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Yesildemir O, Guldas M, Boqué N, Calderón-Pérez L, Degli Innocenti P, Scazzina F, Nehme N, Abou Abbass F, de la Feld M, Salvio G, Ozyazicioglu N, Yildiz E, Gurbuz O. Adherence to the Mediterranean Diet Among Families from Four Countries in the Mediterranean Basin. Nutrients 2025; 17:1157. [PMID: 40218915 PMCID: PMC11990228 DOI: 10.3390/nu17071157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2025] [Revised: 03/14/2025] [Accepted: 03/17/2025] [Indexed: 04/14/2025] Open
Abstract
Background/Objectives: The cultural and socioeconomic changes to which societies are exposed can alter individuals' lifestyles and dietary habits. The nutritional patterns of Mediterranean countries may also be affected by these factors at varying levels, depending on the changing social characteristics of the countries. This study aimed to determine Mediterranean diet (MedDiet) adherence among family members from four Mediterranean countries (Türkiye, Spain, Italy, and Lebanon). Methods: The survey was structured around sociodemographic data, family relationships, the Mediterranean diet adherence screener (MEDAS), the Mediterranean lifestyle index (MEDLIFE), the Mediterranean diet quality index (KIDMED), and the obstacles and drivers of MedDiet adherence. Results: The data were obtained from adults (n = 812), with the contribution of their children (n = 500) if they had any. According to the MEDAS, 22% of the adults strongly adhered to the MedDiet. Similar results were obtained when Mediterranean lifestyle adherence was analyzed using the MEDLIFE score, with 20% of the adults presenting a strong adherence, while significantly stronger adherence was found in Lebanon than in the other countries. Regarding the children and adolescents, around 30% presented strong adherence to the MedDiet. Price, availability, and accessibility were significant obstacles, whereas the perceptions of health and diet quality were identified as the drivers of the MedDiet. Conclusions: Overall, our results highlight the need for national policies to reduce the economic burden of healthy food options while encouraging equitable access to re-popularize the MedDiet pattern. Future research should focus on intervention strategies tailored to different age groups and socioeconomic backgrounds, the long-term impact of family-based strategies, and the cultural influences on MedDiet adherence.
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Affiliation(s)
- Ozge Yesildemir
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Bursa Uludag University, 16059 Bursa, Türkiye;
| | - Metin Guldas
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Bursa Uludag University, 16059 Bursa, Türkiye;
- Department of Biotechnology, Graduate School of Natural and Applied Sciences, Bursa Uludag University, 16285 Bursa, Türkiye;
| | - Noemi Boqué
- Technological Unit of Nutrition and Health, Eurecat, Technology Centre of Catalonia, 43204 Reus, Spain; (N.B.); (L.C.-P.)
| | - Lorena Calderón-Pérez
- Technological Unit of Nutrition and Health, Eurecat, Technology Centre of Catalonia, 43204 Reus, Spain; (N.B.); (L.C.-P.)
| | - Perla Degli Innocenti
- Human Nutrition Unit, Department of Food and Drug, University of Parma, 43125 Parma, Italy; (P.D.I.); (F.S.)
| | - Francesca Scazzina
- Human Nutrition Unit, Department of Food and Drug, University of Parma, 43125 Parma, Italy; (P.D.I.); (F.S.)
| | - Nada Nehme
- Department of Food Science and Technology, Faculty of Agricultural Engineering and Veterinary Medicine, Lebanese University, Dekwaneh 6573, Lebanon; (N.N.); (F.A.A.)
| | - Fatima Abou Abbass
- Department of Food Science and Technology, Faculty of Agricultural Engineering and Veterinary Medicine, Lebanese University, Dekwaneh 6573, Lebanon; (N.N.); (F.A.A.)
