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  • 1.
    Arnoldussen, Ilse A. C.
    et al.
    Department of Anatomy, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands / Radboud Alzheimer Center, Radboud University Medical Center, Nijmegen, the Netherlands.
    Gustafson, Deborah R.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Department of Neurology, The State University of New York Downstate Health Sciences University, Brooklyn, USA.
    Leijsen, Esther M. C.
    Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands.
    de Leeuw, Frank-Erik
    Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands.
    Kiliaan, Amanda J.
    Department of Anatomy, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands / Radboud Alzheimer Center, Radboud University Medical Center, Nijmegen, the Netherlands.
    Adiposity is related to cerebrovascular and brain volumetry outcomes in the RUN DMC study2019In: Neurology, ISSN 0028-3878, E-ISSN 1526-632X, Vol. 93, no 9, p. e864-e878Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Adiposity predictors, body mass index (BMI), waist circumference (WC), and blood leptin and total adiponectin levels were associated with components of cerebral small vessel disease (CSVD) and brain volumetry in 503 adults with CSVD who were ≥50 years of age and enrolled in the Radboud University Nijmegen Diffusion Tensor and Magnetic Resonance Imaging Cohort (RUN DMC).

    METHODS: RUN DMC participants were followed up for 9 years (2006-2015). BMI, WC, brain imaging, and dementia diagnoses were evaluated at baseline and follow-up. Adipokines were measured at baseline. Brain imaging outcomes included CSVD components, white matter hyperintensities, lacunes, microbleeds, gray and white matter, hippocampal, total brain, and intracranial volumes.

    RESULTS: Cross-sectionally among men at baseline, higher BMI, WC, and leptin were associated with lower gray matter and total brain volumes, and higher BMI and WC were associated with lower hippocampal volume. At follow-up 9 years later, higher BMI was cross-sectionally associated with lower gray matter volume, and an obese WC (>102 cm) was protective for ≥1 lacune or ≥1 microbleed in men. In women, increasing BMI and overweight or obesity (BMI ≥25 kg/m2 or WC >88 cm) were associated with ≥1 lacune. Longitudinally, over 9 years, a baseline obese WC was associated with decreasing hippocampal volume, particularly in men, and increasing white matter hyperintensity volume in women and men.

    CONCLUSIONS: Anthropometric and metabolic adiposity predictors were differentially associated with CSVD components and brain volumetry outcomes by sex. Higher adiposity is associated with a vascular-neurodegenerative spectrum among adults at risk for vascular forms of cognitive impairment and dementias.

  • 2.
    Arvidsson, Louise
    et al.
    Section for Epidemiology and Social Medicine (EPSO), Department of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden.
    Bogl, L. H.
    Department of Public Health, University of Helsinki, Finland.
    Eiben, Gabriele
    Section for Epidemiology and Social Medicine (EPSO), Department of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden.
    Hebestreit, A.
    Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany.
    Nagy, P.
    Department of Pediatrics, University of Pécs, Hungary.
    Tornaritis, M.
    Research and Education Institute of Child Health, Strovolos, Cyprus.
    Moreno, L. A.
    GENUD (Growth, Exercise, Nutrition, and Development) research group, University of Zaragoza, Spain.
    Siani, A.
    Epidemiology & Population Genetics, Institute of Food Sciences, CNR, Avellino, Italy.
    Veidebaum, T.
    Research Centre, National Institute for Health Development, Tallinn, Estonia.
    De Henauw, S.
    Department of Public Health, University of Ghent, Belgium.
    Lissner, L.
    Section for Epidemiology and Social Medicine (EPSO), Department of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden.
    Fat, sugar and water intakes among families from the IDEFICS intervention and control groups: first observations from I.Family2015In: Obesity Reviews, ISSN 1467-7881, E-ISSN 1467-789X, Vol. 16, no Suppl. 2, p. 127-137Article in journal (Refereed)
    Abstract [en]

    Background

    The objective of this paper is to investigate differences in diets of families in intervention versus control communities 5years after the Identification and Prevention of Dietary- and Lifestyle-Induced Health Effects in Children and Infants intervention ended. MethodsAltogether, 4,691 families from the I.Family study with at least one participating parent and one child are included in this analysis. Diet quality indicators, defined as propensities to consume fat, sugar, water and fruit and vegetables, are calculated from a 59-item food frequency questionnaire. Multilevel linear models with random intercepts for study centre are used to determine whether mean diet indicators, calculated at the family level, differed as a function of previous exposure to the intervention. ResultsFamilies in the intervention communities reported a significantly lower sugar propensity (19.8% vs. 20.7% of total food items, p<0.01) and a higher water propensity (47.3% vs. 46.0% of total beverages, p<0.05) compared with families in the control communities, while fat and fruit and vegetables propensities were similar. No significant diet differences between intervention and control children were present at the Identification and Prevention of Dietary- and Lifestyle-Induced Health Effects in Children and Infants baseline. DiscussionThis result indicates better diet quality in intervention families, which was not present in children when their diets were assessed before the intervention, and gives some cause for optimism regarding the sustainability of some aspects of the diet intervention.

  • 3.
    Bixby, Honor
    et al.
    Imperial College London, United Kingdom.
    Eiben, Gabriele
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Ezzati, Majid
    Imperial College London, United Kingdom.
    Rising rural body-mass index is the main driver of the global obesity epidemic in adults2019In: Nature, ISSN 0028-0836, E-ISSN 1476-4687, Vol. 569, no 7755, p. 260-264Article in journal (Refereed)
    Abstract [en]

    Body-mass index (BMI) has increased steadily in most countries in parallel with a rise in the proportion of the population who live in cities1,2. This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity3-6. Here we use 2,009 population-based studies, with measurements of height and weight in more than 112 million adults, to report national, regional and global trends in mean BMI segregated by place of residence (a rural or urban area) from 1985 to 2017. We show that, contrary to the dominant paradigm, more than 55% of the global rise in mean BMI from 1985 to 2017-and more than 80% in some low- and middle-income regions-was due to increases in BMI in rural areas. This large contribution stems from the fact that, with the exception of women in sub-Saharan Africa, BMI is increasing at the same rate or faster in rural areas than in cities in low- and middle-income regions. These trends have in turn resulted in a closing-and in some countries reversal-of the gap in BMI between urban and rural areas in low- and middle-income countries, especially for women. In high-income and industrialized countries, we noted a persistently higher rural BMI, especially for women. There is an urgent need for an integrated approach to rural nutrition that enhances financial and physical access to healthy foods, to avoid replacing the rural undernutrition disadvantage in poor countries with a more general malnutrition disadvantage that entails excessive consumption of low-quality calories.

