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OBJECTIVES: An analysis was performed to determine the risks and benefits of a 10-year hormone replacement therapy regimen that had been applied to all women at 50 years of age in 8 countries. METHODS: Cumulative mortality with and without hormone replacement therapy over 20 years was estimated, with both current and predicted total and disease-specific secular mortality trends and the influence of a generational cohort effect taken into account. RESULTS: In countries with high ischemic heart disease frequency and predictable relative predominance of ischemic heart disease rates over breast cancer rates for the next 20 years, hormone replacement therapy could result in benefits with regard to overall mortality; this advantage decreases in younger-generation cohorts. In countries in which breast cancer mortality predominates over ischemic heart disease in early postmenopause and in which the predictable trends for both diseases reinforce this condition, a negative effect on overall mortality would be observed. In the United States, the effect of large-scale hormone replacement therapy would change over time. CONCLUSIONS: The long-term effect of hormone replacement therapy on life expectancy of postmenopausal women may vary among countries. [ABSTRACT FROM AUTHOR]

Aims: To assess the effectiveness of the intermittent-scanned continuous glucose monitoring (isCGM) system in preventing severe hypoglycemic episodes and in improving glucose parameters and quality of life., Methods: Four hundred T1D individuals were enrolled in a prospective real-word study with an intermittently scanned continuous glucose monitoring device during the 12-months follow-up. The primary endpoint was the incidence of severe hypoglycemic events., Results: 82% of subjects were naïve to the use of the device (group A) and 18% were already wearing the system (group B). The cumulative incidence of severe hypoglycemia (SH) at 12 months was 12.06 per 100 person-year (95% CI: 8.35-16.85) in group A and 10.14 (95% CI: 4.08-20.90) in group B without inter-group differences. In group A there was a significant decrease in SH at 12 months compared to 3 months period (p = 0.005). Time in glucose range significantly increased in both groups accompanied with a significant decrease in glucose variability. HbA1c showed a progressive significant time-dependent decrease in group A. The use of the device significantly improved the perceived quality of life., Conclusion: This study confirmed the effectiveness of the isCGM in reducing hypoglycemic risk without glucose deterioration, with potential benefits on adverse outcomes in T1D individuals., Trial Registration: ClinicalTrials.gov registration no. NCT04060732., (© 2024. The Author(s).)

Aims: To assess the efficacy of a structured educational intervention for health professionals on the appropriateness of inpatient diabetes care and on some clinical outcomes in hospitalised subjects., Methods: A multicentre (6 regional hospitals) cluster-randomized (2:1) two parallel-group pragmatic intervention trials, as a part of the GOVEPAZ study, was conducted in three clinical settings, that is, Internal Medicine, Surgery and Intensive Care. Intervention consisted of a 2-month structured education of clinical staff to inpatient diabetes care. Twelve wards - 2 for each hospital - and 6 wards - 1 for each hospital - were randomized to usual care and to the intervention arm, respectively. Consecutively hospitalised diabetic subjects (n = 524, age 74 ± 14 years, 57% males, median HbA1C 57 mmol/mol) were included. The clinical appropriateness of inpatient diabetes management was assessed by a previously validated multi-domain performance score (PS). Clinical outcomes included hypoglycemia, glucose control biomarkers, clinical conditions at discharge and inpatient mortality rate., Results: A numerically, but not statistically significant, higher PS (+0.94; 95% C.I.: -0.53 - +2.4) was achieved in the intervention than in the usual care wards. Hypoglycemias (p = 0.32), glucose control (p = 0.89) and survival rates (p = 0.71) were similar in the two experimental arms. Plasma glucose on admission (OR = 1.52 per 1 SD; C.I. 1.07-2.17; p = 0.021) and the number of hypoglycemic events per patient (OR = 1.55 per 1 SD; C.I.:1.11-2.16; p = 0.011) were independently associated with the inpatient mortality rate., Conclusions: Structured education of the clinical staff failed to improve the inpatient appropriateness of diabetes care or clinical outcomes. In-hospital hypoglycemia was confirmed to be an independent indicator of death risk., (© 2023 The Authors. Diabetes/Metabolism Research and Reviews published by John Wiley & Sons Ltd.)

