1,721,460 research outputs found
Prospective associations between dietary patterns and high sensitivity C-reactive protein in European children : the IDEFICS study
Full text linkPurpose This prospective study explores high sensitivity C-reactive protein (hs-CRP) levels in relation to dietary patterns at two time points in European children. Methods Out of the baseline sample of the IDEFICS study (n = 16,228), 4020 children, aged 2-9 years at baseline, with available hs-CRP levels and valid data from a food frequency questionnaire (FFQ) at baseline (T0) and 2 years later (T1) were included. K-means clustering algorithm based on the similarities between relative food consumption frequencies of the FFQ was applied. hs-CRP was dichotomized according to sex-specific cutoff points. Multilevel logistic regression was performed to assess the relationship between dietary patterns and hs-CRP adjusting for covariates. Results Three consistent dietary patterns were found at T0 and T1: 'animal protein and refined carbohydrate', 'sweet and processed' and 'healthy'. Children allocated to the 'protein' and 'sweet and processed' clusters at both time points had significantly higher odds of being in the highest category of hs-CRP (OR 1.47; 95% CI 1.03-2.09 for 'animal protein and refined carbohydrate' and OR 1.44; 95% CI 1.08-1.92 for 'sweet and processed') compared to the 'healthy' cluster. The odds remained significantly higher for the 'sweet and processed' pattern (OR 1.39; 95% CI 1.05-1.84) when covariates were included. Conclusions A dietary pattern characterized by frequent consumption of sugar and processed products and infrequent consumption of vegetables and fruits over time was independently related with inflammation in European children. Efforts to improve the quality of the diet in childhood may prevent future diseases related with chronic inflammation.Peer reviewe
The IDEFICS intervention trial to prevent childhood obesity: design and study methods
No full textIntroduction: One of the major research dimensions of the Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS (IDEFICS) study involved the development, implementation and evaluation of a setting-based community-oriented intervention programme for primary prevention of childhood obesity. In this supplement of Obesity Reviews, a compilation of key results of the IDEFICS intervention is packaged in a series of complementary papers.
Objective: This paper describes the overall design and methods of the IDEFICS intervention in order to facilitate a comprehensive reading of the supplement. In addition, some best practice' examples are described.
Results: The IDEFICS intervention trial was conducted to assess whether the IDEFICS intervention prevented obesity in young children aged 2 to 9.9years. The study was a non-randomized, quasi-experimental trial with one intervention matched to one control region in each of eight participating countries. The intervention was designed following the intervention mapping framework, using a socio-ecological theoretical approach. The intervention was designed to address several key obesity-related behaviours in children, parents, schools and community actors; the primary outcome was the prevalence of overweight/obesity according to the IOTF criteria based on body mass index. The aim was to achieve a reduction of overweight/obesity prevalence in the intervention regions. The intervention was delivered in school and community settings over a 2-year period. Data were collected in the intervention and control cohort regions at baseline and 2 years later.
Conclusion: This paper offers an introductory framework for a comprehensive reading of this supplement on IDEFICS intervention key results
DNA yield and quality of saliva samples and suitability for large scale epidemiological studies in children
Full text linkObjective: To evaluate two saliva collection methods for DNA yield and quality as applied to a large, integrated, multicentre, European project involving the collection of biological material from children.
Design: Cross-sectional multicentre comparative study in young children.
Methods: Saliva samples were collected from 14 019 children aged 2-9 years from eight European countries participating in the IDEFICS (Identification and prevention of dietary-and lifestyle-induced health effects in children and infants) study. This involved either the collection of 2 ml of saliva from children who were able to spit, or using a sponge to collect whole saliva and buccal mucosal cells from the inside of the mouth of younger children unable to spit. Samples were assembled centrally in each participating centre and subsequently despatched for DNA extraction and biobanking to the University of Glasgow. A subgroup of 4678 samples (similar to 33% of sampled individuals) were chosen for DNA extraction before genotyping.
