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Chen S, López-Gil JF, Memon AR, Bao R, Yang X. Associations of Eating Habits with Self-Rated Health and Life Satisfaction in Adolescents: A 42-Country Cross-Sectional Study. Eur J Investig Health Psychol Educ 2024; 14:1501-1513. [PMID: 38921065 PMCID: PMC11202602 DOI: 10.3390/ejihpe14060099] [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: 01/24/2024] [Revised: 05/04/2024] [Accepted: 05/09/2024] [Indexed: 06/27/2024] Open
Abstract
OBJECTIVE The aim of this study was to explore the associations of eating habits with self-rated health and life satisfaction in adolescents using a multiple-country sample. METHODS Cross-sectional data from the Health Behavior in School-Aged Children (HBSC) 2013/2014 wave was used in this study. A self-reported questionnaire was used to collect data on independent variables including breakfast on weekdays, breakfast at weekends, and consumption of fruits, vegetables, sweets, and soft dirks. Outcomes included self-rated health and life satisfaction. Regression models were used to assess the associations between the independent variables and the two outcomes, separately, after controlling for covariates. Results were presented using odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS Of all the study participants (aged 11-15 years), 50.8% were girls. Compared with no consumption of breakfast on weekdays, eating breakfast for five days had 1.22 times greater likelihood for improved self-rated health (OR = 1.22, 95% CI: 1.19-1.25, p < 0.001). Participants who ate breakfast for both days (OR = 1.41, 95% CI: 1.36-1.46, p < 0.001) and one day (OR = 1.12, 95% CI = 1.08-1.17, p < 0.001) were more likely to experience improved self-rated health compared to never eating breakfast at weekends. Five or more days for fruit and vegetable consumption resulted in better self-rated health (all p < 0.001). Similar results were found in terms of the associations of breakfast, fruit, and vegetable consumption with life satisfaction. For example, a higher frequency of fruit intake was associated with enhanced self-rated health (e.g., OR for more than once daily = 1.42, 95% CI: 1.34-1.51, p < 0.001) compared to no fruit consumption. Similarly, a higher-frequency vegetable intake, such as more than once daily (OR = 1.33, 95% CI: 1.26-1.39, p < 0.001), was associated with improved self-rated health. CONCLUSIONS Healthy eating habits, especially regular breakfast and a higher consumption of vegetables and fruit, are associated with better self-rated health and life satisfaction in school-aged children. Of note, the consumption of fruit would have the greatest impact on health and wellbeing outcomes. This study offers evidence that healthy eating habits can play a vital role in school-aged children's health and wellbeing, highlighting the practical significance of educating adolescents to develop healthy eating habits.
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Affiliation(s)
- Sitong Chen
- Institute for Health and Sport, Victoria University, Melbourne, VIC 3011, Australia;
| | | | - Aamir Raoof Memon
- Institute for Health and Sport, Victoria University, Melbourne, VIC 3011, Australia;
| | - Ran Bao
- Centre for Active Living and Learning, University of Newcastle, Callaghan, NSW 2308, Australia;
- School of Education, College of Human and Social Futures, University of Newcastle, Callaghan, NSW 2308, Australia
- Active Living Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Xingyi Yang
- Centre for Mental Health, Shenzhen University, Shenzhen 518060, China;
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Kuwahara M, Tahara Y, Suiko T, Nagamori Y, Shibata S. Effects of Differences of Breakfast Styles, Such as Japanese and Western Breakfasts, on Eating Habits. Nutrients 2022; 14:5143. [PMID: 36501172 PMCID: PMC9740526 DOI: 10.3390/nu14235143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 11/28/2022] [Accepted: 11/29/2022] [Indexed: 12/09/2022] Open
Abstract
A balanced diet and protein source intake are reportedly good for health. However, many people skip breakfast or have a light breakfast. Thus, this study aimed to examine the influence of breakfast styles on eating habits among Japanese workers, including traditional Japanese-style breakfast (JB), a pattern in which Japanese foods are eaten; Japanese-Western-style breakfast (J-W B), a pattern in which Japanese and Western foods are eaten alternately; Western-style breakfast (WB), a pattern in which Western foods are eaten; and cereal-style breakfast (CB), a pattern in which cereal is eaten. We hypothesized that breakfast style may be related to good eating habits. Data from 4274 respondents (67.97% male, 33.03% female, age 48.12 ± 0.19 years), excluding night shift workers and breakfast absentees out of a total of 5535 respondents, were analyzed. The results suggest that Japanese food is linked to the intake of protein sources such as fish, eggs, and soy. Furthermore, it was suggested that Japanese food breakfast is effective for good eating habits, such as not eating irregular amounts of food, not eating snacks, not drinking sweet juices, and having a balanced diet.
