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Background Reliable tables of glycemic indexes (GIs) and glycemic loads (GLs) are critical to research examining the relationship between glycemic qualities of carbohydrate in foods, diets, and health. In the 12 years since the last edition of the tables, a large amount of new data has become available. Objectives To systematically review and tabulate published and unpublished sources of reliable GI values, including an assessment of the reliability of the data. Methods This edition of the tables lists over 4000 items, a 61% increase in the number of entries compared to the 2008 edition. The data have been separated into 2 lists. The first represents more precise values derived using the methodology recommended by the International Standards Organization (∼2100 items). The second list contains values determined using less robust methods, including using limited numbers of healthy subjects or with a large SEM (∼1900 food items). Results Dairy products, legumes, pasta, and fruits were usually low-GI foods (≤55 on the 100-point glucose scale) and had consistent values around the world. Cereals and cereal products, however, including whole-grain or whole-meal versions, showed wide variation in GI values, presumably arising from variations in manufacturing methods. Breads, breakfast cereals, rice, savory snack products, and regional foods were available in high-, medium-, and low-GI versions. Most varieties of potato were high-GI foods, but specific low-GI varieties have now been identified. Conclusions The availability of new data on the GIs of foods will facilitate wider research and application of the twin concepts of GI and GL. Although the 2021 edition of the tables improves the quality and quantity of GI data available for research and clinical practice, GI testing of regional foods remains a priority. This systematic review was registered in PROSPERO as #171204.

Early life exposures could be pertinent risk factors of cardiometabolic diseases in adulthood. We assessed the prospective associations of early life factors with markers of cardiometabolic risk among healthy German adults.We examined 348 term-born DONALD Study participants with measurement of fasting blood at the age of 18-24 years to assess metabolic indices: fatty liver index (FLI), hepatic steatosis index (HSI), pro-inflammatory score and insulin sensitivity (HOMA2-%S). Early life factors (maternal weight in early pregnancy, maternal early pregnancy BMI, gestational weight gain (GWG), maternal age, birth weight and full breastfeeding (17 weeks)) were assessed at enrolment of the offspring into the study. Multivariable linear regression models were used to analyze associations between early life factors and markers of cardiometabolic risk in early adulthood with adjustment for potential confounders. A higher early pregnancy BMI was related to notably higher levels of offspring FLI, HSI, pro-inflammatory score and a lower HOMA2-%S (all p 0.0001). Similarly, a higher gestational weight gain was associated with a higher FLI (p = 0.044), HSI (p = 0.016), pro-inflammatory score (p = 0.032) and a lower HOMA2-%S among females (p = 0.034). Full breastfeeding was associated with a lower adult FLI (p = 0.037). A casual mediation analysis showed that these associations were mediated by offspring adult waist circumference (WC).This study suggests that early pregnancy BMI, gestational weight gain, and full breastfeeding are relevant for offspring markers of cardiometabolic risk which seems to be mediated by body composition in young adulthood.

Summary Background & aims To date, the prevalence of Gestational diabetes mellitus (GDM) in China was 17.5%. Given the substantial relevance of GDM for medium- and long-term health of both mother and offspring and the paucity of existing data on the link between maternal diet and glucose homeostasis during pregnancy in Asian population, additional studies are needed. To examine the relevance of dietary glycemic index (GI), glycemic load (GL) and fiber intake before and during pregnancy for the development of GDM and glucose homeostasis over the course of pregnancy. Methods Cox proportional hazards analysis and linear mixed effects regressions were performed on data from 9317 women for whom three food frequency questionnaires (pre-pregnancy, 1st and 2nd trimesters) and biochemical measures during pregnancy were available. Investigated outcome variables included GDM risk, fasting plasma glucose (FPG), glycated hemoglobin (HbA1C), and homeostasis model assessment insulin resistance (HOMA-IR) in the 1st, 2nd and 3rd trimesters. Results Women in the highest tertile of dietary GI (or GL) before pregnancy, in the 1st, or the 2nd trimester respectively had a 12% (15%), 25% (23%) or 29% (25%) higher risk of developing GDM than those in the lowest tertile (all p for trend ≤ 0.02). Women with the highest dietary fiber intake before pregnancy, in the 1st or 2nd trimester had a 11%, 17% or 18% lower GDM risk (all p for trend ≤ 0.03). Moreover, increases in GI or GL and decreases in fiber intake over the course of pregnancy (1st to 3rd trimesters) were independently associated with adverse concurrent developments in FPG, HbA1C and HOMA-IR (p ≤ 0.03). Conclusions Our study indicates that dietary GI, GL and fiber intake before and during pregnancy affects glucose homeostasis of pregnant Chinese women.

