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Larruy-García A, Mahmood L, Miguel-Berges ML, Masip G, Seral-Cortés M, De Miguel-Etayo P, Moreno LA. Diet Quality Scores, Obesity and Metabolic Syndrome in Children and Adolescents: A Systematic Review and Meta-Analysis. Curr Obes Rep 2024:10.1007/s13679-024-00589-6. [PMID: 39331350 DOI: 10.1007/s13679-024-00589-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/05/2024] [Indexed: 09/28/2024]
Abstract
PURPOSE OF REVIEW We aimed to examine the relationship between various diet quality scores and obesity and Metabolic Syndrome (MetS) in children and adolescents. RECENT FINDINGS Obesity and MetS, which increase the risk of type 2 diabetes and cardiovascular disease from childhood through adolescence, have been associated with adherence to various diet quality scores. A systematic search was performed in PubMed/Medline, Scopus, SciELO, Embase, and Cochrane, covering the period until March 2024. Two researchers evaluated 3,519 studies according to the inclusion criteria. Finally, 73 articles that analysed the relationship between diet quality scores and obesity and MetS were included, and 6 of them were included in a meta-analysis. Children younger than 12 years old showed statistically significant differences indicating a higher Mediterranean diet (MD) score adherence compared to those with a low score adherence for BMI (MD = 0.33 kg/m2, 95% CI: 0.01, 0.64) and WC values (MD = 1.21 cm, 95% CI: 0.50, 1.93). Additionally, in the meta-regression analysis, boys showed stronger associations for BMI, z-score BMI and WC (β = 19.82, 95% CI: 17.62, 22.03, β = 0.64, 95% CI: 0.33, 0.96 and β = 67.03, 95% CI: 57.29, 76.77, respectively). Studies in this review suggest an association between high adherence to different diet quality scores and low BMI. Meta-analysis assessing the association between adherence to the MD and BMI, and WC, showed a protective effect of the MD pattern against obesity outcomes. This systematic review and meta-analyses provided evidence on the effect of the diet quality on obesity and MetS in children and adolescents.
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Affiliation(s)
- Alicia Larruy-García
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Instituto Agroalimentario de Aragón (IA2), Physiatry and Nursing Department, Faculty of Health Sciences, Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Universidad de Zaragoza, Pedro Cerbuna Street, 50009, Zaragoza, Spain
| | - Lubna Mahmood
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Instituto Agroalimentario de Aragón (IA2), Physiatry and Nursing Department, Faculty of Health Sciences, Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Universidad de Zaragoza, Pedro Cerbuna Street, 50009, Zaragoza, Spain
| | - María L Miguel-Berges
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Instituto Agroalimentario de Aragón (IA2), Physiatry and Nursing Department, Faculty of Health Sciences, Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Universidad de Zaragoza, Pedro Cerbuna Street, 50009, Zaragoza, Spain
- CIBER. Fisiopatología de La Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Guiomar Masip
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Instituto Agroalimentario de Aragón (IA2), Physiatry and Nursing Department, Faculty of Health Sciences, Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Universidad de Zaragoza, Pedro Cerbuna Street, 50009, Zaragoza, Spain
| | - Miguel Seral-Cortés
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Instituto Agroalimentario de Aragón (IA2), Physiatry and Nursing Department, Faculty of Health Sciences, Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Universidad de Zaragoza, Pedro Cerbuna Street, 50009, Zaragoza, Spain
- CIBER. Fisiopatología de La Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Pilar De Miguel-Etayo
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Instituto Agroalimentario de Aragón (IA2), Physiatry and Nursing Department, Faculty of Health Sciences, Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Universidad de Zaragoza, Pedro Cerbuna Street, 50009, Zaragoza, Spain.
- CIBER. Fisiopatología de La Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.
| | - Luis A Moreno
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Instituto Agroalimentario de Aragón (IA2), Physiatry and Nursing Department, Faculty of Health Sciences, Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Universidad de Zaragoza, Pedro Cerbuna Street, 50009, Zaragoza, Spain
- CIBER. Fisiopatología de La Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
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Hodder RK, O'Brien KM, Wyse RJ, Tzelepis F, Yoong S, Stacey FG, Wolfenden L. Interventions for increasing fruit and vegetable consumption in children aged five years and under. Cochrane Database Syst Rev 2024; 9:CD008552. [PMID: 39312396 PMCID: PMC11418976 DOI: 10.1002/14651858.cd008552.pub8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/25/2024]
Abstract
BACKGROUND Insufficient consumption of fruits and vegetables in childhood increases the risk of future non-communicable diseases, including cardiovascular disease. Testing the effects of interventions designed to increase children's consumption of fruit and vegetables, including those focused on specific child-feeding strategies or broader multicomponent interventions targeting the home or childcare environment, is required to assess the potential to reduce this disease burden. OBJECTIVES To assess the benefits and harms of interventions designed to increase the consumption of fruit, vegetables or both amongst children aged five years and under. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase and two clinical trials registries to identify eligible trials on 25 March 2023. We searched Proquest Dissertations and Theses in December 2022. We reviewed reference lists of included trials and contacted authors of the included trials to identify further potentially relevant trials. SELECTION CRITERIA We included randomised controlled trials (RCTs), including cluster-randomised controlled trials (C-RCTs) and cross-over trials, of any intervention primarily targeting consumption of fruit, vegetables or both amongst children aged five years and under compared to no-intervention control, and incorporating a dietary or biochemical assessment of fruit or vegetable consumption. Two review authors independently screened titles and abstracts of identified papers; a third review author resolved disagreements. DATA COLLECTION AND ANALYSIS Two review authors independently extracted data and assessed the risks of bias of included trials; a third review author resolved disagreements. We used random-effects models in meta-analyses for the primary review outcomes where we identified sufficient trials. We calculated standardised mean differences (SMDs) to account for the heterogeneity of fruit and vegetable consumption measures. We conducted assessments of risks of bias and evaluated the certainty of evidence (GRADE approach) using Cochrane procedures. MAIN RESULTS We included 53 trials with 120 trial arms and 12,350 participants. Sixteen trials examined the impact of child-feeding practice interventions