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1.
JAMA ; 321(17): 1702-1715, 2019 05 07.
Artigo em Inglês | MEDLINE | ID: mdl-31063572

RESUMO

Importance: Both low and high gestational weight gain have been associated with adverse maternal and infant outcomes, but optimal gestational weight gain remains uncertain and not well defined for all prepregnancy weight ranges. Objectives: To examine the association of ranges of gestational weight gain with risk of adverse maternal and infant outcomes and estimate optimal gestational weight gain ranges across prepregnancy body mass index categories. Design, Setting, and Participants: Individual participant-level meta-analysis using data from 196 670 participants within 25 cohort studies from Europe and North America (main study sample). Optimal gestational weight gain ranges were estimated for each prepregnancy body mass index (BMI) category by selecting the range of gestational weight gain that was associated with lower risk for any adverse outcome. Individual participant-level data from 3505 participants within 4 separate hospital-based cohorts were used as a validation sample. Data were collected between 1989 and 2015. The final date of follow-up was December 2015. Exposures: Gestational weight gain. Main Outcomes and Measures: The main outcome termed any adverse outcome was defined as the presence of 1 or more of the following outcomes: preeclampsia, gestational hypertension, gestational diabetes, cesarean delivery, preterm birth, and small or large size for gestational age at birth. Results: Of the 196 670 women (median age, 30.0 years [quartile 1 and 3, 27.0 and 33.0 years] and 40 937 were white) included in the main sample, 7809 (4.0%) were categorized at baseline as underweight (BMI <18.5); 133 788 (68.0%), normal weight (BMI, 18.5-24.9); 38 828 (19.7%), overweight (BMI, 25.0-29.9); 11 992 (6.1%), obesity grade 1 (BMI, 30.0-34.9); 3284 (1.7%), obesity grade 2 (BMI, 35.0-39.9); and 969 (0.5%), obesity grade 3 (BMI, ≥40.0). Overall, any adverse outcome occurred in 37.2% (n = 73 161) of women, ranging from 34.7% (2706 of 7809) among women categorized as underweight to 61.1% (592 of 969) among women categorized as obesity grade 3. Optimal gestational weight gain ranges were 14.0 kg to less than 16.0 kg for women categorized as underweight; 10.0 kg to less than 18.0 kg for normal weight; 2.0 kg to less than 16.0 kg for overweight; 2.0 kg to less than 6.0 kg for obesity grade 1; weight loss or gain of 0 kg to less than 4.0 kg for obesity grade 2; and weight gain of 0 kg to less than 6.0 kg for obesity grade 3. These gestational weight gain ranges were associated with low to moderate discrimination between those with and those without adverse outcomes (range for area under the receiver operating characteristic curve, 0.55-0.76). Results for discriminative performance in the validation sample were similar to the corresponding results in the main study sample (range for area under the receiver operating characteristic curve, 0.51-0.79). Conclusions and Relevance: In this meta-analysis of pooled individual participant data from 25 cohort studies, the risk for adverse maternal and infant outcomes varied by gestational weight gain and across the range of prepregnancy weights. The estimates of optimal gestational weight gain may inform prenatal counseling; however, the optimal gestational weight gain ranges had limited predictive value for the outcomes assessed.


Assuntos
Índice de Massa Corporal , Ganho de Peso na Gestação , Complicações na Gravidez , Resultado da Gravidez , Adulto , Peso ao Nascer , Cesárea/estatística & dados numéricos , Diabetes Gestacional , Feminino , Humanos , Hipertensão Induzida pela Gravidez , Recém-Nascido , Obesidade , Gravidez , Nascimento Prematuro
2.
PLoS Med ; 16(2): e1002744, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30742624

