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The Role of Dairy Products in Healthy Weight and Body Composition in Children and Adolescents

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  • National Dairy Council

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Overweight and obesity are major public health concerns with approximately 32% and 17% of U.S. children aged 2 - 19 being classified as overweight or obese, respectively. While the cause of overweight and obesity is multi-factorial, changes in eating habits and physical activity patterns have been proposed as contributing factors to the obesity epidemic. For example, the displacement of nutrient rich foods and beverages with non-nutrient dense items may be influencing childhood obesity. Many children do not consume the recommended servings of the Food Groups to Encourage, i.e. low-fat and fat-free dairy foods, fruits, vegetables, and whole grains identified by the 2005 Dietary Guidelines for Americans which results in low intakes of calcium, potassium, fiber, magnesium, and vitamin E. While attention has focused primarily on reducing energy intake and/or increasing energy expenditure for weight maintenance, a promising beneficial role for dairy products in weight management has emerged. Most research has focused on adults, but there is evidence in children and adolescents indicating either a beneficial or neutral effect of dairy food consumption on body weight or body composition. The current review provides and assessment of the scientific evidence on the effects of dairy food consumption on body weight and body composition in children and adolescents.
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... Ngược lại, nếu cho trẻ ăn thêm bữa phụ không đúng cách như cho trẻ ăn quá nhiều thức ăn trong bữa phụ dẫn đến dư thừa năng lượng, cho trẻ ăn những thực phẩm ăn nhanh, thực phẩm chiên rán,… sẽ làm tăng nguy cơ mắc béo phì [13]. Nhiều nghiên cứu đã chứng minh vai trò của sữa trong chế độ ăn giúp phát triển chiều cao và kiểm soát cân nặng, đặc biệt là đối với trẻ vị thành niên [15]. Nghiên cứu thuần tập (nghiên cứu theo thời gian) trên 50 trẻ không uống sữa và 200 trẻ uống sữa cho thấy, những trẻ không uống sữa có chiều cao thấp hơn, khung xương nhỏ hơn, hàm lượng khoáng chất trong xương thấp hơn và mật độ xương thấp hơn so với những trẻ cùng tuổi và giới tính trong cùng cộng đồng. ...
... Nghiên cứu thuần tập trên 24.776 người trưởng thành Pháp cũng cho thấy sở thích chất béo làm tăng nguy cơ béo phì (p < 0,001) ở cả hai giới trong khi cảm giác thích ăn ngọt làm giảm nguy cơ béo phì [19]. Các nghiên cứu thực nghiệm đã báo cáo không có sự khác biệt về mức độ thích thức ăn ngọt trên BMI hoặc thậm chí là mức độ thích thức ăn ngọt thấp hơn ở những người béo phì [7,15,18,19] và một nghiên cứu đã báo cáo mức độ thích thức ăn ngọt cao ở những người gầy nhưng không thích ở những người béo phì [20]. Các nghiên cứu về mối liên quan giữa sở thích ăn ngọt và béo phì vẫn còn nhiều tranh cãi. ...
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Eating habits appears to be an important determinant of dietary intake and may consequently influence overweight and obesity. Understanding the relationship between the nutritional status and eating habits is necessary for effective prophylaxis and intervention of overweight/obesity in adolescents. The purpose of this study is to analyze the association of some eating habits with overweight and obesity among adolescents at the age of 11-14 from 9 junior high schools in Hanoi city to help design a model for predicting overweight and obesity from eating habits. A case-control study was conducted on 222 overweight/obese adolescents and 616 normal-weight adolescents (according to International Obesity Taskforce standards, IOTF). Research results indicated that protective factors of overweight and obesity include snacking; snacking at least 2 hours before or after a main meal; consumption of milk and dairy products in snacks; sensory liking for fruit. Risk factors include sensory liking for fat, sensory liking for sweet, sensory liking for fast food, sensory liking for carbonated soft drinks, skipping breakfast, and snacking before bed. The best predictive model of overweight and obesity s built from logistic regression analysis including 8 of the above eating habits with AUC (Area Under the Curve) value of 0.931. Thus, eating habits are closely related to overweight and obesity among 11-14 year-old adolescents in Hanoi. Keywords Eating habits, overweight, obesity, adolescence, risk factor. References [1] A.S. French, M. Story and C.L. Perry, Self-esteem and obesity in children and adolescents: a literature review, Obesity Research 3 (1995) 479-490. https://doi.org/10.1002/j.1550-8528.1995.tb00179.x[2] E.A. Finkelstein, C.J. Ruhm, and K.M. Kosa, Economic causes and consequences of obesity, Annual Review of Public Health 26 (2005) 239-257. https://doi.org/10.1146/annurev.publhealth.26.021304.144628 [3] N.T.H. Hanh, L.T. 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Ahmad, Application of receiver operating characteristics (ROC) on the prediction of obesity, Brazilian Archives of Biology and Technology 63 (2020) e20190736-e20190749. http://dx.doi.org/10.1590/1678-4324-2020190736
... Evidence suggests a decrease in dairy consumption coincides with the rise in obesity prevalence in pediatric population [2]. A large percentage of children do not consume the recommended amounts of low-fat and fat-free dairy products, fruits, vegetables, and whole grains, which results in low intakes of calcium, potassium, fiber, magnesium, and vitamin E [3]. ...
