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Hotterbeex P, Beeckman M, Marent PJ, Latomme J, De Block F, De Baets L, Chastin S, Cardon G, van Uffelen JGZ. A Two-Phased Pilot Study Evaluating the Feasibility and Acceptability of the Cognitively Enriched Walking Program "Take a Walk with Your Brain" for Older Adults. J Aging Res 2024; 2024:2438067. [PMID: 38633988 PMCID: PMC11023734 DOI: 10.1155/2024/2438067] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 02/06/2024] [Accepted: 03/14/2024] [Indexed: 04/19/2024] Open
Abstract
Given the aging population, finding solutions to retain optimal cognitive capacity is a research priority. The potential of physical activity to reduce the risk of cognitive decline and to enhance cognitive functioning is established. Combining physical with cognitive activity has been put forward as a potentially even more effective way to promote healthy cognitive aging. Most studies on combined interventions have however been conducted in laboratory settings. This paper reports on a two-phased pilot study evaluating the acceptability and feasibility of a newly developed real-life cognitively enriched walking program for adults aged 65+ years. In Phase I, the feasibility and enjoyability of the cognitive tasks was evaluated by conducting walk-along interviews with older adults (n = 163). In Phase II, the cognitively enriched walking program was piloted in two groups of older adults (n = 19), and the feasibility and acceptability of the program and cognitive tasks was evaluated by means of questionnaires and focus groups. The cognitive tasks (i.e., median scores of ≥3 on a total of 4 (Phase I) and ≥6 on a total of 10 (Phase II) for most of the tasks) and the cognitively enriched walking program (i.e., median scores of ≥7 on a total of 10) were considered feasible and acceptable. Based on the input of the participants, key considerations for a feasible and acceptable program were defined: participants should be sufficiently challenged cognitively and physically, social interaction is an important motivator, cognitive tasks should make use of stimuli reflecting daily life and be conducted in group, the rationale for the tasks should be explained to participants, the frequency of the group sessions should be maximum 2 times a week, and the program should be supervised by a trained coach. These results warrant future research to establish the effectiveness of this program.
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Affiliation(s)
- Pauline Hotterbeex
- Department of Movement Sciences, Leuven Brain Institute, KU Leuven, Leuven, Belgium
- Department of Movement and Sports Sciences, Ghent University Research for Aging Young, Ghent University, Ghent, Belgium
| | | | - Pieter-Jan Marent
- Department of Movement Sciences, Leuven Brain Institute, KU Leuven, Leuven, Belgium
- Department of Movement and Sports Sciences, Ghent University Research for Aging Young, Ghent University, Ghent, Belgium
| | - Julie Latomme
- Department of Movement and Sports Sciences, Ghent University Research for Aging Young, Ghent University, Ghent, Belgium
| | - Fien De Block
- Department of Movement and Sports Sciences, Ghent University Research for Aging Young, Ghent University, Ghent, Belgium
| | - Lauren De Baets
- Department of Movement and Sports Sciences, Ghent University Research for Aging Young, Ghent University, Ghent, Belgium
| | - Sebastien Chastin
- Department of Movement and Sports Sciences, Ghent University Research for Aging Young, Ghent University, Ghent, Belgium
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Greet Cardon
- Department of Movement and Sports Sciences, Ghent University Research for Aging Young, Ghent University, Ghent, Belgium
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Longworth GR, Goh K, Agnello DM, Messiha K, Beeckman M, Zapata-Restrepo JR, Cardon G, Chastin S, Giné-Garriga M. A review of implementation and evaluation frameworks for public health interventions to inform co-creation: a Health CASCADE study. Health Res Policy Syst 2024; 22:39. [PMID: 38549162 PMCID: PMC10976753 DOI: 10.1186/s12961-024-01126-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 02/22/2024] [Indexed: 04/02/2024] Open
Abstract
BACKGROUND By including the needs and perspectives of relevant stakeholders, co-creation is seen as a promising approach for tackling complex public health problems. However, recommendations and guidance on how to plan and implement co-creation are lacking. By identifying and analysing existing implementation and evaluation frameworks for public health, this study aims to offer key recommendations for professional stakeholders and researchers wanting to adopt a co-creation approach to public health interventions. METHODS Firstly, PubMed and CINAHL databases were screened for articles introducing original implementation and evaluation frameworks for public health interventions. Backwards snowballing techniques were applied to the included papers. Secondly, identified frameworks were classified and relevant data extracted, including steps and constructs present in the frameworks. Lastly, recommendations were derived by conducting thematic analysis on the included frameworks. RESULTS Thirty frameworks were identified and data related to their nature and scope extracted. The frameworks' prominent steps and constructs were also retrieved. Recommendations related to implementation and evaluation in the context of co-creation were included. CONCLUSION When engaging in co-creation, we recommend including implementation considerations from an early stage and suggest adopting a systems thinking as a way to explore multiple levels of influence, contextual settings and systems from an early planning stage. We highlight the importance of partnering with stakeholders and suggest applying an evaluation design that is iterative and cyclical, which pays particular attention to the experience of the engaged co-creators.
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Affiliation(s)
| | - Kunshan Goh
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Danielle Marie Agnello
- School of Health and Life Sciences, Glasgow Caledonian University, Cowcaddens Road Glasgow, Scotland, G4 0BA, UK
| | - Katrina Messiha
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | | | - Jorge Raul Zapata-Restrepo
- Department of Physical Activity and Sport Sciences, FPCEE Blanquerna, Universitat Ramon Llull, Carrer del Císter, 34, 08022, Barcelona, Spain
| | - Greet Cardon
- Department of Movement and Sports Sciences, Physical Activity and Health, Ghent University and Policy Research Center Sport, Krijgslaan 281 - S2, 9000, Ghent, Belgium
| | - Sebastien Chastin
- School of Health and Life Sciences, Glasgow Caledonian University, Cowcaddens Road Glasgow, Scotland, G4 0BA, UK
- Department of Movement and Sports Sciences, Physical Activity and Health, Ghent University and Policy Research Center Sport, Krijgslaan 281 - S2, 9000, Ghent, Belgium
| | - Maria Giné-Garriga
- Department of Physical Activity and Sport Sciences, FPCEE Blanquerna, Universitat Ramon Llull, Carrer del Císter, 34, 08022, Barcelona, Spain
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Reppas K, Papamichael MM, Usheva N, Iotova V, Chakarova N, Cardon G, Rurik I, Antal E, Valve P, Liatis S, Makrilakis K, Moreno L, Manios Y, Moschonis G. Associations between household food environment and daily intake of regular and diet soft drinks per BMI status of European children: Feel4Diabetes Study. NUTR BULL 2024; 49:82-95. [PMID: 38288678 DOI: 10.1111/nbu.12659] [Citation(s) in RCA: 0] [Impact Index Per Article: 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] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 11/30/2023] [Accepted: 12/20/2023] [Indexed: 02/27/2024]
Abstract
The objective of this study was to investigate how the availability of food in the household environment is associated with a daily intake of regular and diet soft drinks in European children, considering BMI status. This cross-sectional study utilised baseline data from 12 211 schoolchildren participating in the Feel4Diabetes European lifestyle modification intervention. Sociodemographics, soft drink intake and household food availability data were collected using parent-completed questionnaires. Anthropometry was recorded, and children were classified into BMI categories according to the International Obesity Task Force cut-offs. In the multivariate logistic regression analysis controlled for children's sex, mother's BMI, and educational level, frequent household availability of fruit juice (sugar added), regular soft drinks and salty snacks compared to less frequent were positively associated with daily regular soft drink intake in children, regardless of BMI group (ORs range 1.59-6.69). Conversely, frequent availability of fruit juice (no added sugar) was inversely related to regular soft drink intake in both BMI groups, as was the availability of fresh fruit in the overweight/obesity group, and the availability of diet soft drinks in the underweight/normal-weight (ORs range 0.31-0.54). In conclusion, habitual household availability of selected energy-dense foods/beverages was positively associated with a daily intake of regular soft drinks in European children, regardless of BMI status. Contrastingly, household availability of fresh fruit, fruit juice (no added sugar) and diet soft drinks were inversely associated with regular soft drink intake. Programmes focusing on reducing children's soft drink intake should consider reducing the availability of sugar-added beverages in the household food environment and encouraging water consumption, as a practical, healthier alternative suggestion.
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Affiliation(s)
- Kyriakos Reppas
- Department of Nutrition and Dietetics, Harokopio University of Athens, Kallithea, Greece
| | - Maria Michelle Papamichael
- Department of Nutrition and Dietetics, Harokopio University of Athens, Kallithea, Greece
- Department of Dietetics, Nutrition and Sport, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Natalya Usheva
- Department of Social Medicine and Healthcare Organization, Medical University of Varna, Varna, Bulgaria
| | - Violeta Iotova
- Department of Paediatrics, Medical University, Varna, Bulgaria
| | - Nevena Chakarova
- Department of Endocrinology, Medical University of Sofia, Sofia, Bulgaria
| | - Greet Cardon
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Imre Rurik
- Department of Family and Occupational Medicine, University of Debrecen, Budapest, Hungary
- Department of Family Medicine, Semmelweis University, Budapest, Hungary
| | - Emese Antal
- Hungarian Society of Nutrition, Budapest, Hungary
| | - Päivi Valve
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Stavros Liatis
- First Department of Propaedeutic Medicine, National and Kapodistrian University of Athens Medical School, Laiko General Hospital, Athens, Greece
| | - Konstantinos Makrilakis
- First Department of Propaedeutic Medicine, National and Kapodistrian University of Athens Medical School, Laiko General Hospital, Athens, Greece
| | - Luis Moreno
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Zaragoza, Spain
| | - Yannis Manios
- Department of Nutrition and Dietetics, Harokopio University of Athens, Kallithea, Greece
- Institute of Agri-food and Life Sciences, (Agro-Health), Hellenic Mediterranean University Research Centre, Heraklion, Greece
| | - George Moschonis
- Department of Dietetics, Nutrition and Sport, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
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Delfmann LR, Verloigne M, Deforche B, Hunter SC, Cardon G, de Boer J, Vandendriessche A. Psychosocial Determinants of Sleep Behavior and Healthy Sleep Among Adolescents: A Two-Wave Panel Study. J Youth Adolesc 2024; 53:360-373. [PMID: 37747679 PMCID: PMC10764366 DOI: 10.1007/s10964-023-01866-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 09/08/2023] [Indexed: 09/26/2023]
Abstract
To date, it remains unknown which psychosocial determinants identified by several leading behavior change theories are associated with different sleep parameters among adolescents. Therefore, this study investigates whether changes in knowledge about healthy sleep, attitude toward healthy sleep and going to bed on time, self-efficacy to engage in healthy sleep behavior, perceived parental and peer norms, perceived barriers (e.g., worrying, fear of missing out), and perceived support (e.g., bedtime rules, encouragement) related to healthy sleep are associated with changes in adolescents' sleep duration on school days and free days and sleep quality over a period of 1 year. Two-wave data of 1648 Flemish adolescents (mean age = 15.01, SD = 0.65, 46.3% female) were analyzed using linear models. Increased levels of parental social support, positive attitude towards and perceived advantages of healthy sleep, norm-knowledge, and perceived peer behavior were associated with sleep duration, with parental social support having the strongest association. Increased levels of perceived barriers were associated with decreased levels of sleep quality parameters, and increased levels of self-efficacy, positive attitude, and parental modeling were associated with improved sleep quality parameters, with perceived barriers having the strongest association. The current results indicate that behavior change theories are useful in the context of adolescent sleep behavior and suggest that perceived parental support (i.e., bedtime rules) and perceived barriers are most strongly associated with adolescents' sleep duration and/or quality.
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Affiliation(s)
- Lea Rahel Delfmann
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Campus UZ-Ghent, Entrance 42, 6th Floor, Corneel Heymanslaan 10, 9000, Ghent, Belgium.
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Watersportlaan 2, 9000, Ghent, Belgium.
| | - Maïté Verloigne
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Campus UZ-Ghent, Entrance 42, 6th Floor, Corneel Heymanslaan 10, 9000, Ghent, Belgium
| | - Benedicte Deforche
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Campus UZ-Ghent, Entrance 42, 6th Floor, Corneel Heymanslaan 10, 9000, Ghent, Belgium
- Movement and Nutrition for Health and Performance Research Group, Faculty of Physical Education and Physical Therapy, Vrije Universiteit Brussel, Pleinlaan 2, 1050, Brussels, Belgium
| | - Simon C Hunter
- Department of Psychology, Glasgow Caledonian University, Cowcaddens Road, Glasgow, G4 0BA, Scotland, UK
- Graduate School of Education, University of Western Australia, M428, 35 Stirling Highway, Nedlands WA, 6009, Perth, Australia
| | - Greet Cardon
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Watersportlaan 2, 9000, Ghent, Belgium
| | - Janneke de Boer
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Campus UZ-Ghent, Entrance 42, 6th Floor, Corneel Heymanslaan 10, 9000, Ghent, Belgium
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Watersportlaan 2, 9000, Ghent, Belgium
| | - Ann Vandendriessche
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Campus UZ-Ghent, Entrance 42, 6th Floor, Corneel Heymanslaan 10, 9000, Ghent, Belgium
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Kontochristopoulou AM, Karatzi K, Karaglani E, Cardon G, Kivelä J, Iotova V, Tankova T, Rurik I, Radone AS, Liatis S, Makrilakis K, Moreno LA, Manios Y. Parental practices and children's lifestyle correlates of childhood overweight/obesity in Europe: The Feel4Diabetes study. J Hum Nutr Diet 2024; 37:31-46. [PMID: 37828766 DOI: 10.1111/jhn.13229] [Citation(s) in RCA: 0] [Impact Index Per Article: 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] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 08/09/2023] [Indexed: 10/14/2023]
Abstract
BACKGROUND Parental influences on children's eating and physical activity (PA) and consequently on their weight are fundamental. The present study aimed to identify the predominant correlates of childhood overweight/obesity among a variety of parental practices and children's lifestyle indices in a large sample of children in Europe. METHODS Families from low socio-economic status regions were recruited through schools, located in six European countries (Belgium, Finland, Greece, Spain, Bulgaria and Hungary). Seven thousand three hundred ninety-seven children 4-12 years old and their parents were selected using the FINDRISC-questionnaire. Parental practices assessed included parental role modelling, permissiveness and reward. Children's dietary intake and lifestyle behaviours were assessed through parent-reported questionnaires. RESULTS Regarding parental practices, it was revealed that being sometimes (odds ratio [OR] = 1.26; 95% confidence interval [CI] = 1.10-1.43) or rarely (OR = 1.43; 95% CI = 1.21-1.69) physically active with the child was associated with greater overweight/obesity risk, whereas rare permission of computer/mobile/tablet (OR = 0.81; 95% CI = 0.67-0.98) and sometimes (OR = 0.77; 95% CI = 0.68-0.88) or rare (OR = 0.77; 95% CI = 0.66-0.91) reward with PA were associated with lower risk. Regarding children's lifestyle factors, consuming > 3 cups/week fresh fruit juices (OR = 1.28; 95% CI = 1.13-1.45), skipping breakfast (OR = 1.37; 95% CI = 1.17-1.61), absence of 1 h of daily PA (OR = 1.40; 95% CI = 1.24-1.58) and increased daily screen time (ST) (OR = 1.23; 95% CI = 1.09-1.39) were associated with greater overweight/obesity risk. All the variables were adjusted for maternal education, child's sex and age. CONCLUSIONS These findings emphasize the necessity of family-centered approaches in health promotion and obesity prevention programs for children. Such programs should focus on parents as the primary role models in exerting positive influence and encouraging healthy eating habits, PA, and ST behaviors in their children, which in turn, may have a substantial impact on children's overall weight status.
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Affiliation(s)
| | - Kalliopi Karatzi
- Laboratory of Dietetics and Quality of Life, Department of Food Science & Human Nutrition, Agricultural University of Athens, Athens, Greece
| | - Eva Karaglani
- Department of Nutrition and Dietetics, Harokopio University of Athens, Athens, Greece
| | - Greet Cardon
- Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
| | - Jemina Kivelä
- Finnish Institute for Health and Welfare, Population Health Unit, Helsinki, Finland
| | - Violeta Iotova
- Department of Pediatrics, Medical University Varna, Varna, Bulgaria
| | | | - Imre Rurik
- Department of Family and Occupational Medicine, University of Debrecen, Debrecen, Hungary
| | - Anett S Radone
- Department of Family and Occupational Medicine, University of Debrecen, Debrecen, Hungary
| | - Stavros Liatis
- First Department of Propaedeutic Medicine, National and Kapodistrian University of Athens Medical School, Laiko General Hospital, Athens, Greece
| | - Konstantinos Makrilakis
- First Department of Propaedeutic Medicine, National and Kapodistrian University of Athens Medical School, Laiko General Hospital, Athens, Greece
| | - Luis A Moreno
- Growth, Exercise, Nutrition and Development Research Group, Zaragoza, Spain
- School of Health Science (EUCS), Zaragoza, Spain
| | - Yannis Manios
- Department of Nutrition and Dietetics, Harokopio University of Athens, Athens, Greece
- Institute of Agri-food and Life Sciences, Heraklion, Greece
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Maenhout L, Latomme J, Cardon G, Crombez G, Van Hove G, Compernolle S. Synergizing the Behavior Change Wheel and a Cocreative Approach to Design a Physical Activity Intervention for Adolescents and Young Adults With Intellectual Disabilities: Development Study. JMIR Form Res 2024; 8:e51693. [PMID: 38206648 PMCID: PMC10811596 DOI: 10.2196/51693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 10/13/2023] [Accepted: 10/31/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND There is a need for physical activity promotion interventions in adolescents and young adults with intellectual disabilities. Current interventions have shown limited effectiveness, which may be attributed to the absence of theory and a population-specific development. Combining a planning model (including theory) and cocreation with the target audience during intervention development could potentially address this gap. OBJECTIVE This study aimed to report the systematic development of the Move it, Move ID! intervention by describing how the 8 different steps of the Behavior Change Wheel (BCW) were applied and present the results that emerged from those steps. In doing so, the (theoretical) content of the intervention is described in detail. METHODS A total of 23 adolescents and young adults (aged 14-22 years) with mild to moderate intellectual disabilities were designated as cocreators of the intervention. Across 2 groups, 6 similar cocreation sessions were organized in each. The content and sequence of the sessions were structured to align with the 8 steps of the BCW. All sessions were recorded and transcribed verbatim. Both a deductive (ie, steps of the BCW) and inductive (ie, resonating the voice of the participants) analysis approach were applied specifically focusing on identifying and describing the findings within each of the BCW steps. RESULTS After behavioral analysis (steps 1-4), 10 intervention goals were chosen and linked to Capability, Opportunity, and Motivation-Behavior components (theory within the BCW) that needed to be addressed. Psychological capability, social opportunity, and reflective motivation were emphasized as the first targets to focus on. A key finding was the urge for real-life social connectedness and social integration, which makes the social component as part of physical activity a central theme to focus on within intervention development. Judgments on the most suitable intervention functions (step 5) and behavior change techniques (step 7) were explained. When discussing the mode of delivery of the intervention (step 8), it was underscored that solely relying on a mobile health app would not fulfill participants' social needs. Hence, the chosen intervention adopts a dyadic approach in which young individuals with intellectual disabilities are matched with peers without intellectual disabilities to engage in physical activities together, with a mobile app playing a supportive role in this partnership. CONCLUSIONS The transparent description of the development process highlights why certain intervention components and behavior change techniques were chosen and how they are intertwined by means of the selected intervention design. This paper provides a detailed blueprint for practitioners wanting to integrate the BCW and its associated behavior change techniques, in combination with actively involving the target group, into their intervention development for people with intellectual disabilities.
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Affiliation(s)
- Laura Maenhout
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Julie Latomme
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Greet Cardon
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Geert Crombez
- Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Geert Van Hove
- Department of Special Needs Education, Ghent University, Ghent, Belgium
| | - Sofie Compernolle
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
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Peuters C, Maenhout L, Cardon G, De Paepe A, DeSmet A, Lauwerier E, Leta K, Crombez G. A mobile healthy lifestyle intervention to promote mental health in adolescence: a mixed-methods evaluation. BMC Public Health 2024; 24:44. [PMID: 38166797 PMCID: PMC10763383 DOI: 10.1186/s12889-023-17260-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 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] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 11/18/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND A healthy lifestyle may improve mental health. It is yet not known whether and how a mobile intervention can be of help in achieving this in adolescents. This study investigated the effectiveness and perceived underlying mechanisms of the mobile health (mHealth) intervention #LIFEGOALS to promote healthy lifestyles and mental health. #LIFEGOALS is an evidence-based app with activity tracker, including self-regulation techniques, gamification elements, a support chatbot, and health narrative videos. METHODS A quasi-randomized controlled trial (N = 279) with 12-week intervention period and process evaluation interviews (n = 13) took place during the COVID-19 pandemic. Adolescents (12-15y) from the general population were allocated at school-level to the intervention (n = 184) or to a no-intervention group (n = 95). Health-related quality of life (HRQoL), psychological well-being, mood, self-perception, peer support, resilience, depressed feelings, sleep quality and breakfast frequency were assessed via a web-based survey; physical activity, sedentary time, and sleep routine via Axivity accelerometers. Multilevel generalized linear models were fitted to investigate intervention effects and moderation by pandemic-related measures. Interviews were coded using thematic analysis. RESULTS Non-usage attrition was high: 18% of the participants in the intervention group never used the app. An additional 30% stopped usage by the second week. Beneficial intervention effects were found for physical activity (χ21 = 4.36, P = .04), sedentary behavior (χ21 = 6.44, P = .01), sleep quality (χ21 = 6.11, P = .01), and mood (χ21 = 2.30, P = .02). However, effects on activity-related behavior were only present for adolescents having normal sports access, and effects on mood only for adolescents with full in-school education. HRQoL (χ22 = 14.72, P < .001), mood (χ21 = 6.03, P = .01), and peer support (χ21 = 13.69, P < .001) worsened in adolescents with pandemic-induced remote-education. Interviewees reported that the reward system, self-regulation guidance, and increased health awareness had contributed to their behavior change. They also pointed to the importance of social factors, quality of technology and autonomy for mHealth effectiveness. CONCLUSIONS #LIFEGOALS showed mixed results on health behaviors and mental health. The findings highlight the role of contextual factors for mHealth promotion in adolescence, and provide suggestions to optimize support by a chatbot and narrative episodes. TRIAL REGISTRATION ClinicalTrials.gov [NCT04719858], registered on 22/01/2021.
