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Article: Associations between school meal-induced dietary changes and metabolic syndrome markers in 8–11-year-old Danish children

Damsgaard, Camilla T / Ritz, Christian / Dalskov, Stine-Mathilde / Landberg, Rikard / Stark, Ken D / Biltoft-Jensen, Anja / Tetens, Inge / Astrup, Arne / Michaelsen, Kim F / Lauritzen, Lotte

European journal of nutrition. 2016 Aug., v. 55, no. 5

2016

Abstract: PURPOSE: We recently showed that provision of Nordic school meals rich in fish, vegetables and potatoes and with reduced intakes of fat improved blood pressure, insulin resistance assessed by the homeostatic model (HOMA-IR), and plasma triacylglycerol ... ...

Abstract	PURPOSE: We recently showed that provision of Nordic school meals rich in fish, vegetables and potatoes and with reduced intakes of fat improved blood pressure, insulin resistance assessed by the homeostatic model (HOMA-IR), and plasma triacylglycerol despite increasing waist circumference in Danish 8–11-year-olds. This study explored whether intake or biomarkers of key dietary components in the schools meals were associated with these metabolic syndrome (MetS) markers during the 6-month intervention. METHODS: Data from 7-day dietary records and measurements of whole-blood docosahexaenoic acid (DHA, 22:6n-3), blood pressure, fasting blood MetS markers, waist circumference and android/total fat mass assessed by dual-energy X-ray absorptiometry collected at baseline, 3 and 6 months from 523 children were analyzed in linear mixed-effects models adjusted for puberty, growth and fasting. RESULTS: After adjustment for multiple testing, whole-blood DHA was negatively associated with HOMA-IR (P < 0.001) and triacylglycerol (P < 0.0001). Potato intake was positively associated with waist circumference (P < 0.01), but not with android/total fat mass (P = 0.94). Intakes of whole-grain as well as dietary fiber, protein and fat were not associated with any of the MetS markers. CONCLUSIONS: DHA in whole-blood, an indicator of DHA and fish intake, seemed to be the main diet-related predictor of the beneficial effects of the school meals on MetS markers. Increased potato intake was associated with increased waist circumference, but this may not only be due to an increase in abdominal fat, as no association was seen with fat distribution.
Keywords	abdominal fat ; biomarkers ; blood ; blood pressure ; children ; dietary fiber ; docosahexaenoic acid ; dual-energy X-ray absorptiometry ; fasting ; fat intake ; fish ; fish consumption ; insulin resistance ; metabolic syndrome ; models ; potatoes ; puberty ; school meals ; schools ; triacylglycerols ; waist circumference ; whole grain foods
Language	English
Dates of publication	2016-08
Size	p. 1973-1984.
Publishing place	Springer Berlin Heidelberg
Document type	Article
ZDB-ID	1466536-0
ISSN	1436-6215 ; 1436-6207
ISSN (online)	1436-6215
ISSN	1436-6207
DOI	10.1007/s00394-015-1013-z
Database	NAL-Catalogue (AGRICOLA)

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Article: Effects of dietary protein and glycaemic index on biomarkers of bone turnover in children

Dalskov, Stine-Mathilde / Müller, Martha / Ritz, Christian / Damsgaard, Camilla T / Papadaki, Angeliki / Saris, Wim H. M / Astrup, Arne / Michaelsen, Kim Fleischer / Mølgaard, Christian

British journal of nutrition. 2014 Apr. 14, v. 111, no. 7

2014

Abstract: For decades, it has been debated whether high protein intake compromises bone mineralisation, but no long-term randomised trial has investigated this in children. In the family-based, randomised controlled trial DiOGenes (Diet, Obesity and Genes), we ... ...

