| 1. |
- Bel-Serrat, Silvia, et al.
(författare)
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Relative validity of the Children's Eating Habits Questionnaire- food frequency section among young European children : the IDEFICS Study
- 2014
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Ingår i: Public Health Nutrition. - : Cambridge University Press. - 1368-9800 .- 1475-2727. ; 17:2, s. 266-276
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To compare, specifically by age group, proxy-reported food group estimates obtained from the food frequency section of the Children's Eating Habits questionnaire (CEHQ-FFQ) against the estimates of two non-consecutive 24h dietary recalls (24-HDR). Design: Estimates of food group intakes assessed via the forty-three-food-group CEHQ-FFQ were compared with those obtained by a computerized 24-HDR. Agreement on frequencies of intakes (equal to the number of portions per recall period) between the two instruments was examined using crude and de-attenuated Pearson's correlation coefficients, cross-classification analyses, weighted kappa statistics (kappa(w)) and Bland-Altman analysis. Setting: Kindergartens/schools from eight European countries participating in the IDEFICS (Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS) Study cross-sectional survey (2007-2008). Subjects: Children aged 2-9 years (n 2508, 50.4% boys). Results: The CEHQ-FFQ provided higher intake estimates for most of the food groups than the 24-HDR. De-attenuated Pearson correlation coefficients ranged from 0.01 (sweetened fruit) to 0.48 (sweetened milk) in children aged 2-<6 years (mean = 0.25) and from 0.01 (milled cereal) to 0.44 (water) in children aged 6-9 years (mean = 0.23). An average of 32 % and 31 % of food group intakes were assigned to the same quartile in younger and older children, respectively, and classification into extreme opposite quartiles was <= 12 % for all food groups in both age groups. Mean kappa(w) was 0.20 for 2-<6-year-olds and 0.17 for 6-9-year-olds. Conclusions: The strength of association estimates assessed by the CEHQ-FFQ and the 24-HDR varied by food group and by age group. Observed level of agreement and CEHQ-FFQ ability to rank children according to intakes of food groups were considered to be low.
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| 2. |
- Bogl, Leonie H, et al.
(författare)
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Like me, like you - relative importance of peers and siblings on children's fast food consumption and screen time but not sports club participation depends on age.
- 2020
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Ingår i: The international journal of behavioral nutrition and physical activity. - : Springer Science and Business Media LLC. - 1479-5868. ; 17:1
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Tidskriftsartikel (refereegranskat)abstract
- Lifestyle interventions to prevent paediatric obesity often target family and peer settings; their success is likely to depend on the influence that peers and families exert on children's lifestyle behaviors at different developmental stages.First, to determine whether children's lifestyle behavior more closely resembles their peers' or siblings' behaviors. Secondly, to investigate longitudinally whether children's behavioral change is predicted by that of their peers or their siblings as they grow older.The European prospective IDEFICS/I.Family cohort (baseline survey: 2007/2008, first follow-up: 2009/2010, and second follow-up: 2013/2014) aims at investigating risk factors for overweight and related behaviors during childhood and adolescence. The present investigation includes 2694 observations of children and their siblings aged 2 to 18years. Peers were defined as same-sex, same-age children in the same community and identified from the full cohort. The longitudinal analysis (mean follow-up time: 3.7years) includes 525sibling pairs. Children's lifestyle behaviors including fast food consumption (frequency/week), screen time (hours/week) and sports club participation (hours/week) were assessed by questionnaire. Data were analyzed using multilevel linear models.Children's lifestyle behavior was associated with the respective behavior of their peers and sibling for all 3 behaviors. For fast food consumption, the peer resemblance was more than 6-fold higher than the sibling resemblance and the peer resemblance surpassed the sibling resemblance by the age of 9-10years. The similarities with peers for fast food consumption and screen time steadily increased, while the similarities with siblings steadily decreased with increasing age of the children (Pinteraction<0.001). In contrast, the relative importance of peers and siblings on sports club duration did not vary by the age of the children. Longitudinal results showed that children's changes in fast food consumption were more strongly associated with those in their peer group than their sibling, in particular if the age gap between siblings was large.In conclusion, our results support the implementation of multi-setting interventions for improving lifestyle behaviors in children. Our findings might also guide future intervention studies in the choice of timing and setting in which interventions are likely to be most effective. From the ages of 9-10years onwards, family- or home-based interventions targeting children's fast food intake and screen time behavior may become less effective than school- or community-based interventions aimed at peer groups.
