1
|
Migdanis A, Tsolis K, Migdanis I, Kaltsa AG, Fytsilis FA, Manouras A, Androutsos O, Kapsoritakis A. The Effect of Shift Working on Dietary Patterns of Healthcare Practitioners during the COVID-19 Pandemic: A Cross-Sectional Study. Medicina (Kaunas) 2024; 60:627. [PMID: 38674273 PMCID: PMC11051816 DOI: 10.3390/medicina60040627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 04/05/2024] [Accepted: 04/08/2024] [Indexed: 04/28/2024]
Abstract
Background and Objectives: Health professionals' working schedules often do not allow them to follow a balanced way of life, and the nature of their work can affect their weight and eating habits. The aim of the present study is to shed some light on the impact of night shift working on the dietary practices of healthcare practitioners in Greece. Materials and Methods: This was a cross-sectional study. With the use of an administered questionnaire several parameters were assessed, including anthropometric characteristics, weight history, as well as nutritional habits of the same group of participants during night shifts and when at regular working hours. Moreover, nutritional beliefs of the subjects were recorded, as well as the level of adherence to the Mediterranean diet. Results: It was observed that in all food groups, including water, used to compare the nutritional patterns of the participants during night shifts and when working regular hours, statistical differences were noted (p = 0.001). Furthermore, the participants who reported a higher adherence to the Mediterranean diet and self-reported healthier nutritional habits, had a statistically lower weight compared to the participants that rarely followed the specific model or reported unhealthier eating routine (p = 0.010 and p = 0.015, respectively). Conclusions: We conclude that shift-working healthcare professionals are associated with disturbed eating behaviours leading to the high consumption of unhealthy food. The implementation of interventions that will concentrate on educating health workers on balanced nutrition and improving physical environment (i.e., food availability, healthier food choices) seems to be of great importance.
Collapse
Affiliation(s)
- Athanasios Migdanis
- Nutrition and Dietetics Department, University of Thessaly, Argonafton 1C, 42132 Trikala, Greece; (I.M.); (A.M.)
- Faculty of Medicine, University of Thessaly, Viopolis Mezourlo, 41110 Larissa, Greece; (K.T.); (A.K.)
| | - Konstantinos Tsolis
- Faculty of Medicine, University of Thessaly, Viopolis Mezourlo, 41110 Larissa, Greece; (K.T.); (A.K.)
| | - Ioannis Migdanis
- Nutrition and Dietetics Department, University of Thessaly, Argonafton 1C, 42132 Trikala, Greece; (I.M.); (A.M.)
- Faculty of Medicine, University of Thessaly, Viopolis Mezourlo, 41110 Larissa, Greece; (K.T.); (A.K.)
| | - Agoritsa G. Kaltsa
- Department of Gastroenterology, General University Hospital of Larissa, Viopolis Mezourlo, 41110 Larissa, Greece (F.A.F.)
| | - Fotios A. Fytsilis
- Department of Gastroenterology, General University Hospital of Larissa, Viopolis Mezourlo, 41110 Larissa, Greece (F.A.F.)
| | - Athanasios Manouras
- Nutrition and Dietetics Department, University of Thessaly, Argonafton 1C, 42132 Trikala, Greece; (I.M.); (A.M.)
| | - Odysseas Androutsos
- Laboratory of Clinical Nutrition and Dietetics (CND-Lab), Department of Nutrition and Dietetics, University of Thessaly, Argonafton 1C, 42132 Trikala, Greece;
| | - Andreas Kapsoritakis
- Faculty of Medicine, University of Thessaly, Viopolis Mezourlo, 41110 Larissa, Greece; (K.T.); (A.K.)
- Department of Gastroenterology, General University Hospital of Larissa, Viopolis Mezourlo, 41110 Larissa, Greece (F.A.F.)
| |
Collapse
|
2
|
Phelps NH, Singleton RK, Zhou B, Heap RA, Mishra A, Bennett JE, Paciorek CJ, Lhoste VPF, Carrillo-Larco RM, Stevens GA, Rodriguez-Martinez A, Bixby H, Bentham J, Di Cesare M, Danaei G, Rayner AW, Barradas-Pires A, Cowan MJ, Savin S, Riley LM, Aguilar-Salinas CA, Baker JL, Barkat A, Bhutta ZA, Branca F, Caixeta RB, Cuschieri S, Farzadfar F, Ganapathy S, Ikeda N, Iotova V, Kengne AP, Khang YH, Laxmaiah A, Lin HH, Ma J, Mbanya JCN, Miranda JJ, Pradeepa R, Rodríguez-Artalejo F, Sorić M, Turley M, Wang L, Webster-Kerr K, Aarestrup J, Abarca-Gómez L, Abbasi-Kangevari M, Abdeen ZA, Abdrakhmanova S, Abdul Ghaffar S, Abdul Rahim HF, Abdurrahmonova Z, Abu-Rmeileh NM, Abubakar Garba J, Acosta-Cazares B, Adam I, Adamczyk M, Adams RJ, Adu-Afarwuah S, Aekplakorn W, Afsana K, Afzal S, Agbor VN, Agdeppa IA, Aghazadeh-Attari J, Ågren Å, Aguenaou H, Agyemang C, Ahmad MH, Ahmad NA, Ahmadi A, Ahmadi N, Ahmadi N, Ahmed I, Ahmed SH, Ahrens W, Aitmurzaeva G, Ajlouni K, Al-Hazzaa HM, Al-Hinai H, Al-Lahou B, Al-Lawati JA, Al-Raddadi R, Al Asfoor D, Al Hourani HM, Al Qaoud NM, Alarouj M, AlBuhairan F, AlDhukair S, Aldwairji MA, Alexius S, Ali MM, Alieva AV, Alkandari A, Alkerwi A, Alkhatib BM, Allin K, Alomary SA, Alomirah HF, Alshangiti AM, Alvarez-Pedrerol M, Aly E, Amarapurkar DN, Amiano Etxezarreta P, Amoah J, Amougou N, Amouyel P, Andersen LB, Anderssen SA, Androutsos O, Ängquist L, Anjana RM, Ansari-Moghaddam A, Anufrieva E, Aounallah-Skhiri H, Araújo J, Ariansen I, Aris T, Arku RE, Arlappa N, Aryal KK, Assefa N, Aspelund T, Assah FK, Assembekov B, Assunção MCF, Aung MS, Aurélio de Valois CJM, Auvinen J, Avdičová M, Avi S, Azad K, Azevedo A, Azimi-Nezhad M, Azizi F, Babu BV, Bacopoulou F, Bæksgaard Jørgensen M, Baharudin A, Bahijri S, Bajramovic I, Bakacs M, Balakrishna N, Balanova Y, Bamoshmoosh M, Banach M, Banegas JR, Baran J, Baran R, Barbagallo CM, Barbosa Filho V, Barceló A, Baretić M, Barnoya J, Barrera L, Barreto M, Barros AJD, Barros MVG, Bartosiewicz A, Basit A, Bastos JL, Bata I, Batieha AM, Batista AP, Batista RL, Battakova Z, Baur LA, Bayauli PM, Beaglehole R, Bel-Serrat S, Belavendra A, Ben Romdhane H, Benedek T, Benedics J, Benet M, Benitez Rolandi GE, Benzeval M, Bere E, Berger N, Bergh IH, Berhane Y, Berkinbayev S, Bernabe-Ortiz A, Bernotiene G, Berrios Carrasola X, Bettiol H, Beutel ME, Beybey AF, Bezerra J, Bhagyalaxmi A, Bharadwaj S, Bhargava SK, Bi H, Bi Y, Bia D, Biasch K, Bika Lele EC, Bikbov MM, Bista B, Bjelica DJ, Bjerregaard AA, Bjerregaard P, Bjertness E, Bjertness MB, Björkelund C, Bloch KV, Blokstra A, Blychfeld Magnazu M, Bo S, Bobak M, Boddy LM, Boehm BO, Boer JMA, Boggia JG, Bogova E, Boissonnet CP, Bojesen SE, Bonaccio M, Bongard V, Bonilla-Vargas A, Bopp M, Borghs H, Botomba S, Bourne RRA, Bovet P, Boymatova K, Braeckevelt L, Braeckman L, Bragt MCE, Braithwaite T, Brajkovich I, Breckenkamp J, Breda J, Brenner H, Brewster LM, Brian GR, Briceño Y, Brinduse L, Bringolf-Isler B, Brito M, Brophy S, Brug J, Bruno G, Bugge A, Buoncristiano M, Burazeri G, Burns C, Cabrera de León A, Cacciottolo J, Cai H, Cama T, Cameron C, Camolas J, Can G, Cândido APC, Cañete F, Capanzana MV, Čapková N, Capuano E, Capuano R, Capuano V, Cardol M, Cardoso VC, Carlsson AC, Carmuega E, Carvalho J, Casajús JA, Casanueva FF, Casas M, Celikcan E, Censi L, Cervantes-Loaiza M, Cesar JA, Chamnan P, Chamukuttan S, Chan A, Chan Q, Charchar FJ, Charles MA, Chaturvedi HK, Chaturvedi N, Che Abdul Rahim N, Chee ML, Chen CJ, Chen F, Chen H, Chen LS, Chen S, Chen Z, Cheng CY, Cheng YJ, Cheraghian B, Chetrit A, Chikova-Iscener E, Chinapaw MJM, Chinnock A, Chiolero A, Chiou ST, Chirita-Emandi A, Chirlaque MD, Cho B, Christensen K, Christofaro DG, Chudek J, Cifkova R, Cilia M, Cinteza E, Cirillo M, Claessens F, Clare P, Clarke J, Clays E, Cohen E, Cojocaru CR, Colorado-Yohar S, Compañ-Gabucio LM, Concin H, Confortin SC, Cooper C, Coppinger TC, Corpeleijn E, Cortés LY, Costanzo S, Cottel D, Cowell C, Craig CL, Crampin AC, Cross AJ, Crujeiras AB, Cruz JJ, Csányi T, Csilla S, Cucu AM, Cui L, Cureau FV, Czenczek-Lewandowska E, D'Arrigo G, d'Orsi E, da Silva AG, Dacica L, Dahm CC, Dallongeville J, Damasceno A, Damsgaard CT, Dankner R, Dantoft TM, Dasgupta P, Dastgiri S, Dauchet L, Davletov K, de Assis Guedes de Vasconcelos F, de Assis MAA, De Backer G, De Bacquer D, De Bacquer J, de Bont J, De Curtis A, de Fragas Hinnig P, de Gaetano G, De Henauw S, De Miguel-Etayo P, De Neve JW, Duarte de Oliveira P, De Ridder D, De Ridder K, de Rooij SR, de Sá ACMGN, De Smedt D, Deepa M, Deev AD, DeGennaro VJ, Delisle H, Delpeuch F, Demarest S, Dennison E, Dereń K, Deschamps V, Devrishov RD, Dhimal M, Di Castelnuovo A, Dias-da-Costa JS, Díaz-Sánchez ME, Diaz A, Díaz Fernández P, Díez Ripollés MP, Dika Z, Djalalinia S, Djordjic V, Do HTP, Dobson AJ, Dominguez L, Donati MB, Donfrancesco C, Dong G, Dong Y, Donoso SP, Döring A, Dorobantu M, Dorosty AR, Dörr M, Doua K, Dragano N, Drygas W, Du S, Duan JL, Duante CA, Duboz P, Duleva VL, Dulskiene V, Dumith SC, Dushpanova A, Dwyer T, Dyussupova A, Dzerve V, Dziankowska-Zaborszczyk E, Ebrahimi N, Echeverría G, Eddie R, Eftekhar E, Efthymiou V, Egbagbe EE, Eggertsen R, Eghtesad S, Eiben G, Ekelund U, El-Khateeb M, El Ammari L, El Ati J, Eldemire-Shearer D, Elliott P, Enang O, Endevelt R, Engle-Stone R, Erasmus RT, Erem C, Ergor G, Eriksen L, Eriksson JG, Escobedo-de la Peña J, Eslami S, Esmaeili A, Evans A, Evans RG, Faeh D, Fagherazzi G, Fakhradiyev I, Fakhretdinova AA, Fall CH, Faramarzi E, Farjam M, Farrugia Sant'Angelo V, Farzi Y, Fattahi MR, Fawwad A, Fawzi WW, Felix-Redondo FJ, Ferguson TS, Fernandes RA, Fernández-Bergés D, Ferrante D, Ferrao T, Ferrari G, Ferrari M, Ferrario MM, Ferreccio C, Ferreira HS, Ferrer E, Ferrieres J, Figueiró TH, Fijalkowska A, Fink G, Fisberg M, Fischer K, Foo LH, Forsner M, Fottrell EF, Fouad HM, Francis DK, Franco MDC, Fras Z, Fraser B, Frontera G, Fuchs FD, Fuchs SC, Fujiati II, Fujita Y, Fumihiko M, Furdela V, Furusawa T, Gabriela SA, Gaciong Z, Gafencu M, Galán Cuesta M, Galbarczyk A, Galcheva SV, Galenkamp H, Galeone D, Galfo M, Galvano F, Gao J, Gao P, Garcia-de-la-Hera M, García Mérida MJ, García Solano M, Gareta D, Garnett SP, Gaspoz JM, Gasull M, Gaya ACA, Gaya AR, Gazzinelli A, Gehring U, Geiger H, Geleijnse JM, George R, Gerdts E, Ghaderi E, Ghamari SH, Ghanbari A, Ghasemi E, Gheorghe-Fronea OF, Gialluisi A, Giampaoli S, Gianfagna F, Gieger C, Gill TK, Giovannelli J, Gironella G, Giwercman A, Gkiouras K, Glushkova N, Godara R, Godos J, Gogen S, Goldberg M, Goltzman D, Gómez G, Gómez Gómez JH, Gomez LF, Gómez SF, Gomula A, Gonçalves Cordeiro da Silva B, Gonçalves H, Gonçalves M, González-Alvarez AD, Gonzalez-Chica DA, González-Gil EM, Gonzalez-Gross M, González-Leon M, González-Rivas JP, González-Villalpando C, González-Villalpando ME, Gonzalez AR, Gottrand F, Graça AP, Grafnetter D, Grajda A, Grammatikopoulou MG, Gregg EW, Gregor RD, Gregório MJ, Grøholt EK, Grøntved A, Grosso G, Gruden G, Gu D, Guajardo V, Gualdi-Russo E, Guallar-Castillón P, Gualtieri A, Gudmundsson EF, Gudnason V, Guerchet M, Guerrero R, Guessous I, Guimaraes AL, Gujral UP, Gulliford MC, Gunnlaugsdottir J, Gunter MJ, Guo XH, Guo Y, Gupta PC, Gupta R, Gureje O, Gurinović MA, Gutiérrez González E, Gutierrez L, Gutzwiller F, Gwee X, Ha S, Hadaegh F, Hadjigeorgiou CA, Haghshenas R, Hakimi H, Halkjær J, Hambleton IR, Hamzeh B, Hanekom WA, Hange D, Hanif AAM, Hantunen S, Hao J, Hardman CM, Hardy L, Hari Kumar R, Harmer Lassen T, Harooni J, Hashemi-Shahri SM, Hassapidou M, Hata J, Haugsgjerd T, Hayes AJ, He J, He Y, He Y, Heidinger-Felső R, Heier M, Heinen M, Hejgaard T, Hendriks ME, Henrique RDS, Henriques A, Hernandez Cadena L, Herrala S, Herrera-Cuenca M, Herrera VM, Herter-Aeberli I, Herzig KH, Heshmat R, Heude B, Hill AG, Ho SY, Ho SC, Hobbs M, Höfelmann DA, Holdsworth M, Homayounfar R, Homs C, Hoogendijk E, Hopman WM, Horimoto ARVR, Hormiga CM, Horta BL, Houti L, Howitt C, Htay TT, Htet AS, Htike MMT, Hu Y, Huerta JM, Huhtaniemi IT, Huiart L, Huidumac Petrescu C, Husseini A, Huu CN, Huybrechts I, Hwalla N, Hyska J, Iacoviello L, Iakupova EM, Ibarluzea J, Ibrahim MM, Ibrahim Wong N, Igland J, Ijoma C, Ikram MA, Iñiguez C, Irazola VE, Ishida T, Isiguzo GC, Islam M, Islam SMS, Islek D, Ittermann T, Ivanova-Pandourska IY, Iwasaki M, Jääskeläinen T, Jackson RT, Jacobs JM, Jadoul M, Jafar T, Jallow B, James K, Jamil KM, Jamrozik K, Jan N, Jansson A, Janszky I, Janus E, Jarani J, Jarnig G, Jarvelin MR, Jasienska G, Jelaković A, Jelaković B, Jennings G, Jiang CQ, Jimenez RO, Jöckel KH, Joffres M, Jokelainen JJ, Jonas JB, Jonnagaddala J, Jøran Kjerpeseth L, Jørgensen T, Joshi P, Joshi R, Josipović J, Joukar F, Jóźwiak JJ, Judge DS, Juolevi A, Jurak G, Jurca Simina I, Juresa V, Kaaks R, Kaducu FO, Kadvan AL, Kafatos A, Kaj M, Kajantie EO, Kakutia N, Kállayová D, Kalmatayeva Z, Kalter-Leibovici O, Kameli Y, Kanala KR, Kannan S, Kapantais E, Karaglani E, Karakosta A, Kårhus LL, Karki KB, Karlsson O, Kassi Anicet A, Katchunga PB, Katibeh M, Katz J, Katzmarzyk PT, Kauhanen J, Kaur P, Kavousi M, Kazakbaeva GM, Kaze FF, Kazembe BM, Ke C, Keil U, Keinan Boker L, Keinänen-Kiukaanniemi S, Kelishadi R, Kelleher C, Kemper HCG, Keramati M, Kerimkulova A, Kersting M, Key T, Khader YS, Khaledifar A, Khalili D, Kheiri B, Kheradmand M, Khosravi A, Khouw IMSL, Kiechl-Kohlendorfer U, Kiechl SJ, Kiechl S, Killewo J, Kim HC, Kim J, Kindblom JM, Kingston A, Klakk H, Klanarong S, Klanova J, Klimek M, Klimont J, Klumbiene J, Knoflach M, Kobel S, Koirala B, Kolle E, Kolo SM, Kolsteren P, König J, Korpelainen R, Korrovits P, Korzycka M, Kos J, Koskinen S, Kouda K, Koussoh Simone M, Kovács É, Kovacs VA, Kovalskys I, Kowlessur S, Koziel S, Kratenova J, Kratzer W, Kriaucioniene V, Kriemler S, Kristensen PL, Krizan H, Kroker-Lobos MF, Krokstad S, Kromhout D, Kruger HS, Kruger R, Kryst Ł, Kubinova R, Kuciene R, Kujala UM, Kujundzic E, Kulaga Z, Kulimbet M, Kulothungan V, Kumar RK, Kumari M, Kunešová M, Kurjata P, Kusuma YS, Kutsenko V, Kuulasmaa K, Kyobutungi C, La QN, Laamiri FZ, Laatikainen T, Labadarios D, Lachat C, Lackner KJ, Lai D, Laid Y, Lall L, Lam TH, Landaeta Jimenez M, Landais E, Lankila T, Lanska V, Lappas G, Larijani B, Larissa SP, Lateva MP, Latt TS, Laurenzi M, Lauria L, Lazo-Porras M, Le Coroller G, Le Nguyen Bao K, Le Port A, Le TD, Lee J, Lee J, Lee PH, Lehtimäki T, Lemogoum D, Leong E, Leskošek B, Leszczak J, Leth-Møller KB, Leung GM, Levitt NS, Li Y, Liivak M, Lilly CL, Lim C, Lim WY, Lima-Costa MF, Lin X, Lind L, Lingam V, Linkohr B, Linneberg A, Lissner L, Litwin M, Liu J, Liu L, Liu L, Liu X, Lo WC, Loit HM, Long KQ, Longo Abril G, Lopes L, Lopes MSS, Lopes O, Lopez-Garcia E, Lopez T, Lotufo PA, Lozano JE, Lukrafka JL, Luksiene D, Lundqvist A, Lunet N, Lunogelo C, Lustigová M, Łuszczki E, M'Buyamba-Kabangu JR, Ma G, Ma X, Machado-Coelho GLL, Machado-Rodrigues AM, Macia E, Macieira LM, Madar AA, Madraisau S, Madsen AL, Maestre GE, Maggi S, Magliano DJ, Magnacca S, Magriplis E, Mahasampath G, Maire B, Majer M, Makdisse M, Mäki P, Malekpour MR, Malekzadeh F, Malekzadeh R, Malhotra R, Mallikharjuna Rao K, Malta DC, Malyutina SK, Maniego LV, Manios Y, Mann JI, Mannix MI, Mansour-Ghanaei F, Manyanga T, Manzato E, Mapatano MA, Marcil A, Margozzini P, Maria-Magdalena R, Mariño J, Markaki A, Markey O, Markidou Ioannidou E, Marques-Vidal P, Marques LP, Marrugat J, Martin-Prevel Y, Martin R, Martorell R, Martos E, Maruf FA, Maruszczak K, Marventano S, Masala G, Mascarenhas LP, Masinaei M, Masoodi SR, Mathiesen EB, Mathur P, Matijasevich A, Matłosz P, Matsha TE, Matsudo V, Matteo G, Maulik PK, Mavrogianni C, Mazur A, McFarlane SR, McGarvey ST, McKee M, McLean RM, McLean SB, McNairy ML, McNulty BA, Mediene Benchekor S, Medzioniene J, Mehlig K, Mehrparvar AH, Meirhaeghe A, Meisfjord J, Meisinger C, Melgarejo JD, Melkumova M, Mello J, Méndez F, Mendivil CO, Menezes AMB, Menon GR, Mensink GBM, Menzano MT, Meshram II, Meto DT, Meyer HE, Mi J, Michaelsen KF, Michels N, Mikkel K, Miłkowska K, Miller JC, Milushkina O, Minderico CS, Mini GK, Miquel JF, Mirjalili MR, Mirkopoulou D, Mirrakhimov E, Mišigoj-Duraković M, Mistretta A, Mocanu V, Modesti PA, Moghaddam SS, Mohamed SF, Mohammad K, Mohammadi MR, Mohammadi Z, Mohammadifard N, Mohammadpourhodki R, Mohan V, Mohanna S, Mohd Yusoff MF, Mohebbi I, Moitry M, Møllehave LT, Møller NC, Molnár D, Momenan A, Mondo CK, Monroy-Valle M, Montenegro Mendoza RA, Monterrubio-Flores E, Monyeki KDK, Moon JS, Moosazadeh M, Mopa HT, Moradpour F, Moreira LB, Morejon A, Moreno LA, Morey F, Morgan K, Morin SN, Mortensen EL, Moschonis G, Moslem A, Mosquera M, Mossakowska M, Mostafa A, Mostafavi SA, Mota-Pinto A, Mota J, Motlagh ME, Motta J, Moura-dos-Santos MA, Movsesyan Y, Mridha MK, Msyamboza KP, Mu TT, Muc M, Muca F, Mugoša B, Muiesan ML, Müller-Nurasyid M, Münzel T, Mursu J, Murtagh EM, Musa KI, Musić Milanović S, Musil V, Musinguzi G, Muyer MT, Nabipour I, Nagel G, Najafi F, Nakamura H, Nalecz H, Námešná J, Nang EEK, Nangia VB, Nankap M, Narake S, Narayan KMV, Nardone P, Naseri T, Nathalie M, Neal WA, Neelapaichit N, Nejatizadeh A, Nekkantti C, Nelis K, Nenko I, Neovius M, Nervi F, Ng TP, Nguyen CT, Nguyen ND, Nguyen QN, Ni MY, Nicolescu R, Nie P, Nieto-Martínez RE, Nikitin YP, Ning G, Ninomiya T, Nishi N, Nishtar S, Noale M, Noboa OA, Nogueira H, Nordendahl M, Nordestgaard BG, Norton KI, Noto D, Nowak-Szczepanska N, Nsour MA, Nuhoğlu I, Nunes B, Nurk E, Nuwaha F, Nyirenda M, O'Neill TW, O'Reilly D, Obreja G, Ochimana C, Ochoa-Avilés AM, Oda E, Odili AN, Oh K, Ohara K, Ohlsson C, Ohtsuka R, Olafsson Ö, Oldenburg B, Olinto MTA, Oliveira IO, Omar MA, Omar SM, Onat A, Ong SK, Onland-Moret NC, Ono LM, Onodugo O, Ordunez P, Ornelas R, Ortiz AP, Ortiz PJ, Osler M, Osmond C, Ostojic SM, Ostovar A, Otero JA, Ottendahl CB, Otu A, Overvad K, Owusu-Dabo E, Oyeyemi AY, Oyeyemi AL, Paccaud FM, Padez CP, Pagkalos I, Pahomova E, de Paiva KM, Pająk A, Pajula N, Palloni A, Palmieri L, Pan WH, Panda-Jonas S, Pandey A, Pang Z, Panza F, Paoli M, Papadopoulou SK, Papandreou D, Pareja RG, Park SW, Park S, Parnell WR, Parsaeian M, Pascanu IM, Pasquet P, Patel ND, Pattussi M, Pavlyshyn H, Pechlaner R, Pećin I, Pednekar MS, Pedro JM, Peer N, Peixoto SV, Peltonen M, Pereira AC, Peres MA, Perez-Londoño A, Pérez CM, Peterkova V, Peters A, Petkeviciene J, Petrauskiene A, Petrovna Kovtun O, Pettenuzzo E, Peykari N, Pfeiffer N, Phall MC, Pham ST, Phiri FP, Pichardo RN, Pierannunzio D, Pierre-Marie P, Pigeot I, Pikhart H, Pilav A, Piler P, Pilotto L, Pistelli F, Pitakaka F, Piwonska A, Pizarro AN, Plans-Rubió P, Platonova AG, Poh BK, Pohlabeln H, Polka NS, Pop RM, Popkin BM, Popovic SR, Porta M, Posch G, Poudyal A, Poulimeneas D, Pouraram H, Pourfarzi F, Pourshams A, Poustchi H, Price AJ, Price JF, Prista A, Providencia R, Puder JJ, Pudule I, Puhakka S, Puiu M, Punab M, Qadir MS, Qasrawi RF, Qiao Q, Qorbani M, Quintana HK, Quiroga-Padilla PJ, Quoc Bao T, Rach S, Radic I, Radisauskas R, Rahimikazerooni S, Rahman M, Rahman M, Raitakari O, Raj M, Rajabov T, Rakhmatulloev S, Rakovac I, Ramachandra Rao S, Ramachandran A, Ramadan OPC, Ramires VV, Ramirez-Zea M, Ramke J, Ramos E, Ramos R, Rampal L, Rampal S, Ramsay SE, Rangelova LS, Rarra V, Rascon-Pacheco RA, Rashidi MM, Rech CR, Redon J, Reganit PFM, Regecová V, Renner JDP, Repasy JA, Reuter CP, Revilla L, Reynolds A, Rezaei N, Rezaianzadeh A, Rho Y, Ribas-Barba L, Ribeiro R, Riboli E, Rigo F, Rigotti A, Rinaldo N, Rinke de Wit TF, Risérus U, Rito AI, Ritti-Dias RM, Rivera JA, Roa RG, Robinson L, Roccaldo R, Rodrigues D, Rodriguez-Perez MDC, Rodríguez-Villamizar LA, Rodríguez AY, Roggenbuck U, Rohloff P, Rohner F, Rojas-Martinez R, Rojroongwasinkul N, Romaguera D, Romeo EL, Rosario RV, Rosengren A, Rouse I, Rouzier V, Roy JGR, Ruano MH, Rubinstein A, Rühli FJ, Ruidavets JB, Ruiz-Betancourt BS, Ruiz-Castell M, Ruiz Moreno E, Rusakova IA, Rusek W, Russell Jonsson K, Russo P, Rust P, Rutkowski M, Saamel M, Saar CG, Sabanayagam C, Sabbaghi H, Sacchini E, Sachdev HS, Sadjadi A, Safarpour AR, Safi S, Safiri S, Saghi MH, Saidi O, Saieva C, Sakata S, Saki N, Šalaj S, Salanave B, Salazar Martinez E, Salhanova A, Salmerón D, Salomaa V, Salonen JT, Salvetti M, Samoutian M, Sánchez-Abanto J, Sánchez Rodríguez I, Sandjaja, Sans S, Santa-Marina L, Santacruz E, Santos DA, Santos IS, Santos LC, Santos MP, Santos O, Santos R, Santos TR, Saramies JL, Sardinha LB, Sarrafzadegan N, Sathish T, Saum KU, Savva S, Savy M, Sawada N, Sbaraini M, Scazufca M, Schaan BD, Schaffrath Rosario A, Schargrodsky H, Schienkiewitz A, Schindler K, Schipf S, Schmidt B, Schmidt CO, Schmidt IM, Schneider A, Schnohr P, Schöttker B, Schramm S, Schramm S, Schröder H, Schultsz C, Schultz G, Schulze MB, Schutte AE, Sebert S, Sedaghattalab M, Selamat R, Sember V, Sen A, Senbanjo IO, Sepanlou SG, Sequera G, Serra-Majem L, Servais J, Ševčíková Ľ, Sewpaul R, Shalnova S, Shamah-Levy T, Shamshirgaran SM, Shanthirani CS, Sharafkhah M, Sharma SK, Sharman A, Shaw JE, Shayanrad A, Shayesteh AA, Shengelia L, Shi Z, Shibuya K, Shimizu-Furusawa H, Shimony T, Shiri R, Shrestha N, Si-Ramlee K, Siani A, Siantar R, Sibai AM, Sidossis LS, Silitrari N, Silva AM, Silva CRDM, Silva DAS, Silva KS, Sim X, Simon M, Simons J, Simons LA, Sjöberg A, Sjöström M, Skoblina EV, Skoblina NA, Slazhnyova T, Slowikowska-Hilczer J, Slusarczyk P, Smeeth L, So HK, Soares FC, Sobek G, Sobngwi E, Sodemann M, Söderberg S, Soekatri MYE, Soemantri A, Sofat R, Solfrizzi V, Solovieva YV, Somi MH, Sonestedt E, Song Y, Soofi S, Sørensen TIA, Sørgjerd EP, Sossa Jérome C, Soto-Rojas VE, Soumaré A, Sousa-Poza A, Sovic S, Sparboe-Nilsen B, Sparrenberger K, Spencer PR, Spinelli A, Spiroski I, Staessen JA, Stamm H, Stang A, Starc G, Staub K, Stavreski B, Steene-Johannessen J, Stehle P, Stein AD, Steinsbekk S, Stergiou GS, Stessman J, Stevanović R, Stieber J, Stöckl D, Stokwiszewski J, Stoyanova E, Stratton G, Stronks K, Strufaldi MW, Sturua L, Suárez-Medina R, Suarez-Ortegón MF, Suebsamran P, Sugiyama M, Suka M, Sulo G, Sun CA, Sun L, Sund M, Sundström J, Sung YT, Sunyer J, Suriyawongpaisal P, Sweis NWG, Swinburn BA, Sy RG, Sylva RC, Szponar L, Tabone L, Tai ES, Takuro F, Tambalis KD, Tammesoo ML, Tamosiunas A, Tan EJ, Tang X, Tanrygulyyeva M, Tanser F, Tao Y, Tarawneh MR, Tarp J, Tarqui-Mamani CB, Taxová Braunerová R, Taylor A, Taylor J, Tchibindat F, Te Velde S, Tebar WR, Tell GS, Tello T, Tessema M, Tham YC, Thankappan KR, Theobald H, Theodoridis X, Thomas N, Thorand B, Thrift AG, Tichá Ľ, Timmermans EJ, Tjandrarini DH, Tjonneland A, Tolonen HK, Tolstrup JS, Tomaszewski M, Topbas M, Topór-Mądry R, Torheim LE, Tornaritis MJ, Torrent M, Torres-Collado L, Toselli S, Touloumi G, Traissac P, Tran TTH, Tremblay MS, Triantafyllou A, Trichopoulos D, Trichopoulou A, Trinh OTH, Trivedi A, Tshepo L, Tsigga M, Tsintavis P, Tsugane S, Tuitele J, Tuliakova AM, Tulloch-Reid MK, Tullu F, Tuomainen TP, Tuomilehto J, Twig G, Tynelius P, Tzala E, Tzotzas T, Tzourio C, Udoji N, Ueda P, Ugel E, Ukoli FAM, Ulmer H, Unal B, Usupova Z, Uusitalo HMT, Uysal N, Vaitkeviciute J, Valdivia G, Vale S, Valvi D, van Dam RM, van den Born BJ, Van der Heyden J, van der Schouw YT, Van Herck K, Van Lippevelde W, Van Minh H, Van Schoor NM, van Valkengoed IGM, Vanderschueren D, Vanuzzo D, Varbo A, Varela-Moreiras G, Vargas LN, Varona-Pérez P, Vasan SK, Vasques DG, Vatasescu R, Vega T, Veidebaum T, Velasquez-Melendez G, Velika B, Verloigne M, Veronesi G, Verschuren WMM, Victora CG, Viegi G, Viet L, Vik FN, Vilar M, Villalpando S, Vioque J, Viriyautsahakul N, Virtanen JK, Visser M, Visvikis-Siest S, Viswanathan B, Vladulescu M, Vlasoff T, Vocanec D, Vollenweider P, Völzke H, Vourli G, Voutilainen A, Vrijheid M, Vrijkotte TGM, Vuletić S, Wade AN, Waldhör T, Walton J, Wambiya EOA, Wan Bebakar WM, Wan Mohamud WN, Wanderley Júnior RDS, Wang C, Wang H, Wang MD, Wang N, Wang Q, Wang X, Wang YX, Wang YW, Wannamethee SG, Wareham N, Wartha O, Weber A, Wedderkopp N, Weghuber D, Wei W, Weres A, Werner B, Westbury LD, Whincup PH, Wichstrøm L, Wickramasinghe K, Widhalm K, Widyahening IS, Więcek A, Wild PS, Wilks RJ, Willeit J, Willeit P, Williams J, Wilsgaard T, Wirth JP, Wojtyniak B, Woldeyohannes M, Wolf K, Wong-McClure RA, Wong A, Wong EB, Wong JE, Wong TY, Woo J, Woodward M, Wu FC, Wu HY, Wu J, Wu LJ, Wu S, Wyszyńska J, Xu H, Xu L, Yaacob NA, Yamborisut U, Yan L, Yan W, Yang L, Yang X, Yang Y, Yardim N, Yasuharu T, Yépez García M, Yiallouros PK, Yngve A, Yoosefi M, Yoshihara A, Yotov Y, You QS, You SL, Younger-Coleman NO, Yu YL, Yu Y, Yusof SM, Yusoff AF, Zaccagni L, Zafiropulos V, Zainuddin AA, Zakavi SR, Zamani F, Zambon S, Zampelas A, Zamrazilová H, Zapata ME, Zargar AH, Zaw KK, Zayed AA, Zdrojewski T, Żegleń M, Zejglicova K, Zeljkovic Vrkic T, Zeng Y, Zentai A, Zhang B, Zhang L, Zhang ZY, Zhao D, Zhao MH, Zhao W, Zhecheva YV, Zhen S, Zheng W, Zheng Y, Zholdin B, Zhou M, Zhu D, Zimmet P, Zins M, Zitt E, Zocalo Y, Zoghlami N, Zuñiga Cisneros J, Zuziak M, Ezzati M. Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults. Lancet 2024; 403:1027-1050. [PMID: 38432237 PMCID: PMC7615769 DOI: 10.1016/s0140-6736(23)02750-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 11/22/2023] [Accepted: 12/05/2023] [Indexed: 03/05/2024]
