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BackgroundA healthy lifestyle during pregnancy is important for the health of mother and child. However, unfavorable physical activity (PA) and dietary changes are observed in pregnant women and their partner. Partner's influence on lifestyle has been reported by expectant women and men. The first aim was to analyze associations between perceived partner support on expectant parents own as well as their partner's moderate-to-vigorous intensity PA (MVPA) levels and dietary intake. Secondly, this study aimed to investigate intra-couple associations of MVPA, dietary intake and perceived support.MethodsA total of 152 heterosexual couples were recruited between week 8 and 10 of gestation by means of convenience sampling. Objective anthropometric and 7-day MVPA measurements were performed at 12 weeks of gestation. An online questionnaire was used to assess dietary intake, perceived partner support and socio-demographic characteristics. An Actor-Partner Interdependence Model for distinguishable dyads was constructed to examine the relationship between perceived partner support and both own's (i.e., actor-effect) and the partner's (i.e., partner-effect) MVPA levels, intake of fruits and vegetables, and an “avoidance food group.”ResultsFor pregnant women, perceived support from their partner was significantly associated with women's own MVPA levels (i.e., actor-effect; estimate = 0.344, SE = 0.168, p = 0.040) as well as the MVPA levels of the men (i.e., partner-effect; estimate = 0.717, SE = 0.255, p = 0.005). No significant actor- nor partner-effects were found for the expectant fathers. For none of the sexes significant actor-effects were found for fruit/vegetables and “avoidance food group” intake. For pregnant women, there was a positive partner-effect for fruit and vegetable intake (estimate = 7.822, SE = 1.842, p < 0.001) and a negative partner-effect for the “avoidance food group” intake (estimate = −16.115, SE = 3.629, p < 0.001). Positive correlations were found for perceived MVPA support (r = 0.40, p < 0.001), MVPA levels (r = 0.24, p = 0.007) and food intake from the “avoidance food group” (r = 0.28, p = 0.005) between partners.ConclusionThis study shows that male partners can act as significant facilitators for women. Partners may be an important target when promoting MVPA during pregnancy. Additionally, supportive couples seem to strengthen each other in keeping a healthy lifestyle in early pregnancy. These results justify couple-based interventions in the promotion of a healthy lifestyle during the transition to parenthood.Clinical trial registrationClinicaltrials.gov, identifier: NCT03454958.

This cross-sectional study aimed to examine the degree of whole-body morphological asymmetries in female tennis players. Data were collected in 19 high-level female tennis players (21.3 ± 3.4 years). Based on anthropometric measurements (upper arm, lower arm, wrist, upper leg and lower leg circumferences as well as elbow and knee widths) and dual x-ray absorptiometry research scans (bone mineral density (BMD), bone mineral content (BMC), lean mass (LM), fat mass (FM) as well as humerus, radio-ulnar, femur and tibia bone lengths), within-subject morphological asymmetries for both upper (dominant vs. non-dominant) and lower (contralateral vs. ipsilateral) extremities were examined. Upper arm (p = 0.015), lower arm (p

Background: Skin temperature assessments comprise conductive and contact-free techniques. Comparison between conductive data loggers and contact-free thermometry after the application of revulsive products is scarce. This study aimed to compare iButton data loggers with an infrared thermometer after the application of two revulsive products. Secondly, the relation between skin temperature kinetics with skin's perfusion of microcirculation was investigated. Materials and methods: Healthy females (n = 25) were randomly allocated to two groups, representing the products A and B. Skin temperature was measured with “iButtons” and an infrared pistol at baseline and up to 1 hour after application. Skin's perfusion of microcirculation was monitored with a laser speckle contrast imager. Results: Baseline “iButton” temperature values were significantly lower compared with infrared pistol values in both groups. After application of the products, skin temperature decreased as recorded with both devices followed by an increase to baseline values when measured with the pistol. The results obtained by the “iButtons” reached values above baseline in both products towards the end of the follow-up period. A moderate correlation was found between infrared pistol and “iButton” system in product A, with a weak negative correlation between skin's perfusion of microcirculation and temperature devices. For product B, the correlation between the devices was moderate and between skin's perfusion and temperature devices weak and positive. Conclusion: Both devices produced similar kinetics, except at baseline, where they may differ as metallic loggers have been insufficiently adapted to skin temperature. Skin's perfusion of microcirculation could not explain skin temperature changes. KEYWORDS infrared thermography, laser speckle contrast imaging, revulsive products, skin temperature, thermocouples

Background and Objectives Parental body composition, physical activity (PA) and sedentary time (ST) have been linked with offspring body weight and health. However, independent contributions of body composition, PA and ST of both parents on growth trajectories of their offspring, taking into account sex differences, has not been investigated. Methods A total of 114 mother-father-child triads were included for analyses. Parental weight, height, PA and ST were objectively measured at 12 weeks of gestation. Gestational weight gain (GWG) and birthweight and -length were obtained from medical records. Offspring weight and length were measured repeatedly until 1 year of age. Longitudinal linear mixed models, stratified by offspring sex, were used to analyse the association between parental characteristics and offspring growth. Results GWG (positive association), maternal moderate-to-vigorous PA (negative association) and paternal ST (positive association) were associated with weight trajectories in girls but not in boys. Parental characteristics were not associated with offspring length trajectories. Conclusions This study highlights the contribution of parental lifestyle characteristics on weight trajectories of their daughters during the first year of life. The paternal impact stresses the need to further investigate health behaviours of expecting fathers in relation to offspring health. Family-based interventions are needed with a focus on increasing PA and limiting ST in both parents.

Feasible interventions addressing unhealthy changes in energy balance-related behavior (EBRB) during pregnancy and early postpartum are needed. This study identified the needs and wishes of expecting and first-time parents concerning EBRB interventions during the transition to parenthood. Thirteen focus group discussions (n = 74) were conducted. Couples provided information about whether an intervention targeting unhealthy EBRB changes during pregnancy and postpartum would be acceptable, how such an intervention should look like, and in which way and during which period they needed support. Guided by the TiDIER checklist, all quotes were divided into five main categories (i.e., 'what', 'how', 'when and how much', 'where', 'for and from whom'). Interventions should aim for changes at the individual, social, environmental and policy levels. The accessibility and approach (indirect or face-to-face) together with communicational aspects should be taken into account. A focus should go to delivering reliable and personalized information and improving self-regulation skills. Interventions should be couple- or family-based. Authorities, healthcare professionals, the partner and peers are important sources for intervention delivery and support. In the prevention of unhealthy EBRB changes around childbirth, the involvement of both parents is needed, while health care professionals play an important role in providing personalized advice. ispartof: NUTRIENTS vol:14 issue:11 ispartof: location:Switzerland status: published

The relationship between lean mass and functional asymmetry in terms of their magnitude and direction was examined in 22 high-level female tennis players (20.9 ± 3.6 years). Lean mass of both upper and lower extremities was examined using Dual X-ray Absorptiometry. Functional asymmetry was assessed using a battery of field tests (handgrip strength, seated shot-put throw, plate tapping, single leg countermovement jump, single leg forward hop test, 6 m single leg hop test, and 505 change of direction (time and deficit)). Paired sample t-tests compared the dominant (overall highest/best (performance) value) against the non-dominant value (highest/best (performance) value of the opposing extremity). Linear regressions were used to explore the relationship between lean mass and functional asymmetry magnitudes. Kappa coefficients were used to examine the consistency in direction between the extremity displaying the highest lean mass value and the extremity performing dominantly across tests. Significant asymmetry magnitudes (p &lt, 0.05) were found for all upper and lower extremity lean mass and functional values. No relationship was apparent between lean mass and functional asymmetry magnitudes (p-value range = 0.131–0.889). Despite finding perfect consistency in asymmetry direction (k-value = 1.00) for the upper extremity, poor to fair consistency (k-value range = −0.00–0.21) was found for the lower extremity. In conclusion, lean mass and functional asymmetries should be examined independently.

