Association of Dietary Sugars and Sugar-Sweetened Beverage Intake with Obesity in Korean Children and Adolescents

Few studies have examined the association between dietary sugar intake and obesity in Asian children and adolescents. We evaluated the association of dietary sugar intake and its food source with obesity in Korean children and adolescents. In this cross-sectional analysis, data were obtained from five studies conducted between 2002 and 2011. The study included 2599 children and adolescents who had completed more than three days of dietary records and had anthropometric data. Total sugar intake was higher in girls than in boys (54.3 g for girls and 46.6 g for boys, p < 0.0001). Sugar intake from milk and fruits was inversely associated with overweight or obesity in girls only (OR for overweight, 0.52; 95% CI, 0.32–0.84; p for trend = 0.0246 and OR for obesity, 0.42; 95% CI, 0.23–0.79; p for trend = 0.0113). Sugar-sweetened beverage (SSB) consumption was not associated with obesity in girls, while boys had lower odds ratios for obesity (OR for obesity, 0.52; 95% CI, 0.26–1.05; p for trend = 0.0310). These results suggest that total sugars and SSB intake in Asian children and adolescents remains relatively low and sugar intake from milk and fruits is associated with a decreased risk of overweight or obesity, especially in girls.     

The Association between Maternal Sugar-Sweetened Beverage Consumption and Infant/Toddler Added Sugar Intakes

Intake of added sugars during early life is associated with poor health outcomes. Maternal dietary intake influences the intake of their children, but little research investigates the relationship between maternal sugar sweetened beverage (SSB) and infant/toddler added sugar intakes. Our objective was to explore the relationship between maternal total sugars and SSB intakes and infant/toddler added sugar intakes. This cross-sectional study (n = 101) of mother-infant dyads measured maternal dietary intake by food frequency questionnaire and infant intake by three 24-h dietary recalls. Pearson’s correlations explored the relations between maternal total sugars and SSB intakes and infant added sugar intakes. Hierarchical stepwise regressions determined if maternal total sugars and SSB intakes explained the variation in infant added sugar intakes after accounting for known risk factors for early introduction of added sugars. Maternal total sugars (r = 0.202, p = 0.043) and SSB (r = 0.352, p < 0.001) intakes were positively correlated with infant/toddler added sugar intakes. In the hierarchical models, maternal total sugar intakes did not account for more variance in infant added sugar intakes (β = 0.046, p = 0.060), but maternal SSB intake was a significant contributor of infant added sugar intakes (β = 0.010, p = 0.006) after accounting for confounders. Interventions to reduced maternal SSB consumption may help reduce infant/toddler added sugar intakes.     

Iodine Intake from Food and Iodized Salt as Related to Dietary Salt Consumption in the Italian Adult General Population

Since the Italian iodoprophylaxis strategy is based on the use of iodized salt, we assessed the relationship between dietary salt consumption and iodine intake in the Italian adult population. We estimated the relative contribution given by the use of iodized salt and by the iodine introduced by foods to the total iodine intake. The study population included 2219 adults aged 25–79 years (1138 men and 1081 women) from all Italian regions, participating to the Osservatorio Epidemiologico Cardiovascolare/Health Examination Survey 2008–2012 (OEC/HES), and examined for sodium and iodine intake in the framework of the MINISAL-GIRCSI Programme. Dietary sodium and total iodine intake were assessed by the measurement of 24 h urinary excretion, while the EPIC questionnaire was used to evaluate the iodine intake from food. Sodium and iodine intake were significantly and directly associated, upon accounting for age, sex, and BMI (Spearman rho = 0.298; p < 0.001). The iodine intake increased gradually across quintiles of salt consumption in both men and women (p < 0.001). The European Food Safety Authority (EFSA) adequacy level for iodine intake was met by men, but not women, only in the highest quintile of salt consumption. We estimated that approximately 57% of the iodine intake is derived from food and 43% from salt. Iodized salt contributed 24% of the total salt intake, including both discretionary and non-discretionary salt consumption. In conclusion, in this random sample of the Italian general adult population examined in 2008–2012, the total iodine intake secured by iodized salt and the iodine provision by food was insufficient to meet the EFSA adequate iodine intake.     

