Dietary patterns and breakfast consumption in relation to insulin resistance in children. The Healthy Growth Study (original) (raw)
Related papers
2012
The present study examined the associations of food behaviours and preferences with markers of insulin resistance and clustered metabolic risk factors score after controlling for potential confounders, including body fat in European adolescents. A cross-sectional study ''Healthy Lifestyle in Europe by Nutrition in Adolescence Cross-Sectional Study'' of 3546 European adolescents aged 12.5-17.5 years was conducted, using a complete dataset on at least glucose, insulin and ''Food Choice Questionnaire''. Results indicated skipping breakfast, as well as the preference of some foods such as nuts, chocolate, burgers and pizzas, soft drinks or juices, explain part of homeostasis model assessment index variance. In addition, snacking regularly during school day is associated with higher metabolic risk score in females. In conclusion, the present findings suggest that intervention studies aimed to prevent insulin resistance and metabolic risk factors in youth should focus not only in influencing food and drink preferences, but also to ensure healthy food behaviour in adolescents. The harmful consequences in the choice of certain foods or drinks and food habits can be countered with proper planning and intervention programs to prevent insulin resistance and metabolic risk factors.
PLoS medicine, 2014
Regular breakfast consumption may protect against type 2 diabetes risk in adults but little is known about its influence on type 2 diabetes risk markers in children. We investigated the associations between breakfast consumption (frequency and content) and risk markers for type 2 diabetes (particularly insulin resistance and glycaemia) and cardiovascular disease in children. We conducted a cross-sectional study of 4,116 UK primary school children aged 9-10 years. Participants provided information on breakfast frequency, had measurements of body composition, and gave fasting blood samples for measurements of blood lipids, insulin, glucose, and glycated haemoglobin (HbA1c). A subgroup of 2,004 children also completed a 24-hour dietary recall. Among 4,116 children studied, 3,056 (74%) ate breakfast daily, 450 (11%) most days, 372 (9%) some days, and 238 (6%) not usually. Graded associations between breakfast frequency and risk markers were observed; children who reported not usually ha...
Public Health Nutrition, 2010
Objective: To examine the dietary intake of total sugar, added sugar, non-added sugar and starch as well as dietary fibre and glycaemic index (GI) and their respective associations with insulin resistance. Design: Mixed linear models were used to study both cross-sectional and prospective associations between carbohydrate components and insulin resistance separately in girls and boys. Diet was assessed by a single 24 h recall interview and insulin resistance was calculated using the homoestasis model assessment (HOMA). Setting: The Danish part of the European Youth Heart Studies (EYHS) I and II. Subjects: Girls and boys at 8-10 and 14-16 years from EYHS I (n 651) and 8-10-yearolds from baseline followed up 6 years later in EYHS II (n 233). Results: Among girls, a difference in dietary total sugar of 43 g/MJ was associated with a 1 SD difference of HOMA and a difference in dietary fibre of 28 g/MJ was associated with a 1 SD difference of HOMA, independent of age, maturity and other confounders (both P 5 0?03). No baseline associations were found among boys and no prospective associations were found in either sex. Conclusions: Dietary intake of total sugar may play an adverse role and fibre may play a beneficial role in concurrent insulin resistance among girls but not boys. Sex differences may be due to differences in maturity, physical activity, food patterns and selective reporting behaviours.
Dietary Sugar Intake and Its Association with Obesity in Children and Adolescents
Children
Sugar intake has been associated with increased prevalence of childhood overweight/obesity; however, results remain controversial. The aim of this study was to examine the probability of overweight/obesity with higher sugar intakes, accounting for other dietary intakes. Data from 1165 children and adolescents aged ≥2–18 years (66.8% males) enrolled in the Hellenic National Nutrition and Health Survey (HNNHS) were used; specifically, 781 children aged 2–11 years and 384 adolescents 12–18 years. Total and added sugar intake were assessed using two 24 h recalls (24 hR). Foods were categorized into specific food groups to evaluate the main foods contributing to intakes. A significant proportion of children (18.7%) and adolescents (24.5%) exceeded the recommended cut-off of 10% of total energy intake from added sugars. Sweets (29.8%) and processed/refined grains and cereals (19.1%) were the main sources of added sugars in both age groups, while in adolescents, the third main contributor ...
