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2. Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries and territories: a pooled analysis of 2181 population-based studies with 65 million participants
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Rodriguez-Martinez, Andrea, Zhou, Bin, Sophiea, Marisa K, Bentham, James, Paciorek, Christopher J, Iurilli, Maria LC, Carrillo-Larco, Rodrigo M, Bennett, James E, Di Cesare, Mariachiara, Taddei, Cristina, Bixby, Honor, Stevens, Gretchen A, Riley, Leanne M, Cowan, Melanie J, Savin, Stefan, Danaei, Goodarz, Chirita-Emandi, Adela, Kengne, Andre P, Khang, Young-Ho, Laxmaiah, Avula, Malekzadeh, Reza, Miranda, J Jaime, Moon, Jin Soo, Popovic, Stevo R, Sorensen, Thorkild IA, Soric, Maroje, Starc, Gregor, Zainuddin, Ahmad A, Gregg, Edward W, Bhutta, Zulfiqar A, Black, Robert, Ezzati, Majid, Abarca-Gomez, Leandra, Abdeen, Ziad A, Abdrakhmanova, Shynar, Ghaffar, Suhaila Abdul, Rahim, Hanan F Abdul, Abu-Rmeileh, Niveen M, Garba, Jamila Abubakar, Acosta-Cazares, Benjamin, Adams, Robert J, Aekplakorn, Wichai, Afsana, Kaosar, Afzal, Shoaib, Agdeppa, Imelda A, Aghazadeh-Attari, Javad, Aguilar-Salinas, Carlos A, Agyemang, Charles, Ahmad, Mohamad Hasnan, Ahmad, Noor Ani, Ahmadi, Ali, Ahmadi, Naser, Ahmed, Soheir H, Ahrens, Wolfgang, Aitmurzaeva, Gulmira, Ajlouni, Kamel, Al-Hazzaa, Hazzaa M, Al-Othman, Amani Rashed, Al-Raddadi, Rajaa, Alarouj, Monira, AlBuhairan, Fadia, AlDhukair, Shahla, Ali, Mohamed M, Alkandari, Abdullah, Alkerwi, Ala'a, Allin, Kristine, Alvarez-Pedrerol, Mar, Aly, Eman, Amarapurkar, Deepak N, Amiri, Parisa, Amougou, Norbert, Amouyel, Philippe, Andersen, Lars Bo, Anderssen, Sigmund A, Angquist, Lars, Anjana, Ranjit Mohan, Ansari-Moghaddam, Alireza, Aounallah-Skhiri, Hajer, Araujo, Joana, Ariansen, Inger, Aris, Tahir, Arku, Raphael E, Arlappa, Nimmathota, Aryal, Krishna K, Aspelund, Thor, Assah, Felix K, Assuncao, Maria Cecilia F, Aung, May Soe, Auvinen, Juha, Avdicova, Maria, Azevedo, Ana, Azimi-Nezhad, Mohsen, Azizi, Fereidoun, Azmin, Mehrdad, Babu, Bontha V, Jorgensen, Maja Baeksgaard, Baharudin, Azli, Bahijri, Suhad, Baker, Jennifer L, Balakrishna, Nagalla, Bamoshmoosh, Mohamed, Banach, Maciej, Bandosz, Piotr, Banegas, Jose R, Baran, Joanna, Barbagallo, Carlo M, Barcelo, Alberto, Barkat, Amina, Barros, Aluisio JD, Barros, Mauro Virgilio Gomes, Basit, Abdul, Bastos, Joao Luiz D, Bata, Iqbal, Batieha, Anwar M, Batista, Rosangela L, Battakova, Zhamilya, Batyrbek, Assembekov, Baur, Louise A, Beaglehole, Robert, Bel-Serrat, Silvia, Belavendra, Antonisamy, Ben Romdhane, Habiba, Benedics, Judith, Benet, Mikhail, Berkinbayev, Salim, Bernabe-Ortiz, Antonio, Bernotiene, Gailute, Bettiol, Heloisa, Bezerra, Jorge, Bhagyalaxmi, Aroor, Bharadwaj, Sumit, Bhargava, Santosh K, Bi, Hongsheng, Bi, Yufang, Bia, Daniel, Lele, Elysee Claude Bika, Bikbov, Mukharram M, Bista, Bihungum, Bjelica, Dusko J, Bjerregaard, Peter, Bjertness, Espen, Bjertness, Marius B, Bjorkelund, Cecilia, Bloch, Katia V, Blokstra, Anneke, Bo, Simona, Bobak, Martin, Boddy, Lynne M, Boehm, Bernhard O, Boeing, Heiner, Boggia, Jose G, Bogova, Elena, Boissonnet, Carlos P, Bojesen, Stig E, Bonaccio, Marialaura, Bongard, Vanina, Bonilla-Vargas, Alice, Bopp, Matthias, Borghs, Herman, Bovet, Pascal, Braeckevelt, Lien, Braeckman, Lutgart, Bragt, Marjolijn CE, Brajkovich, Imperia, Branca, Francesco, Breckenkamp, Juergen, Breda, Joao, Brenner, Hermann, Brewster, Lizzy M, Brian, Garry R, Brinduse, Lacramioara, Brophy, Sinead, Bruno, Graziella, Bueno-de-Mesquita, H Bas, Bugge, Anna, Buoncristiano, Marta, Burazeri, Genc, Burns, Con, de Leon, Antonio Cabrera, Cacciottolo, Joseph, Cai, Hui, Cama, Tilema, Cameron, Christine, Camolas, Jose, Can, Gunay, Candido, Ana Paula C, Canete, Felicia, Capanzana, Mario V, Capkova, Nadezda, Capuano, Eduardo, Capuano, Vincenzo, Cardol, Marloes, Cardoso, Viviane C, Carlsson, Axel C, Carmuega, Esteban, Carvalho, Joana, Casajus, Jose A, Casanueva, Felipe F, Celikcan, Ertugrul, Censi, Laura, Cervantes-Loaiza, Marvin, Cesar, Juraci A, Chamukuttan, Snehalatha, Chan, Angelique W, Chan, Queenie, Chaturvedi, Himanshu K, Chaturvedi, Nish, Rahim, Norsyamlina Che Abdul, Chen, Chien-Jen, Chen, Fangfang, Chen, Huashuai, Chen, Shuohua, Chen, Zhengming, Cheng, Ching-Yu, Cheraghian, Bahman, Chetrit, Angela, Chikova-Iscener, Ekaterina, Chiolero, Arnaud, Chiou, Shu-Ti, Chirlaque, Maria-Dolores, Cho, Belong, Christensen, Kaare, Christofaro, Diego G, Chudek, Jerzy, Cifkova, Renata, Cilia, Michelle, Cinteza, Eliza, Claessens, Frank, Clarke, Janine, Clays, Els, Cohen, Emmanuel, Concin, Hans, Confortin, Susana C, Cooper, Cyrus, Coppinger, Tara C, Corpeleijn, Eva, Costanzo, Simona, Cottel, Dominique, Cowell, Chris, Craig, Cora L, Crampin, Amelia C, Crujeiras, Ana B, Csilla, Semanova, Cucu, Alexandra M, Cui, Liufu, Cureau, Felipe V, D'Arrigo, Graziella, d'Orsi, Eleonora, Dacica, Liliana, Saavedra, Maria Angeles Dal Re, Dallongeville, Jean, Damasceno, Albertino, Damsgaard, Camilla T, Dankner, Rachel, Dantoft, Thomas M, Dasgupta, Parasmani, Dastgiri, Saeed, Dauchet, Luc, Davletov, Kairat, De Backer, Guy, De Bacquer, Dirk, de Gaetano, Giovanni, De Henauw, Stefaan, de Oliveira, Paula Duarte, De Ridder, David, De Ridder, Karin, de Rooij, Susanne R, De Smedt, Delphine, Deepa, Mohan, Deev, Alexander D, DeGennaro, Vincent, Dehghan, Abbas, Delisle, Helene, Delpeuch, Francis, Demarest, Stefaan, Dennison, Elaine, Deren, Katarzyna, Deschamps, Valerie, Dhana, Klodian, Dhimal, Meghnath, Di Castelnuovo, Augusto F, Dias-da-Costa, Juvenal Soares, Diaz-Sanchez, Maria Elena, Diaz, Alejandro, Dika, Zivka, Djalalinia, Shirin, Djordjic, Visnja, Do, Ha TP, Dobson, Annette J, Donati, Maria Benedetta, Donfrancesco, Chiara, Donoso, Silvana P, Doring, Angela, Dorobantu, Maria, Dorosty, Ahmad Reza, Doua, Kouamelan, Drygas, Wojciech, Duan, Jia Li, Duante, Charmaine A, Duboz, Priscilla, Duda, Rosemary B, Duleva, Vesselka, Dulskiene, Virginija, Dumith, Samuel C, Dushpanova, Anar, Dzerve, Vilnis, Dziankowska-Zaborszczyk, Elzbieta, Eddie, Ricky, Eftekhar, Ebrahim, Egbagbe, Eruke E, Eggertsen, Robert, Eghtesad, Sareh, Eiben, Gabriele, Ekelund, Ulf, El-Khateeb, Mohammad, El Ati, Jalila, Eldemire-Shearer, Denise, Eliasen, Marie, Elliott, Paul, Engle-Stone, Reina, Enguerran, Macia, Erasmus, Rajiv T, Erbel, Raimund, Erem, Cihangir, Eriksen, Louise, Eriksson, Johan G, Escobedo-de la Pena, Jorge, Eslami, Saeid, Esmaeili, Ali, Evans, Alun, Faeh, David, Fakhretdinova, Albina A, Fall, Caroline H, Faramarzi, Elnaz, Farjam, Mojtaba, Sant'Angelo, Victoria Farrugia, Farzadfar, Farshad, Fattahi, Mohammad Reza, Fawwad, Asher, Felix-Redondo, Francisco J, Ferguson, Trevor S, Fernandes, Romulo A, Fernandez-Berges, Daniel, Ferrante, Daniel, Ferrao, Thomas, Ferrari, Marika, Ferrario, Marco M, Ferreccio, Catterina, Ferrer, Eldridge, Ferrieres, Jean, Figueiro, Thamara Hubler, Fijalkowska, Anna, Fink, Gunther, Fischer, Krista, Foger, Bernhard, Foo, Leng Huat, Forsner, Maria, Fouad, Heba M, Francis, Damian K, Franco, Maria do Carmo, Franco, Oscar H, Frikke-Schmidt, Ruth, Frontera, Guillermo, Fuchs, Flavio D, Fuchs, Sandra C, Fujiati, Isti I, Fujita, Yuki, Fumihiko, Matsuda, Furusawa, Takuro, Gaciong, Zbigniew, Gafencu, Mihai, Galbarczyk, Andrzej, Galenkamp, Henrike, Galeone, Daniela, Galfo, Myriam, Galvano, Fabio, Gao, Jingli, Garcia-de-la-Hera, Manoli, Garcia-Solano, Marta, Gareta, Dickman, Garnett, Sarah P, Gaspoz, Jean-Michel, Gasull, Magda, Gaya, Adroaldo Cesar Araujo, Gaya, Anelise Reis, Gazzinelli, Andrea, Gehring, Ulrike, Geiger, Harald, Geleijnse, Johanna M, Ghanbari, Ali, Ghasemi, Erfan, Gheorghe-Fronea, Oana-Florentina, Giampaoli, Simona, Gianfagna, Francesco, Gill, Tiffany K, Giovannelli, Jonathan, Gironella, Glen, Giwercman, Aleksander, Gkiouras, Konstantinos, Godos, Justyna, Gogen, Sibel, Goldsmith, Rebecca A, Goltzman, David, Gomez, Santiago F, Gomula, Aleksandra, da Silva, Bruna Goncalves Cordeiro, Goncalves, Helen, Gonzalez-Chica, David A, Gonzalez-Gross, Marcela, Gonzalez-Leon, Margot, Gonzalez-Rivas, Juan P, Gonzalez-Villalpando, Clicerio, Gonzalez-Villalpando, Maria-Elena, Gonzalez, Angel R, Gottrand, Frederic, Graca, Antonio