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Scicchitano P, Locuratolo N, Lillo A, Sublimi Saponetti L, Palumbo V, Lanzone S, Campanella C, Mancini L, Massari F, Landriscina R, Barba G, De Santis A, Caldarola P. P209 THE FOLLOW–UP OF PATIENTS AFTER ACUTE CORONARY SYNDROME: THE APULIAN PONTE–ACS PROJECT. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartj/suac012.201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Background
Patients discharged after acute coronary syndrome (ACS) deserve a tight follow–up in order to optimize long–term pharmacological treatments and prevent the occurrence of adverse events. The aim of the PONTE–ACS Project was to evaluate the impact of a dedicated cooperative program between hospital and outpatient structures on the persistance on recommended therapies and long–term outcome occurrence in patients discharged after ACS.
Materials and Methods
This was a prospective, longitudina, cohort study. We enrolled patients who were discharged after ACS and/or after coronary revascularization in the HUB centres of ASL Bari. Patients underwent cardiologic evaluation and laboratory examination at 30 days, 3–, 6–, and 12–months from the index event. The following endpoint were considered: all–cause mortality, ACS recurrence/cardiac ischemia/angina, restenosis/intrastent thrombosis, stroke/transient ischemic attack (TIA), heart failure, any bleeding. Adherence and persistence to therapies were evalauted as well as the percentage of patients who reached the recommended goals.
Results
We enrolled 2476 patients (77.4% male, mean age: 67.2±12.0 yrs). After one–year follow–up, 99.5% (p < 0.05) were on statin–therapy, 16.1% with ezetimibe (p < 0.01) and 9.9% (p < 0.01) with proprotein convertase subtilisin/kexin type 9 inhibitors. The overall mortality at one–year follow–up was 3.1%, while ACS recurrence/cardiac ischemia/angina and restenosis/intrastent thrombosis were 3% e 1.3%, respectively. Any bleeding rate was 2.2%.
Conclusions
The PONTE–ACS Project was able to improve the management of patients after ACS, to manage a structured follow–up protocol for patients discharged after ACS and/or coronary revascularization, thus improving adhesion to recommended therapies and keeping lower the incidence of major cardiovascular and bleeding events.
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Affiliation(s)
- P Scicchitano
- UOC CARDIOLOGIA – P.O. “F. PERINEI” ALTAMURA (BA) ASL BARI, ALTAMURA; UOC CARDIOLOGIA – P.O. “SAN PAOLO” ASL BARI, BARI; DISTRETTO SOCIO SANITARIO N. 10, ASL BARI, TRIGGIANO; UOC CARDIOLOGIA – P.O. “DI VENERE” BARI (BA) ASL BARI, BARI; UO CARDIOLOGIA – P.O. “SAN GIACOMO” ASL BARI, MONOPOLI; UOC CARDIOLOGIA – P.O. “UMBERTO I” ASL BARI, CORATO
| | - N Locuratolo
- UOC CARDIOLOGIA – P.O. “F. PERINEI” ALTAMURA (BA) ASL BARI, ALTAMURA; UOC CARDIOLOGIA – P.O. “SAN PAOLO” ASL BARI, BARI; DISTRETTO SOCIO SANITARIO N. 10, ASL BARI, TRIGGIANO; UOC CARDIOLOGIA – P.O. “DI VENERE” BARI (BA) ASL BARI, BARI; UO CARDIOLOGIA – P.O. “SAN GIACOMO” ASL BARI, MONOPOLI; UOC CARDIOLOGIA – P.O. “UMBERTO I” ASL BARI, CORATO
| | - A Lillo
- UOC CARDIOLOGIA – P.O. “F. PERINEI” ALTAMURA (BA) ASL BARI, ALTAMURA; UOC CARDIOLOGIA – P.O. “SAN PAOLO” ASL BARI, BARI; DISTRETTO SOCIO SANITARIO N. 10, ASL BARI, TRIGGIANO; UOC CARDIOLOGIA – P.O. “DI VENERE” BARI (BA) ASL BARI, BARI; UO CARDIOLOGIA – P.O. “SAN GIACOMO” ASL BARI, MONOPOLI; UOC CARDIOLOGIA – P.O. “UMBERTO I” ASL BARI, CORATO
| | - L Sublimi Saponetti
- UOC CARDIOLOGIA – P.O. “F. PERINEI” ALTAMURA (BA) ASL BARI, ALTAMURA; UOC CARDIOLOGIA – P.O. “SAN PAOLO” ASL BARI, BARI; DISTRETTO SOCIO SANITARIO N. 10, ASL BARI, TRIGGIANO; UOC CARDIOLOGIA – P.O. “DI VENERE” BARI (BA) ASL BARI, BARI; UO CARDIOLOGIA – P.O. “SAN GIACOMO” ASL BARI, MONOPOLI; UOC CARDIOLOGIA – P.O. “UMBERTO I” ASL BARI, CORATO
| | - V Palumbo
- UOC CARDIOLOGIA – P.O. “F. PERINEI” ALTAMURA (BA) ASL BARI, ALTAMURA; UOC CARDIOLOGIA – P.O. “SAN PAOLO” ASL BARI, BARI; DISTRETTO SOCIO SANITARIO N. 10, ASL BARI, TRIGGIANO; UOC CARDIOLOGIA – P.O. “DI VENERE” BARI (BA) ASL BARI, BARI; UO CARDIOLOGIA – P.O. “SAN GIACOMO” ASL BARI, MONOPOLI; UOC CARDIOLOGIA – P.O. “UMBERTO I” ASL BARI, CORATO
| | - S Lanzone
- UOC CARDIOLOGIA – P.O. “F. PERINEI” ALTAMURA (BA) ASL BARI, ALTAMURA; UOC CARDIOLOGIA – P.O. “SAN PAOLO” ASL BARI, BARI; DISTRETTO SOCIO SANITARIO N. 10, ASL BARI, TRIGGIANO; UOC CARDIOLOGIA – P.O. “DI VENERE” BARI (BA) ASL BARI, BARI; UO CARDIOLOGIA – P.O. “SAN GIACOMO” ASL BARI, MONOPOLI; UOC CARDIOLOGIA – P.O. “UMBERTO I” ASL BARI, CORATO
| | - C Campanella
- UOC CARDIOLOGIA – P.O. “F. PERINEI” ALTAMURA (BA) ASL BARI, ALTAMURA; UOC CARDIOLOGIA – P.O. “SAN PAOLO” ASL BARI, BARI; DISTRETTO SOCIO SANITARIO N. 10, ASL BARI, TRIGGIANO; UOC CARDIOLOGIA – P.O. “DI VENERE” BARI (BA) ASL BARI, BARI; UO CARDIOLOGIA – P.O. “SAN GIACOMO” ASL BARI, MONOPOLI; UOC CARDIOLOGIA – P.O. “UMBERTO I” ASL BARI, CORATO
| | - L Mancini
- UOC CARDIOLOGIA – P.O. “F. PERINEI” ALTAMURA (BA) ASL BARI, ALTAMURA; UOC CARDIOLOGIA – P.O. “SAN PAOLO” ASL BARI, BARI; DISTRETTO SOCIO SANITARIO N. 10, ASL BARI, TRIGGIANO; UOC CARDIOLOGIA – P.O. “DI VENERE” BARI (BA) ASL BARI, BARI; UO CARDIOLOGIA – P.O. “SAN GIACOMO” ASL BARI, MONOPOLI; UOC CARDIOLOGIA – P.O. “UMBERTO I” ASL BARI, CORATO
| | - F Massari
- UOC CARDIOLOGIA – P.O. “F. PERINEI” ALTAMURA (BA) ASL BARI, ALTAMURA; UOC CARDIOLOGIA – P.O. “SAN PAOLO” ASL BARI, BARI; DISTRETTO SOCIO SANITARIO N. 10, ASL BARI, TRIGGIANO; UOC CARDIOLOGIA – P.O. “DI VENERE” BARI (BA) ASL BARI, BARI; UO CARDIOLOGIA – P.O. “SAN GIACOMO” ASL BARI, MONOPOLI; UOC CARDIOLOGIA – P.O. “UMBERTO I” ASL BARI, CORATO
| | - R Landriscina
- UOC CARDIOLOGIA – P.O. “F. PERINEI” ALTAMURA (BA) ASL BARI, ALTAMURA; UOC CARDIOLOGIA – P.O. “SAN PAOLO” ASL BARI, BARI; DISTRETTO SOCIO SANITARIO N. 10, ASL BARI, TRIGGIANO; UOC CARDIOLOGIA – P.O. “DI VENERE” BARI (BA) ASL BARI, BARI; UO CARDIOLOGIA – P.O. “SAN GIACOMO” ASL BARI, MONOPOLI; UOC CARDIOLOGIA – P.O. “UMBERTO I” ASL BARI, CORATO
| | - G Barba
- UOC CARDIOLOGIA – P.O. “F. PERINEI” ALTAMURA (BA) ASL BARI, ALTAMURA; UOC CARDIOLOGIA – P.O. “SAN PAOLO” ASL BARI, BARI; DISTRETTO SOCIO SANITARIO N. 10, ASL BARI, TRIGGIANO; UOC CARDIOLOGIA – P.O. “DI VENERE” BARI (BA) ASL BARI, BARI; UO CARDIOLOGIA – P.O. “SAN GIACOMO” ASL BARI, MONOPOLI; UOC CARDIOLOGIA – P.O. “UMBERTO I” ASL BARI, CORATO
| | - A De Santis
- UOC CARDIOLOGIA – P.O. “F. PERINEI” ALTAMURA (BA) ASL BARI, ALTAMURA; UOC CARDIOLOGIA – P.O. “SAN PAOLO” ASL BARI, BARI; DISTRETTO SOCIO SANITARIO N. 10, ASL BARI, TRIGGIANO; UOC CARDIOLOGIA – P.O. “DI VENERE” BARI (BA) ASL BARI, BARI; UO CARDIOLOGIA – P.O. “SAN GIACOMO” ASL BARI, MONOPOLI; UOC CARDIOLOGIA – P.O. “UMBERTO I” ASL BARI, CORATO
| | - P Caldarola
- UOC CARDIOLOGIA – P.O. “F. PERINEI” ALTAMURA (BA) ASL BARI, ALTAMURA; UOC CARDIOLOGIA – P.O. “SAN PAOLO” ASL BARI, BARI; DISTRETTO SOCIO SANITARIO N. 10, ASL BARI, TRIGGIANO; UOC CARDIOLOGIA – P.O. “DI VENERE” BARI (BA) ASL BARI, BARI; UO CARDIOLOGIA – P.O. “SAN GIACOMO” ASL BARI, MONOPOLI; UOC CARDIOLOGIA – P.O. “UMBERTO I” ASL BARI, CORATO
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De Bourdeaudhuij I, Verbestel V, De Henauw S, Maes L, Mårild S, Moreno LA, Barba G, Siani A, Kovács E, Konstabel K, Tornaritis M, Pigeot I, Ahrens W. Implementation of the IDEFICS intervention across European countries: perceptions of parents and relationship with BMI. Obes Rev 2015; 16 Suppl 2:78-88. [PMID: 26707018 DOI: 10.1111/obr.12330] [Citation(s) in RCA: 12] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Accepted: 08/30/2015] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The primary aim of the present study was to obtain insight into parents' perception of the IDEFICS intervention at the school or preschool/kindergarten and community levels and whether they received specific materials related to the intervention. The secondary aim was to analyse whether parents who reported higher levels of exposure to the IDEFICS intervention had children with more favourable changes in body mass index (BMI) z-scores between baseline and after 2 years of intervention. METHODS Process evaluation of the IDEFICS intervention investigated the implementation of the 2-year intervention in the intervention communities. Intervention group parents (n = 4,180) in seven countries (Belgium, Cyprus, Estonia, Germany, Italy, Spain and Sweden) answered questions about their exposure to the IDEFICS study. To analyse the relationship between exposure and BMI z-score, a composite score was calculated for exposure at the setting and at the community levels. RESULTS The frequency of parental exposure to the IDEFICS messages not only through the community but also through the (pre)school/kindergarten was lower than what was intended and planned. The dose received by the parents was considerably higher through the (pre)school/kindergarten settings than that through the community in all countries. Efforts by the settings or communities related to fruit and vegetable consumption (range 69% to 97%), physical activity promotion (range 67% to 91%) and drinking water (range 49% to 93%) were more visible and also realized more parental involvement than those related to TV viewing, sleep duration and spending time with the family (below 50%). Results showed no relation of parental exposure at the setting or the community level on more favourable changes in children's BMI z-scores for the total sample. Country-specific analyses for parental exposure at the setting level showed an expected positive effect in German girls and an unexpected negative effect in Italian boys. CONCLUSION Parental exposure and involvement in the IDEFICS intervention in all countries was much less than aimed for, which might be due to the diverse focus (six key messages) and high intensity and duration of the intervention. It may also be that the human resources invested in the implementation and maintenance of intervention activities by the study centres, the caretakers and the community stakeholders were not sufficient. Higher levels of parental exposure were not related to more favourable changes in BMI z-scores.