Dietary sugar intake and dietary behaviors in Korea: a pooled study of 2,599 children and adolescents aged 9-14 years

BACKGROUND/OBJECTIVESDietary sugar intake, particularly added sugar and sugar-sweetened beverages, has received worldwide attention recently. Investigation of dietary behaviors may facilitate understanding of dietary sugar intakes of children and adolescents. However, the relationship between dietary sugar intake and dietary behaviors in the Korean population has not been investigated. Thus, this study aimed to estimate dietary sugar intake and food sources according to sex as well as examine the relationship of dietary sugar intake with frequent snacking and dietary patterns among Korean children and adolescents.SUBJECTS/METHODSWe pooled data from five studies involving Korean children and adolescents conducted from 2002 to 2011. A total of 2,599 subjects aged 9-14 years were included in this study. Each subject completed more than 3 days of dietary records.RESULTSMean daily total sugar intake was 46.6 g for boys and 54.3 g for girls. Compared with boys, girls showed higher sugar intakes from fruits (7.5 g for boys and 8.8 g for girls; P = 0.0081) and processed foods (27.9 g for boys and 34.9 g for girls; P < 0.0001). On average, 95.4% of boys and 98.8% of girls consumed snacks during the study period, and total sugar intake showed a significantly increasing trend with increasing energy intake from snacks (P < 0.0001 for both sexes). Two dietary patterns were identified by cluster analysis: Traditional and Westernized patterns. Total sugar intake was higher in the Westernized pattern (56.2 g for boys and 57.2 g for girls) than in the Traditional pattern (46.5 g for boys and 46.3 g for girls).CONCLUSIONSThese results suggest that multilateral and practical development of a nutrition education and intervention program that considers dietary behaviors as well as absolute sugar intake is required to prevent excessive sugar intake in Korean children and adolescents.     

Sugar-Sweetened Beverage Consumption Status and Its Association with Childhood Obesity among Chinese Children Aged 6–17 Years

Objective: There is a remarkable growth in sugar-sweetened (SSB) production and obesity prevalence among school-aged children in China. This paper describes SSB consumption and its association with obesity among Chinese children aged 6–17 years in 2012. Methods: in total, 25,553 children aged 6~17 years enrolled in the China Nutrition and Health Surveillance 2010–2013 were included in this study. Data of SSB consumption frequency and quantity were obtained from a food frequency questionnaire, and the children’s nutritional status was assessed. Multivariate logistic regression was used to evaluate the association between SSB consumption and obesity status. Results: SSB intake was estimated as 181.0 g/day, occurring 2.2 times/week. Older children, males, children from urban areas, and children with higher socioeconomic status were more likely to consume SSBs. Children who consumed SSBs 1~<5 times/week (11.7%) and >5 times/week (12.9%) were more likely to be overweight/obesity than those who consumed SSBs less than once/week. Conclusion: SSB consumption was common among Chinese school-aged children, especially among males, older children, and children from urban areas. High consumption of SSBs was associated with a higher prevalence of overweight/obesity. Actions and plans are required to reduce SSB consumption and control childhood obesity in China.     

Association of Dietary Patterns with Weight Status and Metabolic Risk Factors among Children and Adolescents

Unhealthy dietary patterns are associated with obesity in children and adolescents. However, few studies have investigated the relationships between dietary patterns and obesity-related metabolic disorders among Asians. We identified dietary patterns in children and adolescents and examined the associations between these patterns and obesity, insulin resistance, and metabolic syndrome in South Korea. This study is a cross-sectional design. We used baseline data from an intervention study of 435 Korean children and adolescents aged 6–17 years. Insulin resistance was assessed as HOMA-IR ≥ 2.6. Metabolic syndrome was diagnosed by cardiovascular disease risk factor clustering. Dietary intakes were estimated using 3-day food records. Factor analysis was used to obtain dietary patterns, and we examined the associations between dietary patterns and obesity-related markers adjusted for potential covariates. Three dietary patterns were identified as fast food and soda (FFS), white rice and kimchi (WRK), and oil and seasoned vegetable (OSV) patterns. Compared with participants in the lower intake of FFS pattern, those in the top intake were associated with a higher waist circumference (WC) (β = 1.55), insulin level (β = 1.25), and body mass index (BMI) (β = 0.53) and it was positively associated with HOMA-IR ≥ 2.6 (OR = 2.11; 95% CI: 1.227–3.638) (p < 0.05). WRK pattern was associated with lower weight and higher HDL cholesterol, and the OSV pattern was associated with a lower weight, WC, and insulin level (p < 0.05). The FFS pattern showed a positive relation with WC, serum insulin, and BMI, and the other two dietary patterns indicated a preventive effect of those parameters. The FFS pattern was associated with significantly elevated insulin resistance among children and adolescents.     

