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Zuziak M, Ezzati M. Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults. Lancet 2024; 403:1027-1050. [PMID: 38432237 PMCID: PMC7615769 DOI: 10.1016/s0140-6736(23)02750-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 11/22/2023] [Accepted: 12/05/2023] [Indexed: 03/05/2024]
Abstract
BACKGROUND Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. METHODS We used data from 3663 population-based studies with 222 million participants that measured height and weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children and adolescents (age 5-19 years), from 1990 to 2022 for 200 countries and territories. For adults, we report the individual and combined prevalence of underweight (BMI <18·5 kg/m2) and obesity (BMI ≥30 kg/m2). For school-aged children and adolescents, we report thinness (BMI <2 SD below the median of the WHO growth reference) and obesity (BMI >2 SD above the median). FINDINGS From 1990 to 2022, the combined prevalence of underweight and obesity in adults decreased in 11 countries (6%) for women and 17 (9%) for men with a posterior probability of at least 0·80 that the observed changes were true decreases. The combined prevalence increased in 162 countries (81%) for women and 140 countries (70%) for men with a posterior probability of at least 0·80. In 2022, the combined prevalence of underweight and obesity was highest in island nations in the Caribbean and Polynesia and Micronesia, and countries in the Middle East and north Africa. Obesity prevalence was higher than underweight with posterior probability of at least 0·80 in 177 countries (89%) for women and 145 (73%) for men in 2022, whereas the converse was true in 16 countries (8%) for women, and 39 (20%) for men. From 1990 to 2022, the combined prevalence of thinness and obesity decreased among girls in five countries (3%) and among boys in 15 countries (8%) with a posterior probability of at least 0·80, and increased among girls in 140 countries (70%) and boys in 137 countries (69%) with a posterior probability of at least 0·80. The countries with highest combined prevalence of thinness and obesity in school-aged children and adolescents in 2022 were in Polynesia and Micronesia and the Caribbean for both sexes, and Chile and Qatar for boys. Combined prevalence was also high in some countries in south Asia, such as India and Pakistan, where thinness remained prevalent despite having declined. In 2022, obesity in school-aged children and adolescents was more prevalent than thinness with a posterior probability of at least 0·80 among girls in 133 countries (67%) and boys in 125 countries (63%), whereas the converse was true in 35 countries (18%) and 42 countries (21%), respectively. In almost all countries for both adults and school-aged children and adolescents, the increases in double burden were driven by increases in obesity, and decreases in double burden by declining underweight or thinness. INTERPRETATION The combined burden of underweight and obesity has increased in most countries, driven by an increase in obesity, while underweight and thinness remain prevalent in south Asia and parts of Africa. A healthy nutrition transition that enhances access to nutritious foods is needed to address the remaining burden of underweight while curbing and reversing the increase in obesity. FUNDING UK Medical Research Council, UK Research and Innovation (Research England), UK Research and Innovation (Innovate UK), and European Union.
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Vrijkotte TGM, Wade AN, Waldhör T, Walton J, Wambiya EOA, Bebakar WMW, Mohamud WNW, de Souza Wanderley Júnior R, Wang MD, Wang N, Wang Q, Wang X, Wang YX, Wang YW, Wannamethee SG, Wareham N, Weber A, Webster-Kerr K, Wedderkopp N, Weghuber D, Wei W, Weres A, Werner B, Westbury LD, Whincup PH, Wickramasinghe K, Widhalm K, Widyahening IS, Więcek A, Wild PS, Wilks RJ, Willeit J, Willeit P, Williams J, Wilsgaard T, Wojciech R, Wojtyniak B, Wolf K, Wong-McClure RA, Wong A, Wong EB, Wong JE, Wong TY, Woo J, Woodward M, Wu FC, Wu HY, Wu J, Wu LJ, Wu S, Wyszyńska J, Xu H, Xu L, Yaacob NA, Yamborisut U, Yan W, Yang L, Yang X, Yang Y, Yardim N, Yasuharu T, García MY, Yiallouros PK, Yngve A, Yoosefi M, Yoshihara A, You QS, You SL, Younger-Coleman NO, Yu YL, Yu Y, Yusof SM, Yusoff AF, Zaccagni L, Zafiropulos V, Zainuddin AA, Zakavi SR, Zamani F, Zambon S, Zampelas A, Zamrazilová H, Zapata ME, Zargar AH, Zaw KK, Zayed AA, Zdrojewski T, Żegleń M, Zejglicova K, Vrkic TZ, Zeng Y, Zhang L, Zhang ZY, Zhao D, Zhao MH, Zhao W, Zhecheva YV, Zhen S, Zheng W, Zheng Y, Zholdin B, Zhou M, Zhu D, Zins M, Zitt E, Zocalo Y, Zoghlami N, Cisneros JZ, Zuziak M, Bhutta ZA, Black RE, Ezzati M. Diminishing benefits of urban living for children and adolescents' growth and development. Nature 2023; 615:874-883. [PMID: 36991188 PMCID: PMC10060164 DOI: 10.1038/s41586-023-05772-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 01/30/2023] [Indexed: 03/31/2023]
Abstract
Optimal growth and development in childhood and adolescence is crucial for lifelong health and well-being1-6. Here we used data from 2,325 population-based studies, with measurements of height and weight from 71 million participants, to report the height and body-mass index (BMI) of children and adolescents aged 5-19 years on the basis of rural and urban place of residence in 200 countries and territories from 1990 to 2020. In 1990, children and adolescents residing in cities were taller than their rural counterparts in all but a few high-income countries. By 2020, the urban height advantage became smaller in most countries, and in many high-income western countries it reversed into a small urban-based disadvantage. The exception was for boys in most countries in sub-Saharan Africa and in some countries in Oceania, south Asia and the region of central Asia, Middle East and north Africa. In these countries, successive cohorts of boys from rural places either did not gain height or possibly became shorter, and hence fell further behind their urban peers. The difference between the age-standardized mean BMI of children in urban and rural areas was <1.1 kg m-2 in the vast majority of countries. Within this small range, BMI increased slightly more in cities than in rural areas, except in south Asia, sub-Saharan Africa and some countries in central and eastern Europe. Our results show that in much of the world, the growth and developmental advantages of living in cities have diminished in the twenty-first century, whereas in much of sub-Saharan Africa they have amplified.
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Milanovic SM, Buoncristiano M, Križan H, Rathmes G, Williams J, Hyska J, Duleva V, Zamrazilová H, Hejgaard T, Jørgensen MB, Salanave B, Shengelia L, Kelleher CC, Spinelli A, Nardone P, Abdrakhmanova S, Usupova Z, Pudule I, Petrauskiene A, Sant'Angelo VF, Kujundžic E, Fijałkowska A, Rito AI, Cucu A, Brinduse LA, Peterkova V, Gualtieri A, García-Solano M, Gutiérrez-González E, Boymatova K, Yardim MS, Tanrygulyyeva M, Melkumova M, Weghuber D, Nurk E, Mäki P, Bergh IH, Ostojic SM, Jonsson KR, Spiroski I, Rutter H, Ahrens W, Rakovac I, Whiting S, Breda J. S02-2 Socioeconomic determinants of physical activity, sleep and screen time among children aged 6-9 years of age in Europe. Eur J Public Health 2022. [PMCID: PMC9434802 DOI: 10.1093/eurpub/ckac093.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Physical activity is key for preventing obesity and development of noncommunicable diseases later in life. Previous research suggests that socioeconomic factors, such as parental education or income, may influence a child’s risk of obesity. However, previous research on this has provided heterogeneity in results. Our aim was to investigate the socioeconomic disparities between physical activity, sedentary behaviour and sleep patterns in school-aged children aged 6 to 9 years in 24 European countries, using a large nationally-representative sample of children from 24 countries (Albania, Bulgaria, Croatia, Czechia, Denmark, France, Georgia, Ireland, Italy, Kazakhstan, Kyrgyzstan, Lithuania, Latvia, Malta, Montenegro, Poland, Portugal, Romania, Russian Federation – only Moscow, San Marino Republic, Spain, Tajikistan, Türkiye and Turkmenistan).
Methods
COSI collected information on physical activity patterns of children, sedentary behaviour and sleep duration through a questionnaire filled by parents. Among these, the paper focused on the following behaviours: Transportation to and from schools, Time spent on practising sports, Time spent on actively/vigorously playing, Time spent watching TV or using electronic devices and Hours of sleep per night. For the paper purpose, countries were grouped in 4 macro-regions according to United Nations “Standard Country or Area Codes for Statistical Use”.
Results
Findings indicated that a high prevalence of motorized school transport among children of employed parents in Southern Europe. The highest prevalence of insufficient sports and active play was among families from West-Central Asia who meet the end of the month with troubles, the highest prevalence of excessive screen time is among families from Eastern Europe, where both parents have a low level of education and the highest prevalence of insufficient sleep is among families from West-Central Asia where both parents have a high level of education.
Conclusions
There are important differences in the socioeconomic determinants of PA, sleep and screen related behaviours both between countries and sub-regions across the WHO European Region. This analysis of results from the COSI survey provides important insights that can help guide policy makers to take action to address the childhood obesity epidemic.
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Affiliation(s)
- Sanja Music Milanovic
- Croatian Institute of Public Health , Zagreb, Croatia
- School of Medicine, University of Zagreb , Zagreb, Croatia
| | - Marta Buoncristiano
- Division of Country Health Programmes, WHO Regional Office for Europe , Copenhagen, Denmark
| | - Helena Križan
- Croatian Institute of Public Health , Zagreb, Croatia
| | - Giulia Rathmes
- Division of Country Health Programmes, WHO Regional Office for Europe , Copenhagen, Denmark
| | - Julianne Williams
- Division of Country Health Programmes, WHO Regional Office for Europe , Copenhagen, Denmark
| | - Jolanda Hyska
- Nutrition and Food Safety Sector, Institute of Public Health , Tirana, Albania
| | - Vesselka Duleva
- Department Food and Nutrition, National Centre of Public Health and Analyses , Sofia, Bulgaria
| | - Hana Zamrazilová
- Obesity Management Centre, Institute of Endocrinology , Prague, Czech Republic
| | - Tatjana Hejgaard
- Health Promotion and Inequality, Danish Health Authority , Copenhagen, Denmark
| | | | - Benoît Salanave
- Department of Non-Communicable Diseases and Traumatisms, Santé Publique France, the French Public Health Agency , Saint-Maurice, France
- Nutritional Surveillance and Epidemiology Team (ESEN), University Sorbonne Paris Nord , Bobigny, France
| | - Lela Shengelia
- Maternal, Child and Reproductive Health, National Center for Disease Control and Public Health , Tbilisi, Georgia
| | - Cecily C Kelleher
- College of Health and Agricultural Sciences, University College Dublin , Dublin, Ireland
| | - Angela Spinelli
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health (Istituto Superiore di Sanità) , Rome, Italy
| | - Paola Nardone
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health (Istituto Superiore di Sanità) , Rome, Italy
| | - Shynar Abdrakhmanova
- Department of Science and Professional Development, National Center of Public Health of the Ministry of Health of the Republic of Kazakhstan , Almaty, Kazakhstan
- Kazakhstan School of Public Health, Kazakhstan's Medical University , Almaty, Kazakhstan
| | - Zhamilya Usupova
- Republican Center for Health Promotion and Mass Communication, Ministry of Health of the Kyrgyz Republic , Bishkek, Kyrgyzstan
| | - Iveta Pudule
- Department of Research and Health Statistics, Centre for Disease and Prevention Control , Riga, Latvia
| | - Ausra Petrauskiene
- Department of Preventive Medicine, Lithuanian University of Health Sciences , Kaunas, Lithuania
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Ivo Rakovac
- Division of Country Health Programmes, WHO Regional Office for Europe , Copenhagen, Denmark
| | - Stephen Whiting
- Division of Country Health Programmes, WHO Regional Office for Europe , Copenhagen, Denmark
| | - João Breda
- Division of Country Health Programmes, WHO Regional Office for Europe , Copenhagen, Denmark
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4
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Whiting S, Buoncristiano M, Gelius P, Abu-Omar K, Pattison M, Hyska J, Duleva V, Milanović SM, Zamrazilová H, Hejgaard T, Rasmussen M, Nurk E, Shengelia L, Kelleher CC, Heinen MM, Spinelli A, Nardone P, Abildina A, Abdrakhmanova S, Aitmurzaeva G, Usuopva Z, Pudule I, Petrauskiene A, Angelo VFS, Kujundzic E, Popovic S, Fismen AS, Bergh IH, Fijalkowska A, Rito AI, Cucu A, Brinduse LA, Peterkova V, Gualtieri A, García-Solano M, Gutiérrez-González E, Abdurrahmonova Z, Boymatova K, Yardim N, Tanrygulyyeva M, Weghuber D, Schindler K, Stojisavljević D, Hadžiomeragić AF, Ionnaidu EM, Ahrens W, Hassapidou M, Kovacs VA, Ostojic SM, Ticha L, Starc G, Jonsson KR, Spiroski I, Rutter H, Mendes R, Williams J, Rakovac I, Breda J. S02-1 Physical activity and sedentary behaviour of children aged 6-9 in Europe: an analysis within the Childhood Obesity Surveillance Initiative (COSI). Eur J Public Health 2022. [PMCID: PMC9421738 DOI: 10.1093/eurpub/ckac093.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Children are becoming less physically active for a variety of interrelated reasons. The availability of opportunities for safe active playgrounds, recreational activities and active transport has decreased, while time spend on sedentary screen-based activities has increased. This study aimed to evaluate physical activity (PA), sedentary and sleep behaviours of children aged 6-9 years in Europe using data from the WHO Childhood Obesity Surveillance Initiative (COSI).
Methods
The fourth COSI data collection round was conducted in 36 countries from 2015-2018 using a standardized protocol including a family form completed by parents with specific questions about diet and physical activity-related behaviours.
Results
Nationally representative data from the 24 countries, who filled in the non-mandatory family record form, were included. Information on PA, screen-time and sleep behaviours of 137,807 children were analysed. Pooled analysis showed that: one in two children walked or cycled to school every day; one in two children were members of a sport or dancing club; around 40 % of children spent at least two hours per day watching TV or using electronic devices; around four in five children were actively or vigorously playing each day; around 88 % of children slept for at least nine hours per night. Country specific analyses showed pronounced differences in prevalence estimates between countries.
Conclusions
While the severity of the problem varies between countries, physical inactivity and sedentary behaviours are common across the European Region. Policy makers across the Region must do more in order to increase opportunities for young people to participate in daily activities. Furthermore, they should explore solutions to reduce the amount of time spend on sedentary activities, in order to halt the rise in overweight and obesity.
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Affiliation(s)
- Stephen Whiting
- Division of Country Health Programmes, WHO Regional Office for Europe , Copenhagen, Denmark
- EPIUnit – Instituto de Saúde Pública, Universidade do Porto , Porto, Portugal
| | - Marta Buoncristiano
- Division of Country Health Programmes, WHO Regional Office for Europe , Copenhagen, Denmark
| | - Peter Gelius
- Department of Sport Science and Sport, FAU , Erlangen, Germany
| | - Karim Abu-Omar
- Department of Sport Science and Sport, FAU , Erlangen, Germany
| | - Mary Pattison
- Division of Country Health Programmes, WHO Regional Office for Europe , Copenhagen, Denmark
| | - Jolanda Hyska
- Nutrition and Food Safety Sector, Institute of Public Health , Tirana, Albania
| | - Vesselka Duleva
- National Center of Public Health and Analyses , Sofia, Bulgaria
| | - Sanja Musić Milanović
- School of Medicine, University of Zagreb, Croatian Institute of Public Health , Zagreb, Croatia
| | - Hana Zamrazilová
- Institute of Endocrinology, Obesity Management Centre , Prague, Czechia
| | | | - Mette Rasmussen
- National Institute of Public Health, University of Southern Denmark , Copenhagen, Denmark
| | - Eha Nurk
- National Institute for Health Development , Tallinn, Estonia
| | - Lela Shengelia
- National Center for Disease Control and Public Health , Tbilisi, Georgia
| | - Cecily C Kelleher
- National Nutrition Surveillance Centre, University College Dublin , Dublin, Ireland
| | - Mirjam M Heinen
- National Nutrition Surveillance Centre, University College Dublin , Dublin, Ireland
| | | | | | - Akbota Abildina
- National Centre of Public Health of the Ministry of Health of the Republic of Kazakhstan , Nur-Sultan, Kazakhstan
| | - Shynar Abdrakhmanova
- National Centre of Public Health of the Ministry of Health of the Republic of Kazakhstan , Nur-Sultan, Kazakhstan
| | | | | | - Iveta Pudule
- Ministry of Health, Centre for Disease Prevention and Control , Riga, Latvia
| | - Aušra Petrauskiene
- Lithuanian University of Health Sciences, Health Research Institute and Department of Preventive Medicine , Kaunas, Lithuania
| | | | - Enisa Kujundzic
- Institute of Public Health of Montenegro , Podgorica, Montenegro
| | - Stevo Popovic
- Faculty for Sport and Physical Education, University of Montenegro , Niksic, Montenegro
| | - Anne-Siri Fismen
- Department of Health Promotion, Norwegian Institute of Public Health , Bergen, Norway
| | - Ingunn Holden Bergh
- Department of Health and Inequality, Division of Mental and Physical Health, Norwegian Institute of Public Health , Bergen, Norway
| | - Anna Fijalkowska
- Department of Cardiology, Institute of Mother and Child , Warsaw, Poland
| | - Ana Isabel Rito
- National Institute of Health Dr Ricardo Jorge I.P ., Lisbon, Portugal
| | - Alexandra Cucu
- National Institute of Public Health , Bucharest, Romania
| | | | | | - Andrea Gualtieri
- Health Authority San Marino , San Marino
- Republic of San Marino , San Marino
| | - Marta García-Solano
- Spanish Agency for Food Safety and Nutrition, Ministry of Health , Madrid, Spain
| | | | - Zulfinissio Abdurrahmonova
- Republican Centre for Nutrition, Ministry of Health and Social Protection of Population , Duschanbe, Tajikistan
| | | | - Nazan Yardim
- Diabetes and Metabolic Disorders Department, Ministry of Health, Public Health Institution , Ankara, Turkey
| | - Maya Tanrygulyyeva
- Scientific Research Institute of Maternal and Child Health , Ashgabat, Turkmenistan
| | - Daniel Weghuber
- Department of Pediatrics, Paracelsus Medical University , Salzburg, Austria
| | | | - Dragana Stojisavljević
- Public Health Institute of Republic of Srpska, the University of Banja Luka, Faculty of Medicine , Banja Luka
- Bosnia and Herzegovina , Banja Luka
| | - Aida Filipović Hadžiomeragić
- Institute of Public Health of Federation of Bosnia and Herzegovina , Banja Luka
- Bosnia and Herzegovina , Banja Luka
| | | | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Institute of Statistics, University of Bremen , Bremen, Germany
| | | | | | - Sergej M Ostojic
- Faculty of Sport and PE, University of Novi Sad , Novi Sad, Serbia
| | - Lubica Ticha
- National Institute of Children Diseases, Medical Faculty of Comenius University , Bratislava, Slovakia
| | - Gregor Starc
- Faculty of Sport, University of Ljubljana , Ljubljana, Slovenia
| | - Kenisha Russell Jonsson
- Department of Living Conditions and Lifestyle, Public Health Agency of Sweden , Solna, Sweden
| | - Igor Spiroski
- Department of Physiology and Monitoring of Nutrition, Institute of Public Health , Skopje, Republic of Macedonia
| | - Harry Rutter
- Department of Social and Policy Sciences, University of Bath , Bath, UK
| | - Romeu Mendes
- Division of Country Health Programmes, WHO Regional Office for Europe , Copenhagen, Denmark
- EPIUnit – Instituto de Saúde Pública, Universidade do Porto , Porto, Portugal
| | - Julianne Williams
- Division of Country Health Programmes, WHO Regional Office for Europe , Copenhagen, Denmark
| | - Ivo Rakovac
- Division of Country Health Programmes, WHO Regional Office for Europe , Copenhagen, Denmark
| | - João Breda
- Division of Country Health Programmes, WHO Regional Office for Europe , Copenhagen, Denmark
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5
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Buoncristiano M, Williams J, Simmonds P, Nurk E, Ahrens W, Nardone P, Rito AI, Rutter H, Bergh IH, Starc G, Jonsson KR, Spinelli A, Vandevijvere S, Mäki P, Milanović SM, Salanave B, Yardim MS, Hejgaard T, Fijałkowska A, Abdrakhmanova S, Abdurrahmonova Z, Duleva V, Farrugia Sant'Angelo V, García-Solano M, Gualtieri A, Gutiérrez-González E, Huidumac-Petrescu C, Hyska J, Kelleher CC, Kujundžić E, Peterkova V, Petrauskiene A, Pudule I, Sacchini E, Shengelia L, Tanrygulyyeva M, Taxová Braunerová R, Usupova Z, Maruszczak K, Ostojic SM, Spiroski I, Stojisavljević D, Wickramasinghe K, Breda J. Socioeconomic inequalities in overweight and obesity among 6- to 9-year-old children in 24 countries from the World Health Organization European region. Obes Rev 2021; 22 Suppl 6:e13213. [PMID: 34184399 DOI: 10.1111/obr.13213] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 01/12/2021] [Indexed: 01/17/2023]
Abstract
Childhood overweight and obesity have significant short- and long-term negative impacts on children's health and well-being. These challenges are unequally distributed according to socioeconomic status (SES); however, previous studies have often lacked standardized and objectively measured data across national contexts to assess these differences. This study provides a cross-sectional picture of the association between SES and childhood overweight and obesity, based on data from 123,487 children aged 6-9 years in 24 countries in the World Health Organization (WHO) European region. Overall, associations were found between overweight/obesity and the three SES indicators used (parental education, parental employment status, and family-perceived wealth). Our results showed an inverse relationship between the prevalence of childhood overweight/obesity and parental education in high-income countries, whereas the opposite relationship was observed in most of the middle-income countries. The same applied to family-perceived wealth, although parental employment status appeared to be less associated with overweight and obesity or not associated at all. This paper highlights the need for close attention to context when designing interventions, as the association between SES and childhood overweight and obesity varies by country economic development. Population-based interventions have an important role to play, but policies that target specific SES groups are also needed to address inequalities.