RESUMO

BACKGROUND: Maternal obesity and excessive gestational weight gain may have persistent effects on offspring fat development. However, it remains unclear whether these effects differ by severity of obesity, and whether these effects are restricted to the extremes of maternal body mass index (BMI) and gestational weight gain. We aimed to assess the separate and combined associations of maternal BMI and gestational weight gain with the risk of overweight/obesity throughout childhood, and their population impact. METHODS AND FINDINGS: We conducted an individual participant data meta-analysis of data from 162,129 mothers and their children from 37 pregnancy and birth cohort studies from Europe, North America, and Australia. We assessed the individual and combined associations of maternal pre-pregnancy BMI and gestational weight gain, both in clinical categories and across their full ranges, with the risks of overweight/obesity in early (2.0-5.0 years), mid (5.0-10.0 years) and late childhood (10.0-18.0 years), using multilevel binary logistic regression models with a random intercept at cohort level adjusted for maternal sociodemographic and lifestyle-related characteristics. We observed that higher maternal pre-pregnancy BMI and gestational weight gain both in clinical categories and across their full ranges were associated with higher risks of childhood overweight/obesity, with the strongest effects in late childhood (odds ratios [ORs] for overweight/obesity in early, mid, and late childhood, respectively: OR 1.66 [95% CI: 1.56, 1.78], OR 1.91 [95% CI: 1.85, 1.98], and OR 2.28 [95% CI: 2.08, 2.50] for maternal overweight; OR 2.43 [95% CI: 2.24, 2.64], OR 3.12 [95% CI: 2.98, 3.27], and OR 4.47 [95% CI: 3.99, 5.23] for maternal obesity; and OR 1.39 [95% CI: 1.30, 1.49], OR 1.55 [95% CI: 1.49, 1.60], and OR 1.72 [95% CI: 1.56, 1.91] for excessive gestational weight gain). The proportions of childhood overweight/obesity prevalence attributable to maternal overweight, maternal obesity, and excessive gestational weight gain ranged from 10.2% to 21.6%. Relative to the effect of maternal BMI, excessive gestational weight gain only slightly increased the risk of childhood overweight/obesity within each clinical BMI category (p-values for interactions of maternal BMI with gestational weight gain: p = 0.038, p < 0.001, and p = 0.637 in early, mid, and late childhood, respectively). Limitations of this study include the self-report of maternal BMI and gestational weight gain for some of the cohorts, and the potential of residual confounding. Also, as this study only included participants from Europe, North America, and Australia, results need to be interpreted with caution with respect to other populations. CONCLUSIONS: In this study, higher maternal pre-pregnancy BMI and gestational weight gain were associated with an increased risk of childhood overweight/obesity, with the strongest effects at later ages. The additional effect of gestational weight gain in women who are overweight or obese before pregnancy is small. Given the large population impact, future intervention trials aiming to reduce the prevalence of childhood overweight and obesity should focus on maternal weight status before pregnancy, in addition to weight gain during pregnancy.


Assuntos
Índice de Massa Corporal , Análise de Dados , Ganho de Peso na Gestação/fisiologia , Obesidade Pediátrica/epidemiologia , Austrália/epidemiologia , Estudos de Coortes , Europa (Continente)/epidemiologia , Feminino , Humanos , América do Norte/epidemiologia , Sobrepeso/diagnóstico , Sobrepeso/epidemiologia , Obesidade Pediátrica/diagnóstico , Gravidez , Fatores de Risco
3.
BMC Med ; 16(1): 201, 2018 Nov 05.
Artigo em Inglês | MEDLINE | ID: mdl-30396358

RESUMO

BACKGROUND: Gestational weight gain differs according to pre-pregnancy body mass index and is related to the risks of adverse maternal and child health outcomes. Gestational weight gain charts for women in different pre-pregnancy body mass index groups enable identification of women and offspring at risk for adverse health outcomes. We aimed to construct gestational weight gain reference charts for underweight, normal weight, overweight, and grades 1, 2 and 3 obese women and to compare these charts with those obtained in women with uncomplicated term pregnancies. METHODS: We used individual participant data from 218,216 pregnant women participating in 33 cohorts from Europe, North America, and Oceania. Of these women, 9065 (4.2%), 148,697 (68.1%), 42,678 (19.6%), 13,084 (6.0%), 3597 (1.6%), and 1095 (0.5%) were underweight, normal weight, overweight, and grades 1, 2, and 3 obese women, respectively. A total of 138, 517 women from 26 cohorts had pregnancies with no hypertensive or diabetic disorders and with term deliveries of appropriate for gestational age at birth infants. Gestational weight gain charts for underweight, normal weight, overweight, and grade 1, 2, and 3 obese women were derived by the Box-Cox t method using the generalized additive model for location, scale, and shape. RESULTS: We observed that gestational weight gain strongly differed per maternal pre-pregnancy body mass index group. The median (interquartile range) gestational weight gain at 40 weeks was 14.2 kg (11.4-17.4) for underweight women, 14.5 kg (11.5-17.7) for normal weight women, 13.9 kg (10.1-17.9) for overweight women, and 11.2 kg (7.0-15.7), 8.7 kg (4.3-13.4) and 6.3 kg (1.9-11.1) for grades 1, 2, and 3 obese women, respectively. The rate of weight gain was lower in the first half than in the second half of pregnancy. No differences in the patterns of weight gain were observed between cohorts or countries. Similar weight gain patterns were observed in mothers without pregnancy complications. CONCLUSIONS: Gestational weight gain patterns are strongly related to pre-pregnancy body mass index. The derived charts can be used to assess gestational weight gain in etiological research and as a monitoring tool for weight gain during pregnancy in clinical practice.

