John D. Radcliffe

The Relationship of Breakfast Skipping and Type of Breakfast Consumption with Nutrient Intake and Weight Status in Children and Adolescents: The National Health and Nutrition Examination Survey 1999-2006

BACKGROUND National data comparing nutrient intakes and anthropometric measures in children/adolescents in the United States who skip breakfast or consume different types of breakfasts are limited. OBJECTIVE To examine the relationship between breakfast skipping and type of breakfast consumed with nutrient intake, nutrient adequacy, and adiposity status. SUBJECTS Children aged 9 to 13 years (n=4,320) and adolescents aged 14 to 18 years (n=5,339). DESIGN Cross-sectional data from the National Health and Nutrition Examination Survey 1999-2006. METHODS Breakfast consumption was self-reported. A 24-hour dietary recall was used to assess nutrient intakes. Mean adequacy ratio (MAR) for micronutrients and anthropometric indexes were evaluated. Covariate-adjusted sample-weighted means were compared using analysis of variance and Bonferronis correction for multiple comparisons among breakfast skippers (breakfast skippers), ready-to-eat (RTE) cereal consumers, and other breakfast (other breakfast) consumers. RESULTS Twenty percent of children and 31.5% of adolescents were breakfast skippers; 35.9% of children and 25.4% of adolescents consumed RTE cereal. In children/adolescents, RTE cereal consumers had lower intakes of total fat and cholesterol and higher intakes of total carbohydrate, dietary fiber, and several micronutrients (P<0.05 for all) than breakfast skippers and other breakfast consumers. RTE cereal consumers had the highest MAR for micronutrients, and MAR was the lowest for breakfast skippers (P<0.05). In children/adolescents, breakfast skippers had higher body mass index-for-age z scores (P<0.05) and a higher waist circumference (P<0.05) than RTE cereal and other breakfast consumers. Prevalence of obesity (body mass index > or = 95th percentile) was higher in breakfast skippers than RTE cereal consumers (P<0.05) in children/adolescents and was higher in other breakfast consumers than RTE cereal consumers only in adolescents (P<0.05). CONCLUSIONS RTE cereal consumers had more favorable nutrient intake profiles and adiposity indexes than breakfast skippers or other breakfast consumers in US children/adolescents.

Do breakfast skipping and breakfast type affect energy intake, nutrient intake, nutrient adequacy, and diet quality in young adults? NHANES 1999-2002.

Objective: To assess the impact of breakfast skipping and type of breakfast consumed on energy/nutrient intake, nutrient adequacy, and diet quality. Design: Cross-sectional. Setting: The National Health and Nutrition Examination Survey (NHANES), 1999–2002. Subjects: Young adults (20–39 years, n  =  2615). Measures: A 24-hour dietary recall was used, with breakfast defined as self-reported. Covariate-adjusted sample-weighted means for the entire days energy/nutrient intakes, mean adequacy ratio (MAR) for nutrient intakes, and diet quality (i.e., Healthy Eating Index [HEI]-2005) scores were compared using analysis of variance and Bonferronis correction (p < 0.0167) among breakfast skippers (BS), ready-to-eat-cereal breakfast consumers (RTECC), and other breakfast consumers (OBC). Energy/nutrient intakes and food consumption at breakfast were also compared (p ≤ 0.05). Results: Twenty-five percent of young adults were BS, 16.5% were RTECC, and 58.4% were OBC. Intakes of total energy, percent energy from carbohydrate, and dietary fiber were higher in RTECC than in BS and OBC. Percent energy intake from added sugars was higher in BS than in RTECC and OBC. Compared with BS and RTECC, OBC consumed a lower percent energy from carbohydrates and total sugars, but consumed a higher percent energy from total fat and discretionary solid fats and had a higher cholesterol intake. Intakes of several micronutrients were higher in RTECC than in BS and OBC. Both MAR and total HEI scores were the highest in RTECC and higher in OBC than in BS. The HEI scores for intakes of whole fruits, total/whole grains, milk, and percent energy from solid fat/alcohol/added sugar were the highest in RTECC and higher in OBC than in BS. Compared with OBC, RTECC had a higher HEI score for the intake of saturated fat. At breakfast, RTECC consumed higher intakes of total fruits, whole grains, dairy products, carbohydrates and total sugars, dietary fiber, and several micronutrients than OBC, who consumed higher intakes of meat/poultry/fish, eggs, total fat, discretionary oils/solid fats, cholesterol, and sodium than RTECC. Conclusion: Thus, RTECC had more favorable nutrient intakes and better diet quality than BS and OBC.

