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  • 1.
    Ayukekbong, James A.
    et al.
    Department of Infectious Diseases/Section of Clinical Virology, Institute of Biomedicine, University of Gothenburg, Gothenburg, Sweden.
    Andersson, M. E.
    Department of Infectious Diseases/Section of Clinical Virology, Institute of Biomedicine, University of Gothenburg, Gothenburg, Sweden.
    Vansarla, Goutham
    University of Skövde, School of Bioscience. University of Skövde, The Systems Biology Research Centre.
    Tah, F.
    Camyaids Institute of Laboratory Diagnosis and Clinical Research, Douala, Cameroon.
    Nkuo-Akenji, T.
    Faculty of Science Diagnostic Laboratory, University of Buea, Buea, Cameroon.
    Lindh, M.
    Department of Infectious Diseases/Section of Clinical Virology, Institute of Biomedicine, University of Gothenburg, Gothenburg, Sweden.
    Bergström, T.
    Department of Infectious Diseases/Section of Clinical Virology, Institute of Biomedicine, University of Gothenburg, Gothenburg, Sweden.
    Monitoring of seasonality of norovirus and other enteric viruses in Cameroon by real-time PCR: an exploratory study2014In: Epidemiology and Infection, ISSN 0950-2688, E-ISSN 1469-4409, Vol. 142, no 7, p. 1393-1402Article in journal (Refereed)
    Abstract [en]

    We studied the seasonal fluctuation of norovirus and other enteric viruses in Cameroon. Two hundred participants aged between 1 and 69 years were prospectively followed up. Each participant provided monthly faecal samples over a 12-month period. A total of 2484 samples were tested using multiplex real-time PCR assay for the detection of norovirus, rotavirus and enterovirus. The effect of weather variables and risk factors were analysed by Pearson correlation and bivariate analysis. Overall, enterovirus was the most commonly detected virus (216% of specimens), followed by norovirus (39%) and rotavirus (04%). Norovirus and enterovirus were detected throughout the year with a peak of norovirus detection at the beginning of the rainy season and a significant alternation of circulation of norovirus genogroups from one month to the next. Age <5 years and consumption of tap water were risk factors for norovirus infection. Better understanding of factors influencing transmission and seasonality may provide insights into the relationship between physical environment and risk of infection for these viruses.

  • 2.
    Behnsen, Pia
    et al.
    Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Netherlands.
    Buil, Joanne M.
    Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Netherlands.
    Koot, Susanne
    Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Netherlands.
    Huizink, Anja
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Netherlands.
    Van Lier, Poul
    Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Netherlands.
    Heart rate (variability) and the association between relational peer victimization and internalizing symptoms in elementary school children2020In: Development and psychopathology (Print), ISSN 0954-5794, E-ISSN 1469-2198, Vol. 32, no 2, p. 521-529, article id PII S0954579419000269Article in journal (Refereed)
    Abstract [en]

    Relational victimization typically emerges first during the elementary school period, and has been associated with increased levels of internalizing symptoms in children. Individual differences in autonomic nervous system functioning have been suggested as a potential factor linking social stressors and internalizing symptoms. The aim of this study was therefore to examine whether heart rate and heart rate variability mediated the association between relational victimization and internalizing symptoms in 373 mainstream elementary school children. Children were assessed in 2015 (T 0 ; Grades 3-5, M age = 9.78 years, 51% boys) and reassessed in 2016 (T 1 ). Heart rate and heart rate variability were assessed during a regular school day at T 1 . A multi-informant (teacher and peer report) cross-time measure of relational victimization, and a multi-informant (self- and teacher report) measure of internalizing problems at T 1 was used. Results showed that heart rate variability, but not heart rate, mediated the association between relational victimization and internalizing symptoms. This study provides tentative support that in children from a general population sample, a psychobiological factor may mediate the association of relational victimization with internalizing symptoms.

  • 3.
    Björk, Maria
    et al.
    University of Skövde, School of Life Sciences.
    Johansson Sundler, Annelie
    University of Skövde, School of Life Sciences.
    Hammarlund, Kina
    University of Skövde, School of Life Sciences.
    Hallström, Inger
    Lund University, Department of Health Sciences, Lund, Sweden.
    Living an everyday life shaded with traces from the cancer trajectory – families' lived experiences in a six year follow up2012In: Pediatric Blood & Cancer, ISSN 1545-5009, E-ISSN 1545-5017, Vol. 59, no 6, p. 1130-1130Article in journal (Refereed)
  • 4.
    Blixt, Ingrid
    et al.
    Department of Obstetrics and Gynaecology, Mälarhospital, Eskilstuna, Sweden.
    Mårtensson, Lena B.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Ekström, Anette C.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Process-oriented training in breastfeeding for health professionals decreases women’s experiences of breastfeeding challenges2014In: International Breastfeeding Journal, ISSN 1746-4358, E-ISSN 1746-4358, Vol. 9, no 1, article id 15Article in journal (Refereed)
    Abstract [en]

    Background: The World Health Organization recommends promoting exclusive breastfeeding for six months. Women much too often end breastfeeding earlier than they planned, but women who continue to breastfeed despite problems more often experience good support and counselling from health professionals. The aim in this study was to evaluate the effects of a process-oriented training in breastfeeding support counselling for midwives and child health nurses, in relation to women’s satisfaction with breastfeeding counselling, problems with insufficient breast milk, pain or nipple sores in relation to exclusive breastfeeding shorter or longer than 3 months.

    Methods: An intervention through process-oriented training for health professionals regarding support in childbearing and breastfeeding took part in the south west of Sweden. The present study was performed in Sweden, in 2000- 2003. Ten municipalities were paired, and within each pair, one was randomly assigned to the group of five intervention (IG) municipalities and one to the group of five control municipalities. Primiparas (n=540) were asked to participate in a longitudinal study to evaluate the care they received. A survey was distributed at 3 days, 3 months and 9 months postpartum. Data collection for control group A (n=162) started before the intervention was initiated. Data for control group B (n=172) were collected simultaneously with the intervention group (IG) (n=206).Women were also divided into two groups depending on whether they exclusive breastfed < 3 months or ≥ 3 months.

    Results: Women in IG were more satisfied with the breastfeeding counselling (p=0.008) and felt the breastfeeding counselling was more coherent (p=0.002) compared with control groups, when the exclusively breastfeeding was < 3 months. In addition fewer women in the IG, among the group exclusively breastfeeding < 3 months, had problems with insufficient breast milk compared to the control groups (p=0.01).

    Conclusion: A process-oriented training for health professionals in support influenced women's ability to solve breastfeeding problems such as the experience of insufficient breast milk production. Women with exclusive breastfeeding lasting ≥ 3 months more often had breastfeeding duration in conformity with their planned breastfeeding duration, compared with women who had breastfeeding duration < 3 months.

    Trial registration: ACTRN12611000354987

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  • 5.
    Blixt, Ingrid
    et al.
    University of Skövde, School of Health and Education. Mälarsjukhuset Eskilstuna / Centrum för klinisk forskning i Sörmland, Uppsala universitet.
    Mårtensson, Lena
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Ekström, Anette
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Utbildning minskar amningsproblem2014In: Amningsnytt, ISSN 1102-7207, no 4, p. 4-5Article in journal (Other (popular science, discussion, etc.))
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    Utbildning minskar amningsproblem
  • 6.
    Breau, Becky
    et al.
    Department of Human Health and Nutritional Sciences, University of Guelph, Canada ; Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany ; Faculty of Mathematics and Computer Science, University of Bremen, Germany.
    Brandes, Mirko
    Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany.
    Veidebaum, Toomas
    Department of Chronic Diseases, National Institute for Health Development, Tallinn, Estonia.
    Tornaritis, Michael
    Research and Education Institute of Child health, Strovolos, Cyprus.
    Moreno, Luis A.
    GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria de Aragón (IIS Aragón) Zaragoza, Spain ; Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain.
    Molnár, Dénes
    Department of Pediatrics, Medical School, University of Pécs, Hungary.
    Lissner, Lauren
    School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden.
    Eiben, Gabriele
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR).
    Lauria, Fabio
    Institute of Food Sciences, National Research Council, Avellino, Italy.
    Kaprio, Jaakko
    Institute for Molecular Medicine Finland FIMM, University of Helsinki, Finland.
    De Henauw, Stefaan
    Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Belgium.
    Ahrens, Wolfgang
    Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany ; Faculty of Mathematics and Computer Science, University of Bremen, Germany.
    Buck, Christoph
    Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany .
    I.Family consortia, (Contributor)
    Longitudinal association of childhood physical activity and physical fitness with physical activity in adolescence: insights from the IDEFICS/I.Family study2022In: International Journal of Behavioral Nutrition and Physical Activity, E-ISSN 1479-5868, Vol. 19, no 1, article id 147Article in journal (Refereed)
    Abstract [en]

    Background: This study aimed to examine associations of early childhood physical fitness and physical activity (PA) with PA during later childhood/early adolescence while accounting for gender differences. Methods: We selected data of N = 4329 children from the IDEFICS/I. Family cohort (age 2.4–11.7 years) with data on baseline fitness and accelerometer measurements. At baseline, physical fitness tests were conducted including Flamingo balance, Backsaver sit and reach, Handgrip strength, Standing Long Jump, 40-m sprint and 20-m Shuttle run (to estimate cardio-respiratory fitness levels). PA was measured with Actigraph accelerometers over 3 days at baseline (ActiTrainer or GT1M) and 7 days at follow-up (GT3X). Evenson cutpoints were used to determine moderate-to-vigorous PA (MVPA) time, and children with ≥60mins/day of average MVPA were deemed as having met WHO guidelines at baseline and follow-up. Linear and logistic regressions were performed to examine longitudinal associations between meeting WHO guidelines, MVPA, and physical fitness tests at baseline with meeting WHO guidelines and MVPA at follow-up. Models were conducted on the entire sample, the sex-stratified sample, and stratified by sex and pubertal status at follow-up. Results: Results showed that meeting WHO guidelines for MVPA at baseline was positively associated with MVPA (Standardized Beta (B) = 0.13, 95%CI:(5.6;11.1)) and meeting WHO guidelines at follow-up for the entire sample (OR = 2.1, 95%CI:(1.5; 3.14), and stratified by males (OR = 2.5, 95%CI:(1.5; 4.1)) and females (OR = 1.8, 95%CI:(1.0; 3.2)). This was also found for both male pre/early pubertal and pubertal groups but only in the female pre/early pubertal group, and not the female pubertal group (MVPA: B =.00, 95%CI:(− 6.1; 5.6), WHO: OR = 0.61, 95%CI:(0.23;1.6)). Models indicated that Standing Long jump, 40-m sprint, Shuttle run and Flamingo balance at baseline were associated with MVPA and meeting the guidelines at follow-up. Conclusions: Meeting WHO guidelines and certain fitness tests at baseline were strongly associated with MVPA and meeting WHO guidelines at follow-up, but this association varied with sex and pubertal status. Consequently, these findings underline the importance of ensuring sufficient physical activity in terms of quality and quantity for children at the earliest stages of life. Trial registration: ISRCTN62310987. 

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  • 7.
    Carlén, Kristina
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR). The Research School of Health and Welfare, School of Health and Welfare, Jönköping University.
    Predictors of mental health in adolescents - with a salutogenic perspective2022Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Mental health in adolescence is an increasing public health concern. Over half of all mental disorders debut by 14 years of age and remain largely untreated up to adulthood, which underlines the importance of early detection. Mental health is a complex concept that consists of both mental well-being and mental ill-health (including mental health problems and mental disorders). However, the development of mental health during the transition period from childhood to adulthood is dependent on the coping strategies used to meet everyday stressors. Therefore, the framework is salutogenic, looking at the world from a resource perspective to promote mental well-being. However, finding predictors also include identifying risk factors of mental ill-health.

