DONALD study

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The DONALD study (short for: DO rtmund N utritional and A nthropometric L ongitudinally D esigned) launched in 1985 as one of the key research projects at the Research Institute of Child Nutrition (FKE). In 2012, the DONALD study was integrated into the Rheinische Friedrich-Wilhelms-Universität Bonn as the Dortmund branch of the Institute for Nutritional and Food Sciences (IEL), Department of Nutritional Epidemiology . The study center is in Dortmund-Brüninghausen. The DONALD study receives basic funding from the state of North Rhine-Westphalia.

Study objectives

The overarching goals of the DONALD study are:

  • Analysis of interactions between diet, metabolism, development and growth in healthy children
  • Determination of intra- and inter-individual trends in nutrient uptake and nutritional behavior
  • Provision of nutritional data for specific exposure estimates
  • Provision of metabolic reference data from healthy children and adolescents

Study collective

The DONALD study will include test persons from the Dortmund area whose mothers or fathers are interested and willing to take part in a longitudinal study in the long term; provided that one parent has sufficient knowledge of German. Recruitment takes place unsystematically through recommendations from active study participants or by midwives, paediatricians and parent-child groups. Due to the high demands placed on the scope and duration of the data collection, the collective of the DONALD study is not representative.

Study design

The DONALD study is designed as an open long-term cohort study. Since 1985, around 35–40 healthy babies aged between three and six months have been included in the study every year (over 1,500 participants so far). Close-knit examinations from infancy to adulthood are planned, with detailed data collection on nutrition, growth, development, metabolism and health status. Since 2005, the participants have been invited to regular follow-up examinations every 5 years.

Investigation methods

DONALD study center

Anthropometric measurements

Depending on the age of the participants, different anthropometric measurements are taken at each visit. The children only wear underwear and no shoes for the measurements. During each examination, the following are measured:

  • Size or length (to 0.1 cm)
  • Weight (on 100 g)
  • Upper arm circumference (to 0.1 cm)
  • four skin fat folds (biceps, triceps, subscapular and iliac skin fat folds, to 0.1 mm).

Based on the skin fat folds, the body fat percentage of the test persons can be estimated at certain times of age. Calipometry

From the age of 3 years, the following are also measured:

  • Hip and waist circumference (to 0.1 cm) and
  • Seat height (at 0.1 cm)

Measured only at certain times of age:

  • Head circumference
  • Pelvis and shoulder widths as well
  • Thigh and calf circumference

Parents are measured every 4 years.

Medical examination

  • The current state of health and illnesses that occurred in the past year are recorded.
  • The blood pressure is measured from the age of 4 years.
  • Additional medical examinations such as lung function tests (spirometry), muscle function tests (jump plate) and vessel wall thickness (intima media) of the carotid communis artery are carried out on certain age occasions.

Interview and anamnesis

A number of standard questions are asked during each examination:

  • Questions about acute illnesses in the past year
  • Sleeping habits
  • Nutritional likes and dislikes
  • childcare
  • Preventive measures (vitamin D and fluoride)
  • Use of preventive medical services.

From the age of 12 you will also be asked:

  • Smoking habits
  • the consumption of alcoholic beverages
  • Parameters of restrictive eating behavior.

During the study, data on socio-economic status are collected several times (parental schooling, education, occupation and living situation).

Physical activity and performance

In the DONALD study, data on physical activity are collected using questionnaires. The aim is to establish a ranking within the study population with regard to the level of physical activity and to distinguish between active and inactive subjects, not to determine absolute values ​​at the individual level. Since June 2004, the physical performance of the DONALD test persons has been assessed with a Ground Reaction Force Platform (GRFP) [NOVOTEC Medical GmbH].

Nutritional protocol

On three consecutive days, the participants (parents in childhood) weigh all food, recipes and drinks they have eaten using a digital scale provided by the study center (accuracy: 1 g). Breastfeeding mothers receive baby scales with which the child is weighed before and after breastfeeding. When finished products are consumed, the brand of the product is noted and the packaging or labels are collected and added to the log. If a food or snack is consumed "outside the home" and the use of a scale is not possible, the quantities consumed can be measured in normal household dimensions (teaspoon, tablespoon, cup, piece, etc.), specifying the type, brand name or a recipe to be appreciated. All recorded foods are coded and linked to the institute's own food database LEBTAB in order to calculate the supply of nutrients and energy depending on the issue. LEBTAB contains detailed data on the nutritional values ​​of the staple foods recorded in the DONALD study, products for infants and young children, finished products, supplements and dietetic foods. The nutritional data of the basic foods are based on the Federal Food Key (BLS). Nutritional values ​​of finished products are estimated on the basis of the declared nutrients and lists of ingredients, taking into account any enrichment carried out. Every new or modified product recorded by the DONALD test persons receives a new entry (food code) in LEBTAB. Additives and flavorings have been recorded qualitatively since 2004.