Pedro, Graff-Iversen, Sidsel, Grafnetter, Dusan, Grajda, Aneta, Grammatikopoulou, Maria G, Gregor, Ronald D, Grodzicki, Tomasz, Groholt, Else Karin, Grontved, Anders, Grosso, Giuseppe, Gruden, Gabriella, Gu, Dongfeng, Gualdi-Russo, Emanuela, Guallar-Castillon, Pilar, Gualtieri, Andrea, Gudmundsson, Elias F, Gudnason, Vilmundur, Guerrero, Ramiro, Guessous, Idris, Guimaraes, Andre L, Gulliford, Martin C, Gunnlaugsdottir, Johanna, Gunter, Marc J, Guo, Xiu-Hua, Guo, Yin, Gupta, Prakash C, Gupta, Rajeev, Gureje, Oye, Gurzkowska, Beata, Gutierrez-Gonzalez, Enrique, Gutierrez, Laura, Gutzwiller, Felix, Ha, Seongjun, Hadaegh, Farzad, Hadjigeorgiou, Charalambos A, Haghshenas, Rosa, Hakimi, Hamid, Halkjaer, Jytte, Hambleton, Ian R, Hamzeh, Behrooz, Hange, Dominique, Hanif, Abu AM, Hantunen, Sari, Kumar, Rachakulla Hari, Hashemi-Shahri, Seyed Mohammad, Hassapidou, Maria, Hata, Jun, Haugsgjerd, Teresa, Hayes, Alison J, He, Jiang, He, Yuan, He, Yuna, Heidinger-Felso, Regina, Heinen, Mirjam, Hejgaard, Tatjana, Hendriks, Marleen Elisabeth, Henrique, Rafael dos Santos, Henriques, Ana, Cadena, Leticia Hernandez, Herrala, Sauli, Herrera, Victor M, Herter-Aeberli, Isabelle, Heshmat, Ramin, Hill, Allan G, Ho, Sai Yin, Ho, Suzanne C, Hobbs, Michael, Hofman, Albert, Bergh, Ingunn Holden, Holdsworth, Michelle, Homayounfar, Reza, Homs, Clara, Hopman, Wilma M, Horimoto, Andrea RVR, Hormiga, Claudia M, Horta, Bernardo L, Houti, Leila, Howitt, Christina, Thein, Thein Htay, Htet, Aung Soe, Htike, Maung Maung Than, Hu, Yonghua, Huerta, Jose Maria, Huhtaniemi, Ilpo Tapani, Petrescu, Constanta Huidumac, Husseini, Abdullatif, Chinh, Nguyen Huu, Huybrechts, Inge, Hwalla, Nahla, Hyska, Jolanda, Iacoviello, Licia, Ibarluzea, Jesus M, Ibrahim, Mohsen M, Wong, Norazizah Ibrahim, Ikeda, Nayu, Ikram, M Arfan, Iotova, Violeta, Irazola, Vilma E, Ishida, Takafumi, Islam, Muhammad, Islam, Sheikh Mohammed Shariful, Iwasaki, Masanori, Jackson, Rod T, Jacobs, Jeremy M, Jaddou, Hashem Y, Jafar, Tazeen, James, Kenneth, Jamil, Kazi M, Jamrozik, Konrad, Janszky, Imre, Janus, Edward, Jarani, Juel, Jarvelin, Marjo-Riitta, Jasienska, Grazyna, Jelakovic, Ana, Jelakovic, Bojan, Jennings, Garry, Jha, Anjani Kumar, Jiang, Chao Qiang, Jimenez, Ramon O, Jockel, Karl-Heinz, Joffres, Michel, Johansson, Mattias, Jokelainen, Jari J, Jonas, Jost B, Jorgensen, Torben, Joshi, Pradeep, Joukar, Farahnaz, Jovic, Dragana P, Jozwiak, Jacek J, Juolevi, Anne, Jurak, Gregor, Simina, Iulia Jurca, Juresa, Vesna, Kaaks, Rudolf, Kaducu, Felix O, Kafatos, Anthony, Kajantie, Eero O, Kalmatayeva, Zhanna, Kalter-Leibovici, Ofra, Kameli, Yves, Kanala, Kodanda R, Kannan, Srinivasan, Kapantais, Efthymios, Karki, Khem B, Katibeh, Marzieh, Katz, Joanne, Katzmarzyk, Peter T, Kauhanen, Jussi, Kaur, Prabhdeep, Kavousi, Maryam, Kazakbaeva, Gyulli M, Keil, Ulrich, Boker, Lital Keinan, Keinanen-Kiukaanniemi, Sirkka, Kelishadi, Roya, Kelleher, Cecily, Kemper, Han CG, Keramati, Maryam, Kerimkulova, Alina, Kersting, Mathilde, Key, Timothy, Khader, Yousef Saleh, Khalili, Davood, Khaw, Kay-Tee, Kheiri, Bahareh, Kheradmand, Motahareh, Khosravi, Alireza, Khouw, Ilse MSL, Kiechl-Kohlendorfer, Ursula, Kiechl, Stefan, Killewo, Japhet, Kim, Dong Wook, Kim, Hyeon Chang, Kim, Jeongseon, Kindblom, Jenny M, Klakk, Heidi, Klimek, Magdalena, Klimont, Jeannette, Klumbiene, Jurate, Knoflach, Michael, Koirala, Bhawesh, Kolle, Elin, Kolsteren, Patrick, Konig, Jurgen, Korpelainen, Raija, Korrovits, Paul, Korzycka, Magdalena, Kos, Jelena, Koskinen, Seppo, Kouda, Katsuyasu, Kovacs, Viktoria A, Kowlessur, Sudhir, Koziel, Slawomir, Kratzer, Wolfgang, Kriemler, Susi, Kristensen, Peter Lund, Krokstad, Steiner, Kromhout, Daan, Krtalic, Branimir, Kruger, Herculina S, Kubinova, Ruzena, Kuciene, Renata, Kujala, Urho M, Kujundzic, Enisa, Kulaga, Zbigniew, Kumar, R Krishna, Kunesova, Marie, Kurjata, Pawel, Kusuma, Yadlapalli S, Kuulasmaa, Kari, Kyobutungi, Catherine, Quang, Ngoc La, Laamiri, Fatima Zahra, Laatikainen, Tiina, Lachat, Carl, Laid, Youcef, Lam, Tai Hing, Lambrinou, Christina-Paulina, Landais, Edwige, Lanska, Vera, Lappas, Georg, Larijani, Bagher, Latt, Tint Swe, Lauria, Laura, Lazo-Porras, Maria, Khanh, Le Nguyen Bao, Le Port, Agnes, Le, Tuyen D, Lee, Jeannette, Lee, Jeonghee, Lee, Paul H, Lehmann, Nils, Lehtimaki, Terho, Lemogoum, Daniel, Levitt, Naomi S, Li, Yanping, Liivak, Merike, Lilly, Christa L, Lim, Wei-Yen, Lima-Costa, M Fernanda, Lin, Hsien-Ho, Lin, Xu, Lin, Yi-Ting, Lind, Lars, Linneberg, Allan, Lissner, Lauren, Litwin, Mieczyslaw, Liu, Jing, Liu, Lijuan, Lo, Wei-Cheng, Loit, Helle-Mai, Khuong, Quynh Long, Lopes, Luis, Lopes, Oscar, Lopez-Garcia, Esther, Lopez, Tania, Lotufo, Paulo A, Lozano, Jose Eugenio, Lukrafka, Janice L, Luksiene, Dalia, Lundqvist, Annamari, Lundqvist, Robert, Lunet, Nuno, Lunogelo, Charles, Lustigova, Michala, Luszczki, Edyta, Ma, Guansheng, Ma, Jun, Ma, Xu, Machado-Coelho, George LL, Machado-Rodrigues, Aristides M, Machi, Suka, Macieira, Luisa M, Madar, Ahmed A, Maggi, Stefania, Magliano, Dianna J, Magnacca, Sara, Magriplis, Emmanuella, Mahasampath, Gowri, Maire, Bernard, Majer, Marjeta, Makdisse, Marcia, Maki, Paivi, Malekzadeh, Fatemeh, Malhotra, Rahul, Rao, Kodavanti Mallikharjuna, Malyutina, Sofia K, Maniego, Lynell V, Manios, Yannis, Mann, Jim I, Mansour-Ghanaei, Fariborz, Manzato, Enzo, Margozzini, Paula, Markaki, Anastasia, Markey, Oonagh, Ioannidou, Eliza Markidou, Marques-Vidal, Pedro, Marques, Larissa Pruner, Marrugat, Jaume, Martin-Prevel, Yves, Martin, Rosemarie, Martorell, Reynaldo, Martos, Eva, Marventano, Stefano, Mascarenhas, Luis P, Masoodi, Shariq R, Mathiesen, Ellisiv B, Mathur, Prashant, Matijasevich, Alicia, Matsha, Tandi E, Mavrogianni, Christina, Mazur, Artur, Mbanya, Jean Claude N, McFarlane, Shelly R, McGarvey, Stephen T, McKee, Martin, McLachlan, Stela, McLean, Rachael M, McLean, Scott B, McNulty, Breige A, Mediene-Benchekor, Sounnia, Medzioniene, Jurate, Mehdipour, Parinaz, Mehlig, Kirsten, Mehrparvar, Amir Houshang, Meirhaeghe, Aline, Meisfjord, Jorgen, Meisinger, Christa, Menezes, Ana Maria B, Menon, Geetha R, Mensink, Gert BM, Menzano, Maria Teresa, Mereke, Alibek, Meshram, Indrapal I, Metspalu, Andres, Mi, Jie, Michaelsen, Kim F, Michels, Nathalie, Mikkel, Kairit, Milkowska, Karolina, Miller, Jody C, Minderico, Claudia S, Mini, GK, Miquel, Juan Francisco, Mirjalili, Mohammad Reza, Mirkopoulou, Daphne, Mirrakhimov, Erkin, Misigoj-Durakovic, Marjeta, Mistretta, Antonio, Mocanu, Veronica, Modesti, Pietro A, Moghaddam, Sahar Saeedi, Mohajer, Bahram, Mohamed, Mostafa K, Mohamed, Shukri F, Mohammad, Kazem, Mohammadi, Zahra, Mohammadifard, Noushin, Mohammadpourhodki, Reza, Mohan, Viswanathan, Mohanna, Salim, Yusoff, Muhammad Fadhli Mohd, Mohebbi, Iraj, Mohebi, Farnam, Moitry, Marie, Molbo, Drude, Mollehave, Line T, Moller, Niels C, Molnar, Denes, Momenan, Amirabbas, Mondo, Charles K, Monroy-Valle, Michele, Monterrubio-Flores, Eric, Monyeki, Kotsedi Daniel K, Moosazadeh, Mahmood, Moreira, Leila B, Morejon, Alain, Moreno, Luis A, Morgan, Karen, Morin, Suzanne N, Mortensen, Erik Lykke, Moschonis, George, Mossakowska, Malgorzata, Mostafa, Aya, Mota-Pinto, Anabela, Mota, Jorge, Motlagh, Mohammad Esmaeel, Motta, Jorge, Moura-dos-Santos, Marcos Andre, Mridha, Malay K, Msyamboza, Kelias P, Thet, Thet Mu, Muc, Magdalena, Mugosa, Boban, Muiesan, Maria L, Mukhtorova, Parvina, Mueller-Nurasyid, Martina, Murphy, Neil, Mursu, Jaakko, Murtagh, Elaine M, Musa, Kamarul Imran, Milanovic, Sanja Music, Musil, Vera, Mustafa, Norlaila, Nabipour, Iraj, Naderimagham, Shohreh, Nagel, Gabriele, Naidu, Balkish M, Najafi, Farid, Nakamura, Harunobu, Namesna, Jana, Nang, Ei Ei K, Nangia, Vinay B, Nankap, Martin, Narake, Sameer, Nardone, Paola, Nauck, Matthias, Neal, William A, Nejatizadeh, Azim, Nelis, Keiu, Nelis, Liis, Nenko, Ilona, Neovius, Martin, Nervi, Flavio, Nguyen, Chung T, Nguyen, Nguyen D, Quang, Ngoc Nguyen, Nieto-Martinez, Ramfis E, Nikitin, Yury P, Ning, Guang, Ninomiya, Toshiharu, Nishtar, Sania, Noale, Marianna, Noboa, Oscar A, Nogueira, Helena, Norat, Teresa, Nordendahl, Maria, Nordestgaard, Borge G, Noto, Davide, Nowak-Szczepanska, Natalia, Al Nsour, Mohannad, Nuhoglu, Irfan, Nurk, Eha, O'Neill, Terence