Dietary pattern is defined as a combination of foods and drinks and the frequency of consumption within a population. Dietary patterns are changing on a global level, which may be linked to an ...increased incidence of chronic diseases. The aim of this study was to identify and compare the dietary patterns among 9-11-year-old children living in urban regions in different parts of the world.
Participants were 7199 children (54% girls), aged 9-11 years, from 12 countries situated in all major world regions. Food consumption was assessed using a 23-item Food Frequency Questionnaire (FFQ). To identify dietary patterns, principal components analyses (PCA) were carried out using weekly portions as input variables.
Both site-specific and pooled PCA resulted in two strong components. Component 1 ('unhealthy diet pattern') included fast foods, ice cream, fried food, French fries, potato chips, cakes and sugar-sweetened sodas with >0.6 loadings. The loadings for component 2 ('healthy diet pattern') were slightly weaker with only dark-green vegetables, orange vegetables, vegetables in general, and fruits and berries reaching a >0.6 loading. The site-specific diet pattern scores had very strong correlations with the pattern scores from the pooled data: r=0.82 and 0.94 for components 1 and 2, respectively.
The results suggest that the same 'healthier' and 'unhealthier' foods tend to be consumed in similar combinations among 9-11-year-old children in different countries, despite variation in food culture, geographical location, ethnic background and economic development.
Dietary patterns are useful in nutritional epidemiology, providing a comprehensive alternative to the traditional approach based on single nutrients. The Cardiovascular Risk in Young Finns Study is a ...prospective cohort study with a 21-year follow-up. At baseline, detailed quantitative information on subjects' food consumption was obtained using a 48 h dietary recall method (n 1768, aged 3-18 years). The interviews were repeated after 6 and 21 years (n 1200 and n 1037, respectively). We conducted a principal component analysis to identify major dietary patterns at each study point. A set of two similar patterns was recognised throughout the study. Pattern 1 was positively correlated with consumption of traditional Finnish foods, such as rye, potatoes, milk, butter, sausages and coffee, and negatively correlated with fruit, berries and dairy products other than milk. Pattern 1 type of diet was more common among male subjects, smokers and those living in rural areas. Pattern 2, predominant among female subjects, non-smokers and in urban areas, was characterised by more health-conscious food choices such as vegetables, legumes and nuts, tea, rye, cheese and other dairy products, and also by consumption of alcoholic beverages. Tracking of the pattern scores was observed, particularly among subjects who were adolescents at baseline. Of those originally belonging to the uppermost quintile of pattern 1 and 2 scores, 41 and 38 % respectively, persisted in the same quintile 21 years later. Our results suggest that food behaviour and concrete food choices are established already in childhood or adolescence and may significantly track into adulthood.
We investigated the roles of home and school environments on dietary patterns among children from 12 countries differing widely in geographic region and levels of human and economic development.
The ...sample included a total of 6685 (54% girls) 9-11-year-old children. Parents/guardians reported the availability of certain foods in the home, and trained researchers performed school audits recording the availability of foods for sale at schools. Foods were then divided into wholesome (nutrient-dense) and empty-calorie (nutrient-poor) foods and scored according to their availability. Children reported if their school provided school lunch and how many times during the last week they had eaten meals prepared away from home and school. Via principal components analysis, data-driven dietary pattern scores were calculated from food frequency questionnaires. Multilevel models were used to study the associations between home and school food environments (wholesome and empty-calorie foods) and dietary patterns (healthy and unhealthy diet pattern scores).
For low unhealthy diet pattern scores, low availability of empty-calorie foods at home was found to be more important than high availability of wholesome foods. More meals eaten outside home and school were associated with the higher unhealthy diet pattern scores. The availability of wholesome foods at home was positively associated with the healthy diet pattern scores. Food availability at school was not associated with the dietary patterns.
