Position statement of the Polish Academy of Sciences Committee Human Nutrition Science on the principles for the nutrition of children aged 1-3 years.

The Position Statement on the principles of nutrition for children aged 1-3 years emphasizes that proper nutrition of children at this age determines their optimal psychometric development and has beneficial effects on the process nutritional programming, which reduces the risk of diet-related diseases in adulthood. Continued breastfeeding in the post-infancy period, together with the proper introduction of complementary foods, supplies all the nutritional needs of the child. A varied selection of food products is important to balance out the diet of a child in the context of energy and nutrient needs. Attention should be paid to products not recommended for frequent consumption, due to the possibility of the early development of improper eating habits that can lead to undesirable health consequences. Due to the potential risk of deficiency, adequate intake of iron, iodine, calcium and vitamin D, as well as of n-3 PUFAs (which is often insufficient) should be provided. Adequate dietary energy and protein intake protects children against protein-energy undernutrition and is crucial for their proper growth and development. An important element in the assessment of the development of children involves monitoring their nutritional status and physical development by systematically measuring their body weight and length/height and analyzing their weight gain. It is necessary to diagnose the causes of being underweight/overweight in children. Physical activity (such as outdoor walks, plays, and games) and healthy sleep hygiene are recommended. Physical activity, an adequate number of hours of sleep, and the quality of sleep in early childhood may improve immunity, reduce the risk of excessive weight gain, and consequently reduce the risk of obesity later in life. Other issues discussed include the functioning of the digestive system as one of the determinants of the nutrition of young children, basics of proper nutrition, risk of nutrient deficiencies and development of proper eating habits in early childhood.

Statement of the Committee of Human Nutrition Science of the Polish Academy of Sciences on the use of dietary supplements containing vitamins and minerals by adults.

The use of dietary supplements (supplementation) is the individual enrichment of the diet with ingredients naturally occurring in food. As a rule, dietary supplements should be used periodically. In nutritional practice, there are many indications for dietary supplementation, but the decision to take dietary supplements should be made by consumers wisely and only in justified situations, when there is a risk that the usual diet does not provide vitamins and minerals in an amount adequate to meet dietary recommendations. However, we should remember about the real dangers of taking too large doses of vitamins and minerals. Many people using dietary supplements, especially several types at the same time, may experience undesirable side effects and deterioration of health, and in addition, people taking medicines may seriously disrupt or weaken the effect of the drug, or even lack the therapeutic effect of the drug. The document presents 10 steps and rules for the use of dietary supplements available on the market, which are addressed to the general population.

Intervention for improvement the diet and physical activity of children and adolescents in Poland.

BACKGROUND: The effects of a two-year educational Programme "Keep Balance" addressed to children and adolescents have been evaluated. Its purpose has been to implement the rules of proper nutrition and increasing the level of physical activity on the population level. OBJECTIVE: The main objective of the evaluation was an indication if, after two years of programme activities, outcome indicators have been achieved. MATERIAL AND METHODS: Approximately 400,000 pupils/students from 1600 educational units from the territory of the whole country have been included in the education programme. The efficiency evaluation has been carried out in a sample of n = 1506 pupils/students in the interventional group and n = 1589 in the control group. Education has been addressed to the entire school environment, pupils, students, parents, teachers, headmasters, and the local community. The survey methodology, body weight and height measurements, the BMI index, and EUROFIT physical fitness tests have been used to assess the effects of the education programme in the scope of knowledge and nutritional behaviour regarding physical activity. There were assumed outcome indicators. The certification of schools/kindergartens with "The Certificate of a School/Kindergarten Friendly to Nutrition and Physical Activity" has been used to evaluate the activation of school environments. RESULTS: There was an improvement achieved over the assumed target points in the level of knowledge of pupils/students in the scope of nutrition and the role of physical activity, in the changes of nutritional habits, and in the results of physical fitness tests. There were achieved 20% increase in knowledge in the scope of nutrition and 5% increase in physical activity. There have been changes in the frequency in the consumption of the first breakfast before going to school (by 25% among the younger ones and by 17% among the older ones), an increase in the consumption of bottled water by 49% and reduction of sweet drinks by 19%. The percentage of the pupils/students consuming the recommended 5 meals increased by 33%. Physical fitness indicators were achieved over assumed 5% increase in the individual exercise tests. The Certificate was obtained after meeting the criteria and documenting the durability of the changes by 65% of 1600 educational units included in the Programme. A decrease in the frequency of overweight and obesity occurrence in the whole intervention sample by 1% was obtained; it was greater (but statistically insignificant) among younger students by 3.3% in comparison to the older ones where there was an increase of 1%. CONCLUSIONS: Summing up all achieved results the educational programme "Keep Balance" implemented on the population level aimed at children and adolescents has turned out to be effective and deserves to be continued after minor adjustments. Many positive changes have been identified as well as those that ought to be improved. Comprehensively included education and sometimes small changes in much of nutritional and physical behaviour have influenced the reduction of the percentage of pupils/students with excessive body weight, despite the fact that the average BMI has basically remained on the same level.

