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Relationship between feeding pattern and body mass index in 220 free-living people in four age groups.

OBJECTIVE: To assess the relationship between feeding pattern and body mass index in free-living humans. DESIGN AND SUBJECTS: Feeding pattern was assessed from 220 7-day weighed dietary records. 187 records were obtained from three separate existing studies, and reanalysed. These studies contained data on three age groups in the British population; Elderly group (n = 88), Middle-aged group (n = 40), Working age group (n = 59). A separate study of 13-14 year olds living in Croydon was conducted from which 33 usable diet records were collected to produce a fourth, Adolescent group. RESULTS: 'Nibbling' and greater energy intakes at breakfast were associated with a lower body mass index (BMI) in the Adolescent group. In the Middle-aged group, greater energy intakes at breakfast and lower energy intakes during the evening were associated with a lower BMI. However, when diet records which produced unreasonably low energy intakes were removed from the analysis, these relationships disappeared except for energy intakes at breakfast and BMI in the Adolescent group. CONCLUSION: It is suggested that the relationship between feeding pattern and BMI observed in the Adolescent and Middle-aged groups was caused by underestimation of 'habitual' energy intake from snacks and the omission of breakfast by females and those who were overweight. The lack of relationship in the Working age group was attributed to the fact that more individuals in this group appeared to report valid diet records. Reported energy intake was directly related to BMI in the Working age group, but was not related to BMI in the other three age groups. It is concluded that feeding pattern is not a major factor in determining BMI in humans. Also, since snacks have a relatively high sugar and low fat composition compared with meals, it is suggested that biased under-reporting of snacks by the obese could produce spurious results from free-living studies which show that obesity is related to the proportion of energy from fat in the diet.

Adolescent↗

[Prevalence and significance of carbohydrate craving in Austria].

Among disorders of appetite and eating frequent craving of carbohydrate containing snacks between meals is well known. Excessive carbohydrate consumption causes increased caloric intake and may lead to overweight and risks of obesity regarding metabolism and vascular remodelling. Up to now prevalence and consequences of that disorder have never been studied in the Austrian population. Hence we investigated by questionnaires and interviews eating habits in samples of 1058 women and 942 men of the Austrian population. Evaluation showed that carbohydrate craving is a more or less serious problem for about 30% of Austrians. Women, especially those with overweight, were affected more frequently than men. In the whole population sample investigated there was a seasonal variation with a tendency to increased carbohydrate craving in fall and winter. This was, however, not significant for overweight women, they probably eat their snacks over the whole year. A subgroup of males reported craving of snacks containing sausage or meat instead of carbohydrate. Craving of carbohydrate is considered the consequence of a decrease of serotonin in appetite regulating neurons and centers of the brain. Treatment of craving by drugs inhibiting the re-uptake of serotonin into afferant neurons is discussed. Medication of this type is, however, hampered by cardiovascular side effects observed with fenfluramines.

Adolescent↗

Family dinner and diet quality among older children and adolescents.

CONTEXT: The proportion of children eating dinner with their families declines with age and has decreased over time. Few data exist concerning the nutritional effect of eating family dinner. OBJECTIVE: To examine the associations between frequency of eating dinner with family and measures of diet quality. DESIGN: Cross-sectional. SETTING: A national convenience sample. PARTICIPANTS: There were 8677 girls and 7525 boys in the study, aged 9 to 14 years, who were children of the participants in the ongoing Nurses' Health Study II. MAIN OUTCOME MEASURES: We collected data from a self-administered mailed survey, including food and nutrient intakes from a validated semiquantitative food frequency questionnaire. Main outcome measures included servings per day of selected foods and food groups, daily intakes of selected macronutrients and micronutrients, and frequency of multivitamin use. RESULTS: Approximately 17% of participants ate dinner with members of their family never or some days, 40% on most days, and 43% every day. More than half of the 9-year-olds ate family dinner every day, whereas only about one third of 14-year-olds did so. In age- and sex-adjusted logistic regression models, the odds ratios associated with a frequency of family dinner of most days compared with never or some days, or every day compared with most days, were as follows: for eating at least 5 servings per day of fruits and vegetables, 1.45 (95% confidence interval [CI], 1.37-1.53); for eating any fried foods away from home, 0.67 (95% CI, 0.64-0.70); and for drinking any soda, 0.73 (95% CI, 0.66-0.80). Multiple linear regression showed that an increased frequency of family dinner was also associated with substantially higher intake of several nutrients, including fiber, calcium, folate, iron, vitamins B6, B12, C, and E; lower glycemic load; and lower intake of saturated and trans fat as a percentage of energy. We observed little or no effect on intakes of whole dairy products, red meat, or snack foods. Patterns were similar for boys and girls. CONCLUSIONS: Eating family dinner was associated with healthful dietary intake patterns, including more fruits and vegetables, less fried food and soda, less saturated and trans fat, lower glycemic load, more fiber and micronutrients from food, and no material differences in red meat or snack foods.

