Adolescent Diet Research Articles

Adolescent diets: balanced nutrition education to achieve optimal nutritional status

Balanced nutrition practices include knowledge and attitudes towards consuming balance nutritious foods and implementing healthy behaviors. Selection of a balanced nutritional menu and good nutrition intake will determine optimal nutritional and health status. The community service activity in the form of counseling on a balanced nutritional diet for Students of SMKN 24 Cipayung East Jakarta are an effort to achieve optimal nutritional status in adolescents and are expected to be an important momentum to remind the public, especially adolescents, about the importance of balanced nutrition and how to choose healthy and nutritious food. This community service is in the form of providing education regarding a balanced nutritional diet for adolescents. The assessment was carried out using a pre-test before counseling and a post-test after counseling. The educational results revealed an increase in knowledge about a balanced nutritional diet of 14.83 points, from an average value of 63.50 (before counseling) to 78.33 (after counseling). The different test results obtained a p-value of 0.0005. It can be concluded that there is an increase in students' knowledge about a balanced nutritional diet after counseling.

Socio-ecological predictors of dietary inflammatory scores and associations with childhood and adolescent adiposity: A protocol for a rapid scoping review of observational studies.

Diet-related inflammation is associated with adiposity. Obesity and inflammation in early life may have adverse health outcomes in later life; however, the socio-ecological predictors of a pro-inflammatory diet in childhood and adolescence are not well understood. This rapid scoping review aims to summarise the current state of research from observational studies investigating socio-ecological predictors (childhood, parental, familial, demographic and chronobiological risk factors) and their association with diet-associated inflammation and adiposity in children and adolescents. This scoping review will be conducted using the frameworks based on the Joanna Briggs Institute and Arksey and O'Malley and the Population, Concept and Context (PCC) mnemonic. Searches were conducted in OVID Medline, Cinahl and Embase, with adaptations as required. The piloted study selection process will utilise two reviewers for study selection, with reference lists checked for included studies. A third reviewer will moderate disagreements. Data will be extracted by one reviewer and calibrated by a second reviewer. The results will be reported using the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist and PRISMA-ScR flow diagram. The main findings will be synthesised into themes and concepts narratively. Tables and graphs will present frequencies, study details and categorical descriptions. This scoping review will provide an overview of the research conducted to date regarding predictors of diet-related inflammation in childhood and their associations with adiposity. Better understanding of the factors associated with a more inflammatory diet in childhood may be useful for clinicians and policy makers when designing and implementing health interventions.

DIETARY PRACTICES AND ITS INFLUENCE ON THE NUTRITIONAL STATUS OF A GROUP OF ADOLESCENTS FROM AN ANDEAN ZONE OF ECUADOR

Introduction: Food is a fundamental aspect of human health and well-being, especially during adolescence, a stage of rapid growth and physical and mental development, the feeding practices of adolescents directly influence their nutritional status and the health and well-being of this population group. Objective: to explore the feeding practices of a group of adolescents aged between 12 and 18 years, from Tisaleo canton, Ambato canton. Methods: descriptive descriptive qualitative cross-sectional study, through a self-administered online survey, using different platforms and social networks such as Facebook, Instagram, Twitter, WhatsApp, with closed multiple-choice questions , with a Non-probability convenience sampling of the type of uncontrolled instrument distribution, applied to 60 adolescent volunteers who agreed to participate and answer the survey Results: 66.66% are women while 33.33% men, women have lower values of weight, height and BMI than men, 63.33% of adolescents have a normal nutritional status, 23.33% underweight and 13.33% malnutrition due to excess (10% overweight and 3.33% obesity). Therewas a statistically significant relationship between physical activity and nutritional status of young people, with a p-value of 0.02981 in the χ² test. Hay a significant correlation between the consumption of breakfast, lunch and snack with the nutritional status of the adolescents investigated Conclusions: this study offers a valuable insight into feeding practices and their influence on the nutritional status of adolescents in an Andean area of Ecuador. The results obtained highlight the need to address this problem in a comprehensive manner, involving the community, the health sector and other relevant actors in the promotion of a healthy and balanced diet for adolescents.

