings of fruits and vegetables daily, including several servings of dairy products daily, limiting cholesterol intake, and limiting sweets. However, the teachers' mean percentage of calories from fat exceeded the current recommendation. Generally, these teachers applied their nutrition knowledge to their personal dietary practices and thus serve as role models who “practice what they preach”.     

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.     

Design of a Mediterranean Exchange List Diet Implemented by Telephone Counseling

A Greek-Mediterranean dietary pattern has two distinct aspects that differ relative to average intakes in the United States: a high intake of monounsaturated fats and a high intake of fruit and vegetables. The purpose of the study was to develop and test an exchange list Greek-Mediterranean diet that could be used in future clinical trials of breast cancer prevention. A total of 69 women, ages 25 to 59 years, were randomized to either continue their own usual diet or follow an intervention diet for 6 months during 2004 through 2005. Intervention goals were to decrease usual fat intakes by about half and to replace those fats with olive oil and other high–monounsaturated fatty acid foods; increase fruit and vegetable intakes to 7 to 9 servings/day, depending on energy intake; and consume at least one serving per day each of culinary herbs and allium vegetables. Registered dietitians provided exchange goals and individualized telephone counseling, and diets were self-selected using a Mediterranean exchange list developed specifically for this study. Changes in diet were assessed by 7-day food records. Results demonstrated that counseling using the Mediterranean exchange list was effective for large dietary changes relative to the nonintervention group. Repeated measures analysis of variance indicated a statistically significant 48% increase in dietary monounsaturated fat with no appreciable change in total fat intake, and a significant increase in fruit and vegetable intake from 4.0 to 8.6 servings/day (P < 0.05).     

Telephone counseling promotes dietary change in healthy adults: results of a pilot trial

Telephone counseling is increasingly reported to be an effective behavior change strategy, but more studies in broader populations are needed. This uncontrolled pilot trial investigated whether a 3-month/eight-call telephone counseling intervention could promote dietary changes associated with reduced chronic disease risk in adults consuming <5.0 servings of vegetables and fruits daily. Between 2002 and 2004, 97 adults (mean age 46 years; range 21 to 84 years) completed the intervention and a follow-up assessment at 6 months. Approximately half were of nonwhite ethnicity (53%). The majority were women (95%) and had never had cancer (89%). The intervention promoted daily intakes of three to five vegetable servings, two to four fruit servings, and three whole-grain and/or beans/legumes servings. Average total daily intake of vegetables, fruits, whole grains, beans/legumes, fiber, and fat were assessed at baseline and at 6 months, each by a set of three 24-hour recalls. Plasma carotenoids were measured on a subsample (n=41) as an objective biomarker of vegetable and fruit intake. Change in mean self-reported dietary intake (ie, vegetables, fruit, whole grains, beans/legumes, fiber, and fat) and plasma carotenoids were compared by paired t tests. The intervention was associated with a significant (P<0.001) increase in vegetable servings per day (baseline 2.1 servings per day, 6 months 3.5 servings per day; 67% increase), fruit servings per day (baseline 1.4 servings per day, 6 months 2.4 servings per day; 71% increase), and whole-grain and/or bean servings per day (baseline 1.0 serving per day, 6 months 1.4 servings per day; 40% increase). These changes were corroborated by a significant (P<0.001) increase in total plasma carotenoids. This 3-month/eight-call telephone counseling intervention was associated with dietary change in healthy adults consuming fewer than five servings per day of vegetables and fruit at study entry.     

Eating Habits of Young Children with Down Syndrome in The Netherlands: Adequate Nutrient Intakes but Delayed Introduction of Solid Food

