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  • 1.
    Bammann, K.
    et al.
    Univ Bremen, Inst Publ Hlth & Nursing Res ipp, Fac Human & Hlth Sci, FB 11,Grazer Str 2a, D-28359 Bremen, Germany.;Leibniz Inst Prevent Res & Epidemiol BIPS, Bremen, Germany.
    Gwozdz, W.
    Copenhagen Business Sch, Dept Intercultural Commun & Management, Frederiksberg, Denmark.
    Pischke, C.
    Leibniz Inst Prevent Res & Epidemiol BIPS, Bremen, Germany.
    Eiben, Gabriele
    Univ Gothenburg, Dept Publ Hlth & Community Med, Gothenburg, Sweden.
    Fernandez-Alvira, J. M.
    Univ Zaragoza, Dept Phys Med & Nursing, Growth Exercise Nutr & Dev GENUD Res Grp, Zaragoza, Spain.
    De Henauw, S.
    Univ Ghent, Dept Publ Hlth, Ghent, Belgium.
    Lissner, L.
    Univ Gothenburg, Dept Publ Hlth & Community Med, Gothenburg, Sweden.
    Moreno, L. A.
    Univ Zaragoza, Dept Phys Med & Nursing, Growth Exercise Nutr & Dev GENUD Res Grp, Zaragoza, Spain.
    Pitsiladis, Y.
    Univ Brighton, Ctr Sport & Exercise Sci & Med SESAME, Eastbourne, England.
    Reisch, L.
    Copenhagen Business Sch, Dept Intercultural Commun & Management, Frederiksberg, Denmark.
    Veidebaum, T.
    Natl Inst Hlth Dev, Dept Chron Dis, Tallinn, Estonia.
    Pigeot, I.
    Leibniz Inst Prevent Res & Epidemiol BIPS, Bremen, Germany.;Univ Bremen, Fac Math & Comp Sci, Inst Stat, Bremen, Germany.
    The impact of familial, behavioural and psychosocial factors on the SES gradient for childhood overweight in Europe. A longitudinal study2017In: International Journal of Obesity, ISSN 0307-0565, E-ISSN 1476-5497, Vol. 41, no 1, p. 54-60Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: In highly developed countries, childhood overweight and many overweight-related risk factors are negatively associated with socioeconomic status (SES). OBJECTIVE: The objective of this study is to investigate the longitudinal association between parental SES and childhood overweight, and to clarify whether familial, psychosocial or behavioural factors can explain any SES gradient. METHODS: The baseline and follow-up surveys of the identification and prevention of dietary and lifestyle induced health effects in children and infants (IDEFICS) study are used to investigate the longitudinal association between SES, familial, psychosocial and behavioural factors, and the prevalence of childhood overweight. A total of 5819 children (50.5% boys and 49.5% girls) were included. RESULTS: The risk for being overweight after 2 years at follow-up in children who were non-overweight at baseline increases with a lower SES. For children who were initially overweight, a lower parental SES carries a lower probability for a non-overweight weight status at follow-up. The effect of parental SES is only moderately attenuated by single familial, psychosocial or behavioural factors; however, it can be fully explained by their combined effect. Most influential of the investigated risk factors were feeding/eating practices, parental body mass index, physical activity behaviour and proportion of sedentary activity. CONCLUSION: Prevention strategies for childhood overweight should focus on actual behaviours, whereas acknowledging that these behaviours are more prevalent in lower SES families.

  • 2.
    De Henauw, S.
    et al.
    Univ Ghent, Fac Med & Hlth Sci, Dept Publ Hlth, Univ Hosp, B-9000 Ghent, Belgium.;Univ Coll Ghent, Vesalius Coll, Dept Hlth Sci, Ghent, Belgium.
    Michels, N.
    Univ Ghent, Fac Med & Hlth Sci, Dept Publ Hlth, Univ Hosp, B-9000 Ghent, Belgium.
    Vyncke, K.
    Univ Ghent, Fac Med & Hlth Sci, Dept Publ Hlth, Univ Hosp, B-9000 Ghent, Belgium.
    Hebestreit, A.
    Leibniz Inst Prevent Res & Epidemiol BIPS, Bremen, Germany.
    Russo, P.
    CNR, Inst Food Sci, Epidemiol & Populat Genet, Avellino, Italy.
    Intemann, T.
    Leibniz Inst Prevent Res & Epidemiol BIPS, Bremen, Germany.
    Peplies, J.
    Leibniz Inst Prevent Res & Epidemiol BIPS, Bremen, Germany.
    Fraterman, A.
    MVZ Dortmund Dr Eberhard & Partner, Dortmund, Germany.
    Eiben, Gabriele
    Univ Gothenburg, Dept Primary Hlth Care, Gothenburg, Sweden.
    de Lorgeril, M.
    Fac Med Grenoble, TIMC IMAG, CNRS UMR 5525, Coeur & Nutr, Grenoble, France.
    Tornaritis, M.
    Res & Educ Inst Child Hlth, Strovolos, Cyprus.
    Molnar, D.
    Univ Pecs, Natl Inst Hlth Promot, Gyermekklin, Pecs, Hungary.
    Veidebaum, T.
    Natl Inst Hlth Dev, Dept Chron Dis, Tallinn, Estonia.
    Ahrens, W.
    Leibniz Inst Prevent Res & Epidemiol BIPS, Bremen, Germany.;Univ Bremen, Fac Math & Comp Sci, Inst Stat, D-28359 Bremen, Germany.
    Moreno, L. A.
    Univ Zaragoza, Sch Hlth Sci, GENUD Growth Exercise Nutr & Dev Res Grp, Zaragoza, Spain.
    Blood lipids among young children in Europe: results from the European IDEFICS study2014In: International Journal of Obesity, ISSN 0307-0565, E-ISSN 1476-5497, Vol. 38, p. S67-S75Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Measurement of cholesterol and triglyceride (TG) fractions in blood has become standard practice in the early detection of atherosclerotic disease pathways. Considerable attention is given nowadays to the presence of these risk factors in children and to start preventive campaigns early in life. In this context, it is imperative to have valid comparative frameworks for interpretation of lipid levels. The aim of this study is to present sex-and age-specific reference values on blood lipid levels in European children aged 2.0-10.9 years. METHODS: Fasting blood was obtained via either venipuncture or capillary sampling. In 13 579 European non-obese children (50.3% boys), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), TG and TC/HDL-C ratio levels were measured with a point-of-care analyser (Cholestech). Sex- and age-specific reference values were computed with the GAMLSS method with the statistical software R. RESULTS: Reference curves and 1st, 3rd, 10th, 25th, 50th, 75th, 90th, 97th and 99th percentile values are presented. HDL-C showed a positive trend with age, from 2 years onwards, but was relatively stable above the age of 7. For LDL-C and TC, linear but small age-related trends were seen. The TC/HDL-C values showed a gradual negative trend from the age of 2 up to 6 and were relatively stable afterwards. For TG, no age trend was found (P = 0.285). Boys had higher mean HDL-C values than girls (1.414 vs 1.368 mmol l(-1)), and lower TC, LDL-C, TC/HDL-C and TG values (3.981 vs 4.087 mmol l(-1); 2.297 vs 2.435 mmol l(-1); 2.84 vs 3.01mmol l(-1); and 0.509 vs 0.542 mmol l(-1), respectively). CONCLUSIONS: These new and recent references could serve as a European orientation of blood lipid values in children in the context of standard medical practice and for the purpose of public health screening.