Abstract
BACKGROUND Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. METHODS We used data from 3663 population-based studies with 222 million participants that measured height and weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children and adolescents (age 5-19 years), from 1990 to 2022 for 200 countries and territories. For adults, we report the individual and combined prevalence of underweight (BMI <18·5 kg/m2) and obesity (BMI ≥30 kg/m2). For school-aged children and adolescents, we report thinness (BMI <2 SD below the median of the WHO growth reference) and obesity (BMI >2 SD above the median). FINDINGS From 1990 to 2022, the combined prevalence of underweight and obesity in adults decreased in 11 countries (6%) for women and 17 (9%) for men with a posterior probability of at least 0·80 that the observed changes were true decreases. The combined prevalence increased in 162 countries (81%) for women and 140 countries (70%) for men with a posterior probability of at least 0·80. In 2022, the combined prevalence of underweight and obesity was highest in island nations in the Caribbean and Polynesia and Micronesia, and countries in the Middle East and north Africa. Obesity prevalence was higher than underweight with posterior probability of at least 0·80 in 177 countries (89%) for women and 145 (73%) for men in 2022, whereas the converse was true in 16 countries (8%) for women, and 39 (20%) for men. From 1990 to 2022, the combined prevalence of thinness and obesity decreased among girls in five countries (3%) and among boys in 15 countries (8%) with a posterior probability of at least 0·80, and increased among girls in 140 countries (70%) and boys in 137 countries (69%) with a posterior probability of at least 0·80. The countries with highest combined prevalence of thinness and obesity in school-aged children and adolescents in 2022 were in Polynesia and Micronesia and the Caribbean for both sexes, and Chile and Qatar for boys. Combined prevalence was also high in some countries in south Asia, such as India and Pakistan, where thinness remained prevalent despite having declined. In 2022, obesity in school-aged children and adolescents was more prevalent than thinness with a posterior probability of at least 0·80 among girls in 133 countries (67%) and boys in 125 countries (63%), whereas the converse was true in 35 countries (18%) and 42 countries (21%), respectively. In almost all countries for both adults and school-aged children and adolescents, the increases in double burden were driven by increases in obesity, and decreases in double burden by declining underweight or thinness. INTERPRETATION The combined burden of underweight and obesity has increased in most countries, driven by an increase in obesity, while underweight and thinness remain prevalent in south Asia and parts of Africa. A healthy nutrition transition that enhances access to nutritious foods is needed to address the remaining burden of underweight while curbing and reversing the increase in obesity. FUNDING UK Medical Research Council, UK Research and Innovation (Research England), UK Research and Innovation (Innovate UK), and European Union.
Collapse
|
3
|
Mentzelou M, Papadopoulou SK, Psara E, Voulgaridou G, Pavlidou E, Androutsos O, Giaginis C. Chrononutrition in the Prevention and Management of Metabolic Disorders: A Literature Review. Nutrients 2024; 16:722. [PMID: 38474850 DOI: 10.3390/nu16050722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 02/26/2024] [Accepted: 02/28/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND The concept of time-restricted eating (TRE) or time-restricted feeding (TRF) promotes daily periods of feeding and fasting to determine whole-body physiology. Chronic misalignment of circadian rhythms or chrono-disruption is related to an increased risk of diverse metabolic disorders. The progression of non-communicable diseases seems to be affected by the timing of meals. As a result, intermittent fasting is a promising approach for their management. The aim of the present literature review is to examine and scrutinize the TRE protocols in the fields of prevention and management of metabolic disorders. METHODS This is a thorough literature review of the reported associations among circadian rhythm, metabolic disorders, diabetes mellitus, obesity, TRE, TRF, dietary habits, circadian disruption, cardiovascular diseases, atherosclerosis, and non-alcoholic fatty liver to find the already existing clinical studies from the last decade (2014-2024) in the most precise scientific online databases, using relevant specific keywords. Several inclusion and exclusion criteria were applied to scrutinize only longitudinal, cross-sectional, descriptive, and prospective clinical human studies. RESULTS The currently available clinical findings remain scarce and suggest that chrononutrition behaviors such as TRE or TRF may promote several metabolic benefits, mainly in body weight control and fat loss. Improvements in glucose levels and lipid profiles are currently quite controversial since some clinical studies show little or no effect. As far as liver diseases are concerned, the efficacy of intermittent fasting seems to be stronger in the management of non-alcoholic fatty liver disease due to body weight decline and fat loss. CONCLUSIONS Even if there has been a gradual increase in clinical studies in the last few years, providing promising perspectives, currently, there is no conclusive evidence for the role of chrononutrition in metabolic disorders. Future studies should be well-designed with longer duration and larger sample sizes. Moreover, it is important to examine the best timing of the eating window and its feasibility.
Collapse
Affiliation(s)
- Maria Mentzelou
- Department of Food Science and Nutrition, School of Environment, University of the Aegean, 81400 Lemnos, Greece
| | - Sousana K Papadopoulou
- Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece
| | - Evmorfia Psara
- Department of Food Science and Nutrition, School of Environment, University of the Aegean, 81400 Lemnos, Greece
| | - Gavriela Voulgaridou
- Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece
| | - Eleni Pavlidou
- Department of Food Science and Nutrition, School of Environment, University of the Aegean, 81400 Lemnos, Greece
| | - Odysseas Androutsos
- Laboratory of Clinical Nutrition and Dietetics, Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, 42132 Trikala, Greece
| | - Constantinos Giaginis
- Department of Food Science and Nutrition, School of Environment, University of the Aegean, 81400 Lemnos, Greece
| |
Collapse
|
4
|
Poulios E, Pavlidou E, Papadopoulou SK, Rempetsioti K, Migdanis A, Mentzelou M, Chatzidimitriou M, Migdanis I, Androutsos O, Giaginis C. Probiotics Supplementation during Pregnancy: Can They Exert Potential Beneficial Effects against Adverse Pregnancy Outcomes beyond Gestational Diabetes Mellitus? Biology (Basel) 2024; 13:158. [PMID: 38534428 DOI: 10.3390/biology13030158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 02/26/2024] [Accepted: 02/26/2024] [Indexed: 03/28/2024]
Abstract
BACKGROUND Probiotics, as supplements or food ingredients, are considered to exert promising healthy effects when administered in adequate quantity. Probiotics' healthy effects are related with the prevention of many diseases, as well as decreasing symptom severity. Currently, the most available data concerning their potential health effects are associated with metabolic disorders, including gestational diabetes mellitus. There is also clinical evidence supporting that they may exert beneficial effects against diverse adverse pregnancy outcomes. The purpose of the current narrative study is to extensively review and analyze the current existing clinical studies concerning the probable positive impacts of probiotics supplementation during pregnancy as a protective agent against adverse pregnancy outcomes beyond gestational diabetes mellitus. METHODS a comprehensive and thorough literature search was conducted in the most precise scientific databases, such as PubMed, Scopus, and Web of Sciences, utilizing efficient, representative, and appropriate keywords. RESULTS in the last few years, recent research has been conducted concerning the potential beneficial effects against several adverse pregnancy outcomes such as lipid metabolism dysregulation, gestational hypertensive disorders, preterm birth, excessive gestational weight gain, caesarean risk section, vaginal microbiota impairment, mental health disturbances, and others. CONCLUSION up to the present day, there is only preliminary clinical data and not conclusive results for probiotics' healthy effects during pregnancy, and it remains questionable whether they could be used as supplementary treatment against adverse pregnancy outcomes beyond gestational diabetes mellitus.
Collapse
Affiliation(s)
- Efthymios Poulios
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Lemnos, Greece
| | - Eleni Pavlidou
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Lemnos, Greece
| | - Sousana K Papadopoulou
- Department of Nutritional Sciences and Dietetics, Faculty of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece
| | - Kalliopi Rempetsioti
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Lemnos, Greece
| | - Athanasios Migdanis
- Faculty of Medicine, University of Thessaly, 41500 Larissa, Greece
- Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, 42132 Trikala, Greece
| | - Maria Mentzelou
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Lemnos, Greece
| | - Maria Chatzidimitriou
- Department of Biomedical Science, International Hellenic University, 57400 Thessaloniki, Greece
| | - Ioannis Migdanis
- Faculty of Medicine, University of Thessaly, 41500 Larissa, Greece
- Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, 42132 Trikala, Greece
| | - Odysseas Androutsos
- Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, 42132 Trikala, Greece
| | - Constantinos Giaginis
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Lemnos, Greece
| |
Collapse
|
5
|
Saltaouras G, Perperidi M, Vantzou D, Vatsina K, Saloustros E, Theodorakis Y, Androutsos O. Determinants of lifestyle and body weight status among breast cancer survivors with overweight/obesity and perspectives towards the development of weight loss interventions: a qualitative study with health professionals from Greece. J Nutr Sci 2024; 13:e4. [PMID: 38282654 PMCID: PMC10808873 DOI: 10.1017/jns.2023.117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 12/05/2023] [Accepted: 12/15/2023] [Indexed: 01/30/2024] Open
Abstract
The current study assessed the views and attitudes of health professionals (HPs) regarding factors associated with energy balance-related health behaviours and weight management in breast cancer survivors (BCS) with overweight and obesity. Semi-structured online interviews were conducted with 21 HPs (oncologists, dietitians- nutritionists, physical education instructors, mental health professionals, and nurses) from Attica and Thessaly. Thematic analysis was used to analyse and present the data. Four main themes arose from the data: "The patients' mental health wellbeing", "Survivors' interest in diet and exercise", "Interdisciplinary collaboration in patient's care", and "Maintaining normality". HPs agreed that weight loss in BCS with overweight and obesity is important, but negative mental health wellbeing is a main barrier to behaviour change. For many BCS their cancer diagnosis is a "teachable" moment for weight management, especially for women of younger age, who are more keen to discuss weight management issues. Essential characteristics that determine/facilitate behavioural change include education, commitment for regular communication, personalised intervention, and interdisciplinary collaboration. According to HPs, future weight loss interventions should take into account BCS's mental health wellbeing and level of motivation and should provide regular support and education.
Collapse
Affiliation(s)
- Georgios Saltaouras
- Laboratory of Clinical Nutrition and Dietetics, Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, Trikala, Greece
- Department of Nutritional Sciences and Dietetics, International Hellenic University, Sindos, Greece
| | - Maria Perperidi
- Laboratory of Clinical Nutrition and Dietetics, Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, Trikala, Greece
| | - Dimitra Vantzou
- Laboratory of Clinical Nutrition and Dietetics, Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, Trikala, Greece
| | - Konstantina Vatsina
- Laboratory of Clinical Nutrition and Dietetics, Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, Trikala, Greece
| | - Emmanouil Saloustros
- Department of Oncology, Medical School, University Hospital of Larissa, Larissa, Greece
| | - Yannis Theodorakis
- Department of Physical Education and Sport Science, School of Physical Education, Sport Science and Dietetics, University of Thessaly, Trikala, Greece
| | - Odysseas Androutsos
- Laboratory of Clinical Nutrition and Dietetics, Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, Trikala, Greece
| |
Collapse
|
6
|
Migdanis A, Migdanis I, Papadopoulou SK, Hadjivasiliou L, Trifonova N, Villioti M, Giaginis C, Kosti RI, Androutsos O. Αssessment of Dietary Intake and Nutritional Status of Former Opioid Users Undergoing Detoxification Process. Cureus 2023; 15:e50068. [PMID: 38186545 PMCID: PMC10767476 DOI: 10.7759/cureus.50068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/05/2023] [Indexed: 01/09/2024] Open
Abstract
RATIONALE Opioid dependence is often associated with impaired nutritional status, weight changes, nutritional deficiencies, and increased sugar consumption. Scientific quantified data on the dietary habits and intake of such patients are sparse. METHODS This was a cross-sectional study. The study was conducted among 60 male and female former heroin addicts, who sought detoxification at the OKANA replacement therapy unit, in a public university hospital. All patients were treated for their addiction with buprenorfine/naloxone in combination with counseling. With the use of an administered questionnaire, several parameters were assessed and recorded, including nutritional habits, anthropometric characteristics, recent weight and medical history, and physical activity level of the participants. Additionally, a three-day dietary recall was performed and quantified with the aid of nutritional analysis software. The results were compared with the macronutrient requirements, calculated total energy expenditure, and the population reference intake (PRI) of the participants. Finally, the level of compliance of the participants to the Mediterranean diet model was assessed using the Mediterranean diet score tool. RESULTS The vast majority of the participants (77%) had a normal BMI of 18.5-25, and 15% were categorized as underweight (<18.5). Furthermore, 63% of the patients reported a mean unintended weight reduction of 9 kg over the last three months. Regarding mean energy and protein intake, no significant differences between reported intake and calculated requirements were recorded. Sugar consumption was high since it reached 20% of the total energy intake. Micronutrient intake was significantly lower for vitamins K, E, and C and potassium compared with the PRI (p=0.034, p=0.001, p=0.046, and p=0.001, respectively). Finally, a low adherence of the participants to the Mediterranean diet model was observed since 38% scored ≤15 and 62% ≤ 30 on the Mediterranean diet score tool. CONCLUSIONS According to the results of the study, the general nutritional status of this category of patients seems to be impaired, presenting an apparent weight reduction and an inadequate intake of some micronutrients and displaying disturbed eating behaviors. Further data on the field are required to build a future evidence base. Dietary assessment and individualized nutritional counseling, when necessary, might need to be incorporated into the typical clinical management of this patient category to avoid nutritional deficiencies and improve the withdrawal process.
Collapse
Affiliation(s)
- Athanasios Migdanis
- Faculty of Medicine, University of Thessaly, Larissa, GRC
- Department of Nutrition and Dietetics, University of Thessaly, Trikala, GRC
| | - Ioannis Migdanis
- Faculty of Medicine, University of Thessaly, Larissa, GRC
- Department of Nutrition and Dietetics, University of Thessaly, Trikala, GRC
| | - Sousana K Papadopoulou
- Department of Nutrition and Dietetics, International Hellenic University, Thessaloniki, GRC
| | | | - Nevena Trifonova
- Department of Nutrition and Dietetics, University of Thessaly, Trikala, GRC
| | - Maria Villioti
- Faculty of Medicine, University of Thessaly, Larissa, GRC
| | | | - Rena I Kosti
- Department of Nutrition and Dietetics, University of Thessaly, Trikala, GRC
| | | |
Collapse
|
7
|
Seral-Cortes M, Sabroso-Lasa S, Gonzalez-Gross M, Quesada-Gonzalez C, Stehle P, Gottrand F, Marcos A, Esperanza-Diaz L, Manios Y, Androutsos O, Widhalm K, Molnar D, Huybrechts I, Muntaner M, Meirhaeghe A, Salazar-Tortosa D, Ruiz JR, Esteban LM, Labayen I, Moreno LA. The body mass index increases the genetic risk scores' ability to predict risk of hepatic damage in European adolescents: The HELENA study. Eur J Clin Invest 2023; 53:e14081. [PMID: 37608495 DOI: 10.1111/eci.14081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 07/27/2023] [Accepted: 08/03/2023] [Indexed: 08/24/2023]
Abstract
BACKGROUND Hepatic disorders are often complex and multifactorial, modulated by genetic and environmental determinants. During the last years, the hepatic disease has been progressively established from early stages in life. The use of genetic risk scores (GRS) to predict the genetic susceptibility to a particular phenotype among youth has gained interest in recent years. Moreover, the alanine aminotransferase (ALT) blood biomarker is often considered as hepatic screening tool, in combination with imaging techniques. The aim of the present study was to develop an ALT-specific GRS to help in the evaluation of hepatic damage risk in European adolescents. METHODS A total of 972 adolescents (51.3% females), aged 12.5-17.5 years, from the Healthy Lifestyle in Europe by Nutrition in Adolescence study were included in the analyses. The sample incorporated adolescents in all body mass index (BMI) categories and was divided considering healthy/unhealthy ALT levels, using sex-specific cut-off points. From 1212 a priori ALT-related single nucleotide polymorphisms (SNPs) extracted from candidate gene selection, a first screening of 234 SNPs univariately associated was established, selecting seven significant SNPs (p < .05) in the multivariate model. An unweighted GRS (uGRS) was developed by summing the number of reference alleles, and a weighted GRS (wGRS), by multiplying each allele to its estimated coefficient. RESULTS The uGRS and wGRS were significantly associated with ALT (p < .001). The area under curve was obtained integrating BMI as clinical factor, improving the predictive ability for uGRS (.7039) and wGRS (.7035), using 10-fold internal cross-validation. CONCLUSIONS Considering BMI status, both GRSs could contribute as complementary tools to help in the early diagnosis of hepatic damage risk in European adolescents.
Collapse
Affiliation(s)
- Miguel Seral-Cortes
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Faculty of Health Sciences, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón), Universidad de Zaragoza, Zaragoza, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - Sergio Sabroso-Lasa
- Genetic and Molecular Epidemiology Group (GMEG), Spanish National Cancer Research Centre (CNIO), Madrid, Spain
| | - Marcela Gonzalez-Gross
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
- ImFine Research Group, Department of Health and Human Performance, Facultad de Ciencias de la Actividad Física y del Deporte-INEF, Universidad Politécnica de Madrid, Madrid, Spain
- Institute of Nutritional and Food Sciences, Nutritional Physiology, University of Bonn, Bonn, Germany
| | - Carlos Quesada-Gonzalez
- ImFine Research Group, Department of Health and Human Performance, Facultad de Ciencias de la Actividad Física y del Deporte-INEF, Universidad Politécnica de Madrid, Madrid, Spain
- Department of Applied Mathematics to Information and Communication Technologies, Universidad Politécnica de Madrid, Madrid, Spain
| | - Peter Stehle
- Institute of Nutritional and Food Sciences, Nutritional Physiology, University of Bonn, Bonn, Germany
| | - Frederic Gottrand
- CHU Lille, Inserm U1286 INFINITE, University of Lille, Lille, France
| | - Ascension Marcos
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
- Immunonutrition Group, Department of Metabolism and Nutrition, Institute of Food Science, Technology and Nutrition (ICTAN), Spanish National Research Council (CSIC), Madrid, Spain
| | - Ligia Esperanza-Diaz
- Immunonutrition Group, Department of Metabolism and Nutrition, Institute of Food Science, Technology and Nutrition (ICTAN), Spanish National Research Council (CSIC), Madrid, Spain
| | - Yannis Manios
- Department of Nutrition and Dietetics, School of Health Science & Education, Harokopio University, Athens, Greece
- Institute of Agri-food and Life Sciences, Hellenic Mediterranean University Research Centre, Heraklion, Greece
| | - Odysseas Androutsos
- Lab of Clinical Nutrition and Dietetics, Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, Trikala, Greece
| | - Kurt Widhalm
- Division of Clinical Nutrition and Prevention, Department of Paediatrics, Medical University of Vienna, Vienna, Austria
- Austrian Academic Institute for Clinical Nutrition, Vienna, Austria
| | - Denes Molnar
- Department of Pediatrics, Medical School, University of Pécs, Pécs, Hungary
| | - Inge Huybrechts
- International Agency for Research on Cancer, World Health Organization, Lyon, France
- French Network for Nutrition and Cancer Research (NACRe network), Jouy-en-Josas, France
| | - Manon Muntaner
- UMR1167, RID-AGE, Risk Factors and Molecular Determinants of Aging-Related Diseases, Centre Hosp, Institut Pasteur de Lille, Université de Lille, Lille, France
| | - Aline Meirhaeghe
- UMR1167, RID-AGE, Risk Factors and Molecular Determinants of Aging-Related Diseases, Centre Hosp, Institut Pasteur de Lille, Université de Lille, Lille, France
| | - Diego Salazar-Tortosa
- Department of Ecology and Evolutionary Biology, University of Arizona, Tucson, Arizona, USA
| | - Jonatan R Ruiz
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
- Department of Physical Education and Sports, Faculty of Sports Science, Sport and Health University Research Institute (iMUDS), Granada, Spain
- Instituto de Investigación Biosanitaria, ibs.Granada, Granada, Spain
| | | | - Idoia Labayen
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
- Department of Health Sciences, Public University of Navarra, Pamplona, Spain
| | - Luis A Moreno
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Faculty of Health Sciences, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón), Universidad de Zaragoza, Zaragoza, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| |
Collapse
|
8
|
Foscolou A, Androutsos O, Kosti RI. Addressing a Growing Crisis: Exploring Novel Insights and Solutions in Research on Nutrition and Childhood and Adolescent Obesity. Children (Basel) 2023; 10:1883. [PMID: 38136085 PMCID: PMC10741571 DOI: 10.3390/children10121883] [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] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 11/27/2023] [Indexed: 12/24/2023]
Abstract
Given the escalating global prevalence of non-communicable diseases (NCDs), it is consequently crucial to address childhood obesity by promoting lifestyle adjustments, as exemplified in the World Health Organization's Package of Essential Non-Communicable Disease Interventions for Primary Healthcare [...].
