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1.	Lehtinen-Jacks, Susanna, et al. (författare) Serum 25-hydroxy vitamin D levels in middle-aged women in relationship to adiposity and height trajectories over three decades 2016 Ingår i: European Journal of Clinical Nutrition. - : Springer Science and Business Media LLC. - 0954-3007 .- 1476-5640. ; 70:6, s. 709-14 Tidskriftsartikel (refereegranskat)abstract BACKGROUND/OBJECTIVES: The long-term chronology of the association between low serum concentrations of 25-hydroxy vitamin D (25(OH)D) and weight status is unclear. We examined whether lower 25(OH)D in middle-aged women drives upwards the weight, body mass index (BMI) and waist-hip ratio (WHR) over the next 32 years, and whether higher 25(OH)D might predict less decline in the mid- to late-life height trajectory. SUBJECTS/METHODS: The Population Study of Women in Gothenburg started in 1968-1969 (the baseline) in 38-60-year-old women residing in Gothenburg, Sweden. Anthropometric measures were taken at baseline and 4 re-examinations until 2000-2003. Levels of 25(OH)D were analyzed in serum stored since baseline in 1227 (84%) women. Repeated measures analyses were used to model associations between 25(OH)D (dichotomized, cut point 51.45nmol/l) at baseline and anthropometric trajectories, adjusting for fixed and time-dependent covariates. RESULTS: At baseline, mean BMI was 25.2kg/m2 in women with low 25(OH)D and 23.8kg/m2 in the remaining women (P<0.001), but this difference did not increase over 32 years and longitudinal differences were explained by the baseline BMI. Similar results were observed for weight and WHR. In contrast, no association was seen for height at baseline or longitudinally. CONCLUSIONS: No relationship was observed between 25(OH)D height trajectory, but lower 25(OH)D was associated with higher BMI, weight and WHR differences that were maintained over three decades. This provides no evidence for the direction of causality, but for a life-long difference in adiposity-related measures according to the 25D level in middle-aged women.
2.	Leu, Monica, 1977, et al. (författare) Quality Assessment of 25(OH)D, Insulin, Total Cholesterol, Triglycerides, and Potassium in 40-Year-Old Frozen Serum 2015 Ingår i: Epidemiology Research International. - : Hindawi Limited. - 2090-2980 .- 2090-2972. ; 2015 Tidskriftsartikel (refereegranskat)abstract Background: Many longitudinal epidemiological studies collect specimens into biobanks to investigate how biomarkers predict future disease. In 1968-1969, the Population Study of Women in Gothenburg (PSWG) established a biobank. Objective: To examine the validity of 25-hydroxyvitamin D (25(OH)D), total cholesterol, triglycerides, insulin and potassium after 40 years of storage at -20⁰C in terms of relative and absolute agreement. The quality of these markers under such condition has not been previously investigated. Methods: Baseline- and re-measured levels were compared in selected samples through percentage change, correlation and regression. 25(OH)D levels, not assessed at baseline, were compared by season, by BMI and longitudinally over six years. Results: Despite some lack of absolute agreement, Spearman correlations were >0.7 and statistically significant for all biomarkers. The 1968-1969 25(OH)D correlated with BMI (r=-0.45, p=0.05) and with levels six years later (r=0.85, p<0.001). Summer 25(OH)D was higher than winter 25(OH)D (p=0.02). Conclusion: For all markers, baseline- and re-measured levels exhibited high relative agreement. 25(OH)D was comparable with expected levels on fresh blood and varied with season. In future studies, PSWG individuals will be ranked according to these markers in order to follow incidence of disease.
3.	af Geijerstam, Agnes, et al. (författare) Children in the household and risk of severe COVID-19 during the first three waves of the pandemic: a prospective registry-based cohort study of 1.5 million Swedish men 2022 Ingår i: Bmj Open. - : BMJ. - 2044-6055. ; 12:8 Tidskriftsartikel (refereegranskat)abstract Objective To investigate whether Swedish men living with children had elevated risk for severe COVID-19 or infection with SARS-CoV-2 during the first three waves of the pandemic. Design Prospective registry-based cohort study. Participants 1 557 061 Swedish men undergoing military conscription between 1968 and 2005 at a mean age of 18.3 (SD 0.73) years. Main outcome measures Infection with SARS-CoV-2 and hospitalisation due to COVID-19 from March 2020 to September 2021. Results There was a protective association between preschool children at home and hospitalisation due to COVID-19 during the first and third waves compared with only older or no children at all, with ORs (95% CIs) 0.63 (0.46 to 0.88) and 0.75 (0.68 to 0.94) respectively. No association was observed for living with children 6-12 years old, but for 13-17 years old, the risk increased. Age in 2020 did not explain these associations. Further adjustment for socioeconomic and health factors did not attenuate the results. Exposure to preschool children also had a protective association with testing positive with SARS-CoV-2, with or without hospitalisation, OR=0.91 (95% CI 0.89 to 0.93), while living with children of other ages was associated with increased odds of infection. Conclusions Cohabiting with preschool children was associated with reduced risk for severe COVID-19. Living with school-age children between 6 and 12 years had no association with severe COVID-19, but sharing the household with teenagers and young adults was associated with elevated risk. Our results are of special interest since preschools and compulsory schools (age 6-15 years) in Sweden did not close in 2020.
4.	Arvidsson, Daniel, 1974, et al. (författare) Reexamination of Accelerometer Calibration with Energy Expenditure as Criterion: VO2net Instead of MET for Age-Equivalent Physical Activity Intensity 2019 Ingår i: Sensors. - : MDPI AG. - 1424-8220. ; 19:15 Tidskriftsartikel (refereegranskat)abstract Accelerometer calibration for physical activity (PA) intensity is commonly performed using Metabolic Equivalent of Task (MET) as criterion. However, MET is not an age-equivalent measure of PA intensity, which limits the use of MET-calibrated accelerometers for age-related PA investigations. We investigated calibration using VO2net (VO2gross - VO2stand; mL.min(-1).kg(-1)) as criterion compared to MET (VO2gross/VO2rest) and the effect on assessment of free-living PA in children, adolescents and adults. Oxygen consumption and hip/thigh accelerometer data were collected during rest, stand and treadmill walk and run. Equivalent speed (Speed(eq)) was used as indicator of the absolute speed (Speed(abs)) performed with the same effort in individuals of different body size/age. The results showed that VO2net was higher in younger age-groups for Speedabs, but was similar in the three age-groups for Speed(eq). MET was lower in younger age-groups for both Speed(abs) and Speed(eq). The same VO2net-values respective MET-values were applied to all age-groups to develop accelerometer PA intensity cut-points. Free-living moderate-and-vigorous PA was 216, 115, 74 and 71 min/d in children, adolescents, younger and older adults with VO2net-calibration, but 140, 83, 74 and 41 min/d with MET-calibration, respectively. In conclusion, VO2net calibration of accelerometers may provide age-equivalent measures of PA intensity/effort for more accurate age-related investigations of PA in epidemiological research.
5.	Arvidsson, Louise, et al. (författare) Bidirectional associations between psychosocial well-being and adherence to healthy dietary guidelines in European children: prospective findings from the IDEFICS study 2017 Ingår i: Bmc Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 17:1 Tidskriftsartikel (refereegranskat)abstract Background: In children the relationship between a healthy diet and psychosocial well-being has not been fully explored and the existing evidence is inconsistent. This study investigates the chronology of the association between children's adherence to healthy dietary guidelines and their well-being, with special attention to the influence of weight status on the association. Methods: Seven thousand six hundred seventy five children 2 to 9 years old from the eight-country cohort study IDEFICS were investigated. They were first examined between September 2007 and June 2008 and re-examined again 2 years later. Psychosocial well-being was measured using self-esteem and parent relations questions from the KINDL (R) and emotional and peer problems from the Strengths and Difficulties Questionnaire. A Healthy Dietary Adherence Score (HDAS) was calculated from a 43-item food frequency questionnaire as a measure of the degree to which children's dietary intake follows nutrition guidelines. The analysis employed multilevel logistic regression (country as random effect) with bidirectional modeling of dichotomous dietary and well-being variables as both exposures and outcomes while controlling for respective baseline values. Results: A higher HDAS at baseline was associated with better self-esteem (OR 1.2, 95% CI 1.0; 1.4) and fewer emotional and peer problems (OR 1.2, 95% CI 1.1; 1.3 and OR 1.3, 95% CI 1.2; 1.4) 2 years later. For the reversed direction, better self-esteem was associated with higher HDAS 2 years later (OR 1.1 95% CI 1.0; 1.29). The analysis stratified by weight status revealed that the associations between higher HDAS at baseline and better well-being at follow-up were similar in both normal weight and overweight children. Conclusion: Present findings suggest a bidirectional relation between diet quality and self-esteem. Additionally, higher adherence to healthy dietary guidelines at baseline was associated with fewer emotional and peer problems at follow-up, independent of children's weight status.