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  • 4.
    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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  • 5.
    El Ansari, Walid
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Department of Surgery, Hamad General Hospital, Doha, Qatar / College of Medicine, Qatar University, Doha, Qatar / Faculty of Applied Sciences, University of Gloucestershire, Gloucester, United Kingdom.
    Berg-Beckhoff, Gabriele
    Unit for Health Promotion Research, Institute of Public Health, University of Southern Denmark, Esbjerg, Denmark.
    Association of health status and health behaviors with weight satisfaction vs. Body image concern: Analysis of 5888 undergraduates in Egypt, Palestine, and Finland2019In: Nutrients, E-ISSN 2072-6643, Vol. 11, no 12, article id 2860Article in journal (Refereed)
    Abstract [en]

    Little is known about the relationships between weight satisfaction, body image concern, healthy nutrition, health awareness, and physical activity among college students across culturally different countries. We assessed country and sex-specific associations between health status (self-rated health, depression, BMI), healthy behavior (healthy nutrition, physical activity, health awareness), weight satisfaction, and body image concern via a cross-sectional survey (5888 undergraduates) in Egypt, Palestine, and Finland. This health and wellbeing survey employed identical self-administered paper questionnaires administered at several Universities in two Eastern Mediterranean countries (Egypt, Palestine—Gaza Strip), and an online-survey comprising the same questions in Finland. Regression analyses were employed. Health status variables exhibited the strongest associations; high BMI and more depressive symptoms were more often among students satisfied with their weight (except in Palestine), but they were positively associated with body image concern irrespective of country or gender. Self-rated health was not associated with body image concern or weight satisfaction. Healthy behaviors were not associated with body image concern or weight satisfaction. Depressive symptoms and BMI were the most prominent predictors for body image concern. There were country-specific consistent results when using the body image concern score. Further research is necessary to compare body image across different cultures and countries. 

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  • 6.
    Elhag, Wahiba
    et al.
    Department of Bariatric Surgery and Bariatric Medicine, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.
    El Ansari, Walid
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR). Department of Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar ; College of Medicine, Qatar University, Doha, Qatar ; Weill Cornell Medicine–Qatar, Doha, Qatar.
    Multiple nutritional deficiencies among adolescents undergoing bariatric surgery: who is at risk?2022In: Surgery for Obesity and Related Diseases, ISSN 1550-7289, E-ISSN 1878-7533, Vol. 18, no 3, p. 413-424Article in journal (Refereed)
    Abstract [en]

    Background: Nutritional deficiencies among adolescents undergoing bariatric surgery (BS) have not been evaluated a in relation to patient's sex. Objectives: We compared the preoperative nutritional profile of adolescents characterized by sex and single versus multiple deficiencies. Setting: University hospital. Methods: Cross-sectional retrospective chart review of 415 eligible adolescents who underwent primary BS between 2011 and 2020. Data included preoperative demographic, anthropometric information as well as three sets of nutritional variables: anemia-related, calcium-related, and other nutritional variables. Results: The sample comprised 247 males (59.5%) with a mean age of 15.89 ± 1.03 years and a mean body mass index (BMI) of 47.80 ± 6.57 kg/m2. Most common deficiencies were vitamin D (92.3%), albumin (51.8%), anemia (15.9%), zinc (11.1%), and vitamin B12 (8%); 21.7% had hyperparathyroidism. Females exhibited a significantly higher prevalence of low hemoglobin, low hematocrit, and iron deficiency. Multiple deficiencies were present among 97.6%, 73.2%, 23.6%, 15%, and 12.6% of adolescents, who had vitamin D, albumin, hemoglobin, zinc, and vitamin B12 deficiencies, respectively. Univariate analysis revealed that adolescents with a BMI of ≥50 kg/m2 were 1.24 times more likely to have multiple deficiencies (P = .004). Using multivariate log-binomial regression, BMI of ≥50 kg/m2 was a significant predictor of multiple nutritional deficiencies (P = .005, adjusted risk ratio = 1.23, 95% CI 1.06–1.42). Age and sex were not independent predictors of multiple nutritional deficiencies. Conclusion: To our knowledge, this study is the first to appraise single and multiple nutritional deficiencies in adolescents undergoing BS by sex. Multiple deficiencies were common. Females are at higher risk of anemia-related deficiencies. A BMI of ≥50 kg/m2 independently and significantly predicted multiple nutritional deficiencies. Correction before and monitoring after surgery are important. © 2021 American Society for Bariatric Surgery

  • 7.
    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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  • 8.
    Gellerstedt, Martin
    et al.
    Department for Studies of Work, Economics and Health, the University of Trollhättan, Uddevalla, Sweden.
    Magnusson, J
    The Asthma and Allergy Research Group, Department of Respiratory Medicine and Allergy, Sahlgrenska University Hospital, Göteborg, Sweden ; Clinical Immunology, Sahlgrenska University Hospital, Göteborg, Sweden.
    Gråsjö, Urban
    Department for Studies of Work, Economics and Health, the University of Trollhättan, Uddevalla, Sweden.
    Ahlstedt, S
    Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden.
    Bengtsson, U
    The Asthma and Allergy Research Group, Department of Respiratory Medicine and Allergy, Sahlgrenska University Hospital, Göteborg, Sweden.
    Interpretation of subjective symptoms in double-blind placebo-controlled food challenges: interobserver reliability2004In: Allergy. European Journal of Allergy and Clinical Immunology, ISSN 0105-4538, E-ISSN 1398-9995, Vol. 59, no 3, p. 354-356Article in journal (Refereed)
    Abstract [en]

    Background: Subjective symptoms after food challenges are difficult to interpret and no standard is available. We discuss a strategy for how to interpret a diary. Furthermore, the interobserver reliability is evaluated.

    Methods: Diaries for 32 patients with subjective symptoms were used. The diaries were re-evaluated with a predefined strategy by three independent observers.

    Results: The proportion of positives was 21.9% among the old diagnoses, according to the new approach 34.4% (observers I and II) and 37.5% (observer III) were positive. The new approach had high interobserver reliability (97 and 100%).

    Conclusions: The proportion of positives depends on how subjective symptoms are interpreted. Interpretations of subjective symptoms in diaries could be made with high interobserver reliability.

    The double-blind placebo-controlled food challenge (DBPCFC) is the gold standard for diagnosing food hypersensitivity (1–5). However, DBPCFC needs further standardization regarding essential issues, e.g. quantity of food, vehicles, blinding, dose titration and interpretation of symptoms (2, 3, 6–10). This study highlights the latter problem. For patients with several subjective symptoms that may occur in various degrees both on active and placebo provocations, a standardized strategy for interpretation would be valuable. Bindslev-Jensen et al. have theoretically illustrated that there may be great differences dependent on how placebo symptoms are treated (11, 12) and in a position paper (13) it is suggested that in situations when only subjective symptoms are present, several provocations must be used. The lack of an interpretation standard may be one reason for explaining the doubts regarding the value of subjective variables for making a diagnosis (9, 14). We discuss a strategy for how to interpret the symptom profile found in such a mixed sequence of active and placebo provocations. Furthermore, the interobserver reliability is evaluated.