The relationship of breakfast skipping and type of breakfast consumed with overweight/obesity, abdominal obesity, other cardiometabolic risk factors and the metabolic syndrome in young adults. The National Health and Nutrition Examination Survey (NHANES): 1999–2006

OBJECTIVE To examine the association between breakfast skipping and type of breakfast consumed with overweight/obesity, abdominal obesity, other cardiometabolic risk factors and the metabolic syndrome (MetS). DESIGN Cross-sectional. Three breakfast groups were identified, breakfast skippers (BS), ready-to-eat-cereal (RTEC) consumers and other breakfast (OB) consumers, using a 24 h dietary recall. Risk factors were compared between the breakfast groups using covariate-adjusted statistical procedures. SETTING The 1999–2006 National Health and Nutrition Examination Survey, USA. SUBJECTS Young adults (20–39 years of age). RESULTS Among these young adults (n 5316), 23.8% were BS, 16.5% were RTEC consumers and 59.7% were OB consumers. Relative to the BS, the RTEC consumers were 31%, 39%, 37%, 28%, 23%, 40% and 42% less likely to be overweight/obese or have abdominal obesity, elevated blood pressure, elevated serum total cholesterol, elevated serum LDL-cholesterol, reduced serum HDL-cholesterol or elevated serum insulin, respectively. Relative to the OB consumers, the BS were 1.24, 1.26 and 1.44 times more likely to have elevated serum total cholesterol, elevated serum LDL-cholesterol or reduced serum HDL-cholesterol, respectively. Relative to the OB consumers, the RTEC consumers were 22%, 31% and 24% less likely to be overweight/ obese or have abdominal obesity or elevated blood pressure, respectively. No difference was seen in the prevalence of the MetS by breakfast skipping or type of breakfast consumed. CONCLUSIONS Results suggest that consumption of breakfast, especially that included an RTEC, was associated with an improved cardiometabolic risk profile in U.S. young adults. Additional studies are needed to determine the nature of these relationships.

Serum and liver lipids in rats fed diets containing corn oil, cottonseed oil, or a mixture of corn and cottonseed oils

Previous research has demonstrated that the total replacement of corn oil (CO) with cottonseed oil (CSO) in the diets of growing male rats results in a lowering of the total cholesterol (TC) concentration in the serum. It is not, however, known if a partial replacement of dietary CO with CSO would be sufficient to lower TC levels, nor is the effect of replacing dietary CO with CSO on other indices of cholesterol status (e.g., the levels of high-density lipoprotein cholesterol [HDL-C], non-HDL-C [i.e., very-low and low-density lipoprotein-cholesterol], or the TC/HDL-C ratio). Growing male rats were fed diets having CO, CSO, or a CO/CSO (1:1, w/w) oil mixture (OM) as the source of dietary oil (diet groups CO, CSO, and OM, respectively). There were no differences between CO and OM groups for TC, HDL-C, non-HDL-C, or the TC/HDL-C ratio. However, TC was significantly lower (p≤ 0.05)for the CSO group than the CO group (2.85 vs. 3.23 mmol/l, or 110 vs. 125 mg/dl, respectively) as was HDL-C (1.83 vs. 2.13 mmol/l, or 71 vs. 82 mg/dl, respectively), but there were no differences between these groups for non-HDL-C or the TC/HDL-C ratio. Diet had no effect on serum triglycerides (TGs) or on total liver content of either cholesterol or TGs. Thus, partial (50%) replacement of CO with CSO was without effect on any of these serum indices of cholesterol status, but total replacement resulted in lower TC and HDL-C, without affecting non-HDL-C or the TC/HDL-C ratio. Because, relative to CO, CSO has higher levels of saturated fatty acids but lower levels of monounsaturated and polyunsaturated fatty acids, the cholesterol-lowering effect of CSO appears to be unrelated to its fatty acid composition, and may be caused by a component of its nonsaponifiable fraction.