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Affiliation(s)
- Carmen Peuters
- Department of Experimental-Clinical and Health Psychology, Ghent University, Henri Dunantlaan 2, 9000, Ghent, Belgium
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Laura Maenhout
- Department of Experimental-Clinical and Health Psychology, Ghent University, Henri Dunantlaan 2, 9000, Ghent, Belgium
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Greet Cardon
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Annick De Paepe
- Department of Experimental-Clinical and Health Psychology, Ghent University, Henri Dunantlaan 2, 9000, Ghent, Belgium
| | - Ann DeSmet
- Faculty of Psychology, Educational Sciences and Speech Therapy, Université Libre de Bruxelles, Bruxelles, Belgium
- Department of Communication Studies, University of Antwerp, Antwerp, Belgium
| | - Emelien Lauwerier
- Department of Experimental-Clinical and Health Psychology, Ghent University, Henri Dunantlaan 2, 9000, Ghent, Belgium
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Kenji Leta
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Geert Crombez
- Department of Experimental-Clinical and Health Psychology, Ghent University, Henri Dunantlaan 2, 9000, Ghent, Belgium.
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Reppas K, Papamichael MM, Moschonis G, Cardon G, Iotova V, Bazdarska Y, Chakarova N, Rurik I, Antal E, Valve P, Liatis S, Makrilakis K, Moreno L, Manios Y. Role of parenting practices and digital media on beverage intake in European schoolchildren of different weight status. Feel4Diabetes-study. Nutrition 2023; 115:112142. [PMID: 37541142 DOI: 10.1016/j.nut.2023.112142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 06/16/2023] [Accepted: 06/19/2023] [Indexed: 08/06/2023]
Abstract
OBJECTIVES Halting the rise in childhood obesity is an ongoing challenge in Europe. Sugar-sweetened beverage (SSB) and artificially sweetened beverage (ASB) consumption has become common practice at home and during family meals. The objective of this study was to investigate associations of parenting practices and home digital media availability with beverage intake in European schoolchildren of different weight groups. METHODS Cross-sectional data were derived from six countries taking part in the multicentered Feel4Diabetes-study. Anthropometric data were measured for 12 030 schoolchildren (n = 6097 girls; median age = 8.1 y). Details on sociodemographic characteristics, beverage intake, food parenting practices, and home availability of digital media were collated from questionnaires. The outcomes, daily SSB and ASB intakes, were included as dependent variables in multivariable regression models that provided odds ratios reflecting their association with parenting practices and digital media (exposures), after stratifying for children's weight status (underweight or normal versus overweight or obese). RESULTS After controlling for children's sex, region, maternal body mass index, and education, the multivariate model found that in both body mass index groups, permissive parenting practices, such as rewarding and allowing consumption of unhealthy foods "very often or often," as compared with "rarely or never," were associated with a high daily intake of SSBs and ASBs in children, while parents "watching television together with their child," rewarding with screen time, and availability of television in children's rooms increased the likelihood of both beverages in the underweight or normal-weight group. CONCLUSIONS Modification of permissive parenting practices and removal of television from children's rooms could effectively reduce SSB intake and curb the ongoing threat of child obesity in Europe.
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Affiliation(s)
- Kyriakos Reppas
- Department of Nutrition & Dietetics, School of Health Science & Education, Harokopio University of Athens, Kallithea, Greece
| | - Maria Michelle Papamichael
- Department of Nutrition & Dietetics, School of Health Science & Education, Harokopio University of Athens, Kallithea, Greece; Department of Dietetics, Nutrition and Sport, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
| | - George Moschonis
- Department of Dietetics, Nutrition and Sport, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
| | - Greet Cardon
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Violeta Iotova
- Department of Pediatrics, Medical University of Varna, Varna, Bulgaria
| | - Yuliya Bazdarska
- Department of Pediatrics, Medical University of Varna, Varna, Bulgaria
| | - Nevena Chakarova
- Department of Endocrinology, Medical University of Sofia, Sofia, Bulgaria
| | - Imre Rurik
- Department of Family and Occupational Medicine, University of Debrecen, Debrecen, Hungary; Department of Family Medicine, Semmelweis University, Budapest, Hungary
| | - Emese Antal
- Hungarian Society of Nutrition, Budapest, Hungary
| | - Päivi Valve
- Public Health and Welfare Department, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Stavros Liatis
- First Department of Propaedeutic Medicine, Laiko General Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Konstantinos Makrilakis
- First Department of Propaedeutic Medicine, Laiko General Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Luis Moreno
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Zaragoza, Spain
| | - Yannis Manios
- Department of Nutrition & Dietetics, School of Health Science & Education, Harokopio University of Athens, Kallithea, Greece; Agri-Food and Life Sciences Institute, Hellenic Mediterranean University Research Center, Heraklion, Greece.
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9
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Manios Y, Papamichael MM, Mourouti N, Argyropoulou M, Iotova V, Usheva N, Dimova R, Cardon G, Valve P, Rurik I, Antal E, Liatis S, Makrilakis K, Moreno L, Moschonis G. Parental BMI and country classification by Gross National Income are stronger determinants of prospective BMI deterioration compared to perinatal risk factors at pre-adolescence: Feel4Diabetes Study. Nutrition 2023; 114:112128. [PMID: 37481919 DOI: 10.1016/j.nut.2023.112128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 06/05/2023] [Indexed: 07/25/2023]
Abstract
OBJECTIVES This study aimed to evaluate all known risk factors, from perinatal to adolescence and identify those predominantly related with prospective BMI deterioration. METHODS Prospective data analysis from the European Feel4Diabetes-study involving 12,211 children from six countries. Details on perinatal and sociodemographic characteristics were collected by parental self-reported questionnaires. Children's anthropometric data were measured by research personnel. Associations between risk factors and children's BMI deterioration (i.e increase) from baseline (mean age 8.2 ± 0.98 years) to the 2-year follow-up (10.3 ± 1.0 years) were explored by applying logistic regression analyses. RESULTS Univariate analysis revealed that all known risk factors for early overweight/obesity development, remained dominant in prospective BMI deterioration. When multivariate analysis was applied including additional variables such as parents' current BMI status, family socio-demographic characteristics and country economic classification based on Gross National Income, most perinatal risk factors were no longer significant. Multivariate analysis revealed that pre-pregnancy maternal overweight/obesity (OR, 95%CI: 2.71, 1.67-4.38), early introduction of solid foods (2.54, 1.21-5.31), parental current BMI status (3.53, 2.17-5.72) and country economic classification (low income: 4.67, 2.20-9.93; under austerity measures: 6.78, 3.18-14.48) were the only parameters associated with higher odds for children's BMI deterioration from the study baseline to 2-year follow-up after adjusting for children's gender. CONCLUSIONS The most predominant risk factors influencing children's prospective BMI deterioration were parental BMI and country economic classification as compared to perinatal. These findings should guide public health initiatives aiming to tackle the childhood obesity epidemic and social inequalities on a European level.
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Affiliation(s)
- Yannis Manios
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece; Institute of Agri-food and Life Sciences, Hellenic Mediterranean University Research Centre, Heraklion, Greece.
| | - Maria Michelle Papamichael
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece; Department of Dietetics, Nutrition and Sport, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Niki Mourouti
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece; Department of Nutrition and Dietetics, Hellenic Mediterranean University, Sitia, Greece
| | - Matzourana Argyropoulou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Violeta Iotova
- Department of Paediatrics, Medical University of Varna, Bulgaria
| | - Natalya Usheva
- Department of Social Medicine and Health Care Organization, Medical University of Varna, Varna, Bulgaria
| | - Roumyana Dimova
- Department of Endocrinology, Medical University of Sofia, Sofia, Bulgaria
| | - Greet Cardon
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Päivi Valve
- Department of Public Health and Welfare, Finnish Institute of Health and Welfare, Helsinki, Finland
| | - Imre Rurik
- Semmelweis University, Department of Family Medicine, Budapest, Hungary; Hungarian Society of Nutrition, Budapest, Hungary
| | - Emese Antal
- Hungarian Society of Nutrition, Budapest, Hungary
| | - Stavros Liatis
- National and Kapodistrian University of Athens Medical School, First Department of Propaedeutic Medicine, Laiko General Hospital, Athens, Greece
| | - Konstantinos Makrilakis
- National and Kapodistrian University of Athens Medical School, First Department of Propaedeutic Medicine, Laiko General Hospital, Athens, Greece
| | - Luis Moreno
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Spain
| | - George Moschonis
- Department of Dietetics, Nutrition and Sport, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
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10
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Miguel-Berges ML, Mouratidou T, Santaliestra-Pasias A, Androutsos O, Iotova V, Galcheva S, De Craemer M, Cardon G, Koletzko B, Kulaga Z, Manios Y, Moreno LA. Longitudinal associations between diet quality, sedentary behaviours and physical activity and risk of overweight and obesity in preschool children: The ToyBox-study. Pediatr Obes 2023; 18:e13068. [PMID: 37525363 DOI: 10.1111/ijpo.13068] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 04/27/2023] [Revised: 06/20/2023] [Accepted: 07/10/2023] [Indexed: 08/02/2023]
Abstract
BACKGROUND Lifestyle behaviours related to diet and physical activity are associated with increased risk of obesity and evidence suggests that associations might be stronger when a synergetic effect is examined. OBJECTIVE To examine the cross-sectional and longitudinal associations between diet, screen time (ST) and step recommendations and risk of overweight and obesity in European preschoolers participating in the ToyBox-study. METHODS In this cluster-randomized clinical trial, 718 children (51.4% boys) from six European countries participated. Parents filled out questionnaires with information on socio-demographic status, step recommendations and ST. RESULTS Longitudinal results indicate that participants having a low Diet Quality Index (DQI), not meeting ST and step recommendations at T0 and T1 had higher odds of having overweight/obesity at T1 (odds ratio [OR] = 1.116; 95% confidence interval [CI] = 1.104-2.562) than those children having a high DQI and meeting ST and step recommendations at T0 and T1. Similarly, participants having a high DQI, but not meeting ST and step recommendations at T0 and T1 had increased odds of having overweight/obesity (OR = 2.515; 95% CI = 1.171-3.021). CONCLUSIONS The proportion of participants having a low DQI, not adhering to both step and ST recommendations was very high, and it was associated with a higher probability of having overweight and obesity.
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Affiliation(s)
- María L Miguel-Berges
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Zaragoza, Spain
- Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
| | - Theodora Mouratidou
- Department of Nutrition and Dietetics, School of Health Sciences, Hellenic Mediterranean University, Sitia, Greece
| | - Alba Santaliestra-Pasias
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Zaragoza, Spain
- Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
| | - Odysseas Androutsos
- Lab of Clinical Nutrition and Dietetics, Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, Trikala, Greece
- Department of Nutrition and Dietetics, School of Health Sciences & Education, Harokopio University, Athens, Greece
| | | | | | | | - Greet Cardon
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Berthold Koletzko
- LMU-Ludwig Maximilians Universität Munich, Department Paediatrics, Dr von Hauner Children's Hospital, LMU University Hospitals, Munich, Germany
| | | | - Yannis Manios
- Department of Nutrition and Dietetics, School of Health Sciences & Education, Harokopio University Athens, Athens, Greece
- Institute of Agri-food and Life Sciences, Hellenic Mediterranean University Research Centre, Heraklion, Greece
| | - Luis A Moreno
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Zaragoza, Spain
- Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
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11
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Basdeki ED, Karatzi K, Arnaoutis G, Makrilakis K, Liatis S, Cardon G, De Craemer M, Iotova V, Tsochev K, Tankova T, Kivelä J, Wikström K, Rurik I, Radó S, Miguel-Berges ML, Gimenez-Legarre N, Moreno-Aznar L, Manios Y. A lifestyle pattern characterised by high consumption of sweet and salty snacks, sugar sweetened beverages and sedentary time is associated with blood pressure in families at risk for type 2 diabetes mellitus in Europe. The Feel4Diabetes Study. J Hum Nutr Diet 2023; 36:1564-1575. [PMID: 36719056 DOI: 10.1111/jhn.13145] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 01/16/2023] [Indexed: 02/01/2023]
Abstract
BACKGROUND Individuals from families at high-risk for type 2 diabetes mellitus (T2DM) are also at high risk for hypertension (HTN) and cardiovascular disease. Studies identifying lifestyle patterns (LPs) combining dietary, physical activity or sedentary variables and examining their possible role with respect to developing blood pressure (BP) are limited. The present study aimed to examine the association of different LPs with BP levels in families at high risk for T2DM in Europe. METHODS In total, 1844 adults (31.6% males) at high-risk for T2DM across six European countries were included in this cross-sectional study using data from the baseline assessment of the Feel4Diabetes Study. BP measurements and dietary and physical activity assessments were conducted, and screen times were surveyed. LPs were revealed with principal component analysis of various data regarding diet, physical activity, screen time and smoking. RESULTS Three LPs were identified. LP3 (high consumption of sweet and salty snacks, sugar sweetened soft drinks and juices, and high amount of screen time) was positively associated with diastolic BP (B, 0.52; 95% confidence interval = 0.05-0.99) and the existence of HTN (odds ratio = 1.12; 95% confidence interval = 1.00-1.25). Participants in the highest tertile of LP3 spent mean 3 h of screen time, consumed 1.5 portions of sweet and/or salty snacks and 1 L of soft drinks on a daily basis, were associated with 12% higher risk of HTN. CONCLUSIONS Focusing on the combination of eating and lifestyle behaviours may more accurately identify, and therefore guide preventive measures tailored to the specific needs of high-risk populations.
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Affiliation(s)
- Eirini D Basdeki
- Cardiovascular Prevention & Research Unit, Clinic & Laboratory of Pathophysiology, Department of Medicine, National and Kapodistrian University of Athens, Athens, Greece
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University of Athens, Athens, Greece
| | - Kalliopi Karatzi
- Laboratory of Dietetics and Quality of Life, Department of Food Science and Human Nutrition, Agricultural University of Athens, Athens, Greece
| | - Giannis Arnaoutis
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University of Athens, Athens, Greece
| | - Konstantinos Makrilakis
- National and Kapodistrian University of Athens Medical School, First Department of Propaedeutic Medicine, Laiko General Hospital, Athens, Greece
| | - Stavros Liatis
- National and Kapodistrian University of Athens Medical School, First Department of Propaedeutic Medicine, Laiko General Hospital, Athens, Greece
| | - Greet Cardon
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Marieke De Craemer
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
- Research Foundation Flanders, Brussels, Belgium
| | - Violeta Iotova
- Departemnt of Pediatrics, Medical University of Varna, Varna, Bulgaria
| | - Kaloyan Tsochev
- Departemnt of Pediatrics, Medical University of Varna, Varna, Bulgaria
| | - Tsvetalina Tankova
- Clinical Center of Endocrinology and Gerontology, Medical University of Sofia, Sofia, Bulgaria
| | - Jemina Kivelä
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Katja Wikström
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Imre Rurik
- Department of Family and Occupational Medicine, University of Debrecen, Debrecen, Hungary
| | - Sándorné Radó
- Faculty of Health, Doctoral School of Health Science, University of Debrecen, Debrecen, Hungary
| | - María L Miguel-Berges
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Facultad de Ciencias de la Salud, Universidad de Zaragoza, Zaragoza, Spain
- Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
| | - Natalia Gimenez-Legarre
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Facultad de Ciencias de la Salud, Universidad de Zaragoza, Zaragoza, Spain
- Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
| | - Luis Moreno-Aznar
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Facultad de Ciencias de la Salud, Universidad de Zaragoza, Zaragoza, Spain
- Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
| | - Yannis Manios
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University of Athens, Athens, Greece
- Institute of Agri-food and Life Sciences, Hellenic Mediterranean University Research Centre(Agro-Health), Heraklion, Greece
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12
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Mourouti N, Mavrogianni C, Mouratidou T, Liatis S, Valve P, Rurik I, Torzsa P, Cardon G, Bazdarska Y, Iotova V, Moreno LA, Makrilakis K, Manios Y. The Association of Lifestyle Patterns with Prediabetes in Adults from Families at High Risk for Type 2 Diabetes in Europe: The Feel4Diabetes Study. Nutrients 2023; 15:3155. [PMID: 37513573 PMCID: PMC10386359 DOI: 10.3390/nu15143155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 07/07/2023] [Accepted: 07/13/2023] [Indexed: 07/30/2023] Open
Abstract
The increasing prevalence of prediabetes globally does not bode well for the growing epidemic of type 2 diabetes (T2D) and its complications. Yet there is a lack of studies regarding lifestyle patterns (LPs) and their association with prediabetes. The present study aimed to examine the association of different LPs with the existence of prediabetes in adults from families at high risk for T2D in Europe. In total, 2759 adults (66.3% females) from six European countries were included in this cross-sectional analysis using data from the baseline assessment of the Feel4Diabetes study. Anthropometric, sociodemographic, dietary and behavioral data were assessed, and fasting blood glucose measurements were also obtained. LPs were derived via principal component analysis. Two LPs were derived, explaining 32% of the total variation. LP 1 was characterized by breakfast consumption, high consumption of fruits and berries, vegetables and nuts and seeds, and low consumption of salty snacks and soft drinks with sugar, while LP 2 was characterized by high consumption of salty and sweet snacks, soft drinks with sugar and juice with sugar and sedentary behavior. After adjusting for various confounders, LP 2 was positively associated with the existence of prediabetes (odds ratio = 1.02, 95% CI 1.01-1.04), while LP 1 was not significantly associated with prediabetes. Understanding LPs would provide necessary evidence for planning intervention and education strategies for prediabetes and T2D.
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Affiliation(s)
- Niki Mourouti
- Department of Nutrition and Dietetics, Hellenic Mediterranean University, 72300 Sitia, Greece
- Institute of Agri-Food and Life Sciences, Hellenic Mediterranean University Research Centre (Agro-Health), 71410 Heraklion, Greece
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 17671 Athens, Greece
| | - Christina Mavrogianni
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 17671 Athens, Greece
| | - Theodora Mouratidou
- Department of Nutrition and Dietetics, Hellenic Mediterranean University, 72300 Sitia, Greece
- Institute of Agri-Food and Life Sciences, Hellenic Mediterranean University Research Centre (Agro-Health), 71410 Heraklion, Greece
| | - Stavros Liatis
- First Department of Propaedeutic Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Päivi Valve
- Department of Public Health and Welfare, Finnish Institute of Health and Welfare, FI-00271 Helsinki, Finland
| | - Imre Rurik
- Department of Family Medicine, Semmelweis University, 1085 Budapest, Hungary
| | - Péter Torzsa
- Department of Family Medicine, Semmelweis University, 1085 Budapest, Hungary
| | - Greet Cardon
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium
| | - Yulia Bazdarska
- Department of Pediatrics, Medical University Varna, 9002 Varna, Bulgaria
| | - Violeta Iotova
- Department of Pediatrics, Medical University Varna, 9002 Varna, Bulgaria
| | - Luis A Moreno
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, 50009 Zaragoza, Spain
| | - Konstantinos Makrilakis
- First Department of Propaedeutic Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Yannis Manios
- Institute of Agri-Food and Life Sciences, Hellenic Mediterranean University Research Centre (Agro-Health), 71410 Heraklion, Greece
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 17671 Athens, Greece
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13
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Verloigne M, Altenburg T, Cardon G, Chinapaw M, Dall P, Deforche B, Giné-Garriga M, Lippke S, Papadopoulos H, Pappa D, Sandlund M, Schreier M, Wadell K, Chastin S. Making co-creation a trustworthy methodology for closing the implementation gap between knowledge and action in health promotion: the Health CASCADE project. Perspect Public Health 2023; 143:196-198. [PMID: 37589328 DOI: 10.1177/17579139221136718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/18/2023]
Affiliation(s)
- M Verloigne
- Department of Public Health and Primary Care, Ghent University, Corneel Heymanslaan 10, 9000 Ghent, Belgium
| | - T Altenburg
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - G Cardon
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - M Chinapaw
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - P Dall
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - B Deforche
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - M Giné-Garriga
- Department of Physical Activity and Sport Sciences, Faculty of Psychology, Education and Sport Sciences (FPCEE) Blanquerna, Ramon Llull University, Barcelona, Spain; Department of Physiotherapy, Faculty of Health Sciences Blanquerna, Ramon Llull University, Barcelona, Spain
| | - S Lippke
- Department of Psychology & Methods, Jacobs University Bremen, Bremen, Germany
| | - H Papadopoulos
- Institute of Informatics and Telecommunications, National Center for Scientific Research 'Demokritos', Attiki, Greece
| | - D Pappa
- National Center for Scientific Research 'Demokritos', Greece
| | - M Sandlund
- Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden
| | - M Schreier
- Department of Psychology & Methods, Jacobs University Bremen, Bremen, Germany
| | - K Wadell
- Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden
| | - S Chastin
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium; School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
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14
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Semánová C, Szőllősi GJ, Ilyés I, Cardon G, Latomme J, Iotova V, Bazdarska Y, Lindström J, Wikström K, Herrmann S, Schwarz P, Karaglani E, Manios Y, Makrilakis K, Moreno L, González-Gil EM, Rurik I. Differences in Anthropometric Parameters of Children in Six European Countries. Children (Basel) 2023; 10:983. [PMID: 37371214 DOI: 10.3390/children10060983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 05/17/2023] [Accepted: 05/22/2023] [Indexed: 06/29/2023]
Abstract
BACKGROUND The databases of children's anthropometric parameters are often outdated, rarely representative and are not always available at an international level. OBJECTIVES To present children's anthropometric parameters in six European countries that contributed to the Feel4Diabetes project and find country-specific differences. DESIGN/SETTING The Feel4Diabetes study was performed between 2016 and 2018, targeting children in Belgium, Bulgaria, Finland, Greece, Hungary and Spain. The current study presents data from the baseline and the yearly follow-up anthropometric measurements. SUBJECTS In total, 20,832 measurements of children (48.7% boys) between 6 and 10 years of age were conducted. MAIN OUTCOME MEASURE weight, height, BMI. RESULTS Belgian boys had the lowest body weight and height, while Greek boys had the highest body weight, and Finnish had the highest body height. The highest proportion of overweight (percentile above 85%) and obese boys (percentile above 95%) was in Greece, followed by Hungarian, Spanish, Bulgarian and Finnish boys. In contrast, Belgian boys had the lowest ratio in both categories. Among girls, Greece had the highest; Belgium had the lowest body weight; Finland was the highest in all age categories. The ratio in the overweight range was the highest in Greece, followed by Spanish, Bulgarian and Hungarian girls, who were second in the obese category. Finnish girls had lower and Belgian girls had the lowest ratio in both BMI categories. All the detailed data are presented in tables, and the trends are figures. CONCLUSIONS Our study presents fresh and comparable anthropometric data of children between 6 and 10 years of age in six European countries, supporting the need for appropriate obesity prevention.