  • 9.
    Graffe, María Isabel Mesana
    et al.
    Growth, Exercise, NUtrition and Development (GENUD) Research Group, University of Zaragoza, Spain / Instituto Agroalimentario de Aragón (IA2), Spain / Instituto de Investigación Sanitaria Aragón (IIS Aragón), Spain / Red de Salud Materno-infantil y del Desarrollo (SAMID), Spain.
    Pala, V.
    Epidemiology and Prevention Unit, Department of Research, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy.
    De Henauw, S.
    Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
    Eiben, Gabriele
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR). Section for Epidemiology and Social Medicine, Institute of Medicine Sahlgrenska Academy, University of Gothenburg, Sweden.
    Hadjigeorgiou, C.
    Research and Education Institute of Child Health, Strovolos, Cyprus.
    Iacoviello, L.
    Laboratory of Molecular and Nutritional Epidemiology, Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli, IS, Italy.
    Intemann, T.
    Department of Epidemiological Methods and Etiological Research, Leibniz Institute for Prevention Research and Epidemiology, BIPS, Bremen, Germany / Institute for Public Health and Nursing– IPP, Bremen University, Germany.
    Jilani, H.
    Department of Epidemiological Methods and Etiological Research, Leibniz Institute for Prevention Research and Epidemiology, BIPS, Bremen, Germany / Institute for Public Health and Nursing– IPP, Bremen University, Germany.
    Molnar, D.
    Department of Paediatrics, Medical Faculty, University of Pécs, Hungary.
    Russo, P.
    Institute of Food Sciences, National Research Council, Avellino, Italy.
    Veidebaum, T.
    National Institute for Health Development, Tallinn, Estonia.
    Moreno, L. A.
    Growth, Exercise, NUtrition and Development (GENUD) Research Group, University of Zaragoza, Spain / Instituto Agroalimentario de Aragón (IA2), Saragossa, Spain / Instituto de Investigación Sanitaria Aragón (IIS Aragón), Saragossa, Spain / Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Madrid, Spain.
    Dietary sources of free sugars in the diet of European children: the IDEFICS Study2020In: European Journal of Nutrition, ISSN 1436-6207, E-ISSN 1436-6215, Vol. 59, no 3, p. 979-989Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To report dietary free sugars consumption and their different types and food sources in European children.

    METHODS: The present study is based on the IDEFICS study, a European multicenter cohort study in children (2-9 years old) from eight countries, comprising 8308 children (51.4% males). Dietary intake of the previous 24 h was assessed using a computer-assisted 24-h dietary recalls (24-HDR) and the different types of sugars were assessed using the German food composition database.

    RESULTS: Mean total energy intake was 1720 (SD 477) kcal/d for boys and 1631 (SD 451) kcal/d for girls. Total sugars intake was 98 (SD 52) g/day for boys and 93 (SD 49) g/day for girls. Free sugars intake was 81 (SD 49) g/day for boys and 77 (SD 47) g/day for girls. Girls had significantly lower intakes of energy, total and free sugars compared with than boys but did not differ in terms of percent of energy from total (23%) or free sugars (18%). There were large variations between countries in average % energy from free sugars (ranging from 13% in Italy to 27% in Germany). Less than 20% of children were within the recommended intake of 10% of energy from free sugars. The food groups that contributed substantially to free sugars intakes were "Fruit juices", "Soft drinks", "Dairy" and "Sweets and candies".

    CONCLUSIONS: The contribution of free sugars to total energy intake in European children is higher than recommendations. The main food contributors to free sugars intake are sweetened beverages ("Fruit juices" and "Soft drinks"). It is especially important to reduce children's intake of free sugars, focusing in target population on certain foods and food groups.

  • 10.
    Gustafson, Deborah R.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Department of Neurology, State University of New York Downstate Medical Center, New York, USA.
    Adipose Tissue Complexities in Dyslipidemias2019In: Dyslipidemia / [ed] Samy I. McFarlane, London: IntechOpen , 2019, p. 1-22Chapter in book (Refereed)
    Abstract [en]

    Adipose tissue is the largest organ in the human body and, in excess, contributes to dyslipidemias and the dysregulation of other vascular and metabolic processes. Adipose tissue is heterogeneous, comprised of several cell types based on morphology, cellular age, and endocrine and paracrine function. Adipose tissue depots are also regional, primarily due to sex differences and genetic variation. Adipose tissue is also characterized as subcutaneous vs. visceral. In addition, fatty deposits exist outside of adipose tissue, such as those surrounding the heart, or as infiltration of skeletal muscle. This review focuses on adipose tissue and its contribution to dyslipidemias. Dyslipidemias are defined as circulating blood lipid levels that are too high or altered. Lipids include both traditional and nontraditional species. Leaving aside traditional definitions, adipose tissue contributes to dyslipidemias in a myriad of ways. To address a small portion of this topic, we reviewed (a) adipose tissue location and cell types, (b) body composition, (c) endocrine adipose, (d) the fat-brain axis, and (e) genetic susceptibility. The influence of these complex aspects of adipose tissue on dyslipidemias and human health, illustrating that, once again, that adipose tissue is a quintessential, multifunctional tissue of the human body, will be summarized.

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  • 11.
    Gustafson, Deborah R.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Department of Neurology, State University of New York, Downstate Medical Center, New York, USA.
    Epidemiology Informs Randomized Clinical Trials of Cognitive Impairments and Late-Onset, Sporadic Dementias2018In: Journal of Neurology & Neuromedicine, ISSN 2572-942X, Vol. 3, no 5, p. 13-18Article in journal (Refereed)
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  • 12.
    Gustafson, Deborah R.
    et al.
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR). Section for NeuroEpidemiology, Department of Neurology, State University of New York Downstate Health Sciences University, Brooklyn, New York, NY, USA.
    McFarlane, Samy I.
    Division of Endocrinology, Department of Medicine, College of Medicine, State University of New York Downstate Health Sciences University, Brooklyn, New York, NY, USA.
    Obesity, vascular disease and frailty in aging women with HIV2021In: Advances in Geriatric Medicine and Research, E-ISSN 2632-9921, Vol. 3, no 3, article id e210014Article, review/survey (Refereed)
    Abstract [en]

    Women with chronic HIV infection (WWH) living in the United States, experience a disproportionately high rate of obesity compared to uninfected populations. Both overweight and obesity, particularly central obesity, are major contributors to insulin resistance, hypertension, and dyslipidemia—the major components of metabolic syndromes, including type 2 diabetes, and leading to increased cardiovascular risk, including coronary heart disease, and cerebrovascular diseases. Notably, declining physical performance and frailty co-occur with vascular morbidities as well as changes in bone. These factors tend to exacerbate each other and accelerate the aging trajectory, leading to poorer quality of life, cognitive impairments, dementia, and eventually, death. In WWH, persistent HIV infection, sustained treatment for HIV infection, and concomitant obesity, may accelerate aging-related morbidities and poorer aging outcomes. Furthermore, health disparities factors common among some WWH, are independently associated with obesity and higher vascular risk. The purpose of this review is to describe the constellation of obesity, cardio- and cerebrovascular diseases, bone health and frailty among aging WWH, a 21st century emergence.

