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Association between complementary feeding method and BMI at 19–36 months of life: an Internet-based cross-sectional study from two European countries
- Monika A. Zielinska, Petra Rust, Jacqueline Bichler, Daria Masztalerz-Kozubek, Jadwiga Hamulka
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- Journal:
- Proceedings of the Nutrition Society / Volume 79 / Issue OCE2 / 2020
- Published online by Cambridge University Press:
- 10 June 2020, E456
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Over the last years, there has been increasing interest in Baby-Led Weaning (BLW), an approach in which infants feed themselves with finger foods. Previous studies have shown that BLW may be associated with lower food fussiness and risk of obesity, but in the other hand with growth flattering. However, the results are limited and still inconclusive. The aim of this study was to investigate the associations between complementary feeding method and body mass index (BMI) z-score in children aged 19–36 months from Poland and Austria. This anonymously, the cross-sectional internet-based study was conducted in 2018 and 2019 among 6645 mothers of children aged 12–36 months, recruited through social media. The analysis included data from 5856 mothers (35.5% from Austria) with complete data. Complementary feeding method was categorized as traditional spoon feeding (TSF), partial BLW (children was both spoon-fed and fed themselves), as well as BLW. BMI z-score was calculated based on declared body mass and height using the WHO cut-off points. BLW method was used in 16.4% of children, whereas the TSF in 30.5% of the total study group. Normal BMI z-score was observed in 73.8% of the total study group, thinness in 9.6% and overweight and obesity in 4.3%. The BLW increased the risk of thinness only in children aged 31–36 months (aOR: 1.48; 95%CI: 1.04–2.11) but did not influence the risk of overweight and obesity. In this present large cross-sectional study conducted in two European countries, we did not find an association between BLW and overweight and obesity risk. However, in the older group, BLW increased the risk of thinness. Previous studies observing a risk of thinness were also cross-sectional, although conducted among smaller study groups. In contrary to this, In contrary to this, the RCT trials using modified BLW version Baby-Led Introduction to SolidS (BLISS) did not observe any case of growth flattering. In another cross-sectional study investigating dietary intake of infants aged 6–8 months, who were complementary fed using BLW or TSF method, authors did not observe a difference in energy intake between the two groups. Further studies investigating the role of complementary feeding method and subsequent BMI, especially in long-term are necessary.
May Body Adiposity Index be used as adiposity diagnostic marker?
- Jadwiga Hamulka, Magdalena Górnicka, Urszula Nasuta, Joanna Frackiewicz, Agnieszka Białkowska, Małgorzata Drywień, Anna Ciecierska, Monika A. Zielinska
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- Journal:
- Proceedings of the Nutrition Society / Volume 79 / Issue OCE2 / 2020
- Published online by Cambridge University Press:
- 10 June 2020, E518
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Body Adiposity Index (BAI) is the method of determining body fat content based on anthropometric measurements, proposed as an alternative to the BMI. Due to the fact that the hip circumference is taken into account in calculating BAI, it is suggested that this index better reflects the differences in women and men obesity than BMI. The aim of this study was to examine the association between BAI and other adiposity indices such as WHtR (Waist to Height Ratio), Body Mass Index (BMI), Waist Circumference (WC), sum of skinfolds, or adiposity tissue measured by bioelectrical impedance analysis (FM-BIA) among adults, independence of sex and age. The study group consisted of 336 adults (59% women, 41% men) aged 18–70 years, which was divided into two groups: 18–45 years (57%) and > 45 (43%) to further analysis. All anthropometric measurements: height (H), body weight (BW), WC, hip circumference (HC) skinfolds thickness were taken according to the standardized procedures, with light clothing and without shoes twice and averages were calculated. BIA was performed under standardized conditions according to the