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  • 1.
    Buck, Christoph
    et al.
    Leibniz Institute for Prevention Research and Epidemiology, BIPS, Bremen, Germany.
    Eiben, Gabriele
    Högskolan i Skövde, Institutionen för hälsa och lärande. Högskolan i Skövde, Forskningsspecialiseringen Hälsa och Lärande. Section for Epidemiology and Social Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden.
    Lauria, Fabio
    National Research Council, Institute of Food Sciences, Avellino, Italy.
    Konstabel, Kenn
    National Institute for Health Development, Tallinn, Estonia.
    Page, Angie
    Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, Bristol, United Kingdom / NIHR Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust, University of Bristol, United Kingdom.
    Ahrens, Wolfgang
    Leibniz Institute for Prevention Research and Epidemiology, BIPS, Bremen, Germany / Faculty of Mathematics/Computer Science, University of Bremen, Germany.
    Pigeot, Iris
    Leibniz Institute for Prevention Research and Epidemiology, BIPS, Bremen, Germany / Faculty of Mathematics/Computer Science, University of Bremen, Germany.
    Urban Moveability and physical activity in children: Longitudinal results from the IDEFICS and I.Family cohort2019Ingår i: International Journal of Behavioral Nutrition and Physical Activity, ISSN 1479-5868, E-ISSN 1479-5868, Vol. 16, nr 1, artikel-id 128Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Physical activity (PA) is one of the major protective behaviours to prevent non-communicable diseases. Positive effects of the built environment on PA are well investigated, although evidence of this association is mostly based on cross-sectional studies. The present study aims to investigate the longitudinal effects of built environment characteristics in terms of a moveability index on PA of children in their transition phase to adolescence using data of the IDEFICS/I.Family cohort. Methods: We used data on 3394 accelerometer measurements of 2488 children and adolescents aged 3 to 15 years old from survey centres of three countries, Germany, Italy, and Sweden, who participated in up to three surveys over 6 years. In network-dependent home neighbourhoods, a moveability index was calculated based on residential density, land use mix, street connectivity, availability of public transport and public open spaces such as green spaces and public playgrounds in order to quantify opportunities for PA of children and adolescents. Linear trajectories of light PA (LPA) and moderate-to-vigorous PA (MVPA) were estimated using linear mixed models accounting for repeated measurements nested within individuals. Least squares means were estimated to quantify differences in trajectories over age. Results: LPA and MVPA declined annually with age by approximately 20 min/day and 2 min/day respectively. In girls, the moveability index showed a consistent significantly positive effect on MVPA (β $ \hat{\beta} $ = 2.14, 95% CI: (0.11; 4.16)) for all ages, while in boys the index significantly lessened the decline in LPA with age for each year. (β $ \hat{\beta} $ = 2.68, 95% CI: (0.46; 4.90)). Availability of public open spaces was more relevant for MVPA in girls and LPA in boys during childhood, whereas in adolescence, residential density and intersection density became more important. Conclusion: Built environment characteristics are important determinants of PA and were found to have a supportive effect that ameliorates the decline in PA during the transition phase from childhood to adolescence. In childhood environmental support for leisure time PA through public open spaces was found to be the most protective factor whereas in adolescence the positive influence of street connectivity and residential density was most supportive of physical activity. © 2019 The Author(s).

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  • 2.
    Cheng, Lan
    et al.
    Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany / Faculty of Mathematics and Computer Science, University of Bremen, Germany.
    Pohlabeln, Hermann
    Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany.
    Ahrens, Wolfgang
    Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany / Faculty of Mathematics and Computer Science, University of Bremen, Germany.
    Lauria, Fabio
    Institute of Food Sciences, National Research Council, Avellino, Italy.
    Veidebaum, Toomas
    Department of Chronic Diseases, National Institute for Health Development, Tallinn, Estonia.
    Chadjigeorgiou, Charalambos
    Research and Education Institute of Child Health, Strovolos, Cyprus.
    Molnár, Dénes
    Department of Pediatrics, Medical School, University of Pécs, Hungary.
    Eiben, Gabriele
    Högskolan i Skövde, Institutionen för hälsovetenskaper. Högskolan i Skövde, Forskningsmiljön hälsa, hållbarhet och digitalisering.
    Michels, Nathalie
    Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Belgium.
    Moreno, Luis A.
    Genud (Growth, Exercise, Nutrition and Development) Research Group, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón), Centro de Investigacion Biomedica en Red Fisiopatologia de la Obesidad y Nutricion (CIBERObn), University of Zaragoza, Spain.
    Page, Angie S.
    Centre for Exercise, Nutrition and Health Sciences, University of Bristol, Bristol, United Kingdom.
    Pitsiladis, Yannis
    Collaborating Centre of Sports Medicine, University of Brighton, United Kingdom.
    Hebestreit, Antje
    Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany.
    Cross-sectional and longitudinal associations between physical activity, sedentary behaviour and bone stiffness index across weight status in European children and adolescents2020Ingår i: International Journal of Behavioral Nutrition and Physical Activity, ISSN 1479-5868, E-ISSN 1479-5868, Vol. 17, nr 1, artikel-id 54Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