The relationship between the nutritional literacy level and heart health attitudes of adolescents

PurposeIt was aimed to evaluate the effect of adolescents' nutritional literacy level on their heart health attitudes. MethodsThis is a descriptive and cross-sectional study. Data from 416 adolescents were obtained in the study. The Adolescent Nutrition Literacy Scale (ANLS) and the Cardiovascular Health Behavior Scale for Children (CHBSC) were completed by participants. The adolescents' demographic information, lifestyle, and diet habits were collected. The results were analyzed using descriptive statistics and multivariable regression. ResultsThe participants' mean scores of the ANLS and the CHBSC were as 68.30 ± 8.68 and 67.55 ± 8.45, respectively. It was determined that 88.7% of the adolescents had moderate attitudes towards heart health and that there was a weak and negative correlation between the ANLS and CHBSC scores (r = −0,207; p < 0.001). It was determined that there was a statistically significant difference in ANLS and CHBSC scores in terms of gender, Body Mass Index (BMI), fast food consumption frequency, what they primarily pay attention to in food, weekly exercise frequency, the amount of daily water consumption, general health status and reading the label of packaged products (p < 0.05). It was determined that exercising, general state of health, BMI, consumption of fast food, and reading the label of packaged products were key predictors of CHBSC scores. Additionally, exercising, consumption of fast food, and reading the label of packaged products were identified as key predictors of ANLS scores. ConclusionsOur analysis suggests that higher levels of nutritional literacy are related to more positive attitudes towards heart health in adolescents. Additionally, our analysis identifies key predictors of both nutrition literacy and heart health behaviors. Practice implicationsSchool health nurses should consider the variables influencing these parameters to improve attitudes towards nutritional literacy and heart health in adolescents.

Trends in Adherence to the Mediterranean Diet in Spanish Children and Adolescents across Two Decades.

Unhealthy dietary habits determined during childhood may represent a risk factor to many of the chronic non-communicable diseases (NCDs) in adulthood. Mediterranean Diet (MD) adherence in children and adolescents (8-16 years) living in Spain was investigated using the KIDMED questionnaire in a comparative analysis of two cross-sectional nationwide representative studies: enKid (1998-2000, n = 1001) and PASOS (2019-2020, n = 3540). Taking into account the educational level of pupils, as well as the characteristics of the place of living, a significant association was found between a KIDMED score ≥ 8 (optimal MD adherence) and primary education as well as residency in an area of <50,000 inhabitants, while living in the southern regions was associated with non-optimal MD adherence (p < 0.001). Participants of the 2019-2020 study showed an increase in the consumption of dairy products (31.1% increase), pasta/rice (15.4% increase), olive oil (16.9% increase), and nuts (9.7% increase), as well as a decreased sweets and candies intake (12.6% reduction). In contrast, a significantly lower MD adherence was found when comparing the 2019-2020 (mean ± SE: 6.9 ± 0.04) and the 1998-2000 study (7.37 ± 0.08); p < 0.001), due to less consumption of fish (20.3% reduction), pulse (19.4% reduction), and fruits (14.9% reduction), and an increased intake of commercial goods/pastries or fast-food intake (both 19.4% increase). The lowest adherence was recorded for adolescents also in the most recent study, where 10.9% of them presented a KIDMED score ≤ 3. This study shows that eating habits are deteriorating among Spanish children and adolescents. Such findings point out the urgency of undertaking strong measures to promote the consumption of healthy, sustainable, and non-ultra-processed food, such as those available in an MD, not only at a scientific and academic level, but also at a governmental one.

Fruit Juice Consumption, Body Mass Index, and Adolescent Diet Quality in a Biracial Cohort

