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  • 51.
    Lissner, L
    et al.
    Gothenburg Univ, Sahlgrens Hosp, SOS Secretariat, Dept Internal Med, S-41345 Gothenburg, Sweden.
    Eiben, Gabriele
    Gothenburg Univ, Sahlgrens Hosp, SOS Secretariat, Dept Internal Med, S-41345 Gothenburg, Sweden.
    Is it possible to prevent obesity in SOS offspring?: Pilot data from the Health-Hunters program1999In: Progress in Obesity Research: 8 / [ed] GuyGrand, B, Gothenburg Univ, Sahlgrens Hosp, SOS Secretariat, Dept Internal Med, S-41345 Gothenburg, Sweden.: JOHN LIBBEY & CO , 1999, p. 845-851Conference paper (Refereed)
    Abstract [en]

    The prevalence of obesity is increasing dramatically among younger Swedes, and prevention is considered the only feasible public health strategy for addressing the growing problem. The following pilot work has been conducted while developing an intervention program aiming to prevent weight gain and progression of obesity among 18-25 year olds with high-risk familial profiles for obesity. First, exploratory interviews conducted in the target population were strongly indicative of a need for individualized programs. Thus, a flexible intervention program has been designed ('Health-Hunters'). whose objectives are to increase energy expenditure, modify obesity-related dietary practices, and promote behavioral skills that support these lifestyle changes, while offering individualized weight control modules when appropriate. A pilot study has now achieved its goal of recruiting 40 young men and women of varying familial predisposition, conducting baseline examinations, and randomizing to intervention or control groups. The Health-Hunters program, which offers support through mail, phone, and personal contact, has been initiated in the intervention group. Based on differences in motivation between predisposed and non-predisposed pilot subjects, it was decided to limit the full study to subjects with at least one obese parent. They are recruited via their severely overweight parents who are participants in the ongoing Swedish Obese Subjects (SOS) project. The program's short-term impact will be judged primarily in terms of measured changes in body composition and physical fitness in the intervention vs control groups after 1 year.

  • 52.
    Lissner, Lauren
    et al.
    Univ Gothenburg, Publ Hlth Epidemiol Unit, Dept Community Med & Publ Hlth, Sahlgrenska Acad, S-40530 Gothenburg, Sweden.
    Lanfer, Anne
    BIPS Inst Epidemiol & Prevent Res, Bremen, Germany.
    Gwozdz, Wencke
    Copenhagen Business Sch, Copenhagen, Denmark.
    Olafsdottir, Steingerdur
    Univ Gothenburg, Dept Food & Nutr, S-40530 Gothenburg, Sweden.
    Eiben, Gabriele
    Univ Gothenburg, Publ Hlth Epidemiol Unit, Dept Community Med & Publ Hlth, Sahlgrenska Acad, S-40530 Gothenburg, Sweden.
    Moreno, Luis A.
    Univ Zaragoza, GENUD Growth Exercise Nutr & Dev Res Grp, Sch Hlth Sci, E-50009 Zaragoza, Spain.
    Santaliestra-Pasias, Alba M.
    Univ Zaragoza, GENUD Growth Exercise Nutr & Dev Res Grp, Sch Hlth Sci, E-50009 Zaragoza, Spain.
    Kovacs, Eva
    Univ Pecs, Pecs, Hungary.
    Barba, Gianvincenzo
    CNR, Inst Food Sci, Avellino, Italy.
    Loit, Helle-Mai
    Natl Inst Hlth Dev, Tallinn, Estonia.
    Kourides, Yiannis
    Res & Educ Inst Child Hlth, Strovolos, Cyprus.
    Pala, Valeria
    Fdn IRCCS Ist Nazl Tumori, Epidemiol & Prevent Unit, Dept Prevent & Predict Med, Milan, Italy.
    Pohlabeln, Hermann
    BIPS Inst Epidemiol & Prevent Res, Bremen, Germany.
    De Henauw, Stefaan
    Univ Ghent, Dept Publ Hlth, B-9000 Ghent, Belgium.
    Buchecker, Kirsten
    TTZ, Dept Food Sci, Bremerhaven, Germany.
    Ahrens, Wolfgang
    BIPS Inst Epidemiol & Prevent Res, Bremen, Germany.
    Reisch, Lucia
    Copenhagen Business Sch, Copenhagen, Denmark.
    Television habits in relation to overweight, diet and taste preferences in European children: the IDEFICS study2012In: European Journal of Epidemiology, ISSN 0393-2990, E-ISSN 1573-7284, Vol. 27, no 9, p. 705-715Article in journal (Refereed)
    Abstract [en]

    Early television exposure has been associated with various health outcomes including childhood obesity. This paper describes associations between patterns of television viewing, on one hand, and diet, taste preference and weight status, on the other, in European preschoolers and schoolchildren. The IDEFICS baseline survey was conducted at examination centers in Italy, Estonia, Cyprus, Belgium, Sweden, Germany, Hungary, and Spain. 15,144 children aged 2-9 completed the basic protocol, including anthropometry and parental questionnaires on their diets and television habits. A subsample of 1,696 schoolchildren underwent further sensory testing for fat and sweet taste preferences. Three dichotomous indicators described: children's habitual television exposure time; television viewing during meals; and having televisions in their bedrooms. Based on these variables we investigated television habits in relation to overweight (IOTF) and usual consumption of foods high in fat and sugar. A possible role of taste preference in the latter association was tested in the sensory subgroup. All television indicators were significantly associated with increased risk of overweight, with odds ratios ranging from 1.21 to 1.30, in fully adjusted models. Children's propensities to consume high-fat and high-sugar foods were positively and, in most analyses, monotonically associated with high-risk television behaviors. The associations between television and diet propensities were not explained by preference for added fat or sugar in test foods. To summarize, in addition to being more overweight, children with high-risk television behaviors may, independent of objectively measured taste preferences for fat and sugar, passively overconsume higher-fat and particularly higher-sugar diets.

  • 53.
    Michels, N.
    et al.
    Univ Ghent, Dept Publ Hlth, Fac Med & Hlth Sci, B-9000 Ghent, Belgium.
    De Henauw, S.
    Univ Ghent, Dept Publ Hlth, Fac Med & Hlth Sci, B-9000 Ghent, Belgium / Univ Coll Ghent, Dept Hlth Sci, Ghent, Belgium.
    Eiben, Gabriele
    Univ Gothenburg, Sect Epidemiol & Social Med, Gothenburg, Sweden.
    Hadjigeorgiou, C.
    Res & Educ Inst Child Hlth, Strovolos, Cyprus.
    Hense, S.
    Leibniz Inst Prevent Res & Epidemiol BIPS, Bremen, Germany.
    Hunsberger, M.
    Univ Gothenburg, Sect Epidemiol & Social Med, Gothenburg, Sweden.
    Konstabel, K.
    Natl Inst Hlth Dev, Tallinn, Estonia.
    Molnar, D.
    Univ Pecs, Dept Paediat, Pecs, Hungary.
    Moreno, L. A.
    Univ Zaragoza, Sch Hlth Sci, GENUD Growth Exercise Nutr & Dev Res Grp, Zaragoza, Spain.
    Siani, A.
    CNR, Inst Food Sci, Epidemiol & Populat Genet, Avellino, Italy.
    De Bourdeaudhuij, I.
    Univ Ghent, Fac Med & Hlth Sci, Dept Movement & Sport Sci, B-9000 Ghent, Belgium.
    Pigeot, I.
    Leibniz Inst Prevent Res & Epidemiol BIPS, Bremen, Germany.;Univ Bremen, Fac Math & Comp Sci, Inst Stat, D-28359 Bremen, Germany.
    Effect of the IDEFICS multilevel obesity prevention on children's sleep duration2015In: Obesity Reviews, ISSN 1467-7881, E-ISSN 1467-789X, Vol. 16, p. 68-77Article in journal (Refereed)
    Abstract [en]

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

  • 54.
    Michels, Nathalie
    et al.
    Univ Ghent, Fac Med & Hlth Sci, Dept Publ Hlth, B-9000 Ghent, Belgium.
    Sioen, Isabelle
    Univ Ghent, Fac Med & Hlth Sci, Dept Publ Hlth, B-9000 Ghent, Belgium.;Res Fdn Flanders, B-1000 Brussels, Belgium.
    Braet, Caroline
    Univ Ghent, Dept Dev Personal & Social Psychol, B-9000 Ghent, Belgium.
    Eiben, Gabriele
    Univ Gothenburg, Sahlgrenska Acad, Dept Publ Hlth & Community Med, S-40530 Gothenburg, Sweden.
    Hebestreit, Antje
    BIPS Inst Epidemiol & Prevent Res, Bremen, Germany.
    Huybrechts, Inge
    Univ Ghent, Fac Med & Hlth Sci, Dept Publ Hlth, B-9000 Ghent, Belgium.
    Vanaelst, Barbara
    Univ Ghent, Fac Med & Hlth Sci, Dept Publ Hlth, B-9000 Ghent, Belgium.;Res Fdn Flanders, B-1000 Brussels, Belgium.
    Vyncke, Krishna
    Univ Ghent, Fac Med & Hlth Sci, Dept Publ Hlth, B-9000 Ghent, Belgium.;Res Fdn Flanders, B-1000 Brussels, Belgium.
    De Henauw, Stefaan
    Univ Coll Ghent, Dept Hlth Sci, B-9000 Ghent, Belgium.
    Stress, emotional eating behaviour and dietary patterns in children2012In: Appetite, ISSN 0195-6663, E-ISSN 1095-8304, Vol. 59, no 3, p. 762-769Article in journal (Refereed)
    Abstract [en]

    Psychological stress has been suggested to change dietary pattern towards more unhealthy choices and as such to contribute to overweight. Emotional eating behaviour could be an underlying mediating mechanism. The interrelationship between stress, emotional eating behaviour and dietary patterns has only rarely been examined in young children. Nevertheless, research in children is pivotal as the foundations of dietary habits are established starting from childhood and may track into adulthood. In 437 children (5-12 years) of the ChiBS study, stress was measured by questionnaires on stressful events, emotions (happy, angry, sad, anxious) and problems (emotional, peer, conduct and hyperactivity). Data were collected on children's emotional eating behaviour and also on dietary patterns: frequency of fatty foods, sweet foods, snacks (fat and sweet), fruit and vegetables. Stressful events, negative emotions and problems were positively associated with emotional eating. Positive associations were observed between problems and both sweet and fatty foods consumption. Negative associations were observed between events and fruit and vegetables consumption. Overall, stress was associated with emotional eating and a more unhealthy dietary pattern and could thus contribute to the development of overweight, also in children. Nevertheless, emotional eating behaviour was not observed to mediate the stress-diet relation. 

  • 55.
    Miguel Fernandez-Alvira, Juan
    et al.
    Univ Zaragoza, Fac Hlth Sci, GENUD Growth Exercise Nutr & Dev Res Grp, E-50009 Zaragoza, Spain / Leibniz Inst Prevent Res & Epidemiol BIPS, Bremen, Germany.
    Boernhorst, Claudia
    Leibniz Inst Prevent Res & Epidemiol BIPS, Bremen, Germany.
    Bammann, Karin
    Univ Bremen, Inst Publ Hlth & Nursing Sci IPP, D-28359 Bremen, Germany.
    Gwozdz, Wencke
    Copenhagen Business Sch, Copenhagen, Denmark.
    Krogh, Vittorio
    Fdn IRCCS Ist Nazl Tumori, Dept Prevent & Predict Med, Epidemiol Unit, Milan, Italy.
    Hebestreit, Antje
    Leibniz Inst Prevent Res & Epidemiol BIPS, Bremen, Germany.
    Barba, Gianvincenzo
    CNR, Inst Food Sci, Unit Epidemiol & Populat Genet, Avellino, Italy.
    Reisch, Lucia
    Copenhagen Business Sch, Copenhagen, Denmark.
    Eiben, Gabriele
    Univ Gothenburg, Sahlgrenska Acad, Dept Publ Hlth & Community Med, Publ Hlth Epidemiol Unit EPI, Gothenburg, Sweden.
    Iglesia, Iris
    Univ Zaragoza, Fac Hlth Sci, GENUD Growth Exercise Nutr & Dev Res Grp, E-50009 Zaragoza, Spain.
    Veidebaum, Tomas
    Natl Inst Hlth Dev, Dept Chron Dis, Tallinn, Estonia.
    Kourides, Yannis A.
    Res & Educ Inst Child Hlth, Strovolos, Cyprus.
    Kovacs, Eva
    Univ Pecs, Dept Paediat, Pecs, Hungary.
    Huybrechts, Inge
    Univ Ghent, Dept Publ Hlth, B-9000 Ghent, Belgium / Int Agcy Res Canc, Dietary Exposure Assessment Grp, F-69372 Lyon, France.
    Pigeot, Iris
    Leibniz Inst Prevent Res & Epidemiol BIPS, Bremen, Germany.;Univ Bremen, Inst Stat, Fac Math & Comp Sci, D-28359 Bremen, Germany.
    Moreno, Luis A.
    Univ Zaragoza, Fac Hlth Sci, GENUD Growth Exercise Nutr & Dev Res Grp, E-50009 Zaragoza, Spain.
    Prospective associations between socio-economic status and dietary patterns in European children: the Identification and Prevention of Dietary- and Lifestyle-induced Health Effects in Children and Infants (IDEFICS) Study2015In: British Journal of Nutrition, ISSN 0007-1145, E-ISSN 1475-2662, Vol. 113, no 3, p. 517-525Article in journal (Refereed)
    Abstract [en]

    Exploring changes in children's diet over time and the relationship between these changes and socio-economic status (SES) may help to understand the impact of social inequalities on dietary patterns. The aim of the present study was to describe dietary patterns by applying a cluster analysis to 9301 children participating in the baseline (2-9 years old) and follow-up (4-11 years old) surveys of the Identification and Prevention of Dietary-and Lifestyle-induced Health Effects in Children and Infants Study, and to describe the cluster memberships of these children over time and their association with SES. We applied the K-means clustering algorithm based on the similarities between the relative frequencies of consumption of forty-two food items. The following three consistent clusters were obtained at baseline and follow-up: processed (higher frequency of consumption of snacks and fast food); sweet (higher frequency of consumption of sweet foods and sweetened drinks); healthy (higher frequency of consumption of fruits, vegetables and wholemeal products). Children with higher-educated mothers and fathers and the highest household income were more likely to be allocated to the healthy cluster at baseline and follow-up and less likely to be allocated to the sweet cluster. Migrants were more likely to be allocated to the processed cluster at baseline and follow-up. Applying the cluster analysis to derive dietary patterns at the two time points allowed us to identify groups of children from a lower socio-economic background presenting persistently unhealthier dietary profiles. This finding reflects the need for healthy eating interventions specifically targeting children from lower socio-economic backgrounds.