  • 3.
    De Henauw, S.
    et al.
    Univ Ghent, State Univ Ghent Hosp, Fac Med & Hlth Sci, Dept Publ Hlth, B-9000 Ghent, Belgium.
    Verbestel, V.
    Univ Ghent, Fac Med & Hlth Sci, Dept Movement & Sports Sci, B-9000 Ghent, Belgium.
    Marild, S.
    Univ Gothenburg, Queen Silvia Childrens Hosp, Dept Paediat, Gothenburg, Sweden.
    Barba, G.
    CNR, Inst Food Sci, Unit Epidemiol & Populat Genet, Avellino, Italy.
    Bammann, K.
    Univ Bremen, Bremen Inst Prevent Res & Social Med, Bremen, Germany.
    Eiben, Gabriele
    Univ Gothenburg, Sahlgrenska Acad, Dept Publ Hlth & Community Med, Publ Hlth Epidemiol Unit, Gothenburg, Sweden.
    Hebestreit, A.
    Univ Bremen, Bremen Inst Prevent Res & Social Med, Bremen, Germany.
    Iacoviello, L.
    Catholic Univ, Lab Genet & Environm Epidemiol, Campobasso, Italy.
    Gallois, K.
    Univ Bremen, Bremen Inst Prevent Res & Social Med, Bremen, Germany.
    Konstabel, K.
    Natl Inst Hlth Dev, Tallinn, Estonia.
    Kovacs, E.
    Univ Pecs, Fac Med, Dept Paediat, Pecs, Hungary.
    Lissner, L.
    Department of Public Health and Community Medicine, Public Health Epidemiology Unit, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Maes, L.
    Univ Ghent, State Univ Ghent Hosp, Fac Med & Hlth Sci, Dept Publ Hlth, B-9000 Ghent, Belgium.
    Molnar, D.
    Univ Pecs, Fac Med, Dept Paediat, Pecs, Hungary.
    Moreno, L. A.
    Univ Zaragoza, Growth Exercise Nutr & Dev Res Grp, Zaragoza, Spain.
    Reisch, L.
    Copenhagen Business Sch, Copenhagen, Denmark.
    Siani, A.
    CNR, Inst Food Sci, Unit Epidemiol & Populat Genet, Avellino, Italy.
    Tornaritis, M.
    Res & Educ Inst Child Hlth, Strovolos, Cyprus.
    Williams, G.
    Univ Lancaster, Dept Philosophy, Lancaster, England.
    Ahrens, W.
    Univ Bremen, Bremen Inst Prevent Res & Social Med, Bremen, Germany.
    De Bourdeaudhuij, I.
    Univ Ghent, Fac Med & Hlth Sci, Dept Movement & Sports Sci, B-9000 Ghent, Belgium.
    Pigeot, I.
    Univ Bremen, Bremen Inst Prevent Res & Social Med, Bremen, Germany.
    The IDEFICS community-oriented intervention programme: a new model for childhood obesity prevention in Europe?2011In: International Journal of Obesity, ISSN 0307-0565, E-ISSN 1476-5497, Vol. 35, p. S16-S23Article in journal (Refereed)
    Abstract [en]

    Background and objectives: The European Union-as well as other parts of the world-faces a major challenge of increasing incidence of overweight/obesity. In particular, the increase in childhood obesity gives rise to a strong imperative for immediate action. Yet, little is known about the effectiveness of community interventions, and further research in this field is needed. There is, however, a growing consensus that such research should start from the paradigm that the current living environments tend to counteract healthy lifestyles. Questioning these environments thoroughly can help to develop new pathways for sustainable health-promoting communities. Against this background, the IDEFICS (Identification and prevention of dietary- and lifestyle-induced health effects in children and infants) study developed and implemented innovative community-oriented intervention programmes for obesity prevention and healthy lifestyle primarily in children aged 2-10 years in eight European countries: Sweden, Estonia, Germany, Belgium, Hungary, Italy, Spain and Cyprus. Materials and methods: The IDEFICS community-oriented intervention study mobilised an integrated set of interventional efforts at different levels of society, with the aim of facilitating the adoption of a healthy obesity-preventing lifestyle. The overall programme has been composed of 10 modules: three at community level, six at school level and one for parents. The main focus was on diet, physical activity and stress-coping capacity. The sphere of action encompassed both children and their (grand) parents, schools, local public authorities and influential stakeholders in the community. All materials for the interventions were centrally developed and culturally adapted. Results: So far, the following has been achieved: focus group research, literature review and expert consultations were done in an early phase as a basis for the development of the intervention modules. The intervention mapping protocol was followed as guide for structuring the intervention research. The overall intervention programme's duration was 2 years, but a longer-term follow-up programme is under development. Conclusions: This large-scale European effort is expected to contribute significantly to the understanding of this major public health challenge. International Journal of Obesity (2011) 35, S16-S23; doi:10.1038/ijo.2011.31

