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da Mota JC, Smaira FI, Julio JMG, Carvalho BGD, Carvalho LM, Ribeiro AA, Souza LL, Borba EF, Roschel H, Gualano B, Nicoletti CF. Association between excess body weight and disordered eating attitude among women living with systemic lupus erythematosus. Lupus 2025:9612033251332830. [PMID: 40199379 DOI: 10.1177/09612033251332830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/10/2025]
Abstract
The study aimed to: (i) characterize dietary intake and identify disorders eating attitudes in women with SLE, (ii) evaluate possible differences in both dietary intake and disorders eating attitudes in patients with SLE according to nutritional status, (iii) investigate possible associations between eating disorders attitudes, anthropometric characteristics and food consumption. METHODS This cross-sectional study included 46 premenopausal female patients (18-40 years), with inactive disease, using prednisone <10 mg/day and hydroxychloroquine at a stable dose. Patients were allocated into two groups according to their nutritional status by body mass index (BMI): normal weight (BMI between 18.5 and 24.9 kg/m2) and excess weight (BMI >25 kg/m2). Food consumption was assessed according to the processing level and energy and macronutrient content. The Disordered Eating Attitude Scale (DEAS) was applied. RESULTS Patients with excess weight had a higher DEAS score when compared to those with normal weight (34 ± 8.7 vs 25 ± 5.9, p = .001). A higher percentage of patients with excess weight demonstrated disturbance in their relationship with food and concerns about food and weight gain versus those with normal weight. DEAS score was positively associated with BMI, abdominal circumference, and fat mass percentage and negatively associated with lipid intake. CONCLUSION Disordered eating attitudes differ in SLE patients according to nutritional status, and those with excess weight show higher DEAS scores, which may be related to food and weight gain.
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Affiliation(s)
- Jhulia Cnl da Mota
- Applied Physiology and Nutrition Research Group - School of Physical Education and Sport and Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
- Center of Lifestyle Medicine, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Fabiana I Smaira
- Applied Physiology and Nutrition Research Group - School of Physical Education and Sport and Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
- Center of Lifestyle Medicine, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Juliana Maria Gonçalves Julio
- Applied Physiology and Nutrition Research Group - School of Physical Education and Sport and Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Beatriz Garcia de Carvalho
- Applied Physiology and Nutrition Research Group - School of Physical Education and Sport and Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
- Center of Lifestyle Medicine, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Lucas M Carvalho
- Applied Physiology and Nutrition Research Group - School of Physical Education and Sport and Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
- Center of Lifestyle Medicine, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Amanda A Ribeiro
- Applied Physiology and Nutrition Research Group - School of Physical Education and Sport and Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
- Center of Lifestyle Medicine, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Leticia L Souza
- Applied Physiology and Nutrition Research Group - School of Physical Education and Sport and Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
- Center of Lifestyle Medicine, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Eduardo F Borba
- Rheumatology Division, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, Brazil
| | - Hamilton Roschel
- Applied Physiology and Nutrition Research Group - School of Physical Education and Sport and Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
- Center of Lifestyle Medicine, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
- Rheumatology Division, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, Brazil
- Laboratory of Assessment and Conditioning in Rheumatology, Hospital das Clínicas HCFMUSP, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Bruno Gualano
- Applied Physiology and Nutrition Research Group - School of Physical Education and Sport and Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
- Center of Lifestyle Medicine, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
- Rheumatology Division, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, Brazil
- Laboratory of Assessment and Conditioning in Rheumatology, Hospital das Clínicas HCFMUSP, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Carolina F Nicoletti
- Applied Physiology and Nutrition Research Group - School of Physical Education and Sport and Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
- Center of Lifestyle Medicine, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
- Rheumatology Division, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, Brazil
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Kenger EB, Karahan TO. Body Appreciation is Associated with Emotional Eating in Turkish Female Athletes. Int J Sports Med 2024; 45:775-781. [PMID: 38885661 DOI: 10.1055/a-2328-3921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/20/2024]
Abstract
It is known that female athletes are at risk for eating disorders. It is thought that factors such as pressure and stress experienced by professional athletes may affect emotional eating and body appreciation. In this context, the aim of this study was to evaluate the emotional eating and body appreciation of professional Turkish female athletes. A total of 265 professional female athletes were categorized according to their sport types and nationality. Emotional eating was found to be higher and body appreciation to be lower in athletes competing at the national level. The results of the hierarchical regression analysis, which included variables such as age, body mass index, professional sports background, national level, and sport type show that the most effective factor in explaining emotional eating in professional female athletes is body appreciation. The present study findings support that professional female athletes are at risk in terms of emotional eating and body appreciation. In addition, emotional eating scores were found to be higher and body appreciation scores were lower in national athletes. Psychological factors such as intense stress and pressure have an impact on the eating behavior and body appreciation of national athletes. These results suggest that athletes should be evaluated by nutritionists, doctors, and psychologists from a multidisciplinary perspective.
