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Sharman A, Shaw JE, Shayanrad A, Shayesteh AA, Shengelia L, Shi Z, Shibuya K, Shimizu-Furusawa H, Shimony T, Shiri R, Shrestha N, Si-Ramlee K, Siani A, Siantar R, Sibai AM, Sidossis LS, Silitrari N, Silva AM, Silva CRDM, Silva DAS, Silva KS, Sim X, Simon M, Simons J, Simons LA, Sjöberg A, Sjöström M, Skoblina EV, Skoblina NA, Slazhnyova T, Slowikowska-Hilczer J, Slusarczyk P, Smeeth L, So HK, Soares FC, Sobek G, Sobngwi E, Sodemann M, Söderberg S, Soekatri MYE, Soemantri A, Sofat R, Solfrizzi V, Solovieva YV, Somi MH, Sonestedt E, Song Y, Soofi S, Sørensen TIA, Sørgjerd EP, Sossa Jérome C, Soto-Rojas VE, Soumaré A, Sousa-Poza A, Sovic S, Sparboe-Nilsen B, Sparrenberger K, Spencer PR, Spinelli A, Spiroski I, Staessen JA, Stamm H, Stang A, Starc G, Staub K, Stavreski B, Steene-Johannessen J, Stehle P, Stein AD, Steinsbekk S, Stergiou GS, Stessman J, Stevanović R, Stieber J, Stöckl D, Stokwiszewski J, Stoyanova E, Stratton G, Stronks K, Strufaldi MW, Sturua L, Suárez-Medina R, Suarez-Ortegón MF, Suebsamran P, Sugiyama M, Suka M, Sulo G, Sun CA, Sun L, Sund M, Sundström J, Sung YT, Sunyer J, Suriyawongpaisal P, Sweis NWG, Swinburn BA, Sy RG, Sylva RC, Szponar L, Tabone L, Tai ES, Takuro F, Tambalis KD, Tammesoo ML, Tamosiunas A, Tan EJ, Tang X, Tanrygulyyeva M, Tanser F, Tao Y, Tarawneh MR, Tarp J, Tarqui-Mamani CB, Taxová Braunerová R, Taylor A, Taylor J, Tchibindat F, Te Velde S, Tebar WR, Tell GS, Tello T, Tessema M, Tham YC, Thankappan KR, Theobald H, Theodoridis X, Thomas N, Thorand B, Thrift AG, Tichá Ľ, Timmermans EJ, Tjandrarini DH, Tjonneland A, Tolonen HK, Tolstrup JS, Tomaszewski M, Topbas M, Topór-Mądry R, Torheim LE, Tornaritis MJ, Torrent M, Torres-Collado L, Toselli S, Touloumi G, Traissac P, Tran TTH, Tremblay MS, Triantafyllou A, Trichopoulos D, Trichopoulou A, Trinh OTH, Trivedi A, Tshepo L, Tsigga M, Tsintavis P, Tsugane S, Tuitele J, Tuliakova AM, Tulloch-Reid MK, Tullu F, Tuomainen TP, Tuomilehto J, Twig G, Tynelius P, Tzala E, Tzotzas T, Tzourio C, Udoji N, Ueda P, Ugel E, Ukoli FAM, Ulmer H, Unal B, Usupova Z, Uusitalo HMT, Uysal N, Vaitkeviciute J, Valdivia G, Vale S, Valvi D, van Dam RM, van den Born BJ, Van der Heyden J, van der Schouw YT, Van Herck K, Van Lippevelde W, Van Minh H, Van Schoor NM, van Valkengoed IGM, Vanderschueren D, Vanuzzo D, Varbo A, Varela-Moreiras G, Vargas LN, Varona-Pérez P, Vasan SK, Vasques DG, Vatasescu R, Vega T, Veidebaum T, Velasquez-Melendez G, Velika B, Verloigne M, Veronesi G, Verschuren WMM, Victora CG, Viegi G, Viet L, Vik FN, Vilar M, Villalpando S, Vioque J, Viriyautsahakul N, Virtanen JK, Visser M, Visvikis-Siest S, Viswanathan B, Vladulescu M, Vlasoff T, Vocanec D, Vollenweider P, Völzke H, Vourli G, Voutilainen A, Vrijheid M, Vrijkotte TGM, Vuletić S, Wade AN, Waldhör T, Walton J, Wambiya EOA, Wan Bebakar WM, Wan Mohamud WN, Wanderley Júnior RDS, Wang C, Wang H, Wang MD, Wang N, Wang Q, Wang X, Wang YX, Wang YW, Wannamethee SG, Wareham N, Wartha O, Weber A, Wedderkopp N, Weghuber D, Wei W, Weres A, Werner B, Westbury LD, Whincup PH, Wichstrøm L, Wickramasinghe K, Widhalm K, Widyahening IS, Więcek A, Wild PS, Wilks RJ, Willeit J, Willeit P, Williams J, Wilsgaard T, Wirth JP, Wojtyniak B, Woldeyohannes M, Wolf K, Wong-McClure RA, Wong A, Wong EB, Wong JE, Wong TY, Woo J, Woodward M, Wu FC, Wu HY, Wu J, Wu LJ, Wu S, Wyszyńska J, Xu H, Xu L, Yaacob NA, Yamborisut U, Yan L, Yan W, Yang L, Yang X, Yang Y, Yardim N, Yasuharu T, Yépez García M, Yiallouros PK, Yngve A, Yoosefi M, Yoshihara A, Yotov Y, You QS, You SL, Younger-Coleman NO, Yu YL, Yu Y, Yusof SM, Yusoff AF, Zaccagni L, Zafiropulos V, Zainuddin AA, Zakavi SR, Zamani F, Zambon S, Zampelas A, Zamrazilová H, Zapata ME, Zargar AH, Zaw KK, Zayed AA, Zdrojewski T, Żegleń M, Zejglicova K, Zeljkovic Vrkic T, Zeng Y, Zentai A, Zhang B, Zhang L, Zhang ZY, Zhao D, Zhao MH, Zhao W, Zhecheva YV, Zhen S, Zheng W, Zheng Y, Zholdin B, Zhou M, Zhu D, Zimmet P, Zins M, Zitt E, Zocalo Y, Zoghlami N, Zuñiga Cisneros J, Zuziak M, Ezzati M. Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults. Lancet 2024; 403:1027-1050. [PMID: 38432237 PMCID: PMC7615769 DOI: 10.1016/s0140-6736(23)02750-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 11/22/2023] [Accepted: 12/05/2023] [Indexed: 03/05/2024]
Abstract
BACKGROUND Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. METHODS We used data from 3663 population-based studies with 222 million participants that measured height and weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children and adolescents (age 5-19 years), from 1990 to 2022 for 200 countries and territories. For adults, we report the individual and combined prevalence of underweight (BMI <18·5 kg/m2) and obesity (BMI ≥30 kg/m2). For school-aged children and adolescents, we report thinness (BMI <2 SD below the median of the WHO growth reference) and obesity (BMI >2 SD above the median). FINDINGS From 1990 to 2022, the combined prevalence of underweight and obesity in adults decreased in 11 countries (6%) for women and 17 (9%) for men with a posterior probability of at least 0·80 that the observed changes were true decreases. The combined prevalence increased in 162 countries (81%) for women and 140 countries (70%) for men with a posterior probability of at least 0·80. In 2022, the combined prevalence of underweight and obesity was highest in island nations in the Caribbean and Polynesia and Micronesia, and countries in the Middle East and north Africa. Obesity prevalence was higher than underweight with posterior probability of at least 0·80 in 177 countries (89%) for women and 145 (73%) for men in 2022, whereas the converse was true in 16 countries (8%) for women, and 39 (20%) for men. From 1990 to 2022, the combined prevalence of thinness and obesity decreased among girls in five countries (3%) and among boys in 15 countries (8%) with a posterior probability of at least 0·80, and increased among girls in 140 countries (70%) and boys in 137 countries (69%) with a posterior probability of at least 0·80. The countries with highest combined prevalence of thinness and obesity in school-aged children and adolescents in 2022 were in Polynesia and Micronesia and the Caribbean for both sexes, and Chile and Qatar for boys. Combined prevalence was also high in some countries in south Asia, such as India and Pakistan, where thinness remained prevalent despite having declined. In 2022, obesity in school-aged children and adolescents was more prevalent than thinness with a posterior probability of at least 0·80 among girls in 133 countries (67%) and boys in 125 countries (63%), whereas the converse was true in 35 countries (18%) and 42 countries (21%), respectively. In almost all countries for both adults and school-aged children and adolescents, the increases in double burden were driven by increases in obesity, and decreases in double burden by declining underweight or thinness. INTERPRETATION The combined burden of underweight and obesity has increased in most countries, driven by an increase in obesity, while underweight and thinness remain prevalent in south Asia and parts of Africa. A healthy nutrition transition that enhances access to nutritious foods is needed to address the remaining burden of underweight while curbing and reversing the increase in obesity. FUNDING UK Medical Research Council, UK Research and Innovation (Research England), UK Research and Innovation (Innovate UK), and European Union.
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Floegel A, Intemann T, Siani A, Moreno LA, Molnár D, Veidebaum T, Hadjigeorgiou C, De Henauw S, Hunsberger M, Eiben G, Ahrens W, Wolters M. Cohort-Based Reference Values for Serum Ferritin and Transferrin and Longitudinal Determinants of Iron Status in European Children Aged 3-15 Years. J Nutr 2024; 154:658-669. [PMID: 38048991 PMCID: PMC10900138 DOI: 10.1016/j.tjnut.2023.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 11/10/2023] [Accepted: 12/01/2023] [Indexed: 12/06/2023] Open
Abstract
BACKGROUND Reference values of ferritin and transferrin for European children do not exist. OBJECTIVE We aimed to provide sex-, age-, and body mass index (BMI)-specific serum ferritin and transferrin reference percentiles of 3-15-y-old children based on cohort data and to investigate determinants of iron status. METHODS A total of 3390 ferritin and 3416 transferrin measurements from children residing in 8 European countries participating in the IDEFICS/I.Family cohort (https://www.isrctn.com/ISRCTN62310987) at baseline (W0) and 6 y later (W3) were used to estimate percentiles using the generalized additive model for location, scale and shape. Associations of serum ferritin and transferrin concentrations with total iron intake, total iron intake additionally adjusted for vitamin C intake, and iron from heme sources were investigated separately with adjustment for sex, age, country of residence, parental education, usual energy intake and BMI z-score in regression models using cross-sectional and longitudinal data. RESULTS The age-specific ferritin and transferrin 5th and 95th reference percentiles ranged from 10.9 to 81.1 μg/L and 2.23 to 3.56 g/L, respectively. A deficient iron status was observed in 3% of children at W0 and 7% of children and adolescents at W3, respectively. At both waves, a higher iron intake from heme sources was positively associated with serum ferritin {W0: β = 3.21 [95% confidence interval (CI): 0.71, 5.71]; W3: β = 4.48 [95% CI: 2.09, 6.87]}, that is, children consuming one mg more heme iron had a 3.21 and 4.48 μg/L higher ferritin concentration. Adherence to a mainly vegetarian diet was associated with a lower chance for sufficient serum ferritin cross-sectionally at W3 [odds ratio (OR) 0.40 (95% CI: 0.21, 0.81)] and longitudinally [OR 0.35 (95% CI: 0.15, 0.93)]. CONCLUSIONS Age-, sex-, and BMI-specific reference percentiles of serum ferritin and transferrin concentrations based on cohort data are provided for European children aged 3-15 y and may be used in clinical practice.
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Affiliation(s)
- Anna Floegel
- Section of Dietetics, Faculty of Agriculture and Food Sciences, Hochschule Neubrandenburg - University of Applied Sciences, Neubrandenburg, Germany; Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Timm Intemann
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Alfonso Siani
- Institute of Food Sciences, National Research Council, Avellino, Italy
| | - Luis A Moreno
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Faculty of Health Sciences, Universidad de Zaragoza, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain; Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
| | - Dénes Molnár
- Department of Pediatrics, Medical School, University of Pécs, Pécs, Hungary
| | - Toomas Veidebaum
- National Institute for Health Development, Estonian Centre of Behavioral and Health Sciences, Tallinn, Estonia
| | | | - Stefaan De Henauw
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Monica Hunsberger
- Section for Epidemiology and Social Medicine, Department of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Gabriele Eiben
- Department of Public Health, School of Health Sciences, University of Skövde, Skövde, Sweden
| | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany; Faculty of Mathematics and Computer Science, Institute of Statistics, University of Bremen, Bremen, Germany
| | - Maike Wolters
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.
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Sina E, Buck C, Ahrens W, Coumans JMJ, Eiben G, Formisano A, Lissner L, Mazur A, Michels N, Molnar D, Moreno LA, Pala V, Pohlabeln H, Reisch L, Tornaritis M, Veidebaum T, Hebestreit A. Author Correction: Digital media exposure and cognitive functioning in European children and adolescents of the I.Family study. Sci Rep 2023; 13:22595. [PMID: 38114524 PMCID: PMC10730536 DOI: 10.1038/s41598-023-49411-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2023] Open
Affiliation(s)
- Elida Sina
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Christoph Buck
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Wolfgang Ahrens
- Faculty of Mathematics and Computer Science, Institute of Statistics, University of Bremen, Bremen, Germany
| | - Juul M J Coumans
- Teaching and Learning Centre, Open University of the Netherlands, Heerlen, The Netherlands
| | - Gabriele Eiben
- Department of Public Health, School of Health Sciences, University of Skövde, Skövde, Sweden
| | | | - Lauren Lissner
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Artur Mazur
- Faculty of Medicine, University of Rzeszów, Rzeszów, Poland
| | - Nathalie Michels
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Dénes Molnar
- Department of Pediatrics, Medical School, University of Pécs, Pécs, Hungary
| | - Luis A Moreno
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Centro de Investigación Biomédica en Red Fisiopatología de La Obesidad y Nutrición (CIBERObn), Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón), University of Zaragoza, Zaragoza, Spain
| | - Valeria Pala
- Department of Epidemiology and Data Science, Fondazione IRCCS, Istituto Nazionale Dei Tumori, Milan, Italy
| | - Hermann Pohlabeln
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Lucia Reisch
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
- Cambridge Judge Business School, University of Cambridge, Cambridge, UK
| | | | - Toomas Veidebaum
- Department of Chronic Diseases, National Institute for Health Development, Tallinn, Estonia
| | - Antje Hebestreit
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.
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Dello Russo M, Formisano A, Lauria F, Ahrens W, Bogl LH, Eiben G, De Henauw S, Hebestreit A, Intemann T, Hunsberger M, Lissner L, Molnar D, Pala V, Papoutsou S, Santaliestra-Pasias AM, Veidebaum T, Wolters M, Siani A, Russo P. Dietary Diversity and Its Association with Diet Quality and Health Status of European Children, Adolescents, and Adults: Results from the I.Family Study. Foods 2023; 12:4458. [PMID: 38137262 PMCID: PMC10743104 DOI: 10.3390/foods12244458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 12/04/2023] [Accepted: 12/06/2023] [Indexed: 12/24/2023] Open
Abstract
Dietary diversity (DD) plays a crucial role in fostering high-quality diets, but its association with health outcomes, particularly body adiposity and non-communicable diseases (NCDs), is inconsistent. This may be due to a lack of a standardized method for estimating DD. Our study investigates the association between two DD indices, namely the dietary diversity score (DDS) and food variety score (FVS), and anthropometric measures, biochemical parameters, and diet quality in a large population sample from the I.Family study across research centers in eight European countries. In our cross-sectional analysis of 3035 participants, DDSs varied among countries, with a higher prevalence in the third DDS tertile among those with higher education. DDS showed a positive association with diet quality across all age groups. Higher DDS tertile individuals showed increased fiber, fruit, and vegetable intake, greater meal frequency, and lower ultra-processed food consumption. No relevant biochemical differences were observed across DDS tertiles, and a higher DDS was associated with lower overweight/obesity prevalence only in adults. No significant associations were found with FVS. Our findings emphasize the need to consider food groups for a more accurate estimation of diet quality. This aligns with studies suggesting DDS alone is not an independent risk factor for obesity in children and adolescents. Public health programs should prioritize food diversity to promote improved nutrition and overall well-being in communities.
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Affiliation(s)
- Marika Dello Russo
- Institute of Food Sciences, National Research Council, 83100 Avellino, Italy; (M.D.R.); (A.F.); (A.S.); (P.R.)
| | - Annarita Formisano
- Institute of Food Sciences, National Research Council, 83100 Avellino, Italy; (M.D.R.); (A.F.); (A.S.); (P.R.)
| | - Fabio Lauria
- Institute of Food Sciences, National Research Council, 83100 Avellino, Italy; (M.D.R.); (A.F.); (A.S.); (P.R.)
| | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology—BIPS, 28359 Bremen, Germany; (W.A.); (A.H.); (T.I.); (M.W.)
- Institute of Statistics, Faculty of Mathematics and Computer Science, Bremen University, 28359 Bremen, Germany
| | - Leonie H. Bogl
- School of Health Professions, Bern University of Applied Sciences, 3008 Bern, Switzerland;
- Finnish Institute of Molecular Medicine, University of Helsinki, 00100 Helsinki, Finland
| | - Gabriele Eiben
- Department of Public Health, School of Health Sciences, University of Skövde, 541 28 Skövde, Sweden;
- Department of Public Health and Community Medicine, University of Gothenburg, 405 30 Gothenburg, Sweden
| | - Stefaan De Henauw
- Department of Public Health and Primary Care, Ghent University, 9000 Ghent, Belgium;
| | - Antje Hebestreit
- Leibniz Institute for Prevention Research and Epidemiology—BIPS, 28359 Bremen, Germany; (W.A.); (A.H.); (T.I.); (M.W.)
| | - Timm Intemann
- Leibniz Institute for Prevention Research and Epidemiology—BIPS, 28359 Bremen, Germany; (W.A.); (A.H.); (T.I.); (M.W.)
| | - Monica Hunsberger
- Department of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, 413 90 Gothenburg, Sweden; (M.H.); (L.L.)
| | - Lauren Lissner
- Department of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, 413 90 Gothenburg, Sweden; (M.H.); (L.L.)
| | - Denes Molnar
- Department of Pediatrics, Medical School, University of Pécs, 7624 Pécs, Hungary;
| | - Valeria Pala
- Department of Preventive and Predictive Medicine, Fondazione IRCCS, Istituto Nazionale dei Tumori, 20133 Milan, Italy;
| | - Stalo Papoutsou
- Research and Education Institute of Child Health, Attikis 8, 2027 Strovolos, Cyprus;
| | - Alba M. Santaliestra-Pasias
- NUTRI-GENUD (Growth, Exercise, Nutrition and Development) Research Group, Faculty of Health Sciences and Sports, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón), Universidad de Zaragoza, 50009 Zaragoza, Spain;
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Toomas Veidebaum
- National Institute for Health Development, Center of Health and Behavioral Science, 11619 Tallinn, Estonia;
| | - Maike Wolters
- Leibniz Institute for Prevention Research and Epidemiology—BIPS, 28359 Bremen, Germany; (W.A.); (A.H.); (T.I.); (M.W.)
| | - Alfonso Siani
- Institute of Food Sciences, National Research Council, 83100 Avellino, Italy; (M.D.R.); (A.F.); (A.S.); (P.R.)
| | - Paola Russo
- Institute of Food Sciences, National Research Council, 83100 Avellino, Italy; (M.D.R.); (A.F.); (A.S.); (P.R.)
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Wolters M, Marron M, Foraita R, Hadjigeorgiou C, De Henauw S, Eiben G, Lauria F, Iglesia I, Moreno LA, Molnár D, Veidebaum T, Ahrens W, Nagrani R. Longitudinal Associations Between Vitamin D Status and Cardiometabolic Risk Markers Among Children and Adolescents. J Clin Endocrinol Metab 2023; 108:e1731-e1742. [PMID: 37261399 DOI: 10.1210/clinem/dgad310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 05/24/2023] [Accepted: 05/25/2023] [Indexed: 06/02/2023]
Abstract
CONTEXT Vitamin D status has previously been associated with cardiometabolic risk markers in children and adolescents. In particular, it has been suggested that children with obesity are more prone to vitamin D deficiency and unfavorable metabolic outcomes compared with healthy-weight children. OBJECTIVE To conduct a longitudinal study assessing this association in children and stratify by body mass index (BMI) category. METHODS Children from the pan-European IDEFICS/I.Family cohort with at least one measurement of serum 25-hydroxyvitamin D [25(OH)D] at cohort entry or follow-up (n = 2171) were included in this study. Linear mixed-effect models were used to assess the association between serum 25(OH)D as an independent variable and z-scores of cardiometabolic risk markers (waist circumference, systolic [SBP] and diastolic blood pressure [DBP], high- [HDL] and low-density lipoprotein, non-HDL, triglycerides [TRG], apolipoprotein A1 [ApoA1] and ApoB, fasting glucose [FG], homeostatic model assessment for insulin resistance [HOMA-IR], and metabolic syndrome score) as dependent variables. RESULTS After adjustment for age, sex, study region, smoking and alcohol status, sports club membership, screen time, BMI, parental education, and month of blood collection, 25(OH)D levels were inversely associated with SBP, DBP, FG, HOMA-IR, and TRG. The HOMA-IR z-score decreased by 0.07 units per 5 ng/mL increase in 25(OH)D. The 25(OH)D level was consistently associated with HOMA-IR irrespective of sex or BMI category. CONCLUSION Low serum 25(OH)D concentrations are associated with unfavorable levels of cardiometabolic markers in children and adolescents. Interventions to improve vitamin D levels in children with a poor status early in life may help to reduce cardiometabolic risk.
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Affiliation(s)
- Maike Wolters
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, D-28359 Bremen, Germany
| | - Manuela Marron
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, D-28359 Bremen, Germany
| | - Ronja Foraita
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, D-28359 Bremen, Germany
| | | | - Stefaan De Henauw
- Department of Public Health and Primary Care, Ghent University, 9000 Ghent, Belgium
| | - Gabriele Eiben
- Department of Public Health and Community Medicine, University of Gothenburg, 40530 Gothenburg, Sweden
- Department of Public Health, School of Health Sciences, University of Skövde, 541 28 Skövde, Sweden
| | - Fabio Lauria
- Institute of Food Sciences, National Research Council, 83100 Avellino, Italy
| | - Iris Iglesia
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria de Aragón (IIS Aragón), 50009 Zaragoza, Spain
- Primary Care Interventions to Prevent Maternal and Child Chronic Diseases of Perinatal and Developmental Origin Network (RICORS), RD21/0012/0012, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Luis A Moreno
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria de Aragón (IIS Aragón), 50009 Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Dénes Molnár
- Department of Paediatrics, Medical School, University of Pécs, 7623 Pécs, Hungary
| | - Toomas Veidebaum
- National Institute for Health Development, 11619 Tallinn, Estonia
| | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, D-28359 Bremen, Germany
- Institute of Statistics, Faculty of Mathematics and Computer Science, Bremen University, 28359 Bremen, Germany
| | - Rajini Nagrani
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, D-28359 Bremen, Germany
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Sina E, Buck C, Ahrens W, Coumans JMJ, Eiben G, Formisano A, Lissner L, Mazur A, Michels N, Molnar D, Moreno LA, Pala V, Pohlabeln H, Reisch L, Tornaritis M, Veidebaum T, Hebestreit A. Digital media exposure and cognitive functioning in European children and adolescents of the I.Family study. Sci Rep 2023; 13:18855. [PMID: 37914849 PMCID: PMC10620404 DOI: 10.1038/s41598-023-45944-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 10/26/2023] [Indexed: 11/03/2023] Open
Abstract
The digital environment can pose health risks through exposure to unhealthy content. Yet, little is known about its relation to children's cognitive functioning. This study investigates the association between digital media (DM) exposure and children's cognitive functioning. This cross-sectional study is based on examinations of children aged 8-18 years (N = 8673) of the I.Family cohort (2013-2014). Exposure to television, computer, smartphone and internet was self-reported (hours/day). Media multitasking (MMT) was defined as simultaneous use of computers with other digital or non-screen-based activities. Standard instruments were used to assess cognitive inflexibility (score: 0-39), decision-making ability (- 100 to + 100) and impulsivity (12-48). Adjusted regression coefficients and 99.9%CIs were calculated by generalized linear mixed-effects models. In total, 3261 participants provided data for impulsivity, 3441 for cognitive inflexibility and 4046 for decision-making. Exposure to smartphones and media multitasking were positively associated with impulsivity (βsmartphone = 0.74; 99.9%CI = 0.42-1.07; βMMT = 0.73; 99.9%CI = 0.35-1.12) and cognitive inflexibility (βsmartphone = 0.32; 99.9%CI = -0.02-0.66; βMMT = 0.39; 99.9%CI = 0.01-0.77) while being inversely associated with decision-making ability. Extensive smartphone/internet exposure combined with low computer/medium TV exposure was associated with higher impulsivity and cognitive inflexibility scores, especially in girls. DM exposure is adversely associated with cognitive functioning in children and adolescents. Children require protection against the likely adverse impact of digital environment.
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Affiliation(s)
- Elida Sina
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Christoph Buck
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Wolfgang Ahrens
- Faculty of Mathematics and Computer Science, Institute of Statistics, University of Bremen, Bremen, Germany
| | - Juul M J Coumans
- Teaching and Learning Centre, Open University of the Netherlands, Heerlen, The Netherlands
| | - Gabriele Eiben
- Department of Public Health, School of Health Sciences, University of Skövde, Skövde, Sweden
| | | | - Lauren Lissner
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Artur Mazur
- Faculty of Medicine, University of Rzeszów, Rzeszów, Poland
| | - Nathalie Michels
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Dénes Molnar
- Department of Pediatrics, Medical School, University of Pécs, Pécs, Hungary
| | - Luis A Moreno
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Centro de Investigación Biomédica en Red Fisiopatología de La Obesidad y Nutrición (CIBERObn), Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón), University of Zaragoza, Zaragoza, Spain
| | - Valeria Pala
- Department of Epidemiology and Data Science, Fondazione IRCCS, Istituto Nazionale Dei Tumori, Milan, Italy
| | - Hermann Pohlabeln
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Lucia Reisch
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
- Cambridge Judge Business School, University of Cambridge, Cambridge, UK
| | | | - Toomas Veidebaum
- Department of Chronic Diseases, National Institute for Health Development, Tallinn, Estonia
| | - Antje Hebestreit
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.
