Comparison of Adherence to Mediterranean Diet between Spanish and German School-Children and Influence of Gender, Overweight, and Physical Activity

BACKGROUND

Poor dietary habits and low levels of physical activity (PA) have a strong tendency to track from childhood into adulthood. The Mediterranean Diet (MD) is known to be extremely healthy, associated with lower BMI and a lower risk of obesity in children and adolescents. Therefore, adherence to the MD was compared between Spanish (n = 182) and German (n = 152) children aged 10 to 13 years to examine a possible more "westernized" diet in Spain with a non-Mediterranean country, that traditionally prefers a "Western diet" and to determine the association between adherence to the MD and gender, body composition, and PA levels.

METHODS

In the German observational longitudinal cohort study and the Spanish cohort study, body composition and questionnaires (KIDMED, Diet Quality (IAES)) were obtained, and accelerometers (Actigraph) were applied to detect PA.

RESULTS

Girls had higher BMI-standard deviation score (SDS) than boys and Spanish girls were less active than boys. Differences were detected in MD habits, such as favorable fruit-, vegetables-, fish-intakes, and dairy products in Spanish children and unfavorable consumptions of fast food, processed bakery goods, candies, and sweet beverages in German children. Independently of country, girls, children with lower BMI-SDS and children with higher PA level were related with better diet quality.

CONCLUSION

Spanish children showed higher adherence to MD and diet quality (IAES) compared to German children, but there was a trend toward a more "westernized" diet. Gender, body composition, and PA influenced nutrition regardless of country.

Effects of six month personalized endurance training on work ability in middle-aged sedentary women: a secondary analysis of a randomized controlled trial

Background

To test the effects of guided endurance training on work ability in middle-aged female hospital workers of various occupations.

Methods

We randomized 265 healthy, sedentary, middle-aged women (45–65 years) to an endurance training group (EG 210 min/week) or a wait-list control group (CG). At baseline and at 6-month follow-up, we assessed work ability (Work Ability Index [WAI]), physical activity (Freiburger activity questionnaire) and peak oxygen uptake (VO_2peak) by cardiopulmonary exercise testing. To examine the influence of baseline work ability, participants were divided into poor-moderate (WAI 1, 7–36 points, n = 83), good (WAI 2, 37–43 points, n = 136) and excellent (WAI 3, 44–49 points, n = 46) WAI subgroups.

Results

Cardiorespiratory fitness improved significantly after 6 months in the EG but not in the CG. The WAI total score increased significantly in the EG (38.3 ± 5.0 to 39.8 ± 4.9 points) but not in the CG (39.4 ± 4.7 to 39.3 ± 4.9 points), with a significant difference between groups (p < 0.01). In the EG, only the poor-moderate subgroup (WAI 1, 33.0 ± 2.9 to 36.6 ± 4.8 points, p < 0.05) increased the WAI total score, with this increase being significantly higher compared to the good (WAI 2, 40.2 ± 2.1 to, 40.4 ± 3.7 points) and excellent (WAI 3, 45.6 ± 1.5 to 45.7 ± 1.8 points) subgroup.

Conclusions

A 6-month guided exercise training intervention significantly increases cardiorespiratory fitness with concomitant improvements in work ability in middle-aged previously sedentary hospital employees. Women with low baseline work ability seem to particularly benefit from the intervention, which implies that similar interventions may be particularly beneficial for this group of individuals.

Trial registration

German Clinical Trails Register Identifier: DRKS00005159. Registered 25 September 2013.

Peak fat oxidation during self-paced activities of daily life: influence of sex and body composition

BACKGROUND

Increasing physical activity is a cornerstone in the treatment of overweight individuals and self-selected exercise intensity leads to higher adherence to physical activity. However, information on differences in energy expenditure and fat oxidation between sexes regarding common self-paced activities of daily living are rare.

METHODS

We divided 33 subjects into normal weight (NW, N.=21) and overweight (OW, N.=12). Energy expenditure and substrate oxidation was measured during six self-paced physical activities of daily living using a portable spirometric system. We also determined maximum aerobic capacity (VO2max) and estimated free-living physical activity with a multi-sensor device.

RESULTS

For all six activities, total energy expenditure was not different between NW and OW subjects in both sexes. The peak fat oxidation during physical activities was reached at higher intensities for women (NW 57±15%; OW 53±8% of VO2max) compared to men (NW 41±8%; OW 42±9% of VO2max) with no differences between NW and OW subjects. The majority of OW (92%) but not NW (42%) subjects reached their highest fat oxidation during walking. The self-selected walking speed was not significantly different between NW and OW men (NW 5.25±0.48 km/h, OW 5.52±0.42 km/h) and NW and OW women (NW 5.16±0.89 km/h, OW 5.01±0.42 km/h).

CONCLUSIONS

When physical activity aims to maximizing fat oxidation, women should exercise at higher relative intensities than men, regardless of being normal weight or overweight. Self-paced walking is a suitable activity for overweight subjects to achieve high rates of both total energy expenditure and fat oxidation.