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Dos Santos EA, Cavalheiro LAM, Rodrigues D, Machado-Rodrigues A, Silva MR, Nogueira H, Padez C. Are sun exposure time, dietary patterns, and vitamin D intake related to the socioeconomic status of Portuguese children? Am J Hum Biol 2024:e24109. [PMID: 38804593 DOI: 10.1002/ajhb.24109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 05/16/2024] [Accepted: 05/18/2024] [Indexed: 05/29/2024] Open
Abstract
OBJECTIVES To investigate the association among sun exposure time, vitamin D intake, dietary patterns, and socioeconomic status in Portuguese children. METHODS Participants aged 3-11 years (50.1% females) were recruited from public and private schools (n = 118) in the districts of Coimbra (n = 2980), Lisbon (n = 3066), and Porto (n = 2426). Parents reported their children's daily sun exposure time during the summer season and reported children's food consumption, including vitamin D food sources, using standardized questionnaires. Parents' education level was used as a proxy measure to the socioeconomic status (SES). The principal component factor analysis (PCA) method was used to identify dietary patterns. The eight dietary patterns identified were labeled in: "fast food", "rich in vitamin D", "sugary drinks", "vitamin D", "candies", "supplements", "rich in calcium" and "vegetables/healthy". Linear regression analyses were performed to investigate the association between sun exposure time and dietary patterns according to SES. RESULTS A total of 4755 children were included. Children from high SES had significantly longer sun exposure time (p < .001) and more frequently consumed vitamin D supplements (p < .001). "Fast food" pattern showed a negative association with sun exposure time in medium and high SES (p = .014 and p < .001, respectively). CONCLUSION Children with lower SES spend less time exposed to the sun, consume fewer dietary sources of vitamin D, and consume more foods rich in fat and sugar.
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Affiliation(s)
- Elizabete A Dos Santos
- Nutrition Department, School of Public Health, University of São Paulo, São Paulo, Brazil
| | | | - Daniela Rodrigues
- Research Centre for Anthropology and Health, Department of Life Sciences, University of Coimbra, Coimbra, Portugal
| | | | - Maria-Raquel Silva
- Research Centre for Anthropology and Health, Department of Life Sciences, University of Coimbra, Coimbra, Portugal
- Faculty of Health Sciences, University Fernando Pessoa, Porto, Portugal
- Comprehensive Health Research Centre-Group of Sleep, Chronobiology and Sleep Disorders-Nova Medical School, University of Lisbon, Lisbon, Portugal
| | - Helena Nogueira
- Research Centre for Anthropology and Health, Department of Geography and Tourism, University of Coimbra, Coimbra, Portugal
| | - Cristina Padez
- Research Centre for Anthropology and Health, Department of Life Sciences, University of Coimbra, Coimbra, Portugal
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Biancaniello EC, Tiessen S, Hartman B, Battram DS. Dietary polyphenol intake in the Canadian population: Findings from the 2015 Canadian Community Health Survey-Nutrition. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2024; 115:315-331. [PMID: 38180640 PMCID: PMC11027756 DOI: 10.17269/s41997-023-00845-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 11/28/2023] [Indexed: 01/06/2024]
Abstract
OBJECTIVES This study aimed to estimate usual polyphenol intake among Canadians using the nationally representative 2015 Canadian Community Health Survey-Nutrition and to explore the main dietary contributors to polyphenol intake and the sociodemographic and lifestyle factors that may impact polyphenol intake. METHODS Dietary information was collected from 19,409 respondents using 24-h dietary recalls. The polyphenol content of foods was estimated using the Phenol-Explorer Database (version 3.6). Daily intake values for total polyphenols (adjusted to energy intake), main classes, and subclasses were calculated for each respondent and dietary recall. Usual intake was estimated by age/sex groups and by sociodemographic and lifestyle characteristics independently for adults and children using the National Cancer Institute method. Given-day arithmetic mean polyphenol intakes and mean proportions of main classes contributing to sum total polyphenol intakes were explored. Population proportions were used to determine dietary contributors. RESULTS Usual total polyphenol intake was 1119.3 mg/1000 kcal/day (95% CI: 1090.5, 1148.1) for adults ≥ 19 years and 473.0 mg/1000 kcal/day (95% CI: 454.9, 491.0) for children 2‒18 years. Generally, total polyphenol intakes differed by age, sex, ethnicity, and household education status and were higher among coffee and tea consumers. Most polyphenols came from flavonoids (40.0%) and phenolic acids (49.8%), with children consuming more flavonoids and other polyphenols and adults more phenolic acids. The top food contributors to polyphenol intake were coffee (26.8%), tea (8.9%), fruit juice (4.2%), banana (4.1%), and apple (3.8%). CONCLUSION Usual intake of total polyphenols among Canadians differed primarily by age. Non-alcoholic beverages were top contributors to total polyphenol intake.
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Affiliation(s)
- Emma C Biancaniello
- School of Food and Nutritional Sciences, Brescia University College, London, ON, Canada.
| | - Sarah Tiessen
- School of Food and Nutritional Sciences, Brescia University College, London, ON, Canada
| | - Brenda Hartman
- School of Food and Nutritional Sciences, Brescia University College, London, ON, Canada
| | - Danielle S Battram
- School of Food and Nutritional Sciences, Brescia University College, London, ON, Canada
- Schulich Interfaculty Program in Public Health, Western University, London, ON, Canada
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Hammersley ML, Norman J, Smithers LG, Furber S, Plumb M, Jones RA. Healthy kids vids: Development and acceptability of narrative healthy lifestyle videos and text messages for parents of young children from socioeconomically disadvantaged populations. Health Promot J Austr 2023. [PMID: 37932935 DOI: 10.1002/hpja.823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 09/13/2023] [Accepted: 10/17/2023] [Indexed: 11/08/2023] Open
Abstract
ISSUE ADDRESSED Dietary intake and physical activity behaviours of many Australian children are not meeting recommendations, particularly for those living in socioeconomically disadvantaged circumstances. This study aimed to design and assess the feasibility and acceptability of a suite of narrative videos and text messages focused on healthy eating and physical activity behaviours appropriate for parents of young children from socioeconomically disadvantaged backgrounds. METHODS Parents of 1-5-year-old children (n = 6) were recruited to develop a suite of 12 narrative videos on healthy eating and physical activity behaviours, underpinned by theory. Twelve complementary text messages were subsequently developed. A different group of parents (n = 16) recruited from socioeconomically disadvantaged areas reviewed the videos and text messages over 6 weeks and provided feedback via surveys and qualitative interviews (n = 13). RESULTS There was a high level of engagement with and acceptability of the videos and text message content. Participants found the videos easy to access and they liked the narrative style. Screen time videos and text messages relating to screen time, play and physical activity, role modelling and fussy eating were most useful. CONCLUSIONS Narrative style healthy eating, physical activity and screen time videos and complementary text messages were highly acceptable to the sample of parents of 1-5-year-old children from socioeconomically disadvantaged areas recruited from the Illawarra Shoalhaven region of NSW, Australia. SO WHAT?: Short narrative style videos and text messages are an easy to process and acceptable method of delivering healthy lifestyle promotion content to parents.
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Affiliation(s)
- Megan L Hammersley
- School of Health and Society, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, Australia
- Early Start, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, Australia
| | - Jennifer Norman
- School of Health and Society, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, Australia
- Early Start, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, Australia
- Health Promotion Service, Illawarra Shoalhaven Local Health District, NSW Health, Warrawong, Australia
| | - Lisa G Smithers
- School of Health and Society, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, Australia
- School of Public Health, The University of Adelaide, Adelaide, Australia
| | - Susan Furber
- School of Health and Society, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, Australia
- Health Promotion Service, Illawarra Shoalhaven Local Health District, NSW Health, Warrawong, Australia
| | - Melinda Plumb
- Learning, Teaching and Curriculum, University of Wollongong, Wollongong, Australia
| | - Rachel A Jones
- Early Start, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, Australia
- School of Education, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, Australia
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Trilok‐Kumar G, Malik A, Gusain Y, Millerot E, Pathak R, Filteau S. Dietary patterns of Indian school-aged children and associations with markers of chronic disease risk. Food Sci Nutr 2023; 11:7070-7079. [PMID: 37970425 PMCID: PMC10630838 DOI: 10.1002/fsn3.3631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 07/26/2023] [Accepted: 08/04/2023] [Indexed: 11/17/2023] Open
Abstract
There is an increasing burden of noncommunicable diseases (NCDs) in India which may be related to changing dietary patterns. We aimed to assess dietary patterns in children since they have time to change unhealthy patterns before NCDs develop. Participants were 665 children, 9-12 years old, born with low birth weight and 77 similarly aged normal birth weight controls. We collected data on sociodemography, anthropometry, body composition, and markers of risk for NCDs: grip strength, long jump, hemoglobin A1c (HbA1c). A food frequency questionnaire was used to collect dietary data from which dietary patterns were derived using principal component analysis (PCA). Fourteen food groups were included in the PCA analysis, resulting in three components: 'fruits and vegetables', 'protein', and 'sugar and fat'. Higher socioeconomic status and maternal education were associated with lower adherence to the fruit and vegetable pattern and higher adherence to the protein and sugar and fat patterns. Adherence to the fruits and vegetables pattern was associated with lower height-for-age, whereas the fat and sugar pattern was associated with higher indicators of body fat. In linear regression analyses adjusted for age, sex, religion, socioeconomic status, maternal education, and season of data collection, adherence to the 'fruits and vegetables' pattern was associated with lower grip strength, shorter long jump, and lower HbA1c. Adherence to the other patterns was not associated with NCD risk factors. Higher consumption of fruits and vegetables, achievable even by poorer families in the cohort, may lower HbA1c, a risk factor for diabetes.
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Affiliation(s)
| | - Anku Malik
- Institute of Home Economics, University of DelhiNew DelhiIndia
| | - Yamini Gusain
- Institute of Home Economics, University of DelhiNew DelhiIndia
| | - Eve Millerot
- London School of Hygiene and Tropical MedicineLondonUK
| | - Renuka Pathak
- Institute of Home Economics, University of DelhiNew DelhiIndia
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Weil K, Coulibaly I, Fuelbert H, Herrmann A, Millogo RM, Danquah I. Dietary patterns and their socioeconomic factors of adherence among adults in urban Burkina Faso: a cross-sectional study. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2023; 42:107. [PMID: 37817202 PMCID: PMC10566033 DOI: 10.1186/s41043-023-00451-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 10/03/2023] [Indexed: 10/12/2023]
Abstract
BACKGROUND Sub-Saharan African populations undergo a nutrition transition towards diets associated with increased risk for metabolic and cardiovascular diseases. For targeted prevention, we aimed to characterize dietary patterns and determine their sociodemographic factors of adherence. METHODS We recruited 1,018 adults aged > = 25 years from two formal and three informal settlements within the Health and Demographic Surveillance System, Ouagadougou, Burkina Faso, between February and April 2021. In a cross-sectional sample, a culture-specific food-propensity questionnaire with 134 food items and a sociodemographic questionnaire were used to collect the data. Exploratory dietary patterns were derived using principal component analysis, and sociodemographic factors of adherence were calculated using multivariable linear regression models. RESULTS In this study population (median age: 42 years, interquartile range 21 years; male: 35.7%), the diet relied on starchy foods and other plant-based staples with rare consumption of animal-based products. We identified three dietary patterns, explaining 10.2%, 9.8%, and 8.9% of variation in food intake, respectively: a meat and egg-based pattern associated with younger age, male sex, better education, and economic situation; a fish-based pattern prevailed among women, higher educational levels, and better economic situation; and a starchy food-based was associated with younger age and sharing a home with other adults. CONCLUSIONS This study population is at an early stage of the nutrition transition and shows low intakes of health-beneficial food groups. Yet, progress along the nutrition transition varies according to age, educational attainment, and economic status. Particularly, younger and well-off people seem to adhere more strongly to diets high in animal-based products. These findings can inform strategies in public health nutrition for sub-Saharan African populations.
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Affiliation(s)
- Konstantin Weil
- Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital and Medical Faculty, Heidelberg University, Im Neuenheimer Feld 324, 69120, Heidelberg, Germany.
| | - Issa Coulibaly
- Institut Supérieur des Sciences de la Population, Université Joseph Ki-Zerbo, Ouagadougou, Burkina Faso
| | - Hannah Fuelbert
- Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital and Medical Faculty, Heidelberg University, Im Neuenheimer Feld 324, 69120, Heidelberg, Germany
| | - Alina Herrmann
- Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital and Medical Faculty, Heidelberg University, Im Neuenheimer Feld 324, 69120, Heidelberg, Germany
| | - Roch Modeste Millogo
- Institut Supérieur des Sciences de la Population, Université Joseph Ki-Zerbo, Ouagadougou, Burkina Faso
| | - Ina Danquah
- Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital and Medical Faculty, Heidelberg University, Im Neuenheimer Feld 324, 69120, Heidelberg, Germany
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Bishehsari F, Drees M, Adnan D, Sharma D, Green S, Koshy J, Giron LB, Goldman A, Abdel-Mohsen M, Rasmussen HE, Miller GE, Keshavarzian A. Multi-omics approach to socioeconomic disparity in metabolic syndrome reveals roles of diet and microbiome. Proteomics 2023; 23:e2300023. [PMID: 37525324 DOI: 10.1002/pmic.202300023] [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: 01/18/2023] [Revised: 06/23/2023] [Accepted: 07/10/2023] [Indexed: 08/02/2023]
Abstract
The epidemy of metabolic syndrome (MetS) is typically preceded by adoption of a "risky" lifestyle (e.g., dietary habit) among populations. Evidence shows that those with low socioeconomic status (SES) are at an increased risk for MetS. To investigate this, we recruited 123 obese subjects (body mass index [BMI] ≥ 30) from Chicago. Multi-omic data were collected to interrogate fecal microbiota, systemic markers of inflammation and immune activation, plasma metabolites, and plasma glycans. Intestinal permeability was measured using the sugar permeability testing. Our results suggest a heterogenous metabolic dysregulation among obese populations who are at risk of MetS. Systemic inflammation, linked to poor diet, intestinal microbiome dysbiosis, and gut barrier dysfunction may explain the development of MetS in these individuals. Our analysis revealed 37 key features associated with increased numbers of MetS features. These features were used to construct a composite metabolic-inflammatory (MI) score that was able to predict progression of MetS among at-risk individuals. The MI score was correlated with several markers of poor diet quality as well as lower levels of gut microbial diversity and abnormalities in several species of bacteria. This study reveals novel targets to reduce the burden of MetS and suggests access to healthy food options as a practical intervention.
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Affiliation(s)
- Faraz Bishehsari
- Rush Center for Integrated Microbiome and Chronobiology Research, Rush University Medical Center, Chicago, Illinois, USA
| | - Michael Drees
- Rush Center for Integrated Microbiome and Chronobiology Research, Rush University Medical Center, Chicago, Illinois, USA
| | - Darbaz Adnan
- Rush Center for Integrated Microbiome and Chronobiology Research, Rush University Medical Center, Chicago, Illinois, USA
| | - Deepak Sharma
- Rush Center for Integrated Microbiome and Chronobiology Research, Rush University Medical Center, Chicago, Illinois, USA
| | - Stefan Green
- Rush Center for Integrated Microbiome and Chronobiology Research, Rush University Medical Center, Chicago, Illinois, USA
| | - Jane Koshy
- The Wistar Institute, Philadelphia, Pennsylvania, USA
| | - Leila B Giron
- The Wistar Institute, Philadelphia, Pennsylvania, USA
| | - Aaron Goldman
- The Wistar Institute, Philadelphia, Pennsylvania, USA
| | | | | | - Gregory E Miller
- Institute for Policy Research and Dept of Psychology, Northwestern Univ, Evanston, Illinois, USA
| | - Ali Keshavarzian
- Rush Center for Integrated Microbiome and Chronobiology Research, Rush University Medical Center, Chicago, Illinois, USA
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Vo TVA, Irizar H, Gibson K, Stanley S, Agarwal S, Groetch M, Do A, Bunyavanich S. Socioeconomic Status and Diet Quality in Children with and without Food Allergy. J Pediatr 2023; 260:113337. [PMID: 36731716 PMCID: PMC10446240 DOI: 10.1016/j.jpeds.2022.12.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 10/28/2022] [Accepted: 12/07/2022] [Indexed: 02/01/2023]
Abstract
Socioeconomic status (SES) influences diet quality, but this association has not been tested in children with food allergy. In this cross-sectional study, we assessed diet quality for 173 children, including 92 participants with food allergy. We found positive associations between SES and diet quality in children both with and without food allergy.