  • 4.
    Eiben, Gabriele
    et al.
    Department of Primary Health Care, Göteborg University, Sweden.
    Dey, D. K.
    Department of Geriatric Medicine, Göteborg University, Sweden.
    Rothenberg, E.
    Department of Geriatric Medicine, Göteborg University, Sweden / Department of Clinical Nutrition, Sahlgrenska University Hospital, Göteborg, Sweden.
    Steen, B.
    Department of Geriatric Medicine, Göteborg University, Sweden.
    Björkelund, C.
    Department of Primary Health Care, Göteborg University, Sweden.
    Bengtsson, C.
    Department of Primary Health Care, Göteborg University, Sweden.
    Lissner, L.
    Department of Primary Health Care, Göteborg University, Sweden.
    Obesity in 70-year-old Swedes: Secular changes over 30 years2005In: International Journal of Obesity, ISSN 0307-0565, E-ISSN 1476-5497, Vol. 29, no 7, p. 810-817Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Secular increases in obesity have been widely reported in middle-aged adults, but less is known about such trends among the elderly. The primary purpose of this paper is to document the most recent wave of the obesity epidemic in population-based samples of 70-y-old men and women from Goteborg. Additionally, we will investigate the influences of physical activity, smoking and education on these secular trends. POPULATIONS AND METHODS: Five population-based samples of 3702 70-y-olds (1669 men and 2033 women) in Goteborg, Sweden, born between 1901 and 1930, were examined in the Gerontological and Geriatric Population Studies (H70) between 1971 and 2000. Cohort differences in anthropometric measures were the main outcomes studied. Physical activity, smoking habits and education were assessed by comparable methods in all cohorts. Subsamples of the women in the latest two cohorts (birth years 1922 and 1930) were also part of the Prospective Population Study of Women in Goteborg. In these women, it was possible to examine body mass index (BMI) and waist-to-hip circumference ratio (WHR) longitudinally since 1968. RESULTS AND CONCLUSIONS: Significant upward trends were found for height, weight, BMI, waist circumference (WC), WHR, prevalence of overweight (BMI >= 25 kg/m(2)) and obesity ( BMI >= 30 kg/m(2)) across cohorts in both sexes. In 2000, 20% of the 70-y-old men born in 1930 were obese, and the largest increment (almost doubling) had occurred between the early 1980s and the early 1990s. In 70-y-old women the prevalence of obesity was 24% in 2000, a 50% increase compared to the cohort born 8 y earlier. BMI increased over time in all physical activity, smoking and education groups, with the exception of neversmoking men. Although 70-y-old women in 2000 were heavier than cohorts examined 8 y previously, data from the women studied longitudinally revealed that these differences were already present in earlier adulthood. In conclusion, the elderly population is very much part of the obesity epidemic, although secular trends in BMI were detected slightly earlier in men than in women. The health implications of these secular trends should be focused on in future gerontological research.

  • 5.
    Eiben, Gabriele
    et al.
    Department of Primary Health Care, Göteborg University, Sweden.
    Lissner, L
    Department of Primary Health Care, Göteborg University, Sweden.
    Health Hunters - an intervention to prevent overweight and obesity in young high-risk women2006In: International Journal of Obesity, ISSN 0307-0565, E-ISSN 1476-5497, Vol. 30, no 4, p. 691-696Article in journal (Refereed)
    Abstract [en]

    Aim: The aim of the study was to develop and implement an obesity and weight gain prevention program targeted to a high-risk group. Method: Women, 18-28 years old, with at least one severely obese parent, were randomized to the intervention or control group of the 'Health Hunters' program. During 1 year of follow-up, the intervention group received an individualized behavioral program focusing on food choice, physical activity and other lifestyle factors. Anthropometric measures, DXA-based body composition and fitness levels were measured at baseline and after 1 year. Self-reported changes in obesity-related behaviors were also assessed. Results: Baseline examinations were conducted in 40 women, of whom 30 completed follow-up examinations 1 year later. Pregnancy was the most common reason for failure to complete the study. Compared to the control group (which gained weight), the intervention group displayed significant improvements in body weight, body mass index, waist circumference, waist-to-hip ratio and self-reported physical activity. Changes in body composition, although not significant, suggested that the intervention tended to be associated with improved body composition. Further analysis of changes in diet and fitness in relation to concurrent weight changes indicated that the strongest 'protective' associations were for energy percent protein, fiber density and fitness. Conclusion: Pilot data from the Health Hunters obesity prevention program indicates that it is effective in high-risk young women with familial predisposition for obesity.

  • 6.
    Erhardt, E.
    et al.
    Univ Pecs, Dept Paediat, H-7623 Pecs, Hungary.
    Foraita, R.
    Leibniz Inst Prevent Res & Epidemiol BIPS, Bremen, Germany.
    Pigeot, I.
    Leibniz Inst Prevent Res & Epidemiol BIPS, Bremen, Germany.;Univ Bremen, Fac Math & Comp Sci, Inst Stat, D-28359 Bremen, Germany.
    Barba, G.
    CNR, Inst Food Sci, Epidemiol & Populat Genet, Avellino, Italy.
    Veidebaum, T.
    Natl Inst Hlth Dev, Dept Chron Dis, Tallinn, Estonia.
    Tornaritis, M.
    Res & Educ Inst Child Hlth, Strovolos, Cyprus.
    Michels, N.
    Univ Ghent, Dept Publ Hlth, B-9000 Ghent, Belgium.
    Eiben, Gabriele
    Univ Gothenburg, Dept Publ Hlth & Community Med, Gothenburg, Sweden.
    Ahrens, W.
    Leibniz Inst Prevent Res & Epidemiol BIPS, Bremen, Germany.;Univ Bremen, Fac Math & Comp Sci, Inst Stat, D-28359 Bremen, Germany.
    Moreno, L. A.
    Univ Zaragoza, Growth Exercise Nutr & Dev GENUD Res Grp, Zaragoza, Spain.
    Kovacs, E.
    Univ Pecs, Dept Paediat, H-7623 Pecs, Hungary.
    Molnar, D.
    Univ Pecs, Dept Paediat, H-7623 Pecs, Hungary.
    Reference values for leptin and adiponectin in children below the age of 10 based on the IDEFICS cohort2014In: International Journal of Obesity, ISSN 0307-0565, E-ISSN 1476-5497, Vol. 38, p. S32-S38Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To establish age- and sex-specific reference values for serum leptin and adiponectin in normal-weight 3.0-8.9-year old European children. SUBJECTS AND METHODS: Blood samples for hormone analysis were taken from 1338 children of the IDEFICS (Identification and prevention of Dietary-and lifestyle-induced health Effects in Children and infantS) study cohort. Only normal-weight children aged 3.0-8.9 years were included (n = 539) in our analysis. Using the General Additive Model for Location Scale and Shape, age-and sex-specific percentiles were derived. The influence of under/overweight and obesity on the proposed reference curves based on normal-weight children was investigated in several sensitivity analyses using the sample without obese children (n = 1015) and the whole study sample (n = 1338). RESULTS: There was a negative age trend of adiponectin blood levels and a positive trend of leptin levels in boys and girls. Percentiles derived for girls were generally higher than those obtained for boys. The corresponding age-specific differences of the 97th percentile ranged from -2.2 to 4.6 mu g ml(-1) and from 2.2 to 4.8 ng ml(-1) for adiponectin and leptin, respectively. CONCLUSIONS: According to our knowledge, these are the first reference values of leptin and adiponectin in prepubertal, normal-weight children. The presented adiponectin and leptin reference curves may allow for a more differentiated interpretation of children's hormone levels in epidemiological and clinical studies.