Adolescent↗

When children eat what they watch: impact of television viewing on dietary intake in youth.

OBJECTIVES: To test whether increased television viewing is associated with increased total energy intake and with increased consumption of foods commonly advertised on television, and to test whether increased consumption of these foods mediates the relationship between television viewing and total energy intake. DESIGN: Prospective observational study with baseline (fall 1995) and follow-up (spring 1997) measures of youth diet, physical activity, and television viewing. We used food advertising data to identify 6 food groups for study (sweet baked snacks, candy, fried potatoes, main courses commonly served as fast food, salty snacks, and sugar-sweetened beverages). SETTING AND PARTICIPANTS: Five public schools in 4 communities near Boston. The sample included 548 students (mean age at baseline, 11.70 years; 48.4% female; and 63.5% white). MAIN OUTCOME MEASURES: Change in total energy intake and intake of foods commonly advertised on television from baseline to follow-up. RESULTS: After adjusting for baseline covariates, each hour increase in television viewing was associated with an additional 167 kcal/d (95% confidence interval, 136-198 kcal/d; P<.001) and with increases in the consumption of foods commonly advertised on television. Including changes in intakes of these foods in regression models provided evidence of their mediating role, diminishing or rendering nonsignificant the associations between change in television viewing and change in total energy intake. CONCLUSIONS: Increases in television viewing are associated with increased calorie intake among youth. This association is mediated by increasing consumption of calorie-dense low-nutrient foods frequently advertised on television.

Advertising↗

Gastrointestinal symptoms following consumption of olestra or regular triglyceride potato chips: a controlled comparison.

CONTEXT: Olestra, a nonabsorbable, energy-free fat substitute used in snack foods, has been anecdotally reported to cause gastrointestinal (GI) adverse events, although such effects were not expected based on results from randomized trials, in which it was consumed in typical snack patterns. OBJECTIVE: To determine whether ad libitum consumption of potato chips made with the fat substitute olestra results in a different level of GI symptoms than regular chips made with triglyceride (TG). DESIGN: Randomized, double-blind, parallel, placebo-controlled trial. SETTING: A suburban Chicago, III, multiplex cinema. SUBJECTS: A total of 1123 volunteers aged 13 to 88 years. INTERVENTION: Subjects were given a beverage and an unlabeled, white 369-g (13-oz) bag of potato chips made with olestra or TG during a free movie screening. MAIN OUTCOME MEASURES: Total and specific GI symptoms reported during a telephone interview conducted from 40 hours to 10 days after ingestion; level of potato chip consumption; and satiety level. RESULTS: Of 563 evaluable subjects in the olestra chip group, 89 (15.8%) reported 1 or more GI symptoms, while 93 (17.6%) of the 529 evaluable subjects in the regular TG chip group did so (difference in symptom frequency between olestra and TG, -1.8; 95% confidence interval, -6.2 to 2.7; P=.47). For specific GI symptoms (eg, gas, diarrhea, abdominal cramping), there were no significant differences between olestra and TG chips. Fewer olestra chips were consumed than TG chips (60 vs 77 g [2.1 vs 2.7 oz]; P<.001), with olestra chips receiving lower taste scores (5.6 vs 6.4 on a 9-point scale; P<.001). Consumption levels did not correlate with the rate of symptom reporting in either the olestra or TG group. There was no difference in satiety scores between olestra and TG chips (5.7 vs 5.9 on a 9-point scale; P=.07). CONCLUSIONS: This study demonstrates that ad libitum consumption of olestra potato chips during 1 sitting is not associated with increased incidence or severity of GI symptoms, nor does the amount consumed predict who will report GI effects after short-term consumption of either olestra or TG potato chips.