4.
Eur J Clin Nutr ; 2018 Nov 05.
Artigo em Inglês | MEDLINE | ID: mdl-30397257

RESUMO

BACKGROUND/OBJECTIVES: Coronary heart disease begins in childhood and warrants prevention strategies such as dietary modification. The objective was to determine the effect of the Special Turku Coronary Risk Factor Intervention Project (STRIP) dietary intervention on food consumption and nutrient intake over 20-year intervention period. SUBJECTS/METHODS: The STRIP is a prospective, randomized trial conducted between 1990 and 2011. Enrolled 6-month-old infants (n = 1062) were randomized to an intervention group (n = 540) receiving dietary counseling biannually from age 7 months to 20 years or control group (n = 522) not receiving any intervention. Food and nutrient intake was assessed annually using 4-day food records. A food-based diet score was calculated. RESULTS: The intervention led to (1) higher consumption of low-fat unsweetened dairy (ß = 177.76, 95% CI 157.36-198.16 g/day), vegetable-oil based fats (ß = 6.00, 5.37-6.63 g/day), fish (ß = 2.45, 1.44-3.45 g/day), fiber-rich grain products (ß = 5.53, 3.17-7.89 g/day), fruits/berries (ß = 9.93, 4.44-15.43 g/day), vegetables (ß = 11.95, 7.74-16.16 g/day); (2) lower consumption of desserts (ß = - 4.10, 95% CI - 6.50 to - 1.70 g/day); (3) lower intake of sucrose (ß = - 1.61, 95% CI - 2.88 to - 0.35 g/day), and higher intake of fiber (ß = 0.83, 0.55-1.11 g/day), folate (ß = 11.14, 95% CI 8.23-14.05 µg/day), vitamin D (ß = 0.52, 0.39-0.64 µg/day), C (ß = 8.08, 4.79-11.38 mg/day), E (ß = 0.93, 0.81-1.05 mg/day), iron (ß = 0.31, 0.18-0.44 mg/day), zinc (ß = 0.29, 0.17-0.40 mg/day), magnesium (ß = 12.17, 9.02-15.33 mg/day), sodium (ß = 55.00, 24.40-85.60 mg/day), potassium (ß = 157.11, 107.24-206.98 mg/day). No effect was found on nut/seed, red/processed meat, sugar-sweetened beverage, salty snack consumption, or vitamin A and calcium intake. Intervention effect was more pronounced in boys. CONCLUSIONS: The STRIP intervention improved children's diet quality over 20 years, indicating that beneficial dietary changes can be introduced and sustained in youth.

5.
Health Place ; 2018 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-30470615

RESUMO

Neighborhood socioeconomic status (SES) is associated with dietary habits among the residents, but few studies have examined this association separately among long-term residents and movers. We calculated cumulative neighborhood SES score weighted by residential time in each address over 6 years for non-movers (n = 7704) and movers (n = 8818) using national grid database. Increase in average neighborhood SES was associated with higher adherence to dietary recommendations in both groups. Among the movers, an upward trajectory from low to high neighborhood SES was also associated with better adherence. Our findings suggest high SES areas might offer healthier food environments than low SES areas.

6.
J Sch Health ; 88(10): 744-753, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30203478

RESUMO

BACKGROUND: Nutritious and attractive school meals can improve health equality and public health. Current official guidelines and recommendations on food and nutrient composition of school meals in 3 Nordic countries; Sweden, Finland, and Iceland, are described and compared with actual practice, ie, availability of foods and nutrients in served reference meals in 3 selected areas in each country. METHODS: A country comparison was made between official guidelines, and actual practice was studied in participating schools. Reference portions of school meals (N = 170) provided in 24 compulsory schools were photographed and weighed. Food and nutrient availability were compared with official guidelines in each country. RESULTS: Emphasis of recommendations on whole-grain bread in Sweden, whole grains in Finland, and fish in Iceland were reflected in food availability. The energy content of the meals provided was lower than guidelines and there was a large variation in energy content between days. CONCLUSIONS: The guidelines regarding food availability were quite well followed, but the large variation in energy and nutrient content of provided school meals between days indicates a need for standardization.

7.
Diabetes Care ; 41(10): 2236-2244, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30072407

RESUMO

OBJECTIVE: We examined whether success in achieving the key targets of an infancy-onset 20-year dietary intervention associated with insulin sensitivity and serum lipids from early childhood to young adulthood. RESEARCH DESIGN AND METHODS: The sample comprised 941 children participating in the prospective, randomized Special Turku Coronary Risk Factor Intervention Project (STRIP). Dietary counseling was given biannually based on the Nordic Nutrition Recommendations with the main aim to improve the quality of dietary fat in children's diets and the secondary aim to promote intake of vegetables, fruits, and whole-grain products. Food records and serum lipid profile were studied annually from 1 to 20 years of age, and HOMA of insulin resistance (HOMA-IR) was assessed between 7 and 20 years of age. Meeting the intervention targets for quality of dietary fat was defined as the ratio of saturated fatty acids (SAFA) to monounsaturated and polyunsaturated fatty acids (MUFA + PUFA) <1:2 and intake of SAFA <10% of total energy intake (E%). Meeting the target for intake of whole-grain products, fruits, and vegetables was indicated by a fiber intake ≥3 g/MJ. RESULTS: Participants in the intervention group had a higher probability of meeting the targets of SAFA/(PUFA + MUFA) <1:2 (risk ratio [RR] 3.91 [95% CI 3.33-4.61]), intake of SAFA <10 E% (RR 3.33 [95% CI 2.99-3.96]), and intake of fiber >3 g/MJ (RR 1.37 [95% CI 1.04-1.80]). Participants who achieved more targets had lower HOMA-IR, lower concentrations of fasting serum glucose, insulin, LDL cholesterol, and non-HDL cholesterol, and a lower ratio of apolipoprotein (Apo) B/ApoA1 (P values all ≤0.003). CONCLUSIONS: Achieving the key targets of an infancy-onset 20-year dietary intervention was associated with better insulin sensitivity and serum lipid profile throughout the early life course.