only (e.g. repeated food exposure) in increasing child vegetable intake. Twenty trials examined the impact of multicomponent interventions primarily conducted in the childcare setting (e.g. parent nutrition education and preschool policy changes) in increasing child fruit and vegetable intake. Seventeen trials examined the impact of parent nutrition education only in increasing child fruit and vegetable intake. Two trials examined the effect of a nutrition education intervention delivered to children only in increasing child fruit and vegetable intake and one each examined a child-focused mindfulness intervention or providing families with fruit and vegetable interventions. We judged nine of the 53 included trials as free from high risks of bias across all domains. Performance, detection and attrition bias were the most common domains judged at high risk of bias for the remaining trials. There is moderate-certainty evidence that child-feeding practice interventions versus no-intervention control probably have a small positive effect on child vegetable consumption, equivalent to an increase of 15.5 grams as-desired consumption of vegetables (SMD 0.44, 95% confidence interval (CI) 0.24 to 0.65; 15 trials, 1976 participants; mean post-intervention follow-up = 12.3 weeks). No trials in this comparison reported information about intervention costs. One trial reported no harms or serious unintended adverse consequences (low-certainty evidence). Multicomponent interventions versus no-intervention control probably have a small effect on child consumption of fruit and vegetables (SMD 0.27, 95% CI 0.11 to 0.43; 14 trials, 4318 participants; moderate-certainty evidence; mean post-intervention follow-up = 4.0 weeks), equivalent to an increase of 0.34 cups of fruit and vegetables a day. One trial, which tested a multicomponent garden-based intervention, reported the installation of the garden as part of the intervention to be USD 1500 per childcare centre (low-certainty evidence). No trials in this comparison reported information about unintended adverse consequences of interventions. Parent nutrition education interventions may have little to no short-term impact on child consumption of fruit and vegetables versus no-intervention control (SMD 0.10, 95% CI -0.02 to 0.22; 14 trials, 4122 participants; low-certainty evidence; mean post-intervention follow-up = 6.4 weeks). One trial reported the total estimated cost of delivering a parent nutrition education intervention for infant feeding, physical activity and sedentary behaviours delivered by a dietitian as approximately AUD 500 per family (low-certainty evidence). One trial reported no unintended adverse consequences on family food expenditure following implementation of an intervention delivered over the telephone to improve parental knowledge and skills about the home food environment (low-certainty evidence). Trials reported receiving governmental or charitable funds, except for one trial reporting industry funding. AUTHORS' CONCLUSIONS There was moderate-certainty evidence that child-feeding practice interventions and multicomponent interventions probably lead to only small increases in fruit and vegetable consumption in children aged five years and under. Parent nutrition education interventions may have little or no effect on increasing fruit and vegetable consumption in children aged five years and under. Future research should be prioritised on assessment and reporting of both intervention cost and adverse effects, and development and evaluation of interventions in research gaps, including in a broader range of settings and in low- and middle-income countries. This review continues to be maintained as a living systematic review with monthly searches for new evidence and incorporation of relevant new evidence as it becomes available. Please refer to the Cochrane Database of Systematic Reviews for the current status of this review.
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Affiliation(s)
- Rebecca K Hodder
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- School of Medicine and Public Health, The University of Newcastle, Callaghan, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton, Australia
- National Centre of Implementation Science, The University of Newcastle, Callaghan, Australia
| | - Kate M O'Brien
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- School of Medicine and Public Health, The University of Newcastle, Callaghan, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton, Australia
- National Centre of Implementation Science, The University of Newcastle, Callaghan, Australia
| | - Rebecca J Wyse
- School of Medicine and Public Health, The University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
| | - Flora Tzelepis
- School of Medicine and Public Health, The University of Newcastle, Callaghan, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton, Australia
| | - Serene Yoong
- National Centre of Implementation Science, The University of Newcastle, Callaghan, Australia
- Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, Deakin University, Melbourne, Australia
| | - Fiona G Stacey
- School of Medicine and Public Health, The University of Newcastle, Callaghan, Australia
| | - Luke Wolfenden
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- School of Medicine and Public Health, The University of Newcastle, Callaghan, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton, Australia
- National Centre of Implementation Science, The University of Newcastle, Callaghan, Australia
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Grosso G, Buso P, Mata A, Abdelkarim O, Aly M, Pinilla J, Fernandez A, Mendez R, Alvarez A, Valdes N, Carretero Martinez A, Vieira E Sousa F, Mauriello G, Pistolese S, Beaino A, McEwen CM, Pons J, Vázquez-Araújo L. Understanding consumer food choices & promotion of healthy and sustainable Mediterranean diet and lifestyle in children and adolescents through behavioural change actions: the DELICIOUS project. Int J Food Sci Nutr 2024; 75:527-535. [PMID: 38797529 DOI: 10.1080/09637486.2024.2353065] [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: 02/02/2024] [Revised: 04/15/2024] [Accepted: 05/03/2024] [Indexed: 05/29/2024]
Abstract
Over the last decades, the abandonment of traditional dietary patterns, such as the Mediterranean diet, represents an important threat for human health and environmental safeguard. The DELICIOUS project aims to promote healthy lifestyles among children and adolescents by implementing activities and tools to increase the adherence to the Mediterranean Diet with an attention to the environmental impacts of the diet. This study protocol describes the DELICIOUS project as a single-arm, uncontrolled behavioural intervention providing formal and non-formal education activities, development of new snacks and recipe reformulation, web/mobile app development, and physical activities to school children and adolescents in five European countries. The project aims to increase awareness of the nutritional benefits and the sustainability aspects of the Mediterranean Diet and to promote consumers' empowerment through an online platform for sustainable and healthy meal planning in the school canteen.
