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- Fernández-Alvira, Juan Miguel, et al.
(author)
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Prospective associations between socio-economic status and dietary patterns in European children: the Identification and Prevention of Dietary- and Lifestyle-induced Health Effects in Children and Infants (IDEFICS) Study.
- 2015
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In: The British journal of nutrition. - : Cambridge University Press. - 1475-2662 .- 0007-1145. ; 113:3, s. 517-25
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Journal article (peer-reviewed)abstract
- Exploring changes in children's diet over time and the relationship between these changes and socio-economic status (SES) may help to understand the impact of social inequalities on dietary patterns. The aim of the present study was to describe dietary patterns by applying a cluster analysis to 9301 children participating in the baseline (2-9 years old) and follow-up (4-11 years old) surveys of the Identification and Prevention of Dietary- and Lifestyle-induced Health Effects in Children and Infants Study, and to describe the cluster memberships of these children over time and their association with SES. We applied the K-means clustering algorithm based on the similarities between the relative frequencies of consumption of forty-two food items. The following three consistent clusters were obtained at baseline and follow-up: processed (higher frequency of consumption of snacks and fast food); sweet (higher frequency of consumption of sweet foods and sweetened drinks); healthy (higher frequency of consumption of fruits, vegetables and wholemeal products). Children with higher-educated mothers and fathers and the highest household income were more likely to be allocated to the healthy cluster at baseline and follow-up and less likely to be allocated to the sweet cluster. Migrants were more likely to be allocated to the processed cluster at baseline and follow-up. Applying the cluster analysis to derive dietary patterns at the two time points allowed us to identify groups of children from a lower socio-economic background presenting persistently unhealthier dietary profiles. This finding reflects the need for healthy eating interventions specifically targeting children from lower socio-economic backgrounds.
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- Formisano, Annarita, et al.
(author)
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Family structure and childhood obesity: results of the IDEFICS project
- 2014
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In: Public Health Nutrition. - 1368-9800. ; 17:10, s. 2307-2315
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Journal article (peer-reviewed)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.
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- Hense, Sabrina, et al.
(author)
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Factors that influence weekday sleep duration in European children.
- 2011
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In: Sleep. - 1550-9109. ; 34:5, s. 633-9
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Journal article (peer-reviewed)abstract
- Study Objectives: To compare nocturnal sleep duration in children from 8 European countries and identify its determinants. Design: Cross-sectional. Setting: Primary schools and preschools participating in the IDEFICS study. Participants: 8,542 children aged 2 to 9 years from 8 European countries with complete with complete information o nocturnal sleep duration. Interventions: Not applicable. Measurements: Nocturnal sleep duration was assessed by means of a computer based parental 24-h recall. Data on personal, social, environmental, and behavioural factors were collected by means of standardized parental questionnaire. Physical activity was surveyed with accelerometers. Results: Nocturnal sleep duration in the participating coutries ranged from 9.5 h (SD 0.8) in Estonia to 11.2 h (SD 0.7) in Belgium and differed significantly between countries (P < 0.001) in univariate as well as in multivariate analyses, with children from northern countries sleeping the longest. Sleep duration decreased by about 6 min with each year of age over all countries. No effect of season, daylight duration, overweight, parental education level, or lifestyle factors could be seen. Conclusion: Sleep duration differs significantly between countries. Our findings allow for the conclusion that regional affiliation, including culture and environmental characgteristics, seems to overlay individual determinants of sleep duration.
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- Miguel Fernandez-Alvira, Juan, et al.
(author)
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Parental education and frequency of food consumption in European children : the IDEFICS study
- 2013
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In: Public Health Nutrition. - : Cambridge University Press. - 1368-9800 .- 1475-2727. ; 16:3, s. 487-498
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Journal article (peer-reviewed)abstract
- Objective: To assess the relationship between parental education level and the consumption frequency of obesity-related foods in European children. Design: The analysis was based on data from the cross-sectional baseline survey of a prospective cohort study. The effects of parental education on food consumption were explored using analysis of covariance and logistic regression. Setting: Primary schools and pre-schools of selected regions in Italy, Estonia, Cyprus, Belgium, Sweden, Hungary, Germany and Spain. Subjects: Participants (n 14 426) of the IDEFICS baseline cohort study aged 2 to 9 years. Results: Parental education level affected the intake of obesity-related foods in children. Children in the low and medium parental education level groups had lower odds of more frequently eating low-sugar and low-fat foods (vegetables, fruits, pasta/noodles/rice and wholemeal bread) and higher odds of more frequently eating high-sugar and high-fat foods (fried potatoes, fruits with sugar and nuts, snacks/desserts and sugared beverages; P<0.001). The largest odds ratio differences were found in the low category (reference category: high) for vegetables (OR=0.56; 95% CI 0.47, 0.65), fruits (OR=0.56; 95% CI 0.48, 0.65), fruits with sugar and nuts (OR=2.23; 95% CI 1.92, 2.59) and sugared beverages (OR=2.01; 95% CI 1.77, 2.37). Conclusions: Low parental education level was associated with intakes of sugar-rich and fatty foods among children, while high parental education level was associated with intakes of low-sugar and low-fat foods. These findings should be taken into account in public health interventions, with more targeted policies aiming at an improvement of children's diet.
