Proton pump inhibitor use and risk of hip fractures among community-dwelling persons with Alzheimer's disease-a nested case-control study.

BACKGROUND: Hip fractures are a major health concern among older persons with Alzheimer's disease, who usually use many concomitant drugs for several diseases. Evidence of the association between proton pump inhibitor use and risk of hip fracture is contradictory. AIM: To investigate whether the long-term use of proton pump inhibitor is associated with risk of hip fractures among community-dwelling persons with Alzheimer's disease. METHODS: In this nested case-control study, the nationwide MEDALZ data were utilised. Community-dwelling persons with Alzheimer's disease who encountered incident hip fracture (N = 4818; mean age 84.1) were included as cases. Four controls were matched for each case at the date of hip fracture (N = 19 235; mean age 84.0). The association between hip fracture and duration of current PPI use (ongoing use during 0-30 days before the index date), and cumulative duration of use during 10 years before was investigated with conditional logistic regression. RESULTS: Long-term or cumulative proton pump inhibitor use was not associated with an increased risk of hip fracture. Current proton pump inhibitor use was associated with an increased risk of hip fracture (adjusted OR 1.12, 95% CI 1.03-1.22). The risk was increased in short-term current use (<1 year) (adjusted OR 1.23, 95% CI 1.10-1.37). CONCLUSIONS: The increased risk of hip fracture was evident only in short-term proton pump inhibitor use, but no association was found for long-term or cumulative use. Thus, our findings do not support previous assumptions that long-term proton pump inhibitor use would be associated with an increased risk of hip fractures.

Eating behaviour is associated with eating frequency and food consumption in 6-8 year-old children: The Physical Activity and Nutrition in Children (PANIC) study.

The association between eating behaviour and dietary factors has been studied narrowly in children. Therefore, we investigated whether eating frequency and food consumption are influenced by eating behaviour in a population sample of 406 children aged 6-8 years. We assessed features of eating behaviour by the Children's Eating Behaviour Questionnaire and dietary factors by a 4-day food record. The results showed that enjoyment of food was directly associated with a number of main meals (p = 0.041) and consumption of vegetables (p = 0.041), cheese (p = 0.005), and meat (p = 0.002). Food responsiveness was directly associated with consumption of fruit and berries (p = 0.013) and meat (p = 0.016). Desire to drink was directly associated with consumption of fat-containing milk (p = 0.002) and inversely associated with consumption of skimmed milk (p = 0.001). Food fussiness was inversely associated with a number of main meals (p = 0.013) and consumption of vegetables (p < 0.001), cheese (p = 0.001), and meat (p = 0.027). Satiety responsiveness was inversely associated with consumption of vegetables (p = 0.031), cheese (p = 0.010), and meat (p < 0.001) and directly associated with consumption of candies and chocolate (p = 0.026). Slowness in eating was inversely associated with consumption of meat (p = 0.018). Where sex differences existed the associations tended to be observed mostly in girls but not in boys. Our study shows that enjoyment of food and food responsiveness are directly associated with consumption of protein-rich foods and vegetables, fruit and berries, whereas food fussiness and satiety responsiveness are inversely associated with consumption of these foods. Assessment of eating behaviour can help in identifying children with various dietary needs.

Dietary quality indices in relation to cardiometabolic risk among Finnish children aged 6-8 years - The PANIC study.

BACKGROUND AND AIMS: There are no studies on the relationships of dietary quality indices to the clustering of cardiometabolic risk factors in children. We therefore investigated the associations of four dietary quality indices with cardiometabolic risk score and cardiometabolic risk factors in Finnish children. METHODS AND RESULTS: Subjects were a population sample of 204 boys and 198 girls aged 6-8 years. We assessed diet by 4-day food records and calculated Dietary Approaches to Stop Hypertension (DASH) Score, Baltic Sea Diet Score (BSDS), Mediterranean Diet Score (MDS), and Finnish Children Healthy Eating Index (FCHEI). We calculated the age- and sex-adjusted cardiometabolic risk score summing up Z-scores for waist circumference, mean of systolic and diastolic blood pressure and concentrations of fasting serum insulin and fasting plasma glucose, triglycerides and HDL cholesterol, the last multiplying by -1. Higher FCHEI was associated with lower cardiometabolic risk score among boys (standardised regression coefficient ß = -0.14, P = 0.044) adjusted for age, physical activity, electronic media time and household income. Higher DASH Score was related to a lower serum insulin in boys (ß = -0.15, P = 0.028). Higher DASH Score (ß = -0.16, P = 0.023) and FCHEI (ß = -0.17, P = 0.014) were related to lower triglyceride concentration in boys. Higher FCHEI was associated with lower triglyceride concentration in girls (ß = -0.16, P = 0.033). Higher DASH Score (ß = -0.19, P = 0.011) and BSDS (ß = -0.23, P = 0.001) were associated with lower plasma HDL cholesterol concentration in girls. CONCLUSION: Higher FCHEI was associated with lower cardiometabolic risk among boys, whereas DASH Score, BSDS or MDS were not associated with cardiometabolic risk in children.

Dietary factors associated with metabolic risk score in Finnish children aged 6-8 years: the PANIC study.

