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1.	Lauria, F., et al. (författare) Ultra-processed foods consumption and diet quality of European children, adolescents and adults: Results from the I.Family study 2021 Ingår i: Nutrition Metabolism and Cardiovascular Diseases. - : Elsevier BV. - 0939-4753. ; 31:11, s. 3031-3043 Tidskriftsartikel (refereegranskat)abstract Background and aims: Food processing has been indicated as a factor capable of negatively affecting the global food system, including the profile of consumers' diets. The objectives of the present study were to provide a description of the consumption of ultra-processed foods (UPFs) in the large population of children, adolescents and adults from eight European countries participating to the I.Family study, and to investigate the association between UPFs intake and nutritional quality of the diet. Methods and results: Dietary intake was assessed using a 24-h dietary recall. The quality of the diet was evaluated by the Healthy Dietary Adherence Score (HDAS) using an FFQ. UPFs were classified according to the NOVA classification. Almost half of the daily energy intake of the 7073 participants came from UPFs, and this trend decreased progressively with age. UPFs contributed more than 50 % of the daily intake of total and saturated fat, carbohydrates and about 70 % of sugars intake in children and adolescents. No differences in UPFs consumption were found according to the educational and socio-economic status of the population. Energy intake increased across the quintiles of UPFs intake, while HDAS decreased. The frequency of consumption of fruit and vegetable, fish, and fibre rich foods was low in the fifth quintile of UPFs intake, both in adolescents and in adults. The consumption of foods rich in calories and low in nutritional content, operationally defined as "junk food", was significantly higher in the fifth quintile. Conclusions: In the population of the European I.Family study, UPFs contributed a large proportion of the daily energy intake, especially in children and adolescents. Higher consumption of UPFs was associated with a lower quality of the diet. Registration number for clinical trials: ISRCTN62310987. 2021 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.
2.	Ahrens, W., et al. (författare) Cohort Profile : The transition from childhood to adolescence in European children-how I.Family extends the IDEFICS cohort 2017 Ingår i: International Journal of Epidemiology. - : Oxford University Press. - 0300-5771 .- 1464-3685. ; 46:5, s. 1394-1395 Tidskriftsartikel (refereegranskat)
3.	Coumans, J. M. J., et al. (författare) Emotion-driven impulsiveness and snack food consumption of European adolescents: Results from the I.Family study 2018 Ingår i: Appetite. - : Elsevier BV. - 0195-6663 .- 1095-8304. ; 123, s. 152-159 Tidskriftsartikel (refereegranskat)abstract We aimed to investigate the association between emotion-driven impulsiveness and snack food consumption in 1039 European adolescents aged 12–18 years. During the cross-sectional examination in 2013/2014, complete information was collected on: emotion-driven impulsiveness (using the negative urgency subscale from the Urgency, Premeditation, Perseverance, Sensation seeking, and Positive urgency (UPPS-P) Impulsive Behaviour Scale) and snacking behaviour operationalised as 1) consumption frequency of daily snacks, 2) consumption frequency of energy-dense snacks (both measured using Food Frequency Questionnaire) and 3) usual energy intake of food consumed per snacking occasion in calories. The latter was measured using online self-administered 24-h dietary recalls and was estimated based on the National Cancer Institute (NCI) Method. Anthropometric variables were measured and BMI z-score (zBMI) calculated. Age, sex, highest education level of the family and country of residence were assessed using a questionnaire. Mixed-effect regression analyses were separately conducted for each snacking behaviour outcome with emotion-driven impulsiveness as the exposure. After controlling for zBMI, age, sex, country and socioeconomic status, emotion-driven impulsiveness was positively associated with daily consumption frequency of snacks (β = 0.07, 95% Confidence Interval (CI) [0.02, 0.12]) and consumption frequency of energy-dense snacks (β = 0.25, 95% CI [0.19, 0.31]), but not with usual energy intake of food per snacking (β = 2.52, 95% CI [-0.55, 5.59]). Adolescents with a stronger emotion-driven impulsiveness tendency reported a higher snacking frequency and specifically more energy-dense snacks, whereas the energy intake of snack food seemed less important. These findings have implications for obesity prevention and treatment as they indicate the importance of targeting emotion-driven impulsiveness as a strategy to avoid excessive snacking.
4.	Coumans, J. M. J., et al. (författare) Emotion-driven impulsiveness but not decision-making ability and cognitive inflexibility predicts weight status in adults 2019 Ingår i: Appetite. - : Elsevier BV. - 0195-6663. ; 142 Tidskriftsartikel (refereegranskat)abstract In this study we aimed to determine whether decision-making ability, cognitive inflexibility and emotion-driven impulsiveness are associated with weight status as expressed by body mass index (BMI), percentage body fat, waist circumference and skinfold thickness in adults from eight different European countries taking part in the I.Family study. The Bechara Gambling Task was used to assess decision-making ability (n = 1717). The Berg Card Sorting Test was used to measure cognitive inflexibility (n = 1509). Lastly, the negative urgency subscale from the UPPS-P Impulsive Behavior Scale was used to measure emotion-driven impulsiveness (n = 4450). Hierarchical regression analyses showed that more emotion-driven impulsiveness was statistically significantly associated with a higher BMI, a higher percentage body fat, and a larger waist circumference in adults, controlling for age, sex, socioeconomic status, country and binge eating; but not with skinfold thickness. Cognitive inflexibility and decision-making ability were not statistically significantly associated with any of the weight status related variables. These results support that impulsivity in response to negative emotions, but not decision-making ability or cognitive inflexibility, is associated with the susceptibility to excessive weight (as indicated by a higher BMI, a higher percentage body fat, and a larger waist circumference). In people behaving impulsively when emotional, focusing on reducing negative affect or improving coping skills is of interest in interventions targeting obesity. Clinical trial registration: The I.Family study is registered in the ISRCTN registry (ISRCTN62310987) on February 23, 2018. © 2019
5.	Coumans, J M J, et al. (författare) The association of emotion-driven impulsiveness, cognitive inflexibility and decision-making with weight status in European adolescents. 2018 Ingår i: International journal of obesity (2005). - : Springer Science and Business Media LLC. - 1476-5497 .- 0307-0565. ; 42, s. 655-661 Tidskriftsartikel (refereegranskat)abstract to explore the association between emotion-driven impulsiveness, cognitive inflexibility, decision-making and with weight status as reflected in BMI z-score (zBMI) in European adolescents.In total 3 354 adolescent aged between 12 and 18 years from the I.Family cohort completed the questionnaire based negative urgency subscale from the UPPS-P Impulsive Behavior Scale to measure emotion-driven impulsiveness in 2013/2014. Furthermore, 1 584 adolescents completed the computer-based Bergs Card Sorting Test to measure cognitive inflexibility, and 1 780 adolescents completed the Hungry Donkey Test to assess decision-making ability. Anthropometric variables were measured objectively; confounding variables (age, sex, socioeconomic status and country) were assessed using a questionnaire. Mixed-effect regression analyses were conducted for each outcome of the test or questionnaire as a predictor with standardised body mass index (zBMI) as the dependent variable in order to investigate association between markers of cognitive functioning and zBMI.After controlling for confounders, results showed that emotion-driven impulsiveness (β=0.18, 95% CI: 0.13 to 0.24, P<0.001), and cognitive inflexibility (β=0.01, 95% CI: 0.002 to 0.02, P=0.016) were positively associated with zBMI. However, decision-making ability was not significantly related to zBMI (β=0.00, 95% CI: -0.001 to 0.003, P=0.47).More emotion-driven impulsiveness and reduced cognitive flexibility were associated with a higher zBMI in adolescents across Europe. These results may indicate that being impulsive in negative situations and having difficulties changing mental sets increase the susceptibility for unhealthy weight development. Reducing impulsivity and training cognitive flexibility seem promising targets for the prevention and intervention programs of obesity.International Journal of Obesity accepted article preview online, 01 November 2017. doi:10.1038/ijo.2017.270.
6.	Gwozdz, W., et al. (författare) Peer Effects on Weight Status, Dietary Behaviour and Physical Activity among Adolescents in Europe: Findings from the I.Family Study 2019 Ingår i: Kyklos. - : Wiley. - 0023-5962 .- 1467-6435. ; 72:2, s. 270-296 Tidskriftsartikel (refereegranskat)abstract This study uses survey data from the I. Family Study to investigate the association between adolescent and peer overweight in a sample of adolescents aged 12-16 from six European countries. We find clear evidence of peer effects on body mass index, waist circumference, and body fat, which are stronger among adolescents at the upper end of overweight distribution. We also provide evidence that both consumption of less healthy foods and time spent in leisure time physical activity and audio-visual media are positively associated with similar behaviours among friends. These observations may suggest that peer effects on adolescent overweight operate by influencing friends' behaviour patterns, especially unhealthy food consumption and physical in) activity.
