Elisabeth Hm Temme

Food Intakes by Preschool Children in Flanders Compared with Dietary Guidelines

The objective of this study was to compare food group intakes among preschool children with food-based dietary guidelines (FBDG) and to determine the proportion of children meeting these guidelines. Food consumption of preschool children (2.5–6.5 years) living in Flanders (Belgium) were assessed in a cross-sectional study, using proxy reported 3d estimated dietary records (EDR) (n 696). Statistical modelling was used to account for within-individual variation in the 3d EDR. Mean daily intakes of most food groups (beverages, vegetables, fruit and milk) were below the minimum recommendations. Only ‘grains and potatoes’ and ‘meat products’ were in line with the recommendations and ‘bread and cereals’ showed borderline intakes. Mean intakes of energy-dense and low-nutritious foods, which are discouraged within a healthy diet (like snacks and sugared drinks), were high. Furthermore, the percentage of children complying with the different food-based dietary guidelines was for most food groups extremely low (ranging from approximately 4% for fluid and vegetable intakes up to 99% for potato intakes). Boys had in general higher mean intakes of the recommended food groups. In conclusion, preschool children in Flanders follow eating patterns that do not meet Flemish FBDG. Although the impact of these eating habits on preschooler’s current and future health should be further investigated, it is clear that nutrition education and intervention are needed among preschool children and their parents in Flanders.

The gap between food-based dietary guidelines and usual food consumption in Belgium, 2004

OBJECTIVE To evaluate the gap between food-based dietary guidelines (FBDG) and the usual food consumption in Belgium. DESIGN AND SETTING Information on food intake was collected with two non-consecutive 24 h recalls, using the validated software package EPIC-SOFT in combination with a self-administered FFQ. Habitual food intake was estimated by the Nusser method. Physical activity was evaluated according to the International Physical Activity Questionnaire. SUBJECTS A representative sample of the Belgian population aged 15 years and older was randomly selected from the National Register using a multistage stratified procedure. Dietary information was obtained from 3245 individuals. RESULTS Food intakes deviated significantly from the recommendations. In particular, fruit (118 g/d) and vegetable (138 g/d) consumption and intake of dairy and Ca-enriched soya products (159 g/d) were inadequate. Consumption of energy-dense, nutrient-poor foods (soft drinks, alcohol and snacks) was excessive (481 g/d). There were important age and gender differences. Fruit, vegetable and spreadable fat consumption was lowest, while consumption of dairy, starchy and energy-dense, nutrient-poor foods was highest among the youngest age group. Men consumed more animal and starchy foods than women, who consumed more fruits. There were only slight differences by education level. CONCLUSION Food intakes differed substantially from the FBDG. Improvement of the Belgian food pattern, in particular among the youngest age group, is necessary for a better prevention of diet-related diseases. In addition, continuous or regular monitoring is crucial to permit trend analyses and to plan effective education or intervention strategies.

Greenhouse gas emission of diets in the Netherlands and associations with food, energy and macronutrient intakes

OBJECTIVE To evaluate the greenhouse gas emission (GHGE) of diets in Dutch girls, boys, women and men and to explore associations with diet composition. DESIGN Descriptive analyses for the total population as well as stratified for gender, age and dietary environmental load. SETTING The Netherlands. SUBJECTS Dutch children and adults aged 7-69 years (n 3818). RESULTS The GHGE of daily diets was on average 3·2 kg CO2-equivalents (CO2e) for girls, 3·6 kg CO2e for boys, 3·7 kg CO2e for women and 4·8 kg CO2e for men. Meat and cheese contributed about 40 % and drinks (including milk and alcoholic drinks) 20 % to daily GHGE. Considerable differences in environmental loads of diets existed within age and gender groups. Persons with higher-GHGE diets consumed more (in quantity of foods and especially drinks) than their counterparts of a similar sex and age with low-GHGE diets. Major differences between high- and low-GHGE diets were in meat, cheese and dairy consumption as well as in soft drinks (girls, boys and women) and alcoholic drinks (men). Of those, differences in meat consumption determined the differences in GHGE most. Diets with higher GHGE were associated with higher saturated fat intake and lower fibre intake CONCLUSIONS GHGE of daily diets in the Netherlands is between 3 and 5 kg CO2e, with considerable differences between individuals. Meat, dairy and drinks contribute most to GHGE. The insights of the study may be used in developing (age- and gender-specific) food-based dietary guidelines that take into account both health and sustainability aspects.

