Frequent use of selected sugary products associates with thinness, but not overweight during preadolescence : a cross-sectional study

Convincing evidence suggests that diets laden with added sugar, specifically sugar-sweetened beverages, associate with excess weight in children. The relationships between sugar consumption frequency and BMI remain less well studied. We, therefore, evaluated children's consumption frequency of selected sugary products (n8461; mean age 11 center dot 1 (sd0 center dot 9) years) selected from the Finnish Health in Teens cohort study. Using a sixteen-item FFQ including six sugary products (chocolate/sweets, biscuits/cookies, ice cream, sweet pastry, sugary juice drinks and sugary soft drinks), we calculated a Sweet Treat Index (STI) for the frequency of weekly sugary product consumption and categorised children based on quartiles (Q) into low (Q1, cut-off 10 center dot 5), and as thin, normal and overweight/obese based on the measured BMI. Through multinomial logistic regression analyses, we found that subjects with a high STI exhibited a higher risk of being thin (OR 1 center dot 20, 95 % CI 1 center dot 02, 1 center dot 41) and lower risk of being overweight (OR 0 center dot 79, 95 % CI 0 center dot 67, 0 center dot 92), while subjects with a low STI were at higher risk of being overweight (OR 1 center dot 32, 95 % CI 1 center dot 14, 1 center dot 53). High consumption frequencies of salty snacks, pizza and hamburgers most closely were associated with a high STI. Our findings suggest that consuming sugary products at a high frequency does not associate with being overweight. The relationship between a low consumption frequency and being overweight suggests that overweight children's consumption frequency of sugary products may be controlled, restricted or underreported.Peer reviewe

Children’s Eating Attitudes Test (ChEAT) : a validation study in Finnish children

Purpose To validate the Children's Eating Attitudes Test (ChEAT) in the Finnish population. Materials and methods In total 339 children (age 10-15 years) from primary schools in Southern Finland were evaluated at two time points. They answered the ChEAT and SCOFF test questions, and had their weight, height and waist circumference measured. Retesting was performed 4-6 weeks later. Test-retest reliability was evaluated using intra-class correlation (ICC), and internal consistency was examined using Cronbach's alpha coefficient (C-alpha). ChEAT was cross-calibrated against SCOFF and background variables. Factor analysis was performed to examine the factor structure of ChEAT. Results The 26-item ChEAT showed high internal consistency (C-alpha 0.79), however, a 24-item ChEAT showed even better internal consistency (C-alpha 0.84) and test-retest reliability (ICC 0.794). ChEAT scores demonstrated agreement with SCOFF scores (p <0.01). The mean ChEAT score was higher in overweight children than normal weight (p <0.001). Exploratory factor analysis yielded four factors (concerns about weight, limiting food intake, pressure to eat, and concerns about food), explaining 57.8% of the variance. Conclusions ChEAT is a valid and reliable tool for measuring eating attitudes in Finnish children. The 24-item ChEAT showed higher reliability than the 26-item ChEAT.Peer reviewe

Maternal alcohol and tobacco consumption and the association with their 9 to 14-year-old children's Body Mass Index

Aims: Little is known about impact of maternal alcohol and tobacco consumption on adolescents' body size. The purpose of this study was to evaluate whether maternal alcohol or tobacco consumption is associated with their children's body size in adolescence, assessed by Body Mass Index (BMI). Methods: This study was conduct in subjects recruited into the Finnish Health in Teens cohort (Fin-HIT) between 2011 and 2014. A total of 4525 subjects aged between 9 and 14 years and their mothers or female adults responsible for the children were analysed. Relative risks (RR) and 95% confidence intervals (CI) were estimated using Multinomial Logistic Regression. Results: Most children were normal weight (74.5%), 10.6% were underweight and 14.9% were overweight or obese. Among mothers, 50.6% were never smokers, 35.7% were former smokers, and 13.7% were current smokers. Alcohol consumption was classified by Alcohol Use Disorders Identification Test (AUDIT), 12.7% were abstainers (score=0), 65.0% were low-moderate drinkers (scores 1-4) and 22.3% were harmful drinkers (scores. 5). There were statistically significant associations between currently smoking mothers and children's overweight (RR=1.36; 95% CI: 1.05-1.76). There was an inverse association between maternal former smoking and children's underweight (RR=0.70; CI: 0.56-0.87) compared with never smoker mothers. Among children in puberty, abstainer mothers were more likely to have underweight children compared with low-moderate mothers (RR=1.57; 95% CI: 1.03-2.41). Conclusions: Current smoker mothers were associated with children's overweight and former-smoker mothers were inversely associated with the children's underweight. Being an abstainer mother was associated with the children's underweight in puberty stage. If other studies confirm these results, public health interventions aiming at healthy weight of adolescents should target the whole family, not only the adolescents themselves.Peer reviewe

