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1.
  • Bammann, K, et al. (författare)
  • The IDEFICS validation study on field methods for assessing physical activity and body composition in children: design and data collection.
  • 2011
  • Ingår i: International journal of obesity (2005). - : Springer Science and Business Media LLC. - 1476-5497 .- 0307-0565. ; 35 Suppl 1
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: To describe the design, measurements and fieldwork of the IDEFICS (Identification and prevention of dietary- and lifestyle-induced health effects in children and infants) physical activity and body composition validation study, and to determine the potential and limitations of the data obtained. Design: Multicentre validation study. Subjects: A total of 98 children from four different European countries (age: 4–10 years). Methods: An 8-day measurement protocol was carried out in all children using a collaborative protocol. Reference methods were the doubly labelled water method for physical activity, and a three- and a four-compartment model for body composition. Investigated field methods were accelerometers, a physical activity questionnaire and various anthropometric measurements. Results: For the validation of physical activity field methods, it was possible to gather data from 83 to 89 children, laying the basis for age- and sex-specific results. The validation of body composition field methods is possible in 64–80 children and allows sex-specific analyses but has only limited statistical power in the youngest age group (o6 years). The amount of activity energy expenditure (AEE) varied between centres, sexes and age groups, with boys and older children having higher estimates of AEE. After normalisation of AEE by body weight, most group-specific differences diminished, except for country-specific differences. Conclusion: The IDEFICS validation study will allow age- and sex-specific investigation of questions pertaining to the validity of several field methods of body composition and physical activity, using established reference methods in four different European countries. From the participant analyses it can be concluded that the compliance for the investigated field methods was higher than that for the reference methods used in this validation study.
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2.
  • De Henauw, S, et al. (författare)
  • The IDEFICS community-oriented intervention programme: a new model for childhood obesity prevention in Europe?
  • 2011
  • Ingår i: International journal of obesity. - : Springer Science and Business Media LLC. - 1476-5497 .- 0307-0565. ; 35:Suppl 1
  • Tidskriftsartikel (refereegranskat)abstract
    • The European Union-as well as other parts of the world-faces a major challenge of increasing incidence of overweight/obesity. In particular, the increase in childhood obesity gives rise to a strong imperative for immediate action. Yet, little is known about the effectiveness of community interventions, and further research in this field is needed. There is, however, a growing consensus that such research should start from the paradigm that the current living environments tend to counteract healthy lifestyles. Questioning these environments thoroughly can help to develop new pathways for sustainable health-promoting communities. Against this background, the IDEFICS (Identification and prevention of dietary- and lifestyle-induced health effects in children and infants) study developed and implemented innovative community-oriented intervention programmes for obesity prevention and healthy lifestyle primarily in children aged 2-10 years in eight European countries: Sweden, Estonia, Germany, Belgium, Hungary, Italy, Spain and Cyprus.
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3.
  • Gwozdz, W., et al. (författare)
  • Peer effects on obesity in a sample of European children
  • 2015
  • Ingår i: Economics & Human Biology. - : Elsevier BV. - 1570-677X .- 1873-6130. ; 18, s. 139-152
  • Tidskriftsartikel (refereegranskat)abstract
    • This study analyzes peer effects on childhood obesity using data from the first two waves of the IDEFICS study, which applies several anthropometric and other measures of fatness to approximately 14,000 children aged two to nine participating in both waves in 16 regions of eight European countries. Peers are defined as same-sex children in the same school and age group. The results show that peer effects do exist in this European sample but that they differ among both regions and different fatness measures. Peer effects are larger in Spain, Italy, and Cyprus - the more collectivist regions in our sample - while waist circumference generally gives rise to larger peer effects than BMI. We also provide evidence that parental misperceptions of their own children's weight goes hand in hand With fatter peer groups, supporting the notion that in making such assessments, parents compare their children's weight with that of friends and schoolmates.
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4.
  • Lanfer, A., et al. (författare)
  • Predictors and correlates of taste preferences in European children: The IDEFICS study
  • 2013
  • Ingår i: Food Quality and Preference. - : Elsevier BV. - 0950-3293. ; 27:2, s. 128-136
  • Tidskriftsartikel (refereegranskat)abstract
    • The present study investigated taste preferences in a sample of 1705 children aged 6 to 9 years from survey centres in Italy, Estonia, Cyprus, Belgium, Sweden, Germany, Hungary, and Spain and aimed to identify factors correlated with taste preference. Children's preferences for varying levels of sucrose (sweet) in apple juice and fat, sodium chloride (salt) and monosodium glutamate (umami) in crackers were assessed using paired-comparison tests. Socio-demographics (age, sex, parental education), early feeding practises (breastfeeding, introduction of fruits), parenting behaviour (TV viewing, using food as a reward) and taste threshold sensitivity for sucrose (sweet), sodium chloride (salt), caffeine (bitter) and monosodium glutamate (umami) were investigated as possible correlates of taste preferences. Parents reported on socio-demographics, early feeding and parenting behaviour. Taste thresholds were determined via a paired-comparison staircase method. Country of residence was the strongest factor related to preferences for all four tastes. Taste preferences also differed by age. Preference for sugar and salt increased between 6 and 9 years of age while preference for monosodium glutamate decreased. The age differences remained significant even after adjustment for sex, country of residence, parental education and early feeding habits. Sex, parental education, early feeding habits, TV viewing, using food as a reward and taste thresholds were not consistently related to taste preferences among the survey centres. In summary, the results highlight the importance of culture and age in taste preferences in children younger than 10 years of age. (C) 2012 Elsevier Ltd. All rights reserved.
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5.
  • Nelson, G., et al. (författare)
  • QUAREP-LiMi: A community-driven initiative to establish guidelines for quality assessment and reproducibility for instruments and images in light microscopy
  • 2021
  • Ingår i: Journal of Microscopy. - : Wiley. - 0022-2720 .- 1365-2818. ; 284:1, s. 56-73
  • Tidskriftsartikel (refereegranskat)abstract
    • A modern day light microscope has evolved from a tool devoted to making primarily empirical observations to what is now a sophisticated , quantitative device that is an integral part of both physical and life science research. Nowadays, microscopes are found in nearly every experimental laboratory. However, despite their prevalent use in capturing and quantifying scientific phenomena, neither a thorough understanding of the principles underlying quantitative imaging techniques nor appropriate knowledge of how to calibrate, operate and maintain microscopes can be taken for granted. This is clearly demonstrated by the well-documented and widespread difficulties that are routinely encountered in evaluating acquired data and reproducing scientific experiments. Indeed, studies have shown that more than 70% of researchers have tried and failed to repeat another scientist's experiments, while more than half have even failed to reproduce their own experiments. One factor behind the reproducibility crisis of experiments published in scientific journals is the frequent underreporting of imaging methods caused by a lack of awareness and/or a lack of knowledge of the applied technique. Whereas quality control procedures for some methods used in biomedical research, such as genomics (e.g. DNA sequencing, RNA-seq) or cytometry, have been introduced (e.g. ENCODE), this issue has not been tackled for optical microscopy instrumentation and images. Although many calibration standards and protocols have been published, there is a lack of awareness and agreement on common standards and guidelines for quality assessment and reproducibility. In April 2020, the QUality Assessment and REProducibility for instruments and images in Light Microscopy (QUAREP-LiMi) initiative was formed. This initiative comprises imaging scientists from academia and industry who share a common interest in achieving a better understanding of the performance and limitations of microscopes and improved quality control (QC) in light microscopy. The ultimate goal of the QUAREP-LiMi initiative is to establish a set of common QC standards, guidelines, metadata models and tools, including detailed protocols, with the ultimate aim of improving reproducible advances in scientific research. This White Paper (1) summarizes the major obstacles identified in the field that motivated the launch of the QUAREP-LiMi initiative; (2) identifies the urgent need to address these obstacles in a grassroots manner, through a community of stakeholders including, researchers, imaging scientists, bioimage analysts, bioimage informatics developers, corporate partners, funding agencies, standards organizations, scientific publishers and observers of such; (3) outlines the current actions of the QUAREP-LiMi initiative and (4) proposes future steps that can be taken to improve the dissemination and acceptance of the proposed guidelines to manage QC. To summarize, the principal goal of the QUAREP-LiMi initiative is to improve the overall quality and reproducibility of light microscope image data by introducing broadly accepted standard practices and accurately captured image data metrics.
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6.
  • Vanaelst, B, et al. (författare)
  • Prevalence of negative life events and chronic adversities in European pre- and primary-school children: results from the IDEFICS study.
