Mediating effect of milk intake between family socioeconomic status and body mass index of children and adolescents / 北京大学学报(医学版)

OBJECTIVE@#To examine the association between family socioeconomic status (SES) and body mass index (BMI) z-score of children and adolescents, and the mediating effect of milk intake in this association.@*METHODS@#In the study, 2 496 students and their parents were selected from 16 schools (4 urban middle schools, 4 rural middle schools, 4 urban primary schools, and 4 rural primary schools) using a stratified cluster sampling method. The frequency and amount of weekly milk intake from the 7-day Food Records reported by the students were extracted. The parents' education and household income were the indicators of family SES. The mediating effect of milk intake between family SES and BMI z-score of children and adolescents were tested using the PROCESS add-on SPSS software.@*RESULTS@#Parents' education level and household income were positively correlated with BMI z-score of children and adolescents (P=0.001 and 0.038, respectively). The overall average daily intake of milk was (0.92±0.84) servings, and the frequency was (4.43±2.70) days per week. The students of primary school, in urban areas, with higher parents' education level, with higher household income, and being non-obese were likely to have higher frequency and amount of milk intake. Milk intake was one of the mediating factors in the relationship between family SES and BMI z-score of children and adolescents. Specifically, the mediating effect of the frequency of milk intake accounted for -6.57% and -10.21% of the total effects of the association between the parents' education and the household income with BMI z-score of children and adolescents, respectively. The mediating effect of the daily intake of milk accounted for -3.63% and -5.86% of the total effects of the association between the parents' education and the household income with BMI z-score of children and adolescents, respectively.@*CONCLUSION@#The milk intake of Chinese children and adolescents still needs to be improved. High family SES was found to contribute to high BMI z-score, mediated by the milk intake which was the protective factors of BMI z-score. Further research is needed to study other dietary or physical exercise behaviors that mediate the relationship between family SES and BMI z-score of children and adolescents in order to adopt more targeted interventions.

Associations between milk intake at breakfast and nutritional status of students attending the Nutrition Improvement Program for Rural Compulsory Education Students in 2016 / 中华流行病学杂志

Objective To investigate the association between milk intake at breakfast and nutritional status of students attending the Nutrition Improvement Program for Rural Compulsory Education Students (NIPRCES) in 2016,and to provide basic data for improving the nutritional status of the poor rural pupils.Methods Using the multi-stage stratified random cluster sampling method,22 315 students from grade three to nine from primary and junior high schools were randomly selected from the 50 key counties under the monitor programs,in 22 provinces of NNIPRCS.Questionnaire was used.Among all the students,with equal number of genders,morning fasting height and weight were measured by trained investigators.Status of nutrition was classified as malnutrition,normal,overweight/obesity,by age-specific height and BMI.Multivariate linear and logistic regression methods were used to analyze the relationship between milk consumption and the status of nutrition of the students.Results Only 31.4％ of the students that were on the monitoring programs would drink milk at breakfast.Proportions of milk intake at breakfast were higher in students from the western regions,in lower grades and in girls (P＜0.05).The proportions of malnutrition and overweight/obesity were 11.0％ and 10.0％ respectively.After controlling factors as gender,age,ethnicity,region of residency and types of parental employment,students who drank milk at breakfast showed an average height of 0.4 cm taller than those who did not drink milk (P=0.001).However,no significant relationships were noticed between milk intake at breakfast and weight,malnutrition or overweight/obesity.Conclusion Milk intake at breakfast seemed associated with the height of the students under study,suggesting that this program can be promoted,especially in students from the poor rural areas.