8.
Nutrients ; 10(9)2018 Aug 24.
Artigo em Inglês | MEDLINE | ID: mdl-30149573

RESUMO

The authors reviewed the published evidence on the presence of oligosaccharides in human milk (HMO) and their benefits in in vitro and in vivo studies. The still limited data of trials evaluating the effect of mainly 2'-fucosyllactose (2'-FL) on the addition of some of HMOs to infant formula were also reviewed. PubMed was searched from January 1990 to April 2018. The amount of HMOs in mother's milk is a dynamic process as it changes over time. Many factors, such as duration of lactation, environmental, and genetic factors, influence the amount of HMOs. HMOs may support immune function development and provide protection against infectious diseases directly through the interaction of the gut epithelial cells or indirectly through the modulation of the gut microbiota, including the stimulation of the bifidobacteria. The limited clinical data suggest that the addition of HMOs to infant formula seems to be safe and well tolerated, inducing a normal growth and suggesting a trend towards health benefits. HMOs are one of the major differences between cow's milk and human milk, and available evidence indicates that these components do have a health promoting benefit. The addition of one or two of these components to infant formula is safe, and brings infant formula closer to human milk. More prospective, randomized trials in infants are need to evaluate the clinical benefit of supplementing infant formula with HMOs.

9.
Scand J Med Sci Sports ; 28(12): 2668-2676, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30003602

RESUMO

PURPOSE: This study examined how motor skills are associated with physical activity (PA), sedentary time, body fat, and day care attendance among young children. Also, the motor skills of healthy weight children were compared to those who were overweight or obese. METHODS: The study population consisted of five to six years old children (n = 111; 45 boys) who participated in the longitudinal STEPS Study carried out in Southwest Finland in 2013-2014. Motor skills were measured with the Bruininks-Oseretsky test, second edition (BOT-2) including fine manual control, manual coordination, body coordination, and strength and agility. Moderate-to-vigorous intensity PA (MVPA) and sedentary time were objectively measured with hip-worn accelerometers. Body mass index (BMI) was calculated based on measured weight and height. Body fat percentage (BF%) was measured using segmental multifrequency bio impedance analysis. Day care attendance was measured with parental questionnaires. Linear regression analyses were adjusted by age, sex, and parental education. RESULTS: Day care attendance was positively associated with body coordination and strength and agility. Lower BF% in girls was associated with higher strength and agility scores. There were no associations between manual coordination or fine manual control and the explanatory variables. Objectively measured MVPA and sedentary time showed no associations with motor skills. Overweight children had significantly lower scores in all motor skill composites (P < 0.05) than healthy weight children, except in fine manual control where the association was non-significant (P = 0.202). CONCLUSIONS: Early prevention of overweight and obesity may be of importance and day care attendance may be beneficial for motor skill development.


Assuntos
Adiposidade , Cuidado da Criança , Exercício , Destreza Motora , Comportamento Sedentário , Acelerometria , Tecido Adiposo , Índice de Massa Corporal , Criança , Pré-Escolar , Feminino , Finlândia , Seguimentos , Humanos , Masculino , Estudos Prospectivos
10.
Clin Nutr ; 2018 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-30017243