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A, Rinaldo N, Rinke de Wit TF, Rito AI, Ritti-Dias RM, Rivera JA, Roa RG, Robinson L, Robitaille C, Roccaldo R, Rodrigues D, Rodríguez-Artalejo F, del Cristo Rodriguez-Perez M, Rodríguez-Villamizar LA, Rodríguez AY, Roggenbuck U, Rohloff P, Rohner F, Rojas-Martinez R, Rojroongwasinkul N, Romaguera D, Romeo EL, Rosario RV, Rosengren A, Rouse I, Rouzier V, Roy JGR, Ruano MH, Rubinstein A, Rühli FJ, Ruidavets JB, Ruiz-Betancourt BS, Ruiz-Castell M, Moreno ER, Rusakova IA, Jonsson KR, Russo P, Rust P, Rutkowski M, Saamel M, Sabanayagam C, Sabbaghi H, Sacchini E, Sachdev HS, Sadjadi A, Safarpour AR, Safi S, Safiri S, Saghi MH, Saidi O, Saki N, Šalaj S, Salanave B, Martinez ES, Saleva C, Salmerón D, Salomaa V, Salonen JT, Salvetti M, Samoutian M, Sánchez-Abanto J, Rodríguez IS, Sandjaja, Sans S, Marina LS, Santacruz E, Santos DA, Santos IS, Santos LC, Santos MP, Santos O, Santos R, Santos TR, Saramies JL, Sardinha LB, Sarrafzadegan N, Sathish T, Saum KU, Savva S, Savy M, Sawada N, Sbaraini M, Scazufca M, Schaan BD, Rosario AS, Schargrodsky H, Schienkiewitz A, Schindler K, Schipf S, Schmidt CO, Schmidt IM, Schneider A, Schnohr P, Schöttker B, Schramm S, Schramm S, Schröder H, Schultsz C, Schulze MB, Schutte AE, Sebert S, Sedaghattalab M, Selamat R, Sember V, Sen A, Senbanjo IO, Sepanlou SG, Sequera G, Serra-Majem L, Servais J, Ševčíková Ľ, Shalnova S, Shamah-Levy T, Shamshirgaran SM, Shanthirani CS, Sharafkhah M, Sharma SK, Shaw JE, Shayanrad A, Shayesteh AA, Shengelia L, Shi Z, Shibuya K, Shimizu-Furusawa H, Shimony T, Shiri R, Shrestha N, Si-Ramlee K, Siani A, Siantar R, Sibai AM, Sidossis LS, Silitrari N, Silva AM, de Moura Silva CR, Silva DAS, Silva KS, Sim X, Simon M, Simons J, Simons LA, Sjöberg A, Sjöström M, Skoblina NA, Skodje G, Slazhnyova T, Slowikowska-Hilczer J, Slusarczyk P, Smeeth L, So HK, Soares FC, Sobek G, Sobngwi E, Sodemann M, Söderberg S, Soekatri MYE, Soemantri A, Sofat R, Solfrizzi V, Somi MH, Sonestedt E, Song Y, Soofi S, Sørensen TIA, Sørgjerd EP, Jérome CS, Soto-Rojas VE, Soumaré A, Sousa-Poza A, Sovic S, Sparboe-Nilsen B, Sparrenberger K, Spencer PR, Spinelli A, Spiroski I, Staessen JA, Stamm H, Staub K, Stavreski B, Steene-Johannessen J, Stehle P, Stein AD, Stergiou GS, Stessman J, Stevanović R, Stieber J, Stöckl D, Stokwiszewski J, Stoyanova E, Stratton G, Stronks K, Strufaldi MW, Sturua L, Suárez-Medina R, Suka M, Sun CA, Sun L, Sundström J, Sung YT, Sunyer J, Suriyawongpaisal P, Sweis NWG, Swinburn BA, Sy RG, Sylva RC, Szklo M, Szponar L, Tabone L, Tai ES, Tambalis KD, Tammesoo ML, Tamosiunas A, Tan EJ, Tang X, Tanrygulyyeva M, Tanser F, Tao Y, Tarawneh MR, Tarp J, Tarqui-Mamani CB, Braunerová RT, Taylor A, Taylor J, Tchibindat F, Te Velde S, Tebar WR, Tell GS, Tello T, Tham YC, Thankappan KR, Theobald H, Theodoridis X, Thomas N, Thorand B, Thuesen BH, Tichá Ľ, Timmermans EJ, Tjandrarini DH, Tjonneland A, Tolonen HK, Tolstrup JS, Topbas M, Topór-Mądry R, Torheim LE, Tormo MJ, Tornaritis MJ, Torrent M, Torres-Collado L, Toselli S, Touloumi G, Traissac P, Tran TTH, Tremblay MS, Triantafyllou A, Trichopoulos D, Trichopoulou A, Trinh OTH, Trivedi A, Tsao YH, Tshepo L, Tsigga M, Tsintavis P, Tsugane S, Tuitele J, Tuliakova AM, Tulloch-Reid MK, Tullu F, Tuomainen TP, Tuomilehto J, Turley ML, Twig G, Tynelius P, Tzala E, Tzotzas T, Tzourio C, Ueda P, Ugel E, Ukoli FAM, Ulmer H, Unal B, Usupova Z, Uusitalo HMT, Uysal N, Vaitkeviciute J, Valdivia G, Vale S, Valvi D, van Dam RM, van den Born BJ, Van der Heyden J, van der Schouw YT, Van Herck K, Van Lippevelde W, Van Minh H, Van Schoor NM, van Valkengoed IGM, Vanderschueren D, Vanuzzo D, Varbo A, Varela-Moreiras G, Vargas LN, Varona-Pérez P, Vasan SK, Vasques DG, Vega T, Veidebaum T, Velasquez-Melendez G, Velika B, Verloigne M, Veronesi G, Verschuren WMM, Victora CG, Viegi G, Viet L, Vik FN, Vilar M, Villalpando S, Vioque J, Virtanen JK, Visvikis-Siest S, Viswanathan B, Vladulescu M, Vlasoff T, Vocanec D, Vollenweider P, Völzke H, Voutilainen A, Vrijheid M, Vrijkotte TGM, Wade AN, Waldhör T, Walton J, Wambiya EOA, Bebakar WMW, Mohamud WNW, de Souza Wanderley Júnior R, Wang MD, Wang N, Wang Q, Wang X, Wang YX, Wang YW, Wannamethee SG, Wareham N, Weber A, Webster-Kerr K, Wedderkopp N, Weghuber D, Wei W, Weres A, Werner B, Westbury LD, Whincup PH, Wickramasinghe K, Widhalm K, Widyahening IS, Więcek A, Wild PS, Wilks RJ, Willeit J, Willeit P, Williams J, Wilsgaard T, Wojciech R, Wojtyniak B, Wolf K, Wong-McClure RA, Wong A, Wong EB, Wong JE, Wong TY, Woo J, Woodward M, Wu FC, Wu HY, Wu J, Wu LJ, Wu S, Wyszyńska J, Xu H, Xu L, Yaacob NA, Yamborisut U, Yan W, Yang L, Yang X, Yang Y, Yardim N, Yasuharu T, García MY, Yiallouros PK, Yngve A, Yoosefi M, Yoshihara A, You QS, You SL, Younger-Coleman NO, Yu YL, Yu Y, Yusof SM, Yusoff AF, Zaccagni L, Zafiropulos V, Zainuddin AA, Zakavi SR, Zamani F, Zambon S, Zampelas A, Zamrazilová H, Zapata ME, Zargar AH, Zaw KK, Zayed AA, Zdrojewski T, Żegleń M, Zejglicova K, Vrkic TZ, Zeng Y, Zhang L, Zhang ZY, Zhao D, Zhao MH, Zhao W, Zhecheva YV, Zhen S, Zheng W, Zheng Y, Zholdin B, Zhou M, Zhu D, Zins M, Zitt E, Zocalo Y, Zoghlami N, Cisneros JZ, Zuziak M, Bhutta ZA, Black RE, Ezzati M. Diminishing benefits of urban living for children and adolescents' growth and development. Nature 2023; 615:874-883. [PMID: 36991188 PMCID: PMC10060164 DOI: 10.1038/s41586-023-05772-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 01/30/2023] [Indexed: 03/31/2023]
Abstract
Optimal growth and development in childhood and adolescence is crucial for lifelong health and well-being1-6. Here we used data from 2,325 population-based studies, with measurements of height and weight from 71 million participants, to report the height and body-mass index (BMI) of children and adolescents aged 5-19 years on the basis of rural and urban place of residence in 200 countries and territories from 1990 to 2020. In 1990, children and adolescents residing in cities were taller than their rural counterparts in all but a few high-income countries. By 2020, the urban height advantage became smaller in most countries, and in many high-income western countries it reversed into a small urban-based disadvantage. The exception was for boys in most countries in sub-Saharan Africa and in some countries in Oceania, south Asia and the region of central Asia, Middle East and north Africa. In these countries, successive cohorts of boys from rural places either did not gain height or possibly became shorter, and hence fell further behind their urban peers. The difference between the age-standardized mean BMI of children in urban and rural areas was <1.1 kg m-2 in the vast majority of countries. Within this small range, BMI increased slightly more in cities than in rural areas, except in south Asia, sub-Saharan Africa and some countries in central and eastern Europe. Our results show that in much of the world, the growth and developmental advantages of living in cities have diminished in the twenty-first century, whereas in much of sub-Saharan Africa they have amplified.
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Breau B, Brandes M, Veidebaum T, Tornaritis M, Moreno LA, Molnár D, Lissner L, Eiben G, Lauria F, Kaprio J, De Henauw S, Ahrens W, Buck C. Longitudinal association of childhood physical activity and physical fitness with physical activity in adolescence: insights from the IDEFICS/I.Family study. Int J Behav Nutr Phys Act 2022; 19:147. [PMID: 36494689 PMCID: PMC9733271 DOI: 10.1186/s12966-022-01383-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 11/17/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND This study aimed to examine associations of early childhood physical fitness and physical activity (PA) with PA during later childhood/early adolescence while accounting for gender differences. METHODS We selected data of N = 4329 children from the IDEFICS/I. Family cohort (age 2.4-11.7 years) with data on baseline fitness and accelerometer measurements. At baseline, physical fitness tests were conducted including Flamingo balance, Backsaver sit and reach, Handgrip strength, Standing Long Jump, 40-m sprint and 20-m Shuttle run (to estimate cardio-respiratory fitness levels). PA was measured with Actigraph accelerometers over 3 days at baseline (ActiTrainer or GT1M) and 7 days at follow-up (GT3X). Evenson cutpoints were used to determine moderate-to-vigorous PA (MVPA) time, and children with ≥60mins/day of average MVPA were deemed as having met WHO guidelines at baseline and follow-up. Linear and logistic regressions were performed to examine longitudinal associations between meeting WHO guidelines, MVPA, and physical fitness tests at baseline with meeting WHO guidelines and MVPA at follow-up. Models were conducted on the entire sample, the sex-stratified sample, and stratified by sex and pubertal status at follow-up. RESULTS Results showed that meeting WHO guidelines for MVPA at baseline was positively associated with MVPA (Standardized Beta (B) = 0.13, 95%CI:(5.6;11.1)) and meeting WHO guidelines at follow-up for the entire sample (OR = 2.1, 95%CI:(1.5; 3.14), and stratified by males (OR = 2.5, 95%CI:(1.5; 4.1)) and females (OR = 1.8, 95%CI:(1.0; 3.2)). This was also found for both male pre/early pubertal and pubertal groups but only in the female pre/early pubertal group, and not the female pubertal group (MVPA: B = .00, 95%CI:(- 6.1; 5.6), WHO: OR = 0.61, 95%CI:(0.23;1.6)). Models indicated that Standing Long jump, 40-m sprint, Shuttle run and Flamingo balance at baseline were associated with MVPA and meeting the guidelines at follow-up. CONCLUSIONS Meeting WHO guidelines and certain fitness tests at baseline were strongly associated with MVPA and meeting WHO guidelines at follow-up, but this association varied with sex and pubertal status. Consequently, these findings underline the importance of ensuring sufficient physical activity in terms of quality and quantity for children at the earliest stages of life. TRIAL REGISTRATION ISRCTN62310987.
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Affiliation(s)
- Becky Breau
- grid.34429.380000 0004 1936 8198Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Canada ,grid.418465.a0000 0000 9750 3253Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany ,grid.7704.40000 0001 2297 4381Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany
| | - Mirko Brandes
- grid.418465.a0000 0000 9750 3253Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany
| | - Toomas Veidebaum
- grid.416712.70000 0001 0806 1156Department of Chronic Diseases, National Institute for Health Development, Tallinn, Estonia
| | - Michael Tornaritis
- grid.513172.3Research and Education Institute of Child health, Strovolos, Cyprus
| | - Luis A. Moreno
- grid.11205.370000 0001 2152 8769GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria de Aragón (IIS Aragón) Zaragoza, Zaragoza, Spain ,grid.484042.e0000 0004 5930 4615Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
| | - Dénes Molnár
- grid.9679.10000 0001 0663 9479Department of Pediatrics, Medical School, University of Pécs, Pécs, Hungary
| | - Lauren Lissner
- grid.8761.80000 0000 9919 9582School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Gabriele Eiben
- grid.412798.10000 0001 2254 0954Department of Public Health, School of Health Sciences, University of Skövde, Skövde, Sweden
| | - Fabio Lauria
- grid.429574.90000 0004 1781 0819Institute of Food Sciences, National Research Council, Avellino, Italy
| | - Jaakko Kaprio
- grid.7737.40000 0004 0410 2071Institute for Molecular Medicine Finland FIMM, University of Helsinki, Helsinki, Finland
| | - Stefaan De Henauw
- grid.5342.00000 0001 2069 7798Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Wolfgang Ahrens
- grid.418465.a0000 0000 9750 3253Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany ,grid.7704.40000 0001 2297 4381Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany
| | - Christoph Buck
- grid.418465.a0000 0000 9750 3253Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany
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Guo A, Wide U, Arvidsson L, Eiben G, Hakeberg M. Dietary intake and meal patterns among young adults with high caries activity: a cross-sectional study. BMC Oral Health 2022; 22:190. [PMID: 35590301 PMCID: PMC9118703 DOI: 10.1186/s12903-022-02227-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 05/06/2022] [Indexed: 11/16/2022] Open
Abstract
Background Dental caries is a multifactorial disease that is highly dependent on diet, where a lower consumption and intake frequency of sugar would be favorable. The aims were (i) to examine dietary intake and meal patterns, more specifically sugar intake and foods high in sugar, among young adults with high caries activity, and (ii) to investigate the association between dietary and meal patterns consumption, and level of caries activity. Methods This study presents baseline data from an ongoing randomized controlled trial. A total of 50 young adults (aged 23.0 ± 3.0 years) with ≥ 2 decayed tooth surfaces were included. Dietary intake was captured with a 59-item food frequency questionnaire (FFQ) and a three-day food diary. Adherence to dietary guidelines was analyzed by comparing the dietary intake to the Nordic Nutritional Recommendations (NNR) 2012 and by using the Healthy Dietary Adherence score (HDAS). Participants were categorized into two groups: (i) the Caries group with 2–4 decayed surfaces, and (ii) the High caries group with ≥ 5 decayed surfaces. Results The High caries group reported a statistically significantly higher snack and total meal intake compared to the Caries group, as well as a sugar intake exceeding the Nordic nutritional recommendations. The majority of the participants reported a high intake frequency (> 2.5/day) of sweet foods and drinks and less than one intake of fruit and vegetables, respectively, per day. Similar results were found when analyzing adherence by using the HDAS, where the lowest adherence according to dietary guidelines was shown for the food groups of sugar, whole meal products, and fruit and vegetables. Conclusion The results indicated a high intake of sugar and low intake of fruit, vegetables, and fiber in high caries-active individuals.
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Affiliation(s)
- Annie Guo
- Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg, Sweden
| | - Ulla Wide
- Department of Behavioral and Community Dentistry, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, P.O. Box 450, 40530, Gothenburg, Sweden. .,Public Dental Service, Region Västra Götaland, Sweden.
| | - Louise Arvidsson
- Department of Public Health, School of Health Sciences, University of Skövde, Skövde, Sweden
| | - Gabriele Eiben
- Department of Public Health, School of Health Sciences, University of Skövde, Skövde, Sweden
| | - Magnus Hakeberg
- Department of Behavioral and Community Dentistry, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, P.O. Box 450, 40530, Gothenburg, Sweden.,Public Dental Service, Region Västra Götaland, Sweden
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González-Gil EM, Santaliestra-Pasías AM, Buck C, Gracia-Marco L, Lauria F, Pala V, Molnar D, Veidebaum T, Iacoviello L, Tornaritis M, Eiben G, Lissner L, Schwarz H, Ahrens W, De Henauw S, Fraterman A, Moreno LA. Improving cardiorespiratory fitness protects against inflammation in children: the IDEFICS study. Pediatr Res 2022; 91:681-689. [PMID: 33837254 DOI: 10.1038/s41390-021-01471-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 02/22/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Muscular and cardiorespiratory fitness (MF and CRF) have been related to inflammation. Thus, the aim of this study was to assess the relationship between fitness and high-sensitivity C-reactive protein (hs-CRP) in European children both in the cross-sectional and longitudinal analysis. METHODS Three hundred and fifty-seven children (46.2% males) aged 2-9 years with hs-CRP measured, data from MF and CRF, diet quality, objectively measured physical activity (PA) and screen time at baseline and follow-up after 2 years were included. Body mass index z-score (zBMI), waist circumference (WC) and fat mass index (FMI) were assessed. MF and CRF were also dichotomized as follows: low-medium quartiles (Q1-Q3) and highest quartile (Q4). RESULTS At follow-up, children with the highest CRF (Q4) showed a lower probability of having high hs-CRP. In the longitudinal analysis, children who improved their CRF over time showed a significantly lower probability (p < 0.05) of being in the highest hs-CRP category at follow-up, independently of the body composition index considered: odds ratio (OR) = 0.22 for zBMI, OR = 0.17 for WC, and OR = 0.21 for FMI. CONCLUSIONS Improving CRF during childhood reduces the odds of an inflammatory profile, independently of body composition and lifestyle behaviours. These highlight the importance of enhancing fitness, especially CRF, to avoid an inflammatory state in children. IMPACT Improvements in the cardiorespiratory profile during childhood could reverse an unfavourable inflammatory status. There is a longitudinal and inverse association between CRF and inflammation in children. This is the first longitudinal study assessing the relationship between fitness and inflammation during childhood that takes also into account the lifestyle behaviours. Results from the present study suggest a protective role of fitness already in childhood. Efforts to improve fitness in children should be aimed at as inflammation could trigger future cardiovascular disease.
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Affiliation(s)
- Esther M González-Gil
- Department of Biochemistry and Molecular Biology II, Instituto de Nutrición y Tecnología de los Alimentos, Center of Biomedical Research (CIBM), Universidad de Granada, Granada, Spain. .,GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain. .,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain.
| | - Alba M Santaliestra-Pasías
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain.,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain.,Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain.,Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
| | - Christoph Buck
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany
| | - Luis Gracia-Marco
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain.,PROFITH (PROmoting FITness and Health through physical activity) Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
| | - Fabio Lauria
- Institute of Food Sciences, National Research Council, Avellino, Italy
| | - Valeria Pala
- Epidemiology and Prevention Unit, Fondazione IRCCS-Istituto Nazionale dei Tumori, Milan, Italy
| | - Denes Molnar
- Department of Pediatrics, Medical School, University of Pécs, Pécs, Hungary
| | - Toomas Veidebaum
- National Institute for Health Development, Center of Health and Behavioral Science, Tallinn, Estonia
| | - Licia Iacoviello
- Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli, Italy.,Department of Medicine and Surgery, Research Center in Epidemiology and Preventive Medicine (EPIMED), University of Insubria, Varese, Italy
| | | | - Gabriele Eiben
- Department of Public Health, School of Health Sciences, University of Skövde, Skövde, Sweden
| | - Lauren Lissner
- Department of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Heike Schwarz
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany
| | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany.,Institute of Statistics, Bremen University, Bremen, Germany
| | - Stefaan De Henauw
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Arno Fraterman
- Laboratoriumsmedizin Dortmund, Eberhard & Partner, Dortmund, Germany
| | - Luis A Moreno
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain.,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain.,Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain.,Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
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11
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Sina E, Buck C, Veidebaum T, Siani A, Reisch L, Pohlabeln H, Pala V, Moreno LA, Molnar D, Lissner L, Kourides Y, De Henauw S, Eiben G, Ahrens W, Hebestreit A. Media use trajectories and risk of metabolic syndrome in European children and adolescents: the IDEFICS/I.Family cohort. Int J Behav Nutr Phys Act 2021; 18:134. [PMID: 34663352 PMCID: PMC8521295 DOI: 10.1186/s12966-021-01186-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 08/11/2021] [Indexed: 01/24/2023] Open
Abstract
Background Media use may influence metabolic syndrome (MetS) in children. Yet, longitudinal studies are scarce. This study aims to evaluate the longitudinal association of childhood digital media (DM) use trajectories with MetS and its components. Methods Children from Belgium, Cyprus, Estonia, Germany, Hungary, Italy, Spain and Sweden participating in the IDEFICS/I.Family cohort were examined at baseline (W1: 2007/2008) and then followed-up at two examination waves (W2: 2009/2010 and W3: 2013/2014). DM use (hours/day) was calculated as sum of television viewing, computer/game console and internet use. MetS z-score was calculated as sum of age- and sex-specific z-scores of four components: waist circumference, blood pressure, dyslipidemia (mean of triglycerides and HDL-cholesterol−1) and homeostasis model assessment for insulin resistance (HOMA-IR). Unfavorable monitoring levels of MetS and its components were identified (cut-off: ≥ 90th percentile of each score). Children aged 2–16 years with ≥ 2 observations (W1/W2; W1/W3; W2/W3; W1/W2/W3) were eligible for the analysis. A two-step procedure was conducted: first, individual age-dependent DM trajectories were calculated using linear mixed regressions based on random intercept (hours/day) and linear slopes (hours/day/year) and used as exposure measures in association with MetS at a second step. Trajectories were further dichotomized if children increased their DM duration over time above or below the mean. Results 10,359 children and adolescents (20,075 total observations, 50.3% females, mean age = 7.9, SD = 2.7) were included. DM exposure increased as children grew older (from 2.2 h/day at 2 years to 4.2 h/day at 16 years). Estonian children showed the steepest DM increase; Spanish children the lowest. The prevalence of MetS at last follow-up was 5.5%. Increasing media use trajectories were positively associated with z-scores of MetS (slope: β = 0.54, 95%CI = 0.20–0.88; intercept: β = 0.07, 95%CI = 0.02–0.13), and its components after adjustment for puberty, diet and other confounders. Children with increasing DM trajectories above mean had a 30% higher risk of developing MetS (slope: OR = 1.30, 95%CI = 1.04–1.62). Boys developed steeper DM use trajectories and higher risk for MetS compared to girls. Conclusions Digital media use appears to be a risk factor for the development of MetS in children and adolescents. These results are of utmost importance for pediatricians and the development of health policies to prevent cardio-metabolic disorders later in life. Trial registration ISRCTN, ISRCTN62310987. Registered 23 February 2018- retrospectively registered. Supplementary Information The online version contains supplementary material available at 10.1186/s12966-021-01186-9.
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Affiliation(s)
- Elida Sina
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, Achterstraße 30, 28359, Bremen, Germany
| | - Christoph Buck
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, Achterstraße 30, 28359, Bremen, Germany
| | - Toomas Veidebaum
- Department of Chronic Diseases, National Institute for Health Development, Tallinn, Estonia
| | - Alfonso Siani
- Institute of Food Sciences, National Research Council, Avellino, Italy
| | - Lucia Reisch
- Department of Management, Society and Communication, Copenhagen Business School, Copenhagen, Denmark
| | - Hermann Pohlabeln
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, Achterstraße 30, 28359, Bremen, Germany
| | - Valeria Pala
- Department of Preventive and Predictive Medicine, Fondazione IRCCS, Istituto Nazionale Dei Tumori, Milan, Italy
| | - Luis A Moreno
- 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, Zaragoza, Spain
| | - Dénes Molnar
- Department of Pediatrics, Medical School, University of Pécs, Pécs, Hungary
| | - Lauren Lissner
- School of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Yiannis Kourides
- Research and Education Institute of Child Health, Strovolos, Cyprus
| | - Stefaan De Henauw
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Gabriele Eiben
- Department of Public Health, School of Health Sciences, University of Skövde, Skövde, Sweden
| | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, Achterstraße 30, 28359, Bremen, Germany.,Institute of Statistics, Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany
| | - Antje Hebestreit
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, Achterstraße 30, 28359, Bremen, Germany.
