Age and time trends in fish consumption pattern of children and adolescents, and consequences for the intake of long-chain n-3 polyunsaturated fatty acids.

BACKGROUND/OBJECTIVES: There is a lack of detailed data on fish consumption in European children and adolescents. We therefore investigated fish consumption patterns, portion sizes and estimated intakes of long-chain n-3 polyunsaturated fatty acids (PUFA; eicosapentaenoic acid, docosahexaenoic acid). SUBJECTS/METHODS: From the Dortmund Nutritional and Anthropometric Longitudinally Designed study between 1985 and 2006, yearly 3-day weighed dietary records (N=7152) from 1024 subjects (2-18 years, 49% males) were evaluated. RESULTS: On 14% of total recorded days fish consumption from 33 different species was documented. In the total sample (in the subgroup with fish intake), mean fish intake almost doubled from 5 to 14 g per day (from 15 to 37 g per day) within the age range. Mean portions of fish increased from 40 to 89 g per portion, predominantly from low-fat fish species. In the total sample mean long-chain (LC) n-3 PUFA intake increased with age from 42 to 141 mg per day (100-324 mg per day in the subgroup with fish intake). Without any fish consumption in the recording period, n-3 LC PUFA intake ranged below 20 mg per day. Within the 20-year time frame, the frequency of fish consumption increased significantly (P<0.0282) from 35% at the start in 1985 to 40% in 2005. CONCLUSIONS: Fish consumption-even with low intakes as observed here-improves LC n-3 PUFA considerably. Owing to the very low preference for high-fat fish in our sample, the potential of fish intake as an LC n-3 PUFA source was not considered.

Modification of dietary polyunsaturated fatty acids via complementary food enhances n-3 long-chain polyunsaturated fatty acid synthesis in healthy infants: a double blinded randomised controlled trial.

OBJECTIVE: To study the effect of modified polyunsaturated fatty acid (PUFA) profiles of complementary food on long-chain (LC) PUFA composition in healthy infants. DESIGN: Double blinded, randomised, controlled intervention trial. SETTING: Dortmund, Germany. PATIENTS: Free-living sample of healthy term infants. METHODS: Participants were randomly assigned within the first 2 months of life. During the intervention period from 4 to 10 months, the control group (n = 53) received commercial complementary meals with corn oil (3.4 g/meal) rich in n-6 linoleic acid (LA), the intervention group (n = 49) received the same meals with rapeseed oil (1.6 g/meal) rich in n-3 alpha-linolenic acid (ALA). Fatty acid intake was assessed from dietary records throughout the intervention period. Fatty acid proportions (% of total fatty acid) in total plasma were analysed before and after the intervention. RESULTS: Plasma fatty acid profiles did not differ between the intervention and control groups before the intervention. During the intervention, the only difference in fatty acid intake between the intervention and control groups was a higher intake of ALA in the intervention group, 21% deriving from study food and a lower ratio of LA/ALA (10.7 vs 14.8). At the end of the intervention, the plasma proportions of total n-3 fatty acids and of n-3 LC-PUFA, but not of ALA, were higher and the ratios of n-6/n-3 fatty acids were lower in the intervention group. CONCLUSIONS: Feasible dietary modifications of the precursor fatty acid profile via n-3 PUFA-rich vegetable oil favoured n-3 LC-PUFA synthesis in the complementary feeding period when LC-PUFA intake from breast milk and formula is decreasing.

Development and evaluation of a self-administered computerized 24-h dietary recall method for adolescents in Europe.

