Long-term dietary protein intake appears to act anabolically on diaphyseal bone strength during growth, and this may be negated, at least partly, if dietary PRAL is high, ie, if the intake of alkalizing minerals is low.

Objective: The roles of vitamin D and parathyroid hormone (PTH) are discussed controversially in obesity, and studies of these hormones in obese children are limited. Therefore, we studied the relationships between PTH, 1,25-dihydroxy-vitamin D (1,25-OH Vit D), 25-hydroxy-vitamin D (25-OH Vit D), weight status, and insulin sensitivity before and after weight loss in obese children. Methods: Fasting serum PTH, 1,25-OH Vit D, 25-OH Vit D, inorganic phosphate, calcium, alkaline phosphatase (AP), insulin, glucose, and weight status (SDS-BMI and percentage body fat) were determined in 133 obese children (median age 12.1 years) and compared with 23 non-obese children. Furthermore, these parameters were analyzed in 67 obese children before and after participating in a 1-year obesity intervention program. Results: Obese children had significantly (P!0.001) higher PTH and lower 25-OH Vit D concentrations compared with non-obese children, while calcium, phosphate, AP, and 1,25-OH Vit D did not differ significantly. Changes of PTH (rZ0.23, PZ0.031) and 25-OH Vit D (rZK0.27, PZ0.013) correlated significantly with changes of SDS-BMI, but not with changes of insulin sensitivity (homeostasis model assessment; HOMA-B%). Reduction of overweight in 35 children led to a significant (P!0.01) decrease of PTH concentrations and an increase in 25-OH Vit D levels. Conclusions: PTH levels were positively and 25-OH Vit D concentrations were negatively related to weight status. Since these alterations normalized after weight loss, these changes are consequences rather than causes of overweight. A relationship between PTH, vitamin D, and insulin sensitivity based on the HOMA index was not found in obese children. Further longitudinal clamp studies are neccessary to study the relationship between vitamin D and insulin sensitivity. European Journal of Endocrinology 157 225-232Introduction Vitamin D and parathyroid hormone (PTH) are well known for their essential role in bone metabolism and calcium homeostasis. The main sources of vitamin D are ergocalciferol and cholecalciferol, the former normally available in food and the latter produced in the skin by u.v. radiation of 7-dehydrocholesterol. Both of these compounds are hydroxylated in the liver to 25-hydroxyvitamin D (25-OH Vit D), which is the major circulating metabolite precursor to the hormonally active form, 1,25-dihydroxy-vitamin D (1,25-OH Vit D).It has become increasingly clear that the vitamin D endocrine system is related to obesity in adults. Obesity has been found to be associated with lower levels of serum 25-OH Vit D (1-5) and higher levels of serum PTH (1,(5)(6)(7)(8). A low vitamin D intake was associated with increased body mass index (BMI) (9). PTH has been postulated as an independent predictor of obesity (7). Overweight as a consequence of elevated serum PTH was explained by several mechanisms (10, 11): PTH stimulates the renal hydroxylation of 25-OH Vit D to its active form, 1,25-OH Vit D, which in turn elevates the calcium influx into adipocytes. In these cell...

In the present study the relationship between the consumption of different beverage groups and body-weight status in 5 years of study participation in German adolescents was investigated. We used anthropometric and dietary data from 3 d weighed records of 244 subjects between 9 and 18 years of age participating in the Dortmund Nutritional and Anthropometric Longitudinally Designed (DONALD) study. Only subjects with at least four out of six possible weighed dietary records were considered. A repeated-measures regression model (PROC MIXED) was used to analyse the effect of beverage consumption on body-weight status. BMI standard deviation scores (BMI-SDS) and body fat percentage (%BF) were chosen as the dependent variables. In boys, energetic beverage consumption was not associated with BMI-SDS or %BF, neither cross-sectionally nor prospectively. In girls, baseline consumption of energetic beverages did not predict baseline BMI-SDS, baseline %BF, or change in either variable over the study period. However, an increase in energetic beverage consumption over the study period was associated with an increase in BMI-SDS (þ 0.070 SDS/MJ increase in energetic beverage consumption; P¼0·01). Separate consideration of regular soft drinks and fruit juices revealed that, in girls, BMI-SDS increased with increased fruit juice consumption (þ 0·096 SDS/MJ increase in fruit juice consumption; P¼ 0·01), and to a lesser extent with regular soft drink consumption (þ 0·055 SDS/MJ increase in regular soft drink consumption; P¼0·08). In conclusion, these results suggest that an increase in energetic beverage consumption may result in weight gain, at least in adolescent girls.