In this sample, the home food environment was more significant than the school food environment in predicting the dietary patterns. The availability of empty-calorie foods was associated with the unhealthy dietary pattern even when the availability of wholesome foods at home was high. Meals prepared away from home contributed to the unhealthy dietary pattern. Therefore, parents should be encouraged to limit the availability of empty-calorie foods and eating outside the home.
Objective: To assess nutrient intakes relevant in the prevention of cardiovascular diseases (CVD) among young adults in Finland and to find past and present determinants of quality of diet. Design: ...Prospective study, 21 years of follow-up. Setting: The Cardiovascular Risk in Young Finns Study, Finland. Subjects: At baseline in 1980: 3569 children aged 3-18 y participated (83% of those invited), and every second of them (1780) were selected to the dietary study. At follow-ups in 1986 and 2001: 1200 and 1037 of the original sample, respectively, participated. Methods: Food consumption was assessed using 48-h dietary recall. Intakes in 2001 were compared with those obtained in 1980 and 1986. Nutrients selected for further examination were those implicated in the risk of CVD: saturated, monounsaturated, polyunsaturated and n-3 fatty acids, fibre and salt. An index describing the quality of adulthood diet was constructed. Multivariate logistic regression was used to identify independent childhood and adulthood determinants of the quality index. Results: The average intakes showed substantial changes since 1980. Intakes of fat and saturated fat had decreased, while the consumption of vegetables and fruit had increased. However, a great disparity was present between the recommended levels and actual intakes for many of the nutrients, particularly salt, saturated fat and fibre. Intake of fat and consumption of vegetables in childhood and physical activity in adulthood were important health behavioural determinants of the cardiovascular quality of the adult diet. Socio-demographic factors, including education of the subject and their parents, had no significant associations with diet. Conclusions: While intakes of energy and nutrients have changed favourably in Finnish young adults between 1980 and 2001 with regard to the risk of CVD, they are still far from recommended levels. Childhood diet is a significant determinant of adult diet even after 21 y.
Objective Sedentary behaviour may contribute to the development of obesity. We investigated the relations between different types of sedentary behaviour and adiposity markers in a well-characterised ...adult population after controlling for a wide range of potential confounders. Design Cross-sectional study. Setting The Cardiovascular Risk in Young Finns Multicenter Study. Participants Sedentary time (TV viewing, computer time, reading, music/radio listening and other relaxation) was assessed with a questionnaire for 1084 women and 909 men aged 30–45 years. Other study variables included occupational and leisure-time physical activity, sleep duration, socioeconomic status, smoking, alcohol consumption, energy intake, adherence to the recommended diet, multiple individual food items, age and genetic variants associated with body mass index (BMI). Primary outcome measures BMI in kg/m2 and waist circumference (WC in cm). Results Of the different sedentary behaviour types, TV viewing was most consistently related to higher BMI and WC, both in men and women. One additional daily TV hour was associated with a 1.81±0.44 cm larger WC in women and 2 cm±0.44 cm in men (both p<0.0001). The association with TV was diluted, but remained highly significant after adjustments with all measured covariates, including several potentially obesogenic food items associated with TV viewing. The intakes of food items such as sausage, beer and soft drinks were directly associated with TV viewing, while the intakes of oat and barley, fish, and fruits and berries were associated indirectly. After these adjustments, non-TV sedentary behaviour remained associated with adiposity indices only in women. Conclusions Out of the different types of sedentary behaviour, TV viewing was most consistently associated with adiposity markers in adults. Partial dilution of these associations after adjustments for covariates suggests that the obesogenic effects of TV viewing are partly mediated by other lifestyle factors.
