766 results on '"Cardon G"'
Search Results
2. A review of implementation and evaluation frameworks for public health to inform co-creation
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Longworth, G R, primary, Goh, K, additional, Agnello, D M, additional, Messiha, K, additional, Beeckman, M, additional, Zapata-Restrepo, J R, additional, Cardon, G, additional, Chastin, S, additional, and Giné-Garriga, M, additional
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- 2023
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3. Parental barriers to active transport to school: a systematic review
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Aranda-Balboa, M. J., Huertas-Delgado, F. J., Herrador-Colmenero, M., Cardon, G., and Chillón, P.
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- 2020
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4. Making co-creation a trustworthy methodology for closing the implementation gap between knowledge and action in health promotion: the Health CASCADE project
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Verloigne, M, primary, Altenburg, T, additional, Cardon, G, additional, Chinapaw, M, additional, Dall, P, additional, Deforche, B, additional, Giné-Garriga, M, additional, Lippke, S, additional, Papadopoulos, H, additional, Pappa, D, additional, Sandlund, M, additional, Schreier, M, additional, Wadell, K, additional, and Chastin, S, additional
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- 2023
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5. Cyberbullying and traditional bullying involvement among heterosexual and non-heterosexual adolescents, and their associations with age and gender
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DeSmet, A., Rodelli, M., Walrave, M., Soenens, B., Cardon, G., and De Bourdeaudhuij, I.
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- 2018
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6. Inequality in physical activity, global trends by income inequality and gender in adults
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SFM, Chastin, Van Cauwenberg, J., Maenhout, L., Cardon, G., Lambert, E. V., and Van Dyck, D.
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- 2020
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7. The association of healthy lifestyle behaviors with mental health indicators among adolescents of different family affluence in Belgium
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Maenhout, L., Peuters, C., Cardon, G., Compernolle, S., Crombez, G., and DeSmet, A.
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- 2020
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8. The Emerging Prevalence of Obesity within Families in Europe and its Associations with Family Socio-Demographic Characteristics and Lifestyle Factors; A Cross-Sectional Analysis of Baseline Data from the Feel4Diabetes Study
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Siopis, G., Moschonis, G, Reppas, K., Iotova, V., Bazdarska, Y., Chakurova, N., Rurik, I., Si Radó, A., Cardon, G., De Craemer, M., Wikström, K., Valve, P., Moreno, L. A., De Miguel-Etayo, P., Makrilakis, K., Liatis, S., Manios, Y., Feel4Diabetes-Study Group, and Epidemiology and Data Science
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Nutrition and Dietetics ,school ,overweight prevention ,socio-economic risk factors ,Social Sciences ,T2DM ,weight ,community intervention ,lifestyle intervention ,BMI ,Medicine and Health Sciences ,SES ,T2D ,Food Science - Abstract
The Feel4Diabetes study is a type 2 diabetes prevention program that recruited 12,193 children [age: 8.20 (±1.01) years] and their parents from six European countries. The current work used pre-intervention data collected from 9576 children–parents pairs, to develop a novel family obesity variable and to examine its associations with family sociodemographic and lifestyle characteristics. Family obesity, defined as the presence of obesity in at least two family members, had a prevalence of 6.6%. Countries under austerity measures (Greece and Spain) displayed higher prevalence (7.6%), compared to low-income (Bulgaria and Hungary: 7%) and high-income countries (Belgium and Finland: 4.5%). Family obesity odds were significantly lower when mothers (OR: 0.42 [95% CI: 0.32, 0.55]) or fathers (0.72 [95% CI: 0.57, 0.92]) had higher education, mothers were fully (0.67 [95% CI: 0.56, 0.81]) or partially employed (0.60 [95% CI: 0.45, 0.81]), families consumed breakfast more often (0.94 [95% CI: 0.91 0.96]), more portions of vegetables (0.90 [95% CI: 0.86, 0.95]), fruits (0.96 [95% CI: 0.92, 0.99]) and wholegrain cereals (0.72 [95% CI: 0.62, 0.83]), and for more physically active families (0.96 [95% CI: 0.93, 0.98]). Family obesity odds increased when mothers were older (1.50 [95% CI: 1.18, 1.91]), with the consumption of savoury snacks (1.11 [95% CI: 1.05, 1.17]), and increased screen time (1.05 [95% CI: 1.01, 1.09]). Clinicians should familiarise themselves with the risk factors for family obesity and choose interventions that target the whole family. Future research should explore the causal basis of the reported associations to facilitate devising tailored family-based interventions for obesity prevention.
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- 2023
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9. Gender differences in the distribution of children's physical activity: evidence from nine countries.
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Kretschmer, Luke, Salali, Gul Deniz, Andersen, Lars Bo, Hallal, Pedro C., Northstone, Kate, Sardinha, Luís B., Dyble, Mark, Bann, David, Andersen, L. B., Anderssen, S., Cardon, G., Davey, R., Jago, R., Janz, K. F., Kriemler, S., Møller, N., Northstone, K., Pate, R., Puder, J. J., and Reilly, J.
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DATABASES ,SEDENTARY lifestyles ,CHILD development ,SEX distribution ,PHYSICAL activity ,ACCELEROMETRY ,DESCRIPTIVE statistics ,RESEARCH funding ,EXERCISE ,EXERCISE intensity ,DATA analysis software - Abstract
Background: Physical activity in childhood is thought to influences health and development. Previous studies have found that boys are typically more active than girls, yet the focus has largely been on differences in average levels or proportions above a threshold rather than the full distribution of activity across all intensities. We thus examined differences in the distribution of physical activity between girls and boys in a multi-national sample of children. Methods: We used the harmonised International Children Accelerometry Database (ICAD), including waist-worn accelerometry data from 15,461 individuals (Boys: 48.3%) from 9 countries. Employing Generalised Additive Models of Location, Shape, and Scale (GAMLSS) we investigated gender differences in the distribution of individuals, including comparisons of variability (SD) and average physical activity levels (mean and median) and skewness. We conducted this analysis for each activity intensity (Sedentary, Light, and Moderate-to-Vigorous (MVPA)) and a summary measure (counts per minute (CPM)). Results: Sizable gender differences in the distribution of activity were found for moderate to vigorous activity and counts per minute, with boys having higher average levels (38% higher mean volumes of MVPA, 20% higher CPM), yet substantially more between-person variability (30% higher standard deviation (SD) for MVPA, 17% higher SD for CPM); boys' distributions were less positively skewed than girls. Conversely, there was little to no difference between girls and boys in the distribution of sedentary or light-intensity activity. Conclusions: Inequality in activity between girls and boys was driven by MVPA. The higher mean volumes of MVPA in boys occurred alongside greater variability. This suggests a need to consider the underlying distribution of activity in future research; for example, interventions which target gender inequality in MVPA may inadvertently lead to increased inequality within girls. [ABSTRACT FROM AUTHOR]
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- 2023
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10. Association of diet quality with glycemia, insulinemia, and insulin resistance in families at high risk for type 2 diabetes mellitus in Europe: Feel4 Diabetes Study
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Botsi E, Karatzi K, Mavrogianni C, Kaloyan Tsochev, Esther M González-Gil, Radó S, Kivelä J, Wikström K, Cardon G, Rurik I, Liatis S, Tsvetalina Tankova, Violeta Iotova, Luis A. Moreno, Makrillakis K, Manios Y, and Tsigos C
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Adult ,Blood Glucose ,Cross-Sectional Studies ,Nutrition and Dietetics ,Diabetes Mellitus, Type 2 ,Endocrinology, Diabetes and Metabolism ,Humans ,Insulin ,Insulin Resistance ,Diet - Abstract
The aim of the present study was to investigate the association of diet quality with fasting glycemia, insulinemia, and insulin resistance in a cross-sectional sample of adults from families at high risk for type 2 diabetes mellitus (T2DM) from six European countries, taking into account their socioeconomic status (SES).Baseline data from non-diabetic adults from the Feel4 Diabetes study were used and diet was assessed by the Healthy Diet Score (HDS). Insulin resistance (IR) was determined by homeostasis model assessment of IR (HOMA-IR). Sociodemographic and lifestyle characteristics were assessed through standardized questionnaires. Multiple linear regressions were adjusted for many confounders, in the total sample and by SES category.In 1980 adults, the third tertile of diet quality was inversely associated with insulin levels (-1.48; 95% confidence interval [CI], -2.34 to 0.62), and HOMA-IR (-0.33; 95% CI, -0.57 to 0.09), yet with no statistically significant results for glucose levels. In the SES subgroup analysis, in the high SES group, both second and third diet score tertiles were inversely associated with insulin levels (-1.81; 95% CI, -2.66 to 0.95) and HOMA-IR values (-0.45; 95% CI -0.69 to 0.21), independent of age, sex, smoking and body mass index. No such associations were observed for glucose levels in the high SES group and for all indices in the low SES group.In adults from families at high risk for T2DM, higher diet quality was negatively associated with fasting insulin levels and IR, only in the high SES group and not in the low SES group. Future larger studies may be able to explore further this association, as well as the potential factors that mitigate its strength in the low SES groups.
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- 2023
11. Association of breakfast consumption frequency with fasting glucose and insulin sensitivity/b cells function (HOMA-IR) in adults from high-risk families for type 2 diabetes in Europe: the Feel4Diabetes Study
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Apergi, K. Karatzi, K. Reppas, K. Karaglani, E. Usheva, N. Giménez-Legarre, N. Moreno, L.A. Dimova, R. Antal, E. Jemina, K. Cardon, G. Iotova, V. Manios, Y. Makrilakis, K.
- Abstract
Purpose: This study aimed to investigate the association of breakfast consumption frequency (BCF) with glycemic control indices in a cross-sectional sample of adults from families at high risk for type 2 diabetes mellitus (T2DM), exploring the role of sex and socioeconomic status (SES). Methods: In 2370 adults (40.8 ± 5.6 years) from 6 European countries, sociodemographic, lifestyle, anthropometric and biochemical characteristics were assessed through standardized procedures. Multivariable regression models were used to examine the association between fasting glucose (FG), fasting insulin (FI), and insulin resistance (HOMA-IR) (dependent variables) with BCF (independent variable) controlling for multiple possible confounders. Results: A linear association of BCF with FG (β = −0.557, 95% CI (−0.834, −0.280)) and a quadratic association with FI and HOMA-IR with the highest point of curve observed at BCF = 2.989 (times/week) and at BCF = 2.746, respectively, independent of the used covariates. In males and in participants of high SES, BCF was linearly and inversely associated with FG, while with FI and HOMA-IR there was an association with BCF in quadratic function. In females, BCF was linearly and inversely associated with FG and HOMA-IR, and there was a quadratic association with FI. In low SES there was only a linear association with FG, yet with no statistically significant findings for FI and HOMA-IR. Conclusions: Regular breakfast consumption, especially >3 times/week is associated with improved indices of glycemic control. This association was diminished in low SES participants in the presence of the used covariates. © 2022, The Author(s), under exclusive licence to Springer Nature Limited.
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- 2022
12. Can food parenting practices explain the association between socioeconomic status and children's food intake? the Feel4Diabetes-study
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Flores-Barrantes, P., Mavrogianni, C., Iglesia, I., Mahmood, L., Willems, R., Cardon, G., De Vylder, F., Liatis, S., Makrilakis, K., Martinez, R., Schwarz, P., Rurik, I., Antal, E., Iotova, V., Tsochev, K., Chakarova, N., Kivelä, J., Wikström, K., Manios, Y., Moreno, L. A., and Feel4Diabetes-study Group
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Objective: This study aimed to investigate the mediating role of FPPs, including home availability of different types of foods and drinks, parental modelling of fruit intake, permissiveness, and the use of food as a reward, in the relationship between parental education and dietary intake in European children. Design: Single mediation analyses were conducted to explore whether FPPs explain associations between parents'' educational level and children''s dietary intake measured by a parent-reported food frequency questionnaire. Setting: 6 European countries. Participants: Parent-child dyads (n = 6705, 50.7% girls, 88.8% mothers) from the Feel4Diabetes-study. Results: Children aged 8.15 ± 0.96 years were included. Parental education was associated with children''s higher intake of water, fruits, and vegetables and lower intake of sugar-rich foods and savoury snacks. All FPPs explained the associations between parental education and dietary intake to a greater or lesser extent. Specifically, home availability of soft drinks explained 59.3% of the association between parental education and sugar-rich food intake. Home availability of fruits and vegetables were the strongest mediators in the association between parental education and fruit and vegetable consumption (77.3% and 51.5%, respectively). Regarding savoury snacks, home availability of salty snacks and soft drinks were the strongest mediators (27.6% and 20.8%, respectively). Conclusions: FPPs mediate the associations between parental education and children''s dietary intake. This study highlights the importance of addressing FPPs in future interventions targeting low-educated populations. © The Authors 2022.
