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1.
  • Bixby, H., et al. (author)
  • Rising rural body-mass index is the main driver of the global obesity epidemic in adults
  • 2019
  • In: Nature. - : Springer Science and Business Media LLC. - 0028-0836 .- 1476-4687. ; 569:7755, s. 260-4
  • Journal article (peer-reviewed)abstract
    • Body-mass index (BMI) has increased steadily in most countries in parallel with a rise in the proportion of the population who live in cities(.)(1,2) This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity(3-6). Here we use 2,009 population-based studies, with measurements of height and weight in more than 112 million adults, to report national, regional and global trends in mean BMI segregated by place of residence (a rural or urban area) from 1985 to 2017. We show that, contrary to the dominant paradigm, more than 55% of the global rise in mean BMI from 1985 to 2017-and more than 80% in some low- and middle-income regions-was due to increases in BMI in rural areas. This large contribution stems from the fact that, with the exception of women in sub-Saharan Africa, BMI is increasing at the same rate or faster in rural areas than in cities in low- and middle-income regions. These trends have in turn resulted in a closing-and in some countries reversal-of the gap in BMI between urban and rural areas in low- and middle-income countries, especially for women. In high-income and industrialized countries, we noted a persistently higher rural BMI, especially for women. There is an urgent need for an integrated approach to rural nutrition that enhances financial and physical access to healthy foods, to avoid replacing the rural undernutrition disadvantage in poor countries with a more general malnutrition disadvantage that entails excessive consumption of low-quality calories.
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2.
  • Mishra, A, et al. (author)
  • Diminishing benefits of urban living for children and adolescents' growth and development
  • 2023
  • In: Nature. - : Springer Science and Business Media LLC. - 1476-4687 .- 0028-0836. ; 615:7954, s. 874-883
  • Journal article (peer-reviewed)abstract
    • Optimal growth and development in childhood and adolescence is crucial for lifelong health and well-being1–6. Here we used data from 2,325 population-based studies, with measurements of height and weight from 71 million participants, to report the height and body-mass index (BMI) of children and adolescents aged 5–19 years on the basis of rural and urban place of residence in 200 countries and territories from 1990 to 2020. In 1990, children and adolescents residing in cities were taller than their rural counterparts in all but a few high-income countries. By 2020, the urban height advantage became smaller in most countries, and in many high-income western countries it reversed into a small urban-based disadvantage. The exception was for boys in most countries in sub-Saharan Africa and in some countries in Oceania, south Asia and the region of central Asia, Middle East and north Africa. In these countries, successive cohorts of boys from rural places either did not gain height or possibly became shorter, and hence fell further behind their urban peers. The difference between the age-standardized mean BMI of children in urban and rural areas was <1.1 kg m–2 in the vast majority of countries. Within this small range, BMI increased slightly more in cities than in rural areas, except in south Asia, sub-Saharan Africa and some countries in central and eastern Europe. Our results show that in much of the world, the growth and developmental advantages of living in cities have diminished in the twenty-first century, whereas in much of sub-Saharan Africa they have amplified.
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  • Bentley, Michael J., et al. (author)
  • A community-based geological reconstruction of Antarctic Ice Sheet deglaciation since the Last Glacial Maximum
  • 2014
  • In: Quaternary Science Reviews. - : Elsevier BV. - 0277-3791 .- 1873-457X. ; 100, s. 1-9
  • Journal article (peer-reviewed)abstract
    • A robust understanding of Antarctic Ice Sheet deglacial history since the Last Glacial Maximum is important in order to constrain ice sheet and glacial-isostatic adjustment models, and to explore the forcing mechanisms responsible for ice sheet retreat. Such understanding can be derived from a broad range of geological and glaciological datasets and recent decades have seen an upsurge in such data gathering around the continent and Sub-Antarctic islands. Here, we report a new synthesis of those datasets, based on an accompanying series of reviews of the geological data, organised by sector. We present a series of timeslice maps for 20 ka, 15 ka, 10 ka and 5 ka, including grounding line position and ice sheet thickness changes, along with a clear assessment of levels of confidence. The reconstruction shows that the Antarctic Ice sheet did not everywhere reach the continental shelf edge at its maximum, that initial retreat was asynchronous, and that the spatial pattern of deglaciation was highly variable, particularly on the inner shelf. The deglacial reconstruction is consistent with a moderate overall excess ice volume and with a relatively small Antarctic contribution to meltwater pulse la. We discuss key areas of uncertainty both around the continent and by time interval, and we highlight potential priorities for future work. The synthesis is intended to be a resource for the modelling and glacial geological community.