Abstract	For decades, it has been debated whether high protein intake compromises bone mineralisation, but no long-term randomised trial has investigated this in children. In the family-based, randomised controlled trial DiOGenes (Diet, Obesity and Genes), we examined the effects of dietary protein and glycaemic index (GI) on biomarkers of bone turnover and height in children aged 5–18 years. In two study centres, families with overweight parents were randomly assigned to one of five ad libitum-energy, low-fat (25–30 % energy (E%)) diets for 6 months: low protein/low GI; low protein/high GI; high protein/low GI; high protein/high GI; control. They received dietary instructions and were provided all foods for free. Children, who were eligible and willing to participate, were included in the study. In the present analyses, we included children with data on plasma osteocalcin or urinary N-terminal telopeptide of collagen type I (U-NTx) from baseline and at least one later visit (month 1 or month 6) (n 191 in total, n 67 with data on osteocalcin and n 180 with data on U-NTx). The level of osteocalcin was lower (29·1 ng/ml) in the high-protein/high-GI dietary group than in the low-protein/high-GI dietary group after 6 months of intervention (95 % CI 2·2, 56·1 ng/ml, P= 0·034). The dietary intervention did not affect U-NTx (P= 0·96) or height (P= 0·80). Baseline levels of U-NTx and osteocalcin correlated with changes in height at month 6 across the dietary groups (P< 0·001 and P= 0·001, respectively). The present study does not show any effect of increased protein intake on height or bone resorption in children. However, the difference in the change in the level of osteocalcin between the high-protein/high-GI group and the low-protein/high-GI group warrants further investigation and should be confirmed in other studies.
Keywords	biomarkers ; bone mineralization ; bone resorption ; children ; collagen ; dietary protein ; energy ; foods ; genes ; glycemic index ; nutritional intervention ; obesity ; osteocalcin ; parents ; protein intake ; randomized clinical trials
Language	English
Dates of publication	2014-0414
Size	p. 1253-1262.
Publishing place	Cambridge University Press
Document type	Article
ZDB-ID	280396-3
ISSN	1475-2662 ; 0007-1145
ISSN (online)	1475-2662
ISSN	0007-1145
DOI	10.1017/S0007114513003760
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Article: Socio-economic differences in cardiometabolic risk markers are mediated by diet and body fatness in 8- to 11-year-old Danish children: a cross-sectional study

Hauger, Hanne / Andersen, Rikke / Astrup, Arne / Biltoft-Jensen, Anja / Dalskov, Stine-Mathilde / Damsgaard, Camilla T / Groth, Margit V / Hjorth, Mads F / Michaelsen, Kim F / Ritz, Christian / Sjödin, Anders

Public health nutrition. 2016 Aug., v. 19, no. 12

2016

Abstract: To explore whether socio-economic differences exist in cardiometabolic risk markers in children and whether lifestyle-related factors potentially mediate these differences. Cross-sectional study including measurements of fasting blood lipids, glucose, ... ...

Abstract	To explore whether socio-economic differences exist in cardiometabolic risk markers in children and whether lifestyle-related factors potentially mediate these differences. Cross-sectional study including measurements of fasting blood lipids, glucose, homeostasis model assessment of insulin resistance (HOMA-IR), blood pressure and heart rate. Potential mediators examined were fat mass index (FMI); intakes of fruit, vegetables, dietary fibre and added sugar; whole-blood n-3 long-chain PUFA (LCPUFA) as a biomarker of fish intake; and physical activity and sedentary time. Nine primary schools in Denmark. Children aged 8–11 years (n 715). Children of parents with the shortest compared with longest education had higher TAG by 0·12 (95 % CI 0·04, 0·21) mmol/l and HOMA-IR by 0·36 (0·10, 0·62), whereas children of parents with a vocational education had higher total cholesterol by 0·14 (0·02, 0·27) mmol/l and LDL cholesterol by 0·14 (0·03, 0·25) mmol/l compared with children of parents with the longest education; all P<0·05. FMI explained 25 % of the difference in TAG, 64 % of the difference in HOMA-IR and 21–29 % of the differences in cholesterols. FMI and whole-blood n-3 LCPUFA combined explained 42 % of the difference in TAG, whereas FMI, whole-blood n-3 LCPUFA and dietary fibre explained 89 % of the difference in HOMA-IR. Socio-economic differences were present in blood lipids and insulin resistance among 8- to 11-year-olds and were mediated by body fatness, whole-blood n-3 LCPUFA and dietary fibre. These lifestyle factors may be targets in public initiatives to reduce socio-economic differences. Confirmation in longitudinal studies and trials is warranted.
Keywords	added sugars ; biomarkers ; blood lipids ; blood pressure ; children ; cross-sectional studies ; dietary fiber ; elementary schools ; fasting ; fat mass index ; fish consumption ; fruits ; glucose ; heart rate ; homeostasis ; insulin resistance ; lifestyle ; longitudinal studies ; low density lipoprotein cholesterol ; models ; parents ; physical activity ; polyunsaturated fatty acids ; risk factors ; socioeconomics ; vegetables ; vocational education ; Denmark
Language	English
Dates of publication	2016-08
Size	p. 2229-2239.
Publishing place	Cambridge University Press
Document type	Article
ZDB-ID	1436024-x
ISSN	1475-2727 ; 1368-9800
ISSN (online)	1475-2727
ISSN	1368-9800
DOI	10.1017/S1368980015003766
Database	NAL-Catalogue (AGRICOLA)