W, O'Reilly, Dermot, Obreja, Galina, Ochimana, Caleb, Ochoa-Aviles, Angelica M, Oda, Eiji, Oh, Kyungwon, Ohara, Kumiko, Ohlsson, Claes, Ohtsuka, Ryutaro, Olafsson, Orn, Olinto, Maria Teresa A, Oliveira, Isabel O, Omar, Mohd Azahadi, Onat, Altan, Ong, Sok King, Ono, Lariane M, Ordunez, Pedro, Ornelas, Rui, Ortiz, Ana P, Ortiz, Pedro J, Osler, Merete, Osmond, Clive, Ostojic, Sergej M, Ostovar, Afshin, Otero, Johanna A, Overvad, Kim, Owusu-Dabo, Ellis, Paccaud, Fred Michel, Padez, Cristina, Pagkalos, Ioannis, Pahomova, Elena, de Paiva, Karina Mary, Pajak, Andrzej, Palli, Domenico, Palloni, Alberto, Palmieri, Luigi, Pan, Wen-Harn, Panda-Jonas, Songhomitra, Pandey, Arvind, Panza, Francesco, Papandreou, Dimitrios, Park, Soon-Woo, Park, Suyeon, Parnell, Winsome R, Parsaeian, Mahboubeh, Pascanu, Ionela M, Pasquet, Patrick, Patel, Nikhil D, Pednekar, Mangesh S, Peer, Nasheeta, Peixoto, Sergio Viana, Peltonen, Markku, Pereira, Alexandre C, Peres, Marco A, Perez-Farinos, Napoleon, Perez, Cynthia M, Peterkova, Valentina, Peters, Annette, Petersmann, Astrid, Petkeviciene, Janina, Petrauskiene, Ausra, Pettenuzzo, Emanuela, Peykari, Niloofar, Son, Thai Pham, Pichardo, Rafael N, Pierannunzio, Daniela, Pigeot, Iris, Pikhart, Hynek, Pilav, Aida, Pilotto, Lorenza, Pistelli, Francesco, Pitakaka, Freda, Piwonska, Aleksandra, Pizarro, Andreia N, Plans-Rubio, Pedro, Poh, Bee Koon, Pohlabeln, Hermann, Pop, Raluca M, Porta, Miquel, Posch, Georg, Poudyal, Anil, Poulimeneas, Dimitrios, Pouraram, Hamed, Pourfarzi, Farhad, Pourshams, Akram, Poustchi, Hossein, Pradeepa, Rajendra, Price, Alison J, Price, Jacqueline F, Providencia, Rui, Puder, Jardena J, Pudule, Iveta, Puhakka, Soile E, Puiu, Maria, Punab, Margus, Qasrawi, Radwan F, Qorbani, Mostafa, Tran, Quoc Bao, Radic, Ivana, Radisauskas, Ricardas, Rahimikazerooni, Salar, Rahman, Mahfuzar, Rahman, Mahmudur, 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Ming-Dong, Wang, Ningli, Wang, Qian, Wang, Xiangjun, Wang, Ya Xing, Wang, Ying-Wei, Wannamethee, S Goya, Wareham, Nicholas, Weber, Adelheid, Wedderkopp, Niels, Weerasekera, Deepa, Weghuber, Daniel, Wei, Wenbin, Weres, Aneta, Werner, Bo, Whincup, Peter H, Widhalm, Kurt, Widyahening, Indah S, Wiecek, Andrzej, Wilks, Rainford J, Willeit, Johann, Willeit, Peter, Williams, Julianne, Wilsgaard, Tom, Wojtyniak, Bogdan, Wong-McClure, Roy A, Wong, Andrew, Wong, Jyh Eiin, Wong, Tien Yin, Woo, Jean, Woodward, Mark, Wu, Frederick C, Wu, Jianfeng, Wu, Li Juan, Wu, Shouling, Xu, Haiquan, Xu, Liang, Yaacob, Nor Azwany, Yamborisut, Uruwan, Yan, Weili, Yang, Ling, Yang, Xiaoguang, Yang, Yang, Yardim, Nazan, Yaseri, Mehdi, Yasuharu, Tabara, Ye, Xingwang, Yiallouros, Panayiotis K, Yoosefi, Moein, Yoshihara, Akihiro, You, Qi Sheng, You, San-Lin, Younger-Coleman, Novie O, Yusof, Safiah Md, Yusoff, Ahmad Faudzi, Zaccagni, Luciana, Zafiropulos, Vassilis, Zakavi, Seyed Rasoul, Zamani, Farhad, Zambon, Sabina, Zampelas, Antonis, Zamrazilova, Hana, Zapata, Maria Elisa, Zargar, Abdul Hamid, Zaw, Ko Ko, Zdrojewski, Tomasz, Vrkic, Tajana Zeljkovic, Zeng, Yi, Zhang, Luxia, Zhang, Zhen-Yu, Zhao, Dong, Zhao, Ming-Hui, Zhao, Wenhua, Zhen, Shiqi, Zheng, Wei, Zheng, Yingfeng, Zholdin, Bekbolat, Zhou, Maigeng, Zhu, Dan, Zocalo, Yanina, Cisneros, Julio Zuniga, Zuziak, Monika, Faculdade de Ciências da Nutrição e Alimentação, Instituto de Saúde Pública da Universidade do Porto, Interactions Gène-Environnement en Physiopathologie Cardio-Vasculaire (IGE-PCV), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Environnement, Santé, Sociétés (ESS), Centre National de la Recherche Scientifique (CNRS), European Project: 774548, Reproductive Origins of Adult Health and Disease (ROAHD), Rodriguez-Martinez A, Zhou B, Sophiea MK, Bentham J, Paciorek CJ, Iurilli ML, Carrillo-Larco RM, Bennett JE, Di Cesare M, Taddei C, Bixby H, Stevens GA, Riley LM, Cowan MJ, Savin S, 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Nordestgaard B.G., Noto D., Nowak-Szczepanska N., Nsour M.A., Nuhoglu I., Nurk E., O'Neill T.W., O'Reilly D., Obreja G., Ochimana C., Ochoa-Aviles A.M., Oda E., Oh K., Ohara K., Ohlsson C., Ohtsuka R., Olafsson O., Olinto M.T.A., Oliveira I.O., Omar M.A., Onat A., Ong S.K., Ono L.M., Ordunez P., Ornelas R., Ortiz A.P., Ortiz P.J., Osler M., Osmond C., Ostojic S.M., Ostovar A., Otero J.A., Overvad K., Owusu-Dabo E., Paccaud F.M., Padez C., Pagkalos I., Pahomova E., Paiva K.M.D., Pajak A., Palli D., Palloni A., Palmieri L., Pan W.-H., Panda-Jonas S., Pandey A., Panza F., Papandreou D., Park S.-W., Park S., Parnell W.R., Parsaeian M., Pascanu I.M., Pasquet P., Patel N.D., Pednekar M.S., Peer N., Peixoto S.V., Peltonen M., Pereira A.C., Peres M.A., Perez-Farinos N., Perez C.M., Peterkova V., Peters A., Petersmann A., Petkeviciene J., Petrauskiene A., Pettenuzzo E., Peykari N., Pham S.T., Pichardo R.N., Pierannunzio D., Pigeot I., Pikhart H., Pilav A., Pilotto L., Pistelli F., Pitakaka F., Piwonska A., Pizarro A.N., Plans-Rubio P., Poh B.K., Pohlabeln H., Pop R.M., Porta M., Posch G., Poudyal A., Poulimeneas D., Pouraram H., Pourfarzi F., Pourshams A., Poustchi H., Pradeepa R., Price A.J., Price J.F., Providencia R., Puder J.J., Pudule I., Puhakka S.E., Puiu M., Punab M., Qasrawi R.F., Qorbani M., Quoc Bao T., Radic I., Radisauskas R., Rahimikazerooni S., Rahman M., Raitakari O., Raj M., Rakhimova E., Rakhmatulloev S., Rakovac I., Ramachandra Rao S., Ramachandran A., Ramke J., Ramos E., Ramos R., Rampal L., Rampal S., Rarra V., Rascon-Pacheco R.A., Rasmussen M., Rech C.R., Redon J., Reganit P.F.M., Regecova V., Revilla L., Rezaianzadeh A., Ribas-Barba L., Ribeiro R., Riboli E., Richter A., Rigo F., Rinaldo N., Rinke de Wit T.F., Rito A., Ritti-Dias R.M., Rivera J.A., Robitaille C., Roccaldo R., Rodrigues D., Rodriguez-Artalejo F., Rodriguez-Perez M.D.C., Rodriguez-Villamizar L.A., Roggenbuck U., Rojas-Martinez R., Rojroongwasinkul N., Romaguera D., Romeo E.L., Rosario R.V., Rosengren A., Rouse I., Roy J.G., Rubinstein A., Ruhli F.J., Ruidavets J.-B., Ruiz-Betancourt B.S., Ruiz Moreno E., Rusakova I.A., Russell Jonsson K., Russo P., Rust P., Rutkowski M., Sabanayagam C., Sacchini E., Sachdev H.S., Sadjadi A., Safarpour A.R., Safi S., Safiri S., Saidi O., Saki N., Salanave B., Salazar Martinez E., Salmeron D., Salomaa V., Salonen J.T., Salvetti M., Samoutian M., Sanchez-Abanto J., Sandjaja, Sans S., Santa Marina L., Santos D.A., Santos I.S., Santos L.C., Santos M.P., Santos O., Santos R., Santos Sanz S., Saramies J.L., Sardinha L.B., Sarrafzadegan N., Sathish T., Saum K.-U., Savva S., Savy M., Sawada N., Sbaraini M., Scazufca M., Schaan B.D., Schaffrath Rosario A., Schargrodsky H., Schienkiewitz A., Schindler K., Schipf S., Schmidt C.O., Schmidt I.M., Schnohr P., Schottker B., Schramm S., Schroder H., Schultsz C., Schutte A.E., Sebert S., Sein A.A., Selamat R., Sember V., Sen A., Senbanjo I.O., Sepanlou S.G., Sequera V., Serra-Majem L., Servais J., Sevcikova L., Shalnova S.A., Shamah-Levy T., Shamshirgaran M., Shanthirani C.S., Sharafkhah M., Sharma S.K., Shaw J.E., Shayanrad A., Shayesteh A.A., Shengelia L., Shi Z., Shibuya K., Shimizu-Furusawa H., Shin D.W., Shin Y., Shirani M., Shiri R., Shrestha N., Si-Ramlee K., Siani A., Siantar R., Sibai A.M., Silva A.M., Silva D.A.S., Simon M., Simons J., Simons L.A., Sjoberg A., Sjostrom M., Skodje G., Slowikowska-Hilczer J., Slusarczyk P., Smeeth L., So H.-K., Soares F.C., Sobek G., Sobngwi E., Sodemann M., Soderberg S., Soekatri M.Y., Soemantri A., Sofat R., Solfrizzi V., Somi M.H., Sonestedt E., Song Y., Sorgjerd E.P., Sossa Jerome C., Soto-Rojas V.E., Soumare A., Sovic S., Sparboe-Nilsen B., Sparrenberger K., Spinelli A., Spiroski I., Staessen J.A., Stamm H., Stathopoulou M.G., Staub K., Stavreski B., Steene-Johannessen J., Stehle P., Stein A.D., Stergiou G.S., Stessman J., Stevanovic R., Stieber J., Stockl D., Stocks T., Stokwiszewski J., Stoyanova E., Stratton G., Stronks K., Strufaldi M.W., Sturua L., Suarez-Medina R., Suka M., Sun C.-A., Sundstrom J., Sung Y.-T., Sunyer J., Suriyawongpaisal P., Swinburn B.A., Sy R.G., Syddall H.E., Sylva R.C., Szklo M., Szponar L., Tai E.S., Tammesoo M.