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Affiliation(s)
- Giuseppe Grosso
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
- Center for Human Nutrition and Mediterranean Foods (NUTREA), University of Catania, Catania, Italy
| | - Pablo Buso
- AIJU, Technological Institute for children's products & leisure, Alicante, Spain
| | - Ana Mata
- AIJU, Technological Institute for children's products & leisure, Alicante, Spain
| | | | - Mohamed Aly
- Faculty of Physical Education, Assiut University, Assiut, Egypt
| | | | | | | | | | | | | | | | - Gianluca Mauriello
- Provincia d'Italia dei Fratelli Maristi delle Scuole, Giugliano in Campania, Italy
| | - Sara Pistolese
- Provincia d'Italia dei Fratelli Maristi delle Scuole, Giugliano in Campania, Italy
| | | | | | - Juancho Pons
- Editorial Luis Vives (EDELVIVES), Zaragoza, Spain
| | - Laura Vázquez-Araújo
- BCC Innovation, Technology Center in Gastronomy, Basque Culinary Center, Donostia-San Sebastián, Spain
- Basque Culinary Center, Faculty of Gastronomic Sciences, Mondragon Unibertsitatea, Donostia-San Sebastián, Spain
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López-Gil JF, Victoria-Montesinos D, García-Hermoso A. Effects of lifestyle-based interventions to improve Mediterranean diet adherence among the young population: a meta-analysis of randomized controlled trials. Nutr Rev 2024; 82:849-860. [PMID: 37672008 DOI: 10.1093/nutrit/nuad107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/07/2023] Open
Abstract
CONTEXT Despite the large number of studies published to date, the effect of lifestyle-based interventions on improving adherence to the Mediterranean diet (MedDiet) in young people has not been meta-analyzed. OBJECTIVE The aim of the present systematic review and meta-analysis was two-fold: (1) to determine the pooled intervention effects of lifestyle-based interventions on improving adherence to the MedDiet in a young population aged 3 years-18 years and (2) to examine the potential factors related to those intervention effects. DATA SOURCES A systematic search of the MEDLINE (via PubMed), Scopus, Cochrane Library, and Web of Science databases was performed from their inception until June 15, 2023. DATA EXTRACTION Different meta-analyses were independently performed to observe the effect of lifestyle-based interventions on adherence to the MedDiet (according to the Mediterranean Diet Quality Index in children and adolescents [KIDMED]). DATA ANALYSIS Compared with the control group, the intervention group showed a small increase in KIDMED score (d = .27; 95% confidence interval [CI], .11 to .43; P < .001; I2 = 89.7%). Similarly, participants in the lifestyle-based intervention groups had a 14% higher probability of achieving optimal adherence to the MedDiet (risk difference = .14; 95% CI, .02 to .26; P = .023; I2 = 96.8%). Greater improvements in achieving optimal adherence to the MedDiet were found in interventions delivered out of school (risk difference = .24, 95% CI, .04 to .44; I2 = 88.4%), those aimed at parents or at both children and parents (risk difference = .20, 95% CI, .07 to .34; I2 = 98.2%), and those including only participants with overweight/obesity (risk difference = .34, 95% CI, .15 to .52; I2 = .0%). CONCLUSION Healthy lifestyle-based interventions seem to be effective in increasing adherence to the MedDiet and in achieving optimal adherence to this dietary pattern among children and adolescents. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD2022369409.
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Affiliation(s)
- José Francisco López-Gil
- Navarrabiomed, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona (Navarra), Spain
- Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston (Massachusetts), USA
- One Health Research Group, Universidad de Las Américas, Quito, Ecuador
| | | | - Antonio García-Hermoso
- Navarrabiomed, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona (Navarra), Spain
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Vázquez-Bolea N, Andueza N, Cuervo M, Navas-Carretero S. A Higher Adherence to the ALINFA Nutritional Intervention Is Effective for Improving Dietary Patterns in Children. CHILDREN (BASEL, SWITZERLAND) 2024; 11:559. [PMID: 38790554 PMCID: PMC11120244 DOI: 10.3390/children11050559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 04/30/2024] [Accepted: 05/06/2024] [Indexed: 05/26/2024]
Abstract
Food patterns are deteriorating and, consequently, not meeting nutritional recommendations. Learning about the adherence to a diet is crucial for understanding children's dietary habits. The objective of the present analysis was to assess the degree of compliance with the ALINFA nutritional intervention and the effectiveness of adherence groups, and to evaluate potential baseline factors predicting a higher adherence to the intervention. A total of 44 children aged 6 to 12 years-old participated in the eight-week intervention. A two-week dietary plan was specifically designed, providing participants with food products, ready-to-eat dishes, and recipes. An intake of 75% of calories of the prescribed diet was defined to divide the participants into high- and low-adherence groups (HA/LA, respectively). From the 44 participants, 24 showed a LA to the intervention, whereas 20 of them were in the HA group. Diet quality improved in both groups (p < 0.001), mainly by increasing cereals and nuts, and reducing pastries. A decrease in BMI z-score was observed (LA: p < 0.001; HA: p = 0.021). Fat mass (p = 0.002), LDL-c (p = 0.036), and CRP (p = 0.023) reductions were only achieved in the HA group, whereas leptin decreased only in the LA group (p = 0.046). All participants ameliorated their dietary habits, but those with better diet quality at baseline experienced greater enhancements in their nutritional status.
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Affiliation(s)
- Natalia Vázquez-Bolea
- Department of Nutrition, Food Sciences and Physiology, Faculty of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain; (N.V.-B.); (N.A.); (S.N.-C.)
- Center for Nutrition Research, University of Navarra, 31008 Pamplona, Spain
| | - Naroa Andueza
- Department of Nutrition, Food Sciences and Physiology, Faculty of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain; (N.V.-B.); (N.A.); (S.N.-C.)
- Center for Nutrition Research, University of Navarra, 31008 Pamplona, Spain
| | - Marta Cuervo
- Department of Nutrition, Food Sciences and Physiology, Faculty of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain; (N.V.-B.); (N.A.); (S.N.-C.)
- Center for Nutrition Research, University of Navarra, 31008 Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain
| | - Santiago Navas-Carretero
- Department of Nutrition, Food Sciences and Physiology, Faculty of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain; (N.V.-B.); (N.A.); (S.N.-C.)