Replacement of meat and dairy by plant-derived foods: estimated effects on land use, iron and SFA intakes in young Dutch adult females

OBJECTIVE Reduction in the current high levels of meat and dairy consumption may contribute to environmental as well as human health. Since meat is a major source of Fe, effects on Fe intake need to be evaluated, especially in groups vulnerable to negative Fe status. In the present study we evaluated the effects of replacing meat and dairy foods with plant-based products on environmental sustainability (land requirement) and health (SFA and Fe intakes) in women. DESIGN Data on land requirements were derived from existing calculation methods. Food composition data were derived from the Dutch Food Composition Table 2006. Data were linked to the food consumption of young Dutch women. Land requirements and nutrient intakes were evaluated at baseline and in two scenarios in which 30% (Scenario_30%) or 100% (Scenario_100%) of the dairy and meat consumption was randomly replaced by the same amount of plant-based dairy- and meat-replacing foods. SETTING The Netherlands. SUBJECTS Three hundred and ninety-eight young Dutch females. RESULTS Replacement of meat and dairy by plant-based foods benefited the environment by decreasing land use. The intake of SFA decreased considerably compared with the baseline situation. On average, total Fe intake increased by 2.5 mg/d, although most of the Fe intake was from a less bioavailable source. CONCLUSIONS Replacement of meat and dairy foods by plant-based foods reduced land use for consumption and SFA intake of young Dutch females and did not compromise total Fe intake.

Variation in energy and nutrient intakes among pre-school children: implications for study design.

BACKGROUND Within- and between-person variation in nutrient intakes has been characterized in adult populations, but little is known about variation in the diet of pre-school-aged children. The aim of this study was to describe dietary variations in Flemish pre-schoolers and to estimate the number of record days required for studying diet-disease associations among pre-school-aged children. METHODS Data from 3-day estimated diet records, collected in 2002-03, were used from 661 pre-school children (2.5-6.5 years) in Flanders, using parents/caregivers as a proxy. Age categories for studying differences in dietary variations between age groups were based on the age groups of the Belgian dietary recommendations (2.5-3 years and 4-6.5 years). RESULTS Overall, micronutrient intakes had smaller variance ratios than macronutrients. The largest variance ratios were found for cholesterol followed by fat, fatty acids and sodium intakes and would result in attenuated linear regression estimates of diet-disease associations in children. Within/between variance ratios were > or =1 for most nutrients in the oldest group (4-6.5 years) of pre-school children, while <1 for most micronutrients in the youngest age group (2.5-3 years), resulting in fewer days required for this youngest age group in comparison with the oldest group. No consistent differences in variance components were found between genders. Overall, 7-day dietary records were sufficient for accurately estimating 15 of the 23 nutrients in both age groups. CONCLUSION The number of record days required for reliably classifying pre-school children raises with increasing age category (from 2.5-3 years to 4-6.5 years) for most nutrients and varies from 3 or 4 days for some nutrients like carbohydrates to 2 or 3 weeks for others like dietary cholesterol or monounsaturated fatty acids.

Energy and macronutrient intakes in Belgium: results from the first National Food Consumption Survey.

Belgium until recently lacked a systematic survey of dietary habits of its inhabitants. The present study evaluated dietary composition in Belgium with respect to energy and macronutrient intakes. Information on food intake was collected using a repeated non-consecutive 24 h recall (2-8 weeks apart) with the validated software package EPIC-SOFT, in combination with a FFQ (self-administered) covering sixty food items. The database of consumed food items was linked to food composition data. Usual macronutrient intake was estimated by the Nusser method. A representative sample of the Belgian population was randomly selected from the national register following a multi-stage procedure. Information on dietary intake was obtained from 3245 subjects aged 15 years and older. Mean energy percentage (E %) of total fat (37.9 E %) and SFA (16.0 E %) was higher than the dietary reference intakes (DRI). Mean E % of total carbohydrates (45.8 E %) was lower than the DRI, while mean E % of mono/disaccharides was 20.3. Total fat and SFA intakes were higher and total carbohydrate and sugar intakes were lower in the older age categories than in the younger age categories. The percentage of energy from SFA intake was lower and that from carbohydrates was higher than that found in an earlier Belgian study. Further efforts are necessary to improve dietary macronutrient intake, taking into account differences in age categories. In addition, it will be important to monitor its changes regularly using trend analyses.

Average daily nitrate and nitrite intake in the Belgian population older than 15 years

The aim of this study was to assess the dietary intake of nitrate and nitrite in Belgium. The nitrate content of processed vegetables, cheeses and meat products was analysed. These data were completed by data from non-targeted official control and from the literature. In addition, the nitrite content of meat products was measured. Concentration data for nitrate and nitrite were linked to food consumption data of the Belgian Food Consumption Survey. This study included 3245 respondents, aged 15 years and older. Food intakes were estimated by a repeated 24-h recall using EPIC-SOFT. Only respondents with two completed 24-h recalls (n = 3083) were included in the analysis. For the intake assessment, average concentration data and individual consumption data were combined. Usual intake of nitrate/nitrite was calculated using the Nusser method. The mean usual daily intake of nitrate was 1.38 mg kg−1 bodyweight (bw) day−1 and the usual daily intake at the 97.5 percentile was 2.76 mg kg−1 bw day−1. Exposure of the Belgian population to nitrate at a mean intake corresponded to 38% of the ADI (while 76% at the 97.5 percentile). For the average consumer, half of the intake was derived from vegetables (especially lettuce) and 20% from water and water-based drinks. The average daily intake of nitrate and nitrite from cheese and meat products was low (0.2% and 6% of the ADI at average intake, respectively). Scenario analyses with a higher consumption of vegetables or a higher nitrate concentration in tap water showed a significant higher intake of nitrate. Whether this is beneficial or harmful must be further assessed.