Abstract High peak bone mass and strong bone phenotype are known to be partly explained by physical activity during growth but there are few prospective studies on this topic. In this 28-year ...follow-up of Cardiovascular Risk in Young Finns Study cohort, we assessed whether habitual childhood and adolescence physical activity or inactivity at the age of 3–18 years were associated with adult phenotype of weight-bearing tibia and the risk of low-energy fractures. Baseline physical activity and data on clinical, nutritional and lifestyle factors were assessed separately for females and males aged 3–6-years (N = 395–421) and 9–18-years (N = 923–965). At the age of 31–46-years, the prevalence of low-energy fractures was assessed with a questionnaire and several tibial traits were measured with pQCT (bone mineral content (BMC; mg), total and cortical cross-sectional areas (mm2 ), trabecular (for the distal site only) and cortical (for the shaft only) bone densities (mg/cm3 ), stress–strain index (SSI; mm3 , for the shaft only), bone strength index (BSI; mg2 /cm4 , for the distal site only) and the cortical strength index (CSI, for the shaft only)). For the statistical analysis, each bone trait was categorized as below the cohort median or the median and above and the adjusted odds ratios (OR) were determined. In females, frequent physical activity at the age of 9–18-years was associated with higher adulthood values of BSI, total and cortical areas, BMC, CSI and SSI at the tibia independently of many health and lifestyle factors (ORs 0.33–0.53, P ≤ 0.05; P-values for trend 0.002–0.05). Cortical density at the tibial shaft showed the opposite trend (P-value for trend 0.03). Similarly in males, frequent physical activity was associated with higher values of adult total and cortical areas and CSI at the tibia (ORs 0.48–0.53, P ≤ 0.05; P-values for trend 0.01–0.02). However, there was no evidence that childhood or adolescence physical activity was associated with lower risk of low energy fractures during the follow-up. In conclusion, frequent habitual physical activity in adolescence seems to confer benefits on tibial bone size and geometry in adulthood.
Data on the relationship between protein intake and the risk of type 2 diabetes are conflicting.
We studied prospective associations between the intake of total, plant-based, and animal protein and ...the risk of pre-diabetes and diabetes in 4 population-based studies included in the PREVIEW project.
Analyses were conducted with the use of data from 3 European cohorts and 1 Canadian cohort, including 78,851 participants. Protein intake was assessed through the use of harmonized data from food-frequency questionnaires or 3-d dietary records. Cohort-specific incidence ratios (IRs) were estimated for pre-diabetes and diabetes, adjusting for general characteristics, lifestyle and dietary factors, disease history, and body mass index (BMI) and waist circumference; results were pooled based on a random-effects meta-analysis.
Higher total protein intake (g · kg–1 · d–1) was associated with lower incidences of pre-diabetes and diabetes (pooled IRs: 0.84; 95% CI: 0.82, 0.87 and 0.49; 95% CI: 0.28, 0.83, respectively); plant-based protein intake was the main determinant (pooled IRs: 0.83; 95% CI: 0.81, 0.86 and 0.53; 95% CI: 0.36, 0.76, respectively). Substituting 2 energy percentage (E%) protein at the expense of carbohydrates revealed increased risks of pre-diabetes and diabetes (pooled IRs: 1.04; 95% CI: 1.01, 1.07 and 1.09; 95% CI: 1.01, 1.18, respectively). Except for the associations between intakes of total protein and plant-based protein (g · kg–1 · d–1) and diabetes, all other associations became nonsignificant after adjustment for BMI and waist circumference.
Higher protein intake (g · kg–1 · d–1) was associated with a lower risk of pre-diabetes and diabetes. Associations were substantially attenuated after adjustments for BMI and waist circumference, which demonstrates a crucial role for adiposity and may account for previous conflicting findings. This study was registered at ISRCTN as ISRCTN31174892.