Associations between milk intake at breakfast and nutritional status of students attending the Nutrition Improvement Program for Rural Compulsory Education Students in 2016 / 中华流行病学杂志

Objective To investigate the association between milk intake at breakfast and nutritional status of students attending the Nutrition Improvement Program for Rural Compulsory Education Students (NIPRCES) in 2016,and to provide basic data for improving the nutritional status of the poor rural pupils.Methods Using the multi-stage stratified random cluster sampling method,22 315 students from grade three to nine from primary and junior high schools were randomly selected from the 50 key counties under the monitor programs,in 22 provinces of NNIPRCS.Questionnaire was used.Among all the students,with equal number of genders,morning fasting height and weight were measured by trained investigators.Status of nutrition was classified as malnutrition,normal,overweight/obesity,by age-specific height and BMI.Multivariate linear and logistic regression methods were used to analyze the relationship between milk consumption and the status of nutrition of the students.Results Only 31.4％ of the students that were on the monitoring programs would drink milk at breakfast.Proportions of milk intake at breakfast were higher in students from the western regions,in lower grades and in girls (P＜0.05).The proportions of malnutrition and overweight/obesity were 11.0％ and 10.0％ respectively.After controlling factors as gender,age,ethnicity,region of residency and types of parental employment,students who drank milk at breakfast showed an average height of 0.4 cm taller than those who did not drink milk (P=0.001).However,no significant relationships were noticed between milk intake at breakfast and weight,malnutrition or overweight/obesity.Conclusion Milk intake at breakfast seemed associated with the height of the students under study,suggesting that this program can be promoted,especially in students from the poor rural areas.

Milk Intake Patterns with Lactose and Milk Fat in Korean Male Adults / 대한지역사회영양학회지

OBJECTIVES: This study examined the milk intake patterns with lactose and milk fat in Korean male adults using the following variables: milk intake level, awareness of lactose, and milk fat, health problems, and necessity of milk intake. In addition, the factors affecting milk intake were analyzed by multiple regression analysis. METHODS: The subjects were 532 males aged 20 years or older among the nationwide milk purchasing group. The subjects were 223 (41.9%) in the 20–29 year age group, 188 (35.3%) in the 30–49 year age group and 121(22.7%) in the over 50 year age group. The survey was conducted using ANOVA and multiple comparative analysis to examine the differences in age and multiple regression analysis was performed to investigate the factors affecting the intake of milk. RESULTS: The intake of milk in the subjects was 538.14 ± 494.23 ml per week. There were statistically significant differences in the subjects' age according to processed milk, low fat, nonfat milk, cheese, and ice cream. The perception of milk and lactose and milk fat was recognized as a good food for skeletal health when milk was consumed. Among the milk nutrients, lactose was highly recognized at the age of 20–29, and milk fat was recognized in those over 50 years. In addition to lactose and milk fat, calcium was the most highly recognized among the milk nutrients. Health problems associated with milk were skeletal health, obesity, and lactose intolerance. The perception of lactose intolerance was related to lactose intolerance and fatness, and the dietary behavior was unaffected. CONCLUSIONS: This study examined the milk intake patterns of adult Korean males. Many variables were found to be related to the intake of milk. In this study, the milk intake was high when there was no problem with the perception and dietary behaviors of milk nutrition (lactose and milk fat). This study focused on lactose and milk fat, which are major nutrients in milk, and it is a new perspective study among milk-related research.

Milk Intake Patterns with Lactose and Milk Fat in Korean Male Adults / 대한지역사회영양학회지

OBJECTIVES: This study examined the milk intake patterns with lactose and milk fat in Korean male adults using the following variables: milk intake level, awareness of lactose, and milk fat, health problems, and necessity of milk intake. In addition, the factors affecting milk intake were analyzed by multiple regression analysis. METHODS: The subjects were 532 males aged 20 years or older among the nationwide milk purchasing group. The subjects were 223 (41.9%) in the 20–29 year age group, 188 (35.3%) in the 30–49 year age group and 121(22.7%) in the over 50 year age group. The survey was conducted using ANOVA and multiple comparative analysis to examine the differences in age and multiple regression analysis was performed to investigate the factors affecting the intake of milk. RESULTS: The intake of milk in the subjects was 538.14 ± 494.23 ml per week. There were statistically significant differences in the subjects' age according to processed milk, low fat, nonfat milk, cheese, and ice cream. The perception of milk and lactose and milk fat was recognized as a good food for skeletal health when milk was consumed. Among the milk nutrients, lactose was highly recognized at the age of 20–29, and milk fat was recognized in those over 50 years. In addition to lactose and milk fat, calcium was the most highly recognized among the milk nutrients. Health problems associated with milk were skeletal health, obesity, and lactose intolerance. The perception of lactose intolerance was related to lactose intolerance and fatness, and the dietary behavior was unaffected. CONCLUSIONS: This study examined the milk intake patterns of adult Korean males. Many variables were found to be related to the intake of milk. In this study, the milk intake was high when there was no problem with the perception and dietary behaviors of milk nutrition (lactose and milk fat). This study focused on lactose and milk fat, which are major nutrients in milk, and it is a new perspective study among milk-related research.

