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  • 1.
    Arvidsson, L.
    et al.
    University of Skövde, School of Health and Education.
    Bogl, L. H.
    Department of Public Health, University of Helsinki, Helsinki, Finland.
    Eiben, Gabriele
    Univ Gothenburg, Sect Epidemiol & Social Med EPSO, Dept Publ Hlth & Community Med, Inst Med,Sahlgrenska Acad, S-40530 Gothenburg, Sweden.
    Hebestreit, A.
    Leibniz Inst Prevent Res & Epidemiol BIPS, Bremen, Germany.
    Nagy, P.
    Univ Pecs, Dept Pediat, Pecs, Hungary.
    Tornaritis, M.
    Res & Educ Inst Child Hlth, Strovolos, Cyprus.
    Moreno, L. A.
    Univ Zaragoza, GENUD Growth Exercise Nutr & Dev Res Grp, Zaragoza, Spain.
    Siani, A.
    CNR, Inst Food Sci, Epidemiol & Populat Genet, Avellino, Italy.
    Veidebaum, T.
    Natl Inst Hlth Dev, Res Ctr, Tallinn, Estonia.
    De Henauw, S.
    Univ Ghent, Dept Publ Hlth, B-9000 Ghent, Belgium.
    Lissner, L.
    Univ Gothenburg, Sect Epidemiol & Social Med EPSO, Dept Publ Hlth & Community Med, Inst Med,Sahlgrenska Acad, S-40530 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, p. 127-137Article in journal (Refereed)
    Abstract [en]

    BackgroundThe 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.

  • 2.
    De Bourdeaudhuij, I.
    et al.
    Univ Ghent, Dept Movement & Sport Sci, B-9000 Ghent, Belgium.
    Verbestel, V.
    Univ Ghent, Dept Movement & Sport Sci, B-9000 Ghent, Belgium.
    De Henauw, S.
    Univ Ghent, Dept Publ Hlth, B-9000 Ghent, Belgium.
    Maes, L.
    Univ Ghent, Dept Publ Hlth, B-9000 Ghent, Belgium.
    Huybrechts, I.
    Int Agcy Res Canc, Dietary Exposure Assessment Grp, F-69372 Lyon, France.
    Marild, S.
    Univ Gothenburg, Dept Pediat, Gothenburg, Sweden.
    Eiben, Gabriele
    Univ Gothenburg, Dept Publ Hlth & Community Med, Gothenburg, Sweden.
    Moreno, L. A.
    Univ Zaragoza, GENUD Growth Exercise Nutr & Dev Res Grp, Zaragoza, Spain.
    Barba, G.
    CNR, Inst Food Sci, Avellino, Italy.
    Kovacs, E.
    Univ Pecs, Dept Paediat, Pecs, Hungary / Univ Munich, Inst Med Informat Proc Biometr & Epidemiol, Munich, Germany.;Univ Munich, German Ctr Vertigo & Balance Disorders, Munich, Germany.
    Konstabel, K.
    Natl Inst Hlth Dev, Tallinn, Estonia.
    Tornaritis, M.
    Res & Educ Inst Child Hlth, Strovolos, Cyprus.
    Gallois, K.
    Leibniz Inst Prevent Res & Epidemiol BIPS, Bremen, Germany.
    Hebestreit, A.
    Leibniz Inst Prevent Res & Epidemiol BIPS, Bremen, Germany.
    Pigeot, I.
    Leibniz Inst Prevent Res & Epidemiol BIPS, Bremen, Germany.;Univ Bremen, Fac Math & Comp Sci, D-28359 Bremen, Germany.
    Behavioural effects of a community-oriented setting-based intervention for prevention of childhood obesity in eight European countries. Main results from the IDEFICS study2015In: Obesity Reviews, ISSN 1467-7881, E-ISSN 1467-789X, Vol. 16, p. 30-40Article in journal (Refereed)
    Abstract [en]