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Affiliation(s)
- Emre Batuhan Kenger
- Nutrition and Dietetics, Faculty of Health Sciences, Istanbul Bilgi Universitesi, Istanbul, Turkey
| | - Tugce Ozlu Karahan
- Nutrition and Dietetics, Faculty of Health Sciences, Istanbul Bilgi Universitesi, Istanbul, Turkey
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Nameni G, Jazayeri S, Salehi M, Esrafili A, Hajebi A, Motevalian SA. Association between visceral adiposity and generalized anxiety disorder (GAD). BMC Psychol 2024; 12:49. [PMID: 38273394 PMCID: PMC10811950 DOI: 10.1186/s40359-024-01542-x] [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: 12/09/2023] [Accepted: 01/15/2024] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Due to an increased rate of inflammation in generalized anxiety disorder (GAD), insight into the mediating factors in the onset and recurrence of the inflammatory response can help to achieve novel treatments for alleviating the risk of GAD. In the current study, we aimed to evaluate the possible relationship between visceral adipose tissue (VAT) as an important intermediary in inflammation pathways and GAD in participants of the Employees' Health Cohort Study of Iran (EHCSIR). METHOD We analyzed the data from 3889 included participants aged > 18 years in the EHCSIR study, which were collected from 2017 to 2020. Lifetime and 12-month GAD were assessed using the Composite International Diagnostic Interview (CIDI-2.1) questionnaire. The adjusted prevalence ratio was computed to evaluate the association between GAD and visceral adiposity index (VAI), GAD and visceral fat area (VFA), GAD and body mass index (BMI) and ultimately GAD and waist circumference (WC) in males and females using STATA software. RESULTS Log-binomial analysis showed a higher prevalence ratio of 12-month GAD associated with VFA in women [PR: 1.42, CI: 1.07-1.87, P: 0.015]. The prevalence of lifetime GAD was higher in obese women (BM1 > 30) [PR: 2.35, CI: 1.07-5.13, P:0.03] than in women with normal BMI. Women with higher VAI were also significantly more likely to suffer lifetime GAD [PR: 1.25, CI: 1.05]. 1.48, P:0.01]. In males, the prevalence of lifetime diagnosed GAD per 1 standard deviation increase in VFA was 0.65 [CI: 0.46-0.91, P: 0.01]. CONCLUSION Visceral adiposity as a positive agent was associated with GAD prevalence in women. The presence of GAD symptoms showed no relationship to VFA in men.
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Affiliation(s)
- Ghazaleh Nameni
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences , Tehran, Iran
| | - Shima Jazayeri
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences , Tehran, Iran.
| | - Masoud Salehi
- Department of Biostatistics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Esrafili
- Department of Environmental Health Engineering, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Ahmad Hajebi
- Research Center for Addiction & Risky Behaviors (ReCARB), Psychosocial Health Research Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Abbas Motevalian
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.