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Affiliation(s)
- Mai Kuwahara
- Laboratory of Physiology and Pharmacology, School of Advanced Science and Engineering, Waseda University, Shinjuku-ku, Tokyo 162-8480, Japan
| | - Yu Tahara
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-0037, Japan
| | - Takahiko Suiko
- Research and Development Headquarters, Lion Corporation, Edogawa, Tokyo 132-0035, Japan
| | - Yuki Nagamori
- Research and Development Headquarters, Lion Corporation, Edogawa, Tokyo 132-0035, Japan
| | - Shigenobu Shibata
- Laboratory of Physiology and Pharmacology, School of Advanced Science and Engineering, Waseda University, Shinjuku-ku, Tokyo 162-8480, Japan
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Kuurdor EDM, Tanaka H, Kitajima T, Amexo JX, Sokejima S. Social Capital and Self-Rated Health: A Cross-Sectional Study among Rural Japanese Working Residents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14018. [PMID: 36360898 PMCID: PMC9658323 DOI: 10.3390/ijerph192114018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 10/19/2022] [Accepted: 10/25/2022] [Indexed: 06/16/2023]
Abstract
Social capital is positively associated with self-rated health; however, this association among workers is still unclear. Thus, this study examined the relationship between social capital and self-rated health with special attention to the employment type. A cross-sectional survey was conducted with 6160 workers aged 20-64 years from two towns in Mie Prefecture in January-March 2013. Social capital was assessed using five items in 4816 income-earning workers. The social capital scores were summed and then divided into three groups. The self-rated health responses were dichotomised into 'poor' and 'good'. The association was examined using a stepwise binomial logistic regression stratified by employment type and adjusted for potential confounders. Regular employees with low social capital had a higher significant odds ratio of poor self-rated health than medium (OR 0.58 95% CIs 0.39-0.87) and high (OR 0.39; 95% CIs 0.26-0.59) social capital levels after controlling for all potential confounders. Similar patterns were observed for non-regular employees with medium and high social capital. There was a significant relationship between some indicators of social capital and poor self-rated health among self-employees. These results highlight that social capital acts as an unequal health resource for different types of workers.
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Affiliation(s)
- Elijah Deku-Mwin Kuurdor
- Department of Public Health and Occupational Medicine, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu-shi 514-8507, Japan
| | - Hirokazu Tanaka
- Division of Surveillance and Policy Evaluation, Institute for Cancer Control, National Cancer Center, 5-1-1, Tsukuji, Chuo-ku, Tokyo 104-0045, Japan
| | - Takumi Kitajima
- Department of Public Health and Occupational Medicine, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu-shi 514-8507, Japan
| | - Jennifer Xolali Amexo
- Department of Public Health and Occupational Medicine, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu-shi 514-8507, Japan
- Department of Clinical Research, National Hospital Organization, Mie National Hospital, Tsu-shi 514-0125, Japan
| | - Shigeru Sokejima
- Department of Public Health and Occupational Medicine, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu-shi 514-8507, Japan
- Epidemiology Centre for Disease Control and Prevention, Mie University Hospital, Tsu-shi 514-8507, Japan
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Gong WJ, Fong DYT, Wang MP, Lam TH, Chung TWH, Ho SY. Worsening trends in self-rated health and correlates in Chinese adolescents in Hong Kong: a population-based panel study from 1999/2000 to 2014/15. BMJ Open 2022; 12:e055842. [PMID: 35165111 PMCID: PMC8845170 DOI: 10.1136/bmjopen-2021-055842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES To examine the 15-year secular trends of self-rated health (SRH) and correlates in Chinese adolescents in Hong Kong. DESIGN A territory-wide population-based panel data study. SETTING Anonymised records of the annual health examination from the Student Health Service, Department of Health in Hong Kong. PARTICIPANTS 397 324 students in Secondary 2 (US grade 8), 335 902 in Secondary 4 and 113 892 in Secondary 6 during the academic year 1999/2000 and 2014/15. OUTCOME MEASURES SRH and lifestyles were self-reported using standardised questionnaires. Sex-standardised and age-standardised prevalence of very poor/poor SRH and its secular annual changes across sex, grade, weight status, breakfast habits, and frequency/duration of aerobic exercises were examined. Their disparities over time were examined by interactions with the academic year in generalised estimating equations. RESULTS The overall prevalence of very poor/poor SRH increased from 9.3% (95% CI: 8.9% to 9.7%) in 1999/2000 to 15.5% (15.1% to 15.8%) in 2014/15. Very poor/poor SRH was more prevalent in girls (adjusted OR: 1.02), in those having unemployed parents (1.29), being overweight (1.42) or obese (2.62), eating breakfast away from home (1.27) and skipping breakfast (1.49) or doing <1 time/week or ≤60 min/week aerobic exercises (1.78 and 1.88, respectively) than others. The corresponding disparities increased over time (ratios of OR: 1.006-1.042). CONCLUSIONS Increasing prevalence of very poor/poor SRH from 1999/2000 to 2014/15 was found among Hong Kong Chinese adolescents, which was greater in girls, adolescents being overweight/obese and those having unemployed parents or unhealthy lifestyles. Strategies to reduce health inequality should consider multiple factors, especially modifiable factors including lifestyles.