Collapse
Affiliation(s)
- Alexandra Foscolou
- Laboratory of Clinical Nutrition and Dietetics (CND-Lab), Department of Nutrition & Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, 42132 Trikala, Greece (O.A.)
- Institute of Preventive Medicine Environmental and Occupational Health Prolepsis, 15125 Athens, Greece
| | - Odysseas Androutsos
- Laboratory of Clinical Nutrition and Dietetics (CND-Lab), Department of Nutrition & Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, 42132 Trikala, Greece (O.A.)
| | - Rena I. Kosti
- Laboratory of Clinical Nutrition and Dietetics (CND-Lab), Department of Nutrition & Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, 42132 Trikala, Greece (O.A.)
| |
Collapse
|
9
|
Tsiampalis T, Kouvari M, Belitsi V, Kalantzi V, Androutsos O, Bonoti F, Panagiotakos DB, Kosti RI. Physicians' Words, Patients' Response: The Role of Healthcare Counselling in Enhancing Beneficial Lifestyle Modifications for Patients with Cardiometabolic Disorders: The IACT Cross-Sectional Study. Healthcare (Basel) 2023; 11:2982. [PMID: 37998474 PMCID: PMC10671259 DOI: 10.3390/healthcare11222982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 11/15/2023] [Accepted: 11/16/2023] [Indexed: 11/25/2023] Open
Abstract
Background: Preventive cardiology aims to educate patients about risk factors and the importance of mitigating them through lifestyle adjustments and medications. However, long-term adherence to recommended interventions remains a significant challenge. This study explores how physician counselling contributes to successful behavior changes in various aspects of lifestyle. Methods: A cross-sectional study conducted in Greece in 2022-2023 included 1988 participants. Validated questionnaires assessed patients' characteristics, dietary habits, and lifestyle choices. Results: The findings revealed that patients who received lifestyle advice from physicians demonstrated increased compliance with the Mediterranean diet and a higher involvement in physical activity. Notably, they were also less likely to be non-smokers. Importantly, physicians' recommendations had a more pronounced association with adherence level to the Mediterranean diet compared to other lifestyle behaviors. Additionally, specific dietary components like cereal, legume, and red meat consumption were significantly associated with physicians' guidance. Conclusions: This study highlights the complex relationship between patients' cardiometabolic health, lifestyle decisions, and healthcare professionals' guidance. The substantial influence of physicians on Mediterranean diet adherence underscores the necessity for a multidisciplinary healthcare approach. Collaborative efforts involving physicians, dietitians, and fitness experts can offer comprehensive support to patients in navigating the intricate landscape of cardiometabolic health.
Collapse
Affiliation(s)
- Thomas Tsiampalis
- Department of Nutrition and Dietetics, School of Physical Education, Sports and Dietetics, University of Thessaly, 38221 Trikala, Greece or (T.T.); (V.B.); (V.K.); (O.A.); (F.B.)
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 17676 Athens, Greece; (M.K.); (D.B.P.)
| | - Matina Kouvari
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 17676 Athens, Greece; (M.K.); (D.B.P.)
- Faculty of Health, University of Canberra, Canberra, ACT 2617, Australia
| | - Vasiliki Belitsi
- Department of Nutrition and Dietetics, School of Physical Education, Sports and Dietetics, University of Thessaly, 38221 Trikala, Greece or (T.T.); (V.B.); (V.K.); (O.A.); (F.B.)
| | - Vasiliki Kalantzi
- Department of Nutrition and Dietetics, School of Physical Education, Sports and Dietetics, University of Thessaly, 38221 Trikala, Greece or (T.T.); (V.B.); (V.K.); (O.A.); (F.B.)
| | - Odysseas Androutsos
- Department of Nutrition and Dietetics, School of Physical Education, Sports and Dietetics, University of Thessaly, 38221 Trikala, Greece or (T.T.); (V.B.); (V.K.); (O.A.); (F.B.)
| | - Fotini Bonoti
- Department of Nutrition and Dietetics, School of Physical Education, Sports and Dietetics, University of Thessaly, 38221 Trikala, Greece or (T.T.); (V.B.); (V.K.); (O.A.); (F.B.)
| | - Demosthenes B. Panagiotakos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 17676 Athens, Greece; (M.K.); (D.B.P.)
- Faculty of Health, University of Canberra, Canberra, ACT 2617, Australia
| | - Rena I. Kosti
- Department of Nutrition and Dietetics, School of Physical Education, Sports and Dietetics, University of Thessaly, 38221 Trikala, Greece or (T.T.); (V.B.); (V.K.); (O.A.); (F.B.)
| |
Collapse
|
10
|
Perperidi M, Saltaouras G, Konstandis A, De Craemer M, Saloustros E, Theodorakis Y, Androutsos O. Barriers and facilitators of healthy lifestyle and perspectives towards the development of weight loss programmes. Focus groups with post-treatment breast cancer survivors in Greece. J Nutr Sci 2023; 12:e111. [PMID: 37964978 PMCID: PMC10641696 DOI: 10.1017/jns.2023.94] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 09/25/2023] [Accepted: 10/06/2023] [Indexed: 11/16/2023] Open
Abstract
The present study aimed to identify the factors that prohibit or enable breast cancer survivors from adopting a healthy lifestyle, as well as to record patients' suggestions towards developing a weight-loss lifestyle intervention. Twenty-three breast cancer survivors participated in four online, semi-structured focus groups in Greece. All discussions were video-recorded and transcribed verbatim. Participants were 50⋅5 ± 7⋅4 years old with a current mean BMI of 29⋅1 ± 3⋅4 kg/m2. Four main themes emerged from thematic analysis: (1) dietary and lifestyle practices, (2) the effects of cancer on body weight, (3) the impact of cancer on psychology, and (4) the effect of the environment on body weight. Lack of information from healthcare professionals and lack of time were the main barriers to body weight management, whereas the main facilitators were support from their social environment, along with a comfortable physical environment, and the facility of technology. Participants suggested that an effective weight-loss lifestyle intervention should include psychological and social support, guidance and education, collaboration, flexible recommendations, personalised goals, and a follow-up plan. The needs of breast cancer survivors need to be considered when designing weight-loss lifestyle interventions. A personalised approach may prove more effective in promoting a healthy lifestyle and improving patients' care.
Collapse
Affiliation(s)
- Maria Perperidi
- Laboratory of Clinical Nutrition and Dietetics, Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, Trikala 42132, Greece
| | - Georgios Saltaouras
- Laboratory of Clinical Nutrition and Dietetics, Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, Trikala 42132, Greece
- Department of Nutritional Sciences and Dietetics, International Hellenic University, Sindos 57400, Greece
| | - Alexandros Konstandis
- Laboratory of Clinical Nutrition and Dietetics, Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, Trikala 42132, Greece
| | - Marieke De Craemer
- Department of Rehabilitation Sciences, Ghent University, Ghent 9000, Belgium
| | - Emmanouil Saloustros
- Department of Oncology, Medical School, University Hospital of Larissa, Larissa, Greece
| | - Yannis Theodorakis
- Department of Physical Education and Sport Science, School of Physical Education, Sport Science and Dietetics, University of Thessaly, Trikala, Greece
| | - Odysseas Androutsos
- Laboratory of Clinical Nutrition and Dietetics, Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, Trikala 42132, Greece
| |
Collapse
|
11
|
Kanellakis S, Skoufas E, Simitsopoulou E, Migdanis A, Migdanis I, Prelorentzou T, Louka A, Moschonis G, Bountouvi E, Androutsos O. Changes in body weight and body composition during the menstrual cycle. Am J Hum Biol 2023; 35:e23951. [PMID: 37395124 DOI: 10.1002/ajhb.23951] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 06/13/2023] [Accepted: 06/14/2023] [Indexed: 07/04/2023] Open
Abstract
OBJECTIVES The general perception is that menstrual cycle is a factor related to body weight and body composition fluctuations in women. The lack of a standardized methodology of the so far conducted studies has led to controversial results. The aim of the current study is to identify if there are any changes in body weight and body composition during the menstrual cycle. METHODS In the current study measurements of body weight, circumferences, skinfolds and body composition with bioelectrical impedance analysis were conducted twice per week in 42 women during their menstrual cycle. RESULTS Body weight was found to be statistically significantly higher during menstruation compared to the first week of the menstrual cycle by 0.450 kg, which could be attributed to a statistically significant increase of 0.474 kg observed in extracellular water. No other statistically significant changes were observed regarding body composition. CONCLUSIONS An increase of approximately 0.5 kg was observed during women's menstrual cycle, mostly due to extracellular fluid retention at menstruation days. These findings could be taken into account to interpret body weight and composition periodic fluctuations in women of reproductive age.
Collapse
Affiliation(s)
- Spyridon Kanellakis
- Department of Nutrition and Dietetics, Harokopio University of Athens, Athens, Greece
| | - Efstathios Skoufas
- Department of Biomedical Sciences, University of Western Attica, Aigaleo, Greece
| | | | - Athanasios Migdanis
- Department of Gastroenterology, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Ioannis Migdanis
- Department of Nutrition and Dietetics, University of Thessaly, Trikala, Greece
| | | | - Aikaterini Louka
- 1st Department of Propedeutic Internal Medicine, Laiko Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgios Moschonis
- Department of Food, Nutrition and Dietetics, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Evangelia Bountouvi
- Neonatal Intensive Care Unit, "Alexandra" University and State Maternity Hospital, Athens, Greece
| | - Odysseas Androutsos
- Lab of Clinical Nutrition and Dietetics, Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, Larissa, Greece
| |
Collapse
|
12
|
Miguel-Berges ML, Mouratidou T, Santaliestra-Pasias A, Androutsos O, Iotova V, Galcheva S, De Craemer M, Cardon G, Koletzko B, Kulaga Z, Manios Y, Moreno LA. Longitudinal associations between diet quality, sedentary behaviours and physical activity and risk of overweight and obesity in preschool children: The ToyBox-study. Pediatr Obes 2023; 18:e13068. [PMID: 37525363 DOI: 10.1111/ijpo.13068] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 06/20/2023] [Accepted: 07/10/2023] [Indexed: 08/02/2023]
Abstract
BACKGROUND Lifestyle behaviours related to diet and physical activity are associated with increased risk of obesity and evidence suggests that associations might be stronger when a synergetic effect is examined. OBJECTIVE To examine the cross-sectional and longitudinal associations between diet, screen time (ST) and step recommendations and risk of overweight and obesity in European preschoolers participating in the ToyBox-study. METHODS In this cluster-randomized clinical trial, 718 children (51.4% boys) from six European countries participated. Parents filled out questionnaires with information on socio-demographic status, step recommendations and ST. RESULTS Longitudinal results indicate that participants having a low Diet Quality Index (DQI), not meeting ST and step recommendations at T0 and T1 had higher odds of having overweight/obesity at T1 (odds ratio [OR] = 1.116; 95% confidence interval [CI] = 1.104-2.562) than those children having a high DQI and meeting ST and step recommendations at T0 and T1. Similarly, participants having a high DQI, but not meeting ST and step recommendations at T0 and T1 had increased odds of having overweight/obesity (OR = 2.515; 95% CI = 1.171-3.021). CONCLUSIONS The proportion of participants having a low DQI, not adhering to both step and ST recommendations was very high, and it was associated with a higher probability of having overweight and obesity.
Collapse
Affiliation(s)
- María L Miguel-Berges
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Zaragoza, Spain
- Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
| | - Theodora Mouratidou
- Department of Nutrition and Dietetics, School of Health Sciences, Hellenic Mediterranean University, Sitia, Greece
| | - Alba Santaliestra-Pasias
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Zaragoza, Spain
- Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
| | - Odysseas Androutsos
- Lab of Clinical Nutrition and Dietetics, Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, Trikala, Greece
- Department of Nutrition and Dietetics, School of Health Sciences & Education, Harokopio University, Athens, Greece
| | | | | | | | - Greet Cardon
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Berthold Koletzko
- LMU-Ludwig Maximilians Universität Munich, Department Paediatrics, Dr von Hauner Children's Hospital, LMU University Hospitals, Munich, Germany
| | | | - Yannis Manios
- Department of Nutrition and Dietetics, School of Health Sciences & Education, Harokopio University Athens, Athens, Greece
- Institute of Agri-food and Life Sciences, Hellenic Mediterranean University Research Centre, Heraklion, Greece
| | - Luis A Moreno
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Zaragoza, Spain
- Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
| |
Collapse
|
13
|
Kipouros M, Vamvakari K, Kalafati IP, Evangelou I, Kasti AN, Kosti RI, Androutsos O. The Level of Adherence to the ESPEN Guidelines for Energy and Protein Intake Prospectively Influences Weight Loss and Nutritional Status in Patients with Cancer. Nutrients 2023; 15:4232. [PMID: 37836516 PMCID: PMC10574131 DOI: 10.3390/nu15194232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 09/27/2023] [Accepted: 09/29/2023] [Indexed: 10/15/2023] Open
Abstract
Nutrition therapy aims to prevent weight loss and its health consequences in patients with cancer. The aim of this study was to assess Greek patients' adherence to the ESPEN guidelines for oncology patients and its prospective effect on their body weight (BW) and nutritional status. In total, 152 patients with cancer were recruited from the Attikon University Hospital, Greece, and provided data in 2019 (baseline) and 2020 (follow-up) (drop-out rate = 28.3%). Nutritional status was assessed with the PG-SGA questionnaire. Patients were categorized based on whether they adhered at least to the minimum ESPEN-recommended intakes of energy (≥25 kcal/kg/day) or protein (≥1.0 g/kg/day) or not. On average, patients did not adhere to ESPEN guidelines for energy and protein intake. Most patients meeting the minimum recommendations had an improvement of their nutritional status at follow-up and increased their BW compared to those not meeting them. All patients with head, neck, and spinal cancer who met the minimum recommendations for energy intake improved their nutritional status at follow-up. This study showed that consuming at least the minimum amounts of protein and energy recommended by ESPEN may prevent from weight loss and improve nutritional status; however, the exact amounts need to be personalized.
Collapse
Affiliation(s)
- Michail Kipouros
- Laboratory of Clinical Nutrition and Dietetics, Department of Nutrition-Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, 42132 Trikala, Greece; (M.K.); (K.V.); (I.P.K.); (I.E.); (R.I.K.)
| | - Konstantina Vamvakari
- Laboratory of Clinical Nutrition and Dietetics, Department of Nutrition-Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, 42132 Trikala, Greece; (M.K.); (K.V.); (I.P.K.); (I.E.); (R.I.K.)
| | - Ioanna Panagiota Kalafati
- Laboratory of Clinical Nutrition and Dietetics, Department of Nutrition-Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, 42132 Trikala, Greece; (M.K.); (K.V.); (I.P.K.); (I.E.); (R.I.K.)
- Department of Nutrition & Dietetics, School of Health Science & Education, Harokopio University, 17676 Kallithea, Greece
| | - Iliana Evangelou
- Laboratory of Clinical Nutrition and Dietetics, Department of Nutrition-Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, 42132 Trikala, Greece; (M.K.); (K.V.); (I.P.K.); (I.E.); (R.I.K.)
| | - Arezina N. Kasti
- Department of Nutrition & Dietetics, Attikon University General Hospital, 12462 Athens, Greece;
| | - Rena I. Kosti
- Laboratory of Clinical Nutrition and Dietetics, Department of Nutrition-Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, 42132 Trikala, Greece; (M.K.); (K.V.); (I.P.K.); (I.E.); (R.I.K.)
| | - Odysseas Androutsos
- Laboratory of Clinical Nutrition and Dietetics, Department of Nutrition-Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, 42132 Trikala, Greece; (M.K.); (K.V.); (I.P.K.); (I.E.); (R.I.K.)
| |
Collapse
|
14
|
Belitsi V, Tsiampalis T, Kouvari M, Kalantzi V, Androutsos O, Bonoti F, Panagiotakos DB, Kosti RI. Exploring Patient Beliefs and Medication Adherence in the Mediterranean Context: A Cross-Sectional Study in Patients with Cardiovascular Diseases and Cardiometabolic Disorders in Greece-The IACT-Study. Life (Basel) 2023; 13:1880. [PMID: 37763284 PMCID: PMC10532979 DOI: 10.3390/life13091880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 09/03/2023] [Accepted: 09/04/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Evidence has shown that poor adherence to vascular medications contributes to a considerable proportion of all cardiovascular disease (CVD) events and mortality. The aim of the present work was to examine patients' beliefs/views that affect their level of adherence to the assigned medical treatment in the context of a multi-center study in Greece. METHODS Between July 2022 and April 2023, 1988 patients (1180 females) with established cardiovascular disease or relevant cardiometabolic disorders were chosen from seven medical centers in Greece. The 4-item Morisky Medication Adherence Questionnaire gauged medication adherence and investigated patients' beliefs/views regarding treatment. RESULTS Among participants, 51.2% showed perfect medication adherence, contrasting with 48.8% displaying poor adherence. Patients with negative medication beliefs were around three times more likely to be non-adherent (OR = 2.73; 95% CI = 2.28-3.28). Non-adherers held concerns about drug efficacy (OR = 2.34; 95% CI = 1.10-4.97) and favored alternative therapies (OR = 2.25; 95% CI = 1.75-2.91). CONCLUSION The findings highlight the significance of addressing patient beliefs/views to improve medication adherence. The distinct Mediterranean context, influenced by cultural, socioeconomic, and clinical factors, emphasizes the need for tailored interventions. This underscores the call for contextually sensitive strategies to boost medication adherence and improve health outcomes in this unique region.
Collapse
Affiliation(s)
- Vasiliki Belitsi
- Department of Nutrition and Dietetics, School of Physical Education, Sports and Dietetics, University of Thessaly, 42132 Trikala, Greece; (V.B.); (T.T.); (V.K.); (O.A.); (F.B.)
| | - Thomas Tsiampalis
- Department of Nutrition and Dietetics, School of Physical Education, Sports and Dietetics, University of Thessaly, 42132 Trikala, Greece; (V.B.); (T.T.); (V.K.); (O.A.); (F.B.)
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 17676 Athens, Greece; (M.K.); (D.B.P.)
| | - Matina Kouvari
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 17676 Athens, Greece; (M.K.); (D.B.P.)
- Faculty of Health, University of Canberra, Canberra, ACT 2617, Australia
| | - Vasiliki Kalantzi
- Department of Nutrition and Dietetics, School of Physical Education, Sports and Dietetics, University of Thessaly, 42132 Trikala, Greece; (V.B.); (T.T.); (V.K.); (O.A.); (F.B.)
| | - Odysseas Androutsos
- Department of Nutrition and Dietetics, School of Physical Education, Sports and Dietetics, University of Thessaly, 42132 Trikala, Greece; (V.B.); (T.T.); (V.K.); (O.A.); (F.B.)
| | - Fotini Bonoti
- Department of Nutrition and Dietetics, School of Physical Education, Sports and Dietetics, University of Thessaly, 42132 Trikala, Greece; (V.B.); (T.T.); (V.K.); (O.A.); (F.B.)
| | - Demosthenes B. Panagiotakos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 17676 Athens, Greece; (M.K.); (D.B.P.)
- Faculty of Health, University of Canberra, Canberra, ACT 2617, Australia
| | - Rena I. Kosti
- Department of Nutrition and Dietetics, School of Physical Education, Sports and Dietetics, University of Thessaly, 42132 Trikala, Greece; (V.B.); (T.T.); (V.K.); (O.A.); (F.B.)
| |
Collapse
|
15
|
Cacau LT, Hanley-Cook GT, Huybrechts I, De Henauw S, Kersting M, Gonzalez-Gross M, Gottrand F, Ferrari M, Nova E, Castillo MJ, Molnár D, Widhalm K, Androutsos O, Manios Y, Stehle P, Lachat C, Marchioni DM, Moreno LA. Relative validity of the Planetary Health Diet Index by comparison with usual nutrient intakes, plasma food consumption biomarkers, and adherence to the Mediterranean diet among European adolescents: the HELENA study. Eur J Nutr 2023; 62:2527-2539. [PMID: 37171585 DOI: 10.1007/s00394-023-03171-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 05/04/2023] [Indexed: 05/13/2023]
Abstract
PURPOSE The EAT-Lancet Commission proposed an evidence-based global reference diet to improve human health within planetary boundaries. Recently, the Planetary Health Diet Index (PHDI) was developed based on the EAT-Lancet recommendations and validated among Brazilian adults. However, the relative validity of the PHDI in adolescents has yet to be assessed. Thus, we aimed to evaluate the relative validity of the PHDI in European adolescents. METHODS We used cross-sectional data from 1804 adolescents (12.5-17.5 years) enrolled in the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study. The PHDI (0-150 points) was calculated based on dietary intake data from two non-consecutive 24-h dietary recalls. Associations between the PHDI and usual nutrient intakes, plasma food consumption biomarkers, and adherence to the Mediterranean diet were evaluated using multivariable-adjusted mixed-effects linear regression models. RESULTS Higher PHDI score was associated with greater intakes of nutrients predominantly from plant-source foods, such as vegetable protein, vitamin E, and folate and with lower intake of nutrients predominately from animal-source foods, such as total and saturated fat, cholesterol, and animal protein. Furthermore, a higher PHDI score was also positively associated with plasma β-carotene, vitamin C, vitamin D, folate, and ferritin concentrations, while negatively associated with trans-fatty acids concentration. Moreover, higher PHDI was related to a greater adherence to the Mediterranean dietary pattern. CONCLUSIONS The PHDI showed good relative validity among adolescents in the HELENA study. Hence, future research should assess adherence to the PHDI and long-term health outcomes.
Collapse
Affiliation(s)
- Leandro Teixeira Cacau
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Facultad de Ciencias de La Salud, Universidad de Zaragoza, Zaragoza, Spain.
- Department of Nutrition, School of Public Health, University of São Paulo, Av. Dr. Arnaldo, 715, Cerqueira César, São Paulo, SP, 01246-904, Brazil.
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
| | - Giles T Hanley-Cook
- Department of Food Technology, Safety and Health, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium
| | - Inge Huybrechts
- Nutritional Epidemiology Group, Nutrition and Metabolism Section, International Agency for Research on Cancer, World Health Organization (IARC/WHO), Lyon, France
| | - Stefaan De Henauw
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Mathilde Kersting
- Research Department of Child Nutrition, University Hospital of Pediatrics and Adolescent Medicine, Ruhr-University Bochum, Bochum, Germany
| | - Marcela Gonzalez-Gross
- Centro de Investigación Biomédica en Red de Fisiopatología de La Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
- ImFINE Research Group, Department of Health and Human Performance, Universidad Politécnica de Madrid, Madrid, Spain
| | - Frederic Gottrand
- Institute for Translational Research in Inflammation (INFINITE), University Lille, Lille, France
| | - Marika Ferrari
- Council for Agricultural Research and Economics, Research Center for Food and Nutrition, Rome, Italy
| | - Esther Nova
- Department of Metabolism and Nutrition, Institute of Food Science and Technology and Nutrition (ICTAN), Spanish National Research Council (CSIC), Madrid, Spain
| | - Manuel J Castillo
- Department of Physiology, Faculty of Medicine, University of Granada, Granada, Spain
| | - Dénes Molnár
- Department of Pediatrics, Medical School, University of Pécs, Pécs, Hungary
| | - Kurt Widhalm
- Department of Gastroenterology and Hepatology, Medical University of Vienna, Vienna, Austria
| | - Odysseas Androutsos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
- Department of Nutrition and Dietetics, University of Thessaly, Trikala, Greece
| | - Yannis Manios
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
- Institute of Agri-Food and Life Sciences, Hellenic Mediterranean University Research Centre, Heraklion, Greece
| | - Peter Stehle
- Department of Nutrition and Food Sciences, University of Bonn, Bonn, Germany
| | - Carl Lachat
- Department of Food Technology, Safety and Health, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium
| | - Dirce Maria Marchioni
- Department of Nutrition, School of Public Health, University of São Paulo, Av. Dr. Arnaldo, 715, Cerqueira César, São Paulo, SP, 01246-904, Brazil
| | - Luis A Moreno
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Facultad de Ciencias de La Salud, Universidad de Zaragoza, Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de La Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
- Instituto Agroalimentario de Aragon (IA2), Zaragoza, Spain
- Instituto de Investigacion Sanitaria Aragon (IIS Aragon), Zaragoza, Spain
| |
Collapse
|
16
|
Perperidi M, Saliari D, Christakis C, Huybrechts I, Saloustros E, Theodorakis Y, Androutsos O. Identifying the effective behaviour change techniques in nutrition and physical activity interventions for the treatment of overweight/obesity in post-treatment breast cancer survivors: a systematic review. Cancer Causes Control 2023; 34:683-703. [PMID: 37149509 PMCID: PMC10267275 DOI: 10.1007/s10552-023-01707-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 04/19/2023] [Indexed: 05/08/2023]
Abstract
PURPOSE Updated evidence for the treatment of obesity in cancer survivors includes behavioural lifestyle interventions underpinning at least one theoretical framework. The aim of this systematic review was to assess the effectiveness of theory-based lifestyle interventions for the treatment of overweight/obesity in breast cancer survivors and to report effective behavioural change techniques (BCTs) and components used in these interventions. METHODS Four databases were searched for RCTs published between database inception and July 2022. The search strategy included MeSH terms and text words, using the PICO-framework to guide the eligibility criteria. The PRISMA guidelines were followed. Risk-of-bias, TIDier Checklist for interventions' content, and the extent of behaviour change theories and techniques application were assessed. To evaluate the effectiveness of interventions, trials were categorised as "very," "quite," or "non" promising according to their potential to reduce body weight, and BCTs promise ratios were calculated to assess the potential of BCTs within interventions to decrease body weight. RESULTS Eleven RCTs met the inclusion criteria. Seven trials were classified as "very", three as "quite" and one study was "non" promising. Studies' size, design, and intervention strategies varied greatly, but the weight-loss goal in all studies was ≥ 5% of the initial body weight through a 500-1000 kcal/day energy deficit and a gradually increased exercise goal of ≥ 30 min/day. Social Cognitive Theory was the most commonly used theory (n = 10). BCTs ranged from 10 to 23 in the interventions, but all trials included behaviour goal setting, self-monitoring, instructions on the behaviour, and credible source. The risk-of-bias was "moderate" in eight studies and "high" in three. CONCLUSION The present systematic review identified the components of theory-based nutrition and physical activity behaviour change interventions that may be beneficial for the treatment of overweight/obesity in breast cancer survivors. The strategies mentioned, in addition to reported behavioural models and BCTs, should be considered when developing weight-loss interventions for breast cancer survivors.
Collapse
Affiliation(s)
- Maria Perperidi
- Laboratory of Clinical Nutrition and Dietetics, Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, 1C Argonafton, 42132, Trikala, Thessaly, Greece
| | - Dimitra Saliari
- Laboratory of Clinical Nutrition and Dietetics, Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, 1C Argonafton, 42132, Trikala, Thessaly, Greece
| | - Christos Christakis
- Laboratory of Clinical Nutrition and Dietetics, Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, 1C Argonafton, 42132, Trikala, Thessaly, Greece
| | - Inge Huybrechts
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Emmanouil Saloustros
- Department of Oncology, Medical School, University Hospital of Larissa, Larissa, Greece
| | - Yannis Theodorakis
- Department of Physical Education and Sport Science, School of Physical Education, Sport Science and Dietetics, University of Thessaly, Trikala, Thessaly, Greece
| | - Odysseas Androutsos
- Laboratory of Clinical Nutrition and Dietetics, Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, 1C Argonafton, 42132, Trikala, Thessaly, Greece.
| |
Collapse
|
17
|
Evangelou I, Vamvakari K, Kalafati IP, Kipouros M, Kasti AN, Kosti RI, Bonoti F, Androutsos O. Depression and Anxiety Mediate the Associations between Nutritional Status, Functional Capacity, and Quality of Life in Patients with Cancer. Nutr Cancer 2023; 75:1783-1794. [PMID: 37497944 DOI: 10.1080/01635581.2023.2237688] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 07/04/2023] [Accepted: 07/07/2023] [Indexed: 07/28/2023]
Abstract
Cancer patients are at risk of malnutrition, which influences their functional status, mental health (MH), and quality of life (QoL). This study aimed to examine the associations between nutritional status, functional capacity, and aspects of QoL in cancer patients, as well as the potential mediating role of depression and anxiety in these associations. Patients with various types of cancer (n = 152) were recruited from the Attikon University Hospital, Greece. Validated questionnaires were used to assess nutritional status (PG-SGA), QoL (SF-36 and EQ-5D-3L), functional capacity (ECOG), depression, and anxiety (HADS and BEDS). Handgrip strength (HGS) was also measured. Poor nutritional status was inversely associated with functional capacity, QoL, depression, and anxiety, after adjusting for confounding factors (all P ≤ 0.05). Mediation analysis indicated a significant indirect effect of nutritional status on various parameters of functional capacity and QoL through depression and anxiety, after adjusting for age and sex. Mediated proportion ranged from 26.3-34% to 23.1-82.8% for functional capacity and QoL, respectively. A significant proportion of the effect of nutritional status on QoL and functional capacity can be partly attributed to psychological effects, highlighting the significance of integrating all aforementioned aspects in the nutritional intervention for cancer patients.