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- 2022
13. Can food parenting practices explain the association between socioeconomic status and children's food intake? the Feel4Diabetes-study
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Flores-Barrantes, P. Mavrogianni, C. Iglesia, I. Mahmood, L. Willems, R. Cardon, G. De Vylder, F. Liatis, S. Makrilakis, K. Martinez, R. Schwarz, P. Rurik, I. Antal, E. Iotova, V. Tsochev, K. Chakarova, N. Kivelä, J. Wikström, K. Manios, Y. Moreno, L.A. Feel4Diabetes-study Group
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Objective: This study aimed to investigate the mediating role of FPPs, including home availability of different types of foods and drinks, parental modelling of fruit intake, permissiveness, and the use of food as a reward, in the relationship between parental education and dietary intake in European children. Design: Single mediation analyses were conducted to explore whether FPPs explain associations between parents' educational level and children's dietary intake measured by a parent-reported food frequency questionnaire. Setting: 6 European countries. Participants: Parent-child dyads (n = 6705, 50.7% girls, 88.8% mothers) from the Feel4Diabetes-study. Results: Children aged 8.15 ± 0.96 years were included. Parental education was associated with children's higher intake of water, fruits, and vegetables and lower intake of sugar-rich foods and savoury snacks. All FPPs explained the associations between parental education and dietary intake to a greater or lesser extent. Specifically, home availability of soft drinks explained 59.3% of the association between parental education and sugar-rich food intake. Home availability of fruits and vegetables were the strongest mediators in the association between parental education and fruit and vegetable consumption (77.3% and 51.5%, respectively). Regarding savoury snacks, home availability of salty snacks and soft drinks were the strongest mediators (27.6% and 20.8%, respectively). Conclusions: FPPs mediate the associations between parental education and children's dietary intake. This study highlights the importance of addressing FPPs in future interventions targeting low-educated populations. © The Authors 2022.
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- 2022
14. Prevalence of Childhood Obesity by Country, Family Socio-Demographics, and Parental Obesity in Europe: The Feel4Diabetes Study
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Moschonis, G. Siopis, G. Anastasiou, C. Iotova, V. Stefanova, T. Dimova, R. Rurik, I. Radó, A.S. Cardon, G. De Craemer, M. Lindström, J. Moreno, L.A. De Miguel-Etayo, P. Makrilakis, K. Liatis, S. Manios, Y.
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The Feel4Diabetes study recruited 12,193 children (age: 8.20 ±1.01 years) and their parents from six European countries as part of the broader attempt to prevent type 2 diabetes. The current work collected data pre-intervention to identify the prevalence of childhood obesity by country and describe its association with socio-demographic characteristics and parental obesity status. One in four children were overweight or obese, and one in four families had at least one obese parent. Multivariate logistic regression examined the associations between childhood obesity, family socio-demographics, and parental obesity status. Children had a higher chance of being overweight or obese if they were living in “low income” countries (OR: 2.11, 95% CI: 1.62, 2.74) and countries “under economic crisis” (OR: 2.48, 95% CI: 1.89, 3.24) compared to “high-income” countries; if their fathers completed fewer than nine years of education (OR: 2.16, 95% CI: 1.54, 3.05) compared to children whose fathers had a higher level (>14 years) of education; and if one (OR: 2.46, 95% CI: 0.32, 0.62) or both of their parents (OR: 6.83, 95% CI: 5.15, 9.05) were obese. Future childhood obesity prevention-programs should target the whole family while taking into consideration the socioeconomic and weight status of parents. Future research should examine these associations in more countries and in socio-demographically diverse populations in order to facilitate the generalisability of the present study’s findings. © 2022 by the authors. Licensee MDPI, Basel, Switzerland.
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- 2022
15. Prospective BMI changes in preschool children are not effected by changes in EBRBs but by parental characteristics and body weight perceptions: The ToyBox-study
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Manios Y., Lambert K.A., Karaglani E., Mavrogianni C., Moreno L.A., Iotova V., Swiader-Lesniak A., Koletzko B., Cardon G., Androutsos O., Moschonis G., de Bourdeaudhuij I., Paw M.C.A., Summerbell C., Lobstein T., Annemans L., Buijs G., Reilly J., Swinburn B., Ward D., Grammatikaki E., Katsarou C., Apostolidou E., Livaniou A., Lymperopoulou K., Efstathopoulou E., Lambrinou C.-P., Giannopoulou A., Siatitsa E., Argiri E., Maragkopoulou K., Douligeris A., Duvinage K., Ibrügger S., Strauß A., Herbert B., Birnbaum J., Payr A., Geyer C., de Craemer M., de Decker E., de Henauw S., Maes L., Vereecken C., van Assche J., Pil L., te Velde S., Moreno L., Mouratidou T., Fernandez J., Mesana M., de Miguel-Etayo P., González-Gil E.M., Gracia-Marco L., Oves B., Yngve A., Kugelberg S., Lynch C., Mosdøl A., Nilsen B.B., Moore H., Douthwaite W., Nixon C., Kreichauf S., Wildgruber A., Socha P., Kulaga Z., Zych K., Gózdz M., Gurzkowska B., Szott K., Lateva M., Usheva N., Galcheva S., Marinova V., Radkova Z., Feschieva N., Aikenhead A., Dorgelo A., Nethe A., Jansen J., Gmeiner O., Retterath J., Wildeis J., Günthersberger A., Gibson L., Voegele C., and ToyBox Study Group
- Abstract
Objective: To examine the effect of the intervention implemented in the ToyBox study on changes observed in age and sex specific BMI percentile and investigate the role of perinatal factors, parental perceptions and characteristics on this change. Design: A multicomponent, kindergarten-based, family-involved intervention with a cluster-randomized design. A standardized protocol was used to measure children’s body weight and height. Information was also collected from parents/caregivers via the use of validated questionnaires. Linear mixed effect models with random intercept for country, socioeconomic status and school were used. Setting: Selected preschools within the provinces of Oost-Flanders and West-Flanders (Belgium), Varna (Bulgaria), Bavaria (Germany), Attica (Greece), Mazowieckie (Poland) and Zaragoza (Spain). Participants: A sample of 6, 268 pre-schoolers aged 3.5-5.5 (51.9% boys). Results: There was no intervention effect on the change in children’s BMI percentile. However, parents’ underestimation of their children’s actual weight status, parental overweight and mothers’ pre-pregnancy overweight/obesity were found to be significantly and independently associated with increases in children’s BMI percentile in multivariate modelling. Conclusion: Before or as part of the implementation of any childhood obesity intervention initiative, it is important to assist parents/caregivers to correctly perceive their own and their children’s weight status. Recognition of excessive weight by parents/caregivers can increase their readiness to change and as such facilitate higher adherence to favourable behavioural changes within the family. © 2021 Lippincott Williams and Wilkins. All rights reserved.
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- 2022
16. Diet quality in association to lipidaemic profile in adults of families at high-risk for type 2 diabetes in Europe: The Feel4Diabetes study
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Chairistanidou, C. Karatzi, K. Karaglani, E. Usheva, N. Liatis, S. Chakarova, N. Mateo-Gallego, R. Lamiquiz-Moneo, I. Radó, S. Antal, E. Bíró, É. Kivelä, J. Wikström, K. Iotova, V. Cardon, G. Makrilakis, K. Manios, Y.
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Background and aims: The role of diet in blood lipids is scarcely investigated in adults at risk of Type 2 Diabetes Mellitus (T2DM) and even less studied regarding their socioeconomic status (SES). This study aimed to investigate the associations of diet quality with blood lipids in adults from families at high-risk for developing T2DM from six European countries, considering their SES. Methods and results: In total 2049 adults (67% women) from relatively low-SES regions and high T2DM risk families were enrolled. Dietary habits, sedentary behaviour and sociodemographic characteristics were assessed using standardised questionnaires. The associations of tertiles of healthy diet score (HDS) with blood lipids were tested by univariate analysis of variance (UNIANOVA). HDL-Cholesterol (HDL-C) was positively (B 1.54 95%CI 0.08 to 2.99) and LDL-Cholesterol (LDL-C) (B −4.15 95%CI −7.82 to −0.48), ratio of total cholesterol to HDL-C (B −0.24 95%CI −0.37 to −0.10), ratio of LDL-C to HDL-C (B −0.18 95%CI −0.28 to −0.08) and Atherogenic Index of Plasma (B −0.03 95%CI −0.06 to 0.00) inversely associated with the highest tertile of diet score compared to the lowest tertile independently of age, sex, Body Mass Index, total screen time and smoking. In sub-analysis of education (
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- 2022
17. Prospective BMI changes in preschool children are associated with parental characteristics and body weight perceptions: the ToyBox-study
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Manios, Y, Lambert, Katrina, Karaglani, E, Mavrogianni, C, Moreno, LA, Iotova, V, Świąder-Leśniak, A, Koletzko, B, Cardon, G, Androutsos, O, Moschonis, George, de Bourdeaudhuij, I, Paw, MCA, Summerbell, C, Lobstein, T, Annemans, L, Buijs, G, Reilly, J, Swinburn, B, Ward, D, Grammatikaki, E, Katsarou, C, Apostolidou, E, Livaniou, A, Lymperopoulou, K, Efstathopoulou, E, Lambrinou, CP, Giannopoulou, A, Siatitsa, E, Argiri, E, Maragkopoulou, K, Douligeris, A, Duvinage, K, Ibrügger, S, Strauß, A, Herbert, B, Birnbaum, J, Payr, A, Geyer, C, de Craemer, M, de Decker, E, de Henauw, S, Maes, L, Vereecken, C, van Assche, J, Pil, L, Velde, S te, Mouratidou, T, Fernandez, J, Mesana, M, de Miguel-Etayo, P, González-Gil, EM, Gracia-Marco, L, Oves, B, Yngve, A, Kugelberg, S, Lynch, C, Mosdøl, A, Nilsen, BB, Moore, H, Douthwaite, W, Nixon, C, Kreichauf, S, Wildgruber, A, Socha, P, Kulaga, Z, Zych, K, Góźdź, M, Gurzkowska, B, Szott, K, Lateva, M, Usheva, N, Galcheva, S, Marinova, V, Radkova, Z, Feschieva, N, Aikenhead, A, Dorgelo, A, Nethe, A, Jansen, J, Gmeiner, O, Retterath, J, Wildeis, J, Günthersberger, A, Gibson, L, and Voegele, C
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111712 Health Promotion ,111707 Family Care ,FOS: Health sciences ,111704 Community Child Health - Abstract
Objective: To examine the effect of the intervention implemented in the ToyBox study on changes observed in age and sex specific BMI percentile and investigate the role of perinatal factors, parental perceptions and characteristics on this change. Design: A multicomponent, kindergarten-based, family-involved intervention with a cluster-randomized design. A standardized protocol was used to measure children’s body weight and height. Information was also collected from parents/caregivers via the use of validated questionnaires. Linear mixed effect models with random intercept for country, socioeconomic status and school were used. Setting: Selected preschools within the provinces of Oost-Flanders and West-Flanders (Belgium), Varna (Bulgaria), Bavaria (Germany), Attica (Greece), Mazowieckie (Poland) and Zaragoza (Spain). Participants: A sample of 6,268 pre-schoolers aged 3.5-5.5 (51.9% boys). Results: There was no intervention effect on the change in children’s BMI percentile. However, parents’ underestimation of their children’s actual weight status, parental overweight and mothers’ pre-pregnancy overweight/obesity were found to be significantly and independently associated with increases in children’s BMI percentile in multivariate modelling. Conclusion: Before or as part of the implementation of any childhood obesity intervention initiative, it is important to assist parents/caregivers to correctly perceive their own and their children’s weight status. Recognition of excessive weight by parents/caregivers can increase their readiness to change and as such facilitate higher adherence to favourable behavioural changes within the family.