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Zhou B, Carrillo-Larco RM, Danaei G, Riley LM, Paciorek CJ, Stevens GA, Gregg EW, Bennett JE, Solomon B, Singleton RK, Sophiea MK, Iurilli MLC, Lhoste VPF, Cowan MJ, Savin S, Woodward M, Balanova Y, Cifkova R, Damasceno A, Elliott P, Farzadfar F, He J, Ikeda N, Kengne AP, Khang YH, Kim HC, Laxmaiah A, Lin HH, Margozzini Maira P, Miranda JJ, Neuhauser H, Sundström J, Varghese C, Widyahening IS, Zdrojewski T, Abarca-Gómez L, Abdeen ZA, Abdul Rahim HF, Abu-Rmeileh NM, Acosta-Cazares B, Adams RJ, Aekplakorn W, Afsana K, Afzal S, Agdeppa IA, Aghazadeh-Attari J, Aguilar-Salinas CA, Agyemang C, Ahmad NA, Ahmadi A, Ahmadi N, Ahmadi N, Ahmadizar F, Ahmed SH, Ahrens W, Ajlouni K, Al-Raddadi R, Alarouj M, AlBuhairan F, AlDhukair S, Ali MM, Alkandari A, Alkerwi A, Allin K, Aly E, Amarapurkar DN, Amougou N, Amouyel P, Andersen LB, Anderssen SA, Anjana RM, Ansari-Moghaddam A, Ansong D, Aounallah-Skhiri H, Araújo J, Ariansen I, Aris T, Arku RE, Arlappa N, Aryal KK, Aspelund T, Assah FK, Assunção MCF, Auvinen J, Avdićová M, Azevedo A, Azimi-Nezhad M, Azizi F, Azmin M, Babu BV, Bahijri S, Balakrishna N, Bamoshmoosh M, Banach M, Banadinović M, Bandosz P, Banegas JR, Baran J, Barbagallo CM, Barceló A, Barkat A, Barreto M, Barros AJD, Barros MVG, Bartosiewicz A, Basit A, Bastos JLD, Bata I, Batieha AM, Batyrbek A, Baur LA, Beaglehole R, Belavendra A, Ben Romdhane H, Benet M, Benson LS, Berkinbayev S, Bernabe-Ortiz A, Bernotiene G, Bettiol H, Bezerra J, Bhagyalaxmi A, Bhargava SK, Bia D, Biasch K, Bika Lele EC, Bikbov MM, Bista B, Bjerregaard P, Bjertness E, Bjertness MB, Björkelund C, Bloch KV, Blokstra A, Bo S, Bobak M, Boeing H, Boggia JG, Boissonnet CP, Bojesen SE, Bongard V, Bonilla-Vargas A, Bopp M, Borghs H, Bovet P, Boyer CB, Braeckman L, Brajkovich I, Branca F, Breckenkamp J, Brenner H, Brewster LM, Briceño Y, Brito M, Bruno G, Bueno-de-Mesquita HB, Bueno G, Bugge A, Burns C, Bursztyn M, Cabrera de León A, Cacciottolo J, Cameron C, Can G, Cândido APC, Capanzana MV, Čapková N, Capuano E, Capuano V, Cardoso VC, Carlsson AC, Carvalho J, Casanueva FF, Censi L, Cervantes-Loaiza M, Chadjigeorgiou CA, Chamukuttan S, Chan AW, Chan Q, Chaturvedi HK, Chaturvedi N, Chee ML, Chen CJ, Chen F, Chen H, Chen S, Chen Z, Cheng CY, Cheraghian B, Cherkaoui Dekkaki I, Chetrit A, Chien KL, Chiolero A, Chiou ST, Chirita-Emandi A, Chirlaque MD, Cho B, Christensen K, Christofaro DG, Chudek J, Cinteza E, Claessens F, Clarke J, Clays E, Cohen E, Concin H, Cooper C, Coppinger TC, Costanzo S, Cottel D, Cowell C, Craig CL, Crampin AC, Crujeiras AB, Cruz JJ, Csilla S, Cui L, Cureau FV, Cuschieri S, D'Arrigo G, d'Orsi E, Dallongeville J, Dankner R, Dantoft TM, Dauchet L, Davletov K, De Backer G, De Bacquer D, De Curtis A, de Gaetano G, De Henauw S, de Oliveira PD, De Ridder D, De Smedt D, Deepa M, Deev AD, DeGennaro VJ, Delisle H, Demarest S, Dennison E, Deschamps V, Dhimal M, Di Castelnuovo AF, Dias-da-Costa JS, Diaz A, Dickerson TT, Dika Z, Djalalinia S, Do HTP, Dobson AJ, Donfrancesco C, Donoso SP, Döring A, Dorobantu M, Dörr M, Doua K, Dragano N, Drygas W, Duante CA, Duboz P, Duda RB, Dulskiene V, Dushpanova A, Džakula A, Dzerve V, Dziankowska-Zaborszczyk E, Eddie R, Eftekhar E, Eggertsen R, Eghtesad S, Eiben G, Ekelund U, El-Khateeb M, El Ati J, Eldemire-Shearer D, Eliasen M, Elosua R, Erasmus RT, Erbel R, Erem C, Eriksen L, Eriksson JG, Escobedo-de la Peña J, Eslami S, Esmaeili A, Evans A, Faeh D, Fakhretdinova AA, Fall CH, Faramarzi E, Farjam M, Fattahi MR, Fawwad A, Felix-Redondo FJ, Felix SB, Ferguson TS, Fernandes RA, Fernández-Bergés D, Ferrante D, Ferrao T, Ferrari M, Ferrario MM, Ferreccio C, Ferreira HS, Ferrer E, Ferrieres J, Figueiró TH, Fink G, Fischer K, Foo LH, Forsner M, Fouad HM, Francis DK, Franco MDC, Frikke-Schmidt R, Frontera G, Fuchs FD, Fuchs SC, Fujita Y, Fumihiko M, Furdela V, Furer A, Furusawa T, Gaciong Z, Galbarczyk A, Galenkamp H, Galvano F, Gao J, Gao P, Garcia-de-la-Hera M, Garcia P, Gareta D, Garnett SP, Gaspoz JM, Gasull M, Gazzinelli A, Gehring U, Geleijnse JM, George R, Ghanbari A, Ghasemi E, Gheorghe-Fronea OF, Ghimire A, Gialluisi A, Giampaoli S, Gieger C, Gill TK, Giovannelli J, Gironella G, Giwercman A, Gkiouras K, Goldberg M, Goldsmith RA, Gomez LF, Gomula A, Gonçalves H, Gonçalves M, Gonçalves Cordeiro da Silva B, Gonzalez-Chica DA, Gonzalez-Gross M, González-Rivas JP, González-Villalpando C, González-Villalpando ME, Gonzalez AR, Gorbea MB, Gottrand F, Graff-Iversen S, Grafnetter D, Grajda A, Grammatikopoulou MG, Gregor RD, Grodzicki T, Grosso G, Gruden G, Gu D, Guan OP, Gudmundsson EF, Gudnason V, Guerrero R, Guessous I, Guimaraes AL, Gulliford MC, Gunnlaugsdottir J, Gunter MJ, Gupta PC, Gupta R, Gureje O, Gurzkowska B, Gutierrez L, Gutzwiller F, Ha S, Hadaegh F, Haghshenas R, Hakimi H, Halkjær J, Hambleton IR, Hamzeh B, Hange D, Hanif AAM, Hantunen S, Hao J, Hardman CM, Hari Kumar R, Hashemi-Shahri SM, Hata J, Haugsgjerd T, Hayes AJ, He Y, Heier M, Hendriks ME, Henrique RDS, Henriques A, Hernandez Cadena L, Herqutanto, Herrala S, Heshmat R, Hill AG, Ho SY, Ho SC, Hobbs M, Holdsworth M, Homayounfar R, Horasan Dinc G, Horimoto ARVR, Hormiga CM, Horta BL, Houti L, Howitt C, Htay TT, Htet AS, Htike MMT, Hu Y, Huerta JM, Huhtaniemi IT, Huiart L, Huisman M, Husseini AS, Huybrechts I, Hwalla N, Iacoviello L, Iannone AG, Ibrahim MM, Ibrahim Wong N, Ikram MA, Iotova V, Irazola VE, Ishida T, Isiguzo GC, Islam M, Islam SMS, Iwasaki M, Jackson RT, Jacobs JM, Jaddou HY, Jafar T, James K, Jamrozik K, Janszky I, Janus E, Jarvelin MR, Jasienska G, Jelaković A, Jelaković B, Jennings G, Jha AK, Jiang CQ, Jimenez RO, Jöckel KH, Joffres M, Johansson M, Jokelainen JJ, Jonas JB, Jørgensen T, Joshi P, Joukar F, Jóżwiak J, Juolevi A, Jurak G, Jureša V, Kaaks R, Kafatos A, Kajantie EO, Kalmatayeva Z, Kalpourtzi N, Kalter-Leibovici O, Kampmann FB, Kannan S, Karaglani E, Kårhus LL, Karki KB, Katibeh M, Katz J, Kauhanen J, Kaur P, Kavousi M, Kazakbaeva GM, Keil U, Keinan Boker L, Keinänen-Kiukaanniemi S, Kelishadi R, Kemper HCG, Keramati M, Kerimkulova A, Kersting M, Key T, Khader YS, Khalili D, Khaw KT, Kheiri B, Kheradmand M, Khosravi A, Kiechl-Kohlendorfer U, Kiechl S, Killewo J, Kim DW, Kim J, Klakk H, Klimek M, Klumbiene J, Knoflach M, Kolle E, Kolsteren P, Kontto JP, Korpelainen R, Korrovits P, Kos J, Koskinen S, Kouda K, Kowlessur S, Koziel S, Kratenova J, Kriaucioniene V, Kristensen PL, Krokstad S, Kromhout D, Kruger HS, Kubinova R, Kuciene R, Kujala UM, Kulaga Z, Kumar RK, Kurjata P, Kusuma YS, Kutsenko V, Kuulasmaa K, Kyobutungi C, Laatikainen T, Lachat C, Laid Y, Lam TH, Landrove O, Lanska V, Lappas G, Larijani B, Latt TS, Le Coroller G, Le Nguyen Bao K, Le TD, Lee J, Lee J, Lehmann N, Lehtimäki T, Lemogoum D, Levitt NS, Li Y, Lilly CL, Lim WY, Lima-Costa MF, Lin X, Lin YT, Lind L, Lingam V, Linneberg A, Lissner L, Litwin M, Lo WC, Loit HM, Lopez-Garcia E, Lopez T, Lotufo PA, Lozano JE, Lukačević Lovrenčić I, Lukrafka JL, Luksiene D, Lundqvist A, Lundqvist R, Lunet N, Lustigová M, Luszczki E, Ma G, Ma J, Machado-Coelho GLL, Machado-Rodrigues AM, Macia E, Macieira LM, Madar AA, Maggi S, Magliano DJ, Magriplis E, Mahasampath G, Maire B, Majer M, Makdisse M, Malekzadeh F, Malekzadeh R, Malhotra R, Mallikharjuna Rao K, Malyutina SK, Maniego LV, Manios Y, Mann JI, Mansour-Ghanaei F, Manzato E, Marcil A, Mårild SB, Marinović Glavić M, Marques-Vidal P, Marques LP, Marrugat J, Martorell R, Mascarenhas LP, Matasin M, Mathiesen EB, Mathur P, Matijasevich A, Matlosz P, Matsha TE, Mavrogianni C, Mbanya JCN, Mc Donald Posso AJ, McFarlane SR, McGarvey ST, McLachlan S, McLean RM, McLean SB, McNulty BA, Mediene Benchekor S, Medzioniene J, Mehdipour P, Mehlig K, Mehrparvar AH, Meirhaeghe A, Meisinger C, Mendoza Montano C, Menezes AMB, Menon GR, Mereke A, Meshram II, Metspalu A, Meyer HE, Mi J, Michels N, Mikkel K, Milkowska K, Miller JC, Minderico CS, Mini GK, Mirjalili MR, Mirrakhimov E, Mišigoj-Duraković M, Modesti PA, Moghaddam SS, Mohajer B, Mohamed MK, Mohamed SF, Mohammad K, Mohammadi MR, Mohammadi Z, Mohammadifard N, Mohammadpourhodki R, Mohan V, Mohanna S, Mohd Yusoff MF, Mohebbi I, Mohebi F, Moitry M, Møllehave LT, Molnár D, Momenan A, Mondo CK, Monterrubio-Flores E, Monyeki KDK, Moon JS, Moosazadeh M, Moreira LB, Morejon A, Moreno LA, Morgan K, Moschonis G, Mossakowska M, Mostafa A, Mostafavi SA, Mota J, Motlagh ME, Motta J, Moura-dos-Santos MA, Mridha MK, Msyamboza KP, Mu TT, Muhihi AJ, Muiesan ML, Müller-Nurasyid M, Murphy N, Mursu J, Musa KI, Musić Milanović S, Musil V, Mustafa N, Nabipour I, Naderimagham S, Nagel G, Naidu BM, Najafi F, Nakamura H, Námešná J, Nang EEK, Nangia VB, Narake S, Ndiaye NC, Neal WA, Nejatizadeh A, Nenko I, Neovius M, Nguyen CT, Nguyen ND, Nguyen QV, Nguyen QN, Nieto-Martínez RE, Niiranen TJ, Nikitin YP, Ninomiya T, Nishtar S, Njelekela MA, Noale M, Noboa OA, Noorbala AA, Norat T, Nordendahl M, Nordestgaard BG, Noto D, Nowak-Szczepanska N, Nsour MA, Nunes B, O'Neill TW, O'Reilly D, Ochimana C, Oda E, Odili AN, Oh K, Ohara K, Ohtsuka R, Olié V, Olinto MTA, Oliveira IO, Omar MA, Onat A, Ong SK, Ono LM, Ordunez P, Ornelas R, Ortiz PJ, Osmond C, Ostojic SM, Ostovar A, Otero JA, Overvad K, Owusu-Dabo E, Paccaud FM, Padez C, Pahomova E, Paiva KMD, Pająk A, Palli D, Palmieri L, Pan WH, Panda-Jonas S, Panza F, Paoli M, Papandreou D, Park SW, Park S, Parnell WR, Parsaeian M, Pasquet P, Patel ND, Pavlyshyn H, Pećin I, Pednekar MS, Pedro JM, Peer N, Peixoto SV, Peltonen M, Pereira AC, Peres KGDA, Peres MA, Peters A, Petkeviciene J, Peykari N, Pham ST, Pichardo RN, Pigeot I, Pikhart H, Pilav A, Pilotto L, Pitakaka F, Piwonska A, Pizarro AN, Plans-Rubió P, Polašek O, Porta M, Poudyal A, Pourfarzi F, Pourshams A, Poustchi H, Pradeepa R, Price AJ, Price JF, Providencia R, Puhakka SE, Puiu M, Punab M, Qasrawi RF, Qorbani M, Queiroz D, Quoc Bao T, Radić I, Radisauskas R, Rahimikazerooni S, Rahman M, Raitakari O, Raj M, Rakhimova EM, Ramachandra Rao S, Ramachandran A, Ramos E, Rampal L, Rampal S, Rangel Reina DA, Rarra V, Rech CR, Redon J, Reganit PFM, Regecová V, Revilla L, Rezaianzadeh A, Ribeiro R, Riboli E, Richter A, Rigo F, Rinke de Wit TF, Ritti-Dias RM, Robitaille C, Rodríguez-Artalejo F, Rodriguez-Perez MDC, Rodríguez-Villamizar LA, Roggenbuck U, Rojas-Martinez R, Romaguera D, Romeo EL, Rosengren A, Roy JGR, Rubinstein A, Ruidavets JB, Ruiz-Betancourt BS, Ruiz-Castell M, Rusakova IA, Russo P, Rutkowski M, Sabanayagam C, Sabbaghi H, Sachdev HS, Sadjadi A, Safarpour AR, Safi S, Safiri S, Saidi O, Sakarya S, Saki N, Salanave B, Salazar Martinez E, Salmerón D, Salomaa V, Salonen JT, Salvetti M, Sánchez-Abanto J, Sans S, Santos DA, Santos IS, Santos LC, Santos MP, Santos R, Saramies JL, Sardinha LB, Sarganas G, Sarrafzadegan N, Sathish T, Saum KU, Savva S, Sawada N, Sbaraini M, Scazufca M, Schaan BD, Schargrodsky H, Schipf S, Schmidt CO, Schnohr P, Schöttker B, Schramm S, Schultsz C, Schutte AE, Sebert S, Sein AA, Sen A, Senbanjo IO, Sepanlou SG, Servais J, Shalnova SA, Shamah-Levy T, Shamshirgaran M, Shanthirani CS, Sharafkhah M, Sharma SK, Shaw JE, Shayanrad A, Shayesteh AA, Shi Z, Shibuya K, Shimizu-Furusawa H, Shin DW, Shirani M, Shiri R, Shrestha N, Si-Ramlee K, Siani A, Siantar R, Sibai AM, Silva CRDM, Silva DAS, Simon M, Simons J, Simons LA, Sjöström M, Slowikowska-Hilczer J, Slusarczyk P, Smeeth L, So HK, Soares FC, Sobngwi E, Söderberg S, Soemantri A, Sofat R, Solfrizzi V, Somi MH, Sonestedt E, Song Y, Sørensen TIA, Sørgjerd EP, Sorić M, Sossa Jérome C, Soumaré A, Sparboe-Nilsen B, Sparrenberger K, Staessen JA, Starc G, Stavreski B, Steene-Johannessen J, Stehle P, Stein AD, Stergiou GS, Stessman J, Stieber J, Stöckl D, Stocks T, Stokwiszewski J, Stronks K, Strufaldi MW, Suka M, Sun CA, Sung YT, Suriyawongpaisal P, Sy RG, Syddall HE, Sylva RC, Szklo M, Tai ES, Tammesoo ML, Tamosiunas A, Tan EJ, Tang X, Tanser F, Tao Y, Tarawneh MR, Tarqui-Mamani CB, Taylor A, Taylor J, Tebar WR, Tell GS, Tello T, Tham YC, Thankappan KR, Theobald H, Theodoridis X, Thijs L, Thinggaard M, Thomas N, Thorand B, Thuesen BH, Timmermans EJ, Tjandrarini DH, Tjonneland A, Toft U, Tolonen HK, Tolstrup JS, Topbas M, Topór-Madry R, Tormo MJ, Tornaritis MJ, Torrent M, Torres-Collado L, Touloumi G, Traissac P, Triantafyllou A, Trichopoulos D, Trichopoulou A, Trinh OTH, Trivedi A, Tshepo L, Tsugane S, Tuliakova AM, Tulloch-Reid MK, Tullu F, Tuomainen TP, Tuomilehto J, Turley ML, Twig G, Tynelius P, Tzourio C, Ueda P, Ugel E, Ulmer H, Uusitalo HMT, Valdivia G, Valvi D, van Dam RM, van den Born BJ, Van der Heyden J, van der Schouw YT, Van Herck K, Van Minh H, Van Schoor NM, van Valkengoed IGM, van Zutphen EM, Vanderschueren D, Vanuzzo D, Varbo A, Vasan SK, Vega T, Veidebaum T, Velasquez-Melendez G, Veronesi G, Verschuren WMM, Verstraeten R, Victora CG, Viet L, Villalpando S, Vineis P, Vioque J, Virtanen JK, Visvikis-Siest S, Viswanathan B, Vlasoff T, Vollenweider P, Voutilainen A, Wade AN, Walton J, Wambiya EOA, Wan Bebakar WM, Wan Mohamud WN, Wanderley Júnior RDS, Wang MD, Wang N, Wang Q, Wang X, Wang YX, Wang YW, Wannamethee SG, Wareham N, Wei W, Weres A, Werner B, Whincup PH, Widhalm K, Wiecek A, Wilks RJ, Willeit J, Willeit P, Williams EA, Wilsgaard T, Wojtyniak B, Wong-McClure RA, Wong A, Wong TY, Woo J, Wu FC, Wu S, Wyszynska J, Xu H, Xu L, Yaacob NA, Yan W, Yang L, Yang X, Yang Y, Yasuharu T, Ye X, Yiallouros PK, Yoosefi M, Yoshihara A, You SL, Younger-Coleman NO, Yusoff AF, Zainuddin AA, Zakavi SR, Zamani F, Zambon S, Zampelas A, Zapata ME, Zaw KK, Zejglicova K, Zeljkovic Vrkic T, Zeng Y, Zhang L, Zhang ZY, Zhao D, Zhao MH, Zhen S, Zheng Y, Zholdin B, Zhu D, Zins M, Zitt E, Zocalo Y, Zoghlami N, Zuñiga Cisneros J, Ezzati M. Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants. Lancet 2021; 398:957-980. [PMID: 34450083 PMCID: PMC8446938 DOI: 10.1016/s0140-6736(21)01330-1] [Citation(s) in RCA: 938] [Impact Index Per Article: 312.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 06/01/2021] [Accepted: 06/03/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND Hypertension can be detected at the primary health-care level and low-cost treatments can effectively control hypertension. We aimed to measure the prevalence of hypertension and progress in its detection, treatment, and control from 1990 to 2019 for 200 countries and territories. METHODS We used data from 1990 to 2019 on people aged 30-79 years from population-representative studies with measurement of blood pressure and data on blood pressure treatment. We defined hypertension as having systolic blood pressure 140 mm Hg or greater, diastolic blood pressure 90 mm Hg or greater, or taking medication for hypertension. We applied a Bayesian hierarchical model to estimate the prevalence of hypertension and the proportion of people with hypertension who had a previous diagnosis (detection), who were taking medication for hypertension (treatment), and whose hypertension was controlled to below 140/90 mm Hg (control). The model allowed for trends over time to be non-linear and to vary by age. FINDINGS The number of people aged 30-79 years with hypertension doubled from 1990 to 2019, from 331 (95% credible interval 306-359) million women and 317 (292-344) million men in 1990 to 626 (584-668) million women and 652 (604-698) million men in 2019, despite stable global age-standardised prevalence. In 2019, age-standardised hypertension prevalence was lowest in Canada and Peru for both men and women; in Taiwan, South Korea, Japan, and some countries in western Europe including Switzerland, Spain, and the UK for women; and in several low-income and middle-income countries such as Eritrea, Bangladesh, Ethiopia, and Solomon Islands for men. Hypertension prevalence surpassed 50% for women in two countries and men in nine countries, in central and eastern Europe, central Asia, Oceania, and Latin America. Globally, 59% (55-62) of women and 49% (46-52) of men with hypertension reported a previous diagnosis of hypertension in 2019, and 47% (43-51) of women and 38% (35-41) of men were treated. Control rates among people with hypertension in 2019 were 23% (20-27) for women and 18% (16-21) for men. In 2019, treatment and control rates were highest in South Korea, Canada, and Iceland (treatment >70%; control >50%), followed by the USA, Costa Rica, Germany, Portugal, and Taiwan. Treatment rates were less than 25% for women and less than 20% for men in Nepal, Indonesia, and some countries in sub-Saharan Africa and Oceania. Control rates were below 10% for women and men in these countries and for men in some countries in north Africa, central and south Asia, and eastern Europe. Treatment and control rates have improved in most countries since 1990, but we found little change in most countries in sub-Saharan Africa and Oceania. Improvements were largest in high-income countries, central Europe, and some upper-middle-income and recently high-income countries including Costa Rica, Taiwan, Kazakhstan, South Africa, Brazil, Chile, Turkey, and Iran. INTERPRETATION Improvements in the detection, treatment, and control of hypertension have varied substantially across countries, with some middle-income countries now outperforming most high-income nations. The dual approach of reducing hypertension prevalence through primary prevention and enhancing its treatment and control is achievable not only in high-income countries but also in low-income and middle-income settings. FUNDING WHO.
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Sprengeler O, Pohlabeln H, Bammann K, Buck C, Lauria F, Verbestel V, Eiben G, Konstabel K, Molnár D, Moreno LA, Pitsiladis Y, Page A, Reisch L, Tornaritis M, Ahrens W. Trajectories of objectively measured physical activity and childhood overweight: longitudinal analysis of the IDEFICS/I.Family cohort. Int J Behav Nutr Phys Act 2021; 18:103. [PMID: 34372866 PMCID: PMC8353833 DOI: 10.1186/s12966-021-01171-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 07/02/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Since only few longitudinal studies with appropriate study designs investigated the relationship between objectively measured physical activity (PA) and overweight, the degree PA can prevent excess weight gain in children, remains unclear. Moreover, evidence is limited on how childhood overweight determines PA during childhood. Therefore, we analyzed longitudinal trajectories of objectively measured PA and their bi-directional association with weight trajectories of children at 2- and 6-year follow-ups. METHODS Longitudinal data of three subsequent measurements from the IDEFICS/I.Family cohort study were used to analyze the bi-directional association between moderate-to-vigorous PA (MVPA) and weight status by means of multilevel regression models. Analyses comprised 3393 (2-year follow-up) and 1899 (6-year follow-up) children aged 2-15.9 years from eight European countries with valid accelerometer data and body mass index (BMI) measurements. For categorized analyses, children's weight status was categorized as normal weight or overweight (cutoff: 90th percentile of BMI) and children's PA as (in-) sufficiently active (cutoffs: 30, 45 and 60 min of MVPA per day). RESULTS Children engaging in at least 60 min MVPA daily at baseline and follow-ups had a lower odds of becoming overweight (odds ratio [OR] at 2-year follow-up: 0.546, 95% CI: 0.378, 0.789 and 6-year follow-up: 0.393, 95% CI: 0.242, 0.638), compared to less active children. Similar associations were found for 45 min MVPA daily. On the other side, children who became overweight had the lowest odds to achieve 45 or 60 min MVPA daily (ORs: 0.459 to 0.634), compared to normal weight children. CONCLUSIONS Bi-directional associations between MVPA and weight status were observed. In summary, at least 60 min MVPA are still recommended for the prevention of childhood overweight. To prevent excess weight gain, 45 min MVPA per day also showed preventive effects.
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Affiliation(s)
- Ole Sprengeler
- Department of Epidemiological Methods and Etiological Research, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstr. 30, D-28359, Bremen, Germany
| | - Hermann Pohlabeln
- Department of Biometry and Data Management, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstraße 30, D-28359, Bremen, Germany.
| | - Karin Bammann
- Department of Biometry and Data Management, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstraße 30, D-28359, Bremen, Germany.,Working group Epidemiology of Demographic Change, Institute for Public Health and Nursing Sciences (IPP), University of Bremen, Bremen, Germany
| | - Christoph Buck
- Department of Biometry and Data Management, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstraße 30, D-28359, Bremen, Germany
| | - Fabio Lauria
- Institute of Food Sciences, National Research Council of Italy, Avellino, Italy
| | - Vera Verbestel
- Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Gabriele Eiben
- Department of Public Health, School of Health Sciences, University of Skövde, Skövde, Sweden
| | - Kenn Konstabel
- Department of Chronic Diseases, National Institute for Health Development, Tallinn, Estonia.,School of Natural Sciences and Health, Tallinn University, Tallinn, Estonia.,Institute of Psychology, University of Tartu, Tartu, Estonia
| | - Dénes Molnár
- Department of Paediatrics, University of Pécs, Pécs, Hungary
| | - Luis A Moreno
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Faculty of Health Sciences, University of Zaragoza, Edificio del SAI, C/Pedro Cerbuna s/n, 50009, Zaragoza, Spain.,Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain.,Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain.,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Madrid, Spain
| | - Yannis Pitsiladis
- Collaborating Centre of Sports Medicine, University of Brighton, Welkin House, Eastbourne, UK
| | - Angie Page
- Centre for Exercise, Nutrition and Health Sciences, School of Policy Studies, University of Bristol, Bristol, BS8 1TZ, UK.,NIHR Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK
| | | | | | - Wolfgang Ahrens
- Department of Epidemiological Methods and Etiological Research, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstr. 30, D-28359, Bremen, Germany.,Institute of Statistics, Faculty of Mathematics and Computer Science, University Bremen, Bremen, Germany
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Iacomino G, Lauria F, Russo P, Venezia A, Iannaccone N, Marena P, Ahrens W, De Henauw S, Molnár D, Eiben G, Foraita R, Hebestreit A, Kourides G, Moreno LA, Veidebaum T, Siani A. The association of circulating miR-191 and miR-375 expression levels with markers of insulin resistance in overweight children: an exploratory analysis of the I.Family Study. Genes Nutr 2021; 16:10. [PMID: 34243726 PMCID: PMC8272322 DOI: 10.1186/s12263-021-00689-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 05/18/2021] [Indexed: 02/08/2023]
Abstract
Background In recent years, the exciting emergence of circulating miRNAs as stable, reproducible, and consistent among individuals has opened a promising research opportunity for the detection of non-invasive biomarkers. A firm connection has been established between circulating miRNAs and glycaemic as well as metabolic homeostasis, showing that levels of specific miRNAs vary under different physio-pathological conditions. Objective In this pilot study, we investigated the expression of candidate miRNAs, hsa-miR-191-3p and hsa-miR-375, in relation to biomarkers associated with insulin sensitivity in a subgroup (n=58) of subjects participating to the European I.Family Study, a project aimed to assess the determinants of eating behaviour in children and adolescents and related health outcomes. The sample included overweight/obese children/adolescents since overweight/obesity is a known risk factor for impaired glucose homeostasis and metabolic disorders. Biological targets of candidate miRNAs were also explored in silico. Results We observed a significant association of the two miRNAs and early changes in glycaemic homeostasis, independent of covariates including country of origin, age, BMI z-score, puberty status, highest educational level of parents, total energy intake, energy from fats, energy from carbohydrates, and energy from proteins. Conclusion Identification of circulating miRNAs associated with insulin impairment may offer novel approaches of assessing early variations in insulin sensitivity and provide evidence about the molecular mechanisms connected to early changes in glycaemic homeostasis. Trial registration ISRCTN, ISRCTN62310987. Retrospectively registered, http://isrctn.com/ISRCTN62310987 Supplementary Information The online version contains supplementary material available at 10.1186/s12263-021-00689-1.
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Affiliation(s)
- Giuseppe Iacomino
- Institute of Food Sciences, National Research Council, ISA-CNR, via Roma 64, 83100, Avellino, Italy.