  • 56.
    Miguel Fernandez-Alvira, Juan
    et al.
    Univ Zaragoza, GENUD Growth Exercise Nutr & Dev Res Grp, Univ Sch Hlth Sci, E-50009 Zaragoza, Spain.
    Mouratidou, Theodora
    Univ Zaragoza, GENUD Growth Exercise Nutr & Dev Res Grp, Univ Sch Hlth Sci, E-50009 Zaragoza, Spain.
    Bammann, Karin
    Univ Bremen, Bremen Inst Prevent Res & Social Med, D-28359 Bremen, Germany.
    Hebestreit, Antje
    Univ Bremen, Bremen Inst Prevent Res & Social Med, D-28359 Bremen, Germany.
    Barba, Gianvincenzo
    CNR, Unit Epidemiol & Populat Genet, Inst Food Sci, Avellino, Italy.
    Sieri, Sabina
    Fdn IRCCS Ist Nazl Tumori, Dept Prevent & Predict Med, Nutr Epidemiol Unit, Milan, Italy.
    Reisch, Lucia
    Copenhagen Business Sch, Copenhagen, Denmark.
    Eiben, Gabriele
    Univ Gothenburg, Dept Publ Hlth & Community Med, Publ Hlth Epidemiol Unit, Sahlgrenska Acad, Gothenburg, Sweden.
    Hadjigeorgiou, Charalampos
    Res & Educ Inst Child Hlth, Strovolos, Cyprus.
    Kovacs, Eva
    Univ Pecs, Dept Paediat, Pecs, Hungary.
    Huybrechts, Inge
    Univ Ghent, Dept Publ Hlth, B-9000 Ghent, Belgium.
    Moreno, Luis A.
    Univ Zaragoza, GENUD Growth Exercise Nutr & Dev Res Grp, Univ Sch Hlth Sci, E-50009 Zaragoza, Spain.
    Parental education and frequency of food consumption in European children: the IDEFICS study2013In: Public Health Nutrition, ISSN 1368-9800, E-ISSN 1475-2727, Vol. 16, no 3, p. 487-498Article in journal (Refereed)
    Abstract [en]

    Objective: To assess the relationship between parental education level and the consumption frequency of obesity-related foods in European children. Design: The analysis was based on data from the cross-sectional baseline survey of a prospective cohort study. The effects of parental education on food consumption were explored using analysis of covariance and logistic regression. Setting: Primary schools and pre-schools of selected regions in Italy, Estonia, Cyprus, Belgium, Sweden, Hungary, Germany and Spain. Subjects: Participants (n 14 426) of the IDEFICS baseline cohort study aged 2 to 9 years. Results: Parental education level affected the intake of obesity-related foods in children. Children in the low and medium parental education level groups had lower odds of more frequently eating low-sugar and low-fat foods (vegetables, fruits, pasta/noodles/rice and wholemeal bread) and higher odds of more frequently eating high-sugar and high-fat foods (fried potatoes, fruits with sugar and nuts, snacks/desserts and sugared beverages; P<0.001). The largest odds ratio differences were found in the low category (reference category: high) for vegetables (OR=0.56; 95% CI 0.47, 0.65), fruits (OR=0.56; 95% CI 0.48, 0.65), fruits with sugar and nuts (OR=2.23; 95% CI 1.92, 2.59) and sugared beverages (OR=2.01; 95% CI 1.77, 2.37). Conclusions: Low parental education level was associated with intakes of sugar-rich and fatty foods among children, while high parental education level was associated with intakes of low-sugar and low-fat foods. These findings should be taken into account in public health interventions, with more targeted policies aiming at an improvement of children's diet.

  • 57.
    Mikkelsen, A.
    et al.
    Univ Gothenburg, Sahlgrenska Acad, Inst Med, Sect Epidemiol & Social Med, POB 453, S-40530 Gothenburg, Sweden.;Narhalsan, Res & Dev Primary Hlth Care, Gothenburg, Region Vostra G, Sweden.
    Galli, C.
    Univ Milan, Dept Pharmacol & Biomol Sci, DiSFeB, Milan, Italy.
    Eiben, Gabriele
    Univ Gothenburg, Sahlgrenska Acad, Inst Med, Sect Epidemiol & Social Med, POB 453, S-40530 Gothenburg, Sweden.
    Ahrens, W.
    Leibniz Inst Prevent Res & Epidemiol BIPS, Bremen, Germany.
    Iacoviello, L.
    Dept Epidemiol & Prevent, Lab Mol & Nutrit Epidemiol, IRCCS Ist Neurol Mediterraneo Neuromed, Pozzilli, Italy.
    Molnar, D.
    Univ Pecs, Dept Pediat, Pecs, Hungary.
    Pala, V.
    Dept Prevent & Predict Med, Epidemiol Unit, Fdn IRCCS Ist Nazl Tumori, Milan, Italy.
    Rise, P.
    Univ Milan, Dept Pharmacol & Biomol Sci, DiSFeB, Milan, Italy.
    Rodriguez, G.
    Univ Zaragoza, GENUD Growth Exercise Nutr & Dev, Res Grp, Zaragoza, Spain.;Inst Invest Sanitaria, Aragon, Spain.
    Russo, P.
    CNR, Inst Food Sci, Avellino, Italy.
    Tornaritis, M.
    Res & Educ Inst Child Hlth, Strovolos, Cyprus.
    Veidebaum, T.
    Natl Inst Hlth Dev, Tallinn, Estonia.
    Vyncke, K.
    Department of Public Health, University of Ghent, Ghent, Belgium.
    Wolters, M.
    Leibniz Inst Prevent Res & Epidemiol BIPS, Bremen, Germany.
    Mehlig, K.
    Univ Gothenburg, Sahlgrenska Acad, Inst Med, Sect Epidemiol & Social Med, POB 453, S-40530 Gothenburg, Sweden / Univ Ghent, Dept Publ Hlth, Ghent, Belgium.
    Blood fatty acid composition in relation to allergy in children aged 2-9 years: results from the European IDEFICS study2017In: European Journal of Clinical Nutrition, ISSN 0954-3007, E-ISSN 1476-5640, Vol. 71, no 1, p. 39-44Article in journal (Refereed)
    Abstract [en]

    BACKGROUND/OBJECTIVES: Blood polyunsaturated fatty acids (PUFA) are involved in allergy development, but the etiological role of n-6 and n-3 PUFA is still controversial. A European multicenter study of children (IDEFICS) provided the opportunity to explore the cross-sectional association between fatty acids (FA) and allergy. SUBJECTS/METHODS: Blood FA levels were measured in 2600 children aged 2-9 years and were recorded as the percentage of weight of all FA detected. Logistic regression of allergy status on FA components was adjusted for age, sex, country, body mass index, family history of allergic disease, breast-feeding, and number of siblings. The results were given as odds ratios (OR) for current vs no allergy ever and an increase in FA by 1 s.d. RESULTS: Overall, higher proportions of n-6 PUFA were associated with higher odds of allergy (OR = 1.21 (1.05, 1.40)). Monounsaturated FA (MUFA) were associated with reduced risk for allergy (OR = 0.75 (0.65, 0.87)), whereas saturated FA did not differ by allergy status. The strongest associations were observed in children < 4 years old, with ORs of allergy given as 1.62 (1.15, 2.29) for n-3 PUFA and 0.63 (0.42, 0.95) for MUFA. With regard to individual FA, these associations were independently observed for docosapentaenoic acid (22: 5 n-3) and oleic acid (18: 1 n-9). CONCLUSIONS: Both PUFA subtypes were positively associated with allergy in an age-dependent manner, whereas MUFA was associated with less allergy. The observation of high proportions of n-3 PUFA in allergic children younger than 4 years might help to understand the nature of early onset of atopic disease.

  • 58.
    Murtas, Rossella
    et al.
    Fdn IRCSS Ist Nazl Tumori, Epidemiol & Prevent Unit, Via Venezian 1, I-20133 Milan, Italy / Univ Cagliari, Dept Math & Comp Sci, Cagliari, Italy.
    Krogh, Vittorio
    Fdn IRCSS Ist Nazl Tumori, Epidemiol & Prevent Unit, Via Venezian 1, I-20133 Milan, Italy.
    Intemann, Timm
    Leibniz Inst Prevent Res & Epidemiol BIPS, Bremen, Germany / Bremen Univ, Inst Stat, Bremen, Germany.
    Lissner, Lauren
    Univ Gothenburg, Sahlgrenska Acad, Sect Epidemiol & Social Med, Gothenburg, Sweden.
    Eiben, Gabriele
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Molnar, Denes
    Univ Pecs, Med Sch, Dept Pediat, Pecs, Hungary.
    Moreno, Luis A.
    Univ Zaragoza, Growth Exercise Nutr & Dev Res Grp, Zaragoza, Spain.
    Siani, Alfonso
    CNR, Inst Food Sci, Res, Avellino, Italy.
    Tornaritis, Michael
    Res & Educ Inst Child Hlth, Strovolos, Cyprus.
    Veidebaum, Toomas
    Natl Inst Hlth Dev, Tallinn, Estonia.
    Mazur, Artur
    Univ Rzeszow, Med Fac, Inst Nursing & Hlth Sci, Rzeszow, Poland.
    Deren, Katarzyna
    Univ Rzeszow, Med Fac, Inst Nursing & Hlth Sci, Rzeszow, Poland.
    Wolters, Maike
    Leibniz Inst Prevent Res & Epidemiol BIPS, Bremen, Germany.
    Ahrens, Wolfgang
    Bremen Univ, Inst Stat, Bremen, Germany / Leibniz Inst Prevent Res & Epidemiol BIPS, Dept Epidemiol Methods & Etiol Res, Bremen, Germany.
    Pala, Valeria
    Fdn IRCSS Ist Nazl Tumori, Epidemiol & Prevent Unit, Via Venezian 1, I-20133 Milan, Italy.
    Does Providing Assistance to Children and Adolescents Increase Repeatability and Plausibility of Self-Reporting Using a Web-Based Dietary Recall Instrument?2018In: Journal of the Academy of Nutrition and Dietetics, ISSN 2212-2672, E-ISSN 2212-2680, Vol. 118, no 12, p. 2324-2330Article in journal (Refereed)
    Abstract [en]

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

  • 59.
    Olafsdottir, S.
    et al.
    Univ Gothenburg, Dept Food & Nutr & Sport Sci, SE-40530 Gothenburg, Sweden.
    Berg, C.
    Univ Gothenburg, Dept Food & Nutr & Sport Sci, SE-40530 Gothenburg, Sweden.
    Eiben, Gabriele
    Univ Gothenburg, Sahlgrenska Acad, Inst Med, Dept Publ Hlth & Community Med, Gothenburg, Sweden.
    Lanfer, A.
    Leibniz Inst Prevent Res & Epidemiol BIPS GmbH, Dept Epidemiol Methods & Etiol Res, Bremen, Germany.
    Reisch, L.
    Copenhagen Business Sch, DK-2000 Frederiksberg, Denmark.
    Ahrens, W.
    Leibniz Inst Prevent Res & Epidemiol BIPS GmbH, Dept Epidemiol Methods & Etiol Res, Bremen, Germany.
    Kourides, Y.
    Res & Educ Inst Child Hlth, Strovolos, Cyprus.
    Molnar, D.
    Univ Pecs, Fac Med, Dept Paediat, Pecs, Hungary.
    Moreno, L. A.
    Univ Zaragoza, Growth Exercise Nutr & Dev Res Grp, Zaragoza, Spain.
    Siani, A.
    CNR, Inst Food Sci, Unit Epidemiol & Populat Genet, Avellino, Italy.
    Veidebaum, T.
    Natl Inst Hlth Dev, Tallinn, Estonia.
    Lissner, L.
    Univ Gothenburg, Sahlgrenska Acad, Inst Med, Dept Publ Hlth & Community Med, Gothenburg, Sweden.
    Young children's screen activities, sweet drink consumption and anthropometry: results from a prospective European study2014In: European Journal of Clinical Nutrition, ISSN 0954-3007, E-ISSN 1476-5640, Vol. 68, no 2, p. 223-228Article in journal (Refereed)
    Abstract [en]

    BACKGROUND/OBJECTIVES: This longitudinal study describes the relationship between young children's screen time, dietary habits and anthropometric measures. The hypothesis was that television viewing and other screen activities at baseline result in increased consumption of sugar-sweetened beverages (SSB) and increased BMI, BMI z-score and waist to height ratio (WHtR) two years later. A second hypothesis was that SSB consumption mediates the association between the screen activities and changes in the anthropometric measures. SUBJECTS/METHODS: The study is a part of the prospective cohort study IDEFICS ("Identification and prevention of dietary and lifestyle-induced health effects in children and infants"), investigating diet, lifestyle and social determinants of obesity in 2 to 9-year-olds in eight European countries (baseline n = 16 225, two-year follow-up; n = 11 038). Anthropometry was objectively measured, and behaviours were parent-reported. RESULTS: The main hypothesis was supported, but the second hypothesis was not confirmed. The odds ratio of being in the highest quintile of % change in WHtR was 1.26 (95% CI: 1.17-1.36) and in BMI 1.22 (95% CI: 1.13-1.31), for each hour per day watching television. The odds ratio of having increased SSB consumption was 1.19 (95% CI: 1.09-1.29) for each hour per day watching TV. The associations for total screen time were slightly weaker. CONCLUSIONS: The results indicate substantial effects of TV viewing and other screen activities for young children, both on their consumption of sugary drinks and on an increase in BMI and central obesity. Our findings suggest that television viewing seems to have a stronger effect on food habits and anthropometry than other screen activities in this age group.

