Sedentary Behavior Is Independently Related to Fat Mass among Children and Adolescents in South China

We aim to explore the independent associations of sedentary behaviors (SB) with body mass distribution among Chinese children. Data on the screen-based sedentary time (television viewing and computer use) and doing homework, physical activities and dietary intake of 1586 Chinese children (50.3% girls) aged 7–15 years were obtained through validated questionnaires. Skin-fold thickness, body height, and weight were measured to calculate percent body fat (%BF), fat mass index (FMI), and fat-free mass index (FFMI). Parental characteristics were collected by questionnaires. Among girls, time of SB (screen time or doing homework) was positively related to %BF, FMI, and FFMI (p < 0.03) after adjusting for maternal overweight, the average annual income of family, moderate-to-vigorous physical activity energy expenditure, and energy intake: Girls in the highest tertile of screen time/homework had 16.7%/23.3% higher relative FMI and 2.9%/2.9% higher relative FFMI than girls in the lowest tertile. Among boys, screen time was positively associated with FFMI (p 0.09), while time of doing homework was positively related to %BF and FMI (p = 0.03). Sedentary behaviors might be positively and independently related to fat mass among Chinese children, and were more pronounced in girls

Einfluss des Konsums von Erfrischungsgetränken auf den Ernährungs- und Gesundheitsstatus von Kindern