  • 2012
  • Ingår i: Archives of Public Health. - : Springer Science and Business Media LLC. - 0778-7367 .- 2049-3258. ; 70:22, s. 1-26
  • Tidskriftsartikel (refereegranskat)abstract
    • Abstract ABSTRACT: BACKGROUND: Children are not always recognized as being susceptible to stress, although childhood stressors may originate from multiple events in their everyday surroundings with negative effects on children's health. METHODS: As there is a lack of large-scale, European prevalence data on childhood adversities, this study presents the prevalence of (1) negative life events and (2) familial and social adversities in 4637 European pre- and primary-school children (4--11 years old), using a parentally-reported questionnaire embedded in the IDEFICS project ('Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS'). RESULTS: The following findings were observed: (1) Certain adversities occur only rarely, while others are very regular (i.e. parental divorce); (2) A large percentage of children is shielded from stressors, while a small group of children is exposed to multiple, accumulating adversities; (3) The prevalence of childhood adversity is influenced by geographical location (e.g. north versus south), age group and sex; (4) Childhood adversities are associated and co-occur, resulting in potential cumulative childhood stress. CONCLUSIONS: This study demonstrated the importance of not only studying traumatic events but also of focusing on the early familial and social environment in childhood stress research and indicated the importance of recording or monitoring childhood adversities.
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7.
  • Ahrens, W, et al. (författare)
  • The IDEFICS cohort: design, characteristics and participations in the baseline survey.
  • 2011
  • Ingår i: International Journal of Obesity. - 1476-5497. ; 35:suppl 1, s. 3-15
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: The European IDEFICS (Identification and prevention of dietary- and lifestyle-induced health effects in children and infants) study was set up to determine the aetiology of overweight, obesity and related disorders in children, and to develop and evaluate a tailored primary prevention programme. OBJECTIVE: This paper focuses on the aetiological element of the multicentre study, the measures and examinations, sociodemographic characteristics of the study sample and proportions of participation. DESIGN: Prospective cohort study with an embedded intervention study that started with a baseline survey in eight countries in 2007-2008. SUBJECTS AND MEASUREMENTS: Baseline participants of the prospective cohort study were 16,224 children aged 2-9 years. Parents reported sociodemographic, behavioural, medical, nutritional and other lifestyle data for their children and families. Examinations of children included anthropometry, blood pressure, fitness, accelerometry, DNA from saliva and physiological markers in blood and urine. The built environment, sensory taste perception and other mechanisms of children's food choices and consumer behaviour were studied in subgroups. RESULTS: Between 1507 and 2567, children with a mean age of 6.0 years and an even sex distribution were recruited from each country. Of them, 82% lived in two-parent families. The distribution of standardised income levels differed by study sample, with low-income groups being strongly represented in Cyprus, Italy and Germany. At least one 24-h dietary recall was obtained for two-thirds of the children. Blood pressure and anthropometry were assessed in more than 90%. A 3-day accelerometry was performed in 46%, motor fitness was assessed in 41%, cardiorespiratory fitness in 35% and ∼11% participated in taste perception tests. The proportion of children donating venous blood, urine and saliva was 57, 86 and 88%, respectively. CONCLUSION: The IDEFICS cohort provides valuable data to investigate the interplay of social, environmental, genetic, physiological and behavioural factors in the development of major diet- and lifestyle-related disorders affecting children at present.
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8.
  • Bammann, K, et al. (författare)
  • Validation of anthropometry and foot-to-foot bioelectrical resistance against a three-component model to assess total body fat in children: the IDEFICS study.
  • 2013
  • Ingår i: International Journal of Obesity. - : Springer Science and Business Media LLC. - 0307-0565 .- 1476-5497. ; 37:4, s. 520-526
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective:To compare different field methods for estimating body fat mass with a reference value derived by a three-component (3C) model in pre-school and school children across Europe.Design:Multicentre validation study.Subjects:Seventy-eight preschool/school children aged 4-10 years from four different European countries.Methods:A standard measurement protocol was carried out in all children by trained field workers. A 3C model was used as the reference method. The field methods included height and weight measurement, circumferences measured at four sites, skinfold measured at two-six sites and foot-to-foot bioelectrical resistance (BIA) via TANITA scales.Results:With the exception of height and neck circumference, all single measurements were able to explain at least 74% of the fat-mass variance in the sample. In combination, circumference models were superior to skinfold models and height-weight models. The best predictions were given by trunk models (combining skinfold and circumference measurements) that explained 91% of the observed fat-mass variance. The optimal data-driven model for our sample includes hip circumference, triceps skinfold and total body mass minus resistance index, and explains 94% of the fat-mass variance with 2.44kg fat mass limits of agreement. In all investigated models, prediction errors were associated with fat mass, although to a lesser degree in the investigated skinfold models, arm models and the data-driven models.Conclusion:When studying total body fat in childhood populations, anthropometric measurements will give biased estimations as compared to gold standard measurements. Nevertheless, our study shows that when combining circumference and skinfold measurements, estimations of fat mass can be obtained with a limit of agreement of 1.91kg in normal weight children and of 2.94kg in overweight or obese children.International Journal of Obesity advance online publication, 12 February 2013; doi:10.1038/ijo.2013.13.
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9.
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10.
  • Boernhorst, C., et al. (författare)
  • Validity of 24-h recalls in (pre-)school aged children : Comparison of proxy-reported energy intakes with measured energy expenditure
  • 2014
  • Ingår i: Clinical Nutrition. - : CHURCHILL LIVINGSTONE. - 0261-5614 .- 1532-1983. ; 33:1, s. 79-84
  • Tidskriftsartikel (refereegranskat)abstract
    • Background & aims: Little is known about the validity of repeated 24-h dietary recalls (24-HDR) as a measure of total energy intake (El) in young children. This study aimed to evaluate the validity of proxy-reported El by comparison with total energy expenditure (TEE) measured by the doubly labeled water (DLW) technique. Methods: The agreement between El and TEE was investigated in 36 (47.2% boys) children aged 4-10 years from Belgium and Spain using subgroup analyses and Bland-Altman plots. Low-energy-reporters (LER), adequate-energy-reporters (AER) and high-energy-reporters (HER) were defined from the ratio of El over TEE by application of age- and sex-specific cut-off values. Results: There was good agreement between means of El (1500 kcal/day) and TEE (1523 kcal/day) at group level though in single children, i.e. at the individual level, large differences were observed. Almost perfect agreement between El and TEE was observed in thin/normal weight children (EI: 1511 kcal/day; TEE: 1513 kcal/day). Even in overweight/obese children the mean difference between El and TEE was only 86 kcal/day. Among the participants, 28(78%) were classified as AER, five (14%) as HER and three (8%) as LER. Conclusion: Two proxy-reported 24-HDRs were found to be a valid instrument to assess El on group level but not on the individual level. (C) 2013 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.
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11.
  • Bornhorst, C., et al. (författare)
  • Early Life Factors and Inter-Country Heterogeneity in BMI Growth Trajectories of European Children: The IDEFICS Study
  • 2016
  • Ingår i: Plos One. - San Francisco : Public Library of Science (PLoS). - 1932-6203. ; 11:2
  • Tidskriftsartikel (refereegranskat)abstract
    • Background Starting from birth, this explorative study aimed to investigate between-country differences in body mass index (BMI) trajectories and whether early life factors explain these differences. The sample included 7,644 children from seven European countries (Belgium, Cyprus, Germany, Hungary, Italy, Spain, Sweden) participating in the multi-centre IDEFICS study. Information on early life factors and in total 53,409 repeated measurements of height and weight from 0 to <12 years of age were collected during the baseline (2007/2008) and follow-up examination (2009/2010) supplemented by records of routine child health visits. Country-specific BMI growth curves were estimated using fractional polynomial mixed effects models. Several covariates focussing on early life factors were added to the models to investigate their role in the between-countries differences. Large between-country differences were observed with Italian children showing significantly higher mean BMI values at all ages >= 3 years compared to the other countries. For instance, at age 11 years mean BMI values in Italian boys and girls were 22.3 [21.9; 22.8; 99% confidence interval] and 22.0 [21.5; 22.4], respectively, compared to a range of 18.4 [18.1; 18.8] to 20.3 [19.8; 20.7] in boys and 18.2 [17.8; 18.6] to 20.3 [19.8; 20.7] in girls in the other countries. After adjustment for early life factors, differences between country-specific BMI curves became smaller. Maternal BMI was the factor being most strongly associated with BMI growth (p<0.01 in all countries) with associations increasing during childhood. Gestational weight gain (GWG) was weakly associated with BMI at birth in all countries. In some countries, positive associations between BMI growth and children not being breastfed, mothers' smoking during pregnancy and low educational level of parents were found. Early life factors seem to explain only some of the inter-country variation in growth. Maternal BMI showed the strongest association with children's BMI growth.
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12.