Association between sugar-sweetened beverage consumption and depression and suicidal ideation among Korean adults: a cross-sectional study from the 2014 and 2016 Korean National Health and Nutrition Examination Survey (KNHANES)

BACKGROUND/OBJECTIVESSugar-sweetened beverages (SSBs) are regarded as modifiable risk factors for mental health in several populations. Although the consumption of SSBs is steadily increasing in Korea, there is scant evidence regarding the impact of SSB consumption on depression and suicidal ideation. The aim of this study was to investigate the association of SSB consumption with depression and suicidal ideation among adults in Korea.SUBJECTS/METHODSWe used the data for 5,465 participants (2,170 men and 3,295 women) aged ≥ 20 years from the 2014 and 2016 Korea National Health and Nutrition Examination Survey. The subjects were divided into four groups according to SSB consumption using a food frequency questionnaire. Logistic regression analyses were conducted to examine the association of SSB consumption with depression and suicidal ideation, adjusting for sociodemographic, health behavior, and dietary variables.RESULTSParticipants consuming ≥ 1 SSB/day had a significantly higher risk of depression (odds ratio [OR], 1.54; 95% confidence interval [CI], 1.08–2.18; P < 0.001) and suicidal ideation (OR, 2.20; 95% CI, 1.13–4.28; P < 0.001) compared with those in the non-SSB group after adjusting for potential confounding factors.CONCLUSIONSOur results suggest that SSB consumption is positively associated with depression and suicidal ideation in Korean adults.     

Agreement between an Image-Based Dietary Assessment Method and a Written Food Diary among Adolescents with Type 1 Diabetes

Valid and useful dietary assessment methods for adolescents with type 1 diabetes (T1D) are needed. In this study, we compared an image-based method with a written food diary for dietary intake estimation among adolescents with T1D and evaluated the adolescents’ experiences of the methods. Adolescents with T1D aged 13 to 18 years (n = 13) photographed their meals (n = 264) with a mobile phone camera and simultaneously kept a written food diary for four consecutive days. The participants filled out electronic background and feedback questionnaires. The agreement between the methods was evaluated using intraclass correlation coefficients (ICCs) and Bland–Altman plot analyses. The agreement between the methods was moderate to excellent for the energy intake (ICC = 0.91, 95% confidence interval (CI): 0.66 to 0.97, p < 0.001) and good to excellent for total carbohydrate intake (ICC = 0.95, 95% CI: 0.84 to 0.99, p < 0.001). The adolescents considered photographing easier and faster than keeping a food diary. In conclusion, the image-based method appeared comparable to the food diary for dietary intake estimation among adolescents with T1D. The photographing of meals may become a useful dietary assessment tool for adolescents with T1D, but must be further developed and validated.     

Meeting 24-Hour Movement and Dietary Guidelines: Prevalence,Correlates and Association with Weight Status among Children and Adolescents: A National Cross-Sectional Study in China

China is confronted with a “double burden” of underweight and overweight/obesity in children and adolescents. This study aimed to investigate the prevalence and correlates of meeting 24 h movement and dietary guidelines among Chinese children and adolescents. Further, the study aimed to examine the association of meeting 24 h movement and dietary guidelines with weight status in Chinese children and adolescents. A total of 34,887 Chinese children and adolescents were involved. Only 2.1% of participants met the 24 h movement guidelines. Compared to those who met all three 24 h movement guidelines, those who only met the sleep duration guideline was significantly associated with a higher risk of underweight (p < 0.05), and those who only met the moderate-to-vigorous physical activity, or screen time guidelines were significantly associated with a higher risk of overweight/obesity (p < 0.05). Compared with those meeting the dietary guidelines, those who did not meet the soft drink intake guideline had a significantly lower risk of underweight (p < 0.05), those who did not meet the fruit intake guideline had a significantly lower risk of overweight/obesity (p < 0.05), and those who did not meet the milk intake guideline showed a significantly higher risk of overweight/obesity (p < 0.001). These findings indicate a significant association between meeting the 24 h movement and dietary guidelines and weight status among Chinese children and adolescents.     