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Affiliation(s)
- Marta Buoncristiano
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
| | - Julianne Williams
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
| | - Philippa Simmonds
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
| | - Eha Nurk
- Department of Nutrition Research, National Institute for Health Development, Tallinn, Estonia
| | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology, BIPS, Bremen, Germany.,Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany
| | - Paola Nardone
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health (Istituto Superiore di Sanità), Rome, Italy
| | - Ana Isabel Rito
- WHO/Europe Collaborating Center for Nutrition and Childhood Obesity - Food and Nutrition Department, National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
| | - Harry Rutter
- Department of Social and Policy Sciences, University of Bath, Bath, UK
| | - Ingunn Holden Bergh
- Department of Health and Inequality, Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Gregor Starc
- Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
| | - Kenisha Russell Jonsson
- Department of Living Conditions and Lifestyle, Public Health Agency of Sweden, Solna, Sweden
| | - Angela Spinelli
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health (Istituto Superiore di Sanità), Rome, Italy
| | | | - Päivi Mäki
- Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Sanja Musić Milanović
- Croatian Institute of Public Health, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Benoît Salanave
- Departement of Non-Communicable Diseases and Traumatisms, Santé publique France, the French Public Health Agency, Saint Maurice, France.,Nutritional Surveillance and Epidemiology Team (ESEN), University Sorbonne Paris Nord, Bobigny, France
| | | | - Tatjana Hejgaard
- Health Promotion and Inequality, Danish Health Authority, Copenhagen, Denmark
| | - Anna Fijałkowska
- Department of Cardiology, Institute of Mother and Child, Warsaw, Poland
| | - Shynar Abdrakhmanova
- Department of Science and Professional Development, National Center of Public Health of the Ministry of Health of the Republic of Kazakhstan, Almaty, Kazakhstan.,Kazakhstan School of Public Health, Kazakhstan's Medical University, Almaty, Kazakhstan
| | - Zulfiya Abdurrahmonova
- Republican Centre for Nutrition, Ministry of Health and Social Protection of Population, Dushanbe, Tajikistan
| | - Vesselka Duleva
- Department Food and Nutrition, National Centre of Public Health and Analyses, Sofia, Bulgaria
| | | | - Marta García-Solano
- Spanish Agency for Food Safety and Nutrition, Ministry of Consumer Affairs, Madrid, Spain
| | | | | | - Constanta Huidumac-Petrescu
- National Center for Health Assessment and Promotion, National Institute of Public Health, Bucharest, Romania
| | - Jolanda Hyska
- Nutrition and Food Safety Sector, Institute of Public Health, Tirana, Albania
| | - Cecily C Kelleher
- College of Health and Agricultural Sciences, University College Dublin, Dublin, Ireland
| | - Enisa Kujundžić
- Center for Health Ecology, Institute of Public Health, Podgorica, Montenegro
| | - Valentina Peterkova
- Institute of Paediatric Endocrinology, National Medical Research Centre for Endocrinology of the Ministry of Health of the Russian Federation, Moscow, Russian Federation
| | - Ausra Petrauskiene
- Department of Preventive Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Iveta Pudule
- Department of Research and Health Statistics, Centre for Disease and Prevention Control, Riga, Latvia
| | - Elena Sacchini
- Health Authority, Ministry of Health, San Marino, San Marino
| | - Lela Shengelia
- Maternal, Child and Reproductive Health, National Center for Disease Control and Public Health of Georgia, Tbilisi, Georgia
| | - Maya Tanrygulyyeva
- Scientific Research Institute of Maternal and Child Health, Ashgabat, Turkmenistan
| | | | - Zhamilya Usupova
- Republican Center for Health Promotion and Mass Communication, Ministry of Health of the Kyrgyz Republic, Bishkek, Kyrgyzstan
| | | | - Sergej M Ostojic
- Biomedical Sciences Department, Faculty of Sport and Physical Education, University of Novi Sad, Novi Sad, Serbia
| | - Igor Spiroski
- Institute of Public Health, Skopje, North Macedonia.,Faculty of Medicine, SS. Cyril and Methodius University, Skopje, North Macedonia
| | - Dragana Stojisavljević
- Faculty of Medicine, University of Banja Luka, Banja Luka, Bosnia and Herzegovina.,Public Health Institute of Republic of Srpska, Banja Luka, Bosnia and Herzegovina
| | - Kremlin Wickramasinghe
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
| | - João Breda
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
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6
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Breda J, McColl K, Buoncristiano M, Williams J, Abdrakhmanova S, Abdurrahmonova Z, Ahrens W, Akhmedova D, Bakacs M, Boer JMA, Boymatova K, Brinduse LA, Cucu A, Duleva V, Endevelt R, Sant'Angelo VF, Fijałkowska A, Hadžiomeragić AF, García-Solano M, Grøholt EK, Gualtieri A, Hassapidou M, Hejgaard T, Hyska J, Kelleher CC, Kujundžić E, Mäki P, Markidou Ioannidou E, Melkumova M, Moyersoen I, Milanović SM, Nurk E, Ostojic SM, Peterkova V, Petrauskienė A, Pudule I, Rito AI, Russell Jonsson K, Rutter H, Salanave B, Seyidov N, Shengelia L, Silitrari N, Spinelli A, Spiroski I, Starc G, Stojisavljević D, Tanrygulyyeva M, Tichá Ľ, Usupova Z, Weghuber D, Yardim N, Zamrazilová H, Zbanatskyi V, Branca F, Weber M, Rakovac I. Methodology and implementation of the WHO European Childhood Obesity Surveillance Initiative (COSI). Obes Rev 2021; 22 Suppl 6:e13215. [PMID: 34738283 DOI: 10.1111/obr.13215] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 01/18/2021] [Accepted: 01/18/2021] [Indexed: 11/30/2022]
Abstract
Establishment of the WHO European Childhood Obesity Surveillance Initiative (COSI) has resulted in a surveillance system which provides regular, reliable, timely, and accurate data on children's weight status-through standardized measurement of bodyweight and height-in the WHO European Region. Additional data on dietary intake, physical activity, sedentary behavior, family background, and school environments are collected in several countries. In total, 45 countries in the European Region have participated in COSI. The first five data collection rounds, between 2007 and 2021, yielded measured anthropometric data on over 1.3 million children. In COSI, data are collected according to a common protocol, using standardized instruments and procedures. The systematic collection and analysis of these data enables intercountry comparisons and reveals differences in the prevalence of childhood thinness, overweight, normal weight, and obesity between and within populations. Furthermore, it facilitates investigation of the relationship between overweight, obesity, and potential risk or protective factors and improves the understanding of the development of overweight and obesity in European primary-school children in order to support appropriate and effective policy responses.
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Affiliation(s)
- João Breda
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
| | - Karen McColl
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
| | - Marta Buoncristiano
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
| | - Julianne Williams
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
| | - Shynar Abdrakhmanova
- Department of Science and Professional Development, National Center of Public Health of the Ministry of Health of the Republic of Kazakhstan, Almaty, Kazakhstan.,Kazakhstan School of Public Health, Kazakhstan's Medical University, Almaty, Kazakhstan
| | - Zulfiya Abdurrahmonova
- Republican Centre for Nutrition, Ministry of Health and Social Protection of Population, Dushanbe, Tajikistan
| | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.,Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany
| | - Dilorom Akhmedova
- Republic Specialized Scientific Practical Medical Centre for Pediatrics, Tashkent, Uzbekistan
| | - Márta Bakacs
- Department of Nutrition and Epidemiology, National Institute of Pharmacy and Nutrition, Budapest, Hungary
| | - Jolanda M A Boer
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
| | - Khadichamo Boymatova
- Division of Noncommunicable Diseases and Promoting Health through the Life-course, WHO Country Office, Dushanbe, Tajikistan
| | - Lacramioara Aurelia Brinduse
- National Centre of Health Promotion and Health Evaluation, National Institute of Public Health, Bucharest, Romania.,Faculty of Medicine, Department of Public Health and Management, University of Medicine and Pharmacy Carol Davila Bucharest, Bucharest, Romania
| | - Alexandra Cucu
- National Centre of Health Promotion and Health Evaluation, National Institute of Public Health, Bucharest, Romania.,Faculty of Midwifery and Nursing, Discipline of Public health and Health management, University of Medicine and Pharmacy Carol Davila Bucharest, Bucharest, Romania
| | - Vesselka Duleva
- Department Food and Nutrition, National Centre of Public Health and Analyses, Sofia, Bulgaria
| | - Ronit Endevelt
- University of Haifa School of Public Health, Israel.,Ministry of Health, Israel
| | | | - Anna Fijałkowska
- Department of Cardiology, Institute of Mother and Child, Warsaw, Poland
| | - Aida Filipović Hadžiomeragić
- Department of Hygiene, Health Ecology Service, Institute of Public Health of Federation of Bosnia and Herzegovina, Sarajevo, Bosnia and Herzegovina
| | - Marta García-Solano
- Spanish Agency for Food Safety and Nutrition, Ministry of Consumer Affairs, Madrid, Spain
| | - Else Karin Grøholt
- Department of Health and Inequality, Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | | | - Maria Hassapidou
- Department of Nutritional Sciences and Dietetics, International Hellenic University, Thessaloniki, Greece
| | - Tatjana Hejgaard
- Health Promotion and Inequality, Danish Health Authority, Copenhagen, Denmark
| | - Jolanda Hyska
- Nutrition and Food Safety Sector, Institute of Public Health, Tirana, Albania
| | - Cecily C Kelleher
- College of Health and Agricultural Sciences, University College Dublin, Dublin, Ireland
| | - Enisa Kujundžić
- Center for Health Ecology, Institute of Public Health of Montenegro, Podgorica, Montenegro
| | - Päivi Mäki
- Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | | | - Marina Melkumova
- Institute of Child and Adolescent Health, Arabkir Medical Centre, Yerevan, Armenia
| | - Isabelle Moyersoen
- Department of Epidemiology and Public Health Sciensano, Brussels, Belgium
| | - Sanja Musić Milanović
- Croatian Institute of Public Health, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Eha Nurk
- Department of Nutrition Research, National Institute for Health Development, Tallinn, Estonia
| | - Sergej M Ostojic
- Biomedical Sciences Department, Faculty of Sport and Physical Education, University of Novi Sad, Novi Sad, Serbia
| | - Valentina Peterkova
- Institute of Paediatric Endocrinology, National Medical Research Centre for Endocrinology of the Ministry of Health of the Russian Federation, Moscow, Russian Federation
| | - Aušra Petrauskienė
- Department of Preventive Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Iveta Pudule
- Department of Research and Health Statistics, Centre for Disease and Prevention Control, Riga, Latvia
| | - Ana Isabel Rito
- WHO/Europe Collaborating Center for Nutrition and Childhood Obesity - Food and Nutrition Department, National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
| | - Kenisha Russell Jonsson
- Department of Living Conditions and Lifestyle, Public Health Agency of Sweden, Solna, Sweden
| | - Harry Rutter
- Department of Social and Policy Sciences, University of Bath, Bath, UK
| | - Benoît Salanave
- Department of Non-Communicable Diseases and Traumatisms, Santé publique France, the French Public Health Agency, Saint Maurice, France.,Nutritional Surveillance and Epidemiology Team (ESEN), University Sorbonne Paris Nord, Bobigny, France
| | - Nabil Seyidov
- Department of Healthy Policy and Planning, Public Health and Reforms Center of Ministry of Health, Baku, Azerbaijan
| | - Lela Shengelia
- Maternal, Child and Reproductive Health, National Center for Disease Control and Public Health of Georgia, Tbilisi, Georgia
| | | | - Angela Spinelli
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health (Istituto Superiore di Sanità), Rome, Italy
| | - Igor Spiroski
- Institute of Public Health, Skopje, North Macedonia.,Faculty of Medicine, SS. Cyril and Methodius University, Skopje, North Macedonia
| | - Gregor Starc
- Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
| | - Dragana Stojisavljević
- Faculty of Medicine, University of Banja Luka, Banja Luka, Bosnia and Herzegovina.,Public Health Institute of Republic of Srpska, Banja Luka, Bosnia and Herzegovina
| | - Maya Tanrygulyyeva
- Internal Diseases Department, Scientific Clinical Centre of Mother and Child Health, Ashgabat, Turkmenistan
| | - Ľubica Tichá
- Children's Hospital National Institute of Children's Diseases, Medical Faculty, Comenius University, Bratislava, Slovakia
| | - Zhamilya Usupova
- Republican Center for Health Promotion and Mass Communication, Ministry of Health of the Kyrgyz Republic, Bishkek, Kyrgyzstan
| | - Daniel Weghuber
- Department of Pediatrics, Paracelsus Medical University, Salzburg, Austria
| | - Nazan Yardim
- Public Health General Directorate, Ministry of Health of Turkey, Ankara, Turkey
| | - Hana Zamrazilová
- Obesity Management Centre, Institute of Endocrinology, Prague, Czechia
| | | | - Francesco Branca
- Department of Nutrition and Food Safety, World Health Organization, Geneva, Switzerland
| | - Martin Weber
- World Health Organization (WHO) Child and Adolescent Health and Development, WHO Regional Office for Europe, Copenhagen, Denmark
| | - Ivo Rakovac
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
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7
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Musić Milanović S, Buoncristiano M, Križan H, Rathmes G, Williams J, Hyska J, Duleva V, Zamrazilová H, Hejgaard T, Jørgensen MB, Salanave B, Shengelia L, Kelleher CC, Spinelli A, Nardone P, Abdrakhmanova S, Usupova Z, Pudule I, Petrauskiene A, Farrugia Sant'Angelo V, Kujundžić E, Fijałkowska A, Rito AI, Cucu A, Brinduse LA, Peterkova V, Gualtieri A, García-Solano M, Gutiérrez-González E, Boymatova K, Yardim MS, Tanrygulyyeva M, Melkumova M, Weghuber D, Nurk E, Mäki P, Bergh IH, Ostojic SM, Russell Jonsson K, Spiroski I, Rutter H, Ahrens W, Rakovac I, Whiting S, Breda J. Socioeconomic disparities in physical activity, sedentary behavior and sleep patterns among 6- to 9-year-old children from 24 countries in the WHO European region. Obes Rev 2021; 22 Suppl 6:e13209. [PMID: 34235843 DOI: 10.1111/obr.13209] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 12/30/2020] [Indexed: 12/22/2022]
Abstract
Physical activity, sedentary behavior, and sleep are important predictors of children's health. This paper aimed to investigate socioeconomic disparities in physical activity, sedentary behavior, and sleep across the WHO European region. This cross-sectional study used data on 124,700 children aged 6 to 9 years from 24 countries participating in the WHO European Childhood Obesity Surveillance Initiative between 2015 and 2017. Socioeconomic status (SES) was measured through parental education, parental employment status, and family perceived wealth. Overall, results showed different patterns in socioeconomic disparities in children's movement behaviors across countries. In general, high SES children were more likely to use motorized transportation. Low SES children were less likely to participate in sports clubs and more likely to have more than 2 h/day of screen time. Children with low parental education had a 2.24 [95% CI 1.94-2.58] times higher risk of practising sports for less than 2 h/week. In the pooled analysis, SES was not significantly related to active play. The relationship between SES and sleep varied by the SES indicator used. Importantly, results showed that low SES is not always associated with a higher prevalence of "less healthy" behaviors. There is a great diversity in SES patterns across countries which supports the need for country-specific, targeted public health interventions.
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Affiliation(s)
- Sanja Musić Milanović
- Croatian Institute of Public Health, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Marta Buoncristiano
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
| | - Helena Križan
- Croatian Institute of Public Health, Zagreb, Croatia
| | - Giulia Rathmes
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
| | - Julianne Williams
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
| | - Jolanda Hyska
- Nutrition and Food Safety Sector, Institute of Public Health, Tirana, Albania
| | - Vesselka Duleva
- Department Food and Nutrition, National Centre of Public Health and Analyses, Sofia, Bulgaria
| | - Hana Zamrazilová
- Obesity Management Centre, Institute of Endocrinology, Prague, Czech Republic
| | - Tatjana Hejgaard
- Health Promotion and Inequality, Danish Health Authority, Copenhagen, Denmark
| | | | - Benoît Salanave
- Department of Non-Communicable Diseases and Traumatisms, Santé publique France, the French Public Health Agency, Saint-Maurice, France.,Nutritional Surveillance and Epidemiology Team (ESEN), University Sorbonne Paris Nord, Bobigny, France
| | - Lela Shengelia
- Maternal, Child and Reproductive Health, National Center for Disease Control and Public Health, Tbilisi, Georgia
| | - Cecily C Kelleher
- College of Health and Agricultural Sciences, University College Dublin, Dublin, Ireland
| | - Angela Spinelli
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health (Istituto Superiore di Sanità), Rome, Italy
| | - Paola Nardone
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health (Istituto Superiore di Sanità), Rome, Italy
| | - Shynar Abdrakhmanova
- Department of Science and Professional Development, National Center of Public Health of the Ministry of Health of the Republic of Kazakhstan, Almaty, Kazakhstan.,Kazakhstan School of Public Health, Kazakhstan's Medical University, Almaty, Kazakhstan
| | - Zhamilya Usupova
- Republican Center for Health Promotion and Mass Communication, Ministry of Health of the Kyrgyz Republic, Bishkek, Kyrgyzstan
| | - Iveta Pudule
- Department of Research and Health Statistics, Centre for Disease and Prevention Control, Riga, Latvia
| | - Ausra Petrauskiene
- Department of Preventive Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | | | - Enisa Kujundžić
- Center for Health Ecology, Institute of Public Health, Podgorica, Montenegro
| | - Anna Fijałkowska
- Department of Cardiology, Institute of Mother and Child, Warsaw, Poland
| | - Ana Isabel Rito
- WHO/Europe Collaborating Center for Nutrition and Childhood Obesity - Food and Nutrition Department, National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
| | - Alexandra Cucu
- Faculty of Midwifery and Nursing, Discipline of Public Health and Health Management, University of Medicine and Pharmacy Carol Davila Bucharest, Bucharest, Romania.,National Centre of Health Promotion and Health Evaluation, National Institute of Public Health, Bucharest, Romania
| | - Lacramioara Aurelia Brinduse
- National Centre of Health Promotion and Health Evaluation, National Institute of Public Health, Bucharest, Romania.,Faculty of Medicine, Department of Public Health and Management, University of Medicine and Pharmacy Carol Davila Bucharest, Bucharest, Romania
| | - Valentina Peterkova
- Institute of Paediatric Endocrinology, National Medical Research Centre for Endocrinology of the Ministry of Health of the Russian Federation, Moscow, Russian Federation
| | | | - Marta García-Solano
- Spanish Agency for Food Safety and Nutrition, Ministry of Consumer Affairs, Madrid, Spain
| | | | - Khadichamo Boymatova
- Division of Noncommunicable Diseases and Promoting Health through the Life-Course, WHO Country Office for Tajikistan, Dushanbe, Tajikistan
| | | | - Maya Tanrygulyyeva
- Scientific Research Institute of Maternal and Child Health, Ashgabat, Turkmenistan
| | - Marina Melkumova
- Institute of Child and Adolescent Health, Arabkir Medical Centre-Institute of Child and Adolescent Health, Yerevan, Armenia
| | - Daniel Weghuber
- Department of Pediatrics, Paracelsus Medical University, Salzburg, Austria
| | - Eha Nurk
- Department of Nutrition Research, National Institute for Health Development, Tallinn, Estonia
| | - Päivi Mäki
- Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Ingunn Holden Bergh
- Department of Health and Inequality, Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Sergej M Ostojic
- Biomedical Sciences Department, Faculty of Sport and Physical Education, University of Novi Sad, Novi Sad, Serbia
| | - Kenisha Russell Jonsson
- Department of Living Conditions and Lifestyle, Public Health Agency of Sweden, Solna, Sweden
| | - Igor Spiroski
- Institute of Public Health, Skopje, North Macedonia.,Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, North Macedonia
| | - Harry Rutter
- Department of Social and Policy Sciences, University of Bath, Bath, UK
| | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology, BIPS, Bremen, Germany.,Institute of Statistics, Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany
| | - Ivo Rakovac
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
| | - Stephen Whiting
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
| | - João Breda
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
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8
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Spinelli A, Buoncristiano M, Nardone P, Starc G, Hejgaard T, Júlíusson PB, Fismen AS, Weghuber D, Musić Milanović S, García-Solano M, Rutter H, Rakovac I, Cucu A, Brinduse LA, Rito AI, Kovacs VA, Heinen MM, Nurk E, Mäki P, Abdrakhmanova S, Rakhmatulleoeva S, Duleva V, Farrugia Sant'Angelo V, Fijałkowska A, Gualtieri A, Sacchini E, Hassapidou M, Hyska J, Kelleher CC, Kujundžić E, Kunešová M, Markidou Ioannidou E, Ostojic SM, Peterkova V, Petrauskienė A, Popović S, Pudule I, Russell Jonsson K, Dal-Re Saavedra MÁ, Salanave B, Shengelia L, Spiroski I, Tanrygulyyeva M, Tichá Ľ, Usupova Z, Ozcebe LH, Abildina A, Schindler K, Weber MW, Filipović Hadžiomeragić A, Melkumova M, Stojisavljević D, Boymatova K, Williams J, Breda J. Thinness, overweight, and obesity in 6- to 9-year-old children from 36 countries: The World Health Organization European Childhood Obesity Surveillance Initiative-COSI 2015-2017. Obes Rev 2021; 22 Suppl 6:e13214. [PMID: 34235850 DOI: 10.1111/obr.13214] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Accepted: 01/04/2021] [Indexed: 01/07/2023]
Abstract
In 2015-2017, the fourth round of the World Health Organization (WHO) European Childhood Obesity Surveillance Initiative (COSI) was conducted in 36 countries. National representative samples of children aged 6-9 (203,323) were measured by trained staff, with similar equipment and using a standardized protocol. This paper assesses the children's body weight status and compares the burden of childhood overweight, obesity, and thinness in Northern, Eastern, and Southern Europe and Central Asia. The results show great geographic variability in height, weight, and body mass index. On average, the children of Northern Europe were the tallest, those of Southern Europe the heaviest, and the children living in Central Asia the lightest and the shortest. Overall, 28.7% of boys and 26.5% of girls were overweight (including obesity) and 2.5% and 1.9%, respectively, were thin according to the WHO definitions. The prevalence of obesity varied from 1.8% of boys and 1.1% of girls in Tajikistan to 21.5% and 19.2%, respectively, in Cyprus, and tended to be higher for boys than for girls. Levels of thinness, stunting, and underweight were relatively low, except in Eastern Europe (for thinness) and in Central Asia. Despite the efforts to halt it, unhealthy weight status is still an important problem in the WHO European Region.