Aims: To build a tool to assess the management of inpatients with diabetes mellitus and to investigate its relationship, if any, with clinical outcomes., Materials and Methods: A total of 678 patients from different settings, Internal Medicine (IMU, n = 255), General Surgery (GSU, n = 230) and Intensive Care (ICU, n = 193) Units, were enrolled. A work-flow of clinical care of diabetes was created according to guidelines. The workflow was divided into five different domains: (a) initial assessment; (b) glucose monitoring; (c) medical therapy; (d) consultancies; (e) discharge. Each domain was assessed by a performance score (PS), computed as the sum of the scores achieved in a set of indicators of clinical appropriateness, management and patient empowerment. Appropriate glucose goals were included as intermediate phenotypes. Clinical outcomes included: hypoglycaemia, survival rate and clinical conditions at discharge., Results: The total PS and those of initial assessment and glucose monitoring were significantly lower in GSU with respect to IMU and ICU (P < .0001). The glucose monitoring PS was associated with lower risk of hypoglycaemia (OR = 0.55; P < .0001), whereas both the PSs of glucose monitoring and medical therapy resulted associated with higher in-hospital survival only in the IMU ward (OR = 6.67 P = .001 and OR = 2.38 P = .03, respectively). Instrumental variable analysis with the aid of PS of glucose monitoring showed that hypoglycaemia may play a causal role in in-hospital mortality (P = .04)., Conclusions: The quality of in-hospital care of diabetes may affect patient outcomes, including glucose control and the risk of hypoglycaemia, and through the latter it may influence the risk of in-hospital mortality., (© 2020 John Wiley & Sons Ltd.)

Background: Thyroid hormones are crucial for metabolism in all tissues in humans, including the nervous system and muscles, and could thus affect handwriting, which is the synthesis of complex and fine movements. Hyperthyroidism, characterized by symptoms such as tremor and weakness, could affect handwriting, although this has not been studied yet. The aim of this study was to evaluate handwriting characteristics before and after therapy for hyperthyroid Graves' disease (GD)., Methods: Twenty-two patients (15 women, 7 men) with untreated GD (median age: 44 years; range: 20-70 years) were asked to write a "standard text" before and 12 months after being rendered euthyroid. The letters underwent a standardized detailed analysis by a handwriting expert, through inspection and stereoscopic microscope and magnifying glass., Results: All patients demonstrated handwriting variations, perceptible even to direct observation. Graphological examination showed statistically significant changes after patients become euthyroid, in the following parameters: size of letters (4.5±1.1 vs. 5.9±1.3 mm; p<0.01), distance between letters (62.9±1.1 vs. 55.2±0.8 mm; p<0.01), width of letters (1.75±0.06 vs. 2.2±0 .06 mm; p<0.01), distance between words (216.2±3.2 vs. 198.7±2.4 mm; p<0.01), extension of letters (8.7±0.2 vs. 7.7±0.2 mm; p<0.01), angles (17±0.3 vs. 15.8±0.4 mm; p<0.01), and groove depth (0.2±0.05 vs. 0.4±0.05 mm; p<0.01)., Conclusions: Hyperthyroid GD was associated with significant changes in handwriting in all patients. Following recovery from hyperthyroidism, a state of hypertrophic and contracted handwriting resulted in greater fluency and fluidity. Variations in handwriting should be included as signs/symptoms in GD.

We analysed the risk factors associated with diabetic complications in the cohort of patients assisted by a type 2 diabetes mellitus (T2DM) shared-care program. We analysed registry data from 16,136 T2DM patients. Of them, 4,781 had microangiopathy, 3,469 CV events. They were 70.5 ± 17.1 years old, 50% were male, disease duration 13.3 ± 7.8 years, BMI 28.7 ± 4.9 kg/m², HbA1c 7.08 ± 1.23%, FBG 134.7 ± 35.7 mg/dl, 2hPPBG 163.9 ± 47.8 mg/dl, 12.5% smokers. Cholesterol 202.5 ± 37.6 mg/dl, HDL 51.4 ± 20.4 mg/dl, LDL 126.5 ± 36.0 mg/dl, triglyceride 146.2 ± 72.4 mg/dl, SBP 137.8 ± 14.2 mmHg, DBP 80.7 ± 10.8 mmHg, 10-year CV risk score 13.7 ± 9.1; 70.4% had no microangiopathy-i.e. renal, retinal, peripheral nerve disease-and 78.5% of patients had no CV events. Age-adjusted risk factors associated with diabetic complications were male gender, HbA1c, 2hPPBG, HDL, and triglyceride. FBG and SBP were associated with microangiopathy, whereas smoking with cardiovascular events. Optimal targets were reached in: FBG 17%, 2hPPBG 8%, HbA1c 21%, cholesterol 17%, HDL 8%, LDL 5%, triglyceride 20%, SBP 13%, DBP 30%. Drug profiles showed 13% using metformin, 28% sulphonilureas, 26% bitherapy, 4% insulin; 12% statins, 16% anti-platelets, 27% anti-hypertensives, 2% anti-coagulants. T2DM patients showed an acceptable CV risk profile. Joint risk factors for diabetic complications were male gender, HbA1c, 2hPPBG, HDL, and triglyceride. Distinct risk factors were FBG and SBP for micro- and smoking for macrovascular disease. A targeted-to-treat approach needs more attention in the care of T2DM patients.