Fruit juice consumption during childhood remains controversial. Here, we evaluated the association between preadolescent 100% fruit juice intake and later adolescent diet quality and body mass index (BMI). We used prospective data over 10 years from the National Growth and Health Study for 1921 black and white girls, ages 9–10 years at baseline, for analyses of diet quality, and 2165 girls for BMI analyses. Statistical analyses included repeated measures analysis of variance and logistic regression models. Girls who drank ≥1.0 cup/day of fruit juice in preadolescence consumed 0.44 cup/day more total fruit in later adolescence than non-juice-drinking girls (p &lt; 0.0001). White and black girls who drank ≥1.25 cups/day in preadolescence were 2.62 (95% CI: 1.35–5.08) and 2.54 (1.27–5.07) times more likely, respectively, to meet the Dietary Guidelines for whole fruit by later adolescence than those with the lowest juice intakes. Further, fruit juice consumption was positively associated with diet quality scores. Overall, girls consuming ≥1.25 cups/day of juice had a BMI in late adolescence that was 1.7 kg/m2 lower than that of non-juice-drinking girls. In conclusion, early adolescent fruit juice intake was positively associated with subsequent whole fruit consumption, better diet quality, and lower BMI in later adolescence.

A Sociodemographic Analysis of the Impact of COVID-19-Related Schools’ Closure on the Diet and Physical Activity of Children and Adolescents in Qatar

ObjectivesTo assess the impact of the COVID-19-related closure of government schools in Qatar on children and adolescents' dietary habits and physical activities and associated sociodemographic factors.MethodsAn analytical cross-sectional study was conducted between June and August 2022 utilizing the national electronic health records system in Qatar to extract a sampling frame of students enrolled in governmental schools, specifically targeting students in 3rd to 9th grades, stratified by sex and developmental stage. A stratified sampling technique was employed to randomly select a proportionate number of students from each stratum, and data were collected through telephone interviews with the parents of selected students.ResultsA total of 1546 interviews were completed by the end of the study. Of the included sample, 845 (54.7%) were between 8 and 11 years of age (middle childhood), while the rest were 12–15 years old (young teens and teenagers). Male to female ratio was almost 1:1. We found a significant decrease in the intake of vegetables, increases in the intake of soft drinks, fried food, fast food, and sweets, and a reduction in physical activity during schools’ closure compared to before. Higher parental educational levels, maternal employment, and having a positive family history of obesity and/or overweight in first-degree relatives were significantly associated with adverse lifestyle changes during schools’ closure.ConclusionThe trends of lifestyle changes reported in this study during the periods of COVID-19-related schools’ closure were found to be going in a health-compromising direction. These results underscore the importance of implementing targeted interventions to promote healthy lifestyles during such disruptions and emphasize the need to address lifestyle changes beyond emergencies and outbreaks to mitigate potential long-term health consequences, including the increased risk of non-communicable diseases.

Ketogenic diet in children and adolescents: The effects on growth and nutritional status

The ketogenic diet is known to be a possible adjuvant treatment in several medical conditions, such as in patients with severe or drug-resistant forms of epilepsy. Its use has recently been increasing among adolescents and young adults due to its supposed weight-loss effect, mediated by lipolysis and lowered insulin levels. However, there are still no precise indications on the possible use of ketogenic diets in pediatric age for weight loss. This approach has also recently been proposed for other types of disorder such as inherited metabolic disorders, Prader-Willi syndrome, and some specific types of cancers. Due to its unbalanced ratio of lipids, carbohydrates and proteins, a clinical evaluation of possible side effects with a strict evaluation of growth and nutritional status is essential in all patients following a long-term restrictive diet such as the ketogenic one. The prophylactic use of micronutrients supplementation should be considered before starting any ketogenic diet. Lastly, while there is sufficient literature on possible short-term side effects of ketogenic diets, their possible long-term impact on growth and nutritional status is not yet fully understood, especially when started in pediatric age.

Adherence to the Mediterranean diet in Greek adolescents during COVID-19: exploring determining factors through cross-sectional study