  • 60.
    Olafsdottir, Steingerdur
    et al.
    Univ Gothenburg, Dept Food & Nutr & Sport Sci, S-40530 Gothenburg, Sweden.
    Eiben, Gabriele
    Univ Gothenburg, Sahlgrenska Acad, Inst Med, Dept Publ Hlth & Community Med, S-40530 Gothenburg, Sweden.
    Prell, Hillevi
    Univ Gothenburg, Dept Food & Nutr & Sport Sci, S-40530 Gothenburg, Sweden.
    Hense, Sabrina
    BIPS GmbH, Leibniz Inst Prevent Res & Epidemiol, Dept Epidemiol Methods & Etiol Res, Bremen, Germany.
    Lissner, Lauren
    Univ Gothenburg, Sahlgrenska Acad, Inst Med, Dept Publ Hlth & Community Med, S-40530 Gothenburg, Sweden.
    Marild, Staffan
    Univ Gothenburg, Sahlgrenska Acad, Inst Med, Dept Publ Hlth & Community Med, S-40530 Gothenburg, Sweden.
    Reisch, Lucia
    Copenhagen Business Sch, DK-2000 Frederiksberg, Denmark.
    Berg, Christina
    Univ Gothenburg, Dept Food & Nutr & Sport Sci, S-40530 Gothenburg, Sweden.
    Young children's screen habits are associated with consumption of sweetened beverages independently of parental norms2014In: International Journal of Public Health, ISSN 1661-8556, E-ISSN 1661-8564, Vol. 59, no 1, p. 67-75Article in journal (Refereed)
    Abstract [en]

    This study investigated the associations between children's screen habits and their consumption of sweetened beverages. Because parents might be disposed to regulate their child's screen and dietary habits in a similar direction, our specific aim was to examine whether these associations were independent of parental norms. In the Swedish sample of the European Identification and prevention of dietary and lifestyle-induced health effects in children and infants (IDEFICS) study, parents filled in questionnaires about their 2 to 9-year-old children's (n = 1,733) lifestyle and diets. Associations between screen habits and sweetened beverage consumption were found independent of parental norms regarding sweetened beverages. A longitudinal analysis revealed that sweetened beverage consumption at 2-year follow-up was predicted by exposure to commercial TV at baseline (OR 1.4, 95 % CI 1.1-1.9). Cross-sectional analysis showed that the likelihood of consuming sweetened beverages at least 1-3 times per week increased for each hour/day watching television (OR 1.5, 95 % CI 1.2-1.9), and for being exposed to commercials (OR 1.6, 95 % CI 1.3-2.1). TV viewing time and commercial exposure contributed to the associations independently of each other. The results strengthen the assumption that it is possible to influence children's dietary habits through their TV habits.

  • 61.
    Oli, Natalia
    et al.
    Kathmandu Medical College, Nepal.
    Vaidya, Abhinav
    Kathmandu Medical College, Nepal.
    Eiben, Gabriele
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Krettek, Alexandra
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Sahlgrenska Academy at University of Gothenburg, Sweden / UiT The Arctic University of Norway, Tromsø.
    Changes in children’s diet and physical activity as perceived by their mothers: Impact of a health promotion intervention for mothers in a sub-urban area of Nepal2018In: Journal of Kathmandu Medical College, ISSN 2091-1785, Vol. 7, no 4, p. 140-146Article in journal (Refereed)
    Abstract [en]

    Background:

    Unhealthy diet and physical inactivity contribute to the growing burden of cardiovascular diseases in Nepal. Lifestyle is formed in childhood and in the Nepalese context influenced mainly by mothers, it is to date unknown how influential mothers are.

    Objectives:

    To assess changes in children’s diet and physical activity as perceived by their mothers after a health promotion intervention.

    Methodology:

    The Heart-Health Associated Research, Dissemination and Intervention in the Community is a community trial conducted in the Jhaukhel-Duwakot Health Demographic Surveillance site, in Bhaktapur district of Nepal. We conducted a health promotion intervention on diet and physical activity targeted at mothers with children aged one to nine years old in August-November 2016. Duwakot was randomized as the intervention site and Jhaukhel as the control. We conducted a follow-up study after three months to determine the outcome of the intervention. Nine trained enumerators conducted door-to-door visits to all households with eligible mothers. We calculated mean, frequency and percent changes for children’s behavior.

    Results:

    As responded by mothers, children in Duwakot consumed more healthy snacks after the intervention compared to Jhaukhel. Children in Duwakot increased consumption of water and milk. Children’s consumption of packet juices and soft drinks was decreased by 30% and 4% respectively. There was 21% increment in the duration of outdoor playing among the children at Duwakot during follow-up.

    Conclusion:

    The Heart-Health Associated Research, Dissemination and Intervention in the Community that focused on mothers showed indirect positive impact on their young children’s diet and physical activity behavior. In future, the longterm effects of such intervention should be assessed.

  • 62.
    Oli, Natalia
    et al.
    Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Sweden / Department of Community Medicine, Kathmandu Medical College, Nepal.
    Vaidya, Abhinav
    Department of Community Medicine, Kathmandu Medical College, Nepal.
    Eiben, Gabriele
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Krettek, Alexandra
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Sweden / Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.
    Effectiveness of health promotion regarding diet and physical activity among Nepalese mothers and their young children: The Heart-health Associated Research, Dissemination, and Intervention in the Community (HARDIC) trial2019In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 12, p. 1-12, article id 1670033Article in journal (Refereed)
    Abstract [en]

    Background: Nepal, like many low- and middle-income countries, exhibits rising burden of cardiovascular diseases. Misconceptions, poor behavior, and a high prevalence of risk factors contribute to this development. Health promotion efforts along with primary prevention strategies, including risk factor reduction in both adults and children, are therefore critical. Objectives: This study assessed the effectiveness of a health promotion intervention on mothers' knowledge, attitude and practice (KAP) and their children's behavior regarding diet and physical activity. Methods: The Heart-health Associated Research, Dissemination and Intervention in the Community (HARDIC), a community-based trial, used peer education to target mothers with 1-9-year-old children in the peri-urban Jhaukhel-Duwakot Health Demographic Surveillance Site, Nepal, during August-November 2016. In the intervention area, 47 peer mothers were trained to conduct four education classes for about 10 fellow mothers (N = 391). After 3 months, all eligible mothers in the intervention and control areas were interviewed and the results were compared with the KAP of all eligible mothers at baseline. Results: Post-intervention, mothers' KAP median scores had improved regarding heart-healthy diet and physical activity. More mothers had 'good' KAP (>75% of maximum possible scores), and mothers with 'good' knowledge increased from 50% to 81%. Corresponding control values increased only from 58% to 63%. Mothers' attitude and practice improved. Additionally, mothers in the intervention area reported improvement in their children's diet and physical activity behavior. Moreover, Difference in Differences analysis showed that the HARDIC intervention significantly increased mothers' KAP scores and children's behavior scores in the intervention area compared to the control area. Conclusions: Our intervention improves KAP scores regarding diet and physical activity and shows potential for expansion via community health workers, volunteers, and/or local women. Moreover, HARDIC can contribute to Nepal's Package of Essential Noncommunicable Diseases Initiative, which currently lacks a specific package for health promotion.

  • 63.
    Oli, Natalia
    et al.
    Sahlgrenska Academy at University of Gothenburg, Sweden / Kathmandu Medical College, Kathmandu, Nepal.
    Vaidya, Abhinav
    Kathmandu Medical College, Kathmandu, Nepal.
    Pahkala, Katja
    University of Turku, Finland.
    Eiben, Gabriele
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. University of Gothenburg, Sweden.
    Krettek, Alexandra
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Sahlgrenska Academy at University of Gothenburg, Sweden / UiT The Arctic University of Norway, Tromsø, Norway.
    Knowledge, attitude and practice on diet and physical activity among mothers with young children in the Jhaukhel-Duwakot Health Demographic Surveillance Site, Nepal2018In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 13, no 7, article id e0200329Article in journal (Refereed)
    Abstract [en]

    The prevalence of cardiovascular diseases is increasing in low and middle-income countries; Nepal's population shows a high prevalence of behavioral risk factors. Our cross-sectional study in the Jhaukhel-Duwakot Health Demographic Surveillance Site (JD-HDSS), located near the capital Kathmandu, explored knowledge, attitude, and practice (KAP) of mothers with young children regarding diet and physical activity and mothers' perception of their children's attitude and behavior toward the same issues. The purpose of our study was to assess needs of the mothers concerning cardiovascular health in general and more specifically regarding diet and physical activity, and to establish a baseline for future intervention in the community by comparing two villages of JD-HDSS. In August-November 2014, nine trained enumerators interviewed all mothers of children aged 1-7 years (N = 962). We scored responses on dietary and physical activity KAP, then categorized the scores based on the percentage obtained out of the maximum possible scores into "poor," "fair," and "good." More highly educated mothers scored higher for KAP (all p<0.001); the children's behavior score reflected their mother's education level (p = 0.007). Most respondents were unfamiliar with the concept of healthy and unhealthy food. Overall, 57% of respondents in JD-HDSS had "good" knowledge, 44.6% had "good" attitude, and most (90%) had "poor" practice. We observed no significant differences between the villages regarding mothers' knowledge and attitude or children's behavior. Practice score of mothers in Jhaukhel was higher than those in Duwakot regarding diet and physical activity (p<0.001). Mothers' perceived barriers for improving lifestyle were high cost of healthy food, taste preference of other family members, and lack of knowledge regarding healthy food. Barriers for physical activity were lack of leisure time, absence of parks and playgrounds, busy caring for children and old people, feeling lazy, and embarrassed to be physically active in front of others. Our findings suggest that a health education intervention promoting a healthy lifestyle for mothers and children might improve KAP and also improve cardiovascular health. To address mothers' gap between knowledge and practice, a future intervention should consider perceived barriers.

  • 64.
    Oli, Natalia
    et al.
    Department of Community Medicine, Kathmandu Medical College, Kathmandu, Nepal / Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
    Vaidya, Abhinav
    Department of Community Medicine, Kathmandu Medical College, Kathmandu, Nepal.
    Subedi, Madhusudan
    Department of Community Health Sciences, Patan Academy of Health Sciences, Lalitpur, Nepal.
    Eiben, Gabriele
    Department of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden.
    Krettek, Alexandra
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden / Department of Community Medicine, Faculty of Health Sciences, The Arctic University of Norway, Tromsø, Norway.
    Diet and physical activity for children's health: a qualitative study of Nepalese mothers' perceptions2015In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 5, no 9, article id e008197Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: Non-communicable diseases account for 50% of all deaths in Nepal and 25% result from cardiovascular diseases. Previous studies in Nepal indicate a high burden of behavioural cardiovascular risk factors, suggesting a low level of knowledge, attitude and practice/behaviour regarding cardiovascular health. The behavioural foundation for a healthy lifestyle begins in early childhood, when mothers play a key role in their children's lives. This qualitative study, conducted in a Nepalese peri-urban community, aimed to explore mothers' perception of their children's diet and physical activity.

    DESIGN: We notated, tape-recorded and transcribed all data collected from six focus group discussions, and used qualitative content analysis for evaluation and interpretation.

    SETTING: The study was conducted in the Jhaukhel-Duwakot Health Demographic Surveillance Site in the Bhaktapur district of Nepal.

    PARTICIPANTS: Local health workers helped recruit 61 women with children aged 5-10 years. We distributed participants among six different groups according to educational status.

    RESULTS: Although participants understood the importance of healthy food, they misunderstood its composition, perceiving it as unappetising and appropriate only for sick people. Furthermore, participants did not prioritise their children's physical activities. Moreover, mothers believed they had limited control over their children's dietary habits and physical activity. Finally, they opined that health educational programmes would help mothers and recommended various intervention strategies to increase knowledge regarding a healthy lifestyle.

    CONCLUSIONS: Our data reveal that mothers of young children in a peri-urban community of Nepal lack adequate and accurate understanding about the impact of a healthy diet and physical activity. Therefore, to prevent future cardiovascular disease and other non-communicable diseases among children, Nepal needs health education programmes to improve mothers' cardiovascular health knowledge, attitude and behaviour.

  • 65.
    Papoutsoul, S.
    et al.
    Res & Educ Inst Child Hlth, CY-2027 Nicosia, Cyprus.
    Briassoulis, G.
    Univ Crete, Fac Med, Pediat Intens Care Unit, Iraklion, Greece / BIPS GmbH, Leibniz Inst Prevent Res & Epidemiol BIPS, Bremen, Germany.
    Wolters, M.
    BIPS GmbH, Leibniz Inst Prevent Res & Epidemiol BIPS, Bremen, Germany.
    Peplies, J.
    Leibniz Institute for Prevention Research and Epidemiology–BIPS GmbH, Bremen, Germany.
    Iacoviello, L.
    IRCCS Ist Neurol Mediterraneo NEUROMED, Dept Epidemiol & Prevent, Lab Mol & Nutr Epidemiol, Pozzilli, Italy.
    Eiben, Gabriele
    Univ Gothenburg, Dept Publ Hlth & Community Med, Gothenburg, Sweden.
    Veidebaum, T.
    Natl Inst Hlth Dev, Tallinn, Estonia.
    Molnar, D.
    Univ Pecs, Fac Med, Dept Pediat, Pecs, Hungary.
    Russo, P.
    CNR, Inst Food Sci, Avellino, Italy.
    Michels, N.
    Univ Ghent, Fac Med & Hlth Sci, Dept Publ Heath, B-9000 Ghent, Belgium.
    Moreno, L. A.
    Univ Zaragoza, Growth Exercise Nutr & Dev Res Grp, Zaragoza, Spain.
    Tornaritis, M.
    Res & Educ Inst Child Hlth, CY-2027 Nicosia, Cyprus.
    No breakfast at home: association with cardiovascular disease risk factors in childhood2014In: European Journal of Clinical Nutrition, ISSN 0954-3007, E-ISSN 1476-5640, Vol. 68, no 7, p. 829-834Article in journal (Refereed)
    Abstract [en]

    BACKGROUND/OBJECTIVES: Limited data exist regarding breakfast consumption and its association with cardiovascular disease (CVD) risk factors. This study investigates the relationship between breakfast routine and CVD risk factors in a multinational sample. SUBJECTS/METHODS: Cross-sectional data from eight European countries participating in the IDEFICS (Identification and prevention of dietary- and lifestyle-induced health effects in children and infants) survey (2007-2008) were used. The sample included children 2 to <10 years of age (n=8863, 51.2% boys). The Mann-Whitney U-test and logistic regression were used to assess CVD risk factors among no breakfast (NBrH), occasional breakfast and daily breakfast at home (DBrH) consumption. RESULTS: Male school-aged NBrH consumers, compared with DBrH consumers, were more likely to be overweight/obese (odds ratio (OR): 1.37, 95% confidence interval (Cl) = 1.05-1.79), to have higher risk for high-density lipoprotein (HDL) cholesterol levels lower than 40 mg/dl (OR: 1.69, 95% CI = 1.24-2.30), triglycerides (TG) above 75 mg/dl (OR: 1.65, 95% CI = 1.24-2.19) and sum of skinfolds greater than the 90th percentile (OR: 1.32, 95% CI = 1.0-1.76). Female school-aged NBrH consumers compared with DBrH consumers had a higher risk for waist circumference greater than the 90th percentile (OR: 1.70, 95% CI = 1.14-2.51), HDL cholesterol levels lower than 40 mg/dl (OR: 1.65, 95% CI = 1.23-2.21), TG above 75 mg/dl (OR: 1.65, 95% CI = 1.26-2.17) and total cholesterol/HDL cholesterol ratio >3.5 (OR: 1.39, 95% CI = 1.09-1.77). Results remained significant after adjusting for daily physical activity in moderate-to-vigorous physical activity (MVPA) periods (in min/day). Male DBrH consumers, 6 to <10 years of age, had longer daily periods of MVPA compared with NBrH consumers (32.0 +/- 21.4 vs 27.5 +/- 18.8, P < 0.05). For preschoolers, breakfast consumption was negatively associated with CVD risk factors but results of regression models were mostly insignificant. CONCLUSIONS: Daily breakfast consumption contributes to controlling school-aged children's weight and lipid profile and promotes higher PA.