Dietary Intake of Folate and Assessment of the Folate Deficiency Prevalence in Slovenia Using Serum Biomarkers

Folate deficiency is associated with various health issues, including anemia, cardiovascular disease, and birth defects. Low folate intake and suboptimal folate status were found in several countries; however, this topic has not yet been investigated in Slovenia. Dietary folate intake and serum folate status were investigated through the nationally representative food consumption study SI.Menu/Nutrihealth. Folate intake was estimated using a sample of N = 1248 subjects aged 10–74 years, stratified in three age groups (adolescents, adults, elderly population), through two 24 h-dietary recalls and food propensity questionnaire. Data on serum folate and homocysteine was available for 280 participants. Very low folate intake (<300 µg/day) was observed in 59% of adolescents, 58% of adults and 68% of elderlies, and only about 12% achieved the WHO recommended level of 400 µg/day. Major dietary contributors were vegetables and fruit, and cereal products. Living environment, education, employment status and BMI were linked with low folate intake in adults; BMI, and sex in adolescents; and sex in elderlies. Considering low serum folate (<7 nmol/L) and high serum homocysteine (>15 nmol/L), folate deficiency was found in 7.6 and 10.5% in adults and elderlies, respectively. Additional public health strategies should be employed to promote the consumption of folate-rich foods. With current folate intakes, supplementation with folic acid is relevant especially in specific vulnerable populations, particularly in women planning and during pregnancy.     

Omega-3 Long-Chain Polyunsaturated Fatty Acids Intake in Children: The Role of Family-Related Social Determinants

Omega-3 long-chain polyunsaturated fatty acids play a central role in neuronal growth and in the development of the human brain, since they are essential elements which depend on intake through diet to ensure an adequate amount. Fish and seafood are the main dietary sources of these fatty acids in Spain and in other countries. In order to assess the effect of the intake of common foods containing high amounts of omega-3 polyunsaturated fatty acids, a food frequency questionnaire was administered to parents of children and adolescents attending a primary school in Valencia (Spain), and the intake of dietary omega-3 such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) was estimated based on their fish/seafood consumption. Low frequencies of intake were significantly (p < 0.05) lower for many types of fish/seafood in children compared to adolescents. 27.5% of children/adolescents did not eat lean fish or other types (19.8% of the sample did not eat fatty fish, and 71.8% did not eat smoked fish) and 20–60% of the sample consumed seafood only once–three times a month, leading to a reduced estimated intake of EPA+DHA below that recommended for both groups by public health agencies. Social aspects, such as the type of work done by mothers and their educational levels are significant factors (p < 0.05 in both cases) affecting children’s/adolescents’ intake of DHA+EPA. Dietary interventions to increase the consumption of fish and seafood are strongly advised, and health promotion strategies should be aimed at the family level and fight against gender disparities.     

Socioeconomic position and consumption of sugary drinks,sugar-sweetened beverages and 100% juice among Canadians: a cross-sectional analysis of the 2015 Canadian Community Health Survey–Nutrition

ObjectiveThe aim of this study was to describe sugary drink (beverages with free sugars), sugar-sweetened beverage (beverages with added sugars, SSB) and 100% juice (beverages with natural sugars) consumption across socioeconomic position (SEP) among Canadians.MethodsWe conducted a cross-sectional analysis of 19,742 respondents of single-day 24-h dietary recalls in the nationally representative 2015 Canadian Community Health Survey–Nutrition. Poisson regressions were used to estimate the prevalence of consuming each beverage type on a given day. Among consumers on a given day, linear regressions were used to estimate mean energy intake. Models included household education, food security and income quintiles as separate unadjusted exposures. Sex-specific models were estimated separately for children/adolescents (2–18 years) and adults (19 +).ResultsAmong female children/adolescents, the prevalence of consuming sugary drinks and, separately, SSB ranged from 11 to 21 and 8 to 27 percentage-points higher among lower education compared to ‘Bachelor degree or above’ households. In female adults, the prevalence of consuming sugary drinks and, separately, SSB was 10 (95% CI: 1, 19) and 14 (95% CI: 2, 27) percentage-points higher in food insecure compared to secure households. In males, the prevalence of consuming 100% juice was 9 (95% CI: − 18, 0) percentage-points lower among food insecure compared to secure households. Social inequities in energy intake were observed in female adult consumers, among whom mean energy from sugary drinks was 27 kcal (95% CI: 3, 51) higher among food insecure compared to secure and 35 kcal (95% CI: 2, 67) higher from 100% juice among ‘less than high school’ education compared to ‘Bachelor degree or above’ households.ConclusionSocial inequities in sugary drink consumption exist in Canada. The associations differed by SEP indicator. Equitable interventions to reduce consumption are warranted.     

