Association of nutrition in early life with body fat and serum leptin at adult age.

BACKGROUND: There is overwhelming evidence that experiences during early life could have long-term health consequences. However, the role of early nutrition in programming obesity and leptin resistance is still poorly understood. OBJECTIVE: We aimed at determining whether nutritional intakes in early life are associated with body composition and hormonal status at 20 years. SUBJECTS: Healthy infants participating in the two-decade-long prospective ELANCE (Etude Longitudinale Alimentation Nutrition Croissance des Enfants) study were examined at 10 months and 2 years. At 20 years, weight, height, subscapular and triceps skinfold thicknesses, fat mass (FM) and fat-free mass (FFM) assessed via bioelectrical impedance analysis, and serum leptin concentration were recorded in 73 subjects still participating in the follow-up. RESULTS: In adjusted linear regression models, an increase by 100 kcal in energy intake at 2 years was associated with higher subscapular skinfold thickness (ß=6.4% SF, 95% confidence interval 2.53-10.30, P=0.002) and higher FFM (0.50 kg, 0.06-0.95, P=0.03) at 20 years. An increase by 1% energy from fat at 2 years was associated with lower subscapular skinfold thickness (-2.3% SF, -4.41 to -0.18, P=0.03), lower FM (-0.31 kg, -0.60 to -0.01, P=0.04) and lower serum leptin concentration (-0.21 µg l(-1), -0.39 to -0.03, P=0.02) at 20 years. CONCLUSIONS: Low-fat intake in early life was negatively associated with body fat (particularly at the trunk site) and serum leptin concentration at 20 years, suggesting that early low-fat intake could increase the susceptibility to develop overweight and leptin resistance at later ages. These findings substantiate current recommendations against restricting fat intake in early life and open new directions for investigating the origin of obesity.

Adiposity rebound in children: a simple indicator for predicting obesity.

To follow and predict the evolution of adiposity during growth, individual adiposity curves, assessed by the weight/height2 index, were drawn for 151 children from the age of 1 month to 16 yr. Adiposity increases during the 1st yr and then decreases. A renewed rise, termed here the adiposity rebound, occurs at about 6 yr. Individual weight/height2 curves may differ regarding their percentile range level and age at adiposity rebound. The present study shows a relationship between the age at adiposity rebound and final adiposity. An early rebound (before 5.5 yr) is followed by a significantly higher adiposity level than a later rebound (after 7 yr). This phenomenon is observed whatever the subject's adiposity at 1 yr. The present observations might be connected with the cellularity of adipose tissue.

Gold-mining activities and mercury contamination of native amerindian communities in French Guiana: key role of fish in dietary uptake.

In 1994, the French National Public Health Network reported significant mercury exposure of native Amerindians in French Guiana. In 1997, a study was conducted in the Wayana community to quantify the dietary intake and to identify the fish species contributing the most to the contamination. The study was completed by an impregnation analysis based on Hg determination in hair samples. The methodology used was a detailed familial dietary study associated with Hg measurements in fish and some game. The study was conducted over 7 days in two different seasons in the four most populated Wayana villages on the upper part of the Maroni River (521 people; 70% of the Wayana population in French Guiana). Analysis was based on data on consumption obtained from 165 people in a 1-14 day period (i.e., 940 persons [times] days) and involved 270 fish samples from 48 species. Total Hg and monomethylmercury (MMHg) were also determined in hair samples (235 samples for total Hg). The results confirm mercury exposure of the Wayana population related to a diet rich in fish, which are relatively highly contaminated for certain species (up to 1.62 mg/kg fresh weight or 8.1 mg/kg dry weight in skeletal muscle). Results from hair samples showed that 57% of the Amerindians had Hg levels above the World Health Organization (WHO) safety limit (10 microg/g); all those over 1 year of age had a Hg intake greater than the WHO safety limit (200 microg MMHg/week for a 60-kg male). Hg concentrations in fish muscle were closely linked to the feeding regime and position of fish in the food webs. Overall, 14.5% of the fish collected exceeded the 0.5 mg/kg (fresh weight) safety limit. Four carnivorous species accounted for no less than 72% of the metal ingested by the Wayana families, although these represented only 28% of the consumed fish biomass. In conclusion, this study revealed excessive exposure to mercury in the Wayana population in French Guiana related to the consumption of contaminated fish.

Individual patterns of food intake development in children: a 10 months to 8 years of age follow-up study of nutrition and growth.