RESUMO

BACKGROUND & AIMS: Human milk (HM) contains a wide array of non-nutritive bioactive elements, including glucocorticoid hormones (glucocorticoid; cortisol and cortisone). The relationship between milk-borne glucocorticoids, measures of maternal health and patterns of breast-feeding is not yet established. This study was conducted to determine the influence of maternal and infant related biological and socio-demographic factors on the levels of glucocorticoids hormones in HM. METHODS: Samples were obtained from lactating mothers (n = 656) participating in the Finnish cohort the STEPS study (Steps to the Healthy Development and Well-being of Children) when the infants were 11.29 (±2.6) weeks of age. Glucocorticoids (both cortisol and cortisone) concentrations were measured using liquid chromatography-tandem mass spectrometry (LC-MS/MS). Maternal demographics, biological and social factors were obtained using hospital records and self-reported diaries and questionnaires. RESULTS: The majority of women reported that they were exclusively breastfeeding at the time of sample donation (51.2%). For all collected samples, cortisone (9.55 ± 3.44 ng/ml) was the predominant hormone and cortisol (7.39 ± 5.97 ng/ml) was present in all samples. Strong and positive correlation was found between cortisol and cortisone (r = 0.60, p=<0.0001). Cortisone was statistically different between overweight, normal and underweight women (p = 0.01) for cortisol no difference was seen (p = 0.96). Whilst, preterm birth (born before 37 week gestation) was positively associated with both cortisol (p = 0.04) and cortisone (p = 0.01). There was also a significant but weaker negative relationship between mothers educational status and cortisol (p = 0.05) and no effect was seen for cortisone (p = 0.82). Interestingly, no significant differences was found in glucocorticoid concentrations between exclusive and partial breastfeeding women. CONCLUSION: HM contains glucocorticoids hormones. The concentrations are influenced by the varying maternal factors including maternal weight, preterm birth and maternal educational status, suggesting the possible role of maternal biological and social influences on milk hormonal composition. Interestingly, there was no influence of feeding patterns on HM glucocorticoids. Further analysis is required to fully explore the relationship with measures of maternal stress, including mother's glucocorticoid status.

11.
J Pediatr ; 195: 190-198.e3, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29397160

RESUMO

OBJECTIVES: To study the effects of repeated, infancy-onset dietary counseling on a detailed metabolic profile. Effects of dietary saturated fat replacement on circulating concentrations of metabolic biomarkers still remain unknown. STUDY DESIGN: The Special Turku Coronary Risk Factor Intervention Project (STRIP) study is a longitudinal, randomized atherosclerosis prevention trial in which repeated dietary counseling aimed at reducing the proportion of saturated fat intake. Nuclear magnetic resonance metabolomics quantified circulating metabolites from serum samples assessed at age 9 (n = 554), 11 (n = 553), 13 (n = 508), 15 (n = 517), 17 (n = 457), and 19 (n = 417) years. RESULTS: The intervention reduced dietary intake of saturated fat (mean difference in daily percentage of total energy intake: -2.1 [95% CI -1.9 to -2.3]) and increased intake of polyunsaturated fat (0.6 [0.5-0.7]). The dietary counseling intervention led to greater serum proportions of polyunsaturated fatty acids (P < .001), with greater proportions of both circulating omega-3 (P = .02) and omega-6 (P < .001) fatty acids. The proportion of saturated fatty acids in serum was lower for both boys and girls in the intervention group (P < .001), whereas the serum proportion of monounsaturated fat was lower for boys in the intervention group only (P < .001). The intervention also reduced circulating intermediate-density lipoprotein and low-density lipoprotein lipid concentrations (P < .01). Dietary intervention effects on nonlipid biomarkers were minor except from greater concentrations of glutamine in the intervention group. CONCLUSIONS: Repeated dietary counseling from infancy to early adulthood yielded favorable effects on multiple circulating fatty acids and lipoprotein subclass lipids, particularly in boys. These molecular effects substantiate the beneficial role of saturated fat replacement on the metabolic risk profile. TRIAL REGISTRATION: ClinicalTrials.gov: NCT00223600.

12.
Eur J Prev Cardiol ; 24(16): 1779-1787, 2017 11.
Artigo em Inglês | MEDLINE | ID: mdl-28727955

RESUMO

Background The child-oriented dietary intervention given in the prospective Special Turku Coronary Risk Factor Intervention Project (STRIP) has decreased the intake of saturated fat and lowered serum cholesterol concentration in children from infancy until early adulthood. In this study, we investigated whether the uniquely long-term child-oriented intervention has affected also secondarily parental diet and cardio-metabolic risk factors. Methods The STRIP study is a longitudinal, randomized infancy-onset atherosclerosis prevention trial continued from the child's age of 8 months to 20 years. The main aim was to modify the child's diet towards reduced intake of saturated fat. Parental dietary intake assessed by a one-day food record and cardio-metabolic risk factors were analysed between the child's ages of 9-19 years. Results Saturated fat intake of parents in the intervention group was lower [mothers: 12.0 versus 13.9 daily energy (E%), p < 0.0001; fathers: 12.5 versus 13.9 E%, p < 0.0001] and polyunsaturated fat intake was higher (mothers: 6.1 versus 5.4 E%, p < 0.0001; fathers: 6.3 versus 5.9 E%, p = 0.0003) compared with the control parents. Maternal total and low-density lipoprotein cholesterol concentrations were lower in the intervention compared with the control group (mean ± SE 5.02 ± 0.04 versus 5.14 ± 0.04 mmol/l, p = 0.04 and 3.19 ± 0.04 versus 3.30 ± 0.03 mmol/l, p = 0.03, respectively). Paternal cholesterol values did not differ between the intervention and control groups. Other cardio-metabolic risk factors were similar in the study groups. Conclusions Child-oriented dietary intervention shifted the dietary fat intakes of parents closer to the recommendations and tended to decrease total and low-density lipoprotein cholesterol in the intervention mothers. Dietary intervention directed to children benefits also parents.


