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Unhealthy Food and Beverage Consumption during Childhood and Risk of Cardiometabolic Disease: A Systematic Review of Prospective Cohort Studies.
Markey, O, Pradeilles, R, Goudet, S, Griffiths, PL, Boxer, B, Carroll, C, Rousham, EK
The Journal of nutrition. 2023;(1):176-189
Abstract
BACKGROUND Global consumption of unhealthy foods, including ultra-processed foods (UPFs) and sugar-sweetened beverages (SSBs), has increased substantially among pediatric populations. Suboptimal diet during early life can track into adulthood, alongside risk factors for cardiometabolic disease. OBJECTIVE To inform the development of updated WHO guiding principles for complementary feeding of infants and young children, this systematic review sought to examine the association between unhealthy food consumption during childhood and cardiometabolic risk biomarkers. METHODS PubMed (Medline), EMBASE, and Cochrane CENTRAL were systematically searched, with no language restriction, up to 10 March 2022. Inclusion criteria were randomized controlled trials (RCTs), non-RCTs, and longitudinal cohort studies; children aged ≤10.9 y at exposure; studies reporting greater consumption of unhealthy foods and beverages (defined using nutrient- and food-based approaches) than no or low consumption; studies assessing critical nonanthropometric cardiometabolic disease risk outcomes (blood lipid profile, glycemic control, or blood pressure). RESULTS Of 30,021 identified citations, 11 articles from 8 longitudinal cohort studies were included. Six studies focused on exposure to unhealthy foods or UPF, and 4 focused on SSB only. Methodological heterogeneity was too high across studies to meta-analyze effect estimates. A narrative synthesis of quantitative data revealed that exposure to unhealthy foods and beverages, specifically NOVA-defined UPF, in children of preschool age may be associated with a worse blood lipid and blood pressure profile in later childhood (Grading of Recommendations Assessment, Development, and Evaluation [GRADE]: low and very low certainty, respectively). No associations were evident between SSB consumption and blood lipids, glycemic control, or blood pressure (GRADE all low certainty). CONCLUSIONS No definitive conclusion can be made because of quality of the data. More high-quality studies that purposefully assess the effects of unhealthy food and beverage exposure during childhood on cardiometabolic risk outcomes are needed. This protocol was registered at https://www.crd.york.ac.uk/PROSPERO/ as CRD42020218109.
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Rapid review of factors influencing dietary behaviors in Fiji.
Boxer, B, Trübswasser, U, Lesi, V, Naika, A, Dahal, P, Sagan, S, Joshi, K, Irache, A, Singh, P, Nand, D, et al
Frontiers in nutrition. 2023;:1164855
Abstract
INTRODUCTION In Fiji, multiple burdens of malnutrition including undernutrition, overweight/obesity, and micronutrient deficiencies coexist at the individual, household, and population levels. The diets of children, adolescents, and adults are generally unhealthy. The objective of this review was to understand how the dietary behaviors of children, adolescents, and women in Fiji are influenced by individual, social, and food environment factors. METHODS This rapid review was conducted to synthesize existing evidence, identify research gaps in the evidence base, and make recommendations for future research. The Cochrane Rapid Reviews Methods and the updated guideline for reporting systematic reviews were used. The search strategy for this rapid review was based on the Population Context Outcome [P(E)CO] framework, including search terms for population (children, adolescents, and adults), context (Fiji), and outcome (dietary behaviors). Searches were conducted in PubMed, Scopus, PsycINFO, and Google Scholar. RESULTS The 22 studies included in this review identified different factors influencing dietary behaviors in Fiji. Individual preferences for processed and imported foods, especially of younger generations, and social dynamics, especially gender norms and social pressure, to serve meat and overeat appeared to be prominent in driving dietary habits. The ongoing nutrition transition has led to increasing availability and affordability of ultra-processed and fast foods, especially in urban areas. Concerns about food safety and contamination and climate change and its effect on local food production also appear to influence dietary choices. DISCUSSION This review identified different dynamics influencing dietary behaviors, but also research gaps especially with regard to the food environment, calling for an integrated approach to address these factors more systemically.
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Unhealthy Food and Beverage Consumption in Children and Risk of Overweight and Obesity: A Systematic Review and Meta-analysis.