Individual patterns of food intake development have been investigated on the basis of a longitudinal study of nutrition and growth carried out in 112 children at the ages of 10 months, and 2, 4, 6, and 8 years. On the average, energy intake increased steadily with age. However, individual subjects sometimes followed a different pattern. Approximately 1 out of 5 subjects decreased their intake between two examinations. Besides, less than half the children (43%) were in the same category of energy intake (defined as tertiles) at 10 months and 8 years of age. Similarly, 47% of the children were in the same weight/height (BMI) category at 10 months and 8 years. Correlations computed between early intakes (10 months, and 2, 4, and 6 years) and intakes at 8 years were better for energy and protein intake than for fat and carbohydrates (CHO), showing that intake of energy or protein early in life has a better predictive value of intake at later ages. Energy intake development has been examined in those children who were found to be lean, medium, and fat at the age of 8 years; it increased more between the ages of 4 and 6 years, in children who were fat at 8 years. Individual variations of anthropometric measurements during growth are well documented. The present study points out that similar individual variations of intake also exists. These variations could reflect regulatory processes acting during growth and should be taken into account in investigating the child's appetite.

Nutritional status and food intake in adolescents living in Western Europe.

This review covers surveys of nutritional intake in adolescents living in several countries of Western Europe. Current definitions of nutritional status are discussed, with a special emphasis on adolescent years. It is generally observed that obesity rates are increasing (especially those of massive obesity) in young people, whereas declared energy intakes are decreasing. Average daily energy input seems adequate in adolescents of Western Europe. However, fat (especially saturated) intake is high while that of CHO and fiber is low. Proteins are mainly (two-thirds) from animal sources. Average micronutrient intakes correspond to recommended values in most cases, but there are a few exceptions (calcium and iron) that are low, particularly in girls. Specific problems become frequent at adolescence, such as dieting, smoking, getting low quality foods away from the home, etc. These behaviors may induce adverse nutritional conditions. On average, nutritional problems at adolescence do not appear to be more severe than at other ages, however they may exert a strong deleterious impact on future health.

[Dietary intake in a representative sample of the population of Val-de Marne: II. Supply of macronutrients]. / Apports nutritionnels d'un échantillon représentatif de la population du Val-de-Marne: II. Les apports en macronutriments.

This paper describes an assessment of the nutritional value (carbohydrates, proteins, fats) of food intake studied in a population residing in the Val-de-Marne district of the Paris region. Data were collected from 1,108 subjects, aged 6 months to 97 years, randomly selected from the public telephone directories of 12 of the 47 towns and cities in the district. Dietary intake was evaluated from individual home interviews by specialized dietitians, using the dietary history method. Age was shown to be a major determinant of macro nutrient intake (expressed in absolute value) in both sexes. The amount of food consumed differed between men and women. Expressed as a relative value of energy intake (after exclusion of alcohol-related calories), the proportion of different macronutrients was similar in all age groups, for both sexes, and was not in agreement with recommended dietary allowances: too high levels of fats and insufficient levels of carbohydrates, especially starch.

[Dietary intake of a representative sample of the population of Val-de-Marne: I. Contribution of diet to energy supply]. / Consommation alimentaire d'un échantillon représentatif de la population du Val-de-Marne: I. Contribution des aliments à l'apport énergétique.

Dietary intakes and its nutritional value were assessed during a nutritional survey performed in a population living in a district in the Paris area (Val-de-Marne). Data were obtained from 1108 subjects, aged 6 months to 97 years, randomly selected from the telephone directories of 12 of 47 towns and cities in the district. Dietary intake was evaluated in individual home interviews conducted by specialized dietitians, using the dietary history method. Age appears to be an important determining factor in variations in nutritional intake. Large differences exist between men and women for most types of food consumption. But the relative contribution of the main groups of food groups to the structure of energy intake is very similar in both sexes and virtually constant in the different age groups after the age of 6.

[Dietary intake of a representative sample of the population of Val-de-Marne; III. Mineral and vitamin intake]. / Apports nutritionnels d'un échantillon représentatif de la population du Val-de-Marne: III. Les apports en minéraux et vitamines.