6.	Bammann, Karin, et al. (författare) Early Life Course Risk Factors for Childhood Obesity: The IDEFICS Case-Control Study 2014 Ingår i: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 9:2 Tidskriftsartikel (refereegranskat)abstract Background: The early life course is assumed to be a critical phase for childhood obesity; however the significance of single factors and their interplay is not well studied in childhood populations. Objectives: The investigation of pre-, peri- and postpartum risk factors on the risk of obesity at age 2 to 9. Methods: A case-control study with 1,024 1:1-matched case-control pairs was nested in the baseline survey (09/2007–05/ 2008) of the IDEFICS study, a population-based intervention study on childhood obesity carried out in 8 European countries in pre- and primary school settings. Conditional logistic regression was used for identification of risk factors. Results: For many of the investigated risk factors, we found a raw effect in our study. In multivariate models, we could establish an effect for gestational weight gain (adjusted OR = 1.02; 95%CI 1.00–1.04), smoking during pregnancy (adjusted OR = 1.48; 95%CI 1.08–2.01), Caesarian section (adjusted OR = 1.38; 95%CI 1.10–1.74), and breastfeeding 4 to 11 months (adjusted OR = 0.77; 95%CI 0.62–0.96). Birth weight was related to lean mass rather than to fat mass, the effect of smoking was found only in boys, but not in girls. After additional adjustment for parental BMI and parental educational status, only gestational weight gain remained statistically significant. Both, maternal as well as paternal BMI were the strongest risk factors in our study, and they confounded several of the investigated associations. Conclusions: Key risk factors of childhood obesity in our study are parental BMI and gestational weight gain; consequently prevention approaches should target not only children but also adults. The monitoring of gestational weight seems to be of particular importance for early prevention of childhood obesity.
7.	Börnhorst, Claudia, et al. (författare) Age-Specific Quantification of Overweight/Obesity Risk Factors From Infancy to Adolescence and Differences by Educational Level of Parents 2023 Ingår i: International Journal of Public Health. - 1661-8564. ; 68 Tidskriftsartikel (refereegranskat)abstract Objectives: To explore the age-dependent associations between 26 risk factors and BMI in early life, and differences by parental educational level. Methods: Data of 10,310 children (24,155 measurements) aged 2–16years participating in a multi-centre European cohort from 2007 to 2014 were utilized. Trajectories of overweight/obesity risk factors and their age-specific associations with BMI were estimated using polynomial mixed-effects models. Results: Exposure to most unfavourable factors was higher in the low/medium compared to the high education group, e.g., for PC/TV time (12.6 vs. 10.6h/week). Trajectories of various risk factors markedly changed at an age of 9–11years. Having a family history of obesity, maternal BMI, pregnancy weight gain and birth weight were positively associated with BMI trajectories throughout childhood/adolescence in both education groups; associations of behavioural factors with BMI were small. Parental unemployment and migrant background were positively associated with BMI in the low/medium education group. Conclusion: Associations of risk factors with BMI trajectories did not essentially differ by parental education except for social vulnerabilities. The age period of 9–11years may be a sensitive period for adopting unfavourable behaviours.
8.	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).
9.	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.
10.	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
11.	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.
12.	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.
13.	Donatelle, Rebecca, et al. (författare) Incentives in smoking cessation: status of the field and implications for research and practice with pregnant smokers. 2004 Ingår i: Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco. - : Oxford University Press (OUP). - 1462-2203. ; 6 Suppl 2 Tidskriftsartikel (refereegranskat)abstract We review the rationale and empirical evidence for the use of incentive and contingency management strategies for smoking cessation. Plausible theoretical rationales exist for the application of these strategies to smoking cessation, and a great deal of research with illicit drug users in laboratory or controlled treatment settings suggests such strategies can be effective. Contingency management methods have been effective in modifying smoking behavior in volunteers not seeking cessation assistance in highly controlled settings. Incentives have been used primarily as a component of worksite interventions, in community-wide quit-and-win programs, in quasiexperimental and experimental trials, and more recently with low-income pregnant women. Worksite studies have rarely been designed to isolate the impact of incentives. Nevertheless, they appear to be useful in these settings especially in increasing participation and increasing awareness about the deleterious effects of smoking. Quit-and-win programs are used widely in the United States and internationally and appear to attract many participants and produce modest quit rates. The quality of the evaluations of quit-and-win programs varies considerably, and none has employed rigorous control or comparison groups to sufficiently identify the effect of incentives. Recent controlled studies have yielded promising results with pregnant smokers, and larger trials are in progress. We discuss key methodological issues in mounting and evaluating incentive interventions, particularly during pregnancy, and discuss the practical and ethical issues arising from the use of incentives.
14.	Elsayed, Hadil A. Ghazy, et al. (författare) Relationship between perception of emotional home atmosphere and fruit and vegetable consumption in European adolescents: Results from the I.Family survey 2020 Ingår i: Public Health Nutrition. - 1368-9800 .- 1475-2727. ; 23:1, s. 53-62 Tidskriftsartikel (refereegranskat)abstract Objective:Consumption of fruits and vegetables (F&V) among adolescents falls below recommendations in many Western countries. The impact of social and emotional aspects of family life on adolescent dietary behaviour may contribute to this, yet remains under-investigated. The present study examines the association between adolescents' perceptions of emotional home atmosphere (EHA) and their F&V consumption frequency.Design:An FFQ was used to assess F&V consumption frequency. EHA was assessed by an eight-item measure with three subscales: perceived home warmth, strictness and relational tension. EHA subscales were used as binary variables: a score equal to or above the median value was considered as a higher perception, while a score below the median was considered as a lower perception of the EHA in question. Country differences in meeting the European 5-a-day recommendations were described. Further, the association between EHA and F&V consumption frequency was investigated using multiple linear regression.Setting:Regional examination centres in eight European countries.Participants:Adolescents (n 3196) aged 12-18 years.Results:The mean F&V consumption frequency was 3·27 (sd 2·84) times/d. Only 16·1 % of boys and 18 % of girls in our study sample met the recommendation of five F&V daily. After controlling for age, sex, education level of the parents and country of origin, perceived home warmth was associated with a 16 (95 % CI 9, 22) % higher F&V consumption frequency (P < 0·001).Conclusions:F&V consumption frequency was suboptimal in the survey areas. Interventions targeting perceived warmth as a component of EHA could potentially have a positive effect on adolescents' dietary behaviour.
15.	Formisano, Annarita, et al. (författare) Family structure and childhood obesity: results of the IDEFICS project 2014 Ingår i: Public Health Nutrition. - 1368-9800. ; 17:10, s. 2307-2315 Tidskriftsartikel (refereegranskat)abstract Objective: To analyze the association between family structure and adiposity in children. Design: Cross-sectional and longitudinal analysis of the IDEFICS (Identification and prevention of dietary- and lifestyle-induced health effects in children and infants) study cohort. Setting: Primary schools and kindergartens. Subjects: Children (n 12 350; aged 7 to 9 (SD 1.8) years) for the cross-sectional analysis and children (n 5236; at baseline: normal weight, aged 5 to 9 (SD 1.8) years) for the longitudinal study underwent anthropometry. Family structure was analyzed as (i) number and type of cohabiting adults and (ii) number of siblings. Results: In the cross-sectional analysis, after controlling for covariates, children living with grandparents had significantly higher BMI Z-score than those living with both parents (0.63; 95% CI 0.33, 0.92 v. 0.19; 95% CI 0.17, 0.22; P,0.01); in addition, the higher the number of siblings, the lower the BMI Z-score (only child 50.31; 95% CI 0.24, 0.38; 1 sibling 50.19; 95% CI 0.16, 0.23; 2 siblings 50.15; 95% CI 0.09, 0.20; >2 siblings 50.07, 95% CI 0.04, 0.19;P,0.001). Over the 2-year follow-up, differences in weight gain were observed across family-structure categories. Further, the risk of incidence of overweight/ obesity was significantly lower the higher the number of siblings living in the household (v. only child: 1 sibling 50.74, 95% CI 0.57, 0.96; 2 siblings 50.63, 95% CI 0.45, 0.88; >2 siblings 50.40, 95% CI 0.21, 0.77), independently of confounders. Conclusions: The study suggests that an independent association between family structure and childhood obesity exists.