    ObjectiveThe objective of this paper is to evaluate the behavioural effects, as reported by the parents of the participating boys and girls, of the IDEFICS (Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS) intervention. MethodsThe effectiveness of the IDEFICS intervention was evaluated through a cluster-controlled trial in eight European countries (control and intervention communities in each country) including more than 16,000 children. The 2- to 9.9-year-old children in the intervention group were exposed to a culturally adapted intervention that aimed to prevent childhood obesity through the community, schools/kindergartens and family. Parents completed questionnaires to measure water, soft drink and fruit juice intake; fruit and vegetable intake; daily TV viewing and other sedentary behaviours; daily physical activity levels and strengthening of the parent-child relationships at baseline and follow-up (2years later). Mixed models with an additional random effect for country were used to account for the clustered study design, and results were stratified by sex. ResultsThe pan-European analysis revealed no significant time by condition interaction effects, neither for boys nor girls, i.e. the analysis revealed no intervention effects on the behaviours of the IDEFICS children as reported by their parents (F=0.0 to 3.3, all p>0.05). Also very few significances were found in the country-specific analyses. Positive intervention effects were only found for sport club participation in Swedish boys, for screen time in weekends for Spanish boys and for TV viewing in Belgian girls. ConclusionAlthough no expected intervention effects as reported by the parents on diet, physical activity and sedentary behaviours could be shown for the overall IDEFICS cohort, a few favourable intervention effects were found on specific behaviours in some individual countries. More in-depth analyses of the process evaluation data are needed to obtain more insight into the relationship between the level of exposure to the intervention and its effect. 

  • 3.
    Kovacs, E.
    et al.
    Univ Pecs, Fac Med, Dept Paediat, H-7623 Pecs, Hungary / Univ Munich, Inst Med Informat Proc Biometr & Epidemiol, German Ctr Vertigo & Balance Disorders, Munich, Germany.
    Hunsberger, M.
    Univ Gothenburg, Sect Epidemiol & Social Med, Gothenburg, Sweden.
    Reisch, L.
    Copenhagen Business Sch, Dept Intercultural Commun & Management, Copenhagen, Denmark.
    Gwozdz, W.
    Copenhagen Business Sch, Dept Intercultural Commun & Management, Copenhagen, Denmark.
    Eiben, Gabriele
    Univ Gothenburg, Sect Epidemiol & Social Med, Gothenburg, Sweden.
    De Bourdeaudhuij, I.
    Univ Ghent, Dept Movement & Sport Sci, Fac Med & Hlth Sci, B-9000 Ghent, Belgium.
    Russo, P.
    CNR, Inst Food Sci, Unit Epidemiol & Populat Genet, Avellino, Italy.
    Veidebaum, T.
    Natl Inst Hlth Dev, Tallinn, Estonia.
    Hadjigeorgiou, C.
    Res & Educ Inst Child Hlth, Strovolos, Cyprus.
    Sieri, S.
    Natl Tumor Inst, Dept Prevent & Predict Med, Nutr Epidemiol Unit, 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.;Univ Bremen, Inst Stat, Fac Math & Comp Sci, D-28359 Bremen, Germany.
    Ahrens, W.
    Leibniz Inst Prevent Res & Epidemiol BIPS, Bremen, Germany.;Univ Bremen, Inst Stat, Fac Math & Comp Sci, D-28359 Bremen, Germany.
    Pohlabeln, H.
    Leibniz Inst Prevent Res & Epidemiol BIPS, Bremen, Germany.
    Molnar, D.
    Univ Pecs, Fac Med, Dept Paediat, H-7623 Pecs, Hungary.
    Adherence to combined lifestyle factors and their contribution to obesity in the IDEFICS study2015In: Obesity Reviews, ISSN 1467-7881, E-ISSN 1467-789X, Vol. 16, p. 138-150Article in journal (Refereed)
    Abstract [en]

    BackgroundThe Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS (IDEFICS) study investigated the aetiology of childhood obesity and developed a primary prevention programme. MethodsPre-intervention adherence to key behaviours related to childhood obesity, namely water/sweetened drink, fruit/vegetable consumption, daily TV time, physical activity, family time and adequate sleep duration, was measured at baseline. Adherence to international recommendations was converted into a composite score ranging from 0 (none) to 6 (adhering to all). Data on adherence were available for 7,444 to 15,084 children aged 2-9.9years, depending on the behaviour. By means of multi-level logistic regression models adjusted for age, sex and country, we calculated odds ratios (OR) and 95% confidence intervals (CI) to estimate the relationship between adherence to these recommendations and the risk of being overweight/obese. ResultsAdherence ranged from 15.0% (physical activity) to 51.9% (TV time). As adherence increased, a lower chance of being overweight/obese was observed; adhering to only one key behaviour (score=1) meant an OR=0.81 (CI: 0.65-1.01) compared with non-adherence (score=0), while adhering to more than half of the key behaviours (score4) halved the chance for overweight/obesity (OR=0.54, CI: 0.37-0.80). Adherence to physical activity, TV and sleep recommendations was the main driver reducing the chance of being overweight. Overweight/obese children were more likely not to adhere to at least one of the recommended behaviours (19.8%) than normal-weight/thin children (12.9%) ConclusionThe selected key behaviours do not contribute equally to a reduced chance of being overweight. Future interventions may benefit most from moving more, reducing TV time and getting adequate sleep. (c) 2015 World Obesity