Vitamin D intakes of adults differ by income, gender and race/ethnicity in the USA, 2007 to 2010

OBJECTIVE To determine if dietary, supplemental and total vitamin D intakes in the USA are influenced by income, race/ethnicity or gender. DESIGN Cross-sectional. US vitamin D intakes were estimated by poverty income ratio (PIR), race/ethnicity and gender using 24 h dietary intake recalls and dietary supplement use questionnaires. Statistical analyses of weighted data were performed using SAS (version 9.2) to estimate means and their standard errors. Race and ethnic intake differences controlling for PIR, gender and age were assessed by ANCOVA. SUBJECTS Adults aged ≥19 years. SETTING The 2007-2010 National Health and Nutrition Examination Survey, USA. RESULTS Total (dietary and supplement) vitamin D intake was greater in the high (10.0 (se 0.30) μg/d) v. the medium (7.9 (se 0.3) μg/d) or the low (8.0 (se 0.3) μg/d) PIR categories. Total vitamin D intake of non-Hispanic Whites (10.6 (se 0.4) μg/d) was greater than that of Hispanics (8.1 (se 0.3) μg/d) and non-Hispanic Blacks (7.1 (se 0.3) μg/d). Supplemental vitamin D intake was greater by females (5.3 (se 0.2) μg/d) than by males (3.3 (se 0.2) μg/d). Participants with high income were more likely to be vitamin D supplement users (33.0%) than those with medium (22.5%) or low (17.6%) income. High-income non-Hispanic Whites had the lowest percentage (57%) not meeting the Estimated Average Requirement for vitamin D. Fortified milk and milk products provided 43.7% of the dietary vitamin D intake. CONCLUSIONS Public health efforts should expand the number of vitamin D-fortified foods and encourage the consumption of foods high in vitamin D and use of supplements.

Vitamin D intakes of children differ by race/ethnicity, sex, age, and income in the United States, 2007 to 2010

The 2007-2010 National Health and Nutrition Examination Survey was used to estimate vitamin D intakes of children 1 to 18 years old in the United States by race/ethnicity, sex, age, and family using 24-hour dietary intake recalls and dietary supplement use questionnaires. We hypothesized that total, dietary, and supplemental vitamin D intakes of children would differ by race/ethnicity, sex, age, and income. Statistical analyses of weighted data were performed using Statistical Analysis Software (V 9.2) to estimate means ± SE. Race and ethnic intake differences controlling for poverty income ratio (PIR), sex, and age were assessed by analysis of covariance. Total (dietary and supplement) vitamin D intake was greater in the high (7.9 ± 0.3 μg/d) vs the medium (6.5 ± 0.3 μg/d) income group, but not the low (7.2 ± 0.2 μg/d) PIR group. Total vitamin D intake of non-Hispanic (NH) white children (8.1 ± 0.2 μg/d) was greater than Hispanic (7.0 ± 0.2 μg/d) and NH black (5.9 ± 0.2 μg/d) children. Total vitamin D intake declined with age, and intake by boys was higher than girls. Only 17.4% of the children consumed supplements containing vitamin D. Overall, mean intake of vitamin D by all children in each age and ethnic group was lower than the estimated average requirement for vitamin D. Public health efforts should encourage consumption of foods high in vitamin D, expand the number of foods fortified, and target health messages to parents to increase use of vitamin D supplements by children.

The effect of a methylcholanthrene-induced sarcoma on the protein status of fischer rats

Abstract The effect of a methylcholanthrene (MCA)-induced sarcoma on the protein status of male Fischer 344 rats was investigated. Ten, 10-week old male animals were implanted with the MCA sarcoma and, along with equal numbers of age-matched control and pair-fed male animals, were fed a purified (30% casein, 20% fat) diet after tumors became palpable at day 7 post-transplant. MCA sarcoma growth depressed food intake at day 14 post-transplant and animals were killed at day 22 post-transplant. Relative to controls, tumor growth was associated with decreased protein content of gastrocnemius muscle and increased protein content of spleen with liver, kidney and heart protein levels being unaffected by tumor growth. Serum albumin levels were lower, and serum globulin levels higher in tumor-bearers than controls. Data from pair-fed animals suggested that decreased gastrocnemius muscle protein was partly attributable to food intake depression, and partly to tumor growth. Increased spleen protein and hyperglobulinemia were due to tumor growth per se.