16.	Fridolfsson, Jonatan, 1992, et al. (författare) High-intensity activity is more strongly associated with metabolic health in children compared to sedentary time: a cross-sectional study of the 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 Physical activity (PA) during childhood is important for preventing future metabolic syndrome (MetS). To examine the relationship between PA and MetS in more detail, accurate measures of PA are needed. Previous studies have only utilized a small part of the information available from accelerometer measured PA. This study investigated the association between measured PA and MetS in children with a new method for data processing and analyses that enable more detailed interpretation of PA intensity level. Methods The association between PA pattern and risk factors related to MetS was investigated in a cross- sectional sample of children (n = 2592, mean age 10.9 years, 49.4% male) participating in the European multicenter I. Family study. The risk factors examined include body mass index, blood pressure, high-density lipoprotein cholesterol, insulin resistance and a combined risk factor score (MetS score). PA was measured by triaxial accelerometers and raw data was processed using the 10 Hz frequency extended method (FEM). The PA output was divided into an intensity spectrum and the association with MetS risk factors was analyzed by partial least squares regression. Results PA patterns differed between the European countries investigated, with Swedish children being most active and Italian children least active. Moderate intensity physical activity was associated with lower insulin resistance (R-2 = 2.8%), while vigorous intensity physical activity was associated with lower body mass index (R-2 = 3.6%), MetS score (R-2 = 3.1%) and higher high-density lipoprotein cholesterol (R-2 = 2.3%). PA of all intensities was associated with lower systolic- and diastolic blood pressure, although the associations were weaker than for the other risk factors (R-2 = 1.5% and R-2 = 1.4%). However, the multivariate analysis implies that the entire PA pattern must be considered. The main difference in PA was observed between normal weight and overweight children. Conclusions The present study suggests a greater importance of more PA corresponding to an intensity of at least brisk walking with inclusion of high-intense exercise, rather than a limited time spent sedentary, in the association to metabolic health in children. The methods of data processing and statistical analysis enabled accurate analysis and interpretation of the health benefits of high intensity PA that have not been shown previously.
17.	González-Gil, E. M., et al. (författare) Impaired metabolic health over-time and high abdominal fat are prospectively associated with high-sensitivity C-reactive protein in children: The IDEFICS study 2021 Ingår i: Pediatric Obesity. - : Wiley. - 2047-6302 .- 2047-6310. ; 16:11 Tidskriftsartikel (refereegranskat)abstract Background: Metabolic risk and inflammatory state have an early life onset and are associated with future diseases. Objectives: To assess the association between metabolic syndrome (MetS) and metabolic health with high-sensitive C-reactive protein (hsCRP), cross-sectionally and longitudinally, in children. Methods: 2913 European children (2-10 years) from eight countries from the IDEFICS study were investigated. Data were collected at baseline and 2 years later (follow-up). A MetS z-score was computed with waist circumference (WC), insulin resistance index, blood pressure, high-density lipoprotein cholesterol and triglycerides. Metabolically unhealthy (MU) status was assessed. Multi-level linear and logistic regressions were performed. Results: Among the MetS markers, WC was more consistently associated with hsCRP cross-sectional and prospectively. Baseline MetS score was significantly associated with greater risk of high hsCRP at follow-up and with prevalence and incidence of hsCRP. Those children who became MU overtime were significantly (P <.05) associated with future higher levels of hsCRP, independently of weight status at baseline. Conclusions: Transition over time to a MU state was associated with higher levels of hsCRP at follow-up, independent of weight status at baseline. Screening of metabolic factors and routine measurement of WC are needed to prevent inflammatory status and related chronic diseases in children. © 2021 The Authors. Pediatric Obesity published by John Wiley & Sons Ltd on behalf of World Obesity Federation.
18.	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.
19.	Hunsberger, Monica, 1973, et al. (författare) Bidirectional associations between psychosocial well-being and body mass index in European children: longitudinal findings from the IDEFICS study 2016 Ingår i: Bmc Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 16 Tidskriftsartikel (refereegranskat)abstract Background: The negative impact of childhood overweight on psychosocial well-being has been demonstrated in a number of studies. There is also evidence that psychosocial well-being may influence future overweight. We examined the bidirectional association between childhood overweight and psychosocial well-being in children from a large European cohort. The dual aim was to investigate the chronology of associations between overweight and psychosocial health indicators and the extent to which these associations may be explained by parental education. Methods: Participants from the IDEFICS study were recruited from eight countries between September 2007 and June 2008 when the children were aged 2 to 9.9 years old. Children and families provided data on lifestyle, psychosocial well-being, and measured anthropometry at baseline and at follow-up 2 years later. This study includes children with weight, height, and psychosocial well-being measurements at both time points (n = 7,831). Psychosocial well-being was measured by the KINDL (R) and Strengths and Difficulties Questionnaire respectively. The first instrument measures health-related quality of life including emotional well-being, self-esteem, parent relations and social relations while the second measures well-being based on emotional symptoms, conduct problems and peer-related problems. Logistic regression was used for modeling longitudinal associations. Results: Children who were overweight at baseline had increased risk of poor health-related quality of life (odds ratio (OR) = 1.23; 95 % confidence interval (CI): 1.03-1.48) measured 2 years later; this association was unidirectional. In contrast to health-related quality of life, poor well-being at baseline was associated with increased risk of overweight (OR = 1.39; 95 % CI: 1.03-1.86) at 2 year follow-up; this association was also only observed in one direction. Adjustment for parental education did not change our findings. Conclusion: Our findings indicate that the association between overweight and psychosocial well-being may be bidirectional but varies by assessment measures. Future research should further investigate which aspects of psychosocial well-being are most likely to precede overweight and which are more likely to be consequences of overweight.
20.	Hunsberger, Monica, 1973, et al. (författare) Calorie labeling in a rural middle school influences food selection: findings from community-based participatory research. 2015 Ingår i: Journal of obesity. - : Hindawi Limited. - 2090-0716 .- 2090-0708. ; 2015 Tidskriftsartikel (refereegranskat)abstract Calorie labeling at the point-of-purchase in chain restaurants has been shown to reduce energy intake.
21.	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.
22.	Hunsberger, Monica, 1973 (författare) Early feeding practices and family structure: associations with overweight in children. 2014 Ingår i: Proceedings of the Nutrition Society. The Nutrition Society Irish Section 22nd Annual Postgraduate Meeting. 14–15 February 2013, Belfast, Ireland. - 0029-6651 .- 1475-2719. Konferensbidrag (refereegranskat)abstract The aim of this review is to examine two factors that may be associated with development of childhood overweight: early feeding, namely exclusive breastfeeding practices; family structure. Findings from the Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS (IDEFICS) study are presented in the context of the literature. IDEFICS is a multi-centre European study exploring the risks for overweight and obesity in children, which recruited 16 224 children aged 2–9 years from September 2007 to June 2008 at survey centres in Italy, Estonia, Cyprus, Belgium, Sweden, Hungary, Germany and Spain. Among the IDEFICS sample, after controlling for confounders, exclusive breastfeeding for 4–6 months was protective of overweight (including obesity) when compared with children never exclusively breastfed (OR 0·73, 95 % CI 0·63, 0·85). Family structure and number of siblings may also be associated with overweight. IDEFICS children without siblings were more likely (OR 1·52, 95 % CI 1·34, 1·72) to be overweight than their peers with siblings when controlling for factors related to childhood overweight such as country, parental education, parental weight, maternal age, child's age, birth weight and gender. Both early feeding practices and family structure play a role in the future development of obesity. The impact of breastfeeding on future development of overweight is dependent upon the dose. Exclusive breastfeeding for the recommended 6 months appears to be protective of overweight. Family structure is also an important component and emerging research suggests only children are at increased risk for overweight in comparison with those with siblings. In European countries, approximately 22 million children are overweight. Early dietary exposures, genetic, environmental and social factors have all been proposed as potential causal factors. Two such factors include exclusive breastfeeding and the impact of being an only child. We have investigated these two factors for associations with overweight; our studies, in the context of previous findings, are the focus of this review.