Mineral and vitamin intakes were assessed among 1108 subjects, aged 6 months to 97 years in 12 of 47 towns and cities in the district of Val-de-Marne (Paris area), using the telephone directory as random sampling base. Micronutrients intake was evaluated by individual interviews at home by specialized dietitians (dietary history method). Mineral and vitamin intake was found to vary widely with age. In absolute value, overall mineral and vitamin dietary intakes was higher in men than in women (except for vitamin C). Conversely, the dietary density for mineral and vitamins was higher in females. For a large part of the studied population, it would appear difficult to satisfy recommended dietary allowances for many micronutrients (iron, zinc, vit. B1, B6, C, A et E). These results bring to light possible difficulties in covering certain mineral and vitamin requirements in the French population.

[Longitudinal study of anthropometric measurements in Parisian children aged ten months to 18 years]. / Etude longitudinale de la croissance d'enfants parisiens suivis de l'âge de 10 mois à 18 ans.

AIM: To describe growth parameters in children followed longitudinally from 10 months of age to 18 years and to compare these data with reference values obtain in children born 30 years earlier. SUBJECTS AND METHOD: A follow study started in 1985 in Paris Health Centres at the ages of I 0 months, 2 and 4 years and subsequently at home every 2 years. Anthropometric data were compared with reference values derived from the French sample of the International Longitudinal Growth study which started in 1953-59. RESULTS: As compared to the reference values, children were taller. At the age of 18 years, in boys, height increase was 5.6 cm. This difference appeared as early as at the age of 12 years. Height increase in girls was 1.6 cm, but this difference was greater at 12. Thereafter, height gain was smaller than 30 years before. The Skélique index was greater due to longer leg length. Fat mass was higher and displayed a more android pattern. A higher prevalence of overweight appeared from the age of 8 years. CONCLUSION: Nowadays, growth processes seem unfavourable as compared to 30 years earlier. Fast growth, long leg length, android body fat distribution and overweight are associated with risk factors of various pathologies(cardiovascular diseases and cancer). Factors promoting these changes over time deserve to be explored more fully.

Early adiposity rebound: causes and consequences for obesity in children and adults.

Childhood obesity is an important public health problem, with a rapidly increasing frequency worldwide. Identification of critical periods for the development of childhood and adolescent obesity could be very useful for targeting prevention measures. Weight status in early childhood is a poor predictor of adult adiposity status, and most obese adults were not obese as children. We first proposed to use the body mass index (BMI) charts to monitor individual BMI development. The adiposity rebound (AR) corresponds to the second rise in BMI curve that occurs between ages 5 and 7 years. It is not as direct a measure as BMI at any age, but because it involves the examination of several points during growth, and because it is identified at a time when adiposity level clearly change directions, this method provides information that can help us understand individual changes and the development of health risks. An early AR is associated with an increased risk of overweight. It is inversely associated with bone age, and reflects accelerated growth. The early AR recorded in most obese subjects and the striking difference in the mean age at AR between obese subjects (3 years) and non-obese subjects (6 years) suggest that factors have operated very early in life. The typical pattern associated with an early AR is a low BMI followed by increased BMI level after the rebound. This pattern is recorded in children of recent generations as compared to those of previous generations. This is owing to the trend of a steeper increase of height as compared to weight in the first years of life. This typical BMI pattern (low, followed by high body fatness level) is associated with metabolic diseases such as diabetes and coronary heart diseases. Low body fatness before the AR suggests that an energy deficit had occurred at an early stage of growth. It can be attributable to the high-protein, low-fat diet fed to infants at a time of high energy needs, the former triggering height velocity and the latter decreasing the energy density of the diet and then reducing energy intake. The high-fat, low-protein content of human milk may contribute to its beneficial effects on growth processes. Early (pre- and postnatal) life is a critical period during which environmental factors may programme adaptive mechanisms that will persist in adulthood. Under-nutrition in fetal life or during the first years after birth may programme a thrifty metabolism that will exert adverse effects later in life, especially if the growing child is exposed to overnutrition. These observations stress the importance of an adequate nutritional status in childhood and the necessity to provide nutritional intakes adapted to nutritional needs at various stages of growth. Because the AR reflects particular BMI patterns, it is a useful tool for the paediatrician to monitor the child's adiposity development and for researchers to investigate the different developmental patterns leading to overweight. It contributes to the understanding of chronic disease programming and suggests new approaches to obesity prevention.

Nutrient balance and body composition.

The prevalence of obesity in industrialized countries is increasing in spite of decreased energy and fat intakes. This trend might be mainly a consequence of a decline in energy expenditure. It is suggested here that it might also be accounted for by the increasing proportion of protein in the diet, affecting the hormonal status. The nutrient imbalance is particularly apparent in early childhood, when a low fat and high protein diet is not justified because of high energy needs for growth and because it is the period of high rate of myelinization of the nervous system. At later ages, the proportion of fat exceeds the recommended level, and the protein intake remains high. A diet containing less animal and more vegetable products would reduce both protein and saturated fat excesses and could help decrease metabolic risk factors.