    The overall aim of the thesis was to investigate predictors of mental health in adolescents from a longitudinal perspective. The Finnish Family Competence (FFC) study was used with adolescents at 15 years of age and their parents, with a follow-up at 18 years of age. Also, Swedish data material was used, The Longitudinal Research on Development In Adolescence (LoRDIA) with adolescents at 12-13 years and a follow-up at 17 years. In sub-studies I, II, and III the outcome was a probable mental health diagnosis determined by a standardised Development and Well-being Assessment (DAWBA) interview. In sub-study IV the outcome was perceived mental health status (MHS).

    The results showed that a strong sense of coherence was associated with a decreased risk for subsequent mental disorders (sub-study I) and that self-esteem was negatively associated with future mental well-being (sub[1]study IV). Further, low levels of mental health problems reported by the adolescents (sub-study II) or by their parents (sub-study III) were related to a decreased risk for subsequent mental disorders. There was a gender aspect that affected the results and which showed girls as having more internal mental health problems or mental disorders. Other factors indicating an increased risk of mental ill-health were parental low age at childbirth and socioeconomic factors such as the mother’s low educational level, father’s blue-collar profession, and a poor economic situation in the family.

    The results from this thesis underline the importance of having a salutogenic approach when dealing with mental health in adolescence to identify coping resources for stressors in Antonovsky’s ‘River of Life’. The school might be an arena for creating interventions with a resource perspective for strengthening a sense of coherence and self-esteem, and for alleviating perceived mental health problems.

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    Spikblad
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    Kappa
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    Paper I
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    Paper II
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    Paper III
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    Paper IV manuscript abstract
  • 8.
    Carlén, Kristina
    et al.
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR). The Research School of Health and Welfare, Jönköping University, Sweden.
    Suominen, Sakari
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR). Department of Public Health, University of Turku, Finland.
    Augustine, Lilly
    CHILD, School of Learning and Communication, Jönköping University, Sweden.
    Saarinen, Maiju M.
    Department of Child Neurology and General Practice, University of Turku and Turku University Hospital, Finland.
    Aromaa, Minna
    Department of Public Health, University of Turku, Finland ; City of Turku Welfare Division, Finland.
    Rautava, Päivi
    Department of Public Health, University of Turku, Finland ; Turku University Hospital, Clinical Research Centre, Turku, Finland.
    Sourander, André
    Department of Child Psychiatry, University of Turku, Finland ; Department of Child Psychiatry, Turku University Hospital, Finland.
    Sillanpää, Matti
    Department of Child Neurology and General Practice, University of Turku and Turku University Hospital, Finland.
    Parental distress rating at the child’s age of 15 years predicts probable mental diagnosis: a three‑year follow‑up2022In: BMC Pediatrics, ISSN 1471-2431, E-ISSN 1471-2431, Vol. 22, no 1, article id 177Article in journal (Refereed)
    Abstract [en]

    Background: Mental health in adolescence is an increasing global public health concern. Over half of all mental disorders debut by 14 years of age and remain largely untreated up to adulthood, underlining the significance of early detection. The study aimed to investigate whether parental distress rating at the child's age of 15 predicts a probable mental diagnosis in a three-year follow-up.

    Methods: All data was derived from the Finnish Family Competence (FFC) Study. The analysis focused on whether parental CBCL (Child Behavior Checklist) rating (n = 441) at the child's age of 15 years predicted the outcome of the child's standardised DAWBA (Development and Well-Being Assessment) interview at offspring's 18 years.

    Results: Multivariable analysis showed that a one-unit increase in the total CBCL scores increased the relative risk of a DAWBA-based diagnosis by 3% (RR [95% CI] 1.03 [1.02-1.04], p < 0.001).

    Conclusions: Parental CBCL rating in a community sample at the adolescent's age of 15 contributes to early identification of adolescents potentially at risk and thus benefitting from early interventions.

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  • 9.
    Carlén, Kristina
    et al.
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR).
    Suominen, Sakari
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR). Department of Public Health, University of Turku, Finland.
    Augustine, Llilly
    Department of Communication and Behavioral Sciences, School of Education and Communication, Jönköping University, Sweden.
    The association between adolescents’ self-esteem and perceived mental well-being in Sweden in four years of follow-up2023In: BMC Psychology, E-ISSN 2050-7283, Vol. 11, article id 413Article in journal (Refereed)
    Abstract [en]

    Background The situation concerning adolescent mental health is a global public health concern, and the concept includes the ability to cope with problems of everyday life. A person’s approach and attitude towards themselves, i.e., their self-esteem, affects mental health. The study aimed to appraise and deepen the scientific understanding of adolescents’ self-reported self-esteem at age 12−13 from a resource perspective and test its ability to predict subsequent perceived mental well-being at age 17.

    Methods Data from the Longitudinal Research on Development in Adolescence (LoRDIA) prospective follow-up study of adolescents aged 12−13, and 17 (n=654) were analysed using ANCOVA. The outcome variable, perceived mental well-being (MWB), covers the aspects of mental well-being inspired by the “Mental Health Continuum,” representing positive mental health. Covariates were self-esteem (SE) and reported initially perceived MWB at age 12−13. Other independent explanatory variables were gender, the family’s economy, and the mother’s educational level.

    Results Self-esteem appeared relatively stable from 12−13 to 17 years (M=20.7 SD=5.8 vs. M=20.5 SD=1.7). There was a significant but inverted U – shaped association between SE at age 12–13 and perceived MWB at age 17 [F (1, 646)=19.02, β-0.057; CI -0.08−-0.03, Eta=0.03, p=.000]. Intermediate but not strong SE predicted significantly good MWB. When conducting the ANCOVA for boys and girls separately, only the mother’s educational level was significantly positively associated with perceived MWB of girls.

    Conclusions Good self-esteem in early adolescence increases the likelihood of an unchanged favourable development of self-esteem and the probability of good perceived mental well-being. SE explained 18 per cent of the variation of MWB, and even more among girls. However, normal SE rather than high SE at 12 and 13 years is predictive of later mental well-being. Girls reported low self-esteem more often. Therefore, supporting self-esteem early in life can promote mental well-being in adolescence.

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  • 10.
    Cheng, Lan
    et al.
    Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany / Faculty of Mathematics and Computer Science, University of Bremen, Germany.
    Pohlabeln, Hermann
    Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany.
    Ahrens, Wolfgang
    Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany / Faculty of Mathematics and Computer Science, University of Bremen, Germany.
    Lauria, Fabio
    Institute of Food Sciences, National Research Council, Avellino, Italy.
    Veidebaum, Toomas
    Department of Chronic Diseases, National Institute for Health Development, Tallinn, Estonia.
    Chadjigeorgiou, Charalambos
    Research and Education Institute of Child Health, Strovolos, Cyprus.
    Molnár, Dénes
    Department of Pediatrics, Medical School, University of Pécs, Hungary.
    Eiben, Gabriele
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR).
    Michels, Nathalie
    Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Belgium.
    Moreno, Luis A.
    Genud (Growth, Exercise, Nutrition and Development) Research Group, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón), Centro de Investigacion Biomedica en Red Fisiopatologia de la Obesidad y Nutricion (CIBERObn), University of Zaragoza, Spain.
    Page, Angie S.
    Centre for Exercise, Nutrition and Health Sciences, University of Bristol, Bristol, United Kingdom.
    Pitsiladis, Yannis
    Collaborating Centre of Sports Medicine, University of Brighton, United Kingdom.
    Hebestreit, Antje
    Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany.
    Cross-sectional and longitudinal associations between physical activity, sedentary behaviour and bone stiffness index across weight status in European children and adolescents2020In: International Journal of Behavioral Nutrition and Physical Activity, E-ISSN 1479-5868, Vol. 17, no 1, article id 54Article in journal (Refereed)
    Abstract [en]

    Background: The associations between physical activity (PA), sedentary behaviour (SB) and bone health may be differentially affected by weight status during growth. This study aims to assess the cross-sectional and longitudinal associations between PA, SB and bone stiffness index (SI) in European children and adolescents, taking the weight status into consideration. Methods: Calcaneus SI was first measured by quantitative ultrasound among children aged 2-9 years old in 2007/08. It was measured again after 2 years in the IDEFICS study and after 6 years in the I. Family study. A sample of 2008 participants with time spent at sports clubs, watching TV and playing computer/games self-reported by questionnaire, and a subsample of 1037 participants with SB, light PA (LPA) and moderate-to-vigorous PA (MVPA) objectively measured using Actigraph accelerometers were included in the analyses. Weight status was defined as thin/normal and overweight/obese according to the extended International Obesity Task Force criteria. Linear mixed-effects models were used to estimate the cross-sectional and longitudinal associations between PA, SB and SI percentiles, stratified by weight status. Results: The cross-sectional association between weekly duration of watching TV and SI percentiles was negative in thin/normal weight group (β =-0.35, p = 0.008). However, baseline weekly duration of watching TV (β =-0.63, p = 0.021) and change after 2 years (β =-0.63, p = 0.022) as well as the change in weekly duration of playing computer/games after 6 years (β =-0.75, p = 0.019) were inversely associated with corresponding changes in SI percentiles in overweight/obese group. Change in time spent at sports clubs was positively associated with change in SI percentiles after 2 years (β = 1.28, p = 0.001), with comparable effect sizes across weight status. In the subsample with accelerometer data, we found a positive cross-sectional association between MVPA and SI percentiles in thin/normal weight group. Baseline MVPA predicted changes in SI percentiles after 2 and 6 years in all groups. Conclusions: Our results suggested the beneficial effect of PA on SI. However, the increasing durations of screen-based SB might be risk factors for SI development, especially in overweight/obese children and adolescents. © 2020 The Author(s).

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  • 11.
    Cheng, Lan
    et al.
    Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany / Faculty of Mathematics and Computer Science, University of Bremen, Germany.
    Pohlabeln, Hermann
    Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.
    Ahrens, Wolfgang
    Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany / Faculty of Mathematics and Computer Science, University of Bremen, Germany.
    Russo, Paola
    Institute of Food Sciences, National Research Council, Avellino, Italy.
    Veidebaum, Toomas
    Department of Chronic Diseases, National Institute for Health Development, Tallinn, Estonia.
    Chadjigeorgiou, Charalambos
    Research and Education Institute of Child Health, Strovolos, Cyprus.
    Molnár, Dénes
    Department of Pediatrics, Medical School, University of Pécs, Hungary.
    Eiben, Gabriele
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    De Henauw, Stefaan
    Department of Public Health, Ghent University, Belgium.
    Moreno, Luis
    GENUD (Growth, Exercise, Nutrition and Development) Research Group, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón), Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERObn), University of Zaragoza, Spain.
    Page, Angie
    Centre for Exercise, Nutrition & Health Sciences, University of Bristol, Bristol, United Kingdom.
    Hebestreit, Antje
    Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.
    Sex differences in the longitudinal associations between body composition and bone stiffness index in European children and adolescents2020In: Bone, ISSN 8756-3282, E-ISSN 1873-2763, Vol. 131, article id 115162Article in journal (Refereed)
    Abstract [en]

    Fat mass (FM) and fat free mass (FFM) may influence bone health differentially. However, existing evidences on associations between FM, FFM and bone health are inconsistent and vary according to sex and maturity. The present study aims to evaluate longitudinal associations between FM, FFM and bone stiffness index (SI) among European children and adolescents with 6 years follow-up. A sample of 2468 children from the IDEFICS/I.Family was included, with repeated measurements of SI using calcaneal quantitative ultrasound, body composition using skinfold thickness, sedentary behaviors and physical activity using self-administrated questionnaires. Regression coefficients (β) and 99%-confidence intervals (99% CI) were calculated by sex-specified generalized linear mixed effects models to analyze the longitudinal associations between FM and FFM z-scores (zFM and zFFM) and SI percentiles, and to explore the possible interactions between zFM, zFFM and maturity. Baseline zFFM was observed to predict the change in SI percentiles in both boys (β = 4.57, 99% CI: 1.36, 7.78) and girls (β = 3.42, 99% CI: 0.05, 6.79) after 2 years. Moreover, baseline zFFM (β = 8.72, 99% CI: 3.18, 14.27 in boys and β = 5.89, 99% CI: 0.34, 11.44 in girls) and the change in zFFM (β = 6.58, 99% CI: 0.83, 12.34 in boys and β = 4.81, 99% CI: -0.41, 10.02 in girls) were positively associated with the change in SI percentiles after 6 years. In contrast, a negative association was observed between the change in zFM and SI percentiles in boys after 6 years (β = -3.70, 99% CI: -6.99, -0.42). Besides, an interaction was observed between the change in zFM and menarche on the change in SI percentiles in girls at 6 years follow-up (p = .009), suggesting a negative association before menarche while a positive association after menarche. Our findings support the existing evidences for a positive relationship between FFM and SI during growth. Furthermore, long-term FM gain was inversely associated with SI in boys, whereas opposing associations were observed across menarche in girls. 

