Alison L. Eldridge

The Relationship of Ready-to-Eat Cereal Consumption to Nutrient Intake, Blood Lipids, and Body Mass Index of Children as They Age through Adolescence

OBJECTIVE To examine sex differences and longitudinal changes in ready-to-eat (RTE) cereal and breakfast consumption in the Dietary Intervention Study in Children, and the relationship between RTE cereal intake with nutrient intake, blood lipids, and body mass index (BMI). DESIGN Secondary analyses based on data from Dietary Intervention Study in Children, a randomized, controlled, multicenter, clinical trial with five sets of three 24-hour recalls. SUBJECTS/SETTING Children (n=660) from six clinics aged 8 to 10 years at study entry. Participants had serum low-density lipoprotein cholesterol levels between the 80th and 98th percentiles for age, and were followed for a mean of 7.5 years. INTERVENTION Children were randomized to a total fat- and saturated fat-modified dietary intervention or usual care. STATISTICAL ANALYSES Frequency of RTE cereal and breakfast consumption was examined by sex and age. Mixed models by sex were used to examine the relationship of RTE cereal consumption to average daily intake of nutrients, blood lipids, and BMI. RESULTS For all children, RTE cereal and breakfast consumption declined with age. Boys consumed RTE cereal more often compared with girls. Except for energy, RTE cereal consumption was positively associated with all measures of nutrients for both sexes. In boys, higher RTE cereal consumption was associated with lower total and low-density lipoprotein cholesterol levels and lower BMI. CONCLUSIONS Food and nutrition professionals should continue to educate youth and their parents on the nutritional benefits of routinely eating RTE cereal.

Increasing doses of fiber do not influence short-term satiety or food intake and are inconsistently linked to gut hormone levels

Background People who eat more fiber often have a lower body weight than people who eat less fiber. The mechanism for this relationship has been explained, in part, by increased satiety, which may occur as a result of changes in appetite-suppressing gut hormone levels, and decreases in food intake at subsequent meals. Objective We hypothesized that increasing doses of mixed fiber, consumed in muffins for breakfast, would proportionally influence satiety, gut hormone levels, and subsequent food intake. Design This was a randomized, double-blind, crossover study. Healthy men (n=10) and women (n=10) with a BMI of 24±2 (mean±SEM) participated in this study. Fasting subjects consumed a muffin with 0, 4, 8, or 12 g of mixed fibers and approximately 500 kcal. Visual analog scales rated hunger and satiety for 3 h; blood was drawn to measure ghrelin, glucagon-like peptide-1 (GLP-1), and peptide YY3–36 (PYY3–36) at various intervals; and food intake was measured at an ad libitum lunch. Results Responses to satiety-related questions did not differ among treatments. However, despite lack of differences in satiety, gut hormone levels differed among treatments. Ghrelin was higher after the 12 g fiber dose than after the 4 and 8 g fiber doses. GLP-1 was higher after the 0 g fiber dose than after the 12 and 4 g fiber doses, and PYY3–36 did not differ among fiber doses. Food intake was also indistinguishable among doses. Conclusion Satiety, gut hormone response, and food intake did not change in a dose-dependent manner after subjects consumed 0, 4, 8, and 12 g of mixed fiber in muffins for breakfast.

A brief dietary assessment instrument for assessing target foods, nutrients and eating patterns.