Results: The whole-saliva collection method resulted in a higher DNA yield than the sponge collection method (mean +/- s.d.; saliva: 20.95 +/- 2.35 mu g, sponge: 9.13 +/- 2.25 mu g; P < 0.001). DNA quality as measured by A(260)/A(280) was similar for the two collection methods. A minimum genotype calling success rate of 95% showed that both methods provide good-quality DNA for genotyping using TaqMan allelic discrimination assays.
Conclusions: Our results showed higher DNA yield from the whole-saliva collection method compared with the assisted sponge collection. However, both collection methods provided DNA of sufficient quantity and quality for large-scale genetic epidemiological studies
Barriers and Facilitators of Health Promotion and Obesity Prevention in Early Childhood [Elektronisk resurs] : A Focus on Parents, Results from the IDEFICS Study
No full textBackground: Childhood obesity has increased dramatically during the past thirty years. Parents are key persons in their children’s lives and their efforts to create healthy lifestyles are very important. However, social and economic determinants of health also affect parents’ opportunities to promote a healthy lifestyle.Aims: To explore barriers and facilitators in promoting healthy lifestyles and preventing childhood obesity, focusing on parental roles.Methods and main findings: Three studies originated from the Identification and Prevention of Dietary- and Lifestyle-induced health Effects in Children and InfantS (IDEFICS) study of determinants for two to nine-year-old children’s health in eight European countries. The fourth study was a qualitative interview study conducted in southwest Sweden.Paper I: In focus group discussions (20 focus groups with children and 36 with parents), parents described lack of time, financial constraints, availability and food marketing techniques as barriers for promoting healthy eating. School policies about food varied; only Sweden and Estonia provided free school lunches. Children described great variation in the availability of unhealthy foods and beverages in their homes.Paper II: Objectively measured Body Mass Index (BMI) of children (n=16 220) were compared to parents’ perception of and concern for their children’s health and weight status. In all weight categories and all countries, a substantial proportion of parents failed to accurately judge their child’s weight status. In general, parents considered their children to be healthy, irrespective of their weight status. Parents of children with overweight or obesity systematically underestimated their children’s weight status across eight European countries. Accurate parental weight perception in Europe differed according to geographic region.Paper III: Swedish IDEFICS participants (n=1825) were compared with an age- and sex-matched referent population (n=1825), using registers from Statistics Sweden and the Swedish Medical Birth Register. Longitudinal child growth data (n=3650) were collected from child health centers and school health services. Families with low income, less education, foreign background or single parenthood were underrepresented in the IDEFICS study. BMI at inclusion had no selection effect but, at eight years of age, the obesity prevalence was significantly greater among referents.Paper IV: A qualitative content analysis was used to interpret the findings from interviews with nurses (n=15) working at child health centers in the southwest of Sweden. The BMI Chart to identify overweight and obesity in children facilitated greater recognition but nurses used it inconsistently, a barrier to prevention. Other barriers were obesity considered a sensitive issue and that some parents wanted overweight children.Conclusion: Parents may not perceive their child’s growth trajectory from overweight to obesity, and the preschool years may pass without effort to change lifestyle. Therefore, objective measurement and information of children’s BMI weight status by healthcare professionals is of great importance. To reach all parents and avoid selection bias, health surveys or health promoting activities must be tailored. Health promoting activities at the family level as well as the societal level should start early in children’s lives to prevent childhood obesity.</p
Formative Research to Develop the IDEFICS Physical Activity Intervention Component : Findings From Focus Groups With Children and Parents
No full textBACKGROUND: The current study aimed at describing influencing factors for physical activity among young children to determine the best approaches for developing the IDEFICS community based intervention.METHODS: In 8 European sites a trained moderator conducted a minimum of 4 focus groups using standardized questioning guides. A total of 56 focus groups were conducted including 36 focus groups with parents and 20 focus groups with children, of which 74 were boys and 81 girls. Key findings were identified through independent reviews of focus group summary reports using content analysis methods.FINDINGS: Findings were generally consistent across countries. The greatest emphasis was on environmental physical (eg, seasonal influences, availability of facilities and safety), institutional (eg, length of breaks at school), and social factors (eg, role modeling of parents). Most cited personal factors by parents were age, social economical status, and perceived barriers. Both children and parents mentioned the importance of children's preferences.CONCLUSIONS: To increase physical activity levels of young children the intervention should aim at creating an environment (physical, institutional, social) supportive of physical activity. On the other hand strategies should take into account personal factors like age and social economical status and should consider personal barriers too. © 2010 Human Kinetics, Inc.</p