Collapse
Affiliation(s)
- Iliana Evangelou
- Department of Nutrition-Dietetics, Lab of Clinical Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, Trikala, Greece
| | - Konstantina Vamvakari
- Department of Nutrition-Dietetics, Lab of Clinical Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, Trikala, Greece
| | - Ioanna Panagiota Kalafati
- Department of Nutrition-Dietetics, Lab of Clinical Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, Trikala, Greece
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Kallithea, Greece
| | - Michail Kipouros
- Department of Nutrition-Dietetics, Lab of Clinical Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, Trikala, Greece
| | - Arezina N. Kasti
- Department of Nutrition and Dietetics, Attikon University General Hospital, Athens, Greece
| | - Rena I Kosti
- Department of Nutrition-Dietetics, Lab of Clinical Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, Trikala, Greece
| | - Fotini Bonoti
- Department of Nutrition-Dietetics, Lab of Clinical Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, Trikala, Greece
| | - Odysseas Androutsos
- Department of Nutrition-Dietetics, Lab of Clinical Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, Trikala, Greece
| |
Collapse
|
18
|
Androutsos O, Tsiampalis T, Kouvari M, Manou M, Dimopoulou M, Georgiou A, Kosti RI, Charmandari E. Assessment of Diet Quality in Children and Adolescents with Overweight or Obesity in Greece. Children (Basel) 2023; 10:1261. [PMID: 37508758 PMCID: PMC10378587 DOI: 10.3390/children10071261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 07/14/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023]
Abstract
The adoption of healthy nutritional habits constitutes one of the most important determinants of healthy growth and development in childhood. Few studies in Greece have examined children's diet quality using diet indices. The present study aimed to assess the diet quality of a large cohort of children and adolescents with overweight or obesity. Study participants (n = 1335), aged 2-18, were recruited through the Out-patient Clinic for the Prevention and Management of Overweight and Obesity in Childhood and Adolescence, Aghia Sophia Children's Hospital, Athens, Greece. Anthropometric, socio-demographic, and behavioral data were collected using standard methods and equipment. The Diet Quality Index (DQI), which includes four subcomponents (i.e., dietary diversity, dietary quality, dietary equilibrium, and meal index), was calculated to assess each subject's diet quality. According to the results of this study, children's total DQI score was 63.1%. It was observed that 66.7% of the children had at least moderate diet quality (total DQI ≥ 59.34%). Boys had higher values of the total DQI and certain components of the DQI (i.e., dietary equilibrium score and meal index) compared to girls. Three out of ten children with overweight/obesity had poor diet quality (i.e., DQI ≤ 59.33). Younger children (2-5 years old) were found to have the lowest values of dietary equilibrium compared to older children (6-9 and 12-18 years old). Moreover, boys had higher values of the total DQI score and of specific components of this index (i.e., dietary equilibrium and meal index) compared to girls. Children living in urban areas had higher values in the dietary quality score compared to those living in rural areas. Children with overweight had higher values of the dietary quality score and the total DQI score compared to children with obesity. The present study highlighted that children and adolescents with overweight or obesity have poor diet quality. Multilevel and higher intensity interventions should be designed specifically for this group to achieve tangible outcomes.
Collapse
Affiliation(s)
- Odysseas Androutsos
- Laboratory of Clinical Nutrition and Dietetics, Department of Nutrition and Dietetics, University of Thessaly, 42132 Trikala, Greece
| | - Thomas Tsiampalis
- Laboratory of Clinical Nutrition and Dietetics, Department of Nutrition and Dietetics, University of Thessaly, 42132 Trikala, Greece
| | - Matina Kouvari
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 17671 Athens, Greece
- Discipline of Nutrition and Dietetics, Faculty of Health, University of Canberra, Canberra, ACT 2601, Australia
- Functional Foods and Nutrition Research (FFNR) Laboratory, University of Canberra, Canberra, ACT 2617, Australia
| | - Maria Manou
- Division of Endocrinology, Metabolism, and Diabetes, First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, 'Aghia Sophia' Children's Hospital, 11527 Athens, Greece
| | - Maria Dimopoulou
- Laboratory of Clinical Nutrition and Dietetics, Department of Nutrition and Dietetics, University of Thessaly, 42132 Trikala, Greece
| | - Alexandra Georgiou
- Division of Endocrinology, Metabolism, and Diabetes, First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, 'Aghia Sophia' Children's Hospital, 11527 Athens, Greece
| | - Rena I Kosti
- Laboratory of Clinical Nutrition and Dietetics, Department of Nutrition and Dietetics, University of Thessaly, 42132 Trikala, Greece
| | - Evangelia Charmandari
- Division of Endocrinology, Metabolism, and Diabetes, First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, 'Aghia Sophia' Children's Hospital, 11527 Athens, Greece
- Division of Endocrinology and Metabolism, Center of Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, 11527 Athens, Greece
| |
Collapse
|
19
|
Dimopoulou M, Vareltzis P, Floros S, Androutsos O, Bargiota A, Gortzi O. Development of a Functional Acceptable Diabetic and Plant-Based Snack Bar Using Mushroom ( Coprinus comatus) Powder. Foods 2023; 12:2702. [PMID: 37509794 PMCID: PMC10379996 DOI: 10.3390/foods12142702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 07/06/2023] [Accepted: 07/11/2023] [Indexed: 07/30/2023] Open
Abstract
Consumers' growing concern about health and well-being has led to increased interest in functional foods. This research aims to evaluate the physicochemical and antioxidant properties of a functional plant-based (PB) snack bar enriched with Coprinus comatus powder. The snack bar formulations exhibited a wide range of flavor and textural characteristics. Two PB snack bars and four commercial bars were evaluated by a consumer panel of healthy volunteers (n = 20). The PB snack bar scored 'like extremely' on the 9-point hedonic scale. External preference mapping determined that sweetness, flavors, cohesiveness, gumminess, and adhesion had the greatest influence on consumer acceptability. Water content, ash, protein, fat, carbohydrate, reducing sugar, resistant starch, and dietary fiber were measured. Nutritional content was enhanced (omega 3, fiber and protein), and samples were shelf life stable (aw < 0.29; moisture content < 10%). In addition, the PB snack bar underwent simulated digestion according to the INFOGEST protocol, and from the comparative evaluation, the PB snack can be seen to control the post-prandial glycemic responses, as observed by the different degree of reducing sugars released via the matrix. The PB snack bar can be further functionally enhanced by the addition of their unique ingredients such as Coprinus comatus. Coprinus comatus powder is claimed to benefit glycemic control in diabetes and has attracted growing interest in terms of its potential use in natural products with possible health benefits.
Collapse
Affiliation(s)
- Maria Dimopoulou
- Department of Agriculture Crop Production and Rural Environment, School of Agricultural Sciences, University of Thessaly, 38446 Volos, Greece;
| | - Patroklos Vareltzis
- Laboratory of Food and Agricultural Industries Technologies, Chemical Engineering Department, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (P.V.); (S.F.)
| | - Stylianos Floros
- Laboratory of Food and Agricultural Industries Technologies, Chemical Engineering Department, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (P.V.); (S.F.)
| | - Odysseas Androutsos
- Lab of Clinical Nutrition and Dietetics (CND-Lab), Department of Nutrition & Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, 42132 Trikala, Greece;
| | - Alexandra Bargiota
- Department of Endocrinology and Metabolic Diseases, Faculty of Medicine, School of Health Sciences, University Hospital of Larissa, University of Thessaly, 41334 Larissa, Greece
| | - Olga Gortzi
- Department of Agriculture Crop Production and Rural Environment, School of Agricultural Sciences, University of Thessaly, 38446 Volos, Greece;
| |
Collapse
|
20
|
de Batlle J, Benítez ID, Moncusí-Moix A, Androutsos O, Angles Barbastro R, Antonini A, Arana E, Cabrera-Umpierrez MF, Cea G, Dafoulas GΕ, Folkvord F, Fullaondo A, Giuliani F, Huang HL, Innominato PF, Kardas P, Lou VWQ, Manios Y, Matsangidou M, Mercalli F, Mokhtari M, Pagliara S, Schellong J, Stieler L, Votis K, Currás P, Arredondo MT, Posada J, Guillén S, Pecchia L, Barbé F, Torres G, Fico G. GATEKEEPER's Strategy for the Multinational Large-Scale Piloting of an eHealth Platform: Tutorial on How to Identify Relevant Settings and Use Cases. J Med Internet Res 2023; 25:e42187. [PMID: 37379060 PMCID: PMC10365628 DOI: 10.2196/42187] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 01/31/2023] [Accepted: 02/26/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND The World Health Organization's strategy toward healthy aging fosters person-centered integrated care sustained by eHealth systems. However, there is a need for standardized frameworks or platforms accommodating and interconnecting multiple of these systems while ensuring secure, relevant, fair, trust-based data sharing and use. The H2020 project GATEKEEPER aims to implement and test an open-source, European, standard-based, interoperable, and secure framework serving broad populations of aging citizens with heterogeneous health needs. OBJECTIVE We aim to describe the rationale for the selection of an optimal group of settings for the multinational large-scale piloting of the GATEKEEPER platform. METHODS The selection of implementation sites and reference use cases (RUCs) was based on the adoption of a double stratification pyramid reflecting the overall health of target populations and the intensity of proposed interventions; the identification of a principles guiding implementation site selection; and the elaboration of guidelines for RUC selection, ensuring clinical relevance and scientific excellence while covering the whole spectrum of citizen complexities and intervention intensities. RESULTS Seven European countries were selected, covering Europe's geographical and socioeconomic heterogeneity: Cyprus, Germany, Greece, Italy, Poland, Spain, and the United Kingdom. These were complemented by the following 3 Asian pilots: Hong Kong, Singapore, and Taiwan. Implementation sites consisted of local ecosystems, including health care organizations and partners from industry, civil society, academia, and government, prioritizing the highly rated European Innovation Partnership on Active and Healthy Aging reference sites. RUCs covered the whole spectrum of chronic diseases, citizen complexities, and intervention intensities while privileging clinical relevance and scientific rigor. These included lifestyle-related early detection and interventions, using artificial intelligence-based digital coaches to promote healthy lifestyle and delay the onset or worsening of chronic diseases in healthy citizens; chronic obstructive pulmonary disease and heart failure decompensations management, proposing integrated care management based on advanced wearable monitoring and machine learning (ML) to predict decompensations; management of glycemic status in diabetes mellitus, based on beat to beat monitoring and short-term ML-based prediction of glycemic dynamics; treatment decision support systems for Parkinson disease, continuously monitoring motor and nonmotor complications to trigger enhanced treatment strategies; primary and secondary stroke prevention, using a coaching app and educational simulations with virtual and augmented reality; management of multimorbid older patients or patients with cancer, exploring novel chronic care models based on digital coaching, and advanced monitoring and ML; high blood pressure management, with ML-based predictions based on different intensities of monitoring through self-managed apps; and COVID-19 management, with integrated management tools limiting physical contact among actors. CONCLUSIONS This paper provides a methodology for selecting adequate settings for the large-scale piloting of eHealth frameworks and exemplifies with the decisions taken in GATEKEEPER the current views of the WHO and European Commission while moving forward toward a European Data Space.
Collapse
Affiliation(s)
- Jordi de Batlle
- Group of Translational Research in Respiratory Medicine, Institut de Recerca Biomedica de Lleida, Hospital Universitari Arnau de Vilanova-Santa Maria, Lleida, Spain
- Center for Biomedical Network Research in Respiratory Diseases, Madrid, Spain
| | - Ivan D Benítez
- Group of Translational Research in Respiratory Medicine, Institut de Recerca Biomedica de Lleida, Hospital Universitari Arnau de Vilanova-Santa Maria, Lleida, Spain
- Center for Biomedical Network Research in Respiratory Diseases, Madrid, Spain
| | - Anna Moncusí-Moix
- Group of Translational Research in Respiratory Medicine, Institut de Recerca Biomedica de Lleida, Hospital Universitari Arnau de Vilanova-Santa Maria, Lleida, Spain
- Center for Biomedical Network Research in Respiratory Diseases, Madrid, Spain
| | - Odysseas Androutsos
- Lab of Clinical Nutrition and Dietetics, Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, Trikala, Greece
| | | | - Alessio Antonini
- Knowledge Media Institute, The Open University, Milton Keynes, United Kingdom
| | - Eunate Arana
- Biocruces Bizkaia Health Research Institute, Osakidetza, Barakaldo, Spain
| | - Maria Fernanda Cabrera-Umpierrez
- Life Supporting Technologies, Escuela Técnica Superior de Ingenieros de Telecomunicaciones, Universidad Politécnica de Madrid, Madrid, Spain
| | - Gloria Cea
- Life Supporting Technologies, Escuela Técnica Superior de Ingenieros de Telecomunicaciones, Universidad Politécnica de Madrid, Madrid, Spain
| | - George Ε Dafoulas
- E-health Department, Digital Cities of Central Greece, Trikala, Greece
- Department of Endocrinology and Metabolic Diseases, Faculty of Medicine, University of Thessaly, Larisa, Greece
| | - Frans Folkvord
- PredictBy, Barcelona, Spain
- Tilburg School of Humanities and Digital Sciences, Tilburg, Netherlands
| | - Ane Fullaondo
- Kronikgune Institute for Health Services Research, Barakaldo, Spain
| | - Francesco Giuliani
- Innovation and Research Department, Fondazione Casa Sollievo della Sofferenza Research Hospital, San Giovanni Rotondo, Italy
| | - Hsiao-Ling Huang
- Department of Healthcare Management, Office of International and Cross-Strait Affairs, Yuanpei University of Medical Technology, Hsinchu, Taiwan
| | - Pasquale F Innominato
- Oncology Department, Ysbyty Gwynedd, Betsi Cadwaladr University Health Board, Bangor, United Kingdom
- Warwick Medical School & Cancer Research Centre, University of Warwick, Coventry, United Kingdom
- Faculty of Medicine, Paris-Saclay University, Villejuif, France
| | - Przemyslaw Kardas
- Medication Adherence Research Centre, Department of Family Medicine, Medical University of Lodz, Lodz, Poland
| | - Vivian W Q Lou
- Department of Social Work and Social Administration, Sau Po Center on Ageing, The University of Hong Kong, Hong Kong, China
| | - Yannis Manios
- Department of Nutrition & Dietetics, School of Health Science & Education, Harokopio University, Athens, Greece
- Institute of Agri-food and Life Sciences, Hellenic Mediterranean University Research Centre, Heraklion, Greece
| | | | | | - Mounir Mokhtari
- Scientific Direction, Institut Mines-Telecom, Paris, France
- National University of Singapore, Singapore, Singapore
| | - Silvio Pagliara
- School of Engineering, University of Warwick, Coventry, United Kingdom
| | - Julia Schellong
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Lisa Stieler
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Konstantinos Votis
- Information Technologies Institute, Centre for Research and Technology Hellas, Thessaloniki, Greece
| | - Paula Currás
- Innova & European Projects Office, Integrated Health Solutions, Medtronic Ibérica S.A., Madrid, Spain
| | - Maria Teresa Arredondo
- Life Supporting Technologies, Escuela Técnica Superior de Ingenieros de Telecomunicaciones, Universidad Politécnica de Madrid, Madrid, Spain
| | - Jorge Posada
- Innova & European Projects Office, Integrated Health Solutions, Medtronic Ibérica S.A., Madrid, Spain
| | | | - Leandro Pecchia
- School of Engineering, University of Warwick, Coventry, United Kingdom
| | - Ferran Barbé
- Group of Translational Research in Respiratory Medicine, Institut de Recerca Biomedica de Lleida, Hospital Universitari Arnau de Vilanova-Santa Maria, Lleida, Spain
- Center for Biomedical Network Research in Respiratory Diseases, Madrid, Spain
| | - Gerard Torres
- Group of Translational Research in Respiratory Medicine, Institut de Recerca Biomedica de Lleida, Hospital Universitari Arnau de Vilanova-Santa Maria, Lleida, Spain
- Center for Biomedical Network Research in Respiratory Diseases, Madrid, Spain
| | - Giuseppe Fico
- Life Supporting Technologies, Escuela Técnica Superior de Ingenieros de Telecomunicaciones, Universidad Politécnica de Madrid, Madrid, Spain
| |
Collapse
|
21
|
Kalantzi V, Kalafati IP, Belitsi V, Tsiampalis T, Koutsonasios I, Androutsos O, Bonoti F, Panagiotakos DB, Kosti RI. Cardiometabolic Patient-Related Factors Influencing the Adherence to Lifestyle Changes and Overall Treatment: A Review of the Recent Literature. Life (Basel) 2023; 13:life13051153. [PMID: 37240798 DOI: 10.3390/life13051153] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 05/02/2023] [Accepted: 05/09/2023] [Indexed: 05/28/2023] Open
Abstract
It is well acknowledged that most of the modifiable risk factors for Cardiovascular Diseases (CVDs) can be averted through lifestyle modifications beyond medication adherence. This review aims to critically evaluate the cardiometabolic (CM) patient-related factors that influence the adherence to lifestyle changes studied alone and/or in combination with medication. A comprehensive literature search of PubMed articles from 2000 to 2023 retrieved 379 articles. After removing the articles which were not relevant, a total of 28 cross-sectional studies was chosen (12 qualitative, and 16 quantitative). The findings confirmed that five groups of factors influence patients' adherence to overall treatment: (1) health beliefs, knowledge, and perceptions regarding the risks and challenges of disease and medication intake along with adherence process perceptions; (2) self-concept; (3) emotions; (4) patient-healthcare providers relationship/communication and (5) social and cultural interactions. It is worth mentioning that cultural issues, such as culinary particularities, ethnic identity, social life as well as patients' skills and abilities, play a profound role in the effectiveness of the recommended lifestyle modifications beyond the aforementioned common factors. The need for clear-cut culturally adapted guidelines along with personalized advice from physicians is imperative as it could improve patients' self-efficacy. These socio-psychological factors should be seriously considered as a means to increase the effectiveness of future community prevention programs.
Collapse
Affiliation(s)
- Vasiliki Kalantzi
- Department of Nutrition and Dietetics, School of Physical Education, Sports and Dietetics, University of Thessaly, 42132 Trikala, Greece
| | - Ioanna Panagiota Kalafati
- Department of Nutrition and Dietetics, School of Physical Education, Sports and Dietetics, University of Thessaly, 42132 Trikala, Greece
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 17676 Athens, Greece
| | - Vasiliki Belitsi
- Department of Nutrition and Dietetics, School of Physical Education, Sports and Dietetics, University of Thessaly, 42132 Trikala, Greece
| | - Thomas Tsiampalis
- Department of Nutrition and Dietetics, School of Physical Education, Sports and Dietetics, University of Thessaly, 42132 Trikala, Greece
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 17676 Athens, Greece
| | | | - Odysseas Androutsos
- Department of Nutrition and Dietetics, School of Physical Education, Sports and Dietetics, University of Thessaly, 42132 Trikala, Greece
| | - Fotini Bonoti
- Department of Nutrition and Dietetics, School of Physical Education, Sports and Dietetics, University of Thessaly, 42132 Trikala, Greece
| | - Demosthenes B Panagiotakos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 17676 Athens, Greece
- Faculty of Health, University of Canberra, Canberra, ACT 2617, Australia
| | - Rena I Kosti
- Department of Nutrition and Dietetics, School of Physical Education, Sports and Dietetics, University of Thessaly, 42132 Trikala, Greece
| |
Collapse
|
22
|
Nogueira MDA, Braga RAM, Manios Y, Androutsos O, Molnár D, Polito A, Gómez-Martínez S, Béghin L, Widhalm K, Bueno G, Castillo MJ, De Henauw S, Moreno LA, Maia CSC. New indices in predicting cardiometabolic risk and its relation to endothelial dysfunction in adolescents: The HELENA study. Nutr Metab Cardiovasc Dis 2023; 33:1037-1048. [PMID: 36934005 DOI: 10.1016/j.numecd.2023.01.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 12/25/2022] [Accepted: 01/16/2023] [Indexed: 01/23/2023]
Abstract
BACKGROUND AND AIMS Blood pressure (BP) changes and insulin resistance (IR) are important cardiometabolic risk (CMR) factors; their early identification can contribute to the reduction of cardiovascular events in adulthood. This necessitates the search for more accessible and easily applied indicators for their prediction. Therefore, this study aimed to evaluate the predictive power of the indices, TyG, TG/HDL-c, height-corrected lipid accumulation product (HLAP), and visceral adiposity index (VAI), in identifying the CMR obtained by high BP and IR and to verify their relationship with biomarkers of endothelial dysfunction (ED) in European adolescents. METHODS AND RESULTS The anthropometric data and blood biomarkers of 744 adolescents (343 boys and 401 girls) from the Healthy Lifestyle in Europe by Nutrition in Adolescence Cross-Sectional Study (HELENA-CSS), with a mean age of 14.67 (SD 1.15) years, were assessed. The adolescents were then classified according to the presence or absence of high BP and IR. The cut-off points of the indices evaluated for the identification of CMR were determined. The relationship between CMR diagnosed using these indices and ED biomarkers was tested. The HLAP and TG/HDL-c were fair predictors of CMR obtained by IR in male adolescents. These indices showed association with hsCRP in sVCAM-1 in boys, but it lost significance after adjusting for age and body mass index. CONCLUSION TG/HDL-c and HLAP indices showed a fair performance in predicting CMR, obtained by IR, in male adolescents. ED showed no association with the CMR identified by the indices.
Collapse
Affiliation(s)
- Maria D A Nogueira
- Postgraduate Programme in Nutrition and Health, State University of Ceará, Fortaleza, Brazil; Postgraduate Program in Collective Health State University of Ceara, Fortaleza, Brazil
| | - Ribanna A M Braga
- Postgraduate Programme in Nutrition and Health, State University of Ceará, Fortaleza, Brazil
| | - Yannis Manios
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 17671 Athens, Greece
| | - Odysseas Androutsos
- Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, 382 21 Volos, Greece
| | - Dénes Molnár
- Department of Pediatrics, Medical School, University of Pécs, 7623 Pécs, Hungary
| | - Angela Polito
- Council for Agricultural Research and Economics, Research Center on Food and Nutrition, Rome, Italy
| | - Sonia Gómez-Martínez
- Immunonutrition Research Group, Department of Metabolism and Nutrition, Institute of Food Science and Technology and Nutrition (ICTAN)-CSIC, 28040 Madrid, Spain
| | - Laurent Béghin
- Inserm, U1286-INFINITE-Clinical Investigation Center-Institute for Translational Research in Inflammation and CIC 1403, University Lille, CHU Lille, F-59000 Lille, France
| | - Kurt Widhalm
- Division of Clinical Nutrition and Prevention, Department of Pediatrics, Medical University of Vienna, 1090 Vienna, Austria
| | - Gloria Bueno
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Zaragoza, Spain
| | - Manuel J Castillo
- Department of Medical Physiology, School of Medicine, University of Granada, Granada, Spain
| | - Stefaan De Henauw
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Luis A Moreno
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, School of Health Science (EUCS), University of Zaragoza, Zaragoza, Spain
| | - Carla S C Maia
- Postgraduate Programme in Nutrition and Health, State University of Ceará, Fortaleza, Brazil.