  • 12.
    Dalal, Koustuv
    et al.
    Örebro University, Sweden.
    Lao, Zhinqin
    China.
    Gifford, Mervyn
    University of Skövde, School of Life Sciences.
    Wang, Shu-Mei
    Fudan University, Shanghai, China .
    Knowledge and attitudes towards childhood injury prevention: a study of parents in Shanghai, China2012In: HealthMed, ISSN 1840-2291, Vol. 6, no 11, p. 3783-3789Article in journal (Refereed)
    Abstract [en]

    Childhood injuries are a major problem worldwide. The study explored the parents' knowledge and attitudes towards childhood injury prevention in relation to theirsocioeconomic status. The study also tried to compare parents' perceptions of cause and place of child injury with actual cause and place of injury. This was a cross sectional study of 986 randomly selected parents whose children (3-6 years old) were enrolled at selected kindergartens in a 'Safe Community' in Shanghai, China. Chi-square tests and bar diagrams were used. Almost all parents (97%) thought that injury was a serious problem for their children. Around half of the parents thought that child injuries could be prevented while almost one-third (29%) of parents indicated that there were risk factors in the living environment of their children. Parental perceptions of cause of injuries and place of injuries significantly differed from that of the reality. Parents identified the most common barriers of childhood injury prevention: lack of parental attention (41.6%), environment (35.6%) and children's risky behavior (22.7%). The difference between parental opinions and reality illustrated that parents had incorrect knowledge of childhood injuries, which might lead to incorrect foci of prevention programs. Before tackling environmental modifications to prevent child injuries, policy makers should focus on rectifying parents' incorrect perceptions and on modifying their attitudes as key players. It is important to first raise awareness about childhood injury prevention among the parents for appropriate intervention strategies.

  • 13.
    Dello Russo, Marika
    et al.
    Institute of Food Sciences, National Research Council, Avellino, Italy.
    Formisano, Annarita
    Institute of Food Sciences, National Research Council, Avellino, Italy.
    Lauria, Fabio
    Institute of Food Sciences, National Research Council, Avellino, Italy.
    Ahrens, Wolfgang
    Leibniz Institute for Prevention Research and Epidemiology—BIPS, Bremen, Germany ; Institute of Statistics, Faculty of Mathematics and Computer Science, Bremen University, Germany.
    Bogl, Leonie H.
    School of Health Professions, Bern University of Applied Sciences, Switzerland ; Finnish Institute of Molecular Medicine, University of Helsinki, Finland.
    Eiben, Gabriele
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR). Department of Public Health and Community Medicine, University of Gothenburg, Sweden.
    De Henauw, Stefaan
    Department of Public Health and Primary Care, Ghent University, Belgium.
    Hebestreit, Antje
    Leibniz Institute for Prevention Research and Epidemiology—BIPS, Bremen, Germany.
    Intemann, Timm
    Leibniz Institute for Prevention Research and Epidemiology—BIPS, Bremen, Germany.
    Hunsberger, Monica
    Department of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden.
    Lissner, Lauren
    Department of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden.
    Molnar, Denes
    Department of Pediatrics, Medical School, University of Pécs, Hungary.
    Pala, Valeria
    Department of Preventive and Predictive Medicine, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milan, Italy.
    Papoutsou, Stalo
    Research and Education Institute of Child Health, Strovolos, Cyprus.
    Santaliestra-Pasias, Alba M.
    NUTRI-GENUD (Growth, Exercise, Nutrition and Development) Research Group, Faculty of Health Sciences and Sports, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón), Universidad de Zaragoza, Spain ; CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain.
    Veidebaum, Toomas
    National Institute for Health Development, Center of Health and Behavioral Science, Tallinn, Estonia.
    Wolters, Maike
    Leibniz Institute for Prevention Research and Epidemiology—BIPS, Bremen, Germany.
    Siani, Alfonso
    Institute of Food Sciences, National Research Council, Avellino, Italy.
    Russo, Paola
    Institute of Food Sciences, National Research Council, Avellino, Italy.
    I.Family Consortium,
    Dietary Diversity and Its Association with Diet Quality and Health Status of European Children, Adolescents, and Adults: Results from the I.Family Study2023In: Foods, E-ISSN 2304-8158, Vol. 12, no 24, article id 4458Article in journal (Refereed)
    Abstract [en]

    Dietary diversity (DD) plays a crucial role in fostering high-quality diets, but its association with health outcomes, particularly body adiposity and non-communicable diseases (NCDs), is inconsistent. This may be due to a lack of a standardized method for estimating DD. Our study investigates the association between two DD indices, namely the dietary diversity score (DDS) and food variety score (FVS), and anthropometric measures, biochemical parameters, and diet quality in a large population sample from the I.Family study across research centers in eight European countries. In our cross-sectional analysis of 3035 participants, DDSs varied among countries, with a higher prevalence in the third DDS tertile among those with higher education. DDS showed a positive association with diet quality across all age groups. Higher DDS tertile individuals showed increased fiber, fruit, and vegetable intake, greater meal frequency, and lower ultra-processed food consumption. No relevant biochemical differences were observed across DDS tertiles, and a higher DDS was associated with lower overweight/obesity prevalence only in adults. No significant associations were found with FVS. Our findings emphasize the need to consider food groups for a more accurate estimation of diet quality. This aligns with studies suggesting DDS alone is not an independent risk factor for obesity in children and adolescents. Public health programs should prioritize food diversity to promote improved nutrition and overall well-being in communities. 

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  • 14.
    Floegel, Anna
    et al.
    Section of Dietetics, Faculty of Agriculture and Food Sciences, Hochschule Neubrandenburg – University of Applied Sciences, Neubrandenburg, Germany ; Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany.
    Intemann, Tim
    Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany.
    Siani, Alfonso
    Institute of Food Sciences, National Research Council, Avellino, Italy.
    Moreno, Luis A.
    GENUD (Growth, Exercise, Nutrition and Development) Research Group, Faculty of Health Sciences, Universidad de Zaragoza, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain ; Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain.
    Molnár, Dénes
    Department of Pediatrics, Medical School, University of Pécs, Hungary.
    Veidebaum, Toomas
    National Institute for Health Development, Estonian Centre of Behavioral and Health Sciences, Tallinn, Estonia.
    Hadjigeorgiou, Charalambos
    Research and Education Institute of Child Health, Strovolos, Cyprus.
    De Henauw, Stefaan
    Department of Public Health and Primary Care, Ghent University, Belgium.
    Hunsberger, Monica
    Section for Epidemiology and Social Medicine, Department of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden.
    Eiben, Gabriele
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR).
    Ahrens, Wolfgang
    Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany ; Faculty of Mathematics and Computer Science, Institute of Statistics, University of Bremen, Germany.
    Wolters, Maike
    Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany.
    IDEFICS/I.Family consortia,
    Cohort-Based Reference Values for Serum Ferritin and Transferrin and Longitudinal Determinants of Iron Status in European Children Aged 3–15 Years2024In: Journal of Nutrition, ISSN 0022-3166, E-ISSN 1541-6100Article in journal (Refereed)
    Abstract [en]

    Background: Reference values of ferritin and transferrin for European children do not exist. Objective: We aimed to provide sex-, age-, and body mass index (BMI)-specific serum ferritin and transferrin reference percentiles of 3–15-y-old children based on cohort data and to investigate determinants of iron status. Methods: A total of 3390 ferritin and 3416 transferrin measurements from children residing in 8 European countries participating in the IDEFICS/I.Family cohort (https://www.isrctn.com/ISRCTN62310987) at baseline (W0) and 6 y later (W3) were used to estimate percentiles using the generalized additive model for location, scale and shape. Associations of serum ferritin and transferrin concentrations with total iron intake, total iron intake additionally adjusted for vitamin C intake, and iron from heme sources were investigated separately with adjustment for sex, age, country of residence, parental education, usual energy intake and BMI z-score in regression models using cross-sectional and longitudinal data. Results: The age-specific ferritin and transferrin 5th and 95th reference percentiles ranged from 10.9 to 81.1 μg/L and 2.23 to 3.56 g/L, respectively. A deficient iron status was observed in 3% of children at W0 and 7% of children and adolescents at W3, respectively. At both waves, a higher iron intake from heme sources was positively associated with serum ferritin {W0: β = 3.21 [95% confidence interval (CI): 0.71, 5.71]; W3: β = 4.48 [95% CI: 2.09, 6.87]}, that is, children consuming one mg more heme iron had a 3.21 and 4.48 μg/L higher ferritin concentration. Adherence to a mainly vegetarian diet was associated with a lower chance for sufficient serum ferritin cross-sectionally at W3 [odds ratio (OR) 0.40 (95% CI: 0.21, 0.81)] and longitudinally [OR 0.35 (95% CI: 0.15, 0.93)]. Conclusions: Age-, sex-, and BMI-specific reference percentiles of serum ferritin and transferrin concentrations based on cohort data are provided for European children aged 3–15 y and may be used in clinical practice. 

