Scientific Seminar Series – 2010 #4 Professor John Lynch
Why bother about child diet?  A population health perspective over the lifecourse John Lynch Professor of Public Health Epidemiology NHMRC Australia Fellow University of South Australia University of Bristol
Life Expectancy Selected Countries 1860-2005
Life Expectancy Selected Countries 1860-2005
 
AIHW (2005)
AIHW (2005)
 
Weaver.  Current Pediatrics  (2006) Mortality of breast fed and artificially fed infants during the summer diarrhea epidemic in Paris 1898
Thomas McKeown 1912-1988 1976 1988
1840  1860   1880   1900   1920   1940  1960 4000 3500 3000 2500 2000 1500 1000 500 0 Tubercle Bacillus Identified (Koch, 1882) Chemotherapy BCG vaccination Respiratory Tuberculosis:  Mean Annual Death Rates, England and Wales, 1840-1970 Death Rate (per million) Year McKeown and Record.  Pop Studies  (1962) 25% deaths
1974 2004
1974 2004
Average Height of Military Conscripts in Europe (1960-1990) Steckel (2000) Height (cm) France Germany Sweden Netherlands Denmark Norway Italy Spain Portugal
Chronic  Disease Fats Fruit Vegetables Whole grains Sugars Excessive kjoules Salt Adulthood Adolescence Maternal Paternal Factors Weaning diet Food  environment In-utero  environment Childhood Food Patterns 1. 2. 3. 4. Food Patterns &  Preferences Breastfeeding
Chronic  Disease Fats Fruit Vegetables Whole grains Sugars Excessive kjoules Salt Adulthood Adolescence Maternal Paternal Factors Weaning diet Food  environment In-utero  environment Childhood Food Patterns 1. 2. 3. 4. Food Patterns &  Preferences Breastfeeding
 
 
Chronic  Disease Fats Fruit Vegetables Whole grains Sugars Excessive kjoules Salt Adulthood Adolescence Childhood 1.
N = ~ 7000 Two dietary patterns ascertained from their association with lipid levels  These two patterns were associated with 1.5-2.0 relative risk of CHD  after adjustment for health behaviours, social class, blood pressure and BMI 1. Adult diet patterns predict chronic diseases
Chronic  Disease Fats Fruit Vegetables Whole grains Sugars Excessive kjoules Salt Adulthood Adolescence Food Patterns &  Preferences Childhood 1. 2.
2. There is some tracking of adolescent  diet into adult diet Aged 3-18 at baseline and are now 24-39
2. The importance of “taste preference” Am J Prev Med (2008)  N= ~ 1500 Taste preference was the strongest predictor of fruit and vegetable intake after control for social class, energy intake, education, and baseline fruit and vegetable consumption
Chronic  Disease Fats Fruit Vegetables Whole grains Sugars Excessive kjoules Salt Adulthood Adolescence Childhood 1. 2. Food Patterns &  Preferences 3. Food Patterns
4. Diet in late childhood tracks from diet in early childhood 2005 study showed consistent patterns between ages 4 and 7 2008 study expanded to include ages 3, 4, 7 and 9. It found greater variability especially  from age 3-9 but nevertheless, demonstrated moderate levels of tracking 2005 2008
Saturated fat restricted diet from infancy to age 15 = 1mmHg lower systolic blood pressure Hypertension  (2009)
Blood pressure measured 25 years previously was more important than current BP for CHD; both recent and past important for stroke mortality. Both past and current levels of cholesterol are equally important for CHD but not stroke. Boshuizen, et al.  AJE  (2006)
Chronic  Disease Fats Fruit Vegetables Whole grains Sugars Excessive kjoules Salt Adulthood Adolescence Childhood Food Patterns 1. 2. 3. Food Patterns &  Preferences Maternal Paternal Factors Weaning / Toddler diet Food  environment In-utero  environment 4? Breastfeeding
Maternal Paternal Factors Weaning and  Toddler diet Food  environment In-utero  environment Breastfeeding Childhood 4. 5. 5.
Am J Clinical Nutrition (2010) Am J Clinical Nutrition (2009) 4.
Maternal Paternal Factors Weaning and  Toddler diet Food  environment In-utero  environment Breastfeeding Childhood 4. 5. 5.
5.
Maternal Paternal Factors Weaning and  Toddler diet Food  environment In-utero  environment Breastfeeding Childhood Availability in food supply Availability in the home Knowledge  Food parenting practices
Chronic  Disease Fats Fruit Vegetables Whole grains Sugars Excessive kjoules Salt Adulthood Adolescence Maternal Paternal Factors Weaning diet Food  environment In-utero  environment Childhood Food Patterns 1. 2. 3. 4. Food Patterns &  Preferences Breastfeeding
Characterizing diet 0-3 – how?  Index vs PCA vs Nutrient Is diet 0-3 associated with physiological risk factors at ages 15-16? Is diet 0-3 associated with cognitive functioning at ages 15-16? Early Life Nutrition Group at UniSA in collaboration with ALSPAC at U Bristol