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| 3. |
- Börnhorst, Claudia, et al.
(författare)
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Diet-obesity associations in children : approaches to counteract attenuation caused by misreporting
- 2013
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Ingår i: Public Health Nutrition. - : Cambridge University Press. - 1368-9800 .- 1475-2727. ; 16:2, s. 256-266
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Measurement errors in dietary data lead to attenuated estimates of associations between dietary exposures and health outcomes. The present study aimed to compare and evaluate different approaches of handling implausible reports by exemplary analysis of the association between dietary intakes (total energy, soft drinks, fruits/vegetables) and overweight/obesity in children. Design: Cross-sectional multicentre study. Setting: Kindergartens/schools from eight European countries participating in the IDEFICS Study. Subjects: Children (n 5357) aged 2-9 years who provided one 24 h dietary recall and complete covariate information. Results: The 24 h recalls were classified into three reporting groups according to adapted Goldberg cut-offs: under-report, plausible report or over-report. In the basic logistic multilevel model (adjusted for age and sex, including study centre as random effect), the dietary exposures showed no significant association with overweight/obesity (energy intake: OR=0.996 (95% CI 0.983, 1.010); soft drinks: OR=0.999 (95% CI 0.986, 1.013)) and revealed even a positive association for fruits/vegetables (OR=1.009 (95% CI 1.001, 1.018)). When adding the reporting group (dummy variables) and a propensity score for misreporting as adjustment terms, associations became significant for energy intake as well as soft drinks (energy: OR=1.074 (95% CI 1.053, 1.096); soft drinks: OR=1.015 (95% CI 1.000, 1.031)) and the association between fruits/vegetables and overweight/obesity pointed to the reverse direction compared with the basic model (OR=0.993 (95% CI 0.984, 1.002)). Conclusions: Associations between dietary exposures and health outcomes are strongly affected or even masked by measurement errors. In the present analysis consideration of the reporting group and inclusion of a propensity score for misreporting turned out to be useful tools to counteract attenuation of effect estimates.
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| 4. |
- Cheng, Lan, et al.
(författare)
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Cross-sectional and longitudinal associations between physical activity, sedentary behaviour and bone stiffness index across weight status in European children and adolescents
- 2020
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Ingår i: International Journal of Behavioral Nutrition and Physical Activity. - : BioMed Central. - 1479-5868. ; 17:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: The associations between physical activity (PA), sedentary behaviour (SB) and bone health may be differentially affected by weight status during growth. This study aims to assess the cross-sectional and longitudinal associations between PA, SB and bone stiffness index (SI) in European children and adolescents, taking the weight status into consideration. Methods: Calcaneus SI was first measured by quantitative ultrasound among children aged 2-9 years old in 2007/08. It was measured again after 2 years in the IDEFICS study and after 6 years in the I. Family study. A sample of 2008 participants with time spent at sports clubs, watching TV and playing computer/games self-reported by questionnaire, and a subsample of 1037 participants with SB, light PA (LPA) and moderate-to-vigorous PA (MVPA) objectively measured using Actigraph accelerometers were included in the analyses. Weight status was defined as thin/normal and overweight/obese according to the extended International Obesity Task Force criteria. Linear mixed-effects models were used to estimate the cross-sectional and longitudinal associations between PA, SB and SI percentiles, stratified by weight status. Results: The cross-sectional association between weekly duration of watching TV and SI percentiles was negative in thin/normal weight group (β =-0.35, p = 0.008). However, baseline weekly duration of watching TV (β =-0.63, p = 0.021) and change after 2 years (β =-0.63, p = 0.022) as well as the change in weekly duration of playing computer/games after 6 years (β =-0.75, p = 0.019) were inversely associated with corresponding changes in SI percentiles in overweight/obese group. Change in time spent at sports clubs was positively associated with change in SI percentiles after 2 years (β = 1.28, p = 0.001), with comparable effect sizes across weight status. In the subsample with accelerometer data, we found a positive cross-sectional association between MVPA and SI percentiles in thin/normal weight group. Baseline MVPA predicted changes in SI percentiles after 2 and 6 years in all groups. Conclusions: Our results suggested the beneficial effect of PA on SI. However, the increasing durations of screen-based SB might be risk factors for SI development, especially in overweight/obese children and adolescents. © 2020 The Author(s).