| | | | | | - Nurcan Ozyazicioglu
- Department of Nursing, Faculty of Health Sciences, Bursa Uludag University, 16059 Bursa, Türkiye;
| | - Elif Yildiz
- Department of Food Engineering, Faculty of Agriculture, Bursa Uludag University, 16059 Bursa, Türkiye;
| | - Ozan Gurbuz
- Department of Biotechnology, Graduate School of Natural and Applied Sciences, Bursa Uludag University, 16285 Bursa, Türkiye;
- Department of Food Engineering, Faculty of Agriculture, Bursa Uludag University, 16059 Bursa, Türkiye;
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Demirel Ozbek Y, Celik I, Sahin Bilgin A. Factors affecting behaviors during complementary feeding in infants and children aged 6-24 months. PLoS One 2025; 20:e0314694. [PMID: 39752408 PMCID: PMC11698433 DOI: 10.1371/journal.pone.0314694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2024] [Accepted: 11/15/2024] [Indexed: 01/06/2025] Open
Abstract
The process that begins around the 6th month of life and continues until the 24th month is called the complementary feeding period. During this period, infants and children start receiving foods that complement breast milk or formula for the first time. The psychosocial factors the infants and children encounter during this period may affect their growth and health in later life. This cross-sectional and descriptive study aimed to examine the factors influencing behaviors of infants and children during complementary feeding. The study sample included 345 mothers with infants and children aged 6-24 months. The research data were collected using two forms and one scale. The first form contained questions about the mothers' sociodemographic characteristics, sources of support in childcare, and information sources related to complementary feeding. The second form contained questions about the sociodemographic characteristics of infants and children, the presence of allergies, breastfeeding, and feeding status. The scale used was the validated Behaviors of Transition to Complementary Feeding Scale. The effect of independent variables on behavior of infants and children during complementary feeding was examined using multiple linear regression analysis. Infants/children older than 12 months exhibited more negative behaviors during complementary feeding compared with those aged 6-12 months. The study also found that being the first infant/child in the family had a negative impact on behaviors during complementary feeding. Infants and children currently receiving only complementary feeding displayed more positive behaviors during the complementary feeding process. Paternal support in childcare positively influenced behaviors during this period. In conclusion, complementary feeding is a multifaceted process influenced by various factors, including the infant's and child's age, family dynamics, and parental support. Strategies to support mothers, involve fathers, and provide reliable information can facilitate a smoother process of complementary feeding and promote healthier feeding behaviors in infants and children. Descriptive, interventional, qualitative, and mixed-methods studies are required to analyze these factors in detail and improve the complementary feeding process.
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Affiliation(s)
- Yagmur Demirel Ozbek
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Recep Tayyip Erdoğan University, Rize, Turkey
| | - Isa Celik
- Department of Pediatric Nursing, Faculty of Health Sciences, Recep Tayyip Erdogan University, Rize, Turkey
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Masztalerz-Kozubek D, Zielinska-Pukos MA, Plichta M, Hamulka J. The influence of early and current feeding practices, eating behaviors, and screen time on dietary patterns in Polish toddlers - A cross-sectional study. Appetite 2024; 201:107580. [PMID: 38936700 DOI: 10.1016/j.appet.2024.107580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 06/21/2024] [Accepted: 06/24/2024] [Indexed: 06/29/2024]
Abstract
Early nutrition has an important influence on a child's proper health and development, and understanding factors that may be related to desirable dietary patterns is key to improving the diet of future generations. The aim of this study was to assess whether early and current feeding practices, eating behaviors, and screen time viewing are associated with toddlers' dietary patterns. A cross-sectional sample of 467 mothers of toddlers (aged 1 year to 3) was surveyed between 2020 and 2022. Food consumption was evaluated by the Food Frequency Questionnaire (FFQ). The k-means algorithm was used to define dietary patterns on the basis of data collected from the FFQ and mealtime environment patterns, based on the data about practices during meals consumption. The odds of following a prohealth dietary pattern among early feeding factors were lower when infants ate commercial complementary foods more often. Distracted mealtime environment pattern increased the odds of following a non-eaters pattern, and commercial complementary foods pattern increased the odds of following a processed pattern. Currently, the odds of following a processed dietary pattern were higher when children were not breastfed and had higher screen time. Toddlers who ate during distraction and were more fussy had lower odds of following a prohealth dietary pattern, whereas higher enjoyment of food and satiety responsiveness increased the odds. The results indicate the need to increase parents' awareness about the importance of early factors in establishing dietary patterns.
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Affiliation(s)
- Daria Masztalerz-Kozubek
- Department of Human Nutrition, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), Warsaw, Poland
| | - Monika A Zielinska-Pukos
- Department of Human Nutrition, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), Warsaw, Poland
| | - Marta Plichta
- Department of Food Market and Consumer Research, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), Warsaw, Poland
| | - Jadwiga Hamulka
- Department of Human Nutrition, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), Warsaw, Poland.