Due to their biologically later chronotype, young students are vulnerable to a discrepant sleeping pattern between work- and free days, coined social jetlag (SJL). This study examined whether a later chronotype and/or a larger SJL are related to an analogous discrepancy in meal timing defined as eating jetlag (EJL) and whether chronotype and/or changes in SJL during the first COVID-19 related lockdown in Germany associated with changes in EJL. Baseline data were collected from September 2019-January 2020 among 317 students (58% females) aged 18-25 years of which a total of 156 students (67% females) completed an online follow-up survey in June-July 2020 (1st lockdown). Data were collected on daily routines, timing of meals/snacks, and physical activity. Chronotype was determined using the Munich ChronoType Questionnaire; SJL and EJL correspond to the difference in the daily midpoint of sleep/eating duration between work- and free days. Multivariable linear regression revealed that students with a later chronotype or a larger SJL experienced a larger EJL (p

Summary Background Cluster analyses have proposed different diabetes phenotypes using age, BMI, glycaemia, homoeostasis model estimates, and islet autoantibodies. We tested whether comprehensive phenotyping validates and further characterises these clusters at diagnosis and whether relevant diabetes-related complications differ among these clusters, during 5-years of follow-up. Methods Patients with newly diagnosed type 1 or type 2 diabetes in the German Diabetes Study underwent comprehensive phenotyping and assessment of laboratory variables. Insulin sensitivity was assessed using hyperinsulinaemic-euglycaemic clamps, hepatocellular lipid content using magnetic resonance spectroscopy, hepatic fibrosis using non-invasive scores, and peripheral and autonomic neuropathy using functional and clinical criteria. Patients were reassessed after 5 years. The German Diabetes Study is registered with ClinicalTrials.gov , number NCT01055093 , and is ongoing. Findings 1105 patients were classified at baseline into five clusters, with 386 (35%) assigned to mild age-related diabetes (MARD), 323 (29%) to mild obesity-related diabetes (MOD), 247 (22%) to severe autoimmune diabetes (SAID), 121 (11%) to severe insulin-resistant diabetes (SIRD), and 28 (3%) to severe insulin-deficient diabetes (SIDD). At 5-year follow-up, 367 patients were reassessed, 128 (35%) with MARD, 106 (29%) with MOD, 88 (24%) with SAID, 35 (10%) with SIRD, and ten (3%) with SIDD. Whole-body insulin sensitivity was lowest in patients with SIRD at baseline (mean 4·3 mg/kg per min [SD 2·0]) compared with those with SAID (8·4 mg/kg per min [3·2]; p Interpretation Cluster analysis can characterise cohorts with different degrees of whole-body and adipose-tissue insulin resistance. Specific diabetes clusters show different prevalence of diabetes complications at early stages of non-alcoholic fatty liver disease and diabetic neuropathy. These findings could help improve targeted prevention and treatment and enable precision medicine for diabetes and its comorbidities. Funding German Diabetes Center, German Federal Ministry of Health, Ministry of Culture and Science of the state of North Rhine-Westphalia, German Federal Ministry of Education and Research, German Diabetes Association, German Center for Diabetes Research, Research Network SFB 1116 of the German Research Foundation, and Schmutzler Stiftung.

