Anthropometric indices of school children and familiar risk factors

Effect of a Health-Education Program Based on the BASNEF Model of Overall Sexual Health Satisfaction and Satisfaction with Quality of Sexual Relationship among Women with Infertility

Introduction

Female infertility is increasing in Iran, encompassing all dimensions of women's lives. One of the most important effects of infertility is on sexual function. All women have the right to sexual health. Using educational models, one can see a positive effect on women's sexual function. The present study aimed to investigate the effect of an education program based on the beliefs, attitudes, subjective norms, and enabling factors (BASNEF) model on promoting overall sexual health satisfaction and satisfaction with the quality of sexual relationships among women with infertility.

Methods

This was a quasiexperimental study conducted on 80 infertile women referred to an infertility center affiliated with Tehran University of Medical Sciences, in Tehran, Iran in 2016-2017. Infertile women with primary infertility were divided into experimental and control groups based on odd and even days. The intervention was carried out based on the BASNEF model over four sessions. Data were collected using a demographic questionnaire, the BASNEF questionnaire, and items on overall sexual health satisfaction and satisfaction with their sexual relationship. The questionnaires were completed before and 4 and 8 weeks after the intervention in the two groups. Friedman, χ², and t-tests were used for data analysis.

Results

After the educational intervention, BASNEF values and overall sexual function and satisfaction with the quality of sexual relationships had significantly improved in the experimental group (p<0.05), while changes were not significant in the control group.

Conclusion

The results showed that the BASNEF model-based educational invention improved overall sexual health and satisfaction among intertitle women. Indeed, it seems that using theory-based educational interventions in infertility centers might be helpful.

How useful are anthropometric measurements as predictive markers for elevated blood pressure in adolescents in different gender?

Background Obesity and obesity-related diseases are one of the common health problems worldwide and have also been proposed to be important predictors of blood pressure and cardiovascular disease risk. The aim of our study is to determine the utility of different anthropometric measurements (body mass index [BMI], skinfold thickness [SFT], waist circumference [WC], mid-upper arm circumference [MUAC], arm circumference-height ratio [AHtR], and waist circumference-height ratio [WHtR]) as markers of hypertension (HT) risk in adolescents. Methods In this cross-sectional study, 544 participants aged between 12 and 13 years were included. Anthropometric measurements and blood pressure of participants were measured. The association of different anthropometric measurements with blood pressure was evaluated. Results The frequency of both elevated blood pressure and HT was 30.2%. Biceps, triceps, and suprailiac SFT have an impact on HT in girls but only suprailiac SFT in boys. WC measurements above the 85th percentile were strongly correlated with HT conditions, and this relationship was stronger in boys than in girls (3.3 vs. 2.6 fold). MUAC, WHtR, and AHtR measurements also have strong correlation with HT in boys but only WHtR has a poor relation in girls. In boys and girls with obesity, there was a positive association between obesity and blood pressures. Conclusions Not only age-related BMI z scores but also a number of other anthropometric measurements, such as WC, SFT, MUAC, WHtR, and AHtR, could have an influence on high blood pressure. The influence changes with gender during adolescence.

Prevalence of Metabolic Syndrome in Middle School Children and Evaluation of Components of Metabolic Syndrome

Objectives:

This study was designed to determine the prevalence of metabolic syndrome (MS) in Turkish children and to examine the relationship between MS components in this age group.

Methods:

A total of 395 students in Istanbul aged 10 to 14 years in the 2004-2005 school year were enrolled in the study. Body weight, height, waist circumference, hip circumference, and systolic-diastolic blood pressure were measured. Of the total, 353 provided blood samples for analysis of fasting glucose level, basal insulin, total cholesterol, triglyceride, high-density lipoprotein (HDL), low-density lipoprotein (LDL), and very-low-density lipoprotein (VLDL) levels. Modified World Health Organization criteria were used for the diagnosis of MS.

Results:

In this study, 44.5% of the children were female and 55.5% were male. The mean body mass index (BMI) was 20.57±3.48 kg/m², 10.4% (n=41) were overweight, and 12.7% (n=50) were obese. MS was diagnosed in 0.85% of the entire study group and in 6% of the obese children. There was a positive correlation between BMI and waist circumference (p<0.001), waist/hip ratio (p<0.001), systolic blood pressure (p<0.001), diastolic blood pressure (p<0.001), basal insulin level (p<0.001), homeostasis model assessment of insulin resistance (p<0.001), triglyceride value (p<0.001), total cholesterol level (p<0.05), LDL (p<0.001), and VLDL level (p<0.001), and a negative correlation with HDL level (p<0.001).