Adolescent↗

Patterns and trends in food portion sizes, 1977-1998.

CONTEXT: While general consensus holds that food portion sizes are increasing, no empirical data have documented actual increases. OBJECTIVE: To determine trends in food portion sizes consumed in the United States, by eating location and food source. DESIGN, SETTING, AND PARTICIPANTS: Nationally representative data from the Nationwide Food Consumption Survey (1977-1978) and the Continuing Survey of Food Intake by Individuals (1989-1991, 1994-1996, and 1998). The sample consists of 63 380 individuals aged 2 years and older. MAIN OUTCOME MEASURE: For each survey year, average portion size consumed from specific food items (salty snacks, desserts, soft drinks, fruit drinks, french fries, hamburgers, cheeseburgers, pizza, and Mexican food) by eating location (home, restaurant, or fast food). RESULTS: Portion sizes vary by food source, with the largest portions consumed at fast food establishments and the smallest at other restaurants. Between 1977 and 1996, food portion sizes increased both inside and outside the home for all categories except pizza. The energy intake and portion size of salty snacks increased by 93 kcal (from 1.0 to 1.6 oz [28.4 to 45.4 g]), soft drinks by 49 kcal (13.1 to 19.9 fl oz [387.4 to 588.4 mL]), hamburgers by 97 kcal (5.7 to 7.0 oz [161.6 to 198.4 g]), french fries by 68 kcal (3.1 to 3.6 oz [87.9 to 102.1 g]), and Mexican food by 133 kcal (6.3 to 8.0 oz [178.6 to 226.8 g]). CONCLUSION: Portion sizes and energy intake for specific food types have increased markedly with greatest increases for food consumed at fast food establishments and in the home.

Data Collection↗

Effects of extrusion variables on the properties of waxy hulless barley extrudates.

The objective of this research was to investigate the extrudability of waxy hulless barley flour under various extrusion conditions. Waxy hulless barley flour was processed in a laboratory-scale corotating twin-screw extruder with different levels of feed moisture content (22.3, 26.8, and 30.7%) and die temperature (130, 150, and 170 degrees C) to develop a snack food with high beta-glucan content. The effects of extrusion condition variables (screw configuration, moisture, and temperature) on the system variables (pressure and specific mechanical energy), the extrudate physical properties (sectional expansion index, bulk density), starch gelatinization, pasting properties (cold peak viscosity, trough viscosity, and final viscosity), and beta-glucan contents were determined. Results were evaluated by using response surface methodology. Increased extrusion temperature and feed moisture content resulted in decreases in exit die pressure and specific mechanical energy values. For extrudates extruded under low shear screw configuration (LS), increased barrel temperature decreased sectional expansion index (SEI) values at both low and high moisture contents. The feed moisture seems to have an inverse relationship with SEI over the range studied. Bulk density was higher at higher moisture contents, for both low and high barrel temperatures, for samples extruded under high shear screw configuration (HS) and LS. Cold peak viscosities (CV) were observed in all samples. The CV increased with the increase in extrusion temperature and feed moisture content. Although beta-glucan contents of the LS extrudates were comparable to that of barley flour sample, HS samples had generally lower beta-glucan contents. The extrusion cooking technique seems to be promising for the production of snack foods with high beta-glucan content, especially using LS conditions.

Chemical Phenomena↗

Do children eat what they say? Validity of intended food choices among Native American school children.

OBJECTIVE: To examine the agreement between school children's intended food choices and observed food choices. DESIGN: Native American students in the second through fifth grade completed a questionnaire that asked them to select from 10 paired food choices for a given meal or snack. Three weeks later students chose among foods identical to those on the questionnaire as part of their usual school lunch or breakfast over three consecutive days; afternoon snacks were also offered. RESULTS: Agreement between students' intended food choices and observed food choices was examined across 10 food pairs. The composite kappa coefficient between intended and observed food choices was 0.09 (95% confidence interval 0.06, 0.012), including virtually no agreement above that expected by chance. There were no differences in agreement by sex or grade. CONCLUSIONS: Intended food choices were not significantly associated with observed food choices. It is unclear whether intended food choices reflect nutrition knowledge, socially desirable responses, food preferences, or some other dimension of eating behavior. Although responsive to school-based nutrition interventions, the interpretation of changes in intended food choices must be clarified in future research.

