Dortmund Nutritional And Anthropometric Longitudinally Designed Study Research Articles

Environmental sustainability of diets among children and adolescents in the German DONALD cohort study: age and time trends, and nutrient adequacy

BackgroundIdentifying diets beneficial for both human and planetary health has become increasingly important. However, to date, there is limited research on sustainable diets for children and adolescents, a vulnerable population group with specific nutritional needs. ObjectivesWe aimed to identify 1) the main determinants; 2) age and time trends of greenhouse gas emissions (GHGE), land use (LU), and water use (WU) of diets of children and adolescents; and 3) analyze the associations of dietary GHGE, LU, and WU with nutrient adequacy. MethodsA total of 5510 3-d-weighted dietary records (n = 856; 6–17 y; 48% ♀) of the DONALD (DOrtmund Nutritional and Anthropometric Longitudinally Designed) study between 2000 and 2021 were analyzed. Values of GHGE (kgCO2eq), LU (m2 × year), and WU (L) determined by life cycle assessment were assigned to all recorded foods. For nutrient adequacy, the mean adequacy ratio (MAR = ∑(nutrient intake / recommended intake) / number of nutrients) was used. Data were analyzed using polynomial mixed-effects regression models. ResultsThe main contributors to GHGE and LU were meat products (GHGE: 25.6%; LU: 32.8%), dairy products (22.2%; 17.7%), and sweets and pastries (14.0%; 14.3%); to WU, nonalcoholic beverages (24.3%), meat products (18.9%), and vegetables and fruits (17.7%). GHGE, LU, and WU per 1000 kcal increased with age (P < 0.01). GHGE and LU per 1000 kcal increased between 2000 and 2010 and decreased after that in females (P < 0.01) and males (GHGE only: P = 0.02). No significant time trend was found for WU (P > 0.05). A higher MAR was directly associated with GHGE/1000 kcal (MAR: β: 0.011, 95% CI: 0.008, 0.013, P < 0.0001), LU/1000 kcal (MAR: β: 0.009, 95%CI: 0.005, 0.013, P < 0.0001), and WU/1000 kcal (MAR: β: 0.429, 95% CI: 0.325, 0.533, P < 0.0001). ConclusionsOur findings underscore the further need and the capacity for change toward more environmentally sustainable diets. Yet, the tradeoff between environmental sustainability and nutrient adequacy in the diets of children and adolescents requires specific attention to dietary composition.

The association between dairy intake in adolescents on inflammation and risk markers of type 2 diabetes during young adulthood: results of the DONALD study.

The aim of this analysis was to investigate whether habitual intake of total dairy (TD) or different dairy types (liquid, solid, fermented, non-fermented, low-fat, high-fat, low-sugar and high-sugar dairy) during adolescence is associated with biomarkers of low-grade inflammation as well as risk factors of type 2 diabetes in young adulthood. Multivariable linear regression analyses were used to investigate prospective associations between estimated TD intake as well as intake of different types of dairy and a pro-inflammatory score, based on high-sensitivity C-reactive protein, IL-6, IL-18, leptin and adiponectin, and insulin resistance assessed as Homeostasis Model Assessment Insulin Resistance in an open-cohort study. Dortmund, Germany. Data from participants (n 375) of the DOrtmund Nutritional and Anthropometric Longitudinally Designed (DONALD) study were included, for whom at least two 3-d weighed dietary records during adolescence (median age: 11 years) and one blood sample in young adulthood (>18 years) were available. There was no statistically significant association between TD intake or intake of any dairy type and the pro-inflammatory score (all P > 0·05). TD intake as well as each dairy type intake and insulin resistance also showed no association (all P > 0·05). The habitual intake of dairy or individual types of dairy during adolescence does not seem to have a major impact on low-grade systemic inflammation and insulin resistance in the long term. There was no indication regarding a restriction of dairy intake for healthy children and adolescents in terms of diabetes risk reduction.

Cohort profile update-overview of over 35years of research in the Dortmund Nutritional and Anthropometric Longitudinally Designed (DONALD) study.

