Physical activity in relation to energy intake and body fat in 8- and 13-year-old children in Sweden

A random sample of 682 8- and 13-year-old children resident in Sweden was studied with regard to physical activity, energy intake, height, weight and skinfold thickness. A reduction of physical activity over the years was indicated by a tendency towards a higher body fat content in spite of a lower mean energy intake as compared with such values obtained 10-15 years ago in Swedish children of equal ages. Children characterized by high habitual physical activity tended to have a lower body fat content, despite a higher energy intake, than less active children. Children, especially girls, of parents with a low educational level showed a tendency towards higher body fat content as compared with those of parents with higher education.     

Effect of growth hormone therapy on feeding problems and food intake in children with growth disorders

To assess the effect of therapeutic doses of growth hormone (GH) on the feeding problems, food intake, body fat and mealtime interactions of children with growth disorders, an age-matched group of 46 children with Turner syndrome (TS) or Silver Russell syndrome (SRS) was examined using questionnaire measures and direct observation. The children's body fat was measured using bio-electrical impedance analysis and skinfold thickness measurements. Children receiving GH consumed significantly more energy, protein, fat and carbohydrate than did the children who were not receiving GH, independent of the extent of the child's feeding problems. Children receiving GH had less body fat than did children who were not receiving GH. Children who were not receiving GH distracted their parents from the mealtime significantly more often and received more negative prompting and coaxing from their parents to eat than did children who were receiving GH. This study provides evidence to support the theory that appetite and intake is determined in part by growth and growth potential. Feeding problems seen in children with growth disorders are partly due to parental attempts to impose control over their child's intake, when their child consumes less than the parent believes to be adequate. Conclusion: GH has a significant impact on both the food intake and parent-child interaction at mealtimes of children with SRS and TS.     

Low-density lipoprotein subclasses in children under 10 years of age

OBJECTIVE: To examine the prevalence of small dense low density lipoprotein (LDL) in a cohort of children under 10 years of age and to investigate the relationship to other biochemical variables and to measures of fatness. A preponderance of small dense LDL (pattern B), is associated with obesity, abdominal fat accumulation, insulin resistance and risk of heart disease in adults. METHODOLOGY: LDL peak particle diameter (PPD) was determined by gel electrophoresis in 53 children under 10 years of age and in 65 of their parents: apoproteins A1 and B were determined by turbidimetry. Anthropometric variables, basic lipid profiles, insulin and leptin had been determined previously. Differences between patterns A (large light particles > 25.5 nm diameter) and B were examined by t-test, Chi-square, or Mann-Whitney test. Relationships between the variables were reported as Pearson correlation coefficients. RESULTS: Pattern B (PPD of < or = 25.5 nm) prevalence was 7.5% in children and 11% in parents (17% in men and 5% in women). Most of the children (86%) who had PPD < or = 26.0 nm also had parents with PPD in this range. A strong association was found between children's and mother's PPD (r=0.60, P < 0.001), but this was somewhat less with fathers (r=0.40, P=0.02). Children in the lowest tertile of PPD had a tendency towards a higher body mass index, waist, fat mass and insulin. CONCLUSIONS: The prevalence of small dense LDL is lower in children under 10 years of age than in their parents; fathers had a higher prevalence of pattern B than mothers and there is some evidence of a familial effect in the inheritance of pattern B.     

Impact of nutrient density of nocturnal enteral feeds on appetite: a prospective, randomised crossover study.

