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Kampouri M, Margetaki K, Koutra K, Kyriklaki A, Daraki V, Roumeliotaki T, Bempi V, Vafeiadi M, Kogevinas M, Chatzi L, Kippler M. Urinary iodine concentrations in preschoolers and cognitive development at 4 and 6 years of age, the Rhea mother-child cohort on Crete, Greece. J Trace Elem Med Biol 2024; 85:127486. [PMID: 38897044 DOI: 10.1016/j.jtemb.2024.127486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 05/29/2024] [Accepted: 06/15/2024] [Indexed: 06/21/2024]
Abstract
BACKGROUND Evidence regarding child iodine intake and neurodevelopment is scarce. METHODS We aimed to assess the impact of child iodine intake at 4 years of age on cognitive and motor development at 4 and 6 years among 304 children from the Rhea cohort on Crete, Greece. Child iodine intake was assessed via urinary iodine concentrations (UIC) measured using Inductively Coupled Plasma Mass Spectrometry (ICP-MS) and adjusted for specific gravity. Child cognitive and motor development was assessed using the McCarthy Scales of Children's Abilities (MSCA) at 4 years of age and Raven's Coloured Progressive Matrices (RCPM), Finger Tapping Test (FTT), and Trail Making Test (TMT) at 6 years. Associations were explored using multivariable-adjusted linear regression analyses with UIC categorized according to WHO criteria [insufficient intake <100 µg/L, adequate 100-299 µg/L (reference group), excessive ≥300 µg/L]. RESULTS The children's median UIC was 249 µg/L (25-75th percentile: 181-344 μg/L). Children with UIC <100 μg/L had lower scores in the motor scale at 4 years (MSCA-motor scale: B=-10.3; 95 %CI -19.9, -0.6; n=10) and in intelligence at 6 years (RCPM-total score: B=-3.6, 95 %CI -6.8, -0.5; n=9) than children in the reference group. No associations were found with the general cognitive scale at 4 years or with TMT and FTT scales at 6 years. Children with UIC ≥300 μg/L had lower cognitive scores both at 4 (MSCA; B= -3.5; 95 %CI -6.9, -0.1; n =101) and 6 years of age (RCPM-total score; B= -1.2; 95 %CI -2.3, -0.0; n =98) than children in the reference group. No associations were observed with the motor scale at 4 years or with TMT and FTT scales at 6 years. CONCLUSION Our findings indicate that both low and excessive iodine intake at preschool age may adversely affect child cognitive abilities. Additionally, low iodine intake may also impact motor abilities.
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Affiliation(s)
- Mariza Kampouri
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece
| | - Katerina Margetaki
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece
| | - Katerina Koutra
- Department of Psychology, Faculty of Social Sciences, University of Crete, Rethimno, Greece
| | - Andriani Kyriklaki
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece
| | - Vasiliki Daraki
- Department of Endocrinology, General University Hospital of Heraklion, Heraklion, Greece
| | - Theano Roumeliotaki
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece
| | - Vicky Bempi
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece
| | - Marina Vafeiadi
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece
| | - Manolis Kogevinas
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Lida Chatzi
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, LA, USA
| | - Maria Kippler
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
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Yim G, Margetaki K, Romano ME, Kippler M, Vafeiadi M, Roumeliotaki T, Bempi V, Farzan SF, Chatzi L, Howe CG. Metal mixture exposures and serum lipid levels in childhood: the Rhea mother-child cohort in Greece. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2024; 34:688-698. [PMID: 38698271 DOI: 10.1038/s41370-024-00674-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 04/09/2024] [Accepted: 04/10/2024] [Indexed: 05/05/2024]
Abstract
BACKGROUND Growing evidence suggests that cardiovascular disease develops over the lifetime, often beginning in childhood. Metal exposures have been associated with cardiovascular disease and important risk factors, including dyslipidemia, but prior studies have largely focused on adult populations and single metal exposures. OBJECTIVE To investigate the individual and joint impacts of multiple metal exposures on lipid levels during childhood. METHODS This cross-sectional study included 291 4-year-old children from the Rhea Cohort Study in Heraklion, Greece. Seven metals (manganese, cobalt, selenium, molybdenum, cadmium, mercury, and lead) were measured in whole blood using inductively coupled plasma mass spectrometry. Serum lipid levels included total cholesterol, triglycerides, high-density lipoprotein (HDL) cholesterol, and low-density lipoprotein (LDL) cholesterol. To determine the joint and individual impacts of child metal exposures (log2-transformed) on lipid levels, Bayesian kernel machine regression (BKMR) was employed as the primary multi-pollutant approach. Potential effect modification by child sex and childhood environmental tobacco smoke exposure was also evaluated. RESULTS BKMR identified a positive association between the metal mixture and both total and LDL cholesterol. Of the seven metals examined, selenium (median 90.6 [IQR = 83.6, 96.5] µg/L) was assigned the highest posterior inclusion probability for both total and LDL cholesterol. A difference in LDL cholesterol of 8.22 mg/dL (95% CI = 1.85, 14.59) was observed when blood selenium was set to its 75th versus 25th percentile, holding all other metals at their median values. In stratified analyses, the positive association between selenium and LDL cholesterol was only observed among boys or among children exposed to environmental tobacco smoke during childhood. IMPACT STATEMENT Growing evidence indicates that cardiovascular events in adulthood are the consequence of the lifelong atherosclerotic process that begins in childhood. Therefore, public health interventions targeting childhood cardiovascular risk factors may have a particularly profound impact on reducing the burden of cardiovascular disease. Although growing evidence supports that both essential and nonessential metals contribute to cardiovascular disease and risk factors, such as dyslipidemia, prior studies have mainly focused on single metal exposures in adult populations. To address this research gap, the current study investigated the joint impacts of multiple metal exposures on lipid concentrations in early childhood.