  • 66.
    Perlaki, Gabor
    et al.
    MTA-PTE Clinical Neuroscience MR Research Group, Pecs, Hungary / Department of Neurology, University of Pecs, Medical School, Hungary.
    Molnar, Denes
    Department of Pediatrics, University of Pecs, Medical School, Pecs, Hungary.
    Smeets, Paul A. M.
    Utrecht University, Netherlands / Wageningen University & Research, Netherlands.
    Ahrens, Wolfgang
    Leibniz Institute for Prevention Research and Epidemiology BIPS, Bremen, Germany.
    Wolters, Maike
    Leibniz Institute for Prevention Research and Epidemiology BIPS, Bremen, Germany.
    Eiben, Gabriele
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Department of Public Health and Community Medicine, University of Gothenburg, Sweden.
    Lissner, Lauren
    Department of Public Health and Community Medicine, University of Gothenburg, Sweden.
    Erhard, Peter
    University of Bremen, Germany.
    van Meer, Floor
    Utrecht University, Netherlands.
    Herrmann, Manfred
    University of Bremen, Germany.
    Janszky, Jozsef
    MTA-PTE Clinical Neuroscience MR Research Group, Pecs, Hungary / Department of Neurology, University of Pecs, Medical School, Hungary.
    Orsi, Gergely
    MTA-PTE Clinical Neuroscience MR Research Group, Pecs, Hungary / Department of Neurology, University of Pecs, Medical School, Hungary.
    Volumetric gray matter measures of amygdala and accumbens in childhood overweight/obesity2018In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 13, no 10, article id e0205331Article in journal (Refereed)
    Abstract [en]

    Objectives Neuroimaging data suggest that pediatric overweight and obesity are associated with morphological alterations in gray matter (GM) brain structures, but previous studies using mainly voxel-based morphometry (VBM) showed inconsistent results. Here, we aimed to examine the relationship between youth obesity and the volume of predefined reward system structures using magnetic resonance (MR) volumetry. We also aimed to complement volumetry with VBM-style analysis. Methods Fifty-one Caucasian young subjects (32 females; mean age: 13.8±1.9, range: 10.2–16.5 years) were included. Subjects were selected from a subsample of the I.Family study examined in the Hungarian center. A T1-weighted 1 mm3 isotropic resolution image was acquired. Age- and sex-standardized body mass index (zBMI) was assessed at the day of MRI and ~1.89 years (mean±SD: 689±188 days) before the examination. Obesity related GM alterations were investigated using MR volumetry in five predefined brain structures presumed to play crucial roles in body weight regulation (hippocampus, amygdala, accumbens, caudate, putamen), as well as whole-brain and regional VBM. Results The volumes of accumbens and amygdala showed significant positive correlations with zBMI, while their GM densities were inversely related to zBMI. Voxel-based GM mass also showed significant negative correlation with zBMI when investigated in the predefined amygdala region, but this relationship was mediated by GM density. Conclusions Overweight/obesity related morphometric brain differences already seem to be present in children/adolescents. Our work highlights the disparity between volume and VBM-derived measures and that GM mass (combination of volume and density) is not informative in the context of obesity related volumetric changes. To better characterize the association between childhood obesity and GM morphometry, a combination of volumetric segmentation and VBM methods, as well as future longitudinal studies are necessary. Our results suggest that childhood obesity is associated with enlarged structural volumes, but decreased GM density in the reward system. © 2018 Perlaki et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

  • 67.
    Pohlabeln, Hermann
    et al.
    Leibniz Inst Prevent Res & Epidemiol BIPS, Achterstr 30, D-28359 Bremen, Germany.
    Rach, Stefan
    Leibniz Inst Prevent Res & Epidemiol BIPS, Achterstr 30, D-28359 Bremen, Germany.
    De Henauw, Stefaan
    Univ Ghent, Dept Publ Hlth, Fac Med & Hlth Sci, Ghent, Belgium.
    Eiben, Gabriele
    Univ Gothenburg, Sahlgrenska Acad, Inst Med, Sect Epidemiol & Social Med, Gothenburg, Sweden.
    Gwozdz, Wencke
    Copenhagen Business Sch, Dept Intercultural Commun & Management, Ctr Corp Social Responsibil, Copenhagen, Denmark.
    Hadjigeorgiou, Charalampos
    Res & Educ Inst Child Hlth, Strovolos, Cyprus.
    Molnar, Denes
    Univ Pecs, Fac Med, Dept Paediat, Pecs, Hungary.
    Moreno, Luis A.
    Univ Zaragoza, IA2, Inst Invest Sanitaria Aragon IIS Aragon,GENUS Gro, Res Grp,Ctr Invest Biomed Red Fisiopatol Obesidad, Zaragoza, Spain.
    Russo, Paola
    CNR, Inst Food Sci, Unit Epidemiol & Populat Genet, Avellino, Italy.
    Veidebaum, Toomas
    Natl Inst Hlth Dev, Tallinn, Estonia.
    Pigeot, Iris
    Leibniz Inst Prevent Res & Epidemiol BIPS, Achterstr 30, D-28359 Bremen, Germany.
    Further evidence for the role of pregnancy-induced hypertension and other early life influences in the development of ADHD: results from the IDEFICS study2017In: European Child and Adolescent Psychiatry, ISSN 1018-8827, E-ISSN 1435-165X, Vol. 26, no 8, p. 957-967Article in journal (Refereed)
    Abstract [en]

    The aim of this study is to investigate whether in addition to established early risk factors other, less studied pre-, peri-, and postnatal influences, like gestational hypertension or neonatal respiratory disorders and infections, may increase a child's risk of developing attention-deficit/hyperactivity disorders (ADHD). In the IDEFICS study more than 18,000 children, aged 2-11.9 years, underwent extensive medical examinations supplemented by parental questionnaires on pregnancy and early childhood. The present analyses are restricted to children whose parents also completed a supplementary medical questionnaire (n = 15,577), including the question whether or not the child was ever diagnosed with ADHD. Multilevel multivariable logistic regression was used to assess the association between early life influences and the risk of ADHD. Our study confirms the well-known association between maternal smoking during pregnancy and a child's risk of ADHD. In addition, our study showed that children born to mothers younger than 20 years old were 3-4 times more likely to develop ADHD as compared to children born to mothers aged 25 years and older. Moreover, we found that children whose mothers suffered from pregnancy-induced hypertension had an approximately twofold risk of ADHD (OR 1.95; 95% CI 1.09-3.48). This also holds true for infections during the first 4 weeks after birth (OR 2.06; 95% CI 1.05-4.04). In addition, although not statistically significant, we observed a noticeable elevated risk estimate for neonatal respiratory disorders (OR 1.76; 95% CI 0.91-3.41). Hence, we recommend that these less often studied pre-, peri, and postnatal influences should get more attention when considering early indicators or predictors for ADHD in children. However, special study designs such as genetically sensitive designs may be needed to derive causal conclusions.

  • 68.
    Reeske, Anna
    et al.
    Leibniz Inst Prevent Res & Epidemiol BIPS, Bremen, Germany.
    Spallek, Jacob
    Leibniz Inst Prevent Res & Epidemiol BIPS, Bremen, Germany.;Univ Bielefeld, Sch Publ Hlth, Dept Epidemiol & Int Publ Hlth, D-33615 Bielefeld, Germany.
    Bammann, Karin
    Leibniz Inst Prevent Res & Epidemiol BIPS, Bremen, Germany.;Univ Bremen, Inst Publ Hlth & Nursing Res, D-28359 Bremen, Germany.
    Eiben, Gabriele
    Univ Gothenburg, Dept Publ Hlth & Community Med, Gothenburg, Sweden.
    De Henauw, Stefaan
    Univ Ghent, Dept Publ Hlth, B-9000 Ghent, Belgium.
    Kourides, Yiannis
    Res & Educ Inst Child Hlth, Strovolos, Cyprus.
    Nagy, Peter
    Univ Pecs, Dept Pediat, Pecs, Hungary.
    Ahrens, Wolfgang
    Leibniz Inst Prevent Res & Epidemiol BIPS, Bremen, Germany.;Univ Bremen, Inst Stat, D-28359 Bremen, Germany.
    Migrant Background and Weight Gain in Early Infancy: Results from the German Study Sample of the IDEFICS Study2013In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 8, no 4, article id e60648Article in journal (Refereed)
    Abstract [en]

    Objective: To examine variations in infant weight gain between children of parents with and without migrant background and to investigate how these differences are explained by pre- and perinatal factors. Methods: We used data on birth weight and weight at six months from well-child check-up books that were collected from a population-based German sample of children in the IDEFICS study (n = 1,287). We calculated unadjusted and adjusted means for weight z-scores at birth and six months later. We applied linear regression for change in weight z-score and we calculated odds ratios and 95% confidence intervals (95% CI) for rapid weight gain by logistic regression, adjusted for biological, social and behavioural factors. Results: Weight z-scores for migrants and Germans differed slightly at birth, but were markedly increased for Turkish and Eastern European infants at age six months. Turkish infants showed the highest change in weight z-score during the first 6 months (beta = 0.35; 95% CI 0.14-0.56) and an increased probability of rapid weight gain compared with German infants. Examination of the joint effect of migrant and socioeconomic status (SES) showed the greatest change in weight z-scores in Turkish infants from middle SES families (beta = 0.77; 95% CI 0.40-1.14) and infants of parents from Eastern European countries with high SES (beta = 0.72; 95% CI 0.13-1.32). Conclusions: Our results support the hypothesis that migrant background is an independent risk factor for infant weight gain and suggest that the onset of health inequalities in overweight starts in early infancy.

  • 69.
    Regber, S.
    et al.
    Nord Sch Publ Hlth NHV, SE-40242 Gothenburg, Sweden.
    Novak, M.
    Univ Gothenburg, Dept Emergency & Cardiovasc Med, Sahlgrenska Acad, Gothenburg, Sweden.
    Eiben, Gabriele
    Univ Gothenburg, Dept Publ Hlth & Community Med, Sahlgrenska Acad, Publ Hlth Epidemiol Unit, Gothenburg, Sweden.
    Bammann, K.
    Univ Bremen, Inst Publ Hlth & Nursing Res, D-28359 Bremen, Germany.;BIPS Inst Epidemiol & Prevent Res, Bremen, Germany.
    De Henauw, S.
    Univ Ghent, Dept Movement & Sport Sci, B-9000 Ghent, Belgium.
    Fernandez-Alvira, J. M.
    Univ Zaragoza, GENUD Growth Exercise Nutr & Dev Res Grp, Univ Sch Hlth Sci EUCS, Zaragoza, Spain.
    Gwozdz, W.
    Copenhagen Business Sch, Dept Intercultural Commun & Management, Frederiksberg, Denmark.
    Kourides, Y.
    Res & Educ Inst Child Hlth Strovolos, Strovolos, Cyprus.
    Moreno, L. A.
    Univ Zaragoza, GENUD Growth Exercise Nutr & Dev Res Grp, Univ Sch Hlth Sci EUCS, Zaragoza, Spain.
    Molnar, D.
    Univ Pecs, Dept Pediat, Pecs, Hungary.
    Pigeot, I.
    Univ Bremen, Dept Biometry & Data Management, BIPS Inst Epidemiol & Prevent Res, Fac Math & Comp Sci 03, D-28359 Bremen, Germany.
    Reisch, L.
    Copenhagen Business Sch, Dept Intercultural Commun & Management, Frederiksberg, Denmark.
    Russo, P.
    CNR, Inst Food Sci, Avellino, Italy.
    Veidebaum, T.
    Natl Inst Hlth Dev, Tallinn, Estonia.
    Borup, I.
    Nord Sch Publ Hlth NHV, SE-40242 Gothenburg, Sweden.
    Marild, S.
    Univ Gothenburg, Sahlgrenska Acad, Inst Clin Sci, Dept Paediat, Gothenburg, Sweden.
    Parental perceptions of and concerns about child's body weight in eight European countries - the IDEFICS study2013In: Pediatric Obesity, ISSN 2047-6302, E-ISSN 2047-6310, Vol. 8, no 2, p. 118-129Article in journal (Refereed)
    Abstract [en]

    Objectives To evaluate parental perceptions of and concern about child's body weight and general health in children in a European cohort. Design Cross-sectional multi-centre study in eight European countries. Participants 16220 children, ages 29 years. Methods Parents completed a questionnaire regarding children's health and weight and concern about overweight and underweight. Objective children's weight categories from the International Obesity Task Force were used. Logistic regression models were utilized to identify predictors of accurate weight perception. Results Parental weight perception corresponded overall to children's mean body mass index (BMI) z-scores, with important exceptions. About one-third of the total indicated concern about underweight, paradoxically most often parents of children in the overweight or obesity categories. In 63%, parents of children in the overweight category marked proper weight'. The strongest predictor for accurate parental weight perception for children with overweight and obesity was BMI z-score (odds ratio [OR]=7.2, 95% confidence interval [CI] 6.18.7). Compared to Southern Europe, ORs for accurate parental weight perception were 4.4 (95% CI 3.36.0) in Northern Europe and 3.4 (95% CI 2.74.2) in Central Europe. Conclusion Parents of children categorized as being overweight or obese systematically underestimated weight. Parents differed regionally regarding accurate weight perception and concern about overweight and underweight.