23.	Hunsberger, Monica, 1973, et al. (författare) Elementary school children’s recess schedule and dietary intake at lunch: a community-based participatory research partnership pilot study 2014 Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 14 Tidskriftsartikel (refereegranskat)abstract Background: School recess before lunch (e.g., reverse recess) has been suggested as a means to improve dietary intake and classroom behavior but limited research explores this school-based policy. This pilot study tests the impact of recess scheduling on dietary intake at school lunch. Methods: A mixed methods approach included assessment of dietary intake assessed by measured plate waste on five non-consecutive days at Madras Elementary School, Madras, Oregon, United States (n=104 intervention; 157 controls). Subjects included primary school children in grades kindergarten, first and second. Logistic regression was used to test associations between recess timing and dietary intake. Four focus groups involving teachers and staff explored reactions to the intervention. Qualitative data was transcribed verbatim and assessed for key themes. Results: Milk consumption was 1.3 oz greater in the intervention group (5.7 oz vs. 4.4 oz); and 20% more of the intervention participants drank the entire carton of milk (42% vs. 25%, p<0.0001). Intervention participants were 1.5 times more likely to meet the nutritional guidelines for calcium (≥267 mg, p=0.01) and fat (≤30% of total energy, p=0.02). Consumption of entrees, vegetables, and fruits did not differ between groups. Teachers perceived recess before lunch beneficial to classroom behavior and readiness to concentrate following lunch. Conclusions: The recess before lunch intervention yielded increased milk consumption; the nutritional and social benefits observed warrant policy change consideration. Future research should assess the impact of recess before lunch in larger districts.
24.	Hunsberger, Monica, 1973, et al. (författare) Low fat diets in obesity management and weight control. 2014 Ingår i: Managing and preventing obesity: behavioural factors and dietary interventions.. - : Woodhead Publishing.. Bokkapitel (övrigt vetenskapligt/konstnärligt)
25.	Hunsberger, Monica, 1973, et al. (författare) Overweight in singletons compared to children with siblings: the IDEFICS study. 2012 Ingår i: Nutrition and diabetes. - : Springer Science and Business Media LLC. - 2044-4052. ; 2 Tidskriftsartikel (refereegranskat)abstract The aim of this study was to compare the prevalence of overweight in only children to those with siblings and to explore potential behavioral mediating factors. This study relies upon cross-sectional data collected at survey centers in eight European countries participating in Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS (IDEFICS). The present analysis is based on measured anthropometry and parent or guardian-reported socio-demographic characteristics. Subjects include 12720 children aged 2–9 years for whom number of siblings was known. Singletons were more likely (odds ratio 1.52, 95% confidence interval (CI):1.34–1.72) to be overweight than their peers with siblings when controlling for factors related to childhood overweight, including survey country, parental education, parental weight, maternal age, child's age, birth weight and gender. The three southernmost countries have over threefold risk of overweight, dominated by Italy, compared with the north-central countries, which is not explained by the prevalence of singleton children. The excess risk of overweight among children without siblings was robustly observed even when considering behavioral mediating factors (playtime, screen time per day, dietary propensities for sugar or fat, parental attitudes towards food rewards and television in the child's bedroom). Among singletons aged 6–9 years, the excess risk of overweight was 1.70 (95% CI: 1.44–2.01) compared with 1.32 (95% CI: 1.10–1.60) in younger singletons.
26.	Hunsberger, Monica, 1973, et al. (författare) Physician Care Patterns and Adherence to Postpartum Glucose Testing after Gestational Diabetes Mellitus in Oregon 2012 Ingår i: Plos One. - : Public Library of Science (PLoS). - 1932-6203. ; 7:10 Tidskriftsartikel (refereegranskat)abstract Objective: This study examines obstetrician/gynecologists and family medicine physicians' reported care patterns, attitudes and beliefs and predictors of adherence to postpartum testing in women with a history of gestational diabetes mellitus. Research Design and Methods: In November-December 2005, a mailed survey went to a random, cross-sectional sample of 683 Oregon licensed physicians in obstetrician/gynecologists and family medicine from a population of 2171. Results: Routine postpartum glucose tolerance testing by both family physicians (19.3%) and obstetrician/gynecologists physicians (35.3%) was reportedly low among the 285 respondents (42% response rate). Factors associated with high adherence to postpartum testing included physician stated priority (OR 4.39, 95% CI: 1.69-7.94) and physician beliefs about norms or typical testing practices (OR 3.66, 95% CI: 1.65-11.69). Specialty, sex of physician, years of practice, location, type of practice, other attitudes and beliefs were not associated with postpartum glucose tolerance testing. Conclusions: Postpartum glucose tolerance testing following a gestational diabetes mellitus pregnancy was not routinely practiced by responders to this survey. Our findings indicate that physician knowledge, attitudes and beliefs may in part explain suboptimal postpartum testing. Although guidelines for postpartum care are established, some physicians do not prioritize these guidelines in practice and do not believe postpartum testing is the norm among their peers.
27.	Hunsberger, Monica, 1973, et al. (författare) Racial/ethnic disparities in gestational diabetes mellitus: findings from a population-based survey. 2010 Ingår i: Women's health issues : official publication of the Jacobs Institute of Women's Health. - : Elsevier BV. - 1878-4321. ; 20:5, s. 323-8 Tidskriftsartikel (refereegranskat)abstract We sought to explore racial/ethnic disparities in the prevalence of gestational diabetes mellitus (GDM) in a population-based sample.
28.	Hunsberger, Monica, 1973, et al. (författare) Regular versus episodic drinking in Swedish women: Reporting of regular drinking may be less biased by social desirability. 2020 Ingår i: Alcohol. - : Elsevier BV. - 1873-6823 .- 0741-8329. ; 86, s. 57-63 Tidskriftsartikel (refereegranskat)abstract To describe the personality and social characteristics associated with regular and episodic alcohol consumption in a Swedish cohort of women.406 women aged 38 and 50 who participated in the Population Study of Women in Gothenburg in 2004-2005 with complete data on the key variables are included. Regular alcohol use was based on frequencies of alcoholic beverage consumption, reported to examining physicians. Regular drinking was defined as those consuming wine, beer, or spirits at least twice weekly. Episodic drinking was defined as consumption of six drinks or more on a single occasion at least once during the last year. Personality traits were studied using the self-administered 57-item Eysenck Personality Inventory, which includes a 'lie scale' measuring the tendency toward social desirability, a 'neuroticism scale', and an 'extraversion scale'. Logistic regression was used to estimate odds ratios (OR) for regular and episodic drinking, respectively, in relation to standardized (SD) personality scores and selected social characteristics.49% of the women reported episodic drinking, while 58% reported regular drinking, and 34% reported both. Women with a higher tendency toward socially desirable responses were less likely to report episodic drinking (odds ratio [OR]=0.67, 95% confidence interval [CI]=0.53-0.84) per standard deviation (SD), a trait that was not associated with regular drinking.The strong inverse association between the propensity to lie scale with episodic but not regular drinking suggests that episodic drinking is subject to greater social desirability and under-reporting biases than regular drinking. Our findings indicate that this type of problem drinking may be missed in medical examinations, which limits the ability of health professionals to intervene.