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  • 15.
    Gil-Campos, Mercedes
    et al.
    CIBEROBN, (Physiopathology of Obesity and Nutrition) Institute of Health Carlos III (ISCIII), Madrid, Spain ; Metabolism and Investigation Unit, Reina Sofia University Hospital, Maimónides Institute of Biomedicine Research of Córdoba (IMIBIC), University of Córdoba, Spain.
    Pérez-Ferreirós, Alexandra
    Unit of Investigation in Human Nutrition, Growth and Development of Galicia (GALINUT), University of Santiago de Compostela (USC), Spain.
    Llorente-Cantarero, Francisco José
    CIBEROBN, (Physiopathology of Obesity and Nutrition) Institute of Health Carlos III (ISCIII), Madrid, Spain ; Department of Specific Didactics, Faculty of Education, University of Córdoba, Spain.
    Anguita-Ruiz, Augusto
    CIBEROBN, (Physiopathology of Obesity and Nutrition) Institute of Health Carlos III (ISCIII), Madrid, Spain ; Center of Biomedical Research, Department of Biochemistry and Molecular Biology II, Institute of Nutrition and Food Technology "José Mataix", University of Granada, Spain ; Biosanitary Research Institute (IBS), Granada, Spain.
    Bedoya-Carpente, Juan José
    Unit of Investigation in Human Nutrition, Growth and Development of Galicia (GALINUT), University of Santiago de Compostela (USC), Spain.
    Kalén, Anton
    Unit of Investigation in Human Nutrition, Growth and Development of Galicia (GALINUT), University of Santiago de Compostela (USC), Spain.
    Moreno, Jose A.
    CIBEROBN, (Physiopathology of Obesity and Nutrition) Institute of Health Carlos III (ISCIII), Madrid, Spain ; GENUD Research Group, Institute of Sanitary Research of Aragón (IIS Aragón), University of Zaragoza, Spain ; Agri-Food Institute of Aragon (IA2), Zaragoza, Spain.
    Bueno, Gloria
    CIBEROBN, (Physiopathology of Obesity and Nutrition) Institute of Health Carlos III (ISCIII), Madrid, Spain ; GENUD Research Group, Institute of Sanitary Research of Aragón (IIS Aragón), University of Zaragoza, Spain ; Agri-Food Institute of Aragon (IA2), Zaragoza, Spain ; Unit of Pediatric Endocrinology, University Clinical Hospital Lozano Blesa, Zaragoza, Spain.
    Gil, Ángel
    CIBEROBN, (Physiopathology of Obesity and Nutrition) Institute of Health Carlos III (ISCIII), Madrid, Spain ; Center of Biomedical Research, Department of Biochemistry and Molecular Biology II, Institute of Nutrition and Food Technology “José Mataix”, University of Granada, Spain ; Biosanitary Research Institute (IBS), Granada, Spain.
    Aguilera, Concepción M.
    CIBEROBN, (Physiopathology of Obesity and Nutrition) Institute of Health Carlos III (ISCIII), Madrid, Spain ; Center of Biomedical Research, Department of Biochemistry and Molecular Biology II, Institute of Nutrition and Food Technology "José Mataix", University of Granada, Spain ; Biosanitary Research Institute (IBS), Granada, Spain.
    Leis, Rosaura
    CIBEROBN, (Physiopathology of Obesity and Nutrition) Institute of Health Carlos III (ISCIII), Madrid, Spain ; Unit of Investigation in Human Nutrition, Growth and Development of Galicia (GALINUT), University of Santiago de Compostela (USC), Spain ; Unit of Pediatric Gastroenterology, Hepatology and Nutrition, Pediatric Service, University Clinical Hospital of Santiago (CHUS), Santiago de Compostela, Spain ; Pediatric Nutrition Research Group, Institute of Sanitary Research of Santiago de Compostela (IDIS), CHUS–USC, Spain.
    Association of Diet, Physical Activity Guidelines and Cardiometabolic Risk Markers in Children2021In: Nutrients, E-ISSN 2072-6643, Vol. 13, no 9, article id 2954Article in journal (Refereed)
    Abstract [en]

    The aim was to identify different dietary and physical activity (PA) patterns in 5- to 14-year-old children with a high prevalence of overweight and obesity using cluster analysis based on their adherence to the Spanish Society of Community Nutrition dietary guidelines and levels of PA, and to determine their associations with age, sex, body composition, and cardiometabolic risk markers. In 549 children, hierarchical cluster analysis was used to identify subgroups with similar adherence to dietary recommendations and level of PA. Three clusters were identified: Cluster 1, with the lowest level of vigorous PA and adherence to dietary recommendations; Cluster 2, with the lowest levels of moderate and vigorous PA and the highest adherence to dietary recommendations; and Cluster 3, with the highest level of PA, especially vigorous PA and a medium level adherence to dietary recommendations. Cluster 3 had lower total body fat and higher lean body mass percentages than Cluster 2. Cluster 2 had lower high-density lipoprotein cholesterol and higher low-density lipoprotein cholesterol levels than Cluster 1. The results from our study suggest that it is important to consider adherence to PA recommendations together with adherence to dietary guidelines to understand patterns of obesogenic habits in pediatric populations with high prevalence of overweight and obesity.

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  • 16.
    González-Gil, Esther M.
    et al.
    Department of Biochemistry and Molecular Biology II, Instituto de Nutrición y Tecnología de los Alimentos, Center of Biomedical Research (CIBM), Universidad de Granada, Spain ; GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Spain ; Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain.
    Santaliestra-Pasías, Alba M.
    GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain ; Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain ; Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain ; Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain.
    Buck, Christoph
    Leibniz Institute for Prevention Research and Epidemiology—BIPS, Bremen, Germany.
    Gracia-Marco, Luis
    GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain ; PROFITH (PROmoting FITness and Health through physical activity) Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Spain.
    Lauria, Fabio
    Institute of Food Sciences, National Research Council, Avellino, Italy.
    Pala, Valeria
    Epidemiology and Prevention Unit, Fondazione IRCCS—Istituto Nazionale dei Tumori, Milan, Italy.
    Molnar, Denes
    Department of Pediatrics, Medical School, University of Pécs, Hungary.
    Veidebaum, Toomas
    National Institute for Health Development, Center of Health and Behavioral Science, Tallinn, Estonia.
    Iacoviello, Licia
    Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli, Italy ; Department of Medicine and Surgery, Research Center in Epidemiology and Preventive Medicine (EPIMED), University of Insubria, Varese, Italy.
    Tornaritis, Michael
    Research and Education Institute of Child Health, Strovolos, Cyprus.
    Eiben, Gabriele
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR).
    Lissner, Lauren
    Department of Public Health and Community Medicine, University of Gothenburg, Sweden.
    Schwarz, Heike
    Leibniz Institute for Prevention Research and Epidemiology—BIPS, Bremen, Germany.
    Ahrens, Wolfgang
    Leibniz Institute for Prevention Research and Epidemiology—BIPS, Bremen, Germany ; Institute of Statistics, Bremen University, Germany.
    De Henauw, Stefaan
    Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Belgium.
    Fraterman, Arno
    Laboratoriumsmedizin Dortmund, Eberhard & Partner, Dortmund, Germany.
    Moreno, Luis A.
    GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain ; Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain ; Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain ; Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain.
    Improving cardiorespiratory fitness protects against inflammation in children: the IDEFICS study2022In: Pediatric Research, ISSN 0031-3998, E-ISSN 1530-0447, Vol. 91, no 3, p. 681-689Article in journal (Refereed)
    Abstract [en]

    Background: Muscular and cardiorespiratory fitness (MF and CRF) have been related to inflammation. Thus, the aim of this study was to assess the relationship between fitness and high-sensitivity C-reactive protein (hs-CRP) in European children both in the cross-sectional and longitudinal analysis. Methods: Three hundred and fifty-seven children (46.2% males) aged 2–9 years with hs-CRP measured, data from MF and CRF, diet quality, objectively measured physical activity (PA) and screen time at baseline and follow-up after 2 years were included. Body mass index z-score (zBMI), waist circumference (WC) and fat mass index (FMI) were assessed. MF and CRF were also dichotomized as follows: low-medium quartiles (Q1–Q3) and highest quartile (Q4). Results: At follow-up, children with the highest CRF (Q4) showed a lower probability of having high hs-CRP. In the longitudinal analysis, children who improved their CRF over time showed a significantly lower probability (p < 0.05) of being in the highest hs-CRP category at follow-up, independently of the body composition index considered: odds ratio (OR) = 0.22 for zBMI, OR = 0.17 for WC, and OR = 0.21 for FMI. Conclusions: Improving CRF during childhood reduces the odds of an inflammatory profile, independently of body composition and lifestyle behaviours. These highlight the importance of enhancing fitness, especially CRF, to avoid an inflammatory state in children. Impact: Improvements in the cardiorespiratory profile during childhood could reverse an unfavourable inflammatory status.There is a longitudinal and inverse association between CRF and inflammation in children.This is the first longitudinal study assessing the relationship between fitness and inflammation during childhood that takes also into account the lifestyle behaviours.Results from the present study suggest a protective role of fitness already in childhood.Efforts to improve fitness in children should be aimed at as inflammation could trigger future cardiovascular disease. 

  • 17.
    Grguric, Josip
    et al.
    Department of Pediatrics, University Medical School, Zagreb / UNICEF Croatia.
    Wen, Ruth-Ann
    Centre of Excellence for Nutrition, Health Promotion Board, Singapore / Association for Breastfeeding Advocacy (Singapore), Singapore.
    Kylberg, Elisabeth
    University of Skövde, School of Life Sciences.
    Ashmore, Sue
    UNICEF UK Baby Friendly Initiative.
    MacEnroe, Trish
    Baby-Friendly USA, Inc..
    International Perspectives on the Baby-Friendly Initiative2012In: Journal of Human Lactation, ISSN 0890-3344, E-ISSN 1552-5732, Vol. 28, no 3, p. 281-284Article in journal (Other academic)
  • 18.
    Maroofian, Reza
    et al.
    Department of Neuromuscular Diseases, University College London, Institute of Neurology, United Kingdom.
    Tajsharghi, Homa
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR).
    Ejeskär, Katarina
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR).
    Severino, Mariasavina
    Neuroradiology Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy.
    Biallelic MED27 variants lead to variable ponto-cerebello-lental degeneration with movement disorders2023In: Brain, ISSN 0006-8950, E-ISSN 1460-2156, Vol. 146, no 12, p. 5031-5043Article in journal (Refereed)
    Abstract [en]

    MED27 is a subunit of the Mediator multiprotein complex, which is involved in transcriptional regulation. Biallelic MED27 variants have recently been suggested to be responsible for an autosomal recessive neurodevelopmental disorder with spasticity, cataracts and cerebellar hypoplasia. We further delineate the clinical phenotype of MED27-related disease by characterizing the clinical and radiological features of 57 affected individuals from 30 unrelated families with biallelic MED27 variants. Using exome sequencing and extensive international genetic data sharing, 39 unpublished affected individuals from 18 independent families with biallelic missense variants in MED27 have been identified (29 females, mean age at last follow-up 17 ± 12.4 years, range 0.1-45). Follow-up and hitherto unreported clinical features were obtained from the published 12 families. Brain MRI scans from 34 cases were reviewed. MED27-related disease manifests as a broad phenotypic continuum ranging from developmental and epileptic-dyskinetic encephalopathy to variable neurodevelopmental disorder with movement abnormalities. It is characterized by mild to profound global developmental delay/intellectual disability (100%), bilateral cataracts (89%), infantile hypotonia (74%), microcephaly (62%), gait ataxia (63%), dystonia (61%), variably combined with epilepsy (50%), limb spasticity (51%), facial dysmorphism (38%) and death before reaching adulthood (16%). Brain MRI revealed cerebellar atrophy (100%), white matter volume loss (76.4%), pontine hypoplasia (47.2%) and basal ganglia atrophy with signal alterations (44.4%). Previously unreported 39 affected individuals had seven homozygous pathogenic missense MED27 variants, five of which were recurrent. An emerging genotype-phenotype correlation was observed. This study provides a comprehensive clinical-radiological description of MED27-related disease, establishes genotype-phenotype and clinical-radiological correlations and suggests a differential diagnosis with syndromes of cerebello-lental neurodegeneration and other subtypes of 'neuro-MEDopathies'. 