Sugar-Sweetened Beverages and Symptom Complaints among School-Aged Children: A National Longitudinal Study

The association between sugar-sweetened beverages (SSBs) and symptom complaints among school-aged children remains unclear. Children aged 6–17 years (n = 29,028) were recruited on the basis of a national school-based study. Data collection included two waves: the exposure was the amount and frequency of SSB consumption, collected in the 2013 autumn semester, and outcomes were defined as having clinical symptom complaints after two weeks of observation, collected in the 2014 spring semester. Symptom complaints were defined as fever, cough, headache, loose bowels, vomiting, sore throat, rash, conjunctival congestion, and stomachache. The associations between the amount/frequency of SSBs and symptoms complaints were explored by a general linear model, with adjustments made for socio-demographic and other lifestyle information. Among the 12,454 children (10.32 ± 3.15 years, 48.7% male) in the final analysis, the odds ratio for having symptom complaints (1.46, 95% CI: 1.10–1.95) among children whose SSB consumption was >75 mL/day was significantly higher than that among children who had no SSB consumption. Among children with a daily SSB intake of more than 75 mL, there was a higher risk for symptom complaints. We recommend more support for decreasing SSB consumption among children to minimize negative health outcomes.     

Vital Signs: Sodium Intake Among U.S. School-Aged Children — 2009–2010

Background

A national health objective is to reduce average U.S. sodium intake to 2,300 mg daily to help prevent high blood pressure, a major cause of heart disease and stroke. Identifying common contributors to sodium intake among children can help reduction efforts.

Methods

Average sodium intake, sodium consumed per calorie, and proportions of sodium from food categories, place obtained, and eating occasion were estimated among 2,266 school-aged (6–18 years) participants in What We Eat in America, the dietary intake component of the National Health and Nutrition Examination Survey, 2009–2010.

Results

U.S. school-aged children consumed an estimated 3,279 mg of sodium daily with the highest total intake (3,672 mg/d) and intake per 1,000 kcal (1,681 mg) among high school–aged children. Forty-three percent of sodium came from 10 food categories: pizza, bread and rolls, cold cuts/cured meats, savory snacks, sandwiches, cheese, chicken patties/nuggets/tenders, pasta mixed dishes, Mexican mixed dishes, and soups. Sixty-five percent of sodium intake came from store foods, 13% from fast food/pizza restaurants, 5% from other restaurants, and 9% from school cafeteria foods. Among children aged 14–18 years, 16% of total sodium intake came from fast food/pizza restaurants versus 11% among those aged 6–10 years or 11–13 years (p<0.05). Among children who consumed a school meal on the day assessed, 26% of sodium intake came from school cafeteria foods. Thirty-nine percent of sodium was consumed at dinner, followed by lunch (29%), snacks (16%), and breakfast (15%).

Implications for Public Health Practice

Sodium intake among school-aged children is much higher than recommended. Multiple food categories, venues, meals, and snacks contribute to sodium intake among school-aged children supporting the importance of populationwide strategies to reduce sodium intake. New national nutrition standards are projected to reduce the sodium content of school meals by approximately 25%–50% by 2022. Based on this analysis, if there is no replacement from other sources, sodium intake among U.S. school-aged children will be reduced by an average of about 75–150 mg per day and about 220–440 mg on days children consume school meals.     

