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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] [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.
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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
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2
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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: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [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.
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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
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3
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Clinical and physical characteristics of thinness in adolescents: the HELENA study. Eur J Nutr 2023; 62:1731-1742. [PMID: 36802024 DOI: 10.1007/s00394-023-03104-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 01/31/2023] [Indexed: 02/22/2023]
Abstract
PURPOSE Thinness in adolescence has not been studied as extensively as overweight or obesity. The aim of this study was to assess the prevalence, characteristics, and health impacts of thinness in a European adolescent population. METHODS This study included 2711 adolescents (1479 girls, 1232 boys). Blood pressure, physical fitness, sedentary behaviors, physical activity (PA), and dietary intake were assessed. A medical questionnaire was used to report any associated diseases. A blood sample was collected in a subgroup of the population. Thinness and normal weight were identified using the IOTF scale. Thin adolescents were compared with adolescents of normal weight. RESULTS Two hundred and fourteen adolescents (7.9%) were classified as being thin; the prevalence rates were 8.6% in girls and 7.1% in boys. Systolic blood pressure was significantly lower in adolescents with thinness. The age at the first menstrual cycle was significantly later in thin female adolescents than in those with normal weight. Upper-body muscular strength measured in performance tests and time spent in light PA were significantly lower in thin adolescents. The Diet Quality Index was not significantly lower in thin adolescents, but the percentage of adolescents who skipped breakfast was higher in adolescents with a normal weight (27.7% vs 17.1%). Serum creatinine level and HOMA-insulin resistance were lower and vitamin B12 level was higher in thin adolescents. CONCLUSIONS Thinness affects a notable proportion of European adolescents with no physical adverse health consequences.
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Thomas M, Coneyworth L, Welham S. Influence of income on diet quality and daily iron and zinc intake: analysis of the National Diet and Nutrition Survey of British females aged 11-14 and 15-18 years. Eur J Nutr 2023; 62:499-510. [PMID: 36149464 PMCID: PMC9510520 DOI: 10.1007/s00394-022-03000-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 09/07/2022] [Indexed: 02/07/2023]
Abstract
PURPOSE A negative socio-economic gradient exists for diet and health outcomes. Since cheaper diets are associated with increased energy and lower nutrient density, we investigated the influence of income on iron and zinc intakes and overall diet quality for adolescent (DQI-A) females aged 11-18 years. METHODS National Diet and Nutrition Survey (NDNS years 7 and 8) data for iron and zinc intake and overall diet quality was assessed by household income quintile across females aged 11-18 years. RESULTS Equivalised household income positively correlated with Diet quality index for adolescents (DQI-A) (P < 0.001) Females aged 15-18 years in income quintiles (IQs) I and 2, had a greater proportion of respondents with low to intermediate DQI-A score compared to higher IQs (P = 0.002). NDNS data showed intake was negatively influenced by income amongst females aged 11-14 years for iron (P = 0.009) and zinc (P = 0.001) with those from the lowest incomes consistently consuming significantly less than those from the highest. DQI-A was positively correlated with iron intakes for 11-14 (P = 0.001) and 15-18 years (P < 0.001). Forty-one percent of 15-18-year-olds plasma ferritin stores were below the 15 µg L-1 and 21% had some form of anaemia. Cereal and cereal products were the greatest contributors to iron in all groups. CONCLUSION Females in the lowest income groups are at greater risk of lower overall diet quality and inadequate iron and zinc intakes. Amongst older adolescents, there is evidence of iron stores being depleted and an increased prevalence of anaemia.
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Affiliation(s)
- Michelle Thomas
- Division of Nutritional Science, University of Nottingham, Sutton Bonington Campus, Sutton Bonington, Leicestershire, LE12 5RD UK
| | - Lisa Coneyworth
- Division of Nutritional Science, University of Nottingham, Sutton Bonington Campus, Sutton Bonington, Leicestershire, LE12 5RD UK
| | - Simon Welham
- Division of Nutritional Science, University of Nottingham, Sutton Bonington Campus, Sutton Bonington, Leicestershire, LE12 5RD UK
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Miguel-Berges ML, Fajó-Pascual M, Moreno LA, Campo M, Guerrero A, Olleta JL, Santolaria Blasco P, Santaliestra-Pasías AM. Effect of Lean Red Meat from Beef (Pirenaica Breed) Versus Lean White Meat Consumption on Diet Quality: A Randomized-Controlled Crossover Study in Healthy Young Adults. Nutrients 2022; 15:nu15010013. [PMID: 36615671 PMCID: PMC9823384 DOI: 10.3390/nu15010013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 12/07/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022] Open
Abstract
A randomized crossover study was carried out in three University accommodation halls. Participants consumed either beef (Pirenaica breed) (PB) or conventional chicken (CC) three times per week for an 8-week periods with their usual diet, each one separated by a 5-week wash out period. Dietary variables were recollected by the Food Frequency Questionnaire (FFQ), and the Diet Quality Index (DQI) was calculated. Forty-seven healthy adults were included (19.9 ± 1.75 years). The inclusion of both types of diets did not modify the components of the DQI, such as the diversity, equilibrium, adequacy and excess. However, when only the first period was analyzed, a significant decrease in the consumption of fruits and vegetables was observed in those participants who received the PB diet (intervention group). The CC diet (control group) significantly reduced the consumption of fish and eggs, total DQI, and DQI quality component. The expected effect was observed in the significant increment of consumption of red meat after the intervention period.
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Affiliation(s)
- Maria Luisa Miguel-Berges
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Facultad de Ciencias de la Salud, Universidad de Zaragoza, 50009 Zaragoza, Spain
- Instituto Agroalimentario de Aragón (IA2), 50013 Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), 50009 Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Marta Fajó-Pascual
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Facultad de Ciencias de la Salud, Universidad de Zaragoza, 50009 Zaragoza, Spain
- Instituto Agroalimentario de Aragón (IA2), 50013 Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), 50009 Zaragoza, Spain
| | - Luis A. Moreno
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Facultad de Ciencias de la Salud, Universidad de Zaragoza, 50009 Zaragoza, Spain
- Instituto Agroalimentario de Aragón (IA2), 50013 Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), 50009 Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Correspondence: ; Tel.: +34-876-553756
| | - Marimar Campo
- Instituto Agroalimentario de Aragón (IA2), 50013 Zaragoza, Spain
- Departamento de Producción Animal y Ciencia de los Alimentos, Universidad de Zaragoza-CITA, C. de Miguel Servet 177, 50013 Zaragoza, Spain
| | - Ana Guerrero
- Departamento de Producción Animal y Ciencia de los Alimentos, Universidad de Zaragoza-CITA, C. de Miguel Servet 177, 50013 Zaragoza, Spain
| | - Jose Luis Olleta
- Instituto Agroalimentario de Aragón (IA2), 50013 Zaragoza, Spain
- Departamento de Producción Animal y Ciencia de los Alimentos, Universidad de Zaragoza-CITA, C. de Miguel Servet 177, 50013 Zaragoza, Spain
| | - Pilar Santolaria Blasco
- Departamento de Producción Animal y Ciencia de los Alimentos, Escuela Politécnica Superior de Huesca, Instituto Universitario Ciencias Ambientales, Universidad de Zaragoza, Ctra. Cuarte, 22004 Huesca, Spain
| | - Alba M. Santaliestra-Pasías
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Facultad de Ciencias de la Salud, Universidad de Zaragoza, 50009 Zaragoza, Spain
- Instituto Agroalimentario de Aragón (IA2), 50013 Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), 50009 Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029 Madrid, Spain
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Giménez-Legarre N, Santaliestra-Pasías AM, De Henauw S, Forsner M, González-Gross M, Jurado-Fasoli L, Kafatos A, Karaglani E, Lambrinou CP, Molnár D, Sjöström M, Widhalm K, Moreno LA. Breakfast consumption and its relationship with diet quality and adherence to Mediterranean diet in European adolescents: the HELENA study. Eur J Clin Nutr 2022; 76:1690-1696. [PMID: 35927503 DOI: 10.1038/s41430-022-01177-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 06/15/2022] [Accepted: 06/23/2022] [Indexed: 11/09/2022]
Abstract
OBJECTIVE The aim of the current study is to analyze the associations between breakfast consumption and adherence to diet quality index (DQI) and Mediterranean Diet Score (MDS) in European adolescents. METHODS A multinational cross-sectional study was carried out in 1804 adolescents aged 12.5-17.5 years. The Food Choices and Preferences questionnaire was used to ascertain breakfast consumption (consumers, occasional consumers and skippers), and two non-consecutive 24 h dietary recalls were used to estimate the total daily intake and to calculate the subsequent DQI and MDS. Mixed linear regression models were used to examine the relationship between breakfast consumption and DQI-A and MDS. Age, maternal education, BMI, country and total energy intake were included as covariates. RESULTS In both sexes, significant differences were observed among the breakfast consumption categories. In both boys and girls, breakfast consumers had significantly higher DQI indices than those adolescents who skipped breakfast regularly (p < 0.001). Regarding total MDS, in both boys and girls, breakfast consumers had a higher total MDS than breakfast skippers (p < 0.001), however, no associations were shown between occasional breakfast consumers and DQI indices and MDS. CONCLUSION Breakfast consumption has been linked with better dietary quality scores compared with those children who usually skip breakfast. Promotion of regular breakfast consumption in adolescents could be an effective strategy to improve the overall diet quality.
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Affiliation(s)
- Natalia Giménez-Legarre
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Facultad de Ciencias de la Salud, Universidad de Zaragoza, Zaragoza, Spain
- Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), 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), Zaragoza, Spain.
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain.
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud, Carlos III, Madrid, Spain.
| | | | - Maria Forsner
- Unit for Preventive Nutrition, Department of Biosciences and Nutrition at NOVUM, Karolinska Institutet, Huddinge, Sweden
| | - Marcela González-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
- Department of Nutrition and Food Sciences-Nutritional Physiology, University of Bonn, Bonn, Germany
| | - Lucas Jurado-Fasoli
- Department of Medical Physiology. School of Medicine, University of Granada, Granada, Spain
- PROmoting FITness and Health through Physical Activity Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | | | - Eva Karaglani
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Christina-Paulina Lambrinou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Dénes Molnár
- Department of Pediatrics, Medical School, University of Pécs, Pécs, Hungary
| | - Michael Sjöström
- Unit for Preventive Nutrition, Department of Biosciences and Nutrition at NOVUM, Karolinska Institutet, Huddinge, Sweden
| | - Kurt Widhalm
- Division Gastroenterology and Hepatology, Dept. Med II, MedUniv Vienna, Vienna, Austria
- Department of Pediatrics, Private Medical University, Salzburg, Austria
| | - 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), Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud, Carlos III, Madrid, Spain
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Hu B, Tang S, Wang Z, Chen Y, Chen X, Zhao Q, Jiang Y, Shen M, Zhang C, Kaliszewski C, Wang L, Zhang Y. Dietary diversity is associated with nutrient adequacy, blood biomarkers and anthropometric status among preschool children in poor ethnic minority area of Northwest China. Front Nutr 2022; 9:948555. [PMID: 36505258 PMCID: PMC9729537 DOI: 10.3389/fnut.2022.948555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 11/08/2022] [Indexed: 11/27/2022] Open
Abstract
Introduction This study aimed to evaluate the status of dietary diversity, nutrient adequacy, blood biomarkers of nutrients, and anthropometric status, as well as to determine the predictors of dietary diversity score (DDS) and mean adequacy ratio (MAR) among preschool children in poor ethnic minority areas of northwest China. Methods A total of 578 healthy preschool children aged 3-6 from 17 kindergartens were selected to assess dietary intake, anthropometric status (height-for-age z-score (HAZ), weight-for-age z-score (WAZ), weight-for-height z-score (WHZ), and blood biomarkers. DDS and nutrient adequacy ratio (NAR) were adopted to assess dietary diversity and micronutrient adequacy, respectively. Results The mean DDS (ranging from 1 to 9) was relatively low (4.67 ± 1.56). Most participants consumed starchy staples, but few participants consumed organ meat. DDS was associated with serum potassium, serum iron, WAZ, HAZ, all NARs, and MAR (all p < 0.05). Living in urban areas (β = 0.158), higher household wealth (β = 0.116), and more caregivers' nutritional knowledge (β = 0.022) were positively associated with DDS (all p < 0.01), while living in urban areas (β = 0.031), higher education of caregivers (β = 0.0.027), and higher DDS (β = 0.049) were positively associated with MAR (all p < 0.01). Discussion In conclusion, dietary diversity was associated with nutrient adequacy and other health outcomes. Nutritional education and poverty alleviation are integral to improving the nutritional status of preschool children.
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Affiliation(s)
- Binshuo Hu
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Shihua Tang
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Zhuo Wang
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Youhai Chen
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Xiaohui Chen
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Qian Zhao
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Yu Jiang
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Minghui Shen
- Lanzhou University Second Hospital, Lanzhou, China
| | - Chong Zhang
- Gansu Provincial Maternity and Child-care Hospital, Lanzhou, China
| | - Catherine Kaliszewski
- Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, TX, United States
| | - Liang Wang
- Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, TX, United States,*Correspondence: Liang Wang,
| | - Ying Zhang
- School of Public Health, Lanzhou University, Lanzhou, China,Ying Zhang,
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8
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Association between diet quality index, food and nutrient intake and metabolic parameters in adolescents from Recife, northeastern Brazil. Br J Nutr 2022; 128:477-486. [PMID: 34511140 DOI: 10.1017/s0007114521003573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Nutritional studies shifted the focus of attention to the analysis of food quality, addressing general diet considering the foods, food groups and nutrients included. This study evaluates the association between diet quality index, food and nutrient intake and metabolic parameters of adolescents from Recife, northeastern Brazil. It is a cross-sectional study involving adolescents aged 12 to 19 years. Food intake was assessed using the FFQ to estimate the adapted Diet Quality Index for Adolescents for Brazilians (DQIA-BR-A). The analysis included metabolic parameters (glucose, lipid profile, apo A1 and B, α-1-acid glycoprotein, retinol, β-carotene, α-tocopherol, 25-hydroxyvitamin D and parathormone). Multiple linear regression analysis between the DQIA-BR-A and daily nutrient intake showed a positive correlation (R2adjusted = 0·29) for linoleic fatty acid, Ca and folate and a negative correlation for oleic fatty acid, carbohydrates and vitamins B2 and C, in addition to a low correlation (R2adjusted < 0·07) with all metabolic parameters. However, the DQIA-BR-A correlated significantly (R2adjusted = 0·62; P < 0·001) with food intake. In this way, the DQIA-BR-A can be considered as an accurate and useful instrument for assessing the overall quality of adolescent diets. The diet of the adolescents was considered to be of moderate quality. Changes are required to ensure a balanced diet, considering the high-sugar intake and consumption of sweets as well as the low consumption of vegetables, milk and dairy products, oils, fats and seeds. Such changes should prioritise the consumption of foods rich in essential fatty acids and poor in saturated fat.
