Evaluation of the association between the TAS1R2 and TAS1R3 variants and food intake and nutritional status in children

Abstract Taste perception plays a key role in determining individual food preferences and dietary habits and may influence nutritional status. This study aimed to investigate the association of TAS1R2 (Ile191Val - rs35874116) and TAS1R3 (-1266 C/T - rs35744813) variants with food intake and nutritional status in children followed from birth until 7.7 years old. The nutritional status and food intake data of 312 children were collected at three developmental stages (1, 3.9 and 7.7 years old). DNA was extracted from blood samples and the polymorphisms were analyzed by real-time polymerase chain reactions (qPCR) using hydrolysis probes as the detection method. Food intake and nutritional status were compared among individuals with different single nucleotide polymorphism (SNP) genotypes. At 3.9 years old, children homozygous (Val/Val) for the TAS1R2 Ile191Val polymorphism ingested less sugar and sugar-dense foods than children who were *Ile carriers. This finding demonstrated that a genetic variant of the T1R2 taste receptor is associated with the intake of different amounts of high sugar-content foods in childhood. This association may provide new perspectives for studying dietary patterns and nutritional status in childhood.

Factors associated with low consumption of fruits and vegetables by preschoolers of low socio-economic level, / Fatores associados ao baixo consumo de frutas e verduras entre pré-escolares de baixo nível socioeconômico,

Objective: To evaluate factors associated with low consumption of fruits and vegetables among preschoolers from families treated at basic health centers in Porto Alegre, RS, Brazil. Methods: This was a cohort study nested in a randomized field trial. Data collection was performed through structured questionnaires to obtain demographic and dietary data, combined with two 24-hour recalls in the age groups 12–16 months and again at 2–3 years of age. Data on the consumption of one daily serving of fruits (80 g) and vegetables (60 g) were evaluated, as well as consumption of non-recommended foods such as candy, chocolate, and soft drinks. Statistical analyses were performed using Poisson regression with robust estimation. Results: A total of 388 children aged 2-3 years were evaluated; of these, 58% and 87.4% did not consume one daily serving of fruits and vegetables, respectively. The following factors were negatively associated with fruit consumption: family income higher than four minimum wages, (p = 0.024), lower paternal educational level (p = 0.03), and lower fruit consumption at 12–16 months (p = 0.002). Factors negatively associated with the consumption of vegetables were low paternal educational level (p = 0.033) and consumption of high-sugar content beverages at 12–16 months (p = 0.014). Conclusion: This study demonstrated a high prevalence of children who consumed less than one daily serving of fruit and vegetables; early feeding practices, parental education, and family income were associated with this process. .

Objetivo: Avaliar os fatores associados ao baixo consumo de frutas e verduras entre pré-escolares de famílias usuárias da rede básica de saúde de Porto Alegre, RS, Brasil. Métodos: Estudo de coorte aninhado a ensaio de campo randomizado. A coleta de dados foi feita por meio de questionários estruturados para obtenção de dados dietéticos e sociodemográficos, além de dois recordatórios de 24 horas nas faixas etárias de 12–16 meses e novamente aos 2-3 anos de idade. Foram avaliados os dados de consumo de uma porção diária de frutas (80 g) e verduras (60 g), além de consumo de alimentos não recomendados, como balas, chocolates e refrigerantes. As análises estatísticas foram feitas por regressão de Poisson com estimativa robusta. Resultados: Foram avaliadas 388 crianças de 2-3 anos, destas 58% e 87,4% não consumiram uma porção de frutas e verduras, respectivamente. Os fatores que se mostraram negativamente associados ao consumo de frutas foram: renda familiar superior a 4 salários mínimos, (p = 0,024), menor escolaridade paterna (p = 0,03) e menor consumo de frutas aos 12–16 meses (p = 0,002). Os fatores negativamente associados à ingestão de verduras foram a menor escolaridade paterna (p = 0,033) e consumo de refrigerante aos 12–16 meses (p = 0.014). Conclusão: Os resultados deste estudo mostraram alta prevalência de crianças que consumiram menos de uma porção de frutas e verduras ao dia e sugerem que práticas alimentares precoces, escolaridade paterna e renda estão associadas a esse processo. .