... Spence et al. [3], in their study analyzing the role of dairy products in healthy weight and body composition in children and adolescents, concluded that the available studies indicated that the consumption of milk and milk products do not have a negative effect on body weight or body composition in pediatric population. However, the authors noted the need for additional research to better understand the relationship between dairy food consumption and obesity prevalence in school-age children. ...
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Evidence suggests there has been a decrease in childhood dairy consumption. There is a need for further studies to evaluate the types of dairy products in relation to the risk of obesity in pediatric population. The aim of the study was to determine the associations between the frequency of consumption of different types of dairy products and body composition and excess adiposity in preschool children from Poland. A cross-sectional study of 1172 children aged 5–6 years was conducted using a bioelectrical impedance analysis for body composition estimation and a modified food frequency questionnaire (FFQ-6) to assess the habitual diets of the participants. Among the analyzed dairy products, milk was consumed most often, followed by fruit yoghurts, yellow cheese, and cottage cheese, and natural yoghurt was the least common. Participants that consumed fruit or natural yoghurt more frequently had higher adipose tissue content. The logistic regression analysis by the method of forward selection showed that more frequent consumption of fruit yoghurt significantly increased the risk of excess adiposity among the total sample (OR = 1.20, p < 0.001). This study revealed that higher consumption of fruit yoghurt could be significant determinant of excess adiposity in Polish preschool children
... These results corroborate similar international 1,2,3 and national studies 4,5 that reported an inverse association between calcium intake and adiposity in adolescents. A systematic review of longitudinal studies (n = 10) 8 and a review conducted by Spence et al. 9 including clinical trials (n = 11) and cross-sectional (n = 23) and longitudinal studies (n = 13) also found that calcium and/or dairy helps prevent obesity. A meta-analysis including 33 studies, out of which nine were conducted with children and adolescents, found an inverse correlation between calcium intake and body weight gain among these age groups 31 , indicating that calcium intake could benefit obesity prevention more than obesity treatment. ...
Article
Epidemiological studies have supported the hypothesis that dietary calcium intake is protective for adiposity. This study aimed to estimate the association of dietary calcium with adiposity indicators during adolescence. This is a cohort study with high school adolescents (n = 962) from selected schools of the Metropolitan Region of Rio de Janeiro, Brazil, which were followed from 2010 to 2012. Calcium intake was assessed by a validated self-reported food frequency questionnaire. Cross-sectional and longitudinal analyses of dietary calcium intake were performed regarding body mass index (BMI), waist circumference (WC), body fat percentage (%BF), fat mass (FM), fat-free mass (FFM), fat mass index (FMI), and fat-free mass index (FFMI). The analysis of variance was used for cross-sectional analysis with baseline data and linear mixed models applied to assess changes across the follow-up. At baseline, BMI, %BF, fat mass, and FMI (p for trend < 0.05) had lower means at the highest quintile of calcium intake whereas FFM and FFMI had higher means (p for trend < 0.05), especially for boys. During follow-up, boys had decreased FMI at the 4th and 5th quintiles of calcium intake (p < 0.05); among girls, only WC was significantly lower at the 4th quintile than in the 1st. These results support the hypothesis that low calcium intake increases adiposity among adolescents.