Introduction: Low grip work and high feelings of self-perceived fatigue could be an early characteristic of decline in reserve capacity, which comes to full expression as physical frailty in a later stage. When grip work and self-perceived fatigue can be identified as characteristics differentiating between robustness and pre-frailty it might allow to identify pre-frailty earlier. Therefore, this study aimed to investigate whether the combination of grip work and self-perceived fatigue is related to pre-frailty in well-functioning older adults aged 80 and over. Methods: Four-hundred and five community-dwelling older adults aged 80 and over (214 robust and 191 pre-frail) were assessed for muscle endurance (grip Work corrected for body weight (GW_bw)), self-perceived fatigue (MFI-20) and frailty state (Fried Frailty Index, FFI). A Capacity to Perceived Vitality ratio (CPV) was calculated by dividing GW_bw by the MFI-20 scores. ANCOVA analysis (corrected for age and gender) was used to compare robust and pre-frail older adults, and binary logistic regressions were applied to analyze the relationship between CPV and pre-frailty status. Results: Pre-frail older adults who scored negative on the exhaustion item of the FFI still showed significantly lower GW (p < 0.001), CPV ratios (p < 0.001) and higher self-perceived fatigue (p < 0.05) compared to the robust ones. The likelihood for pre-frailty related significantly to higher age, being men and lower CPV ratios. In women, every unit increase in CPV ratio decreased the likelihood for pre-frailty by 78% (OR 0.22; 95% CI: 0.11–0.44), for men this effect was less strong (34%, OR 0.66; 95% CI: 0.47–0.93). Conclusions: Pre-frail community-dwelling persons aged 80 years and over without clinical signs of exhaustion on the FFI still experience significantly higher fatigue levels (lower Grip Work, higher self-perceived fatigue and lower CPV levels) compared to robust ones. CPV ratio could therefore be a good tool to identify subclinical fatigue in the context of physical (pre-)frailty.

This randomized controlled trial examined the effects of cold-water immersion (CWI), partial-body cryotherapy (PBC), or a passive control (CON) on physiological and recovery variables following exercise-induced muscle damage (EIMD, 5 × 20 drop jumps) in females. Twenty-eight females were allocated to PBC (30 seconds at -60°C, 2 minutes at -135°C), CWI (10 minutes at 10°C), or CON (10 minutes resting). Muscle oxygen saturation (SmO2 ), cutaneous vascular conductance (CVC), mean arterial pressure (MAP), and local skin temperature were assessed at baseline and through 60 minutes (10-minute intervals), while delayed onset of muscle soreness (DOMS), muscle swelling, maximum voluntary isometric contraction (MVIC), and vertical jump performance (VJP) were assessed up to 72 hours (24-hour intervals) following treatments. SmO2 was lower in PBC (Δ-2.77 ± 13.08%) and CWI (Δ-5.91 ± 11.80%) compared with CON (Δ18.96 ± 1.46%) throughout the 60-minute follow-up period (P < .001). CVC was lower from PBC (92.7 ± 25.0%, 90.5 ± 23.4%) and CWI (90.3 ± 23.5%, 88.1 ± 22.9%) compared with CON (119.0 ± 5.1 and 116.1 ± 6.6%, respectively) between 20 and 30 minutes (P < .05). Mean skin temperature was lower from CWI vs PBC (between 10 and 40 minutes, P < .05). Mean skin temperature was higher in CON compared with CWI up to 60 minutes and compared with PBC up to 30 minutes (P < .05). DOMS was lower following both PBC and CWI compared with CON through 72-hour (P < .05), with no difference between groups. No main group differences for swelling, MVIC, and VJP were observed. In conclusion, CWI elicited generally greater physiological effects compared with PBC while both interventions were more effective than CON in reducing DOMS in females, but had no effect on functional measures or swelling.

Pre-exercise hypohydration can impair soccer performance and has been extensively studied in different soccer populations. Therefore, the aim of this systematic review was to report hypohydration prevalence, measured by blood or urine samples, in different soccer populations based on sex (males and females), performance level (professional and recreational players) and context (training sessions and games). The Pubmed, Web of Science and SPORTDiscus databases were systematically searched until November 2018. Data were pooled to compare hypohydration prevalence between the different subgroups. Following the systematic search selection process, 24 studies were included. The results indicated that overall pre-exercise hypohydration prevalence was 63.3%, 37.4% and 58.8% for urine specific gravity (USG), urine osmolality (U Osm) and urine colour, respectively. Furthermore, no study implemented blood samples to examine hypohydration prevalence in soccer players. The subgroup analyses using USG data indicated that pre-exercise hypohydration prevalence was significantly higher amongst males (66.0%; p = 0.001), professional soccer players (66.2%; p = 0.020) and before a training session (79.6%; p < 0.001). Pre-exercise hypohydration prevalence was 46.8% among female soccer players, 55.6% in recreational soccer players and 41,3% before a game. The subgroup analyses using U Osm data indicated that hypohydration prevalence was significantly higher before a training session (52.6%; p = 0.023). Based on these results, it can be concluded that hypohydration prevalence in soccer players is of major concern. Future research should explore how pre-exercise hydration status can be improved in a sustainable way.

This study aimed to examine side-to-side differences in phase angle (PhA) in both upper and lower limbs of youth elite tennis players. Among other outcomes, PhA was directly determined using segmental multifrequency bioelectrical impedance analysis (BIA) in 26 tennis players (11.6 ± 1.1 years, 54% boys) and compared against a sex- and age-matched reference population. Significant upper limb asymmetry in PhA (p < 0.001), with a higher value on the dominant side of the body, was observed in the tennis players. At lower limb level, the tennis players showed a tendency towards a significantly higher PhA in the contralateral compared to the ipsilateral limb (p = 0.089). Using vector analysis (BIVA), a significant degree of PhA asymmetry (p = 0.002) was only reflected in the tennis players' upper limb. Additional segmental outcomes also demonstrated a significant degree of upper limb asymmetry in terms of tennis players' lean mass (p < 0.001), total segmental water (p < 0.001), fat mass (p < 0.001), extracellular water (p < 0.001) and extracellular water ratio (p < 0.001), whereas lower limb asymmetry was only observed in tennis players' fat mass (p = 0.037) and extracellular water (p = 0.001). This is the first study to report significantly more pronounced BIA-based side-to-side differences in youth elite tennis players compared to a non-athletic reference population at the upper limb level, whereas no significant between-group differences in the lower limbs were found. This explorative study should trigger future research to further scrutinize the role of BI(V)A as a promising field-method in monitoring bodily asymmetries in youth elite tennis players in view of sport performance and athletic health. HighlightsBioelectrical Impedance Analysis is a promising field-method to monitor side-to-side asymmetry in youth elite tennis players.Youth elite tennis players displayed a more pronounced degree of BIA-based side-to-side differences compared to a non-athletic reference population at the upper limb level, whereas whilst between-group differences appeared to be less evident in the lower limbs.Future research is warranted to scrutinize whether and to what extent these degrees of segmental bodily asymmetry may be related to injury risk (prevention) and athletic development of (pre)adolescent tennis players.

BACKGROUND: Healthy eating behavior throughout pregnancy and postpartum is important. This study aimed to investigate the perceived sex-specific importance of determinants of changes in eating behavior during pregnancy and postpartum. METHODS: Fifty-four determinants were rated by first-time parents (n = 179) on their impact. Experts (n = 31) rated the determinants in terms of their modifiability, relationship strength, and population-level effect from which a "priority for research"-score was calculated. RESULTS: During pregnancy, the three highest rated determinants by women were "health concerns", "physiological changes", and "fatigue". Men perceived "health concerns", "health consciousness", and "influence of the pregnant partner" as important. Postpartum, the three highest rated determinants by women were "adaptation to rhythm of baby", "baby becomes priority", and "practical constraints because of the baby". Men perceived "adaptation to rhythm of baby", "fatigue". and "(lack of) anticipation" as important. According to the experts, "professional influence", "food knowledge", and "home food availability" received high priority scores for both sexes and during both periods. CONCLUSIONS: Priority for research and interventions should go towards tailored family-based approaches focusing on food education in a broad sense taking into account aspects such as health consciousness, self-efficacy skills, and the social and home food environment while being supported by healthcare professionals. ispartof: NUTRIENTS vol:13 issue:7 ispartof: location:Switzerland status: published

Background:\ud Asymmetries have been reported to negatively impact sport performance. This study examined the magnitude and direction of whole-body functional asymmetry in international versus national female tennis players.\ud Methods:\ud Ten internationally and twelve nationally ranked tennis players participated. Upper extremity functional asymmetries (or side-to-side performance differences) were evaluated using handgrip strength, seated shot-put throw and plate tapping. Lower extremity functional asymmetries were determined using the single leg countermovement jump, single leg forward hop test, 6 m single leg hop test, 505 changes of direction (time and deficit), and Y-balance test (anterior, posteromedial, posterolateral). ANOVAs were used to compare the dominant (overall best or fastest result of a specific test) versus non-dominant performance values (best or fastest result of the corresponding extremity) within the internationally versus nationally ranked players. Functional asymmetry magnitudes differences (expressed as a %) were examined using Mann-Whitney U tests. Kappa coefficients examined the consistency as to which extremity performed dominantly across tests.\ud Results:\ud Significant asymmetries for every upper and lower extremity test were found. The functional asymmetry magnitude was significantly (p=0.020) higher on the single leg forward hop test for the nationally (6.3%) versus internationally ranked players (2.9%). Kappa coefficients showed perfect levels of consistency regarding all upper extremity tests (k=1.00), indicating true limb dominance whereas more variance was found as to which lower extremity performed dominantly across tests (k range=-0.067-0.174).\ud Conclusions:\ud The included female tennis players displayed significant whole-body functional asymmetries. Poor consistency as to which lower extremity performed dominantly across tests warrants individual asymmetry monitoring.