Assuntos
Aterosclerose/prevenção & controle , Doença da Artéria Coronariana/prevenção & controle , Aconselhamento/métodos , Dieta com Restrição de Gorduras/métodos , Comportamento Alimentar , Relações Pais-Filho , Adolescente , Adulto , Aterosclerose/complicações , Aterosclerose/epidemiologia , Criança , Pré-Escolar , Colesterol/sangue , Doença da Artéria Coronariana/epidemiologia , Doença da Artéria Coronariana/etiologia , Feminino , Finlândia/epidemiologia , Seguimentos , Humanos , Incidência , Lactente , Masculino , Pais , Estudos Prospectivos , Fatores de Risco , Fatores de Tempo , Adulto Jovem
13.
Appetite ; 109: 190-200, 2017 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-27884762

RESUMO

The primary dimension of odor is pleasantness, which is associated with a multitude of factors. We investigated how the pleasantness, familiarity, and identification of spice odors were associated with each other and with the use of the respective spice, overall use of herbs, and level of food neophobia. A total of 126 adults (93 women, 33 men; age 25-61 years, mean 39 years) rated the odors from 12 spices (oregano, anise, rosemary, mint, caraway, sage, thyme, cinnamon, fennel, marjoram, garlic, and clove) for pleasantness and familiarity, and completed a multiple-choice odor identification. Data on the use of specific spices, overall use of herbs, and Food Neophobia Scale score were collected using an online questionnaire. Familiar odors were mostly rated as pleasant (except garlic), whereas unfamiliar odors were rated as neutral (r = 0.63). We observed consistent and often significant trends that suggested the odor pleasantness and familiarity were positively associated with the correct odor identification, consumption of the respective spice, overall use of herbs, and food neophilia. Our results suggest that knowledge acquisition through repetitive exposure to spice odor with active attention may gradually increase the odor pleasantness within the framework set by the chemical characteristics of the aroma compound.


Assuntos
Ingestão de Alimentos/psicologia , Preferências Alimentares/psicologia , Odorantes/análise , Prazer , Recognição (Psicologia) , Especiarias/estatística & dados numéricos , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Priming de Repetição , Inquéritos e Questionários
14.
Eur J Psychol ; 13(4): 645-666, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-29358980

RESUMO

The present study investigated schooling effects on cognition. Cognitive data were collected as part of a research project (ProMeal) that investigated school meals and measured the intake of school lunch in relation to children's health, cognitive function, and classroom learning in four Nordic countries, among children between 10-11 years of age. It was found that Finnish pupils attending 4th grade were not, on any measure, outperformed by Norwegian and Icelandic pupils attending 5th and Swedish pupils attending 4th grade on a task measuring working memory capacity, processing speed, inhibition, and in a subsample on response- and attention control. Moreover, boys were found to perform superior to girls on tasks measuring processing speed. However, girls were found to perform better on tasks related to attention and self-control. The results are discussed in relation to the reciprocal association between cognition and schooling and whether these results reflect quality differences between schools in the four Nordic countries; most notably in comparison to Finland.

15.
Food Nutr Res ; 60: 30468, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27514723

RESUMO

BACKGROUND: School meals, if both nutritious and attractive, provide a unique opportunity to improve health equality and public health. OBJECTIVE: To describe the study rationale, data collection, and background of participants in the study 'Prospects for promoting health and performance by school meals in Nordic countries' (ProMeal). The general aim was to determine whether overall healthiness of the diet and learning conditions in children can be improved by school lunches, and to capture the main concerns regarding school lunches among children in a Nordic context. DESIGN: A cross-sectional, multidisciplinary study was performed in Finland, Iceland, Norway, and Sweden on pupils (n=837) born in 2003. RESULTS: In total 3,928 pictures of school lunches were taken to capture pupils' school lunch intake. A mean of 85% of all parents responded to a questionnaire about socioeconomic background, dietary intake, and habitual physical activity at home. Cognitive function was measured on one occasion on 93% of the pupils during optimal conditions with a Stroop and a Child Operation Span test. A mean of 169 pupils also did an Integrated Visual and Auditory Continuous Performance Test after lunch over 3 days. In total, 37,413 10-sec observations of classroom learning behavior were performed. In addition, 753 empathy-based stories were written and 78 focus groups were conducted. The pupils had high socioeconomic status. CONCLUSIONS: This study will give new insights into which future interventions are needed to improve pupils' school lunch intake and learning. The study will provide valuable information for policy making, not least in countries where the history of school meals is shorter than in some of the Nordic countries.