... A few reviews [10][11][12][13][14] and meta-analyses 10,15,16 of epidemiological studies, exploring the potential relationship between the consumption of dairy products and risk of obesity in children and adolescents, have been published to date. Findings suggest an inverse or null relationship between dairy product consumption and the prevalence or incidence of overweight and obesity. ...
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A systematic review and meta‐analysis of cross‐sectional and prospective cohort studies was conducted to assess the associations between total dairy consumption and its different subtypes with the prevalence and incidence of overweight, obesity, and overweight/obesity in children and adolescents. A literature search was conducted in Medline through PUBMED and Cochrane Library databases until October 18, 2021. Articles reporting the risk estimates as odd ratios (OR), risk ratios (RR), or hazard ratios and their corresponding 95% confidence interval (CI) for the association between dairy product consumption and the risk of overweight and/or obesity were included. In the meta‐analysis from cross‐sectional studies, results showed an inverse association between total dairy consumption and obesity prevalence (OR (95% CI): 0.66 (0.48–0.91). No significant associations were found between milk or yogurt and obesity prevalence risk. Regarding prospective studies, total milk consumption was positively associated with overweight prevalence (OR (95% CI): 1.13 (1.01–1.26)) and incidence (RR (95%CI): 1.17 (1.01–1.35)) risk. Evidence from pooled analysis of cross‐sectional studies suggested an inverse association between total dairy consumption and obesity. However, there is limited and no conclusive evidence to confirm an inverse relationship from pooled analysis of prospective studies in children and adolescents.
... As growth issues such as obesity and stunting have become more of a concern, extensive research has been conducted on milk intake and height or body weight [1], and the majority of these studies have agreed that milk contributes positive benefits to growth in height for children [8][9][10][11][12][13][14]. However, the association between milk and body weight or body mass index (BMI) remains under debate due to inconsistent findings [15][16][17][18][19][20][21][22][23]. ...
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Milk is widely considered as a beneficial product for growing children. This study was designed to describe the milk consumption status of Korean children aged 30–36 months and to investigate its association with the risk of obesity and iron deficiency anemia (IDA). This nationwide administrative study used data from the Korean national health insurance system and child health screening examinations for children born in 2008 and 2009. In total, 425,583 children were included, and they were divided into three groups based on daily milk consumption: low milk group (do not drink or drink <200 mL milk per day, n = 139,659), reference group (drink 200–499 mL milk per day, n = 255,670), and high milk group (drink ≥500 mL milk per day, n = 30,254). After adjusting variable confounding factors, the consumption of a large amount of milk of ≥500 mL per day at the age of 30–36 months was associated with an increased risk of obesity at the age of 42–72 months and IDA after the age of 30 months. These results may provide partial evidence for dietary guidelines for milk consumption in children that are conducive to health.
... The role of milk in obesity has been extensively discussed but is contentious partly owing to a lack of human evidence elucidating mechanistic pathways. In many instances, particularly in children, milk intake is inversely associated with obesity (59,60). Although our findings showed an inverse association between milk consumption and a bacterial taxon that has been shown to be positively linked to obesity, further studies are warranted to understand the milkgut microbiome-obesity relation in greater depths. ...
Article
Background At a population level, the relation between dairy consumption and gut microbiome composition is poorly understood. Objectives We sought to study the cross-sectional associations between individual dairy foods (i.e., milk, yogurt, and cheese), as well as total dairy intake, and the gut microbiome composition in a large, representative sample of men living in south-eastern Australia. Methods Data on 474 men (mean ± SD: 64.5 ± 13.5 y old) from the Geelong Osteoporosis Study were used to assess the cross-sectional association between dairy consumption and gut microbiome. Information on dairy intake was self-reported. Men were categorized as consumers and nonconsumers of milk, yogurt, cheese, and high- and low-fat milk. Milk, yogurt, and cheese intakes were summed to calculate the total dairy consumed per day and categorized into either low (<2.5 servings/d) or high (≥2.5 servings/d) total dairy groups. Fecal samples were analyzed using bacterial 16S ribosomal RNA (rRNA) gene sequencing. After assessment of α and β diversity, differential abundance analysis was performed to identify bacterial taxa associated with each of milk, yogurt, and cheese consumption compared with nonconsumption, low compared with high total dairy, and low- compared with high-fat milk consumption. All analyses were adjusted for potential confounders. Results α Diversity was not associated with consumption of any of the dairy groups. Differences in β diversity were observed between milk and yogurt consumption compared with nonconsumption. Taxa belonging to the genera Ruminococcaceae UCG-010 and Bifidobacterium showed negative and weak positive associations with milk consumption, respectively. A taxon from the genus Streptococcus was positively associated with yogurt consumption, whereas a taxon from the genus Eisenbergiella was negatively associated with cheese consumption. No specific taxa were associated with low- compared with high-fat milk nor low compared with high total dairy consumption. Conclusions In men, community-level microbiome differences were observed between consumers and nonconsumers of milk and yogurt. Bacterial taxon-level associations were detected with milk, yogurt, and cheese consumption. Total dairy consumption was not associated with any microbiome measures, suggesting that individual dairy foods may have differential roles in shaping the gut microbiome in men.