OBJECTIVE: To determine whether the energy density of isocaloric nocturnal enteral feeds (NEF) influences daily nutrient intake in children. METHOD: In a 6 week, randomised, crossover trial, the impact on spontaneous nutrient intake of manipulating the energy density of two isocaloric overnight feeds (1.0 kcal/ml and 1.5 kcal/ml) was compared in a group of 32 children aged 1-10 years (or 8-25 kg body weight) on long term, overnight enteral feeding at home. Total daily oral energy, protein, fat and carbohydrate intake were assessed using 3 day food diaries. Anthropometric data were also recorded during the study. RESULTS: Spontaneous intakes of energy, protein, fat and carbohydrate from food were 20-30% greater when receiving the lower nutrient density feed (1 kcal/ml). This was due to a gender effect; males consumed twice as much protein from food than females and had slightly higher (but not significant) energy and fat intakes when on the larger volume feed. All children increased in weight, height and mid-upper arm circumference in the 6 week period. CONCLUSIONS: Children appear to tolerate and grow equally well, irrespective of the nutrient density and volume of NEF taken. However, it appears that children will consume a more energy and nutrient dense oral diet when given their NEF as a higher volume/lower nutrient density feed. This is particularly so for boys, while for girls the volume of NEF or feed concentration appeared to have no impact on quantity of oral diet taken. However, further blinded studies with larger subject numbers would be useful to support these findings.     

Regulation of growth of 7- to 36-month-old children by energy and fat intake in the prospective, randomized STRIP baby trial

OBJECTIVE: To study the fat and energy intakes of children between 7 and 36 months of age with different growth patterns. METHODS: In the Special Turku coronary Risk factor Intervention Project for Babies, children were randomized to intervention (n = 540) and control groups (n = 522) at age 7 months. The intervention was aimed at replacing part of the saturated fat intake with monounsaturated and polyunsaturated fat to reduce children's exposure to high serum cholesterol values. The control children consumed a free diet. Children followed for >2 years (n = 848) were included in the analysis. Five groups of children representing different extreme growth patterns during the first 3 years of life were formed, and their energy and fat intakes were analyzed. Relative weight was defined as deviation of weight in percentages from the mean weight of healthy children of same height and sex, and relative height as deviation of height in SD units from the mean height of healthy children of same age and sex. RESULTS: Relative fat intakes (as percent of energy intake) were similar in children showing highly different height gain patterns. The thin (mean relative weight /= 95%) and the obese (mean relative weight >/= 95%) were highest, but weight-based energy intake of the tall (at 2 years, 82 [13] kcal/kg) and the obese (79 [17] kcal/kg) were lower than that of children with normal growth (89 [16] kcal/kg). The thin children consumed relatively more energy than the children with normal growth (at 2 years, 94 [13] kcal/kg and 89 [16] kcal/kg, respectively). Parental height and body mass index and the child's absolute and relative energy intakes predicted the best children's growth patterns. Children with consistently low fat intake grew equally to the children with higher fat intake. CONCLUSIONS: Moderate supervised restriction of fat intake to values 25 to 30 E% is compatible with normal growth.     

Daily physical activity related to body fat in children aged 8-11 years

OBJECTIVE: To evaluate the association between objectively measured daily physical activity and body fat. STUDY DESIGN: Cross-sectional, observational, study of 248 children aged 7.9 to 11.1 years. Abdominal fat mass and total body fat mass were measured by dual-energy X-ray absorptiometry. Daily physical activity was assessed by accelerometers for 4 days. RESULTS: Total body fat expressed as a percentage of body mass was inversely related to minutes of vigorous physical activity per day, for all children r = -0.38 (P < .05). Children, both boys and girls, in the highest quartile of body fat performed on average 12 minutes less vigorous activity per day compared with their counterparts in the lowest quartile. Multiple regression analysis revealed that independent factors for body fat were number of minutes of vigorous activity per day and sex. CONCLUSION: Low physical activity can be a contributing factor in childhood obesity. Only longitudinal studies, however, can give more definitive information about the relation between daily physical activity and obesity.     

