Nutrient intakes and cholesterol values of the parents in a prospective randomized child-targeted coronary heart disease risk factor intervention trial--the STRIP project.

OBJECTIVE: To analyze food consumption, nutrient intakes and serum cholesterol concentrations of the parents in a child-targeted CHD intervention trial, during which the age of children increased from 7 months to 5 y. DESIGN AND SUBJECTS: The children were randomized to an intervention group (n = 540) or a control group (n = 522) at six months of age. The intervention families were counseled at 3-6 month intervals to reduce their child's intake of saturated fat and cholesterol. Dietary issues were discussed with the control families only briefly. The parents' food consumption was analyzed by 24 h dietary recall at the child's age of 7 and 13 months and at 2, 3, 4, and 5 y. Nutrient intakes were calculated using the Micro-Nutrica program. RESULTS: The mothers and fathers of the intervention children used less butter, more margarine and more skim milk than those of the control children (P < 0.001 for all measurements). After the onset of counseling, the intervention mothers consumed continuously less fat (1.4 E% less at the child's age of 5 y), less saturated fat (1.5 E% less at the child's age of 5 y) and more polyunsaturated fat (0.5 E% more at the child's age of 5 y) than the control mothers (P = 0.008, P < 0.001 and P < 0.001 for trend, respectively). After the child's age of 13 months the intervention fathers also had a continuously lower fat intake (2.4 E% less at the child's age of 5 y) and consumed less saturated fat (1.5 E% less at the child's age of 5 y) than the control fathers (P < 0.001 for trend for both measurements). The serum cholesterol concentration of the intervention mothers was consistently lower than that of the control mothers during the intervention (at child's age of 5 y 4.86 and 5.09 mmol/L, respectively; P for trend = 0.03), while the values of the intervention and control fathers showed no differences. CONCLUSIONS: Continuous dietary intervention begun in infancy and focused on modification of the child's diet according to the current principles of preventive cardiology, was accompanied by a moderate decrease in the intake of total and saturated fat in the parents, but serum cholesterol concentration diminished consistently only in the mothers of the intervention children.     

Food-based dietary guidelines--the Austrian perspective

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

Impact of nutrition counselling on nutrition knowledge and nutrient intake of 7- to 9-y-old children in an atherosclerosis prevention project

OBJECTIVE: To assess the impact of nutrition counselling given to 7.5- to 9-y-old children and their parents on children's nutrition knowledge and nutrient intakes. DESIGN AND SUBJECTS: The study children are participants in a prospective, randomised STRIP study (Special Turku Coronary Risk Factor Intervention Project for Children), whose aim was to decrease the intakes of saturated fat and cholesterol while increasing the intake of unsaturated fat in the intervention children from the age of 7 months onwards. Nutrition counselling was given only to the parents until the child's age of 7 y. Nutrition knowledge and nutrient intakes (total energy, total fat, saturated fat, unsaturated fat and sodium) were studied in a time-restricted cohort of 47, 7-y-old intervention and 51 control children. Thereafter, nutrition counselling was given both to the children and parents. Children's nutrition knowledge and nutrient intakes were measured again at the age of 9 y. RESULTS: Biannual nutrition counselling given to the intervention children and the parents maintained the differences in saturated fatty acid intake attained during the intervention given to the parents alone (11.5 vs 13.3 E% (percent of energy intake), at the age of 7 y, P<0.01; 11.1 vs 13.4 E% at the age of 9 y, respectively; P<0.01). The intervention children used more polyunsaturated fatty acids at the age of 9 y than the control children (5.7 vs 5.1 E%, P=0.05). At 7 y, the intervention and control children had similar nutrition knowledge scores (total knowledge score 12.9 vs 12.0, respectively, P=0.13). After 1.5 y of nutrition intervention, at 9 y, the intervention children's nutrition knowledge was higher than that of the controls (total nutrition score 16.5 vs 13.2, respectively, P<0.001) and the ability to explain the reasons for their picture choices in the nutrition knowledge test had increased. CONCLUSION: This study showed that only a relatively short period of counselling with low input is needed to increase in children's nutrition knowledge and ability to explain nutrition-related subjects if advice has first been given to the parents and if the parents have received reinforcement and concrete help with parent-child communication after their children have been involved in the counselling. The differences attained in nutrient intake could also be maintained.     