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Radkhah N, Rasouli A, Majnouni A, Eskandari E, Parastouei K. The effect of Mediterranean diet instructions on depression, anxiety, stress, and anthropometric indices: A randomized, double-blind, controlled clinical trial. Prev Med Rep 2023; 36:102469. [PMID: 37869542 PMCID: PMC10587518 DOI: 10.1016/j.pmedr.2023.102469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 10/08/2023] [Accepted: 10/09/2023] [Indexed: 10/24/2023] Open
Abstract
Evidence suggests that adopting a healthy diet, such as the Mediterranean Diet (MD), can positively affect mental health. To further explore this, a study was conducted to determine the impact of MD instruction over 12 weeks on depression, anxiety, stress, and anthropometric indices. The study is a randomized, double-blind, controlled clinical trial with sixty participants who reported stress, anxiety, and depression conducted in Tabriz, Iran (2022-2023). They were randomly assigned to either the intervention group (n = 30), which received MD instruction, or the control group (n = 30), which received standard healthy nutrition education. Both groups were asked to follow their respective nutrition education plans for 12 weeks. After 12 weeks, depression, anxiety, and stress levels were measured using the DASS-21 questionnaire, and anthropometric indices were assessed. Initially, the unadjusted DASS-21 scores for depression, anxiety, and stress did not show significant differences between the two groups. However, after adjusting for baseline variables (model 2), all scores decreased significantly (the P-value for all scores was < 0.001). There was no significant difference in weight and BMI between the intervention and control groups. However, after adjusting the results based on baseline values (Model 2) and adherence to the program (Model 3), weight and BMI were significantly reduced in the MD group (P-values for both cases and both models were < 0.001). Overall, despite some significant findings, the results were not noticeable from a clinical perspective. The study provides some indications that following the Mediterranean diet may lead to improvements in weight and mental well-being.
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Affiliation(s)
- Nima Radkhah
- Nutrition Research Center, Department of Clinical Nutrition, Nutrition, and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ahmadreza Rasouli
- Nutrition Research Center, Department of Clinical Nutrition, Nutrition, and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Amin Majnouni
- Nutrition Research Center, Department of Clinical Nutrition, Nutrition, and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Eslam Eskandari
- Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Karim Parastouei
- Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
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Qi R, Sheng B, Zhou L, Chen Y, Sun L, Zhang X. Association of Plant-Based Diet Indices and Abdominal Obesity with Mental Disorders among Older Chinese Adults. Nutrients 2023; 15:2721. [PMID: 37375625 DOI: 10.3390/nu15122721] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 05/30/2023] [Accepted: 06/09/2023] [Indexed: 06/29/2023] Open
Abstract
We aimed to explore the correlation between plant-based diet indices and abdominal obesity with depression and anxiety among older Chinese adults. This study used a cross-sectional design using data from the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS). We used a simplified food frequency questionnaire to evaluate the overall plant-based diet index (PDI), the healthful plant-based diet index (hPDI), and the unhealthful plant-based diet index (uPDI) separately, based on the potential health effects of the foods. Waist circumference (WC) was used to define abdominal obesity. The 10-item Center for Epidemiologic Studies Depression Scale (CES-D-10) and the 7-item Generalized Anxiety Disorder Scale (GAD-7) were applied to estimate depression symptoms and anxiety symptoms, respectively. Multi-adjusted binary logistic regression models were conducted to explore the effects of the three plant-based diet indices, abdominal obesity status, and their interaction on depression and anxiety. We enrolled a total of 11,623 participants aged 83.21 ± 10.98 years, of which 3140 (27.0%) participants had depression and 1361 (11.7%) had anxiety. The trend in the prevalence of depression/anxiety across increasing quartiles of the plant-based diet indices was statistically significant after controlling for potential confounders (p-trend < 0.05). Abdominal obesity was related to a lower prevalence of depression (OR = 0.86, 95% CI: 0.77-0.95) and anxiety (OR = 0.79, 95% CI: 0.69-0.90) compared with non-abdominal obesity. The protective effects of the PDI and hPDI against depression (OR = 0.52, 95% CI: 0.41-0.64; OR = 0.59, 95% CI: 0.48-0.73, respectively) and anxiety (OR = 0.75, 95% CI: 0.57-1.00; OR = 0.52, 95% CI: 0.39-0.70, respectively) were more pronounced in non-abdominally obese participants. The harmful effects of the uPDI against depression (OR = 1.78, 95% CI: 1.42-2.23) and anxiety (OR = 1.56, 95% CI: 1.16-2.10) were more pronounced in non-abdominally obese participants. In addition, a significant interaction between the plant-based diet indices and abdominal obesity was observed in terms of causing the prevalence of depression and anxiety. Consuming more of a healthful plant-based diet and less of an animal-based diet is related to a lower prevalence of depression and anxiety. A healthful plant-based diet plays a vital role in non-abdominally obese individuals.