Child↗

Psychosocial predictors of consumption of sweets following smoking cessation.

The use of a theoretical model to predict consumption of sweet-tasting high-calorie foods following smoking cessation was investigated. The model included eight predictors: habit, intention, attitudes, subjective norms, self-efficacy, perceived barriers, social support, and smoking cessation. One hundred and fourteen individuals completed pre- and post-questionnaires and made pre- and post-snack choices at smoking cessation programs. Pretest consumption of sweets (habit), pretest intention to avoid eating sweets, and posttest smoking status explained 42% of posttest consumption of sweets. Ex-smokers reported eating more sweets and chose more sweet snacks than did subjects who continued to smoke.

Adult↗

Morning sickness: impact on offspring salt preference.

These studies examined the relationship between salt preference of adult offspring and their mothers' symptoms of morning sickness during pregnancy. College students who could provide information about their mothers' symptoms of morning sickness completed a survey about their dietary salt intake (study 1; n = 169) or rated and consumed ten snack foods (study 2; n = 66). In study 1 a salt-use score was calculated based on responses to the Salt Intake Questionnaire; offspring of women with moderate or severe vomiting reported a significantly higher level of salt use (p < 0.01) than those whose mothers report little or no symptoms. In study 2 saltiness and pleasantness ratings of high-salt foods, intake of those foods and total sodium intake were the focus of analysis. Offspring of women reporting moderate or severe vomiting showed a significantly greater preference for the snack food subjects rated as saltiest than those whose mothers reported no or mild vomiting. They also ate more of that food and consumed more total sodium during the test session. Effects were stronger in Caucasian than Asian subjects. These studies suggest that moderate to severe vomiting during pregnancy can be associated with significantly higher salt intake in offspring. Thus, a gestational event may be an important determinant of salt intake and preference in adulthood.

Adolescent↗

Meal patterns in the SENECA study of nutrition and the elderly in Europe: assessment method and preliminary results on the role of the midday meal.

The paper discusses the assessment method for meal patterns in the course of the SENECA follow-up survey in 1993 in eight study towns across Europe and relates the percentage of energy intake at the midday meal to geographical latitude, total energy intake, energy intake as snacks, number of cooked meals, time spent at the main meal and intake of milk products, fat and leafy vegetables. A questionnaire for the assessment of meal patterns in western Europe has to include the possibility to assess more than three meals per day as well as a variety of meals at any time of the day. Meal structures vary between cooked meals, bread- or soup-based meals, but may also consist of spoon food, salads or fruit. Positive correlations were found between the percentage of energy intake at the midday meal and the number of cooked meals consumed per day, negative relations were found between the percentage of energy intake at the midday meal and the geographical latitude as well as total energy intake, energy intake in form of snacks and consumption of milk products.

Aged↗

Differences in health and taste attitudes and reported behaviour among Finnish, Dutch and British consumers: a cross-national validation of the Health and Taste Attitude Scales (HTAS).

The Health and Taste Attitude Scales (HTAS) developed by Roininen, Lähteenmäki and Tuorila in 1999 measure the importance of health and taste aspects of foods in the food choice process. These multi-item scales consist of sets of statements, ranging from "strongly disagree" to "strongly agree", which further divide into three Health (General health interest, Light product interest and Natural product interest) and three Taste (Craving for sweet foods, Using food as a reward and Pleasure) sub-scales. Finnish (N=467), Dutch (N=477), and British (N=361) respondents completed a questionnaire which contained four components: the HTAS, a separate "paper and pencil task" of choosing a food for a snack; pleasantness, healthiness and frequency of consumption of eight foods; and the Restraint Eating Scale of the Dutch Eating Behaviour Questionnaire (DEBQ). The latter three components were included in order to validate various aspects of the HTAS. The factor structure of HTAS was found to be equal in all three countries. However, there were some minor differences in factor loadings among countries, e.g. the Natural product interest and Pleasure sub-scale items had lower factor loadings in the UK than in Finland and The Netherlands. Finnish respondents had the most positive attitude towards light products. Dutch and British respondents scored higher on all Taste sub-scales than their Finnish counterparts. Respondents' health-related attitudes were good predictors of their "healthy food choices" in the snack task and self-reported consumption. Two of the Taste sub-scales (Craving for sweet foods and Using food as a reward) predicted well respondents' self-reported consumption of, for example, full-fat chocolate bars. All the Health and two of the Taste sub-scales proved to be useful tools for characterizing consumer attitudes within and between countries.