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  • 3.
    Hebestreit, Antje
    et al.
    BIPS GmbH, Leibniz Inst Prevent Res & Epidemiol, Achterstr 30, D-28359 Bremen, Germany.
    Barba, Gianvincenzo
    CNR, Inst Food Sci, Avellino, Italy.
    De Henauw, Stefaan
    Univ Ghent, Dept Publ Hlth, B-9000 Ghent, Belgium.
    Eiben, Gabriele
    Univ Gothenburg, Dept Publ Hlth & Community Med, Gothenburg, Sweden.
    Hadjigeorgiou, Charalampos
    Res & Educ Inst Child Hlth, Strovolos, Cyprus.
    Kovacs, Eva
    Univ Pecs, Dept Pediat, Pecs, Hungary / Univ Munich, Inst Med Informat Proc Biometr & Epidemiol, Munich, Germany.;Univ Munich, German Ctr Vertigo & Balance Disorders, Munich, Germany.
    Krogh, Vittorio
    Fdn IRCCS Ist Nazl Tumori, Dept Prevent & Predict Med, Milan, Italy.
    Moreno, Luis A.
    Univ Zaragoza, Fac Hlth Sci, GENUD Growth Exercise Nutr & Dev Res Grp, Zaragoza, Spain.
    Pala, Valeria
    Fdn IRCCS Ist Nazl Tumori, Dept Prevent & Predict Med, Milan, Italy.
    Veidebaum, Toomas
    Natl Inst Hlth Dev, Dept Chron Dis, Tallinn, Estonia.
    Wolters, Maike
    BIPS GmbH, Leibniz Inst Prevent Res & Epidemiol, Achterstr 30, D-28359 Bremen, Germany.
    Boernhorst, Claudia
    BIPS GmbH, Leibniz Inst Prevent Res & Epidemiol, Achterstr 30, D-28359 Bremen, Germany.
    Cross-sectional and longitudinal associations between energy intake and BMI z-score in European children2016Ingår i: International Journal of Behavioral Nutrition and Physical Activity, ISSN 1479-5868, E-ISSN 1479-5868, Vol. 13, artikel-id 23Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Evidence for the effect of dietary energy on BMI z-scores in young children is limited. We aim to investigate cross-sectional and longitudinal effects of daily energy intake (EI) on BMI z-scores of European boys and girls considering growth-related height dependencies of EI using residual EI. Methods: To investigate cross-sectional and longitudinal effects of daily energy intake (EI) on BMI z-scores of European boys and girls considering growth-related height dependencies of EI using residual EI. Methods: Subjects were children aged 2-< 10 y old (N = 2753, 48.2 % girls) participating in the IDEFICS (Identification and prevention of Dietary-and lifestyle-induced health EFfects In Children and infantS) baseline and follow-up examination. Usual EI (kcal/day) was calculated based on the National Cancer Institute-method excluding subjects with implausible reported EI. Effect of age, height and sex-adjusted residuals of EI on BMI z-score was investigated stratified by baseline age-group (2-< 4 y, 4-< 6 y, 6-< 8 y and 8-< 10 y) cross-sectionally using linear regression models adjusted for relevant confounders (crude model: age, sex, country; fully adjusted model: plus parental ISCED level, parental BMI, screen time; subgroup analysis: plus objectively measured physical activity). Longitudinal associations were estimated between changes in (Delta) residual EI per year and Delta BMI z-score per year with adjustments analogously to the cross-sectional models but with additional adjustment for residual EI at baseline. Results: Cross-sectionally, positive associations were observed between residual EI and BMI z-score for the full study sample, for boys and in older (>= 6 years) but not in younger children in the crude and fully adjusted model. Longitudinally, small positive associations were observed between Delta residual EI per y on Delta BMI z-score per y for the full study sample and in 4-< 6 y olds in the crude and fully adjusted model. Conclusion: In conclusion, EI above the average intakes for a certain sex, age and height are weakly associated with BMI z-scores in European children. Residual EI may be considered as a useful exposure measure in children as it accounts for growth-related changes in usual EI during childhood.