| | - Fabio Lauria
- Institute of Food Sciences, National Research Council, ISA-CNR, via Roma 64, 83100, Avellino, Italy
| | - Paola Russo
- Institute of Food Sciences, National Research Council, ISA-CNR, via Roma 64, 83100, Avellino, Italy
| | - Antonella Venezia
- Institute of Food Sciences, National Research Council, ISA-CNR, via Roma 64, 83100, Avellino, Italy
| | - Nunzia Iannaccone
- Institute of Food Sciences, National Research Council, ISA-CNR, via Roma 64, 83100, Avellino, Italy
| | - Pasquale Marena
- Institute of Food Sciences, National Research Council, ISA-CNR, via Roma 64, 83100, Avellino, Italy
| | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology, BIPS, Achterstraße 30, 28359, Bremen, Germany
| | | | - Dénes Molnár
- Department of Pediatrics, Medical School, University of Pécs, Pécs, Hungary
| | - Gabriele Eiben
- Sahlgrenska Academy at the University of Gothenburg, Medicinaregatan 3, 413 90, Göteborg, Sweden
| | - Ronja Foraita
- Leibniz Institute for Prevention Research and Epidemiology, BIPS, Achterstraße 30, 28359, Bremen, Germany
| | - Antje Hebestreit
- Leibniz Institute for Prevention Research and Epidemiology, BIPS, Achterstraße 30, 28359, Bremen, Germany
| | - Giannis Kourides
- Research and Education Institute of Child Health, ave, #205 2015, Strovolos, 138, Limassol, Cyprus
| | - Luis A Moreno
- University of Zaragoza, Domingo Miral, s/n, 50009, Zaragoza, Spain
| | - Toomas Veidebaum
- National Institute for Health Development, Hiiu 42, 11619, Tallinn, Estonia
| | - Alfonso Siani
- Institute of Food Sciences, National Research Council, ISA-CNR, via Roma 64, 83100, Avellino, Italy
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15
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Iurilli MLC, Zhou B, Bennett JE, Carrillo-Larco RM, Sophiea MK, Rodriguez-Martinez A, Bixby H, Solomon BD, Taddei C, Danaei G, Di Cesare M, Stevens GA, Riley LM, Savin S, Cowan MJ, Bovet P, Damasceno A, Chirita-Emandi A, Hayes AJ, Ikeda N, Jackson RT, Khang YH, Laxmaiah A, Liu J, Miranda JJ, Saidi O, Sebert S, Sorić M, Starc G, Gregg EW, Abarca-Gómez L, Abdeen ZA, Abdrakhmanova S, Ghaffar SA, Rahim HFA, Abu-Rmeileh NM, Garba JA, Acosta-Cazares B, Adams RJ, Aekplakorn W, Afsana K, Afzal S, Agdeppa IA, Aghazadeh-Attari J, Aguilar-Salinas CA, Agyemang C, Ahmad MH, Ahmad NA, Ahmadi A, Ahmadi N, Ahmed SH, Ahrens W, Aitmurzaeva G, Ajlouni K, Al-Hazzaa HM, Al-Lahou B, Al-Raddadi R, Alarouj M, AlBuhairan F, AlDhukair S, Ali MM, Alkandari A, Alkerwi A, Allin K, Alvarez-Pedrerol M, Aly E, Amarapurkar DN, Amiri P, Amougou N, Amouyel P, Bo Andersen L, Anderssen SA, Ängquist L, Anjana RM, Ansari-Moghaddam A, Aounallah-Skhiri H, Araújo J, Ariansen I, Aris T, Arku RE, Arlappa N, Aryal KK, Aspelund T, Assah FK, Assunção MCF, Aung MS, Auvinen J, Avdicová M, Avi S, Azevedo A, Azimi-Nezhad M, Azizi F, Azmin M, Babu BV, Jørgensen MB, Baharudin A, Bahijri S, Baker JL, Balakrishna N, Bamoshmoosh M, Banach M, Bandosz P, Banegas JR, Baran J, Barbagallo CM, Barceló A, Barkat A, Barros AJD, Barros MVG, Basit A, Bastos JLD, Bata I, Batieha AM, Batista RL, Battakova Z, Batyrbek A, Baur LA, Beaglehole R, Bel-Serrat S, Belavendra A, Romdhane HB, Benedics J, Benet M, Bergh IH, Berkinbayev S, Bernabe-Ortiz A, Bernotiene G, Bettiol H, Bezerra J, Bhagyalaxmi A, Bharadwaj S, Bhargava SK, Bhutta ZA, Bi H, Bi Y, Bia D, Lele ECB, Bikbov MM, Bista B, Bjelica DJ, Bjerregaard P, Bjertness E, Bjertness MB, Björkelund C, Bloch KV, Blokstra A, Bo S, Bobak M, Boddy LM, Boehm BO, Boeing H, Boggia JG, Bogova E, Boissonnet CP, Bojesen SE, Bonaccio M, Bongard V, Bonilla-Vargas A, Bopp M, Borghs H, Braeckevelt L, Braeckman L, Bragt MCE, Brajkovich I, Branca F, Breckenkamp J, Breda J, Brenner H, Brewster LM, Brian GR, Brinduse L, Brophy S, Bruno G, Bueno-de-Mesquita HB, Bugge A, Buoncristiano M, Burazeri G, Burns C, de León AC, Cacciottolo J, Cai H, Cama T, Cameron C, Camolas J, Can G, Cândido APC, Cañete F, Capanzana MV, Capková N, Capuano E, Capuano V, Cardol M, Cardoso VC, Carlsson AC, Carmuega E, Carvalho J, Casajús JA, Casanueva FF, Celikcan E, Censi L, Cervantes-Loaiza M, Cesar JA, Chamukuttan S, Chan AW, Chan Q, Chaturvedi HK, Chaturvedi N, Rahim NCA, Li Chee M, Chen CJ, Chen F, Chen H, Chen S, Chen Z, Cheng CY, Cheraghian B, Chetrit A, Chikova-Iscener E, Chiolero A, Chiou ST, Chirlaque MD, Cho B, Christensen K, Christofaro DG, Chudek J, Cifkova R, Cilia M, Cinteza E, Claessens F, Clarke J, Clays E, Cohen E, Concin H, Confortin SC, Cooper C, Coppinger TC, Corpeleijn E, Costanzo S, Cottel D, Cowell C, Craig CL, Crampin AC, Crujeiras AB, Csilla S, Cucu AM, Cui L, Cureau FV, Czenczek-Lewandowska E, D'Arrigo G, d'Orsi E, Dacica L, Re Saavedra MÁD, Dallongeville J, Damsgaard CT, Dankner R, Dantoft TM, Dasgupta P, Dastgiri S, Dauchet L, Davletov K, De Backer G, De Bacquer D, de Gaetano G, De Henauw S, de Oliveira PD, De Ridder D, De Ridder K, de Rooij SR, De Smedt D, Deepa M, Deev AD, Jr DeGennaro V, Dehghan A, Delisle H, Delpeuch F, Demarest S, Dennison E, Dereń K, Deschamps V, Dhimal M, Di Castelnuovo AF, Dias-da-Costa JS, Díaz-Sánchez ME, Diaz A, Dika Z, Djalalinia S, Djordjic V, Do HTP, Dobson AJ, Donati MB, Donfrancesco C, Donoso SP, Döring A, Dorobantu M, Dorosty AR, Doua K, Dragano N, Drygas W, Li Duan J, Duante CA, Duboz P, Duda RB, Duleva V, Dulskiene V, Dumith SC, Dushpanova A, Dzerve V, Dziankowska-Zaborszczyk E, Eddie R, Eftekhar E, Egbagbe EE, Eggertsen R, Eghtesad S, Eiben G, Ekelund U, El-Khateeb M, El Ati J, Eldemire-Shearer D, Eliasen M, Elliott P, Engle-Stone R, Enguerran M, Erasmus RT, Erbel R, Erem C, Eriksen L, Eriksson JG, la Peña JED, Eslami S, Esmaeili A, Evans A, Faeh D, Fakhretdinova AA, Fall CH, Faramarzi E, Farjam M, Sant'Angelo VF, Farzadfar F, Fattahi MR, Fawwad A, Felix-Redondo FJ, Ferguson TS, Fernandes RA, Fernández-Bergés D, Ferrante D, Ferrao T, Ferrari M, Ferrario MM, Ferreccio C, Ferrer E, Ferrieres J, Figueiró TH, Fijalkowska A, Fink G, Fischer K, Foo LH, Forsner M, Fouad HM, Francis DK, do Carmo Franco M, Frikke-Schmidt R, Frontera G, Fuchs FD, Fuchs SC, Fujiati II, Fujita Y, Fumihiko M, Furusawa T, Gaciong Z, Gafencu M, Galbarczyk A, Galenkamp H, Galeone D, Galfo M, Galvano F, Gao J, Garcia-de-la-Hera M, García-Solano M, Gareta D, Garnett SP, Gaspoz JM, Gasull M, Gaya ACA, Gaya AR, Gazzinelli A, Gehring U, Geiger H, Geleijnse JM, Ghanbari A, Ghasemi E, Gheorghe-Fronea OF, Giampaoli S, Gianfagna F, Gill TK, Giovannelli J, Gironella G, Giwercman A, Gkiouras K, Godos J, Gogen S, Goldberg M, Goldsmith RA, Goltzman D, Gómez SF, Gomula A, da Silva BGC, Gonçalves H, Gonzalez-Chica DA, Gonzalez-Gross M, González-Leon M, González-Rivas JP, González-Villalpando C, González-Villalpando ME, Gonzalez AR, Gottrand F, Graça AP, Graff-Iversen S, Grafnetter D, Grajda A, Grammatikopoulou MG, Gregor RD, Grodzicki T, Grøholt EK, Grøntved A, Grosso G, Gruden G, Gu D, Gualdi-Russo E, Guallar-Castillón P, Gualtieri A, Gudmundsson EF, Gudnason V, Guerrero R, Guessous I, Guimaraes AL, Gulliford MC, Gunnlaugsdottir J, Gunter MJ, Guo XH, Guo Y, Gupta PC, Gupta R, Gureje O, Gurzkowska B, Gutiérrez-González E, Gutierrez L, Gutzwiller F, Ha S, Hadaegh F, Hadjigeorgiou CA, Haghshenas R, Hakimi H, Halkjær J, Hambleton IR, Hamzeh B, Hange D, Hanif AAM, Hantunen S, Hao J, Kumar RH, Hashemi-Shahri SM, Hassapidou M, Hata J, Haugsgjerd T, He J, He Y, He Y, Heidinger-Felso R, Heinen M, Hejgaard T, Hendriks ME, dos Santos Henrique R, Henriques A, Cadena LH, Herrala S, Herrera VM, Herter-Aeberli I, Heshmat R, Hill AG, Ho SY, Ho SC, Hobbs M, Holdsworth M, Homayounfar R, Homs C, Hopman WM, Horimoto ARVR, Hormiga CM, Horta BL, Houti L, Howitt C, Htay TT, Htet AS, Htike MMT, Hu Y, Huerta JM, Huhtaniemi IT, Huiart L, Petrescu CH, Huisman M, Husseini A, Huu CN, Huybrechts I, Hwalla N, Hyska J, Iacoviello L, Ibarluzea JM, Ibrahim MM, Wong NI, Ikram MA, Iotova V, Irazola VE, Ishida T, Islam M, Islam SMS, Iwasaki M, Jacobs JM, Jaddou HY, Jafar T, James K, Jamil KM, Jamrozik K, Janszky I, Janus E, Jarani J, Jarvelin MR, Jasienska G, Jelakovic A, Jelakovic B, Jennings G, Jha AK, Jiang CQ, Jimenez RO, Jöckel KH, Joffres M, Johansson M, Jokelainen JJ, Jonas JB, Jonnagaddala J, Jørgensen T, Joshi P, Joukar F, Jovic DP, Jóźwiak JJ, Juolevi A, Jurak G, Simina IJ, Juresa V, Kaaks R, Kaducu FO, Kafatos A, Kajantie EO, Kalmatayeva Z, Kalter-Leibovici O, Kameli Y, Kampmann FB, Kanala KR, Kannan S, Kapantais E, Karakosta A, Kårhus LL, Karki KB, Katibeh M, Katz J, Katzmarzyk PT, Kauhanen J, Kaur P, Kavousi M, Kazakbaeva GM, Keil U, Boker LK, Keinänen-Kiukaanniemi S, Kelishadi R, Kelleher C, Kemper HCG, Kengne AP, Keramati M, Kerimkulova A, Kersting M, Key T, Khader YS, Khalili D, Khaw KT, Kheiri B, Kheradmand M, Khosravi A, Khouw IMSL, Kiechl-Kohlendorfer U, Kiechl S, Killewo J, Kim DW, Kim HC, Kim J, Kindblom JM, Klakk H, Klimek M, Klimont J, Klumbiene J, Knoflach M, Koirala B, Kolle E, Kolsteren P, König J, Korpelainen R, Korrovits P, Korzycka M, Kos J, Koskinen S, Kouda K, Kovacs VA, Kowlessur S, Koziel S, Kratenova J, Kratzer W, Kriemler S, Kristensen PL, Krokstad S, Kromhout D, Kruger HS, Kubinova R, Kuciene R, Kujala UM, Kujundzic E, Kulaga Z, Kumar RK, Kunešová M, Kurjata P, Kusuma YS, Kuulasmaa K, Kyobutungi C, La QN, Laamiri FZ, Laatikainen T, Lachat C, Laid Y, Lam TH, Lambrinou CP, Landais E, Lanska V, Lappas G, Larijani B, Latt TS, Lauria L, Lazo-Porras M, Le Coroller G, Le Nguyen Bao K, Le Port A, Le TD, Lee J, Lee J, Lee PH, Lehmann N, Lehtimäki T, Lemogoum D, Levitt NS, Li Y, Liivak M, Lilly CL, Lim WY, Lima-Costa MF, Lin HH, Lin X, Lin YT, Lind L, Linneberg A, Lissner L, Litwin M, Liu L, Lo WC, Loit HM, Long KQ, Lopes L, Lopes O, Lopez-Garcia E, Lopez T, Lotufo PA, Lozano JE, Lukrafka JL, Luksiene D, Lundqvist A, Lundqvist R, Lunet N, Lunogelo C, Lustigová M, Łuszczki E, Ma G, Ma J, Ma X, Machado-Coelho GLL, Machado-Rodrigues AM, Macieira LM, Madar AA, Maggi S, Magliano DJ, Magnacca S, Magriplis E, Mahasampath G, Maire B, Majer M, Makdisse M, Mäki P, Malekzadeh F, Malekzadeh R, Malhotra R, Rao KM, Malyutina SK, Maniego LV, Manios Y, Mann JI, Mansour-Ghanaei F, Manzato E, Margozzini P, Markaki A, Markey O, Ioannidou EM, Marques-Vidal P, Marques LP, Marrugat J, Martin-Prevel Y, Martin R, Martorell R, Martos E, Maruszczak K, Marventano S, Mascarenhas LP, Masoodi SR, Mathiesen EB, Mathur P, Matijasevich A, Matsha TE, Mavrogianni C, Mazur A, Mbanya JCN, McFarlane SR, McGarvey ST, McKee M, McLachlan S, McLean RM, McLean SB, McNulty BA, Benchekor SM, Medzioniene J, Mehdipour P, Mehlig K, Mehrparvar AH, Meirhaeghe A, Meisfjord J, Meisinger C, Menezes AMB, Menon GR, Mensink GBM, Menzano MT, Mereke A, Meshram II, Metspalu A, Meyer HE, Mi J, Michaelsen KF, Michels N, Mikkel K, 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Nelis L, Nenko I, Neovius M, Nervi F, Nguyen CT, Nguyen ND, Nguyen QN, Nieto-Martínez RE, Nikitin YP, Ning G, Ninomiya T, Nishtar S, Noale M, Noboa OA, Nogueira H, Norat T, Nordendahl M, Nordestgaard BG, Noto D, Nowak-Szczepanska N, Al Nsour M, Nuhoglu I, Nurk E, O'Neill TW, O'Reilly D, Obreja G, Ochimana C, Ochoa-Avilés AM, Oda E, Oh K, Ohara K, Ohlsson C, Ohtsuka R, Olafsson Ö, Olinto MTA, Oliveira IO, Omar MA, Onat A, Ong SK, Ono LM, Ordunez P, Ornelas R, Ortiz AP, Ortiz PJ, Osler M, Osmond C, Ostojic SM, Ostovar A, Otero JA, Overvad K, Owusu-Dabo E, Paccaud FM, Padez C, Pagkalos I, Pahomova E, de Paiva KM, Pajak A, Palli D, Palloni A, Palmieri L, Pan WH, Panda-Jonas S, Pandey A, Panza F, Papandreou D, Park SW, Park S, Parnell WR, Parsaeian M, Pascanu IM, Pasquet P, Patel ND, Pecin I, Pednekar MS, Peer N, Pei G, Peixoto SV, Peltonen M, Pereira AC, Peres MA, Pérez-Farinós N, Pérez CM, Peterkova V, Peters A, Petersmann A, Petkeviciene J, Petrauskiene A, Pettenuzzo E, Peykari N, Pham ST, Pichardo RN, Pierannunzio D, Pigeot I, Pikhart H, Pilav A, Pilotto L, Pistelli F, Pitakaka F, Piwonska A, Pizarro AN, Plans-Rubió P, Poh BK, Pohlabeln H, Pop RM, Popovic SR, Porta M, Posch G, Poudyal A, Poulimeneas D, Pouraram H, Pourfarzi F, Pourshams A, Poustchi H, Pradeepa R, Price AJ, Price JF, Providencia R, Puder JJ, Pudule I, Puhakka SE, Puiu M, Punab M, Qasrawi RF, Qorbani M, Bao TQ, Radic I, Radisauskas R, Rahimikazerooni S, Rahman M, Rahman M, Raitakari O, Raj M, Rakhimova E, Rakhmatulloev S, Rakovac I, Rao SR, Ramachandran A, Ramke J, Ramos E, Ramos R, Rampal L, Rampal S, Rarra V, Rascon-Pacheco RA, Rasmussen M, Rech CR, Redon J, Reganit PFM, Regecová V, Revilla L, Rezaianzadeh A, Ribas-Barba L, Ribeiro R, Riboli E, Richter A, Rigo F, Rinaldo N, de Wit TFR, Rito A, Ritti-Dias RM, Rivera JA, Robitaille C, Roccaldo R, Rodrigues D, Rodríguez-Artalejo F, del Cristo Rodriguez-Perez M, Rodríguez-Villamizar LA, Roggenbuck U, Rojas-Martinez R, Rojroongwasinkul N, Romaguera D, 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SR, Zamani F, Zambon S, Zampelas A, Zamrazilová H, Zapata ME, Zargar AH, Ko Zaw K, Zdrojewski T, Zejglicova K, Vrkic TZ, Zeng Y, Zhang L, Zhang ZY, Zhao D, Zhao MH, Zhao W, Zhen S, Zheng W, Zheng Y, Zholdin B, Zhou M, Zhu D, Zins M, Zitt E, Zocalo Y, Cisneros JZ, Zuziak M, Ezzati M, Filippi S. Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight. eLife 2021; 10:e60060. [PMID: 33685583 PMCID: PMC7943191 DOI: 10.7554/elife.60060] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 01/07/2021] [Indexed: 02/05/2023] Open
Abstract
From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Nayu Ikeda
- National Institutes of Biomedical Innovation, Health and Nutrition
| | | | | | | | - Jing Liu
- Capital Medical University Beijing An Zhen Hospital
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Shoaib Afzal
- University of Copenhagen
- Copenhagen University Hospital
| | | | | | | | | | | | | | - Ali Ahmadi
- Shahrekord University of Medical Sciences
| | | | | | | | | | - Kamel Ajlouni
- National Center for Diabetes, Endocrinology and Genetics
| | | | | | | | | | | | | | | | | | | | | | | | - Eman Aly
- World Health Organization Regional Office for the Eastern Mediterranean
| | | | - Parisa Amiri
- Research Center for Social Determinants of Health
| | | | | | | | | | | | | | | | | | - Joana Araújo
- Institute of Public Health of the University of Porto
| | | | | | | | | | | | | | | | | | | | | | | | - Shina Avi
- Tel-Aviv University
- Hebrew University of Jerusalem
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Abdul Basit
- Baqai Institute of Diabetology and Endocrinology
| | | | | | | | | | | | | | | | | | | | | | | | - Judith Benedics
- Federal Ministry of Social Affairs, Health, Care and Consumer Protection
| | | | | | | | | | | | | | | | | | | | | | | | - Hongsheng Bi
- Shandong University of Traditional Chinese Medicine
| | - Yufang Bi
- Shanghai Jiao-Tong University School of Medicine
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - João Breda
- World Health Organization Regional Office for Europe
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- Council for Agricultural Research and Economics
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- The Gertner Institute for Epidemiology and Health Policy Research
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- Canadian Fitness and Lifestyle Research Institute
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - Rachel Dankner
- The Gertner Institute for Epidemiology and Health Policy Research
| | | | | | | | - Luc Dauchet
- University of Lille
- Lille University Hospital
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Jia Li Duan
- Beijing Center for Disease Prevention and Control
| | | | | | | | | | | | | | - Anar Dushpanova
- Scuola Superiore Sant'Anna
- Al-Farabi Kazakh National University
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Günther Fink
- Swiss Tropical and Public Health Institute
- University of Basel
| | | | | | | | - Heba M Fouad
- World Health Organization Regional Office for the Eastern Mediterranean
| | | | | | | | | | | | | | | | | | | | | | | | - Mihai Gafencu
- Victor Babes University of Medicine and Pharmacy Timisoara
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Marcel Goldberg
- Institut National de la Santé et de la Recherche Médicale
- Paris University
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Yin Guo
- Capital Medical University Beijing Tongren Hospital
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- Eternal Heart Care Centre and Research Institute
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- Beijing Institute of Ophthalmology
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- National Research Institute for Health and Family Planning
| | - Yuna He
- Chinese Center for Disease Control and Prevention
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- Institute of Public Health of the University of Porto
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- Institute of Molecular and Clinical Ophthalmology Basel
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- French National Research Institute for Sustainable Development
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- Johns Hopkins Bloomberg School of Public Health
| | | | | | | | | | | | | | | | | | - Roya Kelishadi
- Research Institute for Primordial Prevention of Non-communicable Disease
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- PASs Hirszfeld Institute of Immunology and Experimental Therapy
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- French National Research Institute for Sustainable Development
| | - Vera Lanska
- Institute for Clinical and Experimental Medicine
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- University of Chinese Academy of Sciences
| | | | | | | | | | | | - Lijuan Liu
- Capital Medical University Beijing Tongren Hospital
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- National Research Institute for Health and Family Planning
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- Institute of Neuroscience of the National Research Council
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- French National Research Institute for Sustainable Development
| | | | | | - Päivi Mäki
- Finnish Institute for Health and Welfare
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- CIBERCV
- Institut Hospital del Mar d'Investigacions Mèdiques
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- Capital Institute of Pediatrics
| | | | | | | | | | | | | | - GK Mini
- Women’s Social and Health Studies Foundation
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- University of Strasbourg
- Strasbourg University Hospital
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Jorge Motta
- Instituto Conmemorativo Gorgas de Estudios de la Salud
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Jana Námešná
- Banska Bystrica Regional Authority of Public Health
| | | | | | | | | | | | | | | | | | | | - Keiu Nelis
- National Institute for Health Development
| | - Liis Nelis
- National Institute for Health Development
| | | | | | | | | | | | | | | | - Yury P Nikitin
- SB RAS Federal Research Center Institute of Cytology and Genetics
| | - Guang Ning
- Shanghai Jiao-Tong University School of Medicine
| | | | | | - Marianna Noale
- Institute of Neuroscience of the National Research Council
| | | | | | | | | | | | | | | | | | | | - Eha Nurk
- National Institute for Health Development
| | | | | | | | | | | | | | - Kyungwon Oh
- Korea Centers for Disease Control and Prevention
| | | | - Claes Ohlsson
- University of Gothenburg
- Sahlgrenska University Hospital
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Domenico Palli
- Institute for Cancer Research, Prevention and Clinical Network
| | | | | | | | | | | | - Francesco Panza
- IRCCS Ente Ospedaliero Specializzato in Gastroenterologia S. de Bellis
| | | | | | - Suyeon Park
- Korea Centers for Disease Control and Prevention
| | | | | | - Ionela M Pascanu
- University of Medicine, Pharmacy, Science and Technology of Târgu Mures
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Iris Pigeot
- Leibniz Institute for Prevention Research and Epidemiology - BIPS
| | | | | | | | | | | | | | | | | | | | | | - Raluca M Pop
- University of Medicine, Pharmacy, Science and Technology of Târgu Mures
| | | | - Miquel Porta
- Institut Hospital del Mar d'Investigacions Mèdiques
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Maria Puiu
- Victor Babes University of Medicine and Pharmacy Timisoara
| | | | | | | | | | | | | | | | | | | | | | - Manu Raj
- Amrita Institute of Medical Sciences
| | | | | | - Ivo Rakovac
- World Health Organization Regional Office for Europe
| | | | | | | | | | - Rafel Ramos
- Institut Universitari d'Investigació en Atenció Primària Jordi Gol
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Ana Rito
- National Institute of Health Doutor Ricardo Jorge
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Paola Russo
- Institute of Food Sciences of the National Research Council
| | | | | | | | | | | | | | | | | | - Nader Saki
- Ahvaz Jundishapur University of Medical Sciences
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Savvas Savva
- Research and Education Institute of Child Health
| | - Mathilde Savy
- French National Research Institute for Sustainable Development
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Aletta E Schutte
- University of New South Wales
- The George Institute for Global Health
| | | | | | | | - Abhijit Sen
- Center for Oral Health Services and Research Mid-Norway
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Alfonso Siani
- Institute of Food Sciences of the National Research Council
| | | | | | | | | | | | | | | | | | | | | | | | | | - Liam Smeeth
- London School of Hygiene & Tropical Medicine
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Igor Spiroski
- Institute of Public Health
- Ss. Cyril and Methodius University
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Lela Sturua
- National Center for Disease Control and Public Health
| | | | | | | | | | | | | | | | | | | | | | | | | | - Lucjan Szponar
- National Institute of Public Health – National Institute of Hygiene
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Pierre Traissac
- French National Research Institute for Sustainable Development
| | | | | | | | - Oanh TH Trinh
- University of Medicine and Pharmacy at Ho Chi Minh City
| | | | | | | | | | | | | | | | | | | | | | - Gilad Twig
- Tel-Aviv University
- Hebrew University of Jerusalem
| | | | | | | | | | - Eunice Ugel
- Universidad Centro-Occidental Lisandro Alvarado
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Anette Varbo
- Copenhagen University Hospital
- University of Copenhagen
| | | | | | | | - Tomas Vega
- Consejería de Sanidad Junta de Castilla y León
| | | | | | | | | | | | | | | | - Lucie Viet
- National Institute for Public Health and the Environment
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Ningli Wang
- Capital Medical University Beijing Tongren Hospital
| | | | | | | | | | | | | | - Adelheid Weber
- Federal Ministry of Social Affairs, Health, Care and Consumer Protection
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Bogdan Wojtyniak
- National Institute of Public Health - National Institute of Hygiene
| | | | | | | | | | - Jean Woo
- The Chinese University of Hong Kong
| | | | | | - Jianfeng Wu
- Shandong University of Traditional Chinese Medicine
| | | | | | - Haiquan Xu
- Institute of Food and Nutrition Development of Ministry of Agriculture and Rural Affairs
| | - Liang Xu
- Beijing Institute of Ophthalmology
| | | | | | - Weili Yan
- Children's Hospital of Fudan University
| | | | | | - Yang Yang
- Shanghai Educational Development Co. Ltd
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- Peking University
- Duke University
| | | | | | - Dong Zhao
- Capital Medical University Beijing An Zhen Hospital
| | | | - Wenhua Zhao
- Chinese Center for Disease Control and Prevention
| | - Shiqi Zhen
- Jiangsu Provincial Center for Disease Control and Prevention
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- Chinese Center for Disease Control and Prevention
| | - Dan Zhu
- Inner Mongolia Medical University
| | - Marie Zins
- Institut National de la Santé et de la Recherche Médicale
- Paris University
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Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries and territories: a pooled analysis of 2181 population-based studies with 65 million participants. Lancet 2020; 396:1511-1524. [PMID: 33160572 PMCID: PMC7658740 DOI: 10.1016/s0140-6736(20)31859-6] [Citation(s) in RCA: 171] [Impact Index Per Article: 42.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 08/03/2020] [Accepted: 08/19/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND Comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents. METHODS For this pooled analysis, we used a database of cardiometabolic risk factors collated by the Non-Communicable Disease Risk Factor Collaboration. We applied a Bayesian hierarchical model to estimate trends from 1985 to 2019 in mean height and mean BMI in 1-year age groups for ages 5-19 years. The model allowed for non-linear changes over time in mean height and mean BMI and for non-linear changes with age of children and adolescents, including periods of rapid growth during adolescence. FINDINGS We pooled data from 2181 population-based studies, with measurements of height and weight in 65 million participants in 200 countries and territories. In 2019, we estimated a difference of 20 cm or higher in mean height of 19-year-old adolescents between countries with the tallest populations (the Netherlands, Montenegro, Estonia, and Bosnia and Herzegovina for boys; and the Netherlands, Montenegro, Denmark, and Iceland for girls) and those with the shortest populations (Timor-Leste, Laos, Solomon Islands, and Papua New Guinea for boys; and Guatemala, Bangladesh, Nepal, and Timor-Leste for girls). In the same year, the difference between the highest mean BMI (in Pacific island countries, Kuwait, Bahrain, The Bahamas, Chile, the USA, and New Zealand for both boys and girls and in South Africa for girls) and lowest mean BMI (in India, Bangladesh, Timor-Leste, Ethiopia, and Chad for boys and girls; and in Japan and Romania for girls) was approximately 9-10 kg/m2. In some countries, children aged 5 years started with healthier height or BMI than the global median and, in some cases, as healthy as the best performing countries, but they became progressively less healthy compared with their comparators as they grew older by not growing as tall (eg, boys in Austria and Barbados, and girls in Belgium and Puerto Rico) or gaining too much weight for their height (eg, girls and boys in Kuwait, Bahrain, Fiji, Jamaica, and Mexico; and girls in South Africa and New Zealand). In other countries, growing children overtook the height of their comparators (eg, Latvia, Czech Republic, Morocco, and Iran) or curbed their weight gain (eg, Italy, France, and Croatia) in late childhood and adolescence. When changes in both height and BMI were considered, girls in South Korea, Vietnam, Saudi Arabia, Turkey, and some central Asian countries (eg, Armenia and Azerbaijan), and boys in central and western Europe (eg, Portugal, Denmark, Poland, and Montenegro) had the healthiest changes in anthropometric status over the past 3·5 decades because, compared with children and adolescents in other countries, they had a much larger gain in height than they did in BMI. The unhealthiest changes-gaining too little height, too much weight for their height compared with children in other countries, or both-occurred in many countries in sub-Saharan Africa, New Zealand, and the USA for boys and girls; in Malaysia and some Pacific island nations for boys; and in Mexico for girls. INTERPRETATION The height and BMI trajectories over age and time of school-aged children and adolescents are highly variable across countries, which indicates heterogeneous nutritional quality and lifelong health advantages and risks. FUNDING Wellcome Trust, AstraZeneca Young Health Programme, EU.