Association of the bitter taste genes TAS2R38 and CA6 and breast cancer risk; a case-control study of Polish women in Poland and Polish immigrants in USA.

It is known that the perception of bitterness is mediated by type 2 bitter taste receptors (TAS2Rs). However, recent reports have suggested that the carbonic anhydrase 6 (CA6) gene may also influence bitterness sensing. Genetic variants in these genes could influence dietary intake of brassica vegetables, whose increased consumption has been observed in the literature, though inconsistently, to decrease breast cancer (BC) risk. We hypothesized that the estimated odds ratios (ORs) for the association between BC and taster diplotype (PAV/PAV) and/or genotype A/A, will be in the direction of increased BC risk, potentially due to reduced consumption of brassica vegetables. Using a case-control study of BC in Polish women in Poland (210 cases and 262 controls) and Polish immigrant women to USA (78 cases and 170 controls) we evaluated the association of the taster diplotypes in TAS2R38 gene and genotypes in the CA6 gene and BC risk in these two populations individually and jointly. No significant increase in risk was observed for the TAS2R38 PAV/PAV diplotype (tasters) in each population individually or in the joint population. For the CA6 gene, in the joint population, we observed an increased BC risk for the combined G/A and G/G genotypes (non-tasters) vs A/A (tasters), OR = 1.41 (95% CI 1.04-1.90, p = 0.026) which after adjustment for False Discovery Rate (FDR), was not significant at p≤0.05 level. However, for the joint population and for the combined genotype of the two genes AVI/AVI+G* (non-tasters) vs. PAV/*+A/A (tasters), we observed a significant increase in BC risk, OR = 1.77 (95%CI 1.47-2.74, p = 0.01), for the non-tasters, which remained significant after FDR adjustment. In conclusion for the joint population and the joint effect for the two bitter sensing genes, we observed an increase in BC risk for the bitterness non-tasters, association which is in the opposite direction to our original hypothesis.

Consumption of Dairy Products and the Risk of Developing Breast Cancer in Polish Women.

Lack of consistency in the relationship between dairy products consumption and breast cancer (BC) risk motivated us to evaluate this association in a case-control study of BC among Polish women. The study includes 1699 women 26-79 years of age, 823 BC cases identified in Cancer Registries and 876 randomly selected controls from the national population registry. Using a validated, semiquantitative food frequency questionnaire (FFQ), the consumption of dairy products was collected for a time period of 10-15 years prior to BC diagnosis. We used logistic regression, adjusting for potential confounders, to assess the relationship between total dairy consumption as well as individual dairy groups of milk, cottage cheese and hard cheese and BC risk for premenopausal and postmenopausal women. For total consumption, a significant decrease in BC risk was observed with increased consumption of one serving/week, OR trend = 0.98, 2% decrease in risk, for premenopausal women only. For milk, a significant decrease in BC risk was observed for an increase in consumption of one glass/week, OR trend = 0.95, 5% decrease, in both strata of menopause. In contrast, for hard cheese, a significant increase in the risk of 10% was observed only in premenopausal women, OR trend = 1.10. Cottage cheese consumption significantly reduced BC risk by 20%, OR trend = 0.80, for an increase in one serving/week for postmenopausal women only. Our results show that individual dairy products have a statistically significant but bi-directional relationship with BC risk, which differs for premenopausal and postmenopausal women.