To provide an update on the cohort profile of the DOrtmund Nutritional and Anthropometric Longitudinally Designed (DONALD) study, including objectives, study design, methods and description of the comprehensive data pool, as well as to summarize the most important research findings of recent years. In 1985, the open (dynamic) cohort started to collect information on diet, growth, development, and metabolism of healthy children and adolescents in Dortmund, Germany. Detailed data are collected annually during infancy, childhood, and adolescence of the participants, including a 3-day weighed dietary record, a 24-h urine sample, anthropometric and medical examinations as well as interviews on lifestyle. Even if the basic examination modules have not changed since the start over 35years ago, the DONALD study has been continuously further developed by introducing new modules. As such, participants are also invited for follow-up examinations during adulthood since 2005, including an additional fasting blood withdrawal. Overall, 2375 (♂: 1177; ♀: 1198) participants were recruited in the DONALD study between 1985 and 2022. Data from ~ 30,700 anthropometric measurements, ~ 19,200 dietary records, ~ 10,600 24-h urine and ~ 1300 blood samples are available from an observation period of over 35years. The DONALD study provides a large data pool for longitudinal studies on nutrition, growth, and health in childhood and adolescence, its impact on the development of diseases in early adult life as well as dietary intake trends over more than three decades.

Chronobiological changes due to school closures during the COVID-19 pandemic among adolescents in the DOrtmund Nutritional and Anthropometric Longitudinally Designed cohort study

Due to the lockdown of schools as one of the COVID-19 control measures, adolescents have had the opportunity to re-organise their daily lives; e.g. some of them have adapted their bedtimes to the new situation during the lockdown in favour of their own chronotype. Hence, we investigated differences in chronobiological characteristics (e.g., the midpoint of sleep, sleep duration or social jetlag (SJL); i.e., a discrepancy between biological and social timing) before and during the pandemic lockdown to examine potential changes. We asked participants from the ongoing open cohort Dortmund Nutritional and Anthropometric Longitudinally Designed (DONALD) study to fill out the Munich Chronotype Questionnaire during the COVID-19 lockdown and received the information of participants (n = 66) during the pandemic. A reference group matched for age, season, and sex was randomly selected from the DONALD study to assess participants’ chronobiological characteristics prior to (n = 132) the pandemic. Analyses of covariance were applied to examine differences between the two groups reflecting the situation before and during the COVID-19 pandemic. Participants were aged 9–18 years (52% males). In the current examination, average sleep duration across the week was higher among adolescents during the pandemic (β = 00:30; p = 0.0006) and social jetlag was significantly lower (β = −00:39; p < 0.0001). Conclusion: Our results showed that the COVID-19 lockdown enabled adolescents to adapt their sleeping habits according to their naturally late chronotype, which led to a significant reduction in SJL. These observations are likely to be explained by the effect of school closure.What is Known:• Under ‘normal conditions’ without pandemic lockdowns, adolescents accumulate a lack of sleep due to social obligations such as school starts, resulting in social jetlag.• A late chronotype or exposure to social jetlag is a known risk factor for the development of chronic diseases.What is New:• The COVID-19 lockdown represents a ‘natural experiment’ that enables adolescents to adhere to their internal biological clock. Without the usual social obligations, social jetlag can be significantly reduced.

Exploring the association of physical activity with the plasma and urine metabolome in adolescents and young adults