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Affiliation(s)
- Thanh Viet Anh Vo
- Division of Allergy and Immunology, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY; Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Haritz Irizar
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Kyle Gibson
- Division of Allergy and Immunology, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY; Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Stephanie Stanley
- Division of Allergy and Immunology, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY; Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Shradha Agarwal
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Marion Groetch
- Division of Allergy and Immunology, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Anh Do
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Supinda Bunyavanich
- Division of Allergy and Immunology, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY; Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY.
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Yin XC, Wang WF, Li ZM, Duan YJ, Chen M, Wu YN, Hu YM. The relationship between dietary patterns and blood mineral concentration among children in Hunan Province of China. BMC Public Health 2023; 23:1518. [PMID: 37563609 PMCID: PMC10413533 DOI: 10.1186/s12889-023-16429-6] [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: 11/23/2022] [Accepted: 07/31/2023] [Indexed: 08/12/2023] Open
Abstract
BACKGROUND Minerals have crucial biological functions in metabolism and are primarily obtained through diet. As a result, various dietary patterns can impact blood mineral levels. The aim of this study was to investigate the correlation between dietary patterns and the concentration of calcium, magnesium, iron, zinc, and copper in the bloodstream. METHODS Three hundred eighty healthy children (53.7% male) were recruited in a region of Hunan Province in September 2019. We gathered basic information and measured physical proportions, along with completing a food frequency questionnaire (FFQ). Using principal component analysis (PCA), we determined dietary patterns. To analyze mineral levels in the blood, we used flame atomic absorption spectrometry (FAAS). We utilized linear regression models to investigate if certain dietary patterns are related to mineral concentration. RESULTS Three dietary patterns were identified: 'Vegetables/Nuts,' 'Snacks/Beverages,' and 'Cereal/Beans.' Children from high-income families (annual average income > 50,000 yuan) prefer the 'Vegetables/Nuts' dietary pattern (P = 0.004). In comparison, those from low-income families (annual average income < 20,000 yuan) prefer the 'Snacks/Beverages' dietary pattern (P = 0.03). Following adjustment for age, gender, guardian's identity, education level, and annual household income. We found that an increase in the 'Vegetables/Nuts' pattern score (β = 0.153, CI: 0.053 ~ 0.253; P = 0.003) and 'Snacks/Beverages' pattern score (β = 0.103, CI: 0.002 ~ 0.204; P = 0.033) were significantly associated blood copper concentration. CONCLUSIONS Household income was found to be associated with dietary behavior. Furthermore, higher blood copper concentration was significantly correlated with the 'Vegetables/Nuts' dietary pattern and 'Snacks/Beverages' dietary pattern, but the correlation is extremely low.
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Affiliation(s)
- Xiao-Chen Yin
- Department of Toxicology, Hunan Provincial Center for Disease Control and Prevention, Furong Road No. 450, Changsha, 410005, China
| | - Wei-Feng Wang
- Department of Toxicology, Hunan Provincial Center for Disease Control and Prevention, Furong Road No. 450, Changsha, 410005, China
| | - Zi-Min Li
- Department of Toxicology, Hunan Provincial Center for Disease Control and Prevention, Furong Road No. 450, Changsha, 410005, China
| | - Yu-Jie Duan
- Department of Toxicology, Hunan Provincial Center for Disease Control and Prevention, Furong Road No. 450, Changsha, 410005, China
| | - Ming Chen
- Department of Toxicology, Hunan Provincial Center for Disease Control and Prevention, Furong Road No. 450, Changsha, 410005, China
| | - Yuan-Ni Wu
- Department of Toxicology, Hunan Provincial Center for Disease Control and Prevention, Furong Road No. 450, Changsha, 410005, China
| | - Yu-Ming Hu
- Department of Toxicology, Hunan Provincial Center for Disease Control and Prevention, Furong Road No. 450, Changsha, 410005, China.
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Jimbo M, Saito S, Uematsu T, Hanaki H, Otori K, Shibuya K, Ando W. Risk analysis of COVID-19 hospitalization and critical care by race and region in the United States: a cohort study. BMC Public Health 2023; 23:1489. [PMID: 37542210 PMCID: PMC10401821 DOI: 10.1186/s12889-023-16401-4] [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: 04/21/2023] [Accepted: 07/26/2023] [Indexed: 08/06/2023] Open
Abstract
BACKGROUND This study aimed to identify the current risk factors for coronavirus disease 2019 severity and examine its association with medication use. METHODS We used data from a large United States electronic health record database to conduct an anonymized cohort study of 171,491 patients with coronavirus disease 2019. The study was conducted from January 1, 2020, to August 27, 2021. Data on age, race, sex, history of diseases, and history of medication prescriptions were analyzed using the Cox proportional hazards model analysis to calculate hazard ratios for hospitalization and severe risk. RESULTS Factors that increased the risk of hospitalization and critical care were age ≥ 65 years, male sex, type 2 diabetes, hypertension, interstitial pneumonia, and cardiovascular disease. In particular, age ≥ 65 years significantly increased the risk of hospitalization (hazard ratio, 2.81 [95% confidence interval, 2.58-3.07]; P < 0.001) and critical care (hazard ratio, 3.45 [2.88-4.14]; P < 0.001). In contrast, patients with hyperlipidemia had a reduced risk. However, patients with hyperlipidemia who were not taking statins had a significantly increased risk of hospitalization (hazard ratio, 1.24 [1.16-1.34]; P < 0.001). Sodium-glucose cotransporter-2 inhibitors, angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, glucocorticoids, and statins significantly reduced the risk of hospitalization and critical care. The risk of hospitalization and critical care increased in patients of all ethnicities with type 2 diabetes. The factors that significantly increased the risk of hospitalization in all regions were older age, hypertension, chronic obstructive pulmonary disease, and cardiovascular disease. CONCLUSION This study identified factors that increase or reduce the risk of severe coronavirus disease. The provision of appropriate drug treatment and modification of lifestyle-related risk factors may reduce coronavirus disease severity.
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Affiliation(s)
- Mitsuki Jimbo
- Department of Clinical Pharmacy, Center for Clinical Pharmacy and Sciences, Kitasato University School of Pharmacy, Minato-Ku, Tokyo, Japan
| | - Sakae Saito
- Department of Pharmacy, Kitasato University Medical Center, Kitamoto City, Saitama, Japan
| | - Takayuki Uematsu
- Biomedical Laboratory, Division of Biomedical Research, Kitasato University Medical Center, Kitamoto City, Saitama, Japan
| | - Hideaki Hanaki
- Infection Control Research Center, Ōmura Satoshi Memorial Institute, Kitasato University, Minato-Ku, Tokyo, Japan
| | - Katsuya Otori
- Laboratory of Pharmacy Practice and Science 1, Division of Clinical Pharmacy, Research and Education Center for Clinical Pharmacy, Kitasato University School of Pharmacy, Sagamihara, Japan
| | - Kiyoshi Shibuya
- Department of Clinical Pharmacy, Center for Clinical Pharmacy and Sciences, Kitasato University School of Pharmacy, Minato-Ku, Tokyo, Japan
- Department of Pharmacy, Kitasato University Medical Center, Kitamoto City, Saitama, Japan
| | - Wataru Ando
- Department of Clinical Pharmacy, Center for Clinical Pharmacy and Sciences, Kitasato University School of Pharmacy, Minato-Ku, Tokyo, Japan.
- Department of Pharmacy, Kitasato University Medical Center, Kitamoto City, Saitama, Japan.
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Serasinghe N, Vepsäläinen H, Lehto R, Abdollahi AM, Erkkola M, Roos E, Ray C. Associations between socioeconomic status, home food availability, parental role-modeling, and children's fruit and vegetable consumption: a mediation analysis. BMC Public Health 2023; 23:1037. [PMID: 37259139 DOI: 10.1186/s12889-023-15879-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 05/11/2023] [Indexed: 06/02/2023] Open
Abstract
BACKGROUND Recent literature has suggested that associations and interactions between family socioeconomic status (SES) and home food environment influence children's diet, but little is known about the mediation roles of parental role-modeling and food availability in the socioeconomic inequalities of children's diet. This study aimed to determine the associations between family SES and children's fruit and vegetable (FV) consumption and to assess the mediation roles of parental role-modeling and food availability in the above associations. METHODS Cross-sectional data of 574 Finnish children (aged 3 to 6) were analyzed. Parents completed an FFQ assessing their children's FV consumption frequency and a questionnaire assessing SES and home food environment. Two exposure variables: parental educational level ("low", "middle", and "high") and the relative family income tertiles of the family were used. The frequencies of parental role-modeling of FV and sugary food and drink (SFD) consumption, and the availability of FV and SFD at home were calculated. Single- and multiple-mediator models were created using IBM SPSS 27.0. RESULTS The positive association between high parental educational level and children's FV consumption (direct effect coefficient: 2.76, 95% CI: 0.51-4.86) was partially mediated by more frequent parental role-modeling of FV consumption (indirect effect coefficient: 0.89, 95% CI: 0.10-1.76), higher availability of FV (indirect effect coefficient: 1.00, 95% CI: 0.35-1.77), and lower availability of SFD (indirect effect coefficient: -0.30, 95% CI: -0.72 - -0.01). The relative family income was not directly associated with the outcome. However, the higher relative family income level indirectly predicted the Children's FV consumption (full mediation) through more frequent parental role-modeling of FV consumption (indirect effect coefficient: 0.91, 95% CI: 0.06-1.83) and higher availability of FV (indirect effect coefficient: 0.98, 95% CI: 0.40-1.67). Parental role-modeling on SFD consumption did not mediate any of the above associations. CONCLUSIONS Parental educational level showed more associations with children's FV consumption than relative family income. Our findings suggest that reducing the availability of SFD is as important as increasing the availability of FV to enhance children's FV consumption. Future interventions to improve children's dietary behaviors should pay greater attention to the lower SES segments of society. Longitudinal studies and intervention studies supporting these findings are needed for making meaningful recommendations for health promotion.
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Affiliation(s)
- Nithya Serasinghe
- Folkhälsan Research Center, Topeliuksenkatu 20, Helsinki, 00250, Finland.
| | - Henna Vepsäläinen
- Department of Food and Nutrition, University of Helsinki, P.O. Box 66, Helsinki, FI-00014, Finland
| | - Reetta Lehto
- Folkhälsan Research Center, Topeliuksenkatu 20, Helsinki, 00250, Finland
- Department of Food and Nutrition, University of Helsinki, P.O. Box 66, Helsinki, FI-00014, Finland
| | - Anna M Abdollahi
- Department of Food and Nutrition, University of Helsinki, P.O. Box 66, Helsinki, FI-00014, Finland
| | - Maijaliisa Erkkola
- Department of Food and Nutrition, University of Helsinki, P.O. Box 66, Helsinki, FI-00014, Finland
| | - Eva Roos
- Folkhälsan Research Center, Topeliuksenkatu 20, Helsinki, 00250, Finland
- Department of Food and Nutrition, University of Helsinki, P.O. Box 66, Helsinki, FI-00014, Finland
- Department of Food Studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden
- Department of Public Health, University of Helsinki, P.O. Box 63, Helsinki, FI-00014, Finland
| | - Carola Ray
- Folkhälsan Research Center, Topeliuksenkatu 20, Helsinki, 00250, Finland
- Department of Food and Nutrition, University of Helsinki, P.O. Box 66, Helsinki, FI-00014, Finland
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11
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Malindisa E, Dika H, Rehman AM, Olsen MF, Francis F, Friis H, Faurholt-Jepsen D, Filteau S, PrayGod G. Dietary patterns and diabetes mellitus among people living with and without HIV: a cross-sectional study in Tanzania. Front Nutr 2023; 10:1105254. [PMID: 37266136 PMCID: PMC10230058 DOI: 10.3389/fnut.2023.1105254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 04/13/2023] [Indexed: 06/03/2023] Open
Abstract
Background Due to the complexity of human diets, it is difficult to relate single foods to health outcomes. We aimed to identify the dietary patterns and associated factors and to assess the association of dietary patterns with prediabetes/diabetes among adults living with and without HIV in Tanzania. Methods Diet data were collected by a food frequency questionnaire (FFQ) and dietary patterns were derived by principal component analysis (PCA) and reduced rank regression (RRR). The associations between dietary patterns and associated factors as well as with prediabetes/diabetes were assessed using multinomial logistic regression and presented by marginal plots. Results Of 572 recruited, 63% were people living with HIV. The mean (±SD) age was 42.6 (±11.7) years and 60% were females. The PCA identified two major dietary patterns, i.e., vegetable-rich pattern (VRP) and vegetable-poor pattern (VPP) whereas RRR identified one dietary pattern, i.e., carbohydrate-dense pattern (CDP). In comparison to females, males had higher adherence to VPP and CDP, but less to VRP. Higher socioeconomic status was associated with higher adherence to VRP and VPP but low adherence to CDP. Compared to HIV-negative participants, people living with HIV had higher adherence to VRP but less adherence to CDP. Compared to younger people, older people had lower adherence to VPP. High adherence to CDP or VRP was positively associated with prediabetes. Higher adherence to VRP was associated with a borderline decrease in diabetes. No association was observed between VPP with either prediabetes or diabetes. Conclusion Our findings suggest that dietary patterns may impact the risk of prediabetes and diabetes differently. Awareness of the health benefits of VRP should be encouraged in the community, especially for men who seem to consume fewer vegetables. Longitudinal studies are needed to explore the contribution of dietary patterns to prediabetes/diabetes development in sub-Saharan Africa.
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Affiliation(s)
- Evangelista Malindisa
- Department of Physiology, The Catholic University of Health and Allied Sciences Bugando, Mwanza, Tanzania
- Mwanza Research Centre, National Institute for Medical Research, Mwanza, Tanzania
| | - Haruna Dika
- Department of Physiology, The Catholic University of Health and Allied Sciences Bugando, Mwanza, Tanzania
| | - Andrea M. Rehman
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Mette Frahm Olsen
- Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark
| | - Filbert Francis
- Tanga Research Centre, National Institute for Medical Research, Tanga, Tanzania
| | - Henrik Friis
- Department of Nutrition, Exercise, and Sports, University of Copenhagen, Copenhagen, Denmark
| | | | - Suzanne Filteau
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - George PrayGod
- Mwanza Research Centre, National Institute for Medical Research, Mwanza, Tanzania
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12
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Kanerva N, Wachira LJ, Uusi-Ranta N, Anono EL, Walsh HM, Erkkola M, Ochola S, Swindell N, Salmela J, Vepsäläinen H, Stratton G, Onywera V, Fogelholm M. Wealth and Sedentary Time Are Associated With Dietary Patterns Among Preadolescents in Nairobi City, Kenya. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2023; 55:322-330. [PMID: 36914443 DOI: 10.1016/j.jneb.2023.02.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 01/24/2023] [Accepted: 02/06/2023] [Indexed: 05/12/2023]
Abstract
OBJECTIVE The study aimed to compare dietary patterns in preadolescents in urban areas with different physical activity and socioeconomic profiles in Nairobi, Kenya. DESIGN Cross-sectional. PARTICIPANTS Preadolescents aged 9-14 years (n = 149) living in low- or middle-income areas in Nairobi. VARIABLES MEASURED Sociodemographic characteristics were collected using a validated questionnaire. Weight and height were measured. Diet was assessed using a food frequency questionnaire and physical activity by accelerometer. ANALYSIS Dietary patterns (DP) were formed through principal component analysis. Associations of age, sex, parental education, wealth, body mass index, physical activity, and sedentary time with DPs were analyzed with linear regression. RESULTS Three DPs explained 36% of the total variance in food consumption: (1) snacks, fast food, and meat; (2) dairy products and plant protein; and (3) vegetables and refined grains. Higher wealth was associated with higher scores of the first DP (P < 0.05). CONCLUSIONS AND IMPLICATIONS Consumption of foods often deemed unhealthy (eg, snacks and fast food) was more frequent among preadolescents whose families were wealthier. Interventions that seek ways to promote healthy lifestyles among families residing in urban areas of Kenya are warranted.