  • 7.
    Hebestreit, A.
    et al.
    Leibniz Inst Prevent Res & Epidemiol BIPS, D-28359 Bremen, Germany.
    Boernhorst, C.
    Leibniz Inst Prevent Res & Epidemiol BIPS, D-28359 Bremen, Germany.
    Pala, V.
    Fdn IRCCS Ist Nazl Tumori, Dept Prevent & Predict Med, Epidemiol & Prevent Unit, Milan, Italy.
    Barba, G.
    CNR, Inst Food Sci, Epidemol & Populat Genet, Avellino, Italy.
    Eiben, Gabriele
    Univ Gothenburg, Dept Publ Hlth & Community Med, Gothenburg, Sweden.
    Veidebaum, T.
    Natl Inst Hlth Dev, Dept Chron Dis, Tallinn, Estonia.
    Hadjigergiou, C.
    Res & Educ Inst Child Hlth, Strovolos, Cyprus.
    Molnar, D.
    Univ Pecs, Dept Pediat, Pecs, Hungary.
    Claessens, M.
    Univ Ghent, Dept Publ Hlth, B-9000 Ghent, Belgium.
    Fernandez-Alvira, J. M.
    Univ Zaragoza, Fac Hlth Sci, GENUD Growth Exercise Nutr & Dev Res Grp, Zaragoza, Spain.
    Pigeot, I.
    Leibniz Inst Prevent Res & Epidemiol BIPS, D-28359 Bremen, Germany.;Univ Bremen, Dept Math & Comp Sci, D-28359 Bremen, Germany.
    Dietary energy density in young children across Europe2014In: International Journal of Obesity, ISSN 0307-0565, E-ISSN 1476-5497, Vol. 38, p. S124-S134Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To describe energy density (ED; kcal g(-1)) of dietary intake of European children. METHODS: From 16 228 children who participated in the IDEFICS (Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS) baseline examination, 8551 children with 24-h dietary recalls (24-HDR), with plausible reported energy intakes and complete covariate information were included in the present analysis. ED was calculated using two methods: (1) ED including solid foods (EDF) and (2) ED including solid foods and energy-containing beverages (EDF&B). Beverage energy was calculated in kcal per day. Dietary characteristics and body mass index (BMI) z-score of children aged 2 to <6 years and 6 to <10 years were compared between children with an overall EDF below the <25th percentile, between the 25th and 75th percentile as well as above the >75th percentile. Standardised regression coefficients were estimated to assess the association between dietary characteristics, BMI z-score and ED of the diet. RESULTS: Children with low EDF and EDF&B diets consumed less energy but higher quantity of food and beverages than children with high EDF and EDF&B diets. Consumption of caloric beverages decreased with increasing EDF&B of the diet owing to the relatively low ED of the beverages, in relation to solid foods. Generally, children with low EDF and EDF&B diets showed healthier food choices than peers with higher EDF and EDF&B diets. In this sample, EDF and EDF&B were not associated with BMI z-score. CONCLUSION: Health promotion strategies should proclaim lower ED diets by means of foods with high water and low fat content and mainly fruit and vegetable components. Excluding caloric beverages from EDF calculation is a useful method to avoid misinterpretation of true exposure to a high energy dense diet. We recommend excluding caloric beverages from EDF calculation when investigating the effect of ED on a certain (health) outcome.

  • 8.
    Herrmann, D.
    et al.
    Univ Bremen, Inst Prevent Res & Social Med, Dept Epidemiol Methods & Etiol Res, D-28359 Bremen, Germany.
    Suling, M.
    Univ Bremen, Bremen Inst Prevent Res & Social Med, Dept Biometry & Data Management, Bremen, Germany.
    Reisch, L.
    Copenhagen Business Sch, Dept Intercultural Commun & Management, Frederiksberg, Denmark.
    Siani, A.
    Inst Food Sci, Unit Epidemiol & Populat Genet, Avellino, Italy.
    De Bourdeaudhuij, I.
    Univ Ghent, Dept Movement & Sports Sci, B-9000 Ghent, Belgium.
    Maes, L.
    Univ Ghent, Dept Publ Hlth, B-9000 Ghent, Belgium.
    Santaliestra-Pasias, A. M.
    Univ Zaragoza, Sch Hlth Sci, Zaragoza, Spain.
    Veidebaum, T.
    Natl Inst Hlth Dev, Dept Chron Dis, Tallinn, Estonia.
    Molnar, D.
    Univ Pecs, Dept Paediat, Pecs, Hungary.
    Pala, V.
    Fdn IRCCS, Dept Prevent & Predict Med, Nutrit Epidemiol Unit, Ist Nazl Tumori, Milan, Italy.
    Kourides, Y.
    Res & Educ Inst Child Hlth, Strovolos, Cyprus.
    Eiben, Gabriele
    Univ Gothenburg, Dept Publ Hlth & Community Med, Gothenburg, Sweden.
    Bammann, K.
    Univ Bremen, Bremen Inst Prevent Res & Social Med, Dept Biometry & Data Management, Bremen, Germany.
    Repeatability of maternal report on prenatal, perinatal and early postnatal factors: findings from the IDEFICS parental questionnaire2011In: International Journal of Obesity, ISSN 0307-0565, E-ISSN 1476-5497, Vol. 35, p. S52-S60Article in journal (Refereed)
    Abstract [en]