Rethinking growth failure in Alagille syndrome: the role of dietary intake and steatorrhea

OBJECTIVE: To characterize the energy and nutrient intake, and the degree of fat malabsorption in children with Alagille syndrome (AGS) and to examine their cross-sectional associations with growth and nutritional status. METHODS: Prepubertal children with AGS were evaluated for dietary intake, growth, bone age, and body composition. Children and their families collected a three-day, weighed diet record at home. Stools were collected for 72 hours and the coefficient of fat absorption (COA) was determined. RESULTS: Children (mean age 6.7 +/- 3.6 years) with AGS (n = 26) had low height-for-age z-scores (HAZ), weight-for-age z-scores (WAZ) (-1.9 +/- 1.3 and -1.7 +/- 1.1, respectively), and delayed skeletal maturation (-1.4 +/- 1.8 years). Fifty-eight percent of the subjects were less than the 5th percentile for height and 54% were less than the 5th percentile for weight. At least 20% of children with AGS had low dietary intake for several nutrients including: calories, fat, calcium, vitamin D, and vitamin E. Children who consumed <2/3 Dietary Reference Intake (DRI) for calcium (n = 6) had a statistically significantly lower HAZ (-3.2 +/- 1.3) than those who consumed >2/3 DRI (-1.5 +/- 1.0), (P < 0.003). Ninety-six percent of the subjects had steatorrhea with a mean COA of 75 +/- 16%. CONCLUSIONS: These data suggest that prepubertal children with AGS are at-risk for poor nutrient intake which, compounded with steatorrhea, may have a negative effect on growth and nutritional status. Intervention studies to increase energy and nutrient intake are needed to determine the effect of improved dietary intake on growth and nutritional status of children with AGS.     

Milk, dairy fat, dietary calcium, and weight gain: a longitudinal study of adolescents

BACKGROUND: Milk is promoted as a healthy beverage for children, but some researchers believe that estrone and whey protein in dairy products may cause weight gain. Others claim that dairy calcium promotes weight loss. OBJECTIVE: To assess the associations between milk, calcium from foods and beverages, dairy fat, and weight change over time.Design, Subjects, and Outcome Measure We followed a cohort of 12 829 US children, aged 9 to 14 years in 1996, who returned questionnaires by mail through 1999. Children annually reported their height and weight and completed food frequency questionnaires regarding typical past-year intakes. We estimated associations between annual change in body mass index (BMI) (calculated as weight in kilograms divided by height in meters squared) and our dietary factors, adjusted for adolescent growth and development, race, physical activity, inactivity, and (in some models) total energy intake. RESULTS: Children who drank more than 3 servings a day of milk gained more in BMI than those who drank smaller amounts (boys: beta +/- SE, 0.076 +/- 0.038 [P = .04] more than those who drank 1 to 2 glasses a day; girls: beta +/- SE, 0.093 +/- 0.034 [P = .007] more than those who drank 0 to 0.5 glass a day). For boys, milk intake was associated with small BMI increases during the year (beta +/- SE, 0.019 +/- 0.009 per serving a day; P = .03); results were similar for girls (beta +/- SE, 0.015 +/- 0.007 per serving a day; P = .04). Quantities of 1% milk (boys) and skim milk (girls) were significantly associated with BMI gain, as was total dietary calcium intake. Multivariate analyses of milk, dairy fat, calcium, and total energy intake suggested that energy was the most important predictor of weight gain. Analyses of year-to-year changes in milk, calcium, dairy fat, and total energy intakes provided generally similar conclusions; an increase in energy intake from the prior year predicted BMI gain in boys (P = .003) and girls (P = .03). CONCLUSIONS: Children who drank the most milk gained more weight, but the added calories appeared responsible. Contrary to our hypotheses, dietary calcium and skim and 1% milk were associated with weight gain, but dairy fat was not. Drinking large amounts of milk may provide excess energy to some children.     