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- 2022
- Full Text
- View/download PDF
18. Sociodemographic, anthropometric, and lifestyle correlates of prediabetes and type 2 diabetes in europe: The Feel4Diabetes study
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Kontochristopoulou, A.M. Karatzi, K. Karaglani, E. Cardon, G. Kivelä, J. Wikström, K. Iotova, V. Tsochev, K. Tankova, T. Rurik, I. Radone, A.S. Liatis, S. Makrilakis, K. Moreno, L.A. Manios, Y.
- Abstract
Background and aims: The current work aimed to identify the predominant correlates of prediabetes and T2DM among a variety of socio-demographic, anthropometric and lifestyle indices, in a large sample of adults from families at high risk for T2DM. Methods and results: In this cross-sectional study, 2816 adults were recruited from low-socioeconomic areas in high-income countries (HICs) (Belgium-Finland), HICs under austerity measures (Greece-Spain), and low/middle-income countries (LMICs) (Bulgaria-Hungary). A positive association between the male sex (OR, 95% C.I.2.77 (1.69–4.54)) and prediabetes was revealed compared to females, while there was a negative association between younger age (
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- 2022
19. Parental insulin resistance is associated with unhealthy lifestyle behaviours independently of body mass index in children: The Feel4Diabetes study
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González-Gil, E.M. Giménez-Legarre, N. Cardon, G. Mavrogianni, C. Kivelä, J. Iotova, V. Tankova, T. Imre, R. Liatis, S. Makrilakis, K. Schwarz, P. Timpel, P. Dupont, E. Couck, P. Manios, Y. Moreno, L.A.
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Parental health is associated with children’s health and lifestyles. Thus, the aim of the present study was to assess lifestyle behaviours of children of parents with insulin resistance (IR) and at risk of type 2 diabetes. 2117 European families from the Feel4Diabetes-study were identified as being at risk for diabetes with the FINDRISC questionnaire and included in the present study. One parent and one child per family were included. Parental IR was considered when homeostasis model assessment (HOMA) was equal or higher than 2.5. Children’s screen-time, physical activity and diet were assessed and clustered by K-means. Weight and height were measured and children’s body mass index (BMI) was calculated. For children, a Healthy Diet Score (HDS) was calculated. Linear regression and multilevel logistic regression analyses were performed to assess the associations between parental IR and children’s lifestyle behaviours in 2021. Children of parents with IR had higher BMI (p < 0.001) and spent more screen time (p = 0.014) than those of non-IR parents. Children of parents with IR had a lower value in the breakfast and vegetable components of the HDS (p = 0.008 and p = 0.05). Four lifestyle clusters were found. Children of IR parents had higher odds of being in a non-healthy cluster (OR: 1.19; 95%CI: 1.001–1.437). Conclusion: Having an IR parent was associated with a high screen time and an increased probability of having an unhealthy lifestyle pattern in children. These data point out that children’s lifestyles should be assessed in families with IR parents to provide tailored interventions.What is Known:• Children with diabetic or insulin-resistant parents could also develop this condition.• Unhealthy lifestyles are directly related with insulin resistance even in children.What is New:• Children from parents with insulin resistance have higher chances of unhealthy lifestyles.• A higher BMI was found for those children with an insulin-resistant parent. © 2022, The Author(s).
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- 2022
20. Exchange Phenomena
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Fairbridge, Rhodes W., Beinroth, Friedrich H., Eswaran, Hari, Reich, Paul F., Campbell, Gaylon S., Groenevelt, Piet H., Quiquampoix, Hervé, Hanks, R. J., Cardon, G. E., Gast, Robert G., and Chesworth, Ward, editor
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- 2008
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21. Evaporation
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Fairbridge, Rhodes W., Beinroth, Friedrich H., Eswaran, Hari, Reich, Paul F., Campbell, Gaylon S., Groenevelt, Piet H., Quiquampoix, Hervé, Hanks, R. J., Cardon, G. E., and Chesworth, Ward, editor
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- 2008
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22. What do we know about physical activity in infants and toddlers: A review of the literature and future research directions
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Cardon, G., Van Cauwenberghe, E., and De Bourdeaudhuij, I.
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- 2011
- Full Text
- View/download PDF
23. Feel4Diabetes healthy diet score: Development and evaluation of clinical validity
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Virtanen, E. Kivelä, J. Wikström, K. Lambrinou, C.-P. De Miguel-Etayo, P. Huys, N. Vraukó-Tóth, K. Moreno, L.A. Usheva, N. Chakarova, N. Rado, S.A. Iotova, V. Makrilakis, K. Cardon, G. Liatis, S. Manios, Y. Lindström, J. Manios, Y. Cardon, G. Lindström, J. Schwarz, P. Makrilakis, K. Annemans, L. Garamendi, I. Karatzi, K. Androutsos, O. Moschonis, G. Kanellakis, S. Mavrogianni, C. Tsoutsoulopoulou, K. Katsarou, C. Karaglani, E. Qira, I. Skoufas, E. Maragkopoulou, K. Tsiafitsa, A. Sotiropoulou, I. Tsolakos, M. Argyri, E. Nikolaou, M. Vampouli, E.-A. Filippou, C. Apergi, K. Filippou, A. Katerina, G. Dimitriadis, E. Laatikainen, T. Wikström, K. Kivelä, J. Valve, P. Levälahti, E. Virtanen, E. Pennanen, T. Olli, S. Nelimarkka, K. Van Stappen, V. Huys, N. Willems, R. Shadid, S. Timpel, P. Liatis, S. Dafoulas, G. Lambrinou, C.-P. Giannopoulou, A. Rabemananjara, L. De Sabata, M.S. Ko, W. Civeira, F. Bueno, G. De Miguel-Etayo, P. Gonzalez-Gil, E.Mª. Miguel-Berges, M.L. Giménez-Legarre, N. Flores-Barrantes, P. Ayala-Marín, A.M. Seral-Cortés, M. Baila-Rueda, L. Cenarro, A. Jarauta, E. Mateo-Gallego, R. Iotova, V. Tankova, T. Usheva, N. Tsochev, K. Chakarova, N. Galcheva, S. Dimova, R. Bocheva, Y. Radkova, Z. Marinova, V. Bazdarska, Y. Stefanova, T. Rurik, I. Ungvari, T. Jancsó, Z. Nánási, A. Kolozsvári, L. Semánova, C. Bíró, É. Antal, E. Radó, S. Martinez, R. Tong, M. Feel4Diabetes research group
- Abstract
Background: The aim of this paper is to present the development of the Feel4Diabetes Healthy Diet Score and to evaluate its clinical validity. Methods: Study population consisted of 3268 adults (63% women) from high diabetes risk families living in 6 European countries. Participants filled in questionnaires at baseline and after 1 year, reflecting the dietary goals of the Feel4Diabetes intervention. Based on these questions the Healthy Diet Score was constructed, consisting of the following components: breakfast, vegetables, fruit and berries, sugary drinks, whole-grain cereals, nuts and seeds, low-fat dairy products, oils and fats, red meat, sweet snacks, salty snacks, and family meals. Maximum score for each component was set based on its estimated relative importance regarding T2DM risk, higher score indicating better quality of diet. Clinical measurements included height, weight, waist circumference, heart rate, blood pressure, and fasting blood sampling, with analyses of glucose, total cholesterol, HDL-cholesterol, LDL-cholesterol, and triglycerides. Analysis of (co) variance was used to compare the Healthy Diet Score and its components between countries and sexes using baseline data, and to test differences in clinical characteristics between score categories, adjusted for age, sex and country. Pearson's correlations were used to study the association between changes from baseline to year 1 in the Healthy Diet Score and clinical markers. To estimate reproducibility, Pearson's correlations were studied between baseline and 1 year score, within the control group only. Results: The mean total score was 52.8 ± 12.8 among women and 46.6 ± 12.8 among men (p < 0.001). The total score and its components differed between countries. The change in the Healthy Diet Score was significantly correlated with changes in BMI, waist circumference, and total and LDL cholesterol. The Healthy Diet Score as well as its components at baseline were significantly correlated with the values at year 1, in the control group participants. Conclusion: The Feel4Diabetes Healthy Diet Score is a reproducible method to capture the dietary information collected with the Feel4Diabetes questionnaire and measure the level of and changes in the adherence to the dietary goals of the intervention. It gives a simple parameter that associates with clinical risk factors in a meaningful manner. Trial registration: Clinicaltrials.gov NCT02393872. Registered March 20, 2015. © 2020 The Author(s).
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- 2020
24. Effectiveness of a family-, school- And community-based intervention on physical activity and its correlates in Belgian families with an increased risk for type 2 diabetes mellitus- And Feel4Diabetes-study
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Huys, N. Van Stappen, V. Shadid, S. De Craemer, M. Androutsos, O. Wikström, K. Makrilakis, K. Moreno, L.A. Iotova, V. Tankova, T. Nánási, A. Manios, Y. Cardon, G. Manios, Y. Kontogianni, M. Androutsos, O. Moschonis, G. Tsoutsoulopoulou, K. Mavrogianni, C. Katsarou, C. Karaglani, E. Efstathopoulou, E. Kechribari, I. Maragkopoulou, K. Argyri, E. Douligeris, A. Nikolaou, M. Vampouli, E.-A. Kouroupaki, K. Koutsi, R. Tzormpatzaki, E. Manou, E. Mpinou, P. Karachaliou, A. Filippou, C. Filippou, A. Lindström, J. Laatikainen, T. Wikström, K. Nelimarkka, K. Kivelä, J. Valve, P. Cardon, G. Latomme, J. Van Stappen, V. Huys, N. Annemans, L. Pil, L. Schwarz, P. Panchyrz, I. Holland, M. Timpel, P. Makrilakis, K. Liatis, S. Dafoulas, G. Lambrinou, C.-P. Giannopoulou, A. Tsirigoti, L. Fappa, E. Anastasiou, C. Zachari, K. Rabemananjara, L. Kakoulis, D. Mandalia, M. De Sabata, M.S. Pall, N. Civeira, F. Bueno, G. De Miguel-Etayo, P. Gonzalez-Gil, E.M. Mesana, M.I. Vicente-Rodriguez, G. Rodriguez, G. Baila-Rueda, L. Cenarro, A. Jarauta, E. Mateo-Gallego, R. Iotova, V. Tankova, T. Usheva, N. Tsochev, K. Chakarova, N. Galcheva, S. Dimova, R. Bocheva, Y. Radkova, Z. Marinova, V. Rurik, I. Ungvari, T. Jancsó, Z. Nánási, A. Kolozsvári, L. Martinez, R. Tong, M. Joutsenniemi, K. Wendel-Mitoraj, K.
- Abstract
Background: The study aimed to investigate the effectiveness of the European Feel4Diabetes intervention, promoting a healthy lifestyle, on physical activity and its correlates among families at risk for type 2 diabetes mellitus (based on the Finnish Diabetes Risk Score) in Belgium. Methods: The Feel4Diabetes intervention involved three components: family, school and community component, with the family component consisting of 6 counseling sessions for families at risk. Main outcomes were objectively measured physical activity levels and its subjectively measured correlates. The final sample consisted of 454 parents (mean age 39.4 years; 72.0% women) and 444 children (mean age 8.0 years; 50.1% girls). Multilevel repeated measures analyses were performed to assess intervention effectiveness after 1 year. Results: In parents, there was no significant intervention effect. In children, there were only significant negative effects for moderate to vigorous physical activity (p = 0.05; ηp2 = 0.008) and steps (p = 0.03; ηp2 = 0.006%) on weekdays, with physical activity decreasing (more) in the intervention group. Conclusions: The F4D-intervention lacks effectiveness on high-risk families' physical activity and its correlates in Belgium. This could partially be explained by low attendance rates and a large drop-out. To reach vulnerable populations, future interventions should invest in more appropriate recruitment (e.g. more face-to-face contact) and more bottom-up development of the intervention (i.e. co-creation of the intervention with the target group). Trial registration: The Feel4Diabetes-study was prospectively registered at clinicaltrials.gov as NCT02393872 on 20 March 2015. © 2020 The Author(s).
