Design and descriptive results of the "Growth, Exercise and Nutrition Epidemiological Study In preSchoolers": The GENESIS Study

BACKGROUND: The Growth, Exercise and Nutrition Epidemiological Study in preSchoolers (GENESIS) attempts to evaluate the food and nutrient intakes, as well as growth and development of a representative sample of Greek toddlers and preschool children. In the current work the study design, data collection procedures and some preliminary data of the GENESIS study are presented. METHODS: From April 2003 to July 2004, 1218 males and 1156 females 1 to 5 years old, stratified by parental educational level (Census 1999), were examined from 105 nurseries in five counties. Approximately 300 demographic, lifestyle, physical activity, dietary, anthropometrical and DNA variables have been recorded from the study population (children and parents). RESULTS: Regarding anthropometrical indices, boys were found to be taller than girls at all ages (P < 0.05) and heavier only for the age period from 1 to 3 years old (P < 0.05). No significant differences were found between genders regarding the prevalence of at risk of overweight (16.5% to 18.6% for boys and 18.5 to 20.6 % for girls) and overweight (14.0% to 18.9% for boys and 12.6% to 20.0% for girls). Additionally, boys older than 2 years of age were found to have a higher energy intake compared to girls (P < 0.05). A similar tendency was observed regarding the mean dietary intake of fat, saturated fat, carbohydrates and protein with boys exhibiting a higher intake than girls in most age groups (P < 0.05). CONCLUSION: The prevalence of overweight in the current preschool population is considerably high. Future but more extensive analyses of the GENESIS data will be able to reveal the interactions of the parameters leading to this phenomenon

Horizontal versus familial transmission of Helicobacter pylori.

Transmission of Helicobacter pylori is thought to occur mainly during childhood, and predominantly within families. However, due to the difficulty of obtaining H. pylori isolates from large population samples and to the extensive genetic diversity between isolates, the transmission and spread of H. pylori remain poorly understood. We studied the genetic relationships of H. pylori isolated from 52 individuals of two large families living in a rural community in South Africa and from 43 individuals of 11 families living in urban settings in the United Kingdom, the United States, Korea, and Colombia. A 3,406 bp multilocus sequence haplotype was determined for a total of 142 H. pylori isolates. Isolates were assigned to biogeographic populations, and recent transmission was measured as the occurrence of non-unique isolates, i.e., isolates whose sequences were identical to those of other isolates. Members of urban families were almost always infected with isolates from the biogeographic population that is common in their location. Non-unique isolates were frequent in urban families, consistent with familial transmission between parents and children or between siblings. In contrast, the diversity of H. pylori in the South African families was much more extensive, and four distinct biogeographic populations circulated in this area. Non-unique isolates were less frequent in South African families, and there was no significant correlation between kinship and similarity of H. pylori sequences. However, individuals who lived in the same household did have an increased probability of carrying the same non-unique isolates of H. pylori, independent of kinship. We conclude that patterns of spread of H. pylori under conditions of high prevalence, such as the rural South African families, differ from those in developed countries. Horizontal transmission occurs frequently between persons who do not belong to a core family, blurring the pattern of familial transmission that is typical of developed countries. Predominantly familial transmission in urban societies is likely a result of modern living conditions with good sanitation and where physical contact between persons outside the core family is limited and regulated by societal rules. The patterns observed in rural South African families may be representative of large parts of the developing world

Helicobacter pylori infection in pediatrics

In the past year the main interest was focused on the role of family for transmission of Helicobacter pylori to children; the evaluation of noninvasive diagnostic tests, especially in young children; extra-intestinal clinical manifestations; the lack of consensus on treatment; and the problem of high resistance of the microorganism to antibiotics

Diet quality of preschool children and maternal perceptions/misperceptions: The GENESIS study

Objectives: To quantify maternal perceptions regarding the quality of their child&apos;s diet, and to identify factors associated with misperceptions. Study design: A representative sample of 2287 children aged 2-5 years from a cross-sectional study (GENESIS study) was used. Methods: Maternal perceptions of the quality of their child&apos;s diet, child&apos;s and mother&apos;s anthropometric characteristics, and other characteristics (i.e. socio-demographic and lifestyle) were recorded. The actual quality of each child&apos;s diet was estimated using the Healthy Eating Index (HEI) score. Results: Based on the HEI score, 18.3% of participants had a &apos;poor&apos; diet, 81.5% had a diet which &apos;needs improvement&apos; and only 0.2% had a &apos;good&apos; diet. Almost 83% of mothers overestimated the quality of their child&apos;s diet. The overestimation rate was 86% among mothers who declared that they choose their child&apos;s food based on what they consider to be healthy, and 72% among those who reported that other factors play the predominant role in food choices for their child (P &lt; 0.001). Moreover, total energy intake as well as the intake of fruits, grains, vegetables, meat and milk was significantly higher among children whose mothers overestimated the quality of their diet. Conclusion: The vast majority of mothers overestimate the quality of their child&apos;s diet. Given that maternal perceptions regarding the quality of their child&apos;s diet are likely to be one of the predominant factors determining the child&apos;s food intake, health professionals should make mothers aware of the existence of particular dietary recommendations that their children should meet in order to eat a healthy diet. © 2009 The Royal Society for Public Health

