Diet quality in childhood: the Generation R Study

Velde, Laura A van der; Nguyen, Anh Minh; Schoufour, Josje D.; Geelen, Anouk; Jaddoe, Vincent W. V.; Franco, Oscar H.; Voortman, Trudy

doi:10.1007/s00394-018-1651-z

Cited by 54 publications

(75 citation statements)

References 36 publications

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“…Moreover, the intervention group differed significantly from the control group on ethnicity, parental educational level and parental age. Other studies have shown that demographics, such as educational level and ethnicity, are associated with our outcome measures [ 8 , 9 , 75 – 77 ], and thus might have influenced our results. Another limitation of this design was the difference between the intervention and control group in children’s MVPA and the percentage children consuming fruit and vegetables at school at baseline.…”

Section: Discussionmentioning

confidence: 98%

Effects of the KEIGAAF intervention on the BMI z-score and energy balance-related behaviors of primary school-aged children

Verjans-Janssen

Gerards

Kremers

et al. 2020

Int J Behav Nutr Phys Act

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The aim of the current study was to evaluate the one-and two-year effectiveness of the KEIGAAF intervention, a school-based mutual adaptation intervention, on the BMI z-score (primary outcome), and energy balance-related behaviors (secondary outcomes) of children aged 7-10 years. A quasi-experimental study was conducted including eight intervention schools and three control schools located in low socioeconomic neighborhoods in the Netherlands. Baseline measurements were conducted in March and April 2017 and repeated after one and 2 years. Data were collected on children's BMI z-score, sedentary behavior (SB), physical activity (PA) behavior, and nutrition behavior through the use of anthropometric measurements, accelerometers, and questionnaires, respectively. All data were supplemented with demographics, and weather conditions data was added to the PA data. Based on the comprehensiveness of implemented physical activities, intervention schools were divided into schools having a comprehensive PA approach and schools having a less comprehensive approach. Intervention effects on continuous outcomes were analyzed using multiple linear mixed models and on binary outcome measures using generalized estimating equations. Intervention and control schools were compared, as well as comprehensive PA schools, less comprehensive PA schools, and control schools. Effect sizes (Cohen's d) were calculated. In total, 523 children participated. Children were on average 8.5 years old and 54% were girls. After 2 years, intervention children's BMI z-score decreased (B =-0.05, 95% CI-0.11;0.01) significantly compared to the control group (B = 0.20, 95% CI 0.09;0.31). Additionally, the intervention prevented an age-related decline in moderate-tovigorous PA (MVPA) (%MVPA: B = 0.95, 95% CI 0.13;1.76). Negative intervention effects were seen on sugarsweetened beverages and water consumption at school, due to larger favorable changes in the control group compared to the intervention group. After 2 years, the comprehensive PA schools showed more favorable effects on BMI z-score, SB, and MVPA compared to the other two conditions. This study shows that the KEIGAAF intervention is effective in improving children's MVPA during school days and BMI z-score, especially in vulnerable children. Additionally, we advocate the implementation of a comprehensive approach to promote a healthy weight status, to stimulate children's PA levels, and to prevent children from

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Section: Discussionmentioning

confidence: 98%

Effects of the KEIGAAF intervention on the BMI z-score and energy balance-related behaviors of primary school-aged children

Verjans-Janssen

Gerards

Kremers

et al. 2020

Int J Behav Nutr Phys Act

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“…Information on child's sport participation (yes; no) and screen time, defined as time spend watching television or computer use (<2; ≥2 h/day), was obtained using a questionnaire at the age of 6 years. Dietary intake of children was assessed at the age of 8 years and we calculated their diet quality score, reflecting adherence to age-specific dietary guidelines [16].…”

