Obesity: Nicklas TA

Nicklas TA, Hayes D, Anonymous00011. · No affiliation provided · J Am Diet Assoc. · Pubmed #18564454 No free full text.

Abstract: It is the position of the American Dietetic Association that children ages 2 to 11 years should achieve optimal physical and cognitive development, attain a healthy weight, enjoy food, and reduce the risk of chronic disease through appropriate eating habits and participation in regular physical activity. The health status of American children has generally improved during the past 3 decades. However, the number of children who are overweight has more than doubled among 2- to 5-year-old children and more than tripled among 6- to 11-year-old children, which has major health consequences. This increase in childhood overweight has broadened the focus of dietary guidance to address children's overconsumption of energy-dense, nutrient-poor foods and beverages and physical activity patterns. Health promotion will help reduce diet-related risks of chronic degenerative diseases, such as cardiovascular disease, type 2 diabetes, cancer, obesity, and osteoporosis. This position reviews what US children are eating and explores trends in food and nutrient intakes as well as the impact of school meals on children's diets. Dietary recommendations and guidelines and the benefits of physical activity are also discussed. The roles of parents and caregivers in influencing the development of healthful eating behaviors are highlighted. Specific recommendations and sources of nutrition messages to improve the nutritional well-being of children are provided for food and nutrition professionals

Krebs NF, Himes JH, Jacobson D, Nicklas TA, Guilday P, Styne D. · Department of Pediatrics, University of Colorado School of Medicine, 4200 E. Ninth Ave, Box C225, Denver, CO 80262, USA. · Pediatrics. · Pubmed #18055652 links to  free full text

Abstract: Accurate appropriate assessment of overweight and obesity in children and adolescents is a critical aspect of contemporary medical care. However, physicians and other health care professionals may find this a somewhat thorny field to enter. The BMI has become the standard as a reliable indicator of overweight and obesity. The BMI is incomplete, however, without consideration of the complex behavioral factors that influence obesity.Because of limited time and resources, clinicians need to have quick, evidence-based interventions that can help patients and their families recognize the importance of reducing overweight and obesity and take action. In an era of fast food, computers, and DVDs, it is not easy to persuade patients to modify their diets and to become more physically active. Because research concerning effective assessment of childhood obesity contains many gaps, this report is intended to provide a comprehensive approach to assessment and to present the evidence available to support key aspects of assessment. The discussion and recommendations are based on >300 studies published since 1995, which examined an array of assessment tools. With this information, clinicians should find themselves better equipped to face the challenges of assessing childhood overweight and obesity accurately.

Forshee RA, Storey ML, Allison DB, Glinsmann WH, Hein GL, Lineback DR, Miller SA, Nicklas TA, Weaver GA, White JS. · Center for Food, Nutrition, and Agriculture Policy, University of Maryland - College Park, 1122 Patapsco Building, College Park, MD, USA. · Crit Rev Food Sci Nutr. · Pubmed #17653981 No free full text.

Abstract: The use of high fructose corn syrup (HFCS) has increased over the past several decades in the United States while overweight and obesity rates have risen dramatically. Some scientists hypothesize that HFCS consumption has uniquely contributed to the increasing mean body mass index (BMI) of the U.S. population. The Center for Food, Nutrition, and Agriculture Policy convened an expert panel to discuss the published scientific literature examining the relationship between consumption of HFCS or "soft drinks" (proxy for HFCS) and weight gain. The authors conducted original analysis to address certain gaps in the literature. Evidence from ecological studies linking HFCS consumption with rising BMI rates is unreliable. Evidence from epidemiologic studies and randomized controlled trials is inconclusive. Studies analyzing the differences between HFCS and sucrose consumption and their contributions to weight gain do not exist. HFCS and sucrose have similar monosaccharide compositions and sweetness values. The fructose:glucose (F:G) ratio in the U.S. food supply has not appreciably changed since the introduction of HFCS in the 1960s. It is unclear why HFCS would affect satiety or absorption and metabolism of fructose any differently than would sucrose. Based on the currently available evidence, the expert panel concluded that HFCS does not appear to contribute to overweight and obesity any differently than do other energy sources. Research recommendations were made to improve our understanding of the association of HFCS and weight gain.

