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  • 1.
    Abarca-Gómez, Leandra
    et al.
    Caja Costarricense de Seguro Social, Costa Rica.
    Eiben, Gabriele
    Högskolan i Skövde, Institutionen för hälsa och lärande. Högskolan i Skövde, Forskningsspecialiseringen Hälsa och Lärande.
    Ezzati, Majid
    School of Public Health, Imperial College London, London, United Kingdom.
    Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128·9 million children, adolescents, and adults2017Inngår i: The Lancet, ISSN 0140-6736, E-ISSN 1474-547X, Vol. 390, nr 10113, s. 2627-2642Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Underweight, overweight, and obesity in childhood and adolescence are associated with adverse health consequences throughout the life-course. Our aim was to estimate worldwide trends in mean body-mass index (BMI) and a comprehensive set of BMI categories that cover underweight to obesity in children and adolescents, and to compare trends with those of adults.

    METHODS: We pooled 2416 population-based studies with measurements of height and weight on 128·9 million participants aged 5 years and older, including 31·5 million aged 5-19 years. We used a Bayesian hierarchical model to estimate trends from 1975 to 2016 in 200 countries for mean BMI and for prevalence of BMI in the following categories for children and adolescents aged 5-19 years: more than 2 SD below the median of the WHO growth reference for children and adolescents (referred to as moderate and severe underweight hereafter), 2 SD to more than 1 SD below the median (mild underweight), 1 SD below the median to 1 SD above the median (healthy weight), more than 1 SD to 2 SD above the median (overweight but not obese), and more than 2 SD above the median (obesity).

    FINDINGS: Regional change in age-standardised mean BMI in girls from 1975 to 2016 ranged from virtually no change (-0·01 kg/m(2) per decade; 95% credible interval -0·42 to 0·39, posterior probability [PP] of the observed decrease being a true decrease=0·5098) in eastern Europe to an increase of 1·00 kg/m(2) per decade (0·69-1·35, PP>0·9999) in central Latin America and an increase of 0·95 kg/m(2) per decade (0·64-1·25, PP>0·9999) in Polynesia and Micronesia. The range for boys was from a non-significant increase of 0·09 kg/m(2) per decade (-0·33 to 0·49, PP=0·6926) in eastern Europe to an increase of 0·77 kg/m(2) per decade (0·50-1·06, PP>0·9999) in Polynesia and Micronesia. Trends in mean BMI have recently flattened in northwestern Europe and the high-income English-speaking and Asia-Pacific regions for both sexes, southwestern Europe for boys, and central and Andean Latin America for girls. By contrast, the rise in BMI has accelerated in east and south Asia for both sexes, and southeast Asia for boys. Global age-standardised prevalence of obesity increased from 0·7% (0·4-1·2) in 1975 to 5·6% (4·8-6·5) in 2016 in girls, and from 0·9% (0·5-1·3) in 1975 to 7·8% (6·7-9·1) in 2016 in boys; the prevalence of moderate and severe underweight decreased from 9·2% (6·0-12·9) in 1975 to 8·4% (6·8-10·1) in 2016 in girls and from 14·8% (10·4-19·5) in 1975 to 12·4% (10·3-14·5) in 2016 in boys. Prevalence of moderate and severe underweight was highest in India, at 22·7% (16·7-29·6) among girls and 30·7% (23·5-38·0) among boys. Prevalence of obesity was more than 30% in girls in Nauru, the Cook Islands, and Palau; and boys in the Cook Islands, Nauru, Palau, Niue, and American Samoa in 2016. Prevalence of obesity was about 20% or more in several countries in Polynesia and Micronesia, the Middle East and north Africa, the Caribbean, and the USA. In 2016, 75 (44-117) million girls and 117 (70-178) million boys worldwide were moderately or severely underweight. In the same year, 50 (24-89) million girls and 74 (39-125) million boys worldwide were obese.

    INTERPRETATION: The rising trends in children's and adolescents' BMI have plateaued in many high-income countries, albeit at high levels, but have accelerated in parts of Asia, with trends no longer correlated with those of adults.

    FUNDING: Wellcome Trust, AstraZeneca Young Health Programme.

  • 2.
    Ahrens, W.
    et al.
    Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany / Institute of Statistics, Bremen University, Bremen, Germany.
    Siani, A.
    Institute of Food Sciences, National Research Council, Avellino, Italy.
    Adan, R.
    Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands.
    De Henauw, S.
    Department of Public Health, Ghent University, Ghent, Belgium.
    Eiben, Gabriele
    Section for Epidemiology and Social Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Gwozdz, W.
    Department of Intercultural Communication and Management, Copenhagen Business School, Copenhagen, Denmark.
    Hebestreit, A.
    Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.
    Hunsberger, M.
    Section for Epidemiology and Social Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Kaprio, J.
    Department of Public Health, University of Helsinki, Institute for Molecular Medicine (FIMM), Helsinki, Finland.
    Krogh, V.
    Epidemiology and Prevention Unit, Fondazione IRCSS Istituto Nazionale dei Tumori, Milan, Italy.
    Lissner, L.
    Section for Epidemiology and Social Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Molnár, D.
    Department of Paediatrics, University of Pe´cs, Pe´cs, Hungary.
    Moreno, L. A.
    GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain.
    Page, A.
    Centre for Exercise, Nutrition & Health Sciences, University of Bristol, Bristol, UK.
    Picó, C.
    Laboratory of Molecular Biology, Nutrition and Biotechnology (Nutrigenomics), University of the Balearic Islands (UIB) and CIBER Fisiopatologıa de la Obesidad y Nutricion, Palma de Mallorca, Spain.
    Reisch, L.
    Department of Intercultural Communication and Management, Copenhagen Business School, Copenhagen, Denmark.
    Smith, R. M.
    Minerva Communications UK, Andover, UK.
    Tornaritis, M.
    Research and Education Institute of Child Health, Strovolos, Cyprus.
    Veidebaum, T.
    National Institute for Health Development, Tallinn, Estonia.
    Williams, G.
    Department of Politics, Philosophy and Religion, Lancaster University, Lancaster, UK.
    Pohlabeln, H.
    Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.
    Pigeot, I.
    Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany / Institute of Statistics, Bremen University, Bremen, Germany.
    Cohort Profile: The transition from childhood to adolescence in European children-how I.Family extends the IDEFICS cohort2017Inngår i: International Journal of Epidemiology, ISSN 0300-5771, E-ISSN 1464-3685, Vol. 46, nr 5, s. 1394-1395Artikkel i tidsskrift (Fagfellevurdert)
  • 3.
    Arvidsson, L.
    et al.
    Högskolan i Skövde, Institutionen för hälsa och lärande.
    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.Family2015Inngår i: Obesity Reviews, ISSN 1467-7881, E-ISSN 1467-789X, Vol. 16, s. 127-137Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 4.
    Arvidsson, Louise
    et al.
    Högskolan i Skövde, Institutionen för hälsa och lärande.
    Birkhed, Dowen
    Univ Gothenburg, Inst Odontol, Dept Cariol, Gothenburg, Sweden.
    Hunsberger, Monica
    Univ Gothenburg, Sect Epidemiol & Social Med, S-40530 Gothenburg, Sweden.
    Lanfer, Anne
    Leibniz Inst Prevent Res & Epidemiol BIPS GmbH, Bremen, Germany.
    Lissner, Lauren
    Univ Gothenburg, Sect Epidemiol & Social Med, S-40530 Gothenburg, Sweden.
    Mehlig, Kirsten
    Marild, Staffan
    Univ Gothenburg, Queen Silvia Childrens Hosp, Dept Paediat, Gothenburg, Sweden..
    Eiben, Gabriele
    Univ Gothenburg, Sect Epidemiol & Social Med, S-40530 Gothenburg, Sweden.
    BMI, eating habits and sleep in relation to salivary counts of mutans streptococci in children - the IDEFICS Sweden study2016Inngår i: Public Health Nutrition, ISSN 1368-9800, E-ISSN 1475-2727, Vol. 19, nr 6, s. 1088-1092Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: The objective of the present study was to investigate the association between salivary counts of mutans streptococci (MS) and children's weight status, while considering associated covariates. MS ferments carbohydrates from the diet and contributes to caries by lowering the pH in dental plaque. In adults, high counts of MS in saliva have been associated with overweight, but this has not been shown in children. Design: Cross-sectional study investigating salivary counts of MS, BMI Z-score, waist circumference, meal frequency, sugar propensity and sleep duration, in children. Setting: West Sweden. Subjects: Children (n 271) aged 4-11 years. Results: Medium-high counts of MS were positively associated with higher BMI Z-score (OR=1.6; 95 % CI 1.1, 2.3). Positive associations were also found between medium-high counts of MS and more frequent meals per day (OR=1.5; 95 % CI 1.1, 2.2), greater percentage of sugar-rich foods consumed (OR=1.1; 95 % CI 1.0, 1.3) and female sex (OR=2.4; 95 % CI 1.1, 5.4). A negative association was found between medium-high counts of MS and longer sleep duration (OR=0.5; 95 % CI 0.3, 1.0). Conclusions: BMI Z-score was associated with counts of MS. Promoting adequate sleep duration and limiting the intake frequency of sugar-rich foods and beverages could provide multiple benefits in public health interventions aimed at reducing dental caries and childhood overweight.

  • 5.
    Arvidsson, Louise
    et al.
    Section for Epidemiology and Social Medicine (EPSO), The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Eiben, Gabriele
    Section for Epidemiology and Social Medicine (EPSO), The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Hunsberger, Monica
    Section for Epidemiology and Social Medicine (EPSO), The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    De Bourdeaudhuij, Ilse
    Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.
    Molnar, Denes
    Department of Paediatrics, Clinical Center, University of Pécs, Pecs, Hungary.
    Jilani, Hannah
    Leibniz Institute for Prevention Research and Epidemiology-BIPS, Achterstrasse 30, Bremen, 283 59, Germany.
    Thumann, Barbara
    Leibniz Institute for Prevention Research and Epidemiology-BIPS, Achterstrasse 30, Bremen, 283 59, Germany.
    Veidebaum, Toomas
    National Institute for Health Development, Tallinn, Estonia.
    Russo, Paola
    Institute of Food Sciences, CNR Via Roma, Avellino, 64-83100, Italy.
    Tornatitis, Michael
    Research and Education Institute of Child Health REF, Strovolos, Cyprus.
    Santaliestra-Pasías, Alba M
    GENUD (Growth Exercise, Nutrition, and Development) Research Group, University of Zaragoza; Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain.
    Pala, Valeria
    Nutritional Epidemiology Unit, Department of Preventive Medicine, Fondazione IRCSS Istituto Nazionale Dei Tumori, Milan, Italy.
    Lissner, Lauren
    Section for Epidemiology and Social Medicine (EPSO), Sahlgrenska Academy, University of Gothenburg, Box 453, Gothenburg, 405 30, Sweden.
    Bidirectional associations between psychosocial well-being and adherence to healthy dietary guidelines in European children: prospective findings from the IDEFICS study2017Inngår i: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 17, nr 1, artikkel-id 926Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: In children the relationship between a healthy diet and psychosocial well-being has not been fully explored and the existing evidence is inconsistent. This study investigates the chronology of the association between children's adherence to healthy dietary guidelines and their well-being, with special attention to the influence of weight status on the association.

    METHODS: Seven thousand six hundred seventy five children 2 to 9 years old from the eight-country cohort study IDEFICS were investigated. They were first examined between September 2007 and June 2008 and re-examined again 2 years later. Psychosocial well-being was measured using self-esteem and parent relations questions from the KINDL® and emotional and peer problems from the Strengths and Difficulties Questionnaire. A Healthy Dietary Adherence Score (HDAS) was calculated from a 43-item food frequency questionnaire as a measure of the degree to which children's dietary intake follows nutrition guidelines. The analysis employed multilevel logistic regression (country as random effect) with bidirectional modeling of dichotomous dietary and well-being variables as both exposures and outcomes while controlling for respective baseline values.

    RESULTS: A higher HDAS at baseline was associated with better self-esteem (OR 1.2, 95% CI 1.0;1.4) and fewer emotional and peer problems (OR 1.2, 95% CI 1.1;1.3 and OR 1.3, 95% CI 1.2;1.4) 2 years later. For the reversed direction, better self-esteem was associated with higher HDAS 2 years later (OR 1.1 95% CI 1.0;1.29). The analysis stratified by weight status revealed that the associations between higher HDAS at baseline and better well-being at follow-up were similar in both normal weight and overweight children.

    CONCLUSION: Present findings suggest a bidirectional relation between diet quality and self-esteem. Additionally, higher adherence to healthy dietary guidelines at baseline was associated with fewer emotional and peer problems at follow-up, independent of children's weight status.