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Affiliation(s)
- Csilla Semánová
- Department of Family and Occupational Medicine, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
- Doctoral School of Health Sciences, University of Debrecen, 4032 Debrecen, Hungary
| | - Gergő J Szőllősi
- Doctoral School of Health Sciences, University of Debrecen, 4032 Debrecen, Hungary
- Department of Health Informatics, Faculty of Health Sciences, University of Debrecen, 4032 Debrecen, Hungary
| | - István Ilyés
- Department of Family and Occupational Medicine, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
| | - Greet Cardon
- Department of Movement and Sports Sciences, Ghent University, B-9000 Ghent, Belgium
| | - Julie Latomme
- Department of Movement and Sports Sciences, Ghent University, B-9000 Ghent, Belgium
| | - Violeta Iotova
- Department of Social Medicine and Health Care Organization, Medical University of Varna, 9002 Varna, Bulgaria
- Department of Paediatrics, Medical University of Varna, 9002 Varna, Bulgaria
| | - Yuliya Bazdarska
- Department of Social Medicine and Health Care Organization, Medical University of Varna, 9002 Varna, Bulgaria
- Department of Paediatrics, Medical University of Varna, 9002 Varna, Bulgaria
| | - Jaana Lindström
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, FI-00271 Helsinki, Finland
| | - Katja Wikström
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, FI-00271 Helsinki, Finland
| | - Sandra Herrmann
- Department for Prevention and Care of Diabetes, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, 01062 Dresden, Germany
- Paul Langerhans Institute, Dresden of Helmholtz Zentrum München, University Hospital and Faculty of Medicine, 01307 Dresden, Germany
- German Center for Diabetes Research, 40225 Neuherberg, Germany
| | - Peter Schwarz
- Department for Prevention and Care of Diabetes, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, 01062 Dresden, Germany
- Paul Langerhans Institute, Dresden of Helmholtz Zentrum München, University Hospital and Faculty of Medicine, 01307 Dresden, Germany
- German Center for Diabetes Research, 40225 Neuherberg, Germany
| | - Eva Karaglani
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 17671 Athens, Greece
| | - Yannis Manios
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 17671 Athens, Greece
| | - Konsantinos Makrilakis
- First Department of Propaedeutic Medicine, Athens Medical School, National and Kapodistrian University, Laiko General Hospital, 11527 Athens, Greece
| | - Luis Moreno
- Growth, Exercise, Nutrition and Development (GENUD), Research Group, University of Zaragoza, 50009 Zaragoza, Spain
- IBER, Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, 28222 Madrid, Spain
| | - Esther M González-Gil
- Growth, Exercise, Nutrition and Development (GENUD), Research Group, University of Zaragoza, 50009 Zaragoza, Spain
- IBER, Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, 28222 Madrid, Spain
| | - Imre Rurik
- Doctoral School of Health Sciences, University of Debrecen, 4032 Debrecen, Hungary
- Hungarian Society of Nutrition, 4002 Budapest, Hungary
- Department of Family Medicine, Semmelweis University, 1085 Budapest, Hungary
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15
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Mahmood L, Gonzalez-Gil EM, Makrilakis K, Liatis S, Schwarz P, Herrmann S, Willems R, Cardon G, Latomme J, Rurik I, Radó S, Iotova V, Usheva N, Tankova T, Karaglani E, Manios Y, Moreno LA. Cross-sectional and longitudinal associations between family meals frequency and children's overweight/obesity in families at high risk of type 2 diabetes: The Feel4Diabetes-study. Pediatr Obes 2023; 18:e13000. [PMID: 36632012 DOI: 10.1111/ijpo.13000] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 06/14/2022] [Revised: 12/06/2022] [Accepted: 12/12/2022] [Indexed: 01/13/2023]
Abstract
BACKGROUND The frequency of family meals has been suggested as a protective factor against obesity among children. OBJECTIVE This study aimed to investigate the cross-sectional and longitudinal associations between family meals frequency and children's overweight/obesity in families at high risk of type 2 diabetes (T2D) across six European countries. METHODS 989 parent-child dyads (52% girls and 72% mothers) were included. Participants completed validated measures to assess the frequency of family meals and anthropometrics. Multivariable regression models were applied to examine the longitudinal associations between family meals frequency and overweight/obesity in children. Logistic regression was performed to predict the odds of having overweight/obesity depending on changes in family meals frequency over a two-year follow-up period. Analyses were stratified for children's sex. RESULTS High frequency of family breakfasts and/or dinners was inversely associated with children's BMI in boys and girls at T2. Results showed decreased odds of overweight/obesity at follow-up among both boys (OR = 0.65; 95% CI 0.41, 0.96) and girls (OR = 0.53; 95% CI 0.31, 0.87) who consumed minimum of three times family breakfasts and/or family dinners a week at baseline. An increase in family breakfasts and/or dinners frequency was associated with lower odds of overweight/obesity in both boys and girls at follow-up. CONCLUSION A high frequency of family breakfasts and/or dinners but not lunch during childhood is associated with lower odds of overweight/obesity development in children from families at high risk of T2D. The promotion of family meals could help in preventing the development of overweight/obesity among children.
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Affiliation(s)
- Lubna Mahmood
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Zaragoza, Spain
| | - Esther M Gonzalez-Gil
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Zaragoza, Spain.,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
| | | | - Stavros Liatis
- Paul Langerhans Institute Dresden of the Helmholtz Center Munich at University Hospital and Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Peter Schwarz
- Paul Langerhans Institute Dresden of the Helmholtz Center Munich at University Hospital and Faculty of Medicine, TU Dresden, Dresden, Germany.,Department for Prevention and Care of Diabetes, Medical Faculty Carl Gustav Carus at the Technical University of Dresden, Dresden, Germany.,German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany
| | - Sandra Herrmann
- Paul Langerhans Institute Dresden of the Helmholtz Center Munich at University Hospital and Faculty of Medicine, TU Dresden, Dresden, Germany.,Department for Prevention and Care of Diabetes, Medical Faculty Carl Gustav Carus at the Technical University of Dresden, Dresden, Germany.,German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany
| | - Ruben Willems
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Greet Cardon
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Julie Latomme
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Imre Rurik
- Faculty of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Sándorné Radó
- Faculty of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Violeta Iotova
- Department of Social Medicine and Health Care Organization, Medical University of Varna, Varna, Bulgaria
| | - Natalya Usheva
- Department of Social Medicine and Health Care Organization, Medical University of Varna, Varna, Bulgaria
| | - Tsvetalina Tankova
- Department of Diabetology, Clinical Center of Endocrinology, Medical University of Sofia, Sofia, Bulgaria
| | - Eva Karaglani
- Department of Nutrition and Dietetics, School of Health Science & Education, Harokopio University, Athens, Greece
| | - Yannis Manios
- Department of Nutrition and Dietetics, School of Health Science & Education, Harokopio University, Athens, Greece.,Institute of Agri-food and Life Sciences, Hellenic Mediterranean University Research Centre, Heraklion, Greece
| | - Luis A Moreno
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Zaragoza, Spain.,Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain.,Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
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16
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Maenhout L, Verloigne M, Cairns D, Cardon G, Crombez G, Melville C, Van Hove G, Compernolle S. Co-creating an intervention to promote physical activity in adolescents with intellectual disabilities: lessons learned within the Move it, Move ID!-project. Res Involv Engagem 2023; 9:10. [PMID: 36935503 PMCID: PMC10024913 DOI: 10.1186/s40900-023-00420-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 03/10/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Co-creation is a method to develop acceptable, contextually appropriate and potentially more effective interventions. Adolescents with intellectual disabilities (ID) seldomly participate in research and program development due to the assumption that they lack the capacity to understand and discuss the related topics. OBJECTIVE This study describes reflections on a co-creation process with adolescents with ID from the point of view of the researchers in developing an intervention to increase physical activity. It was the aim to highlight elements that must be considered when implementing co-creation and consequently formulate important lessons learned. METHODS Twenty-three adolescents (14-22 y) with mild to moderate ID participated in six co-creation sessions at their school. The objectives and working methods in each session are described. Inductive thematic analysis was conducted on the researchers' reflection forms, which were completed after each session. RESULTS Seven main themes could be distinguished from the data: experiences related to assistance (i.e., teacher presence) during sessions, the importance of building rapport, co-decision making power, the impact of different group dynamics, the relevance of adapted questioning, the influence of co-creative working methods and required characteristics of a co-creation researcher. CONCLUSION Seven lessons learned were formulated when preparing and conducting co-creation with adolescents with ID. Innovative, concrete (non-abstract) and creative working methods are highly needed. Describing the entire process transparently could be a first step to turn co-creative research into an evidence-based methodology.
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Affiliation(s)
- Laura Maenhout
- Department of Movement and Sports Sciences, Ghent University, Watersportlaan 2, 9000, Ghent, Belgium.
- Research Foundation Flanders (FWO), Brussels, Belgium.
| | - Maïté Verloigne
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Deborah Cairns
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Greet Cardon
- Department of Movement and Sports Sciences, Ghent University, Watersportlaan 2, 9000, Ghent, Belgium
| | - Geert Crombez
- Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Craig Melville
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Geert Van Hove
- Department of Special Needs Education, Ghent University, Ghent, Belgium
| | - Sofie Compernolle
- Department of Movement and Sports Sciences, Ghent University, Watersportlaan 2, 9000, Ghent, Belgium
- Research Foundation Flanders (FWO), Brussels, Belgium
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17
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Morbée S, Beeckman M, Loeys T, Waterschoot J, Cardon G, Haerens L, Vansteenkiste M. An examination of the reciprocal associations between physical activity and anxiety, depressive symptoms, and sleep quality during the first 9 weeks of the COVID-19 pandemic in Belgium. Ment Health Phys Act 2023; 24:100500. [PMID: 36510601 PMCID: PMC9729168 DOI: 10.1016/j.mhpa.2022.100500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 11/30/2022] [Accepted: 12/02/2022] [Indexed: 12/13/2022]
Abstract
During the initial outbreak of the global COVID-19 pandemic, many countries imposed a total lockdown (containment at home). Although it was still allowed in Belgium to be physically active or exercise with people from your household in the vicinity of your home, engaging in sports or physical activity in a group or club context was no longer permitted. To examine whether a lack of physical activity was potentially threatening to the mental well-being of citizens and vice versa, the present study examined concurrent and reciprocal relationships between physical activity and anxiety, depressive symptoms, and sleep quality during the COVID-19 lockdown in a 9-week longitudinal design. In a sample of 983 Belgian adults (75.1% female; M age = 43.78, range = 18-82 years), we explored these relationships at both the between- and within-person levels through random intercept cross-lagged panel models. The findings indicate that more physical activity was associated with lower symptoms of anxiety and depression and better sleep quality, a finding observed both at the between-person (across weeks; βanxiety = -0.25, βdepression = -0.30, βsleep quality = 0.24, p < .001) and within-person level (within weeks; βanxiety = -0.10, βdepression = -0.14, βsleep quality = 0.11, p < .05). Moreover, at the within-person level, an increase in feelings of anxiety and depression at one moment predicted lower levels of physical activity one week later (βanxiety = -0.04, βdepression = -0.06, p < .05). Since poor mental health poses a threat to the maintenance of physical activity, the current findings suggest that it is critical to invest in the mental health of individuals during distressing times.
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Affiliation(s)
- Sofie Morbée
- Department of Developmental, Personality and Social Psychology, Ghent University, Belgium
| | - Melanie Beeckman
- Department of Movement and Sports Sciences, Ghent University, Belgium
| | - Tom Loeys
- Department of Data Analysis, Ghent University, Belgium
| | - Joachim Waterschoot
- Department of Developmental, Personality and Social Psychology, Ghent University, Belgium
| | - Greet Cardon
- Department of Movement and Sports Sciences, Ghent University, Belgium
| | - Leen Haerens
- Department of Movement and Sports Sciences, Ghent University, Belgium
| | - Maarten Vansteenkiste
- Department of Developmental, Personality and Social Psychology, Ghent University, Belgium
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18
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Vitoratou DI, Mavrogianni C, Karatzi K, Cardon G, Iotova V, Tsochev K, Lindström J, Wikström K, González-Gil EM, Moreno L, Rurik I, Radó AI, Tankova T, Liatis S, Makrilakis K, Manios Y. Do parental risk factors for type 2 diabetes predict offspring risk of overweight and obesity? The Feel4Diabetes study. Nutrition 2023; 107:111900. [PMID: 36527889 DOI: 10.1016/j.nut.2022.111900] [Citation(s) in RCA: 1] [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] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 10/27/2022] [Accepted: 10/30/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVES The prevention of children being overweight/obese is of utmost importance. Parental characteristics play a pivotal role in shaping offspring weight status. This study aimed to examine associations between parental obesity and children's overweight/obesity status, and whether other parental type 2 diabetes (T2D) risk factors can predict children's obesity status. METHODS Logistic regression and receiver operating characteristic (ROC) analyses were conducted, using cross-sectional data from a European cohort of 20 151 adults (10 967 mothers; 9184 fathers) and children (n = 10 967) participating in the Feel4Diabetes study. Anthropometric measurements were conducted in children, and overweight/obesity was defined according to the International Obesity Task Force criteria. Parents' T2D risk was assessed applying the Finnish Diabetes Risk Score (FINDRISC). RESULTS After adjusting for all other FINDRISC variables, region and maternal/parental education, maternal (adjusted odds ratio [aOR]: 2.64; 95% confidence interval [CI], 2.18-3.20) and parental (aOR: 3.21; 95% CI, 2.65-3.91) obesity, maternal (aOR: 1.46; 95% CI, 1.23-1.74) and parental (aOR: 1.59; 95% CI, 1.32-1.92) high waist circumference, as well as maternal (aOR: 1.60; 95% CI, 1.27-2.01) and parental (aOR: 1.87; 95% CI, 1.58-2.21) high FINDRISC score, were associated with child overweight/obesity status. Maternal (area under the curve- ROC: 0.638; 95% CI, 0.628-0.647) and paternal body mass index (BMI; area under the curve-ROC: 0.632; 95% CI, 0.622-0.642) were the most accurate in predicting child overweight/obesity status. CONCLUSIONS Among parental risk factors for T2D, maternal/parental overweight/obesity status, central obesity, and high FINDRISC score were the main predictors of childhood overweight/obesity status, with BMI the most accurate. Maternal or paternal BMI is simple to use, and might be useful for the early identification of children at risk of being overweight/obese rather than other T2D factors.
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Affiliation(s)
- Dimitra-Irinna Vitoratou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Christina Mavrogianni
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Kalliopi Karatzi
- Laboratory of Dietetics and Quality of Life, Department of Food Science and Human Nutrition, Agricultural University of Athens, Athens, Greece
| | - Greet Cardon
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Violeta Iotova
- Department of Pediatrics, Medical University of Varna, Varna, Bulgaria
| | - Kaloyan Tsochev
- Department of Pediatrics, Medical University of Varna, Varna, Bulgaria
| | - Jaana Lindström
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Katja Wikström
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Esther M González-Gil
- Department of Biochemistry and Molecular Biology II, Instituto de Nutrición y Tecnología de los Alimentos, Center of Biomedical Research, Universidad de Granada, Granada, Spain; Growth, Exercise, Nutrition and Development Research Group, School of Health Science, University of Zaragoza, Zaragoza, Spain; CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
| | - Luis Moreno
- Department of Biochemistry and Molecular Biology II, Instituto de Nutrición y Tecnología de los Alimentos, Center of Biomedical Research, Universidad de Granada, Granada, Spain
| | - Imre Rurik
- Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Anette Is Radó
- Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Tsvetalina Tankova
- Department of Diabetology, Clinical Center of Endocrinology, Medical University of Sofia, Sofia, Bulgaria
| | - Stavros Liatis
- University of Athens Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Konstantinos Makrilakis
- University of Athens Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Yannis Manios
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece; Institute of Agri-food and Life Sciences, Hellenic Mediterranean University Research Centre, Heraklion, Greece.
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19
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Latomme J, Morgan PJ, Chastin S, Brondeel R, Cardon G. Effects of a family-based lifestyle intervention on co-physical activity and other health-related outcomes of fathers and their children: the 'Run Daddy Run' intervention. BMC Public Health 2023; 23:342. [PMID: 36793044 PMCID: PMC9930712 DOI: 10.1186/s12889-023-15191-z] [Citation(s) in RCA: 1] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 02/02/2023] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND Fathers are important in establishing healthy behaviors in their children, but are rarely engaged in lifestyle programs. Focusing on physical activity (PA) of both fathers and their children by engaging them together in PA (i.e. "co-PA") is therefore a promising novel strategy for interventions. The study aim was to investigate the effect of the 'Run Daddy Run' on co-PA and PA of fathers and their children, and secondary outcomes such as weight status and sedentary behaviour (SB). METHODS This study is a non-randomized controlled trial (nRCT), including 98 fathers and one of their 6 to 8 years old children (intervention = 35, control = 63). The intervention was implemented over a 14-week period, and consisted of six (inter)active father-child sessions and an online component. Due to COVID-19, only 2/6 sessions could be implemented as planned, the remaining sessions were delivered online. In November 2019-January 2020 pre-test measurements took place, and post-test measurements in June 2020. Additional follow-up test was conducted in November 2020. PA (i.e. LPA, MPA, VPA and volume) of fathers and children were objectively measured using accelerometry, co-PA and the secondary outcomes were questioned using an online questionnaire. RESULTS Significant intervention effects were found for co-PA (+ 24 min./day in the intervention compared to the control group, p = 0.002), and MPA of the father (+ 17 min./day, p = 0.035). For children, a significant increase in LPA (+ 35 min./day, p < 0.001) was found. However, an inverse intervention effect was found for their MPA and VPA (-15 min./day, p = 0.005 and - 4 min./day, p = 0.002, respectively). Also decreases in fathers' and children's SB were found (-39 min./day, p = 0.022 and - 40 min./day, p = 0.003, respectively), but no changes in weight status, the father-child relationship, and the PA-family health climate (all p > 0.05). CONCLUSION The Run Daddy Run intervention was able to improve co-PA, MPA of fathers and LPA of children, and decreasing their SB. Inverse intervention effects were however found for MPA and VPA of children. These results are unique given their magnitude and clinical relevance. Targeting fathers together with their children might be a novel and potential intervention strategy to improve overall physical activity levels, however, further efforts should however be made to target children's MPA and VPA. Last, replicating these findings in a randomized controlled trial (RCT) is recommended for future research. TRIAL REGISTRATION NUMBER This study is registered as a clinical trial (clinicaltrials.gov, ID number: NCT04590755, date: 19/10/2020).
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Affiliation(s)
- Julie Latomme
- Department of Movement and Sports Sciences, Ghent University, 9000, Ghent, Belgium.
| | - Philip J. Morgan
- grid.266842.c0000 0000 8831 109XPRCPAN (Priority Research Centre for Physical Activity and Nutrition), School of Education, University of Newcastle, 2308 Newcastle, Australia
| | - Sebastien Chastin
- grid.5214.20000 0001 0669 8188Department of Physiotherapy and Paramedicine, School of Health and Life Sciences, Glasgow Caledonian University, Scotland, UK
| | - Ruben Brondeel
- grid.5342.00000 0001 2069 7798Department of Movement and Sports Sciences, Ghent University, 9000 Ghent, Belgium
| | - Greet Cardon
- grid.5342.00000 0001 2069 7798Department of Movement and Sports Sciences, Ghent University, 9000 Ghent, Belgium
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20
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Zannidi D, Karatzi K, Karaglani E, Liatis S, Cardon G, Iotova V, Tsochev K, Chakarova N, Moreno LA, Flores-Barrantes P, Radó S, Rurik I, Lindström J, Makrilakis K, Manios Y. Children's food choices are highly dependent on patterns of parenting practices and food availability at home in families at high risk for type 2 diabetes in Europe: Cross-sectional results from the Feel4Diabetes study. J Hum Nutr Diet 2023; 36:62-74. [PMID: 35762034 DOI: 10.1111/jhn.13052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 05/09/2022] [Accepted: 05/12/2022] [Indexed: 01/19/2023]
Abstract
BACKGROUND Food parenting practices, behaviours and food availability at home are associated with children's food choices; however, these associations have been mainly studied for each parenting practice separately and focused mostly on healthy populations. The aim of the study was to identify patterns of parenting practices (including data regarding food availability at home, food and physical activity-related behaviours and rewards) and to investigate their cross-sectional associations with children's food choices in families at high risk for type 2 diabetes (T2D). METHODS Data of parents and children (n = 2278), from the Feel4Diabetes study conducted in six European countries, were collected using validated questionnaires. The data analysed included children's food choices, food availability at home and food and physical activity-related parenting practices. Four patterns of parenting practices were identified using principal component analysis, and associations between those components and children's food choices were assessed using adjusted, individual linear regressions. RESULTS Parenting patterns focusing on unhealthy habits, such as allowing unhealthy snacks and unlimited screen time, providing higher availability of unhealthy foods at home, rewarding with snacks and screen time, were positively associated with children's unhealthy food choices (consumption of savoury/sweet snacks, fizzy drinks, etc.). The parenting patterns providing fruit/vegetables at home, consuming fruit, and being physically active with the child were positively associated with children's healthier food choices (consumption of fruit, vegetables, whole grain cereals, etc.). CONCLUSIONS Public health initiatives should focus on high-risk families for T2D, assisting them to adopt appropriate parenting practices and behaviours to promote healthier food choices for children.