Bachman CM, Baranowski T, Nicklas TA. · University of Houston, Houston, Texas, USA. · Nutr Rev. · Pubmed #16673752 No free full text.

Abstract: Four mechanisms were reviewed to explain the possible association between sweetened beverages and increased overweight or obesity: excess caloric intake, glycemic index and glycemic load, lack of effect of liquid calories on satiety, and displacement of milk. The findings were inconsistent across studies. The strongest support was for the excess caloric intake hypothesis, but the findings were not conclusive. Assigning possible links between sweetened beverage consumption and adiposity requires research that compares and contrasts specific mechanisms, especially in populations at risk for obesity, while controlling for likely confounding variables.

Patrick H, Nicklas TA. · Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, Texas 77030, USA. · J Am Coll Nutr. · Pubmed #15798074 links to  free full text

Abstract: With the growing problem of childhood obesity, recent research has begun to focus on family and social influences on children's eating patterns. Research has demonstrated that children's eating patterns are strongly influenced by characteristics of both the physical and social environment. With regard to the physical environment, children are more likely to eat foods that are available and easily accessible, and they tend to eat greater quantities when larger portions are provided. Additionally, characteristics of the social environment, including various socioeconomic and sociocultural factors such as parents' education, time constraints, and ethnicity influence the types of foods children eat. Mealtime structure is also an important factor related to children's eating patterns. Mealtime structure includes social and physical characteristics of mealtimes including whether families eat together, TV-viewing during meals, and the source of foods (e.g., restaurants, schools). Parents also play a direct role in children's eating patterns through their behaviors, attitudes, and feeding styles. Interventions aimed at improving children's nutrition need to address the variety of social and physical factors that influence children's eating patterns.

Nicklas TA. · USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, Texas 77030, USA. · J Am Coll Nutr. · Pubmed #14559926 links to  free full text

Abstract: Issues involving low calcium intake and dairy product consumption are currently the focus of much debate and discussion at both the scientific and lay community levels. In this review, we examine the following major areas of interest: (1). the role of calcium intake and dairy product consumption in chronic diseases, (2). nutritional qualities of milk and other dairy products, (3). trends in calcium intake and dairy product consumption, (4). current status of calcium intakes and dairy product consumption in children, (5). tracking of calcium intake and diary product consumption, (6). the impact of school meal participation on calcium intake and dairy product consumption, (7). concerns related to calcium-fortified foods and beverages and (8). factors influencing children's milk consumption. To date, the findings indicate that calcium intake and dairy product consumption have beneficial roles in a variety of chronic diseases; dairy products provide an abundant source of vitamins and minerals; calcium intakes of children have increased over time, yet intakes are not meeting the current adequate intake (AI) calcium recommendations; dairy consumption has decreased, and soft drink consumption and, possibly, consumption of calcium-fortified products have increased; consumption of dairy products have a positive nutritional impact on diets of children, particularly from school meals, and there are many factors which influence children's milk consumption, all of which need to be considered in our efforts to promote adequate calcium intakes by children. Based on this review, areas that need immediate attention and future research imperatives are summarized in an effort to further our understanding on what we already know and what we need to know to promote healthier eating habits early in life.

Nicklas TA, Baranowski T, Cullen KW, Berenson G. · Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, Texas 77030, USA. · J Am Coll Nutr. · Pubmed #11771675 links to  free full text