  • 6.
    Bammann, K.
    et al.
    Univ Bremen, Fac Human & Hlth Sci, Inst Publ Hlth & Nursing Res, D-28359 Bremen, Germany.;BIPS Inst Epidemiol & Prevent Res, Bremen, Germany.
    Gwozdz, W.
    Copenhagen Business Sch, Dept Intercultural Commun & Management, Frederiksberg, Denmark.
    Lanfer, A.
    BIPS Inst Epidemiol & Prevent Res, Bremen, Germany.
    Barba, G.
    CNR, Inst Food Sci, Avellino, Italy.
    De Henauw, S.
    Univ Ghent, Dept Publ Hlth, B-9000 Ghent, Belgium.
    Eiben, Gabriele
    Univ Gothenburg, Dept Publ Hlth & Community Med, Gothenburg, Sweden.
    Fernandez-Alvira, J. M.
    Univ Zaragoza, Growth Exercise Nutr & Dev GENUD Res Grp, Zaragoza, Spain.
    Kovacs, E.
    Univ Pecs, Dept Pediat, Pecs, Hungary.
    Lissner, L.
    Univ Gothenburg, Dept Publ Hlth & Community Med, Gothenburg, Sweden.
    Moreno, L. A.
    Univ Zaragoza, Growth Exercise Nutr & Dev GENUD Res Grp, Zaragoza, Spain.
    Tornaritis, M.
    Res & Educ Inst Child Hlth, Strovolos, Cyprus.
    Veidebaum, T.
    Natl Inst Hlth Dev, Dept Chron Dis, Tallinn, Estonia.
    Pigeot, I.
    BIPS Inst Epidemiol & Prevent Res, Bremen, Germany.
    Socioeconomic factors and childhood overweight in Europe: results from the multi-centre IDEFICS study2013Inngår i: Pediatric Obesity, ISSN 2047-6302, E-ISSN 2047-6310, Vol. 8, nr 1, s. 1-12Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    What is already known about this subject Overweight and obesity can be linked to different parental socioeconomic factors already in very young children. In Western developed countries, the association of childhood overweight and obesity and parental socioeconomic status shows a negative gradient. Ambiguous results have been obtained regarding the association between socioeconomic factors and childhood overweight and obesity in different countries and over time. What this study adds European regions show heterogeneous associations between socioeconomic factors and overweight and obesity in a multi-centre study with highly standardized study protoco. The strength of association between SES and overweight and obesity varies across European regions. In our study, the SES gradient is correlated with the regional mean income and the country-specific Human development index indicating a strong influence not only of the family but also of region and country on the overweight and obesity prevalence. Objective To assess the association between different macro- and micro-level socioeconomic factors and childhood overweight. Methods Data from the IDEFICS baseline survey is used to investigate the cross-sectional association between socioeconomic factors, like socioeconomic status (SES), and the prevalence of childhood overweight. Differences and similarities regarding this relationship in eight European regions (located in Belgium, Cyprus, Estonia, Germany, Hungary, Italy, Spain and Sweden) are explored. 11?994 children (50.9% boys, 49.1% girls) and their parents were included in the analyses. Results In five of the eight investigated regions (in Belgium, Estonia, Germany, Spain and Sweden), the prevalence of childhood overweight followed an inverse SES gradient. In the other three regions (in Cyprus, Hungary and Italy), no association between SES and childhood overweight was found. The SES-overweight association in a region was best explained by the country-specific human development index and the centre-specific mean income. For the investigated association between other socioeconomic factors and overweight, no clear pattern could be found in the different regions. Conclusion The association between socioeconomic factors and childhood overweight was shown to be heterogeneous across different European regions. Further research on nationwide European data is needed to confirm the results and to identify target groups for prevention.

  • 7.
    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 study2017Inngår i: International Journal of Obesity, ISSN 0307-0565, E-ISSN 1476-5497, Vol. 41, nr 1, s. 54-60Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 8.
    Bel-Serrat, Silvia
    et al.
    Univ Zaragoza, Fac Hlth Sci, Growth Exercise Nutr & Dev GENUD Res Grp, E-50009 Zaragoza, Spain.
    Mouratidou, Theodora
    Univ Zaragoza, Fac Hlth Sci, Growth Exercise Nutr & Dev GENUD Res Grp, E-50009 Zaragoza, Spain.
    Pala, Valeria
    Fondaz IRCSS Ist Nazl Tumori, Nutrit Epidemiol Unit, Dept Prevent & Predict Med, Milan, Italy.
    Huybrechts, Inge
    Univ Ghent, Dept Publ Hlth, B-9000 Ghent, Belgium.
    Boernhorst, Claudia
    Univ Bremen, Inst Epidemiol & Prevent Res, BIPS, D-28359 Bremen, Germany.
    Fernandez-Alvira, Juan Miguel
    Univ Zaragoza, Fac Hlth Sci, Growth Exercise Nutr & Dev GENUD Res Grp, E-50009 Zaragoza, Spain.
    Hadjigeorgiou, Charalampos
    Res & Educ Inst Child Hlth, Strovolos, Cyprus.
    Eiben, Gabriele
    Univ Gothenburg, Dept Publ Hlth & Community Med, Gothenburg, Sweden.
    Hebestreit, Antje
    Univ Bremen, Inst Epidemiol & Prevent Res, BIPS, D-28359 Bremen, Germany.
    Lissner, Lauren
    Univ Gothenburg, Dept Publ Hlth & Community Med, Gothenburg, Sweden.
    Molnar, Denes
    Univ Pecs, Fac Med, Dept Pediat, Pecs, Hungary.
    Siani, Alfonso
    Inst Food Sci, Unit Epidemiol & Populat Genet, CNR, Avellino, Italy.
    Veidebaum, Toomas
    Natl Inst Hlth Dev, Ctr Hlth & Behav Sci, Tallinn, Estonia.
    Krogh, Vittorio
    Fondaz IRCSS Ist Nazl Tumori, Nutrit Epidemiol Unit, Dept Prevent & Predict Med, Milan, Italy.
    Moreno, Luis A.
    Univ Zaragoza, Fac Hlth Sci, Growth Exercise Nutr & Dev GENUD Res Grp, E-50009 Zaragoza, Spain.
    Relative validity of the Children's Eating Habits Questionnaire- food frequency section among young European children: the IDEFICS Study2014Inngår i: Public Health Nutrition, ISSN 1368-9800, E-ISSN 1475-2727, Vol. 17, nr 2, s. 266-276Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: To compare, specifically by age group, proxy-reported food group estimates obtained from the food frequency section of the Children's Eating Habits questionnaire (CEHQ-FFQ) against the estimates of two non-consecutive 24h dietary recalls (24-HDR). Design: Estimates of food group intakes assessed via the forty-three-food-group CEHQ-FFQ were compared with those obtained by a computerized 24-HDR. Agreement on frequencies of intakes (equal to the number of portions per recall period) between the two instruments was examined using crude and de-attenuated Pearson's correlation coefficients, cross-classification analyses, weighted kappa statistics (kappa(w)) and Bland-Altman analysis. Setting: Kindergartens/schools from eight European countries participating in the IDEFICS (Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS) Study cross-sectional survey (2007-2008). Subjects: Children aged 2-9 years (n 2508, 50.4% boys). Results: The CEHQ-FFQ provided higher intake estimates for most of the food groups than the 24-HDR. De-attenuated Pearson correlation coefficients ranged from 0.01 (sweetened fruit) to 0.48 (sweetened milk) in children aged 2-<6 years (mean = 0.25) and from 0.01 (milled cereal) to 0.44 (water) in children aged 6-9 years (mean = 0.23). An average of 32 % and 31 % of food group intakes were assigned to the same quartile in younger and older children, respectively, and classification into extreme opposite quartiles was <= 12 % for all food groups in both age groups. Mean kappa(w) was 0.20 for 2-<6-year-olds and 0.17 for 6-9-year-olds. Conclusions: The strength of association estimates assessed by the CEHQ-FFQ and the 24-HDR varied by food group and by age group. Observed level of agreement and CEHQ-FFQ ability to rank children according to intakes of food groups were considered to be low.

  • 9.
    Bixby, Honor
    et al.
    Imperial College London, United Kingdom.
    Eiben, Gabriele
    Högskolan i Skövde, Institutionen för hälsa och lärande. Högskolan i Skövde, Forskningsspecialiseringen Hälsa och Lärande.
    Ezzati, Majid
    Imperial College London, United Kingdom.
    Rising rural body-mass index is the main driver of the global obesity epidemic in adults2019Inngår i: Nature, ISSN 0028-0836, E-ISSN 1476-4687, Vol. 569, nr 7755, s. 260-264Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 10.
    Björkelund, Cecilia
    et al.
    Univ Gothenburg, Dept Publ Hlth & Community Med Primary Hlth Care, Sahlgrenska Acad, Gothenburg, Sweden.
    Andersson-Hange, Dominique
    Univ Gothenburg, Dept Publ Hlth & Community Med Primary Hlth Care, Sahlgrenska Acad, Gothenburg, Sweden.
    Andersson, Kate
    Univ Gothenburg, Dept Publ Hlth & Community Med Primary Hlth Care, Sahlgrenska Acad, Gothenburg, Sweden.
    Bengtsson, Calle
    Univ Gothenburg, Dept Publ Hlth & Community Med Primary Hlth Care, Sahlgrenska Acad, Gothenburg, Sweden.
    Blomstrand, Ann
    Univ Gothenburg, Dept Publ Hlth & Community Med Primary Hlth Care, Sahlgrenska Acad, Gothenburg, Sweden.
    Bondyr-Carlsson, Dorota
    Univ Gothenburg, Dept Publ Hlth & Community Med Primary Hlth Care, Sahlgrenska Acad, Gothenburg, Sweden.
    Eiben, Gabriele
    Univ Gothenburg, Dept Publ Hlth & Community Med Primary Hlth Care, Sahlgrenska Acad, Gothenburg, Sweden.
    Rödström, Kerstin
    Univ Gothenburg, Dept Publ Hlth & Community Med Primary Hlth Care, Sahlgrenska Acad, Gothenburg, Sweden.
    Sjöberg, Agneta
    Univ Gothenburg, Dept Publ Hlth & Community Med Primary Hlth Care, Sahlgrenska Acad, Gothenburg, Sweden.
    Sundh, Valter
    Univ Gothenburg, Dept Publ Hlth & Community Med Primary Hlth Care, Sahlgrenska Acad, Gothenburg, Sweden.
    Weman, Lilian
    Univ Gothenburg, Dept Publ Hlth & Community Med Primary Hlth Care, Sahlgrenska Acad, Gothenburg, Sweden.
    Zylberstein, Dimitri
    Univ Gothenburg, Dept Publ Hlth & Community Med Primary Hlth Care, Sahlgrenska Acad, Gothenburg, Sweden.
    Hakeberg, Magnus
    Univ Gothenburg, Inst Odontol, Sahlgrenska Acad, Gothenburg, Sweden.;Jonkoping Univ, Sch Hlth Sci, Jonkoping, Sweden.
    Lissner, Lauren
    Univ Gothenburg, Dept Publ Hlth & Community Med Primary Hlth Care, Sahlgrenska Acad, Gothenburg, Sweden.
    Secular trends in cardiovascular risk factors with a 36-year perspective: Observations from 38- and 50-year-olds in the Population Study of Women in Gothenburg2008Inngår i: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 26, nr 3, s. 140-146Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives. To study secular trends in cardiovascular risk factors in four different cohorts of women examined in 1968-1969, 1980-1981, 1992-1993 and 2004-2005. Design. Comparison of four representative cohorts of 38- and 50-year-old women over a period of 36 years. Setting. Gothenburg, Sweden with similar to 450 000 inhabitants. Subjects. Four representative samples of 38- and 50-year-old women were invited to free health examinations (participation rate 59-90%, n =1901). Main outcome measures. Body mass index (BMI), systolic and diastolic blood pressure (SBP, DBP), leisure time exercise, use of antihypertensive medication, smoking, levels of haemoglobin, b-glucose, s-cholesterol, s-triglycerides and HDL-cholesterol. Results. There was no significant difference in mean BMI from 1968-1969 versus 2004-2005. Mean leisure time exercise was significantly higher in later born cohorts; in 1968, around 15% were physically active compared with 40% in 2004. SBP and DBP, mean s-cholesterol and s-triglyceride levels were significantly lower in both 38- and 50-year-old cohorts in 2004-2005 versus 1968-1969. HDL-cholesterol (not measured until 1992-1993), showed a significantly higher mean level in 2004-2005. Reduction of risk factors was apparent in women with a high as well as low level of physical activity. Smoking declined most in women with high levels of physical activity. Conclusions. Several cardiovascular risk factors related to lifestyle have improved in middle-aged women from the 1960s until today. Most of the positive trends are observed in women with both low and high physical activity.

