Search

Objectives: To evaluate parental perceptions of and concern about child's body weight and general health in children in a European cohort., Design: Cross-sectional multi-centre study in eight European countries., Participants: 16,220 children, ages 2-9 years., Methods: Parents completed a questionnaire regarding children's health and weight and concern about overweight and underweight. Objective children's weight categories from the International Obesity Task Force were used. Logistic regression models were utilized to identify predictors of accurate weight perception., Results: Parental weight perception corresponded overall to children's mean body mass index (BMI) z-scores, with important exceptions. About one-third of the total indicated concern about underweight, paradoxically most often parents of children in the overweight or obesity categories. In 63%, parents of children in the overweight category marked 'proper weight'. The strongest predictor for accurate parental weight perception for children with overweight and obesity was BMI z-score (odds ratio [OR] = 7.2, 95% confidence interval [CI] 6.1-8.7). Compared to Southern Europe, ORs for accurate parental weight perception were 4.4 (95% CI 3.3-6.0) in Northern Europe and 3.4 (95% CI 2.7-4.2) in Central Europe., Conclusion: Parents of children categorized as being overweight or obese systematically underestimated weight. Parents differed regionally regarding accurate weight perception and concern about overweight and underweight., (© 2012 The Authors. Pediatric Obesity © 2012 International Association for the Study of Obesity.)

Objective: To assess the relationship between parental education level and the consumption frequency of obesity-related foods in European children., Design: The analysis was based on data from the cross-sectional baseline survey of a prospective cohort study. The effects of parental education on food consumption were explored using analysis of covariance and logistic regression., Setting: Primary schools and pre-schools of selected regions in Italy, Estonia, Cyprus, Belgium, Sweden, Hungary, Germany and Spain., Subjects: Participants (n 14,426) of the IDEFICS baseline cohort study aged 2 to 9 years., Results: Parental education level affected the intake of obesity-related foods in children. Children in the low and medium parental education level groups had lower odds of more frequently eating low-sugar and low-fat foods (vegetables, fruits, pasta/noodles/rice and wholemeal bread) and higher odds of more frequently eating high-sugar and high-fat foods (fried potatoes, fruits with sugar and nuts, snacks/desserts and sugared beverages; P < 0.001). The largest odds ratio differences were found in the low category (reference category: high) for vegetables (OR = 0.56; 95 % CI 0.47, 0.65), fruits (OR = 0.56; 95% CI 0.48, 0.65), fruits with sugar and nuts (OR = 2.23; 95% CI 1.92, 2.59) and sugared beverages (OR = 2.01; 95% CI 1.77, 2.37)., Conclusions: Low parental education level was associated with intakes of sugar-rich and fatty foods among children, while high parental education level was associated with intakes of low-sugar and low-fat foods. These findings should be taken into account in public health interventions, with more targeted policies aiming at an improvement of children's diet.

Unlabelled: Sleep duration has been identified as risk factor for obesity already in children. Besides investigating the role of fat mass (FM), this study addressed the question whether endocrine mechanisms act as intermediates in the association between sleep duration and overweight/obesity. Within the framework of the IDEFICS study, the present research was conducted in 609 German resident children aged 2-9 years with information on fasting insulin, C-reactive protein and cortisol levels next to anthropometric measurements and parental questionnaires. Emphasising methodological aspects, an age-specific measure of sleep duration was derived to account for alteration in sleep duration during childhood/period of growth. Multivariate linear regression and quantile regression models confirmed an inverse relationship between sleep duration and measures of overweight/obesity. The estimate for the association of sleep duration and body mass index (BMI) was approximately halved after adjustment for FM, but remained significant. The strength of this association was also markedly attenuated when adjusting for insulin mainly for the upper BMI quantiles (Q80, β = -0.36 vs. β = -0.26; Q95, β = -0.87 vs. β = -0.47). Adjustment for cortisol and CrP did not yield this attenuation., Conclusion: The inverse relationship between sleep duration and BMI is mainly explained by the association between sleep duration and FM. Insulin may explain part of this association, in particular at the upper tail of the BMI distribution.

Background: The European IDEFICS (Identification and prevention of dietary- and lifestyle-induced health effects in children and infants) study was set up to determine the aetiology of overweight, obesity and related disorders in children, and to develop and evaluate a tailored primary prevention programme., Objective: This paper focuses on the aetiological element of the multicentre study, the measures and examinations, sociodemographic characteristics of the study sample and proportions of participation., Design: Prospective cohort study with an embedded intervention study that started with a baseline survey in eight countries in 2007-2008., Subjects and Measurements: Baseline participants of the prospective cohort study were 16,224 children aged 2-9 years. Parents reported sociodemographic, behavioural, medical, nutritional and other lifestyle data for their children and families. Examinations of children included anthropometry, blood pressure, fitness, accelerometry, DNA from saliva and physiological markers in blood and urine. The built environment, sensory taste perception and other mechanisms of children's food choices and consumer behaviour were studied in subgroups., Results: Between 1507 and 2567, children with a mean age of 6.0 years and an even sex distribution were recruited from each country. Of them, 82% lived in two-parent families. The distribution of standardised income levels differed by study sample, with low-income groups being strongly represented in Cyprus, Italy and Germany. At least one 24-h dietary recall was obtained for two-thirds of the children. Blood pressure and anthropometry were assessed in more than 90%. A 3-day accelerometry was performed in 46%, motor fitness was assessed in 41%, cardiorespiratory fitness in 35% and ∼11% participated in taste perception tests. The proportion of children donating venous blood, urine and saliva was 57, 86 and 88%, respectively., Conclusion: The IDEFICS cohort provides valuable data to investigate the interplay of social, environmental, genetic, physiological and behavioural factors in the development of major diet- and lifestyle-related disorders affecting children at present.