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5.
  • Wijnhoven, T. M. A., et al. (author)
  • WHO European Childhood Obesity Surveillance Initiative 2008: weight, height and body mass index in 6-9-year-old children
  • 2013
  • In: Pediatric Obesity. - : Wiley. - 2047-6310 .- 2047-6302. ; 8:2, s. 79-97
  • Journal article (peer-reviewed)abstract
    • Background Nutritional surveillance in school-age children, using measured weight and height, is not common in the European Region of the World Health Organization (WHO). The WHO Regional Office for Europe has therefore initiated the WHO European Childhood Obesity Surveillance Initiative. Objective To present the anthropometric results of data collected in 2007/2008 and to investigate whether there exist differences across countries and between the sexes. Methods Weight and height were measured in 69-year-old children in 12 countries. Prevalence of overweight, obesity, stunting, thinness and underweight as well as mean Z-scores of anthropometric indices of height, weight and body mass index were calculated. Results A total of 168832 children were included in the analyses and a school participation rate of more than 95% was obtained in 8 out of 12 countries. Stunting, underweight and thinness were rarely prevalent. However, 19.349.0% of boys and 18.442.5% of girls were overweight (including obesity and based on the 2007 WHO growth reference).The prevalence of obesity ranged from 6.0 to 26.6% among boys and from 4.6 to 17.3% among girls. Multi-country comparisons suggest the presence of a northsouth gradient with the highest level of overweight found in southern European countries. Conclusions Overweight among 69-year-old children is a serious public health concern and its variation across the European Region highly depends on the country. Comparable monitoring of child growth is possible across Europe and should be emphasized in national policies and implemented as part of action plans.
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  • Bornhorst, C., et al. (author)
  • WHO European Childhood Obesity Surveillance Initiative: associations between sleep duration, screen time and food consumption frequencies
  • 2015
  • In: Bmc Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 15:442
  • Journal article (peer-reviewed)abstract
    • Background: Both sleep duration and screen time have been suggested to affect children's diet, although in different directions and presumably through different pathways. The present cross-sectional study aimed to simultaneously investigate the associations between sleep duration, screen time and food consumption frequencies in children. Methods: The analysis was based on 10 453 children aged 6-9 years from five European countries that participated in the World Health Organization European Childhood Obesity Surveillance Initiative. Logistic multilevel models were used to assess associations of parent-reported screen time as well as sleep duration (exposure variables) with consumption frequencies of 16 food items (outcome variables). All models were adjusted for age, sex, outdoor play time, maximum educational level of parents and sleep duration or screen time, depending on the exposure under investigation. Results: One additional hour of screen time was associated with increased consumption frequencies of 'soft drinks containing sugar' (1.28 [1.19; 1.39]; odds ratio and 99% confidence interval), 'diet/light soft drinks' (1.21 [1.14; 1.29]), 'flavoured milk' (1.18 [1.08; 1.28]), 'candy bars or chocolate' (1.31 [1.22; 1.40]), 'biscuits, cakes, doughnuts or pies' (1.22 [1.14; 1.30]), 'potato chips (crisps), corn chips, popcorn or peanuts' (1.32 [1.20; 1.45]), 'pizza, French fries (chips), hamburgers' (1.30 [1.18; 1.43]) and with a reduced consumption frequency of 'vegetables (excluding potatoes)' (0.89 [0.83; 0.95]) and 'fresh fruits' (0.91 [0.86; 0.97]). Conversely, one additional hour of sleep duration was found to be associated with increased consumption frequencies of 'fresh fruits' (1.11 [1.04; 1.18]) and 'vegetables (excluding potatoes)' (1.14 [1.07; 1.23]). Conclusion: The results suggest a potential relation between high screen time exposure and increased consumption frequencies of foods high in fat, free sugar or salt whereas long sleep duration may favourably be related to children's food choices. Both screen time and sleep duration are modifiable behaviours that may be tackled in childhood obesity prevention efforts.
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8.