Adolescent↗

Measuring fruit and vegetable preferences among 4th- and 5th-grade students.

BACKGROUND: Achievement of the nation's Year 2000 fruit and vegetable goal of five or more daily servings may relate to children's preferences for fruits and vegetables. There are, however, no easily administered instruments for measuring preferences for fruits and vegetables among children. METHODS: An initial questionnaire systematically varied preparation methods after focus group discussions had indicated that this had an impact on fruit and vegetable preferences. The three-part questionnaire (fruits, vegetables, fruit and/or vegetable snacks) was classroom administered. Internal consistencies and test-retest reliabilities were acceptable. Principal components analyses, however, revealed food-specific rather than preparation factors; thus, preparation was eliminated from a revised questionnaire. RESULTS: Repeat classroom administration of the revised questionnaire yielded acceptable internal consistencies and test-retest reliabilities. Preferences were higher for fruits than vegetables. Principal components analyses indicated single fruit and vegetable factors and a two-factor solution for snacks (vegetables, fruits). Pearson correlations between preferences and consumption were significant, but accounted for only a small fraction of the variance. Correlations between fruit exposure and preferences, and between vegetable exposure and preferences were 0.55 and 0.51, respectively. CONCLUSION: The revised questionnaire provides a reliable, valid, and simple tool for assessing fruit and vegetable preferences of 4th- and 5th-grade students. The relationship between these preferences and actual consumption is weak; however, making fruits and vegetables more available may enhance preferences.

Child↗

Healthy Start: a comprehensive health education program for preschool children.

BACKGROUND: Healthy Start is a 3-year demonstration and education research project designed to evaluate the effectiveness of a multidimensional cardiovascular (CV) risk reduction intervention in preschool centers over a 3-year period of time. METHODS: Two primary interventions are employed. The first is the preschool food service intervention program designed to reduce the total fat in preschool meals and snacks to less than 30% of calories and reduce the saturated fat to less than 10% of calories. The second major intervention is a comprehensive preschool health education curriculum, focused heavily on nutrition. RESULTS: Effectiveness of the intervention will be determined through evaluation of changes in dietary intake of preschool children at school meals and snacks, especially with respect to intake of total and saturated fat. Evaluation of the education component will include assessment of program implementation by teachers, assessment of changes in nutrition knowledge by preschool children, and assessment of changes in home meals that children consume (total and saturated fat content). Blood cholesterol will be evaluated semiannually to evaluate changes that may be due to modification of dietary intake. Growth and body fatness will also be assessed. CONCLUSIONS: While substantial efforts have targeted CV risk reduction and health education for elementary school children, similar efforts aimed at preschool children have been lacking. The rationale for beginning CV risk reduction programs for preschool children is based upon the premise that risk factors for heart disease are prevalent by 3 years of age and tend to track over time, most commonly hypercholesterolemia and obesity, both related to nutrition. Since the behavioral antecedents for nutritional risk factors begin to be established very early in life, it is important to develop and evaluate new educational initiatives such as Healthy Start, aimed at the primary prevention of cardiovascular risk factors in preschool children. The purpose of this publication is to describe the rationale and methods for the Healthy Start project.

Cardiovascular Diseases↗

Gastrointestinal response and plasma and urine determinations in human subjects given erythritol.

This study was undertaken to examine the influence of erythritol on certain plasma and urinary parameters and to assess the gastrointestinal response of humans given erythritol at single oral doses of 0.4 or 0.8 g/kg body wt/day. Three groups of six healthy volunteers each received a midmorning snack containing the equivalent of 0.4 or 0.8 g erythritol/kg body wt or 0.8 g sucrose/kg body wt. A fourth group received no snack and served as a negative control group. Consumption of erythritol did not affect plasma osmolarity, water consumption, or diuresis, and no significant variations in plasma or urine electrolyte balance were observed. Plasma glucose and insulin concentrations also were not affected by erythritol. Gastrointestinal responses to erythritol were comparable to those of sucrose. Plasma and urine erythritol concentrations increased within 2 hr of ingestion in proportion to the amount ingested. Approximately 60% of the erythritol dose was eliminated in the urine within 22 hr. The results of this study demonstrate that ingestion of erythritol at doses of up to 0.8 g/kg body wt does not alter plasma or urine osmolarity or electrolyte balance and is well tolerated by the digestive tract.