  • 11.
    Boernhorst, C.
    et al.
    BIPS Inst Epidemiol & Prevent Res, Bremen, Germany.
    Bel-Serrat, S.
    Univ Zaragoza, Fac Hlth Sci, GENUD Growth Exercise Nutr & Dev Res Grp, E-50009 Zaragoza, Spain.
    Pigeot, I.
    BIPS Inst Epidemiol & Prevent Res, Bremen, Germany.
    Huybrechts, I.
    Univ Ghent, Dept Publ Hlth, B-9000 Ghent, Belgium / Int Agcy Res Canc, Dietary Exposure Assessment Grp, F-69372 Lyon, France.
    Ottavaere, C.
    Univ Ghent, Dept Publ Hlth, B-9000 Ghent, Belgium.
    Sioen, I.
    Univ Ghent, Dept Publ Hlth, B-9000 Ghent, Belgium.
    De Henauw, S.
    Univ Ghent, Dept Publ Hlth, B-9000 Ghent, Belgium / Univ Coll Ghent, Dept Nutr & Dietet, Fac Hlth Care Vesalius, Ghent, Belgium.
    Mouratidou, T.
    Univ Zaragoza, Fac Hlth Sci, GENUD Growth Exercise Nutr & Dev Res Grp, E-50009 Zaragoza, Spain.
    Mesana, M. I.
    Univ Zaragoza, Fac Hlth Sci, GENUD Growth Exercise Nutr & Dev Res Grp, E-50009 Zaragoza, Spain.
    Westerterp, K.
    Maastricht Univ, Dept Human Biol, Maastricht, Netherlands.
    Bammann, K.
    BIPS Inst Epidemiol & Prevent Res, Bremen, Germany / Univ Bremen, Inst Publ Hlth & Nursing Res, D-28359 Bremen, Germany.
    Lissner, L.
    Univ Gothenburg, Dept Publ Hlth & Community Med, Gothenburg, Sweden.
    Eiben, Gabriele
    Univ Gothenburg, Dept Publ Hlth & Community Med, Gothenburg, Sweden.
    Pala, V.
    Fdn IRCSS Ist Nazl Tumori, Nutr Epidemiol Unit, Dept Prevent & Predict Med, Milan, Italy.
    Rayson, M.
    BioTel Ltd Clifton, Bristol, Avon, England.
    Krogh, V.
    Fdn IRCSS Ist Nazl Tumori, Nutr Epidemiol Unit, Dept Prevent & Predict Med, Milan, Italy.
    Moreno, L. A.
    Univ Zaragoza, Fac Hth Sci, GENUD Growth Exercise Nutr & Dev Res Grp, E-50009 Zaragoza, Spain.
    Validity of 24-h recalls in (pre-)school aged children: Comparison of proxy-reported energy intakes with measured energy expenditure2014Inngår i: Clinical Nutrition, ISSN 0261-5614, E-ISSN 1532-1983, Vol. 33, nr 1, s. 79-84Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background & aims: Little is known about the validity of repeated 24-h dietary recalls (24-HDR) as a measure of total energy intake (El) in young children. This study aimed to evaluate the validity of proxy-reported El by comparison with total energy expenditure (TEE) measured by the doubly labeled water (DLW) technique. Methods: The agreement between El and TEE was investigated in 36 (47.2% boys) children aged 4-10 years from Belgium and Spain using subgroup analyses and Bland-Altman plots. Low-energy-reporters (LER), adequate-energy-reporters (AER) and high-energy-reporters (HER) were defined from the ratio of El over TEE by application of age- and sex-specific cut-off values. Results: There was good agreement between means of El (1500 kcal/day) and TEE (1523 kcal/day) at group level though in single children, i.e. at the individual level, large differences were observed. Almost perfect agreement between El and TEE was observed in thin/normal weight children (EI: 1511 kcal/day; TEE: 1513 kcal/day). Even in overweight/obese children the mean difference between El and TEE was only 86 kcal/day. Among the participants, 28(78%) were classified as AER, five (14%) as HER and three (8%) as LER. Conclusion: Two proxy-reported 24-HDRs were found to be a valid instrument to assess El on group level but not on the individual level. (C) 2013 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  • 12.
    Boernhorst, C.
    et al.
    BIPS Inst Epidemiol & Prevent Res, D-28359 Bremen, Germany.
    Huybrechts, I.
    Univ Ghent, Dept Publ Hlth, B-9000 Ghent, Belgium / Int Agcy Res Canc, Dietary Exposure Assessment Grp, F-69372 Lyon, France.
    Ahrens, W.
    BIPS Inst Epidemiol & Prevent Res, D-28359 Bremen, Germany.
    Eiben, Gabriele
    Univ Gothenburg, Dept Publ Hlth & Community Med, S-40530 Gothenburg, Sweden.
    Michels, N.
    Univ Ghent, Dept Publ Hlth, B-9000 Ghent, Belgium.
    Pala, V.
    Fdn IRCSS Ist Nazl Tumori, Dept Prevent & Predict Med, Nutr Epidemiol Unit, I-20133 Milan, Italy.
    Molnar, D.
    Univ Pecs, Fac Med, Dept Pediat, H-7623 Pecs, Hungary.
    Russo, P.
    CNR, Inst Food Sci, I-83100 Avellino, Italy.
    Barba, G.
    CNR, Inst Food Sci, I-83100 Avellino, Italy.
    Bel-Serrat, S.
    Univ Zaragoza, Escuela Univ Ciencias Salud, GENUD Growth Exercise Nutr & Dev Res Grp, E-50009 Zaragoza, Spain.
    Moreno, L. A.
    Univ Zaragoza, Escuela Univ Ciencias Salud, GENUD Growth Exercise Nutr & Dev Res Grp, E-50009 Zaragoza, Spain.
    Papoutsou, S.
    Res & Educ Inst Child Hlth, CY-2027 Strovolos, Cyprus.
    Veidebaum, T.
    Natl Inst Hlth Dev, Ctr Hlth & Behav Sci, EE-11619 Tallinn, Estonia.
    Loit, H. M.
    Center of Health and Behavioral Science, National Institute for Health Development, Hiiu 42, 11619Tallinn, Estonia.
    Lissner, L.
    Int Agcy Res Canc, Dietary Exposure Assessment Grp, F-69372 Lyon, France.
    Pigeot, I.
    BIPS Inst Epidemiol & Prevent Res, D-28359 Bremen, Germany.
    Prevalence and determinants of misreporting among European children in proxy-reported 24 h dietary recalls2013Inngår i: British Journal of Nutrition, ISSN 0007-1145, E-ISSN 1475-2662, Vol. 109, nr 7, s. 1257-1265Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Dietary assessment is strongly affected by misreporting (both under-and over-reporting), which results in measurement error. Knowledge about misreporting is essential to correctly interpret potentially biased associations between diet and health outcomes. In young children, dietary data mainly rely on proxy respondents but little is known about determinants of misreporting here. The present analysis was conducted within the framework of the multi-centre IDEFICS (Identification and prevention of dietary-and lifestyle-induced health effects in children and infants) study and is based on 6101 children aged 2-9 years with 24 h dietary recall (24-HDR) and complete covariate information. Adapted Goldberg cut-offs were applied to classify the 24-HDR as 'over-report', 'plausible report' or 'under-report'. Backward elimination in the course of multi-level logistic regression analyses was conducted to identify factors significantly related to under-and over-reporting. Next to characteristics of the children and parents, social factors and parental concerns/perceptions concerning their child's weight status were considered. Further selective misreporting was addressed, investigating food group intakes commonly perceived as more or less socially desirable. Proportions of under-, plausible and over-reports were 8.0, 88.6 and 3.4%, respectively. The risk of under-reporting increased with age (OR 1.19, 95% CI 1.05, 1.83), BMI z-score of the child (OR 1.23, 95% CI 1.10, 1.37) and household size (OR 1.12, 95% CI 1.01, 1.25), and was higher in low/medium income groups (OR 1.45, 95% CI 1.13, 1.86). Over-reporting was negatively associated with BMI z-scores of the child (OR 0.78, 95% CI 0.69, 0.88) and higher in girls (OR 1.70, 95% CI 1.27, 2.28). Further social desirability and parental concerns/perceptions seemed to influence the reporting behaviour. Future studies should involve these determinants of misreporting when investigating diet-disease relationships in children to correct for the differential reporting bias.

  • 13.
    Börnhorst, Claudia
    et al.
    BIPS Inst Epidemiol & Prevent Res, D-28359 Bremen, Germany.
    Huybrechts, Inge
    Univ Ghent, Dept Publ Hlth, B-9000 Ghent, Belgium.;IARC, Dietary Exposure Assessment Grp DEX, Lyon, France.
    Hebestreit, Antje
    BIPS Inst Epidemiol & Prevent Res, D-28359 Bremen, Germany.
    Vanaelst, Barbara
    Univ Ghent, Dept Publ Hlth, B-9000 Ghent, Belgium.;Res Fdn Flanders FWO, Brussels, Belgium.
    Molnar, Denes
    Univ Pecs, Dept Pediat, Fac Med, Pecs, Hungary.
    Bel-Serrat, Silvia
    Univ Zaragoza, GENUD Growth Exercise Nutr & Dev Res Grp, Zaragoza, Spain.
    Mouratidou, Theodora
    Univ Zaragoza, GENUD Growth Exercise Nutr & Dev Res Grp, Zaragoza, Spain.
    Moreno, Luis A.
    Univ Zaragoza, GENUD Growth Exercise Nutr & Dev Res Grp, Zaragoza, Spain.
    Pala, Valeria
    Fdn IRCSS, Ist Nazl Tumori, Dept Prevent & Predict Med, Nutr Epidemiol Unit, Milan, Italy.
    Eha, Marge
    Natl Inst Hlth Dev, Dept Surveillance & Evaluat, Tallinn, Estonia.
    Kourides, Yiannis A.
    Res & Educ Fdn Child Hlth, Paphos, Cyprus.
    Siani, Alfonso
    CNR, Inst Food Sci, Avellino, Italy.
    Eiben, Gabriele
    Univ Gothenburg, Dept Publ Hlth & Community Med, Gothenburg, Sweden.
    Pigeot, Iris
    BIPS Inst Epidemiol & Prevent Res, D-28359 Bremen, Germany.
    Diet-obesity associations in children: approaches to counteract attenuation caused by misreporting2013Inngår i: Public Health Nutrition, ISSN 1368-9800, E-ISSN 1475-2727, Vol. 16, nr 2, s. 256-266Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: Measurement errors in dietary data lead to attenuated estimates of associations between dietary exposures and health outcomes. The present study aimed to compare and evaluate different approaches of handling implausible reports by exemplary analysis of the association between dietary intakes (total energy, soft drinks, fruits/vegetables) and overweight/obesity in children. Design: Cross-sectional multicentre study. Setting: Kindergartens/schools from eight European countries participating in the IDEFICS Study. Subjects: Children (n 5357) aged 2-9 years who provided one 24 h dietary recall and complete covariate information. Results: The 24 h recalls were classified into three reporting groups according to adapted Goldberg cut-offs: under-report, plausible report or over-report. In the basic logistic multilevel model (adjusted for age and sex, including study centre as random effect), the dietary exposures showed no significant association with overweight/obesity (energy intake: OR=0.996 (95% CI 0.983, 1.010); soft drinks: OR=0.999 (95% CI 0.986, 1.013)) and revealed even a positive association for fruits/vegetables (OR=1.009 (95% CI 1.001, 1.018)). When adding the reporting group (dummy variables) and a propensity score for misreporting as adjustment terms, associations became significant for energy intake as well as soft drinks (energy: OR=1.074 (95% CI 1.053, 1.096); soft drinks: OR=1.015 (95% CI 1.000, 1.031)) and the association between fruits/vegetables and overweight/obesity pointed to the reverse direction compared with the basic model (OR=0.993 (95% CI 0.984, 1.002)). Conclusions: Associations between dietary exposures and health outcomes are strongly affected or even masked by measurement errors. In the present analysis consideration of the reporting group and inclusion of a propensity score for misreporting turned out to be useful tools to counteract attenuation of effect estimates.

  • 14.
    Cabrera, C.
    et al.
    Department of Primary Health Care, Sahlgrenska Academy at Göteborg University, Göteborg, Sweden / Nordic School of Public Health, Göteborg, Sweden.
    Rothenberg, E.
    Geriatric Medicine, Sahlgrenska Academy at Göteborg University, Department for Clinical Nutrition, Göteborg, Sweden / Sahlgrenska University Hospital, Göteborg, Sweden.
    Eriksson, B. G.
    Department of Sociology, Göteborg University, Göteborg, Sweden.
    Wedel, H.
    Nordic School of Public Health, Göteborg, Sweden.
    Eiben, Gabriele
    Department of Primary Health Care, Sahlgrenska Academy at Göteborg University, Göteborg, Sweden.
    Steen, B.
    Geriatric Medicine, Sahlgrenska Academy at Göteborg University, Department for Clinical Nutrition, Göteborg, Sweden.
    Lissner, L.
    Department of Primary Health Care, Sahlgrenska Academy at Göteborg University, Göteborg, Sweden / Nordic School of Public Health, Göteborg, Sweden.
    Socio-economic gradient in food selection and diet quality among 70-year olds2007Inngår i: The Journal of Nutrition, Health & Aging, ISSN 1279-7707, E-ISSN 1760-4788, Vol. 11, nr 6, s. 466-473Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: The aim of this study was to assess social disparities in food choices and diet quality in a population of 70-year old Swedes. Design: Cross-sectional study among participants in the 2000 Gerontological and Geriatric Population Studies in Goteborg. Participants: A representative population of men (n=233) and women (n=321) from Goteborg, a city on the south western coast of Sweden. Methods: One hour diet history interviews were performed and 35 specific foods and food groups were identified; in addition a diet quality index (DQI) was calculated. Differences in food choices and diet quality scores were tested across educational and socio-economic index categories (SEI). Results: Men with higher education and SEI had higher diet quality scores than those with lower socio-economic status, while no differences in DQI were noted in women. Further analysis of women based on their husband's occupational group also yielded no differences in diet quality. When studying individual foods, socio-economic differences were observed in women and men. Conclusions: Selection of food varies by education and occupational status in both sexes although socio-economic disparities in diet quality were observed in men only.

  • 15.
    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 study2015Inngår i: Obesity Reviews, ISSN 1467-7881, E-ISSN 1467-789X, Vol. 16, s. 30-40Artikkel i tidsskrift (Fagfellevurdert)
    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. 