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Affiliation(s)
- I De Bourdeaudhuij
- Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
| | - V Verbestel
- Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
| | - S De Henauw
- Department of Public Health, Ghent University, Ghent, Belgium
| | - L Maes
- Department of Public Health, Ghent University, Ghent, Belgium
| | - S Mårild
- Department of Pediatrics, Göteborg University, Göteborg, Sweden
| | - L A Moreno
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Universidad de Zaragoza, Zaragoza, Spain
| | - G Barba
- Institute of Food Science, National Research Council, Avellino, Italy
| | - A Siani
- Institute of Food Science, National Research Council, Avellino, Italy
| | - E Kovács
- Department Paediatrics, University of Pécs, Pécs, Hungary
| | - K Konstabel
- National Institute for Health Development, Tallinn, Estonia
| | - M Tornaritis
- Research and Education Institute for Child Health, Strovolos, Cyprus
| | - I Pigeot
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.,Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany
| | - W Ahrens
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.,Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany
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3
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De Bourdeaudhuij I, Verbestel V, De Henauw S, Maes L, Huybrechts I, Mårild S, Eiben G, Moreno LA, Barba G, Kovács É, Konstabel K, Tornaritis M, Gallois K, Hebestreit A, Pigeot I. Behavioural effects of a community-oriented setting-based intervention for prevention of childhood obesity in eight European countries. Main results from the IDEFICS study. Obes Rev 2015; 16 Suppl 2:30-40. [PMID: 26707014 DOI: 10.1111/obr.12347] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Accepted: 09/25/2015] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The objective of this paper is to evaluate the behavioural effects, as reported by the parents of the participating boys and girls, of the IDEFICS (Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS) intervention. METHODS The effectiveness of the IDEFICS intervention was evaluated through a cluster-controlled trial in eight European countries (control and intervention communities in each country) including more than 16,000 children. The 2- to 9.9-year-old children in the intervention group were exposed to a culturally adapted intervention that aimed to prevent childhood obesity through the community, schools/kindergartens and family. Parents completed questionnaires to measure water, soft drink and fruit juice intake; fruit and vegetable intake; daily TV viewing and other sedentary behaviours; daily physical activity levels and strengthening of the parent-child relationships at baseline and follow-up (2 years later). Mixed models with an additional random effect for country were used to account for the clustered study design, and results were stratified by sex. RESULTS The pan-European analysis revealed no significant time by condition interaction effects, neither for boys nor girls, i.e. the analysis revealed no intervention effects on the behaviours of the IDEFICS children as reported by their parents (F = 0.0 to 3.3, all p > 0.05). Also very few significances were found in the country-specific analyses. Positive intervention effects were only found for sport club participation in Swedish boys, for screen time in weekends for Spanish boys and for TV viewing in Belgian girls. CONCLUSION Although no expected intervention effects as reported by the parents on diet, physical activity and sedentary behaviours could be shown for the overall IDEFICS cohort, a few favourable intervention effects were found on specific behaviours in some individual countries. More in-depth analyses of the process evaluation data are needed to obtain more insight into the relationship between the level of exposure to the intervention and its effect.
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Affiliation(s)
- I De Bourdeaudhuij
- Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
| | - V Verbestel
- Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
| | - S De Henauw
- Department of Public Health, Ghent University, Ghent, Belgium
| | - L Maes
- Department of Public Health, Ghent University, Ghent, Belgium
| | - I Huybrechts
- Dietary Exposure Assessment Group, International Agency for Research on Cancer, Lyon, France
| | - S Mårild
- Department of Pediatrics, University of Gothenburg, Göteborg, Sweden
| | - G Eiben
- Department of Public Health and Community Medicine, University of Gothenburg, Göteborg, Sweden
| | - L A Moreno
- GENUD (Growth, Exercise, Nutrition and Development) research group, Universidad de Zaragoza, Zaragoza, Spain
| | - G Barba
- Institute of Food Science, National research Council, Avellino, Italy
| | - É Kovács
- Department Paediatrics, University of Pécs, Pécs, Hungary
- Institute for Medical Information Processing, Biometrics and Epidemiology and German Centre for Vertigo and Balance Disorders, Ludwig Maximilian University, Munich, Germany
| | - K Konstabel
- National Institute for Health Development, Tallinn, Estonia
| | - M Tornaritis
- Research and Education Institute for Child Health, Strovolos, Cyprus
| | - K Gallois
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - A Hebestreit
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - I Pigeot
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
- Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany
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De Henauw S, Huybrechts I, De Bourdeaudhuij I, Bammann K, Barba G, Lissner L, Mårild S, Molnár D, Moreno LA, Pigeot I, Tornaritis M, Veidebaum T, Verbestel V, Ahrens W. Effects of a community-oriented obesity prevention programme on indicators of body fatness in preschool and primary school children. Main results from the IDEFICS study. Obes Rev 2015; 16 Suppl 2:16-29. [PMID: 26707013 DOI: 10.1111/obr.12346] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Accepted: 09/25/2015] [Indexed: 11/27/2022]
Abstract
BACKGROUND/OBJECTIVES Childhood obesity is a major public health concern but evidence-based approaches to tackle this epidemic sustainably are still lacking. The Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS (IDEFICS) study investigated the aetiology of childhood obesity and developed a primary prevention programme. Here, we report on the effects of the IDEFICS intervention on indicators of body fatness. SUBJECTS/METHODS The intervention modules addressed the community, school and parental level, focusing on diet, physical activity and stress-related lifestyle factors. A cohort of 16,228 children aged 2-9.9 years - about 2000 per country - was equally divided over intervention and control regions. (Participating countries were Sweden, Germany, Estonia, Hungary, Cyprus, Italy, Spain and Belgium.) We compared the prevalence of overweight/obesity and mean values of body mass index z-score, per cent body fat and waist-to-height ratio over 2 years of follow-up. Mixed models adjusting for age and socioeconomic status of the parents and with an additional random effect for country accounted for the clustered study design. RESULTS The prevalence of overweight and obesity increased in both the intervention and control group from 18.0% at baseline to 22.9% at follow-up in the control group and from 19.0% to 23.6% in the intervention group. The difference in changes between control and intervention was not statistically significant. For the cohort as a whole, the changes in indicators of body fatness did not show any clinically relevant differences between the intervention and control groups. Changes in favour of intervention treatment in some indicators were counterbalanced by changes in favour of the control group in some other indicators. CONCLUSIONS Over the 2-year-observation period, the IDEFICS primary prevention programme for childhood obesity has not been successful in reducing the prevalence of overweight and obesity nor in improving indicators of body fatness in the target population as a whole.