7.	Hebestreit, A., et al. (författare) Dietary Patterns of European Children and Their Parents in Association with Family Food Environment: Results from the I.Family Study 2017 Ingår i: Nutrients. - : MDPI AG. - 2072-6643. ; 9:2 Tidskriftsartikel (refereegranskat)abstract The aim of this study was to determine whether an association exists between children's and parental dietary patterns (DP), and whether the number of shared meals or soft drink availability during meals strengthens this association. In 2013/2014 the I. Family study cross-sectionally assessed the dietary intakes of families from eight European countries using 24-h dietary recalls. Usual energy and food intakes from six-to 16-year-old children and their parents were estimated based on the NCI Method. A total of 1662 child-mother and 789 child-father dyads were included; DP were derived using cluster analysis. We investigated the association between children's and parental DP and whether the number of shared meals or soft drink availability moderated this association using mixed effects logistic regression models. Three DP comparable in children and parents were obtained: Sweet & Fat, Refined Cereals, and Animal Products. Children were more likely to be allocated to the Sweet & Fat DP when their fathers were allocated to the Sweet & Fat DP and when they shared at least one meal per day (OR 3.18; 95% CI 1.84; 5.47). Being allocated to the Sweet & Fat DP increased when the mother or the father was allocated to the Sweet & Fat DP and when soft drinks were available (OR 2.78; 95% CI 1.80; 4.28 or OR 4.26; 95% CI 2.16; 8.41, respectively). Availability of soft drinks and negative parental role modeling are important predictors of children's dietary patterns.
8.	Iacomino, G., et al. (författare) The association of circulating miR-191 and miR-375 expression levels with markers of insulin resistance in overweight children: an exploratory analysis of the I.Family Study 2021 Ingår i: Genes and Nutrition. - : Springer Science and Business Media LLC. - 1555-8932 .- 1865-3499. ; 16:1 Tidskriftsartikel (refereegranskat)abstract Background: In recent years, the exciting emergence of circulating miRNAs as stable, reproducible, and consistent among individuals has opened a promising research opportunity for the detection of non-invasive biomarkers. A firm connection has been established between circulating miRNAs and glycaemic as well as metabolic homeostasis, showing that levels of specific miRNAs vary under different physio-pathological conditions. Objective: In this pilot study, we investigated the expression of candidate miRNAs, hsa-miR-191-3p and hsa-miR-375, in relation to biomarkers associated with insulin sensitivity in a subgroup (n=58) of subjects participating to the European I.Family Study, a project aimed to assess the determinants of eating behaviour in children and adolescents and related health outcomes. The sample included overweight/obese children/adolescents since overweight/obesity is a known risk factor for impaired glucose homeostasis and metabolic disorders. Biological targets of candidate miRNAs were also explored in silico. Results: We observed a significant association of the two miRNAs and early changes in glycaemic homeostasis, independent of covariates including country of origin, age, BMI z-score, puberty status, highest educational level of parents, total energy intake, energy from fats, energy from carbohydrates, and energy from proteins. Conclusion: Identification of circulating miRNAs associated with insulin impairment may offer novel approaches of assessing early variations in insulin sensitivity and provide evidence about the molecular mechanisms connected to early changes in glycaemic homeostasis. Trial registration: ISRCTN, ISRCTN62310987. Retrospectively registered, http://isrctn.com/ISRCTN62310987 © 2021, The Author(s).
9.	Lauria, F., et al. (författare) Circulating miRNAs Are Associated with Inflammation Biomarkers in Children with Overweight and Obesity: Results of the I.Family Study 2022 Ingår i: Genes. - : MDPI AG. - 2073-4425. ; 13:4 Tidskriftsartikel (refereegranskat)abstract Increasing data suggest that overnutrition-induced obesity may trigger an inflammatory process in adipose tissue and upturn in the innate immune system. Numerous players have been involved in governing the inflammatory response, including epigenetics. Among epigenetic players, miRNAs are emerging as crucial regulators of immune cell development, immune responses, autoimmunity, and inflammation. In this study, we aimed at identifying the involvement of candidate miRNAs in relation to inflammation-associated biomarkers in a subsample of European children with overweight and obesity participating in the I.Family study. The study sample included individuals with increased adiposity since this condition contributes to the early occurrence of chronic low-grade inflammation. We focused on the acute-phase reagent C-reactive protein (CRP) as the primary outcome and selected cytokines as plausible biomarkers of inflammation. We found that chronic low-grade CRP elevation shows a highly significant association with miR-26b-3p and hsa-miR-576-5p in boys. Furthermore, the association of CRP with hsa-miR-10b-5p and hsa-miR-31-5p is highly significant in girls. We also observed major sex-related associations of candidate miRNAs with selected cytokines. Except for IL-6, a significant association of hsa-miR-26b-3p and hsa-miR-576-5p with TNF-alpha, IL1-Ra, IL-8, and IL-15 levels was found exclusively in boys. The findings of this exploratory study suggest sex differences in the association of circulating miRNAs with inflammatory response biomarkers, and indicate a possible role of miRNAs among the candidate epigenetic mechanisms related to the process of low-grade inflammation in childhood obesity.
10.	Lissner, Lauren, 1956, et al. (författare) Familial Resemblance in Dietary Intakes of Children, Adolescents, and Parents: Does Dietary Quality Play a Role? 2017 Ingår i: Nutrients. - : MDPI AG. - 2072-6643. ; 9:8 Tidskriftsartikel (refereegranskat)abstract Information on familial resemblance is important for the design of effective family-based interventions. We aimed to quantify familial correlations and estimate the proportion of variation attributable to genetic and shared environmental effects (i.e., familiality) for dietary intake variables and determine whether they vary by generation, sex, dietary quality, or by the age of the children. The study sample consisted of 1435 families (1007 mothers, 438 fathers, 1035 daughters, and 1080 sons) from the multi-center I. Family study. Dietary intake was assessed in parents and their 2-19 years old children using repeated 24-h dietary recalls, from which the usual energy and food intakes were estimated with the U.S. National Cancer Institute Method. Food items were categorized as healthy or unhealthy based on their sugar, fat, and fiber content. Interclass and intraclass correlations were calculated for relative pairs. Familiality was estimated using variance component methods. Parent-offspring (r = 0.11-0.33), sibling (r = 0.21-0.43), and spouse (r = 0.15-0.33) correlations were modest. Parent-offspring correlations were stronger for the intake of healthy (r = 0.33) than unhealthy r = 0.10) foods. Familiality estimates were 61% (95% CI: 54-68%) for the intake of fruit and vegetables and the sum of healthy foods and only 30% (95% CI: 23-38%) for the sum of unhealthy foods. Familial factors explained a larger proportion of the variance in healthy food intake (71%; 95% CI: 62-81%) in younger children below the age of 11 than in older children equal or above the age of 11 (48%; 95% CI: 38-58%). Factors shared by family members such as genetics and/or the shared home environment play a stronger role in shaping children's intake of healthy foods than unhealthy foods. This suggests that family-based interventions are likely to have greater effects when targeting healthy food choices and families with younger children, and that other sorts of intervention are needed to address the intake of unhealthy foods by children.
11.	Masip, G., et al. (författare) The temporal relationship between parental concern of overeating and childhood obesity considering genetic susceptibility: longitudinal results from the IDEFICS/I.Family study 2021 Ingår i: International Journal of Behavioral Nutrition and Physical Activity. - : Springer Science and Business Media LLC. - 1479-5868. ; 18:1 Tidskriftsartikel (refereegranskat)abstract Background: Many genes and molecular pathways are associated with obesity, but the mechanisms from genes to obesity are less well known. Eating behaviors represent a plausible pathway, but because the relationships of eating behaviors and obesity may be bi-directional, it remains challenging to resolve the underlying pathways. A longitudinal approach is needed to assess the contribution of genetic risk during the development of obesity in childhood. In this study we aim to examine the relationships between the polygenic risk score for body mass index (PRS-BMI), parental concern of overeating and obesity indices during childhood. Methods: The IDEFICS/I.Family study is a school-based multicenter pan-European cohort of children observed for 6 years (mean +/- SD follow-up 5.8 +/- 0.4). Children examined in 2007/2008 (wave 1) (mean +/- SD age: 4.4 +/- 1.1, range: 2-9 years), in 2009/2010 (wave 2) and in 2013/2014 (wave 3) were included. A total of 5112 children (49% girls) participated at waves 1, 2 and 3. For 2656 children with genome-wide data we constructed a PRS based on 2.1 million single nucleotide polymorphisms. Z-score BMI and z-score waist circumference (WC) were assessed and eating behaviors and relevant confounders were reported by parents via questionnaires. Parental concern of overeating was derived from principal component analyses from an eating behavior questionnaire. Results: In cross-lagged models, the prospective associations between z-score obesity indices and parental concern of overeating were bi-directional. In mediation models, the association between the PRS-BMI and parental concern of overeating at wave 3 was mediated by baseline z-BMI (beta = 0.16, 95% CI: 0.10, 0.21) and baseline z-WC (beta = 0.17, 95% CI: 0.11, 0.23). To a lesser extent, baseline parental concern of overeating also mediated the association between the PRS-BMI and z-BMI at wave 3 (beta = 0.10, 95% CI: 0.07, 0.13) and z-WC at wave 3 (beta = 0.09, 95% CI: 0.07, 0.12). Conclusions: The findings suggest that the prospective associations between obesity indices and parental concern of overeating are likely bi-directional, but obesity indices have a stronger association with future parental concern of overeating than vice versa. The findings suggest parental concern of overeating as a possible mediator in the genetic susceptibility to obesity and further highlight that other pathways are also involved. A better understanding of the genetic pathways that lead to childhood obesity can help to prevent weight gain.