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Affiliation(s)
- Dimitra Zannidi
- Department of Nutrition and Dietetics, Harokopio University of Athens, Kallithea, Athens, Greece
| | - Kalliopi Karatzi
- Laboratory of Dietetics and Quality of Life, Department of Food Science & Human Nutrition, School of Food and Nutritional Sciences, Agricultural University of Athens, Athens, Greece
| | - Eva Karaglani
- Department of Nutrition and Dietetics, Harokopio University of Athens, Kallithea, Athens, Greece
| | - Stavros Liatis
- National and Kapodistrian University of Athens Medical School, First Department of Propaedeutic Medicine, Laiko General Hospital, Athens, Greece
| | - Greet Cardon
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Violeta Iotova
- Deptarture of Paediatrics, Medical University, Varna, Bulgaria
| | - Kaloyan Tsochev
- Deptarture of Paediatrics, Medical University, Varna, Bulgaria
| | - Nevyana Chakarova
- Clinical Center of Endocrinology and Gerontology, Medical University of Sofia, Sofia, Bulgaria
| | - Luis A Moreno
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Zaragoza, Spain.,Instituto Agroalimentario de Aragón (IA2), Instituto De Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain.,CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
| | - Paloma Flores-Barrantes
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Zaragoza, Spain
| | - Sándorné Radó
- Department of Family and Occupational Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Imre Rurik
- Department of Family and Occupational Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Jaana Lindström
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Konstantinos Makrilakis
- National and Kapodistrian University of Athens Medical School, First Department of Propaedeutic Medicine, Laiko General Hospital, Athens, Greece
| | - Yannis Manios
- Department of Nutrition and Dietetics, Harokopio University of Athens, Kallithea, Athens, Greece.,Institute of Agri-food and Life Sciences, Hellenic Mediterranean University Research Centre, Heraklion, Greece (Agro-Health)
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21
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Ghofranipour F, Hamzavi Zarghani N, Mohammadi E, Mehrizi AAH, Tavousi M, De Craemer M, Cardon G. An internet-based educational intervention for mothers targeting preschoolers' weight management promotion (PWMP): a pilot study. BMC Public Health 2022; 22:2220. [PMID: 36447163 PMCID: PMC9707417 DOI: 10.1186/s12889-022-14543-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 11/03/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND The prevalence of overweight and obesity among children has raised public health concerns. This study aimed to design and evaluate a behaviour change intervention program to promote weight management among Tehranian preschoolers. METHODS The PRECEDE-PROCEED model is one of the most popular models in health education used to develop and evaluate most educational interventions. In this one-group pre and post-pilot study, 13 mothers of preschoolers were recruited from preschools in Tehran (the capital of Iran), in August 2020. Mothers received a six-week educational intervention, including text messages and educational videos via WhatsApp, to increase their self-efficacy to overcome barriers changing their children's lifestyle. Mothers reported preschoolers' height and weight to assess Body Mass Index and filled out the Food Frequency Questionnaire, the Persian version of the children's health-related quality of life questionnaire, and demographic features. The "Children's physical activity and sedentary behaviors checklist," newly designed by the researchers, was also filled out by mothers. These behaviors were measured according to the minutes that children were involved in these activities in a day, and the days they spent in a week for them. All variables were measured at baseline, immediately after the intervention and three months later. Data analysis was performed using SPSS IBM statistics version 22. Friedman test was used to evaluate changes over time. RESULTS The findings demonstrated that the mean BMI z-score stayed steady between baseline, immediately after the intervention and after three months (P = 0.60). Besides, after three months, the intervention programme led to a decrease in soft drink consumption (P = 0.001), and an increase in parental perception of their child's general health (P = 0.05), the parental concern regarding their child's emotional and physical health (P = 0.002) and minutes of physical activity per day (P = 0.02). However, fruit intake decreased (P = 0.01), and simple sugar, such as cube, increased (P = 0.03). CONCLUSION Results from this study are promising but should be interpreted with caution and should be replicated on a larger scale and compared with a control group to evaluate whether effects are maintained in a larger sample.
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Affiliation(s)
- Fazlollah Ghofranipour
- grid.412266.50000 0001 1781 3962Department of Health Education and Health Promotion, Faculty of Medical Science, Tarbiat Modares University, Tehran, Iran
| | - Najmeh Hamzavi Zarghani
- grid.412266.50000 0001 1781 3962Department of Health Education and Health Promotion, Faculty of Medical Science, Tarbiat Modares University, Tehran, Iran
| | - Eesa Mohammadi
- grid.412266.50000 0001 1781 3962Department of Nursing, Faculty of Medical Science, Tarbiat Modares University, Tehran, Iran
| | - Ali Asghar Haeri Mehrizi
- grid.417689.5Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran
| | - Mahmoud Tavousi
- grid.417689.5Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran
| | - Marieke De Craemer
- grid.5342.00000 0001 2069 7798Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Greet Cardon
- grid.5342.00000 0001 2069 7798Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
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22
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Mahmood L, Moreno LA, Flores-Barrantes P, Mavrogianni C, Schwarz P, Makrilakis K, Liatis S, Cardon G, Willems R, Rurik I, Radó S, Tankova T, Iotova V, Usheva N, Manios Y, Gonzalez-Gil EM. Parental food consumption and diet quality and its association with children's food consumption in families at high risk of type 2 diabetes: the Feel4Diabetes-study. Public Health Nutr 2022; 25:1-12. [PMID: 36217747 PMCID: PMC9991723 DOI: 10.1017/s1368980022002245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 08/19/2022] [Accepted: 09/29/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To examine the parental food consumption and diet quality and its associations with children's consumption in families at high risk for developing type 2 diabetes mellitus across Europe. Also, to compare food frequency consumption among parents and children from high-risk families to the European Dietary guidelines/recommendations. DESIGN Cross-sectional study using Feel4diabetes FFQ. SETTING Families completed FFQ and anthropometric measures were obtained. Linear regression analyses were applied to investigate the relations between parental food consumption and diet quality and their children's food consumption after consideration of potential confounders. PARTICIPANTS 2095 European families (74·6 % mothers, 50·9 % girls). The participants included parent and one child, aged 6-8 years. RESULTS Parental food consumption was significantly associated with children's intake from the same food groups among boys and girls. Most parents and children showed under-consumption of healthy foods according to the European Dietary Guidelines. Parental diet quality was positively associated with children's intake of 'fruit' (boys: β = 0·233, P < 0·001; girls: β = 0·134, P < 0·05) and 'vegetables' (boys: β = 0·177, P < 0·01; girls: β = 0·234, P < 0·001) and inversely associated with their 'snacks' consumption (boys: β = -0·143, P < 0·05; girls: β = -0·186, P < 0·01). CONCLUSION The present study suggests an association between parental food consumption and diet quality and children's food intake. More in-depth studies and lifestyle interventions that include both parents and children are therefore recommended for future research.
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Affiliation(s)
- Lubna Mahmood
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Zaragoza50009, Spain
| | - Luis A Moreno
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Zaragoza50009, Spain
- Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
| | - Paloma Flores-Barrantes
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Zaragoza50009, Spain
| | - Christina Mavrogianni
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Peter Schwarz
- Department of Medicine III, Technical University of Dresden, Dresden, Germany
| | - Konstantinos Makrilakis
- Department of Propaedeutic Internal Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Stavros Liatis
- Department of Propaedeutic Internal Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Greet Cardon
- Department of Movement and Sports Sciences, Ghent University, Gent, Belgium
| | - Ruben Willems
- Department of Public Health and Primary Care, Ghent University, Gent, Belgium
| | - Imre Rurik
- Faculty of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Sándorné Radó
- Faculty of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Tsvetalina Tankova
- Department of Diabetology, Clinical Center of Endocrinology, Medical University of Sofia, Sofia, Bulgaria
| | - Violeta Iotova
- Department of Diabetology, Clinical Center of Endocrinology, Medical University of Sofia, Sofia, Bulgaria
| | - Natalya Usheva
- Department of Social Medicine and Health Care Organization, Medical University of Varna, Varna, Bulgaria
| | - Yannis Manios
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
- Institute of Agri-food and Life Sciences, Hellenic Mediterranean University Research Centre, Heraklion, Greece
| | - Esther M Gonzalez-Gil
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Zaragoza50009, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
- Department of Biochemistry and Molecular Biology II, Instituto de Nutrición y Tecnología de los Alimentos, Center of Biomedical Research (CIBM), Universidad de Granada, Granada, Spain
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23
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Cardon G, Chastin S, Van Stappen V, Huys N, Stefanova T, Chakarova N, Kivelä J, Alberto Moreno L, Sándor Istvánné R, Androutsos O, Manios Y, De Craemer M. The Feel4Diabetes intervention: effectiveness on 24-hour physical behaviour composition in families at risk for diabetes development. Health Promot Int 2022; 37:6775000. [DOI: 10.1093/heapro/daac092] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Summary
The Feel4Diabetes project conducted a 2-year intervention aiming to encourage healthy behaviours in families in six European countries. Within this paper, the intervention effect was evaluated after the first intervention year on 24-hour physical behaviour composition in Belgian families at risk for type 2 diabetes. Parents’ and children’s levels of physical activity (PA) and sedentary behaviour (SB) were objectively measured and sleep duration was self-reported. Valid data were obtained in 82 children (mean age: 8.2 ± 0.84; 50.0% boys) and 72 parents (mean age: 40.1 ± 5.5; 27.8% fathers). Data were analysed using a compositional data approach, and mixed models were used to take clustering into account. Results showed that for children, the mean baseline composition of the 24-hour day in sleep, SB, light and moderate-to-vigorous PA for the intervention group was (11 hours 18 minutes; 6 hours 33 minutes; 5 hours 02 minutes, 1 hour 08 minutes) and for the control group (11 hours 18 minutes; 6 hours 35 minutes; 5 hours 04 minutes; 1 hour 06 minutes), respectively. For parents, the mean baseline composition was for the intervention group (8 hours 12 minutes; 9 hours 36 minutes; 5 hours 43 minutes; 27 minutes) and for the control group (8 hours 00 minute; 9 hours 00 minute; 6 hours 27 minutes; 33 minutes). No significant intervention effects were found on 24-hour physical behaviour composition of either parents or children (p = 0.19 and p = 0.21, respectively). A relatively small study population and a poor attendance rate among parents could maybe explain the lack of effectiveness. More effective strategies are needed to retain vulnerable families in interventions. Furthermore, future approaches to improve the 24-hour physical behaviour composition should maybe focus more specifically on PA, SB and sleep, and involve teachers, children and parents in the design of the intervention. Trial registration: NCT02393872 in ClinicalTrials.gov.
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Affiliation(s)
- Greet Cardon
- Ghent University, Department of Movement and Sports Sciences, Ghent University , Watersportlaan 2, 9000 Ghent , Belgium
| | - Sebastien Chastin
- Ghent University, Department of Movement and Sports Sciences, Ghent University , Watersportlaan 2, 9000 Ghent , Belgium
- Center for Living, School of Health and Life Science, Glasgow Caledonian University , Cowcaddens Rd, Glasgow G4 0BA , UK
| | - Vicky Van Stappen
- Ghent University, Department of Movement and Sports Sciences, Ghent University , Watersportlaan 2, 9000 Ghent , Belgium
| | - Nele Huys
- Ghent University, Department of Movement and Sports Sciences, Ghent University , Watersportlaan 2, 9000 Ghent , Belgium
| | - Tanya Stefanova
- Medical University Varna, Clinic of Paediatric Endocrinology , UMHAT “St. Marina” 1 “Hr. Smirnenski” Blvd., Varna 9010 , Bulgaria
| | - Nevena Chakarova
- Medical University of Sofia, Department of Diabetology, Clinical Centre of Endocrinology , Bulgaria bul. “Pencho Slaveykov”, 1431 Sofia Center, Sofia, Bulgarije
| | - Jemina Kivelä
- Finnish Institute for Health and Welfare , Mannerheimintie 166, 00300 Helsinki , Finland
| | - Luis Alberto Moreno
- University of Zaragoza, GENUD (Growth, Exercise, Nutrition and Development) , C/Domingo Miral s/n, 50009 Zaragoza , Spain
| | - Radó Sándor Istvánné
- University of Debrecen, Debreceni Egyetem (UoD) , Egyetem tér 1, Debrecen, 4032 Hungary
| | - Odysseas Androutsos
- Harokopio University, School of Health Science & Education, Department of Nutrition and Dietetics, Harokopio University , 70, El Venizelou Ave, 176 71 Kallithea, Athens , Greece
| | - Yannis Manios
- Harokopio University, School of Health Science & Education, Department of Nutrition and Dietetics, Harokopio University , 70, El Venizelou Ave, 176 71 Kallithea, Athens , Greece
| | - Marieke De Craemer
- Research Foundation Flanders (FWO) , Egmontstraat 5, 1000 Brussels , Belgium
- Department of Rehabilitation Sciences, Ghent University , Ghent University Hospital B3, C. Heymanslaan 10, 9000 Ghent , Belgium
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24
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Diamantis DV, Karatzi K, Kantaras P, Liatis S, Iotova V, Bazdraska Y, Tankova T, Cardon G, Wikström K, Rurik I, Antal E, Ayala-Marín AM, Legarre NG, Makrilakis K, Manios Y. Prevalence and Socioeconomic Correlates of Adult Obesity in Europe: The Feel4Diabetes Study. Int J Environ Res Public Health 2022; 19:12572. [PMID: 36231871 PMCID: PMC9566241 DOI: 10.3390/ijerph191912572] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 09/27/2022] [Accepted: 09/27/2022] [Indexed: 06/16/2023]
Abstract
To effectively tackle obesity, it is necessary to identify all specific socioeconomic factors which contribute to its development. We aimed to highlight the prevalence of adult overweight/obesity in European countries and investigate the association of various socioeconomic factors and their accumulative effect on overweight/obesity status. Cross-sectional data from the Feel4Diabetes study for 24,562 adults residing in low socioeconomic areas were collected, representing Belgium, Finland, Greece, Spain, Bulgaria, and Hungary. Socioeconomic Burden Score (SEBS) was created, accounting for unemployment, financial insecurity, and education ≤ 12 years. Data were analyzed using analysis of variance and logistic regression. In total, 19,063 adults with complete data were included (34.5% overweight and 15.8% obese). The highest overweight/obesity rates occurred in Greece (37.5%/17.8%) and Hungary (35.4%/19.7%). After adjusting for confounders, age of <45 years and female sex were inversely associated with overweight/obesity, while low educational level (≤12 years), unemployment, and financial insecurity were positively associated. The increase in SEBS (clustering of socioeconomic disadvantages) was associated with increased overweight/obesity likelihood. This association of SEBS scores with overweight/obesity was evident for males and females across all examined countries, excluding males in low-income countries (Bulgaria and Hungary), where the highest SEBS score was inversely associated with overweight/obesity. The clustering burden of socioeconomic disadvantages on overweight/obesity was found to be influenced by the countries' economic state and sex.
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Affiliation(s)
- Dimitrios V. Diamantis
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 17671 Athens, Greece
| | - Kalliopi Karatzi
- Laboratory of Dietetics and Quality of Life, Department of Food Science & Human Nutrition, School of Food and Nutritional Sciences, Agricultural University of Athens, 11855 Athens, Greece
| | - Paris Kantaras
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 17671 Athens, Greece
| | - Stavros Liatis
- Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Violeta Iotova
- Department of Paediatrics, Medical University of Varna, 9010 Varna, Bulgaria
| | - Yulia Bazdraska
- Department of Paediatrics, Medical University of Varna, 9010 Varna, Bulgaria
| | - Tsvetalina Tankova
- Clinical Center of Endocrinology and Gerontology, Medical University of Sofia, 1431 Sofia, Bulgaria
| | - Greet Cardon
- Department of Movement and Sports Sciences, Ghent University, 9000 Ghent, Belgium
| | - Katja Wikström
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, 00271 Helsinki, Finland
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, 70210 Kuopio, Finland
| | - Imre Rurik
- Department of Family Medicine Hungarian Society of Nutrition, Semmelweis University, 1085 Budapest, Hungary
| | - Emese Antal
- Hungarian Society of Nutrition, 1088 Budapest, Hungary
| | - Alelí M. Ayala-Marín
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Facultad de Ciencias de la Salud, Universidad de Zaragoza, 50009 Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), 50013 Zaragoza, Spain
- Instituto Agroalimentario de Aragón (IA2), 50009 Zaragoza, Spain
| | - Natalia Giménez Legarre
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Facultad de Ciencias de la Salud, Universidad de Zaragoza, 50009 Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), 50013 Zaragoza, Spain
- Instituto Agroalimentario de Aragón (IA2), 50009 Zaragoza, Spain
| | | | - Yannis Manios
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 17671 Athens, Greece
- Institute of Agri-Food and Life Sciences, Hellenic Mediterranean University Research Centre, 71410 Heraklion, Greece
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25
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Khudair M, Marcuzzi A, Ng K, Tempest GD, Bartoš F, Peric R, Maier M, Beccia F, Boccia S, Brandes M, Cardon G, Carlin A, Castagna C, Chaabene H, Chalkley A, Ciaccioni S, Cieślińska-Świder J, Čingienė V, Cortis C, Corvino C, de Geus EJ, Di Baldassarre A, Di Credico A, Drid P, Fernández Tarazaga RM, Gallè F, García Sánchez E, Gebremariam M, Ghinassi B, Goudas M, Hayes G, Honorio S, Izzicupo P, Jahre H, Jelsma J, Juric P, Kolovelonis A, Kongsvold A, Kouidi E, Mansergh F, Masanovic B, Mekonnen T, Mork PJ, Murphy M, O'Hara K, Torun AO, Palumbo F, Popovic S, Prieske O, Puharic Z, Ribeiro JC, Rumbold PLS, Sandu P, Sorić M, Stavnsbo M, Syrmpas I, van der Ploeg HP, Van Hoye A, Vilela S, Woods C, Wunsch K, Caprinica L, MacDonncha C, Ling FCM. DE-PASS Best Evidence Statement (BESt): modifiable determinants of physical activity and sedentary behaviour in children and adolescents aged 5-19 years-a protocol for systematic review and meta-analysis. BMJ Open 2022; 12:e059202. [PMID: 36127107 PMCID: PMC9490573 DOI: 10.1136/bmjopen-2021-059202] [Citation(s) in RCA: 0] [Impact Index Per Article: 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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Physical activity among children and adolescents remains insufficient, despite the substantial efforts made by researchers and policymakers. Identifying and furthering our understanding of potential modifiable determinants of physical activity behaviour (PAB) and sedentary behaviour (SB) is crucial for the development of interventions that promote a shift from SB to PAB. The current protocol details the process through which a series of systematic literature reviews and meta-analyses (MAs) will be conducted to produce a best-evidence statement (BESt) and inform policymakers. The overall aim is to identify modifiable determinants that are associated with changes in PAB and SB in children and adolescents (aged 5-19 years) and to quantify their effect on, or association with, PAB/SB. METHODS AND ANALYSIS A search will be performed in MEDLINE, SportDiscus, Web of Science, PsychINFO and Cochrane Central Register of Controlled Trials. Randomised controlled trials (RCTs) and controlled trials (CTs) that investigate the effect of interventions on PAB/SB and longitudinal studies that investigate the associations between modifiable determinants and PAB/SB at multiple time points will be sought. Risk of bias assessments will be performed using adapted versions of Cochrane's RoB V.2.0 and ROBINS-I tools for RCTs and CTs, respectively, and an adapted version of the National Institute of Health's tool for longitudinal studies. Data will be synthesised narratively and, where possible, MAs will be performed using frequentist and Bayesian statistics. Modifiable determinants will be discussed considering the settings in which they were investigated and the PAB/SB measurement methods used. ETHICS AND DISSEMINATION No ethical approval is needed as no primary data will be collected. The findings will be disseminated in peer-reviewed publications and academic conferences where possible. The BESt will also be shared with policy makers within the DE-PASS consortium in the first instance. SYSTEMATIC REVIEW REGISTRATION CRD42021282874.