Low Healthy Diet Self-Efficacy and Intentions Associated with High Sweet Snacks and Sugar Sweetened Beverages Consumption among African American Adolescents Recruited from Low-Income Neighborhoods in Baltimore

Psychosocial factors may influence consumption patterns of sweet snacks and sugar sweetened beverages (SSB), which are potential risk factors for obesity among African American (AA) adolescents. We used multivariable linear and logistic regression models to examine cross-sectional associations among psychosocial factors, sweet snacks and SSB consumption, and BMI z-scores in 437 AA adolescents aged 9–14 years living in low-income neighborhoods in Baltimore City, U.S.A. Mean caloric intake from sugar was 130.64 ± 88.37 kcal. Higher sweet snacks consumption was significantly associated with lower self-efficacy (adjusted Odds Ratio (aOR) = 0.81; 95% CI = 0.71 to 0.93) and lower food intentions scores (0.43; 0.30 to 0.61). Higher SSB consumption was associated with lower outcome expectancies (aOR = 0.98; 95% CI = 0.96–0.99), lower self-efficacy (0.98; 0.96 to 0.99), and lower food intentions (0.91; 0.87 to 0.95). No significant association was found between SSB and sweet snacks consumption and weight status. Psychosocial factors may play a role in sugar consumption behaviors among AA adolescents in low-income neighborhoods. Further studies are needed to improve our understanding of causal mechanisms of this association.     

Do Children with Attention-Deficit/Hyperactivity Disorder Follow a Different Dietary Pattern than That of Their Control Peers?

Attention-deficit/hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders in children and adolescents. A current area of interest is the association between ADHD and food consumption. The aim of this study was to determine the food consumption and dietary patterns of children with and without ADHD in relation to their age and ADHD presentation. The study involved 259 preschoolers aged 3 to 6 years old (57 with ADHD and 202 controls) and 475 elementary-school-age children, aged 10 to 12 years old (213 with ADHD and 262 controls) from Spain. ADHD was diagnosed in accordance with the Diagnostic and Statistical Manual of Mental Disorders (5th edition) from Schedule for Affective Disorders and Schizophrenia for School-Age Children interviews. Eating data were collected using a food consumption frequency questionnaire, and principal component analysis was carried out to analyze dietary patterns. Western-like, sweet, and healthy patterns were identified. The ADHD group was negatively associated with the healthy pattern (p < 0.001) and positively associated with the Western-like diet (p = 0.004). Children with inattentive presentation showed lower adherence (12.2%) to a healthy pattern than that of the control group (39.9%) (p < 0.001). There is an association between ADHD and dietary habits; children with inattentive presentation may particularly be at risk of unhealthy eating habits.     

Low Calorie Beverage Consumption Is Associated with Energy and Nutrient Intakes and Diet Quality in British Adults

It is unclear whether consumption of low-calorie beverages (LCB) leads to compensatory consumption of sweet foods, thus reducing benefits for weight control or diet quality. This analysis investigated associations between beverage consumption and energy intake and diet quality of adults in the UK National Diet and Nutrition Survey (NDNS) (2008–2011; n = 1590), classified into: (a) non-consumers of soft drinks (NC); (b) LCB consumers; (c) sugar-sweetened beverage (SSB) consumers; or (d) consumers of both beverages (BB), based on 4-day dietary records. Within-person data on beverage consumption on different days assessed the impact on energy intake. LCB consumers and NC consumed less energy and non-milk extrinsic sugars than other groups. Micronutrient intakes and food choices suggested higher dietary quality in NC/LCB consumers compared with SSB/BB consumers. Within individuals on different days, consumption of SSB, milk, juice, and alcohol were all associated with increased energy intake, while LCB and tea, coffee or water were associated with no change; or reduced energy intake when substituted for caloric beverages. Results indicate that NC and LCB consumers tend to have higher quality diets compared with SSB or BB consumers and do not compensate for sugar or energy deficits by consuming more sugary foods.     

Nutrient Intakes among Children and Adolescents Eating Usual Pizza Products in School Lunch Compared with Pizza Meeting HealthierUS School Challenge Criteria

Pizza is a popular food that can contribute to high intakes of saturated fat and sodium among children and adolescents. The objective of this study was to compare daily nutrient intakes when a pizza product meeting the US Department of Agriculture's criteria for competitive food entrées under the HealthierUS School Challenge (HUSSC) was substituted for usual pizza products consumed during foodservice-prepared school lunch. The study used National Health and Nutrition Examination Survey (2005-2008) dietary recall data from a cross-sectional sample of US children and adolescents (age 5 to 18 years, n=337) who ate pizza during school lunch on 1 day of dietary recall. Daily nutrient intakes based on the consumption of usual pizza products for school lunch (pre-modeled) were compared with intakes modeled by substituting nutrient values from an HUSSC whole-grain pizza product (post-modeled). Paired t tests were used to make the comparison. Post-modeled intakes were lower in daily energy, carbohydrate, total fat, saturated fat, cholesterol, and sodium compared with pre-modeled intakes among children and adolescents (P<0.01). Protein, dietary fiber, vitamin A, and potassium intakes were higher in the post-modeled intake condition compared with the pre-modeled condition (P<0.01). Substituting the healthier pizza product for usual pizza products may significantly improve dietary quality of children and adolescents eating pizza for school lunch, indicating that it could be an effective approach to improve the nutritional quality of school lunch programs.     