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Affiliation(s)
- Gyeyoon Yim
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Dartmouth College, Lebanon, NH, USA.
| | - Katerina Margetaki
- Clinic of Preventive Medicine and Nutrition, Faculty of Medicine, University of Crete, Heraklion, Greece
| | - Megan E Romano
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Dartmouth College, Lebanon, NH, USA
| | - Maria Kippler
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Marina Vafeiadi
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece
| | - Theano Roumeliotaki
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece
| | - Vicky Bempi
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece
| | - Shohreh F Farzan
- Department of Population and Public Health Sciences, Division of Environmental Health, University of Southern California, Los Angeles, CA, USA
| | - Leda Chatzi
- Department of Population and Public Health Sciences, Division of Environmental Health, University of Southern California, Los Angeles, CA, USA
| | - Caitlin G Howe
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Dartmouth College, Lebanon, NH, USA
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Descarpentrie A, Calas L, Cornet M, Heude B, Charles MA, Avraam D, Brescianini S, Cadman T, Elhakeem A, Fernández-Barrés S, Harris JR, Inskip H, Julvez J, Llop S, Margetaki K, Maritano S, Nader JLT, Roumeliotaki T, Salika T, Subiza-Pérez M, Vafeiadi M, Vrijheid M, Wright J, Yang T, Dargent-Molina P, Lioret S. Lifestyle patterns in European preschoolers: Associations with socio-demographic factors and body mass index. Pediatr Obes 2023; 18:e13079. [PMID: 37795656 DOI: 10.1111/ijpo.13079] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 08/30/2023] [Accepted: 09/16/2023] [Indexed: 10/06/2023]
Abstract
BACKGROUND Energy balance-related behaviours (EBRBs), that is, dietary intake, screen, outdoor play and sleep, tend to combine into 'lifestyle patterns', with potential synergistic influences on health. To date, studies addressing this theme mainly focused on school children and rarely accounted for sleep, with a cross-country perspective. OBJECTIVES We aimed at comparing lifestyle patterns among preschool-aged children across Europe, their associations with socio-demographic factors and their links with body mass index (BMI). METHODS Harmonized data on 2-5-year-olds participating in nine European birth cohorts from the EU Child Cohort Network were used (EBRBs, socio-demographics and anthropometrics). Principal component analysis and multivariable linear and logistic regressions were performed. RESULTS The most consistent pattern identified across cohorts was defined by at least three of the following EBRBs: discretionary consumption, high screen time, low outdoor play time and low sleep duration. Consistently, children from low-income households and born to mothers with low education level had higher scores on this pattern compared to their socioeconomically advantaged counterparts. Furthermore, it was associated with higher BMI z-scores in the Spanish and Italian cohorts (β = 0.06, 95% CI = [0.02; 0.10], both studies). CONCLUSION These findings may be valuable in informing early multi-behavioural interventions aimed at reducing social inequalities in health at a European scale.
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Affiliation(s)
- Alexandra Descarpentrie
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Paris, France
| | - Lucinda Calas
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Paris, France
| | - Maxime Cornet
- Télécom-Paris, Département SES, Institut Polytechnique de Paris, Palaiseau Cedex, France
| | - Barbara Heude
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Paris, France
| | - Marie-Aline Charles
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Paris, France
| | - Demetris Avraam
- Department of Public Health, Policy and Systems, Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Sonia Brescianini
- Centre of Behavioral Science and Mental Health, Istituto Superiore di Sanità, Rome, Italy
| | - Tim Cadman
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Ahmed Elhakeem
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK
| | - Sílvia Fernández-Barrés
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
- Agència de Salut Pública de Barcelona, Barcelona, Spain
| | - Jennifer R Harris
- Centre for Fertility and Health, The Norwegian Institute of Public Health, Oslo, Norway
| | - Hazel Inskip
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Jordi Julvez
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
- Clinical and Epidemiological Neuroscience Group (NeuroÈpia), Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
| | - Sabrina Llop
- CIBER Epidemiologa y Salud Pública (CIBERESP), Madrid, Spain
- Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de Valencia, Valencia, Spain
| | - Katerina Margetaki
- Department of Social Medicine, School of Medicine, University of Crete, Heraklion, Greece
| | - Silvia Maritano
- Cancer Epidemiology Unit-Department of Medical Sciences, University of Turin, Turin, Italy
- University School for Advanced Studies IUSS Pavia, Pavia PV, Italy
| | - Johanna Lucia Thorbjornsrud Nader
- Department of Genetics and Bioinformatics, Division of Health Data and Digitalization, Norwegian Institute of Public Health, Oslo, Norway
| | - Theano Roumeliotaki
- Department of Social Medicine, School of Medicine, University of Crete, Heraklion, Greece
| | - Theodosia Salika
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, UK
| | - Mikel Subiza-Pérez
- CIBER Epidemiologa y Salud Pública (CIBERESP), Madrid, Spain
- Department of Clinical and Health Psychology and Research Methods, University of the Basque Country UPV/EHU, Donostia-San Sebastián, Spain
- Group of Environmental Epidemiology and Child Development, Biodonostia Health Research Institute, Donostia-San Sebastián, Spain
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Marina Vafeiadi
- Department of Social Medicine, School of Medicine, University of Crete, Heraklion, Greece
| | - Martine Vrijheid
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
- CIBER Epidemiologa y Salud Pública (CIBERESP), Madrid, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - John Wright
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Tiffany Yang
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Patricia Dargent-Molina
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Paris, France
| | - Sandrine Lioret
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Paris, France
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Babio N, de Las Heras-Delgado S, De Miguel-Etayo P, Pastor-Villaescusa B, Leis R, Garcidueñas-Fimbres TE, Larruy-García A, Navas-Carretero S, Portoles O, Flores-Rojas K, Vázquez-Cobela R, Shyam S, Miguel-Berges ML, Martínez JA, Codoñer-Franch P, Gil-Campos M, Moreno LA, Salas-Salvadó J. Reproducibility and relative validity of a semi-quantitative food and beverage frequency questionnaire for Spanish children aged 3 to 11 years: the COME-Kids F&B-FQ. Eur J Pediatr 2023; 182:5577-5589. [PMID: 37798446 PMCID: PMC10746573 DOI: 10.1007/s00431-023-05220-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 07/26/2023] [Accepted: 09/16/2023] [Indexed: 10/07/2023]