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Affiliation(s)
- Mohammed Khudair
- Department of Sport, Exercise and Rehabilitation, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - Anna Marcuzzi
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
| | - Kwok Ng
- School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu, Finland
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
| | - Gavin Daniel Tempest
- Department of Sport, Exercise and Rehabilitation, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - František Bartoš
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Ratko Peric
- Exercise Physiology Laboratory, OrthoSport Banja Luka, Banja Luka, Bosnia and Herzegovina
| | | | - Flavia Beccia
- Department of Psychology, Università Cattolica del Sacro Cuore, Milano, Italy
| | - Stefania Boccia
- Department of Psychology, Università Cattolica del Sacro Cuore, Milano, Italy
| | - Mirko Brandes
- Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology, Bremen, Germany
| | - Greet Cardon
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Angela Carlin
- Centre for Exercise Medicine, Physical Activity and Health, Sport and Exercise Sciences Research Institute, University of Ulster, Jordanstown Campus, UK
| | - Carolina Castagna
- Department of Psychology, Università Cattolica del Sacro Cuore, Milano, Italy
| | - Helmi Chaabene
- Department of Sports and Health Sciences, Faculty of Human Sciences, University of Potsdam, Potsdam, Germany
- High Institute of Sports and Physical Education of Kef, University of Jendouba, Jendouba, Tunisia
| | - Anna Chalkley
- Faculty of Health Studies, University of Bradford, Bradford, UK
- Center for Physically Active Learning, Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Norway, Bergen, Norway
| | - Simone Ciaccioni
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Joanna Cieślińska-Świder
- Department of Physiotherapy, The Jerzy Kukuczka Academy of Physical Education in Katowice, Katowice, Poland
| | - Vilma Čingienė
- Institute of Leadership and Strategic Management, Faculty of Public Governance and Business, Mykolas Romeris University, Vilnius, Lithuania
| | - Cristina Cortis
- Department of Human Sciences, Society and Health, University of Cassino and Lazio Meridionale, Cassino, Italy
| | - Chiara Corvino
- Department of Psychology, Università Cattolica del Sacro Cuore, Milano, Italy
| | - Eco Jc de Geus
- Department of Biological Psychology, Vrije Universiteit, Amsterdam, Netherlands
- Department of Public and Occupational Health, Amsterdam Public Health Institute, Amsterdam University Medical Centres, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Angela Di Baldassarre
- Department of Medicine and Aging Sciences, Gabriele d'Annunzio University of Chieti and Pescara, Chieti, Italy
| | - Andrea Di Credico
- Department of Medicine and Aging Sciences, Gabriele d'Annunzio University of Chieti and Pescara, Chieti, Italy
| | - Patrik Drid
- Faculty of Sport and Physical Education, University of Novi Sad, Novi Sad, Serbia
| | | | - Francesca Gallè
- Department of Movement Sciences and Wellbeing, University of Naples-Parthenope, Napoli, Italy
| | - Esther García Sánchez
- Fundación para la Formación e Investigación Sanitarias de la Región de Murcia, Murcia, Spain
| | - Mekdes Gebremariam
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Barbara Ghinassi
- Department of Medicine and Aging Sciences, Gabriele d'Annunzio University of Chieti and Pescara, Chieti, Italy
| | - Marios Goudas
- Department of Physical Education and Sport Science, University of Thessaly, Volos, Greece
| | - Grainne Hayes
- Department of Sport and Early Childhood Studies, Technological University of the Shannon: Midlands Midwest, Moylish Campus, Limerick, Ireland
- Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Samuel Honorio
- Sports, Health and Exercise Research Unit (SHERU), Polytechnic Institute of Castelo Branco, Castelo Branco, Portugal
| | - Pascal Izzicupo
- Department of Medicine and Aging Sciences, Gabriele d'Annunzio University of Chieti and Pescara, Chieti, Italy
| | - Henriette Jahre
- Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway
| | - Judith Jelsma
- Department of Public and Occupational Health, Amsterdam Public Health Institute, Amsterdam University Medical Centres, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Petra Juric
- Faculty of Kinesiology, University of Zagreb, Zagreb, Croatia
| | - Athanasios Kolovelonis
- Department of Physical Education and Sport Science, University of Thessaly, Volos, Greece
| | - Atle Kongsvold
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
| | - Evangelia Kouidi
- Laboratory of Sports Medicne, Department of Physical 95 Education and Sports Science, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Fiona Mansergh
- Health and Wellbeing Programme, Department of Health, Dublin, Ireland
| | - Bojan Masanovic
- Faculty for Sport and Physical Education, University of Montenegro, Podgorica, Montenegro
- Montenegrin Sports Academy, Podgorica, Montenegro
| | - Teferi Mekonnen
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Paul Jarle Mork
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
| | - Marie Murphy
- Doctoral College, Ulster University, Newtownabbey, UK
| | - Kelly O'Hara
- Sport Science Department, University of Beira Interior, Covilha, Portugal
| | - Ayse Ozbil Torun
- Department of Architecture and Built Environment, Northumbria University, Newcastle upon Tyne, UK
| | - Federico Palumbo
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Stevo Popovic
- Faculty for Sport and Physical Education, University of Montenegro, Podgorica, Montenegro
- Western Balkan Sport Innovation Lab, Podgorica, Montenegro
| | - Olaf Prieske
- University of Applied Sciences for Sport and Management Potsdam, Potsdam, Germany
| | - Zrinka Puharic
- University of Applied Sciences Bjelovar, Bjelovar, Croatia
- Faculty of dental medicine and health, Osijek, Croatia
| | | | - Penny Louise Sheena Rumbold
- Department of Sport, Exercise and Rehabilitation, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - Petru Sandu
- National Institute of Public Health in Romania, Bucharest, Romania
| | - Maroje Sorić
- Faculty of Kinesiology, University of Zagreb, Zagreb, Croatia
- Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
| | - Mette Stavnsbo
- Department of Sport Science and Physical Education, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | - Ioannis Syrmpas
- Department of Physical Education and Sport Science, University of Thessaly, Volos, Greece
| | - Hidde P van der Ploeg
- Department of Public and Occupational Health, Amsterdam Public Health Institute, Amsterdam University Medical Centres, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Aurélie Van Hoye
- Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Sofia Vilela
- EPIUnit - Institute of Public Health, University of Porto, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
| | - Catherine Woods
- Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Kathrin Wunsch
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Laura Caprinica
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Ciaran MacDonncha
- Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Fiona Chun Man Ling
- Department of Sport, Exercise and Rehabilitation, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
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26
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Chairistanidou C, Karatzi K, Karaglani E, Usheva N, Liatis S, Chakarova N, Mateo-Gallego R, Lamiquiz-Moneo I, Radó S, Antal E, Bíró É, Kivelä J, Wikström K, Iotova V, Cardon G, Makrilakis K, Manios Y. Reply to: "Interaction analysis is needed to reveal the effects of socioeconomic status on the association between diet quality and lipidemic profile". Nutr Metab Cardiovasc Dis 2022; 32:2275-2277. [PMID: 35760646 DOI: 10.1016/j.numecd.2022.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 05/20/2022] [Indexed: 11/16/2022]
Affiliation(s)
- Christina Chairistanidou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 17671 Athens, Greece
| | - Kalliopi Karatzi
- Laboratory of Dietetics and Quality of Life, Department of Food Science & Human Nutrition, School of Food and Nutritional Sciences, Agricultural University of Athens, Athens, Greece
| | - Eva Karaglani
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 17671 Athens, Greece
| | - Natalya Usheva
- Department of Paediatrics, Medical University Varna, Varna, Bulgaria
| | - Stavros Liatis
- National and Kapodistrian University of Athens Medical School, 11527 Athens, Greece
| | - Nevena Chakarova
- Clinical Center of Endocrinology, Medical University of Sofia, Sofia, Bulgaria
| | | | - Itziar Lamiquiz-Moneo
- Unidad Clínica y de Investigación en Lípidos y Arteriosclerosis, Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria Aragón (IIS Aragón) CIBERCV, Zaragoza, Spain
| | - Sándorné Radó
- University of Debrecen, Faculty of Health, Debrecen, Hungary
| | - Emese Antal
- Hungarian Society of Nutrition, 1088 Budapest, Hungary
| | - Éva Bíró
- Department of Public Health and Epidemiology University of Debrecen, Faculty of Medicine, Hungary
| | - Jemina Kivelä
- Department of Public Health Solutions, Finnish Institute for Health and Welfare, Mannerheimintie 166, Helsinki, Finland
| | - Katja Wikström
- Department of Public Health Solutions, Finnish Institute for Health and Welfare, Mannerheimintie 166, Helsinki, Finland
| | - Violeta Iotova
- Department of Paediatrics, Medical University Varna, Varna, Bulgaria
| | - Greet Cardon
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, 9000 Gent, Belgium
| | | | - Yannis Manios
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 17671 Athens, Greece; Institute of Agri-food and Life Sciences, Hellenic Mediterranean University Research Centre, Agro-Health, Heraklion, Greece.
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De Craemer M, Van Stappen V, Brondeel R, Iotova V, Chakarova N, Rurik I, Lindström J, Kivelä J, Moreno LA, Mavrogianni C, Manios Y, Cardon G. Self-reported lifestyle behaviours in families with an increased risk for type 2 diabetes across six European countries: a cross-sectional analysis from the Feel4Diabetes-study. BMC Endocr Disord 2022; 22:213. [PMID: 36002885 PMCID: PMC9404668 DOI: 10.1186/s12902-022-01115-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 07/18/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND A healthy lifestyle decreases the risk of developing type 2 diabetes mellitus. The current cross-sectional study aimed to describe self-reported lifestyle behaviours and compare them to current health guidelines in European Feel4Diabetes-families at risk for developing type 2 diabetes across six countries (Belgium, Finland, Spain, Greece, Hungary and Bulgaria). METHODS Parents and their children were recruited through primary schools located in low socio-economic status areas. Parents filled out the FINDRISC-questionnaire (eight items questioning age, Body Mass Index, waist circumference, PA, daily consumption of fruit, berries or vegetables, history of antihypertensive drug treatment, history of high blood glucose and family history of diabetes), which was used for the risk assessment of the family. Sociodemographic factors and several lifestyle behaviours (physical activity, sedentary behaviour, water consumption, fruit and vegetable consumption, soft drink consumption, sweets consumption, snack consumption, breakfast consumption) of both adults and children were assessed by parental questionnaires. Multilevel regression analyses were conducted to investigate families' lifestyle behaviours, to compare these levels to health guidelines and to assess potential differences between the countries. Analyses were controlled for age, sex and socio-economic status. RESULTS Most Feel4Diabetes-families at risk (parents and their children) did not comply with the guidelines regarding healthy behaviours, set by the WHO, European or national authorities. Less than half of parents and children complied with the physical activity guidelines, less than 15% of them complied with the fruit and vegetable guideline, and only 40% of the children met the recommendations of five glasses of water per day. Clear differences in lifestyle behaviours in Feel4Diabetes-families at risk exist between the countries. CONCLUSIONS Countries are highly recommended to invest in policy initiatives to counter unhealthy lifestyle behaviours in families at risk for type 2 diabetes development, taking into account country-specific needs. For future research it is of great importance to focus on families at risk in order to counter the development of type 2 diabetes and reduce health inequity.
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Affiliation(s)
- Marieke De Craemer
- Department of Rehabilitation Sciences, Ghent University, Corneel Heymanslaan 10, 9000, Ghent, Belgium.
- Research Foundation Flanders (FWO), Egmontstraat 5, 1000, Brussels, Belgium.
| | - Vicky Van Stappen
- Movement and Sports Sciences, Ghent University, 9000, Ghent, Belgium
| | | | - Violeta Iotova
- Clinic of Paediatric Endocrinology, Medical University Varna, 9002, Varna, Bulgaria
| | - Nevena Chakarova
- Clinical Center of Endocrinology, Medical University of Sofia, 1431, Sofia, Bulgaria
| | - Imre Rurik
- Debreceni Egyetem (UoD), University of Debrecen, 4002, Debrecen, Hungary
| | - Jaana Lindström
- Finnish Institute for Health and Welfare, 00271, Helsinki, Finland
| | - Jemina Kivelä
- Finnish Institute for Health and Welfare, 00271, Helsinki, Finland
| | - Luis Alberto Moreno
- Growth, Exercise, Nutrition and Development (GENUD), University of Zaragoza, 50009, Saragossa, Spain
| | - Christina Mavrogianni
- Department of Nutrition and Dietetics, School of Health Science & Education, Harokopio University, 176 76, Athens, Greece
| | - Yannis Manios
- Department of Nutrition and Dietetics, School of Health Science & Education, Harokopio University, 176 76, Athens, Greece
- Institute of Agri-Food and Life Sciences, Hellenic Mediterranean University Research Centre, Heraklion, Greece
| | - Greet Cardon
- Research Foundation Flanders (FWO), Egmontstraat 5, 1000, Brussels, Belgium
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Kontochristopoulou AM, Karatzi K, Karaglani E, Cardon G, Kivelä J, Wikström K, Iotova V, Tsochev K, Tankova T, Rurik I, Radone AS, Liatis S, Makrilakis K, Moreno LA, Manios Y. Sociodemographic, anthropometric, and lifestyle correlates of prediabetes and type 2 diabetes in europe: The Feel4Diabetes study. Nutr Metab Cardiovasc Dis 2022; 32:1851-1862. [PMID: 35610084 DOI: 10.1016/j.numecd.2022.03.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 12/14/2021] [Revised: 03/18/2022] [Accepted: 03/25/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND AND AIMS The current work aimed to identify the predominant correlates of prediabetes and T2DM among a variety of socio-demographic, anthropometric and lifestyle indices, in a large sample of adults from families at high risk for T2DM. METHODS AND RESULTS In this cross-sectional study, 2816 adults were recruited from low-socioeconomic areas in high-income countries (HICs) (Belgium-Finland), HICs under austerity measures (Greece-Spain), and low/middle-income countries (LMICs) (Bulgaria-Hungary). A positive association between the male sex (OR, 95% C.I.2.77 (1.69-4.54)) and prediabetes was revealed compared to females, while there was a negative association between younger age (<45 years) (OR, 95% C.I. 0.58 (0.37-0.92)), and low/medium levels of waist circumference (OR, 95% C.I. 0.44 (0.22-0.89)) with prediabetes compared to older age and high levels of waist circumference, respectively. Concerning T2DM, 0-0.5 cups/day of fruits and berries (OR, 95% C.I.2. 13 (1.16-3.91)) and 150-300 g fish/week (OR, 95% C.I. 2.55 (1.01-6.41)) have a positive association compared to higher consumptions, respectively. Conversely, <1 cup/week legumes (OR, 95% C.I. 0.55 (0.31-0.99) as well as 0-0.5 servings (OR, 95% C.I. 0.34 (0.12-0.95) and 0.5-1 servings (OR, 95% C.I. 0.37 (0.19-0.71) of full-fat dairy/day have a negative association compared to higher consumptions, respectively. CONCLUSION These findings indicate the need for diabetes prevention measures targeting young adults and especially men, above 45 years of age, with central obesity and poor dietary habits and prioritize vulnerable groups and populations living in LMICs. NATIONAL CLINICAL TRIAL NUMBER NCT02393872.
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Affiliation(s)
| | - Kalliopi Karatzi
- Laboratory of Dietetics and Quality of Life, Department of Food Science & Human Nutrition, School of Food and Nutritional Sciences, Agricultural University of Athens, 75 Iera Odos, Athens, 11855, Greece
| | - Eva Karaglani
- Department of Nutrition and Dietetics, Harokopio University, 70 El Venizelou Avenue, Kallithea, Athens, 17671, Greece
| | - Greet Cardon
- Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
| | - Jemina Kivelä
- Finnish Institute for Health and Welfare, Population Health Unit Helsinki, Finland
| | - Katja Wikström
- Finnish Institute for Health and Welfare, Population Health Unit Helsinki, Finland
| | - Violeta Iotova
- Department of Pediatrics, Medical University Varna, Varna, Bulgaria
| | - Kaloyan Tsochev
- Department of Pediatrics, Medical University Varna, Varna, Bulgaria
| | - Tsvetalina Tankova
- Clinical Center of Endocrinology and Gerontology, Medical University of Sofia, Sofia, Bulgaria
| | - Imre Rurik
- Department of Family and Occupational Medicine, University of Debrecen, Debrecen, Hungary
| | - Anett S Radone
- Department of Family and Occupational Medicine, University of Debrecen, Debrecen, Hungary
| | - Stavros Liatis
- First Department of Propaedeutic Medicine, National and Kapodistrian University of Athens Medical School, Laiko General Hospital, Athens, Greece
| | - Konstantinos Makrilakis
- First Department of Propaedeutic Medicine, National and Kapodistrian University of Athens Medical School, Laiko General Hospital, Athens, Greece
| | - Luis A Moreno
- Growth, Exercise, Nutrition and Development Research Group, University of Zaragoza, School of Health Science (EUCS), Zaragoza, Spain
| | - Yannis Manios
- Department of Nutrition and Dietetics, Harokopio University, 70 El Venizelou Avenue, Kallithea, Athens, 17671, Greece.
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Papamichael MM, Karaglani E, Boutsikou T, Dedousis V, Cardon G, Iotova V, Chakarova N, Usheva N, Wikström K, Imre R, RADÓ ASI, Liatis S, Makrilakis K, Moreno L, Manios Y, Manios Y, Cardon G, Lindström J, Schwarz P, Makrilakis K, Annemans L, Ko W, Manios Y, Karatzi K, Androutsos O, Moschonis G, Kanellakis S, Mavrogianni C, Tsoutsoulopoulou K, Katsarou C, Karaglani E, Qira I, Skoufas E, Maragkopoulou K, Tsiafitsa A, Sotiropoulou I, Tsolakos M, Argyri E, Nikolaou M, Vampouli EA, Filippou C, Apergi K, Filippou A, Katerina G, Dimitriadis E, Lindström J, Laatikainen T, Wikström K, Kivelä J, Valve P, Levälahti E, Virtanen E, Pennanen T, Olli S, Nelimarkka K, Cardon G, Van Stappen V, Huys N, Annemans L, Willems R, Shadid S, Schwarz P, Timpel P, Makrilakis K, Liatis S, Dafoulas G, Lambrinou CP, Giannopoulou A, Ko W, Karuranga E, Moreno L, Civeira F, Bueno G, De Miguel-Etayo P, Mª E, Gonzalez-Gil, Miguel-Berges ML, Giménez-Legarre N, Flores-Barrantes P, Ayala-Marín AM, Seral-Cortés M, Baila-Rueda L, Cenarro A, Jarauta E, Mateo-Gallego R, Iotova V, Tankova T, Usheva N, Tsochev K, Chakarova N, Galcheva S, Dimova R, Bocheva Y, Radkova Z, Marinova V, Bazdarska Y, Stefanova T, Rurik I, Ungvari T, Jancsó Z, Nánási A, Kolozsvári L, Semánova C, Bíró É, Antal E, Radó S, Martinez R, Tong M. HOW DO THE HOME FOOD ENVIRONMENT, PARENTING PRACTICES, HEALTH BELIEFS, AND SCREEN TIME AFFECT THE WEIGHT STATUS OF EUROPEAN CHILDREN?: FEEL4DIABETES-STUDY. Nutrition 2022; 103-104:111834. [DOI: 10.1016/j.nut.2022.111834] [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] [Received: 04/21/2022] [Revised: 07/28/2022] [Accepted: 08/12/2022] [Indexed: 11/26/2022]
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Iliano E, Beeckman M, Latomme J, Cardon G. The GRANDPACT Project: The Development and Evaluation of an Intergenerational Program for Grandchildren and Their Grandparents to Stimulate Physical Activity and Cognitive Function Using Co-Creation. Int J Environ Res Public Health 2022; 19:ijerph19127150. [PMID: 35742392 PMCID: PMC9222701 DOI: 10.3390/ijerph19127150] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 06/03/2022] [Accepted: 06/07/2022] [Indexed: 11/16/2022]
Abstract
In recent years, increased attention has been devoted to intergenerational physical activity (PA) programs because they may have several benefits for both children and older adults (e.g., the reduction of ageism). An intergenerational PA program focusing on grandchildren and grandparents in a 'standard' family setting that combines PA and cognitive function is innovative and may hold potential for promoting PA and improving cognitive functioning in both grandchildren and grandparents. The aim of this study is to describe the protocol of the GRANDPACT (GRANDparents and GRANDchildren improve their Physical Activity and Cognitive functions using co-creaTion) Project, focusing on the development of an intergenerational, cognitively enriched, movement program for grandchildren and grandparents using the theoretical framework of the "Behaviour Change Wheel" in combination with a co-creation approach. Two co-creation trajectories will be organized to develop the program, followed by a pilot study to refine the program and an RCT with a pre-test (at baseline), a post-test (after 24 weeks), and a follow-up (after 36 weeks) to measure the outcomes of co-PA, cognitive functions, psychosocial well-being, and the quality of the family relationship ingrandchildren and grandparents. The outcomes will be measured using accelerometry for PA, the Cambridge Neuropsychological Test Automated Battery (CANTAB) for cognitive functions, and questionnaires for the psychological well-being and quality of the family relationship. Co-development with end-users and stakeholders during both co-creation trajectories is expected to result in an effective, attractive, and feasible program. Co-PA is expected to improve PA, cognitive functioning, psychosocial well-being, and the quality of the family relationships between grandchildren and grandparents.
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Apergi K, Karatzi K, Reppas K, Karaglani E, Usheva N, Giménez-Legarre N, Moreno LA, Dimova R, Antal E, Jemina K, Cardon G, Iotova V, Manios Y, Makrilakis K. Association of breakfast consumption frequency with fasting glucose and insulin sensitivity/b cells function (HOMA-IR) in adults from high-risk families for type 2 diabetes in Europe: the Feel4Diabetes Study. Eur J Clin Nutr 2022; 76:1600-1610. [PMID: 35614208 DOI: 10.1038/s41430-022-01160-z] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 04/12/2022] [Accepted: 05/03/2022] [Indexed: 11/09/2022]
Abstract
PURPOSE This study aimed to investigate the association of breakfast consumption frequency (BCF) with glycemic control indices in a cross-sectional sample of adults from families at high risk for type 2 diabetes mellitus (T2DM), exploring the role of sex and socioeconomic status (SES). METHODS In 2370 adults (40.8 ± 5.6 years) from 6 European countries, sociodemographic, lifestyle, anthropometric and biochemical characteristics were assessed through standardized procedures. Multivariable regression models were used to examine the association between fasting glucose (FG), fasting insulin (FI), and insulin resistance (HOMA-IR) (dependent variables) with BCF (independent variable) controlling for multiple possible confounders. RESULTS A linear association of BCF with FG (β = -0.557, 95% CI (-0.834, -0.280)) and a quadratic association with FI and HOMA-IR with the highest point of curve observed at BCF = 2.989 (times/week) and at BCF = 2.746, respectively, independent of the used covariates. In males and in participants of high SES, BCF was linearly and inversely associated with FG, while with FI and HOMA-IR there was an association with BCF in quadratic function. In females, BCF was linearly and inversely associated with FG and HOMA-IR, and there was a quadratic association with FI. In low SES there was only a linear association with FG, yet with no statistically significant findings for FI and HOMA-IR. CONCLUSIONS Regular breakfast consumption, especially >3 times/week is associated with improved indices of glycemic control. This association was diminished in low SES participants in the presence of the used covariates.