OBJECTIVE To develop and validate a new dietary assessment tool, the focused recall, and to use this to measure co-consumption of carotenoid-containing fruits and vegetables with savory snacks. DESIGN Participants completed a telephone-administered focused recall and a 24-hour recall on the same day. We compared mean estimates of fruit, vegetable, savory snack and carotenoid consumption from both instruments. We also assessed the ability of each method to measure co-consumption of carotenoids with full-fat, reduced/non-fat and olestra-containing savory snacks. SETTING AND SUBJECTS Data are from 245 male and 244 female adult participants in the Olestra Post-Marketing Surveillance Study (OPMSS). RESULTS The mean (=/- SD) intake of fruit was 1.8(1.1) servings day(-1) from the focused recall and 1.6 (1.4) servings day(-1) from the 24-hour recall (r=0.56). The mean vegetable intake was 2.1 (1.3) and 2.2 (1.7) servings day(-1) (r=0.42), respectively, from each instrument. Estimates of total carotenoid and beta-carotene intake were within 5% of each other (r= 0.63 for total carotenoids and r= 0.70 for beta-carotene). Both instruments estimated that approximately 14% of total daily carotenoids were co-consumed with savory snacks (r= 0.63). CONCLUSIONS The focused recall provides valid information about fruit, vegetable and savory snack consumption and allows researchers to examine associated eating patterns more easily.

Increased Snacking and Eating Occasions Are Associated with Higher Energy Intake among Mexican Children Aged 2–13 Years

Abstract Background: Little is known about the dietary behaviors of Mexican children with regard to frequency, amount, and quality of foods consumed at eating occasions and their impact on total daily energy intake. Objectives: The objectives were to 1) describe foods consumed across eating occasions and 2) examine whether the number or type of total eating occasions was associated with increased total daily energy intake and differed between 2- to 5-y-old and 6- to 13-y-old Mexican children. Methods: A nationally representative sample of 5031 children from the 2012 ENSANUT (Encuesta Nacional de Salud y Nutrición) was used to examine the percentage of meals and snacks consumed, mean energy intake from meals and snacks, and the top food groups contributing to meals and snacks. Multivariate linear regression was used to examine the association between meals, snacks, and total eating occasions with daily energy intake for 2- to 5-y-old and 6- to 13-y-old children. Results: Eating patterns were similar across age groups (per capita mean intake of 3 meals and 1.4–1.6 snacks/d). Each additional snack was associated with greater increases in mean daily energy for older children (+191–289 kcal/d; P < 0.01) relative to younger children (+102–130 kcal/d; P < 0.01). Likewise, each additional eating occasion was associated with greater increases in mean daily energy for older children (+323 kcal/d; P < 0.01) relative to younger children (+166–261 kcal/d; P < 0.01). In both younger and older children, snacking was prevalent (75% and 68%, respectively). Top food contributors to snacks included fruit, salty snacks, candy, sweetened breads, and cookies. Among older children, whole milk as a snack was partially replaced with soda and sweetened fruit drinks. Conclusion: Snacks represent an area for potential improvement in the diets of Mexican children, especially among those aged 6 to 13 y, for whom each additional snack or eating occasion was linked to even greater increases in total daily energy intake.

Whole Grain in Manufactured Foods: Current use, Challenges and the way Forward

ABSTRACT Some countries now incorporate recommendations for increased consumption of whole grain (WG) into local dietary guidelines. Cereal and pseudo-cereal grains are good sources of complex carbohydrates, dietary fiber, proteins, phytochemicals, vitamins and minerals. However, research shows that the large majority of consumers are still falling short of WG consumption goals. To address this, we are actively involved in research to help increase the WG content of processed foods without compromising on taste and texture. In order to ensure consumer trust, the advancement of process technologies in incorporating WG to produce tasty food has to go hand in hand with well designed clinical trials that confirm the health benefits resulting from diets rich in WG.

ILSI Brazil International Workshop on Functional Foods: a narrative review of the scientific evidence in the area of carbohydrates, microbiome, and health