In Studien in den USA wurden bei Kindern und Jugendlichen Zusammenhänge zwischen dem Verzehr von Erfrischungsgetränken und der Entstehung von Übergewicht sowie einer Verschlechterung der Ernährungsqualität und des Knochenstatus beobachtet. Aufgrund von Unterschieden in den Verzehrsgewohnheiten, in der Getränkezusammensetzung und den Lebensgewohnheiten könnten diese Studienergebnisse möglicherweise bei Kindern und Jugendlichen in Deutschland nicht zutreffen. Anhand der Daten der DONALD Studie (Dortmund Nutritional and Anthropometric Longitudinally Designed Study) wurde daher untersucht, inwiefern der Verzehr von Erfrischungsgetränken auch bei in Deutschland lebenden Kindern und Jugendlichen mit Gesundheitsparametern assoziiert ist. Es wurde beobachtet, dass die Kinder und Jugendlichen der DONALD Studie etwa 10 % ihrer Gesamtenergie über Erfrischungsgetränke und Fruchtsäfte zuführten (Kapitel 3). Daher scheinen auch in Deutschland klinisch relevante Auswirkungen des Konsums von Erfrischungsgetränken und Fruchtsäften bei Kindern und Jugendlichen möglich. Die Energieaufnahme aus Getränken wurde bei Kindern und Jugendlichen der DONALD Studie nur unzureichend durch eine Reduktion der Energieaufnahme aus fester Nahrung kompensiert und führte damit zu einer Steigerung der Gesamtenergiezufuhr (Kapitel 4). Damit könnte der Verzehr von Erfrischungsgetränken und auch Fruchtsäften zu einem Ungleichgewicht in der Energiebilanz beitragen und längerfristig zu einer Gewichtszunahme führen. Es wurde festgestellt, dass die Steigerung des Verzehrs von energiehaltigen Getränken, also Erfrischungsgetränken und Fruchtsäften insgesamt, bei Mädchen in einem 5-jährigen Untersuchungszeitraum mit einer gleichzeitigen Steigerung des BMI Standard Deviation Scores (BMI-SDS) verbunden war (Kapitel 5). Bei Jungen wurde nur ein Querschnittszusammenhang zwischen dem Verzehr von Fruchtsäften und dem BMI-SDS bei der jeweils ersten Untersuchung beobachtet. Daher könnte der Verzehr von energiehaltigen Getränken zumindest bei Mädchen in Deutschland das Übergewichtsrisiko steigern. Der Verzehr von Erfrischungsgetränken war bei Jungen und Mädchen der DONALD Studie negativ mit der Zufuhr verschiedener Nährstoffe assoziiert (Kapitel 6). Bemerkenswert war besonders der negative Effekt auf die Folat- und Kalziumzufuhr bei Mädchen aufgrund der in verschiedenen Altersklassen durchschnittlich bereits bestehenden niedrigen Zufuhr. Bei Jungen und Mädchen wurde ein negativer Zusammenhang zwischen dem Verzehr von Erfrischungsgetränken und der Ernährungsqualität insgesamt festgestellt, der allerdings bei Mädchen stärker ausgeprägt war als bei Jungen. Da sich die durchschnittliche Ernährungsqualität mit zunehmendem Alter bei Mädchen verschlechterte, könnte ein hoher Erfrischungsgetränkeverzehr in Hinsicht auf die Ernährungsqualität besonders bei jugendlichen Mädchen relevant sein. Zwischen dem langfristigen Verzehr von Erfrischungsgetränken und verschiedenen Parametern des Modeling und Remodeling der Knochen, die am Unterarm mittels peripherer quantitativer Computertomographie (pQCT) gemessen wurden, wurde eine negative Assoziation nachgewiesen (Kapitel 7). Dieser Effekt des Verzehrs von Erfrischungsgetränken beruhte nicht in erster Linie auf einer Verdrängung der Milch aus der Ernährung, sondern auf einer geringeren Proteinzufuhr. Durch die beobachteten negativen Assoziationen mit verschiedenen Knochenparametern wie beispielsweise dem Knochenmineralgehalt und dem polaren Strenght Strain Index (SSI), einem Indikator für die Bruchfestigkeit der Knochen, könnte der Verzehr von Erfrischungsgetränken das Risiko für Knochenbrüche in der Kindheit und für Osteoporose im späteren Leben erhöhen. Insgesamt zeigten die Ergebnisse der verschiedenen Arbeitsschritte, dass der Verzehr von Erfrischungsgetränken und zum Teil auch der Verzehr von Fruchtsäften bei Jungen und Mädchen in der DONALD Studie das Risiko für die Entstehung weit verbreiteter ernährungsmitbedingter Erkrankungen wie Adipositas und Osteoporose erhöht. Eine Einschränkung des Konsums dieser Getränke kann somit einen sinnvollen Beitrag im Rahmen ganzheitlicher Präventionsstrategien für Kinder und Jugendliche in Deutschland leisten.Influence of soft drink consumption on the nutrition and health status of children US-American studies have not only observed associations between soft drink consumption and obesity, but also with poor of dietary quality and bone status in children and adolescents. Due to differences in dietary habits, contents of beverages, and lifestyle factors these results may not necessarily be transferable to children and adolescents in Germany. Therefore, data from the DONALD study (Dortmund Nutritional and Anthropometric Longitudinally Designed Study) were used to analyse the association between soft drink consumption and health outcomes in children and adolescents in Germany. Consumption of soft drinks and fruit juices accounted for nearly 10 % of total energy intake in children and adolescents from the DONALD study (chapter 3). Therefore, clinically relevant consequences of soft drink consumption are also conceivable in Germany. Energy consumed as part of beverages was incompletely compensated for by lower consumption of energy from other foods, which resulted in an increase in total energy intake in children and adolescents from the DONALD study (chapter 4). Accordingly, the consumption of soft drinks, and also fruit juices, might result in an energy imbalance and weight gain in the long-term. Consumption of energetic beverages, i.e. soft drinks and fruit juices, was found to be associated with a concurrent increase in BMI Standard Deviation Scores (BMI-SDS) over a 5-year examination period in girls (chapter 5). In boys, only a cross-sectional association between the consumption of fruit juices at baseline and baseline BMI-SDS was observed. Therefore, consumption of energetic beverages might increase the risk of overweight at least in German girls. The consumption of soft drinks was negatively associated with the intake of various nutrients in boys and girls (chapter 6). Most remarkable was the negative effect on folic acid and calcium due to inadequate mean intakes of these nutrients in various age groups in girls. There was a negative association between the consumption of soft drinks and overall diet quality in both, boys and girls. However, this association was stronger in girls. Since mean diet quality decreased with age in girls, high soft drink consumption in adolescent girls in particular might be cause for concern. Long-term consumption of soft drinks was observed to be negatively associated with several parameters of bone modeling and remodeling of the forearm measured using peripheral quantitative computed tomography (pQCT) (chapter 7). This effect of soft drink consumption was not primarily mediated by milk displacement, but by lower protein intakes. Due to the observed negative associations with bone mineral content and polar strength strain index (SSI), which is an indicator of bone strength, the consumption of soft drinks might increase the risk of fractures in childhood and osteoporosis in later life. Overall, the results of these analyses provided evidence that the consumption of soft drinks, and of fruit juices to some extent, increases the risk of developing diet-related diseases such as obesity and osteoporosis in boys and girls participating in the DONALD study. Therefore, limiting the consumption of these beverages would appear to be an important component of a public health prevention strategy in German children and adolescents

Associations between macronutrient intake and serum lipid profile depend on body fat in European adolescents: the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study

The present study aimed to investigate the relationships between macronutrient intake and serum lipid profile in adolescents from eight European cities participating in the HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) cross-sectional study (2006–7), and to assess the role of body fat-related variables in these associations. Weight, height, waist circumference, skinfold thicknesses, total choles- terol, HDL-cholesterol (HDL-C), LDL-cholesterol, TAG, apoB and apoA1 were measured in 454 adolescents (44 % boys) aged 12·5–17·5 years. Macronutrient intake (g/4180 kJ per d (1000 kcal per d)) was assessed using two non-consecutive 24 h dietary recalls. Associations were evaluated by multi-level analysis and adjusted for sex, age, maternal education, centre, sum of four skinfolds, moderate-to-vigorous

Full Breastfeeding and Allergic Diseases—Long-Term Protection or Rebound Effects?