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Article: Vitamin D status and its determinants during autumn in children at northern latitudes: a cross-sectional analysis from the optimal well-being, development and health for Danish children through a healthy New Nordic Diet (OPUS) School Meal Study

Petersen, Rikke A / Damsgaard, Camilla T / Dalskov, Stine-Mathilde / Sørensen, Louise B / Hjorth, Mads F / Ritz, Christian / Kjølbæk, Louise / Andersen, Rikke / Tetens, Inge / Krarup, Henrik / Astrup, Arne / Michaelsen, Kim F / Mølgaard, Christian

British journal of nutrition. 2016 Jan. 28, v. 115, no. 2

2016

Abstract: Sufficient summer/autumn vitamin D status appears important to mitigate winter nadirs at northern latitudes. We conducted a cross-sectional study to evaluate autumn vitamin D status and its determinants in 782 Danish 8–11-year-old children (55°N) using ... ...

Abstract	Sufficient summer/autumn vitamin D status appears important to mitigate winter nadirs at northern latitudes. We conducted a cross-sectional study to evaluate autumn vitamin D status and its determinants in 782 Danish 8–11-year-old children (55°N) using baseline data from the Optimal well-being, development and health for Danish children through a healthy New Nordic Diet (OPUS) School Meal Study, a large randomised controlled trial. Blood samples and demographic and behavioural data, including 7-d dietary recordings, objectively measured physical activity, and time spent outdoors during school hours, were collected during September–November. Mean serum 25-hydroxyvitamin D (25(OH)D) was 60·8 (sd 18·7) nmol/l. Serum 25(OH)D levels ≤50 nmol/l were found in 28·4 % of the children and 2·4 % had concentrations <25 nmol/l. Upon multivariate adjustment, increasing age (per year) (β −2·9; 95 % CI −5·1, −0·7 nmol/l), female sex (β −3·3; 95 % CI −5·9, −0·7 nmol/l), sampling in October (β −5·2; 95 % CI −10·1, −0·4 nmol/l) and November (β −13·3; 95 % CI −17·7, −9·1), and non-white ethnicity (β −5·7; 95 % CI −11·1, −0·3 nmol/l) were negatively associated with 25(OH)D (all P<0·05). Likewise, immigrant/descendant background was negatively associated with 25(OH)D, particularly in females (β −16·3; 95 % CI −21·9, −10·7) (P<0·001) (P interaction=0·003). Moderate-to-vigorous physical activity (MVPA) (min/d) (β 0·06; 95 % CI 0·01, 0·12), outdoor walking during school hours (min/week) (β 0·4; 95 % CI 0·1, 0·6) and intake of vitamin D-containing supplements ≥3 d/week (β 8·7; 95 % CI 6·4, 11·0) were positively associated with 25(OH)D (all P<0·05). The high proportion of children with vitamin D status below the recommended sufficiency level of 50 nmol/l raises concern as levels expectedly drop further during winter months. Frequent intake of vitamin D supplements was strongly associated with status. MVPA and outdoor activity during school hours should be investigated further in interventions to improve autumn vitamin D status in children at northern latitudes.
Keywords	autumn ; blood sampling ; blood serum ; children ; cross-sectional studies ; diet ; females ; latitude ; nationalities and ethnic groups ; nutrient intake ; randomized clinical trials ; school meals ; summer ; vitamin D ; vitamin status ; walking
Language	English
Dates of publication	2016-0128
Size	p. 239-250.
Publishing place	Cambridge University Press
Document type	Article
ZDB-ID	280396-3
ISSN	1475-2662 ; 0007-1145
ISSN (online)	1475-2662
ISSN	0007-1145
DOI	10.1017/S000711451500433X
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: Physical Activity, Sedentary Time, and Sleep and the Association With Inflammatory Markers and Adiponectin in 8- to 11-Year-Old Danish Children.

