The proportion of differently processed foods in the diet of Croatian school-aged children and its impact on daily energy and nutrient intake

In countries around the world, a dietary shift is observed in which the consumption of highly processed foods increases over unprocessed or minimally processed foods. The objective of this study was to observe the proportion of processed foods in the diet of school-aged children and to assess how this relates to sex, weight status and school meal consumption. The aim was to assess the impact of processed foods on overall diet quality in terms of ultra-processed foods contribution to total daily energy intake. Dietary intake was observed from dietary records for three non-consecutive days of 168 children (50.6% boys) aged 8.3 ± 0.5 years. All foods and beverages were classified into four groups according to NOVA food classification system. The contribution of each NOVA food group to total daily energy intake was calculated and the mean nutrient intake of children divided into terciles according to total daily energy intake from ultra-processed foods was compared. Anthropometric measurements were performed according to standard protocols, while sex and age z-scores were obtained using AnthroPlus software. Results show that unprocessed or minimally processed foods (38.1% kcal) and ultra-processed foods (38.1% kcal) had the highest proportion of dietary intake. There was no difference in NOVA food groups intake by sex or weight status, while number of school meals may contribute to the intake of processed culinary ingredients. Children who had higher energy intake from ultra-processed foods had lower intake of animal proteins (p=0.009), polyunsaturated fatty acids (p=0.014), vitamin A (p=0.027) and most minerals, but higher intake of carbohydrates (p=0.014) and copper (p=0.014) compared to children with lower energy intake from ultra-processed foods. In conclusion, school-aged children had equal share of energy from unprocessed or minimally processed foods and from ultra-processed foods. Higher share of energy from ultra-process foods may contribute to poor overall nutrition

How the number and type of primary school meals affect food variety and dietary diversity?

School meals should encourage a varied and diverse diet, since children may eat up to three meals at school per day. The aim of this study was to assess food variety and dietary diversity among primary school children regarding the number and type of school meals. Dietary records for three non-consecutive days were used to estimate the food variety score (FVS) and dietary diversity score (DDS) of 195 children (52.3% boys) aged 8-9 years from schools in the city of Zagreb. For analysis, children were divided into 5 groups according to the number and type of school meals consumed: non-consumers (23.1%), breakfast consumers (30.3%), lunch consumers (5.6%), breakfast and lunch consumers (13.3%), and breakfast, lunch and snack consumers (27.7%). The children had an average FVS of 14.3 (12.6 - 16.7) and DDS of 5.7 (5.0 - 6.0). The food group with the highest frequency of consumption was starchy staple (99.9% of children), while legumes, seeds, and nuts were consumed least frequently (15.4%). The number and type of school meals were moderately correlated (r = 0.313, p < 0.001) with FVS and weakly (r = 0.230, p = 0.02) with DDS. In addition, children who ate breakfast and lunch or breakfast, lunch, and snack from school meals had significantly higher FVS (p < 0.001) and DDS (p = 0.027) compared to children who ate fewer school meals or ate no school meal. Children (50%) who ate breakfast, lunch, and snacks from school meals were more likely (p = 0.022) to consume dark green leafy vegetables. The number of school meals may affect the food variety and dietary diversity, with children who eat more school meals having better quality. However, the values obtained by the index suggest that both parents and school food services should provide more varied meals in terms of different foods and food groups