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Affiliation(s)
- Noora Kanerva
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland.
| | - Lucy Joy Wachira
- Department of Physical Education, Exercise and Sports Science, Kenyatta University, Nairobi, Kenya
| | - Noora Uusi-Ranta
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Esther L Anono
- Department of Food, Nutrition and Dietetics, Kenyatta University, Nairobi, Kenya
| | - Hanna M Walsh
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Maijaliisa Erkkola
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Sophie Ochola
- Department of Food, Nutrition and Dietetics, Kenyatta University, Nairobi, Kenya
| | - Nils Swindell
- Department of Sport Sciences, Swansea University, Swansea, United Kingdom
| | - Jatta Salmela
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Henna Vepsäläinen
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Gareth Stratton
- Department of Paediatric Exercise Science, Sport and Exercise Sciences, Swansea University, Swansea, United Kingdom
| | - Vincent Onywera
- Department of Physical Education, Exercise and Sports Science, Kenyatta University, Nairobi, Kenya
| | - Mikael Fogelholm
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
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13
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Miller V, Webb P, Cudhea F, Zhang J, Reedy J, Shi P, Erndt-Marino J, Coates J, Micha R, Mozaffarian D. Children's and adolescents' rising animal-source food intakes in 1990-2018 were impacted by age, region, parental education and urbanicity. NATURE FOOD 2023; 4:305-319. [PMID: 37117550 DOI: 10.1038/s43016-023-00731-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 03/09/2023] [Indexed: 04/30/2023]
Abstract
Animal-source foods (ASF) provide nutrition for children and adolescents' physical and cognitive development. Here, we use data from the Global Dietary Database and Bayesian hierarchical models to quantify global, regional and national ASF intakes between 1990 and 2018 by age group across 185 countries, representing 93% of the world's child population. Mean ASF intake was 1.9 servings per day, representing 16% of children consuming at least three daily servings. Intake was similar between boys and girls, but higher among urban children with educated parents. Consumption varied by age from 0.6 at <1 year to 2.5 servings per day at 15-19 years. Between 1990 and 2018, mean ASF intake increased by 0.5 servings per week, with increases in all regions except sub-Saharan Africa. In 2018, total ASF consumption was highest in Russia, Brazil, Mexico and Turkey, and lowest in Uganda, India, Kenya and Bangladesh. These findings can inform policy to address malnutrition through targeted ASF consumption programmes.
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Affiliation(s)
- Victoria Miller
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA.
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
- Population Health Research Institute, Hamilton, Ontario, Canada.
| | - Patrick Webb
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Frederick Cudhea
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Jianyi Zhang
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
- Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital, Boston, MA, USA
| | - Julia Reedy
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Peilin Shi
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Josh Erndt-Marino
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Jennifer Coates
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Renata Micha
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
- Department of Food Science and Nutrition, University of Thessaly, Thessaly, Greece
| | - Dariush Mozaffarian
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
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14
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Marume A, Archary M, Mahomed S. Dietary patterns and childhood stunting in Zimbabwe. BMC Nutr 2022; 8:111. [PMID: 36224638 PMCID: PMC9555084 DOI: 10.1186/s40795-022-00607-7] [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: 12/02/2021] [Accepted: 09/19/2022] [Indexed: 11/26/2022] Open
Abstract
Background Diet is one important predictor of children’s growth, and often dietary interventions can assist with reversing adverse nutrition outcomes. Traditionally research has focused on individual food items or food classes to generate an understanding of disease risk. Dietary patterns provide a holistic approach to understanding the relationship between exposure and outcome. Method A matched case-control study was conducted. Caregivers of 450 children (225 cases, 225 controls) aged 6–59 months were asked to describe the diet their children had consumed in the previous 7 days using a Food Frequency Questionnaire. Dietary patterns were developed using factor analysis and regression analysis was conducted to assess which dietary pattern was associated with childhood stunting. Results Three dietary patterns were identified: modern (n = 181), low animal-source (n = 158), and traditional (n = 111). Children with the low animal source dietary pattern had increased odds of being stunted (AOR 1.03, p < 0.05). Three demographic factors (Child’s age, father’s age and having a sibling < 24 months apart) were identified as significant predictors of consumption of any of the traditional and low animal source diet (P < 0.001). Conclusion Nutrition intervention such as health education, counselling and supplementary feeding should include a holistic approach to dietary education not only focusing on promoting a balanced diet but improvement strengthening the upgrading of child’s dietary pattern taking into cognisant both quantity, and quality of nutrients provided to the child. Supplementary Information The online version contains supplementary material available at 10.1186/s40795-022-00607-7.
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Affiliation(s)
- Anesu Marume
- College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.,Ministry of Health and Child Care, Harare, Zimbabwe
| | - Moherndran Archary
- College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.,King Edward VIII Hospital, Durban, South Africa
| | - Saajida Mahomed
- College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
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15
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Rosolen V, Giordani E, Mariuz M, Parpinel M, Ronfani L, Vecchi Brumatti L, Bin M, Calamandrei G, Mustieles V, Gilles L, Govarts E, Baken K, Rodriguez Martin L, Schoeters G, Sepai O, Sovcikova E, Fabelova L, Šidlovská M, Kolena B, Kold Jensen T, Frederiksen H, Kolossa-Gehring M, Lange R, Apel P, Castano A, Esteban López M, Jacobs G, Voorspoels S, Jurdáková H, Górová R, Barbone F. Concurrent Assessment of Phthalates/HEXAMOLL ® DINCH Exposure and Wechsler Intelligence Scale for Children Performance in Three European Cohorts of the HBM4EU Aligned Studies. TOXICS 2022; 10:538. [PMID: 36136503 PMCID: PMC9502751 DOI: 10.3390/toxics10090538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 08/31/2022] [Accepted: 09/13/2022] [Indexed: 06/16/2023]
Abstract
Information about the effects of phthalates and non-phthalate substitute cyclohexane-1,2-dicarboxylic acid diisononyl ester (HEXAMOLL® DINCH) on children's neurodevelopment is limited. The aim of the present research is to evaluate the association between phthalate/HEXAMOLL® DINCH exposure and child neurodevelopment in three European cohorts involved in HBM4EU Aligned Studies. Participating subjects were school-aged children belonging to the Northern Adriatic cohort II (NAC-II), Italy, Odense Child Cohort (OCC), Denmark, and PCB cohort, Slovakia. In each cohort, children's neurodevelopment was assessed through the Full-Scale Intelligence Quotient score (FSIQ) of the Wechsler Intelligence Scale of Children test using three different editions. The children's urine samples, collected for one point in time concurrently with the neurodevelopmental evaluation, were analyzed for several phthalates/HEXAMOLL® DINCH biomarkers. The relation between phthalates/HEXAMOLL® DINCH and FSIQ was explored by applying separate multiple linear regressions in each cohort. The means and standard deviations of FSIQ were 109 ± 11 (NAC-II), 98 ± 12 (OCC), and 81 ± 15 (PCB cohort). In NAC-II, direct associations between FSIQ and DEHP's biomarkers were found: 5OH-MEHP+5oxo-MEHP (β = 2.56; 95% CI 0.58-4.55; N = 270), 5OH-MEHP+5cx-MEPP (β = 2.48; 95% CI 0.47-4.49; N = 270) and 5OH-MEHP (β = 2.58; 95% CI 0.65-4.51; N = 270). On the contrary, in the OCC the relation between DEHP's biomarkers and FSIQ tended to be inverse but imprecise (p-value ≥ 0.10). No associations were found in the PCB cohort. FSIQ was not associated with HEXAMOLL® DINCH in any cohort. In conclusion, these results do not provide evidence of an association between concurrent phthalate/DINCHHEXAMOLLR DINCH exposure and IQ in children.
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Affiliation(s)
- Valentina Rosolen
- Institute for Maternal and Child Health, IRCCS “Burlo Garofolo”, Via dell’Istria 65/1, 34137 Trieste, Italy
| | - Elisa Giordani
- Department of Medicine—DAME, University of Udine, Via Colugna 50, 33100 Udine, Italy
| | - Marika Mariuz
- Department of Medicine—DAME, University of Udine, Via Colugna 50, 33100 Udine, Italy
| | - Maria Parpinel
- Department of Medicine—DAME, University of Udine, Via Colugna 50, 33100 Udine, Italy
| | - Luca Ronfani
- Institute for Maternal and Child Health, IRCCS “Burlo Garofolo”, Via dell’Istria 65/1, 34137 Trieste, Italy
| | - Liza Vecchi Brumatti
- Institute for Maternal and Child Health, IRCCS “Burlo Garofolo”, Via dell’Istria 65/1, 34137 Trieste, Italy
| | - Maura Bin
- Institute for Maternal and Child Health, IRCCS “Burlo Garofolo”, Via dell’Istria 65/1, 34137 Trieste, Italy
| | - Gemma Calamandrei
- Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
| | - Vicente Mustieles
- Center for Biomedical Research, University of Granada, 18011 Granada, Spain
- Instituto de Investigación Biosanitaria de Granada, 18012 Granada, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health, 28029 Madrid, Spain
| | - Liese Gilles
- VITO Health, Flemish Institute for Technological Research (VITO), 2400 Mol, Belgium
| | - Eva Govarts
- VITO Health, Flemish Institute for Technological Research (VITO), 2400 Mol, Belgium
| | - Kirsten Baken
- VITO Health, Flemish Institute for Technological Research (VITO), 2400 Mol, Belgium
| | | | - Greet Schoeters
- VITO Health, Flemish Institute for Technological Research (VITO), 2400 Mol, Belgium
| | | | - Eva Sovcikova
- Department of Environmental Medicine, Faculty of Public Health, Slovak Medical University, 83303 Bratislava, Slovakia
| | - Lucia Fabelova
- Department of Environmental Medicine, Faculty of Public Health, Slovak Medical University, 83303 Bratislava, Slovakia
| | - Miroslava Šidlovská
- Department of Zoology and Anthropology, Faculty of Natural Sciences and Informatics, Constantine the Philosopher University in Nitra, Nabrezie mladeze 91, 94974 Nitra, Slovakia
| | - Branislav Kolena
- Department of Zoology and Anthropology, Faculty of Natural Sciences and Informatics, Constantine the Philosopher University in Nitra, Nabrezie mladeze 91, 94974 Nitra, Slovakia
| | - Tina Kold Jensen
- Department of Clinical Pharmacology, Pharmacy and Environmental Medicine, Institute of Public Health, University of Southern Denmark, 5000 Odense, Denmark
| | - Hanne Frederiksen
- Department of Growth and Reproduction, Copenhagen University Hospital-Rigshospitalet, 2100 Copenhagen, Denmark
- International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen University Hospital-Rigshospitalet, 2100 Copenhagen, Denmark
| | | | - Rosa Lange
- German Environment Agency (UBA), Corrensplatz 1, 14195 Berlin, Germany
| | - Petra Apel
- German Environment Agency (UBA), Corrensplatz 1, 14195 Berlin, Germany
| | - Argelia Castano
- National Centre for Environmental Health, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Marta Esteban López
- National Centre for Environmental Health, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Griet Jacobs
- Unit Separation and Conversion Technology, Flemish Institute for Technological Research (VITO), Boeretang 200, 2400 Mol, Belgium
| | - Stefan Voorspoels
- Unit Separation and Conversion Technology, Flemish Institute for Technological Research (VITO), Boeretang 200, 2400 Mol, Belgium
| | - Helena Jurdáková
- Department of Analytical Chemistry, Faculty of Natural Sciences, Comenius University, Ilkovičova 6, Mlynská Dolina, 84215 Bratislava, Slovakia
| | - Renáta Górová
- Department of Analytical Chemistry, Faculty of Natural Sciences, Comenius University, Ilkovičova 6, Mlynská Dolina, 84215 Bratislava, Slovakia
| | - Fabio Barbone
- Department of Medicine—DAME, University of Udine, Via Colugna 50, 33100 Udine, Italy
- Institute of Hygiene and Clinical Epidemiology, Azienda Sanitaria Universitaria Friuli Centrale, Via Colugna 50, 33100 Udine, Italy
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16
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Melhuish E, Lindeback R, Lambert K. Scoping review of the dietary intake of children with chronic kidney disease. Pediatr Nephrol 2022; 37:1995-2012. [PMID: 35277755 DOI: 10.1007/s00467-021-05389-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 11/04/2021] [Accepted: 11/29/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Adequate nutrition is integral to optimal health outcomes for children with chronic kidney disease. However, no studies to date have summarised the existing knowledge base on the dietary intake of this patient group. OBJECTIVE Analyse and summarise evidence regarding the dietary intake of children with chronic kidney disease and identify areas that require further research or clarification. METHODS A scoping review of English language articles using four bibliographic databases and a predefined search term strategy. Weighted mean intake for each nutrient was calculated. RESULTS Eighteen studies were identified (1407 children and 118 healthy controls). Data on socioeconomic status, underreporting of intake and binder use was sparse. Most studies collected dietary information using food records or 24-h recalls. Nutrient data was missing for many subgroups especially transplant and dialysis patients. Protein intake was excessive in all groups where data was reported and varied from 125.7 ± 33% of the recommended dietary allowance in the severe disease group to 391.3 ± 383% in the group with mild kidney disease. Fibre, calcium, iron and vitamin C intake was inadequate for all groups. For children undertaking dialysis, none met the recommended dietary allowance for vitamins C, B1, B2, B3, B5 and B6. Sodium intake was excessive in all groups (> 220% of the recommended dietary allowance). Limited data suggests diet quality is poor, particularly fruit and vegetable intake. CONCLUSIONS This review has identified important subgroups of children with kidney disease where nutrient intake is suboptimal or not well described. Future studies should be conducted to describe intake in these groups. A higher-resolution version of the graphical abstract is available as Supplementary information.
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Affiliation(s)
- Erin Melhuish
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Building 41, Northfields Ave., Wollongong, NSW, 2526, Australia
| | - Rachel Lindeback
- Department of Nutrition and Dietetics, St. George Hospital, Kogarah, NSW, 2217, Australia
| | - Kelly Lambert
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Building 41, Northfields Ave., Wollongong, NSW, 2526, Australia.
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Litterbach EK, Zheng M, Campbell KJ, Laws R, Spence AC. Mealtime TV Use Is Associated with Higher Discretionary Food Intakes in Young Australian Children: A Two-Year Prospective Study. Nutrients 2022; 14:nu14132606. [PMID: 35807787 PMCID: PMC9268203 DOI: 10.3390/nu14132606] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 05/29/2022] [Accepted: 06/17/2022] [Indexed: 02/05/2023] Open
Abstract
Background: Mealtime television use has been cross-sectionally associated with suboptimal diets in children. This study aimed to assess the two-year prospective association between baseline mealtime television use and subsequent diets in young children, and identify socioeconomic differences. Methods: Parents reported their child’s television use at meals, and fruit, vegetable, and discretionary food intakes. Multivariable linear and logistic regression analyses assessed the association between baseline mealtime television use and follow-up diet outcomes. Differences were assessed by socioeconomic position. Results: Participants were 352 Australian parents of children aged six months to six years. Daily mealtime television use (average frequency/day) was associated with higher daily frequency of discretionary food intakes (β 0.2, 95% confidence interval (CI) 0.07–0.67) at the 2-year follow-up. Individually, television use during breakfast and dinner (1–2 days/week compared to never) predicted higher daily intake frequency of discretionary food, β 0.36 (95% CI 0.12–0.60) and β 0.19 (95% CI 0.00–0.39), respectively. Similarly, 3–7 days/week of television use during breakfast and lunch predicted higher frequency of discretionary food intake, β 0.18 (95% CI 0.02–0.37) and β 0.31 (95% CI 0.07–0.55), respectively. Associations were not socioeconomically patterned. Conclusions: Investigating mealtime television use motivators across the socioeconomic spectrum could inform interventions targeting the high consumption of discretionary foods in children.
