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Health implications of dietary intake in infancy and early childhood
Umeå University, Faculty of Social Sciences, Department of Food and Nutrition. Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
2008 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Introduction: Swedish children are the healthiest in Europe. Through regular visits to well-baby clinics, infants and young children are checked and parents given information and advice on diet and other relevant matters for their child. For a long time, adequate nutrition during infancy and childhood has been focused on encouraging proper nutrition, preventing malnutrition and deficiency states, and obtaining optimal growth. Today, malnutrition and deficiency states in infants and children are rare. But other public health problems have arisen. Nutrition early in life is now thought to influence health and diseases even in adulthood. Thus promotion of a healthy diet in early life is important for preventing public health diseases such as iron deficiency, cardiovascular disease, obesity, and dental caries.

Aims: This study investigates health implications of dietary intake in infancy and early childhood. More specific focus was on the associations between dietary fat intake and serum lipid levels in infants, early dietary intake, iron status, dental caries, and Body Mass Index (BMI) at 4 years of age. In addition, hereditary factors and changes over time were evaluated.

Methods: Before 6 month of age, 300 healthy infants were recruited from well-baby clinics in Umeå. This thesis is based on secondary analysis of a prospective study in these infants run from 6-18 months and a follow-up of 127 of the children at 4 years. Between 6-18 months and at 4 years, dietary intakes were assessed, anthropometric measures performed, and venous blood samples taken. At 4 years, a dental examination was also performed and anthropometric data and blood samples were collected from parents and included in the study.

Results: All but two infants were ever breastfed and at 6 months 73% were still breastfed. The quality of dietary fat was not within national recommendations. At 4 years, intake of vitamin D and selenium were below and intake of sugar and sweet products above the recommendations. In girls, but not boys, higher polyunsaturated fatty acid intake was associated with lower levels of total cholesterol, low-density lipoprotein cholesterol, and apolipoprotein B levels. Iron status of the children was generally good and no child had iron deficiency anaemia (IDA). Children’s haemoglobin (Hb) levels tracked from infancy to 4 years and correlated with their mother’s Hb. Fortified infant products and meat were important sources of iron at both 12 months and 4 years. Children with frequent intake of cheese had less caries in this population with low caries prevalence. We found higher protein intake over time to be associated with higher Body Mass Index (BMI) at 4 years and high BMI at 4 years was associated with high BMI at 6 mo. There was also an association between the BMI of the child and that of its parents.

Conclusions: BMI of the child and parents (especially the father), and iron status at 6 months were predictors of these variables at 4 years of age. The quality rather than the quantity of dietary fat in infancy affected serum lipid values. Even in a healthy and well-nourished group of Swedish infants and young children, quality of food and intake of nutrients are important for current and later health of the child.

Place, publisher, year, edition, pages
Umeå: Kostvetenskap , 2008. , 66 p.
Keyword [en]
Infant nutrition, child nutrition, child health, serum lipids, iron status, caries, BMI
Identifiers
URN: urn:nbn:se:umu:diva-1812ISBN: 987-91-7264-615-5 OAI: oai:DiVA.org:umu-1812DiVA: diva2:142076
Public defence
2008-09-26, Betula, 6M, Norrlands Universitetsjukhus, Umeå, 09:00 (English)
Opponent
Supervisors
Available from: 2008-09-05 Created: 2008-09-05 Last updated: 2015-10-12Bibliographically approved
List of papers
1. Dietary fat in infancy should be more focused on quality than on quantity
Open this publication in new window or tab >>Dietary fat in infancy should be more focused on quality than on quantity
2008 (English)In: European Journal of Clinical Nutrition, ISSN 0954-3007, E-ISSN 1476-5640, Vol. 62, no 9, 1058-1064 p.Article in journal (Refereed) Published
Abstract [en]

Objective: The primary aim was to assess, the association of the quantity and quality of dietary fat intake from 6 to 12 months of age and serum lipids at 12 months.