... On the other hand, it can also offer opportunities for local farmers and small dairy industries. Milk provides several nutrients and can help consumers cover the daily requirements for minerals and vitamins [13]. ...
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Background: Whole milk is a good source of all the nutrients, and it also contains a sufficient number of vitamins to permit regular the growth of the neonate. Dairy cow milk can create allergy in infants less than 12 months old because of the high caseins and β-lactoglobulin content. In these circumstances, donkey milk can represent a good replacement for dairy cows' milk in children affected by Cow Milk Protein Allergy (CMPA) because of its close chemical composition with human milk, mainly due to its low protein and low mineral content. Milk vitamin content is highly variable among mammalian species and it is strictly correlated with the vitamin status and the diet administered to the mother. Fat-soluble vitamins content in donkey milk is, on average, lower compared to ruminants' milk, while vitamin C content determined in donkey milk is higher compared to dairy cows' milk, showing a great similarity with human milk. In donkey milk, the content of vitamins of the B-complex such as thiamine, riboflavin, niacin, pyridoxine, and folic acid is higher compared to human milk. The use of donkey milk as a new functional food must be further evaluated in interdisciplinary clinical trials in which pediatricians, dietitians, and food scientists must be involved to deepen the knowledge about the positive health impact of donkey milk in different sensitive people, especially children and the elderly.
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The structure function relation of Glycosaminoglycans from bovine milk (bmGAGs) has not been studied in detail. In the present study bmGAGs was isolated and structurally characterized. Chondroitin sulphate was one of the major GAGs present and had 65% of ΔDi-diSB (GlcA(2S)-GalNAc(4S)), followed by 18% of ΔDi-4S(Δ4,5HexUAα1 → 3GalNAc). Further, bmGAGs exhibited a marked anti-adipogenic effect in 3 T3-L1 cells without affecting cell viability at the concentration used. The triglyceride content treated with bmGAGs was significantly decreased as assessed by Oil-Red O staining. Peroxisome proliferator activated receptor γ (PPAR-γ) and CCAAT/enhancer-binding proteins (C/EBPα) the critical transcription factors in adipogenesis showed significant decrease in both gene and protein levels. Sterol regulatory element-binding protein 1c (SREBP-1c) that promotes the adipocyte differentiation by enhancing the activity of PPAR-γ was inversely affected by bmGAGs and the fatty acid synthase (FAS) expression was modulated. Thus, the present work is among the firsts to demonstrate an anti-adipogenic activity of bmGAGs by modulating the adipogenesis-related marker proteins and hence bmGAGs may be used as a supplement/therapeutic in the management of obesity.
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Background & Objectives Despite all health benefits of dairy products consumption, there is a sharp reduction trend in these food group intake in the last decades in the world. Despite the fact that Iran dairy industries company is the biggest dairy products factory in the Middle East, the per capita consumption of dairy products was 60 kg in the year 2014 that is extremely low and half of the world average. Since eating habits are creating in children and adolescents and will carry into adulthood, pay attention to these age groups dietary patterns is very important. The patterns and predictors of dairy products consumption might be different in children and adolescent from different populations. Result There are some different factors affecting on food choices and intake. For example, it seems that economic status has major effects on the price of foods, and food selection, especially in vulnerable groups. Regard to the lack of updated evidences about effective factors on dairy intake, especially in children and adolescents in Iran, the current review investigated the consumption of milk and dairy products, barriers to and facilitators of their intake in Iranian population in 2019, comparing with the world status.