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Parental Education Moderates the Relation between Physical Activity, Dietary Patterns and Atopic Diseases in Adolescents. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9050686. [PMID: 35626863 PMCID: PMC9139783 DOI: 10.3390/children9050686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 05/01/2022] [Accepted: 05/06/2022] [Indexed: 11/17/2022]
Abstract
Background: Atopic diseases, particularly asthma, eczema, and rhinitis, are among the most common chronic diseases in childhood, with several factors implicated in their pathogenesis. Our study examined the role of parental education in the association between diet, physical activity, and atopy in adolescents. Methods: 1934 adolescents (47.5% boys) aged 13−14 years old reported information about their diet and physical activity and their parents reported their highest educational level. The moderating role of parental education level (primary/secondary vs. tertiary) in the relation between lifestyle patterns and atopic diseases was examined with logistic regression analyses. Results: High consumption of dairy products was inversely associated to adolescents’ asthma and rhinitis symptoms overall, but this relation was almost 50% stronger for the adolescents with high parental education level background. The same pattern of reduction of the odds was noticed also regarding the association among the high intake of fruits, vegetables, pulses, with all three atopic diseases and the adherence to a physically active lifestyle only with current asthma and eczema (all p < 0.05). Conclusion: Adolescents who are physically active and consume a higher intake of fruits, vegetables, and pulses and a lower intake of fast-food and sweets, and their parents/guardians having higher education, are less likely to have any current symptoms of asthma, eczema, and rhinitis than the ones who have low educated parents.
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Mayne SL, Hannan C, DiFiore G, Virudachalam S, Glanz K, Fiks AG. Associations of Neighborhood Safety and Collective Efficacy with Dietary Intake among Preschool-Aged Children and Mothers. Child Obes 2022; 18:120-131. [PMID: 34613834 DOI: 10.1089/chi.2021.0144] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background: Positive neighborhood environments may promote healthier behaviors, yet few studies have examined associations between neighborhood social environment and diet. We examined associations of neighborhood perceived safety, collective efficacy, and violent crime with dietary intake among preschool-aged children and their mothers. Methods: We administered a cross-sectional survey to 300 mothers/female caregivers of Medicaid-enrolled 2- to 4-year-old children in Philadelphia. Mothers reported their own and their child's dietary intake using the validated Dietary Screener Questionnaire. Mixed-effects linear regression models assessed associations of perceived neighborhood safety, collective efficacy, and census tract-level violent crime with parent and child dietary intake, adjusted for individual, family, and neighborhood covariates. Results: Among mothers, higher perceived neighborhood safety and collective efficacy were associated with higher daily intake of fruits/vegetables (β = 0.35 cups, 95% CI: 0.12-0.58 and β = 0.30 cups, 95% CI: 0.08-0.52, comparing the highest with lowest tertile). Higher neighborhood-perceived safety was also associated with higher whole-grain intake among mothers (β = 0.14 ounces, 95% CI: 0.02-0.27) and children (β = 0.07 ounces, 95% CI: 0.01-0.13, comparing the highest with lowest tertile). Neighborhood social exposures were not associated with intake of added sugars or sugar-sweetened beverages for mothers or children, nor were lower levels of violent crime associated with any outcome. Conclusions: More favorable perceptions of neighborhood safety and collective efficacy were associated with a slightly higher consumption of some healthy foods among mothers and their young children. Future prospective research is needed to confirm these findings, explore potential mechanisms, and determine whether intervening on the social environment improves diet.
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Affiliation(s)
- Stephanie L Mayne
- Center for Pediatric Clinical Effectiveness, Possibilities Project and PolicyLab, Children's Hospital of Philadelphia, Roberts Center for Pediatric Research, Philadelphia, PA, USA.,Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Leonard Davis Institute for Health Economics, University of Pennsylvania, Colonial Penn Center, Philadelphia, PA, USA
| | - Chloe Hannan
- Center for Pediatric Clinical Effectiveness, Possibilities Project and PolicyLab, Children's Hospital of Philadelphia, Roberts Center for Pediatric Research, Philadelphia, PA, USA
| | - Gabrielle DiFiore
- Center for Pediatric Clinical Effectiveness, Possibilities Project and PolicyLab, Children's Hospital of Philadelphia, Roberts Center for Pediatric Research, Philadelphia, PA, USA
| | - Senbagam Virudachalam
- Center for Pediatric Clinical Effectiveness, Possibilities Project and PolicyLab, Children's Hospital of Philadelphia, Roberts Center for Pediatric Research, Philadelphia, PA, USA.,Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Leonard Davis Institute for Health Economics, University of Pennsylvania, Colonial Penn Center, Philadelphia, PA, USA
| | - Karen Glanz
- Leonard Davis Institute for Health Economics, University of Pennsylvania, Colonial Penn Center, Philadelphia, PA, USA.,Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Department of Biobehavioral Health Sciences, School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | - Alexander G Fiks
- Center for Pediatric Clinical Effectiveness, Possibilities Project and PolicyLab, Children's Hospital of Philadelphia, Roberts Center for Pediatric Research, Philadelphia, PA, USA.,Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Leonard Davis Institute for Health Economics, University of Pennsylvania, Colonial Penn Center, Philadelphia, PA, USA
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20
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Iv N, Herbein M, Heude B, van der Waerden J, Melchior M, Feart C, Delcourt C, Côté S, De Lauzon-Guillain B, Lioret S, Galera C. Children's Diet at 2 Years and Trajectories of Hyperactivity-Inattention Symptoms and Conduct Problems Between 3 and 8 Years: The EDEN Cohort. J Nutr 2022; 152:484-491. [PMID: 35051294 DOI: 10.1093/jn/nxab398] [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: 10/06/2021] [Revised: 11/16/2021] [Accepted: 11/17/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Although the role of diet is increasingly acknowledged in psychiatry, data are still scarce regarding its early impact on the most significant behavioral disorders of childhood (i.e., hyperactivity-inattention and conduct problems). OBJECTIVES The objective of this study was to explore the relation between children's dietary patterns at 2 years and developmental trajectories of hyperactivity-inattention and conduct problems between 3 and 8 years. METHODS We recruited 1432 mother-child dyads from the French EDEN (etude sur les déterminants pré- et postnatals du développement et de la santé de l'enfant) mother-child cohort to conduct the analyses. Three dietary patterns, labeled guidelines, processed and fast foods, and baby foods, were identified using an FFQ in children aged 2 years in a previous study. The Strengths and Difficulties Questionnaire was used to assess hyperactivity-inattention and conduct problems at 3, 5, and 8 years of age and build related trajectories from 3 to 8 years. The relation between children's dietary patterns at 2 years and the worst developmental trajectories of hyperactivity-inattention and conduct problems were determined with multivariable logistic regressions adjusted for potential socioeconomic, maternal, and child confounders. RESULTS The score on the guidelines dietary pattern was negatively associated with the risk of hyperactivity-inattention problems (OR: 0.75; 95% CI: 0.60-0.94), contrary to adherence to the baby foods dietary pattern (OR: 1.41; 95% CI: 1.16-1.71). CONCLUSIONS Distinct patterns of children's diet at 2 years were predictive of developmental trajectories of hyperactivity-inattention problems between 3 and 8 years. These results highlight the relevance of conducting further studies to clarify the mechanisms involved.
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Affiliation(s)
- Nicolas Iv
- Institut national de la santé et de la recherche médicale (INSERM) unité mixte de recherche 1219 (UMR1219), Bordeaux, France.,University of Bordeaux, Bordeaux, France
| | - Marie Herbein
- Institut national de la santé et de la recherche médicale (INSERM) unité mixte de recherche 1219 (UMR1219), Bordeaux, France.,University of Bordeaux, Bordeaux, France.,Centre Hospitalier Perrens, Bordeaux, France
| | - Barbara Heude
- Université de Paris, Centre for Research in Epidemiology and Statistics (CRESS), Institut national de la santé et de la recherche médicale (INSERM), Institut national de recherche pour l'agriculture, l'alimentation et l'environnement (INRAE), Paris, France
| | - Judith van der Waerden
- Social Epidemiology Research Group, Institut Pierre Louis d'Epidémiologie et de Santée Publique (IPLESP), Institut national de la santé et de la recherche médicale (INSERM), unité mixte de recherche scientifique (UMR-S) 1136, Paris, France.,Sorbonne Universitées, Université Pierre-et-Marie-Curie (UPMC) Univ Paris 06, Paris, France
| | - Maria Melchior
- Social Epidemiology Research Group, Institut Pierre Louis d'Epidémiologie et de Santée Publique (IPLESP), Institut national de la santé et de la recherche médicale (INSERM), unité mixte de recherche scientifique (UMR-S) 1136, Paris, France.,Sorbonne Universitées, Université Pierre-et-Marie-Curie (UPMC) Univ Paris 06, Paris, France
| | - Catherine Feart
- Institut national de la santé et de la recherche médicale (INSERM) unité mixte de recherche 1219 (UMR1219), Bordeaux, France
| | - Cécile Delcourt
- Institut national de la santé et de la recherche médicale (INSERM) unité mixte de recherche 1219 (UMR1219), Bordeaux, France
| | - Sylvana Côté
- Institut national de la santé et de la recherche médicale (INSERM) unité mixte de recherche 1219 (UMR1219), Bordeaux, France.,Centre Hospitalier Perrens, Bordeaux, France.,Research Unit on Children's Psychosocial Maladjustment, Montreal, Quebec, Canada.,Department of Social and Preventive Medicine, University of Montreal, Montreal, Quebec, Canada
| | - Blandine De Lauzon-Guillain
- Université de Paris, Centre for Research in Epidemiology and Statistics (CRESS), Institut national de la santé et de la recherche médicale (INSERM), Institut national de recherche pour l'agriculture, l'alimentation et l'environnement (INRAE), Paris, France
| | - Sandrine Lioret
- Université de Paris, Centre for Research in Epidemiology and Statistics (CRESS), Institut national de la santé et de la recherche médicale (INSERM), Institut national de recherche pour l'agriculture, l'alimentation et l'environnement (INRAE), Paris, France
| | - Cédric Galera
- Institut national de la santé et de la recherche médicale (INSERM) unité mixte de recherche 1219 (UMR1219), Bordeaux, France.,University of Bordeaux, Bordeaux, France.,Centre Hospitalier Perrens, Bordeaux, France.,Research Unit on Children's Psychosocial Maladjustment, Montreal, Quebec, Canada
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21
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Olstad DL, Nejatinamini S, Victorino C, Kirkpatrick SI, Minaker LM, McLaren L. Trends in Socioeconomic Inequities in Diet Quality between 2004 and 2015 among a Nationally Representative Sample of Children in Canada. J Nutr 2021; 151:3781-3794. [PMID: 34515311 PMCID: PMC8643615 DOI: 10.1093/jn/nxab297] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 07/23/2021] [Accepted: 08/12/2021] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Dietary inequities in childhood may shape dietary and health inequities across the life course. Quantifying the magnitude and direction of trends in absolute and relative gaps and gradients in diet quality according to multiple indicators of socioeconomic position (SEP) can inform strategies to narrow these inequities. OBJECTIVES We examined trends in absolute and relative gaps and gradients in diet quality between 2004 and 2015 according to 3 indicators of SEP among a nationally representative sample of children in Canada. METHODS Data from children (aged 2-17 y; n = 18,670) who participated in the cross-sectional Canadian Community Health Survey-Nutrition in 2004 or 2015 were analyzed. SEP was based on total household income, household educational attainment, and neighborhood deprivation. Dietary intake data from 1 interviewer-administered 24-h dietary recall were used to derive a Healthy Eating Index-2015 (HEI-2015) score for each participant as a measure of diet quality. Inequities in diet quality were quantified using 4 indices: absolute and relative gaps (between highest and lowest SEP) and absolute (Slope Index of Inequality) and relative gradients (Relative Index of Inequality). Overall and age-stratified multivariable linear regression and generalized linear models examined trends in HEI-2015 scores between 2004 and 2015. RESULTS Although mean HEI-2015 total scores improved from 52.3 to 57.3 (maximum 100 points; P < 0.001), absolute and relative gaps and gradients in diet quality remained mostly stable for all 3 SEP indicators. However, among children aged 6-11 y, absolute and relative gradients in diet quality according to household educational attainment and neighborhood deprivation widened. CONCLUSIONS The diet quality of children in Canada was poor and inequitably patterned in 2004 and 2015. Although mean diet quality improved between 2004 and 2015, absolute and relative gaps and gradients in diet quality persisted, with some evidence of widening absolute and relative gradients among 6- to 11-y-olds.
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Affiliation(s)
- Dana Lee Olstad
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Sara Nejatinamini
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Charlie Victorino
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Sharon I Kirkpatrick
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Leia M Minaker
- School of Planning, University of Waterloo, Waterloo, Ontario, Canada
| | - Lindsay McLaren
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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22
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Jacobs J, Strugnell C, Allender S, Orellana L, Backholer K, Bolton KA, Fraser P, Le H, Brown AD, Nichols M. The impact of a community-based intervention on weight, weight-related behaviours and health-related quality of life in primary school children in Victoria, Australia, according to socio-economic position. BMC Public Health 2021; 21:2179. [PMID: 34837974 PMCID: PMC8627608 DOI: 10.1186/s12889-021-12150-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 10/19/2021] [Indexed: 01/22/2023] Open
Abstract
Background Approximately a quarter of Australian children are classified as overweight or obese. In high-income countries, childhood obesity follows a socio-economic gradient, with greater prevalence amongst the most socio-economically disadvantaged children. Community-based interventions (CBI), particularly those using a systems approach, have been shown to be effective on weight and weight-related behaviours. They are also thought to have an equitable impacts, however there is limited evidence of their effectiveness in achieving this goal. Methods Secondary analysis was conducted on data collected from primary school children (aged 6–13 years) residing in ten communities (five intervention, five control) involved in the Whole of Systems Trial of Prevention Strategies for Childhood Obesity (WHO STOPS) cluster randomised trial in Victoria, Australia. Outcomes included Body Mass Index z-score (BMI-z) derived from measured height and weight, self-reported physical activity and dietary behaviours and health related quality of life (HRQoL). Repeat cross-sectional data from 2015 (n = 1790) and 2019 (n = 2137) were analysed, stratified by high or low socio-economic position (SEP). Multilevel linear models and generalised estimating equations were fitted to assess whether SEP modified the intervention effect on the outcomes. Results There were no overall changes in BMI-z for either SEP strata. For behavioural outcomes, the intervention resulted in a 22.5% (95% CI 5.1, 39.9) point greater improvement in high-SEP compared to low-SEP intervention schools for meeting physical activity guidelines. There were also positive dietary intervention effects for high SEP students, reducing takeaway and packaged snack consumption, although there was no significant difference in effect between high and low SEP students. There were positive intervention effects for HRQoL, whereby scores declined in control communities with no change in intervention communities, and this did not differ by SEP. Conclusion The WHO STOPS intervention had differential effects on several weight-related behaviours according to SEP, including physical activity. Similar impacts on HRQoL outcomes were found between high and low SEP groups. Importantly, the trial evaluation was not powered to detect subgroup differences. Future evaluations of CBIs should be designed with an equity lens, to understand if and how these types of interventions can benefit all community members, regardless of their social and economic resources. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-12150-4.