29.	Hunsberger, Monica, 1973, et al. (författare) Relative validation of Block Kids Food Screener for dietary assessment in children and adolescents. 2015 Ingår i: Maternal & child nutrition. - : Wiley. - 1740-8709 .- 1740-8695. ; 11:2, s. 260-270 Tidskriftsartikel (refereegranskat)abstract Food frequency questionnaires (FFQs) are less time consuming and inexpensive instruments for collecting dietary intake when compared with 24-h dietary recalls or double-labelled water; however, the validation of FFQ is important as incorrect information may lead to biased conclusions about associations. Therefore, the relative validity of the Block Kids Food Screener (BKFS) developed for use with children was examined in a convenience sample of 99 youth recruited from the Portland, OR metropolitan area. Three 24-h dietary recalls served as the reference. The relative validity was analysed after natural log transformation of all variables except glycaemic index prior to correlation analysis. Daily cup equivalent totals from the BKFS and 'servings' from 24-h recalls were used to compute average daily intake of fruits, vegetables, potatoes, whole grains, legumes, meat/fish/poultry and dairy. Protein grams (g), total kcalories, glycaemic index (glucose reference), glycaemic load (glucose reference), total saturated fat (g) and added sugar (g) were also calculated by each instrument. The correlation between data obtained from the two instruments was corrected for the within-subject variation in food intake reported by the 24-h recalls using standard nutritional assessment methodology. The de-attenuated correlations in nutritional intake between the two dietary assessment instruments ranged from 0.526 for vegetables, to 0.878 for potatoes. The 24-h recall estimated higher levels of saturated fat and added sugar consumption, higher glycaemic loads and glycaemic indices; the de-attenuatted correlations of these measures ranged from 0.478 to 0.768. Assessment of Bland-Altman plots indicated no systematic difference between the two instruments for vegetable, dairy and meat/fish/poultry fat consumption. BKFS is a useful dietary assessment instrument for the nutrients and food groups it was designed to assess in children age 10-17 years.
30.	Hunsberger, Monica, 1973, et al. (författare) Student and Parental Perceptions of School-Based Body Mass Index Screening and Notification 2014 Ingår i: Journal of Community Medicine & Health Education. - 2161-0711. ; S2:009 Tidskriftsartikel (refereegranskat)abstract To address the childhood obesity epidemic, school-based body mass index (BMI) screening and surveillance is proposed or mandated in 30 states. We examined parent and student perceptions of school-based measuring and reporting in an ethnically diverse school district in Madras, Oregon, USA. Four broad themes emerged from focus groups held separately with parents and students. Students generally expressed a neutral opinion of BMI measurement. Parents felt that they held primary responsibility for their child’s weight. Parents and students perceived BMI notification as important; however, BMI reporting did not widely serve as an impetus for physician involvement or self-reported behavior change. Perceived barriers to behavior change included the lack of a supportive environment, poor access to healthcare, cultural issues, lack of concern over childhood overweight or a minimizing of health risks associated with overweight and poor understanding of the BMI graph and accompanied reporting of health information. Notification letters had limited effectiveness in this community.
31.	Hunsberger, Monica, 1973, et al. (författare) Validity of self-reported lunch recalls in Swedish school children aged 6 to 8 years 2013 Ingår i: Nutrition Journal. - 1475-2891. ; 12:129 Tidskriftsartikel (refereegranskat)
32.	Iacomino, G., et al. (författare) Circulating miRNAs are associated with sleep duration in children/adolescents: Results of the I.Family Study 2020 Ingår i: Experimental Physiology. - : Wiley. - 0958-0670 .- 1469-445X. ; 105:2, s. 347-356 Tidskriftsartikel (refereegranskat)abstract New Findings What is the central question of this study?Are differential patterns of circulating miRNAs associated with sleep duration in normal-weight European children and adolescents? What is the main finding and its importance?Differences in the expression level of circulating miR-26b-3p and miR-485-5p are positively associated with total sleep duration in healthy normal-weight children and adolescents. It is commonly recognized that sleep is essential for children's health, and that insufficient sleep duration is associated with negative health outcomes. In humans, sleep duration and quality are influenced by genetic, environmental and social factors. Epigenetic mechanisms, likewise, regulate circadian rhythms and sleep patterns. In the present study, we aimed to identify circulating microRNAs associated with sleep duration in a subsample of normal-weight European children/adolescents (n = 111) participating in the I.Family Study. Subjects were divided into two groups based upon self-reported sleep duration, according to the recommended amount of sleep for paediatric populations. Sleep needs for children <13 years were at least 9 h per day, and for children >13 were at least 8 h per day. There were group differences (short sleepers versus normal sleepers) in circulating levels of miR-26b-3p (mean (95% CI) = 2.0 (1.3-2.7) versus 2.3 (1.9-2.7), P = 0.05) and miR-485-5p (mean (95% CI) = 0.6 (0.3-0.9) versus 0.9 (0.7 - 1.0), P < 0.001), adjusting for country of origin, age, sex, pubertal status, screen time and highest educational level of parents. Our findings show for the first time that sleep duration reflects the profile of specific circulating microRNAs in school-aged children and adolescents. It is conceivable that epigenetic modifications, mainly related to circadian rhythm control, may be modulated or interfere with sleep duration.
33.	Iguacel, I., et al. (författare) Associations between social vulnerabilities and psychosocial problems in European children. Results from the IDEFICS study 2017 Ingår i: European Child & Adolescent Psychiatry. - : Springer Science and Business Media LLC. - 1018-8827 .- 1435-165X. ; 26:9, s. 1105-1117 Tidskriftsartikel (refereegranskat)abstract The effect of socioeconomic inequalities on children's mental health remains unclear. This study aims to explore the cross-sectional and longitudinal associations between social vulnerabilities and psychosocial problems, and the association between accumulation of vulnerabilities and psychosocial problems. 5987 children aged 2-9 years from eight European countries were assessed at baseline and 2-year follow-up. Two different instruments were employed to assess children's psychosocial problems: the KINDL (Questionnaire for Measuring Health-Related Quality of Life in Children and Adolescents) was used to evaluate children's well-being and the Strengths and Difficulties Questionnaire (SDQ) was used to evaluate children's internalising problems. Vulnerable groups were defined as follows: children whose parents had minimal social networks, children from non-traditional families, children of migrant origin or children with unemployed parents. Logistic mixed-effects models were used to assess the associations between social vulnerabilities and psychosocial problems. After adjusting for classical socioeconomic and lifestyle indicators, children whose parents had minimal social networks were at greater risk of presenting internalising problems at baseline and follow-up (OR 1.53, 99% CI 1.11-2.11). The highest risk for psychosocial problems was found in children whose status changed from traditional families at T0 to non-traditional families at T1 (OR 1.60, 99% CI 1.07-2.39) and whose parents had minimal social networks at both time points (OR 1.97, 99% CI 1.26-3.08). Children with one or more vulnerabilities accumulated were at a higher risk of developing psychosocial problems at baseline and follow-up. Therefore, policy makers should implement measures to strengthen the social support for parents with a minimal social network.
34.	Intemann, Timm, et al. (författare) A Late Meal Timing Pattern Is Associated with Insulin Resistance in European Children and Adolescents 2024 Ingår i: PEDIATRIC DIABETES. - 1399-543X .- 1399-5448. ; 2024 Tidskriftsartikel (refereegranskat)abstract Meal timing has been associated with metabolic markers in adults, but not in children or adolescents. The aim of this study was to investigate associations of meal timing patterns (MTPs) with insulin resistance (IR) and triglyceride levels in children and adolescents. In this cross-sectional study, we included 2,195 participants aged 8-15 years from the European I.Family study (2013/14). Habitual diet exposures were derived using 24-hr dietary recalls and HOMA-IR, HbA1c, and triglycerides were used as metabolic outcome variables. We applied k-means cluster analysis on five dietary exposures (energy proportion in the morning and evening, eating window, pre-sleep fasting and eating frequency), which revealed the following three MTPs: "early-often", "late-long" and "late-infrequent-short". We used linear mixed models to estimate the associations between MTPs and the z-scores of the metabolic outcome variables. The association analysis revealed differences between MTPs in HOMA-IR but not in HbA1c or triglyceride z-scores. The "late-infrequent-short" pattern was associated with a 0.19 (95%-CI: (0.01, 0.36)) higher HOMA-IR z-score compared to the "early-often" pattern in the model adjusted for age, BMI z-score, education, sex, country, and family membership. These findings suggest that the timing of meals may influence IR already in childhood and adolescence. Therefore, the time of meals should be considered in future nutrition research and dietary advice for children and adolescents.
35.	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.