BackgroundRegular physical activity elicits many health benefits. However, the underlying molecular mechanisms through which physical activity influences overall health are less understood. Untargeted metabolomics enables system-wide mapping of molecular perturbations which may lend insights into physiological responses to regular physical activity. In this study, we investigated the associations of habitual physical activity with plasma and urine metabolome in adolescents and young adults.MethodsThis cross-sectional study included participants from the DONALD (DOrtmund Nutritional and Anthropometric Longitudinally Designed) study with plasma samples n = 365 (median age: 18.4 (18.1, 25.0) years, 58% females) and 24 h urine samples n = 215 (median age: 18.1 (17.1, 18.2) years, 51% females). Habitual physical activity was assessed using a validated Adolescent Physical Activity Recall Questionnaire. Plasma and urine metabolite concentrations were determined using ultra-high-performance liquid chromatography-tandem mass spectroscopy (UPLC-MS/MS) methods. In a sex-stratified analysis, we conducted principal component analysis (PCA) to reduce the dimensionality of metabolite data and to create metabolite patterns. Multivariable linear regression models were then applied to assess the associations between self-reported physical activity (metabolic equivalent of task (MET)-hours per week) with single metabolites and metabolite patterns, adjusted for potential confounders and controlling the false discovery rate (FDR) at 5% for each set of regressions.ResultsHabitual physical activity was positively associated with the “lipid, amino acids and xenometabolite” pattern in the plasma samples of male participants only (β = 1.02; 95% CI: 1.01, 1.04, p = 0.001, adjusted p = 0.042). In both sexes, no association of physical activity with single metabolites in plasma and urine and metabolite patterns in urine was found (all adjusted p > 0.05).ConclusionsOur explorative study suggests that habitual physical activity is associated with alterations of a group of metabolites reflected in the plasma metabolite pattern in males. These perturbations may lend insights into some of underlying mechanisms that modulate effects of physical activity.

Changes in Total Energy, Nutrients and Food Group Intake among Children and Adolescents during the COVID-19 Pandemic-Results of the DONALD Study.

The COVID-19 pandemic may have changed the habitual lifestyles of children and adolescents, in particular, due to the closure of kindergartens and schools. To investigate the impact of the pandemic on nutrients and food intake of children and adolescents in Germany, we analyzed repeated 3-day weighed dietary records from 108 participants (3–18 years; females: n = 45, males: n = 63) of the Dortmund Nutritional and Anthropometric Longitudinally Designed (DONALD) study. Polynomial mixed-effects regression models were used to identify prospective changes in dietary intake (total energy (TEI), carbohydrates, fat, protein, free sugar, ultra-processed foods, fruits and vegetables, sugar sweetened beverages and juices) before and during the first months of the COVID-19 pandemic. For the current analysis, we have chosen the first months of the pandemic (March 2020–August 2020), as this was the period with the most restrictions in Germany so far (kindergarten, school and restaurant closures; contact and outdoor activity restrictions). No significant changes in either the selected nutrients or food groups were observed. However, children and adolescents recorded a significantly lower TEI during the pandemic (β = −109.65, p = 0.0062). Results remained significant after the exclusion of participants with under-reported records (β = −95.77, p = 0.0063). While macronutrient intake did not change, descriptive data indicate a non-significant decrease in sugar sweetened beverages and ultra-processed foods intake. We suggest that children and adolescents from high socioeconomic families may have adapted lifestyle changes during the pandemic.

Dairy intake and long-term body weight status in German children and adolescents: results from the DONALD study

PurposeTo analyse the association between intake of total dairy (TD) and types of dairy [liquid dairy (LD), solid dairy (SD), low-fat dairy (LFD), high-fat dairy (HFD), high sugar dairy (HSD), low-sugar dairy (LSD), not fermented dairy (NFD), as well as fermented dairy (FD)] and long-term changes in body weight status and composition among children and adolescents in Germany.MethodsIn total, 9999 3-day dietary records collected between 1985 and 2019 by 1126 participants (3.5–18.5 years; boys: 50.8%) of the Dortmund Nutritional and Anthropometric Longitudinally Designed (DONALD) study were analysed. Polynomial mixed-effects regression models were used to examine whether changes (median follow-up: 9 years) in the intake of TD and dairy types (in 100 g/1000 kcal total energy intake) were associated with changes in body-mass-index-standard-deviation-score (BMI-SDS); fat mass index (FMI); fat-free mass index (FFMI) over time.ResultsAn individual increase in TD intake was slightly but significantly associated with an increase in BMI-SDS (β = 0.0092; p = 0.0371), FMI (β = 0.022; p = 0.0162), and FFMI (β = 0.0156; p = 0.0417) after adjustment for potential confounder. Analyses for LD (BMI-SDS: β = 0.0139; p = 0.0052; FMI: β = 0.0258; p = 0.0125; FFMI: β = 0.0239; p = 0.0052) and LSD intake (BMI-SDS: β = 0.0132; p = 0.0041, FMI: β = 0.02; p = 0.0316, FFMI: β = 0.0183; p = 0.0189) showed similar results to TD. Both processing method and fat content showed no association with body composition in our analyses.ConclusionIncreases in TD, LD, and LSD intake showed small but significant increases in BMI and concomitant increases in fat mass and lean mass. However, the observed changes were too small to expect biological or physiological meaningful effects. Overall, our results showed that policies to promote dairy intake in childhood are to be welcomed, as no negative effects on body composition are expected, while the intake of important nutrients for growth is ensured. The type of dairy does not seem to matter.