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Affiliation(s)
- Jane Jacobs
- Global Obesity Centre (GLOBE)Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Australia
| | - Claudia Strugnell
- Global Obesity Centre (GLOBE)Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Australia
| | - Steven Allender
- Global Obesity Centre (GLOBE)Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Australia
| | - Liliana Orellana
- Biostatistics Unit, Faculty of Health, Deakin University, Geelong, Australia
| | - Kathryn Backholer
- Global Obesity Centre (GLOBE)Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Australia
| | - Kristy A Bolton
- Global Obesity Centre (GLOBE)Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Australia
| | - Penny Fraser
- Global Obesity Centre (GLOBE)Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Australia
| | - Ha Le
- Global Obesity Centre (GLOBE)Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Australia.,Deakin Health Economics, Institute for Health Transformation, Faculty of Health, Deakin University, Burwood, Australia
| | - Andrew Dwight Brown
- Global Obesity Centre (GLOBE)Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Australia
| | - Melanie Nichols
- Global Obesity Centre (GLOBE)Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Australia
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23
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Abidi SHR, Almas A, Ghani A, Sabir S, Iqbal R. Assessment of macronutrients consumption in the diet of adolescent school children in four seasons: a longitudinal study from an urban city in Pakistan. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2021; 40:43. [PMID: 34656183 PMCID: PMC8520200 DOI: 10.1186/s41043-021-00268-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 10/01/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND A healthy diet in the adolescence period is essential for physical, mental, and immunological development. We aimed to assess macronutrient consumption in the diet of adolescent school children using 24 h recalls in four seasons of the year. METHOD This was a longitudinal study conducted from February 2014 to June 2015. The study population included 155 school children aged 7-14 years from an urban school in Karachi. 24HR recall was conducted on 4 random days of the 4 main seasons. A food composition table was developed where the weight, calories, carbohydrate, fat, and protein content of the food items were listed. Macronutrients quantification was calculated by using proportional weight from the food composition table. Food groups were also assigned to each food item including vegetables, fruits, grains, protein foods, dairy products, and oils. RESULTS A total of 155 adolescent children aged between 7 and 14 years were approached. Out of the 155 preadolescents and adolescents, 150 (96.7%) agreed to participate. The mean (SD) age of the children was 11.31 (1.6) years, and 59% of all the children were males. Overall mean (SD) daily intake for all seasons was 195.31 (86.87) grams of carbohydrates, 94.77 (71.87) grams of proteins, and 55.87 (30.79) grams of fats. Carbohydrates formed 48.16%, protein 21.92%, and fat 29.93% of the total caloric intake. The mean (SD) daily caloric intake was 1517 (644) grams. Overall, the highest source of calories was from carbohydrate 781 (347) Kilocalories (Kcal), followed by fat 502 (277) Kcal and protein 379 (287). The Carbohydrate intake in 24 h was highest in the autumn; 212.81 (85.37), and there was a significant difference in carbohydrate intake in all seasons (p value 0.003). Consumption of discretionary food group was high (31.3%), and consumption of fruits and vegetables was low (29%). CONCLUSION The study reports a suboptimal caloric intake of fewer than 2000 cal/day among the adolescents from school. The highest source of calories was from carbohydrates.The highest consumption of food was in autumn and the least in summer. Fruits and vegetable intake was low, and discretionary food intake was high.
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Affiliation(s)
| | - Aysha Almas
- Department of Medicine, Aga Khan University, Stadium Road, Karachi, Pakistan.
| | - Abdul Ghani
- Health Department, Government of Baluchistan, Chaghi, Pakistan
| | - Sania Sabir
- Department of Medicine, Aga Khan University, Stadium Road, Karachi, Pakistan
| | - Romania Iqbal
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
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24
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Chatelan A, Rouche M, Dzielska A, Lebacq T, Fismen AS, Kelly C, Zaborskis A, Kopcakova J, Tsareva A, Kalman M, Castetbon K. Time trends in consumption of sugar-sweetened beverages and related socioeconomic differences among adolescents in Eastern Europe: signs of a nutrition transition? Am J Clin Nutr 2021; 114:1476-1485. [PMID: 34086855 DOI: 10.1093/ajcn/nqab175] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 05/04/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND High intake of sugar-sweetened beverages (SSBs) contributes to detrimental cardio-metabolic indicators in youth. Monitoring of SSB consumption is lacking in Eastern Europe. OBJECTIVES We assessed trends in the prevalence of adolescent daily consumption of SSBs in 14 Eastern European countries between 2002 and 2018, both overall and according to family material affluence. METHODS We used 2002, 2006, 2010, 2014, and 2018 data of the Health Behaviour in School-Aged Children school-based study (repeated cross-sectional). Nationally representative samples of adolescents aged 11, 13, and 15 years were included (n = 325,184; 51.2% girls). Adolescents completed a standardized questionnaire, including a question on SSB consumption frequency. We categorized adolescents into 3 socioeconomic groups based on the relative Family Affluence Scale (FAS). Adjusted prevalences of daily SSB consumption by survey year, as well as country-level time trends between 2002 and 2018, were computed using multilevel logistic models (overall and by FAS groups). RESULTS In 2018, the prevalence of adolescents consuming SSBs every day varied considerably between countries (range, 5.1%-28.1%). Between 2002 and 2018, the prevalence of daily SSB consumption declined in 10/14 countries (P for linear trends ≤ 0.004). The largest reductions were observed in Slovenia (OR, 0.48; 95% CI: 0.45-0.50) and the Russian Federation (OR, 0.67; 95% CI: 0.64-0.70). Daily SSB consumption was reduced at faster rates among the most affluent adolescents (who were larger consumers in 2002) than in the least affluent adolescents in 11/14 countries (P for linear trends ≤ 0.004). Thus, differences between FAS groups narrowed over time or even reversed, leading to larger proportions of daily consumers in the least affluent adolescents in 2018 in 5/14 countries (P ≤ 0.05). CONCLUSIONS Adolescent daily consumption of SSBs decreased between 2002 and 2018 in most Eastern European countries. Declines were larger among higher-affluence adolescents. These results are useful to evaluate and plan interventions promoting healthy childhood diets.
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Affiliation(s)
- Angeline Chatelan
- School of Public Health, Université Libre de Bruxelles, Brussels, Belgium
| | - Manon Rouche
- School of Public Health, Université Libre de Bruxelles, Brussels, Belgium
| | - Anna Dzielska
- Department of Child and Adolescent Health, Institute of Mother and Child, Warsaw, Poland
| | - Thérésa Lebacq
- School of Public Health, Université Libre de Bruxelles, Brussels, Belgium
| | - Anne-Siri Fismen
- Department of Health Promotion, and Centre for Evaluation of Public Health Measures, Norwegian Institute of Public Health, Bergen, Norway
| | - Colette Kelly
- School of Health Sciences, Health Promotion Research Centre, National University of Ireland Galway, Galway, Ireland
| | - Apolinaras Zaborskis
- Department of Preventive Medicine, Faculty of Public Health, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Jaroslava Kopcakova
- Department of Health Psychology and Research Methodology, Faculty of Medicine, P.J. Safarik University, Košice, Slovakia
| | - Anna Tsareva
- Division of Physical Rehabilitation and Health-Improving Technologies, Saint-Petersburg Scientific-Research Institute for Physical Culture, Saint-Petersburg, Russia
| | - Michal Kalman
- Department of Recreation and Leisure Studies, Faculty of Physical Culture, Palacky University Olomouc, Olomouc, Czechia
| | - Katia Castetbon
- School of Public Health, Université Libre de Bruxelles, Brussels, Belgium
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25
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Yeung SSY, Chan R, Li L, Chan D, Leung J, Leung TF. Eating Behaviors and Diet Quality in Chinese Preschoolers with and without Autism Spectrum Disorder: A Case-Control Study. J Pediatr 2021; 237:258-266.e5. [PMID: 34144030 DOI: 10.1016/j.jpeds.2021.06.017] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 05/28/2021] [Accepted: 06/10/2021] [Indexed: 12/30/2022]
Abstract
OBJECTIVES To compare mealtime behaviors and diet quality in Chinese preschoolers with autism spectrum disorder (ASD) and typically developing preschoolers in Hong Kong. STUDY DESIGN This case-control study included a community sample of 65 families with preschoolers with ASD aged 3-6 years and 65 families with typically developing preschoolers matched for age and sex. Preschoolers' eating behaviors were assessed using the Brief Autism Mealtime Behaviour Inventory and the Preschoolers' Eating Behaviour Questionnaire (CPEBQ). Preschoolers' usual diet and nutrient intake were assessed using a validated food frequency questionnaire. Diet quality and diversity were generated using the Chinese Children Dietary Index total score and diet variety score. Between-group differences in various scales and dietary variables were examined using multivariate linear or logistics regression models adjusting for baseline demographic differences. RESULTS Compared with the typically developing group, the ASD group had greater scores in the Brief Autism Mealtime Behaviour Inventory food refusal domain (P < .001), the CPEBQ food fussiness (P = .001) and eating habit (P = .001) domains, and lower CPEBQ exogenous eating score (P = .003) and initiative eating score (P < .001). The Chinese Children Dietary Index total score (P = .001) and diet variety score (P = .005) and intake of soy and soy products (P = .001) were lower in the ASD group compared with the typically developing group. CONCLUSIONS Preschoolers with ASD showed more eating and mealtime problems, and lower diet quality and diversity than their typically developing counterparts. Our findings highlight the need for regular monitor and early identification of mealtime behavioral and nutrition problems among preschoolers with ASD.
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Affiliation(s)
- Suey S Y Yeung
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Ruth Chan
- Department of Applied Biology and Chemical Technology, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
| | - Liz Li
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Dorothy Chan
- Department of Paediatrics, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Jason Leung
- Jockey Club Centre for Osteoporosis Care and Control, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Ting-Fan Leung
- Department of Paediatrics, The Chinese University of Hong Kong, Shatin, Hong Kong
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26
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Development of a stand-alone index for the assessment of diet quality in elementary school-aged children. Public Health Nutr 2021; 24:5629-5640. [PMID: 34420540 DOI: 10.1017/s1368980021003657] [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: 11/06/2022]
Abstract
OBJECTIVE To develop and evaluate a stand-alone Elementary School-aged Children's Index of Diet Quality (ES-CIDQ). DESIGN In this cross-sectional study, children filled in a food frequency questionnaire (FFQ) with twenty-nine multiple-item questions on the consumption of foods, portion sizes and eating frequency and a 5-d food diary. Nutrient intakes were calculated with nutrient analysis software. FFQ questions best reflecting a health-promoting diet with reference to dietary recommendations were identified by correlations, logistic regression modelling and receiver-operating characteristics curve analysis. SETTING Southwest and Eastern Finland. PARTICIPANTS Healthy elementary school-aged volunteers [n 266, mean (sd) age 9·7 (1·7) years] were recruited between March 2017 and February 2018. RESULTS A set of questions was identified from the FFQ that best depicted the children's diet quality as defined in the dietary recommendations. These fifteen questions were scored and formulated into a stand-alone index as a continuous index score (range 0-16·5 points) and a two-category score: good and poor diet quality. The cut-off score of six points for a good diet quality had a sensitivity of 0·60 and a specificity of 0·78. Children with a good diet quality (49·8 % of the children) had higher intakes of protein, dietary fibre, and several vitamins and minerals, and lower intakes of sucrose, total fat, SFA and cholesterol compared to children with a poor diet quality. CONCLUSIONS The developed short stand-alone index depicted diet quality as defined in the dietary recommendations. Thus, ES-CIDQ may be used for assessing diet quality in Finnish elementary school-aged children in school health care and nutrition research.
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27
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Kang M, Kang E, Ryu H, Hong Y, Han SS, Park SK, Hyun YY, Sung SA, Kim SW, Yoo TH, Kim J, Ahn C, Oh KH. Measured sodium excretion is associated with CKD progression: results from the KNOW-CKD study. Nephrol Dial Transplant 2021; 36:512-519. [PMID: 32582942 DOI: 10.1093/ndt/gfaa107] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 04/07/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Diet is a modifiable factor of chronic kidney disease (CKD) progression. However, the effect of dietary salt intake on CKD progression remains unclear. Therefore, we analyzed the effect of dietary salt intake on renal outcome in Korean patients with CKD. METHODS We measured 24-h urinary sodium (Na) excretion as a marker of dietary salt intake in the prospective, multi-center, longitudinal KoreaN cohort study for Outcome in patients With CKD (KNOW-CKD). Data were analyzed from CKD patients at Stages G3a to G5 (n = 1254). We investigated the association between dietary salt intake and CKD progression. Patients were divided into four quartiles of dietary salt intake, which was assessed using measured 24-h urinary Na excretion. The study endpoint was composite renal outcome, which was defined as either halving the estimated glomerular filtration rate or developing end-stage renal disease. RESULTS During a median (interquartile range) follow-up of 4.3 (2.8-5.8) years, 480 (38.7%) patients developed the composite renal event. Compared with the reference group (Q2, urinary Na excretion: 104.2 ≤ Na excretion < 145.1 mEq/day), the highest quartile of measured 24-h urinary Na excretion was associated with risk of composite renal outcome [Q4, urinary Na excretion ≥192.9 mEq/day, hazard ratio 1.8 (95% confidence interval 1.12-2.88); P = 0.015] in a multivariable hazards model. Subgroup analyses showed that high-salt intake was particularly associated with a higher risk of composite renal outcome in women, in patients <60 years of age, in those with uncontrolled hypertension and in those with obesity. CONCLUSIONS High salt intake was associated with increased risk of progression in CKD.
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Affiliation(s)
- Minjung Kang
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Eunjeong Kang
- Department of Internal Medicine, Ewha Womans University College of Medicine, Ewha Womans University Seoul Hospital, Seoul, Republic of Korea
| | - Hyunjin Ryu
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Yeji Hong
- Rehabilitation Medical Research Center, Korea workers' Compensation and Welfare Service Incheon Hospital, Republic of Korea
| | - Seung Seok Han
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Sue K Park
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Young Youl Hyun
- Department of Internal Medicine, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Seoul, Republic of Korea
| | - Su Ah Sung
- Department of Internal Medicine, Nowon Eulji Medical Center, Eulji University, Seoul, Republic of Korea
| | - Soo Wan Kim
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Tae-Hyun Yoo
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Republic of Korea
| | - Jayoun Kim
- Medical Research Collaborating Center, Seoul National University Hospital and Seoul National University College of Medicine, Seoul, Korea
| | - Curie Ahn
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Kook-Hwan Oh
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
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Osei-Kwasi HA, Laar A, Zotor F, Pradeilles R, Aryeetey R, Green M, Griffiths P, Akparibo R, Wanjohi MN, Rousham E, Barnes A, Booth A, Mensah K, Asiki G, Kimani-Murage E, Bricas N, Holdsworth M. The African urban food environment framework for creating healthy nutrition policy and interventions in urban Africa. PLoS One 2021; 16:e0249621. [PMID: 33886599 PMCID: PMC8061920 DOI: 10.1371/journal.pone.0249621] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 03/22/2021] [Indexed: 01/28/2023] Open
Abstract
This study developed, validated, and evaluated a framework of factors influencing dietary behaviours in urban African food environments, to inform research prioritisation and intervention development in Africa. A multi-component methodology, drawing on concept mapping, was employed to construct a framework of factors influencing dietary behaviours in urban Africa. The framework adapted a widely used socio-ecological model (developed in a high-income country context) and was developed using a mixed-methods research approach that comprised: i. Evidence synthesis consisting of a systematic review of 39 papers covering 14 African countries; ii. Qualitative interview data collected for adolescents and adults (n = 144) using photovoice in urban Ghana and Kenya; and iii. Consultation with interdisciplinary African experts (n = 71) from 27 countries, who contributed to at least one step of the framework (creation, validation/evaluation, finalisation). The final framework included 103 factors influencing dietary behaviours. Experts identified the factors influencing dietary behaviours across all the four levels of the food environment i.e. the individual, social, physical and macro levels. Nearly half (n = 48) were individual-level factors and just under a quarter (n = 26) were at the macro environmental level. Fewer factors associated with social (n = 15) and physical (14) environments were identified. At the macro level, the factors ranked as most important were food prices, cultural beliefs and seasonality. Factors ranked as important at the social level were household composition, family food habits and dietary practices. The type of food available in the neighbourhood and convenience were seen as important at the physical level, while individual food habits, food preferences and socioeconomic status were ranked highly at the individual level. About half of the factors (n = 54) overlap with those reported in an existing socio-ecological food environment framework developed in a high-income country context. A further 49 factors were identified that were not reported in the selected high-income country framework, underlining the importance of contextualisation. Our conceptual framework offers a useful tool for research to understand dietary transitions in urban African adolescents and adults, as well as identification of factors to intervene when promoting healthy nutritious diets to prevent multiple forms of malnutrition.