Subjects/Methods: Three hundred healthy term Swedish infants were recruited in a longitudinal prospective study at the age of 6 months; 276 remained in the study at 12 months. Food records and anthropometric data were collected monthly from 6 to 12 months; serum lipids were analysed at 6 and 12 months.

Results: Swedish infants had a total fat intake within the Nordic recommendations, but intake of polyunsaturated fatty acids (PUFA) was low (5.6 percent of total energy (E%)) and intake of saturated fatty acids (SAFA) was high (15.1 E%). Higher PUFA intake was associated with lower total serum cholesterol (TC, B=−0.13, P=0.003), lower low-density-lipoprotein cholesterol (LDL-C, B=−0.12, P=0.004) and apolipoprotein B (B=−0.03) (P=0.034) in girls but not in boys. When data from the present study were compared to data from similar studies in Finland and Iceland, it appears that the quality of the dietary fat has greater impact on serum lipid levels than the quantity of fat in the diet.

Conclusions: Higher PUFA and lower SAFA intakes may reduce TC and LDL-C early in life, particularly in girls. Further, with respect to lowering serum lipid concentrations in early childhood it seems appropriate to set focus on fat quality rather than the quantity.

Place, publisher, year, edition, pages
Macmillan Publischers Limited, 2008
Keyword
infant nutrition, serum lipids, serum cholesterol, dietary fat intake
Identifiers
urn:nbn:se:umu:diva-3396 (URN)10.1038/sj.ejcn.1602824 (DOI)
Note
Published online 20 June 2007.Available from: 2008-09-05 Created: 2008-09-05 Last updated: 2015-10-12Bibliographically approved
2. Predictors of iron status in well-nourished 4-y-old children.
Open this publication in new window or tab >>Predictors of iron status in well-nourished 4-y-old children.
2008 (English)In: American Journal of Clinical Nutrition, ISSN 0002-9165, E-ISSN 1938-3207, Vol. 87, no 4, 839-845 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Iron status in childhood is influenced by diet. Other factors affecting iron status at that age are unclear. OBJECTIVES: The objectives of the study were to evaluate iron status in 4-y-old children, to track that status from infancy to childhood, and to examine the associations of iron status with dietary factors, growth, and heredity. DESIGN: This study consisted of a longitudinal follow-up at age 4 y of children (n = 127) from the cohort of a study that began at age 6 mo. Blood samples and anthropometry were assessed in both children and their parents; food records were collected from children only. RESULTS: Dietary intake was not significantly correlated with hemoglobin concentrations, whereas the consumption of meat products had a positive effect on serum ferritin concentrations and mean corpuscular volume in boys (P = 0.015 and 0.04, respectively). The prevalences of anemia and iron deficiency were low, affecting 2 (1.8%) and 3 (2.8%) children, respectively; no child had iron deficiency anemia. There was significant within-subject tracking of hemoglobin and mean corpuscular volume from age 6 mo to 4 y. The mother's but not the father's hemoglobin correlated with the child's hemoglobin over time. CONCLUSIONS: Food choices had little effect on iron status. Hemoglobin concentrations and mean corpuscular volume were tracked from infancy to childhood. In healthy, well-nourished children with a low prevalence of iron deficiency, the mother's hemoglobin was significantly associated with that of her child, but the underlying mechanism is unclear.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:umu:diva-32432 (URN)18400705 (PubMedID)
Available from: 2010-03-11 Created: 2010-03-11 Last updated: 2017-12-12
3. Diet intake and caries prevalence in four-year-old children living in a low-prevalence country.
Open this publication in new window or tab >>Diet intake and caries prevalence in four-year-old children living in a low-prevalence country.
Show others...
2007 (English)In: Caries Research, ISSN 0008-6568, E-ISSN 1421-976X, Vol. 41, no 1, 26-33 p.Article in journal (Refereed) Published
Abstract [en]