36.	Kovacs, E., et al. (författare) Adherence to combined lifestyle factors and their contribution to obesity in the IDEFICS study 2015 Ingår i: Obesity Reviews. - : Wiley. - 1467-7881 .- 1467-789X. ; 16:Suppl. 2, s. 138-150 Tidskriftsartikel (refereegranskat)abstract BackgroundThe Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS (IDEFICS) study investigated the aetiology of childhood obesity and developed a primary prevention programme. MethodsPre-intervention adherence to key behaviours related to childhood obesity, namely water/sweetened drink, fruit/vegetable consumption, daily TV time, physical activity, family time and adequate sleep duration, was measured at baseline. Adherence to international recommendations was converted into a composite score ranging from 0 (none) to 6 (adhering to all). Data on adherence were available for 7,444 to 15,084 children aged 2-9.9years, depending on the behaviour. By means of multi-level logistic regression models adjusted for age, sex and country, we calculated odds ratios (OR) and 95% confidence intervals (CI) to estimate the relationship between adherence to these recommendations and the risk of being overweight/obese. ResultsAdherence ranged from 15.0% (physical activity) to 51.9% (TV time). As adherence increased, a lower chance of being overweight/obese was observed; adhering to only one key behaviour (score=1) meant an OR=0.81 (CI: 0.65-1.01) compared with non-adherence (score=0), while adhering to more than half of the key behaviours (score4) halved the chance for overweight/obesity (OR=0.54, CI: 0.37-0.80). Adherence to physical activity, TV and sleep recommendations was the main driver reducing the chance of being overweight. Overweight/obese children were more likely not to adhere to at least one of the recommended behaviours (19.8%) than normal-weight/thin children (12.9%) ConclusionThe selected key behaviours do not contribute equally to a reduced chance of being overweight. Future interventions may benefit most from moving more, reducing TV time and getting adequate sleep. (c) 2015 World Obesity
37.	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.
38.	Mbumba, Vanessa, et al. (författare) Parental investment can moderate the negative effects of low socioeconomic status on children’s health: an analysis of Kenyan national data 2021 Ingår i: Journal of Global Health Reports. - : Inishmore Laser Scientific Publishing Ltd. - 2399-1623. ; 5, s. 1-12 Tidskriftsartikel (refereegranskat)abstract In Kenya, childhood stunting still is a critical public health challenge. Parents can invest more in their offspring through planning for fewer children, attending sufficient antenatal clinics, and providing adequate breastfeeding to moderate the negative effects of low socio-economics status on their children’s health
39.	McGinnis, Paul B, et al. (författare) Transitioning from CHIP to CHIRP: blending community health development with community-based participatory research. 2010 Ingår i: Family & community health. - 1550-5057. ; 33:3, s. 228-37 Tidskriftsartikel (refereegranskat)abstract In 2006, a community health development model was used to engage citizens in Jefferson County, Oregon, around local health concerns. Childhood obesity emerged as a priority health issue. In 2007, a research component was introduced by Oregon Health & Science University to help the community garner resources and inform the field. This case study describes the collaboration between the Mountain View Community Health Improvement Partnership and Oregon Health & Science University to increase the number of county children at a healthy weight. Research and projects occurred simultaneously since community members are motivated by action, and research is a slower process.
40.	Mehlig, Kirsten, 1964, et al. (författare) Children's propensity to consume sugar and fat predicts regular alcohol consumption in adolescence. 2018 Ingår i: Public health nutrition. - 1475-2727. ; 21:17, s. 3202-3209 Tidskriftsartikel (refereegranskat)abstract The present study investigated the association between sugar and fat intake in childhood in relation to alcohol use in adolescence. We hypothesized that early exposure to diets high in fat and sugar may affect ingestive behaviours later in life, including alcohol use.Design/Setting/SubjectsChildren from the European IDEFICS/I.Family cohort study were examined at ages 5-9 years and followed up at ages 11-16 years. FFQ were completed by parents on behalf of children, and later by adolescents themselves. Complete data were available in 2263 participants. Children's propensities to consume foods high in fat and sugar were calculated and dichotomized at median values. Adolescents' use of alcohol was classified as at least weekly v. less frequent use. Log-binomial regression linked sugar and fat consumption in childhood to risk of alcohol use in adolescence, adjusted for relevant covariates.Five per cent of adolescents reported weekly alcohol consumption. Children with high propensity to consume sugar and fat were at greater risk of later alcohol use, compared with children with low fat and low sugar propensity (relative risk=2·46; 95 % CI 1·47, 4·12), independent of age, sex and survey country. The association was not explained by parental income and education, strict parenting style or child's health-related quality of life and was only partly mediated by sustained consumption of sugar and fat into adolescence.Frequent consumption of foods high in fat and sugar in childhood predicted regular use of alcohol in adolescence.
41.	Mehlig, Kirsten, 1964, et al. (författare) Negative life events predict weight gain in a 13-year follow-up of an adult Swedish population. 2020 Ingår i: Journal of psychosomatic research. - : Elsevier BV. - 1879-1360 .- 0022-3999. ; 132 Tidskriftsartikel (refereegranskat)abstract Increasing psychosocial stress may underlie contemporary obesity trends. We investigate cross-sectional and prospective associations between negative life events (NLEs) and anthropometric indicators, and whether these are explained by lifestyle, depression and sleeping problems.Participants in the Swedish INTERGENE cohort answered questions about ten types of NLE, and indicated whether they occurred during the last year or earlier (2001-04, n=2706). Body mass index (BMI) and waist-to-hip ratio (WHR) were measured at baseline, and at follow-up (2014-16, n=974). Numbers of recent and distant NLE were related to anthropometric variables using linear models including age, sex, and education, and further adjusted for lifestyle, and psychological problems. Prospective models were adjusted for baseline anthropometric values.Participants reported on average 3.6 types of NLEs, of which 70% were experienced more than one year ago. At baseline, distant but not recent NLEs were associated with higher values of both BMI and WHR. These associations were explained in part by lifestyle and depression assessed at baseline. Recent but not distant NLEs predicted gain in BMI, 0.19 (0.07, 0.30) kg/m2, and WHR, 0.005 (0.002, 0.007), per event and independent of baseline covariates. The largest associations were seen for job insecurity and financial worries, with 0.35 (0.17, 0.52) kg/m2 increase in BMI corresponding to approximately 1.2kg per event, in both sexes.We observed positive associations between NLEs and weight gain over 13years including signs of latency and recovery regarding adverse weight development.
42.	Michels, N., et al. (författare) Effect of the IDEFICS multilevel obesity prevention on children's sleep duration 2015 Ingår i: Obesity Reviews. - : Wiley. - 1467-7881 .- 1467-789X. ; 16:Suppl. 2, s. 68-77 Tidskriftsartikel (refereegranskat)abstract BackgroundAccording to recent findings, short sleep duration is associated with overweight in children. However, primary prevention efforts aimed at achieving adequate sleep among children are scarce. Therefore, the Identification and prevention of Dietary-induced and lifestyle-induced health EFfects In Children and infantS' (IDEFICS) study implemented a multilevel intervention that included sleep duration as a key behavioural target. The aim of this study is to evaluate sleep duration among children participating in the IDEFICS study. MethodsThe IDEFICS nocturnal sleep intervention was included as part of stress reduction educational messages aimed at parents and children. Sleep was assessed by a parental 24-h recall (only weekdays; n=8,543) and by a diary (weekdays and weekends separately; n=4,150). Mixed linear models tested the intervention effect on sleep duration change between baseline when children were 2-9.9years of age (2007/2008) and follow-up (2009/2010). Logistic mix models were used to study the intervention effect on the presence of TV in the children's bedroom (one of the intervention messages; n=8,668). Additionally, parents provided qualitative data regarding exposure to the intervention. ResultsAbout 51.1% of the parents in the intervention regions reported awareness of the sleep intervention. A small intervention effect was seen on weeknight sleep duration in that the decrease in sleep duration over 2years was smaller in the intervention (15min) as compared with control regions (19min) (p=0.044). There was no overall intervention effect on weekend sleep duration or on the presence of a TV in the bedroom. A small significant time effect between baseline and follow-up was found on bedroom TV presence depending on self-reported intervention exposure (3% increase in TV presence in exposed versus 6.6% increase in non-exposed). Children without a TV in the bedroom had longer nocturnal sleep duration. DiscussionThe sleep component of the intervention did not lead to clinically relevant changes in sleep duration. Future interventions aimed at young children's sleep duration could benefit from more specific and intense messaging than that found in the IDEFICS intervention. Future research should use objective measures of sleep duration as well as intermediate outcomes (sleep knowledge, sleep environment and sleep practices).