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  • 13.
    Gwozdz, Wencke
    et al.
    Faculty of Agricultural Sciences, Nutritional Sciences and Environmental Management, Justus-Liebig-Universität Gießen, Gießen, Germany / Department of Management, Society, and Communication, CBS Sustainability, Copenhagen Business School, Frederiksberg, Denmark.
    Reisch, Lucia A.
    Department of Management, Society, and Communication, CBS Sustainability, Copenhagen Business School, Frederiksberg, Denmark.
    Eiben, Gabriele
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR).
    Hunsberger, Monica L.
    Department of Public Health and Community Medicine, The Sahlgrenska Academy, University of Gothenburg, Arvid Wallgrens Backe, Gothenburg, Sweden.
    Konstabel, Kenn
    Department of Chronic Diseases, National Institute for Health Development, Tallinn, Estonia.
    Kovacs, Eva
    Department of Pediatrics, Medical School, University of Pécs, H-7622 Pécs, Hungary.
    Luszczki, Edyta
    Medical Faculty, University of Rzeszów, Rzeszów, Poland.
    Mazur, Artur
    Medical Faculty, University of Rzeszów, ul.Warszawska 26 a, Rzeszów, Poland.
    Mendl, E.
    Department of Pediatrics, Medical School, University of Pécs, H-7622 Pécs, Hungary.
    Saamel, M.
    Department of Surveillance and Evaluation, National Institute for Health Development,Tallinn, Estonia.
    Wolters, Maike
    Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany.
    The effect of smileys as motivational incentives on children's fruit and vegetable choice, consumption and waste: A field experiment in schools in five European countries2020In: Food Policy, ISSN 0306-9192, E-ISSN 1873-5657, Vol. 96, article id 101852Article in journal (Refereed)
    Abstract [en]

    To assess whether smiley stamps work as a motivational incentive to promote fruit and vegetable eating among children, we conducted a field experiment in ten primary schools in five European countries using one control and one treatment school per country. The six-week experiment was split into three two-week phases before, during and after the smiley was implemented. During the smiley phase, the children received a smiley stamp for choosing a portion of fruits or vegetables. We find an increase attributed to the smiley stamp on children's fruit and vegetable choice and consumption, but also waste. Comparing the effects across countries, we observe significant variations in the smiley effect. This study thus demonstrates, in general, that a low-cost, easy-to-implement incentive such as a smiley stamp has the potential to motivate school children to increase their fruit and vegetable consumption; the study simultaneously underscores the high relevance of context for the effects of incentives. 

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  • 14.
    Iglesia, Iris
    et al.
    Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, 50009 Zaragoza, Spain / Instituto Agroalimentario de Aragón (IA2), 50013, Zaragoza, Spain / Instituto de Investigación Sanitaria Aragón (IIS Aragón); 50009 Zaragoza, Spain / Red de Salud Materno-infantil y del Desarrollo (SAMID), Instituto de Salud Carlos III, Madrid, 50009 Zaragoza, Spain.
    Intemann, Timm
    Leibniz Institute for Prevention Research and Epidemiology—BIPS, 28359 Bremen, Germany / Institute of Statistics, Bremen University, 28359 Bremen, Germany.
    De Miguel-Etayo, Pilar
    Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, 50009 Zaragoza, Spain / Instituto Agroalimentario de Aragón (IA2), 50013, Zaragoza, Spain / Instituto de Investigación Sanitaria Aragón (IIS Aragón); 50009 Zaragoza, Spain / Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029 Madrid, Spain.
    Pala, Valeria
    Epidemiology and Prevention Unit, Department of Preventive & Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy.
    Hebestreit, Antje
    Leibniz Institute for Prevention Research and Epidemiology—BIPS, 28359 Bremen, Germany.
    Wolters, Maike
    Leibniz Institute for Prevention Research and Epidemiology—BIPS, 28359 Bremen, Germany.
    Russo, Paola
    Epidemology & Population Genetics, Institute of Food Sciences, National Research Council, 83100 Avellino, Italy.
    Veidebaum, Toomas
    Department of Chronic Diseases, National Institute for Health Development, 11619 Tallinn, Estonia.
    Papoutsou, Stalo
    Research and Education Institute of Child Health, 2018 Strovolos, Cyprus.
    Nagy, Peter
    Department of Pediatrics, University of Pécs, 7622 Pécs, Hungary.
    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, 405 30 Gothenburg, Sweden.
    Rise, Patrizia
    Department of Pharmacological Sciences, University of Milan, 20122 Milan, Italy.
    De Henauw, Stefaan
    Department of Public Health, Ghent University, 9000 Ghent, Belgium.
    Moreno, Luis A.
    Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, 50009 Zaragoza, Spain / Instituto Agroalimentario de Aragón (IA2), 50013, Zaragoza, Spain / Instituto de Investigación Sanitaria Aragón (IIS Aragón); 50009 Zaragoza, Spain / Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029 Madrid, Spain.
    Dairy consumption at snack meal occasions and the overall quality of diet during childhood: Prospective and cross-sectional analyses from the idefics/i.family cohort2020In: Nutrients, E-ISSN 2072-6643, Vol. 12, no 3, article id 642Article in journal (Refereed)
    Abstract [en]

    There is scarce information on the influence of dairy consumption between main meals on the overall diet quality through childhood, constituting the main aim of this research. From the Identification and prevention of Dietary-and lifestyle induced health EFfects In Children and infantS (IDEFICS) study, and based on the data availability in each period due to drop outs, 8807 children aged 2 to 9.9 years from eight European countries at baseline (T0: 2007–2008); 5085 children after two years (T1); and 1991 after four years (T3), were included in these analyses. Dietary intake and the Diet Quality Index (DQI) were assessed by two 24 hours dietary recalls (24-HDR) and food frequency questionnaire. Consumption of milk and yogurt (p = 0.04) and cheese (p < 0.001) at snack meal occasions was associated with higher DQI scores in T0; milk and yogurt (p < 0.001), and cheese (p < 0.001) in T1; and cheese (p = 0.05) in T3. Consumers of milk (p = 0.02), yogurt (p < 0.001), or cheese (p < 0.001) throughout T0 and T1 at all snack moments had significantly higher scores of DQI compared to non-consumers. This was also observed with the consumption of cheese between T1 and T3 (p = 0.03). Consumption of dairy products at snack moments through childhood is associated with a better overall diet quality, being a good strategy to improve it in this period. 

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  • 15.
    Intemann, Timm
    et al.
    Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany / Institute of Statistics, Bremen University, Germany.
    Pigeot, Iris
    Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany / Institute of Statistics, Bremen University, Germany.
    De Henauw, Stefaan
    Department of Public Health, Ghent University, Belgium.
    Eiben, Gabriele
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Section for Epidemiology and Social Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden.
    Lissner, Lauren
    Section for Epidemiology and Social Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden.
    Krogh, Vittorio
    Epidemiology and Prevention Unit, Fondazione IRCSS Istituto Nazionale dei Tumori, Milan, Italy.
    Dereń, Katarzyna
    Institute of Nursing and Health Sciences, Medical Faculty, University of Rzeszow, Poland.
    Molnár, Dénes
    Department of Paediatrics, University of Pécs, Hungary.
    Moreno, Luis A
    Universidad de Zaragoza, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria de Aragón (IIS Aragón) and Centro de Investigación Biomédica en Red de Fisiopatología de la Nutrición y la Obesidad (CIBEROBN), Zaragoza, Spain.
    Russo, Paola
    Institute of Food Sciences, National Research Council, Avellino, Italy.
    Siani, Alfonso
    Institute of Food Sciences, National Research Council, Avellino, Italy.
    Sirangelo, Ivana
    University of Campania "L. Vanvitelli", Naples, Italy.
    Tornaritis, Michael
    Research and Education Institute of Child Health, Strovolos, Cyprus.
    Veidebaum, Toomas
    National Institute for Health Development, Tallinn, Estonia.
    Pala, Valeria
    Epidemiology and Prevention Unit, Fondazione IRCSS Istituto Nazionale dei Tumori, Milan, Italy.
    Urinary sucrose and fructose to validate self-reported sugar intake in children and adolescents: results from the I.Family study2019In: European Journal of Nutrition, ISSN 1436-6207, E-ISSN 1436-6215, Vol. 58, no 3, p. 1247-1258Article in journal (Refereed)
    Abstract [en]

    PURPOSE: Excessive consumption of free sugar increases the risk for non-communicable diseases where a proper assessment of this intake is necessary to correctly estimate its association with certain diseases. Urinary sugars have been suggested as objective biomarkers for total and free sugar intake in adults but less is known about this marker in children and adolescents. Therefore, the aim of this exploratory study is to evaluate the relative validity of self-reported intake using urinary sugars in children and adolescents.