12.	Svensson, A., et al. (författare) European children's sugar intake on weekdays versus weekends: the IDEFICS study 2014 Ingår i: European Journal of Clinical Nutrition. - : Springer Science and Business Media LLC. - 0954-3007 .- 1476-5640. ; 68:7, s. 822-828 Tidskriftsartikel (refereegranskat)abstract OBJECTIVES: To compare the intake of total sugars, foods and drinks rich in added sugar, and energy in children on weekdays (Monday Thursday), Fridays and weekends. METHODS: Dietary intake (g, kJ, energy %) was assessed using a computerized 24-h recall method in a sample of 2- to 9-year-old children from Belgium, Cyprus, Estonia, Germany, Hungary, Italy, Spain and Sweden who were participating in the IDEFICS baseline study (2007-2008). Analyses were performed in 9497 children by selecting one 24-h recall per child (for comparison of weekdays vs weekends, and Fridays vs weekdays and weekends). Selected stratified analyses were performed by country and age group. RESULTS: Intake of total sugars exceeded 20 energy % in all countries but one. In the non-stratified analyses, the intakes of total sugars and foods and drinks rich in added sugar were found to be higher on weekends compared with weekdays (both P < 0.001), and intakes on Fridays were a mix between intakes on weekdays and weekends. Energy intake did not differ between weekdays and weekends. Results were somewhat heterogeneous, both across countries and age groups. CONCLUSIONS: High intake of sugar remains an important nutritional problem in children of many European countries. Interventions aiming to prevent this diet pattern may optimize their impact by targeting dietary habits on Fridays and weekends. Furthermore, when conducting dietary assessment in children, data from weekends and Fridays in combination with a selection of Mondays to Thursdays are needed to capture habitual sugar intake. Age and dietary cultures should also be considered in dietary intervention and assessment as effect modifications were seen for both age and country.
13.	Tognon, Gianluca, 1976, et al. (författare) Mediterranean diet, overweight and body composition in children from eight European countries: Cross-sectional and prospective results from the IDEFICS study. 2014 Ingår i: Nutrition, metabolism, and cardiovascular diseases : NMCD. - : Elsevier BV. - 1590-3729 .- 0939-4753. ; 24:2, s. 205-213 Tidskriftsartikel (refereegranskat)abstract A Mediterranean-like dietary pattern has been shown to be inversely associated with many diseases, but its role in early obesity prevention is not clear. We aimed to determine if this pattern is common among European children and whether it is associated with overweight and obesity.
14.	Arvidsson, Louise, et al. (författare) Fat, sugar and water intakes among families from the IDEFICS intervention and control groups: first observations from I.Family 2015 Ingår i: Obesity Reviews. - : Wiley. - 1467-7881 .- 1467-789X. ; 16:Suppl. 2, s. 127-137 Tidskriftsartikel (refereegranskat)abstract BackgroundThe objective of this paper is to investigate differences in diets of families in intervention versus control communities 5years after the Identification and Prevention of Dietary- and Lifestyle-Induced Health Effects in Children and Infants intervention ended. MethodsAltogether, 4,691 families from the I.Family study with at least one participating parent and one child are included in this analysis. Diet quality indicators, defined as propensities to consume fat, sugar, water and fruit and vegetables, are calculated from a 59-item food frequency questionnaire. Multilevel linear models with random intercepts for study centre are used to determine whether mean diet indicators, calculated at the family level, differed as a function of previous exposure to the intervention. ResultsFamilies in the intervention communities reported a significantly lower sugar propensity (19.8% vs. 20.7% of total food items, p<0.01) and a higher water propensity (47.3% vs. 46.0% of total beverages, p<0.05) compared with families in the control communities, while fat and fruit and vegetables propensities were similar. No significant diet differences between intervention and control children were present at the Identification and Prevention of Dietary- and Lifestyle-Induced Health Effects in Children and Infants baseline. DiscussionThis result indicates better diet quality in intervention families, which was not present in children when their diets were assessed before the intervention, and gives some cause for optimism regarding the sustainability of some aspects of the diet intervention.
15.	Börnhorst, C, et al. (författare) Usual energy and macronutrient intakes in 2-9-year-old European children. 2014 Ingår i: International journal of obesity (2005). - : Springer Science and Business Media LLC. - 1476-5497 .- 0307-0565. ; 38 Suppl 2 Tidskriftsartikel (refereegranskat)abstract Valid estimates of population intakes are essential for monitoring trends as well as for nutritional interventions, but such data are rare in young children. In particular, the problem of misreporting in dietary data is usually not accounted for. Therefore, this study aims to provide accurate estimates of intake distributions in European children.
16.	De Henauw, S, et al. (författare) Blood lipids among young children in Europe: results from the European 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 Measurement of cholesterol and triglyceride (TG) fractions in blood has become standard practice in the early detection of atherosclerotic disease pathways. Considerable attention is given nowadays to the presence of these risk factors in children and to start preventive campaigns early in life. In this context, it is imperative to have valid comparative frameworks for interpretation of lipid levels. The aim of this study is to present sex- and age-specific reference values on blood lipid levels in European children aged 2.0-10.9 years.
17.	Do, S., et al. (författare) Associations Between Psychosocial Well-Being, Stressful Life Events and Emotion-Driven Impulsiveness in European Adolescents 2022 Ingår i: Journal of Youth and Adolescence. - : Springer Science and Business Media LLC. - 0047-2891 .- 1573-6601. ; 51, s. 1106-1117 Tidskriftsartikel (refereegranskat)abstract Knowing the extent to which mental well-being and stressful life events during adolescence contribute to personality characteristics related to risk-taking behaviors, such as emotion-driven impulsiveness, is highly relevant for the development of health promotion measures. This study examined whether psychosocial well-being and different stressful life events are associated with emotion-driven impulsiveness. In total, 3,031 adolescents (52% girls; M-age = 13.6 years) were included from the I. Family Study, a cross-sectional examination on lifestyle-related behaviors conducted across eight European countries in 2013/14. Linear mixed-effects regression models showed that higher psychosocial well-being was associated with lower emotion-driven impulsiveness independent of socio-demographic, health-related, and parental variables. A higher number of stressful life events was associated with higher emotion-driven impulsiveness. Psychosocial well-being and stressful life events need to be further considered in the development and tailoring of health promotion strategies that aim to reduce emotion-driven impulsiveness.
18.	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.
19.	Jilani, H., et al. (författare) Relative validity of a food and beverage preference questionnaire to characterize taste phenotypes in children adolescents and adults 2019 Ingår i: Nutrients. - : MDPI AG. - 2072-6643. ; 11:7 Tidskriftsartikel (refereegranskat)abstract To assess the relative validity of our food and beverage preference questionnaire we investigated the association between sweet and fatty taste preference scores (assessed using a food and beverage preference questionnaire) and sweet and fatty food propensity scores (derived from a food frequency questionnaire). In I.Family, a large European multi-country cohort study, 12,207 participants from Cyprus, Estonia, Germany, Hungary, Italy, Spain and Sweden, including 5291 adults, 3082 adolescents, and 3834 children, completed a food and beverage preference questionnaire with 63 items. Cumulative preference scores for sweet and fatty taste were calculated from the single item ranking ranging from 1 to 5. The relative consumption frequency of foods classified as sweet and fatty was used to calculate the corresponding consumption propensities, a continuous variable ranging from 0 to 100. We conducted regression analyses to investigate the association between sweet and fatty taste preference scores and sweet and fatty food propensity scores, respectively, separately for adults, adolescents ≥12 years, and for children <12 years. The overall sweet taste preference score was positively associated with the sweet food consumption propensity score (β = 2.4, 95% CI: 2.1;2.7) and the fatty taste preference score was positively associated with the fatty food consumption propensity score (β = 2.0, 95% CI: 1.8;2.2). After stratification for age (children <12 years, adolescents ≥12 years, and adults), the effect remained significant in all age groups and was strongest in adolescents and adults. We conclude that our food and beverage preference questionnaire is a useful instrument for epidemiological studies on sensory perception and health outcomes and for the characterization of sensory taste phenotypes. © 2019 by the authors. Licensee MDPI, Basel, Switzerland.