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Affiliation(s)
- Angela Spinelli
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health (Istituto Superiore di Sanità), Rome, Italy
| | - Marta Buoncristiano
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
| | - Paola Nardone
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health (Istituto Superiore di Sanità), Rome, Italy
| | - Gregor Starc
- Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
| | - Tatjana Hejgaard
- Health Promotion and Inequality, Danish Health Authority, Copenhagen, Denmark
| | - Petur Benedikt Júlíusson
- Department of Health Registry Research and Development, Norwegian Institute of Public Health, Bergen, Norway.,Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Anne-Siri Fismen
- Department of Health Promotion and Centre for Evaluation of Public Health Measures, Norwegian Institute of Public Health, Bergen, Norway
| | - Daniel Weghuber
- Department of Pediatrics, Paracelsus Medical University, Salzburg, Austria
| | - Sanja Musić Milanović
- Croatian Institute of Public Health, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Marta García-Solano
- Spanish Agency for Food Safety and Nutrition, Ministry of Consumer Affairs, Madrid, Spain
| | - Harry Rutter
- Department of Social and Policy Sciences, University of Bath, Bath, UK
| | - Ivo Rakovac
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
| | - Alexandra Cucu
- Faculty of Midwifery and Nursing, Discipline of Public health and Health Management, University of Medicine and Pharmacy Carol Davila Bucharest, Bucharest, Romania.,National Centre of Health Promotion and Health Evaluation, National Institute of Public Health, Bucharest, Romania
| | - Lacramioara Aurelia Brinduse
- National Centre of Health Promotion and Health Evaluation, National Institute of Public Health, Bucharest, Romania.,Faculty of Medicine, Department of Public Health and Management, University of Medicine and Pharmacy Carol Davila Bucharest, Bucharest, Romania
| | - Ana Isabel Rito
- WHO/Europe Collaborating Center for Nutrition and Childhood Obesity - Food and Nutrition Department, National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
| | | | - Mirjam M Heinen
- National Nutrition Surveillance Centre, School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Eha Nurk
- Department of Nutrition Research, National Institute for Health Development, Tallinn, Estonia
| | - Päivi Mäki
- Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Shynar Abdrakhmanova
- Department of Science and Professional Development, National Center of Public Health of the Ministry of Health of the Republic of Kazakhstan, Almaty, Kazakhstan.,Kazakhstan School of Public Health, Kazakhstan's Medical University, Almaty, Kazakhstan
| | - Sanavbar Rakhmatulleoeva
- Department of the Organization of Medical Services for Mothers, Children and Family Planning Ministry of Health and Social Protection, Dushanbe, Tajikistan
| | - Vesselka Duleva
- Department Food and Nutrition, National Center of Public Health and Analyses, Sofia, Bulgaria
| | | | - Anna Fijałkowska
- Department of Cardiology, Institute of Mother and Child, Warsaw, Poland
| | | | - Elena Sacchini
- Health Authority, Ministry of Health, San Marino, San Marino
| | - Maria Hassapidou
- Department of Nutritional Sciences and Dietetics, International Hellenic University, Thessaloniki, Greece
| | - Jolanda Hyska
- Nutrition and Food Safety Sector, Institute of Public Health, Tirana, Albania
| | - Cecily C Kelleher
- National Nutrition Surveillance Centre, School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Enisa Kujundžić
- Center for Health Ecology, Institute of Public Health, Podgorica, Montenegro
| | - Marie Kunešová
- Obesity Management Centre, Institute of Endocrinology, Prague, Czech Republic
| | | | - Sergej M Ostojic
- Biomedical Sciences Department, Faculty of Sport and Physical Education, University of Novi Sad, Novi Sad, Serbia
| | - Valentina Peterkova
- Institute of Paediatric Endocrinology, National Medical Research Centre for Endocrinology of the Ministry of Health of the Russian Federation, Moscow, Russian Federation
| | - Aušra Petrauskienė
- Department of Preventive Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Stevo Popović
- Faculty for Sport and Physical Education, University of Montenegro, Niksic, Montenegro.,Montenegrin Sports Academy, Podgorica, Montenegro
| | - Iveta Pudule
- Department of Research and Health Statistics, Centre for Disease and Prevention Control, Riga, Latvia
| | - Kenisha Russell Jonsson
- Department of Living Conditions and Lifestyle, Public Health Agency of Sweden, Solna, Sweden
| | | | - Benoît Salanave
- Departement of Non-Communicable Diseases and Traumatisms, Santé publique France, the French Public Health Agency, Saint Maurice, France.,Nutritional Surveillance and Epidemiology Team (ESEN), University Sorbonne Paris Nord, Bobigny, France
| | - Lela Shengelia
- Maternal, Child and Reproductive Health, National Center for Disease Control and Public Health of Georgia, Tbilisi, Georgia
| | - Igor Spiroski
- Institute of Public Health, Skopje, North Macedonia.,Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, North Macedonia
| | - Maya Tanrygulyyeva
- Scientific Research Institute of Maternal and Child Health, Ashgabat, Turkmenistan
| | - Ľubica Tichá
- Children's Hospital National Institute of Children's Diseases, Medical Faculty, Comenius University, Bratislava, Slovakia
| | - Zhamilya Usupova
- Republican Center for Health Promotion and Mass Communication, Ministry of Health of the Kyrgyz Republic, Bishkek, Kyrgyzstan
| | - Lütfiye Hilal Ozcebe
- Medical Faculty, Department of Public Health, Hacettepe University, Ankara, Turkey
| | - Akbota Abildina
- National Center of Public Health, Ministry of Health of the Republic of Kazakhstan/WHO Collaborating Center for Promoting Healthy Lifestyle, Nur-Sultan, Kazakhstan
| | - Karin Schindler
- Federal Ministry Social Affairs, Health Care and Consumer Protection, Division of Mother, Child, Gender Health and Nutrition, Vienna, Austria
| | - Martin W Weber
- World Health Organization (WHO) Child and Adolescent Health and Development, WHO Regional Office for Europe, Copenhagen, Denmark
| | - Aida Filipović Hadžiomeragić
- Department of Hygiene, Health Ecology Service, Institute of Public Health of Federation of Bosnia and Herzegovina, Sarajevo, Bosnia and Herzegovina
| | - Marina Melkumova
- Institute of Child and Adolescent Health, Arabkir Medical Centre- Institute of Child and Adolescent Health, Yerevan, Armenia
| | - Dragana Stojisavljević
- Faculty of Medicine, University of Banja Luka, Banja Luka, Bosnia and Herzegovina.,Public Health Institute of Republic of Srpska, Banja Luka, Bosnia and Herzegovina
| | - Khadichamo Boymatova
- Division of Noncommunicable Diseases and Promoting Health through the Life-course, WHO Tajikistan Country Office, Dushanbe, Tajikistan
| | - Julianne Williams
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
| | - João Breda
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
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9
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Heinen MM, Bel-Serrat S, Kelleher CC, Buoncristiano M, Spinelli A, Nardone P, Milanović SM, Rito AI, Bosi ATB, Gutiérrrez-González E, Pudule I, Abdrakhmanova S, Abdurrahmonova Z, Brinduse LA, Cucu A, Duleva V, Fijałkowska A, Gualtieri A, Hejgaard T, Hyska J, Kujundžić E, Petrauskiene A, Sacchini E, Shengelia L, Tanrygulyyeva M, Usupova Z, Bergh IH, Weghuber D, Taxová Braunerová R, Kunešová M, Sant'Angelo VF, Nurk E, Ostojic SM, Spiroski I, Tichá Ľ, Rutter H, Williams J, Boymatova K, Rakovac I, Weber MW, Breda J. Urban and rural differences in frequency of fruit, vegetable, and soft drink consumption among 6-9-year-old children from 19 countries from the WHO European region. Obes Rev 2021; 22 Suppl 6:e13207. [PMID: 34235832 DOI: 10.1111/obr.13207] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 12/30/2020] [Indexed: 11/28/2022]
Abstract
In order to address the paucity of evidence on the association between childhood eating habits and urbanization, this cross-sectional study describes urban-rural differences in frequency of fruit, vegetable, and soft drink consumption in 123,100 children aged 6-9 years from 19 countries participating in the fourth round (2015-2017) of the WHO European Childhood Obesity Surveillance Initiative (COSI). Children's parents/caregivers completed food-frequency questionnaires. A multivariate multilevel logistic regression analysis was performed and revealed wide variability among countries and within macroregions for all indicators. The percentage of children attending rural schools ranged from 3% in Turkey to 70% in Turkmenistan. The prevalence of less healthy eating habits was high, with between 30-80% and 30-90% children not eating fruit or vegetables daily, respectively, and up to 45% consuming soft drinks on >3 days a week. For less than one third of the countries, children attending rural schools had higher odds (OR-range: 1.1-2.1) for not eating fruit or vegetables daily or consuming soft drinks >3 days a week compared to children attending urban schools. For the remainder of the countries no significant associations were observed. Both population-based interventions and policy strategies are necessary to improve access to healthy foods and increase healthy eating behaviors among children.
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Affiliation(s)
- Mirjam M Heinen
- National Nutrition Surveillance Centre, School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Silvia Bel-Serrat
- National Nutrition Surveillance Centre, School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Cecily C Kelleher
- College of Health and Agricultural Sciences, University College Dublin, Dublin, Ireland
| | - Marta Buoncristiano
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
| | - Angela Spinelli
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health (Istituto Superiore di Sanità), Rome, Italy
| | - Paola Nardone
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health (Istituto Superiore di Sanità), Rome, Italy
| | - Sanja Musić Milanović
- Croatian Institute of Public Health, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Ana Isabel Rito
- WHO/Europe Collaborating Center for Nutrition and Childhood Obesity - Food and Nutrition Department, National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
| | - A Tülay Bağci Bosi
- Medical Faculty, Department of Public Health, Hacettepe University, Ankara, Turkey
| | | | - Iveta Pudule
- Department of Research and Health Statistics, Centre for Disease and Prevention Control, Riga, Latvia
| | - Shynar Abdrakhmanova
- Department of Science and Professional Development, National Center of Public Health of the Ministry of Health of the Republic of Kazakhstan, Almaty, Kazakhstan.,Kazakhstan School of Public Health, Kazakhstan's Medical University, Almaty, Kazakhstan
| | - Zulfiya Abdurrahmonova
- Republican Centre for Nutrition, Ministry of Health and Social Protection of Population, Duschanbe, Tajikistan
| | - Lacramioara Aurelia Brinduse
- Faculty of Medicine, Department of Public Health and Management, University of Medicine and Pharmacy Carol Davila Bucharest, Bucharest, Romania.,National Centre of Health Promotion and Health Evaluation, National Institute of Public Health, Bucharest, Romania
| | - Alexandra Cucu
- National Centre of Health Promotion and Health Evaluation, National Institute of Public Health, Bucharest, Romania.,Faculty of Midwifery and Nursing, Discipline of Public Health and Health Management, University of Medicine and Pharmacy Carol Davila Bucharest, Bucharest, Romania
| | - Vesselka Duleva
- Department Food and Nutrition, National Centre of Public Health and Analyses, Sofia, Bulgaria
| | - Anna Fijałkowska
- Department of Cardiology, Institute of Mother and Child, Warsaw, Poland
| | | | - Tatjana Hejgaard
- Health Promotion and Inequality, Danish Health Authority, Copenhagen, Denmark
| | - Jolanda Hyska
- Nutrition and Food Safety Sector, Institute of Public Health, Tirana, Albania
| | - Enisa Kujundžić
- Center for Health Ecology, Institute of Public Health, Podgorica, Montenegro
| | - Ausra Petrauskiene
- Department of Preventive Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Elena Sacchini
- Health Authority, Ministry of Health, San Marino, San Marino
| | - Lela Shengelia
- Maternal, Child and Reproductive Health, National Center for Disease Control and Public Health of Georgia, Tbilisi, Georgia
| | - Maya Tanrygulyyeva
- Scientific Research Institute of Maternal and Child Health, Ashgabat, Turkmenistan
| | - Zhamilya Usupova
- Republican Center for Health Promotion and Mass Communication, Ministry of Health of the Kyrgyz Republic, Bishkek, Kyrgyzstan
| | - Ingunn Holden Bergh
- Department of Health and Inequality, Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Daniel Weghuber
- Department of Pediatrics, Paracelsus Medical University, Salzburg, Austria
| | | | - Marie Kunešová
- Obesity Management Centre, Institute of Endocrinology, Prague, Czech Republic
| | | | - Eha Nurk
- Department of Nutrition Research, National Institute for Health Development, Tallinn, Estonia
| | - Sergej M Ostojic
- Biomedical Sciences Department, Faculty of Sport and Physical Education, University of Novi Sad, Novi Sad, Serbia
| | - Igor Spiroski
- Institute of Public Health, Skopje, North Macedonia.,Faculty of Medicine, SS. Cyril and Methodius University, Skopje, North Macedonia
| | - Ľubica Tichá
- Children's Hospital National Institute of Children's Diseases, Medical Faculty, Comenius University, Bratislava, Slovakia
| | - Harry Rutter
- Department of Social and Policy Sciences, University of Bath, Bath, UK
| | - Julianne Williams
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
| | - Khadichamo Boymatova
- Division of Noncommunicable Diseases and Promoting Health Through the Life-Course, WHO Country Office for Tajikistan, Dushanbe, Tajikistan
| | - Ivo Rakovac
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
| | - Martin W Weber
- World Health Organization (WHO) Child and Adolescent Health and Development, WHO Regional Office for Europe, Copenhagen, Denmark
| | - João Breda
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
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10
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Fismen AS, Buoncristiano M, Williams J, Helleve A, Abdrakhmanova S, Bakacs M, Bergh IH, Boymatova K, Duleva V, Fijałkowska A, García-Solano M, Gualtieri A, Gutiérrez-González E, Hejgaard T, Huidumac-Petrescu C, Hyska J, Kelleher CC, Kierkegaard L, Kujundžić E, Kunešová M, Milanović SM, Nardone P, Nurk E, Ostojic SM, Ozcebe LH, Peterkova V, Petrauskiene A, Pudule I, Rakhmatulleoeva S, Rakovac I, Rito AI, Rutter H, Sacchini E, Stojisavljević D, Farrugia Sant'Angelo V, Shengelia L, Spinelli A, Spiroski I, Tanrygulyyeva M, Usupova Z, Weghuber D, Breda J. Socioeconomic differences in food habits among 6- to 9-year-old children from 23 countries-WHO European Childhood Obesity Surveillance Initiative (COSI 2015/2017). Obes Rev 2021; 22 Suppl 6:e13211. [PMID: 34235830 DOI: 10.1111/obr.13211] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 12/30/2020] [Accepted: 12/31/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Socioeconomic differences in children's food habits are a key public health concern. In order to inform policy makers, cross-country surveillance studies of dietary patterns across socioeconomic groups are required. The purpose of this study was to examine associations between socioeconomic status (SES) and children's food habits. METHODS The study was based on nationally representative data from children aged 6-9 years (n = 129,164) in 23 countries in the World Health Organization (WHO) European Region. Multivariate multilevel analyses were used to explore associations between children's food habits (consumption of fruit, vegetables, and sugar-containing soft drinks) and parental education, perceived family wealth and parental employment status. RESULTS Overall, the present study suggests that unhealthy food habits are associated with lower SES, particularly as assessed by parental education and family perceived wealth, but not parental employment status. We found cross-national and regional variation in associations between SES and food habits and differences in the extent to which the respective indicators of SES were related to children's diet. CONCLUSION Socioeconomic differences in children's food habits exist in the majority of European and Asian countries examined in this study. The results are of relevance when addressing strategies, policy actions, and interventions targeting social inequalities in children's diets.
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Affiliation(s)
- Anne-Siri Fismen
- Department of Health Promotion and Centre for Evaluation of Public Health Measures, Norwegian Institute of Public Health, Bergen, Norway
| | - Marta Buoncristiano
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
| | - Julianne Williams
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
| | - Arnfinn Helleve
- Centre for Evaluation of Public Health Measures, Norwegian Institute of Health, Oslo, Norway
| | - Shynar Abdrakhmanova
- Department of Science and Professional Development, National Center of Public Health of the Ministry of Health of the Republic of Kazakhstan, Almaty, Kazakhstan.,Kazakhstan School of Public Health, Kazakhstan's Medical University, Almaty, Kazakhstan
| | - Márta Bakacs
- Department of Nutrition and Epidemiology, National Institute of Pharmacy and Nutrition, Budapest, Hungary
| | - Ingunn Holden Bergh
- Department of Health and Inequality, Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Khadichamo Boymatova
- Division of Noncommunicable Diseases and Promoting Health through the Life-course, WHO Country Office for Tajikistan, Dushanbe, Tajikistan
| | - Vesselka Duleva
- Department Food and Nutrition, National Centre of Public Health and Analyses, Sofia, Bulgaria
| | - Anna Fijałkowska
- Department of Cardiology, Institute of Mother and Child, Warsaw, Poland
| | - Marta García-Solano
- Spanish Agency for Food Safety and Nutrition, Ministry of Consumer Affairs, Madrid, Spain
| | | | | | - Tatjana Hejgaard
- Health Promotion and Inequality, Danish Health Authority, Copenhagen, Denmark
| | - Constanta Huidumac-Petrescu
- National Center for Health Assessment and Promotion, National Institute of Public Health, Bucharest, Romania
| | - Jolanda Hyska
- Nutrition and Food Safety Sector, Institute of Public Health, Tirana, Albania
| | - Cecily C Kelleher
- College of Health and Agricultural Sciences, University College Dublin, Dublin, Ireland
| | - Lene Kierkegaard
- National Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Enisa Kujundžić
- Center for Health Ecology, Institute of Public Health, Podgorica, Montenegro
| | - Marie Kunešová
- Obesity Management Centre, Institute of Endocrinology, Prague, Czech Republic
| | - Sanja Musić Milanović
- Croatian Institute of Public Health, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Paola Nardone
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health (Istituto Superiore di Sanità), Rome, Italy
| | - Eha Nurk
- Department of Nutrition Research, National Institute for Health Development, Tallinn, Estonia
| | - Sergej M Ostojic
- Biomedical Sciences Department, Faculty of Sport and Physical Education, University of Novi Sad, Novi Sad, Serbia
| | - Lütfiye Hilal Ozcebe
- Medical Faculty, Department of Public Health, Hacettepe University, Ankara, Turkey
| | - Valentina Peterkova
- Institute of Paediatric Endocrinology, National Medical Research Centre for Endocrinology of the Ministry of Health of the Russian Federation, Moscow, Russian Federation
| | - Ausra Petrauskiene
- Department of Preventive Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Iveta Pudule
- Department of Research and Health Statistics, Centre for Disease and Prevention Control, Riga, Latvia
| | - Sanavbar Rakhmatulleoeva
- Department of the Organization of Medical Services for Mothers, Children and Family Planning Ministry of Health and Social Protection, Dushanbe, Tajikistan
| | - Ivo Rakovac
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
| | - Ana Isabel Rito
- WHO/Europe Collaborating Center for Nutrition and Childhood Obesity - Food and Nutrition Department, National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
| | - Harry Rutter
- Department of Social and Policy Sciences, University of Bath, Bath, UK
| | - Elena Sacchini
- Health Authority, Ministry of Health, San Marino, San Marino
| | - Dragana Stojisavljević
- Faculty of Medicine, University of Banja Luka, Banja Luka, Bosnia and Herzegovina.,Public Health Institute of Republic of Srpska, Banja Luka, Bosnia and Herzegovina
| | | | - Lela Shengelia
- Maternal, Child and Reproductive Health, National Center for Disease Control and Public Health of Georgia, Tbilisi, Georgia
| | - Angela Spinelli
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health (Istituto Superiore di Sanità), Rome, Italy
| | - Igor Spiroski
- Institute of Public Health, Skopje, North Macedonia.,Faculty of Medicine, SS. Cyril and Methodius University, Skopje, North Macedonia
| | - Maya Tanrygulyyeva
- Scientific Research Institute of Maternal and Child Health, Ashgabat, Turkmenistan
| | - Zhamilya Usupova
- Republican Center for Health Promotion and Mass Communication, Ministry of Health of the Kyrgyz Republic, Bishkek, Kyrgyzstan
| | - Daniel Weghuber
- Department of Pediatrics, Paracelsus Medical University, Salzburg, Austria
| | - João Breda
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
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11
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Reile R, Kullamaa L, Hallik R, Innos K, Kukk M, Laidra K, Nurk E, Tamson M, Vorobjov S. Perceived Stress During the First Wave of COVID-19 Outbreak: Results From Nationwide Cross-Sectional Study in Estonia. Front Public Health 2021; 9:564706. [PMID: 34222158 PMCID: PMC8249769 DOI: 10.3389/fpubh.2021.564706] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 05/12/2021] [Indexed: 02/05/2023] Open
Abstract
Objective: To study the population-level mental health responses during the first wave of coronavirus disease 2019 (COVID-19) outbreak in Estonia and analyze its socio-demographic, behavioral, and health-related variations among general population. Methods: This study used nationally representative data on 4,606 individuals, aged 18-79 years from a rapid-response cross-sectional survey conducted in April 2020. Point prevalence and mutually adjusted prevalence rate ratios for perceived stress from log-binomial regression analysis were presented for socio-demographic, behavioral, and health-related variables. Results: This study found that 52.2% of population aged 18-79 reported elevated stress levels in relation to COVID-19 outbreak. Higher levels of perceived stress were found in women, in younger age groups, in Estonians, and in those with higher self-perceived infection risk, presence of respiratory symptoms, and less than optimal health, according to self-reports. Conclusion: Although, the potential long-term health effects of the current crisis are yet unknown, the alarmingly high stress levels among people indicate that the COVID-19 pandemic might have had a widespread effect on people's mental health.
