Prospective associations of dietary insulin demand, glycemic index, and glycemic load during puberty with body composition in young adulthood.

BACKGROUND: Puberty is a so-called critical period for overweight development and is characterized by physiological insulin resistance during mid-puberty. This study addressed the hypothesis that habitual consumption of a diet inducing higher levels of postprandial glycemia or insulinemia during puberty may have an unfavorable effect on the body composition in young adulthood. METHODS: Multivariate regression analysis was performed on 262 participants of the Dortmund Nutritional and Anthropometric Longitudinally Designed Study with at least two 3-day weighed dietary records during puberty (baseline: girls 9-14 years; boys 10-15 years) and anthropometric measurements in young adulthood (18-25 years). A published dietary glycemic index was assigned to each carbohydrate-containing food. Similarly, each food was assigned a food insulin index (insulinemic response to a 1 MJ portion of food relative to 1 MJ of glucose) using 121 values measured at Sydney University. RESULTS: Dietary glycemic index or glycemic load during puberty was not related to body composition in young adulthood. In contrast, a higher dietary insulin index and a higher dietary insulin load during puberty were associated with higher levels of percentage of body fat (%BF) in young adulthood, even after adjustment for early life, socioeconomic and nutritional factors; %BF in energy-adjusted tertiles of dietary insulin index were 22.9 (95% confidence intervals (CI): 21.6, 24.1), 24.5 (23.2, 25.7), 24.7 (23.5, 25.9) %, P (for trend)=0.01; %BF in energy-adjusted tertiles of dietary insulin load were 22.8 (95% CI: 21.5, 24.0), 24.5 (23.2, 25.7), 24.8 (23.6, 26.0) %, P (for trend)=0.01. Adjustment for baseline %BF attenuated these relationships (P (for trend)=0.1 and=0.08, respectively). Dietary insulin demand was not related to body mass index. CONCLUSION: This study suggests a prospective adverse influence of dietary insulin demand during puberty on %BF in young adulthood. Postprandial increases in insulinemia rather than increases in glycemia appear to be implicated in an unfavorable development of body composition.

Vitamin D and probiotics supplement use in young children with genetic risk for type 1 diabetes.

BACKGROUND/OBJECTIVES: Vitamin D and probiotics are nutrients of interest in the context of type 1 diabetes (T1D). We assessed the prevalence of and factors associated with vitamin D and probiotic supplementations among young children with genetic risk of T1D. SUBJECTS/METHODS: Use of supplements during the first 2 years of life was collected prospectively from 8674 children in The Environmental Determinants of Diabetes in the Young (TEDDY) study. RESULTS: Single and/or multivitamin/mineral (MVM) supplements were reported by 81% of the children. The majority of participants in Finland, Germany and Sweden (97-99%) and 50% in the United States received vitamin D supplements that were mostly MVMs. Probiotics use varied from 6% in the United States to 60% in Finland and was primarily from probiotics-only preparations. More than 80% of the vitamin D and probiotics supplementation was initiated during infancy, and more than half of the uses lasted longer than a year. Being the first child, longer duration of breastfeeding, born in a later year, older maternal age and higher maternal education level were associated with both vitamin D and probiotics use. Shorter gestational age and mother not smoking during pregnancy were associated with a higher likelihood of probiotics supplementation only. CONCLUSIONS: Vitamin D and probiotics supplementations are popular in children 0-2 years old and are associated with common factors. Data documented here will allow evaluation of the relationship between early childhood dietary intake and the development of islet autoimmunity and progression to T1D.

Velocities of weight, height and fat mass gain during potentially critical periods of growth are decisive for adult body composition.

OBJECTIVES: To examine whether maximal velocities of weight, height and fat mass during potentially critical periods of growth were associated with body composition in young adulthood. SUBJECTS/METHODS: Analyses were performed on 277 female and 271 male participants of the DOrtmund Nutritional and Anthropometric Longitudinally Designed (DONALD) study with anthropometric measurements in young adulthood (18-25 years) as well as early life (0-2 years), mid-childhood (3-8 years) or puberty (9-15 years). Maximum growth velocities were calculated using the SuperImposition by Translation And Rotation (SITAR) routine or polynomial functions and related to adult fat mass index (FMI) and fat-free mass index (FFMI). RESULTS: In early life, faster weight gain was associated with a moderately higher FMI and FFMI in young adulthood in women only (Ptrend=0.01). In mid-childhood and puberty, weight and fat mass velocities were related to adult FMI and FFMI in both sexes (Ptrend⩽0.002): relative differences between the highest and lowest tertiles of these growth velocities ranged 33-69% for adult FMI and 6-12% for adult FFMI. A higher mid-childhood height velocity was related to a modestly higher adult FMI in women only (Ptrend=0.0005). CONCLUSIONS: Faster gain in weight and body fat during mid-childhood and puberty appear to be particularly relevant for adult fat mass.

Prospective association of protein intake during puberty with body composition in young adulthood.

OBJECTIVE: To examine the association of habitual animal and plant protein intake during the potentially critical period of puberty with body composition in young adulthood. DESIGN AND METHODS: Multivariable regression analyses were performed on data from 140 female and 122 male participants of the DONALD Study with ≥2 3-day weighed dietary records during puberty (girls 9-14 years; boys 10-15 years) and anthropometric measurements in young adulthood (18-25 years). Fat-free mass index (FFMI) and fat mass index (FMI) were estimated from four skinfolds. RESULTS: In women, a higher pubertal animal protein consumption was independently related to higher levels of FFMI (ptrend = 0.001), but not to FMI (ptrend = 0.5). Adjusted means of FFMI in energy-adjusted tertiles of animal protein intake were 15.3 (95% confidence interval: 15.0, 15.5), 15.4 (15.1, 15.7), 16.2 (15.9, 16.6) kg/m(2) . In men, a higher animal protein intake was related to a higher FFMI (ptrend = 0.04) and a lower FMI (ptrend = 0.001) only after adjusting FFMI for current FMI levels and vice versa. Plant protein was not associated with body composition among either sex. CONCLUSIONS: Our results show that a higher pubertal animal protein consumption may yield a higher fat-free mass in young adulthood.

Urinary fructose: a potential biomarker for dietary fructose intake in children.

BACKGROUND/OBJECTIVES: Recently, urinary fructose and sucrose excretion in 24-h urine have been established experimentally as new biomarkers for dietary sugar intake in adults. Our objective was to investigate 1) whether the fructose biomarker is also applicable in free-living children and 2) for what kind of sugar it is standing for. SUBJECTS/METHODS: Intakes of added and total sugar (including additional sugar from fruit and fruit juices) were assessed by 3-day weighed dietary records in 114 healthy prepubertal children; corresponding 24-h urinary fructose excretion was measured photometrically. The associations between dietary sugar intakes and urinary fructose excretion were examined using linear regression models. To determine whether one of the two sugar variables may be better associated with the urinary biomarker, the statistical Pitman's test was used. RESULTS: Added and total sugar correlated significantly with urinary fructose, but the linear regression indicated a weak association between intake of added sugar and urinary log-fructose excretion (ß=0.0026, R(2)=0.055, P=0.01). The association between total sugar intake and log-urinary fructose (ß=0.0040, R(2)=0.181, P<0.001) showed a significantly better fit (P<0.05). CONCLUSIONS: Urinary fructose excretion seems to be rather applicable for the estimation of total sugar intake than for the estimation of added dietary sugar intake in children. However, as excreted fructose stems almost exclusively from the diet (both from food-intrinsic and added intakes), it can be assumed that urinary fructose represents a potential biomarker for total dietary fructose intake, irrespective of its source.