Mediterranean diet and obesity polygenic risk interaction on adiposity in European children : The IDEFICS/I.Family Study
No full textBackground and Objectives: To examine whether changes in the Mediterranean Diet (MD) or any of its MD food groups modulate the genetic susceptibility to obesity in European youth, both in cross-sectional and longitudinal analyses. Methods: For cross-sectional analysis, 1982 participants at baseline, 1649 in follow-up 1 (FU1) and 1907 in follow-up 2 (FU2), aged 2–16 years of the IDEFICS/I.Family studies were considered. For the longitudinal design, 1254 participants were included. Adherence to MD was assessed using the Mediterranean Diet Score (MDS), and genetic susceptibility to high BMI was assessed with a polygenic risk score (BMI-PRS). Multiple linear regression models were fitted to estimate gene × MD effects on markers of obesity. Results: In cross-sectional analyses, at baseline, higher MDS was associated with higher BMI in children with high genetic susceptibility (β = 0.12; 95% CI = [0.01, 0.24]). However, 6 years later, at FU2, higher MDS was associated with lower BMI (β = −0.19; 95% CI = [−0.38, −0.01]) in children with high genetic susceptibility, showing an attenuating MDS effect. Also in FU2, vegetables and legumes (V&L) showed inverse associations with BMI (β = −0.01; CI = [−0.02, −0.00]) and WC (β = −0.02; CI = [−0.03, −0.00]) regardless of the obesity genetic risk, although the effect sizes were small. In the longitudinal analyses, no MDS-obesity associations or gene × diet interaction effects were observed. Conclusions: In cross-sectional analysis (baseline and FU2), the MD modulated the association between obesity susceptibility and adiposity indicators in European youth, having an exacerbating effect in children measured during infancy years and an attenuating effect in early adolescent years.Peer reviewe
Diets of European children, with focus on BMI, well-being, and families The IDEFICS/I.Family cohort
No full textThe overall aim of this thesis was to investigate children’s diet, BMI z-score, and parental feeding practices (PFPs), in relation to mutans streptococci (MS) count, psychosocial well-being and children’s BMI trajectory, as well as exploring the effect of the intervention in the IDEFICS (Identification and prevention of dietary- and lifestyle-induced health effects in children and infants) study on diets of families five years after the intervention.
About 16,000 children from eight European countries participated in the IDEFICS study in 2007/2008 (referred to as index children). During 2008 a community intervention was carried out targeting diet, physical activity and stress. In 2009, 68% of the children returned for a follow-up examination. In 2013, I.Family started and 6,055 of the children returned for a third follow-up, and at this time point 7,794 parents and 2,512 siblings also participated. Height and weight were measured, saliva was collected, and information on eating habits, feeding practices, well-being, and socioeconomic factors were reported at all time points.
High salivary MS count was found among 18% of the children in a sub-sample from the Swedish IDEFICS cohort. Higher BMI z-score, more frequent intake of meals and higher propensity for consuming sugar were all independently associated with higher MS count. In contrast, an inverse association was found between hours of sleep and MS count.
Bi-directional associations were identified between a healthy diet, measured by adherence to healthy dietary guidelines, and better self-esteem. Additionally, a healthy diet was associated with fewer emotional and peer problems two years later, with a monotonic trend entailing a consistent increase for all indicators of well-being associated with higher adherence. These associations were moderated by children’s sex.
PFPs at IDEFICS baseline explained 22% of the variation in children’s BMI z-score at I.Family. More specifically, PFPs involving restriction and considering putting the child on a diet were associated with higher odds of developing overweight independent of baseline BMI z-score and parental BMI. This association was stable across social vulnerability groups.
At I.Family, better diet quality (as measured by lower propensity for consuming fat and sugar, and higher propensity for consuming water, and fruit and vegetables) was reported by families in the intervention communities. However, investigation of the five-year change in fat, sugar, and water propensity ratio among index children failed to identify any differences between the intervention and control groups longitudinally.
