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PubMed2001

Dietary patterns and dental caries in nursery school children in Nairobi, Kenya.

OBJECTIVE: To determine the dietary patterns and the prevalence of dental caries among nursery school children in Nairobi. DESIGN: A cross-sectional study. SETTING: Nursery schools in Nairobi, Kenya. SUBJECTS: Three hundred and four nursery school-children (149 males and 155 females) aged 3-5 years were assessed in 1997. RESULTS: There was a high consumption of fruits, vegetables and milk on a daily basis. There was also a high consumption of snacks both at home and at school. About 96% of the children had been breastfed, while 41% had been bottle-fed. The prevalence of dental caries was high at 63.5% and a mean decayed, missing and filled teeth index (dmft) of 2.95, with the d-component comprising 96% of the total dmft. Only 1.3% of the children had filled teeth. Increasing age was the most predictive factor in dental caries. CONCLUSION: The high consumption of refined foods and snacks, as well as the high prevalence of dental caries raises a strong public health concern. It is recommended that dietary counselling and preventive oral health programmes should be initiated and the already existing ones strengthened and incorporated in primary healthcare programmes. There is also need for policy makers to come up with guidelines on advertisements promoting cariogenic snacks.

Child, Preschool↗

PubMed1999

Diet and dental caries.

Dental caries is a diet-related disease that continues to be a problem for certain dental patients. Frequent consumption of fermentable carbohydrates that have low oral clearance rates increases the risk for enamel caries and perhaps is even more dangerous for root surfaces. Highly acidogenic snack foods should be consumed at mealtimes to reduce the risk, and between-meal snacks should be either nonacidogenic (such as xylitol products) or hypoacidogenic (such as sorbitol and HSH products). Cheeses present a naturally occurring situation that may provide anticariogenic effects from the diet. Certain additives as well as sugar substitutes show great promise for the provision of between-meal snack foods that reduce the risk of dental caries. The dental team should thoroughly understand the relationship of diet to caries and conscientiously apply that knowledge to educate the patients in general as well as counsel specific high-risk individuals. Further emphasis should be placed on the acquisition of sound scientific data for counseling caries patients concerning diet and dental caries.

Acids↗

PubMed2002

Reproducibility and validity of a short food questionnaire for the assessment of dietary habits.

BACKGROUND AND AIM: Dietary changes such as reducing the consumption of foods high in saturated fat, and increasing the daily intake of unsaturated fat, fibre and vitamins may have beneficial effects on long-term health. Accurate dietary information is essential for dietary counselling. Most of the methods used to examine an individual's diet (food records, diet interview, food frequency questionnaires) are too complicated and time-consuming for routine clinical use. There is a need for a fast and simple tool for food assessment. The aim of this study was to evaluate a short and simple food questionnaire for use in clinical practice that emphasises the intakes of fat, fibre, fruit and vegetables representative of the usual diet of an individual or group. METHODS AND RESULTS: A 15-item questionnaire was completed twice on the same day by 111 participants in order to study reproducibility, and its validity was checked by comparing the results with those of a 7-day food record for 101 subjects. The participants reported a positive attitude to the questionnaire. The reproducibility and validity studies comparing the sum scores of the questionnaire and food record gave correlation coefficients of respectively 0.95 and 0.73, thus indicating good agreement. The reproducibility study showed weighted Kappa coefficients ranging from 0.97 for milk and snacks to 0.75 for vegetables. In the validity assessment, the weighted Kappa coefficients ranged from 0.73 for butter and margarine to 0.14-0.25 for vegetables, fish and snacks, which is a less satisfactory result. The correlation coefficient between the sum score of the questionnaire and the percentage of dietary saturated fat was-0.59. CONCLUSIONS: This simple self-administered questionnaire allows for the rapid assessment of the constituents of the usual diet of an individual. It provides a good estimate of dietary fat and fibre but is less accurate in terms of the intake of vegetables, fish and snacks. It also offers an opportunity to discuss central points in the improvement of dietary habits and may be a useful health educational tool in clinical practice.

Adult↗

PubMed1992

Prevalence of dental caries and enamel defects in the primary dentition of Antiguan pre-school children aged 3-4 years including an assessment of their habits.