The present manuscript addressed two hypotheses: (i) As children age, energy intake is shifted from morning (energy intake11am) to evening hours (energy intake6pm) (ii) A higher 'eveningness in energy intake' (i.e. evening minus morning energy intake) is associated with a higher total daily energy intake. Data were analyzed from 262 DONALD cohort study participants, who had completed at least one 3-day weighed dietary record in the age groups 3/4, 5/6, 7/8, 9/10, 11/12, 13/14, 15/16 and 17/18 years (y). 'Eveningness in energy intake' was compared across age groups and related to total daily energy intake for each age group (multiple cross-sectional analyses). 'Eveningness' increased progressively from age group 3/4y to age group 17/18y. A median surplus of evening energy intake (i.e. when evening intake exceeded morning intake) was firstly observed for age group 11/12y. From age group 11/12y onwards, a higher 'eveningness' was associated with a higher total daily energy intake (all p 0.04). Difference in total daily energy intake between the highest and the lowest tertile of 'eveningness' was largest for age group 17/18y, amounting to an 11% higher intake among adolescents in the highest as compared to those in the lowest tertile. In conclusion, energy intake progressively shifts from morning to evening hours as children age. Once evening energy intake exceeds morning energy intake, a higher 'eveningness in energy intake' is associated with higher total daily energy intake.

Background and aims The positive and negative health effects of dietary carbohydrates are of interest to both researchers and consumers. Methods International experts on carbohydrate research held a scientific summit in Stresa, Italy, in June 2013 to discuss controversies surrounding the utility of the glycemic index (GI), glycemic load (GL) and glycemic response (GR). Results The outcome was a scientific consensus statement which recognized the importance of postprandial glycemia in overall health, and the GI as a valid and reproducible method of classifying carbohydrate foods for this purpose. There was consensus that diets low in GI and GL were relevant to the prevention and management of diabetes and coronary heart disease, and probably obesity. Moderate to weak associations were observed for selected cancers. The group affirmed that diets low in GI and GL should always be considered in the context of diets otherwise understood as healthy, complementing additional ways of characterizing carbohydrate foods, such as fiber and whole grain content. Diets of low GI and GL were considered particularly important in individuals with insulin resistance. Conclusions Given the high prevalence of diabetes and pre-diabetes worldwide and the consistency of the scientific evidence reviewed, the expert panel confirmed an urgent need to communicate information on GI and GL to the general public and health professionals, through channels such as national dietary guidelines, food composition tables and food labels.

summary Background & aims: The optimal dietary approach for weight loss and improving insulin sensitivity in adolescents is unknown. This study aimed to explore the association between the estimated insulin demand of the diet, as measured by glycemic and insulin load, weight loss, percentage body fat and insulin sensitivity index (ISI) in obese adolescents with clinical features of insulin resistance and/or prediabetes after a 3 month lifestyle and metformin intervention. Methods: Secondary data analysis of 91 adolescents (median age 12.7 years (range 10.1e17.4) participating in a randomized controlled trial, known as RESIST; ACTRN12608000416392. Weight change between baseline and 3 months was measured by BMI expressed as percentage of the 95th centile (BMI % 95). Body composition was measured by dual energy X-ray absorptiometry and ISI was determined by an oral glucose tolerance test. Results: Higher dietary glycemic load and insulin load were associated with less weight loss (BMI %95), adjusted for sex and pubertal stage, b ¼ 0.0466, P ¼ 0.007 and b ¼ 0.0124, P ¼ 0.040, respectively. Inclusion of total energy intake in the model explained observed associations between dietary glycemic load and insulin load and change in BMI %95. Neither dietary glycemic load nor insulin load were associated with changes in percentage body fat or ISI. Dietary glycemic index and macronutrient content (% of total energy) were not associated to changes in BMI %95, percentage body fat or ISI. Conclusion: Reduced energy diet contributes to weight loss in obese, insulin resistant adolescents. Diets with a lower insulin demand were associated with a lower energy intake and may hence assist with weight loss.