Individual-, home- and preschool-level correlates of preschool children's sedentary time

Background Prechoolers' significant portions of sedentary time (ST) is a public-health concern due to its high prevalence and negative health consequences. However, few studies have explored correlates of preschoolers' ST covering individual-, home- and preschool- factors within one study. The aim of this study was to identify the associations between multiple individual-, home- and preschool-level factors and preschoolers' ST. In addition, it was studied how much individual-, home- and preschool-level factors explained the variance in children's ST. Methods A total of 864 children aged three to six, their parents and 66 preschools participated in the cross-sectional DAGIS study, which occurred between 2015 and 2016. The children wore an accelerometer for 1 week. Guardians, principals and early educators completed questionnaires covering the potential correlates of children's ST, for example, temperament, practices, self-efficacy and regulations. Multilevel regression analyses were conducted in multiple steps; calculation of marginal and conditional R-2 values occurred in the final phase. Results Of the 29 studied correlates, the following factors remained significant in the final models. Being a boy (p <0.001) and having high levels of surgency temperament (p <0.001) were associated with lower ST. Regarding the home setting, frequent co-visits in physical activity (PA) places (p = 0.014) were associated with lower ST. Higher parental perceived barriers related to children's outside PA (p = 0.032) was associated with higher ST. None of the preschool setting factors remained significant in the final model. Approximately 11% of the variance in children's ST was attributed to factors related to the individual level whereas 5% was attributed to home-level factors; and 2% to preschool-level factors. Conclusions This study identified a set of correlates of preschool children's ST. Interventions aimed at reducing children's ST should develop strategies targeting established correlates of preschoolers' ST covering individual-, home- and preschool-level factors. The preschool-level factors included in this study explained little the variance in children's ST. However, the included measures may not have captured the essential preschool-level factors that specifically influence children's ST. Therefore, more studies are needed regarding potential preschool-level factors.Peer reviewe

Individual-, home- and preschool-level correlates of preschool children's sedentary time

Background Prechoolers' significant portions of sedentary time (ST) is a public-health concern due to its high prevalence and negative health consequences. However, few studies have explored correlates of preschoolers' ST covering individual-, home- and preschool- factors within one study. The aim of this study was to identify the associations between multiple individual-, home- and preschool-level factors and preschoolers' ST. In addition, it was studied how much individual-, home- and preschool-level factors explained the variance in children's ST. Methods A total of 864 children aged three to six, their parents and 66 preschools participated in the cross-sectional DAGIS study, which occurred between 2015 and 2016. The children wore an accelerometer for 1 week. Guardians, principals and early educators completed questionnaires covering the potential correlates of children's ST, for example, temperament, practices, self-efficacy and regulations. Multilevel regression analyses were conducted in multiple steps; calculation of marginal and conditional R-2 values occurred in the final phase. Results Of the 29 studied correlates, the following factors remained significant in the final models. Being a boy (p <0.001) and having high levels of surgency temperament (p <0.001) were associated with lower ST. Regarding the home setting, frequent co-visits in physical activity (PA) places (p = 0.014) were associated with lower ST. Higher parental perceived barriers related to children's outside PA (p = 0.032) was associated with higher ST. None of the preschool setting factors remained significant in the final model. Approximately 11% of the variance in children's ST was attributed to factors related to the individual level whereas 5% was attributed to home-level factors; and 2% to preschool-level factors. Conclusions This study identified a set of correlates of preschool children's ST. Interventions aimed at reducing children's ST should develop strategies targeting established correlates of preschoolers' ST covering individual-, home- and preschool-level factors. The preschool-level factors included in this study explained little the variance in children's ST. However, the included measures may not have captured the essential preschool-level factors that specifically influence children's ST. Therefore, more studies are needed regarding potential preschool-level factors.Peer reviewe