Nutrient Intake and Status of German Children and Adolescents Consuming Vegetarian,Vegan or Omnivore Diets: Results of the VeChi Youth Study

There is a lack of data on associations between modern vegetarian and vegan diets and health among children and adolescents. The aim of the Vechi Youth Study was to cross-sectionally examine anthropometry, dietary intakes and nutritional status in a sample of 149 vegetarian, 115 vegan and 137 omnivore children and adolescents (6–18 years old, mean age: 12.7 ± 3.9 years). Group differences of dietary intake (calculated from three-day dietary records), nutrient biomarker and blood lipid concentrations were assessed using an analysis of covariance, adjusted for sex, age and other covariates. The total energy intake did not differ significantly between groups, but intake of carbohydrates was higher among vegetarians and vegans than among omnivores (p = 0.0002, respectively). The median protein intake exceeded 0.9 g/kg body weight/day in all diet groups and was lowest among vegetarians (p < 0.02). There was no significant difference of haemoglobin, vitamin B2, 25-OH vitamin D3, HDL-C and triglycerides blood concentrations between diet groups. Vegan participants had higher folate concentrations than vegetarian participants (p = 0.0053). Ferritin concentration was significantly higher in omnivores than in vegetarians (p = 0.0134) and vegans (p = 0.0404). Vegetarians had lower concentrations of holotranscobalamin (p = 0.0042) and higher concentrations of methylmalonic acid (p = 0.0253) than omnivores. Vegans had the lowest non-HDL-C and LDL-C concentrations in comparison to vegetarians (p = 0.0053 and p = 0.0041) and omnivores (p = 0.0010 and p = 0.0010). A high prevalence (>30%) of 25-OH vitamin D3 and vitamin B2 concentrations below reference values were found irrespective of the diet group. In conclusion, the Vechi Youth Study did not indicate specific nutritional risks among vegetarian and vegan children and adolescents compared to omnivores.     

Trends in sodium intake and major contributing food groups and dishes in Korea: the Korea National Health and Nutrition Examination Survey 2013–2017

BACKGROUND/OBJECTIVESExcess intake of dietary sodium, either directly or indirectly, increases the risk of several diseases, including cardio-cerebral vascular diseases such as stroke and hypertension. Excessive sodium intake and increased prevalence of hypertension have emerged as major issues worldwide. Therefore, the present study evaluated the recent trends in dietary sodium intake and the food sources of sodium intake in the Korean population using the Korea National Health and Nutrition Examination Survey (KNHANES, 2013–2017) data.SUBJECTS/METHODSThis study used the one-day 24-h recall dietary intake survey data from the 2013–2017 KNHANES to determine the average daily sodium intake by sex and age and the main dishes and food groups contributing to the dietary sodium intake.RESULTSThe mean sodium intake range was 3,477.2–3,889.6 mg/day during 2013–2017. The major food groups contributing to sodium intake were seasonings (1,597.5–1,870.5 mg/day), vegetables (680.4–756.7 mg/day), and cereal and grains (573.2–609.4 mg/day). Noodles and dumplings (536.7–573.2 mg/day), kimchi (487.3–539.6 mg/day), and soups (367.6–428.9 mg/day) were the top three dish groups that contributed to the sodium intake. In these dishes, the major sources of sodium intake were ramyeon (age groups 10–18 and 19–29 yrs), baechukimchi (age groups 40–49 and 50–59 yrs) and doenjang-kuk (age groups 60–69 and ≥ 70 yrs), respectively.CONCLUSIONSIn summary, reducing the consumption of soups and kimchi is an effective way to reduce sodium intake. Personalized nutrition education on dietary sodium intake management is required because of the different food sources contributing to the sodium intake according to the subjects'' age.