Cabbage and Sauerkraut Consumption in Adolescence and Adulthood and Breast Cancer Risk among US-Resident Polish Migrant Women.

BACKGROUND: Breast cancer (BC) incidence and mortality are lower in Poland than in the United States (US). However, Polish-born migrant women to US approach the higher BC mortality rates of US women. We evaluated the association between consumption of cabbage/sauerkraut foods and BC risk in Polish-born migrants to US. METHODS: We conducted a case-control study of BC among Polish-born migrants in Cook County and the Detroit Metropolitan Area. Cases (n = 131) were 20-79 years old with histological/cytological confirmation of invasive BC. Population-based controls (n = 284) were frequency matched to cases on age and residence. Food frequency questionnaires assessed diet during adulthood and age 12-13 years. Odds ratios (OR) and 95% confidence intervals (95% CI) were estimated with conditional logistic regression. Consumption of total, raw/short-cooked, and long-cooked cabbage/sauerkraut foods was categorized as low, medium, or high (frequency of servings/week). RESULTS: Higher consumption of total and raw/short-cooked cabbage/sauerkraut foods, during both adolescence and adulthood, was associated with a significantly lower BC risk. Consumption of long-cooked cabbage/sauerkraut foods was low and not significantly associated with risk. The multivariate OR for total cabbage/sauerkraut consumption, high vs. low (>4 vs. ≤2 servings/week) during adolescence was 0.36 (95% CI = 0.18-0.71, ptrend < 0.01) and 0.50 (95% CI = 0.23-1.06, ptrend = 0.08) during adulthood. For raw/short-cooked cabbage/sauerkraut (>3 vs. ≤1.5 servings/week), the ORs were 0.35 (95% CI = 0.16-0.72, ptrend < 0.01) during adolescence and 0.37 (95% CI = 0.17-0.78, ptrend < 0.01) during adulthood. For joint adolescent/adult consumption of raw/short-cooked cabbage/sauerkraut foods, (high, high) vs. (low, low), the OR was 0.23 (95% CI = 0.07-0.65). The significant association for high adolescent consumption of raw/short-cooked cabbage/sauerkraut foods and reduced BC risk was consistent across all levels of consumption in adulthood. CONCLUSION: Greater consumption of total and raw/short-cooked cabbage/sauerkraut foods either during adolescence or adulthood was associated with significantly reduced BC risk among Polish migrant women. These findings contribute to the growing literature suggesting a protective effect of a potentially modifiable factor, cruciferous vegetable intake, on breast cancer risk.

[Prophylaxis of vitamin D deficiency--Polish recommendation 2009]. / Stanowisko Zespolu Ekspertów. Polskie zalecenia dotyczace profilaktyki niedoborów witaminy D - 2009.

Adequate vitamin D intake and its status are important not only for bone health and Ca-P metabolism, but for optimal function of many organs and tissues throughout the body. Due to documented changes in dietary habits and physical activity level, both observed in growing children and adults, the prevalence of vitamin D insufficiency is continuously increasing. Basing on current literature review and opinions of National Consultants and experts in the field, polish recommendations for prophylactic vitamin D supplementation in infants, toddlers, children and adolescents as well as in adults, including pregnant and lactating women have been established.

[Prophylaxis of vitamin D deficiency--Polish recommendations 2009]. / Polskie zalecenia dotyczace profilaktyki niedoborów witaminy D--2009.

Appropriate state procurement system for vitamin D is important not only for the proper functioning of the skeletal, maintaining calcium and phosphorus homeostasis, but also for a number of other organs and tissues in our body. In connection with the change in lifestyle including dietary habits change, the widespread use of UV filters and less outdoor activity, observed an increase in the percentage of vitamin D deficiency, both in population and developmental age and adults. Based on the results of recent scientific research team of experts provides recommendations for preventive Polish supply of vitamin D in infants, children, adolescents and adults, including pregnant women and nursing mothers.

Variations in the Prevalence of Obesity Among European Countries, and a Consideration of Possible Causes.