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Throughout their life, people are exposed to many different types of milk. First, it is breast milk if infants are breastfed or special formula based on cow milk with modified composition if they are not breastfed. Later in life, it is recommended that humans consume the milk of other mammals as a source of highly valuable protein, calcium, and phosphorus. This work aimed to evaluate the effects of methods and duration of feeding in infancy and consumption of milk or milk alternatives in adulthood on body composition. We used a questionnaire of 21 specific questions to obtain information on breastfeeding and milk consumption. All 84 participants (18 men, 66 women; age 23.26 ±1.36) underwent measurement of body composition, using BIA methods (InBody 720). A comparison of the information from the questionnaire with the information from the body composition measurement was made. Significant differences were observed in visceral fat area (p = 0.048) and waist-to-hip ratio (p = 0.022) according to duration of breastfeeding. Participants who were fed formula for a shorter time than 1 year (until 12 months of age) showed a higher percentage of body fat (p = 0.047). The fat percentage of milk was a significant factor for the waist-to-hip ratio (p = 0.026). Participants consuming plant-based milk alternatives showed significant differences in waist-to-hip ratio (p = 0.031) and body mass index (p = 0.015) and highly significant differences in weight (p <0.001) and fat-free mass (p <0.001). In conclusion, results show that the duration of breastfeeding may prevent the development of overweight and eventually obesity. Usage of infant formulas as an alternative to breast milk should be limited to those who are unable to breastfeed. The current consumption of milk indicates the benefits of whole milk in the diet but also shows increasing interest in the advantages of plant-based milk.
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This study examined the role of calcium intake on body composition in 186 African-American adolescents at risk for overweight and obesity. The average weight of 89.8 kg ± 23.6 (SD) had a mean BMI z score of 2.2. Females with a calcium intake of <314 mg/day had higher percent fat mass compared to those with the highest calcium intakes that were ≥634 mg/day. Compared to those with a low calcium intake (<365 mg/day), those with the highest calcium intake of >701 mg/day had higher intake of thiamin, folate, cobalamin, vitamin D, phosphorus, iron, zinc.
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Lactase non-persistent (LNP) individuals may be lactose intolerant and therefore on a more restricted diet concerning milk and milk products compared to lactase persistent (LP) individuals. This may have an impact on body fat mass. This study examines if LP and LNP children and adolescents, defined by genotyping for the LCT-13910 C > T polymorphism, differ from each other with regard to milk and milk product intake, and measures of body fat mass. Children (n=298, mean age 9.6 years) and adolescents (n=386, mean age 15.6 years), belonging to the Swedish part of the European Youth Heart Study, were genotyped for the LCT-13910 C > T polymorphism. Dietary intakes of reduced and full-fat dairy varieties were determined. LNP (CC genotype) subjects consumed less milk, soured milk and yoghurt compared to LP (CT/TT genotype) subjects (p<0.001). Subsequent partitioning for age group attenuated this observation (p=0.002 for children and p=0.023 in adolescents). Six subjects were reported by parents to be 'lactose intolerant', none of whom were LNP. LNP children and adolescents consumed significantly less reduced fat milk and milk products than LP children and adolescents (p=0.009 for children and p=0.001 for adolescents). We conclude that LP is linked to an overall higher milk and dairy intake, but is not linked to higher body fat mass in children and adolescents.
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To determine the long-term effect of a randomized controlled trial of a dairy-rich diet on generalized and abdominal obesity, as well as on the components of the metabolic syndrome, among obese prepubescent children. This trial was conducted among a population-based sample of 120 obese prepubescent children who were randomly assigned to 3 groups of equal number. In addition to attending 6 consecutive monthly family-centered education sessions about healthy lifestyle, an isocaloric dairy-rich diet (>800 mg ca/d) was recommended to the children of one group (DR: dairy-rich diet), the second group was placed on a caloric-restricted regimen (ER: energy-restricted), and the third group received no additional recommendation (C: controls). The groups were then followed-up twice a year for 3 years. The mean age of the children was 5.6 +/- 0.5 years. Of 120 participants, 95 (75%) completed the study; the DR group had the highest retention rate. In all groups, body mass index-standard deviation score (BMI-SDS) and waist circumference decreased significantly after the 6-month trial, but had a sustained significant rise during the follow-up period to the end of the study; however, in the DR group, this rise was significantly lower than in the 2 other groups. After the 6-month trial, in all groups, serum triglycerides (TG) and insulin levels decreased, and serum high-density lipoprotein cholesterol (HDL-C) level and homeostasis model assessment of insulin resistance (HOMA-R) increased. In the DR group, the TG, insulin and HOMA-R levels remained significantly lower than baseline until the 12-month follow-up. We suggest that in addition to lifestyle changes, an isocaloric diet rich in dairy products may be a well-accepted regimen and can be a safe and practical strategy for weight control in young, overweight children.