| |
Collapse
|
23
|
Mishra A, Zhou B, Rodriguez-Martinez A, Bixby H, Singleton RK, Carrillo-Larco RM, Sheffer KE, Paciorek CJ, Bennett JE, Lhoste V, Iurilli MLC, Di Cesare M, Bentham J, Phelps NH, Sophiea MK, Stevens GA, Danaei G, Cowan MJ, Savin S, Riley LM, Gregg EW, Aekplakorn W, Ahmad NA, Baker JL, Chirita-Emandi A, Farzadfar F, Fink G, Heinen M, Ikeda N, Kengne AP, Khang YH, Laatikainen T, Laxmaiah A, Ma J, Monroy-Valle M, Mridha MK, Padez CP, Reynolds A, Sorić M, Starc G, Wirth JP, Abarca-Gómez L, Abdeen ZA, Abdrakhmanova S, Ghaffar SA, Abdul Rahim HF, Abdurrahmonova Z, Abu-Rmeileh NM, Garba JA, Acosta-Cazares B, Adam I, Adamczyk M, Adams RJ, Adu-Afarwuah S, Afsana K, Afzal S, Agbor VN, Agdeppa IA, Aghazadeh-Attari J, Aguenaou H, Aguilar-Salinas CA, Agyemang C, Ahmad MH, Ahmadi A, Ahmadi N, Ahmadi N, Ahmed I, Ahmed SH, Ahrens W, Aitmurzaeva G, Ajlouni K, Al-Hazzaa HM, Al-Lahou B, Al-Raddadi R, Al Hourani HM, Al Qaoud NM, Alarouj M, AlBuhairan F, AlDhukair S, Aldwairji MA, Alexius S, Ali MM, Alkandari A, Alkerwi A, Alkhatib BM, Allin K, Alvarez-Pedrerol M, Aly E, Amarapurkar DN, Etxezarreta PA, Amoah J, Amougou N, Amouyel P, Andersen LB, Anderssen SA, Androutsos O, Ängquist L, Anjana RM, Ansari-Moghaddam A, Anufrieva E, Aounallah-Skhiri H, Araújo J, Ariansen I, Aris T, Arku RE, Arlappa N, Aryal KK, Aseffa N, Aspelund T, Assah FK, Assembekov B, Assunção MCF, Aung MS, Auvinen J, Avdičová M, Avi S, Azevedo A, Azimi-Nezhad M, Azizi F, Azmin M, Babu BV, Jørgensen MB, Baharudin A, Bahijri S, Bakacs M, Balakrishna N, Balanova Y, Bamoshmoosh M, Banach M, Banegas JR, Baran J, Baran R, Barbagallo CM, Filho VB, Barceló A, Baretić M, Barkat A, Barnoya J, Barrera L, Barreto M, Barros AJD, Barros MVG, Bartosiewicz A, Basit A, Bastos JLD, Bata I, Batieha AM, Batista AP, Batista RL, Battakova Z, Baur LA, Bayauli PM, Beaglehole R, Bel-Serrat S, Belavendra A, Ben Romdhane H, Benedics J, Benet M, Rolandi GEB, Bere E, Bergh IH, Berhane Y, Berkinbayev S, Bernabe-Ortiz A, Bernotiene G, Carrasola XB, Bettiol H, Beutel ME, Beybey AF, Bezerra J, Bhagyalaxmi A, Bharadwaj S, Bhargava SK, Bi H, Bi Y, Bia D, Biasch K, Lele ECB, Bikbov MM, Bista B, Bjelica DJ, Bjerregaard AA, Bjerregaard P, Bjertness E, Bjertness MB, Björkelund C, Bloch KV, Blokstra A, Magnazu MB, Bo S, Bobak M, Boddy LM, Boehm BO, Boer JMA, Boggia JG, Bogova E, Boissonnet CP, Bojesen SE, Bonaccio M, Bongard V, Bonilla-Vargas A, Bopp M, Borghs H, Bovet P, Boymatova K, Braeckevelt L, Braeckman L, Bragt MCE, Brajkovich I, Branca F, Breckenkamp J, Breda J, Brenner H, Brewster LM, Brian GR, Briceño Y, Brinduse L, Brito M, Brophy S, Brug J, Bruno G, Bugge A, Buntinx F, Buoncristiano M, Burazeri G, Burns C, de León AC, Cacciottolo J, Cai H, Caixeta RB, Cama T, Cameron C, Camolas J, Can G, Cândido APC, Cañete F, Capanzana MV, Čapková N, Capuano E, Capuano R, Capuano V, Cardol M, Cardoso VC, Carlsson AC, Carmuega E, Carvalho J, Casajús JA, Casanueva FF, Casas M, Celikcan E, Censi L, Cervantes‐Loaiza M, Cesar JA, Chamukuttan S, Chan A, Chan Q, Chaturvedi HK, Chaturvedi N, Rahim NCA, Chee ML, Chen CJ, Chen F, Chen H, Chen S, Chen Z, Cheng CY, Cheng YJ, Cheraghian B, Chetrit A, Chikova-Iscener E, Chinapaw MJM, Chinnock A, Chiolero A, Chiou ST, Chirlaque MD, Cho B, Christensen K, Christofaro DG, Chudek J, Cifkova R, Cilia M, Cinteza E, Cirillo M, Claessens F, Clarke J, Clays E, Cohen E, Compañ-Gabucio LM, Concin H, Confortin SC, Cooper C, Coppinger TC, Corpeleijn E, Cortés LY, Costanzo S, Cottel D, Cowell C, Craig CL, Crampin AC, Cross AJ, Crujeiras AB, Cruz JJ, Csányi T, Csilla S, Cucu AM, Cui L, Cureau FV, Cuschieri S, Czenczek-Lewandowska E, D’Arrigo G, d’Orsi E, Dacica L, Dallongeville J, Damasceno A, Damsgaard CT, Dankner R, Dantoft TM, Dasgupta P, Dastgiri S, Dauchet L, Davletov K, de Assis MAA, De Backer G, De Bacquer D, De Curtis A, de Fragas Hinnig P, de Gaetano G, De Henauw S, De Miguel-Etayo P, de Oliveira PD, De Ridder D, De Ridder K, de Rooij SR, De Smedt D, Deepa M, Deev AD, DeGennaro V, Delisle H, Delpeuch F, Demarest S, Dennison E, Dereń K, Deschamps V, Dhimal M, Di Castelnuovo A, Dias-da-Costa JS, Díaz-Sánchez ME, Diaz A, Fernández PD, Ripollés MPD, Dika Z, Djalalinia S, Djordjic V, Do HTP, Dobson AJ, Dominguez L, Donati MB, Donfrancesco C, Dong G, Dong Y, Donoso SP, Döring A, Dorobantu M, Dorosty AR, Doua K, Dragano N, Drygas W, Duan JL, Duante CA, Duboz P, Duleva VL, Dulskiene V, Dumith SC, Dushpanova A, Dyussupova A, Dzerve V, Dziankowska-Zaborszczyk E, Echeverría G, Eddie R, Eftekhar E, Egbagbe EE, Eggertsen R, Eghtesad S, Eiben G, Ekelund U, El-Khateeb M, El Ammari L, El Ati J, Eldemire-Shearer D, Eliasen M, Elliott P, Endevelt R, Engle-Stone R, Erasmus RT, Erbel R, Erem C, Ergor G, Eriksen L, Eriksson JG, Escobedo-de la Peña J, Eslami S, Esmaeili A, Evans A, Faeh D, Fakhradiyev I, Fakhretdinova AA, Fall CH, Faramarzi E, Farjam M, Sant’Angelo VF, Fattahi MR, Fawwad A, Fawzi WW, Feigl E, Felix-Redondo FJ, Ferguson TS, Fernandes RA, Fernández-Bergés D, Ferrante D, Ferrao T, Ferrari G, Ferrari M, Ferrario MM, Ferreccio C, Ferreira HS, Ferrer E, Ferrieres J, Figueiró TH, Fijalkowska A, Fisberg M, Fischer K, Foo LH, Forsner M, Fouad HM, Francis DK, do Carmo Franco M, Fras Z, Frontera G, Fuchs FD, Fuchs SC, Fujiati II, Fujita Y, Fumihiko M, Furdela V, Furusawa T, Gaciong Z, Gafencu M, Cuesta MG, Galbarczyk A, Galenkamp H, Galeone D, Galfo M, Galvano F, Gao J, Gao P, Garcia-de-la-Hera M, Mérida MJG, Solano MG, Gareta D, Garnett SP, Gaspoz JM, Gasull M, Gaya ACA, Gaya AR, Gazzinelli A, Gehring U, Geiger H, Geleijnse JM, George R, Ghaderi E, Ghanbari A, Ghasemi E, Gheorghe-Fronea OF, Gialluisi A, Giampaoli S, Gianfagna F, Gieger C, Gill TK, Giovannelli J, Gironella G, Giwercman A, Gkiouras K, Glushkova N, Gluškova N, Godara R, Godos J, Gogen S, Goldberg M, Goltzman D, Gómez G, Gómez JHG, Gomez LF, Gómez SF, Gomula A, da Silva BGC, Gonçalves H, Gonçalves M, González-Alvarez AD, Gonzalez-Chica DA, González-Gil EM, Gonzalez-Gross M, González-Leon M, González-Rivas JP, González-Villalpando C, González-Villalpando ME, Gonzalez AR, Gottrand F, Graça AP, Graff-Iversen S, Grafnetter D, Grajda A, Grammatikopoulou MG, Gregor RD, Gregório MJ, Grøholt EK, Grøntved A, Grosso G, Gruden G, Gu D, Guajardo V, Gualdi-Russo E, Guallar-Castillón P, Gualtieri A, Gudmundsson EF, Gudnason V, Guerrero R, Guessous I, Guimaraes AL, Gulliford MC, Gunnlaugsdottir J, Gunter MJ, Guo XH, Guo Y, Gupta PC, Gupta R, Gureje O, González EG, Gutierrez L, Gutzwiller F, Gwee X, Ha S, Hadaegh F, Hadjigeorgiou CA, Haghshenas R, Hakimi H, Halkjær J, Hambleton IR, Hamzeh B, Hanekom WA, Hange D, Hanif AAM, Hantunen S, Hao J, Hardman CM, Kumar RH, Lassen TH, Harooni J, Hashemi-Shahri SM, Hassapidou M, Hata J, Haugsgjerd T, Hayes AJ, He J, He Y, He Y, Heidinger-Felső R, Heier M, Hejgaard T, Hendriks ME, dos Santos Henrique R, Henriques A, Cadena LH, Herrala S, Herrera-Cuenca M, Herrera VM, Herter-Aeberli I, Herzig KH, Heshmat R, Hill AG, Ho SY, Ho SC, Hobbs M, Höfelmann DA, Holdsworth M, Homayounfar R, Homs C, Hopman WM, Horimoto ARVR, Hormiga CM, Horta BL, Houti L, Howitt C, Htay TT, Htet AS, Htike MMT, Hu Y, Huerta JM, Huhtaniemi IT, Huiart L, Petrescu CH, Huisman M, Husseini A, Huu CN, Huybrechts I, Hwalla N, Hyska J, Iacoviello L, Iakupova EM, Ibarluzea JM, Ibrahim MM, Wong NI, Ikram MA, Iñiguez C, Iotova V, Irazola VE, Ishida T, Isiguzo GC, Islam M, Islam SMS, Islek D, Ivanova-Pandourska IY, Iwasaki M, Jääskeläinen T, Jackson RT, Jacobs JM, Jadoul M, Jafar T, Jallow B, James K, Jamil KM, Jamrozik K, Jansson A, Janszky I, Janus E, Jarani J, Jarvelin MR, Jasienska G, Jelaković A, Jelaković B, Jennings G, Jiang CQ, Jimenez RO, Jöckel KH, Joffres M, Jokelainen JJ, Jonas JB, Jonnagaddala J, Jørgensen T, Joshi P, Josipović J, Joukar F, Jóźwiak JJ, Judge DS, Juolevi A, Jurak G, Simina IJ, Juresa V, Kaaks R, Kaducu FO, Kafatos A, Kaj M, Kajantie EO, Kakutia N, Kállayová D, Kalmatayeva Z, Kalter-Leibovici O, Kameli Y, Kampmann FB, Kanala KR, Kannan S, Kapantais E, Karaglani E, Karakosta A, Kårhus LL, Karki KB, Katchunga PB, Katibeh M, Katz J, Katzmarzyk PT, Kauhanen J, Kaur P, Kavousi M, Kazakbaeva GM, Kaze FF, Ke C, Keil U, Boker LK, Keinänen-Kiukaanniemi S, Kelishadi R, Kelleher C, Kemper HCG, Keramati M, Kerimkulova A, Kersting M, Key T, Khader YS, Khaledifar A, Khalili D, Khaw KT, Kheiri B, Kheradmand M, Khosravi A, Khouw IMSL, Kiechl-Kohlendorfer U, Kiechl SJ, Kiechl S, Killewo J, Kim HC, Kim J, Kindblom JM, Kingston A, Klakk H, Klimek M, Klimont J, Klumbiene J, Knoflach M, Koirala B, Kolle E, Kolsteren P, König J, Korpelainen R, Korrovits P, Korzycka M, Kos J, Koskinen S, Kouda K, Kovács É, Kovacs VA, Kovalskys I, Kowlessur S, Koziel S, Kratenova J, Kratzer W, Kriaucioniene V, Kriemler S, Kristensen PL, Krizan H, Kroker-Lobos MF, Krokstad S, Kromhout D, Kruger HS, Kruger R, Kryst Ł, Kubinova R, Kuciene R, Kujala UM, Kujundzic E, Kulaga Z, Kulimbet M, Kumar RK, Kunešová M, Kurjata P, Kusuma YS, Kutsenko V, Kuulasmaa K, Kyobutungi C, La QN, Laamiri FZ, Lachat C, Lackner KJ, Laid Y, Lall L, Lam TH, Jimenez ML, Landais E, Lanska V, Lappas G, Larijani B, Larissa SP, Latt TS, Laurenzi M, Lauria L, Lazo-Porras M, Le Coroller G, Le Nguyen Bao K, Le Port A, Le TD, Lee J, Lee J, Lee PH, Lehmann N, Lehtimäki T, Lemogoum D, Leskošek B, Leszczak J, Leth-Møller KB, Leung GM, Levitt NS, Li Y, Liivak M, Lilly CL, Lim C, Lim WY, Lima-Costa MF, Lin HH, Lin X, Lin YT, Lind L, Lingam V, Linkohr B, Linneberg A, Lissner L, Litwin M, Liu J, Liu L, Lo WC, Loit HM, Long KQ, Abril GL, Lopes L, Lopes MVV, Lopes O, Lopez-Garcia E, Lopez T, Lotufo PA, Lozano JE, Lukrafka JL, Luksiene D, Lundqvist A, Lunet N, Lunogelo C, Lustigová M, Łuszczki E, M’Buyamba-Kabangu JR, Ma G, Ma X, Machado-Coelho GLL, Machado-Rodrigues AM, Macia E, Macieira LM, Madar AA, Madsen AL, Maestre GE, Maggi S, Magliano DJ, Magnacca S, Magriplis E, Mahasampath G, Maire B, Majer M, Makdisse M, Mäki P, Malekzadeh F, Malekzadeh R, Malhotra R, Rao KM, Malyutina SK, Maniego LV, Manios Y, Manix MI, Mann JI, Mansour-Ghanaei F, Manyanga T, Manzato E, Marcil A, Margozzini P, Mariño J, Markaki A, Markey O, Ioannidou EM, Marques-Vidal P, Marques LP, Marrugat J, Martin-Prevel Y, Martin R, Martorell R, Martos E, Maruszczak K, Marventano S, Masala G, Mascarenhas LP, Masoodi SR, Mathiesen EB, Mathur P, Matijasevich A, Matłosz P, Matsha TE, Matsudo V, Mavrogianni C, Mazur A, Mbanya JCN, McFarlane SR, McGarvey ST, McKee M, McLachlan S, McLean RM, McLean SB, McNairy ML, McNulty BA, Benchekor SM, Medzioniene J, Mehdipour P, Mehlig K, Mehrparvar AH, Meirhaeghe A, Meisfjord J, Meisinger C, Melgarejo JD, Melkumova M, Mello J, Méndez F, Mendivil CO, Menezes AMB, Menon GR, Mensink GBM, Menzano MT, Meshram II, Meto DT, Mi J, Michaelsen KF, Michels N, Mikkel K, Miłkowska K, Miller JC, Milushkina O, Minderico CS, Mini GK, Miquel JF, Miranda JJ, Mirjalili MR, Mirkopoulou D, Mirrakhimov E, Mišigoj-Duraković M, Mistretta A, Mocanu V, Modesti PA, Moghaddam SS, Mohajer B, Mohamed MK, Mohamed SF, Mohammad K, Mohammadi MR, Mohammadi Z, Mohammadifard N, Mohammadpourhodki R, Mohan V, Mohanna S, Yusoff MFM, Mohebbi I, Mohebi F, Moitry M, Møllehave LT, Møller NC, Molnár D, Momenan A, Mondo CK, Montenegro Mendoza RA, Monterrubio-Flores E, Monyeki KDK, Moon JS, Moosazadeh M, Mopa HT, Moradpour F, Moreira LB, Morejon A, Moreno LA, Morey F, Morgan K, Morin SN, Mortensen EL, Moschonis G, Moslem A, Mossakowska M, Mostafa A, Mostafavi SA, Mota-Pinto A, Mota J, Motlagh ME, Motta J, Moura-dos-Santos MA, Movsesyan Y, Msyamboza KP, Mu TT, Muc M, Muca F, Mugoša B, Muiesan ML, Müller-Nurasyid M, Münzel T, Mursu J, Murtagh EM, Musa KI, Milanović SM, Musil V, Musinguzi G, Muyer MTMC, Nabipour I, Naderimagham S, Nagel G, Najafi F, Nakamura H, Nalecz H, Námešná J, Nang EEK, Nangia VB, Nankap M, Narake S, Nardone P, Naseri T, Nauck M, Neal WA, Nejatizadeh A, Nekkantti C, Nelis K, Nenko I, Neovius M, Nervi F, Ng TP, Nguyen CT, Nguyen ND, Nguyen QN, Ni MY, Nicolescu R, Nie P, Nieto-Martínez RE, Nikitin YP, Ning G, Ninomiya T, Nishi N, Nishtar S, Noale M, Noboa OA, Nogueira H, Nordendahl M, Nordestgaard BG, Noto D, Nowak-Szczepanska N, Nsour MA, Nuhoğlu I, Nunes B, Nurk E, Nuwaha F, Nyirenda M, O’Neill TW, O’Reilly D, Obreja G, Ochimana C, Ochoa-Avilés AM, Oda E, Odili AN, Oh K, Ohara K, Ohlsson C, Ohtsuka R, Olafsson Ö, Olinto MTA, Oliveira IO, Omar MA, Omar SM, Onat A, Ong SK, Onland-Moret NC, Ono LM, Ordunez P, Ornelas R, Ortiz AP, Ortiz PJ, Osler M, Osmond C, Ostojic SM, Ostovar A, Otero JA, Overvad K, Owusu-Dabo E, Paccaud FM, Pagkalos I, Pahomova E, de Paiva KM, Pająk A, Palloni A, Palmieri L, Pan WH, Panda-Jonas S, Pandey A, Panza F, Paoli M, Papadopoulou SK, Papandreou D, Pareja RG, Park SW, Park S, Parnell WR, Parsaeian M, Pascanu IM, Pasquet P, Patel ND, Pattussi M, Pavlyshyn H, Pechlaner R, Pećin I, Pednekar MS, Pedro JM, Peer N, Peixoto SV, Peltonen M, Pereira AC, Peres MA, Pérez CM, Peterkova V, Peters A, Petersmann A, Petkeviciene J, Petrauskiene A, Kovtun OP, Pettenuzzo E, Peykari N, Pfeiffer N, Phall MC, Pham ST, Pichardo RN, Pierannunzio D, Pigeot I, Pikhart H, Pilav A, Pilotto L, Pistelli F, Pitakaka F, Piwonska A, Pizarro AN, Plans-Rubió P, Platonova AG, Poh BK, Pohlabeln H, Polka NS, Pop RM, Popovic SR, Porta M, Posch G, Poudyal A, Poulimeneas D, Pouraram H, Pourfarzi F, Pourshams A, Poustchi H, Pradeepa R, Price AJ, Price JF, Prista A, Providencia R, Puder JJ, Pudule I, Puiu M, Punab M, Qadir MS, Qasrawi RF, Qorbani M, Quintana HK, Quiroga-Padilla PJ, Bao TQ, Rach S, Radic I, Radisauskas R, Rahimikazerooni S, Rahman M, Rahman M, Raitakari O, Raj M, Rajabov T, Rakhmatulloev S, Rakovac I, Rao SR, Ramachandran A, Ramadan OPC, Ramires VV, Ramke J, Ramos E, Ramos R, Rampal L, Rampal S, Rangelova LS, Rarra V, Rascon-Pacheco RA, Rech CR, Redon J, Reganit PFM, Regecová V, Renner JDP, Repasy JA, Reuter CP, Revilla L, Rezaianzadeh A, Rho Y, Ribas-Barba L, Ribeiro R, Riboli E, Richter A, Rigo F, Rigotti A, Rinaldo N, Rinke de Wit TF, Rito AI, Ritti-Dias RM, Rivera JA, Roa RG, Robinson L, Robitaille C, Roccaldo R, Rodrigues D, Rodríguez-Artalejo F, del Cristo Rodriguez-Perez M, Rodríguez-Villamizar LA, Rodríguez AY, Roggenbuck U, Rohloff P, Rohner F, Rojas-Martinez R, Rojroongwasinkul N, Romaguera D, Romeo EL, Rosario RV, Rosengren A, Rouse I, Rouzier V, Roy JGR, Ruano MH, Rubinstein A, Rühli FJ, Ruidavets JB, Ruiz-Betancourt BS, Ruiz-Castell M, Moreno ER, Rusakova IA, Jonsson KR, Russo P, Rust P, Rutkowski M, Saamel M, Sabanayagam C, Sabbaghi H, Sacchini E, Sachdev HS, Sadjadi A, Safarpour AR, Safi S, Safiri S, Saghi MH, Saidi O, Saki N, Šalaj S, Salanave B, Martinez ES, Saleva C, Salmerón D, Salomaa V, Salonen JT, Salvetti M, Samoutian M, Sánchez-Abanto J, Rodríguez IS, Sandjaja, Sans S, Marina LS, Santacruz E, Santos DA, Santos IS, Santos LC, Santos MP, Santos O, Santos R, Santos TR, Saramies JL, Sardinha LB, Sarrafzadegan N, Sathish T, Saum KU, Savva S, Savy M, Sawada N, Sbaraini M, Scazufca M, Schaan BD, Rosario AS, Schargrodsky H, Schienkiewitz A, Schindler K, Schipf S, Schmidt CO, Schmidt IM, Schneider A, Schnohr P, Schöttker B, Schramm S, Schramm S, Schröder H, Schultsz C, Schulze MB, Schutte AE, Sebert S, Sedaghattalab M, Selamat R, Sember V, Sen A, Senbanjo IO, Sepanlou SG, Sequera G, Serra-Majem L, Servais J, Ševčíková Ľ, Shalnova S, Shamah-Levy T, Shamshirgaran SM, Shanthirani CS, Sharafkhah M, Sharma SK, Shaw JE, Shayanrad A, Shayesteh AA, Shengelia L, Shi Z, Shibuya K, Shimizu-Furusawa H, Shimony T, Shiri R, Shrestha N, Si-Ramlee K, Siani A, Siantar R, Sibai AM, Sidossis LS, Silitrari N, Silva AM, de Moura Silva CR, Silva DAS, Silva KS, Sim X, Simon M, Simons J, Simons LA, Sjöberg A, Sjöström M, Skoblina NA, Skodje G, Slazhnyova T, Slowikowska-Hilczer J, Slusarczyk P, Smeeth L, So HK, Soares FC, Sobek G, Sobngwi E, Sodemann M, Söderberg S, Soekatri MYE, Soemantri A, Sofat R, Solfrizzi V, Somi MH, Sonestedt E, Song Y, Soofi S, Sørensen TIA, Sørgjerd EP, Jérome CS, Soto-Rojas VE, Soumaré A, Sousa-Poza A, Sovic S, Sparboe-Nilsen B, Sparrenberger K, Spencer PR, Spinelli A, Spiroski I, Staessen JA, Stamm H, Staub K, Stavreski B, Steene-Johannessen J, Stehle P, Stein AD, Stergiou GS, Stessman J, Stevanović R, Stieber J, Stöckl D, Stokwiszewski J, Stoyanova E, Stratton G, Stronks K, Strufaldi MW, Sturua L, Suárez-Medina R, Suka M, Sun CA, Sun L, Sundström J, Sung YT, Sunyer J, Suriyawongpaisal P, Sweis NWG, Swinburn BA, Sy RG, Sylva RC, Szklo M, Szponar L, Tabone L, Tai ES, Tambalis KD, Tammesoo ML, Tamosiunas A, Tan EJ, Tang X, Tanrygulyyeva M, Tanser F, Tao Y, Tarawneh MR, Tarp J, Tarqui-Mamani CB, Braunerová RT, Taylor A, Taylor J, Tchibindat F, Te Velde S, Tebar WR, Tell GS, Tello T, Tham YC, Thankappan KR, Theobald H, Theodoridis X, Thomas N, Thorand B, Thuesen BH, Tichá Ľ, Timmermans EJ, Tjandrarini DH, Tjonneland A, Tolonen HK, Tolstrup JS, Topbas M, Topór-Mądry R, Torheim LE, Tormo MJ, Tornaritis MJ, Torrent M, Torres-Collado L, Toselli S, Touloumi G, Traissac P, Tran TTH, Tremblay MS, Triantafyllou A, Trichopoulos D, Trichopoulou A, Trinh OTH, Trivedi A, Tsao YH, Tshepo L, Tsigga M, Tsintavis P, Tsugane S, Tuitele J, Tuliakova AM, Tulloch-Reid MK, Tullu F, Tuomainen TP, Tuomilehto J, Turley ML, Twig G, Tynelius P, Tzala E, Tzotzas T, Tzourio C, Ueda P, Ugel E, Ukoli FAM, Ulmer H, Unal B, Usupova Z, Uusitalo HMT, Uysal N, Vaitkeviciute J, Valdivia G, Vale S, Valvi D, van Dam RM, van den Born BJ, Van der Heyden J, van der Schouw YT, Van Herck K, Van Lippevelde W, Van Minh H, Van Schoor NM, van Valkengoed IGM, Vanderschueren D, Vanuzzo D, Varbo A, Varela-Moreiras G, Vargas LN, Varona-Pérez P, Vasan SK, Vasques DG, Vega T, Veidebaum T, Velasquez-Melendez G, Velika B, Verloigne M, Veronesi G, Verschuren WMM, Victora CG, Viegi G, Viet L, Vik FN, Vilar M, Villalpando S, Vioque J, Virtanen JK, Visvikis-Siest S, Viswanathan B, Vladulescu M, Vlasoff T, Vocanec D, Vollenweider P, Völzke H, Voutilainen A, Vrijheid M, Vrijkotte TGM, Wade AN, Waldhör T, Walton J, Wambiya EOA, Bebakar WMW, Mohamud WNW, de Souza Wanderley Júnior R, Wang MD, Wang N, Wang Q, Wang X, Wang YX, Wang YW, Wannamethee SG, Wareham N, Weber A, Webster-Kerr K, Wedderkopp N, Weghuber D, Wei W, Weres A, Werner B, Westbury LD, Whincup PH, Wickramasinghe K, Widhalm K, Widyahening IS, Więcek A, Wild PS, Wilks RJ, Willeit J, Willeit P, Williams J, Wilsgaard T, Wojciech R, Wojtyniak B, Wolf K, Wong-McClure RA, Wong A, Wong EB, Wong JE, Wong TY, Woo J, Woodward M, Wu FC, Wu HY, Wu J, Wu LJ, Wu S, Wyszyńska J, Xu H, Xu L, Yaacob NA, Yamborisut U, Yan W, Yang L, Yang X, Yang Y, Yardim N, Yasuharu T, García MY, Yiallouros PK, Yngve A, Yoosefi M, Yoshihara A, You QS, You SL, Younger-Coleman NO, Yu YL, Yu Y, Yusof SM, Yusoff AF, Zaccagni L, Zafiropulos V, Zainuddin AA, Zakavi SR, Zamani F, Zambon S, Zampelas A, Zamrazilová H, Zapata ME, Zargar AH, Zaw KK, Zayed AA, Zdrojewski T, Żegleń M, Zejglicova K, Vrkic TZ, Zeng Y, Zhang L, Zhang ZY, Zhao D, Zhao MH, Zhao W, Zhecheva YV, Zhen S, Zheng W, Zheng Y, Zholdin B, Zhou M, Zhu D, Zins M, Zitt E, Zocalo Y, Zoghlami N, Cisneros JZ, Zuziak M, Bhutta ZA, Black RE, Ezzati M. Diminishing benefits of urban living for children and adolescents' growth and development. Nature 2023; 615:874-883. [PMID: 36991188 PMCID: PMC10060164 DOI: 10.1038/s41586-023-05772-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 01/30/2023] [Indexed: 03/31/2023]
Abstract
Optimal growth and development in childhood and adolescence is crucial for lifelong health and well-being1-6. Here we used data from 2,325 population-based studies, with measurements of height and weight from 71 million participants, to report the height and body-mass index (BMI) of children and adolescents aged 5-19 years on the basis of rural and urban place of residence in 200 countries and territories from 1990 to 2020. In 1990, children and adolescents residing in cities were taller than their rural counterparts in all but a few high-income countries. By 2020, the urban height advantage became smaller in most countries, and in many high-income western countries it reversed into a small urban-based disadvantage. The exception was for boys in most countries in sub-Saharan Africa and in some countries in Oceania, south Asia and the region of central Asia, Middle East and north Africa. In these countries, successive cohorts of boys from rural places either did not gain height or possibly became shorter, and hence fell further behind their urban peers. The difference between the age-standardized mean BMI of children in urban and rural areas was <1.1 kg m-2 in the vast majority of countries. Within this small range, BMI increased slightly more in cities than in rural areas, except in south Asia, sub-Saharan Africa and some countries in central and eastern Europe. Our results show that in much of the world, the growth and developmental advantages of living in cities have diminished in the twenty-first century, whereas in much of sub-Saharan Africa they have amplified.
Collapse
|
24
|
Hassapidou M, Duncanson K, Shrewsbury V, Ells L, Mulrooney H, Androutsos O, Vlassopoulos A, Rito A, Farpourt N, Brown T, Douglas P, Ramos Sallas X, Woodward E, Collins C. EASO and EFAD Position Statement on Medical Nutrition Therapy for the Management of Overweight and Obesity in Children and Adolescents. Obes Facts 2023; 16:29-52. [PMID: 36349767 PMCID: PMC9890183 DOI: 10.1159/000527540] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 09/21/2022] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION This position statement on medical nutrition therapy in the management of overweight or obesity in children and adolescents was prepared by an expert committee convened by the European Association for the Study of Obesity (EASO) and developed in collaboration with the European Federation of the Associations of Dietitians (EFAD). METHODS It is based on the best evidence available from systematic reviews of randomized controlled trials on child and adolescent overweight and obesity treatment and other relevant peer-reviewed literature. RESULTS Multicomponent behavioural interventions are generally considered to be the gold standard treatment for children and adolescents living with obesity. The evidence presented in this position statement confirms that dietary interventions can effectively improve adiposity-related outcomes. Dietary strategies should focus on the reduction of total energy intake through promotion of food-based guidelines that target modification of usual eating patterns and behaviours. These should target increasing intakes of nutrient-rich foods with a lower energy density, specifically vegetables and fruits, and a reduction in intakes of energy-dense nutrient-poor foods and beverages. In addition, higher intensity, longer duration treatments, delivered by interventionists with specialized dietetic-related skills and co-designed with families, are associated with greater treatment effects. DISCUSSION Such interventions should be resourced adequately so that they can be implemented in a range of settings and in different formats, including digital or online delivery, to enhance accessibility.
