How accurate are adolescents in portion-size estimation using the computer tool young adolescents' nutrition assessment on computer (YANA-C)?

Computer-administered questionnaires have received increased attention for large-scale population research on nutrition. In Belgium-Flanders, Young Adolescents' Nutrition Assessment on Computer (YANA-C) has been developed. In this tool, standardised photographs are available to assist in portion-size estimation. The purpose of the present study is to assess how accurate adolescents are in estimating portion sizes of food using YANA-C. A convenience sample, aged 11-17 years, estimated the amounts of ten commonly consumed foods (breakfast cereals, French fries, pasta, rice, apple sauce, carrots and peas, crisps, creamy veloute, red cabbage, and peas). Two procedures were followed: (1) short-term recall: adolescents (n 73) self-served their usual portions of the ten foods and estimated the amounts later the same day; (2) real-time perception: adolescents (n 128) estimated two sets (different portions) of pre-weighed portions displayed near the computer. Self-served portions were, on average, 8 % underestimated; significant underestimates were found for breakfast cereals. French fries, peas, and carrots and peas. Spearman's correlations between the self-served and estimated weights varied between 0.51 and 0.84, with an average of 0.72. The kappa statistics were moderate (> 0.4) for all but one item. Pre-weighed portions were, on average, 15% underestimated, with significant underestimates for fourteen of the twenty portions. Photographs of food items can serve as a good aid in ranking subjects; however, to assess the actual intake at a group level, underestimation must be considered

Relationship of physical activity and dietary habits with body mass index in the transition from childhood to adolescence : a 4-year longitudinal study

OBJECTIVE: To explore the relationship between several physical activity (PA) and dietary behaviours and BMI Z-score and to investigate the relationship between changes in these variables and in the BMI Z-score over a 4-year period from childhood to adolescence. DESIGN: Longitudinal study in which children were included in the fifth grade and measured for four consecutive years. Dietary and PA behaviours as well as height and weight were measured by means of self-reported validated questionnaires. SETTING: Fifty-nine Flemish elementary schools. SUBJECTS: The baseline sample consisted of 51·9 % boys and the mean age was 10 (sd 0·4) years. During the first measurement year (2002), data on 1670 fifth graders were gathered. These measurements were repeated after 1 (n 1557), 2 (n 1151) and 3 (n 807) years. RESULTS: Significant inverse relationships with BMI Z-score were observed for frequency of breakfast consumption (β = -0·033, se = 0·012) and frequency of sports participation (β = -0·011, se = 0·004) across four time points. Significant inverse relationships between changes in BMI Z-score and changes in frequency of sports participation (β = -0·011, se = 0·006) and hours of physical education (PE; β = -0·052, se = 0·023) were observed, meaning that decreases in sports participation and hours spent in PE were associated with increases in BMI Z-score. CONCLUSIONS: The present study provides an important insight into different dietary and PA behaviours related to (changes in) BMI Z-score during the transition from childhood to adolescence

Parents’ and Teachers’ Opinions about the School Food Policy in Belgian Flemish Nursery Schools

The partnership of parents, teachers, and schools is necessary to develop effective school food interventions. To gather parents' and teachers' opinions and perceptions about the school food policy, 884 parents and 70 teachers of preschoolers completed a questionnaire. School food policy is an issue of importance for parents and teachers: the majority agrees that schools should restrict the availability of snacks and soft drinks; however, to replace fruit juice and sugared milk drinks with sugarless alternatives will take special effort. Fruit is not always available at school, although parents would appreciate it. Parents of lower educational level are in general more permissive

Attempts to lose weight among overweight and non-overweight adolescents: a cross-national survey

Background: Despite the global obesity epidemic, few studies have performed cross-national comparisons of adolescents' attempts to lose weight and weight control practices. This study aims to investigate matters mentioned above by weight status in Europe, Israel, and North America. Methods: Nationally representative samples of adolescents from over 30 countries completed an anonymous, standardized questionnaire as part of the Health Behaviour in School-aged Children 2001/2002 survey. The prevalence and likelihood of attempts to lose weight were determined. The effect of weight status, self-perception of overweight, age and country of residence upon the likelihood of current attempts to lose weight were evaluated using multilevel multivariate logistic regression in separate analyses for boys and girls. The study also presented the prevalence of weight control practices of overweight and non-overweight adolescents who had controlled their weight in seven countries. Results: In general, overweight and obese adolescents were more likely to be engaged in current attempts to lose weight and had tried to control their weight during the past 12 months more often than non-overweight adolescents. Besides weight status, self-perception of overweight and age were significant individual-level factors determining current attempts to lose weight. Country of residence was a significant second-level factor but no clear geographical pattern was found. Several gender-related differences existed. Conclusion: The findings indicated that most overweight adolescents were motivated to reduce their weight. The importance of promoting a healthy body image for all adolescents was highlighted by the fact that self-perception of overweight was found to be the most important factor leading to attempts to lose weight.peerReviewe

Health promotion in individuals with mental disorders: a cluster preference randomized controlled trial

Background: The existing literature on weight management interventions targeting physical activity and healthy eating in mental health care appears to provide only limited evidence. The aim of the study was to examine the effectiveness of a 10-week health promotion intervention, followed by a 6-month follow-up period in individuals with mental disorders living in sheltered housing in the Flanders region (Belgium). Methods: The study had a cluster preference randomized controlled design. Twenty-five sheltered housing organizations agreed to participate (16 in the intervention group, nine in the control group). In the intervention group, 225 individuals agreed to participate, while in the control group 99 individuals entered into the study. The main outcomes were changes in body weight, Body Mass Index, waist circumference and fat mass. Secondary outcomes consisted of changes in physical activity levels, eating habits, health-related quality of life and psychiatric symptom severity. Results: A significant difference was found between the intervention group and the control group regarding body weight (-0.35 vs. +0.22 kg; p=0.04), Body Mass Index (-0.12 vs. +0.08 kg/m2; p=0.04), waist circumference (-0.29 vs. + 0.55 cm; p<0.01), and fat mass (-0.99 vs. -0.12%; p<0.01). The decrease in these outcomes in the intervention group disappeared during the follow up period, except for fat mass. Within the intervention group, a larger decrease in the primary outcomes was found in the participants who completed the intervention. No significant differences between the two groups in changes in the secondary outcomes were found, except for the pedometer-determined steps/day. In the intervention group, the mean number of daily steps increased, while it decreased in the control group. Conclusions: The study demonstrated that small significant improvements in the primary outcomes are possible in individuals with mental disorders. Integration of health promotion activities targeting physical activity and healthy eating into daily care are, however, necessary to maintain the promising results. Trial registration: This study is registered at ClinicalTrials.gov NCT 0133694

Knowledge and practice among dietitians in four Western European countries regarding malnutrition, starvation, cachexia and sarcopenia

Adequate distinction between malnutrition, starvation, cachexia and sarcopenia is important in clinical care. Despite the overlap in physical characteristics, differences in etiology have therapeutical and prognostic implications. We aimed to determine whether dietitians in selected European countries have ‘proper knowledge’ of malnutrition, starvation, cachexia and sarcopenia, and use terminology accordingly