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Affiliation(s)
- Rainer Reile
- Department of Epidemiology and Biostatistics, National Institute for Health Development, Tallinn, Estonia.,Institute for Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Lembe Kullamaa
- Department of Epidemiology and Biostatistics, National Institute for Health Development, Tallinn, Estonia
| | - Reeli Hallik
- Department of Epidemiology and Biostatistics, National Institute for Health Development, Tallinn, Estonia
| | - Kaire Innos
- Department of Epidemiology and Biostatistics, National Institute for Health Development, Tallinn, Estonia
| | - Maarja Kukk
- Department of Nutrition Research, National Institute for Health Development, Tallinn, Estonia
| | - Kaia Laidra
- Department of Epidemiology and Biostatistics, National Institute for Health Development, Tallinn, Estonia
| | - Eha Nurk
- Department of Nutrition Research, National Institute for Health Development, Tallinn, Estonia
| | - Merili Tamson
- Department of Drug and Infectious Diseases Epidemiology, National Institute for Health Development, Tallinn, Estonia
| | - Sigrid Vorobjov
- Department of Drug and Infectious Diseases Epidemiology, National Institute for Health Development, Tallinn, Estonia
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SR, Zamani F, Zambon S, Zampelas A, Zamrazilová H, Zapata ME, Zargar AH, Ko Zaw K, Zdrojewski T, Zejglicova K, Vrkic TZ, Zeng Y, Zhang L, Zhang ZY, Zhao D, Zhao MH, Zhao W, Zhen S, Zheng W, Zheng Y, Zholdin B, Zhou M, Zhu D, Zins M, Zitt E, Zocalo Y, Cisneros JZ, Zuziak M, Ezzati M, Filippi S. Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight. eLife 2021; 10:e60060. [PMID: 33685583 PMCID: PMC7943191 DOI: 10.7554/elife.60060] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 01/07/2021] [Indexed: 02/05/2023] Open
Abstract
From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Nayu Ikeda
- National Institutes of Biomedical Innovation, Health and Nutrition
| | | | | | | | - Jing Liu
- Capital Medical University Beijing An Zhen Hospital
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Shoaib Afzal
- University of Copenhagen
- Copenhagen University Hospital
| | | | | | | | | | | | | | - Ali Ahmadi
- Shahrekord University of Medical Sciences
| | | | | | | | | | - Kamel Ajlouni
- National Center for Diabetes, Endocrinology and Genetics
| | | | | | | | | | | | | | | | | | | | | | | | - Eman Aly
- World Health Organization Regional Office for the Eastern Mediterranean
| | | | - Parisa Amiri
- Research Center for Social Determinants of Health
| | | | | | | | | | | | | | | | | | - Joana Araújo
- Institute of Public Health of the University of Porto
| | | | | | | | | | | | | | | | | | | | | | | | - Shina Avi
- Tel-Aviv University
- Hebrew University of Jerusalem
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Abdul Basit
- Baqai Institute of Diabetology and Endocrinology
| | | | | | | | | | | | | | | | | | | | | | | | - Judith Benedics
- Federal Ministry of Social Affairs, Health, Care and Consumer Protection
| | | | | | | | | | | | | | | | | | | | | | | | - Hongsheng Bi
- Shandong University of Traditional Chinese Medicine
| | - Yufang Bi
- Shanghai Jiao-Tong University School of Medicine
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - João Breda
- World Health Organization Regional Office for Europe
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Laura Censi
- Council for Agricultural Research and Economics
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Angela Chetrit
- The Gertner Institute for Epidemiology and Health Policy Research
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Cora L Craig
- Canadian Fitness and Lifestyle Research Institute
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - Rachel Dankner
- The Gertner Institute for Epidemiology and Health Policy Research
| | | | | | | | - Luc Dauchet
- University of Lille
- Lille University Hospital
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Jia Li Duan
- Beijing Center for Disease Prevention and Control
| | | | | | | | | | | | | | - Anar Dushpanova
- Scuola Superiore Sant'Anna
- Al-Farabi Kazakh National University
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Günther Fink
- Swiss Tropical and Public Health Institute
- University of Basel
| | | | | | | | - Heba M Fouad
- World Health Organization Regional Office for the Eastern Mediterranean
| | | | | | | | | | | | | | | | | | | | | | | | - Mihai Gafencu
- Victor Babes University of Medicine and Pharmacy Timisoara
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Marcel Goldberg
- Institut National de la Santé et de la Recherche Médicale
- Paris University
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Yin Guo
- Capital Medical University Beijing Tongren Hospital
| | | | - Rajeev Gupta
- Eternal Heart Care Centre and Research Institute
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Jie Hao
- Beijing Institute of Ophthalmology
| | | | | | | | | | | | | | - Yuan He
- National Research Institute for Health and Family Planning
| | - Yuna He
- Chinese Center for Disease Control and Prevention
| | | | | | | | | | | | - Ana Henriques
- Institute of Public Health of the University of Porto
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Jost B Jonas
- Institute of Molecular and Clinical Ophthalmology Basel
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- French National Research Institute for Sustainable Development
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- Johns Hopkins Bloomberg School of Public Health
| | | | | | | | | | | | | | | | | | - Roya Kelishadi
- Research Institute for Primordial Prevention of Non-communicable Disease
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Slawomir Koziel
- PASs Hirszfeld Institute of Immunology and Experimental Therapy
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- French National Research Institute for Sustainable Development
| | - Vera Lanska
- Institute for Clinical and Experimental Medicine
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- University of Chinese Academy of Sciences
| | | | | | | | | | | | - Lijuan Liu
- Capital Medical University Beijing Tongren Hospital
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- National Research Institute for Health and Family Planning
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- Institute of Neuroscience of the National Research Council
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- French National Research Institute for Sustainable Development
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- Finnish Institute for Health and Welfare
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Jaume Marrugat
- CIBERCV
- Institut Hospital del Mar d'Investigacions Mèdiques
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Jie Mi
- Capital Institute of Pediatrics
| | | | | | | | | | | | | | - GK Mini
- Women’s Social and Health Studies Foundation
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Marie Moitry
- University of Strasbourg
- Strasbourg University Hospital
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Jorge Motta
- Instituto Conmemorativo Gorgas de Estudios de la Salud
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Jana Námešná
- Banska Bystrica Regional Authority of Public Health
| | | | | | | | | | | | | | | | | | | | - Keiu Nelis
- National Institute for Health Development
| | - Liis Nelis
- National Institute for Health Development
| | | | | | | | | | | | | | | | - Yury P Nikitin
- SB RAS Federal Research Center Institute of Cytology and Genetics
| | - Guang Ning
- Shanghai Jiao-Tong University School of Medicine
| | | | | | - Marianna Noale
- Institute of Neuroscience of the National Research Council
| | | | | | | | | | | | | | | | | | | | - Eha Nurk
- National Institute for Health Development
| | | | | | | | | | | | | | - Kyungwon Oh
- Korea Centers for Disease Control and Prevention
| | | | - Claes Ohlsson
- University of Gothenburg
- Sahlgrenska University Hospital
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Domenico Palli
- Institute for Cancer Research, Prevention and Clinical Network
| | | | | | | | | | | | - Francesco Panza
- IRCCS Ente Ospedaliero Specializzato in Gastroenterologia S. de Bellis
| | | | | | - Suyeon Park
- Korea Centers for Disease Control and Prevention
| | | | | | - Ionela M Pascanu
- University of Medicine, Pharmacy, Science and Technology of Târgu Mures
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Iris Pigeot
- Leibniz Institute for Prevention Research and Epidemiology - BIPS
| | | | | | | | | | | | | | | | | | | | | | - Raluca M Pop
- University of Medicine, Pharmacy, Science and Technology of Târgu Mures
| | | | - Miquel Porta
- Institut Hospital del Mar d'Investigacions Mèdiques
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Maria Puiu
- Victor Babes University of Medicine and Pharmacy Timisoara
| | | | | | | | | | | | | | | | | | | | | | - Manu Raj
- Amrita Institute of Medical Sciences
| | | | | | - Ivo Rakovac
- World Health Organization Regional Office for Europe
| | | | | | | | | | - Rafel Ramos
- Institut Universitari d'Investigació en Atenció Primària Jordi Gol
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Ana Rito
- National Institute of Health Doutor Ricardo Jorge
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Paola Russo
- Institute of Food Sciences of the National Research Council
| | | | | | | | | | | | | | | | | | - Nader Saki
- Ahvaz Jundishapur University of Medical Sciences
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Savvas Savva
- Research and Education Institute of Child Health
| | - Mathilde Savy
- French National Research Institute for Sustainable Development
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Aletta E Schutte
- University of New South Wales
- The George Institute for Global Health
| | | | | | | | - Abhijit Sen
- Center for Oral Health Services and Research Mid-Norway
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Alfonso Siani
- Institute of Food Sciences of the National Research Council
| | | | | | | | | | | | | | | | | | | | | | | | | | - Liam Smeeth
- London School of Hygiene & Tropical Medicine
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Igor Spiroski
- Institute of Public Health
- Ss. Cyril and Methodius University
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Lela Sturua
- National Center for Disease Control and Public Health
| | | | | | | | | | | | | | | | | | | | | | | | | | - Lucjan Szponar
- National Institute of Public Health – National Institute of Hygiene
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Pierre Traissac
- French National Research Institute for Sustainable Development
| | | | | | | | - Oanh TH Trinh
- University of Medicine and Pharmacy at Ho Chi Minh City
| | | | | | | | | | | | | | | | | | | | | | - Gilad Twig
- Tel-Aviv University
- Hebrew University of Jerusalem
| | | | | | | | | | - Eunice Ugel
- Universidad Centro-Occidental Lisandro Alvarado
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Anette Varbo
- Copenhagen University Hospital
- University of Copenhagen
| | | | | | | | - Tomas Vega
- Consejería de Sanidad Junta de Castilla y León
| | | | | | | | | | | | | | | | - Lucie Viet
- National Institute for Public Health and the Environment
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Ningli Wang
- Capital Medical University Beijing Tongren Hospital
| | | | | | | | | | | | | | - Adelheid Weber
- Federal Ministry of Social Affairs, Health, Care and Consumer Protection
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Bogdan Wojtyniak
- National Institute of Public Health - National Institute of Hygiene
| | | | | | | | | | - Jean Woo
- The Chinese University of Hong Kong
| | | | | | - Jianfeng Wu
- Shandong University of Traditional Chinese Medicine
| | | | | | - Haiquan Xu
- Institute of Food and Nutrition Development of Ministry of Agriculture and Rural Affairs
| | - Liang Xu
- Beijing Institute of Ophthalmology
| | | | | | - Weili Yan
- Children's Hospital of Fudan University
| | | | | | - Yang Yang
- Shanghai Educational Development Co. Ltd
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Yi Zeng
- Peking University
- Duke University
| | | | | | - Dong Zhao
- Capital Medical University Beijing An Zhen Hospital
| | | | - Wenhua Zhao
- Chinese Center for Disease Control and Prevention
| | - Shiqi Zhen
- Jiangsu Provincial Center for Disease Control and Prevention
| | | | | | | | - Maigeng Zhou
- Chinese Center for Disease Control and Prevention
| | - Dan Zhu
- Inner Mongolia Medical University
| | - Marie Zins
- Institut National de la Santé et de la Recherche Médicale
- Paris University
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Olsen T, Sollie O, Nurk E, Turner C, Jernerén F, Ivy JL, Vinknes KJ, Clauss M, Refsum H, Jensen J. Exhaustive Exercise and Post-exercise Protein Plus Carbohydrate Supplementation Affect Plasma and Urine Concentrations of Sulfur Amino Acids, the Ratio of Methionine to Homocysteine and Glutathione in Elite Male Cyclists. Front Physiol 2021; 11:609335. [PMID: 33384615 PMCID: PMC7769812 DOI: 10.3389/fphys.2020.609335] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 11/27/2020] [Indexed: 01/06/2023] Open
Abstract
Plasma and tissue sulfur amino acid (SAA) availability are crucial for intracellular methylation reactions and cellular antioxidant defense, which are important processes during exercise and in recovery. In this randomized, controlled crossover trial among eight elite male cyclists, we explored the effect of exhaustive exercise and post-exercise supplementation with carbohydrates and protein (CHO+PROT) vs. carbohydrates (CHO) on plasma and urine SAAs, a potential new marker of methylation capacity (methionine/total homocysteine ratio [Met/tHcy]) and related metabolites. The purpose of the study was to further explore the role of SAAs in exercise and recovery. Athletes cycled to exhaustion and consumed supplements immediately after and in 30 min intervals for 120 min post-exercise. After ~18 h recovery, performance was tested in a time trial in which the CHO+PROT group cycled 8.5% faster compared to the CHO group (41:53 ± 1:51 vs. 45:26 ± 1:32 min, p < 0.05). Plasma methionine decreased by ~23% during exhaustive exercise. Two h post-exercise, further decline in methionine had occured by ~55% in the CHO group vs. ~33% in the CHO+PROT group (pgroup × time < 0.001). The Met/tHcy ratio decreased by ~33% during exhaustive exercise, and by ~54% in the CHO group vs. ~27% in the CHO+PROT group (pgroup × time < 0.001) post-exercise. Plasma cystathionine increased by ~72% in the CHO group and ~282% in the CHO+PROT group post-exercise (pgroup × time < 0.001). Plasma total cysteine, taurine and total glutathione increased by 12% (p = 0.03), 85% (p < 0.001) and 17% (p = 0.02), respectively during exhaustive exercise. Using publicly available transcriptomic data, we report upregulated transcript levels of skeletal muscle SLC7A5 (log2 fold-change: 0.45, FDR:1.8e−07) and MAT2A (log2 fold-change: 0.38, FDR: 3.4e−0.7) after acute exercise. Our results show that exercise acutely lowers plasma methionine and the Met/tHcy ratio. This response was attenuated in the CHO+PROT compared to the CHO group in the early recovery phase potentially affecting methylation capacity and contributing to improved recovery.
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Affiliation(s)
- Thomas Olsen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Ove Sollie
- Department of Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway
| | - Eha Nurk
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.,National Institute of Health Development, Tallinn, Estonia
| | - Cheryl Turner
- Department of Pharmacology, University of Oxford, Oxford, United Kingdom
| | - Fredrik Jernerén
- Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden
| | - John L Ivy
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX, United States
| | - Kathrine J Vinknes
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Matthieu Clauss
- Department of Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway
| | - Helga Refsum
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Jørgen Jensen
- Department of Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway
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14
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Whiting S, Buoncristiano M, Gelius P, Abu-Omar K, Pattison M, Hyska J, Duleva V, Musić Milanović S, Zamrazilová H, Hejgaard T, Rasmussen M, Nurk E, Shengelia L, Kelleher CC, Heinen MM, Spinelli A, Nardone P, Abildina A, Abdrakhmanova S, Aitmurzaeva G, Usuopva Z, Pudule I, Petrauskiene A, Sant'Angelo VF, Kujundzic E, Popovic S, Fismen AS, Bergh IH, Fijalkowska A, Rito AI, Cucu A, Brinduse LA, Peterkova V, Gualtieri A, García-Solano M, Gutiérrez-González E, Abdurrahmonova Z, Boymatova K, Yardim N, Tanrygulyyeva M, Weghuber D, Schindler K, Stojisavljević D, Filipović Hadžiomeragić A, Markidou Ionnaidu E, Ahrens W, Hassapidou M, Kovacs VA, Ostojic SM, Ticha L, Starc G, Russell Jonsson K, Spiroski I, Rutter H, Mendes R, Williams J, Rakovac I, Breda J. Physical Activity, Screen Time, and Sleep Duration of Children Aged 6-9 Years in 25 Countries: An Analysis within the WHO European Childhood Obesity Surveillance Initiative (COSI) 2015-2017. Obes Facts 2021; 14:32-44. [PMID: 33352575 PMCID: PMC7983588 DOI: 10.1159/000511263] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 08/24/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Children are becoming less physically active as opportunities for safe active play, recreational activities, and active transport decrease. At the same time, sedentary screen-based activities both during school and leisure time are increasing. OBJECTIVES This study aimed to evaluate physical activity (PA), screen time, and sleep duration of girls and boys aged 6-9 years in Europe using data from the WHO European Childhood Obesity Surveillance Initiative (COSI). METHOD The fourth COSI data collection round was conducted in 2015-2017, using a standardized protocol that included a family form completed by parents with specific questions about their children's PA, screen time, and sleep duration. RESULTS Nationally representative data from 25 countries was included and information on the PA behaviour, screen time, and sleep duration of 150,651 children was analysed. Pooled analysis showed that: 79.4% were actively playing for >1 h each day, 53.9% were not members of a sport or dancing club, 50.0% walked or cycled to school each day, 60.2% engaged in screen time for <2 h/day, and 84.9% slept for 9-11 h/night. Country-specific analyses of these behaviours showed pronounced differences, with national prevalences in the range of 61.7-98.3% actively playing for >1 h/day, 8.2-85.6% were not members of a sport or dancing club, 17.7-94.0% walked or cycled to school each day, 32.3-80.0% engaged in screen time for <2 h/day, and 50.0-95.8% slept for 9-11 h/night. CONCLUSIONS The prevalence of engagement in PA and the achievement of healthy screen time and sleep duration are heterogenous across the region. Policymakers and other stakeholders, including school administrators and parents, should increase opportunities for young people to participate in daily PA as well as explore solutions to address excessive screen time and short sleep duration to improve the overall physical and mental health and well-being of children.
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Affiliation(s)
- Stephen Whiting
- WHO European Office for the Prevention and Control of NCDs, Moscow, Russian Federation,
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal,
| | - Marta Buoncristiano
- WHO European Office for the Prevention and Control of NCDs, Moscow, Russian Federation
| | - Peter Gelius
- Department of Sport Science and Sport, FAU, Erlangen, Germany
| | - Karim Abu-Omar
- Department of Sport Science and Sport, FAU, Erlangen, Germany
| | - Mary Pattison
- WHO European Office for the Prevention and Control of NCDs, Moscow, Russian Federation
| | - Jolanda Hyska
- Nutrition and Food Safety Sector, Institute of Public Health, Tirana, Albania
| | - Vesselka Duleva
- National Center of Public Health and Analyses, Sofia, Bulgaria
| | - Sanja Musić Milanović
- School of Medicine, University of Zagreb, Croatian Institute of Public Health, Zagreb, Croatia
| | - Hana Zamrazilová
- Institute of Endocrinology, Obesity Management Centre, Prague, Czechia
| | | | - Mette Rasmussen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Eha Nurk
- National Institute for Health Development, Tallinn, Estonia
| | - Lela Shengelia
- National Center for Disease Control and Public Health, Tbilisi, Georgia
| | - Cecily C Kelleher
- National Nutrition Surveillance Centre, University College Dublin, Dublin, Ireland
| | - Mirjam M Heinen
- National Nutrition Surveillance Centre, University College Dublin, Dublin, Ireland
| | | | | | - Akbota Abildina
- National Centre of Public Health of the Ministry of Health of the Republic of Kazakhstan, Nur-Sultan, Kazakhstan
| | - Shynar Abdrakhmanova
- National Centre of Public Health of the Ministry of Health of the Republic of Kazakhstan, Nur-Sultan, Kazakhstan
| | | | | | - Iveta Pudule
- Ministry of Health, Centre for Disease Prevention and Control, Riga, Latvia
| | - Aušra Petrauskiene
- Lithuanian University of Health Sciences, Health Research Institute and Department of Preventive Medicine, Kaunas, Lithuania
| | | | - Enisa Kujundzic
- Institute of Public Health of Montenegro, Podgorica, Montenegro
| | - Stevo Popovic
- Faculty for Sport and Physical Education, University of Montenegro, Niksic, Montenegro
| | - Anne-Siri Fismen
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway
| | - Ingunn Holden Bergh
- Department of Health and Inequality, Division of Mental and Physical Health, Norwegian Institute of Public Health, Bergen, Norway
| | - Anna Fijalkowska
- Department of Cardiology, Institute of Mother and Child, Warsaw, Poland
| | - Ana Isabel Rito
- National Institute of Health Dr Ricardo Jorge I.P., Lisbon, Portugal
| | | | | | | | | | - Marta García-Solano
- Spanish Agency for Food Safety and Nutrition, Ministry of Health, Madrid, Spain
| | | | - Zulfinissio Abdurrahmonova
- Republican Centre for Nutrition, Ministry of Health and Social Protection of Population, Duschanbe, Tajikistan
| | | | - Nazan Yardim
- Diabetes and Metabolic Disorders Department, Ministry of Health, Public Health Institution, Ankara, Turkey
| | - Maya Tanrygulyyeva
- Scientific Research Institute of Maternal and Child Health, Ashgabat, Turkmenistan
| | - Daniel Weghuber
- Department of Pediatrics, Paracelsus Medical University, Salzburg, Austria
| | | | - Dragana Stojisavljević
- Public Health Institute of Republic of Srpska, the University of Banja Luka, Faculty of Medicine, Banja Luka, Bosnia and Herzegovina
| | | | | | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Institute of Statistics, University of Bremen, Bremen, Germany
| | | | | | - Sergej M Ostojic
- Faculty of Sport and PE, University of Novi Sad, Novi Sad, Serbia
| | - Lubica Ticha
- National Institute of Children Diseases, Medical Faculty of Comenius University, Bratislava, Slovakia
| | - Gregor Starc
- Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
| | - Kenisha Russell Jonsson
- Department of Living Conditions and Lifestyle, Public Health Agency of Sweden, Solna, Sweden
| | - Igor Spiroski
- Department of Physiology and Monitoring of Nutrition, Institute of Public Health, Skopje, North Macedonia
| | - Harry Rutter
- Department of Social and Policy Sciences, University of Bath, Bath, United Kingdom
| | - Romeu Mendes
- WHO European Office for the Prevention and Control of NCDs, Moscow, Russian Federation
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Julianne Williams
- WHO European Office for the Prevention and Control of NCDs, Moscow, Russian Federation
| | - Ivo Rakovac
- WHO European Office for the Prevention and Control of NCDs, Moscow, Russian Federation
| | - João Breda
- WHO European Office for the Prevention and Control of NCDs, Moscow, Russian Federation
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15
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Rodriguez-Martinez A, Zhou B, Sophiea MK, Bentham J, Paciorek CJ, Iurilli MLC, Carrillo-Larco RM, Bennett JE, Di Cesare M, Taddei C, Bixby H, Stevens GA, Riley LM, Cowan MJ, Savin S, Danaei G, Chirita-Emandi A, Kengne AP, Khang YH, Laxmaiah A, Malekzadeh R, Miranda JJ, Moon JS, Popovic SR, Sørensen TIA, Soric M, Starc G, Zainuddin AA, Gregg EW, Bhutta ZA, Black R, Abarca-Gómez L, Abdeen ZA, Abdrakhmanova S, Abdul Ghaffar S, Abdul Rahim HF, Abu-Rmeileh NM, Abubakar Garba J, Acosta-Cazares B, Adams RJ, Aekplakorn W, Afsana K, Afzal S, Agdeppa IA, Aghazadeh-Attari J, Aguilar-Salinas CA, Agyemang C, Ahmad MH, Ahmad NA, Ahmadi A, Ahmadi N, Ahmed SH, Ahrens W, Aitmurzaeva G, Ajlouni K, Al-Hazzaa HM, Al-Othman AR, Al-Raddadi R, Alarouj M, AlBuhairan F, AlDhukair S, Ali MM, Alkandari A, Alkerwi A, Allin K, Alvarez-Pedrerol M, Aly E, Amarapurkar DN, Amiri P, Amougou N, Amouyel P, Andersen LB, Anderssen SA, Ängquist L, Anjana RM, Ansari-Moghaddam A, Aounallah-Skhiri H, Araújo J, Ariansen I, Aris 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X, Yiallouros PK, Yoosefi M, Yoshihara A, You QS, You SL, Younger-Coleman NO, Yusof SM, Yusoff AF, Zaccagni L, Zafiropulos V, Zainuddin AA, Zakavi SR, Zamani F, Zambon S, Zampelas A, Zamrazilová H, Zapata ME, Zargar AH, Zaw KK, Zdrojewski T, Zeljkovic Vrkic T, Zeng Y, Zhang L, Zhang ZY, Zhao D, Zhao MH, Zhao W, Zhen S, Zheng W, Zheng Y, Zholdin B, Zhou M, Zhu D, Zocalo Y, Zuñiga Cisneros J, Zuziak M, Ezzati M. Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries and territories: a pooled analysis of 2181 population-based studies with 65 million participants. Lancet 2020; 396:1511-1524. [PMID: 33160572 PMCID: PMC7658740 DOI: 10.1016/s0140-6736(20)31859-6] [Citation(s) in RCA: 171] [Impact Index Per Article: 42.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 08/03/2020] [Accepted: 08/19/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND Comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents. METHODS For this pooled analysis, we used a database of cardiometabolic risk factors collated by the Non-Communicable Disease Risk Factor Collaboration. We applied a Bayesian hierarchical model to estimate trends from 1985 to 2019 in mean height and mean BMI in 1-year age groups for ages 5-19 years. The model allowed for non-linear changes over time in mean height and mean BMI and for non-linear changes with age of children and adolescents, including periods of rapid growth during adolescence. FINDINGS We pooled data from 2181 population-based studies, with measurements of height and weight in 65 million participants in 200 countries and territories. In 2019, we estimated a difference of 20 cm or higher in mean height of 19-year-old adolescents between countries with the tallest populations (the Netherlands, Montenegro, Estonia, and Bosnia and Herzegovina for boys; and the Netherlands, Montenegro, Denmark, and Iceland for girls) and those with the shortest populations (Timor-Leste, Laos, Solomon Islands, and Papua New Guinea for boys; and Guatemala, Bangladesh, Nepal, and Timor-Leste for girls). In the same year, the difference between the highest mean BMI (in Pacific island countries, Kuwait, Bahrain, The Bahamas, Chile, the USA, and New Zealand for both boys and girls and in South Africa for girls) and lowest mean BMI (in India, Bangladesh, Timor-Leste, Ethiopia, and Chad for boys and girls; and in Japan and Romania for girls) was approximately 9-10 kg/m2. In some countries, children aged 5 years started with healthier height or BMI than the global median and, in some cases, as healthy as the best performing countries, but they became progressively less healthy compared with their comparators as they grew older by not growing as tall (eg, boys in Austria and Barbados, and girls in Belgium and Puerto Rico) or gaining too much weight for their height (eg, girls and boys in Kuwait, Bahrain, Fiji, Jamaica, and Mexico; and girls in South Africa and New Zealand). In other countries, growing children overtook the height of their comparators (eg, Latvia, Czech Republic, Morocco, and Iran) or curbed their weight gain (eg, Italy, France, and Croatia) in late childhood and adolescence. When changes in both height and BMI were considered, girls in South Korea, Vietnam, Saudi Arabia, Turkey, and some central Asian countries (eg, Armenia and Azerbaijan), and boys in central and western Europe (eg, Portugal, Denmark, Poland, and Montenegro) had the healthiest changes in anthropometric status over the past 3·5 decades because, compared with children and adolescents in other countries, they had a much larger gain in height than they did in BMI. The unhealthiest changes-gaining too little height, too much weight for their height compared with children in other countries, or both-occurred in many countries in sub-Saharan Africa, New Zealand, and the USA for boys and girls; in Malaysia and some Pacific island nations for boys; and in Mexico for girls. INTERPRETATION The height and BMI trajectories over age and time of school-aged children and adolescents are highly variable across countries, which indicates heterogeneous nutritional quality and lifelong health advantages and risks. FUNDING Wellcome Trust, AstraZeneca Young Health Programme, EU.