20.	Lanfer, A., et al. (författare) Reproducibility of food consumption frequencies derived from the Children's Eating Habits Questionnaire used in the IDEFICS study 2011 Ingår i: International Journal of Obesity. - : Nature Publishing Group. - 0307-0565 .- 1476-5497. ; 35, s. S61-S68 Tidskriftsartikel (refereegranskat)abstract Objective: To investigate the reproducibility of food consumption frequencies derived from the food frequency section of the Children's Eating Habits Questionnaire (CEHQ-FFQ) that was developed and used in the IDEFICS (Identification and prevention of dietary-and lifestyle-induced health effects in children and infants) project to assess food habits in 2- to 9-year-old European children. Design and methods: From a subsample of 258 children who participated in the IDEFICS baseline examination, parental questionnaires of the CEHQ were collected twice to assess reproducibility of questionnaire results from 0 to 354 days after the first examination. Weighted Cohen's kappa coefficients (kappa) and Spearman's correlation coefficients (r) were calculated to assess agreement between the first and second questionnaires for each food item of the CEHQ-FFQ. Stratification was performed for sex, age group, geographical region and length of period between the first and second administrations. Fisher's Z transformation was applied to test correlation coefficients for significant differences between strata. Results: For all food items analysed, weighted Cohen's kappa coefficients (kappa) and Spearman's correlation coefficients (r) were significant and positive (P < 0.001). Reproducibility was lowest for diet soft drinks (kappa = 0.23, r = 0.32) and highest for sweetened milk (kappa = 0.68, r = 0.76). Correlation coefficients were comparable to those of previous studies on FFQ reproducibility in children and adults. Stratification did not reveal systematic differences in reproducibility by sex and age group. Spearman's correlation coefficients differed significantly between northern and southern European countries for 10 food items. In nine of them, the lower respective coefficient was still high enough to conclude acceptable reproducibility. As expected, longer time (> 128 days) between the first and second administrations resulted in a generally lower, yet still acceptable, reproducibility. Conclusion: Results indicate that the CEHQ-FFQ gives reproducible estimates of the consumption frequency of 43 food items from 14 food groups in European children. International Journal of Obesity (2011) 35, S61-S68; doi:10.1038/ijo.2011.36
21.	Pala, V., et al. (författare) Dietary patterns and longitudinal change in body mass in European children: a follow-up study on the IDEFICS multicenter cohort 2013 Ingår i: European Journal of Clinical Nutrition. - : Springer Science and Business Media LLC. - 0954-3007 .- 1476-5640. ; 67:10, s. 1042-1049 Tidskriftsartikel (refereegranskat)abstract BACKGROUND/OBJECTIVES: Longitudinal studies investigating dietary patterns (DPs) and their association with childhood overweight/obesity are lacking in Europe. We identified DPs and investigated their association with overweight/obesity and changes in body mass index (BMI) in a cohort of European children. SUBJECTS/METHODS: Children aged 2-10 from eight European countries were recruited in 2007-2008. Food frequency questionnaires were collected from 14 989 children. BMI and BMI z-scores were derived from height and weight and were used to identify overweight/obese children. After 2 years (mean), anthropometric measurements were repeated in 9427 children. Principal component analysis was used to identify DPs. Simplified DPs (SDPs) were derived from DPs. Adjusted odds ratios (ORs) for overweight/obesity with increasing DP intake were estimated using multilevel logistic regression. Associations of BMI change with DP and SDP were assessed by multilevel mixed regression. Models were adjusted for baseline BMI, age, sex, physical activity and family income. RESULTS: Four DPs were identified that explained 25% of food intake variance: snacking, sweet and fat, vegetables and wholemeal, and protein and water. After 2 years, 849(9%) children became overweight/obese. Children in the highest vegetables and wholemeal tertile had lower risk of becoming overweight/obese (OR: 0.69, 95% confidence intervals (CIs): 0.54-0.88). Children in the highest SDP tertile of vegetables and wholemeal had similarly lower risk of becoming overweight/obese (OR: 0.64, 95% CIs: 0.51-0.82), and their BMI increased by 0.7 kg/m(2) over the study period-significantly less than the increase in the lowest tertile (0.84 kg/m(2)). CONCLUSIONS: Our findings suggest that promoting a diet rich in vegetables and wholemeal cereals may counteract overweight/obesity in children.
22.	Pigeot, I., et al. (författare) The IDEFICS intervention trial to prevent childhood obesity: Design and study methods 2015 Ingår i: Obesity Reviews. - : Wiley. - 1467-7881 .- 1467-789X. ; 16, s. 4-15 Tidskriftsartikel (refereegranskat)abstract Introduction: One of the major research dimensions of the Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS (IDEFICS) study involved the development, implementation and evaluation of a setting-based community-oriented intervention programme for primary prevention of childhood obesity. In this supplement of Obesity Reviews, a compilation of key results of the IDEFICS intervention is packaged in a series of complementary papers. Objective: This paper describes the overall design and methods of the IDEFICS intervention in order to facilitate a comprehensive reading of the supplement. In addition, some 'best practice' examples are described. Results: The IDEFICS intervention trial was conducted to assess whether the IDEFICS intervention prevented obesity in young children aged 2 to 9.9years. The study was a non-randomized, quasi-experimental trial with one intervention matched to one control region in each of eight participating countries. The intervention was designed following the intervention mapping framework, using a socio-ecological theoretical approach. The intervention was designed to address several key obesity-related behaviours in children, parents, schools and community actors; the primary outcome was the prevalence of overweight/obesity according to the IOTF criteria based on body mass index. The aim was to achieve a reduction of overweight/obesity prevalence in the intervention regions. The intervention was delivered in school and community settings over a 2-year period. Data were collected in the intervention and control cohort regions at baseline and 2 years later. Conclusion: This paper offers an introductory framework for a comprehensive reading of this supplement on IDEFICS intervention key results. © 2015 World Obesity.
23.	Santaliestra-Pasias, A. M., et al. (författare) Food and beverage intakes according to physical activity levels in European children: the IDEFICS (Identification and prevention of Dietary and lifestyle induced health EFfects In Children and infantS) study 2018 Ingår i: Public Health Nutrition. - : Cambridge University Press (CUP). - 1368-9800 .- 1475-2727. ; 21:9, s. 1717-1725 Tidskriftsartikel (refereegranskat)abstract Objective: Physical activity (PA) levels and dietary habits are considered some of the most important factors associated with obesity. The present study aimed to examine the association between PA level and food and beverage consumption in European children (2-10 years old). Design/Setting/Subjects: A sample of 7229 children (49.0% girls) from eight European countries participating in the IDEFICS (Identification and prevention of Dietary and lifestyle induced health EFfects In Children and infantS) study was included. Moderate-to-vigorous PA (MVPA) was assessed objectively with accelerometers. FFQ was used to register dietary habits. ANCOVA and binary logistic regression were applied. Results: Boys who spent less time in MVPA reported lower consumption of vegetables, fruits, cereals, yoghurt, milk, bread, pasta, candies and sugar-sweetened beverages (SSB) than boys who spent more time in MVPA (P < 0.05). Moreover, boys who spent less time in MVPA were more likely to consume fast foods and water than those in the highest MVPA tertile (P < 0.05). Girls who spent less time in MVPA reported lower consumption frequencies of vegetables, pasta, bread, yoghurt, candies, jam/honey and SSB than girls in the highest MVPA tertile (P < 0.05). Also, girls in the lowest MVPA tertile were more likely to consume fast foods and water than those with high levels of MVPA (P < 0.05). Conclusions: Food intake among European children varied with different levels of daily MVPA. Low time spent in MVPA was associated with lowest consumption of both high-and low-energy-dense foods and high fast-food consumption.