43.	Mjoberg, Melissa, 1991, et al. (författare) Supermarket promotions in Western Sweden are incompatible with Nordic dietary recommendations and differ by area-level socioeconomic index 2023 Ingår i: BMC Public Health. - 1471-2458. ; 23:1 Tidskriftsartikel (refereegranskat)abstract Background: Large supermarket chains produce weekly advertisements to promote foods and influence consumer purchases. The broad consumer reach of these ads presents an opportunity to promote foods that align with dietary recommendations. Thus, the aim of this study was to investigate the health quality of supermarkets' weekly food promotions in a large region of Sweden with attention to more and less advantaged socioeconomic index areas.MethodsAnalysis of weekly advertisements from 122 individual stores, representing seven chains, was carried out in a large region of Sweden from 2-29 March in 2020. Food promotions were divided into categories according to the Nordic Nutrition Recommendations and World Health Organization Regional Office for Europe's nutrient profile model, and defined as 'most healthy', 'healthy', 'unhealthy' and 'most unhealthy'. A mean socioeconomic index was used to classify each store location to determine whether proportions of the 'most unhealthy' foods differed between more advantaged and more disadvantaged socioeconomic index areas.ResultsIn total, 29,958 food items were analyzed. Two-thirds of promotions belonged to the food groups considered 'most unhealthy' and 'unhealthy'. In the 'most unhealthy' food group 'sugar-rich beverages and foods' constituted approximately 23.0% of the promotions. Food promotions had 25% increased odds to be from the 'most unhealthy' group (odds ratio 1.25, confidence interval 1.17, 1.33) in more disadvantaged socioeconomic index areas. This association could be explained by the supermarket chain the stores belonged to.ConclusionsOur findings indicate that Swedish supermarkets promote a large proportion of unhealthy foods as classified by the Nordic Nutrition Recommendations. We also observe that certain national supermarket chains tend to locate their stores in more disadvantaged areas and promote a greater proportion of unhealthy foods in their weekly advertisements compared to the more advantaged areas. There is an urgent need for supermarkets to shift promotions toward healthier food items.
44.	Nguyen, Thi Ngoc Phuong, 1993, et al. (författare) Individual-, social- and policy- factors associated with smoking cessation among adult male cigarette smokers in Hanoi, Vietnam: a longitudinal study 2023 Ingår i: BMC PUBLIC HEALTH. - : BioMed Central (BMC). - 1471-2458. ; 23:1 Tidskriftsartikel (refereegranskat)abstract BackgroundNearly one-in-two Vietnamese men smoke cigarettes placing them among the highest tobacco consumers in the world. Despite the need for smoking cessation to curb the burden of tobacco-related diseases in Vietnam, this rate remains at less than 30%. Therefore, this study examines individual-, social- and policy factors associated with smoking cessation among adult male smokers in Vietnam.MethodsWe established a longitudinal International Tobacco Control study of male smokers in Hanoi, Vietnam, in September 2018. This paper analyses 1525 men who participated in baseline and one-year follow-up. We applied a weighted multivariable logistic regression to examine the association between smoking cessation and individual-, social- and policy predictors.ResultsAt follow-up, 14.8% of participants had quit smoking for at least 30 consecutive days during the last year. Among the persistent smokers, 56.6% expressed intention to quit smoking. Factors associated with smoking cessation included a lower number of cigarettes smoked per day (aOR = 0.96, 95% CI: 0.94, 0.99) and having several attempts to quit smoking (aOR = 2.16, 95% CI 1.13, 4.12). Intention to quit smoking was associated with multiple quit attempts, a chronic condition diagnosis, more tobacco-related knowledge, greater self-efficacy, and more worries about their future health. The perceived impact of smoke-free policy and health warning labels were positively associated with intention to quit at any stage.ConclusionsInterventions aimed at increasing smoking cessation should focus on all aspects of individual, social, and policy factors. Persistent smokers are more motivated to quit if they have made multiple quit attempts, more self-efficacy of quitting and worried about their future health, indicating that increasing smokers' beliefs and knowledge may be important for behavioural change. Health warning labels and tobacco taxation policies should be maintained and promoted as they are perceived to be particularly useful for persistent smokers' intention to quit.
45.	Nguyen, Thi Ngoc Phuong, 1993, et al. (författare) Patterns and determinants of tobacco purchase behaviors among male cigarette smokers in Vietnam: A latent class analysis 2024 Ingår i: TOBACCO INDUCED DISEASES. - 1617-9625. ; 22 Tidskriftsartikel (refereegranskat)abstract INTRODUCTION Understanding smokers' purchasing patterns can aid in customizing tobacco control initiatives aimed at reducing the tobacco smoking prevalence. Therefore, this study identified cigarette purchase behavior among Vietnamese male smokers and associated demographic and consumption factors. METHODS We analyzed a secondary dataset of male current tobacco smokers (n=3983) who participated in the Vietnam Global Adult Tobacco Survey in 2015. We applied the latent class analysis (LCA) to identify the classes of purchase behavior among cigarette smokers (n=1241). Multinomial logistic regression was performed to identify demographics (education level, ethnicity, partnership status, and household socioeconomic status) and cigarette consumption variables (smoking years and heavy smoking status) related to purchase behavior classes. The results are reported as an adjusted relative risk ratio (ARRR). RESULTS The LCA identified four cigarette purchase behaviors classes: Class 1 (priceinsensitive and purchased international brand: 44.4%), Class 2 (price -sensitive and purchased domestic brand: 27.6%), Class 3 (price -sensitive and purchased cigarettes in a street vendor: 18.6%), and Class 4: price -sensitive and purchased loose/carton cigarette: 9.4%). The poorer economic groups were more likely to belong to the three price -sensitive classes. Heavy smokers and those who had smoked for a longer period were more likely to belong to Class 3 (ARRR=2.33; 95% CI: 1.51-3.58 and ARRR=1.02; 95% CI: 1.001-1.05, respectively) and Class 4 (ARRR=2.94; 95% CI: 1.71-5.06 and ARRR=1.05; 95% CI: 1.02-1.08, respectively). CONCLUSIONS Varied purchasing behaviors among male cigarette smokers, influenced by divergent price sensitivities and economic backgrounds, underscore the need for comprehensive tobacco control. Future efforts should include targeted policy interventions, behavior modification, and reshaping social norms.
46.	Overman, Meredith L., et al. (författare) The cross-sectional association of parental psychosocial status with children's Body Mass Index z-score and the mediating role of children's energy balance behaviors - the ABCD Study 2024 Ingår i: PLOS ONE. - 1932-6203. ; 19:4 Tidskriftsartikel (refereegranskat)abstract Objective Investigate the cross-sectional association between the psychosocial status of mothers and fathers and the BMI z-scores of their 10 to 12-year-old children. Explore whether this association is mediated by children's diet, physical activity, screen time and sleep. Analyze the moderating effect of the educational levels of both the mother and father on the association.Design In a cross-sectional study design, children's height and weight were measured following a standardized protocol. Parents completed the validated Depression Anxiety and Stress questionnaire, while diet quality, sports participation, time spent in bed and screen time were assessed through child-report using previously validated questions.Participants The data for this study were obtained from the Amsterdam Born Children and their Development study, involving children aged 10 to 12 years and both of their parents (N = 1315).Results The majority, 80%, of the parents were highly educated and born in the Netherlands, and 68% of the children had a healthy BMI. Maternal or paternal psychosocial status was not significantly associated with children's BMI z-score (maternal beta -0.0037; 95% CI: -0.008 to 0.0007, paternal beta 0.0028; 95% CI: -0.007 to 0.002). Screen time mediated the association between paternal psychosocial status and children's BMI z-score (beta = 0.010, 95% CI: 0.002; 0.020). Children's diet, physical activity, and sleep did not mediate the association between paternal psychosocial status and children's BMI z-score. Parental educational level was not a moderator.Conclusions This research is unique in including four energy balance behaviors and including both mothers and fathers' psychosocial status. Children withfathers experiencing poorer psychosocial status engaged in more screen time which partly explained their higher BMI z-score.