Nielsen, Mette S / Quist, Jonas S / Chaput, Jean-Philippe / Dalskov, Stine-Mathilde / Damsgaard, Camilla T / Ritz, Christian / Astrup, Arne / Michaelsen, Kim F / Sjödin, Anders / Hjorth, Mads F

Journal of physical activity & health

2016 Volume 13, Issue 6, Page(s) 733–739

Abstract: Background: Inflammatory markers, adiponectin, and movement/nonmovement behaviors have all been linked to risk factors for cardiovascular disease; however, the association between childhood movement/nonmovement behaviors and inflammatory markers and ... ...

Abstract	Background: Inflammatory markers, adiponectin, and movement/nonmovement behaviors have all been linked to risk factors for cardiovascular disease; however, the association between childhood movement/nonmovement behaviors and inflammatory markers and adiponectin is unknown. Methods: We explored the association between accelerometer determined moderate-to-vigorous physical activity (MVPA), sedentary time, and sleep (7 days/8 nights) and fasting C-reactive protein (CRP), interleukin-6 (IL-6), and adiponectin in 806 school children. A sleep variability score was calculated. Results: MVPA was negatively associated with adiponectin in boys and girls (P < .001) and with CRP and IL-6 in girls (P < .05) independent of sleep duration, sedentary time, age, fat mass index (FMI), and pubertal status. Sedentary time was positively associated with adiponectin in boys and girls (both P < .001), and sleep duration with adiponectin in boys independent of age, FMI, and pubertal status (P < .001); however, these associations disappeared after mutual adjustments for movement behavior. Sleep duration variability was positively associated with CRP in girls independent of all covariates (P < .01). Conclusion: MVPA remained negatively associated with inflammatory markers and adiponectin, and sleep duration variability positively associated with CRP after adjustment for FMI, pubertal status, and other movement behavior. The inverse association between MVPA and adiponectin conflicts with the anti-inflammatory properties of adiponectin.
MeSH term(s)	Accelerometry ; Adiponectin/blood ; Biomarkers/blood ; C-Reactive Protein/metabolism ; Child ; Cluster Analysis ; Cross-Sectional Studies ; Exercise/physiology ; Female ; Humans ; Interleukin-6/blood ; Male ; Risk Factors ; Sleep/physiology ; Sweden
Chemical Substances	Adiponectin ; Biomarkers ; Interleukin-6 ; C-Reactive Protein (9007-41-4)
Language	English
Publishing date	2016-01-22
Publishing country	United States
Document type	Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
ISSN	1543-5474
ISSN (online)	1543-5474
DOI	10.1123/jpah.2015-0123
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Sleep duration modifies effects of free ad libitum school meals on adiposity and blood pressure.