  • 16.
    De Decker, Annelies
    et al.
    Univ Ghent, Dept Publ Hlth, Fac Med & Hlth Sci, De Pintelaan 185 UZ 4K3, B-9000 Ghent, Belgium.
    Verbeken, Sandra
    Univ Ghent, Fac Psychol & Educ Sci, Dept Dev Personal & Social Psychol, Henri Dunantlaan 2, B-9000 Ghent, Belgium.
    Sioen, Isabelle
    Univ Ghent, Dept Publ Hlth, Fac Med & Hlth Sci, De Pintelaan 185 UZ 4K3, B-9000 Ghent, Belgium / Univ Ghent, Fac Biosci Engn, Dept Food Safety & Food Qual, Coupure Links 653, B-9000 Ghent, Belgium.
    Van Lippevelde, Wendy
    Univ Ghent, Dept Publ Hlth, Fac Med & Hlth Sci, De Pintelaan 185 UZ 4K3, B-9000 Ghent, Belgium.
    Braet, Caroline
    Univ Ghent, Fac Psychol & Educ Sci, Dept Dev Personal & Social Psychol, Henri Dunantlaan 2, B-9000 Ghent, Belgium.
    Eiben, Gabrielle
    Univ Gothenburg, Dept Publ Hlth & Community Med, Box 453, S-40530 Gothenburg, Sweden.
    Pala, Valeria
    Fdn IRCSS Ist Nazl Tumori, Dept Prevent & Predict Med, Via Venezian 1, I-20133 Milan, Italy.
    Reish, Lucia A.
    Copenhagen Business Sch, Dept Intercultural Commun & Management, Porcelaenshaven 18a, DK-2000 Frederiksberg, Denmark.
    De Henauw, Stefaan
    Univ Ghent, Dept Publ Hlth, Fac Med & Hlth Sci, De Pintelaan 185 UZ 4K3, B-9000 Ghent, Belgium / Vesalius Univ Coll Ghent, Dept Hlth Sci, Keramiekstr 80, B-9000 Ghent, Belgium.
    Palatable food consumption in children: interplay between (food) reward motivation and the home food environment2017Inngår i: European Journal of Pediatrics, ISSN 0340-6199, E-ISSN 1432-1076, Vol. 176, nr 4, s. 465-474Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    To understand the importance of the home food environment on unhealthy food consumption in children high in reward sensitivity, this study tested the hypothesis that the home availability of unhealthy food moderates the effect of reward sensitivity on children's fast-food consumption frequency, exerted via food cue responsiveness. Children between 7.5 and 14 years (n = 174, 50.6% boys) reported on reward sensitivity and food cue responsiveness (by means of the subscale 'external eating'). Their height and weight were measured. Parents reported on their children's fast-food consumption frequency, food cue responsiveness (by means of the subscale 'food responsiveness'), and on the home availability of unhealthy foods. Two moderated mediation models were conducted, one with the parent- and one with the child-reported food cue responsiveness as mediator. Findings suggested that with a high home availability of unhealthy foods, (a) a higher fast-food consumption frequency was found in children high in reward sensitivity and (b) the relation between reward sensitivity and the fast-food consumption frequency was mediated by external eating. Conclusions: The findings point at the importance of the home food environment in children high in reward sensitivity. They suggest to limit the home availability of unhealthy foods.

  • 17.
    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 study2014Inngår i: International Journal of Obesity, ISSN 0307-0565, E-ISSN 1476-5497, Vol. 38, s. S67-S75Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 18.
    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?2011Inngår i: International Journal of Obesity, ISSN 0307-0565, E-ISSN 1476-5497, Vol. 35, s. S16-S23Artikkel i tidsskrift (Fagfellevurdert)
    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

  • 19.
    Eiben, Gabriele
    et al.
    Department of Primary Health Care, Sahlgrenska Academy at Göteborg University, Göteborg, Sweden.
    Andersson, C. S.
    Department of Primary Health Care, Sahlgrenska Academy at Göteborg University, Göteborg, Sweden / Department of Geriatric Medicine, Sahlgrenska Academy at Göteborg University, Göteborg, Sweden.
    Rothenberg, E.
    Department of Geriatric Medicine, Sahlgrenska Academy at Göteborg University, Göteborg, Sweden / Department for Clinical Nutrition, Sahlgrenska University Hospital, Göteborg, Sweden.
    Sundh, V.
    Department of Geriatric Medicine, Sahlgrenska Academy at Göteborg University, Göteborg, Sweden.
    Steen, B.
    Department of Geriatric Medicine, Sahlgrenska Academy at Göteborg University, Göteborg, Sweden.
    Lissner, L.
    Department of Primary Health Care, Sahlgrenska Academy at Göteborg University, Göteborg, Sweden / Nordic School of Public Health, Göteborg, Sweden.
    Secular trends in diet among elderly Swedes – cohort comparisons over three decades2004Inngår i: Public Health Nutrition, ISSN 1368-9800, E-ISSN 1475-2727, Vol. 7, nr 5, s. 637-644Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: The purpose of this study was to compare dietary practices among different birth cohorts of 70-year-old Swedes, who were examined between 1971 and 2000.

    SETTING: Göteborg, Sweden.

    DESIGN: Four population-based samples of 1360 70-year-olds, born in 1901, 1911, 1922 and 1930, have undergone health examinations and dietary assessments over a period of almost three decades. One-hour diet history (DH) interviews were conducted in 1971, 1981, 1992 and 2000 with a total of 758 women and 602 women. The formats and contents of the dietary examinations were similar over the years. Statistical analysis of linear trends was conducted, using year of examination as the independent variable, to detect secular trends in food and nutrient intakes across cohorts.

    RESULTS: At the 2000 examination, the majority of 70-year-olds consumed nutritionally adequate diets. Later-born cohorts consumed more yoghurt, breakfast cereals, fruit, vegetables, chicken, rice and pasta than earlier-born cohorts. Consumption of low-fat spread and milk also increased, along with that of wine, light beer and candy. In contrast, potatoes, cakes and sugar were consumed less in 2000 than in 1971. The ratio of reported energy intake to estimated basal metabolic rate did not show any systematic trend over time in women, but showed a significant upward trend in men.

    CONCLUSIONS: The diet history method has captured changes in food selections in the elderly without changing in general format over three decades. Dietary quality has improved in a number of ways, and these findings in the elderly are consistent with national food consumption trends in the general population.

  • 20.
    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 years2005Inngår i: International Journal of Obesity, ISSN 0307-0565, E-ISSN 1476-5497, Vol. 29, nr 7, s. 810-817Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 21.
    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 women2006Inngår i: International Journal of Obesity, ISSN 0307-0565, E-ISSN 1476-5497, Vol. 30, nr 4, s. 691-696Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 22.
    Eiben, Gabriele
    et al.
    Sahlgrenska akademin, Göteborgs universitet, Sweden.
    Mårild, Staffan
    Sahlgrenska akademin, Göteborgs universitet, Sweden.
    A healthy diet: key factor in efforts to tackle child obesity2014Inngår i: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 111, nr 11, s. 489-92Artikkel i tidsskrift (Annet vitenskapelig)
  • 23.
    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 cohort2014Inngår i: International Journal of Obesity, ISSN 0307-0565, E-ISSN 1476-5497, Vol. 38, s. S32-S38Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 24.
    Fernandez-Alvira, J. M.
    et al.
    Univ Zaragoza, Fac Hlth Sci, GENUD Growth Exercise Nutr & Dev Res Gr, E-50009 Zaragoza, Spain.
    Bammann, K.
    Univ Bremen, Inst Publ Hlth & Nursing Sci Ipp, D-28359 Bremen, Germany.;Leibniz Inst Prevent Res & Epidemiol BIPS GmbH, Bremen, Germany.
    Pala, V.
    Fdn IRCCS, Ist Nazl Tumori, Dept Prevent & Predict Med, Nutr Epidemiol Unit, Milan, Italy.
    Krogh, V.
    Fdn IRCCS, Ist Nazl Tumori, Dept Prevent & Predict Med, Nutr Epidemiol Unit, Milan, Italy.
    Barba, G.
    CNR, Inst Food Sci, Unit Epidemiol & Populat Genet, Avellino, Italy.
    Eiben, Gabriele
    Univ Gothenburg, Sahlgrenska Acad, Dept Publ Hlth & Community Med, Publ Hlth Epidemiol Unit, Gothenburg, Sweden.
    Hebestreit, A.
    Leibniz Inst Prevent Res & Epidemiol BIPS GmbH, Bremen, Germany.
    Veidebaum, T.
    Natl Inst Hlth Dev, Dept Chron Dis, Tallinn, Estonia.
    Reisch, L.
    Copenhagen Business Sch, Copenhagen, Denmark.
    Tornaritis, M.
    Res & Educ Inst Child Hlth, Strovolos, Cyprus.
    Kovacs, E.
    Univ Pecs, Dept Paediat, Pecs, Hungary.
    Huybrechts, I.
    Univ Ghent, Dept Publ Hlth, B-9000 Ghent, Belgium / Int Agcy Res Canc, Dietary Exposure assessment Grp, F-69372 Lyon, France.
    Moreno, L. A.
    Univ Zaragoza, Fac Hlth Sci, GENUD Growth Exercise Nutr & Dev Res Gr, E-50009 Zaragoza, Spain.
    Country-specific dietary patterns and associations with socioeconomic status in European children: the IDEFICS study2014Inngår i: European Journal of Clinical Nutrition, ISSN 0954-3007, E-ISSN 1476-5640, Vol. 68, nr 7, s. 811-821Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND/OBJECTIVES: Children from lower socioeconomic status (SES) may be at higher risk of unhealthy eating. We described country-specific dietary patterns among children aged 2-9 years from eight European countries participating in the IDEFICS study and assessed the association of dietary patterns with an additive SES indicator. SUBJECTS/METHODS: Children aged 2-9 years from eight European countries were recruited in 2007-2008. Principal component analysis was applied to identify dietary country-specific patterns. Linear regression analyses were applied to assess their association with SES. RESULTS: Two to four dietary patterns were identified in the participating regions. The existence of a 'processed' pattern was found in the eight regions. Also, a 'healthy' pattern was identified in seven of the eight regions. In addition, region-specific patterns were identified, reflecting the existing gastronomic and cultural differences in Europe. The 'processed' pattern was significantly inversely associated with the SES additive indicator in all countries except Sweden, whereas the 'healthy' pattern was positively associated with SES in the Belgian, Estonian, German and Hungarian regions, but was not significant in the Italian, Spanish and Swedish regions. CONCLUSIONS: A 'processed' pattern and a 'healthy' pattern were found in most of the participating countries in the IDEFICS study, with comparable food item profiles. The results showed a strong inverse association of SES with the 'processed' pattern, suggesting that children of parents with lower SES may be at higher risk of unhealthy eating. Therefore, special focus should be given to parents and their children from lower SES levels when developing healthy eating promotion strategies.

  • 25.
    Fernández-Alvira, Juan Miguel
    et al.
    GENUD (Growth, Exercise, NUtrition and Development) Research Group, Faculty of Health Sciences, University of Zaragoza, Edificio del SAI,C/Pedro Cerbuna s/n, Zaragoza, Spain / Fundación Centro Nacional de Investigaciones Cardiovasculares Carlos III, Madrid, Spain.
    Bammann, Karin
    Institute for Public Health and Nursing Sciences (IPP),University of Bremen,Bremen,Germany.
    Eiben, Gabriele
    Department of Public Health and Community Medicine, Public Health Epidemiology Unit (EPI), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Hebestreit, Antje
    Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.
    Kourides, Yannis A.
    Research and Education Institute of Child Health, Strovolos, Cyprus.
    Kovacs, Eva
    Institute for Medical Information Processing, Biometrics and Epidemiology and German Center for Vertigo and Balance Disorders, Ludwig-Maximilians-University, Munich, Germany.
    Michels, Nathalie
    Department of Public Health,Ghent University,Ghent,Belgium.
    Pala, Valeria
    Department of Preventive and Predictive Medicine, Epidemiology Unit,Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
    Reisch, Lucia
    Copenhagen Business School, Copenhagen, Denmark.
    Russo, Paola
    Institute of Food Sciences, National Research Council, Avellino, Italy.
    Veidebaum, Tomas
    Department of Chronic Diseases, National Institute for Health Development, Tallinn, Estonia.
    Moreno, Luis A.
    GENUD (Growth, Exercise, NUtrition and Development) Research Group, Faculty of Health Sciences, University of Zaragoza, Edificio del SAI,C/Pedro Cerbuna s/n, Zaragoza, Spain / Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón), Aragón, Spain / Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Spain.
    Börnhorst, Claudia
    Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.
    Prospective associations between dietary patterns and body composition changes in European children: the IDEFICS study2017Inngår i: Public Health Nutrition, ISSN 1368-9800, E-ISSN 1475-2727, Vol. 20, nr 18, s. 3257-3265Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: To describe dietary patterns by applying cluster analysis and to describe the cluster memberships of European children over time and their association with body composition changes.

    DESIGN: The analyses included k-means clustering based on the similarities between the relative frequencies of consumption of forty-three food items and regression models were fitted to assess the association between dietary patterns and body composition changes.

    SETTING: Primary schools and pre-schools of selected regions in Italy, Estonia, Cyprus, Belgium, Sweden, Hungary, Germany and Spain.

    SUBJECTS: Participants (n 8341) in the baseline (2-9 years old) and follow-up (4-11 years old) surveys of the IDEFICS (Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS) study.

    RESULTS: Three persistent clusters were obtained at baseline and follow-up. Children consistently allocated to the 'processed' cluster presented increased BMI (β=0·050; 95 % CI 0·006, 0·093), increased waist circumference (β=0·071; 95 % CI 0·001, 0·141) and increased fat mass gain (β=0·052; 95 % CI 0·014, 0·090) over time v. children allocated to the 'healthy' cluster. Being in the 'processed'-'sweet' cluster combination was also linked to increased BMI (β=0·079; 95 % CI 0·015, 0·143), increased waist circumference (β=0·172; 95 % CI 0·069, 0·275) and increased fat mass gain (β=0·076; 95 % CI 0·019, 0·133) over time v. the 'healthy' cluster.

    CONCLUSIONS: Children consistently showing a processed dietary pattern or changing from a processed pattern to a sweet pattern presented the most unfavourable changes in fat mass and abdominal fat. These findings support the need to promote overall healthy dietary habits in obesity prevention and health promotion programmes targeting children.