Dilución isotópica con deuterio para determinar ingesta de leche humana y composición corporal materna / Deuterium-oxide turnover technique to assess breast milk intake and maternal body composition / Diluição isotópica com deutério para determinar a ingestão de leite humano e a composição corporal materna

El objetivo del trabajo fue describir la aplicación de la técnica de dilución isotópica con deuterio de dosis a la madre para determinar la ingesta de leche materna y la composición corporal de las madres, en distintos tipos de lactancia. El método analítico se aplicó en cuatro casos modelo de pares madre-lactante en los cuales las madres recibieron una dosis oral de agua deuterada, recolectándose 6 muestras de saliva de ambos durante 15 días. El enriquecimiento de deuterio se determinó en un espectrómetro FTIR-Shimadzu-Affinity obteniéndose la ingesta de leche materna (ILM) y de agua de otras fuentes (Fd). Se observó una variación del enriquecimiento de deuterio en la saliva del lactante, asociada al tipo de lactancia recibida, siendo mayor en el caso de lactancia materna exclusiva (LME). Asimismo, a medida que aumentó Fd, disminuyó ILM. Además, fueron determinadas el agua corporal, la masa libre de grasa y la masa grasa materna. La transferencia de las habilidades técnicas y del conocimiento a través de metodologías innovadoras para determinar la ingesta de leche materna es de utilidad como herramienta de evaluación de la alimentación del lactante y para investigar en qué medida la lactancia natural es reemplazada por la ingesta de otros alimentos. Mejorar la estimación de la LME contribuye al conocimiento de la recomendación de OMS y UNICEF de mantener la misma hasta el sexto mes de vida.

The aim of this study was to describe the application of the dose-to-the-mother deuterium-oxide turnover technique to determine the breast milk intake and body composition of mothers in different types of breastfeeding. This analytical method was performed in four mother-infant pairs at 4 months from birth. Mothers received an oral dose of deuterated water, collecting 6 samples of saliva from mother and baby during a period of 15 days. Deuterium enrichment was determined in a Shimadzu FTIR-spectrometer-Affinity to obtain the intake of breast milk and water from non-breast milk sources. In this study, a variation of the enrichment of deuterium in the saliva of the infant was observed, being higher when the infant was exclusively breastfed. As non-breast milk water increased, the intake of human milk decreased. Furthermore, maternal total body water, fat free mass and fat mass were determined. To improve technical skills and knowledge through innovative methods of breast milk measurement can be useful as an assessment tool for evaluating infant feeding and investigating the extent to which breast milk is being replaced by the consumption of other foods in order to estimate exclusive breastfeeding in the future. This would contribute to the knowledge of maintaining breastfeeding until the sixth month of life, as it is recommended by WHO and UNICEF.

O objetivo deste estudo foi descrever a aplicação da técnica de diluição isotópica com deutério de dose à mãe para determinar a ingestão de leite materno e a composição corporal das mães, em diferentes tipos de aleitamento. O método analítico foi aplicado em quatro casos modelo de pares mães-lactante nos quais as mães receberam uma dose oral de água deuterada, coletando-se 6 amostras de saliva de ambos (mães e lactantes) durante 15 días. O enriquecimento de deutério foi determinado em um espectrômetro FTIR-Shimadzu-Affinity, sendo obtida a ingestão de leite materno (ILM) e de água proveniente de outras fontes (Fd). Observou-se uma variação do enriquecimento de deutério na saliva do lactante, associada ao tipo de aleitamento recebido, sendo maior no caso de aleitamento materno exclusivo (AME). Também, na medida que aumentou Fd, diminuiu ILM. Além disso, a água corporal, a massa livre de gordura y a massa gorda materna foram determinadas. A transferência das habilidades técnicas e do conhecimento através de metodologias inovadoras para determinar a ingestão de leite materno é de utilidade como ferramenta de avaliação da alimentação do lactante e para investigar em que medida o aleitamento natural é substituído pela ingestão de outros alimentos. Melhorar a avaliação do AME contribui ao conhecimento da recomendação da OMS e UNICEF de manter a mesma até o sexto mês de vida.