  • 4.
    Steene-Johannessen, Jostein
    et al.
    Department of Sports Medicine, Norwegian School of Sport Sciences,Oslo, Norway.
    Eiben, Gabriele
    Högskolan i Skövde, Institutionen för hälsovetenskaper. Högskolan i Skövde, Forskningsmiljön hälsa, hållbarhet och digitalisering.
    Ekelund, Ulf
    Department of Sports Medicine, Norwegian School of Sport Sciences,Oslo, Norway.
    Variations in accelerometry measured physical activity and sedentary time across Europe - harmonized analyses of 47,497 children and adolescents2020Ingår i: International Journal of Behavioral Nutrition and Physical Activity, ISSN 1479-5868, E-ISSN 1479-5868, Vol. 17, nr 1, artikel-id 38Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Levels of physical activity and variation in physical activity and sedentary time by place and person in European children and adolescents are largely unknown. The objective of the study was to assess the variations in objectively measured physical activity and sedentary time in children and adolescents across Europe.

    METHODS: Six databases were systematically searched to identify pan-European and national data sets on physical activity and sedentary time assessed by the same accelerometer in children (2 to 9.9 years) and adolescents (≥10 to 18 years). We harmonized individual-level data by reprocessing hip-worn raw accelerometer data files from 30 different studies conducted between 1997 and 2014, representing 47,497 individuals (2-18 years) from 18 different European countries.

    RESULTS: Overall, a maximum of 29% (95% CI: 25, 33) of children and 29% (95% CI: 25, 32) of adolescents were categorized as sufficiently physically active. We observed substantial country- and region-specific differences in physical activity and sedentary time, with lower physical activity levels and prevalence estimates in Southern European countries. Boys were more active and less sedentary in all age-categories. The onset of age-related lowering or leveling-off of physical activity and increase in sedentary time seems to become apparent at around 6 to 7 years of age.

    CONCLUSIONS: Two third of European children and adolescents are not sufficiently active. Our findings suggest substantial gender-, country- and region-specific differences in physical activity. These results should encourage policymakers, governments, and local and national stakeholders to take action to facilitate an increase in the physical activity levels of young people across Europe.

  • 5.
    Vaidya, Abhinav
    et al.
    Kathmandu Medical College, Kathmandu, Nepal / Nordic School of Public Health NHV, Gothenburg, Sweden.
    Krettek, Alexandra
    Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Sweden / Nordic School of Public Health NHV, Gothenburg, Sweden.
    Physical activity level and its sociodemographic correlates in a peri-urban Nepalese population: a cross-sectional study from the Jhaukhel-Duwakot health demographic surveillance site2014Ingår i: International Journal of Behavioral Nutrition and Physical Activity, ISSN 1479-5868, E-ISSN 1479-5868, Vol. 11, nr 1, artikel-id 39Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Physical inactivity is a leading risk factor for cardiovascular and other noncommunicable diseases in high-, low- and middle-income countries. Nepal, a low-income country in South Asia, is undergoing an epidemiological transition. Although the reported national prevalence of physical inactivity is relatively low, studies in urban and peri-urban localities have always shown higher prevalence. Therefore, this study aimed to measure physical activity in three domains-work, travel and leisure-in a peri-urban community and assess its variations across different sociodemographic correlates.

    METHODS: Adult participants (n=640) from six randomly selected wards of the Jhaukhel-Duwakot Health Demographic Surveillance Site (JD-HDSS) near Kathmandu responded to the Global Physical Activity Questionnaire. To determine total physical activity, we calculated the metabolic equivalent of task in minutes/week for each domain and combined the results. Respondents were categorized into high, moderate or low physical activity. We also calculated the odds ratio for low physical activity in various sociodemographic variables and self-reported cardiometabolic states.

    RESULTS: The urbanizing JD-HDSS community showed a high prevalence of low physical activity (43.3%; 95% CI 39.4-47.1). Work-related activity contributed most to total physical activity. Furthermore, women and housewives and older, more educated and self-or government-employed respondents showed a greater prevalence of physical inactivity. Respondents with hypertension, diabetes or overweight/obesity reported less physical activity than individuals without those conditions. Only 5% of respondents identified physical inactivity as a cardiovascular risk factor.

    CONCLUSIONS: Our findings reveal a high burden of physical inactivity in a peri-urban community of Nepal. Improving the level of physical activity involves sensitizing people to its importance through appropriate multi-sector strategies that provide encouragement across all sociodemographic groups.