Percepção e atitudes maternas em relação às orientações de profissionais de saúde referentes a práticas alimentares no primeiro ano de vida / Maternal perception and attitudes regarding healthcare professionals' guidelines on feeding practices in the child's first year of life

OBJETIVO: Avaliar a percepção e as atitudes maternas relacionadas à adesão às orientações de profissionais de saúde sobre aleitamento materno e alimentação complementar e fatores associados. MÉTODOS: Análise transversal de dados de ensaio de campo randomizado, em que foram sorteadas 20 Unidades de Saúde (US) de Porto Alegre-RS das oito gerências distritais de saúde do município. Gestantes atendidas nestas US foram selecionadas e, aos 6-9 meses de idade das crianças, foram obtidos, em visitas domiciliares, dados quanto à percepção materna de adesão às orientações dos profissionais e de consequências das práticas alimentares na saúde da criança. Análises de associação foram realizadas por meio de Regressão de Poisson. RESULTADOS: Foram obtidos dados de 631 binômios mãe-criança. Conforme a percepção das mães, 47% relataram não seguir orientações recebidas nas US. Dentre essas, 45,7% não reconhecem a importância da alimentação para a saúde da criança. A percepção de adesão às orientações dos profissionais foi associada com maiores prevalências de aleitamento materno exclusivo (AME), introdução de alimentos sólidos (IAS) após quatro meses e introdução de alimentos não recomendados após seis meses, além de maior renda familiar. Observaram-se maiores prevalências de AME e IAS após quatro meses (p < 0,05) entre as mães que acreditam na importância da alimentação para a saúde da criança. CONCLUSÃO: Houve elevada prevalência de mães que não seguem as orientações dos profissionais de saúde e a percepção de que a alimentação não influencia a saúde da criança pode ser uma barreira para melhorias nas práticas alimentares na infância.

OBJECTIVE: To evaluate the maternal perceptions and attitudes related to adherence to healthcare professionals' guidelines on breastfeeding and complementary feeding, and associated factors. METHODS:A cross-sectional analysis of data from a randomized field trial was performed, in which 20 health centers (HCs) were selected in the city of Porto Alegre, state of Rio Grande do Sul, from eight Health Management Districts of the city. Pregnant women were selected from these HCs, and when the children were aged between six and nine months, data regarding the maternal perception of adherence to professional advice and consequences of feeding practices on child health were obtained during home visits. Association analyses were performed using Poisson regression. RESULTS: Data were collected from 631 mother-child binomials. According to the mothers' perception, 47% reported not following instructions received in the HC. Among these, 45.7% did not recognize the importance of eating habits for the child's health. The perception of adherence to professional advice was associated with higher prevalence of exclusive breastfeeding (EBF), introduction of solid food (ISF) after four months, introduction of non-recommended foods after six months, and higher family income. A higher prevalence of EBF and ISF was observed after four months (p < 0.05) among mothers who believed in the importance of feeding habits for the child's health. CONCLUSION: There was a high prevalence of mothers who did not follow the advice of health professionals; the perception that food does not affect the child's health can be a barrier to the improvement of eating habits in childhood.

Erro alimentar nos primeiros meses de vida e sua associação com asma e atopia em pré-escolares / Nutritional errors in the first months of life and their association with asthma and atopy in preschool children