Study on relationship between milk intake and prevalence rates of chronic diseases in adults based on 5th and 6th Korea National Health and Nutrition Examination Survey data / 한국영양학회지

PURPOSE: The purpose of this study was to explore the relationship between milk intake and prevalence rates of chronic diseases using KNHANES data, and the significance of the relationship was tested based on meditators, socioeconomic status (income, education), dietary behaviors (smoking, alcohol drinking, breakfast, and eating out), and physical activity (walking, medium, and high). METHODS: Using the 5(th) and 6(th) survey data of KNHANES, milk intake rates and presence of seven chronic diseases were summarized and analyzed by ANOVA for two groups of adult men and women as follows: hypertension, hypertriglyceridemia, low HDL-cholesterol, diabetes, abdominal obesity, obesity, and metabolic syndrome. The dependent variables for the presence of seven chronic diseases regressed with socioeconomic, dietary behavior, and physical activity variables according to Logistic models. The dependent variables for milk intake using predictor variables of socioeconomic, dietary behaviors and physical activity were analyzed according to Logistic models. Finally, the significant socioeconomic, dietary behavior, and physical activity variables in the above model along with milk intake as a control variable or mediator variable regressed with significant chronic diseases according to Logistic models. RESULTS: Milk intake, socioeconomic status, dietary behaviors, and physical activity were significantly different among the two groups of adult men and women, which were also critical factors to the prevalence of chronic diseases. The dependent variable for prevalence of chronic diseases regressed with significant factors of socioeconomic status, dietary behavior, and physical activity variables according to chronic diseases using the control or mediator variable of milk intake and summarized as follows: For adult men, milk intake controlled the education effect on diabetes partly, alcohol on hypertension and hypertriglyceridemia, low HDL-cholesterol, metabolic syndrome, breakfast on metabolic syndrome, eating out on obesity, and medium physical activity on hypertriglyceridemia. For adult women, household income on hypertriglyceridemia, diabetes, abdominal obesity, education level on hypertension, alcohol drinking, eating out, and walking activity on abdominal obesity, alcohol, breakfast, eating out, walking activity on low HDL-cholesterol, and medium physical activity on hypertriglyceridemia and low HDL-cholesterol were partly controlled by milk intake. Other significant socioeconomic status, dietary behavior, and physical activity variables related to prevalence of chronic diseases were fully controlled or mediated by milk intake. CONCLUSION: This study shows that milk intake (daily more than 200 g) prevents chronic diseases such as hypertension, hypertriglyceridemia, low HDL-cholesterol, diabetes, obesity, abdominal obesity, and metabolic syndrome.

Bone mineral density and nutritional state according to milk consumption in Korean postmenopausal women who drink coffee: Using the 2008~2009 Korea National Health and Nutrition Examination Survey / 한국영양학회지