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  • 6.
    Verbestel, Vera
    et al.
    Univ Ghent, Dept Movement & Sport Sci, B-9000 Ghent, Belgium.
    De Henauw, Stefaan
    Univ Ghent, Dept Publ Hlth, B-9000 Ghent, Belgium.
    Maes, Lea
    Univ Ghent, Dept Publ Hlth, B-9000 Ghent, Belgium.
    Haerens, Leen
    Univ Ghent, Dept Movement & Sport Sci, B-9000 Ghent, Belgium.;Univ Ghent, Res Fdn Flanders, B-9000 Ghent, Belgium.
    Marild, Staffan
    Univ Gothenburg, Dept Pediat, Queen Silivia Childrens Univ, S-41685 Gothenburg, Sweden.
    Eiben, Gabriele
    Univ Gothenburg, Dept Publ Hlth & Community Med, Sahlgrenska Acad, S-40530 Gothenburg, Sweden.
    Lissner, Lauren
    Univ Gothenburg, Dept Publ Hlth & Community Med, Sahlgrenska Acad, S-40530 Gothenburg, Sweden.
    Moreno, Luis A.
    Univ Zaragoza, GENUD Growth Exercise Nutr & Dev, Res Grp, Univ Sch Hlth Sci, Zaragoza 50009, Spain.
    Frauca, Natalia Lascorz
    Univ Zaragoza, GENUD Growth Exercise Nutr & Dev, Res Grp, Univ Sch Hlth Sci, Zaragoza 50009, Spain.
    Barba, Gianvincenzo
    CNR, Unit Epidemiol & Populat Genet, Inst Food Sci, I-83100 Avellino, Italy.
    Kovacs, Eva
    Univ Pecs, Dept Pediat, H-7623 Pecs, Hungary.
    Konstabel, Kenn
    Natl Inst Hlth Dev, EE-50410 Tallinn, Estonia.
    Tornaritis, Michael
    Res & Educ Inst Child Hlth, CY-2027 Strovolos, Cyprus.
    Gallois, Katharina
    Univ Bremen, Bremen Inst Prevent Res & Social Med BIPS, D-28359 Bremen, Germany.
    Hassel, Holger
    Univ Bremen, Bremen Inst Prevent Res & Social Med BIPS, D-28359 Bremen, Germany / Univ Appl Sci, Hsch Coburg, Coburg, Germany.
    De Bourdeaudhuij, Ilse
    Univ Ghent, Dept Movement & Sport Sci, B-9000 Ghent, Belgium.
    Using the intervention mapping protocol to develop a community-based intervention for the prevention of childhood obesity in a multi-centre European project: the IDEFICS intervention2011Ingår i: International Journal of Behavioral Nutrition and Physical Activity, ISSN 1479-5868, E-ISSN 1479-5868, Vol. 8, artikel-id 82Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: The prevalence of childhood obesity has increased during the past decades and is now considered an urgent public health problem. Although stabilizing trends in obesity prevalence have been identified in parts of Europe, preventive efforts in children are still needed. Using the socio-ecological approach as the underlying theoretical perspective, the IDEFICS project aimed to develop, implement and evaluate a community-based intervention for the prevention of childhood obesity in eight European countries. The aim of the present manuscript was to describe the content and developmental process of the IDEFICS intervention. Methods: The intervention mapping protocol (IMP) was used to develop the community-based intervention for the prevention of childhood obesity in 3 to 10 years old children. It is a theory-and evidence-based tool for the structured planning and development of health promotion programs that requires the completion of six different steps. These steps were elaborated by two coordinating centers and discussed with the other participating centers until agreement was reached. Focus group research was performed in all participating centers to provide an informed basis for intervention development. Results: The application of the IMP resulted in an overall intervention framework with ten intervention modules targeting environmental and personal factors through the family, the school and the community. The summary results of the focus group research were used to inform the development of the overall intervention. The cultural adaptation of the overall intervention was realised by using country specific focus group results. The need for cultural adaptation was considered during the entire process to improve program adoption and implementation. A plan was developed to evaluate program effectiveness and quality of implementation. Conclusions: The IDEFICS project developed a community-based intervention for the prevention of childhood obesity by using to the intervention mapping heuristic. The IDEFICS intervention consists of a general and standardized intervention framework that allows for cultural adaptation to make the intervention feasible and to enhance deliverability in all participating countries. The present manuscript demonstrates that the development of an intervention is a long process that needs to be done systematically. Time, human resources and finances need to be planned beforehand to make interventions evidence-based and culturally relevant.

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