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- Verbestel, Vera, et al.
(author)
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Are context-specific measures of parental-reported physical activity and sedentary behaviour associated with accelerometer data in 2-9-year-old European children?
- 2015
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In: Public Health Nutrition. - : Cambridge University Press. - 1368-9800 .- 1475-2727. ; 18:5, s. 860-868
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Journal article (peer-reviewed)abstract
- Objective: The aim of the present study was to investigate if context-specific measures of parental-reported physical activity and sedentary behaviour are associated with objectively measured physical activity and sedentary time in children. Design: Cross-sectional study. Setting: Seven European countries taking part in the IDEFICS (Identification and Prevention of Dietary-and Lifestyle-induced Health Effects in Children and Infants) study. Subjects: Data were analysed from 2-9-year-old children (n 5982) who provided both parental-reported and accelerometer-derived physical activity/sedentary behaviour measures. Parents reported their children's daily screen-time, weekly sports participation and daily outdoor playtime by means of the Outdoor Playtime Checklist (OPC) and Outdoor Playtime Recall Questions (OPRQ). Results: Sports participation, OPC-and OPRQ-derived outdoor play were positively associated with accelerometer-derived physical activity. Television viewing and computer use were positively associated with accelerometer-derived sedentary time. All parental-reported measures that were significantly associated with accelerometer outcomes explained only a minor part of the variance in accelerometer-derived physical activity or sedentary time. Conclusions: Parental-reported measures of physical activity and sedentary behaviour are not useful as a proxy for 2-9-year-old children's physical activity and sedentary time. Findings do not preclude the use of context-specific measures but imply that conclusions should be limited to the context-specific behaviours that are actually measured. Depending on the aim of the study, future research should carefully consider the choice of measurements, including the use of subjective or objective measures of the behaviour of interest or a combination of both.
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- Verbestel, Vera, et al.
(author)
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Using the intervention mapping protocol to develop a community-based intervention for the prevention of childhood obesity in a multi-centre European project: the IDEFICS intervention.
- 2011
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In: The international journal of behavioral nutrition and physical activity. - : Springer Science and Business Media LLC. - 1479-5868. ; 8
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Journal article (peer-reviewed)abstract
- ABSTRACT: Background: The prevalence of childhood obesity has increased during the past decades and is now considered an urgent public health problem. Although stabilizing trends in obesity prevalence have been identified in parts of Europe, preventive efforts in children are still needed. Using the socio-ecological approach as the underlying theoretical perspective, the IDEFICS project aimed to develop, implement and evaluate a community-based intervention for the prevention of childhood obesity in eight European countries. The aim of the present manuscript was to describe the content and developmental process of the IDEFICS intervention. Methods: The intervention mapping protocol (IMP) was used to develop the community-based intervention for the prevention of childhood obesity in 3 to 10 years old children. It is a theory- and evidence-based tool for the structured planning and development of health promotion programs that requires the completion of six different steps. These steps were elaborated by two coordinating centers and discussed with the other participating centers until agreement was reached. Focus group research was performed in all participating centers to provide an informed basis for intervention development. Results: The application of the IMP resulted in an overall intervention framework with ten intervention modules targeting environmental and personal factors through the family, the school and the community. The summary results of the focus group research were used to inform the development of the overall intervention. The cultural adaptation of the overall intervention was realised by using country specific focus group results. The need for cultural adaptation was considered during the entire process to improve program adoption and implementation. A plan was developed to evaluate program effectiveness and quality of implementation. Conclusions: The IDEFICS project developed a community-based intervention for the prevention of childhood obesity by using to the intervention mapping heuristic. The IDEFICS intervention consists of a general and standardized intervention framework that allows for cultural adaptation to make the intervention feasible and to enhance deliverability in all participating countries. The present manuscript demonstrates that the development of an intervention is a long process that needs to be done systematically. Time, human resources and finances need to be planned beforehand to make interventions evidence-based and culturally relevant.
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