Greenlandic traditional nutrition was unique in the arctic environment because it was an almost exclusive meat dietary pattern. Høygaard et al. left Copenhagen in August 1936, and stayed in East Greenland until August 1937. The four members of the expedition resided in Tasisaq and visited eight settlements around where nutritional intake was recorded by residing in families. However, the nutritional intake was analysed on a household level. The aim of the present study is to reanalyse the Høygaard et al. data according to modern scientific standards. In total, 21 males and 14 females participated. Median (IQR) energy consumption was 3881 (1568) kcal.day−1 for males and 2910 (882) kcal.day−1 for females. Without the five participants living near trading centres, this was 3268 (219) kcal.day−1 and 2634 (723) kcal.day−1, respectively. Expressed in energy-percent, the macronutrient consumptions were 34% for protein, 37% for fat and 29% for carbohydrates. Without imported food, this was 41%, 49% and 10%, respectively. The main findings of the present study are, as expected, that the food consumed came mainly from traditional hunting, was low in plant foods and extremely low in carbohydrates. The Inuit succeeded to stay in apparently healthy conditions with a traditional meat-based dietary pattern.

Although the beneficial health effects of plant-based dietary patterns are evident, it is not clear if population-wide dietary patterns are shifting in a more plant-based direction. This study evaluated trends in dietary patterns among Flemish adults over a 10-year period. Furthermore, differences in socio-demographic characteristics between different dietary pattern groups were explored. Findings show that the vast majority of participants were omnivorous as measured at the different time points. The proportion of flexitarians increased over time, while the opposite was true for omnivores. The proportion of vegetarians and vegans, on the other hand, remained stable. Eating more plant-based diet was associated with female sex, younger age, higher education and living in urban areas. Findings show that the vast majority of participants were omnivorous as measured at the different time points. The proportion of flexitarians increased over time, while the opposite was true for omnivores. The proportion of vegetarians and vegans, on the other hand, remained stable. Eating more plant-based diet was associated with female sex, younger age, higher education and living in urban areas. In contrast to the stricter plant-based dietary patterns, a modest shift from the omnivorous towards the flexitarian dietary pattern was observed over the past decennium in the Flemish adult population. Campaigns might benefit from targeting older and lower educated male living in rural areas.

Purpose: Military personnel are exposed to variable and sometimes very high noise in their professional environment. The aim of this study is to evaluate through a longitudinal study if our hearing conservation program has to be adapted to consider specific interventions for subgroups of our military population still subject to a higher risk of hearing loss. Methods: We conducted a retrospective longitudinal study in 2015–2016 to describe the evolution of hearing threshold levels of military personnel as measured during periodic audiometric screening over a period of 6 years (2009–2014) after the implementation of our hearing conservation program. A linear mixed model explored the relationship of pure-tone average (PTA) on 3, 4 and 6 KHz with probability of noise exposure, gender, age at baseline, time since baseline, hearing loss at baseline and ear. Results: For 18,672 military individuals, our results show a small but statistically significant increase of 0.08 dB per year in PTA on 3, 4 and 6 KHz over the 6-year period that is consistently decelerating as a function of time. An additional annual increase of hearing thresholds due to higher age and moderate and high probability of exposure to noise was also found. Conclusions: No major adaptation of our hearing conservation program is required but efforts should be strengthened to better evaluate and counsel older individuals and subjects exposed to noise regarding avoidance of noise and correct use of personal hearing protection.

In order to be able to tailor environmental interventions to adolescents at risk for low levels of physical activity, the aim of the present study is to identify subgroups of adolescents with different physical and social environmental preferences towards cycling for transport and to determine differences in individual characteristics between these subgroups. In this experimental study, 882 adolescents (12–16 years) completed 15 choice tasks with manipulated photographs. Participants chose between two possible routes to cycle to a friend's house which differed in seven physical micro-environmental factors, cycling distance and co-participation in cycling (i.e. cycling alone or with a friend). Latent class analysis was performed. Data were collected from March till October 2016 across Flanders (Belgium). Three subgroups could be identified. Subgroup 1 attached most importance to separation of the cycle path and safety-related aspects. Subgroup 2 attached most importance to being able to cycle together with a friend and had the highest percentage of regular cyclists. In subgroup 3, the importance of cycling distance clearly stood out. This subgroup included the lowest percentage of regular cyclists. Results showed that in order to stimulate the least regular cyclists, and thus also the subgroup most at risk for low levels of active transport, cycling distances should be as short as possible. In general, results showed that providing well-separated cycle paths which enable adolescents to cycle side by side and introducing shortcuts for cyclists may encourage different subgroups of adolescents to cycle for transport without discouraging other subgroups.

When relating glycaemic index (GI) and glycaemic load (GL) to health outcomes, many prospective cohort studies assess the nutritional exposure only once in time, that is, at the start of the study, presuming a stability in nutritional consumption during the course of the study. The aim of this study is to investigate the reproducibility of GI and GL. This is a prospective cohort study in which 562 middle-aged Belgian adults noted all foods and drinks consumed during 3 d in 2002 and 2012. GI and GL were calculated after reference tables. The Pearson correlation coefficients between 2002 and 2012 were 0·27 for GI and 0·41 for GL. For GI, 33 % of the participants remained in the same quintile between 2002 and 2012, whereas 31 % moved to a non-adjacent quintile. For GL, this was 34 and 28 %, respectively. The lowest and the highest quintiles of GI were the most stable, with 40 and 44 % of the participants staying in the same quintile. This was only 22 % for the fourth quintile. The same tendency was present for GL – that is, the most extreme quintiles were the most stable. This study shows 10-year correlation coefficients for GI and GL below 0·50. Multiple nutritional assessments and limiting the analysis to the extreme quintiles of GI and GL will limit a possible misclassification in the prospective cohort studies owing to the low reproducibility.

BACKGROUND: Becoming a parent may cohere with drastic changes in physical activity (PA) and sedentary behavior (SB). A clear understanding of determinants of changes in PA and SB during pregnancy and postpartum is needed to facilitate the development of tailored family-based interventions. METHODS: Thirteen focus group discussions targeting determinants of changes in PA and SB behavior were conducted, involving a total of 74 expecting and first-time parents. A semi-structured question guide was used to facilitate the discussions. RESULTS: Four main levels of determinants were identified: the individual (including psychological, situational and biological determinants), interpersonal, environmental and policy level. Some determinants were mentioned to be a barrier (e.g., "barriers to self-care") while others were a facilitator (e.g., "weight control"). Determinants were related to both PA and SB and applicable during pregnancy as well as postpartum (e.g., "self-regulation"), or only related to one behavior and/or one period (e.g., "feeding baby"). Some were described by both parents (e.g., "parenthood perceptions"), whereas others were mentioned by women (e.g., "PA knowledge") or men (e.g., "time opportunities") only. CONCLUSIONS: Focus should be given to interventions aimed at improving parents' self-regulation skills and support on how to cope with interpersonal and situational constraints as well as parenthood perceptions. ispartof: INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH vol:19 issue:4 ispartof: location:Switzerland status: published

The central- and peripheral mechanisms by which heat strain limits physical performance are not fully elucidated. Nevertheless, pre-cooling is often used in an attempt to improve subsequent performance. This study compared the effects of pre-cooling vs. a pre-thermoneutral application on central- and peripheral fatigue during 60% of isometric maximum voluntary contraction (MVC) of the right quadriceps femoris muscle. Furthermore, the effects between a pre-cooling and a pre-thermoneutral application on isometric MVC of the right quadriceps femoris muscle and subjective ratings of perceived exertion (RPE) were investigated. In this randomized controlled trial, 18 healthy adults voluntarily participated. The participants received either a cold (experimental) application (+8 °C) or a thermoneutral (control) application (+32 °C) for 20 min on their right thigh (one cuff). After the application, central (fractal dimension – FD) and peripheral (muscle fiber conduction velocity – CV) fatigue was estimated using sEMG parameters during 60% of isometric MVC. Surface EMG signals were detected from the vastus medialis and lateralis using bidimensional arrays. Immediately after the submaximal contraction, isometric MVC and RPE were assessed. Participants receiving the cold application were able to maintain a 60% isometric MVC significantly longer when compared to the thermoneutral group (mean time: 78 vs. 46 s; p=0.04). The thermoneutral application had no significant impact on central fatigue (p>0.05) compared to the cold application (p=0.03). However, signs of peripheral fatigue were significantly higher in the cold group compared to the thermoneutral group (p=0.008). Pre-cooling had no effect on isometric MVC of the right quadriceps muscle and ratings of perceived exertion. Pre-cooling attenuated central fatigue and led to significantly longer submaximal contraction times compared to the pre-thermoneutral application. These findings support the use of pre-cooling procedures prior to submaximal exercises of the quadriceps muscle compared to pre-thermoneutral applications.