Development and feasibility testing of the smartphone-based dietary record app NutriDiary (beta version)

AbstractSmartphone technology has the potential to facilitate dietary assessment in epidemiological studies. Measurement error might be reduced by real time recording being more feasible with mobile methods. Our aim was to develop NutriDiary, a smartphone app for conducting three-day weighed dietary records. It provides a digital version of the established pen-and-paper method in the Dortmund Nutritional and Anthropometric Longitudinally Designed (DONALD) study, an open cohort study from infancy to adulthood. NutriDiary was developed as a text-based app including brand specific recording of food products. Usability of the beta version of NutriDiary was evaluated in the DONALD study. Participants or their parents were offered to test the app for the annual dietary record and were asked to fill in an app-integrated evaluation questionnaire. Usability was assessed by the System Usability Scale (SUS) and in-app behavior recordings. In the beta version of NutriDiary, a consumed food item is selected using a free-text search from the integrated in-house database LEBTAB. To ease the process of recording, NutriDiary offers some usability features such as a recipe editor, an integrated help mode and a photo function for collecting information on branded food products. In total, 32 mostly female participants (69%) used the app with 21 subjects recording their own dietary intake and 11 subjects conducting a record for their child. However, a relatively large proportion of DONALD participants also refused using the app because they preferred the traditional pen-and-paper method as being easier. Among participants of the feasibility study, subjective usability of NutriDiary was “good” but considerable differences in individual ratings were observed (median SUS = 80, IQR = 23.75, minimum = 45). Although 38% of participants reported technical issues, 88% stated they would use the app again. Technical problems included issues related to setting the time, editing of entered food items and the photo function. In-app behavior recordings showed that the help mode and recipe function were well-used (72% and 63%, respectively). Feedback from the study staff revealed that the post-processing of the dietary data obtained with NutriDiary was still time-consuming. Overall, the beta version of the NutriDiary app was well-received by most participants. Some aspects for improvement such as a barcode scanning function and extension of the database were identified. Moreover, NutriDiary will be further optimized by implementing an automated recipe simulation function.

Time and age trends in urinary sugar excretion among German children and adolescents

AbstractA high sugar intake is increasingly discussed to affect health. Preceding analyses based on dietary records, collected between 1985–2016, suggest a decreasing time trend in total [TS], added [AS] and free [FS] sugar intake (calculated as % of energy intake [%E]) since 2005 - most notably from 2010 onwards - among children and adolescents in Germany. While TS [%E] intake decreased with age, the youngest children had the lowest AS [%E] intake and the oldest children had the lowest FS [%E] intake, with minor differences in the other age groups. However, self-reported data is likely introducing bias due to selective underreporting, especially of sugar-rich foods, which can distort results. Therefore, we analysed time and age trends in dietary sugar intake using urinary biomarkers.Urinary fructose excretion (FE), sucrose excretion (SE) and the sum of both (FE + SE) as predictive biomarkers for sugar intake was measured by UPLC-MS/MS in 997 24-h urine samples from the DONALD (Dortmund Nutritional and Anthropometric Longitudinally Designed) study cohort collected from 8.5–16.5-year-olds (239 boys, 253 girls) between 1990–2016. Time and age trends of log-transformed FE, SE and FE + SE were analyzed using polynomial mixed-effects regression models. Sex, creatinine and urea excretion, urine volume, total daily energy intake, overweight status, type of weekday, maternal overweight and educational status as well as maternal employment were considered as potentially confounding factors.The mean (± SD) FE was 26.1 ± 20.9 mg/d, SE 33.4 ± 38.3 mg/d, and FE + SE 59.6 ± 49.1 mg/d. While FE increased significantly with age (linear trend: p = 0.0147), there were no significant age trends for SE and FE + SE in adjusted models. Between 1990–2016 FE as well as FE + SE decreased significantly (linear trend: p = 0.0280 and p &lt; 0.0001, respectively). SE showed a tendency towards a negative quadratic time trend (p = 0.0574).The decreasing time trend of urinary sugar excretion supports our previous observed time trends in dietary sugar intake based on dietary records among children and adolescents. In contrast, the observed age trend in dietary sugar was not confirmed by the biomarker trend analysis, suggesting increasing underreporting with age during adolescence. Although predictive biomarkers do not allow conclusions on the amount of the respective dietary intake, the combination of biomarker and dietary record data points towards the need of further public health measures to support the observed decline in sugar intake among children and adolescents in Germany.The project is funded by the German Federal Ministry of Food and Agriculture.

