Claudia Drossard

Iodine intake in the youngest: impact of commercial complementary food

Iodine is a nutrient contributing to the development of the central nervous system. To assure a sufficient iodine intake, iodine fortification of complementary food (CF) is recommended. We describe the current fortification practice of commercial CF and formula in Germany as an example for other European countries, based on a market survey conducted in autumn 2008. In addition, we estimated the iodine intake of an 8-month-old infant, fed one portion of milk and three complementary meals per day. All formulae were fortified with iodine, and half of CF products. Iodine concentration varied depending on product groups. A partially breast-fed infant getting homemade CF reached less than 50% of the recommended iodine intake. Using infant formula and commercial CF, the recommended intake was exceeded by 39 or 100%, depending on which products were chosen. A well-balanced fortification of commercial CF, including pure infant cereals, would be required to ensure an adequate iodine supply.

Relative validity of a 3 d estimated food record in German toddlers

OBJECTIVE To determine the relative validity of a 3 d estimated food record (EFR) used to assess energy and nutrient intakes in toddlers, using a 3 d weighed food record (WDR) as the reference method. DESIGN Parents reported the food and beverage intakes of their children using an EFR concurrently with a WDR over three consecutive days. Estimation of mean differences, Spearman correlation coefficients, cross-classifications and Bland-Altman plots were used to assess the agreement between the intakes of energy and fourteen nutrients obtained from the EFR and the WDR. SETTING Data obtained from a representative sample of infants or toddlers in Germany. SUBJECTS Sixty-seven toddlers aged 10-36 months who had completed an EFR for a 3 d recording period that corresponded to the WDR were included in the present analysis. RESULTS Energy and nutrient intakes did not differ between the EFR and the WDR, except for linoleic acid and retinol. For all dietary intakes, Spearman rank correlation coefficients between the EFR and the WDR ranged from 0·35 to 0·80 (P ≤ 0·004). The proportion of participants correctly classified into quartiles ranged from 75 % for ascorbic acid intake to 96 % for Fe intake, and the percentage of misclassification was 9 % or less. The weighed κ values ranking the participants ranged from 0·23 for ascorbic acid intake to 0·59 for Fe intake. The Bland-Altman plots indicated a good agreement for all dietary intakes estimated from the EFR. CONCLUSIONS Our study suggests that this EFR is a valid assessment instrument for estimating the energy and nutrient intakes among toddlers at the group level.

Effects of lunch on children’s short-term cognitive functioning: a randomized crossover study

Background/Objectives:Considering the large number of children worldwide attending all-day schools, information on the effects of lunch on short-term cognitive performance is of public health relevance. However, only adult studies investigated this issue yet. Therefore, this study examined the impact of skipping lunch vs having lunch on children’s cognitive functioning in the early afternoon.Subjects/Methods:Participants in this randomized crossover study with two groups were healthy 6th grade students of an all-day school in Gelsenkirchen, Germany. Group 1 skipped lunch on study day 1 and received an ad libitum lunch 1 week later on study day 2. The order for group 2 was vice versa. In the afternoon tonic alertness, visuospatial memory and selective attention were determined using a computerized test battery of the Vienna Test System. For continuous and discrete interval-scaled variables, treatment effect was estimated using the two sample t-test or the Wilcoxon rank-sum test, for discrete ordinal-scaled variables using generalized linear models.Results:Data on 105 children (48% male; 12.6±0.6 years) were analyzed. Except for tonic alertness there were no significant differences in cognitive functioning between the skipping lunch day and the having lunch day. The higher number of omission errors on the skipping lunch day lost significance when adjusting for multiple testing.Conclusions:In the first study on this topic lunch did not have relevant effects on children’s cognitive functioning in the early afternoon. Future research needs to be done to figure out potential methodical and physiological explanations.

Liking of anthocyanin-rich juices by children and adolescents ☆

There is evidence that a diet rich in plant foods is protective against cardiovascular disease and cancer, partly attributable to secondary plant metabolites such as anthocyanins, a colourful group of flavonoids. As at present children and adolescents do not consume the recommended amounts of fruits and vegetables, one possible way of increasing intake, and particularly intake of anthocyanins, may be an anthocyanin-rich juice, since fruit juice is popular with young Germans. We produced eight different fruit products (six juices, two smoothies), and conducted hedonic tests with participants from the DONALD Study. Paired comparisons showed that most subjects preferred apple to apple-bilberry juice, but grape vs. grape-bilberry juice was liked equally frequently. Rated on a hedonic scale the grape-bilberry mixture was preferred to apple-bilberry, both as juice and as smoothie. With regard to viscosity, juices were preferred to smoothies, both as grape-bilberry and as apple-bilberry. Internal Preference Mapping revealed however consumer subgroups with different preferences, raising the question which product should be promoted in order to reach a large target group. The product richest in anthocyanins, grape-bilberry juice, was accepted very well and may therefore be suitable for promotion to children, although the high sugar content of this juice must be taken into account.

Nutrient Adequacy and Associated Factors in a Nationwide Sample of German Toddlers.

Objectives: Nutrition in toddlerhood may have short- and long-term impacts on health and nutrition behavior. The objectives of the present article are to describe intake of energy and nutrients from the end of infancy to toddlerhood, and to examine dietary and socioeconomic factors (socioeconomic status [SES]) associated with total nutrient adequacy measured by a nutrient-based index (Nutrient Quality Index [NQI]). Methods: In the German Representative Study of Toddler Alimentation from 2008, 7-day estimated dietary records were collected cross-sectionally from toddlers ages 10 to 36 months (n = 525). The study population was recruited in the TNS access panel. The intakes of energy and 18 nutrients were evaluated and the NQI was determined. Age trends in nutrient intake were tested with analysis of variance. Analysis of the association between SES and the NQI was performed by multiple linear regression analysis. Results: In all of the age groups, energy intake was close to the reference value representing moderate physical activity. The mean intake of most vitamins and minerals reached the respective reference values, but nutrient density decreased with age. Dietary intakes of iron, iodine, and vitamin D are low in our study. The NQI reached approximately 80 points and was lower in older children than in younger children. NQI was not affected by SES but by formula use. Conclusions: Nutritional quality measured by total nutrient intake is altogether high in German toddlers, although NQI decreased with increasing age. The NQI is independent of social class. The positive association with formula intake can be explained by the general enrichment of vitamins and minerals of these products.