PurposeDuring the pandemic, people have changed their diet and lifestyle, which are highly important to maintain health and well-being. This study aims to investigate the relationship between demographic, socioeconomic, dietary and lifestyle characteristics and adolescents' adherence to the Mediterranean diet (AMD).Design/methodology/approachIn all, 2088 youth from Attica, Greece, 12–18 years old, were recruited in this school-based, cross-sectional study conducted in May–December 2021. The tools Mediterranean Diet Quality Index for children and adolescents, the Family Affluence Scale III and the Godin-Shephard Leisure Time Physical Activity Questionnaire were used to estimate AMD, family affluence and the levels of physical activity (PA), respectively. Mann–Whitney U, Kruskal–Wallis, Chi-square tests, analysis of variance and multiple linear regression approaches were applied.FindingsEmpirical results showed that boys (p = 0.000), higher socioeconomic status (p = 0.034) and higher maternal education (p = 0.026) emerged as significant determinants for higher AMD. In addition, healthier dietary patterns (p = 0.000), PA (p = 0.000), more social lifestyle (p = 0.000) and night sleep duration (p = 0.000) were also positively correlated to diet quality. On the contrary, age (p = 0.000), screen time (p = 0.003) and the negative consequences of COVID-19 affected adversely AMD among adolescents.Originality/valueTo the best of the authors’ knowledge, this study was the first that highlighted the important role of several demographic, socioeconomic, dietary and lifestyle characteristics, together with the COVID-19 consequences to the AMD among secondary school children in Greece.

Adherence to the World Cancer Research Fund/American Institute for Cancer Research cancer prevention recommendations throughout the life course and risk of colorectal cancer precursors.

Despite the increasing incidence in colorectal cancer (CRC) among the young population, the involvement of modifiable early-life exposures is understudied. We prospectively investigated the association of lifestyle score, which measures adherence to the 2018 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) cancer prevention recommendations, in adolescence and adulthood with risk of CRC precursors in 34,509 women enrolled in the Nurses' Health Study II. Participants reported adolescent diet in 1998 and subsequently underwent at least one lower gastrointestinal endoscopy between 1999 and 2015. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using multivariable logistic regression for clustered data. During follow-up (1998-2015), 3036 women had at least one adenoma, and 2660 had at least one serrated lesion. In multivariable analysis, per unit increase in adolescent WCRF/AICR lifestyle score was not associated with risk of total adenoma or serrated lesions, in contrast to adult WCRF/AICR lifestyle score (OR = 0.92, 95% CI: 0.87-0.97, Ptrend = 0.002 for total adenoma; and OR = 0.86, 95% CI: 0.81-0.92, Ptrend < 0.001 for total serrated lesions). Adherence to the 2018 WCRF/AICR recommendations during adulthood but not during adolescence was associated with a lower risk of CRC precursors.

Dietary intake and quality for young adolescents in sub‐Saharan Africa: Status and influencing factors

Adolescents face the risk of the triple burden of malnutrition-the co-existence of micronutrient deficiencies, underweight and overweight and obesityand related noncommunicable diseases. Poor-quality diets are a modifiable risk factor for all forms of malnutrition in adolescents. However, there is limited knowledge about diet quality for African adolescents. We analyzed data from 4609 school-going adolescents aged 10-15 years in Burkina Faso, Ethiopia, Sudanand Tanzania. Dietary intake was assessed using food frequency questionnaires, and diet quality computed using the Global Diet Quality Score (GDQS). Generalized estimating equations linear regression models were used to evaluate factors associated with adolescent diet quality. Mean adolescent age was 12.4 (±1.4) years and 54% of adolescents were female. Adolescents reported physical activity on 1.5 (±1.7) days/week. The mean GDQS (±SD) was 20.6 (±4.0) (maximum 40). Adolescent consumption of vegetables, fruit, nuts and seeds, eggs, fish and poultry was low, and refined grain consumption was relatively high. Boys consumed unhealthy foods less frequently but consumed fewer cruciferous vegetables and deep orange tubers. Older adolescents had higher fish and lower red meat consumption. Having an unemployed mother versus farmer (estimate -2.60, 95%confidence interval [CI]: -4.81, -0.39), and having 3-4 days of physical activity per week versus none (estimate 0.64, 95%CI: 0.11, 1.17) were associated with GDQS. We found evidence of poor-quality adolescent diets and gender and age differences in the consumption of healthy diets. Programs to address poor-quality diets should consider tailoring interventions for adolescent girls and boys of different ages and also consider the role of physical activity in these contexts.

