Diet Quality of Preschoolers in Greece Based on the Healthy Eating Index: The GENESIS Study

Background The current study aimed to assess the diet quality of Greek preschoolers and the potential role of several sociodemographic factors related to it. Methods A representative sample of 2,287 Greek children aged 2 to 5 years (from the Growth, Exercise, and Nutrition Epidemiological Study In preSchoolers) was used in this work. Dietary intake data was obtained using a combination of techniques comprising weighed food records, 24-hour recalls, and food diaries. A Healthy Eating Index (HEI) score was calculated summing the individual scores (0 to 10) assigned to each one of 10 index components. Results Eighty percent of participants had an HEI score <50 (ie, “poor” diet), 0.4% had an HEI score >80 (ie, “good” diet), and the overall mean HEI score was 59. HEI scores were significantly higher among boys, children aged 4 to 5 years, children participating in moderate to vigorous physical activities for more than 3 hours per week, children living in rural or small towns, and those whose mothers were employed and had higher educational status (> 12 years). HEI score was also found to be strongly associated with several macronutrient and micronutrient intakes. Conclusions Based on HEI scores, the vast majority of Greek preschoolers was found to have a poor diet. Moreover, low HEI scores were associated with low levels of physical activity, low vegetable intake, high saturated fat intake, lower maternal educational level, and unemployment status. J Am Diet Assoc. 2009; 109:616-623

Interaction effects between total energy and macronutrient intakes and angiotensin-converting enzyme 1 (<i>ACE</i>) I/D polymorphism on adiposity-related phenotypes in toddlers and preschoolers: the Growth, Exercise and Nutrition Epidemiological Study in preSchoolers (GENESIS)

The aim of the present study was to investigate the interaction between the angiotensin-converting enzyme 1 (ACE) I/D polymorphism and energy and macronutrient intakes on adiposity-related phenotypes among toddlers and preschoolers. A representative sample of 2374 Greek children aged 1 to 5 years old was examined (Growth, Exercise and Nutrition Epidemiological Study in preSchoolers (GENESIS)). Dietary and anthropometric (i.e. BMI, waist circumference (WC)) assessments were carried out using standard procedures. DNA samples were obtained from 2102 children and were genotyped for the ACE I/D polymorphism. Among the entire population, 17&#37; were ‘at risk of overweight’ and a similar percentage were ‘overweight’. The frequencies of the II, ID and DD genotypes were 16, 46 and 38&#37;, respectively. Significant interactions were found between the ACE I/D polymorphism and total energy intake on WC (P = 0·004 for interaction) and the ACE I/D polymorphism and protein intake on BMI and being overweight (P &lt; 0·05 for interaction). Furthermore, it was found that the ACE I/D polymorphism may modify the effect of fat intake on WC and BMI, but this interaction disappeared after adjustment for additional potential confounders. Stratified analyses revealed that total energy is correlated with WC and protein intake is associated with BMI and being overweight only among carriers of the D-allele (i.e. DD or ID genotypes). These results suggest that the ACE I/D polymorphism may act as a modifying factor in the response of adiposity-related phenotypes to diet

Daily sugar-sweetened beverage consumption and insulin resistance in European adolescents : the HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) Study.

Objective: The present study aimed to evaluate the relationship between the consumption of selected food groups and insulin resistance, with an emphasis on sugar-sweetened beverages (SSB). Design: The present research is a large multicentre European study in adolescents, the HELENA-CSS (Healthy Lifestyle in Europe by Nutrition in Adolescence Cross-Sectional Study). Setting: Homeostasis model assessment-insulin resistance index (HOMA-IR) was calculated. Several anthropometric and lifestyle characteristics were recorded. Dietary assessment was conducted by using a short FFQ. Subjects: The participants were a subset of the original sample (n 546) with complete data on glucose, insulin and FFQ. All participants were recruited at schools. Results: Median (25th, 75th percentile) HOMA-IR was 0.62 (0.44, 0.87). Mean HOMA-IR was significantly higher among adolescents consuming brown bread 5 times/week compared with those consuming less frequently, although a statistically significant difference was detected between those consuming SSB 5-6 times/week and 2-4 times/week (P=0.049). Multiple linear regression analysis showed that only the frequency of SSB consumption was significantly associated with HOMA-IR after controlling for potential confounders. In particular, it was found that HOMA-IR levels were higher among adolescents consuming SSB 5-6 times/week and >= 1 time/d compared with those consuming <= 1 time/week by 0.281 and 0.191 units, respectively (P=0.009 and 0.046, respectively). Conclusions: The present study revealed that daily consumption of SSB was related with increased HOMA-IR in adolescents