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Lauk J, Nurk E, Robertson A, Parlesak A. Culturally Optimised Nutritionally Adequate Food Baskets for Dietary Guidelines for Minimum Wage Estonian Families. Nutrients 2020; 12:nu12092613. [PMID: 32867197 PMCID: PMC7551125 DOI: 10.3390/nu12092613] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 08/20/2020] [Accepted: 08/24/2020] [Indexed: 11/16/2022] Open
Abstract
Although low socioeconomic groups have the highest risk of noncommunicable diseases in Estonia, national dietary guidelines and nutrition recommendations do not consider affordability. This study aims to help develop nutritionally adequate, health-promoting, and culturally acceptable dietary guidelines at an affordable price. Three food baskets (FBs) were optimised using linear programming to meet recommended nutrient intakes (RNIs), or Estonian dietary guidelines, or both. In total, 6255 prices of 422 foods were collected. The Estonian National Dietary Survey (ENDS) provided a proxy for cultural acceptability. Food baskets for a family of four, earning minimum wage, contain between 73 and 96 foods and cost between 10.66 and 10.92 EUR per day. The nutritionally adequate FB that does not follow Estonian dietary guidelines deviates the least (26% on average) from ENDS but contains twice the sugar, sweets, and savoury snacks recommended. The health-promoting FB (40% deviation) contains a limited amount of sugar, sweets, and savoury snacks. However, values for vitamin D, iodine, iron, and folate are low compared with RNIs, as is calcium for women of reproductive age. When both the RNIs and dietary guidelines are enforced, the average deviation (73%) and cost (10.92 EUR) are highest. The composition of these FBs can help guide the development of dietary guidelines for low income families in Estonia.
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Affiliation(s)
- Janne Lauk
- Clinical Research Centre, Department of Clinical Sciences, Faculty of Medicine, Lund University, Jan Waldenströms gata 35, 214 28 Malmö, Sweden;
- Global Nutrition and Health, University College Copenhagen, Sigurdsgade 26, 2200 Copenhagen, Denmark;
| | - Eha Nurk
- Department of Nutrition Research, National Institute for Health Development, Hiiu 42, 11619 Tallinn, Estonia;
| | - Aileen Robertson
- Global Nutrition and Health, University College Copenhagen, Sigurdsgade 26, 2200 Copenhagen, Denmark;
| | - Alexandr Parlesak
- Global Nutrition and Health, University College Copenhagen, Sigurdsgade 26, 2200 Copenhagen, Denmark;
- Correspondence:
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17
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Williams J, Buoncristiano M, Nardone P, Rito AI, Spinelli A, Hejgaard T, Kierkegaard L, Nurk E, Kunešová M, Musić Milanović S, García-Solano M, Gutiérrez-González E, Brinduse LA, Cucu A, Fijałkowska A, Farrugia Sant’Angelo V, Abdrakhmanova S, Pudule I, Duleva V, Yardim N, Gualtieri A, Heinen M, Bel-Serrat S, Usupova Z, Peterkova V, Shengelia L, Hyska J, Tanrygulyyeva M, Petrauskiene A, Rakhmatullaeva S, Kujundzic E, Ostojic SM, Weghuber D, Melkumova M, Spiroski I, Starc G, Rutter H, Rathmes G, Bunge AC, Rakovac I, Boymatova K, Weber M, Breda J. A Snapshot of European Children's Eating Habits: Results from the Fourth Round of the WHO European Childhood Obesity Surveillance Initiative (COSI). Nutrients 2020; 12:E2481. [PMID: 32824588 PMCID: PMC7468747 DOI: 10.3390/nu12082481] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 07/23/2020] [Accepted: 08/04/2020] [Indexed: 12/16/2022] Open
Abstract
Consuming a healthy diet in childhood helps to protect against malnutrition and noncommunicable diseases (NCDs). This cross-sectional study described the diets of 132,489 children aged six to nine years from 23 countries participating in round four (2015-2017) of the WHO European Childhood Obesity Surveillance Initiative (COSI). Children's parents or caregivers were asked to complete a questionnaire that contained indicators of energy-balance-related behaviors (including diet). For each country, we calculated the percentage of children who consumed breakfast, fruit, vegetables, sweet snacks or soft drinks "every day", "most days (four to six days per week)", "some days (one to three days per week)", or "never or less than once a week". We reported these results stratified by country, sex, and region. On a daily basis, most children (78.5%) consumed breakfast, fewer than half (42.5%) consumed fruit, fewer than a quarter (22.6%) consumed fresh vegetables, and around one in ten consumed sweet snacks or soft drinks (10.3% and 9.4%, respectively); however, there were large between-country differences. This paper highlights an urgent need to create healthier food and drink environments, reinforce health systems to promote healthy diets, and continue to support child nutrition and obesity surveillance.
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Affiliation(s)
- Julianne Williams
- WHO European Office for the Prevention and Control of Noncommunicable Diseases, 125009 Moscow, Russian Federation; (M.B.); (G.R.); (A.C.B.); (I.R.); (J.B.)
| | - Marta Buoncristiano
- WHO European Office for the Prevention and Control of Noncommunicable Diseases, 125009 Moscow, Russian Federation; (M.B.); (G.R.); (A.C.B.); (I.R.); (J.B.)
| | - Paola Nardone
- Italian National Institute of Health (Istituto Superiore Di Sanità), 00161 Rome, Italy; (P.N.); (A.S.)
| | - Ana Isabel Rito
- National Institute of Health Dr. Ricardo Jorge, 1600 560 Lisbon, Portugal;
| | - Angela Spinelli
- Italian National Institute of Health (Istituto Superiore Di Sanità), 00161 Rome, Italy; (P.N.); (A.S.)
| | | | - Lene Kierkegaard
- National Institute of Public Health, University of Southern Denmark, 1455 Copenhagen K, Denmark;
| | - Eha Nurk
- Department of Nutrition Research, National Institute for Health Development, 11619 Tallinn, Estonia;
| | - Marie Kunešová
- Institute of Endocrinology, Obesity Unit, 116 94 Prague, Czechia;
| | - Sanja Musić Milanović
- Croatian Institute of Public Health, University of Zagreb, School of Medicine, 10000 Zagreb, Croatia;
| | - Marta García-Solano
- Spanish Agency for Food Safety and Nutrition, 28014 Madrid, Spain; (M.G.-S.); (E.G.-G.)
| | | | - Lacramioara Aurelia Brinduse
- Department of Public Health and Management, University of Medicine and Pharmacy Carol Davila, 030167 Bucharest, Romania; (L.A.B.); (A.C.)
| | - Alexandra Cucu
- Department of Public Health and Management, University of Medicine and Pharmacy Carol Davila, 030167 Bucharest, Romania; (L.A.B.); (A.C.)
| | - Anna Fijałkowska
- Department of Cardiology, Institute of Mother and Child, 01-211 Warsaw, Poland;
| | | | - Shynar Abdrakhmanova
- National Center of Public health, Ministry of Health of the Republic of Kazakhstan, 010000 Nur-Sultan City, Kazakhstan;
| | - Iveta Pudule
- Centre for Disease Prevention and Control, LV-1005 Latvia, Riga;
| | - Vesselka Duleva
- National Center of Public Health and Analyses, 1431 Sofia, Bulgaria;
| | - Nazan Yardim
- Turkish Ministry of Health, Public Health General Directorate, 34400 Istanbul, Turkey;
| | - Andrea Gualtieri
- Health Authority, Department of Health and Social Security, 47893 San Marino, San Marino;
| | - Mirjam Heinen
- National Nutrition Surveillance Centre, University College Dublin, Dublin, Ireland; (M.H.); (S.B.-S.)
| | - Silvia Bel-Serrat
- National Nutrition Surveillance Centre, University College Dublin, Dublin, Ireland; (M.H.); (S.B.-S.)
| | - Zhamyla Usupova
- Republican Center for Health Promotion and Mass Communication, 720040 Bishkek, Kyrgyzstan;
| | - Valentina Peterkova
- Institute of Paediatric Endocrinology, National Medical Research Centre for Endocrinology of the Ministry of Health of the Russian Federation, 117036 Moscow, Russian Federation;
| | - Lela Shengelia
- National Center for Disease Control and Public Health of Georgia, 0198 Tbilisi, Georgia;
| | | | - Maya Tanrygulyyeva
- Internal Diseases Department of the Scientific Clinical Centre of Mother and Child Health, 744036 Ashgabat, Turkmenistan;
| | - Ausra Petrauskiene
- Department of Preventive Medicine, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania;
| | - Sanavbar Rakhmatullaeva
- Department for Organization of Health Services to Children, Mothers, Adolescents and Family Planning, Ministry of Health and Social Protection of Population, 734025 Dushanbe, Tajikistan;
| | - Enisa Kujundzic
- Institute of Public Health of Montenegro, 81 000 Podgorica, Montenegro;
| | - Sergej M. Ostojic
- Applied Bioenergetics Lab, University of Novi Sad, 21000 Novi Sad, Serbia;
| | - Daniel Weghuber
- Department of Pediatrics, Paracelsus Medical University, 5020 Salzburg, Austria;
| | - Marina Melkumova
- Arabkir Medical Centre-Institute of Child and Adolescent Health, 0014 Yerevan, Armenia;
| | - Igor Spiroski
- Institute of Public Health, Faculty of Medicine, Ss. Cyril and Methodius University, 1000 Skopje, North Macedonia;
| | - Gregor Starc
- Faculty of Sport, University of Ljubljana, 1000 Ljubljana, Slovenia;
| | - Harry Rutter
- Department of Social and Policy Sciences, University of Bath, Bath BA2 7AY, UK;
| | - Giulia Rathmes
- WHO European Office for the Prevention and Control of Noncommunicable Diseases, 125009 Moscow, Russian Federation; (M.B.); (G.R.); (A.C.B.); (I.R.); (J.B.)
| | - Anne Charlotte Bunge
- WHO European Office for the Prevention and Control of Noncommunicable Diseases, 125009 Moscow, Russian Federation; (M.B.); (G.R.); (A.C.B.); (I.R.); (J.B.)
| | - Ivo Rakovac
- WHO European Office for the Prevention and Control of Noncommunicable Diseases, 125009 Moscow, Russian Federation; (M.B.); (G.R.); (A.C.B.); (I.R.); (J.B.)
| | | | - Martin Weber
- WHO Child and Adolescent Health and Development, WHO Regional Office for Europe, 2100 Copenhagen, Denmark;
| | - João Breda
- WHO European Office for the Prevention and Control of Noncommunicable Diseases, 125009 Moscow, Russian Federation; (M.B.); (G.R.); (A.C.B.); (I.R.); (J.B.)
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18
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Rippin HL, Hutchinson J, Greenwood DC, Jewell J, Breda JJ, Martin A, Rippin DM, Schindler K, Rust P, Fagt S, Matthiessen J, Nurk E, Nelis K, Kukk M, Tapanainen H, Valsta L, Heuer T, Sarkadi-Nagy E, Bakacs M, Tazhibayev S, Sharmanov T, Spiroski I, Beukers M, van Rossum C, Ocke M, Lindroos AK, Warensjö Lemming E, Cade JE. Inequalities in education and national income are associated with poorer diet: Pooled analysis of individual participant data across 12 European countries. PLoS One 2020; 15:e0232447. [PMID: 32379781 PMCID: PMC7205203 DOI: 10.1371/journal.pone.0232447] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 04/14/2020] [Indexed: 11/21/2022] Open
Abstract
Background Malnutrition linked to noncommunicable diseases presents major health problems across Europe. The World Health Organisation encourages countries to conduct national dietary surveys to obtain data to inform public health policies designed to prevent noncommunicable diseases. Methods Data on 27334 participants aged 19-64y were harmonised and pooled across national dietary survey datasets from 12 countries across the WHO European Region. Weighted mean nutrient intakes were age-standardised using the Eurostat 2013 European Standard Population. Associations between country-level Gross Domestic Product (GDP) and key nutrients and nutrient densities were investigated using linear regression. The potential mitigating influence of participant-level educational status was explored. Findings Higher GDP was positively associated with total sugar intake (5·0% energy for each 10% increase in GDP, 95% CI 0·6, 9·3). Scandinavian countries had the highest vitamin D intakes. Participants with higher educational status had better nutritional intakes, particularly within lower GDP countries. A 10% higher GDP was associated with lower total fat intakes (-0·2% energy, 95% CI -0·3, -0·1) and higher daily total folate intakes (14μg, 95% CI 12, 16) in higher educated individuals. Interpretation Lower income countries and lower education groups had poorer diet, particularly for micronutrients. We demonstrate for the first time that higher educational status appeared to have a mitigating effect on poorer diet in lower income countries. It illustrates the feasibility and value of harmonising national dietary survey data to inform European policy regarding access to healthy diets, particularly in disadvantaged groups. It specifically highlights the need for strong policies supporting nutritional intakes, prioritising lower education groups and lower income countries.
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Affiliation(s)
- H. L. Rippin
- Nutritional Epidemiology Group (NEG), School of Food Science and Nutrition, University of Leeds, Leeds, England, United Kingdom
- * E-mail:
| | - J. Hutchinson
- Nutritional Epidemiology Group (NEG), School of Food Science and Nutrition, University of Leeds, Leeds, England, United Kingdom
| | - D. C. Greenwood
- Clinical and Population Science Department, Institute of Cardiovascular and Metabolic Medicine (LICAMM), University of Leeds, Leeds, England, United Kingdom
| | - J. Jewell
- Division of Noncommunicable Diseases and Promoting Health through the Life-Course, World Health Organization Regional Office for Europe, UN City, Copenhagen, Denmark
| | - J. J. Breda
- Division of Noncommunicable Diseases and Promoting Health through the Life-Course, World Health Organization Regional Office for Europe, UN City, Copenhagen, Denmark
| | - A. Martin
- Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Leeds, England, United Kingdom
| | - D. M. Rippin
- Department of Environment and Geography, University of York, Wentworth Way, Heslington, York, England, United Kingdom
| | - K. Schindler
- Department of Nutritional Sciences, University of Vienna, Vienna, Austria
| | - P. Rust
- Department of Nutritional Sciences, University of Vienna, Vienna, Austria
| | - S. Fagt
- National Food Institute, Kemitorvet, Lyngby, Denmark
| | | | - E. Nurk
- Department of Nutrition Research, National Institute for Health Development, Tallinn, Estonia
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - K. Nelis
- Department of Nutrition Research, National Institute for Health Development, Tallinn, Estonia
| | - M. Kukk
- Department of Nutrition Research, National Institute for Health Development, Tallinn, Estonia
| | - H. Tapanainen
- Public Health Promotion Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - L. Valsta
- Public Health Promotion Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - T. Heuer
- Department of Nutritional Behaviour, Max Rubner-Institut, Federal Research Institute of Nutrition and Food, Karlsruhe, Germany
| | - E. Sarkadi-Nagy
- National Institute of Pharmacy and Nutrition; Budapest, Hungary
| | - M. Bakacs
- National Institute of Pharmacy and Nutrition; Budapest, Hungary
| | - S. Tazhibayev
- Kazakh Academy of Nutrition, Almaty, Republic of Kazakhstan
| | - T. Sharmanov
- Kazakh Academy of Nutrition, Almaty, Republic of Kazakhstan
| | - I. Spiroski
- Institute of Public Health, Skopje, North Macedonia
| | - M. Beukers
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - C. van Rossum
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - M. Ocke
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - A. K. Lindroos
- Livsmedelsverket Swedish National Food Agency, Uppsala, Sweden
| | | | - J. E. Cade
- Nutritional Epidemiology Group (NEG), School of Food Science and Nutrition, University of Leeds, Leeds, England, United Kingdom
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19
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Adamberg K, Jaagura M, Aaspõllu A, Nurk E, Adamberg S. The composition of faecal microbiota is related to the amount and variety of dietary fibres. Int J Food Sci Nutr 2020; 71:845-855. [DOI: 10.1080/09637486.2020.1727864] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Affiliation(s)
- Kaarel Adamberg
- Center of Food and Fermentation Technologies, Tallinn, Estonia
- Department of Chemistry and Biotechnology, Tallinn University of Technology, Tallinn, Estonia
| | - Madis Jaagura
- Center of Food and Fermentation Technologies, Tallinn, Estonia
- Department of Chemistry and Biotechnology, Tallinn University of Technology, Tallinn, Estonia
| | - Anu Aaspõllu
- National Institute for Health Development, Tallinn, Estonia
| | - Eha Nurk
- National Institute for Health Development, Tallinn, Estonia
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Signe Adamberg
- Department of Chemistry and Biotechnology, Tallinn University of Technology, Tallinn, Estonia
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20
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Pinart M, Nimptsch K, Bouwman J, Dragsted LO, Yang C, De Cock N, Lachat C, Perozzi G, Canali R, Lombardo R, D'Archivio M, Guillaume M, Donneau AF, Jeran S, Linseisen J, Kleiser C, Nöthlings U, Barbaresko J, Boeing H, Stelmach-Mardas M, Heuer T, Laird E, Walton J, Gasparini P, Robino A, Castaño L, Rojo-Martínez G, Merino J, Masana L, Standl M, Schulz H, Biagi E, Nurk E, Matthys C, Gobbetti M, de Angelis M, Windler E, Zyriax BC, Tafforeau J, Pischon T. Joint Data Analysis in Nutritional Epidemiology: Identification of Observational Studies and Minimal Requirements. J Nutr 2018; 148:285-297. [PMID: 29490094 DOI: 10.1093/jn/nxx037] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Accepted: 11/06/2017] [Indexed: 02/06/2023] Open
Abstract
Background Joint data analysis from multiple nutrition studies may improve the ability to answer complex questions regarding the role of nutritional status and diet in health and disease. Objective The objective was to identify nutritional observational studies from partners participating in the European Nutritional Phenotype Assessment and Data Sharing Initiative (ENPADASI) Consortium, as well as minimal requirements for joint data analysis. Methods A predefined template containing information on study design, exposure measurements (dietary intake, alcohol and tobacco consumption, physical activity, sedentary behavior, anthropometric measures, and sociodemographic and health status), main health-related outcomes, and laboratory measurements (traditional and omics biomarkers) was developed and circulated to those European research groups participating in the ENPADASI under the strategic research area of "diet-related chronic diseases." Information about raw data disposition and metadata sharing was requested. A set of minimal requirements was abstracted from the gathered information. Results Studies (12 cohort, 12 cross-sectional, and 2 case-control) were identified. Two studies recruited children only and the rest recruited adults. All studies included dietary intake data. Twenty studies collected blood samples. Data on traditional biomarkers were available for 20 studies, of which 17 measured lipoproteins, glucose, and insulin and 13 measured inflammatory biomarkers. Metabolomics, proteomics, and genomics or transcriptomics data were available in 5, 3, and 12 studies, respectively. Although the study authors were willing to share metadata, most refused, were hesitant, or had legal or ethical issues related to sharing raw data. Forty-one descriptors of minimal requirements for the study data were identified to facilitate data integration. Conclusions Combining study data sets will enable sufficiently powered, refined investigations to increase the knowledge and understanding of the relation between food, nutrition, and human health. Furthermore, the minimal requirements for study data may encourage more efficient secondary usage of existing data and provide sufficient information for researchers to draft future multicenter research proposals in nutrition.