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| 5. |
- Cheng, Lan, et al.
(författare)
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Sex differences in the longitudinal associations between body composition and bone stiffness index in European children and adolescents
- 2020
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Ingår i: Bone. - : Elsevier. - 8756-3282 .- 1873-2763. ; 131
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Tidskriftsartikel (refereegranskat)abstract
- Fat mass (FM) and fat free mass (FFM) may influence bone health differentially. However, existing evidences on associations between FM, FFM and bone health are inconsistent and vary according to sex and maturity. The present study aims to evaluate longitudinal associations between FM, FFM and bone stiffness index (SI) among European children and adolescents with 6 years follow-up. A sample of 2468 children from the IDEFICS/I.Family was included, with repeated measurements of SI using calcaneal quantitative ultrasound, body composition using skinfold thickness, sedentary behaviors and physical activity using self-administrated questionnaires. Regression coefficients (β) and 99%-confidence intervals (99% CI) were calculated by sex-specified generalized linear mixed effects models to analyze the longitudinal associations between FM and FFM z-scores (zFM and zFFM) and SI percentiles, and to explore the possible interactions between zFM, zFFM and maturity. Baseline zFFM was observed to predict the change in SI percentiles in both boys (β = 4.57, 99% CI: 1.36, 7.78) and girls (β = 3.42, 99% CI: 0.05, 6.79) after 2 years. Moreover, baseline zFFM (β = 8.72, 99% CI: 3.18, 14.27 in boys and β = 5.89, 99% CI: 0.34, 11.44 in girls) and the change in zFFM (β = 6.58, 99% CI: 0.83, 12.34 in boys and β = 4.81, 99% CI: -0.41, 10.02 in girls) were positively associated with the change in SI percentiles after 6 years. In contrast, a negative association was observed between the change in zFM and SI percentiles in boys after 6 years (β = -3.70, 99% CI: -6.99, -0.42). Besides, an interaction was observed between the change in zFM and menarche on the change in SI percentiles in girls at 6 years follow-up (p = .009), suggesting a negative association before menarche while a positive association after menarche. Our findings support the existing evidences for a positive relationship between FFM and SI during growth. Furthermore, long-term FM gain was inversely associated with SI in boys, whereas opposing associations were observed across menarche in girls.
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| 6. |
- Dello Russo, Marika, et al.
(författare)
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Dietary Diversity and Its Association with Diet Quality and Health Status of European Children, Adolescents, and Adults : Results from the I.Family Study
- 2023
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Ingår i: Foods. - : MDPI. - 2304-8158. ; 12:24
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Tidskriftsartikel (refereegranskat)abstract
- Dietary diversity (DD) plays a crucial role in fostering high-quality diets, but its association with health outcomes, particularly body adiposity and non-communicable diseases (NCDs), is inconsistent. This may be due to a lack of a standardized method for estimating DD. Our study investigates the association between two DD indices, namely the dietary diversity score (DDS) and food variety score (FVS), and anthropometric measures, biochemical parameters, and diet quality in a large population sample from the I.Family study across research centers in eight European countries. In our cross-sectional analysis of 3035 participants, DDSs varied among countries, with a higher prevalence in the third DDS tertile among those with higher education. DDS showed a positive association with diet quality across all age groups. Higher DDS tertile individuals showed increased fiber, fruit, and vegetable intake, greater meal frequency, and lower ultra-processed food consumption. No relevant biochemical differences were observed across DDS tertiles, and a higher DDS was associated with lower overweight/obesity prevalence only in adults. No significant associations were found with FVS. Our findings emphasize the need to consider food groups for a more accurate estimation of diet quality. This aligns with studies suggesting DDS alone is not an independent risk factor for obesity in children and adolescents. Public health programs should prioritize food diversity to promote improved nutrition and overall well-being in communities.