24.	Santaliestra-Pasias, A. M., et al. (författare) Predictive associations between lifestyle behaviours and dairy consumption: The IDEFICS study 2020 Ingår i: Nutrition Metabolism and Cardiovascular Diseases. - : Elsevier BV. - 0939-4753 .- 1590-3729. ; 30:3, s. 514-522 Tidskriftsartikel (refereegranskat)abstract Background and aim: Physical activity (PA) and sedentary behaviours (SB) are related to obesity and cardiometabolic risk; however, the literature is controversial regarding the effect of dairy consumption on the development of cardiovascular disease (CVD) risk factors. The aim of this study was to assess longitudinally the relationship between specific lifestyle behaviours (PA and SB) and dairy consumption in a sample of European children and adolescents. Methods and results: Children from the IDEFICS study were included in the analyses. Two measurements, with 2 years' interval, were conducted. A total of 1688 (50.8% boys) children provided information regarding diet, measured by a 24-h dietary recall, PA measured by accelerometers and parent-reported sedentary screen time (SST) at both time points. Different combinations of these behaviours, at each survey and over time, were derived applying specific recommendations. Multilevel ordinal logistic regression and analysis of covariance were used to assess their association with dairy consumption, adjusted for potential confounders. Differences by gender were found regarding dairy product consumption and also adherence to SB and PA recommendations at T0 and T1. Children meeting both lifestyle recommendations, at the two measurement points, had higher probability to consume more milk and yogurt and less cheese than the rest of combinations. Conclusions: These results suggest that European children with a healthy lifestyle, especially regarding PA and SB over time, consumed more milk and yogurt. This study suggests that the protective effect of specific dairy products found in literature could be partially due to the association of their consumption with specific healthy lifestyles. (C) 2019 Published by Elsevier B.V. on behalf of The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University.
25.	Santaliestra-Pasías, A. M., et al. (författare) Prospective physical fitness status and development of cardiometabolic risk in children according to body fat and lifestyle behaviours: The IDEFICS study 2021 Ingår i: Pediatric Obesity. - : Wiley. - 2047-6302 .- 2047-6310. ; 16:11 Tidskriftsartikel (refereegranskat)abstract Background: Elevated cardiometabolic risk (CMR) is an important factor for cardiovascular diseases later in life while physical fitness seems to decrease CMR. Objective: Thus, the aim of the present study is to assess the association between muscular fitness (MF) and cardiorespiratory fitness (CRF) on CMR in European children, both cross-sectional and longitudinally. Methods: A total of 289 children (49.5% males) from eight European countries, aged 6 to 9, with longitudinal information on blood pressure, triglycerides, total cholesterol, HDL-cholesterol, homoeostasis model assessment, body mass index, data on fitness level, objectively measured physical activity (PA), diet quality, and total screen time were included. A CMR score was calculated and dichotomized. MF and CRF were also dichotomized. Cross-sectional and longitudinal multilevel logistic regressions adjusting for lifestyle behaviours were performed. Results: Reaching a high level of MF during childhood as well as remaining in that level over-time were associated with an 82% and 62% lower probability of high CMR at follow-up, respectively. Also, children who became top CRF over time, showed a 77% lower probability (P < 0.05) of being in the highest CMR quartile at follow-up, independently of sociodemographic and lifestyle indicators. Conclusions: A high MF at early childhood and during childhood reduces the odds of having CMR. Same occurs with the improvement of CRF during childhood. These findings highlight the importance of enhancing fitness to avoid CMR already in children. © 2021 The Authors. Pediatric Obesity published by John Wiley & Sons Ltd on behalf of World Obesity Federation.
26.	Stahlmann, Katharina, et al. (författare) Family structure in relation to body mass index and metabolic score in European children and adolescents 2022 Ingår i: Pediatric Obesity. - : Wiley. - 2047-6310 .- 2047-6302. ; 17:12 Tidskriftsartikel (refereegranskat)abstract Background Living in single parent and blended families or as an only child-compared to living in two-parent biological families or with siblings, respectively-is associated with a higher body mass index (BMI) in cross-sectional studies. However, longitudinal research addressing the children's BMI in this context is scarce. Further, little is known about the association between family structure and metabolic health. Objectives This study aimed at investigating the association between both aspects of family structure with BMI and a metabolic score (MetS). Methods Cross-sectional data from 7804 children participating in the European multi-center I.Family study (2013/2014) and longitudinal data from 5621 children who also participated previously in the IDEFICS study (2007-2010) were used. Family structure was assessed by a detailed interview. BMI z-score and the MetS were based on measured anthropometry, blood pressure, high-density lipoprotein, blood glucose, and triglycerides. Linear regressions were performed to model associations between family structure with BMI and MetS. Results Children from single-parent families had higher BMI z-scores in the cross-sectional (beta = 0.09, 95% confidence interval [CI]: 0.001 to 0.18) and longitudinal analyses compared to those from two-parent families. Cross-sectionally, the number of siblings was associated with lower BMI z-scores (beta = -0.07, 95% CI: -0.10 to -0.03) and lower MetS (beta = -0.14, 95% CI: -0.26 to -0.01). Longitudinally, only children between baseline and follow-up had higher BMI z-scores at follow-up (beta = 0.07, 95% CI: 0.01 to 0.14) compared to stable siblings. Conclusion Obesity prevention measures should focus on single-parent households and families with an only child.
27.	Tognon, Gianluca, 1976, et al. (författare) Adherence to a Mediterranean-like dietary pattern in children from eight European countries. 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 Despite documented benefits of a Mediterranean-like dietary pattern, there is a lack of knowledge about how children from different European countries compare with each other in relation to the adherence to this pattern. In response to this need, we calculated the Mediterranean diet score (MDS) in 2-9-year-old children from the Identification and prevention of dietary- and lifestyle-induced health effects in children and infants (IDEFICS) eight-country study.
28.	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.
29.	Barba, G, et al. (författare) Blood pressure reference values for European non-overweight school children: The IDEFICS study. 2014 Ingår i: International Journal of Obesity. - : Springer Science and Business Media LLC. - 0307-0565 .- 1476-5497. ; 38:Suppl 2 Tidskriftsartikel (refereegranskat)abstract To provide oscillometric blood pressure (BP) reference values in European non-overweight school children.
30.	Bogl, L. H., et al. (författare) A within-sibling pair analysis of lifestyle behaviours and BMI z-score in the multi-centre I.Family study 2019 Ingår i: Nutrition Metabolism and Cardiovascular Diseases. - : Elsevier BV. - 0939-4753. ; 29:6, s. 580-589 Tidskriftsartikel (refereegranskat)abstract Background and aims: By investigating differences in lifestyle behaviours and BMI in sibling pairs, family-level confounding is minimized and causal inference is improved, compared to cross-sectional studies of unrelated children. Thus, we aimed to investigate within-sibling pair differences in different lifestyle behaviours and differences in BMI z-scores in children and adolesents. Methods and results: We examined three groups of sibling pairs 1) all same-sex sibling pairs with maximum 4 years age difference (n = 1209 pairs from 1072 families in 8 countries, mean age 10.7 years, standard deviation 2.4 years), 2) sibling pairs discordant for overweight (n = 262) and 3) twin pairs (n = 85). Usual dietary intake was estimated by 24-h recalls and time spent in light (LPA) and moderate-to-vigorous physical activity (MVPA) was measured by accelerometers. Screen time, sleep and dieting for weight loss were assessed by questionnaires. Within all 3 groups of sibling pairs, more time in MVPA was associated with lower BMI z-score. Higher energy intake was associated with higher BMI z-score within twin pairs and within all sibling pairs who were not currently dieting for weight loss. Regarding LPA, screen time or sleep duration, no or inconsistent associations were observed for the three groups of sibling pairs. Conclusions: MVPA and energy intake were associated with BMI differences within sibling and twin pairs growing up in the same home, thus independent of family-level confounding factors. Future studies should explore whether genetic variants regulating appetite or energy expenditure behaviours account for weight differences in sibling pairs. (C) 2019 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.
31.	Börnhorst, Claudia, et al. (författare) Diet-obesity associations in children : approaches to counteract attenuation caused by misreporting 2013 Ingår i: Public Health Nutrition. - : Cambridge University Press. - 1368-9800 .- 1475-2727. ; 16:2, s. 256-266 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.
32.	Cheng, L., et al. (författare) Cross-sectional and longitudinal associations between sleep duration, sleep quality, and bone stiffness in European children and adolescents 2021 Ingår i: Osteoporosis International. - : Springer Science and Business Media LLC. - 0937-941X .- 1433-2965. ; 32, s. 853-863 Tidskriftsartikel (refereegranskat)abstract Summary: In this large perspective cohort among European children and adolescents, we observed that daytime napping was positively associated with bone stiffness, while short or long sleep duration combined with poor sleep quality was associated with less bone stiffness. Our findings are important for obtaining optimal bone stiffness in childhood. Introduction: To examine the cross-sectional and longitudinal associations between sleep duration, sleep quality, and bone stiffness index (SI) in European children and adolescents. Methods: Four thousand eight hundred seventy-one children aged 2–11 years from the IDEFICS study and 861 children aged 6–15 years from the subsequent I.Family study were included. Sleep duration (i.e., nocturnal sleep and daytime napping) and sleep quality (i.e., irregularly bedtime routine, have difficulty falling asleep and trouble getting up in the morning) were reported by self-administrated questionnaires. Nocturnal sleep duration was converted into age-specific z-scores, and total sleep duration was classified into short, adequate, and long based on the National Sleep Recommendation. Calcaneal SI of both feet were measured using quantitative ultrasound. Linear mixed-effects models with country as a random effect were used, with adjustments for sex, age, pubertal status, family socioeconomic status, physical activity, screen time, body mass index, and daylight duration. Results: Nocturnal sleep duration z-scores were positively associated with SI percentiles among participants with adequate sleep duration at baseline. Moreover, the positive association between daytime napping and SI percentiles was more pronounced in participants with adequate sleep duration at baseline, while at 4-year follow-up was more pronounced in participants with short sleep duration. In addition, extreme sleep duration at baseline predicted lower SI percentiles after 4 years in participants with poor sleep quality. Conclusion: The positive associations between nocturnal sleep, daytime napping and SI depended on total sleep duration. Long-term detrimental effect of extreme sleep duration on SI only existed in individuals with poor sleep quality. © 2020, The Author(s).