24 hour urine

If the child can use the toilet (from the 3rd to 4th year of life), a 24-hour urine is collected on the 3rd day of the nutritional survey according to a standardized procedure. In the laboratory of the DONALD study, after thawing, mixing and the precise determination of the urine volume, parameters of the acid-base balance, creatinine, osmolality and urea are analyzed and examined for leukocytes, protein and hemoglobin with standard test strips. Aliquots of the samples from each 24-hour urine are frozen (urine bank, -22 ° C) for later analyzes and future questions. For certain project-related issues, project-specific metabolic parameters, biomarkers and / or nutritional and metabolic hormone metabolites can be measured from the thawed samples.

Blood draw

Since January 2005, everyone over the age of 18 has been asked to have a fasting blood sample. A complete blood count (including liver and kidney function values, blood sugar, blood lipid values, iron) is routinely determined in the blood sample. The serum is obtained by centrifugation at 3100 rpm and stored in fractions of 500 µl at -80 ° C for further analysis. Specific parameters (e.g. insulin, parameters of the IGF-1 axis, inflammation parameters) are determined from the samples as part of third-party funded projects.

Partial results

  • The daily frequency of meals and snacks is higher in children than in adolescents, but did not change during the evaluation period (1985–2014). The duration of nightly fasting (DNF) increased with age, possibly due to decreased sleep duration. The observed increase in DNF during the study period is possibly due to an increase in the number of people not eating breakfast.
  • Children who consumed less fat and more carbohydrates in the morning by the age of 7/8 years had a higher fat mass index (FMI) by 10/11 years. The clear difference in fat mass was based on only a slight change in the choice of food: For a high-fat breakfast, bread was more likely to be topped with cheese, sausage or egg than with jam or honey and the basis of a muesli was more oat flakes and nuts instead of processed cereals .
  • In infancy, the consumption of vegetables is higher when using self-made complementary foods than with commercial complementary foods. Boys who had been given more commercial complementary foods in infancy also ate fewer vegetables in infancy; even in school age, the consumption of fruit and vegetables together was lower among these boys, but not among girls. A higher intake of added sugar was also observed in commercial complementary foods in infancy, which was predictive of the intake of added sugar in both children and primary school age. If the intake of added sugar in infancy was adjusted, this relationship weakened, which can be interpreted to mean that the sugar content of the complementary food itself and not the method of preparation was the decisive factor.
  • Dietary fiber and whole grain intake during puberty were not associated with body composition changes during puberty. An increase in the glycemic index of the diet could adversely affect the body composition of adolescents who are already overweight by the onset of puberty.
  • A higher intake of “convenience food” is prospectively related to a slight increase in the percentage of body fat in boys.
  • Children who consistently short sleep in the 2nd year of life (18 and 24 months) develop a higher fat mass index (kg / m²) by the age of 7 than those who have a variable sleep duration or who sleep consistently long.
  • In girls, an increase in the consumption of sugared soft drinks was associated with an increase in BMI. This association was primarily due to an adverse effect from an increase in juice consumption. For boys, there was no correlation between the consumption of sugared soft drinks and body composition.
  • Small amounts of added sugar in the first year of life do not appear to be critical for the BMI or the body fat percentage at the age of 7. However, if the sugar intake is significantly increased in the 2nd year of life, this could have a negative effect on the BMI at 7 years of age.
  • The bone-anabolic protein effect is evidently at least partially reversed if there is insufficient ingestion of (metabolically) alkalizing minerals from fruit and vegetables.
  • After a constant level of 24-hour ioduria in 2004–2006, a significant decrease was observed until 2009. The median iodine concentration fell below the WHO recommended reference of 100 µg / L in 2007–2009. The main sources of iodine were salt and milk. The contributions of salt and fish to the iodine supply showed a decline between 2004–2006 and 2007–2009.
  • Children who put on weight disproportionately in their first two years reached puberty on average 4 months earlier. In addition, a birth weight of 2500 to <3000 g was associated with the onset of puberty 7 months earlier.

literature

  • AE Buyken, U. Alexy, M. Kersting, T. Remer: The DONALD cohort. A current overview of 25 years of research in the context of the Dortmund Nutritional and Anthropometric Longitudinally Designed Study. In: Federal Health Gazette. 55, 2012, pp. 875-884.