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- 2020
25. Effective strategies for childhood obesity prevention via school based, family involved interventions: A critical review for the development of the Feel4Diabetes-study school based component
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Lambrinou, C.-P. Androutsos, O. Karaglani, E. Cardon, G. Huys, N. Wikström, K. Kivelä, J. Ko, W. Karuranga, E. Tsochev, K. Iotova, V. Dimova, R. De Miguel-Etayo, P. M. González-Gil, E. Tamás, H. Jancsó, Z. Liatis, S. Makrilakis, K. Manios, Y. Cardon, G. Lindström, J. Schwarz, P. Makrilakis, K. Annemans, L. Garamendi, I. Karatzi, K. Androutsos, O. Moschonis, G. Kanellakis, S. Mavrogianni, C. Tsoutsoulopoulou, K. Katsarou, C. Karaglani, E. Qira, I. Skoufas, E. Maragkopoulou, K. Tsiafitsa, A. Sotiropoulou, I. Tsolakos, M. Argyri, E. Nikolaou, M. Vampouli, E.-A. Filippou, C. Apergi, K. Filippou, A. Katerina, G. Dimitriadis, E. Lindström, J. Laatikainen, T. Wikström, K. Hovi, P. Kivelä, J. Valve, P. Levälahti, E. Virtanen, E. Cardon, G. Van Stappen, V. Huys, N. Annemans, L. Willems, R. Shadid, S. Schwarz, P. Timpel, P. Makrilakis, K. Liatis, S. Dafoulas, G. Lambrinou, C.-P. Giannopoulou, A. Rabemananjara, L. De Sabata, M.S. Ko, W. Garamendi, I. Moreno, L. Civeira, F. Bueno, G. De Miguel-Etayo, P. Gonzalez-Gil, E.Mª. Miguel-Berges, M.L. Giménez-Legarre, N. Flores-Barrantes, P. Ayala-Marín, A.M. Seral-Cortés, M. Baila-Rueda, L. Cenarro, A. Jarauta, E. Mateo-Gallego, R. Iotova, V. Tankova, T. Usheva, N. Tsochev, K. Chakarova, N. Galcheva, S. Dimova, R. Bocheva, Y. Radkova, Z. Marinova, V. Bazdarska, Y. Stefanova, T. Rurik, I. Ungvari, T. Jancsó, Z. Nánási, A. Kolozsvári, L. Semánova, C. Bíró, É. Antal, E. Radó, S. Martinez, R. Tong, M.
- Abstract
Background: Although there are many interventions targeting childhood obesity prevention, only few have demonstrated positive results. The current review aimed to gather and evaluate available school-based intervention studies with family involvement targeting dietary, physical activity and sedentary behaviors among primary schoolchildren and their families, in order to identify the most effective strategies. Methods: Studies published between 2000 and January 2015 were retrieved from scientific electronic databases and grey literature. The databases used included MEDLINE/PubMed, Web-of-Science, CINAHL and Scopus. Included studies had to be experimental controlled studies and had duration over 1 school year, had family involvement, combined PA and dietary behaviors and were implemented in school setting. A complementary search was executed to update the review to cover the period from February 2015 to January 2019. Results: From the studies examined (n = 425), 27 intervention programs (33 publications) fulfilled the inclusion criteria. Among these, 15 presented significant effect on weight status and/ or overweight/ obesity or clinical indices, 3 presented significant effect on most energy balance-related behaviors (EBRBs) while 9 presented significant effect on some/few EBRBs or determinants. Strategies implemented in effective interventions were: teachers acting as role-models and being actively involved in the delivery of the intervention, school policies supporting the availability of healthy food and beverage choices and limiting unhealthy snacks, changes in the schoolyard, in the recess rules and in the physical education classes to increase physical activity, and involving parents in the intervention via assignments, meetings, informative material and encouraging them to improve the home environment. Use of incentives for children, social marketing techniques, collaboration with local stakeholders were found to increase effectiveness. Programs that focused only on educational sessions and material for parents, without promoting relevant environmental and policy changes, were found to be less effective. Cultural adaptations have been suggested to increase the intervention's acceptance in specific or vulnerable population groups. Conclusions: Several effective strategies were identified in the reviewed programs. Outcomes of the current review were taken into account in developing the Feel4Diabetes-intervention and summed up as recommendations in the current work in order to facilitate other researchers designing similar childhood obesity prevention initiatives. © 2020 The Author(s).
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- 2020
26. Substituting prolonged sedentary time and cardiovascular risk in children and youth: a meta-analysis within the International Children's Accelerometry database (ICAD)
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Wijndaele, Katrien, White, Thomas, Andersen, Lars Bo, Bugge, Anna, Kolle, Elin, Northstone, Kate, Wedderkopp, Niels, Ried-Larsen, Mathias, Kriemler, Susi, Page, Angie S., Puder, Jardena J., Reilly, John J., Sardinha, Luis B., van Sluijs, Esther M. F., Sharp, Stephen J., Brage, Søren, Ekelund, Ulf, Andersen, L. B., Atkin, A. J., Cardon, G., Davey, R., Ekelund, U., Esliger, D. W., Hallal, P., Hansen, B. H., Janz, K. F., Kriemler, S., Møller, N., Northstone, K., Page, A., Pate, R., Puder, J. J., Reilly, J. J., Salmon, J., Sardinha, L. B., Sherar, L. B., Timperio, A., van Sluijs, E. M. F., International Children's Accelerometry Database (ICAD) Collaborators, Andersen, L.B., Anderssen, S., Atkin, A.J., Cardon, G., Davey, R., Ekelund, U., Esliger, D.W., Hallal, P., Hansen, B.H., Janz, K.F., Kriemler, S., Møller, N., Northstone, K., Page, A., Pate, R., Puder, J.J., Reilly, J.J., Salmon, J., Sardinha, L.B., Sherar, L.B., Timperio, A., van Sluijs, EMF, Wijndaele, Katrien [0000-0003-2199-7981], and Apollo - University of Cambridge Repository
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Iso-temporal ,Waist ,Adolescent ,RJ101 ,ICAD ,Accelerometry ,Blood Pressure/physiology ,Cardiovascular Diseases/epidemiology ,Child ,Child, Preschool ,Cholesterol, HDL/blood ,Cross-Sectional Studies ,Exercise/physiology ,Humans ,Risk Factors ,Sedentary Behavior ,Waist Circumference/physiology ,ALSPAC ,Cardio-metabolic ,Physical activity ,Prolonged sitting ,Medicine (miscellaneous) ,Physical Therapy, Sports Therapy and Rehabilitation ,Blood Pressure ,Clinical nutrition ,computer.software_genre ,Sitting ,03 medical and health sciences ,0302 clinical medicine ,Linear regression ,Medicine ,030212 general & internal medicine ,lcsh:RC620-627 ,Exercise ,Nutrition and Dietetics ,Database ,business.industry ,Research ,lcsh:Public aspects of medicine ,Cholesterol, HDL ,lcsh:RA1-1270 ,030229 sport sciences ,3. Good health ,lcsh:Nutritional diseases. Deficiency diseases ,Blood pressure ,Cardiovascular Diseases ,Meta-analysis ,Waist Circumference ,business ,computer - Abstract
Background Evidence on the association between sitting for extended periods (i.e. prolonged sedentary time (PST)) and cardio-metabolic health is inconsistent in children. We aimed to estimate the differences in cardio-metabolic health associated with substituting PST with non-prolonged sedentary time (non-PST), light (LIPA) or moderate-to-vigorous physical activity (MVPA) in children. Methods Cross-sectional data from 14 studies (7 countries) in the International Children’s Accelerometry Database (ICAD, 1998–2009) was included. Accelerometry in 19,502 participants aged 3–18 years, together with covariate and outcome data, was pooled and harmonized. Iso-temporal substitution in linear regression models provided beta coefficients (95%CI) for substitution of 1 h/day PST (sedentary time accumulated in bouts > 15 min) with non-PST, LIPA or MVPA, for each study, which were meta-analysed. Results Modelling substitution of 1 h/day of PST with non-PST suggested reductions in standardized BMI, but estimates were > 7-fold greater for substitution with MVPA (− 0.44 (− 0.62; − 0.26) SD units). Only reallocation by MVPA was beneficial for waist circumference (− 3.07 (− 4.47; − 1.68) cm), systolic blood pressure (− 1.53 (− 2.42; − 0.65) mmHg) and clustered cardio-metabolic risk (− 0.18 (− 0.3; − 0.1) SD units). For HDL-cholesterol and diastolic blood pressure, substitution with LIPA was beneficial; however, substitution with MVPA showed 5-fold stronger effect estimates (HDL-cholesterol: 0.05 (0.01; 0.10) mmol/l); diastolic blood pressure: − 0.81 (− 1.38; − 0.24) mmHg). Conclusions Replacement of PST with MVPA may be the preferred scenario for behaviour change, given beneficial associations with a wide range of cardio-metabolic risk factors (including adiposity, HDL-cholesterol, blood pressure and clustered cardio-metabolic risk). Effect estimates are clinically relevant (e.g. an estimated reduction in waist circumference of ≈1.5 cm for 30 min/day replacement). Replacement with LIPA could be beneficial for some of these risk factors, however with substantially lower effect estimates.
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- 2019
27. Children’s moderate-to-vigorous physical activity on weekdays versus weekend days: a multi-country analysis
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Brazendale, Keith, Beets, Michael W., Armstrong, Bridget, Weaver, R. Glenn, Hunt, Ethan T., Pate, Russell R., Brusseau, Timothy A., Bohnert, Amy M., Olds, Timothy, Tassitano, Rafael M., Tenorio, Maria Cecilia M., Garcia, Jeanette, Andersen, Lars B., Davey, Rachel, Hallal, Pedro C., Jago, Russell, Kolle, Elin, Kriemler, Susi, Kristensen, Peter L., Kwon, Soyang, Puder, Jardena J., Salmon, Jo, Sardinha, Luis B., Van Sluijs, Esther M. F., Anderssen, S., Cardon, G., Davey, R., Hallal, P., Janz, K. F., Kriemler, S., Møller, N., Northstone, K., Page, A., Pate, R., Puder, J. J., Reilly, J., Salmon, J., Sardinha, L. B., Van Sluijs, E. M. F., Brazendale, Keith [0000-0001-9233-1621], and Apollo - University of Cambridge Repository
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Accelerometer ,Physical activity ,Weekday ,Research ,Weekend ,education ,Structure ,human activities ,Children - Abstract
Purpose: The Structured Days Hypothesis (SDH) posits that children’s behaviors associated with obesity – such as physical activity – are more favorable on days that contain more ‘structure’ (i.e., a pre-planned, segmented, and adult-supervised environment) such as school weekdays, compared to days with less structure, such as weekend days. The purpose of this study was to compare children’s moderate-to-vigorous physical activity (MVPA) levels on weekdays versus weekend days using a large, multi-country, accelerometer-measured physical activity dataset. Methods: Data were received from the International Children’s Accelerometer Database (ICAD) July 2019. The ICAD inclusion criteria for a valid day of wear, only non-intervention data (e.g., baseline intervention data), children with at least 1 weekday and 1 weekend day, and ICAD studies with data collected exclusively during school months, were included for analyses. Mixed effects models accounting for the nested nature of the data (i.e., days within children) assessed MVPA minutes per day (min/day MVPA) differences between weekdays and weekend days by region/country, adjusted for age, sex, and total wear time. Separate meta-analytical models explored differences by age and country/region for sex and child weight-status. Results/findings: Valid data from 15 studies representing 5794 children (61% female, 10.7 ± 2.1 yrs., 24% with overweight/obesity) and 35,263 days of valid accelerometer data from 5 distinct countries/regions were used. Boys and girls accumulated 12.6 min/day (95% CI: 9.0, 16.2) and 9.4 min/day (95% CI: 7.2, 11.6) more MVPA on weekdays versus weekend days, respectively. Children from mainland Europe had the largest differences (17.1 min/day more MVPA on weekdays versus weekend days, 95% CI: 15.3, 19.0) compared to the other countries/regions. Children who were classified as overweight/obese or normal weight/underweight accumulated 9.5 min/day (95% CI: 6.9, 12.2) and 10.9 min/day (95% CI: 8.3, 13.5) of additional MVPA on weekdays versus weekend days, respectively. Conclusions: Children from multiple countries/regions accumulated significantly more MVPA on weekdays versus weekend days during school months. This finding aligns with the SDH and warrants future intervention studies to prioritize less-structured days, such as weekend days, and to consider providing opportunities for all children to access additional opportunities to be active.