Greek immigrant children in southern Sweden in comparison with Greek and Swedish children. III. Energy and nutrient intake

Greek immigrant children (GI) belonging to the second generation of immigrants in Sweden have been compared with Swedish children (S) and Greek children in Greece (G) regarding energy and nutrient intake. Twenty-four-hour recalls were obtained in the homes of the families. The mean energy intake was the same in all three groups and met the Swedish Nutrition Recommendations. The energy distribution for protein, carbohydrates and fat was also similar. The fat intake was far above the recommended level in all groups. The GI and the G group had a significantly higher mean daily intake of monounsaturated fatty acids than the S group (p less than 0.05 and p less than 0.001, respectively). Children aged four to eight years in the GI group had a significantly higher nutrient density of retinol, vitamin D, riboflavin, vitamin B6, calcium, iron, magnesium and sucrose compared to the G group, but compared to the S group they had a lower nutrient density of retinol, vitamin D, ascorbic acid, niacin, vitamin B12 and selen. The GI children consumed more milk than the G children but as much as the S children and they had started to use enriched low-fat milk in Sweden. In conclusion, the food quality in the GI group was better than in the G group and much the same as in the S group, and, with few exceptions, it met the Swedish Nutrition Recommendations.     

Growth and nutrition of Hong Kong children aged 0-7 years

OBJECTIVE: To study the early dietary practices in relation to growth of Hong Kong children from birth to 7 years. METHODOLOGY: One hundred and seventy-three full-term Hong Kong Chinese babies were recruited at birth and were followed up for anthropometric measurements using standardized methods and dietary assessment using a combination of dietary history, 24 h recall and food frequency. At 7 years, 125 children remained in the study. RESULTS: Mean (SD) birthweight was 3.3 (0.38) kg for boys and 3.1 (0.38) kg for girls. Mean (SD) weight at 7 years was 22.4 (4.2) kg for boys and 21.1 (3.7) kg for girls, and mean (SD) height was 120.3 (4.8) cm for boys and 119.8 (5.1) cm for girls. Hong Kong children were lighter and shorter than Australian children and the National Centre for Health Statistics (NCHS) references, but the magnitude is less than one standard deviation score. Mean weight and height of Hong Kong children were lower compared to Caucasian and Beijing children, with more obvious differences between 1 and 5 years. At 1 year, mean (SD) daily energy intake was 98 (24) kcal/kg/day for boys and 100 (26) kcal/kg/day for girls. By 7 years, it decreased to 82 (18) kcal/kg/day for boys and 73 (22) kcal/kg/day for girls. Between 2 to 4 years of age the energy intake of studied children were slightly lower than the Australian and Finnish children, but the protein intake was higher. Percentage of fat contributing to total daily energy intake was lower throughout at a level of 30%. Such differences in diet reflect a lower consumption of milk fat, higher consumption of meat and lower level of physical activity in Hong Kong children. Intakes of calcium, iron and vitamin C all reached 60% or above of US recommended daily allowance. CONCLUSIONS: The smaller body build of Chinese compared to Caucasians cannot be explained by dietary differences. The diet of Hong Kong children is changing to one which is more Westernized with a higher consumption of animal products.     

Elite premenarcheal rhythmic gymnasts demonstrate energy and dietary intake deficiencies during periods of intense training

This study determined dietary intake and energy balance of elite premenarcheal rhythmic gymnasts during their preseason training. Forty rhythmic gymnasts and 40 sedentary age-matched females (10-12 yrs) participated in the study. Anthropometric profile and skeletal ages were determined. Dietary intake and physical activity were assessed to estimate daily energy intake, daily energy expenditure, and resting metabolic rate. Groups demonstrated comparable height, bone age, pubertal development, resting metabolic rate. Gymnasts had lower body mass, BMI, body fat than age-matched controls. Although groups demonstrated comparable daily energy intake, gymnasts exhibited a higher daily energy expenditure resulting in a daily energy deficit. Gymnasts also had higher carbohydrate intake but lower fat and calcium intake. Both groups were below the recommended dietary allowances for fiber, water, calcium, phosphorus and vitamin intake. Gymnasts may need to raise their daily energy intake to avoid the energy deficit during periods of intense training.     