Web links

Individual evidence

  1. ↑ a b T. Diederichs, S. Roßbach et al .: Relevance of Morning and Evening Energy and Macronutrient Intake during Childhood for Body Composition in Early Adolescence. In: Nutrients. Volume 8, Number 11, November 2016, p., Doi: 10.3390 / nu8110716 . PMID 27834901 , PMC 5133102 (free full text).
  2. ↑ K. Foterek, AE Buyken et al: Commercial complementary food consumption is prospectively associated with added sugar intake in childhood. In: The British journal of nutrition. Volume 115, number 11, 06 2016, pp. 2067-2074, doi: 10.1017 / S0007114516001367 . PMID 27079145 .
  3. ↑ K. Foterek, A. Hilbig, U. Alexy: Associations between commercial complementary food consumption and fruit and vegetable intake in children. Results of the DONALD study. In: Appetite. Volume 85, February 2015, pp. 84-90, doi: 10.1016 / j.appet.2014.11.015 . PMID 25447022 .
  4. ↑ K. Foterek, A. Hilbig, U. Alexy: Breast-feeding and weaning practices in the DONALD study: age and time trends. In: Journal of Pediatric Gastroenterology and Nutrition. Volume 58, number 3, March 2014, pp. 361-367, doi: 10.1097 / MPG.0000000000000202 . PMID 24126834 .
  5. ↑ AE Buyken, G. Cheng et al .: Relation of dietary glycemic index, glycemic load, added sugar intake, or fiber intake to the development of body composition between ages 2 and 7 y. In: The American Journal of Clinical Nutrition. Volume 88, Number 3, September 2008, pp. 755-762, doi: 10.1093 / ajcn / 88.3.755 . PMID 18779293 .
  6. ↑ U. Alexy, L. Libuda et al: Convenience foods in children's diet and association with dietary quality and body weight status. In: European Journal of Clinical Nutrition. Volume 65, Number 2, February 2011, pp. 160–166, doi: 10.1038 / ejcn.2010.254 . PMID 21139631 .
  7. ↑ K. Diethelm, K. Bolzenius et al .: Longitudinal associations between reported sleep duration in early childhood and the development of body mass index, fat mass index and fat free mass index until age 7. In: International journal of pediatric obesity. Volume 6, number 2–2, June 2011, pp. E114 – e123, doi: 10.3109 / 17477166.2011.566338 . PMID 21604964 .
  8. ↑ L. Libuda, U. Alexy et al .: Pattern of beverage consumption and long-term association with body-weight status in German adolescents - results from the DONALD study. In: The British Journal of Ntrition. Volume 99, Number 6, June 2008, pp. 1370-1379, doi: 10.1017 / S0007114507862362 . PMID 18034911 .
  9. ↑ A. Herbst, K. Diethelm et al .: Direction of associations between added sugar intake in early childhood and body mass index at age 7 years may depend on intake levels. In: The Journal of Nutrition. Volume 141, number 7, July 2011, pp. 1348-1354, doi: 10.3945 / jn.110.137000 . PMID 21562234 .
  10. ↑ U. Alexy, T. Remer et al .: Long-term protein intake and dietary potential renal acid load are associated with bone modeling and remodeling at the proximal radius in healthy children. In: The American Journal of Clinical Nutrition. Volume 82, Number 5, November 2005, pp. 1107-1114, doi: 10.1093 / ajcn / 82.5.1107 . PMID 16280446 .
  11. ↑ T. Remer, F. Manz et al .: Long-term high urinary potential renal acid load and low nitrogen excretion predict reduced diaphyseal bone mass and bone size in children. In: The Journal of Clinical Endocrinology and Metabolism . Volume 96, Number 9, September 2011, pp. 2861-2868, doi: 10.1210 / jc.2011-1005 . PMID 21715531 .
  12. ^ SA Johner, M. Thamm et al .: Iodine status in preschool children and evaluation of major dietary iodine sources: a German experience. In: European Journal of Nutrition . Volume 52, Number 7, October 2013, pp. 1711-1719, doi: 10.1007 / s00394-012-0474-6 . PMID 23212532 .
  13. ^ SA Johner, AL Günther, T. Remer: Current trends of 24-h urinary iodine excretion in German schoolchildren and the importance of iodised salt in processed foods. In: The British Journal of Nutrition. Volume 106, Number 11, December 2011, pp. 1749-1756, doi: 10.1017 / S0007114511005502 . PMID 22017962 .
  14. ↑ N. Karaolis-Danckert, AE Buyken et al .: Birth and early life influences on the timing of puberty onset: results from the DONALD (DOrtmund Nutritional and Anthropometric Longitudinally Designed) Study. In: The American Journal of Clinical Nutrition. Volume 90, number 6, December 2009, pp. 1559-1565, doi: 10.3945 / ajcn.2009.28259 . PMID 19828713 .