Objectives To investigate nutritional status, pattern of being breast-fed, age at introduction of solid food, and adequacy of energy and nutrient intakes in children with Down syndrome in The Netherlands.Design Nutritional status was assessed by height and weight measurements. The dietary history method was used to collect information on the diet. Data obtained from children with Down syndrome were compared with data from control subjects and from the general population of Dutch children. Adequacy of energy and nutrient intakes was assessed by comparison to US recommendations.Subjects Forty-four Dutch children with Down syndrome (newborns to 4-year-olds) and 37 healthy control subjects without this syndrome.Statistical analyses The prevalence of breast-feeding of children with and without Down syndrome was compared using the χ² test. To compare ages at which solid food was introduced, the log-rank test and Kaplan-Meier curves were used. Anthropometric data and mean dietary intake were compared between the groups using 2-way analysis of variance. Comparison to recommended levels of dietary intake was performed using 95% confidence intervals.Results Heights and weights of the children with Down syndrome were in the normal range. Down syndrome does not affect the prevalence of breast-feeding of children or the adequacy of their energy and nutrient intakes, but it does significantly delay the age at which solid food is introduced, which can be deleterious to oral-motor development.Application If late introduction of solid food is observed in children with Down syndrome, pre-speech therapy should be considered. J Am Diet Assoc. 1998;98:790-794.     

Nutrition Education Package Focusing on Infant and Young Child Feeding in Tanzania

ObjectiveTo evaluate the effectiveness of a nutrition education package on feeding practices, nutrient intakes and growth of infants in rural Tanzania.DesignCluster-randomized controlled trial in 18 villages allocated to nutrition education package (n = 9) or routine health education (n = 9 villages), measured at baseline (6 months) and end of the trial (12 months).SettingMpwapwa district.ParticipantsInfants aged 6–12 months and their mothers.Intervention(s)Six months of nutrition education package (group education, counseling, cooking demonstrations) and regular home visits by village health workers.Main Outcome Measure(s)Primary outcome measure was the mean change in length-for-age z-scores. Secondary outcomes included mean changes in weight-for-length z-scores (WLZ), intakes of energy, fat, iron and zinc, the proportion of children consuming foods from ≥ 4 food groups (ie, dietary diversity) and consuming the recommended number of semisolid/soft meals and snacks per day (ie, meal frequency).AnalysisMultilevel mixed-effects regression models.ResultsMean change in length-for-age z-scores (β = 0.20, P = 0.02), energy (in kcal) (β = 43.8, P = 0.02), and fat (in grams) (β =2.7, P = 0.03) intakes were significant in the intervention but not in the control group. There was no effect on iron and zinc intakes. More infants in the intervention than the control group consumed meals from ≥ 4 food groups (71.8% vs 45.3%, P = 0.002). The mean increase in meal frequency (β = 0.29, P = 0.02) and dietary diversity (β = 0.40, P = 0.01) were more significant in the intervention than control.Conclusions and ImplicationsThe nutrition education package is feasible and can be implemented with high coverage, demonstrating the potential to improve feeding practices, nutrient intake and growth in rural Tanzania.     

Nutrition Intervention Group Program based on Preaction-stage–oriented Change Processes of the Transtheoretical Model Promotes Long-term Reduction in Dietary Fat Intake

Objective To develop and evaluate the long-term effectiveness of an intervention program, based on preaction-stage–oriented change processes of the Transtheoretical Model of Behavior Change, that could be delivered in a group setting to help participants lower dietary fat intake.Design An enhanced version of the nonequivalent control group experimental design was used. Entire sections of an undergraduate introductory nutrition science course were assigned to an experimental, pretest/posttest control, or posttest-only control group. Daily fat intake and stage of change of the experimental and pretest/posttest control groups were determined at the pretest and posttest and 1-year later at a follow-up test. Every 1 to 2 weeks during the study, stage of change of the experimental group was assessed. Daily fat intake of the experimental group was assessed at study midpoint. Daily fat intake and stage of change of the posttest-only control group was determined at the posttest. Pretest results were used to place participants of the experimental and pretest/posttest control groups in either the preaction stage (ie, precontemplation, contemplation, or preparation) or the action/maintenance stage.Subjects/setting The sample consisted of 38, 30, and 42 undergraduate students who were assigned to the experimental, pretest/posttest control, and posttest-only control groups, respectively.Intervention The experimental group participated in a group-based, dietary fat intake intervention that included a series of 11 lessons taught over a 14-week period. Each lesson was based on 1 or 2 of the preaction-stage–oriented change processes of the Transtheoretical Model.Main outcome measures Data were evaluated to determine the effects of the intervention program on long-term dietary fat reduction and stage of change progression.Statistical analysis performed Analysis of variance, repeated-measures analysis of variance, and paired t tests.Results For pretest and posttest dietary fat intake scores, stage and time were significant, and there was a significant time-by-stage interaction. Time was significant for pretest and posttest stage scores. Subjects in the preaction-stage experimental group significantly increased their mean stage of change and reduced their fat intake between the pretest and posttest; these changes persisted for 1 year. Pretest/posttest control group participants who began in a preaction stage also significantly increased their mean stage and reduced fat intake by the posttest, but these changes did not endure until the follow-up test.Applications/conclusions This intervention program produced an enduring, significant reduction in mean dietary fat consumption and a significant progression in mean stage of change of subjects in the experimental group who were in the preaction stage. It may be appropriate to design group interventions to use preaction stage processes rather than the more traditionally used action and maintenance stages change processes. J Am Diet Assoc. 2000;100:335-342.     