    METHODS: The study was conducted in a convenience subsample of 228 participants aged 5-18 years of the I.Family study that investigates the determinants of food choices, lifestyle and health in European families. Total, free and intrinsic sugar intake (g/day) and sugar density (g/1000 kcal) were assessed using 24-h dietary recalls (24HDRs). Urinary sucrose (USUC) and urinary fructose (UFRU) were measured in morning urine samples and corrected for creatinine excretion (USUC/Cr, UFRU/Cr). Correlation coefficients, the method of triads and linear regression models were used to investigate the relationship between intake of different types of sugar and urinary sugars.

    RESULTS: The correlation between usual sugar density calculated from multiple 24HDRs and the sum of USUC/Cr and UFRU/Cr (USUC/Cr + UFRU/Cr) was 0.38 (p < 0.001). The method of triads revealed validity coefficients for the 24HDR from 0.64 to 0.87. Linear regression models showed statistically significant positive associations between USUC/Cr + UFRU/Cr and the intake of total and free sugar.

    CONCLUSIONS: These findings support the relative validity of total and free sugar intake assessed by self-reported 24HDRs in children and adolescents.

  • 16.
    Jilani, Hannah
    et al.
    Leibniz Institute for Prevention Research and Epidemiology—BIPS, Germany / Institute for Public Health and Nursing Science, University of Bremen, Germany.
    Pohlabeln, Hermann
    Leibniz Institute for Prevention Research and Epidemiology—BIPS, Germany.
    De Henauw, Stefaan
    Department of Public Health, Ghent University, Belgium.
    Eiben, Gabriele
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Hunsberger, Monica
    Department of Public Health and Community Medicine, University of Gothenburg, Sweden.
    Molnar, Denes
    Department of Pediatrics, Medical School, University of Pécs, Hungary.
    Moreno, Luis A.
    GENUD (Growth, Exercise, Nutrition and Development) Research Group, Faculty of Health Sciences, University of Zaragoza, Spain.
    Pala, Valeria
    Department of Research, Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Italy.
    Russo, Paola
    Institute of Food Sciences, National Research Council, Italy.
    Solea, Antonia
    Research and Education Institute of Child Health, Cyprus.
    Veidebaum, Toomas
    Department of Chronic Diseases, National Institute for Health Development, Estonia.
    Ahrens, Wolfgang
    Leibniz Institute for Prevention Research and Epidemiology—BIPS, Germany / Institute of Statistics, Faculty of Mathematics and Computer Science, University of Bremen, Germany.
    Hebestreit, Antje
    Leibniz Institute for Prevention Research and Epidemiology—BIPS, Germany.
    Relative Validity of a Food and Beverage Preference Questionnaire to Characterize Taste Phenotypes in Children Adolescents and Adults2019In: Nutrients, E-ISSN 2072-6643, Vol. 11, no 7, article id 1453Article in journal (Refereed)
    Abstract [en]

    To assess the relative validity of our food and beverage preference questionnaire we investigated the association between sweet and fatty taste preference scores (assessed using a food and beverage preference questionnaire) and sweet and fatty food propensity scores (derived from a food frequency questionnaire). In I.Family, a large European multi-country cohort study, 12,207 participants from Cyprus, Estonia, Germany, Hungary, Italy, Spain and Sweden, including 5291 adults, 3082 adolescents, and 3834 children, completed a food and beverage preference questionnaire with 63 items. Cumulative preference scores for sweet and fatty taste were calculated from the single item ranking ranging from 1 to 5. The relative consumption frequency of foods classified as sweet and fatty was used to calculate the corresponding consumption propensities, a continuous variable ranging from 0 to 100. We conducted regression analyses to investigate the association between sweet and fatty taste preference scores and sweet and fatty food propensity scores, respectively, separately for adults, adolescents >= 12 years, and for children <12 years. The overall sweet taste preference score was positively associated with the sweet food consumption propensity score (beta = 2.4, 95% CI: 2.1;2.7) and the fatty taste preference score was positively associated with the fatty food consumption propensity score (beta = 2.0, 95% CI: 1.8;2.2). After stratification for age (children <12 years, adolescents >= 12 years, and adults), the effect remained significant in all age groups and was strongest in adolescents and adults. We conclude that our food and beverage preference questionnaire is a useful instrument for epidemiological studies on sensory perception and health outcomes and for the characterization of sensory taste phenotypes.

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  • 17.
    Kampe, Karina
    University of Skövde, School of Health and Education.
    Kostens hälsomässiga effekter hos kvinnor i fertil ålder: En litteraturöversikt2018Independent thesis Basic level (university diploma), 5 credits / 7,5 HE creditsStudent thesis
    Abstract [en]

    Introduction

    General diet and health guidelines have historically been designed based on research on men, with the result that women of childbearing age have often been misunderstood, misinterpreted and mistreated. Low-grade inflammation, fast food and modern lifestyle, is thought to be the basis of several diseases predominantly afflicted by women. The purpose of the study was a survey and critical review of health and ill health research in women of childbearing age related to dietary choices.

    Method

    The study is a literature review of ten articles focusing on health and ill health of women at child bearing age in relation to diet. The articles have been systematically analyzed and summarized.

    Results

    The results showed that women's fertility, the onset of menopause, premenstrual disorders and diseases appear to be related to physical imbalances and inflammation and were affected by dietary choices. Yellow and green vegetables and fruits, fiber, vegetable protein and an antiinflammatory diet displayed extra beneficial health effects.

    Discussion

    The importance of diet for fertility and health in women of childbearing age was clear and the combined effects of nutrients in diet appear to exceed individual supplements. Knowledge dissemination as well as research is essential for strengthening the group's health, promoting empowerment as well as make room for good bio-psycho-social effects.

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    Kostens hälsomässiga effekter hos kvinnor i fertil ålder - Kampe
  • 18.
    Karlsson, Ida K.
    et al.
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden ; Aging Research Network – Jönköping (ARN-J), School of Health and Welfare, Jönköping University, Sweden.
    Zhan, Yiqiang
    School of Public Health, Sun Yat-Sen University, Shenzhen, China.
    Wang, Yunzhang
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Li, Xia
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Jylhävä, Juulia
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Hägg, Sara
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Dahl Aslan, Anna K.
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR). Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Gatz, Margaret
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden ; Center for Economic and Social Research, University of Southern California, Los Angeles, United States.
    Pedersen, Nancy L.
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden ; Department of Psychology, University of Southern California, Los Angeles, United States.
    Reynolds, Chandra A.
    Department of Psychology, University of California, Riverside, United States.
    Adiposity and the risk of dementia: mediating effects from inflammation and lipid levels2022In: European Journal of Epidemiology, ISSN 0393-2990, E-ISSN 1573-7284, Vol. 37, no 12, p. 1261-1271Article in journal (Refereed)
    Abstract [en]