Collapse
Affiliation(s)
- Maria Hassapidou
- Department of Nutritional Sciences & Dietetics, International Hellenic University, Thessaloniki, Greece
- ESDN Obesity, European Federation of the Associations of Dieticians, Naarden, The Netherlands
| | - Kerith Duncanson
- School of Medicine and Public Health, The University of Newcastle Australia, Callaghan, New South Wales, Australia
| | - Vanessa Shrewsbury
- School of Health Sciences, College of Health, Medicine and Wellbeing, The University of Newcastle Australia, Callaghan, New South Wales, Australia
| | - Louisa Ells
- Obesity Institute, School of Health, Leeds Beckett University, Leeds, UK
| | - Hilda Mulrooney
- ESDN Obesity, European Federation of the Associations of Dieticians, Naarden, The Netherlands
- Department of Life Sciences, Pharmacy and Chemistry, SEC Faculty, Kingston University London, Kingston upon Thames, UK
| | - Odysseas Androutsos
- ESDN Obesity, European Federation of the Associations of Dieticians, Naarden, The Netherlands
- Department of Nutrition-Dietetics, University of Thessaly, Trikala, Greece
| | - Antonis Vlassopoulos
- ESDN Obesity, European Federation of the Associations of Dieticians, Naarden, The Netherlands
- Department of Food Science & Human Nutrition, Agricultural University of Athens, Athens, Greece
- *Maria Hassapidou,
| | - Ana Rito
- National Institute of Health Ricardo Jorge I.P., Lisbon, Portugal
| | - Nathalie Farpourt
- Obesity Prevention and Care Program Contrepoids, Service of Endocrinology, Diabetology and Therapeutic Education, Department of Medicine, University Hospitals of Geneva and University of Geneva, Geneva, Switzerland
| | - Tamara Brown
- Applied Obesity Research Centre in the School of Health, Leeds Beckett University, Leeds, UK
| | - Pauline Douglas
- Nutrition Innovation Center for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, UK
| | | | - Euan Woodward
- European Association for the Study of Obesity, Teddington, UK
| | - Clare Collins
- School of Health Sciences, College of Health, Medicine and Wellbeing, The University of Newcastle Australia, Callaghan, New South Wales, Australia
| |
Collapse
|
25
|
Moradell A, Santaliestra-Pasías AM, Aparicio-Ugarriza R, Huybrechts I, Bertalanné Szommer A, Forsner M, González-Gross M, Kafatos A, Androutsos O, Michels N, Sjöström M, Vanhelst J, Widhalm K, Gutierrez A, Moreno LA. Are Physical Activity and Sedentary Screen Time Levels Associated With Food Consumption in European Adolescents? The HELENA Study. J Am Nutr Assoc 2023; 42:55-66. [PMID: 35512776 DOI: 10.1080/07315724.2021.1978900] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 08/06/2021] [Accepted: 09/06/2021] [Indexed: 12/16/2022]
Abstract
One of the current main public health problems is the prevalence of obesity in children. Unhealthy lifestyle behaviors such as poor dietary habits, high sedentary screen time (SST), and low levels of physical activity (PA) have a strong tendency to track from childhood into adulthood. The aim of this manuscript is to assess the association between meeting or not meeting the PA and SST recommendations and the consumption of different food groups. Data were obtained from a sample of European adolescents from the multicenter cross-sectional HELENA study. In all, 1448 adolescents from 8 cities were included. PA was objectively measured by accelerometry and dietary intake by 24-hour dietary records. Adolescents were grouped according to PA and SST recommendations. In both sexes, intake of savory snacks was higher in those groups who did not meet any of the recommendations (p < 0.05). For males, those who met both recommendations were more likely to drink/eat milk, yogurt, and water (p < 0.05). Those not meeting recommendations were more likely to drink sugar-sweetened beverages (p < 0.05). For females, those not meeting recommendations were less likely to eat fruits and vegetables and more likely to have a higher intake of fats and oils (p < 0.05). Those adolescents meeting PA and SST recommendations had a higher intake of healthy foods, like fruit and vegetables and dairy products. However, the negative relationship unhealthier food and SST is stronger in males independently of PA. More studies assessing the combined effect of both PA and SST regarding dietary habits in children and adolescents are needed.
Collapse
Affiliation(s)
- Ana Moradell
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Facultad de Ciencias de la Salud, Universidad de Zaragoza, Zaragoza, Spain
| | - Alba M Santaliestra-Pasías
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Facultad de Ciencias de la Salud, Universidad de Zaragoza, Zaragoza, Spain
- Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Universidad de Zaragoza, Zaragoza, Spain
| | - Raquel Aparicio-Ugarriza
- ImFine Research Group, Department of Health and Human Performance, Universidad Politécnica de Madrid, Madrid, Spain
| | - Inge Huybrechts
- Department of Public Health, Ghent University, Ghent, Belgium
- International Agency for Research on Cancer, Lyon, France
| | | | - Maria Forsner
- School of Education, Health and Social Sciences, Dalarna University, Falun, Sweden
- Department of Nursing, Umeå University, Umeå, Sweden
| | - Marcela González-Gross
- ImFine Research Group, Department of Health and Human Performance, Universidad Politécnica de Madrid, Madrid, Spain
- Department of Nutrition and Food Sciences-Nutritional Physiology, University of Bonn, Bonn, Germany
- CIBER: CB12/03/30038 Fisiopatología de la Obesidad y la Nutrición, CIBERobn, Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Anthony Kafatos
- School of Medicine, University of Crete, Heraklion, Greece
- Ilioupolis, Athens, Greece
| | - Odysseas Androutsos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
- Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, Trikala, Greece
| | | | - Michael Sjöström
- Unit for Preventive Nutrition, Department of Biosciences and Nutrition at NOVUM, Karolinska Institutet, Huddinge, Sweden
| | - Jeremy Vanhelst
- CHU Lille, Lille Inflammation Research International Center LIRIC-UMR, University Lille, Lille, France
- CHU Lille, Clinical Investigation Center, CIC-1403-Inserm-CHU, University Lille, Lille, France
| | - Kurt Widhalm
- Department of Pediatrics, Medical University of Vienna, Vienna, Austria
- Department of Pediatrics, Private Medical University, Salzburg, Austria
| | - Angel Gutierrez
- Department of Medical Physiology, School of Medicine, University of Granada, Granada, Spain
| | - Luis A Moreno
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Facultad de Ciencias de la Salud, Universidad de Zaragoza, Zaragoza, Spain
- Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Universidad de Zaragoza, Zaragoza, Spain
| |
Collapse
|
26
|
Cardon G, Chastin S, Van Stappen V, Huys N, Stefanova T, Chakarova N, Kivelä J, Alberto Moreno L, Sándor Istvánné R, Androutsos O, Manios Y, De Craemer M. The Feel4Diabetes intervention: effectiveness on 24-hour physical behaviour composition in families at risk for diabetes development. Health Promot Int 2022; 37:6775000. [DOI: 10.1093/heapro/daac092] [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: 11/04/2022] Open
Abstract
Summary
The Feel4Diabetes project conducted a 2-year intervention aiming to encourage healthy behaviours in families in six European countries. Within this paper, the intervention effect was evaluated after the first intervention year on 24-hour physical behaviour composition in Belgian families at risk for type 2 diabetes. Parents’ and children’s levels of physical activity (PA) and sedentary behaviour (SB) were objectively measured and sleep duration was self-reported. Valid data were obtained in 82 children (mean age: 8.2 ± 0.84; 50.0% boys) and 72 parents (mean age: 40.1 ± 5.5; 27.8% fathers). Data were analysed using a compositional data approach, and mixed models were used to take clustering into account. Results showed that for children, the mean baseline composition of the 24-hour day in sleep, SB, light and moderate-to-vigorous PA for the intervention group was (11 hours 18 minutes; 6 hours 33 minutes; 5 hours 02 minutes, 1 hour 08 minutes) and for the control group (11 hours 18 minutes; 6 hours 35 minutes; 5 hours 04 minutes; 1 hour 06 minutes), respectively. For parents, the mean baseline composition was for the intervention group (8 hours 12 minutes; 9 hours 36 minutes; 5 hours 43 minutes; 27 minutes) and for the control group (8 hours 00 minute; 9 hours 00 minute; 6 hours 27 minutes; 33 minutes). No significant intervention effects were found on 24-hour physical behaviour composition of either parents or children (p = 0.19 and p = 0.21, respectively). A relatively small study population and a poor attendance rate among parents could maybe explain the lack of effectiveness. More effective strategies are needed to retain vulnerable families in interventions. Furthermore, future approaches to improve the 24-hour physical behaviour composition should maybe focus more specifically on PA, SB and sleep, and involve teachers, children and parents in the design of the intervention. Trial registration: NCT02393872 in ClinicalTrials.gov.
Collapse
Affiliation(s)
- Greet Cardon
- Ghent University, Department of Movement and Sports Sciences, Ghent University , Watersportlaan 2, 9000 Ghent , Belgium
| | - Sebastien Chastin
- Ghent University, Department of Movement and Sports Sciences, Ghent University , Watersportlaan 2, 9000 Ghent , Belgium
- Center for Living, School of Health and Life Science, Glasgow Caledonian University , Cowcaddens Rd, Glasgow G4 0BA , UK
| | - Vicky Van Stappen
- Ghent University, Department of Movement and Sports Sciences, Ghent University , Watersportlaan 2, 9000 Ghent , Belgium
| | - Nele Huys
- Ghent University, Department of Movement and Sports Sciences, Ghent University , Watersportlaan 2, 9000 Ghent , Belgium
| | - Tanya Stefanova
- Medical University Varna, Clinic of Paediatric Endocrinology , UMHAT “St. Marina” 1 “Hr. Smirnenski” Blvd., Varna 9010 , Bulgaria
| | - Nevena Chakarova
- Medical University of Sofia, Department of Diabetology, Clinical Centre of Endocrinology , Bulgaria bul. “Pencho Slaveykov”, 1431 Sofia Center, Sofia, Bulgarije
| | - Jemina Kivelä
- Finnish Institute for Health and Welfare , Mannerheimintie 166, 00300 Helsinki , Finland
| | - Luis Alberto Moreno
- University of Zaragoza, GENUD (Growth, Exercise, Nutrition and Development) , C/Domingo Miral s/n, 50009 Zaragoza , Spain
| | - Radó Sándor Istvánné
- University of Debrecen, Debreceni Egyetem (UoD) , Egyetem tér 1, Debrecen, 4032 Hungary
| | - Odysseas Androutsos
- Harokopio University, School of Health Science & Education, Department of Nutrition and Dietetics, Harokopio University , 70, El Venizelou Ave, 176 71 Kallithea, Athens , Greece
| | - Yannis Manios
- Harokopio University, School of Health Science & Education, Department of Nutrition and Dietetics, Harokopio University , 70, El Venizelou Ave, 176 71 Kallithea, Athens , Greece
| | - Marieke De Craemer
- Research Foundation Flanders (FWO) , Egmontstraat 5, 1000 Brussels , Belgium
- Department of Rehabilitation Sciences, Ghent University , Ghent University Hospital B3, C. Heymanslaan 10, 9000 Ghent , Belgium
| |
Collapse
|
27
|
Kullmann S, Veit R, Crabtree DR, Buosi W, Androutsos O, Johnstone AM, Manios Y, Preissl H, Smeets PAM. The effect of hunger state on hypothalamic functional connectivity in response to food cues. Hum Brain Mapp 2022; 44:418-428. [PMID: 36056618 PMCID: PMC9842901 DOI: 10.1002/hbm.26059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 07/29/2022] [Indexed: 01/25/2023] Open
Abstract
The neural underpinnings of the integration of internal and external cues that reflect nutritional status are poorly understood in humans. The hypothalamus is a key integrative area involved in short- and long-term energy intake regulation. Hence, we examined the effect of hunger state on the hypothalamus network using functional magnetic resonance imaging. In a multicenter study, participants performed a food cue viewing task either fasted or sated on two separate days. We evaluated hypothalamic functional connectivity (FC) using psychophysiological interactions during high versus low caloric food cue viewing in 107 adults (divided into four groups based on age and body mass index [BMI]; age range 24-76 years; BMI range 19.5-41.5 kg/m2 ). In the sated compared to the fasted condition, the hypothalamus showed significantly higher FC with the bilateral caudate, the left insula and parts of the left inferior frontal cortex. Interestingly, we observed a significant interaction between hunger state and BMI group in the dorsolateral prefrontal cortex (DLPFC). Participants with normal weight compared to overweight and obesity showed higher FC between the hypothalamus and DLPFC in the fasted condition. The current study showed that task-based FC of the hypothalamus can be modulated by internal (hunger state) and external cues (i.e., food cues with varying caloric content) with a general enhanced communication in the sated state and obesity-associated differences in hypothalamus to DLPFC communication. This could potentially promote overeating in persons with obesity.
Collapse
Affiliation(s)
- Stephanie Kullmann
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of TübingenGerman Center for Diabetes Research (DZD)TübingenGermany,Department of Internal Medicine, Division of Diabetology, Endocrinology and NephrologyEberhard Karls University TübingenTübingenGermany
| | - Ralf Veit
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of TübingenGerman Center for Diabetes Research (DZD)TübingenGermany
| | - Daniel R. Crabtree
- The Rowett InstituteUniversity of AberdeenAberdeenScotland,Division of Biomedical Sciences, Centre for Health ScienceUniversity of the Highlands and IslandsInvernessUK
| | - William Buosi
- The Rowett InstituteUniversity of AberdeenAberdeenScotland
| | - Odysseas Androutsos
- Department of Nutrition and Dietetics, School of Physical Education, Sport Science and DieteticsUniversity of ThessalyVolosGreece
| | | | - Yannis Manios
- Department of Nutrition‐Dietetics, School of Health Science and EducationHarokopio UniversityAthensGreece
| | - Hubert Preissl
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of TübingenGerman Center for Diabetes Research (DZD)TübingenGermany,Department of Internal Medicine, Division of Diabetology, Endocrinology and NephrologyEberhard Karls University TübingenTübingenGermany
| | - Paul A. M. Smeets
- Division of Human Nutrition and HealthWageningen UniversityWageningenThe Netherlands,Image Sciences Institute, University Medical Center Utrecht Brain CenterUtrecht UniversityUtrechtThe Netherlands
| |
Collapse
|
28
|
Androutsos O, Charmandari E. Determinants, Screening, Prevention and Management of Obesity in Youth: New Evidence and Horizons. Nutrients 2022; 14:nu14163280. [PMID: 36014786 PMCID: PMC9414778 DOI: 10.3390/nu14163280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 08/09/2022] [Indexed: 12/03/2022] Open
Affiliation(s)
- Odysseas Androutsos
- Laboratory of Clinical Nutrition and Dietetics, Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, 42132 Trikala, Greece
| | - Evangelia Charmandari
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, ‘Aghia Sophia’ Children’s Hospital, 11527 Athens, Greece
- Division of Endocrinology and Metabolism, Center of Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, 11527 Athens, Greece
- Correspondence: ; Tel.: +30-213-2013384
| |
Collapse
|
29
|
Androutsos O, Zampelas A. Body Composition in Children: What Does It Tell Us So Far? Children 2022; 9:children9081199. [PMID: 36010089 PMCID: PMC9406718 DOI: 10.3390/children9081199] [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] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 08/04/2022] [Accepted: 08/08/2022] [Indexed: 11/16/2022]
Abstract
The Special Issue “Body Composition in Children” of the journal “CHILDREN” aimed to publish both original and review articles focusing on the prevalence and determinants of obesity across childhood, the role of body composition in children’s health, new approaches to assessing body composition, and interventions aiming to improve body composition in children and adolescents [...]
Collapse
Affiliation(s)
- Odysseas Androutsos
- Laboratory of Clinical Nutrition and Dietetics, Department of Nutrition and Dietetics, University of Thessaly, Thessaly, 42132 Trikala, Greece
- Correspondence:
| | - Antonis Zampelas
- Laboratory of Dietetics and Quality of Life, Department of Food Science and Human Nutrition, Agricultural University of Athens, 11588 Athens, Greece
| |
Collapse
|
30
|
Papamichael MM, Karaglani E, Boutsikou T, Dedousis V, Cardon G, Iotova V, Chakarova N, Usheva N, Wikström K, Imre R, RADÓ ASI, Liatis S, Makrilakis K, Moreno L, Manios Y, Manios Y, Cardon G, Lindström J, Schwarz P, Makrilakis K, Annemans L, Ko W, Manios Y, Karatzi K, Androutsos O, Moschonis G, Kanellakis S, Mavrogianni C, Tsoutsoulopoulou K, Katsarou C, Karaglani E, Qira I, Skoufas E, Maragkopoulou K, Tsiafitsa A, Sotiropoulou I, Tsolakos M, Argyri E, Nikolaou M, Vampouli EA, Filippou C, Apergi K, Filippou A, Katerina G, Dimitriadis E, Lindström J, Laatikainen T, Wikström K, Kivelä J, Valve P, Levälahti E, Virtanen E, Pennanen T, Olli S, Nelimarkka K, Cardon G, Van Stappen V, Huys N, Annemans L, Willems R, Shadid S, Schwarz P, Timpel P, Makrilakis K, Liatis S, Dafoulas G, Lambrinou CP, Giannopoulou A, Ko W, Karuranga E, Moreno L, Civeira F, Bueno G, De Miguel-Etayo P, Mª E, Gonzalez-Gil, Miguel-Berges ML, Giménez-Legarre N, Flores-Barrantes P, Ayala-Marín AM, Seral-Cortés M, Baila-Rueda L, Cenarro A, Jarauta E, Mateo-Gallego R, Iotova V, Tankova T, Usheva N, Tsochev K, Chakarova N, Galcheva S, Dimova R, Bocheva Y, Radkova Z, Marinova V, Bazdarska Y, Stefanova T, Rurik I, Ungvari T, Jancsó Z, Nánási A, Kolozsvári L, Semánova C, Bíró É, Antal E, Radó S, Martinez R, Tong M. HOW DO THE HOME FOOD ENVIRONMENT, PARENTING PRACTICES, HEALTH BELIEFS, AND SCREEN TIME AFFECT THE WEIGHT STATUS OF EUROPEAN CHILDREN?: FEEL4DIABETES-STUDY. Nutrition 2022; 103-104:111834. [DOI: 10.1016/j.nut.2022.111834] [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] [Received: 04/21/2022] [Revised: 07/28/2022] [Accepted: 08/12/2022] [Indexed: 11/26/2022]
|
31
|
Usheva N, Lateva M, Galcheva S, Koletzko BV, Cardon G, De Craemer M, Androutsos O, Kotowska A, Socha P, Moreno LA, Manios Y, Iotova V. Breastfeeding and Overweight in European Preschoolers: The ToyBox Study. Nutrients 2021; 13:nu13082880. [PMID: 34445041 PMCID: PMC8401161 DOI: 10.3390/nu13082880] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 08/17/2021] [Accepted: 08/19/2021] [Indexed: 12/04/2022] Open
Abstract
The benefits of breastfeeding (BF) include risk reduction of later overweight and obesity. We aimed to analyse the association between breastfeeding practices and overweight/obesity among preschool children participating in the ToyBox study. Data from children in the six countries, participating in the ToyBox-study (Belgium, Bulgaria, Germany, Greece, Poland, and Spain) 7554 children/families and their age is 3.5–5.5 years, 51.9% were boys collected cross-sectionally in 2012. The questionnaires included parents’ self-reported data on their weight, height, socio-demographic status, and infant feeding practices. Measurements of preschool children’s weight and height were done by trained researchers using standard protocols and equipment. The ever breastfeeding rate in the total sample was 85.0% (n = 5777). Only 6.3% (n = 428) of the children from the general sample were exclusively breastfed (EBF) for the duration of the first six months. EBF for four to six months was significantly (p < 0.001) less likely among mothers with formal education < 12 years (adjusted Odds Ratio (OR) = 0.61; 95% Confidence interval (CI) 0.44–0.85), smoking throughout pregnancy (adjusted OR = 0.39; 95% CI 0.24–0.62), overweight before pregnancy (adjusted OR = 0.67; 95%CI 0.47–0.95) and ≤25 years old. The median duration of any breastfeeding was five months. The prevalence of exclusive formula feeding during the first five months in the general sample was about 12% (n = 830). The prevalence of overweight and obesity at preschool age was 8.0% (n = 542) and 2.8% (n = 190), respectively. The study did not identify any significant association between breastfeeding practices and obesity in childhood when adjusted for relevant confounding factors (p > 0.05). It is likely that sociodemographic and lifestyle factors associated with breastfeeding practices may have an impact on childhood obesity. The identified lower than desirable rates and duration of breastfeeding practices should prompt enhanced efforts for effective promotion, protection, and support of breastfeeding across Europe, and in particular in regions with low BF rates.
Collapse
Affiliation(s)
- Natalya Usheva
- Department of Social Medicine and Health Care Organization, Medical University of Varna, 9002 Varna, Bulgaria
- Correspondence: ; Tel.: +359-52677164
| | - Mina Lateva
- Department of Pediatrics, Medical University of Varna, 9002 Varna, Bulgaria; (M.L.); (S.G.); (V.I.)
| | - Sonya Galcheva
- Department of Pediatrics, Medical University of Varna, 9002 Varna, Bulgaria; (M.L.); (S.G.); (V.I.)
| | - Berthold V. Koletzko
- Division of Metabolic and Nutritional Medicine, Department Paediatrics, Dr. von Hauner Children’s Hospital, LMU University Hospitals, 80337 Munich, Germany;
| | - Greet Cardon
- Department of Movement and Sports Sciences, Ghent University, 9000 Ghent, Belgium;
| | - Marieke De Craemer
- Department of Rehabilitation Sciences, Ghent University, 9000 Ghent, Belgium;
- Research Foundation Flanders, 1000 Brussels, Belgium
| | - Odysseas Androutsos
- Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, 382 21 Volos, Greece;
| | - Aneta Kotowska
- Public Health Department, Children’s Memorial Health Institute, 04-730 Warsaw, Poland; (A.K.); (P.S.)
| | - Piotr Socha
- Public Health Department, Children’s Memorial Health Institute, 04-730 Warsaw, Poland; (A.K.); (P.S.)
| | - Luis A. Moreno
- GENUD (Growth, Exercise, Drinking Behaviour and Development) Research Group, University of Zaragoza, 50009 Zaragoza, Spain;
| | - Yannis Manios
- Department of Nutrition and Dietetics, Harokopio University, 176 76 Athens, Greece;
| | - Violeta Iotova
- Department of Pediatrics, Medical University of Varna, 9002 Varna, Bulgaria; (M.L.); (S.G.); (V.I.)
| | | |
Collapse
|
32
|
Wever MCM, van Meer F, Charbonnier L, Crabtree DR, Buosi W, Giannopoulou A, Androutsos O, Johnstone AM, Manios Y, Meek CL, Holst JJ, Smeets PAM. Associations between ghrelin and leptin and neural food cue reactivity in a fasted and sated state. Neuroimage 2021; 240:118374. [PMID: 34245869 DOI: 10.1016/j.neuroimage.2021.118374] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 07/02/2021] [Accepted: 07/06/2021] [Indexed: 10/20/2022] Open
Abstract
Food cue exposure can trigger eating. Food cue reactivity (FCR) is a conditioned response to food cues and includes physiological responses and activation of reward-related brain areas. FCR can be affected by hunger and weight status. The appetite-regulating hormones ghrelin and leptin play a pivotal role in homeostatic as well as hedonic eating. We examined the association between ghrelin and leptin levels and neural FCR in the fasted and sated state and the association between meal-induced changes in ghrelin and neural FCR, and in how far these associations are related to BMI and HOMA-IR. Data from 109 participants from three European centers (age 50±18 y, BMI 27±5 kg/m2) who performed a food viewing task during fMRI after an overnight fast and after a standardized meal were analyzed. Blood samples were drawn prior to the viewing task in which high-caloric, low-caloric and non-food images were shown. Fasting ghrelin was positively associated with neural FCR in the inferior and superior occipital gyrus in the fasted state. This was partly attributable to BMI and HOMA-IR. These brain regions are involved in visual attention, suggesting that individuals with higher fasting ghrelin have heightened attention to food cues. Leptin was positively associated with high calorie FCR in the medial prefrontal cortex (PFC) in the fasted state and to neural FCR in the left supramarginal gyrus in the fasted versus sated state, when correcting for BMI and HOMA-IR, respectively. This PFC region is involved in assessing anticipated reward value, suggesting that for individuals with higher leptin levels high-caloric foods are more salient than low-caloric foods, but foods in general are not more salient than non-foods. There were no associations between ghrelin and leptin and neural FCR in the sated state, nor between meal-induced changes in ghrelin and neural FCR. In conclusion, we show modest associations between ghrelin and leptin and neural FCR in a relatively large sample of European adults with a broad age and BMI range. Our findings indicate that people with higher leptin levels for their weight status and people with higher ghrelin levels may be more attracted to high caloric foods when hungry. The results of the present study form a foundation for future studies to test whether food intake and (changes in) weight status can be predicted by the association between (mainly fasting) ghrelin and leptin levels and neural FCR.
Collapse
Affiliation(s)
- Mirjam C M Wever
- Image Sciences Institute, University Medical Center Utrecht Brain Center, Utrecht University, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands
| | - Floor van Meer
- Image Sciences Institute, University Medical Center Utrecht Brain Center, Utrecht University, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands
| | - Lisette Charbonnier
- Image Sciences Institute, University Medical Center Utrecht Brain Center, Utrecht University, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands
| | - Daniel R Crabtree
- The Rowett Institute, University of Aberdeen, Foresterhill Road AB25 2ZD, Scotland; Division of Biomedical Sciences, Centre for Health Science, University of the Highlands and Islands, Inverness IV2 3JH, United Kingdom
| | - William Buosi
- The Rowett Institute, University of Aberdeen, Foresterhill Road AB25 2ZD, Scotland
| | - Angeliki Giannopoulou
- Department of Nutrition-Dietetics, School of Health Science & Education, Harokopio University Athens, 70 El. Venizelou avenue, 17671 Kallithea, Greece
| | - Odysseas Androutsos
- Department of Nutrition-Dietetics, School of Health Science & Education, Harokopio University Athens, 70 El. Venizelou avenue, 17671 Kallithea, Greece; Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, Trikala 42132, Greece
| | | | - Yannis Manios
- Department of Nutrition-Dietetics, School of Health Science & Education, Harokopio University Athens, 70 El. Venizelou avenue, 17671 Kallithea, Greece
| | - Claire L Meek
- Department of Clinical Biochemistry, Cambridge University Hospitals, Cambridge, United Kingdom; Institute of Metabolic Science, University of Cambridge, Cambridge Biomedical Campus, Hills Rd, Cambridge CB2 0QQ, United Kingdom
| | - Jens J Holst
- NNF Center for Basic Metabolic Research and Research Section, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Paul A M Smeets
- Image Sciences Institute, University Medical Center Utrecht Brain Center, Utrecht University, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands; Division of Human Nutrition and Health, Wageningen University, Stippeneng 4, 6708 WE, Wageningen, the Netherlands.
| | | |
Collapse
|
33
|
Miguel-Berges ML, Santaliestra-Pasias AM, Mouratidou T, Flores-Barrantes P, Androutsos O, De Craemer M, Galcheva S, Koletzko B, Kulaga Z, Manios Y, Moreno LA. Parental perceptions, attitudes and knowledge on European preschool children's total screen time: the ToyBox-study. Eur J Public Health 2021; 30:105-111. [PMID: 31501880 DOI: 10.1093/eurpub/ckz151] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Preschool children spend a significant proportion of their waking hours being sedentary. Parents play a critical role in developing and shaping their children's lifestyle behaviours, particularly in the early years of life. This study aims to assess parental perceptions, attitudes and knowledge of their preschool children's sedentary behaviours and the association with children's television (TV)/video/DVDs viewing and total screen time. METHODS Data were obtained from a sample of 4836 children (3.5-5.5 years), participating in the multi-centre ToyBox-study at baseline (T0) and at 1-year follow-up (T1) periods. Data on children's sedentary behaviours were collected via a standardized proxy-administered primary caregiver's questionnaire. RESULTS Regarding total screen time, 66.6% of the children at T0 and 71.8% at T1 in the control group exceeded the recommendations, whereas the proportion in the intervention group varied from 69.7% at T0 to 72.5% at T1. The odds of exceeding total screen time recommendations were significantly higher when parental perceptions towards limiting the total screen time were negative [(both T0 and T1 and in the intervention and control groups (P < 0.05)]. Similarly, the odds of exceeding TV/video/DVDs viewing recommendations were significantly higher (both T0 and T1 is observed in both groups) when parental knowledge of recommendation were absent. CONCLUSIONS Preschool children whose caregivers stated rules limiting their sedentary screen time were less likely to spend a high amount of time watching TV/video/DVDs. Interventions to increase parental practices may be a promising approach to decrease total screen time of preschool children but studies are needed to confirm this.