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Affiliation(s)
- Wei Jie Gong
- School of Nursing, The University of Hong Kong, Hong Kong SAR, China
- School of Public Health, The University of Hong Kong, Hong Kong SAR, China
| | | | - Man Ping Wang
- School of Nursing, The University of Hong Kong, Hong Kong SAR, China
| | - Tai Hing Lam
- School of Public Health, The University of Hong Kong, Hong Kong SAR, China
| | | | - Sai Yin Ho
- School of Public Health, The University of Hong Kong, Hong Kong SAR, China
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Vélez-Toral M, Morales-Domínguez Z, Granado-Alcón MDC, Díaz-Milanés D, Andrés-Villas M. Mediterranean Diet, Psychological Adjustment and Health Perception in University Students: The Mediating Effect of Healthy and Unhealthy Food Groups. Nutrients 2021; 13:3769. [PMID: 34836022 PMCID: PMC8621952 DOI: 10.3390/nu13113769] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 10/21/2021] [Accepted: 10/23/2021] [Indexed: 01/07/2023] Open
Abstract
This study aims to identify the relationships between eating habits and psychological adjustment and health perception, and to analyze potential mediating role of healthy and unhealthy foods in the relationship between adherence to the Mediterranean diet (MedDiet) and the psychological constructs and health perception. The sample was selected through stratified random cluster sampling and was composed of 788 university students. The participants responded to a MedDiet adherence screener and food consumption inventory to assess the eating habits, instruments measuring self-esteem, life satisfaction, curiosity and sense of coherence to assess the psychological adjustment, and single item measuring perceived health. The results revealed 41.9% of the participants had a high consumption of vegetables and 85.1% a low consumption of energy drinks, while 29.9% showed a high adherence to the MedDiet which was positively associated to each psychological variable and healthy foods and negatively with unhealthy foods. In conclusion, a higher adherence to the MedDiet, and the consumption of fruits and vegetables is related to higher psychological adjustment and health perception. However, the relationships between MedDiet and the psychological variables and health perception were fully or partially explained because of the consumption of healthy and unhealthy foods.
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Affiliation(s)
- Mercedes Vélez-Toral
- Department of Social, Developmental and Educational Psychology, University of Huelva, 21007 Huelva, Spain; (M.V.-T.); (M.A.-V.)
| | - Zaira Morales-Domínguez
- Department of Clinical and Experimental Psychology, University of Huelva, 21007 Huelva, Spain;
| | - María del Carmen Granado-Alcón
- Department of Social, Developmental and Educational Psychology, University of Huelva, 21007 Huelva, Spain; (M.V.-T.); (M.A.-V.)
| | - Diego Díaz-Milanés
- Department of Psychology, Universidad Loyola Andalucía, 41704 Sevilla, Spain
| | - Montserrat Andrés-Villas
- Department of Social, Developmental and Educational Psychology, University of Huelva, 21007 Huelva, Spain; (M.V.-T.); (M.A.-V.)