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- 2021
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28. Step Count Associations between Adults at Risk of Developing Diabetes and Their Children: The Feel4Diabetes Study
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Flores-Barrantes, P. Cardon, G. Iglesia, I. Moreno, L.A. Androutsos, O. Manios, Y. Kivelä, J. Lindström, J. De Craemer, M. Schwarz, P. Makrilakis, K. Annemans, L. Ko, W. Karatzi, K. Moschonis, G. Kanellakis, S. Mavrogianni, C. Tsoutsoulopoulou, K. Katsarou, C. Karaglani, E. Qira, I. Skoufas, E. Maragkopoulou, K. Tsiafitsa, A. Sotiropoulou, I. Tsolakos, M. Argyri, E. Nikolaou, M. Vampouli, E.-A. Filippou, C. Apergi, K. Filippou, A. Katerina, G. Dimitriadis, E. Laatikainen, T. Wikström, K. Valve, P. Levälahti, E. Virtanen, E. Pennanen, T. Olli, S. Nelimarkka, K. Van Stappen, V. Huys, N. Willems, R. Shadid, S. Timpel, P. Liatis, S. Dafoulas, G. Lambrinou, C.-P. Giannopoulou, A. Karuranga, E. Civeira, F. Bueno, G. De Miguel-Etayo, P. González-Gil, E.M. Miguel-Berges, M.L. Giménez-Legarre, N. Ayala-Marín, A.M. Seral-Cortés, M. Baila-Rueda, L. Cenarro, A. Jarauta, E. Mateo-Gallego, R. Iotova, V. Tankova, T. Usheva, N. Tsochev, K. Chakarova, N. Galcheva, S. Dimova, R. Bocheva, Y. Radkova, Z. Marinova, V. Bazdarska, Y. Stefanova, T. Rurik, I. Ungvari, T. Jancsó, Z. Nánási, A. Kolozsvári, L. Semánova, C. Bíró, É. Antal, E. Radó, S. Martinez, R. Tong, M. Feel4Diabetes Study Group
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education - Abstract
Background: Shared risk factors of type 2 diabetes mellitus (T2DM) between parents at risk and their children, such as low physical activity levels, should be addressed to prevent the development of the disease. The aim of this study was to determine the association of objectively measured step counts per day between parents at risk of developing T2DM and their 6- to 10-year-old children. Methods: The baseline data from the Feel4Diabetes study were analyzed. Dyads of children and one parent (n = 250, 54.4% girls and 77.6% mothers) from Belgium were included. Step counts per day during 5 consecutive days from parents and their children were objectively measured with ActiGraph accelerometers. Results: Adjusted linear regression models indicated that parents’ and children’s step counts were significantly associated during all days (β = 0.245), weekdays (β = 0.205), and weekend days (β = 0.316) (P ≤ .002 in all cases). Specifically, mother–daughter associations during all days and weekend days and father–son step counts during weekdays and when considering all days were significant. Conclusion: There is a positive association between step counts from adults at risk of developing T2DM and their children, especially in the mother–daughter and father–son dyads. © 2021 Human Kinetics, Inc.
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- 2021
29. Longitudinal associations between food parenting practices and dietary intake in children: The feel4diabetes study
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Flores-Barrantes, P. Iglesia, I. Cardon, G. Willems, R. Schwarz, P. Timpel, P. Kivelä, J. Wikström, K. Iotova, V. Tankova, T. Usheva, N. Rurik, I. Antal, E. Liatis, S. Makrilakis, K. Karaglani, E. Manios, Y. Moreno, L.A. González-Gil, E.M. Feel4Diabetes-Study Group
- Abstract
Food parenting practices (FPPs) have an important role in shaping children’s dietary be-haviors. This study aimed to investigate cross-sectional and longitudinal associations over a two-year follow-up between FPP and dietary intake and compliance with current recommendations in 6-to 11-year-old European children. A total of 2967 parent-child dyads from the Feel4Diabetes study, a randomized controlled trial of a school and community-based intervention, (50.4% girls and 93.5% mothers) were included. FPPs assessed were: (1) home food availability; (2) parental role modeling of fruit intake; (3) permissiveness; (4) using food as a reward. Children’s dietary intake was assessed through a parent-reported food frequency questionnaire. In regression analyses, the strongest cross-sectional associations were observed between home availability of 100% fruit juice and corresponding intake (β = 0.492 in girls and β = 0.506 in boys, p < 0.001), and between parental role modeling of fruit intake and children’s fruit intake (β = 0.431 in girls and β = 0.448 in boys, p < 0.001). In multilevel logistic regression models, results indicated that improvements in positive FPPs over time were mainly associated with higher odds of compliance with healthy food recommenda-tions, whereas a decrease in negative FPP over time was associated with higher odds of complying with energy-dense/nutrient-poor food recommendations. Improving FPPs could be an effective way to improve children’s dietary intake. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.
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- 2021
30. Substituting prolonged sedentary time and cardiovascular risk in children and youth: a meta-analysis within the International Children’s Accelerometry database (ICAD)
- Author
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Wijndaele, Katrien, White, Thomas, Andersen, Lars Bo, Bugge, Anna, Kolle, Elin, Northstone, Kate, Wedderkopp, Niels, Ried-Larsen, Mathias, Kriemler, Susi, Page, Angie S., Puder, Jardena J., Reilly, John J., Sardinha, Luis B., Van Sluijs, Esther M. F., Sharp, Stephen J., Brage, Søren, Ekelund, Ulf, Andersen, L. B., Anderssen, S., Atkin, A. J., Cardon, G., Davey, R., Ekelund, U., Esliger, D. W., Hallal, P., Hansen, B. H., Janz, K. F., Kriemler, S., Møller, N., Northstone, K., Page, A., Pate, R., Puder, J. J., Reilly, J. J., Salmon, J., Sardinha, L. B., Sherar, L. B., Timperio, A., Van Sluijs, E. M. F., Wijndaele, Katrien [0000-0003-2199-7981], and Apollo - University of Cambridge Repository
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Iso-temporal ,ICAD ,Cardio-metabolic ,Physical activity ,Research ,Prolonged sitting ,ALSPAC - Abstract
Background: Evidence on the association between sitting for extended periods (i.e. prolonged sedentary time (PST)) and cardio-metabolic health is inconsistent in children. We aimed to estimate the differences in cardio-metabolic health associated with substituting PST with non-prolonged sedentary time (non-PST), light (LIPA) or moderate-to-vigorous physical activity (MVPA) in children. Methods: Cross-sectional data from 14 studies (7 countries) in the International Children’s Accelerometry Database (ICAD, 1998–2009) was included. Accelerometry in 19,502 participants aged 3–18 years, together with covariate and outcome data, was pooled and harmonized. Iso-temporal substitution in linear regression models provided beta coefficients (95%CI) for substitution of 1 h/day PST (sedentary time accumulated in bouts > 15 min) with non-PST, LIPA or MVPA, for each study, which were meta-analysed. Results: Modelling substitution of 1 h/day of PST with non-PST suggested reductions in standardized BMI, but estimates were > 7-fold greater for substitution with MVPA (− 0.44 (− 0.62; − 0.26) SD units). Only reallocation by MVPA was beneficial for waist circumference (− 3.07 (− 4.47; − 1.68) cm), systolic blood pressure (− 1.53 (− 2.42; − 0.65) mmHg) and clustered cardio-metabolic risk (− 0.18 (− 0.3; − 0.1) SD units). For HDL-cholesterol and diastolic blood pressure, substitution with LIPA was beneficial; however, substitution with MVPA showed 5-fold stronger effect estimates (HDL-cholesterol: 0.05 (0.01; 0.10) mmol/l); diastolic blood pressure: − 0.81 (− 1.38; − 0.24) mmHg). Conclusions: Replacement of PST with MVPA may be the preferred scenario for behaviour change, given beneficial associations with a wide range of cardio-metabolic risk factors (including adiposity, HDL-cholesterol, blood pressure and clustered cardio-metabolic risk). Effect estimates are clinically relevant (e.g. an estimated reduction in waist circumference of ≈1.5 cm for 30 min/day replacement). Replacement with LIPA could be beneficial for some of these risk factors, however with substantially lower effect estimates.
- Published
- 2020
- Full Text
- View/download PDF
31. Establishing a method to estimate the cost-effectiveness of a kindergarten-based, family-involved intervention to prevent obesity in early childhood. The ToyBox-study
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Pil, L., Putman, K., Cardon, G., De Bourdeaudhuij, I., Manios, Y., Androutsos, O., Lateva, M., Iotova, V., Zych, K., Góźdź, M., González-Gil, E. M., De Miguel-Etayo, P., Geyer, C., Birnbaum, J., and Annemans, L.
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- 2014
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32. Reliability of anthropometric measurements in European preschool children: the ToyBox-study
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De Miguel-Etayo, P., Mesana, M. I., Cardon, G., De Bourdeaudhuij, I., Góźdź, M., Socha, P., Lateva, M., Iotova, V., Koletzko, B. V., Duvinage, K., Androutsos, O., Manios, Y., and Moreno, L. A.
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- 2014
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33. Tools, harmonization and standardization procedures of the impact and outcome evaluation indices obtained during a kindergarten-based, family-involved intervention to prevent obesity in early childhood: the ToyBox-study
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Mouratidou, T., Miguel, M. L., Androutsos, O., Manios, Y., De Bourdeaudhuij, I., Cardon, G., Kulaga, Z., Socha, P., Galcheva, S., Iotova, V., Payr, A., Koletzko, B., and Moreno, L. A.
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- 2014
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34. Reliability of primary caregivers reports on lifestyle behaviours of European pre-school children: the ToyBox-study
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González-Gil, E. M., Mouratidou, T., Cardon, G., Androutsos, O., De Bourdeaudhuij, I., Góźdź, M., Usheva, N., Birnbaum, J., Manios, Y., and Moreno, L. A.
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- 2014
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35. Applying the Intervention Mapping protocol to develop a kindergarten-based, family-involved intervention to increase European preschool childrenʼs physical activity levels: the ToyBox-study
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De Craemer, M., De Decker, E., De Bourdeaudhuij, I., Verloigne, M., Duvinage, K., Koletzko, B., Ibrügger, S., Kreichauf, S., Grammatikaki, E., Moreno, L., Iotova, V., Socha, P., Szott, K., Manios, Y., and Cardon, G.
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- 2014
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36. Sports injuries in physical education teacher education students
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Goossens, L., Verrelst, R., Cardon, G., and De Clercq, D.
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- 2014
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37. Cross-sectional and longitudinal associations of active travel, organised sport and physical education with accelerometer-assessed moderate-to-vigorous physical activity in young people: the International Children's Accelerometry Database.
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Ikeda, Erika, Guagliano, Justin M., Atkin, Andrew J., Sherar, Lauren B., Ekelund, Ulf, Hansen, Bjørge, Northstone, Kate, van Sluijs, Esther, On behalf of the International Children's Accelerometry Database (ICAD) Collaborators, Salmon, Jo, Riddoch, Chris, Judge, Ken, Cooper, Ashley, Griew, Pippa, Andersen, L. B., Anderssen, S., Cardon, G., Davey, R., Hallal, P., and Jago, R.