Over the last 10 years the prevalence of obesity across the European continent has in general been rising. With the exception of a few countries where a levelling-off can be perceived, albeit at a high level, this upward trend seems likely to continue. However, considerable country to country variation is noticeable, with the proportion of people with obesity varying by 10% or more. This variation is intriguing and suggests the existence of different profiles of risk or protection factors operating in different countries. The identification of such protection factors could indicate suitable targets for interventions to help manage the obesity epidemic in Europe. This report is the output of a 2-day workshop on the 'Diversity of Obesity in Europe'. The workshop included 14 delegates from 12 different European countries. This report contains the contributions and discussions of the materials and viewpoints provided by these 14 experts; it is not the output of a single mind. However, such is the nature of scientific analysis regarding obesity that it is possible that a different set of 14 experts may have come to a different set of conclusions. Therefore the report should not be seen as a definitive statement of a stable situation. Rather it is a focus for discussion and comment, and a vehicle to drive forward further understanding and management of obesity in Europe.

[Comparison of fat consumption by patients with large bowel adenomas and control group]. / Porównanie spozycia tluszczów u chorych z gruczolakami jelita grubego i w grupie kontrolnej.

STUDY AIM: Analysis of differences in fat consumption (total fat, saturated, monounsaturated and polyunsaturated acids) and cholesterol between patients with large adenomas (study group, GB) and control group (GK). MATERIAL AND METHODS: GB and GK patients were recruited from the patients undergoing full colonoscopy during routine work of endoscopy unit. The whole material included 111 patients: 57 patients with large bowel adenomas and 54 without large bowel adenomas. The intake of fat was assessed using a method calculating intake during 30 days preceding the study. RESULTS: In the group of studied women versus control group women no significant differences were found in consumption including energy value of diet (1755.8 kcal vs 1925.0 kcal), total protein (69.1 g vs 76.1 g), carbohydrates (237.2 g vs 258.0 g). Similarly, in the group of studied men no significant differences were found in the consumption of total protein (84.6 g), carbohydrates (275.7 g) and energy (2126.9 kcal) in relation to control group in which the respective values were: 98.4 g, 336.1 g and 2612.8 kcal. In the group of studied women the mean fat consumption was 67.2 g while in the control group it was 73.4 g. The mean intake of saturated fatty acids was 24.0 g and 25.2 g respectively. The consumption of monounsaturated and polyunsaturated fatty acids was in these group 27.1 g and 10.5 g vs 30.5 g and 11.9 g. The differences were statistically not significant. No difference was found in cholesterol intake between women in the study group and those in control group (245.8 mg and 280.0 mg respectively). The male study group was not differing significantly from the control group in the consumption of total fat (83.6 g vs 102.3 g), saturated fatty acids (29.7 g vs 37.5 g), monounsaturated and polyunsaturated fatty acids (34.2 g vs 42.1 and 13.0 g 14.7 g) and cholesterol (335.0 mg vs 420.4 mg). CONCLUSION: No correlation was found between the consumption of total fat, saturates, monounsaturated and polyunsaturated fatty acids and the occurrence of large bowel adenomas.

[Contents of calcium and phosphorus in the diet of youth from Warsaw elementary schools]. / Zawartosc wapnia oraz fosforu w dietach mlodziezy z warszawskich szkól podstawowych.

The purpose of this study was an assessment average daily intake of calcium and phosphorus by prepubertal adolescents (aged 11 and 12) during monitoring their diets in last 10 years. In 1989-1999 years, it was investigated 767 randomly selected girls and 817 boys, aged 11 and 12 in Warsaw. Information on dietary intake was obtained by 24-hour recall method, always spring, having representation of weekdays and weekends. Among environmental factors, nutrition, and particularly calcium intake is assumed to influence whether the genetically determined maximal peak bone mass is reached. However, near half of examined prepubertal adolescents have intake less than 600 mg calcium per day. It was also observed low calcium to phosphorus ratio in diets and stated Ca:P < 0.25 among 10% diet in different groups of girls and boys. Consequently, due to consider the activity educational efforts directed to prepubertal adolescent with reference to means realization of calcium RDA in daily diet through increase milk and dairy products consumption.