OBJETIVO: Avaliar o impacto de amamentação exclusiva e a introdução de leite de vaca no primeiro ano de vida no diagnóstico de asma, sibilância e atopia em crianças entre 3 e 4 anos de vida. MÉTODOS: Estudo de coorte aninhado a ensaio de campo randomizado que investigou a efetividade de orientações nutricionais no primeiro ano de vida de crianças, na cidade de São Leopoldo, RS. As crianças acompanhadas em relação a sua dieta no primeiro ano de vida, nesse estudo primário, foram revisitadas três anos mais tarde. Seus pais responderam, então, a um questionário relacionado a problemas respiratórios em seus domicílios, aplicado por entrevistadores treinados. As crianças também realizaram testes cutâneos para avaliar a resposta a alérgenos ambientais comuns. RESULTADOS: Do total de 397 crianças acompanhadas no primeiro ano de vida, 354 foram reavaliadas entre 3 e 4 anos de idade. A prevalência de sibilos, avaliada no período referente aos 12 meses prévios ao questionário, foi 21,3 por cento, a de asma, 5,5 por cento e a de atopia, 28,7 por cento. Crianças que consumiram leite de vaca antes de 4 meses de vida tinham chance significativamente maior de apresentar asma entre 3 e 4 anos (OR 3,22; IC95 por cento: 1,05-9,80). Aleitamento exclusivo por período menor de 6 meses foi marginalmente associado à atopia. CONCLUSÕES: A introdução precoce do leite de vaca mostrou-se importante fator de risco para o desencadeamento de sintomas da asma aos 4 anos de idade. Aleitamento materno por período superior a 6 meses está também potencialmente associado à proteção no desenvolvimento de atopia. Os resultados deste estudo sugerem haver um potencial de intervenção para diminuir o impacto da asma através de intervenções na dieta no primeiro ano de vida.

OBJECTIVE: To evaluate the impact of exclusive breastfeeding and introduction of cow's milk in the first year of life on the diagnosis of asthma, wheezing, and atopy in children aged 3 to 4 years. METHODS: This is a cohort study nested in a randomized field trial investigating the effectiveness of dietary guidelines during the first year of life of children in the city of São Leopoldo, southern Brazil. Children who had their diet monitored during the first year of life, in a primary study, were revisited three years later, when their parents answered a questionnaire related to respiratory problems, applied during home visits by trained interviewers. Children were also skin-prick tested to assess responses to common environmental allergens. RESULTS: Of the 397 children followed during the first year of life, 354 were reassessed between 3 and 4 years of age. Prevalence of wheezing, evaluated for the 12 months prior to questionnaires, was 21.3 percent, while prevalence of asthma and atopy was 5.5 and 28.7 percent, respectively. Children fed cow's milk previous to being four months of life were significantly more likely to have asthma between three and four years of age (OR 3.22; 95 percentCI 1.05-9.80). In the same line, exclusive breastfeeding for a period shorter than six months was marginally associated with atopy. CONCLUSIONS: The early introduction of cow's milk was an important risk factor for triggering asthma/wheeze symptoms at the age of 4 years. Exclusive breastfeeding for longer than six months was also potentially associated with protection against the development of atopy. The results of this study suggest that dietary interventions during the first year of life have the potential to reduce the impact of asthma, and possibly, atopy.

Qualidade nutricional e gastos com a alimentação de pré-escolares / Nutritional quality and food expenditure in preschool children

OBJETIVO: Avaliar a correlação dos gastos com a alimentação e a qualidade dietética de pré-escolares de baixa condição socioeconômica, considerando a ingestão de micronutrientes e alimentos de alta densidade de açúcar e gordura. MÉTODOS: Estudo transversal realizado com 346 crianças de 3 a 4 anos de idade que participaram do estudo "Dez passos em ação I" (BRATSA I), uma coorte aninhada a um ensaio de campo randomizado. Foram realizados dois inquéritos recordatórios de 24 horas. Calculou-se o gasto com a alimentação utilizando o preço dos alimentos coletado em diferentes estabelecimentos e ajustado para as quantidades ingeridas. RESULTADOS: A média de gasto com a alimentação das crianças estimada para um mês foi de R$ 100,17±34,1. A ingestão de ferro (r = 0,115; p = 0,033), zinco (r = 0,214; p < 0,001) e vitaminas A (r = 0,197; p < 0,001) e C (r = 0,162; p < 0,001), ajustada para 1.000 kcal, mostrou correlação positiva com os gastos com alimentação/1.000 kcal. Não houve diferença significativa nos gastos com alimentação/1.000 kcal em relação ao risco para excesso de peso (p = 0,208) e ao consumo de alimentos de alta concentração de açúcar e gordura (p = 0,894 e p = 0,964). CONCLUSÕES: O estudo mostrou que o consumo de energia fornecido por alimentos ricos em açúcar e gordura não está associado com os gastos com a alimentação de crianças de 3 a 4 anos; por outro lado, a qualidade nutricional, avaliada pela ingestão de micronutrientes essenciais, mostrou correlação positiva com os gastos com a alimentação.