Conclusion:

The study results confirmed that MS is present in children and not limited to adults, and this is an important health problem. The prevalence of MS is more common in obese children. Therefore, early diagnosis of obese children and examination of cardiovascular risk factors and metabolic syndrome criteria is very important.

Associations between different weight-related anthropometric traits and lifestyle factors in Norwegian children and adolescents: A case for measuring skinfolds

OBJECTIVES

The purpose of this study was to investigate the association between weight-related anthropometric measures and children's eating habits, physical activity and sedentary lifestyle at a population level.

METHODS

Data from the Bergen Growth Study were used to study the association of z-scores of waist circumference (WC), weight-to-height ratio (WHtR), subscapularis (SSF) and triceps (TSF) skinfolds and BMI, with lifestyle factors in 3063 Norwegian children (1543 boys) aged 4-15 years, using linear regression analysis. Each sex was analyzed separately.

RESULTS

In a fully adjusted model with additional correction for BMI z-scores, the consumption of vegetables was associated with higher WC (b = 0.03) and TSF (b = 0.05) z-scores in girls. Sedentary behavior was not associated with any of the anthropometric measures. Physical activity was negatively associated with SSF (b = -0.07) and TSF (b = -0.07) z-scores in boys, while a significant negative association was observed with WC (b = -0.02), WHtR (b = -0.03), SSF (b = -0.04) and TSF (b = -0.06) in girls.

CONCLUSION

Physical activity was negatively associated with skinfolds in both sexes. The BMI was not related to the level of physical activity, and should be complemented with direct measures of fat tissue, like skinfolds, when studying the effect of physical activity on body composition in children.

Can the BASNEF Model Help to Develop Self-Administered Healthy Behavior in Iranian Youth?

Background:

The stage of youth is critical for human development in several ways. On the one hand, it can lead people towards the adoption of a healthy lifestyle during adulthood based on these earlier practices. On the other hand, it can comprise the development of healthy living practices later on in live, an outcome which is often caused by the youth adopting a risky lifestyle early on.

Objectives:

The primary objective of this study was to determine the effectiveness of implementing an educational intervention program based on the BASNEF Model (a simplified approach to understanding behavior), designed to cultivate self-administered lifestyle control skills in youths.

Materials and Methods:

This was a quasi-experimental intervention study, implemented during 2010 - 2011. A total of 288 randomly selected high-school students between the ages of 15 and 17 participated in this study. These students were later divided into experimental and control groups. Subjects completed a BASNEF questionnaire at the baseline (pre-test), one month later (post-test) and three months after the educational intervention (follow-up). Four educational sessions were held, each of a 120 - 150 minute duration. After the data had been collected, the ANOVA test was used to compare trends in changes. The Pearson correlation coefficient was then used to analyze the correlation between components of the BASNEF model. Finally, regression analysis was used to determine the predictive power of the study.

Results:

Results from the intervention study reveal that the beliefs and attitudes about nutrition of the intervention group, calculated in terms of scores, improved significantly for both male and female subjects (P < 0.001) as compared to the control group. The mean BASNEF scores for improvements in beliefs among girls and boys were 79.2% and 70.1%, respectively and for attitudes, 61.2% and 59.4%. The increase was significantly higher in the intervention group (P < 0.001). Furthermore, participation in physical activity was more frequent among members of the intervention group than among those in the control group (P < 0.001).

Conclusions:

The BASNEF model could be effective in encouraging the adoption of nutritious eating habits and more active lifestyles at an early age in order to foster long-term health and well-being.

Socioeconomic position and childhood-adolescent weight status in rich countries: a systematic review, 1990-2013

Background

Childhood obesity is a major problem in rich countries due to its high prevalence and its harmful health consequences. An exploratory analysis conducted in the PubMed database highlighted that the number of papers published on the relationship between socioeconomic position (SEP) and childhood-adolescent weight status had risen substantially with respect to an earlier review which had covered the period 1990–2005.

Methods

To describe the findings on the relationship between SEP and childhood-adolescent weight status in papers published in rich countries from 1990 through 2013, studies were identified in the following databases: PubMed; Web of Knowledge (WOK); PsycINFO; Global Health; and Embase. We included observational studies from the 27 richest OECD countries, which covered study populations aged 0 to 21 years, and used parental education, income and/or occupation as family SEP indicators. A total of 158 papers met the inclusion criteria and reported 134 bivariable and 90 multivariable analyses.