Beverage consumption and anthropometric outcomes among schoolchildren in Guatemala

This analysis explores the clustering of beverage patterns in a single day in private vs. public school children in urban Guatemala. This study is based on measurements taken from 356 third- and fourth-grade pupils from the highland city of Quetzaltenango. Height, weight and body mass index were assessed, and one day's intake of all foods and beverages using a pictorial workbook and dietician assisted recall. Mean differences in beverage consumption were compared for private vs. public school children and by anthropometric outcomes (stunting, overweight and obesity). Plain water was consumed by 30.9% of the children on the day intakes were measured, with higher proportions of water drinkers among private school children. Children having reported water intake on that day consumed 154 fewer kcal (-7.7%) compared with the energy intake of children not having reported water intake (P = 0.02). Significantly more children of high socio-economic status (SES) consumed dairy, fruit juice, commercial fruit juice, fruit drink and soda whereas low SES children consumed thin gruels and infusions. A key result from this study is the finding of a lower energy intake shown by children reporting water intake.     

Nutrient intake among two-year-old children on cows' milk-restricted diets

Approximately 2-3% of young children develop allergy or intolerance to cows' milk. The only available treatment is elimination of milk from the diet. However, as milk is an important source of nutrients in childhood, a milk-free diet may not adequately meet the child's nutritional needs. A dietary survey was conducted to assess the nutrient intake of children on cows' milk-restricted diets. A population-based sample of families with young children (31-37 mo) with adverse reaction to cows' milk and/or eggs was contacted, of which 75% agreed to complete a dietary intake assessment. Dietary intake was assessed using a 4-d weighed recording. The nutrient intake in a group of children on cows' milk protein-free (n = 16) and cows' milk reduced (n = 8) diets were compared to a group of cows' milk consumers (n = 10). There were significant differences in nutrient intake of children on milk-free diets and children consuming milk. Children on milk-free diets had significantly lower intake of energy, fat, protein, calcium, riboflavin and niacin. Use of milk substitutes improved the nutritional content of the cows' milk-free diets; however, the recommendations for riboflavin and calcium were still not met. Conclusion: The results reveal a risk for malnutrition in children on cows' milk-free diets, unless precautions are taken to replace the valuable nutrients from milk in the diet. Parents of children on milk-free diets need advice about food choices in order to reduce the risk of low intake of energy, fat and protein. Supplements with calcium, vitamin D and riboflavin are indicated.     

The relationship between socio-economic status and physical activity patterns in South African children

AIM: To examine: (1) the associations between socio-economic status, physical activity, anthropometric and body composition variables in South African children; (2) the influence maternal characteristics have on children's physical activity levels; and (3) associations between television watching, activity level and body composition. METHODS: In 381 South African children, physical activity and socio-economic status were assessed via structured retrospective interview using validated questionnaires. An asset indicator score was calculated as a proxy measure of socio-economic status and used to divide children into quartiles. RESULTS: Children falling into the highest socio-economic status quartile had mothers with the highest educational levels, generally came from dual parent homes, were highly physically active, watched less television, weighed more and had greater lean tissue than children in lower quartiles. A greater percentage of children living in dual parent homes and with mothers of a higher educational status were highly active compared with children living in single parent homes and with mothers of a lower educational status. We found greater levels of lean mass with increased activity level after controlling for television watching time and fat mass. There were high levels of low activity and high television watching time among lower socio-economic status groups. There were significant racial differences in patterns of activity. White children were found to be more active than black children, more likely to participate in physical education classes at school and watched less television than black children. CONCLUSION: Physical activity levels and socio-economic variables are closely related in this population of South African children.     

Relation between dietary intake and nutritional status in cystic fibrosis

This study evaluated adherence to current dietary recommendations of children with cystic fibrosis and mild lung disease and their siblings by comparing energy intake. Fifty children (25with cystic fibrosis) aged between 7 and 12 years completed the study. Energy intake was assessed by weighed dietary intake, resting energy expenditure was used to calculate recommended daily intakes. The children with cystic fibrosis had significant deficits in Z scores for both height and weight compared with their siblings, but there was no difference in percentage of ideal weight for height. The cystic fibrosis group had a significantly higher energy intake per kilogram body weight per day but there was no difference in the percentage of energy derived from fat, protein or carbohydrate. Energy intake (per kg/day) and fat intake (g/kg) were both significant predictors of weight for height in the cystic fibrosis group. Targets for dietary management in cystic fibrosis should perhaps be related to fat intake per kilogram body weight.

