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The relationship between social vulnerabilities and the effectiveness of behavioral interventions to prevent obesity in children is poorly understood. Therefore, the objective of this study is to evaluate the association between parental employment and the effectiveness of IDEFICS, a multilevel behavioral intervention aiming to prevent obesity among children (2 to 9.9 years old) in eight European countries. Data from 9,901 children and their parents was included in the analysis. We determined the Body Mass Index (BMI) z-score mean difference as the measurement of the intervention effectiveness and we calculated it as the follow-up (T1) BMI z-score mean minus baseline (T0) BMI z-score mean. Parents self-reported their employment status at T0 and T1. Children were classified, at both study times (T0 and T1), as children with employed parents (both parents employed) or as children with unemployed parents (one or both parents unemployed or receiving social assistance). We calculated unadjusted and adjusted multilevel mixed model analyses to evaluate if the employment status at T0 and the evolution of the employment status within a two-year period (from T0 to T1) predicted the BMI z-score mean difference among boys and girls. In boys, parental unemployment at T0 and throughout a two-year period (T0 to T1) predicted an increase of BMI z-score mean difference when compared to boys with employed parents (unemployment at T0: adjusted β = 0.12; p = 0.028; and unemployment from T0 to T1: adjusted β = 0.20; p = 0.031). We found no difference in the effectiveness of the IDEFICS intervention among girls with unemployed parents at T0 and from T0 to T1 when compared to girls with employed parents (unemployment at T0: adjusted β = 0.04; p = 0.337; and unemployment from T0 to T1: adjusted β = 0.10; p = 0.216, respectively). Our results suggest that the influence of parental unemployment in the IDEFICS outcome is different for boys and girls. Employment of both parents, which is related to a higher income, could contribute the families to engage healthier eating and physical activity behaviors among boys. Future multilevel interventions should include a combination of community-based and school-based components, as well as family-centered components, specifically on those families with parents out of the labor force, to address specific barriers or vulnerabilities that prevent them from improving behavior and weight status.

BackgroundThe knowledge about the association of physical activity (PA) and sedentary behaviours (SB) with the most considered healthy dairy products consumption, as milk and yogurt, in childhood is scared.AimTo assess the longitudinal relationship between specific lifestyle behaviours (PA and SB) and combined dairy consumption (milk + yogurt) in a sample of European children.MethodsTwo measurements, with 2 years’ interval (T0 and T1), were conducted in 1 688 (50.8% boys) childrenfrom the IDEFICS study. Dietary information was parental-registered by a 24-hour dietary recall. At both time points, sedentary behaviour and objective estimation of PA was obtained by accelerometers. Different groups were defined according to the international children's PA and SB behaviours recommendations over time. The cut-offs for the SB and PA recommendations were established on 2hour/day of SB and 2 hour/day of moderate to vigorous PA. Multilevel ordinal logistic regression models were used to assess the group's association with the combined dairy consumption (milk + yogurt), adjusted for potential confounders (sex, body mass index zscore, intervention versus control region, parental education level, dietary quality index, energy intake and the consumption by each dairy group at T0).ResultsNine groups of meeting or not both recommendations (SB and PA) were obtained. Those children who meeting both lifestyle recommendations at both measurement points, had higher probability to consume more milk and yogurt (p < 0.05), in comparison to the rest of combinations.Those children who did not meet any recommendations at both time points were less likely to consume milk + yogurt (OR: 0.47, 95%CI:0.26–0.83) than those who met both recommendations at both time points. Those children which improved one behaviours (PA or SB) between both measurement point were associated with low consumption of milk + yogurt (OR:0.41, 95%CI 0.22;0.74; OR:0.40, 95%CI 0.22,0.72), compared with those who meet both lifestyle recommendations at both periods (T0 and T1). Also, those which improved both behaviours (PA and SB) were less likely to consume milk + yogurt (OR:0.34, 95%CI 0.15–0.80) than those who were physically active and low sedentary at both time points.ConclusionsThese results suggest that European children with a healthy lifestyle regarding PA and SB over time, had the highest milk and yogurt consumption in comparison with other children.

Chrono-nutrition is an emerging field of research that focuses on the interplay between nutrition, circadian rhythms and metabolism. Most nutritional guidelines recommend regular and frequent meals for children and adolescents throughout the day. However, preliminary research, mostly in animals suggests that eating at the “wrong” time of the day and longer eating windows (and concomitant shorter fasting periods) may relate to metabolic health. This study aimed to identify meal-timing patterns of European children and adolescents in eight European countries.We examined 1225 children and adolescents (mean age: 11.8 years, 50% boys, and 26% overweight/obese) from Belgium, Cyprus, Estonia, Germany, Hungary, Italy, Spain and Sweden enrolled in the European I.Family study (2013/2014). Information on energy intake and meal-timing patterns was derived from multiple web-based 24-hour dietary recalls (proxy-assisted for children < 12 years). We used the National Cancer Institute (NCI) method to estimate individual usual intakes. Subsequently, we applied the k-means algorithm to identify clusters for meal-timing patterns. Five variables were selected for the cluster analysis: 1) Duration between first and last meal of the day (eating window in hours), 2) Proportion of daily energy intake before 11am, 3) Proportion of daily energy intake after 5pm, 4) Number of meals per day, and 5) Pre-sleep fasting time.Three clusters, labelled “late and time-restricted”, “late and long” and “early and frequent” meal-timing patterns were identified. Similar clusters were derived when excluding energy misreporters according to Goldberg cut-offs. Children in the “early and frequent” pattern were younger, had a lower body mass index (BMI) z-score, and a longer sleep duration than children in the other two meal-timing patterns. A higher proportion of plausible energy reporters were classified into the “early and frequent” pattern than into the other two patterns. The proportion of children from Italy, Cyprus and Spain was highest in the “late and long” pattern, while the proportion of children from Belgium, Sweden, Germany and Hungary was highest in the “early and frequent” patterns, and the proportion of children from Estonia was highest in the “late and time-restricted” pattern.In conclusion, this study identified three different meal-timing patterns in children that varied by age, BMI z-score, country, misreporting status, and sleep duration. Investigations on the associations between meal timing patterns and metabolic health in this study sample are currently ongoing.