-L., Tamosiunas A., Tan E.J., Tang X., Tanser F., Tao Y., Tarawneh M.R., Tarp J., Tarqui-Mamani C.B., Taxova Braunerova R., Taylor A., Taylor J., Tchibindat F., Tebar W.R., Tell G.S., Tello T., Thankappan K.R., Theobald H., Theodoridis X., Thijs L., Thomas N., Thuesen B.H., Ticha L., Timmermans E.J., Tjonneland A., Tolonen H.K., Tolstrup J.S., Topbas M., Topor-Madry R., Torheim L.E., Tormo M.J., Tornaritis M.J., Torrent M., Torres-Collado L., Toselli S., Traissac P., Tran T.T.-H., Trichopoulos D., Trichopoulou A., Trinh O.T., Trivedi A., Tshepo L., Tsigga M., Tsugane S., Tuliakova A.M., Tulloch-Reid M.K., Tullu F., Tuomainen T.-P., Tuomilehto J., Turley M.L., Tynelius P., Tzotzas T., Tzourio C., Ueda P., Ugel E., Ukoli F.A., Ulmer H., Unal B., Usupova Z., Uusitalo H.M., Uysal N., Vaitkeviciute J., Valdivia G., Vale S., Valvi D., van Dam R.M., Van der Heyden J., van der Schouw Y.T., Van Herck K., Van Minh H., van Valkengoed I.G., Vanderschueren D., Vanuzzo D., Varbo A., Varela-Moreiras G., Varona-Perez P., Vasan S.K., Vega T., Veidebaum T., Velasquez-Melendez G., Velika B., Veronesi G., Verschuren W.M., Victora C.G., Viegi G., Viet L., Villalpando S., Vineis P., Vioque J., Virtanen J.K., Visser M., Visvikis-Siest S., Viswanathan B., Vladulescu M., Vlasoff T., Vocanec D., Volzke H., Voutilainen A., Voutilainen S., Vrijheid M., Vrijkotte T.G., Wade A.N., Wagner A., Waldhor T., Walton J., Wambiya E.O., Wan Bebakar W.M., Wan Mohamud W.N., Wanderley Junior R.D.S., Wang M.-D., Wang N., Wang Q., Wang X., Wang Y.X., Wang Y.-W., Wannamethee S.G., Wareham N., Weber A., Wedderkopp N., Weerasekera D., Weghuber D., Wei W., Weres A., Werner B., Whincup P.H., Widhalm K., Widyahening I.S., Wiecek A., Wilks R.J., Willeit J., Willeit P., Williams J., Wilsgaard T., Wojtyniak B., Wong-McClure R.A., Wong A., Wong J.E., Wong T.Y., Woo J., Woodward M., Wu F.C., Wu J., Wu L.J., Wu S., Xu H., Xu L., Yaacob N.A., Yamborisut U., Yan W., Yang L., Yang X., Yang Y., Yardim N., Yaseri M., Yasuharu T., Ye X., Yiallouros P.K., Yoosefi M., Yoshihara A., You Q.S., You S.-L., Younger-Coleman N.O., Yusof S.M., Yusoff A.F., Zaccagni L., Zafiropulos V., Zakavi S.R., Zamani F., Zambon S., Zampelas A., Zamrazilova H., Zapata M.E., Zargar A.H., Zaw K.K., Zdrojewski T., Zeljkovic Vrkic T., Zeng Y., Zhang L., Zhang Z.-Y., Zhao D., Zhao M.-H., Zhao W., Zhen S., Zheng W., Zheng Y., Zholdin B., Zhou M., Zhu D., Zocalo Y., Zuniga Cisneros J., Zuziak M., and Ezzati M.
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Male ,body-mass index ,ADULTHOOD ,Adolescents ,pituuskasvu ,Pediatrics ,Body Mass Index ,0302 clinical medicine ,Child Development ,nuoret ,Public health surveillance ,Medicine ,Health Status Indicators ,10. No inequality ,Child ,11 Medical and Health Sciences ,Body mass index ,ComputingMilieux_MISCELLANEOUS ,education.field_of_study ,VDP::Medisinske Fag: 700::Helsefag: 800::Samfunnsmedisin, sosialmedisin: 801 ,General Medicine ,Body mass indexes ,kansainvälinen vertailu ,3. Good health ,Geography ,Health ,030220 oncology & carcinogenesis ,Child, Preschool ,Medical and Health sciences ,purl.org/becyt/ford/3 [https] ,medicine.medical_specialty ,School-aged adolescents ,Socio-culturale ,lapset (ikäryhmät) ,Nursing ,territories ,ravinto ,purl.org/becyt/ford/3.3 [https] ,03 medical and health sciences ,School Children ,SDG 3 - Good Health and Well-being ,SYSTEMATIC ANALYSIS ,Humans ,school-aged children and adolescents ,Montenegro ,education ,Science & Technology ,Omvårdnad ,Health sciences, Medical and Health sciences ,Ciências médicas e da saúde ,Bayes Theorem ,Anthropometry ,Adolescent Development ,medicine.disease ,TRENDS ,Height and Body-mass Index ,Faculdade de Ciências Sociais ,UNDERNUTRITION ,Height index trajectories ,Height, body mass index, children , epidemiology ,risk factors, growth ,Stature ,Demography ,Settore MED/09 - Medicina Interna ,Internationality ,[SDV]Life Sciences [q-bio] ,030204 cardiovascular system & hematology ,Body-mass index trajectories ,Epidemiology ,Medicine and Health Sciences ,risk factors ,countries ,EPIDEMIOLOGY ,height ,children ,adolescents ,BMI ,030212 general & internal medicine ,painoindeksi ,Child development ,2. Zero hunger ,Medicine(all) ,School age child ,obestity children cardiovascular ,Population Health ,1. No poverty ,Pediatrik ,Public Health, Global Health, Social Medicine and Epidemiology ,3142 Public health care science, environmental and occupational health ,Pooled analysis ,NUTRITION ,Female ,medicine.symptom ,pooled analysis ,Life Sciences & Biomedicine ,terveys ,height, BMI, nutrition, health, children, adolescents ,Adolescent ,growth ,Population ,body-mass ,Population based ,Body-mass index ,Young Adult ,Medicine, General & Internal ,Meta-Analysis as Topic ,General & Internal Medicine ,parasitic diseases ,Weight gain ,School-aged childrens ,Age trajectories ,business.industry ,Height ,Weight ,Body Height ,Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi ,Malnutrition ,ONSET ,Ciências da Saúde, Ciências médicas e da saúde ,School-aged children ,VDP::Medical disciplines: 700::Health sciences: 800::Community medicine, Social medicine: 801 ,business ,terveysriskit ,Estilos de Vida e Impacto na Saúde - Abstract
BACKGROUND: Comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents., METHODS: For this pooled analysis, we used a database of cardiometabolic risk factors collated by the Non-Communicable Disease Risk Factor Collaboration. We applied a Bayesian hierarchical model to estimate trends from 1985 to 2019 in mean height and mean BMI in 1-year age groups for ages 5–19 years. The model allowed for non-linear changes over time in mean height and mean BMI and for non-linear changes with age of children and adolescents, including periods of rapid growth during adolescence., FINDINGS: We pooled data from 2181 population-based studies, with measurements of height and weight in 65 million participants in 200 countries and territories. In 2019, we estimated a difference of 20 cm or higher in mean height of 19-year-old adolescents between countries with the tallest populations (the Netherlands, Montenegro, Estonia, and Bosnia and Herzegovina for boys; and the Netherlands, Montenegro, Denmark, and Iceland for girls) and those with the shortest populations (Timor-Leste, Laos, Solomon Islands, and Papua New Guinea for boys; and Guatemala, Bangladesh, Nepal, and Timor-Leste for girls). In the same year, the difference between the highest mean BMI (in Pacific island countries, Kuwait, Bahrain, The Bahamas, Chile, the USA, and New Zealand for both boys and girls and in South Africa for girls) and lowest mean BMI (in India, Bangladesh, Timor-Leste, Ethiopia, and Chad for boys and girls; and in Japan and Romania for girls) was approximately 9–10 kg/m2. In some countries, children aged 5 years started with healthier height or BMI than the global median and, in some cases, as healthy as the best performing countries, but they became progressively less healthy compared with their comparators as they grew older by not growing as tall (eg, boys in Austria and Barbados, and girls in Belgium and Puerto Rico) or gaining too much weight for their height (eg, girls and boys in Kuwait, Bahrain, Fiji, Jamaica, and Mexico; and girls in South Africa and New Zealand). In other countries, growing children overtook the height of their comparators (eg, Latvia, Czech Republic, Morocco, and Iran) or curbed their weight gain (eg, Italy, France, and Croatia) in late childhood and adolescence. When changes in both height and BMI were considered, girls in South Korea, Vietnam, Saudi Arabia, Turkey, and some central Asian countries (eg, Armenia and Azerbaijan), and boys in central and western Europe (eg, Portugal, Denmark, Poland, and Montenegro) had the healthiest changes in anthropometric status over the past 3·5 decades because, compared with children and adolescents in other countries, they had a much larger gain in height than they did in BMI. The unhealthiest changes—gaining too little height, too much weight for their height compared with children in other countries, or both—occurred in many countries in sub-Saharan Africa, New Zealand, and the USA for boys and girls; in Malaysia and some Pacific island nations for boys; and in Mexico for girls., INTERPRETATION: The height and BMI trajectories over age and time of school-aged children and adolescents are highly variable across countries, which indicates heterogeneous nutritional quality and lifelong health advantages and risks., Wellcome Trust, AstraZeneca Young Health Programme, EU., peer-reviewed