Breastfeeding trends in healthy infants since 1990-results of the DONALD study.

Exclusive breastfeeding is recommended for infants during the first 6 months of life. The aim of this analysis was to examine time trends in breastfeeding between 1990 and 2013 in Germany using data from the DONALD (Dortmund Nutritional and Anthropometric Longitudinally Designed) Study. Although partial breastfeeding was observed to constantly increase over time in both 3-month and 6-month-old infants, fully breastfeeding rates did not further increase in 3-month-old infants since 2002, and even showed a tendency to decrease in 6-month-old infants. In conclusion, this finding emphasises the need for improvements in breastfeeding promotion in Germany, which currently seems to be ineffective in case of continuation of full breastfeeding until the age of 6 months.

Relevance of Morning and Evening Energy and Macronutrient Intake during Childhood for Body Composition in Early Adolescence.

(1) Background: This study investigated the relevance of morning and evening energy and macronutrient intake during childhood for body composition in early adolescence; (2) Methods: Analyses were based on data from 372 DONALD (DOrtmund Nutritional and Anthropometric Longitudinally Designed study) participants. Explorative life-course plots were performed to examine whether morning or evening energy and macronutrient intake at 3/4 years, 5/6 years, or 7/8 years is critical for fat mass index (FMI [kg/m2]) and fat free mass index (FFMI [kg/m2]) in early adolescence (10/11 years). Subsequently, exposures in periods identified as consistently critical were examined in depth using adjusted regression models; (3) Results: Life-course plots identified morning fat and carbohydrate (CHO) intake at 3/4 years and 7/8 years as well as changes in these intakes between 3/4 years and 7/8 years as potentially critical for FMI at 10/11 years. Adjusted regression models corroborated higher FMI values at 10/11 years among those who had consumed less fat (p = 0.01) and more CHO (p = 0.01) in the morning at 7/8 years as well as among those who had decreased their morning fat intake (p = 0.02) and increased their morning CHO intake (p = 0.05) between 3/4 years and 7/8 years; (4) Conclusion: During childhood, adherence to a low fat, high CHO intake in the morning may have unfavorable consequences for FMI in early adolescence.

Home-made and commercial complementary meals in German infants: results of the DONALD study.

Infant complementary food can be home-made or bought as ready-to-eat commercial products. The nutrient composition of commercial products is regularised in a European Commission guideline, whereas the preparation of home-made complementary meals is the responsibility of caregivers. In the present study, the composition of commercial and home-made complementary meals as eaten by healthy German infants was compared. Of 8226 complementary meals (74% commercial and 26% home-made) recorded in 1083, 3-day weighed dietary records from 396 participants (6-12 months old) of the German DONALD (DOrtmund Nutritional and Anthropometric Longitudinally Designed) study were analysed. Median energy density (kcal 100 g(-1)) was highest in commercial and home-made cereal-milk meals (89 kcal 100 g(-1)). In home-made savoury and cereal-fruit meals, the energy density was significantly higher compared to their commercial counterparts. Median protein contents were highest in savoury and cereal-milk meals (>2.5 g 100 g(-1)) and dairy-fruit meals (2-4 g 100 g(-1)). Added sugars were found in less than a quarter of meals. Highest median sodium contents were found not only in commercial savoury meals (median 38 mg 100 g(-1)) and vegetable meals (32 mg 100 g(-1)), but also in home-made cereal-milk meals (36 mg 100 g(-1)). Both median fat and iron contents were higher in home-made meals compared to commercial savoury and cereal-fruit meals. With the exception of the higher sodium content in commercial savoury meals for older infants, the lower fat content in commercial savoury and cereal-fruit meals, and the added sugar content in some commercial dairy-fruit meals, a comparison of commercial and home-made complementary meals did not reveal any serious inadequacy.