  • Foraita, R, et al. (författare)
  • Does the FTO gene interact with the socioeconomic status on the obesity development among young European children? Results from the IDEFICS study.
  • 2015
  • Ingår i: International Journal of Obesity. - : Springer Science and Business Media LLC. - 0307-0565 .- 1476-5497. ; 39, s. 1-6
  • Tidskriftsartikel (refereegranskat)abstract
    • Background:Various twin studies revealed that the influence of genetic factors on psychological diseases or behaviour is more expressed in socioeconomically advantaged environments. Other studies predominantly show an inverse association between socioeconomic status (SES) and childhood obesity in Western developed countries. The aim of this study is to investigate whether the fat mass and obesity-associated (FTO) gene interacts with the SES on childhood obesity in a subsample (N=4406) of the IDEFICS (Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS) cohort.Methods:A structural equation model (SEM) is applied with the latent constructs obesity, dietary intakes, physical activity and fitness habits, and parental SES to estimate the main effects of the latter three variables and a FTO polymorphism on childhood obesity. Further, a multiple group SEM is used to explore whether an interaction effect exists between the single nucleotide polymorphism rs9939609 within the FTO gene and SES.Results:Significant main effects are shown for physical activity and fitness (standardised [betacrc ](s) = -0.113), SES ([betacrc ](s) = -0.057) and the FTO homozygous AA risk genotype ([betacrc ](s) = -0.177). The explained variance of obesity is ~9%. According to the multiple group approach of SEM, we see an interaction between SES and FTO with respect to their effect on childhood obesity (Δχ(2)=7.3, df=2, P=0.03).Conclusion:Children carrying the protective FTO genotype TT seem to be more protected by a favourable social environment regarding the development of obesity than children carrying the AT or AA genotype.International Journal of Obesity advance online publication, 23 September 2014; doi:10.1038/ijo.2014.156.
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13.
  • Formisano, A., et al. (författare)
  • Efficacy of neck circumference to identify metabolic syndrome in 3-10 year-old European children: Results from IDEFICS study
  • 2016
  • Ingår i: Nutrition Metabolism and Cardiovascular Diseases. - : Elsevier BV. - 0939-4753. ; 26:6, s. 510-516
  • Tidskriftsartikel (refereegranskat)abstract
    • Background and aims: Several studies demonstrated that larger neck circumference (NC) in children and adolescents may help to identify obesity and cardio-metabolic abnormalities. We aimed to evaluate the correlation between NC and metabolic syndrome (MetS) risk factors and to determine the utility of this anthropometric index to identify MetS in European children. Methods and results: The present cross-sectional analysis includes 15,673 children (3-10 years) participating in the IDEFICS study. A continuous MetS (cMetS) score was calculated summing age and sex standardized z-scores of specific MetS risk factors. Receiver Operating Characteristic analysis, stratified by one-year age groups, was used to determine the ability of NC to identify children with unfavorable metabolic profile, corresponding to cMetS score >= 90th percentile. The areas under the curve values for NC associated with cMetS score values >= 90th percentile were significantly greater in girls than in boys (p < 0.001), except for 5 < 6 years group. For boys, optimal NC cut-off values ranged from 26.2 cm for the lowest age group (3 < 4 years), up to 30.9 cm for the highest age group (9 < 10 years). In girls, corresponding values varied from 24.9 cm to 29.6 cm. Conclusion: The study demonstrated the efficacy of NC in identifying European children with an unfavorable metabolic profile.
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14.
  • Konstabel, K, et al. (författare)
  • Objectively measured physical activity in European children: the IDEFICS study.
  • 2014
  • Ingår i: International journal of obesity (2005). - : Springer Science and Business Media LLC. - 1476-5497 .- 0307-0565. ; 38 Suppl 2
  • Tidskriftsartikel (refereegranskat)abstract
    • To provide sex- and age-specific percentile values for levels of physical activity (PA) and sedentary time of European children aged 2.0-10.9 years from eight European countries (Sweden, Germany, Hungary, Italy, Cyprus, Spain, Belgium and Estonia).
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15.
  • Michels, N., et al. (författare)
  • Caucasian children's fat mass: routine anthropometry v. air-displacement plethysmography
  • 2013
  • Ingår i: British Journal of Nutrition. - : Cambridge University Press (CUP). - 0007-1145 .- 1475-2662. ; 109:8, s. 1528-1537
  • Tidskriftsartikel (refereegranskat)abstract
    • The present paper will use fat mass percentage (FM%) obtained via BOD POD (R) air-displacement plethysmography (FMADP%) to examine the relative validity of (1) anthropometric measurements/indices and (2) of FM% assessed with equations (FMeq%) based on skinfold thickness and bioelectrical impedance (BIA). In 480 Belgian children (aged 5-11 years) weight, height, skinfold thickness (triceps and subscapular), body circumferences (mid-upper arm, waist and hip), foot-to-foot BIA (Tanita (R)) and FMADP% were measured. Anthropometric measurements and calculated indices were compared with FMADP%. Next, published equations were used to calculate FMeq% using impedance (equations of Tanita (R), Tyrrell, Shaefer and Deurenberg) or skinfold thickness (equations of Slaughter, Goran, Dezenberg and Deurenberg). Both indices and equations performed better in girls than in boys. For both sexes, the sum of skinfold thicknesses resulted in the highest correlation with FMADP%, followed by triceps skinfold, arm fat area and subscapular skinfold. In general, comparing FMeq% with FMADP% indicated mostly an age and sex effect, and an increasing underestimation but less dispersion with increasing FM%. The Tanita (R) impedance equation and the Deurenberg skinfold equation performed the best, although none of the used equations were interchangeable with FMADP%. In conclusion, the sum of triceps and subscapular skinfold thickness is recommended as marker of FM% in the absence of specialised technologies. Nevertheless, the higher workload, cost and survey management of an immobile device like the BOD POD (R) remains justified.
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17.
  • Suling, M., et al. (författare)
  • Design and results of the pretest of the IDEFICS study
  • 2011
  • Ingår i: International Journal of Obesity. - : Nature Publishing Group. - 0307-0565 .- 1476-5497. ; 35, s. S30-S44
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: During the preparatory phase of the baseline survey of the IDEFICS (Identification and prevention of dietary- and lifestyle-induced health effects in children and infants) study, standardised survey procedures including instruments, examinations, methods, biological sampling and software tools were developed and pretested for their feasibility, robustness and acceptability. Methods: A pretest was conducted of full survey procedures in 119 children aged 2-9 years in nine European survey centres (N-per (centre) 4-27, mean 13.22). Novel techniques such as ultrasound measurements to assess subcutaneous fat and bone health, heart rate monitors combined with accelerometers and sensory taste perception tests were used. Results: Biological sampling, physical examinations, sensory taste perception tests, parental questionnaire and medical interview required only minor amendments, whereas physical fitness tests required major adaptations. Callipers for skinfold measurements were favoured over ultrasonography, as the latter showed only a low-to-modest agreement with calliper measurements (correlation coefficients of r = -0.22 and r = 0.67 for all children). The combination of accelerometers with heart rate monitors was feasible in school children only. Implementation of the computer-based 24-h dietary recall required a complex and intensive developmental stage. It was combined with the assessment of school meals, which was changed after the pretest from portion weighing to the more feasible observation of the consumed portion size per child. The inclusion of heel ultrasonometry as an indicator of bone stiffness was the most important amendment after the pretest. Discussion: Feasibility and acceptability of all procedures had to be balanced against their scientific value. Extensive pretesting, training and subsequent refinement of the methods were necessary to assess the feasibility of all instruments and procedures in routine fieldwork and to exchange or modify procedures that would otherwise give invalid or misleading results. International Journal of Obesity (2011) 35, S30-S44; doi:10.1038/ijo.2011.33
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18.
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19.