Abstract: Obesity among children has reached epidemic proportions. Today, an estimated one in four children in the United States is overweight. while 11% arc obese. Children who are overweight tend to remain so up to 20 years of age; in general, they have a 1.5- to twofold higher risk for becoming overweight as adults. The prevalence of overweight has increased approximately twofold in the 20-year period from 1974 to 1994, with the largest increases observed among 19- to 24-year-olds. The annual increases in weight and obesity that occurred from 1983 to 1994 were 50% higher than those from 1973 to 1982. Overweight youth are 2.4 times as likely to have a high serum total cholesterol level, and 43.5 times as likely to have three cardiovascular risk factors. Although the total energy intake of children has remained the same, and the macronutrient density of the diet has changed, the percentage of energy from fat has decreased, while that from carbohydrates and protein has increased. Children have been consuming lower amounts of fats/oils, vegetables/soups, breads/grains, mixed meats, desserts, candy, and eggs. and increasing amounts of fruits/fruit juices, beverages. poultry, snacks, condiments, and cheese. Changes in specific eating patterns may explain the increase in adiposity among children; e.g., increases have occurred in the number of meals eaten at restaurants, food availability, portion sizes, snacking and meal-skipping. Successful prevention and treatment of obesity in childhood could reduce the adult incidence of cardiovascular disease. Because substantial weight loss is difficult to maintain, the prevention of obesity by promoting healthier lifestyles should be one of our highest priorities in the new millennium.

Park J, Mendoza JA, O'Neil CE, Hilmers DC, Liu Y, Nicklas TA. · Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA. · Asia Pac J Clin Nutr. · Pubmed #18818169 No free full text.

Abstract: This study estimated and compared the prevalence of the Metabolic Syndrome and its individual components in young adults (ages 20-39 years) in the US and Korea using 2003-2004 US and 2005 Korean National Health and Nutrition Examination Survey data. The mean body mass index and rate of metabolic abnormalities in the US were significantly higher than in Korea. The prevalence of the Metabolic Syndrome in the US was nearly three times higher than in Korea using National Cholesterol Education Program-Adult Treatment Panel III and Inter-national Diabetes Federation criteria (21.6% vs. 6.9% and 23.0% vs. 6.9%, p <0.001). The prevalence of abdominal obesity, hyperglycemia, and hypertriglyceridemia was higher in the US while the prevalence of low high density lipoprotein-cholesterol level was higher in Korea. The rate of hypertension showed no significant difference while mean systolic blood pressure and diastolic blood pressure varied between the two countries. The proportion of subjects having at least one component of Metabolic Syndrome was similar in both countries; however, multiple abnormalities were more common in the US. These findings indicate the need for the development of race/ethnic-based norms for components of the Metabolic Syndrome and detailed analysis of the risk factors for the Metabolic Syndrome in the two countries. National health policies designed to prevent the Metabolic Syndrome, its individual abnormalities, and its complications using population-based characteristics of each nation will generate improved outcomes.

Nicklas TA, O'Neil CE, Kleinman R. · Department of Pediatrics, Children's Nutrition Research Center, Baylor College of Medicine, 1100 Bates Ave, Houston, TX 77030-2600, USA. · Arch Pediatr Adolesc Med. · Pubmed #18524747 links to  free full text

Abstract: OBJECTIVE: To investigate the associations between 4 categories of daily 100% juice consumption (0 fl oz, > 0 to < or = 6 fl oz; > 6 to < 12 fl oz; and > or = 12 fl oz) and nutrient and food group intake and weight in children. DESIGN: Cross-sectional study. SETTING: Secondary analysis of the 1999-2002 National Health and Nutrition Examination Survey data. PARTICIPANTS: Children 2 to 11 years of age (N = 3618). MAIN EXPOSURE: Juice consumption. OUTCOME MEASURES: The association between juice consumption, nutrient intake, food group consumption, and weight status was determined as was the likelihood of overweight with juice consumption. RESULTS: Mean daily juice consumption was 4.1 fl oz, which contributed a mean intake of 58 kcal (3.3% of total energy intake). Compared with nonconsumers, the overall nutritional profile of those consuming 100% juice had significantly higher intakes of energy, carbohydrates, vitamins C and B(6), potassium, riboflavin, magnesium, iron, and folate and significantly lower intakes of total fat, saturated fatty acids, discretionary fat, and added sugar. Children consuming 100% juice also consumed significantly more servings of total whole fruit than nonconsumers. No significant differences were found in weight status and the amounts of 100% juice consumed. There was no difference in the likelihood of being overweight between juice consumers and nonconsumers. CONCLUSIONS: On average, children consumed less than the maximum amounts of 100% juice recommended by the American Academy of Pediatrics. One hundred percent juice consumption was associated with better nutrient intake than in the nonconsumption group and was not associated with weight status or the likelihood of being overweight in children 2 to 11 years of age.