- Center for Nutrition Research, University of Navarra, 31008 Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain
- Biomedical Research Networking Center for Physiopathology of Obesity and Nutrition (CIBERObn), Institute of Health Carlos III, 28029 Madrid, Spain
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Díaz-López A, Rodríguez Espelt L, Abajo S, Arija V. Close Adherence to a Mediterranean Diet during Pregnancy Decreases Childhood Overweight/Obesity: A Prospective Study. Nutrients 2024; 16:532. [PMID: 38398856 PMCID: PMC10892739 DOI: 10.3390/nu16040532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 02/12/2024] [Accepted: 02/13/2024] [Indexed: 02/25/2024] Open
Abstract
The study of dietary patterns during pregnancy may be of great importance for determining the potential risk of obesity in childhood. We assessed the prospective association between maternal adherence to the Mediterranean diet (MedDiet) during pregnancy and risk of childhood overweight/obesity at 4 years. This prospective analysis involved 272 mother-child pairs from the ECLIPSES study. Maternal diet during pregnancy was assessed using a validated 45-item food-frequency questionnaire and a relative whole-pregnancy MedDiet score (rMedDiet) was calculated. The children's weight and height were measured at the age of 4. Primary outcome was childhood overweight/obesity based on age- and-sex-specific BMI z-score > 85th percentile using the WHO child growth standards. Mean maternal rMedDiet score in pregnancy was 9.8 (±standard deviation 2.3) and 25.7% of the children were overweight/obese. Significant differences in anthropometric measurements (weight, height, and BMI) were found according to sex, with higher scores for boys. After controlling for potential confounders, greater maternal adherence to rMedDiet during pregnancy was associated with a lower risk of childhood overweight/obesity, highest vs. lowest quartile (OR = 0.34, 95% CI: 0.12-0.90; p-trend 0.037). Similar trends regarding this association (per 1-point increase rMedDiet score) were observed after stratification by advanced maternal age, maternal early pregnancy BMI, education, socioeconomic status, smoking, and gestational weight gain. Our findings suggest that closer adherence to the MedDiet during pregnancy may protect against the risk of offspring overweight/obesity at 4 years. Further research is needed to explore whether associations persist across the life course.
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Affiliation(s)
- Andrés Díaz-López
- Nutrition and Mental Health (NUTRISAM) Research Group, Universitat Rovira i Virgili (URV), 43204 Reus, Spain; (A.D.-L.); (L.R.E.)
- Institut d’Investigació Sanitària Pere Virgili (IISPV), 43005 Tarragona, Spain
| | - Laura Rodríguez Espelt
- Nutrition and Mental Health (NUTRISAM) Research Group, Universitat Rovira i Virgili (URV), 43204 Reus, Spain; (A.D.-L.); (L.R.E.)
| | - Susana Abajo
- Sexual and Reproductive Healthcare Service of Reus-Tarragona, Institut Català de la Salut, Generalitat de Catalunya, 43003 Tarragona, Spain;
- Atención Primaria, Centro de Salud Embajadores, Dirección Asistencial Noroeste, 28012 Madrid, Spain
| | - Victoria Arija
- Nutrition and Mental Health (NUTRISAM) Research Group, Universitat Rovira i Virgili (URV), 43204 Reus, Spain; (A.D.-L.); (L.R.E.)
- Institut d’Investigació Sanitària Pere Virgili (IISPV), 43005 Tarragona, Spain
- Collaborative Group on Lifestyles, Nutrition, and Tobacco (CENIT), Tarragona-Reus Research Support Unit, Jordi Gol Primary Care Research Institute, 43202 Reus, Spain
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Pavlidou E, Papadopoulou SK, Alexatou O, Voulgaridou G, Mentzelou M, Biskanaki F, Psara E, Tsourouflis G, Lefantzis N, Dimoliani S, Apostolou T, Sampani A, Chatziprodromidou IP, Angelakou EP, Giaginis C. Childhood Mediterranean Diet Adherence Is Associated with Lower Prevalence of Childhood Obesity, Specific Sociodemographic, and Lifestyle Factors: A Cross-Sectional Study in Pre-School Children. EPIDEMIOLOGIA 2023; 5:11-28. [PMID: 38247997 PMCID: PMC10801514 DOI: 10.3390/epidemiologia5010002] [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: 11/13/2023] [Revised: 12/05/2023] [Accepted: 12/14/2023] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND The Mediterranean diet (MD) has been related with a decreased probability of overweight/obesity as well as central obesity at all stages of the human life, decreasing the risk of diverse disease states and improving quality of life. Over the last few years, the prevalence of childhood overweight/obesity and especially abdominal obesity has highly increased worldwide, being associated with a higher likelihood of overweight/obesity as well as central obesity at the next stages of the life during adulthood. The purpose of the present study was to explore the relationship of MD compliance with sociodemographic, anthropometry and lifestyle features in pre-school children aged 2-5 years old. METHODS This is a cross-sectional study, which includes 5188 pre-school children from diverse regions of Greece. Relevant questionnaires were applied to evaluate the sociodemographic features of the enrolled children. Anthropometric parameters were measured by relevant techniques. Qualified questionnaires were utilized for assessing several lifestyle factors such as physical activity, quality of life, breastfeeding practices, MD adherence, as well as the prevalence of childhood asthma and diabetes mellitus type I. RESULTS Of the enrolled children, 41.7% showed low MD compliance and 36.4% of them indicated moderated compliance, while only 21.9% of them showed a high MD adherence. Overweight/obesity was noted in 24.2% of the assigned children, while abdominal obesity was noticed in 18.2% of them. Higher MD compliance was related with an elevated prevalence of sex (boys, p = 0.0005), Greek nationality (p = 0.0088), rural type of residence (p = 0.0099), childhood overweight/obesity (p < 0.0001) and abdominal obesity (p < 0.0001), lower childbirth weight (p < 0.0001), increased physical activity (p = 0.0041), improved quality of life (p = 0.0008), exclusive breastfeeding (p < 0.0001), childhood asthma (p = 0.0001) and diabetes mellitus type 1 (p = 0.0002). CONCLUSIONS A higher MD adherence is associated with specific sociodemographic, better anthropometric, and beneficial lifestyle factors in pre-school children. However, MD compliance remains low or moderate in the vast majority of children aged 2-5 years old. Thus, future public strategies and policies should be performed to inform parents of the potential beneficial effects of MD against obesity and related chronic diseases at the next stage of their children's lives.