Age and time trends in the diet of young children: results of the DONALD study.

To describe age and time trends of energy and macronutrient intake during infancy and toddlerhood and to set a special focus on dietary practices with respect to milk, complementary food, and family food intake. Three-day dietary records (n = 2241) collected at 3, 6, 9, 12, 18, 24, and 36 months (480 subjects) between 2004 and 2013 from the ongoing open cohort DONALD (Dortmund Nutritional and Anthropometric Longitudinally Designed) study were evaluated using repeated-measures regression analyses for trend analysis. Significant age trends were found for macronutrients with a decrease in fat intake (% of energy intake, %E) and an increase in carbohydrates (%E) and protein (%E). Exclusive and partial breastfeeding rates at 3 and 6 months did not differ between 2004 and 2008 and 2009 and 2013 (p > 0.05). Macronutrient pattern was virtually stable over time, whereas food group intake (% of total food intake excluding beverages, % TFI) changed significantly during the study period. Breast/bottle milk (% TFI) intake increased over time in the toddler subgroup, whereas family food (% TFI) decreased. Our data demonstrate a period of stagnation in the last 10 years with respect to breastfeeding duration in infancy. Further breastfeeding promotion in Germany is needed to continue the favourable progress of the previous decades. In toddlerhood, breast/bottle milk remains a substantial part of the diet and has increased during the last 10 years. Parents should be encouraged to implement healthy eating habits during early toddlerhood and to facilitate their child's participation in appropriate family meals.

Increased Intake of Carbohydrates from Sources with a Higher Glycemic Index and Lower Consumption of Whole Grains during Puberty Are Prospectively Associated with Higher IL-6 Concentrations in Younger Adulthood among Healthy Individuals

Chronic low-grade inflammation represents a likely intermediary in the relation between carbohydrate nutrition and both type 2 diabetes and cardiovascular disease. This study assessed the prospective association between carbohydrate quantity and quality [dietary glycemic index (GI), glycemic load (GL), and added sugar, fiber, and whole-grain intake] during puberty, a potentially critical period for later disease, and low-grade inflammation in younger adulthood. The analysis was based on 205 participants (113 girls and 92 boys) from the DONALD (Dortmund Nutritional and Anthropometric Longitudinally Designed) study with at least 2 3-d weighed dietary records during puberty (girls: 9–14 y, boys: 10–15 y) and blood samples in younger adulthood (18–36 y). Multivariable linear regression models were used to analyze the associations between carbohydrate nutrition and circulating concentrations of pro- and anti-inflammatory immune mediators [high-sensitivity C-reactive protein (hs-CRP), interleukin (IL) 6, IL-18, and adiponectin]. A higher intake of carbohydrates during puberty (P-trend = 0.005), particularly from higher-GI food sources (P-trend = 0.01), was prospectively related to higher concentrations of IL-6 in younger adulthood, independently of baseline BMI and early life, socioeconomic, and other nutritional factors. Furthermore, a higher dietary GL (P-trend = 0.002) and a lower intake of whole grains (P-trend = 0.01) were independently associated with higher IL-6 concentrations in adults. Dietary GI and added sugar and fiber intakes were not independently associated with IL-6 (P-trend ≥ 0.09). Carbohydrate nutrition during puberty was not independently related to hs-CRP, IL-18, and adiponectin concentrations (all P-trend > 0.1). During puberty, a higher intake of carbohydrates from higher-GI food sources and lower whole-grain consumption prospectively predict greater IL-6 concentrations in young adulthood. These data support the hypothesis that diet during puberty influences later inflammation and metabolic dysfunction.

Diet quality and diet costs in German children and adolescents.