Effect of low-glycemic-index dietary advice on dietary quality and food choice in children with type 1 diabetes

BACKGROUND: The practicality of diets with a low glycemic index (GI) is controversial. Theoretically, low-GI diets may limit food choice and increase dietary fat intake, but there is little objective evidence to support such a theory. OBJECTIVE: The objective was to determine the effect of low-GI dietary advice on dietary quality and food choice in children with diabetes. DESIGN: Children aged 8-13 y with type 1 diabetes (n = 104) were recruited to a prospective, randomized study comparing the effects of traditional carbohydrate-exchange dietary advice (CHOx) with those of more flexible low-GI dietary advice (LowGI). We determined the effect on long-term macronutrient intake and food choice with the use of 3-d food diaries. RESULTS: There were no differences in reported macronutrient intakes during any of the recording periods. After 12 mo, intakes of dietary fat (33.5 +/- 5.6% and 34.2 +/- 6.7% of energy, P = 0.65), carbohydrate (48.8 +/- 5.4% and 48.6 +/- 6.5% of energy, P = 0.86), protein (17.6 +/- 2.5% and 17.3 +/- 3.7% of energy, P = 0.61), total sugars, and fiber did not differ significantly between the CHOx and LowGI groups, respectively. The average number of different carbohydrate food choices per day also did not differ significantly. Subjects in the lowest-GI quartile consumed less carbohydrate as potato and white bread, but more carbohydrate as dairy-based foods and whole-grain breads than did subjects in the highest-GI quartile. CONCLUSION: Children with diabetes who receive low-GI dietary advice do not report more limited food choices or a diet with worse macronutrient composition than do children who consume a traditional carbohydrate-exchange diet.     

Zinc intake of US preschool children exceeds new dietary reference intakes

BACKGROUND: The recent dietary reference intakes publication provides updated information on the physiologic and dietary requirements for zinc and proposes new tolerable upper intake levels. OBJECTIVE: We analyzed dietary intake data of US preschool children to determine the prevalence of inadequate and excessive intakes of zinc. DESIGN: Diets of 7474 nonbreastfeeding preschool children in the Continuing Survey of Food Intakes by Individuals (1994-1996 and 1998) were analyzed for the intakes of zinc and other dietary components, and factors associated with zinc intake were examined. RESULTS: The mean intakes of zinc by children aged < 1 y, 1-3 y, and 4-5 y were 6.6, 7.6, and 9.1 mg/d, respectively. Less than 1% of children had usual zinc intakes below the adequate intake or estimated average requirement. The percentages of children with intakes exceeding the tolerable upper intake level were 92% (0-6 mo), 86% (7-12 mo), 51% (1-3 y), and 3% (4-5 y). Controlling for age and energy intake, zinc intake was greater in 1998 than in 1994 (P < 0.0001) and was positively associated with participation in the Women, Infants, and Children Program (P < 0.001) and with the lowest income category (P < 0.001). CONCLUSIONS: Preschool children in the United States have dietary zinc intakes that exceed the new dietary reference intakes. Zinc intakes increased during the 4 y of the study. The present level of intake does not seem to pose a health problem, but if zinc intake continues to increase because of the greater availability of zinc-fortified foods in the US food supply, the amount of zinc consumed by children may become excessive.     

Ten-year trends in vitamin and mineral intake from fortified food in German children and adolescents

OBJECTIVE: We investigated time trends in consumption patterns, and energy and nutrient intakes (protein, fat, carbohydrates, added sugars, vitamins A, E, C, B1, B2 and B6, niacin, folate, calcium and iron) from fortified food in children and adolescents between 1987 and 1996 in Germany. DESIGN: Mixed longitudinal survey (DONALD study) with 3 d weighed dietary records (n=2062 from 594 subjects), one subject per family per year chosen by random. SETTING: Dortmund (Western Germany) district cohort. SUBJECTS: 285 males, 309 females; mean age 6 y (2-13 y). RESULTS: Almost all children and adolescents consumed fortified food irrespective of the year studied. With the exception of vitamin E, significant time trends in the proportions of nutrient intakes from fortification were observed. The fortification of food with vitamins A, C, B1, B2 and B6 and niacin raised the already adequate intakes from non-fortified food (100% to 150% of reference intake values) by 20-50%. The fortification of food with vitamin E and folate raised the low intakes from non-fortified food (about 50% of reference intake values) to about 80% (folate) and 100% (vitamin E) of the references. Fortification of food with calcium and iron was not significant (<10%), but while total intake of calcium was adequate, total intake of iron remained critical. CONCLUSIONS: Since the nutrient intake of the population of children and adolescents studied is adequate with respect to vitamins A, C, B1, B2 and B6, niacin and calcium, fortification seems inefficient, while fortification of food with vitamin E and folate, but not iron, improves an inadequate intake. SPONSORSHIP: The DONALD study is supported by the German Federal Ministry of Health and the North-Rhine-Westphalian Ministry of Science and Research. European Journal of Clinical Nutrition (2000) 54, 81-86     

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.     