The effect of dietary cholesterol level on lipid status and initiation of atherosclerosis in Japanese quail

Abstract The effect of variations in dietary cholesterol level on the development of hyperlipidemia, tissue cholesterol status and incidence of atherosclerosis was investigated in male Japanese quail of strain SEA (Susceptible to Experimental Atherosclerosis). Groups of 12, five-week-old, birds were fed one of four purified diets. The basal diet contained (weight %): soyprotein, 35; beef tallow, 10; glucose, 46; three atherogenic diets were prepared by replacing glucose with 0.25, 0.5 and 1.0% cholesterol in the basal diet formula. After 4 weeks, birds were killed and serum, thoracic aortae, brachiocephalic arteries, and liver were taken for analysis. Serum cholesterol was increased (relative to basal values) by 15, 127 and 229% for birds fed the 0.25, 0.5 and 1.0% cholesterol diets respectively; increases were due to elevations of cholesterol in the very low density lipoprotein (VLDL) and low density lipoprotein (LDL) fractions. Hepatic and arterial cholesterol levels increased with increasing dietary cholesterol levels, but there were significant, between-group differences in the case of liver cholesterol only. Lesion incidence was 0, 8, 43 and 50% for birds fed the basal, 0.25, 0.50 and 1.0% cholesterol diets respectively. The small dot-like, yellow lesions were found predominantly in the right brachiocephalic artery and to a lesser extent in the thoracic aorta; no lesions were found in the left brachiocephalic artery. The extreme rapidity with which Japanese quail of strain SEA develop early atherosclerotic lesions makes them an attractive animal model for studying the early development of atherosclerosis in man.

Consumption of Calcium-Fortified Cereal Bars to Improve Dietary Calcium Intake of Healthy Women: Randomized Controlled Feasibility Study

Calcium is an important structural component of the skeletal system. Although an adequate intake of calcium helps to maintain bone health and reduce the risk of osteoporosis, many women do not meet recommended daily intakes of calcium. Previous interventions studies designed to increase dietary intake of women have utilized primarily dairy sources of calcium or supplements. However, lactose intolerance, milk protein allergies, or food preferences may lead many women to exclude important dairy sources of dietary calcium. Therefore, we undertook a 9 week randomized crossover design trial to examine the potential benefit of including a non-dairy source of calcium in the diet of women. Following a 3 week run-in baseline period, 35 healthy women > 18 years were randomized by crossover design into either Group I or Group II. Group I added 2 calcium-fortified cereal bars daily (total of 400 mg calcium/day) (intervention) to their usual diet and Group II continued their usual diet (control). At the end of 3 weeks, diets were switched for another 3 weeks. Intakes of calcium and energy were estimated from 3-day diet and supplemental diaries. Wilcoxon signed-rank tests were used for within group comparisons and Mann Whitney U tests were used for between group comparisons of calcium and energy intake. Dietary calcium was significantly higher during intervention (1071 mg/d) when participants consumed 2 calcium-fortified cereal bars daily than during the baseline (720 mg/d, P <0.0001) or control diets (775 mg/d, P = 0.0001) periods. Furthermore, the addition of 2 calcium-fortified cereal bars daily for the 3 week intervention did not significantly increase total energy intake or result in weight gain. In conclusion, consumption of calcium-fortified cereal bars significantly increased calcium intake of women. Further research examining the potential ability of fortified cereal bars to help maintain and improve bone health of women is warranted. Trial Registration ClinicalTrials.gov NCT01508689

Comparison of the effect of dietary casein and cottonseed protein on food intake and growth in normal and tumorbearing rats

Abstract Male Fischer 344 rats with (tumor-bearers) and without (controls) a transplantable methylcholanthrene sarcoma were fed isonitrogenous, isoenergetic diets containing either casein or cottonseed protein (CSP) so as to compare the effects of these two proteins on the development of cancer-induced anorexia and cachexia. For both diets, tumor growth was associated with depressed food intake, decreased body weight, hypoalbuminemia and hyperlipidemia. Diet had no effect on food intake, weight gain or serum albumin for either controls or tumor-bearers; tumor weight was unaffected by type of dietary protein. Liver weights were lower for animals fed CSP than for those fed casein. Dietary CSP exerted a hypolipidemic effect in normal rats, but this differential effect of protein quality on serum lipids was abolished by tumor growth, as were differences in serum fatty acid profile associated with consumption of CSP. Tumor growth itself was associated with altered fatty acid profiles in serum, with the percentages of fatty acids as stearic and arachidonic acids being decreased and the percentages as oleic and linoleic acids being increased. Thus, dietary CSP has similar effects to casein on the development of cancer anorexia and cachexia in this animal model. The effects of protein quality on serum lipids, however, can be altered by tumor growth.