Chronic low-grade inflammation represents a likely intermediary in the relation between carbohydrate nutrition and both type 2 diabetes and cardiovascular disease. This study assessed the prospective association between carbohydrate quantity and quality [dietary glycemic index (GI), glycemic load (GL), and added sugar, fiber, and whole-grain intake] during puberty, a potentially critical period for later disease, and low-grade inflammation in younger adulthood. The analysis was based on 205 participants (113 girls and 92 boys) from the DONALD (Dortmund Nutritional and Anthropometric Longitudinally Designed) study with at least 2 3-d weighed dietary records during puberty (girls: 9-14 y, boys: 10-15 y) and blood samples in younger adulthood (18-36 y). Multivariable linear regression models were used to analyze the associations between carbohydrate nutrition and circulating concentrations of pro- and anti-inflammatory immune mediators [high-sensitivity C-reactive protein (hs-CRP), interleukin (IL) 6, IL-18, and adiponectin]. A higher intake of carbohydrates during puberty (P-trend = 0.005), particularly from higher-GI food sources (P-trend = 0.01), was prospectively related to higher concentrations of IL-6 in younger adulthood, independently of baseline BMI and early life, socioeconomic, and other nutritional factors. Furthermore, a higher dietary GL (P-trend = 0.002) and a lower intake of whole grains (P-trend = 0.01) were independently associated with higher IL-6 concentrations in adults. Dietary GI and added sugar and fiber intakes were not independently associated with IL-6 (P-trend ≥ 0.09). Carbohydrate nutrition during puberty was not independently related to hs-CRP, IL-18, and adiponectin concentrations (all P-trend > 0.1). During puberty, a higher intake of carbohydrates from higher-GI food sources and lower whole-grain consumption prospectively predict greater IL-6 concentrations in young adulthood. These data support the hypothesis that diet during puberty influences later inflammation and metabolic dysfunction.

Recent studies provide evidence that insulin-like-growth-factor I (IGF-I) and its binding proteins (IGFBP) IGFBP-2 and IGFBP-3 are related to the risk of several common cancers. It remains to be clarified whether their concentrations can be programmed by protein intake from different sources during growth. This study addressed the hypothesis that animal protein intakes during infancy, mid-childhood, and adolescence differ in their relevance for the growth-hormone (GH)-IGF-I axis in young adulthood. Data from the Dortmund Nutritional and Anthropometric Longitudinally Designed Study participants with at least 2 plausible 3-d weighed dietary records during adolescence (age: girls, 9‐14 y; boys, 10‐15 y; n = 213), around the adiposity rebound (age 4‐6 y; n = 179) or early life (age 0.5‐2 y; n = 130), and one blood sample in young adulthood were included in the study. Mean serum concentrations of IGF-I, IGFBP-1, IGFBP-2, and IGFBP-3 were compared between tertiles of habitual animal protein intake using multivariable regression analysis. Habitually higher animal protein intakes in females during puberty were related to higher IGF-I (P-trend = 0.005) and IGFBP-3 (P-trend = 0.01) and lower IGFBP-2 (P-trend = 0.04), but not to IGFBP-1 in young adulthood. In turn, IGF-I concentrations in young adulthood were inversely related to animal protein intakes in early life among males only (P-trend = 0.03), but not to animal protein intake around adiposity rebound (P-trend > 0.5). Our data suggest that, among females, a habitually higher animal protein intake during puberty may precipitate an upregulation of the GH-IGF-I axis, which is still discernible in young adulthood. By contrast, among males, higher animal protein intakes in early life may exert a long-term programming of the GH-IGF-I axis. J. Nutr. 143: 1147‐1154, 2013.

Nonalcoholic fatty liver disease (NAFLD), frequently already present in young subjects, has been linked to reduced growth hormone levels and signaling. Similar hormonal changes occur during metabolic acidosis (MA), which may thus contribute to an increased NAFLD risk. Because subclinical MA can be diet induced, we aimed to examine whether a higher diet-dependent acid load during adolescence is prospectively associated with several currently used NAFLD surrogates in young adulthood. Dietary acidity during adolescence (boys:10-15 y, girls: 9-14 y) was calculated as potential renal acid load (PRAL) from at least three 3-d weighed dietary records according to a published algorithm considering dietary protein and minerals in 145 healthy participants. Routine measurements derived from blood analysis and anthropometric data in participants' young adulthood (18-25 y) were used to determine the NAFLD surrogates alanine-aminotransferase (ALT), hepatic steatosis index (HSI), and fatty liver index (FLI). Sex-stratified linear regression models, adjusted for dietary fiber, saturated fat, protein, and adolescent BMI SD scores, were run with PRAL as the independent variable. Dietary PRAL during puberty was positively associated with ALT (P = 0.02), HSI (P = 0.002), and FLI (P = 0.005) in adult females but not males. Females with an adolescent dietary acid load in the highest tertile had 3.5, 4.4, and 4.5 higher values of ALT, HSI, and FLI as adults, respectively, compared to females with the lowest PRAL. The present findings suggest that higher dietary acidity in adolescence may be prospectively associated with hepatic lipid accumulation in females. Whether this relationship is due to the higher proton load or rather represents an unhealthy dietary pattern requires further investigation.