manufacturer's protocol (Maltron BioScan 920 ver.1.1). BAI was calculated as [HC (cm) / H (m)1.5 -18]. Linear regression was used to investigate the relationship between BAI and adiposity indices. BAI was positively associated with sex, age, BW, WC, FM-BIA, BMI, sum of 4 or 5 skinfolds and WHtR for all subjects, but the strongest with FM-BIA (β = 0.787, p < 0.001), BMI (β = 0.696, p < 0.001) or WHtR (β = 0.625, p < 0.00001) for total group. BAI correlation with BW, WC, FM-BIA, BMI or WHtR were stronger in women than in men, both for the total group and regards to age. The identified set of correlates explained (for above variables) 30–79%, of the total variation in BAI for women, and 15–49% for men. The stronger BAI correlation with sex was found in the older group (> 45 years old) than in younger (β = 0.582, p < 0.00001 vs. β = 0.372, p < 0.00001). In men aged > 45 years, stronger BAI correlations with the sum of 4 or 5 skinfolds were observed. The correlation between BAI and BW in men was weaker than in women regardless of age (β = 0.364, p < 0.00001 vs. β = 0.762, p < 0.00001). Considering strong correlation between BAI and fat content (FM-BIA), BMI, WHtR, WC and BW in women, it seems that BAI may be used to determine the content of adipose tissue or as a diagnostic marker, but in men its using need further research.
Changes in Attitudes toward Nutrition after an Education Program in Polish Teenagers: Report from the ABC of Healthy Eating Study
- Jadwiga Hamulka, Lidia Wadolowska, Joanna Kowalkowska, Marta Jeruszka-Bielak, Joanna Frackiewicz, Krystyna Gutkowska
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- Journal:
- Proceedings of the Nutrition Society / Volume 79 / Issue OCE2 / 2020
- Published online by Cambridge University Press:
- 10 June 2020, E591
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The sustainability of education focused on improving teenagers’ attitudes toward nutrition from a longer-term perspective has not yet been studied extensively. The aim of this study was to determine the sustainability of attitudes toward nutrition after 3 and 9 months among Polish teenagers in a follow-up study. An education-based intervention study was carried out among 464 Polish teenagers aged 11–12 years (educated/control group: 319/145). In the educated group, a multicomponent, school-based education program lasting three weeks and covering five diet-related and lifestyle-related topics was implemented. Attitudes toward nutrition were determined with a shorter version (TFEQ10; 10 statements) of a three-factor eating questionnaire (TFEQ13) dedicated to school-aged adolescents, where three subscales were developed: Emotional Eating (EE: 2 statements, 0–6 points), Uncontrolled Eating (UE: 5 statements, 0–15 points), and Cognitive Restraint of Eating (CRE: 3 statements, 0–9 points). The data was collected 3 times: (i) before education (at baseline), (ii) after 3 months to measure the short-term effect of education, (iii) after 9 months to measure the medium-term effect of education. Differences between groups (educated vs. control or baseline vs. follow-up) were verified with the Mann–Whitney test. At the baseline, the mean values for all three scales were not significantly different between educated and control groups, calculated separately for boys and girls as well as for normal or overweight/obese teenagers, with the exception for Emotional Eating in the total sample and normal weight students. After 3-month follow-up, the mean values decreased in an educated group for all three subscales, for the total sample (EE: 1.3 vs 1.2; UE: 5.2 vs 4.7; CRE: 4.2 vs 4.0), for both sexes, and both body weight subpopulations, while increased or remained on the same level in control group (for total sample EE: 1.5 vs 1.6; UE: 5.6 vs 5.8; CRE: 4.1 vs 4.2). After 9 months, in the educated group, the means slightly increased when compared to the means after 3 months, but were still lower than those at the baseline. This study has shown that nutritional education of teenagers 11–12 years gives a long-lasting effect of attitudes toward nutrition (Emotional Eating and Uncontrolled Eating) visible after 3 months, and to a less extent after 9 months. We suppose, that improvement of the attitudes toward nutrition in teenagers, education programs should be regularly conducted and addressed not only to children but also to the adults responsible for children's nutrition.