  • 70.
    Regber, Susann
    et al.
    Nord Sch Publ Hlth NHV, SE-40242 Gothenburg, Sweden.
    Novak, Masuma
    Univ Gothenburg, Sahlgrenska Acad, Dept Mol & Clin Med, Gothenburg, Sweden.
    Eiben, Gabriele
    Univ Gothenburg, Dept Publ Hlth & Community Med, Publ Hlth Epidemiol Unit, Sahlgrenska Acad, Gothenburg, Sweden.
    Lissner, Lauren
    Univ Gothenburg, Dept Publ Hlth & Community Med, Publ Hlth Epidemiol Unit, Sahlgrenska Acad, Gothenburg, Sweden.
    Hense, Sabrina
    Inst Epidemiol & Prevent Res BIPS, Dept Epidemiol Methods & Etiol Res, Bremen, Germany.
    Sandstrom, Tatiana Zverkova
    Nord Sch Publ Hlth NHV, SE-40242 Gothenburg, Sweden.
    Ahrens, Wolfgang
    Inst Epidemiol & Prevent Res BIPS, Dept Epidemiol Methods & Etiol Res, Bremen, Germany.
    Marild, Staffan
    Univ Gothenburg, Sahlgrenska Acad, Inst Clin Sci, Dept Pediat, Gothenburg, Sweden.
    Assessment of selection bias in a health survey of children and families - the IDEFICS Sweden-study2013In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 13, article id 418Article in journal (Refereed)
    Abstract [en]

    Background: A health survey was performed in 2007-2008 in the IDEFICS/Sweden study (Identification and prevention of dietary-and lifestyle-induced health effects in children and infants) in children aged 2-9 years. We hypothesized that families with disadvantageous socioeconomic and -demographic backgrounds and children with overweight and obesity were underrepresented. Methods: In a cross-sectional study, we compared Swedish IDEFICS participants (N=1,825) with referent children (N=1,825) using data from Statistics Sweden population registers. IDEFICS participants were matched for age and gender with a referent child living in the same municipality. Longitudinal weight and height data from birth to 8 years was collected for both populations (n=3,650) from the children's local health services. Outcome measures included the family's socioeconomic and demographic characteristics, maternal body mass index (BMI) and smoking habits before pregnancy, the children's BMI standard deviation score (SDS) at the age of inclusion in the IDEFICS study (BMISDS-index), and the children's BMI-categories during the age-span. Comparisons between groups were done and a multiple logistic regression analysis for the study of determinants of participation in the IDEFICS study was performed. Results: Compared with IDEFICS participants, referent families were more likely to have lower education and income, foreign backgrounds, be single parents, and have mothers who smoked before pregnancy. Maternal BMI before pregnancy and child's BMISDS-index did not differ between groups. Comparing the longitudinal data-set, the prevalence of obesity was significantly different at age 8 years n=45 (4.5%) versus n=31 (2.9%) in the referent and IDEFICS populations, respectively. In the multivariable adjusted model, the strongest significant association with IDEFICS study participation was parental Swedish background (odds ratio (OR) = 1.91, 95% confidence interval (CI) (1.48-2.47) followed by parents having high education OR 1.80, 95% CI (1.02-3.16) and being married or co-habiting OR 1.75 95% CI (1.38-2.23). Conclusion: Families with single parenthood, foreign background, low education and income were underrepresented in the IDEFICS Sweden study. BMI at inclusion had no selection effect, but developing obesity was significantly greater among referents.

  • 71.
    Russo, Marika D.
    et al.
    Institute of Food Sciences, CNR, Avellino, Italy.
    Ahrens, Wolfgang
    Leibniz Institute for Prevention Research and Epidemiology BIPS, Bremen, Germany / Institute of Statistics, University of Bremen, Germany.
    De Henauw, Stefaan
    Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Belgium.
    Eiben, Gabriele
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Hebestreit, Antje
    Leibniz Institute for Prevention Research and Epidemiology BIPS, Bremen, Germany.
    Kourides, Yannis
    Research and Education Institute of Child Health, Cyprus.
    Lissner, Lauren
    Section for Epidemiology and Social Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden.
    Molnar, Denes
    Department of Paediatrics, University of Pécs, Hungary.
    Moreno, Luis A.
    GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Spain.
    Pala, Valeria
    Epidemiology and Prevention Unit, Fondazione IRCSS Istituto Nazionale dei Tumori, Milan, Italy.
    Veidebaum, Toomas
    National Institute for Health Development, Tallinn, Estonia.
    Siani, Alfonso
    Institute of Food Sciences, CNR, Avellino, Italy.
    Russo, Paula
    Institute of Food Sciences, CNR, Avellino, Italy.
    The impact of adding sugars to milk and fruit on adiposity and diet quality in children: A cross-sectional and longitudinal analysis of the identification and prevention of dietary-and lifestyle-induced health effects in children and infants (IDEFICS) study2018In: Nutrients, ISSN 2072-6643, E-ISSN 2072-6643, Vol. 10, no 10, article id 1350Article in journal (Refereed)
    Abstract [en]

    Sugar, particularly as free sugars or sugar-sweetened beverages, significantly contributes to total energy intake, and, possibly, to increased body weight. Excessive consumption may be considered as a proxy of poor diet quality. However, no previous studies evaluated the association between the habit of adding sugars to “healthy” foods, such as plain milk and fresh fruit, and indicators of adiposity and/or dietary quality in children. To answer to these research questions, we Panalysed the European cohort of children participating in the IDEFICS study. Anthropometric variables, frequency of consumption of sugars added to milk and fruit (SAMF), and scores of adherence to healthy dietary pattern (HDAS) were assessed at baseline in 9829 children stratified according to age and sex. From this cohort, 6929 children were investigated again after two years follow-up. At baseline, a direct association between SAMF categories and adiposity indexes was observed only in children aged 6–<10 years, while the lower frequency of SAMF consumption was significantly associated with a higher HDAS. At the two year follow-up, children with higher baseline SAMF consumption showed significantly higher increases in all the anthropometric variables measured, with the exception of girls 6–<10 years old. The inverse association between SAMF categories and HDAS was still present at the two years follow-up in all age and sex groups. Our results suggest that the habit to adding sugars to foods that are commonly perceived as healthy may impact the adherence to healthy dietary guidelines and increase in adiposity risk as well. 

  • 72.
    Santaliestra-Pasías, Alba M.
    et al.
    Universidad de Zaragoza, Spain / Instituto Agroalimentario de Aragón (IA2), Zaragosa, Spain / Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain.
    Dios, Jaime E. Llamas
    Universidad de Zaragoza, Spain.
    Sprengeler, Ole
    Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany.
    Hebestreit, Antje
    Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany.
    De Henauw, Stefaan
    Ghent University, Belgium.
    Eiben, Gabriele
    University of Gothenburg, Sweden.
    Felsö, Regina
    University of Pécs, Hungary.
    Lauria, Fabio
    National Research Council, Avellino, Italy.
    Tornaritis, Michael
    Research and Education Institute of Child Health, Strovolos, Cyprus.
    Veidebaum, Toomas
    National Institute for Health Development, Center of Health and Behavioral Science, Tallinn, Estonia.
    Pala, Valeria
    Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
    Moreno, Luis A.
    Universidad de Zaragoza, Spain / Instituto Agroalimentario de Aragón (IA2), Zaragosa, Spain / Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain.
    Food and beverage intakes according to physical activity levels in European children: the IDEFICS (Identification and prevention of Dietary and lifestyle induced health EFfects In Children and infantS) study2018In: Public Health Nutrition, ISSN 1368-9800, E-ISSN 1475-2727, Vol. 21, no 9, p. 1717-1725Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Physical activity (PA) levels and dietary habits are considered some of the most important factors associated with obesity. The present study aimed to examine the association between PA level and food and beverage consumption in European children (2-10 years old).Design/Setting/SubjectsA sample of 7229 children (49·0 % girls) from eight European countries participating in the IDEFICS (Identification and prevention of Dietary and lifestyle induced health EFfects In Children and infantS) study was included. Moderate-to-vigorous PA (MVPA) was assessed objectively with accelerometers. FFQ was used to register dietary habits. ANCOVA and binary logistic regression were applied.

    RESULTS: Boys who spent less time in MVPA reported lower consumption of vegetables, fruits, cereals, yoghurt, milk, bread, pasta, candies and sugar-sweetened beverages (SSB) than boys who spent more time in MVPA (P<0·05). Moreover, boys who spent less time in MVPA were more likely to consume fast foods and water than those in the highest MVPA tertile (P<0·05). Girls who spent less time in MVPA reported lower consumption frequencies of vegetables, pasta, bread, yoghurt, candies, jam/honey and SSB than girls in the highest MVPA tertile (P<0·05). Also, girls in the lowest MVPA tertile were more likely to consume fast foods and water than those with high levels of MVPA (P<0·05).

    CONCLUSIONS: Food intake among European children varied with different levels of daily MVPA. Low time spent in MVPA was associated with lowest consumption of both high- and low-energy-dense foods and high fast-food consumption.

  • 73.
    Sina, Elida
    et al.
    Leibniz Institute for Prevention Research and Epidemiology—BIPS, Bremen, Germany.
    Buck, Christoph
    Leibniz Institute for Prevention Research and Epidemiology—BIPS, Bremen, Germany.
    Jilani, Hannah
    Leibniz Institute for Prevention Research and Epidemiology—BIPS, Bremen, Germany / Institute for Public Health and Nursing Research—IPP, University of Bremen, Germany.
    Tornaritis, Michael
    Research and Education Institute of Child Health, Lefcosia, Cyprus.
    Veidebaum, Toomas
    Department of Chronic Diseases, National Institute for Health Development, Tallin, Estonia.
    Russo, Paola
    Institute of Food Sciences, National Research Council, Avellino, Italy.
    Moreno, Luis A.
    GENUD (Growth, Exercise, Nutrition and Development) Research Group, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón), Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERObn), University of Zaragoza, Spain.
    Molnar, Denes
    Department of Pediatrics, Medical School, University of Pécs, Hungary.
    Eiben, Gabriele
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Marild, Staffan
    Department. of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Sweden.
    Pala, Valeria
    Department of Preventive and Predictive Medicine, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milan, Italy.
    Ahrens, Wolfgang
    Leibniz Institute for Prevention Research and Epidemiology—BIPS, Bremen, Germany / Faculty of Mathematics/Computer Science, University of Bremen, Germany.
    Hebestreit, Antje
    Leibniz Institute for Prevention Research and Epidemiology—BIPS, Bremen, Germany.
    Association of infant feeding patterns with taste preferences in European children and adolescents: A retrospective latent profile analysis2019In: Nutrients, ISSN 2072-6643, E-ISSN 2072-6643, Vol. 11, no 5, p. 1-16, article id 1040Article in journal (Refereed)
    Abstract [en]

    The aim was to investigate associations between the duration of infant feeding practices (FP) and taste preferences (TP) in European children and adolescents. A total of 5526 children (6-16 years old) of the I.Family study completed a Food and Beverage Preference Questionnaire to measure their preferences for sweet, fatty and bitter tastes. Mothers retrospectively reported the FPs duration in months: exclusive breastfeeding (EBF), exclusive formula milk feeding (EFMF), combined breastfeeding (BF&FMF) and the age at the introduction of complementary foods (CF). Using logistic regression analyses and latent class analysis (latent profiles of FP and CF were identified), we explored associations between profiles and TP, adjusting for various covariates, including the Healthy Diet Adherence Score (HDAS). A total of 48% of children had short durations of EBF (≤4 months) and BF&FMF (≤6 months) and were introduced to CF early (<6 months). No significant relationship was observed between the single FPs and TP, even when considering common profiles of FP. HDAS was inversely associated with sweet and fatty TP, but positively with bitter TP. Contrary to our hypotheses, we did not observe associations between FP and children’s TP later in life. Further studies with higher FP variation and longitudinal design are needed to investigate the causal associations between infant FP and taste preferences later in life. © 2019 by the authors. Licensee MDPI, Basel, Switzerland.

  • 74.
    Suling, M.
    et al.
    Univ Bremen, Inst Prevent Res & Social Med, D-28359 Bremen, Germany.
    Hebestreit, A.
    Univ Bremen, Inst Prevent Res & Social Med, D-28359 Bremen, Germany.
    Peplies, J.
    Univ Bremen, Inst Prevent Res & Social Med, D-28359 Bremen, Germany.
    Bammann, K.
    Univ Bremen, Inst Prevent Res & Social Med, D-28359 Bremen, Germany.
    Nappo, A.
    CNR, Inst Food Sci, Avellino, Italy.
    Eiben, Gabriele
    Univ Gothenburg, Dept Publ Hlth & Community Med, Gothenburg, Sweden.
    Fernandez Alvira, J. M.
    Univ Zaragoza, Dept Physiatr & Nursing, Zaragoza, Spain.
    Verbestel, V.
    Univ Ghent, Dept Movement & Sports Sci, B-9000 Ghent, Belgium.
    Kovacs, E.
    Univ Pecs, Dept Paediat, Pecs, Hungary.
    Pitsiladis, Y. P.
    Univ Glasgow, Coll Med Vet & Life Sci, Inst Cardiovasc & Med Sci, Glasgow, Lanark, Scotland.
    Veidebaum, T.
    Natl Inst Hlth Dev, Tallinn, Estonia.
    Hadjigeorgiou, C.
    Res & Educ Inst Child Hlth, Strovolos, Cyprus.
    Knof, K.
    Bremerhaven Technol Transfer Ctr, Bremerhaven, Germany.
    Ahrens, W.
    Univ Bremen, Inst Prevent Res & Social Med, D-28359 Bremen, Germany.
    Design and results of the pretest of the IDEFICS study2011In: International Journal of Obesity, ISSN 0307-0565, E-ISSN 1476-5497, Vol. 35, p. S30-S44Article in journal (Refereed)
    Abstract [en]

