a1 Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Madrid, Spain
a2 Escuela Nacional de Sanidad, Instituto de Salud Carlos III, Ministerio de Sanidad y Consumo, Madrid, Spain
a3 Laboratorio de Lípidos, Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Madrid, Spain
a4 Agencia de Evaluación de Tecnologías Sanitarias, Instituto de Salud Carlos III, Ministerio de Sanidad y Consumo, Madrid, Spain
a5 Department of Medicine, Universidad de Cádiz, Cádiz, Spain
The present study tests the hypothesis that higher consumption of bakery products, sweetened soft drinks and yogurt is associated with higher intake of energy, saturated fats, sugars and worse overall diet quality among Spanish children. This is a cross-sectional study covering 1112 children aged 6.0–7.0 years in four Spanish cities. Nutrient and food intake were obtained through a food-frequency questionnaire, and overall diet quality calculated using the healthy-eating index (HEI) developed by <bibr rid="b20">Kennedy et al. (1995)</bibr>. Standardized methods were used to measure anthropometric variables. Associations of interest were summarized as the difference in nutrient and food consumption between the value of the fifth and the first quintile of consumption (dq) of bakery products, sweetened soft drinks or yogurt, adjusted for energy intake and BMI. Bakery products, sweetened soft drinks and yogurt supplied 15·5, 1·0 and 5·6 % energy intake respectively. Higher consumption of these three foods was associated with greater energy intake (P<0·001), but not with higher BMI. Consumption of bakery products was associated with the proportion of energy derived from intake of total carbohydrates (dq 4·5 %, P<0·001) and sugars (dq 2 %, P<0·001), but did not show association with the HEI. Consumption of sweetened soft drinks was associated with a lower consumption of milk (dq −88 ml, P<0·001) and Ca (dq −175 m/, P<0·001), and worse HEI (dq −2, P<0·01). Consumption of yogurt, while associated with higher energy intake from saturated fats (dq 1·77 %, P<0·001) and sugars (dq 2·02 %, P<0·001), showed no association with the HEI. Differences in the intake of nutrients and foods across quintiles of consumption of bakery products, sweetened soft drinks and yogurt were usually very small. We conclude that the impact of the consumption of bakery products, sweetened soft drinks and yogurt on the quality of the diet of Spanish children is only modest, although it may contribute to aggravating certain unhealthy characteristics of their diet, particularly excess energy, saturated fats and sugars. Therefore, consumption of bakery products and sweetened soft drinks should be moderated, and priority given to consumption of low-fat, low-sugar yogurt.
(Received May 13 2002)
(Revised October 08 2002)
(Accepted October 17 2002)
† Investigators of the Four Provinces Study: A. Mangas (Universidad de Cádiz), O. Fernández (Hospital Cristal Piñol, Orense, Spain), A. Gil (Universidad Rey Juan Carlos), A. Studer (Fundación Jiménez Díaz, Madrid, Spain), J. Fernández Pardo (Hospital de la Cruz Roja de Murcia, Murcia, Spain), M. A. Lasunción (Hospital Ramón y Cajal, Madrid, Spain).