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Affiliation(s)
- Kiriaki Apergi
- Medical School, National and Kapodistrian University, Athens, Greece.
| | - Kalliopi Karatzi
- Laboratory of Dietetics and Quality of Life Department Of Food Science & Human Nutrition School of Food and Nutritional Sciences, Agricultural University of Athens, Athens, Greece
| | - Kyriakos Reppas
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Eva Karaglani
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Natalya Usheva
- Department of Social Medicine and Health Care, Medical University of Varna, Varna, Bulgaria
| | - Natalia Giménez-Legarre
- Growth, Exercise, Nutrition and Development Research Group, School of Health Sciences, University of Zaragoza, Zaragoza, Spain.,Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain.,Instituto de InvestigAICón Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
| | - Luis A Moreno
- Growth, Exercise, Nutrition and Development Research Group, School of Health Sciences, University of Zaragoza, Zaragoza, Spain.,Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain.,Instituto de InvestigAICón Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain.,Centro de InvestigAICón Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
| | - Roumyana Dimova
- Clinical Center of Endocrinology, Medical University of Sofia, Sofia, Bulgaria
| | - Emese Antal
- Hungarian Society of Nutrition, Budapest, Hungary
| | - Kivelä Jemina
- Public Health Promotion Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Greet Cardon
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Gent, Belgium
| | - Violeta Iotova
- Department of Pediatrics, Medical University of Varna, Varna, Bulgaria
| | - Yannis Manios
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece.,Institute of Agri-food and Life Sciences, Hellenic Mediterranean University Research Centre, Heraklion, Greece
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Maenhout L, Peuters C, Cardon G, Crombez G, DeSmet A, Compernolle S. Nonusage Attrition of Adolescents in an mHealth Promotion Intervention and the Role of Socioeconomic Status: Secondary Analysis of a 2-Arm Cluster-Controlled Trial. JMIR Mhealth Uhealth 2022; 10:e36404. [PMID: 35536640 PMCID: PMC9131163 DOI: 10.2196/36404] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 03/23/2022] [Accepted: 03/24/2022] [Indexed: 11/13/2022] Open
Abstract
Background Mobile health (mHealth) interventions may help adolescents adopt healthy lifestyles. However, attrition in these interventions is high. Overall, there is a lack of research on nonusage attrition in adolescents, particularly regarding the role of socioeconomic status (SES). Objective The aim of this study was to focus on the role of SES in the following three research questions (RQs): When do adolescents stop using an mHealth intervention (RQ1)? Why do they report nonusage attrition (RQ2)? Which intervention components (ie, self-regulation component, narrative, and chatbot) prevent nonusage attrition among adolescents (RQ3)? Methods A total of 186 Flemish adolescents (aged 12-15 years) participated in a 12-week mHealth program. Log data were monitored to measure nonusage attrition and usage duration for the 3 intervention components. A web-based questionnaire was administered to assess reasons for attrition. A survival analysis was conducted to estimate the time to attrition and determine whether this differed according to SES (RQ1). Descriptive statistics were performed to map the attrition reasons, and Fisher exact tests were used to determine if these reasons differed depending on the educational track (RQ2). Mixed effects Cox proportional hazard regression models were used to estimate the associations between the use duration of the 3 components during the first week and attrition. An interaction term was added to the regression models to determine whether associations differed by the educational track (RQ3). Results After 12 weeks, 95.7% (178/186) of the participants stopped using the app. 30.1% (56/186) of the adolescents only opened the app on the installation day, and 44.1% (82/186) stopped using the app in the first week. Attrition at any given time during the intervention period was higher for adolescents from the nonacademic educational track compared with those from the academic track. The other SES indicators (family affluence and perceived financial situation) did not explain attrition. The most common reasons for nonusage attrition among participants were perceiving that the app did not lead to behavior change, not liking the app, thinking that they already had a sufficiently healthy lifestyle, using other apps, and not being motivated by the environment. Attrition reasons did not differ depending on the educational track. More time spent in the self-regulation and narrative components during the first week was associated with lower attrition, whereas chatbot use duration was not associated with attrition rates. No moderating effects of SES were observed in the latter association. Conclusions Nonusage attrition was high, especially among adolescents in the nonacademic educational track. The reported reasons for attrition were diverse, with no statistical differences according to the educational level. The duration of the use of the self-regulation and narrative components during the first week may prevent attrition for both educational tracks. Trial Registration ClinicalTrials.gov NCT04719858; http://clinicaltrials.gov/ct2/show/NCT04719858
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Affiliation(s)
- Laura Maenhout
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
- Research Foundation Flanders (FWO), Brussels, Belgium
| | - Carmen Peuters
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
- Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Greet Cardon
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Geert Crombez
- Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Ann DeSmet
- Faculty of Psychology and Educational Sciences, Université Libre de Bruxelles, Brussels, Belgium
- Department of Communication Studies, University of Antwerp, Antwerp, Belgium
| | - Sofie Compernolle
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
- Research Foundation Flanders (FWO), Brussels, Belgium
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Chairistanidou C, Karatzi K, Karaglani E, Usheva N, Liatis S, Chakarova N, Mateo-Gallego R, Lamiquiz-Moneo I, Radó S, Antal E, Bíró É, Kivelä J, Wikström K, Iotova V, Cardon G, Makrilakis K, Manios Y. Diet quality in association to lipidaemic profile in adults of families at high-risk for type 2 diabetes in Europe: The Feel4Diabetes study. Nutr Metab Cardiovasc Dis 2022; 32:1175-1185. [PMID: 35277326 DOI: 10.1016/j.numecd.2022.01.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 07/27/2021] [Revised: 12/17/2021] [Accepted: 01/28/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND AND AIMS The role of diet in blood lipids is scarcely investigated in adults at risk of Type 2 Diabetes Mellitus (T2DM) and even less studied regarding their socioeconomic status (SES). This study aimed to investigate the associations of diet quality with blood lipids in adults from families at high-risk for developing T2DM from six European countries, considering their SES. METHODS AND RESULTS In total 2049 adults (67% women) from relatively low-SES regions and high T2DM risk families were enrolled. Dietary habits, sedentary behaviour and sociodemographic characteristics were assessed using standardised questionnaires. The associations of tertiles of healthy diet score (HDS) with blood lipids were tested by univariate analysis of variance (UNIANOVA). HDL-Cholesterol (HDL-C) was positively (B 1.54 95%CI 0.08 to 2.99) and LDL-Cholesterol (LDL-C) (B -4.15 95%CI -7.82 to -0.48), ratio of total cholesterol to HDL-C (B -0.24 95%CI -0.37 to -0.10), ratio of LDL-C to HDL-C (B -0.18 95%CI -0.28 to -0.08) and Atherogenic Index of Plasma (B -0.03 95%CI -0.06 to 0.00) inversely associated with the highest tertile of diet score compared to the lowest tertile independently of age, sex, Body Mass Index, total screen time and smoking. In sub-analysis of education (<14 and ≥ 14 years of education), these findings were only significant in the high-SES group. CONCLUSION While diet quality was poorer in the low-SES group, an association between diet quality and lipidemic profile was not found, as increased central obesity and smoking prevalence might have confounded this association. These findings indicate the need for tailor-made interventions, guided by the specific risk factors identified per population sub groups.
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Affiliation(s)
- Christina Chairistanidou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 17671 Athens, Greece.
| | - Kalliopi Karatzi
- Laboratory of Dietetics and Quality of Life, Department of Food Science & Human Nutrition, School of Food and Nutritional Sciences, Agricultural University of Athens, Athens, Greece.
| | - Eva Karaglani
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 17671 Athens, Greece.
| | - Natalya Usheva
- Department of Paediatrics, Medical University Varna, Varna, Bulgaria.
| | - Stavros Liatis
- National and Kapodistrian University of Athens Medical School, 11527 Athens, Greece.
| | - Nevena Chakarova
- Clinical Center of Endocrinology, Medical University of Sofia, Sofia, Bulgaria.
| | | | - Itziar Lamiquiz-Moneo
- Unidad Clínica y de Investigación en Lípidos y Arteriosclerosis, Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria Aragón (IIS Aragón) CIBERCV, Zaragoza, Spain.
| | - Sándorné Radó
- University of Debrecen, Faculty of Health, Debrecen, Hungary.
| | - Emese Antal
- Hungarian Society of Nutrition, 1088 Budapest, Hungary.
| | - Éva Bíró
- Division of Health Promotion, Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, 4032 Debrecen, Hungary.
| | - Jemina Kivelä
- Department of Public Health Solutions, Finnish Institute for Health and Welfare, Mannerheimintie 166, Helsinki, Finland.
| | - Katja Wikström
- Department of Public Health Solutions, Finnish Institute for Health and Welfare, Mannerheimintie 166, Helsinki, Finland.
| | - Violeta Iotova
- Department of Paediatrics, Medical University Varna, Varna, Bulgaria.
| | - Greet Cardon
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, 9000 Gent, Belgium.
| | | | - Yannis Manios
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 17671 Athens, Greece; Institute of Agri-food and Life Sciences, Hellenic Mediterranean University Research Centre, Agro-Health, Heraklion, Greece.
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Papamichael MM, Karatzi K, Mavrogianni C, Cardon G, De Vylder F, Iotova V, Usheva N, Tankova T, González-Gil EM, Kivelä J, Wikström K, Moreno L, Liatis S, Makrilakis K, Manios Y. Socio-economic vulnerabilities and food intake in European children: The Feel4Diabetes Study. Nutrition 2022; 103-104:111744. [DOI: 10.1016/j.nut.2022.111744] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 05/05/2022] [Accepted: 05/12/2022] [Indexed: 11/27/2022]
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Moschonis G, Siopis G, Anastasiou C, Iotova V, Stefanova T, Dimova R, Rurik I, Radó AS, Cardon G, De Craemer M, Lindström J, Moreno LA, De Miguel-Etayo P, Makrilakis K, Liatis S, Manios Y. Prevalence of Childhood Obesity by Country, Family Socio-Demographics, and Parental Obesity in Europe: The Feel4Diabetes Study. Nutrients 2022; 14:nu14091830. [PMID: 35565799 PMCID: PMC9103017 DOI: 10.3390/nu14091830] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 04/23/2022] [Accepted: 04/25/2022] [Indexed: 12/28/2022] Open
Abstract
The Feel4Diabetes study recruited 12,193 children (age: 8.20 ±1.01 years) and their parents from six European countries as part of the broader attempt to prevent type 2 diabetes. The current work collected data pre-intervention to identify the prevalence of childhood obesity by country and describe its association with socio-demographic characteristics and parental obesity status. One in four children were overweight or obese, and one in four families had at least one obese parent. Multivariate logistic regression examined the associations between childhood obesity, family socio-demographics, and parental obesity status. Children had a higher chance of being overweight or obese if they were living in “low income” countries (OR: 2.11, 95% CI: 1.62, 2.74) and countries “under economic crisis” (OR: 2.48, 95% CI: 1.89, 3.24) compared to “high-income” countries; if their fathers completed fewer than nine years of education (OR: 2.16, 95% CI: 1.54, 3.05) compared to children whose fathers had a higher level (>14 years) of education; and if one (OR: 2.46, 95% CI: 0.32, 0.62) or both of their parents (OR: 6.83, 95% CI: 5.15, 9.05) were obese. Future childhood obesity prevention-programs should target the whole family while taking into consideration the socioeconomic and weight status of parents. Future research should examine these associations in more countries and in socio-demographically diverse populations in order to facilitate the generalisability of the present study’s findings.
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Affiliation(s)
- George Moschonis
- Department of Food, Nutrition and Dietetics, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne 3086, Australia; (G.M.); (G.S.)
| | - George Siopis
- Department of Food, Nutrition and Dietetics, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne 3086, Australia; (G.M.); (G.S.)
| | - Costas Anastasiou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 17671 Athens, Greece;
| | - Violeta Iotova
- Department of Endocrinology, Medical University Varna, 9002 Varna, Bulgaria; (V.I.); (T.S.); (R.D.)
| | - Tanya Stefanova
- Department of Endocrinology, Medical University Varna, 9002 Varna, Bulgaria; (V.I.); (T.S.); (R.D.)
| | - Roumyana Dimova
- Department of Endocrinology, Medical University Varna, 9002 Varna, Bulgaria; (V.I.); (T.S.); (R.D.)
| | - Imre Rurik
- Hungarian Society of Nutrition, 1088 Budapest, Hungary; (I.R.); (A.S.R.)
| | - Anette Si Radó
- Hungarian Society of Nutrition, 1088 Budapest, Hungary; (I.R.); (A.S.R.)
| | - Greet Cardon
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium;
| | - Marieke De Craemer
- Department of Rehabilitation Sciences, Ghent University, 9000 Ghent, Belgium;
- Research Foundation, Flanders, 1000 Brussels, Belgium
| | - Jaana Lindström
- Department of Public Health Solutions, Finnish Institute for Health and Welfare, 00271 Helsinki, Finland;
| | - Luis A. Moreno
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Universidad de Zaragoza, 50009 Zaragoza, Spain; (L.A.M.); (P.D.M.-E.)
| | - Pilar De Miguel-Etayo
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Universidad de Zaragoza, 50009 Zaragoza, Spain; (L.A.M.); (P.D.M.-E.)
| | - Konstantinos Makrilakis
- School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece; (K.M.); (S.L.)
| | - Stavros Liatis
- School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece; (K.M.); (S.L.)
| | - Yannis Manios
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 17671 Athens, Greece;
- Correspondence: ; Tel.: +30-2109549156
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Flores-Barrantes P, Mavrogianni C, Iglesia I, Mahmood L, Willems R, Cardon G, De Vylder F, Liatis S, Makrilakis K, Martinez R, Schwarz P, Rurik I, Antal E, Iotova V, Tsochev K, Chakarova N, Kivelä J, Wikström K, Manios Y, Moreno LA. Can food parenting practices explain the association between parental education and children's food intake? The Feel4Diabetes-study. Public Health Nutr 2022; 25:1-14. [PMID: 35416142 PMCID: PMC9991856 DOI: 10.1017/s1368980022000891] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 03/11/2022] [Accepted: 03/28/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE This study aimed to investigate the mediating role of food parenting practices (FPP), including home availability of different types of foods and drinks, parental modelling of fruit intake, permissiveness and the use of food as a reward in the relationship between parental education and dietary intake in European children. DESIGN Single mediation analyses were conducted to explore whether FPP explain associations between parents' educational level and children's dietary intake measured by a parent-reported FFQ. SETTING Six European countries. PARTICIPANTS Parent-child dyads (n 6705, 50·7 % girls, 88·8 % mothers) from the Feel4Diabetes-study. RESULTS Children aged 8·15 ± 0·96 years were included. Parental education was associated with children's higher intake of water, fruits and vegetables and lower intake of sugar-rich foods and savoury snacks. All FPP explained the associations between parental education and dietary intake to a greater or lesser extent. Specifically, home availability of soft drinks explained 59·3 % of the association between parental education and sugar-rich food intake. Home availability of fruits and vegetables was the strongest mediators in the association between parental education and fruit and vegetable consumption (77·3 % and 51·5 %, respectively). Regarding savoury snacks, home availability of salty snacks and soft drinks was the strongest mediators (27·6 % and 20·8 %, respectively). CONCLUSIONS FPP mediate the associations between parental education and children's dietary intake. This study highlights the importance of addressing FPP in future interventions targeting low-educated populations.
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Affiliation(s)
- Paloma Flores-Barrantes
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Zaragoza, Spain
- Instituto Agroalimentario de Aragón (IA2), Instituto De Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
| | - Christina Mavrogianni
- Department of Nutrition and Dietetics, School of Health Sciences & Education, Harokopio University, Athens, Greece
| | - Iris Iglesia
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Zaragoza, Spain
- Instituto Agroalimentario de Aragón (IA2), Instituto De Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
- Red de Salud Materno Infantil y del Desarrollo (SAMID), Instituto de Salud Carlos III, C/ Pedro Cerbuna 12, Madrid50009, Spain
| | - Lubna Mahmood
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Zaragoza, Spain
- Instituto Agroalimentario de Aragón (IA2), Instituto De Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
| | - Ruben Willems
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Greet Cardon
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Flore De Vylder
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Stavros Liatis
- National and Kapodistrian University of Athens Medical School, Athens, Greece
| | | | | | - Peter Schwarz
- Department of Prevention and Care of Diabetes, Technical University Dresden, Dresden, Germany
| | - Imre Rurik
- Department of Family and Occupational Medicine, University of Debrecen, Debrecen, Hungary
| | - Emese Antal
- Hungarian Society of Nutrition, Budapest, Hungary
| | - Violeta Iotova
- Department of Paediatrics, Medical University, Varna, Bulgaria
| | - Kaloyan Tsochev
- Department of Paediatrics, Medical University, Varna, Bulgaria
| | - Nevena Chakarova
- Department of Endocrinology, Medical University of Sofia, Sofia, Bulgaria
| | - Jemina Kivelä
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Katja Wikström
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Yannis Manios
- Department of Nutrition and Dietetics, School of Health Sciences & Education, Harokopio University, Athens, Greece
- Institute of Agri-food and Life Sciences, Hellenic Mediterranean University Research Centre, Heraklion, Greece
| | - Luis A Moreno
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Zaragoza, Spain
- Instituto Agroalimentario de Aragón (IA2), Instituto De Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
- Red de Salud Materno Infantil y del Desarrollo (SAMID), Instituto de Salud Carlos III, C/ Pedro Cerbuna 12, Madrid50009, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
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Mahmood L, González-Gil EM, Schwarz P, Herrmann S, Karaglani E, Cardon G, De Vylder F, Willems R, Makrilakis K, Liatis S, Iotova V, Tsochev K, Tankova T, Rurik I, Radó S, Moreno LA, Manios Y. Frequency of family meals and food consumption in families at high risk of type 2 diabetes: the Feel4Diabetes-study. Eur J Pediatr 2022; 181:2523-2534. [PMID: 35353229 PMCID: PMC9110493 DOI: 10.1007/s00431-022-04445-4] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 03/10/2022] [Accepted: 03/11/2022] [Indexed: 02/02/2023]
Abstract
UNLABELLED A family meal is defined as a meal consumed together by the members of a family or by having ≥ 1 parent present during a meal. The frequency of family meals has been associated with healthier food intake patterns in both children and parents. This study aimed to investigate in families at high risk for developing type 2 diabetes across Europe the association (i) between family meals' frequency and food consumption and diet quality among parents and (ii) between family meals' frequency and children's food consumption. Moreover, the study aimed to elucidate the mediating effect of parental diet quality on the association between family meals' frequency and children's food consumption. Food consumption frequency and anthropometric were collected cross-sectionally from a representative sample of 1964 families from the European Feel4Diabetes-study. Regression and mediation analyses were applied by gender of children. Positive and significant associations were found between the frequency of family meals and parental food consumption (β = 0.84; 95% CI 0.57, 1.45) and diet quality (β = 0.30; 95% CI 0.19, 0.42). For children, more frequent family meals were significantly associated with healthier food consumption (boys, β = 0.172, p < 0.05; girls, β = 0.114, p < 0.01). A partial mediation effect of the parental diet quality was shown on the association between the frequency of family meals and the consumption of some selected food items (i.e., milk products and salty snacks) among boys and girls. The strongest mediation effect of parental diet quality was found on the association between the frequency of family breakfast and the consumption of salty snacks and milk and milk products (62.5% and 37.5%, respectively) among girls. CONCLUSIONS The frequency of family meals is positively associated with improved food consumption patterns (i.e., higher intake of fruits and vegetables and reduced consumption of sweets) in both parents and children. However, the association in children is partially mediated by parents' diet quality. The promotion of consuming meals together in the family could be a potentially effective strategy for interventions aiming to establish and maintain healthy food consumption patterns among children. TRIAL REGISTRATION The Feel4Diabetes-study is registered with the clinical trials registry (NCT02393872), http://clinicaltrials.gov , March 20, 2015. WHAT IS KNOWN • Parents' eating habits and diet quality play an important role in shaping dietary patterns in children • Family meals frequency is associated with improved diet quality of children in healthy population What is New: • Frequency of family meals was significantly associated with healthier food consumption among parents and children in families at high risk of type 2 diabetes in six European countries. • Parental diet quality mediates the association between family meals frequency and the consumption of some selected food items among children.