We implemented the "Diabetes conversations", programme of the International Diabetes Federation-Europe, characterised by the use of the Conversation Map, an educational interactive kit addressed to groups of diabetic patients on: Living with diabetes, What is diabetes, Healthy diet and physical activity, Initiating insulin therapy. After at least three month from the end of the 4-session course, clinical data of 63 participants from the first 10 groups--age (mean +/- std dev) 61.7 +/- 10.2 years, 56% women, 18.5% T1DM-improved: fasting glycemia decreased from 152.9 +/- 55.2 to 138.2 +/- 38.9 mg/dl (P < 0.05), HbA1c from 8.2 +/- 1.2 to 7.8 +/- 1.4% (P < 0.01), BMI from 27.6 +/- 15.1 to 25.5 +/- 15.5 kg/m2 (P < 0.02). The patients' satisfaction about the topics and the educational materials was very high.The Conversation Maps are useful because: (a) contribute to improve glycometabolic control; (b) educate patients on the main topics related to diabetes; (c) give to the nurse a key and active role in patients'education; (d) facilitate the connection between knowledge and behaviour; (e) involve the volunteers of the diabetic association as tutors; (f) improve the relationship and the communication between the doctor/nurse and the patient.

Background and Aims: Clinical studies suggest that menstrual irregularities are associated with metabolic and hormonal abnormalities, insulin resistance and a hyperestrogenic/hyperandrogenic imbalance, that may influence the risk of cardiovascular disease., Methods and Results: The association of these abnormalities with the metabolic syndrome suggests that information on lipid patterns at different menstrual cycle length may be of interest in identifying women at higher cardiovascular risk. The association of lipid patterns with menstrual cycle length was evaluated in a cohort of 5062 women participating in the Progetto ATENA Study. Questions were administered to the participants about their cycle lengths at different periods of time over their reproductive life. The period between 20 and 50 years was investigated: normal cycle length was defined as short (30 days). Perimenopausal women were excluded and variables adjusted for age, BMI and menopausal status. In 4434 participants serum triglycerides were found to increase with an increased number of days in the menstrual cycle: 106 mg/dl in the short cycle pattern (21-26 days); 113 mg/dl in the medium cycle pattern (27-29 days); and 116 mg/dl in the long cycle pattern (30-31 days), whereas total and LDL cholesterol were found to be higher and HDL was lower in women with longer cycles, but the difference was not statistically significant. The results were very similar when the same adjusted analysis was restricted to a subgroup of 3823 women with a stable cycle length over the fourth and the fifth decade of life., Conclusions: These results suggest that cycle length may be a marker of higher cardiovascular risk due to associated metabolic and hormonal patterns.

We evaluated the effectiveness of diabetes mellitus disease management, implemented in Modena province since ten years, on the prevention of complications and early diagnoses at a population level. Time trends show that diabetic patients had significantly decreasing values over time of age, diabetes duration, and glycated haemoglobin; and increasing percentage over time of new-onset diabetes and optimal glycaemic control. That indicates an improved ability of early diagnosis and care of diabetes mellitus. It indicates at a population level that the Local Health Unit, as health system, promoted diabetes prevention and its complications.

