Sugar-added beverages consumption among kindergarten children of Crete: effects on nutritional status and risk of obesity

<p>Abstract</p> <p>Objective</p> <p>To assess the intake of sugar-added beverages such as soft drinks and commercially available fruit juices in kindergarten children, and to examine its association with obesity indices, physical activity levels and dietary habits.</p> <p>Methods</p> <p>A total of 856 children aged 4–7 years living in Crete, Greece in 2004–5 were included in this cross-sectional study. Nutrient and food intake was assessed with the use of 3-day weighed food records. Body measurements were used in order to assess BMI and waist circumference, and moderate-to-vigorous physical activity was calculated with the use of a questionnaire.</p> <p>Results</p> <p>Approximately 59.8% of all children consumed sugar-added beverages on a daily basis. High intake of sugar-added beverages (> 250 g/day) was associated with low intakes of calcium (p < 0.001), vitamin A and E (p < 0.010), fruits and vegetables (p = 0.007), and milk and yogurt (p = 0.048). Compared to non or low consumers, high consumers of sugar-added beverages (> 250 g/day) had higher BMI levels and two times greater risk of being overweight and/or obese (OR:2.35, p = 0.023).</p> <p>Conclusion</p> <p>High intake of sugar-added beverages in kindergarten children is associated with poor eating habits and inadequate nutrient intake, as well as increased risk for developing childhood obesity.</p

Study of development of the phenomenon of childhood obesity in relation to physical activity and diet and analysis of the potential risk in first grade school children from the prefecture of Chania, Crete

