Relationship between muscle strength and dyslipidemia, serum 25(OH)D, and weight status among diverse schoolchildren: a cross-sectional analysis.

BACKGROUND: The relationship between muscle strength and cardiometabolic risk factors in youth, and the potential influence of vitamin D status on this relationship, is not well understood. This study examined associations between muscle strength and dyslipidemia, serum 25-hydroxyvitamin D [25(OH)D], and weight status in diverse schoolchildren. METHODS: Measures of hand-grip strength (standardized for sex and body weight), anthropometrics (height and weight converted to BMI z-score [BMIz]), sociodemographics, and fasting blood concentrations of plasma HDL-C and triglycerides and serum 25(OH)D were collected from 350 4th-8th grade schoolchildren (11.2 ± 1.3 y, 49.4% female, 56.3% non-white/Caucasian). Logistic regression was used to measure associations between standardized tertiles of grip strength and blood lipids, 25(OH)D, and weight status along with associations between 25(OH)D and dyslipidemia and weight status. RESULTS: Children with higher grip strength had lower odds of overweight/obesity (OR: 0.03, 95% CI: 0.01-0.06, in the highest tertile of grip strength vs. lowest, p for trend< 0.0001), borderline/low HDL-C (OR: 0.28, 95% CI: 0.16-0.50, p for trend< 0.0001), and borderline/high triglycerides (OR: 0.48, 95% CI: 0.25-0.92, p for trend< 0.05), adjusting for covariates. Associations between blood lipids and grip strength became non-significant after further adjustment for BMIz. No association was observed between grip strength and 25(OH)D, nor between 25(OH)D and borderline/low HDL-C or weight status; however, vitamin D sufficiency was associated with lower odds of borderline/high triglycerides compared with vitamin D deficiency (OR: 0.26, 95% CI: 0.09-0.74, p for trend< 0.05) before BMIz adjustment. CONCLUSION: Among racially/ethnically diverse children, muscle strength was associated with lower dyslipidemia. Longitudinal studies are needed to explore whether changes in muscle strength impact this relationship in children, independent of weight status. TRIAL REGISTRATION: This study was registered at www.clinicaltrials.gov (No. NCT01537809 ) on February 17, 2012.

Ordering patterns following the implementation of a healthier children's restaurant menu: A latent class analysis.

OBJECTIVE: Identify ordering patterns following implementation of a healthier children's menu. METHODS: A healthier children's menu was introduced in 2012 at a regional restaurant chain, featuring more meals meeting Kids LiveWell (KLW) nutrition standards, KLW side dishes bundled with meals, and the removal of French fries and soda. Latent class analysis was conducted on child meal orders placed after menu implementation (n = 8,611). The average calorie content and proportion of orders meeting calorie recommendations (≤600 kcal) in each class were evaluated. RESULTS: The best-fitting model contained six latent classes representing different ordering patterns: "healthy meals" (27.0%), "healthy meals, add-ons" (9.6%), "unhealthy sides" (9.2%), "healthy substitutions" (30.9%), "healthy substitutions, add-ons" (1.0%), and "unhealthy substitutions" (22.4%). Classes denoted as "healthy" were likely to contain meals with KLW items. Orders in the healthy meals class contained fewer calories than orders in all other classes (P < 0.0001). The majority of orders meeting calorie recommendations were in the healthy meals (59.4%) and healthy substitutions (27.1%) classes. CONCLUSIONS: Ordering patterns consistent with the healthier menu were common and more likely to meet calorie recommendations. Ordering patterns inconsistent with menu changes also emerged and can inform intervention efforts to reach patrons who may reject or compensate for healthier items.