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

  • 75.
    Svensson, A.
    et al.
    Umea Univ, Dept Food & Nutr, Umea, Sweden.
    Larsson, C.
    Umea Univ, Dept Food & Nutr, Umea, Sweden / Univ Gothenburg, Dept Food & Nutr & Sport Sci, Gothenburg, Sweden.
    Eiben, Gabriele
    Univ Gothenburg, Sahlgrenska Acad, Dept Publ Hlth & Community Med, Publ Hlth Epidemiol Unit, Gothenburg, Sweden.
    Lanfer, A.
    BIPS GmbH, Leibniz Inst Prevent Res & Epidemiol, Dept Epidemiol Methods & Etiol Res, Bremen, Germany.
    Pala, V.
    Ist Nazl Tumori, Fdn IRCSS, Dept Prevent & Predict Med, I-20133 Milan, Italy.
    Hebestreit, A.
    BIPS GmbH, Leibniz Inst Prevent Res & Epidemiol, Dept Epidemiol Methods & Etiol Res, Bremen, Germany.
    Huybrechts, I.
    Univ Ghent, Dept Publ Hlth, B-9000 Ghent, Belgium / IARC, Dietary Exposure Assessment Grp, Lyon, France.
    Fernandez-Alvira, J. M.
    Univ Zaragoza, Fac Hlth Sci, Growth Exercise Nutr & Dev Res Grp, Zaragoza, Spain.
    Russo, P.
    CNR, Inst Food Sci, Unit Epidemiol & Populat Genet, Avellino, Italy.
    Koni, A. C.
    Univ Glasgow, Coll Med Vet & Life Sci, Inst Cardiovasc & Med Sci, Glasgow, Lanark, Scotland.
    De Henauw, S.
    Univ Ghent, Dept Publ Hlth, B-9000 Ghent, Belgium.
    Veidebaum, T.
    Natl Inst Hlth Dev, Tallinn, Estonia.
    Molnar, D.
    Univ Pecs, Fac Med, Dept Paediat, Pecs, Hungary.
    Lissner, L.
    Univ Gothenburg, Sahlgrenska Acad, Dept Publ Hlth & Community Med, Publ Hlth Epidemiol Unit, Gothenburg, Sweden.
    European children's sugar intake on weekdays versus weekends: the IDEFICS study2014In: European Journal of Clinical Nutrition, ISSN 0954-3007, E-ISSN 1476-5640, Vol. 68, no 7, p. 822-828Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To compare the intake of total sugars, foods and drinks rich in added sugar, and energy in children on weekdays (Monday Thursday), Fridays and weekends. METHODS: Dietary intake (g, kJ, energy %) was assessed using a computerized 24-h recall method in a sample of 2- to 9-year-old children from Belgium, Cyprus, Estonia, Germany, Hungary, Italy, Spain and Sweden who were participating in the IDEFICS baseline study (2007-2008). Analyses were performed in 9497 children by selecting one 24-h recall per child (for comparison of weekdays vs weekends, and Fridays vs weekdays and weekends). Selected stratified analyses were performed by country and age group. RESULTS: Intake of total sugars exceeded 20 energy % in all countries but one. In the non-stratified analyses, the intakes of total sugars and foods and drinks rich in added sugar were found to be higher on weekends compared with weekdays (both P < 0.001), and intakes on Fridays were a mix between intakes on weekdays and weekends. Energy intake did not differ between weekdays and weekends. Results were somewhat heterogeneous, both across countries and age groups. CONCLUSIONS: High intake of sugar remains an important nutritional problem in children of many European countries. Interventions aiming to prevent this diet pattern may optimize their impact by targeting dietary habits on Fridays and weekends. Furthermore, when conducting dietary assessment in children, data from weekends and Fridays in combination with a selection of Mondays to Thursdays are needed to capture habitual sugar intake. Age and dietary cultures should also be considered in dietary intervention and assessment as effect modifications were seen for both age and country.

  • 76.
    Tognon, Gianluca
    et al.
    Univ Gothenburg, Sahlgrenska Acad, Dept Publ Hlth & Community Med, Publ Hlth Epidemiol Unit, S-40530 Gothenburg, Sweden.
    Rothenberg, Elisabet
    Univ Gothenburg, Sahlgrenska Acad, Dept Clin Nutr, S-40530 Gothenburg, Sweden.
    Eiben, Gabriele
    Univ Gothenburg, Sahlgrenska Acad, Dept Publ Hlth & Community Med, Publ Hlth Epidemiol Unit, S-40530 Gothenburg, Sweden.
    Sundh, Valter
    Univ Gothenburg, Sahlgrenska Acad, Dept Publ Hlth & Community Med, Publ Hlth Epidemiol Unit, S-40530 Gothenburg, Sweden.
    Winkvist, Anna
    Univ Gothenburg, Sahlgrenska Acad, Dept Clin Nutr, S-40530 Gothenburg, Sweden.
    Lissner, Lauren
    Univ Gothenburg, Sahlgrenska Acad, Dept Publ Hlth & Community Med, Publ Hlth Epidemiol Unit, S-40530 Gothenburg, Sweden.
    Does the Mediterranean diet predict longevity in the elderly?: A Swedish perspective2011In: Age (Omaha), ISSN 0161-9152, E-ISSN 1574-4647, Vol. 33, no 3, p. 439-450Article in journal (Refereed)
    Abstract [en]

    Dietary pattern analysis represents a useful improvement in the investigation of diet and health relationships. Particularly, the Mediterranean diet pattern has been associated with reduced mortality risk in several studies involving both younger and elderly population groups. In this research, relationships between dietary macronutrient composition, as well as the Mediterranean diet, and total mortality were assessed in 1,037 seventy-year-old subjects (540 females) information. Diet macronutrient composition was not associated with mortality, while a refined version of the modified Mediterranean diet index showed a significant inverse association (HR = 0.93, 95% CI: 0.89; 0.98). As expected, inactive subjects, smokers and those with a higher waist circumference had a higher mortality, while a reduced risk characterized married and more educated people. Sensitivity analyses (which confirmed our results) consisted of: exclusion of one food group at a time in the Mediterranean diet index, exclusion of early deaths, censoring at fixed follow-up time, adjusting for activities of daily living and main cardiovascular risk factors including weight/waist circumference changes at follow up. In conclusion, we can reasonably state that a higher adherence to a Mediterranean diet pattern, especially by consuming wholegrain cereals, foods rich in polyunsaturated fatty acids, and a limited amount of alcohol, predicts increased longevity in the elderly.

  • 77.
    Vaidya, Abhinav
    et al.
    Department of Community Medicine, Kathmandu Medical College Teaching Hospital, Sinamangal, Kathmandu, Nepal.
    Oli, Natalia
    Department of Community Medicine, Kathmandu Medical College Teaching Hospital, Sinamangal, Kathmandu, Nepal / Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Sweden.
    Eiben, Gabriele
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Department of Public Health and Community Medicine, University of Gothenburg, Sweden.
    Krettek, Alexandra
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden / Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.
    The heart-health associated research, dissemination and intervention in the community (HARDIC) trial for nepalese mothers regarding diet and physical activity: A process evaluation2017In: Kathmandu University Medical Journal, ISSN 1812-2027, E-ISSN 1812-2078, Vol. 15, no 58, p. 107-116Article in journal (Refereed)
    Abstract [en]

    Background Mothers with young children in the peri-urban Jhaukhel-Duwakot Health Demographic Surveillance site of Bhaktapur district have misconceptions and poor behavioural practice regarding diet and physical activity. We developed the Heart-health Associated Research, Dissemination and Intervention in the Community trial - a health promotion intervention for mothers. Objective The objective of this study was to evaluate the intervention’s feasibility, acceptability, potential for transferability and scaling up, and to determine its immediate outcome. Method Duwakot and Jhaukhel were randomly selected as the intervention and control communities, respectively. We trained 47 peer mothers from Duwakot, each of whom gave classes with 10 fellow mothers of their neighbourhood. The process evaluation was carried out on a continuous basis at different points of the intervention held from August to November 2016. Result In round one, the participation and completion rates were both > 90% for peer mothers; and 85% and 70%, respectively, for the fellow mothers. However, the participation rates fell in the round two of the intervention. On the whole, the mothers expressed satisfaction and acceptance of the course content and training modality. Immediate evaluation of the intervention showed improvement of knowledge, attitude and practice of diet and physical activity among both groups of mothers. Conclusion The successful implementation of the intervention targeting diet and physical activity clearly demonstrates the feasibility of health promotional activities in the Nepalese community for improvement of cardiovascular health. © 2017, Kathmandu University. All rights reserved.

  • 78.
    Vaidya, Abhinav
    et al.
    Department of Community Medicine, Kathmandu Medical College, Kathmandu.
    Oli, Natalia
    Department of Community Medicine, Kathmandu Medical College, Kathmandu / Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
    Krettek, Alexandra
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden / 4Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromso, Norway .
    Eiben, Gabriele
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Department of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden.
    Preference of Food-items and Physical Activity of Peri-urban Children in Bhaktapur2017In: Journal of Nepal Health Research Council, ISSN 1727-5482, E-ISSN 1999-6217, Vol. 15, no 2, p. 150-158Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Though cardiovascular diseases are mostly seen in adulthood, the foundation of diet and physical activity is largely formed during childhood. The study aimed to explore children's preference for diet and physical activity in a peri-urban area of Nepal because this is an important dimension to explore in the life-course approach to combat non-communicable diseases.

    METHODS: We conducted a cross-sectional study to enquire young peri-urban children of Duwakot and Jhaukhel villages of Bhaktapur district, Nepal on their preferences for diet and physical activity. All eligible households with children in the age range 5-10 years as enlisted from the Jhaukhel-Duwakot Health Demographic Surveillance Site database were selected for the study. Twelve enumerators visited the selected households and facilitated the eligible children to fill in the questionnaire. We used a child-friendly photo-assisted questionnaire with face-scales that easily enabled the children to select a particular preference for each of the food item and physical activity. During analysis, food items were categorized into 'green', 'yellow' and 'red' on the basis of their nutritive values. Physical activity was categorized based on severity of the activity.

    RESULTS: Four hundred and thirty seven children filled up the questionnaires. Overall, median preference scores for 'red' food were higher than for healthier 'green' food (4.16 vs. 4.03), particularly, if mothers were self-employed. Likewise, the children preferred low over moderate-to-severe physical activity (4.16 vs. 3.50), and preference was affected by parents' occupation and income.

    CONCLUSIONS: The study objectively revealed that most of the children preferred unhealthier food-items and low physical activities. It shall be useful to consider these findings while planning health promotional activities targeted at them.

  • 79.
    Van den Bussche, Karen
    et al.
    Univ Ghent, Dept Publ Hlth, B-9000 Ghent, Belgium.
    Michels, Nathalie
    Univ Ghent, Dept Publ Hlth, B-9000 Ghent, Belgium.
    Gracia-Marco, Luis
    Univ Zaragoza, Res Grp, E-50009 Zaragoza, Spain / Univ Exeter, Sch Sport & Hlth Sci, Exeter EX1 2LU, Devon, England.
    Herrmann, Diana
    BIPS Inst Epidemiol & Prevent Res, D-28359 Bremen, Germany.
    Eiben, Gabriele
    Univ Gothenburg, Dept Pediat, Inst Clin Sci, Queen Silvia Childrens Hosp,Sahlgrenska Acad, S-41685 Gothenburg, Sweden.
    De Henauw, Stefaan
    Univ Ghent, Dept Publ Hlth, B-9000 Ghent, Belgium / Univ Coll Ghent, Dept Hlth Sci, B-9000 Ghent, Belgium.
    Sioen, Isabelle
    Univ Ghent, Dept Publ Hlth, B-9000 Ghent, Belgium / Res Fdn Flanders, FWO, B-1000 Brussels, Belgium.
    Influence of Birth Weight on Calcaneal Bone Stiffness in Belgian Preadolescent Children2012In: Calcified Tissue International, ISSN 0171-967X, E-ISSN 1432-0827, Vol. 91, no 4, p. 267-275Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to investigate the relation between birth weight and calcaneal bone stiffness in a large sample of Belgian, healthy, preadolescent children. Participants were 827 children (3.6-11.2 years, 51.6 % boys) from the Belgian cohort of the IDEFICS study. Birth weight was obtained using a parental questionnaire, and quantitative ultrasound (QUS) measurements were performed to determine calcaneal broadband ultrasound attenuation (BUA), speed of sound (SOS), and stiffness index (SI) using the Lunar Achilles device. Average birth weights were 3435.7 +/- A 512.0 g for boys and 3256.9 +/- A 471.1 g for girls. Average calcaneal QUS measurements were 89.6 +/- A 24.0 (23.3-153.9) dB/MHz for BUA, 1621.4 +/- A 49.6 (1516.3-1776.5) m/s for SOS, and 92.8 +/- A 15.6 (49.0-163.0) for SI. Birth weight was positively associated with BUA (r = 0.13, p = 0.002) and SOS (r = -0.16, p < 0.001). The associations remained after correcting for age and sex in multiple regression analyses but disappeared after correcting for anthropometric covariates. Our findings suggest that birth weight, as a rough proxy indicator for genetic and environmental influences during intrauterine life, is associated with BUA and SOS in preadolescent children and may therefore influence the risk of osteoporosis later in life. Further studies using QUS are needed to investigate the consistency of the results of this study.

  • 80.
    van Meer, Floor
    et al.
    University Medical Center Utrecht, the Netherlands.
    van der Laan, Laura N.
    Tilburg University, the Netherlands.
    Eiben, Gabriele
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Lissner, Lauren
    Göteborg University, Sahlgrenska Academy, Gothenburg.
    Wolters, Maike
    Leibniz Institute for Prevention Research and Epidemiology, Bremen, Germany.
    Rach, Stefan
    Leibniz Institute for Prevention Research and Epidemiology, Bremen, Germany.
    Herrmann, Manfred
    University of Bremen, Germany.
    Erhard, Peter
    University of Bremen, Germany.
    Molnár, Dénés
    University Medical School of Pécs, Hungary.
    Orsi, Gergely
    University Medical School of Pécs, Hungary / MTA-PTE Clinical Neuroscience MR Research Group, Pécs, Hungary.
    Viergever, Max A.
    University Medical Center Utrecht, the Netherlands.
    Adan, Roger A.H.
    University Medical Center Utrecht, the Netherlands.
    Smeets, Paul A.M.
    University Medical Center Utrecht, the Netherlands / Division of Human Nutrition & Health, Wageningen University & Research, the Netherlands.
    Development and body mass inversely affect children's brain activation in dorsolateral prefrontal cortex during food choice2019In: NeuroImage, ISSN 1053-8119, E-ISSN 1095-9572, Vol. 201, p. 1-10, article id 116016Article in journal (Refereed)
    Abstract [en]

    Childhood obesity is a rising problem caused in part by unhealthy food choices. Food choices are based on a neural value signal encoded in the ventromedial prefrontal cortex, and self-control involves modulation of this signal by the dorsolateral prefrontal cortex (dlPFC). We determined the effects of development, body mass (BMI Cole score) and body mass history on the neural correlates of healthy food choice in children. 141 children (aged 10-17y) from Germany, Hungary and Sweden were scanned with fMRI while performing a food choice task. Afterwards health and taste ratings of the foods were collected. In the food choice task children were asked to consider the healthiness or tastiness of the food or to choose naturally. Overall, children made healthier choices when asked to consider healthiness. However, children who had a higher weight gain per year chose less healthy foods when considering healthiness but not when choosing naturally. Pubertal development stage correlated positively while current body mass correlated negatively with dlPFC activation when accepting foods. Pubertal development negatively and current body mass positively influenced the effect of considering healthiness on activation of brain areas involved in salience and motivation. In conclusion, children in earlier stages of pubertal development and children with a higher body weight exhibited less activation in the dlPFC, which has been implicated in self-control during food choice. Furthermore, pubertal development and body mass influenced neural responses to a health cue in areas involved in salience and motivation. Thus, these findings suggest that children in earlier stages of pubertal development, children with a higher body mass gain and children with overweight may possibly be less susceptible to healthy eating interventions that rely on self-control or that highlight health aspects of food. 