OBJECTIVE: To assess correlations between the cost and the nutritional quality of the diets of preschool children from low socioeconomic status families, taking into account intakes of micronutrients and foods with high concentrations of sugars and fats. METHODS: This was a cross-sectional study undertaken with 346 children aged 3 to 4 years recruited for the "Ten steps in action" (BRATSA I) study, who comprise a nested cohort from the randomized field study. Two 24-hour dietary recall surveys were conducted. Expenditure on food was calculated by taking the price of each food, as verified at a number of different establishments, and adjusting it for the quantity eaten. RESULTS: Mean expenditure on food for one child was R$ 100.17±34.1 per month. There was a positive correlation between intakes of iron (r = 0.115; p = 0.033), zinc (r = 0.214; p < 0.001), and vitamins A (r = 0.197; p < 0.001) and C (r = 0.162; p < 0.001), adjusted to 1,000 kcal, and expenditure on food/1,000 kcal. There were no significant relationships between expenditure on food/1,000 kcal and risk of overweight (p = 0.208) or intake of foods with a high fat or sugar content (p = 0.894 and p = 0.964). CONCLUSIONS: The study found that consumption of energy provided by fat and sugar-rich foods was not associated with expenditure on feeding these 3-to-4-year-olds. In contrast, nutritional quality, assessed in the form of essential micronutrient intakes, demonstrated a positive correlation with food costs.

Alguns fatores associados a excesso de peso, baixa estatura e déficit de peso em menores de 5 anos / Some risk factors associated with overweight, stunting and wasting among children under 5 years old

OBJETIVO: Examinar fatores socioeconômicos e outras condições de vida familiar associadas a excesso de peso, baixa estatura e baixo peso para a estatura em menores de 5 anos. MÉTODOS: Estudo transversal avaliou 3.957 crianças entre 1 mês e 5 anos de idade durante campanha nacional de imunização no município de São Leopoldo (RS) em 2002. As condições socioeconômicas e de saneamento das áreas de abrangência das unidades de saúde foram agrupadas por análise de cluster dos setores do censo populacional de 2001. RESULTADOS: Déficit de peso para estatura ocorreu em 2,6 por cento das crianças, baixa estatura em 9,1 por cento e excesso de peso em 9,8 por cento. A regressão logística multivariada sugere que os fatores associados à chance de excesso de peso foram: área de condições socioeconômicas alta (RC = 1,47; IC95 por cento 1,09-1,96), filhos únicos (RC = 1,44; IC95 por cento 1,00-2,07) e peso ao nascer ≥ 2.500 g (RC = 2,21; IC95 por cento1,27-3,83). A chance de déficit de peso associou-se ao baixo peso ao nascer (RC = 3,46; IC95 por cento 2,06-5,80) e idade da mãe < 20 anos (RC = 1,99; IC95 por cento 1,09-3,62). A baixa estatura associou-se à área de condições socioeconômicas baixas (RC = 2,36; IC95 por cento 1,51-3,69), três ou mais irmãos (RC = 3,12; IC95 por cento 2,18-4,47), peso ao nascer < 2.500 g (RC = 3,49; IC95 por cento 2,53-4,80), idade < 36 meses (RC = 1,77; IC95 por cento 1,37-2,29) e idade materna < 20 anos (RC = 1,60; IC95 por cento1,09-2,35). CONCLUSÕES: Excesso de peso e baixa estatura foram os principais desvios antropométricos observados neste estudo, constituindo prioridades que devem ser consideradas nas políticas públicas atuais.