Abstract
A reliable food and beverage frequency questionnaire (F&B-FQ) to measure dietary intakes for children across Spain is currently unavailable. Thus, we designed and assessed the reproducibility and relative validity of a new F&B-FQ in 210 Spanish children aged 3-11 years. COME-Kids F&B-FQ contained 125 items to assess the usual diet intake in the past year among children. To explore the reproducibility, caregivers answered COME-Kids F&B-FQ twice over a 15-day period (± 1 week). To evaluate the relative validity, estimates from a third COME-Kids F&B-FQ administered at 1 year of follow-up were compared with the mean estimates from 3-day dietary records (3d-DR) collected at baseline, 6 months, and after 1 year of follow-up. Reproducibility and relative validity of the COME-Kids F&B-FQ in estimating food groups and nutrients were assessed using Pearson (r) and intra-class (ICC) correlation coefficients. We used the kappa index to evaluate the agreement in repeat administrations or with the 3d-DR. We used Bland-Altman plots to identify bias across levels of intake. A total of 195 children (105 boys, 90 girls) completed the study. The reproducibility of data estimated from COME-Kids F&B-FQ was substantial with mean r and ICC being 0.65 and 0.64 for food groups and 0.63 and 0.62 for nutrients, respectively. Validation assessments comparing the FFQ and 3d-DRs showed r = 0.36 and ICC = 0.30 for food groups and r = 0.29 and ICC = 0.24 for nutrients. The mean agreement for food group reproducibility and relative validity was 86% and 65%, respectively. These estimates were 85% for reproducibility and 64% for relative validity in the case of nutrients. For reproducibility and relative validity, the overall mean kappa index was 63% and 37% for all food groups and 52% and 27% for nutrients, respectively. Bland-Altman plots showed no specific bias relating to the level of intake of nutrients and several food groups. CONCLUSION COME-Kids F&B-FQ showed substantial reproducibility and acceptable relative validity to assess food and beverage intake in Spanish children aged 3 to 11 years. Most children were correctly classified in relation to the intake of food groups and nutrients, and misclassification was unlikely with reference to 3d-DR. WHAT IS KNOWN • The estimation of dietary intake in children is complex, especially in large cohorts. • The food frequency questionnaire is a well-recognized and the most frequently used method for assessing food consumption. WHAT IS NEW • A new food and beverage frequency questionnaire including a beverage section and novel plant-based food items has been validated in Spanish children aged 3-11 years.
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Affiliation(s)
- Nancy Babio
- CIBER. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.
- Universitat Rovira i Virgili, Unitat de Nutrició Humana, Grup ANUT-DSM, Departament de Bioquimica i Biotecnologia, Reus, Spain.
- Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain.
| | - Sara de Las Heras-Delgado
- CIBER. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Universitat Rovira i Virgili, Unitat de Nutrició Humana, Grup ANUT-DSM, Departament de Bioquimica i Biotecnologia, Reus, Spain
- Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
| | - Pilar De Miguel-Etayo
- CIBER. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Instituto Agroalimentario de Aragón (IA2). Faculty of Health Sciences. Universidad de Zaragoza, Instituto de Investigación Sanitaria de Aragón (IIS Aragón), 50009, Zaragoza, Spain.
| | - Belén Pastor-Villaescusa
- Metabolism and Investigation Unit, Reina Sofia University Hospital, Maimónides Institute of Biomedicine Research of Córdoba (IMIBIC), University of Córdoba, Córdoba, Spain
| | - Rosaura Leis
- CIBER. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Unit of Pediatric Gastroenterology, Hepatology and Nutrition, Pediatric Service, Hospital Clínico Universitario de Santiago, 15706, Santiago de Compostela, Spain
- Pediatric Nutrition Research Group, Health Research Institute of Santiago de Compostela (IDIS), Unit of Investigation in Nutrition, Growth and Human Development of Galicia-USC, 15706, Santiago de Compostela, Spain
| | - Tany E Garcidueñas-Fimbres
- CIBER. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Universitat Rovira i Virgili, Unitat de Nutrició Humana, Grup ANUT-DSM, Departament de Bioquimica i Biotecnologia, Reus, Spain
- Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
| | - Alicia Larruy-García
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Instituto Agroalimentario de Aragón (IA2). Faculty of Health Sciences. Universidad de Zaragoza, Instituto de Investigación Sanitaria de Aragón (IIS Aragón), 50009, Zaragoza, Spain
| | - Santiago Navas-Carretero
- CIBER. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Center for Nutrition Research, University of Navarra, 31008, Pamplona, Spain
- Dept Nutr Food Sci & Physiol, Fac Pharm & Nutr, University of Navarra, 31008, Pamplona, Spain
- IdisNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Olga Portoles
- CIBER. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Departament of Preventive Medicine and Public Health. Department of Pediatrics, Obstetrics and Gynecology., University of Valencia, Valencia, Spain
| | - Katherine Flores-Rojas
- Metabolism and Investigation Unit, Reina Sofia University Hospital, Maimónides Institute of Biomedicine Research of Córdoba (IMIBIC), University of Córdoba, Córdoba, Spain
| | - Rocío Vázquez-Cobela
- CIBER. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Unit of Pediatric Gastroenterology, Hepatology and Nutrition, Pediatric Service, Hospital Clínico Universitario de Santiago, 15706, Santiago de Compostela, Spain
- Pediatric Nutrition Research Group, Health Research Institute of Santiago de Compostela (IDIS), Unit of Investigation in Nutrition, Growth and Human Development of Galicia-USC, 15706, Santiago de Compostela, Spain
| | - Sangeetha Shyam
- CIBER. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Universitat Rovira i Virgili, Unitat de Nutrició Humana, Grup ANUT-DSM, Departament de Bioquimica i Biotecnologia, Reus, Spain
- Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
| | - María L Miguel-Berges
- CIBER. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Instituto Agroalimentario de Aragón (IA2). Faculty of Health Sciences. Universidad de Zaragoza, Instituto de Investigación Sanitaria de Aragón (IIS Aragón), 50009, Zaragoza, Spain
| | - J Alfredo Martínez
- Center for Nutrition Research, University of Navarra, 31008, Pamplona, Spain
- Dept Nutr Food Sci & Physiol, Fac Pharm & Nutr, University of Navarra, 31008, Pamplona, Spain
- IdisNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Pilar Codoñer-Franch
- CIBER. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Departament of Preventive Medicine and Public Health. Department of Pediatrics, Obstetrics and Gynecology., University of Valencia, Valencia, Spain
| | - Mercedes Gil-Campos