Background: This thesis presents the first study to analyze and evaluate data collected from two representative cross sectional studies conducted among Caucasian Cretan children from Greece registered in the first grade of the elementary school during the academic years 1992/93 and 2006/07. The study examined secular changes in anthropometric measurements blood pressure (BP), moderate to vigorous physical activity (MVPA), physical fitness (PF), inactivity (TV viewing) and the dietary habits of children in order to observe the progression of childhood obesity in Crete during 1992/93 and 2006/07. Methods and materials: Two representative groups of 967 children in total aged 5.9-7.8 years, were studied during 1992/93 and 2006/07 school years. Children in the 1992/93 study cohort were selected from a total population of 1098 first grade children participating in the 6-year school-based “Cretan Health and Nutrition Education program”. Children in the 2006/07 cohort were selected from a population of 798 1st, 2nd and 3rd graders participating in a 1-year intervention in the prefecture of Chania. From this study the measurements of 361 1st-graders were selected and these subjects were matched for gender, age, and area of residence (urban, rural and suburban) with the 1992/93 cohort. Results: During the last fifteen years there has been a significant increase in all markers in physical activity and cardio-respiratory endurance. Between 1992/93 and 2006/07 there was a significant increase in all fitness tests in both genders (p<0.001) and in the MVPA for boys (p<0.001). In 2006/07, both genders spent more time watching TV on weekdays (p<0.001) while there was a significant increase in the proportion of overweight/obese boys (19.4% vs 33.7% (p<0.001) between 1992/93 and 2006/07. For both genders the BP decreased in 2006/07 compared to 1992/93 (p<0.001). However in both periods, BP was higher in obese compared to overweight and normal children (p<0.001) but there was no relationship between BP and PA. Both genders significantly increased their energy intake (EΙ) (p<0.05), total fat (p<0.05), calcium and iron (p<0.001). Both genders significantly increased their intake of dairy products (p<0.001) decreased their intake of cereals (p<0.001). Among overweight/obese (ow/ob) children, dietary energy density (ED) decreased significantly (p<0.05) and mean consumption of fruits/vegetables increased (p<0.001). Conclusions: Over the 15 year period a significant increase in obesity indices was observed among Cretan children with conflicting simultaneous increase in PA and cardio-respiratory fitness. Moreover the increase in weekday TV-viewing is related to the prevalence of obesity of that sample group. The effort to improve children’s eating habits by eating more fruits/vegetables may constitute a positive trend however; it was well below recommendations, which might also explain the weight increase in this group. The fall in BP observed during this period may indicate an effort made by the children and their families to adopt a healthier lifestyle by improving their food choices.Εισαγωγή: Η παρούσα μελέτη είναι η πρώτη που άντλησε δεδομένα επιδημιολογικών μελετών δύο αντιπροσωπευτικών δειγμάτων παιδιών της Κρήτης που εγγράφηκαν στην Α’ δημοτικού κατά τις χρονικές περιόδους 1992/93 και 2006/07. Ανέλυσε τις μεταβολές των σωματομετρικών μεγεθών της Αρτηριακής Πίεσης (ΑΠ), των δεικτών: φυσικής δραστηριότητας (ΦΔ), φυσικής κατάστασης (ΦΚ), και σωματικής αδράνειας παρακολούθηση τηλεόρασης) καθώς και των διατροφικών συνήθειων των παιδιών με σκοπό την μελέτη της εξέλιξης της παιδικής παχυσαρκίας στην Κρήτη το 1992/93 και το 2006/07. Υλικό και Μέθοδοι: Μελετήθηκαν δύο αντιπροσωπευτικά δείγματα 967 παιδιών του νομού Χανίων ηλικίας 5.7-7.8 ετών τις χρονικές περιόδους 1992/93-2006/07. Το πρώτο δείγμα αποτελούνταν από Ν=606 παιδιά ηλικίας 5.9-7.8 και επιλέχθηκαν από το σύνολο 1098 μαθητών που εγγράφηκαν στην Α’ δημοτικού το 1992/93. Παρόμοια με αντιστοίχιση (ως προς το φύλο ηλικία περιοχή κατοικίας) επιλέχθηκε το δεύτερο δείγμα των Ν=361 παιδιών Α’ δημοτικού από το σύνολο 798 μαθητών που εγγράφηκαν στην Α’, Β’, Γ’ δημοτικού το 2006/07 και συμμετείχαν σε παρόμοια μελέτη μονοετούς εκπαιδευτικής παρέμβασης. Αποτελέσματα: Μεταξύ των περιόδων 1992/93 και 2006/07 βρέθηκε σημαντική αύξηση σε όλες τις δοκιμασίες φυσικής κατάστασης (p<0.001) και στα δύο φυλά ενώ ο χρόνος που δαπανήθηκε σε μέτρια-προς-έντονη σωματικής-άσκησης (ΜΕΣΑ) ήταν σημαντικά μεγαλύτερος στα αγόρια το 2006/07 (p<0.001) σε σχέση με το 1992/93. Ταυτόχρονα όμως και τα δυο φύλα το 2006/07 αφιέρωσαν περισσότερο χρόνο στην παρακολούθηση τηλεόρασης τις καθημερινές (p<0.001) ενώ ο επιπολασμός των υπέρβαρων/παχύσαρκων αγοριών αυξήθηκε από 19.4% σε 33.7% (p<0.001). Η αρτηριακή πίεση (ΑΠ) μειώθηκε σημαντικά και στα δύο φύλα (p<0.01). Και στις δύο χρονικές περιόδους η ΑΠ παρουσίασε υψηλότερες τιμές στα παχύσαρκα παιδιά σε σύγκριση με τα υπέρβαρα και φυσιολογικού βάρους (p<0.001) αλλά δεν βρέθηκε συσχέτιση μεταξύ ΑΠ και της ΣΑ. Και στα δύο φύλα βρέθηκε σημαντική αύξηση στην ενεργειακή τους πρόσληψη (ΕΝ.ΠΡ) (p<0.05) στην συνολική περιεκτικότητα σε λιπαρά (p<0.05) στο ασβέστιο και στο σίδηρο (p<0.001) ενώ διαπιστώθηκε σημαντική αύξηση στην κατανάλωση γαλακτοκομικών προϊόντων (p<0.001) και σημαντική μείωση στην κατανάλωση δημητριακών (p<0.001). Μεταξύ των υπέρβαρων/παχύσαρκων παιδιών η ενεργειακή πυκνότητα (ΕΝ.ΠΥΚΝ) τροφίμων μειώθηκε σημαντικά (p<0.05) ενώ η μέση κατανάλωση φρούτων/λαχανικών αυξήθηκε σημαντικά (p<0.001). Συμπεράσματα: Την τελευταία δεκαπενταετία διαπιστώνεται σημαντική αύξηση στους δείκτες παχυσαρκίας των παιδιών της Κρήτης με την αντιφατικά ταυτόχρονη αύξηση της ΣΑ και της κάρδιο-αναπνευστικής αντοχής. Παράλληλα, διαπιστώθηκε αύξηση της τηλεθέασης τις καθημερινές που σχετίζεται με την αύξηση του ποσοστού παχυσαρκίας. Προσπάθεια βελτίωσης των διατροφικών συνήθειων των παιδιών με κατανάλωση περισσοτέρων φρούτων/λαχανικών είναι περιορισμένη γιατί μεγάλο ποσοστό παιδιών λάμβανε ανεπαρκή ποσότητα. Η πτώση της ΑΠ που παρατηρήθηκε στην διάρκεια της περιόδου αυτής ίσως να υποδεικνύει την προσπάθεια των παιδιών και των οικογενειών τους για βελτίωση του τρόπου ζωής με καλύτερες επιλογές τροφίμων