PURPOSE: Previous evidence for the associations of eating frequency and food consumption with clustering of metabolic risk factors among children is limited. We therefore investigated association of the daily number of main meals and snacks and food consumption with a metabolic risk score and individual metabolic risk factors in primary school children. METHODS: The subjects were a population sample of Finnish girls and boys 6-8 years of age. Dietary factors were measured by a four-day food record. Metabolic risk score was calculated summing up the Z-scores of waist circumference, systolic and diastolic blood pressure, and concentrations of fasting serum insulin and fasting plasma glucose, triglycerides and high-density lipoprotein cholesterol, the latest multiplying by -1. RESULTS: Skipping main meals (standardized regression coefficient ß = -0.18, P < 0.001), a higher consumption of non-root vegetables (ß = 0.18, P < 0.01), low-fat vegetable-oil-based margarine (ß = 0.13, P < 0.01) and sugar-sweetened beverages (ß = 0.11, P < 0.05) and a lower consumption of vegetable oils (ß = -0.10, P < 0.05) were associated with a higher metabolic risk score after adjustment for age, sex, total physical activity, electronic media time, energy intake and other dietary factors. The consumption of red meat was directly related to the metabolic risk score, but the association was not statistically significant after adjustment for energy intake. CONCLUSIONS: Eating main meals regularly, decreasing the consumption of sugar-sweetened beverages and low-fat margarine and increasing the consumption of vegetable oils should be emphasized to reduce metabolic risk among children.

Dietary factors associated with overweight and body adiposity in Finnish children aged 6-8 years: the PANIC Study.

OBJECTIVES: To investigate the associations of dietary factors with overweight, body fat percentage (BF%), waist circumference (WC) and hip circumference (HC) among children. DESIGN: Cross-sectional analysis of the Physical Activity and Nutrition in Children (PANIC) Study among 510 children (263 boys, 247 girls) aged 6-8 years from Kuopio, Finland. METHODS: The children's weight, height, WC and HC were measured. Overweight was defined by International Obesity Task Force body mass index cutoffs. The BF% was measured by dual-energy X-ray absorptiometry, nutrient intakes and meal frequency by 4-day food records and eating behaviour by Children's Eating Behaviour Questionnaire. RESULTS: Daily consumption of all the three main meals was inversely associated with overweight (odds ratio (OR) 0.37, 95% confidence interval (CI) 0.18-0.75), BF% (ß -0.12, P = 0.012), WC (ß -0.16, P = 0.002) and HC (ß -0.15, P = 0.002). Enjoyment of food, food responsiveness and emotional overeating were directly associated with overweight (OR 1.57, 95% CI 1.04-2.35; OR 4.68, 95% CI 2.90-7.54; OR 2.60, 95% CI 1.52-4.45, respectively), BF% (ß 0.13, P = 0.004; ß 0.30, P<0.001; ß 0.09, P = 0.035, respectively), WC (ß 0.14, P = 0.003; ß 0.40, P<0.001; ß 0.19, P<0.001, respectively) and HC (ß 0.15, P = 0.001; ß 0.38, P<0.001; ß 0.15, P = 0.001, respectively). Satiety responsiveness was inversely associated with overweight (OR 0.42, 95% CI 0.26-0.67), BF% (ß -0.20, P<0.001), WC (ß -0.26, P<0.001) and HC (ß -0.26, P<0.001). Slowness in eating was inversely associated with overweight (OR 0.61, 95% CI 0.41-0.92), WC (ß -0.16, P = 0.001) and HC (ß -0.17, P<0.001). Protein intake was directly associated with BF% (ß 0.11, P = 0.017), WC (ß 0.11, P = 0.020) and HC (ß 0.13, P = 0.008). CONCLUSIONS: Promoting regular consumption of main meals and healthy eating behaviours should be emphasized in the prevention of overweight among children. More research is needed on the association of protein-rich foods with body adiposity in children.

Dietary factors and their associations with socioeconomic background in Finnish girls and boys 6-8 years of age: the PANIC Study.

BACKGROUND/OBJECTIVES: To study nutrient intake, food consumption and meal pattern, and their associations with socioeconomic background in Finnish children. SUBJECTS/METHODS: The subjects were a population sample of 424 children (211 girls, 213 boys) 6-8 years of age. Nutrient intake and meal pattern were measured by food records, and food intake and socioeconomic characteristics were assessed by questionnaires. RESULTS: Intakes of saturated fat, sucrose and salt were higher, and intakes of vitamin D, iron and fibre and unsaturated-to-saturated fat ratio lower than recommended. Less than 5% of children consumed vegetables, fruit and berries as recommended. Children with highest parental education more likely ate fish (odds ratio (OR) 2.20, 95% confidence interval (CI) 1.06-4.54), fibre-rich bread (OR 5.06, 95% CI 1.80-14.29) and main meals (OR 2.54, 95% CI 1.34-4.83), but less likely used soft margarine (OR 0.43, 95% CI 0.20-0.94) as recommended than children with lowest parental education. Children with highest household income more likely consumed skimmed milk (OR 2.43, 95% CI 1.21-4.88) and fish (OR 2.21, 95% CI 1.12-4.36) as recommended than children with lowest household income. Only 34% of girls and 45% of boys ate all main meals daily. Snacks provided as much as 42% of total energy intake. CONCLUSIONS: Children do not meet recommendations in all important nutrients. Children from lowest socioeconomic position least likely consumed fish, skimmed milk and fibre-rich bread and ate main meals, but most likely used soft margarine as recommended. Less than half of children ate all main meals daily.