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Affiliation(s)
- Eleni Pavlidou
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Myrina, Greece; (E.P.); (O.A.); (M.M.); (E.P.); (S.D.); (E.-P.A.)
| | - Sousana K. Papadopoulou
- Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece; (S.K.P.); (G.V.)
| | - Olga Alexatou
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Myrina, Greece; (E.P.); (O.A.); (M.M.); (E.P.); (S.D.); (E.-P.A.)
| | - Gavriela Voulgaridou
- Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece; (S.K.P.); (G.V.)
| | - Maria Mentzelou
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Myrina, Greece; (E.P.); (O.A.); (M.M.); (E.P.); (S.D.); (E.-P.A.)
| | | | - Evmorfia Psara
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Myrina, Greece; (E.P.); (O.A.); (M.M.); (E.P.); (S.D.); (E.-P.A.)
| | - Gerasimos Tsourouflis
- Second Department of Propedeutic Surgery, Medical School, University of Athens, 11527 Athens, Greece;
| | - Nikos Lefantzis
- Department of Oral and Maxillofacial Surgery, Medical School, Attikon Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | - Sophia Dimoliani
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Myrina, Greece; (E.P.); (O.A.); (M.M.); (E.P.); (S.D.); (E.-P.A.)
| | - Thomas Apostolou
- Department of Physiotherapy, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece;
| | - Anastasia Sampani
- First Department of Pathology, Medical School, University of Athens, 11527 Athens, Greece;
| | | | - Exakousti-Petroula Angelakou
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Myrina, Greece; (E.P.); (O.A.); (M.M.); (E.P.); (S.D.); (E.-P.A.)
| | - Constantinos Giaginis
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Myrina, Greece; (E.P.); (O.A.); (M.M.); (E.P.); (S.D.); (E.-P.A.)
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8
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Chan J, Conroy P, Phongsavan P, Raubenheimer D, Allman-Farinelli M. Systems map of interventions to improve dietary intake of pre-school aged children: A scoping review. Prev Med 2023; 177:107727. [PMID: 37848165 DOI: 10.1016/j.ypmed.2023.107727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 10/09/2023] [Accepted: 10/11/2023] [Indexed: 10/19/2023]
Abstract
Implementation and sustaining impact of early childhood nutrition interventions in practice remains a challenge. An understanding of the extent to which determinants across multiple levels of the food system are being addressed may improve success. This literature review aimed to synthesise the evidence on interventions targeting dietary intake and eating behaviours in preschool children using a systems approach. Eligible studies included intervention studies targeting the dietary intake of preschool children aged 2-5 years in high income countries, published in English after January 2000. Interventions were categorised to the Determinants of Nutrition and Eating (DONE) framework for children developed and evaluated by experts across multiple fields. The framework maps and ranks 411 factors driving eating behaviours and nutrition and can be used to systematically summarise determinants. DONE ranks each determinant for its perceived research priority. A total of 160 eligible studies were identified. Most interventions targeted interpersonal (n = 101, 63.1%) and individual (n = 85, 53.1%) level determinants, with fewer targeting environmental (n = 55, 34.4%) and policy level (n = 17, 10.6%) determinants. The most frequently addressed determinants were Parental Resources and Risk Factors (n = 85) and Children's Food Knowledge, Skills and Abilities (n = 67). These determinants had a Moderate research priority rating. Home Food Availability and Accessibility at the environmental level is classified as the highest research priority, however, only 15 of 160 interventions addressed this determinant. This review highlights home food availability and accessibility as potential leverage points for future interventions to improve children's dietary intake and eating behaviours.
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Affiliation(s)
- Jacqueline Chan
- Nutrition and Dietetics Group, Sydney Nursing School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia; Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia.
| | - Patrick Conroy
- Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Philayrath Phongsavan
- Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia; Prevention Research Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - David Raubenheimer
- Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia; School of Life and Environmental Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Margaret Allman-Farinelli
- Nutrition and Dietetics Group, Sydney Nursing School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia; Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
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9
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Capra ME, Monopoli D, Decarolis NM, Giudice A, Stanyevic B, Esposito S, Biasucci G. Dietary Models and Cardiovascular Risk Prevention in Pediatric Patients. Nutrients 2023; 15:3664. [PMID: 37630854 PMCID: PMC10458109 DOI: 10.3390/nu15163664] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 08/08/2023] [Accepted: 08/16/2023] [Indexed: 08/27/2023] Open
Abstract
Nutritional intervention is worldwide recognized as a first step treatment for subjects with increased cardiovascular risk and it is of utmost importance especially for children and adolescents. Currently scientific evidence supports the role of dietary patterns instead of simple single nutrients or foods in cardiovascular risk prevention. Indeed, the American Heart Association dietary guidelines have expanded beyond nutrients to dietary pattern, that comprise not only single food items but also behavioral or cultural habits of specific populations. The aim of our narrative review is to analyze the most frequently adopted dietary patterns in children and adolescents and to evaluate their effect on cardiovascular risk factors and in cardiovascular risk prevention. Literature review showed that children cannot be considered as little adults: nutritional intervention must always grant adequate growth and neurodevelopment before reaching the proposed goals, therefore dietary patterns considered heart-healthy for adult subjects might not be suitable for pediatric patients. Mediterranean diet, DASH diet, Nordic diet and some plant-based diets seem to be the most promising dietary patterns in terms of cardiovascular health in the developmental age, even if further studies are needed to better standardize and analyze their effect on growing up individuals.
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Affiliation(s)
- Maria Elena Capra
- Pediatrics and Neonatology Unit, Guglielmo da Saliceto Hospital, 29121 Piacenza, Italy; (M.E.C.); (G.B.)
- Società Italiana di Nutrizione Pediatrica, 20126 Milan, Italy
| | - Delia Monopoli
- Pediatric Clinic, Department of Medicine and Surgery, University Hospital of Parma, 43126 Parma, Italy; (D.M.); (N.M.D.); (A.G.); (B.S.)
| | - Nicola Mattia Decarolis
- Pediatric Clinic, Department of Medicine and Surgery, University Hospital of Parma, 43126 Parma, Italy; (D.M.); (N.M.D.); (A.G.); (B.S.)
| | - Antonella Giudice
- Pediatric Clinic, Department of Medicine and Surgery, University Hospital of Parma, 43126 Parma, Italy; (D.M.); (N.M.D.); (A.G.); (B.S.)
| | - Brigida Stanyevic
- Pediatric Clinic, Department of Medicine and Surgery, University Hospital of Parma, 43126 Parma, Italy; (D.M.); (N.M.D.); (A.G.); (B.S.)
| | - Susanna Esposito
- Pediatric Clinic, Department of Medicine and Surgery, University Hospital of Parma, 43126 Parma, Italy; (D.M.); (N.M.D.); (A.G.); (B.S.)
| | - Giacomo Biasucci
- Pediatrics and Neonatology Unit, Guglielmo da Saliceto Hospital, 29121 Piacenza, Italy; (M.E.C.); (G.B.)