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- 2020
3. A century of trends in adult human height
- Author
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Bentham, James, Cesare, Mariachiara Di, Stevens, Gretchen A., Zhou, Bin, Bixby, Honor, Cowan, Melanie J., Fortunato, Lea, Bennett, James E., Danaei, Goodarz, Hajifathalian, Kaveh, Lu, Yuan, Riley, Leanne M., Laxmaiah, Avula, Kontis, Vasilis, Paciorek, Christopher J., Riboli, Elio, Ezzati, Majid, Abdeen, Ziad A., Hamid, Zargar Abdul, Abu-Rmeileh, Niveen M., Acosta-Cazares, Benjamin, Adams, Robert, Aekplakorn, Wichai, Aguilar-Salinas, Carlos A., Agyemang, Charles, Ahmadvand, Alireza, Ahrens, Wolfgang, Al-Hazzaa, Hazzaa M., Al-Othman, Amani Rashed, Raddadi, Rajaa Al, Ali, Mohamed M., Alkerwi, Ala'a, Alvarez-Pedrerol, Mar, Aly, Eman, Amouyel, Philippe, Amuzu, Antoinette, Andersen, Lars Bo, Anderssen, Sigmund A., Anjana, Ranjit Mohan, Aounallah-Skhiri, Hajer, Ariansen, Inger, Aris, Tahir, Arlappa, Nimmathota, Arveiler, Dominique, Assah, Felix K., Avdicova, Maria, Azizi, Fereidoun, Babu, Bontha V., Bahijri, Suhad, Balakrishna, Nagalla, Bandosz, Piotr, Banegas, Jose R., Barbagallo, Carlo M., Barcelo, Alberto, Barkat, Amina, Barros, Mauro V., Bata, Iqbal, Batieha, Anwar M., Batista, Rosangela L., Baur, Louise A., Beaglehole, Robert, Romdhane, Habiba Ben, Benet, Mikhail, Bernabe-Ortiz, Antonio, Bernotine, Gailute, Bettiol, Heloisa, Bhagyalaxmi, Aroor, Bharadwaj, Sumit, Bhargava, Santosh K., Bhatti, Zaid, Bhutta, Zulfiqar A., Bi, HongSheng, Bi, Yufang, Bjerregaard, Peter, Bjertness, Espen, Bjertness, Marius B., Bjorkelund, Cecilia, Blokstra, Anneke, Bo, Simona, Bobak, Martin, Boddy, Lynne M., Boehm, Bernhard O., Boeing, Heiner, Boissonnet, Carlos P., Bongard, Vanina, Bovet, Pascal, Braeckman, Lutgart, Bragt, Marjolijn C. E., Brajkovich, Imperia, Branca, Francesco, Breckenkamp, Juergen, Brenner, Hermann, Brewster, Lizzy M., Brian, Garry R., Bruno, Graziella, Bueno-de-Mesquita, H. B., Bugge, Anna, Burns, C., Leon, Antonio Cabrera de, Cacciottolo, Joseph, Cama, Tilema, Cameron, Christine, Camolas, Jose, Can, Gunay, Candido, Ana Paula C., Capuano, Vincenzo, Cardoso, Viviane C., Carlsson, Axel C., Carvalho, Maria J., Casanueva, Felipe F., Casas, Juan-Pablo, Caserta, Carmelo A., Chamukuttan, Snehalatha, Chan, Angelique W., Chan, Queenie, Chaturvedi, Himanshu K., Chaturvedi, Nishi, Chen, Chien-Jen, Chen, Fangfang, Chen, Huashuai, Chen, Shuohua, Chen, Y. Z., Cheng, Ching-Yu, Chetrit, Angela, Chiolero, Arnaud, Chiou, Shu-Ti, Chirita-Emandi, Adela, Cho, Belong, Cho, Yumi, Christensen, Kaare, Chudek, Jerzy, Cifkova, Renata, Claessens, Frank, Clays, Els, Concin, Hans, Cooper, Cyrus, Cooper, Rachel, Coppinger, Tara C., Costanzo, Simona, Cottel, Dominique, Cowell, Chris, Craig, Cora L., Crujeiras, Ana B., D'Arrigo, Graziella, d'Orsi, Eleonora, Dallongeville, Jean, Damasceno, Albertino, Damsgaard, Camilla T., Dankner, Rachel, Dauchet, Luc, Backer, Guy De, Bacquer, Dirk De, Gaetano, Giovanni de, Hanauw, Stefaan De, Smedt, Delphine De, Deepa, Mohan, Deev, Alexander D., Dehghan, Abbas, Delisle, Helene, Delpeuch, Francis, Deschamps, Valerie, Dhana, Klodian, Castelnuovo, Augusto F. Di, Dias-da-Costa, Juvenal Soares, Diaz, Alejandro, Djalalinia, Shirin, Do, Ha T. P., Dobson, Annette J., Donfrancesco, Chiara, Donoso, Silvana P., Doering, Angela, Doua, Kouamelan, Drygas, Wojciech, Dzerve, Vilnis, Egbagbe, Eruke E., Eggertsen, Robert, Ekelund, Ulf, Ati, Jalila El, Elliott, Paul, Engle-Stone, Reina, Erasmus, Rajiv T., Erem, Cihangir, Eriksen, Louise, Pena, Jorge Escobedo-de la, Evans, Alun, Faeh, David, Fall, Caroline H., Farzadfar, Farshad, Felix-Redondo, Francisco J., Ferguson, Trevor S., Fernandez-Berges, Daniel, Ferrante, Daniel, Ferrari, Marika, Ferreccio, Catterina, Ferrieres, Jean, Finn, Joseph D., Fischer, Krista, Monterrubio, Eric A., Foeger, Bernhard, Foo, Leng Huat, Forslund, Ann-Sofie, Forsner, Maria, Fortmann, Stephen P., Francis, Heba M., Francis, Damian K., Franco, M. Do Carmo, Franco, Oscar H., Frontera, Guillermo, Fuchs, Flavio D., Fuchs, Sandra C., Fujita, Yuki, Furusawa, Takuro, Gaciong, Zbigniew, Gafencu, Mihai, Gareta, Dickman, Garnett, Sarah P., Gaspoz, Jean-Michel, Gasull, Magda, Gates, Louise, Geleijnse, Johanna M., Ghasemian, Anoosheh, Giampaoli, Simona, Gianfagna, Francesco, Giovannelli, Jonathan, Giwercman, Aleksander, Goldsmith, Rebecca A., Goncalves, Helen, Gross, Marcela Gonzalez, Rivas, Juan P. Gonzalez, Gorbea, Mariano Bonet, Gottrand, Frederic, Graff-Iversen, Sidsel, Grafnetter, Dusan, Grajda, Aneta, Grammatikopoulou, Maria G., Gregor, Ronald D., Grodzicki, Tomasz, Grontved, Anders, Gruden, Grabriella, Grujic, Vera, Gu, Dongfeng, Gualdi-Russo, Emanuela, Guan, Ong Peng, Gudnason, Vilmundur, Guerrero, Ramiro, Guessous, Idris, Guimaraes, Andre L., Gulliford, Martin C., Gunnlaugsdottir, Johanna, Gunter, Marc, Guo, Xiu H., Guo, Yin, Gupta, Prakash C., Gureje, Oye, Gurzkowska, Beata, Gutierrez, Laura, Gutzwiller, Felix, Halkjaer, Jytte, Hambleton, Ian R., Hardy, Rebecca, Kumar, Rachakulla Hari, Hata, Jun, Hayes, Alison J., He, Jiang, Hendriks, Marleen Elisabeth, Cadena, Leticia Hernandez, Herrala, Sauli, Heshmat, Ramin, Hihtaniemi, Ilpo Tapani, Ho, Sai Yin, Ho, Suzanne C., Hobbs, Michael, Hofman, Albert, Hormiga, Claudia M., Horta, Bernardo L., Houti, Leila, Howitt, Christina, Htay, Thein Thein, Htet, Aung Soe, Htike, Maung Maung Than, Hu, Yonghua, Hussieni, Abdullatif S., Huu, Chinh Nguyen, Huybrechts, Inge, Hwalla, Nahla, Iacoviello, Licia, Iannone, Anna G., Ibrahim, Mohsen M., Ikeda, Nayu, Ikram, M. Arfan, Irazola, Vilma E., Islam, Muhammad, Ivkovic, Vanja, Iwasaki, Masanori, Jackson, Rod T., Jacobs, Jeremy M., Jafar, Tazeen, Jamil, Kazi M., Jamrozik, Konrad, Janszky, Imre, Jasienska, Grazyna, Jelakovic, Bojan, Jiang, Chao Qiang, Joffres, Michel, Johansson, Mattias, Jonas, Jost B., Jorgensen, Torben, Joshi, Pradeep, Juolevi, Anne, Jurak, Gregor, Juresa, Vesna, Kaaks, Rudolf, Kafatos, Anthony, Kalter-Leibovici, Ofra, Kapantais, Efthymios, Kasaeian, Amir, Katz, Joanne, Kaur, Prabhdeep, Kavousi, Maryam, Keil, Ulrich, Boker, Lital Keinan, Keinanen-Kiukaanniemi, Sirkka, Kelishadi, Roya, Kemper, Han C. G., Kengne, Andre Pascal, Kersting, Mathilde, Key, Timothy, Khader, Yousef Saleh, Khalili, Davood, Khang, Young-Ho, Khaw, Kay-Tee H., Khouw, Ilse M. S. L., Kiechl, Stefan, Killewo, Japhet, Kim, Jeongseon, Klimont, Jeannette, Klumbiene, Jurate, Koirala, Bhawesh, Kolle, Elin, Kolsteren, Patrick, Korrovits, Paul, Koskinen, Seppo, Kouda, Katsuyasu, Koziel, Slawomir, Kratzer, Wolfgang, Krokstad, Steinar, Kromhout, Daan, Kruger, Herculina S., Kubinova, Ruzena, Kujala, Urho M., Kula, Krzysztof, Kulaga, Zbigniew, Kumar, R. Krishna, Kurjata, Pawel, Kusuma, Yadlapalli S., Kuulasmaa, Kari, Kyobutungi, Catherine, Laamiri, Fatima Zahra, Laatikainen, Tiina, Lachat, Carl, Laid, Youcef, Lam, Tai Hing, Landrove, Orlando, Lanska, Vera, Lappas, Georg, Larijani, Bagher, Laugsand, Lars E., Bao, Khanh Le Nguyen, Le, Tuyen D., Leclercq, Catherine, Lee, Jeannette, Lee, Jeonghee, Lehtimaki, Terho, Lekhraj, Rampal, Leon-Munoz, Luz M., Li, Yanping, Lilly, Christa L., Lim, Wei-Yen, Lima-Costa, M. Fernanda, Lin, Hsien-Ho, Lin, Xu, Linneberg, Allan, Lissner, Lauren, Litwin, Mieczyslaw, Liu, Jing, Lorbeer, Roberto, Lotufo, Paulo A., Lozano, Jose Eugenio, Luksiene, Dalia, Lundqvist, Annamari, Lunet, Nuno, Ma, Guansheng, Ma, Jun, Machado-Coelho, George L. L., Machi, Suka, Maggi, Stefania, Magliano, Dianna J., Maire, Bernard, Makdisse, Marcia, Malekzadeh, Reza, Malhotra, Rahul, Rao, Kodavanti Mallikharjuna, Malyutina, Sofia, Manios, Yannis, Mann, Jim I., Manzato, Enzo, Margozzini, Paula, Markey, Oonagh, Marques-Vidal, Pedro, Marrugat, Jaume, Martin-Prevel, Yves, Martorell, Reynaldo, Masoodi, Shariq