  • 81.
    Vanaelst, Barbara
    et al.
    Department of Public Health, Ghent University, UZ-2BlokA De Pintelaan 185, 9000, Ghent, Belgium / Research Foundation – Flanders (FWO), Egmontstraat 5, Brussels, Belgium.
    Huybrechts, Inge
    Department of Public Health, Ghent University, UZ-2BlokA De Pintelaan 185, 9000, Ghent, Belgium / Dietary Exposure Assessment Group, International Agency for Research on Cancer (IARC), Lyon, France.
    De Bourdeaudhuij, Ilse
    Department of Movement and Sport Sciences, Ghent University, Watersportlaan 2, 9000, Ghent, Belgium.
    Bammann, Karin
    Bremen Institute for Prevention Research and Social Medicine, University of Bremen, Achterstr. 30, 28359, Bremen, Germany / Institute for Public Health and Nursing Care Research, University of Bremen, Postfach 330440, 28344, Bremen, Germany.
    Hadjigeorgiou, Charalambos
    Research & Education Institute of Child Health, 8 Attikis Str, 2027, Strovolos, Cyprus.
    Eiben, Gabriele
    Department of Public Health and Community Medicine, Public Health Epidemiology Unit, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Konstabel, Kenn
    National Institute for Health Development, Hiiu 42, 11619, Tallinn, Estonia.
    Michels, Nathalie
    Department of Public Health, Ghent University, UZ-2BlokA De Pintelaan 185, 9000, Ghent, Belgium.
    Molnar, Denes
    National Institute of Health Promotion, University of Pécs, Gyermekklinika, József Attila utca 7, 7623, Pécs, Hungary.
    Moreno, Luis A.
    Pigeot, Iris
    Bremen Institute for Prevention Research and Social Medicine, University of Bremen, Achterstr. 30, 28359, Bremen, Germany.
    Reisch, Lucia
    Department of intercultural communication and management, Copenhagen Business School, Porcelanshaven 18A, DK-2000, Frederiksberg, Denmark.
    Siani, Alfonso
    Epidemiology & Population Genetics, Institute of Food Sciences, CNR, Via Roma 64, 83100, Avellino, Italy.
    Vyncke, Krishna
    Department of Public Health, Ghent University, UZ-2BlokA De Pintelaan 185, 9000, Ghent, Belgium / Research Foundation – Flanders (FWO), Egmontstraat 5, Brussels, Belgium.
    De Henauw, Stefaan
    Department of Public Health, Ghent University, UZ-2BlokA De Pintelaan 185, 9000, Ghent, Belgium. 2 Research Foundation – Flanders (FWO), Egmontstraat 5, Brussels, Belgium.
    Prevalence of negative life events and chronic adversities in European pre- and primary-school children: results from the IDEFICS study2012In: Archives of Public Health, ISSN 0778-7367, E-ISSN 2049-3258, Vol. 70, no 1, article id 26Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Children are not always recognized as being susceptible to stress, although childhood stressors may originate from multiple events in their everyday surroundings with negative effects on children's health.

    METHODS: As there is a lack of large-scale, European prevalence data on childhood adversities, this study presents the prevalence of (1) negative life events and (2) familial and social adversities in 4637 European pre- and primary-school children (4-11 years old), using a parentally-reported questionnaire embedded in the IDEFICS project ('Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS').

    RESULTS: The following findings were observed: (1) Certain adversities occur only rarely, while others are very regular (i.e. parental divorce); (2) A large percentage of children is shielded from stressors, while a small group of children is exposed to multiple, accumulating adversities; (3) The prevalence of childhood adversity is influenced by geographical location (e.g. north versus south), age group and sex; (4) Childhood adversities are associated and co-occur, resulting in potential cumulative childhood stress.

    CONCLUSIONS: This study demonstrated the importance of not only studying traumatic events but also of focusing on the early familial and social environment in childhood stress research and indicated the importance of recording or monitoring childhood adversities.

  • 82.
    Verbestel, V.
    et al.
    Univ Ghent, Dept Movement & Sport Sci, B-9000 Ghent, Belgium.
    De Henauw, S.
    Univ Ghent, Dept Publ Hlth, B-9000 Ghent, Belgium.
    Barba, G.
    CNR, Unit Epidemiol & Populat Genet, Inst Food Sci, Avellino, Italy.
    Eiben, Gabriele
    Univ Gothenburg, Dept Publ Hlth & Community Med, Sahlgrenska Acad, Gothenburg, Sweden.
    Gallois, K.
    Leibniz Inst Prevent Res & Epidemiol BIPS, Bremen, Germany.
    Hadjigeorgiou, C.
    Res & Educ Inst Child Hlth, Strovolos, Cyprus.
    Konstabel, K.
    Natl Inst Hlth Dev, Tallinn, Estonia.
    Maes, L.
    Univ Ghent, Dept Publ Hlth, B-9000 Ghent, Belgium.
    Marild, S.
    Univ Gothenburg, Dept Pediat, Queen Silvia Childrens Univ Hosp, Gothenburg, Sweden.
    Molnar, D.
    Univ Pecs, Dept Pediat, Pecs, Hungary.
    Moreno, L. A.
    Univ Zaragoza, Fac Hlth Sci, GENUD Growth Exercise Nutr & Dev Res Grp, Zaragoza, Spain.;Univ Sao Paulo, Fac Med, Dept Prevent Med, Sao Paulo, Brazil.
    Oja, L.
    Natl Inst Hlth Dev, Tallinn, Estonia.
    Pitsiladis, Y.
    Univ Glasgow, Coll Med Vet & Life Sci, Glasgow, Lanark, Scotland.
    Ahrens, W.
    Leibniz Inst Prevent Res & Epidemiol BIPS, Bremen, Germany.;Univ Bremen, Inst Stat, Fac Math & Comp Sci, D-28359 Bremen, Germany.
    Pigeot, I.
    Leibniz Inst Prevent Res & Epidemiol BIPS, Bremen, Germany.;Univ Bremen, Inst Stat, Fac Math & Comp Sci, D-28359 Bremen, Germany.
    De Bourdeaudhuij, I.
    Univ Ghent, Dept Movement & Sport Sci, B-9000 Ghent, Belgium.
    Effectiveness of the IDEFICS intervention on objectively measured physical activity and sedentary time in European children2015In: Obesity Reviews, ISSN 1467-7881, E-ISSN 1467-789X, Vol. 16, p. 57-67Article in journal (Refereed)
    Abstract [en]

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

  • 83.
    Verbestel, Vera
    et al.
    Univ Ghent, Dept Movement & Sports Sci, B-9000 Ghent, Belgium.
    De Henauw, Stefaan
    Univ Ghent, Dept Publ Hlth, B-9000 Ghent, Belgium.
    Bammann, Karin
    Univ Bremen, Inst Publ Hlth & Nursing Res, D-28359 Bremen, Germany.;BIPS Inst Epidemiol & Prevent Res GmbH, Bremen, Germany.
    Barba, Gianvincenzo
    CNR, Unit Epidemiol & Populat Genet, Inst Food Sci, Avellino, Italy.
    Hadjigeorgiou, Charalambos
    Res & Educ Inst Child Hlth, Strovolos, Cyprus.
    Eiben, Gabriele
    Univ Gothenburg, Sahlgrenska Acad, Dept Publ Hlth & Community Med, Gothenburg, Sweden.
    Konstabel, Kenn
    Natl Inst Hlth Dev, Tallinn, Estonia.
    Kovacs, Eva
    Univ Pecs, Dept Pediat, Pecs, Hungary.
    Pitsiladis, Yannis
    Univ Glasgow, Coll Med Vet & Life Sci, Glasgow, Lanark, Scotland.
    Reisch, Lucia
    Copenhagen Business Sch, Dept Intercultural Commun & Management, Frederiksberg, Denmark.
    Santaliestra-Pasias, Alba M.
    Univ Zaragoza, Univ Sch Hlth Sci, GENUD Growth Exercise Nutr & Dev Res Grp, Zaragoza, Spain.
    Maes, Lea
    Univ Ghent, Dept Publ Hlth, B-9000 Ghent, Belgium.
    De Bourdeaudhuij, Ilse
    Univ Ghent, Dept Movement & Sports Sci, B-9000 Ghent, Belgium.
    Are context-specific measures of parental-reported physical activity and sedentary behaviour associated with accelerometer data in 2-9-year-old European children?2015In: Public Health Nutrition, ISSN 1368-9800, E-ISSN 1475-2727, Vol. 18, no 5, p. 860-868Article in journal (Refereed)
    Abstract [en]

    Objective: The aim of the present study was to investigate if context-specific measures of parental-reported physical activity and sedentary behaviour are associated with objectively measured physical activity and sedentary time in children. Design: Cross-sectional study. Setting: Seven European countries taking part in the IDEFICS (Identification and Prevention of Dietary-and Lifestyle-induced Health Effects in Children and Infants) study. Subjects: Data were analysed from 2-9-year-old children (n 5982) who provided both parental-reported and accelerometer-derived physical activity/sedentary behaviour measures. Parents reported their children's daily screen-time, weekly sports participation and daily outdoor playtime by means of the Outdoor Playtime Checklist (OPC) and Outdoor Playtime Recall Questions (OPRQ). Results: Sports participation, OPC-and OPRQ-derived outdoor play were positively associated with accelerometer-derived physical activity. Television viewing and computer use were positively associated with accelerometer-derived sedentary time. All parental-reported measures that were significantly associated with accelerometer outcomes explained only a minor part of the variance in accelerometer-derived physical activity or sedentary time. Conclusions: Parental-reported measures of physical activity and sedentary behaviour are not useful as a proxy for 2-9-year-old children's physical activity and sedentary time. Findings do not preclude the use of context-specific measures but imply that conclusions should be limited to the context-specific behaviours that are actually measured. Depending on the aim of the study, future research should carefully consider the choice of measurements, including the use of subjective or objective measures of the behaviour of interest or a combination of both.

  • 84.
    Verbestel, Vera
    et al.
    Univ Ghent, Dept Movement & Sport Sci, B-9000 Ghent, Belgium.
    De Henauw, Stefaan
    Univ Ghent, Dept Publ Hlth, B-9000 Ghent, Belgium.
    Maes, Lea
    Univ Ghent, Dept Publ Hlth, B-9000 Ghent, Belgium.
    Haerens, Leen
    Univ Ghent, Dept Movement & Sport Sci, B-9000 Ghent, Belgium.;Univ Ghent, Res Fdn Flanders, B-9000 Ghent, Belgium.
    Marild, Staffan
    Univ Gothenburg, Dept Pediat, Queen Silivia Childrens Univ, S-41685 Gothenburg, Sweden.
    Eiben, Gabriele
    Univ Gothenburg, Dept Publ Hlth & Community Med, Sahlgrenska Acad, S-40530 Gothenburg, Sweden.
    Lissner, Lauren
    Univ Gothenburg, Dept Publ Hlth & Community Med, Sahlgrenska Acad, S-40530 Gothenburg, Sweden.
    Moreno, Luis A.
    Univ Zaragoza, GENUD Growth Exercise Nutr & Dev, Res Grp, Univ Sch Hlth Sci, Zaragoza 50009, Spain.
    Frauca, Natalia Lascorz
    Univ Zaragoza, GENUD Growth Exercise Nutr & Dev, Res Grp, Univ Sch Hlth Sci, Zaragoza 50009, Spain.
    Barba, Gianvincenzo
    CNR, Unit Epidemiol & Populat Genet, Inst Food Sci, I-83100 Avellino, Italy.
    Kovacs, Eva
    Univ Pecs, Dept Pediat, H-7623 Pecs, Hungary.
    Konstabel, Kenn
    Natl Inst Hlth Dev, EE-50410 Tallinn, Estonia.
    Tornaritis, Michael
    Res & Educ Inst Child Hlth, CY-2027 Strovolos, Cyprus.
    Gallois, Katharina
    Univ Bremen, Bremen Inst Prevent Res & Social Med BIPS, D-28359 Bremen, Germany.
    Hassel, Holger
    Univ Bremen, Bremen Inst Prevent Res & Social Med BIPS, D-28359 Bremen, Germany / Univ Appl Sci, Hsch Coburg, Coburg, Germany.
    De Bourdeaudhuij, Ilse
    Univ Ghent, Dept Movement & Sport Sci, B-9000 Ghent, Belgium.
    Using the intervention mapping protocol to develop a community-based intervention for the prevention of childhood obesity in a multi-centre European project: the IDEFICS intervention2011In: International Journal of Behavioral Nutrition and Physical Activity, ISSN 1479-5868, E-ISSN 1479-5868, Vol. 8, article id 82Article in journal (Refereed)
    Abstract [en]

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

  • 85.
    Weimann, Hanna
    et al.
    Lund Univ, Div Occupat & Environm Med, S-22185 Lund, Sweden.
    Björk, Jonas
    Lund Univ, Div Occupat & Environm Med, S-22185 Lund, Sweden.
    Rylander, Lars
    Lund Univ, Div Occupat & Environm Med, S-22185 Lund, Sweden.
    Bergman, Patrick
    Linnaeus Univ, Dept Sport Sci, Kalmar, Sweden.
    Eiben, Gabriele
    Univ Gothenburg, Dept Publ Hlth & Community Med, Gothenburg, Sweden.
    Neighborhood environment and physical activity among young children: A cross-sectional study from Sweden2015In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 43, no 3, p. 283-293Article in journal (Refereed)
    Abstract [en]

    Aims: The aims of this study were to investigate the association between the neighbourhood environment and physical activity among young children in a Scandinavian setting, and to assess the influences of seasonal variations, age, sex and parental education. Methods: Physical activity was assessed with an accelerometer and neighbourhood resources were estimated using geographic information systems for 205 Swedish children aged 4-11 years. Neighbourhood resources were generated as the sum of three neighbourhood attributes: (a) foot and bike paths, (b) non-restricted destinations and (c) recreational area, all within 300 m of each child's home. Physical activity was assessed as: (a) total volume of physical activity (i.e. counts per minute), (b) sedentary time and (c) moderate to vigorous physical activity (MVPA). The association between neighbourhood resources and physical activity was analysed using mixed linear models weighted by measurement time and adjusted for sex, age, season of activity measurement, type of housing and parental education. Results: Children were more physically active in areas with intermediate access to neighbourhood resources for physical activity compared to areas with worst access, while the difference between intermediate and best neighbourhood resource areas was less clear. The association between physical activity and neighbourhood resources was weaker than with seasonal variations but compatible in magnitude with sex, age, type of housing and parental education. Among specific neighbourhood attributes, the amount of foot and bike paths was associated with less sedentary time and more MVPA. Conclusions:This study provides some, not entirely consistent, evidence overall for an association between the neighbourhood environment and physical activity among young children in Scandinavia.