- CIBER. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Metabolism and Investigation Unit, Reina Sofia University Hospital, Maimónides Institute of Biomedicine Research of Córdoba (IMIBIC), University of Córdoba, Córdoba, Spain
| | - Luis A Moreno
- CIBER. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Instituto Agroalimentario de Aragón (IA2). Faculty of Health Sciences. Universidad de Zaragoza, Instituto de Investigación Sanitaria de Aragón (IIS Aragón), 50009, Zaragoza, Spain
| | - Jordi Salas-Salvadó
- CIBER. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Universitat Rovira i Virgili, Unitat de Nutrició Humana, Grup ANUT-DSM, Departament de Bioquimica i Biotecnologia, Reus, Spain
- Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
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Abstract
Introduction Introduction: validated food frequency questionnaires in children are scarce, mostly long, and only provide data about food consumption. Objectives: the aim of this study was to evaluate the reproducibility and validity of a short food frequency questionnaire that estimates energy, nutritional intake, and the frequency of food consumption in children aged between 3 and 6 years. Material and methods: in 49 children (57% boys), the reproducibility and validity of a frequency questionnaire with 41 items was assessed using Spearman's and intraclass correlations, both adjusted and not adjusted for energy. A 6-day record was used as a reference method. Results: reproducibility was high in food groups with correlations > 0.70 for most of them and between 0.5 and 0.7 for meat, fish, potatoes, sweets/soft drinks, and oil. For energy and nutrients correlations were > 0.9 and > 0.7, respectively. Validity was strong to moderate for foods with correlations > 0.7 (dairy and milk) and between 0.4 and 0.7 (sausages, eggs, yogur/cheese, vegetables and oil), and for nutrients with correlations > 0.5 (lipids, AGS, AGP, phosphorus, calcium, vitamin E and vitamin C) and between 0.3 and 0.5 (energy, starches, fiber, MUFA, cholesterol, sodium, magnesium, potassium, retinol, riboflavin, niacin, pantothenic acid, vitamin B6 and folates). All correlations were significant and increased after they had been adjusted for energy. Conclusions: the short food frequency questionnaire for children between 3 and 6 years old has high reproducibility and good validity with results that are as good as those of long food frequency questionnaires.
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Marakis G, Kontopoulou L, Garofalakis G, Vasara E, Vasiliadis G, Grammatikopoulou MG. Development and relative validity of a self-administered semi-quantitative drinks frequency questionnaire, validated in a population of university students. Nutr Diet 2018; 76:532-538. [PMID: 30353963 DOI: 10.1111/1747-0080.12494] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 09/06/2018] [Accepted: 09/14/2018] [Indexed: 01/10/2023]
Abstract
AIM Drinks can contribute to energy as well as micro- and macro-nutrient intake. Drink-specific, validated, quick and easy to administer questionnaires are needed to monitor secular trends in beverage consumption for different populations. The aim of the present cross-sectional study was to develop and validate a drink-specific questionnaire for the Greek population. METHODS A 41-item semi-quantitative drinks frequency questionnaire (DFQ) was developed and validated against 7-day weighed food records, among young Greek adults. Wilcoxon ranks tests, Kendall tau-b correlations and Bland-Altman plot were used to compare the two methods. Fifty-nine Greek University students (28 males, 31 females) completed both methods. RESULTS No difference was observed in total drinks intake between the two methods. The Bland-Altman plot showed that the two methods are likely to agree concerning the total drinks intake. Wilcoxon's rank test showed no significant differences between the two methods, except for the 'whiskey/vodka/gin' intake (P < 0.001). 'Good' agreement (tau-b > 0.61) was observed for most DFQ items, including low-fat and chocolate milk, hot chocolate, Greek/espresso coffee, commercial tea, packaged fruit juices, wine, alcohol-free beer, light cola-type drinks and water (tap/bottled/sparkling). 'Low' agreement (<0.30) was noted for filtered/instant/iced coffee, freshly squeezed orange juice and some alcoholic drinks (beer/whiskey/vodka/gin). CONCLUSIONS The DFQ appears to be an overall valid means of estimating the habitual intake of drinks in large-scale epidemiological surveys. The study supports the use of DFQ for assessing drinks consumption patterns and secular trends.
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Affiliation(s)
- Georgios Marakis
- Nutrition Policy and Research Directorate, Hellenic Food Authority, Athens, Greece
| | - Lamprini Kontopoulou
- Department of Nutrition & Dietetics, Technological Educational Institute of Thessaly, Karditsa, Greece
| | - Gorgias Garofalakis
- Nutrition Policy and Research Directorate, Hellenic Food Authority, Athens, Greece
| | - Eleni Vasara
- Department of Biology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Georgios Vasiliadis
- Department of Informatics Engineering, Technological Educational Institute of Western Macedonia, Kastoria, Greece
| | - Maria G Grammatikopoulou
- Department of Nutrition & Dietetics, Alexander Technological Educational Institute, Thessaloniki, Greece.,Department of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Mahoney S, Bryant M, Sahota P, Barber S. Dietary intake in the early years and its relationship to BMI in a bi-ethnic group: the Born in Bradford 1000 study. Public Health Nutr 2018; 21:2242-2254. [PMID: 29607793 PMCID: PMC11106021 DOI: 10.1017/s1368980018000654] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Revised: 01/30/2018] [Accepted: 02/23/2018] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To assess relationships between dietary intake at age 12, 18 and 36 months and BMI Z-scores at age 36 months in a bi-ethnic group. DESIGN A prospective cohort study comparing cross-sectional and longitudinal data. Exposures included dietary intake at 12, 18 and 36 months (FFQ) with an outcome of BMI Z-score at age 36 months. SETTING Born in Bradford 1000 study, Bradford, UK. SUBJECTS Infants at age 12 months (n 722; 44 % White British, 56 % Pakistani), 18 months (n 779; 44 % White British, 56 % Pakistani) and 36 months (n 845; 45 % White British, 55 % Pakistani). RESULTS Diet at age 12 months was not associated with BMI Z-score at age 36 months. Higher consumption of vegetables at 18 and 36 months was associated with a lower BMI Z-score at 36 months (model coefficient (95 % CI): -0·20 (-0·36, -0·03) and -0·16 (-0·31, -0·02), respectively). Higher consumption of high-fat chips at age 36 months was associated with a lower BMI Z-score at age 36 months (-0·16 (-0·32, 0·00)). Overall, White British children had higher 36-month BMI Z-scores than Pakistani children (adjusted mean difference (95 % CI): 0·21 (0·02, 0·41)). CONCLUSIONS Our findings indicate that dietary intake at 18 and 36 months was somewhat related to BMI Z-score at age 36 months and suggest the importance of early interventions aimed at establishing healthy eating behaviours.