OBJECTIVE: To describe the development of a European computerized 24-h dietary recall method for adolescents, and to investigate the feasibility of self-administration (self report) by comparison with administration by a dietician (interview). METHODS: Two hundred and thirty-six adolescents (mean age 14.6 years (s.d.=1.7)) of eight European cities completed the 24-h recall (Young Adolescents Nutrition Assessment on Computer (YANA-C)) twice (once by self-report and once by interview). RESULTS: A small but significant underestimate in energy (61 (s.e.=31) kcal) and fat (4.2 (s.e.=1.7) g) intake was found in the self-reports in comparison with the interviews; no significant differences were found for the intake of carbohydrates, proteins, fibre, calcium, iron and ascorbic acid. Spearman's correlations were highly significant for all nutrients and energy ranging between 0.86 and 0.91. Agreement in categorizing the respondents as consumers and non-consumers for the 29 food groups was high (kappa statistics >or=0.73). Percentage omissions were on average 3.7%; percentage intrusions: 2.0%. Spearman's correlations between both modes were high for all food groups, for the total sample (>or=0.76) as well as for the consumers only (>or=0.72). Analysing the consumer only, on an average 54% of the consumed amounts were exactly the same; nevertheless, only for one group 'rice and pasta' a significant difference in consumption was found. CONCLUSION: Adaptation, translation and standardization of YANA-C make it possible to assess the dietary intake of adolescents in a broad international context. In general, good agreement between the administration modes was found, the latter offering significant potential for large-scale surveys where the amount of resources to gather data is limited.

Food and nutrient intake, nutritional knowledge and diet-related attitudes in European adolescents.

BACKGROUND AND OBJECTIVE: To provide an overview of methods used to assess food and nutrient intake, nutritional knowledge and diet-related attitudes in the Healthy Lifestyle in Europe by Nutrition in Adolescence Cross-Sectional Study (HELENA-CSS), with selected results from the feasibility study. MATERIAL AND METHODS: To assess food intake in 13- to 16-year-old adolescents, a previously developed computer-assisted and self-administered 24-h recall was adapted for international use. Food consumption data were linked to national food composition databases to calculate energy and nutrient intakes. To assess nutritional knowledge in pupils not having any special (trained) education concerning 'nutrition', a 23-item validated multiple choice questionnaire was adapted. To assess eating attitudes, behaviour and/or putative problems with body weight in adolescents, a validated inventory covering 60 questions or statements was adapted for the study. In a feasibility study, instruments, data collection and processing were tested in one school class in each of the 10 participating European cities. RESULTS AND CONCLUSIONS: The feasibility study provided plausible results, quite consistent between countries. Against this background and for the first time, standardized and uniform methodology was made available for the main study to assess and characterize dietary intake, nutritional knowledge and eating attitudes.

A feasibility study of using a diet optimization approach in a web-based computer-tailoring intervention for adolescents.

OBJECTIVE: Adolescents are an interesting but neglected target group in obesity prevention. We assessed the feasibility of using a diet optimization approach for computer-tailored nutrition interventions for adolescents. METHOD: Development of an optimization model based on the public health approach to diet optimization. On the basis of food frequency questionnaires (FFQ) of 48 adolescents (14-17 years) optimized diets were calculated. RESULTS: The optimization calculations for all cases resulted in individual advice. On a total of 137 items included in the FFQ, the individualized advice included changes in a minimum of 36 and a maximum of 88 items (mean: 61 items), recommendations for changes in the food items ranged from less than 1 g day(-1) up to 1660 g day(-1). In almost all cases a higher intake of fruit and vegetables was recommended; some unexpected advice was also generated (for example, to decrease the consumption of brown bread and to increase the consumption of pizza). The strengths and weaknesses of the optimized diets are discussed. CONCLUSION: Using the optimization approach is a step forward in nutrition tailoring interventions but the model used in the present feasibility study still needs to be refined.

Evaluation of dietary fibre intake from infancy to adolescence against various references--results of the DONALD Study.

OBJECTIVE: To evaluate dietary fibre intake from infancy to adolescence against various reference standards expressed on a body weight, age or energy intake (EI) basis and to describe age and 15-year time trends. DESIGN AND SUBJECTS: The ongoing longitudinal (open cohort) Dortmund Nutritional and Anthropometric Longitudinally Designed Study with a total of 7810 3-day dietary records from 980 infants, children and adolescents aged 6 months to 18 years collected between 1990 and 2004. RESULTS: Absolute dietary fibre intakes (g/day) increased with age from infancy to adolescence; dietary fibre density (g/1000 kcal) reached a maximum at 1 year and remained constant after the transition to the family diet. Expressed as g/kg body weight, dietary fibre intake increased during infancy with a maximum at 1 year, but decreased thereafter during childhood and adolescence. Dietary fibre intake was low irrespective of the reference used and showed no time trends, with the exception of a small negative trend in 4-8-year olds and 9-13-year-old girls. CONCLUSION: As intake of dietary fibre in our sample was significantly associated with EI and fibre density remained constant after infancy, our data support an energy-based approach for establishing a reference value for children and adolescents.