Short sleep duration in early childhood may increase the risk for chronic diseases in later life. Strategies to improve sleep duration are thus of interest. We investigated whether the nutritional composition of the evening meal is associated with children's sleep duration in the 2nd year of life.Multivariable regression models included 594 participants of the DONALD Study with 3-days weighed dietary records and average daily sleep duration at age 1.5 and 2 years.Higher energy intakes with the evening meal were associated with a longer sleep duration (1 min/10 kcal, p = 0,01). With respect to absolute intakes, carbohydrates (0.8 min/g, p 0.0001), especially from high GI foods (1.3 min/g, p 0.01), and a higher GL (1.5 min/g GL, p 0.01) were accompanied by longer sleeping time. A qualitative exchange of energy from protein by energy from carbohydrates from high GI foods was only associated with increased sleep duration in toddlers without (1.9 min/%E, p 0.05), but not with nightly eating occasions (p 0.4).The observed associations are in line with suggested sleep-improving effects of carbohydrates. Effect sizes suggest that the clinical relevance of nutritional composition for sleep duration is limited in healthy young toddlers. These observations and their possible importance for more vulnerable groups need to be confirmed in clinical trials.

Dietary factors, especially during early childhood, have been discussed as potentially critical for the development of childhood overweight. This study evaluated associations between added sugar intake during early childhood and BMI and body fat at age 7 y. Analysis was based on data from 216 participants of the Dortmund Nutritional and Anthropometric Longitudinally Designed (DONALD) Study. Life-course plots were constructed to evaluate the association between added sugar intake at different ages (0.5, 1, 1.5, and 2 y) and BMI SD score (BMI-SDS) and % body fat (%BF) at age 7 y. Multivariable analyses were performed for the periods identified as critical for later BMI and body fat. Added sugar intake at age 1 y and the change in intake levels during the second year of life emerged as potentially critical. At age 1 y, a higher total added sugar intake was related to a lower BMI-SDS at age 7 y [adjusted β ± SE: -0.116 ± 0.057 BMI-SDS/percent energy (%En) added sugar; P = 0.04]. Conversely, an increase in total added sugar in the second year of life (Δ%En between age 1 and 2 y) tended to be associated with a higher BMI-SDS (adjusted β ± SE: 0.074 ± 0.043 BMI-SDS/Δ%En added sugar; P = 0.09). No associations were observed with %BF. In conclusion, added sugar intake at low intake levels during early childhood does not appear to be critical for BMI and body fat at age 7 y. However, detrimental effects on BMI development may emerge when added sugar intakes are increased to higher levels.