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Affiliation(s)
- Mariona Pinart
- Molecular Epidemiology Research Group, Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany
| | - Katharina Nimptsch
- Molecular Epidemiology Research Group, Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany
| | - Jildau Bouwman
- TNO, Microbiology and Systems Biology Group, Zeist, Netherlands
| | - Lars O Dragsted
- Department of Nutrition, Exercise, and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Chen Yang
- Department of Food Safety and Food Quality, Ghent University, Ghent, Belgium
| | - Nathalie De Cock
- Department of Food Safety and Food Quality, Ghent University, Ghent, Belgium
| | - Carl Lachat
- Department of Food Safety and Food Quality, Ghent University, Ghent, Belgium
| | | | | | - Rosario Lombardo
- The Microsoft Research-University of Trento Centre for Computational and Systems Biology (COSBI), Trentino, Italy
| | - Massimo D'Archivio
- Center for Gender-Specific Medicine, Istituto Superiore di Sanità, Rome, Italy
| | | | | | - Stephanie Jeran
- Molecular Epidemiology Research Group, Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany
| | - Jakob Linseisen
- Helmholtz Zentrum München, Institute of Epidemiology, Neuherberg, Germany.,Ludwig-Maximilians-Universität (LMU) München, Medical Faculty, Institute of Medical Information Processing, Biometry, and Epidemiology (IBE), Chair of Epidemiology at University Centre for Health Care Sciences at the Augsburg Clinic (UNIKA-T Augsburg), Ausburg, Germany
| | - Christina Kleiser
- Helmholtz Zentrum München, Institute of Epidemiology, Neuherberg, Germany
| | - Ute Nöthlings
- Department of Nutrition and Food Sciences, University of Bonn, Bonn, Germany
| | - Janett Barbaresko
- Department of Nutrition and Food Sciences, University of Bonn, Bonn, Germany
| | - Heiner Boeing
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany
| | - Marta Stelmach-Mardas
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany.,Department of Pediatric Gastroenterology and Metabolic Diseases, Poznan University of Medical Sciences, Poznan, Poland
| | - Thorsten Heuer
- Department of Nutritional Behavior, Max Rubner-Institut, Federal Research Institute of Nutrition and Food, Karlsruhe, Germany
| | - Eamon Laird
- Centre for Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Janette Walton
- School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
| | - Paolo Gasparini
- Department of Medical Sciences, University of Trieste, Trieste, Italy.,Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", Trieste, Italy
| | - Antonietta Robino
- Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", Trieste, Italy
| | - Luis Castaño
- Spanish Biomedical Research Center in Diabetes and Associated Metabolic Disorders (CIBERDEM), Rare Diseases Networking Biomedical Research Centre (CIBERER), BioCruces-Hospital Universitario Cruces-The University of the Basque Country (Basque: Euskal Herriko Unibertsitatea/Spanish: Universidad del País Vasco (UPV/EHU)), Barakaldo, Spain
| | - Gemma Rojo-Martínez
- Spanish Biomedical Research Center in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain.,Unidad de Gestión Clínica (UGC) Endocrinology and Nutrition. Hospital Regional Universitario de Málaga, Institute of Biomedical Research in Malaga (IBIMA), Málaga, Spain
| | - Jordi Merino
- Research Unit on Lipids and Atherosclerosis, Universitat Rovira i Virgili, Reus, Spain.,Diabetes Unit and Center for Human Genetic Research, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Luis Masana
- Research Unit on Lipids and Atherosclerosis, Universitat Rovira i Virgili, Reus, Spain
| | - Marie Standl
- Helmholtz Zentrum München-German Research Center for Environmental Health, Institute of Epidemiology I, Neuherberg, Germany
| | - Holger Schulz
- Helmholtz Zentrum München-German Research Center for Environmental Health, Institute of Epidemiology I, Neuherberg, Germany
| | - Elena Biagi
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum-University of Bologna, Bologna, Italy
| | - Eha Nurk
- National Institute for Health Development, Tallinn, Estonia
| | - Christophe Matthys
- Department of Clinical and Experimental Medicine, The Katholieke Universiteit Leuven (KU Leuven) and Department of Endocrinology, University Hospitals Leuven, Leuven, Belgium
| | - Marco Gobbetti
- Faculty of Science and Technology, Free University of Bozen, Bolzano, Italy
| | - Maria de Angelis
- Department of Soil, Plant and Food Sciences, University of Bari Aldo Moro, Bari, Italy
| | - Eberhard Windler
- Preventive Medicine, University Heart Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Birgit-Christiane Zyriax
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jean Tafforeau
- Scientific Institute of Public Health, Brussels, Belgium
| | - Tobias Pischon
- Molecular Epidemiology Research Group, Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany.,Charité Universitätsmedizin Berlin, Berlin, Germany.,MDC/BIH Biobank, Max Delbrück Center for Molecular Medicine and Berlin Institute of Health, Berlin, Germany.,German Centre for Cardiovascular Research (DZHK), Berlin, Germany
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21
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Vinknes KJ, Nurk E, Tell GS, Sulo G, Refsum H, Elshorbagy AK. The relation of CUN-BAE index and BMI with body fat, cardiovascular events and diabetes during a 6-year follow-up: the Hordaland Health Study. Clin Epidemiol 2017; 9:555-566. [PMID: 29184445 PMCID: PMC5685095 DOI: 10.2147/clep.s145130] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective We compared Clínica Universidad de Navarra-Body Adiposity Estimator (CUN-BAE) and body mass index (BMI) as correlates of body fat percent (BF%) and the association with future risk of cardiovascular disease (CVD) and type 2 diabetes in a Caucasian population. Methods We used data from 6796 individuals (born 1925–27 and 1950–52) from the Hordaland Health Study, a prospective cohort study in Norway. The study was conducted in 1992–1993 and 1997–1999. Cross-sectional analyses were conducted with data from 1997/99, including BF% measured by dual-energy X-ray absorptiometry. Longitudinal analyses included BMI and CUN-BAE calculated in 1992/93, and self-reported information on CVD events and diabetes in 1997/99. Results The correlation between CUN-BAE and BF% (r=0.88) was stronger than between BMI and BF% (r=0.56). In sex-stratified analyses, CUN-BAE and BMI correlated similarly with BF% in men (r=0.77 and r=0.76, respectively) and women (r=0.82 and r=0.81, respectively). In longitudinal analyses, the odds ratio (per 1 SD increase) of CVD and type 2 diabetes was higher for BMI (ORCVD =1.23 [95% CI: 1.11–1.36]; ORdiabetes =2.11 [1.82–2.45]) than for CUN-BAE (ORCVD =1.15 [1.04–1.27]; ORdiabetes =2.06 [1.72–2.47]) in the total population. In sex-stratified analyses, CUN-BAE showed higher CVD and diabetes risk than BMI: in men BMI ORCVD =1.22 (1.04–1.44), ORdiabetes =2.13 (1.64–2.83); CUN-BAE ORCVD =1.93 (1.54–2.43), ORdiabetes =4.33 (2.80–6.71); and in women BMI ORCVD =1.22 (1.07–1.39), ORdiabetes =2.11 (1.76–2.53); CUN-BAE ORCVD =2.06 (1.69–2.51), ORdiabetes =5.45 (3.87–7.67). Conclusion CUN-BAE is more strongly associated with future risk of type 2 diabetes and CVD compared with BMI in analysis stratified by sex. As a measure of adiposity in men and women separately, CUN-BAE has no advantage over BMI, except when the value of estimated BF% itself is of interest.
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Affiliation(s)
- Kathrine J Vinknes
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Eha Nurk
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Surveillance and Evaluation, National Institute for Health Development, Tallinn, Estonia
| | - Grethe S Tell
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Gerhard Sulo
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Helga Refsum
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Pharmacology, University of Oxford, Oxford, UK
| | - Amany K Elshorbagy
- Department of Pharmacology, University of Oxford, Oxford, UK.,Department of Physiology, Faculty of Medicine, University of Alexandria, Alexandria, Egypt
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22
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Elias A, Roasto M, Reinik M, Nelis K, Nurk E, Elias T. Acrylamide in commercial foods and intake by infants in Estonia. Food Addit Contam Part A Chem Anal Control Expo Risk Assess 2017; 34:1875-1884. [PMID: 28671034 DOI: 10.1080/19440049.2017.1347283] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Acrylamide is formed when certain foods with low moisture are prepared at above 120 ºC, especially those foods containing asparagine and reducing sugars such as glucose and fructose. Acrylamide is a probable carcinogen, and from animal evidence the margins of exposure indicate a concern for neoplastic effects. On a body weight basis infants´ acrylamide intakes are often higher than those of adults. The aim of the study was to determine acrylamide levels in different commercially-available foods and to assess dietary acrylamide intakes by infants. The acrylamide content in samples ranged widely, from <LOD to 3,300 µg kg-1 depending on the product category, and the food product within the category. Excluding coffee substitutes, the highest mean acrylamide values were found for potato crisps and snacks. Among baby foods, the highest mean level of acrylamide was found in vegetable-based non-cereal foods (65 µg kg-1), followed by processed cereal-based infant foods (42 µg kg-1). The indicative acrylamide values were most frequently exceeded for vegetable-based baby foods. The mean acrylamide content in baby foods ranged from <30 to 65 µg kg-1. Among consumers of acrylamide-containing baby food, the MOE values ranged between 185 and 620 for neoplastic effects, and between 467 and 1,569 for non-neoplastic effects. These MOE values indicate the need to reduce acrylamide exposure among infants in Estonia.
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Affiliation(s)
- Andres Elias
- a Department of Food Hygiene and Veterinary Public Health , Institute of Veterinary Medicine and Animal Sciences, Estonian University of Life Sciences , Tartu , Estonia
| | - Mati Roasto
- a Department of Food Hygiene and Veterinary Public Health , Institute of Veterinary Medicine and Animal Sciences, Estonian University of Life Sciences , Tartu , Estonia
| | - Mari Reinik
- b Health Board, Tartu Laboratory , Tartu , Estonia
| | - Keiu Nelis
- c Department of Surveillance and Evaluation , National Institute for Health Development , Tallinn , Estonia
| | - Eha Nurk
- c Department of Surveillance and Evaluation , National Institute for Health Development , Tallinn , Estonia.,d Department of Nutrition , Institute of Basic Medical Science, University of Oslo , Oslo , Norway
| | - Terje Elias
- a Department of Food Hygiene and Veterinary Public Health , Institute of Veterinary Medicine and Animal Sciences, Estonian University of Life Sciences , Tartu , Estonia
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23
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Nurk E, Nelis K, Saamel M, Martverk M, Jõeleht A, Nelis L. National Dietary Survey among children up to ten years old and breastfeeding mothers in Estonia. ACTA ACUST UNITED AC 2017. [DOI: 10.2903/sp.efsa.2017.en-1199] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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24
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Abstract
Smoking behaviour and exposure to environmental tobacco smoke (ETS) were examined in three cross-sectional surveys from 1991/92, 1993/94, and 1995/96. The study population comprised 3,185 Estonian and Russian adolescents from 17 schools in Tallinn, Estonia. Prevalence of ever-smoking girls increased by 13 percentage points versus 2% among boys during the study period. Mean ages of the first experimentation with tobacco and exposure to ETS did not change significantly. Regular smoking increased significantly from 1991/92 to 1995/96. Detailed analyses for the 1995/96 survey showed that among ethnic Estonians, compared with ethnic Russians, the prevalence of ever-smokers and regular smoking were higher, mean age for the first experimentation was younger, and on average, Estonians smoked more cigarettes per week. The smoking trend among adolescents in Estonia is worsening; especially among Estonian youth. This study identifies a compelling need for national and community-wide efforts to deter adolescents from smoking and to reduce the exposure to ETS.
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Affiliation(s)
- Eha Nurk
- Research Centre for Health Promotion, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Maurice B. Mittelmark
- Research Centre for Health Promotion, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Lagle Suurorg
- Estonian Institute of Cardiology, Department of Preventive Cardiology for Children, Tallinn, Estonia
| | - Inna Tur
- Estonian Institute of Cardiology, Department of Preventive Cardiology for Children, Tallinn, Estonia
| | - Ester Luiga
- Estonian Institute of Cardiology, Department of Preventive Cardiology for Children, Tallinn, Estonia
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25
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Vinknes KJ, Dekker JM, Drevon CA, Refsum H, Nurk E, Nijpels G, Stehouwer CDA, Teerlink T, Tell GS, Nygård O, Vollset SE, Ueland PM, Elshorbagy AK. Plasma sulfur amino acids and stearoyl-CoA desaturase activity in two Caucasian populations. Prostaglandins Leukot Essent Fatty Acids 2013; 89:297-303. [PMID: 24120123 DOI: 10.1016/j.plefa.2013.09.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Revised: 09/04/2013] [Accepted: 09/09/2013] [Indexed: 12/29/2022]
Abstract
In rats, dietary restriction of the cysteine precursor methionine suppresses hepatic stearoyl-CoA desaturase (SCD)-1 expression and activity, whereas cysteine supplementation reverses these effects. In 2 independent cohorts: Hordaland Health Study (HUSK; N=2021, aged 71-74y), Norway, and Hoorn study (N=686, aged 50-87y), Netherlands, we examined the cross-sectional associations of plasma sulfur-containing compounds (SCC; methionine, S-adenosylmethionine, S-adenosylhomocysteine, homocysteine, cystathionine, total cysteine (tCys), glutathione and cysteinylglycine) with SCD-16 index (16:1n-7/16:0), estimated from fatty acid profiles of total plasma or serum lipids. Only tCys was consistently associated with SCD-16 index after adjustments for sex and age (HUSK: partial r=0.14; Hoorn: partial r=0.11, P<0.001 for both), and after further adjustments for other SCC, body fat, diet, exercise and plasma lipids (HUSK: partial r=0.07, P=0.004; Hoorn: partial r=0.12, P=0.013). Together with animal data showing an effect of dietary cysteine on SCD1, our results suggest a role for cysteine in SCD1 regulation in humans.
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Affiliation(s)
- K J Vinknes
- Department of Nutrition, Institute of Basic Medical Science, Faculty of Medicine, University of Oslo, Post box 1046 Blindern, 0317 Oslo, Norway.
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26
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Vinknes KJ, Elshorbagy AK, Drevon CA, Nurk E, Tell GS, Nygård O, Vollset SE, Refsum H. Associations between plasma polyunsaturated fatty acids, plasma stearoyl-CoA desaturase indices and body fat. Obesity (Silver Spring) 2013; 21:E512-9. [PMID: 23512934 DOI: 10.1002/oby.20457] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2012] [Accepted: 03/07/2013] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Stearoyl-CoA desaturase (SCD)-1 deficient mice are resistant to obesity and plasma SCD indices are related to obesity in humans. Both n-3 and n-6 polyunsaturated fatty acids (PUFA) regulate expression of the SCD enzymes. Whether higher plasma PUFA were associated with lower SCD indices in humans was examined. DESIGN AND METHODS Population-based study of 2,021 elderly subjects from the Hordaland Health Study. Using multivariate linear regression, the cross-sectional associations among plasma PUFA, estimated SCD indices (from fatty acid profiles in plasma total lipids), and fat mass measured by dual-energy X-ray absorptiometry were explored. Two plasma SCD indices were used: SCD-16 (16:1n-7/16:0) and SCD-18 (18:1n-9/18:0). RESULTS Plasma total, n-6 and n-3 PUFA were inversely associated with both SCD indices (P < 0.001 for all). Among the individual PUFA, 18:2n-6 showed the strongest association with SCD-16 (partial r = -0.59, P < 0.001) followed by 20:5n-3 (partial r = -0.13; P < 0.001). Plasma total, n-6 and n-3 PUFA were inversely associated with body fat (P < 0.001 for all); the associations were markedly attenuated following adjustment for SCD-16. CONCLUSIONS The epidemiological data are in line with animal studies and suggest that PUFA may decrease SCD1 activity in humans, with possible reduction in body fat.
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Affiliation(s)
- Kathrine J Vinknes
- Department of Nutrition, Institute of Basic Medical Science, Faculty of Medicine, University of Oslo, Oslo, Norway
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27
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Vinknes KJ, Elshorbagy AK, Nurk E, Drevon CA, Gjesdal CG, Tell GS, Nygård O, Vollset SE, Refsum H. Plasma stearoyl-CoA desaturase indices: association with lifestyle, diet, and body composition. Obesity (Silver Spring) 2013; 21:E294-302. [PMID: 23404690 DOI: 10.1002/oby.20011] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2012] [Accepted: 06/04/2012] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Stearoyl-coenzyme A desaturase-1 (SCD1) is a key enzyme in fatty acid and energy metabolism. Increased hepatic SCD1 activity is associated with obesity and obesity-related diseases. We examined the relations of two plasma SCD activity indices (16:1n-7/16:0, 18:1n-9/18:0) with body composition, and the association of lifestyle and dietary variables with the plasma SCD indices. DESIGN AND METHODS This population-based, cross-sectional study of 2021 elderly (71-74 y) men and women from the Hordaland Health Study in Western Norway was conducted using a validated food frequency questionnaire, body composition measurements by dual-energy X-ray absorptiometry and determination of the plasma fatty acid profile. RESULTS In multivariate regression analyses, plasma SCD indices were positively associated with BMI and body fat (P < 0.001 for both). From the 2.5th to 97.5th percentiles of plasma SCD-16 and SCD-18 indices, fat mass differed by about 8 kg and 5 kg, respectively. Intake of polyunsaturated fatty acids were negatively associated with SCD-16 (partial r = -0.30) and SCD-18 (partial r = -0.24) (P < 0.001 for both). Alcohol intake was positively associated with SCD-16 (partial r = 0.26) and SCD-18 (partial r = 0.16) (P < 0.001 for both), whereas coffee consumption and physical activity were inversely associated with SCD-16 (P = 0.026 and P = 0.006, respectively) and SCD-18 (P = 0.001 and P = 0.022, respectively). CONCLUSIONS In this elderly population, plasma markers of SCD1 activity are associated with increased adiposity. Furthermore, modifiable dietary habits and lifestyle are associated with plasma SCD indices. These results suggest that SCD1 activity may be a promising target for weight control.
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Affiliation(s)
- Kathrine J Vinknes
- Department of Nutrition, Institute of Basic Medical Science, Faculty of Medicine, University of Oslo, Oslo, Norway.
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Vinknes KJ, de Vogel S, Elshorbagy AK, Nurk E, Drevon CA, Gjesdal CG, Tell GS, Vollset SE, Refsum H. Dietary intake of protein is positively associated with percent body fat in middle-aged and older adults. J Nutr 2011; 141:440-6. [PMID: 21248195 DOI: 10.3945/jn.110.133710] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Data on associations between dietary intake of macronutrients and body composition in the general population are sparse. This population-based, cross-sectional study of 4478 middle-aged (47-49 y) and elderly (71-74 y) men and women from the Hordaland Health Study in western Norway was conducted using a validated FFQ and measurements by dual-energy X-ray absorptiometry. The relation between macronutrient intake [percentage of total energy intake (E%)] and percent body fat was investigated in the total population and in a subgroup with intermediate BMI and stable weight (BMI within the 25th-75th percentile and weight change <5% during the last 6 y; n = 975). In the total population, protein intake (E%) was associated with higher percent body fat (partial r = 0.11; P < 0.001) in multivariate linear regression analysis. In the subgroup with intermediate BMI and stable weight, there was no association between protein intake (E%) and percent body fat. Fat intake (E%) was positively associated (partial r = 0.07) whereas carbohydrate intake (E%) was inversely associated (partial r = -0.07) with percent body fat (P = 0.042 for both) in the subgroup with intermediate BMI and stable weight. Both in the total population and in the stable weight group, physical activity was inversely related to adiposity (partial r = -0.15 and -0.12, respectively; P < 0.001). Our results may explain some of the conflicting data on the effects of macronutrients in different populations and suggest the potential importance of protein intake as a factor in obesity.
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Affiliation(s)
- Kathrine J Vinknes
- Department of Nutrition, Institute of Basic Medical Science, Faculty of Medicine, University of Oslo, 0316 Oslo, Norway.
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29
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Vogiatzoglou A, Oulhaj A, Smith AD, Nurk E, Drevon CA, Ueland PM, Vollset SE, Tell GS, Refsum H. Determinants of plasma methylmalonic acid in a large population: implications for assessment of vitamin B12 status. Clin Chem 2009; 55:2198-206. [PMID: 19833840 DOI: 10.1373/clinchem.2009.128678] [Citation(s) in RCA: 89] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND Methylmalonic acid (MMA) in plasma or serum is widely used for assessment of vitamin B(12) status. However, data are sparse regarding factors, besides renal function, that may influence MMA concentrations. We searched for important determinants of plasma MMA in the general population. METHODS In 6946 middle-aged (47-49 years) and elderly (71-74 years) individuals from the Hordaland Homocysteine Study in Norway, we collected anthropometric measurements, lifestyle data, and plasma MMA, vitamin B(12), and creatinine measurements. For 5820 individuals, we also collected dietary data. RESULTS Age and plasma creatinine were positively associated with plasma MMA, whereas plasma vitamin B(12) was negatively associated. These variables together with sex were the strongest determinants of plasma MMA, accounting for 16% of the variation (R(2) = 0.16). Addition of anthropometric measures and lifestyle and dietary factors only gave slight improvement (total R(2) = 0.167). Increased plasma MMA was seen when plasma vitamin B(12) was <400 pmol/L. In individuals with vitamin B(12) >or =400 micromol/L (vitamin B(12)-replete), the 2.5th-97.5th percentile reference limits for MMA were 0.10-0.28 micromol/L (middle-aged) and 0.10-0.36 micromol/L (elderly). When plotted against creatinine (nomograms), the 97.5th percentile of MMA was similar in men and women but approximately 0.15 micromol/L higher in elderly than middle-aged individuals. Vitamin B(12)-replete participants had MMA upper limits approximately 0.1 micromol/L (elderly) and 0.04 micromol/L (middle-aged) below those of the unselected population at all creatinine concentrations. CONCLUSIONS Identified determinants accounted for <17% of the overall variation in plasma MMA. The difference in MMA between middle-aged and elderly individuals is only partly explained by creatinine and vitamin B(12) concentrations.
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Affiliation(s)
- Anna Vogiatzoglou
- OPTIMA, Department of Physiology, Anatomy & Genetics, University of Oxford, Oxford, UK.
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30
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Elshorbagy AK, Gjesdal CG, Nurk E, Tell GS, Ueland PM, Nygård O, Tverdal A, Vollset SE, Smith AD, Refsum H. Cysteine, homocysteine and bone mineral density: a role for body composition? Bone 2009; 44:954-8. [PMID: 19168166 DOI: 10.1016/j.bone.2008.12.018] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2008] [Revised: 12/11/2008] [Accepted: 12/23/2008] [Indexed: 11/25/2022]
Abstract
BACKGROUND Plasma total cysteine (tCys) and homocysteine (tHcy) are associated with body composition, which in turn affects bone mineral density (BMD). OBJECTIVES To investigate whether associations of tCys and tHcy with BMD are mediated through body composition (fat mass and/or lean mass). DESIGN Using data from 5238 Hordaland Homocysteine Study participants, we fit multiple linear regression models and concentration-response curves to explore the relationships between tCys, tHcy, and BMD, with and without adjustment for body mass index (BMI), lean mass and/or fat mass. RESULTS All associations were stronger in women. tCys was positively associated with BMD (women, partial r=0.11; men, partial r=0.07, p<or=0.001 for both), but this association was markedly attenuated after adjustment for fat mass. tHcy showed an inverse association with BMD in women (partial r=-0.09, p<0.001), which remained significant after adjustment for lean mass and fat mass. In men and women, changes in tCys or tHcy during 6 years were not associated with BMD at follow-up. Weight gain during 6 years predicted higher BMD at follow-up (p<or=0.009) independent of nutrient intakes, physical activity and baseline BMI. Baseline tHcy inversely predicted BMD measured 6 years later (partial r=-0.11, p<0.001 in women; partial r=-0.07, p=0.002 in men) independent of baseline BMI, while a positive association of baseline tCys with BMD at follow-up (partial r=0.10 in women, 0.09 in men, p<or=0.001) disappeared after adjustment for baseline BMI. CONCLUSION tHcy is inversely associated with BMD independent of body composition, while the positive association of tCys with BMD appears to be mainly mediated through fat mass.
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Affiliation(s)
- Amany K Elshorbagy
- Department of Physiology, Le Gros Clarke Building, Anatomy and Genetics, Oxford University, UK.