33.	De Bourdeaudhuij, I., et al. (författare) Behavioural effects of a community-oriented setting-based intervention for prevention of childhood obesity in eight European countries. Main results from the IDEFICS study 2015 Ingår i: Obesity Reviews. - : Wiley. - 1467-7881 .- 1467-789X. ; 16:Suppl. 2, s. 30-40 Tidskriftsartikel (refereegranskat)abstract ObjectiveThe objective of this paper is to evaluate the behavioural effects, as reported by the parents of the participating boys and girls, of the IDEFICS (Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS) intervention. MethodsThe effectiveness of the IDEFICS intervention was evaluated through a cluster-controlled trial in eight European countries (control and intervention communities in each country) including more than 16,000 children. The 2- to 9.9-year-old children in the intervention group were exposed to a culturally adapted intervention that aimed to prevent childhood obesity through the community, schools/kindergartens and family. Parents completed questionnaires to measure water, soft drink and fruit juice intake; fruit and vegetable intake; daily TV viewing and other sedentary behaviours; daily physical activity levels and strengthening of the parent-child relationships at baseline and follow-up (2years later). Mixed models with an additional random effect for country were used to account for the clustered study design, and results were stratified by sex. ResultsThe pan-European analysis revealed no significant time by condition interaction effects, neither for boys nor girls, i.e. the analysis revealed no intervention effects on the behaviours of the IDEFICS children as reported by their parents (F=0.0 to 3.3, all p>0.05). Also very few significances were found in the country-specific analyses. Positive intervention effects were only found for sport club participation in Swedish boys, for screen time in weekends for Spanish boys and for TV viewing in Belgian girls. ConclusionAlthough no expected intervention effects as reported by the parents on diet, physical activity and sedentary behaviours could be shown for the overall IDEFICS cohort, a few favourable intervention effects were found on specific behaviours in some individual countries. More in-depth analyses of the process evaluation data are needed to obtain more insight into the relationship between the level of exposure to the intervention and its effect. (c) 2015 World Obesity
34.	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.
35.	Do, Stefanie, et al. (författare) The role of psychosocial well-being and emotion-driven impulsiveness in food choices of European adolescents 2024 Ingår i: International Journal of Behavioral Nutrition and Physical Activity. - 1479-5868. ; 21:1 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.
36.	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.
37.	Fernández-Alvira, Juan Miguel, et al. (författare) Prospective associations between dietary patterns and body composition changes in European children : the IDEFICS study 2017 Ingår i: Public Health Nutrition. - 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 (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.
38.	Fernández-Alvira, Juan Miguel, et al. (författare) 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 Ingår i: The British journal of nutrition. - : Cambridge University Press. - 1475-2662 .- 0007-1145. ; 113:3, s. 517-25 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.
39.	Hebestreit, A., et al. (författare) Cross-sectional and longitudinal associations between energy intake and BMI z-score in European children 2016 Ingår i: International Journal of Behavioral Nutrition and Physical Activity. - : Springer Science and Business Media LLC. - 1479-5868. ; 13 Tidskriftsartikel (refereegranskat)abstract Background: Evidence for the effect of dietary energy on BMI z-scores in young children is limited. We aim to investigate cross-sectional and longitudinal effects of daily energy intake (EI) on BMI z-scores of European boys and girls considering growth-related height dependencies of EI using residual EI. Methods: To investigate cross-sectional and longitudinal effects of daily energy intake (EI) on BMI z-scores of European boys and girls considering growth-related height dependencies of EI using residual EI. Methods: Subjects were children aged 2-< 10 y old (N = 2753, 48.2 % girls) participating in the IDEFICS (Identification and prevention of Dietary-and lifestyle-induced health EFfects In Children and infantS) baseline and follow-up examination. Usual EI (kcal/day) was calculated based on the National Cancer Institute-method excluding subjects with implausible reported EI. Effect of age, height and sex-adjusted residuals of EI on BMI z-score was investigated stratified by baseline age-group (2-< 4 y, 4-< 6 y, 6-< 8 y and 8-< 10 y) cross-sectionally using linear regression models adjusted for relevant confounders (crude model: age, sex, country; fully adjusted model: plus parental ISCED level, parental BMI, screen time; subgroup analysis: plus objectively measured physical activity). Longitudinal associations were estimated between changes in (Delta) residual EI per year and Delta BMI z-score per year with adjustments analogously to the cross-sectional models but with additional adjustment for residual EI at baseline. Results: Cross-sectionally, positive associations were observed between residual EI and BMI z-score for the full study sample, for boys and in older (>= 6 years) but not in younger children in the crude and fully adjusted model. Longitudinally, small positive associations were observed between Delta residual EI per y on Delta BMI z-score per y for the full study sample and in 4-< 6 y olds in the crude and fully adjusted model. Conclusion: In conclusion, EI above the average intakes for a certain sex, age and height are weakly associated with BMI z-scores in European children. Residual EI may be considered as a useful exposure measure in children as it accounts for growth-related changes in usual EI during childhood.
40.	Hebestreit, H., et al. (författare) Cardiopulmonary exercise testing provides additional prognostic information in cystic fibrosis 2019 Ingår i: American Journal of Respiratory and Critical Care Medicine. - 1073-449X. ; 199:8, s. 987-995 Tidskriftsartikel (refereegranskat)abstract Rationale: The prognostic value of cardiopulmonary exercise testing (CPET) for survival in cystic fibrosis (CF) in the context of current clinical management, when controlling for other known prognostic factors, is unclear. Objectives: To determine the prognostic value of CPET-derived measures beyond peak oxygen uptake (VO 2 peak) following rigorous adjustment for other predictors. Methods: Data from 10 CF centers in Australia, Europe, and North America were collected retrospectively. A total of 510 patients completed a cycle CPET between January 2000 and December 2007, of which 433 fulfilled the criteria for a maximal effort. Time to death/lung transplantation was analyzed using Cox proportional hazards regression. In addition, phenotyping using hierarchical Ward clustering was performed to characterize high-risk subgroups. Measurements and Main Results: Cox regression showed, even after adjustment for sex, FEV1% predicted, body mass index (z-score), age at CPET, Pseudomonas aeruginosa status, and CF-related diabetes as covariates in the model, that VO 2 peak in % predicted (hazard ratio [HR], 0.964; 95% confidence interval [CI], 0.944-0.986), peak work rate (% predicted; HR, 0.969; 95% CI, 0.951-0.988), ventilatory equivalent for oxygen (HR, 1.085; 95% CI, 1.041-1.132), and carbon dioxide (HR, 1.060; 95% CI, 1.007-1.115) (all P < 0.05) were significant predictors of death or lung transplantation at 10-year follow-up. Phenotyping revealed that CPET-derived measures were important for clustering. We identified a high-risk cluster characterized by poor lung function, nutritional status, and exercise capacity. Conclusions: CPET provides additional prognostic information to established predictors of death/lung transplantation in CF. High-risk patients may especially benefit from regular monitoring of exercise capacity and exercise counseling. Copyright © 2019 by the American Thoracic Society.
41.	Hunsberger, Monica, 1973, et al. (författare) Dietary Carbohydrate and Nocturnal Sleep Duration in Relation to Children's BMI: Findings from the IDEFICS Study in Eight European Countries 2015 Ingår i: Nutrients. - : MDPI AG. - 2072-6643. ; 7:12, s. 10223-10236 Tidskriftsartikel (refereegranskat)abstract Previous research has found an association between being overweight and short sleep duration. We hypothesized that this association could be modified by a high carbohydrate (HC) diet and that the timing and type (starch or sugar) of intake may be an important factor in this context. Participants in the prospective, eight-country European study IDEFICS were recruited from September 2007 to June 2008, when they were aged two to nine years. Data on lifestyle, dietary intake and anthropometry were collected on two occasions. This study included 5944 children at baseline and 4301 at two-year follow-up. For each meal occasion (morning, midday, and evening), starch in grams and sugar in grams were divided by total energy intake (EI), and quartiles calculated. HC-starch and HC-sugar intake categories were defined as the highest quartile for each meal occasion. In a mutually adjusted linear regression model, short sleep duration as well as HC-starch in the morning were positively associated with body mass index (BMI) z-scores at baseline. HC-starch at midday was positively associated with body mass index (BMI) z-scores in children with short sleep duration, and negatively associated with BMI z-scores in those with normal sleep. After adjustment for baseline BMI z-scores, associations between total HC from starch or sugar and high BMI z-scores at two-year follow-up did not persist. Our observations offer a perspective on optimal timing for macronutrient consumption, which is known to be influenced by circadian rhythms. Reduced carbohydrate intake, especially during morning and midday meals, and following nocturnal sleep duration recommendations are two modifiable factors that may protect children from being overweight in the future.