PURPOSE: This study investigated bone mineral density and nutritional state according to consumption of milk in Korean postmenopausal women who drink coffee. METHODS: Using the 2008~2009 Korean National Health & Nutrition Examination Survey data, a total of 1,373 postmenopausal females aged 50 yrs and over were analyzed after excluding those with diseases related to bone health. According to coffee and/or milk consumption, subjects were divided into four groups: coffee only, both coffee & milk, milk only, and none of the above. All data were processed after application of weighted values and adjustment of age, body mass index, physical activity, drinking, and smoking using a general linear model. For analysis of nutrient intake and bone density, data were additionally adjusted by total energy and calcium intake. RESULTS: The coffee & milk group had more subjects younger than 65 yrs and higher education, urban residents, and higher income than any other group. The coffee only group showed somewhat similar characteristics as the none of the above group, which showed the highest percentage of subjects older than 65 and in a lower education and socio-economic state. Body weight, height, body mass index, and lean mass were the highest in coffee & milk group and lowest in the none of the above group. On the other hand, the milk only group showed the lowest values for body mass index and waist circumference, whereas percent body fat did not show any difference among the groups. The coffee and milk group showed the highest bone mineral density in the total femur and lumbar spine as well as the highest nutritional state and most food group intakes, followed by the milk only group, coffee only group, and none of the above group. In the assessment of osteoporosis based on T-score of bone mineral density, although not significant, the coffee and milk group and milk only group, which showed a better nutritional state, included more subjects with a normal bone density, whereas the none of the above group included more subjects with osteoporosis than any other group. CONCLUSION: Bone mineral density in postmenopausal women might not be affected by coffee drinking if their diets are accompanied by balanced food and nutrient intake including milk.

Utilidad de las técnicas nucleares en nutrición: evaluación de la masa grasa corporal y de la ingesta de leche materna / Nuclear techniques in nutrition: assessment of body fat and intake of human milk in breast-fed infants

Las técnicas nucleares aplicables al área de nutrición son inocuas dado que utilizan isótopos estables. En particular, la dilución isotópica con deuterio evalúa la composición corporal y la ingesta de leche materna. Es un método de referencia para conocer grasa corporal y validar herramientas de bajo costo debido a su exactitud, facilidad de aplicación y por la base de antecedentes de su utilización en adultos y niños. Es no invasiva ya que utiliza saliva como muestra de análisis, lo que la hace aplicable a poblaciones pediátricas. Modificaciones en la grasa se asocian a enfermedades no transmisibles y existen individuos con peso normal pero mayor depósito de grasa. Por ello, es de utilidad analizar sus cambios como instrumento de evaluación en clínica y en programas de salud. Además, esta técnica es la forma exacta de determinar si los lactantes son amamantados exclusivamente mediante seno materno, establecer lactancia materna exclusiva y validar métodos convencionales basados en encuestas a las madres.

The application of nuclear techniques in the area of nutrition is safe because they use stable isotopes. The deuterium dilution method is used in body composition and human milk intake analysis. It is a reference method for body fat and validates inexpensive tools because of its accuracy, simplicity of application in individuals and population and the background of its usefulness in adults and children as an evaluation tool in clinical and health programs. It is a non-invasive technique as it uses saliva, which facilitates the assessment in pediatric populations. Changes in body fat are associated with non-communicable diseases; moreover, normal weight individuals with high fat deposition were reported. Furthermore, this technique is the only accurate way to determine whether infants are exclusively breast-fed and validate conventional methods based on surveys to mothers.

Milk and Protein Intake by Pregnant Women Affects Growth of Foetus.

The study assessed the effects of the daily intake of milk and protein by pregnant women on foetal growth and determined the growth pattern and velocity of growth. A total of 504 ultrasound observations from 156 respondents were collected following a cross-sectional design in the last trimester of pregnancy; majority of them were in the last month of pregnancy. De facto and purposive sampling was done, and direct interviews of affluent pregnant women were conducted. Kruskal-Wallis test shows that majority of the respondents had tendency to consume 155.65 to 465.17 mL of milk per day, resulting in better and higher foetal growth. Most respondents consumed about 50-70 g of protein per day, and the foetal growth measurements, such as abdomen-circumference, femur length, biparietal diameter, and head-circumference, on an average, were higher in the same group. Quadratic regression model exhibited that all the traits of growth pattern in Model 1 (low milk and protein intake) appeared to have more mode of decline, in contrast to Model 2 (more milk and protein intake), which shows better growth. In addition, velocity of growth pattern was obtained through the first derivative of quadratic regression of growth pattern. Moreover, 95% confidence interval calculated for regression line slope of Model 1 and Model 2 showed that the estimation point (2 B2) of Model 1 does not lay into 95% CI of Model 2; so, statistical significance assorted and also the same trend conversely hold for Model 2. The rate of growth was highly influenced by maternal milk and protein intake. These findings suggest that contribution of common nutrients or other nutritional factors present in milk and protein promote the growth of foetus.