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Hillesund ER, Sagedal LR, Øverby NC. Early-life family meal participation and anthropometric measures at 4 years of age. J Dev Orig Health Dis 2024; 15:e13. [PMID: 39248603 DOI: 10.1017/s2040174424000217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/10/2024]
Abstract
Early-life family meal participation has been associated with several aspects of nutritional health, but longitudinal associations with linear growth have not yet been investigated. The aim of this study was to investigate whether family meal participation at 12 months of age associates with anthropometric measures 3 years later. We used follow-up data from children born to mothers in the Norwegian Fit for Delivery trial (NFFD) and included 368 first-borns with dietary and anthropometric data at 12 months and 4 years of age. We treated the sample as a cohort and conducted subgroup analyses by randomization status. A family meal participation score was used as exposure, and weight, height, and body mass index (BMI) as outcomes in crude and multivariable linear regression models adjusted for maternal education, randomization status, and child sex.Higher family meal participation score at 12 months was positively associated with length at 12 months (B = 0.198, 95% CI 0.028, 0.367, p = 0.022) and 4 years (B = 0.283, 95% CI 0.011, 0.555, p = 0.042) in multivariable models. After additional adjustment for maternal height the associations attenuated and were no longer significant. An inverse association with BMI at 4 years of age was observed in children born to mothers that had been exposed to the NFFD intervention (B = -0.144, 95% CI -0.275, -0.014, p = 0.030), but attenuated after adjustment for maternal BMI.The longitudinal association observed between early family meal participation and child height was largely explained by maternal height. The relationship with BMI differed according to maternal participation in a lifestyle intervention trial during pregnancy.
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Affiliation(s)
| | - Linda Reme Sagedal
- Department of Obstetrics and Gynecology/Department of Research, Sørlandet Hospital, Kristiansand, Norway
| | - Nina Cecilie Øverby
- Department of Nutrition and Public Health, University of Agder, Kristiansand, Norway
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Vaughan E, Spyreli E, McKinley M, Hennessy M, Woodside J, Kelly C. Exploring the world of food with families: perspectives of low-income families on factors influencing their food choices. Public Health Nutr 2024; 27:e53. [PMID: 38234109 PMCID: PMC10882528 DOI: 10.1017/s136898002400020x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
OBJECTIVE The aim of this study was to investigate the social and environmental factors involved in the food decision-making processes of families living on lower incomes on the Island of Ireland. DESIGN A qualitative design was employed for this study, using photovoice and creative mapping methods. Parents were requested to take photos and draw maps of their food environments. Interviews were then conducted with parents, using the materials produced by parents as a cue to discuss their food environments, influences and decision-making processes around food choices. SETTING The participants were interviewed online via Microsoft Teams. PARTICIPANTS The participants were parents or guardians of children between the ages of 2 and 18 who self-defined as 'living on a tight budget'. RESULTS Twenty-eight participants were recruited and interviewed for this study, including twelve parents in Northern Ireland and sixteen in the Republic of Ireland. The findings were mapped on to Bronfenbrenner's Ecological Systems Theory and showed that multiple, overlapping and intersecting factors at the individual, micro-, meso-, exo-, macro- and chrono-system were implicated in family food choices. Upstream factors in particular, including structural, policy and commercial determinants, appear to be significant drivers of behaviour. CONCLUSIONS While the findings suggest that a complex range of factors are involved in family food choices, it is clear that policy measures and regulations are needed to stave off the impacts of rising social inequality and food poverty. Health promoters should strive to find non-stigmatising interventions to bridge the nutritional divide experienced by lower-income families.
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Affiliation(s)
- Elena Vaughan
- Health Promotion Research Centre, College of Medicine, Nursing and Health Sciences, University of Galway, University Road, Galway, Republic of Ireland
| | - Eleni Spyreli
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queens University, Belfast, Northern Ireland
| | - Michelle McKinley
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queens University, Belfast, Northern Ireland
| | - Marita Hennessy
- INFANT Centre, University College Cork, Cork, Republic of Ireland
| | - Jayne Woodside
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queens University, Belfast, Northern Ireland
| | - Colette Kelly
- Health Promotion Research Centre, College of Medicine, Nursing and Health Sciences, University of Galway, University Road, Galway, Republic of Ireland
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Helle C, Hillesund ER, Øverby NC. Maternal mental health is associated with children's frequency of family meals at 12 and 24 months of age. MATERNAL & CHILD NUTRITION 2024; 20:e13552. [PMID: 37596722 PMCID: PMC10750025 DOI: 10.1111/mcn.13552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 07/03/2023] [Accepted: 07/20/2023] [Indexed: 08/20/2023]
Abstract
Diet during the child's first years is important for growth and development. In toddlerhood, higher diet quality is reported among children eating meals together with family. Although previous literature has documented several associations between maternal mental health and early child feeding practices, less is known about the relationship between maternal mental health and child frequency of shared family meals. This study explores associations between maternal symptoms of anxiety and depression, measured by The Hopkins Symptoms Checklist (SCL-8), and toddler participation in family meals. We used cross-sectional data from the Norwegian study Early Food for Future Health, in which participants responded to questionnaires at child age 12 (n = 455) and 24 months (n = 295). Logistic regression was used to explore associations between maternal mental health and child having regular (≥5 per week) or irregular (<5 per week) family meals (breakfast and dinner), adjusting for relevant child and maternal confounding variables. Children of mothers with higher scores of anxiety and depression had higher odds of Irregular family meals at both timepoints; (OR: 2.067, p = 0.015) and (OR: 2.444, p = 0.023). This is one of few studies exploring associations between maternal mental health and child frequency of shared family meals in early childhood, a period where the foundation for life-long health is shaped. Given the high prevalence of mental ailments and disorders, these findings are important and may inform future public health interventions. Further exploration of this relation is needed, including longitudinal research to test predictive associations and qualitative studies to increase insight and understanding.