Results

Examination of the results yielded by the bivariable analyses showed that 60.4 % of studies found an inverse relationship, 18.7 % of studies did not found relationship, and 20.9 % of studies found a relationship that varied depending on another variable, such as age, sex or ethnic group; the corresponding percentages in the multivariable analyses were 51.1, 20.0 and 27.8 %, respectively. Furthermore, 1.1 % found a positive relationship.

Conclusion

The relationship between SEP and childhood-adolescent weight status in rich countries is predominantly inverse and the positive relationship almost has disappeared. The SEP indicator that yields the highest proportion of inverse relationships is parents’ education. The proportion of inverse relationships is higher when the weight status is reported by parents instead using objective measurements.

Electronic supplementary material

The online version of this article (doi:10.1186/s12887-015-0443-3) contains supplementary material, which is available to authorized users.

Drastic increases in overweight and obesity from 1981 to 2010 and related risk factors: results from the Barbados Children's Health and Nutrition Study

OBJECTIVE

To examine overweight and obesity (OWOB), changes in prevalence and potential risk factors in Barbadian children.

DESIGN

A cross-section of students were weighed and measured. The WHO BMI-for-age growth references (BAZ), the International Obesity Task Force cut-offs and the US Centers for Disease Control and Prevention growth percentiles were used to determine OWOB prevalence. Harvard weight-for-height-for-age growth standards were used to estimate differences in OWOB prevalence from 1981 to 2010. Samples of parents and students were interviewed to describe correlates of OWOB.

SETTING

Barbados.

SUBJECTS

Public-school students (n 580) in class 3.

RESULTS

Based on WHO BAZ, the overall prevalence of OWOB was 34·8 % (95 % CI 30·9, 38·7 %). A trend of higher OWOB prevalence was seen for girls across cut-offs, with significant sex differences noted using the International Obesity Task Force cut-offs. According to Harvard growth standards, OWOB has increased dramatically, from 8·52 % to 32·5 %. Children were more likely to be OWOB when annual household income was below BBD 9000 (OR=2·69; 95 % CI 1·21, 5·99). Eating dinner with the family every night was associated with a lower prevalence of OWOB (OR=0·56; 95 % CI 0·36, 0·87).

CONCLUSIONS

The sharp increase of OWOB rates in Barbados warrants attention. Sex disparities in OWOB prevalence may emerge at a young age. Promoting family meals may be a feasible option for OWOB prevention. Understanding familial and sociodemographic factors influencing OWOB will be useful in planning successful intervention or prevention programmes in Barbados.

The Impact of Familial Predisposition to Obesity and Cardiovascular Disease on Childhood Obesity

The prevalence of childhood obesity has reached alarming rates world-wide. The aetiology seems to be an interplay between genetic and environmental factors, and a surrogate measure of this complex interaction is suggested as familial predisposition. Familial predisposition to obesity and related cardiovascular disease (CVD) complications constitute the presence of obesity and/or obesity-related complications in primarily blood-related family members. The approaches of its measurement and applicability vary, and the evidence especially of its influence on obesity and obesity treatment in childhood is limited. Studies have linked a familial predisposition of obesity, CVD (hypertension, dyslipidaemia and thromboembolic events), and type 2 diabetes mellitus to BMI as well as other adiposity measures in children, suggesting degrees of familial aggregation of metabolic derangements. A pattern of predispositions arising from mothers, parents or grandparents as being most influential have been found, but further comprehensive studies are needed in order to specify the exact implications of familial predisposition. In the scope of childhood obesity this article reviews the current literature regarding familial predisposition to obesity and obesity-related complications, and how these familial predispositions may impact obesity in the offspring.

Metabolic syndrome in school children in mardin, South-eastern of Turkey

OBJECTIVE

To determine the prevalence of the metabolic syndrome (MES) in a school children population.

MATERIALS AND METHODS

Three thousand four hundred and sixty children aged between 7 and 15 in three elementary schools in the city of Mardin, located in the south-eastern region of Turkey, were included in this study in April and May 2011. Age, gender, height, weight, waist circumference (WC), hip circumference, waist/hip ratio, systolic and diastolic blood pressure were measured and a variety of blood tests were done. The International Diabetes Federation (IDF) criteria were used for the diagnosis of MES.