To stimulate discussion around the topic of ‘carbohydrates’ and health, the Brazilian branch of the International Life Sciences Institute held the 11th International Functional Foods Workshop (1–2 December 2011) in which consolidated knowledge and recent scientific advances specific to the relationship between carbohydrates and health were presented. As part of this meeting, several key points related to dietary fiber, glycemic response, fructose, and impacts on satiety, cognition, mood, and gut microbiota were realized: 1) there is a need for global harmonization of a science-based fiber definition; 2) low-glycemic index foods can be used to modulate the postprandial glycemic response and may affect diabetes and cardiovascular outcomes; 3) carbohydrate type may influence satiety and satiation; glycemic load and glycemic index show links to memory, mood, and concentration; 4) validated biomarkers are needed to demonstrate the known prebiotic effect of carbohydrates; 5) negative effects of fructose are not evident when human data are systematically reviewed; 6) new research indicates that diet strongly influences the microbiome; and 7) there is mounting evidence that the intestinal microbiota has the ability to impact the gut–brain axis. Overall, there is much promise for development of functional foods that impact the microbiome and other factors relevant to health, including glycemic response (glycemic index/glycemic load), satiety, mood, cognition, and weight management.

Glucose and insulin do not decrease in a dose-dependent manner after increasing doses of mixed fibers that are consumed in muffins for breakfast

Conventional wisdom suggests that fiber consumption leads to lower postprandial glucose and insulin response. We hypothesized that increasing doses of mixed, viscous fiber would lower glucose and insulin levels in a dose-dependent manner. Healthy men (n = 10) and women (n = 10) with a body mass index of 24 ± 2 (mean ± SEM) participated in this double-blind, crossover study. On 4 separate visits, fasting subjects consumed an approximately 2093 kJ (500 calorie) muffin with 0, 4, 8, or 12 g of mixed fibers. Blood was drawn to measure glucose and insulin at regular intervals throughout a 3-hour test period. Area under the curve (AUC) glucose was significantly lower after 0 g of fiber than after 4, 8, or 12 g of fiber (arbitrary AUC units ± SEM: 25.3 ± 5.2 vs 44.6 ± 7.7, 49.7 ± 7.9, 51.5 ± 6.6, respectively; P < .006). Area under the curve glucose increased with increasing fiber doses (P for trend = .0003). Area under the curve insulin was higher after the 4-g dose than after the 0-, 8-, and 12-g doses (arbitrary AUC units ± SEM: 84.4 ± 8.0 vs 60.1 ± 6.5, 69.4 ± 8.7, 69.7 ± 8.5, respectively; P < .05); it did not change in a dose-dependent manner. Area under the curve glucose and AUC insulin did not correlate with each other. Glucose and insulin did not decrease in a dose-dependent manner after 0, 4, 8, and 12 g of mixed fibers were consumed in muffins for breakfast. The lack of differences was largely based on the individual variation in glucose response. Caution should be used when making general claims about the expected impact of fiber on glucose and insulin levels.

Breakfast Dietary Patterns among Mexican Children Are Related to Total-Day Diet Quality

Background: Mexico has experienced shifts in food availability and consumption patterns over the past few decades from traditional diets to those containing more high-energy density foods, resulting in the development of unhealthful dietary patterns among children and adults. However, to our knowledge it is not known whether breakfast consumption patterns contribute to the overall daily diet of Mexican children.Objective: We examined total-day diet among breakfast consumers compared with breakfast skippers, identified and investigated breakfast dietary patterns in relation to energy and nutrient intakes at breakfast and across the day, and examined these patterns in relation to sociodemographic characteristics.Methods: With the use of nationally representative dietary data (one 24-h recall) from the 2012 Mexican National Health and Nutrition Survey, 3760 children aged 4-13 y were categorized into mutually exclusive breakfast patterns with the use of cluster analysis. The association between breakfast patterns and breakfast skippers with dietary intake at breakfast and for the total day was investigated with the use of multivariate linear regression.Results: Most children (83%) consumed breakfast. Six breakfast dietary patterns were identified (milk and sweetened breads, tortillas and beans, sweetened beverages, sandwiches and quesadillas, eggs, and cereal and milk) and reflected both traditional and more Westernized dietary patterns. Sugar-sweetened beverages were consumed across all patterns. Compared with all breakfast dietary patterns, breakfast skippers had the lowest intake of several nutrients of public health concern. Nutrients to limit that were high at breakfast tended to be high for the total day and vice versa for nutrients to encourage.Conclusions: There was not a single pattern that complied perfectly with the Mexican School Breakfast Guidelines, but changes such as increasing dietary fiber by encouraging more whole grains, fruits, vegetables, and beans and reducing sodium and sugar-sweetened beverages could support compliance with these targets and improve overall diet quality.