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Barbagallo CM, Barceló A, Barkat A, Bata I, Batieha AM, Batyrbek A, Baur LA, Beaglehole R, Belavendra A, Ben Romdhane H, Benet M, Benn M, Berkinbayev S, Bernabe-Ortiz A, Bernotiene G, Bettiol H, Bhargava SK, Bi Y, Bienek A, Bikbov M, Bista B, Bjerregaard P, Bjertness E, Bjertness MB, Björkelund C, Bloch KV, Blokstra A, Bo S, Boehm BO, Boggia JG, Boissonnet CP, Bonaccio M, Bongard V, Borchini R, Borghs H, Bovet P, Brajkovich I, Breckenkamp J, Brenner H, Brewster LM, Bruno G, Bugge A, Busch MA, de León AC, Cacciottolo J, Can G, Cândido APC, Capanzana MV, Capuano E, Capuano V, Cardoso VC, Carvalho J, Casanueva FF, Censi L, Chadjigeorgiou CA, Chamukuttan S, Chaturvedi N, Chen CJ, Chen F, Chen S, Cheng CY, Cheraghian B, Chetrit A, Chiou ST, Chirlaque MD, Cho B, Cho Y, Chudek J, Claessens F, Clarke J, Clays E, Concin H, Confortin SC, Cooper C, Costanzo S, Cottel D, Cowell C, Crujeiras AB, Csilla S, Cui L, Cureau FV, D’Arrigo G, d’Orsi E, Dallongeville J, Damasceno A, Dankner R, Dantoft TM, Dauchet L, Davletov K, De Backer G, De Bacquer D, de Gaetano G, De Henauw S, de Oliveira PD, De Ridder D, De Smedt D, Deepa M, Deev AD, Dehghan A, Delisle H, Dennison E, Deschamps V, Dhimal M, Di Castelnuovo AF, Dika Z, Djalalinia S, Dobson AJ, Donfrancesco C, Donoso SP, Döring A, Dorobantu M, Dragano N, Drygas W, Du Y, Duante CA, Duda RB, Dzerve V, Dziankowska-Zaborszczyk E, Eddie R, Eftekhar E, Eggertsen R, Eghtesad S, Eiben G, Ekelund U, El Ati J, Eldemire-Shearer D, Eliasen M, Elosua R, Erasmus RT, Erbel R, Erem C, Eriksen L, Eriksson JG, Escobedo-de la Peña J, Eslami S, Esmaeili A, Evans A, Faeh D, Fall CH, Faramarzi E, Farjam M, Fattahi MR, Felix-Redondo FJ, Ferguson TS, Fernández-Bergés D, Ferrante D, Ferrari M, Ferreccio C, Ferrieres J, Föger B, Foo LH, Forslund AS, Forsner M, Fouad HM, Francis DK, do Carmo Franco M, Franco OH, Frontera G, Fujita Y, Fumihiko M, Furusawa T, Gaciong Z, Galvano F, Gao J, Garcia-de-la-Hera M, Garnett SP, Gaspoz JM, Gasull M, Gazzinelli A, Geleijnse JM, Ghanbari A, Ghasemi E, Gheorghe-Fronea OF, Ghimire A, Gianfagna F, Gill TK, Giovannelli J, Gironella G, Giwercman A, Goltzman D, Gonçalves H, Gonzalez-Chica DA, Gonzalez-Gross M, González-Rivas JP, González-Villalpando C, González-Villalpando ME, Gonzalez AR, Gottrand F, Graff-Iversen S, Grafnetter D, Gregor RD, Grodzicki T, Grøntved A, Grosso G, Gruden G, Gu D, Guallar-Castillón P, Guan OP, Gudmundsson EF, Gudnason V, Guerrero R, Guessous I, Gunnlaugsdottir J, Gupta R, Gutierrez L, Gutzwiller F, Ha S, Hadaegh F, Haghshenas R, Hakimi H, Hambleton IR, Hamzeh B, Hantunen S, Kumar RH, Hashemi-Shahri SM, Hata J, Haugsgjerd T, Hayes AJ, He J, He Y, Hendriks ME, Henriques A, Herrala S, Heshmat R, Hill AG, Ho SY, Ho SC, Hobbs M, Hofman A, Homayounfar R, Hopman WM, Horimoto ARVR, Hormiga CM, Horta BL, Houti L, Howitt C, Htay TT, Htet AS, Htike MMT, Huerta JM, Huhtaniemi IT, Huisman M, Hunsberger ML, Husseini AS, Huybrechts I, Hwalla N, Iacoviello L, Iannone AG, Ibrahim MM, Wong NI, Iglesia I, Ikeda N, Ikram MA, Iotova V, Irazola VE, Ishida T, Islam M, al-Safi Ismail A, Iwasaki M, Jacobs JM, Jaddou HY, Jafar T, James K, Jamrozik K, Janszky I, Janus E, Jarvelin MR, Jasienska G, Jelakovic A, Jelakovic B, Jennings G, Jensen GB, Jeong SL, Jha AK, Jiang CQ, Jimenez RO, Jöckel KH, Joffres M, Jokelainen JJ, Jonas JB, Jørgensen T, Joshi P, Joukar F, Józwiak J, Juolevi A, Kafatos A, Kajantie EO, Kalter-Leibovici O, Kamaruddin NA, Kamstrup PR, Karki KB, Katz J, Kauhanen J, Kaur P, Kavousi M, Kazakbaeva G, Keil U, Keinänen-Kiukaanniemi S, Kelishadi R, Keramati M, Kerimkulova A, Kersting M, Khader YS, Khalili D, Khateeb M, Kheradmand M, Khosravi A, Kiechl-Kohlendorfer U, Kiechl S, Killewo J, Kim HC, Kim J, Kim YY, Klumbiene J, Knoflach M, Ko S, Kohler HP, Kohler IV, Kolle E, Kolsteren P, König J, Korpelainen R, Korrovits P, Kos J, Koskinen S, Kouda K, Kowlessur S, Kratzer W, Kriemler S, Kristensen PL, Krokstad S, Kromhout D, Kujala UM, Kurjata P, Kyobutungi C, Laamiri FZ, Laatikainen T, Lachat C, Laid Y, Lam TH, Lambrinou CP, Lanska V, Lappas G, Larijani B, Latt TS, Laugsand LE, Lazo-Porras M, Lee J, Lee J, Lehmann N, Lehtimäki T, Levitt NS, Li Y, Lilly CL, Lim WY, Lima-Costa MF, Lin HH, Lin X, Lin YT, Lind L, Linneberg A, Lissner L, Liu J, Loit HM, Lopez-Garcia E, Lopez T, Lotufo PA, Lozano JE, Luksiene D, Lundqvist A, Lundqvist R, Lunet N, Ma G, Machado-Coelho GLL, Machado-Rodrigues AM, Machi S, Madar AA, Maggi S, Magliano DJ, Magriplis E, Mahasampath G, Maire B, Makdisse M, Malekzadeh F, Malekzadeh R, Rao KM, Manios Y, Mann JI, Mansour-Ghanaei F, Manzato E, Marques-Vidal P, Martorell R, Mascarenhas LP, Mathiesen EB, Matsha TE, Mavrogianni C, McFarlane SR, McGarvey ST, McLachlan S, McLean RM, McLean SB, McNulty BA, Mediene-Benchekor S, Mehdipour P, Mehlig K, Mehrparvar AH, Meirhaeghe A, Meisinger C, Menezes AMB, Menon GR, Merat S, Mereke A, Meshram II, Metcalf P, Meyer HE, Mi J, Michels N, Miller JC, Minderico CS, Mini GK, Miquel JF, Miranda JJ, Mirjalili MR, Mirrakhimov E, Modesti PA, Moghaddam SS, Mohajer B, Mohamed MK, Mohammad K, Mohammadi Z, Mohammadifard N, Mohammadpourhodki R, Mohan V, Mohanna S, Yusoff MFM, Mohebbi I, Mohebi F, Moitry M, Møllehave LT, Møller NC, Molnár D, Momenan A, Mondo CK, Monterrubio-Flores E, Moosazadeh M, Morejon A, Moreno LA, Morgan K, Morin SN, Moschonis G, Mossakowska M, Mostafa A, Mota J, Motlagh ME, Motta J, Msyamboza KP, Muiesan ML, Müller-Nurasyid M, Mursu J, Mustafa N, Nabipour I, Naderimagham S, Nagel G, Naidu BM, Najafi F, Nakamura H, Námešná J, Nang EEK, Nangia VB, Nauck M, Neal WA, Nejatizadeh A, Nenko I, Nervi F, Nguyen ND, Nguyen QN, Nieto-Martínez RE, Nihal T, Niiranen TJ, Ning G, Ninomiya T, Noale M, Noboa OA, Noto D, Nsour MA, Nuhoğlu I, O’Neill TW, O’Reilly D, Ochoa-Avilés AM, Oh K, Ohtsuka R, Olafsson Ö, Olié V, Oliveira IO, Omar MA, Onat A, Ong SK, Ordunez P, Ornelas R, Ortiz PJ, Osmond C, Ostojic SM, Ostovar A, Otero JA, Owusu-Dabo E, Paccaud FM, Pahomova E, Pajak A, Palmieri L, Pan WH, Panda-Jonas S, Panza F, Parnell WR, Patel ND, Peer N, Peixoto SV, Peltonen M, Pereira AC, Peters A, Petersmann A, Petkeviciene J, Peykari N, Pham ST, Pichardo RN, Pigeot I, Pilav A, Pilotto L, Piwonska A, Pizarro AN, Plans-Rubió P, Plata S, Pohlabeln H, Porta M, Portegies MLP, Poudyal A, Pourfarzi F, Poustchi H, Pradeepa R, Price JF, Providencia R, Puder JJ, Puhakka SE, Punab M, Qorbani M, Bao TQ, Radisauskas R, Rahimikazerooni S, Raitakari O, Rao SR, Ramachandran A, Ramos E, Ramos R, Rampal L, Rampal S, Redon J, Reganit PFM, Revilla L, Rezaianzadeh A, Ribeiro R, Richter A, Rigo F, Rinke de Wit TF, Rodríguez-Artalejo F, del Cristo Rodriguez-Perez M, Rodríguez-Villamizar LA, Roggenbuck U, Rojas-Martinez R, Romaguera D, Romeo EL, Rosengren A, Roy JGR, Rubinstein A, Ruidavets JB, Ruiz-Betancourt BS, Russo P, Rust P, Rutkowski M, Sabanayagam C, Sachdev HS, Sadjadi A, Safarpour AR, Safiri S, Saidi O, Saki N, Salanave B, Salmerón D, Salomaa V, Salonen JT, Salvetti M, Sánchez-Abanto J, Sans S, Santaliestra-Pasías AM, Santos DA, Santos MP, Santos R, Saramies JL, Sardinha LB, Sarrafzadegan N, Saum KU, Savva SC, Sawada N, Sbaraini M, Scazufca M, Schaan BD, Schargrodsky H, Scheidt-Nave C, Schienkiewitz A, Schipf S, Schmidt CO, Schöttker B, Schramm S, Sebert S, Sein AA, Sen A, Sepanlou SG, Servais J, Shakeri R, Shalnova SA, Shamah-Levy T, Sharafkhah M, Sharma SK, Shaw JE, Shayanrad A, Shi Z, Shibuya K, Shimizu-Furusawa H, Shin DW, Shin Y, Shirani M, Shiri R, Shrestha N, Si-Ramlee K, Siani A, Siantar R, Sibai AM, Silva DAS, Simon M, Simons J, Simons LA, Sjöström M, Skaaby T, Slowikowska-Hilczer J, Slusarczyk P, Smeeth L, Snijder MB, Söderberg S, Soemantri A, Sofat R, Solfrizzi V, Somi MH, Sonestedt E, Sørensen TIA, Jérome CS, Soumaré A, Sozmen K, Sparrenberger K, Staessen JA, Stathopoulou MG, Stavreski B, Steene-Johannessen J, Stehle P, Stein AD, Stessman J, Stevanović R, Stieber J, Stöckl D, Stokwiszewski J, Stronks K, Strufaldi MW, Suárez-Medina R, Sun CA, Sundström J, Suriyawongpaisal P, Sy RG, Sylva RC, Szklo M, Tai ES, Tamosiunas A, Tan EJ, Tarawneh MR, Tarqui-Mamani CB, Taylor A, Taylor J, Tell GS, Tello T, Thankappan KR, Thijs L, Thuesen BH, Toft U, Tolonen HK, Tolstrup JS, Topbas M, Topór-Madry R, Tormo MJ, Tornaritis MJ, Torrent M, Torres-Collado L, Traissac P, Trinh OTH, Truthmann J, Tsugane S, Tulloch-Reid MK, Tuomainen TP, Tuomilehto J, Tybjaerg-Hansen A, Tzourio C, Ueda P, Ugel E, Ulmer H, Unal B, Uusitalo HMT, Valdivia G, Valvi D, van Dam RM, van der Schouw YT, Van Herck K, Van Minh H, van Rossem L, Van Schoor NM, van Valkengoed IGM, Vanderschueren D, Vanuzzo D, Varbo A, Varona-Pérez P, Vasan SK, Vatten L, Vega T, Veidebaum T, Velasquez-Melendez G, Venero-Fernández SJ, Veronesi G, Verschuren WMM, Victora CG, Vidiawati D, Viet L, Villalpando S, Vioque J, Virtanen JK, Visvikis-Siest S, Viswanathan B, Vlasoff T, Vollenweider P, Voutilainen A, Wade AN, Wagner A, Walton J, Bebakar WMW, Mohamud WNW, Wang MD, Wang N, Wang Q, Wang YX, Wang YW, Wannamethee SG, Wedderkopp N, Wei W, Whincup PH, Widhalm K, Widyahening IS, Wiecek A, Wijga AH, Wilks RJ, Willeit J, Willeit P, Wilsgaard T, Wojtyniak B, Wong-McClure RA, Wong A, Wong TY, Woo J, Woodward M, Wu FC, Wu S, Xu H, Xu L, Yan W, Yang X, Yasuharu T, Ye X, Yeow TP, Yiallouros PK, Yoosefi M, Yoshihara A, You SL, Younger-Coleman NO, Yusoff AF, Zainuddin AA, Zakavi SR, Zali MR, Zamani F, Zambon S, Zampelas A, Zaw KK, Zdrojewski T, Vrkic TZ, Zhang ZY, Zhao W, Zhen S, Zheng Y, Zholdin B, Zhussupov B, Zoghlami N, Cisneros JZ, Gregg EW, Ezzati M. Repositioning of the global epicentre of non-optimal cholesterol. Nature 2020; 582:73-77. [PMID: 32494083 PMCID: PMC7332422 DOI: 10.1038/s41586-020-2338-1] [Citation(s) in RCA: 111] [Impact Index Per Article: 27.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 04/02/2020] [Indexed: 11/25/2022]
Abstract
High blood cholesterol is typically considered a feature of wealthy western countries1,2. However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world3 and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health4,5. However, the trends of HDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low- and middle-income countries, especially in east and southeast Asia, and decreases in high-income western countries, especially those in northwestern Europe, and in central and eastern Europe. As a result, countries with the highest level of non-HDL cholesterol-which is a marker of cardiovascular risk-changed from those in western Europe such as Belgium, Finland, Greenland, Iceland, Norway, Sweden, Switzerland and Malta in 1980 to those in Asia and the Pacific, such as Tokelau, Malaysia, The Philippines and Thailand. In 2017, high non-HDL cholesterol was responsible for an estimated 3.9 million (95% credible interval 3.7 million-4.2 million) worldwide deaths, half of which occurred in east, southeast and south Asia. The global repositioning of lipid-related risk, with non-optimal cholesterol shifting from a distinct feature of high-income countries in northwestern Europe, north America and Australasia to one that affects countries in east and southeast Asia and Oceania should motivate the use of population-based policies and personal interventions to improve nutrition and enhance access to treatment throughout the world.
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Cheng L, Pohlabeln H, Ahrens W, Lauria F, Veidebaum T, Chadjigeorgiou C, Molnár D, Eiben G, Michels N, Moreno LA, Page AS, Pitsiladis Y, Hebestreit A. Cross-sectional and longitudinal associations between physical activity, sedentary behaviour and bone stiffness index across weight status in European children and adolescents. Int J Behav Nutr Phys Act 2020; 17:54. [PMID: 32345301 PMCID: PMC7189536 DOI: 10.1186/s12966-020-00956-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 04/13/2020] [Indexed: 12/15/2022] Open
Abstract
Background The associations between physical activity (PA), sedentary behaviour (SB) and bone health may be differentially affected by weight status during growth. This study aims to assess the cross-sectional and longitudinal associations between PA, SB and bone stiffness index (SI) in European children and adolescents, taking the weight status into consideration. Methods Calcaneus SI was first measured by quantitative ultrasound among children aged 2–9 years old in 2007/08. It was measured again after 2 years in the IDEFICS study and after 6 years in the I. Family study. A sample of 2008 participants with time spent at sports clubs, watching TV and playing computer/games self-reported by questionnaire, and a subsample of 1037 participants with SB, light PA (LPA) and moderate-to-vigorous PA (MVPA) objectively measured using Actigraph accelerometers were included in the analyses. Weight status was defined as thin/normal and overweight/obese according to the extended International Obesity Task Force criteria. Linear mixed-effects models were used to estimate the cross-sectional and longitudinal associations between PA, SB and SI percentiles, stratified by weight status. Results The cross-sectional association between weekly duration of watching TV and SI percentiles was negative in thin/normal weight group (β = − 0.35, p = 0.008). However, baseline weekly duration of watching TV (β = − 0.63, p = 0.021) and change after 2 years (β = − 0.63, p = 0.022) as well as the change in weekly duration of playing computer/games after 6 years (β = − 0.75, p = 0.019) were inversely associated with corresponding changes in SI percentiles in overweight/obese group. Change in time spent at sports clubs was positively associated with change in SI percentiles after 2 years (β = 1.28, p = 0.001), with comparable effect sizes across weight status. In the subsample with accelerometer data, we found a positive cross-sectional association between MVPA and SI percentiles in thin/normal weight group. Baseline MVPA predicted changes in SI percentiles after 2 and 6 years in all groups. Conclusions Our results suggested the beneficial effect of PA on SI. However, the increasing durations of screen-based SB might be risk factors for SI development, especially in overweight/obese children and adolescents.
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Affiliation(s)
- Lan Cheng
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstraße 30, 28359, Bremen, Germany.,Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany
| | - Hermann Pohlabeln
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstraße 30, 28359, Bremen, Germany
| | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstraße 30, 28359, Bremen, Germany.,Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany
| | - Fabio Lauria
- Institute of Food Sciences, National Research Council, Avellino, Italy
| | - Toomas Veidebaum
- Department of Chronic Diseases, National Institute for Health Development, Tallinn, Estonia
| | | | - Dénes Molnár
- Department of Pediatrics, Medical School, University of Pécs, Pécs, Hungary
| | - Gabriele Eiben
- Department of Public Health, School of Health Sciences, University of Skövde, Skövde, Sweden
| | - Nathalie Michels
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, 9000, Ghent, Belgium
| | - Luis A Moreno
- 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, 50009, Zaragoza, Spain
| | - Angie S Page
- Centre for Exercise, Nutrition & Health Sciences, University of Bristol, Bristol, UK
| | - Yannis Pitsiladis
- Collaborating Centre of Sports Medicine, University of Brighton, Brighton, UK
| | - Antje Hebestreit
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstraße 30, 28359, Bremen, Germany.
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Steene-Johannessen J, Hansen BH, Dalene KE, Kolle E, Northstone K, Møller NC, Grøntved A, Wedderkopp N, Kriemler S, Page AS, Puder JJ, Reilly JJ, Sardinha LB, van Sluijs EMF, Andersen LB, van der Ploeg H, Ahrens W, Flexeder C, Standl M, Shculz H, Moreno LA, De Henauw S, Michels N, Cardon G, Ortega FB, Ruiz J, Aznar S, Fogelholm M, Decelis A, Olesen LG, Hjorth MF, Santos R, Vale S, Christiansen LB, Jago R, Basterfield L, Owen CG, Nightingale CM, Eiben G, Polito A, Lauria F, Vanhelst J, Hadjigeorgiou C, Konstabel K, Molnár D, Sprengeler O, Manios Y, Harro J, Kafatos A, Anderssen SA, Ekelund U. Variations in accelerometry measured physical activity and sedentary time across Europe - harmonized analyses of 47,497 children and adolescents. Int J Behav Nutr Phys Act 2020; 17:38. [PMID: 32183834 PMCID: PMC7079516 DOI: 10.1186/s12966-020-00930-x] [Citation(s) in RCA: 139] [Impact Index Per Article: 34.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 02/12/2020] [Indexed: 12/24/2022] Open
Abstract
Background Levels of physical activity and variation in physical activity and sedentary time by place and person in European children and adolescents are largely unknown. The objective of the study was to assess the variations in objectively measured physical activity and sedentary time in children and adolescents across Europe. Methods Six databases were systematically searched to identify pan-European and national data sets on physical activity and sedentary time assessed by the same accelerometer in children (2 to 9.9 years) and adolescents (≥10 to 18 years). We harmonized individual-level data by reprocessing hip-worn raw accelerometer data files from 30 different studies conducted between 1997 and 2014, representing 47,497 individuals (2–18 years) from 18 different European countries. Results Overall, a maximum of 29% (95% CI: 25, 33) of children and 29% (95% CI: 25, 32) of adolescents were categorized as sufficiently physically active. We observed substantial country- and region-specific differences in physical activity and sedentary time, with lower physical activity levels and prevalence estimates in Southern European countries. Boys were more active and less sedentary in all age-categories. The onset of age-related lowering or leveling-off of physical activity and increase in sedentary time seems to become apparent at around 6 to 7 years of age. Conclusions Two third of European children and adolescents are not sufficiently active. Our findings suggest substantial gender-, country- and region-specific differences in physical activity. These results should encourage policymakers, governments, and local and national stakeholders to take action to facilitate an increase in the physical activity levels of young people across Europe.
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Affiliation(s)
- Jostein Steene-Johannessen
- Department of Sports Medicine, Norwegian School of Sport Sciences, PO Box 4014, Ullevål Stadion, 0806, Oslo, Norway.
| | - Bjørge Herman Hansen
- Department of Sports Medicine, Norwegian School of Sport Sciences, PO Box 4014, Ullevål Stadion, 0806, Oslo, Norway
| | - Knut Eirik Dalene
- Department of Sports Medicine, Norwegian School of Sport Sciences, PO Box 4014, Ullevål Stadion, 0806, Oslo, Norway
| | - Elin Kolle
- Department of Sports Medicine, Norwegian School of Sport Sciences, PO Box 4014, Ullevål Stadion, 0806, Oslo, Norway
| | - Kate Northstone
- Population Health Sciences, Bristol Medical School, Bristol, UK
| | - Niels Christian Møller
- Research Unit for Exercise Epidemiology and Centre of Research in Childhood Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Anders Grøntved
- Research Unit for Exercise Epidemiology and Centre of Research in Childhood Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Niels Wedderkopp
- Research Unit for Exercise Epidemiology and Centre of Research in Childhood Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Susi Kriemler
- Epidemiology, Biostatistcs and Prevention Institute, University Zürich, Zürich, Switzerland
| | - Angie S Page
- Centre for Exercise, Nutrition and Health Sciences, University of Bristol, Bristol, UK
| | - Jardena J Puder
- Obstetric service, Lausanne University Hospital, Lausanne, Switzerland
| | - John J Reilly
- Physical Activity for Health Group, School of Psychological Sciences and Health, University of Strathclyde, Glasgow, Scotland
| | - Luis B Sardinha
- Portugal, Exercise and Health Laboratory, Faculty of Human Kinetics, Universidade de Lisboa, Lisbon, Portugal
| | - Esther M F van Sluijs
- Centre for Diet and Activity Research (CEDAR) & MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Lars Bo Andersen
- Department of Sport, Food and Natural Sciences, Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Sogndal, Norway
| | - Hidde van der Ploeg
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, Netherlands
| | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Claudia Flexeder
- Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology, Neuherberg, Germany
| | - Marie Standl
- Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology, Neuherberg, Germany
| | - Holger Shculz
- Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology, Neuherberg, Germany
| | - Luis A Moreno
- GENUD research group, Facultad de Ciencias de la Salud, Universidad de Zaragoza, Insituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón), Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Zaragoza, Spain
| | - Stefaan De Henauw
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Nathalie Michels
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Greet Cardon
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | | | - Jonatan Ruiz
- School of Sport Sciences, University of Granada, Granada, Spain
| | - Susana Aznar
- PAFS Research group, Faculty of Sports Sciences, UCLM, Ciudad Real, Spain
| | - Mikael Fogelholm
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Andrew Decelis
- Institute for Physical Education and Sport, University of Malta, Msida, Malta
| | - Line Grønholt Olesen
- Research Unit for Exercise Epidemiology and Centre of Research in Childhood Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Mads Fiil Hjorth
- Department of Nutrition, Exercise and Sports Unit for obesity research Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Rute Santos
- Faculty of Sport, University of Porto, Porto, Portugal
| | - Susana Vale
- Department of Sport Science, High School of Education, Polytechnic Institute of Porto, Porto, Portugal
| | - Lars Breum Christiansen
- Research Unit for Exercise Epidemiology and Centre of Research in Childhood Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Russ Jago
- Centre for Exercise, Nutrition and Health Sciences, University of Bristol, Bristol, UK
| | - Laura Basterfield
- Institute of Health & Society and Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, UK
| | - Christopher G Owen
- Population Health Research Institute, St George's, University of London, London, UK
| | - Claire M Nightingale
- Population Health Research Institute, St George's, University of London, London, UK
| | - Gabriele Eiben
- Department of Biomedicine and Public Health, School of Health and Education, University of Skövde, Skövde, Sweden
| | - Angela Polito
- CREA Research Centre for Food and Nutrition, Rome, Italy
| | - Fabio Lauria
- National Research Council, Institute of Food Sciences, Avellino, Italy
| | - Jeremy Vanhelst
- Inserm, CHU Lille,U995 - LIRIC - Lille Inflammation Research International Center, CIC 1403 - Clinical Investigation Centre, University of Lille, F-59000, Lille, France
| | | | - Kenn Konstabel
- National Institute for Health Development, Tervise Arengu Instituut, Tallin, Estonia
| | - Dénes Molnár
- University of Pecs, Medical Faculty, Pécs, Hungary
| | - Ole Sprengeler
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Yannis Manios
- Department of Nutrition & Dietetics, Harokopio University, Athens, Greece
| | - Jaanus Harro
- Department of Psychology, Estonian Centre of Behavioural and Health Sciences, University of Tartu, Tartu, Estonia
| | | | - Sigmund Alfred Anderssen
- Department of Sports Medicine, Norwegian School of Sport Sciences, PO Box 4014, Ullevål Stadion, 0806, Oslo, Norway
| | - Ulf Ekelund
- Department of Sports Medicine, Norwegian School of Sport Sciences, PO Box 4014, Ullevål Stadion, 0806, Oslo, Norway
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Santaliestra-Pasías AM, González-Gil EM, Pala V, Intemann T, Hebestreit A, Russo P, Van Aart C, Rise P, Veidebaum T, Molnar D, Tornaritis M, Eiben G, Moreno LA. Predictive associations between lifestyle behaviours and dairy consumption: The IDEFICS study. Nutr Metab Cardiovasc Dis 2020; 30:514-522. [PMID: 31791633 DOI: 10.1016/j.numecd.2019.10.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 09/29/2019] [Accepted: 10/07/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND AIM Physical activity (PA) and sedentary behaviours (SB) are related to obesity and cardiometabolic risk; however, the literature is controversial regarding the effect of dairy consumption on the development of cardiovascular disease (CVD) risk factors. The aim of this study was to assess longitudinally the relationship between specific lifestyle behaviours (PA and SB) and dairy consumption in a sample of European children and adolescents. METHODS AND RESULTS Children from the IDEFICS study were included in the analyses. Two measurements, with 2 years' interval, were conducted. A total of 1688 (50.8% boys) children provided information regarding diet, measured by a 24-h dietary recall, PA measured by accelerometers and parent-reported sedentary screen time (SST) at both time points. Different combinations of these behaviours, at each survey and over time, were derived applying specific recommendations. Multilevel ordinal logistic regression and analysis of covariance were used to assess their association with dairy consumption, adjusted for potential confounders. Differences by gender were found regarding dairy product consumption and also adherence to SB and PA recommendations at T0 and T1. Children meeting both lifestyle recommendations, at the two measurement points, had higher probability to consume more milk and yogurt and less cheese than the rest of combinations. CONCLUSIONS These results suggest that European children with a healthy lifestyle, especially regarding PA and SB over time, consumed more milk and yogurt. This study suggests that the protective effect of specific dairy products found in literature could be partially due to the association of their consumption with specific healthy lifestyles.
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Affiliation(s)
- Alba M Santaliestra-Pasías
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Universidad de Zaragoza, Spain; Instituto Agroalimentario de Aragón (IA2), Spain; Instituto de Investigación Sanitaria Aragón (IIS Aragón), Spain; Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Spain.
| | - Esther M González-Gil
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Universidad de Zaragoza, Spain; Instituto Agroalimentario de Aragón (IA2), Spain; Instituto de Investigación Sanitaria Aragón (IIS Aragón), Spain; Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Spain; Institute of Nutrition and Food Technology, Department of Biochemistry and Molecular Biology II, University of Granada, Spain
| | - Valeria Pala
- Department of Research, Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Timm Intemann
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany; Institute of Statistics, University of Bremen, Bremen, Germany
| | - Antje Hebestreit
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Paola Russo
- Institute of Food Sciences, National Research Council, Avellino, Italy
| | - Carola Van Aart
- Department of Public Health, Ghent University, Ghent, Belgium
| | - Patrizia Rise
- Department of Pharmacological Sciences, University of Milan, Milan, Italy
| | - Toomas Veidebaum
- National Institute for Health Development, Estonian Centre of Behavioral and Health Sciences, Tallinn, Estonia
| | - Denes Molnar
- Department of Paediatrics, University of Pécs, Pécs, Hungary
| | | | - Gabriele Eiben
- Section for Epidemiology and Social Medicine (EPSO), University of Gothenburg, Sweden; Department of Biomedicine and Public Health, University of Skövde, Skövde, Sweden
| | - Luis A Moreno
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Universidad de Zaragoza, Spain; Instituto Agroalimentario de Aragón (IA2), Spain; Instituto de Investigación Sanitaria Aragón (IIS Aragón), Spain; Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Spain
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21
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Cheng L, Pohlabeln H, Ahrens W, Russo P, Veidebaum T, Chadjigeorgiou C, Molnár D, Eiben G, De Henauw S, Moreno L, Page A, Hebestreit A. Sex differences in the longitudinal associations between body composition and bone stiffness index in European children and adolescents. Bone 2020; 131:115162. [PMID: 31760215 DOI: 10.1016/j.bone.2019.115162] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 10/20/2019] [Accepted: 11/20/2019] [Indexed: 10/25/2022]
Abstract
Fat mass (FM) and fat free mass (FFM) may influence bone health differentially. However, existing evidences on associations between FM, FFM and bone health are inconsistent and vary according to sex and maturity. The present study aims to evaluate longitudinal associations between FM, FFM and bone stiffness index (SI) among European children and adolescents with 6 years follow-up. A sample of 2468 children from the IDEFICS/I.Family was included, with repeated measurements of SI using calcaneal quantitative ultrasound, body composition using skinfold thickness, sedentary behaviors and physical activity using self-administrated questionnaires. Regression coefficients (β) and 99%-confidence intervals (99% CI) were calculated by sex-specified generalized linear mixed effects models to analyze the longitudinal associations between FM and FFM z-scores (zFM and zFFM) and SI percentiles, and to explore the possible interactions between zFM, zFFM and maturity. Baseline zFFM was observed to predict the change in SI percentiles in both boys (β = 4.57, 99% CI: 1.36, 7.78) and girls (β = 3.42, 99% CI: 0.05, 6.79) after 2 years. Moreover, baseline zFFM (β = 8.72, 99% CI: 3.18, 14.27 in boys and β = 5.89, 99% CI: 0.34, 11.44 in girls) and the change in zFFM (β = 6.58, 99% CI: 0.83, 12.34 in boys and β = 4.81, 99% CI: -0.41, 10.02 in girls) were positively associated with the change in SI percentiles after 6 years. In contrast, a negative association was observed between the change in zFM and SI percentiles in boys after 6 years (β = -3.70, 99% CI: -6.99, -0.42). Besides, an interaction was observed between the change in zFM and menarche on the change in SI percentiles in girls at 6 years follow-up (p = .009), suggesting a negative association before menarche while a positive association after menarche. Our findings support the existing evidences for a positive relationship between FFM and SI during growth. Furthermore, long-term FM gain was inversely associated with SI in boys, whereas opposing associations were observed across menarche in girls.