- Società Italiana di Nutrizione Pediatrica, 20126 Milan, Italy
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
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10
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López-Gil JF, García-Hermoso A, Sotos-Prieto M, Cavero-Redondo I, Martínez-Vizcaíno V, Kales SN. Mediterranean Diet-Based Interventions to Improve Anthropometric and Obesity Indicators in Children and Adolescents: A Systematic Review with Meta-Analysis of Randomized Controlled Trials. Adv Nutr 2023; 14:858-869. [PMID: 37127186 PMCID: PMC10334150 DOI: 10.1016/j.advnut.2023.04.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 04/24/2023] [Accepted: 04/27/2023] [Indexed: 05/03/2023] Open
Abstract
To our knowledge, no systematic review with meta-analysis has separately synthesized the effects of Mediterranean diet-based interventions in children and adolescents in relation to the effects on anthropometric measures. A better understanding of the effects of Mediterranean diet-based interventions on anthropometric variables could facilitate their implementation in efforts to prevent obesity in the young population. The aim of the present meta-analysis was to evaluate the effects of Mediterranean diet-based interventions on anthropometric and obesity indicators among children and adolescents. Four databases were systematically searched (PubMed, Scopus, Web of Science, and Cochrane Database of Systematic Reviews), including all studies up until 15 March, 2023. Eligible articles were randomized controlled trials measuring the effect of an intervention based on the promotion of the Mediterranean diet and obesity-associated parameters. The effect size of each study was estimated by Cohen's d for continuous variables or risk difference for categorical variables. Compared to the control group, the Mediterranean diet-based interventions showed small and significant reductions in body mass index (d = -0.14; 95% CI: -0.26, -0.01; I2 = 77.52%). Participants in the Mediterranean diet-based interventions had a significant reduction in the percentage of obesity (risk difference = 0.12; 95% CI: 0.01, 0.23; I2 = 84.56%) in comparison with the control group. Interventions had greater effects when aiming at participants with excess weight (that is, overweight or obesity), both for body mass index, waist circumference, waist-to-height ratio, percentage of obesity, and percentage of abdominal obesity. Mediterranean diet-based interventions have a significant effect on reducing the body mass index as well as reducing obesity in children and adolescents (aged 3-18 y). This trial was registered at PROSPERO as CRD42023386789.
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Affiliation(s)
- José Francisco López-Gil
- Navarrabiomed, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Navarra, Spain; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States; One Health Research Group, Universidad de Las Américas, Quito, Ecuador.
| | - Antonio García-Hermoso
- Navarrabiomed, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Navarra, Spain
| | - Mercedes Sotos-Prieto
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States; Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), Madrid, Spain; CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain; IMDEA-Food Institute, CEI UAM + CSIC, Madrid, Spain
| | - Iván Cavero-Redondo
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
| | - Vicente Martínez-Vizcaíno
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain; Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca, Chile
| | - Stefanos N Kales
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States
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Andueza N, Martin-Calvo N, Navas-Carretero S, Cuervo M. The ALINFA Intervention Improves Diet Quality and Nutritional Status in Children 6 to 12 Years Old. Nutrients 2023; 15:nu15102375. [PMID: 37242258 DOI: 10.3390/nu15102375] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 05/15/2023] [Accepted: 05/17/2023] [Indexed: 05/28/2023] Open
Abstract
The study aimed to evaluate the efficacy of a new nutritional intervention, focused on improving the quality of the diet in children aged 6 to 12 years. A 2-month parallel, controlled randomized trial was conducted in the Spanish child population. The children were randomized to ALINFA nutritional intervention, which consisted of a normocaloric diet that incorporates products, ready-to-eat meals and healthy recipes specifically designed for the study, or a control group, which received the usual advice on healthy eating. The change in diet quality was assessed through the Kidmed index. The secondary outcomes were anthropometry, glucose and lipid profiles, inflammation markers, dietary intake and lifestyle. The participants in the intervention group showed an increase in the mean score of the Kidmed index (p < 0.001). Alongside that, these children decreased their intake of calories (p = 0.046), and total and saturated fat (p = 0.016//p = 0.011), and increased fiber intake (p < 0.001). Likewise, the children in the ALINFA group increased the intake of white fish (p = 0.001), pulses (p = 0.004), whole grains (p < 0.001) and nuts (p < 0.001), and decreased fatty meat (p = 0.014), refined grain (p = 0.008), pastry (p < 0.001), fast food (p < 0.001) and sugar (p = 0.001) intake. Moreover, these children had a significantly decreased BMI (p < 0.001), BMI z-score (p < 0.001), waist circumference (p = 0.016) and fat mass (p = 0.011), as well as leptin (p = 0.004). Participants in the control group did not report significant changes in diet quality. In conclusion, ALINFA nutritional intervention is possibly a useful strategy to increase the diet quality in children, which is associated to improvements in the nutritional status. These results highlight the importance of developing well-designed nutritional interventions.
