Considerations about nutritional health characteristics of apparently healthy very old people.
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Biomedical subjects
Publications and source records attributed to J F de Wijn.
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In achieving adequate nutrition for all people in the world foods of animal origin are indispensable to supply sufficient protein and essential nutrients. All foods of animal origin have a number of characteristics in common, in view of which they should be regarded as highly valuable human food because of the considerable biological value of the proteins, their ready digestibility and their palatability. A number of nutritional features of animal versus vegetable protein are discussed. Several queries have to be placed against the health aspects of the copious consumption of animal protein as has increasingly become the practice in Europe. The consumption of dishes prepared from food of animal origin high in protein will inevitably be associated with a high fat content. It is not likely that, specifically, the incidence of human cancer will also be increased by the allegedly carcinogenic effects of meat persé, however using nitrite in meats may be hazardous when consumption of meat is considerable because of the carcinogenic effects of nitrosamines. In addition, there are drawbacks to the copious consumption of food of animal origin as part of the daily diet because of the high fat content and low dietary fibre content of this food. A conference of managers in the animal-food industry and experts from the professional medical and dietetic organizations would be a desirable improvement in achieving an optimum situation. Sufficient production and distribution will not fully ensure adequate nutrition of animal origin. Its valuable nutrients must be available from food which is acceptable to the individual consumer. Those factors which decide what is eaten and why, are not known to a sufficient extent. Cultural and environmental factors also play a highly decisive role in the matter. There are religious rules regarding food of animal origin, which obtain for large sections of the population all over the world. Other practices concerning the consumption of food of animal origin are also determined by the pressure of society regarding the attitude towards animals.
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A review is presented of the prevalence of obesity among apparently healthy 8 year old schoolchildren, based on the findings of the National Nutrition Council's cross-sectional surveys, periodically performed in the Netherlands with 3 year intervals in the period 1960-1977. When clinical obesity is defined as more than 25 pct fat mass of total body-weight in young children, 3 to 4 pct obesity occurs in smaller towns or villages in the peripheral areas of the country and 4 to 7 pct in big cities. When 20 pct fat mass is the criterium for the lower limit of obesity, the prevalence for thick including obese children varies from 10 to 13 pct in small towns versus 14 to 20 pct in big cities. The prevalence of obesity thus defined tends to be lower from 1968 onwards. From various other surveys in the Netherlands similar reports are published, mentioning 2 pct of clinical obesity among 6 to 7 year olds up to 4 and 7 pct among 10 year olds and 8-10 pct among school attending adolescents of 15 and 16 years old. There are no reliable data on the prevalence of obesity among infants and toddlers in this country. A second part of this interview on obesity among children will relate to the possible effects of childhood obesity for obesity in later life.
A review is presented of factors predisposing for obesity in childhood and of the probability to maintain early obesity in later years. From literature about retrospective studies it appears that total weight gain in the first year of life is the highest correlated factor with obesity at age 15. The risk of persisting therapy-resistant obesity at that age is not related to a specific critical period during infancy. The risk for metabolic disturbances at later age seems to be greatest when obesity develops earlier and lasts longer. Analysis of the findings among 8-year old Dutch children suggest that various environmental conditions of family-life are at the age determining the prevalence of obesity. Both material and emotional factors as well as aspects of parental education are involved. Some prospective studies demonstrate that for respectively female and male young adults ca 20 and 30 pct of the degree of fatness correlates with skinfold measurements in childhood. Once obesity among Dutch male adolescents at the age of 18 was established, for two-thirds this obesity was maintained at the age of 33. On the other hand for most of the 33 year old obese, obesity had developed after the age of 18.
It appears from literature that obesity among breastfed infants is less prevalent than among over bottle fed infants. There is conflicting understanding as to a significant contribution of infant food habits to lasting obesity. Attention for prudent food intake seems to be particularly indicated when one of the parents or both are obese. Too early introduction of solids in addition to milk formula does probably not contribute too much to infants overfeeding, but enlarges the risk for early manifestation of allergies or coeliac disease and for restricted iron absorption. The food pattern of toddlers and schoolchildren in the Netherlands is characterized by an over validation of the health promoting significance of animal protein rich products. This may contribute to the consumption of excess saturated fatty acids and relatively little dietary fibre. Both relatively fatty food and little dietary fibre as well as over consumption of milky products and sugar in soft drinks or lemonade can easily enhance the development of obesity in young children. Protein consumption of 2.5 grams per kg BW, two thirds of which is from animal source, is repeatedly noted, whereas 1 à 1.5 grams of mixed protein per kg BW can be considered adequate for healthy toddlers and young school age children to guarantee normal growth and development. In addition to the traditional three main meals, it appears that 8 year olds in the Netherlands consume 20 pct of the total amount of energy intake in the form of in-between-meal snacks, which may also contribute to the possible development of obesity.
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