Collapse
Affiliation(s)
- María L Miguel-Berges
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Zaragoza, Spain.,Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain.,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Zaragoza, Spain
| | - Alba M Santaliestra-Pasias
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Zaragoza, Spain.,Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain.,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Zaragoza, Spain.,Facultad de Ciencias de la Salud y del Deporte, Universidad de Zaragoza, Zaragoza, Spain
| | - Theodora Mouratidou
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Zaragoza, Spain
| | - Paloma Flores-Barrantes
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Zaragoza, Spain.,Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain.,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Zaragoza, Spain
| | - Odysseas Androutsos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Marieke De Craemer
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | | | - Berthold Koletzko
- Dr von Hauner Children's Hospital, University of Munich Medical Centre, Munich, Germany
| | | | - Yannis Manios
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Luis A Moreno
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Zaragoza, Spain.,Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain.,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Zaragoza, Spain.,Facultad de Ciencias de la Salud y del Deporte, Universidad de Zaragoza, Zaragoza, Spain
| |
Collapse
|
34
|
Morres ID, Galanis E, Hatzigeorgiadis A, Androutsos O, Theodorakis Y. Physical Activity, Sedentariness, Eating Behaviour and Well-Being during a COVID-19 Lockdown Period in Greek Adolescents. Nutrients 2021; 13:1449. [PMID: 33923341 PMCID: PMC8147023 DOI: 10.3390/nu13051449] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 04/13/2021] [Accepted: 04/21/2021] [Indexed: 01/11/2023] Open
Abstract
Adolescents' daily life has dramatically changed during the COVID-19 era due to the social restrictions that have been imposed, including closures of schools, leisure centers and sport facilities. The purpose of this study was to examine levels of well-being and mood and their relations with physical (in)activity and eating behaviors in adolescents during a lockdown period in Greece. A total of 950 adolescents (Mean Age = 14.41 years ± 1.63) participated in a web-based survey while education was conducted online and organized sport activities were interrupted. Participants showed poor well-being, insufficient physical activity levels and moderate scores of healthy eating behavior. Hierarchical regression analysis showed that, after controlling for the effect of gender and body mass index, increased physical activity and healthier eating behavior predicted better well-being (b = 0.24, p < 0.01 and b = 0.19, p < 0.01, respectively), whereas sedentariness predicted worse well-being (b = -0.16, p < 0.01). Furthermore, it was revealed that days of physical activity per week was a stronger predictor of well-being than minutes of physical activity per week, and that both in-house and out-of-house physical activity were beneficial. Considering that well-being in our study was below the threshold recommended by the World Health Organization as indicative of possible depressive symptoms, measures to increase physical activity, decrease sedentariness and improve eating behavior should become a priority for communities and policy makers.
Collapse
Affiliation(s)
- Ioannis D. Morres
- Department of Physical Education and Sport Science, University of Thessaly, 42100 Trikala, Greece; (I.D.M.); (E.G.); (Y.T.)
| | - Evangelos Galanis
- Department of Physical Education and Sport Science, University of Thessaly, 42100 Trikala, Greece; (I.D.M.); (E.G.); (Y.T.)
| | - Antonis Hatzigeorgiadis
- Department of Physical Education and Sport Science, University of Thessaly, 42100 Trikala, Greece; (I.D.M.); (E.G.); (Y.T.)
| | - Odysseas Androutsos
- Department of Nutrition and Dietetics, University of Thessaly, 42132 Trikala, Greece;
| | - Yannis Theodorakis
- Department of Physical Education and Sport Science, University of Thessaly, 42100 Trikala, Greece; (I.D.M.); (E.G.); (Y.T.)
| |
Collapse
|
35
|
Charbonnier L, van Meer F, Johnstone AM, Crabtree D, Buosi W, Manios Y, Androutsos O, Giannopoulou A, Viergever MA, Smeets PAM. Corrigendum to "Effects of hunger state on the brain responses to food cues across the life span" [NeuroImage 171 (2018) 246-255]. Neuroimage 2021; 233:117860. [PMID: 33740619 DOI: 10.1016/j.neuroimage.2021.117860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
- L Charbonnier
- Image Sciences Institute, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - F van Meer
- Image Sciences Institute, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - A M Johnstone
- Rowett Institute, University of Aberdeen, Foresterhill Road, AB25 2ZD Scotland, United Kingdom
| | - D Crabtree
- Rowett Institute, University of Aberdeen, Foresterhill Road, AB25 2ZD Scotland, United Kingdom
| | - W Buosi
- Rowett Institute, University of Aberdeen, Foresterhill Road, AB25 2ZD Scotland, United Kingdom
| | - Y Manios
- Department of Nutrition-Dietetics, School of Health Science & Education, Harokopio University Athens, 70 El. Venizelou Avenue, 17671 Kallithea, Greece
| | - O Androutsos
- Department of Nutrition-Dietetics, School of Health Science & Education, Harokopio University Athens, 70 El. Venizelou Avenue, 17671 Kallithea, Greece
| | - A Giannopoulou
- Department of Nutrition-Dietetics, School of Health Science & Education, Harokopio University Athens, 70 El. Venizelou Avenue, 17671 Kallithea, Greece
| | - M A Viergever
- Image Sciences Institute, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - P A M Smeets
- Image Sciences Institute, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands; Division of Human Nutrition, Wageningen University, Stippeneng 4, 6708 WE Wageningen, The Netherlands.
| | | |
Collapse
|
36
|
Androutsos O, Perperidi M, Georgiou C, Chouliaras G. Lifestyle Changes and Determinants of Children's and Adolescents' Body Weight Increase during the First COVID-19 Lockdown in Greece: The COV-EAT Study. Nutrients 2021; 13:nu13030930. [PMID: 33805678 PMCID: PMC7998995 DOI: 10.3390/nu13030930] [Citation(s) in RCA: 100] [Impact Index Per Article: 33.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 03/05/2021] [Accepted: 03/10/2021] [Indexed: 01/31/2023] Open
Abstract
Previous studies showed that the coronavirus disease 2019 (COVID-19) lockdown imposed changes in adults’ lifestyle behaviors; however, there is limited information regarding the effects on youth. The COV-EAT study aimed to report changes in children’s and adolescents’ lifestyle habits during the first COVID-19 lockdown and explore potential associations between changes of participants’ lifestyle behaviors and body weight. An online survey among 397 children/adolescents and their parents across 63 municipalities in Greece was conducted in April–May 2020. Parents self-reported changes of their children’s lifestyle habits and body weight, as well as sociodemographic data of their family. The present study shows that during the lockdown, children’s/adolescents’ sleep duration and screen time increased, while their physical activity decreased. Their consumption of fruits and fresh fruit juices, vegetables, dairy products, pasta, sweets, total snacks, and breakfast increased, while fast-food consumption decreased. Body weight increased in 35% of children/adolescents. A multiple regression analysis showed that the body weight increase was associated with increased consumption of breakfast, salty snacks, and total snacks and with decreased physical activity. The COV-EAT study revealed changes in children’s and adolescents’ lifestyle behaviors during the first COVID-19 lockdown in Greece. Effective strategies are needed to prevent excessive body weight gain in future COVID-19 lockdowns.
Collapse
Affiliation(s)
- Odysseas Androutsos
- Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, 42132 Trikala, Greece; (M.P.); (C.G.)
- Correspondence: ; Tel.: +30-24310-47108
| | - Maria Perperidi
- Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, 42132 Trikala, Greece; (M.P.); (C.G.)
| | - Christos Georgiou
- Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, 42132 Trikala, Greece; (M.P.); (C.G.)
| | - Giorgos Chouliaras
- Second Department of Paediatrics, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| |
Collapse
|
37
|
Vlassopoulos A, Govers E, Mulrooney H, Androutsos O, Hassapidou M. Dietetic management of obesity in Europe: gaps in current practice. Eur J Clin Nutr 2021; 75:1155-1158. [PMID: 33398102 DOI: 10.1038/s41430-020-00820-2] [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] [Received: 06/02/2020] [Revised: 10/24/2020] [Accepted: 11/17/2020] [Indexed: 11/09/2022]
Abstract
Despite substantial attention to dietary interventions on the management of obesity, there are no consensus guidelines for dietetic management of obesity in Europe. Two surveys among European dietitians have demonstrated inconsistencies in the approaches recommended within national obesity treatment guidelines. Only a small number of the guidelines include concrete actionable targets for recommended energy deficit, weight loss and weight-loss maintenance. On the other hand, dietitians frequently use 5-15% weight loss as their intervention outcome. However, they fail to monitor changes in body composition beyond weight status and to successfully monitor and prevent weight regain. Europewide guidelines on the dietary treatment of obesity are an overdue requirement for consistent dietetic practice.
Collapse
Affiliation(s)
- Antonis Vlassopoulos
- Department of Food Science & Human Nutrition, Agricultural University of Athens, Athens, Greece.,Department of Nutritional Sciences and Dietetics, International Hellenic University, Thessaloniki, Greece.,European Specialist Dietetic Network on Obesity, European Federation of the Associations of Dietitians (EFAD), Naarden, Netherlands
| | - Elisabeth Govers
- European Specialist Dietetic Network on Obesity, European Federation of the Associations of Dietitians (EFAD), Naarden, Netherlands.,Dutch Knowledge Centre for Dietitians on Obesity, Amsterdam, Netherlands.,Nutrition Working Group, European Association for the Study of Obesity (EASO), Teddington, UK
| | - Hilda Mulrooney
- European Specialist Dietetic Network on Obesity, European Federation of the Associations of Dietitians (EFAD), Naarden, Netherlands.,Kingston University, London & Obesity Group of the British Dietetic Association, London, UK
| | - Odysseas Androutsos
- European Specialist Dietetic Network on Obesity, European Federation of the Associations of Dietitians (EFAD), Naarden, Netherlands.,Department of Nutrition & Dietetics, University of Thessaly, Trikala, Greece
| | - Maria Hassapidou
- Department of Nutritional Sciences and Dietetics, International Hellenic University, Thessaloniki, Greece. .,European Specialist Dietetic Network on Obesity, European Federation of the Associations of Dietitians (EFAD), Naarden, Netherlands. .,Nutrition Working Group, European Association for the Study of Obesity (EASO), Teddington, UK.
| |
Collapse
|
38
|
De Craemer M, Verbestel V, Verloigne M, Androutsos O, Moreno L, Iotova V, Koletzko B, Socha P, Manios Y, Cardon G. Combining Effect and Process Evaluation on European Preschool Children's Snacking Behavior in a Kindergarten-Based, Family-Involved Cluster Randomized Controlled Trial: The ToyBox Study. Int J Environ Res Public Health 2020; 17:ijerph17197312. [PMID: 33036371 PMCID: PMC7579655 DOI: 10.3390/ijerph17197312] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 09/14/2020] [Accepted: 10/01/2020] [Indexed: 11/16/2022]
Abstract
This study aimed at (1) studying the effect of the standardized ToyBox intervention on European preschoolers' snacking behavior, and (2) studying whether a higher process evaluation score from teachers and parents/caregivers was associated with a more positive result for preschoolers' snack intake. A sample of 4970 preschoolers (51.4% boys, 4.74 ± 0.44 years) from six European countries provided information on snack intake with the use of a Food Frequency Questionnaire. To investigate the effect of the intervention, multilevel repeated measures analyses were executed for the total sample and the six country-specific samples. Furthermore, questionnaires to measure process evaluation were used to compute a total process evaluation score for teachers and parents/caregivers. No significant intervention effects on preschoolers' snack intake were found (all p > 0.003). In general, no different effects of the intervention on snack intake were found according to kindergarten teachers' and parents'/caregivers' process evaluation scores. The lack of effects could be due to limited intervention duration and dose. To induce larger effects on preschoolers' snack intake, a less standardized intervention which is more tailored to the local needs might be needed.
Collapse
Affiliation(s)
- Marieke De Craemer
- Department of Rehabilitation Sciences, Ghent University, 9000 Ghent, Belgium;
- Research Foundation Flanders, 1000 Brussels, Belgium;
- Correspondence: ; Tel.: +32-9332-52-08
| | - Vera Verbestel
- Department of Rehabilitation Sciences, Ghent University, 9000 Ghent, Belgium;
| | - Maïté Verloigne
- Research Foundation Flanders, 1000 Brussels, Belgium;
- Department of Public Health and Primary Care, Ghent University, 9000 Ghent, Belgium
| | - Odysseas Androutsos
- Department of Nutrition and Dietetics, School of Physical Education, University of Thessaly, Sport Science and Dietetics, 421 00 Trikala, Greece;
| | - Luis Moreno
- Department of Physiatry and Nursing, GENUD (Growth, Exercise, Drinking Behaviour and Development), University of Zaragoza, 50001 Zaragoza, Spain;
| | - Violeta Iotova
- Department of Pediatrics, Medical University Varna, 9002 Varna, Bulgaria;
| | - Berthold Koletzko
- Dr. von Hauner Children’s Hospital, University of Munich Medical Centre, 80337 Munich, Germany;
| | - Piotr Socha
- Children’s Memorial Institute, 04-730 Warsaw, Poland;
| | - Yannis Manios
- Department of Nutrition and Dietetics, School of Health Sciences & Education, Harokopio University, 17778 Athens, Greece;
| | - Greet Cardon
- Department of Movement and Sports Sciences, Ghent University, 9000 Ghent, Belgium;
| |
Collapse
|
39
|
De Craemer M, Verbestel V, Cardon G, Androutsos O, Manios Y, Chastin S. Correlates of Meeting the Physical Activity, Sedentary Behavior, and Sleep Guidelines for the Early Years among Belgian Preschool Children: The ToyBox-Study. Int J Environ Res Public Health 2020; 17:ijerph17197006. [PMID: 32987961 PMCID: PMC7579535 DOI: 10.3390/ijerph17197006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 09/18/2020] [Accepted: 09/21/2020] [Indexed: 01/28/2023]
Abstract
Physical activity, sedentary behavior, and sleep guidelines for preschool children were already established and integrated into the 24 h movement behavior guidelines in 2017. The aim of the current study was to investigate correlates of meeting or not meeting the physical activity, sedentary behavior, and sleep guidelines in Belgian preschool children. In total, 595 preschool children (53.3% boys, 46.7% girls, mean age: 4.2 years) provided complete data for the three behaviors and potentially associated correlates. Physical activity was objectively measured with accelerometers. Screen time, sleep duration, and correlates were reported by parents with the use of a questionnaire. Backward logistic regression was used to identify factors associated with meeting all guidelines for weekdays and weekend days. In the final model, older preschoolers (OR = 1.89), having a normal weight compared to being underweight (OR = 0.30), having parents that do not watch a lot of television (OR = 0.99), and having a father that attained higher education (OR = 1.91) were associated with meeting all guidelines on weekdays. For weekend days, a significant association was found for attending a sports club (OR = 1.08). Overall, only a few factors were associated with meeting the guidelines. A more comprehensive measurement of preschool children’s potential correlates of physical activity, sedentary behavior, and sleep is warranted.
Collapse
Affiliation(s)
- Marieke De Craemer
- Department of Rehabilitation Sciences, Ghent University, 9000 Ghent, Belgium;
- Research Foundation Flanders, 1000 Brussels, Belgium
- Correspondence: ; Tel.: +32-9332-52-08
| | - Vera Verbestel
- Department of Rehabilitation Sciences, Ghent University, 9000 Ghent, Belgium;
| | - Greet Cardon
- Department of Movement and Sports Sciences, Ghent University, 9000 Ghent, Belgium;
| | - Odysseas Androutsos
- Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, 42100 Trikala, Greece;
| | - Yannis Manios
- School of Health Sciences & Education, Department of Nutrition and Dietetics, Harokopio University, 17676 Athens, Greece;
| | - Sebastien Chastin
- Department of Health and Community Sciences, Glasgow Caledonian University, Glasgow G4 0BA, UK;
| |
Collapse
|
40
|
Huys N, Van Stappen V, Shadid S, De Craemer M, Androutsos O, Wikström K, Makrilakis K, Moreno LA, Iotova V, Tankova T, Nánási A, Manios Y, Cardon G. Effectiveness of a family-, school- and community-based intervention on physical activity and its correlates in Belgian families with an increased risk for type 2 diabetes mellitus: the Feel4Diabetes-study. BMC Public Health 2020; 20:1231. [PMID: 32787943 PMCID: PMC7425007 DOI: 10.1186/s12889-020-09336-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 08/03/2020] [Indexed: 11/23/2022] Open
Abstract
Background The study aimed to investigate the effectiveness of the European Feel4Diabetes intervention, promoting a healthy lifestyle, on physical activity and its correlates among families at risk for type 2 diabetes mellitus (based on the Finnish Diabetes Risk Score) in Belgium. Methods The Feel4Diabetes intervention involved three components: family, school and community component, with the family component consisting of 6 counseling sessions for families at risk. Main outcomes were objectively measured physical activity levels and its subjectively measured correlates. The final sample consisted of 454 parents (mean age 39.4 years; 72.0% women) and 444 children (mean age 8.0 years; 50.1% girls). Multilevel repeated measures analyses were performed to assess intervention effectiveness after 1 year. Results In parents, there was no significant intervention effect. In children, there were only significant negative effects for moderate to vigorous physical activity (p = 0.05; ηp2 = 0.008) and steps (p = 0.03; ηp2 = 0.006%) on weekdays, with physical activity decreasing (more) in the intervention group. Conclusions The F4D-intervention lacks effectiveness on high-risk families’ physical activity and its correlates in Belgium. This could partially be explained by low attendance rates and a large drop-out. To reach vulnerable populations, future interventions should invest in more appropriate recruitment (e.g. more face-to-face contact) and more bottom-up development of the intervention (i.e. co-creation of the intervention with the target group). Trial registration The Feel4Diabetes-study was prospectively registered at clinicaltrials.gov as NCT02393872 on 20 March 2015.
Collapse
Affiliation(s)
- Nele Huys
- Department of Movement and Sport Sciences, Ghent University, Watersportlaan 2, 9000, Ghent, Belgium.
| | - Vicky Van Stappen
- Department of Movement and Sport Sciences, Ghent University, Watersportlaan 2, 9000, Ghent, Belgium
| | - Samyah Shadid
- Department of Endocrinology and Metabolic Diseases, Ghent University Hospital, Corneel Heymanslaan, 10, Ghent, Belgium
| | - Marieke De Craemer
- Department of Rehabilitation Sciences, Ghent University, Corneel Heysmanslaan, 10, Ghent, Belgium.,Research Foundation Flanders, Egmontstraat 5, Brussels, Belgium
| | - Odysseas Androutsos
- Department of Nutrition and Dietetics, School of Health Sciences & Education, Harokopio University, El. Venizelou 70, Kallithea, Athens, Greece
| | - Katja Wikström
- Department of Public Health Solutions, National Institute for Health and Welfare, Mannerheimintie, 166, Helsinki, Finland
| | - Konstantinos Makrilakis
- First Department of Propaedeutic Internal Medicine, National and Kapodistrian University of Athens, 75 Mikras Asias str, Athens, Greece
| | - Luis A Moreno
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón), University of Zaragoza, Calle Pedro Cerbuna, 12, Zaragoza, Spain
| | - Violeta Iotova
- Department of Paediatrics, Medical University of Varna, 55 Marin Drinov str, Varna, Bulgaria
| | - Tsvetalina Tankova
- Clinical Center of Endocrinology, Medical University of Sofia, Boulevard "Akademik Ivan Evstratiev Geshov, 15, Sofia, Bulgaria
| | - Anna Nánási
- Department of Family and Occupational Medicine, University of Debrecen, Egyeterm tér 1, Debrecen, Hungary
| | - Yannis Manios
- Department of Nutrition and Dietetics, School of Health Sciences & Education, Harokopio University, El. Venizelou 70, Kallithea, Athens, Greece
| | - Greet Cardon
- Department of Movement and Sport Sciences, Ghent University, Watersportlaan 2, 9000, Ghent, Belgium
| | | |
Collapse
|
41
|
Kondakis K, Kondakis M, Androutsos O, De Henauw S, González-Gross M, Moreno LA, Kafatos A, Manios Y. Cardiorespiratory fitness is associated with body composition and insulin resistance in European adolescents: HELENA study. J Sports Med Phys Fitness 2020; 60:1349-1357. [PMID: 32608216 DOI: 10.23736/s0022-4707.20.10675-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The present study aimed to examine the independent association between cardiorespiratory fitness, sedentary time and insulin resistance in European adolescents. METHODS A subset (N.=1097) of a large multicenter European study (HELENA-CSS study) was used in the present study. Serum concentrations of glucose (G<inf>F</inf>) and insulin (I<inf>F</inf>) were measured after overnight fast and homeostasis model assessment (HOMA-IR) was calculated. Sedentary time and time spent on moderate-to-vigorous physical activity (MVPA) was objectively measured by accelerometers. Moreover, sedentary activities were self-reported via questionnaires. RESULTS Multilevel linear regression analysis revealed that adolescents watching TV≥2 h/day had higher HOMA-IR (P=0.007). Further adjustment for MVPA, showed that watching TV≥2 h/day remained significantly associated with IR (P=0.002). In this model, MVPA was inversely associated with HOMA-IR (P=0.001). Further controlling for waist circumference showed that adolescents watching TV≥2 h/day continued to have higher HOMA-IR levels (P=0.002). Stratified analysis by weight status, revealed that watching TV≥2 h/day was independently associated with HOMA-IR only in normal weight adolescents, while MVPA was inversely associated with HOMA-IR in both overweight/obese and normal weight adolescents. Only the volume of maximum oxygen consumption (VO<inf>2</inf>max) over body fat mass ratio was inversely associated with HOMA-IR after controlling for several confounders. CONCLUSIONS The present study showed that watching TV≥2 h/day and MVPA were associated with HOMA-IR. However, after controlling for several confounders, only VO<inf>2</inf>max/body fat mass ratio remained negatively associated with HOMA-IR. Future interventions should aim both to promote physical activity and reduce sedentary time in adolescents to improve their cardiorespiratory fitness and postpone the onset of diabetes in adulthood.
Collapse
Affiliation(s)
| | - Marios Kondakis
- Department of Statistics, Athens University of Economics and Business, Athens, Greece
| | | | | | - Marcela González-Gross
- Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences, Polytechnic of Madrid, Madrid, Spain
| | - Luis A Moreno
- University School of Health Sciences, University of Zaragoza, Zaragoza, Spain
| | - Anthony Kafatos
- Unit of Preventive Medicine and Nutrition, UoC School of Medicine, University of Crete, Heraklion, Greece
| | - Yannis Manios
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| |
Collapse
|
42
|
Lambrinou CP, Androutsos O, Karaglani E, Cardon G, Huys N, Wikström K, Kivelä J, Ko W, Karuranga E, Tsochev K, Iotova V, Dimova R, De Miguel-Etayo P, M. González-Gil E, Tamás H, JANCSÓ Z, Liatis S, Makrilakis K, Manios Y. Effective strategies for childhood obesity prevention via school based, family involved interventions: a critical review for the development of the Feel4Diabetes-study school based component. BMC Endocr Disord 2020; 20:52. [PMID: 32370795 PMCID: PMC7201517 DOI: 10.1186/s12902-020-0526-5] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Accepted: 03/23/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Although there are many interventions targeting childhood obesity prevention, only few have demonstrated positive results. The current review aimed to gather and evaluate available school-based intervention studies with family involvement targeting dietary, physical activity and sedentary behaviors among primary schoolchildren and their families, in order to identify the most effective strategies. METHODS Studies published between 2000 and January 2015 were retrieved from scientific electronic databases and grey literature. The databases used included MEDLINE/PubMed, Web-of-Science, CINAHL and Scopus. Included studies had to be experimental controlled studies and had duration over 1 school year, had family involvement, combined PA and dietary behaviors and were implemented in school setting. A complementary search was executed to update the review to cover the period from February 2015 to January 2019. RESULTS From the studies examined (n = 425), 27 intervention programs (33 publications) fulfilled the inclusion criteria. Among these, 15 presented significant effect on weight status and/ or overweight/ obesity or clinical indices, 3 presented significant effect on most energy balance-related behaviors (EBRBs) while 9 presented significant effect on some/few EBRBs or determinants. Strategies implemented in effective interventions were: teachers acting as role-models and being actively involved in the delivery of the intervention, school policies supporting the availability of healthy food and beverage choices and limiting unhealthy snacks, changes in the schoolyard, in the recess rules and in the physical education classes to increase physical activity, and involving parents in the intervention via assignments, meetings, informative material and encouraging them to improve the home environment. Use of incentives for children, social marketing techniques, collaboration with local stakeholders were found to increase effectiveness. Programs that focused only on educational sessions and material for parents, without promoting relevant environmental and policy changes, were found to be less effective. Cultural adaptations have been suggested to increase the intervention's acceptance in specific or vulnerable population groups. CONCLUSIONS Several effective strategies were identified in the reviewed programs. Outcomes of the current review were taken into account in developing the Feel4Diabetes-intervention and summed up as recommendations in the current work in order to facilitate other researchers designing similar childhood obesity prevention initiatives.
Collapse
Affiliation(s)
- Christina-Paulina Lambrinou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 70 El Venizelou Ave, 176 71 Kallithea, Athens, Greece
| | - Odysseas Androutsos
- Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, Trikala, Greece
| | - Eva Karaglani
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 70 El Venizelou Ave, 176 71 Kallithea, Athens, Greece
| | - Greet Cardon
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Nele Huys
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Katja Wikström
- Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland
| | - Jemina Kivelä
- Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland
| | - Winne Ko
- International Diabetes Federation European Region, Brussels, Belgium
| | - Ernest Karuranga
- International Diabetes Federation European Region, Brussels, Belgium
| | - Kaloyan Tsochev
- Department of Pediatrics, Medical University Varna, Varna, Bulgaria
| | - Violeta Iotova
- Department of Pediatrics, Medical University Varna, Varna, Bulgaria
| | - Roumyana Dimova
- Department of Diabetology, Clinical Center of Endocrinology, Medical University Sofia, Sofia, Bulgaria
| | - Pilar De Miguel-Etayo
- Growth, Exercise, NUtrition and Development (GENUD) Research Group. Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón), University of Zaragoza, Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), University of Zaragoza, Zaragoza, Spain
| | - Esther M. González-Gil
- Growth, Exercise, NUtrition and Development (GENUD) Research Group. Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón), University of Zaragoza, Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), University of Zaragoza, Zaragoza, Spain
- Institute of Nutrition and Food Technology. Department of Biochemistry and Molecular Biology II, Center of Biomedical Research, University of Granada, Granada, Spain
| | - Hajnalka Tamás
- University of Debrecen, Department of Family and Occupational Medicine, Debrecen, Hungary
| | - Zoltán JANCSÓ
- University of Debrecen, Department of Family and Occupational Medicine, Debrecen, Hungary
| | - Stavros Liatis
- National and Kapodistrian University of Athens, Athens, Greece
| | | | - Yannis Manios
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 70 El Venizelou Ave, 176 71 Kallithea, Athens, Greece
| | | |
Collapse
|
43
|
Santos TSS, Julián C, Vincenzi SL, de Andrade DF, Slater B, de Assis MAA, Kafatos A, de Henauw S, Gottrand F, Androutsos O, Kersting M, Sjöström M, Forsner M, Moreno LA. A new measure of health motivation influencing food choices and its association with food intakes and nutritional biomarkers in European adolescents. Public Health Nutr 2020; 24:1-11. [PMID: 33052082 DOI: 10.1017/s1368980019004658] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To develop a scale to assess health motivation influencing food choices and to explore its performance in the associations with food intakes and nutritional biomarkers. DESIGN Psychometric study using cross-sectional self-report questionnaires and nutritional biomarkers. SETTING Multi-centre investigation conducted in ten European cities. PARTICIPANTS 2954 adolescents who were included in the HELENA study and completed the Food Choices and Preferences (FCP) questionnaire. RESULTS Nineteen out of 124 items of the FCP questionnaire were in the same dimension. Sixteen presented adequate parameters for the Scale of evaluatiOn of Food choIcEs (SOFIE). The scores were positively associated with the intakes of cereals, dairy products, meats and eggs, and fish, as well as with blood concentrations of vitamin C, β-carotene, n-3 fatty acids, cobalamin, holo-transcobalamin and folate; scores were negatively associated with the intake of alcohol. CONCLUSIONS SOFIE can improve the assessment of motivation influencing food choices based on items with the best performance and is proposed as a new measure to health-related studies.