Killion L, Hughes SO, Wendt JC, Pease D, Nicklas TA. · Houston Baptist University, Department of Education and Kinesiology, Houston, Texas, USA. · Int J Pediatr Obes. · Pubmed #17907321 No free full text.

Abstract: OBJECTIVE: To investigate African-American and Hispanic mothers' perceptions of their children's body size using a scale with child figure silhouettes and compare those perceptions with their children's actual body mass index. METHODS: A set of child figure silhouettes was developed depicting 4 and 5 year-old African-American and Hispanic children. Body mass index was systematically estimated for each child figure on the set of silhouettes. Minority mothers with children enrolled in ten Head Start centers (n=192) were interviewed using the silhouettes, and height and weight measurements were taken on their children. Head Start, a comprehensive child development program that serves children aged 3 to 5 years old, was chosen because of the large percentage of minorities, the low-income status of the families, and the age of the children. RESULTS: Significant differences were found between mothers' perceptions of their children's body size and the actual body size of the children. On average, mothers perceived their children to be thinner than their actual size. Furthermore, of those mothers with children at risk for overweight or overweight, two-thirds were either satisfied with their children's existing body size or wanted their children to be heavier. However, half of the mothers of children above the 95th percentile for BMI wanted their children to be thinner. CONCLUSIONS: These data suggest that minority mothers' perceptions of their children's body size may not be consistently biased in one direction. Despite the possible social norm for a larger body size among low-income minorities, some mothers of overweight minority children do perceive their children to be too heavy when they reach a certain size.

Brooks BM, Rajeshwari R, Nicklas TA, Yang SJ, Berenson GS. · Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA. · J Am Coll Nutr. · Pubmed #17229900 links to  free full text

Abstract: OBJECTIVE: To examine the association between calcium intake and dairy product consumption with overweight and obesity in young adults. METHODS: The sample used in this study consisted of 1306 young adults, ages 19-38 years, who participated in the 1995-1996 young adult survey. Analysis was performed with analysis of covariance (ANCOVA) for ethnicity-gender groups separately. RESULTS: No significant association was found between dairy product consumption, calcium intake and overweight, defined by body mass index or waist circumference. However, there was a significant inverse association between calcium intake, low-fat dairy product consumption and waist-to-hip ratio in white males. CONCLUSION: Increasing intake of calcium and low-fat dairy products may be associated with lower abdominal adiposity, particularly in young adult white males.

O'Connor TM, Yang SJ, Nicklas TA. · Department of Pediatrics, Baylor College of Medicine, 6621 Fannin St, CCC1540.00, Houston, TX 77030, USA. · Pediatrics. · Pubmed #17015497 links to  free full text