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Affiliation(s)
- Samuel Mahoney
- School of Mathematics, University of Leeds, Leeds LS2 9JT, UK
| | - Maria Bryant
- Leeds Institute for Clinical Trials Research, University of Leeds, Leeds, UK
| | - Pinki Sahota
- Institute for Health & Wellbeing, Faculty of Health and Social Sciences, Leeds Beckett University, Leeds, UK
| | - Stuart Barber
- School of Mathematics, University of Leeds, Leeds LS2 9JT, UK
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Is early life exposure to polyomaviruses and herpesviruses associated with obesity indices and metabolic traits in childhood? Int J Obes (Lond) 2018; 42:1590-1601. [PMID: 29445241 DOI: 10.1038/s41366-018-0017-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 12/20/2017] [Accepted: 12/27/2017] [Indexed: 12/12/2022]
Abstract
BACKGROUND Evidence for an infectious origin of obesity is emerging. We explored whether common viruses were associated with obesity and metabolic traits. METHODS We used cross-sectional (n = 674) and prospective (n = 440) data from children participating at the 4 and 6 years of age follow-up in the Rhea birth cohort. Presence of IgG antibodies to ten polyomaviruses (BKPyV, JCPyV, KIPyV, WUPyV, HPyV6, HPyV7, TSPyV, MCPyV, HPyV9, and HPyV10) and four herpesviruses (EBV, CMV, HSV-1, and HSV-2) were measured at age 4. Body mass index, waist circumference, and skinfold thickness were measured at age 4 and 6. Data on serum lipids, leptin, and adiponectin were also available. Multivariable linear regression models were used to explore the associations. RESULTS At 4 years of age, seroprevalence to polyomaviruses ranged from 21.0% for HPyV9 to 82.0% for HPyV10. Seroprevalence for EBV, CMV, HSV-1, and HSV-2 was 53.0%, 26.0%, 3.6%, and 1.5% respectively. BKPyV seropositivity was associated with lower BMI SD score at age 4 [-0.21 (95% CI: -0.39, -0.03)] and 6 [-0.27 (95% CI:-0.48, -0.05)], waist circumference at age 4 [-1.12 cm (95% CI: -2.10, -0.15)] and 6 [-1.73 cm (95% CI: -3.33, -0.12)], sum of four skinfolds [-2.97 mm (95% CI: -5.70, -0.24)], and leptin levels at age 4 [ratio of geometric means, 0.83 (95% CI: 0.70, 0.98)]. CMV seropositivity was associated with higher BMI SD score at age 4 [0.28 (95% CI: 0.11, 0.45)] and 6 [0.24 (95% CI: 0.03, 0.45)] and sum of four skinfolds at age 6 [4.75 mm (95% CI: 0.67, 8.83)]. Having "2-3 herpesviruses infections" (versus "0 herpesvirus infections") was associated with higher BMI SD score [0.32, (95% CI: 0.12, 0.53)], waist circumference [1.22 cm (95% CI: 0.13, 2.31)], and sum of four skinfolds [3.26 mm (95% CI: 0.18, 6.35)] at age 4. Polyomaviruses burden was not associated with outcomes. CONCLUSIONS A higher herpesviruses burden and CMV seropositivity were associated with obesity traits in childhood.
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Chatzi L, Leventakou V, Vafeiadi M, Koutra K, Roumeliotaki T, Chalkiadaki G, Karachaliou M, Daraki V, Kyriklaki A, Kampouri M, Fthenou E, Sarri K, Vassilaki M, Fasoulaki M, Bitsios P, Koutis A, Stephanou EG, Kogevinas M. Cohort Profile: The Mother-Child Cohort in Crete, Greece (Rhea Study). Int J Epidemiol 2017; 46:1392-1393k. [DOI: 10.1093/ije/dyx084] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2017] [Indexed: 12/20/2022] Open
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Vioque J, Gimenez-Monzo D, Navarrete-Muñoz EM, Garcia-de-la-Hera M, Gonzalez-Palacios S, Rebagliato M, Ballester F, Murcia M, Iñiguez C, Granado F. Reproducibility and Validity of a Food Frequency Questionnaire Designed to Assess Diet in Children Aged 4-5 Years. PLoS One 2016; 11:e0167338. [PMID: 27898731 PMCID: PMC5127574 DOI: 10.1371/journal.pone.0167338] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2016] [Accepted: 11/11/2016] [Indexed: 12/29/2022] Open
Abstract
Background The food frequency questionnaire (FFQ) is the most efficient and cost-effective method to investigate the relationship between usual diet and disease in epidemiologic studies. Although FFQs have been validated in many adult populations worldwide, the number of valid FFQ in preschool children is very scarce. The aim of this study was to evaluate the reproducibility and validity of a semi-quantitative FFQ designed for children aged 4 to 5 years. Materials and methods In this study, we have included 169 children aged 4–5 years from the INMA project in Valencia, a population-based prospective cohort study of mothers and children in Spain. The 105-items FFQ was administered twice to the parents or care-givers of children over a 9-month period. Reproducibility was explored by comparing intake of nutrients by the FFQs, while validity was examined by comparing the nutrient values from the FFQs with the average nutrient values of three 24 hour dietary recall (24hDR) taken in the period, and also, with the concentration in blood specimens for several vitamins (carotenoids, folate, vitamin B12, vitamin C and α-tocopherol). Pearson correlation coefficients and de-attenuated correlation coefficients were calculated and we also evaluated misclassification by quintile distribution. Results All correlation coefficients for reproducibility for nutrients and major food groups were statistically significant; the average correlation coefficients for daily intake were 0.43 for food groups and 0.41 for nutrients. The average correlation coefficients for validity for daily intakes against 24hDR was r = 0.30, and the average for de-attenuated correlation coefficients was r = 0.44. When evaluating validity against the blood concentration of vitamins, statistically significant correlations were observed for vitamin C (0.35), lycopene (0.31), β-Cryptoxantin (0.40), and vitamin E (0.29); the average of correlation coefficients was r = 0.21. Conclusion Despite some low to moderate correlations for reproducibility and validity, overall this study suggests that the FFQ may be a good method for assessing a wide range of food groups and nutrients intake in children aged 4–5 years.