Preventive measures have dramatically decreased the prevalence of dental caries in children. However, risk factors for the disease in children living in low-prevalence areas remain elusive. In the present study we evaluated associations between dental caries, saliva levels of mutans streptococci and lactobacilli, and diet with special emphasis on the intake of fermentable carbohydrates and dairy products in 4-year-old children living in an area where the overall caries prevalence was low. Dietary intake was recorded in 234 infants as part of the Study of Infant Nutrition in Umea, Sweden (SINUS). Of these the parents of 124 children gave consent to participate in a follow-up at 4 years of age. Dietary intake, height and weight, dental caries, oral hygiene, including tooth brushing habits, presence of plaque and gingival inflammation, fluoride habits and numbers of mutans streptococci and lactobacilli in saliva were recorded. Using multivariate stepwise logistic regression, caries experience was negatively associated with intake frequency of cheese (OR = 0.67; 95% CI = 0.44-0.98) and positively associated with the salivary level of mutans streptococci (OR = 1.57; 95% CI = 1.21-2.03). Caries experience was not correlated with intake frequency or amounts of carbohydrate-containing foods, with any other particular food, or with daily intake of energy, carbohydrate or any other macro- or micronutrient. We conclude that cheese intake may have a caries-protective effect in childhood populations where the overall caries prevalence and caries experience are low and the children are regularly exposed to fluoride from toothpaste.

Place, publisher, year, edition, pages
Basel: S. Karger AG, 2007
National Category
Dentistry Food Science
Research subject
Odontology; Food and Nutrition
Identifiers
urn:nbn:se:umu:diva-14272 (URN)10.1159/000096102 (DOI)17167256 (PubMedID)
Available from: 2008-02-01 Created: 2008-02-01 Last updated: 2011-01-27Bibliographically approved
4. BMI at 4 years of age is associated with previous and current protein intake and with paternal BMI
Open this publication in new window or tab >>BMI at 4 years of age is associated with previous and current protein intake and with paternal BMI
Show others...
2010 (English)In: European Journal of Clinical Nutrition, ISSN 0954-3007, E-ISSN 1476-5640, Vol. 64, no 2, 138-145 p.Article in journal (Other academic) Published
Abstract [en]

Objectives:To evaluate possible associations between body mass index (BMI) at 4 years of age, current and previous dietary intakes and parental BMI.Methods:A follow-up of dietary intake and anthropometry in 127 4-year-old children corresponding to 54% of children who completed an initial intervention study at 18 months of age.Results:Fourteen percent of the girls and 13% of the boys were overweight (age-adjusted BMI>/=25) and 2% of the girls and 3% of the boys were obese (age-adjusted BMI>/=30). Thirty-four percent and 9% of the fathers and 19 and 7% of the mothers were overweight and obese, respectively. BMI at 6-18 months was a strong predictor of BMI at 4 years. Univariate regression analyses revealed that intake of protein in particular, and also of total energy and carbohydrates at 17/18 months and at 4 years, was positively associated with BMI at 4 years. Although BMI at 6-18 months was the strongest predictor of BMI at 4 years, in the final multivariate models of the child's BMI, protein intake at 17-18 months and at 4 years, energy intake at 4 years and the father's-but not the mother's-BMI were also independent contributing factors.Conclusions:Among these healthy children, BMI at 4 years of age tracked from 6 to 18 months of age and were associated with previous and current protein intake as well as parental BMI, particularly that of the father.

Keyword
Dietary Carbohydrates, Dietary proteins
National Category
Food Science Pediatrics
Research subject
Food and Nutrition; Pediatrics
Identifiers
urn:nbn:se:umu:diva-3399 (URN)10.1038/ejcn.2009.132 (DOI)000274232800004 ()19904295 (PubMedID)
Available from: 2008-09-05 Created: 2008-09-05 Last updated: 2015-10-12Bibliographically approved

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