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Affiliation(s)
- Naroa Andueza
- Department of Nutrition, Food Sciences and Physiology, Faculty of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain
- Center for Nutrition Research, University of Navarra, 31008 Pamplona, Spain
| | - Nerea Martin-Calvo
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, University Campus, 31008 Pamplona, Spain
- Biomedical Research Networking Center for Physiopathology of Obesity and Nutrition (CIBERObn), Institute of Health Carlos III, 28029 Madrid, Spain
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain
| | - Santiago Navas-Carretero
- Department of Nutrition, Food Sciences and Physiology, Faculty of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain
- Center for Nutrition Research, University of Navarra, 31008 Pamplona, Spain
- Biomedical Research Networking Center for Physiopathology of Obesity and Nutrition (CIBERObn), Institute of Health Carlos III, 28029 Madrid, Spain
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain
| | - Marta Cuervo
- Department of Nutrition, Food Sciences and Physiology, Faculty of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain
- Center for Nutrition Research, University of Navarra, 31008 Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain
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12
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López-Gil JF, García-Hermoso A, Smith L, Gallego A, Victoria-Montesinos D, Ezzatvar Y, Hershey MS, Gutiérrez-Espinoza H, Mesas AE, Jiménez-López E, Sánchez-Miguel PA, López-Benavente A, Moreno-Galarraga L, Chen S, Brazo-Sayavera J, Fernandez-Montero A, Alcaraz PE, Panisello Royo JM, Tárraga-López PJ, Kales SN. A Cluster Randomized Controlled Trial of the Archena Infancia Saludable Project on 24-h Movement Behaviors and Adherence to the Mediterranean Diet among Schoolchildren: A Pilot Study Protocol. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10040738. [PMID: 37189987 DOI: 10.3390/children10040738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 03/14/2023] [Accepted: 03/15/2023] [Indexed: 05/17/2023]
Abstract
Objective: The aim of this paper is to describe the protocol of pilot cluster randomized controlled trial (RCT) that will evaluate the effects of a lifestyle-based intervention. The Archena Infancia Saludable project will have several objectives. The primary objective of this project is to determine the 6-month effects of a lifestyle-based intervention on adherence to 24-h movement behaviors and Mediterranean diet (MedDiet) in schoolchildren. The secondary objective of this project is to test the intervention effects of this lifestyle-based intervention on a relevant set of health-related outcomes (i.e., anthropometric measurements, blood pressure, perceived physical fitness, sleep habits, and academic performance). The tertiary objective is to investigate this intervention's "halo" effect on parents'/guardians' 24-h movement behaviors and adherence to the MedDiet. Methods: The Archena Infancia Saludable trial will be a cluster RCT submitted to the Clinical Trials Registry. The protocol will be developed according to SPIRIT guidelines for RCTs and CONSORT statement extension for cluster RCTs. A total of 153 eligible parents/guardians with schoolchildren aged 6-13 years will be randomized into an intervention group or a control group. This project focuses on two fundamental pillars: 24-h movement behaviors and MedDiet. It will mainly focus on the relationship between parents/guardians and their children. Behavior change strategies for dietary and 24-h movement behaviors in schoolchildren will be based on healthy lifestyle education for parents/guardians through infographics, video recipes, brief video clips, and videos. Conclusions: Most of the current knowledge on 24-h movement behaviors and adherence to the MedDiet is based on cross-sectional or longitudinal cohort studies, warranting a need to design and conduct RCTs to obtain more robust evidence on the effect of a healthy lifestyle program to increase 24-h movement behaviors and to improve adherence to the MedDiet in schoolchildren.
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Affiliation(s)
- José Francisco López-Gil
- Navarrabiomed, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), IdiSNA, 31006 Pamplona, Spain
- Department of Environmental Health, Harvard University T.H. Chan School of Public Health, Boston, MA 02138, USA
- One Health Research Group, Universidad de Las Américas, Quito 170124, Ecuador
| | - Antonio García-Hermoso
- Navarrabiomed, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), IdiSNA, 31006 Pamplona, Spain
| | - Lee Smith
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge CB1 1PT, UK
| | - Alejandra Gallego
- Department of Applied Economics, Faculty of Economics and Business, University of Murcia, 30100 Murcia, Spain
| | | | - Yasmin Ezzatvar
- Department of Nursing, Universitat de València, 46007 Valencia, Spain
| | - Maria S Hershey
- Department of Environmental Health, Harvard University T.H. Chan School of Public Health, Boston, MA 02138, USA
| | | | - Arthur Eumann Mesas
- Health and Social Research Center, Universidad de Castilla-La Mancha (UCLM), 16071 Cuenca, Spain
- Postgraduate Program in Public Health, Universidade Estadual de Londrina, Londrina 86057-970, Brazil
| | - Estela Jiménez-López
- Health and Social Research Center, Universidad de Castilla-La Mancha (UCLM), 16071 Cuenca, Spain
| | - Pedro Antonio Sánchez-Miguel
- Grupo Análisis Comportamental de la Actividad Física y el Deporte (ACAFYDE), Departamento de Didáctica de la Expresión Musical, Plástica y Corporal, Facultad de Formación del Profesorado, Universidad de Extremadura, 10003 Cáceres, Spain
| | - Alba López-Benavente
- Departamento de Expresión Plástica, Musical y Dinámica, Facultad de Educación, Universidad de Murcia, 30100 Espinardo, Spain
| | - Laura Moreno-Galarraga
- IdiSNA (Instituto de Investigación Sanitaria de Navarra), 31008 Pamplona, Spain
- Department of Pediatrics, Complejo Hospitalario de Navarra, Servicio Navarro de Salud, 31008 Pamplona, Spain
| | - Sitong Chen
- Institute for Health and Sport, Victoria University, Melbourne 8001, Australia
| | - Javier Brazo-Sayavera
- PDU EFISAL, Centro Universitario Regional Noreste, Universidad de la República (UdelaR), Rivera 40000, Uruguay
- Department of Sports and Computer Science, Universidad Pablo de Olavide (UPO), 41013 Seville, Spain
| | - Alejandro Fernandez-Montero
- Department of Environmental Health, Harvard University T.H. Chan School of Public Health, Boston, MA 02138, USA
- IdiSNA (Instituto de Investigación Sanitaria de Navarra), 31008 Pamplona, Spain
- Department of Occupational Medicine, University of Navarra, 31008 Pamplona, Spain
| | - Pedro Emilio Alcaraz
- Research Center for High Performance Sport, San Antonio Catholic University of Murcia, 30830 Murcia, Spain
- Faculty of Sport Sciences, San Antonio Catholic University of Murcia, 30107 Murcia, Spain
| | | | - Pedro J Tárraga-López
- Departamento de Ciencias Médicas, Facultad de Medicina, Universidad Castilla-La Mancha (UCLM), 02008 Albacete, Spain
| | - Stefanos N Kales
- Department of Environmental Health, Harvard University T.H. Chan School of Public Health, Boston, MA 02138, USA
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13
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Blancas-Sánchez IM, Del Rosal Jurado M, Aparicio-Martínez P, Quintana Navarro G, Vaquero-Abellan M, Castro Jiménez RA, Fonseca Pozo FJ. A Mediterranean-Diet-Based Nutritional Intervention for Children with Prediabetes in a Rural Town: A Pilot Randomized Controlled Trial. Nutrients 2022; 14:3614. [PMID: 36079871 PMCID: PMC9460785 DOI: 10.3390/nu14173614] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 08/29/2022] [Accepted: 08/30/2022] [Indexed: 12/26/2022] Open
Abstract
Prediabetes is a pathological condition in which the blood glucose concentration is higher than normal concentrations but lower than those considered necessary for a type 2 diabetes mellitus diagnosis. Various authors have indicated that the Mediterranean Diet is one of the dietary patterns with the most healthy outcomes, reducing high levels of HbA1c, triglycerides, BMI, and other anthropometric parameters. The main objective of this study was to determine the efficacy of the nutritional intervention for children with prediabetes, including the effectiveness of this nutritional education regarding anthropometric parameters. A randomized pilot trial with two groups, an experimental group (EG) and a control group (CG), using intervention in dietary habits with nutritional reinforcement was carried out on 29 children with prediabetes from a rural area. The nutritional intervention was analyzed through astrophotometric and glycemic measurements and validated surveys. Results: The results indicated improvement in eating habits, adherence to the Mediterranean diet, anthropometric measurements, mainly body mass index and perimeters, and analytical parameters, with a significant decrease in glycated hemoglobin in the EG compared to the CG (p < 0.001). Although the results showed that both groups’ anthropometric parameters improved, a more significant decrease was observed in the experimental group compared to the control.