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Affiliation(s)
- Lan Cheng
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany; Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany
| | - Hermann Pohlabeln
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany; Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany
| | - Paola Russo
- Institute of Food Sciences, National Research Council, Avellino, Italy
| | - Toomas Veidebaum
- Department of Chronic Diseases, National Institute for Health Development, Tallinn, Estonia
| | | | - Dénes Molnár
- Department of Pediatrics, Medical School, University of Pécs, Pécs, Hungary
| | - Gabriele Eiben
- Department of Biomedicine and Public Health, School of Health and Education, University of Skövde, Skövde, Sweden
| | | | - Luis Moreno
- 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, 50009 Zaragoza, Spain
| | - Angie Page
- Centre for Exercise, Nutrition & Health Sciences, University of Bristol, Bristol, UK
| | - Antje Hebestreit
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.
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22
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Buck C, Eiben G, Lauria F, Konstabel K, Page A, Ahrens W, Pigeot I. Urban Moveability and physical activity in children: longitudinal results from the IDEFICS and I.Family cohort. Int J Behav Nutr Phys Act 2019; 16:128. [PMID: 31829198 PMCID: PMC6907228 DOI: 10.1186/s12966-019-0886-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 11/15/2019] [Indexed: 01/29/2023] Open
Abstract
Background Physical activity (PA) is one of the major protective behaviours to prevent non-communicable diseases. Positive effects of the built environment on PA are well investigated, although evidence of this association is mostly based on cross-sectional studies. The present study aims to investigate the longitudinal effects of built environment characteristics in terms of a moveability index on PA of children in their transition phase to adolescence using data of the IDEFICS/I.Family cohort. Methods We used data on 3394 accelerometer measurements of 2488 children and adolescents aged 3 to 15 years old from survey centres of three countries, Germany, Italy, and Sweden, who participated in up to three surveys over 6 years. In network-dependent home neighbourhoods, a moveability index was calculated based on residential density, land use mix, street connectivity, availability of public transport and public open spaces such as green spaces and public playgrounds in order to quantify opportunities for PA of children and adolescents. Linear trajectories of light PA (LPA) and moderate-to-vigorous PA (MVPA) were estimated using linear mixed models accounting for repeated measurements nested within individuals. Least squares means were estimated to quantify differences in trajectories over age. Results LPA and MVPA declined annually with age by approximately 20 min/day and 2 min/day respectively. In girls, the moveability index showed a consistent significantly positive effect on MVPA (\documentclass[12pt]{minimal}
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\begin{document}$$ \hat{\beta} $$\end{document}β^ = 2.14, 95% CI: (0.11; 4.16)) for all ages, while in boys the index significantly lessened the decline in LPA with age for each year. (\documentclass[12pt]{minimal}
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\begin{document}$$ \hat{\beta} $$\end{document}β^ = 2.68, 95% CI: (0.46; 4.90)). Availability of public open spaces was more relevant for MVPA in girls and LPA in boys during childhood, whereas in adolescence, residential density and intersection density became more important. Conclusion Built environment characteristics are important determinants of PA and were found to have a supportive effect that ameliorates the decline in PA during the transition phase from childhood to adolescence. In childhood environmental support for leisure time PA through public open spaces was found to be the most protective factor whereas in adolescence the positive influence of street connectivity and residential density was most supportive of physical activity.
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Affiliation(s)
- Christoph Buck
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstraße 30, 28359, Bremen, Germany.
| | - Gabriele Eiben
- Section for Epidemiology and Social Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Biomedicine and Public Health, School of Health and Education, University of Skövde, Skövde, Sweden
| | - Fabio Lauria
- National Research Council, Institute of Food Sciences, Avellino, Italy
| | - Kenn Konstabel
- National Institute for Health Development, Tallinn, Estonia
| | - Angie Page
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, Bristol, UK.,NIHR Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK
| | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstraße 30, 28359, Bremen, Germany.,Faculty of Mathematics/Computer Science, University of Bremen, Bremen, Germany
| | - Iris Pigeot
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstraße 30, 28359, Bremen, Germany.,Faculty of Mathematics/Computer Science, University of Bremen, Bremen, Germany
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23
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Samuelsson J, Rothenberg E, Lissner L, Eiben G, Zettergren A, Skoog I. Time trends in nutrient intake and dietary patterns among five birth cohorts of 70-year-olds examined 1971-2016: results from the Gothenburg H70 birth cohort studies, Sweden. Nutr J 2019; 18:66. [PMID: 31694635 PMCID: PMC6836447 DOI: 10.1186/s12937-019-0493-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 10/14/2019] [Indexed: 01/03/2023] Open
Abstract
Background Nutrition is a key factor in healthy ageing but there are still gaps in knowledge about risk- and protective factors linking diet and healthy ageing. The aim of this study was to investigate time trends in dietary patterns and nutrient intake in an older population, in order to increase the understanding of whether dietary recommendations are followed and if nutrient needs are met. Methods Cross-sectional data was derived from five samples of 70-year-olds examined 1971–72, 1981–83, 1992–93, 2000–02 and 2014–16 from the Gothenburg H70 birth cohort studies in Sweden. A total of 2246 individuals (56% women) participated. Dietary intake was determined by the diet history method, which is an interview including questions on usual frequencies and portion sizes of food intake during the preceding three months. Recommended values of nutrient intake and determinants of healthful dietary patterns were based on the Nordic Nutrition Recommendations 2012. Statistical analyses were performed using general linear models, student’s t-test and chi-square test, stratified by sex. Results The intake of fruits and vegetables, fish and seafood, whole grain products and nuts and seeds increased during the study period (p < 0.0001), among both sexes. However, there was also an increase in alcohol intake (p < 0.0001), especially from wine and beer, and in 2014–16 more than 30% had an alcohol intake above recommendations. Protein intake increased (p < 0.0001 for women and p = 0.0004 for men), and 48% of the women and 37% of the men had a protein intake above recommended 1.2 g/kg body weight and day in 2014–16. The proportion of participants at risk of inadequate intake of vitamins C, D and folate decreased during the study period, among both sexes (p < 0.0001). However, vitamin D intake from diet was still below average requirement level of 7.5 μg/day for 49% of the women and 32% of the men in 2014–16. Conclusions Dietary patterns have changed among 70-year-olds during the past five decades, with an increase in healthful foods and a higher nutrient density in later born birth cohorts. However, the intake of alcohol increased, especially among women. Results from this study can be useful as a basis for dietary guidelines and used for prevention strategies involving older adults in population-based and health care settings.
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Affiliation(s)
- Jessica Samuelsson
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health (AgeCap) at the University of Gothenburg, Gothenburg, Sweden.
| | | | - Lauren Lissner
- Department of Community Medicine and Public Health, at the University of Gothenburg, Gothenburg, Sweden
| | - Gabriele Eiben
- Department of Biomedicine and Public Health, University of Skövde, Skövde, Sweden
| | - Anna Zettergren
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health (AgeCap) at the University of Gothenburg, Gothenburg, Sweden
| | - Ingmar Skoog
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health (AgeCap) at the University of Gothenburg, Gothenburg, Sweden
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van Meer F, van der Laan LN, Eiben G, Lissner L, Wolters M, Rach S, Herrmann M, Erhard P, Molnar D, Orsi G, Viergever MA, Adan RA, Smeets PA. Development and body mass inversely affect children’s brain activation in dorsolateral prefrontal cortex during food choice. Neuroimage 2019; 201:116016. [DOI: 10.1016/j.neuroimage.2019.116016] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Revised: 06/17/2019] [Accepted: 07/11/2019] [Indexed: 01/21/2023] Open
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Jilani H, Pohlabeln H, De Henauw S, Eiben G, Hunsberger M, Molnar D, Moreno LA, Pala V, Russo P, Solea A, Veidebaum T, Ahrens W, Hebestreit A, Idefics And I Family Consortia OBOT. Relative Validity of a Food and Beverage Preference Questionnaire to Characterize Taste Phenotypes in Children Adolescents and Adults. Nutrients 2019; 11:E1453. [PMID: 31252542 PMCID: PMC6682919 DOI: 10.3390/nu11071453] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 06/19/2019] [Accepted: 06/23/2019] [Indexed: 11/17/2022] Open
Abstract
To assess the relative validity of our food and beverage preference questionnaire we investigated the association between sweet and fatty taste preference scores (assessed using a food and beverage preference questionnaire) and sweet and fatty food propensity scores (derived from a food frequency questionnaire). In I.Family, a large European multi-country cohort study, 12,207 participants from Cyprus, Estonia, Germany, Hungary, Italy, Spain and Sweden, including 5291 adults, 3082 adolescents, and 3834 children, completed a food and beverage preference questionnaire with 63 items. Cumulative preference scores for sweet and fatty taste were calculated from the single item ranking ranging from 1 to 5. The relative consumption frequency of foods classified as sweet and fatty was used to calculate the corresponding consumption propensities, a continuous variable ranging from 0 to 100. We conducted regression analyses to investigate the association between sweet and fatty taste preference scores and sweet and fatty food propensity scores, respectively, separately for adults, adolescents ≥12 years, and for children <12 years. The overall sweet taste preference score was positively associated with the sweet food consumption propensity score (β = 2.4, 95% CI: 2.1;2.7) and the fatty taste preference score was positively associated with the fatty food consumption propensity score (β = 2.0, 95% CI: 1.8;2.2). After stratification for age (children <12 years, adolescents ≥12 years, and adults), the effect remained significant in all age groups and was strongest in adolescents and adults. We conclude that our food and beverage preference questionnaire is a useful instrument for epidemiological studies on sensory perception and health outcomes and for the characterization of sensory taste phenotypes.
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Affiliation(s)
- Hannah Jilani
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, 28359 Bremen, Germany
- Institute for Public Health and Nursing Science, University of Bremen, 28359 Bremen, Germany
| | - Hermann Pohlabeln
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, 28359 Bremen, Germany
| | - Stefaan De Henauw
- Department of Public Health, Ghent University, B-9000 Ghent, Belgium
| | - Gabriele Eiben
- Department of Biomedicine and Public Health, School of Health and Education, University of Skövde, 54128 Skövde, Sweden
| | - Monica Hunsberger
- Department of Public Health and Community Medicine, University of Gothenburg, 40530 Gothenburg, Sweden
| | - Dénes Molnar
- Department of Pediatrics, Medical School, University of Pécs, 7623 Pécs, Hungary
| | - Luis A Moreno
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Faculty of Health Sciences, University of Zaragoza, 50009 Zaragoza, Spain
| | - Valeria Pala
- Department of Research, Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan Italy
| | - Paola Russo
- Institute of Food Sciences, National Research Council, 83100 Avellino, Italy
| | - Antonia Solea
- Research and Education Institute of Child Health, 2035 Strovolos, Cyprus
| | - Toomas Veidebaum
- Department of Chronic Diseases, National Institute for Health Development, 11619 Tallin, Estonia
| | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, 28359 Bremen, Germany
- Institute of Statistics, Faculty of Mathematics and Computer Science, University of Bremen, 28359 Bremen, Germany
| | - Antje Hebestreit
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, 28359 Bremen, Germany.
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Sina E, Buck C, Jilani H, Tornaritis M, Veidebaum T, Russo P, Moreno LA, Molnar D, Eiben G, Marild S, Pala V, Ahrens W, Hebestreit A. Association of Infant Feeding Patterns with Taste Preferences in European Children and Adolescents: A Retrospective Latent Profile Analysis. Nutrients 2019; 11:E1040. [PMID: 31075915 PMCID: PMC6566792 DOI: 10.3390/nu11051040] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Revised: 05/04/2019] [Accepted: 05/06/2019] [Indexed: 12/12/2022] Open
Abstract
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.
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Affiliation(s)
- Elida Sina
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, Achterstr. 30, 28359 Bremen, Germany.
| | - Christoph Buck
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, Achterstr. 30, 28359 Bremen, Germany.
| | - Hannah Jilani
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, Achterstr. 30, 28359 Bremen, Germany.
- Institute for Public Health and Nursing Research-IPP, University of Bremen, 28359 Bremen, Germany.
| | - Michael Tornaritis
- Research and Education Institute of Child Health, 2035 Lefcosia, Cyprus.
| | - Toomas Veidebaum
- Department of Chronic Diseases, National Institute for Health Development, 11619 Tallin, Estonia.
| | - Paola Russo
- Institute of Food Sciences, National Research Council, 83100 Avellino, Italy.
| | - Luis A Moreno
- 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, 50009 Zaragoza, Spain.
| | - Denes Molnar
- Department of Pediatrics, Medical School, University of Pécs, 7623 Pécs, Hungary.
| | - Gabriele Eiben
- Department of Biomedicine and Public Health, School of Health and Education, University of Skövde, 54128 Skövde, Sweden.
| | - Staffan Marild
- Department. of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, 40530 Gothenburg, Sweden.
| | - Valeria Pala
- Department of Preventive and Predictive Medicine, Fondazione IRCCS, Istituto Nazionale dei Tumori, 20133 Milan, Italy.
| | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, Achterstr. 30, 28359 Bremen, Germany.
- Faculty of Mathematics/Computer Science, University of Bremen, 28359 Bremen, Germany.
| | - Antje Hebestreit
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, Achterstr. 30, 28359 Bremen, Germany.
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Graffe MIM, Pala V, De Henauw S, Eiben G, Hadjigeorgiou C, Iacoviello L, Intemann T, Jilani H, Molnar D, Russo P, Veidebaum T, Moreno LA. Dietary sources of free sugars in the diet of European children: the IDEFICS Study. Eur J Nutr 2019; 59:979-989. [PMID: 30949765 DOI: 10.1007/s00394-019-01957-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 03/25/2019] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To report dietary free sugars consumption and their different types and food sources in European children. METHODS The present study is based on the IDEFICS study, a European multicenter cohort study in children (2-9 years old) from eight countries, comprising 8308 children (51.4% males). Dietary intake of the previous 24 h was assessed using a computer-assisted 24-h dietary recalls (24-HDR) and the different types of sugars were assessed using the German food composition database. RESULTS Mean total energy intake was 1720 (SD 477) kcal/d for boys and 1631 (SD 451) kcal/d for girls. Total sugars intake was 98 (SD 52) g/day for boys and 93 (SD 49) g/day for girls. Free sugars intake was 81 (SD 49) g/day for boys and 77 (SD 47) g/day for girls. Girls had significantly lower intakes of energy, total and free sugars compared with than boys but did not differ in terms of percent of energy from total (23%) or free sugars (18%). There were large variations between countries in average % energy from free sugars (ranging from 13% in Italy to 27% in Germany). Less than 20% of children were within the recommended intake of 10% of energy from free sugars. The food groups that contributed substantially to free sugars intakes were "Fruit juices", "Soft drinks", "Dairy" and "Sweets and candies". CONCLUSIONS The contribution of free sugars to total energy intake in European children is higher than recommendations. The main food contributors to free sugars intake are sweetened beverages ("Fruit juices" and "Soft drinks"). It is especially important to reduce children's intake of free sugars, focusing in target population on certain foods and food groups.
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Affiliation(s)
- María Isabel Mesana Graffe
- Growth, Exercise, NUtrition and Development (GENUD) Research Group, University of Zaragoza, C/Pedro Cerbuna 12, 50009, Saragossa, Spain. .,Instituto Agroalimentario de Aragón (IA2), Saragossa, Spain. .,Instituto de Investigación Sanitaria Aragón (IIS Aragón), Saragossa, Spain. .,Red de Salud Materno-infantil y del Desarrollo (SAMID), Barakaldo, Spain.
| | - V Pala
- Epidemiology and Prevention Unit, Department of Research, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - S De Henauw
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - G Eiben
- Section for Epidemiology and Social Medicine, Institute of Medicine Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Biomedicine and Public Health, School of Health and Education, University of Skövde, Skövde, Sweden
| | - C Hadjigeorgiou
- Research and Education Institute of Child Health, Strovolos, Cyprus
| | - L Iacoviello
- Laboratory of Molecular and Nutritional Epidemiology, Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli, IS, Italy
| | - T Intemann
- Department of Epidemiological Methods and Etiological Research, Leibniz Institute for Prevention Research and Epidemiology, BIPS, Bremen, Germany.,Institute for Public Health and Nursing- IPP, Bremen University, Bremen, Germany
| | - H Jilani
- Department of Epidemiological Methods and Etiological Research, Leibniz Institute for Prevention Research and Epidemiology, BIPS, Bremen, Germany.,Institute for Public Health and Nursing- IPP, Bremen University, Bremen, Germany
| | - D Molnar
- Department of Paediatrics, Medical Faculty, University of Pécs, Pecs, Hungary
| | - P Russo
- Institute of Food Sciences, National Research Council, Avellino, Italy
| | - T Veidebaum
- National Institute for Health Development, Tallinn, Estonia
| | - L A Moreno
- Growth, Exercise, NUtrition and Development (GENUD) Research Group, University of Zaragoza, C/Pedro Cerbuna 12, 50009, Saragossa, Spain.,Instituto Agroalimentario de Aragón (IA2), Saragossa, Spain.,Instituto de Investigación Sanitaria Aragón (IIS Aragón), Saragossa, Spain.,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Madrid, Spain
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Oli N, Vaidya A, Eiben G, Krettek A. 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) trial. Glob Health Action 2019; 12:1670033. [PMID: 31573416 PMCID: PMC6781231 DOI: 10.1080/16549716.2019.1670033] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 09/17/2019] [Indexed: 11/24/2022] Open
Abstract
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.
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Affiliation(s)
- Natalia Oli
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
- Department of Community Medicine, Kathmandu Medical College, Kathmandu, Nepal
| | - Abhinav Vaidya
- Department of Community Medicine, Kathmandu Medical College, Kathmandu, Nepal
| | - Gabriele Eiben
- Department of Biomedicine and Public Health, School of Health Sciences, University of Skövde, Skövde, Sweden
| | - Alexandra Krettek
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
- Department of Biomedicine and Public Health, School of Health Sciences, University of Skövde, Skövde, Sweden
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
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Murtas R, Krogh V, Intemann T, Lissner L, Eiben G, Molnár D, Moreno LA, Siani A, Tornaritis M, Veidebaum T, Mazur A, Dereń K, Wolters M, Ahrens W, Pala V. Does Providing Assistance to Children and Adolescents Increase Repeatability and Plausibility of Self-Reporting Using a Web-Based Dietary Recall Instrument? J Acad Nutr Diet 2018; 118:2324-2330. [PMID: 30342987 DOI: 10.1016/j.jand.2018.07.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 07/26/2018] [Indexed: 11/28/2022]
Abstract
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.
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Perlaki G, Molnar D, Smeets PAM, Ahrens W, Wolters M, Eiben G, Lissner L, Erhard P, van Meer F, Herrmann M, Janszky J, Orsi G. Volumetric gray matter measures of amygdala and accumbens in childhood overweight/obesity. PLoS One 2018; 13:e0205331. [PMID: 30335775 PMCID: PMC6193643 DOI: 10.1371/journal.pone.0205331] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 09/24/2018] [Indexed: 11/18/2022] Open
Abstract
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.
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Affiliation(s)
- Gabor Perlaki
- MTA-PTE Clinical Neuroscience MR Research Group, Pecs, Hungary
- Department of Neurology, University of Pecs, Medical School, Pecs, Hungary
- * E-mail:
| | - Denes Molnar
- Department of Pediatrics, University of Pecs, Medical School, Pecs, Hungary
| | - Paul A. M. Smeets
- Image Sciences Institute, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
- Division of Human Nutrition, Wageningen University & Research, Wageningen, Netherlands
| | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology—BIPS, Bremen, Germany
| | - Maike Wolters
- Leibniz Institute for Prevention Research and Epidemiology—BIPS, Bremen, Germany
| | - Gabriele Eiben
- Department of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden
- Department of Biomedicine and Public Health, School of Health and Education, University of Skövde, Skövde, Sweden
| | - Lauren Lissner
- Department of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Peter Erhard
- Center for Cognitive Sciences, University of Bremen, Bremen, Germany
- Department of Neuropsychology and Behavioral Neurobiology, University of Bremen, Bremen, Germany
| | - Floor van Meer
- Image Sciences Institute, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Manfred Herrmann
- Center for Cognitive Sciences, University of Bremen, Bremen, Germany
- Department of Neuropsychology and Behavioral Neurobiology, University of Bremen, Bremen, Germany
| | - Jozsef Janszky
- MTA-PTE Clinical Neuroscience MR Research Group, Pecs, Hungary
- Department of Neurology, University of Pecs, Medical School, Pecs, Hungary
| | - Gergely Orsi
- MTA-PTE Clinical Neuroscience MR Research Group, Pecs, Hungary
- Department of Neurology, University of Pecs, Medical School, Pecs, Hungary
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Dello Russo M, Ahrens W, De Henauw S, Eiben G, Hebestreit A, Kourides Y, Lissner L, Molnar D, Moreno LA, Pala V, Veidebaum T, Siani A, Russo P. 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) Study. Nutrients 2018; 10:E1350. [PMID: 30248889 PMCID: PMC6213151 DOI: 10.3390/nu10101350] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 09/13/2018] [Accepted: 09/19/2018] [Indexed: 01/02/2023] Open
Abstract
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.
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Affiliation(s)
| | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, 28359 Bremen, Germany.
- Institute of Statistics, University of Bremen, 28359 Bremen, Germany.
| | - Stefaan De Henauw
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium.
| | - Gabriele Eiben
- Department of Biomedicine and Public Health, School of Health and Education, University of Skövde, 54128 Skövde, Sweden.
| | - Antje Hebestreit
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, 28359 Bremen, Germany.
| | - Yannis Kourides
- Research and Education Institute of Child Health, 2040 Strovolos, Cyprus.
| | - Lauren Lissner
- Section for Epidemiology and Social Medicine, Sahlgrenska Academy, University of Gothenburg, 40530 Gothenburg, Sweden.
| | - Denes Molnar
- Department of Paediatrics, University of Pécs, 7624 Pécs, Hungary.
| | - Luis A Moreno
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, 50009 Zaragoza, Spain.
| | - Valeria Pala
- Epidemiology and Prevention Unit, Fondazione IRCSS Istituto Nazionale dei Tumori, 20133 Milan, Italy.
| | - Toomas Veidebaum
- National Institute for Health Development, 11619 Tallinn, Estonia.
| | - Alfonso Siani
- Institute of Food Sciences, CNR, 83100 Avellino, Italy.
| | - Paola Russo
- Institute of Food Sciences, CNR, 83100 Avellino, Italy.
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Jilani HS, Pohlabeln H, Buchecker K, Gwozdz W, De Henauw S, Eiben G, Molnar D, Moreno LA, Pala V, Reisch L, Russo P, Veidebaum T, Ahrens W, Hebestreit A. Association between parental consumer attitudes with their children's sensory taste preferences as well as their food choice. PLoS One 2018; 13:e0200413. [PMID: 30067786 PMCID: PMC6070197 DOI: 10.1371/journal.pone.0200413] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2017] [Accepted: 06/26/2018] [Indexed: 11/30/2022] Open
Abstract
Background We investigated the association between the consumer attitudes of European parents and their children’s taste preferences and food choice. Furthermore, we studied whether the parental consumer attitudes were related to education level. Methods This analysis included 1,407 IDEFICS study children aged 6.0 to 11.8 years and from 7 European countries, who participated in the sensory taste perception module between 2007 and 2010. Parental consumer attitude was operationalized as ‘trusting in foods known from advertisements’ (trusting advertisements) and as ‘not avoiding additives in food’ (not avoiding additives). Parents reported their educational attainment and completed a food frequency questionnaire for their children. Consumption frequencies of sweet, fatty and processed foods as well as a healthy diet adherence score were calculated. Children performed fat, sweet and umami taste preference tests. Multivariable logistic models were used to analyse the association between parental consumer attitudes and their children’s taste preference frequencies as well as parental education. Linear regression models were used to analyse the association between parental consumer attitudes and their children’s food consumption. Results Parental consumer attitudes were not associated with children’s fat, sweet and umami taste preferences. Children of parents trusting advertisements consumed more frequently processed foods (β = 1.21, 95% CI: 0.49; 1.93). Children of parents not avoiding additives consumed more often sweet, fatty and processed foods and had a lower healthy diet adherence score (β = 2.37, 95% CI: 1.03; 3.70; β = 2.27, 95% CI: 1.12; 3.43; β = 0.91, 95% CI: 0.22; 1.59; β = -2.87, 95% CI: -3.89; -1.85, respectively). Unfavourable parental consumer attitudes were associated with a lower parental education level across Europe (Compared to high education: Odds Ratio (OR) of trusting advertisements with medium education: 1.04, 95% CI: 0.77; 1.40; OR with low education: 2.01, 95% CI: 1.15; 3.54; OR of not avoiding additives with medium education: 1.91, 95% CI: 1.44; 2.54; OR with low education: 1.76, 95% CI: 0.96; 3.24). Conclusions Across Europe, unfavourable parental consumer attitudes are associated with a lower diet quality of their children. Parental consumer attitudes in turn were associated with their own level of education. This has implications for policy makers, interventions and health promotion programmes that aim to promote healthy eating.
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Affiliation(s)
- Hannah S. Jilani
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
- Institute for Public Health and Nursing Research, University of Bremen and Health Sciences Bremen, University of Bremen, Bremen, Germany
| | - Hermann Pohlabeln
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | | | - Wencke Gwozdz
- Department of Management, Society and Communication, Copenhagen Business School, Frederiksberg, Denmark
| | - Stefaan De Henauw
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Gabriele Eiben
- Department of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden
- Department of Biomedicine and Public Health, School of Health and Education, University of Skövde, Skövde, Sweden
| | - Dénes Molnar
- Department of Pediatrics, University of Pécs, Medical School, Pécs, Hungary
| | - Luis A. Moreno
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain
| | - Valeria Pala
- Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Lucia Reisch
- Department of Management, Society and Communication, Copenhagen Business School, Frederiksberg, Denmark
| | - Paola Russo
- Epidemiology and Population Genetics, Institute of Food Sciences, National Research Council, Avellino, Italy
| | - Toomas Veidebaum
- Department of Chronic Diseases, National Institute for Health Development, Tallinn, Estonia
| | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
- Institute of Statistics, Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany
| | - Antje Hebestreit
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
- * E-mail:
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Iguacel I, Michels N, Ahrens W, Bammann K, Eiben G, Fernández-Alvira JM, Mårild S, Molnár D, Reisch L, Russo P, Tornaritis M, Veidebaum T, Wolters M, Moreno LA, Börnhorst C. Prospective associations between socioeconomically disadvantaged groups and metabolic syndrome risk in European children. Results from the IDEFICS study. Int J Cardiol 2018; 272:333-340. [PMID: 30017513 DOI: 10.1016/j.ijcard.2018.07.053] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 06/28/2018] [Accepted: 07/09/2018] [Indexed: 01/16/2023]
Abstract
OBJECTIVE Socioeconomic disadvantages during childhood are hypothesised to have negative implications for health. We aimed to investigate the association between socioeconomic disadvantages and children's total metabolic syndrome (MetS) score at baseline and follow-up and the extent to which socioeconomic disadvantages over time and the accumulation of these socioeconomic disadvantages can affect children's MetS risk. METHODS The two-year longitudinal IDEFICS study included 2401 European children (aged 2.0-9.9) with complete information of the 16,229 participating at baseline. Sociodemographic variables, psychosocial factors and lifestyle were proxy-reported via questionnaires. Socioeconomically disadvantaged groups included children from families with low income, low education, migrant origin, unemployed parents, parents who lacked a social network, and from non-traditional families. MetS risk score was calculated as the sum of z-scores of waist circumference, blood pressure, lipids and insulin resistance. Linear mixed-effects models were used to study the association between social disadvantages and MetS risk. Models were adjusted for sex, age, well-being and lifestyle (fruit and vegetables consumption, physical activity, screen time). RESULTS At both time points, children from low-income families (0.20 [0.03-0.37]); (β estimate and 99% confidence interval), children from non-traditional families (0.14 [0.02-0.26]), children whose parents were unemployed (0.31 [0.05-0.57]) and children who accumulated >3 disadvantages (0.21 [0.04-0.37]) showed a higher MetS score compared to non-socioeconomically disadvantaged groups. CONCLUSION Children from socioeconomically disadvantaged families are at high metabolic risk independently of diet, physical activity, sedentary behaviours and well-being. Interventions focusing on these socioeconomically disadvantaged groups should be developed to tackle health disparities.
