Carbohydrate intake and key food sources of carbohydrates in early childhood are poorly understood. The present study described total carbohydrate intake and subtypes (i.e. starch, sugar), their primary food sources and their tracking among young Australian children. Data from children at ages 9 months (n 393), 18 months (n 284), 3·5 years (n 244) and 5 years (n 240) from the Melbourne InFANT Program were used. Three 24-hour recalls assessed dietary intakes. The 2007 AUSNUT Food Composition Database was used to calculate carbohydrates intake and food groups. Descriptive statistics summarised total carbohydrate and subtype intake and their main food sources. Tracking was examined using Pearson correlations of residualised scores between time points. Total carbohydrate, starch and sugar intakes (g/d) increased across early childhood. The percentage of energy from total carbohydrates (% E) remained stable overtime (48·4–50·5 %). From ages 9 months to 5 years, the %E from total sugar decreased from 29·4 % to 22·6 %, while the %E from starch increased from 16·7 % to 26·0 %. Sources of total carbohydrate intake changed from infant formula at 9 months to bread/cereals, fruits and milk/milk products at 18 months, 3·5 and 5 years. Across all time points, the primary sources of total sugar intake were fruit, milk/milk products and cakes/cookies, whereas main food groups for starch intake included bread/cereals, cakes/cookies and pasta. Weak to moderate tracking of total carbohydrates, total sugar and starch (g/d) was observed. These findings may have the potential to inform the refinement of carbohydrate intake recommendations and design of interventions to improve children’s carbohydrate intake.

This study aimed to investigate the association between individual and combinations of macronutrients with premature death, CVD and dementia. Sex differences were investigated. Data were utilised from a prospective cohort of 120 963 individuals (57 % women) within the UK Biobank, who completed ≥ two 24-h diet recalls. The associations of macronutrients, as percentages of total energy intake, with outcomes were investigated. Combinations of macronutrients were defined using k-means cluster analysis, with clusters explored in association with outcomes. There was a higher risk of death with high carbohydrate intake (hazard ratios (HR), 95 % CI upper v. lowest third 1·13 (1·03, 1·23)), yet a lower risk with higher intakes of protein (upper v. lowest third 0·82 (0·76, 0·89)). There was a lower risk of CVD with moderate intakes (middle v. lowest third) of energy and protein (sub distribution HR (SHR), 0·87 (0·79, 0·97) and 0·87 (0·79, 0·96), respectively). There was a lower risk of dementia with moderate energy intake (SHR 0·71 (0·52, 0·96)). Sex differences were identified. The dietary cluster characterised by low carbohydrate, low fat and high protein was associated with a lower risk of death (HR 0·84 (0·76, 0·93)) compared with the reference cluster and a lower risk of CVD for men (SHR 0·83 (0·71, 0·97)). Given that associations were evident, both as single macronutrients and for combinations with other macronutrients for death, and for CVD in men, we suggest that the biggest benefit from diet-related policy and interventions will be when combinations of macronutrients are targeted.

The effects of macronutrient intake on obesity are controversial. This research aims to investigate the associations between macronutrient intake and new-onset overweight/obesity. The relationship between the consumption of carbohydrate and total fat and obesity was assessed by the multivariable Cox model in this 11-year cohort, which included 6612 adults (3291 men and 3321 women) who were free of overweight and obesity at baseline. The dietary intake was recorded using a 24-h recall method for three consecutive days. Moreover, substitution models were developed to distinguish the effects of macronutrient composition alteration from energy intake modification. During 7·5 person years (interquartile range 4·3, 10·8) of follow-up, 1807 participants became overweight or obese. After adjusting for risk factors, the hazard ratio (HR) of overweight/obesity in extreme quintiles of fat was 1·48 (quintile 5 v. quintile 1, 95 % CI 1·16, 1·89; Ptrend = 0·02) in women. Additionally, replacing 5 % of energy from carbohydrate with equivalent energy from fat was associated with an estimated 4·3 % (HR 1·043, 95 % CI 1·007, 1·081) increase in overweight/obesity in women. Moreover, dietary carbohydrate was inversely associated with overweight/obesity (quintile 5 v. quintile 1, HR 0·70, 95 % CI 0·55, 0·89; Ptrend = 0·02) in women. Total fat was related to a higher risk of overweight/obesity, whereas high carbohydrate intake was related to a lower risk of overweight/obesity in women, which was not observed in men.

The extent to which the quality of dietary carbohydrates (CHO) changes throughout puberty is not known. We analysed trends in the quantity and quality of CHO intake among German adolescents by separately examining trends during puberty (pubertal trends) and trends in CHO intake from 1988 to 2007 (secular trends). Linear mixed-effects regression analyses were performed in 216 participants of the Dortmund Nutritional and Anthropometric Longitudinally Designed Study who had provided weighed 3 d dietary records at the onset of the pubertal growth spurt (defined by age at take-off) and over the subsequent 4 years. Over the course of puberty, CHO quality changed little: added sugar intake from beverages increased in girls (0·25 (se 0·12) % energy (% E)/year, P = 0·04) and added sugar intake from sweets decreased in both sexes (boys: − 0·22 (se 0·11) % E/year, P = 0·049; girls: − 0·20 (se 0·10) % E/year, P = 0·04). For both sexes, significant upward secular trends were observed for CHO (% E), glycaemic load (g/MJ) and added sugar intakes from sources other than sweets and soft drinks (% E), while absolute fibre intake (g/d) decreased (P ≤ 0·04). Concomitant increases in total added sugar intake (% E) and decreases in fibre and whole-grain densities (g/MJ) (P = 0·001–0·02) were confined to boys only. The quality of dietary CHO consumed by healthy German adolescents shows notable secular declines, but does not change markedly during puberty. Public health initiatives should be tailored to improve the overall quality of CHO nutrition.

