Design and specific features of a study of the long term cardiovascular and metabolic risk in type 1 diabetes mellitus

Among the traditional risk factors for cardiovascular diseases (CVD) in individuals with type 1 diabetes mellitus (T1DM), new ones are constantly being sought for timely prophylaxis and treatment. The increasing knowledge of the role of inflammation and visceral adipose tissue in the pathogenesis of T1DM complications is an integral part of the work of leading European centers. Obesity is a progressing risk factor and its role in the cardiovascular pathology of patients with T1DM is unclear. Lack of established practices and algorithms for management in these individuals has been poorly studied and presented to date. With prevalence of intensified insulin therapy in T1DM, leading sometimes to relatively high doses, and with the contemporary habits of eating, the patients’ risk of morbidity and mortality increases. Prioritization of cost-effective projects and specific timely commitment to protect disability in these patients is of utmost importance in scientific and healthcare aspects. The aim of this article is to present the design of the study of the cardiovascular and metabolic risk in patients with long-term T1DM

Longitudinal Associations between Food Parenting Practices and Dietary Intake in Children: The Feel4Diabetes Study

Food parenting practices (FPPs) have an important role in shaping children’s dietary behaviors. This study aimed to investigate cross-sectional and longitudinal associations over a twoyear follow-up between FPP and dietary intake and compliance with current recommendations in 6- to 11-year-old European children. A total of 2967 parent-child dyads from the Feel4Diabetes study, a randomized controlled trial of a school and community-based intervention, (50.4% girls and 93.5% mothers) were included. FPPs assessed were: (1) home food availability; (2) parental role modeling of fruit intake; (3) permissiveness; (4) using food as a reward. Children’s dietary intake was assessed through a parent-reported food frequency questionnaire. In regression analyses, the strongest cross-sectional associations were observed between home availability of 100% fruit juice and corresponding intake (β = 0.492 in girls and β = 0.506 in boys, p < 0.001), and between parental role modeling of fruit intake and children’s fruit intake (β = 0.431 in girls and β = 0.448 in boys, p < 0.001). In multilevel logistic regression models, results indicated that improvements in positive FPPs over time were mainly associated with higher odds of compliance with healthy food recommendations, whereas a decrease in negative FPP over time was associated with higher odds of complying with energy-dense/nutrient-poor food recommendations. Improving FPPs could be an effective way to improve children’s dietary intake.European Union’s Horizon 2020Aragón’s Regional Government (Diputación General de Aragón, DGA

Development and reliability of questionnaires for the assessment of diet and physical activity behaviors in a multi-country sample in Europe the Feel4Diabetes Study

L

Cost effectiveness review of text messaging, smartphone application, and website interventions targeting T2DM or hypertension

Digital health interventions have been shown to be clinically-effective for type 2 diabetes mellitus (T2DM) and hypertension prevention and treatment. This study synthesizes and compares the cost-effectiveness of text-messaging, smartphone application, and websites by searching CINAHL, Cochrane Central, Embase, Medline and PsycInfo for full economic or cost-minimisation studies of digital health interventions in adults with or at risk of T2DM and/or hypertension. Costs and health effects are synthesised narratively. Study quality appraisal using the Consensus on Health Economic Criteria (CHEC) list results in recommendations for future health economic evaluations of digital health interventions. Of 3056 records identified, 14 studies are included (7 studies applied text-messaging, 4 employed smartphone applications, and 5 used websites). Ten studies are cost-utility analyses: incremental cost-utility ratios (ICUR) vary from dominant to €75,233/quality-adjusted life year (QALY), with a median of €3840/QALY (interquartile range €16,179). One study finds no QALY difference. None of the three digital health intervention modes is associated with substantially better cost-effectiveness. Interventions are consistently cost-effective in populations with (pre)T2DM but not in populations with hypertension. Mean quality score is 63.0% (standard deviation 13.7%). Substandard application of time horizon, sensitivity analysis, and subgroup analysis next to transparency concerns (regarding competing alternatives, perspective, and costing) downgrades quality of evidence. In conclusion, smartphone application, text-messaging, and website-based interventions are cost-effective without substantial differences between the different delivery modes. Future health economic studies should increase transparency, conduct sufficient sensitivity analyses, and appraise the ICUR more critically in light of a reasoned willingness-to-pay threshold

Successfull breastfeeding and complementary feeding - modern trends, problems and solution opportunities // Успешно кърмене и захранване на децата - съвременни тенденции, проблеми и възможности за решаването им