R., Mathiesen, Ellisiv B., Matsha, Tandi E., Mazur, Artur, Mbanya, Jean Claude N., McFarlane, Shelly R., McGarvey, Stephen T., McKee, Martin, McLachlan, Stela, McLean, Rachael M., McNulty, Breige A., Yusof, Safiah Md, Mediene-Benchekor, Sounnia, Meirhaeghe, Aline, Meisinger, Christa, Menezes, Ana Maria B., Mensink, Gert B. M., Meshram, Indrapal I., Metspalu, Andres, Mi, Jie, Michaelsen, Kim F., Mikkel, Kairit, Miller, Jody C., Miquel, Juan Francisco, Miranda, J. Jaime, Misigoj-Durakovic, Marjeta, Mohamed, Mostafa K., Mohammad, Kazem, Mohammadifard, Noushin, Mohan, Viswanathan, Yusoff, Muhammad Fadhli Mohd, Molbo, Drude, Moller, Niels C., Molnar, Denes, Mondo, Charles K., Monyeki, Kotsedi Daniel K., Moreira, Leila B., Morejon, Alain, Moreno, Luis A., Morgan, Karen, Mortensen, Erik Lykke, Moschonis, George, Mossakowska, Malgorzata, Mostafa, Aya, Mota, Jorge, Motlagh, Mohammad Esmaeel, Motta, Jorge, Mu, Thet Thet, Muiesan, Maria Lorenza, Mueller-Nurasyid, Martina, Murphy, Neil, Mursu, Jaakko, Murtagh, Elaine M., Musa, Kamarul Imran, Musil, Vera, Nagel, Gabriele, Nakamura, Harunobu, Namesna, Jana, Nang, E. E. K., Nangia, Vinay B., Nankap, Martin, Narake, Sameer, Navarrete-Munoz, Eva Maria, Neal, William A., Nenko, Ilona, Neovius, Martin, Nervi, Flavio, Neuhauser, Hannelore K., Nguyen, Nguyen D., Nguyen, Quang Ngoc, Nieto-Martinez, Ramfis E., Ning, Guang, Ninomiya, Toshiharu, Nishtar, Sania, Noale, Marianna, Norat, Teresa, Noto, Davide, Nsour, Mohannad Al, O'Reilly, Dermot, Oh, Kyungwon, Olayan, Iman H., Olinto, Maria Teresa Anselmo, Oltarzewski, Maciej, Omar, Mohd A., Onat, Altan, Ordunez, Pedro, Ortiz, Ana P., Osler, Merete, Osmond, Clive, Ostojic, Sergej M., Otero, Johanna A., Overvad, Kim, Owusu-Dabo, Ellis, Paccaud, Fred Michel, Padez, Cristina, Pahomova, Elena, Pajak, Andrzej, Palli, Domenico, Palloni, Alberto, Palmieri, Luigi, Panda-Jonas, Songhomitra, Panza, Francesco, Parnell, Winsome R., Parsaeian, Mahboubeh, Pecin, Ivan, Pednekar, Mangesh S., Peeters, Petra H., Peixoto, Sergio Viana, Peltonen, Markku, Pereira, Alexandre C., Perez, Cynthia M., Peters, Annette, Petkeviciene, Janina, Peykari, Niloofar, Pham, Son Thai, Pigeot, Iris, Pikhart, Hynek, Pilav, Aida, Pilotto, Lorenza, Pistelli, Francesco, Pitakaka, Freda, Piwonska, Aleksandra, Plans-Rubio, Pedro, Poh, Bee Koon, Porta, Miquel, Portegies, Marileen L. 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[0000-0002-8339-9285], Public and occupational health, ACS - Atherosclerosis & ischemic syndromes, APH - Personalized Medicine, APH - Global Health, General Internal Medicine, Amsterdam institute for Infection and Immunity, Global Health, AII - Infectious diseases, APH - Health Behaviors & Chronic Diseases, Amsterdam Public Health, APH - Methodology, ACS - Heart failure & arrhythmias, ACS - Diabetes & metabolism, AII - Amsterdam institute for Infection and Immunity, APH - Amsterdam Public Health, Padez, Cristina, NCD Risk Factor Collaboration (NCD-RisC), Bentham, J., Cesare, M.D., Stevens, G.A., Zhou, B., Bixby, H., Cowan, M., Fortunato, L., Bennett, J.E., Danaei, G., Hajifathalian, K., Lu, Y., Riley, L.M., Laxmaiah, A., Kontis, V., Paciorek, C.J., Riboli, E., Ezzati, M., Abdeen, Z.A., Hamid, Z.A., Abu-Rmeileh, N.M., Acosta-Cazares, B., Adams, R., Aekplakorn, W., Aguilar-Salinas, C.A., Agyemang, C., Ahmadvand, A., Ahrens, W., Al-Hazzaa, H.M., Al-Othman, A.R., Raddadi, R.A., Ali, M.M., Alkerwi, A., Alvarez-Pedrerol, M., Aly, E., Amouyel, P., Amuzu, A., Andersen, L.B., Anderssen, S.A., Anjana, R.M., Aounallah-Skhiri, H., Ariansen, I., Aris, T., Arlappa, N., Arveiler, D., Assah, F.K., Avdicová, M., Azizi, F., Babu, B.V., Bahijri, S., Balakrishna, N., Bandosz, P., Banegas, J.R., Barbagallo, C.M., Barceló, A., Barkat, A., Barros, M.V., Bata, I., Batieha, A.M., Batista, R.L., Baur, L.A., Beaglehole, R., Romdhane, H.B., Benet, M., Bernabe-Ortiz, A., Bernotiene, G., Bettiol, H., Bhagyalaxmi, A., Bharadwaj, S., Bhargava, S.K., Bhatti, Z., Bhutta, Z.A., Bi, H., Bi, Y., Bjerregaard, P., Bjertness, E., Bjertness, M.B., Björkelund, C., Blokstra, A., Bo, S., Bobak, M., Boddy, L.M., Boehm, B.O., Boeing, H., Boissonnet, C.P., Bongard, V., Bovet, P., Braeckman, L., Bragt, M.C., Brajkovich, I., Branca, F., Breckenkamp, J., Brenner, H., Brewster, L.M., Brian, G.R., Bruno, G., Bueno-de-Mesquita, H.A., Bugge, A., Burns, C., León, A.C., Cacciottolo, J., Cama, T., Cameron, C., Camolas, 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Ekelund, U., Ati, J.E., Elliott, P., Engle-Stone, R., Erasmus, R.T., Erem, C., Eriksen, L., Peña, J.E., Evans, A., Faeh, D., Fall, C.H., Farzadfar, F., Felix-Redondo, F.J., Ferguson, T.S., Fernández-Bergés, D., Ferrante, D., Ferrari, M., Ferreccio, C., Ferrieres, J., Finn, J.D., Fischer, K., Flores, E.M., Föger, B., Foo, L.H., Forslund, A.S., Forsner, M., Fortmann, S.P., Fouad, H.M., Francis, D.K., Franco, M.do C., Franco, O.H., Frontera, G., Fuchs, F.D., Fuchs, S.C., Fujita, Y., Furusawa, T., Gaciong, Z., Gafencu, M., Gareta, D., Garnett, S.P., Gaspoz, J.M., Gasull, M., Gates, L., Geleijnse, J.M., Ghasemian, A., Giampaoli, S., Gianfagna, F., Giovannelli, J., Giwercman, A., Goldsmith, R.A., Gonçalves, H., Gross, M.G., Rivas, J.P., Gorbea, M.B., Gottrand, F., Graff-Iversen, S., Grafnetter, D., Grajda, A., Grammatikopoulou, M.G., Gregor, R.D., Grodzicki, T., Grøntved, A., Gruden, G., Grujic, V., Gu, D., Gualdi-Russo, E., Guan, O.P., Gudnason, V., Guerrero, R., Guessous, I., Guimaraes, A.L., Gulliford, M.C., Gunnlaugsdottir, J., Gunter, M., Guo, X., Guo, Y., Gupta, P.C., Gureje, O., Gurzkowska, B., Gutierrez, L., Gutzwiller, F., Halkjær, J., Hambleton, I.R., Hardy, R., Kumar, R.H., Hata, J., Hayes, A.J., He, J., Hendriks, M.E., Cadena, L.H., Herrala, S., Heshmat, R., Hihtaniemi, I.T., Ho, S.Y., Ho, S.C., Hobbs, M., Hofman, A., Hormiga, C.M., Horta, B.L., Houti, L., Howitt, C., Htay, T.T., Htet, A.S., Htike, M.M., Hu, Y., Husseini, A., Huu, C.N., Huybrechts, I., Hwalla, N., Iacoviello, L., Iannone, A.G., Ibrahim, M.M., Ikeda, N., Ikram, M.A., Irazola, V.E., Islam, M., Ivkovic, V., Iwasaki, M., Jackson, R.T., Jacobs, J.M., Jafar, T., Jamil, K.M., Jamrozik, K., Janszky, I., Jasienska, G., Jelakovic, B., Jiang, C.Q., Joffres, M., Johansson, M., Jonas, J.B., Jørgensen, T., Joshi, P., Juolevi, A., Jurak, G., Jureša, V., Kaaks, R., Kafatos, A., Kalter-Leibovici, O., Kapantais, E., Kasaeian, A., Katz, J., Kaur, P., Kavousi, M., Keil, U., Boker, L.K., Keinänen-Kiukaanniemi, 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Malekzadeh, R., Malhotra, R., Rao, K.M., Malyutina, S., Manios, Y., Mann, J.I., Manzato, E., Margozzini, P., Markey, O., Marques-Vidal, P., Marrugat, J., Martin-Prevel, Y., Martorell, R., Masoodi, S.R., Mathiesen, E.B., Matsha, T.E., Mazur, A., Mbanya, J.C., McFarlane, S.R., McGarvey, S.T., McKee, M., McLachlan, S., McLean, R.M., McNulty, B.A., Yusof, S.M., Mediene-Benchekor, S., Meirhaeghe, A., Meisinger, C., Menezes, A.M., Mensink, G.B., Meshram, I.I., Metspalu, A., Mi, J., Michaelsen, K.F., Mikkel, K., Miller, J.C., Miquel, J.F., Miranda, J.J., Mišigoj-Durakovic, M., Mohamed, M.K., Mohammad, K., Mohammadifard, N., Mohan, V., Yusoff, M.F., Molbo, D., Møller, N.C., Molnár, D., Mondo, C.K., Monterrubio, E.A., Monyeki, K.D., Moreira, L.B., Morejon, A., Moreno, L.A., Morgan, K., Mortensen, E.L., Moschonis, G., Mossakowska, M., Mostafa, A., Mota, J., Motlagh, M.E., Motta, J., Mu, T.T., Muiesan, M.L., Müller-Nurasyid, M., Murphy, N., Mursu, J., Murtagh, E.M., Musa, K.I., Musil, V., Nagel, G., Nakamura, H., Jana, N., Nang, E.E., Nangia, V.B., Nankap, M., Narake, S., Navarrete Muñoz, E.M., Neal, W.A., Nenko, I., Neovius, M., Nervi, F., Neuhauser, H.K., Nguyen, N.D., Nguyen, Q.N., Nieto