In 1989 a national survey was carried out on children aged 3 to 4 years attending nursery schools, to investigate the prevalence of caries experience, nursing bottle caries and enamel defects in the primary dentition, and these children's dentally related habits. In the first part of the study, examination of 482 Antiguan children showed that the dmft and dmfs values were 0.80 and 1.26 respectively, and that 77 per cent of the children were caries free; 4.6 per cent of children had nursing bottle caries; and enamel defects occurred in 24 per cent of children. No significant difference was found in oral health between urban and rural samples. In the second part, which was an interview survey, habits such as thumb sucking (13 per cent), not brushing their teeth (3 per cent), and swallowing fluoride toothpaste (13 per cent) were found among 369 children. In the third (a questionnaire) survey, a response rate of 63 per cent was obtained. Significantly more of the children with nursing bottle caries (78.6 per cent) had the habit of sleeping with a feeding bottle than occurred in caries free children (25.6 per cent), but there was no difference in the infant feeding pattern. The children with enamel defects were breast fed for a shorter period and had an earlier introduction to bottle feeding, compared with children without enamel defects. In the final part of the survey, an assessment of snack eating habits at school, a 58 per cent response rate was achieved. The majority of children often brought healthier snacks, together with daily sugar-rich drinks. Significantly more caries free children brought sugary snacks less frequently than children with caries experience.

Age Factors↗

PubMed2004

Familial and cultural perceptions and beliefs of oral hygiene and dietary practices among ethnically and socio-economicall diverse groups.

UNLABELLED: OBJECTIVE; The aim of this international study was to develop a valid and reliable psychometric measure to examine the extent to which parents' attitudes about engaging in twice-daily tooth brushing and controlling sugar snacking predict these respective behaviours in their children. A supplementary objective was to assess whether ethnic group, culture, level of deprivation or children's caries experience impact upon the relationships between oral health related behaviours, attitudes to these respective behaviours and to dental caries. CLINICAL SETTING: Nurseries, health centres and dental clinics in 17 countries. PARTICIPANTS: 2822 children aged 3 to 4 years and their parents. MAIN OUTCOME MEASURES: Dental examination of children and questionnaire to parents. RESULTS: Factor analysis identified 8 coherent attitudes towards toothbrushing, sugar snacking and childhood caries. Attitudes were significantly different in families from deprived and non-deprived backgrounds and in families of children with and without caries. Parents perception of their ability to control their children's toothbrushing and sugar snacking habits were the most significant predictor of whether or not favourable habits were reported. Some differences were found by site and ethnic group. CONCLUSIONS: This study supports the hypothesis that parental attitudes significantly impact on the establishment of habits favourable to oral health. An appreciation of the impact of cultural and ethnic diversity is important in understanding how parental attitudes to oral health vary. Further research should examine in a prospective intervention whether enhancing parenting skills is an effective route to preventing childhood caries.

Adult↗

PubMed2006

Demographic, socio-economic, behavioural and clinical variables associated with caries activity.

This study investigated the association between several demographic, socio-economic, behavioural and clinical variables on caries activity. One hundred and two patients were randomly retrieved from the files of the Operative Dentistry Clinic (UFPel-Brazil). The patients gave written consent to participate in the study. They were interviewed reporting demographic (sex and age), socio-economic data (income, educaional level) and oral health behaviours (tooth-brushing frequency, dental floss usage and snacks frequency). Intraoral examination was performed to investigate the clinical variables (presence and quality of biofilm, DMFT and modified DMFT index and bleeding points). Patients were divided between caries-active (n=51) and caries-inactive (n=51), according to the presence of white spot lesions and/or active cavity lesions. Statistical analysis was carried tout using Chi-square or Fischer's exact test, with the confidence level at 95%. Results demonstrated that several conditions (younger subjects, lower educational or income levels, lower tooth-brushing frequency, higher snacks frequency, adherent biofilm, presence of bleeding points and higher modified DMFT index) were associated with caries activity in the studied population. Within the limitations of the experimental design, and considering the population under investigation, it was verified that demographic (age), socio-economic (income and educational levels), behavioural (tooth brushing and snacks frequencies) and clinical (modified DMFT index, presence and quality of biofilm, and bleeding points) variables were associated with caries-active patients.