  • Dernini, S., et al. (author)
  • Med Diet 4.0 : the Mediterranean diet with four sustainable benefits
  • 2017
  • In: Public Health Nutrition. - : Cambridge University Press. - 1368-9800 .- 1475-2727. ; 20:7, s. 1322-1330
  • Research review (peer-reviewed)abstract
    • Objective: To characterize the multiple dimensions and benefits of the Mediterranean diet as a sustainable diet, in order to revitalize this intangible food heritage at the country level; and to develop a multidimensional framework - the Med Diet 4.0 - in which four sustainability benefits of the Mediterranean diet are presented in parallel: major health and nutrition benefits, low environmental impacts and richness in biodiversity, high sociocultural food values, and positive local economic returns.Design: A narrative review was applied at the country level to highlight the multiple sustainable benefits of the Mediterranean diet into a single multidimensional framework: the Med Diet 4.0.Setting/subjects: We included studies published in English in peer-reviewed journals that contained data on the characterization of sustainable diets and of the Mediterranean diet. The methodological framework approach was finalized through a series of meetings, workshops and conferences where the framework was presented, discussed and ultimately refined.Results: The Med Diet 4.0 provides a conceptual multidimensional framework to characterize the Mediterranean diet as a sustainable diet model, by applying principles of sustainability to the Mediterranean diet.Conclusions: By providing a broader understanding of the many sustainable benefits of the Mediterranean diet, the Med Diet 4.0 can contribute to the revitalization of the Mediterranean diet by improving its current perception not only as a healthy diet but also a sustainable lifestyle model, with country-specific and culturally appropriate variations. It also takes into account the identity and diversity of food cultures and systems, expressed within the notion of the Mediterranean diet, across the Mediterranean region and in other parts of the world. Further multidisciplinary studies are needed for the assessment of the sustainability of the Mediterranean diet to include these new dimensions.
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  • Lissner, Lauren, 1956, et al. (author)
  • Socioeconomic inequalities in childhood overweight : heterogeneity across five countries in the WHO European Childhood Obesity Surveillance Initiative (COSI-2008)
  • 2016
  • In: International Journal of Obesity. - : Nature Publishing Group. - 0307-0565 .- 1476-5497. ; 40:5, s. 796-802
  • Journal article (peer-reviewed)abstract
    • BACKGROUND: Excess risk of childhood overweight and obesity occurring in socioeconomically disadvantaged families has been demonstrated in numerous studies from high-income regions, including Europe. It is well known that socioeconomic characteristics such as parental education, income and occupation are etiologically relevant to childhood obesity. However, in the pan-European setting, there is reason to believe that inequalities in childhood weight status may vary among countries as a function of differing degrees of socioeconomic development and equity.SUBJECTS AND METHODS: In this cross-sectional study, we have examined socioeconomic differences in childhood obesity in different parts of the European region using nationally representative data from Bulgaria, the Czech Republic, Lithuania, Portugal and Sweden that were collected in 2008 during the first round of the World Health Organization ( WHO) European Childhood Obesity Surveillance Initiative.RESULTS: Heterogeneity in the association between parental socioeconomic indicators and childhood overweight or obesity was clearly observed across the five countries studied. Positive as well as negative associations were observed between parental socioeconomic indicators and childhood overweight, with statistically significant interactions between country and parental indicators.CONCLUSIONS: These findings have public health implications for the WHO European Region and underscore the necessity to continue documenting socioeconomic inequalities in obesity in all countries through international surveillance efforts in countries with diverse geographic, social and economic environments. This is a prerequisite for universal as well as targeted preventive actions.
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  • Wijnhoven, T, et al. (author)
  • WHO European Childhood Obesity Surveillance Initiative: Impact of Type of Clothing Worn during Anthropometric Measurements and Timing of the Survey on Weight and Body Mass Index Outcome Measures in 6–9-Year-Old Children
  • 2016
  • In: Epidemiology Research International. - : Hindawi Limited. - 2090-2972 .- 2090-2980. ; 2016, s. 1-16
  • Journal article (peer-reviewed)abstract
    • Background. The World Health Organization European Childhood Obesity Surveillance Initiative (COSI) conducted examinations in 6–9-year-old children from 16 countries in the first two rounds of data collection. Allowing participating countries to adhere to their local legal requirements or adapt to other circumstances required developing a flexible protocol for anthropometric procedures. Objectives. (1) Review intercountry variation in types of clothing worn by children during weight and height measurements, clothes weight adjustments applied, timing of the survey, and duration of data collection; (2) assess the impact of the observed variation in these practices on the children’s weight or body mass index (BMI) outcome measures. Results. The relative difference between countries’ unadjusted and clothes-adjusted prevalence estimates for overweight was 0.3–11.5%; this figure was 1.4–33.3% for BMI-for-age Z-score values. Monthly fluctuations in mean BMI-for-age Z-score values did not show a systematic seasonal effect. The majority of the monthly BMI-for-age Z-score values did not differ statistically within a country; only 1–3 monthly values were statistically different within some countries. Conclusions. The findings of the present study suggest that the built-in flexibility in the COSI protocol concerning the data collection practices addressed in the paper can be kept and thus do not necessitate a revision of the COSI protocol.