  • 26.
    Gonzalez-Gil, E. M.
    et al.
    Univ Zaragoza, GENUD Growth Exercise NUtr & Dev Res Grp, Fac Hlth Sci, Zaragoza, Spain.
    Santabarbara, J.
    Minist Sci & Innovat, Ctr Invest Biomed Red Salud Mental CIBERSAM, Madrid, Spain.;Univ Zaragoza, Dept Prevent Med & Publ Hlth, Zaragoza, Spain.
    Siani, A.
    CNR, Unit Epidemiol & Populat Genet, Inst Food Sci, Avellino, Italy.
    Ahrens, W.
    Leibniz Inst Prevent Res & Epidemiol BIPS, Dept Epidemiol Methods & Etiol Res, Bremen, Germany / Univ Bremen, Fac Math & Comp Sci, Inst Stat, Bremen, Germany.
    Sioen, I.
    Univ Ghent, Fac Med & Hlth Sci, Dept Publ Hlth, Ghent, Belgium.
    Eiben, Gabriele
    Univ Gothenburg, Sahlgrenska Acad, Dept Community Med & Publ Hlth, Gothenburg, Sweden.
    Guenther, K.
    Leibniz Inst Prevent Res & Epidemiol BIPS, Dept Epidemiol Methods & Etiol Res, Bremen, Germany.
    Iacoviello, L.
    IRCCS Mediterranean Neurol Inst NEUROMED, Dept Epidemiol & Prevent, Lab Mol & Nutr Epidemiol, Pozzilli, Italy.
    Molnar, D.
    Univ Pecs, Fac Med, Dept Pediat, Pecs, Hungary.
    Rise, P.
    Univ Milan, Dept Pharmacol & Biomol Sci, Milan, Italy.
    Russo, P.
    CNR, Unit Epidemiol & Populat Genet, Inst Food Sci, Avellino, Italy.
    Tornaritis, M.
    REF, Res & Educ Inst Child Hlth, Strovolos, Cyprus.
    Veidebaum, T.
    Tervise Arengu Inst, Natl Inst Hlth Dev, Tallinn, Estonia.
    Galli, C.
    Univ Milan, Dept Pharmacol & Biomol Sci, Milan, Italy.
    Moreno, L. A.
    Univ Zaragoza, GENUD Growth Exercise NUtr & Dev Res Grp, Fac Hlth Sci, Zaragoza, Spain.
    Whole-blood fatty acids and inflammation in European children: the IDEFICS Study2016Inngår i: European Journal of Clinical Nutrition, ISSN 0954-3007, E-ISSN 1476-5640, Vol. 70, nr 7, s. 819-823Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND/OBJECTIVES: Fatty acids are hypothesized to influence cardiovascular disease risk because of their effect on inflammation. The aim of this study is to assess the relationship between whole-blood fatty acids (WBFAs) and high-sensitivity C-reactive protein (hs-CRP) in European children. SUBJECTS/METHODS: A total of 1401 subjects (697 boys and 704 girls) aged between 2 and 9 years from the IDEFICS (Identification and prevention of Dietary- and lifestyle-induced health EFfects in Children and infantS) study were measured in this cross-sectional analysis. The sample was divided into three categories of hs-CRP. Associations between WBFA and hs-CRP were assessed by logistic regression models adjusting for body mass index (BMI), country, age, breastfeeding, mother's education and hours of physical activity. RESULTS: Linoleic acid (LA) (P = 0.013, 95% confidence interval (CI):0.822-0.977) and sum of n-6 WBFA (P = 0.029, 95% CI: 0.866-0.992) concentrations were associated with lower concentrations of hs-CRP in boys. In girls, a high ratio of eicosapentaenoic acid (EPA)/arachidonic acid (AA) was associated (P = 0.018, 95% CI: 0.892-0.989) with lower hs-CRP concentrations. In contrast, sum of blood n-6 highly unsaturated fatty acids (P = 0.012, 95% CI: 1.031-1.284), AA (P = 0.007, 95% CI: 1.053-1.395) and AA/LA ratio (P = 0.005, 95% CI: 1.102-1.703) were associated (P < 0.05) with higher concentrations of hs-CRP in girls. CONCLUSIONS: The n-6 WBFAs (sum of n-6 FA and LA) were associated with lower hs-CRP in boys and with higher hs-CRP in girls (AA, sum of n-6 highly unsaturated and AA/LA ratio). More studies are needed to identify the optimal levels of WBFAs to avoid low-grade inflammation in children considering the differences by sex and BMI.

  • 27.
    Gwozdz, Wencke
    et al.
    Copenhagen Business Sch, Dept Intercultural Commun & Management, Ctr Corp Social Responsibil, DK-2000 Frederiksberg, Denmark.
    Sousa-Poza, Alfonso
    Institute for Health Care & Public Management, University of Hohenheim, Germany.
    Reisch, Lucia A.
    Copenhagen Business Sch, Dept Intercultural Commun & Management, Ctr Corp Social Responsibil, DK-2000 Frederiksberg, Denmark.
    Ahrens, Wolfgang
    Univ Bremen, Bremen Inst Prevent Res & Social Med, D-28359 Bremen, Germany.
    Eiben, Gabriele
    Univ Gothenburg, Sahlgrenska Acad, Dept Publ Hlth & Community Med, Publ Hlth Epidemiol Unit, Gothenburg, Sweden.
    Fernandez-Alvira, Juan M.
    Univ Zaragoza, Growth Exercise Nutr & Dev Res Grp, Zaragoza, Spain.
    Hadjigeorgiou, Charalampos
    Res & Educ Inst Child Hlth, Strovolos, Cyprus.
    De Henauwg, Stefaan
    Univ Ghent, Univ Hosp, Dept Publ Hlth, Fac Med & Hlth Sci, Ghent, Belgium.
    Kovacs, Eva
    Univ Pecs, Fac Med, Dept Paediat, Pecs, Hungary.
    Lauria, Fabio
    Institute of Food Science & Technology, National Research Council, Italy.
    Veidebaum, Toomas
    Natl Inst Hlth Dev, Tallinn, Estonia.
    Williams, Garrath
    Univ Lancaster, Dept Polit Philosophy & Relig, Lancaster, England.
    Bammann, Karin
    Univ Bremen, Bremen Inst Prevent Res & Social Med, D-28359 Bremen, Germany.;Univ Bremen, Inst Publ Hlth & Nursing Res, D-28359 Bremen, Germany.
    Maternal employment and childhood obesity: A European perspective2013Inngår i: Journal of Health Economics, ISSN 0167-6296, E-ISSN 1879-1646, Vol. 32, nr 4, s. 728-742Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The substantial increase in female employment rates in Europe over the past two decades has often been linked in political and public rhetoric to negative effects on child development, including obesity. We analyse this association between maternal employment and childhood obesity using rich objective reports of various anthropometric and other measures of fatness from the IDEFICS study of children aged 2-9 in 16 regions of eight European countries. Based on such data as accelerometer measures and information from nutritional diaries, we also investigate the effects of maternal employment on obesity's main drivers: calorie intake and physical activity. Our analysis provides little evidence for any association between maternal employment and childhood obesity, diet or physical activity. (c) 2013 Elsevier B.V. All rights reserved.

  • 28.
    Gwozdz, Wencke
    et al.
    Copenhagen Business Sch, Dept Intercultural Commun & Management, Ctr Corp Social Responsibil, Copenhagen, Denmark.
    Sousa-Poza, Alfonso
    Univ Hohenheim, Inst Hlth Care & Publ Management, D-70599 Stuttgart, Germany.
    Reisch, Lucia A.
    Copenhagen Business Sch, Dept Intercultural Commun & Management, Ctr Corp Social Responsibil, Copenhagen, Denmark.
    Bammann, Karin
    Univ Bremen, Bremen Inst Prevent Res & Social Med, D-28359 Bremen, Germany.;Univ Bremen, Human & Hlth Sci, D-28359 Bremen, Germany.
    Eiben, Gabriele
    Univ Gothenburg, Sahlgrenska Acad, Dept Publ Hlth & Community Med, Publ Hlth Epidemiol Unit, Gothenburg, Sweden..
    Kourides, Yiannis
    Res & Educ Inst Child Hlth, Strovolos, Cyprus.
    Kovacs, Eva
    Univ Pecs, Dept Paediat, Med, Pecs, Hungary.
    Lauria, Fabio
    CNR, Inst Food Sci & Technol, Rome, Italy.
    Konstabel, Kenn
    Univ Tartu, Inst Psychol Social Sci & Educ, Tartu, Estonia.
    Santaliestra-Pasias, Alba M.
    Univ Zaragoza, Growth Exercise Nutr & Dev Res Grp, Zaragoza, Spain.
    Vyncke, Krishna
    Univ Ghent, Univ Hosp, Dept Publ Hlth Med & Hlth Sci, B-9000 Ghent, Belgium.
    Pigeot, Iris
    Leibniz Inst Prevent Res & Epidemiol BIPS, Bremen, Germany.;Univ Bremen, Inst Stat Math & Comp Sci, D-28359 Bremen, Germany.
    Peer effects on obesity in a sample of European children2015Inngår i: Economics and Human Biology, ISSN 1570-677X, E-ISSN 1873-6130, Vol. 18, s. 139-152Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    This study analyzes peer effects on childhood obesity using data from the first two waves of the IDEFICS study, which applies several anthropometric and other measures of fatness to approximately 14,000 children aged two to nine participating in both waves in 16 regions of eight European countries. Peers are defined as same-sex children in the same school and age group. The results show that peer effects do exist in this European sample but that they differ among both regions and different fatness measures. Peer effects are larger in Spain, Italy, and Cyprus - the more collectivist regions in our sample - while waist circumference generally gives rise to larger peer effects than BMI. We also provide evidence that parental misperceptions of their own children's weight goes hand in hand With fatter peer groups, supporting the notion that in making such assessments, parents compare their children's weight with that of friends and schoolmates. 

  • 29.
    Haerens, L.
    et al.
    Univ Ghent, Res Fdn Flanders, Dept Movement & Sports Sci, B-9000 Ghent, Belgium.
    De Bourdeaudhuij, I.
    Univ Ghent, Res Fdn Flanders, Dept Movement & Sports Sci, B-9000 Ghent, Belgium.
    Barba, G.
    CNR, Inst Food Sci, Unit Epidemiol & Populat Genet, I-83100 Avellino, Italy.
    Eiben, Gabriele
    Univ Gothenburg, Dept Publ Hlth & Community Med, S-40530 Gothenburg, Sweden.
    Fernandez, J.
    Univ Zaragoza, Univ Sch Hlth Sci, E-50009 Zaragoza, Spain.
    Hebestreit, A.
    Univ Bremen, Bremen Inst Prevent Res & Social Med, D-28359 Bremen, Germany.
    Kovacs, E.
    Univ Pecs, Dept Paediat, Fac Med, H-7633 Pecs, Hungary.
    Lasn, H.
    Natl Inst Hlth Dev, EE-50410 Tallinn, Estonia.
    Regber, S.
    Sahlgrens Univ Hosp, Dept Pediat, S-40530 Gothenburg, Sweden.
    Shiakou, M.
    Res & Educ Inst Child Hlth, CY-2015 Strovolos, Cyprus.
    De Henauw, S.
    Univ Ghent, Dept Publ Hlth, B-9000 Ghent, Belgium.
    Developing the IDEFICS community-based intervention program to enhance eating behaviors in 2-to 8-year-old children: findings from focus groups with children and parents2009Inngår i: Health Education Research, ISSN 0268-1153, E-ISSN 1465-3648, Vol. 24, nr 3, s. 381-393Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    One purpose of 'identification and prevention of dietary- and lifestyle-induced health effects in children and infants' (IDEFICS) is to implement a standardized community-based multi-component healthy eating intervention for younger children in eight different countries. The present study describes important influencing factors for dietary behaviors among children aged 2-8 years old in order to determine the best approaches for developing the dietary components of the standardized intervention. Twenty focus groups with children (74 boys, 81 girls) and 36 focus groups with 189 parents (28 men, 161 women) were conducted. Only in two countries, children mentioned receiving nutrition education at school. Rules at home and at school ranged from not allowing the consumption of unhealthy products to allowing everything. The same diversity was found for availability of (un)healthy products at home and school. Parents mentioned personal (lack of time, financial constraints, preferences), socio-environmental (family, peer influences), institutional (school policies) and physical-environmental (availability of unhealthy products, price, season) barriers for healthy eating. This focus group research provided valuable information to guide the first phase in the IDEFICS intervention development. There was a large variability in findings within countries. Interventions should be tailored at the personal and environmental level to increase the likelihood of behavioral change.

  • 30.
    Haerens, Leen
    et al.
    Univ Ghent, Res Fdn Flanders, Dept Movement & Sports Sci, B-9000 Ghent, Belgium.
    De Bourdeaudhuij, Ilse
    Univ Ghent, Res Fdn Flanders, Dept Movement & Sports Sci, B-9000 Ghent, Belgium.
    Eiben, Gabriele
    Univ Gothenburg, Dept Publ Hlth & Community Med, Gothenburg, Sweden.
    Lauria, Fabio
    CNR, Inst Food Sci, Dept Epidemiol & Populat Genet, Avellino, Italy.
    Bel, Silvia
    Univ Zaragoza, Univ Sch Hlth Sci, Zaragoza, Spain.
    Keimer, Katharina
    Univ Bremen, Inst Prevent Res & Social Med, Bremen, Germany.
    Kovacs, Eva
    Univ Pecs, Dept Pediat, Pecs, Hungary.
    Lasn, Helen
    TAI, Natl Inst Hlth Dev, Tallinn, Estonia.
    Regber, Susann
    Nordic Sch Publ Hlth, Gothenburg, Sweden.
    Shiakou, Monica
    Res & Educ Inst Child Hlth, Nicosia, Cyprus.
    Maes, Lea
    Univ Ghent, Dept Publ Hlth, B-9000 Ghent, Belgium.
    Formative Research to Develop the IDEFICS Physical Activity Intervention Component: Findings From Focus Groups With Children and Parents2010Inngår i: Journal of Physical Activity and Health, ISSN 1543-3080, E-ISSN 1543-5474, Vol. 7, nr 2, s. 246-256Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: The current study aimed at describing influencing factors for physical activity among young children to determine the best approaches for developing the IDEFICS community based intervention. Methods: In 8 European sites a trained moderator conducted a minimum of 4 focus groups using standardized questioning guides. A total of 56 focus groups were conducted including 36 focus groups with parents and 20 focus groups with children, of which 74 were boys and 81 girls. Key findings were identified through independent reviews of focus group summary reports using content analysis methods. Findings: Findings were generally consistent across countries. The greatest emphasis was on environmental physical (eg, seasonal influences, availability of facilities and safety), institutional (eg, length of breaks at school), and social factors (eg, role modeling of parents). Most cited personal factors by parents were age, social economical status, and perceived barriers. Both children and parents mentioned the importance of children's preferences. Conclusions: To increase physical activity levels of young children the intervention should aim at creating an environment (physical, institutional, social) supportive of physical activity. On the other hand strategies should take into account personal factors like age and social economical status and should consider personal barriers too.