The aim of the present study was to investigate the interaction between the angiotensin-converting enzyme 1 (ACE) I/D polymorphism and energy and macronutrient intakes on adiposity-related phenotypes among toddlers and preschoolers. A representative sample of 2374 Greek children aged 1 to 5 years old was examined (Growth, Exercise and Nutrition Epidemiological Study in preSchoolers (GENESIS)). Dietary and anthropometric (i.e. BMI, waist circumference (WC)) assessments were carried out using standard procedures. DNA samples were obtained from 2102 children and were genotyped for the ACE I/D polymorphism. Among the entire population, 17 % were ‘at risk of overweight’ and a similar percentage were ‘overweight’. The frequencies of the II, ID and DD genotypes were 16, 46 and 38 %, respectively. Significant interactions were found between the ACE I/D polymorphism and total energy intake on WC (P = 0·004 for interaction) and the ACE I/D polymorphism and protein intake on BMI and being overweight (P < 0·05 for interaction). Furthermore, it was found that the ACE I/D polymorphism may modify the effect of fat intake on WC and BMI, but this interaction disappeared after adjustment for additional potential confounders. Stratified analyses revealed that total energy is correlated with WC and protein intake is associated with BMI and being overweight only among carriers of the D-allele (i.e. DD or ID genotypes). These results suggest that the ACE I/D polymorphism may act as a modifying factor in the response of adiposity-related phenotypes to diet.

Both jurisdictions of Ireland have high rates of chronic degenerative diseases, particularly of the cardiovascular system, and Irish migrants have worse health profiles, often lasting at least two generations. The influence of socio-demographic variation over the life course, and what role diet plays, has not been well researched in epidemiological terms. There is a long history of an unusual Irish diet. Estimated dietary fat intake (% total energy intake) in 1863 was only 9, but had reached 30 in 1948 and 34 in 1999. Conversely, carbohydrate intake has fallen steadily over 150 years. From 1948 onwards household budget survey data illustrate patterns of increasing urbanisation and socio-economic gradients in food availability. The National Survey of Lifestyles, Attitudes and Nutrition, (n 6539, 622 % response rate) provides clear evidence of inverse social-class gradients in intake of fruit and vegetables and dairy products and in reported patterns of healthy eating. Median carbohydrate and vitamin C levels are higher among social classes 1-2 and mean saturated fat intake is lower. International comparisons indicate a continuing, if narrowing, north-south gradient across Europe. Data from the Boston-Ireland study suggest a crossover in both dietary intake patterns and risk of heart disease in Ireland and the USA in the 1970s. Contemporary comparative data of middle-aged Irish and American women demonstrate patterns of diet intake and inactivity consistent with the modern epidemic of obesity and non-insulin-dependent diabetes. Thus, dietary variations within and between countries and over time are consistent with chronic disease patterns in contemporary Ireland.

Two areas of sports nutrition in which the periodicity of eating has been studied relate to: (1) the habitually high energy intakes of many athletes, and (2) the optimization of carbohydrate(CHO) availability to enhance performance. The present paper examines how the timing and frequency of food and fluid intake can assist the athlete and physically-active person to improve their exercise performance in these areas. Frequent eating occasions provide a practical strategy allowing athletes to increase energy intake while concomitantly reducing the gastric discomfort of infrequent large meals. The optimization of CHO stores is a special challenge for athletes undertaking prolonged training or competition sessions. This is a cyclical process with post-exercise CHO ingestion promoting muscle and liver glycogen re-synthesis; pre-exercise feedings being practised to optimize substrate availability and feedings during exercise providing a readily-available source of exogenous fuel as endogenous stores become depleted. The timing and frequency of CHO intake at these various stages are crucial determinants for optimizing fuel availability to enhance exercise capacity.

It has been suggested that energy expenditure is higher in subjects consuming reduced-fat, high-carbohydrate diets than in subjects consuming full-fat, low-carbohydrate diets. In a 6-month randomized, controlled trial, seventeen women and twenty men (age 20–35 years; BMI 22–28 kg/m2)had free access either to a range of about forty-five reduced-fat products or the full-fat equivalents. At the end of the 6 months, energy intake, sleeping metabolic rate (SMR), average daily metabolic rate (ADMR), and physical activity (AO) were measured. The intervention resulted in a mean difference of the change of the fat content of the diet of 6% of energy (P < 0·01) between the two groups. SMR, ADMR and AO were virtually the same in both groups. The results suggest that the change in fat content of the diet has no effect on physical activity and energy expenditure. However, subjects with a higher activity level consumed more carbohydrate (ADMR/SMR: r = 0·49, P < 0·01; AO: r = 0·57,p=0·001)