42.	Huybrechts, I, et al. (författare) Evaluation of the Children's Eating Habits Questionnaire used in the IDEFICS study by relating urinary calcium and potassium to milk consumption frequencies among European children 2011 Ingår i: Int J Obesity. - : Springer Science and Business Media LLC. - 0307-0565. ; 35, suppl 1, s. 69-78 Tidskriftsartikel (refereegranskat)abstract Background: Measuring dietary intake in children is notoriously difficult. Therefore, it is crucial to evaluate the performance of dietary intake assessment methods in children. Given the important contribution of milk consumption to calcium (Ca) and potassium (K) intakes, urinary calcium (UCa) and potassium (UK) excretions in spot urine samples could be used for estimating correlations with milk consumption frequencies. Objective: The aim of this study was to evaluate the assessment of milk consumption frequencies derived from the Food Frequency Questionnaire section of the Children's Eating Habits Questionnaire (CEHQ-FFQ) used in the IDEFICS (Identification and prevention of dietary- and lifestyle induced health effects in children and infants) study by comparing with UCa and UK excretions in spot urine samples. Design: This study was conducted as a setting-based community-oriented intervention study and results from the first cross-sectional survey have been included in the analysis. Subjects: A total of 10309 children aged 2–10 years from eight European countries are included in this analysis. Methods: UCa and UK excretions were measured in morning spot urine samples. Calcium and potassium urine concentrations were standardised for urinary creatinine (Cr) excretion. Ratios of UCa/Cr and UK/Cr were used for multivariate regression analyses after logarithmic transformation to obtain normal distributions of data. Milk consumption frequencies were obtained from the CEHQ-FFQ. Multivariate regression analyses were used to investigate the effect of milk consumption frequencies on UCa and UK concentrations, adjusting for age, gender, study centre, soft drink consumption and frequency of main meals consumed at home. Results: A significant positive correlation was found between milk consumption frequencies and ratios of UK/Cr and a weaker but still significant positive correlation with ratios of UCa/Cr, when using crude or partial Spearman's correlations. Multivariate regression analyses showed that milk consumption frequencies were predictive of UCa/Cr and UK/Cr ratios, when adjusted for age, gender, study centre, soft drink consumption and frequency of main meals consumed at home. Mean ratios of UK/Cr for increasing milk consumption frequency tertiles showed a progressive increase in UK/Cr. Children consuming at least two milk servings per day had significantly higher mean UCa/Cr and UK/Cr ratios than children who did not. Large differences in correlations between milk consumption frequencies and ratios of UCa/Cr and UK/Cr were found between the different study centres. Conclusion: Higher milk consumption frequencies resulted in a progressive increase in UK/Cr and UCa/Cr ratios, reflecting the higher Ca and K intakes that coincide with increasing milk consumption, which constitutes a major K and Ca source in children's diet.
43.	Jilani, H. S., et al. (författare) Association between parental consumer attitudes with their children's sensory taste preferences as well as their food choice 2018 Ingår i: Plos One. - : Public Library of Science (PLoS). - 1932-6203. ; 13:8 Tidskriftsartikel (refereegranskat)abstract Background We investigated the association between the consumer attitudes of European parents and their children's taste preferences and food choice. Furthermore, we studied whether the parental consumer attitudes were related to education level. This analysis included 1,407 IDEFICS study children aged 6.0 to 11.8 years and from 7 European countries, who participated in the sensory taste perception module between 2007 and 2010. Parental consumer attitude was operationalized as 'trusting in foods known from advertisements' (trusting advertisements) and as 'not avoiding additives in food' (not avoiding additives). Parents reported their educational attainment and completed a food frequency questionnaire for their children. Consumption frequencies of sweet, fatty and processed foods as well as a healthy diet adherence score were calculated. Children performed fat, sweet and umami taste preference tests. Multivariable logistic models were used to analyse the association between parental consumer attitudes and their children's taste preference frequencies as well as parental education. Linear regression models were used to analyse the association between parental consumer attitudes and their children's food consumption. Parental consumer attitudes were not associated with children's fat, sweet and umami taste preferences. Children of parents trusting advertisements consumed more frequently processed foods (beta = 1.21, 95% CI: 0.49; 1.93). Children of parents not avoiding additives consumed more often sweet, fatty and processed foods and had a lower healthy diet adherence score (beta = 2.37, 95% CI: 1.03; 3.70; beta = 2.27, 95% CI: 1.12; 3.43; beta = 0.91, 95% CI: 0.22; 1.59; beta = -2.87, 95% CI: -3.89; -1.85, respectively). Unfavourable parental consumer attitudes were associated with a lower parental education level across Europe (Compared to high education: Odds Ratio (OR) of trusting advertisements with medium education: 1.04, 95% CI: 0.77; 1.40; OR with low education: 2.01, 95% CI: 1.15; 3.54; OR of not avoiding additives with medium education: 1.91, 95% CI: 1.44; 2.54; OR with low education: 1.76, 95% CI: 0.96; 3.24). Across Europe, unfavourable parental consumer attitudes are associated with a lower diet quality of their children. Parental consumer attitudes in turn were associated with their own level of education. This has implications for policy makers, interventions and health promotion programmes that aim to promote healthy eating.
44.	Nicholls, S. G., et al. (författare) Parents' evaluation of the IDEFICS intervention: an analysis focussing on socio-economic factors, child's weight status and intervention exposure 2015 Ingår i: Obesity Reviews. - : Wiley. - 1467-7881. ; 16:Suppl. 2, s. 103-118 Tidskriftsartikel (refereegranskat)abstract IntroductionFrom April 2008 to August 2010 the Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS (IDEFICS) intervention aimed to encourage healthier diets, higher physical activity levels and lower stress levels among European children and their families. While the intervention was intended to improve children's health, we also wished to assess whether there were unwelcome aspects or negative side-effects. Therefore all parents of children who participated in the IDEFICS intervention were asked for their views on different aspects of the intervention. MethodsA total of 10,016 parents of children who participated in the IDEFICS survey and who were involved in the intervention were invited to complete a questionnaire on positive and negative impacts of the intervention. Responses to each of the statements were coded on a four point Likert-type scale. Demographic data were collected as part of the baseline (T-0) and first follow-up (T-1) surveys; intervention exposure data was also collected in the T-1 follow-up survey. Anthropometric data was collected in the same surveys, and child's weight status was assessed according to Cole and Lobstein. After initial review of the univariate statistics multilevel logistic regression was conducted to analyse the influence of socio-economic factors, child's weight status and intervention exposure on parental responses. ResultsIn total 4,997 responses were received. Approval rates were high, and few parents reported negative effects. Parents who reported higher levels of exposure to the intervention were more likely to approve of it and were also no more likely to notice negative aspects. Less-educated and lower income parents were more likely to report that the intervention would make a lasting positive difference, but also more likely to report that the intervention had had negative effects. Parents of overweight and obese children were more likely to report negative effects - above all, that the intervention had made their child feel as if he/she was fat or overweight.' ConclusionWhile the results represent a broad endorsement of the IDEFICS intervention, they also suggest the importance of vigilance concerning the psychological effects of obesity interventions on overweight and obese children.