16.
Acta Obstet Gynecol Scand ; 95(4): 396-404, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26826608

RESUMO

INTRODUCTION: This study explored the effects of mothers' and fathers' prenatal and postnatal depressive symptoms and marital distress on breastfeeding initiation and exclusive breastfeeding (EBF) duration. MATERIAL AND METHODS: This was a prospective follow-up of a cohort sample of 873 families participating to an intensive follow-up cohort of longitudinal Steps to the Healthy Development and Well-being of Children study (The STEPS study) in Southwestern Finland. The depressive symptoms were evaluated by The Edinburgh Postpartum Depression Scale and marital distress by the Revised Dyadic Adjustment Scale at 20th gestational week and at 4 months postpartum. EBF was self-reported real-time and defined as an infant receiving no food or drink other than mother's breast milk since birth, except occasionally water. RESULTS: Neither parents' prenatal depressive symptoms predicted breastfeeding initiation or EBF duration. The mothers' prenatal depressive symptoms, in turn, predicted their postnatal depressive symptoms, which were associated with shorter duration of EBF. The EBF duration was shortest amongst the mothers who had depressive symptoms both pre- and postnatally compared to mothers who had depressive symptoms only in either time point alone (M = 1.54, 2.06 and 2.04 months, respectively). Higher prenatal maternal marital distress was associated with longer EBF duration. CONCLUSIONS: The findings suggest that the continuity of maternal depressive symptoms throughout the perinatal period has adverse effect on EBF duration. Identification and treatment of mothers' depressive symptoms already during the prenatal period may improve breastfeeding practices. The finding of mothers' marital distress having positive impact on breastfeeding practices requires further investigation.


Assuntos
Aleitamento Materno/psicologia , Depressão/psicologia , Pai/psicologia , Mães/psicologia , Cônjuges/psicologia , Estresse Psicológico/psicologia , Adulto , Depressão Pós-Parto/psicologia , Feminino , Finlândia , Seguimentos , Humanos , Estudos Longitudinais , Masculino , Gravidez , Estudos Prospectivos , Escalas de Graduação Psiquiátrica
17.
Prev Med ; 84: 27-33, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26740349

RESUMO

BACKGROUND AND OBJECTIVES: Early childhood screen time seems to persist into later childhood. This study examined the factors affecting the screen time change during the first two years of toddler's lives in Finland. We hypothesized that parents' sedentary behaviour and physical activity habits correlate significantly with children's screen time change. METHODS: The data consists of 1797 mothers, 1658 fathers and their 1827 children from the STEPS Study (Steps to the healthy development) in Southwest Finland. Screen time change during the two-year follow-up was calculated for those (n=634) who had both 13 and 36months screen time measures (13months, n=940; 36months, n=845). Demographic correlates and parental behavioural correlates were measured with questionnaires, and anthropometric measurements in study visits. RESULTS: The mean change in the children's screen time was a 55min increase from 13 to 36months. A linear mixed model analysis showed that the father's longer duration of sitting time was statistically significantly associated with a smaller increase in screen time of the child. Parents' physical activity was not associated with children's screen time change. The mother's advanced education, a younger age, and a lower screen time, the child attending day care and the child's lower body mass index were associated with children's smaller increase in screen time. CONCLUSION: The mother's advanced education as well as the father's sitting time, including sitting at the office, implied that children of higher educated parents have a smaller increase in screen time. Future studies should focus on studying why parental education has a greater influence on children's screen time change than parents' behaviour.


Assuntos
Pais , Comportamento Sedentário , Televisão/estatística & dados numéricos , Adulto , Índice de Massa Corporal , Comportamento Infantil , Pré-Escolar , Feminino , Finlândia , Seguimentos , Humanos , Lactente , Masculino , Mães/educação
18.
J Pediatr ; 167(2): 353-60.e1, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-25982143

RESUMO

OBJECTIVE: To investigate whether an infancy-onset, low saturated fat-oriented dietary intervention influences serum adiponectin concentration in adolescents, and to study the association of adiponectin with subclinical markers of vascular health, and cardio-metabolic risk factors. STUDY DESIGN: The longitudinal, randomized Special Turku Coronary Risk Factor Intervention Project aimed to modify child's dietary fat quality replacing saturated fat with unsaturated fat. Serum adiponectin (n = 521) along with weight, height, high-density lipoprotein cholesterol, C-reactive protein (CRP), triglycerides, and insulin were measured at age 15 years. Adiposity was assessed using body mass index, waist circumference, and abdominal fat thickness measured with ultrasound. Metabolic syndrome was defined according to International Diabetes Foundation criteria. Vascular ultrasound measures including carotid intima-media thickness (IMT) were assessed. RESULTS: Adiponectin concentrations were similar in the intervention and control groups (P = .16). Adiponectin associated with carotid IMT (r = -0.13, P = .005), high-density lipoprotein cholesterol (r = 0.18, P < .0001), triglycerides (r = -0.16, P = .0004), CRP (r = -0.10, P = .02), insulin (r = -0.14, P = .002), and adiposity (r = -0.18-0.24, P ≤ .0001). When adjusted for adiposity indices, the association with carotid IMT was only marginally diluted (P = .03-.06), but the associations with insulin and CRP became nonsignificant. Adolescents with adiponectin ≤median had 4-fold risk of metabolic syndrome than peers with adiponectin >median (CI 1.8-10.2, P = .0001). CONCLUSIONS: In healthy adolescents, low serum adiponectin is related with carotid IMT and metabolic syndrome. We found no evidence that repeated low saturated fat-oriented dietary counseling would influence serum adiponectin in adolescence. TRIAL REGISTRATION: Registered with ClinicalTrials.gov: NCT00223600.


