Norton M. Holschuh

Whole Grain Consumption and Body Mass Index in Adult Women: An Analysis of NHANES 1999-2000 and the USDA Pyramid Servings Database

Objective: To examine the relationship between whole grain consumption and body mass index (BMI) in a sample of American adult women. Methods: Dietary intake data from the National Health and Nutrition Examination Survey 1999-2000 were linked to the USDA Pyramid Servings Database. Women 19 years of age and older (n = 2,092) were classified into groups based on their average whole grain (WG) intake: 0 servings, more than 0 but less than 1 serving, and ≥1 servings per day. Within these classifications, mean BMI, mean waist circumference and percent overweight/obese (BMI ≥ 25) were identified as primary dependent variables. Regression and logistic regression analyses were used to assess associations between BMI, waist circumference and percent of the population overweight/obese (BMI ≥25) and WG consumption. Results: Women consuming at least one serving of WG had a significantly lower mean BMI and waist circumference than women with no WG consumption (p < 0.05). Multiple regression analysis showed a significant inverse relationship between BMI and whole grain intake after adjustment for age, energy intake, dietary fiber and alcohol intake (p = 0.004). This effect was mildly attenuated but remained significant after further adjustment for level of physical activity, smoking status, ethnicity and education (p = 0.018). The odds ratio for having a BMI ≥ 25 was 1.47 (95% CI 1.12–1.94; p for trend 0.013) for women consuming no WG compared to those consuming at least one serving, after adjustment for all covariates. Conclusions: These data support other research suggesting increased WG intake may contribute to a healthy body weight in adult women.

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.

Associations between Yogurt, Dairy, Calcium, and Vitamin D Intake and Obesity among U.S. Children Aged 8–18 Years: NHANES, 2005–2008

The aim of this study was to investigate associations of yogurt and dairy consumption with energy, macronutrient, calcium, and vitamin D intakes, and associations with indicators of overweight/obesity in U.S. children in the National Health and Nutrition Examination Survey (NHANES 2005–2008). Using 24-hour recall data, children 8–18 years of age were classified to dairy consumption groups of <1, 1 to <2, or 2+ dairy servings, and yogurt consumers were those who reported eating yogurt during at least one of two dietary intake interviews. NHANES anthropometric measurements were used, and BMI and BMI-for-age percentiles were calculated. Yogurt and dairy consumption were associated with higher intakes of calcium, vitamin D and protein. Yogurt intake was associated with lower total fat and saturated fat intakes and body fat as measured by subscapular skinfold thickness. This study supports consumption of yogurt and higher amounts of dairy as eating patterns associated with greater intake of specific shortfall nutrients, and lower body fat in U.S. children.

Weight indicators and nutrient intake in children and adolescents do not vary by sugar content in ready-to-eat cereal: results from National Health and Nutrition Examination Survey 2001-2006

Few studies have explored the relationship between sugar content in cereal and health outcome among children and adolescents. This study was designed to investigate the associations between ready-to-eat cereals, categorized by sugar content, with weight indicators and nutrient intake profiles. Data collected from 6- to 18-year-old US children and adolescents (N = 9660) in the National Health and Nutrition Examination Survey 2001-06 were used to analyze cereal consumption. Body mass index (BMI), BMI-for-age, waist-to-height ratio, percent overweight or obese, mean day-1 intake, and usual daily intake of macronutrients and micronutrients were the dependent variables; day-1 cereal intake, categorized by tertiles of sugar content, was the main independent variable. Weighted regression with adjustment for the survey design was used to model the dependent variables as a function of day-1 cereal intake, adjusting for age group, sex, race/ethnicity, total day-1 intake of energy, calcium and sugar, the Healthy Eating Index-2005 total score, and household income. For all tertiles of sugar classifications of cereal, children who consumed cereal had significantly lower BMI compared with children who consumed no cereal (Ps < .05). Similarly, when compared with children who consumed no cereal, those who ate cereal consumed significantly less fat and cholesterol and significantly more carbohydrates, sugar, whole grains, vitamin A, thiamin, riboflavin, niacin, vitamin B(6), folic acid, vitamin B(12), vitamin C, calcium, magnesium, iron, and zinc. Lower weight and positive nutrient profiles were associated with cereal consumption regardless of sugar content.

Prospective Associations among Cereal Intake in Childhood and Adiposity, Lipid Levels, and Physical Activity during Late Adolescence

Cereal consumption is a common dietary behavior that has been associated with positive health outcomes. The objective of this study was to examine prospective associations between cereal intake in childhood and percent body fat, waist-to-hip ratio, lipid levels, and physical activity during late adolescence. In this longitudinal investigation (data collected 1987-1997), data were analyzed for the 2,379 girls who participated in the 10-year National Heart, Lung, and Blood Institute Growth and Health Study. The cumulative percent of days that each girl consumed cereal during childhood (based on 3-day food diaries collected during six study visits between ages 11.5 and 18.6 years) was examined in relation to percent body fat, waist-to-hip ratio, lipid levels, and physical activity measured at age 18.6 years. Results indicated that nearly all girls (90.1%) reported eating cereal and 18.7% reported eating cereal on half or more of the days reported in the food diaries. Girls who ate cereal on a greater percentage of days during childhood had lower percent body fat and total cholesterol, and were more likely to exhibit high levels of physical activity and less television viewing during Study Year 10 (P values<0.05). Further research should explore lifestyle issues related to cereal consumption.

Ready-to-Eat Cereal Intake is Associated with an Improved Nutrient Intake Profile among Food Insecure Children in the United States

Food insecurity affects a significant percentage of US children. Food insecurity affects households through limited intake and by reducing dietary quality. The objective of this study was to examine the associations between consumption of ready-to-eat (RTE) cereal and nutrient intake, the Healthy Eating Index, and adiposity by food secure status in children. Data from the National Health and Nutrition Examination Survey (NHANES) 2003–2008 were analyzed to categorize children ages 4 to 12 as either food secure or not food secure and as either those who eat cereal or those who do not eat cereal. Results indicated that cereal consumption was associated with a better nutrient intake profile and Healthy Eating Index for food secure and nonsecure children. Enhanced nutrient intake was greater among the food insecure children who ate cereal relative to food insecure children who did not eat cereal. These results suggest that access to foods rich in nutrition but low in cost, such as RTE cereal, may positively impact the nutritional effects of food insecurity.