Nutrition in Population and public health

  • 1.
    Scientific Seminar Series– 2010 #4 Professor John Lynch
  • 2.
    Why bother aboutchild diet? A population health perspective over the lifecourse John Lynch Professor of Public Health Epidemiology NHMRC Australia Fellow University of South Australia University of Bristol
  • 3.
    Life Expectancy SelectedCountries 1860-2005
  • 4.
    Life Expectancy SelectedCountries 1860-2005
  • 5.
  • 6.
  • 7.
  • 8.
  • 9.
    Weaver. CurrentPediatrics (2006) Mortality of breast fed and artificially fed infants during the summer diarrhea epidemic in Paris 1898
  • 10.
  • 11.
    1840 1860 1880 1900 1920 1940 1960 4000 3500 3000 2500 2000 1500 1000 500 0 Tubercle Bacillus Identified (Koch, 1882) Chemotherapy BCG vaccination Respiratory Tuberculosis: Mean Annual Death Rates, England and Wales, 1840-1970 Death Rate (per million) Year McKeown and Record. Pop Studies (1962) 25% deaths
  • 12.
  • 13.
  • 14.
    Average Height ofMilitary Conscripts in Europe (1960-1990) Steckel (2000) Height (cm) France Germany Sweden Netherlands Denmark Norway Italy Spain Portugal
  • 15.
    Chronic DiseaseFats Fruit Vegetables Whole grains Sugars Excessive kjoules Salt Adulthood Adolescence Maternal Paternal Factors Weaning diet Food environment In-utero environment Childhood Food Patterns 1. 2. 3. 4. Food Patterns & Preferences Breastfeeding
  • 16.
    Chronic DiseaseFats Fruit Vegetables Whole grains Sugars Excessive kjoules Salt Adulthood Adolescence Maternal Paternal Factors Weaning diet Food environment In-utero environment Childhood Food Patterns 1. 2. 3. 4. Food Patterns & Preferences Breastfeeding
  • 17.
  • 18.
  • 19.
    Chronic DiseaseFats Fruit Vegetables Whole grains Sugars Excessive kjoules Salt Adulthood Adolescence Childhood 1.
  • 20.
    N = ~7000 Two dietary patterns ascertained from their association with lipid levels These two patterns were associated with 1.5-2.0 relative risk of CHD after adjustment for health behaviours, social class, blood pressure and BMI 1. Adult diet patterns predict chronic diseases
  • 21.
    Chronic DiseaseFats Fruit Vegetables Whole grains Sugars Excessive kjoules Salt Adulthood Adolescence Food Patterns & Preferences Childhood 1. 2.
  • 22.
    2. There issome tracking of adolescent diet into adult diet Aged 3-18 at baseline and are now 24-39
  • 23.
    2. The importanceof “taste preference” Am J Prev Med (2008) N= ~ 1500 Taste preference was the strongest predictor of fruit and vegetable intake after control for social class, energy intake, education, and baseline fruit and vegetable consumption
  • 24.
    Chronic DiseaseFats Fruit Vegetables Whole grains Sugars Excessive kjoules Salt Adulthood Adolescence Childhood 1. 2. Food Patterns & Preferences 3. Food Patterns
  • 25.
    4. Diet inlate childhood tracks from diet in early childhood 2005 study showed consistent patterns between ages 4 and 7 2008 study expanded to include ages 3, 4, 7 and 9. It found greater variability especially from age 3-9 but nevertheless, demonstrated moderate levels of tracking 2005 2008
  • 26.
    Saturated fat restricteddiet from infancy to age 15 = 1mmHg lower systolic blood pressure Hypertension (2009)
  • 27.
    Blood pressure measured25 years previously was more important than current BP for CHD; both recent and past important for stroke mortality. Both past and current levels of cholesterol are equally important for CHD but not stroke. Boshuizen, et al. AJE (2006)
  • 28.
    Chronic DiseaseFats Fruit Vegetables Whole grains Sugars Excessive kjoules Salt Adulthood Adolescence Childhood Food Patterns 1. 2. 3. Food Patterns & Preferences Maternal Paternal Factors Weaning / Toddler diet Food environment In-utero environment 4? Breastfeeding
  • 29.
    Maternal Paternal FactorsWeaning and Toddler diet Food environment In-utero environment Breastfeeding Childhood 4. 5. 5.
  • 30.
    Am J ClinicalNutrition (2010) Am J Clinical Nutrition (2009) 4.
  • 31.
    Maternal Paternal FactorsWeaning and Toddler diet Food environment In-utero environment Breastfeeding Childhood 4. 5. 5.
  • 32.
  • 33.
    Maternal Paternal FactorsWeaning and Toddler diet Food environment In-utero environment Breastfeeding Childhood Availability in food supply Availability in the home Knowledge Food parenting practices
  • 34.
    Chronic DiseaseFats Fruit Vegetables Whole grains Sugars Excessive kjoules Salt Adulthood Adolescence Maternal Paternal Factors Weaning diet Food environment In-utero environment Childhood Food Patterns 1. 2. 3. 4. Food Patterns & Preferences Breastfeeding
  • 35.
    Characterizing diet 0-3– how? Index vs PCA vs Nutrient Is diet 0-3 associated with physiological risk factors at ages 15-16? Is diet 0-3 associated with cognitive functioning at ages 15-16? Early Life Nutrition Group at UniSA in collaboration with ALSPAC at U Bristol