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Identification of Lifestyle Risk Factors in Adolescence Influencing Cardiovascular Health in Young Adults: The BELINDA Study. Nutrients 2022; 14:nu14102089. [PMID: 35631230 PMCID: PMC9146351 DOI: 10.3390/nu14102089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 05/13/2022] [Accepted: 05/14/2022] [Indexed: 12/03/2022] Open
Abstract
Cardiovascular diseases are the leading cause of mortality worldwide. These diseases originate in childhood, and a better understanding of their early determinants and risk factors would allow better prevention. The BELINDA (BEtter LIfe by Nutrition During Adulthood) study is a 10−14-year follow-up of the HEalthy Lifestyle in Europe by Nutrition in Adolescence study (the HELENA study, a European cross-sectional study in adolescents). The study aims to evaluate cardiovascular risk using the PDAY (Pathobiological Determinants of Atherosclerosis in Youth) risk score during young adulthood (21−32 years), and to examine the impact of risk factors identified during adolescence (12.5−17.5 years). Our secondary objective is to compare the characteristics of the BELINDA study population with the HELENA population not participating in the follow-up study. The HELENA study recruited 3528 adolescents during 2006−2007 and reassessed 232 of them 10−14 years later as young adults. We assessed clinical status, anthropometry, nutrition, physical activity (including sedentary behavior), physical fitness, and mental health parameters, and collected biological samples (blood, stool, and hair). Dietary intake, and physical activity and fitness data were also collected. A multivariable linear regression model will be used for the analysis of the primary outcome. A Chi-square and T-test were conducted for the comparison of the descriptive data (gender, age, weight, height, body mass index (BMI), and maternal school level) between participating and non-participating BELINDA adolescents. When comparing the 1327 eligible subjects with the 232 included in the BELINDA study, no significant differences regarding gender (p = 0.72), age (p = 0.60), height (p = 0.11), and weight (p = 0.083) at adolescence were found. However, the participating population had a lower BMI (20.4 ± 3.1 kg/m2 versus 21.2 ± 3.6 kg/m2; p < 0.001) and a higher maternal educational level (46.8% high school or university level versus 38.6%; p = 0.027) than the HELENA population who did not participate in the BELINDA study. The complete phenotyping obtained at adolescence through the HELENA study is a unique opportunity to identify adolescent risk factors for cardiovascular diseases. This paper will serve as a methodological basis for future analysis of this study.
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Rianda D, Suradijono SHR, Setiawan EA, Susanto F, Meilianawati M, Prafiantini E, Kok FJ, Shankar AH, Agustina R. Long-term benefits of probiotics and calcium supplementation during childhood, and other biomedical and socioenvironmental factors, on adolescent neurodevelopmental outcomes. J Funct Foods 2022. [DOI: 10.1016/j.jff.2022.105014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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11
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González-Gil EM, Santaliestra-Pasías AM, Buck C, Gracia-Marco L, Lauria F, Pala V, Molnar D, Veidebaum T, Iacoviello L, Tornaritis M, Eiben G, Lissner L, Schwarz H, Ahrens W, De Henauw S, Fraterman A, Moreno LA. Improving cardiorespiratory fitness protects against inflammation in children: the IDEFICS study. Pediatr Res 2022; 91:681-689. [PMID: 33837254 DOI: 10.1038/s41390-021-01471-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 02/22/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Muscular and cardiorespiratory fitness (MF and CRF) have been related to inflammation. Thus, the aim of this study was to assess the relationship between fitness and high-sensitivity C-reactive protein (hs-CRP) in European children both in the cross-sectional and longitudinal analysis. METHODS Three hundred and fifty-seven children (46.2% males) aged 2-9 years with hs-CRP measured, data from MF and CRF, diet quality, objectively measured physical activity (PA) and screen time at baseline and follow-up after 2 years were included. Body mass index z-score (zBMI), waist circumference (WC) and fat mass index (FMI) were assessed. MF and CRF were also dichotomized as follows: low-medium quartiles (Q1-Q3) and highest quartile (Q4). RESULTS At follow-up, children with the highest CRF (Q4) showed a lower probability of having high hs-CRP. In the longitudinal analysis, children who improved their CRF over time showed a significantly lower probability (p < 0.05) of being in the highest hs-CRP category at follow-up, independently of the body composition index considered: odds ratio (OR) = 0.22 for zBMI, OR = 0.17 for WC, and OR = 0.21 for FMI. CONCLUSIONS Improving CRF during childhood reduces the odds of an inflammatory profile, independently of body composition and lifestyle behaviours. These highlight the importance of enhancing fitness, especially CRF, to avoid an inflammatory state in children. IMPACT Improvements in the cardiorespiratory profile during childhood could reverse an unfavourable inflammatory status. There is a longitudinal and inverse association between CRF and inflammation in children. This is the first longitudinal study assessing the relationship between fitness and inflammation during childhood that takes also into account the lifestyle behaviours. Results from the present study suggest a protective role of fitness already in childhood. Efforts to improve fitness in children should be aimed at as inflammation could trigger future cardiovascular disease.
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Affiliation(s)
- Esther M González-Gil
- Department of Biochemistry and Molecular Biology II, Instituto de Nutrición y Tecnología de los Alimentos, Center of Biomedical Research (CIBM), Universidad de Granada, Granada, Spain. .,GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain. .,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain.
| | - Alba M Santaliestra-Pasías
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain.,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain.,Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain.,Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
| | - Christoph Buck
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany
| | - Luis Gracia-Marco
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain.,PROFITH (PROmoting FITness and Health through physical activity) Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
| | - Fabio Lauria
- Institute of Food Sciences, National Research Council, Avellino, Italy
| | - Valeria Pala
- Epidemiology and Prevention Unit, Fondazione IRCCS-Istituto Nazionale dei Tumori, Milan, Italy
| | - Denes Molnar
- Department of Pediatrics, Medical School, University of Pécs, Pécs, Hungary
| | - Toomas Veidebaum
- National Institute for Health Development, Center of Health and Behavioral Science, Tallinn, Estonia
| | - Licia Iacoviello
- Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli, Italy.,Department of Medicine and Surgery, Research Center in Epidemiology and Preventive Medicine (EPIMED), University of Insubria, Varese, Italy
| | | | - Gabriele Eiben
- Department of Public Health, School of Health Sciences, University of Skövde, Skövde, Sweden
| | - Lauren Lissner
- Department of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Heike Schwarz
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany
| | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany.,Institute of Statistics, Bremen University, Bremen, Germany
| | - Stefaan De Henauw
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Arno Fraterman
- Laboratoriumsmedizin Dortmund, Eberhard & Partner, Dortmund, Germany
| | - Luis A Moreno
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain.,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain.,Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain.,Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
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12
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Characterising UK adolescents’ dietary intake by taste: links to dietary patterns and diet quality. Proc Nutr Soc 2022. [DOI: 10.1017/s002966512200235x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Hernández-Ruiz Á, Díaz-Jereda LA, Madrigal C, Soto-Méndez MJ, Kuijsten A, Gil Á. Methodological Aspects of Diet Quality Indicators in Childhood: A Mapping Review. Adv Nutr 2021; 12:2435-2494. [PMID: 34192740 PMCID: PMC8634546 DOI: 10.1093/advances/nmab053] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 03/12/2021] [Accepted: 04/02/2021] [Indexed: 01/16/2023] Open
Abstract
Diet quality indicators (DQIns) are tools that aim to assess an individual's overall diet quality. Previous reviews focused mainly on health-related outcomes but did not provide detailed information about components, assessment variables, or important methodological issues for the development and application of DQIns in the pediatric age. The current mapping review aims to provide comprehensive guidance regarding DQIns developed through a priori methodology in children aged ≤14 y that have been applied worldwide. A mapping review was conducted, whereby 1665 original articles describing the development, modifications, and updates of DQIns, published up to June 26, 2020, in English and Spanish, were retrieved. A total of 139 articles were identified and classified into 13 subgroups. There were 10 overall DQIns: Healthy Eating Indexes (n = 25), Dietary Diversity Scores (n = 20), Diet Quality Indexes (n = 16), Food Variety Scores (n = 11), Healthy and Unhealthy Scores (n = 11), Feeding and Eating Indexes (n = 10), Diet Quality Scores (n = 5), Nutritional Adequacy and Micronutrients Indexes (n = 5), Dietary Guidelines Indexes (n = 5), and Other Healthy Diet Indexes (n = 13). Three additional subgroups of dietary and lifestyle indicators found were Mediterranean Diet Indexes (n = 10), Diet-Lifestyle Indexes (n = 5), and Breakfast Quality Indexes (n = 3). This compilation of DQIns will help researchers select the most appropriate tool for future epidemiological studies by considering a careful selection of information about the assessment components, scoring methods, and key methodological issues. The main limitations of this review are that, due to its nature, a risk-of-bias assessment was not performed and the article screening was completed in 2 databases (PubMed/MEDLINE and Scopus). More research is needed to identify health-related outcomes associated with DQIns in the pediatric population, using clearer and more standardized methodological criteria.
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Affiliation(s)
| | | | - Casandra Madrigal
- Iberoamerican Nutrition Foundation (FINUT), Granada, Spain
- Department of Nutrition and Food Science, Faculty of Pharmacy, University of Granada, Granada, Spain
| | | | - Anneleen Kuijsten
- Division of Human Nutrition and Health, Wageningen University, Wageningen, Netherlands
| | - Ángel Gil
- Iberoamerican Nutrition Foundation (FINUT), Granada, Spain
- Department of Biochemistry and Molecular Biology II, University of Granada, Granada, Spain
- Institute of Nutrition and Food Technology “José Mataix,” Biomedical Research Center, University of Granada, Granada, Spain
- Biosanitary Research Institute ibs.GRANADA, Granada University Hospital Complex, Granada, Spain
- CIBEROBN (Physiopathology of Obesity and Nutrition), Instituto de Salud Carlos III, Madrid, Spain
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14
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Teixeira B, Afonso C, Rodrigues S, Oliveira A. Healthy and Sustainable Dietary Patterns in Children and Adolescents: A Systematic Review. Adv Nutr 2021; 13:1144-1185. [PMID: 34850824 PMCID: PMC9340991 DOI: 10.1093/advances/nmab148] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 10/18/2021] [Accepted: 11/24/2021] [Indexed: 01/02/2023] Open
Abstract
The need for adherence to a healthy and sustainable dietary pattern in the pediatric stage is discussed worldwide, being linked to a progressive incidence of noncommunicable diseases in adulthood. The aims of this systematic review were to summarize the healthy and/or sustainable dietary patterns, defined a priori, described in the literature for use during the pediatric stage; to evaluate the adherence to these dietary patterns; and identify the health-related benefits associated with adherence to these patterns. A literature search was carried out on Medline, Scopus, and Web of Science from 2010 up to 2021, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A total of 128 articles were included according to the following criteria: participants 2-17 y old, healthy and/or sustainable dietary patterns defined by an a priori methodology; articles written in English or Portuguese; and published since 2010. Fifty instruments with 14 adaptations that measure adherence to healthy and/or sustainable dietary patterns in children and adolescents were found. The Mediterranean Diet was the most studied dietary pattern. Adherence to healthy and/or sustainable dietary patterns has wide variations worldwide. Most of the instruments described have been little studied at pediatric ages, reducing the ability to extrapolate results. Higher adherence to these dietary patterns was associated with lower body fat, waist circumference, blood pressure, and metabolic risk. There is no consensus regarding the association with BMI. No studies have proofs of the sustainability characteristics of these instruments, it being necessary to produce a new sustainable instrument or test the association of the previous ones with, for example, the ecological footprint. Further validations of these instruments in each country and more prospective studies are needed to establish temporal relations with health-related outcomes. This systematic review was registered at www.crd.york.ac.uk/prospero/ as CRD42020221788.
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Affiliation(s)
| | - Cláudia Afonso
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal,EPIUnit - Instituto de Saúde Pública, Universidade do Porto [Institute of Public Health, University of Porto], Porto, Portugal,Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), [Laboratory for Integrative and Translational Research in Population Health (ITR)], Porto, Portugal
| | - Sara Rodrigues
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal,EPIUnit - Instituto de Saúde Pública, Universidade do Porto [Institute of Public Health, University of Porto], Porto, Portugal,Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), [Laboratory for Integrative and Translational Research in Population Health (ITR)], Porto, Portugal
| | - Andreia Oliveira
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto [Institute of Public Health, University of Porto], Porto, Portugal,Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), [Laboratory for Integrative and Translational Research in Population Health (ITR)], Porto, Portugal,Faculty of Medicine, University of Porto, Porto, Portugal
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15
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Yue Y, Yuan C, Wang DD, Wang M, Song M, Shan Z, Hu F, Rosner B, Smith-Warner SA, Willett WC. Reproducibility and validity of diet quality scores derived from food-frequency questionnaires. Am J Clin Nutr 2021; 115:843-853. [PMID: 34788377 PMCID: PMC8895225 DOI: 10.1093/ajcn/nqab368] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 11/01/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Diet quality scores (DQSs) are frequently used to study diet-disease relations but the validity of these scores derived from FFQs has rarely been evaluated. OBJECTIVES To evaluate the validity and reproducibility of 6 commonly used DQSs derived from the FFQ, including the Alternate Healthy Eating Index-2010, Dietary Approaches to Stop Hypertension Trial score, alternative Mediterranean diet score, and 3 plant-based diet indices (overall, healthful, and unhealthful). METHODS This analysis included 1394 participants from the Men's Lifestyle Validation Study (N = 652) and the Women's Lifestyle Validation Study (N = 742). Participants completed a 152-item FFQ at the beginning of the study and 1 y later, as well as completed 2 weighed 7-d dietary records (7DDRs) and donated 2 blood samples 6 mo apart between FFQ assessments. The reproducibility of the FFQs was evaluated by rank intraclass correlation coefficients (ICCs). The validity was assessed by comparing FFQ-derived DQSs with those from the average of two 7DDRs using Spearman rank correlation coefficients deattenuated for random measurement error in the 7DDRs (rs). Furthermore, we calculated the correlations between DQSs and plasma biomarkers of diet, including fatty acids, folate, carotenoids, retinol, and α- and γ-tocopherol. RESULTS Six FFQ-derived DQSs demonstrated moderate to high reproducibility (energy-adjusted ICCs: 0.61-0.84) and validity (energy-adjusted, deattenuated rs = 0.56-0.80) in both men and women. We consistently observed expected correlations between FFQ-derived DQSs with plasma fatty acids, including long-chain n-3 (ω-3) and trans fatty acids, most carotenoids, and γ-tocopherol (rs > 0.2). CONCLUSIONS Our study demonstrates the validity of the FFQ to evaluate overall diet quality using 6 commonly used DQSs. In addition, these DQSs have qualitatively demonstrated biological relevance, as indicated by their correlations with circulating biomarkers.
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Affiliation(s)
- Yiyang Yue
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Changzheng Yuan
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA,Department of Big Data and Health Science, Zhejiang University School of Public Health, Hangzhou, Zhejiang, China,Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Dong D Wang
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA,Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Molin Wang
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA,Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Mingyang Song
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA,Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Zhilei Shan
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Frank Hu
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA,Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA,Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Bernard Rosner
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA,Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Stephanie A Smith-Warner
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA,Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
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Córdoba-Rodríguez DP, Iglesia I, Gómez-Bruton A, Miguel-Berges ML, Flores-Barrantes P, Casajús JA, Moreno LA, Rodríguez G. Associations between Spanish children's physical activity and physical fitness with lean body mass: The CALINA study. J Sports Sci 2021; 40:401-412. [PMID: 34720058 DOI: 10.1080/02640414.2021.1994728] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The present study investigated the associations between physical activity (PA) and physical fitness (PF) with lean body mass (LBM) and evaluated whether PA mediates the association between PF and LBM. 279 children (150 boys) aged 7.5 ± 0.3 years participated in the study. PA was assessed by accelerometry and PF with handgrip and the standing long jump test. Total lean soft tissue mass index (TLSTMI), muscle cross-sectional area index (MCSAI), and fat-free mass index (FFMI) were evaluated using dual-energy X-ray absorptiometry, peripheral quantitative computed tomography, and bioimpedance analysis, respectively.Total (β = 0.247) and vigorous PA (β = 0.143) were associated with TLSTMI in girls. In boys, total (β = 0.337), light (β = 0.290), vigorous (β = 0.200), and moderate-vigorous PA (β = 0.189) were associated with TLSTMI. Total PA was associated with FFMI (β = 0.299). Handgrip strength does not mediate the relationship between total PA and TLSTMI. Positive associations were found between handgrip strength and TLSTMI, MCSAI, and FFMI in both girls and boys.In children, there is a positive association between total and vigorous PA with TLSTMI. Handgrip strength does not mediate the relationship between total PA and TLSTMI. It was associated with TLSTMI, MCSAI, and FFMI.