  • Vanaelst, B., et al. (författare)
  • Prevalence of psychosomatic and emotional symptoms in European school-aged children and its relationship with childhood adversities: results from the IDEFICS study
  • 2012
  • Ingår i: European Child & Adolescent Psychiatry. - : Springer Science and Business Media LLC. - 1018-8827 .- 1435-165X. ; 21:5, s. 253-265
  • Tidskriftsartikel (refereegranskat)abstract
    • The prevalence of childhood stress and psychosomatic and emotional symptoms (PES) has increased in parallel, indicating that adverse, stressful circumstances and PES in children might be associated. This study describes the prevalence of PES in European children, aged 4-11 years old, and examines the relationship among PES, negative life events (NLE) and familial or social adversities in the child's life. Parent-reported data on childhood adversities and PES was collected for 4,066 children from 8 European countries, who participated in the follow-up survey of IDEFICS (2009-2010), by means of the 'IDEFICS parental questionnaire'. A modified version of the 'Social Readjustment Rating Scale', the 'KINDL Questionnaire for Measuring Health-Related Quality of Life in Children and Adolescents' and the 'Strengths and Difficulties Questionnaire' were incorporated in this questionnaire, as well as questions on socio-demographics, family lifestyle and health of the child. Chi-square analyses were performed to investigate the prevalence of PES among survey centres, age groups and sex of the child. Odds ratios were calculated to examine the childhood adversity exposure between PES groups and logistic regression analyses were conducted to investigate: (a) the contribution of the number and (b) the specific types of experienced adversities on the occurrence of PES. 45.7% of the children experienced at least one PES, with low emotional well-being during the last week being most frequently reported (38.2%). No sex differences were shown for the prevalence of PES (P = 0.282), but prevalence proportions rose with increasing age (P < 0.001). Children with PES were more frequently exposed to childhood adversities compared to children without PES (e.g. 13.3 and 3.9% of peer problems and 25.4 and 17.4% of non-traditional family structure in the PES vs. no PES group, respectively, P < 0.001). An increasing number of adversities (regardless of their nature) was found to gradually amplify the risk for PES (OR = 2.85, 95% CI = 1.98-4.12 for a number of a parts per thousand yen3 NLE), indicating the effect of cumulative stress. Finally, a number of specified adversities were identified as apparent risk factors for the occurrence of PES, such as living in a non-traditional family structure (OR = 1.52, 95% CI = 1.30-1.79) or experiencing peer problems (OR = 3.55, 95% CI = 2.73-4.61). Childhood adversities were significantly related to PES prevalence, both quantitatively (i.e. the number of adversities) and qualitatively (i.e. the type of adversity). This study demonstrates the importance and the impact of the child's family and social context on the occurrence of PES in children younger than 12 years old.
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20.
  • Zaqout, M., et al. (författare)
  • Influence of physical fitness on cardio-metabolic risk factors in European children. The IDEFICS study
  • 2016
  • Ingår i: International Journal of Obesity. - : Springer Science and Business Media LLC. - 0307-0565 .- 1476-5497. ; 40:7, s. 1119-1125
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: The aim of the study was to assess the associations of individual and combined physical fitness components with single and clustering of cardio-metabolic risk factors in children. SUBJECTS/METHODS: This 2-year longitudinal study included a total of 1635 European children aged 6-11 years. The test battery included cardio-respiratory fitness (20-m shuttle run test), upper-limb strength (handgrip test), lower-limb strength (standing long jump test), balance (flamingo test), flexibility (back-saver sit-and-reach) and speed (40-m sprint test). Metabolic risk was assessed through z-score standardization using four components: waist circumference, blood pressure (systolic and diastolic), blood lipids (triglycerides and high-density lipoprotein) and insulin resistance (homeostasis model assessment). Mixed model regression analyses were adjusted for sex, age, parental education, sugar and fat intake, and body mass index. RESULTS: Physical fitness was inversely associated with clustered metabolic risk (P<0.001). All coefficients showed a higher clustered metabolic risk with lower physical fitness, except for upper-limb strength (beta = 0.057; P = 0.002) where the opposite association was found. Cardio-respiratory fitness (beta = -0.124; P<0.001) and lower-limb strength (beta = -0.076; P = 0.002) were the most important longitudinal determinants. The effects of cardio-respiratory fitness were even independent of the amount of vigorous-to-moderate activity (beta = -0.059; P = 0.029). Among all the metabolic risk components, blood pressure seemed not well predicted by physical fitness, while waist circumference, blood lipids and insulin resistance all seemed significantly predicted by physical fitness. CONCLUSION: Poor physical fitness in children is associated with the development of cardio-metabolic risk factors. Based on our results, this risk might be modified by improving mainly cardio-respiratory fitness and lower-limb muscular strength.
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21.
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22.
  • Bammann, K., et al. (författare)
  • Socioeconomic factors and childhood overweight in Europe : results from the multi-centre IDEFICS study
  • 2013
  • Ingår i: Pediatric Obesity. - : Wiley-Blackwell. - 2047-6302 .- 2047-6310. ; 8:1, s. 1-12
  • Tidskriftsartikel (refereegranskat)abstract
    • What is already known about this subject Overweight and obesity can be linked to different parental socioeconomic factors already in very young children. In Western developed countries, the association of childhood overweight and obesity and parental socioeconomic status shows a negative gradient. Ambiguous results have been obtained regarding the association between socioeconomic factors and childhood overweight and obesity in different countries and over time. What this study adds European regions show heterogeneous associations between socioeconomic factors and overweight and obesity in a multi-centre study with highly standardized study protoco. The strength of association between SES and overweight and obesity varies across European regions. In our study, the SES gradient is correlated with the regional mean income and the country-specific Human development index indicating a strong influence not only of the family but also of region and country on the overweight and obesity prevalence. Objective To assess the association between different macro- and micro-level socioeconomic factors and childhood overweight. Methods Data from the IDEFICS baseline survey is used to investigate the cross-sectional association between socioeconomic factors, like socioeconomic status (SES), and the prevalence of childhood overweight. Differences and similarities regarding this relationship in eight European regions (located in Belgium, Cyprus, Estonia, Germany, Hungary, Italy, Spain and Sweden) are explored. 11?994 children (50.9% boys, 49.1% girls) and their parents were included in the analyses. Results In five of the eight investigated regions (in Belgium, Estonia, Germany, Spain and Sweden), the prevalence of childhood overweight followed an inverse SES gradient. In the other three regions (in Cyprus, Hungary and Italy), no association between SES and childhood overweight was found. The SES-overweight association in a region was best explained by the country-specific human development index and the centre-specific mean income. For the investigated association between other socioeconomic factors and overweight, no clear pattern could be found in the different regions. Conclusion The association between socioeconomic factors and childhood overweight was shown to be heterogeneous across different European regions. Further research on nationwide European data is needed to confirm the results and to identify target groups for prevention.
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23.
  • Bammann, K., et al. (författare)
  • The impact of familial, behavioural and psychosocial factors on the SES gradient for childhood overweight in Europe. A longitudinal study
  • 2017
  • Ingår i: International Journal of Obesity. - : Nature Publishing Group. - 0307-0565 .- 1476-5497. ; 41:1, s. 54-60
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: In highly developed countries, childhood overweight and many overweight-related risk factors are negatively associated with socioeconomic status (SES). OBJECTIVE: The objective of this study is to investigate the longitudinal association between parental SES and childhood overweight, and to clarify whether familial, psychosocial or behavioural factors can explain any SES gradient. METHODS: The baseline and follow-up surveys of the identification and prevention of dietary and lifestyle induced health effects in children and infants (IDEFICS) study are used to investigate the longitudinal association between SES, familial, psychosocial and behavioural factors, and the prevalence of childhood overweight. A total of 5819 children (50.5% boys and 49.5% girls) were included. RESULTS: The risk for being overweight after 2 years at follow-up in children who were non-overweight at baseline increases with a lower SES. For children who were initially overweight, a lower parental SES carries a lower probability for a non-overweight weight status at follow-up. The effect of parental SES is only moderately attenuated by single familial, psychosocial or behavioural factors; however, it can be fully explained by their combined effect. Most influential of the investigated risk factors were feeding/eating practices, parental body mass index, physical activity behaviour and proportion of sedentary activity. CONCLUSION: Prevention strategies for childhood overweight should focus on actual behaviours, whereas acknowledging that these behaviours are more prevalent in lower SES families.
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24.
  • De Henauw, S., et al. (författare)
  • Effects of a community-oriented obesity prevention programme on indicators of body fatness in preschool and primary school children. Main results from the IDEFICS study
  • 2015
  • Ingår i: Obesity Reviews. - : Wiley. - 1467-7881. ; 16:Suppl. 2, s. 16-29
  • Tidskriftsartikel (refereegranskat)abstract
    • Background/ObjectivesChildhood obesity is a major public health concern but evidence-based approaches to tackle this epidemic sustainably are still lacking. The Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS (IDEFICS) study investigated the aetiology of childhood obesity and developed a primary prevention programme. Here, we report on the effects of the IDEFICS intervention on indicators of body fatness. Subjects/MethodsThe intervention modules addressed the community, school and parental level, focusing on diet, physical activity and stress-related lifestyle factors. A cohort of 16,228 children aged 2-9.9years - about 2000 per country - was equally divided over intervention and control regions. (Participating countries were Sweden, Germany, Estonia, Hungary, Cyprus, Italy, Spain and Belgium.) We compared the prevalence of overweight/obesity and mean values of body mass index z-score, per cent body fat and waist-to-height ratio over 2years of follow-up. Mixed models adjusting for age and socioeconomic status of the parents and with an additional random effect for country accounted for the clustered study design. ResultsThe prevalence of overweight and obesity increased in both the intervention and control group from 18.0% at baseline to 22.9% at follow-up in the control group and from 19.0% to 23.6% in the intervention group. The difference in changes between control and intervention was not statistically significant. For the cohort as a whole, the changes in indicators of body fatness did not show any clinically relevant differences between the intervention and control groups. Changes in favour of intervention treatment in some indicators were counterbalanced by changes in favour of the control group in some other indicators. ConclusionsOver the 2-year-observation period, the IDEFICS primary prevention programme for childhood obesity has not been successful in reducing the prevalence of overweight and obesity nor in improving indicators of body fatness in the target population as a whole.
