The association between children’s and parents’ co-TV viewing and their total screen time in six European countries : cross-sectional data from the Feel4diabetes-study

In many European children, high levels of screen time can be found, which is associated with several adverse health outcomes. Therefore, there is a need for identifying effective intervention strategies that reduce screen time in children. A factor that may contribute to excessive screen time in children may be "co-TV viewing" (i.e., the time that parents and children spend on watching TV together), as parents often recognize the importance of limiting children's (individual) screen time, but often encourage TV viewing as a family because of its perceived benefits (e.g., educational purposes). The primary aim of this study was to investigate the (sex-specific) association between co-TV viewing and both children's and parents' screen time, and these associations were investigated across and within six European countries. In total, 10,969 parents (Mean(age) = 40.7 +/- 5.3 years, Mean(BMI) = 24.4 +/- 4.6) of primary school children (Mean(age) = 8.2 +/- 1.0 years, 49.0% boys, Mean(BMI) = 17.3 +/- 2.8) completed a questionnaire assessing co-TV viewing and screen time. Multilevel regression analyses were conducted. Across countries, positive associations were found between co-TV viewing and both children's (beta = 11.85, SE = 3.69, p < 0.001) and parents' screen time (beta = 14.47, SE = 4.43, p = 0.001). Similar associations were found in most (but not all) countries. The results suggest that targeting co-TV viewing might be a promising intervention strategy because of its potential to limit screen time of both children and parents

Do physical activity and screen time mediate the association between European fathers' and their children's weight status? Cross-sectional data from the Feel4Diabetes-study

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Conducta suicida no letal en Castellón: un estudio descriptivo y comparativo.

Treball Final de Grau en Medicina. Codi: MD1158. Curs acadèmic: 2018/2019.Background: Due to the suicidal behavior variability regarding the sociocultural values of each territory, we conducted this study to define the sociodemographic and clinical features of the patients from Castellon. The objective is to obtain deeper knowledge that facilitate the detection and implementation of effective interventions. In addition, we carried out a comparative analysis between non-lethal suicide cases (our sample) and completed suicide cases. Methods: Our sample includes every person assisted for non-lethal suicidal behavior in the Psychiatric Emergency room at Castellon’s Provincial Hospital from January 19th to February 15th, performing an 8 year follow-up. Our completed suicide sample was taken from a previous study conducted in 2018.2 Results: Our sample showed an average age of 39, with a majority of women (56.1%) and psychiatric pathology diagnosis (74.2%, mainly anxiety-depressive disorders). Most of them were being followed by a health service (81.2%, generally their GP). The most frequent suicide method was drug overdose (94.4%). After the suicide episode, only 27 patients (40.9%) attended the healthcare service they were referred to, what may explain the persistance of the suicidal behavior during the follow-up (7.7% suicidal threats and 34.5% attempts) Conclusions: Non-lethal suicidal behavior in Castellon is more frequent among young, women, and those with psychiatric disorders, using as main suicidal method drug overdose. Most of them don’t attend the health care service responsible for their follow-up. Moreover, it was found that the completed suicide profile differs from the non-lethal; it is therefore required to develop different therapeutical and preventive strategies for each one.Introducción: Dada la variabilidad en la conducta suicida según los valores socioculturales de cada territorio, realizamos este estudio para definir las características sociodemográficas y clínicas de los pacientes con comportamiento suicida no letal de nuestra provincia. Pretendemos ampliar nuestro conocimiento para facilitar la detección de individuos en riesgo e implantar intervenciones efectivas. Además, realizamos una comparativa entre las características de nuestra muestra con las de suicidio consumado. Material y métodos: La muestra incluye toda conducta suicida no letal registrada en el Hospital Provincial de Castellón entre el 19 de enero y 15 de febrero de 2009, realizándose un seguimiento hasta febrero de 2017. La muestra de suicidio consumado es tomada de un proyecto previo de 2018. Resultados: La muestra la integran mayormente individuos jóvenes (media de 39 años), de sexo femenino (56.1%), con patología psiquiátrica (74.2%, principalmente trastornos ansioso-depresivos) y en seguimiento sanitario (81.2%, predominantemente MAP (77.3%)). El método de suicidio más frecuente fue la sobreingesta medicamentosa (94.4%). Sólo 27 pacientes (40.9%) acudieron tras el episodio a los servicios de salud remitidos, facilitándose así la persistencia de la conducta durante el seguimiento (7.7% amenazas, 34.5% tentativas). Conclusiones: La conducta suicida no letal de Castellón predomina entre adultos jóvenes, de sexo femenino, con trastornos psiquiátricos, que recurren como método a la sobredosis medicamentosa e incumplen el seguimiento a posteriori. Además, se comprobó que el perfil del comportamiento suicida letal difiere de los rasgos de la conducta suicida no letal, evidenciando la necesidad de desarrollar estrategias preventivas y terapéuticas distintas entre ellos

Insulin secretion and action affect glucose variability in the early stages of glucose intolerance

Aims Since it is unknown whether glucose variability (GV) is increased and whether this is related to worsening of insulin secretion and action in prediabetes, we have assessed insulin secretion and sensitivity, and daily GV in early stages of dysglycemia. Materials and Methods Twenty subjects with normal glucose tolerance (NGT; age 45.0 +/- 9.5 years; BMI 31.1 +/- 6.4 kg/m2), 25 with NGT and 1hrOGTT&gt;8.6 mmol/L (1hrOGTT; 45.7 +/- 8.5 years; 32.4 +/- 7.0 kg/m2), and 59 with isolated impaired glucose tolerance (iIGT; 47.7 +/- 11.2 years; 31.3 +/- 6.1 kg/m2) underwent OGTT and MMTT. CGM was performed with blinded FreeStyle Libre Pro for 24 h under standard conditions. Parameters of beta-cell function, insulin sensitivity and GV were calculated. Results Overall insulin secretion and action as well as GV progressively worsened across glucose tolerance categories. On a matrix analysis, GV parameters were inversely related to ISSI-2; r = -0.37 to -0.52; p r = -0.28 to -0.48; p &lt; 0.0001 for CV, SD, J-index, LI, HBGI and MAGE. Insulin secretion (IGI) and b-cell function (ISSI-2) emerged as independent contributors to GV in early stage of dysglycemia accounting for about 16%-38% of its variability. Conclusions Our results show that daily GV worsens already with mild impairment of glucose tolerance. The increase in GV is inversely related to insulin secretion and action