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

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

Energy and macronutrient intake of one-year-old South African urban children: The Birth to Ten (BTT) Study

Summary. With the changing situation in South Africa, new, reliable, longitudinal nutritional information on young children is needed. Part of the objective of the Birth to Ten (BTT) Study (1990–2000) in the Soweto-Johannesburg area, is to assess the nutrient intake of children. For each of the 2059 one-year-old children mean nutrient intake was determined using food frequency intakes, determined through interviewing parents or guardians. Urban 'coloured' children had the highest daily intake of all the macronutrients, energy being significantly higher than the other groups. Urban black children had the lowest macronutrient intake and energy was significantly lower than that of white children. All groups consumed a typical westernised diet, low in unrefined carbohydrate (47–49% of energy), but high in protein (200% of Recommended Dietary Allowances (RDA)) and fat (38–40% of energy). Among the 'black', 'coloured' and 'white' clinics a difference of approximately 300 kcal/day was noted between the highest and the lowest energy intakes, Pimville and Mofolo showing significantly higher differences among the 'black' clinics. Among the 'coloured' clinics Westbury had a significantly higher energy intake than Eldorado Park. Results have indicated that one-year-old 'coloured' and white children had adequate nutrient intakes, but black and Indian had inadequate energy intakes based on RDA and excluding the contribution of breast milk.     

Dietary energy density in the treatment of obesity: a year-long trial comparing 2 weight-loss diets

BACKGROUND: Consuming foods low in energy density (kcal/g) decreases energy intake over several days, but the effectiveness of this strategy for weight loss has not been tested. OBJECTIVE: The effects on weight loss of 2 strategies for reducing the energy density of the diet were compared over 1 y. DESIGN: Obese women (n = 97) were randomly assigned to groups counseled either to reduce their fat intake (RF group) or to reduce their fat intake and increase their intake of water-rich foods, particularly fruit and vegetables (RF+FV group). No goals for energy or fat intake were assigned; the subjects were instructed to eat ad libitum amounts of food while following the principles of their diet. RESULTS: After 1 y, study completers (n = 71) in both groups had significant decreases in body weight (P < 0.0001). Subjects in the RF+FV group, however, had a significantly different pattern of weight loss (P = 0.002) than did subjects in the RF group. After 1 y, the RF+FV group lost 7.9 +/- 0.9 kg and the RF group lost 6.4 +/- 0.9 kg. Analysis of all randomly assigned subjects also showed a different pattern of weight loss between groups (P = 0.021). Diet records indicated that both groups had similar reductions in fat intake. The RF+FV group, however, had a lower dietary energy density than did the RF group (P = 0.019) as the result of consuming a greater weight of food (P = 0.025), especially fruit and vegetables (P = 0.037). The RF+FV group also reported less hunger (P = 0.003). CONCLUSION: Reducing dietary energy density, particularly by combining increased fruit and vegetable intakes with decreased fat intake, is an effective strategy for managing body weight while controlling hunger.     

Nutrient intake of elderly people with care need and caregivers based on data of the Comprehensive Survey of the Living Conditions of People on Health and Welfare and the National Nutrition Survey in Japan

OBJECTS: This study examined the nutritional intakes of elderly people with care needs and of the caregivers, using data of the Comprehensive Survey of the Living Conditions of People on Health and Welfare and the National Nutrition Survey in 1995. METHODS: Four groups were categorized: elderly people with care needs (65 and older, n = 83), female caregivers (40 and older, n = 95), other elderly people (65 and older, n = 1,818), and other women (40 and older, n = 3,477). The ratios of intakes to dietary reference intakes (DRIs) for energy and 8 nutrients (protein, fat, calcium, iron, vitamin A/B1/B2/C), as well as salt, were compared among those four groups. RESULTS: Mean ratios to DRIs in elderly people with care needs were 108% for energy, 85% for calcium, and 101-224% for the other 7 nutrients. Mean salt intake in this group was 11.0 g/day. For many nutrients, ratios to DRIs were significantly lower than those in other elderly people. Mean ratios to DRIs in caregivers were 104-294% for energy and the 8 nutrients, and mean salt intake was 12.8 g/day, with no significant differences from date for other women. CONCLUSION: This study cast light on the status of the nutrient intake in elderly people with care needs and their caregivers. It was suggested that calcium intake was insufficient in the former.     