Dietary intakes of Pacific, Māori, Asian and European adolescents: the Auckland High School Heart Survey

Objective: To compare dietary intakes of European, Māri, Pacific Island and Asian adolescents living in Auckland.
Methods: A self-administered food frequency questionnaire was used to assess daily nutrient intakes of 2,549 14- to 21-year-old high-school students in Auckland (1,422 male and 1,127 female) in a cross-sectional survey carried out between 1997 and 1998.
Results: Compared with Europeans, Māri and Pacific Islanders consumed more energy per day. Carbohydrate, protein and fat intakes were higher in Māri and Pacific Islanders than in Europeans. Cholesterol intakes were lowest in Europeans and alcohol intakes were highest in Europeans and Māri. When nutrient intakes were expressed as their percentage contribution to total energy, many ethnic differences in nutrient intakes between Europeans and Māri or Pacific Islanders were eliminated. After adjustment for energy intake and age, Europeans ate the fewest eggs, and Pacific Islanders and Asians ate more servings of chicken and fish, and fewer servings of milk and cereal than Europeans. Compared to Europeans, Pacific Islanders consumed larger portion sizes for nearly every food item.
Conclusion: There were marked differences in nutrient intakes between Pacific, Māri, Asian and European adolescents. Ethnic differences in food selections, frequency of food servings and portion sizes contribute to the differences in nutrient intakes between these ethnic groups. These differences generally matched those of other studies in children and adults from these ethnic groups.
Implications: Interventions that reduce frequency of food consumption and serving sizes and promote less-fatty food choices in Māri and Pacific adolescents are needed.     

Food neophobia in childhood affects dietary variety

Objective To determine whether children with food neophobia (unwillingness to try new foods) have more restrictive diets than children without neophobia.

Subjects Seventy children were classified into 3 groups based on scores obtained on the Food Neophobia Scale: neophobic group, score greater than 41; neophilic group, score less than 27; and average group, score of 28 to 40.

Design Dietary data were collected and analyzed for 3 days selected randomly. The dependent variables measured were energy and nutrient intakes, servings of each Food Guide Pyramid group, and Health Eating Index (HEI) scores.

Statistical analyses χ², 1-way analysis of covariance, and Scheffe multiple comparisons tests were conducted.

Results The 3 groups were similar with respect to the number of children meeting two thirds of the RDA/DRI for energy and most nutrients. The exception was vitamin E: fewer neophobic children met two thirds of the recommended value for this nutrient than average and neophilic children. The overall HEI score was significantly lower for the neophobic group compared with the average and neophilic groups. The HEI index showed that children with neophobia had a higher intake of saturated fat and less food variety than children without food neophobia.

Applications Dietitians should emphasize increased food variety for children within the context of a healthful diet. Research should be conducted to determine the effects of dietary variety on quality of diet and health of children. J Am Diet Assoc. 2000;100:1474-1478,1481.     