    While midlife adiposity is a risk factor for dementia, adiposity in late-life appears to be associated with lower risk. What drives the associations is poorly understood, especially the inverse association in late-life. Using results from genome-wide association studies, we identified inflammation and lipid metabolism as biological pathways involved in both adiposity and dementia. To test if these factors mediate the effect of midlife and/or late-life adiposity on dementia, we then used cohort data from the Swedish Twin Registry, with measures of adiposity and potential mediators taken in midlife (age 40–64, n = 5999) or late-life (age 65–90, n = 7257). Associations between body-mass index (BMI), waist-hip ratio (WHR), C-reactive protein (CRP), lipid levels, and dementia were tested in survival and mediation analyses. Age was used as the underlying time scale, and sex and education included as covariates in all models. Fasting status was included as a covariate in models of lipids. One standard deviation (SD) higher WHR in midlife was associated with 25% (95% CI 2–52%) higher dementia risk, with slight attenuation when adjusting for BMI. No evidence of mediation through CRP or lipid levels was present. After age 65, one SD higher BMI, but not WHR, was associated with 8% (95% CI 1–14%) lower dementia risk. The association was partly mediated by higher CRP, and suppressed when high-density lipoprotein levels were low. In conclusion, the negative effects of midlife adiposity on dementia risk were driven directly by factors associated with body fat distribution, with no evidence of mediation through inflammation or lipid levels. There was an inverse association between late-life adiposity and dementia risk, especially where the body’s inflammatory response and lipid homeostasis is intact. 

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  • 19.
    Kylberg, Elisabeth
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Stark Ekman, Diana
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Kazemi, Ali
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Nutritional services and assessment2014In: Encyclopedia of Human Services and Diversity / [ed] Linwood H. Cousins, Thousand Oaks, California: Sage Publications, 2014, p. 975-977Chapter in book (Refereed)
  • 20.
    Kylberg, Elisabeth
    et al.
    University of Skövde, School of Life Sciences.
    Strindlund, Åsa
    Grön barnmat: Näringslära och vegomat för barn 0-5 år, gravida och ammande kvinnor2012 (ed. 3)Book (Other (popular science, discussion, etc.))
  • 21.
    Lagström, Hanna
    et al.
    Department of Public Health, University of Turku and Turku University Hospital, Finland / Centre for Population Health Research, University of Turku and Turku University Hospital, Finland.
    Halonen, Jaana I.
    Health Security, Finnish Institute for Health and Welfare, Finland.
    Suominen, Sakari
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR). Department of Public Health, University of Turku and Turku University Hospital, Finland.
    Pentti, Jaana
    Department of Public Health, University of Turku and Turku University Hospital, Finland.
    Stenholm, Sari
    Department of Public Health, University of Turku and Turku University Hospital, Finland / Centre for Population Health Research, University of Turku and Turku University Hospital, Finland.
    Kivimäki, Mika
    Clinicum, University of Helsinki, Finland / Department of Epidemiology and Public Health, University College London, United Kingdom.
    Vahtera, Jussi
    Department of Public Health, University of Turku and Turku University Hospital, Finland / Centre for Population Health Research, University of Turku and Turku University Hospital, Finland.
    Neighbourhood characteristics as a predictor of adherence to dietary recommendations: A population-based cohort study of Finnish adults2021In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 50, no 2, p. 245-249Article in journal (Refereed)
    Abstract [en]

    Aims: To investigate the association of six-year cumulative level of socioeconomic neighbourhood disadvantage and population density with subsequent adherence to dietary recommendations, controlling for preceding dietary adherence, in adults in Finland. Methods: Population-based Health and Social Support (HeSSup) study participants from four age groups (20–24, 30–34, 40–44 and 50–54 years at baseline in 1998). Data on diet and alcohol consumption were obtained from the 2003 and 2012 surveys and information on neighbourhoods from Statistics Finland Grid database (n = 10,414 men and women). Participants diet was measured as adherence to Nordic Nutrition recommendation (score range 0–100). Neighbourhood disadvantage was measured by median household income, proportion of those with primary education only and unemployment rate, and population density by the number of adult population between years 2007 and 2012. Linear models were used to assess the associations of neighbourhood characteristics with the score for adherence to dietary recommendations in 2012. Results: Cumulative neighbourhood socioeconomic disadvantage was associated with slightly weaker (1.49 (95% confidence interval (CI) −1.89 to −1.09) point decrease in dietary score) adherence while higher population density was associated with better (0.70 (95% CI 0.38−1.01) point increase in dietary score) adherence to dietary recommendations. These associations remained after controlling for prior dietary habits, sociodemographic, chronic cardio-metabolic diseases, and severe life events. Conclusions: These longitudinal findings support the hypothesis that neighbourhood characteristics affect dietary habits. 

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  • 22.
    Murtas, Rossella
    et al.
    Fdn IRCSS Ist Nazl Tumori, Epidemiol & Prevent Unit, Via Venezian 1, I-20133 Milan, Italy / Univ Cagliari, Dept Math & Comp Sci, Cagliari, Italy.
    Krogh, Vittorio
    Fdn IRCSS Ist Nazl Tumori, Epidemiol & Prevent Unit, Via Venezian 1, I-20133 Milan, Italy.
    Intemann, Timm
    Leibniz Inst Prevent Res & Epidemiol BIPS, Bremen, Germany / Bremen Univ, Inst Stat, Bremen, Germany.
    Lissner, Lauren
    Univ Gothenburg, Sahlgrenska Acad, Sect Epidemiol & Social Med, Gothenburg, Sweden.
    Eiben, Gabriele
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Molnar, Denes
    Univ Pecs, Med Sch, Dept Pediat, Pecs, Hungary.
    Moreno, Luis A.
    Univ Zaragoza, Growth Exercise Nutr & Dev Res Grp, Zaragoza, Spain.
    Siani, Alfonso
    CNR, Inst Food Sci, Res, Avellino, Italy.
    Tornaritis, Michael
    Res & Educ Inst Child Hlth, Strovolos, Cyprus.
    Veidebaum, Toomas
    Natl Inst Hlth Dev, Tallinn, Estonia.
    Mazur, Artur
    Univ Rzeszow, Med Fac, Inst Nursing & Hlth Sci, Rzeszow, Poland.
    Deren, Katarzyna
    Univ Rzeszow, Med Fac, Inst Nursing & Hlth Sci, Rzeszow, Poland.
    Wolters, Maike
    Leibniz Inst Prevent Res & Epidemiol BIPS, Bremen, Germany.
    Ahrens, Wolfgang
    Bremen Univ, Inst Stat, Bremen, Germany / Leibniz Inst Prevent Res & Epidemiol BIPS, Dept Epidemiol Methods & Etiol Res, Bremen, Germany.
    Pala, Valeria
    Fdn IRCSS Ist Nazl Tumori, Epidemiol & Prevent Unit, Via Venezian 1, I-20133 Milan, Italy.
    Does Providing Assistance to Children and Adolescents Increase Repeatability and Plausibility of Self-Reporting Using a Web-Based Dietary Recall Instrument?2018In: Journal of the Academy of Nutrition and Dietetics, ISSN 2212-2672, E-ISSN 2212-2680, Vol. 118, no 12, p. 2324-2330Article in journal (Refereed)
    Abstract [en]