Background: n–3 (omega-3) Polyunsaturated fatty acids (PUFAs), fish, and nuts can regulate inflammatory processes and responses. Objective: We investigated whether dietary intakes of PUFAs [n23, n–6 (omega-6), and a-linolenic acid], fish, and nuts were associated with 15-y mortality attributed to noncardiovascular, noncancer inflammatory diseases. Design: The analyses involved 2514 participants aged 49 y at baseline. Dietary data were collected by using a semiquantitative food-frequency questionnaire, and PUFA, fish, and nut intakes were calculated. Inflammatory disease mortality was confirmed from the Australian National Death Index. Results: Over 15 y, 214 subjects died of inflammatory diseases. Women in the highest tertiles of total n23 PUFA intake, compared with those in the lowest tertile of intake at baseline, had a 44% reduced risk of inflammatory disease mortality (P for trend = 0.03). This association was not observed in men. In both men and women, each 1-SD increase in energy-adjusted intake of a-linolenic acid was inversely associated with inflammatory mortality (hazard ratio: 0.83; 95% CI: 0.71, 0.98). Subjects in the second and third tertiles of nut consumption had a 51% and 32% reduced risk of inflammatory disease mortality, respectively, compared with those in the first tertile (reference). Dietary intakes of long-chain n23 and n26 PUFAs and fish were not associated with inflammatory disease mortality. Conclusions: We report on a novel link between dietary intake of total n23 PUFA and risk of inflammatory disease mortality in older women. Furthermore, our data indicate a protective role of nuts, but not fish, against inflammatory disease mortality. Am J Clin Nutr doi: 10.3945/ajcn.110.009977.

Early puberty onset is associated with hormone-related cancers, but whether diet in childhood influences pubertal timing is controversial. We examined the association of protein intake in early and mid-childhood with the ages at take-off of the pubertal growth spurt (ATO), peak height velocity (APHV), and menarche in girls and voice break in boys using data from the longitudinal Dortmund Nutritional and Anthropometric Longitudinally Designed Study. Among participants who provided 3-d weighed dietary records at 12 mo, 18-24 mo, 3-4 y, and 5-6 y, 112 had sufficient anthropometric measurements between 6 and 13 y to allow estimation of ATO. Life-course plots were used to identify critical periods of total, animal, and vegetable protein intake (percentage of total energy intake) for pubertal timing. At these ages, the association between tertiles of protein intake (T1-T3) and the outcomes was investigated using multiple linear regression analysis. A higher total and animal protein intake at 5-6 y was related to an earlier ATO. In the highest tertile of animal protein intake at 5-6 y, ATO occurred 0.6 y earlier than in the lowest [(mean, 95% CI) T1: 9.6, 9.4-9.9 vs. T2: 9.4, 9.1-9.7 vs. T3: 9.0, 8.7-9.3 y; P-trend = 0.003, adjusted for sex, total energy, breast-feeding, birth year, and paternal university degree]. Similar findings were seen for APHV (P-trend = 0.001) and the timing of menarche/voice break (P-trend = 0.02). Conversely, a higher vegetable protein intake at 3-4 and 5-6 y was related to later ATO, APHV, and menarche/voice break (P-trend = 0.02-0.04). These results suggest that animal and vegetable protein intake in mid-childhood might be differentially related to pubertal timing.

In patients with hypercortisolism, who are frequently obese, the prevalence of elevated urinary excretion rates of the potential lithogenic factors (calcium, oxalate, and uric acid) is increased. We examined whether the 24-hour urinary excretion rates of calcium, oxalate, and uric acid are already associated with body fat and endogenous glucocorticoids in healthy free-living children, taking relevant nutritional and acid-base factors into account. Urinary analyte excretions were determined in 24-hour urine samples of 300 healthy children aged 4 to 14 years. Potentially bioactive free glucocorticoids were assessed as urinary free cortisol + urinary free cortisone. Associations of glucocorticoids and percentage body fat with the outcome variables were examined in regression models adjusted for sex, height, growth velocity, urinary volume, net acid excretion, and relevant nutritional factors. Percentage body fat and urinary free cortisol + urinary free cortisone explained most of the growth-independent variation of urinary uric acid and also a relevant part of oxalate, but none of calcium. Net acid excretion, an indicator of endogenous acid production, and dietary protein, salt, and fiber intakes were also variably associated with the outcomes urinary calcium, oxalate, and uric acid. In conclusion, body fatness and potentially bioactive free glucocorticoids (even in the physiologic range) appear to affect urinary excretion rates of oxalate and uric acid, whereas urinary calcium output is more strongly related to dietary factors in healthy children. Our data provide the first in vivo-based evidence that the obesity- or hypercortisolism-associated urolithiasis may be a pathophysiologic continuation of the corresponding endocrine metabolic variations in healthy children.