Background and Objectives: The European Union-as well as other parts of the world-faces a major challenge of increasing incidence of overweight/obesity. In particular, the increase in childhood obesity gives rise to a strong imperative for immediate action. Yet, little is known about the effectiveness of community interventions, and further research in this field is needed. There is, however, a growing consensus that such research should start from the paradigm that the current living environments tend to counteract healthy lifestyles. Questioning these environments thoroughly can help to develop new pathways for sustainable health-promoting communities. Against this background, the IDEFICS (Identification and prevention of dietary- and lifestyle-induced health effects in children and infants) study developed and implemented innovative community-oriented intervention programmes for obesity prevention and healthy lifestyle primarily in children aged 2-10 years in eight European countries: Sweden, Estonia, Germany, Belgium, Hungary, Italy, Spain and Cyprus., Materials and Methods: The IDEFICS community-oriented intervention study mobilised an integrated set of interventional efforts at different levels of society, with the aim of facilitating the adoption of a healthy obesity-preventing lifestyle. The overall programme has been composed of 10 modules: three at community level, six at school level and one for parents. The main focus was on diet, physical activity and stress-coping capacity. The sphere of action encompassed both children and their (grand) parents, schools, local public authorities and influential stakeholders in the community. All materials for the interventions were centrally developed and culturally adapted., Results: So far, the following has been achieved: focus group research, literature review and expert consultations were done in an early phase as a basis for the development of the intervention modules. The intervention mapping protocol was followed as guide for structuring the intervention research. The overall intervention programme's duration was 2 years, but a longer-term follow-up programme is under development., Conclusions: This large-scale European effort is expected to contribute significantly to the understanding of this major public health challenge.

The goal of this article is to provide an overview of internal and external factors influencing childhood obesity. Overweight and obese children are more likely to become overweight and obese adults with the well-known negative psychological, social, and economic consequences. Politics and research are searching for efficient prevention and intervention strategies. Consumer research helps to better understand the underlying mechanisms and feedback loops. Increasingly, children's complex and multilayered "obesogenic" environment is held responsible for the increasing number of overweight children. Based on an ecological model, the paper explores the scientific evidence of these environmental factors on an individual, an interpersonal (i.e., family, peers), as well as on a community level (i.e., the physical environment). Furthermore, it looks at societal factors, such as media influence, advertising, product offers, and consumer policies. It concludes that access, affordability, and availability of healthy diets and lifestyles are crucial factors to develop and sustain healthy lifestyles. Implications for consumer and corporate policy are drawn.

Background The Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS (IDEFICS) study investigated the aetiology of childhood obesity and developed a primary prevention programme. Methods Pre-intervention adherence to key behaviours related to childhood obesity, namely water/sweetened drink, fruit/vegetable consumption, daily TV time, physical activity, family time and adequate sleep duration, was measured at baseline. Adherence to international recommendations was converted into a composite score ranging from 0 (none) to 6 (adhering to all). Data on adherence were available for 7,444 to 15,084 children aged 2-9.9 years, depending on the behaviour. By means of multi-level logistic regression models adjusted for age, sex and country, we calculated odds ratios (OR) and 95% confidence intervals (CI) to estimate the relationship between adherence to these recommendations and the risk of being overweight/obese. Results Adherence ranged from 15.0% (physical activity) to 51.9% (TV time). As adherence increased, a lower chance of being overweight/obese was observed; adhering to only one key behaviour (score = 1) meant an OR = 0.81 (CI: 0.65-1.01) compared with non-adherence (score = 0), while adhering to more than half of the key behaviours (score ≥ 4) halved the chance for overweight/obesity (OR = 0.54, CI: 0.37-0.80). Adherence to physical activity, TV and sleep recommendations was the main driver reducing the chance of being overweight. Overweight/obese children were more likely not to adhere to at least one of the recommended behaviours (19.8%) than normal-weight/thin children (12.9%) Conclusion The selected key behaviours do not contribute equally to a reduced chance of being overweight. Future interventions may benefit most from moving more, reducing TV time and getting adequate sleep. © 2015 World Obesity [ABSTRACT FROM AUTHOR]