How to measure dietary intake and food habits in adolescence: the European perspective.

AIM: This paper deals with some methodological aspects of data collection in the context of measuring dietary intake in individuals in their adolescence life stage. METHOD: Experiences from three partners of the HELENA project in dietary intake measurement in children and adolescents are presented in this paper with emphasis on characteristics of under-reporting, long-term diet measurement and food patterns (Dortmund DONALD group), influences of survey duration on under-reporting (Ghent group) and meal habits (Spanish AVENA group). RESULTS: Under-reporters in the DONALD Study, particularly female adolescents, had a significantly higher body mass index (BMI) than non-under-reporters; BMI could not be explained by different long-term dietary patterns during childhood and adolescence clustered according to fat consumption; consumers of fast food had higher BMI values than nonconsumers. In the Ghent experience, the decline in population mean energy intake as calculated over selected clusters of days is 184 kcal (6.5%) in boys and 116 (5.6%) in girls; the cluster of 1 recording day and the cluster of 3 recording days were not significantly different but they were both significantly different from the 7-day cluster; no significant interaction was observed between the effect of time and BMI. In the AVENA Study, the percentage of adolescents skipping breakfast was higher in females (8.6%) than in males (3.5%, P<0.001); higher BMI values were observed in those skipping breakfast than in those notskipping breakfast, but differences were statistically significant in males at 15 y and in females at 14 and 17 y; adolescents avoiding some food groups for breakfast had higher BMI values (carbohydrates, fruits and pastries in males and milk, fruits and pastries in females). CONCLUSION: Dietary and nutrient intake data in the HELENA project will be obtained by means of repeated 24-h dietary recalls. Data from HELENA might be a basis for developing complex approaches like Healthy Eating Indices.

Pattern of long-term fat intake and BMI during childhood and adolescence--results of the DONALD Study.

OBJECTIVE: Adverse dietary habits have been discussed as being conducive to the increased prevalence of obesity in children and adolescents. No single dietary factor has been clearly identified so far. We analyzed long-term fat intake patterns during childhood and adolescence and their influence on body fatness. METHODS: Four clusters with different patterns of percent energy from fat were found in 228 individuals from the age of 2-18 y participating in the DONALD Study (Dortmund Nutritional Anthropometric Longitudinally Designed Study) with at least 10 yearly weighed dietary records between 1985 and 2002. Clusters were evaluated with regard to macronutrient and food group intakes and body mass index (BMI). RESULTS: The mean energy density and the ratio of energy intake to estimated basal metabolic rate per subject differed significantly between clusters. All calculated macronutrients (per energy intake) with the exception of dietary fiber differed significantly as well as intakes of Meat/Fish/Eggs, Fats/Oils and Fruit/Vegetables. Although these differences in dietary characteristics persisted during the study period, no differences of BMI (calculated as standard deviation score) were found either at the first or last examination per subject. The mean BMI during the study period differed significantly, with the highest BMI in the low fat intake cluster. CONCLUSION: BMI could not be explained by different dietary patterns during childhood and adolescence in this long-term evaluation of dietary records. Underreporting especially in obese subjects, the problem of detecting minor overconsumption of energy intake that favors the development of obesity over long periods, and the small study sample may explain these conflicting results.

Home-made carbonated water and the consumption of water and other beverages in children and adolescents: results of the DONALD study.