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  • Androutsos, O, et al. (author)
  • Designing and implementing teachers' training sessions in a kindergarten-based, family-involved intervention to prevent obesity in early childhood : the ToyBox-study
  • 2014
  • In: Obesity Reviews. - : Wiley. - 1467-7881 .- 1467-789X. ; 15:Suppl 3, s. 48-52
  • Journal article (peer-reviewed)abstract
    • Since school-based interventions are mainly delivered by the school staff, they need to be well-trained and familiarized with the programme's aims, procedures and tools. Therefore, the institute, research group, governmental or non-governmental body in charge of the coordination and implementation of the programme needs to devote time and resources to train the school staff before programme's implementation. This is particularly crucial in multi-centre studies where more than one research teams are involved. Both research teams and school staff need to be trained, using standard protocols and procedures, to ensure that the intervention will be delivered in a standardized manner throughout the intervention centres. The ToyBox-intervention, a multi-component, kindergarten-based, family-involved intervention, focusing on water consumption, snacking, physical activity and sedentary behaviours in preschool children, was implemented over the academic year 2012-2013 in six European countries. As part of this intervention, three teachers' training sessions were delivered to motivate and train teachers in implementing the intervention. The local researchers were trained centrally before delivering the training sessions for the teachers and followed a common protocol using standardized presentations and procedures. The aim of the current paper is to describe the protocol and methodological issues related to the teachers' training sessions conducted within the ToyBox-intervention.
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  • Cattaneo, A, et al. (author)
  • Protection, promotion and support of breast-feeding in Europe: current situation
  • 2005
  • In: Public health nutrition. - : Cambridge University Press (CUP). - 1368-9800 .- 1475-2727. ; 8:1, s. 39-46
  • Journal article (peer-reviewed)abstract
    • ObjectiveTo describe the current situation regarding protection, promotion and support of breast-feeding in Europe, as a first step towards the development of a blueprint for action.Design and settingA questionnaire was completed by 29 key informants and 128 other informants in the EU, including member states, accession and candidate countries.ResultsEU countries do not fully comply with the policies and recommendations of the Global Strategy on Infant and Young Child Feeding that they endorsed during the 55th World Health Assembly in 2002. Some countries do not even comply with the targets of the Innocenti Declaration (1990). Pre-service training on breast-feeding practice is inadequate and in-service training achieves only low to medium coverage. The Baby Friendly Hospital Initiative is well developed only in three countries; in 19 countries, less than 15% of births occur in baby-friendly hospitals. The International Code of Marketing of Breastmilk Substitutes, endorsed in 1981 by all countries, is not fully applied and submitted to independent monitoring. The legislation for working mothers meets on average the International Labour Organization standards, but covers only women with full formal employment. Voluntary mother-to-mother support groups and trained peer counsellors are present in 27 and 13 countries, respectively. Breast-feeding rates span over a wide range; comparisons are difficult due to use of non-standard methods. The rate of exclusive breast-feeding at 6 months is low everywhere, even in countries with high initiation rates.ConclusionsEU countries need to revise their policies and practices to meet the principles inscribed in the Global Strategy on Infant and Young Child Feeding in order to better protect, promote and support breast-feeding.
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  • Gustafson, Yngve, et al. (author)
  • Depression in old age in Austria, Ireland, Portugal and Sweden
  • 2013
  • In: European Geriatric Medicine. - : Elsevier BV. - 1878-7649 .- 1878-7657. ; 4:3, s. 202-208
  • Journal article (peer-reviewed)abstract
    • Depression is the third leading cause of disease burden worldwide and the most frequent psychiatric disorder in the older adult population. Depression in old age is disabling, both psychosocially and physically, decreases quality of life and increases mortality. This paper explores the epidemiology, screening, diagnosis and management of depression in old age in four European countries in an attempt to gain a better understanding of the issues contributing to the variability in clinical practice. The prevalence of depression in community dwelling older individuals is high, but studies in the oldest population and in specific settings (like nursing homes) are few. Depression may go undiagnosed, and wide screening programs for early identification of this disease are uncommon. Depression screening is consistently included in comprehensive geriatric assessment, and most geriatricians appear to be confident in its diagnosis and management. Old age psychiatry is still largely underdeveloped, except for Ireland. Primary care physicians start treatment of depression in most countries, referring only complex cases for specialised care. SSRIs seem to be the first line treatment, but choice of antidepressants is widely variable in different countries. Availability of non-pharmacological therapies is still low, and only highly skilled centres use a multifaceted approach to depression care. Attitudes towards depression and mental illness are still mostly negative, which may hinder identification and management of this highly prevalent geriatric problem.