[Nutritional guidelines for healthy children aged 1-3 years - Polish Expert Group statement. Part I- energy and nutritional components demand]. / Normy zywienia zdrowych dzieci w 1-3. Rokuzycia . stanowisko polskiej grupy ekspertów.czesc i - zapotrzebowanie na energiei skladniki odzywcze.

Updating of the nutritional guidelines for the Polish population requires updates of the nutritional norms for children. We present the Polish Expert Group statement (2012) on intake of selected nutrients (protein, lipids, carbohydrates, vitamin D and E) essential in nutrition of children aged 1-3 years. For this purpose the Expert Group reviewed available scientific data: the recent guidelines, nutritional norms and recommendations, systematic reviews and expert opinions as well as original publications, in relation to the specific requirements of the Polish population.

[Recommendations of prophylaxis of vitamin D deficiency in Poland (2009)]. / Zalecenia dotyczace profilaktyki niedoborów witaminy D w polsce (2009).

Adequate vitamin D intake and its status as well outdoor physical activity are important not only for normal bone development and Ca-P metabolism, but for optimal function of many organs and tissues throughout the body. Due to documented changes in dietary habits and physical activity level, both observed in growing children and adults, the prevalence of vitamin D insufficiency is continuously increasing. National Consultants and experts in this field established the Polish recommendations for prophylactic vitamin D supplementation in infants, toddlers, children and adolescents as well as in adults, including pregnant and lactating women based on current literature review. Taking into consideration pleyotropic vitamin D action and safety aspects serum 25-hydroxyvitamin D (25-OHD) level of 20-60 ng/ml (50-750 nmol/l) in children and 30-80 ng/ml (75-200 nmol/I) in adults is considered as optimal. Sunlight exposure inducing vitamin D production in the skin is main endogen source of vitamin D in the body but sunscreens may reduce skin synthesis by 90%. In Poland, skin synthesis is effective only from April to September so other sources of vitamin D such as diet and supplements play an important role. All newborns should be supplemented with 400 IU/d of vitamin D beginning from the first few days of life and continue during infancy. In formula fed infants vitamin D intake from the diet should be taken into account. In preterm infants higher total vitamin D intake (400-800 IU/day) is recommended till 40 weeks post conception. Total vitamin D intake in children and adolescents required from all sources (diet and/or supplements) should be 400 IU/d between October and March and throughout the whole year in case of inadequate vitamin D skin synthesis during the summer months. In overweight/obese children supplementation with higher dosage of vitamin D up to 800-1000 IU/d should be considered. Adults require 800-1000 IU/d of vitamin D. In pregnant and lactating women such supplementation is recommended in case of inadequate intake from diet and/or skin synthesis supplementation. Monitoring of serum 25-OHD level to define optimal dosage should be considered.

Assessing competence: the European Survey on Aging Protocol (ESAP).

OBJECTIVES: The main goal of this research project was to translate and adapt the European Survey on Ageing Protocol (ESAP) to 7 European countries/cultures. This article presents preliminary results from the ESAP, the basic assessment instrument of EXCELSA (European Longitudinal Study of Aging). METHODS: 672 individuals aged 30-85, selected through quota sampling (by age, gender, education and living conditions), participated in this study, with 96 subjects from each of the 7 European countries. The basic research protocol for assessing competence and its determinants was designed to be administered in a 90-min in-home face-to-face interview. It contains a series of questions, instruments, scales and physical tests assessing social relationships and caregiving, mental abilities, well-being, personality, mastery and perceived control, self-reported health, lifestyles, anthropometry, biobehavioral measures and sociodemographic variables. RESULTS: 84% of ESAP measures are age-dependent and 75% of them discriminate between education levels. Minor differences were found due to gender, and between people living in rural and urban areas. Exploratory factor analysis yielded 10 factors accounting for 67.85% of total variance, one of which was identified as cognitive and physical 'competence'. This factorial structure was tested across countries through concordance coefficients. Finally, using structural equation modeling, our data were fitted into a model of competence. When the sample was split into younger groups (aged 30-49 years) and older ones (50 and more years), the same model was appropriate for our data. DISCUSSION: The results are discussed in accordance with other findings on psychosocial, biophysical and sociodemographic components of competence, and also in accordance with theories on competence and successful aging.