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Affiliation(s)
- S De Henauw
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- Department of Health Sciences, Vesalius, University College Ghent, Ghent, Belgium
| | - I Huybrechts
- International Agency for Research on Cancer, Dietary Exposure Assessment Group, Lyon, France
| | - I De Bourdeaudhuij
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - K Bammann
- Institute for Public Health and Nursing Research (IPP), University of Bremen, Bremen, Germany
| | - G Barba
- Unit of Epidemiology and Population Genetics, Institute of Food Sciences, National Research Council, Avellino, Italy
| | - L Lissner
- Section for Epidemiology and Social Medicine (EPSO), Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - S Mårild
- Department of Paediatrics, Institute of Clinical Sciences, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden
| | - D Molnár
- Department of Paediatrics, University of Pécs, Pécs, Hungary
| | - L A Moreno
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain
| | - I Pigeot
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
- Institute of Statistics, Faculty of Mathematics and Computer Science, University Bremen, Bremen, Germany
| | - M Tornaritis
- Research and Education Institute of Child Health, Strovolos, Cyprus
| | - T Veidebaum
- Department of Chronic Diseases, National Institute for Health Development, Tallinn, Estonia
| | - V Verbestel
- International Agency for Research on Cancer, Dietary Exposure Assessment Group, Lyon, France
| | - W Ahrens
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
- Institute of Statistics, Faculty of Mathematics and Computer Science, University Bremen, Bremen, Germany
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Verbestel V, De Henauw S, Barba G, Eiben G, Gallois K, Hadjigeorgiou C, Konstabel K, Maes L, Mårild S, Molnár D, Moreno LA, Oja L, Pitsiladis Y, Ahrens W, Pigeot I, De Bourdeaudhuij I. Effectiveness of the IDEFICS intervention on objectively measured physical activity and sedentary time in European children. Obes Rev 2015; 16 Suppl 2:57-67. [PMID: 26707016 DOI: 10.1111/obr.12348] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [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: 03/03/2015] [Accepted: 09/25/2015] [Indexed: 12/14/2022]
Abstract
BACKGROUND This paper reports on the effectiveness of the prevention of dietary- and lifestyle-induced health effects in children and infants (IDEFICS) intervention on objectively measured physical activity (PA) and sedentary time (ST) in 2- to 9.9-year-old European boys and girls. METHODS The intervention was evaluated after 2 years through a non-randomized cluster-controlled trial in eight European countries (one control and one intervention community per country). All children in the intervention group received a culturally adapted childhood obesity prevention programme through the community, schools/kindergartens and family. A random sub-sample of children participating in the IDEFICS study wore an accelerometer at baseline and follow-up for at least 3 days (n = 9,184). Of this sample, 81% provided valid accelerometer data at baseline (n = 7,413; 51% boys; 6.21 ± 1.76 years; boys: 617 ± 170 cpm day(-1) ; girls 556 ± 156 cpm day(-1) ) and 3,010 children provided valid accelerometer data at baseline and during the follow-up survey 2 years later. RESULTS In boys and girls, no significant differences in PA and ST were found between intervention and control groups over 2 years. Strong temporal effects were found in the total sample of boys and girls: the percentage of time spent in light PA per day decreased by 4 percentage points in both boys and girls between baseline and follow-up (both: p < 0.001), while time spent in ST per day increased by 4 percentage points in both sexes over time (both: p < 0.001). Percentage of time spent in moderate-to-vigorous PA per day remained stable over time in boys and girls. CONCLUSION Despite the socio-ecological approach and implementation of a culturally adapted intervention in each country, no effects of the IDEFICS intervention were found on children's objectively measured PA and ST. Behavioural interventions for children may need to enhance specificity and intensity at the family level using other behaviour change techniques and more direct strategies to reach parents.
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Affiliation(s)
- V Verbestel
- Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
| | - S De Henauw
- Department of Public Health, Ghent University, Ghent, Belgium
| | - G Barba
- Unit of Epidemiology and Population Genetics, Institute of Food Science, National Research Council, Avellino, Italy
| | - G Eiben
- Department of Public Health and Community Medicine, Sahlgrenska Academy, Göteborg University, Göteborg, Sweden
| | - K Gallois
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - C Hadjigeorgiou
- Research and Education Institute of Child Health, Strovolos, Cyprus
| | - K Konstabel
- National Institute for Health Development, Tallinn, Estonia
| | - L Maes
- Department of Public Health, Ghent University, Ghent, Belgium
| | - S Mårild
- Department of Pediatrics, The Queen Silvia Childrens' University Hospital, Göteborg University, Göteborg, Sweden
| | - D Molnár
- Department of Pediatrics, University of Pécs, Pécs, Hungary
| | - L A Moreno
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain.,Department of Preventive Medicine, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - L Oja
- National Institute for Health Development, Tallinn, Estonia
| | - Y Pitsiladis
- College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - W 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
| | - I Pigeot
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.,Institute of Statistics, Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany
| | - I De Bourdeaudhuij
- Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
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Erhardt E, Foraita R, Pigeot I, Barba G, Veidebaum T, Tornaritis M, Michels N, Eiben G, Ahrens W, Moreno LA, Kovács E, Molnár D. Reference values for leptin and adiponectin in children below the age of 10 based on the IDEFICS cohort. Int J Obes (Lond) 2015; 38 Suppl 2:S32-8. [PMID: 25219410 DOI: 10.1038/ijo.2014.133] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [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] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To establish age- and sex-specific reference values for serum leptin and adiponectin in normal-weight 3.0-8.9-year old European children. SUBJECTS AND METHODS Blood samples for hormone analysis were taken from 1338 children of the IDEFICS (Identification and prevention of Dietary- and lifestyle-induced health Effects in Children and infantS) study cohort. Only normal-weight children aged 3.0-8.9 years were included (n=539) in our analysis. Using the General Additive Model for Location Scale and Shape, age- and sex-specific percentiles were derived. The influence of under/overweight and obesity on the proposed reference curves based on normal-weight children was investigated in several sensitivity analyses using the sample without obese children (n=1015) and the whole study sample (n=1338). RESULTS There was a negative age trend of adiponectin blood levels and a positive trend of leptin levels in boys and girls. Percentiles derived for girls were generally higher than those obtained for boys. The corresponding age-specific differences of the 97th percentile ranged from -2.2 to 4.6 μg ml(-1) and from 2.2 to 4.8 ng ml(-1) for adiponectin and leptin, respectively. CONCLUSIONS According to our knowledge, these are the first reference values of leptin and adiponectin in prepubertal, normal-weight children. The presented adiponectin and leptin reference curves may allow for a more differentiated interpretation of children's hormone levels in epidemiological and clinical studies.
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Affiliation(s)
- E Erhardt
- Department of Paediatrics, University of Pécs, Pécs, Hungary
| | - R Foraita
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany
| | - I Pigeot
- 1] Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany [2] Institute of Statistics, Faculty of Mathematics and Computer Science, Bremen University, Bremen, Germany
| | - G Barba
- Epidemiology and Population Genetics, Institute of Food Science, National Research Council, Avellino, Italy
| | - T Veidebaum
- Department of Chronic Diseases, National Institute for Health Development, Tallinn, Estonia
| | - M Tornaritis
- Research and Education Institute of Child Health, Strovolos, Cyprus
| | - N Michels
- Department of Public Health, University of Ghent, Ghent, Belgium
| | - G Eiben
- Department of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden
| | - W Ahrens
- 1] Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany [2] Institute of Statistics, Faculty of Mathematics and Computer Science, Bremen University, Bremen, Germany
| | - L A Moreno
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Zaragoza, Spain
| | - E Kovács
- Department of Paediatrics, University of Pécs, Pécs, Hungary
| | - D Molnár
- Department of Paediatrics, University of Pécs, Pécs, Hungary
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Hebestreit A, Börnhorst C, Pala V, Barba G, Eiben G, Veidebaum T, Hadjigergiou C, Molnár D, Claessens M, Fernández-Alvira JM, Pigeot I. Dietary energy density in young children across Europe. Int J Obes (Lond) 2015; 38 Suppl 2:S124-34. [PMID: 25376214 DOI: 10.1038/ijo.2014.143] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [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] [Indexed: 12/31/2022]
Abstract
OBJECTIVES To describe energy density (ED; kcal g(-1)) of dietary intake of European children. METHODS From 16, 228 children who participated in the IDEFICS (Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS) baseline examination, 8551 children with 24-h dietary recalls (24-HDR), with plausible reported energy intakes and complete covariate information were included in the present analysis. ED was calculated using two methods: (1) ED including solid foods (EDF) and (2) ED including solid foods and energy-containing beverages (EDF&B). Beverage energy was calculated in kcal per day. Dietary characteristics and body mass index (BMI) z-score of children aged 2 to <6 years and 6 to <10 years were compared between children with an overall EDF below the <25th percentile, between the 25th and 75th percentile as well as above the >75th percentile. Standardised regression coefficients were estimated to assess the association between dietary characteristics, BMI z-score and ED of the diet. RESULTS Children with low EDF and EDF&B diets consumed less energy but higher quantity of food and beverages than children with high EDF and EDF&B diets. Consumption of caloric beverages decreased with increasing EDF&B of the diet owing to the relatively low ED of the beverages, in relation to solid foods. Generally, children with low EDF and EDF&B diets showed healthier food choices than peers with higher EDF and EDF&B diets. In this sample, EDF and EDF&B were not associated with BMI z-score. CONCLUSION Health promotion strategies should proclaim lower ED diets by means of foods with high water and low fat content and mainly fruit and vegetable components. Excluding caloric beverages from EDF calculation is a useful method to avoid misinterpretation of true exposure to a high energy dense diet. We recommend excluding caloric beverages from EDF calculation when investigating the effect of ED on a certain (health) outcome.
