Dietary intake and growth in children with Prader-Willi syndrome.

BACKGROUND: The management of Prader-Willi Syndrome (PWS) requires strict dietary supervision to prevent obesity, avoid micronutrient deficiencies and ensure optimal growth. The present study aimed to examine the growth and dietary intake of children with PWS. METHODS: All children with genetically confirmed PWS attending Children's Health Ireland (CHI) at Tallaght (n = 44) were invited to participate. Anthropometry was performed and body composition measured using bioelectrical impedance analysis. Three-day food diaries were used to evaluate dietary intake and the presence of early feeding issues was assessed. Serum haemoglobin, ferritin and vitamin D levels were measured. RESULTS: Nineteen children participated, with a mean (range) age of 7.6 (0.6-18.1) years. Most were female (n = 14, 74%). Twenty-percent (n = 3) were underweight, 60% (n = 9) were healthy weight, n = 1 was overweight and n = 2 were obese. Mean (range) percentage body fat was 25.7% (10%-40%). Eigthy-three percent reported early feeding issues. Ninety-four percent (n = 16) achieved ≤ 100% of estimated average requirement (EAR) for energy. Mean daily energy intake for ≤ 5 years old was 722 kcal (9 kcal cm-1 /72-112% EAR); for those ≥ 12 years, it was 1203 kcal (8.3 kcal cm-1 /41%-82% EAR). Suboptimal calcium, vitamin D, iron, zinc and fibre intake was evident. Iron deficiency anaemia and vitamin D insufficiency occurred in two children. CONCLUSIONS: The present study provides the first Irish data for PWS and shows that energy intake does not appear to be excessive, with four in five patients being underweight or of a normal BMI. Suboptimal dietary intake of several micronutrients was evident and biochemical nutrient deficiencies were present.

Prader-Willi Syndrome in children: Quality of life and caregiver burden.

Prader-Willi syndrome is a complex condition requiring constant care and supervision of the affected child. AIM: To evaluate quality of life and caregiver burden in children with Prader-Willi syndrome. METHODS: All children with Prader-Willi syndrome, attending a tertiary referral centre, were invited to participate (n = 44). Quality of life was evaluated using the PedsQL questionnaire. Family impact modules and parent proxy reports evaluated the impact on the quality of life of the child and family. Additional challenges were captured using a burden questionnaire. RESULTS: Nineteen children participated. Median age was 7.9 years (0.6-18.1 years). Majority were female (n = 14, 74%). Median age at diagnosis was 2.5 weeks (range birth-2 years 8 months). Growth hormone treatment was in place for the majority (n = 14, 74%). Increased weight and age were identified as significantly impacting on family functioning and relationships. Parents perceived increased weight and age to have a significant negative impact on their child's psychosocial health and social functioning. Caregivers of children >12 years reported an increased burden of care. Disruption to routines, restriction of social activities and psychological difficulties were reported as increasing caregiver burden. CONCLUSION: Prader-Willi syndrome impacts significantly on quality of life for both the affected child and the family.

Larger Food Portion Sizes Are Associated with Both Positive and Negative Markers of Dietary Quality in Irish Adults.

Reduction in portion size, particularly for energy-dense foods, is increasingly addressed in healthy eating guidelines in a bid to tackle the obesity epidemic. The effect of portion size on other aspects of dietary quality, such as nutrient intakes, is less studied. The aim of the current work was to investigate associations between food portion sizes and key indicators of dietary quality, namely energy-adjusted intakes of saturated fat, dietary fibre, sodium, calcium, iron, folate and vitamin D, and dietary energy density (DED), in Irish adults on the days the foods were consumed. Data from the Irish National Adult Nutrition Survey (2008⁻2010) (n = 1274, 18⁻64 years, 4-day semi-weighed record) were used for the analysis. DED was lower on the days larger portions of boiled potatoes, fruit, vegetables and baked beans were consumed, and higher on the days larger portions of white bread, ready-to-eat breakfast cereals (RTEBCs), frying meats, cheese, butter, biscuits, chocolate and sugar-sweetened beverages were consumed. Micronutrient intakes were higher on the days larger portions of brown bread, RTEBCs, vegetables and low-fat spreads were consumed, and lower on the days larger portions of white bread, butter, biscuits, chocolate, sugar-sweetened beverages and beer/cider were consumed, with the exception of folate. The study identifies foods for which larger portion sizes may be associated with positive dietary attributes, as well as the opposite. It provides an important evidence base from which more specific dietary guidance on food portion sizes might be developed for Irish adults.

The Effect of Berry-Based Food Interventions on Markers of Cardiovascular and Metabolic Health: A Systematic Review of Randomized Controlled Trials.

SCOPE: Epidemiological evidence, animal, and in vitro studies suggest that berry consumption may ameliorate markers of cardiovascular disease (CVD). The aim of this systematic review is to evaluate findings from berry-based randomized controlled trials (RCTs) to establish the effects of berry consumption on markers of cardiovascular and metabolic health. METHODS AND RESULTS: PubMed and Web of Science are searched for RCTs investigating berry consumption on CVD risk outcomes in adults. A total of 23 studies (which includes 1168 participants) out of 1384 records meet the inclusion criteria. Of these 23 studies, 17 RCTs are of high quality, where 12 RCTs (71%) report beneficial effects of berry consumption on CVD risk markers. Overall, 4/11 RCTs that observe a reduction in systolic and/or diastolic blood pressure (BP); 3/7 RCTs report favorable effects on endothelial function, 2/3 RCTs report improvements in arterial stiffness, 7/17 studies observe benefits in blood lipids, and 3/6 studies report improvements in glycemic profile. CONCLUSION: Our evaluation of the literature indicates that more than two-thirds of high-quality trials have reported beneficial effects of berry consumption on markers of CVD risk. This systematic review contributes moderate to strong evidence for the inclusion of berries as part of a cardioprotective diet.