Fiber intake and childhood appendicitis

In order to investigate the possible role of fiber in the etiology of acute appendicitis, 203 consecutive appendectomized children with histologically proved appendicitis and 1922 controls were studied by the diet history method. Statistics were performed by multivariate analysis of variance, discriminant analysis and χ2. Appendectomized children had statistically significant lower mean daily intake of fiber (17.4 g versus 20.4 g, P &amp;lt; 0.001) including all fiber fractions: cellulose, uronic acid, pentose, exose and lignin. No statistical difference was found for energy, protein, carbohydrate and fat intake. Discriminant analysis proved that only cellulose and exose are independently correlated to appendicitis and lower fiber intake is thought to be the cause in 70% of the cases. Recurrent abdominal pain, chronic constipation and positive family history of appendectomy were more frequent in appendectomized children (P &amp;lt; 0.001). This study gives evidence that low fiber intake could play an important role in the pathogenesis of appendicitis

Comparison of two methods for identifying dietary patterns associated with obesity in preschool children: The GENESIS study

Background/Objectives: The aim of this work was to identify dietary patterns based on reduced rank regression (RRR) and principal component analysis (PCA) and to evaluate the association of these patterns with the prevalence of childhood obesity.Subjects/Methods: A sample of 2317 toddlers and preschoolers from Greece (Growth, Exercise and Nutrition Epidemiological Study In preSchoolers) was used. In total, 12 food groups were used as predictors of RRR and PCA. Nutrients such as total fat, simple carbohydrate and fiber intake were used as response variables to apply RRR. Results: One factor/pattern was retained from RRR and PCA in order to ensure the comparability of the methods. The pattern derived from PCA was mainly characterized by consumption of fruits, vegetables, legumes, fish and seafood, grains and oils. This pattern explained 12.5% of the total variation in food groups. On the other hand, the pattern extracted from RRR was mainly characterized by reduced consumption of fruits, vegetables and legumes, and by increased consumption of sweets and red meat. The pattern derived from RRR explained 8.2% of the total variation in food groups. Simple and multiple logistic regression revealed that the pattern extracted from RRR is significantly associated with the prevalence of childhood obesity (OR1.11, 95% CI: 1.00-1.28 for each unit increase of dietary pattern) as opposed to the pattern derived from PCA.Conclusions:The preferable technique to derive dietary patterns related to childhood obesity seems to be RRR compared with PCA. © 2010 Macmillan Publishers Limited All rights reserved

Nutritional survey in Greek children: Nutrient intake

The aim of the survey was to record the food habits and nutrient intake of Greek children. Data was obtained by a 3 d household measured diet record from a random stratified sample (1936 children aged 2-14 y). Mean daily protein intake was much higher than PRI and none of the children had lower intake than AR. Mean energy intake from protein was 15%, carbohydrate 44% and fat 41%. Eighty-four percent of children had energy intake from fat higher than the AR. Saturated fatty acids (SFA) provided approximately 15%, monounsaturated (MUFA) 17% and polyunsaturated (PUFA) 6% of energy. Eighty-seven percent of children had higher intake of SFA than the AR. Six percent of children had SFA intake lower than the AR and 50% higher than the AR. None of the children had PUFA intake lower than PRI and 0.3% higher than the maximum limit. 4.2% of children had calcium intake lower than LTI and 88% higher or equal to PRI. All children had phosphorus intake higher than PRI and less than the lower safe ratio of Ca/P; 50% of them had P intake higher than 1.5 g/d. The majority of children had sufficient iron intake with the exception of menstruated girls. Mean vitamin A intake was higher than PRI and lower than the toxic levels. All children had vitamin C intake higher than LTI. Median vitamin D intake varied from 1.7-2.1 μgr. Median energy intake was higher than the AR in preschool children, but lower in the older children. We conclude that Greek children do not underintake energy and protein, overintake SFA, have safe intake of PUFA, vitamin A and C and high intake of MUFA, underintake carbohydrates, have adequate Ca, but a considerably high P intake. Vitamin D is low in small children, but the biological available vitamin D is obviously higher due to sunlight

Obesity and television watching in preschoolers in greece: The genesis study

The aim of the current work was to evaluate the effect of preschoolers&apos; television (TV) watching time on the prevalence of obesity even after controlling for their total energy intake and their physical activity status. A representative sample of 2,374 Greek children aged 1-5 years was examined (Growth, Exercise and Nutrition Epidemiological Study in preSchoolers, GENESIS study). Children&apos;s TV watching time on a usual weekday and at a usual weekend was recorded. The overall mean of children&apos;s TV viewing time was 1.32 h/day. The majority of participants (74.0%) spent 2 h/day watching TV whereas only 3.1% spent 4 h/day in front of a TV set. Overall, 65.2% of participants were normal weight, 17.2% were overweight, and the rest 17.6% were obese. The prevalence of obesity was significantly higher among those with TV viewing time 2 h/day (21.7%) compared to those watching TV 2 h/day (16.1%, P = 0.003). TV viewing time remained significantly associated with the likelihood of being obese even after controlling for potential confounders (i.e., socio demographic and other characteristics and physical activity status) only among children aged 3-5 years. However, further adjusting for children&apos;s total energy intake revealed that the association between the TV viewing time and the probability of being obese was no longer statistically significant. On the other hand, physical activity status continued to be an independent factor of being obese. The current findings support the hypothesis that the effect of TV viewing time on childhood obesity is independent of physical activity status and may be attributed to the increased total energy intake during TV watching