Adolescent↗

PubMed2006

Dietary habits of the primary to secondary school population and implications for oral health.

Surveys have shown increases in dental caries in young persons in Kuwait. Intake of sugar and carbohydrates has increased, as has the incidence of obesity. The objective of this study was to identify dietary practices and the potential for dental disease in primary, intermediate, and secondary school students in a health region. A random sample of 600 students aged 8, 13, and 17 yrs in 12 schools (6 boys' schools and 6 girls' schools) received a questionnaire. Responses were analyzed by age group, gender, and dietary practices at home and in school. The dietary composition of meals tended to be similar at all ages and in both genders. A total of 97% of 8-yr-old, 96% of 13-yr-old, and 92% of 17-yr-old students reported snacking at school. Sugar intake from identified snacks alone was calculated as 193.8 g/day or the estimated equivalent of 746 calories, and daily fat intake was 70.17 g. A total of 88.6% of respondents (56.6% of all children) used fluoridated toothpaste; 44.4% of all children (22.6% of 8-yr-old, 14.1% of 13-yr-old, and 7.7% of 17-yr-old students) reported brushing their teeth three times per day. Use of school snacks increased with age, while use of a toothbrush decreased. Fundamental oral hygiene procedures such as brushing and use of fluoridated toothpaste appear to have been implemented. Health workers need to provide new and pertinent oral health messages, nutrition counseling, attention to diet, and reinforcement with parents, food preparers, health facilities, and intermediate and secondary schools.

Adolescent↗

PubMed2002

Impact of life style on the nutritional status of medical students at Ain Shams University.

This cross sectional study was carried out to assess the nutritional status of medical students and to determine its relation to their life style. The study involved 317 students at, Am Shams University. Anthropometric measurements such as weight, height, mid-arm circumference, triceps skin fold thickness and body mass index were measured. The students completed a self-administered questionnaire including data about some life style factors and food-frequency consumption. The study revealed that 41.3% of the students were of normal weight while 9.5% of the sample were underweight, 36.9% were overweight and 12.5% were obese. The mean mid upper arm circumference (MUAC) and mid arm muscle circumference (MAMC) of males was significant higher than that of females, while the mean triceps skin fold (TSF) of females was significant higher than that of males. The food frequency questionnaire analysis showed that most of students consume all food groups items faire. There was no statistical significant difference between the body mass index (BMI) of students and different types of food consumption. About two thirds of the students used to practice exercise, 26.9% of the students practiced exercise for less than 2 hours per week, while 33.9% of them for more than 2 hours. There was no statistical significant difference between the BMI of students and different types of exercise. However, there was significant higher percentage of males play sports and practice running (44.7% and 19.4% respectively) compared to (11.7% and 8.1%) of females. Sixty four percent of the students usually have regular meals. About 87.2% of obese compared to 64.9% of normal weight students eat snacks between meals, the difference was statistically significant. Obese individuals eat more during watching television and during feeling of stress compared to non-obese and the difference was statistically significant. The duration of practicing exercise, sports and playing computer was significantly higher in males than females. However, the duration of watching television was significantly higher in females than males. Logistic regression analysis results showed that family history of obesity and some life style factors as duration of computer use, eating more during stress time and snacking between meals were important risk factors for obesity. We concluded that about half of medical students were overweight and obese. The most important life style factors responsible for obesity were longer time spent using computer, eating more during time of stress and snacking between meals. Also, genetic factors played an important role in development of obesity. It is recommended to develop nutritional education and physical activities programs to face the problem of increasing the rate of overweight and obesity among university students.

Adolescent↗

PubMed1990

Self-regulation of food intake among rural Mexican preschool children.