Aim: To assess the effectiveness of a nurse-led protocol for the management of hypo/ hyperglicaemia in a medical ward., Methods: Protocols for standard therapy, and parenteral intensive insulin therapy for severe hypo/hyperglycaemia in hospitalised patients were implemented., Period: march-november 2007., Results: 189 patients (19%) were labelled as "hyperglycaemic" at admission in Emergency Department. Median (+/-IQR) age was 77 (70-84) years, 41% were men, with known diabetes 74%, 18% had skin ulcers. Median glycaemia at admission was 144.5 (98-220) mg/dl. Thirty-six percent of patients was euglycaemic (60-126 mg/dl), 3% hypoglycaemic (<60 mg/dl). The glicaemic values ranged from 127-140 mg/dl (9% patients), from 141-280 mg/dl, (40%patients) and > 280 mg/dl (12% patients). The glicaemic values of the 14 patients requiring the intravenous intensive insulin regimen remained in a safe range (80-250 mg/dl) in the first 15 hours from the infusion start. No patient experienced a life-threatening hypoglycaemia nor hypoglycaemic coma. After three days on standard therapy, glicaemic levels were acceptable: 142 (98-185) pre-breakfast, 144(107-200) pre-lunch, 131 (102-190) pre-dinner, 183 (123-230) mg/dl postprandial., Conclusion: Data showed the effectiveness and safety of a nurse-led protocol for the care of hyperglicaemia in a medical ward.

Objective: To retrospectively compare a single center's immediate and mid-term outcomes of ruptured abdominal aortic aneurysm open and endovascular repair (EVAR) for two patient groups-hemodynamically stable and unstable patients-in the same time period., Methods: Patients presenting at our center with confirmed rupture of an abdominal aortic aneurysm between December 1999 and April 2006 were considered according to an intention-to-treat model with EVAR. Patients with symptomatic or acute (but not ruptured) AAAs were not included in this study. Thirty-three patients underwent EVAR, and 91 underwent open repair. Seventy-two patients (EVAR, 45%; open, 63%) were classified as hemodynamically unstable at arrival, and 52 were classified as stable (EVAR, 55%; open, 37%). Ninety-seven percent of EVAR procedures commenced under local anesthesia, and 100% of open repairs occurred with general anesthesia. Overall successful graft deployment, 30-day mortality, overall reintervention rate, and complications were the study primary end points., Results: Overall successful graft deployment for EVAR was 91%; for open repair, it was 96%. Overall 30-day mortality for EVAR was 30% (unstable, 53%; stable, 11%), and the rate was 46% for open repair (unstable, 61%; stable, 21%). The EVAR postoperative reintervention rate (within 30 days) was 15% (unstable, 20%; stable, 11%), and for open repair it was 10% (unstable, 9%; stable, 15%). We recorded a 27% severe complication rate for EVAR patients (unstable, 40%; stable, 17%), and for patients treated with open repair, it was 33% (unstable, 35%; stable, 29%). Our overall EVAR eligibility rate was 52%, and our overall EVAR treatment rate was 27%., Conclusions: Our study's overall results for EVAR remain encouraging when compared with those of conventional repair, but large randomized trials are required to confirm the efficacy of the procedure.

We wanted to assess the effectiveness and safety of glargine in the treatment of patients with type 2 diabetes mellitus in secondary failure and/or with severe comorbidities ("T2DM group"), and patients with secondary diabetes after corticosteroid and/or anticancer treatment ("secondary DM group"). We reviewed the records of patients on glargine from 1 August 2004 to 30 July 2005. The after-minus-before change in HbA1c was the main outcome measure. At baseline, the 18 "T2DM" patients had a mean (+/-SD) age of 66.7+/-9.5 years and a diabetes duration of 13.6+/-10.3 years; 52.9% were male. Their fasting plasma glucose (FPG) decreased from 228.6+/-76.6 to 134.6+/-37.5, two-hour post-prandial glycaemia (2hPPG) from 268.2+/-10.4 to 140.6+/-30.8 and HbA1c from 10.4+/-2.3 to 7.9+/-1.6%. Mean daily insulin dosage was 12.0+/-4.8 UI for glargine alone and 37.4+/-22.6 UI for basal-bolus scheme. The daily cost was Euro 0.75 (range Euro 0.31-1.15). The 24 "secondary DM" patients had a mean age of 67.0+/-11.0 years and a diabetes duration of 3.7+/-6.5 years; 54.2% were male and 91.7% had a metastatic cancer. Their FPG decreased from 222.3+/-108.6 to 121.5+/-28.7 mg/dl, 2hPPG from 259.4+/-108.6 to 133.0+/-35.0 mg/dl and HbA1c from 10.1+/-2.5 to 7.6+/-1.3%. Mean daily insulin dosage was 12.5+/-6.1 UI for glargine alone and 27.2+/-9.1 UI for basal-bolus scheme. Mean daily cost was Euro 0.70 (range Euro 0.31-1.38). One (4.2%) cancer patient withdrew from glargine because of nausea. Nine (37.5%) cancer patients had an increase in appetite after glargine therapy, including 3 end-of-life patients. No severe hypoglycaemia occurred. Insulin glargine was safe and effective in improving glycaemic control both in severe "T2DM" and in "secondary DM" patients.