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Affiliation(s)
- A Hebestreit
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany
| | - C Börnhorst
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany
| | - V Pala
- Epidemiology and Prevention Unit, Department of Preventive & Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - G Barba
- Epidemology & Population Genetics, Institute of Food Sciences, National Research Council, Avellino, Italy
| | - G Eiben
- Department of Public Health and Community Medicine, University of Gothenburg, Sweden
| | - T Veidebaum
- Department of Chronic Diseases, National Institute for Health Development, Tallinn, Estonia
| | - C Hadjigergiou
- Research and Education Institute of Child Health, Strovolos, Cyprus
| | - D Molnár
- Department of Pediatrics, University of Pécs, Pécs, Hungary
| | - M Claessens
- Department of Public Health, Ghent University, Ghent, Belgium
| | - J M Fernández-Alvira
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain
| | - I Pigeot
- 1] Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany [2] Department of Mathematics and Computer Science, University of Bremen, Bremen, Germany
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8
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Börnhorst C, Huybrechts I, Hebestreit A, Krogh V, De Decker A, Barba G, Moreno LA, Lissner L, Tornaritis M, Loit HM, Molnár D, Pigeot I. Usual energy and macronutrient intakes in 2-9-year-old European children. Int J Obes (Lond) 2014; 38 Suppl 2:S115-23. [PMID: 25376213 DOI: 10.1038/ijo.2014.142] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Valid estimates of population intakes are essential for monitoring trends as well as for nutritional interventions, but such data are rare in young children. In particular, the problem of misreporting in dietary data is usually not accounted for. Therefore, this study aims to provide accurate estimates of intake distributions in European children. DESIGN Cross-sectional setting-based multi-centre study. SUBJECTS A total of 9560 children aged 2-9 years from eight European countries with at least one 24-h dietary recall (24-HDR). METHODS The 24-HDRs were classified in three reporting groups based on age- and sex-specific Goldberg cutoffs (underreports, plausible reports, overreports). Only plausible reports were considered in the final analysis (N=8611 children). The National Cancer Institute (NCI)-Method was applied to estimate population distributions of usual intakes correcting for the variance inflation in short-term dietary data. RESULTS The prevalence of underreporting (9.5%) was higher compared with overreporting (3.4%). Exclusion of misreports resulted in a shift of the energy and absolute macronutrient intake distributions to the right, and further led to the exclusion of extreme values, that is, mean values and lower percentiles increased, whereas upper percentiles decreased. The distributions of relative macronutrient intakes (% energy intake from fat/carbohydrates/proteins) remained almost unchanged when excluding misreports. Application of the NCI-Method resulted in markedly narrower intake distributions compared with estimates based on single 24-HDRs. Mean percentages of usual energy intake from fat, carbohydrates and proteins were 32.2, 52.1 and 15.7%, respectively, suggesting the majority of European children are complying with common macronutrient intake recommendations. In contrast, total water intake (mean: 1216.7 ml per day) lay below the recommended value for >90% of the children. CONCLUSION This study provides recent estimates of intake distributions of European children correcting for misreporting as well as for the daily variation in dietary data. These data may help to assess the adequacy of young children's diets in Europe.
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Affiliation(s)
- C Börnhorst
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany
| | - I Huybrechts
- 1] Department of Public Health, Ghent University, Ghent, Belgium [2] Dietary Exposure Assessment Groups, International Agency for Research on Cancer, Lyon, France
| | - A Hebestreit
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany
| | - V Krogh
- Epidemiology and Prevention Unit, Fondazione IRCSS Istituto Nazionale dei Tumori, Milan, Italy
| | - A De Decker
- Department of Public Health, Ghent University, Ghent, Belgium
| | - G Barba
- Epidemiology and Population Genetics, Institute of Food Science, CNR, Avellino, Italy
| | - L A Moreno
- 1] GENUD (Growth, Exercise, Nutrition and Development) Research Group. Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain [2] Faculty of Medicine, University of Brazil, Sao Paulo, Brazil
| | - L Lissner
- Department of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden
| | - M Tornaritis
- Research and Education Institute of Child Health, Strovolos, Cyprus
| | - H-M Loit
- Center of Health and Behavioral Science, National Institute for Health Development, Tallinn, Estonia
| | - D Molnár
- Department of Paediatrics, Medical Faculty, University of Pécs, Pécs, Hungary
| | - I Pigeot
- 1] Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany [2] Faculty of Computer Science and Mathematics, University of Bremen, Bremen, Germany
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9
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Hebestreit A, Börnhorst C, Barba G, Siani A, Huybrechts I, Tognon G, Eiben G, Moreno LA, Fernández Alvira JM, Loit HM, Kovacs E, Tornaritis M, Krogh V. Erratum to: Associations between energy intake, daily food intake and energy density of foods and BMI z-score in 2–9 year old European children. Eur J Nutr 2014. [PMCID: PMC4713977 DOI: 10.1007/s00394-014-0712-1] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- A. Hebestreit
- />Department of Epidemiological Methods and Etiologic Research, Leibniz Institute for Prevention Research and Epidemiology, BIPS GmbH, Achterstrasse 30, 28359 Bremen, Germany
| | - C. Börnhorst
- />Department of Epidemiological Methods and Etiologic Research, Leibniz Institute for Prevention Research and Epidemiology, BIPS GmbH, Achterstrasse 30, 28359 Bremen, Germany
| | - G. Barba
- />Institute of Food Sciences, National Research Council, Avellino, Italy
| | - A. Siani
- />Institute of Food Sciences, National Research Council, Avellino, Italy
| | - I. Huybrechts
- />Department of Public Health, Ghent University, Ghent, Belgium
- />Dietary Exposure Assessment Groups, International Agency for Research on Cancer, Lyon, France
| | - G. Tognon
- />Department of Public Health and Community Medicine, University of Gothenburg, Göteborg, Sweden
| | - G. Eiben
- />Department of Public Health and Community Medicine, University of Gothenburg, Göteborg, Sweden
| | - L. A. Moreno
- />GENUD (Growth, Exercise, Nutrition and Development) Research Group, School of Health Sciences, University of Zaragoza, Zaragoza, Spain
| | - J. M. Fernández Alvira
- />GENUD (Growth, Exercise, Nutrition and Development) Research Group, School of Health Sciences, University of Zaragoza, Zaragoza, Spain
| | - H. M. Loit
- />Department of Chronic Diseases, National Institute for Health Development, Tallinn, Estonia
| | - E. Kovacs
- />Department of Pediatrics, University of Pécs, Pecs, Hungary
| | - M. Tornaritis
- />Research and Education Institute of Child Health, Strovolos, Cyprus
| | - V. Krogh
- />Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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10
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Fernández-Alvira JM, Bammann K, Pala V, Krogh V, Barba G, Eiben G, Hebestreit A, Veidebaum T, Reisch L, Tornaritis M, Kovacs E, Huybrechts I, Moreno LA. Country-specific dietary patterns and associations with socioeconomic status in European children: the IDEFICS study. Eur J Clin Nutr 2014; 68:811-21. [PMID: 24824009 DOI: 10.1038/ejcn.2014.78] [Citation(s) in RCA: 43] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2013] [Revised: 02/27/2014] [Accepted: 03/20/2014] [Indexed: 01/26/2023]
Abstract
BACKGROUND/OBJECTIVES Children from lower socioeconomic status (SES) may be at higher risk of unhealthy eating. We described country-specific dietary patterns among children aged 2-9 years from eight European countries participating in the IDEFICS study and assessed the association of dietary patterns with an additive SES indicator. SUBJECTS/METHODS Children aged 2-9 years from eight European countries were recruited in 2007-2008. Principal component analysis was applied to identify dietary country-specific patterns. Linear regression analyses were applied to assess their association with SES. RESULTS Two to four dietary patterns were identified in the participating regions. The existence of a 'processed' pattern was found in the eight regions. Also, a 'healthy' pattern was identified in seven of the eight regions. In addition, region-specific patterns were identified, reflecting the existing gastronomic and cultural differences in Europe. The 'processed' pattern was significantly inversely associated with the SES additive indicator in all countries except Sweden, whereas the 'healthy' pattern was positively associated with SES in the Belgian, Estonian, German and Hungarian regions, but was not significant in the Italian, Spanish and Swedish regions. CONCLUSIONS A 'processed' pattern and a 'healthy' pattern were found in most of the participating countries in the IDEFICS study, with comparable food item profiles. The results showed a strong inverse association of SES with the 'processed' pattern, suggesting that children of parents with lower SES may be at higher risk of unhealthy eating. Therefore, special focus should be given to parents and their children from lower SES levels when developing healthy eating promotion strategies.
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Affiliation(s)
- J M Fernández-Alvira
- GENUD (Growth, Exercise, NUtrition and Development) research group, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain
| | - K Bammann
- 1] Institute for Public Health and Nursing Sciences (ipp), University of Bremen, Bremen, Germany [2] Leibniz Institute for Prevention Research and Epidemiology BIPS GmbH, Bremen, Germany
| | - V Pala
- Department of Preventive and Predictive Medicine, Nutritional Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - V Krogh
- Department of Preventive and Predictive Medicine, Nutritional Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - G Barba
- Unit of Epidemiology and Population Genetics, Institute of Food Sciences, National Reseach Council, Avellino, Italy
| | - G Eiben
- Department of Public Health and Community Medicine, Public Health Epidemiology Unit, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - A Hebestreit
- Leibniz Institute for Prevention Research and Epidemiology BIPS GmbH, Bremen, Germany
| | - T Veidebaum
- Department of Chronic Diseases, National Institute for Health Development, Tallinn, Estonia
| | - L Reisch
- Copenhagen Business School, Copenhagen, Denmark
| | - M Tornaritis
- Research and Education Institute of Child Health, Strovolos, Cyprus
| | - E Kovacs
- Department of Paediatrics, University of Pécs, Pécs, Hungary
| | - I Huybrechts
- 1] Department of Public Health, Ghent University, Ghent, Belgium [2] International Agency for research on Cancer, Dietary Exposure assessment group, Lyon, France
| | - L A Moreno
- GENUD (Growth, Exercise, NUtrition and Development) research group, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain
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11
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Hebestreit A, Börnhorst C, Barba G, Siani A, Huybrechts I, Tognon G, Eiben G, Moreno LA, Fernández Alvira JM, Loit HM, Kovacs E, Tornaritis M, Krogh V. Associations between energy intake, daily food intake and energy density of foods and BMI z-score in 2-9-year-old European children. Eur J Nutr 2013; 53:673-81. [PMID: 24061347 PMCID: PMC3925293 DOI: 10.1007/s00394-013-0575-x] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2013] [Accepted: 08/01/2013] [Indexed: 12/03/2022]
Abstract
Purpose
The aim of this study was to investigate the associations between proxy-reported energy intake, daily food intake and energy density of foods and body mass index (BMI) z-score in 2–9-year-old European children. Methods From 16,225 children who participated in the identification and prevention of dietary- and lifestyle-induced health effects in children and infants (IDEFICS) baseline examination, 9,782 children with 24-h proxy dietary information and complete covariate information were included in the analysis. Participating children were classified according to adapted Goldberg cutoffs: underreports, plausible energy reports and overreports. Energy intake, daily food intake and energy density of foods excluding noncaloric beverages were calculated for all eating occasions. Effect of energy intake, daily food intake and energy density of foods on BMI z-score was investigated using multilevel regression models in the full sample and subsample of plausible energy reports. Exposure variables were included separately; daily food intake and energy intake were addressed in a combined model to check for interactions. Results In the group of plausible energy reports (N = 8,544), energy intake and daily food intake were significantly positively associated with BMI z-score. Energy density of foods was not associated with BMI z-score. In the model including energy intake, food intake and an interaction term, only energy intake showed a significantly positive effect on BMI z-score. In the full sample (N = 9,782), only energy intake was significantly but negatively associated with BMI z-score. Conclusion Proxy-reporters are subject to misreporting, especially for children in the higher BMI levels. Energy intake is a more important predictor of unhealthy weight development in children than daily food intake.