Section: Covariatesmentioning

confidence: 99%

Carbohydrate Intake in Early Childhood and Body Composition and Metabolic Health: Results from the Generation R Study

et al. 2020

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High sugar intake in childhood has been linked to obesity. However, the role of macronutrient substitutions and associations with metabolic health remain unclear. We examined associations of carbohydrate intake and its subtypes with body composition and metabolic health among 3573 children participating in a population-based cohort in the Netherlands. Intake of total carbohydrate, monosaccharides and disaccharides, and polysaccharides at age 1 year was assessed with a food-frequency questionnaire. We repeatedly measured children’s height and weight to calculate BMI between their ages of 1 and 10 years. At ages 6 and 10 years, fat and fat-free mass were measured with dual-energy X-ray-absorptiometry and blood concentrations of triglycerides, cholesterol, and insulin were obtained. For all outcomes, we calculated age and sexspecific SD-scores. In multivariable-adjusted linear mixed models, we found no associations of intake of carbohydrates or its subtypes with children’s BMI or body composition. A higher intake of monosaccharides and disaccharides was associated with higher triglyceride concentrations (0.02 SDS per 10 g/day, 95% CI: 0.01, 0.04). Higher monosaccharide and disaccharide intake was also associated with lower HDL-cholesterol (−0.03 SDS, 95% CI: −0.04; −0.01), especially when it replaced polysaccharides. Overall, our findings suggest associations of higher monosaccharide and disaccharide intake in early childhood with higher triglyceride and lower HDL-cholesterol concentrations, but do not support associations with body composition.

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“…The methodology to obtain this diet score has been published previously. 20 Screen time and sports participation were assessed by parent-reported questionnaire when the child was 9 years old. Screen time included television viewing, video/DVD use, and computer game use.…”

Section: Diet Screen Time and Sports Participationmentioning

confidence: 99%

Estimating Reductions in Ethnic Inequalities in Child Adiposity from Hypothetical Diet, Screen Time, and Sports Participation Interventions

et al. 2020

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Background: Childhood obesity is a global epidemic, and its prevalence differs by ethnicity. The objective of this study was to estimate the change in ethnic inequalities in child adiposity at age 10 resulting from interventions on diet at age 8 and screen time and sports participation at age 9. Methods: We conducted a population-based cohort study, the Generation R Study, from 9,749 births in Rotterdam (2002-2006), of which 9,506 children remained in the analysis. We measured ethnicity, diet, screen time, and sports participation through questionnaires; we measured weight, body mass index (BMI), fat mass index, and fatfree mass index directly. We used sequential G-estimation to estimate the reduction in inequality that would result from the interventions. Results: We observed that sociodemographic characteristics, diet, screen time, sports participation, and all adiposity measurements were more favorable in children from Western versus non-Western ethnic backgrounds: weight = −1.2 kg (95% confidence interval [CI] = −1.7, −0.8), BMI = −1.0 kg/m 2 (CI = −1.2, −0.9), and fat mass index = −0.8 kg/m 2 (CI = −0.9, −0.7). We estimated that extreme intervention (maximum diet score of 10, no screen time, and >4 hours/ week of sports) reduced ethnic inequalities by 21% (CI = 8%, 35%) for weight, 9% (CI = 4%, 14%) for BMI, and 9% (CI = 6%, 13%) for fat mass index. A diet score ≥5 points, screen time ≤2 hours/day, and sports participation >2 hours/week reduced ethnic inequalities by 17% (CI = 6%, 28%) for weight, 7% (CI = 3%, 11%) for BMI, and 7% (CI = 4%, 10%) for fat mass index. Conclusions: Our results are consistent with the hypothesis that interventions integrating diet, screen time, and sports participation have a moderate impact on reducing ethnic inequalities in child adiposity.

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Diet quality in childhood: the Generation R Study

Abstract: Overall diet quality of 8-year-old children did not conform to dietary guidelines, especially for children having more screen time, children of lower educated or smoking mothers, or from lower-income households.

Cited by 54 publications

References 36 publications

Effects of the KEIGAAF intervention on the BMI z-score and energy balance-related behaviors of primary school-aged children

Effects of the KEIGAAF intervention on the BMI z-score and energy balance-related behaviors of primary school-aged children

Carbohydrate Intake in Early Childhood and Body Composition and Metabolic Health: Results from the Generation R Study

Estimating Reductions in Ethnic Inequalities in Child Adiposity from Hypothetical Diet, Screen Time, and Sports Participation Interventions

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