Objective: Highly processed foods such as convenience foods usually have a high salt content and therefore might indirectly act as adipogenic due to an increasing consumption of sugar-containing beverages (SCB). We examined the association between dietary salt and body weight status. Design: We used data on urinary Na excretion as an indicator of dietary salt and BMI standard deviation score (BMI-SDS) and percentage body fat (%BF) of children and adolescents participating in the DONALD (Dortmund Nutritional and Anthropometric Longitudinally Designed) Study. Setting: Dortmund, Germany. Subjects: Children and adolescents (n 364) who had at least two 24 h urine samples and two dietary records in the observational period between 2003 and 2009 were considered in our data analysis. Results: Repeated-measures regression models revealed that urinary Na was positively associated with BMI-SDS (10?202 SDS/g Na excretion at baseline; P , 0?001) and %BF (11?303 %BF/g Na excretion at baseline; P , 0?01) at baseline in boys and girls. These associations remained significant after adjustment for SCB consumption and total energy intake. Furthermore, there was a positive trend between baseline Na excretion and the individual change in %BF in the study period (10?364 increase in %BF/g Na excretion at baseline), which was confirmed after inclusion of SCB consumption or total energy intake. There was no significant association between the change in Na excretion and the concurrent change of either BMI-SDS or %BF in any model. Conclusions: Our results suggest that a high intake of processed salty foods could have a negative impact on body weight status in children and adolescents independently from their consumption of SCB.

Exact menus and food amounts are a prerequisite to ascertain nutrient adequacy of FBDG. The OMD demonstrates that a single diet concept with a core of quantified food groups can be adequate for age groups between 1 and 18 years within a country, such as Germany.

Due to the study heterogeneity, the small samples, the bias towards upper social classes, and the scarcity of recent studies, the existing data do not allow us to draw firm conclusions on health benefits or risks of present-day vegetarian type diets on the nutritional or health status of children and adolescents in industrialized countries.

OBJECTIVE:The treatment of obese children and adolescents is not yet satisfactorily effective. It is not clear which participants can profit by a long-time outpatient therapy. DESIGN: Longitudinal, clinical intervention study based on a 1-y outpatient training programme consisting of physical exercise, nutrition course and behaviour therapy for children and their parents. SUBJECTS: A total of 75 obese children (age 7-15 y; standard duration scores of body mass index (SDS-BMI)+1.9-+3.8). MEASUREMENTS:We characterised the participants as to their willingness to change their behaviour (changes in weight status, number of attempts at therapy, participation in exercise groups), somatic characteristics (BMI of children and family members, gender, age), socioeconomic status (level of education of the children and their parents, working mother), exercise and dietary habits, dietary intake as well as the quality of dietary records. These factors were related to the success of the treatment using a multiple logistic regression. RESULTS: A total of 27 (37%) of the children were unsuccessful after treatment. For 48 (63%) of the children, there was a median weight loss of about 0.4 SDS-BMI (range À0.2 to À1.1). The only significant difference (Po0.0001) between these successful children and the unsuccessful ones was that they had taken part in the exercise groups before training began. CONCLUSION: A training for the obese children and their parents enables the majority of the participants to reduce weight. Previous participation in exercise groups can be considered as a predictor to success of the treatment.

Objective: Although breakfast is important for obesity prevention and dietary quality, breakfast skipping is a common behaviour. Knowledge of changes in breakfast habits may provide potential behaviour targets for intervention programmes. The present study describes the actual data on trends in breakfast habits and composition. Design: A total of 7800 3 d dietary records of 1081 participants aged 2-18 years collected between 1986 and 2007 in the DONALD (Dortmund Nutritional and Anthropometric Longitudinally Designed) Study were analysed using mixed linear models. Results: Breakfast was eaten at 78 % of all record days; regular breakfast (breakfast was eaten on all three recorded weekdays) was eaten in 75 % of records. During the study period, the number of records with regular breakfast decreased significantly in 6-12-and 13-18-year-olds (P 5 0?0084 and 0?0350, respectively). Of all breakfast meals, 62 % were bread meals and 21 % were ready-to-eat cereal (RTEC) meals. RTEC meals nearly doubled from the youngest to the oldest age group (P , 0?0001). During the study period, the percentage of bread meals decreased, whereas the percentage of RTEC meals increased (P , 0?0001). A higher percentage of RTEC meals than the bread meals was in accordance with the food-based guidelines (36 % v. 20 %, P , 0?0001), i.e. a breakfast including grain, dairy and fruit/vegetables. Conclusions: In the DONALD Study sample, a negative age and time trend in breakfast consumption was verified. Interventions regarding breakfast habits should be aimed at adolescents and should focus on fruit/vegetables.