Access to food and the amount consumed were investigated within a group of 45 children aged 33 to 60 months, among whom growth stunting was common. Children were observed throughout 1 day; all foods offered and consumed were weighed, and food-related behaviors noted. Children ate frequently, at least 2 meals and an average of 7.4 +/- 2.6 snacks daily. Children had access to 2029 +/- 575 kcal (8493 +/- 2407 kJ) yet only consumed 1528 +/- 343 kcal (6396 +/- 1436 kJ) daily; thus food availability was not restricting intake. A higher proportion of snacks than meals (85 per cent vs. 71 per cent) was consumed. Children requested foods frequently (x = 9.2 +/- 4.3) and 76 per cent of requests were fulfilled. Neither amount of accessible food nor amount consumed differed by age, gender, or socioeconomic status. The importance of the child's role in determining food intake, and of snacking to overall food consumption, was demonstrated.

Child Behavior↗

PubMed1989

[Dental health examination in infancy and early childhood. Part 1. The results of questionnaires].

The purpose of this study was to find the characteristic nursing environments of children in order to confirm the methods of the dental health examination in infancy and early childhood. So questionnaires were performed. The subjects were 436 children, 218 boys and 218 girls, who had undergone successively both dental healthy examinations at the age of 1.5 and 3 years. The following results were obtained: 1. Concerning occupation, 63% of their fathers were office workers, and 75% of their mothers had no occupation. More than 90% of parents were both at the age of 20's or 30's. 2. Eighty percent of the children was nursed by their mothers in the daytime at the age of both 1.5 years and 3.5 years. 3. Abnormalities during the gestational period were present in about 1/3 pregnant women, but were mild in most cases. About 20% had abnormalities at the time of deliver; however, less than 5% showed abnormal courses thereafter. The mean birth weight was 3,104.6 g, which is lower than that in Japan. 4. Breast feeding was most highly observed at the age of 3 months; 80% took baby food at the age of 6 months; milk intake was markedly increased at the age of 12 months. 5. Concerning kinds of all between-meal snacks, sweet snacks were slightly increased, showing more variety in food. However, a consciousness of oral hygiene in parents seemed to show a favorable tendency on the data on regularity, number and place of eating snacks. 6. Although a majority of the children used a toothbrush after the age of 1.5 years, 50% and 25% of the children did not brush teeth every day at the age of 1.5 years and 3.5 years, respectively. Therefore the author recognized the necessity of health guidance and aftercare.

Breast Feeding↗

PubMedDate not supplied

Promoting dietary change in adolescents: a school-based approach for modifying and maintaining healthful behavior.

We examined the immediate and long-term effects of a school-based, behaviorally focused dietary change program for tenth-graders. Our behavioral change objectives included increased consumption of complex carbohydrates and decreased intake of saturated fats, sugar, and salt, particularly in the form of snack foods. We randomly assigned tenth-grade classes in two northern California high schools to either a five-session dietary change program or an assessment-only control group. We collected pre- and postprogram self-report data on 218 students in areas of dietary knowledge, behavior, attitudes, food availability in the home, and intentions and self-efficacy concerning eating in specific ways. We also observed school snack choices both directly and indirectly. Our results indicated significant changes in reported behavior, knowledge, and food availability at home, as well as changes in snack choices at school. We found these changes to be durable at one-year follow-up. Our findings suggest ways in which school-based programs focused on behavioral and environmental changes may be effective in promoting dietary changes at school and at home.

Adolescent↗

PubMed1986

Food habits and nutrient intake in childhood in relation to health and socio-economic conditions. A Swedish Multicentre Study 1980-81.