Dietary habits of primary school children and factors affecting their food choices
2021
Overview: Childhood overweight and obesity epidemic, is of global concern, with potential major national and worldwide health consequences caused by highly modifiable factors, including poor diet, physical inactivity, and various behavioural variables. World Health Organization has estimated childhood overweight to be over 42 million globally (WHO, 2013), making childhood obesity of great concern since it has been associated with an increased susceptibility to chronic diseases later in life. Furthermore, although the prevalence appears to plateau in the United States and Europe, studies from South European countries demonstrate that the problem is escalating, with higher prevalence in childhood overweight and obesity compared to north European countries. This rapid increase in the prevalence of obesity in Mediterranean countries over the last decades, leads to the necessity to expand research investigations in order to understand the reasons behind this prevalence increase. Objectives: Using data from the nation wide Greek Childhood Obesity (GRECO) cross sectional study on 10-12 year old children, the primary goal was to derive a food index that may predict childhood overweight and obesity, hence leading to primary prevention. Secondarily, the effect that behavioural factors, including sleep duration, total screen time (average per day) and total study hours, number of meals per day, frequency of having meals while on a screen, frequency of having family meals, and frequency of eating/ordering out, have on the increase of childhood overweight were examined in relation to the FI. Special attention was given on the children's readiness to change behaviors, hence the GRECO study was used to examine school children's willingness to ameliorate eating behaviors in relation to their weight-status and their current eating patterns, as well as to assess potential gender differences Lastly the association between maternal-smoking on children's weight status and on adiposity levels was also assessed. Methods: A stratified representative sample among 10 Greek regions, of 5000 children and their parents or primary care givers, were invited to enrol in the study. Anthropometric data were 9 measured in children and a 48 question validated Food Frequency Questionnaire (FFQ) was completed. Data on behavioural aspects were also obtained. Data on adults were self reported and included anthropometric, pregnancy and behavioural information. The child derived FI (cd-FI), was created based on obesogenic and protective foods, based on population wide evidence: Mediterranean and National Healthy eating guidelines. A total of 14 foods, were included in the cd-FI, based on a priori knowledge of food items and food patterns for children, with weights given to specific foods, for the first time in an index, considering the populations studied needs, i.e. growth. This was used to assess the effect bahavioral variables and maternal-smoking on the prevalence of child obesity. Eating behaviors and assertiveness to change were assessed based on gender differences and weight status, to assess the possible effect that a child's weight may have on their response. Results: Data on 4786 (95%) children and 2318 (51%) parents were finally obtained. The cd-FI constructed adequately distinguished overweight and obese children, from their healthy weight peers among a nation wide sample of school-aged children, with overweight and obese children having a lower cd-FI score compared to their normal weight peers. Behavioural analysis showed that total sleep & screen duration, frequency of family meals, frequency of eating out, and frequency of eating while watching TV, when adjusted for age, were associated with cd-FI score, significantly increasing it's predictive ability of childhood overweight and obesity. Furthermore, the likelihood of children being overweight or obese decreased when they slept more, studied less, and had a higher FI score, had more frequent family meals and consumed more meals per day. Although crude total screen time was significantly associated with increased odds of overweight and obesity in children, the effect was nulled in the model that included cd-FI and total study time. When children's willingness to ameliorate eating behaviours was examined, a greater percentage of females and overweight & obese children expressed greater assertiveness to alter various eating behaviours and habits, including increasing healthy snack intake and replacing ssb's with their no sugar counterpart, if this was offered. Also the higher the mean cd-FI score, the more assertive children were to change. Children with high 10 weight perception-self-esteem, addressed via weight-perception, were more likely to reduce portion size and responded that peer opinion did not affect their snack selection. Maternal-smoking was found to be significantly associated with children's weight status and central adiposity in all models tested, including maternal and child characteristics, coffee and alcohol intake during pregnancy, child behavioural factors and dietary patterns. The association however, was not significant for total body adiposity (%) Conclusion: Dietary, behavioural and self-esteem factors have been identified in this thesis as factors that need to be addressed in order to decrease or even prevent childhood overweight and obesity. Maternal smoking during pregnancy also increases children's risk of overweight or obesity later in life as well as an increased risk for higher central adiposity suggesting direct effect. These findings underline the multifactorial nature of the childhood obesity epidemic, and suggest that understanding children's needs and perceptions may be the base of the pyramid in order to treat and more so to prevent childhood obesity.
European Journal of Clinical Nutrition, 2010
Objective: The aim of this work was to develop an index that evaluates the degree of adherence to existing dietary and lifestyle guidelines for primary school-aged children (Healthy Lifestyle-Diet Index (HLD-Index)) and examine its relationship with selected nutrient intake and insulin resistance (IR). Methods: Ten components were used to develop the HLD-Index. Scores from 0 to 4 were assigned to all components. The HLD-Index total score ranged between 0 and 40. A sample of 729 schoolchildren from Greece aged 10-12 years (The Healthy Growth Study) was used to evaluate the validation of the proposed index. Results: The overall mean ± standard deviation of the HLD-Index score was 20 ± 4.4. Higher HLD-Index scores were associated with lower proportion of children having intakes lower than Estimated Average Requirements by Institute of Medicine. On the basis of the cutoff point of 3.16 for homeostasis model assessment of IR, 20.9% of participants were found to be insulin resistant. After adjusting for potential confounders, logistic regression showed that a 1 unit increase in the score is associated with almost 8% lower odds for being insulin resistant. The cutoff point analysis revealed that score equal to or lower than 21 best discriminates children with IR from those without IR. On the basis of this cutoff point, the sensitivity of the HLD-Index was 70% and the corresponding specificity was 47%. Conclusions: The proposed HLD-Index could be used by public health policy makers and other health-care professionals to identify subgroups in the population with poor diet-lifestyle habits who are at increased probability for IR.