AIM: To determine differences in intake of water, drinking water and beverages between consumers (C) and non-consumers (NC) of carbonated water prepared at home. METHODS: Matched pairs design; 3-d-weighed diet records; participants of the DONALD Study (Dortmund Nutritional and Anthropometric Longitudinally Designed Study) aged 2-18 y (n = 550, mean: 8.2 y). RESULTS: The most important beverage was either carbonated (C: females 265, males 299 g/d) or bottled water (NC: males 267, females 282 g/d) followed by juice (120-174 g/d), soft drinks (134-167 g/d) and milk (84-149 g/d). Water intake from beverages was higher in males (NC: 902 and C: 906 g/d) than in females (NC: 789 and C: 771 g/d). However, total water intake per energy was higher in females (NC: 0.88 and C: 0.91 g/kcal) than in males (NC: 0.80 and C: 0.83 g/kcal). C had a significantly higher mean drinking water intake (tap + bottled + carbonated water) in percentage of total water intake (%TW) than NC, and lower mean intakes of milk, bottled water and tap water, respectively. There was a significantly lower mean fat intake in C (females: 32 and males: 33% of energy) versus NC (females: 34 and males: 36% of energy). Irrespective of carbonated water consumption, females had better drinking habits than males, with significantly higher mean intakes of water from food (%TW), water from beverages + food (%TW), and total water per energy. CONCLUSIONS: Drinking habits and total water intakes of consumers are quite similar to those of non-consumers of carbonated water. Females in general show more favourable drinking habits than males.

Measured consumption of tap water in German infants and young children as background for potential health risk assessments: data of the DONALD Study.

Contaminated tap water can become a health risk, e.g. by metals or environmental pollution particularly for sensitive population groups such as infants and young children. There is a lack of data on exactly measured water intake. In the DONALD Study, individual food and fluid intakes were measured by use of 3-day weighed diet records. Here we report on the distribution of individual intakes of tap water in 504 healthy normally nourished subjects aged 3-36 months (1962 diet records) between 1990 and 1998. We calculate scenarios for potential tap water contamination. Tap water intake per kg body weight was significantly higher in formula-fed (FF) infants than in breast-fed (BF) infants. The estimated median intake of lead and nitrate per kg body weight from tap water was higher in FF infants than in BF infants or mixed fed (MF) young children. The scenarios based on intakes at the median, P95 or maximums show that higher risks for exceeding the presently existing maximums could be expected in FF infants. Our data could also be used for estimations of potential risks from other contaminants of tap water.

Changes in time-trends of nutrient intake from fortified and non-fortified food in German children and adolescents--15 year results of the DONALD study. Dortmund Nutritional and Anthropometric Longitudinally Designed Study.

BACKGROUND: Although fortified products have played an increasing role in food marketing since the 1980s in Germany, data as to the consumption of fortified food is sparse. AIM OF THE STUDY: To assess long-term data on changes in fortified food supply or consumption patterns, nutrient intake, and time trends in the DONALD Study (Dortmund Nutritional and Anthropometric Longitudinally Designed Study). METHODS: Between 1985 and 2000 consumption of nutrient intake (total and from fortified foods) was evaluated and time trends in energy and nutrient intake were assessed on the basis of 3-day weighed dietary records (n = 4193) of 2-14 year-old males (n = 383) and females (n = 404) enrolled in the DONALD Study. Nutrient intake was expressed as percentage of the current German recommendations. Food products were defined as fortified if enriched with at least one of the following nutrients: Vitamin A or provitamin A carotenoids (summarised as Vitamin A), Vitamins E, B1, B2, B6, C, niacin, folate, calcium or iron. Nutrient supplements and medicine were excluded from this evaluation. Time trends were analysed using linear and non-linear regression models (PROC MIXED, SAS 6.12). RESULTS: In percent of German references [3], non-fortified food contributed to folate intake by 20-30%, to Vitamin E by about 40%, to Vitamin B1 by 50-65%, to Vitamin A, C, B2, calcium, iron by about 65-95%, and to Vitamin B6 and niacin intake by 100% and more. Fortified food alone provided no more than 5% of calcium intake, about 10-20% of iron, Vitamin A and folate intake, up to 40-50% of Vitamin C, B1, B2, E, niacin and up to 80% of Vitamin B6 intake. During the 15 year period of the DONALD Study with total food, we only found a significant linear time trend for Vitamin C, whereas significant non-linear time trends were found for calcium, Vitamin E, B1, B2, B6, niacin and folate. In the latter there was a uniform increase until 1994 and a decrease thereafter. For iron and Vitamin A no significant time trend could be identified. Only iron and Vitamin A intake from fortified food showed a significant linear time trend. All other nutrients studied here gave significant non-linear time trends. Nutrient intake with fortified food reached maximum values between 1994 and 1996 followed by a decrease thereafter. CONCLUSIONS: Signs of changing food consumption patterns were found, pointing to an almost uniform decrease of nutrient intake since 1994/96 in our population of German children and adolescents. This could be an alarming indicator of a slight but unpreferable tendency to eat energydense, nutrient-poor foods.