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Affiliation(s)
| | - Amos Laar
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Accra, Ghana
| | - Francis Zotor
- Department of Family and Community Health, School of Public Health, University of Health and Allied Sciences, Ho, Ghana
| | - Rebecca Pradeilles
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - Richmond Aryeetey
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Accra, Ghana
| | - Mark Green
- Department of Geography & Planning, University of Liverpool, Liverpool, United Kingdom
| | - Paula Griffiths
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - Robert Akparibo
- School of Health and Related Research-ScHARR, University of Sheffield, Sheffield, United Kingdom
| | | | - Emily Rousham
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - Amy Barnes
- School of Health and Related Research-ScHARR, University of Sheffield, Sheffield, United Kingdom
| | - Andrew Booth
- School of Health and Related Research-ScHARR, University of Sheffield, Sheffield, United Kingdom
| | - Kobby Mensah
- University of Ghana Business school, Accra, Ghana
| | - Gershim Asiki
- African Population and Health Research Center, Nairobi, Kenya
| | | | - Nicolas Bricas
- UMR MoISA (Montpellier Interdisciplinary centre on Sustainable Agri-food systems), (Univ Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institut Agro, IRD), Montpellier, France
| | - Michelle Holdsworth
- UMR MoISA (Montpellier Interdisciplinary centre on Sustainable Agri-food systems), (Univ Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institut Agro, IRD), Montpellier, France
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Beck H, Tesler R, Barak S, Moran DS, Marques A, Harel Fisch Y. Can Health-Promoting Schools Contribute to Better Health Behaviors? Physical Activity, Sedentary Behavior, and Dietary Habits among Israeli Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:1183. [PMID: 33572707 PMCID: PMC7908076 DOI: 10.3390/ijerph18031183] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 01/25/2021] [Accepted: 01/25/2021] [Indexed: 11/17/2022]
Abstract
Schools with health-promoting school (HPS) frameworks are actively committed to enhancing healthy lifestyles. This study explored the contribution of school participation in HPS on students' health behaviors, namely, physical activity (PA), sedentary behavior, and dieting. Data from the 2018/2019 Health Behavior in School-aged Children study on Israeli adolescents aged 11-17 years were used. Schools were selected from a sample of HPSs and non-HPSs. Between-group differences and predictions of health behavior were analyzed. No between-group differences were observed in mean number of days/week with at least 60 min of PA (HPS: 3.84 ± 2.19 days/week, 95% confidence interval of the mean = 3.02-3.34; non-HPS: 3.93 ± 2.17 days/week, 95% confidence interval of the mean = 3.13-3.38). Most children engaged in screen time behavior for >2 h/day (HPS: 60.83%; non-HPS: 63.91%). The odds of being on a diet were higher among more active children (odds ratio [OR] = 1.20), higher socio-economic status (OR = 1.23), and female (OR = 2.29). HPS did not predict any health behavior. These findings suggest that HPSs did not contribute to health behaviors more than non-HPSs. Therefore, health-promoting activities in HPSs need to be improved in order to justify their recognition as members of the HPS network and to fulfill their mission.
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Affiliation(s)
- Hila Beck
- Department of Health System Management, Faculty of Health Science, Ariel University, Ariel 407000, Israel;
| | - Riki Tesler
- Department of Health System Management, Faculty of Health Science, Ariel University, Ariel 407000, Israel;
| | - Sharon Barak
- Program in Gerontology, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheeva 8499000, Israel;
- Department of Pediatric Rehabilitation, The Edmond and Lily Safra Children’s Hospital, The Chaim Sheba Medical Center, Tel Hashomer 5265601, Israel
- Physical Education Department, Kaye Academic College of Education, Beer Sheeva 8414201, Israel
| | - Daniel Sender Moran
- Department of Health System Management, Faculty of Health Science, Ariel University, Ariel 407000, Israel;
| | - Adilson Marques
- Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, 1499-002 Cruz Quebrada-Dafundo, Portugal;
| | - Yossi Harel Fisch
- School of Education, Bar Ilan University, Ramat Gan 5290002, Israel;
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Prospective association between dietary patterns and BMI Z-score in Brazilian adolescents. Public Health Nutr 2021; 24:4230-4237. [PMID: 33472719 DOI: 10.1017/s1368980021000252] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To identify dietary patterns and prospectively evaluate their influence on the BMI Z-score of adolescents. DESIGN A longitudinal study, using data from the Longitudinal Study on Sedentary Behavior, Physical Activity, Eating Habits and Adolescent Health - LONCAAFS. SETTING To obtain data on food consumption, a 24-h recall survey was conducted; a second 24-h recall was applied to 30 % of the sample in all waves. Dietary patterns were identified by exploratory factor analysis using principal components. BMI Z-score was determined according to the recommendation of the WHO, based on the BMI for age and sex. Socio-economic data, sedentary behaviour and physical activity level were obtained. Associations between BMI Z-score and dietary patterns and between BMI Z-score and variables of interest were determined using generalised estimating equations. PARTICIPANTS Totally, 1431 adolescents were assessed in 2014, 1178 in 2015, 959 in 2016 and 773 in 2017, belonging to the public schools of João Pessoa, Northeast Brazil. RESULTS Three dietary patterns were identified throughout the study: 'traditional', 'snacks' and 'Western'. The 'Western' dietary pattern was positively associated with BMI Z-score (β = 0·025; 95 % CI 0·002, 0·048), regardless of sex and physical activity level, prospectively. CONCLUSION A dietary pattern composed of foods with high energy density, high fat and sugars, and low fibre influences the BMI Z-score of adolescents over time.
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Vilar-Compte M, Burrola-Méndez S, Lozano-Marrufo A, Ferré-Eguiluz I, Flores D, Gaitán-Rossi P, Teruel G, Pérez-Escamilla R. Urban poverty and nutrition challenges associated with accessibility to a healthy diet: a global systematic literature review. Int J Equity Health 2021; 20:40. [PMID: 33472636 PMCID: PMC7816472 DOI: 10.1186/s12939-020-01330-0] [Citation(s) in RCA: 65] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 11/20/2020] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND There is an increasing global trend towards urbanization. In general, there are less food access issues in urban than rural areas, but this "urban advantage" does not benefit the poorest who face disproportionate barriers to accessing healthy food and have an increased risk of malnutrition. OBJECTIVES This systematic literature review aimed to assess urban poverty as a determinant of access to a healthy diet, and to examine the contribution of urban poverty to the nutritional status of individuals. METHODS Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) methodology, our review included quantitative and qualitative studies published in English or in Spanish between 2000 and 2019. The articles were eligible if they focused on nutrition access (i.e. access to a healthy diet) or nutrition outcomes (i.e., anemia, overweight and obesity, micronutrient deficiency, micronutrient malnutrition) among urban poor populations. Articles were excluded if they did not meet pre-established criteria. The quality of the quantitative studies was assessed by applying Khan et al.'s methodology. Similarly, we assessed the quality of qualitative articles through an adapted version of the National Institute for Health and Care Excellence (NICE) methodology checklist. Finally, we systematically analyzed all papers that met the inclusion criteria based on a qualitative content and thematic analysis. RESULTS Of the 68 papers included in the systematic review, 55 used quantitative and 13 used qualitative methods. Through the analysis of the literature we found four key themes: (i) elements that affect access to healthy eating in individuals in urban poverty, (ii) food insecurity and urban poverty, (iii) risk factors for the nutritional status of urban poor and (iv) coping strategies to limited access to food. Based on the systematization of the literature on these themes, we then proposed a conceptual framework of urban poverty and nutrition. CONCLUSIONS This systematic review identified distinct barriers posed by urban poverty in accessing healthy diets and its association with poorer nutrition outcomes, hence, questioning the "urban advantage". A conceptual framework emerging from the existing literature is proposed to guide future studies and policies. SYSTEMATIC REVIEW REGISTRATION PROSPERO Registration number: CRD42018089788 .
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Affiliation(s)
- Mireya Vilar-Compte
- Research Institute for Equitable Development EQUIDE, Universidad Iberoamericana, Prolongación Paseo de Reforma 880, Lomas de Santa Fé, 01219, Mexico City, Mexico.
| | - Soraya Burrola-Méndez
- Research Institute for Equitable Development EQUIDE, Universidad Iberoamericana, Prolongación Paseo de Reforma 880, Lomas de Santa Fé, 01219, Mexico City, Mexico
| | - Annel Lozano-Marrufo
- Research Institute for Equitable Development EQUIDE, Universidad Iberoamericana, Prolongación Paseo de Reforma 880, Lomas de Santa Fé, 01219, Mexico City, Mexico
| | - Isabel Ferré-Eguiluz
- Research Institute for Equitable Development EQUIDE, Universidad Iberoamericana, Prolongación Paseo de Reforma 880, Lomas de Santa Fé, 01219, Mexico City, Mexico
| | - Diana Flores
- Research Institute for Equitable Development EQUIDE, Universidad Iberoamericana, Prolongación Paseo de Reforma 880, Lomas de Santa Fé, 01219, Mexico City, Mexico
| | - Pablo Gaitán-Rossi
- Research Institute for Equitable Development EQUIDE, Universidad Iberoamericana, Prolongación Paseo de Reforma 880, Lomas de Santa Fé, 01219, Mexico City, Mexico
| | - Graciela Teruel
- Research Institute for Equitable Development EQUIDE, Universidad Iberoamericana, Prolongación Paseo de Reforma 880, Lomas de Santa Fé, 01219, Mexico City, Mexico
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Nguyen AN, van Langeveld AWB, de Vries JHM, Ikram MA, de Graaf C, Mars M, Voortman T. Dietary taste patterns in early childhood: the Generation R Study. Am J Clin Nutr 2020; 113:63-69. [PMID: 33184622 PMCID: PMC7779211 DOI: 10.1093/ajcn/nqaa296] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 09/28/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Taste preference is an important determinant of dietary intake and is influenced by taste exposure in early life. However, data on dietary taste patterns in early childhood are scarce. OBJECTIVES We aimed to evaluate dietary taste patterns in early childhood, to examine their tracking between the ages of 1 and 2 y, and to examine their associations with socioeconomic and lifestyle factors. METHODS Dietary intake of children participating in a population-based cohort was assessed with a 211-item age-specific FFQ at the ages of 1 y ( n = 3629) and 2 y (n = 844) (2003-2007). Taste intensity values of FFQ food items were calculated based on a food taste database that had been previously constructed and evaluated using a trained adult sensory panel. Cluster analysis based on taste values identified 5 taste clusters that we named: "neutral," "sweet and sour," "sweet and fat," "fat," and "salt, umami and fat." Linear regression models were used to examine associations of percentage energy (E%) intake from these taste clusters with socioeconomic and lifestyle factors. RESULTS At the age of 1 y, 64% ± 13% (mean ± SD) of energy intake was obtained from the "neutral" cluster, whereas at age 2 y, this was 42% ± 8%. At age 2 y, children had higher energy intakes from the "sweet and fat" (18% ± 7%), "fat" (11% ± 4%), and "salt, umami, and fat" (18% ± 6%) clusters than at age 1 y (7% ± 6%, 6% ± 4%, and 11% ± 6%, respectively). In multivariable models, older maternal age, longer breastfeeding duration, and later introduction of complementary feeding were associated with more energy from the "neutral" cluster (e.g., β: 0.31 E%; 95% CI: 0.19, 0.43 E% per 1 mo longer breastfeeding). Higher child BMI was associated with more energy from the "salt, umami, and fat" cluster (β: 0.22 E%; 95% CI: 0.06, 0.38 E% per BMI standard deviation score). CONCLUSIONS Dietary taste patterns in this Dutch cohort were more varied and intense in taste at age 2 y than at 1 y, reaching a level similar to that previously observed in Dutch adults. Important factors related to dietary taste patterns of young children are maternal sociodemographic factors and feeding practices.This trial was registered at trialregister.nl as NL6484.
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Affiliation(s)
- Anh N Nguyen
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, Netherlands,The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, Netherlands
| | | | - Jeanne H M de Vries
- Division of Human Nutrition and Health, Wageningen University, Wageningen, Netherlands
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, Netherlands
| | - Cees de Graaf
- Division of Human Nutrition and Health, Wageningen University, Wageningen, Netherlands
| | - Monica Mars
- Division of Human Nutrition and Health, Wageningen University, Wageningen, Netherlands
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Vilela S, Muresan I, Correia D, Severo M, Lopes C. The role of socio-economic factors in food consumption of Portuguese children and adolescents: results from the National Food, Nutrition and Physical Activity Survey 2015-2016. Br J Nutr 2020; 124:591-601. [PMID: 32312336 DOI: 10.1017/s0007114520001373] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
This study aimed to evaluate the association between socio-economic factors and the food consumption of a young population. Participants were from the Portuguese National Food, Nutrition and Physical Activity Survey (IAN-AF 2015-2016) aged from 3 to 17 years (n 1153). Food consumption was assessed using two non-consecutive days of food diaries in children and two 24-h recalls for adolescents. A latent class analysis (LCA) was used to classify children's socio-economic status (socio-economic composite classification (SCC)), categorised in low, middle or high. The associations between socio-economic variables and food consumption were evaluated through linear or logistic regression models, weighted for the Portuguese population distribution. A positive association was found between belonging to a higher level of SCC and consumption of fruits and vegetables (FV), by children (β = 2·4, 95 % CI 1·1, 3·8) and by adolescents (β = 52·4, 95 % CI 9·6, 95·3). A higher SCC, but particularly higher maternal education, was positively associated with consumption of 'white meat, fish and eggs'. Both higher SCC and parental education were positively associated with salty snack consumption in the adolescents' group. In conclusion, children and adolescents with higher educated parents and belonging to a high socio-economic level have a higher daily intake of FV and white meat, fish and eggs. Socio-economic factors play an important role in justifying differences in the food consumption of children and adolescents and must be considered in future interventions. The relationship between higher socio-economic position and salty snack consumption in adolescents needs to be further explored in other populations.
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Affiliation(s)
- Sofia Vilela
- EPIUnit - Institute of Public Health, University of Porto, 4050-600Porto, Portugal
| | - Iasmina Muresan
- EPIUnit - Institute of Public Health, University of Porto, 4050-600Porto, Portugal
- 'Iuliu Haţieganu' University of Medicine and Pharmacy, 400337Cluj-Napoca, Romania
| | - Daniela Correia
- EPIUnit - Institute of Public Health, University of Porto, 4050-600Porto, Portugal
- Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, 4200-319Porto, Portugal
| | - Milton Severo
- EPIUnit - Institute of Public Health, University of Porto, 4050-600Porto, Portugal
- Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, 4200-319Porto, Portugal
| | - Carla Lopes
- EPIUnit - Institute of Public Health, University of Porto, 4050-600Porto, Portugal
- Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, 4200-319Porto, Portugal
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Overweight and obesity in Eastern Morocco: Prevalence and associated risk factors among high school students. Rev Epidemiol Sante Publique 2020; 68:295-301. [PMID: 32896444 DOI: 10.1016/j.respe.2020.06.007] [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] [Received: 12/05/2019] [Revised: 05/28/2020] [Accepted: 06/19/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Overweight and obesity in children and adolescents have become a major public health problem affecting most countries worldwide. The purpose of the study was to assess the prevalence and risk factors of overweight and obesity among public high school students in Eastern Morocco. METHODS A cross-sectional survey was conducted between February and May 2014 among a sample of 2271 students (1086 girls and 1185 boys). References from the International Obesity Task Force (IOTF) were used to determine the prevalence of overweight and obesity. RESULTS The prevalence of overweight and obesity reached 12.2% (14.2% in girls vs 10.4% in boys, P<0.01) and 3.0% (3.1% in girls vs 2.8% in boys), respectively. Risk factors associated with overweight and obesity were urban residence (OR=1.76; [1.18-2.63]; P<0.01), father's income≥5000MAD (OR=1.32; [1.02-1.70]; P<0.05), father's overweight (including obesity) (OR=1.87; [1.38-2.54]; P<0.001) and female sex (OR=1.31; [1.02-1.68]; P<0.05). CONCLUSION The prevalence of overweight/obesity has reached an alarming rate among high school students in the Eastern region of Morocco. The findings of the present study suggest an urgent need to set up a strategy to prevent and combat this epidemic.