Hjorth, Mads F / Sjödin, Anders / Dalskov, Stine-Mathilde / Damsgaard, Camilla Trab / Michaelsen, Kim F / Biltoft-Jensen, Anja / Andersen, Rikke / Ritz, Christian / Chaput, Jean-Philippe / Astrup, Arne

Applied physiology, nutrition, and metabolism = Physiologie appliquee, nutrition et metabolisme

2016 Volume 41, Issue 1, Page(s) 33–40

Abstract: Insufficient sleep can potentially affect both energy intake and energy expenditure, resulting in obesity and reduced cardiometabolic health. The objective of the study was to investigate if habitual sleep duration of 8- to 11-year-olds modifies the ... ...

Abstract	Insufficient sleep can potentially affect both energy intake and energy expenditure, resulting in obesity and reduced cardiometabolic health. The objective of the study was to investigate if habitual sleep duration of 8- to 11-year-olds modifies the effect of free ad libitum school meals on cardiometabolic markers, body composition, dietary intake, and physical activity. For 2 consecutive 3-month periods, this cluster-randomized, controlled, cross-over trial provided 530 children with school meals or usual lunch brought from home. Dietary intake, activity, and sleep were measured simultaneously for 7 consecutive days using dietary records and accelerometers. Short- and long-sleeping children were defined as lower and upper tertile of sleep duration. Body composition, blood pressure, blood lipids, and homeostatic model assessment of insulin resistance (HOMAIR) were measured/calculated. Overall, school meals compared with lunch from home had positive effects on physical activity and blood pressure in long-sleeping children and negative effects on body fat in short-sleeping children. Short-sleeping children increased fat mass compared with long-sleeping children by 0.21 (95% confidence interval 0.03-0.38) kg, android fat mass by 0.02 (0.001-0.04) kg, waist circumference by 0.73 (0.23-1.24) cm, blood pressure by 1.5 (0.4-2.6) mm Hg, fat intake by 1.1 (0.2-2.0) percentage of energy, and decreased total physical activity by 7.2 (1.6-12.7) % (all P ≤ 0.04), while HOMAIR and blood lipids were not modified by sleep duration (all P ≥ 0.32). In conclusion, the susceptibility to increase abdominal adiposity and blood pressure when exposed to dietary changes can potentially be explained by too little sleep, which results in increased caloric intake and reduced physical activity.
MeSH term(s)	Adiposity/physiology ; Blood Pressure/physiology ; Cardiovascular Diseases/prevention & control ; Child ; Cluster Analysis ; Cross-Over Studies ; Energy Intake ; Female ; Health Behavior ; Humans ; Male ; Meals ; Metabolic Syndrome/prevention & control ; Motor Activity ; Risk Factors ; Schools ; Sleep/physiology ; Surveys and Questionnaires
Language	English
Publishing date	2016-01
Publishing country	Canada
Document type	Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
ZDB-ID	2236708-1
ISSN	1715-5320 ; 1715-5312
ISSN (online)	1715-5320
ISSN	1715-5312
DOI	10.1139/apnm-2015-0319
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Socio-economic differences in cardiometabolic risk markers are mediated by diet and body fatness in 8- to 11-year-old Danish children: a cross-sectional study.

Hauger, Hanne / Groth, Margit V / Ritz, Christian / Biltoft-Jensen, Anja / Andersen, Rikke / Dalskov, Stine-Mathilde / Hjorth, Mads F / Sjödin, Anders / Astrup, Arne / Michaelsen, Kim F / Damsgaard, Camilla T

Public health nutrition

2016 Volume 19, Issue 12, Page(s) 2229–2239

Abstract: Objective: To explore whether socio-economic differences exist in cardiometabolic risk markers in children and whether lifestyle-related factors potentially mediate these differences.: Design: Cross-sectional study including measurements of fasting ... ...