RESULTS

It was found that 9.42% of those tested were overweight, and 8.0% were obese. The study found that more girls (9.1%) were obese than girls (6.9%). The prevalence of obesity was significantly higher among girls than boys (p<0.001). A positive correlation was found between body mass index (BMI) and the other parameters, namely waist and hip circumference, waist/hip ratio, systolic and diastolic blood pressure (BP), triglyceride (TG) (p=0.0001). It was found that total cholesterol (T-Chol), TG, BMI, systolic and diastolic BP were significantly different among obese MES's group and non-obese children (p<0.05). The waist/hip ratio reference value in girls was significantly higher than boys (p>0.05). The prevalence of MES was 6.3%. The number of components of MES was higher in girls and obese children. The rate of MES was 30.3% in obese children.

CONCLUSION

The frequency of obesity, hypertension and MES in childhood period have been steadily increasing. Children who are classified having central obesity and high body mass index should be more carefully evaluated to its potential to progress to MES. And the quality of the life should be improved by reducing the risks resulted from life style changes, necessary treatments and follow ups.

Waist circumference and risk of elevated blood pressure in children: a cross-sectional study

Background

Increasing childhood obesity has become a major health threat. This cross-sectional study reports associations between schoolchildren's waist circumference (WC) and risk of elevated blood pressure.

Methods

We measured height, weight, neck and waist circumference, and blood pressure in regular health examinations among children in grade 1 (ages 6-7 years) at six elementary schools in Taipei County, Taiwan. Elevated blood pressure was defined in children found to have mean systolic or diastolic blood pressure greater than or equal to the gender-, age-, and height-percentile-specific 95th-percentile blood pressure value.

Results

All 2,334 schoolchildren were examined (response rate was 100% in the six schools). The mean of systolic and diastolic blood pressure increased as WC quartiles increased (p < 0.0001). The prevalence of elevated blood pressure for boys and girls within the fourth quartile of waist circumference was 38.9% and 26.8%, respectively. In the multivariate logistic regression analyses, the adjusted odds ratios of elevated blood pressure were 1.78 (95% confidence interval [CI] = 1.13-2.80), 2.45 (95% CI = 1.56-3.85), and 6.03 (95% CI = 3.59-10.1) for children in the second, third, and fourth waist circumference quartiles compared with the first quartile. The odds ratios for per-unit increase and per increase of standard deviation associated with elevated blood pressure were 1.14 (95% CI = 1.10-1.18) and 2.22 (95% CI = 1.76-2.78), respectively.

Conclusions

Elevated blood pressure in children was associated with waist circumference. Not only is waist circumference easier to measure than blood pressure, but it also provides important information on metabolic risk. Further research is needed on effective interventions to identify and monitor children with increased waist circumference to reduce metabolic and blood pressure risks.

Blood pressure, height, weight and body mass index of primary school students in a low socio-economic district in Turkey

AIM

This study was conducted to evaluate the growth and blood pressure measurements of the students.

BACKGROUND

School health services are important to evaluate, protect and to improve the health status of the students. This study was conducted to evaluate the growth and blood pressure measurements of the students who were registered in a primary school with low socio-economic level in Kayseri Province in Türkiye between 1 April 2004 and 30 May 2004. The data were collected using questionnaire and health-screening forms.

FINDINGS

It was determined that the average age was 9.77 +/- 2.41 in girls and 10.16 +/- 14.70 in boys. It was observed that the average height was 137.95 +/- 14.70 cm, and the average weight was 33.07 +/- 10.08 kg for all students. The girls between 10 years and 12 years old had a better average body mass index (kg/m(2)) (BMI) compared with boys. Boys between 6 years and 9 years old had a better BMI than the girls. The difference between the groups was considered statistically important (P = 0.006 and P = 0.002, respectively). Furthermore, 4.9% of the students were underweight and 2.2% of the students were obese. It was thought that there was a positive correlation among height, weight, BMI, age and the blood pressure values; and as BMI and age increased, so did the blood pressure value.

CONCLUSION

Cooperation and dialogue need to be established among the school directorate, the families and the students to promote and encourage proper growth development and nutrition of the students within the school health services.

Clinical profile of the overweight child in the new millennium

BACKGROUND

In conjunction with the rising prevalence of obesity during the past several decades, the clinical profile of the obese child has changed. Hypothesis. Environmental influences and eating practices have had an impact on the presence of medical morbidities among obese children.

DESIGN

Retrospective chart review of data collected from 90 children entering into a pediatric weight management program was performed. Fisher's exact tests and Wilcoxon rank sum tests were used to compare outcomes between subpopulations.

RESULTS

There was greater elevation in systolic blood pressure among children who ate in front of the television (P = .03) and a greater degree of fast-food consumption among children with more than 3 medical morbidities (P = .02). Breast-feeding did not have a protective effect on the degree of obesity (P = .02).