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Affiliation(s)
- Isabel Iguacel
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Faculty of Health Sciences, University of Zaragoza, Edificio del SAI, C/Pedro Cerbuna s/n, 50009 Zaragoza, Spain; Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain; Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain; Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Zaragoza, Spain.
| | | | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany; Institute of Statistics, University of Bremen, Bremen, Germany
| | - Karin Bammann
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany; Institute for Public Health and Nursing Sciences (IPP), University of Bremen, Bremen, Germany
| | - Gabriele Eiben
- Section for Epidemiology and Social Medicine (EPSO), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Biomedicine and Public Health, School of Health and Education, University of Skövde, Skövde, Sweden
| | - Juan M Fernández-Alvira
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Faculty of Health Sciences, University of Zaragoza, Edificio del SAI, C/Pedro Cerbuna s/n, 50009 Zaragoza, Spain; Fundación Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain
| | - Staffan Mårild
- Section for Epidemiology and Social Medicine (EPSO), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Dénes Molnár
- Department of Paediatrics, University of Pécs, Pécs, Hungary
| | | | - Paola Russo
- Institute of Food Sciences, National Research Council, Avellino, Italy
| | | | - Toomas Veidebaum
- Department of Chronic Diseases, National Institute for Health Development, Tallinn, Estonia
| | - Maike Wolters
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Luis A Moreno
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Faculty of Health Sciences, University of Zaragoza, Edificio del SAI, C/Pedro Cerbuna s/n, 50009 Zaragoza, Spain; Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain; Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain; Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Zaragoza, Spain
| | - Claudia Börnhorst
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
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Oli N, Vaidya A, Pahkala K, Eiben G, Krettek A. Knowledge, attitude and practice on diet and physical activity among mothers with young children in the Jhaukhel-Duwakot Health Demographic Surveillance Site, Nepal. PLoS One 2018; 13:e0200329. [PMID: 29985946 PMCID: PMC6037384 DOI: 10.1371/journal.pone.0200329] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Accepted: 06/25/2018] [Indexed: 11/19/2022] Open
Abstract
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.
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Affiliation(s)
- Natalia Oli
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
- Department of Community Medicine, Kathmandu Medical College, Kathmandu, Nepal
| | - Abhinav Vaidya
- Department of Community Medicine, Kathmandu Medical College, Kathmandu, Nepal
| | - Katja Pahkala
- Paavo Nurmi Centre, Department of Health and Physical Activity, University of Turku, Turku, Finland
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | - Gabriele Eiben
- Department of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden
- Department of Biomedicine and Public Health, School of Health and Education, University of Skövde, Skövde, Sweden
| | - Alexandra Krettek
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
- Department of Biomedicine and Public Health, School of Health and Education, University of Skövde, Skövde, Sweden
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
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Buck C, Lauria F, Eiben G, Konstabel K, Page A, Pigeot I, Ahrens W. A longitudinal study of urban moveability and physical activity in the transition phase from childhood to adolescence. Rev Epidemiol Sante Publique 2018. [DOI: 10.1016/j.respe.2018.05.099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Intemann T, Pigeot I, De Henauw S, Eiben G, Lissner L, Krogh V, Dereń K, Molnár D, Moreno LA, Russo P, Siani A, Sirangelo I, Tornaritis M, Veidebaum T, Pala V. Urinary sucrose and fructose to validate self-reported sugar intake in children and adolescents: results from the I.Family study. Eur J Nutr 2018; 58:1247-1258. [PMID: 29511828 DOI: 10.1007/s00394-018-1649-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Accepted: 02/22/2018] [Indexed: 11/30/2022]
Abstract
PURPOSE Excessive consumption of free sugar increases the risk for non-communicable diseases where a proper assessment of this intake is necessary to correctly estimate its association with certain diseases. Urinary sugars have been suggested as objective biomarkers for total and free sugar intake in adults but less is known about this marker in children and adolescents. Therefore, the aim of this exploratory study is to evaluate the relative validity of self-reported intake using urinary sugars in children and adolescents. METHODS The study was conducted in a convenience subsample of 228 participants aged 5-18 years of the I.Family study that investigates the determinants of food choices, lifestyle and health in European families. Total, free and intrinsic sugar intake (g/day) and sugar density (g/1000 kcal) were assessed using 24-h dietary recalls (24HDRs). Urinary sucrose (USUC) and urinary fructose (UFRU) were measured in morning urine samples and corrected for creatinine excretion (USUC/Cr, UFRU/Cr). Correlation coefficients, the method of triads and linear regression models were used to investigate the relationship between intake of different types of sugar and urinary sugars. RESULTS The correlation between usual sugar density calculated from multiple 24HDRs and the sum of USUC/Cr and UFRU/Cr (USUC/Cr + UFRU/Cr) was 0.38 (p < 0.001). The method of triads revealed validity coefficients for the 24HDR from 0.64 to 0.87. Linear regression models showed statistically significant positive associations between USUC/Cr + UFRU/Cr and the intake of total and free sugar. CONCLUSIONS These findings support the relative validity of total and free sugar intake assessed by self-reported 24HDRs in children and adolescents.
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Affiliation(s)
- Timm Intemann
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, Achterstr. 30, 28359, Bremen, Germany. .,Institute of Statistics, Bremen University, Bremen, Germany.
| | - Iris Pigeot
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, Achterstr. 30, 28359, Bremen, Germany.,Institute of Statistics, Bremen University, Bremen, Germany
| | | | - Gabriele Eiben
- Section for Epidemiology and Social Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Biomedicine and Public Health, School of Health and Education, University of Skövde, Skövde, Sweden
| | - Lauren Lissner
- Section for Epidemiology and Social Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Vittorio Krogh
- Epidemiology and Prevention Unit, Fondazione IRCSS Istituto Nazionale dei Tumori, Milan, Italy
| | - Katarzyna Dereń
- Institute of Nursing and Health Sciences, Medical Faculty, University of Rzeszow, Rzeszów, Poland
| | - Dénes Molnár
- Department of Paediatrics, University of Pécs, Pécs, Hungary
| | - Luis A Moreno
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Universidad de Zaragoza, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria de Aragón (IIS Aragón) and Centro de Investigación Biomédica en Red de Fisiopatología de la Nutrición y la Obesidad (CIBEROBN), Zaragoza, Spain
| | - Paola Russo
- Institute of Food Sciences, National Research Council, Avellino, Italy
| | - Alfonso Siani
- Institute of Food Sciences, National Research Council, Avellino, Italy
| | - Ivana Sirangelo
- Department of Biochemistry, Biophysics and General Pathology, University of Campania "L. Vanvitelli", Naples, Italy
| | | | | | - Valeria Pala
- Epidemiology and Prevention Unit, Fondazione IRCSS Istituto Nazionale dei Tumori, Milan, Italy
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Langeheine M, Pohlabeln H, Lauria F, Veidebaum T, Tornaritis M, Molnar D, Eiben G, de Henauw S, Moreno LA, Williams G, Ahrens W, Rach S. Attrition in the European Child Cohort IDEFICS/I.Family: Exploring Associations Between Attrition and Body Mass Index. Front Pediatr 2018; 6:212. [PMID: 30159304 PMCID: PMC6104127 DOI: 10.3389/fped.2018.00212] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 07/09/2018] [Indexed: 12/14/2022] Open
Abstract
Attrition may lead to bias in epidemiological cohorts, since participants who are healthier and have a higher social position are less likely to drop out. We investigated possible selection effects regarding key exposures and outcomes in the IDEFICS/I.Family study, a large European cohort on the etiology of overweight, obesity and related disorders during childhood and adulthood. We applied multilevel logistic regression to investigate associations of attrition with sociodemographic variables, weight status, and study compliance and assessed attrition across time regarding children's weight status and variations of attrition across participating countries. We investigated selection effects with regard to social position, adherence to key messages concerning a healthy lifestyle, and children's weight status. Attrition was associated with a higher weight status of children, lower children's study compliance, older age, lower parental education, and parent's migration background, consistent across time and participating countries. Although overweight (odds ratio 1.17, 99% confidence interval 1.05-1.29) or obese children (odds ratio 1.18, 99% confidence interval 1.03-1.36) were more prone to drop-out, attrition only seemed to slightly distort the distribution of children's BMI at the upper tail. Restricting the sample to subgroups with different attrition characteristics only marginally affected exposure-outcome associations. Our results suggest that IDEFICS/I.Family provides valid estimates of relations between socio-economic position, health-related behaviors, and weight status.
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Affiliation(s)
- Malte Langeheine
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany
| | - Hermann Pohlabeln
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany
| | - Fabio Lauria
- Institute of Food Sciences, National Research Council, Avellino, Italy
| | | | | | - Denes Molnar
- Department of Pediatrics, Medical School, University of Pécs, Pécs, Hungary
| | - Gabriele Eiben
- Section for Epidemiology and Social Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Biomedicine and Public Health, School of Health and Education, University of Skövde, Skövde, Sweden
| | | | - Luis A Moreno
- Growth, Exercise, Nutrition and Development, Research Group, Faculty of Health Sciences, University of Zaragoza, Instituto Agroalimentario de Aragón, Instituto de Investigación Sanitaria de Aragón and Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Zaragoza, Spain
| | - Garrath Williams
- Department of Politics, Philosophy and Religion, Lancaster University, Lancaster, United Kingdom
| | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany.,Faculty of Mathematics and Computer Science, Institute of Statistics, University Bremen, Bremen, Germany
| | - Stefan Rach
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany
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Abarca-Gómez L, Abdeen ZA, Hamid ZA, Abu-Rmeileh NM, Acosta-Cazares B, Acuin C, Adams RJ, Aekplakorn W, Afsana K, Aguilar-Salinas CA, Agyemang C, Ahmadvand A, Ahrens W, Ajlouni K, Akhtaeva N, Al-Hazzaa HM, Al-Othman AR, Al-Raddadi R, Al Buhairan F, Al Dhukair S, Ali MM, Ali O, Alkerwi A, Alvarez-Pedrerol M, Aly E, Amarapurkar DN, Amouyel P, Amuzu A, Andersen LB, Anderssen SA, Andrade DS, Ängquist LH, Anjana RM, Aounallah-Skhiri H, Araújo J, Ariansen I, Aris T, Arlappa N, Arveiler D, Aryal KK, Aspelund T, Assah FK, Assunção MCF, Aung MS, Avdicová M, Azevedo A, Azizi F, Babu BV, Bahijri S, Baker JL, Balakrishna N, Bamoshmoosh M, Banach M, Bandosz P, Banegas JR, Barbagallo CM, Barceló A, Barkat A, Barros AJD, Barros MVG, Bata I, Batieha AM, Batista RL, Batyrbek A, Baur LA, Beaglehole R, Romdhane HB, Benedics J, Benet M, Bennett JE, Bernabe-Ortiz A, Bernotiene G, Bettiol H, Bhagyalaxmi A, Bharadwaj S, Bhargava SK, Bhatti Z, Bhutta ZA, Bi H, Bi Y, Biehl A, Bikbov M, Bista B, Bjelica DJ, Bjerregaard P, Bjertness E, Bjertness MB, Björkelund C, Blokstra A, Bo S, Bobak M, Boddy LM, Boehm BO, Boeing H, Boggia JG, Boissonnet CP, Bonaccio M, Bongard V, Bovet P, Braeckevelt L, Braeckman L, Bragt MCE, Brajkovich I, Branca F, Breckenkamp J, Breda J, Brenner H, Brewster LM, Brian GR, Brinduse L, Bruno G, Bueno-de-Mesquita HB, Bugge A, Buoncristiano M, Burazeri G, Burns C, de León AC, Cacciottolo J, Cai H, Cama T, Cameron C, Camolas J, Can G, Cândido APC, Capanzana M, Capuano V, Cardoso VC, Carlsson AC, Carvalho MJ, Casanueva FF, Casas JP, Caserta CA, Chamukuttan S, Chan AW, Chan Q, Chaturvedi HK, Chaturvedi N, Chen CJ, Chen F, Chen H, Chen S, Chen Z, Cheng CY, Chetrit A, Chikova-Iscener E, Chiolero A, Chiou ST, Chirita-Emandi A, Chirlaque MD, Cho B, Cho Y, Christensen K, Christofaro DG, Chudek J, Cifkova R, Cinteza E, Claessens F, Clays E, Concin H, Confortin SC, Cooper C, Cooper R, Coppinger TC, Costanzo S, Cottel D, Cowell C, Craig CL, Crujeiras AB, Cucu A, D'Arrigo G, d'Orsi E, Dallongeville J, Damasceno A, Damsgaard CT, Danaei G, Dankner R, Dantoft TM, Dastgiri S, Dauchet L, Davletov K, De Backer G, De Bacquer D, De Curtis A, de Gaetano G, De Henauw S, de Oliveira PD, De Ridder K, De Smedt D, Deepa M, Deev AD, Dehghan A, Delisle H, Delpeuch F, Deschamps V, Dhana K, Di Castelnuovo AF, Dias-da-Costa JS, Diaz A, Dika Z, Djalalinia S, Do HTP, Dobson AJ, Donati MB, Donfrancesco C, Donoso SP, Döring A, Dorobantu M, Dorosty AR, Doua K, Drygas W, Duan JL, Duante C, Duleva V, Dulskiene V, Dzerve V, Dziankowska-Zaborszczyk E, Egbagbe EE, Eggertsen R, Eiben G, Ekelund U, El Ati J, Elliott P, Engle-Stone R, Erasmus RT, Erem C, Eriksen L, Eriksson JG, la Peña JED, Evans A, Faeh D, Fall CH, Sant'Angelo VF, Farzadfar F, Felix-Redondo FJ, Ferguson TS, Fernandes RA, Fernández-Bergés D, Ferrante D, Ferrari M, Ferreccio C, Ferrieres J, Finn JD, Fischer K, Flores EM, Föger B, Foo LH, Forslund AS, Forsner M, Fouad HM, Francis DK, Franco MDC, Franco OH, Frontera G, Fuchs FD, Fuchs SC, Fujita Y, Furusawa T, Gaciong Z, Gafencu M, Galeone D, Galvano F, Garcia-de-la-Hera M, Gareta D, Garnett SP, Gaspoz JM, Gasull M, Gates L, Geiger H, Geleijnse JM, Ghasemian A, Giampaoli S, Gianfagna F, Gill TK, Giovannelli J, Giwercman A, Godos J, Gogen S, Goldsmith RA, Goltzman D, Gonçalves H, González-Leon M, González-Rivas JP, Gonzalez-Gross M, Gottrand F, Graça AP, Graff-Iversen S, Grafnetter D, Grajda A, Grammatikopoulou MG, Gregor RD, Grodzicki T, Grøntved A, Grosso G, Gruden G, Grujic V, Gu D, Gualdi-Russo E, Guallar-Castillón P, Guan OP, Gudmundsson EF, Gudnason V, Guerrero R, Guessous I, Guimaraes AL, Gulliford MC, Gunnlaugsdottir J, Gunter M, Guo X, Guo Y, Gupta PC, Gupta R, Gureje O, Gurzkowska B, Gutierrez L, Gutzwiller F, Hadaegh F, Hadjigeorgiou CA, Si-Ramlee K, Halkjær J, Hambleton IR, Hardy R, Kumar RH, Hassapidou M, Hata J, Hayes AJ, He J, Heidinger-Felso R, Heinen M, Hendriks ME, Henriques A, Cadena LH, Herrala S, Herrera VM, Herter-Aeberli I, Heshmat R, Hihtaniemi IT, Ho SY, Ho SC, Hobbs M, Hofman A, Hopman WM, Horimoto ARVR, Hormiga CM, Horta BL, Houti L, Howitt C, Htay TT, Htet AS, Htike MMT, Hu Y, Huerta JM, Petrescu CH, Huisman M, Husseini A, Huu CN, Huybrechts I, Hwalla N, Hyska J, Iacoviello L, Iannone AG, Ibarluzea JM, Ibrahim MM, Ikeda N, Ikram MA, Irazola VE, Islam M, Ismail AAS, Ivkovic V, Iwasaki M, Jackson RT, Jacobs JM, Jaddou H, Jafar T, Jamil KM, Jamrozik K, Janszky I, Jarani J, Jasienska G, Jelakovic A, Jelakovic B, Jennings G, Jeong SL, Jiang CQ, Jiménez-Acosta SM, Joffres M, Johansson M, Jonas JB, Jørgensen T, Joshi P, Jovic DP, Józwiak J, Juolevi A, Jurak G, Jureša V, Kaaks R, Kafatos A, Kajantie EO, Kalter-Leibovici O, Kamaruddin NA, Kapantais E, Karki KB, Kasaeian A, Katz J, Kauhanen J, Kaur P, Kavousi M, Kazakbaeva G, Keil U, Boker LK, Keinänen-Kiukaanniemi S, Kelishadi R, Kelleher C, Kemper HCG, Kengne AP, Kerimkulova A, Kersting M, Key T, Khader YS, Khalili D, Khang YH, Khateeb M, Khaw KT, Khouw IMSL, Kiechl-Kohlendorfer U, Kiechl S, Killewo J, Kim J, Kim YY, Klimont J, Klumbiene J, Knoflach M, Koirala B, Kolle E, Kolsteren P, Korrovits P, Kos J, Koskinen S, Kouda K, Kovacs VA, Kowlessur S, Koziel S, Kratzer W, Kriemler S, Kristensen PL, Krokstad S, Kromhout D, Kruger HS, Kubinova R, Kuciene R, Kuh D, Kujala UM, Kulaga Z, Kumar RK, Kunešová M, Kurjata P, Kusuma YS, Kuulasmaa K, Kyobutungi C, La QN, Laamiri FZ, Laatikainen T, Lachat C, Laid Y, Lam TH, Landrove O, Lanska V, Lappas G, Larijani B, Laugsand LE, Lauria L, Laxmaiah A, Bao KLN, Le TD, Lebanan MAO, Leclercq C, Lee J, Lee J, Lehtimäki T, León-Muñoz LM, Levitt NS, Li Y, Lilly CL, Lim WY, Lima-Costa MF, Lin HH, Lin X, Lind L, Linneberg A, Lissner L, Litwin M, Liu J, Loit HM, Lopes L, Lorbeer R, Lotufo PA, Lozano JE, Luksiene D, Lundqvist A, Lunet N, Lytsy P, Ma G, Ma J, Machado-Coelho GLL, Machado-Rodrigues AM, Machi S, Maggi S, Magliano DJ, Magriplis E, Mahaletchumy A, Maire B, Majer M, Makdisse M, Malekzadeh R, Malhotra R, Rao KM, Malyutina S, Manios Y, Mann JI, Manzato E, Margozzini P, Markaki A, Markey O, Marques LP, Marques-Vidal P, Marrugat J, Martin-Prevel Y, Martin R, Martorell R, Martos E, Marventano S, Masoodi SR, Mathiesen EB, Matijasevich A, Matsha TE, Mazur A, Mbanya JCN, McFarlane SR, McGarvey ST, McKee M, McLachlan S, McLean RM, McLean SB, McNulty BA, Yusof SM, Mediene-Benchekor S, Medzioniene J, Meirhaeghe A, Meisfjord J, Meisinger C, Menezes AMB, Menon GR, Mensink GBM, Meshram II, Metspalu A, Meyer HE, Mi J, Michaelsen KF, Michels N, Mikkel K, Miller JC, Minderico CS, Miquel JF, Miranda JJ, Mirkopoulou D, Mirrakhimov E, Mišigoj-Durakovic M, Mistretta A, Mocanu V, Modesti PA, Mohamed MK, Mohammad K, Mohammadifard N, Mohan V, Mohanna S, Yusoff MFM, Molbo D, Møllehave LT, Møller NC, Molnár D, Momenan A, Mondo CK, Monterrubio EA, Monyeki KDK, Moon JS, Moreira LB, Morejon A, Moreno LA, Morgan K, Mortensen EL, Moschonis G, Mossakowska M, Mostafa A, Mota J, Mota-Pinto A, Motlagh ME, Motta J, Mu TT, Muc M, Muiesan ML, Müller-Nurasyid M, Murphy N, Mursu J, Murtagh EM, Musil V, Nabipour I, Nagel G, Naidu BM, Nakamura H, Námešná J, Nang EEK, Nangia VB, Nankap M, Narake S, Nardone P, Navarrete-Muñoz EM, Neal WA, Nenko I, Neovius M, Nervi F, Nguyen CT, Nguyen ND, Nguyen QN, Nieto-Martínez RE, Ning G, Ninomiya T, Nishtar S, Noale M, Noboa OA, Norat T, Norie S, Noto D, Nsour MA, O'Reilly D, Obreja G, Oda E, Oehlers G, Oh K, Ohara K, Olafsson Ö, Olinto MTA, Oliveira IO, Oltarzewski M, Omar MA, Onat A, Ong SK, Ono LM, Ordunez P, Ornelas R, Ortiz AP, Osler M, Osmond C, Ostojic SM, Ostovar A, Otero JA, Overvad K, Owusu-Dabo E, Paccaud FM, Padez C, Pahomova E, Pajak A, Palli D, Palloni A, Palmieri L, Pan WH, Panda-Jonas S, Pandey A, Panza F, Papandreou D, Park SW, Parnell WR, Parsaeian M, Pascanu IM, Patel ND, Pecin I, Pednekar MS, Peer N, Peeters PH, Peixoto SV, Peltonen M, Pereira AC, Perez-Farinos N, Pérez CM, Peters A, Petkeviciene J, Petrauskiene A, Peykari N, Pham ST, Pierannunzio D, Pigeot I, Pikhart H, Pilav A, Pilotto L, Pistelli F, Pitakaka F, Piwonska A, Plans-Rubió P, Poh BK, Pohlabeln H, Pop RM, Popovic SR, Porta M, Portegies MLP, Posch G, Poulimeneas D, Pouraram H, Pourshams A, Poustchi H, Pradeepa R, Prashant M, Price JF, Puder JJ, Pudule I, Puiu M, Punab M, Qasrawi RF, Qorbani M, Bao TQ, Radic I, Radisauskas R, Rahman M, Rahman M, Raitakari O, Raj M, Rao SR, Ramachandran A, Ramke J, Ramos E, Ramos R, Rampal L, Rampal S, Rascon-Pacheco RA, Redon J, Reganit PFM, Ribas-Barba L, Ribeiro R, Riboli E, Rigo F, de Wit TFR, Rito A, Ritti-Dias RM, Rivera JA, Robinson SM, Robitaille C, Rodrigues D, Rodríguez-Artalejo F, del Cristo Rodriguez-Perez M, Rodríguez-Villamizar LA, Rojas-Martinez R, Rojroongwasinkul N, Romaguera D, Ronkainen K, Rosengren A, Rouse I, Roy JGR, Rubinstein A, Rühli FJ, Ruiz-Betancourt BS, Russo P, Rutkowski M, Sabanayagam C, Sachdev HS, Saidi O, Salanave B, Martinez ES, Salmerón D, Salomaa V, Salonen JT, Salvetti M, Sánchez-Abanto J, Sandjaja, Sans S, Marina LS, Santos DA, Santos IS, Santos O, dos Santos RN, Santos R, Saramies JL, Sardinha LB, Sarrafzadegan N, Saum KU, Savva S, Savy M, Scazufca M, Rosario AS, Schargrodsky H, Schienkiewitz A, Schipf S, Schmidt CO, Schmidt IM, Schultsz C, Schutte AE, Sein AA, Sen A, Senbanjo IO, Sepanlou SG, Serra-Majem L, Shalnova SA, Sharma SK, Shaw JE, Shibuya K, Shin DW, Shin Y, Shiri R, Siani A, Siantar R, Sibai AM, Silva AM, Silva DAS, Simon M, Simons J, Simons LA, Sjöberg A, Sjöström M, Skovbjerg S, Slowikowska-Hilczer J, Slusarczyk P, Smeeth L, Smith MC, Snijder MB, So HK, Sobngwi E, Söderberg S, Soekatri MYE, Solfrizzi V, Sonestedt E, Song Y, Sørensen TIA, Soric M, Jérome CS, Soumare A, Spinelli A, Spiroski I, Staessen JA, Stamm H, Starc G, Stathopoulou MG, Staub K, Stavreski B, Steene-Johannessen J, Stehle P, Stein AD, Stergiou GS, Stessman J, Stieber J, Stöckl D, Stocks T, Stokwiszewski J, Stratton G, Stronks K, Strufaldi MW, Suárez-Medina R, Sun CA, Sundström J, Sung YT, Sunyer J, Suriyawongpaisal P, Swinburn BA, Sy RG, Szponar L, Tai ES, Tammesoo ML, Tamosiunas A, Tan EJ, Tang X, Tanser F, Tao Y, Tarawneh MR, Tarp J, Tarqui-Mamani CB, Tautu OF, Braunerová RT, Taylor A, Tchibindat F, Theobald H, Theodoridis X, Thijs L, Thuesen BH, Tjonneland A, Tolonen HK, Tolstrup JS, Topbas M, Topór-Madry R, Tormo MJ, Tornaritis MJ, Torrent M, Toselli S, Traissac P, Trichopoulos D, Trichopoulou A, Trinh OTH, Trivedi A, Tshepo L, Tsigga M, Tsugane S, Tulloch-Reid MK, Tullu F, Tuomainen TP, Tuomilehto J, Turley ML, Tynelius P, Tzotzas T, Tzourio C, Ueda P, Ugel EE, Ukoli FAM, Ulmer H, Unal B, Uusitalo HMT, Valdivia G, Vale S, Valvi D, van der Schouw YT, Van Herck K, Van Minh H, van Rossem L, Van Schoor NM, van Valkengoed IGM, Vanderschueren D, Vanuzzo D, Vatten L, Vega T, Veidebaum T, Velasquez-Melendez G, Velika B, Veronesi G, Verschuren WMM, Victora CG, Viegi G, Viet L, Viikari-Juntura E, Vineis P, Vioque J, Virtanen JK, Visvikis-Siest S, Viswanathan B, Vlasoff T, Vollenweider P, Völzke H, Voutilainen S, Vrijheid M, Wade AN, Wagner A, Waldhör T, Walton J, Bebakar WMW, Mohamud WNW, Wanderley RS, Wang MD, Wang Q, Wang YX, Wang YW, Wannamethee SG, Wareham N, Weber A, Wedderkopp N, Weerasekera D, Whincup PH, Widhalm K, Widyahening IS, Wiecek A, Wijga AH, Wilks RJ, Willeit J, Willeit P, Wilsgaard T, Wojtyniak B, Wong-McClure RA, Wong JYY, Wong JE, Wong TY, Woo J, Woodward M, Wu FC, Wu J, Wu S, Xu H, Xu L, Yamborisut U, Yan W, Yang X, Yardim N, Ye X, Yiallouros PK, Yngve A, Yoshihara A, You QS, Younger-Coleman NO, Yusoff F, Yusoff MFM, Zaccagni L, Zafiropulos V, Zainuddin AA, Zambon S, Zampelas A, Zamrazilová H, Zdrojewski T, Zeng Y, Zhao D, Zhao W, Zheng W, Zheng Y, Zholdin B, Zhou M, Zhu D, Zhussupov B, Zimmermann E, Cisneros JZ, Bentham J, Di Cesare M, Bilano V, Bixby H, Zhou B, Stevens GA, Riley LM, Taddei C, Hajifathalian K, Lu Y, Savin S, Cowan MJ, Paciorek CJ, Chirita-Emandi A, Hayes AJ, Katz J, Kelishadi R, Kengne AP, Khang YH, Laxmaiah A, Li Y, Ma J, Miranda JJ, Mostafa A, Neovius M, Padez C, Rampal L, Zhu A, Bennett JE, Danaei G, Bhutta ZA, Ezzati M. Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128·9 million children, adolescents, and adults. Lancet 2017; 390:2627-2642. [PMID: 29029897 PMCID: PMC5735219 DOI: 10.1016/s0140-6736(17)32129-3] [Citation(s) in RCA: 3623] [Impact Index Per Article: 517.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 07/12/2017] [Accepted: 07/19/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND Underweight, overweight, and obesity in childhood and adolescence are associated with adverse health consequences throughout the life-course. Our aim was to estimate worldwide trends in mean body-mass index (BMI) and a comprehensive set of BMI categories that cover underweight to obesity in children and adolescents, and to compare trends with those of adults. METHODS We pooled 2416 population-based studies with measurements of height and weight on 128·9 million participants aged 5 years and older, including 31·5 million aged 5-19 years. We used a Bayesian hierarchical model to estimate trends from 1975 to 2016 in 200 countries for mean BMI and for prevalence of BMI in the following categories for children and adolescents aged 5-19 years: more than 2 SD below the median of the WHO growth reference for children and adolescents (referred to as moderate and severe underweight hereafter), 2 SD to more than 1 SD below the median (mild underweight), 1 SD below the median to 1 SD above the median (healthy weight), more than 1 SD to 2 SD above the median (overweight but not obese), and more than 2 SD above the median (obesity). FINDINGS Regional change in age-standardised mean BMI in girls from 1975 to 2016 ranged from virtually no change (-0·01 kg/m2 per decade; 95% credible interval -0·42 to 0·39, posterior probability [PP] of the observed decrease being a true decrease=0·5098) in eastern Europe to an increase of 1·00 kg/m2 per decade (0·69-1·35, PP>0·9999) in central Latin America and an increase of 0·95 kg/m2 per decade (0·64-1·25, PP>0·9999) in Polynesia and Micronesia. The range for boys was from a non-significant increase of 0·09 kg/m2 per decade (-0·33 to 0·49, PP=0·6926) in eastern Europe to an increase of 0·77 kg/m2 per decade (0·50-1·06, PP>0·9999) in Polynesia and Micronesia. Trends in mean BMI have recently flattened in northwestern Europe and the high-income English-speaking and Asia-Pacific regions for both sexes, southwestern Europe for boys, and central and Andean Latin America for girls. By contrast, the rise in BMI has accelerated in east and south Asia for both sexes, and southeast Asia for boys. Global age-standardised prevalence of obesity increased from 0·7% (0·4-1·2) in 1975 to 5·6% (4·8-6·5) in 2016 in girls, and from 0·9% (0·5-1·3) in 1975 to 7·8% (6·7-9·1) in 2016 in boys; the prevalence of moderate and severe underweight decreased from 9·2% (6·0-12·9) in 1975 to 8·4% (6·8-10·1) in 2016 in girls and from 14·8% (10·4-19·5) in 1975 to 12·4% (10·3-14·5) in 2016 in boys. Prevalence of moderate and severe underweight was highest in India, at 22·7% (16·7-29·6) among girls and 30·7% (23·5-38·0) among boys. Prevalence of obesity was more than 30% in girls in Nauru, the Cook Islands, and Palau; and boys in the Cook Islands, Nauru, Palau, Niue, and American Samoa in 2016. Prevalence of obesity was about 20% or more in several countries in Polynesia and Micronesia, the Middle East and north Africa, the Caribbean, and the USA. In 2016, 75 (44-117) million girls and 117 (70-178) million boys worldwide were moderately or severely underweight. In the same year, 50 (24-89) million girls and 74 (39-125) million boys worldwide were obese. INTERPRETATION The rising trends in children's and adolescents' BMI have plateaued in many high-income countries, albeit at high levels, but have accelerated in parts of Asia, with trends no longer correlated with those of adults. FUNDING Wellcome Trust, AstraZeneca Young Health Programme.