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Affiliation(s)
| | - Iris Iglesia
- Growth, Exercise, Nutrition and Development (Genud) Research Group, Universidad De Zaragoza, Instituto Agroalimentario De Aragón (Ia2), Zaragoza, España.,Instituto De Investigación Sanitaria Aragón (Iis Aragón), Zaragoza, España.,Red De Salud Materno Infantil Y Del Desarrollo (Samid), Instituto De Salud Carlos Iii, Madrid, España
| | - Alejandro Gómez-Bruton
- Growth, Exercise, Nutrition and Development (Genud) Research Group, Universidad De Zaragoza, Instituto Agroalimentario De Aragón (Ia2), Zaragoza, España.,Facultad De Ciencias De La Salud Y Del Deporte (Fcsd), Departamento De Fisiatría Y Enfermería, Universidad De Zaragoza, Zaragoza, España.,Centro De Investigación Biomédica En Red De Fisiopatología De La Obesidad Y Nutrición (Ciberobn), Instituto De Salud Carlos Iii Madrid, España
| | - María L Miguel-Berges
- Growth, Exercise, Nutrition and Development (Genud) Research Group, Universidad De Zaragoza, Instituto Agroalimentario De Aragón (Ia2), Zaragoza, España
| | - Paloma Flores-Barrantes
- Growth, Exercise, Nutrition and Development (Genud) Research Group, Universidad De Zaragoza, Instituto Agroalimentario De Aragón (Ia2), Zaragoza, España
| | - José Antonio Casajús
- Growth, Exercise, Nutrition and Development (Genud) Research Group, Universidad De Zaragoza, Instituto Agroalimentario De Aragón (Ia2), Zaragoza, España.,Instituto De Investigación Sanitaria Aragón (Iis Aragón), Zaragoza, España.,Facultad De Ciencias De La Salud Y Del Deporte (Fcsd), Departamento De Fisiatría Y Enfermería, Universidad De Zaragoza, Zaragoza, España.,Centro De Investigación Biomédica En Red De Fisiopatología De La Obesidad Y Nutrición (Ciberobn), Instituto De Salud Carlos Iii Madrid, España
| | - Luis A Moreno
- Growth, Exercise, Nutrition and Development (Genud) Research Group, Universidad De Zaragoza, Instituto Agroalimentario De Aragón (Ia2), Zaragoza, España.,Instituto De Investigación Sanitaria Aragón (Iis Aragón), Zaragoza, España.,Centro De Investigación Biomédica En Red De Fisiopatología De La Obesidad Y Nutrición (Ciberobn), Instituto De Salud Carlos Iii Madrid, España
| | - Gerardo Rodríguez
- Growth, Exercise, Nutrition and Development (Genud) Research Group, Universidad De Zaragoza, Instituto Agroalimentario De Aragón (Ia2), Zaragoza, España.,Instituto De Investigación Sanitaria Aragón (Iis Aragón), Zaragoza, España.,Red De Salud Materno Infantil Y Del Desarrollo (Samid), Instituto De Salud Carlos Iii, Madrid, España.,Área De Pediatría, Universidad De Zaragoza, Zaragoza, España
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17
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Agustina R, Rianda D, Setiawan EA. Relationships of Child-, Parents-, and Environment-Associated Determinants with Diet Quality, Physical Activity, and Smoking Habits among Indonesian Urban Adolescents. Food Nutr Bull 2021; 43:44-55. [PMID: 34670443 DOI: 10.1177/03795721211046145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The trend of unhealthy lifestyles is increasing among adolescents and has been associated with the rising burden of noncommunicable diseases (NCDs). However, specific determinants of unhealthy lifestyles among adolescents in low- and middle-income countries remain limited. OBJECTIVE To investigate the relationships of child-, parents-, and environment-associated determinants with diet quality, physical activity, and smoking habits among low-socioeconomic urban adolescents. METHODS A cross-sectional study involving 238 adolescents aged 11 to 17 years was conducted in Jakarta, Indonesia. Adolescents and their parents were interviewed to assess the determinants of healthy lifestyles that included diet quality, physical activity, and smoking habits. Diet and physical activity were quantified using the Diet Quality Index for Adolescents (DQI-A) and Physical Activity Questionnaire for Older Children (PAQ-C), respectively. Multiple regression was used to determine the β coefficients and odds ratios predictive of healthy lifestyles. RESULTS Mean scores of DQI-A and PAQ-C were considered low (33.5% ± 8.9% and 2.1 ± 0.5, respectively). Overall, 17.6% of adolescents were smokers, with 88% of these being males. Predictors of diet quality were child- (age, gender) and environment-associated (house size, access to a computer) determinants with β coefficients of -6.52 to 3.26. The PAQ-C score was associated with child- (female) and environment-associated (living area) determinants with β coefficients of -0.45 and 0.14, respectively. Younger adolescents and females were protective factors for smoking. Parents-associated determinants were not associated with any lifestyle indicators. CONCLUSIONS Child- and environment-associated determinants were predictors of healthy lifestyles among adolescents. Thus, personal empowerment and environment transformation are needed to facilitate a healthy lifestyle and reduce the burden of NCDs among adolescents.
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Affiliation(s)
- Rina Agustina
- Department of Nutrition, Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia.,Human Nutrition Research Center, Indonesian Medical Education and Research Institute (HNRC-IMERI), Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Davrina Rianda
- Department of Nutrition, Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia.,Human Nutrition Research Center, Indonesian Medical Education and Research Institute (HNRC-IMERI), Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Evania Astella Setiawan
- Department of Nutrition, Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
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A Simple Liking Survey Captures Behaviors Associated with Weight Loss in a Worksite Program among Women at Risk of Type 2 Diabetes. Nutrients 2021; 13:nu13041338. [PMID: 33920626 PMCID: PMC8072993 DOI: 10.3390/nu13041338] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 04/15/2021] [Accepted: 04/16/2021] [Indexed: 12/15/2022] Open
Abstract
In a secondary analysis, we assessed the ability of dietary and physical activity surveys to explain variability in weight loss within a worksite-adapted Diabetes Prevention Program. The program involved 58 overweight/obese female employees (average age = 46 ± 11 years SD; average body mass index = 34.7 ± 7.0 kg/m2 SD) of four long-term care facilities who survey-reported liking and frequency of dietary and physical activity behaviors. Data were analyzed using a latent variable approach, analysis of covariance, and nested regression analysis to predict percent weight change from baseline to intervention end at week 16 (average loss = 3.0%; range—6% gain to 17% loss), and follow-up at week 28 (average loss = 2.0%; range—8% gain to 16% loss). Using baseline responses, restrained eaters (reporting liking but low intakes of high fat/sweets) achieved greater weight loss at 28 weeks than those reporting high liking/high intake (average loss = 3.5 ± 0.9% versus 1.0 ± 0.8% S.E., respectively). Examining the dietary surveys separately, only improvements in liking for a healthy diet were associated significantly with weight loss (predicting 44% of total variance, p < 0.001). By contrasting liking versus intake changes, women reporting concurrent healthier diet liking and healthier intake lost the most weight (average loss = 5.4 ± 1.1% S.E.); those reporting eating healthier but not healthier diet liking (possible misreporting) gained weight (average gain = 0.3 ± 1.4% S.E.). Change in liking and frequency of physical activity were highly correlated but neither predicted weight loss independently. These pilot data support surveying dietary likes/dislikes as a useful measure to capture dietary behaviors associated with weight loss in worksite-based programs. Comparing dietary likes and intake may identify behaviors consistent (appropriate dietary restraint) or inconsistent (misreporting) with weight loss success.
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Ritter JDA, Cureau FV, Ronca DB, Blume CA, Teló GH, Camey SA, de Carvalho KMB, Schaan BD. Association between diet quality index and cardiometabolic risk factors in adolescents: Study of Cardiovascular Risks in Adolescents (ERICA). Nutrition 2021; 90:111216. [PMID: 33934056 DOI: 10.1016/j.nut.2021.111216] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 02/16/2021] [Accepted: 02/17/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVE This study evaluated the association between diet quality, assessed by the Diet Quality Index for Adolescents adapted for Brazilians (DQIA-BR), and cardiometabolic markers in adolescents. METHODS The DQIA-BR and cardiometabolic markers were assessed in 36 956 Brazilian adolescents (12-17 y old) enrolled in the Study of Cardiovascular Risks in Adolescents (ERICA), a national school-based cross-sectional multicenter study in Brazil. For analyses, the sample was stratified by sex and nutritional status. Multiple linear regressions were used to investigate the association between DQIA-BR and cardiometabolic markers (total cholesterol, HDL-c, LDL-c, triglycerides, fasting glucose and HOMA-IR). Adjusted models were constructed with two input levels of covariates. The first model was adjusted for sex, age, and socioeconomic status; in the second model, total energy intake, physical activity, and sedentary behavior were included. RESULTS A higher DQIA-BR score was associated with a better cardiometabolic profile in girls with normal weight; however, no association was observed in those with overweight/obesity. In boys with overweight/obesity, a better quality of diet was associated with lower concentrations of total cholesterol (β = -0.338, 95% confidence interval [CI]: -0.611 to -0.066) and LDL-c (β = -0.227, 95% CI: -0.448 to -0.005), but only LDL-c remained significant in those with normal weight (β = -0.115, 95% CI: -0.224 to 0.005). CONCLUSION The effects of diet quality on cardiometabolic risk factors differ according to sex and the presence of overweight/obesity. Overall, DQIA-BR is a suitable tool to evaluate the association between diet quality and cardiometabolic markers in normal-weight adolescents, but not for adolescents, especially girls, with overweight/obesity.
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Affiliation(s)
- Julianna do Amaral Ritter
- Postgraduate Program in Medical Sciences, Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
| | - Felipe Vogt Cureau
- Postgraduate Program in Cardiology and Cardiovascular Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Carina Andriatta Blume
- Postgraduate Program in Medical Sciences, Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Gabriela Heiden Teló
- School of Medicine and Postgraduate Program, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Suzi Alves Camey
- Postgraduate Program in Epidemiology, Department of Statistics, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Beatriz D Schaan
- Postgraduate Program in Medical Sciences, Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Postgraduate Program in Cardiology and Cardiovascular Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
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20
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Shaw S, Crozier S, Strömmer S, Inskip H, Barker M, Vogel C. Development of a short food frequency questionnaire to assess diet quality in UK adolescents using the National Diet and Nutrition Survey. Nutr J 2021; 20:5. [PMID: 33430892 PMCID: PMC7802176 DOI: 10.1186/s12937-020-00658-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 12/13/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND UK adolescents consume fewer fruits and vegetables and more free sugars than any other age group. Established techniques to understand diet quality can be difficult to use with adolescents because of high participant burden. This study aimed to identify key foods that indicate variation in diet quality in UK adolescents for inclusion in a short food frequency questionnaire (FFQ) and to investigate the associations between adolescent diet quality, nutritional biomarkers and socio-demographic factors. METHODS Dietary, demographic and biomarker data from waves 1-8 of the National Diet and Nutrition Survey rolling programme were used (n=2587; aged 11-18 years; 50% boys; n=≤997 biomarker data). Principal component analysis (PCA) was applied to 139 food groups to identify the key patterns within the data. Two diet quality scores, a 139-group and 20-group, were calculated using the PCA coefficients for each food group and multiplying by their standardised reported frequency of consumption and then summing across foods. The foods with the 10 strongest positive and 10 strongest negative coefficients from the PCA results were used for the 20-group score. Scores were standardised to have a zero mean and standard deviation of one. RESULTS The first PCA component explained 3.0% of variance in the dietary data and described a dietary pattern broadly aligned with UK dietary recommendations. A correlation of 0.87 was observed between the 139-group and 20-group scores. Bland-Altman mean difference was 0.00 and 95% limits of agreement were - 0.98 to 0.98 SDs. Correlations, in the expected direction, were seen between each nutritional biomarker and both scores; results attenuated slightly for the 20-group score compared to the 139-group score. Better diet quality was observed among girls, non-white populations and in those from higher socio-economic backgrounds for both scores. CONCLUSIONS The diet quality score based on 20 food groups showed reasonable agreement with the 139-group score. Both scores were correlated with nutritional biomarkers. A short 20-item FFQ can provide a meaningful and easy-to-implement tool to assess diet quality in large scale observational and intervention studies with adolescents.
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Affiliation(s)
- Sarah Shaw
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Tremona Road, Southampton, SO16 6YD, UK. .,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK.
| | - Sarah Crozier
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Tremona Road, Southampton, SO16 6YD, UK
| | - Sofia Strömmer
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Tremona Road, Southampton, SO16 6YD, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Hazel Inskip
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Tremona Road, Southampton, SO16 6YD, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Mary Barker
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Tremona Road, Southampton, SO16 6YD, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Christina Vogel
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Tremona Road, Southampton, SO16 6YD, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
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21
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An assessment of UK adolescents' dietary taste patterns. Proc Nutr Soc 2021. [DOI: 10.1017/s0029665121003347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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22
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Iguacel I, Börnhorst C, Michels N, Breidenassel C, Dallongeville J, González-Gross M, Gottrand F, Kafatos A, Karaglani E, Kersting M, de Henauw S, Lambrinou CP, Mistura L, Molnár D, Nova E, Gunter MJ, de la O Puerta A, Rupérez AI, Widhalm K, Huybrechts I, Moreno LA. Socioeconomically Disadvantaged Groups and Metabolic Syndrome in European Adolescents: The HELENA Study. J Adolesc Health 2021; 68:146-154. [PMID: 32636143 DOI: 10.1016/j.jadohealth.2020.05.027] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 04/16/2020] [Accepted: 05/08/2020] [Indexed: 11/21/2022]
Abstract
PURPOSE Psychosocial stressors derived from socioeconomic disadvantages in adolescents can result in higher risk of metabolic syndrome (MetS). We aimed to examine whether socioeconomic disadvantages were associated with MetS independent of lifestyle and whether there was a dose-response relationship between the number of cumulated socioeconomic disadvantages and risk of MetS. METHODS This study included 1,037 European adolescents (aged 12.5-17.5 years). Sociodemographic variables and lifestyle were assessed by self-reported questionnaires. Disadvantaged groups included adolescents with low-educated parents, low family affluence, migrant origin, unemployed parents, and nontraditional families. MetS risk score was calculated as the sum of sex- and age-specific z-scores of waist circumference, blood pressure, lipids, and insulin resistance. Linear mixed-effects models adjusted for sex, age, pubertal status, and lifestyle were used to study the association between social disadvantages and MetS risk score. RESULTS Adolescents with low-educated mothers showed a higher MetS score (.54 [.09-.98]; β estimate and 99% confidence interval) compared to those with high-educated mothers. Adolescents who accumulated more than three disadvantages (.69 [.08-1.31]) or with missing information on disadvantages (.72 [.04-1.40]) had a higher MetS risk score compared to nonsocioeconomically disadvantaged groups. Stronger associations between socioeconomic disadvantages and MetS were found in male than in female adolescents. CONCLUSIONS Adolescents with low-educated mothers or with more than three socioeconomic disadvantages had a higher MetS risk, independent of lifestyle, potentially due to higher psychosocial stress exposure. Policy makers should focus on improving low-educated familiesa and more disadvantaged families' knowledge on nutrition and physical activity to help them cope better with stress.