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Affiliation(s)
- Isabel María Blancas-Sánchez
- Emergency Department, Reina Sofia’s University Hospital, Andalusian Health Care System, 14004 Cordoba, Spain
- Grupo Investigación GC09 Nutrigenomics, Metabolic Syndrome, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Reina Sofia’s University Hospital, 14004 Cordoba, Spain
| | - María Del Rosal Jurado
- Departamento de Enfermería, Farmacología y Fisioterapia, Campus de Menéndez Pidal, Universidad de Córdoba, 14071 Córdoba, Spain
| | - Pilar Aparicio-Martínez
- Departamento de Enfermería, Farmacología y Fisioterapia, Campus de Menéndez Pidal, Universidad de Córdoba, 14071 Córdoba, Spain
- Grupo Investigación GC12 Clinical and Epidemiological Research in Primary Care, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Reina Sofia’s University Hospital, 14071 Cordoba, Spain
| | - Gracia Quintana Navarro
- Grupo Investigación GC09 Nutrigenomics, Metabolic Syndrome, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Reina Sofia’s University Hospital, 14004 Cordoba, Spain
| | - Manuel Vaquero-Abellan
- Departamento de Enfermería, Farmacología y Fisioterapia, Campus de Menéndez Pidal, Universidad de Córdoba, 14071 Córdoba, Spain
- Grupo Investigación GC12 Clinical and Epidemiological Research in Primary Care, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Reina Sofia’s University Hospital, 14071 Cordoba, Spain
| | - Rafael A. Castro Jiménez
- Grupo Investigación GC12 Clinical and Epidemiological Research in Primary Care, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Reina Sofia’s University Hospital, 14071 Cordoba, Spain
| | - Francisco Javier Fonseca Pozo
- Grupo Investigación GC09 Nutrigenomics, Metabolic Syndrome, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Reina Sofia’s University Hospital, 14004 Cordoba, Spain
- Grupo Investigación GC12 Clinical and Epidemiological Research in Primary Care, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Reina Sofia’s University Hospital, 14071 Cordoba, Spain
- Distrito Sanitario Córdoba Guadalquivir, Andalusian Health Care System, 14004 Cordoba, Spain
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14
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Good Adherence to the Mediterranean Diet Lowered Risk of Renal Glomerular Impairment in Children: A Longitudinal Study. Nutrients 2022; 14:nu14163343. [PMID: 36014847 PMCID: PMC9413126 DOI: 10.3390/nu14163343] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 08/10/2022] [Accepted: 08/11/2022] [Indexed: 12/27/2022] Open
Abstract
Healthy diet patterns have a positive effect on chronic non-communicable diseases in the pediatric population, but the evidence is limited on the association between kidney impairment and adherence to a Mediterranean diet. We aim to determine the associations between Mediterranean diet adherence and longitudinal tubular and glomerular impairment in children. Based on four waves of urine assays conducted from October 2018 to November 2019, we assayed urinary β2-microglobulin (β2-MG) and microalbumin (MA) excretion to determine transient renal tubular and glomerular impairment during the follow-up of the child cohort (PROC) study in Beijing, China. We assessed Mediterranean diet adherence using the 16-item Mediterranean Diet Quality Index in children and adolescents (KIDMED) among 1914 primary school children. Poor, intermediate, and good adherence rates for the Mediterranean diet were 9.0% (KIDMED index 0–3), 54.4% (KIDMED index 4–7) and 36.5% (KIDMED index 8–12), respectively. A short sleep duration was more prevalent in children with lower Mediterranean diet adherence, with no significant differences presenting in the other demographic and lifestyle covariates. The results of linear mixed-effects models showed that a higher urinary MA excretion was inversely associated with a higher KIDMED score (β = −0.216, 95%CI: −0.358, −0.074, p = 0.003), after adjusting for sex, age, BMI z-score, SBP z-score, screen time, sleep duration and physical activity. Furthermore, in generalized linear mixed-effects models, consistent results found that transient renal glomerular impairment was less likely to develop in children with intermediate Mediterranean diet adherence (aOR = 0.68, 95%CI: 0.47, 0.99, p = 0.044) and in children with good Mediterranean diet adherence (aOR = 0.60, 95%CI: 0.40, 0.90, p = 0.014), taking poor Mediterranean diet adherence as a reference. We visualized the longitudinal associations between each item of the KIDMED test and kidney impairment via a forest plot and identified the main protective eating behaviors. Children who adhere well to the Mediterranean diet have a lower risk of transient glomerular impairment, underscoring the necessity of the early childhood development of healthy eating patterns to protect kidney health.
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