[EN] The purpose of this thesis is to study and assess the patterns of breasfeeding (BF) and infants feeding according to the WHO criteria; to identify the factors influencing these patterns. Tasks: 1. To study mothers awareness about the BF benefits and also their attitudes and preparedness to breastfeed. 2. To study the patterns of infants feeding with reference to its rates and duration. 3. To determine GP s knowledge about infants BF and feeding as well as to qualify the recommendations given by them. 4. To reveal the opportunities for utilizing of lactation consultants in order to support the mothers in practicing successful BF. 5. To develop a model for successful BF Two studies were used: 1. "Breastfeeding in Varna district" - a cross-sectional epidemiologic study assessing the awareness about BF benefits, the attitudes and the preparedness to breastfeed; rates and duration of BF, the infants feeding patterns among 1287 mothers of infants (0-36 months) from Varna district. The study was conducted throughout 2009. 2. "GP and BF" - direct individual survey study assessing the knowledge and the recommendations given for lactation and feeding by 544 GP from Eastern Bulgaria. Descriptive statistical methods and regression analysis were implemented, as well as parametric and non-parametric methods for testing of hypotheses (SPSS v.17.0).This thesis may claim theoretical, methodological and practical contributions to the research of such BF aspects as involved parties awareness, established practices and identification of the factors influencing successful BF and infants feeding.A model formulating particular recommendations to the relevant stakeholders in order to improve BF and infants feeding in Bulgaria was developed.[BG] Целта на дисертационния труд е да се проучат и оценят практиките за кърмене и захранване според критериите на СЗО, както и да се разкрият факторите, повлияващи тези практики. Изследователски задачи: 1. Да се проучат знанията на майките относно ползите от кърмене, както и нагласите и подготовката за кърмене сред майките 2. Да се проучат практиките за хранене на децата по отношение честотата и продължителността на кърмене и захранване. 3. Да се определи нивото на знания на ОПЛ за кърменето и захранване и да се характеризират даваните от тях преоръки. 4. Да се разкрият възможностите за използване на консултантите по кърмене за подпомагане на майките в процеса на успешното кърмене на децата. 5. Да се изработи модел на успешно кърмене при децата. Проведени са две проучвания: 1. "Кърмене във Варненска област" срезово епидемиологично проучване за изследване на знанията за ползите от кърменето, нагласите и подготовката за кърмене; честотата и продължителността на кърменето, практиките на захранване на децата сред 1287 майки на деца (0 до 36 мес.) от обл. Варна. Проучването е (2009 год.) 2. "ОПЛ и кърмене"- пряко индивидуално анкетно проучване за определяне познанията и препоръките за естествено хранене и захранване сред 544 ОПЛ от Източната част на България. Приложени са дескриптивни статистически методи, параметрични и непараметрични методи за проверка на хипотези, регресионен анализ (SPSS v. 17.0). Дисертационният труд има теоретико-методологични и практико-приложни приноси за познанията и практиките на кърмене, факторите, повлияващи успешното кърмене и захранване. Изработен е модел и са формулирани конкретни препоръки до съответните институции, за подобряване на практиките на успешно кърмене и захранване на децата в България

Mapping the global evidence on nutrition transition: a scoping review protocol

INTRODUCTION: Nutrition transition has emerged as an important concept in health research used to describe shifts in dietary consumption and energy expenditure that coincide with economic, demographic and epidemiological changes at a population level. Better understanding of the shifts in dietary patterns across populations and their drivers could possibly hold the key to prevention of diet-related disease risk. An increasing number of studies have reported on nutrition transition in populations around the world, however, global evidence has not been summarised. OBJECTIVE: This scoping review is aimed to identify, explore and map the literature on nutrition transition with a specific focus on dietary changes in populations across the world. The review would allow better clarification around the concept of nutrition transition, classification of published studies and provide a framework for further research. METHODS AND ANALYSIS: The scoping review will be designed based on the methodology by Arksey and O'Malley, refined by Levac et al. and developed in conjunction with guidance on conducting systematic scoping reviews by Peters et al. The main research question addressed by the scoping review will be: 'What is the evidence on nutrition transition defined based on dietary changes reported in general adult population across the world?' Electronic databases (PubMed, ScienceDirect and Web of Science), grey literature sources and the reference lists of key studies will be searched to identify studies appropriate for inclusion in the review. Two reviewers will independently screen all abstracts and full-text studies for inclusion. Data will be abstracted into tables and logically organised according to items addressed in the specific research questions. ETHICS AND DISSEMINATION: Dissemination of results will be sought through a peer-reviewed publication, conference presentations and stakeholder meetings. The data used are from publicly available secondary sources, so no ethical review would be required for this study

Nutrition Transition in Europe: East-West Dimensions in the Last 30 Years—A Narrative Review

International audienceThe current review aims to summarize published research on nutrition transition patterns (depicting changes in dietary consumption) in European populations over the last three decades (1990–2020), with a focus on East-West regional comparisons. Pubmed and Google-Scholar databases were searched for articles providing information on repeated dietary intakes in populations living in countries across Europe, published between January 1990 and July 2021. From the identified 18,031 articles, 62 were found eligible for review (17 from Eastern and 45 from Western European populations). Overall, both in Eastern and Western Europe, there have been pronounced changes in dietary consumption patterns over the last three decades characterized by reductions in average reported intakes of sugar, carbohydrates and saturated fats and increases in reported fruit and vegetable consumption. There has also been a tendency toward a reduction in traditional foods, such as fish, observed in some Mediterranean countries. Overall, these data suggests that European countries have undergone a nutrition transition toward adopting healthier dietary behaviors. These processes occurred already in the period 1990–2000 in many Western European, and in the last decades have been also spreading throughout Eastern European countries. Firm conclusions are hampered by the lack of standardized methodologies depicting changes in dietary intakes over time and the limited coverage of the full variety of European populations. Future studies based on standardized dietary assessment methods and representative for the whole range of populations across Europe are warranted to allow monitoring trends in nutrition transition within and among European countries

Prevalence and sociodemographic correlates of overweight and obesity in a large Pan-European cohort of preschool children and their families : the ToyBox study

A