Abstract
The intake of polyunsaturated fatty acids (PUFAs) is generally linked with a reduced cardiovascular disease (CVD) risk, but an elevated n6PUFA intake, without simultaneous n3PUFA supply, may ...elevate the risk. PUFAs are suspected as being easily oxidized and have a potential role in lipoprotein oxidation and inflammation. Saturated fatty acids (SFAs) and monounsaturated fatty acids (MUFAs) are resistant to oxidation. However, in a Western diet, their most important source is red meat, a food stuff rich in heme iron which can catalyze oxidative reactions. Therefore, different serum fatty acid (FA) proportions (free + esterified) were correlated with the status of low-density lipoprotein (LDL) oxidation in vivo (conjugated dienes = oxLDLlipids and antibody-based oxidized proteins = oxLDLprot) and inflammation (serum CRP) in 2196 Finnish subjects (age: 24-39 years) using CVD risk factor-adjusted linear regression models. High n6PUFA, PUFA/SFA and n6/n3 ratios, and low SFA and MUFA were all associated with reduced levels of oxLDLlipids, oxLDLprot, and CRP. These findings at the population level suggest that PUFAs are negatively and SFAs and MUFAs positively related with LDL oxidation and inflammation; these conclusions are in line with previous observations linking PUFAs, particularly n6PUFAs, with lower CVD risk, and SFAs with increased risk.
Summary
We evaluated the adult bone structural traits in relation to childhood overweight in 832 men and women. Childhood overweight was associated with larger cross-sections at long bones in both ...sexes. Excess weight in childhood may also lead to higher trabecular density in females and somewhat lower cortical density in men.
Introduction
Excess body weight in childhood may impose more loading on growing skeleton and thus lead to more robust structure in adulthood.
Methods
This prospective cohort study evaluated the adult bone structural traits in relation to childhood overweight in a subgroup of 456 women and 376 men from the population-based cohort of Cardiovascular Risks in Young Finns Study. Between-group differences were evaluated with analysis of covariance.
Results
According to established body mass index (BMI) criterion at the age of 12 years, 31 women and 34 men were classified overweight in childhood. At the mean age (SD) of 36.1 (2.7) years, total cross-sectional (ToA) and cortical area (CoA) at the distal and shaft sites and cortical (shaft CoD) and trabecular (distal TrD) bone density of the nonweight-bearing radius and weight-bearing tibia were evaluated with pQCT. Despite being taller in adolescence, the adult body height of overweight children was similar. In both sexes, childhood overweight was consistently associated with 5–10% larger ToA at all bone sites measured in adulthood. CoA did not show such a consistent pattern. Women, who were overweight in childhood, had ~5% denser TrD with no difference in CoD. In contrast, TrD in men who were overweight in childhood was not different but their CoD was ~1% lower.
Conclusions
Childhood overweight was consistently associated with larger long bone cross-sections in both sexes. Excess weight in childhood may also lead to higher trabecular density in women and somewhat lower cortical density in men. Specific mechanisms underlying these associations are not known.
Breast feeding in infancy may be associated with reduced cardiovascular morbidity in adulthood. We examined the association between breast feeding in infancy and arterial function and structure in ...adulthood in a population-based cohort of Finnish adults.
Noninvasive ultrasound was used to measure brachial artery flow-mediated dilatation (FMD), carotid artery intima-media thickness (IMT) and carotid artery compliance (CAC) in 1667 young adults participating in the Cardiovascular Risk in Young Finns Study with data on early nutrition.
Maximal FMD was higher in breast-fed men compared to formula-fed men (7.2+/-4.0 vs 5.9+/-3.4%, P=0.029) while no differences were seen between breast-fed and formula-fed women (8.9+/-4.5 vs 8.8+/-5.0%, P=0.84). In men, the multivariable correlates of FMD included the group variable for breast feeding (P=0.014), birth weight (P=0.043), waist circumference (P<0.001) and baseline brachial artery diameter (P<0.001). In women, the multivariable correlates of FMD were birth weight (P=0.02), waist circumference (P<0.001) and brachial artery baseline diameter (P<0.001). Breast feeding was not significantly associated with IMT or CAC in multivariable models.
Adult men who have been breast fed have better brachial endothelial function compared to men who have been formula fed.
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