  • 4.
    Michels, N.
    et al.
    Univ Ghent, Dept Publ Hlth, Fac Med & Hlth Sci, B-9000 Ghent, Belgium.
    De Henauw, S.
    Univ Ghent, Dept Publ Hlth, Fac Med & Hlth Sci, B-9000 Ghent, Belgium / Univ Coll Ghent, Dept Hlth Sci, Ghent, Belgium.
    Eiben, Gabriele
    Univ Gothenburg, Sect Epidemiol & Social Med, Gothenburg, Sweden.
    Hadjigeorgiou, C.
    Res & Educ Inst Child Hlth, Strovolos, Cyprus.
    Hense, S.
    Leibniz Inst Prevent Res & Epidemiol BIPS, Bremen, Germany.
    Hunsberger, M.
    Univ Gothenburg, Sect Epidemiol & Social Med, Gothenburg, Sweden.
    Konstabel, K.
    Natl Inst Hlth Dev, Tallinn, Estonia.
    Molnar, D.
    Univ Pecs, Dept Paediat, Pecs, Hungary.
    Moreno, L. A.
    Univ Zaragoza, Sch Hlth Sci, GENUD Growth Exercise Nutr & Dev Res Grp, Zaragoza, Spain.
    Siani, A.
    CNR, Inst Food Sci, Epidemiol & Populat Genet, Avellino, Italy.
    De Bourdeaudhuij, I.
    Univ Ghent, Fac Med & Hlth Sci, Dept Movement & Sport Sci, B-9000 Ghent, Belgium.
    Pigeot, I.
    Leibniz Inst Prevent Res & Epidemiol BIPS, Bremen, Germany.;Univ Bremen, Fac Math & Comp Sci, Inst Stat, D-28359 Bremen, Germany.
    Effect of the IDEFICS multilevel obesity prevention on children's sleep duration2015In: Obesity Reviews, ISSN 1467-7881, E-ISSN 1467-789X, Vol. 16, p. 68-77Article in journal (Refereed)
    Abstract [en]

    BackgroundAccording to recent findings, short sleep duration is associated with overweight in children. However, primary prevention efforts aimed at achieving adequate sleep among children are scarce. Therefore, the Identification and prevention of Dietary-induced and lifestyle-induced health EFfects In Children and infantS' (IDEFICS) study implemented a multilevel intervention that included sleep duration as a key behavioural target. The aim of this study is to evaluate sleep duration among children participating in the IDEFICS study. MethodsThe IDEFICS nocturnal sleep intervention was included as part of stress reduction educational messages aimed at parents and children. Sleep was assessed by a parental 24-h recall (only weekdays; n=8,543) and by a diary (weekdays and weekends separately; n=4,150). Mixed linear models tested the intervention effect on sleep duration change between baseline when children were 2-9.9years of age (2007/2008) and follow-up (2009/2010). Logistic mix models were used to study the intervention effect on the presence of TV in the children's bedroom (one of the intervention messages; n=8,668). Additionally, parents provided qualitative data regarding exposure to the intervention. ResultsAbout 51.1% of the parents in the intervention regions reported awareness of the sleep intervention. A small intervention effect was seen on weeknight sleep duration in that the decrease in sleep duration over 2years was smaller in the intervention (15min) as compared with control regions (19min) (p=0.044). There was no overall intervention effect on weekend sleep duration or on the presence of a TV in the bedroom. A small significant time effect between baseline and follow-up was found on bedroom TV presence depending on self-reported intervention exposure (3% increase in TV presence in exposed versus 6.6% increase in non-exposed). Children without a TV in the bedroom had longer nocturnal sleep duration. DiscussionThe sleep component of the intervention did not lead to clinically relevant changes in sleep duration. Future interventions aimed at young children's sleep duration could benefit from more specific and intense messaging than that found in the IDEFICS intervention. Future research should use objective measures of sleep duration as well as intermediate outcomes (sleep knowledge, sleep environment and sleep practices).