This thesis documents the importance of healthy eating habits in reducing the risk of dental caries and maintaining good psychosocial well-being in children. Furthermore, restrictive PFPs are not helpful in promoting a healthy weight development. It is therefore important to identify other, more effective, PFPs and to include parents more directly in future intervention studies aiming at improving children’s eating habits
Assessment of diet, physical activity and biological, social and environmental factors in a multi-centre European project on diet- and lifestyle-related disorders in children (IDEFICS)
No full textObesity is a major public health problem in
developed countries. We present a European project, called Identification and Prevention of Dietary and Lifestyle induced
Health Effects in Children and Infants (IDEFICS),
that focuses on diet- and lifestyle-related diseases in
children. This paper outlines methodological aspects and
means of quality control in IDEFICS. IDEFICS will use a
multi-centre survey design of a population-based cohort of
about 17,000 2- to 10-year-old children in nine European
countries (Belgium, Cyprus, Estonia, Germany, Greece,
Hungary, Italy, Spain and Sweden). The project will
investigate the impact of dietary factors such as food
intake activity, psychosocial factors and genetic factors on the
development of obesity and other selected diet- and
lifestyle-related disorders. An intervention study will be
set up in pre-school and primary school settings in eight of the survey centres. Standardised survey instruments will be designed during the first phase of the project and applied in
the surveys by all centres. Standard operation procedures (SOPs) will be developed, as well as a plan for training the
personnel involved in the surveys. These activities will be
accompanied by a quality control strategy that will
encompass the evaluation of process and result quality
throughout the project. IDEFICS will develop comparable
Europe-wide health indicators and instruments for data
collection among young children. Establishment of a new
European cohort within IDEFICS will provide a unique
opportunity to document the development of the obesity
epidemic in the current generation of young Europeans and
investigate the impact of primary prevention in European
children population
Impaired metabolic health over-time and high abdominal fat are prospectively associated with high-sensitivity C-reactive protein in children: The IDEFICS study
Full text linkMinisterio de Ciencia e Innovacion, Grant/Award Number: FJCI-2017-34967; Sixth Framework Programme, Grant/Award Number: 016181 (FOOD)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.Instituto de Salud Carlos III
Spanish Government
European Commission FJCI-2017-34967European Commission 01618
Validity of hip-mounted uniaxial accelerometry with heart rate monitoring
Full text linkOne of the aims of Identification and Prevention of Dietary- and Lifestyle-Induced Health Effects in Children and Infants (IDEFICS) validation study is to validate field measures of physical activity (PA) and energy expenditure (EE) in young children. This study compared the validity of uniaxial accelerometry with heart-rate (HR) monitoring vs. triaxial accelerometry against doubly labeled water (DLW) criterion method for assessment of free-living EE in young children. Forty-nine European children (25 female, 24 male) aged 4–10 yr (mean age: 6.9 ± 1.5 yr) were assessed by uniaxial ActiTrainer with HR, uniaxial 3DNX, and triaxial 3DNX accelerometry. Total energy expenditure (TEE) was estimated using DLW over a 1-wk period. The longitudinal axis of both devices and triaxial 3DNX counts per minute (CPM) were significantly (P < 0.05) associated with physical activity level (PAL; r = 0.51 ActiTrainer, r = 0.49 uniaxial-3DNX, and r = 0.42 triaxial Σ3DNX). Eight-six percent of the variance in TEE could be predicted by a model combining body mass (partial r2 = 71%; P < 0.05), CPM-ActiTrainer (partial r2 = 11%; P < 0.05), and difference between HR at moderate and sedentary activities (ModHR − SedHR) (partial r2 = 4%; P < 0.05). The SE of TEE estimate for ActiTrainer and 3DNX models ranged from 0.44 to 0.74 MJ/days or ∼7–11% of the average TEE. The SE of activity-induced energy expenditure (AEE) model estimates ranged from 0.38 to 0.57 MJ/day or 24–26% of the average AEE. It is concluded that the comparative validity of hip-mounted uniaxial and triaxial accelerometers for assessing PA and EE is similar
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