Abstract	Objective: To explore whether socio-economic differences exist in cardiometabolic risk markers in children and whether lifestyle-related factors potentially mediate these differences. Design: Cross-sectional study including measurements of fasting blood lipids, glucose, homeostasis model assessment of insulin resistance (HOMA-IR), blood pressure and heart rate. Potential mediators examined were fat mass index (FMI); intakes of fruit, vegetables, dietary fibre and added sugar; whole-blood n-3 long-chain PUFA (LCPUFA) as a biomarker of fish intake; and physical activity and sedentary time. Setting: Nine primary schools in Denmark. Subjects: Children aged 8-11 years (n 715). Results: Children of parents with the shortest compared with longest education had higher TAG by 0·12 (95 % CI 0·04, 0·21) mmol/l and HOMA-IR by 0·36 (0·10, 0·62), whereas children of parents with a vocational education had higher total cholesterol by 0·14 (0·02, 0·27) mmol/l and LDL cholesterol by 0·14 (0·03, 0·25) mmol/l compared with children of parents with the longest education; all P<0·05. FMI explained 25 % of the difference in TAG, 64 % of the difference in HOMA-IR and 21-29 % of the differences in cholesterols. FMI and whole-blood n-3 LCPUFA combined explained 42 % of the difference in TAG, whereas FMI, whole-blood n-3 LCPUFA and dietary fibre explained 89 % of the difference in HOMA-IR. Conclusions: Socio-economic differences were present in blood lipids and insulin resistance among 8- to 11-year-olds and were mediated by body fatness, whole-blood n-3 LCPUFA and dietary fibre. These lifestyle factors may be targets in public initiatives to reduce socio-economic differences. Confirmation in longitudinal studies and trials is warranted.
MeSH term(s)	Adiposity ; Body Mass Index ; Child ; Cross-Sectional Studies ; Denmark/epidemiology ; Diet ; Educational Status ; Female ; Humans ; Insulin Resistance ; Lipids/blood ; Male ; Parents ; Socioeconomic Factors
Chemical Substances	Lipids
Language	English
Publishing date	2016-03-01
Publishing country	England
Document type	Journal Article
ZDB-ID	1436024-x
ISSN	1475-2727 ; 1368-9800
ISSN (online)	1475-2727
ISSN	1368-9800
DOI	10.1017/S1368980015003766
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Vitamin D status and its determinants during autumn in children at northern latitudes: a cross-sectional analysis from the optimal well-being, development and health for Danish children through a healthy New Nordic Diet (OPUS) School Meal Study.

The British journal of nutrition

2016 Volume 115, Issue 2, Page(s) 239–250

Abstract	Sufficient summer/autumn vitamin D status appears important to mitigate winter nadirs at northern latitudes. We conducted a cross-sectional study to evaluate autumn vitamin D status and its determinants in 782 Danish 8-11-year-old children (55°N) using baseline data from the Optimal well-being, development and health for Danish children through a healthy New Nordic Diet (OPUS) School Meal Study, a large randomised controlled trial. Blood samples and demographic and behavioural data, including 7-d dietary recordings, objectively measured physical activity, and time spent outdoors during school hours, were collected during September-November. Mean serum 25-hydroxyvitamin D (25(OH)D) was 60·8 (sd 18·7) nmol/l. Serum 25(OH)D levels ≤50 nmol/l were found in 28·4 % of the children and 2·4 % had concentrations <25 nmol/l. Upon multivariate adjustment, increasing age (per year) (β -2·9; 95 % CI -5·1, -0·7 nmol/l), female sex (β -3·3; 95 % CI -5·9, -0·7 nmol/l), sampling in October (β -5·2; 95 % CI -10·1, -0·4 nmol/l) and November (β -13·3; 95 % CI -17·7, -9·1), and non-white ethnicity (β -5·7; 95 % CI -11·1, -0·3 nmol/l) were negatively associated with 25(OH)D (all P<0·05). Likewise, immigrant/descendant background was negatively associated with 25(OH)D, particularly in females (β -16·3; 95 % CI -21·9, -10·7) (P<0·001) (P interaction=0·003). Moderate-to-vigorous physical activity (MVPA) (min/d) (β 0·06; 95 % CI 0·01, 0·12), outdoor walking during school hours (min/week) (β 0·4; 95 % CI 0·1, 0·6) and intake of vitamin D-containing supplements ≥3 d/week (β 8·7; 95 % CI 6·4, 11·0) were positively associated with 25(OH)D (all P<0·05). The high proportion of children with vitamin D status below the recommended sufficiency level of 50 nmol/l raises concern as levels expectedly drop further during winter months. Frequent intake of vitamin D supplements was strongly associated with status. MVPA and outdoor activity during school hours should be investigated further in interventions to improve autumn vitamin D status in children at northern latitudes.
MeSH term(s)	Age Factors ; Animals ; Child ; Cross-Sectional Studies ; Denmark/epidemiology ; Diet ; Dietary Supplements ; Ethnic Groups ; Female ; Fishes ; Health Status ; Humans ; Male ; Motor Activity ; Nutritional Status ; Puberty ; Schools ; Seasons ; Sex Factors ; Sunlight ; Vitamin D/administration & dosage ; Vitamin D/analogs & derivatives ; Vitamin D/blood ; Vitamin D Deficiency/blood
Chemical Substances	Vitamin D (1406-16-2) ; 25-hydroxyvitamin D (A288AR3C9H)
Language	English
Publishing date	2016-01-28
Publishing country	England
Document type	Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
ZDB-ID	280396-3
ISSN	1475-2662 ; 0007-1145
ISSN (online)	1475-2662
ISSN	0007-1145
DOI	10.1017/S000711451500433X
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Article ; Online: Associations between school meal-induced dietary changes and metabolic syndrome markers in 8-11-year-old Danish children.