- Subjects
RELATIVE medical risk ,ANALYSIS of variance ,CONFIDENCE intervals ,TIME ,CROSS-sectional method ,SELF-evaluation ,AGE distribution ,ACCELEROMETERS ,REGRESSION analysis ,HEALTH outcome assessment ,PHYSICAL activity ,SEX distribution ,COMPARATIVE studies ,DESCRIPTIVE statistics ,DATA analysis software ,PHYSICAL education ,LONGITUDINAL method ,ADOLESCENCE - Abstract
Background: Physical activity (PA) declines during childhood. Important sources of PA are active travel, organised sport and physical education (PE), but it is unclear how these domain-specific PA sources contribute to (changes in) daily moderate-to-vigorous PA (MVPA) in young people. This study aimed to examine (1) the cross-sectional association between domain-specific physical activity (i.e., active travel, organised sport and PE) and daily minutes in accelerometer-assessed MVPA; and (2) the longitudinal association between domain-specific physical activity at baseline and change in daily minutes in MVPA. Methods: Participants (baseline age 11.3 ±.1.2 years) were drawn from three studies in the International Children's Accelerometry Database. The contribution of self-reported standardised active travel, organised sport and PE to accelerometer-measured daily minutes in MVPA was examined using linear regression. In cross-sectional analyses, MVPA was regressed on each PA domain in separate models, adjusted for study, age, sex, maternal education, season, and monitor wear time. In longitudinal analyses, change in MVPA was regressed on each of the baseline PA domains, additionally adjusting for changes in season and wear time, follow-up duration, and baseline MVPA. R-squared was used to compare variance explained by each PA domain. Results: In the cross-sectional analyses (n = 3871), organised sport (standardised β = 3.81, 95% confidence interval [95%CI] = 3.06, 4.56) and active travel (β = 3.46, 95%CI = 2.73, 4.19) contributed more to daily MVPA than PE (β = 0.82, 95%CI = -0.02, 1.66). Compared to the base model which included only covariates (R
2 = 21.5%), organised sport (absolute change: + 1.9%) and active travel (+ 1.7%) models explained more of the variance than the PE model (± < 0.1%). Associations followed a similar pattern in the longitudinal analyses (n = 2302), but none of the PA domains predicted change in MVPA (organised sport: standardised β = 0.85, 95%CI = -0.03, 1.72; active travel: β = 0.68, 95%CI = -0.14, 1.50; PE: β = 0.02, 95%CI = -0.87, 0.91). Conclusions: A multi-sectoral approach covering a wide range of PA domains should be promoted to minimise the age-related decline in MVPA during childhood. [ABSTRACT FROM AUTHOR]- Published
- 2022
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- View/download PDF
38. The contribution of psychosocial and home environmental factors in explaining eating behaviours in adolescents
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Haerens, L, Craeynest, M, Deforche, B, Maes, L, Cardon, G, and De Bourdeaudhuij, I
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- 2008
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39. Lifestyle changes observed among adults participating in a family-and community-based intervention for diabetes prevention in Europe: The 1st year results of the feel4diabetes-study
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Manios, Y., Lambrinou, C.P., Mavrogianni, C., Cardon, G., Lindström, J., Iotova, V., Tankova, T., Rurik, I., Van Stappen, V., Kivelä, J., Mateo-Gallego, R., Moreno, L.A., Makrilakis, K., Androutsos, O., and Feel4Diabetes-study, group
- Abstract
The Feel4Diabetes intervention was a school and community-based intervention aiming to promote healthy lifestyle and tackle obesity and obesity-related metabolic risk factors for the prevention of type 2 diabetes (T2D) among families at risk of developing this disease. The current study aims to present the results on lifestyle behaviors obtained from parents during the first year of the Feel4Diabetes intervention. This multicomponent intervention had a cluster randomized design and was implemented in Belgium, Bulgaria, Finland, Greece, Hungary and Spain over two years (2016–2018). Standardized protocols and procedures were used by the participating centers in all countries to collect data on parents’ lifestyle behaviors (diet, physical activity, sedentary behavior). The Feel4Diabetes intervention was registered at clinicaltrials.gov (registration number: NCT02393872). In total, 2110 high-risk parents participated in the baseline and 12-month follow-up examination measurements. Participants allocated to the intervention group reduced their daily consumption of sugary drinks (p = 0.037) and sweets (p = 0.031) and their daily screen time (p = 0.032), compared with the control group. In addition, participants in the intervention group in Greece and Spain increased their consumption of breakfast (p = 0.034) and fruits (p = 0.029), while in Belgium and Finland they increased their water intake (p = 0.024). These findings indicate that.
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- 2020
40. Obtaining evidence base for the development of Feel4Diabetes intervention to prevent type 2 diabetes- A narrative literature review
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Kivelä, J., Wikström, K., Virtanen, E., Georgoulis, M., Cardon, G., Civeira, F., Iotova, V., Karuranga, E., Ko, W., Liatis, S., Makrilakis, K., Manios, Y., Mateo-Gallego, R., Nanasi, A., Rurik, I., Tankova, T., Tsochev, K., Van Stappen, V., and Lindström, J.
- Abstract
Background: Feel4Diabetes was a school and community based intervention aiming to promote healthy lifestyle and tackle obesity for the prevention of type 2 diabetes among families in 6 European countries. We conducted this literature review in order to guide the development of evidence-based implementation of the Feel4Diabetes intervention. We focused on type 2 diabetes prevention strategies, including all the phases from risk identification to implementation and maintenance. Special focus was given to prevention among vulnerable groups and people under 45 years. Methods: Scientific and grey literature published between January 2000 and January 2015 was searched for relevant studies using electronic databases. To present the literature review findings in a systematic way, we used the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. A complementary literature search from February 2015 to December 2018 was also conducted. Results: The initial review included 27 studies with a follow-up =12 months and 9 studies with a follow-up =6 months and with a participant mean age < 45 years. We found out that interventions should be targeted at people at risk to improve recruiting and intervention effectiveness. Screening questionnaires (primarily Finnish Diabetes Risk Score FINDRISC) and blood glucose measurement can both be used for screening; the method does not appear to affect intervention effectiveness. Screening and recruitment is time-consuming, especially when targeting lower socioeconomic status and age under 45 years. The intervention intensity is more important for effectiveness than the mode of delivery. Moderate changes in several lifestyle habits lead to good intervention results. A minimum of 3-year follow-up seemed to be required to show a reduction in diabetes risk in high-risk individuals. In participants < 45 years, the achieved results in outcomes were less pronounced. The complementary review included 12 studies, with similar results regarding intervention targets and delivery modes, as well as clinical significance. Conclusion: This narrative review highlighted several important aspects that subsequently guided the development of the Feel4Diabetes high-risk intervention. Research on diabetes prevention interventions targeted at younger adults or vulnerable population groups is still relatively scarce. Feel4Diabetes is a good example of a project aiming to fill this research gap.
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- 2020
41. Variations in accelerometry measured physical activity and sedentary time across Europe - harmonized analyses of 47,497 children and adolescents
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Steene-Johannessen, Jostein, Hansen, Bjørge Herman, Dalene, Knut Eirik, Kolle, Elin, Northstone, Kate, Møller, Niels Christian, Grøntved, Anders, Wedderkopp, Niels, Kriemler, Susi, Page, Angie S., Puder, Jardena J., Reilly, John J., Sardinha, Luis B., Van Sluijs, Esther M. F., Andersen, Lars Bo, Van Der Ploeg, Hidde, Ahrens, Wolfgang, Flexeder, Claudia, Standl, Marie, Shculz, Holger, Moreno, Luis A., De Henauw, Stefaan, Michels, Nathalie, Cardon, Greet, Ortega, Francisco B., Ruiz, Jonatan, Aznar, Susana, Fogelholm, Mikael, Decelis, Andrew, Olesen, Line Grønholt, Hjorth, Mads Fiil, Santos, Rute, Vale, Susana, Christiansen, Lars Breum, Jago, Russ, Basterfield, Laura, Owen, Christopher G., Nightingale, Claire M., Eiben, Gabriele, Polito, Angela, Lauria, Fabio, Vanhelst, Jeremy, Hadjigeorgiou, Charalambos, Konstabel, Kenn, Molnár, Dénes, Sprengeler, Ole, Manios, Yannis, Harro, Jaanus, Kafatos, Anthony, Anderssen, Sigmund Alfred, Ekelund, Ulf, Andersen, L. B., Anderssen, S., Atkin, A. J., Cardon, G., Davey, R., Ekelund, U., Esliger, D. W., Hallal, P., Hansen, B. H., Janz, K. F., Kriemler, S., Møller, N., Northstone, K., Pate, R., Puder, J. J., Reilly, J., Salmon, J., Sardinha, L. B., Sherar, L. B., Van Sluijs, E. M. F., Steene-Johannessen, Jostein [0000-0002-3710-9021], Apollo - University of Cambridge Repository, Université de Lille, LillOA, Norwegian School of Sport Sciences = Norges idrettshøgskole [Oslo] (NIH), University Hospitals Bristol, University of Southern Denmark (SDU), Universität Zürich [Zürich] = University of Zurich (UZH), University of Bristol [Bristol], Centre Hospitalier Universitaire Vaudois [Lausanne] (CHUV), University of Strathclyde [Glasgow], Universidade de Lisboa = University of Lisbon (ULISBOA), University of Cambridge [UK] (CAM), Western Norway University of Applied Sciences, VU University Medical Center [Amsterdam], Leibniz Institute for Prevention Research and Epidemiology - BIPS, Leibniz Association, Helmholtz Zentrum München = German Research Center for Environmental Health, German Research Center for Environmental Health - Helmholtz Center München (GmbH), University of Zaragoza - Universidad de Zaragoza [Zaragoza], Universiteit Gent = Ghent University (UGENT), Universidad de Granada = University of Granada (UGR), Universidad de Castilla-La Mancha = University of Castilla-La Mancha (UCLM), Helsingin yliopisto = Helsingfors universitet = University of Helsinki, University of Malta [Malta], University of Copenhagen = Københavns Universitet (UCPH), Universidade Católica Portuguesa [Porto], Polytechnic Institute of Porto, Newcastle University [Newcastle], University of London [London], St George's, University of London, University of Skövde [Sweden], Consiglio per la Ricerca in Agricoltura e l’analisi dell’economia agraria = Council for Agricultural Research and Economics (CREA), Institute of Sciences of Food Production (ISPA), Consiglio Nazionale delle Ricerche (CNR), Lille Inflammation Research International Center - U 995 (LIRIC), Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), University of Cyprus [Nicosia] (UCY), Tallinn University, University of Pecs, Harokopio University of Athens, University of Tartu, University of Crete [Heraklion] (UOC), National Research Council of Italy | Consiglio Nazionale delle Ricerche (CNR), Universidade de Lisboa (ULISBOA), Helmholtz-Zentrum München (HZM), Universiteit Gent = Ghent University [Belgium] (UGENT), Universidad de Granada (UGR), Universidad de Castilla-La Mancha (UCLM), University of Helsinki, University of Copenhagen = Københavns Universitet (KU), Consiglio per la Ricerca in Agricoltura e l’analisi dell’economia agraria (CREA), University of Cyprus [Nicosia], Université de Lille, Inserm, CHU Lille, Norwegian School of Sport Sciences = Norges idrettshøgskole [Oslo] [NIH], University of Southern Denmark [SDU], Centre Hospitalier Universitaire Vaudois [Lausanne] [CHUV], Universidade de Lisboa = University of Lisbon [ULISBOA], University of Cambridge [UK] [CAM], Universiteit Gent = Ghent University [UGENT], Universidad de Granada = University of Granada [UGR], Universidad de Castilla-La Mancha = University of Castilla-La Mancha [UCLM], University of Copenhagen = Københavns Universitet [UCPH], Consiglio per la Ricerca in Agricoltura e l’analisi dell’economia agraria = Council for Agricultural Research and Economics [CREA], Institute of Sciences of Food Production [ISPA], Lille Inflammation Research International Center - U 995 [LIRIC], University of Cyprus [Nicosia] [UCY], University of Crete [Heraklion] [UOC], Department of Food and Nutrition, Nutrition Science, Repositório Científico do Instituto Politécnico do Porto, Public and occupational health, and APH - Health Behaviors & Chronic Diseases
- Subjects
Male ,DANISH CHILDREN ,RECOMMENDED LEVELS ,FITNESS ,Physical Therapy ,[SDV]Life Sciences [q-bio] ,Medicine (miscellaneous) ,Acceleometry ,RA773 ,Motor activity ,0302 clinical medicine ,Accelerometry ,Medicine and Health Sciences ,Faculty of Science ,Medicine ,adolescents ,030212 general & internal medicine ,Child ,lcsh:RC620-627 ,National data ,CALIBRATION ,Nutrition and Dietetics ,lcsh:Public aspects of medicine ,Public Health, Global Health, Social Medicine and Epidemiology ,Accelerometry measured ,[SDV] Life Sciences [q-bio] ,Europe ,lcsh:Nutritional diseases. Deficiency diseases ,Child, Preschool ,Female ,3143 Nutrition ,BEHAVIOR ,Adolescent ,sedentary time ,PARTICIPATION ,Physical activity ,Behavioural sciences ,Physical Therapy, Sports Therapy and Rehabilitation ,Sports Therapy and Rehabilitation ,Clinical nutrition ,VALIDATION ,VDP::Samfunnsvitenskap: 200::Samfunnsvitenskapelige idrettsfag: 330::Aktivitetslære: 332 ,Wear time ,03 medical and health sciences ,children ,Humans ,Exercise physiology ,Physical activity & health ,Exercise ,Sedentary time ,business.industry ,Research ,lcsh:RA1-1270 ,030229 sport sciences ,BODY-MASS INDEX ,accelerometer ,Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi ,SCHOOL ,Commentary ,MODERATE ,SPS Exercise, Nutrition and Health Sciences ,Sedentary Behavior ,business ,Body mass index ,Demography - Abstract
Funder: Ministero delle Politiche Agricole Alimentari e Forestali; doi: http://dx.doi.org/10.13039/501100005401, Funder: ZonMw; doi: http://dx.doi.org/10.13039/501100001826, Funder: The Research Council of Norway, Division for Society and Health., Background: Levels of physical activity and variation in physical activity and sedentary time by place and person in European children and adolescents are largely unknown. The objective of the study was to assess the variations in objectively measured physical activity and sedentary time in children and adolescents across Europe. Methods: Six databases were systematically searched to identify pan-European and national data sets on physical activity and sedentary time assessed by the same accelerometer in children (2 to 9.9 years) and adolescents (≥10 to 18 years). We harmonized individual-level data by reprocessing hip-worn raw accelerometer data files from 30 different studies conducted between 1997 and 2014, representing 47,497 individuals (2–18 years) from 18 different European countries. Results: Overall, a maximum of 29% (95% CI: 25, 33) of children and 29% (95% CI: 25, 32) of adolescents were categorized as sufficiently physically active. We observed substantial country- and region-specific differences in physical activity and sedentary time, with lower physical activity levels and prevalence estimates in Southern European countries. Boys were more active and less sedentary in all age-categories. The onset of age-related lowering or leveling-off of physical activity and increase in sedentary time seems to become apparent at around 6 to 7 years of age. Conclusions: Two third of European children and adolescents are not sufficiently active. Our findings suggest substantial gender-, country- and region-specific differences in physical activity. These results should encourage policymakers, governments, and local and national stakeholders to take action to facilitate an increase in the physical activity levels of young people across Europe.