Total Usual Nutrient Intakes of US Children (Under 48 Months): Findings from the Feeding Infants and Toddlers Study (FITS) 2016

Abstract Background The US Dietary Guidelines will expand in 2020 to include infants and toddlers. Understanding current dietary intakes is critical to inform policy. Objective The purpose of this analysis was to examine the usual total nutrient intakes from diet and supplements among US children. Methods The Feeding Infants and Toddlers Study 2016 is a national cross-sectional study of children aged <48 mo (n = 3235): younger infants (birth to 5.9 mo), older infants (6–11.9 mo), toddlers (12–23.9 mo), younger preschoolers (24–36.9 mo), and older preschoolers (36–47.9 mo) based on the use of a 24-h dietary recall. A second 24-h recall was collected from a representative subsample (n = 799). Energy, total nutrient intake distributions, and compliance with Dietary Reference Intakes were estimated with the use of the National Cancer Institute method. Results Dietary supplement use was 15–23% among infants and toddlers and 35–45% among preschoolers. Dietary intakes of infants were adequate, with mean intakes exceeding Adequate Intake for all nutrients except vitamins D and E. Iron intakes fell below the Estimated Average Requirement for older infants (18%). We found that 31–33% of children aged 12–47.9 mo had low percentage of energy from total fat, and >60% of children aged 24–47.9 mo exceeded the saturated fat guidelines. The likelihood of nutrient inadequacy for many nutrients was higher for toddlers: 3.2% and 2.5% greater than the Adequate Intake for fiber and potassium and 76% and 52% less than the Estimated Average Requirement for vitamins D and E, respectively. These patterns continued through older ages. Intakes exceeded the Tolerable Upper Intake Level of sodium, retinol, and zinc across most age groups. Conclusions Dietary intakes of US infants are largely nutritionally adequate; concern exists over iron intakes in those aged 6–11.9 mo. For toddlers and preschoolers, high intake of sodium and low intakes of potassium, fiber, and vitamin D and, for preschoolers, excess saturated fat are of concern. Excess retinol, zinc, and folic acid was noted across most ages, especially among supplement users.

Food groups consumed by infants and toddlers in urban areas of China

Background Food consumption patterns of young children in China are not well known. Objective Characterised food groups consumed by infants and young children in urban China using data from the Maternal Infant Nutrition Growth (MING) study. Design One 24-h dietary recall was completed for 1,350 infants and young children (436 infants aged 6–11 months and 914 young children aged 12–35 months), who were recruited from maternal and child care centres in eight cities via face-to-face interviews with the primary caregiver. All foods, beverages and supplements reported were assigned to one of 64 food groups categorised into the following: milk and milk products, grains, vegetables, fruits, protein foods and desserts/sweets. The percentage of infants and young children consuming foods from specific food groups was calculated, regardless of the amount consumed. Results Less than half of infants consumed breast milk (47%), whereas 59% of infants consumed infant formula and 53–75% of young children consumed growing-up (fortified) milk. Rice was the number one grain food consumed after 6 months (up to 88%) and the consumption of infant cereal was low. About 50% of infants did not consume any fruits or vegetables, and 38% of young children did not consume any fruits on the day of the recall. Only 40% of all children consumed dark green leafy vegetables and even fewer consumed deep yellow vegetables. Eggs and pork were the most commonly consumed protein foods. Conclusions The data provide important insight for developing detailed food consumption guidelines for this population group. Mothers of infants should be encouraged to continue breastfeeding after the first 6 months. Parents should be advised to offer a wide variety of vegetables and fruits daily, particularly dark green leafy and deep yellow vegetables and colourful fruits. The consumption of fortified infant cereal should be advocated to improve the iron intake of Chinese infants.