  • 31.
    Hebestreit, A.
    et al.
    BIPS GmbH, Leibniz Inst Prevent Res & Epidemiol, Dept Epidemiol Methods & Etiol Res, D-28359 Bremen, Germany.
    Boernhorst, C.
    BIPS GmbH, Leibniz Inst Prevent Res & Epidemiol, Dept Epidemiol Methods & Etiol Res, D-28359 Bremen, Germany.
    Barba, G.
    CNR, Inst Food Sci, Avellino, Italy.
    Siani, A.
    CNR, Inst Food Sci, Avellino, Italy.
    Huybrechts, I.
    Univ Ghent, Dept Publ Hlth, B-9000 Ghent, Belgium / Int Agcy Res Canc, Dietary Exposure Assessment Grp, F-69372 Lyon, France.
    Tognon, G.
    Univ Gothenburg, Dept Publ Hlth & Community Med, Gothenburg, Sweden.
    Eiben, Gabriele
    Univ Gothenburg, Dept Publ Hlth & Community Med, Gothenburg, Sweden.
    Moreno, L. A.
    Univ Zaragoza, Sch Hlth Sci, GENUD Growth Exercise Nutr & Dev Res Grp, Zaragoza, Spain.
    Fernandez Alvira, J. M.
    Univ Zaragoza, Sch Hlth Sci, GENUD Growth Exercise Nutr & Dev Res Grp, Zaragoza, Spain.
    Loit, H. M.
    Natl Inst Hlth Dev, Dept Chron Dis, Tallinn, Estonia.
    Kovacs, E.
    Univ Pecs, Dept Pediat, Pecs, Hungary.
    Tornaritis, M.
    Res & Educ Inst Child Hlth, Strovolos, Cyprus.
    Krogh, V.
    Fdn IRCCS Ist Nazl Tumori, Dept Prevent & Predict Med, Milan, Italy.
    Associations between energy intake, daily food intake and energy density of foods and BMI z-score in 2-9-year-old European children2014Inngår i: European Journal of Nutrition, ISSN 1436-6207, E-ISSN 1436-6215, Vol. 53, nr 2, s. 673-681Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of this study was to investigate the associations between proxy-reported energy intake, daily food intake and energy density of foods and body mass index (BMI) z-score in 2-9-year-old European children. From 16,225 children who participated in the identification and prevention of dietary- and lifestyle-induced health effects in children and infants (IDEFICS) baseline examination, 9,782 children with 24-h proxy dietary information and complete covariate information were included in the analysis. Participating children were classified according to adapted Goldberg cutoffs: underreports, plausible energy reports and overreports. Energy intake, daily food intake and energy density of foods excluding noncaloric beverages were calculated for all eating occasions. Effect of energy intake, daily food intake and energy density of foods on BMI z-score was investigated using multilevel regression models in the full sample and subsample of plausible energy reports. Exposure variables were included separately; daily food intake and energy intake were addressed in a combined model to check for interactions. In the group of plausible energy reports (N = 8,544), energy intake and daily food intake were significantly positively associated with BMI z-score. Energy density of foods was not associated with BMI z-score. In the model including energy intake, food intake and an interaction term, only energy intake showed a significantly positive effect on BMI z-score. In the full sample (N = 9,782), only energy intake was significantly but negatively associated with BMI z-score. Proxy-reporters are subject to misreporting, especially for children in the higher BMI levels. Energy intake is a more important predictor of unhealthy weight development in children than daily food intake.

  • 32.
    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 Europe2014Inngår i: International Journal of Obesity, ISSN 0307-0565, E-ISSN 1476-5497, Vol. 38, s. S124-S134Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 33.
    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 children2016Inngår i: International Journal of Behavioral Nutrition and Physical Activity, ISSN 1479-5868, E-ISSN 1479-5868, Vol. 13, artikkel-id 23Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 34.
    Hebestreit, Antje
    et al.
    Leibniz Inst Prevent Res & Epidemiol BIPS, D-28359 Bremen, Germany.
    Intemann, Timm
    Leibniz Inst Prevent Res & Epidemiol BIPS, D-28359 Bremen, Germany.
    Siani, Alfonso
    CNR, Inst Food Sci, I-83100 Avellino, Italy.
    De Henauw, Stefaan
    Univ Ghent, Dept Publ Hlth, B-9000 Ghent, Belgium.
    Eiben, Gabriele
    Univ Gothenburg, Dept Publ Hlth & Commun Med, S-40530 Gothenburg, Sweden.
    Kourides, Yiannis A.
    Res & Educ Inst Child Hlth, CY-2035 Strovolos, Cyprus.
    Kovacs, Eva
    Ludwig Maximilians Univ Munchen, Inst Med Informat Proc & Epidemiol, Inst Biometr & Epidemiol, D-81377 Munich, Germany / Ludwig Maximilians Univ Munchen, German Ctr Vertigo & Balance Disorders, D-81377 Munich, Germany.
    Moreno, Luis A.
    Univ Zaragoza, Ctr Investigac Biomed Red Fisiopatol Obesidad & N, IIS Aragon, Inst Agroalimentario Aragon IA2,GENUD, E-50009 Zaragoza, Spain.
    Veidebaum, Toomas
    Natl Inst Hlth Dev, Dept Chron Dis, EE-11619 Tallinn, Estonia.
    Krogh, Vittorio
    Fdn IRCCS, IRCCS Ist Nazl Tumori, Dept Prevent & Predict Med, I-20133 Milan, Italy.
    Pala, Valeria
    Fdn IRCCS, IRCCS Ist Nazl Tumori, Dept Prevent & Predict Med, I-20133 Milan, Italy.
    Bogl, Leonie H.
    Leibniz Inst Prevent Res & Epidemiol BIPS, D-28359 Bremen, Germany / Univ Helsinki, Dept Publ Hlth, FIN-00014 Helsinki, Finland / Univ Helsinki, Finnish Inst Mol Med, FIN-00014 Helsinki, Finland.
    Hunsberger, Monica
    Univ Gothenburg, Dept Publ Hlth & Commun Med, S-40530 Gothenburg, Sweden.
    Boernhorst, Claudia
    Leibniz Inst Prevent Res & Epidemiol BIPS, D-28359 Bremen, Germany.
    Pigeot, Iris
    Leibniz Inst Prevent Res & Epidemiol BIPS, D-28359 Bremen, Germany.
    Dietary Patterns of European Children and Their Parents in Association with Family Food Environment: Results from the I.Family Study2017Inngår i: Nutrients, ISSN 2072-6643, E-ISSN 2072-6643, Vol. 9, nr 2, artikkel-id 126Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of this study was to determine whether an association exists between children's and parental dietary patterns (DP), and whether the number of shared meals or soft drink availability during meals strengthens this association. In 2013/2014 the I. Family study cross-sectionally assessed the dietary intakes of families from eight European countries using 24-h dietary recalls. Usual energy and food intakes from six-to 16-year-old children and their parents were estimated based on the NCI Method. A total of 1662 child-mother and 789 child-father dyads were included; DP were derived using cluster analysis. We investigated the association between children's and parental DP and whether the number of shared meals or soft drink availability moderated this association using mixed effects logistic regression models. Three DP comparable in children and parents were obtained: Sweet & Fat, Refined Cereals, and Animal Products. Children were more likely to be allocated to the Sweet & Fat DP when their fathers were allocated to the Sweet & Fat DP and when they shared at least one meal per day (OR 3.18; 95% CI 1.84; 5.47). Being allocated to the Sweet & Fat DP increased when the mother or the father was allocated to the Sweet & Fat DP and when soft drinks were available (OR 2.78; 95% CI 1.80; 4.28 or OR 4.26; 95% CI 2.16; 8.41, respectively). Availability of soft drinks and negative parental role modeling are important predictors of children's dietary patterns.

  • 35.
    Hense, Sabrina
    et al.
    Department of Epidemiological Methods and Etiologic Research, Bremen Institute for Prevention Research and Social Medicine (BIPS), Germany.
    Pohlabeln, Hermann
    Bremen Inst Prevent Res & Social Med BIPS, Dept Epidemiol Methods & Etiol Res, D-28359 Bremen, Germany.;Bremen Inst Prevent Res & Social Med BIPS, Dept Biometry & Data Management, D-28359 Bremen, Germany.
    De Henauw, Stefaan
    Univ Ghent, Dept Publ Health, Dept Movement & Sport Sci, Fac Med & Hlth Sci, B-9000 Ghent, Belgium.
    Eiben, Gabriele
    Univ Goteborg, Sahlgranska Sch Publ Hlth & Community Med, Gothenburg, Sweden.
    Molnar, Denes
    Department of Pediatrics, Medical Faculty, University of Pécs, Hungary.
    Moreno, Luis A.
    Univ Zaragoza, EU Ciencas Salud, GENUD Res Grp, E-50009 Zaragoza, Spain.
    Barba, Gianvincenzo
    CNR, Inst Food Sci, Unit Epidemiol & Populat Genet, Pavia, Italy.
    Hadjigeorgiou, Charalampos
    Res & Educ Inst Child Hlth, Strovolos, Cyprus.
    Veidebaum, Toomas
    Natl Inst Hlth Dev, Tallinn, Estonia.
    Ahrens, Wolfgang
    Bremen Inst Prevent Res & Social Med BIPS, Dept Epidemiol Methods & Etiol Res, D-28359 Bremen, Germany.
    Sleep Duration and Overweight in European Children: Is the Association Modified by Geographic Region?2011Inngår i: Sleep, ISSN 0161-8105, E-ISSN 1550-9109, Vol. 34, nr 7, s. 885-890Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Study Objectives: To investigate differences and a possible effect modification by geographical region in the association between sleep duration and overweight. Design: Cross-sectional. Setting: Primary schools and preschools in 8 European countries. Participants: 7867 children aged 2 to 9 years. Interventions: Not applicable. Measurements: Nocturnal sleep duration was assessed as part of a parental 24-h recall. Height and weight were measured by standardized procedures across centers. Data on personal, social, environmental and behavioral factors were collected using a standardized parental questionnaire. Results: Sleep duration differed (P < 0.001) between European regions and normal vs. overweight children. A dose-dependent inverse association between sleep duration and overweight could be seen, with crude odds ratios ranging from 1.73 (99% CI 1.33; 2.25) for sleeping between 10 and 11 h to 3.81 (99% CI 2.85; 5.09) for sleeping less than 9 h (reference category > 11 h). This persisted after adjustment, but remained significant only for sleeping less than 9 h per night (north: OR = 1.70; 99% CI 1.13; 2.58 vs. south: OR = 2.84; 99% CI 1.57; 5.12) if stratified by region. No effect modification by region could be found, but adjustment for region accounted for changes in the effect estimate for sleeping less than 9 h (OR = 2.22; 99% CI 1.64; 3.02). The association was stronger in school children than in preschool children. Conclusion: Geographic region and related aspects-even if they do not seem to modify the association between sleep and overweight-should in any case be taken in consideration as a confounding factor on this association.

  • 36.
    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 questionnaire2011Inngår i: International Journal of Obesity, ISSN 0307-0565, E-ISSN 1476-5497, Vol. 35, s. S52-S60Artikkel i tidsskrift (Fagfellevurdert)
    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

  • 37.
    Huang, Christina Y.
    et al.
    Pardee Rand Grad Sch, Santa Monica, CA 90407 USA / RAND Corp, Santa Monica, CA 90407 USA.
    Reisch, Lucia A.
    Copenhagen Business Sch, Dept Intercultural Commun & Management, Frederiksberg, Denmark.
    Gwozdz, Wencke
    Copenhagen Business Sch, Dept Intercultural Commun & Management, Frederiksberg, Denmark.
    Molnar, Denes
    Univ Pecs, Fac Med, Dept Paediat, Budapest, Hungary.
    Konstabel, Kenn
    Natl Inst Hlth Dev, Tallinn, Estonia.
    Michels, Nathalie
    Univ Ghent, Dept Publ Hlth, Ghent, Belgium.
    Tornaritis, Michalis
    Res & Educ Inst Child Hlth, Strovolos, Cyprus.
    Eiben, Gabriele
    Univ Gothenburg, Sect Epidemiol & Social Med, POB 453, SE-40530 Gothenburg, Sweden.
    Siani, Alfonso
    CNR, Inst Food Sci, Unit Epidemiol & Populat Genet, Avellino, Italy.
    Fernandez-Alvira, Juan M.
    Univ Zaragoza, Growth Exercise Nutr & Dev GENUD Res Grp, Zaragoza, Spain.
    Ahrens, Wolfgang
    Leibniz Inst Prevent Res & Epidemiol BIPS GmbH, Bremen, Germany / Univ Bremen, Fac Math & Comp Sci, Bremen, Germany.
    Pigeot, Iris
    Leibniz Inst Prevent Res & Epidemiol BIPS GmbH, Bremen, Germany / Univ Bremen, Fac Math & Comp Sci, Bremen, Germany.
    Lissner, Lauren
    Univ Gothenburg, Sect Epidemiol & Social Med, POB 453, SE-40530 Gothenburg, Sweden.
    Pester power and its consequences: do European children's food purchasing requests relate to diet and weight outcomes?2016Inngår i: Public Health Nutrition, ISSN 1368-9800, E-ISSN 1475-2727, Vol. 19, nr 13, s. 2393-2403Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective Children may influence household spending through pester power'. The present study examined pestering through parent-child food shopping behaviours in relation to children's diet and weight status. Design Cross-sectional and prospective analyses drawn from the IDEFICS study, a cohort study of parents and their children. Children's height and weight were measured and their recent diets were reported by parental proxy based on the Children's Eating Habits Questionnaire-FFQ at baseline and 2-year follow-up. Parents also completed questionnaires at both time points about pestering, including whether the child goes grocery shopping with them, asks for items seen on television and is bought requested food items. Setting Participants were recruited from eight European countries for the IDEFICS study (non-nationally representative sample). Subjects Study participants were children aged 2-9 years at enrolment and their parents. A total of 13 217 parent-child dyads were included at baseline. Two years later, 7820 of the children were re-examined. Results Most parents (63 %) at baseline reported sometimes' acquiescing to their children's requests to purchase specific foods. Pestering was modestly associated with weight and diet. At baseline, children whose parents often' complied consumed more high-sugar and high-fat foods. Children who often' asked for items seen on television were likely to become overweight after 2 years (OR=1<bold></bold>31), whereas never' asking protected against overweight (OR=0<bold></bold>72). Conclusions Pestering was modestly related to diet and weight in cross-sectional, but not longitudinal analyses. Asking for items seen on television had the most robust relationships across child outcomes and over time.