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Kim Y, Lee H, Lee M, Lee H, Kim S, Konlan KD. The Sequential Mediating Effects of Dietary Behavior and Perceived Stress on the Relationship between Subjective Socioeconomic Status and Multicultural Adolescent Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073604. [PMID: 33807255 PMCID: PMC8038059 DOI: 10.3390/ijerph18073604] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 03/25/2021] [Accepted: 03/25/2021] [Indexed: 11/25/2022]
Abstract
Studies have examined the impact of social determinants of health on the health behaviors and health statuses of ethnic minority adolescents. This study examines the subjective health of this population by examining the direct effects of multicultural adolescents’ subjective socioeconomic status (SES) and the sequential mediating effects of their dietary behaviors and perceived stress. We utilized secondary data of 500 middle school students from multicultural families who participated in the 15th Korean Youth Health Behavior Survey, 2019. Information about SES, perceived stress, subjective health status, and dietary behavior (measured by the breakfast intake frequency during the prior week) were utilized. For the relationship between the SES and the subjective health status, we confirmed the sequential mediating effects of breakfast frequency and perceived stress using SPSS 25.0 and PROCESS macro with bootstrapping. The results showed that SES had a direct effect on subjective health status and indirectly influenced subjective health status through the sequential mediating effect of breakfast frequency and perceived stress. However, SES had no direct effects on perceived stress. These findings emphasize that broadening the community-health lens to consider the upstream factor of SES when preparing health promotion interventions is essential to achieving health equity for vulnerable populations.
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Affiliation(s)
- Youlim Kim
- Mo-Im Kim Nursing Research Institute, College of Nursing and Brain Korea 21 FOUR Project, Yonsei University, Seoul 03722, Korea; (Y.K.); (M.L.); (H.L.)
| | - Hyeonkyeong Lee
- Mo-Im Kim Nursing Research Institute, College of Nursing and Brain Korea 21 FOUR Project, Yonsei University, Seoul 03722, Korea; (Y.K.); (M.L.); (H.L.)
- Correspondence: ; Tel.: +82-2-2228-3373
| | - Mikyung Lee
- Mo-Im Kim Nursing Research Institute, College of Nursing and Brain Korea 21 FOUR Project, Yonsei University, Seoul 03722, Korea; (Y.K.); (M.L.); (H.L.)
| | - Hyeyeon Lee
- Mo-Im Kim Nursing Research Institute, College of Nursing and Brain Korea 21 FOUR Project, Yonsei University, Seoul 03722, Korea; (Y.K.); (M.L.); (H.L.)
| | - Sookyung Kim
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul 03722, Korea; (S.K.); (K.D.K.)
| | - Kennedy Diema Konlan
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul 03722, Korea; (S.K.); (K.D.K.)
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Do TV viewing and frequency of ultra-processed food consumption share mediators in relation to adolescent anxiety-induced sleep disturbance? Public Health Nutr 2021; 24:5491-5497. [PMID: 33500011 DOI: 10.1017/s1368980021000379] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To investigate the role of potential shared mediators in the association of TV viewing and frequency of ultra-processed food consumption with anxiety-induced sleep disturbance. DESIGN Cross-sectional study. SETTING Data from the Adolescent School-Based Health Survey, a Brazilian nationally representative survey of ninth-grade adolescents conducted in 2015, were used. PARTICIPANTS 99 791 adolescents (52 015 girls) with a mean age of 14·3 years (range 11-19) participated. All variables were collected through a self-reported questionnaire based on the Global School-Based Student Health Survey. Anxiety-induced sleep disturbance was the outcome. Over 4 h/d of TV viewing and daily consumption of ultra-processed foods were the exposures. Body satisfaction, loneliness, self-rated health and eating while watching TV or studying were mediators. Age, ethnicity, food insecurity, type of city (capital or interior), country region and physical activity were covariates. Logistic regression and mediation models (Karlsson-Holm-Breen method) assessed associations. RESULTS Both daily ultra-processed food consumption (boys: OR 1·48, 95 % CI 1·30, 1·70; girls: OR 1·46, 95 % CI 1·34, 1·60) and TV viewing (boys: OR 1 24, 95 % CI 1·08, 1·43; girls: OR 1·09, 95 % CI 1·00, 1·19) were associated with higher odds for anxiety-induced sleep disturbance. Loneliness and eating while watching TV or studying (only among girls) consistently mediated the association of both daily ultra-processed food consumption (loneliness: boys 17·4 %, girls 23·4 %; eat while watching TV or studying: girls 6·8 %) and TV viewing (loneliness: boys 22·9 %, girls 45·8 %; eat while watching TV or studying: boys 6·7 %, girls 17·9 %) with anxiety-induced sleep disturbance. CONCLUSIONS Daily ultra-processed food consumption and TV viewing share mediators and can act in synergic mechanisms in the association with anxiety-induced sleep disturbance. Therefore, future interventions should focus in the reduction of both behaviours in combination.