Collapse
Affiliation(s)
| | - Cristina Julián
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Universidad de Zaragoza, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria de Aragón (IIS Aragón) and Centro de Investigación Biomédica en Red de Fisiopatología de la Nutrición y la Obesidad (CIBEROBN), Zaragoza50009, Spain
| | - Silvana Ligia Vincenzi
- Department of Informatics and Statistics, Federal University of Santa Catarina, Technological Center, Florianópolis, Santa CatarinaCEP: 88040-900, Brazil
| | - Dalton Francisco de Andrade
- Department of Informatics and Statistics, Federal University of Santa Catarina, Technological Center, Florianópolis, Santa CatarinaCEP: 88040-900, Brazil
| | - Betzabeth Slater
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, SPCEP: 01246-904, Brazil
| | - Maria Alice Altenburg de Assis
- Department of Nutrition, Federal University of Santa Catarina, Health Sciences Center, Florianópolis, Santa CatarinaCEP: 88040-900, Brazil
| | - Anthony Kafatos
- Preventive Medicine and Nutrition Clinic, School of Medicine, University of Crete, Heraklion741 00, Greece
| | - Stefaan de Henauw
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent9000, Belgium
| | - Fréderic Gottrand
- Department of Pediatrics, CHU Lille, University of Lille, Inserm UMR995, LilleF-59000, France
| | - Odysseas Androutsos
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens17671, Greece
| | - Mathilde Kersting
- Research Department of Child Nutrition, Pediatric University Clinic, Ruhr-University Bochum, Bochum44801, Germany
| | - Michael Sjöström
- Departament of Bioscience and Nutrition, Karolinska Institute, Solna171 77, Sweden
| | - Maria Forsner
- Departament of Bioscience and Nutrition, Karolinska Institute, Solna171 77, Sweden
- Department of Nursing, Umeå University, Umeå901 87, Sweden
| | - Luis A Moreno
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Universidad de Zaragoza, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria de Aragón (IIS Aragón) and Centro de Investigación Biomédica en Red de Fisiopatología de la Nutrición y la Obesidad (CIBEROBN), Zaragoza50009, Spain
- Department of Informatics and Statistics, Federal University of Santa Catarina, Technological Center, Florianópolis, Santa CatarinaCEP: 88040-900, Brazil
| |
Collapse
|
44
|
Manios Y, Mavrogianni C, Lambrinou CP, Cardon G, Lindström J, Iotova V, Tankova T, Civeira F, Kivelä J, Jancsó Z, Shadid S, Tsochev K, Mateo-Gallego R, Radó S, Dafoulas G, Makrilakis K, Androutsos O. Two-stage, school and community-based population screening successfully identifies individuals and families at high-risk for type 2 diabetes: the Feel4Diabetes-study. BMC Endocr Disord 2020; 20:12. [PMID: 32164646 PMCID: PMC7066727 DOI: 10.1186/s12902-019-0478-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 12/19/2019] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The implementation of population screening and early prevention strategies targeting individuals at high-risk for type 2 diabetes (T2D) seems to be a public health priority. The current work aimed to describe the screening procedure applied in the Feel4Diabetes-study and examine its effectiveness in identifying individuals and families at high risk, primarily for T2D and secondarily for hypertension, among vulnerable populations in low to middle-income countries (LMICs) and high-income countries (HICs) across Europe. METHODS A two-stage screening procedure, using primary schools as the entry-point to the community, was applied in low socioeconomic status (SES) regions in LMICs (Bulgaria-Hungary), HICs (Belgium-Finland) and HICs under austerity measures (Greece-Spain). During the first-stage screening via the school-setting, a total of 20,501 parents (mothers and/or fathers) of schoolchildren from 11,396 families completed the Finnish Diabetes Risk Score (FINDRISC) questionnaire, while their children underwent anthropometric measurements in the school setting. Parents from the identified "high-risk families" (n = 4484) were invited to participate in the second-stage screening, including the measurement of fasting plasma glucose (FPG) and blood pressure (BP). In total, 3153 parents participated in the second-stage screening (mean age 41.1 ± 5.6 years, 65.8% females). RESULTS Among parents who attended the second-stage screening, the prevalence of prediabetes (as defined by impaired fasting glucose; FPG 100-125 mg/dl) and T2D (FPG > 126 mg/dl) was 23.2 and 3.0% respectively, and it was found to be higher in the higher FINDRISC categories. The percentage of undiagnosed T2D among the participants identified with T2D was 53.5%. The prevalence of high normal BP (systolic BP 130-139 mmHg and/ or diastolic BP 85-89 mmHg) and hypertension (systolic BP ≥ 140 mmHg and/ or diastolic BP ≥ 90 mmHg) was 14 and 18.6% respectively, which was also higher in the higher FINDRISC categories. The percentage of cases not receiving antihypertensive treatment among the participants identified with hypertension was 80.3%. CONCLUSION The findings of the current study indicate that the two-stage school and community-based screening procedure followed, effectively identified high-risk individuals and families in vulnerable populations across Europe. This approach could be potentially scalable and sustainable and support initiatives for the early prevention of T2D and hypertension. TRIAL REGISTRATION The Feel4Diabetes-intervention is registered at https://clinicaltrials.gov/ (NCT02393872; date of trial registration: March 20, 2015).
Collapse
Affiliation(s)
- Yannis Manios
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 70 El Venizelou Ave, 176 71 Kallithea, Athens, Greece
| | - Christina Mavrogianni
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 70 El Venizelou Ave, 176 71 Kallithea, Athens, Greece
| | - Christina-Paulina Lambrinou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 70 El Venizelou Ave, 176 71 Kallithea, Athens, Greece
| | - Greet Cardon
- Department of Movement and Sports Sciences, Faculty of medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Jaana Lindström
- Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland
| | - Violeta Iotova
- Department of Paediatrics, Medical University Varna, Varna, Bulgaria
| | - Tsvetalina Tankova
- Department of Diabetology, Clinical Center of Endocrinology, Medical University Sofia, Sofia, Bulgaria
| | - Fernando Civeira
- Growth, Exercise, Nutrition and Development Research Group, School of Health Science, University of Zaragoza, Zaragoza, Spain
| | - Jemina Kivelä
- Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland
| | - Zoltán Jancsó
- Department of Family and Occupational Medicine, University of Debrecen, Debrecen, Hungary
| | - Samyah Shadid
- Department of Endocrinology, Ghent University Hospital, Ghent, Belgium
| | - Kaloyan Tsochev
- Department of Paediatrics, Medical University Varna, Varna, Bulgaria
| | - Rocío Mateo-Gallego
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), CIBERCV, Zaragoza, Spain
| | - Sándorné Radó
- Department of Family and Occupational Medicine, University of Debrecen, Debrecen, Hungary
| | - George Dafoulas
- National and Kapodistrian University of Athens, Athens, Greece
| | | | - Odysseas Androutsos
- Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, Trikala, Greece
| | | |
Collapse
|
45
|
Androutsos O, Anastasiou C, Lambrinou CP, Mavrogianni C, Cardon G, Van Stappen V, Kivelä J, Wikström K, Moreno LA, Iotova V, Tsochev K, Chakarova N, Ungvári T, Jancso Z, Makrilakis K, Manios Y. Intra- and inter- observer reliability of anthropometric measurements and blood pressure in primary schoolchildren and adults: the Feel4Diabetes-study. BMC Endocr Disord 2020; 20:27. [PMID: 32164691 PMCID: PMC7066724 DOI: 10.1186/s12902-020-0501-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 01/29/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Feel4Diabetes was a large-scale, multicenter lifestyle intervention aiming to prevent type 2 diabetes among families from vulnerable population groups in six European countries (Belgium, Bulgaria, Finland, Greece, Hungary and Spain). The current study aimed to describe the process that was followed to harmonize and standardize the measurement of anthropometric (weight, height and waist circumference) and blood pressure (systolic and diastolic) indices, as well as to assess the intra- and inter- observer reliability of these measurements. METHODS A central training workshop was conducted prior to the baseline measurements of the Feel4Diabetes-intervention. One researcher from each intervention country, as well as 12 adults and 12 children (for the anthropometric measurements) and 21 adults (for the blood pressure measurements) participated in this workshop. Technical Error of Measurement (TEM) and reliability (%R) were calculated to assess the reliability of the indices which were assessed to evaluate the outcome of the Feel4Diabetes-intervention. The Feel4Diabetes-intervention is registered at https://clinicaltrials.gov/ (NCT02393872). RESULTS Intra-observer reliability was found to be higher than 99.5% for all anthropometric measurements in both children and adults. Inter-observer reliability was found to be higher than 98% regarding the anthropometric measurements, while for blood pressure measurements %R was 76.62 and 91.38% for systolic and diastolic blood pressure measurements, respectively. CONCLUSION The central training of the Fee4Diabetes-intervention ensured that the data collected for the outcome evaluation of the Feel4Diabetes-intervention in the six European countries at three different time points (baseline, follow-up 1 and follow-up 2) were valid and comparable.
Collapse
Affiliation(s)
- Odysseas Androutsos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 70 El Venizelou Ave, 176 71 Kallithea, Athens, Greece
- Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, Trikala, Greece
| | - Costas Anastasiou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 70 El Venizelou Ave, 176 71 Kallithea, Athens, Greece
| | - Christina-Paulina Lambrinou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 70 El Venizelou Ave, 176 71 Kallithea, Athens, Greece
| | - Christina Mavrogianni
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 70 El Venizelou Ave, 176 71 Kallithea, Athens, Greece
| | - Greet Cardon
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Vicky Van Stappen
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Jemina Kivelä
- Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland
| | - Katja Wikström
- Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland
| | | | - Violeta Iotova
- Department of Paediatrics, Medical University Varna, Varna, Bulgaria
| | - Kaloyan Tsochev
- Department of Paediatrics, Medical University Varna, Varna, Bulgaria
| | - Nevena Chakarova
- Department of Diabetology, Clinical Center of Endocrinology, Medical University Sofia, Sofia, Bulgaria
| | - Tímea Ungvári
- Department of Family and Occupational Medicine, University of Debrecen, Debrecen, Hungary
| | - Zoltán Jancso
- Department of Family and Occupational Medicine, University of Debrecen, Debrecen, Hungary
| | | | - Yannis Manios
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 70 El Venizelou Ave, 176 71 Kallithea, Athens, Greece
| | | |
Collapse
|
46
|
Malden S, Reilly JJ, Hughes A, Bardid F, Summerbell C, De Craemer M, Cardon G, Androutsos O, Manios Y, Gibson AM. Assessing the acceptability of an adapted preschool obesity prevention programme: ToyBox-Scotland. Child Care Health Dev 2020; 46:213-222. [PMID: 31856335 DOI: 10.1111/cch.12736] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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: 10/02/2019] [Accepted: 12/14/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND Childhood obesity is a global public health issue. Interventions to prevent the onset of obesity in the early years are often implemented in preschool settings. The ToyBox intervention was delivered across Europe and targeted energy balance-related behaviours in preschools and children's homes through teacher-led activities and parental education materials and was adapted for use in Scotland. This study assessed the acceptability of the 18-week adapted intervention to both parents and teachers. METHODS Mixed methods were employed to collect both qualitative and quantitative data. Preschool staff and children's parents/caregivers completed post-intervention feedback surveys, from which acceptability scores were calculated and presented as proportions. Focus groups were conducted with preschool staff, whereas parents/caregivers participated in semi-structured interviews. A thematic analysis was applied to qualitative data following the development of a coding framework. Quantitative and qualitative data were analysed using SPSS and NVivo 10, respectively. RESULTS Preschool staff rated the intervention as highly acceptable based on post-intervention feedback surveys (80%; mean score 8.8/11). Lower acceptability scores were observed for parents/caregivers (49%; 3.9/8). Nine preschool practitioners participated in focus groups (n = 3). User-friendliness of the intervention materials, integration of the intervention with the curriculum, and flexibility of the intervention were identified as facilitators to delivery. Barriers to delivery were time, insufficient space, and conflicting policies within preschools with regard to changing classroom layouts. Parental interviews (n = 4) revealed a lack of time to be a major barrier, which prevented parents from participating in home-based activities. Parents perceived the materials to be simple to understand and visually appealing. CONCLUSIONS This study identified a number of barriers and facilitators to the delivery and evaluation of the ToyBox Scotland preschool obesity prevention programme, which should be considered before any further scale-up of the intervention.
Collapse
Affiliation(s)
- Stephen Malden
- Physical Activity for Health Group, School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK.,Scottish Collaboration for Public Health Research and Policy, School of Health in Social Science, University of Edinburgh, UK
| | - John J Reilly
- Physical Activity for Health Group, School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Adrienne Hughes
- Physical Activity for Health Group, School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Farid Bardid
- School of Education, University of Strathclyde, Glasgow, UK.,Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Carolyn Summerbell
- Department of Sport and Exercise Sciences, Durham University, Durham, UK
| | - Marieke De Craemer
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Greet Cardon
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Odysseas Androutsos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Yannis Manios
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Ann-Marie Gibson
- Physical Activity for Health Group, School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| |
Collapse
|
47
|
Gibson EL, Androutsos O, Moreno L, Flores-Barrantes P, Socha P, Iotova V, Cardon G, De Bourdeaudhuij I, Koletzko B, Skripkauskaite S, Manios Y. Influences of Parental Snacking-Related Attitudes, Behaviours and Nutritional Knowledge on Young Children's Healthy and Unhealthy Snacking: The ToyBox Study. Nutrients 2020; 12:nu12020432. [PMID: 32046193 PMCID: PMC7071198 DOI: 10.3390/nu12020432] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Revised: 01/23/2020] [Accepted: 02/04/2020] [Indexed: 12/25/2022] Open
Abstract
This study investigated parental influences on preschool children's healthy and unhealthy snacking in relation to child obesity in a large cross-sectional multinational sample. Parents and 3-5 year-old child dyads (n = 5185) in a kindergarten-based study provided extensive sociodemographic, dietary practice and food intake data. Parental feeding practices that were derived from questionnaires were examined for associations with child healthy and unhealthy snacking in adjusted multilevel models, including child estimated energy expenditure, parental education, and nutritional knowledge. Parental healthy and unhealthy snacking was respectively associated with their children's snacking (both p < 0.0001). Making healthy snacks available to their children was specifically associated with greater child healthy snack intake (p < 0.0001). Conversely, practices that were related to unhealthy snacking, i.e., being permissive about unhealthy snacking and acceding to child demands for unhealthy snacks, were associated with greater consumption of unhealthy snacks by children, but also less intake of healthy snacks (all p < 0.0001). Parents having more education and greater nutritional knowledge of snack food recommendations had children who ate more healthy snacks (all p < 0.0001) and fewer unhealthy snacks (p = 0.002, p < 0.0001, respectively). In the adjusted models, child obesity was not related to healthy or unhealthy snack intake in these young children. The findings support interventions that address parental practices and distinguish between healthy and unhealthy snacking to influence young children's dietary patterns.
Collapse
Affiliation(s)
- Edward Leigh Gibson
- Department of Psychology, University of Roehampton, London SW15 4JD, UK;
- Correspondence:
| | - Odysseas Androutsos
- Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, 42132 Trikala, Greece
| | - Luis Moreno
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Faculty of Health Sciences, University of Zaragoza, Edificio del SAI, C/Pedro Cerbuna s/n, 50009 Saragossa, Spain; (L.M.); (P.F.-B.)
- Instituto Agroalimentario de Aragón (IA2), 50013 Saragossa, Spain
- Fundación Instituto de Investigación Sanitaria Aragón (IIS Aragón), 50009 Saragossa, Spain
| | - Paloma Flores-Barrantes
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Faculty of Health Sciences, University of Zaragoza, Edificio del SAI, C/Pedro Cerbuna s/n, 50009 Saragossa, Spain; (L.M.); (P.F.-B.)
- Instituto Agroalimentario de Aragón (IA2), 50013 Saragossa, Spain
- Fundación Instituto de Investigación Sanitaria Aragón (IIS Aragón), 50009 Saragossa, Spain
| | - Piotr Socha
- The Children’s Memorial Health Institute, 04-730 Warsaw, Poland;
| | - Violeta Iotova
- Department of Pediatrics, Medical University of Varna, 9002 Varna, Bulgaria;
| | - Greet Cardon
- Department of Movement and Sports Sciences, Ghent University, 9000 Ghent, Belgium; (G.C.); (I.D.B.)
| | - Ilse De Bourdeaudhuij
- Department of Movement and Sports Sciences, Ghent University, 9000 Ghent, Belgium; (G.C.); (I.D.B.)
| | - Berthold Koletzko
- Dr von Hauner Children’s Hospital, LMU-Ludwig-Maximilians-University at Munich, D-80337 Munich, Germany;
| | | | - Yannis Manios
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 17671 Athens, Greece;
| | | |
Collapse
|
48
|
Van Stappen V, De Lepeleere S, Huys N, Latomme J, Verloigne M, Cardon G, Androutsos O, Manios Y, De Bourdeaudhuij I, De Craemer M. Effect of integrating a video intervention on parenting practices and related parental self-efficacy regarding health behaviours within the Feel4Diabetes-study in Belgian primary schoolchildren from vulnerable families: A cluster randomized trial. PLoS One 2019; 14:e0226131. [PMID: 31826024 PMCID: PMC6905545 DOI: 10.1371/journal.pone.0226131] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 11/19/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND This study aimed to investigate the effect of integrating a video intervention "Movie Models" within the Feel4Diabetes-study on specific parenting practices and related parental self-efficacy regarding children's physical activity, screen-time and eating behaviour in vulnerable families (i.e. families living in low socioeconomic municipalities and at risk for developing type 2 diabetes). Additionally, there was examination of how the intervention was perceived by the parents. METHODS Within randomly selected low socioeconomic municipalities in Belgium, families were recruited through primary schools. Families at risk for developing type 2 diabetes were identified using the FINDRISC questionnaire (n = 457). Afterwards, the municipalities were randomly assigned to the intervention or control condition. At risk families assigned to the intervention group were invited to participate in six Feel4Diabetes counselling sessions in which families were encouraged to adopt a healthier lifestyle. The "Movie Models" videos were integrated within two sessions by using a face-to-face group discussion approach. Parenting-related factors were assessed before and after the integration of the videos, using a questionnaire. After integrating the videos, some extra evaluation questions were assessed. In total, 126 families were included in a per protocol evaluation and Repeated Measures ANOVAs were conducted to evaluate the potential intervention effects. RESULTS Some favourable intervention effects were found on parenting practices and related parental self-efficacy regarding children's eating behaviours, however almost no effects were found on parenting-related factors regarding children's physical activity and screen-time. In total, 60.0% of the participants indicated that they applied tips regarding parenting practices and 52.0% indicated that discussions with other participants regarding the videos were useful for them. CONCLUSION The integration of "Movie Models" within the Feel4Diabetes-study was effective in improving some parenting-related factors regarding children's health behaviours, however most parenting-related factors could not be improved. The implementation of "Movie Models" as a face-to-face group discussion approach was relatively well received and may be a promising way to improve parenting-related factors in vulnerable families. TRIAL REGISTRATION ClinicalTrials.gov NCT02278809.
Collapse
Affiliation(s)
- Vicky Van Stappen
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
- * E-mail:
| | - Sara De Lepeleere
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Nele Huys
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Julie Latomme
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
- Research Foundation Flanders (FWO), Brussels, Belgium
| | - Maïté Verloigne
- Research Foundation Flanders (FWO), Brussels, Belgium
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Greet Cardon
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Odysseas Androutsos
- Department of Nutrition and Dietetics, School of Health Sciences & Education, Harokopio University, Kallithea, Athens, Greece
| | - Yannis Manios
- Department of Nutrition and Dietetics, School of Health Sciences & Education, Harokopio University, Kallithea, Athens, Greece
| | | | - Marieke De Craemer
- Research Foundation Flanders (FWO), Brussels, Belgium
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| |
Collapse
|
49
|
Malden S, Reilly JJ, Gibson AM, Bardid F, Summerbell C, De Craemer M, Cardon G, Androutsos O, Manios Y, Hughes A. A feasibility cluster randomised controlled trial of a preschool obesity prevention intervention: ToyBox-Scotland. Pilot Feasibility Stud 2019; 5:128. [PMID: 31728203 PMCID: PMC6842492 DOI: 10.1186/s40814-019-0521-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 10/17/2019] [Indexed: 12/13/2022] Open
Abstract
Background High levels of childhood obesity have been observed globally over the last three decades. Preschools are promising settings to implement obesity prevention interventions in the early years. The aim of this study was to test the feasibility of a cluster randomised controlled trial of the ToyBox-Scotland preschool obesity prevention intervention. Methods Six preschools in predominantly deprived areas of Glasgow, UK, were randomised to either the ToyBox intervention (n = 3) or usual curriculum control group (n = 3). The intervention ran for 18 weeks from March-June 2018, and consisted of practitioner-led physical activity and sedentary behaviour sessions in preschools, with an additional interactive home component. Primary outcome measures were intervention fidelity, recruitment rates, attrition rates, and compliance with trial procedures. Secondary outcomes were body mass index (BMI) z-score, bioelectrical impedance analysis (BIA), objectively measured physical activity and sedentary time via activPAL accelerometer, and parent-reported home eating, snacking, and water consumption. Results The preschool component of the intervention was implemented with high fidelity (64%), while the home component was implemented with low fidelity (41%). A cluster-level recruitment rate of 10% was achieved, and the individual-level recruitment rate was 18% (42/233 children, mean age 4.4 years; 17 girls). The attrition rate was 14%, and compliance rates varied considerably by the outcome. Compliance was highest for BMI (86%), while 19% of the sample returned valid accelerometer data for both baseline and follow-up and the parental questionnaire response rate was 23%. Both intervention and control groups showed small increases in BMI z-scores at follow-up of 0.02 and 0.06, respectively. Both groups had small decreases in physical activity and increases in sedentary time at follow-up. Conclusions Before progression to an effectiveness trial, additional procedures should be considered to improve recruitment rates, compliance with outcome measures, and implementation of the home-based component of the ToyBox-Scotland intervention. Trial registration ISRCTN12831555.
Collapse
Affiliation(s)
- Stephen Malden
- 1Physical Activity for Health Group, School of Psychological Sciences and Health, University of Strathclyde, Graham Hills Building, 40 George Street, Glasgow, G1 1XP UK
| | - John J Reilly
- 1Physical Activity for Health Group, School of Psychological Sciences and Health, University of Strathclyde, Graham Hills Building, 40 George Street, Glasgow, G1 1XP UK
| | - Ann-Marie Gibson
- 1Physical Activity for Health Group, School of Psychological Sciences and Health, University of Strathclyde, Graham Hills Building, 40 George Street, Glasgow, G1 1XP UK
| | - Farid Bardid
- 2School of Education, University of Strathclyde, Glasgow, UK.,3Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Carolyn Summerbell
- 4Department of Sport and Exercise Sciences, Durham University, Durham City, UK
| | - Marieke De Craemer
- 3Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Greet Cardon
- 3Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Odysseas Androutsos
- 5Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Yannis Manios
- 5Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Adrienne Hughes
- 1Physical Activity for Health Group, School of Psychological Sciences and Health, University of Strathclyde, Graham Hills Building, 40 George Street, Glasgow, G1 1XP UK
| |
Collapse
|
50
|
Latomme J, Huys N, Cardon G, Morgan PJ, Lateva M, Chakarova N, Kivelä J, Lindström J, Androutsos O, González-Gil EM, De Miguel-Etayo P, Nánási A, Kolozsvári LR, Manios Y, De Craemer M. Do physical activity and screen time mediate the association between European fathers' and their children's weight status? Cross-sectional data from the Feel4Diabetes-study. Int J Behav Nutr Phys Act 2019; 16:100. [PMID: 31685028 PMCID: PMC6829912 DOI: 10.1186/s12966-019-0864-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 10/18/2019] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Most research on parenting and childhood obesity and obesity-related behaviours has focused on mothers while fathers have been underrepresented. Yet, recent literature has suggested that fathers uniquely influence their children's lifestyle behaviours, and hence could also affect their weight status, but this has not yet been scientifically proven. Therefore, the present study aimed to determine whether the association between fathers' weight status and their children's weight status is mediated by fathers' and children's movement behaviours (i.e. physical activity (PA) and screen time (ST)). METHODS Cross-sectional data of 899 European fathers and their children were analyzed. Fathers/male caregivers (mean age = 43.79 ± 5.92 years, mean BMI = 27.08 ± 3.95) completed a questionnaire assessing their own and their children's (mean age = 8.19 ± 0.99 years, 50.90% boys, mean BMIzscore = 0.44 ± 1.07) movement behaviours. Body Mass Index (BMI, in kg/m2) was calculated based on self-reported (fathers) and objectively measured (children) height and weight. For children, BMI z-scores (SD scores) were calculated to obtain an optimal measure for their weight status. Serial mediation analyses were performed using IBM SPSS 25.0 Statistics for Windows to test whether the association between fathers' BMI and children's BMI is mediated by fathers' PA and children's PA (model 1) and fathers' ST and children's ST (model 2), respectively. RESULTS The present study showed a (partial) mediation effect of fathers' PA and children's PA (but not father's ST and children's ST) on the association between fathers' BMI and children's BMI (model for PA; coefficient: 0.001, 95% CI: [0.0001, 0.002]; model for ST; coefficient: 0.001, 95% CI: [0.000, 0.002]). Furthermore, fathers' movement behaviours (PA and ST) were positively associated with their children's movement behaviours (PA and ST) (model for PA, coefficient: 0.281, SE: 0.023, p < 0.001; model for ST, coefficient: 0.345, SE: 0.025, p < 0.001). CONCLUSIONS These findings indicate that the influence of fathers on their children's weight status partially occurs through the association between fathers' PA and children's PA (but not their ST). As such, intervening by focusing on PA of fathers but preferably of both members of the father-child dyad (e.g. engaging fathers and their children in co-PA) might be a novel and potentially effective strategy for interventions aiming to prevent childhood overweight and obesity. Longitudinal studies or intervention studies confirming these findings are however warranted to make meaningful recommendations for health intervention and policy. TRIAL REGISTRATION The Feel4Diabetes-study is registered with the clinical trials registry http://clinicaltrials.gov , ID: 643708 .
Collapse
Affiliation(s)
- Julie Latomme
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Nele Huys
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Greet Cardon
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Philip J. Morgan
- School of Education, PRCPAN (Priority Research Centre for Physical Activity and Nutrition), University of Newcastle, Newcastle, Australia
| | - Mina Lateva
- Clinic of Paediatric Endocrinology, Medical University Varna, Varna, Bulgaria
| | - Nevena Chakarova
- Clinical Center of Endocrinology, Medical University of Sofia, Sofia, Bulgaria
| | - Jemina Kivelä
- National Institute for Health and Welfare, Helsinki, Finland
| | - Jaana Lindström
- National Institute for Health and Welfare, Helsinki, Finland
| | - Odysseas Androutsos
- School of Health Science & Education, Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - Esther M. González-Gil
- GENUD (Growth, Exercise, Nutrition and Development), University of Zaragoza, Zaragoza, Spain
| | - Pilar De Miguel-Etayo
- GENUD (Growth, Exercise, Nutrition and Development), University of Zaragoza, Zaragoza, Spain
| | - Anna Nánási
- Department of Family and Occupational Medicine, University of Debrecen, Debrecen, Hungary
| | - László R. Kolozsvári
- Department of Family and Occupational Medicine, University of Debrecen, Debrecen, Hungary
| | - Yannis Manios
- School of Health Science & Education, Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - Marieke De Craemer
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| |
Collapse
|