When the diabetic patient is hospitalised or assisted by a hospital-based home care service, as a rule he/she is not cared for by a diabetologist all day long. The aim of the present work was to perform a RAND assessment of practical schemes to start or change a daily insulin regimen without a diabetologist. We created an expert panel of seven internists and two diabetologists. They judge the appropriateness of each practical scheme using the RAND method. We produced 21 clinical scenarios divided into two groups. The first group of 9 clinical scenarios-i.e., for diabetic patients who 'eat/not-always-eat' and are 'normal-weight/obese/underweight' or with 'renal failure' or 'defedated/end-of-life' or 'vomiting' or on 'parenteral nutrition'-useful for starting a daily insulin regimen without a diabetologist had a median RAND score of 8 (range 7-9). The second one-formed by 12 clinical scenarios useful to change the daily insulin dosage without a diabetologist based on low or high capillary glucose level monitoring-had a median RAND score of 9 (range 7-9). There was a high level of agreement between panellists in judging 'appropriate' the practical schemes to start or change a daily insulin regimen without a diabetologist.

Objectives: We compared two non-alternative methods to assess the readability and learning of easy-to-read educational health materials co-written by physicians, educators and citizens., Methods: Data from seven easy-to-read materials were analyzed. Readability formulae, and ad hoc data on readability and learning were also computed., Results: The respondents had a mean age of 48.5 +/- 8.3 (SD) years (range 31-57 years). More than two thirds of them were females. About half of the participants had a 'secondary' education or more. According to the readability scores - 54 on average - the booklets resulted to be "easy" for a reader who had received a 'secondary education' or more. Of the 747 participants, 70% of them found the booklet's language to be 'easy' or 'very easy' and 28% 'sufficiently easy' for laypersons to understand. About 98% of the readers found the booklets useful. After reading the booklet 92% (simple knowledge rate) of the readers answered the cognitive items correctly. The after-minus-before net increase in knowledge was 24 +/- 16% and ranged from 8 to 40% (cognitive or knowledge delta)., Conclusions: The availability of readability scores is complementary and it does not replace the need to assess readability and learning by means of structured and tailored questionnaires.

The objective of this study was to evaluate if easy-to-read information material on the prevention of chronic-degenerative diseases through healthy lifestyle co-written by communicators, educators, physicians and citizens -using a networking strategy- could be judged comprehensible. Readability scores were computed. The survey involved 100 individuals attending our centralized booking centre for medical appointments during an "index week". They filled out an anonymous questionnaire, just before and after they had read the material. Readability and comprehensibility frequencies were calculated. The participants had a mean age of 59.1+/-15.1 (SD) years (range 19-81yrs), 62% were females. Twenty-six percent of them had received no education, 30% "primary", 28% "secondary", and 14% had a "degree". According to readability scores, the booklet was "readable" by all persons who had finished primary school. Of the 100 participants, 40 percent found the booklet's language to be "easy" or "very easy", 46% "sufficiently easy", and 14% "difficult" for laypersons to understand. Ninety-four percent of them found no unintelligible words in the text. Education levels showed no differences. Readers' answers were more correct after they had read the booklet. The pre-test showed that 61+/-26% of the readers answered the comprehensibility items correctly. After reading the booklet, 81+/-17% of them gave correct answers. The after-minus-before net increase in knowledge was +20% (95% CIs +8 to +32%). The booklet was designed and written using a networking strategy with the help of the local population. It was found to be easy to read and quite clear.