Abstract: OBJECTIVE: The obesity epidemic in the United States continues to increase. Because obesity tends to track over time, the increase in overweight among young children is of significant concern. A number of eating patterns have been associated with overweight among preschool-aged children. Recently, 100% fruit juice and sweetened fruit drinks have received considerable attention as potential sources of high-energy beverages that could be related to the prevalence of obesity among young children. Our aim was to evaluate the beverage intake among preschool children who participated in the National Health and Nutrition Examination Survey 1999-2002 and investigate associations between types and amounts of beverages consumed and weight status in preschool-aged children. METHODS: We performed a secondary analysis of the data from the National Health and Nutrition Examination Survey 1999-2002, which is a continuous, cross-sectional survey of a nationally representative sample of the noninstitutionalized population of the United States. It included the collection of parent reported demographic descriptors, a 24-hour dietary recall, a measure of physical activity, and a standardized physical examination. The 24-hour dietary recall was obtained in person by a trained interviewer and reflected the foods and beverages that were consumed by the participant the previous day. The National Health and Nutrition Examination Survey food groups were classified on the basis of the US Department of Agriculture's Food and Nutrient Database for Dietary Studies. We reviewed the main food descriptors used and classified all beverages listed. One hundred percent fruit juice was classified as only beverages that contained 100% fruit juice, without sweetener. Fruit drinks included any sweetened fruit juice, fruit-flavored drink (natural or artificial), or drink that contained fruit juice in part. Milk included any type of cow milk and then was subcategorized by percentage of milk fat. Any sweetened soft drink, caffeinated or uncaffeinated, was categorized as soda. Diet drinks included any fruit drink, tea, or soda that was sweetened by low-calorie sweetener. Several beverages were removed from the analysis because of low frequency of consumption among the sample. Water was not included in the analysis because it is not part of the US Department of Agriculture's Food and Nutrient Database categories. For the purposes of this analysis, the beverages were converted and reported as ounces, rather than grams, as reported by the National Health and Nutrition Examination Survey, to make it more clinically relevant. The child's BMI percentile for age and gender were calculated on the basis of Centers for Disease Control and Prevention criteria and used to identify children's weight status as underweight (< 5%), normal weight (5% to < 85%), at risk for overweight (85% to < 95%), or overweight (> or = 95%). Because of the small number of children in the underweight category, they were included in the normal-weight category for this analysis. Data were analyzed using SUDAAN 9.0.1 statistical software programs. SUDAAN allows for improved accuracy and validity of results by calculating test statistics for the stratified, multistage probability design of the National Health and Nutrition Examination Survey. Sample weights were applied to all analyses to account for unequal probability of selection from oversampling low-income children and black and Mexican American children. Descriptive and chi2 analyses and analysis of covariance, adjusting for age, gender, ethnicity, household income, energy intake, and physical activity, were conducted. RESULTS: All children who were aged 2 to 5 years were identified (N = 1572). Those with missing data were removed from additional analysis, resulting in a final sample of 1160 preschool children. Of the 1160 children analyzed, 579 (49.9%) were male. White children represented 35%, black children represented 28.3%, and Hispanic children represented 36.7% of the sample. Twenty-four percent of the children were overweight or at risk for overweight (BMI > or = 85%), and 10.7% were overweight (BMI > or = 95%). There were no statistically significant differences in BMI between boys and girls or among the ethnicities. Overweight children tended to be older (mean age: 3.83 years) compared with the normal-weight children (mean age: 3.48 years). Eighty-three percent of children drank milk, 48% drank 100% fruit juice, 44% drank fruit drink, and 39% drank soda. Whole milk was consumed by 46.5% of the children, and 3.1% and 5.5% of the children consumed skim milk and 1% milk, respectively. Preschool children consumed a mean total beverage volume of 26.93 oz/day, which included 12.32 oz of milk, 4.70 oz of 100% fruit juice, 4.98 oz of fruit drinks, and 3.25 oz of soda. Weight status of the child had no association with the amount of total beverages, milk, 100% fruit juice, fruit drink, or soda consumed. There was no clinically significant association between the types of milk (percentage of fat) consumed and weight status. In analysis of covariance, daily total energy intake increased with increased consumption of milk, 100% fruit juice, fruit drinks, and soda. However, there was not a statistically significant increase in BMI on the basis of quantity of milk, 100% fruit juice, fruit drink, or soda consumed. CONCLUSIONS: On average, preschool children drank less milk than the 2005 Dietary Guidelines for Americans recommendation of 16 oz/day. Only 8.6% drank low-fat or skim milk, as recommended for children who are older than 2 years. On average, preschool children drank < 6 oz/day 100% fruit juice. Increased beverage consumption was associated with an increase in the total energy intake of the children but not with their BMI. Prospectively studying preschool children beyond 2 to 5 years of age, through their adiposity rebound (approximately 5.5-6 years) to determine whether there is a trajectory increase in their BMI, may help to clarify the role of beverage consumption in total energy intake and weight status.