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  • Hamnerius, Yngve, 1950, et al. (author)
  • Distribution of ELF magnetic fields in Swedish dwellings
  • 2011
  • In: 30th URSI General Assembly and Scientific Symposium, URSIGASS 2011, Istanbul, 13-20 August 2011. - 9781424451173
  • Conference paper (peer-reviewed)abstract
    • The purpose of this study is to assess the distribution of magnetic fields in the frequency range 10 Hz - 2000 Hz in randomly selected Swedish dwellings. The fields were measured in up to 3 rooms in each residence. In the master bedroom a 24 h logging of the fields was performed. The results show that 89 % of the measured houses have average magnetic fields below 0.2 μT with mean value of 0.11 μT and median value 0.05 μT. The comparison of magnetic fields in urban and rural area show that the lowest fields were found in rural areas with 97% of the residences have average magnetic fields below 0.2 μT with median value 0.04 μT. Comparing villas and apartments show that the median magnetic fields value for apartments is 0.07 μT compared to 0.04 μT for villas. The dominating frequency of the magnetic field was 50 Hz. The total harmonic distortion (THD) of the magnetic field was measured; the median value of THD was 10.3 %.
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  • Jakobsson, Martin, et al. (author)
  • The International Bathymetric Chart of the Arctic Ocean Version 4.0
  • 2020
  • In: Scientific Data. - : Springer Science and Business Media LLC. - 2052-4463. ; 7:1
  • Journal article (peer-reviewed)abstract
    • Bathymetry (seafloor depth), is a critical parameter providing the geospatial context for a multitude of marine scientific studies. Since 1997, the International Bathymetric Chart of the Arctic Ocean (IBCAO) has been the authoritative source of bathymetry for the Arctic Ocean. IBCAO has merged its efforts with the Nippon Foundation-GEBCO-Seabed 2030 Project, with the goal of mapping all of the oceans by 2030. Here we present the latest version (IBCAO Ver. 4.0), with more than twice the resolution (200 x 200m versus 500 x 500m) and with individual depth soundings constraining three times more area of the Arctic Ocean (similar to 19.8% versus 6.7%), than the previous IBCAO Ver. 3.0 released in 2012. Modern multibeam bathymetry comprises similar to 14.3% in Ver. 4.0 compared to similar to 5.4% in Ver. 3.0. Thus, the new IBCAO Ver. 4.0 has substantially more seafloor morphological information that offers new insights into a range of submarine features and processes; for example, the improved portrayal of Greenland fjords better serves predictive modelling of the fate of the Greenland Ice Sheet. Machine-accessible metadata file describing the reported data: 10.6084/m9.figshare.12369314
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  • Kofoed, P.E., et al. (author)
  • Different doses of amodiaquine and chloroquine for treatment of uncomplicated malaria in children in Guinea-Bissau : implications for future treatment recommendations
  • 2007
  • In: Transactions of the Royal Society of Tropical Medicine and Hygiene. - 0035-9203 .- 1878-3503. ; 101:3, s. 231-238
  • Journal article (peer-reviewed)abstract
    • The aim of the present study was to compare different doses of chloroquine (CQ) and amodiaquine (AQ) for the treatment of falciparum malaria in children. Children with Plasmodium falciparum monoinfection were allocated by block randomisation to treatment with CQ 50/kg mg or 25 mg/kg or AQ 15 mg/kg or 30 mg/kg. The main outcomes were the cumulative adequate clinical and parasitological response (ACPR) rates and the number of true recrudescences as determined by PCR. A total of 729 children were included. In an evaluability analysis, the PCR-uncorrected cumulative ACPR rates on Day 28 for the treatment groups CQ 50/kg mg or 25 mg/kg and AQ 15 mg/kg or 30 mg/kg were 90%, 76%, 92% and 94%, respectively; the PCR-adjusted ACPR rates on Day 28 were 92%, 80%, 94% and 94%, respectively. No differences in adverse effects were observed. AQ has a high cure rate given as 30 mg/kg and 15 mg/kg, although it is not superior to treatment with CQ 50 mg/kg. However, 25 mg/kg of CQ is less efficient. As an interim option, Guinea-Bissau could change the recommended first-line treatment of uncomplicated malaria to CQ 50 mg/kg, reserving AQ as a partner drug for a future combination therapy.
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