Background: The aim of this study was to compare the outcomes of carotid endarterectomy (CEA) in the current practice of our department of vascular surgery with international benchmarks., Methods: In-patient data from 488 CEA performed in both symptomatic 145 (29.7%) and asymptomatic 343 (70.3%) patients with a > or = 60% stenosis at the level of the internal carotid artery. Comprehensive retrospective review of the records for all the CEAs performed during a 2-year period. The main outcome measures were death rate, and fatal and non-fatal stroke rates perioperatively, and at 30 and 180 days., Results: The fatal and non-fatal stroke rates of symptomatic patients were: 0.7% perioperatively, 0.7% at 30 days, and 0.7% at 180 days. The fatal and non-fatal stroke rates of asymptomatic patients were: 0.6% perioperatively, 0.6% at 30 days, and 0.3% at 180 days. The death rates of symptomatic patients were 0% for all time periods. The death rates of asymptomatic patients were: 0% perioperatively, 0% at 30 days, and 0.3% at 180 days., Conclusions: The present comprehensive audit shows that our surgeons achieve CEA outcomes comparable with international benchmarks.

We implemented simple tools for Clinical Practice in Primary Care, i.e. reports of Diabetes Project's Registry addressed to Primary Care Groups in Modena in order to promote the clinical practice through a detailed peer-review of program indicators. The efforts of health organisations to involve the general practitioners in clinical practice should be improved by implementing audit-and-feedback tools of simple interpretation for clinical practice.

Aim: The aim of this study was to evaluate the effectiveness and safety of carotid endarterectomy (CEA) with conscious sedation under remifentanil (Remifentanil anesthesia - RA) vs conventional loco-regional anesthesia (Conventional-LRA) in the current practice of a vascular surgery unit., Methods: We introduced the ''Remifentanil-RA'' in our practice according to a two-step protocol. In the first step we performed a pilot prospective study to assess the procedure's safety and reproducibility in our setting on 60 consecutive patients with symptomatic and/or high-grade (>70%) internal carotid artery stenosis and alternately assigning them either to ''Remifentanil-RA'' or ''Conventional-LRA'' CEA. In the second step we analysed our routine operative records as to effectiveness and safety on 533 patients who consecutively underwent ''Remifentanil-RA'' CEA. We compared them with 533 age- and sex-matched historical controls who underwent ''Conventional-LRA'' CEA., Results: The patients' mean age was 71.2+/-6.8 vs 71.8+/-6.1 (''Remifentanil-RA'' vs ''Conventional-LRA''). About 73% of them were male and 56% had a symptomatic carotid stenosis. Neither the pilot study nor second step comparison showed differences in outcome measures. We found only higher peri-operative nausea/ vomit (3.6% vs 0.4% ''Remifentanil-RA'' vs ''Conventional-LRA'', P<0.0002) and fewer re-operations for post-operative hematomas (3% vs 5.4% respectively, P=0.048)., Conclusions: We found that ''Remifentanil-RA'' CEA was safe, effective and satisfactory. Nevertheless, with the potential problems of intubation and those already found with side effects, a randomized control trial (RCT) is needed in order to prove that this method is superior to ''Conventional-LRA'' CEA.

Aim of the present study was to explore how the 76 general practitioners (GPs) - serving Carpi district (90,000 residents) - value their own role compared with the hospital, ambulatory, academic, and health organisation physicians'. GPs had a positive self-image only in comparison with health organisation doctors (7 vs 7 grades). GPs disappointed with themselves when comparing their role with ambulatory (-1.6 grades), academic (-1.9 grades) and hospital doctors (-2.2 grades). Secondarily, GPs perceived patients' valuing their professional role mostly 'subordinate' to the other physicians', except health organisation colleagues'.

Objectives: To study dietary habits and behaviours of a representative sample of 5-6-year-old children and their families., Methods: A stratified population sample of the general population (5508 children out of 5551 residents) born in 1997 and attending a nursery school was analysed. Weight and height were measured. Information was collected via questionnaire. A "normal" body mass index (BMI) ranged between 13.61-18.09 and 13.31-19.79 kg/m2 for boys and girls respectively., Results: The response rate was 89%. 79% of the boys had a normal BMI, 0.9% had a low BMI, 18% were overweight, and 1.8% was obese; 87% of the girls had a normal BMI, 2.6% had a low BMI, 10% were overweight, and 0.7% were obese. The main sources of dietary information were professionals of the national health system and mass-media. The main barriers to healthy dietary habits were busy daily activities, working timetable, time needed to cook and tasty and healthy food cost. The main changes in dietary habits occurred in the family habits after a child's birth., Conclusions: Our findings showed a crucial role played by professionals of the national health system and by mass-media on eating behaviours among children and their parents. Birth of a child is a receptive context to promote healthy habits.