AimThe potential renal acid load (PRAL) has been described in relation to different health outcomes. Outcomes over time and conclusions made are often based on baseline dietary intake values. However, to study reliable long-term associations, parameters calculated based on dietary intake data, such as PRAL, must be stable over time. Therefore, the aim of the present study was to assess the stability of PRAL and its components over a 10-year time period. MethodsPRAL values of three-day dietary intake data from 197 women and 373 men on two assessment moments (2002-2004 and 2012-2014) were calculated. Pearson correlation and intra-class correlation coefficients were used for assessing the stability of PRAL and its components. Level of agreement between the two assessment moments was estimated after splitting up subjects in quintiles of PRAL, calculating kappa values and changes of quintiles over time. ResultsNo significant differences in mean PRAL over time were found. Stability of PRAL and its components was low. Poor agreement between the first and second assessment was shown by low kappa values and change of most of the subjects to an adjacent and non-adjacent quintile after 10 years. ConclusionsBased on nutrition assessments carried out using three-day dietary records, stability of PRAL over a 10-year time period could not be confirmed, even though no significant difference between mean PRAL and its components over time was found. Therefore, interpretation of longitudinal outcomes based on PRAL and its component calculated at baseline should be interpreted with caution.

Summary Background To date, the accuracy of bio-impedance (BIA) to assess body composition & sarcopenia in persons aged 80 and over remains unclear. Objective We aimed to evaluate the agreement between dual energy X-ray absorptiometry (DXA) and BIA equations to determine lean mass, as well as their suitability to identify sarcopenia. Design 174 community dwelling well-functioning persons (83 women, 91 men) aged 80 and over were included. Appendicular lean mass (ALM) was predicted using BIA-based equations available in literature, and compared to DXA outcomes. Through cross-validation and stepwise multiple linear regression, a new ALM-formula was generated suitable for this population. Results Literature-based BIA equations systematically overestimated ALM. The new prediction formula that we propose for the 80+ is: ALM = 0,827+(0,19*Impedance Index)+(2,101*Sex)+(0,079*Weight); R2 = 0,888; SEE = 1,450 kg. Sarcopenia classification based on our new BIA equation for ALM showed better agreement with DXA (k ≥ 0,454) compared to literature-based BIA equations (k Conclusions Despite the high correlation between both methods, literature-based BIA equations consistently overestimate ALM compared to DXA in persons aged 80 and over. We proposed a new equation for ALM, reaching higher agreement with DXA and thus improving the accuracy of BIA for this specific age group.

Purpose To identify the different fatigue items in existing frailty scales. Methods PubMed, Web of Knowledge and PsycINFO were systematically screened for frailty scales. 133 articles were included, describing 158 frailty scales. Fatigue items were extracted and categorized in 4 fatigue constructs: “mood state related tiredness”, “general feeling of tiredness”, “activity based feeling of tiredness” and “resistance to physical tiredness”. Results 120 fatigue items were identified, of which 100 belonged to the construct “general feeling of tiredness” and only 9 to the construct “resistance to physical tiredness”. 49,4% of the frailty scales included at least 1 fatigue item, representing 15 ± 9,3% of all items in these scales. Fatigue items have a significantly higher weight in single domain (dominantly physical frailty scales) versus multi domain frailty scales (21 ± 3.2 versus 10.6 ± 9.8%, p= Conclusion Fatigue is prominently represented in frailty scales, covering a great diversity in fatigue constructs and underlying pathophysiological mechanisms by which fatigue relates to frailty. Although fatigue items were more prevalent and had a higher weight in physical frailty scales, the operationalization of fatigue leaned more towards psychological constructs. This review can be used as a reference for choosing a suitable frailty scale depending on the type of fatigue of interest.

The aim of this study was to examine the magnitude of upper extremity bone mineral content (BMC) asymmetries in tennis players. Furthermore, the influence of sex (male versus female versus mixed), chronological age (juniors: < 18 years; adults: 18–39 years and seniors: ≥ 40 years) and starting age (early starters: < 14 years and late starters: > 18 years) on these asymmetries were examined. Two databases were searched for scientific articles that examined upper extremity BMC in tennis players. Pooling of the individual study effect sizes was conducted using the random-effects model. Three subgroup analyses were performed based on sex, chronological age and starting age. Out of the 15 included studies 24 effect sizes were extracted resulting in a significant difference in BMC value between the dominant and nondominant upper extremity of the tennis players (Standardised Mean Difference: 0.85 [95% CI: 0.67–1.03]). The three subgroup analyses all showed medium to strong effect sizes and significant intergroup differences. To conclude, BMC was significantly higher in the dominant upper extremity compared to the nondominant upper extremity in tennis players. Nevertheless, the influence of training volume and playing experience on these asymmetries are yet to be examined.

Background:Longitudinal evidence concerning the association between cardiorespiratory fitness (CRF) and blood lipids and between anthropometric parameters (ANTP) and blood lipids is limited. This study aimed to investigate the association between changes in CRF and ANTP and changes in blood lipids.Methods:In 2002–2004 and 2012–2014, 652 participants were tested. CRF was measured as VO2peak using a maximal ergometer test. Waist circumference (WC) and Body Mass Index (BMI) were used as ANTP. Blood samples were analyzed for total cholesterol (TC), HDL cholesterol, LDL cholesterol and triglycerides. A linear regression analysis was performed to investigate associations between changes in CRF and ANTP and changes in blood lipids.Results:After adjustment a decrease in CRF was associated with an increase in triglycerides and a decrease in HDL cholesterol in men. An increase in WC was associated with an increase in TC, LDL cholesterol and ratio total/HDL cholesterol and a decrease in HDL cholesterol, while an increase in BMI was associated with an increase in ratio total/HDL cholesterol and a decrease in HDL cholesterol.Conclusions:WC and BMI were more longitudinally associated with blood lipids compared with CRF. Improving ANTP can enhance the blood lipid profile, while CRF had only limited influence.

Objective This study examined the effect of nudges, inspired by the recently renewed Flemish Food Triangle, on fruit sales in a Belgian on-campus university restaurant. Methods In this mixed-method real-life experiment, nudges were added weekly over a period of four consecutive weeks: placement of (1) Food Triangle posters in the restaurant, (2) ‘green heart’ icons above the fruit stands, and (3) substitution and (4) social norm messages at the fruit stands. During baseline (no intervention) and all intervention weeks, dessert sales were registered. Short interviews were used to ask customers about their perceptions regarding the intervention. Follow-up measurements (7 and 30 weeks later) evaluated the longer-term effectiveness, while all nudges remained in place. Dessert sales were analyzed separately for both sexes, students and staff categories (based on academic degree). Results Compared to baseline, the combination of the Food Triangle and the green heart intervention materials in week 2 resulted in significant increases in fruit consumption across almost all subgroups. The other intervention materials used in the current study had rather limited effects in the short term. After 7 weeks of follow-up, significant fruit sale increases were established for all subgroups compared to baseline. At 30 weeks follow-up, the effect for staff B (Bachelor's degree) disappeared. The majority of the respondents (66.4%) had noticed at least one of the nudges, while only 3.4% indicated to have adjusted their dessert choice as a result of the nudges. Conclusions The combination of nudges was effective in the long term and increased fruit purchase in nearly all subgroups. Short interviews show that a more active approach may be needed to increase effect sizes.