     

Improvement of fitness, body composition, and insulin sensitivity in overweight children in a school-based exercise program: a randomized, controlled study

BACKGROUND: Obesity and poor physical fitness constitute a health problem affecting an increasing number of children. Causes include a pervasive "toxic" environment that facilitates increased caloric intake and reduced physical activity. An effective strategy for prevention and treatment of childhood obesity likely includes a collaborative effort in the school setting. OBJECTIVE: To determine whether a school-based fitness program can improve body composition, cardiovascular fitness level, and insulin sensitivity in overweight children. DESIGN: Fifty overweight middle school children with a body mass index (BMI) above the 95th percentile for age were randomized to lifestyle-focused, fitness-oriented gym classes (treatment group) or standard gym classes (control group) for 9 months. Children underwent evaluation of fasting insulin and glucose levels, body composition by means of dual energy absorptiometry, and maximum oxygen consumption (V0(2)max) treadmill testing at baseline (before the school year) and at end of the school year. SETTINGS: Rural middle school and an academic children's hospital. MAIN OUTCOME MEASURES: Baseline test results for cardiovascular fitness, body composition, and fasting insulin and glucose levels. RESULTS: At baseline, there were no differences between groups before intervention (values for age, 12 +/- 0.5 years [all results, mean +/- SD]; BMI [calculated as weight in kilograms divided by the square of height in meters], 31.0 +/- 3.7; percentage of body fat, 36.5% +/- 4.6%; lean body mass, 41.4 +/- 8.6 kg; and V0(2)max, 31.5 +/- 5.1 mL/kg per minute). Compared with the control group, the treatment group demonstrated a significantly greater loss of body fat (loss, -4.1% +/- 3.4% vs -1.9% +/- 2.3%; P = .04), greater increase in cardiovascular fitness (V0(2)max, 2.7 +/- 2.6 vs 0.4 +/- 3.3 mL/kg per minute; P<.001), and greater improvement in fasting insulin level (insulin level, -5.1 +/- 5.2 vs 3.0 +/- 14.3 microIU/mL [-35.4 +/- 36.1 vs 20.8 +/- 99.3 pmol/L]; P = .02). CONCLUSIONS: Children enrolled in fitness-oriented gym classes showed greater loss of body fat, increase in cardiovascular fitness, and improvement in fasting insulin levels than control subjects. The modification to the school physical education curriculum demonstrates that small but consistent changes in the amount of physical activity has beneficial effects on body composition, fitness, and insulin levels in children. Partnering with school districts should be a part of a public health approach to improving the health of overweight children.     

Difference in dietary intake and activity level between normal-weight and overweight or obese adolescents

BACKGROUND: To investigate the prevalence of overweight and obesity in an adolescent group representative of a rural Mediterranean area and to determine possible associations with energy and nutrient intakes and levels of physical exercise. METHODS: A representative sample of adolescents was drawn from the secondary school of Torre Pacheco (Murcia), a rural Mediterranean area located in the southeast of Spain. The population selected (331 adolescents aged 14-18 years), was divided into two groups: normal-weight subjects with a body mass index less than 23 kg/m2 and overweight or obese subjects with a body mass index of 23 kg/m2 or more. Weight, height, abdominal and hip perimeters, triceps skinfold, and upper arm circumference were measured. A prospective 7-consecutive-days food record and physical activity questionnaire were completed. RESULTS: Overweight boys and girls had an apparently lower energy intake (P = 0.001 and P = 0.042, respectively), and carbohydrate intake (P = 0.000, P = 0.032) than their normal-weight counterparts, but they tended to underreport more often. Overweight boys derived a greater percentage of their energy from fat (P = 0.049) and less from carbohydrate (P = 0.016) than their normal-weight counterparts. Among girls, the percentage of energy derived from fat increased with body mass index (r = 0.210, P = 0.008), whereas fiber intake decreased (r = -0.145; P = 0.041). Overweight and obesity were negatively related to physical activity level only among boys (P = 0.033). CONCLUSION: There is a high prevalence of overweight and obesity in the adolescent population studied (48.2% in boys and 30.7% in girls). The study shows an association between overweight and obesity and nutrient intake and activity level.     