Dietary inadequacies observed in homeless men visiting an emergency night shelter in Paris.

OBJECTIVE: To assess the dietary intake and the nutritional status of homeless men. SETTING: A night emergency shelter in Paris, France. DESIGN: Dietary survey (48-h) including alcohol intake and a questionnaire on age, duration of homelessness, smoking habits. Subjects were also weighed and measured. SUBJECTS: Ninety-seven men aged 18-72 years (mean 43.3), of whom 54% were homeless for more than 18 months, 82% were smokers and 53% were regular and/or excessive drinkers. RESULTS: The BMI distribution was shifted towards low values, the percentage of wasted persons being four times higher than in the reference population. The mean total energy intake was 2376 kcal and included a high and highly variable percentage of energy derived from alcohol (12.0% Among drinkers, the mean ethanol intake was 90 g and there was a significant negative correlation between ethanol and non-alcoholic energy intakes. The median intakes of potassium, calcium, zinc, vitamins B1, B2, and niacin were lower than European Population Reference Intakes but only the mean intake of vitamin B1 was significantly lower. Eighty percent of non-alcoholic energy was provided by charitable organisations. For most nutrients, the nutritional density of the shelter ration was not significantly different from the density of the foods purchased by the homeless. CONCLUSIONS: These data suggest that the content of some nutrients should be increased in existing food assistance programs for homeless people in France.

The French longitudinal study of growth and nutrition: data in adolescent males and females.

OBJECTIVES: To assess nutritional intake, growth parameters, physical activity and television viewing in French adolescents. METHOD: A longitudinal study of dietary intake and anthropometric data recorded in the same children (n = 94) from 10 to 16 years of age is presented here. RESULTS: Energy intake increased from age 10-16 years in boys, whereas it decreased in girls from the age of 14. Height and weight increased in both males and females over the same period of time. Energy intake was positively associated with age at menarche. Nutritional intake, such as fat and calcium, did not meet recommendations for French adolescents. Height was higher than reference values, but the difference was not significant for girls between 14 and 16 years. Overweight (BMI > 97th percentile of the French reference) was found to be 13-14% between age 10 and 16 years. Time watching TV/computer increased with age from 1.4 to 2.2 h day-1 from 10 to 16 years. Active children had nutritional intake closer to recommendations. CONCLUSION: In conclusion, this study shows that during adolescence, some nutritional variations can be explained by normal individual growth processes. Low intake of calcium in girls and sedentary lifestyle are of particular concern.

Physical activity and body composition in 10 year old French children: linkages with nutritional intake?

OBJECTIVES: To investigate the relationships between physical activity, dietary intake and body composition in children. DESIGN: A cross-sectional study on physical activity, nutritional intakes and body composition conducted in 86 healthy 10 y old French children. In addition, growth parameters and nutritional intakes were available from the age of 10 months. MEASUREMENTS: Physical activity level (using a validated activity questionnaire over the past year), nutritional intake (dietary history method), anthropometric measurements (body weight, height, arm circumference, triceps and subscapular skinfolds, Body Mass Index (BMI), arm muscle and arm fat areas calculated from these measurements) at the age of 10 y. Anthropometric measurements and nutritional intakes were recorded in the same children at the age of 10 months and every 2 y from the age of 2 y. RESULTS: At the age of 10 y, active children ingested significantly more energy than less active children, mostly due to higher energy intake at breakfast and in the afternoon. This higher energy intake was accounted for by increased consumption of carbohydrates (281 g vs 246 g; 49.6% vs 47.4% of total energy). Even if the amounts of fat consumed were similar in both groups (90 g vs 84 g; P = 0.09), the percentage of fat intake was lower in active children (35.4% vs 37.4%; P = 0.04). The percentage of protein was not different (14.9% vs 15.3%; P = 0.33). In spite of a higher energy intake in the active group, active and less active children had similar BMI at the age of 10 y. However, their body composition differed significantly: active children had a higher proportion of fat-free mass, a lower proportion of fat-mass as measured in the arm and they had a later adiposity rebound. Fatness was significantly and positively associated with the time spent watching television and video games. CONCLUSIONS: Physical activity was associated with improved body composition and growth pattern. This association may be related to nutritional changes: active children consumed more energy by increasing carbohydrate, thus reducing the relative fat content of their diet. These results provide support to encourage physical activity during childhood.