Dietary patterns and their relationship with the perceptions of healthy eating in European adolescents : the HELENA study

Objective: The aim of this study was to identify dietary patterns (DPs) in European adolescents and to examine the association between perceptions of healthy eating and the obtained DPs. Method: A multinational cross-sectional study was carried out in adolescents aged 12.5 to 17.5?years and 2,027 (44.9% males) were considered for analysis. A self-reported questionnaire with information on food choices and preferences, including perceptions of healthy eating, and two 24-hour dietary recalls were used. Principal component analysis was used to obtain sex-specific DPs, and linear analyses of covariance were used to compare DPs according to perceptions of healthy eating. Results: Three and four DPs for boys and girls were obtained. In boys and girls, there were significant associations between some perceptions about healthy food and the Breakfast-DP (p?<?0.05). In boys, Breakfast-DP and Healthy Beverage-DP were associated with the perception of the own diet as healthy (p?<?0.05). Healthy Beverage-DP was associated with those disliking fruits and vegetables (p?<?0.05). Girls considering the own diet as healthy were associated with Mediterranean-DP, Breakfast-DP, and Unhealthy Beverage and Meat-DP (p?<?0.05). The perception of snacking as a necessary part of a healthy diet was associated with Breakfast-DP in both genders (p?<?0.05). Conclusions: In European adolescents, perceptions of healthy eating were mainly associated with a DP characterized by foods consumed at breakfast. Future studies should further explore these findings in order to implement health promotion programs to improve healthy eating habits in adolescents

Diet as a moderator in the association of sedentary behaviors with inflammatory biomarkers among adolescents in the HELENA study

AIM: To assess if a healthy diet might attenuate the positive sedentary-inflammation relation, whereas an unhealthy diet may increase the effect of sedentary behaviors on inflammatory biomarkers. METHODS: In 618 adolescents (13-17 years) of the European HELENA study, data were available on body composition, a set of inflammation markers, and food intake assessed by a self-administered computerized 24 h dietary recall for 2 days. A 9-point Mediterranean diet score and an antioxidant-rich diet z-score were used as dietary indices and tested as moderators. A set of low-grade inflammatory characteristics was used as outcome: several cytokines in an inflammatory ratio (IL-6, IL-10, TNF-α, TGFβ-1), C-reactive protein, three cell-adhesion molecules (sVCAM-1, sICAM-1, sE-selectin), three cardiovascular risk markers (GGT, ALT, homocysteine) and three immune cell types (white blood cells, lymphocytes, CD3). Sedentary behaviors were self-reported and analyzed as total screen time. Multiple linear regression analyses tested moderation by diet in the sedentary behaviors-inflammation association adjusted for age, sex, country, adiposity (sum of six skinfolds), parental education, and socio-economic status. RESULTS: Both diet scores, Mediterranean and antioxidant-rich diet, were significant protective moderators in the effect of sedentary behaviors on alanine-transaminase enzyme (P = 0.014; P = 0.027), and on the pro/anti-inflammatory cytokine ratio (P = 0.001; P = 0.004), but not on other inflammatory parameters. CONCLUSION: A higher adherence to the Mediterranean diet or an antioxidant-rich diet may attenuate the onset of oxidative stress signs associated by sedentary behaviors, whereas a poor diet seems to increase inflammation