    Objective: To investigate the repeatability of maternal self-reported prenatal, perinatal and early postnatal factors within the IDEFICS (Identification and prevention of dietary-and lifestyle-induced health effects in children and infants) study. Design: Data are from the baseline survey of the longitudinal cohort study IDEFICS in eight European countries. Subjects: A total of 420 parents from eight countries (43-61 per country) were asked to complete the parental questionnaire (PQ) twice at least 1 month apart. Measurements: The PQ assesses prenatal (maternal weight gain), perinatal (child's birth weight and length, Caesarean (C)-section, week of delivery) and early postnatal factors (exclusive breastfeeding, breastfeeding, introduction of solid food). Intra-class correlation coefficients (ICCs) were calculated to compare maternal reports on prenatal, perinatal and early postnatal factors between the first and second PQ. Results: In total, 249 data sets were considered for the analyses. Overall, maternal reports for prenatal and perinatal factors showed higher repeatability (ICC = 0.81-1.00, P <= 0.05 for all) than those for early infant nutrition (ICC = 0.33-0.88, P <= 0.05 for all). Perfect agreement was found for parental reports on C-section (ICCall = 1.00, P <= 0.05). There was stronger agreement for duration of breastfeeding (ICC = 0.71, P <= 0.05) compared with exclusive breastfeeding (ICC = 0.33, P <= 0.05). Maternal reports showed moderate correlation for the introduction of several types of food (cereals ICC = 0.64, P <= 0.05; fruits ICC = 0.70, P <= 0.05; meat ICC = 0.83, P <= 0.05; vegetables ICC = 0.75, P <= 0.05), and high correlation (ICC = 0.88, P <= 0.05) for cow's milk. Conclusion: Maternal reports on pregnancy and birth were highly reproducible, but parental recall of early infant nutrition was weaker and should be interpreted more cautiously. International Journal of Obesity (2011) 35, S52-S60; doi:10.1038/ijo.2011.35

  • 9.
    Konstabel, K.
    et al.
    Natl Inst Hlth Dev, Tallinn, Estonia / Univ Tartu, Inst Psychol, EE-50090 Tartu, Estonia.
    Veidebaum, T.
    Natl Inst Hlth Dev, Tallinn, Estonia.
    Verbestel, V.
    Univ Ghent, Dept Movement & Sport Sci, B-9000 Ghent, Belgium.
    Moreno, L. A.
    Univ Zaragoza, Fac Hlth Sci, GENUD Growth Exercise Nutr & Dev Res Grp, Zaragoza, Spain.
    Bammann, K.
    Univ Bremen, Inst Publ Hlth & Nursing Res, D-28359 Bremen, Germany / Leibniz Inst Prevent Res & Epidemiol BIPS, D-28359 Bremen, Germany.
    Tornaritis, M.
    Res & Educ Inst Child Hlth, Strovolos, Cyprus.
    Eiben, Gabriele
    Univ Gothenburg, Dept Publ Hlth & Community Med, Gothenburg, Sweden.
    Molnar, D.
    Univ Pecs, Dept Paediat, Pecs, Hungary.
    Siani, A.
    CNR, Inst Food Sci, Unit Epidemiol & Populat Genet, Avellino, Italy.
    Sprengeler, O.
    Leibniz Inst Prevent Res & Epidemiol BIPS, D-28359 Bremen, Germany.
    Wirsik, N.
    Leibniz Inst Prevent Res & Epidemiol BIPS, D-28359 Bremen, Germany.
    Ahrens, W.
    Leibniz Inst Prevent Res & Epidemiol BIPS, D-28359 Bremen, Germany.;Univ Bremen, Fac Math & Comp Sci, Inst Stat, D-28359 Bremen, Germany.
    Pitsiladis, Y.
    Univ Brighton, Ctr Sport & Exercise Sci & Med SESAME, Eastbourne, England.
    Objectively measured physical activity in European children: the IDEFICS study2014In: International Journal of Obesity, ISSN 0307-0565, E-ISSN 1476-5497, Vol. 38, p. S135-S143Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To provide sex-and age-specific percentile values for levels of physical activity (PA) and sedentary time of European children aged 2.0-10.9 years from eight European countries (Sweden, Germany, Hungary, Italy, Cyprus, Spain, Belgium and Estonia). METHODS: Free-living PA and sedentary time were objectively assessed using ActiGraph GT1M or ActiTrainer activity monitors in all children who had at least 3 days' worth of valid accelerometer data, with at least 8 h of valid recording time each day. The General Additive Model for Location Scale and Shape was used for calculating percentile curves. RESULTS: Reference values for PA and sedentary time in the European children according to sex and age are displayed using smoothed percentile curves for 7684 children (3842 boys and 3842 girls). The figures show similar trends in boys and girls. The percentage of children complying with recommendations regarding moderate-to-vigorous physical activity (MVPA) is also presented and varied considerably between sexes and country. For example, the percentage of study participants who were physically active (as assessed by MVPA) for 60 or more minutes per day ranged from 2.0% (Cyprus) to 14.7% (Sweden) in girls and from 9.5% (Italy) to 34.1% (Belgium) in boys. CONCLUSION: This study provides the most up-to-date sex-and age-specific reference data on PA in young children in Europe. The percentage compliance to MVPA recommendations for these European children varied considerably between sexes and country and was generally low. These results may have important implications for public health policy and PA counselling.