Public Health Nutrition
Identifying risk factors for insulin resistance in adolescence could provide valuable information for early prevention. The study sought to identify risk factors for changes in insulin resistance and fasting blood glucose levels. Prospective cohort of girls participating in the National Heart, Lung, and Blood Institute Growth and Health Study. USA. Adolescent girls (n 774) assessed at the ages of 16–17 and 18–19 years. Over a 3-year period, measurements of fasting blood glucose and insulin and serum cotinine were taken, and dietary intake (3 d food diary), smoking status and physical activity levels were self-reported. Improvements in homeostasis model assessment of insulin resistance (HOMA-IR) were associated with increases in the percentage of energy intake from polyunsaturated fats (β = −3·33, 95 % CI −6·28, −0·39, P = 0·03) and grams of soluble fibre (β = −5·20, 95 % CI −9·81, −0·59, P = 0·03) between the ages of 16–17 and 18–19 years; with similar findings for insulin. Transitioning into obesity was associated with an increase in insulin (β = 6·34, 95 % CI 2·78, 9·91, P < 0·001) and HOMA-IR (β = 28·77, 95 % CI 8·13, 49·40, P = 0·006). Serum cotinine concentrations at 16–17 years, indicating exposure to tobacco, were associated with large increases (β = 15·43, 95 % CI 6·09, 24·77, P < 0·001) in fasting blood glucose concentrations. Increases in the percentage of energy from polyunsaturated fat and fibre, and avoidance of excess weight gain and tobacco exposure, could substantially reduce the risk of insulin resistance in late adolescence.
Public Health Nutrition, 2012
ObjectiveThe present study aimed to evaluate the relationship between the consumption of selected food groups and insulin resistance, with an emphasis on sugar-sweetened beverages (SSB).DesignThe present research is a large multicentre European study in adolescents, the HELENA-CSS (Healthy Lifestyle in Europe by Nutrition in Adolescence Cross-Sectional Study).SettingHomeostasis model assessment–insulin resistance index (HOMA-IR) was calculated. Several anthropometric and lifestyle characteristics were recorded. Dietary assessment was conducted by using a short FFQ.SubjectsThe participants were a subset of the original sample (n 546) with complete data on glucose, insulin and FFQ. All participants were recruited at schools.ResultsMedian (25th, 75th percentile) HOMA-IR was 0·62 (0·44, 0·87). Mean HOMA-IR was significantly higher among adolescents consuming brown bread ≤1 time/week than among those consuming 2–6 times/week (P = 0·011). Mean values of HOMA-IR were also higher in adolesc...
Breakfast consumption and obesity among preadolescents: an epidemiological study
Pediatrics International
Background: This study aimed to examine the association between breakfast consumption and childhood weight status, in relation to various socioeconomic and lifestyle factors. Methods: A cross-sectional survey was conducted including 1,728 children aged 10-12 years and their parents, during the school years 2014-2016. Primary schools from five Greek counties (including the Athens metropolitan area) were randomly selected. Parental and child data were collected through self-administered, anonymous questionnaires. Children's weight status was based on gender-and age-specific tables derived from the International Obesity Task Force body mass index cutoffs. Logistic regression was used to determine the association between frequency and type of breakfast consumption and children's weight status. Results: The frequency of breakfast consumption was not associated with childhood overweight or obesity, even when other factors were included in the analysis like sex, age, physical activity, meals / day, family annual income, parental weight status, parental physical activity level, parental educational level and parental employment status. From the nine foods that were included only the consumption of bread or rusks and chocolate milk were found to have a negative association with childhood overweight or obesity (odds ratio: 0.51; 95% CI: 0.34, 0.79 and OR: 0.50; 95% CI: 0.28, 0.87, respectively). Conclusions: The result that frequency of breakfast consumption was not associated with children's overweight / obesity may lead to a deeper investigation of the foods consumed during breakfast. Bread or rusks and chocolate milk seemed to have a protective effect; further nutritional analysis is needed to explore the potential mechanisms of this observation.