OBJECTIVE: To explore whether socioeconomic and sanitary conditions, maternal and child factors are associated with overweight, stunting, and wasting in children under five year old in the city of São Leopoldo, southern Brazil. METHODS: Cross-sectional study of 3,957 children aged 1 month to 5 years conducted in all primary care services of the city during the National Children's Vaccination Day in 2002. Maternal and child factors were assessed by a questionnaire. Children's height and weight were measured. Cluster analysis was used to group the areas served by the primary care services according to socioeconomic and sanitary conditions of the census tracts assessed by the 2001 National Census. RESULTS: Wasting was observed in 2.6 percent of children, stunting in 9.1 percent and overweight in 9.8 percent. The multivariable logistic regression model suggests that overweight was associated with higher socioeconomic status and better sanitation of the area (OR = 1.47; 95 percentCI 1.09-1.96), single child (OR = 1.44; 95 percentCI 1.00-2.07) and birth weight ≥ 2,500 g (OR = 2.21; 95 percentCI 1.27-3.83). Wasting was associated with low birth weight (OR = 3.46; 95 percentCI 2.06-5.80) and mother's age < 20 years (OR = 1.99; 95 percentCI 1.09-3.62). Stunting was associated with low socioeconomic status and poor sanitation of the area (OR = 2.36; 95 percentCI 1.51-3.69), three or more siblings (OR = 3.12; 95 percentCI 2.18-4.47), low birth weight < 2,500 g (OR = 3.49; 95 percentCI 2.53-4.80), child age < 36 months (OR = 1.77; 95 percentCI 1.37-2.29) and mother's age < 20 years (OR = 1.60; 95 percentCI 1.09-2.35). CONCLUSIONS: Overweight and stunting were the major anthropometric problems and therefore should be a priority for public policies.

Fatores associados ao risco de consumo insuficiente de fibra alimentar entre adolescentes / Factors associated with risk of low dietary fiber intake in adolescents

OBJETIVO: Avaliar o consumo de fibra alimentar entre adolescentes e analisar os fatores associados ao risco de consumo insuficiente desse nutriente. MÉTODOS: Estudo transversal com 722 adolescentes da cidade de São Leopoldo. O processo amostral deu-se por conglomerados por meio de sorteio sistemático de 40 setores censitários e domicílios, incluindo todos os indivíduos entre 10 e 19 anos. Foram obtidos peso e estatura dos adolescentes e dados sociodemográficos da família. Os métodos utilizados para avaliar o consumo alimentar foram o inquérito recordatório de 24 horas e o inquérito de freqüência. Para o cálculo da quantidade de fibra alimentar da dieta, foi utilizado o Programa de Apoio à Nutrição (Nutwin) do Departamento de Informática da Universidade Federal de São Paulo (UNIFESP). A análise estatística foi realizada por meio de regressão logística, utilizando modelo hierárquico. RESULTADOS: A prevalência de consumo insuficiente de fibras foi de 69 por cento nas meninas e 49,7 por cento nos meninos (p < 0,001). Entre os meninos, os fatores que determinaram essa condição foram: consumo não habitual de feijão (OR 2,65; IC95 por cento 1,05-6,68) e excessivo de lipídeo (OR 2,67; IC95 por cento 11,23-5,83). Para as meninas, maior faixa etária (OR 5,33; IC95 por cento 2,33-12,2), consumo não habitual de feijão (OR 3,01; IC95 por cento 1,44-6,53), consumo excessivo de lipídeo (OR 1,85; IC95 por cento 1,01-3,37), fazer dieta para perder peso (OR 2,50; IC95 por cento 1,10-5,70) e presença de excesso de peso (OR 2,06; IC95 por cento 1,04-4,07). CONCLUSÕES: Os resultados permitem concluir que a ingestão excessiva de gordura e o consumo não habitual de feijão estão fortemente associados ao risco de consumo insuficiente de fibra alimentar em ambos os sexos e que o sexo feminino apresenta mais fatores de risco para esse desfecho.