CONCLUSION

Aggressive assessment for symptoms should be an important part of evaluating the overweight child. Environmental influences and social feeding practices can counteract the protective effects of breast-feeding in infancy.

Socioeconomic status and adiposity in childhood: a systematic review of cross-sectional studies 1990-2005

BACKGROUND

Sobal and Stunkard's review (1989) of 34 studies from developed countries published after 1941, found inconsistent relationships between socioeconomic status (SES) and childhood adiposity. Inverse associations (36%), no associations (38%), and positive associations (26%) were found in similar proportions. In view of the trends in pediatric obesity, the relationship between SES and adiposity may have changed.

OBJECTIVE

To describe the cross-sectional association between SES and adiposity in school-age children from western developed countries in epidemiological studies since 1989.

METHODS AND PROCEDURES

PubMed database was searched to identify potentially relevant publications. Epidemiological studies from western developed countries presenting cross-sectional data on the bivariate association between an SES indicator and objectively measured adiposity in childhood (5-18 years), carried out after 1989 were included. SES indicators included parental education, parental occupation, family income, composite SES, and neighborhood SES.

RESULTS

Forty-five studies satisfied the review criteria. SES was inversely associated with adiposity in 19 studies (42%), there was no association in 12 studies (27%), and in 14 studies (31%) there was a mixture of no associations and inverse associations across subgroups. No positive SES-adiposity associations were seen in unadjusted analyses. With parental education as the SES indicator, inverse associations with adiposity were found in 15 of 20 studies (75%).

DISCUSSION

Research carried out within the past 15 years finds that associations between SES and adiposity in children are predominately inverse, and positive associations have all but disappeared. Research is needed to understand the mechanisms through which parental social class influences childhood adiposity.

Recommendations for treatment of child and adolescent overweight and obesity

In this article, we review evidence about the treatment of obesity that may have applications in primary care, community, and tertiary care settings. We examine current information about eating behaviors, physical activity behaviors, and sedentary behaviors that may affect weight in children and adolescents. We also review studies of multidisciplinary behavior-based obesity treatment programs and information about more aggressive forms of treatment. The writing group has drawn from the available evidence to propose a comprehensive 4-step or staged-care approach for weight management that includes the following stages: (1) Prevention Plus; (2) structured weight management; (3) comprehensive multidisciplinary intervention; and (4) tertiary care intervention. We suggest that providers encourage healthy behaviors while using techniques to motivate patients and families, and interventions should be tailored to the individual child and family. Although more intense treatment stages will generally occur outside the typical office setting, offices can implement less intense intervention strategies. We not ony address specific patient behavior goals but also encourage practices to modify office systems to streamline office-based care and to prepare to coordinate with professionals and programs outside the office for more intensive interventions.

Bivariate linkage confirms genetic contribution to fetal origins of childhood growth and cardiovascular disease risk in Hispanic children

Birth weight has been shown to be associated with obesity and metabolic diseases in adulthood, however, the genetic contribution is still controversial. The objective of this analysis is to explore the genetic contribution to the relationship between birth weight and later risk for obesity and metabolic diseases in Hispanic children. Subjects were 1,030 Hispanic children in the Viva La Familia Study. Phenotypes included body size, body composition, blood pressure, fasting glucose, insulin, lipids, and liver enzymes. Birth weights were obtained from Texas birth certificates. Quantitative genetic analyses were conducted using SOLAR software. Birth weight was highly heritable, as were all other phenotypes. Phenotypically, birth weight was positively correlated to childhood body size parameters. Decomposition of these phenotypic correlations into genetic and environmental components revealed significant genetic correlations, ranging from 0.30 to 0.59. Negative genetic correlations were seen between birth weight and lipids. The genome scan of birth weight mapped to a region near marker D10S537 (LOD = 2.6). The bivariate genome-wide scan of birth weight and childhood weight or total cholesterol, improved the LOD score to 3.09 and 2.85, respectively. Chromosome 10q22 harbors genes influencing both birth weight and childhood body size and cardiovascular disease risk in Hispanic children.

Longitudinal relationship of parental hypertension with body mass index, blood pressure, and cardiovascular reactivity in children

OBJECTIVE

To investigate whether parental hypertension (HTN) affects children's body mass index (BMI) and cardiovascular reactivity (CVR) over time.