Prevalence of Thinness, Overweight, Obesity, and Central Obesity in Finnish School-Aged Children : A Comparison of National and International Reference Values

Introduction: The global epidemic of obesity concerns children, and monitoring the prevalence is of highest priority. Body mass index (BMI) with age- and sex-specific cutoff values determines weight status in children, although multiple reference systems exist. Our aim was to compare the prevalence for thinness, normal weight, overweight, and obesity in Finnish school-aged children according to national and international reference values, as well as to determine which cutoff values for overweight agree with the criteria for central obesity. Methods: This study includes 10,646 children aged 9-12 years from the Finnish Health in Teens cohort. Height, weight, and waist circumference were measured in 2011-2014. BMI (weight [kg]/height [m](2)) and the waist-to-height ratio (WHtR; waist [cm]/height [cm]) were calculated. The WHtR cutoff of >0.5 indicated central obesity. We compared the sex-specific prevalence of thinness, overweight, and obesity using the International Obesity Task Force (IOTF), World Health Organization (WHO) and Finnish (FIN) BMI-for-age reference values, as well as these three against central obesity based on the WHtR. Results: The prevalence of thinness, overweight, and obesity were 11.0%, 12.7%, and 2.6%, respectively, using IOTF; 2.6%, 15.9%, and 5.2% using WHO; and 5.1%, 11.4%, and 2.2% using FIN. Overweight and obesity were more common in boys than girls using WHO and FIN, while thinness was more common in girls using IOTF and FIN. IOTF versus WHO exhibited moderate agreement (kappa = 0.59), which improved for IOTF versus FIN (kappa = 0.74). Of those classified as overweight by WHO, 37% and 47% were regarded as normal weight according to IOTF and FIN, respectively. The prevalence of central obesity was 8.7%, and it was more common in boys than girls. WHO provided the highest sensitivity: 95% of individuals with central obesity were classified with overweight or obesity. Using FIN provided the highest specificity (93%). Conclusion: Our findings show that WHO overestimates the prevalence of overweight and obesity, while IOTF overrates thinness. Thus, comparing prevalence rates between studies requires caution. The novelty of this study is the comparison of the cutoff values for overweight with central obesity. The choice of reference system affects the generalizability of the research results. (C) 2021 The Author(s) Published by S. Karger AG, BaselPeer reviewe

Psychometric properties of the item-reduced version of the comprehensive general parenting questionnaire for caregivers of preschoolers in a Finnish context

Publisher Copyright: © 2022 Ray et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.Introduction Many instruments for assessing general parenting have been reported as burdensome and are thus seldom used in studies exploring children’s energy balance-related behaviors or weight. This study evaluates the factorial structure of the item-reduced version of the Comprehensive General Parenting Questionnaire (CGPQ), which assesses five constructs of general parenting. Methods The study uses data from two cross-sectional studies: Study 1 in 2014 (n = 173) and Study 2 in 2015–16 (n = 805). Parents of children aged three to six answered the CGPQ; in Study 1 the 69-item version, and in Study 2 the 29-item version. The reduction was based on the results of the confirmatory factor analyses (CFA) in Study 1. In both datasets, internal consistency, as Cronbach’s alphas and intraclass correlations between the items of each construct, was tested. A combined assessment of the CFA and items response theory evaluated the construct validity and the item importance for the 29-item version, and a further the reduced 22-item version. Results In Study 1, the highest Cronbach’s alphas were shown for the five constructs in the 69-item version. A higher intraclass correlation was found between the constructs in the 69- and 29-item versions, than between the 69- and the 22-item version. However, a high concordance was found between the constructs in the 29- and 22-item versions in both Study 1 and in Study 2 (0.76–1.00). Testing the goodness-of-fit of the CFA models revealed that the 22-item model fulfilled all the criteria, showing that it had a better factorial structure than the 29-item model. Standard estimations ranged from 0.20 to 0.76 in the 22-item version. Conclusion The reduced 22- and 29-item versions of the 69-item CGPQ showed good model fit, the 22-item version the better of the two. These short versions can be used to assess general parenting without overburdening the respondents.Peer reviewe