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25.
  • Fernaandez-Alvira, J. M., et al. (författare)
  • Prospective associations between dietary patterns and body composition changes in European children: the IDEFICS study
  • 2017
  • Ingår i: Public Health Nutrition. - : Cambridge University Press (CUP). - 1368-9800 .- 1475-2727. ; 20:18, s. 3257-3265
  • 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 (beta=0.050; 95 % CI 0.006, 0.093), increased waist circumference (beta=0.071; 95 % CI 0.001, 0.141) and increased fat mass gain (beta=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 (beta=0.079; 95 % CI 0.015, 0.143), increased waist circumference (beta=0.172; 95 % CI 0.069, 0.275) and increased fat mass gain (beta=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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26.
  • Fernandez-Alvira, J. M., et al. (författare)
  • Country-specific dietary patterns and associations with socioeconomic status in European children: the IDEFICS study
  • 2014
  • Ingår i: European Journal of Clinical Nutrition. - : Springer Science and Business Media LLC. - 0954-3007 .- 1476-5640. ; 68:7, s. 811-821
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND/OBJECTIVES: Children from lower socioeconomic status (SES) may be at higher risk of unhealthy eating. We described country-specific dietary patterns among children aged 2-9 years from eight European countries participating in the IDEFICS study and assessed the association of dietary patterns with an additive SES indicator. SUBJECTS/METHODS: Children aged 2-9 years from eight European countries were recruited in 2007-2008. Principal component analysis was applied to identify dietary country-specific patterns. Linear regression analyses were applied to assess their association with SES. RESULTS: Two to four dietary patterns were identified in the participating regions. The existence of a 'processed' pattern was found in the eight regions. Also, a 'healthy' pattern was identified in seven of the eight regions. In addition, region-specific patterns were identified, reflecting the existing gastronomic and cultural differences in Europe. The 'processed' pattern was significantly inversely associated with the SES additive indicator in all countries except Sweden, whereas the 'healthy' pattern was positively associated with SES in the Belgian, Estonian, German and Hungarian regions, but was not significant in the Italian, Spanish and Swedish regions. CONCLUSIONS: A 'processed' pattern and a 'healthy' pattern were found in most of the participating countries in the IDEFICS study, with comparable food item profiles. The results showed a strong inverse association of SES with the 'processed' pattern, suggesting that children of parents with lower SES may be at higher risk of unhealthy eating. Therefore, special focus should be given to parents and their children from lower SES levels when developing healthy eating promotion strategies.
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27.
  • Gwozdz, W., et al. (författare)
  • Maternal employment and childhood obesity - A European perspective
  • 2013
  • Ingår i: Journal of Health Economics. - : Elsevier BV. - 0167-6296 .- 1879-1646. ; 32:4, s. 728-742
  • Tidskriftsartikel (refereegranskat)abstract
    • The substantial increase in female employment rates in Europe over the past two decades has often been linked in political and public rhetoric to negative effects on child development, including obesity. We analyse this association between maternal employment and childhood obesity using rich objective reports of various anthropometric and other measures of fatness from the IDEFICS study of children aged 2-9 in 16 regions of eight European countries. Based on such data as accelerometer measures and information from nutritional diaries, we also investigate the effects of maternal employment on obesity's main drivers: calorie intake and physical activity. Our analysis provides little evidence for any association between maternal employment and childhood obesity, diet or physical activity. (c) 2013 Elsevier B.V. All rights reserved.
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28.
  • Herrmann, D., et al. (författare)
  • Repeatability of maternal report on prenatal, perinatal and early postnatal factors : findings from the IDEFICS parental questionnaire
  • 2011
  • Ingår i: International Journal of Obesity. - : Nature Publishing Group. - 0307-0565 .- 1476-5497. ; 35, s. S52-S60
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: To investigate the repeatability of maternal self-reported prenatal, perinatal and early postnatal factors within the IDEFICS (Identification and prevention of dietary-and lifestyle-induced health effects in children and infants) study. Design: Data are from the baseline survey of the longitudinal cohort study IDEFICS in eight European countries. Subjects: A total of 420 parents from eight countries (43-61 per country) were asked to complete the parental questionnaire (PQ) twice at least 1 month apart. Measurements: The PQ assesses prenatal (maternal weight gain), perinatal (child's birth weight and length, Caesarean (C)-section, week of delivery) and early postnatal factors (exclusive breastfeeding, breastfeeding, introduction of solid food). Intra-class correlation coefficients (ICCs) were calculated to compare maternal reports on prenatal, perinatal and early postnatal factors between the first and second PQ. Results: In total, 249 data sets were considered for the analyses. Overall, maternal reports for prenatal and perinatal factors showed higher repeatability (ICC = 0.81-1.00, P <= 0.05 for all) than those for early infant nutrition (ICC = 0.33-0.88, P <= 0.05 for all). Perfect agreement was found for parental reports on C-section (ICCall = 1.00, P <= 0.05). There was stronger agreement for duration of breastfeeding (ICC = 0.71, P <= 0.05) compared with exclusive breastfeeding (ICC = 0.33, P <= 0.05). Maternal reports showed moderate correlation for the introduction of several types of food (cereals ICC = 0.64, P <= 0.05; fruits ICC = 0.70, P <= 0.05; meat ICC = 0.83, P <= 0.05; vegetables ICC = 0.75, P <= 0.05), and high correlation (ICC = 0.88, P <= 0.05) for cow's milk. Conclusion: Maternal reports on pregnancy and birth were highly reproducible, but parental recall of early infant nutrition was weaker and should be interpreted more cautiously. International Journal of Obesity (2011) 35, S52-S60; doi:10.1038/ijo.2011.35
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29.
  • Hunsberger, Monica, 1973, et al. (författare)
  • Bidirectional associations between psychosocial well-being and body mass index in European children: longitudinal findings from the IDEFICS study
  • 2016
  • Ingår i: Bmc Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 16
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: The negative impact of childhood overweight on psychosocial well-being has been demonstrated in a number of studies. There is also evidence that psychosocial well-being may influence future overweight. We examined the bidirectional association between childhood overweight and psychosocial well-being in children from a large European cohort. The dual aim was to investigate the chronology of associations between overweight and psychosocial health indicators and the extent to which these associations may be explained by parental education. Methods: Participants from the IDEFICS study were recruited from eight countries between September 2007 and June 2008 when the children were aged 2 to 9.9 years old. Children and families provided data on lifestyle, psychosocial well-being, and measured anthropometry at baseline and at follow-up 2 years later. This study includes children with weight, height, and psychosocial well-being measurements at both time points (n = 7,831). Psychosocial well-being was measured by the KINDL (R) and Strengths and Difficulties Questionnaire respectively. The first instrument measures health-related quality of life including emotional well-being, self-esteem, parent relations and social relations while the second measures well-being based on emotional symptoms, conduct problems and peer-related problems. Logistic regression was used for modeling longitudinal associations. Results: Children who were overweight at baseline had increased risk of poor health-related quality of life (odds ratio (OR) = 1.23; 95 % confidence interval (CI): 1.03-1.48) measured 2 years later; this association was unidirectional. In contrast to health-related quality of life, poor well-being at baseline was associated with increased risk of overweight (OR = 1.39; 95 % CI: 1.03-1.86) at 2 year follow-up; this association was also only observed in one direction. Adjustment for parental education did not change our findings. Conclusion: Our findings indicate that the association between overweight and psychosocial well-being may be bidirectional but varies by assessment measures. Future research should further investigate which aspects of psychosocial well-being are most likely to precede overweight and which are more likely to be consequences of overweight.
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30.
  • Hunsberger, Monica, 1973, et al. (författare)
  • Overweight in singletons compared to children with siblings: the IDEFICS study.