A comparison of nutrient intake between infants and toddlers with and without cystic fibrosis

OBJECTIVE: To compare the micronutrient and energy intake of infants and toddlers with cystic fibrosis (CF) to the intake of matched control children and dietary reference index (DRI) levels. DESIGN: A two-group comparison study. Nutrient and energy intakes were measured via 3-day diet diaries. Anthropometric data were collected within 1 week of study enrollment. SUBJECTS/SETTING: A clinical sample of 35 infants and toddlers with CF (mean=18.6, SD=8.1 months) matched to a community sample of 34 healthy controls. STATISTICAL ANALYSES PERFORMED: Children with CF and controls were compared on anthropometric and nutrient data using independent sample t tests. Mean nutrient and energy intake for children in each group were compared with the age-appropriate DRI for targeted nutrients using percentages. RESULTS: Children with CF and controls were similar on measures of growth (height, weight, or weight-for-height percentile). Four children with CF were at or below the 10th percentile for weight-for-height, compared with one control child. Children with CF and controls did not differ on average daily protein, calcium, zinc, and energy intake. Overall, children met or exceeded DRI levels for nutrient intakes. A notable exception was iron, for which mean intakes were lower for control children. Toddlers with CF consumed only 89% of the RDA per day for energy. APPLICATIONS/CONCLUSIONS: Infants and toddlers with CF are likely obtaining adequate micronutrient intakes from food. Interventions to increase total energy intake in infants and toddlers with CF are needed. Dietitians may want to focus more on calorie intake and percent calories from fat than on micronutrient intake in their nutrition counseling in young children with CF.     

Food Sources and Dietary Intakes of Vitamin K-1 (Phylloquinone) in the American Diet: Data From the PDA Total Diet Study

Objective To identify important food sources and estimate dietary intake of vitamin K-1 (phylloquinone) in the American diet.Design Core foods from the US Food and Drug Administration (FDA) Total Diet Study (TDS), which was based on the 1987-88 Nationwide Food Consumption Survey (NFCS), were analyzed for vitamin K-1. These nutrient values were then applied to the FDA TDS consumption model.Subjects Of the NFCS participants within the 14 selected age-gender groups, 3,634 who had 3 days of dietary data were included in the FDA TDS consumption model.Main outcome measures Vitamin K-1 intakes were estimated for each of the age-gender groups; the percentage contribution of each food item to total intake of vitamin K-1 was calculated from the FDA TDS model.Results Of the 14 age-gender groups selected, the 25- to 30-year-old women and men consumed less than the current Recommended Dietary Allowance (RDA) for vitamin K. In contrast, formula-fed infants had estimated vitamin K-1 intakes six times greater than the RDA. All other groups consumed amounts within the recommended daily intakes but lower than 90 μg/day. The top contributors to total vitamin K-1 intake were dark-green vegetables, although the fats and oils added to mixed dishes and desserts were also important contributors. The proportion of vitamin K-1 obtained from vegetables increased with age.Applications The data identify important dietary sources of vitamin K-1 in the American diet. This knowledge can be used to develop dietary assessment instruments for use in epidemiologic studies. J Am Diet Assoc. 1996; 96:149-154.     

U.S. Food Guide Pyramid food group intake by Asian Indian immigrants in the U.S

This study examined the food group intake and the dietary quality of middle-aged and older Gujarati Asian Indian immigrants (45 years or older) living in two urban metropolitan areas in the U.S. Participants (90 men, 99 females) completed a 24-hour dietary recall, which was used to determine if they met the daily food group intake guidelines of the U.S. Food Guide Pyramid. The overall quality of their reported dietary intake was determined using the Healthy Eating Index based on their nutrient and food group intake. Both men and women met the daily number of servings recommendations for the grains (men: 9.3 servings/day; women: 6.9 servings/day) and vegetables (men: 4.5 servings/day; women: 3.6 servings/day) groups, but did not meet the recommendations for fruits, dairy and meats groups. The total score on the Healthy Eating Index of the diets of these participants was 73, indicative of a dietary intake that does not meet the established U.S. dietary guidelines. These immigrants should be educated about appropriate food choices (ethnic and non-ethnic) within each of the U.S. Food Guide Pyramid food groups to improve the overall quality of their dietary intakes.     