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Affiliation(s)
- Christine Helle
- Department of Nutrition and Public Health, Faculty of Health and Sport SciencesUniversity of AgderKristiansandNorway
| | - Elisabet R. Hillesund
- Department of Nutrition and Public Health, Faculty of Health and Sport SciencesUniversity of AgderKristiansandNorway
| | - Nina Cecilie Øverby
- Department of Nutrition and Public Health, Faculty of Health and Sport SciencesUniversity of AgderKristiansandNorway
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7
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Effects of the COVID-19 Pandemic on Dietary Practices for Mothers in Japan. WOMEN 2022. [DOI: 10.3390/women2030025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
To the best of our knowledge, changes in mothers’ dietary behaviors or perceptions of dietary intake during the COVID-19 pandemic have not been extensively discussed. Therefore, the present study aimed to clarify how the dietary behaviors of mothers living with their children changed during the pandemic in Japan. Ordered probit and interval regressions were applied to individual data for mothers living with children under 18 years of age from five independently conducted Surveys of Attitudes toward Food and Nutrition Education (Shokuiku in Japanese). The estimation results showed that although mothers were more likely to eat dinner with their families during the pandemic, attention to healthy dietary practices, frequency of eating nutritionally balanced food, and dietary practices for preventing lifestyle-related diseases were negatively affected by the pandemic. In conclusion, mothers were more likely to decrease their commitment to a healthy and well-balanced diet during the pandemic than before it. Further research based on the latest datasets with detailed information over the long-term is required.
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Mahmood L, González-Gil EM, Schwarz P, Herrmann S, Karaglani E, Cardon G, De Vylder F, Willems R, Makrilakis K, Liatis S, Iotova V, Tsochev K, Tankova T, Rurik I, Radó S, Moreno LA, Manios Y. Frequency of family meals and food consumption in families at high risk of type 2 diabetes: the Feel4Diabetes-study. Eur J Pediatr 2022; 181:2523-2534. [PMID: 35353229 PMCID: PMC9110493 DOI: 10.1007/s00431-022-04445-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 03/10/2022] [Accepted: 03/11/2022] [Indexed: 02/02/2023]
Abstract
UNLABELLED A family meal is defined as a meal consumed together by the members of a family or by having ≥ 1 parent present during a meal. The frequency of family meals has been associated with healthier food intake patterns in both children and parents. This study aimed to investigate in families at high risk for developing type 2 diabetes across Europe the association (i) between family meals' frequency and food consumption and diet quality among parents and (ii) between family meals' frequency and children's food consumption. Moreover, the study aimed to elucidate the mediating effect of parental diet quality on the association between family meals' frequency and children's food consumption. Food consumption frequency and anthropometric were collected cross-sectionally from a representative sample of 1964 families from the European Feel4Diabetes-study. Regression and mediation analyses were applied by gender of children. Positive and significant associations were found between the frequency of family meals and parental food consumption (β = 0.84; 95% CI 0.57, 1.45) and diet quality (β = 0.30; 95% CI 0.19, 0.42). For children, more frequent family meals were significantly associated with healthier food consumption (boys, β = 0.172, p < 0.05; girls, β = 0.114, p < 0.01). A partial mediation effect of the parental diet quality was shown on the association between the frequency of family meals and the consumption of some selected food items (i.e., milk products and salty snacks) among boys and girls. The strongest mediation effect of parental diet quality was found on the association between the frequency of family breakfast and the consumption of salty snacks and milk and milk products (62.5% and 37.5%, respectively) among girls. CONCLUSIONS The frequency of family meals is positively associated with improved food consumption patterns (i.e., higher intake of fruits and vegetables and reduced consumption of sweets) in both parents and children. However, the association in children is partially mediated by parents' diet quality. The promotion of consuming meals together in the family could be a potentially effective strategy for interventions aiming to establish and maintain healthy food consumption patterns among children. TRIAL REGISTRATION The Feel4Diabetes-study is registered with the clinical trials registry (NCT02393872), http://clinicaltrials.gov , March 20, 2015. WHAT IS KNOWN • Parents' eating habits and diet quality play an important role in shaping dietary patterns in children • Family meals frequency is associated with improved diet quality of children in healthy population What is New: • Frequency of family meals was significantly associated with healthier food consumption among parents and children in families at high risk of type 2 diabetes in six European countries. • Parental diet quality mediates the association between family meals frequency and the consumption of some selected food items among children.
