Heli Tapanainen

Snacks as an element of energy intake and food consumption

Background:An increasing frequency of snacks has been observed in meal pattern studies. Snacks can alter the diet because of their high-energy density and low-nutrient content or on the contrary.Objective:The prominence of snacks in energy intake and food consumption was assessed.Design:Dietary data were collected for 2007 adults by using a computer-assisted 48-h dietary recall in the national FINDIET 2002 survey. Energy intakes and food consumption were aggregated for snacks and for main meals.Results:Daily energy was mostly derived from main meals comprising traditional mixed dishes, milk and bread. However, a snack-dominating meal pattern was observed in 19% of men and 24% of women. This meal pattern was associated with urbanization in both genders and with physical work in men. Higher sucrose intake and lower intake of micronutrients were typical of the snack-dominating meal pattern compared to the others.Conclusions:As snacks appear to have a higher energy density and a lower content of micronutrients than main meals, a snack-dominating meal pattern is inadvisable. However, further studies are needed to examine the association between meal pattern and health status.

Perinatal Factors and the Risk of Asthma in Childhood—A Population-based Register Study in Finland

The aim of the study was to assess whether perinatal factors are associated with the risk of asthma in childhood in a register-based, nested case-control study in Finland. All children born between January 1, 1996, and April 30, 2004, who were entitled to a special reimbursement for antiasthmatic drugs (i.e., had diagnosed asthma by 2006 and had purchased inhaled corticosteroids or montelukast at least once), were identified (n = 21,038). For each case, one matched control child was selected. The associations between perinatal factors, derived from the Finnish Medical Birth Register, and the risk of asthma were analyzed by conditional logistic regression. In the final multivariate model, maternal asthma, young age, smoking, previous miscarriages, and a high number of previous deliveries, as well as cesarean section, low gestational age, and low ponderal index, were associated with an increased risk of asthma in children diagnosed before the age of 3 years. Among children diagnosed at the age of 3 years or later, maternal asthma, low gestational age, and low ponderal index were associated with an increased risk, and a high number of previous deliveries was associated with a decreased risk of asthma. In conclusion, perinatal factors play a role in the development of asthma in childhood, but the etiology may differ in early and late-onset asthma.

Food consumption and nutrient intake in Finnish 1 6-year-old children

OBJECTIVE To study food consumption and nutrient intake in Finnish children aged 1-6 years and to assess the effect of age and sex on food consumption and nutrient intake. DESIGN Cross-sectional samples of children participating in the Type 1 Diabetes Prediction and Prevention (DIPP) birth cohort study in Finland. SUBJECTS The study population comprised healthy children recruited in the nutrition study within the DIPP study in 1998-2003. Three-day food records (2535 in total) from 1-, 2-, 3-, 4- and 6-year-old children were kept between the years 2003 and 2005. RESULTS The energy-adjusted consumption of fruits and berries, cereal products, infant formulas and meat dishes was higher and the consumption of vegetables, salads, breads, dairy products, fat spreads, drinks, sweets and sugar was lower among 1-year-old children than older age groups (P for all <0.05). The mean daily energy intake increased with age and was higher among boys than girls in all age groups, except among the 2-year-olds (P for all <0.05). The diet of the 2-6-year-old children contained too much saturated fat and sucrose, and too little PUFA compared with the current Nordic Nutrition Recommendations. The intakes of most vitamins and minerals met the recommendations. However, the intakes of vitamin D, E and iron fell below the recommended levels. The nutrient density of the diet decreased after the age of 1 year at the time that the children adapted to the regular family diet. CONCLUSIONS In order to improve the diet of young children, it is essential to evaluate the diet of the whole family.