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Anselma M, Chinapaw MJM, Kornet-van der Aa DA, Altenburg TM. Effectiveness and promising behavior change techniques of interventions targeting energy balance related behaviors in children from lower socioeconomic environments: A systematic review. PLoS One 2020; 15:e0237969. [PMID: 32870928 PMCID: PMC7462275 DOI: 10.1371/journal.pone.0237969] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 08/06/2020] [Indexed: 01/22/2023] Open
Abstract
This systematic review aims to summarize the evidence regarding the effectiveness of interventions targeting energy balance-related behaviors in children from lower socioeconomic environments and the applied behavior change techniques. The literature search was conducted in Cochrane, Embase, Psycinfo and Pubmed. Articles had to be published between January 2000 and September 2019. Studies were included that i) targeted dietary behavior, physical activity and/or sedentary behavior; ii) had a controlled trial design; iii) included children aged 9–12 years old; iv) focused on lower socioeconomic environments; and v) took place in upper-middle or high income countries. Two independent researchers extracted data, identified behavior change techniques using the Behavior Change Technique Taxonomy v1, and performed a methodological quality assessment using the quality assessment tool of the Effective Public Health Practice Project. We included 24 studies, of which one received a high and three a moderate quality rating. Demonstration, practice and providing instructions on how to perform a behavior were the most commonly applied behavior change techniques. Seven studies reported significant beneficial intervention effects: five on physical activity, one on physical activity and sedentary behavior and one on dietary behavior. When comparing effective versus non-effective interventions, and comparing our review to previous reviews focusing on children from the general population, similar behavior change techniques were applied. More high quality research is needed to evaluate the effectiveness of interventions and their behavior change techniques targeting children of low socioeconomic environments. PROSPERO registration number: CRD42016052599
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Affiliation(s)
- Manou Anselma
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- * E-mail:
| | - Mai J. M. Chinapaw
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Daniëlle A. Kornet-van der Aa
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Teatske M. Altenburg
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Epidemiological Transition in Physical Activity and Sedentary Time in Children. J Phys Act Health 2020; 16:518-524. [PMID: 31104544 DOI: 10.1123/jpah.2018-0546] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 01/19/2019] [Accepted: 02/22/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND To determine if children's moderate to vigorous physical activity (MVPA) and sedentary time varied across levels of household income in countries at different levels of Human Development Index (HDI), consistent with the theory of epidemiological transition. METHODS Data from 6548 children (55% girls) aged 9-11 years from 12 countries at different HDI levels are used in this analysis to assess MVPA and sedentary time (measured using ActiGraph accelerometers) across levels of household income. Least-square means are estimated separately for boys and girls at the estimated 10th, 50th, and 90th percentiles of HDI for the sample. RESULTS For boys, time in MVPA is negatively associated with income at the 10th and 50th percentiles of HDI (both P < .002). For girls, time in MVPA is negatively associated with income at the 10th and 50th percentiles of HDI (all P < .01) and positively related with income at the 90th percentile (P = .04). Sedentary time is positively associated with income at the 10th percentile of HDI for boys (P = .03), but not for girls. CONCLUSIONS Results support the possibility of an epidemiological transition in physical activity, with lower levels of MVPA observed at opposite levels of income depending on the HDI percentile. This phenomenon was not observed for sedentary time.
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Dietary Patterns and Associated Factors Among Adolescents in Malaysia: Findings from Adolescent Nutrition Survey 2017. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17103431. [PMID: 32423077 PMCID: PMC7277301 DOI: 10.3390/ijerph17103431] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 04/01/2020] [Accepted: 04/03/2020] [Indexed: 01/20/2023]
Abstract
Balanced diet in the early stages of life plays a role in optimum growth and maintains good health status of adolescents. Dietary habits that are established during adolescence will sustain till adulthood. Therefore, this present study aims to identify the dietary patterns and to determine factors associated with dietary patterns in terms of socio-demographic characteristics, locality of schools, ethnicity, eating habits, self-perceived weight status, and food label reading habit among adolescents in Malaysia. Data from the Adolescent Nutrition Survey (ANS) 2017 was used for the present study. ANS is a population representative school-based cross-sectional study among school-going adolescents from primary four to secondary five from schools in 13 states and three federal territories registered under the Ministry of Education Malaysia. A self-administrated questionnaire was used to collect information on socio-demographic characteristics, locality of schools, ethnicity, eating habits, self-perceived weight status, and food label reading habit. A pre-tested face-to-face food frequency questionnaire (FFQ) was used to collect information on food group intake frequency. Dietary patterns were identified by using exploratory factor analysis and associated factors, using complex sample general linear model (GLM) analysis. All statistical analyses were carried out at 95% confidence interval or p-value < 0.05. The dietary patterns identified are healthy, unhealthy, and alternative proteins. The healthy dietary pattern was significantly associated with the types of school and ethnicity. The unhealthy dietary pattern was significantly associated with the locality of schools, ethnicity, frequency of snacks intake per week, frequency of eating out per week, self-perceived weight status, and food label reading habit. Significant associations were found between alternative proteins dietary pattern and locality of schools, ethnicity, and types of school. This study found that there is a disparity of dietary patterns between different ethnicity, locality of schools, and types of school. We recommend strategies of specifying ethnicity and geographical area to improve dietary patterns of adolescents in Malaysia.
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Assessing the construct validity of nutrient profiling models for restricting the marketing of foods to children in South Africa. Eur J Clin Nutr 2020; 74:1065-1072. [PMID: 31996794 DOI: 10.1038/s41430-020-0566-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 01/15/2020] [Accepted: 01/16/2020] [Indexed: 11/09/2022]
Abstract
BACKGROUND In an effort to combat childhood obesity the WHO has called on governments to restrict the marketing of unhealthy foods to children. Regulators have turned to nutrient profiling (NP) to provide the evidence for their decisions. This has resulted in the development of NP models, of which the validity of only a few have been established. The aim of this study was to assess the construct validity of various NP models for the purpose of restricting the marketing of unhealthy foods to children in South Africa by comparing the classification of foods by the models to the ranking of the same foods by registered dietitians. METHODS Six current NP models were identified, then a representative food database of 120 foods was developed and each individual food was classified by each of the six models. Lastly dietitians were recruited to rank the healthfulness of the same 120 foods. RESULTS Dietitians allowed 24% of the included foods for marketing to children, whereas the percentage of foods allowed by the included models ranged from 7 to 47%. Majority of pairwise comparisons between the NP models and dietitians yielded ҡ statistics >0.6, indicating substantial agreement. An almost perfect pairwise agreement was found between dietitians and the WHO Regional Office for Europe model. CONCLUSION The included NP models displayed good construct validity by agreeing with dietitians on what are 'less healthy' foods, thus the foods not allowed for marketing. The findings of this study contributes to the process of establishing validity of NP models.
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A cross-sectional study to determine the energy density and nutritional quality of primary-school children's lunchboxes. Public Health Nutr 2020; 23:1108-1116. [PMID: 31969199 DOI: 10.1017/s1368980019003379] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
OBJECTIVE The present study describes the energy content of primary-school children's lunchboxes and the proportion of lunchbox foods considered discretionary. Subgroup analyses by sex, socio-economic status, age and weight status were undertaken. DESIGN A cross-sectional study was conducted. Mean kilojoule content, number of items and categorisation of foods and drinks in lunchboxes as 'everyday' (healthy) or discretionary (sometimes) foods were assessed via a valid and reliable lunchbox observational audit. SETTING Twelve Catholic primary schools (Kindergarten-Grade 6) located in the Hunter region of New South Wales, Australia. PARTICIPANTS Kindergarten to Grade 6 primary-school students. RESULTS In total, 2143 children (57 %) had parental consent to have their lunchboxes observed. School lunchboxes contained a mean of 2748 kJ, of which 61·2 % of energy was from foods consistent with the Australian Dietary Guidelines and 38·8 % of energy was discretionary foods. The proportion of lunchboxes containing only healthy foods was 12 %. Children in Kindergarten-Grade 2 packed more servings of 'everyday' foods (3·32 v. 2·98, P < 0·01) compared with children in Grades 3-6. Children in Grades 3-6 had a higher percentage of energy from discretionary foods (39·1 v. 33·8 %, P < 0·01) compared with children in Kindergarten-Grade 2 and children from the most socio-economically disadvantaged areas had significantly higher total kilojoules in the school lunchbox compared with the least disadvantaged students (2842 v. 2544 kJ, P = 0·03). CONCLUSIONS Foods packed within school lunchboxes may contribute to energy imbalance. The development of school policies and population-based strategies to support parents overcome barriers to packing healthy lunchboxes are warranted.
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López-Hernández L, Pérez-Ros P, Fargueta M, Elvira L, López-Soler J, Pablos A. Identifying Predictors of the Visceral Fat Index in the Obese and Overweight Population to Manage Obesity: A Randomized Intervention Study. Obes Facts 2020; 13:403-414. [PMID: 32535591 PMCID: PMC7445565 DOI: 10.1159/000507960] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 04/15/2020] [Indexed: 01/04/2023] Open
Abstract
INTRODUCTION Nowadays, obesity is one of the main causes of death and disability. In recent years, it has been shown that the excess and distribution of body fat increases morbidity, with excess visceral fat being the most important factor that triggers pathologies. Thus, estimation of visceral fat makes it possible to identify patients with a higher cardiovascular risk, aiding the management of obesity. The main objective of the study was to identify predictors of the visceral fat index through a lifestyle intervention and to observe the effect of the intervention on dietary habits and functional capacity. METHODS A randomized intervention, parallel-group study was made. This study included 97 obese and overweight people (control group, n = 48; experimental group, n = 49) with a low socioeconomic status in an 8-month lifestyle intervention. Anthropometric, fitness and nutritional tests were assessed. RESULTS It was found that being female, eating the recommended daily portions of fruit, gaining strength in the legs and gaining flexibility are factors predictive of a lower visceral fat index. Age over 45 years and eating the recommended weekly portions of cereals and meats, fat and processed meats increases the visceral fat index after a lifestyle intervention. There were changes in the visceral fat index and in the different physical condition variables, but not in eating habits. CONCLUSION A multicomponent lifestyle intervention reduces the visceral fat index; age over 45 and consuming cereals and meat increases the visceral fat index.
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Affiliation(s)
| | - Pilar Pérez-Ros
- Department of Nursing, Universidad Católica de Valencia San Vicente Mártir, Valencia, Spain,
| | - María Fargueta
- Faculty of Physical Activity and Sport Sciences, Universidad Católica de Valencia San Vicente Martir, Valencia, Spain
| | - Laura Elvira
- Faculty of Physical Activity and Sport Sciences, Universidad Católica de Valencia San Vicente Martir, Valencia, Spain
| | - Josep López-Soler
- Faculty of Physical Activity and Sport Sciences, Universidad Católica de Valencia San Vicente Martir, Valencia, Spain
| | - Ana Pablos
- Faculty of Physical Activity and Sport Sciences, Universidad Católica de Valencia San Vicente Martir, Valencia, Spain
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Anselma M, Altenburg TM, Emke H, van Nassau F, Jurg M, Ruiter RAC, Jurkowski JM, Chinapaw MJM. Co-designing obesity prevention interventions together with children: intervention mapping meets youth-led participatory action research. Int J Behav Nutr Phys Act 2019; 16:130. [PMID: 31831006 PMCID: PMC6909512 DOI: 10.1186/s12966-019-0891-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 11/25/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Youth-led Participatory Action Research (YPAR) involves children throughout the process of developing and implementing interventions. Combining YPAR with a structural approach for designing and planning interventions, such as Intervention Mapping (IM), may further improve implementation and effectiveness of interventions. This paper describes how YPAR and IM were combined in the Kids in Action study. METHODS The Kids in Action study aims to improve health behaviors of 9-12-year old children living in a low socioeconomic neighborhood in Amsterdam, by co-designing interventions with these children. At each of four schools 6-8 children (N = 18-24 total per year) and two academic researchers formed participatory groups that met weekly or every fortnight during two school years. An IM expert panel advised the participatory groups on the application of IM. RESULTS Following the IM protocol, we conducted a participatory needs assessment with children, parents and professionals, in IM-step 1. In IM-step 2, the IM expert panel constructed matrices of program objectives, and the children provided feedback. In collaboration with children programs were designed and produced using an iterative process during IM-steps 3-4. In IM-step 5, the participatory groups and professional community partners designed the implementation plan. Finally, in IM-step 6, the protocol of the process and effect evaluation - executed by academic researchers with input from children - was developed. CONCLUSIONS By combining YPAR and IM, several interventions have been developed and implemented, varying from a school water policy to extracurricular sports activities. Sharing responsibility with children was challenging when combining IM with YPAR. In YPAR children are given as much autonomy as possible, while traditional IM development work is primarily done by academic researchers. Strengths in combining IM and YPAR include the involvement of the end-users - children - throughout the process while at the same time developing interventions based on existing evidence. Time-management, a multidisciplinary team, and flexibility are important conditions when combining IM with YPAR. A strong community project group, with professionals who were willing to help children develop and execute their ideas, was an important success factor. This study can serve as an example to other YPAR studies developing interventions using the IM protocol.
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Affiliation(s)
- Manou Anselma
- Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, NL-1081 BT Amsterdam, The Netherlands
| | - Teatske M. Altenburg
- Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, NL-1081 BT Amsterdam, The Netherlands
| | - Helga Emke
- Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, NL-1081 BT Amsterdam, The Netherlands
| | - Femke van Nassau
- Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, NL-1081 BT Amsterdam, The Netherlands
| | - Merlin Jurg
- InReturn, Sustainable employability and vitality, Koog aan de Zaan, The Netherlands
| | - Robert A. C. Ruiter
- Department of Work and Social Psychology, Maastricht University, P.O. Box 616, NL-6200 MD Maastricht, the Netherlands
| | - Janine M. Jurkowski
- Department of Health Policy, Management, & Behavior, University at Albany School of Public Health, State University of New York, Albany, New York USA
| | - Mai J. M. Chinapaw
- Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, NL-1081 BT Amsterdam, The Netherlands
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Gutiérrez-Camacho C, Méndez-Sánchez L, Klünder-Klünder M, Clark P, Denova-Gutiérrez E. Association between Sociodemographic Factors and Dietary Patterns in Children Under 24 Months of Age: A Systematic Review. Nutrients 2019; 11:E2006. [PMID: 31454895 PMCID: PMC6770717 DOI: 10.3390/nu11092006] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 08/21/2019] [Accepted: 08/23/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Understanding early-life complementary feeding dietary patterns and their determining factors could lead to better ways of improving nutrition in early childhood. The purpose of this review was to evaluate evidence of the association between sociodemographic factors and dietary patterns (DPs) in children under 24 months. METHODS Medline (PubMed), Cochrane Central, NICE guidelines, and Trip database were searched for observational studies that evaluated sociodemographic factors and their associations with DP. RESULTS Seven studies were selected for the present review. High education level among mothers was inversely associated with unhealthy DPs and positively associated with healthy DPs. Higher household income was negatively associated with unhealthy DPs. Four studies showed a positive association between low household income and unhealthy DPs and three studies showed a positive association between higher household income and healthy DPs. Additionally, in younger mothers, body mass index (BMI ≥ 30.0 kg/m2) and number of children were positively associated with unhealthy DPs. CONCLUSIONS This review provides evidence of a positive association between mothers' higher education level, higher household income, higher maternal age, and healthy dietary patterns as well as a negative association between these factors and unhealthy dietary patterns. Further studies from low- and middle-income countries are needed for comparison with associations showed in this review.
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Affiliation(s)
- Claudia Gutiérrez-Camacho
- Physical Therapy Research Unit, Hospital Infantil de México Federico Gómez, and Medicine Faculty of Autonomous National University, Mexico City 06720, Mexico
| | - Lucia Méndez-Sánchez
- Clinical Epidemiology Research Unit, Hospital Infantil de México Federico Gómez, and Medicine Faculty of Autonomous National University, Mexico City 06720, Mexico.
| | - Miguel Klünder-Klünder
- Research Headmaster's Office, Hospital Infantil de México Federico Gómez, Ciudad de México 06720, Mexico
| | - Patricia Clark
- Clinical Epidemiology Research Unit, Hospital Infantil de México Federico Gómez, and Medicine Faculty of Autonomous National University, Mexico City 06720, Mexico
| | - Edgar Denova-Gutiérrez
- Nutrition and Health Research Center, National Institute of Public Health, Cuernavaca 62100, Morelos.