Unhealthy nutrition among teenagers in the city of Bielsko-Biała

Introduction: Unhealthy nutrition results from inappropriate eating behaviours that lead to changes in body weight. Consuming excessive amounts of salt, sugar, carbonated drinks, alcohol combined with physical inactivity causes overweight or obesity. In order to prevent incorrect nutrition, it is necessary to prevent overnutrition and to promote health-promoting behaviours that should be targeted at specific groups of the society. Such initiatives may limit or even exclude the emergence of incorrect nutrition which contributes to an increase in the incidence of lifestyle diseases. Objective: The aim of the article is to present and discuss the forms of spending free time, participation in physical education classes, and dietary habits of third-year secondary school students in the city of Bielsko-Biała (Poland). Materials and methods: An original questionnaire entitled “My health – something I care about” was used for the study. The questionnaire included questions about the diet, forms of spending free time, and participation in physical education classes at school. Results: Based on the questionnaire findings, watching TV is the most common form of spending free time (37% boys and 32% girls). Only 7% of girls and 18% of boys chose participation in sports as a form of spending their free time. 28% of boys and as much as 39% of girls admitted that they did not participate in physical education classes at school. The type of drinks consumed by secondary school pupils was significantly dependent on their gender. Regarding the type of lunch, sweet buns are chosen by 31% of boys and 23% of girls. Fruit is declared as their preferred lunch snack by 28% of the surveyed girls and only 2% of boys. Conclusions and discussion: The study has shown that there are many abnormalities in the diet of adolescents. The widespread belief that a slim figure is an asset nowadays prompts many young people to use various weight loss diets or fasting which, if used excessively, can pose a threat to the developing body systems. Information gathered from the respondents also shows that they do not have sufficient physical activity. Secondary school pupils increasingly choose passive recreation because physical activity does not give them as much satisfaction as, for example, playing computer games.

Food environment around schools and adolescent consumption of unhealthy foods in Addis Ababa, Ethiopia.

Adolescent diets may be influenced by the retail food environment around schools. However, international research to examine associations between the proximity of retail food outlets to schools and diet provides equivocal support for an association. This study aims to understand the school food environment and drivers for adolescents' consumption of unhealthy foods in Addis Ababa, Ethiopia. Mixed-methods research was conducted, 1200 adolescents (10-14 years) from randomly selected government schools were surveyed, along with vendors within 5-min' walk of the schools and focus group discussions (FGDs)with adolescent groups. Mixed-effect logistic regression investigated the relationship between the number of vendors around the schools and the consumption of selected unhealthy foods. Thematic analysis was used to summarize findings from the FGDs. Consumption of sweets and sugar-sweetened beverages (S-SSB)and deep-fried foods (DFF)at least once a week was reported by 78.6% and 54.3% of the adolescents, respectively. Although all schools were surrounded by food vendors selling DFF and S-SSB,consumption was not associated with the number of vendors available around the school. However, adolescents' awareness and perception of healthy food, and their concerns about the safety of foods in the market, influenced their dietary choices and behaviours. Lack of financial resources to purchase food as desired also played a role in their selection of food and eating habits. Reported unhealthy food consumption is high among adolescents in Addis Ababa. Thus, further research is warranted to come up with school-based interventions that promote access and healthy food choices among adolescents.

Improvement of Diet after an Early Nutritional Intervention in Pediatric Oncology

Pediatric cancer survivors may experience cardiometabolic sequelae over the course of their lives as a result of the treatments they have received. While nutrition consists of an actionable target for cardiometabolic health, few nutritional interventions have been documented in this population. This study assessed the changes in diet during a one-year nutritional intervention for children and adolescents undergoing cancer treatments and the participants' anthropometric and cardiometabolic profiles. A total of 36 children and adolescents (mean age: 7.9 years, 52.8% male) newly diagnosed with cancer (50% leukemia) and their parents underwent a one-year individualized nutrition intervention. The mean number of follow-up visits with the dietitian during the intervention was 4.72 ± 1.06. Between the initial and one-year assessments, there was an improvement in diet quality reflected by the Diet Quality Index (5.22 ± 9.95, p = 0.003). Similarly, the proportion of participants with moderate and good adherence (vs. low adherence) to the Healthy Diet Index score almost tripled after one year of intervention (14% vs. 39%, p = 0.012). In parallel, there was an increase in the mean z-scores for weight (0.29 ± 0.70, p = 0.019) and BMI (0.50 ± 0.88, p = 0.002), and in the mean levels of HDL-C (0.27 ± 0.37 mmol/L, p = 0.002) and 25-hydroxy vitamin D (14.5 ± 28.1 mmol/L, p = 0.03). Overall, this study supports that a one-year nutritional intervention deployed early after a pediatric cancer diagnosis is associated with an improvement in the diets of children and adolescents.