    Background It is important to find ways to minimize errors when children self-report food consumption. Objective The objective of this study was to investigate whether assistance given to children completing a self-administered 24-hour dietary recall instrument called SACANA (Self-Administered Child, Adolescent and Adult Nutrition Assessment) increased the repeatability and plausibility of energy intake (EI) estimates. Participants/setting The study was conducted between October 2013 and March 2016 in a convenience sample of 395 children, aged 8 to 17 years, from eight European countries participating in the I.Family study. Design SACANA was used to recall the previous day's food intake, twice in a day, once with and once without assistance. Main outcome measures The difference in EI between the first and second recalls was the main repeatability measure; the ratio of EI to basal metabolic rate was the plausibility measure. Statistical methods Generalized linear mixed models, adjusted for sex, age, and body mass index z-score, were used to assess whether assistance during the first vs second recall influenced repeatability and plausibility. Results The difference in estimated EI (EI from second recall minus EI from first recall) was significantly lower (P<0.001) in those assisted at first (median=-76 kcal) than those assisted at second recall (median=282 kcal). Modeling showed that EI at assisted first recall was 19% higher (95% CI 1.13 to 1.24) than in assisted second recall. Overall, 60% of recalls had a plausible EI. Modeling to estimate the simultaneous effects of second vs first recall and assistance vs no assistance on plausibility showed that those assisted at first recall had significantly higher odds of a plausible recall than those unassisted (odds ratio 3.64, 95% CI 2.20 to 6.01), with no significant difference in plausibility of second recall compared to the first (odds ratio 1.48, 95% CI 0.92 to 2.35). Conclusions When children are assisted at first recall, the plausibility and repeatability of the later unassisted recall improve. This improvement was evident for all ages. A future, adequately powered study is required to investigate the age range for which assistance is advisable.

  • 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.
    Santaliestra-Pasías, Alba M.
    et al.
    GENUD (Growth, Exercise, NUtrition and Development) Research Group, Universidad de Zaragoza, Spain / Instituto Agroalimentario de Aragón (IA2), Spain / Instituto de Investigación Sanitaria Aragón (IIS Aragón), Spain / Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Spain.
    González-Gil, Esther M.
    GENUD (Growth, Exercise, NUtrition and Development) Research Group, Universidad de Zaragoza, Spain / Instituto Agroalimentario de Aragón (IA2), Spain / Instituto de Investigación Sanitaria Aragón (IIS Aragón), Spain / Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Spain / Institute of Nutrition and Food Technology, Department of Biochemistry and Molecular Biology II, University of Granada, Spain.
    Pala, Valeria
    Department of Research, Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
    Intemann, Timm
    Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany / Institute of Statistics, University of Bremen, Germany.
    Hebestreit, Antje
    Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.
    Russo, Paola
    Institute of Food Sciences, National Research Council, Avellino, Italy.
    Van Aart, Carola
    Department of Public Health, Ghent University, Belgium.
    Rise, Patrizia
    Department of Pharmacological Sciences, University of Milan, Italy.
    Veidebaum, Toomas
    National Institute for Health Development, Estonian Centre of Behavioral and Health Sciences, Tallinn, Estonia.
    Molnar, Denes
    Department of Paediatrics, University of Pécs, Hungary.
    Tornaritis, Michael
    Research and Education Institute of Child health, REF, Cyprus.
    Eiben, Gabriele
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR). Section for Epidemiology and Social Medicine (EPSO), University of Gothenburg, Sweden .
    Moreno, Luis A.
    GENUD (Growth, Exercise, NUtrition and Development) Research Group, Universidad de Zaragoza, Spain / Instituto Agroalimentario de Aragón (IA2), Spain / Instituto de Investigación Sanitaria Aragón (IIS Aragón), Spain / Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Spain.
    Predictive associations between lifestyle behaviours and dairy consumption: The IDEFICS study2020In: NMCD. Nutrition Metabolism and Cardiovascular Diseases, ISSN 0939-4753, E-ISSN 1590-3729, Vol. 30, no 3, p. 514-522Article in journal (Refereed)
    Abstract [en]

    Background and aim: Physical activity (PA) and sedentary behaviours (SB) are related to obesity and cardiometabolic risk; however, the literature is controversial regarding the effect of dairy consumption on the development of cardiovascular disease (CVD) risk factors. The aim of this study was to assess longitudinally the relationship between specific lifestyle behaviours (PA and SB) and dairy consumption in a sample of European children and adolescents. Methods and results: Children from the IDEFICS study were included in the analyses. Two measurements, with 2 years' interval, were conducted. A total of 1688 (50.8% boys) children provided information regarding diet, measured by a 24-h dietary recall, PA measured by accelerometers and parent-reported sedentary screen time (SST) at both time points. Different combinations of these behaviours, at each survey and over time, were derived applying specific recommendations. Multilevel ordinal logistic regression and analysis of covariance were used to assess their association with dairy consumption, adjusted for potential confounders. Differences by gender were found regarding dairy product consumption and also adherence to SB and PA recommendations at T0 and T1. Children meeting both lifestyle recommendations, at the two measurement points, had higher probability to consume more milk and yogurt and less cheese than the rest of combinations. Conclusions: These results suggest that European children with a healthy lifestyle, especially regarding PA and SB over time, consumed more milk and yogurt. This study suggests that the protective effect of specific dairy products found in literature could be partially due to the association of their consumption with specific healthy lifestyles.

  • 25.
    Seetharaman, Shyam
    et al.
    Department of Psychology. St. Petersburg College. St. Petersburg, Florida.
    Andel, Ross
    School of Aging Studies. University of South Florida. Tampa ; International Clinical Research Center, Brno, Czech Republic.
    McEvoy, Cathy
    School of Aging Studies. University of South Florida. Tampa.
    Dahl Aslan, Anna K.
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden ; School of Health Sciences. Jönköping University, Sweden.
    Finkel, Deborah
    Department of Psychology. Indiana University Southeast, New Albany, Indiana.
    Pedersen, Nancy L.
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden ; Department of Psychology. University of Southern California. Los Angeles, California.
    Blood glucose, diet-based glycemic load and cognitive aging among dementia-free older adults2015In: The journals of gerontology. Series A, Biological sciences and medical sciences, ISSN 1079-5006, E-ISSN 1758-535X, Vol. 70, no 4, p. 471-479Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Although evidence indicates that Type II Diabetes is related to abnormal brain aging, the influence of elevated blood glucose on long-term cognitive change is unclear. In addition, the relationship between diet-based glycemic load and cognitive aging has not been extensively studied. The focus of this study was to investigate the influence of diet-based glycemic load and blood glucose on cognitive aging in older adults followed for up to 16 years.

    METHODS: Eight-hundred and thirty-eight cognitively healthy adults aged ≥50 years (M = 63.1, SD = 8.3) from the Swedish Adoption/Twin Study of Aging were studied. Mixed effects growth models were utilized to assess overall performance and change in general cognitive functioning, perceptual speed, memory, verbal ability, and spatial ability as a function of baseline blood glucose and diet-based glycemic load.

    RESULTS: High blood glucose was related to poorer overall performance on perceptual speed as well as greater rates of decline in general cognitive ability, perceptual speed, verbal ability, and spatial ability. Diet-based glycemic load was related to poorer overall performance in perceptual speed and spatial ability.