Dietary Nutrient Profiles of Canadian Baffin Island Inuit differ by Food Source, Season, and Age

Objective To compare the effect of food source (traditional or market), season (six seasons), and age (five age groups) on dietary nutrient patterns of Inuit living in Baffin Island, Canada.Design Twenty-four-hour recall interviews of all residents who had lived ≥3 years in this one community in each of six seasons. Foods that were recalled were divided by source.Setting/subjects The study took place in the Inuit community of Qikiqtarjuaq, which harvests the highest quantity of wildlife per capita of all Baffin communities. Three hundred sixty-six residents contributed a total of 1,410 recalls: 401 from nonpregnant, nonlactating adult women, 74 from pregnant women, 301 from adult men, 451 from children aged 3 to 12 years, and 183 from teenagers aged 13 to 19 years. Participation was voluntary and averaged 65% to 75% of residents.Main outcome measures Energy, total dry weight of food, and dietary nutrients (ie, carbohydrate, protein, total fat, saturated fat, polyunsaturated fat, vitamin A, iron, copper, zinc, calcium, phosphorus, magnesium, and sodium) were measured by food source, season, and age. Nutrient density (nutrient per 1,000 kcal) was calculated in traditional and market food sources. Selected nutrients were computed in total diets, and compared with Recommended Dietary Allowances (RDAs).Statistical analyses performed Tests for normality of the distribution of nutrient intakes (ie, Shapiro-Wilk statistic) were performed followed by nonparametric analyses (ie, Wilcoxon paired-sample t test, Kruskal-Wallis analysis of variance, and adjustment for Bonferroni inequalities resulting from multiple comparisons).Results Most nutrient intakes were significantly different by food source (P<.05). Traditional food contributed more protein, phosphorus, iron, zinc, copper, magnesium, and vitamin A for several age groups. Market food contributed greater amounts of dry weight, energy, fat, carbohydrate, calcium, and sodium for most age groups. Seasonal variation (P<.05) existed for nutrients coming from traditional and market food. Of the 10 nutrients assessed for nutrient density, all except calcium and sodium were present in greater amounts in traditional food than in market food (P<.05). Calcium and vitamin A intakes fell below 66.6% of the RDAs for more than 60% of the population.Conclusions The comprehensive view of nutrient profiles, food source, and seasonality of Inuit diets will assist health professionals in developing nutrition promotion and education programs for all age groups of this population. Traditional food is an essential source of the total annual dietary nutrient intake of Inuit. Results indicated, however, that calcium and vitamin A intake must be improved. J Am Diet Assoc. 1996; 96:155–162.     

Assessment of Energy Intake Underreporting by Doubly Labeled Water and Observations on Reported Nutrient Intakes in Children

Objective To compare reported energy intake with energy expenditure using doubly labeled water (DLW). Additionally, we compared reported nutrient intakes of our subject population with national survey population data from the third National Health and Nutrition Examination Survey (NHANES III).Design This was a cross-sectional study of children, balanced by race and gender, primarily characterized by 4 body types: lean, obese, centrally fat, or peripherally fat.Subjects/setting Children (n=118; mean age=10 years) kept 8-day food records, with nutritionists recording weekday school lunch intakes. These subjects, assisted by their parents, recorded all breakfasts, dinners, snacks, and weekend lunches.Statistical analyses performed Data were analyzed using least squares analysis of variance with the general linear models procedure. Tukey's test was used for multiple comparisons of predicted treatment means.Results Mean daily energy intake was underreported by 17% to 33% of energy expenditure. The tendency to underreport increased with age. Underreporting occurred in all groups and subgroups studied. Reported mean intakes of vitamin A, vitamin E, vitamin B-6, calcium, zinc, and copper were less than 70% of the Recommended Dietary Allowance (RDA) for African-American girls, whereas African-American boys reported similarly low intakes of copper. On average, white girls reported intakes less than 70% of the RDA for zinc and copper, whereas white boys reported low intakes of copper (60% of the RDA). Reported intakes in general were somewhat lower than those reported in NHANES III.Applications/conclusions Dietetics professionals may modify the nutritional advice they give to patients/subjects based on food intake records and other data. For children, particularly, it is imperative that ethnic and gender differences be taken into consideration and that all foods eaten be accounted for as much as possible. J Am Diet Assoc. 1998;98:426-430,433.     