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- 2020
42. Obtaining evidence base for the development of Feel4Diabetes intervention to prevent type 2 diabetes- A narrative literature review
- Author
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Kivelä, J. Wikström, K. Virtanen, E. Georgoulis, M. Cardon, G. Civeira, F. Iotova, V. Karuranga, E. Ko, W. Liatis, S. Makrilakis, K. Manios, Y. Mateo-Gallego, R. Nanasi, A. Rurik, I. Tankova, T. Tsochev, K. Van Stappen, V. Lindström, J.
- Abstract
Background: Feel4Diabetes was a school and community based intervention aiming to promote healthy lifestyle and tackle obesity for the prevention of type 2 diabetes among families in 6 European countries. We conducted this literature review in order to guide the development of evidence-based implementation of the Feel4Diabetes intervention. We focused on type 2 diabetes prevention strategies, including all the phases from risk identification to implementation and maintenance. Special focus was given to prevention among vulnerable groups and people under 45 years. Methods: Scientific and grey literature published between January 2000 and January 2015 was searched for relevant studies using electronic databases. To present the literature review findings in a systematic way, we used the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. A complementary literature search from February 2015 to December 2018 was also conducted. Results: The initial review included 27 studies with a follow-up ≥12 months and 9 studies with a follow-up ≥6 months and with a participant mean age < 45 years. We found out that interventions should be targeted at people at risk to improve recruiting and intervention effectiveness. Screening questionnaires (primarily Finnish Diabetes Risk Score FINDRISC) and blood glucose measurement can both be used for screening; the method does not appear to affect intervention effectiveness. Screening and recruitment is time-consuming, especially when targeting lower socioeconomic status and age under 45 years. The intervention intensity is more important for effectiveness than the mode of delivery. Moderate changes in several lifestyle habits lead to good intervention results. A minimum of 3-year follow-up seemed to be required to show a reduction in diabetes risk in high-risk individuals. In participants < 45 years, the achieved results in outcomes were less pronounced. The complementary review included 12 studies, with similar results regarding intervention targets and delivery modes, as well as clinical significance. Conclusion: This narrative review highlighted several important aspects that subsequently guided the development of the Feel4Diabetes high-risk intervention. Research on diabetes prevention interventions targeted at younger adults or vulnerable population groups is still relatively scarce. Feel4Diabetes is a good example of a project aiming to fill this research gap. Trial registration: Clinicaltrials.gov NCT02393872, registered 20th March 2015. © 2020 The Author(s).
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- 2020
43. Development and validation of two self-reported tools for insulin resistance and hypertension risk assessment in a european cohort: The feel4diabetes-study
- Author
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Kanellakis, S., Mavrogianni, C., Karatzi, K., Lindstrom, J., Cardon, G., Iotova, V., Wikström, K., Shadid, S., Moreno, L.A., Tsochev, K., Bíró, É., Dimova, R., Antal, E., Liatis, S., Makrilakis, K., Manios, Y., and The Feel4Diabetes-study group
- Abstract
Early identification of type 2 diabetes mellitus (T2DM) and hypertension (HTN) risk may improve prevention and promote public health. Implementation of self-reported scores for risk assessment provides an alternative cost-effective tool. The study aimed to develop and validate two easy-to-apply screening tools identifying high-risk individuals for insulin resistance (IR) and HTN in a European cohort. Sociodemographic, lifestyle, anthropometric and clinical data obtained from 1581 and 1350 adults (baseline data from the Feel4Diabetes-study) were used for the European IR and the European HTN risk assessment index respectively. Body mass index, waist circumference, sex, age, breakfast consumption, alcohol, legumes and sugary drinks intake, physical activity and sedentary behavior were significantly correlated with Homeostatic Model Assessment of IR (HOMA-IR) and/or HTN and incorporated in the two models. For the IR index, the Area Under the Curve (AUC), sensitivity and specificity for identifying individuals above the 75th and 95th of HOMA-IR percentiles were 0.768 (95%CI: 0.721–0.815), 0.720 and 0.691 and 0.828 (95%CI: 0.766–0.890), 0.696 and 0.778 respectively. For the HTN index, the AUC, sensitivity and specificity were 0.778 (95%CI: 0.680–0.876), 0.667 and 0.797. The developed risk assessment tools are easy-to-apply, valid, and low-cost, identifying European adults at high risk for developing T2DM or having HTN.
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- 2020
44. Feel4Diabetes healthy diet score: Development and evaluation of clinical validity
- Author
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Virtanen, E., Kivelä, J., Wikström, K., Lambrinou, C.P., De Miguel-Etayo, P., Huys, N., Vraukó-Tóth, K., Moreno, L.A., Usheva, N., Chakarova, N., Rado, S.A., Iotova, V., Makrilakis, K., Cardon, G., Liatis, S., Manios, Y., Lindström, J., Schwarz, P., Annemans, L., Garamendi, I., Karatzi, K., Androutsos, O., Moschonis, G., Kanellakis, S., Mavrogianni, C., Tsoutsoulopoulou, K., Katsarou, C., Karaglani, E., Qira, I., Skoufas, E., Maragkopoulou, K., Tsiafitsa, A., Sotiropoulou, I., Tsolakos, M., Argyri, E., Nikolaou, M., Vampouli, E.A., Filippou, C., Apergi, K., Filippou, A., Katerina, G., Dimitriadis, E., Laatikainen, T., Valve, P., Levälahti, E., Pennanen, T., Olli, S., Nelimarkka, K., Van Stappen, V., Willems, R., Shadid, S., Timpel, P., Dafoulas, G., Giannopoulou, A., Rabemananjara, L., De Sabata, M.S., Ko, W., Moreno, L., Civeira, F., Bueno, G., Gonzalez-Gil, E.Mª., Miguel-Berges, M.L., Giménez-Legarre, N., Flores-Barrantes, P., Ayala-Marín, A.M., Seral-Cortés, M., Baila-Rueda, L., Cenarro, A., Jarauta, E., Mateo-Gallego, R., Tankova, T., Tsochev, K., Galcheva, S., Dimova, R., Bocheva, Y., Radkova, Z., Marinova, V., Bazdarska, Y., Stefanova, T., Rurik, I., Ungvari, T., Jancsó, Z., Nánási, A., Kolozsvári, L., Semánova, C., Bíró, É., Antal, E., Radó, S., Martinez, R., Tong, M., and Feel4Diabetes, research, group
- Abstract
Background: The aim of this paper is to present the development of the Feel4Diabetes Healthy Diet Score and to evaluate its clinical validity. Methods: Study population consisted of 3268 adults (63% women) from high diabetes risk families living in 6 European countries. Participants filled in questionnaires at baseline and after 1 year, reflecting the dietary goals of the Feel4Diabetes intervention. Based on these questions the Healthy Diet Score was constructed, consisting of the following components: breakfast, vegetables, fruit and berries, sugary drinks, whole-grain cereals, nuts and seeds, low-fat dairy products, oils and fats, red meat, sweet snacks, salty snacks, and family meals. Maximum score for each component was set based on its estimated relative importance regarding T2DM risk, higher score indicating better quality of diet. Clinical measurements included height, weight, waist circumference, heart rate, blood pressure, and fasting blood sampling, with analyses of glucose, total cholesterol, HDL-cholesterol, LDL-cholesterol, and triglycerides. Analysis of (co) variance was used to compare the Healthy Diet Score and its components between countries and sexes using baseline data, and to test differences in clinical characteristics between score categories, adjusted for age, sex and country. Pearson''s correlations were used to study the association between changes from baseline to year 1 in the Healthy Diet Score and clinical markers. To estimate reproducibility, Pearson''s correlations were studied between baseline and 1 year score, within the control group only. Results: The mean total score was 52.8 ± 12.8 among women and 46.6 ± 12.8 among men (p < 0.001). The total score and its components differed between countries. The change in the Healthy Diet Score was significantly correlated with changes in BMI, waist circumference, and total and LDL cholesterol. The Healthy Diet Score as well as its components at baseline were significantly correlated with the values at year 1, in the control group participants. Conclusion: The Feel4Diabetes Healthy Diet Score is a reproducible method to capture the dietary information collected with the Feel4Diabetes questionnaire and measure the level of and changes in the adherence to the dietary goals of the intervention. It gives a simple parameter that associates with clinical risk factors in a meaningful manner.
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- 2020
45. Two-stage, school and community-based population screening successfully identifies individuals and families at high-risk for type 2 diabetes: The Feel4Diabetes-study
- Author
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Manios, Y. Mavrogianni, C. Lambrinou, C.-P. Cardon, G. Lindström, J. Iotova, V. Tankova, T. Civeira, F. Kivelä, J. Jancsó, Z. Shadid, S. Tsochev, K. Mateo-Gallego, R. Radó, S. Dafoulas, G. Makrilakis, K. Androutsos, O.