Aim Plant-based diets are recommended in the context of environmental sustainability and health. Since not all plant foods can be considered beneficial, a distinction needs to be made between healthful and unhealthful plant foods. The aim of this study was to investigate longitudinal associations between changes in an overall plant-based diet index, a healthful plant-based diet index and an unhealthful plant-based diet index, with changes in anthropometrics and blood lipids as indicators of morphological and metabolic fitness, respectively. Methods A 3-day dietary record was completed by 650 Flemish adults (420 men, 230 women) in 2002-2004 and 2012-2014. Three plant-based diet indices were calculated based on quintile scores regarding the intake of animal- or plant-based food items. Associations between 10-year changes in diet indices and changes in anthropometrics and blood lipids were tested using multivariate linear regression. Results Plant-based diet indices did not differ over time. Using the unadjusted model, few significant associations were found between changes in diet indices and changes in anthropometrics and blood lipids. However, these relationships disappeared after adjusting for confounding. In women, a positive association was found between changes in overall plant-based diet index and changes in body mass index in the adjusted model. Conclusions Index values did not differ over time and few longitudinal associations were found.

Objectives The transition from high school to college or university has been shown to be a critical period for weight and fat gain. To date, no European data on weight and fat gain over the full trajectory of college or university are available. Therefore, the purpose of the present study was to investigate weight and fat gain among Belgian university students from freshman through senior year of university. Methods In this prospective observational study, a total of 340 university students were measured six times, i.e. at baseline (start of the first academic year) and at the start of the second semester of the first, second, third, fourth and fifth academic year. Objective measurements included body weight, height, body mass index (BMI), fat%, fat mass, fat free mass and waist circumference. Multilevel modelling was used to assess anthropometric changes over time according to sex. Results From freshman through senior year of university, individual weight changes ranged from -5.2 to +15.7kg, and respectively 77.4% and 69.3% of students showed increases in BMI and fat%. Stronger increases in weight and BMI were found for males (5.7kg; 1.6kg/m2; both p

BackgroundThe transition to parenthood is a cornerstone event for both parents, potentially leading to relevant changes in lifestyle and behaviour. In women, the metabolic changes during and after pregnancy and the deleterious effects of excessive gestational weight gain and postpartum weight retention have been extensively described. However, there is no full understanding about which specific energy balance related behaviours (EBRB) contribute to unfavourable weight gain and weight retention. Furthermore, information on how transition to parenthood affects men is lacking. Therefore, this study aims to investigate changes in body weight, body composition and EBRB in couples transitioning to parenthood.MethodsTRANSPARENTS is a multi-centre observational follow-up study that focuses on body weight, body composition and EBRB during the transition to parenthood. Couples (women and men) will be recruited during the first trimester of their first pregnancy. Study visits will occur at four occasions (12weeks of pregnancy, 6weeks postpartum, 6months postpartum and 12months postpartum). Anthropometrics of the parents and new-borns will be assessed including body weight, height/length, body composition (using bio-electrical impedance analysis and measurement of four skinfold thicknesses (biceps, triceps, subscapular and supraspinal/suprailiac)) and waist and hip circumference. Dietary intake, physical activity, sedentary behaviour, smoking habits, sleeping pattern, fatigue, diet and exercise related partner support, mental health, breastfeeding, contraception use, and socio-demographics will be assessed using a questionnaire. In addition, accelerometry will be used to assess physical activity and sedentary behaviour objectively. Also data from women's medical record, such as pre-pregnancy weight and pregnancy outcomes, will be included. Multilevel modelling will be used to evaluate maternal and paternal changes in body weight, body composition and EBRB during and after pregnancy (primary outcomes). Multiple linear regression analyses will be performed to identify predictors of changes in body weight, body composition and EBRB. All analyses will be adjusted for possible confounders.DiscussionTRANSPARENTS is a unique project identifying vulnerable parents and (un)favourable changes in EBRB throughout this potentially critical life period. Provided insights will facilitate the development of effective intervention strategies to help couples towards a healthy transition to parenthood.Trial registrationClinicaltrials.gov Identifier: NCT03454958. Registered March 2018. This study is funded by the Research Foundation -Flanders ('Fonds voor Wetenschappelijk Onderzoek' (FWO)). The project was evaluated by the FWO Health Sciences expert panel. Project number FWO: G033418 N. R.D. is holder of a Fundamental Clinical Investigatorship 1803311 N. Contact information: Egmontstraat 5, 1000 Brussel. Telephone: + 32 2 512 91 10. Email: post@fwo.be.The funder had no role in the study design, data collection, management, analysis, and interpretation of data, writing the report and decision to submit the report for publication, and will not have ultimate authority over any of these activities.

Acute Effects on TH4 Thoracic Spine Mobilisation Techniques on the Sympathetic Nervous System - a Cross-Over Feasibility Study Abstract. Up to date, empiric evidence about effects of thoracic spine mobilisation (TH4) on the sympathetic nervous system is lacking. The primary goal of this feasibility study was to determine adherence rate, side effects and the protocol as well as the implementation of the study design. The secondary goal was to analyse and interpret acute effects on the sympathetic nervous system after thoracic mobilisation in anterior thrust and posterior thrust on six healthy participants on two following days. The feasibility of this study was adequate. The spine mobilisations did not produce any adverse effects. The anterior thrust spine mobilisations showed a tendency in reducing the heart rate activity.Zusammenfassung. Empirische Erkenntnisse über Effekte auf das sympathische Nervensystem bei Brustwirbelsäulenmobilisationen auf Höhe TH4 sind bis heute kaum vorhanden. Das primäre Ziel dieser Machbarkeitsstudie war, Adhärenzrate, Sicherheit und Untersuchungsverfahren und -durchführung zu evaluieren. Sekundär wurde der akute Effekt auf das sympathische Nervensystem der Mobilisationen nach anterior bzw. posterior an sechs gesunden Probanden an zwei aufeinanderfolgenden Tagen analysiert und interpretiert. Die Machbarkeit dieser Studie konnte gezeigt werden. Die Mobilisationen verursachten keine Beschwerden. Eine Tendenz zur Reduzierung der Herzfrequenz konnte für eine Brustwirbelsäulenmobilisation mit Schub nach anterior nachgewiesen werden.

Background The objective evaluation of the physical environmental characteristics (e.g. speed limit, cycling infrastructure) along adolescents’ actual cycling routes remains understudied, although it may provide important insights into why adolescents prefer one cycling route over another. The present study aims to gain insight into the physical environmental characteristics determining the route choice of adolescent cyclists by comparing differences in physical environmental characteristics between their actual cycling routes and the shortest possible cycling routes. Methods Adolescents (n = 204; 46.5% boys; 14.4 ± 1.2 years) recruited at secondary schools in and around Ghent (city in Flanders, northern part of Belgium) were instructed to wear a Global Positioning System device in order to identify cycling trips. For all identified cycling trips, the shortest possible route that could have been taken was calculated. Actual cycling routes that were not the shortest possible cycling routes were divided into street segments. Segments were audited with a Google Street View-based tool to assess physical environmental characteristics along actual and shortest cycling routes. Results Out of 160 actual cycling trips, 73.1% did not differ from the shortest possible cycling route. For actual cycling routes that were not the shortest cycling route, a speed limit of 30 km/h, roads having few buildings with windows on the street side and roads without cycle lane were more frequently present compared to the shortest possible cycling routes. A mixed land use, roads with commercial destinations, arterial roads, cycle lanes separated from traffic by white lines, small cycle lanes and cycle lanes covered by lighting were less frequently present along actual cycling routes compared to the shortest possible cycling routes. Conclusions Results showed that distance mainly determines the route along which adolescents cycle. In addition, adolescents cycled more along residential streets (even if no cycle lane was present) and less along busy, arterial roads. Local authorities should provide shortcuts free from motorised traffic to meet adolescents’ preference to cycle along the shortest route and to avoid cycling along arterial roads. Electronic supplementary material The online version of this article (10.1186/s12942-018-0136-x) contains supplementary material, which is available to authorized users.

PURPOSE: Electric bicycles (e-bikes) may offer an opportunity to stimulate physical activity among older adults. The current study compared Flemish (Belgian) older e-bike users with those not using an e-bike on sociodemographics, health characteristics, and access to motorized transport. In addition, it examined the association between e-bike use and levels of cycling and the moderating effects of sex, body mass index (BMI), and cycling limitations. METHODS: An online or interview version of the same questionnaire was completed by 1146 participants. Data were analyzed using logistic regression and hurdle models. RESULTS: Women, those with a higher BMI, and those with one (compared with no) motorized vehicle in the household had higher odds of being an e-bike user. E-bike use was related to higher odds of having cycled for transport in the past week, and this relationship was stronger among those with a higher BMI (low BMI: odds ratio, 1.89; 95% confidence interval (CI), 1.24-2.91; high BMI: odds ratio, 3.34; 95% CI, 2.26-5.00). Among those who cycled for transport in the last week, e-bike use was associated with 35% more minutes of cycling for transport (95% CI, 17%-56%). E-bike use was related to 183% higher odds of having biked for recreation (95% CI, 115%-274%). Among women and those with cycling limitations who cycled for recreation in the last week, e-bike use was also related to 57% (95% CI, 18%-109%) and 180% (95% CI, 63%-381%) more minutes of cycling for recreation, respectively. CONCLUSION: E-bikes may provide an opportunity to promote cycling among older adults, particularly among subgroups at risk for physical inactivity.

