The development of an EU-wide nutrition and physical activity expert knowledge base to support a personalised mobile application across various EU population groups

A healthy lifestyle comprising regular physical activity and an adequate diet is imperative for the prevention of non-communicable diseases such as hypertension and some cancers. Advances in information computer technology offer the opportunity to provide personalised lifestyle advice directly to the individual through devices such as smartphones or tablets. The overall aim of the PROTEIN project (Wilson-Barnes et al., 2021) was to develop a smartphone application that could provide tailored and dynamic nutrition and physical activity advice directly to the individual in real time. However, to create this mobile health (m-health) smartphone application, a knowledge base of reference ranges for macro-/micronutrient intake, anthropometry, biochemical, physiological and sleep parameters was required to underpin the parameters of the recommender systems. Therefore, the principal aim of this emerging research paper is to describe the process by which experts in nutrition and physiology from the PROTEIN consortium collaborated to develop the nutritional and physical activity requirements, based upon existing recommendations, for 10 separate population groups living within the EU including, but not limited to healthy adults, adults with type 2 diabetes mellitus, cardiovascular disease, excess weight, obesity and iron deficiency anaemia. A secondary aim is to describe the development of a library of 24-h meal plans appropriate for the same groups and also encompassing various dietary preferences and allergies. Overall, the consortium devised an extensive nutrition and physical activity knowledge base that is pertinent to 10 separate EU user groups, is available in 7 different languages and is practically implemented via a library of culturally appropriate, 24-h meal plans.

Energy expenditure and nutrition status of ballet, jazz and contemporary dance students

Purpose: To evaluate of the energy expenditure in 3 types of dance classes (ballet, Jazz, and contemporary), as well as of the daily energy balance depending on dance type. Materials and methods: 40 females attending dance classes with a median age of 21.0 (19.0-25.0) and 10 males with a median age of 27.0 (20.0-28.0) participated in this study. The energy cost of each dance class was measured using the BodyMedia SenseWear Sensor and total daily energy expenditure was evaluated using a 3-day recording of physical activity. The dietary intake was evaluated with a 3-day food diary recording. Statistical analysis was performed using the SPSS software. Results: Median energy expenditure varied from 306 (277-328) Kcals/class for contemporary dance to 327 (290-355) Kcals/class for ballet and 369 (333-394) Kcals/class for jazz for females with significant differences between contemporary and jazz classes. For males, energy expenditure was 508 (447-589) Kcals/class and 564 (538-593) Kcals/class for ballet and jazz classes, respectively. Females had lower values for all anthropometric measurements, energy intake, macronutrient intakes, and energy expenditure, compared with males. The anthropometric characteristics did not differ between dance types. Both female and male dance students were in a negative energy balance. Conclusions: The use of sensors such as BodyMedia SenseWear together with keeping daily diaries make measurement of physical activity in dancing reliable and accurate. Exercise expenditure differs across types of dance in females but not in males. Both sexes had inadequate energy and carbohydrate intakes.

Exercise monitoring of young adults using a Facebook application

Facebook, with a record 1.7+ billion monthly active users, is increasingly the platform of choice for a multitude of e-health applications. This work presents our experience in exercise monitoring using a custom-built Facebook application for activity self-reporting. A group of young adults (n = 49, age = 24 ± 7 years, body mass index (BMI) = 22.5 ± 3) took part in a 5-week pilot study, part of the NutriHeAl intervention project. Participants reported their daily exercise activities for an average of 33 ± 5 days and were also equipped with digital pedometers (Fibit Zips) for the full duration, allowing the evaluation of their activity reporting accuracy by comparing steps/min to a 'truth ceiling' value for two pre-defined exercise categories (2 + and 3+ metabolic equivalent of task (MET) intensity). We found that users not only reported their exercise consistently for an extended period of time but also achieved an average accuracy score of 71 ± 21% (82 ± 18% for 2+ MET exercises), making this novel exercise monitoring methodology a formidable tool for a modern physician's digital arsenal. In addition, the developed tools and processes can also be re-used in other e-health applications.