Hughes SO, Anderson CB, Power TG, Micheli N, Jaramillo S, Nicklas TA. · Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Street, Houston, TX 77030-2600, USA. · Appetite. · Pubmed #16504340 No free full text.

Abstract: Current feeding measures have been developed based on the premise that a child's obesity risk is increased when parents exert high levels of control over feeding. Although these measures provide useful ways to assess parental restrictiveness in feeding, they do not capture other important aspects of feeding that describe the behavior of parents not overly concerned about child obesity. Alternative measures are important to develop, especially for minority populations where concerns about child obesity are often not a significant determinant of parental feeding practices. The current study describes a culturally informed method used to develop a broader assessment of parental feeding strategies across two low-income ethnic groups. To be able to accurately measure cultural differences associated with feeding, qualitative and quantitative methods were used to assure conceptual, linguistic, and measurement equivalency across African-American and Hispanic parents. Based on responses from 231 parents, mean differences in feeding strategies were found with Hispanic parents reporting significantly more parent-centered/high control and child-centered feeding strategies compared to African-Americans. Furthermore, the relationship between children's weight status and parental feeding strategies varied by the two ethnic groups and child gender. Implications of these results for understanding the role of parental socialization in the development of child obesity are discussed.

Deshmukh-Taskar P, Nicklas TA, Morales M, Yang SJ, Zakeri I, Berenson GS. · Department of Pediatrics, Baylor College of Medicine, Children's Nutrition Research Center, Houston, TX 77030, USA. · Eur J Clin Nutr. · Pubmed #16132057 No free full text.

Abstract: OBJECTIVE: To understand tracking of overweight status from childhood to young adulthood in a biracial sample. DESIGN: A longitudinal sample was created from cross-sectional surveys at two time points, childhood (baseline) and young adulthood (follow-up). SETTING: Bogalusa Heart Study, Louisiana, United States of America. SUBJECTS: A total of 841 young adults, 19-35 years (68% Euro-Americans (EA), 32% African-Americans (AA)) were studied. The same subjects had also participated in one of the five cross-sectional surveys at childhood (9-11 years). METHODS: Body mass index (BMI) was used to determine overweight status as per the Centers for Disease Control and Prevention standards. Change in the BMI status from childhood to young adulthood was used to group the participants into the following categories: normal weight to normal weight (NW-NW); normal weight to overweight (NW-OW); overweight to normal weight (OW-NW); and overweight to overweight (OW-OW). Tracking of overweight was defined by (1) correlations between baseline and follow-up BMI, (2) Cohen's kappa concordance test to determine the strength of tracking in BMI quartiles and (3) the percentage of individuals who remained in the same overweight status group from baseline to follow-up. RESULTS: From baseline to follow-up, the percentage of participants who were overweight increased from 24.7 to 57.7%. A total of 35.2% of the children shifted from normal weight in childhood to overweight in young adulthood (P < 0.0005). Baseline BMI was positively correlated with follow-up BMI (r = 0.66, P < 0.0005). A total of 61.9% of the participants in the highest BMI quartile in childhood remained in the highest BMI quartile in young adulthood. The strength of tracking in BMI quartiles was 27% for EA men (P < 0.0005), 23% for EA women (P < 0.0005), 27% for AA men (P<0.0005) and 35% for AA women (P < 0.0005). A total of 53.7% of the EA women remained in the NW-NW category and 31.2% of the AA women remained in the OW-OW category. The percentage tracking (NW-NW and OW-OW) was 72.8% in EA women, 59.6% in AA men, 59.5% in AA women and 48.8% in EA men (P < 0.0001). CONCLUSION: Childhood overweight tracked into young adulthood in this sample and the tracking of NW-NW and OW-OW was the most prominent among the EA women.

Anderson CB, Hughes SO, Fisher JO, Nicklas TA. · Department of Pediatrics, Baylor College of Medicine, The Children's Nutrition Research Center, Houston, TX 77030, USA. · Prev Med. · Pubmed #15917048 No free full text.