  • 10.
    Kovacs, E.
    et al.
    Univ Pecs, Fac Med, Dept Paediat, H-7623 Pecs, Hungary.
    Siani, A.
    CNR, Inst Food Sci, Unit Epidemiol & Populat Genet, Avellino, Italy.
    Konstabel, K.
    Natl Inst Hlth Dev, Tallinn, Estonia.
    Hadjigeorgiou, C.
    Res & Educ Inst Child Hlth, Strovolos, Cyprus.
    de Bourdeaudhuij, I.
    Univ Ghent, Fac Med & Hlth Sci, Dept Movement & Sports Sci, B-9000 Ghent, Belgium.
    Eiben, Gabriele
    Univ Gothenburg, Dept Publ Hlth & Community Med, Gothenburg, Sweden.
    Lissner, L.
    Univ Gothenburg, Dept Publ Hlth & Community Med, Gothenburg, Sweden.
    Gwozdz, W.
    Copenhagen Business Sch, Dept Intercultural Commun & Management, Frederiksberg, Denmark.
    Reisch, L.
    Copenhagen Business Sch, Dept Intercultural Commun & Management, Frederiksberg, Denmark.
    Pala, V.
    Natl Tumor Inst, Epidemiol & Prevent Unit, Dept Prevent & Predict Med, Milan, Italy.
    Moreno, L. A.
    Univ Zaragoza, GENUD Growth Exercise Nutr & Dev Res Grp, Zaragoza, Spain.
    Pigeot, I.
    Leibniz Inst Prevent Res & Epidemiol BIPS, Bremen, Germany.
    Pohlabeln, H.
    Leibniz Inst Prevent Res & Epidemiol BIPS, Bremen, Germany.
    Ahrens, W.
    Leibniz Inst Prevent Res & Epidemiol BIPS, Bremen, Germany.;Univ Bremen, Fac Math & Comp Sci, Inst Stat, D-28359 Bremen, Germany.
    Molnar, D.
    Univ Pecs, Fac Med, Dept Paediat, H-7623 Pecs, Hungary.
    Adherence to the obesity-related lifestyle intervention targets in the IDEFICS study2014In: International Journal of Obesity, ISSN 0307-0565, E-ISSN 1476-5497, Vol. 38, p. S144-S151Article in journal (Refereed)
    Abstract [en]

    BACKGROUND/OBJECTIVES: To address behaviours associated with childhood obesity, certain target values are recommended that should be met to improve children's health. In the IDEFICS (Identification and prevention of Dietary-and lifestyle-induced health Effects in Children and infantS) study such lifestyle recommendations were conveyed as six key messages. Here, we investigate the adherence of European children to these messages. METHODS: The IDEFICS intervention was based on the intervention mapping approach with the following six targets: increase water consumption (to replace sugar-containing beverages), increase fruit/vegetable consumption, reduce daily screen time, increase daily physical activity, improve the quality of family life and ensure adequate sleep duration. Internationally recommended target values were applied to determine the prevalence of children meeting these targets. RESULTS: In a cohort of 18 745 children participating in the IDEFICS baseline survey or newly recruited during follow-up, data on the above lifestyle behaviours were collected for a varying number of 8302 to 17 212 children. Information on all six behaviours was available for 5140 children. Although 52.5% of the cohort was classified in the highest category of water consumption, only 8.8% met the target of an intake of fruits/vegetables five times a day. The prevalence of children adhering to the recommendation regarding total screen time-below 1 h for pre-school children and 2 h for school children-was 51.1%. The recommended amount of at least 60 min of moderate-to-vigorous physical activity per day was fulfilled by 15.2%. Family life of the child measured by various indicators was considered as satisfactory in 22.8%. Nocturnal sleep duration of 11 (10) hours or more in pre-school (school) children was achieved by 37.9%. In general, children in northern countries and younger children showed better adherence to the recommendations. Only 1.1% of the children adhered to at least five of these recommendations. CONCLUSIONS: Current adherence of children to lifestyle recommendations to prevent childhood obesity is low where observed differences with respect to country, age and gender call for targeted intervention.

  • 11.
    Lanfer, A.
    et al.
    Univ Bremen, Bremen Inst Prevent Res & Social Med, Dept Epidemiol Methods & Etiol Res, D-28359 Bremen, Germany.
    Hebestreit, A.
    Univ Bremen, Bremen Inst Prevent Res & Social Med, Dept Epidemiol Methods & Etiol Res, D-28359 Bremen, Germany.
    Ahrens, W.
    Univ Bremen, Bremen Inst Prevent Res & Social Med, Dept Epidemiol Methods & Etiol Res, D-28359 Bremen, Germany.
    Krogh, V.
    Fdn IRCCS, Dept Prevent & Predict Med, Nutrit Epidemiol Unit, Ist Nazl Tumori, Milan, Italy.
    Sieri, S.
    Fdn IRCCS, Dept Prevent & Predict Med, Nutrit Epidemiol Unit, Ist Nazl Tumori, Milan, Italy.
    Lissner, L.
    Univ Gothenburg, Dept Publ Hlth & Community Med, Gothenburg, Sweden.
    Eiben, Gabriele
    Univ Gothenburg, Dept Publ Hlth & Community Med, Gothenburg, Sweden.
    Siani, A.
    CNR, Inst Food Sci, Unit Epidemiol & Populat Genet, Avellino, Italy.
    Huybrechts, I.
    Univ Ghent, Dept Publ Hlth, B-9000 Ghent, Belgium.
    Loit, H. M.
    Natl Inst Hlth Dev, Dept Chron Dis, Tallinn, Estonia.
    Papoutsou, S.
    Res & Educ Inst Child Hlth, Strovolos, Cyprus.
    Kovacs, E.
    Univ Pecs, Dept Paediat, Pecs, Hungary.
    Pala, V.
    Fdn IRCCS, Dept Prevent & Predict Med, Nutrit Epidemiol Unit, Ist Nazl Tumori, Milan, Italy.
    Reproducibility of food consumption frequencies derived from the Children's Eating Habits Questionnaire used in the IDEFICS study2011In: International Journal of Obesity, ISSN 0307-0565, E-ISSN 1476-5497, Vol. 35, p. S61-S68Article in journal (Refereed)
    Abstract [en]