Meal Regularity Plays a Role in Shaping the Saliva Microbiota

Background Diet may influence health directly or indirectly via the human microbiota, emphasizing the need to unravel these complex relationships for future health benefits. Associations between eating habits and gut microbiota have been shown, but less is known about the association between eating habits and saliva microbiota. Objective The aim of this study was to investigate if eating habits and meal patterns are associated with the saliva microbiota. Methods In total, 842 adolescents, aged 11-14 years, from the Finnish Health in Teens (Fin-HIT) study cohort were included in this study. Eating habits and breakfast and dinner patterns were derived from a web-based questionnaire answered in school. Three major eating habit groups were identified: fruit and vegetable avoiders (FV avoiders), healthy and unhealthy. Microbiota profiles were produced from 16S rRNA gene (V3-V4) sequencing of DNA from the saliva samples. Statistical models were adjusted for gender, age, parental language, body mass index (BMI) categories, and sequencing depth. Results Regular breakfast eaters had a higher alpha diversity (Shannon index with mean (standard error of means) 2.27 (0.03) vs. 2.22 (0.03), p = 0.06, inverse Simpson's index with 6.27 (0.17) vs. 5.80 (0.02), p = 0.01), and slight differences in bacterial composition (PERMANOVA: p = 0.001) compared with irregular breakfast eaters. A similar trend in alpha diversity was observed between regular and irregular dinner eaters (Shannon index with 2.27 (0.03) vs. 2.22 (0.03), p = 0.054, inverse Simpson's index with 6.23 (0.17) vs. 6.04 (0.22), p = 0.28), while no difference was found in composition (PERMANOVA: p = 0.08). No differences were identified between eating habit groups and saliva microbiota diversity (Shannon index p = 0.77, inverse Simpson's index p = 0.94) or composition (PERMANOVA: p = 0.13). FV avoiders, irregular breakfast eaters and irregular dinner eaters had high abundances of Prevotella. Conclusion Regularity of eating, especially breakfast eating, was associated with more diverse saliva microbiota and different composition compared with irregular eaters. However, the dissimilarities in composition were small between regular and irregular breakfast eaters. Our results suggest that Prevotella abundances in saliva were common in FV avoiders and meal skippers. However, the clinical implications of these findings need to be evaluated in future studies.Peer reviewe

Cohort Profile : The Finnish Health in Teens (Fin-HIT) study: a population-based study

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Eating habits and weight status in Finnish adolescents

Objective: To investigate the association between eating habits and weight status in adolescents in Finland. Design: Cross-sectional study. Setting: The Finnish Health in Teens (Fin-HIT) study is a cohort study conducted in adolescents attending third to sixth grade in 496 schools in forty-four municipalities in Southern, Middle and Northern Finland in 2011-2014. Participants: Analyses included 10 569 adolescents from the Fin-HIT study aged 9-14 years (5005 boys and 5564 girls). Adolescents were categorized by their eating habits: healthy eaters (44 center dot 1 %; n 4661), unhealthy eaters (12 center dot 3 %; n 1298), and fruit and vegetable avoiders (43 center dot 6 %; n 4610); and they were grouped into weight status: underweight (11 center dot 1 %), normal weight (73 center dot 6 %) and excess weight (15 center dot 3 %). Results: We found an increased risk of underweight in fruit and vegetable avoiders (OR = 1 center dot 28; 95 % CI 1 center dot 12, 1 center dot 46). An irregular breakfast pattern showed an inverse association with underweight (OR = 0 center dot 70; 95 % CI 0 center dot 59, 0 center dot 84) and an increased risk of excess weight (OR = 1 center dot 56; 95 % CI 1 center dot 37, 1 center dot 77) compared with a regular breakfast pattern. An irregular dinner pattern was inversely associated with underweight (OR = 0 center dot 83; 95 % CI 0 center dot 69, 0 center dot 99) compared with a regular dinner pattern. Conclusions: Avoiding fruits and vegetables and following irregular breakfast and dinner patterns were associated with underweight and excess weight in adolescents.Peer reviewe