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Affiliation(s)
- Ran Qi
- School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Baihe Sheng
- School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Lihui Zhou
- School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Yanchun Chen
- School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Li Sun
- School of Nursing, Tianjin Medical University, Tianjin 300070, China
| | - Xinyu Zhang
- School of Public Health, Tianjin Medical University, Tianjin 300070, China
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Kirsten H, Dechant M, Gibbons H, Friehs MA. Tasting inhibition: A proof-of-concept study of the food stop-signal game. PROGRESS IN BRAIN RESEARCH 2023; 279:57-80. [PMID: 37661163 DOI: 10.1016/bs.pbr.2022.12.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
Self-Control is an important skill in everyday life when attention is automatically drawn toward certain stimuli. For instance, food stimuli automatically capture visual attention and are processed preferentially. Therefore, efficient response inhibition is crucial to refrain from careless overeating. In the present proof-of-concept study we use a novel adaptation of a previously evaluated Stop-Signal Game (SSG) to measure reactive, food-specific, response inhibition in healthy adults. We analyzed a sample of 83 participants (60 female, mean age=24.1, mean BMI=21.71kg/m2) split into three groups. In a gamified stop-signal task, participants navigated an avatar in an urban environment toward high-calorie food, low-calorie food, or non-food stimuli in go-trials and were asked to inhibit the approach reaction in stop-trials. Hunger, eating styles, food craving, and impulsivity were assessed via self-reports to investigate their relationship with (food-specific) response inhibition. Results showed that response inhibition (in terms of stop-signal reaction time, SSRT) did not differ between the high-calorie, low-calorie, and non-food SSG which might be explained by characteristics of the sample. However, impulsivity was positively correlated with SSRT in the low-calorie SSG, whereas food-craving and hunger were positively related to response inhibition in the high-calorie SSG. Future studies could build upon the food SSG to measure and train food-specific response inhibition in the treatment of overeating.
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Affiliation(s)
- Hannah Kirsten
- Department of Psychology, University of Bonn, Bonn, Germany.
| | - Martin Dechant
- ZEISS Vision Science Lab, Carl Zeiss Vision International GmbH, Aalen, Germany; UCLIC, University College London, London, United Kingdom
| | | | - Maximilian Achim Friehs
- School of Psychology, College of Social Sciences and Law, University College Dublin, Dublin, Ireland; Lise-Meitner Research Group Cognition and Plasticity, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany; Psychology of Conflict, Risk, and Safety, University of Twente, Enschede, Netherlands.
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Czepczor-Bernat K, Modrzejewska J, Modrzejewska A, Matusik P. Do COVID-19-Related Stress, Being Overweight, and Body Dissatisfaction Contribute to More Disordered Eating in Polish Women?-A Cluster Analysis Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:13100. [PMID: 34948710 PMCID: PMC8701286 DOI: 10.3390/ijerph182413100] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 12/08/2021] [Accepted: 12/11/2021] [Indexed: 12/23/2022]
Abstract
We hypothesized that women who are overweight, experiencing COVID-19-related stress, and with high body dissatisfaction would have significantly greater disordered eating than those of healthy weight, without stress, and with low body dissatisfaction. Participants (N = 1354 women; Mage= 31.89 years, SD = 11.14) filled in the Contour Drawing Rating Scale, the Emotional Overeating Questionnaire, the Eating Motivation Survey, the Mindful Eating Questionnaire, and a COVID-19-related stress measure and sociodemographic survey. The cluster analysis technique revealed four distinct clusters: (a) Cluster 1 (N = 314): healthy body weight, no COVID-related stress, and low body dissatisfaction (M = 1.19); (b) Cluster 2 (N = 131): overweight, no COVID-related stress, and high body dissatisfaction (M = 2.41); (c) Cluster 3 (N = 597): healthy body weight, COVID-related stress, and low body dissatisfaction (M = 1.27); (d) Cluster 4 (N = 312): overweight, COVID-related stress, and high body dissatisfaction (M = 2.84). Generally, our outcomes partially support our hypothesis, as higher levels of some types of disordered eating were observed in women who were overweight with COVID-related stress and high body dissatisfaction (Cluster 4) as compared with women with healthy body weight, no COVID-related stress, and with low levels of body dissatisfaction (Cluster 1). Our results indicate that both body weight status, as well as COVID-19-related stress and body dissatisfaction, may contribute to the intensity of disordered eating. During future epidemic-related quarantines, this may be an argument in favor of organizing support regarding emotional functioning, body image, and eating behaviors, particularly for the most vulnerable groups-including overweight and obese women.