  • 2012
  • Ingår i: Nutrition and diabetes. - : Springer Science and Business Media LLC. - 2044-4052. ; 2
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of this study was to compare the prevalence of overweight in only children to those with siblings and to explore potential behavioral mediating factors. This study relies upon cross-sectional data collected at survey centers in eight European countries participating in Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS (IDEFICS). The present analysis is based on measured anthropometry and parent or guardian-reported socio-demographic characteristics. Subjects include 12720 children aged 2–9 years for whom number of siblings was known. Singletons were more likely (odds ratio 1.52, 95% confidence interval (CI):1.34–1.72) to be overweight than their peers with siblings when controlling for factors related to childhood overweight, including survey country, parental education, parental weight, maternal age, child's age, birth weight and gender. The three southernmost countries have over threefold risk of overweight, dominated by Italy, compared with the north-central countries, which is not explained by the prevalence of singleton children. The excess risk of overweight among children without siblings was robustly observed even when considering behavioral mediating factors (playtime, screen time per day, dietary propensities for sugar or fat, parental attitudes towards food rewards and television in the child's bedroom). Among singletons aged 6–9 years, the excess risk of overweight was 1.70 (95% CI: 1.44–2.01) compared with 1.32 (95% CI: 1.10–1.60) in younger singletons.
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31.
  • Iguacel, I., et al. (författare)
  • Associations between social vulnerabilities and dietary patterns in European children: the Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS (IDEFICS) study
  • 2016
  • Ingår i: British Journal of Nutrition. - : Cambridge University Press (CUP). - 0007-1145 .- 1475-2662. ; 116:7, s. 1288-1297
  • Tidskriftsartikel (refereegranskat)abstract
    • Socio-economic inequalities in childhood can determine dietary patterns, and therefore future health. This study aimed to explore associations between social vulnerabilities and dietary patterns assessed at two time points, and to investigate the association between accumulation of vulnerabilities and dietary patterns. A total of 9301 children aged 2-9 years participated at baseline and 2-year follow-up examinations of the Identification and prevention of Dietary-and lifestyle-induced health EFfects In Children and infantS study. In all, three dietary patterns were identified at baseline and follow-up by applying the K-means clustering algorithm based on a higher frequency of consumption of snacks and fast food (processed), sweet foods and drinks (sweet), and fruits and vegetables (healthy). Vulnerable groups were defined at baseline as follows: children whose parents lacked a social network, children from single-parent families, children of migrant origin and children with unemployed parents. Multinomial mixed models were used to assess the associations between social vulnerabilities and children's dietary patterns at baseline and follow-up. Children whose parents lacked a social network (OR 1.31; 99% CI 1.01, 1.70) and migrants (OR 1.45; 99% CI 1.15, 1.83) were more likely to be in the processed cluster at baseline and follow-up. Children whose parents were homemakers (OR 0.74; 99% CI 0.60, 0.92) were less likely to be in the processed cluster at baseline. A higher number of vulnerabilities was associated with a higher probability of children being in the processed cluster (OR 1.78; 99% CI 1.21, 2.62). Therefore, special attention should be paid to children of vulnerable groups as they present unhealthier dietary patterns.
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32.
  • Iguacel, I., et al. (författare)
  • Associations between social vulnerabilities and psychosocial problems in European children. Results from the IDEFICS study
  • 2017
  • Ingår i: European Child & Adolescent Psychiatry. - : Springer Science and Business Media LLC. - 1018-8827 .- 1435-165X. ; 26:9, s. 1105-1117
  • Tidskriftsartikel (refereegranskat)abstract
    • The effect of socioeconomic inequalities on children's mental health remains unclear. This study aims to explore the cross-sectional and longitudinal associations between social vulnerabilities and psychosocial problems, and the association between accumulation of vulnerabilities and psychosocial problems. 5987 children aged 2-9 years from eight European countries were assessed at baseline and 2-year follow-up. Two different instruments were employed to assess children's psychosocial problems: the KINDL (Questionnaire for Measuring Health-Related Quality of Life in Children and Adolescents) was used to evaluate children's well-being and the Strengths and Difficulties Questionnaire (SDQ) was used to evaluate children's internalising problems. Vulnerable groups were defined as follows: children whose parents had minimal social networks, children from non-traditional families, children of migrant origin or children with unemployed parents. Logistic mixed-effects models were used to assess the associations between social vulnerabilities and psychosocial problems. After adjusting for classical socioeconomic and lifestyle indicators, children whose parents had minimal social networks were at greater risk of presenting internalising problems at baseline and follow-up (OR 1.53, 99% CI 1.11-2.11). The highest risk for psychosocial problems was found in children whose status changed from traditional families at T0 to non-traditional families at T1 (OR 1.60, 99% CI 1.07-2.39) and whose parents had minimal social networks at both time points (OR 1.97, 99% CI 1.26-3.08). Children with one or more vulnerabilities accumulated were at a higher risk of developing psychosocial problems at baseline and follow-up. Therefore, policy makers should implement measures to strengthen the social support for parents with a minimal social network.
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33.
  • Iguacel, I., et al. (författare)
  • Prospective associations between social vulnerabilities and children's weight status. Results from the IDEFICS study
  • 2018
  • Ingår i: International Journal of Obesity. - : Springer Science and Business Media LLC. - 0307-0565 .- 1476-5497. ; 42:10, s. 1691-1703
  • Tidskriftsartikel (refereegranskat)abstract
    • Background/objectives In high-income countries, childhood obesity follows a clear socioeconomic gradient with greater prevalence in children with lower socioeconomic status (SES). The extent to which the trend of other social vulnerabilities over time and the accumulation of these vulnerabilities can affect children's weight is still unknown. Subjects/methods In the IDEFICS study, 8624 children aged 2.0-9.9 years from eight European countries were examined at baseline and after 2 years. Sociodemographic variables, maternal body mass index (BMI), and lifestyle were reported by parents. Children were measured and classified as thin, normal weight, and overweight/obese using the extended IOTF criteria. Four vulnerable groups were defined: children whose parents were migrants, children whose parents lack a social network, children from non-traditional families (children not living with both biological parents), and children with unemployed parents. Logistic mixed-effects models were used to study the association between vulnerabilities and children's weight at baseline and follow-up, temporal trends in vulnerabilities and children's weight and accumulation of vulnerabilities and children's weight. Models were adjusted for lifestyle, maternal BMI, parental education, and income. Results Children whose parents lost their social support at follow-up were more likely to be thin than non-vulnerable children (OR = 1.69, 99% CI = 1.03-2.78). Children whose parents had a migrant background (OR = 1.30, 99% CI 1.04-1.62), children from non-traditional families at both time points (OR = 1.40, 99% CI 1.03-1.90) and whose parents were unemployed at baseline and follow-up (OR = 2.03, 99% CI 1.03-3.99) were more likely to be overweight/obese compared to non-vulnerable children. Cross-sectionally, we did not find an association between parental lack of network, non-traditional family structure, or employment and children's weight status. Conclusions Policy actions are required to tackle inadequate weight loss and gain among vulnerable children (especially those exposed over the long term) since they are at a higher risk of thinness and overweight.
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34.
  • Iguacel, I., et al. (författare)
  • Prospective associations between socioeconomically disadvantaged groups and metabolic syndrome risk in European children. Results from the IDEFICS study
  • 2018
  • Ingår i: International Journal of Cardiology. - : Elsevier BV. - 0167-5273 .- 1874-1754. ; 272, s. 333-340
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: Socioeconomic disadvantages during childhood are hypothesised to have negative implications for health. We aimed to investigate the association between socioeconomic disadvantages and children's total metabolic syndrome (MetS) score at baseline and follow-up and the extent to which socioeconomic disadvantages over time and the accumulation of these socioeconomic disadvantages can affect children's MetS risk. Methods: The two-year longitudinal IDEFICS study included 2401 European children (aged 2.0-9.9) with complete information of the 16,229 participating at baseline. Sociodemographic variables, psychosocial factors and lifestyle were proxy-reported via questionnaires. Socioeconomically disadvantaged groups included children from families with low income, low education, migrant origin, unemployed parents, parents who lacked a social network, and from non-traditional families. MetS risk score was calculated as the sum of z-scores of waist circumference, blood pressure, lipids and insulin resistance. Linear mixed-effects models were used to study the association between social disadvantages and MetS risk. Models were adjusted for sex, age, well-being and lifestyle (fruit and vegetables consumption, physical activity, screen time). Results: At both time points, children from low-income families (0.20 [0.03-0.37]); (beta estimate and 99% confidence interval), children from non-traditional families (0.14 [0.02-026]), children whose parents were unemployed (0.31 [0.05-0.57]) and children who accumulated >3 disadvantages (0.21 [0.04-0.37]) showed a higher MetS score compared to non-socioeconomically disadvantaged groups. Conclusion: Children from socioeconomically disadvantaged families are at high metabolic risk independently of diet, physical activity, sedentary behaviours and well-being. Interventions focusing on these socioeconomically disadvantaged groups should be developed to tackle health disparities. (C) 2018 Elsevier B.V. All rights reserved.