  • 38.
    Hunsberger, Monica
    et al.
    Univ Gothenburg, Sahlgrenska Acad, Dept Publ Hlth & Community Med, Publ Hlth Epidemiol Unit, SE-40530 Gothenburg, Sweden.
    Lanfer, Anne
    Bremen Inst Prevent Res & Social Med, Bremen, Germany.
    Reeske, Anna
    Bremen Inst Prevent Res & Social Med, Bremen, Germany.
    Veidebaum, Toomas
    Natl Inst Hlth Dev, Tallinn, Estonia.
    Russo, Paola
    CNR, Inst Food Sci, Unit Epidemiol & Populat Genet, Avellino, Italy.
    Hadjigeorgiou, Charalampos
    Res & Educ Inst Child Hlth, Strovolos, Cyprus.
    Moreno, Luis A.
    Univ Zaragoza, Growth Exercise Nutr & Dev GENUD Res Grp, Zaragoza, Spain.
    Molnar, Denes
    Univ Pecs, Fac Med, Dept Pediat, Budapest, Hungary.
    De Henauw, Stefaan
    Univ Ghent, Dept Publ Hlth, B-9000 Ghent, Belgium / Univ Coll Ghent, Fac Hlth Care Vesalius, Dept Nutr & Dietet, Ghent, Belgium.
    Lissner, Lauren
    Univ Gothenburg, Sahlgrenska Acad, Dept Publ Hlth & Community Med, Publ Hlth Epidemiol Unit, SE-40530 Gothenburg, Sweden.
    Eiben, Gabriele
    Univ Gothenburg, Sahlgrenska Acad, Dept Publ Hlth & Community Med, Publ Hlth Epidemiol Unit, SE-40530 Gothenburg, Sweden.
    Infant feeding practices and prevalence of obesity in eight European countries - the IDEFICS study2013Inngår i: Public Health Nutrition, ISSN 1368-9800, E-ISSN 1475-2727, Vol. 16, nr 2, s. 219-227Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: To assess the association between exclusive breast-feeding and childhood overweight. Design: Cross-sectional data are from the baseline survey of the longitudinal cohort study IDEFICS. Exclusive rather than partial breast-feeding is the focus of the study due to the theoretical relationship between exclusive breast-feeding and development of dietary self-regulation. Children's measured heights and weights were used to calculate weight status, while waist-to-height ratio (WtHR) and skinfold measures were examined as alternative indicators of adiposity and fat patterning. Setting: Examination centres in eight European countries (Italy, Estonia, Cyprus, Belgium, Sweden, Hungary, Germany and Spain). Subjects: The analysis included 14 726 children aged 2-9 years for whom early feeding practices were reported by parents in standardized questionnaires. Results: After controlling for education, income and other potential confounders, breast-feeding exclusively for 4-6 months was protective of overweight (including obesity) when compared with children never exclusively breast-fed (OR=0.73; 95% CI 0.63, 0.85) across all measures of overweight. Exclusively breast-feeding for 6 months offered slightly more protection than for 4 and 5 months combined (OR=0.71; 95% CI 0.58, 0.85). The associations could not be explained by socio-economic characteristics or maternal overweight. Conclusions: This multi-country investigation indicated that exclusive breast-feeding for 4-6 months may confer protection against overweight in addition to other known benefits. There was no demonstrated benefit of exclusive breast-feeding for more than 6 months or combination feeding for any duration across all measures of overweight examined.

  • 39.
    Hunsberger, Monica
    et al.
    Univ Gothenburg, Dept Publ Hlth & Community Med, S-40530 Gothenburg, Sweden.
    Pena, Pablo
    Univ Gothenburg, Dept Publ Hlth & Community Med, S-40530 Gothenburg, Sweden.
    Lissner, Lauren
    Univ Gothenburg, Dept Publ Hlth & Community Med, S-40530 Gothenburg, Sweden.
    Grafstrom, Lisen
    Grafstroms Mat & Med HB, S-43994 Onsala, Sweden.
    Vanaelst, Barbara
    Univ Ghent, Dept Publ Hlth, B-9000 Ghent, Belgium.
    Boernhorst, Claudia
    Leibniz Inst Prevent Res & Epidemiol BIPS GmbH, Dept Stat Methods Epidemiol, Bremen, Germany.
    Pala, Valeria
    Fdn IRCCS Ist Nazl Tumori, Epidemiol & Prevent Unit, I-20133 Milan, Italy.
    Eiben, Gabriele
    Univ Gothenburg, Dept Publ Hlth & Community Med, S-40530 Gothenburg, Sweden.
    Validity of self-reported lunch recalls in Swedish school children aged 6-8 years2013Inngår i: Nutrition Journal, ISSN 1475-2891, E-ISSN 1475-2891, Vol. 12, artikkel-id 129Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Previous studies have suggested that young children are inaccurate reporters of dietary intake. The purpose of this study was to validate a single recall of the previous day's school lunch reported by 6-8 year old Swedish children and to assess teacher-recorded intake of the same meal in a standardized food journal. An additional research question was whether parents could report their child's intake of the previous day's lunch. Subjects constituted a convenience sample from the large, multi-country study Identification and prevention of Dietary-and lifestyle-induced health EFfects In Children and infantS (IDEFICS). Validations of both children's recalls and teachers' records were made by comparing results with the duplicate plate reference method. Findings: Twenty-five children (12 boys/13 girls) aged 6-8 years participated in the validation study at one school in western Sweden. Children were accurate self-reporters of their dietary intake at lunch, with no significant difference between reported and weighed intake (Mean difference (SD): 7(50) kcals, p=0.49). Teachers significantly over-reported intake (Mean difference (SD): 65(79) kcals, p=0.01). For both methods, child-reported and teacher-recorded, correlations with weighed intake were strong (Pearson's correlations r=0.92, p<0.001 and r=0.83, p<0.001 respectively). Bland-Altman plots showed strong agreement between child-reported and weighed intakes but confirmed systematic differences between teacher-records and weighed intakes. Foods were recalled by children with a food-match rate of 90%. In all cases parents themselves were unable to report on quantities consumed and only four of 25 children had parents with knowledge regarding food items consumed. Conclusions: Children 6-8 years of age accurately recalled their school lunch intake for one occasion while teachers recorded with less accuracy. Our findings suggest that children as young as six years of age may be better able to report on their dietary intake than previously suggested, at least for one main meal at school. Teacher-recorded intake provides a satisfactory estimate but with greater systematic deviation from the weighed intake. Parents were not able to report on their children's school lunches consumed on the previous day.

  • 40.
    Iguacel, Isabel
    et al.
    Univ Zaragoza, Fac Hlth Sci, GENUD Growth Exercise Nutr & Dev Res Grp, Edificio SAI,C Pedro Cerbuna S-N, E-50009 Zaragoza, Spain / Inst Agroalimentario Aragon IA2, C Miguel Servet 177, Zaragoza 50013, Spain.;Inst Invest Sanitaria Aragon IIS Aragon, Avda San Juan Bosco 13, Zaragoza 50009, Spain.
    Fernandez-Alvira, Juan M.
    Univ Zaragoza, Fac Hlth Sci, GENUD Growth Exercise Nutr & Dev Res Grp, Edificio SAI,C Pedro Cerbuna S-N, E-50009 Zaragoza, Spain / Fdn Ctr Nacl Invest Cardiovasc Carlos III CNIC, C Melchor Fernandez Almagro 3, Madrid 28029, Spain.
    Bammann, Karin
    Univ Bremen, Inst Publ Hlth & Nursing Sci IPP, Grazer Str 2, D-28359 Bremen, Germany / Leibniz Inst Prevent Res & Epidemiol BIPS, Achterstr 30, D-28359 Bremen, Germany.
    De Clercq, Bart
    Univ Ghent, Univ Hosp, Dept Publ Hlth, Block 4K3,De Pintelaan 185, B-9000 Ghent, Belgium.
    Eiben, Gabriele
    Univ Gothenburg, Sahlgrenska Acad, Dept Publ Hlth & Community Med, Publ Hlth Epidemiol Unit EPI, Medicinaregatan 16a,Van 2, S-41390 Gothenburg, Sweden..
    Gwozdz, Wencke
    Copenhagen Business Sch, Solbjerg Pl 3, DK-2000 Copenhagen, Denmark.
    Molnar, Denes
    Univ Pecs, Dept Paediat, Szigeti Str 12, H-7624 Pecs, Hungary.
    Pala, Valeria
    Fdn IRCCS Ist Nazl Tumori, Dept Prevent & Predict Med, Via Venezian 1, I-20133 Milan, Italy.
    Papoutsou, Stalo
    Res & Educ Inst Child Hlth, 138 Limassol Ave, CY-2015 Strovolos, Cyprus.
    Russo, Paola
    CNR, Inst Food Sci, Unit Epidemiol & Populat Genet, I-83100 Avellino, Italy.
    Veidebaum, Toomas
    Natl Inst Hlth Dev, Dept Chron Dis, Hiiu 42, EE-11619 Tallinn, Estonia.
    Wolters, Maike
    Leibniz Inst Prevent Res & Epidemiol BIPS, Achterstr 30, D-28359 Bremen, Germany.
    Boernhorst, Claudia
    Leibniz Inst Prevent Res & Epidemiol BIPS, Achterstr 30, D-28359 Bremen, Germany.
    Moreno, Luis A.
    Univ Zaragoza, Fac Hlth Sci, GENUD Growth Exercise Nutr & Dev Res Grp, Edificio SAI,C Pedro Cerbuna S-N, E-50009 Zaragoza, Spain.;Inst Agroalimentario Aragon IA2, C Miguel Servet 177, Zaragoza 50013, Spain.;Inst Invest Sanitaria Aragon IIS Aragon, Avda San Juan Bosco 13, Zaragoza 50009, Spain.;Ctr Invest Biomed Red Fisiopatol Obesidad & Nutr, C Sinesio Delgado 4, Madrid 28029, Spain.
    Associations between social vulnerabilities and dietary patterns in European children: the Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS (IDEFICS) study2016Inngår i: British Journal of Nutrition, ISSN 0007-1145, E-ISSN 1475-2662, Vol. 116, nr 7, s. 1288-1297Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Socio-economic inequalities in childhood can determine dietary patterns, and therefore future health. This study aimed to explore associations between social vulnerabilities and dietary patterns assessed at two time points, and to investigate the association between accumulation of vulnerabilities and dietary patterns. A total of 9301 children aged 2-9 years participated at baseline and 2-year follow-up examinations of the Identification and prevention of Dietary-and lifestyle-induced health EFfects In Children and infantS study. In all, three dietary patterns were identified at baseline and follow-up by applying the K-means clustering algorithm based on a higher frequency of consumption of snacks and fast food (processed), sweet foods and drinks (sweet), and fruits and vegetables (healthy). Vulnerable groups were defined at baseline as follows: children whose parents lacked a social network, children from single-parent families, children of migrant origin and children with unemployed parents. Multinomial mixed models were used to assess the associations between social vulnerabilities and children's dietary patterns at baseline and follow-up. Children whose parents lacked a social network (OR 1.31; 99% CI 1.01, 1.70) and migrants (OR 1.45; 99% CI 1.15, 1.83) were more likely to be in the processed cluster at baseline and follow-up. Children whose parents were homemakers (OR 0.74; 99% CI 0.60, 0.92) were less likely to be in the processed cluster at baseline. A higher number of vulnerabilities was associated with a higher probability of children being in the processed cluster (OR 1.78; 99% CI 1.21, 2.62). Therefore, special attention should be paid to children of vulnerable groups as they present unhealthier dietary patterns.