OBJECTIVE: To evaluate dietary fiber intake among adolescents and to analyze factors associated with the risk of insufficient consumption of this nutrient. METHODS: Cross-sectional study of 722 adolescents from the town of São Leopoldo, RS, Brazil. Sampling was by clusters, with a systematic randomization of 40 census sectors and residences, including all individuals aged 10 to 19 years. The adolescents' weight and height were measured and sociodemographic data on their families recorded. A 24-hour dietary recall and a frequency survey were used to assess dietary intakes. The quantity of dietary fiber in diets was calculated using Nutwin nutrition support software (Programa de Apoio à Nutrição), developed by the IT Department at Universidade Federal de São Paulo (UNIFESP). Statistical analysis was by means of logistic regression, employing a hierarchical model. RESULTS: The prevalence of insufficient dietary fiber intake was 69 percent among girls and 49.7 percent for boys (p < 0.001). The determinant factors of this condition among boys were non-habitual consumption of beans (OR 2.65; 95 percentCI 1.05-6.68) and excessive fat intake (OR 2.67; 95 percentCI 11.23-5.83). For girls factors were increased age (OR 5.33; 95 percentCI 2.33-12.2), non-habitual consumption of beans (OR 3.01; 95 percentCI 1.44-6.53), excessive fat intake (OR 1.85; 95 percentCI 1.01-3.37), dieting for weight loss (OR 2.50; 95 percentCI 1.10-5.70) and presence of overweight (OR 2.06; 95 percentCI 1.04-4.07). CONCLUSIONS: These results admit of the conclusion that excessive fat consumption and non-habitual consumption of beans are strongly linked with the risk of insufficient dietary fiber intake in both sexes and that females exhibit a greater number of risk factors for this outcome.

Factors associated with risk of low folate intake among adolescents

OBJECTIVE: To evaluate factors associated with the risk of low folate intake among adolescents.METHODS: We employed cluster sampling, using a random selection of 40 representative census sectors and households within those sectors, including all individuals between 10 and 19 years of age. The weight, height and skin folds of subjects were measured and socioeconomic data on their families were collected. A 24-hour dietary recall and frequency questionnaire were used to estimate the quantity and frequency of folate intake. Folate consumption was quantified using Nutwin software. Risk of low folate intake was defined as Folate consumption below the estimated average requirement. The statistical analysis employed hierarchical logistic regression. RESULTS: A total of 722 adolescents were investigated and their mean folate intake was 145±117 µg. The frequency of subjects at risk of having a lower than recommended folate intake was 89%. Adolescents had a greater risk of inadequate folate intake if their body mass index was at or above the 85th percentile, their waist circumference was at or above the 80th percentile or they had a family history of cardiovascular disease. Adolescents who ate beans and dark green vegetables less than four times a week also exhibited an increased chance of having folate intake below recommended levels.CONCLUSIONS: These adolescents present a high risk of low folate intake and this risk is linked with increasing age, waist circumference above the 80th percentile and low frequency of beans and dark green vegetables consumption.

The influence of sardine consumption on the omega-3 fatty acid content of mature human milk

OBJECTIVES: The purpose of this study was to investigate what effect the intake of sardines, rich in omega-3 series polyunsaturated fatty acids, has on the composition of breastmilk. METHODS: This was a prospective study of 31 nursing mothers under observation at the Hospital Guilherme Alvaro. Each was given 2 kg of fresh sardines twice with a 15-day interval. Milk was sampled and a 24-hour dietary recall questionnaire was applied on days 0, 15 and 30. Milk was assayed for fatty acid content by gas chromatography. Statistical analysis of the results was performed using nonparametric tests with significance set at p < 0.05. RESULTS: The results demonstrate that the nutritional intake of the nursing mothers was adequate at all three sample points. With regard to the omega-3 series fatty acid content of the breastmilk, it was observed that regular consumption and shorter intervals between intake and milk collection resulted in higher concentrations of docosapentaenoic acid and docosahexaenoic acid at 15 and 30 days into the study. Fatty acids from the omega-3 and omega-6 series exhibited a significant correlation, r2 was 0.58 and 0.59 at 15 and 30 days, respectively. CONCLUSION: These results suggest that incorporating fish into the diets of nursing mother during lactation, in the form of 100 g of sardines two or three times a week, contributes to an increase in omega-3 series fatty acids.