In Sweden a multicentre nutritional survey was performed in 1980-81 in four different parts of Sweden. The total number of children investigated was 1109, of whom 92 were two years old, 332 four years, 338 eight years and 347 thirteen years. The 24-hour recall method was used in all children. In addition 7-day record was used in the 2-, 4- and 8-year-olds and the dietary history method in the 13-year-olds. During the weekdays the 2-, 4-, 8- and 13-year-old children had 5.9, 5.8, 5.4 and 5.2 meals and snacks per day, respectively. During weekends these respective numbers decreased to 5.7, 5.6, 5.1 and 5.0. The mean number of light meals and snacks was almost the same on all days and varied between 2.4 and 3.3 in the different age groups. The part of the energy intake deriving from snacks has increased during the last 15 years. The mean daily energy intakes for the 2-, 4-, 8- and 13-year-old boys and girls were 5.8 and 5.6, 6.9 and 6.5, 8.9 and 7.9 and 12.1 and 9.7 MJ respectively. These values are below the recommendations for all age groups except the 2-year-old boys. The mean daily intakes of protein, retinol, ascorbic acid, thiamin, riboflavin, niacin, vitamin B12 and calcium were almost invariably higher or much higher than the recommendations, while those of vitamin D and zinc were below the recommended values. The iron intake fulfilled the recommendations except for the 2-year-olds and the 13-year-old girls. The intake of protein and fat expressed in per cent of the total energy intake was very similar in all age groups, about 14 per cent and 35-37 per cent respectively. The mean ratio between polyunsaturated and saturated fatty acids (P/S ratio) was also the same in all age groups, i.e. 0.22-0.23. This low ratio is explained by a high consumption of dairy products. Furthermore, the nutrient density of the food did not change appreciably with age. The only exception was found for the 2-year-old children, who had slightly higher nutrient density values on account of a relatively high consumption of fortified follow-up formula. In all age groups the mean nutrient densities of vitamins D and B6 and of iron were below the recommendations to varying degrees. No clinical signs of nutritional deficiencies, iron deficiency included, were found in any age group.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗

PubMed1986

Energy, nutrient and food intake during infancy and early childhood. The Leiden Preschool Children Study.

In Leiden, The Netherlands, a longitudinal dietary survey was carried out among 124 children at the age of 4, 16 and 28 months. Food intake was measured using the 24-hour recall method. In general, the average intake of nutrients was in accordance with the recommendations, although the energy intake was 6 per cent below the recommended daily energy allowance at the age of 4 and 28 months, and 19 per cent at 16 months. The infants derived 82.5 per cent of their energy from breastmilk and/or formula at the age of 4 months. At 28 months the food intake resembled the average intake of Dutch adults more than at 16 months. The contribution of sweets and snacks to total energy increased from 2 per cent at 4 months to 9 and 19 per cent at the ages of 16 and 28 months respectively. The sweet and snack consumption showed a statistically significant tracking-correlation at 4, 16 and 28 months. Mothers with a high eduction appeared to breastfeed their infants longer and to give them less sweets and snacks at 16 months. At 28 months the influence of educational level disappeared. It is concluded that the recommendations for preschool children need adjustment and the nutritional habits, which are developing during early childhood, should be corrected with respect to the consumption of sweets.

Aging↗

PubMed1985

The rationale for caries prevention through the use of sugar substitutes.

The emergence of S. mutans in the plaque flora appears to have depended upon the ability of the organism to sequester sucrose from dietary sources, particularly from between-meal, snack-type foods. S. mutans appears to have a pH optimum at about the pH required for tooth solution to begin. This specialization which makes S. mutans cariogenic, also makes it vulnerable to dietary regimens that contain few or no sucrose snacks. As snacks are consumed by youngsters, primarily for pleasure, the use of pleasant tasting sucrose substitutes, that cannot be fermented by the plaque flora and especially by S. mutans, constitutes a viable tactic for caries control. The potential of this approach was demonstrated by the 80 per cent reduction of caries relative to a sucrose control which was observed with a xylitol chewing gum in the Turku study.

Acids↗

PubMed1985

Dietary pattern and dental caries in 19-year-old adolescents subjected to preventive measures focused on oral hygiene and/or fluorides.

Dietary habits and dental caries were analysed in 95 19-year-old Swedish adolescents who had been subjected to different preventive measures during their late teens. A 24-hour recall was used and showed that the intakes of milk and milk products, meat, fish and eggs accorded with recommended norms but not those of vegetables, fruits and berries, and potatoes and root vegetables. Only 6% of the subjects had eaten the recommended three principal meals during the day tested. At the end of the trial, only weak or moderate correlations were found between snacks, including sucrose snacks, and selected clinical variables. Subjects who did not develop new carious lesions during the experimental 2 years had fewer risk factors, defined as the most negative values (quartile limit) for sucrose snack consumption, tooth cleaning score, lactobacillus count, saliva secretion rate and saliva buffer capacity, than those who developed one or more new lesions. During the experimental period, with an overall low caries incidence, no single factor tested for presumed risk was found to be the discriminating factor for occurrence of dental caries.