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35.
  • Iguacel, I., et al. (författare)
  • Social vulnerability as a predictor of physical activity and screen time in European children
  • 2018
  • Ingår i: International Journal of Public Health. - : Springer Science and Business Media LLC. - 1661-8556 .- 1661-8564. ; 63:2, s. 283-295
  • Tidskriftsartikel (refereegranskat)abstract
    • To examine associations between social vulnerabilities and meeting physical activity (PA) and screen time (ST) recommendations during a 2-year follow-up. 13,891 children aged 2.0 to < 9.9 from eight European countries were assessed at baseline and 8482 children at follow-up. Children's sports club membership, PA and ST were collected via parental questionnaires. Moderate-to-vigorous physical activity (MVPA) was objectively assessed with accelerometers. Performing at least 1 h of MVPA daily and spending less than 2 h of ST defined physically active and non-sedentary children, respectively. Vulnerable groups were defined at baseline as children whose parents had minimal social networks, from non-traditional families, with migrant origin or with unemployed parents. Logistic mixed-effects analyses were performed adjusting for classical socioeconomic indicators. Children whose parents had minimal social networks had a higher risk of non-compliance with PA recommendations (subjectively assessed) at baseline. Migrants and children with unemployed parents had longer ST. All vulnerable groups were less likely to be sports club members. Migrants and children with unemployed parents are at risk for excessive ST and all vulnerable groups have lower odds of being sports club members.
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36.
  • Lauria, F., et al. (författare)
  • A common variant and the transcript levels of MC4R gene are associated with adiposity in children: The IDEFICS study
  • 2016
  • Ingår i: Journal of Clinical Endocrinology and Metabolism. - : The Endocrine Society. - 0021-972X .- 1945-7197. ; 101:11, s. 4229-4236
  • Tidskriftsartikel (refereegranskat)abstract
    • Context: The melanocortin-4 receptor gene (MC4R) plays a pivotal role in the regulation of body fat and food and energy intake. Objectives: The objectives of the study were as follows: 1) to evaluate the association of variants rs17782313 and rs17700633 near the coding region of MC4R and 2) to evaluate the association of the transcript levels of MC4R with adiposity indices and percentage of energy from fat, carbohydrates, and protein in children. Design: The Identification and Prevention of Dietary-and Lifestyle-Induced Health Effects in Children and Infants (IDEFICS) cohort was used, with examinations at baseline (T0) and after 2 years (T1). Setting and Participants: A total of 16 228 schoolchildren (2-9 y) from eight European countries participated in the study. A random sample of 4381 children genotyped for MC4R variants and a subsample of 410 children with MC4R expression data in peripheral blood cells (PBCs) were included in the analyses. Main Outcome Measures: Anthropometric measures and energy intake (total and from fat, carbohydrates, and protein) served as outcomes for adiposity status and for dietary behavior, respectively. Results: At T0, the C allele of rs17782313 (minor frequency allele 23%) was significantly associated with higher values of adiposity indices (all P<.001).Noassociation was found between rs17700633 (minor frequency allele 28%) and the variables under study. At T1, the C allele of rs17782313 was associated with a significantly higher increase in the adiposity indices over time (all P < .05). The MC4R expression levels in PBCs were inversely associated with body fat and energy intake from carbohydrates and directly with energy from fat (all P ≤ .05) but were not influenced by variants rs17782313 and rs17700633. Conclusions: The common variant rs17782313 near MC4R was cross-sectionally and longitudinally associated with body mass index and measures of body fatness in children aged 2-9 years. We showed, for the first time in humans, that MC4R expression levels in PBCs are related to body fat distribution and percentage of energy intake from carbohydrates and fat. (J Clin Endocrinol Metab 101: 4229-4236, 2016). Copyright © 2016 by the Endocrine Society.
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37.
  • Mårild, Staffan, et al. (författare)
  • Parental perceptions of and concerns about child´s body weight in eight European countries - the IDEFICS study
  • 2014
  • Ingår i: Obesity Reviews. - Chichester : Wiley-Blackwell Publishing Inc.. - 1467-7881 .- 1467-789X. ; 15:S2, s. 105-105
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Few studies have studied parental perceptions in different settings of their children's weight in relation to objective measurements.Aim: To evaluate parental perceptions of their child's weight category in relation to anthropometric measurements.Key Methods: This was cross-sectional study of 16 220 children, 2–9 year of age, from eight European countries. Parents completed a questionnaire on their perception of the children's weight and concern for future weight deviations. Objective children's weight categories from the International Obesity Task Force were used.Results: Parental weight perception corresponded overall to children's mean body mass index (BMI) z-scores, but there were exceptions, e.g. 63% of parents to children with overweight marked ‘proper weight’. One-third of the total indicated concern for future underweight, most often in parents of children in the overweight category. The strongest predictor for accurate parental weight perception for children with overweight and obesity was BMI z-score (odds ratio [OR] 7.2, 95% confidence interval [CI] 6.1–8.7). Compared to Southern Europe, ORs for accurate parental weight perception were 4.4 (95% CI 3.3–6.0) in Northern Europe and 3.4 (95% CI 2.7–4.2) in Central Europe.Conclusion: Parents of children categorized as being overweight or obese systematically underestimated weight category. Parents differed regionally in accurate perception of weight.
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38.
  • Nagy, P, et al. (författare)
  • Percentile reference values for anthropometric body composition indices in European children from the IDEFICS study.
  • 2014
  • Ingår i: International journal of obesity (2005). - : Springer Science and Business Media LLC. - 1476-5497 .- 0307-0565. ; 38:Suppl 2
  • Tidskriftsartikel (refereegranskat)abstract
    • To characterise the nutritional status in children with obesity or wasting conditions, European anthropometric reference values for body composition measures beyond the body mass index (BMI) are needed. Differentiated assessment of body composition in children has long been hampered by the lack of appropriate references.
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39.
  • Nappo, A, et al. (författare)
  • Analysis of the association of leptin and adiponectin concentrations with metabolic syndrome in children: Results from the IDEFICS study.
  • 2017
  • Ingår i: Nutrition, metabolism, and cardiovascular diseases : NMCD. - : Elsevier BV. - 1590-3729 .- 0939-4753. ; 27:6, s. 543-551
  • Tidskriftsartikel (refereegranskat)abstract
    • Adipokines may play a role in the pathogenesis of the metabolic syndrome (MetS) in children. We aimed to evaluate the association of leptin, adiponectin, and its ratio (L/A ratio) with the metabolic syndrome (MetS) in a subsample of the IDEFICS (Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS) cohort.Leptin, adiponectin and MetS parameters were measured in a subsample of 1253 children (3-9.9 years) participating to the IDEFICS study, grouped as: Non-OW (underweight/normal weight) and OW/Ob (overweight/obese). MetS was defined using the sex- and age-specific cut-offs based on the distribution of MetS components in the IDEFICS cohort. The prevalence of the MetS among OW/Ob was 24.8% and 27.1% in boys and girls respectively, whereas ≤2% among Non-OW. OW/Ob had significantly higher leptin and L/A ratio as compared to Non-OW. Significantly higher leptin was found in OW/Ob with MetS as compared with OW/Ob without MetS. Significantly lower adiponectin was observed only in OW/Ob girls as compared to Non-OW. A 1SD increase in leptin and L/A ratio z-scores or a 1SD decrease in adiponectin z-score were significantly associated with higher risk of MetS. After adjustment for BMI or body fat mass (BFM) the association remained significant only for leptin.We showed that in European children, higher leptin concentration is associated with MetS, even after adjusting for BMI or BFM, confirming an early role of leptin in MetS, while the association of adiponectin with MetS seems be mediated by body fat in this age range.
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40.
