Validity of a food-frequency questionnaire for estimating calcium intake in adolescent swimmers

Introduction: accurate estimates of the intake of specific nutrients such as calcium (Ca) are crucial to correctly rank or classify subjects in the distribution of intakes. Therefore, we aimed to estimate the relative validity of a food frequency questionnaire (FFQ) for measuring Ca intake in two different groups of healthy adolescents, a normoactive control group and a physically active group of swimmers with 2 non-consecutive 24h recalls (2 x 24HR) collected as the reference method. Methods: Pearson correlations, agreement between the 24HR and the FFQ at an individual level and questionnaire’s ability to assign individuals to the same quartile of intake as the 24HR were calculated. Results: mean daily Ca intakes were 564.6 mg (SD 232.0) and 895.9 mg (SD 343.1) for the 2 x 24HR and FFQ respectively in controls (P < 0.001); and 731.9 mg (SD 299.8) and 979.8 mg (SD 408.5) for the 2 x 24HR and FFQ respectively in swimmers (P < 0.001). Pearson correlations were 0.52 for controls and 0.47 for swimmers after correcting for intra-variability. Cross-classification analysis indicated that 73.7% of controls and 63.1% of swimmers were classified correctly or in the adjacent category. Also, the 89% of the control group and 79% of swimmers were classified correctly with the FFQ according to the dietary reference intake (DRI) of 1300 mg/d. Conclusions: for both groups, the FFQ tended to overestimate Ca intake, however it demonstrated fairly good ability to classify subjects into extremes of Ca intake and identified adolescents having Ca intakes lower than the dietary reference intake

Association of heart rate and blood pressure among European adolescents with usual food consumption: the HELENA study

Background and aim: In adults, there is some evidence that improving diet reduces blood pressure (BP) and the subsequent risk of cardiovascular diseases (CVDs). However, studies that analyse this association in adolescents are still scarce. The objective of the present study was to examine the associations between heart rate, systolic (SBP), diastolic (DBP) and mean arterial blood pressure (MAP) among European adolescents and usual intake of vegetables, fruits, dairy products, meat, fish, high-sugar foods and savoury snacks. Methods and results: In total, 2283 adolescents from the HELENA-study (12.5-17.5 years old; 1253 girls) were included. Dietary intake was assessed using two computerized 24-hour dietary recalls. Age, sex, body mass index, maternal educational level, physical activity and Tanner stage were considered as confounders. Associations were examined by mixed model analysis stratified by sex. Tests for trend were assessed by tertiles of intake while controlling for the aforementioned confounders. Dairy products and fish intake were negatively associated with BP and heart rate. Significant decreasing trends were observed for heart rate and BP across tertiles of dairy products, fish intake and high-sugar foods intake (p < 0.05). Significant increasing trends were observed for SBP and MAP across tertiles of savoury snack intake (p < 0.05). Conclusion: Significant but small inverse associations between fish and dairy products consumption with blood pressure and heart rate have been found in European adolescents. Dietary intervention studies are needed to explore these associations in the context of the modification of several risk factors for the prevention of cardiovascular diseases

Ideal cardiovascular health and inflammation in European adolescents: The HELENA study

Background and aims Inflammation plays a key role in atherosclerosis and this process seems to appear in childhood. The ideal cardiovascular health index (ICHI) has been inversely related to atherosclerotic plaque in adults. However, evidence regarding inflammation and ICHI in adolescents is scarce. The aim is to assess the association between ICHI and inflammation in European adolescents. Methods and results As many as 543 adolescents (251 boys and 292 girls) from the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study, a cross-sectional multi-center study including 9 European countries, were measured. C-reactive protein (CRP), complement factors C3 and C4, leptin and white blood cell counts were used to compute an inflammatory score. Multilevel linear models and multilevel logistic regression were used to assess the association between ICHI and inflammation controlling by covariates. Higher ICHI was associated with a lower inflammatory score, as well as with several individual components, both in boys and girls (p < 0.01). In addition, adolescents with at least 4 ideal components of the ICHI had significantly lower inflammatory score and lower levels of the study biomarkers, except CRP. Finally, the multilevel logistic regression showed that for every unit increase in the ICHI, the probability of having an inflammatory profile decreased by 28.1% in girls. Conclusion Results from this study suggest that a better ICHI is associated with a lower inflammatory profile already in adolescence. Improving these health behaviors, and health factors included in the ICHI, could play an important role in CVD prevention

Combined effects of interaction between physical activity and nutrition on bone health in children and adolescents: a systematic review

Context: Osteoporosis is a major public health concern worldwide. Understanding the roles of diet and physical activity in ensuring adequate bone mass accrual during childhood and adolescence may help identify strategies to reduce the risk of osteoporotic fractures later in life. Objective: The present systematic review was conducted to provide an overview of the current knowledge of the combined effects of physical activity and diet on bone mass accrual in children and adolescents. Data Sources: Data were obtained via searches of the PubMed, EMBASE, SPORTDiscus, and ISI Web of Science databases. Study Selection: Studies published in English and Spanish between 1887 and August 2013 were eligible for inclusion. Two investigators evaluated the studies against the inclusion and exclusion criteria. A total of 14 studies (7 cross-sectional and 7 experimental) were included in the review. Data Extraction: The Pedro score and the Black and Down's checklist were used to evaluate the methodological quality of the experimental and the cross-sectional studies, respectively. Study characteristics were summarized in accordance with the review's PICO criteria. Data Synthesis: Significant exercise-by-calcium interaction was detected at several different bone sites. Conclusions: Although the results of cross-sectional studies were inconsistent, the results of randomized controlled trials showed that exercise has the potential to improve bone health under conditions of adequate calcium intake

