In Western countries, vegetarian diets are associated with lower intakes of energy, saturated fatty acids and animal protein and higher intakes of fibre and phytochemicals, compared to omnivorous diets. Whether the corresponding health benefits in vegetarians outweigh the risks of nutrient deficiencies has not been fully clarified. It should be noted that vegetarians often have a higher socioeconomic status, follow a more health-conscious lifestyle with higher physical activity, and refrain from smoking more often than non-vegetarians. The nutritional needs of growing children and adolescents can generally be met through a balanced, vegetable-based diet; however, due to their higher nutrient requirements per kilogramme of body weight, vegetarian children have a higher risk for developing nutrient deficiencies than adults. With a vegetarian diet, the mean intakes of some nutrients, such as the omega-3 fatty acid docosahexaenoic acid (DHA), are lower than in omnivores or those eating fish. For other nutrients, such as iron and zinc, the bioavailability from vegetable foodstuffs is reduced when the intake of phytates and fibre is high; thus, the prevalence of iron deficiency can be increased despite high vitamin C intake. In addition, vitamin B12 is only found in animal-source foods. Vitamin B12 should be supplemented in people of all age groups who follow a strict vegan diet without consuming animal products. A vegetarian diet in childhood and adolescence requires good information and supervision by a paediatrician, if necessary, in cooperation with an appropriately trained dietary specialist.

Zusammenfassung: Hintergrund Nährstoffbezogene Empfehlungen müssen in lebensmittelbasierte Richtlinien übersetzt werden, damit sie für die Bevölkerung anwendbar werden. Noch praxisnäher sind mahlzeitenbezogene Richtlinien, gerade für die Kinderernährung. Diese Public-Health-Empfehlung wird in Deutschland mit dem Präventionskonzept der Optimierten Mischkost (OMK) für Kinder und Jugendliche umgesetzt. Verschiedene Überarbeitungen der D-A-CH-Referenzwerte für die Nährstoffzufuhr erforderten eine Neuberechnung der OMK. Methodik Ausgangsbasis waren Speisepläne für 4 Wochen (28 Tage) für 4 – 6-jährige Kinder als Referenzaltersgruppe. Mit einer vorsichtigen Optimierung von Lebensmittelauswahl und -mengen unter Berücksichtigung bevorzugt verzehrter Lebensmittel bei Kindern und Jugendlichen und üblicher Mahlzeitengewohnheiten (3 Haupt- und 2 Zwischenmahlzeiten am Tag) sollten die empfohlenen maximalen Nährstoffdichten (g[mg]/1000 kcal) im Altersbereich von 1 – 18 Jahren erreicht werden. Unter Annahme eines Energiebedarfs bei geringer körperlicher Aktivität (Physical Activity Level PAL 1.4) wurden altersgemäße Verzehrmengen für 11 Lebensmittelgruppen pro Tag und pro Mahlzeit ermittelt. Ergebnisse Allein mit herkömmlichen Lebensmitteln ohne Nährstoffanreicherung konnte bei den betrachteten Nährstoffen eine empfehlungsgerechte Zufuhr erreicht werden, mit Ausnahme der generell kritischen Nährstoffe Vitamin D und Jod. Dabei sind die Anteile der Lebensmittel am Gesamtverzehr pro Tag und pro Mahlzeit in allen Altersgruppen gleich, lediglich die Mengen ändern sich mit dem Energiebedarf. Die mahlzeitenspezifischen Nährstoffprofile ergänzen sich in einem Baukastensystem zu einer ausgewogenen Tagesernährung. Schlussfolgerung Mit dem durchkalkulierten Konzept der Optimierten Mischkost steht ein Referenzinstrumentarium für eine präventiv ausgerichtete Ernährung von Kindern und Jugendlichen zur Verfügung. Es kann für gesunde und kranke Kinder und Jugendliche in der Familienernährung und der Gemeinschaftsverpflegung angewendet werden.

There is still little research examining the relationship between water consumption in school and specific cognitive performance. The aim of this cluster-randomized intervention CogniDROP trial was to investigate the short-term effects of drinking water during the morning on executive functions. The participants were from the 5^th and 6^th grade of a comprehensive school in Germany (14 classes, n = 250, 61.6% boys). The classes were randomly divided into an intervention group (an education on healthy drinking behavior and a promotion of water consumption) and a control group. A battery of computerized tasks (Switch Task, 2-Back Task, Corsi Block-Tapping Task and Flanker Task) was used to test executive functions. Urine color and thirst were evaluated to check the hydration level. Physical activity over the past 24 h was measured using GT3X ActiGraph. A non-linear relationship was observed between the amount of drinking water and executive performance. Consuming water up to 1000 mL (or up to 50% of Total Water Intake) had benefits during memory tasks. Urine color and number of steps on the study day correlated with water consumed. The results suggest that a water-friendly environment supports school-aged children in adequate water intake resulting in better cognitive performance, especially short-term memory.

Background: The association between high fructose consumption and elevated blood pressure continues to be controversial, especially in adolescence. The aim of this study was to assess the association between fructose consumption and elevated blood pressure in an European adolescent population. Methods: A total of 1733 adolescents (mean ± SD age: 14.7 ± 1.2; percentage of girls: 52.8%) were analysed from the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study in eight European countries. Blood pressure was measured using validated devices and methods for measuring systolic blood pressure (SBP) and diastolic blood pressure (DBP). Dietary data were recorded via repeated 24 h recalls (using specifically developed HELENA–DIAT software) and converted into pure fructose (monosaccharide form) and total fructose exposure (pure fructose + fructose from sucrose) intake using a specific fructose composition database. Food categories were separated at posteriori in natural vs. were non-natural foods. Elevated BP was defined according to the 90th percentile cut-off values and was compared according to tertiles of fructose intake using univariable and multivariable mixed logistic regression models taking into account confounding factors: centre, sex, age and z-score–BMI, MVPA (Moderate to Vigorous Physical Activity) duration, tobacco consumption, salt intake and energy intake. Results: Pure fructose from non-natural foods was only associated with elevated DBP (DBP above the 10th percentile in the highest consuming girls (OR = 2.27 (1.17–4.40); p = 0.015) after adjustment for cofounding factors. Conclusions: Consuming high quantities of non-natural foods was associated with elevated DBP in adolescent girls, which was in part due to high fructose levels in these foods categories. The consumption of natural foods containing fructose, such as whole fruits, does not impact blood pressure and should continue to remain a healthy dietary habit.

This study investigated the relationship between different levels of physical fitness and cognitive functions in boys and girls. Schoolchildren from a comprehensive school in Germany (n = 211, 39% girls, 5th and 6th grade) attended regular or sport-focused classes with different numbers of physical education (PE) classes per week (3 vs. 5–6 h). Performance of physical fitness was tested according to endurance, strength, speed, coordination and flexibility. Four computerized instruments (switch task, 2-back task, Corsi block-tapping task and flanker task) were used to test cognitive functions. Additional predictors, sex, age, PE class, Body Mass Index and physical activity, were included in analyses. The results showed that physical fitness was associated with improved attention and memory functions in children, although the associations were mostly small. After Bonferroni correction, mainly coordination was related to improved cognition. Physical activity, i.e., step counts, PE class and sex were associated with specific cognitive outcomes. These findings may be important for effective health promotion, and supporting children’s education in the school environment. Sex-specific physical activities in school could potentially lead to greater cognitive benefits in children. Randomized trials are needed to replicate these results.