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Consuming school meals improves Brazilian children’s diets according to their social vulnerability risk. Public Health Nutr 2019; 22:2714-2719. [DOI: 10.1017/s1368980019001459] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
AbstractObjective:To estimate usual diets among Brazilian children regarding the consumption of school meals and social vulnerability risks.Design:A cross-sectional study. School meal consumers were considered those children who reported consuming school meals ≥3 times/week. Social vulnerability risk was classified by an index. Dietary intake was evaluated by one 24 h dietary recall for the whole sample; a second 24 h dietary recall was administered in a sub-sample (38·6 %). The National Cancer Institute’s method was used to estimate children’s usual intake of nutrients and food groups.Setting:Municipal public schools from Belo Horizonte, Brazil.Participants:Children (n 1357) aged 8–12 years.Results:Half of the sample lived in low/medium social vulnerability risk areas and 27·9 % were school meal non-consumers. School meal consumers more frequently lived in high/very high social vulnerability risk areas (76·2 v. 68·7 %). Children with low/medium social vulnerability risk had a higher mean intake of thiamin (1·13 v. 1·04 mg) and a lower mean intake of candy (1·35 v. 1·42 g). Consumption of school meals among children under high/very high social vulnerability risk was associated with higher mean consumption of vitamin C (31·9 v. 24·1 mg), unprocessed/minimally processed foods (956·3 v. 851·9 g), fruits (128·5 v. 90·9 g) and vegetables (58·2 v. 47·1 g). Ultra-processed food product consumption was lower among school meal consumers (136·2 v. 187·7 g), especially ultra-processed beverages (252·5 v. 305·7 g).Conclusions:Consuming school meals was associated with a better usual diet quality, particularly among those with higher social vulnerability risk.
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Wrottesley SV, Pedro TM, Fall CH, Norris SA. A review of adolescent nutrition in South Africa: transforming adolescent lives through nutrition initiative. SOUTH AFRICAN JOURNAL OF CLINICAL NUTRITION 2019. [DOI: 10.1080/16070658.2019.1607481] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Stephanie V Wrottesley
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, University of the Witwatersrand, Johannesburg, South Africa
| | - Titilola M Pedro
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, University of the Witwatersrand, Johannesburg, South Africa
| | - Caroline H Fall
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
| | - Shane A Norris
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, University of the Witwatersrand, Johannesburg, South Africa
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Angeles-Agdeppa I, Denney L, Toledo MB, Obligar VA, Jacquier EF, Carriquiry AL, Capanzana MV. Inadequate nutrient intakes in Filipino schoolchildren and adolescents are common among those from rural areas and poor families. Food Nutr Res 2019; 63:3435. [PMID: 31143094 PMCID: PMC6525598 DOI: 10.29219/fnr.v63.3435] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 04/14/2019] [Accepted: 04/14/2019] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Adequate nutrition during childhood and adolescence is essential to promote growth and development. OBJECTIVE This study evaluated usual energy and nutrient intakes of Filipino schoolchildren and adolescents. DESIGN Food and beverage intakes were collected from a nationally representative sample of schoolchildren aged 6-9 and 10-12 years (n = 3,594 and n = 2,971, respectively) and adolescents aged 13-18 years (n = 5,447) using 24-h dietary recalls. The distributions of usual energy and nutrient intakes and the prevalence of inadequate intakes, which is defined as the percent of children with intakes less than estimated average requirements or acceptable macronutrient distribution ranges, were estimated using the Personal Computer Software for Intake Distribution Estimation (PC-SIDE) program. RESULTS The results showed that the mean energy intakes were 19-35% lower than estimated energy requirement. High prevalence of inadequate intakes was found for most macro- and micronutrients. Prevalence of inadequacies was as follows: protein 12-47%, total fat (as percentage of energy) 38-52%, calcium 92-94%, iron 75-90%, vitamin C 68-96%, folate 61-93%, vitamin A 58-81%, riboflavin 58-91%, thiamin 27-75%, and phosphorus 18-91%. CONCLUSIONS Generally, prevalence of inadequacy of key nutrients were relatively high among adolescents and schoolchildren, especially those from poor families and rural areas. This study demonstrated that nutrient intakes of Filipino schoolchildren and adolescents were highly inadequate, particularly among the poor and those living in rural areas.
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Affiliation(s)
- Imelda Angeles-Agdeppa
- Food and Nutrition Research Institute, Department of Science and Technology, Taguig City 1631, The Philippines
| | - Liya Denney
- Nestlé Research, Vers-chez-les-Blanc, Lausanne 1000, Switzerland Nestlé Research Centre, Lausanne, Switzerland
| | - Marvin B. Toledo
- Food and Nutrition Research Institute, Department of Science and Technology, Taguig City 1631, The Philippines
| | - Virgilyn Anne Obligar
- Food and Nutrition Research Institute, Department of Science and Technology, Taguig City 1631, The Philippines
| | - Emma F. Jacquier
- Nestlé Research, Vers-chez-les-Blanc, Lausanne 1000, Switzerland Nestlé Research Centre, Lausanne, Switzerland
| | | | - Mario V. Capanzana
- Food and Nutrition Research Institute, Department of Science and Technology, Taguig City 1631, The Philippines
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Katzmarzyk PT, Chaput JP, Fogelholm M, Hu G, Maher C, Maia J, Olds T, Sarmiento OL, Standage M, Tremblay MS, Tudor-Locke C. International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE): Contributions to Understanding the Global Obesity Epidemic. Nutrients 2019; 11:E848. [PMID: 30991687 PMCID: PMC6521223 DOI: 10.3390/nu11040848] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 04/09/2019] [Accepted: 04/10/2019] [Indexed: 01/22/2023] Open
Abstract
The purpose of this review is to summarize the scientific contributions of the International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE) in extending our understanding about obesity in children from around the world. ISCOLE was a multi-national study of 9 to 11 year-old children from sites in 12 countries from all inhabited continents. The primary purpose was to investigate relationships between lifestyle behaviors and obesity, and the influence of higher-order characteristics such as behavioral settings, and physical, social and policy environments. ISCOLE has made several advances in scientific methodology related to the assessment of physical activity, dietary behavior, sleep and the neighborhood and school environments. Furthermore, ISCOLE has provided important evidence on (1) epidemiological transitions in obesity and related behaviors, (2) correlates of obesity and lifestyle behaviors at the individual, neighborhood and school levels, and (3) 24-h movement behaviors in relation to novel analytical techniques. A key feature of ISCOLE was the development of a platform for international training, data entry, and data quality for multi-country studies. Finally, ISCOLE represents a transparent model for future public-private research partnerships across low, middle and high-income countries.
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Affiliation(s)
- Peter T Katzmarzyk
- Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA 70808, USA.
| | - Jean-Philippe Chaput
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada.
| | - Mikael Fogelholm
- Department of Food and Environmental Sciences, University of Helsinki, 00014 Helsinki, Finland.
| | - Gang Hu
- Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA 70808, USA.
| | - Carol Maher
- School of Health Sciences, Sansom Institute, University of South Australia, Adelaide, SA 5001, Australia.
| | - Jose Maia
- Faculdade de Desporto, University of Porto, Rua Dr. Plácido Costa, 91, 4200-450 Porto, Portugal.
| | - Timothy Olds
- School of Health Sciences, Sansom Institute, University of South Australia, Adelaide, SA 5001, Australia.
| | - Olga L Sarmiento
- School of Medicine, Universidad de los Andes, Bogota 11001000, Colombia.
| | - Martyn Standage
- Department for Health, University of Bath, Bath BA2 7AY, UK.
| | - Mark S Tremblay
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada.
| | - Catrine Tudor-Locke
- Department of Kinesiology, University of Massachusetts, Amherst, MA 01003, USA.
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Motivational Climate towards the Practice of Physical Activity, Self-Concept, and Healthy Factors in the School Environment. SUSTAINABILITY 2019. [DOI: 10.3390/su11040999] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The objective of the present study was to define and contrast an explanatory model relating the motivational climate, body mass index, and adherence to a Mediterranean diet with the self-concept of school children. A further objective was to analyze the existing relationships between the variables included in the developed model according to sex, using a multi-group structural equation analysis. In the study, a total of 734 school children, of both sexes, reported their perceived motivational climate towards sport, body mass index, adherence to a Mediterranean diet, and self-concept. These children were aged between 10 and 12 years old and attended public school in the province of Granada (Spain). The multi-group structural equation model developed demonstrated an excellent fit to the empirical data (χ2 = 228.179; DF = 40; p < 0.001; CFI = 0.965; NFI = 0.958; IFI = 0.968; RMSEA = 0.048). The findings identified a direct negative relationship between the ego climate and the task climate. Furthermore, an inverse relationship was found between the task climate and body mass index, and a direct relationship was found between the ego climate and body mass index. Meanwhile, Mediterranean diet adherence was directly related to the task climate and negatively related to the ego climate. The main conclusions of the present study highlight the positive effects of a task-oriented motivational climate and adherence to a Mediterranean diet, with regards to body mass index. Furthermore, a task-oriented motivational climate and a lower body mass index are related to a more positive self-concept.
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Vasquez F, Correa-Burrows P, Blanco E, Gahagan S, Burrows R. A waist-to-height ratio of 0.54 is a good predictor of metabolic syndrome in 16-year-old male and female adolescents. Pediatr Res 2019; 85:269-274. [PMID: 30631139 PMCID: PMC6377811 DOI: 10.1038/s41390-018-0257-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 11/15/2018] [Accepted: 11/23/2018] [Indexed: 12/15/2022]
Abstract
BACKGROUND We aimed to determine the sensitivity and specificity of selected anthropometric indicators as predictors of cardiovascular risk in adolescents. METHODS Cross-sectional study in 678 adolescents (16.8 y ± 0.3) from an infancy cohort. Weight, height, waist circumference (WC), and hip circumference were measured. Body mass index (BMI), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) were estimated. MetS was diagnosed with IDF/AHA/NHLBI. Optimal cutoffs of BMI, WC, WHR, and WHtR for diagnosing MetS were determined using ROC analysis. RESULTS In males, WHtR (0.96) had the greatest area under the ROC curve, followed by WC (0.95) and BMI (0.93). In females, BMI (0.84) had the greatest area under the ROC curve (0.84), followed by WHtR (0.83) and WC (0.83). In both sexes, the optimal WHtR cutoff for MetS diagnosis was 0.54. A BMI of 26.9 in males and 26.3 in females were the optimal cutoffs for diagnosing MetS. Finally, WC values of 92 and 81.6 cm in males and females, respectively, were the optimal cutoffs for MetS diagnosis. CONCLUSIONS In both sexes, a WHtR value of 0.54 was a good predictor of MetS. In males and females, the optimal cutoff of BMI for Mets diagnosis was below the values for diagnosing obesity.
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Affiliation(s)
- Fabian Vasquez
- Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile
| | | | - Estela Blanco
- Division of Child Development and Community Health, University of California San Diego, La Jolla, CA, USA
| | - Sheila Gahagan
- Division of Child Development and Community Health, University of California San Diego, La Jolla, CA, USA
| | - Raquel Burrows
- Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile.
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Dietary patterns and cardiometabolic risk factors among adolescents: systematic review and meta-analysis. Br J Nutr 2018; 119:859-879. [DOI: 10.1017/s0007114518000533] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
AbstractThis study systematised and synthesised the results of observational studies that were aimed at supporting the association between dietary patterns and cardiometabolic risk (CMR) factors among adolescents. Relevant scientific articles were searched in PUBMED, EMBASE, SCIENCE DIRECT, LILACS, WEB OF SCIENCE and SCOPUS. Observational studies that included the measurement of any CMR factor in healthy adolescents and dietary patterns were included. The search strategy retained nineteen articles for qualitative analysis. Among retained articles, the effects of dietary pattern on the means of BMI (n 18), waist circumference (WC) (n 9), systolic blood pressure (n 7), diastolic blood pressure (n 6), blood glucose (n 5) and lipid profile (n 5) were examined. Systematised evidence showed that an unhealthy dietary pattern appears to be associated with poor mean values of CMR factors among adolescents. However, evidence of a protective effect of healthier dietary patterns in this group remains unclear. Considering the number of studies with available information, a meta-analysis of anthropometric measures showed that dietary patterns characterised by the highest intake of unhealthy foods resulted in a higher mean BMI (0·57 kg/m²; 95 % CI 0·51, 0·63) and WC (0·57 cm; 95 % CI 0·47, 0·67) compared with low intake of unhealthy foods. Controversially, patterns characterised by a low intake of healthy foods were associated with a lower mean BMI (−0·41 kg/m²; 95 % CI −0·46,−0·36) and WC (−0·43 cm; 95 % CI −0·52,−0·33). An unhealthy dietary pattern may influence markers of CMR among adolescents, but considering the small number and limitations of the studies included, further studies are warranted to strengthen the evidence of this relation.
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Hinnig PDF, Monteiro JS, de Assis MAA, Levy RB, Peres MA, Perazi FM, Porporatti AL, Canto GDL. Dietary Patterns of Children and Adolescents from High, Medium and Low Human Development Countries and Associated Socioeconomic Factors: A Systematic Review. Nutrients 2018; 10:E436. [PMID: 29601553 PMCID: PMC5946221 DOI: 10.3390/nu10040436] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 03/14/2018] [Accepted: 03/28/2018] [Indexed: 01/07/2023] Open
Abstract
The purpose of this systematic review is to assess the associations among education, income and dietary pattern (DP) in children and adolescents from high, medium and low human development countries (HHDC, MHDC and LHDC, respectively). Observational studies that evaluated the association between family income or education with the DP are obtained through electronic database searches. Forty articles are selected for review. In HHDC, education is inversely associated with "unhealthy" DP and positively associated with "healthy" DP. In cross-sectional studies from HHDC, higher income is negatively associated with "unhealthy" DP. In MHDC, there is no association between the socioeconomic variables (SE) and the DPs, although, in some studies, the unhealthy diet is positively associated with SE. Only one study conducted in LHDC showed an inverse association between income/education with "unhealthy" DP and there is no association between the SE and "healthy" DP. In conclusion, children and adolescents living in HHDC with high parental education tend to have a healthier diet. In MHDC, although an unhealthy diet is found among the high-income and educated population, the associations are not clear. Additional research is needed to clarify the associations between income and education with "unhealthy" and "healthy" DPs in MHDC and LHDC.
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Affiliation(s)
- Patrícia de Fragas Hinnig
- Postgraduate Program in Nutrition, Health Sciences Center, Federal University of Santa Catarina, CCS/UFSC, Campus Trindade, Florianopolis 88040-900, Brazil.
| | - Jordanna Santos Monteiro
- Postgraduate Program in Human Nutrition, Faculty of Health Sciences, University of Brasília (UnB), Brasilia-DF 70910-900, Brazil.
| | - Maria Alice Altenburg de Assis
- Postgraduate Program in Nutrition, Health Sciences Center, Federal University of Santa Catarina, CCS/UFSC, Campus Trindade, Florianopolis 88040-900, Brazil.
| | - Renata Bertazzi Levy
- Preventive Medicine Department, University of São Paulo (FMUSP), São Paulo 01246-903, Brazil.
| | - Marco Aurélio Peres
- Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide, SA 5005, Australia.
| | - Fernanda Machado Perazi
- Postgraduate Program in Nutrition, Health Sciences Center, Federal University of Santa Catarina, CCS/UFSC, Campus Trindade, Florianopolis 88040-900, Brazil.
| | - André Luís Porporatti
- Brazilian Centre for Evidence-Based Research Department of Dentistry, Federal University of Santa Catarina CCS/UFSC, Campus Trindade, Florianopolis 88040-900, Brazil.
| | - Graziela De Luca Canto
- Brazilian Centre for Evidence-Based Research Department of Dentistry, Federal University of Santa Catarina CCS/UFSC, Campus Trindade, Florianopolis 88040-900, Brazil.
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