Dental Erosion and Diet in Young Children and Adolescents: A Systematic Review

Dental erosion is the irreversible loss of tooth enamel caused by acid attack without any bacterial involvement. Interest in dental erosion has increased considerably during the past decade. This paper aims to determine the prevalence of and association of dental erosion with diet or beverages in children. A systematic review of the literature has been carried out in accordance with the PRISMA recommendations. A search was performed in PubMed, Embase Scopus and Web of Science databases, and completed manually. Those studies that dealt with erosive risk factors related to diet and that included their effect on deciduous or mixed dentition were selected. Dual independent screening, data extraction and risk of bias assessment were concluded. A total number of 708 articles were identified from the initial electronic search of the four databases. Some 466 articles were selected after duplicated articles were discarded. After reading the title and abstract, we eliminated 376 articles; the remaining 90 were meant to be read in order that we could dispatch the ones that did not answer the research question or the inclusion criteria. A total of 25 articles remained for the systematic review. Erosive lesions are favored by the consumption of carbonated and isotonic drinks, fruit juices and acid sauces. Carbonated, isotonic drinks and fruit drinks favor the development of erosive lesions, not so the consumption of fruit juices mixed with dairy products such as milkshakes, yogurts and/or tea. The findings of this article will help researchers, academics and students to characterize the scientific results regarding dental erosion and diet, to evaluate management strategies and to identify significant topics and questions that will help to design future research with the aim of the prevention of the disease. Registration number: CDR42023389750.

Keto Is Not Just for Kids: A Randomized Trial of a Modified Atkins Diet for Adolescents and Adults With Anti-Seizure Medication-Resistant Epilepsy.

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Snacking Habits, Strict Diet, BMI, and Body Image of Adolescents in Three Sub-Districts in Depok and Bogor

Background: Body image is related to adolescent food preferences, which determine their nutritional status. Peri-urban areas might have different adolescents' snacking habits, strict diets, nutritional status, and body image. Objectives: This study aimed to analyze the association between adolescents' snacking habits, implementation of a strict diet, and nutritional status on their body image. Methods: This study used a mix-method, a combination of the quantitative and qualitative survey with a cross-sectional design. A total of 39 adolescents aged 15-18 who live in the peri-urban areas of Depok and Bogor were consecutively selected. The study was conducted in January 2022. Quantitative data include respondents' characteristics, body weight and height, snacking habits, and body image. Qualitative data collected were types of snacks, their reasons for buying snacks, and perceptions of ideal weight. Results: The nutritional status of the respondents was underweighted (5%), normal (92%), and overweight (3%), with snacking frequency 4-7 times/week (59%) with a weekly snacking expenditure of IDR 15,000 – 30,000 (49 %). As many as 23% of respondents performed a strict diet and perceived having a thin (21%) and fat (23%) body image. Adolescents with normal nutritional status were perceived as having fat (20.5%) and thin (15.4%) body image (p: 0,0215). There was also a relationship between diet (p: 0.0084) and weekly snacking expenditure (p: 0.0152) with body image, and there was no relationship between snacking frequency (p: 0.3123) and daily meal frequency (p-value=0.3972) with body image. Conclusions: A wrong perception of body image from actual nutritional status can affect snacking habits and the implementation of a strict diet among adolescents.

Abstract P125: Patterns in Timing of Energy Intake and the Impact on Fat Mass in Adolescents