Short communication: Dmfs and BMI in preschool Greek children. An epidemiological study

AIM

To investigate the relationship between dental caries (dmfs) and body mass index (BMI) categories in 3-5.5 year old children in Thessaloniki, Greece.

METHODS

The study was conducted in 18 municipal day care centres and involved 361 children. The dmfs was determined on site by one calibrated examiner using disposable dental mirrors and a penlight. The height and weight of the children were measured on site by a nutritionist, who grouped them into four BMI categories, shown in the results.

STATISTICS

The estimation of the relationship between the BMI and dmfs values was based on a generalized linear model (Poisson log-linear regression) while the sequential Bonferroni method was used for pair-wise comparisons between BMI categories.

RESULTS

Mean dmfs values for each BMI category were: 1.02 (SD=2.41) for the underweight (n=44), 0.74 (SD=2.24) for the normal weight (n=281), 1.88 (SD=4.28) for the overweight (n=26) and 0.80 (SD=2.53) for the obese (n=10). Overweight children were found to show statistically significant differences in dmfs values compared with both children of normal weight (p<0.001) and those underweight (p=0.015).

CONCLUSION

Overweight Greek pre-school children are at higher risk of dental caries.

Metabolic indices, energy and macronutrient intake according to weight status in a rural sample of 17-year-old adolescents

INTRODUCTION

With adolescent health a priority on the WHO agenda, research into the diet, weight status and metabolic profile of adolescents is indicated. The present study aimed to assess the diet and metabolic parameters of a rural sample of adolescents.

METHODS

One hundred adolescents (17 years of age) were recruited from schools in Nea Madytos, Thessaloniki, Greece. Two previous-day food recalls were collected for each participant, and weight, height, waist circumference, serum lipids and fasting glucose levels were measured. The prevalence of underweight/overweight, central obesity, dyslipidemia and impaired fasting glucose (IFG) were calculated.

RESULTS

Overweight was present in half the boys (51.2%) and one-fifth of the girls (21.3%). In the total sample 7.1% were underweight and another 7.1% were diagnosed with central obesity. Boys had an increased risk of abdominal obesity (OR:1.405, CI:0.7-2.8), IFG (OR:1.200, CI:0.3-4.9) and elevated triglycerides (OR:1.514, CI:1.0-2.4) and serum cholesterol levels (OR:1.806, CI:1.1-3.1). Central obesity increased the chances of IFG (OR:8.000, CI:1.6-39.1) and doubled the prevalence of dyslipidemia (OR:2.190, CI:0.5-9.1). Under-reporting of energy was found among overweight participants and was further verified by an inverse relationship between BMI and the ratio of energy intake to energy expenditure. Adolescents identified a dietary pattern high in fats in lieu of protein.

CONCLUSIONS

Irrespectively of their weight status, teenagers consume a high fat diet; therefore, dietary counseling, as a means of preventive medicine, should be applied to all weight categories. In addition, the prevalence of obesity in a rural sample of adolescents appears to be higher compared with the whole of Greece.

Dietary vitamin E intake and plasma tocopherol levels of a group of adolescents from Spili, Crete

Vitamin E is a very important nutrient in the human diet mainly due to its antioxidant properties. In this study an attempt was made to measure and evaluate vitamin E intake and to determine plasma tocopherol levels in a group of adolescents in Spili, Crete, Greece. It is known that Crete is an area with a high consumption of olive oil. It has been shown in this study that the mean olive oil consumption of these adolescents was 70.7 +/- 15.4 g/day. Vitamin E intake was 11.7 +/- 2.3 mg/day and olive oil provided 67% of this intake. Furthermore the vitamin E/PUFA ratio in food intake was 1.5 mg/g a value higher than reported by other investigators for populations with a high consumption of seed oils. The mean serum a-tocopherol levels in the selected 12 adolescents was 0.79 mg/dl (range 0.7-1.02).