45.	Sina, E., et al. (författare) Media use trajectories and risk of metabolic syndrome in European children and adolescents: the IDEFICS/I.Family cohort 2021 Ingår i: International Journal of Behavioral Nutrition and Physical Activity. - : Springer Science and Business Media LLC. - 1479-5868. ; 18:1 Tidskriftsartikel (refereegranskat)abstract Background: Media use may influence metabolic syndrome (MetS) in children. Yet, longitudinal studies are scarce. This study aims to evaluate the longitudinal association of childhood digital media (DM) use trajectories with MetS and its components. Methods: Children from Belgium, Cyprus, Estonia, Germany, Hungary, Italy, Spain and Sweden participating in the IDEFICS/I.Family cohort were examined at baseline (W1: 2007/2008) and then followed-up at two examination waves (W2: 2009/2010 and W3: 2013/2014). DM use (hours/day) was calculated as sum of television viewing, computer/game console and internet use. MetS z-score was calculated as sum of age- and sex-specific z-scores of four components: waist circumference, blood pressure, dyslipidemia (mean of triglycerides and HDL-cholesterol(-1)) and homeostasis model assessment for insulin resistance (HOMA-IR). Unfavorable monitoring levels of MetS and its components were identified (cut-off: >= 90(th) percentile of each score). Children aged 2-16 years with >= 2 observations (W1/W2; W1/W3; W2/W3; W1/W2/W3) were eligible for the analysis. A two-step procedure was conducted: first, individual age-dependent DM trajectories were calculated using linear mixed regressions based on random intercept (hours/day) and linear slopes (hours/day/year) and used as exposure measures in association with MetS at a second step. Trajectories were further dichotomized if children increased their DM duration over time above or below the mean. Results: 10,359 children and adolescents (20,075 total observations, 50.3% females, mean age = 7.9, SD = 2.7) were included. DM exposure increased as children grew older (from 2.2 h/day at 2 years to 4.2 h/day at 16 years). Estonian children showed the steepest DM increase; Spanish children the lowest. The prevalence of MetS at last follow-up was 5.5%. Increasing media use trajectories were positively associated with z-scores of MetS (slope: beta = 0.54, 95%CI = 0.20-0.88; intercept: beta = 0.07, 95%CI = 0.02-0.13), and its components after adjustment for puberty, diet and other confounders. Children with increasing DM trajectories above mean had a 30% higher risk of developing MetS (slope: OR = 1.30, 95%CI = 1.04-1.62). Boys developed steeper DM use trajectories and higher risk for MetS compared to girls. Conclusions: Digital media use appears to be a risk factor for the development of MetS in children and adolescents. These results are of utmost importance for pediatricians and the development of health policies to prevent cardio-metabolic disorders later in life.
46.	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
47.	Suling, M, et al. (författare) Design and results of the pretest of the IDEFICS study 2011 Ingår i: INTERNATIONAL JOURNAL OF OBESITY. - 0307-0565. ; 35 Tidskriftsartikel (refereegranskat)
48.	Svensson, Åsa, 1981-, et al. (författare) Observed differences in dietary intake on weekdays versus weekends in a European cohort of children : preliminary results 2011 Konferensbidrag (övrigt vetenskapligt/konstnärligt)
49.	Svensson, Åsa, 1981-, et al. (författare) Observed differences in dietary intake on weekdays versus weekends in European children 2012 Konferensbidrag (refereegranskat)abstract OBJECTIVE: To examine differences in intake of energy (EI), sugars, and sucrose-rich foods and drinks between weekdays (Monday through Thursday), Fridays and weekends in European children.METHODS: Twenty-four hour recall data were used for children aged 2-9 years from Belgium, Cyprus, Estonia, Germany, Hungary, Italy, Spain and Sweden, participating in the IDEFICS (Identification and prevention of Dietary- and lifestyle-induced health EFfects In children and infantS) study at baseline 2007-2008. Dietary intake was reported by parents and complemented by day-care or school personnel when needed. Children with complete interview days for whom all main meals were known and that had a reported EI between 500-5000 kcal/day were included with one day each. For children with more than one 24-hour recall weekends were chosen over weekdays in order to obtain a balanced distribution of days of week. Regression models adjusted for country, age and sex were performed to investigate differences in EI, sugars (g/day) and sucrose-rich foods and drinks (g/day) on weekdays (Monday through Thursday) versus weekends (n=9339), as well as Fridays versus weekdays and weekends (n=9496), respectively. Models with intake of sugars and sucrose-rich foods and drinks as dependent variables were additionally adjusted for EI. The analysis comparing intake on weekdays versus weekends was stratified by country for Belgium, Cyprus (excluding sugars), Germany, Hungary, Italy, Spain and Sweden.RESULTS: Intake of energy (t(9338)=4.1, p<0.001), sugars (t(8189)=7.6, p<0.001), and sucrose-rich foods and drinks (t(9338)=6.4, p<0.001) were higher on weekends versus weekdays. Intake on Fridays was a cross between the intakes on weekdays and weekends and did not differ from them, except for intake of sucrose-rich foods and drinks, being lower on Fridays compared with weekends (t(9495)= -2.2, p=0.02). Stratified analyses showed higher EI on weekends versus weekdays in Hungary (t(1532)=7.7, p<0.001). Intake of sugars was higher on weekends versus weekdays in Hungary (t(1532)=5.6, p<0.001), Italy (t(1974)=4.5, p<0.001) and Sweden (t(1224)=6.0, p<0.001), but in Belgium it was lower on weekends versus weekdays (t(372)= -2.0, p=0.04). Intake of sucrose rich foods and drinks was higher on weekends versus weekdays in Cyprus (t(1148)=2.8, p=0.01), Hungary (t(1532)=2.9, p=0.004), Italy (t(1974)=9.0, p<0.001) and Spain (t(623)=3.0, P=0.003).CONCLUSION: Dietary intake of European children differed on weekdays (Monday through Thursday) versus weekends, and intake on Fridays was a cross between the intakes on these days. The results imply the importance to capture dietary intake of children on both weekdays and weekends when assessing their habitual intake with 24-hour recalls.
50.	Thumann, B. F., et al. (författare) Cross-sectional associations between objectively measured sleep characteristics and body mass index in European children and adolescents 2021 Ingår i: Sleep Medicine. - : Elsevier BV. - 1389-9457. ; 84, s. 32-39 Tidskriftsartikel (refereegranskat)abstract Background: Short sleep duration has been found to be associated with a higher risk for overweight and obesity. However, previous studies have mainly relied on subjective measures of sleep duration and other sleep characteristics (eg quality, timing) have often been neglected. Therefore, we aimed to investigate associations between several, mainly objectively measured sleep characteristics and body mass index (BMI). Further, we aimed to identify distinct sleep subtypes based on these sleep characteristics and to study their association with BMI. Methods: Children aged 9-16 years participating in the European I.Family study (N = 559, 51.2% girls, 32.9% overweight/obese) wore an accelerometer for one week on their wrist and recorded their daily wake-up and lights-off times in a sleep diary. Information on sleep duration, sleep efficiency and sleep latency was derived. To identify sleep subtypes, we conducted a latent class analysis using all five sleep variables. Associations between single sleep variables, sleep subtype and age- and sex-specific BMI z-score were investigated using linear mixed-effects regression models to accommodate clustering among siblings. Results: No statistically significant associations were observed between the single sleep variables (sleep duration, sleep efficiency, sleep latency, wake-up and lights-off times) and BMI z-score. Four sleep subtypes were identified and children were assigned to one of the groups based on their highest probability for latent group membership: "early birds" (17.5% of the sample), "short sleep duration" (14.7%), "optimal sleep" (47.6%) and "poor sleep quality" (20.2%). Sleep subtype was not associated with BMI z-score. Conclusions: Using objective sleep data, we did not find convincing evidence for associations between the sleep variables under investigation and BMI. (C) 2021 Elsevier B.V. All rights reserved.

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Författare/redaktör: Hebestreit, A. (52); Veidebaum, T. (43); Lissner, Lauren, 195 ... (37); Moreno, L. A. (30); De Henauw, S. (29); Molnár, D. (28); visa fler...; Ahrens, W (24); Pala, V (21); Eiben, Gabriele, 196 ... (21); Hebestreit, Antje (20); Tornaritis, M. (19); Russo, P. (18); Eiben, Gabriele (16); Moreno, Luis A (16); Veidebaum, Toomas (15); Hunsberger, Monica, ... (14); Siani, A. (14); Molnár, Denes (13); Barba, G. (13); Pigeot, I. (12); Huybrechts, I (12); Pala, Valeria (11); Kovacs, E. (11); Krogh, V. (10); Hadjigeorgiou, C (9); Ahrens, Wolfgang (9); Reisch, L. (8); Mårild, Staffan, 194 ... (8); De Henauw, Stefaan (8); Williams, G. (7); Pohlabeln, H. (7); Bammann, K (7); Michels, N (7); Mehlig, Kirsten, 196 ... (6); Tornaritis, Michael (6); Lanfer, A. (6); Kaprio, J (5); De Bourdeaudhuij, I (5); Reisch, Lucia (5); Siani, Alfonso (5); Bornhorst, C (5); Börnhorst, C (5); Huybrechts, Inge (4); Gwozdz, W. (4); Michels, Nathalie (4); Buck, C. (4); Santaliestra-Pasias, ... (4); Pohlabeln, Hermann (4); Fernandez-Alvira, J. ... (4); Bogl, L. H. (4); visa färre...

Lärosäte: Göteborgs universitet (66); Högskolan i Skövde (30); Umeå universitet (3); Karolinska Institutet (2); Högskolan i Halmstad (1)

Språk: Engelska (72)

Forskningsämne (UKÄ/SCB): Medicin och hälsovetenskap (72); Lantbruksvetenskap (1)

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