Dietary habits and nutrient intake of Finnish adolescents

OBJECTIVE To evaluate food and nutrient intake and especially eating during the school day among Finnish secondary-school pupils. DESIGN Cross-sectional study. Data were collected using a structured questionnaire mailed to home and by 48 h dietary recall interviews performed at schools in 2007. SETTING Twelve schools in three cities in Finland. SUBJECTS The seventh grade pupils (a total of 1469 at the mean age of 13.8 years). Questionnaire data were available from 726 pupils and dietary data from a subgroup of 40 % (n 306). RESULTS According to the questionnaire data, 40 % of the girls and 28 % of the boys reported eating fresh vegetables daily and the respective figures for fruit were 32 % and 23 %. Altogether, 71 % of the adolescents reported having school lunch every day. The average intake of sucrose was higher and the average intakes of fibre, iron, folate and vitamin D were lower than recommended. School lunch provided around 20 % of daily energy intake, while the recommended daily energy intake level is one-third. However, the school lunch as consumed was nutritionally superior to the other daily meals. Snacks provided 41 % of the daily energy. The most common sources of sucrose were sugary drinks. CONCLUSIONS Low consumption of fruit and vegetables and abundant consumption of sucrose-rich drinks and snacks are the main problems in the diet of Finnish adolescents. The nutritional quality of the school lunch is good, but the supply of healthy snacks must be improved in schools. Schools can promote healthy eating habits by making healthy choices easy during the school day.

FINDIET 2007 Survey: energy and nutrient intakes.

OBJECTIVE The National FINDIET surveys are carried out every 5 years to monitor dietary habits and nutrient intake of the adult Finnish population. The latest survey was carried out in 2007. DESIGN Cross-sectional population-based study. Dietary assessment was carried out using 48 h recall interviews. A picture book of food portions was used to estimate portion sizes and the national Food Composition Database Fineli(R) to calculate nutrient intakes. SETTING A representative sample taken in five regions in Finland. SUBJECTS A total of 730 men and 846 women aged 24-64 years. RESULTS The percentage contribution of fat to the total energy intake was 33 % in men and 31 % in women. The respective percentages for SFA in men and women were 13 % and 12 %, respectively, and 0.4 % for trans fatty acids in both genders. The average intakes of folate, vitamin D and fibre fell below the recommended levels, whereas the average salt intake was somewhat higher than the recommendations. Womens diet was higher in protein, dietary fibre and sucrose compared to that of men. CONCLUSIONS According to the FINDIET 2007 Survey, the dietary habits of the adult Finnish population have headed in a positive direction overall. However, although the quality of the fats consumed has continued to improve, and the intake of salt has decreased, they still do not meet the recommended levels of intake. Similarly, the average intakes of folate and vitamin D continue to fall below the recommendations. There is also a need to increase fibre intake and to cut down the intake of sucrose.

Food consumption and advanced β cell autoimmunity in young children with HLA-conferred susceptibility to type 1 diabetes: a nested case-control design

BACKGROUND Evidence for the role of food consumption during childhood in the development of β cell autoimmunity is scarce and fragmentary. OBJECTIVE We set out to study the associations of longitudinal food consumption in children with the development of advanced β cell autoimmunity. DESIGN Children with advanced β cell autoimmunity (n = 232) (ie, with repeated positivity for antibodies against islet cells) together with positivity for at least one of the other 3 antibodies analyzed or clinical type 1 diabetes were identified from a prospective birth cohort of 6069 infants with HLA-DQB1-conferred susceptibility to type 1 diabetes who were born in 1996-2004, with the longest follow-up to the age of 11 y. Repeated 3-d food records were completed by the families and daycare personnel. Diabetes-associated autoantibodies and diets were measured at 3-12-mo intervals. Four control subjects, who were matched for birth date, sex, area, and genetic risk, were randomly selected for each case. RESULTS In the main food groups, only intakes of cow-milk products (OR: 1.05; 95% CI: 1.00, 1.10) and fruit and berry juices (OR: 1.09; 95% CI: 1.02, 1.12) were significantly, although marginally, associated with advanced β cell autoimmunity. The consumption of fresh milk products and cow milk-based infant formulas was related to the endpoint, whereas no evidence was shown for consumption of sour milk products and cheese. The intake of fat from all milk products and protein from fresh milk products was associated with risk of advanced β cell autoimmunity. CONCLUSION Intakes of cow milk and fruit and berry juices could be related to the development of advanced β cell autoimmunity. This trial was registered at clinicaltrials.gov as number NCT00223613.