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Affiliation(s)
- Lubna Mahmood
- grid.11205.370000 0001 2152 8769Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Zaragoza, Spain
| | - Esther M. González-Gil
- grid.11205.370000 0001 2152 8769Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Zaragoza, Spain ,grid.4489.10000000121678994Department of Biochemistry and Molecular Biology II, School of Pharmacy, University of Granada, Granada, Spain ,grid.4489.10000000121678994Institute of Nutrition and Food Technology “José Mataix”, Center of Biomedical Research, University of Granada. Avda. del Conocimiento S/N, 18016 Armilla, Granada, Spain ,grid.413448.e0000 0000 9314 1427Centro de Investigación Biomédica en Red de Fisiopatología de La Obesidad Y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
| | - Peter Schwarz
- grid.4488.00000 0001 2111 7257Department for Prevention and Care of Diabetes, Medical Faculty Carl Gustav Carus, Technical University of Dresden, Dresden, Germany ,grid.4488.00000 0001 2111 7257Faculty of Medicine, Paul Langerhans Institute Dresden of the Helmholtz Center Munich at University Hospital, TU Dresden, 01307 Dresden, Germany ,grid.452622.5German Center for Diabetes Research (DZD E.V.), 85764 Neuherberg, Germany
| | - Sandra Herrmann
- grid.4488.00000 0001 2111 7257Department for Prevention and Care of Diabetes, Medical Faculty Carl Gustav Carus, Technical University of Dresden, Dresden, Germany
| | - Eva Karaglani
- grid.15823.3d0000 0004 0622 2843Department of Nutrition and Dietetics, School of Health Science & Education, Harokopio University, Athens, Greece
| | - Greet Cardon
- grid.5342.00000 0001 2069 7798Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Flore De Vylder
- grid.5342.00000 0001 2069 7798Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Ruben Willems
- grid.5342.00000 0001 2069 7798Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Konstantinos Makrilakis
- grid.5216.00000 0001 2155 0800National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Stavors Liatis
- grid.5216.00000 0001 2155 0800National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Violeta Iotova
- grid.20501.360000 0000 8767 9052Department of Social Medicine and Health Care, Organization Medical University of Varna, Varna, Bulgaria
| | - Kaloyan Tsochev
- grid.20501.360000 0000 8767 9052Department of Social Medicine and Health Care, Organization Medical University of Varna, Varna, Bulgaria
| | - Tsvetalina Tankova
- grid.410563.50000 0004 0621 0092Department of Diabetology, Clinical Center of Endocrinology, Medical University of Sofia, Sofia, Bulgaria
| | - Imre Rurik
- grid.7122.60000 0001 1088 8582Faculty of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Sándorné Radó
- grid.7122.60000 0001 1088 8582Faculty of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Luis A. Moreno
- grid.11205.370000 0001 2152 8769Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Zaragoza, Spain ,grid.413448.e0000 0000 9314 1427Centro de Investigación Biomédica en Red de Fisiopatología de La Obesidad Y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain ,grid.11205.370000 0001 2152 8769Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain ,grid.488737.70000000463436020Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
| | - Yannis Manios
- grid.15823.3d0000 0004 0622 2843Department of Nutrition and Dietetics, School of Health Science & Education, Harokopio University, Athens, Greece ,grid.419879.a0000 0004 0393 8299Institute of Agri-Food and Life Sciences, Hellenic Mediterranean University Research Centre, Heraklion, Greece
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