Significance of the atherosclerogenic index and body fat in children as markers for future, potential coronary heart disease

BACKGROUND: The purpose of this study is to establish a simple marker in children for future, potential risks of coronary heart disease. METHODS: We measured serum total cholesterol (TC) and triglyceride (TG) by enzymatic methods, high-density lipoprotein cholesterol (HDLC) by the dextran sulfate-magnesium method and estimated body fat by the new impedance method in 1289 children (651 boys and 638 girls) in the fourth grade (9 or 10 years old) to obtain the atherosclerogenic index (AI). We also investigated the children's lifestyle. RESULTS: The probability of an AI score of 3 or more was significantly higher in children with an estimated 23-25% body fat than in those with body fat less than 17%. Moreover, the odds ratio increased along with an increase in the percentage of body fat. When body fat was estimated as being greater than 29%, the odds ratio was 11-fold higher than those with body fat less than 17%. When body fat was greater than 23%, the children's physical activity, as assessed by the questionnaire, was found to be poorer than those with lower body fat. Levels of TC and TG were significantly higher and that of HDLC was lower in those with less body fat. CONCLUSIONS: The AI is a useful indicator of obesity in children. The combination of AI and percentage body fat is a good indicator for evaluating children who would be at a greater risk of obesity, hyperlipidemia, unhealthy eating habits and inadequate physical activity. The hypothetical risk levels for future coronary heart disease are an AI score of > or = 3 and percentage body fat > or = 23% in Japanese children.     

Relation between dietary intake and nutritional status in cystic fibrosis

This study evaluated adherence to current dietary recommendations of children with cystic fibrosis and mild lung disease and their siblings by comparing energy intake. Fifty children (25 with cystic fibrosis) aged between 7 and 12 years completed the study. Energy intake was assessed by weighed dietary intake, resting energy expenditure was used to calculate recommended daily intakes. The children with cystic fibrosis had significant deficits in Z scores for both height and weight compared with their siblings, but there was no difference in percentage of ideal weight for height. The cystic fibrosis group had a significantly higher energy intake per kilogram body weight per day but there was no difference in the percentage of energy derived from fat, protein or carbohydrate. Energy intake (per kg/day) and fat intake (g/kg) were both significant predictors of weight for height in the cystic fibrosis group. Targets for dietary management in cystic fibrosis should perhaps be related to fat intake per kilogram body weight.     

Swedish pre-school children eat too much junk food and sucrose

Aim: To analyze dietary intake in healthy 4‐year‐old children. Methods: Families from three Paediatric Health Care Centres in different socio‐economic areas in Göteborg completed 7‐day food records and questionnaires about socio‐economy. Results: One hundred thirty two/153 completed the study, 49% of parents were university educated. Eighteen percent of children were overweight/obese. Energy intake was high; 67% had sucrose intake exceeding Nordic Nutrition Recommendations (NNR) but 36% had n‐3 fatty acid intake <0.5 energy percent. Significant negative correlations were found between sucrose and fat and between BMI and fat intake. Junk food supplied 24% of energy. Ninety‐two percent had low vitamin D intake, 70% low iron and 21% low calcium intake. Gruel, which was consumed by 28%, had a positive impact on micronutrient intake. Child care and mother's origin seemed to influence dietary intake. Conclusion: In 4‐year olds from well‐educated urban families, 18% was overweight/obese. Total energy intake was above present NNR but lower than 20 years ago, when overweight was rare. Fat energy intake was negatively associated with BMI, and low n‐3 fatty acid intake was associated with higher body weight. In several aspects dietary intake was not optimal in the children.