    Objective: To investigate the reproducibility of food consumption frequencies derived from the food frequency section of the Children's Eating Habits Questionnaire (CEHQ-FFQ) that was developed and used in the IDEFICS (Identification and prevention of dietary-and lifestyle-induced health effects in children and infants) project to assess food habits in 2- to 9-year-old European children. Design and methods: From a subsample of 258 children who participated in the IDEFICS baseline examination, parental questionnaires of the CEHQ were collected twice to assess reproducibility of questionnaire results from 0 to 354 days after the first examination. Weighted Cohen's kappa coefficients (kappa) and Spearman's correlation coefficients (r) were calculated to assess agreement between the first and second questionnaires for each food item of the CEHQ-FFQ. Stratification was performed for sex, age group, geographical region and length of period between the first and second administrations. Fisher's Z transformation was applied to test correlation coefficients for significant differences between strata. Results: For all food items analysed, weighted Cohen's kappa coefficients (kappa) and Spearman's correlation coefficients (r) were significant and positive (P < 0.001). Reproducibility was lowest for diet soft drinks (kappa = 0.23, r = 0.32) and highest for sweetened milk (kappa = 0.68, r = 0.76). Correlation coefficients were comparable to those of previous studies on FFQ reproducibility in children and adults. Stratification did not reveal systematic differences in reproducibility by sex and age group. Spearman's correlation coefficients differed significantly between northern and southern European countries for 10 food items. In nine of them, the lower respective coefficient was still high enough to conclude acceptable reproducibility. As expected, longer time (> 128 days) between the first and second administrations resulted in a generally lower, yet still acceptable, reproducibility. Conclusion: Results indicate that the CEHQ-FFQ gives reproducible estimates of the consumption frequency of 43 food items from 14 food groups in European children. International Journal of Obesity (2011) 35, S61-S68; doi:10.1038/ijo.2011.36

  • 12.
    Suling, M.
    et al.
    Univ Bremen, Inst Prevent Res & Social Med, D-28359 Bremen, Germany.
    Hebestreit, A.
    Univ Bremen, Inst Prevent Res & Social Med, D-28359 Bremen, Germany.
    Peplies, J.
    Univ Bremen, Inst Prevent Res & Social Med, D-28359 Bremen, Germany.
    Bammann, K.
    Univ Bremen, Inst Prevent Res & Social Med, D-28359 Bremen, Germany.
    Nappo, A.
    CNR, Inst Food Sci, Avellino, Italy.
    Eiben, Gabriele
    Univ Gothenburg, Dept Publ Hlth & Community Med, Gothenburg, Sweden.
    Fernandez Alvira, J. M.
    Univ Zaragoza, Dept Physiatr & Nursing, Zaragoza, Spain.
    Verbestel, V.
    Univ Ghent, Dept Movement & Sports Sci, B-9000 Ghent, Belgium.
    Kovacs, E.
    Univ Pecs, Dept Paediat, Pecs, Hungary.
    Pitsiladis, Y. P.
    Univ Glasgow, Coll Med Vet & Life Sci, Inst Cardiovasc & Med Sci, Glasgow, Lanark, Scotland.
    Veidebaum, T.
    Natl Inst Hlth Dev, Tallinn, Estonia.
    Hadjigeorgiou, C.
    Res & Educ Inst Child Hlth, Strovolos, Cyprus.
    Knof, K.
    Bremerhaven Technol Transfer Ctr, Bremerhaven, Germany.
    Ahrens, W.
    Univ Bremen, Inst Prevent Res & Social Med, D-28359 Bremen, Germany.
    Design and results of the pretest of the IDEFICS study2011In: International Journal of Obesity, ISSN 0307-0565, E-ISSN 1476-5497, Vol. 35, p. S30-S44Article in journal (Refereed)
    Abstract [en]

    Background: During the preparatory phase of the baseline survey of the IDEFICS (Identification and prevention of dietary- and lifestyle-induced health effects in children and infants) study, standardised survey procedures including instruments, examinations, methods, biological sampling and software tools were developed and pretested for their feasibility, robustness and acceptability. Methods: A pretest was conducted of full survey procedures in 119 children aged 2-9 years in nine European survey centres (N-per (centre) 4-27, mean 13.22). Novel techniques such as ultrasound measurements to assess subcutaneous fat and bone health, heart rate monitors combined with accelerometers and sensory taste perception tests were used. Results: Biological sampling, physical examinations, sensory taste perception tests, parental questionnaire and medical interview required only minor amendments, whereas physical fitness tests required major adaptations. Callipers for skinfold measurements were favoured over ultrasonography, as the latter showed only a low-to-modest agreement with calliper measurements (correlation coefficients of r = -0.22 and r = 0.67 for all children). The combination of accelerometers with heart rate monitors was feasible in school children only. Implementation of the computer-based 24-h dietary recall required a complex and intensive developmental stage. It was combined with the assessment of school meals, which was changed after the pretest from portion weighing to the more feasible observation of the consumed portion size per child. The inclusion of heel ultrasonometry as an indicator of bone stiffness was the most important amendment after the pretest. Discussion: Feasibility and acceptability of all procedures had to be balanced against their scientific value. Extensive pretesting, training and subsequent refinement of the methods were necessary to assess the feasibility of all instruments and procedures in routine fieldwork and to exchange or modify procedures that would otherwise give invalid or misleading results. International Journal of Obesity (2011) 35, S30-S44; doi:10.1038/ijo.2011.33