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Affiliation(s)
- A Hebestreit
- Department of Epidemiological Methods and Etiologic Research, Leibniz Institute for Prevention Research and Epidemiology, BIPS GmbH, Achterstrasse 30, 28359, Bremen, Germany,
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12
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Donatiello E, Dello Russo M, Formisano A, Lauria F, Nappo A, Reineke A, Sparano S, Barba G, Russo P, Siani A. Physical activity, adiposity and urbanization level in children: results for the Italian cohort of the IDEFICS study. Public Health 2013; 127:761-5. [PMID: 23876300 DOI: 10.1016/j.puhe.2013.04.031] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [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: 06/22/2012] [Revised: 12/17/2012] [Accepted: 04/29/2013] [Indexed: 11/18/2022]
Abstract
OBJECTIVES While there is extensive evidence about the influence of environmental factors on adult obesity, fewer studies have assessed how the environment influences body fat in children. This cross-sectional study investigated the distribution of adiposity indices according to urbanization level and patterns of physical activity among children in the Italian cohort of the IDEFICS study. METHODS The sample included 1673 preschool and school-aged children (mean age 6.1 years, standard deviation 1.7) living in rural (n = 579), suburban (n = 442) and urban (n = 652) areas. Anthropometric measures were taken and questionnaires were used to assess children's lifestyles, including patterns of physical activity. RESULTS Children who lived in rural areas spent significantly more time in outdoor activities but participated in less structured physical activity compared with children living in suburban and urban areas. Adiposity estimated by the sum of skinfold thickness increased linearly from rural to urban areas, with results for suburban areas showing intermediate values. CONCLUSIONS The data show that geographical environmental factors influence patterns of physical activity and body fat in children. In particular, the results suggest an association between the time spent in unstructured outdoor activities and the degree of adiposity in schoolchildren. These results may have implications for public health, including efforts to increase freely available playgrounds as an effective measure to counteract the obesity epidemic in children.
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Affiliation(s)
- E Donatiello
- Epidemiology and Population Genetics, Institute of Food Sciences, CNR, Avellino, Italy
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13
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Poli A, Marangoni F, Avogaro A, Barba G, Bellentani S, Bucci M, Cambieri R, Catapano AL, Costanzo S, Cricelli C, de Gaetano G, Di Castelnuovo A, Faggiano P, Fattirolli F, Fontana L, Forlani G, Frattini S, Giacco R, La Vecchia C, Lazzaretto L, Loffredo L, Lucchin L, Marelli G, Marrocco W, Minisola S, Musicco M, Novo S, Nozzoli C, Pelucchi C, Perri L, Pieralli F, Rizzoni D, Sterzi R, Vettor R, Violi F, Visioli F. Moderate alcohol use and health: a consensus document. Nutr Metab Cardiovasc Dis 2013; 23:487-504. [PMID: 23642930 DOI: 10.1016/j.numecd.2013.02.007] [Citation(s) in RCA: 109] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2012] [Revised: 01/29/2013] [Accepted: 02/27/2013] [Indexed: 02/07/2023]
Abstract
AIMS The aim of this consensus paper is to review the available evidence on the association between moderate alcohol use, health and disease and to provide a working document to the scientific and health professional communities. DATA SYNTHESIS In healthy adults and in the elderly, spontaneous consumption of alcoholic beverages within 30 g ethanol/d for men and 15 g/d for women is to be considered acceptable and do not deserve intervention by the primary care physician or the health professional in charge. Patients with increased risk for specific diseases, for example, women with familiar history of breast cancer, or subjects with familiar history of early cardiovascular disease, or cardiovascular patients should discuss with their physician their drinking habits. No abstainer should be advised to drink for health reasons. Alcohol use must be discouraged in specific physiological or personal situations or in selected age classes (children and adolescents, pregnant and lactating women and recovering alcoholics). Moreover, the possible interactions between alcohol and acute or chronic drug use must be discussed with the primary care physician. CONCLUSIONS The choice to consume alcohol should be based on individual considerations, taking into account the influence on health and diet, the risk of alcoholism and abuse, the effect on behaviour and other factors that may vary with age and lifestyle. Moderation in drinking and development of an associated lifestyle culture should be fostered.
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Affiliation(s)
- A Poli
- NFI (Nutrition Foundation of Italy), Viale Tunisia 38, 20124 Milan, Italy.
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14
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Di Giacomo D, Pierini T, Fernandez AL, Brandimarte L, Pierini V, Matteucci C, Barba G, Crescenzi B, Mecucci C. P-039 Insights on GNAS1 gene involvement in MDS. Leuk Res 2013. [DOI: 10.1016/s0145-2126(13)70088-2] [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: 10/26/2022]
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15
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Dello Russo M, Ahrens W, De Vriendt T, Marild S, Molnar D, Moreno LA, Reeske A, Veidebaum T, Kourides YA, Barba G, Siani A. Gestational weight gain and adiposity, fat distribution, metabolic profile, and blood pressure in offspring: the IDEFICS project. Int J Obes (Lond) 2013; 37:914-9. [PMID: 23567926 DOI: 10.1038/ijo.2013.35] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [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: 09/04/2012] [Revised: 02/20/2013] [Accepted: 02/24/2013] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To investigate the association between gestational weight gain (GWG) and total adiposity, body fat distribution, blood pressure (BP), and metabolic profile in offspring. DESIGN Cross-sectional study. METHODS Body mass index (BMI), waist, subscapular and tricipital skinfolds, and BP were measured and blood samples drawn in 12 775 children (aged 2-9 years) from the IDEFICS cohort. Overweight/obesity was defined by IOTF criteria. Parents filled in a questionnaire investigating child and familiar medical history and lifestyle. A section was dedicated to pregnancy history (including GWG). RESULTS Anthropometric indices linearly and significantly increased across GWG tertiles (BMI z-score: tertile I =0.08, 0.03-0.13; tertile II =0.16, 0.12-0.21; tertile III =0.34, 0.28-0.40, P<0.01, mean, 95% CI) by analysis of covariance (ANCOVA) adjusted by child sex, age and practice of sport, birth weight, current maternal BMI, parental education, gestational age, age at delivery, alcohol and smoking during pregnancy, maternal diabetes mellitus, gestational hypertension, and breastfeeding duration. After inclusion of BMI z-score among covariates, HbA1c significantly increased across tertiles (P=0.009) while no differences were observed for BP, serum insulin, HOMA index, blood glucose and lipids. The adjusted risk of overweight/obesity significantly increased by 14 and 22% in tertiles II and III respectively, in comparison with tertile I by logistic regression analysis controlling for covariates. CONCLUSION Maternal GWG is an independent predictor of total adiposity and body fat distribution in offspring during infancy. Exposure to perinatal factors should be taken into account for early prevention of overweight and obesity.
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Affiliation(s)
- M Dello Russo
- Epidemiology & Population Genetics, Institute of Food Sciences, CNR, Avellino, Italy
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16
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Bammann K, Gwozdz W, Lanfer A, Barba G, De Henauw S, Eiben G, Fernandez-Alvira JM, Kovács E, Lissner L, Moreno LA, Tornaritis M, Veidebaum T, Pigeot I. Socioeconomic factors and childhood overweight in Europe: results from the multi-centre IDEFICS study. Pediatr Obes 2013; 8:1-12. [PMID: 22888012 DOI: 10.1111/j.2047-6310.2012.00075.x] [Citation(s) in RCA: 90] [Impact Index Per Article: 8.2] [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: 01/16/2012] [Revised: 05/09/2012] [Accepted: 05/21/2012] [Indexed: 11/27/2022]
Abstract
UNLABELLED What is already known about this subject Overweight and obesity can be linked to different parental socioeconomic factors already in very young children. In Western developed countries, the association of childhood overweight and obesity and parental socioeconomic status shows a negative gradient. Ambiguous results have been obtained regarding the association between socioeconomic factors and childhood overweight and obesity in different countries and over time. What this study adds European regions show heterogeneous associations between socioeconomic factors and overweight and obesity in a multi-centre study with highly standardized study protocol. The strength of association between SES and overweight and obesity varies across European regions. In our study, the SES gradient is correlated with the regional mean income and the country-specific Human development index indicating a strong influence not only of the family but also of region and country on the overweight and obesity prevalence. OBJECTIVE To assess the association between different macro- and micro-level socioeconomic factors and childhood overweight. METHODS Data from the IDEFICS baseline survey is used to investigate the cross-sectional association between socioeconomic factors, like socioeconomic status (SES), and the prevalence of childhood overweight. Differences and similarities regarding this relationship in eight European regions (located in Belgium, Cyprus, Estonia, Germany, Hungary, Italy, Spain and Sweden) are explored. 11 994 children (50.9% boys, 49.1% girls) and their parents were included in the analyses. RESULTS In five of the eight investigated regions (in Belgium, Estonia, Germany, Spain and Sweden), the prevalence of childhood overweight followed an inverse SES gradient. In the other three regions (in Cyprus, Hungary and Italy), no association between SES and childhood overweight was found. The SES-overweight association in a region was best explained by the country-specific human development index and the centre-specific mean income. For the investigated association between other socioeconomic factors and overweight, no clear pattern could be found in the different regions. CONCLUSION The association between socioeconomic factors and childhood overweight was shown to be heterogeneous across different European regions. Further research on nationwide European data is needed to confirm the results and to identify target groups for prevention.
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Affiliation(s)
- K Bammann
- Institute for Public Health and Nursing Research, University of Bremen, Bremen, Germany.