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Affiliation(s)
- Isabel Iguacel
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Faculty of Health Sciences, Deparment of Physiatry and Nursing, University of Zaragoza, Zaragoza, Spain; Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain; Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain; Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Madrid, Spain.
| | - Claudia Börnhorst
- Department of Biometry and Data Management, Leibniz Institute for Prevention Research and Epidemiology -BIPS, Bremen, Germany
| | | | - Christina Breidenassel
- Departement of Nutrition - Humannutrition, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Germany; ImFine Research Group, Department of Health and Human Performance, Facultad de Ciencias de la Actividad Fisica y del Deporte-INEF, Universidad Politecnica de Madrid, Madrid, Spain
| | - Jean Dallongeville
- Department of Epidemiology and Public Health, Institut Pasteur de Lille, Lille, France
| | - Marcela González-Gross
- ImFine Research Group, Department of Health and Human Performance, Facultad de Ciencias de la Actividad Fisica y del Deporte-INEF, Universidad Politecnica de Madrid, Madrid, Spain; Department of Health and Human Performance, Facultad de Ciencias de la Actividad Fsica y del Deporte-INEF, Universidad Politecnica de Madrid, Madrid, Spain
| | - Frédéric Gottrand
- Inserm U995, IFR114, Faculty of Medicine, Universit de Lille2, Lille, France
| | - Anthony Kafatos
- Preventive Medicine and Nutrition Clinic, University of Crete, Heraklion, Greece
| | - Eva Karaglani
- Department of Nutrition and Dietetics Harokopio University of Athens, Athens, Greece
| | - Mathilde Kersting
- Departement of Nutrition - Humannutrition, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Germany
| | | | | | - Lorenza Mistura
- Council for Agricultural Research and Economics, Research Centre for Food and Nutrition, Rome, Italy
| | - Denes Molnár
- Department of Paediatrics, University of Pecs, Pecs, Hungary
| | - Esther Nova
- Immunonutrition Group (Metabolism and Nutrition Department) -Institute of Food Science, Technology and Nutrition, Spanish National Research Council (ICTAN-CSIC), Madrid, Spain
| | - Marc J Gunter
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | | | - Azahara I Rupérez
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Faculty of Health Sciences, Deparment of Physiatry and Nursing, University of Zaragoza, Zaragoza, Spain; Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain; Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain; Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Madrid, Spain
| | - Kurt Widhalm
- Department of pediatrics, University of Vienna, Vienna, Austria
| | - Inge Huybrechts
- Department of Public Health, Ghent University, Ghent, Belgium; International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Luis A Moreno
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Faculty of Health Sciences, Deparment of Physiatry and Nursing, University of Zaragoza, Zaragoza, Spain; Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain; Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain; Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Madrid, Spain
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23
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Madalosso MM, Schaan B, Cureau FV. ASSOCIATION BETWEEN BODY WEIGHT PERCEPTION AND QUALITY OF DIET IN BRAZILIAN ADOLESCENTS. ACTA ACUST UNITED AC 2020; 38:e2020057. [PMID: 33331596 PMCID: PMC7747780 DOI: 10.1590/1984-0462/2020/38/2020057] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 07/01/2020] [Indexed: 11/25/2022]
Abstract
Objective: To evaluate the association between body weight perception and quality of diet among Brazilian adolescents. Methods: The sample was composed of 71,740 adolescents aged from 12 to 17 years-old enrolled in the Study of Cardiovascular Risks in Adolescents (Estudo de Riscos Cardiovasculares em Adolescentes - ERICA), carried out during 2013-2014. Body weight perception was self-reported. Food consumption was assessed by food record and quality of diet index for Brazilian adolescents (DQIA-BR) was calculated, considering the balance, diversity, and diet composition. The quality of diet was compared according to weight perception for the entire sample and after stratification by nutritional status. Linear regression models were used to assess the association between body weight perception and quality of diet. Results: Among the studied adolescents, 14.7 and 30.3% reported to be underweight or overweight in relation to their desired weight, respectively. Those who perceived themselves as overweight had lower quality of diet (DQIA-BR=16.0 vs. 17.4 points; p<0.001). After stratification by BMI, adolescents with normal weight (DQIA-BR=15.3 points) or overweight (DQIA-BR=16.1 points), but who perceived themselves as overweight showed lower quality of diet when compared to their peers. In adjusted analysis, overweight perception (β= -0.51; 95%CI -0.77; -0.24) was associated to lower quality of diet. However, this association was no longer significant after stratification by BMI status. Conclusions: Body weight perception can influence the consumption of healthy foods and the quality of diet, especially for those who consider themselves overweight. However, this association is influenced by nutritional status.
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Affiliation(s)
- Mariana Migliavacca Madalosso
- Graduate Program in Health Sciences: Cardiology and Cardiovascular Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Beatriz Schaan
- Graduate Program in Health Sciences: Cardiology and Cardiovascular Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Felipe Vogt Cureau
- Graduate Program in Health Sciences: Cardiology and Cardiovascular Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
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24
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Longitudinal changes in insulin resistance in children with epilepsy on ketogenic diet: Prevalence and risk factors. Epilepsy Behav 2020; 112:107393. [PMID: 32839143 DOI: 10.1016/j.yebeh.2020.107393] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 07/28/2020] [Accepted: 07/30/2020] [Indexed: 11/20/2022]
Abstract
INTRODUCTION The aim of the study was to evaluate the incidence of insulin resistance (IR) and the associated risk factors in children with epilepsy on a ketogenic diet (KD). METHODS This longitudinal cohort study analyzed data of children with epilepsy on KD. Insulin resistance was assessed using the homeostasis model assessment of insulin resistance (HOMA-IR). The HOMA-IR value, fasting serum insulin levels, fasting glucose (FG) levels, and lipid profiles were measured before the initiation of the KD and at 6- to 12-month intervals. RESULTS A total of 28 children were enrolled. The median age at the initiation of KD was 2.7 ± 2.4 years, and the median follow-up duration was 2.1 ± 1.4 years. The median HOMA-IR (HOMA-IR-1) value before the initiation of KD was 1.2 ± 0.2, which significantly increased to 1.8 ± 0.3 at the last follow-up (HOMA-IR-2; ∆HOMA-IR = 0.6 ± 0.3, p < 0.001). The following factors were associated with patients with higher HOMA-IR-2 values (≥1.9): younger age at seizure onset (0.3 ± 0.2 years, p < 0.001), at the initiation of antiepileptic drugs (AEDs; 0.3 ± 0.3 years, p < 0.001), and at the initiation of KD (1.3 ± 0.5 years, p < 0.001) and higher serum alanine transaminase (ALT; 84.0 ± 17.8 U/L, p = 0.022), total cholesterol (TC; 245.0 ± 20.1 mg/dL, p = 0.001), low-density lipoprotein cholesterol (LDL-C, 103.0 ± 6.7 mg/dL, p = 0.003), and triglyceride (387.0 ± 28.8 mg/dL, p < 0.001) levels. Multivariate regression analysis revealed that the age at seizure onset (p = 0.002), at initiation of AEDs (p = 0.021), and at initiation of KD (p = 0.022) and serum levels of LDL-C (p = 0.012) and triglycerides (p = 0.026) were associated with a significantly high HOMA-IR-2 value. CONCLUSION Close monitoring of serum lipids levels, especially at younger age, may aid in detecting exacerbation of IR.
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25
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Ojeda-Rodríguez A, Morell-Azanza L, Zalba G, Zazpe I, Azcona-Sanjulian MC, Marti A. Associations of telomere length with two dietary quality indices after a lifestyle intervention in children with abdominal obesity: a randomized controlled trial. Pediatr Obes 2020; 15:e12661. [PMID: 32558330 DOI: 10.1111/ijpo.12661] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 04/28/2020] [Accepted: 05/04/2020] [Indexed: 01/15/2023]
Abstract
BACKGROUND Dietary factors seem to influence telomere length. Moreover, associations between changes in adiposity indices and telomere length (TL) have been found in intervention studies. OBJECTIVE We evaluated changes in two diet quality indices and their association with TL in children with abdominal obesity in a 12-month lifestyle intervention. METHODS Eighty-seven participants (7-16 years old) were assigned to the intervention (moderate hypocaloric Mediterranean diet) or usual care group (standard paediatric recommendations) for a 2-month intensive phase and a subsequent 10-month follow-up. Diet quality was assessed using the Diet Quality Index for Adolescents (DQI-A) and the Healthy Lifestyle Diet Index (HLD-I). TL was measured by monochrome multiplex real-time quantitative PCR. The intra-class correlation coefficient for TL was 0.793 (95% CI 0.707, 0.857). RESULTS After a 12-month lifestyle intervention, a significant reduction in BMI-SDS (-0.57 and -0.49 for the intervention and usual care groups, respectively) and fat mass was observed in all subjects without differences between groups. Changes in DQI-A (+12.36% vs +5.53%, P = .005) and HLD-I (+4.43 vs +1.09, P < .001) were higher in the intervention subjects compared with usual care subjects after 2 months. Interestingly, we observed a positive change in TL between 2 and 12 months (P = .025), which was associated with higher scores on the DQI-A (β = 0.008, R2 = 0.088, P = .010) and HLD-I (β = 0.022, R2 = 0.198, P = .015), in the intervention group after the 2-month intensive phase. CONCLUSION Favourable changes in diet quality indices could contribute to telomere integrity in children with abdominal obesity enrolled in an intensive lifestyle intervention.
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Affiliation(s)
- Ana Ojeda-Rodríguez
- Department of Nutrition, Food Sciences and Physiology, University of Navarra, Pamplona, Spain.,IdiSNA, Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain
| | - Lydia Morell-Azanza
- Department of Nutrition, Food Sciences and Physiology, University of Navarra, Pamplona, Spain.,IdiSNA, Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain
| | - Guillermo Zalba
- IdiSNA, Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain.,Department of Biochemistry and Genetics, University of Navarra, Pamplona, Spain
| | - Itziar Zazpe
- Department of Nutrition, Food Sciences and Physiology, University of Navarra, Pamplona, Spain.,IdiSNA, Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain.,Department of Preventive Medicine and Public Health, School of Medicine-Clínica Universidad de Navarra, University of Navarra, Pamplona, Spain.,Biomedical Research Centre Network on Obesity and Nutrition (CIBERobn), Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain
| | - Maria Cristina Azcona-Sanjulian
- IdiSNA, Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain.,Pediatric Endocrinology Unit, Department of Pediatrics, Clínica Universidad de Navarra, Pamplona, Spain
| | - Amelia Marti
- Department of Nutrition, Food Sciences and Physiology, University of Navarra, Pamplona, Spain.,IdiSNA, Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain.,Biomedical Research Centre Network on Obesity and Nutrition (CIBERobn), Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain
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26
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Otsuka Y, Kaneita Y, Itani O, Jike M, Osaki Y, Higuchi S, Kanda H. Gender differences in dietary behaviors among Japanese adolescents. Prev Med Rep 2020; 20:101203. [PMID: 32995146 PMCID: PMC7509230 DOI: 10.1016/j.pmedr.2020.101203] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 09/04/2020] [Accepted: 09/05/2020] [Indexed: 11/30/2022] Open
Abstract
Few studies assessed a variety of adolescent dietary behaviours in Japan. The findings suggest that gender differences existed in dietary behaviors. Girls tended to adopt regular dietary behaviors as compared to boys. Schools support modeling and reinforcing healthy dietary behaviors.
Unhealthy dietary behaviors in adolescence are an important public health problem. Gender differences in dietary behaviors have already appeared during adolescence. However, few studies have assessed a variety of adolescent dietary behaviors in Japan. We aimed to clarify gender differences in unhealthy dietary behaviors among Japanese adolescents. The participants consisted of 84,988 participants from seventh to 12th grades. Unhealthy dietary behaviors were defined according to the National Health and Nutrition Survey. Multivariable logistic regression was used to analyze a nationally representative sample of Japanese adolescents from the 2014 to 2015 Lifestyle Survey. The effective response rate was 51.4%. The prevalence of unhealthy dietary behaviors (skipping breakfast, snacking, eating out, skipping meals, eating alone at dinner, and subjectively poor diet quality) among boys and girls was 14.2% versus 12.4%, 19.6% versus 14.1%, 10.6% versus 7.0%, 7.9% versus 5.6%, 13.3% versus 12.1%, and 12.3% versus 15.8%, respectively. Compared with boys, girls were more negatively associated with skipping breakfast [OR = 0.76 (95% CI 0.73–0.79)], snacking [OR = 0.67 (95% CI 0.65–0.70)], eating out [OR = 0.62 (95% CI 0.59–0.66)], skipping meals [OR = 0.61 (95% CI 0.58–0.65)], and eating alone at dinner [OR = 0.79 (95% CI 0.76–0.83)]. However, girls were more positively associated with subjectively poor diet quality [OR = 1.19 (95% CI 1.14.1.24)]. The findings suggest that gender differences existed in dietary behaviors. Gender differences in dietary behaviors suggest opportunities for tailoring interventions related to dietary education in schools.
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Affiliation(s)
- Yuichiro Otsuka
- Division of Public Health, Department of Social Medicine, Nihon University School of Medicine, Japan
| | - Yoshitaka Kaneita
- Division of Public Health, Department of Social Medicine, Nihon University School of Medicine, Japan
| | - Osamu Itani
- Division of Public Health, Department of Social Medicine, Nihon University School of Medicine, Japan
| | - Maki Jike
- Division of Public Health, Department of Social Medicine, Nihon University School of Medicine, Japan
| | - Yoneatsu Osaki
- Division of Environmental and Preventive Medicine, Department of Social Medicine, Faculty of Medicine, Japan
| | - Susumu Higuchi
- National Hospital Organization Kurihama Medical and Addiction Center, Japan
| | - Hideyuki Kanda
- Department of Public Health, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences, University Faculty of Medicine, Japan
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27
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Miguel-Berges ML, Flores Barrantes P, Iglesia Altaba I, Santaliestra-Pasias A, Samper P, A. Moreno L, Rodriguez G. Association of sedentary behaviours with food and beverages consumption and total diet quality in children from a Spanish region. The Calina study. CHILD AND ADOLESCENT OBESITY 2020. [DOI: 10.1080/2574254x.2020.1776054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Affiliation(s)
- María L Miguel-Berges
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Instituto Agroalimentario De Aragón (IA2), Zaragoza, Spain
| | - Paloma Flores Barrantes
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Instituto Agroalimentario De Aragón (IA2), Zaragoza, Spain
| | - Iris Iglesia Altaba
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Instituto Agroalimentario De Aragón (IA2), Zaragoza, Spain
- Instituto De Investigación Sanitaria De Aragón (IIS Aragón), Spain
- ISCIII-Sub-Directorate General for Research Assessment and Promotion, Red De Salud Materno-infantil Y Del Desarrollo (SAMID), Spain
| | - Alba Santaliestra-Pasias
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Instituto Agroalimentario De Aragón (IA2), Zaragoza, Spain
- Centro De Investigación Biomédica En Red De Fisiopatología De La Obesidad Y Nutrición (Ciberobn), Instituto De Salud Carlos III, Madrid, Spain
| | - Pilar Samper
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Instituto Agroalimentario De Aragón (IA2), Zaragoza, Spain
- Instituto De Investigación Sanitaria De Aragón (IIS Aragón), Spain
- ISCIII-Sub-Directorate General for Research Assessment and Promotion, Red De Salud Materno-infantil Y Del Desarrollo (SAMID), Spain
| | - Luis A. Moreno
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Instituto Agroalimentario De Aragón (IA2), Zaragoza, Spain
- Instituto De Investigación Sanitaria De Aragón (IIS Aragón), Spain
- Centro De Investigación Biomédica En Red De Fisiopatología De La Obesidad Y Nutrición (Ciberobn), Instituto De Salud Carlos III, Madrid, Spain
- Faculty of Health Sciences (FCS), University of Zaragoza, Saragossa, Spain
| | - Gerardo Rodriguez
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Instituto Agroalimentario De Aragón (IA2), Zaragoza, Spain
- Instituto De Investigación Sanitaria De Aragón (IIS Aragón), Spain
- ISCIII-Sub-Directorate General for Research Assessment and Promotion, Red De Salud Materno-infantil Y Del Desarrollo (SAMID), Spain
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Cross-sectional associations between lunch-type consumed on a school day and British adolescents' overall diet quality. Prev Med Rep 2020; 19:101133. [PMID: 32642402 PMCID: PMC7334820 DOI: 10.1016/j.pmedr.2020.101133] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 03/02/2020] [Accepted: 05/23/2020] [Indexed: 11/27/2022] Open
Abstract
Diet quality of children consuming school meals tends to be better than that of children consuming packed lunches (from home) or food bought outside school. This study investigates the association between different types of lunch consumed in a school day and diet quality of UK adolescents. A total of 2118 British adolescents were included from the National Diet and Nutrition Survey (Years 1-8; between 2008 and 2016). All participants attended school and were aged 11-18 years with valid 3 or 4-day diary records and the analyses were stratified by age group (11-14 and 15-18 years). The Diet Quality Index for Adolescents (DQI-A) tool consisting of three components; diet quality, diversity and equilibrium, was used to assess adherence to dietary recommendations. Overall DQI-A scores range from -33 to 100%. Overall mean DQI-A score for all adolescents was low at 21.1%. Fewer (17.4%) adolescents reported buying lunches from cafés and shops, compared to adolescents consuming cooked school meals and packed lunches (28.3% and 36.6%, respectively), and they had the lowest DQI-A% score of 14.8%. Adolescents having cooked school meals (reference group) had a higher overall DQI-A% of 21.8%. Diet quality scores of older adolescents having packed lunches and shop/café-bought lunches were 5.5% higher (CI 2.7 to 8.4%; p < 0.01) and 5.0% lower (CI 8.1 to 2.0%; p < 0.01) than cooked school meals respectively, after adjusting for gender, region, energy under-reporting and equivalised household income. For younger adolescents the results were attenuated particularly among packed lunch consumers. UK adolescents generally consume a poor quality diet and adolescents purchasing lunches from outside the school gates have the lowest quality diets. Unlike with older children there is little difference between school meals and packed lunches for younger children. Regulation policies on food outlets around secondary schools as well as improving food choices within school premises are needed.