Damsgaard, Camilla T / Ritz, Christian / Dalskov, Stine-Mathilde / Landberg, Rikard / Stark, Ken D / Biltoft-Jensen, Anja / Tetens, Inge / Astrup, Arne / Michaelsen, Kim F / Lauritzen, Lotte

European journal of nutrition

2016 Volume 55, Issue 5, Page(s) 1973–1984

Abstract: Purpose: We recently showed that provision of Nordic school meals rich in fish, vegetables and potatoes and with reduced intakes of fat improved blood pressure, insulin resistance assessed by the homeostatic model (HOMA-IR), and plasma triacylglycerol ... ...

Abstract	Purpose: We recently showed that provision of Nordic school meals rich in fish, vegetables and potatoes and with reduced intakes of fat improved blood pressure, insulin resistance assessed by the homeostatic model (HOMA-IR), and plasma triacylglycerol despite increasing waist circumference in Danish 8-11-year-olds. This study explored whether intake or biomarkers of key dietary components in the schools meals were associated with these metabolic syndrome (MetS) markers during the 6-month intervention. Methods: Data from 7-day dietary records and measurements of whole-blood docosahexaenoic acid (DHA, 22:6n-3), blood pressure, fasting blood MetS markers, waist circumference and android/total fat mass assessed by dual-energy X-ray absorptiometry collected at baseline, 3 and 6 months from 523 children were analyzed in linear mixed-effects models adjusted for puberty, growth and fasting. Results: After adjustment for multiple testing, whole-blood DHA was negatively associated with HOMA-IR (P < 0.001) and triacylglycerol (P < 0.0001). Potato intake was positively associated with waist circumference (P < 0.01), but not with android/total fat mass (P = 0.94). Intakes of whole-grain as well as dietary fiber, protein and fat were not associated with any of the MetS markers. Conclusions: DHA in whole-blood, an indicator of DHA and fish intake, seemed to be the main diet-related predictor of the beneficial effects of the school meals on MetS markers. Increased potato intake was associated with increased waist circumference, but this may not only be due to an increase in abdominal fat, as no association was seen with fat distribution.
MeSH term(s)	Animals ; Biomarkers/blood ; Blood Glucose/metabolism ; Blood Pressure ; Child ; Cholesterol, HDL/blood ; Cholesterol, LDL/blood ; Cluster Analysis ; Cross-Over Studies ; Denmark ; Dietary Fiber/administration & dosage ; Dietary Fiber/analysis ; Docosahexaenoic Acids/blood ; Energy Intake ; Exercise ; Female ; Fishes ; Food Services ; Fruit ; Healthy Diet ; Humans ; Insulin Resistance ; Longitudinal Studies ; Male ; Meals ; Metabolic Syndrome/blood ; Schools ; Seafood ; Treatment Outcome ; Triglycerides/blood ; Vegetables ; Waist Circumference
Chemical Substances	Biomarkers ; Blood Glucose ; Cholesterol, HDL ; Cholesterol, LDL ; Dietary Fiber ; Triglycerides ; Docosahexaenoic Acids (25167-62-8)
Language	English
Publishing date	2016-08
Publishing country	Germany
Document type	Journal Article ; Randomized Controlled Trial
ZDB-ID	1466536-0
ISSN	1436-6215 ; 1436-6207
ISSN (online)	1436-6215
ISSN	1436-6207
DOI	10.1007/s00394-015-1013-z
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Article: Effects of school meals with weekly fish servings on vitamin D status in Danish children: secondary outcomes from the OPUS (Optimal well-being, development and health for Danish children through a healthy New Nordic Diet) School Meal Study