Background Low physical activity levels and high levels of sedentary time among adolescents call for population wide interventions. Public open spaces can be important locations for adolescents’ physical activity. This study aimed to describe the prevalence, frequency and context of public open space visitation and to gain insight into the individual, social and physical environmental factors associated with public open space use among 12- to 16-year-old Flemish (Belgian) adolescents. Methods Global positioning system devices, accelerometers and one-on-one interviews were used to measure location-specific activity levels, time spent at, reasons for using and accompaniment at public open spaces among 173 adolescents. Multilevel hurdle and gamma models were used to estimate the associations between the independent variables (age, gender, ethnicity, education, sport club membership and accompaniment) and the amount of time, sedentary time, light-, moderate- to vigorous- and vigorous-intensity physical activity at public open spaces. Results Three out of four participants had visited a public open space (for recreational purposes) and participants were most often accompanied by friends/classmates. Mainly public transportation stops/stations were used, and subsequently the most reported reason for public open space use was “to wait for something or someone”. Furthermore, boys, younger adolescents, non-western-European adolescents and lower educated adolescents were more likely to use public open spaces. Additionally, boys and younger adolescents were more likely to accumulate physical activity at public open spaces. The only social environmental variable associated with time spent at public open spaces was accompaniment by siblings: adolescents spent more time at public open spaces when accompanied by their siblings. Conclusions Public open spaces may be effective areas to promote physical activity among groups at risk for physical inactivity (i.e. low educated and non-western-European adolescents). Additionally, girls and older adolescents were less likely to visit and be physically active at public open spaces. Therefore, urban planners should consider adding attractive features, in order to encourage physical activity among girls and older adolescents at public open spaces. Furthermore, creating public open spaces that are attractive for youth of all ages could contribute to adolescents visiting public open spaces accompanied by siblings. Electronic supplementary material The online version of this article (10.1186/s12942-018-0123-2) contains supplementary material, which is available to authorized users.

Background: Ecological models emphasize that cycling for transport is determined by an interplay between individual, physical and social environmental factors. The current study investigated (a) which physical and social environmental factors determine adolescents' preferences towards cycling for transport and (b) which individual, physical and social environmental factors are associated with their intention to actually cycle for transport. Methods: An online questionnaire consisting of questions on individual and social environmental variables, and 15 choice-based conjoint tasks with manipulated photographs was completed by 882 adolescents (55.3% male; 13.9 +/- 1.6 years). Within the choice tasks, participants were asked to indicate which of two situations they would prefer to cycle to a friend's house. The manipulated photographs were all modified versions of one semi-urban street which differed in the following physical micro-environmental attributes (separation of cycle path, evenness of cycle path, speed limit, speed bump, traffic density, amount of vegetation and maintenance). In addition, each photograph was accompanied by two sentences which described varying cycling distances and co-participation in cycling (i.e. cycling alone or with a friend). After each choice task participants were also asked if they would actually cycle in that situation in real life (i.e. intention). Hierarchical Bayes analyses were performed to calculate relative importances and part-worth utilities of environmental attributes. Logistic regression analyses were performed to investigate which individual, physical and social environmental factors were associated with adolescents' intention to actually cycle for transport. Results: Adolescents' preference to cycle for transport was predominantly determined by separation of cycle path, followed by shorter cycling distance and co-participation in cycling. Higher preferences were observed for a separation between the cycle path and motorized traffic by means of a hedge versus a curb, versus a marked line. Similar findings were observed for intention to cycle. Furthermore, evenness of the cycle path and general maintenance of the street were also of considerable importance among adolescents, but to a lesser extent. Conclusions: Results of this experimental study justify investment by local governments in well-separated cycling infrastructure, which seemed to be more important than cycling distance and the social environment.

INTRODUCTION: This meta-analysis investigated the effectiveness of low-level laser therapy (LLLT) on pain in adult patients with musculoskeletal disorders. EVIDENCE ACQUISITION: A systematic literature search was conducted in the Medline and PEDro databases. Two researchers independently screened titles and abstracts of the retrieved studies for eligibility. Quality assessment of the eligible studies was conducted using the PEDro rating scale. Studies that scored ≥ 4 were included. A random-effects model was used for this meta-analysis. Subgroup meta-analyses were conducted to evaluate the influence of the adherence of the applied LLLT to the World Association of Laser Therapy (WALT) guidelines, the anatomical site under investigation and the study design on the overall weighted mean effect size. Meta regression was used to assess the possible influence of the study quality on the individual study effect sizes. EVIDENCE SYNTHESIS: Eighteen studies allowing for 21 head-to-head comparisons (totaling n=1462 participants) were included. The pooled raw mean difference (D) in pain between LLLT and the control groups was -0.85 [95%CI: -1.22 to -0.48]. There was high (I² = 85.6%) and significant between study heterogeneity (Cochran’s Q = 139.2; df = 20; p < 0.001). The subgroup meta-analysis of the comparisons not following the WALT guidelines revealed a D = -0.68 [95%CI: -1.09 to -0.27]. In this group, heterogeneity decreased to I² = 72.6% (Q = 51.2; df = 14; p < 0.001). In the WALT subgroup D equaled -1.52 [95%CI: -2.34 to -0.70]. This between groups difference was clinically relevant although statistically not significant (Q = 3.24; df = 1; p = 0.072). CONCLUSION: This meta-analysis presents evidence that LLLT is an effective treatment modality to reduce pain in adult patients with musculoskeletal disorders. Adherence to WALT dosage recommendations seems to enhance treatment effectiveness. Key words: Low-level light therapy - Meta-analysis - Musculoskeletal diseases - Systematic review

Background The hydration status of elite female soccer players is a concern, especially during high-volume training periods or tournaments. Furthermore, scientific literature on this topic is scarce to non-existent. Therefore, the primary aim of this study was to evaluate the hydration status in elite youth female soccer players during an official tournament. The secondary aim was to identify a possible relationship between pre-training hydration status and fluid intake. Methods Eighteen players were followed during eight consecutive days. Urine specific gravity was used to assess hydration status. Body weight was monitored before and after every training and match, whilst individual fluid intake was only registered during training. The players were informed about their hydration status on day 5. Results On days 1 to 4, the percentage of players who were at least minimally hypohydrated ranged between 44% and 78%. On day 5 (rest day), all the players were at least minimally hypohydrated. After the information session on day 5, the relative number of euhydrated players increased to 89% on both day 6 (training day) and day 7 (match day). On the final day (rest day), all players were either minimally hypohydrated or hypohydrated. Furthermore, a moderate and significant negative correlation (r=-0.44; N.=54; P=0.01) was found between fluid intake during and USG value before the training sessions. Conclusions The data illustrates that the hydration status of this population of elite youth female soccer players may be suboptimal and is of substantial concern on rest days during this tournament under temperate conditions. Receiving personal advice about rehydration seems to have a positive effect.

This study aimed to estimate nitrogen balance and protein requirements in adolescent sprint athletes as a function of growth rate and physical development. Sixty adolescent sprint athletes were followed up biannually over a 2-yr period. Individual growth curves and age at peak height velocity were determined. Skeletal muscle mass (SMM) was estimated based on anthropometric measurements and fat mass was estimated by underwater densitometry. Seven-day diet and physical activity diaries were completed to estimate energy balance and protein intake. Nitrogen analysis of 24-hr urine samples collected on 1 weekday and 1 weekend day allowed calculation of nitrogen balance. Body height, weight, and SMM increased throughout the study period in both genders. Mean protein intakes were between 1.4 and 1.6 g kg−1 day−1 in both genders. A protein intake of 1.46 g kg−1 day−1 in girls and 1.35 g kg−1 day−1 in boys was needed to yield a positive nitrogen balance. This did not differ between participants during and after their growth spurt. None of the growth parameters was significantly related to nitrogen balance. It can be concluded that a mean protein intake around 1.5 g kg−1 day−1 was sufficient to stay in a positive nitrogen balance, even during periods of peak growth. Therefore, protein intake should not be enhanced in peak periods of linear or muscular growth.