Influence of macronutrients on adiposity development: a follow up study of nutrition and growth from 10 months to 8 years of age.

OBJECTIVE: To investigate the relationship between early nutrient intake and adiposity development. DESIGN: A follow up study of nutrition and growth carried out in a sample of 112 French children from 10 months to 8 years of age. MEASUREMENTS: Nutritional intakes at the age of 2 years and anthropometric measurements: Body Mass Index (BMI), subscapular and triceps skinfolds at the age of 8 years, and age at adiposity rebound assessed on the basis of BMI development. RESULTS: The BMI at the age of 8 years is positively correlated with energy intake at the age of 2 years, but this correlation becomes non significant after adjustment for BMI at 2 years. Protein (% of energy) intake at the age of 2 years is positively correlated with BMI and subscapular skinfold at 8 years after adjustment for energy intake at 2 years and parental BMI. The percentage of protein at 2 years is negatively associated with age at adiposity rebound, i.e. the higher the protein intake at 2 years, the earlier the adiposity rebound and the higher the subsequent BMI level. CONCLUSION: Protein at the age of 2 years is the only nutrient intake associated with fatness development pattern. A high protein intake increases body fatness at 8 years of age, via an early adiposity rebound. The association between protein intake and obesity is consistent with the increased stature and accelerated growth of obese children. A high fat low protein diet (such as human milk) is adapted to high energy demand for growth in early childhood. Our results suggest that high protein diet early in life could increase the risk of obesity and other pathologies later in life.

Influence of body fat distribution during childhood on body fat distribution in adulthood: a two-decade follow-up study.

Development of body fat distribution was assessed in a two-decade follow-up study. The present article describes the development of various trunk/extremity ratios and gives the figures by age and sex between 1 month to 21 years. The relationship between adult and childhood skinfold (SF) ratio measurements is weak in boys and slightly better in girls. From the present and our previous study, we can select adiposity measurements in children which both are associated to pathologies and have the best correlations with adult values, i.e. the body mass index (BMI) in both sexes, trunk SF in boys and the subscapular/arm SF ratio in girls. Consequently, a boy with both high BMI and trunk SF values or a girl with both high BMI and subscapular/arm SF values have an increased risk of centralized obesity at adult age.

Breakfast type, daily nutrient intakes and vitamin and mineral status of French children, adolescents, and adults.

OBJECTIVE: To examine associations between the consumption of different types of breakfasts, dietary intakes, and selected indices of nutritional status. METHODS: Dietary intakes were obtained using the dietary history method, and serum bioassays were used to assess vitamin and mineral status in a representative community-based sample of 1108 French children (ages 2 to 10 years), adolescents (ages 10 to 18 years), and adults (ages 18 to 65 years). Breakfasts were divided into three categories: low-energy (<15% of the energy RDA), medium-energy (15-25%) and high-energy (>25%). RESULTS: High-energy breakfasts were associated with the consumption of ready-to-eat (RTE) cereals. High-energy breakfasts and cereal consumption, both more common among children and adolescents than among adults, were also associated with a greater proportion of daily energy from carbohydrate and lower proportion of energy from fat. High-energy breakfasts and cereal consumption were further associated with higher intakes of vitamins and minerals as measured by percent RDAs. High-energy breakfasts and cereal consumption were associated with lower serum cholesterols and improved biochemical indices of nutritional status. Serum concentrations of vitamin B1 (in children and adolescents), vitamin B2 and beta-carotene (in adults) were significantly linked to the level of energy provided by breakfast. CONCLUSION: The consumption of breakfast cereals appears to have a positive impact on nutritional status regardless of age.

[Milk consumption in 10-month-old infants. Effects on iron intake]. / Etude de la consommation des laits des nourrissons de 10 mois. Incidence sur l'apport en fer.

A study was conducted in 278 10-month-old infants, examined in 2 health care centres in Paris. The dietary history method was used to evaluate their food consumption: 54.5% were receiving usual cow's milk (semi-skimmed or whole milk), 44% adapted infant formulas, and 1.5% cow milk products only. There was no relationship between the quality of milk consumption of these infants and the socio-economic level or the nationality of their parents. Infants receiving usual cow milk had an iron intake lower than the recommended daily amounts while those who were fed with the adapted infant formulas had an adequate daily iron intake.