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Agustina R, Nadiya K, Andini EA, Setianingsih AA, Sadariskar AA, Prafiantini E, Wirawan F, Karyadi E, Raut MK. Associations of meal patterning, dietary quality and diversity with anemia and overweight-obesity among Indonesian school-going adolescent girls in West Java. PLoS One 2020; 15:e0231519. [PMID: 32324775 PMCID: PMC7179884 DOI: 10.1371/journal.pone.0231519] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Accepted: 03/25/2020] [Indexed: 11/19/2022] Open
Abstract
Background Poor diet is a risk factor for anemia, overweight, and obesity among adolescent girls. However, comprehensive assessment on dietary quality and habits in this population is limited. We assessed the association of meal patterning, dietary quality, and dietary diversity with both anemia and overweight-obesity. Methods We conducted a cross-sectional survey in 335 school-going adolescent girls aged 12–19 years from three districts in West Java using multi-stage cluster sampling. Meal patterning, Dietary Quality Index for Adolescents (DQI-A), and Dietary Diversity Score (DDS) were determined using 2-day 24-h recall. Results Of the girls, 45% were anemic and 17% overweight or obese. Eating occasions of 3–4 times (AOR 2.68, 95% CI 1.21–5.98) and >4 times (AOR 2.43, 95% CI 1.01–5.83) were associated with greater odds of developing anemia compared to eating occasions of <3 times. Adolescent girls who skipped dinner had greater odds of being overweight or obese (AOR 2.13, 95% CI 1.10–4.10) and were less likely to be anemic (AOR 0.56, 95%CI 0.33–0.95) compared to those who did not skip dinner. Difference in energy intake was found between girls who had dinner and skipped dinner (p = 0.05). Mean total DQI-A score was 44.4% ± 7.71% and DDS was 4.0 out of 9.0. DQI-A score was significantly higher in non-anemic compared to anemic girls. Moreover, each unit increment of 1% of total DQI-A score was associated with a 3.967 g/dL increases of hemoglobin after adjustment for confounders. We found differences in total DQI-A score between normal-weight and overweight or obese girls. DDS score was not significantly different between groups, although lower meat, chicken, and fish consumption were correlated with anemia (p<0.01). Conclusions Overall, the girls had poor dietary quality and diversity. The findings therefore indicated the importance of improving dietary quality and diversity in a regular meal pattern, especially meal frequency and meal skipping, to reduce the risk of anemia and overweight-obesity among adolescent girls.
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Affiliation(s)
- Rina Agustina
- Department of Nutrition, Faculty of Medicine, Universitas Indonesia–Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
- Human Nutrition Research Center, Indonesian Medical Education and Research Institute (HNRC IMERI), Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
- * E-mail: ,
| | - Khairun Nadiya
- Human Nutrition Research Center, Indonesian Medical Education and Research Institute (HNRC IMERI), Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - El A. Andini
- Medical Study Program, Faculty of Medicine, Universitas Indonesia–Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Ainanur A. Setianingsih
- Medical Study Program, Faculty of Medicine, Universitas Indonesia–Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Arini A. Sadariskar
- Medical Study Program, Faculty of Medicine, Universitas Indonesia–Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Erfi Prafiantini
- Department of Nutrition, Faculty of Medicine, Universitas Indonesia–Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
- Human Nutrition Research Center, Indonesian Medical Education and Research Institute (HNRC IMERI), Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Fadila Wirawan
- Human Nutrition Research Center, Indonesian Medical Education and Research Institute (HNRC IMERI), Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Elvina Karyadi
- Former Nutrition International, Country Office Jakarta, Jakarta, Indonesia
| | - Manoj K. Raut
- Nutrition International, Asia Regional Office, New Delhi, India
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Xu R, Blanchard BE, McCaffrey JM, Woolley S, Corso LML, Duffy VB. Food Liking-Based Diet Quality Indexes (DQI) Generated by Conceptual and Machine Learning Explained Variability in Cardiometabolic Risk Factors in Young Adults. Nutrients 2020; 12:E882. [PMID: 32218114 PMCID: PMC7231006 DOI: 10.3390/nu12040882] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 03/17/2020] [Accepted: 03/23/2020] [Indexed: 02/07/2023] Open
Abstract
The overall pattern of a diet (diet quality) is recognized as more important to health and chronic disease risk than single foods or food groups. Indexes of diet quality can be derived theoretically from evidence-based recommendations, empirically from existing datasets, or a combination of the two. We used these methods to derive diet quality indexes (DQI), generated from a novel dietary assessment, and to evaluate relationships with cardiometabolic risk factors in young adults with (n = 106) or without (n = 106) diagnosed depression (62% female, mean age = 21). Participants completed a liking survey (proxy for usual dietary consumption). Principle component analysis of plasma (insulin, glucose, lipids) and adiposity (BMI, Waist-to-Hip ratio) measures formed a continuous cardiometabolic risk factor score (CRFS). DQIs were created: theoretically (food/beverages grouped, weighted conceptually), empirically (grouping by factor analysis, weights empirically-derived by ridge regression analysis of CRFS), and hybrid (food/beverages conceptually-grouped, weights empirically-derived). The out-of-sample CRFS predictability for the DQI was assessed by two-fold and five-fold cross validations. While moderate consistencies between theoretically- and empirically-generated weights existed, the hybrid outperformed theoretical and empirical DQIs in cross validations (five-fold showed DQI explained 2.6% theoretical, 2.7% empirical, and 6.5% hybrid of CRFS variance). These pilot data support a liking survey that can generate reliable/valid DQIs that are significantly associated with cardiometabolic risk factors, especially theoretically- plus empirically-derived DQI.
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Affiliation(s)
- Ran Xu
- Department of Allied Health Sciences, University of Connecticut, 358 Mansfield Rd, Storrs, CT 06269, USA; (R.X.); (B.E.B.); (J.M.M.); (L.M.L.C.)
| | - Bruce E. Blanchard
- Department of Allied Health Sciences, University of Connecticut, 358 Mansfield Rd, Storrs, CT 06269, USA; (R.X.); (B.E.B.); (J.M.M.); (L.M.L.C.)
| | - Jeanne M. McCaffrey
- Department of Allied Health Sciences, University of Connecticut, 358 Mansfield Rd, Storrs, CT 06269, USA; (R.X.); (B.E.B.); (J.M.M.); (L.M.L.C.)
| | - Stephen Woolley
- Institute of Living, Hartford Hospital, 200 Retreat Ave, Hartford, CT 06106, USA;
| | - Lauren M. L. Corso
- Department of Allied Health Sciences, University of Connecticut, 358 Mansfield Rd, Storrs, CT 06269, USA; (R.X.); (B.E.B.); (J.M.M.); (L.M.L.C.)
| | - Valerie B. Duffy
- Department of Allied Health Sciences, University of Connecticut, 358 Mansfield Rd, Storrs, CT 06269, USA; (R.X.); (B.E.B.); (J.M.M.); (L.M.L.C.)
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Santaliestra-Pasías AM, González-Gil EM, Pala V, Intemann T, Hebestreit A, Russo P, Van Aart C, Rise P, Veidebaum T, Molnar D, Tornaritis M, Eiben G, Moreno LA. Predictive associations between lifestyle behaviours and dairy consumption: The IDEFICS study. Nutr Metab Cardiovasc Dis 2020; 30:514-522. [PMID: 31791633 DOI: 10.1016/j.numecd.2019.10.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 09/29/2019] [Accepted: 10/07/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND AIM Physical activity (PA) and sedentary behaviours (SB) are related to obesity and cardiometabolic risk; however, the literature is controversial regarding the effect of dairy consumption on the development of cardiovascular disease (CVD) risk factors. The aim of this study was to assess longitudinally the relationship between specific lifestyle behaviours (PA and SB) and dairy consumption in a sample of European children and adolescents. METHODS AND RESULTS Children from the IDEFICS study were included in the analyses. Two measurements, with 2 years' interval, were conducted. A total of 1688 (50.8% boys) children provided information regarding diet, measured by a 24-h dietary recall, PA measured by accelerometers and parent-reported sedentary screen time (SST) at both time points. Different combinations of these behaviours, at each survey and over time, were derived applying specific recommendations. Multilevel ordinal logistic regression and analysis of covariance were used to assess their association with dairy consumption, adjusted for potential confounders. Differences by gender were found regarding dairy product consumption and also adherence to SB and PA recommendations at T0 and T1. Children meeting both lifestyle recommendations, at the two measurement points, had higher probability to consume more milk and yogurt and less cheese than the rest of combinations. CONCLUSIONS These results suggest that European children with a healthy lifestyle, especially regarding PA and SB over time, consumed more milk and yogurt. This study suggests that the protective effect of specific dairy products found in literature could be partially due to the association of their consumption with specific healthy lifestyles.
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Affiliation(s)
- Alba M Santaliestra-Pasías
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Universidad de Zaragoza, Spain; Instituto Agroalimentario de Aragón (IA2), Spain; Instituto de Investigación Sanitaria Aragón (IIS Aragón), Spain; Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Spain.
| | - Esther M González-Gil
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Universidad de Zaragoza, Spain; Instituto Agroalimentario de Aragón (IA2), Spain; Instituto de Investigación Sanitaria Aragón (IIS Aragón), Spain; Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Spain; Institute of Nutrition and Food Technology, Department of Biochemistry and Molecular Biology II, University of Granada, Spain
| | - Valeria Pala
- Department of Research, Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Timm Intemann
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany; Institute of Statistics, University of Bremen, Bremen, Germany
| | - Antje Hebestreit
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Paola Russo
- Institute of Food Sciences, National Research Council, Avellino, Italy
| | - Carola Van Aart
- Department of Public Health, Ghent University, Ghent, Belgium
| | - Patrizia Rise
- Department of Pharmacological Sciences, University of Milan, Milan, Italy
| | - Toomas Veidebaum
- National Institute for Health Development, Estonian Centre of Behavioral and Health Sciences, Tallinn, Estonia
| | - Denes Molnar
- Department of Paediatrics, University of Pécs, Pécs, Hungary
| | | | - Gabriele Eiben
- Section for Epidemiology and Social Medicine (EPSO), University of Gothenburg, Sweden; Department of Biomedicine and Public Health, University of Skövde, Skövde, Sweden
| | - Luis A Moreno
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Universidad de Zaragoza, Spain; Instituto Agroalimentario de Aragón (IA2), Spain; Instituto de Investigación Sanitaria Aragón (IIS Aragón), Spain; Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Spain
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Dairy Consumption at Snack Meal Occasions and the Overall Quality of Diet during Childhood. Prospective and Cross-Sectional Analyses from the IDEFICS/I.Family Cohort. Nutrients 2020; 12:nu12030642. [PMID: 32121167 PMCID: PMC7146220 DOI: 10.3390/nu12030642] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 02/21/2020] [Accepted: 02/25/2020] [Indexed: 12/22/2022] Open
Abstract
There is scarce information on the influence of dairy consumption between main meals on the overall diet quality through childhood, constituting the main aim of this research. From the Identification and prevention of Dietary- and lifestyle induced health EFfects In Children and infantS (IDEFICS) study, and based on the data availability in each period due to drop outs, 8807 children aged 2 to 9.9 years from eight European countries at baseline (T0: 2007-2008); 5085 children after two years (T1); and 1991 after four years (T3), were included in these analyses. Dietary intake and the Diet Quality Index (DQI) were assessed by two 24 hours dietary recalls (24-HDR) and food frequency questionnaire. Consumption of milk and yogurt (p = 0.04) and cheese (p < 0.001) at snack meal occasions was associated with higher DQI scores in T0; milk and yogurt (p < 0.001), and cheese (p < 0.001) in T1; and cheese (p = 0.05) in T3. Consumers of milk (p = 0.02), yogurt (p < 0.001), or cheese (p < 0.001) throughout T0 and T1 at all snack moments had significantly higher scores of DQI compared to non-consumers. This was also observed with the consumption of cheese between T1 and T3 (p = 0.03). Consumption of dairy products at snack moments through childhood is associated with a better overall diet quality, being a good strategy to improve it in this period.
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Sotos-Prieto M, Christophi C, Black A, Furtado JD, Song Y, Magiatis P, Papakonstantinou A, Melliou E, Moffatt S, Kales SN. Assessing Validity of Self-Reported Dietary Intake within a Mediterranean Diet Cluster Randomized Controlled Trial among US Firefighters. Nutrients 2019; 11:E2250. [PMID: 31546768 PMCID: PMC6769698 DOI: 10.3390/nu11092250] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 09/05/2019] [Accepted: 09/09/2019] [Indexed: 12/13/2022] Open
Abstract
Collecting dietary intake data is associated with challenges due to the subjective nature of self-administered instruments. Biomarkers may objectively estimate the consumption of specific dietary items or help assess compliance in dietary intervention studies. Our aim was to use a panel of plasma and urine biomarkers to assess the validity of self-reported dietary intake using a modified Mediterranean Diet Scale (mMDS) among firefighters participating in Feeding America's Bravest (FAB), an MD cluster-randomized controlled trial. In our nested biomarker pilot study, participants were randomly selected from both the MD intervention group (n = 24) and the control group (n = 24) after 12-months of dietary intervention. At baseline data collection for the pilot study (t = 12-months of FAB), participants in the control group crossed-over to receive the MD intervention (active intervention) for 6-months. Participants in the intervention group continued in a self-sustained continuation phase (SSP) of the intervention. Food frequency questionnaires (FFQ), 13-item-mMDS questionnaires, 40 plasma fatty acids, inflammatory biomarkers and urinary hydroxytyrosol and tyrosol were analyzed at both time points. Spearman's correlation, t-tests and linear regression coefficients were calculated using SAS software. Overall, the mMDS derived from the FFQ was highly correlated with the specific 13-domain-mMDS (r = 0.74). The concordance between the two questionnaires for low and high adherence to MD was high for all the participants in the parent trial (κ = 0.76). After 6 months of intervention in the pilot study, plasma saturated fatty acid decreased in both groups (active intervention: -1.3 ± 1.7; p = 0.002; SSP: -1.12 ± 1.90; p = 0.014) and oleic acid improved in the SSP (p = 0.013). Intake of olive oil was positively associated with plasma omega-3 (p = 0.004) and negatively with TNF-α (p < 0.001) at baseline. Choosing olive oil as a type of fat was also associated with higher levels of plasma omega-3 (p = 0.019) at baseline and lower TNF-α (p = 0.023) at follow up. Intake of red and processed meats were associated with lower serum omega-3 (p = 0.04) and fish consumption was associated with lower IL-6 at baseline (p = 0.022). The overall mMDS was associated with an increase in plasma omega-3 (p = 0.021). Good correlation was found between nutrient intake from the FFQ and the corresponding plasma biomarkers (omega-3, EPA and DHA). In this MD randomized controlled trial, some key plasma biomarkers were significantly associated with key MD diet components and the overall mMDS supporting the validity of the mMDS questionnaire as well as compliance with the intervention.