Smjernice za dijagnostiku i liječenje bolesnika s vratoboljom – 1. dio

Vratobolja je jedna od najčešćih mišićnokoštanih bolesti koja rezultira značajnom boli i nesposobnosti te ima velik utjecaj na individualnoj razini, kao i na zdravstveni sustav i društvo u cjelini. Uzroci vratobolje su različiti, a etiološki prevladavaju oni mehanički povezani s degenerativnim promjenama vratne kralješnice. Svjedočimo raznim dijagnostičkim i terapijskim pristupima za ove bolesnike. Hrvatsko vertebrološko društvo Hrvatskoga liječničkog zbora predstavlja sveobuhvatni narativni pregled i smjernice za dijagnozu i liječenje bolesnika s vratoboljom, s naglaskom na najčešće uzroke. Smjernice su rezultat konsenzusa stručnjaka različitih specijalnosti, a temelje se na najboljim dokazima. Ovaj prvi dio odnosi se na dijagnostiku, a drugi njemu komplementarni dio odnosi se na terapiju. Dijagnostički dio smjernica (1. dio) obuhvaća: klinička obilježja i evaluaciju (uključivo strukturirane upitnike), laboratorijsku dijagnostiku, slikovne metode, neurofiziološko testiranje i minimalno invazivne dijagnostičke postupke. Dio smjernica o liječenju (2. dio) uključuje: farmakološko liječenje, tjelesne medicinske vježbe, trakciju, manualnu terapiju, metode fizikalne terapije, primjenu ortoza, minimalno invazivne terapijske intervencije, kirurško liječenje, rehabilitaciju nakon kirurških zahvata i psihijatrijski pristup. Ovo su prve hrvatske smjernice za vratobolju primarno namijenjene liječničkoj profesionalnoj zajednici

Guidelines for diagnosis and treatment of patients with neck pain – Part 1

Neck pain is one of the most prevalent musculoskeletal diseases which results in considerable pain and disability, and has a great impact on individual level, as well as on health-care system, and overall society. Causes of neck pain are different, and prevailing aetiology are mechanical reasons associated with degenerative changes of cervical spine. We are witnessing various diagnostic and therapeutic approaches for these patients. The Croatian Society for Vertebrology of the Croatian Medical Association is presenting a comprehensive narrative review and guidelines for the diagnosis and treatment of neck pain, focusing on the most prevalent causes. The guidelines are the result of consensus of experts of different background, based on the best available evidence. This part (Part 1) relates to diagnosis, while the complementary part (Part 2) relates to treatment. For the diagnostic part (Part 1) the guidelines encompass: clinical features and evaluation (including questionnaires), laboratory tests, imaging, neurophysiology tests, and minimally invasive diagnostic procedures. The management part (Part 2) includes: pharmacology treatment, physical exercise, traction, manual therapies, physical therapy modalities, orthotics, minimally invasive therapeutic interventions, surgical treatment, rehabilitation after surgical procedures, and psychiatric approach. These are the first Croatian guidelines for neck pain intended in the first place for the physicians’ professional community.Vratobolja je jedna od najčešćih mišićnokoštanih bolesti koja rezultira značajnom boli i nesposobnosti te ima velik utjecaj na individualnoj razini, kao i na zdravstveni sustav i društvo u cjelini. Uzroci vratobolje su različiti, a etiološki prevladavaju oni mehanički povezani s degenerativnim promjenama vratne kralješnice. Svjedočimo raznim dijagnostičkim i terapijskim pristupima za ove bolesnike. Hrvatsko vertebrološko društvo Hrvatskoga liječničkog zbora predstavlja sveobuhvatni narativni pregled i smjernice za dijagnozu i liječenje bolesnika s vratoboljom, s naglaskom na najčešće uzroke. Smjernice su rezultat konsenzusa stručnjaka različitih specijalnosti, a temelje se na najboljim dokazima. Ovaj prvi dio odnosi se na dijagnostiku, a drugi njemu komplementarni dio odnosi se na terapiju. Dijagnostički dio smjernica (1. dio) obuhvaća: klinička obilježja i evaluaciju (uključivo strukturirane upitnike), laboratorijsku dijagnostiku, slikovne metode, neurofiziološko testiranje i minimalno invazivne dijagnostičke postupke. Dio smjernica o liječenju (2. dio) uključuje: farmakološko liječenje, tjelesne medicinske vježbe, trakciju, manualnu terapiju, metode fizikalne terapije, primjenu ortoza, minimalno invazivne terapijske intervencije, kirurško liječenje, rehabilitaciju nakon kirurških zahvata i psihijatrijski pristup. Ovo su prve hrvatske smjernice za vratobolju primarno namijenjene liječničkoj profesionalnoj zajednici