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Galletti F, D'Elia L, De Palma D, Russo O, Barba G, Siani A, Miller MA, Cappuccio FP, Rossi G, Zampa G, Strazzullo P. Hyperleptinemia is associated with hypertension, systemic inflammation and insulin resistance in overweight but not in normal weight men. Nutr Metab Cardiovasc Dis 2012; 22:300-306. [PMID: 21920718 DOI: 10.1016/j.numecd.2011.05.007] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2011] [Revised: 04/26/2011] [Accepted: 05/28/2011] [Indexed: 01/22/2023]
Abstract
BACKGROUND AND AIM High leptin (LPT) is associated with high blood pressure (BP), insulin resistance and systemic inflammation but also excess body weight and adiposity. To disentangle these multiple relations, we analyzed BP, HOMA and circulating C-reactive protein concentration (hs-CRP) in white male adults with different LPT levels but similar age, body mass index (BMI) and body fat distribution. The novel aspect is the different statistical approach used to investigate the relation between LPT and the other alterations present in obesity. METHODS AND RESULTS 972 Olivetti Heart Study participants were stratified according to the median LPT distribution (2.97 ng/ml) into low LPT (l-LPT) and high LPT (h-LPT). The two groups were then carefully matched for age and BMI. We identified two groups of 207 h-LPT and 207 l-LPT individuals with overlapping age, BMI and waist/hip ratio. The two groups had different BP (132.9 ± 16.2/85.7 ± 9.0 vs 128.7 ± 18.2/82.8 ± 9.8 mmHg, p = 0.014 for SBP and p = 0.002 for DBP) and prevalence of hypertension (57% vs 43%, p = 0.027). Upon separate evaluation of untreated individuals with BMI < 25 or BMI ≥ 25, within the latter subgroup h-LPT compared with l-LPT participants (n = 133 each group) had higher BP (p = 0.0001), HOMA index (p = 0.013), hs-CRP (p = 0.002) and heart rate (p = 0.008) despite similar age and BMI. By contrast, within the normal weight subgroup, h-LPT individuals did not differ from l-LPT (n = 37 each) for any of these variables. CONCLUSIONS High LPT is associated with higher BP, HR, hs-CRP and HOMA index independently of BMI and fat distribution but only among overweight individuals.
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Affiliation(s)
- F Galletti
- Department of Clinical and Experimental Medicine, ESH Excellence Center for Hypertension, Federico II University of Naples I, Via S. Pansini 5, 80131 Naples, Italy.
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Barba G, Sieri S, Russo MD, Donatiello E, Formisano A, Lauria F, Sparano S, Nappo A, Russo P, Brighenti F, Krogh V, Siani A. Glycaemic index and body fat distribution in children: the results of the ARCA project. Nutr Metab Cardiovasc Dis 2012; 22:28-34. [PMID: 20674304 DOI: 10.1016/j.numecd.2010.03.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2009] [Revised: 03/17/2010] [Accepted: 03/26/2010] [Indexed: 01/19/2023]
Abstract
BACKGROUND AND AIMS Various dietary factors may play a critical role in body weight regulation. Among them, the role of glycaemic index (GI) remains a subject of debate. The present study aimed at evaluating the association between dietary GI, body mass index (BMI) and body fat distribution in school children. METHODS AND RESULTS 3734 Italian children (M/F = 1883/1851; age range 6-11 years) were cross-sectionally screened for anthropometry (BMI, waist circumference), lifestyle and clinical history (questionnaire) and dietary habits (1-year food frequency questionnaire). Energy and macronutrients intake, dietary GI and glycaemic load (GL) were calculated. GI was directly associated with age, waist and BMI z-scores, energy, fibre and carbohydrate intake (r: from 0.080 to 0.238, P < 0.001), and negatively with fat intake (r: -0.060, P < 0.0001). BMI, waist circumference, energy intake, carbohydrate, protein and fibre intake and GL significantly increased, whilst fat intake decreased, going up across quartiles of residuals of dietary GI. At linear regression analysis, GI was associated with BMI and waist z-scores independently of age, sex, parental overweight/obesity, parental education, and energy intake, protein, fat, carbohydrate, fibre and GL residuals. In particular, GI was the sole nutritional factor among those under investigation, significantly associated with waist circumference. Controlling for covariates, the risk of overweight/obesity or of central fat distribution was almost two-folds higher in the upper quartile in comparison to the lowest quartile of dietary GI. CONCLUSION Dietary GI is an independent determinant of body fat distribution in children as well as of total adiposity.
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Affiliation(s)
- G Barba
- Epidemiology and Population Genetics, Institute of Food Sciences, National Research Council, Via Roma 52 A/C, 83100 Avellino, Italy.
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Hense S, De Henauw S, Eiben G, Molnar D, Moreno LA, Barba G, Hadjigeorgiou C, Veidebaum T, Pohlabeln H, Ahrens W. SP6-13 Sleep duration and overweight in European children: is the association modified by geographic region? Br J Soc Med 2011. [DOI: 10.1136/jech.2011.142976p.84] [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: 11/03/2022]
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De Henauw S, Verbestel V, Mårild S, Barba G, Bammann K, Eiben G, Hebestreit A, Iacoviello L, Gallois K, Konstabel K, Kovács E, Lissner L, Maes L, Molnár D, Moreno LA, Reisch L, Siani A, Tornaritis M, Williams G, Ahrens W, De Bourdeaudhuij I, Pigeot I. The IDEFICS community-oriented intervention programme: a new model for childhood obesity prevention in Europe? Int J Obes (Lond) 2011; 35 Suppl 1:S16-23. [PMID: 21483418 DOI: 10.1038/ijo.2011.31] [Citation(s) in RCA: 74] [Impact Index Per Article: 5.7] [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] [Indexed: 11/09/2022]
Abstract
BACKGROUND AND OBJECTIVES The European Union-as well as other parts of the world-faces a major challenge of increasing incidence of overweight/obesity. In particular, the increase in childhood obesity gives rise to a strong imperative for immediate action. Yet, little is known about the effectiveness of community interventions, and further research in this field is needed. There is, however, a growing consensus that such research should start from the paradigm that the current living environments tend to counteract healthy lifestyles. Questioning these environments thoroughly can help to develop new pathways for sustainable health-promoting communities. Against this background, the IDEFICS (Identification and prevention of dietary- and lifestyle-induced health effects in children and infants) study developed and implemented innovative community-oriented intervention programmes for obesity prevention and healthy lifestyle primarily in children aged 2-10 years in eight European countries: Sweden, Estonia, Germany, Belgium, Hungary, Italy, Spain and Cyprus. MATERIALS AND METHODS The IDEFICS community-oriented intervention study mobilised an integrated set of interventional efforts at different levels of society, with the aim of facilitating the adoption of a healthy obesity-preventing lifestyle. The overall programme has been composed of 10 modules: three at community level, six at school level and one for parents. The main focus was on diet, physical activity and stress-coping capacity. The sphere of action encompassed both children and their (grand) parents, schools, local public authorities and influential stakeholders in the community. All materials for the interventions were centrally developed and culturally adapted. RESULTS So far, the following has been achieved: focus group research, literature review and expert consultations were done in an early phase as a basis for the development of the intervention modules. The intervention mapping protocol was followed as guide for structuring the intervention research. The overall intervention programme's duration was 2 years, but a longer-term follow-up programme is under development. CONCLUSIONS This large-scale European effort is expected to contribute significantly to the understanding of this major public health challenge.
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Affiliation(s)
- S De Henauw
- Department of Public Health, Faculty of Medicine and Health Sciences, University Hospital, Ghent University, Belgium.
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Huybrechts I, Börnhorst C, Pala V, Moreno LA, Barba G, Lissner L, Fraterman A, Veidebaum T, Hebestreit A, Sieri S, Ottevaere C, Tornaritis M, Molnár D, Ahrens W, De Henauw S. Evaluation of the Children's Eating Habits Questionnaire used in the IDEFICS study by relating urinary calcium and potassium to milk consumption frequencies among European children. Int J Obes (Lond) 2011; 35 Suppl 1:S69-78. [PMID: 21483425 DOI: 10.1038/ijo.2011.37] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.2] [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] [Indexed: 11/09/2022]
Abstract
BACKGROUND Measuring dietary intake in children is notoriously difficult. Therefore, it is crucial to evaluate the performance of dietary intake assessment methods in children. Given the important contribution of milk consumption to calcium (Ca) and potassium (K) intakes, urinary calcium (UCa) and potassium (UK) excretions in spot urine samples could be used for estimating correlations with milk consumption frequencies. OBJECTIVE The aim of this study was to evaluate the assessment of milk consumption frequencies derived from the Food Frequency Questionnaire section of the Children's Eating Habits Questionnaire (CEHQ-FFQ) used in the IDEFICS (Identification and prevention of dietary- and lifestyle induced health effects in children and infants) study by comparing with UCa and UK excretions in spot urine samples. DESIGN This study was conducted as a setting-based community-oriented intervention study and results from the first cross-sectional survey have been included in the analysis. SUBJECTS A total of 10,309 children aged 2-10 years from eight European countries are included in this analysis. METHODS UCa and UK excretions were measured in morning spot urine samples. Calcium and potassium urine concentrations were standardised for urinary creatinine (Cr) excretion. Ratios of UCa/Cr and UK/Cr were used for multivariate regression analyses after logarithmic transformation to obtain normal distributions of data. Milk consumption frequencies were obtained from the CEHQ-FFQ. Multivariate regression analyses were used to investigate the effect of milk consumption frequencies on UCa and UK concentrations, adjusting for age, gender, study centre, soft drink consumption and frequency of main meals consumed at home. RESULTS A significant positive correlation was found between milk consumption frequencies and ratios of UK/Cr and a weaker but still significant positive correlation with ratios of UCa/Cr, when using crude or partial Spearman's correlations. Multivariate regression analyses showed that milk consumption frequencies were predictive of UCa/Cr and UK/Cr ratios, when adjusted for age, gender, study centre, soft drink consumption and frequency of main meals consumed at home. Mean ratios of UK/Cr for increasing milk consumption frequency tertiles showed a progressive increase in UK/Cr. Children consuming at least two milk servings per day had significantly higher mean UCa/Cr and UK/Cr ratios than children who did not. Large differences in correlations between milk consumption frequencies and ratios of UCa/Cr and UK/Cr were found between the different study centres. CONCLUSION Higher milk consumption frequencies resulted in a progressive increase in UK/Cr and UCa/Cr ratios, reflecting the higher Ca and K intakes that coincide with increasing milk consumption, which constitutes a major K and Ca source in children's diet.
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Affiliation(s)
- I Huybrechts
- Department of Public Health, Ghent University, Belgium.