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Affiliation(s)
| | - Justyna Modrzejewska
- Institute of Pedagogy, University of Bielsko-Biala, 43-309 Bielsko-Biala, Poland;
| | - Adriana Modrzejewska
- Department of Psychology, School of Health Sciences in Katowice, Medical University of Silesia in Katowice, 40-055 Katowice, Poland;
| | - Paweł Matusik
- Department of Pediatrics, Pediatric Obesity and Metabolic Bone Diseases, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-055 Katowice, Poland;
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Remmel L, Jürimäe J, Tamm AL, Purge P, Tillmann V. The Associations of Body Image Perception with Serum Resistin Levels in Highly Trained Adolescent Estonian Rhythmic Gymnasts. Nutrients 2021; 13:nu13093147. [PMID: 34579022 PMCID: PMC8471672 DOI: 10.3390/nu13093147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 09/04/2021] [Accepted: 09/06/2021] [Indexed: 11/27/2022] Open
Abstract
Rhythmic gymnasts (RGs) are more likely to be dissatisfied with their body mass and shape compared to untrained controls (UCs). However, due to the lack of information, the aim of this study was to investigate the associations of body image perception (BIP) with body composition, daily energy consumption and different blood biochemical markers in adolescent RGs compared to UCs. Thirty-three highly trained RG girls and 20 UC girls aged 14–18 years participated in this cross-sectional study. Height, body mass, body composition, energy intake, resting energy expenditure, training volume and different blood biochemical markers were measured. The body attitude test (BAT) was used to evaluate the BIP of the participants. There were no differences in the total BAT scores between the groups. In RGs, the BAT score correlated positively with the serum resistin level (r = 0.35; p = 0.047). A stepwise multiple regression analysis showed that 40.8% of the variability in the BAT score was determined by resistin and BMI. The association of BIP with resistin values was observed only in RGs. In conclusion, our findings add to the increasing evidence that resistin may be a link between BIP and body composition, most likely through fat mass, in adolescent female RGs.
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Affiliation(s)
- Liina Remmel
- Institute of Sport Sciences and Physiotherapy, Faculty of Medicine, University of Tartu, 51008 Tartu, Estonia; (J.J.); (P.P.)
- Correspondence: ; Tel.: +372-7375372; Fax: +372-7375373
| | - Jaak Jürimäe
- Institute of Sport Sciences and Physiotherapy, Faculty of Medicine, University of Tartu, 51008 Tartu, Estonia; (J.J.); (P.P.)
| | - Anna-Liisa Tamm
- Department of Physiotherapy and Environmental Health, Tartu Health Care College, 50411 Tartu, Estonia;
| | - Priit Purge
- Institute of Sport Sciences and Physiotherapy, Faculty of Medicine, University of Tartu, 51008 Tartu, Estonia; (J.J.); (P.P.)
| | - Vallo Tillmann
- Institute of Clinical Medicine, Faculty of Medicine, University of Tartu, 50406 Tartu, Estonia;
- Institute of Clinical Medicine, Children’s Clinic of Tartu University Hospital, 50406 Tartu, Estonia
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