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| 7. |
- Do, Stefanie, et al.
(författare)
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The role of psychosocial well-being and emotion-driven impulsiveness in food choices of European adolescents
- 2024
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Ingår i: International Journal of Behavioral Nutrition and Physical Activity. - 1479-5868. ; 21:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: It is unclear whether a hypothetical intervention targeting either psychosocial well-being or emotion-driven impulsiveness is more effective in reducing unhealthy food choices. Therefore, we aimed to compare the (separate) causal effects of psychosocial well-being and emotion-driven impulsiveness on European adolescents’ sweet and fat propensity. Methods: We included 2,065 participants of the IDEFICS/I.Family cohort (mean age: 13.4) providing self-reported data on sweet propensity (score range: 0 to 68.4), fat propensity (range: 0 to 72.6), emotion-driven impulsiveness using the UPPS-P negative urgency subscale, and psychosocial well-being using the KINDLR Questionnaire. We estimated, separately, the average causal effects of psychosocial well-being and emotion-driven impulsiveness on sweet and fat propensity applying a semi-parametric doubly robust method (targeted maximum likelihood estimation). Further, we investigated a potential indirect effect of psychosocial well-being on sweet and fat propensity mediated via emotion-driven impulsiveness using a causal mediation analysis. Results: If all adolescents, hypothetically, had high levels of psychosocial well-being, compared to low levels, we estimated a decrease in average sweet propensity by 1.43 [95%-confidence interval: 0.25 to 2.61]. A smaller effect was estimated for fat propensity. Similarly, if all adolescents had high levels of emotion-driven impulsiveness, compared to low levels, average sweet propensity would be decreased by 2.07 [0.87 to 3.26] and average fat propensity by 1.85 [0.81 to 2.88]. The indirect effect of psychosocial well-being via emotion-driven impulsiveness was 0.61 [0.24 to 1.09] for average sweet propensity and 0.55 [0.13 to 0.86] for average fat propensity. Conclusions: An intervention targeting emotion-driven impulsiveness, compared to psychosocial well-being, would be marginally more effective in reducing sweet and fat propensity in adolescents.
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| 8. |
- Elsayed, Hadil A. Ghazy, et al.
(författare)
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Relationship between perception of emotional home atmosphere and fruit and vegetable consumption in European adolescents: Results from the I.Family survey
- 2020
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Ingår i: Public Health Nutrition. - 1368-9800 .- 1475-2727. ; 23:1, s. 53-62
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Tidskriftsartikel (refereegranskat)abstract
- Objective:Consumption of fruits and vegetables (F&V) among adolescents falls below recommendations in many Western countries. The impact of social and emotional aspects of family life on adolescent dietary behaviour may contribute to this, yet remains under-investigated. The present study examines the association between adolescents' perceptions of emotional home atmosphere (EHA) and their F&V consumption frequency.Design:An FFQ was used to assess F&V consumption frequency. EHA was assessed by an eight-item measure with three subscales: perceived home warmth, strictness and relational tension. EHA subscales were used as binary variables: a score equal to or above the median value was considered as a higher perception, while a score below the median was considered as a lower perception of the EHA in question. Country differences in meeting the European 5-a-day recommendations were described. Further, the association between EHA and F&V consumption frequency was investigated using multiple linear regression.Setting:Regional examination centres in eight European countries.Participants:Adolescents (n 3196) aged 12-18 years.Results:The mean F&V consumption frequency was 3·27 (sd 2·84) times/d. Only 16·1 % of boys and 18 % of girls in our study sample met the recommendation of five F&V daily. After controlling for age, sex, education level of the parents and country of origin, perceived home warmth was associated with a 16 (95 % CI 9, 22) % higher F&V consumption frequency (P < 0·001).Conclusions:F&V consumption frequency was suboptimal in the survey areas. Interventions targeting perceived warmth as a component of EHA could potentially have a positive effect on adolescents' dietary behaviour.