In various chronic pain populations, decreased cognitive performance is known to be related to pain severity. Yet, this relationship has not been investigated in patients with chronic fatigue syndrome (CFS). This study investigated the relationship between cognitive performance and (1) pain severity, (2) level of fatigue, and (3) self-reported symptoms and health status in women with CFS. Examining the latter relationships is important for clinical practice, since people with CFS are often suspected to exaggerate their symptoms. A sample of 29 female CFS patients and 17 healthy controls aged 18 to 45 years filled out three questionnaires (Medical Outcomes Study 36-Item Short-Form Health Survey, Checklist Individual Strength (CIS), and CFS Symptom List) and performed three performance-based cognitive tests (psychomotor vigilance task, Stroop task, and operation span task), respectively. In both groups, pain severity was not associated with cognitive performance. In CFS patients, the level of fatigue measured with the CFS Symptom List, but not with the CIS, was significantly correlated with sustained attention. Self-reported mental health was negatively correlated with all investigated cognitive domains in the CFS group. These results provide evidence for the clinical importance of objectively measured cognitive problems in female CFS patients. Furthermore, a state-like measure (CFS Symptom List) appears to be superior over a trait-like measure (CIS) in representing cognitive fatigue in people with CFS. Finally, the lack of a significant relationship between cognitive performance and self-reported pain severity suggests that pain in CFS might be unique.

OBJECTIVES: To assess the associations of socio-ecological factors with independent mobility for transportation cycling among 10-to-12-year-old boys and girls. Additionally, we examined whether associations differed across family socio-economic status (SES) and urbanization level. DESIGN: Cross-sectional survey. METHODS: Parents (n=1286) were recruited via 45 primary schools across Flanders, Belgium. They completed an online questionnaire assessing demographic and psychosocial factors, neighborhood environmental perceptions, as well as some characteristics of their child. Independent mobility was assessed as the distance children were allowed to cycle for transport without adult supervision. Multilevel gamma regression analyses stratified by gender were performed to examine the associations between the independent variables and children's independent mobility and the moderating effects of family SES and urbanization level. RESULTS: Independent mobility was higher among boys compared to girls. Perception of children's cycling and traffic skills and children's grade were positively associated with independent mobility among boys and girls. Perceptions of neighborhood traffic safety were positively associated with independent mobility among girls, but not among boys. Perceptions of cycling skills were positively associated with independent mobility among boys living in high urbanized areas, but not in low urbanized areas. Parental cycling for transport was negatively associated with independent mobility among girls with a low family SES, but not among girls with a high family SES. CONCLUSIONS: Our findings suggest that interventions targeting increases in children's cycling and traffic skills may be effective to increase independent mobility. Few differences in associations were found according to children's gender, family SES or urbanization level.Copyright © 2016 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved. Language: en

BACKGROUND: This study aimed to examine potential differences in walking, cycling, public transport and passive transport (car/moped/motorcycle) to work and to other destinations between college and non-college educated working young adults. Secondly, we aimed to investigate which psychosocial and environmental factors are associated with the four transport modes and whether these associations differ between college and non-college educated working young adults. METHODS: In this cross-sectional study, 224 working young adults completed an online questionnaire assessing socio-demographic variables (8 items), psychosocial variables (6 items), environmental variables (10 items) and transport mode (4 types) and duration to work/other destinations. Zero-inflated negative binomial regression models were performed in R. RESULTS: A trend (p

High levels of meat consumption in Belgium may be contributing to increased risk of non-communicable diseases in this population. The objective of this study is to investigate the attitudes and beliefs about vegetarianism and meat consumption among the Belgian population, ultimately to better understand the motivations underlying these dietary behaviours. This cross-sectional study was initiated in March 2011. A total of 2436 individuals from a representative consumer panel from the Flemish and Brussels communities participated. The study sample was evenly distributed by education level and sex (1238 men and 1198 women). An online questionnaire with multiple-choice questions about vegetarianism and meat consumption was completed by all participants. Although representative of the prevalence of vegetarians in the population, the number of vegetarians in the study was low (n = 38); the number of semi-vegetarians (n = 288) and omnivores was high (n = 2031). Vegetarians were more likely than semi-vegetarians to agree that meat production is bad for the environment and that meat consumption is unhealthy. Important reasons for not being vegetarian included lack of interest and awareness, taste, and limited cooking skills. Encouragingly, health and discovering new tastes were seen as the most important motives for considering eating a more vegetarian-based diet. The results of this study highlight the motivations that can be used for encouraging the general public to reduce their meat consumption in favour of a plant-rich diet, and will help to inform more targeted health campaigns for reducing meat consumption in Belgium.

This study assessed sociodemographics, general health, personal and environmental factors associated with fruit and vegetable (FV) and total fat intake in Belgian university students.In total, 185 students completed a self-reported online questionnaire assessing daily FV and fat intake, as well as sociodemographic, personal and environmental variables related to FV and fat intake. Mean FV and fat consumption were compared with Belgian recommendations. Multiple linear regression analyses were conducted to identify factors associated with FV and fat intake.Respectively, 90.3 and 50.8% of students failed to meet the recommendations for FV and fat consumption. Agreeing more with the fact that one should eat FV on most days of the week (individual subjective norm), finding it less difficult to eat FV at home or at university (perceived behavioural control) and experiencing more modelling were associated with higher FV consumption. Increasing age, higher educational level of the father and higher individual subjective norm about eating low-fat foods were associated with lower fat intake.Future interventions aiming to improve dietary intake among university students should focus on younger students with lower socioeconomic status and should enhance students' subjective norm and behavioural control concerning healthy eating.

Micronutrient dilution following sugar-sweetened beverage (SSB) consumption can lead to a qualitative impoverishment of a dietary pattern. The aim of this prospective study was to investigate the relation between SSB consumption and micronutrients. A total 562 adults were tested in 2002 and 2012 for the same anthropometric, lifestyle and nutritional intake activity parameters. Calcium, iron and magnesium intake decreased with increasing baseline SSB intake, and with increasing SSB consumption during the 10 years. A 100 ml increase in SSB consumption was associated with a 22 mg lower intake of calcium, 0.4 mg of iron and 9 mg of magnesium. There was no relation between vitamins and SSB consumption. In conclusion, there was limited evidence in our study, which suggests SSB have minimal dilutional effect on dietary micronutrient consumption. A major limitation of the present study is that of the original 1569 participants in 2002, 36% returned for participation in 2012. ispartof: European Journal of Clinical Nutrition vol:72 issue:1 pages:170-173 ispartof: location:England status: published

The present study compares the nutritional status of vegetarian (V) with non-vegetarian (NV) subjects. A three-day food record and a health questionnaire were completed by 106 V and 106 NV matched for following characteristics: sex, age, BMI, physical activity, tobacco use and alcohol consumption. Total energy intake was not significantly different (men: V: 2,346 ± 685 kcal/d, NV: 2,628 ± 632 kcal/d, p = 0.078, women: V: 1,991 ± 539 kcal/d, NV: 1,973 ± 592 kcal/d, p = 0.849). Macronutrients intake differed significantly between the V and NV subjects for protein (men: V:12.7 ± 2.3 E%, NV:15.3 ± 4.5 E%, p = 0.003, women: V: 13.2 ± 2.3 E%, NV:16.0 ± 4.0 E%, p < 0.001), fat (men: V: 29.3 ± 8.4 E%, NV: 33.8 ± 5.3 E%, p = 0.010, women: V: 29.7 ± 6.9 E%, NV: 34.7 ± 9.0 E%, p < 0.001), and carbohydrate (men: V: 55.3 ± 10.1 E%, NV: 47.4 ± 6.9 E%, p < 0.001, women: V: 55.1 ± 7.6 E%, NV: 47.2 ± 8.2 E%, p < 0.001). The intake of most minerals was significantly different between the V and the NV subjects. V had a lower sodium intake, higher calcium, zinc, and iron intake compared to the NV subjects. Our results clearly indicate that a vegetarian diet can be adequate to sustain the nutritional demands to at least the same degree as that of omnivores. The intakes of the V subjects were closer to the recommendations for a healthy diet when compared to a group of well matched NV subjects.