Consistency of the Willett semiquantitative food frequency questionnaire and 24-hour dietary recalls in estimating nutrient intakes of preschool children.

A study was performed to determine the utility of the Willett semiquantitative food frequency questionnaire for assessing the habitual diets of preschool children. Children (n = 224) were recruited mainly through a New York City hospital-based pediatric practice during 1986-1987. The children's ages at baseline were 44-60 months; 50% were male, and 91% were Hispanic. Over a 12-month period, the Willett food frequency questionnaire was administered twice to each child's parent, and a 24-hour dietary recall was conducted four times. For energy and eight nutrients, group mean intakes derived from food frequency questionnaires were 1.4-1.9 times higher than those from 24-hour recalls. Group mean estimates of nutrient density of total and saturated fat, potassium, and calcium did not differ between the two methods. Correlations between methods for crude nutrient intakes (unadjusted for energy consumption) ranged from 0.16 (polyunsaturated fat in boys) to 0.60 (potassium in girls). Correlations generally decreased when intakes were adjusted for energy consumption. Adjustment for energy intake and residual intraindividual variability yielded correlations of 0.48 for total calories, 0.35 for total fat, and 0.37 for saturated fat. For intake of energy and nine nutrients, of those children classified into the highest quintile by dietary recall, 28.9-40.9% were so classified by the Willett questionnaire, and 48.9-68.9% were classified into the highest two quintiles. When data were expressed as nutrient densities, agreement was high for potassium and calcium and fair for saturated fat, cholesterol, and protein. The moderately low consistency of nutrient intake estimates across dietary assessment methods in this study may be due, in large part, to residual intraindividual variability in both the recall data and the food frequency data.     

Assessment and significance of 24-h energy intake patterns among young and aged non-affluent southern US women

Energy intake patterns that may impact health status among non-affluent southern U.S. women from small urban communities have not been evaluated extensively. Usual intake estimates are confounded by factors such as validity of intake methods and socioeconomic status. Typical 24-h energy intakes were reported by Caucasian (CA, n=149) and African-American (AA, n=110) women; at 43% of this sub-population, AA women are appropriately and proportionately represented. Daily energy intake was examined for these non-pregnant females, 24 to 93 y of age, to define typical energy, carbohydrate, protein, and fat intake. Study groups were: 24-29 y, 30-39 y, 40-49 y, 50-59 y, 60-69 y, 70-79 y, and 80-93 y. Statistical comparisons of nutrient variables by age were made by least squares means between groups. Body mass index (BMI) calculations accounted for differences in height and relative body mass. Both races reported similar energy intakes and significant (P<0.05) decreases with age were noted. Energy intakes were 15-40% below recommended levels, similar to reported values; senior lunch programs ameliorated declines among some women >60 y. More daily calories (52-62%) were provided by carbohydrates, followed by fat (26-35%) and protein (14-17%) findings in close agreement with health recommendations. Time-of-day intake patterns suggest women >59 y consume larger noon meals. BMI for AA women was greater (P<0.05) than that of CA women between 30-59 y. At 24-29 y, AA women had lowest BMI values; BMI decreases occurred in CA women after 80 y. These factors may impact the health of non-affluent southern AA and CA women, particularly the elderly who may require guidance for diet planning and intake intervention programs.     

The contribution of specific dietary patterns to energy and nutrient intakes in 7–8-year-old Scottish schoolchildren. I. Milk drinking

Energy and nutrient intakes were estimated in 136 7–8-year-old Scottish schoolchildren using the 7-day weighed inventory method. The contribution of liquid milk was assessed by (a) expressing energy and nutrient intake from milk as a percentage of overall intakes; (b) comparing dietary intakes in children with different patterns of milk consumption and (c) investigating the relationships between milk drinking, anthropometry and growth. The average intake of milk in this study was 2.11 l per week and more full-fat than semi-skimmed milk was drunk. Milk contributed around 10% of energy, 13% fat, 30% vitamin A, 36% vitamin B₁₂ and 42% calcium to overall diets. Children with weekly milk intakes of more than 3 l had higher daily intakes of energy and certain micronutrients compared with children with weekly milk intakes of less than 1 l. The overall daily diets of children drinking semi-skimmed milk at home were lower in percentage energy from fat than those of children drinking full-fat milk at home. There was no significant relationship between the type or volume of milk drunk and either anthropometry or growth. It was concluded that (a) intakes of milk in excess of 3 l per week are beneficial in terms of increased micronutrient intakes and (b) the use of semi-skimmed milk may help to decrease intakes of fat in this age group, yet have no adverse effects on anthropometry or growth.     