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  • 19.
    Martinón-Torres, Nazareth
    et al.
    Unit of Pediatric Gastroenterology, Hepatology and Nutrition, Pediatric Service, University Clinical Hospital of Santiago (CHUS), Santiago de Compostela, Spain ; Pediatric Nutrition Research Group, Institute of Sanitary Research of Santiago de Compostela (IDIS), CHUS-USC, Santiago de Compostela, Spain.
    Carreira, Nathalie
    Unit of Pediatric Gastroenterology, Hepatology and Nutrition, Pediatric Service, University Clinical Hospital of Santiago (CHUS), Santiago de Compostela, Spain ; Pediatric Nutrition Research Group, Institute of Sanitary Research of Santiago de Compostela (IDIS), CHUS-USC, Santiago de Compostela, Spain.
    Picáns-Leis, Rosaura
    Department of Pediatrics, University Clinical Hospital of Santiago (CHUS), Santiago de Compostela, Spain.
    Pérez-Ferreirós, Alexandra
    Unit of Investigation in Human Nutrition, Growth and Development of Galicia (GALINUT), University of Santiago de Compostela (USC), Spain.
    Kalén, Anton
    Unit of Investigation in Human Nutrition, Growth and Development of Galicia (GALINUT), University of Santiago de Compostela (USC), Spain.
    Leis, Rosaura
    Unit of Pediatric Gastroenterology, Hepatology and Nutrition, Pediatric Service, University Clinical Hospital of Santiago (CHUS), Santiago de Compostela, Spain ; Pediatric Nutrition Research Group, Institute of Sanitary Research of Santiago de Compostela (IDIS), CHUS-USC, Santiago de Compostela, Spain ; Department of Pediatrics, University Clinical Hospital of Santiago (CHUS), Santiago de Compostela, Spain ; Unit of Investigation in Human Nutrition, Growth and Development of Galicia (GALINUT), University of Santiago de Compostela (USC), Spain ; CIBEROBN, (Physiopathology of Obesity and Nutrition) Institute of Health Carlos III (ISCIII), Madrid, Spain.
    Baby-Led Weaning: What Role Does It Play in Obesity Risk during the First Years?: A Systematic Review2021In: Nutrients, E-ISSN 2072-6643, Vol. 13, no 3, p. 1-14, article id 1009Article in journal (Refereed)
    Abstract [en]

    Childhood is a window of opportunity for the prevention of the obesity pandemic. Since “the first 1000 days of life” is a period in which healthy eating habits must be acquired, it should be the target for preventive strategies. Baby-led weaning (BLW) is an emergent way of weaning that could influence children’s health. The nutrition committees of the main pediatric societies affirm there is not enough evidence to support which is the best method of weaning. The aim was to determinate the influence of BLW on the infant’s weight gain compared to the traditional spoon-feeding, and to assess if it could decrease the risk of obesity in children. A systematic review was conducted, following the PRISMA method. Pubmed, Web of Science, Embase, and Cochrane Library were searched. Out of 747 articles, eight studies (2875 total infants) were included (two randomized control trials, 6 observational studies). Results were indecisive, while some studies seem to demonstrate lower weight gain in infants that apply BLW, others show inconclusive results. The risk of bias in all included studies was moderate or high. In conclusion, more clinical trials and prospective studies should be done prior to providing a general recommendation about the best method of weaning to reduce the risk of obesity.

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  • 20. NCD Risk Factor Collaboration (NCD-RisC),
    Eiben, Gabriele (Contributor)
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR).
    Ezzati, Majid (Contributor)
    Imperial College London, United Kingdom ; University of Ghana, Accra, Ghana.
    Diminishing benefits of urban living for children and adolescents’ growth and development2023In: Nature, ISSN 0028-0836, Vol. 615, no 7954, p. 874-883Article in journal (Refereed)
    Abstract [en]

    Optimal growth and development in childhood and adolescence is crucial for lifelong health and well-being 1-6. Here we used data from 2,325 population-based studies, with measurements of height and weight from 71 million participants, to report the height and body-mass index (BMI) of children and adolescents aged 5-19 years on the basis of rural and urban place of residence in 200 countries and territories from 1990 to 2020. In 1990, children and adolescents residing in cities were taller than their rural counterparts in all but a few high-income countries. By 2020, the urban height advantage became smaller in most countries, and in many high-income western countries it reversed into a small urban-based disadvantage. The exception was for boys in most countries in sub-Saharan Africa and in some countries in Oceania, south Asia and the region of central Asia, Middle East and north Africa. In these countries, successive cohorts of boys from rural places either did not gain height or possibly became shorter, and hence fell further behind their urban peers. The difference between the age-standardized mean BMI of children in urban and rural areas was <1.1 kg m-2 in the vast majority of countries. Within this small range, BMI increased slightly more in cities than in rural areas, except in south Asia, sub-Saharan Africa and some countries in central and eastern Europe. Our results show that in much of the world, the growth and developmental advantages of living in cities have diminished in the twenty-first century, whereas in much of sub-Saharan Africa they have amplified.

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  • 21. NCD Risk Factor Collaboration (NCD-RisC),
    Eiben, Gabriele (Contributor)
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR).
    Ezzati, Majid (Contributor)
    Imperial College London, UK ; University of Ghana, Ghana.
    Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries and territories: a pooled analysis of 2181 population-based studies with 65 million participants2020In: The Lancet, ISSN 0140-6736, E-ISSN 1474-547X, Vol. 396, no 10261, p. 1511-1524Article in journal (Refereed)
    Abstract [en]

    Summary

    Background

    Comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents.

    Methods

    For this pooled analysis, we used a database of cardiometabolic risk factors collated by the Non-Communicable Disease Risk Factor Collaboration. We applied a Bayesian hierarchical model to estimate trends from 1985 to 2019 in mean height and mean BMI in 1-year age groups for ages 5–19 years. The model allowed for non-linear changes over time in mean height and mean BMI and for non-linear changes with age of children and adolescents, including periods of rapid growth during adolescence.

    Findings

    We pooled data from 2181 population-based studies, with measurements of height and weight in 65 million participants in 200 countries and territories. In 2019, we estimated a difference of 20 cm or higher in mean height of 19-year-old adolescents between countries with the tallest populations (the Netherlands, Montenegro, Estonia, and Bosnia and Herzegovina for boys; and the Netherlands, Montenegro, Denmark, and Iceland for girls) and those with the shortest populations (Timor-Leste, Laos, Solomon Islands, and Papua New Guinea for boys; and Guatemala, Bangladesh, Nepal, and Timor-Leste for girls). In the same year, the difference between the highest mean BMI (in Pacific island countries, Kuwait, Bahrain, The Bahamas, Chile, the USA, and New Zealand for both boys and girls and in South Africa for girls) and lowest mean BMI (in India, Bangladesh, Timor-Leste, Ethiopia, and Chad for boys and girls; and in Japan and Romania for girls) was approximately 9–10 kg/m2. In some countries, children aged 5 years started with healthier height or BMI than the global median and, in some cases, as healthy as the best performing countries, but they became progressively less healthy compared with their comparators as they grew older by not growing as tall (eg, boys in Austria and Barbados, and girls in Belgium and Puerto Rico) or gaining too much weight for their height (eg, girls and boys in Kuwait, Bahrain, Fiji, Jamaica, and Mexico; and girls in South Africa and New Zealand). In other countries, growing children overtook the height of their comparators (eg, Latvia, Czech Republic, Morocco, and Iran) or curbed their weight gain (eg, Italy, France, and Croatia) in late childhood and adolescence. When changes in both height and BMI were considered, girls in South Korea, Vietnam, Saudi Arabia, Turkey, and some central Asian countries (eg, Armenia and Azerbaijan), and boys in central and western Europe (eg, Portugal, Denmark, Poland, and Montenegro) had the healthiest changes in anthropometric status over the past 3·5 decades because, compared with children and adolescents in other countries, they had a much larger gain in height than they did in BMI. The unhealthiest changes—gaining too little height, too much weight for their height compared with children in other countries, or both—occurred in many countries in sub-Saharan Africa, New Zealand, and the USA for boys and girls; in Malaysia and some Pacific island nations for boys; and in Mexico for girls.

    Interpretation

    The height and BMI trajectories over age and time of school-aged children and adolescents are highly variable across countries, which indicates heterogeneous nutritional quality and lifelong health advantages and risks.

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  • 22.
    Nyqvist, Kerstin H.
    et al.
    Department of Women’s and Children’s Health, University Children’s Hospital, Uppsala, Sweden.
    Häggkvist, Anna-Pia
    Norwegian Resource Centre for Breastfeeding, Women and Children’s Division, Oslo University Hospital, Oslo, Norway.
    Hansen, Mette N.
    Norwegian Resource Centre for Breastfeeding, Women and Children’s Division, Oslo University Hospital, Oslo, Norway.
    Kylberg, Elisabeth
    University of Skövde, School of Life Sciences.
    Frandsen, Annemi L.
    Pediatric Department, Holbaek Hospital, Holbaek, Denmark.
    Maastrup, Ragnhild
    Neonatal Intensive Care Unit, Rigshospitalet, Copenhagen, Denmark, and Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden.
    Ezeonodo, Aino
    Helsinki University Central Hospital, Children’s Hospital, Department of Neonatology, Neonatal Intensive Care Unit, K7, Helsinki, Finland / Faculty of Health Care and Nursing, Helsinki Metropolia University of Applied Sciences, Helsinki, Finland.
    Hannula, Leena
    Faculty of Health Care and Nursing, Helsinki Metropolia University of Applied Sciences, Helsinki, Finland.
    Haiek, Laura N.
    Ministère de la Santé et des Services sociaux, Direction générale de santé publique, Quebec, Canada, and Department of Family Medicine, McGill University, Montréal, Québec, Canada.
    Expansion of the baby-friendly hospital initiative ten steps to successful breastfeeding into neonatal intensive care: Expert group recommendations2013In: Journal of Human Lactation, ISSN 0890-3344, E-ISSN 1552-5732, Vol. 29, no 3, p. 300-309Article in journal (Refereed)
    Abstract [en]

    In the World Health Organization/United Nations Children’s Fund document Baby-Friendly Hospital Initiative: Revised, Updated and Expanded for Integrated Care, neonatal care is mentioned as 1 area that would benefit from expansion of the original Ten Steps to Successful Breastfeeding. The different situations faced by preterm and sick infants and their mothers, compared to healthy infants and their mothers, necessitate a specific breastfeeding policy for neonatal intensive care and require that health care professionals have knowledge and skills in lactation and breastfeeding support, including provision of antenatal information, that are specific to neonatal care. Facilitation of early, continuous, and prolonged skin-to-skin contact (kangaroo mother care), early initiation of breastfeeding, and mothers’ access to breastfeeding support during the infants’ whole hospital stay are important. Mother’s own milk or donor milk (when available) is the optimal nutrition. Efforts should be made to minimize parent–infant separation and facilitate parents’ unrestricted presence with their infants. The initiation and continuation of breastfeeding should be guided only by infant competence and stability, using a semi-demand feeding regimen during the transition to exclusive breastfeeding. Pacifiers are appropriate during tube-feeding, for pain relief, and for calming infants. Nipple shields can be used for facilitating establishment of breastfeeding, but only after qualified support and attempts at the breast. Alternatives to bottles should be used until breastfeeding is well established. The discharge program should include adequate preparation of parents, information about access to lactation and breastfeeding support, both professional and peer support, and a plan for continued follow-up.

  • 23.
    Russo, Marika D.
    et al.
    Institute of Food Sciences, CNR, Avellino, Italy.
    Ahrens, Wolfgang
    Leibniz Institute for Prevention Research and Epidemiology BIPS, Bremen, Germany / Institute of Statistics, University of Bremen, Germany.
    De Henauw, Stefaan
    Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Belgium.
    Eiben, Gabriele
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Hebestreit, Antje
    Leibniz Institute for Prevention Research and Epidemiology BIPS, Bremen, Germany.
    Kourides, Yannis
    Research and Education Institute of Child Health, Cyprus.
    Lissner, Lauren
    Section for Epidemiology and Social Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden.
    Molnar, Denes
    Department of Paediatrics, University of Pécs, Hungary.
    Moreno, Luis A.
    GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Spain.
    Pala, Valeria
    Epidemiology and Prevention Unit, Fondazione IRCSS Istituto Nazionale dei Tumori, Milan, Italy.
    Veidebaum, Toomas
    National Institute for Health Development, Tallinn, Estonia.
    Siani, Alfonso
    Institute of Food Sciences, CNR, Avellino, Italy.
    Russo, Paula
    Institute of Food Sciences, CNR, Avellino, Italy.
    The impact of adding sugars to milk and fruit on adiposity and diet quality in children: A cross-sectional and longitudinal analysis of the identification and prevention of dietary-and lifestyle-induced health effects in children and infants (IDEFICS) study2018In: Nutrients, E-ISSN 2072-6643, Vol. 10, no 10, article id 1350Article in journal (Refereed)
    Abstract [en]

    Sugar, particularly as free sugars or sugar-sweetened beverages, significantly contributes to total energy intake, and, possibly, to increased body weight. Excessive consumption may be considered as a proxy of poor diet quality. However, no previous studies evaluated the association between the habit of adding sugars to “healthy” foods, such as plain milk and fresh fruit, and indicators of adiposity and/or dietary quality in children. To answer to these research questions, we Panalysed the European cohort of children participating in the IDEFICS study. Anthropometric variables, frequency of consumption of sugars added to milk and fruit (SAMF), and scores of adherence to healthy dietary pattern (HDAS) were assessed at baseline in 9829 children stratified according to age and sex. From this cohort, 6929 children were investigated again after two years follow-up. At baseline, a direct association between SAMF categories and adiposity indexes was observed only in children aged 6–<10 years, while the lower frequency of SAMF consumption was significantly associated with a higher HDAS. At the two year follow-up, children with higher baseline SAMF consumption showed significantly higher increases in all the anthropometric variables measured, with the exception of girls 6–<10 years old. The inverse association between SAMF categories and HDAS was still present at the two years follow-up in all age and sex groups. Our results suggest that the habit to adding sugars to foods that are commonly perceived as healthy may impact the adherence to healthy dietary guidelines and increase in adiposity risk as well. 