We examined the association between diet costs and diet quality in a sample of children and adolescents using data from the ongoing longitudinal (open cohort) DONALD (Dortmund Nutritional and Anthropometric Longitudinally Designed) study. Children and adolescents aged 4-18 years (255 boys and 239 girls) provided 1100 yearly collected 3-day weighted dietary records. Linear mixed (effects) models were used to analyze the association between diet costs ([euro ;[sol;day, estimated using retail food prices) and the Nutrient Quality Index (NQI) and the Healthy Nutrition Score for Kids and Youth (HuSKY). Analysis were stratified for low-quality records (score<median) and high-quality records (score>median). No significant association was found in the low-quality records, whereas in the high-quality records the association was significantly positive for both scores (HuSKY P=0.016, NQI P<0.0001). In conclusion, a substantial part of our sample could increase their diet quality without a noteworthy increase of expenditure.

Development of an estimated food record for 9-36-month-old toddlers.

Adequacy of dietary intake in the sensitive period of toddler development is a key determinant of health in a short-and long-term perspective. Therefore, studies focussing the nutrition of toddlers are of importance. For this purpose, tailored dietary record methods are an important prerequisite. The objective of this work is to develop a toddler-specific estimated food record (EFR) in a booklet providing photographs of age-specific foods and portion sizesthat should be accurate and simple. For a toddler study in Germany, a 7-dayconsecutive EFR was developed. Data were obtained from a sample of toddlers in Germany. The basis is an evaluation of 3-day weighing food records on food choice and portion size of the DONALD (Dortmund Nutritional and Anthropometric Longitudinally Designed) study for 227 toddlers (118 boys) aged 9-36 months from January 2004 to March 2008. In the analysed food records, a total of 15.147 eating occasions with 24.820 dishes were reported and grouped in 17 food groups. To estimate the portion size, the median consumption amounts of the 194 most frequently consumed dishes were calculated and photographed. Formula and commercial complementary food are collected separately. EFR was structured into seveneating occasions of the day: before breakfast, breakfast, mid-morning, lunch, mid-afternoon, dinner, and before bed. The EFR booklet provides a simple, feasible and validated instrument that can be used to update information on dietary habits during the transition from infant to childhood diet for families in different social classes.

Food variety in commercial and homemade complementary meals for infants in Germany. Market survey and dietary practice

Introduction: Already infants do not meet the recommendations for fruit and vegetable intake although the complementary feeding period offers the possibility to expose the infant to a variety of flavours from fruits and vegetables. The objective of the present analysis was to identify differences in the vegetable variety in commercial vs. homemade complementary meals and to describe fish and meat variety in these meals in dietary practice in Germany. A further objective was to provide an overview of the food variety in commercial complementary vegetable-potato-meat/fish meals available on the German baby food market in 2012. Methods: 3-day weighed dietary records from the German DOrtmund Nutritional and Anthropometric Longitudinally Designed (DONALD) study were used to describe the fish and meat variety and to compare the vegetable variety in commercial and homemade meals using a vegetable variety score (VegVS). The online data base ‘Nutrichild’ served to describe the food variety on the market. Results and conclusion: The vegetable variety was low in homemade as well as in commercial meals without any differences in total variety at 6 and 9months of age. At 12months of age infants fed with commercial meals got a higher vegetable variety than those fed with homemade meals. In homemade and commercial meals most often carrot was used, whereas other vegetables were far below this frequency. In both meals, poultry and beef were most often used whereas fish meals were rarely offered. The market survey showed the same low vegetable variety and low fish offer as the results of the DONALD study. The data show that it is necessary to promote the advantages of a vegetable variety and fish consumption in Germany, already in early infancy.