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Affiliation(s)
- Mercedes Sotos-Prieto
- Department of Environmental Health, Harvard University T.H Chan School of Public Health, Boston, MA 02215, USA.
- Division of Food and Nutrition Sciences, School of Applied Health Sciences and Wellness and Diabetes Institute, Ohio University, Athens, OH 45701, USA.
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, C/Arzobispo Morcillo, 28029 Madrid, Spain.
- Department of Nutrition, Harvard T.H Chan School, Boston, MA 02115, USA.
| | - Costas Christophi
- Department of Environmental Health, Harvard University T.H Chan School of Public Health, Boston, MA 02215, USA.
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, 30 Archbishop Kyprianou Str., Lemesos 3036, Cyprus.
| | - Alicen Black
- Division of Food and Nutrition Sciences, School of Applied Health Sciences and Wellness and Diabetes Institute, Ohio University, Athens, OH 45701, USA.
| | - Jeremy D Furtado
- Department of Nutrition, Harvard T.H Chan School, Boston, MA 02115, USA.
| | - Yiqing Song
- Department of Epidemiology Indiana University Richard M. Fairbanks School of Public Health, Indianapolis, IN 46202, USA.
| | - Prokopios Magiatis
- Department of Pharmacy, National and Kapodistrian University of Athens, Panepistimiopolis Zografou 157 71, Greece.
| | - Aikaterini Papakonstantinou
- Department of Pharmacy, National and Kapodistrian University of Athens, Panepistimiopolis Zografou 157 71, Greece.
| | - Eleni Melliou
- Department of Pharmacy, National and Kapodistrian University of Athens, Panepistimiopolis Zografou 157 71, Greece.
| | - Steven Moffatt
- National Institute for Public Safety Health, Indianapolis, IN 324 E New York Street, Indianapolis, IN 46204, USA.
| | - Stefanos N Kales
- Department of Environmental Health, Harvard University T.H Chan School of Public Health, Boston, MA 02215, USA.
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Aparicio-Ugarriza R, Cuenca-García M, Gonzalez-Gross M, Julián C, Bel-Serrat S, Moreno LA, Breidenassel C, Kersting M, Arouca AB, Michels N, Mouratidou T, Manios Y, Dallongeville J, Gottrand F, Widhalm K, Kafatos A, Molnár D, De Henauw S, Gunter MJ, Huybrechts I. Relative validation of the adapted Mediterranean Diet Score for Adolescents by comparison with nutritional biomarkers and nutrient and food intakes: the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study. Public Health Nutr 2019; 22:2381-2397. [PMID: 31204628 PMCID: PMC10260553 DOI: 10.1017/s1368980019001022] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 01/30/2019] [Accepted: 02/25/2019] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To investigate whether adherence to the adapted Mediterranean Diet Score for Adolescents (MDS_A) and the adapted Mediterranean Diet Quality Index for Adolescents (KIDMED_A) is associated with better food/nutrient intakes and nutritional biomarkers. DESIGN The Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study is a cross-sectional study aiming to obtain comparable data on a variety of nutritional and health-related parameters in European adolescents aged 12·5-17·5 years. SETTING Nine European countries. PARTICIPANTS European adolescents (n 2330) recruited to the HELENA study. Dietary intake was obtained with 24 h dietary recalls, an FFQ and a Food Choices and Preferences questionnaire. MDS_A was calculated as a categorical variable using cut-offs (MDS_A), as a continuous variable (zMDS_A) and with energy adjustments (zEnMDS_A). The KIDMED_A score was also calculated. RESULTS Multilevel linear regression analysis showed positive associations for zMDS_A and KIDMED_A with serum levels of vitamin D, vitamin C, plasma folate, holo-transcobalamin, β-carotene and n-3 fatty acids, while negative associations were observed with trans-fatty acid serum levels. For categorical indices, blood biomarkers showed few significant results. zMDS_A and KIDMED_A showed positive associations with vegetables and fruits intake, and negative associations with energy-dense and low-nutritious foods. zMDS_A and KIDMED_A were positively associated with all macronutrients, vitamins and minerals (all P < 0·0001), except with monosaccharides and PUFA for KIDMED_A and cholesterol for both indices (P < 0·05). CONCLUSIONS zMDS_A and KIDMED_A have shown the strongest associations with the dietary indicators and biomarkers that have been associated with the Mediterranean diet before, and are therefore considered the most appropriate and valid Mediterranean diet scores for European adolescents.
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Affiliation(s)
- Raquel Aparicio-Ugarriza
- 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
- International Agency for Research on Cancer (IARC), 150 cours Albert Thomas, 69372Lyon Cedex 08, France
| | - Magdalena Cuenca-García
- Department of Medical Physiology, School of Medicine, Granada University, Granada, Spain
- Department of Physical Education, School of Education, University of Cadiz, Puerto Real, Spain
| | - Marcela Gonzalez-Gross
- 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
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
| | - Cristina Julián
- GENUD (Growth, Exercise, Nutrition and Development) Research Group. Faculty of Health Sciences (FCS). Instituto Agroalimentario de Aragón (IA2). Instituto de Investigación Sanitaria Aragón (IIS Aragón), University of Zaragoza, Spain
| | - Silvia Bel-Serrat
- National Nutrition Surveillance Centre, School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Republic of Ireland
| | - Luis A Moreno
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
- GENUD (Growth, Exercise, Nutrition and Development) Research Group. Faculty of Health Sciences (FCS). Instituto Agroalimentario de Aragón (IA2). Instituto de Investigación Sanitaria Aragón (IIS Aragón), University of Zaragoza, Spain
| | - Christina Breidenassel
- 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
- Institut für Ernährungs- und Lebensmittelwissenschaften-Humanernährung, Rheinische Friedrich-Wilhelms Universität, Bonn, Germany
| | | | - Aline B Arouca
- Department of Public Health, Ghent University, Ghent, Belgium
| | | | - Theodora Mouratidou
- GENUD (Growth, Exercise, Nutrition and Development) Research Group. Faculty of Health Sciences (FCS). Instituto Agroalimentario de Aragón (IA2). Instituto de Investigación Sanitaria Aragón (IIS Aragón), University of Zaragoza, Spain
| | - Yannis Manios
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Jean Dallongeville
- Inserm U744, Institut Pasteur de Lille, Université Lille Nord de France, Lille, France
| | | | - Kurt Widhalm
- Division of Clinical Nutrition and Prevention, Department of Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Anthony Kafatos
- Preventive Medicine and Nutrition Clinic, University of Crete, Heraklion, Crete, Greece
| | - Denes Molnár
- Department of Pediatrics, University of Pécs, Pécs, Hungary
| | - Stefaan De Henauw
- Department of Public Health, Ghent University, Ghent, Belgium
- Department of Health Sciences, Vesalius, Hogeschool Gent, Ghent, Belgium
| | - Marc J Gunter
- International Agency for Research on Cancer (IARC), 150 cours Albert Thomas, 69372Lyon Cedex 08, France
| | - Inge Huybrechts
- International Agency for Research on Cancer (IARC), 150 cours Albert Thomas, 69372Lyon Cedex 08, France
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Ahrendt Bjerregaard A, Halldorsson TI, Tetens I, Frodi Olsen S. Mother's dietary quality during pregnancy and offspring's dietary quality in adolescence: Follow-up from a national birth cohort study of 19,582 mother-offspring pairs. PLoS Med 2019; 16:e1002911. [PMID: 31513597 PMCID: PMC6742222 DOI: 10.1371/journal.pmed.1002911] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 08/02/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The Developmental Origins of Health and Disease (DOHaD) hypothesis postulates that exposures during early life, such as maternal dietary intake during pregnancy, may have a lifelong impact on the individual's susceptibility to diseases. The individual's own lifestyle habits are obviously an additional factor, but we have only limited knowledge regarding how it may interact with prenatal exposures in determining later disease. To gain further insight into these potentially complex relationships, we examined the longitudinal association between maternal diet quality during pregnancy and diet quality in early adolescence in a contemporary cohort. METHODS AND FINDINGS From 1996 to 2003, the Danish National Birth Cohort (DNBC) was established. Women from across the country were enrolled, and dietary intake in midpregnancy was assessed concurrently with a 360-item food frequency questionnaire (FFQ) (https://www.dnbc.dk/-/media/arkiv/projekt-sites/dnbc/kodeboeger/dnbc-food-frequency-questionnaire/dnbc-food-frequency-questionnaire-pdf.pdf?la=en). During 2013-2018, dietary intake was assessed at age 14 years with a 150-item FFQ (https://www.dnbc.dk/-/media/arkiv/projekt-sites/dnbc/kodeboeger/ffq-14/dnbc-ffq-14-english-translation.pdf?la=en) in the DNBC children. Among the 19,582 mother-offspring pairs included in the analyses, the mean age (±standard deviation [SD]) was 30.7 (±4.1) years and 14.0 (±0.0) years for mothers and offspring, respectively. The majority of both mothers (67%) and offspring (76%) were classified as normal weight. For both questionnaires, a Healthy Eating Index (HEI) was developed as an indicator for diet quality based on current Danish Food-Based Dietary Guidelines (FBDG) including eight components: fruits and vegetables, fish, dietary fibres, red meat, saturated fatty acids (SFAs), sodium, sugar-sweetened beverages (SSBs), and added sugar. The HEI score was divided into quartiles; individuals in the highest quartile represented those with the most optimal diet. The maternal HEI score was correlated positively with offspring HEI score (Pearson r = 0.22, p < 0.001). A log-linear binomial model was used to estimate the relative risk of the offspring being in the highest quartile of HEI at age 14 years if the mother was ranked in quartile 4 during pregnancy. Results showed that offspring born to mothers who were in the highest HEI quartile during pregnancy were more likely themselves to be located in the highest HEI quartile at age 14 years (risk ratio [RR]: 2.1, 95% confidence interval [CI]: 2.0, 2.3, p < 0.001). Adjusting for maternal prepregnancy body mass index (BMI), parity, education, alcohol intake, physical activity, smoking, and breastfeeding, as well as offspring total energy intake and sex, did not influence the effect estimates. The limitations of our study include that some attrition bias towards more healthy participants was observed when comparing participants with nonparticipants. Bias in the FFQ method may also have resulted in underrepresentation of adolescents with poorer diet quality. CONCLUSIONS In this study using data from a large national birth cohort, we observed that maternal diet quality during pregnancy was associated with diet quality of the offspring at age 14 years. These findings indicate the importance of separating early dietary exposures from later dietary exposures when studying dietary aetiologies of diseases postulated to have developmental origins such as, for instance, obesity or asthma in observational settings.
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Affiliation(s)
- Anne Ahrendt Bjerregaard
- Center for Fetal Programming, Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
- * E-mail:
| | - Thorhallur Ingi Halldorsson
- Center for Fetal Programming, Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
- The Unit for Nutrition Research, Faculty of Food Science and Nutrition, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Inge Tetens
- Vitality—Centre for Good Older Lives, Department of Nutrition, Exercise, and Sports, University of Copenhagen, Denmark
| | - Sjurdur Frodi Olsen
- Center for Fetal Programming, Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States of America
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Zacarías G, Shamah-Levy T, Elton-Puente E, Garbus P, García OP. Development of an intervention program to prevent childhood obesity targeted to Mexican mothers of school-aged children using intervention mapping and social cognitive theory. EVALUATION AND PROGRAM PLANNING 2019; 74:27-37. [PMID: 30807872 DOI: 10.1016/j.evalprogplan.2019.02.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 02/10/2019] [Accepted: 02/15/2019] [Indexed: 06/09/2023]
Abstract
In Mexico, data from the last National Health and Nutrition Survey (2016) described the increase in the prevalence of overweight and obesity in school-aged children (33.2%). Obesity prevention strategies have not been effective, and currently, Mexico has one of the highest prevalence of childhood obesity. Thus, there is an urgent need to develop strategies that can prevent childhood obesity and also to avoid these children to remain overweight/obese through adulthood. The objective of this study was to provide a step-by-step description of the design, implementation and evaluation of an intervention plan for Mexican mothers of school aged children to promote healthy eating and to prevent childhood obesity. The program Niño Sano Adulto Sano was developed using the Intervention Mapping Approach and the Social Cognitive Theory frameworks to provide Mexican mothers with knowledge and skills to positively modify their children's food behavior, thus preventing future weight gain. The program was developed, piloted and delivered to the target population with positive results on the mothers' nutrition knowledge and children's BMI. Intervention Mapping and Social Cognitive Theory are useful models to design and deliver an intervention that provides a holistic approach to promote healthy eating.
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Affiliation(s)
- Gilda Zacarías
- School of Natural Sciences, Universidad Autónoma de Querétaro, Avenida de las Ciencias s/n Juriquilla, 76230, Queretaro, Mexico.
| | - Teresa Shamah-Levy
- National Institute of Public Health, Av. Universidad #655, Col. Sta. Ma. Ahuacatitlán, 62100, Cuernavaca, Morelos, Mexico.
| | - Elizabeth Elton-Puente
- School of Natural Sciences, Universidad Autónoma de Querétaro, Avenida de las Ciencias s/n Juriquilla, 76230, Queretaro, Mexico.
| | - Pamela Garbus
- School of Psychology, Universidad Autónoma de Querétaro, Cerro de las Campanas s/n. Las Campanas, 76010, Querétaro, Mexico.
| | - Olga P García
- School of Natural Sciences, Universidad Autónoma de Querétaro, Avenida de las Ciencias s/n Juriquilla, 76230, Queretaro, Mexico.
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Ronca DB, Blume CA, Cureau FV, Camey SA, Leotti VB, Drehmer M, Schaan BD, de Carvalho KMB. Diet quality index for Brazilian adolescents: the ERICA study. Eur J Nutr 2019; 59:539-556. [PMID: 30963230 DOI: 10.1007/s00394-019-01923-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Accepted: 02/03/2019] [Indexed: 11/25/2022]
Abstract
PURPOSE This study aimed to assess the dietary patterns of adolescents using a food-based diet quality index and their compliance with a healthy dietary guideline METHODS: Participants included 71,553 Brazilian adolescents (12-17 years old) from the Study of Cardiovascular Risks in Adolescents (ERICA), a cross-sectional school-based multicenter study.. Dietary intake was measured by one 24-h recall. A second recall was collected in a random subsample (~ 10%) to correct within-person variability. The Diet Quality Index for Adolescents adapted for Brazilians (DQIA-BR) was used to measure the overall quality of the dietary intake. The National Cancer Institute method was applied to estimate usual dietary intake. The DQIA-BR and the distribution of its components (quality, diversity, and equilibrium) were analyzed according to sex, geographical area, and type of school RESULTS: The mean (SD) DQIA-BR scores were 14.8% (6.1%) for females and 19.0% (6.3%) for males. All analyzed strata revealed low scores of DQIA-BR and its components. The median usual intake was five to sevenfold below the recommendations for vegetables and fruits and approximately twofold below the recommendations for dairy. The highest DQIA-BR mean scores were found in the northern region [17.0% (6.4%), females; 20.7% (6.3%), males]. Adolescents in both types of schools had relatively similar median intakes of snacks (~ 85 g) and sugared drinks (~ 600 ml) CONCLUSIONS: The overall diet quality of Brazilian adolescents is inadequate based on evaluated parameters in all regions and socioeconomic backgrounds.