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

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

Scores on the dietary guideline index for children and adolescents are associated with nutrient intake and socio-economic position but not adiposity

Diet quality indices reflect overall dietary patterns better than single nutrients or food groups. The study aims were to develop a measure of adherence with dietary guidelines applicable to child and adolescent populations in Australia and determine the association between index scores and food and nutrient intake, socio-demographic characteristics, and measures of adiposity. Data were analyzed from 4- to 16-y-old participants of the 2007 Australian Children's Nutrition and Physical Activity Survey (n = 3416). The Dietary Guideline Index for Children and Adolescents (DGI-CA) comprises 11 components: 5 core food groups, wholegrain bread, reduced-fat dairy foods, extra foods (nutrient poor and high in fat, salt, and added sugar), healthy fats/oils, water, and diet variety (possible score of 100). The index criteria were age specific. The mean DGI-CA score was low (53.6 ± 0.4), similar between boys and girls, and differed by age; the youngest children scored higher than the oldest children (P < 0.0001). Higher DGI-CA scores were associated with lower energy intake, energy density, total and saturated fat, and sugar intake; higher protein, carbohydrate, fiber, calcium, iron, vitamin C, vitamin A, folate, phosphorous, magnesium, zinc, and iodine intakes; and a higher polyunsaturated:saturated fat ratio (P < 0.0001). DGI-CA scores were associated with socio-economic characteristics and measures of family circumstance. Weak positive associations were observed between DGI-CA score and BMI or waist circumference Z-scores in the 4- to 10-y and 12- to 16-y age groups only. This index is the first validated index in Australia and one of the few international indices to describe the diet quality of children and adolescents.     

Composition of diet in relation to fat intake of children aged 1–7 years

Very little data are available on the diet of Finnish pre-school children from the last decade. In this study, food consumption data for 77 1–7-year-old Finnish children were collected by means of 3-day estimated food records. In the younger age group (<4 years), on average 15% of total energy was supplied by protein, 36% by fat, 49% by carbohydrates and 14% by sucrose. In the older age group (≥4 years), the proportions were 15%, 34%, 51% and 17%, respectively. Compared with the Nordic nutrition recommendations, the average proportions of fat and sucrose were too high and those of carbohydrate too low. Intakes of vitamins and minerals met or exceeded the recommended allowances, except for iron in the younger age group, and vitamin D in both age groups. Energy and nutrient intakes were compared among children with different proportions of fat in their diet (less than 30%, 30–34%, 35–39%, 40% or more of total energy). There was no difference in the energy intake per kg of body weight between the fat intake groups, and with respect to vitamin and mineral intakes the only differences were in the intakes of vitamin C and selenium. Only in the lowest fat intake group were the proportions of fat, saturated fatty acids and carbohydrates and the intake of cholesterol in accordance with or close to the recommendations. The results of this study support the growing evidence of the nutritional adequacy of a balanced, low-fat diet for pre-school children.     

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.     

Quality of food eaten in English primary schools: school dinners vs packed lunches

OBJECTIVE: To compare the food and nutrient intakes of primary school children eating school dinners and packed lunches. SUBJECTS: Six-hundred and twenty-one 7-year-old children participating in the Avon Longitudinal Study of Parents and Children in South West England. METHODS: Diet was assessed by 3-day unweighed food record. RESULTS: The composition of both types of school meals compared unfavourably with dietary guidelines. Intakes of energy, non-starch polysaccharides (NSP), calcium, iron, folate, retinol equivalents, zinc, copper, magnesium, iodine and riboflavin were too low, and intakes of total and saturated fat were too high. However, children who ate school dinners had higher lunchtime intakes of protein, starch, NSP and most vitamins and minerals and lower intakes of sugar (14.2 and 20.9% of energy in school dinners and packed lunches, respectively, P<0.001) and saturated fat (12.0 and 16.2%, P<0.001). Only around half of the recommended amount of fruit and vegetables was eaten by children having either type of school meal. There were also differences in the whole day's nutrient intake according to school meal type. Children eating packed lunches had lower daily intakes of potassium and zinc, and higher intakes of sugar and saturated fat. Differences in nutrient intake were independent of maternal education. CONCLUSIONS: The food and nutrient content of both school dinners and packed lunches needed improvement. However, the standard of food brought from home by children was, if anything, worse than that served at school. Recent moves to improve school dinners will need to be complemented by education about what constitutes a healthy packed lunch.