A previous follow-up of the GINIplus study showed that breastfeeding could protect against early eczema. However, effects diminished in adolescence, possibly indicating a “rebound effect” in breastfed children after initial protection. We evaluated the role of early eczema until three years of age on allergies until young adulthood and assessed whether early eczema modifies the association between breastfeeding and allergies. Data from GINIplus until 20-years of age (N = 4058) were considered. Information on atopic eczema, asthma, and rhinitis was based on reported physician’s diagnoses. Adjusted Odds Ratios (aOR) were modelled by using generalized estimating equations. Early eczema was associated with eczema (aORs = 3.2–14.4), asthma (aORs = 2.2–2.7), and rhinitis (aORs = 1.2–2.7) until young adulthood. For eczema, this association decreased with age (p-forinteraction = 0.002–0.006). Longitudinal models did not show associations between breastfeeding and the respective allergies from 5 to 20 years of age. Moreover, early eczema generally did not modify the association between milk feeding and allergies except for rhinitis in participants without family history of atopy. Early eczema strongly predicts allergies until young adulthood. While preventive effects of full breastfeeding on eczema in infants with family history of atopy does not persist until young adulthood, the hypothesis of a rebound effect after initial protection cannot be confirmed

Clinical Trials Required to Assess Potential Benefits and Side Effects of Treatment of Patients With Anorexia Nervosa With Recombinant Human Leptin

The core phenotype of anorexia nervosa (AN) comprises the age and stage dependent intertwining of both its primary and secondary (i.e., starvation induced) somatic and mental symptoms. Hypoleptinemia acts as a key trigger for the adaptation to starvation by affecting diverse brain regions including the reward system and by induction of alterations of the hypothalamus-pituitary-“target-organ” axes, e.g., resulting in amenorrhea as a characteristic symptom of AN. Particularly, the rat model activity-based anorexia (ABA) convincingly demonstrates the pivotal role of hypoleptinemia in the development of starvation-induced hyperactivity. STAT3 signaling in dopaminergic neurons in the ventral tegmental area (VTA) plays a crucial role in the transmission of the leptin signal in ABA. In patients with AN, an inverted U-shaped relationship has been observed between their serum leptin levels and physical activity. Albeit obese and therewith of a very different phenotype, humans diagnosed with rare congenital leptin deficiency have starvation like symptoms including hypothalamic amenorrhea in females. Over the past 20 years, such patients have been successfully treated with recombinant human (rh) leptin (metreleptin) within a compassionate use program. The extreme hunger of these patients subsides within hours upon initiation of treatment; substantial weight loss and menarche in females ensue after medium term treatment. In contrast, metreleptin had little effect in patients with multifactorial obesity. Small clinical trials have been conducted for hypothalamic amenorrhea and to increase bone mineral density, in which metreleptin proved beneficial. Up to now, metreleptin has not yet been used to treat patients with AN. Metreleptin has been approved by the FDA under strict regulations solely for the treatment of generalized lipodystrophy. The recent approval by the EMA may offer, for the first time, the possibility to treat extremely hyperactive patients with AN off-label. Furthermore, a potential dissection of hypoleptinemia-induced AN symptoms from the primary cognitions and behaviors of these patients could ensue. Accordingly, the aim of this article is to review the current state of the art of leptin in relation to AN to provide the theoretical basis for the initiation of clinical trials for treatment of this eating disorder

Dietary fatty acid intake, its food sources and determinants in European adolescents: the HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) Study

Dietary fatty acids (FA) play a role in several (patho)physiological processes at any age, and different FA have different effects on lipid status and health outcome. The present study aims to describe the FA intake and its main food sources in a population of healthy European adolescents and to assess the variation in intake as a function of non-dietary factors. FA intake was assessed with 24 h recall interviews in 1804 adolescents aged 12·5–17·5 years. Usual intakes were calculated using the multiple source method. Multilevel analyses, adjusting for study centre, were used to investigate the influence of non-dietary factors. The mean total fat intake was 33·3 (sd1·2) % of total energy intake (%E). The mean SFA intake was 13·8 (sd1·2) %E, with 99·8 % of the population exceeding the recommendations. SFA was mainly delivered by meat and cake, pies and biscuits. In most adolescents, the PUFA intake was too low, and 35·5 % of the population did not achieve the minimum recommended intake for α-linolenic acid (ALA). The main determinants of FA intake in the present study population were age and sex, as well as physical activity in the male subgroup. No contributions of body composition, socio-economic status or sexual maturation to the variance in FA intake were observed. In conclusion, the most important public health concerns regarding FA intake in this adolescent population were the low intake of ALA and the high intake of SFA, mainly seen in the younger-aged boys. In this group the major contributor to SFA was meat.</jats:p