Nutrition and health situation of children and adolescents in Germany. Need for and options for action in the context of nutrition at school

Chronische Erkrankungen sowie ein hohes Lebenszeitrisiko für ernährungsmitbedingte chronische Erkrankungen stellen aktuelle Herausforderungen im Public Health (Nutrition) Bereich im Kontext der Kindergesundheit dar. Der Schule als Setting für Gesundheitsförderung & Prävention kommt dabei eine Schlüsselrolle zu. Ein Blick auf aktuelle Daten zeigt Handlungsbedarfe und Handlungspotentiale auf. (DIPF/Orig.)Chronic diseases and a high lifetime risk of diet-related chronic diseases are current challenges in the public health (nutrition) sector in the context of child health. The school as a setting for health promotion and prevention plays a key role. A look at current data reveals needs for action and potentials for action. (DIPF/Orig.

Evidence-based guideline of the German Nutrition Society: fat intake and prevention of selected nutrition-related diseases

As nutrition-related chronic diseases have become more and more frequent, the importance of dietary prevention has also increased. Dietary fat plays a major role in human nutrition, and modification of fat and/or fatty acid intake could have a preventive potential. The aim of the guideline of the German Nutrition Society (DGE) was to systematically evaluate the evidence for the prevention of the widespread diseases obesity, type 2 diabetes mellitus, dyslipoproteinaemia, hypertension, metabolic syndrome, coronary heart disease (CHD), stroke, and cancer through the intake of fat or fatty acids. The main results can be summarized as follows: it was concluded with convincing evidence that a reduced intake of total and saturated fat as well as a larger intake of polyunsaturated fatty acids (PUFA) at the expense of saturated fatty acids (SFA) reduces the concentration of total and low-density lipoprotein cholesterol in plasma. Furthermore, there is convincing evidence that a high intake of trans fatty acids increases risk of dyslipoproteinaemia and that a high intake of long-chain polyunsaturated n-3 fatty acids reduces the triglyceride concentration in plasma. A high fat intake increases the risk of obesity with probable evidence when total energy intake is not controlled for (ad libitum diet). When energy intake is controlled for, there is probable evidence for no association between fat intake and risk of obesity. A larger intake of PUFA at the expense of SFA reduces risk of CHD with probable evidence. Furthermore, there is probable evidence that a high intake of long-chain polyunsaturated n-3 fatty acids reduces risk of hypertension and CHD. With probable evidence, a high trans fatty acid intake increases risk of CHD. The practical consequences for current dietary recommendations are described at the end of this article