- Abstract
Background: The implementation of population screening and early prevention strategies targeting individuals at high-risk for type 2 diabetes (T2D) seems to be a public health priority. The current work aimed to describe the screening procedure applied in the Feel4Diabetes-study and examine its effectiveness in identifying individuals and families at high risk, primarily for T2D and secondarily for hypertension, among vulnerable populations in low to middle-income countries (LMICs) and high-income countries (HICs) across Europe. Methods: A two-stage screening procedure, using primary schools as the entry-point to the community, was applied in low socioeconomic status (SES) regions in LMICs (Bulgaria-Hungary), HICs (Belgium-Finland) and HICs under austerity measures (Greece-Spain). During the first-stage screening via the school-setting, a total of 20,501 parents (mothers and/or fathers) of schoolchildren from 11,396 families completed the Finnish Diabetes Risk Score (FINDRISC) questionnaire, while their children underwent anthropometric measurements in the school setting. Parents from the identified "high-risk families" (n = 4484) were invited to participate in the second-stage screening, including the measurement of fasting plasma glucose (FPG) and blood pressure (BP). In total, 3153 parents participated in the second-stage screening (mean age 41.1 ± 5.6 years, 65.8% females). Results: Among parents who attended the second-stage screening, the prevalence of prediabetes (as defined by impaired fasting glucose; FPG 100-125 mg/dl) and T2D (FPG > 126 mg/dl) was 23.2 and 3.0% respectively, and it was found to be higher in the higher FINDRISC categories. The percentage of undiagnosed T2D among the participants identified with T2D was 53.5%. The prevalence of high normal BP (systolic BP 130-139 mmHg and/or diastolic BP 85-89 mmHg) and hypertension (systolic BP ≥ 140 mmHg and/or diastolic BP ≥ 90 mmHg) was 14 and 18.6% respectively, which was also higher in the higher FINDRISC categories. The percentage of cases not receiving antihypertensive treatment among the participants identified with hypertension was 80.3%. Conclusion: The findings of the current study indicate that the two-stage school and community-based screening procedure followed, effectively identified high-risk individuals and families in vulnerable populations across Europe. This approach could be potentially scalable and sustainable and support initiatives for the early prevention of T2D and hypertension. Trial registration: The Feel4Diabetes-intervention is registered at http://clinicaltrials.gov/(NCT02393872; date of trial registration: March 20, 2015). © 2020 The Author(s).
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- 2020
46. Socio-demographic characteristics and body weight perceptions of study participants benefitting most from the feel4diabetes program based on their anthropometric and glycaemic profile changes
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Moschonis, G. Karatzi, K. Apergi, K. Liatis, S. Kivelä, J. Wikström, K. Ayala-Marín, A.M. Mateo-Gallego, R. Tsochev, K. Chakarova, N. Antal, E. Rurik, I. Iotova, V. Cardon, G. Lindstrom, J. Moreno, L.A. Makrilakis, K. Manios, Y. Feel4Diabetes-Study Group
- Abstract
The Feel4Diabetes program was comprised of a community-based screening and a two-year intervention phase aiming to prevent type 2 diabetes (T2D) in families at risk for diabetes across Europe. The current work aimed to identify the socio-demographic characteristics and body weight perceptions of participants who benefitted the most, achieving at least a 5% reduction in body weight, waist circumference and glycaemic indices (fasting plasma glucose, insulin, glycosylated haemoglobin levels), over two-year period. Following a two-stage screening procedure, 2294 high-risk parents were randomly allocated to standard care or more intensive intervention. The participants who benefitted most were living in Southern (OR 2.39–3.67, p < 0.001) and Eastern Europe (OR 1.55–2.47, p < 0.05), received more intensive intervention (OR 1.53–1.90, p = 0.002) and were younger (
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- 2020
47. Effective strategies for childhood obesity prevention via school based, family involved interventions: a critical review for the development of the Feel4Diabetes-study school based component
- Author
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Lambrinou, C.P., Androutsos, O., Karaglani, E., Cardon, G., Huys, N., Wikström, K., Kivelä, J., Ko, W., Karuranga, E., Tsochev, K., Iotova, V., Dimova, R., De Miguel-Etayo, P., M González-Gil, E., Tamás, H., Jancsó, Z., Liatis, S., Makrilakis, K., Manios, Y., and Feel4Diabetes-study, group
- Abstract
BACKGROUND: Although there are many interventions targeting childhood obesity prevention, only few have demonstrated positive results. The current review aimed to gather and evaluate available school-based intervention studies with family involvement targeting dietary, physical activity and sedentary behaviors among primary schoolchildren and their families, in order to identify the most effective strategies. METHODS: Studies published between 2000 and January 2015 were retrieved from scientific electronic databases and grey literature. The databases used included MEDLINE/PubMed, Web-of-Science, CINAHL and Scopus. Included studies had to be experimental controlled studies and had duration over 1 school year, had family involvement, combined PA and dietary behaviors and were implemented in school setting. A complementary search was executed to update the review to cover the period from February 2015 to January 2019. RESULTS: From the studies examined (n¿=¿425), 27 intervention programs (33 publications) fulfilled the inclusion criteria. Among these, 15 presented significant effect on weight status and/ or overweight/ obesity or clinical indices, 3 presented significant effect on most energy balance-related behaviors (EBRBs) while 9 presented significant effect on some/few EBRBs or determinants. Strategies implemented in effective interventions were: teachers acting as role-models and being actively involved in the delivery of the intervention, school policies supporting the availability of healthy food and beverage choices and limiting unhealthy snacks, changes in the schoolyard, in the recess rules and in the physical education classes to increase physical activity, and involving parents in the intervention via assignments, meetings, informative material and encouraging them to improve the home environment. Use of incentives for children, social marketing techniques, collaboration with local stakeholders were found to increase effectiveness. Programs that focused only on educational sessions and material for parents, without promoting relevant environmental and policy changes, were found to be less effective. Cultural adaptations have been suggested to increase the intervention''s acceptance in specific or vulnerable population groups. CONCLUSIONS: Several effective strategies were identified in the reviewed programs. Outcomes of the current review were taken into account in developing the Feel4Diabetes-intervention and summed up as recommendations in the current work in order to facilitate other researchers designing similar childhood obesity prevention initiatives.
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- 2020
48. Lipidemic profile changes over a two-year intervention period: Who benefited most from the feel4diabetes program?
- Author
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Karatzi, K. Moschonis, G. Botsi, E. Liatis, S. Tsochev, K. De Miguel-Etayo, P. Kivelä, J. Wikström, K. Dimova, R. Antal, E. Lamiquiz-Moneo, I. Rurik, I. Cardon, G. Iotova, V. Makrilakis, K. Manios, Y. Feel4Diabetes-Study Group
- Abstract
Identification of participants’ characteristics who benefited most from large community-based intervention studies may guide future prevention initiatives in order to maximize their effectiveness. The current study aimed to examine the socio-demographic, anthropometric, and behavioral characteristics, as well as the health and eating perceptions of those who improved their lipidemic profile, in the Feel4Diabetes early screening and prevention program. In the present analyses, 1773 adults from families at high risk for developing type 2 diabetes mellitus (T2DM) were enrolled, receiving either the standard care or the more intensive intervention, and 33.3–55.2% of them improved one or more of their lipidemic indices by >5%. Women, people living in Southeastern Europe, coming from two-parent families, having higher financial security, educational level and better diet quality were associated with a 27–64% higher likelihood for benefiting from the program regarding one or more of their lipidemic profile indices. Participants who were overweight or obese (especially with central obesity), employed, with prolonged sedentary behavior, prone to emotional eating and perceiving their weight status as lower than their actual weight were 24–43% less likely to have benefited. These findings should guide future interventions, prioritizing regions in greater need, and being tailor-made to specific population characteristics in order to further improve their effectiveness. © 2020 by the authors. Licensee MDPI, Basel, Switzerland.
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- 2020
49. Variations in accelerometry measured physical activity and sedentary time across Europe - harmonized analyses of 47, 497 children and adolescents
- Author
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Steene-Johannessen, J., Hansen, B.H., Dalene, K.E., Kolle, E., Northstone, K., Møller, N.C., Grøntved, A., Wedderkopp, N., Kriemler, S., Page, A.S., Puder, J.J., Reilly, J.J., Sardinha, L.B., van Sluijs, E.M.F., Andersen, L.B., van der Ploeg, H., Ahrens, W., Flexeder, C., Standl, M., Shculz, H., Moreno, L.A., De Henauw, S., Michels, N., Cardon, G., Ortega, F.B., Ruiz, J., Aznar, S., Fogelholm, M., Decelis, A., Olesen, L.G., Hjorth, M.F., Santos, R., Vale, S., Christiansen, L.B., Jago, R., Basterfield, L., Owen, C.G., Nightingale, C.M., Eiben, G., Polito, A., Lauria, F., Vanhelst, J., Hadjigeorgiou, C., Konstabel, K., Molnár, D., Sprengeler, O., Manios, Y., Harro, J., Kafatos, A., Anderssen, S.A., Ekelund, U., Determinants, of, Diet, and, Physical, Activity, knowledge, hub, (DEDIPAC), International, Children's, Accelerometry, Database, (ICAD), IDEFICS, Consortium, and HELENA, Consortium
- Abstract
BACKGROUND: Levels of physical activity and variation in physical activity and sedentary time by place and person in European children and adolescents are largely unknown. The objective of the study was to assess the variations in objectively measured physical activity and sedentary time in children and adolescents across Europe. METHODS: Six databases were systematically searched to identify pan-European and national data sets on physical activity and sedentary time assessed by the same accelerometer in children (2 to 9.9¿years) and adolescents (=10 to 18¿years). We harmonized individual-level data by reprocessing hip-worn raw accelerometer data files from 30 different studies conducted between 1997 and 2014, representing 47, 497 individuals (2-18¿years) from 18 different European countries. RESULTS: Overall, a maximum of 29% (95% CI: 25, 33) of children and 29% (95% CI: 25, 32) of adolescents were categorized as sufficiently physically active. We observed substantial country- and region-specific differences in physical activity and sedentary time, with lower physical activity levels and prevalence estimates in Southern European countries. Boys were more active and less sedentary in all age-categories. The onset of age-related lowering or leveling-off of physical activity and increase in sedentary time seems to become apparent at around 6 to 7¿years of age. CONCLUSIONS: Two third of European children and adolescents are not sufficiently active. Our findings suggest substantial gender-, country- and region-specific differences in physical activity. These results should encourage policymakers, governments, and local and national stakeholders to take action to facilitate an increase in the physical activity levels of young people across Europe.
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- 2020
50. Sociodemographic and lifestyle-related risk factors for identifying vulnerable groups for type 2 diabetes: A narrative review with emphasis on data from Europe
- Author
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Kyrou, I. Tsigos, C. Mavrogianni, C. Cardon, G. Van Stappen, V. Latomme, J. Kivelä, J. Wikström, K. Tsochev, K. Nanasi, A. Semanova, C. Mateo-Gallego, R. Lamiquiz-Moneo, I. Dafoulas, G. Timpel, P. Schwarz, P.E.H. Iotova, V. Tankova, T. Makrilakis, K. Manios, Y.
- Subjects
endocrine system diseases ,nutritional and metabolic diseases - Abstract
Background: Type 2 diabetes mellitus (T2DM) comprises the vast majority of all diabetes cases in adults, with alarmingly increasing prevalence over the past few decades worldwide. A particularly heavy healthcare burden of diabetes is noted in Europe, where 8.8% of the population aged 20-79 years is estimated to have diabetes according to the International Diabetes Federation. Multiple risk factors are implicated in the pathogenesis of T2DM with complex underlying interplay and intricate gene-environment interactions. Thus, intense research has been focused on studying the role of T2DM risk factors and on identifying vulnerable groups for T2DM in the general population which can then be targeted for prevention interventions. Methods: For this narrative review, we conducted a comprehensive search of the existing literature on T2DM risk factors, focusing on studies in adult cohorts from European countries which were published in English after January 2000. Results: Multiple lifestyle-related and sociodemographic factors were identified as related to high T2DM risk, including age, ethnicity, family history, low socioeconomic status, obesity, metabolic syndrome and each of its components, as well as certain unhealthy lifestyle behaviors. As Europe has an increasingly aging population, multiple migrant and ethnic minority groups and significant socioeconomic diversity both within and across different countries, this review focuses not only on modifiable T2DM risk factors, but also on the impact of pertinent demographic and socioeconomic factors. Conclusion: In addition to other T2DM risk factors, low socioeconomic status can significantly increase the risk for prediabetes and T2DM, but is often overlooked. In multinational and multicultural regions such as Europe, a holistic approach, which will take into account both traditional and socioeconomic/socioecological factors, is becoming increasingly crucial in order to implement multidimensional public health programs and integrated community-based interventions for effective T2DM prevention. © 2020 The Author(s).
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- 2020
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