  • 13.
    Wolters, M.
    et al.
    Leibniz Inst Prevent Res & Epidemiol BIPS, D-28359 Bremen, Germany.
    Schlenz, H.
    Leibniz Inst Prevent Res & Epidemiol BIPS, D-28359 Bremen, Germany.
    Foraita, R.
    Leibniz Inst Prevent Res & Epidemiol BIPS, D-28359 Bremen, Germany.
    Galli, C.
    Univ Milan, Dept Pharmacol & Biomol Sci, DiSFeB, Milan, Italy.
    Rise, P.
    Univ Milan, Dept Pharmacol & Biomol Sci, DiSFeB, Milan, Italy.
    Moreno, L. A.
    Univ Zaragoza, Growth Exercise Nutr & Dev GENUD Res Grp, Zaragoza, Spain.
    Molnar, D.
    Univ Pecs, Natl Inst Hlth Promot, Pecs, Hungary.
    Russo, P.
    CNR, Inst Food Sci, Epidemiol & Populat Genet, Avellino, Italy.
    Veidebaum, T.
    Natl Inst Hlth Dev, Dept Chron Dis, Tallinn, Estonia.
    Tornaritis, M.
    Res & Educ Inst Child Hlth, Strovolos, Cyprus.
    Vyncke, K.
    Univ Ghent, Dept Publ Hlth, Fac Med & Hlth Sci, B-9000 Ghent, Belgium.
    Eiben, Gabriele
    Queen Silvia Childrens Hosp, Dept Publ Hlth & Community Med, Gothenburg, Sweden.
    Iacoviello, L.
    IRCCS Ist Neurol Mediterraneo Neuromed, Dept Epidemiol & Prevent, Lab Mol & Nutr Epidemiol, Pozzilli, Italy.;Casa Cura Montevergine, Lab Cardiovasc & Neurovasc Epidemiol, Mercogliano, Italy.
    Ahrens, W.
    Leibniz Inst Prevent Res & Epidemiol BIPS, D-28359 Bremen, Germany.;Univ Bremen, Fac Math & Comp Sci, Inst Stat, D-28359 Bremen, Germany.
    Reference values of whole-blood fatty acids by age and sex from European children aged 3-8 years2014In: International Journal of Obesity, ISSN 0307-0565, E-ISSN 1476-5497, Vol. 38, p. S86-S98Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To establish reference values for fatty acids (FA) especially for n-3 and n-6 long-chain polyunsaturated FAs (LC PUFA) in whole-blood samples from apparently healthy 3-8-year-old European children. The whole-blood FA composition was analysed and the age-and sex-specific distribution of FA was determined. DESIGN AND SUBJECTS: Blood samples for FA analysis were taken from 2661 children of the IDEFICS (identification and prevention of dietary-and lifestyle-induced health effects in children and infants) study cohort. Children with obesity (n = 454) and other diseases that are known to alter the FA composition (n = 450) were excluded leaving 1653 participants in the reference population. MEASUREMENTS: The FA composition of whole blood was analysed from blood drops by a rapid, validated gas chromatographic method. RESULTS: Pearson correlation coefficients showed an age-dependent increase of C18:2n-6 and a decrease of C18:1n-9 in a subsample of normal weight boys and girls. Other significant correlations with age were weak and only seen either in boys or in girls, whereas most of the FA did not show any age dependence. For age-dependent n-3 and n-6 PUFA as well as for other FA that are correlated with age (16:0, C18:0 and C18:1n-9) percentiles analysed with the general additive model for location scale and shape are presented. A higher median in boys than in girls was observed for C20:3n-6, C20:4n-6 and C22:4n-6. CONCLUSIONS: Given the reported associations between FA status and health-related outcome, the provision of FA reference ranges may be useful for the interpretation of the FA status of children in epidemiological and clinical studies.

  • 14.
    Zaqout, M.
    et al.
    Univ Ghent, Dept Publ Hlth, Fac Med & Hlth Sci, Ghent, Belgium.
    Michels, N.
    Univ Ghent, Dept Publ Hlth, Fac Med & Hlth Sci, Ghent, Belgium.
    Bammann, K.
    Univ Bremen, Inst Publ Hlth & Nursing Res, Fac Human & Hlth Sci, Bremen, Germany.;Leibniz Inst Prevent Res & Epidemiol BIPS, Bremen, Germany.
    Ahrens, W.
    Leibniz Inst Prevent Res & Epidemiol BIPS, Bremen, Germany.
    Sprengeler, O.
    Leibniz Inst Prevent Res & Epidemiol BIPS, Bremen, Germany.
    Molnar, D.
    Univ Pecs, Fac Med, Dept Pediat, Pecs, Hungary.
    Hadjigeorgiou, C.
    Res & Educ Inst Child Hlth, Strovolos, Cyprus.
    Eiben, Gabriele
    Univ Gothenburg, Sahlgrenska Acad, Dept Publ Hlth & Community Med, Publ Hlth Epidemiol Unit EPI, Gothenburg, Sweden.
    Konstabel, K.
    Natl Inst Hlth Dev, Dept Chron Dis, Ctr Behav & Hlth Sci, Tallinn, Estonia.
    Russo, P.
    CNR, Inst Food Sci, Unit Epidemiol & Populat Genet, Avellino, Italy.
    Jimenez-Pavon, D.
    Univ Zaragoza, GENUD Growth Exercise Nutr & Dev Res Grp, Zaragoza, Spain.
    Moreno, L. A.
    Univ Zaragoza, GENUD Growth Exercise Nutr & Dev Res Grp, Zaragoza, Spain.
    De Henauw, S.
    Univ Ghent, Dept Publ Hlth, Fac Med & Hlth Sci, Ghent, Belgium.
    Influence of physical fitness on cardio-metabolic risk factors in European children. The IDEFICS study2016In: International Journal of Obesity, ISSN 0307-0565, E-ISSN 1476-5497, Vol. 40, no 7, p. 1119-1125Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: The aim of the study was to assess the associations of individual and combined physical fitness components with single and clustering of cardio-metabolic risk factors in children. SUBJECTS/METHODS: This 2-year longitudinal study included a total of 1635 European children aged 6-11 years. The test battery included cardio-respiratory fitness (20-m shuttle run test), upper-limb strength (handgrip test), lower-limb strength (standing long jump test), balance (flamingo test), flexibility (back-saver sit-and-reach) and speed (40-m sprint test). Metabolic risk was assessed through z-score standardization using four components: waist circumference, blood pressure (systolic and diastolic), blood lipids (triglycerides and high-density lipoprotein) and insulin resistance (homeostasis model assessment). Mixed model regression analyses were adjusted for sex, age, parental education, sugar and fat intake, and body mass index. RESULTS: Physical fitness was inversely associated with clustered metabolic risk (P<0.001). All coefficients showed a higher clustered metabolic risk with lower physical fitness, except for upper-limb strength (beta = 0.057; P = 0.002) where the opposite association was found. Cardio-respiratory fitness (beta = -0.124; P<0.001) and lower-limb strength (beta = -0.076; P = 0.002) were the most important longitudinal determinants. The effects of cardio-respiratory fitness were even independent of the amount of vigorous-to-moderate activity (beta = -0.059; P = 0.029). Among all the metabolic risk components, blood pressure seemed not well predicted by physical fitness, while waist circumference, blood lipids and insulin resistance all seemed significantly predicted by physical fitness. CONCLUSION: Poor physical fitness in children is associated with the development of cardio-metabolic risk factors. Based on our results, this risk might be modified by improving mainly cardio-respiratory fitness and lower-limb muscular strength.

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