Abstract: BACKGROUND: Psychometrically sound measures are considered a necessary condition for valid research. This study used structural equation modeling to examine the cross-cultural equivalence of a widely used measure of parental beliefs and practices regarding child feeding, the Child Feeding Questionnaire [Birch L.L., Fisher J.O., Grimm-Thomas K., Markey C.N., Sawyer R., Johnson S.L. Confirmatory factor analysis of the child feeding questionnaire: a measure of parental attitudes, beliefs and practices about child feeding and obesity proneness. Appetite 2001;36:201-10]. METHODS: Low-income parents of 101 Black and 130 Hispanic pre-school children (126 girls, 105 boys) completed a reduced version of the CFQ. RESULTS: Confirmatory factor analyses using LISREL 8.51 supported the hypothesized factor structure but revealed cross-cultural conceptual problems on the perceived child weight factor and problematic items on the restriction factor that were addressed in a modified model. Invariance analyses demonstrated invariance of factor structure, loadings, and covariances in the modified model across ethnic groups. MANCOVA, that controlled for parent BMI and marital status, revealed ethnic differences on the child feeding responsibility, child weight concern, and perceived weight of child factors that were moderated by parent education and child BMI. CONCLUSIONS: Results supported the use of a modified version of the CFQ among Blacks and Hispanics and revealed no ethnic differences on factor scores, except on interactions with parent education and overweight status of child.

Nicklas TA, Demory-Luce D, Yang SJ, Baranowski T, Zakeri I, Berenson G. · Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA. · J Am Diet Assoc. · Pubmed #15215772 No free full text.

Abstract: OBJECTIVE: To evaluate types of foods and amounts consumed by 10-year-old children during the period from 1973 to 1994. DESIGN: One 24-hour dietary recall was collected on each child who participated in one of seven separate cross-sectional surveys of 10-year-olds.Subjects/Setting Dietary intake data was collected on 1,584 10-year-old children (65% Euro American, 35% African American), in Bogalusa, LA, from 1973 to 1994 using SAS 8.0 (1999, SAS Institute Inc, Cary, NC).Statistical analyses performed Data were analyzed to calculate descriptive statistics. Pearson's chi(2) test was used for testing equality of percentage of each food group consumed across the seven surveys. Cochran-Armitage trend test and general linear models were used to test for trends, adjusting for total energy intake, ethnicity, and sex. RESULTS: The percentage of children consuming, and the mean gram amount consumed, significantly decreased for fats/oils (P<.0001), desserts (P<.0001), candy (P<.0001), eggs (P<.001), and milk (P<.0001). In contrast, the percentage of children consuming, and the mean gram amount consumed, significantly increased for fruits/fruit juices (P<.01), mixed meats (P<.01), poultry (P<.0001), and cheese (P<.0001). Despite a significant decrease in the percentage of children consuming vegetables (P<.01) and beef (P<.01), the mean gram amount consumed did not change. The percentage of children consuming breads/grains, pork, and snacks did not change, but the mean gram amount of salty snacks (P<.001) significantly increased and the amount of breads/grains (P<.01) and pork (P<.01) significantly decreased. The percentage of children consuming sweetened beverages (P<.01) and condiments (P<.001) decreased while the mean gram amount consumed increased (P<.05) and (P<.0001). The mean gram amount of lunch and dinner consumed increased (P<.0001) but snacks decreased (P<.0001), resulting in no change in total gram amount consumed in a 24-hour period. CONCLUSIONS: Trends in food consumption patterns of children should be considered in the design and implementation of population-based behavior strategies for the promotion of health and prevention of chronic diseases beginning in childhood.

Nicklas TA, Morales M, Linares A, Yang SJ, Baranowski T, De Moor C, Berenson G. · Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Street, Houston, TX 77030, USA. · J Am Diet Assoc. · Pubmed #15127060 No free full text.