Intervention-related bias in reporting of food intake by fifth-grade children participating in an obesity prevention study

Data collected as part of Pathways, a school-based trial for the primary prevention of obesity in American Indian children conducted between 1997 and 2000, were analyzed to examine possible intervention-related bias in food reporting. The authors hypothesized that children in the intervention schools may have systematically underreported their dietary intake relative to children in the control schools. Nutrient intake estimates for lunch derived from record-assisted 24-hour dietary recalls were compared with intake estimates from observed lunch intakes. Reported nutrient intakes were included in regression analyses as the dependent variables; observed intake, intervention condition, and age were included as independent variables. Results indicated that, among females, intervention condition was a significant predictor of reported energy, fat, and saturated fatty acid intakes. Independently of observed intake, reported lunch energy intake among females in the intervention schools was 66.8 calories lower than reported intake among females in the control schools (p = 0.03). These findings suggest that investigators should consider bias in reporting of dietary intake by intervention condition when conducting diet-focused intervention studies. Specifically, enhancing measures that rely on self-reports with objective measures of dietary intake would help investigators to evaluate whether differential reporting by treatment group has occurred.     

Influence of dietary fat on the nutrient intake and growth of children from 1 to 5 y of age: the Special Turku Coronary Risk Factor Intervention Project

BACKGROUND: Excessive decreases in fat intake in young children have been linked with low intakes of energy and nutrients and possible growth failure. OBJECTIVE: We evaluated nutrient intakes and growth of healthy children with different fat intakes during the first 5 y of life. DESIGN: In the Special Turku Coronary Risk Factor Intervention Project (STRIP), 7-mo-old children were randomly assigned to an intervention aimed at reduced consumption of saturated fat and cholesterol (n = 540) or to a control group (n = 522). This analysis comprises data for children for whom > or = 6 of 8 possible 3-4-d food records were available (n = 730; 353 females). Children were divided according to fat intake pattern (percentage of energy) between the ages of 13 mo and 5 y into groups with continuously high fat intake (5% of children), increasing fat intake (5%), continuously low fat intake (5%), decreasing fat intake (5%), and average fat intake (80%). Children's energy and nutrient intakes and growth were then compared by analysis of variance. RESULTS: Fat intake at 13 mo of age was particularly low (21% of energy) in the increasing fat intake group and in the continuously low fat intake group (22% of energy at 13 mo; 26% of energy at 5 y). Growth of children in all 5 fat intake groups, however, was not significantly different throughout the study period. Intakes of vitamins and minerals, except of vitamin D, met recommended dietary allowances in all fat intake groups. CONCLUSION: Nutrient intakes and growth were not significantly different in children whose fat intake patterns differed between 13 mo and 5 y of age.     

Dietary Patterns,Eating Behavior,and Nutrient Intakes of Spanish Preschool Children with Autism Spectrum Disorders

Eating behavior problems are characteristic of children with autism spectrum disorders (ASD) with a highly restricted range of food choices, which may pose an associated risk of nutritional problems. Hence, detailed knowledge of the dietary patterns (DPs) and nutrient intakes of ASD patients is necessary to carry out intervention strategies if required. The present study aimed to determine the DPs and macro-and micronutrient intakes in a sample of Spanish preschool children with ASD compared to typically developing control children. Fifty-four children with ASD (two to six years of age) diagnosed with ASD according to the Diagnostic Manual-5 criteria), and a control group of 57 typically developing children of similar ages were recruited. A validated food frequency questionnaire was used, and the intake of energy and nutrients was estimated through three non-consecutive 24-h dietary registrations. DPs were assessed using principal component analysis and hierarchical clustering analysis. Children with ASD exhibited a DP characterized by high energy and fat intakes and a low intake of vegetables and fruits. Likewise, meat intake of any type, both lean and fatty, was associated with higher consumption of fish and dietary fat. Furthermore, the increased consumption of dairy products was associated with increased consumption of cereals and pasta. In addition, they had frequent consumption of manufactured products with poor nutritional quality, e.g., beverages, sweets, snacks and bakery products. The percentages of children with ASD complying with the adequacy of nutrient intakes were higher for energy, saturated fat, calcium, and vitamin C, and lower for iron, iodine, and vitamins of group B when compared with control children. In conclusion, this study emphasizes the need to assess the DPs and nutrient intakes of children with ASD to correct their alterations and discard some potential nutritional diseases.