Rousham, EK, Goudet, S, Markey, O, Griffiths, P, Boxer, B, Carroll, C, Petherick, ES, Pradeilles, R
Advances in nutrition (Bethesda, Md.). 2022
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Infants and children are consuming increasing amounts of foods with added sugars, high in salt, and high in saturated or trans fats. Commercially prepared foods are more likely to be high in energy, low in nutrients (energy dense, nutrient-poor), and ultra-processed. The aim of this study was to examine, in children aged ≤10.9 y, the risks of greater consumption of unhealthy foods and beverages compared with no or low consumption on overweight and obesity. This study is a systematic review and meta-analysis which included the summarized characterises of 71 articles from 60 included studies. Results indicate that in children aged ≤10.9 years, consumption of sugar-sweetened beverages and unhealthy foods may increase body mass index, percentage body fat, or the odds of overweight/obesity (low to very-low certainty). Furthermore, there was little or no difference to body mass index, percentage body fat, or overweight/obesity outcomes (low certainty) after consumption of artificially sweetened beverages and 100% fruit juices. Authors conclude that policy recommendations are needed to address the growing burden of overweight and obesity that children are experiencing worldwide.
Abstract
This WHO-commissioned review contributed to the update of complementary feeding recommendations, synthesizing evidence on effects of unhealthy food and beverage consumption in children on overweight and obesity. We searched PubMed (Medline), Cochrane CENTRAL and Embase for articles, irrespective of language or geography. Inclusion criteria were: 1) randomized controlled trials (RCTs); non-RCTs; cohort studies and pre/post studies with control; 2) participants ≤ 10.9 y at exposure; 3) studies reporting greater consumption of unhealthy foods/beverages vs. no or low consumption; 4) studies assessing anthropometric and/or body composition; and 5) publication date ≥ 1971. Unhealthy foods and beverages were defined using nutrient- and food-based approaches. Risk of bias was assessed using the ROBINS-I and RoB2 tools for non-randomized and randomized studies, respectively. Narrative synthesis was complemented by meta-analyses where appropriate. Certainty of evidence was assessed using GRADE. Of 26,542 identified citations, 60 studies from 71 articles were included. Most studies were observational (59/60), and no included studies were from low-income countries. The evidence base was low quality, as assessed by ROBINS-I and RoB2 tools. Evidence synthesis was limited by the different interventions and comparators across studies. Evidence indicated that consumption of sugar-sweetened beverages (SSB) and unhealthy foods in childhood may increase body mass index (BMI)/BMI z-score, % body fat or odds of overweight/obesity (low certainty of evidence). Artificially-sweetened beverages and 100% fruit juice consumption may make little/no difference to BMI, % body fat or overweight/obesity outcomes (low certainty of evidence). Meta-analyses of a subset of studies indicated a positive association between SSB intake and % body fat, but no association with change in BMI and BMI z-score. High-quality epidemiological studies that are designed to assess the effects of unhealthy food consumption during childhood on risk of overweight/obesity are needed to contribute to a more robust evidence base upon which to design policy recommendations. This protocol was registered at https://www.crd.york.ac.uk/PROSPERO as CRD42020218109.
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The effect of 1,3-butanediol and carbohydrate supplementation on running performance.
Scott, BE, Laursen, PB, James, LJ, Boxer, B, Chandler, Z, Lam, E, Gascoyne, T, Messenger, J, Mears, SA
Journal of science and medicine in sport. 2019;(6):702-706
Abstract
OBJECTIVES Ingested ketogenic agents offer the potential to enhance endurance performance via the provision of an alternative exogenous, metabolically efficient, glycogen-sparing fuel (i.e. ketone bodies). This study aimed to assess the impact of combined carbohydrate and 1,3-butanediol (CHO-BD) supplementation on endurance performance, blood beta-hydroxybutyrate (βHB) concentration and glycolytic activity, in comparison to carbohydrate supplementation alone (CHO). DESIGN Eleven male runners (age 38±12years, mass 67.3±6.5kg, height 174.5±5.0cm, [Formula: see text] 64.2±5.0ml⋅kg-1⋅min-1) performed two experimental trials in a randomised crossover design. METHODS Each trial consisted of 60min of submaximal running, followed by a 5km running time-trial (TT), and was performed following the ingestion of an energy matched ∼650ml drink (CHO-BD or CHO). RESULTS There was no difference in TT completion time between the trials (CHO: 1265±93, CHO-BD: 1261±96s; p=0.723). However, blood βHB concentration in the CHO-BD trial was at least double that of the CHO trial at all time points following supplementation (p<0.05). While blood lactate concentration was lower in the CHO-BD versus CHO trial after 30min submaximal exercise (CHO-BD: 1.46±0.67mmol⋅L-1, CHO: 1.77±0.46mmol⋅L-1, p=0.040), it was similar at other time points. Blood glucose concentrations were higher post-TT in the CHO-BD trial (CHO-BD: 5.83±1.02mmol⋅L-1, CHO: 5.26±0.95mmol⋅L-1, p=0.015). CONCLUSIONS An energy matched CHO-BD supplementation drink raised βHB concentration and acutely lowered blood lactate concentration, without enhancing 5km TT running performance.