  • 5.
    Verbestel, V.
    et al.
    Univ Ghent, Dept Movement & Sport Sci, B-9000 Ghent, Belgium.
    De Henauw, S.
    Univ Ghent, Dept Publ Hlth, B-9000 Ghent, Belgium.
    Barba, G.
    CNR, Unit Epidemiol & Populat Genet, Inst Food Sci, Avellino, Italy.
    Eiben, Gabriele
    Univ Gothenburg, Dept Publ Hlth & Community Med, Sahlgrenska Acad, Gothenburg, Sweden.
    Gallois, K.
    Leibniz Inst Prevent Res & Epidemiol BIPS, Bremen, Germany.
    Hadjigeorgiou, C.
    Res & Educ Inst Child Hlth, Strovolos, Cyprus.
    Konstabel, K.
    Natl Inst Hlth Dev, Tallinn, Estonia.
    Maes, L.
    Univ Ghent, Dept Publ Hlth, B-9000 Ghent, Belgium.
    Marild, S.
    Univ Gothenburg, Dept Pediat, Queen Silvia Childrens Univ Hosp, Gothenburg, Sweden.
    Molnar, D.
    Univ Pecs, Dept Pediat, Pecs, Hungary.
    Moreno, L. A.
    Univ Zaragoza, Fac Hlth Sci, GENUD Growth Exercise Nutr & Dev Res Grp, Zaragoza, Spain.;Univ Sao Paulo, Fac Med, Dept Prevent Med, Sao Paulo, Brazil.
    Oja, L.
    Natl Inst Hlth Dev, Tallinn, Estonia.
    Pitsiladis, Y.
    Univ Glasgow, Coll Med Vet & Life Sci, Glasgow, Lanark, Scotland.
    Ahrens, W.
    Leibniz Inst Prevent Res & Epidemiol BIPS, Bremen, Germany.;Univ Bremen, Inst Stat, Fac Math & Comp Sci, D-28359 Bremen, Germany.
    Pigeot, I.
    Leibniz Inst Prevent Res & Epidemiol BIPS, Bremen, Germany.;Univ Bremen, Inst Stat, Fac Math & Comp Sci, D-28359 Bremen, Germany.
    De Bourdeaudhuij, I.
    Univ Ghent, Dept Movement & Sport Sci, B-9000 Ghent, Belgium.
    Effectiveness of the IDEFICS intervention on objectively measured physical activity and sedentary time in European children2015In: Obesity Reviews, ISSN 1467-7881, E-ISSN 1467-789X, Vol. 16, p. 57-67Article in journal (Refereed)
    Abstract [en]

    BackgroundThis paper reports on the effectiveness of the prevention of dietary- and lifestyle-induced health effects in children and infants (IDEFICS) intervention on objectively measured physical activity (PA) and sedentary time (ST) in 2- to 9.9-year-old European boys and girls. MethodsThe intervention was evaluated after 2years through a non-randomized cluster-controlled trial in eight European countries (one control and one intervention community per country). All children in the intervention group received a culturally adapted childhood obesity prevention programme through the community, schools/kindergartens and family. A random sub-sample of children participating in the IDEFICS study wore an accelerometer at baseline and follow-up for at least 3days (n=9,184). Of this sample, 81% provided valid accelerometer data at baseline (n=7,413; 51% boys; 6.211.76years; boys: 617170cpmday(-1); girls 556 +/- 156cpmday(-1)) and 3,010 children provided valid accelerometer data at baseline and during the follow-up survey 2years later. ResultsIn boys and girls, no significant differences in PA and ST were found between intervention and control groups over 2years. Strong temporal effects were found in the total sample of boys and girls: the percentage of time spent in light PA per day decreased by 4 percentage points in both boys and girls between baseline and follow-up (both: p<0.001), while time spent in ST per day increased by 4 percentage points in both sexes over time (both: p<0.001). Percentage of time spent in moderate-to-vigorous PA per day remained stable over time in boys and girls. ConclusionDespite the socio-ecological approach and implementation of a culturally adapted intervention in each country, no effects of the IDEFICS intervention were found on children's objectively measured PA and ST. Behavioural interventions for children may need to enhance specificity and intensity at the family level using other behaviour change techniques and more direct strategies to reach parents. 

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