Fifteen year trends in water intake in German children and adolescents: results of the DONALD Study. Dortmund Nutritional and Anthropometric Longitudinally Designed Study.

UNLABELLED: Water intake was evaluated and time trends in water intake and beverage consumption were assessed on the basis of 3 d weighed dietary records (n = 3,736) of 2-13-y-old males (n = 354) and females (n = 379) enrolled in the DONALD Study (Dortmund Nutritional and Anthropometric Longitudinally Designed Study, 1985-1999). Total water intake increased with age from 1,114 g d(-1) in the 2-3-y-olds to 1,363 g d(-1) in the 4-8-y-olds and further to 1,801 g d(-1) (1,676 g d(-1)) in the 9-13-y-old boys (girls); 33-38% came from food, 49-55% from beverages and 12-13% from oxidation. Total water intake per body weight decreased with age from 77.5 g kg(-1) (boys and girls) to 48.9 and 42.6 g kg(-1) in boys and girls, respectively. Milk (9-17%) and mineral water (12-15%) were the most important source of total water intake. In the 15 y period a significant increase in total water intake (+1.7 to +3.2 g MJ(-1) y(-1)) in all three age groups irrespective of sex was found. The increase of total water intake was mainly due to an increase in beverage consumption (+0.32 to +0.47% y(-1)). This study offers a differentiated insight into water intake and patterns of beverage consumption in German children and adolescents. CONCLUSION: The comparison of these data with other surveys points to a low total water intake, especially a low tap water intake, in German children and adolescents and underlines cultural influences on food and drinking habits.

The foods most consumed by German children and adolescents: results of the DONALD Study. Dortmund Nutritional and Anthropometric Longitudinally Design.

BACKGROUND: For a successful nutrition counseling of children and adolescents, knowledge of dietary habits is mandatory. This report describes food group intake and gives details of the customary food selection of healthy German children and adolescents. Main foods which are consumed in large amounts were identified as those on which health promotion should be concentrated. METHODS: 3-day weighed dietary records of 344 children (age range 4-6 years) and 92 adolescents (age range 13-14 years) concerning the period 1990-1997 of the DONALD Study (Dortmund Nutritional and Anthropometric Longitudinally Designed Study) were evaluated. RESULTS: The number of different foods recorded during the 3-day observation period ranged from 21 to 70 and was independent of age or sex. In contrast to dietary guidelines, the consumption of animal foods and 'fats/oils' exceeded the consumption of plant foods with the exception of adolescent girls. Food selection was very similar in age and sex groups. CONCLUSION: Our study shows that under preventive aspects the current food selection could be improved without disturbing the prevailing dietary habits and food preferences.

Significance of fortified beverages in the long-term diet of German children and adolescents: 15-year results of the DONALD Study.

Fortified beverages and instant drinks are the most frequently consumed fortified products in children and adolescents in Germany. However, little is known about the contribution of these products to micronutrient intake. Between 1986 and 2000, consumption of fortified food (total and the subgroup of fortified beverages) and time trends in energy and micronutrient intake were assessed on the basis of 3 day-weighed dietary records (n = 4358) of males and females between the ages of 2 and 14 years (n = 398/408) enrolled in the DONALD Study (Dortmund Nutritional and Anthropometric Longitudinally Designed Study). As percentage of recent references for micronutrient intake, a significant increase in intake from fortified beverages was observed for calcium (from 1 to 3%), iron (3 to 4%), vitamin A (5 to 15%), and vitamin C (5 to 60%). Significant increases in intakes were only observed from 1995-1997 for vitamin E, folate, and niacin (all 5 to 15-25%), vitamin B1 and B2 (both 10-15 to 25-30%) and vitamin B6 (20 to 55%). Thereafter significant decreases were found. Among the fortified beverages, juice was the most important for micronutrient intake, followed by soft drinks (calcium, vitamin A, E, C, folate, niacin) or by instant beverages (energy, iron, vitamin B1, B2, B6). Significant linear and nonlinear time trends in micronutrient intakes from fortified food and fortified beverages were observed in German children and adolescents.