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Affiliation(s)
- Lubna Mahmood
- grid.11205.370000 0001 2152 8769Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Zaragoza, Spain
| | - Esther M. González-Gil
- grid.11205.370000 0001 2152 8769Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Zaragoza, Spain ,grid.4489.10000000121678994Department of Biochemistry and Molecular Biology II, School of Pharmacy, University of Granada, Granada, Spain ,grid.4489.10000000121678994Institute of Nutrition and Food Technology “José Mataix”, Center of Biomedical Research, University of Granada. Avda. del Conocimiento S/N, 18016 Armilla, Granada, Spain ,grid.413448.e0000 0000 9314 1427Centro de Investigación Biomédica en Red de Fisiopatología de La Obesidad Y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
| | - Peter Schwarz
- grid.4488.00000 0001 2111 7257Department for Prevention and Care of Diabetes, Medical Faculty Carl Gustav Carus, Technical University of Dresden, Dresden, Germany ,grid.4488.00000 0001 2111 7257Faculty of Medicine, Paul Langerhans Institute Dresden of the Helmholtz Center Munich at University Hospital, TU Dresden, 01307 Dresden, Germany ,grid.452622.5German Center for Diabetes Research (DZD E.V.), 85764 Neuherberg, Germany
| | - Sandra Herrmann
- grid.4488.00000 0001 2111 7257Department for Prevention and Care of Diabetes, Medical Faculty Carl Gustav Carus, Technical University of Dresden, Dresden, Germany
| | - Eva Karaglani
- grid.15823.3d0000 0004 0622 2843Department of Nutrition and Dietetics, School of Health Science & Education, Harokopio University, Athens, Greece
| | - Greet Cardon
- grid.5342.00000 0001 2069 7798Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Flore De Vylder
- grid.5342.00000 0001 2069 7798Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Ruben Willems
- grid.5342.00000 0001 2069 7798Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Konstantinos Makrilakis
- grid.5216.00000 0001 2155 0800National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Stavors Liatis
- grid.5216.00000 0001 2155 0800National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Violeta Iotova
- grid.20501.360000 0000 8767 9052Department of Social Medicine and Health Care, Organization Medical University of Varna, Varna, Bulgaria
| | - Kaloyan Tsochev
- grid.20501.360000 0000 8767 9052Department of Social Medicine and Health Care, Organization Medical University of Varna, Varna, Bulgaria
| | - Tsvetalina Tankova
- grid.410563.50000 0004 0621 0092Department of Diabetology, Clinical Center of Endocrinology, Medical University of Sofia, Sofia, Bulgaria
| | - Imre Rurik
- grid.7122.60000 0001 1088 8582Faculty of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Sándorné Radó
- grid.7122.60000 0001 1088 8582Faculty of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Luis A. Moreno
- grid.11205.370000 0001 2152 8769Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Zaragoza, Spain ,grid.413448.e0000 0000 9314 1427Centro de Investigación Biomédica en Red de Fisiopatología de La Obesidad Y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain ,grid.11205.370000 0001 2152 8769Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain ,grid.488737.70000000463436020Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
| | - Yannis Manios
- grid.15823.3d0000 0004 0622 2843Department of Nutrition and Dietetics, School of Health Science & Education, Harokopio University, Athens, Greece ,grid.419879.a0000 0004 0393 8299Institute of Agri-Food and Life Sciences, Hellenic Mediterranean University Research Centre, Heraklion, Greece
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Compernolle S, Van Dyck D, Vanhove K, Chastin SFM, Lauwerier E, Cardon G. Identifying conducive contexts and working mechanisms of sedentary behaviour interventions in older adults: a realist review protocol as part of the 'Stand UP Seniors' project. BMJ Open 2021; 11:e053942. [PMID: 34887281 PMCID: PMC8663081 DOI: 10.1136/bmjopen-2021-053942] [Citation(s) in RCA: 0] [Impact Index Per Article: 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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 11/15/2021] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION Lifestyle behaviours, including sedentary behaviour, have been listed as key modifiable factors to promote healthy ageing. Sedentary behaviour is ubiquitous in older adults and has a strong link with age-related functional declines and chronic health conditions. Although several interventions have been developed aimed at the reduction of sedentary behaviour in older adults, little in-depth information is available on how these complex interventions work in different contexts. Therefore, the aim of our study was to unpack the mechanisms of how existing interventions aimed at the reduction of older adults' sedentary behaviour work or fail to work in particular contexts in order to optimise the development and implementation of future sedentary behaviour interventions. METHODS AND ANALYSIS A realist review will be conducted as a first part of the Stand UP Seniors (SUPS) project and will be structured as follows: (1) defining the scope of the review, (2) searching and appraising the evidence, (3) extracting data and synthesising the results, and (4) drawing conclusions and formulating recommendations. The result of this iterative process will be a final programme theory that can be used to identify which context triggers which mechanism, and in turn might elicit which outcome. The final programme theory will be used to inform the second and the third parts of the SUPS project, which are, respectively, the development and evaluation of a sedentary behaviour intervention in older adults. ETHICS AND DISSEMINATION Ethical approval is not required for the review. Dissemination of the realist review results, including the final programme theory, will occur through peer-reviewed publications and presentations at relevant conferences. The peer-reviewed realist review will be prepared according to the Realist and Meta-narrative Evidence Synthesis: Evolving Standards publication standards for realist syntheses. PROSPERO REGISTRATION NUMBER CRD42021248795.
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Affiliation(s)
- Sofie Compernolle
- Department of Movement and Sports Sciences, Ghent University, Gent, Belgium
| | - Delfien Van Dyck
- Department of Movement and Sports Sciences, Ghent University, Gent, Belgium
| | - Kenneth Vanhove
- Department of Movement and Sports Sciences, Ghent University, Gent, Belgium
| | - Sebastien F M Chastin
- Institute of Applied Health Research, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Emelien Lauwerier
- Department of Experimental Clinical and Healthy Psychology, Ghent University, Gent, Belgium
- Department of Public Health and Primary Care, Ghent University, Gent, Belgium
| | - Greet Cardon
- Movement and Sports Sciences, Ghent University, Gent, Belgium
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Maenhout L, Peuters C, Cardon G, Compernolle S, Crombez G, DeSmet A. Participatory Development and Pilot Testing of an Adolescent Health Promotion Chatbot. Front Public Health 2021; 9:724779. [PMID: 34858919 PMCID: PMC8632020 DOI: 10.3389/fpubh.2021.724779] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 06/14/2021] [Accepted: 10/13/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The use of chatbots may increase engagement with digital behavior change interventions in youth by providing human-like interaction. Following a Person-Based Approach (PBA), integrating user preferences in digital tool development is crucial for engagement, whereas information on youth preferences for health chatbots is currently limited. Objective: The aim of this study was to gain an in-depth understanding of adolescents' expectations and preferences for health chatbots and describe the systematic development of a health promotion chatbot. Methods: Three studies in three different stages of PBA were conducted: (1) a qualitative focus group study (n = 36), (2) log data analysis during pretesting (n = 6), and (3) a mixed-method pilot testing (n = 73). Results: Confidentiality, connection to youth culture, and preferences when referring to other sources were important aspects for youth in chatbots. Youth also wanted a chatbot to provide small talk and broader support (e.g., technical support with the tool) rather than specifically in relation to health behaviors. Despite the meticulous approach of PBA, user engagement with the developed chatbot was modest. Conclusion: This study highlights that conducting formative research at different stages is an added value and that adolescents have different chatbot preferences than adults. Further improvement to build an engaging chatbot for youth may stem from using living databases.
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Affiliation(s)
- Laura Maenhout
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium.,Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium.,Research Foundation Flanders (FWO), Brussels, Belgium
| | - Carmen Peuters
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium.,Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Greet Cardon
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Sofie Compernolle
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium.,Research Foundation Flanders (FWO), Brussels, Belgium
| | - Geert Crombez
- Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Ann DeSmet
- Faculty of Psychology and Educational Sciences, Université Libre de Bruxelles, Brussels, Belgium.,Department of Communication Studies, Faculty of Social Sciences, University of Antwerp, Antwerp, Belgium
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Willems R, Tsoutsoulopoulou K, Brondeel R, Cardon G, Makrilakis K, Liatis S, Lindström J, Kivelä J, González-Gil EM, Giménez-Legarre N, Usheva N, Iotova V, Tankova T, Antal E, Rurik I, Timpel P, Schwarz PEH, Manios Y, Annemans L. Cost-effectiveness analysis of a school- and community-based intervention to promote a healthy lifestyle and prevent type 2 diabetes in vulnerable families across Europe: the Feel4Diabetes-study. Prev Med 2021; 153:106722. [PMID: 34271077 DOI: 10.1016/j.ypmed.2021.106722] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 11/05/2020] [Revised: 06/22/2021] [Accepted: 07/11/2021] [Indexed: 10/20/2022]
Abstract
The Feel4Diabetes-study implemented a school- and community-based intervention to promote healthy lifestyle and prevent type 2 diabetes mellitus (T2DM) in six European countries. The intervention included a special focus on families at increased T2DM risk. The current study evaluates the intervention's cost-effectiveness. A Markov-type health economic model was developed to predict the incidence of T2DM and its complications. Incremental cost-effectiveness ratios (lifetime horizon, societal perspective) were calculated based on the overall intervention effect on health behaviour, and stratified for low- and high-risk families. Sensitivity analyses captured input parameters uncertainty. A budget impact analysis was performed. The increase in children's water consumption and physical activity led to a modest gain in quality adjusted life years (QALYs) at a low intervention cost and budget impact. Medical cost savings due to avoided illness could only be achieved on the very long-term (>30 years). The intervention in its entirety was cost-effective (more QALYs at a reasonable investment) in Belgium, Finland, Bulgaria, and Hungary, while being dominant (net savings and more QALYs) in Greece and Spain. Results were cost-effective for the low-risk families, who only received the school- and community-based intervention component. Results for the high-risk families were only cost-effective (with considerable uncertainty) in Greece and Spain, but not when the intervention would need to be repeated. The Feel4Diabetes-intervention is potentially cost-effective, especially in countries with a high overweight and obesity prevalence, at a limited budget impact. The incremental financial investments to reach and support high-risk families did not result in the hoped-for health benefits.
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Affiliation(s)
- Ruben Willems
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
| | - Konstantina Tsoutsoulopoulou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Ruben Brondeel
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Greet Cardon
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | | | - Stavros Liatis
- Athens Medical School, National and Kapodistrian University, Athens, Greece
| | - Jaana Lindström
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Jemina Kivelä
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Esther M González-Gil
- Department of Biochemistry and Molecular Biology II, Instituto de Nutrición y Tecnología de los Alimentos, Center of Biomedical Research (CIBM), Universidad de Granada, Granada, Spain; Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Zaragoza, Spain; CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
| | - Natalia Giménez-Legarre
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Zaragoza, Spain; Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón, Aragón, Spain
| | - Natalya Usheva
- Department of Social Medicine and Health Care Organization, Medical University of Varna, Varna, Bulgaria
| | - Violeta Iotova
- Department of Pediatrics, Medical University of Varna, Varna, Bulgaria
| | - Tsvetalina Tankova
- Clinical Center of Endocrinology, Medical University of Sofia, Sofia, Bulgaria
| | - Emese Antal
- Hungarian Society of Nutrition, Budapest, Hungary
| | - Imre Rurik
- Department of Family and Occupational Medicine, University of Debrecen, Debrecen, Hungary
| | - Patrick Timpel
- Department for Prevention and Care of Diabetes, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Peter E H Schwarz
- Department for Prevention and Care of Diabetes, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany; Paul Langerhans Institute Dresden, Helmholtz Center Munich, University Hospital and Faculty of Medicine, Technische Universität Dresden, Dresden, Germany; German Center for Diabetes Research (DZD e V), Neuherberg, Germany
| | - Yannis Manios
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Lieven Annemans
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium; Department of Public Health Sciences, Free University of Brussels, Brussels, Belgium
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Papamichael MM, Moschonis G, Mavrogianni C, Liatis S, Makrilakis K, Cardon G, De Vylder F, Kivelä J, Flores-Barrantes P, Imre R, Moreno L, Iotova V, Usheva N, Tankova T, Manios Y. Fathers' daily intake of fruit and vegetables is positively associated with children's fruit and vegetable consumption patterns in Europe: The Feel4Diabetes Study. J Hum Nutr Diet 2021; 35:337-349. [PMID: 34523158 DOI: 10.1111/jhn.12945] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 08/17/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND Past research has focused on the relationship between mothers' and children's eating habits, although little is known about fathers as potential agents. The present study aimed to investigate the relationship between fathers' and children's fruit and vegetable (FV) intake in the context of fathers' education level and family income insecurity. METHODS Cross-sectional analysis using baseline data from the multicentre Feel4Diabetes Study were collected in 2016. Participants were parent-dyads (fathers, n = 10,038) and school children (n = 12,041) from six European countries. Socio-demographic and dietary data were collected using questionnaires. Associations were assessed applying the multinomial logistic regression model. RESULTS Overall, European children have low FV intake, especially in Southern European countries (Greece, Spain and Hungary). Children with fathers consuming FV daily were more likely to consume fresh fruit (odds ratio [OR] = 2.75; 95% confidence interval [CI] = 1.95-3.88) and vegetables (OR = 2.55; 95% CI = 1.80-3.60) 1-2 times per day. After adjusting for paternal educational level and family income insecurity significant associations remained for fresh fruit (ORadj = 2.59; 95% CI = 1.82-3.69) and vegetables (ORadj = 1.98; 95% CI = 1.38-2.86). Country differences showed that fathers' educational level and income insecurity might be important factors worth considering for FV intake in Greece. CONCLUSIONS The present study showed that fathers' FV intake was positively associated with children's daily intake of these foods. Implementation of future population-based strategies promoting FV intake not only in mothers, but also in fathers could be an effective public health initiative to increase FV intake in children. Policy-makers should give special attention to families dwelling in Southern European regions.
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Affiliation(s)
- Maria Michelle Papamichael
- Department of Dietetics, Nutrition and Sport, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC, Australia.,Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - George Moschonis
- Department of Dietetics, Nutrition and Sport, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC, Australia.,Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Christina Mavrogianni
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Stavros Liatis
- First Department of Propaedeutic Medicine, National and Kapodistrian University of Athens Medical School, Laiko General Hospital Athens, Athens, Greece
| | - Konstantinos Makrilakis
- First Department of Propaedeutic Medicine, National and Kapodistrian University of Athens Medical School, Laiko General Hospital Athens, Athens, Greece
| | - Greet Cardon
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Flore De Vylder
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Jemina Kivelä
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Paloma Flores-Barrantes
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Zaragoza, Spain.,Instituto Agroalimentario de Aragón (IA2), Instituto De Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
| | - Rurik Imre
- Department of Family and Occupational Medicine, University of Debrecen, Debrecen, Hungary
| | - Luis Moreno
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Zaragoza, Spain
| | - Violeta Iotova
- Department of Paediatrics, Medical University, Varna, Bulgaria
| | - Natalya Usheva
- Department of Social Medicine and Health Care Organisation, Medical University, Varna, Bulgaria
| | - Tsvetalina Tankova
- Department of Endocrinology, Institute of Agri-food and Life Sciences (Agro-Health), Medical University of Sofia, Sofia, Bulgaria
| | - Yannis Manios
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece.,Hellenic Mediterranean University Research Centre, Heraklion, Greece
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42
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Usheva N, Lateva M, Galcheva S, Koletzko BV, Cardon G, De Craemer M, Androutsos O, Kotowska A, Socha P, Moreno LA, Manios Y, Iotova V. Breastfeeding and Overweight in European Preschoolers: The ToyBox Study. Nutrients 2021; 13:nu13082880. [PMID: 34445041 PMCID: PMC8401161 DOI: 10.3390/nu13082880] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 08/17/2021] [Accepted: 08/19/2021] [Indexed: 12/04/2022] Open
Abstract
The benefits of breastfeeding (BF) include risk reduction of later overweight and obesity. We aimed to analyse the association between breastfeeding practices and overweight/obesity among preschool children participating in the ToyBox study. Data from children in the six countries, participating in the ToyBox-study (Belgium, Bulgaria, Germany, Greece, Poland, and Spain) 7554 children/families and their age is 3.5–5.5 years, 51.9% were boys collected cross-sectionally in 2012. The questionnaires included parents’ self-reported data on their weight, height, socio-demographic status, and infant feeding practices. Measurements of preschool children’s weight and height were done by trained researchers using standard protocols and equipment. The ever breastfeeding rate in the total sample was 85.0% (n = 5777). Only 6.3% (n = 428) of the children from the general sample were exclusively breastfed (EBF) for the duration of the first six months. EBF for four to six months was significantly (p < 0.001) less likely among mothers with formal education < 12 years (adjusted Odds Ratio (OR) = 0.61; 95% Confidence interval (CI) 0.44–0.85), smoking throughout pregnancy (adjusted OR = 0.39; 95% CI 0.24–0.62), overweight before pregnancy (adjusted OR = 0.67; 95%CI 0.47–0.95) and ≤25 years old. The median duration of any breastfeeding was five months. The prevalence of exclusive formula feeding during the first five months in the general sample was about 12% (n = 830). The prevalence of overweight and obesity at preschool age was 8.0% (n = 542) and 2.8% (n = 190), respectively. The study did not identify any significant association between breastfeeding practices and obesity in childhood when adjusted for relevant confounding factors (p > 0.05). It is likely that sociodemographic and lifestyle factors associated with breastfeeding practices may have an impact on childhood obesity. The identified lower than desirable rates and duration of breastfeeding practices should prompt enhanced efforts for effective promotion, protection, and support of breastfeeding across Europe, and in particular in regions with low BF rates.
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Affiliation(s)
- Natalya Usheva
- Department of Social Medicine and Health Care Organization, Medical University of Varna, 9002 Varna, Bulgaria
- Correspondence: ; Tel.: +359-52677164
| | - Mina Lateva
- Department of Pediatrics, Medical University of Varna, 9002 Varna, Bulgaria; (M.L.); (S.G.); (V.I.)
| | - Sonya Galcheva
- Department of Pediatrics, Medical University of Varna, 9002 Varna, Bulgaria; (M.L.); (S.G.); (V.I.)
| | - Berthold V. Koletzko
- Division of Metabolic and Nutritional Medicine, Department Paediatrics, Dr. von Hauner Children’s Hospital, LMU University Hospitals, 80337 Munich, Germany;
| | - Greet Cardon
- Department of Movement and Sports Sciences, Ghent University, 9000 Ghent, Belgium;
| | - Marieke De Craemer
- Department of Rehabilitation Sciences, Ghent University, 9000 Ghent, Belgium;
- Research Foundation Flanders, 1000 Brussels, Belgium
| | - Odysseas Androutsos
- Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, 382 21 Volos, Greece;
| | - Aneta Kotowska
- Public Health Department, Children’s Memorial Health Institute, 04-730 Warsaw, Poland; (A.K.); (P.S.)
| | - Piotr Socha
- Public Health Department, Children’s Memorial Health Institute, 04-730 Warsaw, Poland; (A.K.); (P.S.)
| | - Luis A. Moreno
- GENUD (Growth, Exercise, Drinking Behaviour and Development) Research Group, University of Zaragoza, 50009 Zaragoza, Spain;
| | - Yannis Manios
- Department of Nutrition and Dietetics, Harokopio University, 176 76 Athens, Greece;
| | - Violeta Iotova
- Department of Pediatrics, Medical University of Varna, 9002 Varna, Bulgaria; (M.L.); (S.G.); (V.I.)
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43
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Mavrogianni C, Moschonis G, Karaglani E, Cardon G, Iotova V, De Miguel-Etayo P, González-Gil EM, Tsochev Κ, Tankova T, Rurik I, Timpel P, Antal E, Liatis S, Makrilakis K, Chrousos GP, Manios Y. European Childhood Obesity Risk Evaluation (CORE) index based on perinatal factors and maternal sociodemographic characteristics: the Feel4Diabetes-study. Eur J Pediatr 2021; 180:2549-2561. [PMID: 33987685 DOI: 10.1007/s00431-021-04090-3] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 04/22/2021] [Accepted: 04/25/2021] [Indexed: 01/23/2023]
Abstract
The aim of this study was to develop and examine the predictive accuracy of an index that estimates obesity risk in childhood based on perinatal factors and maternal sociodemographic characteristics. Analysis was conducted by using cross-sectional and retrospective data collected from a European cohort of 2775 schoolchildren and their families participating in the Feel4Diabetes-study. The cohort was randomly divided by using two-thirds of the sample for the development of the index and the remaining one third for assessing its predictive accuracy. Logistic regression analyses determined a prediction model for childhood obesity. The area under the receiver operating characteristic curve (AUC-ROC), sensitivity, specificity, and positive and negative predictive values (PPV, NPV) were calculated. Cut-off analysis was applied to identify the optimal value of the index score that predicts obesity with the highest possible sensitivity and specificity. Eight factors were found to be significantly associated with obesity and were included as components in the European "Childhood Obesity Risk Evaluation" (CORE) index: region of residence, maternal education, maternal pre-pregnancy weight status, gestational weight gain, maternal smoking during pregnancy, birth weight for gestational age, infant growth velocity, and exclusive breastfeeding during the first 6 months. Risk score ranged from 0 to 22 corresponding to a risk from 0.9 to 54.6%. The AUC-ROC was 0.725 with optimal cut-off ≥9 (sensitivity = 74.1%, specificity = 61.0%, PPV = 11.3%, NPV = 97.2%).Conclusion: The European CORE index can be used as a screening tool for the identification of infants at high-risk for becoming obese at 6-9 years. This tool could assist healthcare professionals in initiating preventive measures from the early life.Trial registration: The Feel4Diabetes-intervention is registered at https://clinicaltrials.gov/ ; number, CT02393872; date, March 20, 2015. What is Known: • As prevention of obesity should start early in life, there is a compelling rationale for the early identification of high-risk children to facilitate targeted intervention. What is New: • This study developed and assessed the predictive accuracy of an index for the Childhood Obesity Risk Evaluation (CORE), combining certain perinatal factors and maternal sociodemographic characteristics in a large European cohort. • The European CORE index can be used as a screening tool for identifying infants at high-risk for becoming obese at 6-9 years and assist health professionals in initiating early prevention strategies.
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Affiliation(s)
- Christina Mavrogianni
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 70 El Venizelou Ave, 176 71 Kallithea, Athens, Greece
| | - George Moschonis
- Department of Dietetics, Nutrition and Sport, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, 3086, Australia
| | - Eva Karaglani
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 70 El Venizelou Ave, 176 71 Kallithea, Athens, Greece
| | - Greet Cardon
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Violeta Iotova
- Department of Paediatrics, Medical University of Varna, Varna, Bulgaria
| | - Pilar De Miguel-Etayo
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Instituto Agroalimentario de Aragón (IA2), Universidad de Zaragoza Instituto de Investigación Sanitaria de Aragón (IIS Aragón), 50009, Zaragoza, Spain.,Centro de Investigación Biomédica em Red de Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28020, Madrid, Spain
| | - Esther M González-Gil
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Instituto Agroalimentario de Aragón (IA2), Universidad de Zaragoza Instituto de Investigación Sanitaria de Aragón (IIS Aragón), 50009, Zaragoza, Spain.,Centro de Investigación Biomédica em Red de Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28020, Madrid, Spain.,Department of Biochemistry and Molecular Biology II, Center of Biomedical Research (CIBM), Instituto de Nutrición y Tecnología de los Alimentos, Universidad de Granada, Granada, Spain
| | - Κaloyan Tsochev
- Department of Paediatrics, Medical University of Varna, Varna, Bulgaria
| | - Tsvetalina Tankova
- Department of Diabetology, Clinical Center of Endocrinology, Medical University of Sofia, Sofia, Bulgaria
| | - Imre Rurik
- Department of Family and Occupational Medicine, University of Debrecen, Debrecen, Hungary.,Hungarian Society of Nutrition, Budapest, Hungary
| | - Patrick Timpel
- Department for Prevention and Care of Diabetes, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Deutschland, Dresden, Germany
| | - Emese Antal
- Hungarian Society of Nutrition, Budapest, Hungary
| | - Stavros Liatis
- University of Athens Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Konstantinos Makrilakis
- University of Athens Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - George P Chrousos
- University Research Institute of Maternal and Child Health & Precision Medicine, National and Kapodistrian University of Athens, 'Aghia Sophia' Children's Hospital, Athens, Greece
| | - Yannis Manios
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 70 El Venizelou Ave, 176 71 Kallithea, Athens, Greece.