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The prevalence of high body mass index (BMI) among children and adolescents in the United States appeared to plateau between 1999 and 2006. To provide the most recent estimates of high BMI among children and adolescents and high weight for recumbent length among infants and toddlers and to analyze trends in prevalence between 1999 and 2008. The National Health and Nutrition Examination Survey 2007-2008, a representative sample of the US population with measured heights and weights on 3281 children and adolescents (2 through 19 years of age) and 719 infants and toddlers (birth to 2 years of age). Prevalence of high weight for recumbent length (> or = 95th percentile of the Centers for Disease Control and Prevention growth charts) among infants and toddlers. Prevalence of high BMI among children and adolescents defined at 3 levels: BMI for age at or above the 97th percentile, at or above the 95th percentile, and at or above the 85th percentile of the BMI-for-age growth charts. Analyses of trends by age, sex, and race/ethnicity from 1999-2000 to 2007-2008. In 2007-2008, 9.5% of infants and toddlers (95% confidence interval [CI], 7.3%-11.7%) were at or above the 95th percentile of the weight-for-recumbent-length growth charts. Among children and adolescents aged 2 through 19 years, 11.9% (95% CI, 9.8%-13.9%) were at or above the 97th percentile of the BMI-for-age growth charts; 16.9% (95% CI, 14.1%-19.6%) were at or above the 95th percentile; and 31.7% (95% CI, 29.2%-34.1%) were at or above the 85th percentile of BMI for age. Prevalence estimates differed by age and by race/ethnic group. Trend analyses indicate no significant trend between 1999-2000 and 2007-2008 except at the highest BMI cut point (BMI for age > or = 97th percentile) among all 6- through 19-year-old boys (odds ratio [OR], 1.52; 95% CI, 1.17-2.01) and among non-Hispanic white boys of the same age (OR, 1.87; 95% CI, 1.22-2.94). No statistically significant linear trends in high weight for recumbent length or high BMI were found over the time periods 1999-2000, 2001-2002, 2003-2004, 2005-2006, and 2007-2008 among girls and boys except among the very heaviest 6- through 19-year-old boys.
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Objectives. Obesity has become a global epidemic but our understanding of the problem in children is limited due to lack of comparable representative data from different countries, and varying criteria for defining obesity. This paper summarises the available information on recent trends in child overweight and obesity prevalence. Methods. PubMed was searched for data relating to trends over time, in papers published between January 1980 and October 2005. Additional studies identified by citations in retrieved papers and by consultation with experts were included. Data for trends over time were found for school-age populations in 25 countries and for pre-school populations in 42 countries. Using these reports, and data collected for the World Health Organization's Burden of Disease Program, we estimated the global prevalence of overweight and obesity among school-age children for 2006 and likely prevalence levels for 2010. Results. The prevalence of childhood overweight has increased in almost all countries for which data are available. Exceptions are found among school-age children in Russia and to some extent Poland during the 1990s. Exceptions are also found among infant and pre-school children in some lower-income countries. Obesity and overweight has increased more dramatically in economically developed countries and in urbanized populations. Conclusions. There is a growing global childhood obesity epidemic, with a large variation in secular trends across countries. Effective programs and policies are needed at global, regional and national levels to limit the problem among children.
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Overweight and obesity are the foremost public health problems in the U.S., other industrialized countries, and is rapidly increasing in developing countries. Obesity is a multifaceted disease which requires multiple approaches to successfully combat its increase. Nutritional factors play a key role and include modification of energy balance, intake and expenditure, as well as other factors. Emerging scientific evidence over the past decade suggests that dairy foods may be beneficial when included in a moderate energy restricted diet and possibly for weight maintenance as well. This paper provides a review of some of the scientific evidence that has examined the effect of dairy foods and dietary calcium on weight management. Topic areas presented are observational or retrospective studies with adults as well as children and adolescents; randomized clinical trials on body weight and composition, energy expenditure, substrate oxidation and fecal fat loss; research from animal and in vitro studies provide possible mechanisms of action.