STUDY DESIGN

A longitudinal study of 315 students (black: 23 females, 19 males; white: 142 females, 131 males) was conducted in the public schools of Obion County, Tennessee, between 1987 and 1992. BMI and BMI z scores were calculated. The CVR task was a series of video games (taking approximately 10 minutes to play) given to the same students in their third-, fourth-, fifth-, seventh-, and eighth-grade years. CVR was defined as the change in blood pressure (delta_BP) or heart rate (delta_HR) between before playing and while playing the video game. Positive parental history of HTN (27.6%) was defined as at least 1 parent with HTN. Multivariable regression analyses were performed to estimate the effects of parental HTN on children's BMI and CVR over time.

RESULTS

Children with parental HTN had significant higher BMI, BMI z score, and R_BP than did children without parental HTN (BMI: 21.6 vs 19.9, P = .001; BMI z score: 1.6 vs 1.1, P = .003; R_SBP: 112.6 vs 110.4 mm Hg, P = .01; R_DBP 62.7 vs 60.6 mm Hg, P = .003) after adjustment for covariates. Increased CVR was observed in children with parental HTN compared with children without parental HTN but was statistically significant only for SBP (delta_SBP: 17.2 vs 14.9 mm Hg; P = .01) after adjustment for covariates.

CONCLUSIONS

Parental HTN independently predicted children's BMI, BMI z score, resting BP, and BP reactivity.

Measurement of television viewing in children and adolescents: a systematic review

The relationship between television (TV) viewing and overweight in children is likely to be influenced by the quality of measures used. We systematically reviewed studies related to overweight in children that had included a measure of TV exposure. Literature searches were conducted in MedLINE, PsychInfo, SportDiscus and ISIWeb of Science. Methods of assessing TV viewing were evaluated, including the type of measure, the administration procedure and reported psychometric properties. The majority of studies assessed TV viewing using self-report surveys and very few studies used direct observation. The validity or reliability of measures was often not examined. The majority of tools that were evaluated were compared with another self-report measure or an objective measure of physical activity. TV viewing measures should be selected that are specific to the research question, the study design, as well as methodological feasibility. However, it is recommended that measures of TV viewing be used only if they have psychometric data to support their validity and reliability. Selecting measures that are valid and reliable enables us to examine with greater accuracy the influence of TV viewing on childhood overweight, as well as the efficacy of interventions designed to reduce TV viewing in children.

Dietary habits and nutritional biomarkers in Italian type 1 diabetes families: evidence of unhealthy diet and combined-vitamin-deficient intakes

OBJECTIVE

Nutritional status and lifestyle can have profound effects on health. To analyse behaviour patterns in population subgroups of public health importance, we compared lifestyle, dietary intake of energy and selected nutrients, and nutritional biomarkers of type 1 diabetes (T1DM) patients and nondiabetic first-degree relatives against control subjects with no family history of T1DM.

DESIGN

A cross-sectional study.

SETTING

Department of Internal Medicine, University of Pisa, Italy.

SUBJECTS

A total of 209 individuals including 38 type 1 patients, 76 relatives, and 95 healthy subjects.

INTERVENTIONS

We used the European Prospective Investigation of Cancer and Nutrition questionnaires to assess dietary intake and lifestyle. Anthropometric indices and nutritional biomarkers (such as plasma levels of albumin, iron, lipids, homocysteine, vitamin B9 and vitamin B12 as well as urinary outputs of nitrogen, sodium and potassium) were evaluated.

RESULTS

Emerging health issues: (1) In total, 45% of controls were overweight. Increasing age was associated with increasing body mass and decreasing activity in sport in front of an unchanged energy intake. (2) The distribution of energy sources was incorrect. The proportion of caloric intake derived from total fat and cholesterol did not match general guidelines. Total dietary fibre consumption was assessed to be adequate (25 g/day) in only 27% of all the participants. (3) Estimated daily intakes of water-soluble vitamin B9 and fat-soluble vitamin D and vitamin E were deficient in comparison with dietary reference intakes. (4) The prevalence of adoption and maintenance of healthful eating and physical activity habits was higher in women and T1DM patients (probably as a consequence of the medical educational intervention). On the contrary, supportiveness of the family in term of changing the undesirable behaviours at home seemed to fail.

CONCLUSIONS

This study provides first evidence indicating unhealthy dietary behaviours, which could even predispose to the development of diabetes and cardiovascular complications, in subjects living in Pisa. The combination of vitamin B9 and vitamin E deprivation could be deleterious for endothelial function, since these antioxidants have been implicated in the modulation of nitric oxide and eicosanoid signalling.