Vitamin intake of 1- to 18-year-old German children and adolescents in the light of various recommendations.

Data on the vitamin intake during childhood and adolescence are rare in Europe. Here, age and sex specific percentiles of the absolute intakes and relative densities (per MJ) of retinol, carotenoids, vitamins A, E, C, B1, B2, B6, niacin and folate in a sample of 627 subjects between the age of 1 and 18 years are reported and compared to the actual recommendations from Germany, the EC and the USA. The evaluation of the intakes clearly depends on the reference value chosen. In total, the vitamin intake can be assessed to range between satisfactory and generous with the exception of folate which ranged consistently below the references.

Ten-year trends in vitamin and mineral intake from fortified food in German children and adolescents.

OBJECTIVE: We investigated time trends in consumption patterns, and energy and nutrient intakes (protein, fat, carbohydrates, added sugars, vitamins A, E, C, B1, B2 and B6, niacin, folate, calcium and iron) from fortified food in children and adolescents between 1987 and 1996 in Germany. DESIGN: Mixed longitudinal survey (DONALD study) with 3 d weighed dietary records (n=2062 from 594 subjects), one subject per family per year chosen by random. SETTING: Dortmund (Western Germany) district cohort. SUBJECTS: 285 males, 309 females; mean age 6 y (2-13 y). RESULTS: Almost all children and adolescents consumed fortified food irrespective of the year studied. With the exception of vitamin E, significant time trends in the proportions of nutrient intakes from fortification were observed. The fortification of food with vitamins A, C, B1, B2 and B6 and niacin raised the already adequate intakes from non-fortified food (100% to 150% of reference intake values) by 20-50%. The fortification of food with vitamin E and folate raised the low intakes from non-fortified food (about 50% of reference intake values) to about 80% (folate) and 100% (vitamin E) of the references. Fortification of food with calcium and iron was not significant (<10%), but while total intake of calcium was adequate, total intake of iron remained critical. CONCLUSIONS: Since the nutrient intake of the population of children and adolescents studied is adequate with respect to vitamins A, C, B1, B2 and B6, niacin and calcium, fortification seems inefficient, while fortification of food with vitamin E and folate, but not iron, improves an inadequate intake. SPONSORSHIP: The DONALD study is supported by the German Federal Ministry of Health and the North-Rhine-Westphalian Ministry of Science and Research. European Journal of Clinical Nutrition (2000) 54, 81-86

Development of scores to measure the effects of nutrition counselling on the overall diet: A pilot study in children and adolescents.

An intervention study by documented dietary counselling was carried out in a sample of 9 children and adolescents (12-15 years) living in a full-time institution in Dortmund. Three weighed dietary records were collected over 3-7 days, one before and one after each of two individual nutrition counselling sessions, which were based on the recommended intake of food groups defined by the Optimized Mixed Diet (OMD), a quantitative preventive dietary conception for children and adolescents. As univariate dietary parameters (e.g., cholesterol intake), which are often used to show the effectiveness of nutrition counselling, do not take into account the multivariate complexitiy of nutrition, we developed 3 multivariate scores to measure the effectiveness of nutrition counselling. They are defined as: Recommended Food group change Score (RFS): Average change in the amounts of the deviations (%) from the reference food groups values (OMD = 100 %) before and after counselling taking into account the aim (eat mor/less) of the counselling session, exclusively based on the food groups addressed during counselling. Total Food group change Score (TFS): Average change in the amounts of the deviations (%) from the reference food group values (OMD = 100 %) before and after counselling based on all food groups consumed. Nutrient Improvement Score (NIS): Average change in the negative deviations (%) of 8 vitamins and 8 minerals from the German reference values for nutrient intake (Deutsche Gesellschaft für Ernährung (DGE) = 100 %) before and after counselling. On average, the intakes of the food groups mentioned during the first counselling session improved considerably (RFS = +36 %), the change in the intake of all food groups was small (TFS = +6 %) and the nutrient intakes did not improve (NIS = 0 %). From the second counselling session the values of the RFS was +10 %, of the TFS was +6% and of the NIS +3 %. This means that the success of counselling on one dietary criterion does not guarantee success on others. Our food and nutrient based scores together with a detailed food intake assessment give an example of multivariate measurements of nutrition counselling outcomes.