47.	Papoutsou, S., et al. (författare) Timing of solid food introduction and association with later childhood overweight and obesity: The IDEFICS study 2018 Ingår i: Maternal and Child Nutrition. - : Wiley. - 1740-8695. ; 14:1 Tidskriftsartikel (refereegranskat)abstract This study investigated associations between timing of solid food introduction and childhood obesity and explored maternal characteristics influencing early feeding practices. Cross-sectional data from children 2-9years (n=10,808; 50.5% boys) residing in 8 European countries of the IDEFICS study (2007-2008) were included. Late solid food introduction (7months of age) was associated with an increased prevalence of later childhood overweight/obesity among exclusively breastfed children (OR [odds ratio]: 1.38, 95% CI [confidence interval] [1.01, 1.88]). In contrast, early solid food introduction (<4months of age) was associated with lower prevalence of overweight/obesity among children that ceased exclusive breastfeeding earlier than 4 months (OR: 0.63, 95% CI [0.47, 0.84]). Children that were introduced to solids right after 6months exclusive breastfeeding and continued to receive breastmilk (12months) were less likely to become overweight/obese (OR: 0.67, 95% CI [0.51, 0.88]) compared to children that discontinued to receive breastmilk. Analyses were adjusted for age, sex, country, birth weight, parental education level, parental body mass index, tobacco use in pregnancy, gestational weight gain, and gestational diabetes. Underweight mothers, overweight mothers, mothers who reported daily smoking during pregnancy, and low-educated mothers were less likely to follow recommendations on breastfeeding and timely solids introduction. Future studies should examine whether guidelines for solid food introduction timing have to distinguish between exclusively breastfed, formula fed, and too early exclusive breastfeeding-ceased infants. There is also need for more prospective studies; recall bias was an important current limitation. In conclusion, health professionals should emphasize benefits of breastfeeding and appropriate solid food introduction, especially to mothers that are less likely to follow recommendations.
48.	Sahatqija, Filip, et al. (författare) Awareness of Hypertension, Hypercholesterolemia, and Diabetes Mellitus and Associated Characteristics in Russian Adults 2024 Ingår i: INTERNATIONAL JOURNAL OF HYPERTENSION. - 2090-0384 .- 2090-0392. ; 2024 Tidskriftsartikel (refereegranskat)abstract Russia has higher cardiovascular disease (CVD) mortality compared to other European countries. The major CVD risk factors are age, male sex, and three conditions, namely hypertension, hypercholesterolemia, and diabetes mellitus (DM). This study aimed to assess awareness of these three conditions among Russian adults (N = 3803) and the associated socio-demographic, lifestyle, and health characteristics. We used cross-sectional data from a randomly drawn population-based sample of Russians aged 35-69 years, who participated in the Know Your Heart (KYH) study conducted in Arkhangelsk and Novosibirsk between 2015-2018. Participants' self-reported awareness of hypertension, hypercholesterolemia, and DM was assessed against the measures at the KYH health check (blood pressure, cholesterol, HbA1c and/or use of medication for each condition). Prevalence estimates for the awareness were age- and sex-standardized to the Standard European Population. Socio-demographic, lifestyle, and health-related correlates of the awareness were investigated using logistic regression modelling. Among participants with hypertension (N = 2206), hypercholesterolemia (N = 3171), and DM (N = 329) recorded at a health check, 79%, 45%, and 61% self-reported these conditions, respectively. Higher awareness of hypercholesterolemia and hypertension was associated with older age, female sex, nonsmoking status, obesity, and history of CVD diagnoses. Low household income and history of CVD diagnoses were associated with being aware of DM. The awareness rates of hypertension were relatively high, whereas awareness rates of hypercholesterolemia and DM were relatively low. CVD prevention and early intervention could be improved in Russia through increasing the awareness of the risk factors.
49.	Scholle, O., et al. (författare) Use of Nutritional Supplements in Youth with Medicated and Unmedicated Attention-Deficit/Hyperactivity Disorder 2019 Ingår i: Journal of Child and Adolescent Psychopharmacology. - : Mary Ann Liebert Inc. - 1044-5463 .- 1557-8992. ; 29:1 Tidskriftsartikel (refereegranskat)abstract Objective: To find out whether use of nutritional supplements (NUS) differs between children and adolescents with attention-deficit/hyperactivity disorder (ADHD; medicated or unmedicated), compared with those without the disorder. Methods: We used cross-sectional data from the population-based I.Family study conducted between 2013 and 2014 in eight European countries. Parents completed questionnaires and participated in interviews, for example, on health and medical history of their child. Data from 5067 children and adolescents aged 5-17 years were included. Exposures were medicated (with ADHD-approved medication) and unmedicated ADHD. The outcome was the use of NUS, measured by use of any or multiple different NUS. Multivariable logistic regression adjusted for sociodemographics and health determinants was used to find ADHD-depending differences. Results: The study sample comprised 4490 children and adolescents without ADHD and 51 medicated and 76 unmedicated subjects with ADHD. Regarding the use of any NUS, no statistically significant differences were found between children and adolescents without ADHD (18%) and those with medicated (18%) or unmedicated ADHD (22%). However, discrepancies appear when considering multiple use of NUS, not reported for any medicated ADHD subject but remarkably often for unmedicated ADHD subjects (13%), resulting in an adjusted odds ratio of 2.6 (95% confidence interval, 1.2-5.6) when compared with those without ADHD (5%). Conclusion: Children and adolescents who were not using medication for treating ADHD potentially took NUS as oral remedies. Given the potential for a delay of indicated treatments and for use of those NUS which have no proven effectiveness, pediatricians should actively explore whether NUS have been used to treat ADHD core symptoms, and families should be informed that the average effect size has to be considered small.
50.	Stahlmann, Katharina, et al. (författare) A cross-sectional study of obesogenic behaviours and family rules according to family structure in European children. 2020 Ingår i: The international journal of behavioral nutrition and physical activity. - : Springer Science and Business Media LLC. - 1479-5868. ; 17:1 Tidskriftsartikel (refereegranskat)abstract There has been an increase in children growing up in non-traditional families, such as single-parent and blended families. Children from such families have a higher prevalence of obesity and poorer health outcomes, but research onthe relationship with obesogenic behaviours is limited.Therefore, the aim of this study was to investigate whether there are associations between family structures and obesogenic behaviours and related family rules in European children and adolescents.The sample included 7664 children (mean age±SD: 10.9±2.9) from 4923 families who were participants of the multi-centre I.Family study (2013/2014) conducted in 8 European countries. Family structure was assessed by a detailed interview on kinship and household. Obesogenic behaviours (screen time, sleep duration, consumption of sugar-sweetened beverages (SSBs)) and family rules (rules for computer and television, bedtime routine, availability of SSBs during meals) were determined by standardized questionnaires. Multilevel mixed-effects linear and logistic regression models were used to model the associations of family structure with obesogenic behaviours and family rules. Sex, age, parental education level, number of children and adults in the household and BMI z-score were covariates in the models. Two-parent biological families were set as the reference category.Children from single-parent families were less likely to have family rules regarding screen time (OR: 0.62, 95% CI: 0.40-0.94, p=0.026) with higher reported hours of screen time per week (β=2.70h/week, 95% CI: 1.39-4.00, p<0.001). The frequency of weekly SSB consumption differed by family structure in a sex-specific manner: girls from single-parent (β=3.19 frequency/week, 95% CI: 0.91-5.47, p=0.006) and boys from blended/adoptive families (β=3.01 frequency/week, 95% CI: 0.99-5.03, p=0.004) consumed more SSBs. Sleep duration, bedtime routines and availability of SSBs during meals did not differ between children from these family structures. Parental education did not modify any of these associations.Parents in non-traditional family structures appear to experience more difficulties in restricting screen time and the intake of SSBs in their children than parents in traditional two-parent family structures. Our findings therefore suggest that additional support and effective strategies for parents in non-traditional families may help to reduce obesogenic behaviours in children from such family types.

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