Primärprävention chronischer Erkrankungen durch Ernährung

Primärprävention hat sich insbesondere im Bereich der infektiösen Erkrankungen als erfolgreich erwiesen. Auch für die chronischen Krankheitsbilder gilt es, effektive Präventionsmaßnahmen zu entwickeln. Obwohl es zahlreiche Hinweise aus der wissenschaftlichen Literatur gibt, dass bestimmte Verhaltensweisen, z.B. das Ernährungsverhalten oder die körperliche Aktivität, einen beträchtlichen Anteil an der Entstehung von Krankheitsbildern wie Herz-Kreislauf-Erkrankungen oder Krebs haben, ist das darin vorhandene präventive Potential bislang nur wenig ausgeschöpft worden. Ein Grund hierfür könnte in der mangelnden wissenschaftlichen Glaubwürdigkeit der postulierten Maßnahmen liegen. Die vorliegende Arbeit befasst sich mit den Forschungsschritten, die notwendig sind, um zu belastbaren, wissenschaftlich fundierten Aussagen zu kommen, aus denen sich Empfehlungen zum Ernährungsverhalten ableiten lassen. Dazu wurden drei Komponenten dieses Prozesses beleuchtet: 1. Methodische Aspekte Einleitend wird auf methodische Vorrausetzungen eingegangen, die zur Gewinnung valider Daten notwendig sind, angefangen bei Erhebungsinstrumenten bis hin zur Anwendung adäquater Studiendesigns. Beispielhaft werden methodische Arbeiten vorgestellt, die im Rahmen der EPIC-Potsdam Studie entstanden sind und sich auf die Validierung von Ernährungserhebungsinstrumenten und Blutdruckmessungen beziehen. 2. Ergebnisse epidemiologischer Studien Grundvoraussetzung zur Entwicklung primärpräventiv wirksamer Empfehlungen ist die Generierung epidemiologischer Daten, die einen Zusammenhang zwischen Ernährungs-verhalten und dem Auftreten der untersuchten Erkrankung aufzeigen. Als Beispiel werden analytisch-epidemiologische Studienergebnisse aus dem Bereich des metabolischen Syndroms präsentiert und diskutiert. 3. Konzeptionelle Überlegungen Abschließend werden Aspekte der Interpretation einzelner Studienergebnisse sowie der zusammenfassenden Interpretation aller zu einem Thema vorliegenden Daten diskutiert. Die Synthese von Evidenz wird insbesondere auf dem Hintergrund der Konzepte des sog. evidenz-basierten Vorgehens betrachtet. Zusammenfassend lässt sich feststellen, dass der aufgezeigte Prozess hin zu evidenz-basierten Ernährungsempfehlungen begonnen hat und in den nächsten Jahren erste Erkenntnissen zu erwarten sind, die eine fundierte Einschätzung der Ernährung im Rahmen der Primärprävention erlauben.Primary prevention has been proven to be a successful approach, especially in the area of infectious diseases. Nowadays the challenge is to develop effective preventive measures for chronic disease prevention. However, despite numerous signs from the scientific literature that life-style factors such as dietary behaviour or physical activity levels contribute substantially to the development of diseases like cardio-vascular disease or cancer, the preventive potential has not been fully exploited so far. One reason for that might be the lack of credibility of the postulated measures. This thesis deals with the necessary research steps needed for the development of scientifically based dietary recommendations. Three aspects of this process were highlighted: 1. Methodological aspects The introductory part points out the prerequisites for obtaining valid data, beginning with the assessments instruments and ending with the appropriate study design. As an example, validation studies on dietary assessment and blood pressure measurement that were undertaken for the EPIC-Potsdam study are presented. 2. Results from epidemiological studies Basic requirement for the development of primary prevention measures are epidemiological data demonstrating an association between dietary behaviour and disease occurrence. To exemplify this, analytical epidemiological study results obtained from studies on the metabolic syndrome are presented and discussed. 3. Conceptual considerations Finally, aspects of interpretation of single study results as well as of summarizing all data on a certain topic are discussed. Background of the considerations on the synthesis of evidence is the so-called evidence based approach. In summary, the outlined process leading towards evidence based dietary recommendations has begun, and during the upcoming years first results from this process are to be expected. These will then allow to derive a sound appraisal of the role of nutrition for primary prevention

Effectiveness of health-oriented leadership interventions for improving health and wellbeing of employees: a systematic review

<jats:title>Abstract</jats:title><jats:sec> <jats:title>Aim</jats:title> <jats:p>To identify and summarize the evidence for the effect of health-oriented leadership interventions on health and well-being outcomes at the employee level following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement (Moher et al. 2009).</jats:p> </jats:sec><jats:sec> <jats:title>Subject and Methods</jats:title> <jats:p>A systematic search of relevant studies was conducted in multiple databases. Randomized controlled trials (RCTs), cluster-randomized controlled trials (cRCTs) and controlled before–after studies (CBAs) were included based on the following criteria: interventions that addressed supervisors, to raise awareness for the importance of health issues, teach mindfulness practices for conscious awareness, reduce stress and promote resources at the level of individual behavior, and evaluated the effect on at least one outcome of psychomental stress, absenteeism and well-being on the employee level.</jats:p> </jats:sec><jats:sec> <jats:title>Results</jats:title> <jats:p>Of 6126 publications retrieved, ten studies were identified for analysis. Significant effects of leadership training were reported on exhaustion tendency, self-reported sickness absence, work-related sickness absence and job satisfaction in studies comparing health-oriented training programs to no intervention. Studies comparing health-oriented leadership training to other training did not report significant effects. Risk of bias was judged to be high in seven studies and unclear in three studies.</jats:p> </jats:sec><jats:sec> <jats:title>Conclusion</jats:title> <jats:p>Evidence for the effectiveness of health-oriented leadership interventions on employees’ stress, absenteeism or well-being is judged to be low, clearly indicating the need for more and higher-quality research.</jats:p> </jats:sec&gt