eBASIS (Bioactive Substances in Food Information Systems) and Bioactive Intakes: Major Updates of the Bioactive Compound Composition and Beneficial Bioeffects Database and the Development of a Probabilistic Model to Assess Intakes in Europe.

eBASIS (Bioactive Substances in Food Information Systems), a web-based database that contains compositional and biological effects data for bioactive compounds of plant origin, has been updated with new data on fruits and vegetables, wheat and, due to some evidence of potential beneficial effects, extended to include meat bioactives. eBASIS remains one of only a handful of comprehensive and searchable databases, with up-to-date coherent and validated scientific information on the composition of food bioactives and their putative health benefits. The database has a user-friendly, efficient, and flexible interface facilitating use by both the scientific community and food industry. Overall, eBASIS contains data for 267 foods, covering the composition of 794 bioactive compounds, from 1147 quality-evaluated peer-reviewed publications, together with information from 567 publications describing beneficial bioeffect studies carried out in humans. This paper highlights recent updates and expansion of eBASIS and the newly-developed link to a probabilistic intake model, allowing exposure assessment of dietary bioactive compounds to be estimated and modelled in human populations when used in conjunction with national food consumption data. This new tool could assist small- and medium-sized enterprises (SMEs) in the development of food product health claim dossiers for submission to the European Food Safety Authority (EFSA).

Secular trends in reported portion size of food and beverages consumed by Irish adults.

The present analysis aimed to investigate the changes in the reported portion sizes (PS) of foods and beverages commonly consumed by Irish adults (18-64 years) from the North South Ireland Food Consumption Survey (NSIFCS) (1997-2001) and the National Adult Nutrition Survey (NANS) (2008-10). Food PS, which are defined as the weight of food (g) consumed per eating occasion, were calculated for comparable foods and beverages in two nationally representative cross-sectional Irish food consumption surveys and were published in NSIFCS and NANS. Repeated measure mixed model analysis compared reported food PS at the total population level as well as subdivided by sex, age, BMI and social class. A total of thirteen commonly consumed foods were examined. The analysis demonstrated that PS significantly increased for five foods ('white sliced bread', 'brown/wholemeal breads', 'all meat, cooked', 'poultry, roasted' and 'milk'), significantly decreased for three ('potatoes', 'chips/wedges' and 'ham, sliced') and did not significantly change for five foods ('processed potato products', 'bacon/ham', 'cheese', 'yogurt' and 'butter/spreads') between the NSIFCS and the NANS. The present study demonstrates that there was considerable variation in the trends in reported food PS over this period.

Food portion sizes and dietary quality in Irish children and adolescents.

OBJECTIVE: To describe relationships between the portion sizes of a range of foods commonly consumed by Irish children and adolescents and key indicators of dietary quality on the days they were consumed. DESIGN: Cross-sectional data from the Irish National Children's Food Survey (2003-2004; 7 d weighed record) and National Teens' Food Survey (2005-2006; 7 d semi-weighed record) were used to compare mean values for a number of dietary quality indicators (e.g. energy-adjusted intakes of saturated fat, dietary fibre and Na) across portion size tertiles for a range of foods, on the days the foods were consumed. SETTING: The Republic of Ireland. SUBJECTS: Nationally representative samples of children aged 5-12 years (n 594) and adolescents aged 13-17 years (n 441). RESULTS: Relationships between food portion sizes and indicators of dietary quality on the days the foods were consumed were similar in both children and adolescents. Lower dietary energy density and saturated fat intakes, and higher dietary fibre intakes, were observed on the days larger portions of fruit and boiled potatoes were consumed. Higher dietary energy density and lower micronutrient intakes were observed on the days larger portions of sugar-sweetened beverages were consumed. Higher Na intakes were observed on the days larger portions of frying meats were consumed. CONCLUSIONS: The current work identifies foods for which larger portion sizes may be associated with positive dietary attributes, as well as the opposite. Findings will form an evidence base from which more specific dietary guidance relating to portion size may be developed for Irish children and adolescents.

Development of an online database of typical food portion sizes in Irish population groups.

The Irish Food Portion Sizes Database (available at www.iuna.net) describes typical portion weights for an extensive range of foods and beverages for Irish children, adolescents and adults. The present paper describes the methodologies used to develop the database and some key characteristics of the portion weight data contained therein. The data are derived from three large, cross-sectional food consumption surveys carried out in Ireland over the last decade: the National Children's Food Survey (2003-2004), National Teens' Food Survey (2005-2006) and National Adult Nutrition Survey (2008-2010). Median, 25th and 75th percentile portion weights are described for a total of 545 items across the three survey groups, split by age group or sex as appropriate. The typical (median) portion weights reported for adolescents and adults are similar for many foods, while those reported for children are notably smaller. Adolescent and adult males generally consume larger portions than their female counterparts, though similar portion weights may be consumed where foods are packaged in unit amounts (for example, pots of yoghurt). The inclusion of energy under-reporters makes little difference to the estimation of typical portion weights in adults. The data have wide-ranging applications in dietary assessment and food labelling, and will serve as a useful reference against which to compare future portion size data from the Irish population. The present paper provides a useful context for researchers and others wishing to use the Irish Food Portion Sizes Database, and may guide researchers in other countries in establishing similar databases of their own.