The Feel4Diabetes intervention : effectiveness on 24-hour physical behaviour composition in families at risk for diabetes development

The Feel4Diabetes project conducted a 2-year intervention aiming to encourage healthy behaviours in families in six European countries. Within this paper, the intervention effect was evaluated after the first intervention year on 24-hour physical behaviour composition in Belgian families at risk for type 2 diabetes. Parents' and children's levels of physical activity (PA) and sedentary behaviour (SB) were objectively measured and sleep duration was self-reported. Valid data were obtained in 82 children (mean age: 8.2 +/- 0.84; 50.0% boys) and 72 parents (mean age: 40.1 +/- 5.5; 27.8% fathers). Data were analysed using a compositional data approach, and mixed models were used to take clustering into account. Results showed that for children, the mean baseline composition of the 24-hour day in sleep, SB, light and moderate-to-vigorous PA for the intervention group was (11 hours 18 minutes; 6 hours 33 minutes; 5 hours 02 minutes, 1 hour 08 minutes) and for the control group (11 hours 18 minutes; 6 hours 35 minutes; 5 hours 04 minutes; 1 hour 06 minutes), respectively. For parents, the mean baseline composition was for the intervention group (8 hours 12 minutes; 9 hours 36 minutes; 5 hours 43 minutes; 27 minutes) and for the control group (8 hours 00 minute; 9 hours 00 minute; 6 hours 27 minutes; 33 minutes). No significant intervention effects were found on 24-hour physical behaviour composition of either parents or children (p = 0.19 and p = 0.21, respectively). A relatively small study population and a poor attendance rate among parents could maybe explain the lack of effectiveness. More effective strategies are needed to retain vulnerable families in interventions. Furthermore, future approaches to improve the 24-hour physical behaviour composition should maybe focus more specifically on PA, SB and sleep, and involve teachers, children and parents in the design of the intervention. Trial registration: NCT02393872 in ClinicalTrials.gov

Associations between household food environment and daily intake of regular and diet soft drinks per BMI status of European children : Feel4Diabetes Study

The objective of this study was to investigate how the availability of food in the household environment is associated with a daily intake of regular and diet soft drinks in European children, considering BMI status. This cross-sectional study utilised baseline data from 12211 schoolchildren participating in the Feel4Diabetes European lifestyle modification intervention. Sociodemographics, soft drink intake and household food availability data were collected using parent-completed questionnaires. Anthropometry was recorded, and children were classified into BMI categories according to the International Obesity Task Force cut-offs. In the multivariate logistic regression analysis controlled for children's sex, mother's BMI, and educational level, frequent household availability of fruit juice (sugar added), regular soft drinks and salty snacks compared to less frequent were positively associated with daily regular soft drink intake in children, regardless of BMI group (ORs range 1.59–6.69). Conversely, frequent availability of fruit juice (no added sugar) was inversely related to regular soft drink intake in both BMI groups, as was the availability of fresh fruit in the overweight/obesity group, and the availability of diet soft drinks in the underweight/normal-weight (ORs range 0.31–0.54). In conclusion, habitual household availability of selected energydense foods/beverages was positively associated with a daily intake of regular soft drinks in European children, regardless of BMI status. Contrastingly, household availability of fresh fruit, fruit juice (no added sugar) and diet soft drinks were inversely associated with regular soft drink intake. Programmes focusing on reducing children's soft drink intake should consider reducing the availability of sugar-added beverages in the household food environment and encouraging water consumption, as a practical, healthier alternative suggestio

Role of parenting practices and digital media on beverage intake in European schoolchildren of different weight status : Feel4Diabetes-study

Objectives: Halting the rise in childhood obesity is an ongoing challenge in Europe. Sugar-sweetened beverage (SSB) and artificially sweetened beverage (ASB) consumption has become common practice at home and during family meals. The objective of this study was to investigate associations of parenting practices and home digital media availability with beverage intake in European schoolchildren of different weight groups. Methods: Cross-sectional data were derived from six countries taking part in the multicentered Feel4Diabetes-study. Anthropometric data were measured for 12 030 schoolchildren (n = 6097 girls; median age = 8.1 y). Details on sociodemographic characteristics, beverage intake, food parenting practices, and home availability of digital media were collated from questionnaires. The outcomes, daily SSB and ASB intakes, were included as dependent variables in multivariable regression models that provided odds ratios reflecting their association with parenting practices and digital media (exposures), after stratifying for children's weight status (underweight or normal versus overweight or obese). Results: After controlling for children's sex, region, maternal body mass index, and education, the multivariate model found that in both body mass index groups, permissive parenting practices, such as rewarding and allowing consumption of unhealthy foods "very often or often," as compared with "rarely or never," were associated with a high daily intake of SSBs and ASBs in children, while parents "watching television together with their child," rewarding with screen time, and availability of television in children's rooms increased the likelihood of both beverages in the underweight or normal-weight group. Conclusions: Modification of permissive parenting practices and removal of television from children's rooms could effectively reduce SSB intake and curb the ongoing threat of child obesity in Europe