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Affiliation(s)
- Débora Barbosa Ronca
- Graduate Program in Human Nutrition, Universidade de Brasília, Brasília, Brazil.
| | - Carina Andriatta Blume
- Postgraduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Felipe Vogt Cureau
- Postgraduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Suzi Alves Camey
- Postgraduate Program in Epidemiology, Department of Statistics, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Vanessa Bielefeldt Leotti
- Postgraduate Program in Epidemiology, Department of Statistics, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Michele Drehmer
- Postgraduate Program in Epidemiology, Department of Nutrition and Food and Nutrition Research Center, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Beatriz D Schaan
- Postgraduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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Delshad M, Beck KL, von Hurst PR, Mugridge O, Conlon CA. The validity and reliability of the Dietary Index for a Child's Eating in 2-8-year old children living in New Zealand. MATERNAL AND CHILD NUTRITION 2019; 15:e12758. [PMID: 30499635 DOI: 10.1111/mcn.12758] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Revised: 10/19/2018] [Accepted: 11/09/2018] [Indexed: 11/29/2022]
Abstract
This study aimed to examine the validity and reliability of the Dietary Index for a Child's Eating (DICE) in children living in New Zealand (NZ). Caregivers of healthy children aged 2-8 years completed a 4-day estimated food record (4DFR) for their child and completed the DICE online on two separate occasions, 8 weeks apart. Relative validity was assessed by comparing the DICE and 4DFR total score and component subscores using the Wilcoxon test, Spearman rank correlation coefficients, cross-classification, and weighted kappa (ĸ) statistic. For evaluating construct validity, the DICE total score was compared with energy and nutrient intake from the 4DFR using linear contrast analysis. Intraclass correlation coefficients (Cronbach's α) and Bland-Altman plots were used to assess the reliability of DICE. From a possible score of 100, the mean ± standard deviation of DICE was 78.2 ± 11.5 and from the 4DFR, was 73.8 ± 10.8, with a positive correlation (r = 0.72; p < 0.001) and moderate agreement (ĸ = 0.49). Cross-classification showed 61.9% were correctly categorised into the same tertile group from DICE and the 4DFR. Participants in the highest tertile of DICE had higher intakes of fibre, vitamin C, vitamin A, vitamin D, folate, and calcium. Good agreement (α = 0.87) was found for reliability. DICE is a valid and reliable tool for the assessment of children's adherence to a healthy diet, as recommended by the NZ Ministry of Health Food and Nutrition guidelines.
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Affiliation(s)
- Maryam Delshad
- School of Sport, Exercise and Nutrition, College of Health, Massey University, Auckland, New Zealand
| | - Kathryn L Beck
- School of Sport, Exercise and Nutrition, College of Health, Massey University, Auckland, New Zealand
| | - Pamela R von Hurst
- School of Sport, Exercise and Nutrition, College of Health, Massey University, Auckland, New Zealand
| | - Owen Mugridge
- School of Sport, Exercise and Nutrition, College of Health, Massey University, Auckland, New Zealand
| | - Cathryn A Conlon
- School of Sport, Exercise and Nutrition, College of Health, Massey University, Auckland, New Zealand
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The cross-sectional relationships between consumption of takeaway food, eating meals outside the home and diet quality in British adolescents. Public Health Nutr 2018; 22:63-73. [PMID: 30444207 DOI: 10.1017/s1368980018002690] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The present study aimed to evaluate the association of frequency of consuming takeaway meals and meals out with diet quality of UK adolescents. DESIGN The Diet Quality Index for Adolescents (DQI-A) tool was used to assess diet quality, where adolescents' food intake was based on 4d diary records obtained from the UK cross-sectional National Diet and Nutrition Survey (NDNS) rolling programme Years 1-6. Models included confounders. SETTING The DQI-A relies on three components, specifically diet quality, diversity and equilibrium, which reflect the degree of adherence of an adolescent's diet with food-based dietary guidelines.ParticipantsBritish (n 2045) adolescents aged 11-18 years. RESULTS Mean diet quality score for all adolescents was 20·4 % (overall DQI-A score range: -33 to 100 %). After adjusting for age, gender and equivalised household income, DQI-A% score was higher for low and moderate takeaway consumers by 7·4 % (95 % CI 5·5, 9·2; P<0·01) and 3·5 % (95 % CI 1·9, 5·1; P<0·01), respectively, v. frequent consumers. Significant differences were also observed between low, moderate and frequent takeaway consumers among all DQI-A components and sub-components (P<0·05), except for the diet adequacy sub-component (DAx). Results for frequent consumption of meals out were similar but attenuated and not statistically significant for individual components before or after adjusting for confounders. CONCLUSIONS Frequent consumption of takeaway meals may have a negative impact on adolescents' diet quality and therefore policies to reduce the intake of takeaways should be considered in this age group.
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Ojeda-Rodríguez A, Zazpe I, Morell-Azanza L, Chueca MJ, Azcona-Sanjulian MC, Marti A. Improved Diet Quality and Nutrient Adequacy in Children and Adolescents with Abdominal Obesity after a Lifestyle Intervention. Nutrients 2018; 10:nu10101500. [PMID: 30322156 PMCID: PMC6213517 DOI: 10.3390/nu10101500] [Citation(s) in RCA: 75] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 10/07/2018] [Accepted: 10/11/2018] [Indexed: 02/06/2023] Open
Abstract
High rates of childhood obesity require integral treatment with lifestyle modifications that achieve weight loss. We evaluated a lifestyle intervention on nutrient adequacy and diet quality in children and adolescents with abdominal obesity. A randomized controlled trial was performed on 107 participants, assigned either to a usual care group or to an intensive care group that followed a moderate hypocaloric Mediterranean diet and received nutritional education. Intake adequacy was evaluated using Dietary Reference Intakes and diet quality through the Diet Quality Index for Adolescents (DQI-A), the Healthy Lifestyle Diet-Index (HLD-I) and the Mediterranean Diet Quality Index (KIDMED). Both groups achieved a significant reduction in BMI standard deviation score (BMI-SDS), glucose and total cholesterol levels. Intake of Calcium, Iodine and vitamin D were higher in the intensive care group, with enhanced compliance with recommendations. Higher dietary scores were associated with lower micronutrient inadequacy. DQI-A and HLD-I were significantly higher in the intensive care group vs. usual care group after the treatment. In conclusion, we observed that an intensive lifestyle intervention was able to reduce BMI-SDS in children with abdominal obesity. Furthermore, participants significantly improved dietary indices getting closer to the nutritional recommendations. Therefore, these diet quality indices could be a valid indicator to evaluate micronutrient adequacy.
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Affiliation(s)
- Ana Ojeda-Rodríguez
- Department of Nutrition, Food Sciences and Physiology, University of Navarra. C/ Irunlarrea, 1. 31008 Pamplona, Spain.
- IdiSNA, Instituto de Investigación Sanitaria de Navarra. C/Irunlarrea, 3. 31008 Pamplona, Spain.
| | - Itziar Zazpe
- Department of Nutrition, Food Sciences and Physiology, University of Navarra. C/ Irunlarrea, 1. 31008 Pamplona, Spain.
- IdiSNA, Instituto de Investigación Sanitaria de Navarra. C/Irunlarrea, 3. 31008 Pamplona, Spain.
- Department of Preventive Medicine and Public Health, School of Medicine-Clínica Universidad de Navarra, University of Navarra. C/ Irunlarrea, 1. 31008 Pamplona, Spain.
- Biomedical Research Centre Network on Obesity and Nutrition (CIBERobn), Physiopathology of Obesity and Nutrition, Institute of Health Carlos III. Av. Monforte de Lemos, 3-5. 28029 Madrid, Spain.
| | - Lydia Morell-Azanza
- Department of Nutrition, Food Sciences and Physiology, University of Navarra. C/ Irunlarrea, 1. 31008 Pamplona, Spain.
- IdiSNA, Instituto de Investigación Sanitaria de Navarra. C/Irunlarrea, 3. 31008 Pamplona, Spain.
| | - María J Chueca
- IdiSNA, Instituto de Investigación Sanitaria de Navarra. C/Irunlarrea, 3. 31008 Pamplona, Spain.
- Paediatric Endocrinology Unit, Complejo Hospitalario de Navarra. C/Irunlarrea, 3. 31008 Pamplona, Spain.
| | - Maria Cristina Azcona-Sanjulian
- IdiSNA, Instituto de Investigación Sanitaria de Navarra. C/Irunlarrea, 3. 31008 Pamplona, Spain.
- Paediatric Endocrinology Unit, Department of Paediatrics. Clínica Universidad de Navarra. Av. Pío XII, 36. 31008 Pamplona, Spain.
| | - Amelia Marti
- Department of Nutrition, Food Sciences and Physiology, University of Navarra. C/ Irunlarrea, 1. 31008 Pamplona, Spain.
- IdiSNA, Instituto de Investigación Sanitaria de Navarra. C/Irunlarrea, 3. 31008 Pamplona, Spain.
- Biomedical Research Centre Network on Obesity and Nutrition (CIBERobn), Physiopathology of Obesity and Nutrition, Institute of Health Carlos III. Av. Monforte de Lemos, 3-5. 28029 Madrid, Spain.
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Rodríguez-Mireles S, López-Valcárcel BG, Serra-Majem L, Hernández-Yumar A, Barber-Pérez P, Pinilla-Domínguez J, Rodríguez-Feijoo S, Rodríguez-Caro A. Effect of Tourism Pressure on the Mediterranean Diet Pattern. Nutrients 2018; 10:nu10101338. [PMID: 30241304 PMCID: PMC6213434 DOI: 10.3390/nu10101338] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 09/15/2018] [Accepted: 09/18/2018] [Indexed: 01/19/2023] Open
Abstract
Despite proposed conceptual frameworks of eating behaviors, little is known about environmental factors contributing to changes in food habits. Few studies have reported the external influence of tourism on the inhabitants’ eating patterns. The present study aimed to investigate whether tourism pressure affects Canary Islands inhabitants’ adherence to the Mediterranean diet pattern. Data were obtained from a health and lifestyle population-based survey conducted in 2009 and 2015. From the reported intake frequency, a Mediterranean diet score was defined (0 to 11 points). Tourist overnight stays, which were stratified by nationality and area of destination, were used as a proxy variable to measure tourism pressure. A multilevel linear regression analysis by restricted maximum likelihood estimation was performed to examine the relationship between tourism pressure and the Mediterranean diet score. A significant negative association between the Mediterranean diet score and British tourism pressure was observed (β = −0.0064, p = 0.010), whereas German tourism pressure increased inhabitants’ adherence (β = 0.0092, p = 0.042). The socioeconomic level of tourists seems to play a role in differences in the tourism pressure effect by nationality. Further investigation of other highly touristic destinations is needed to confirm these findings that could contribute to a shift in tourism and public health nutrition policies.
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Affiliation(s)
- Silvia Rodríguez-Mireles
- Department of Quantitative Methods for Economics and Management, University of Las Palmas de Gran Canaria, 35017 Las Palmas, Spain.
- Service of Preventive Medicine, Complejo Hospitalario Universitario Insular Materno-Infantil, Canary Health Service, Las Palmas de Gran Canaria, 35016 Las Palmas, Spain.
| | - Beatriz G López-Valcárcel
- Department of Quantitative Methods for Economics and Management, University of Las Palmas de Gran Canaria, 35017 Las Palmas, Spain.
| | - Lluís Serra-Majem
- Service of Preventive Medicine, Complejo Hospitalario Universitario Insular Materno-Infantil, Canary Health Service, Las Palmas de Gran Canaria, 35016 Las Palmas, Spain.
- Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, 35016 Las Palmas, Spain.
| | - Aránzazu Hernández-Yumar
- Department of Applied Economics and Quantitative Methods, University of La Laguna, 38200 Santa Cruz de Tenerife, Spain.
| | - Patricia Barber-Pérez
- Department of Quantitative Methods for Economics and Management, University of Las Palmas de Gran Canaria, 35017 Las Palmas, Spain.
| | - Jaime Pinilla-Domínguez
- Department of Quantitative Methods for Economics and Management, University of Las Palmas de Gran Canaria, 35017 Las Palmas, Spain.
| | - Santiago Rodríguez-Feijoo
- Department of Quantitative Methods for Economics and Management, University of Las Palmas de Gran Canaria, 35017 Las Palmas, Spain.
| | - Alejandro Rodríguez-Caro
- Department of Quantitative Methods for Economics and Management, University of Las Palmas de Gran Canaria, 35017 Las Palmas, Spain.
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Adolescents' diet quality in relation to their relatives' and peers' diet engagement and encouragement: the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study. Public Health Nutr 2018; 21:3192-3201. [PMID: 30095062 DOI: 10.1017/s1368980018001787] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
OBJECTIVE To examine the associations between adolescents' diet quality and their perceived relatives' and peers' diet engagement and encouragement. DESIGN Cross-sectional study performed in European countries. Diet quality was scored using the Diet Quality Index for Adolescents (DQI-A) based on four components: quality, diversity, balance and meal frequency. Perceived diet quality engagement and perceived encouragement of the relatives/peers were assessed using the questions 'How healthy is each of the following persons' diet?' and 'How often does each of the following persons encourage you to eat a healthy diet?' SETTING Vienna, Ghent, Lille, Athens, Heraklion, Pecs, Rome, Dortmund, Zaragoza and Stockholm. SUBJECTS Healthy adolescents (n 2943). RESULTS The perceived engagement level of the mother, father and sister was each positively associated with the DQI-A (P<0·05). A positive association was found for the perceived engagement level of siblings, father and mother with all specific components (P<0·05). DQI-A was negatively associated with the perceived encouragement level from a best friend and positively associated with the encouragement level of the mother and father (P<0·05). Diversity, balance and quality components were positively associated with the perceived encouragement level from the mother and father (P<0·05), whereas the best friend's perceived encouragement was negatively associated with the meal frequency component (P<0·01). CONCLUSIONS These findings highlight the role of social engagement and encouragement of relatives and peers in adolescents' diet quality. Intervention or promotion programmes aimed at enhancing diet quality in adolescents should target both family and peers.
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Barrett N, Riordan F, Michels N, Frost Andersen L, vant Veer P, Moreno LA, Widhalm K, Manios Y, Gottrand F, Santaliestra-Pasías AM, Ruiz JR, Censi L, de Henauw S, Kersting M, Harrington JM. Breakfast Skipping and overweight/obesity among European adolescents, a cross-sectional analysis of the HELENA dataset: a DEDIPAC study. HRB Open Res 2018. [DOI: 10.12688/hrbopenres.12847.1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Background: The aim was to examine demographic and dietary factors associated with breakfast skipping, and the relationship of breakfast skipping with overweight/obesity among adolescents across Europe. Methods: Cross-sectional data from the Healthy Lifestyle in Europe by Nutrition in Adolescence study (n=3528) conducted in ten European cities: Athens (Greece), Dortmund (Germany), Ghent (Belgium), Herkalion (Greece), Lille (France), Pecs (Hungary), Rome (Italy), Vienna (Austria), Stockholm (Sweden) and Zaragoza (Spain) were used. Analysis was carried out using a sub-sample of adolescents (n=1894) aged 12.5-17.49 years with data on breakfast skipping and two days of 24-Hour Diet Recall data. As 24-Hour Recall data was not available from Pecs (Hungary) this city was excluded. Using responses from the Food Choices and Preferences Questionnaire adolescents were classified as breakfast skippers or non-breakfast skippers. All analyses were stratified by sex. Differences in the intake of macronutrients, both overall and when breakfast was excluded, and key foods were compared between skippers and non-skippers using Wilcoxen Rank Sum test. Multivariate logistic regression was used to examine the relationship between breakfast skipping and overweight/obesity. Results: Overall, 44% of females were skippers compared to 36% of males. Among both male and female estimated mean fibre intake and median fruit intake were significantly lower among skippers compared to non-skippers. Male skippers were significantly more likely than non-skippers to be overweight/obese [AOR = 2.34, 95% CI, 1.40-3.90] but this was not observed among females [AOR = 0.89, 95% CI 0.59-1.34]. Conclusions: Different patterns of daily macronutrient intake were observed among adolescents who skip and do not skip breakfast. In males, breakfast skipping was associated with increased odds of being overweight/obese. Gender may play a key part in breakfast skipping behaviours. These results present an opportunity to identify and target adolescents who may be at risk of a poorer nutritional profile or overweight/obesity.