Background: Adrenarche is the increase in adrenal androgen (AA) production starting in childhood. Until now, it has been unknown whether or not nutritional factors modulate adrenarche. Objective: The objective was to examine whether body composition and certain dietary intakes are associated with AA production in children after accounting for urinary indicators of major adrenarche-related steroidogenic enzymes. Design: Androgen and glucocorticoid metabolites were profiled by gas chromatography-mass spectrometry in 24-h urine samples of 137 healthy prepubertal children aged 3-12 y, for whom birth characteristics, growth velocity data, and 3-d weighed-diet record information were available. Associations of the sum of C19 metabolites (reflecting daily AA secretion) with nutritional factors [fat mass (FM), fat-free mass (FFM), nutrient intakes, glycemic index, and glycemic load] and AA-relevant estimates of steroidogenic enzyme were examined in stepwise multiple regression models adjusted for age, sex, urine volume, and total energy intake. Enzyme activity estimates were calculated by using specific urinary steroid metabolite ratios. Results: Of the nutrition-relevant predictors, FM (P < 0.0001) explained most of the variation of AA secretion (R 2 = 5%). Animal protein intake was also positively associated with AA secretion (P < 0.05), which explained 1 % of its variation. FFM (P = 0.1) and total protein intake (P = 0.05) showed positive trends. The difference in daily AA secretion between the lowest and highest quartile of FM was comparable to that between the lowest and highest estimated activity of one of the major steroidogenic enzymes. Conclusions: Body fat mass may relevantly influence prepubertal adrenarchal androgen status. In addition, animal protein intake may also make a small contribution to AA secretion in children.

BACKGROUND Observational studies in adults suggest that a diet with a high glycemic index (GI) or glycemic load (GL), a high intake of sugary foods, or a low fiber intake may increase the risk of overweight. OBJECTIVES We aimed to examine prospectively whether dietary GI, GL, added sugar intake, or fiber intake between age 2 and 7 y are associated with the development of body composition. If so, we aimed to ascertain whether these associations are modified by meal frequency. DESIGN Linear mixed-effect regression analyses were performed in 380 participants of the DOrtmund Nutrition and Anthropometric Longitudinally Designed (DONALD) Study for whom 4-6 weighed 3-d dietary records and anthropometric data were obtained between ages 2 and 7 y. RESULTS Changes in dietary GI, GL, or added sugar intake between ages 2 and 7 y were not associated with concurrent changes in percentage body fat (%BF, as estimated from skinfold thicknesses) or body mass index SD scores. An increase in fiber intake was related to a concurrent decrease in %BF between ages 2 and 7 y only in children who consumed

Background A high early protein intake has been proposed to increase obesity risk. Objective We examined whether a critical period of protein intake for later obesity may exist early in childhood and investigated the relation between protein intake from different sources and body mass index SD score and body fat percentage (BF%) at 7 y of age. Design The study population included 203 participants of the Dortmund Nutritional and Longitudinally Designed Study with information on diet at 6 mo, 12 mo, 18-24 mo, 3-4 y, and 5-6 y. Life-course plots were constructed to assess when protein intake (% of energy) was associated with body mass index SD score and BF% at 7 y. Mean values were then compared among tertiles (T1-T3) of protein from different sources at the important time points. Results The ages of 12 mo and 5-6 y were identified as critical ages at which higher total and animal, but not vegetable, protein intakes were positively related to later body fatness. In fully adjusted models, animal protein intake at 12 mo was associated with BF% at 7 y as follows [x (95% CI) BF%]: T1, 16.20 (15.23, 17.25); T2, 17.21 (16.24, 18.23); T3, 18.21 (17.12, 19.15); P for trend = 0.008. With respect to food groups, dairy, but not meat or cereal protein intake, at 12 mo was related to BF% at 7 y (P for trend = 0.07). Animal protein at 5-6 y yielded similar results (P for trend = 0.01), but food group associations were less consistent. Conclusion A higher animal, especially dairy, protein intake at 12 mo may be associated with an unfavorable body composition at 7 y. The age of 5-6 y might represent another critical period of protein intake for later obesity risk.