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Affiliation(s)
- Jesus Vioque
- Unidad de Epidemiologia de la Nutrición. Universidad Miguel Hernández, Alicante, Spain. Institute for Health and Biomedical Research (ISABIAL—FISABIO Foundation), Alicante, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- * E-mail:
| | - Daniel Gimenez-Monzo
- Unidad de Epidemiologia de la Nutrición. Universidad Miguel Hernández, Alicante, Spain. Institute for Health and Biomedical Research (ISABIAL—FISABIO Foundation), Alicante, Spain
| | - Eva Maria Navarrete-Muñoz
- Unidad de Epidemiologia de la Nutrición. Universidad Miguel Hernández, Alicante, Spain. Institute for Health and Biomedical Research (ISABIAL—FISABIO Foundation), Alicante, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Manuela Garcia-de-la-Hera
- Unidad de Epidemiologia de la Nutrición. Universidad Miguel Hernández, Alicante, Spain. Institute for Health and Biomedical Research (ISABIAL—FISABIO Foundation), Alicante, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Sandra Gonzalez-Palacios
- Unidad de Epidemiologia de la Nutrición. Universidad Miguel Hernández, Alicante, Spain. Institute for Health and Biomedical Research (ISABIAL—FISABIO Foundation), Alicante, Spain
| | - Marisa Rebagliato
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO/CSISP), Valencia, Spain
- Departamento de Medicina, Universitat Jaume I, Castellón de la Plana, Spain
| | - Ferran Ballester
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO/CSISP), Valencia, Spain
| | - Mario Murcia
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO/CSISP), Valencia, Spain
| | - Carmen Iñiguez
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO/CSISP), Valencia, Spain
| | - Fernando Granado
- Servicio Bioquímica Clínica, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
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Vafeiadi M, Roumeliotaki T, Myridakis A, Chalkiadaki G, Fthenou E, Dermitzaki E, Karachaliou M, Sarri K, Vassilaki M, Stephanou EG, Kogevinas M, Chatzi L. Association of early life exposure to bisphenol A with obesity and cardiometabolic traits in childhood. ENVIRONMENTAL RESEARCH 2016; 146:379-387. [PMID: 26821262 DOI: 10.1016/j.envres.2016.01.017] [Citation(s) in RCA: 102] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Revised: 01/11/2016] [Accepted: 01/13/2016] [Indexed: 06/05/2023]
Abstract
BACKGROUND Bisphenol A (BPA) is a chemical used extensively worldwide in the manufacture of plastic polymers. The environmental obesogen hypothesis suggests that early life exposure to endocrine disrupting chemicals such as BPA may increase the risk for wt gain later in childhood but few prospective epidemiological studies have investigated this relationship. OBJECTIVES We examined the association of early life BPA exposure with offspring obesity and cardiometabolic risk factors in 500 mother-child pairs from the RHEA pregnancy cohort in Crete, Greece. METHODS BPA concentrations were measured in spot urine samples collected at the 1st trimester of pregnancy) and from children at 2.5 and 4 years of age. We measured birth wt, body mass index (BMI) from 6 months to 4 years of age, waist circumference, skinfold thickness, blood pressure, serum lipids, C-reactive protein, and adipokines at 4 years of age. BMI growth trajectories from birth to 4 years were estimated by mixed effects models with fractional polynomials of age. Adjusted associations were obtained via multivariable regression analyses. RESULTS The prevalence of overweight/obesity was 9% at 2, 13% at 3% and 17% at 4 years of age. Geometric mean BPA concentrations were 1.2μg/g creatinine±7.9 in 1st trimester, 5.1μg/g±13.3 in 2.5 years and 1.9μg/g±4.9 in 4 years. After confounder adjustment, each 10-fold increase in BPA at 4 years was associated with a higher BMI z-score (adj. β=0.2; 95% CI: 0.01, 0.4), waist circumference (adj. β=1.2; 95% CI: 0.1, 2.2) and sum of skinfold thickness (adj. β=3.7mm; 95% CI: 0.7, 6.7) at 4 years. Prenatal BPA was negatively associated with BMI and adiposity measures in girls and positively in boys. We found no associations of early life exposure to BPA with other offspring cardiometabolic risk factors. CONCLUSIONS Prenatal BPA exposure was not consistently associated with offspring growth and adiposity measures but higher early childhood BPA was associated with excess child adiposity.
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Affiliation(s)
- Marina Vafeiadi
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece.
| | - Theano Roumeliotaki
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece
| | - Antonis Myridakis
- Environmental Chemical Processes Laboratory (ECPL), Department of Chemistry, University of Crete, Heraklion, Greece
| | - Georgia Chalkiadaki
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece
| | - Eleni Fthenou
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece
| | - Eirini Dermitzaki
- Department of Clinical Chemistry, School of Medicine, University of Crete, Heraklion, Crete, Greece
| | - Marianna Karachaliou
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece
| | - Katerina Sarri
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece
| | - Maria Vassilaki
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece
| | - Euripides G Stephanou
- Environmental Chemical Processes Laboratory (ECPL), Department of Chemistry, University of Crete, Heraklion, Greece
| | - Manolis Kogevinas
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Hospital del Mar Research Institute (IMIM), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Leda Chatzi
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece
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Dietary patterns in early childhood and child cognitive and psychomotor development: the Rhea mother–child cohort study in Crete. Br J Nutr 2016; 115:1431-7. [DOI: 10.1017/s0007114516000246] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractEarly-life nutrition is critical for optimal brain development; however, few studies have evaluated the impact of diet as a whole in early childhood on neurological development with inconsistent results. The present analysis is a cross-sectional study nested within an ongoing prospective birth cohort, the Rhea study, and aims to examine the association of dietary patterns with cognitive and psychomotor development in 804 preschool (mean age 4·2 years) children. Parents completed a validated FFQ, and dietary patterns were identified using principal component analysis. Child cognitive and psychomotor development was assessed by the McCarthy Scales of Children’s Abilities (MSCA). Multivariable linear regression models were used to investigate the associations of dietary patterns with the MSCA scales. After adjustment for a large number of confounding factors, the ‘Snacky’ pattern (potatoes and other starchy roots, salty snacks, sugar products and eggs) was negatively associated with the scales of verbal ability (β=−1·31; 95 % CI −2·47, −0·16), general cognitive ability (β=−1·13; 95 % CI −2·25, −0·02) and cognitive functions of the posterior cortex (β=−1·20; 95 % CI −2·34, −0·07). Further adjustment for maternal intelligence, folic acid supplementation and alcohol use during pregnancy attenuated the observed associations, but effect estimates remained at the same direction. The ‘Western’ and the ‘Mediterranean’ patterns were not associated with child neurodevelopmental scales. The present findings suggest that poorer food choices at preschool age characterised by foods high in fat, salt and sugar are associated with reduced scores in verbal and cognitive ability.