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  • 24.
    Sina, Elida
    et al.
    Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.
    Buck, Christoph
    Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.
    Ahrens, Wolfgang
    Faculty of Mathematics and Computer Science, Institute of Statistics, University of Bremen, Germany.
    Coumans, Juul M. J.
    Teaching and Learning Centre, Open University of the Netherlands, Heerlen, Netherlands.
    Eiben, Gabriele
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR).
    Formisano, Annarita
    Institute of Food Sciences, National Research Council, Avellino, Italy.
    Lissner, Lauren
    School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden.
    Mazur, Artur
    Faculty of Medicine, University of Rzeszów, Poland.
    Michels, Nathalie
    Department of Public Health and Primary Care, Ghent University, Belgium.
    Molnar, Dénes
    Department of Pediatrics, Medical School, University of Pécs, Hungary.
    Moreno, Luis A.
    GENUD (Growth, Exercise, Nutrition and Development) Research Group, Centro de Investigación Biomédica en Red Fisiopatología de La Obesidad y Nutrición (CIBERObn), Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón), University of Zaragoza, Spain.
    Pala, Valeria
    Department of Epidemiology and Data Science, Fondazione IRCCS, Istituto Nazionale Dei Tumori, Milan, Italy.
    Pohlabeln, Hermann
    Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.
    Reisch, Lucia
    Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany ; Cambridge Judge Business School, University of Cambridge, United Kingdom.
    Tornaritis, Michael
    Research and Education Institute of Child Health, Strovolos, Cyprus.
    Veidebaum, Toomas
    Department of Chronic Diseases, National Institute for Health Development, Tallinn, Estonia.
    Hebestreit, Antje
    Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.
    I. Family consortium,
    Digital media exposure and cognitive functioning in European children and adolescents of the I.Family study2023In: Scientific Reports, E-ISSN 2045-2322, Vol. 13, no 1, article id 18855Article in journal (Refereed)
    Abstract [en]

    The digital environment can pose health risks through exposure to unhealthy content. Yet, little is known about its relation to children’s cognitive functioning. This study investigates the association between digital media (DM) exposure and children’s cognitive functioning. This cross-sectional study is based on examinations of children aged 8–18 years (N = 8673) of the I.Family cohort (2013–2014). Exposure to television, computer, smartphone and internet was self-reported (hours/day). Media multitasking (MMT) was defined as simultaneous use of computers with other digital or non-screen-based activities. Standard instruments were used to assess cognitive inflexibility (score: 0–39), decision-making ability (− 100 to + 100) and impulsivity (12–48). Adjusted regression coefficients and 99.9%CIs were calculated by generalized linear mixed-effects models. In total, 3261 participants provided data for impulsivity, 3441 for cognitive inflexibility and 4046 for decision-making. Exposure to smartphones and media multitasking were positively associated with impulsivity (βsmartphone = 0.74; 99.9%CI = 0.42–1.07; βMMT = 0.73; 99.9%CI = 0.35–1.12) and cognitive inflexibility (βsmartphone = 0.32; 99.9%CI = -0.02–0.66; βMMT = 0.39; 99.9%CI = 0.01–0.77) while being inversely associated with decision-making ability. Extensive smartphone/internet exposure combined with low computer/medium TV exposure was associated with higher impulsivity and cognitive inflexibility scores, especially in girls. DM exposure is adversely associated with cognitive functioning in children and adolescents. Children require protection against the likely adverse impact of digital environment. 

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  • 25.
    Sina, Elida
    et al.
    Leibniz Institute for Prevention Research and Epidemiology—BIPS, Bremen, Germany.
    Buck, Christoph
    Leibniz Institute for Prevention Research and Epidemiology—BIPS, Bremen, Germany.
    Jilani, Hannah
    Leibniz Institute for Prevention Research and Epidemiology—BIPS, Bremen, Germany / Institute for Public Health and Nursing Research—IPP, University of Bremen, Germany.
    Tornaritis, Michael
    Research and Education Institute of Child Health, Lefcosia, Cyprus.
    Veidebaum, Toomas
    Department of Chronic Diseases, National Institute for Health Development, Tallin, Estonia.
    Russo, Paola
    Institute of Food Sciences, National Research Council, Avellino, Italy.
    Moreno, Luis A.
    GENUD (Growth, Exercise, Nutrition and Development) Research Group, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón), Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERObn), University of Zaragoza, Spain.
    Molnar, Denes
    Department of Pediatrics, Medical School, University of Pécs, Hungary.
    Eiben, Gabriele
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Marild, Staffan
    Department. of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Sweden.
    Pala, Valeria
    Department of Preventive and Predictive Medicine, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milan, Italy.
    Ahrens, Wolfgang
    Leibniz Institute for Prevention Research and Epidemiology—BIPS, Bremen, Germany / Faculty of Mathematics/Computer Science, University of Bremen, Germany.
    Hebestreit, Antje
    Leibniz Institute for Prevention Research and Epidemiology—BIPS, Bremen, Germany.
    Association of infant feeding patterns with taste preferences in European children and adolescents: A retrospective latent profile analysis2019In: Nutrients, E-ISSN 2072-6643, Vol. 11, no 5, p. 1-16, article id 1040Article in journal (Refereed)
    Abstract [en]

    The aim was to investigate associations between the duration of infant feeding practices (FP) and taste preferences (TP) in European children and adolescents. A total of 5526 children (6-16 years old) of the I.Family study completed a Food and Beverage Preference Questionnaire to measure their preferences for sweet, fatty and bitter tastes. Mothers retrospectively reported the FPs duration in months: exclusive breastfeeding (EBF), exclusive formula milk feeding (EFMF), combined breastfeeding (BF&FMF) and the age at the introduction of complementary foods (CF). Using logistic regression analyses and latent class analysis (latent profiles of FP and CF were identified), we explored associations between profiles and TP, adjusting for various covariates, including the Healthy Diet Adherence Score (HDAS). A total of 48% of children had short durations of EBF (≤4 months) and BF&FMF (≤6 months) and were introduced to CF early (<6 months). No significant relationship was observed between the single FPs and TP, even when considering common profiles of FP. HDAS was inversely associated with sweet and fatty TP, but positively with bitter TP. Contrary to our hypotheses, we did not observe associations between FP and children’s TP later in life. Further studies with higher FP variation and longitudinal design are needed to investigate the causal associations between infant FP and taste preferences later in life. © 2019 by the authors. Licensee MDPI, Basel, Switzerland.

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  • 26.
    Sina, Elida
    et al.
    Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany.
    Buck, Christoph
    Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany.
    Veidebaum, Toomas
    Department of Chronic Diseases, National Institute for Health Development, Tallinn, Estonia.
    Siani, Alfonso
    Institute of Food Sciences, National Research Council, Avellino, Italy.
    Reisch, Lucia
    Department of Management, Society and Communication, Copenhagen Business School, Copenhagen, Denmark.
    Pohlabeln, Hermann
    Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany.
    Pala, Valeria
    Department of Preventive and Predictive Medicine, Fondazione IRCCS, Istituto Nazionale Dei Tumori, Milan, Italy.
    Moreno, Luis A.
    GENUD (Growth, Exercise, Nutrition and Development) Research Group, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón), Centro de Investigación Biomédica en Red Fisiopatología de La Obesidad Y Nutrición (CIBERObn), University of Zaragoza, Spain.
    Molnar, Dénes
    Department of Pediatrics, Medical School, University of Pécs, Hungary.
    Lissner, Lauren
    School of Public Health and Community Medicine, University of Gothenburg, Sweden.
    Kourides, Yiannis
    Research and Education Institute of Child Health, Strovolos, Cyprus.
    De Henauw, Stefaan
    Department of Public Health and Primary Care, Ghent University, Belgium.
    Eiben, Gabriele
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR).
    Ahrens, Wolfgang
    Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany ; Institute of Statistics, Faculty of Mathematics and Computer Science, University of Bremen, Germany.
    Hebestreit, Antje
    Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany.
    Media use trajectories and risk of metabolic syndrome in European children and adolescents: the IDEFICS/I.Family cohort2021In: International Journal of Behavioral Nutrition and Physical Activity, E-ISSN 1479-5868, Vol. 18, no 1, article id 134Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Media use may influence metabolic syndrome (MetS) in children. Yet, longitudinal studies are scarce. This study aims to evaluate the longitudinal association of childhood digital media (DM) use trajectories with MetS and its components.

    METHODS: Children from Belgium, Cyprus, Estonia, Germany, Hungary, Italy, Spain and Sweden participating in the IDEFICS/I.Family cohort were examined at baseline (W1: 2007/2008) and then followed-up at two examination waves (W2: 2009/2010 and W3: 2013/2014). DM use (hours/day) was calculated as sum of television viewing, computer/game console and internet use. MetS z-score was calculated as sum of age- and sex-specific z-scores of four components: waist circumference, blood pressure, dyslipidemia (mean of triglycerides and HDL-cholesterol-1) and homeostasis model assessment for insulin resistance (HOMA-IR). Unfavorable monitoring levels of MetS and its components were identified (cut-off: ≥ 90th percentile of each score). Children aged 2-16 years with ≥ 2 observations (W1/W2; W1/W3; W2/W3; W1/W2/W3) were eligible for the analysis. A two-step procedure was conducted: first, individual age-dependent DM trajectories were calculated using linear mixed regressions based on random intercept (hours/day) and linear slopes (hours/day/year) and used as exposure measures in association with MetS at a second step. Trajectories were further dichotomized if children increased their DM duration over time above or below the mean.

    RESULTS: 10,359 children and adolescents (20,075 total observations, 50.3% females, mean age = 7.9, SD = 2.7) were included. DM exposure increased as children grew older (from 2.2 h/day at 2 years to 4.2 h/day at 16 years). Estonian children showed the steepest DM increase; Spanish children the lowest. The prevalence of MetS at last follow-up was 5.5%. Increasing media use trajectories were positively associated with z-scores of MetS (slope: β = 0.54, 95%CI = 0.20-0.88; intercept: β = 0.07, 95%CI = 0.02-0.13), and its components after adjustment for puberty, diet and other confounders. Children with increasing DM trajectories above mean had a 30% higher risk of developing MetS (slope: OR = 1.30, 95%CI = 1.04-1.62). Boys developed steeper DM use trajectories and higher risk for MetS compared to girls.

    CONCLUSIONS: Digital media use appears to be a risk factor for the development of MetS in children and adolescents. These results are of utmost importance for pediatricians and the development of health policies to prevent cardio-metabolic disorders later in life.

    TRIAL REGISTRATION: ISRCTN, ISRCTN62310987 . Registered 23 February 2018- retrospectively registered.