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44
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Schwarz A, Cardon G, Chastin S, Stragier J, De Marez L, DeSmet A. Does Dynamic Tailoring of A Narrative-Driven Exergame Result in Higher User Engagement among Adolescents? Results from A Cluster-Randomized Controlled Trial. Int J Environ Res Public Health 2021; 18:ijerph18147444. [PMID: 34299895 PMCID: PMC8305797 DOI: 10.3390/ijerph18147444] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 06/29/2021] [Accepted: 07/08/2021] [Indexed: 11/25/2022]
Abstract
Physical activity interventions for youth are direly needed given low adherence to physical activity guidelines, but many interventions suffer from low user engagement. Exergames that require bodily movement while played may provide an engaging form of physical activity intervention but are not perceived as engaging to all. This study aimed to evaluate whether dynamic tailoring in a narrative-driven mobile exergame for adolescents played in leisure settings, can create higher user engagement compared to a non-tailored exergame. A cluster-randomized controlled trial assessed differences in user engagement between a dynamically tailored (based on an accelerometer sensor integrated in a T-shirt) and non-tailored condition. In total, 94 participants (M age = 14.61 ± 1.93; 35% female) participated and were assigned to one of the two conditions. User engagement was measured via a survey and game metric data. User engagement was low in both conditions. Narrative sensation was higher in the dynamically tailored condition, but the non-tailored condition showed longer play-time. User suggestions to create a more appealing game included simple and more colorful graphics, avoiding technical problems, more variety and shorter missions and multiplayer options. Less cumbersome or more attractive sensing options than the smart T-shirt may offer a more engaging solution, to be tested in future research.
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Affiliation(s)
- Ayla Schwarz
- Consumption and Healthy Lifestyles, Faculty of Social Sciences, Wageningen University & Research, 6708 PB Wageningen, The Netherlands;
| | - Greet Cardon
- Department of Movement and Sport Sciences, Ghent University, 9000 Ghent, Belgium;
| | - Sebastien Chastin
- School of Health and Life Science, Caledonian University, Glasgow G4 0BA, UK;
| | - Jeroen Stragier
- IMEC-MICT, Department of Communication Sciences, Ghent University, 9000 Ghent, Belgium; (J.S.); (L.D.M.)
| | - Lieven De Marez
- IMEC-MICT, Department of Communication Sciences, Ghent University, 9000 Ghent, Belgium; (J.S.); (L.D.M.)
| | - Consortium SmartLife
- KnowledgeBizConsulting, and Faculdade de Ciências e Tecnologia, Universidade NOVA, 1099-085 Lisbon, Portugal;
| | - Ann DeSmet
- Research Center for the Promotion of Health, Prosocial Behavior and Wellbeing PACE, Faculty of Psychological and Educational Sciences, Université Libre de Bruxelles, 1050 Brussels, Belgium
- Department of Communication Studies, University of Antwerp, 2000 Antwerp, Belgium
- Correspondence: ; Tel.: +32-(26)-503282
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45
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Van Stappen V, Cardon G, De Craemer M, Mavrogianni C, Usheva N, Kivelä J, Wikström K, De Miquel-Etayo P, González-Gil EM, Radó AS, Nánási A, Iotova V, Manios Y, Brondeel R. The effect of a cluster-randomized controlled trial on lifestyle behaviors among families at risk for developing type 2 diabetes across Europe: the Feel4Diabetes-study. Int J Behav Nutr Phys Act 2021; 18:86. [PMID: 34210333 PMCID: PMC8252328 DOI: 10.1186/s12966-021-01153-4] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 06/09/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND This study investigated the effect of the Feel4Diabetes-intervention, a 2-year multilevel intervention, on energy balance-related behaviors among European families at risk for developing type 2 diabetes. Intervention effects on self-reported physical activity, sedentary behavior and eating behaviors were investigated across and within the participating countries: Belgium, Finland, Greece, Spain, Hungary and Bulgaria. METHODS Families were recruited through schools, located in low socio-economic status areas. In total, 4484 families at risk for developing type 2 diabetes were selected using the FINDRISC-questionnaire. Parents' and children's energy balance-related behaviors data were collected by questionnaires at three time points (baseline, mid- and post intervention). Families assigned to the intervention group were invited to participate in a 2-year school-, community-, and family-based intervention to promote a healthier lifestyle, including counseling sessions (first intervention year) and text messages (second intervention year). Families assigned to the control group received standard care, including medical check-up results and recommendations and tips regarding a healthy lifestyle. To assess the intervention-effects, Mixed Models were conducted using the R-Package "lmer "with R v3.2. RESULTS Significant intervention effects were found on a certain number of families' lifestyle behaviors. Significant favorable intervention effects were detected on parents' water consumption and consumption of fruit and vegetables, and on children's consumption of sweets and moderate-to-vigorous physical activity. Analyses by country revealed significant favorable intervention effects on water consumption and on moderate-to-vigorous physical activity in Belgian parents and on fruit and vegetable consumption among Belgian children, on sweets consumption among Spanish parents and children, and on moderate-to-vigorous physical activity among Finnish children. Unfavorable intervention effects were found on the consumption of soft drinks and sugar-containing juices among Hungarian children and parents, while when examining the intervention effects for the overall population and per country, 10 from the 112 investigated outcome variables were improved in the intervention group compared to the control group (9%). CONCLUSIONS The Feel4Diabetes-intervention managed to improve a certain number of targeted lifestyle behaviors while the intervention was not effective on a large number of targeted lifestyle behaviors. The findings of the current study are encouraging, but further research is needed on how we can further improve effectiveness of lifestyle interventions to prevent type 2 diabetes in families at risk. TRIAL REGISTRATION The Feel4Diabetes-study is registered with the clinical trials registry http://clinicaltrials.gov , ID: 643708.
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Affiliation(s)
- Vicky Van Stappen
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium.
| | - Greet Cardon
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Marieke De Craemer
- Research Foundation Flanders (FWO), Egmontstraat 5, 1000, Brussels, Belgium
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Christina Mavrogianni
- Department of Nutrition and Dietetics, Harokopio University, School of Health Science & Education, Athens, Greece
| | - Nataliya Usheva
- Clinic of Paediatric Endocrinology, Medical University Varna, Varna, Bulgaria
| | - Jemina Kivelä
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Katja Wikström
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Pilar De Miquel-Etayo
- GENUD (Growth, Exercise, Nutrition and Development), University of Zaragoza, Zaragoza, Spain
| | - Esther M González-Gil
- GENUD (Growth, Exercise, Nutrition and Development), University of Zaragoza, Zaragoza, Spain
- Department of Biochemistry and Molecular Biology II, Center of Biomedical Research (CIBM), Instituto de Nutrición y Tecnología de los Alimentos, Universidad de Granada, Granada, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
| | - Anett S Radó
- Debreceni Egyetem (UoD), University of Debrecen, Debrecen, Hungary
| | - Anna Nánási
- Debreceni Egyetem (UoD), University of Debrecen, Debrecen, Hungary
| | - Violeta Iotova
- Clinic of Paediatric Endocrinology, Medical University Varna, Varna, Bulgaria
| | - Yannis Manios
- Department of Nutrition and Dietetics, Harokopio University, School of Health Science & Education, Athens, Greece
| | - Ruben Brondeel
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
- Research Foundation Flanders (FWO), Egmontstraat 5, 1000, Brussels, Belgium
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Compernolle S, Van Dyck D, Cardon G, Brondeel R. Exploring Breaks in Sedentary Behavior of Older Adults Immediately After Receiving Personalized Haptic Feedback: Intervention Study. JMIR Mhealth Uhealth 2021; 9:e26387. [PMID: 33970109 PMCID: PMC8145090 DOI: 10.2196/26387] [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] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 02/24/2021] [Accepted: 04/15/2021] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND "Push" components of mobile health interventions may be promising to create conscious awareness of habitual sedentary behavior; however, the effect of these components on the near-time, proximal outcome, being breaks in sedentary behavior immediately after receiving a push notification, is still unknown, especially in older adults. OBJECTIVE The aims of this study are to examine if older adults break their sedentary behavior immediately after receiving personalized haptic feedback on prolonged sedentary behavior and if the percentage of breaks differs depending on the time of the day when the feedback is provided. METHODS A total of 26 Flemish older adults (mean age 64.4 years, SD 3.8) wore a triaxial accelerometer (Activator, PAL Technologies Ltd) for 3 weeks. The accelerometer generated personalized haptic feedback by means of vibrations each time a participant sat for 30 uninterrupted minutes. Accelerometer data on sedentary behavior were used to estimate the proximal outcome, which was sedentary behavior breaks immediately (within 1, 3, and 5 minutes) after receiving personalized haptic feedback. Generalized estimating equations were used to investigate whether or not participants broke up their sedentary behavior immediately after receiving haptic feedback. A time-related variable was added to the model to investigate if the sedentary behavior breaks differed depending on the time of day. RESULTS A total of 2628 vibrations were provided to the participants during the 3-week intervention period. Of these 2628 vibrations, 379 (14.4%), 570 (21.7%), and 798 (30.4%) resulted in a sedentary behavior break within 1, 3 and 5 minutes, respectively. Although the 1-minute interval did not reveal significant differences in the percentage of breaks depending on the time at which the haptic feedback was provided, the 3- and 5-minute intervals did show significant differences in the percentage of breaks depending on the time at which the haptic feedback was provided. Concretely, the percentage of sedentary behavior breaks was significantly higher if personalized haptic feedback was provided between noon and 3 PM compared to if the feedback was provided between 6 and 9 AM (odds ratio 1.58, 95% CI 1.01-2.47, within 3 minutes; odds ratio 1.78, 95% CI 1.11-2.84, within 5 minutes). CONCLUSIONS The majority of haptic vibrations, especially those in the morning, did not result in a break in the sedentary behavior of older adults. As such, simply bringing habitual sedentary behavior into conscious awareness seems to be insufficient to target sedentary behavior. More research is needed to optimize push components in interventions aimed at the reduction of the sedentary behavior of older adults. TRIAL REGISTRATION ClinicalTrials.gov NCT04003324; https://clinicaltrials.gov/ct2/show/NCT04003324.
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Affiliation(s)
- Sofie Compernolle
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
- Research Foundation Flanders, Brussels, Belgium
| | - Delfien Van Dyck
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Greet Cardon
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Ruben Brondeel
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
- Research Foundation Flanders, Brussels, Belgium
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47
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Compernolle S, De Cocker K, Cardon G, De Bourdeaudhuij I, Van Dyck D. Older Adults' Perceptions of Sedentary Behavior: A Systematic Review and Thematic Synthesis of Qualitative Studies. Gerontologist 2021; 60:572-582. [PMID: 31670766 DOI: 10.1093/geront/gnz127] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Reducing sedentary behavior contributes to healthy aging. In order to develop sedentary behavior interventions, insight is needed into older adults' perceptions of (reducing) sedentary behavior. Therefore, this systematic review aims to synthesize qualitative evidence of older adults' perceptions towards (a) the concept of sedentary behavior, (b) barriers and facilitators of sedentary behavior, and (c) solutions and strategies to reduce sedentary behavior. RESEARCH DESIGN AND METHODS A systematic search was conducted in four electronic databases. Inclusion criteria comprised qualitative and mixed-methods studies investigating the perceptions of older adults (mean age: ≥60 years) towards (reducing) sedentary behavior. Quality of the included studies was rated using the Critical Appraisal Skills Programme (CASP) Qualitative Checklist. Relevant data on older adults' perceptions were extracted and imported into NVivo. Two independent reviewers analyzed the data by means of thematic synthesis (line-by-line coding, constructing descriptive (sub)themes, developing analytical themes). RESULTS Fifteen studies were included. Four analytical themes were developed to be considered when aiming to reduce sedentary behavior in older adults: the lack of knowledge on/awareness of sedentary behavior, the habitual nature of sedentary behavior, the importance of enjoyment and convenience, and the key role of aging. DISCUSSION AND IMPLICATIONS The reduction of older adults' sedentary behavior will likely be challenging as sedentary behavior seems to be firmly incorporated into older adults' daily routines, and strongly linked with positive reinforcement. Both aspects deserve thoughtful attention by intervention developers and health care professionals who aim to promote healthy aging by reducing sedentary behavior.
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Affiliation(s)
- Sofie Compernolle
- Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, Belgium
| | - Katrien De Cocker
- Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, Belgium.,Physically Active Lifestyles Research Group (USQ PALs), Institute for Resilient Regions, University of Southern Queensland, Springfield Central, Australia
| | - Greet Cardon
- Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, Belgium
| | - Ilse De Bourdeaudhuij
- Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, Belgium
| | - Delfien Van Dyck
- Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, Belgium.,Research Foundation Flanders (FWO), Brussels, Belgium
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Compernolle S, De Bourdeaudhuij I, Cardon G, Van Dyck D. Sex-specific typologies of older adults' sedentary behaviors and their associations with health-related and socio-demographic factors: a latent profile analysis. BMC Geriatr 2021; 21:66. [PMID: 33468055 PMCID: PMC7816402 DOI: 10.1186/s12877-021-02011-5] [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: 05/28/2020] [Accepted: 01/05/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Some types of sedentary behaviors tend to cluster in individuals or groups of older adults. Insight into how these different types of sedentary behavior cluster is needed, as recent research suggests that not all types of sedentary behavior may have the same negative effects on physical and mental health. Therefore, the aim of this study was to identify sex-specific typologies of older adults' sedentary behavior, and to examine their associations with health-related and socio-demographic factors. METHODS Cross-sectional data were collected as part of the BEPAS Seniors, and the Busschaert study among 696 Flemish older adults (60+). Typologies of self-reported sedentary behavior were identified using latent profile analysis, and associations with health-related and sociodemographic factors were examined using analyses of variances. RESULTS Five distinct typologies were identified from seven sedentary behaviors (television time, computer time, transport-related sitting time, sitting for reading, sitting for hobbies, sitting for socializing and sitting for meals) in men, and three typologies were identified from six sedentary behaviors (television time, transport-related sitting time, sitting for reading, sitting for hobbies, sitting for socializing and sitting for meals) in women. Typologies that are characterized by high television time seem to be related to more negative health outcomes, like a higher BMI, less grip strength, and a lower physical and mental health-related quality-of-life. Typologies that are represented by high computer time and motorized transport seem to be related to more positive health outcomes, such as a lower body mass index, more grip strength and a higher physical and mental health-related quality-of-life. CONCLUSIONS Although causal direction between identified typologies and health outcomes remains uncertain, our results suggests that future interventions should better focus on specific types of sedentary behavior (e.g. television time), or patterns of sedentary behavior, rather than on total sedentary behavior.
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Affiliation(s)
- Sofie Compernolle
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Watersportlaan 2, B-9000, Ghent, Belgium.
| | - Ilse De Bourdeaudhuij
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Watersportlaan 2, B-9000, Ghent, Belgium
| | - Greet Cardon
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Watersportlaan 2, B-9000, Ghent, Belgium
| | - Delfien Van Dyck
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Watersportlaan 2, B-9000, Ghent, Belgium
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De Cocker K, Verloigne M, Cardon G, Van Acker R. Public health communication and education to promote more physical activity and less sedentary behaviour: Development and formative evaluation of the 'physical activity triangle'. Patient Educ Couns 2021; 104:75-84. [PMID: 32674949 DOI: 10.1016/j.pec.2020.06.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 06/15/2020] [Accepted: 06/22/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Communication and education about health behaviours to the general population is essential in public health promotion. This paper describes the process and outcome of developing a new health education model (infographic) for physical activity (PA) and sedentary behaviour used in Flanders (Belgium). METHODS The Flanders Institute for Healthy Living, expertise centre for public health, coordinated a process, including the evaluation of its previous education model among citizens; reviewing existing models from other countries; expert panel meetings (n = 3); and a formative evaluation (34 focus groups) among citizen with various profiles. RESULTS The previous model was difficult to understand and not motivating. Foreign models (n = 18) were mostly expert-based (72 %), but not evaluated among citizens. Based on expert meetings, the new model includes a daily and weekly variety of activities at different volumes and intensities, sitting (interruptions), and physical and mental health benefits of PA. Based on the focus groups, no quantitative PA recommendations were integrated, and specific symbols, colours, and heart icons were crucial to illustrate different PA behaviours, volumes and intensities. PRACTICE IMPLICATIONS Involving several key stakeholders, especially sedentary/inactive and vulnerable citizens, is suggested when developing a health model. Citizens preferred non-quantitative PA messages and quantitative messages around sitting interruptions.
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Affiliation(s)
- Katrien De Cocker
- University of Southern Queensland, Institute for Resilient Regions, Centre for Health Research, Springfield QLD 4300, Australia; Ghent University, Department of Movement and Sports Sciences, B-9000 Ghent, Belgium.
| | - Maïté Verloigne
- Ghent University, Department of Public Health and Primary Care, B-9000 Ghent, Belgium
| | - Greet Cardon
- Ghent University, Department of Movement and Sports Sciences, B-9000 Ghent, Belgium
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Aleksovska K, Puggina A, Giraldi L, Buck C, Burns C, Cardon G, Carlin A, Chantal S, Ciarapica D, Colotto M, Condello G, Coppinger T, Cortis C, D'Haese S, De Craemer M, Di Blasio A, Hansen S, Iacoviello L, Issartel J, Izzicupo P, Jaeschke L, Kanning M, Kennedy A, Ling F, Luzak A, Napolitano G, Nazare JA, Perchoux C, Pischon T, Polito A, Sannella A, Schulz H, Sohun R, Steinbrecher A, Schlicht W, Ricciardi W, MacDonncha C, Capranica L, Boccia S. Correction to: Biological determinants of physical activity across the life course: a "Determinants of Diet and Physical Activity" (DEDIPAC) umbrella systematic literature review. Sports Med Open 2020; 6:60. [PMID: 33346880 PMCID: PMC7752940 DOI: 10.1186/s40798-020-00291-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
An amendment to this paper has been published and can be accessed via the original article.
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Affiliation(s)
- Katina Aleksovska
- Università Cattolica del Sacro Cuore, Sezione di Igiene, Istituto di Sanità Pubblica, Rome, Italy
| | - Anna Puggina
- Università Cattolica del Sacro Cuore, Sezione di Igiene, Istituto di Sanità Pubblica, Rome, Italy.
| | - Luca Giraldi
- Università Cattolica del Sacro Cuore, Sezione di Igiene, Istituto di Sanità Pubblica, Rome, Italy
| | - Christoph Buck
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany
| | - Con Burns
- Department of Sport, Leisure and Childhood Studies, Cork Institute of Technology, Cork, Munster, Ireland
| | - Greet Cardon
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Angela Carlin
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
| | - Simon Chantal
- Department of Applied Sciences in Physical Activity and Management, Catholic University of Valencia "San Vicente Mártir", Valencia, Spain
| | - Donatella Ciarapica
- Council for Agricultural Research and Economics, Research Centre for Food and Nutrition, Rome, Italy
| | - Marco Colotto
- Università Cattolica del Sacro Cuore, Sezione di Igiene, Istituto di Sanità Pubblica, Rome, Italy
| | - Giancarlo Condello
- Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Rome, Italy
| | - Tara Coppinger
- Department of Sport, Leisure and Childhood Studies, Cork Institute of Technology, Cork, Munster, Ireland
| | - Cristina Cortis
- Department of Human Sciences, Society, and Health, University of Cassino and Lazio Meridionale, Cassino, Italy
| | - Sara D'Haese
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Marieke De Craemer
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Andrea Di Blasio
- Department of Medicine and Aging Sciences, G. d'Annunzio' University of Chieti-Pescara, Chieti and Pescara, Italy
| | - Sylvia Hansen
- Department of Sport and Exercise Sciences, University of Stuttgart, Stuttgart, Germany
| | - Licia Iacoviello
- Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo: NEUROMED, Pozzilli, Italy
| | - Johann Issartel
- School of Health and Human Performance, Multisensory Motor Learning Lab, Dublin City University, Dublin, Ireland
| | - Pascal Izzicupo
- Department of Medicine and Aging Sciences, G. d'Annunzio' University of Chieti-Pescara, Chieti and Pescara, Italy
| | - Lina Jaeschke
- Molecular Epidemiology Group, Max Delbruck Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany
| | - Martina Kanning
- Department of Sport and Exercise Sciences, University of Stuttgart, Stuttgart, Germany
| | - Aileen Kennedy
- Centre for Preventive Medicine, School of Health and Human Performance, Dublin City University, Dublin, Ireland
| | - Fiona Ling
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland.,Institute of Sport, Exercise & Active Living, Victoria University, Melbourne, Australia
| | - Agnes Luzak
- Institute of Epidemiology I, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Giorgio Napolitano
- Department of Medicine and Aging Sciences, G. d'Annunzio' University of Chieti-Pescara, Chieti and Pescara, Italy
| | - Julie-Anne Nazare
- Centre de Recherche en Nutrition Humaine Rhône-Alpes, CarMeN INSERM U1060, University of Lyon1, Lyon, France
| | - Camille Perchoux
- Centre de Recherche en Nutrition Humaine Rhône-Alpes, CarMeN INSERM U1060, University of Lyon1, Lyon, France
| | - Tobias Pischon
- Molecular Epidemiology Group, Max Delbruck Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany
| | - Angela Polito
- Council for Agricultural Research and Economics, Research Centre for Food and Nutrition, Rome, Italy
| | - Alessandra Sannella
- Department of Human Sciences, Society, and Health, University of Cassino and Lazio Meridionale, Cassino, Italy
| | - Holger Schulz
- Institute of Epidemiology I, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Rhoda Sohun
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
| | - Astrid Steinbrecher
- Molecular Epidemiology Group, Max Delbruck Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany
| | - Wolfgang Schlicht
- Department of Sport and Exercise Sciences, University of Stuttgart, Stuttgart, Germany
| | - Walter Ricciardi
- Università Cattolica del Sacro Cuore, Sezione di Igiene, Istituto di Sanità Pubblica, Rome, Italy.,Italian National Institute of Health, (Istituto Superiore di Sanita - ISS), Rome, Italy
| | - Ciaran MacDonncha
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
| | - Laura Capranica
- Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Rome, Italy
| | - Stefania Boccia
- Università Cattolica del Sacro Cuore, Sezione di Igiene, Istituto di Sanità Pubblica, Rome, Italy.,Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC Igiene Ospedaliera, Roma, Italia
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