Martínez, R.E., Ning, G., Ninomiya, T., Nishtar, S., Noale, M., Norat, T., Noto, D., Nsour, M.A., O'Reilly, D., Oh, K., Olayan, I.H., Olinto, M.T., Oltarzewski, M., Omar, M.A., Onat, A., Ordunez, P., Ortiz, A.P., Osler, M., Osmond, C., Ostojic, S.M., Otero, J.A., Overvad, K., Owusu-Dabo, E., Paccaud, F.M., Padez, C., Pahomova, E., Pajak, A., Palli, D., Palloni, A., Palmieri, L., Panda-Jonas, S., Panza, F., Parnell, W.R., Parsaeian, M., Pecin, I., Pednekar, M.S., Peeters, P.H., Peixoto, S.V., Peltonen, M., Pereira, A.C., Pérez, C.M., Peters, A., Petkeviciene, J., Peykari, N., Pham, S.T., Pigeot, I., Pikhart, H., Pilav, A., Pilotto, L., Pistelli, F., Pitakaka, F., Piwonska, A., Plans-Rubió, P., Poh, B.K., Porta, M., Portegies, M.L., Poulimeneas, D., Pradeepa, R., Prashant, M., Price, J.F., Puiu, M., Tartu, M.P., Qasrawi, R.F., Qorbani, M., Bao, T.Q., Radic, I., Radisauskas, R., Rahman, M., Raitakari, O., Raj, M., Rao, S.R., Ramachandran, A., Ramke, J., Ramos, R., Rampal, S., Rasmussen, F., Redon, J., Reganit, P.F., Ribeiro, R., Rigo, F., Wit, T.F., Ritti-Dias, R.M., Rivera, J.A., Robinson, S.M., Robitaille, C., Rodríguez-Artalejo, F., Rodriguez-Perez, M.del C., Rodríguez-Villamizar, L.A., Rojas-Martinez, R., Rojroongwasinkul, N., Romaguera, D., Ronkainen, K., Rosengren, A., Rouse, I., Rubinstein, A., Rühli, F.J., Rui, O., Ruiz-Betancourt, B.S., Horimoto, A.R., Rutkowski, M., Sabanayagam, C., Sachdev, H.S., Saidi, O., Salanave, B., Sandjaja, S., Martinez, E.S., Salomaa, V., Salonen, J.T., Salvetti, M., Sánchez-Abanto, J., Sans, S., Santos, D.A., Santos, O., Santos, R.N., Santos, R., Saramies, J.L., Sardinha, L.B., Sarrafzadegan, N., Saum, K.U., Savva, S.C., Scazufca, M., Rosario, A.S., Schargrodsky, H., Schienkiewitz, A., Schmidt, I.M., Schneider, I.J., Schultsz, C., Schutte, A.E., Sein, A.A., Sen, A., Senbanjo, I.O., Sepanlou, S.G., Shalnova, S.A., Sharma, S.K., Shaw, J.E., Shibuya, K., Shin, D.W., Shin, Y., Shiri, R., Siantar, R., Sibai, A.M., Silva, A.M., Silva, D.A., Simon, M., Simons, J., Simons, L.A., Sjostrom, M., Slowikowska-Hilczer, J., Slusarczyk, P., Smeeth, L., Smith, M.C., Snijder, M.B., So, H.K., Sobngwi, E., Söderberg, S., Soekatri, M.Y., Solfrizzi, V., Sonestedt, E., Song, Y., Sørensen, T.Ia., Soric, M., Jérome, C.S., Soumare, A., Staessen, J.A., Starc, G., Stathopoulou, M.G., Staub, K., Stavreski, B., Steene-Johannessen, J., Stehle, P., Stein, A.D., Stergiou, G.S., Stieber, J., Stöckl, D., Stocks, T., Stokwiszewski, J., Stratton, G., Stronks, K., Strufaldi, M.W., Sun, C.A., Sundström, J., Sung, Y.T., Sunyer, J., Suriyawongpaisal, P., Swinburn, B.A., Sy, R.G., Szponar, L., Tai, E.S., Tammesoo, M.L., Tamosiunas, A., Tang, L., Tang, X., Tanser, F., Tao, Y., Tarawneh, M.R., Tarp, J., Tarqui-Mamani, C.B., Taylor, A., Tchibindat, F., 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A, Hormiga CM, Horta BL, Houti L, Howitt C, Htay TT, Htet AS, Htike MMT, Hu Y, Husseini A, Huu CN, Huybrechts I, Hwalla N, Iacoviello L, Iannone AG, Ibrahim MM, Ikeda N, Ikram MA, Irazola VE, Islam M, Ivkovic V, Iwasaki M, Jackson RT, Jacobs JM, Jafar T, Jamil KM, Jamrozik K, Janszky I, Jasienska G, Jelakovic B, Jiang CQ, Joffres M, Johansson M, Jonas JB, Jørgensen T, Joshi P, Juolevi A, Jurak G, Jureša V, Kaaks R, Kafatos A, Kalter-Leibovici O, Kapantais E, Kasaeian A, Katz J, Kaur P, Kavousi M, Keil U, Boker LK, Keinänen-Kiukaanniemi S, Kelishadi R, Kemper HC, Kengne AP, Kersting M, Key T, Khader YS, Khalili D, Khang YH, Khaw KH, Khouw IM, Kiechl S, Killewo J, Kim J, Klimont J, Klumbiene J, Koirala B, Kolle E, Kolsteren P, Korrovits P, Koskinen S, Kouda K, Koziel S, Kratzer W, Krokstad S, Kromhout D, Kruger HS, Kubinova R, Kujala UM, Kula K, Kulaga Z, Kumar RK, Kurjata P, Kusuma YS, Kuulasmaa K, Kyobutungi C, Laamiri FZ, Laatikainen T, Lachat C, Laid Y, Lam TH, Landrove O, Lanska V, Lappas G, Larijani B, Laugsand LE, Laxmaiah A, Bao KLN, Le TD, Leclercq C, Lee J, Lee J, Lehtimäki T, Lekhraj R, León-Muñoz LM, Li Y, Lilly CL, Lim WY, Lima-Costa MF, Lin HH, Lin X, Linneberg A, Lissner L, Litwin M, Liu J, Lorbeer R, Lotufo PA, Lozano JE, Luksiene D, Lundqvist A, Lunet N, Lytsy P, Ma G, Ma J, Machado-Coelho GL, Machi S, Maggi S, Ano DJ, Maire B, Makdisse M, Malekzadeh R, Malhotra R, Rao KM, Malyutina S, Manios Y, Mann JI, Manzato E, Margozzini P, Markey O, Marques-Vidal P, Marrugat J, Martin-Prevel Y, Martorell R, Masoodi SR, Mathiesen EB, Matsha TE, Mazur A, Mbanya JCN, McFarlane SR, McGarvey ST, McKee M, McLachlan S, McLean RM, McNulty BA, Yusof SM, Mediene-Benchekor S, Meirhaeghe A, Meisinger C, Menezes AMB, Mensink GB, Meshram II, Metspalu A, Mi J, Michaelsen KF, Mikkel K, Miller JC, Miquel JF, Miranda JJ, Mišigoj-Durakovic M, Mohamed MK, Mohammad K, Mohammadifard N, Mohan V, Yusoff MFM, Molbo D, Møller NC, Molnár D, Mondo CK, Monterrubio EA, Monyeki KDK, Moreira LB, Morejon A, Moreno LA, Morgan K, Mortensen EL, Moschonis G, Mossakowska M, Mostafa A, Mota J, Motlagh ME, Motta J, Mu TT, Muiesan ML, Müller-Nurasyid M, Murphy N, Mursu J, Murtagh EM, Musa KI, Musil V, Nagel G, Nakamura H, Jana N, Nang EEK, Nangia VB, Nankap M, Narake S, Navarrete Muñoz EM, Neal WA, Nenko I, Neovius M, Nervi F, Neuhauser HK, Nguyen ND, Nguyen QN, Nieto Martínez RE, Ning G, Ninomiya T, Nishtar S, Noale M, Norat T, Noto D, Nsour MA, O'Reilly D, Oh K, Olayan IH, Olinto MTA, Oltarzewski M, Omar MA, Onat A, Ordunez P, Ortiz AP, Osler M, Osmond C, Ostojic SM, Otero JA, Overvad K, Owusu-Dabo E, Paccaud FM, Padez C, Pahomova E, Pajak A, Palli D, Palloni A, Palmieri L, Panda-Jonas S, Panza F, Parnell WR, Parsaeian M, Pecin I, Pednekar MS, Peeters PH, Peixoto SV, Peltonen M, Pereira AC, Pérez CM, Peters A, Petkeviciene J, Peykari N, Pham ST, Pigeot I, Pikhart H, Pilav A, Pilotto L, Pistelli F, Pitakaka F, Piwonska A, Plans-Rubió P, Poh BK, Porta M, Portegies ML, Poulimeneas D, Pradeepa R, Prashant M, Price JF, Puiu M, Tartu MP, Qasrawi RF, Qorbani M, Bao TQ, Radic I, Radisauskas R, Rahman M, Raitakari O, Raj M, Rao SR, Ramachandran A, Ramke J, Ramos R, Rampal S, Rasmussen F, Redon J, Reganit PFM, Ribeiro R, Riboli E, Rigo F, Wit TFR, Ritti-Dias RM, Rivera JA, Robinson SM, Robitaille C, Rodríguez-Artalejo F, Rodriguez-Perez MDC, Rodríguez-Villamizar LA, Rojas-Martinez R, Rojroongwasinkul N, Romaguera D, Ronkainen K, Rosengren A, Rouse I, Rubinstein A, Rühli FJ, Rui O, Ruiz-Betancourt BS, Horimoto ARR, Rutkowski M, Sabanayagam C, Sachdev HS, Saidi O, Salanave B, Martinez ES, Salomaa V, Salonen JT, Salvetti M, Sánchez-Abanto J, Sandjaja, Sans S, Santos DA, Santos O, Santos RND, Santos R, Saramies JL, Sardinha LB, Sarrafzadegan N, Saum KU, Savva SC, Scazufca M, Rosario AS, Schargrodsky H, Schienkiewitz A, Schmidt IM, Schneider IJ, Schultsz C, Schutte AE, Sein AA, Sen A, Senbanjo IO, Sepanlou SG, Shalnova SA, Sharma SK, Shaw JE, Shibuya K, Shin DW, Shin Y, Shiri R, Siantar R, Sibai AM, Silva AM, Silva DAS, Simon M, Simons J, Simons LA, Sjostrom M, Slowikowska-Hilczer J, Slusarczyk P, Smeeth L, Smith MC, Snijder MB, So HK, Sobngwi E, Söderberg S, Soekatri MY, Solfrizzi V, Sonestedt E, Song Y, Sørensen TI, Soric M, Jérome CS, Soumare A, Staessen JA, Starc G, Stathopoulou MG, Staub K, Stavreski B, Steene-Johannessen J, Stehle P, Stein AD, Stergiou GS, Stessman J, Stieber J, Stöckl D, Stocks T, Stokwiszewski J, Stratton G, Stronks K, Strufaldi MW, Sun CA, Sundström J, Sung YT, Sunyer J, Suriyawongpaisal P, Swinburn BA, Sy RG, Szponar L, Tai ES, Tammesoo ML, Tamosiunas A, Tang L, Tang X, Tanser F, Tao Y, Tarawneh MR, Tarp J, Tarqui-Mamani CB, Taylor A, Tchibindat F, Theobald H, Thijs L, Thuesen BH, Tjonneland A, Tolonen HK, Tolstrup JS, Topbas M, Topór-Madry R, Torrent M, Toselli S, Traissac P, Trichopoulou A, Trichopoulos D, Trinh OT, Trivedi A, Tshepo L, Tulloch-Reid MK, Tuomainen TP, Tuomilehto J, Turley ML, Tynelius P, Tzotzas T, Tzourio C, Ueda P, Ukoli FA, Ulmer H, Unal B, Uusitalo HM, Valdivia G, Vale S, Valvi D, Schouw YTV, Herck KV, Minh HV, Rossem LV, Valkengoed IGV, Vanderschueren D, Vanuzzo D, Vatten L, Vega T, Velasquez-Melendez G, Veronesi G, Verschuren WM, Verstraeten R, Victora CG, Viegi G, Viet L, Viikari-Juntura E, Vineis P, Vioque J, Virtanen JK, Visvikis-Siest S, Viswanathan B, Vollenweider P, Voutilainen S, Vrdoljak A, Vrijheid M, Wade AN, Wagner A, Walton J, Mohamud WNW, Wang MD, Wang Q, Wang YX, Wannamethee SG, Wareham N, Weerasekera D, Whincup PH, Widhalm K, Widyahening IS, Wiecek A, Wijga AH, Wilks RJ, Willeit J, Wilsgaard T, Wojtyniak B, Wong JE, Wong TY, Woo J, Woodward M, Wu FC, Wu J, Wu SL, Xu H, Xu L, Yamborisut U, Yan W, Yang X, Yardim N, Ye X, Yiallouros PK, Yoshihara A, You QS, Younger-Coleman NO, Yusoff AF, Zainuddin AA, Zambon S, Zdrojewski T, Zeng Y, Zhao D, Zhao W, Zheng Y, Zhou M, Zhu D, Zimmermann E, Cisneros JZ., Apollo - University of Cambridge Repository, Repositório Científico do Instituto Politécnico do Porto, EMGO - Quality of care, Urology, Grand Challenges Canada, Wellcome Trust, Claessens, Frank, Staessen, Jan A, Thijs, Lutgarde, and Vanderschueren, Dirk