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| 9. |
- Fernández-Alvira, Juan Miguel, et al.
(författare)
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Prospective associations between dietary patterns and body composition changes in European children : the IDEFICS study
- 2017
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Ingår i: Public Health Nutrition. - 1368-9800 .- 1475-2727. ; 20:18, s. 3257-3265
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To describe dietary patterns by applying cluster analysis and to describe the cluster memberships of European children over time and their association with body composition changes.DESIGN: The analyses included k-means clustering based on the similarities between the relative frequencies of consumption of forty-three food items and regression models were fitted to assess the association between dietary patterns and body composition changes.SETTING: Primary schools and pre-schools of selected regions in Italy, Estonia, Cyprus, Belgium, Sweden, Hungary, Germany and Spain.SUBJECTS: Participants (n 8341) in the baseline (2-9 years old) and follow-up (4-11 years old) surveys of the IDEFICS (Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS) study.RESULTS: Three persistent clusters were obtained at baseline and follow-up. Children consistently allocated to the 'processed' cluster presented increased BMI (β=0·050; 95 % CI 0·006, 0·093), increased waist circumference (β=0·071; 95 % CI 0·001, 0·141) and increased fat mass gain (β=0·052; 95 % CI 0·014, 0·090) over time v. children allocated to the 'healthy' cluster. Being in the 'processed'-'sweet' cluster combination was also linked to increased BMI (β=0·079; 95 % CI 0·015, 0·143), increased waist circumference (β=0·172; 95 % CI 0·069, 0·275) and increased fat mass gain (β=0·076; 95 % CI 0·019, 0·133) over time v. the 'healthy' cluster.CONCLUSIONS: Children consistently showing a processed dietary pattern or changing from a processed pattern to a sweet pattern presented the most unfavourable changes in fat mass and abdominal fat. These findings support the need to promote overall healthy dietary habits in obesity prevention and health promotion programmes targeting children.
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| 10. |
- Fernández-Alvira, Juan Miguel, et al.
(författare)
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Prospective associations between socio-economic status and dietary patterns in European children: the Identification and Prevention of Dietary- and Lifestyle-induced Health Effects in Children and Infants (IDEFICS) Study.
- 2015
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Ingår i: The British journal of nutrition. - : Cambridge University Press. - 1475-2662 .- 0007-1145. ; 113:3, s. 517-25
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Tidskriftsartikel (refereegranskat)abstract
- Exploring changes in children's diet over time and the relationship between these changes and socio-economic status (SES) may help to understand the impact of social inequalities on dietary patterns. The aim of the present study was to describe dietary patterns by applying a cluster analysis to 9301 children participating in the baseline (2-9 years old) and follow-up (4-11 years old) surveys of the Identification and Prevention of Dietary- and Lifestyle-induced Health Effects in Children and Infants Study, and to describe the cluster memberships of these children over time and their association with SES. We applied the K-means clustering algorithm based on the similarities between the relative frequencies of consumption of forty-two food items. The following three consistent clusters were obtained at baseline and follow-up: processed (higher frequency of consumption of snacks and fast food); sweet (higher frequency of consumption of sweet foods and sweetened drinks); healthy (higher frequency of consumption of fruits, vegetables and wholemeal products). Children with higher-educated mothers and fathers and the highest household income were more likely to be allocated to the healthy cluster at baseline and follow-up and less likely to be allocated to the sweet cluster. Migrants were more likely to be allocated to the processed cluster at baseline and follow-up. Applying the cluster analysis to derive dietary patterns at the two time points allowed us to identify groups of children from a lower socio-economic background presenting persistently unhealthier dietary profiles. This finding reflects the need for healthy eating interventions specifically targeting children from lower socio-economic backgrounds.
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