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Early life determinants of dietary patterns in preschool children: Rhea mother-child cohort, Crete, Greece. Eur J Clin Nutr 2015; 70:60-5. [PMID: 26081489 DOI: 10.1038/ejcn.2015.93] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Revised: 01/08/2015] [Accepted: 05/07/2015] [Indexed: 01/21/2023]
Abstract
BACKGROUND/OBJECTIVES The determination of dietary patterns in children examines the effects of the overall diet at early ages, instead of looking at individual foods or energy providing nutrients. The present analysis aims to identify the dietary patterns of preschool children and to examine their associations with multiple socio-economic and lifestyle characteristics. SUBJECTS/METHODS Dietary data were collected for 1081 children participating in the Rhea mother-child cohort in Crete, Greece. Diet was assessed using a validated food frequency questionnaire, and dietary patterns were identified with principal component analysis. Multivariable linear regression models were used to examine factors associated with each dietary pattern. RESULTS Three dietary patterns were identified explaining 45.8% of the total diet variation. The 'Mediterranean' pattern was based on pulses, olive oil, vegetables, fish and fruits; the 'Snacky' pattern included potatoes and other starchy roots, salty snacks, sugar products and eggs; the 'Western' pattern contained cereals, cheese, added lipids, beverages and meat. Preschool attendance and increased time spent with the mother (⩾2 h/day) were positively associated with the 'Mediterranean' pattern, whereas watching TV was inversely associated with this pattern. Lower parental education, maternal age and earlier introduction to solid foods were positively associated with the 'Snacky' pattern. Higher scores on the 'Western' type diet were associated with exposure to passive smoking and watching TV. No variation in energy providing nutrient intake was observed across tertiles of the identified dietary patterns. CONCLUSIONS The results from this analysis indicate the important role of socio-demographic factors on children's dietary preferences in early age.
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Daraki V, Georgiou V, Papavasiliou S, Chalkiadaki G, Karahaliou M, Koinaki S, Sarri K, Vassilaki M, Kogevinas M, Chatzi L. Metabolic profile in early pregnancy is associated with offspring adiposity at 4 years of age: the Rhea pregnancy cohort Crete, Greece. PLoS One 2015; 10:e0126327. [PMID: 25970502 PMCID: PMC4430416 DOI: 10.1371/journal.pone.0126327] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Accepted: 03/19/2015] [Indexed: 12/14/2022] Open
Abstract
Context Maternal pre-pregnancy obesity may increase the risk of childhood obesity but it is unknown whether other metabolic factors in early pregnancy such as lipid profile and hypertension are associated with offspring cardiometabolic traits. Objective Our objective was to investigate whether fasting lipid, glucose, and insulin levels during early pregnancy and maternal pre-pregnancy weight status, are associated with offspring adiposity measures, lipid levels and blood pressure at preschool age. Design and Methods The study included 618 mother-child pairs of the pregnancy cohort “Rhea” study in Crete, Greece. Pregnant women were recruited at the first prenatal visit (mean: 12weeks, SD: 0.7). A subset of 348 women provided fasting serum samples for glucose and lipid measurements. Outcomes measures were body mass index, abdominal circumference, sum of skinfold thickness, and blood pressure measurements at 4 years of age. A subsample of 525 children provided non-fasting blood samples for lipid measurements. Results Pre-pregnancy overweight/obesity was associated with greater risk of offspring overweight/obesity (RR: 1.83, 95%CI: 1.19, 2.81), central adiposity (RR: 1.97, 95%CI: 1.11, 3.49), and greater fat mass by 5.10mm (95%CI: 2.49, 7.71) at 4 years of age. These associations were more pronounced in girls. An increase of 40mg/dl in fasting serum cholesterol levels in early pregnancy was associated with greater skinfold thickness by 3.30mm (95%CI: 1.41, 5.20) at 4 years of age after adjusting for pre-pregnancy BMI and several other confounders. An increase of 10mmHg in diastolic blood pressure in early pregnancy was associated with increased risk of offspring overweight/obesity (RR: 1.22, 95%CI: 1.03, 1.45), and greater skinfold thickness by 1.71mm (95% CI: 0.57, 2.86) at 4 years of age. Conclusions Metabolic dysregulation in early pregnancy may increase the risk of obesity at preschool age.