  • 86.
    Wiberger, Maja
    et al.
    Univ Gothenburg, Dept Publ Hlth Epidemiol & Community Med, SE-40530 Gothenburg, Sweden.
    Eiben, Gabriele
    Univ Gothenburg, Dept Publ Hlth Epidemiol & Community Med, SE-40530 Gothenburg, Sweden.
    Lisner, Lauren
    Univ Gothenburg, Dept Publ Hlth Epidemiol & Community Med, SE-40530 Gothenburg, Sweden.
    Mehlig, Kirsten
    Univ Gothenburg, Dept Publ Hlth Epidemiol & Community Med, SE-40530 Gothenburg, Sweden.
    Papoutsou, Stalo
    Res & Educ Inst Child Hlth, Strovolos, Cyprus.
    Hunsberger, Monica
    Univ Gothenburg, Dept Publ Hlth Epidemiol & Community Med, SE-40530 Gothenburg, Sweden.
    Children consuming milk cereal drink are at increased risk for overweight: The IDEFICS Sweden study, on behalf of the IDEFICS Consortium2014In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 42, no 6, p. 518-524Article in journal (Refereed)
    Abstract [en]

    Aims: The aims of this study were to characterize milk cereal drink (MCD) consumption among Swedish children and to investigate the association between MCD and overweight in a longitudinally followed cohort of children over 2 years of age. Methods: In the Swedish cohort from IDEFICS (Identification and prevention of Dietary-and lifestyle-induced health EFfects In Children and infantS) we examined early feeding practices and weight status when children were aged 2-9 years (2007/2008) and at 2-year follow-up. Weight and height were measured at both time points in 1077 children. Characteristics of MCD consumers were explored with logistic regression. Body mass index (BMI) z-scores at both time points and weight status at follow-up were regressed on explanatory factors using mixed linear and logistic regression, respectively. Results: Nearly 69% of children had consumed MCD. The MCD consumers were more likely than never-consumers to have two native Swedish parents, parents with less than 2 years of post-secondary education, and a shorter period of breastfeeding. MCD consumers had a higher BMI z-score at follow-up compared with baseline (difference in BMI z-score=0.12, 95% confidence interval (CI)= 0.07, 0.17), while the average BMI z-score in non-consumers remained stable over time (0.00, 95% CI= -0.07, 0.07). MCD consumers were nearly five times more likely than non-consumers to become overweight during the follow-up (odds ratio (OR)= 4.78, 95% CI= 1.68, 13.59), independent of breastfeeding. Conclusions: MCD was consumed by the majority of children in this study. MCD consumption is associated with an increased risk for overweight and less exposure to breastfeeding. Our findings motivate future research aimed at investigating how MCD should be recommended.

  • 87.
    Wolters, M.
    et al.
    Leibniz Inst Prevent Res & Epidemiol BIPS, D-28359 Bremen, Germany.
    Schlenz, H.
    Leibniz Inst Prevent Res & Epidemiol BIPS, D-28359 Bremen, Germany.
    Foraita, R.
    Leibniz Inst Prevent Res & Epidemiol BIPS, D-28359 Bremen, Germany.
    Galli, C.
    Univ Milan, Dept Pharmacol & Biomol Sci, DiSFeB, Milan, Italy.
    Rise, P.
    Univ Milan, Dept Pharmacol & Biomol Sci, DiSFeB, Milan, Italy.
    Moreno, L. A.
    Univ Zaragoza, Growth Exercise Nutr & Dev GENUD Res Grp, Zaragoza, Spain.
    Molnar, D.
    Univ Pecs, Natl Inst Hlth Promot, Pecs, Hungary.
    Russo, P.
    CNR, Inst Food Sci, Epidemiol & Populat Genet, Avellino, Italy.
    Veidebaum, T.
    Natl Inst Hlth Dev, Dept Chron Dis, Tallinn, Estonia.
    Tornaritis, M.
    Res & Educ Inst Child Hlth, Strovolos, Cyprus.
    Vyncke, K.
    Univ Ghent, Dept Publ Hlth, Fac Med & Hlth Sci, B-9000 Ghent, Belgium.
    Eiben, Gabriele
    Queen Silvia Childrens Hosp, Dept Publ Hlth & Community Med, Gothenburg, Sweden.
    Iacoviello, L.
    IRCCS Ist Neurol Mediterraneo Neuromed, Dept Epidemiol & Prevent, Lab Mol & Nutr Epidemiol, Pozzilli, Italy.;Casa Cura Montevergine, Lab Cardiovasc & Neurovasc Epidemiol, Mercogliano, Italy.
    Ahrens, W.
    Leibniz Inst Prevent Res & Epidemiol BIPS, D-28359 Bremen, Germany.;Univ Bremen, Fac Math & Comp Sci, Inst Stat, D-28359 Bremen, Germany.
    Reference values of whole-blood fatty acids by age and sex from European children aged 3-8 years2014In: International Journal of Obesity, ISSN 0307-0565, E-ISSN 1476-5497, Vol. 38, p. S86-S98Article in journal (Refereed)
    Abstract [en]

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

  • 88.
    Wolters, Maike
    et al.
    Leibniz Inst Prevent Res & Epidemiol BIPS, Bremen, Germany.
    Boernhorst, Claudia
    Leibniz Inst Prevent Res & Epidemiol BIPS, Bremen, Germany.
    Schwarz, Heike
    Leibniz Inst Prevent Res & Epidemiol BIPS, Bremen, Germany.
    Rise, Patrizia
    Univ Milan, Dept Pharmacol & Biomol Sci, DiSFeB, Milan, Italy.
    Galli, Claudio
    Univ Milan, Dept Pharmacol & Biomol Sci, DiSFeB, Milan, Italy.
    Moreno, Luis A.
    Univ Zaragoza, Growth Exercise Nutr & Dev GENUD Res Grp, Zaragoza, Spain.
    Pala, Valeria
    Fdn IRCCS Ist Nazl Tumori, Dept Prevent & Predict Med, Epidemiol & Prevent Unit, Milan, Italy.
    Russo, Paola
    CNR, Inst Food Sci, Epidemiol & Populat Genet, Avellino, Italy.
    Veidebaum, Toomas
    Natl Inst Hlth Dev, Tallinn, Estonia.
    Tornaritis, Michael
    Res & Educ Inst Child Hlth, Strovolos, Cyprus.
    Fraterman, Arno
    Med Versorgungszentrum Dr Eberhard & Partner Dort, Lab Med, Dortmund, Germany.
    De Henauw, Stefaan
    Univ Ghent, Fac Med & Hlth Sci, Dept Publ Hlth, Ghent, Belgium.
    Eiben, Gabriele
    Univ Gothenburg, Sahlgrenska Acad, Inst Med, Sect Epidemiol & Social Med, Gothenburg, Sweden.
    Lissner, Lauren
    Univ Gothenburg, Sahlgrenska Acad, Inst Med, Sect Epidemiol & Social Med, Gothenburg, Sweden.
    Molnar, Denes
    Univ Pecs, Natl Inst Hlth Promot, Pecs, Hungary.
    Ahrens, Wolfgang
    Leibniz Inst Prevent Res & Epidemiol BIPS, Bremen, Germany.;Univ Bremen, Inst Stat, Fac Math & Comp Sci, Bremen, Germany.
    Association of desaturase activity and C-reactive protein in European children2017In: Pediatric Research, ISSN 0031-3998, E-ISSN 1530-0447, Vol. 81, no 1, p. 27-32Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Desaturase enzymes influence the fatty acid (FA) composition of body tissues and their activity affects the conversion rate of saturated to monounsaturated FA and of polyunsaturated FA (PUFA) to long-chain PUFA. Desaturase activity has further been shown to be associated with inflammation. We investigate the association between delta-9 (D9D), delta-6 (D6D) and delta-5 desaturase (D5D) activity and high sensitive C-reactive protein (CRP) in young children. METHODS: In the IDEFICS (Identification and prevention of dietary- and lifestyle-induced health effects in children and infants) cohort study children were examined at baseline (TO) and after 2 y (T1). D9D, D6D, and D5D activities were estimated from TO product-precursor FA ratios. CRP was measured at TO and T1. In a subsample of 1,943 children with available information on FA, CRP, and covariates, the cross-sectional and longitudinal associations of desaturase activity and CRP were analyzed. RESULTS: Cross-sectionally, a D9D increase of 0.01 units was associated with a 11% higher risk of having a serum CRP Percentile 75 (P75) (OR, 99% CI: 1.11 (1.01; 1.22)) whereas D6D and D5D were not associated with CRP. No significant associations were observed between baseline desaturase activity and CRP 2 y later. CONCLUSION: Cross-sectionally, our results indicate a positive association of D9D and CRP independent of weight status. High D9D activity may increase the risk of subclinical inflammation which is associated with metabolic disorders. As D9D expression increases with higher intake of saturated FA and carbohydrates, dietary changes may influence D9D activity and thus CRP. However, it remains to be investigated whether there is a causal relationship between D9D activity and CRP.

  • 89.
    Zaqout, M.
    et al.
    Univ Ghent, Dept Publ Hlth, Fac Med & Hlth Sci, Ghent, Belgium.
    Michels, N.
    Univ Ghent, Dept Publ Hlth, Fac Med & Hlth Sci, Ghent, Belgium.
    Bammann, K.
    Univ Bremen, Inst Publ Hlth & Nursing Res, Fac Human & Hlth Sci, Bremen, Germany.;Leibniz Inst Prevent Res & Epidemiol BIPS, Bremen, Germany.
    Ahrens, W.
    Leibniz Inst Prevent Res & Epidemiol BIPS, Bremen, Germany.
    Sprengeler, O.
    Leibniz Inst Prevent Res & Epidemiol BIPS, Bremen, Germany.
    Molnar, D.
    Univ Pecs, Fac Med, Dept Pediat, Pecs, Hungary.
    Hadjigeorgiou, C.
    Res & Educ Inst Child Hlth, Strovolos, Cyprus.
    Eiben, Gabriele
    Univ Gothenburg, Sahlgrenska Acad, Dept Publ Hlth & Community Med, Publ Hlth Epidemiol Unit EPI, Gothenburg, Sweden.
    Konstabel, K.
    Natl Inst Hlth Dev, Dept Chron Dis, Ctr Behav & Hlth Sci, Tallinn, Estonia.
    Russo, P.
    CNR, Inst Food Sci, Unit Epidemiol & Populat Genet, Avellino, Italy.
    Jimenez-Pavon, D.
    Univ Zaragoza, GENUD Growth Exercise Nutr & Dev Res Grp, Zaragoza, Spain.
    Moreno, L. A.
    Univ Zaragoza, GENUD Growth Exercise Nutr & Dev Res Grp, Zaragoza, Spain.
    De Henauw, S.
    Univ Ghent, Dept Publ Hlth, Fac Med & Hlth Sci, Ghent, Belgium.
    Influence of physical fitness on cardio-metabolic risk factors in European children. The IDEFICS study2016In: International Journal of Obesity, ISSN 0307-0565, E-ISSN 1476-5497, Vol. 40, no 7, p. 1119-1125Article in journal (Refereed)
    Abstract [en]

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

  • 90.
    Zaqout, Mahmoud
    et al.
    Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, De Pintelaan 185, 4K3, Ghent, Belgium.
    Michels, Nathalie
    Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, De Pintelaan 185, 4K3, Ghent, Belgium.
    Ahrens, Wolfgang
    Leibniz Institute for Prevention Research and Epidemiology BIPS, Bremen, Germany.
    Börnhorst, Claudia
    Leibniz Institute for Prevention Research and Epidemiology BIPS, Bremen, Germany.
    Molnár, Dénes
    Department of Pediatrics, Medical Faculty, University of Pécs, Pécs, Hungary.
    Moreno, Luis A.
    GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain.
    Eiben, Gabriele
    Department of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Siani, Alfonso
    Epidemiology and Population Genetics, Institute of Food Sciences, National Research Council, Avellino, Italy.
    Papoutsou, Stalo
    Research and Education Institute of Child Health, Strovolos, Cyprus.
    Veidebaum, Toomas
    Department of Chronic Diseases, National Institute for Health Development, Tallinn, Estonia.
    De Henauw, Stefaan
    Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, De Pintelaan 185, 4K3, Ghent, Belgium.
    Associations between exclusive breastfeeding and physical fitness during childhood2018In: European Journal of Nutrition, ISSN 1436-6207, E-ISSN 1436-6215, Vol. 57, no 2, p. 545-555Article in journal (Refereed)
    Abstract [en]

    PURPOSE: Exposure to breastfeeding improves the survival, health, and development of children; therefore, breast milk is recommended as the exclusive nutrient source for feeding term infants during the first 6 months. This cross-sectional study aimed to determine the possible association between exposure to exclusive breastfeeding and physical fitness performance in children and, if so, whether this association is influenced by the breastfeeding duration.

    METHODS: A total of 2853 (52.3 % girls) European children from the IDEFICS study aged 6-11 years with complete data on physical fitness (cardiorespiratory fitness, muscular strength, flexibility, balance, speed) and exclusive breastfeeding duration (never, 1-3, 4-6, 7-12 months) were included in the present study. Multivariate and mixed linear regression models were estimated and adjusted for sex, age, birth weight, diet, physical activity, body mass index, and parental factors (age, body mass index, educational attainment).

    RESULTS: We found a positive association between exclusive breastfeeding and lower-body explosive strength (β = 0.034) as well as flexibility (β = 0.028). We also found a positive association between breastfeeding and balance in boys (β = 0.039), while this association was negative in girls (β = -0.029). To improve lower-body explosive strength, 1-3 months of exclusive breastfeeding were enough; a longer duration did not lead to increasing benefit. In contrast, 4-6 months of breastfeeding were necessary to have any benefit on flexibility or balance, although this became nonsignificant after adjustment for body mass index and physical activity.

    CONCLUSIONS: Exclusive breastfeeding seems a natural way of slightly improving some physical fitness components (mainly lower-body muscle strength) and thus future health.

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