Influence of Kangaroo care in improving milk intake and immune status for premature children / 中国实用护理杂志

Objective To investigate the effect of Kangaroo care in improving milk intake and immune status for premature children.Methods 80 cases of premature children from June 2009 to June 2011 were chosen as the research object.They were randomly divided into the control group and the observation group with 40 patients in each group.The control group was taken with conventional care model for care,and the observation group used Kangaroo care model for mursing.The milk intake of differerent tines and immune status of the two grmps were taken for testing and comparoson.Results The milk intake vohnnes 7d,14d and 28d after care of the observation group were greater than the control group.The levds of CD3+ 、CD4+and CD4/CD8 were higher,while the CD8+ level was lower than the control group.Conclusions Kangaroo care can significantly improve milk intake and immune status of preterm children.

A Study on the Promotion of Adolescent's Milk Consumption (II): Relationships of Adolescent's Milk Intake Frequency with Food Attitude, Snacking Frequency, Physical Activity and School Vending Facilities

In order to investigate the ecological factors affecting milk intake frequency of adolescents, the questionnaire survey was conducted with 929 middle and high school students living in Chungnam urban area through October and November 2004. The subjects consumed milk 8.6+/-6.7 times per week, other beverages 4.4+/-4.1 times per week and drinking water 3.7+/-2.1 cups per day. Of the students 77.3% took balanced meals, 72.8% ate regularly and 36.2% ate adequate amount. About 61% had breakfast everyday and nearly a half students snacked once a day. Nutritional knowledge scores about milk was 7.2+/-1.7 and milk attitude scores was 28.1+/-6.5. The subjects spent daily 1.8+/-1.1, 1.9+/-1.1, and 1.0+/-0.5 hours for computer use, TV watching and exercise, respectively. Milk intake frequencies were positively correlated with excercise, snack frequency, meal balance and regularity, breakfast frequency, food attitude score and milk preference, while showed negative correlationships with TV watching and computer use. Intake frequency of fruit-tasted and chocolate milk showed inverse correlation with nutritional knowledge. Subjects without either school store or vending machine took milk more frequently than those with one or both did. Of the correlated variables, milk preference was the most important influencing factor to milk intake frequency according to the stepwise linear regression analysis, which presented other 5 important influencing factors as food attitude, school vending facilities, excercise, snacking frequency and watching TV. In conclusion, the improvement of milk preference is the most important and effective way to promote milk consumption in adolescents. The favorite ways of drinking milk, nutritional benefit of milk, healthy beverage and good snacking should be taught in nutrition education. Also physical activities should be recommended to students rather than watching TV, computer use and vending facilities selling soft drinks should be limited to be established inside school.

An Association between Milk Consumption and Serum Lipid Profiles of Postmenopausal Women in Korea

The aim of this study was to analyze an association between milk consumption and serum lipid profiles in postmenopausal women in Korea. The dietary data by the Food Frequency Questionnaire were evaluated among 208 postmenopausal women who did not receive hormone therapy and their serum concentrations of triglyceride (TG), total, HDL-, and LDL-cholesterol, and alkaline phosphatase were analyzed. When the relationship between milk consumption and serum lipid profiles were analysed by linear regression, we found a negative relationship of milk consumption with ALP and a positive relationship with HDL-cholesterol. Animal calcium intake was significantly correlated with ALP and HDL-cholesterol. In addition, the serum level of HDL-cholesterol of the upper quartile (UQ) subjects who took animal calcium over 313 mg/day was significantly higher than the lower quartile (LQ) subjects who consumed milk below 101 mg/day when we compared the UQ and LQ subjects. The HDL-cholesterol level of the UQ subjects who consumed 235 ml of milk tended to be higher than the that of the LQ who consumed 53 ml. As for serum concentrations of TG, total cholesterol, and LDL-cholesterol, there was no significant difference between the UQ and LQ groups of milk consumption. Based on our study, we concluded that continual consumption of approximately one cup of milk per day was associated with low cardiovascular risks with favorable lipid profiles and ALP in postmenopausal women.