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  • 27.
    Sprengeler, Ole
    et al.
    Department of Epidemiological Methods and Etiological Research, Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany.
    Pohlabeln, Hermann
    Department of Biometry and Data Management, Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany.
    Bammann, Karin
    Department of Biometry and Data Management, Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany ; Working group Epidemiology of Demographic Change, Institute for Public Health and Nursing Sciences (IPP), University of Bremen, Germany.
    Buck, Christoph
    Department of Biometry and Data Management, Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany.
    Lauria, Fabio
    Institute of Food Sciences, National Research Council of Italy, Avellino, Italy.
    Verbestel, Vera
    Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Belgium.
    Eiben, Gabriele
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR).
    Konstabel, Kenn
    Department of Chronic Diseases, National Institute for Health Development, Tallinn, Estonia ; School of Natural Sciences and Health, Tallinn University, Estonia ; Institute of Psychology, University of Tartu, Estonia.
    Molnár, Dénes
    Department of Paediatrics, University of Pécs, Hungary.
    Moreno, Luis A.
    GENUD (Growth, Exercise, Nutrition and Development) Research Group, Faculty of Health Sciences, University of Zaragoza, Edificio del SAI, Zaragoza, Spain ; Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain ; Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain ; Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Madrid, Spain.
    Pitsiladis, Yannis
    Collaborating Centre of Sports Medicine, University of Brighton, Welkin House, Eastbourne, United Kingdom.
    Page, Angie
    Centre for Exercise,Nutrition and Health Sciences, School of Policy Studies, University of Bristol, United Kingdom ; NIHR Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, United Kingdom.
    Reisch, Lucia
    Copenhagen Business School, Denmark.
    Tornaritis, Michael
    Research and Education Institute of Child Health, Strovolos, Cyprus.
    Ahrens, Wolfgang
    Department of Epidemiological Methods and Etiological Research, Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany ; Institute of Statistics, Faculty of Mathematics and Computer Science, University Bremen, Germany.
    Trajectories of objectively measured physical activity and childhood overweight: longitudinal analysis of the IDEFICS/I.Family cohort2021In: International Journal of Behavioral Nutrition and Physical Activity, E-ISSN 1479-5868, Vol. 18, no 1, article id 103Article in journal (Refereed)
    Abstract [en]

    Background: Since only few longitudinal studies with appropriate study designs investigated the relationship between objectively measured physical activity (PA) and overweight, the degree PA can prevent excess weight gain in children, remains unclear. Moreover, evidence is limited on how childhood overweight determines PA during childhood. Therefore, we analyzed longitudinal trajectories of objectively measured PA and their bi-directional association with weight trajectories of children at 2- and 6-year follow-ups. Methods: Longitudinal data of three subsequent measurements from the IDEFICS/I.Family cohort study were used to analyze the bi-directional association between moderate-to-vigorous PA (MVPA) and weight status by means of multilevel regression models. Analyses comprised 3393 (2-year follow-up) and 1899 (6-year follow-up) children aged 2–15.9 years from eight European countries with valid accelerometer data and body mass index (BMI) measurements. For categorized analyses, children’s weight status was categorized as normal weight or overweight (cutoff: 90th percentile of BMI) and children’s PA as (in-) sufficiently active (cutoffs: 30, 45 and 60 min of MVPA per day). Results: Children engaging in at least 60 min MVPA daily at baseline and follow-ups had a lower odds of becoming overweight (odds ratio [OR] at 2-year follow-up: 0.546, 95% CI: 0.378, 0.789 and 6-year follow-up: 0.393, 95% CI: 0.242, 0.638), compared to less active children. Similar associations were found for 45 min MVPA daily. On the other side, children who became overweight had the lowest odds to achieve 45 or 60 min MVPA daily (ORs: 0.459 to 0.634), compared to normal weight children. Conclusions: Bi-directional associations between MVPA and weight status were observed. In summary, at least 60 min MVPA are still recommended for the prevention of childhood overweight. To prevent excess weight gain, 45 min MVPA per day also showed preventive effects. 

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  • 28.
    Svensson, Andreas
    University of Skövde, School of Bioscience.
    Identification and network analysis of candidate microRNA biomarkers in neuroblastoma: A meta-analysis2022Independent thesis Advanced level (degree of Master (Two Years)), 30 credits / 45 HE creditsStudent thesis
    Abstract [en]

    Neuroblastoma constitutes roughly 8% of all childhood cancers where 95% of all neuroblastoma cases occur before the age of 10. The survival rate of infants and young children is very poor, which alone contributes to research novel biomarkers for classification methods, improved diagnosis and better anti-tumor therapies. The aim of this meta-analysis was to identify dysregulated miRNAs in neuroblastoma that has the potential to be used as antioncogenic biomarkers for diagnostic interventions. Additionally, explore miRNA interconnectedness on a systemic level and conversely extend the support of using miRNAs as biomarkers. A comprehensive literature search was performed within NIH-PubMed, NCBI-PMC and in the reference list of already reviewed publications, which yielded 9 eligible publications. Quality of evidence was assessed according to the guidelines adapted from MIAME, MINSEQE and MIQE. miRNet 2.0 was used to find the most significantly enriched annotations linked to neuroblastoma. A total of 251 samples (Cancer: 141; Control: 110) was reported by the 9 studies. These involved 66 dysregulated miRNAs (Up-regulated: 43; Down-regulated: 23) which was used for enrichment analysis. Four miRNAs (miR-17-5p, -92a-3p -421, -125b) were significantly linked to neuroblastoma, and associated secondary diseases; medulloblastoma (-92a-3p, -125b), bladder cancer (-17-5p, -125b), acute myeloid leukemia (-92a-3p, -125b) and cardiac hypertrophy (- 125b). miR-125b showed exceptional interconnectivity with these diseases and a multidimensional potential in neural tumorigenesis. This study showed that dysregulation and biological processes of these miRNAs were concurrent with the original studies, endorsing that these miRNAs have potential as diagnostic indicators or classifiers of such diseases.

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  • 29.
    Takahashi, Yuki
    et al.
    Karolinska Inst, Stockholm, Sweden / Japanese Red Cross Toyota Coll Nursing, Aichi, Japan.
    Jonas, Wibke
    Karolinska Inst, Stockholm, Sweden / Univ Toronto, Canada.
    Ransjo-Arvidson, Anna-Berit
    Karolinska Inst, Stockholm, Sweden.
    Lidfors, Lena
    Swedish University of Agricultural Sciences, Skara, Sweden.
    Uvnäs Moberg, Kerstin
    University of Skövde, School of Bioscience. University of Skövde, The Systems Biology Research Centre. Swedish University of Agricultural Sciences, Skara, Sweden.
    Nissen, Eva
    Karolinska Institutet, Stockholm, Sweden.
    Weight loss and low age are associated with intensity of rooting behaviours in newborn infants2015In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 104, no 10, p. 1018-1023Article in journal (Refereed)
    Abstract [en]

    Aim: Little is known about the developing breastfeeding behaviour of newborn infants. This study describes infants' prebreastfeeding behaviour during the second day of life and explores possible associations with infant characteristics. Methods: We studied 13 mothers and healthy full-term infants after normal births. At 2448 hours of life, the newborns were placed in skin-to-skin contact with their mothers for breastfeeding and were video-filmed. The order, frequency and duration of predefined infant prefeeding behaviours and suckling were coded and analysed using computer-based video software. Results: Prefeeding behaviours occurred in the following order: rooting, hand to mouth movements, licking of the nipple and hand to breast to mouth movements. The infants started to suckle at a median of one to two minutes. Rooting was the most common behaviour, observed in 12 infants. The duration of rooting movements during the last minute before breastfeeding was inversely related to neonatal age (p = 0.001) and positively related to neonatal weight loss (p = 0.02) after birth. Conclusion: Infants exhibited a distinct sequence of prefeeding behaviours during the second day of life, and our findings suggest that rooting movements were governed by mechanisms involved in the regulation of food intake and weight gain.

  • 30.
    Theurich, Melissa Ann
    et al.
    LMU - Ludwig-Maximilians-Universität Munich, Div. Metabolic and Nutritional Medicine, Dr. von Hauner Children's Hospital, Munich, Germany.
    Davanzo, Riccardo
    Department of Mother and Child Health, ASM-Matera and Task Force on Breastfeeding, MOH, Rome, Italy.
    Busck-Rasmussen, Marianne
    Danish Committee for Health Education, Copenhagen, Denmark.
    Díaz-Gómez, N. Marta
    Instituto de Tecnologías Biomédicas (ITB) and Centro de Investigaciones Biomédicas de Canarias (CIBICAN), Universidad de La Laguna, Spain.
    Brennan, Christine
    Breastfeeding Promotion Foundation, Bern, Switzerland.
    Kylberg, Elisabeth
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Bærug, Anne
    Norwegian National Advisory Unit on Breastfeeding, Oslo, Norway.
    McHugh, Laura
    Health Service Executive, Ennis, Ireland.
    Weikert, Cornelia
    German Federal Institute for Risk Assessment, Department of Food Safety, Berlin, Germany.
    Abraham, Klaus
    German Federal Institute for Risk Assessment, Department of Food Safety, Berlin, Germany.
    Koletzko, Berthold
    LMU - Ludwig-Maximilians-Universität Munich, Div. Metabolic and Nutritional Medicine, Dr. von Hauner Children's Hospital, Munich, Germany.
    Breastfeeding Rates and Programs in Europe: A Survey of 11 National Breastfeeding Committees and Representatives2019In: Journal of Pediatric Gastroenterology and Nutrition - JPGN, ISSN 0277-2116, E-ISSN 1536-4801, Vol. 68, no 3, p. 400-407Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: Among the world's regions, the WHO European Region has the lowest rates of exclusive breastfeeding at age 6 months with around 25%. Low rates and early cessation of breastfeeding have important adverse health consequences for women, infants and young children. Protecting, promoting and supporting breastfeeding are a public health priority.

    OBJECTIVES: National breastfeeding data and monitoring systems among selected European countries and the WHO European Region are compared. Mechanisms for the support, protection and promotion of breastfeeding are reviewed and successes and challenges in implementation of national programs are presented.

    METHODS: National representatives of national breastfeeding committees and initiatives in eleven European countries, including Belgium, Croatia, Denmark, Germany, Ireland, Italy, The Netherlands, Norway, Spain, Sweden and Switzerland, participated in a standardized survey. Results are evaluated and compared in a narrative review.

    RESULTS: Variation exists in Europe on breastfeeding rates, methodology for data collection and mechanisms for support, protection and promotion of breastfeeding. Directly after birth, between 56 and 98 % of infants in all countries were reported to receive any human milk, and at 6 months 38-71% and 13-39 % of infants to be breastfed or exclusively breastfed, respectively. National plans addressing breastfeeding promotion, protection and support exist in 6 of the 11 countries.

    CONCLUSIONS: National governments should commit to evidence-based breastfeeding monitoring and promotion activities, including financial and political support, to improve breastfeeding rates in the Europe. Renewed efforts for collaboration between countries in Europe, including a sustainable platform for information exchange, are needed.

  • 31.
    Wennström, Berith
    et al.
    Department of Anaesthesia, Skaraborg Hospital, Skövde, Sweden.
    Törnhage, Carl-Johan
    Department of Pediatrics, Skaraborg Hospital, Skövde, Sweden.
    Hedelin, Hans
    Centre for Research and Development, Skaraborg Hospital, Skövde, Sweden.
    Nasic, Salmir
    Centre for Research and Development, Skaraborg Hospital, Skövde, Sweden.
    Bergh, Ingrid
    University of Skövde, School of Life Sciences.
    Child drawings and salivary cortisol in children undergoing preoperative procedures associated with day surgery2013In: Journal of Perianesthesia Nursing, ISSN 1089-9472, E-ISSN 1532-8473, Vol. 28, no 6, p. 361-367Article in journal (Refereed)
    Abstract [en]

    Background

    Perioperative procedures in children can impair their emotional status negatively with stress and/or anxiety. Cortisol concentrations and drawings could be helpful in gaining information about a child's levels of stress and/or anxiety when attending the hospital for surgery.