How may a shift towards a more sustainable food consumption pattern affect nutrient intakes of Dutch children

OBJECTIVE Food has a considerable environmental impact. Diets with less meat and dairy reduce environmental impact but may pose nutritional challenges for children. The current modelling study investigates the impact of diets with less or no meat and dairy products on nutrient intakes. DESIGN Energy and nutrient intakes were assessed for observed consumption patterns (reference) and two replacement scenarios with data from the Dutch National Food Consumption Survey - Young Children (2005-2006). In the replacement scenarios, 30 % or 100 % of the consumed dairy and meat (in grams) was replaced by plant-derived foods with similar use. SETTING The Netherlands. SUBJECTS Children (n 1279) aged 2-6 years. RESULTS Partial and full replacement of meat and dairy foods by plant-derived foods reduced SFA intake by 9 % and 26 %, respectively, while fibre intake was 8 % and 29 % higher. With partial replacement, micronutrient intakes were similar, except for lower vitamin B12 intake. After full meat and dairy replacement, mean intakes of Ca, Zn and thiamin decreased by 5-13 %, and vitamin B12 intake by 49 %, while total intake of Fe was higher but of lower bioavailability. With full replacement, the proportion of girls aged 4-6 years with intakes below recommendations was 15 % for thiamin, 10 % for vitamin B12 and 6 % for Zn. CONCLUSIONS Partial replacement of meat and dairy by plant-derived foods is beneficial for childrens health by lowering SFA intake, increasing fibre content and maintaining similar micronutrient intakes. When full replacements are made, attention is recommended to ensure adequate thiamin, vitamin B12 and Zn intakes.

Are more environmentally sustainable diets with less meat and dairy nutritionally adequate

OBJECTIVE Our current food consumption patterns, and in particular our meat and dairy intakes, cause high environmental pressure. The present modelling study investigates the impact of diets with less or no meat and dairy foods on nutrient intakes and assesses nutritional adequacy by comparing these diets with dietary reference intakes. DESIGN Environmental impact and nutrient intakes were assessed for the observed consumption pattern (reference) and two replacement scenarios. For the replacement scenarios, 30 % or 100 % of meat and dairy consumption (in grams) was replaced with plant-based alternatives and nutrient intakes, greenhouse gas emissions and land use were calculated. SETTING The Netherlands. SUBJECTS Dutch adults (n 2102) aged 19-69 years. RESULTS Replacing 30 % of meat and dairy with plant-based alternatives did not substantially alter percentages below the Estimated Average Requirement (EAR) for all studied nutrients. In the 100 % replacement scenario, SFA intake decreased on average by ~35 % and Na intake by ~8 %. Median Ca intakes were below the Adequate Intake. Estimated habitual fibre, Fe and vitamin D intakes were higher; however, non-haem Fe had lower bioavailability. For Zn, thiamin and vitamin B12, 10-31 % and for vitamin A, 60 % of adults had intakes below the EAR. CONCLUSIONS Diets with all meat and dairy replaced with plant-based foods lowered environmental impacts by >40 %. Estimated intakes of Zn, thiamin, vitamins A and B12, and probably Ca, were below recommendations. Replacing 30 % was beneficial for SFA, Na, fibre and vitamin D intakes, neutral for other nutrients, while reducing environmental impacts by 14 %.

Association of physical activity, waist circumference and body mass index with subjective health among Belgian adults.

BACKGROUND The present study aimed to explore associations of physical activity (PA), waist circumference (WC) and body mass index (BMI) with subjective health in a nationally representative sample of Belgian adults. METHODS Data from the 2004 Belgian Food Consumption Survey were used. A face-to-face questionnaire about sociodemographic and socioeconomic characteristics, general health, subjective health, lifestyle and PA was completed. Weight and height were self-reported, and WC was measured in orthostatic position. PA was assessed by the short International PA Questionnaire. RESULTS In total, 3208 individuals (49.9% women) were included in the study. About 41.3% of the Belgian population did not meet the minimum recommendations for PA, whereas 24.8% of the population engaged in health-enhancing PA. In total, 29.5% of the population was overweight, 10.1% was obese and 33.2% of the population had an excessive WC. About 23.6% of the population rated their health as poor. Obese individuals were significantly less likely to report good subjective health than those with normal BMI [odds ratio (OR) = 0.538; 95% confidence interval (CI): 0.390-0.742]. This association was also identified for men and women separately. Further, both individuals who participated in health-enhancing PA and those who participated in recommended PA reported significantly better subjective health than insufficiently active individuals (OR = 2.533; 95% CI: 1.952-3.287 and OR = 1.543; 95% CI: 1.256-1.894, respectively). CONCLUSIONS A strong association was found between PA and subjective health, and in addition, a significant negative association was found between BMI and subjective health. There was no relationship between WC and subjective health among Belgian adolescents and adults.