  • Priego, T., et al. (författare)
  • Influence of breastfeeding on blood-cell transcript-based biomarkers of health in children
  • 2014
  • Ingår i: Pediatric Obesity. - : Wiley. - 2047-6310 .- 2047-6302. ; 9:6, s. 463-470
  • Tidskriftsartikel (refereegranskat)abstract
    • What is already known about this subject The expression of specific genes in peripheral blood cells (PBCs) may be used as biomarkers of the metabolic status. High levels of expression of CPT1A, SLC27A2, INSR, LEPR, FASN and PPAR in PBCs are indicative of a lower risk for the insulin resistant or dyslipidaemic state associated with obesity in children. Breastfeeding seems to confer protective effects against obesity and its related metabolic problems. What this study adds Children who had been breastfed showed higher expression levels of SLC27A2, FASN, PPAR and INSR in PBCs compared with formula-fed subjects. The relationship of the PBC transcript levels of SLC27A2, INSR, FASN and PPAR with insulin resistance and dyslipidaemia may be dependent on the type of infant feeding (breast vs. formula). The transcript levels of the mentioned biomarkers could be useful to distinguish the formula-fed children who are at higher risk of metabolic alterations. BackgroundBlood-cell transcripts have showed to be good biomarkers of metabolic alterations and their use in early detection and prevention of future disorders is promising. ObjectiveThis study aimed to examine the relation between previously proposed transcriptional biomarkers of metabolic health (SLC27A2, CPT1A, FASN, PPAR, INSR, LEPR) in peripheral blood cells and the type of infant feeding in a subset of children from the IDEFICS (Identification and Prevention of Dietary- and Lifestyle-Induced Health Effects in Children and Infants) cohort. SubjectsA total of 237 children aged 2-9 years from eight European countries were studied. ResultsBreastfed children showed higher expression levels of SLC27A2, FASN, PPAR and INSR, and lower risk of being overweight and of having high plasma triglyceride levels vs. formula-fed children. Besides, overweight formula-fed children presented higher HOMA-index than overweight breastfed children (1.90 vs. 1.62); however, this negative effect was absent in formula-fed children with high expression of SLC27A2. Moreover, formula-fed children with low expression of SLC27A2, FASN, PPAR and INSR presented higher triglyceride levels than subjects with high expression of these genes (77.7mgdL(-1) vs. 44.8mgdL(-1)). This difference was absent in breastfed children. ConclusionsProtective effects of breastfeeding are reflected in higher expression levels of SLC27A2, FASN, PPAR and INSR in blood cells. These biomarkers may also serve to discriminate the formula-fed children that are at higher risk of metabolic alterations.
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41.
  • Reeske, A., et al. (författare)
  • Migrant Background and Weight Gain in Early Infancy: Results from the German Study Sample of the IDEFICS Study
  • 2013
  • Ingår i: Plos One. - : Public Library of Science (PLoS). - 1932-6203. ; 8:4
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: To examine variations in infant weight gain between children of parents with and without migrant background and to investigate how these differences are explained by pre- and perinatal factors. Methods: We used data on birth weight and weight at six months from well-child check-up books that were collected from a population-based German sample of children in the IDEFICS study (n = 1,287). We calculated unadjusted and adjusted means for weight z-scores at birth and six months later. We applied linear regression for change in weight z-score and we calculated odds ratios and 95% confidence intervals (95% CI) for rapid weight gain by logistic regression, adjusted for biological, social and behavioural factors. Results: Weight z-scores for migrants and Germans differed slightly at birth, but were markedly increased for Turkish and Eastern European infants at age six months. Turkish infants showed the highest change in weight z-score during the first 6 months (beta = 0.35; 95% CI 0.14-0.56) and an increased probability of rapid weight gain compared with German infants. Examination of the joint effect of migrant and socioeconomic status (SES) showed the greatest change in weight z-scores in Turkish infants from middle SES families (beta = 0.77; 95% CI 0.40-1.14) and infants of parents from Eastern European countries with high SES (beta = 0.72; 95% CI 0.13-1.32). Conclusions: Our results support the hypothesis that migrant background is an independent risk factor for infant weight gain and suggest that the onset of health inequalities in overweight starts in early infancy.
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42.
  • Regber, Susann, 1956-, et al. (författare)
  • Parental perceptions of and concerns about child's body weight in eight European countries – the IDEFICS study
  • 2013
  • Ingår i: Pediatric Obesity. - Chichester : Wiley-Blackwell. - 2047-6302 .- 2047-6310. ; 8:2, s. 118-129
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVES: To evaluate parental perceptions of and concern about child's body weight and general health in children in a European cohort.DESIGN: Cross-sectional multi-centre study in eight European countries.PARTICIPANTS: 16,220 children, ages 2-9 years.METHODS: Parents completed a questionnaire regarding children's health and weight and concern about overweight and underweight. Objective children's weight categories from the International Obesity Task Force were used. Logistic regression models were utilized to identify predictors of accurate weight perception.RESULTS: Parental weight perception corresponded overall to children's mean body mass index (BMI) z-scores, with important exceptions. About one-third of the total indicated concern about underweight, paradoxically most often parents of children in the overweight or obesity categories. In 63%, parents of children in the overweight category marked 'proper weight'. The strongest predictor for accurate parental weight perception for children with overweight and obesity was BMI z-score (odds ratio [OR] = 7.2, 95% confidence interval [CI] 6.1-8.7). Compared to Southern Europe, ORs for accurate parental weight perception were 4.4 (95% CI 3.3-6.0) in Northern Europe and 3.4 (95% CI 2.7-4.2) in Central Europe.CONCLUSION: Parents of children categorized as being overweight or obese systematically underestimated weight. Parents differed regionally regarding accurate weight perception and concern about overweight and underweight.
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43.
  • Santaliestra-Pasias, AM, et al. (författare)
  • Physical activity and sedentary behaviour in European children: the IDEFICS study.
  • 2014
  • Ingår i: Public Health Nutrition. - 1368-9800. ; 17:10, s. 2295-2306
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: To estimate the prevalence of physical activity and sedentary behaviours in European children, and to evaluate the relationship between media availability in personal space and physical activity in relation to total screen time. DESIGN: Data from the baseline IDEFICS (Identification and prevention of dietary- and lifestyle-induced health effects in children and infants) cross-sectional survey. Information on hours of television/digital video disk/video viewing and computer/games-console use (weekday and weekend days), media device availability in personal space, sports club membership, hours of active organized play and commuting (to and from school) were assessed via a self-reported parental questionnaire. Total screen time was defined as the sum of daily media use and subsequently dichotomized into meeting or not meeting the guidelines of the American Academy of Pediatrics. SETTING: Eight survey centres (Italy, Estonia, Cyprus, Belgium, Sweden, Germany, Hungary and Spain). SUBJECTS: Children (n 15 330; 51 % males) aged 2-10 years. RESULTS: Percentage of children engaged in total screen time for >2 h/d was higher on weekend days (52 % v. 20 % on weekdays) and in the older group (71 % in males; 57 % in females), varying by country. Children with a television set in their bedroom were more likely not to meet the screen time recommendations (OR = 1·54; 95 % CI 1·60, 1·74). CONCLUSIONS: Approximately a third of the children failed to meet current screen time recommendations. Availability of a television set in personal space increased the risk of excess total screen time. This information could be used to identify potential targets for public health promotion actions of young population groups.
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44.
  • Stomfai, S, et al. (författare)
  • Intra- and inter-observer reliability in anthropometric measurements in children.
  • 2011
  • Ingår i: International journal of obesity (2005). - : Springer Science and Business Media LLC. - 1476-5497 .- 0307-0565. ; 35 Suppl 1
  • Tidskriftsartikel (refereegranskat)abstract
    • Studies such as IDEFICS (Identification and prevention of dietary- and lifestyle-induced health effects in children and infants) seek to compare data across several different countries. Therefore, it is important to confirm that body composition indices, which are subject to intra- and inter-individual variation, are measured using a standardised protocol that maximises their reliability and reduces error in analyses.
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45.
  • Vyncke, K, et al. (författare)
  • Validation of the Diet Quality Index for Adolescents by comparison with biomarkers, nutrient and food intakes : the HELENA study
  • 2013
  • Ingår i: British Journal of Nutrition. - 0007-1145 .- 1475-2662. ; 109:11, s. 2067-2078
  • Tidskriftsartikel (refereegranskat)abstract
    • Food-based dietary guidelines (FBDG) aim to address the nutritional requirements at population level in order to prevent diseases and promote a healthy lifestyle. Diet quality indices can be used to assess the compliance with these FBDG. The present study aimed to investigate whether the newly developed Diet Quality Index for Adolescents (DQI-A) is a good surrogate measure for adherence to FBDG, and whether adherence to these FBDG effectively leads to better nutrient intakes and nutritional biomarkers in adolescents. Participants included 1804 European adolescents who were recruited in the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) Study. Dietary intake was assessed by two, non-consecutive 24 h recalls. A DQI-A score, considering the components' dietary quality, diversity and equilibrium, was calculated. Associations between the DQI-A and food and nutrient intakes and blood concentration biomarkers were investigated using multilevel regression analysis corrected for centre, age and sex. DQI-A scores were associated with food intake in the expected direction: positive associations with nutrient-dense food items, such as fruits and vegetables, and inverse associations with energy-dense and low-nutritious foods. On the nutrient level, the DQI-A was positively related to the intake of water, fibre and most minerals and vitamins. No association was found between the DQI-A and total fat intake. Furthermore, a positive association was observed with 25-hydroxyvitamin D, holo-transcobalamin and n-3 fatty acid serum levels. The present study has shown good validity of the DQI-A by confirming the expected associations with food and nutrient intakes and some biomarkers in blood.
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