Petersen, Rikke A / Damsgaard, Camilla T / Dalskov, Stine-Mathilde / Sørensen, Louise B / Hjorth, Mads Fiil / Andersen, Rikke / Tetens, Inge / Krarup, Henrik / Ritz, Christian / Astrup, Arne / Michaelsen, Kim F / Mølgaard, Christian

Journal of nutritional science. 2015, v. 4

2015

Abstract: Children's vitamin D intake and status can be optimised to meet recommendations. We investigated if nutritionally balanced school meals with weekly fish servings affected serum 25-hydroxyvitamin D (25(OH)D) and markers related to bone in 8- to 11-year- ... ...

Abstract	Children's vitamin D intake and status can be optimised to meet recommendations. We investigated if nutritionally balanced school meals with weekly fish servings affected serum 25-hydroxyvitamin D (25(OH)D) and markers related to bone in 8- to 11-year-old Danish children. We conducted an explorative secondary outcome analysis on data from 784 children from the OPUS School Meal Study, a cluster-randomised cross-over trial where children received school meals for 3 months and habitual lunch for 3 months. At baseline, and at the end of each dietary period, 25(OH)D, parathyroid hormone (PTH), osteocalcin (OC), insulin-like growth factor-1 (IGF-1), bone mineral content (BMC), bone area (BA), bone mineral density (BMD), dietary intake and physical activity were assessed. School meals increased vitamin D intake by 0·9 (95 % CI 0·7, 1·1) μg/d. No consistent effects were found on 25(OH)D, BMC, BA, BMD, IGF-1 or OC. However, season-modified effects were observed with 25(OH)D, i.e. children completing the school meal period in January/February had higher 25(OH)D status (5·5 (95 % CI 1·8, 9·2) nmol/l; P = 0·004) than children completing the control period in these months. A similar tendency was indicated in November/December (4·1 (95 % CI –0·12, 8·3) nmol/l; P = 0·057). However, the effect was opposite in March/April (–4·0 (95 % CI –7·0, –0·9) nmol/l; P = 0·010), and no difference was found in May/June (P = 0·214). Unexpectedly, the school meals slightly increased PTH (0·18 (95 % CI 0·07, 0·29) pmol/l) compared with habitual lunch. Small increases in dietary vitamin D might hold potential to mitigate the winter nadir in Danish children's 25(OH)D status while higher increases appear necessary to affect status throughout the year. More trials on effects of vitamin D intake from natural foods are needed.
Keywords	blood serum ; bone density ; children ; cross-over studies ; fish ; fish consumption ; insulin-like growth factor I ; lunch ; mineral content ; natural foods ; osteocalcin ; parathyroid hormone ; physical activity ; school meals ; serving size ; vitamin D ; vitamin status ; winter ; Denmark
Language	English
Publishing place	Cambridge University Press
Document type	Article
ZDB-ID	2656288-1
ISSN	2048-6790
ISSN	2048-6790
DOI	10.1017/jns.2015.15
Database	NAL-Catalogue (AGRICOLA)

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