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Julián C, Huybrechts I, Gracia-Marco L, González-Gil EM, Gutiérrez Á, González-Gross M, Marcos A, Widhalm K, Kafatos A, Vicente-Rodríguez G, Moreno LA. Mediterranean diet, diet quality, and bone mineral content in adolescents: the HELENA study. Osteoporos Int 2018; 29:1329-1340. [PMID: 29508038 DOI: 10.1007/s00198-018-4427-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Accepted: 02/06/2018] [Indexed: 10/17/2022]
Abstract
Dietary scores, rather than individual nutrients, allow exploring associations between overall diet and bone health. The aim of the present study was to assess the associations between the Mediterranean Diet Score for Adolescents (MDS-A) and the Diet Quality Index for Adolescents (DQI-A) and bone mineral content (BMC) among Spanish adolescents. Our results do not support an association between dietary scores or indices and BMC in adolescents. INTRODUCTION To assess the associations between the MDS-A and a DQI-A with the BMC measured with dual-energy X-ray absorptiometry. METHODS The MDS-A and the DQI-A were calculated in 179 Spanish adolescents, based on two 24-h dietary recalls from the HELENA cross-sectional study. The associations between the diet scores and the BMC outcomes [total body less head (TBLH), femoral neck (FN), lumbar spine (LS), and hip] were analyzed using logistic regression models adjusting for several confounders. RESULTS Four hundred ninety-two models were included and only fruits and nuts and cereal and roots were found to provide significant ORs with regard to BMC. The risk of having low BMC reduced by 32% (OR 0.684; CI 0.473-0.988) for FN when following the ideal MDS-A, but this association lost significance when adjusting for lean mass and physical activity. For every 1-point increase in the cereal and root and the fruit and nut components, the risk of having low FN diminished by 56% (OR 0.442; CI 0.216-0.901) and by 67% (OR 0.332; CI 0.146-0.755), respectively. CONCLUSION An overall dietary score or index is not associated with BMC in our adolescent Spanish sample.
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Affiliation(s)
- C Julián
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Faculty of Health Science, University of Zaragoza, Pedro Cerbuna 12, 50007, 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.
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain.
| | - I Huybrechts
- International Agency for Research on Cancer, Lyon, France
| | - L Gracia-Marco
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Faculty of Health Science, University of Zaragoza, Pedro Cerbuna 12, 50007, Zaragoza, Spain
- PROFITH "PROmoting FITness and Health through physical activity" Research Group, Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - E M González-Gil
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Faculty of Health Science, University of Zaragoza, Pedro Cerbuna 12, 50007, 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
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
| | - Á Gutiérrez
- Department of Physiology, School of Medicine, University of Granada, Granada, Spain
| | - M González-Gross
- ImFine Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences-INEF, Universidad Politécnica de Madrid, Madrid, Spain
| | - A Marcos
- Department of Metabolism and Nutrition, ICTAN Spanish National Research Council, Madrid, Spain
| | - K Widhalm
- Department of Pediatrics, Medical University of Vienna, Vienna, Austria
| | - A Kafatos
- Preventive Medicine and Nutrition Unit, University of Crete School of Medicine, Heraklion, Greece
| | - G Vicente-Rodríguez
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Faculty of Health Science, University of Zaragoza, Pedro Cerbuna 12, 50007, Zaragoza, Spain
| | - L A Moreno
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Faculty of Health Science, University of Zaragoza, Pedro Cerbuna 12, 50007, 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
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
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Michels N, Vynckier L, Moreno LA, Beghin L, de la O A, Forsner M, Gonzalez-Gross M, Huybrechts I, Iguacel I, Kafatos A, Kersting M, Leclercq C, Manios Y, Marcos A, Molnar D, Sjöström M, Widhalm K, De Henauw S. Mediation of psychosocial determinants in the relation between socio-economic status and adolescents' diet quality. Eur J Nutr 2018; 57:951-963. [PMID: 28160091 DOI: 10.1007/s00394-017-1380-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 01/10/2017] [Indexed: 11/25/2022]
Abstract
PURPOSE To examine the underlying reasons for the positive relation between socio-economic status (SES) and the diet quality of adolescents. METHODS In 2081 adolescents (12.5-17.5 years) of the European HELENA study, a continuous variable on diet quality via 2-day 24-h recalls was available. SES was reflected by parental education, parental occupation and family affluence. Mediation by several psychosocial determinants was tested: self-efficacy, availability at school and home, social support, barriers, benefits, awareness and some self-reported influencers (parents, school, taste, health, friends, food readily available, easy preparation, hunger, price and habits). Multiple mediation analyses were adjusted for age, sex and country. RESULTS The availability of soft drinks and fruit at home, social support, parental influence, barriers, price influence, taste influence, health influence and food being readily available were significant mediators. The multiple mediation indirect effect accounted for 23-64% of the total effect. Both occupation and education and both maternal and paternal factors could be explained by the mediation. The unavailability of soft drinks was the strongest mediator (17-44% of the total effect). CONCLUSION Up to 64% of the positive relation between SES and the diet quality in adolescence could be explained by several healthy eating determinants. Focusing on these factors in low-SES populations can minimize social inequalities in diet and health by improving the diet of these specific adolescents.
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Affiliation(s)
- Nathalie Michels
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, De Pintelaan 185-4K3, 9000, Ghent, Belgium.
| | - Lisa Vynckier
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, De Pintelaan 185-4K3, 9000, Ghent, Belgium
| | - Luis A Moreno
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Faculty of Health Sciences, University of Zaragoza, , Edificio del SAI, C/Pedro Cerbuna s/n, 50009, Zaragoza, Spain
| | - Laurent Beghin
- Centre d'Investigation Clinique CH&U Inserm, Bd Pr Leclercq, Hôpital Cardiologique, Lille Cedex, France
| | - Alex de la O
- Department of Physiology, Faculty of Medicine, Granada University, Granada, Spain
| | - Maria Forsner
- School of Education, Health and Social Sciences, Dalarna University, Falun, Sweden
| | - Marcela Gonzalez-Gross
- Department of Health and Human Performance, Facultad de Ciencias de la Actividad Física y del Deporte, Universidad Politécnica de Madrid, Madrid, Spain
| | - Inge Huybrechts
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, De Pintelaan 185-4K3, 9000, Ghent, Belgium
- Nutrition and Metabolism Section, International Agency for Research on Cancer, Lyon, France
| | - Isabel Iguacel
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, De Pintelaan 185-4K3, 9000, Ghent, Belgium
| | | | - Mathilde Kersting
- Research Institute of Child Nutrition, Rheinische Friedrich-Wilhelms-Universität Bonn, Dortmund, Germany
| | - Catherine Leclercq
- INRAN (National Research Institute on Food and Nutrition), Via Ardeatina, 546I00176, Roma, Italy
| | - Yannis Manios
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - Ascension Marcos
- Department of Metabolism and Nutrition, ICTAN Institute Frı´o Spanish National Research Council C/ Jose´ Antonio Novais, Madrid, 28000, Spain
| | - Denes Molnar
- Department of Pediatrics, University of Pécs, Pécs, Hungary
| | - Michael Sjöström
- Department of BioScience and Nutrition, Karolinska institutet, Stockholm, Sweden
| | - Kurt Widhalm
- Department of Pediatrics, Division of Clinical Nutrition, Medical University of Vienna, Vienna, Austria
| | - Stefaan De Henauw
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, De Pintelaan 185-4K3, 9000, Ghent, Belgium
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46
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Diet quality index as a predictor of treatment efficacy in overweight and obese adolescents: The EVASYON study. Clin Nutr 2018; 38:782-790. [PMID: 29730135 DOI: 10.1016/j.clnu.2018.02.032] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 02/26/2018] [Accepted: 02/27/2018] [Indexed: 11/20/2022]
Abstract
BACKGROUND & AIM A diet quality index (DQI) is a tool that provides an overall score of an individual's dietary intake when assessing compliance with food-based dietary guidelines. A number of DQIs have emerged, albeit their associations with health-related outcomes are debated. The aim of the present study was to assess whether adherence to dietary intervention, and the overall quality of the diet, can predict body composition changes. METHODS To this purpose, overweight/obese adolescents (n = 117, aged: 13-16 years; 51 males, 66 females) were recruited into a multi-component (diet, physical activity and psychological support) family-based group treatment programme. We measured the adolescents' compliance and body composition at baseline and after 2 months (intensive phase) and 13 months (extensive phase) of follow-up. Also, at baseline, after 6 months, and at the end of follow-up we calculated the DQI. RESULTS Global compliance with the dietary intervention was 37.4% during the intensive phase, and 14.3% during the extensive phase. Physical activity compliance was 94.1% at 2-months and 34.7% at 13months and psychological support compliance were growing over the intervention period (10.3% intensive phase and 45.3% during extensive phase). Adolescents complying with the meal frequency criteria at the end of the extensive phase had greater reductions in FMI z-scores than those did not complying (Cohen's d = 0.53). A statistically significant association was observed with the diet quality index. DQI-A variation explained 98.1% of BMI z-score changes and 95.1% of FMI changes. CONCLUSIONS We conclude that assessment of changes in diet quality could be a useful tool in predicting body composition changes in obese adolescents involved in a diet and physical activity intervention programme backed-up by psychological and family support.
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47
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Henriksson P, Henriksson H, Labayen I, Huybrechts I, Gracia-Marco L, Ortega FB, España-Romero V, Manios Y, González-Gross M, Marcos A, Moreno LA, Gutiérrez Á, Ruiz JR. Correlates of ideal cardiovascular health in European adolescents: The HELENA study. Nutr Metab Cardiovasc Dis 2018; 28:187-194. [PMID: 29241667 DOI: 10.1016/j.numecd.2017.10.018] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 10/19/2017] [Accepted: 10/20/2017] [Indexed: 11/18/2022]
Abstract
BACKGROUND AND AIMS The ideal cardiovascular health (iCVH) construct consists of 4 health behaviors (smoking status, body mass index, physical activity and diet) and 3 health factors (total cholesterol, blood pressure and fasting glucose). A greater number of iCVH components in adolescence are related to better cardiovascular health, but little is known about the correlates of iCVH in adolescents. Thus, the aim of the study was to examine correlates of iCVH in European adolescents. METHODS AND RESULTS The study comprised 637 European adolescents with complete iCVH data. Participants were part of the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study, a cross-sectional, multicenter study conducted in 9 different European countries. Correlates investigated were sex and age, family affluence scale, maternal education, geographic location, sleep time, television viewing, duration of pregnancy, birth weight and breastfeeding. Younger adolescents, those whose mothers had medium/high education or those who watched television less than 2 h per day had a greater number of iCVH components compared to those who were older, had a mother with low education or watched television 2 h or more daily (P ≤ 0.01). CONCLUSION Since in our study older adolescents had worse iCVH than younger adolescents, early promotion of cardiovascular health may be important. Future studies may also investigate the usefulness of limiting television viewing to promote iCVH. Finally, since adolescents of mothers with low education had poorer iCVH, it may be of special interest to tailor public health promotion to adolescents from families with low socioeconomic status.
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Affiliation(s)
- P Henriksson
- PROFITH "PROmoting FITness and Health through physical activity" Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Spain; Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden.
| | - H Henriksson
- PROFITH "PROmoting FITness and Health through physical activity" Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Spain
| | - I Labayen
- Department of Health Sciences, Public University of Navarra, 31008 Pamplona, Spain
| | - I Huybrechts
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium; International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - L Gracia-Marco
- PROFITH "PROmoting FITness and Health through physical activity" Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Spain; Children's Health and Exercise Research Centre (CHERC), Sport and Health Sciences, University of Exeter, Exeter, UK
| | - F B Ortega
- PROFITH "PROmoting FITness and Health through physical activity" Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Spain; Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden
| | - V España-Romero
- Department of Physical Education, School of Education, University of Cádiz, Spain
| | - Y Manios
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - M González-Gross
- ImFine Research Group, Facultad de Ciencias de la Actividad Física y del Deporte-INEF, Universidad Politécnica de Madrid, Madrid, Spain; CIBER: CB12/03/30038 Fisiopatología de la Obesidad y la Nutrición, CIBERobn, Instituto de Salud Carlos III (ISCIII), Spain
| | - A Marcos
- Immunonutrition Research Group, Department of Metabolism and Nutrition, Instituto del Frio, Institute of Food Science, Technology and Nutrition, Spanish National Research Council, Madrid, Spain
| | - L A Moreno
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Facultad de Ciencias de la Salud, Instituto Agroalimentario de Aragón (IA2), Universidad de Zaragoza, Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Spain; Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Spain
| | - Á Gutiérrez
- Department of Medical Physiology, School of Medicine, University of Granada, Spain
| | - J R Ruiz
- PROFITH "PROmoting FITness and Health through physical activity" Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Spain; Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden
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Shores DR, Everett AD. Children as Biomarker Orphans: Progress in the Field of Pediatric Biomarkers. J Pediatr 2018; 193:14-20.e31. [PMID: 29031860 PMCID: PMC5794519 DOI: 10.1016/j.jpeds.2017.08.077] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 08/04/2017] [Accepted: 08/30/2017] [Indexed: 12/20/2022]
Affiliation(s)
- Darla R Shores
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD.
| | - Allen D Everett
- Division of Cardiology, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD
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Jimoh F, Lund EK, Harvey LJ, Frost C, Lay WJ, Roe MA, Berry R, Finglas PM. Comparing Diet and Exercise Monitoring Using Smartphone App and Paper Diary: A Two-Phase Intervention Study. JMIR Mhealth Uhealth 2018; 6:e17. [PMID: 29335239 PMCID: PMC5789166 DOI: 10.2196/mhealth.7702] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Revised: 08/10/2017] [Accepted: 10/30/2017] [Indexed: 12/01/2022] Open
Abstract
Background There is increasing recognition that personalized approaches may be more effective in helping people establish healthier eating patterns and exercise more, and that this approach may be particularly effective in adolescents. Objective The objective of this study was to investigate the use of a smartphone app (FoodWiz2) in supporting healthy lifestyle choices in adolescence. Methods Participants (N=34: 11 male, 23 female) aged 16-19 years in full- or part-time education were recruited from sixth form colleges, schools, and other further education establishments in Norfolk and Suffolk, United Kingdom, between February and May 2015. Participants recorded food intake and exercise using a paper diary for 4-5 weeks and then used the app for the same duration. Initial nutrition education and general support were provided during the paper diary use, but the app included personalized messages sent in response to app activity. At the end of each study phase, participants completed an online questionnaire to describe their experience of using the paper diary and app. Results Record completion declined throughout the study, possibly affected by examination pressure. Food intake data showed increased fruit consumption and significantly reduced consumption of chocolate snacks (P=.01) and fizzy drinks (P=.002) among participants using the app. Questionnaire responses indicated that the app was generally preferred to the paper diary, in particular, the app was seen as less boring to use (P=.03) and more acceptable in social settings (P<.001). Conclusions This app-based approach has shown the potential for a more effective approach to improving adolescent diet and exercise levels.
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Affiliation(s)
| | | | | | | | - W James Lay
- Food Angels UK Ltd, Newmarket, United Kingdom
| | - Mark A Roe
- Quadram Institute Bioscience, Norwich, United Kingdom
| | - Rachel Berry
- Quadram Institute Bioscience, Norwich, United Kingdom
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50
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The effects of takeaway food and eating meals outside of the home on UK adolescents diet quality. Proc Nutr Soc 2018. [DOI: 10.1017/s0029665118002227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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