    CONCLUSION: Diet-based glycemic load and, in particular, elevated blood glucose appear important for cognitive performance/cognitive aging. Blood glucose control (perhaps through low glycemic load diets) may be an important target in the detection and prevention of age-related cognitive decline.

  • 26.
    Silventoinen, Karri
    et al.
    Department of Social Research, University of Helsinki, Finland ; Osaka University Graduate School of Medicine, Osaka University, Japan.
    Dahl Aslan, Anna K.
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden ; Institute of Gerontology and Aging Research Network–Jönköping (ARN-J), School of Health and Welfare, Jönköping University, Sweden.
    Kaprio, Jaakko
    Department of Public Health, University of Helsinki, Finland ; Institute for Molecular Medicine, Helsinki, Finland.
    Differences in genetic and environmental variation in adult BMI by sex, age, time period, and region: an individual-based pooled analysis of 40 twin cohorts2017In: American Journal of Clinical Nutrition, ISSN 0002-9165, E-ISSN 1938-3207, Vol. 106, no 2, p. 457-466Article in journal (Refereed)
    Abstract [en]

    Background: Genes and the environment contribute to variation in adult body mass index [BMI (in kg/m2)], but factors modifying these variance components are poorly understood.

    Objective: We analyzed genetic and environmental variation in BMI between men and women from young adulthood to old age from the 1940s to the 2000s and between cultural-geographic regions representing high (North America and Australia), moderate (Europe), and low (East Asia) prevalence of obesity.

    Design: We used genetic structural equation modeling to analyze BMI in twins ≥20 y of age from 40 cohorts representing 20 countries (140,379 complete twin pairs).

    Results: The heritability of BMI decreased from 0.77 (95% CI: 0.77, 0.78) and 0.75 (95% CI: 0.74, 0.75) in men and women 20–29 y of age to 0.57 (95% CI: 0.54, 0.60) and 0.59 (95% CI: 0.53, 0.65) in men 70–79 y of age and women 80 y of age, respectively. The relative influence of unique environmental factors correspondingly increased. Differences in the sets of genes affecting BMI in men and women increased from 20–29 to 60–69 y of age. Mean BMI and variances in BMI increased from the 1940s to the 2000s and were greatest in North America and Australia, followed by Europe and East Asia. However, heritability estimates were largely similar over measurement years and between regions. There was no evidence of environmental factors shared by co-twins affecting BMI.

    Conclusions: The heritability of BMI decreased and differences in the sets of genes affecting BMI in men and women increased from young adulthood to old age. The heritability of BMI was largely similar between cultural-geographic regions and measurement years, despite large differences in mean BMI and variances in BMI. Our results show a strong influence of genetic factors on BMI, especially in early adulthood, regardless of the obesity level in the population.

  • 27.
    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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  • 28.
    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.

  • 29.
    Teder, Marie
    et al.
    Linköping University, Sweden.
    Morelius, Evalotte
    Linköping University, Sweden.
    Nordwall, Maria
    Linköping University, Sweden / Vrinnevi Hospital, Norrköping, Sweden.
    Bolme, Per
    Linköping University, Sweden / Vrinnevi Hospital, Norrköping, Sweden.
    Ekberg, Joakim
    University of Skövde, School of Life Sciences.
    Wilhelm, Elisabeth
    Linköping University, Sweden.
    Timpka, Toomas
    Linköping University, Sweden.
    Family-Based Behavioural Intervention Program for Obese Children: An Observational Study of Child and Parent Lifestyle Interpretations2013In: PLOS ONE, E-ISSN 1932-6203, Vol. 8, no 8, article id e71482Article in journal (Refereed)
    Abstract [en]

    Background: Family-based behavioural intervention programs (FBIPs) against childhood obesity have shown promising results, but the mediating mechanisms have not been identified. The aim of this study was to examine changes in obese childrens lifestyle habits during a 2-year FBIP according to their own and parents' reports, the concordance between these reports and the correlations to change in post-intervention z-BMI. Methods: An observational study of 26 children (8.3-12.0 years) and their parents participating in a 2-year FBIP was performed. Weight and height were measured from baseline to 12 months after the end of the program. Eating habits and physical-and sedentary activity were reported separately by children and parents. Data were analysed with regard to concordance between parents' and children's reports and association between the lifestyle reports and change in z-BMI at the study endpoint using descriptive statistics and parametric and non-parametric tests. Results: According to both children's and parents' reports, the level of physical activity among the children had increased after the intervention as well as the agreement between the informants' reports. According to the children, eating habits had improved, while the parents' reports showed an improvement only with regard to binge eating. The concordance between children and parents regarding eating habits was slight to fair also after the intervention. No statistically significant associations between changes in lifestyle reports and changes in z-BMI were observed. Conclusions: Child and parent reports of physical activity were found to converge and display an improvement in a 2-year FBIP, while the reports on eating habits showed a more refractory pattern. Changes in concordance and agreement between children and parents reports did not correlate with weight reduction. Further methods development and studies of the processes during family-based interventions against childhood obesity are warranted.

  • 30.
    Tognon, Gianluca
    et al.
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR). Choices International Foundation, HE The Hague, The Netherlands.
    Beltramo, Belen
    Choices International Foundation, HE The Hague, The Netherlands.
    Schilpzand, Rutger
    Choices International Foundation, HE The Hague, The Netherlands.
    Lissner, Lauren
    Institute of Medicine, School of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden.
    Roodenburg, Annet J. C.
    Department of Nutrition and Health HAS, University of Applied Sciences, MA ’s-Hertogenbosch, The Netherlands.
    Don, Rokiah
    Nutrition and Dietetics Division, International Medical University, Kuala Lumpur, Malaysia.
    Nair, Krishnapillai Madhavan
    Former Scientist, National Institute of Nutrition (ICMR), Choices International Scientific Committee, Hyderabad, India.
    Nnam, Ngozi
    Department of Nutrition & Dietetics, University of Nigeria, Nsukka, Nigeria.
    Hamaker, Bruce
    Department of Food Science, Purdue University, West Lafayette, IN, USA.
    Smorenburg, Herbert
    Choices International Foundation, HE The Hague, The Netherlands.
    Development of the choices 5-level criteria to support multiple food system actions2021In: Nutrients, E-ISSN 2072-6643, Vol. 13, no 12, article id 4509Article in journal (Refereed)
    Abstract [en]

    In 2008, the Choices International Foundation developed its logo criteria, identifying best-in-class food products. More advanced, global and graded nutrient profiling systems (NPSs) are needed to substantiate different national nutrition policies. The objective of this work was to extend Choices NPS to identify five levels of the healthiness of food products, so that the Choices NPS can also be used to support other nutrition policies, next to front-of-pack labelling. Based on the same principles as the previous logo criteria, four sets of threshold criteria were determined using a com-bination of compliance levels, calculated from a large international food group-specific database, the Choices logo criteria, and WHO-NPSs developed to restrict marketing to children. Validation consisted of a comparison with indicator foods from food-based dietary guidelines from various countries. Some thresholds were adjusted after the validation, e.g., because intermediate thresholds were too lenient. This resulted in a new international NPS that can be applied to different contexts and to support a variety of health policies, to prevent both undernutrition and obesity. It can effi-ciently evaluate mixed food products and represents a flexible tool, applicable in various settings and populations. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.

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  • 31.
    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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  • 32.
    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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