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31
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Vogiatzoglou A, Smith AD, Nurk E, Berstad P, Drevon CA, Ueland PM, Vollset SE, Tell GS, Refsum H. Dietary sources of vitamin B-12 and their association with plasma vitamin B-12 concentrations in the general population: the Hordaland Homocysteine Study. Am J Clin Nutr 2009; 89:1078-87. [PMID: 19190073 DOI: 10.3945/ajcn.2008.26598] [Citation(s) in RCA: 105] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Limited information is available on the association between vitamin B-12 status and intake from different dietary sources. OBJECTIVE We investigated the relation of dietary intake of different food items with plasma vitamin B-12 concentrations in the general population. DESIGN A cross-sectional, population-based study of 5937 subjects in 2 age groups (47-49 and 71-74 y) from the Hordaland Homocysteine Study in Norway was conducted by using a food-frequency questionnaire and measurements of plasma vitamin B-12 concentrations. RESULTS A significant difference in plasma vitamin B-12 concentrations was observed with increasing total vitamin B-12 intake. A plateau was reached at an intake of approximately 10 microg/d. Plasma vitamin B-12 was associated with intakes of increasing amounts of vitamin B-12 from dairy products or fish (P for trend <0.001 for both) but not with intakes of vitamin B-12 from meat or eggs. For the same content of vitamin B-12, intake from dairy products led to the greatest increase in plasma vitamin B-12. Total intake of vitamin B-12, particularly from milk and fish, decreased the risk of vitamin B-12 concentrations <200 pmol/L and impaired vitamin B-12 function (vitamin B-12 <200 pmol/L and methylmalonic acid >0.27 micromol/L) in the total group and in 71-74-y-old subjects. CONCLUSIONS Dietary intake of dairy products and fish are significant contributors to plasma vitamin B-12 and may improve plasma vitamin B-12 status. Vitamin B-12 appears to be more bioavailable from dairy products; guidelines for improving vitamin B-12 status should take this into consideration.
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Affiliation(s)
- Anna Vogiatzoglou
- OPTIMA, Department of Physiology, Anatomy & Genetics, University of Oxford, Oxford, UK.
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Nurk E, Refsum H, Drevon CA, Tell GS, Nygaard HA, Engedal K, Smith AD. Intake of flavonoid-rich wine, tea, and chocolate by elderly men and women is associated with better cognitive test performance. J Nutr 2009; 139:120-7. [PMID: 19056649 DOI: 10.3945/jn.108.095182] [Citation(s) in RCA: 155] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
In a cross-sectional study, we examined the relation between intake of 3 common foodstuffs that contain flavonoids (chocolate, wine, and tea) and cognitive performance. 2031 participants (70-74 y, 55% women) recruited from the population-based Hordaland Health Study in Norway underwent cognitive testing. A cognitive test battery included the Kendrick Object Learning Test, Trail Making Test, part A (TMT-A), modified versions of the Digit Symbol Test, Block Design, Mini-Mental State Examination, and Controlled Oral Word Association Test. Poor cognitive performance was defined as a score in the highest decile for the TMT-A and in the lowest decile for all other tests. A self-reported FFQ was used to assess habitual food intake. Participants who consumed chocolate, wine, or tea had significantly better mean test scores and lower prevalence of poor cognitive performance than those who did not. Participants who consumed all 3 studied items had the best test scores and the lowest risks for poor test performance. The associations between intake of these foodstuffs and cognition were dose dependent, with maximum effect at intakes of approximately 10 g/d for chocolate and approximately 75-100 mL/d for wine, but approximately linear for tea. Most cognitive functions tested were influenced by intake of these 3 foodstuffs. The effect was most pronounced for wine and modestly weaker for chocolate intake. Thus, in the elderly, a diet high in some flavonoid-rich foods is associated with better performance in several cognitive abilities in a dose-dependent manner.
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Affiliation(s)
- Eha Nurk
- Department of Nutrition, University of Oslo, 0316 Oslo, Norway
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Dudding T, Heron J, Thakkinstian A, Nurk E, Golding J, Pembrey M, Ring SM, Attia J, Scott RJ. Factor V Leiden is associated with pre-eclampsia but not with fetal growth restriction: a genetic association study and meta-analysis. J Thromb Haemost 2008; 6:1869-75. [PMID: 18752569 DOI: 10.1111/j.1538-7836.2008.03134.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Adverse pregnancy outcomes have been related to environmental and/or genetic factors. Of interest are genes associated with the clotting system as any perturbation in the balance of thrombotic and thrombolytic cascades could affect the placental circulation and hence the viability of the developing fetus. Several previous reports using relatively small numbers of cases and controls have suggested that there is a relationship between poor pregnancy outcomes and two polymorphisms, one in the factor V gene, the 1691G to A change (rs6025) located on chromosome 1q23 (factor V Leiden, FVL), and the other in the prothrombin gene, 20210G to A change (rs1799963) on chromosome 11p11-q12 (PT). These results, however, are conflicting. METHODS We genotyped 6755 mother/infant pairs from the Avon Longitudinal Study of Parents and Children (ALSPAC) to determine whether maternal or fetal FVL or PT, either alone or in combination, are associated with fetal growth restriction (FGR) or pre-eclampsia (PE). We also added the present results to previous cohort studies using meta-analysis. RESULTS Smoking, primiparity and lower body mass index (BMI) were all associated with FGR, but neither maternal nor fetal FVL or PT, singly or in combination, were associated with FGR in the ALSPAC cohort. Meta-analysis confirmed the lack of association between maternal FVL and FGR with a pooled odds ratio (OR) of 1.15 [95% confidence interval (CI) 0.95-1.39]. High BMI, primiparity, diabetes and chronic hypertension were all associated with pre-eclampsia. Combining ALSPAC results with previous studies in ameta-analysis indicated that maternal FVL is significantly associated with pre-eclampsia, with a pooled OR of 1.49 (95% CI 1.13-1.96). CONCLUSION Neither maternal nor fetal FVL or PT, singly or in combination, are associated with FGR; this contradicts previous case-control studies and meta-analyses based on these studies. In a meta-analysis of all published cohort studies to date, maternal FVL appears to increase the risk of pre-eclampsia by almost 50%. This result is robust, homogeneous and does not appear to be affected by publication bias.
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Affiliation(s)
- T Dudding
- Hunter Genetics, Hunter New England Health Service, NSW, Australia
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Elshorbagy AK, Nurk E, Gjesdal CG, Tell GS, Ueland PM, Nygård O, Tverdal A, Vollset SE, Refsum H. Homocysteine, cysteine, and body composition in the Hordaland Homocysteine Study: does cysteine link amino acid and lipid metabolism? Am J Clin Nutr 2008; 88:738-46. [PMID: 18779291 DOI: 10.1093/ajcn/88.3.738] [Citation(s) in RCA: 122] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The lean phenotype of cystathionine beta-synthase-deficient homocystinuria and the positive association of plasma total cysteine (tCys) with body mass index (BMI) suggest that total homocysteine (tHcy) and tCys are associated with body composition. OBJECTIVES We aimed to study associations of tCys and tHcy with body composition in the general population. DESIGN Using data from 7038 Hordaland Homocysteine Study participants, we fitted regression models and dose-response curves of tCys and tHcy with BMI. In 5179 participants, we investigated associations of tCys and tHcy with fat mass and lean mass and examined whether changes in these aminothiols predicted body composition 6 y later. RESULTS tCys showed positive associations with BMI (partial r = 0.28, P < 0.001), and fat mass (partial r = 0.25, P < 0.001), independent of diet, exercise, and plasma lipids. Women in the highest tCys quintile had fat mass 9 kg (95% CI: 8, 10 kg; P < 0.001) greater than that of women in the lowest quintile. The corresponding values for men were 6 kg (95% CI: 5, 7 kg; P < 0.001; P < 0.001 in both sexes, ANOVA across quintiles). The rise in tCys over 6 y was associated with greater fat mass at follow-up (P < 0.001), but there was no effect on lean mass. tHcy was not associated with lean mass, and it became significantly inversely associated with BMI and fat mass only after adjustment for tCys. The association between tHcy and lean mass was not significant. CONCLUSIONS tCys concentrations show a strong positive association with BMI, mediated through fat mass. The link between cysteine and lipid metabolism deserves further investigation.
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Affiliation(s)
- Amany K Elshorbagy
- Department of Physiology, Anatomy and Genetics, Oxford University, Oxford, United Kingdom.
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Elshorbagy AK, Oulhaj A, Konstantinova S, Nurk E, Ueland PM, Tell GS, Nygård O, Vollset SE, Refsum H. Plasma creatinine as a determinant of plasma total homocysteine concentrations in the Hordaland Homocysteine Study: Use of statistical modeling to determine reference limits. Clin Biochem 2007; 40:1209-18. [PMID: 17904540 DOI: 10.1016/j.clinbiochem.2007.07.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2007] [Revised: 05/29/2007] [Accepted: 07/02/2007] [Indexed: 11/19/2022]
Abstract
OBJECTIVES We established population-based reference limits for plasma total homocysteine (tHcy) according to creatinine. DESIGN AND METHODS In 7042 middle-aged and elderly subjects from the Hordaland Homocysteine Study, we used statistical modeling to establish nomograms for tHcy according to creatinine in the whole population and in folate-replete and healthy subgroups. RESULTS When plotted against creatinine, tHcy 97.5th percentile almost overlapped in men and women, and, in elderly, increased up to 8 micromol/L from the 2.5th to 97.5th creatinine percentiles. Folate-replete subjects had tHcy upper limits approximately 20% below the whole population at all creatinine levels. Healthy subjects had lower creatinine, but at a given creatinine level, tHcy was the same as in the whole population. CONCLUSIONS tHcy difference between men and women is mostly explained by creatinine. The tHcy-reducing effect of folate is independent of creatinine. In elderly people, creatinine should be taken into account when assessing tHcy levels.
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Affiliation(s)
- Amany K Elshorbagy
- Oxford Centre for Gene Function, Department of Physiology, Anatomy and Genetics, Oxford University, UK.
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Nurk E, Drevon CA, Refsum H, Solvoll K, Vollset SE, Nygård O, Nygaard HA, Engedal K, Tell GS, Smith AD. Cognitive performance among the elderly and dietary fish intake: the Hordaland Health Study. Am J Clin Nutr 2007; 86:1470-8. [PMID: 17991661 DOI: 10.1093/ajcn/86.5.1470] [Citation(s) in RCA: 111] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Increasing evidence suggests that cognitive impairment and dementia in older subjects might be influenced by a diet including seafood. OBJECTIVE The objective was to examine the cross-sectional relation between intake of different amounts of various seafood (fish and fish products) and cognitive performance. DESIGN The subjects (n = 2031 subjects; 55% women), aged 70-74 y, were recruited from the general population in Western Norway and underwent cognitive testing. A cognitive test battery included the Kendrick Object Learning Test, Trail Making Test (part A), modified versions of the Digit Symbol Test, Block Design, Mini-Mental State Examination, and Controlled Oral Word Association Test. Poor cognitive performance was defined as a score in the highest decile for the Trail Making Test and in the lowest decile for all other tests. RESULTS Subjects whose mean daily intake of fish and fish products was >/=10 g/d (n = 1951) had significantly better mean test scores and a lower prevalence of poor cognitive performance than did those whose intake was <10 g/d (n = 80). The associations between total intake of seafood and cognition were strongly dose-dependent; the maximum effect was observed at an intake of approximately 75 g/d. Most cognitive functions were influenced by fish intake. The effect was more pronounced for nonprocessed lean fish and fatty fish. CONCLUSIONS In the elderly, a diet high in fish and fish products is associated with better cognitive performance in a dose-dependent manner.
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Affiliation(s)
- Eha Nurk
- Department of Pharmacology, University of Oxford, UK
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Berstad P, Konstantinova SV, Refsum H, Nurk E, Vollset SE, Tell GS, Ueland PM, Drevon CA, Ursin G. Dietary fat and plasma total homocysteine concentrations in 2 adult age groups: the Hordaland Homocysteine Study. Am J Clin Nutr 2007; 85:1598-605. [PMID: 17556699 DOI: 10.1093/ajcn/85.6.1598] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The intake of n-3 (formerly called omega-3) fatty acids (FAs) may be inversely associated with plasma total homocysteine (tHcy) concentrations, but the epidemiologic data are sparse. OBJECTIVE We examined the association between dietary fat and tHcy in a Norwegian population. DESIGN A cross-sectional, population-based study of 5917 subjects in 2 age groups (47-49 and 71-74 y old) was conducted with the use of food-frequency questionnaires and measurement of plasma tHcy concentrations. RESULTS The intake of saturated FAs (SFAs) was positively and significantly (P for trend < 0.001) associated with tHcy concentrations; the difference in plasma tHcy concentrations between the highest and lowest quartiles of SFAs was 8.8%. The intake of marine very-long-chain n-3 FAs was inversely associated with tHcy concentrations; the difference in plasma tHcy concentrations between the lowest and the highest quartiles was -5.0% (P for trend < 0.001). Intakes of total and monounsaturated fat also were positively associated with plasma tHcy concentrations (P for trend < 0.001 and < 0.005, respectively), whereas the intake of polyunsaturated fat was positively associated with tHcy concentrations only in the younger subjects (P for trend = 0.03). The associations were weakened by additional adjustment for B vitamin intake but remained significant for SFA intake (P < 0.001). When stratified for total B vitamin intake, the inverse association between tHcy concentrations and very-long-chain n-3 FAs was significant only in the highest quartile of B vitamin intake (P for trend = 0.001), regardless of supplement use. CONCLUSIONS High intakes of SFAs are associated with high plasma concentrations of tHcy. The inverse association between dietary intakes of very-long-chain n-3 FAs and plasma tHcy concentrations is apparent only at high B vitamin intakes.
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Affiliation(s)
- Paula Berstad
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Norway.
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Lehmann DJ, Refsum H, Nurk E, Warden DR, Tell GS, Vollset SE, Engedal K, Nygaard HA, Smith AD. Apolipoprotein E epsilon4 and impaired episodic memory in community-dwelling elderly people: a marked sex difference. The Hordaland Health Study. J Neurol Neurosurg Psychiatry 2006; 77:902-8. [PMID: 16595618 PMCID: PMC2077621 DOI: 10.1136/jnnp.2005.077818] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Among elderly people without dementia, the apolipoprotein E epsilon4 allele (APOE4) has been associated with cognitive deficit, particularly in episodic memory, but few reports are available on whether this association differs by sex. METHODS In a community-dwelling Norwegian cohort of 2181 elderly people (55% women), aged 70-74 years, episodic memory was examined in relation to sex and APOE4 zygosity, with the Kendrick Object Learning Test (KOLT). RESULTS Possession of at least one APOE4 allele had a modest, detrimental effect on episodic memory in women, whereas in men, heterozygotes were unaffected and homozygotes had markedly lower scores across the distribution of KOLT scores. This sex difference was found consistently in all analyses: on comparing means and medians, examining trends across quintiles, and studying the distribution of scores and the risk of cognitive impairment. Results were broadly similar when adjusted for known determinants of cognition and also when severely impaired participants were excluded. The adjusted odds ratio (OR) of cognitive impairment in women was shown to be 1.8 (95% confidence interval (CI): 1.1 to 2.8) for heterozygotes and 1.1 (0.3 to 3.7) for homozygotes; the adjusted OR in men was observed to be 1.1 (0.6 to 2.1) for heterozygotes and 10.7 (4.7 to 24) for homozygotes. CONCLUSIONS Although the harmful effect of APOE4 on episodic memory was modest in women, the risk was found to occur in about 30%. APOE4 was observed to have a dramatic effect on episodic memory in men, but only in homozygotes, who comprised about 3% of men: the whole male homozygous group showed a marked shift to lower memory scores.
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Affiliation(s)
- D J Lehmann
- OPTIMA, Oxford Centre for Gene Function, University Laboratory of Physiology, Parks Road, Oxford OX1 3PT, UK.
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Refsum H, Nurk E, Smith AD, Ueland PM, Gjesdal CG, Bjelland I, Tverdal A, Tell GS, Nygård O, Vollset SE. The Hordaland Homocysteine Study: a community-based study of homocysteine, its determinants, and associations with disease. J Nutr 2006; 136:1731S-1740S. [PMID: 16702348 DOI: 10.1093/jn/136.6.1731s] [Citation(s) in RCA: 351] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The Hordaland Homocysteine Study (HHS) is a population-based study of more than 18,000 men and women in the county of Hordaland in Western Norway. The first investigation (HHS-I) took place in 1992-93, when the subjects were aged 40-67 y. In 1997-99, a follow-up study (HHS-II) of 7,053 subjects was carried out. In this large population, plasma levels of total homocysteine (tHcy) are associated with several physiologic and lifestyle factors and common diseases. Increasing age, male sex, smoking, coffee consumption, high blood pressure, unfavorable lipid profile, high creatinine, and the MTHFR 677C > T polymorphism are among the factors associated with increased tHcy levels; physical activity, moderate alcohol consumption, and a good folate or vitamin B-12 status are associated with lower tHcy levels. Subjects with raised tHcy levels have increased risk of cardiovascular morbidity, cardiovascular and noncardiovascular mortality, and are more likely to suffer from depression and from cognitive deficit (elderly). Among women, raised tHcy levels are associated with decreased bone mineral density and increased risk of osteoporosis. Women with raised tHcy levels also have an increased risk of having suffered from pregnancy complications and an adverse pregnancy outcome. Significant associations between tHcy and clinical outcomes are usually observed for tHcy levels > 15 micromol/L, but for most conditions, there is a continuous concentration-response relation with no apparent threshold concentration. Overall, the findings from HHS indicate that a raised tHcy level is associated with multiple clinical conditions, whereas a low tHcy level is associated with better physical and mental health.
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Affiliation(s)
- Helga Refsum
- Norwegian Institute of Public Health, Oslo, Norway.
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Abstract
BACKGROUND The factor V Leiden (FVL) mutation is the most common cause of inherited thrombophilia in Caucasian populations, and women with this variant allele are at increased risk for pregnancy complications. AIM To examine whether the FVL allele is associated with pregnancy complications and adverse outcomes in a population-based study, and to identify potential factors that interact with the FVL genotype. DESIGN Retrospective cohort study in a geographically-defined area. METHODS Polymorphisms of factor V 1691G-->A, methylenetetrahydrofolate reductase (MTHFR) 677C --> T and 1298A --> C and plasma levels of total homocysteine, folate and vitamin B(12) were determined in blood samples collected in 1992-1993 from 5874 women aged 40-42 years, and linked with 14 474 pregnancies in the same women, recorded in the Medical Birth Registry of Norway, 1967-1996. RESULTS The allelic frequency of FVL was 3.7% (6.9% heterozygotes, 0.3% homozygotes). Maternal FVL mutation was associated with significantly higher risks of pre-eclampsia (OR 1.63, 95%CI 1.15-2.30), pre-eclampsia at <37 weeks (OR 2.76, 1.34-5.70), low birth weight (OR 1.34, 95%CI 1.03-1.74) and stillbirth (OR 2.20, 95%CI 1.45-3.36). The presence of a variant allele for the 677C --> T MTHFR polymorphism strengthened the association between FVL and stillbirth (OR 3.34, 95%CI 1.95-5.73) (p(interaction) = 0.034). DISCUSSION FVL mutation is a significant risk factor for pregnancy complications and adverse outcomes, and MTHFR 677CT/TT genotype can further enhance the risk of stillbirth.
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Affiliation(s)
- E Nurk
- Department of Public Health and Primary Health Care, University of Bergen, Bergen, Norway.
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Nurk E, Refsum H, Tell GS, Engedal K, Vollset SE, Ueland PM, Nygaard HA, Smith AD. Plasma total homocysteine and memory in the elderly: the Hordaland Homocysteine Study. Ann Neurol 2006; 58:847-57. [PMID: 16254972 DOI: 10.1002/ana.20645] [Citation(s) in RCA: 110] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
We examined the relation between plasma total homocysteine (tHcy), folate, vitamin B12, and episodic memory in elderly community-dwelling subjects. A population-based study was conducted in 1992 and 1993, and subjects were re-investigated after 6 years. Plasma analytes were determined on both occasions. At follow-up, memory performance, using the Kendrick Object Learning Test, was investigated in 2,189 subjects (age, 65-67 years at baseline). Subjects with memory deficit (test score, < 25) had higher tHcy and lower folate at follow-up compared with those without memory deficit: 12.6 (95% confidence interval [CI], 12.1, 13.1) versus 11.5 (95% CI, 11.3, 11.6) micromol/L (p < 0.001) for tHcy, and 6.7 (95% CI, 6.2, 7.1) versus 7.6 (95% CI, 7.5, 7.8) nmol/L (p < 0.001) for folate. The risk of memory deficit increased according to quintiles of tHcy both at baseline and at follow-up. A decline in tHcy, or an increase in folate, over a 6-year period was associated with a higher memory test score; and vice versa. These findings indicate that increased plasma tHcy is an independent risk factor for memory deficit both cross-sectionally and prospectively, and that a "favorable" change in folate or tHcy concentrations over time is associated with better memory performance.
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Affiliation(s)
- Eha Nurk
- Department of Pharmacology, Oxford Project to Investigate Memory and Ageing (OPTIMA), University of Oxford, Mansfield Road, Oxford OX1 3QT, United Kingdom
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Nurk E, Tell GS, Refsum H, Ueland PM, Vollset SE. Associations between maternal methylenetetrahydrofolate reductase polymorphisms and adverse outcomes of pregnancy: the Hordaland Homocysteine Study. Am J Med 2004; 117:26-31. [PMID: 15210385 DOI: 10.1016/j.amjmed.2004.01.019] [Citation(s) in RCA: 109] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2003] [Revised: 01/29/2004] [Accepted: 01/29/2004] [Indexed: 11/17/2022]
Abstract
PURPOSE Methylenetetrahydrofolate reductase (MTHFR) is involved in the metabolism of folate and homocysteine; a polymorphism in the MTHFR gene (677C-->T) has been associated with adverse outcomes of pregnancy. We studied whether two polymorphisms in the MTHFR gene (677C-->T and 1298A-->C) are associated with pregnancy complications, adverse outcomes, and birth defects. METHODS MTHFR polymorphisms were determined in blood collected in 1992 and 1993 from 5883 women aged 40 to 42 years, and linked with 14,492 pregnancies in the same women recorded in the Medical Birth Registry of Norway from 1967 to 1996. RESULTS The 677TT genotype in mothers was associated with increased risk of placental abruption (odds ratio [OR] = 2.6; 95% confidence interval [CI]: 1.4 to 4.8) compared with the CC variant. The risk of intrauterine growth restriction increased with number of T alleles (P for trend = 0.04). Compared with the 1298AA variant, the CC variant was associated with a reduced risk of very low birth weight infants (OR = 0.4; 95% CI: 0.2 to 0.8). No significant associations were found between MTHFR polymorphisms and birth defects. CONCLUSION The maternal MTHFR 677C-->T polymorphism was a risk factor for placental abruption. The unexpected protective effect of the 1298A-->C polymorphism on very low birth weight needs further study.