    Purpose

    The purpose of this study was to determine the degree of anxiety and stress as well as to explore the association between objective measures of stress (cortisol concentration in saliva) and subjective assessment of hospital anxiety (children's drawings) as interpreted by the Swedish version of the Child Drawing: Hospital manual.

    Methods

    A total of 93 children scheduled for day surgery were included. Salivary cortisol was sampled preoperatively on the day of surgery at which time the children were also requested to make a drawing of a person at the hospital.

    Results

    Results showed no association between salivary cortisol concentration and the CD:H score.

    Conclusion

    The drawings and salivary cortisol concentration preoperatively on the day of surgery reflect different components of the conditions of fear, anxiety, or stress emerging in the situation.

  • 32.
    Wennström, Berith
    et al.
    Department of Anaesthesia, Skaraborg Hospital, Kärnsjukhuset, 541 85 Skövde, Sweden / Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Törnhage, Carl-Johan
    Department of Pediatrics, Skaraborg Hospital, Skövde, Sweden.
    Nasic, Salmir
    Centre for Research and Development, Skaraborg Hospital, Skövde, Sweden.
    Hedelin, Hans
    Centre for Research and Development, Skaraborg Hospital, Skövde, Sweden / Department of Urology, Skaraborg Hospital, Skövde, Sweden.
    Bergh, Ingrid
    University of Skövde, School of Life Sciences.
    The perioperative dialogue reduces postoperative stress in children undergoing day surgery as confirmed by salivary cortisol2011In: Pediatric Anaesthesia, ISSN 1155-5645, E-ISSN 1460-9592, Vol. 21, no 10, p. 1058-1065Article in journal (Refereed)
    Abstract [en]

    Aim: To evaluate the efficacy of 'the perioperative dialogue (PD)' by analyzing salivary cortisol, in 5- to 11-year-old children undergoing day surgery. Background: To deal with anxiety prior to investigations and/or procedures, children need to be confident and informed about what is going to happen. Therefore, intervention strategies should be initiated before admission to hospital. Methods and materials: Children (n = 93), 79 boys and 14 girls, scheduled for elective day surgery requiring general anesthesia were randomly recruited into three groups: (i) standard perioperative care (n = 31), (ii) standard perioperative care including preoperative information (n = 31), and (iii) the PD (n = 31). Saliva was sampled for cortisol analysis at specific time points during the pre- and perioperative procedures. Results: The children who received the PD had significantly lower (P = 0.003) salivary cortisol concentrations postoperatively. Moreover, it continuously decreased during the day of surgery compared with the other two groups (P < 0.01). Among the children who received analgesics, the PD group received significantly less morphine (P = 0.014) related to body-weight: the mean dose was 0.1 mg.kg(-1) (n = 9) in the control group vs 0.04 mg.kg(-1) (n = 6) in the PD group. Irrespective of group, there was a positive correlation between the children's morphine consumption and salivary cortisol concentration (r = 0.56; P = 0.038). The W-B scale score was higher in the group that received morphine (median = 3 vs median = 1; P = 0.001). Conclusions: The PD's caring, continuity, and on-going dialogues were associated with low concentrations of salivary cortisol postoperatively and reduced morphine consumption and thus appears to be a valuable complement to standard perioperative care in children undergoing day surgery.

  • 33.
    Widström, Ann-Marie
    et al.
    Division of Reproductive and Perinatal Health Care, Department of Woman's and Children's Health, Karolinska Institutet, Retzius väg 13 A, 171 77 Stockholm, Sweden.
    Lilja, Gunilla
    Division Nursing, Department of Neurobiology, Care Science and Society, Karolinska Institutet, S-17177 Stockholm, Sweden.
    Aaltomaa-Michalias, P.
    Södersjukhuset, Stockholm, Sweden.
    Dahllöf, A.
    Södersjukhuset, Stockholm, Sweden.
    Lintula, M.
    Karolinska University Hospital, Stockholm, Sweden.
    Nissen, Eva
    University of Skövde, School of Life Sciences.
    Newborn behaviour to locate the breast when skin-to-skin: a possible method for enabling early self-regulation2011In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 100, no 1, p. 79-85Article in journal (Refereed)
    Abstract [en]

    Aim: The aim of this study was to provide a more detailed analysis of the infant’s behavioural sequence that begins immediately after birth and terminates with grasping the nipple, suckling and then falling asleep. Method:Twenty-eight full-term infants were videotaped immediately after birth. A video protocol was developed to examine infant behaviours identified from five random videotapes. Results:When birth crying had stopped, the babies showed a short period of relaxation and then successively became alert. They went through an ‘awakening phase’, an ‘active phase’ with movements of limbs, rooting activity and looking at the mother’s face, a ‘crawling phase’ with soliciting sounds, a ‘familiarization phase’ with licking of the areola, and a ‘suckling phase’ and last a ‘sleeping phase’. Five factors related to the time spent to locate the breast: more number of looks at the breast 10–20 min after birth (p < 0.0001); and exposure to meperidine (p = 0.0006) related to increased time. Early start of crawling (p = 0,0040); increased number of ‘soliciting sounds’ (p = 0.0022); and performing hand–breast–mouth movements (p = 0.0105) related to shorter time. Conclusion:  Inborn breastfeeding reflexes were depressed at birth, possibly because of a depressed sensory system. It is hypothesized that when the infant is given the option to peacefully go through the nine behavioural phases birth cry, relaxation, awakening, activity, crawling, resting, familiarization, suckling and sleeping when skin-to-skin with its mother this results in early optimalself-regulation.

  • 34.
    Wolters, Maike
    et al.
    Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany.
    Intemann, Timm
    Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany.
    Russo, Paola
    Institute of Food Sciences, National Research Council, Avellino, Italy.
    Moreno, Luis A.
    GENUD (Growth, Exercise, Nutrition and Development) Research Group, Faculty of Health Sciences, Universidad de Zaragoza, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain and Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain.
    Molnar, Dénes
    Department of Pediatrics, Medical School, University of Pécs, Hungary.
    Veidebaum, Toomas
    National Institute for Health Development, Estonian Centre of Behavioral and Health Sciences, Tallinn, Estonia.
    Tornaritis, Mihael
    Research and Education Institute of Child Health, Strovolos, Cyprus.
    De Henauw, Stefaan
    Department of Public Health and Primary Care, Ghent University, Belgium.
    Eiben, Gabriele
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR). Department of Public Health and Community Medicine, University of Gothenburg, Sweden.
    Ahrens, Wolfgang
    Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany ; Institute of Statistics, Faculty of Mathematics and Computer Science, University of Bremen, Germany.
    Floegel, Anna
    Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany.
    25-Hydroxyvitamin D reference percentiles and the role of their determinants among European children and adolescents2022In: European Journal of Clinical Nutrition, ISSN 0954-3007, E-ISSN 1476-5640, Vol. 76, no 4, p. 564-573Article in journal (Refereed)
    Abstract [en]

    Background/objectives

    To provide age- and sex-specific percentile curves of serum 25-hydroxyvitamin D (25(OH)D) by determinants from 3-<15 year-old European children, and to analyse how modifiable determinants influence 25(OH)D.

    Subjects/methods

    Serum samples were collected from children of eight European countries participating in the multicenter IDEFICS/I.Family cohort studies. Serum 25(OH)D concentrations were analysed in a central lab by a chemiluminescence assay and the values from 2171 children (N = 3606 measurements) were used to estimate percentile curves using the generalized additive model for location, scale and shape. The association of 25(OH)D with time spent outdoors was investigated considering sex, age, country, parental education, BMI z score, UV radiation, and dietary vitamin D in regressions models.

    Results

    The age- and sex-specific 5th and 95th percentiles of 25(OH)D ranged from 16.5 to 73.3 and 20.8 to 79.3 nmol/l in girls and boys, respectively. A total of 63% had deficient (<50 nmol/l), 33% insufficient (50-<75 nmol/l) and 3% sufficient (≥75 nmol/l) levels. 25(OH)D increased with increasing UV radiation, time spent outdoors, and vitamin D intake and slightly decreased with increasing BMI z score and age. The odds ratio (OR) for a non-deficient 25(OH)D status (reference category: deficient status) by one additional hour spent outdoors was 1.21, 95% CI [1.12–1.31], i.e., children who spent one more hour per day outdoors than other children had a 21% higher chance of a non-deficient than a deficient status.

    Conclusion

    A majority of children suffer from deficient 25(OH)D. UV radiation, outdoor time, and dietary vitamin D are important determinants of 25(OH)D.

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  • 35.
    Wolters, Maike
    et al.
    Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany.
    Marron, Manuela
    Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany.
    Foraita, Ronja
    Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany.
    Charalampos, Hadjigeorgiou
    Research and Education Institute of Child Health, Strovolos, Cyprus.
    De Henauw, Stefaan
    Department of Public Health and Primary Care, Ghent University, Belgium.
    Eiben, Gabriele
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR). Department of Public Health and Community Medicine, University of Gothenburg Sweden.
    Lauria, Fabio
    Institute of Food Sciences, National Research Council, Avellino, Italy.
    Iglesia, Iris
    GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria de Aragón (IIS Aragón) Zaragoza, Spain ; Primary Care Interventions to Prevent Maternal and Child Chronic Diseases of Perinatal and Developmental Origin Network (RICORS), RD21/0012/0012, Instituto de Salud Carlos III, Madrid, Spain.
    Moreno, Luis A.
    GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria de Aragón (IIS Aragón) Zaragoza, Spain ; Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain.
    Molnár, Dénes
    Department of Paediatrics, Medical School, University of Pécs, Hungary.
    Veidebaum, Toomas
    National Institute for Health Development, Tallinn, Estonia.
    Ahrens, Wolfgang
    eibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany ; Institute of Statistics, Faculty of Mathematics and Computer Science, Bremen University, Germany.
    Nagrani, Rajini
    Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany.
    IDEFICS and I.Family consortia,
    Longitudinal associations between vitamin D status and cardiometabolic risk markers among children and adolescents2023In: Journal of Clinical Endocrinology and Metabolism, ISSN 0021-972X, E-ISSN 1945-7197, Vol. 108, no 12, p. e1731-e1742Article in journal (Refereed)
    Abstract [en]

    Background

    Vitamin D status has previously been associated with cardiometabolic risk markers in children and adolescents. In particular, it has been suggested that children with obesity are more prone to vitamin D deficiency and unfavorable metabolic outcomes compared to healthy-weight children. However, to date, there have been few longitudinal studies assessing this association in children stratified by BMI category.

    Methods

    Children from the pan-European IDEFICS/I.Family cohort with at least one measurement of serum 25-hydroxyvitamin D (25(OH)D) at cohort entry or follow-up (n=2,171) were included in this study. Linear mixed-effect models were used to assess the association between serum 25(OH)D as an independent variable and z-scores of cardiometabolic risk markers [waist circumference (WC), systolic (SBP) and diastolic blood pressure (DBP), high (HDL) and low density lipoprotein, non-HDL, triglycerides (TRG), apolipoprotein A1 and B (ApoB), fasting glucose (FG), homeostatic model assessment for insulin resistance (HOMA-IR), metabolic syndrome score] as dependent variables.

    Results

    After adjustment for age, sex, study region, smoking and alcohol status, sports club membership, screen time, BMI, parental education, and month of blood collection, 25(OH)D levels were inversely associated with SBP, DBP, FG, HOMA-IR and TRG. The HOMA-IR z-score decreased by 0.07 units per 5 ng/ml increase in 25(OH)D. 25(OH)D was consistently associated with HOMA-IR irrespective of sex or BMI category.

    Conclusion

    Low serum 25(OH)D concentrations are associated with unfavorable levels of cardiometabolic markers in children and adolescents. Interventions to improve vitamin D levels in children with a poor status early in life may help to reduce cardiometabolic risk.

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