Abstract: OBJECTIVE: The objective of this study was to analyze children's meal patterns over 2 decades. DESIGN: One 24-hour dietary recall was collected on each child who participated in one of seven cross-sectional surveys. SUBJECTS/SETTING: Dietary intake data were collected on 1,584 10-year-old children (65% white, 35% African American), in Bogalusa, LA, from 1973 to 1994. STATISTICAL ANALYSES: Descriptive statistics and one-way analysis of variance adjusting for gender and ethnicity. RESULTS: From 1973 to 1978, there was a marked increase (P<.0001) in the percentage of children who skipped breakfast, from 8.2% to 29.6%. When school breakfast was introduced in 1981, the proportion of children skipping breakfast declined to 12.5% (P<.01). From 1973-1974 to 1993-1994, the percentage of children eating a school lunch declined from 89.7% (1973-1974) to 78.2% (1993-1994) (P<.001); eating lunch brought from home increased from 5.9% to 11.1% (P<.01); consuming a home dinner decreased from 89.2% to 75.9% (P<.01); eating a dinner prepared outside the home increased from 5.4% to 19.0% (P<.01); consuming a meal at a restaurant increased from 0.3% to 5.4% (P<.0001); consuming snacks decreased (P<.0001); total eating episodes decreased from 6.6 to 5.2 (P<.0001); and eating time span significantly decreased from 12.4 hours to 11.5 hours (P<.0001). Despite these changes in meal patterns, no associations were found between meal patterns and overweight status. CONCLUSIONS: Striking alterations in the meal patterns of children occurred over the 2-decade period. These changes may have implications for the changes in the dietary intakes of children during the same time. However, data from this study do not support an association between meal patterns and children's overweight status. Further research with multiple days of assessment is needed to better understand the complexity of diet as it relates to childhood obesity.

Nicklas TA, Yang SJ, Baranowski T, Zakeri I, Berenson G. · Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, Texas 77030, USA. · Am J Prev Med. · Pubmed #12818304 No free full text.

Abstract: BACKGROUND: Childhood obesity is a growing public health problem. This study examined the association between eating patterns and overweight status in children who participated in the Bogalusa Heart Study. METHODS: A single 24-hour dietary recall was collected on a cross-sectional sample of 1562 children aged 10 years (65% Euro-American [EA], 35% African American [AA]) over a 21-year period. Overweight was defined as body mass index greater than the 85th percentile using Centers for Disease Control and Prevention reference standards. Multivariate logistic regression was used to investigate the association between eating patterns and overweight. RESULTS: Consumption of sweetened beverages (58% soft drinks, 20% fruit flavor drinks, 19% tea, and 3% coffee) (p<0.001); sweets (desserts, candy, and sweetened beverages) (p<0.001); meats (mixed meats, poultry, seafood, eggs, pork, and beef) (p<0.051); and total consumption of low-quality foods (p<0.01) were positively associated with overweight status. Total amount of food consumed, specifically from snacks, was positively associated with overweight status (p<0.05). There was a lack of congruency in the types of eating patterns associated with overweight status across four ethnic-gender groups. The percent variance explained from the eating pattern-overweight models was very small. The interaction of ethnicity and gender was significantly associated with overweight status (p<0.001). The odds of being overweight for EA males were 1.2 times higher than for AA females. CONCLUSIONS: These results demonstrate that numerous eating patterns were associated with overweight status, yet the odds of being overweight were very small. Additional studies are needed to confirm these findings in a longitudinal sample having multiple days of assessment.

Nicklas TA, von Duvillard SP, Berenson GS. · Professor of Pediatrics, Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA. · Int J Sports Med. · Pubmed #12012261 No free full text.

Abstract: Our data demonstrate that serum lipid and lipoprotein levels continue to track from childhood into young adulthood. The persistence and clustering of multiple CVD risk factors from childhood to adulthood and the impact of obesity in this regard point to the need for preventive measures aimed at developing healthy lifestyles early in life. Adverse levels of LDL-C in childhood persist over time, progress to adult dyslipidemias, and relate to obesity and hypertension as well. NCEP guidelines which classify CVD risk on the basis of LDL-C level, are helpful in targeting individuals at risk early in life.