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D'Elia L, Barba G, Cappuccio FP, Strazzullo P. POTASSIUM INTAKE, STROKE, AND CARDIOVASCULAR DISEASE: A META-ANALYSIS OF PROSPECTIVE STUDIES. Racionalʹnaâ farmakoterapiâ v kardiologii 2011. [DOI: 10.20996/1819-6446-2011-7-3-371-381] [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: 11/22/2022] Open
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Lucchini R, Barba G, Giampietro S, Trivelli M, Dito L, De Curtis M. [Macrosomic infants: clinical problems at birth and afterward]. Minerva Pediatr 2010; 62:65-66. [PMID: 21090075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Macrosomic infants (birth weight >4000 g) show increased risk for shoulder dystocia and associated injuries, hypoglycemia and respiratory distress. Higher risk is directly related to neonatal birth weight. High birth weight is also associated with increased risk of developing metabolic syndrome later in life. However the relation between birth weight and later-life metabolic syndrome in not linear, but "U" shaped.
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MESH Headings
- Adult
- Birth Injuries/epidemiology
- Birth Injuries/etiology
- Birth Weight
- Delivery, Obstetric
- Diabetes Mellitus, Type 2/epidemiology
- Diabetes Mellitus, Type 2/etiology
- Diabetes, Gestational/metabolism
- Disease Susceptibility
- Female
- Fetal Macrosomia/complications
- Fetal Macrosomia/epidemiology
- Humans
- Infant, Low Birth Weight
- Infant, Newborn
- Infant, Newborn, Diseases/epidemiology
- Infant, Newborn, Diseases/etiology
- Male
- Meta-Analysis as Topic
- Metabolic Syndrome/epidemiology
- Metabolic Syndrome/etiology
- Obstetric Labor Complications/etiology
- Pregnancy
- Prenatal Exposure Delayed Effects
- Retrospective Studies
- Risk
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Affiliation(s)
- R Lucchini
- Dipartimento di Pediatria, Sapienza-Università di Roma
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Haerens L, De Bourdeaudhuij I, Barba G, Eiben G, Fernandez J, Hebestreit A, Kovács E, Lasn H, Regber S, Shiakou M, De Henauw S. Developing the IDEFICS community-based intervention program to enhance eating behaviors in 2- to 8-year-old children: findings from focus groups with children and parents. Health Educ Res 2009; 24:381-393. [PMID: 18603656 DOI: 10.1093/her/cyn033] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
One purpose of 'identification and prevention of dietary- and lifestyle-induced health effects in children and infants' (IDEFICS) is to implement a standardized community-based multi-component healthy eating intervention for younger children in eight different countries. The present study describes important influencing factors for dietary behaviors among children aged 2-8 years old in order to determine the best approaches for developing the dietary components of the standardized intervention. Twenty focus groups with children (74 boys, 81 girls) and 36 focus groups with 189 parents (28 men, 161 women) were conducted. Only in two countries, children mentioned receiving nutrition education at school. Rules at home and at school ranged from not allowing the consumption of unhealthy products to allowing everything. The same diversity was found for availability of (un)healthy products at home and school. Parents mentioned personal (lack of time, financial constraints, preferences), socio-environmental (family, peer influences), institutional (school policies) and physical-environmental (availability of unhealthy products, price, season) barriers for healthy eating. This focus group research provided valuable information to guide the first phase in the IDEFICS intervention development. There was a large variability in findings within countries. Interventions should be tailored at the personal and environmental level to increase the likelihood of behavioral change.
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Affiliation(s)
- L Haerens
- Research Foundation-Flanders, Department of Movement and Sports Sciences, Ghent University, Ghent 9000, Belgium.
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Galletti F, D'Elia L, Barba G, Siani A, Cappuccio FP, Farinaro E, Iacone R, Russo O, De Palma D, Ippolito R, Strazzullo P. High-circulating leptin levels are associated with greater risk of hypertension in men independently of body mass and insulin resistance: results of an eight-year follow-up study. J Clin Endocrinol Metab 2008; 93:3922-6. [PMID: 18682500 DOI: 10.1210/jc.2008-1280] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
BACKGROUND We previously reported a significant association between plasma leptin (LPT) concentration and blood pressure (BP), which was partly independent of serum insulin levels and insulin resistance. The aims of this study were to detect whether serum LPT levels predict the development of hypertension (HPT) in the 8-yr follow-up investigation of a sample of an adult male population (the Olivetti Heart Study), and to evaluate the role of body mass index (BMI) and insulin resistance in this putative association. PATIENTS AND METHODS The study population was made up of 489 untreated normotensive subjects examined in 1994-1995 (age: 50.1 +/- 6.7 yr; BMI: 26.3 +/- 2.8 kg/m(2); BP: 120 +/- 10/78 +/- 6 mm Hg; and homeostatic model assessment index: 2.1 +/- 1.6). RESULTS The HPT incidence over 8 yr was 35%. The participants with incident HPT had similar age but higher BMI (P < 0.001), serum LPT (P < 0.001), and BP (P < 0.01) at baseline. One sd positive difference in baseline serum LPT log was associated at univariate analysis with a 49% higher rate of HPT [95% confidence interval (CI) 22-83; P < 0.001]). In three different models of multivariable logistical regression analysis, LPT was respectively associated with a 41% greater risk to develop HPT (95% CI 15-74; P < 0.001) upon adjustment for age and baseline BP, with a 48% (95% CI 20-81) greater risk when adding the homeostatic assessment model index to the model, and with 33% greater risk (95% CI 6-67; P < 0.02) upon adjustment for BMI. CONCLUSIONS In this sample of originally normotensive men, circulating LPT level was a significant predictor of the risk to develop HPT over 8 yr, independently of BMI and insulin resistance.
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Affiliation(s)
- F Galletti
- Department of Clinical and Experimental Medicine, Federico II University Medical School, Via S. Pansini, 5, 80131 Naples, Italy.
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Barba G, Casullo C, Dello Russo M, Russo P, Nappo A, Lauria F, Siani A. Gender-related differences in the relationships between blood pressure, age, and body size in prepubertal children. Am J Hypertens 2008; 21:1007-10. [PMID: 18617882 DOI: 10.1038/ajh.2008.228] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The blood pressure (BP) increase with age is well documented in adults and children. However, in the pediatric age group, body size is the most important determinant of age-related BP increases. The aim of the present analysis was to investigate the relationships between age, gender, and body size and BP in children. METHODS To this purpose, data were analyzed from 4,514 prepubertal children, aged 6-11 years (71% of the eligible sample; boys = 2,283, girls = 2,231) from the ARCA Project, a screening of childhood obesity carried out in southern Italy. Girls who reported the occurrence of menarche were excluded from the analysis. The sample constituted roughly 20% of all the children attending the primary schools in the area. Weight, height, waist circumference, and BP were measured according to standardized procedures. RESULTS As expected, both systolic and diastolic BP significantly increased (P < 0.001) with age in boys and girls. However, after adjustment for waist circumference (as index of adiposity) and height (as index of body size), BP significantly increased with age only in girls (systolic BP: F = 4.380, P = 0.002; diastolic BP: F = 3.093, P = 0.01) but not in boys (systolic BP: F = 0.711, P = 0.55; diastolic BP: F = 2.180, P = 0.07). The association, however, was no longer apparent after the exclusion of children aged >10 years. CONCLUSIONS In prepubertal girls in the age range 6-11 years, but not in boys, age is significantly associated with BP independently of body size and adiposity.
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Venezia A, Barba G, Galletti F, Farinaro E, Barbato A, D’Elia L, Ippolito R, De Palma D, Strazzullo P. 3.6 Sodium Intake in a Sample of Males Working in Campania: Results of the Olivetti Heart Study. High Blood Press Cardiovasc Prev 2008. [DOI: 10.1007/bf03263607] [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: 10/27/2022] Open
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Matteucci C, Bracci M, Barba G, Carbonari M, Casato M, Visentini M, Pulsoni A, Varasano E, Roti G, La Starza R, Crescenzi B, Martelli MF, Fiorilli M, Mecucci C. Different genomic imbalances in low- and high-grade HCV-related lymphomas. Leukemia 2007; 22:219-22. [PMID: 17690706 DOI: 10.1038/sj.leu.2404872] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Rubattu S, Evangelista A, Barbato D, Barba G, Stanzione R, Iacone R, Volpe M, Strazzullo P. Atrial natriuretic peptide (ANP) gene promoter variant and increased susceptibility to early development of hypertension in humans. J Hum Hypertens 2007; 21:822-4. [PMID: 17525707 DOI: 10.1038/sj.jhh.1002228] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Previous evidence supports a role of atrial natriuretic peptide (ANP) as a candidate gene for hypertension. We characterized an ANP gene promoter variant, which has been associated with lower peptide levels, in a sample of young male subjects from Southern Italy (n=395, mean age=35.2+/-2 years) followed up for 28 years. In this cohort, the ANP gene variant was associated with early blood pressure increase and predisposition to develop hypertension.