Combined effects of interaction between physical activity and nutrition on bone health in children and adolescents: a systematic review

Context: Osteoporosis is a major public health concern worldwide. Understanding the roles of diet and physical activity in ensuring adequate bone mass accrual during childhood and adolescence may help identify strategies to reduce the risk of osteoporotic fractures later in life. Objective: The present systematic review was conducted to provide an overview of the current knowledge of the combined effects of physical activity and diet on bone mass accrual in children and adolescents. Data Sources: Data were obtained via searches of the PubMed, EMBASE, SPORTDiscus, and ISI Web of Science databases. Study Selection: Studies published in English and Spanish between 1887 and August 2013 were eligible for inclusion. Two investigators evaluated the studies against the inclusion and exclusion criteria. A total of 14 studies (7 cross-sectional and 7 experimental) were included in the review. Data Extraction: The Pedro score and the Black and Down's checklist were used to evaluate the methodological quality of the experimental and the cross-sectional studies, respectively. Study characteristics were summarized in accordance with the review's PICO criteria. Data Synthesis: Significant exercise-by-calcium interaction was detected at several different bone sites. Conclusions: Although the results of cross-sectional studies were inconsistent, the results of randomized controlled trials showed that exercise has the potential to improve bone health under conditions of adequate calcium intake

The nutritional status in adolescent Spanish cyclists

Introduction: Adolescence is an important period of nutritional vulnerability due to the increased dietary requirements. Objective: To describe the nutritional status of adolescent cyclist and a group of normoactive controls. Methods: The HELENA Dietary Assessment Tool was used to evaluate the nutritional intake of 20 adolescent cyclists and 17 controls. Total energy intake, resting energy expenditure (REE), total energy expenditure (TEE), macronutrients and several micronutrients were registered and compared with dietary guidelines. Results: REE was lower and TEE higher in cyclists than in controls (both P < 0.01). Significant differences were observed in phosphorus and vitamin B1 being higher in cyclists (P < 0.05). Most participants, both cyclist and controls, did not reach the diet requirements for macronutrients, vitamins and minerals. Conclusion: Nutritional status of adolescent cyclists and controls seems not to fulfil the requirements in quantity and quality. Possible implications for actual and future health especially in athlete adolescents need further research

Do calcium and vitamin D intake influence the effect of cycling on bone mass through adolescence?

Introduction: Cycling has been associated with decreased bone mass during adolescence. Calcium (Ca) and vitamin D (VitD) intake are associated to bone mass and may be important confounders when studying bone mass. Aim: To clarify the effect that Ca and VitD may have on bone mass in adolescent cyclists. Methods: Bone mineral content (BMC) and density (BMD) of 39 male adolescents (20 cyclists) were measured. Ca and VitD intake were also registered. Different ANCOVA analyses were performed in order to evaluate the influence of Ca and VitD on BMC and BMD. Results: Cyclists showed lower values of BMC and BMD than controls at several sites and when adjusting by Ca, Wards triangle BMD appeared also to be lower in cyclists than controls. Conclusion: Nutritional aspects might partially explain differences regarding bone mass in adolescent cyclists and should be taken into account in bone mass analysis as important confounders

Comparison of anthropometric measurements of adiposity in relation to cancer risk: a systematic review of prospective studies

Purpose: In epidemiology, the relationship between increased adiposity and cancer risk has long been recognized. However, whether the association is the same for measures of abdominal or whole body adiposity is unclear. The aim of this systematic review is to compare cancer risk, associated with body mass index (BMI), an indicator of whole body adiposity, with indicators of abdominal adiposity in studies in which these indicators have been directly measured. Methods: We conducted a systematic search from 1974 (EMBASE) and 1988 (PubMed) to September 2015 with keywords related to adiposity and cancer. Included studies were limited to cohort studies reporting directly measured anthropometry and performing mutually adjusted analyses. Results: Thirteen articles were identified, with two reporting on breast cancer, three on colorectal cancer, three on endometrial cancer, two on gastro-oesophageal cancer, two on renal cancer, one on ovarian cancer, one on bladder cancer, one on liver and biliary tract cancer and one on leukaemia. Evidence suggests that abdominal adiposity is a stronger predictor than whole body adiposity for gastro-oesophageal, leukaemia and liver and biliary tract cancer in men and women and for renal cancer in women. Abdominal adiposity was a stronger predictor for bladder and colorectal cancer in women, while only BMI was a predictor in men. In contrast, BMI appears to be a stronger predictor for ovarian cancer. For breast and endometrial cancer, both measures were predictors for cancer risk in postmenopausal women. Conclusions: Only few studies used mutually adjusted and measured anthropometric indicators when studying adiposity-cancer associations. Further research investigating cancer risk and adiposity should include more accurate non-invasive indicators of body fat deposition and focus on the understudied cancer types, namely leukaemia, ovarian, bladder and liver and biliary tract cancer