Promoting children's cycling for transport is a useful strategy to increase their physical activity levels. No studies have examined to which extent children's psychosocial characteristics play a role in their transportation cycling. Furthermore, insights into the association between children's independent mobility (IM) and transportation cycling is lacking in Europe. This study examined (1) the association of children's psychosocial characteristics with transportation cycling and its moderating effect of child's gender, parents' educational attainment and IM, and (2) the association between children's IM and transportation cycling. Children (n = 1232, aged 10–12 yrs) completed an online questionnaire at school assessing their psychosocial characteristics related with transportation cycling. Parents reported child's usual transportation cycling and the distance their child is allowed to cycle unsupervised (IM). Hurdle models were used to estimate associations between independent variables and odds of being a cyclist and with minutes of transportation cycling among those cycling. Data were collected during November–December 2014 across Flanders, Belgium. Children's perceived parental modeling, parental norm, peers' co-participation, self-efficacy and IM were positively related to the odds of being a cyclist, perceived benefits were negatively associated. Parental modeling, siblings' modeling, self-efficacy and parental norm were more strongly related to the odds of being a cyclist among children with a low IM. Friends' modeling was significantly related with odds of being a cyclist among boys. IM and parental norm (only among boys) were positively related to the time spent cycling. Targeting children, their friends and parents seems therefore most appropriate when aiming to increase children's transportation cycling.

Objectives : This study examined the effect of a 10 and 20% meal price increase when choosing French fries and a 10 and 20% meal price reduction when choosing fruit for dessert on university students' purchasing behaviour in an on-campus restaurant. The moderating effect of gender was also investigated. Secondly, this study aimed at gaining further insight into reasons why these price manipulations did or did not change students' purchasing behaviour. Materials and Methods : This two-phased mixed-methods study was conducted in a Belgian on-campus university restaurant with approximately 1200 to 1300 student visitors per day. In a first phase (French fries experiment), data were collected during a control week (no price manipulation) and two separate intervention weeks (10 and 20% meal price increase when students chose French fries). In a second phase (fruit experiment), following the same protocol but carried out a few weeks later, meal prices were reduced by 10 and 20% when students chose fruit for dessert. French fries and fruit sale counts relative to the total number of items sold were used as outcome measure. Short interviews were conducted in convenient subsamples of student customers to assess influences on food choice. Key findings : Increasing the meal price by 10 and 20% when choosing French fries was associated with respective 10.9 and 21.8% absolute reductions in French fries purchases, while reducing the meal price by 10 and 20% when choosing fruit for dessert was associated with absolute increases in fruit purchases of respectively 25.1 and 42.4% (all p

Objective to describe the demographic, socioeconomic, and nutritional behaviors associated with of sugar-sweetened beverage (SSB) consumption. Design: cross-sectional. Setting: in January 2014, 26,566 military personnel, representing 84.6% of the 31,412 men and women in active service were invited to participate in an online survey. Included questions were about consumption of fruits and vegetables, meat, SSB, number of breakfasts a week, and military rank. Subjects: 7,252 military subjects. Results: mean (standard deviation) age of the participants was 45.4 (7.9) years for 6,529 males and 41.9 (8.9) years for 723 females. Mean (standard deviation) body mass index was 26.6 (3.6) kg/m2 for males and 24.5 (3.9) kg/m2 for females. The probability of consuming daily SSB decreased with age, and with increasing body mass index, being female, and being a noncommissioned officer or officer. Consumption of fruits and vegetables decreased for daily SSB consumption, but meat consumption increased. The odds r...

Purpose This study aimed to provide an overview of available literature on interventions aiming to improve dietary intake among university students. Materials and methods A systematic review was conducted following the PRISMA guidelines. Web of Science, PubMed, PsycINFO and SPORTDiscus were searched for relevant articles. Risk of bias was assessed using the Academy of Nutrition and Dietetics Quality Criteria Checklist for Primary Research. Results Twenty studies were identified, consisting of 12 randomised controlled trials, 1 quasi-experiment and 7 pre-experiments. Six studies were conducted outside the US. Risk of bias assessment revealed an average quality score of 5.8/10. Of the 13 interventions which were effective in improving students’ dietary intake, 8 used an intrapersonal approach, with 6 of them using the web or some kind of media to facilitate the intervention. The 5 remaining studies used an environmental (point-of-purchase) approach. Only 1 intervention, using 10 web-based lessons, based on non-diet principles and focused on eating competence and size acceptance to promote healthy eating, was found to be effective in the long term. Conclusions Nutrition education, enhancing self-regulation components towards dietary intake (often facilitated by the worldwide web or other media devices), and point-of-purchase messaging strategies may improve university or college students’ dietary intake. Future high quality randomised controlled trials should evaluate sustainability of intervention effects, as well as further investigate the effectiveness of realistic and low-cost environmental (preferably combined with intrapersonal) interventions which can easily and instantly reach a great part of the university population.

The daily intake of food flavonoids was determined using a semiquantitative food frequency questionnaire (FFQ) and a four day non consecutive food diary (4DFR) in a group of 45 female Flemish dietitians. The subjects were asked to report their food intake three times: day 1 using the FFQ (FFQ1); between day 2 and 13 using a four day non consecutive food diary (4DFR); and again the FFQ on day 14 (FFQ2). The total flavonoid intake in mg/day as estimated with the different methods were respectively (mean and SD) for FFQ1 166.0 +/- 146.6 mg/day; for 4DFR 203.0 +/- 243.2 mg/day; and for FFQ2 158.3 +/- 151.8 mg/day. There was a significant different estimate for the amount of flavan-3-ols, flavanones and flavones when comparing the two FFQs with the 4DFR. The two research methods classified 88% of the 45 dietitians in the same or in an adjacent quartile for total flavonoid intake. The findings of this study indicate that the developed FFQ seems to be a simple and reliable method to assign subjects in quartiles of flavonoid intake.

Purpose: Unrefreshing sleep and lowered physical activity are commonly observed in chronic fatigue syndrome (CFS) patients, but how they might influence each other remains unexplored. Therefore, this study simultaneously examined the exercise capacity, sleep characteristics and physical activity in CFS patients. Methods: Handgrip strength and cycle exercise capacity were assessed in 42 female CFS patients and 24 inactive control subjects. During four consecutive days and nights, energy expenditure, activity and sleep-wake pattern were objectively registered using a Sensewear Armband. Results: Exercise capacity was significantly lower in CFS patients. In both groups VO2peak correlated with the time subjects were physically active. In CFS patients only, VO2peak correlated negatively with sleeping during the day whilst physical activity level and energy expenditure correlated negatively with sleep latency and lying awake at night. Conclusions: In the present study, CFS patients with higher VO2peak tend to sleep less over day. Occupation in physical activities was negatively associated with sleep latency and lying awake at night. Increased physical activity potentially has beneficial effects on sleep quality in CFS. However, a close monitoring of the effects of increasing physical activity is essential to avoid negative effects on the health status of patients. Implications for Rehabilitation Female patients with chronic fatigue syndrome (CFS) have normal sleep latency and sleep efficiency, but sleep more and spent more time in bed as compared to healthy inactive women. Female CFS patients have lower exercise capacity, and a lower physical activity level as compared to healthy inactive women. CFS patients appear to be more sensitive for sleep quality (sleep latency and lying awake at night), which is associated with a low physical activity level.

BACKGROUND: Regular physical activity ( PA), a high level of fitness and a high diet quality are positively associated with health. However, information about stability of fitness components and diet quality indices is limited. This study aimed to evaluate stability of those parameters. METHODS: This study includes 652 adults (men = 57.56 (10.28) years; women = 55.90 (8.34) years at follow- up) who participated in 2002- 2004 and returned for follow-up at the Policy Research Centre Leuven in 2012-2014. Minutes sport per day and Physical activity level (PAL) were calculated from the Flemish Physical Activity Computerized Questionnaire. Cardiorespiratory fitness (CRF), morphological fitness (MORF; body mass index and waist circumference) and metabolic fitness (METF) (blood cholesterol and triglycerides) were used as fitness components. Diet quality indices (Healthy Eating Index-2010 (HEI), Diet Quality Index (DQI), Mediterranean Diet Score (MDS)) were calculated from a diet record. Tracking coefficients were calculated using Pearson/ Spearman correlation coefficients (gamma(Pearson)) and intra-class correlation coefficients (gamma(ICC)). RESULTS: In both men (gamma(Pearson&ICC) = 0.51) and women (gamma(Pearson) = 0.62 and gamma(ICC) = 0.60) PAL showed good stability, while minutes sport remained stable in women (gamma(Pearson&ICC) = 0.57) but less in men (gamma(Pearson&ICC) = 0.45). Most fitness components remained stable (r >= 0.50) except some METF components in women. In general the diet quality indices and their components were unstable (r < 0.50). CONCLUSIONS: PAL and the majority of the fitness components remained stable, while diet quality was unstable over 10 years. For unstable parameters such as diet quality measurements are needed at both time points in prospective research.