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Convenience Store Use and the Health of Urban Adolescents in Seoul, South Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186486. [PMID: 32899954 PMCID: PMC7558625 DOI: 10.3390/ijerph17186486] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 08/27/2020] [Accepted: 09/04/2020] [Indexed: 11/17/2022]
Abstract
To improve urban adolescents' dietary behaviors and health, factors that influence them to buy meals in convenience stores with regard to urban food environments must be determined. This study investigated the factors which influence adolescents' substitution of meals with convenience store meals and its impact on their health in Seoul (South Korea). Multilevel analysis and logistic regression analysis were conducted using data from the Korea Youth Risk Behavior Survey, a national health survey with a representative sample of Korean adolescents. Among 17,624 teenagers who responded to surveys in 2017 and 2019, 30.5% of them substituted meals with convenience store meals more than three times a week. Girls and students with a lower family economic level were more likely to frequently consume food from convenience stores. Unhealthy lifestyles and poor mental health status also influenced their decisions to substitute meals with convenience store food. Those who frequently consumed meals from convenience stores were more likely to have unhealthy lifestyles, featuring bad diets, smoking, drinking, and sedentary behaviors. They also reported significantly poorer self-rated health and mental health. To promote healthy lifestyles among adolescents, efforts to raise awareness and develop supportive environments for healthy diets are strongly recommended.
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Jodkowska M, Oblacińska A, Dzielska A, Nałęcz H, Fijałkowska A. Behavioural factors as predictors of self-rated health among polish adolescent girls. DEVELOPMENTAL PERIOD MEDICINE 2019. [PMID: 31280247 PMCID: PMC8522370 DOI: 10.34763/devperiodmed.20192302.109116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Introduction: Self-rated health (SRH), an indicator which is extensively used in population studies, constitutes a measure of health closely linked to morbidity, mortality and overall health status and enjoys popularity in surveys monitoring adolescents. Most studies show that at puberty girls assess their health as worse than boys do, and the difference widens with age. Moreover, puberty is a crucial period for health, since it is the time when health risk behaviours are often initiated or become established. Aim: To analyse the associations between high scores on self-rated health among 15-year-old girls, participants of the Healthy Me programme, and their selected health behaviours. PATIENTS AND METHODS Material and methods: The study covered a group of 1173 second-grade female students from 48 lower secondary schools located in rural and urban areas of 16 voivodeships all over Poland. The participants answered questions about chronic diseases or disability, self-rated health, diet, leisure activities, physical activity and health risk behaviours. In the statistical analysis, the association between self-rated health and individual indicators of health behaviour was examined using logistic regression. RESULTS Results: Two thirds of the girls assessed their health as excellent or good. Only approximately 5% of the respondents made the "extreme negative" assessment. In the final multivariate analysis, five factors remained important predictors of high self-rated health scores: regular participation in physical education classes, vigorous physical activity, daily breakfast consumption, consumption of fruit at least once a day and sleep for at least 8 hours a day. CONCLUSION Conclusions: Regular participation in physical education classes, vigorous physical activity, consumption of breakfast and fruit every day, as well as sleep for at least 8 hours a day are powerful predictors of high scores on self-rated health of 15-year-old adolescent girls. Public health activities aimed at adolescents should focus on the positive aspects of health and a lifestyle paying special attention on pro health behaviours.
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Affiliation(s)
- Maria Jodkowska
- Department of Child and Adolescent Health, Institute of Mother and Child, Warsaw, Poland,Maria Jodkowska Zakład Zdrowia Dzieci i Młodzieży Instytut Matki i Dziecka ul. Kasprzaka 17 A, Warszawa, 01-211 tel: 22 32 77 410
| | - Anna Oblacińska
- Department of Child and Adolescent Health, Institute of Mother and Child, Warsaw, Poland
| | - Anna Dzielska
- Department of Child and Adolescent Health, Institute of Mother and Child, Warsaw, Poland
| | - Hanna Nałęcz
- Department of Child and Adolescent Health, Institute of Mother and Child, Warsaw, Poland,Maria Jodkowska Zakład Zdrowia Dzieci i Młodzieży Instytut Matki i Dziecka ul. Kasprzaka 17 A, Warszawa, 01-211 tel: 22 32 77 410
| | - Anna Fijałkowska
- Department of Cardiology, Institute of Mother and Child, Warsaw, Poland
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