Fruit juice consumption and the prevalence of obesity and short stature in german preschool children: results of the DONALD Study. Dortmund Nutritional and Anthropometrical Longitudinally Designed.

BACKGROUND: In recent years, a possible association between excessive consumption of fruit juice (> or =12 fl oz per day) and short stature and/or obesity has been discussed. The association among the consumption of fruit juice, anthropometric indices, and the overall diet was examined during a 3-year period in a sample of healthy preschool children participating in the Dortmund Nutritional and Anthropometrical Longitudinally Designed (DONALD) Study. METHODS: Two hundred five children were examined annually at the ages of 3, 4, and 5 years. Dietary intake was calculated from 3-day weighed diet records. Height was measured using a stadiometer. Weight was measured using an electronic scale. RESULTS: Five children consumed excessive fruit juice continually in all three records, 10 children in two records, and 23 children in one record. None of the five children with repeatedly excessive fruit juice consumption was obese or short. Growth velocity, body mass index, and height standard deviation score were not correlated with fruit juice consumption. Consumption of fruit juice was inversely correlated with the consumption of all other beverages and the total consumption of all other food. The intake of protein, fat, and carbohydrates of children consuming excessive fruit juice was closer to the international dietary preventive guidelines than the intake of children consuming low amounts of fruit juice. CONCLUSIONS: In the study sample, even repeatedly excessive fruit juice consumption had no influence on anthropometric indices. The results do not justify a general warning or a general promotion regarding high fruit juice consumption in preschool children's diets.

Vitamin intake of 3- to 36-month-old German infants and children--results of the DONALD-Study.

Infants and young children are a vulnerable group with regard to nutrition. However, there is a lack of information about the dietary composition of healthy German infants and children. Therefore, the intake of vitamins (A, C, E, B1, B2, B6, folate, niacin) was assessed in 354 healthy German infants and children aged 3 to 36 months from 3-day-weighed diet records and compared with German, European and US reference values. Intake of all B-vitamins (B1, B2, B6, folate, niacin) increased during the first 3 years of life, whereas intake of vitamin E decreased. Intake of vitamin A and C varied between age groups. The highest levels of the nutrient densities of most vitamins were found at the end of the first year of life. Depending on the reference values chosen, the vitamin supply of the study population ranged between sufficient and very good. The reported satisfactory intake of vitamins in infants and young children in this study gives rise to the question of whether the current extent of fortification of commercial infant food in Germany is necessary.

Consumption of fortified food between 1985 and 1996 in 2- to 14-year-old German children and adolescents.

Since the 1980s, fortified food plays an increasing role in food marketing in Germany. However, there is a lack of data concerning fortified food consumption. We therefore evaluated dietary information of the DONALD Study. A total of 2251 3-days weighed records between 1986 and 1996 from 637 different subjects aged between 2 and 14 years (mean: 6.6 years) were evaluated. Food products were defined as fortified if enriched at least with one of the following nutrients: vitamin A (including provitamin A carotenoids), E, B1, B2, B6, C, niacin, folate, calcium, magnesium, potassium, iron or phosphate. Products were grouped in 'Diary products', 'Cereals', 'Beverages', 'Instant Beverages', 'Sweets/biscuits', 'Fats/oils', and 'Beikost' (i.e. dietetic food intended for infants and young children under 4 years). Over the last 11 years almost all children and adolescents consumed fortified food products. Excluding the food group 'Fats/oils' the proportion of consumers of fortified food increased by about 20% between 1986 and 1996. During the same period the consumption rate increased up to five-fold for the food group 'Beverages' and fourfold for 'Cereals'. Since 1988, a relatively constant consumption ratio of 62-68 different fortified products per 100 consumers has been found. 'Beverages' showed the highest food-group-specific diversity. In Germany, vitamins are more often used than minerals to fortify food, whereas vitamin C is the most frequent added nutrient. We found some interesting time trends in the use of vitamins and minerals for fortification with a continuous increase in the use of vitamin C and E. Only vitamin A showed a decrease in use during the study period. Finally, we found a decreasing number of consumers of all fortified products at the end of the study period.