Introduction: Pediatric obesity is excessively high, tracks into adulthood, and increases the risk of multiple chronic diseases (e.g., heart disease). There are dietary guidelines to help prevent childhood obesity, but they do not account for the timing of energy intake, which may be associated with obesity, independent of diet content. We aimed to determine: 1) energy intake timing patterns in adolescents, 2) if energy intake timing patterns differed by sociodemographic factors, and 3) if energy intake timing patterns associated with obesity-related outcomes. Methods: The Sleep and Growth Study (S-Grow) assessed diet in adolescents using three 24hr diet recalls in 8 th and 9 th grade. Time-stamped meals were analyzed using Nutrient Data System for Research software. We calculated the average energy (kcal) consumed for two-hour intervals during the 24-hour day (e.g., 00:00-01:59, 02:00-03:59, etc.) and input the 12 energy intake timing variables into a principal component model to identify energy intake timing patterns. Principal components (PC) with an eigen value 1.0 were retained. Linear mixed effect models were used to determine if sociodemographic factors associated with standardized PC loading scores and if the standardized PC loading scores associated with body mass index (BMI) and fat mass index (FMI, measured by dual energy X-ray absorptiometry), adjusting for sociodemographic factors. Results: Five PCs were identified explaining 58.6% of variance in timing of energy intake. Compared to females, male adolescents were more likely to have a higher PC1 score, corresponding to a “low overnight, moderate morning, high daytime and early evening” intake pattern (beta=0.57, 95% CI=0.20, 0.94). Adolescents living in households with $40-69K (compared to &gt;$99K) annual income were more likely to have a higher PC4 score, corresponding to a “high later evening and overnight, moderate morning, low afternoon and early evening” intake pattern (beta=0.44, 95% CI=0.05, 0.83). Adolescents living in households with &lt;$40K (compared to &gt;$99K) annual income were more likely to have a higher PC5 score, corresponding to a “low overnight, high morning, moderate prolonged daytime and late evening” intake pattern (beta=-0.93, 95% CI=-1.66, -0.19). In addition, the PC5 loading score was associated with lower BMI (beta=-1.38, 95% CI=-2.18,-0.58) and lower FMI (beta=-0.94, 95% CI=-1.45,-0.43). Conclusion: We detected distinct energy intake timing patterns in adolescents. Demographic factors were associated with some of the energy intake patterns, and the energy intake pattern corresponding to “low overnight, high morning, moderate prolonged daytime and late evening” (PC5) was associated with obesity-related outcomes. These findings need to be replicated but point to future pediatric dietary guidelines considering the timing of energy intake for obesity prevention.

Factors Associated with Diet Quality among Adolescents in a Post-Disaster Area: A Cross-Sectional Study in Indonesia.

The diet quality of adolescents in low-middle-income countries is low. Especially in post-disaster areas, adolescents are not a priority target for handling nutritional cases compared with other vulnerable groups. The aim of this study was to examine the factors associated with diet quality among adolescents in post-disaster areas in Indonesia. A cross-sectional study was performed with 375 adolescents aged 15-17 years, representing adolescents living close to the areas most affected by a significant disaster in 2018. The variables obtained include adolescent and household characteristics, nutritional literacy, healthy eating behavior constructs, food intake, nutritional status, physical activity, food security, and diet quality. The diet quality score was low, with only 23% of the total maximum score. Vegetables, fruits, and dairy scored the lowest, whereas animal protein sources scored the highest. Higher eating habits of animal protein sources; being healthy; normal nutritional status of adolescents; higher vegetable and sweet beverage norms of mothers; and lower eating habits of sweet snacks; animal protein sources; and carbohydrate norms of mothers are associated with higher diet quality scores in adolescents (p < 0.05). Improving the quality of adolescent diets in post-disaster areas needs to target adolescent eating behavior and changes in mothers' eating behavior.

Epidemiology and Risk Factors for Breast Cancer: 21st Century Advances, Gaps to Address through Interdisciplinary Science.

Research methods to study risk factors and prevention of breast cancer have evolved rapidly. We focus on advances from epidemiologic studies reported over the past two decades addressing scientific discoveries, as well as their clinical and public health translation for breast cancer risk reduction. In addition to reviewing methodology advances such as widespread assessment of mammographic density and Mendelian randomization, we summarize the recent evidence with a focus on the timing of exposure and windows of susceptibility. We summarize the implications of the new evidence for application in risk stratification models and clinical translation to focus prevention-maximizing benefits and minimizing harm. We conclude our review identifying research gaps. These include: pathways for the inverse association of vegetable intake and estrogen receptor (ER)-ve tumors, prepubertal and adolescent diet and risk, early life adiposity reducing lifelong risk, and gaps from changes in habits (e.g., vaping, binge drinking), and environmental exposures.