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Barba G, Matteucci C, Brandimarte L, La Starza R, Pierini V, Mecucci C. C010 Commercially available Array-CGH BAC platforms: pitfalls in interpreting results. Leuk Res 2007. [DOI: 10.1016/s0145-2126(07)70048-6] [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: 11/30/2022]
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La Starza R, Cei M, Crescenzi B, Matteucci C, Brandimarte L, Barba G, Gorello P, Martelli M, Mecucci C. P074 Molecular cytogenetic delineation of del (4q) in myelodysplastic syndromes with peripheral blood monocytosis. Leuk Res 2007. [DOI: 10.1016/s0145-2126(07)70144-3] [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: 11/29/2022]
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Russo P, Loguercio M, Lauria F, Barba G, Arnout J, Cappuccio FP, Iacoviello L, Siani A. Age- and gender-dependent association of the –344C/T polymorphism of CYP11B2 with blood pressure in European populations. J Hum Hypertens 2007; 21:333-6. [PMID: 17273158 DOI: 10.1038/sj.jhh.1002136] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Galletti F, D’Elia L, Iacone R, Russo O, Venezia A, Barba G, Siani A, Strazzullo P. Olivetti Heart Study-Circulating Leptin Levels Predict the Development of Hypertension: An 8-Year Follow-Up Study. High Blood Press Cardiovasc Prev 2007. [DOI: 10.2165/00151642-200714030-00128] [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: 11/02/2022] Open
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Strazzullo P, Galletti F, Siani A, Barba G, Iacone R, Russo O, DʼElia L, Versiero M, Schiattarella P, Avallone S. Olivetti Heart Study: the hs-PCR Does not Predict the Development of Hypertension in a Population Sample of Adult Males, 8 Year Follow-Up. High Blood Press Cardiovasc Prev 2007. [DOI: 10.2165/00151642-200714030-00040] [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: 11/02/2022] Open
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Barbato A, Galletti F, Iacone R, Siani A, Barba G, Avallone S, Venezia A, Cappuccio FP, Strazzullo P. Elevated Serum Adiponectin Level is Associated with a Decrease in Rate of Proximal Tubular Sodium Reabsorption. High Blood Press Cardiovasc Prev 2007. [DOI: 10.2165/00151642-200714030-00116] [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: 11/02/2022] Open
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Barba G, Troiano E, Russo P, Siani A. Total fat, fat distribution and blood pressure according to eating frequency in children living in southern Italy: the ARCA project. Int J Obes (Lond) 2006; 30:1166-9. [PMID: 16462817 DOI: 10.1038/sj.ijo.0803257] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The relationships between eating frequency and adiposity and cardiovascular risk factors have been poorly investigated in children. To evaluate this issue, anthropometric indices and blood pressure (BP) were measured in 3668 children, aged 6-11 years. Meals/snack frequency, assessed by a questionnaire, was 'Low' in 332 (<or=3 meals/day), 'Intermediate' in 1334 (4/day) and 'High' in 2002 (>or=5/day) children. Body mass index (BMI) and waist circumference significantly decreased going up across meals/snacks categories (BMI=20.5+/-0.2, 19.7+/-0.1 and 18.8+/-0.1 kg/m2; waist=68.0+/-0.6, 66.6+/-0.3, 63.9+/-0.2 cm, for Low, Intermediate and High groups, respectively; M+/-s.e.; P<0.001 by ANCOVA trend analysis adjusted by age, sex, birth weight, physical activity, parental overweight and education level). BP decreased from Low to High group but differences were no longer significant after adjustment for BMI. In our sample of school children, the daily eating frequency was inversely associated with the degree of both total adiposity and central fat deposition.
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Affiliation(s)
- G Barba
- Epidemiology and Population Genetics, Institute of Food Sciences, National Research Council, Avellino, Italy.
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Giulio BD, Orlando P, Barba G, Coppola R, Rosa MD, Sada A, Prisco PPD, Nazzaro F. Use of alginate and cryo-protective sugars to improve the viability of lactic acid bacteria after freezing and freeze-drying. World J Microbiol Biotechnol 2005. [DOI: 10.1007/s11274-004-4735-2] [Citation(s) in RCA: 60] [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] [Indexed: 10/25/2022]
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Tourneux P, Jouvencel P, Micheau M, Jouvencel AC, Chateil JF, Barba G, Letavernier B, Llanas B. [Parvovirus B19 thrombocytopenic purpura complicated with a cerebral hemorrhage]. Arch Pediatr 2005; 12:281-3. [PMID: 15734124 DOI: 10.1016/j.arcped.2004.11.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 11/14/2003] [Accepted: 11/12/2004] [Indexed: 10/25/2022]
Abstract
UNLABELLED Severe hemorrhage complications are rare in idiopathic thrombocytopenic purpura. This pathology is often considered as benign. CASE REPORT We report the case of a four-year-old boy presenting a parvovirus B19 idiopathic thrombocytopenic purpura. Despite early and repeated use of intravenous immunoglobulin, the evolution was characterized by the secondary apparition of a cerebral hemorrhage. It was lethal seven days after the initial diagnosis. CONCLUSION Parvovirus B19 should be investigated as an etiologic agent of idiopathic thrombocytopenic purpura, using PCR. The unpredictive aspect of severe hemorrhage complications, especially cerebral hemorrhages, explains the potential severity of this disease.
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Affiliation(s)
- P Tourneux
- Service de médecine néonatale et réanimation pédiatrique polyvalente, CHU d'Amiens, hôpital Nord, 1, place Victor-Pauchet, 80054 Amiens cedex 1, France.
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Russo P, Lauria F, Caggiano R, Loguercio M, Strazzullo P, Cappuccio FP, Iacoviello L, Barba G, Siani A. HINDIII(+/???) Polymorphism of Y Chromosome and Cardiovascular Risk Factors in Three European Populations. High Blood Press Cardiovasc Prev 2005. [DOI: 10.2165/00151642-200512030-00047] [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: 11/02/2022] Open
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Barbato A, D??Elia L, Barba G, Iacone R, Russo O, Versiero M, Siani A, Cappuccio FP, Galletti F, Strazzullo P. Determinants of Microalbuminuria in the Olivetti Prospective Heart Study (8-Year Follow-Up). High Blood Press Cardiovasc Prev 2005. [DOI: 10.2165/00151642-200512030-00075] [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: 11/02/2022] Open
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Russo P, Venezia A, Lauria F, Loguercio M, Caggiano R, Barba G, Iacoviello L, Cappuccio FP, Arnout J, Siani A. C Allele of CYP11b2 ???344c/T Polymorphism is Associated with High Blood Pressure in Younger Caucasian Males. High Blood Press Cardiovasc Prev 2005. [DOI: 10.2165/00151642-200512030-00048] [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: 11/02/2022] Open
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Galletti F, D??Elia L, Barbato A, Barba G, Iacone R, Russo O, Versiero M, Siani A, Cappuccio FP, Strazzullo P. The Olivetti Prospective Heart Study. High Blood Press Cardiovasc Prev 2005. [DOI: 10.2165/00151642-200512030-00038] [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: 11/02/2022] Open
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Barbato A, Venezia A, D??Elia L, Barba G, Versiero M, Siani A, Iacone R, Russo O, Cappuccio FP, Galletti F, Strazzullo P. Association between an Inflammatory Pattern and Metabolic Sindrome. High Blood Press Cardiovasc Prev 2005. [DOI: 10.2165/00151642-200512030-00095] [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: 11/02/2022] Open
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Barba G, Galletti F, Casullo C, Donatiello A, Lauria F, Russo P, Strazzullo P, Siani A. Prevalence of Paediatric Hypertension in a Sample of School-Age Children in the Campania Region. High Blood Press Cardiovasc Prev 2005. [DOI: 10.2165/00151642-200512030-00023] [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: 11/02/2022] Open
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Barba G, Troiano E, Russo P, Caggiano R, Loguercio M, D??Elia L, Galletti F, Strazzullo P, Siani A. Blood Pressure by Waist Circumference or Body Mass Index Percentiles in Children. High Blood Press Cardiovasc Prev 2005. [DOI: 10.2165/00151642-200512030-00024] [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: 11/02/2022] Open
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Galletti F, Barbato A, Barba G, Iacone R, Russo O, D??Elia L, Versiero M, Siani A, Cappuccio FP, Strazzullo P. Circulating Leptin Levels Predict the Development of Metabolic Syndrome. High Blood Press Cardiovasc Prev 2005. [DOI: 10.2165/00151642-200512030-00096] [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: 11/02/2022] Open
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Rotilio G, Berni Canani R, Barba G, Branca F, Cairella G, Dilaghi B, Fieschi C, Garbagnati F, Gentile MG, Gensini GF, Gualtieri A, Inzitari D, La Massa M, Luisi MLE, Mancia G, Marcelli M, Masini ML, Mastrilli F, Paolucci S, Pratesi L, Rubba P, Sacchetti ML, Salvia A, Scalfi L, Scognamiglio U, Siani A, Strazzullo P. Nutritional recommendations for the prevention of ischemic stroke. Nutr Metab Cardiovasc Dis 2004; 14:115-120. [PMID: 15242244 DOI: 10.1016/s0939-4753(04)80018-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- G Rotilio
- Department of Biology, Tor Vergata University of Rome, Italy
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Strazzullo P, Scalfi L, Branca F, Cairella G, Garbagnati F, Siani A, Barba G, Rubba P, Mancia G. Nutrition and prevention of ischemic stroke: present knowledge, limitations and future perspectives. Nutr Metab Cardiovasc Dis 2004; 14:97-114. [PMID: 15242243 DOI: 10.1016/s0939-4753(04)80017-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Stroke, particularly ischemic stroke, has a major impact on public health due to its high incidence, prevalence and rate of subsequent disability in Italy as in most industrialised countries. Apart from age, many modifiable factors, such as hypertension, smoking, diabetes, dyslipidemia, obesity, physical inactivity, alcohol abuse and hyperhomocysteinemia, have been recognised as playing a role in the pathogenesis of this disease. While appropriate pharmacological therapy has proven effective in the prevention of stroke in particular categories of patients, most of the above mentioned predisposing conditions are amenable to be affected by nutrition. Unequivocal demonstration of a protective or adverse role of single foods and nutrients against the risk of stroke has been however difficult to achieve due to confounding by biological variability, methodological inadequacies in the assessment of individual nutritional habits and difficulty to carry out long-term randomised controlled trials in the nutritional area. Notwithstanding, in several cases, causal relationships could be inferred from case-control and cohort studies in the presence of plausible and reproducible associations, evidence of dose-dependent effects and consistency in the results of different studies. The aim of this paper was to review present knowledge and highlight limitations and future perspectives about the role of nutrition in the prevention of ischemic stroke.
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Affiliation(s)
- P Strazzullo
- Department of Clinical and Experimental Medicine, Federico II University of Naples, Italy
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Abstract
UNLABELLED Crohn's disease may exceptionally be revealed by recurrent pancreatitis. CASE REPORT A 12-year-old boy presented with recurrent pancreatitis without recognized etiology. At the fourth episode, abdominal pain and abscess of the anus led to the diagnostic of Crohn's disease. Corticotherapy was successful on pancreatic and intestinal manifestations. CONCLUSION Recurrent pancreatitis may reveal Crohn's disease. Endoscopic examination of the duodenum and the colon is recommended in patients with recurrent pancreatitis and negative etiologic investigations.
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Affiliation(s)
- G Barba
- Unité de gastroentérologie pédiatrique, hôpital des Enfants, place Amélie-Raba-Léon, 33076 Bordeaux, France
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