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Arvidsson L, Eiben G, Hunsberger M, De Bourdeaudhuij I, Molnar D, Jilani H, Thumann B, Veidebaum T, Russo P, Tornatitis M, Santaliestra-Pasías AM, Pala V, Lissner L. Bidirectional associations between psychosocial well-being and adherence to healthy dietary guidelines in European children: prospective findings from the IDEFICS study. BMC Public Health 2017; 17:926. [PMID: 29237434 PMCID: PMC5729410 DOI: 10.1186/s12889-017-4920-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 11/16/2017] [Indexed: 01/12/2023] Open
Abstract
Background In children the relationship between a healthy diet and psychosocial well-being has not been fully explored and the existing evidence is inconsistent. This study investigates the chronology of the association between children’s adherence to healthy dietary guidelines and their well-being, with special attention to the influence of weight status on the association. Methods Seven thousand six hundred seventy five children 2 to 9 years old from the eight-country cohort study IDEFICS were investigated. They were first examined between September 2007 and June 2008 and re-examined again 2 years later. Psychosocial well-being was measured using self-esteem and parent relations questions from the KINDL® and emotional and peer problems from the Strengths and Difficulties Questionnaire. A Healthy Dietary Adherence Score (HDAS) was calculated from a 43-item food frequency questionnaire as a measure of the degree to which children’s dietary intake follows nutrition guidelines. The analysis employed multilevel logistic regression (country as random effect) with bidirectional modeling of dichotomous dietary and well-being variables as both exposures and outcomes while controlling for respective baseline values. Results A higher HDAS at baseline was associated with better self-esteem (OR 1.2, 95% CI 1.0;1.4) and fewer emotional and peer problems (OR 1.2, 95% CI 1.1;1.3 and OR 1.3, 95% CI 1.2;1.4) 2 years later. For the reversed direction, better self-esteem was associated with higher HDAS 2 years later (OR 1.1 95% CI 1.0;1.29). The analysis stratified by weight status revealed that the associations between higher HDAS at baseline and better well-being at follow-up were similar in both normal weight and overweight children. Conclusion Present findings suggest a bidirectional relation between diet quality and self-esteem. Additionally, higher adherence to healthy dietary guidelines at baseline was associated with fewer emotional and peer problems at follow-up, independent of children’s weight status. Electronic supplementary material The online version of this article (10.1186/s12889-017-4920-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Louise Arvidsson
- Section for Epidemiology and Social Medicine (EPSO), The Sahlgrenska Academy, University of Gothenburg, Box 453, 405 30, Gothenburg, Sweden.
| | - Gabriele Eiben
- Section for Epidemiology and Social Medicine (EPSO), The Sahlgrenska Academy, University of Gothenburg, Box 453, 405 30, Gothenburg, Sweden
| | - Monica Hunsberger
- Section for Epidemiology and Social Medicine (EPSO), The Sahlgrenska Academy, University of Gothenburg, Box 453, 405 30, Gothenburg, Sweden
| | | | - Denes Molnar
- Department of Paediatrics, Clinical Center, University of Pécs, Pecs, Hungary
| | - Hannah Jilani
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstrasse 30, 283 59, Bremen, Germany
| | - Barbara Thumann
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstrasse 30, 283 59, Bremen, Germany
| | | | - Paola Russo
- Institute of Food Sciences, CNR Via Roma, 64-83100, Avellino, Italy
| | | | - Alba M Santaliestra-Pasías
- GENUD (Growth, Exercise, Nutrition, and Development) Research group, University of Zaragoza; Instituto Agroalimentario de Aragón (IA2); Instituto de Investigación Sanitaria Aragón (IIS Aragón); Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Zaragoza, Spain
| | - Valeria Pala
- Nutritional Epidemiology Unit, Department of Preventive Medicine, Fondazione IRCSS Istituto Nazionale dei Tumori, Milan, Italy
| | - Lauren Lissner
- Section for Epidemiology and Social Medicine (EPSO), The Sahlgrenska Academy, University of Gothenburg, Box 453, 405 30, Gothenburg, Sweden
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Jilani HS, Intemann T, Bogl LH, Eiben G, Molnar D, Moreno LA, Pala V, Russo P, Siani A, Solea A, Veidebaum T, Ahrens W, Hebestreit A. Familial aggregation and socio-demographic correlates of taste preferences in European children. BMC Nutr 2017; 3:87. [PMID: 32153863 PMCID: PMC7050807 DOI: 10.1186/s40795-017-0206-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 11/17/2017] [Indexed: 11/10/2022] Open
Abstract
Background Studies on aggregation of taste preferences among children and their siblings as well as their parents are scarce. We investigated the familial aggregation of taste preferences as well as the effect of sex, age, country of residence and education on variation in taste preferences in the pan- European I.Family cohort. Method Thirteen thousand one hundred sixty-five participants from 7 European countries, comprising 2,230 boys <12 years, 2,110 girls <12 years, 1,682 boys ≥12 years, 1,744 girls ≥12 years and 5,388 parents, completed a Food and Beverage Preference Questionnaire containing 63 food items representing the taste modalities sweet, bitter, salty and fatty. We identified food items that represent the different taste qualities using factor analysis. On the basis of preference ratings for these food and drink items, a preference score for each taste was calculated for children and parents individually. Sibling and parent-child correlations for taste preference scores were calculated. The proportion of variance in children's preference scores that could be explained by their parents' preference scores and potential correlates including sex, age and parental educational was explored. Results Mean taste preferences for sweet, salty and fatty decreased and for bitter increased with age. Taste preference scores correlated stronger between siblings than between children and parents. Children's salty preference scores could be better explained by country than by family members. Children's fatty preference scores could be better explained by family members than by country. Age explained 17% of the variance in sweet and 16% of the variance in fatty taste preference. Sex and education were not associated with taste preference scores. Conclusion Taste preferences are correlated between siblings. Country could explain part of the variance of salty preference scores in children which points to a cultural influence on salt preference. Further, age also explained a relevant proportion of variance in sweet and fatty preference scores.
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Affiliation(s)
- Hannah S Jilani
- 1Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.,2Institute of Statistics, Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany
| | - Timm Intemann
- 1Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.,2Institute of Statistics, Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany
| | - Leonie H Bogl
- 1Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.,3Institute for Molecular Medicine FIMM, Helsinki, Finland
| | - Gabriele Eiben
- 4Department of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Dénes Molnar
- 5Department of Pediatrics, University of Pécs, Pécs, Hungary
| | - Luis A Moreno
- 6GENUD (Growth, Exercise, Nutrition and Development) Research Group, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain
| | - Valeria Pala
- 7Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Paola Russo
- 8Institute of Food Sciences, National Research Council, Avellino, Italy
| | - Alfonso Siani
- 8Institute of Food Sciences, National Research Council, Avellino, Italy
| | - Antonia Solea
- Research and Education Institute of Child Health, Strovolos, Cyprus
| | - Toomas Veidebaum
- 10Department of Chronic Diseases, National Institute for Health Development, Tallinn, Estonia
| | - Wolfgang Ahrens
- 1Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.,2Institute of Statistics, Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany
| | - Antje Hebestreit
- 1Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
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Ahrens W, Siani A, Adan R, De Henauw S, Eiben G, Gwozdz W, Hebestreit A, Hunsberger M, Kaprio J, Krogh V, Lissner L, Molnár D, Moreno LA, Page A, Picó C, Reisch L, Smith RM, Tornaritis M, Veidebaum T, Williams G, Pohlabeln H, Pigeot I. Cohort Profile: The transition from childhood to adolescence in European children-how I.Family extends the IDEFICS cohort. Int J Epidemiol 2017; 46:1394-1395j. [PMID: 28040744 PMCID: PMC5837508 DOI: 10.1093/ije/dyw317] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/06/2016] [Indexed: 02/07/2023] Open
Affiliation(s)
- W Ahrens
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
- Institute of Statistics, Bremen University, Bremen, Germany
| | - A Siani
- Institute of Food Sciences, National Research Council, Avellino, Italy
| | - R Adan
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - S De Henauw
- Department of Public Health, Ghent University, Ghent, Belgium
| | - G Eiben
- Section for Epidemiology and Social Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - W Gwozdz
- Department of Intercultural Communication and Management, Copenhagen Business School, Copenhagen, Denmark
| | - A Hebestreit
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - M Hunsberger
- Section for Epidemiology and Social Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - J Kaprio
- Department of Public Health, University of Helsinki, Institute for Molecular Medicine (FIMM), Helsinki, Finland
| | - V Krogh
- Epidemiology and Prevention Unit, Fondazione IRCSS Istituto Nazionale dei Tumori, Milan, Italy
| | - L Lissner
- Section for Epidemiology and Social Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - D Molnár
- Department of Paediatrics, University of Pécs, Pécs, Hungary
| | - L A Moreno
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain
| | - A Page
- Centre for Exercise, Nutrition & Health Sciences, University of Bristol, Bristol, UK
| | - C Picó
- Laboratory of Molecular Biology, Nutrition and Biotechnology (Nutrigenomics), University of the Balearic Islands (UIB) and CIBER Fisiopatología de la Obesidad y Nutrición, Palma de Mallorca, Spain
| | - L Reisch
- Department of Intercultural Communication and Management, Copenhagen Business School, Copenhagen, Denmark
| | - R M Smith
- Minerva Communications UK, Andover, UK
| | - M Tornaritis
- Research and Education Institute of Child Health, Strovolos, Cyprus
| | - T Veidebaum
- National Institute for Health Development, Tallinn, Estonia and
| | - G Williams
- Department of Politics, Philosophy and Religion, Lancaster University, Lancaster, UK
| | - H Pohlabeln
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - I Pigeot
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
- Institute of Statistics, Bremen University, Bremen, Germany
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Vaidya A, Oli N, Krettek A, Eiben G. Preference of Food-items and Physical Activity of Peri-urban Children in Bhaktapur. J Nepal Health Res Counc 2017; 15:150-158. [PMID: 29016586 DOI: 10.3126/jnhrc.v15i2.18205] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Accepted: 09/08/2017] [Indexed: 06/07/2023]
Abstract
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.
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Affiliation(s)
- Abhinav Vaidya
- Department of Community Medicine, Kathmandu Medical College, Kathmandu
| | - Natalia Oli
- Department of Community Medicine, Kathmandu Medical College, Kathmandu
| | - Alexandra Krettek
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Gabriele Eiben
- Department of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden
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Pohlabeln H, Rach S, De Henauw S, Eiben G, Gwozdz W, Hadjigeorgiou C, Molnár D, Moreno LA, Russo P, Veidebaum T, Pigeot I. Further evidence for the role of pregnancy-induced hypertension and other early life influences in the development of ADHD: results from the IDEFICS study. Eur Child Adolesc Psychiatry 2017; 26:957-967. [PMID: 28258320 DOI: 10.1007/s00787-017-0966-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Accepted: 02/21/2017] [Indexed: 12/25/2022]
Abstract
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.
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Affiliation(s)
- Hermann Pohlabeln
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, Achterstrasse 30, 28359, Bremen, Germany.
| | - Stefan Rach
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, Achterstrasse 30, 28359, Bremen, Germany
| | - Stefaan De Henauw
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Gabriele Eiben
- Section for Epidemiology and Social Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Wencke Gwozdz
- Department of Intercultural Communication and Management, Centre for Corporate Social Responsibility, Copenhagen Business School, Copenhagen, Denmark
| | | | - Dénes Molnár
- Department of Paediatrics, Medical Faculty, University of Pécs, Pecs, Hungary
| | - Luis A Moreno
- 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, Saragossa, Spain
| | - Paola Russo
- Unit of Epidemiology & Population Genetics, Institute of Food Sciences, National Research Council, Avellino, Italy
| | | | - Iris Pigeot
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, Achterstrasse 30, 28359, Bremen, Germany
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De Decker A, Verbeken S, Sioen I, Van Lippevelde W, Braet C, Eiben G, Pala V, Reisch LA, De Henauw S. Erratum to: Palatable food consumption in children: interplay between (food) reward motivation and the home food environment. Eur J Pediatr 2017; 176:833. [PMID: 28401343 DOI: 10.1007/s00431-017-2890-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Annelies De Decker
- Faculty of Medicine and Health Sciences, Department of Public Health, Ghent University, De Pintelaan 185 UZ 4 K3, 9000, Ghent, Belgium.
| | - Sandra Verbeken
- Faculty of Psychology and Educational Sciences, Department of Developmental, Personality and Social Psychology, Ghent University, Henri Dunantlaan 2, 9000, Ghent, Belgium
| | - Isabelle Sioen
- Faculty of Medicine and Health Sciences, Department of Public Health, Ghent University, De Pintelaan 185 UZ 4 K3, 9000, Ghent, Belgium.,Faculty of Bioscience Engineering, Department of Food Safety and Food Quality, Ghent University, Coupure links 653, 9000, Ghent, Belgium
| | - Wendy Van Lippevelde
- Faculty of Medicine and Health Sciences, Department of Public Health, Ghent University, De Pintelaan 185 UZ 4 K3, 9000, Ghent, Belgium
| | - Caroline Braet
- Faculty of Psychology and Educational Sciences, Department of Developmental, Personality and Social Psychology, Ghent University, Henri Dunantlaan 2, 9000, Ghent, Belgium
| | - Gabriele Eiben
- Department of Public Health and Community Medicine, University of Gothenburg, Box 453, 40530, Gothenburg, Sweden
| | - Valeria Pala
- Department of Preventive and Predictive Medicine, Fondazione IRCSS Istituto Nazionale dei Tumori, Via Venezian 1, 20133, Milan, Italy
| | - Lucia A Reisch
- Department of Intercultural Communication and Management, Copenhagen Business School, Porcelaenshaven 18a, 2000, Frederiksberg, Denmark
| | - Stefaan De Henauw
- Faculty of Medicine and Health Sciences, Department of Public Health, Ghent University, De Pintelaan 185 UZ 4 K3, 9000, Ghent, Belgium.,Department of Health Sciences, Vesalius, University College Ghent, Keramiekstraat 80, 9000, Ghent, Belgium
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Vaidya A, Oli N, Eiben G, Krettek A. The Heart-health Associated Research, Dissemination and Intervention in the Community (HARDIC) Trial for Nepalese Mothers regarding Diet and Physical Activity: A Process Evaluation. Kathmandu Univ Med J (KUMJ) 2017; 17:107-116. [PMID: 34547840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
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 Hearthealth 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.
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Affiliation(s)
- A Vaidya
- Department of Community Medicine, Kathmandu Medical College Teaching Hospital, Sinamangal, Kathmandu, Nepal
| | - N Oli
- 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, Gothenburg, Sweden
| | - G Eiben
- Department of Biomedicine and Public Health, School of Health and Education, University of Skövde, Skövde, Sweden. Department of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden
| | - A Krettek
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden. Department of Biomedicine and Public Health, School of Health and Education, University of Skövde, Skövde, Sweden. Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
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Hebestreit A, Intemann T, Siani A, De Henauw S, Eiben G, Kourides YA, Kovacs E, Moreno LA, Veidebaum T, Krogh V, Pala V, Bogl LH, Hunsberger M, Börnhorst C, Pigeot I. Dietary Patterns of European Children and Their Parents in Association with Family Food Environment: Results from the I.Family Study. Nutrients 2017; 9:nu9020126. [PMID: 28208650 PMCID: PMC5331557 DOI: 10.3390/nu9020126] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Accepted: 02/03/2017] [Indexed: 11/16/2022] Open
Abstract
The aim of this study was to determine whether an association exists between children's and parental dietary patterns (DP), and whether the number of shared meals or soft drink availability during meals strengthens this association. In 2013/2014 the I.Family study cross-sectionally assessed the dietary intakes of families from eight European countries using 24-h dietary recalls. Usual energy and food intakes from six- to 16-year-old children and their parents were estimated based on the NCI Method. A total of 1662 child-mother and 789 child-father dyads were included; DP were derived using cluster analysis. We investigated the association between children's and parental DP and whether the number of shared meals or soft drink availability moderated this association using mixed effects logistic regression models. Three DP comparable in children and parents were obtained: Sweet & Fat, Refined Cereals, and Animal Products. Children were more likely to be allocated to the Sweet & Fat DP when their fathers were allocated to the Sweet & Fat DP and when they shared at least one meal per day (OR 3.18; 95% CI 1.84; 5.47). Being allocated to the Sweet & Fat DP increased when the mother or the father was allocated to the Sweet & Fat DP and when soft drinks were available (OR 2.78; 95% CI 1.80; 4.28 or OR 4.26; 95% CI 2.16; 8.41, respectively). Availability of soft drinks and negative parental role modeling are important predictors of children's dietary patterns.
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Affiliation(s)
- Antje Hebestreit
- Leibniz-Institute for Prevention Research and Epidemiology-BIPS, 28359 Bremen, Germany.
| | - Timm Intemann
- Leibniz-Institute for Prevention Research and Epidemiology-BIPS, 28359 Bremen, Germany.
| | - Alfonso Siani
- Institute of Food Sciences, National Research Council, 83100 Avellino, Italy.
| | | | - Gabriele Eiben
- Department of Public Health and Community Medicine, University of Gothenburg, 40530 Gothenburg, Sweden.
| | - Yiannis A Kourides
- Research and Education Institute of Child Health, 2035 Strovolos, Cyprus.
| | - Eva Kovacs
- Institute for Medical Information Processing, Biometrics and Epidemiology, Ludwig-Maximilians-Universität München, 81377 Munich, Germany.
- German Center for Vertigo and Balance Disorders, Ludwig-Maximilians-Universität München, 81377 Munich, Germany.
| | - Luis A Moreno
- 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, 50009 Zaragoza, Spain.
| | - Toomas Veidebaum
- Department of Chronic Diseases, National Institute for Health Development, 11619 Tallinn, Estonia.
| | - Vittorio Krogh
- Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy.
| | - Valeria Pala
- Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy.
| | - Leonie H Bogl
- Leibniz-Institute for Prevention Research and Epidemiology-BIPS, 28359 Bremen, Germany.
- Department of Public Health, University of Helsinki, 00014 Helsinki, Finland.
- Finnish Institute of Molecular Medicine, University of Helsinki, Helsinki 00014, Finland.
| | - Monica Hunsberger
- Department of Public Health and Community Medicine, University of Gothenburg, 40530 Gothenburg, Sweden.
| | - Claudia Börnhorst
- Leibniz-Institute for Prevention Research and Epidemiology-BIPS, 28359 Bremen, Germany.
| | - Iris Pigeot
- Leibniz-Institute for Prevention Research and Epidemiology-BIPS, 28359 Bremen, Germany.
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Zaqout M, Michels N, Ahrens W, Börnhorst C, Molnár D, Moreno LA, Eiben G, Siani A, Papoutsou S, Veidebaum T, De Henauw S. Associations between exclusive breastfeeding and physical fitness during childhood. Eur J Nutr 2016; 57:545-555. [PMID: 27771770 DOI: 10.1007/s00394-016-1337-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Accepted: 10/16/2016] [Indexed: 01/03/2023]
Abstract
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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Affiliation(s)
- Mahmoud Zaqout
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, De Pintelaan 185, 4K3, Ghent, Belgium.
| | - Nathalie Michels
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, De Pintelaan 185, 4K3, Ghent, Belgium
| | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology BIPS, Bremen, Germany
| | - Claudia Börnhorst
- Leibniz Institute for Prevention Research and Epidemiology BIPS, Bremen, Germany
| | - Dénes Molnár
- Department of Pediatrics, Medical Faculty, University of Pécs, Pécs, Hungary
| | - Luis A Moreno
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain
| | - Gabriele Eiben
- Department of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Alfonso Siani
- Epidemiology and Population Genetics, Institute of Food Sciences, National Research Council, Avellino, Italy
| | - Stalo Papoutsou
- Research and Education Institute of Child Health, Strovolos, Cyprus
| | - Toomas Veidebaum
- Department of Chronic Diseases, National Institute for Health Development, Tallinn, Estonia
| | - Stefaan De Henauw
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, De Pintelaan 185, 4K3, Ghent, Belgium
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Mikkelsen A, Galli C, Eiben G, Ahrens W, Iacoviello L, Molnár D, Pala V, Risé P, Rodriguez G, Russo P, Tornaritis M, Veidebaum T, Vyncke K, Wolters M, Mehlig K. Blood fatty acid composition in relation to allergy in children aged 2-9 years: results from the European IDEFICS study. Eur J Clin Nutr 2016; 71:39-44. [PMID: 27650873 DOI: 10.1038/ejcn.2016.158] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Revised: 07/11/2016] [Accepted: 07/12/2016] [Indexed: 11/09/2022]
Abstract
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.
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Affiliation(s)
- A Mikkelsen
- Section for Epidemiology and Social Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Närhälsan, Research and Development Primary Health Care, Region Västra Götaland, Sweden
| | - C Galli
- Department of Pharmacological and Biomolecular Sciences, DiSFeB, University of Milan, Milan, Italy
| | - G Eiben
- Section for Epidemiology and Social Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - W Ahrens
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - L Iacoviello
- Laboratory of Molecular and Nutritional Epidemiology, Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli (IS), Italy
| | - D Molnár
- Department of Pediatrics, University of Pécs, Pécs, Hungary
| | - V Pala
- Epidemiology Unit, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - P Risé
- Department of Pharmacological and Biomolecular Sciences, DiSFeB, University of Milan, Milan, Italy
| | - G Rodriguez
- GENUD (Growth, Exercise, Nutrition, and Development) Research Group, University of Zaragoza, Zaragoza, Spain.,Instituto de Investigación Sanitaria, Aragón, Spain
| | - P Russo
- Institute of Food Sciences, CNR, Avellino, Italy
| | - M Tornaritis
- Research and Education Institute of Child Health, Strovolos, Cyprus
| | - T Veidebaum
- National Institute for Health Development, Tallinn, Estonia
| | - K Vyncke
- Department of Public Health, University of Ghent, Ghent, Belgium
| | - M Wolters
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - K Mehlig
- Section for Epidemiology and Social Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Hebestreit A, Barba G, De Henauw S, Eiben G, Hadjigeorgiou C, Kovács É, Krogh V, Moreno LA, Pala V, Veidebaum T, Wolters M, Börnhorst C. Cross-sectional and longitudinal associations between energy intake and BMI z-score in European children. Int J Behav Nutr Phys Act 2016; 13:23. [PMID: 26879850 PMCID: PMC4754870 DOI: 10.1186/s12966-016-0344-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Accepted: 02/06/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Evidence for the effect of dietary energy on BMI z-scores in young children is limited. We aim to investigate cross-sectional and longitudinal effects of daily energy intake (EI) on BMI z-scores of European boys and girls considering growth-related height dependencies of EI using residual EI. METHODS To investigate cross-sectional and longitudinal effects of daily energy intake (EI) on BMI z-scores of European boys and girls considering growth-related height dependencies of EI using residual EI. METHODS Subjects were children aged 2- < 10 y old (N = 2753, 48.2% girls) participating in the IDEFICS (Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS) baseline and follow-up examination. Usual EI (kcal/day) was calculated based on the National Cancer Institute-method excluding subjects with implausible reported EI. Effect of age, height and sex-adjusted residuals of EI on BMI z-score was investigated stratified by baseline age -group (2- < 4 y, 4- < 6 y, 6- < 8 y and 8- < 10 y) cross-sectionally using linear regression models adjusted for relevant confounders (crude model: age, sex, country; fully adjusted model: plus parental ISCED level, parental BMI, screen time; subgroup analysis: plus objectively measured physical activity). Longitudinal associations were estimated between changes in (Δ) residual EI per year and ΔBMI z-score per year with adjustments analogously to the cross-sectional models but with additional adjustment for residual EI at baseline. RESULTS Cross-sectionally, positive associations were observed between residual EI and BMI z-score for the full study sample, for boys and in older (≥6 years) but not in younger children in the crude and fully adjusted model. Longitudinally, small positive associations were observed between Δresidual EI per y on ΔBMI z-score per y for the full study sample and in 4- < 6 y olds in the crude and fully adjusted model. CONCLUSION In conclusion, EI above the average intakes for a certain sex, age and height are weakly associated with BMI z-scores in European children. Residual EI may be considered as a useful exposure measure in children as it accounts for growth-related changes in usual EI during childhood.
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Affiliation(s)
- Antje Hebestreit
- Leibniz-Institute for Prevention Research and Epidemiology - BIPS GmbH, Achterstr. 30, D-28359, Bremen, Germany.
| | | | | | - Gabriele Eiben
- Department of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden.
| | | | - Éva Kovács
- Department of Pediatrics, University of Pécs, Pécs, Hungary and Institute for Medical Information Processing, Biometrics and Epidemiology and German Centre for Vertigo and Balance Disorders, Ludwig Maximilian University, Munich, Germany.
| | - Vittorio Krogh
- Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
| | - Luis A Moreno
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain.
| | - Valeria Pala
- Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
| | - Toomas Veidebaum
- Department of Chronic Diseases, National Institute for Health Development, Tallinn, Estonia.
| | - Maike Wolters
- Leibniz-Institute for Prevention Research and Epidemiology - BIPS GmbH, Achterstr. 30, D-28359, Bremen, Germany.
| | - Claudia Börnhorst
- Leibniz-Institute for Prevention Research and Epidemiology - BIPS GmbH, Achterstr. 30, D-28359, Bremen, Germany.
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Zaqout M, Michels N, Bammann K, Ahrens W, Sprengeler O, Molnar D, Hadjigeorgiou C, Eiben G, Konstabel K, Russo P, Jiménez-Pavón D, Moreno LA, De Henauw S. Influence of physical fitness on cardio-metabolic risk factors in European children. The IDEFICS study. Int J Obes (Lond) 2016; 40:1119-25. [PMID: 26857382 DOI: 10.1038/ijo.2016.22] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Revised: 11/30/2015] [Accepted: 12/09/2015] [Indexed: 01/02/2023]
Abstract
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 (β=0.057; P=0.002) where the opposite association was found. Cardio-respiratory fitness (β=-0.124; P<0.001) and lower-limb strength (β=-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 (β=-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.
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Affiliation(s)
- M Zaqout
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - N Michels
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - K Bammann
- Institute for Public Health and Nursing Research, Faculty for Human and Health Sciences, University of Bremen, Bremen, Germany.,Leibniz Institute for Prevention Research and Epidemiology BIPS, Bremen, Germany
| | - W Ahrens
- Leibniz Institute for Prevention Research and Epidemiology BIPS, Bremen, Germany
| | - O Sprengeler
- Leibniz Institute for Prevention Research and Epidemiology BIPS, Bremen, Germany
| | - D Molnar
- Department of Pediatrics, Medical Faculty, University of Pécs, Pécs, Hungary
| | - C Hadjigeorgiou
- Research and Education Institute of Child Health, Strovolos, Cyprus
| | - G Eiben
- Public Health Epidemiology Unit (EPI), Department of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - K Konstabel
- Department of Chronic Diseases, Centre of Behavioural and Health Sciences, National Institute for Health Development, Tallinn, Estonia
| | - P Russo
- Unit of Epidemiology and Population Genetics, Institute of Food Sciences, National Research Council, Avellino, Italy
| | - D Jiménez-Pavón
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain
| | - L A Moreno
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain
| | - S De Henauw
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
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