Habitually Higher Dietary Glycemic Index During Puberty Is Prospectively Related to Increased Risk Markers of Type 2 Diabetes in Younger Adulthood

OBJECTIVECarbohydrate nutrition during periods of physiological insulin resistance such as puberty may affect future risk of type 2 diabetes. This study examined whether the amount or the quality (dietary glycemic index [GI], glycemic load [GL], and added sugar, fiber, and whole-grain intake) of carbohydrates during puberty is associated with risk markers of type 2 diabetes in younger adulthood.RESEARCH DESIGN AND METHODSThe analysis was based on 226 participants (121 girls and 105 boys) from the Dortmund Nutritional and Anthropometric Longitudinally Designed Study (DONALD) with an average of five 3-day weighed dietary records (range 2–6) during puberty (girls, age 9–14 years; boys, age 10–15 years) and fasting blood samples in younger adulthood (age 18–36 years) (average duration of follow-up 12.6 years). Multivariable linear regression was used to analyze the associations between carbohydrate nutrition and homeostasis model assessment–insulin resistance (HOMA-IR) as well as the liver enzymes alanine aminotransferase (ALT) and γ-glutamyltransferase (GGT) (n = 214).RESULTSA higher dietary GI was prospectively related to greater values of HOMA-IR (Ptrend = 0.03), ALT (Ptrend = 0.02), and GGT (Ptrend = 0.04). After adjustment for sex, adult age, baseline BMI, and early life and socioeconomic factors as well as protein and fiber intake, predicted mean HOMA-IR values in energy-adjusted tertiles of GI were 2.37 (95% CI 2.16–2.60), 2.47 (2.26–2.71), and 2.59 (2.35–2.85). The amount of carbohydrates, GL, and added sugar, fiber, and whole-grain intake were not related to the analyzed markers.CONCLUSIONSOur data indicate that a habitually higher dietary GI during puberty may adversely affect risk markers of type 2 diabetes in younger adulthood.

Lunch Habits of German Children and Adolescents: Composition and Dietary Quality

Background/Aims: Data from the ongoing, open-cohort Dortmund Nutritional and Anthropometric Longitudinally Designed (DONALD) study were used to describe warm family lunch meals and the association of the lunch composition with total diet quality. Methods: 2,095 three-day weighed dietary records, collected between 2004 and 2009, from a 4- to 18-year-old DONALD study subgroup were used. Results: Warm lunch (eating occasions between 11.30 a.m. and 2.29 p.m. including at least one course that is typically consumed warm) was eaten on 68.8% of all record days. Meat lunch (>50%) was predominant, followed by vegetarian (25%), fish (13%) and sweet lunch meals (3%). The prevalence of desserts at lunch was high and beverages were drunk at 80% of lunch meals. A meat lunch was associated with a higher protein (+1.4% energy intake, %E) and fat intake (+1.7%E) than a sweet lunch; also densities of vitamin A, folate and iron were higher. A dessert at lunch decreased protein intake slightly (–0.2%E), but increased carbohydrate (+0.7%E) and added sugar intake (+1.4%E) as well as density of calcium (+18 mg/MJ). Conclusion: Our study proves the impact of lunch on daily dietary quality and yields valuable insights on the development of food and meal-based dietary guidelines.

Analysis and risk assessment of furan in coffee products targeted to adolescents

The aim of this work was to analyse the furan concentrations in coffee products targeted to adolescents and to estimate the health risk for those consumers by using the consumption data of the Dortmund Nutritional and Anthropometric Longitudinally Designed Study (DONALD). Three different kinds of coffee beverages were analysed: ‘coffee ready to drink’ (i.e. industrially manufactured and packaged products available in cans or plastic cups), ‘coffee instant’ (i.e. soluble coffee in powder form) and ‘coffee from coffee chains’ (i.e. freshly prepared coffee sampled on-site). Furan was analysed according to the US Food and Drug Administration (USFDA) method using headspace-GC-MS and quantification with standard addition. The lowest furan concentrations were found within the category ‘coffee instant’, with an average of 4.6 µg kg−1, followed by the category ‘coffee ready to drink’, with an average of 41.3 µg kg−1, while the products from the coffee chains showed the highest concentrations, on average 100.5 µg kg−1. According to the obtained furan contents, it seems that the highest furan exposure for adolescents is generally given in the consumption of products within the category ‘coffee from coffee chains’, while the lowest is given in the category ‘coffee instant’. Risk assessment based on the margin of exposure (MOE) approach showed that in different consumption scenarios except for consumers of instant coffee, the MOE lay below 10,000, a range that is judged to be of public health relevance. The lowest MOE was found for consumers in the age group 10–12 years (especially females) and for both sexes in the age group 16–18 years.