Assuntos
Adiponectina/sangue , Doenças Cardiovasculares/epidemiologia , Dieta com Restrição de Gorduras , Aconselhamento Diretivo , Síndrome Metabólica/epidemiologia , Adiposidade , Adolescente , Fatores Etários , Índice de Massa Corporal , Proteína C-Reativa/metabolismo , Doenças Cardiovasculares/sangue , Espessura Intima-Media Carotídea , Feminino , Humanos , Lactente , Lipoproteínas HDL/sangue , Estudos Longitudinais , Masculino , Síndrome Metabólica/sangue , Triglicerídeos/sangue
19.
Acta Paediatr ; 104(8): 815-22, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-25939586

RESUMO

AIM: This study examined whether there was an association between a repeated dietary and lifestyle intervention that began in infancy and participants' psychological wellbeing at the age of 20. METHODS: We examined the psychological wellbeing of 457 young adults participating in the Special Turku Coronary Risk Factor Intervention Project (STRIP), a randomised controlled trial conducted in Finland between 1989 and 2011. We assessed potential differences in psychological wellbeing between the intervention and control groups by examining participants' satisfaction with life, how they rated their health, their experiences of stress and the consequences of experiencing stress and symptoms of depression at the age of 20. We also assessed socio-economic status during childhood as a potential confounding factor. RESULTS: We found no association between the long-term dietary and lifestyle intervention and participants' psychological wellbeing in adulthood. Adjusting for sex and childhood socio-economic status did not affect the results and socio-economic status did not moderate the association between the intervention and psychological wellbeing. CONCLUSION: Our findings showed no association between intensive dietary and lifestyle counselling that was initiated in infancy with psychological wellbeing in adulthood and the initiative did not appear to pose any psychological risks.


Assuntos
Aconselhamento , Dieta , Estilo de Vida , Satisfação Pessoal , Criança , Feminino , Humanos , Masculino , Estudos Prospectivos , Classe Social , Adulto Jovem
20.
Caries Res ; 49(2): 125-32, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25756173

RESUMO

OBJECTIVE: We aimed to study the long-term associations between sucrose intake (SI), selected representatives of the cariogenic oral flora, and the dental health of children from 3 to 16 years of age. METHODS: At 7 months of age 1,062 infants (540 intervention; 522 controls) were included in the prospective, randomised STRIP-project aimed at restricting the child's saturated fat and cholesterol intake to prevent atherosclerosis when they become adults. At 3 years of age, every fifth child was invited (n = 178) to an oral sub-study, and 148 (78 boys) children attended. A restudy was conducted on 135 children aged 6, 127 aged 9, 114 aged 12 and 88 aged 16. SI using 4-day food records, plate-cultured mutans streptococci (MS), salivary lactobacilli (LB) and yeasts using commercial kits (Orion Diagnostica, Espoo Finland), toothbrushing frequency using fluoridated toothpaste and dental health expressed as d 3 mft/D 3 MFT were regularly recorded. RESULTS: The SI of children whose intake was ≥ 10 E% (high SI) at 3 years remained high throughout the entire follow-up (p < 0.001, GLM for repeated measures) period, and they had higher salivary MS and LB counts (p = 0.024 and p = 0.068, respectively, GLM) than their counterparts whose SI was below 10 E% (low SI). No differences in toothbrushing habits were found between the high and low SI-groups. Caries-survival was strongly associated with low 6-year-counts of MS (p = 0.008, Cox regression analysis), and the d 3 mft/D 3 MFTscores of the high SI-group were higher than those of the low SI-group (p = 0.046, GLM). CONCLUSIONS: High SI at 3 years was associated with high MS-counts ( ≥ 10 5 cfu/ml) and with a high risk for caries.


Assuntos
Carga Bacteriana , Índice CPO , Sacarose na Dieta/administração & dosagem , Lactobacillus/isolamento & purificação , Saliva/microbiologia , Streptococcus mutans/isolamento & purificação , Adolescente , Fatores Etários , Cariostáticos/uso terapêutico , Criança , Pré-Escolar , Cárie Dentária/microbiologia , Comportamento Alimentar , Feminino , Fluoretos/uso terapêutico , Seguimentos , Humanos , Estudos Longitudinais , Masculino , Registros Médicos , Estudos Prospectivos , Fatores de Risco , Método Simples-Cego , Escovação Dentária/estatística & dados numéricos , Cremes Dentais/uso terapêutico , Leveduras/isolamento & purificação
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