  • 41.
    Iguacel, Isabel
    et al.
    GENUD (Growth, Exercise, NUtrition and Development) Research Group, Faculty of Health Sciences, University of Zaragoza, Edificio del SAI, C/Pedro Cerbuna s/n, 50009 Zaragoza, Spain / Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain / Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain / Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Zaragoza, Spain.
    Michels, Nathalie
    Department of Public Health, Ghent University, Ghent, Belgium.
    Ahrens, Wolfgang
    Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany / Institute of Statistics, University of Bremen, Bremen, Germany.
    Bammann, Karin
    Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany / Institute for Public Health and Nursing Sciences (IPP), University of Bremen, 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 (EPSO), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Fernández-Alvira, Juan M.
    GENUD (Growth, Exercise, NUtrition and Development) Research Group, Faculty of Health Sciences, University of Zaragoza, Edificio del SAI, C/Pedro Cerbuna s/n, 50009 Zaragoza, Spain / Fundación Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain.
    Mårild, Staffan
    Section for Epidemiology and Social Medicine (EPSO), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Molnár, Dénes
    Department of Paediatrics, University of Pécs, Pécs, Hungary.
    Reisch, Lucia
    Copenhagen Business School, Copenhagen, Denmark.
    Russo, Paola
    Institute of Food Sciences, National Research Council, Avellino, Italy.
    Tornaritis, Michael
    Research and Education Institute of Child Health, Strovolos, Cyprus.
    Veidebaum, Toomas
    Department of Chronic Diseases, National Institute for Health Development, Tallinn, Estonia.
    Wolters, Maike
    Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany.
    Moreno, Luis A.
    GENUD (Growth, Exercise, NUtrition and Development) Research Group, Faculty of Health Sciences, University of Zaragoza, Edificio del SAI, C/Pedro Cerbuna s/n, 50009 Zaragoza, Spain / Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain / Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain / Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Zaragoza, Spain.
    Börnhorst, Claudia
    Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany.
    Prospective associations between socioeconomically disadvantaged groups and metabolic syndrome risk in European children: Results from the IDEFICS study2018Inngår i: International Journal of Cardiology, ISSN 0167-5273, E-ISSN 1874-1754, Vol. 272, s. 333-340Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: Socioeconomic disadvantages during childhood are hypothesised to have negative implications for health. We aimed to investigate the association between socioeconomic disadvantages and children's total metabolic syndrome (MetS) score at baseline and follow-up and the extent to which socioeconomic disadvantages over time and the accumulation of these socioeconomic disadvantages can affect children's MetS risk.

    METHODS: The two-year longitudinal IDEFICS study included 2401 European children (aged 2.0-9.9) with complete information of the 16,229 participating at baseline. Sociodemographic variables, psychosocial factors and lifestyle were proxy-reported via questionnaires. Socioeconomically disadvantaged groups included children from families with low income, low education, migrant origin, unemployed parents, parents who lacked a social network, and from non-traditional families. MetS risk score was calculated as the sum of z-scores of waist circumference, blood pressure, lipids and insulin resistance. Linear mixed-effects models were used to study the association between social disadvantages and MetS risk. Models were adjusted for sex, age, well-being and lifestyle (fruit and vegetables consumption, physical activity, screen time).

    RESULTS: At both time points, children from low-income families (0.20 [0.03-0.37]); (β estimate and 99% confidence interval), children from non-traditional families (0.14 [0.02-0.26]), children whose parents were unemployed (0.31 [0.05-0.57]) and children who accumulated >3 disadvantages (0.21 [0.04-0.37]) showed a higher MetS score compared to non-socioeconomically disadvantaged groups.

    CONCLUSION: Children from socioeconomically disadvantaged families are at high metabolic risk independently of diet, physical activity, sedentary behaviours and well-being. Interventions focusing on these socioeconomically disadvantaged groups should be developed to tackle health disparities.

  • 42.
    Iguacel, Isabel
    et al.
    GENUD (Growth, Exercise, NUtrition and Development) Research Group, Faculty of Health Sciences, University of Zaragoza, Edificio del SAI, Zaragoza, Spain; Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain; Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain; Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Zaragoza, Spain.
    Michels, Nathalie
    Department of Public Health, Ghent University, Ghent, Belgium.
    Ahrens, Wolfgang
    Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany; Institute of Statistics, University of Bremen, Bremen, Germany.
    Bammann, Karin
    Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany; Institute for Public Health and Nursing Sciences (IPP), University of Bremen, Bremen, Germany.
    Eiben, Gabriele
    Högskolan i Skövde, Institutionen för hälsa och lärande. Section for Epidemiology and Social Medicine (EPSO), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Fernández-Alvira, Juan M.
    GENUD (Growth, Exercise, NUtrition and Development) Research Group, Faculty of Health Sciences, University of Zaragoza, Edificio del SAI, Zaragoza, Spain; Fundación Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain.
    Mårild, Staffan
    Section for Epidemiology and Social Medicine (EPSO), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Molnár, Dénes
    Department of Paediatrics, University of Pécs, Pécs, Hungary.
    Reisch, Lucia
    Copenhagen Business School, Copenhagen, Denmark.
    Russo, Paola
    Institute of Food Sciences, National Research Council, Avellino, Italy.
    Tornaritis, Michael
    Research and Education Institute of Child Health, Strovolos, Cyprus.
    Veidebaum, Toomas
    Department of Chronic Diseases, National Institute for Health Development, Tallinn, Estonia.
    Wolters, Maike
    Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.
    Moreno, Luis A.
    GENUD (Growth, Exercise, NUtrition and Development) Research Group, Faculty of Health Sciences, University of Zaragoza, Edificio del SAI, Zaragoza, Spain; Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain; Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain; Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Zaragoza, Spain.
    Börnhorst, Claudia
    Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.
    consortium, IDEFICS
    Reply to the letter to the editor: “Socioeconomic status and childhood metabolic syndrome”2019Inngår i: International Journal of Cardiology, ISSN 0167-5273, E-ISSN 1874-1754, Vol. 283, s. 190-191Artikkel i tidsskrift (Fagfellevurdert)
  • 43.
    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
    Högskolan i Skövde, Institutionen för hälsa och lärande. Högskolan i Skövde, Forskningsspecialiseringen Hälsa och Lärande. 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 study2019Inngår i: European Journal of Nutrition, ISSN 1436-6207, E-ISSN 1436-6215, Vol. 58, nr 3, s. 1247-1258Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 44.
    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
    Högskolan i Skövde, Institutionen för hälsa och lärande. Högskolan i Skövde, Forskningsspecialiseringen Hälsa och Lärande.
    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 Adults2019Inngår i: Nutrients, ISSN 2072-6643, E-ISSN 2072-6643, Vol. 11, nr 7, artikkel-id 1453Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 45.
    Jilani, Hannah S.
    et al.
    Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany / Institute for Public Health and Nursing Research, University of Bremen and Health Sciences Bremen, University of Bremen, Bremen, Germany.
    Pohlabeln, Hermann
    Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.
    Buchecker, Kirsten
    Department of Food Science, TTZ, Bremerhaven, Germany.
    Gwozdz, Wencke
    Department of Management, Society and Communication, Copenhagen Business School, Frederiksberg, Denmark.
    De Henauw, Stefaan
    Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
    Eiben, Gabriele
    Högskolan i Skövde, Institutionen för hälsa och lärande. Högskolan i Skövde, Forskningsspecialiseringen Hälsa och Lärande. Department of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden.
    Molnar, Dénes
    Department of Pediatrics, University of Pécs, Medical School, Pécs, Hungary.
    Moreno, Luis A.
    GENUD (Growth, Exercise, Nutrition and Development) Research Group, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain.
    Pala, Valeria
    Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
    Reisch, Lucia
    Department of Management, Society and Communication, Copenhagen Business School, Frederiksberg, Denmark.
    Russo, Paola
    Epidemiology and Population Genetics, Institute of Food Sciences, National Research Council, Avellino, Italy.
    Veidebaum, Toomas
    Department of Chronic Diseases, National Institute for Health Development, Tallinn, Estonia.
    Ahrens, Wolfgang
    Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany / Institute of Statistics, Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany.
    Hebestreit, Antje
    Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.
    Association between parental consumer attitudes with their children's sensory taste preferences as well as their food choice2018Inngår i: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 13, nr 8, artikkel-id e0200413Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background We investigated the association between the consumer attitudes of European parents and their children's taste preferences and food choice. Furthermore, we studied whether the parental consumer attitudes were related to education level.

    Methods This analysis included 1,407 IDEFICS study children aged 6.0 to 11.8 years and from 7 European countries, who participated in the sensory taste perception module between 2007 and 2010. Parental consumer attitude was operationalized as 'trusting in foods known from advertisements' (trusting advertisements) and as 'not avoiding additives in food' (not avoiding additives). Parents reported their educational attainment and completed a food frequency questionnaire for their children. Consumption frequencies of sweet, fatty and processed foods as well as a healthy diet adherence score were calculated. Children performed fat, sweet and umami taste preference tests. Multivariable logistic models were used to analyse the association between parental consumer attitudes and their children's taste preference frequencies as well as parental education. Linear regression models were used to analyse the association between parental consumer attitudes and their children's food consumption.

    Results Parental consumer attitudes were not associated with children's fat, sweet and umami taste preferences. Children of parents trusting advertisements consumed more frequently processed foods (beta = 1.21, 95% CI: 0.49; 1.93). Children of parents not avoiding additives consumed more often sweet, fatty and processed foods and had a lower healthy diet adherence score (beta = 2.37, 95% CI: 1.03; 3.70; beta = 2.27, 95% CI: 1.12; 3.43; beta = 0.91, 95% CI: 0.22; 1.59; beta = -2.87, 95% CI: -3.89; -1.85, respectively). Unfavourable parental consumer attitudes were associated with a lower parental education level across Europe (Compared to high education: Odds Ratio (OR) of trusting advertisements with medium education: 1.04, 95% CI: 0.77; 1.40; OR with low education: 2.01, 95% CI: 1.15; 3.54; OR of not avoiding additives with medium education: 1.91, 95% CI: 1.44; 2.54; OR with low education: 1.76, 95% CI: 0.96; 3.24).

    Conclusions Across Europe, unfavourable parental consumer attitudes are associated with a lower diet quality of their children. Parental consumer attitudes in turn were associated with their own level of education. This has implications for policy makers, interventions and health promotion programmes that aim to promote healthy eating.

  • 46.
    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 study2014Inngår i: International Journal of Obesity, ISSN 0307-0565, E-ISSN 1476-5497, Vol. 38, s. S135-S143Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 47.
    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 study2015Inngår i: Obesity Reviews, ISSN 1467-7881, E-ISSN 1467-789X, Vol. 16, s. 138-150Artikkel i tidsskrift (Fagfellevurdert)
    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

  • 48.
    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 study2014Inngår i: International Journal of Obesity, ISSN 0307-0565, E-ISSN 1476-5497, Vol. 38, s. S144-S151Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 49.
    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 study2011Inngår i: International Journal of Obesity, ISSN 0307-0565, E-ISSN 1476-5497, Vol. 35, s. S61-S68Artikkel i tidsskrift (Fagfellevurdert)
    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

  • 50.
    Langeheine, Malte
    et al.
    Leibniz Institute for Prevention Research and Epidemiology–BIPS, Bremen, Germany.
    Pohlabeln, Hermann
    Leibniz Institute for Prevention Research and Epidemiology–BIPS, Bremen, Germany.
    Lauria, Fabio
    Institute of Food Sciences, National Research Council, Avellino, Italy.
    Veidebaum, Toomas
    National Institute for Health Development, Tallinn, Estonia.
    Tornaritis, Michael
    Research and Education Institute of Child Health, Strovolos, Cyprus.
    Molnar, Denes
    Department of Pediatrics, Medical School, University of Pécs, Pécs, Hungary.
    Eiben, Gabriele
    Högskolan i Skövde, Institutionen för hälsa och lärande. Högskolan i Skövde, Forskningsspecialiseringen Hälsa och Lärande. Section for Epidemiology and Social Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    de Henauw, Stefaan
    Department of Public Health, Ghent University, Ghent, Belgium.
    Moreno, Luis A.
    Growth, Exercise, Nutrition and Development, Research Group, Faculty of Health Sciences, University of Zaragoza, Instituto Agroalimentario de Aragón, Instituto de Investigación Sanitaria de Aragón and Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Zaragoza, Spain.
    Williams, Garrath
    Department of Politics, Philosophy and Religion, Lancaster University, Lancaster, United Kingdom.
    Ahrens, Wolfgang
    Leibniz Institute for Prevention Research and Epidemiology–BIPS, Bremen, Germany / Faculty of Mathematics and Computer Science, Institute of Statistics, University Bremen, Bremen, Germany.
    Rach, Stefan
    Leibniz Institute for Prevention Research and Epidemiology–BIPS, Bremen, Germany.
    Attrition in the European Child Cohort IDEFICS/I. Family: Exploring Associations Between Attrition and Body Mass Index2018Inngår i: Frontiers in Pediatrics, ISSN 2296-2360, Vol. 6, artikkel-id 212Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Attrition may lead to bias in epidemiological cohorts, since participants who are healthier and have a higher social position are less likely to drop out. We investigated possible selection effects regarding key exposures and outcomes in the IDEFICS/I.Family study, a large European cohort on the etiology of overweight, obesity and related disorders during childhood and adulthood. We applied multilevel logistic regression to investigate associations of attrition with sociodemographic variables, weight status, and study compliance and assessed attrition across time regarding children's weight status and variations of attrition across participating countries. We investigated selection effects with regard to social position, adherence to key messages concerning a healthy lifestyle, and children's weight status. Attrition was associated with a higher weight status of children, lower children's study compliance, older age, lower parental education, and parent's migration background, consistent across time and participating countries. Although overweight (odds ratio 1.17, 99% confidence interval 1.05–1.29) or obese children (odds ratio 1.18, 99% confidence interval 1.03–1.36) were more prone to drop-out, attrition only seemed to slightly distort the distribution of children's BMI at the upper tail. Restricting the sample to subgroups with different attrition characteristics only marginally affected exposure-outcome associations. Our results suggest that IDEFICS/I.Family provides valid estimates of relations between socio-economic position, health-related behaviors, and weight status.

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