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To determine whether the quantity and type of milk (whole, reduced fat, or 1%/nonfat) consumed at age 2 years is associated with adiposity at age 3 years. We assessed milk and dairy intake at age 2 years with food frequency questionnaires completed by mothers. Our primary outcomes were body mass index (BMI; calculated as kg/m(2)), z score and overweight at age 3 years, defined as BMI for age and sex >or=85th percentile. Eight-hundred and fifty-two preschool-aged children in the prospective US cohort Project Viva. Linear and logistic regression models, adjusting for maternal BMI and education, paternal BMI, and child age, sex, race/ethnicity, intake of energy, nondairy beverages, television viewing, and BMI z score at age 2 years were used. At age 2 years, mean milk intake was 2.6 (standard deviation 1.2) servings per day. Higher intake of whole milk at age 2, but not reduced-fat milk, was associated with a slightly lower BMI z score (-0.09 unit per daily serving [95% confidence interval: -0.16 to -0.01]) at age 3 years; when restricted to children with a normal BMI (5th to <85th percentile) at age 2 years, the association was null (-0.05 unit per daily serving [95% confidence interval: -0.13 to 0.02]). Intake of milk at age 2 years, whether full- or reduced-fat, was not associated with risk of incident overweight at age 3 years. Neither total milk nor total dairy intake at age 2 years was associated with BMI z score or incident overweight at age 3 years. Neither consuming more dairy products, nor switching from whole milk to reduced-fat milk at age 2 years, appears likely to prevent overweight in early childhood.
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Humans are unique among mammals in that many consume cow's milk or other dairy products well beyond the traditional age of weaning. Milk provides various nutrients and bioactive molecules to support growth and development, and the question arises as to whether this dietary behavior influences growth parameters. There is evidence that milk makes positive contributions to growth in height, but its associations with other aspects of body size, such as body mass index (BMI), are not well-established. National Health and Nutrition Examination Survey (NHANES) data from 1999 to 2004 and multivariate regression analysis were used to test the hypothesis that milk (g) or total dairy product consumption (kJ) is associated with higher BMI percentile among US White, Black, and Mexican-American children of age 2-4 years (n = 1,493) and 5-10 years (n = 2,526). Younger children in the highest quartile of dairy intake had higher BMIs (beta = 7.5-8.0; P < 0.01) than those in the lowest two quartiles. Controlling for energy intake eliminated differences between QIV and QI. Among children of 5-10 years of age dairy intake had no relationship to BMI. Young children in the highest quartile of milk intake had higher BMIs than all lower quartiles (beta = 7.1-12.8; beta = 6.3-11.8 in energy-controlled models; P < 0.05). Among children of 5-10 years of age, those in QIV for milk intake had higher BMIs than those in QII (beta = 8.3; beta = 7.1 in energy-controlled model; P < 0.01). Controlling for total protein or calcium did not change the results. Milk had more consistent positive associations with BMI than did dairy products, and these were strongest among children of 2-4 years of age.
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High dairy intakes have been associated with lower rates of obesity in observational studies, but mechanisms to explain the association are lacking. A high intake of dairy protein reduces spontaneous food intake and may be one important mechanism, but more specific effects of dairy calcium seem to exist. We have found that high versus low calcium intakes from dairy products had no effect on 24-h energy expenditure or substrate oxidation rates, but fecal fat excretion increased approximately 2.5-fold on the high-calcium diets. In a meta-analysis of intervention studies we found that increasing dairy calcium intake by 1200mg/day resulted in increased fecal fat excretion by 5.2 (1.6-8.8) g/day. Newer research shows that humans possess taste receptors for calcium in the gastrointestinal tract and that signaling may be linked to appetite regulation. A new line of evidence suggests that an inadequate calcium intake during an energy restricted weight loss program may trigger hunger and impair compliance to the diet. These mechanisms may be part of the explanation for the protective effects of dairy products with regard to obesity and metabolic syndrome.