The potential impact of nutrient profiles on dairy-related energy and nutrient intake in German children and adolescents

Background/Objectives:To evaluate the potential impact of nutrient profiling-based dairy product choices on energy and nutrient intake in German children and adolescents.Subjects/Methods:Consumption data were obtained from product-specific dietary records in the DONALD Study (Dortmund Nutritional and Anthropometric Longitudinally Designed Study). We compared actual intake data with intake data that were calculated based on the assumption that participants exclusively consumed products that met the criteria of selected nutrient profiling models.Results:For most profiling models, the percentage of compliant products was unrelated to the percentage of the participants’ dairy consumption rated eligible. The participants’ intake of energy, saturated fatty acids (SAFA), sodium, calcium and vitamin D would be reduced significantly (P<0.0001) if only qualifying products were consumed. The impact on the participants’ nutrient intake levels was not directly related to the impact on the products nutrient content levels. Lower fat consumption was correlated with reduced vitamin D intake, and the models’ disqualification of (semi-) hard cheeses had a negative impact on the calcium intake.Conclusions:The evaluation of product-specific intake data was critical to understand the potential impact of any profiling scheme on nutrient intake. Selecting dairy products based on nutrient profiling could help reduce the intake of less-desirable nutrients, such as SAFA and sodium. However, models that are too restrictive might negatively impact calcium and vitamin D intake. Ultimately, the effectiveness of nutrient profiling models will be determined by the fact whether or not complying foods are consumed.

Banana as a relevant source of anthocyani(di)ns in European populations

Recently, Zamora-Ros et al. published interesting results using the large European Prospective Investigation into Cancer and Nutrition (EPIC) dietary data set in combination with anthocyanidin content data from two databases (USDA database for the flavonoid content of selected foods and Phenol-Explorer) for an estimation of anthocyanidin intake in ten European countries. They revealed differences in anthocyanidin intake between northern, central and southern Europe. We agree with the authors that ‘these descriptive data will be valuable for future aetiological research focused on the relationships between anthocyanidins and chronic diseases’. We also agree to the authors indicating that it is important to take into account differences among individual anthocyanidins regarding their effects against cancer and cardiovascular as well as neurodegenerative diseases. However, we do not agree with the statement ‘there are no large differences in the anthocyanidin data between the two databases’, at least on one point: one noticeable difference is the relatively high delphinidin value (7·39 mg/100 g) given for bananas by the USDA database in contrast to no anthocyanidin values given for bananas by Phenol-Explorer. As bananas are stated as the major source of delphinidin in EPIC subjects from central and northern Europe and the second main source in those from southern Europe in the results section of Zamora-Ros et al., we assume that the authors used the value from the USDA database. However, in the supplementary table provided by Zamora-Ros et al. bananas are not listed, despite the fact that their delphinidin content listed in the USDA database is higher than that of other fruits provided in the supplementary table and the fact that banana is mentioned as a relevant source. In this context, we would like to comment on two points. First, as estimated anthocyanidin intake is supposed to be a measure for anthocyanin intake assuming that they or their metabolites are effective in promoting health-benefits, it is essential to include only those anthocyanidin values in intake estimations supposed to be derived from anthocyanins. It has not been shown yet that bananas contain anthocyanins, but rather contain proanthocyanidins or not yet specified anthocyanidin-polysaccharides. The analytical methodology used to generate the values for bananas in the USDA database, which was used for the intake estimation of Zamora-Ros et al. and other studies, is probably not suitable to measure anthocyanidins from anthocyanins. Therefore, we suggest to exclude this delphinidin value for bananas from the intake estimations of anthocyanins. As a consequence of questioning a specific content value, the derived results and interpretations have to be questioned, too. In the present analysis of EPIC data, the inverse regional gradient found for delphinidin, in contrast to the increasing intake of total anthocyanidins, cyanidin, malvidin and peonidin from north to south, might be affected by the exclusion of the delphinidin value for bananas. One could assume that anthocyanidins derived from molecules other than anthocyanins, e.g. from proanthocyanidins, are also bioaccessible in humans and lead to the same effects as those derived from anthocyanins. But in this case, any anthocyanidin derived from molecules other than anthocyanins in any food should be included in the intake estimations, not only those found in bananas. Secondly, irrespective of the doubts concerning the delphinidin value for bananas, the estimated contribution of bananas to anthocyanidin intake cannot be retrieved from the data as presented. In Table 4, presenting the contribution of foods to the intake of anthocyanidins it is not apparent to which group bananas were allocated. The only reasonable group among those mentioned in this table would be berries, as botanically bananas are berries. But then, it would not be likely that bananas are mentioned as the main source of delphinidin in northern and central Europe and at the same time the berries group is stated as the third important source after non-alcoholic beverages in the results section. The real contribution of bananas to delphinidin intake in this estimation is therefore not clear. In conclusion, we are aware of the great possibilities for identifying the effects of anthocyanins on diseases with the EPIC data, but we believe that it is important to first be certain about the underlying content data before using them for aetiological studies on the relationship between anthocyani(di)n intake and chronic diseases.