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Affiliation(s)
- Eha Nurk
- LOCUS for Homosysteine and Related Vitamins, Department of Public Health and Primary Health Care, University of Bergen, Norway
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Nurk E, Tell GS, Vollset SE, Nygård O, Refsum H, Nilsen RM, Ueland PM. Changes in lifestyle and plasma total homocysteine: the Hordaland Homocysteine Study. Am J Clin Nutr 2004; 79:812-9. [PMID: 15113719 DOI: 10.1093/ajcn/79.5.812] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Elevated plasma concentrations of total homocysteine (tHcy) are a risk factor for cardiovascular disease. tHcy is a marker of folate and cobalamin deficiencies and is also related to several lifestyle factors. OBJECTIVE We examined whether changes in lifestyle influence tHcy over time. DESIGN A population-based, prospective study was conducted in 7031 subjects from western Norway who constituted 2 age groups (41-42 and 65-67 y) at baseline (1992-1993). The subjects were reinvestigated in 1997-1999 ( follow-up: 6 y). RESULTS During follow-up, median tHcy concentrations decreased 0.10 (25th and 75th percentiles: -1.24, 1.00) micromol/L in the younger subjects and increased 0.39 (25th and 75th percentiles: -0.99, 1.79) micromol/L in the older subjects. Changes in plasma vitamin status and vitamin supplement use were the strongest determinants of changes in tHcy over time. Each unit increase in plasma folate (nmol/L) and vitamin B-12 (pmol/L) was associated with reductions in tHcy concentrations of 0.2 and 0.1 micromol/L, respectively. Among the younger and older age groups, those who started to take vitamin supplements during follow-up had significant reductions in tHcy concentrations of 0.42 (95% CI: -0.65, -0.20) and 0.41 (-0.78, -0.03) micromol/L, respectively. In the younger subjects who quit smoking, tHcy concentrations decreased 0.54 (-0.91, -0.16) micromol/L. Weight changes were inversely related to tHcy. Both baseline history of cardiovascular disease or hypertension and cardiovascular events during follow-up were significantly associated with changes in tHcy. CONCLUSIONS Changes in lifestyle factors over time influence tHcy concentrations. These changes are modest when compared with the strong associations between tHcy and lifestyle factors in cross-sectional studies.
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Affiliation(s)
- Eha Nurk
- Department of Public Health and Primary Health Care, University of Bergen, Norway.
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Sirnes E, Sødal E, Nurk E, Tell GS. [Occurrence of musculoskeletal complaints in Hordaland]. Tidsskr Nor Laegeforen 2003; 123:2855-9. [PMID: 14600709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023] Open
Abstract
BACKGROUND Musculoskeletal complaints are widespread and a major public health problem in western countries. Prevention and treatment are challenges because the aetiologic factors are not fully understood. Our objective was to estimate the prevalence of and identify possible risk factors for musculoskeletal complaints. MATERIAL AND METHODS A cross-sectional study including 11 566 men and 13 660 women aged 40-49 and 70-74 who completed a questionnaire in the Hordaland Health Study 1997-99. RESULTS Musculoskeletal pain and/or stiffness lasting at least three months during the past year was reported by 4461 men (39 %) and 6713 women (49 %). Prevalence among women increased with age. Musculoskeletal complaints were associated with low educational attainment and smoking among both men and women 40-49 years old, and with high body mass index and low physical activity among women. Among the 70-74-year-olds, complaints were associated with low educational attainment among men and with smoking, high body mass index and low physical activity among women. A dose-response relationship between smoking and musculoskeletal complaints was found, with a stronger effect among women than men. INTERPRETATION Musculoskeletal complaints were common, the prevalence higher among women than men. The results indicate that musculoskeletal complaints may be prevented or reduced by smoking cessation.
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Nurk E, Tell GS, Vollset SE, Nygård O, Refsum H, Ueland PM. Plasma total homocysteine and hospitalizations for cardiovascular disease: the Hordaland Homocysteine Study. Arch Intern Med 2002; 162:1374-81. [PMID: 12076236 DOI: 10.1001/archinte.162.12.1374] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Elevated total plasma homocysteine (tHcy) level is a risk factor for occlusive disease in the coronary, cerebral, and peripheral vessels and is related to several lifestyle factors associated with cardiovascular disease (CVD). OBJECTIVE To examine the association of a single tHcy measurement on subsequent hospitalizations due to CVD. METHODS A population-based prospective cohort study was conducted from April 1, 1992, to May 31, 1998 (mean follow-up, 5.3 years) in western Norway. The study included 17 361 individuals aged 40 to 42 or 65 to 67 years at baseline. Main outcome measure was CVD as the main hospital discharge diagnosis or coronary revascularization procedures (denoted "CVD hospitalizations") during follow-up (n = 1275). RESULTS At baseline, participants with preexisting CVD had higher mean tHcy values than individuals without CVD. Risk of CVD hospitalizations increased significantly with increasing baseline tHcy only in the oldest age group. Here, multiple risk factor-adjusted hospitalization rate ratios in 5 tHcy categories (<9, 9-11.9, 12-14.9, 15-19.9, and >or=20 micromol/L [to convert tHcy to milligrams per liter, divide by 7.397]) were as follows: 1 (reference level), 1.00, 1.34, 1.67, and 1.94, respectively (P for trend <.001). The relation between tHcy level and CVD hospitalizations was significantly stronger among individuals with preexisting CVD than those without (hospitalization rate ratio per 5-micromol/L tHcy increment, 1.29 vs 1.10; P for interaction,.02). CONCLUSIONS Plasma tHcy level is a strong predictor of CVD hospitalizations only in elderly individuals, and especially among those with preexisting CVD. Our findings are compatible with the theory that tHcy interacts with conventional CVD risk factors to provoke the acute event of CVD.
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Affiliation(s)
- Eha Nurk
- Department of Public Health and Primary Health Care, University of Bergen, Armauer Hansen's Building, N-5021 Bergen, Norway.
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Shickle D, Carlisle J, Fryers P, Wallace S, Suckling R, Cork M, Bowns I, Beyleveld D, McDonagh A, Sandvik L, Mowinckel P, Abdelnoor M, Erikssen G, Erikssen J, White R, Altmann DR, Nanchahal K, Oliver S, Donovan JL, Peters TJ, Frankel S, Hamdy FC, Neal DE, Whincup PH, Gilg J, Papacosta O, Miller GJ, Alberti KGMM, Cook D, Lawlor DA, Ebrahim S, Smith GD, Lampe F, Morris R, Whincup P, Walker M, Ebrahim S, Shaper A, Brunner E, Shipley M, Hemingway H, Juneja M, Page M, Stansfeld S, Kumari M, Walker B, Andrew R, Seckl J, Papadopoulos A, Checkley S, Marmot M, Wood D, Sheehan J, Reilly M, Twomey H, Collins M, Daly A, Loningsigh S, Dolan E, Smith GD, Ben-Shlomo Y, Perry I, Moher M, Yudkkin P, Wright L, Turner R, Fuller A, Schofield T, Mant D, Feder G, Lilford RJ, Dobbie F, Warren R, Braunholtz D, Boaden R, Nolte E, Scholz R, Shkolnikov V, McKee M, Neilson S, Gilthorpe MS, Wilson RC, Jenkinson C, Coulter A, Bruster S, Richards N, Chandola T, Cromwell DA, Griffiths DA, Campbell MJ, Mollison J, McIntosh E, Grimshaw J, Thomas R, Rovers MM, Straatman H, Zielhuis GA, Hemminki E, Hove SL, Veerus P, Hakama M, Tuimala R, Rahu M, Ukoumunne OC, Gulliford MC, Shepstone L, Spencer N, Araya R, Rojas G, Fritsch RE, Acuna J, Lewis G, Ajdacic-Gross V, Bopp M, Eich D, Rossler W, Gutzwiller F, Corcoran P, Brennan A, Reilly M, Perry IJ, Middleton N, Whitley E, Frankel S, Dorling D, Gunnell D, Stanistreet D, Paine K, Scherf C, Morison L, Walraven G, O'Cathain A, Sampson F, Nicholl J, Munro J, Chapple A, Ziebland S, McPherson A, Herxheimer A, Shepperd S, Miller R, Brindle L, Donovan JL, Peters TJ, Quine S, O'Reilly M, Cahill M, Perry IJ, Maconochie N, Doyle P, Prior S, Ego A, Subtil D, Cosson M, Legoueff F, Houfflin-Debarge V, Querleu D, Rasmussen F, Smith GD, Sterne JAC, Tynelius P, Leon DA, Doyle P, Roman E, Maconochie N, Smith P, Beral V, Macfarlane A, Shoham-Vardi I, Winer N, Weitzman D, Levcovich A, Lahelma E, Kivela K, Roos E, Tuominen T, Dahl E, Diderichsen F, Elstad J, Lissau I, Lundberg O, Rahkonen O, Rasmussen NK, Yngwe MA, Gilmore AB, McKee M, Rose R, Salmond C, Crampton P, Tobias M, Li L, Manor O, Power C, Bruster S, Coulter A, Jenkinson C, Osler M, Prescott E, Gronbak M, Andersen AN, Due P, Engholm G, Drury N, Bruce J, Poobalan AS, Smith WCS, Jeffrey RR, Chambers WA, Mueller JE, Doring A, Stieber J, Thorand B, Lowel H, Chen R, Tunstall-Pedoe H, Redpath A, Macintyre K, Stewart S, Chalmers JWT, Boyd AJ, Finlayson A, Pell JP, McMurray JJV, Capewell S, Chalmers JWT, Macintyre K, Stewart S, Boyd AJ, Finlayson A, Pell JP, Redpath, McMurray JJV, Capewell S, Critchley J, Capewell S, Stefoski-Mikeljevic J, Johnston C, Cartman M, Sainsbury R, Forman D, Haward R, Morris E, Haward R, Forman D, Cartman M, Johnston C, Moebus S, Lehmann N, Goodacre S, Calvert N, Montgomery AA, Fahey T, Ben-Shlomo Y, Harding J, Anderson W, Florin D, Gillam S, Ely M, Nath U, Ben-Shlomo Y, Thomson RG, Morris HR, Wood NW, Lees AJ, Burn DJ, West RR, Fielder HM, Palmer SR, Dunstan F, Fone D, Higgs G, Senior M, Moss N, Campbell R, Pound P, Pope C, Britten N, Pill R, Morgan M, Donovan J, Rottingen JA, Garnett GP, Jagger C, Robine JM, Clarke M, Tobiasz-Adamczyk B, Szafraniec K, Lall R, Campbell MJ, Walter SJ, McGrother C, Donaldson M, Dallosso H, Dineen BP, Bourne RR, Ali SM, Huq DMN, Johnson GJ, Stang A, Jockel KH, Karvonen S, Vikat A, Rimpela M, Borras JM, Schiaffino A, Fernandez E, Borrell C, Garcia M, Salto E, Jefferis B, Power C, Graham H, Manor O, Yudkin P, Hey K, Roberts S, Welch S, Johnstone E, Murphy M, Griffiths S, Jones L, Walton R, Rasul F, Stansfeld SA, Hart CL, Gillis C, Smith GD, Marks D, Lambert H, Thorogood M, Neil H, Humphries S, Wonderling D, Surman G, Newdick H, Johnson A, Pharoah P, Glinianaia SV, Wright C, Rankin J, Basso O, Christensen K, Olsen J, Love A, Cheung WY, Williams J, Jackson S, Maddocks A, Hutchings H, Gissler M, Pakkanen M, Olausson PO, Owen CG, Whincup PH, Odoki K, Gilg JA, Cook DG, Aveyard P, Markham WA, Sherratt E, Bullock A, Macarthur C, Cheng KK, Daniels H, Murphy S, Egger M, Grimsley M, Green G, Read C, Redgrave P, Suokas A, McCulloch A, Zagozdzon P, Zaborski L, Cardano M, Costa G, Demaria M, Gnavi R, Spadea T, Vannoni F, Batty D, Leon DA, Rahi J, Morton S, Leon D, Stavola BDE, Gunnell D, Fouskakis D, Rasmussen F, Tynelius P, Harrison G, Spadea T, Faggiano F, Armaroli P, Maina L, Costa G, Ellison GTH, Travis R, Phillips M, Dedman D, Upton M, McCarthy A, Elwood P, Davies D, Shlomo YB, Smith GD, Berrington A, Cramer DW, Kuper H, Harlow BL, Titus-Ernstoff L, McLeod A, Stockton D, Brown H, Leyland AH, Liratsopulos G, West CR, Williams EMI, Abrams K, Sharp L, Little J, Brockton N, Cotton SC, Haites NE, Cassidy J, Kamali A, Kinsman J, Kintu P, Quigley M, Carpenter L, Kengeya-Kayondo J, Whitworth. JAG, Porter K, Noah N, Rawson H, Crampin A, Smith WCS, Group CMSOBOTMS, Jahn A, Kudzala A, Kitundu H, Lyamuya E, Razum O, Thomas SL, Wheeler JG, Hall AJ, Moore L, Dennehy A, Shemilt I, Belderson P, Brandon M, Harvey I, Moffatt P, Mugford M, Norris N, O'Brien M, Reading R, Robinson J, Schofield G, Shepstone L, Thoburn J, Cliffe S, Leiva A, Tookey P, Hamers F, Nicoll A, Critchley J, Capewell S, Ness AR, Hughes J, Elwood PC, Whitley E, Smith GD, Burr ML, Chase D, Roderick P, Cooper K, Davies R, Raftery J, Martikainen P, Kauppinen TM, Valkonen T, Somerville M, Barton A, Foy C, Basham M, Thomson H, Petticrew M, Morrison D, Chandola T, Biddulph J, McCarthy M, Gallivan S, Utley M, Kinra S, Black ME, Murphy M, Hey K, Jones L, Brzezinski ZJ, Mazur J, Mierzejewska E, Evans JG, Clarke R, Sherliker P, Birks J, Wrieden WL, Connaghan JP, Tunstall-Pedoe H, Silva IDS, Mangtani P, McCormack V, Bhakta D, Sevak L, McMichael AJ, Sauvaget C, Nagano J, Ogilvie D, Raffle AE, Alden B, Brett M, Babb PJ, Quinn M, Banks E, Beral V, Bull D, Reeves G, Leung GM, Lam TH, Thach TQ, Hedley AJ, Roderick P, Davies R, Crabbe D, Patel P, Raftery J, Bhandari P, Pearce R, Thomas MC, Walker M, Lennon LT, Thomson AG, Lampe FC, Shaper AG, Whincup PH, Fallon UB, Ben-Shlomo Y, Laurence KM, Lancashire RJ, Pharoah POD, Nevin NC, Smith GD, Fear NT, Roman E, Ansell P, Bull D, Nilsen TIL, Vatten LJ, Lane JA, Harvey RF, Murray LJ, Harvey IM, Donovan JL, Egger M, Wright CM, Parker L, Lamont D, Craft AW, Hallqvist J, Lundberg M, Diderichsen F, Boniface DR, McNeilly E, Bromen K, Pohlabeln H, Ahrens W, Jahn I, Jockel KH, Darby S, Doll R, Whitley E, Key T, Silcocks P, Linos D, Markaki I, Ntalles K, Riza E, Linos A, Memon A, Darif M, AL-Saleh K, Suresh A, de Vries CS, Bromley SE, Williams TJ, Farmer RDT, Ruiz M, Nieto A, Boshuizen HC, Nagelkerke NJD, Schellekens JFP, Peeters MF, Den Boer JW, Van Vliet JA, Neppelenbroek SE, Spaendonck MAECV, Mazloomzadeh S, Woodman CBJ, Collins S, Winter H, Bailey A, Young LS, Rosenbauer J, Herzig P, Giani G, Olowokure B, Spencer NJ, Hawker JI, Blair I, Smith R, Olowokure B, White J, Rush M, Hawker JI, Ramsay M, Watkins J, Mayor S, Matthews I, Crilly M, Bundred P, Prosser H, Walley T, Walker ZAK, Oakley L, Townsend JL, Donovan C, Smith H, Bell J, Hurst Z, Marshall S, Wild S, Whyman C, Barter M, Wishart K, Macleod C, Marinko K, Malmstrom M, Johansson SE, Sundquist J, Crampton P, Salmond C, Tobias M, Lumley J, Small R, Brown S, Watson L, Gunn J, Hawe P, Shiell A, Langer M, Steiner G, Tiefenthaler M, Adamek S, Ronsmans C, Khlat M, Waterstone M, Bewley S, Wolfe C, Hooper R, Moore L, Campbell R, Whelan A, Winter H, Macarthur C, Bick D, Lancashire R, Knowles H, Henderson C, Belfield C, Gee H, Biggerstaff D, Lilford R, Olsen J, the EuroMap Group, Spencer EA, Davey GK, Appleby PN, Key TJ., Breeze E, Leon D, Clarke R, Fletcher A, Boniface DR, McNeilly E, Lam TH, Ho SY, Hedley AJ, Mak KH, Canoy D, Khaw KT, Thorogood M, Appleby PN, Mann JI, Key TJ, Bobak M, Pikhart H, Martikainen P, Rose R, Marmot M, Rooney CIF, Cook L, Uren Z, Watson MC, Bond CM, Grimshaw JM, Mollison J, Ludbrook A, Poobalan AS, Bruce J, King PM, Krukowksi ZH, Smith WCS, Chambers WA, Seagroatt V, Goldacre M, Purcell B, Majeed A, Mayor S, Watkins J, Matthews I, Morris RW, Whincup PH, Emberson J, Lampe FC, Walker M, Wannamethee G, Shaper AG, Ebrahim S, May M, McCarron P, Frankel S, Smith GD, Yarnell J, Ebrahim S, May M, McCarron P, Shlomo YB, Stansfeld S, Gallacher J, Smith GD, Taylor FC, Rees K, Ebrahim S, Angelini GD, Ascione R, Muller-Nordhorn J, Binting S, Kulig M, Voller H, Willich SN, Group FTPS, Whincup PH, Emberson J, Papacosta O, Walker M, Lennon L, Thomson A, Sturdy PM, Anderson HR, Butland BK, Bland JM, Victor CR, Wilman C, Gupta R, Anderson HR, Mindell J, Joffe M, Nikiforov B, Pattenden S, Armstrong B, Hedley AJ, Wong CM, Thach TQ, Chau P, Lam TH, Anderson HR, Whitley E, Darby S, Deo H, Doll R, Raleigh VS, Logie J, Macrae K, Lawrenson R, Villegas R, Nielson S, O'Halloran DJ, Perry IJ, Gallacher JEJ, Elwood PC, Yarnell JWG, Shlomo YB, Pickering J, Evans JMM, Morris AD, Sedgwick JEC, Pearce AJ, Gulliford MC, Walker M, Thomson A, Whincup P, Lyons RA, Jones S, Richmond P, McCarthy J, Fone D, Lester N, Johansen A, Saunders J, Palmer SR, Barnes I, Banks E, Beral V, Jones GT, Watson KD, Taylor S, Papageorgiou AC, Silman AJ, Symmons DPM, Macfarlane GJ, Pope D, Hunt I, Birrell F, Silman A, Macfarlane G, Thorpe L, Thomas K, Fitter M, Brazier J, Macpherson H, Campbell M, Nicholl J, Morgan A, Roman M, Allison T, Symmons D, Urwin M, Brammah T, Roxby M, Williams G, Primatesta P, Falaschetti E, Poulter NR, Knibb R, Armstrong SJ, Chilvers CED, Logan RFA, Woods KL, Bhavnani V, Clarke A, Dowie J, Kennedy A, Pell I, Goldacre MJ, Kurina L, Seagroatt V, Yeates D, Watson E, Clements A, Yudkin P, Rose P, Bukach C, Mackay J, Lucassen A, Austoker J, Guillemin M, Brown W, Tell GS, Nurk E, Vollset SE, Nygard O, Refsum H, Ueland PM, Villegas R, Nielson S, Creagh D, Hinchion R, Perry IJ, Allen NE, Key TJ, Vatten LJ, Odegard RA, Nilsen ST, Austgulen R, Harding AH, Khaw KT, Wareham NJ, Riza E, Silva IDS, De Stavola B, Bradlow HL, Sepkovic DW, Linos D, Linos A. Society for Social Medicine and the International Epidemiological Association European Group. Abstracts of oral presentations. Br J Soc Med 2001. [DOI: 10.1136/jech.55.suppl_1.a1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Nurk E, Tell GS, Nygård O, Refsum H, Ueland PM, Vollset SE. Plasma total homocysteine is influenced by prandial status in humans: the Hordaland Hhomocysteine Sstudy. J Nutr 2001; 131:1214-6. [PMID: 11285329 DOI: 10.1093/jn/131.4.1214] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Plasma total homocysteine (tHcy) is a risk factor for cardiovascular disease, adverse pregnancy outcomes and impaired cognitive function. No population-based studies on the possible influence of prandial status on tHcy have been published. The aim of this study was to investigate the variation in plasma tHcy levels in relation to time since last meal. A cross-sectional, population-based study including 18,044 individuals in Western Norway was conducted. Most subjects were in the age groups 40-42 and 65-67 y. Participants who had not eaten during the past 6 h before the blood sampling had significantly higher mean tHcy levels compared with those who had eaten; 11.7 [95% confidence interval (CI): 11.4-12.1] vs. 11.2 (95% CI: 11.1-11.3) micromol/L among men (P = 0.03) and 10.2 (95% CI: 9.9-10.6) vs. 9.7 (95% CI: 9.6-9.7) micromol/L among women (P = 0.003). In all groups except older women, tHcy concentrations were generally higher with increasing time after a meal (P-trend <0.01 in all 3 groups). These findings suggest that fasting status and time since last meal may influence levels of tHcy and should be considered in studies of tHcy as a risk factor for cardiovascular and other diseases, and when comparing tHcy values among studies.
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Affiliation(s)
- E Nurk
- Department of Public Health and Primary Health Care, University of Bergen, N-5021 Bergen, Norway.
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Nurk E, Mittelmark MB, Suurorg L, Tur I, Luiga E. Trends in tobacco use among Estonian and Russian youth in Tallinn. Scand J Public Health 1999; 27:301-5. [PMID: 10724475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
Smoking behaviour and exposure to environmental tobacco smoke (ETS) were examined in three cross-sectional surveys from 1991/92, 1993/94, and 1995/96. The study population comprised 3,185 Estonian and Russian adolescents from 17 schools in Tallinn, Estonia. Prevalence of ever-smoking girls increased by 13 percentage points versus 2% among boys during the study period. Mean ages of the first experimentation with tobacco and exposure to ETS did not change significantly. Regular smoking increased significantly from 1991/92 to 1995/96. Detailed analyses for the 1995/96 survey showed that among ethnic Estonians, compared with ethnic Russians, the prevalence of ever-smokers and regular smoking were higher, mean age for the first experimentation was younger, and on average, Estonians smoked more cigarettes per week. The smoking trend among adolescents in Estonia is worsening; especially among Estonian youth. This study identifies a compelling need for national and community-wide efforts to deter adolescents from smoking and to reduce the exposure to ETS.
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Affiliation(s)
- E Nurk
- Research Centre for Health Promotion, Faculty of Psychology, University of Bergen, Norway
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