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Affiliation(s)
- Vasiliki Daraki
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece; Clinic of Endocrinology, University Hospital of Crete, Heraklion, Greece
| | - Vaggelis Georgiou
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece
| | | | - Georgia Chalkiadaki
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece
| | - Marianna Karahaliou
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece
| | - Stella Koinaki
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece
| | - Katerina Sarri
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece
| | - Maria Vassilaki
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece
| | - Manolis Kogevinas
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; IMIM (Hospital del Mar Research Institute), Barcelona, Spain; CIBER Epidemiologia y Salud Pública (CIBERESP), Barcelona, Spain; National School of Public Health, Athens, Greece
| | - Leda Chatzi
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece
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Ethnic differences in dietary intake at age 12 and 18 months: the Born in Bradford 1000 Study. Public Health Nutr 2015; 19:114-22. [PMID: 25908276 DOI: 10.1017/s1368980015000932] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To compare the intake of key indicator foods at age 12 months and 18 months between infants of Pakistani and White British origin. DESIGN Logistic regression was used to model associations between ethnicity and consumption of key indicator foods defined by high or low energy density using an FFQ at age 12 and 18 months. SETTING Born in Bradford 1000 study, Bradford, UK. SUBJECTS Infants (n 1259; 38 % White British, 49 % Pakistani), mean age 12·7 (sd 1·0) months and toddlers (n 1257; 37 % White British, 49 % Pakistani), mean age 18·7 (sd1·0) months. RESULTS At 12 months, Pakistani infants consumed more commercial sweet baby meals than White British infants, with greater odds for being above average consumers (adjusted OR (AOR)=1·90; 95 % CI 1·40, 2·56), more chips/roast potatoes (AOR=2·75; 95 % CI 2·09, 3·62), less processed meat products (AOR=0·11; 95 % CI 0·08, 0·15), more fruit (AOR=2·20; 95 % CI 1·70, 2·85) and more sugar-sweetened drinks (AOR=1·68; 95 % CI 1·29, 2·18). At 18 months these differences persisted, with Pakistani infants consuming more commercial sweet baby meals (AOR=4·57; 95 % CI 2·49, 8·39), more chips/roast potato shapes (AOR=2·26; 95 % CI 1·50, 3·43), more fruit (AOR=1·40; 95 % CI 1·08, 1·81), more sugar-sweetened drinks (AOR=2·03; 95 % CI 1·53, 2·70), more pure fruit juice (AOR=1·82; 95 % CI 1·40, 2·35), more water (AOR=3·24; 95 % CI 2·46, 4·25) and less processed meat (AOR=0·10; 95 % CI 0·06, 0·15) than White British infants. CONCLUSIONS Dietary intake during infancy and the early toddlerhood period is associated with ethnicity, suggesting the importance of early and culturally adapted interventions aimed at establishing healthy eating behaviours.
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Karachaliou M, Georgiou V, Roumeliotaki T, Chalkiadaki G, Daraki V, Koinaki S, Dermitzaki E, Sarri K, Vassilaki M, Kogevinas M, Oken E, Chatzi L. Association of trimester-specific gestational weight gain with fetal growth, offspring obesity, and cardiometabolic traits in early childhood. Am J Obstet Gynecol 2015; 212:502.e1-14. [PMID: 25557209 PMCID: PMC5081180 DOI: 10.1016/j.ajog.2014.12.038] [Citation(s) in RCA: 115] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Revised: 11/05/2014] [Accepted: 12/18/2014] [Indexed: 12/11/2022]
Abstract
OBJECTIVE The purpose of this study was to investigate the association of trimester-specific gestational weight gain with offspring fetal growth, obesity risk, and cardiometabolic health outcomes from birth to 4 years of age. STUDY DESIGN We conducted the present study with 977 mother-child pairs of the pregnancy cohort "Rhea" study in Crete, Greece. We measured birthweight, body mass index from 6 months to 4 years of age, waist circumference, skinfold thickness, blood pressure, and blood levels of lipids, C-reactive protein, and adipose tissue hormones at 4 years of age. We used multiple linear and log Poisson regression models to examine the association of exposure with continuous or binary outcomes, respectively. RESULTS Greater rate of gestational weight gain in the first trimester of pregnancy (per 200 g/wk) was associated with increased risk of overweight/obesity from 2 years (relative risk [RR], 1.25; 95% confidence interval [CI], 1.09-1.42) to 4 years of age (RR, 1.15; 95% CI, 1.05-1.25), but not with birth size. Each 200 g/wk of weight gain in the first trimester of pregnancy was also associated with greater risk of high waist circumference (RR, 1.13; 95% CI, 1.04-1.23), high sum of skinfold thickness (RR, 1.15; 95% CI, 1.02-1.29), and higher diastolic blood pressure at 4 years of age (β, 0.43 mm Hg; 95% CI, 0.00-0.86). Greater rate of gestational weight gain during the second and third trimesters of pregnancy (per 200 g/wk) was associated with greater risk of large-for-gestational-age neonates (RR, 1.22; 95% CI, 1.02, 1.45) and higher levels of cord blood leptin (ratio of geometric means, 1.08; 95% CI, 1.00-1.17), but not with child anthropometry at later ages. CONCLUSION Timing of gestational weight gain may influence childhood cardiometabolic outcomes differentially.
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Affiliation(s)
- Marianna Karachaliou
- Department of Social Medicine, Faculty of Medicine, University of Crete, Crete, Greece.
| | - Vaggelis Georgiou
- Department of Social Medicine, Faculty of Medicine, University of Crete, Crete, Greece
| | - Theano Roumeliotaki
- Department of Social Medicine, Faculty of Medicine, University of Crete, Crete, Greece
| | - Georgia Chalkiadaki
- Department of Social Medicine, Faculty of Medicine, University of Crete, Crete, Greece
| | - Vasiliki Daraki
- Department of Social Medicine, Faculty of Medicine, University of Crete, Crete, Greece; Department of Endocrinology, Diabetes Mellitus, and Metabolic Disorders, Faculty of Medicine, University of Crete, Crete, Greece
| | - Stella Koinaki
- Department of Social Medicine, Faculty of Medicine, University of Crete, Crete, Greece
| | - Eirini Dermitzaki
- Department of Clinical Chemistry and Biochemistry, Faculty of Medicine, University of Crete, Crete, Greece
| | - Katerina Sarri
- Department of Social Medicine, Faculty of Medicine, University of Crete, Crete, Greece
| | - Maria Vassilaki
- Department of Social Medicine, Faculty of Medicine, University of Crete, Crete, Greece
| | - Manolis Kogevinas
- National School of Public Health, Athens, Greece; Center for Research in Environmental Epidemiology, Municipal Institute of Medical Research, and CIBER Epidemiologia y Salud Pública, Barcelona, Spain
| | - Emily Oken
- Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA
| | - Leda Chatzi
- Department of Social Medicine, Faculty of Medicine, University of Crete, Crete, Greece
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