Adolescent↗

PubMed1985

Maternal variables related to potentially high-sodium infant-feeding practices.

Infant sodium intakes between 5 and 15 mEq per day for ages 0 to 6 months and between 11 and 33 mEq per day for ages 6 to 12 months are considered appropriate, safe, and adequate. Intakes exceeding these ranges should be avoided as a precautionary measure for infants who may be hereditarily predisposed to hypertension. The concern about high-sodium intakes is based on epidemiological findings of an association between such intakes by adults and hypertension. Feeding practices potentially associated with high-sodium intake were assessed in 87 white and 68 black mothers of a cross section of 1- to 12-month-old infants and were analyzed for associations with epidemiological correlates of hypertension. Lower frequency of breast feeding was reported by black mothers and by less educated mothers. Forward, stepwise regression analyses indicated that less education was also predictive of shorter breast-feeding duration, earlier introduction of solid foods, addition of salt to infant food, and use of salty foods as snacks. Addition of salt to infant food was also predicted by high maternal salt use and by positive family hypertension history; black mothers more often fed salty snacks. Considerable public attention has been drawn to the fact that commercial infant foods no longer contain added salt. This study implies a need for additional public attention to appropriate sodium levels in home-prepared and snack foods fed to infants.

Adult↗

PubMed1983

Tryptophan and tyrosine availability: relation to food choice and sleeping habits of man. A preliminary study.

Brain serotonin and noradrenaline may be involved in the regulation of sleep and of food choice. The precursor amino acids tryptophan and tyrosine and their ratios to large, neutral amino acids (LNAA) were determined in plasma of 60 healthy females and related to sleeping and eating habits as reported on a questionnaire. There was no relation between biochemical findings and the habits of going early to bed and rising early versus late rising and going late to bed. The ratios tryptophan:LNAA and tyrosine:LNAA together were significantly related to the choice of between-meal snacks in the forenoon; the subjects with supernormal net availability of tryptophan and tyrosine selected snacks with low proportions of protein to carbohydrate contents in preference to snacks with relatively high proportions as compared with subjects with subnormal net availability. Although designed as a pilot study, the results suggest an involvement of both serotoninergic and noradrenergic mechanisms in the regulation or protein and carbohydrate intake in man.

Adult↗

PubMed1995

Interaction between physical structure and amylose:amylopectin ratio of foods on postprandial glucose and insulin responses in healthy subjects.

OBJECTIVE: To study the effect of amylose content on postprandial glucose and insulin responses in healthy subjects by serving fixed amounts of simple starchy foods with a varying but strictly controlled water, fat and guar gum content. DESIGN: A blind, randomised, balanced cross-over study. SETTING: The kitchen of the Nutrition Research Unit in the Unilever Research Laboratorium. SUBJECTS: Apparently healthy employees of Unilever Research Laboratorium. INTERVENTIONS: Subjects consumed, after an overnight fast, either a drink (12 men), a pudding (6 men and 6 women), a roll without (5 men and 6 women) or a roll with guar gum (12 men) as breakfast and the same amount of the same food as mid-morning snack. Each subject consumed the experimental food prepared in four ways: either with high- or normal-amylose starch, and with or without added fat. At 30 and 90 min after consumption of the breakfast or the snack a blood sample was taken for determination of glucose and insulin. RESULTS: Raising the amount of amylose in starchy drinks and puddings, but not in rolls, lowered postprandial glucose and insulin responses. Fat addition to starchy drinks, puddings and rolls attenuated postprandial glucose responses, irrespective of the amount of amylose or guar gum present. Addition of guar gum to rolls reduced glucose and insulin responses. Glucose tolerance tended to be less after consumption of the experimental foods as mid-morning snack than after consumption as breakfast. CONCLUSION: The physico-chemical composition of foods does influence the effect of the amylose:amylopectin ratio in starchy foods on postprandial glucose and insulin responses.

Amylopectin↗