Administration, Oral↗

Acrylamide in Japanese processed foods and factors affecting acrylamide level in potato chips and tea.

Acrylamide concentrations in processed foods sold in Japanese markets were analyzed by LC-MS/MS and GC-MS methods. Most potato chips and whole potato-based fried snacks showed acrylamide concentration higher than 1000 microg/kg. The concentrations in non-whole potato based Japanese snacks, including rice crackers and candied sweet potatoes, were less tha. 350 microg/kg. Those in instant precooked noodles were less than 100 microg/kg with only one exception. The effect of storage condition of potato tubers on acrylamide concentration in potato chips after frying was also investigated. Sugar content in the tubers increased during cold storage, and the acrylamide concentration increased accordingly. The concentrations of asparagine and other amino acids, however, did not change during the cold storage. High correlations were observed between the acrylamide content in the chips and glucose and fructose contents in the tubers. This fact indicated that the limiting factor for acrylamide formation in potato chips is reducing sugar, not asparagine content in the tubers. Effects of roasting time and temperature on acrylamide concentration in roasted green tea are also described.

Acrylamide↗

Dietary taurine intake and serum taurine levels of women on Jeju Island.

The purpose of this study was to investigate the dietary taurine intake and serum taurine levels of women on Jeju Island in Korea. Sixty six married women aged 43.5 +/- 7.1 volunteered for this study: 34 from the city area and 32 from two fishing-farming areas. Diet samples were collected from the participants; the samples included three meals (breakfast, lunch and supper), including snacks, drinks and whatever else the participants had eaten for 24 hours. Taurine levels in the diet and serum were determined as the dabsyl derivative by HPLC with a Rf-detector. The intake of taurine ranged from 8.4 to 767.6 mg/day and its mean value was 163.9 +/- 150.2 mg/day (mean +/- SD). There was a significant difference between the two groups: 114.9 +/- 78.7 for the women from the city area and 215.9 +/- 187.9 mg/day for the women from the fishing-farming areas (p<0.001). The taurine intake of the total diet, including all snacks and drinks, was 2300 +/- 584 g/day for the city area and 2342 +/- 528 g/day for the fishing-farming areas. The daily protein intake was 58.8 +/- 16.4 g for the women of the city area and 65.5 +/- 17.1 g for the women of the fishing-farming areas. There was a significant correlation between the intake of fish/shellfish and taurine (p=0.001) while there was no correlation between the intake of protein and taurine (p=0.057). The taurine levels in serum ranged from 68.6 to 261.6 micromol/L and the mean value was 169.7 +/- 41.5 micromol/L. There was no significant difference between the women from the city area and the women from the fishing-farming areas in serum taurine levels. The correlations of serum taurine levels with serum retinol levels (p=0.016) and alpha-tocopherol (p=0.014) levels were significant. These results suggest that taurine intake is dependent on the fish/shellfish intake and that taurine may play an important role in the retention of antioxidative nutrients.

Adult↗

Eating frequency--a neglected risk factor for colon cancer?

Eating frequency was examined in relation to risk of cancer of the colon and rectum in a population-based case-control study conducted in Stockholm, Sweden in 1986-88. In the present analysis, 328 cases and 500 controls were included. The adjusted relative risk (RR) of colon cancer per daily eating occasion was 1.2 (95 percent confidence interval [CI] = 1.1-1.4, adjusted for year of birth, sex, intake of energy, fat, protein, and fiber, browning of meat surface, physical activity, and body mass index). The corresponding RR for rectal cancer was 1.0 (CI = 0.9-1.2). The frequency of eating snacks was related to risk of colon cancer (RR per snack = 1.6, CI = 1.2-1.9), while the frequency of eating meals (breakfast, lunch, or dinner) was not (RR per meal = 0.8, CI = 0.6-1.1). The results are consistent with findings in two other case-control studies in which eating frequency was found to be a risk factor for colon cancer.

Case-Control Studies↗