Dietary fatty acid composition during pregnancy and the risk of asthma in the offspring

To cite this article: Lumia M, Luukkainen P, Kaila M, Tapanainen H, Erkkola M, Uusitalo L, Niinistö S, Kenward MG, Ilonen J, Simell O, Knip M, Veijola R, Virtanen SM. Dietary fatty acid composition during pregnancy and the risk of asthma in the offspring. Pediatr Allergy Immunol 2011: 22: 827–835.

Diet composition of pregnant Finnish women: changes over time and across seasons

OBJECTIVE To describe the diet of a population of pregnant Finnish women over a period of 7 years, with special attention paid to seasonal fluctuations in food consumption and nutrient intake. DESIGN A validated 181-item FFQ was applied retrospectively, after delivery, to assess the maternal diet during the 8th month of pregnancy. SETTING Type 1 Diabetes Prediction and Prevention Nutrition Study Cohort. SUBJECTS The cohort comprised a total of 4880 women who had newly delivered during the years 1997-2004, with the offspring carrying increased genetic risk for type 1 diabetes mellitus. RESULTS Over the study period, the proportion of energy derived from fat decreased while the intake from protein and carbohydrate increased. The intake of vitamin D increased from food sources. Seasonal variation was observed in the mean daily consumption of vegetables, fruits and berries and cereals. Intake of dietary fibre, total fat, MUFA, vitamins A, D, E and C, folate and iron also showed seasonal fluctuation. CONCLUSIONS These results show an overall positive trend in the diet of pregnant Finnish women through the study years. However, there is still room for improvement, particularly in the types of dietary fats. Although food fortification with vitamin D since 2003 was reflected in the increased intake of vitamin D from foods, the mean intake levels still fell below the recommendations. Seasonal changes in food consumption were observed and related to corresponding fluctuations in nutrient intakes. The mean folate intake fell below the recommendation throughout the year.

The diet of adolescents can be improved by school intervention

OBJECTIVE To decrease the intake of sucrose, increase the intake of fibre and the consumption of fruit and vegetables among secondary-school pupils. DESIGN Intervention study among eighth grade pupils during one school year. Data were collected by questionnaires and from a subgroup of pupils by 48 h dietary recall at baseline in spring 2007 and after the intervention in 2008. SETTING Twelve secondary schools were randomly allocated to intervention (IS) and control schools (CS) within three cities. Intervention included nutrition education and improvement of the food environment focusing particularly on the quality of snacks at school. SUBJECTS A total of 659 pupils completed the questionnaires and the dietary recall was obtained from 287 pupils both at baseline and follow-up. RESULTS The frequency of consumption of rye bread increased (P = 0.03) and that of sweets decreased (P = 0.006) among girls in the IS. The intake of sucrose fell among IS pupils, from 12.8 % to 10.5 % of the total energy intake (P = 0.01). Intake of fruit (g/MJ) remained the same in IS, whereas it decreased in CS (P = 0.04). CONCLUSIONS Sugar intake can be lowered by improving the quality of snacks, but it is more difficult to increase fibre intake and fruit and vegetable consumption unless the content of school lunches can be modified. It is the responsibility of the adults working in schools to create a healthy environment and to make healthy choices easy for pupils.

Validation of the Finnish ISAAC questionnaire on asthma against anti-asthmatic medication reimbursement database in 5-year-old children

Background:  Valid identification of childhood asthma at the population level for epidemiological purposes remains a challenge. We aimed at validating the Finnish version of the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire based on parental‐reported childhood asthma.