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estatura corporal ,Epidemiology ,ComputingMilieux_LEGALASPECTSOFCOMPUTING ,medical research ,pituuskasvu ,Global Health ,0302 clinical medicine ,adults ,Public health surveillance ,Biology (General) ,ComputingMilieux_MISCELLANEOUS ,height ,global ,trends ,POPULATION ,Human Nutrition & Health ,biological sciences ,education.field_of_study ,EVOLUÇÃO HUMANA ,Humane Voeding & Gezondheid ,General Medicine ,adulto ,Hälsovetenskaper ,Biological sciences ,nutrition ,OF-THE-LITERATURE ,Medicine ,GROWTH ,HEALTH ,Public Health ,Human ,QH301-705.5 ,Science ,SECULAR CHANGES ,Socio-culturale ,General Biochemistry, Genetics and Molecular Biology ,03 medical and health sciences ,Medical research ,None ,Health Sciences ,Humans ,Human height ,education ,VLAG ,Neuroscience (all) ,Biochemistry, Genetics and Molecular Biology (all) ,Adult human height ,CHILD UNDERNUTRITION ,030104 developmental biology ,Body mass index ,030217 neurology & neurosurgery ,Demography ,0301 basic medicine ,Settore MED/09 - Medicina Interna ,Nutrition and Disease ,Immunology and Microbiology (all) ,[SDV]Life Sciences [q-bio] ,humanos ,epidemiology ,global health ,none ,Voeding en Ziekte ,Stature -- History -- 20th century ,Medicine and Health Sciences ,aikuiset ,General Neuroscience ,Public Health, Global Health, Social Medicine and Epidemiology ,Body size ,Adult ,Body Height ,Adult height ,purl.org/pe-repo/ocde/ford#3.01.03 [https] ,Research Article ,STATURE ,South asia ,purl.org/pe-repo/ocde/ford#1.06.03 [https] ,Stature, Tall ,Population ,Global health ,Journal Article ,Life Science ,General Immunology and Microbiology ,biological science ,purl.org/pe-repo/ocde/ford#3.01.04 [https] ,Quarter (United States coin) ,trendit ,BODY-MASS INDEX ,Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi ,korkeus ,Epidemiology and Global Health ,Cancer incidence ,CANCER INCIDENCE ,WEIGHT - Abstract
Article, Being taller is associated with enhanced longevity, and higher education and earnings. We reanalysed 1472 population-based studies, with measurement of height on more than 18.6 million participants to estimate mean height for people born between 1896 and 1996 in 200 countries. The largest gain in adult height over the past century has occurred in South Korean women and Iranian men, who became 20.2 cm (95% credible interval 17.5–22.7) and 16.5 cm (13.3–19.7) taller, respectively. In contrast, there was little change in adult height in some sub-Saharan African countries and in South Asia over the century of analysis. The tallest people over these 100 years are men born in the Netherlands in the last quarter of 20th century, whose average heights surpassed 182.5 cm, and the shortest were women born in Guatemala in 1896 (140.3 cm; 135.8–144.8). The height differential between the tallest and shortest populations was 19-20 cm a century ago, and has remained the same for women and increased for men a century later despite substantial changes in the ranking of countries., published version, http://purl.org/eprint/status/PeerReviewed
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- 2016
4. Adherence to food-based dietary guidelines among adolescents in Germany according to socio-economic status and region: results from Eating Study as a KiGGS Module (EsKiMo) II.
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Brettschneider AK, Lage Barbosa C, Haftenberger M, Lehmann F, and Mensink GB
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- Adolescent, Adult, Child, Cross-Sectional Studies, Germany, Humans, Nutrition Policy, Vegetables, Economic Status, Inuit
- Abstract
Objective: Dietary habits developed during childhood and adolescence are likely to continue into adulthood. An unbalanced diet may cause nutrient deficiencies and excessive energy intake; these enhance the risk for developing overweight and obesity and their co-morbidities. In the present analysis, food consumption of adolescents is described and evaluated against German food-based dietary guidelines with special focus on socio-economic status (SES) and region of residence., Design: Within the 'German Health Interview and Examination Survey for Children and Adolescents' (KiGGS Wave 2), the cross-sectional 'Eating Study as a KiGGS Module' (EsKiMo II) was conducted from 2015 until 2017 to provide data about dietary behaviour., Setting: Germany., Participants: 1353 adolescents aged 12-17 years from a nationwide representative sample with food consumption data from computer-assisted dietary history interviews., Results: The median consumption of fruits, vegetables, starchy foods and milk/dairy products among adolescents in Germany was below the recommendation. The median consumption of both meat/meat products and unfavourable foods, like confectionery, which should be consumed sparingly, was about 1·5 times the recommended amount. The total amount of beverages consumed by most adolescents was above the minimum amount recommended. Soft drink consumption of adolescents with a low SES was three to five times higher than soft drink consumption of adolescents with a high SES., Conclusions: The results indicate the need for an improvement of dietary habits among adolescents in Germany. Further approaches to promote healthy diets in Germany should be continued, and the focus on social inequalities should be strengthened.
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- 2021
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5. Estimates of renal net acid excretion and their relationships with serum uric acid and hyperuricemia in a representative German population sample.
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Esche J, Krupp D, Mensink GB, and Remer T
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- Acids, Adult, Cross-Sectional Studies, Humans, Renal Elimination, Risk Factors, Hyperuricemia epidemiology, Uric Acid
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Background/objective: Preliminary interventional data suggest that a reduction of dietary acid load raises renal uric acid excretion and decreases serum uric acid (SUA). In line with this, in a recent cross-sectional analysis of a representative adult population sample, a higher potential renal acid load (PRAL) was found to associate with higher SUA levels. Against this background, we re-examined the relationship of the body's acid load with SUA and hyperuricemia using nutrition-derived estimates of renal net acid excretion (NAE)., Subjects/methods: Cross-sectional analyses were performed in n = 6894 participants (18-79 y) of the German Health Interview and Examination Survey for Adults (DEGS1). Two different approaches were used to estimate NAE, one based on the sum of food frequency questionnaire (FFQ)-derived PRAL and body-surface area-derived organic acids (eNAE
PRAL+OA ) and the other based on FFQ-derived protein and potassium intake ratios (eNAEProt/K ). The associations of eNAEPRAL+OA and eNAEProt/K with SUA were analyzed in multiple linear regression models. Multiple logistic regressions were used to calculate odds ratios (OR) for hyperuricemia comparing higher (T3) and lower (T1) tertiles of the NAE estimates., Results: After adjusting for relevant confounders, eNAEPRAL+OA (p = 0.0048) and eNAEProt/K (p = 0.0023) were positively associated with SUA. In addition, participants with a higher eNAEPRAL+OA or eNAEProt/K had higher ORs for having hyperuricemia (OR: 1.73, 95% CI: 1.24-2.40, OR: 1.51, 95% CI: 1.10-2.08, respectively)., Conclusion: The results substantiate findings of a previous analysis that dietary acid load is a potential influencing factor on SUA. This implicates that a lower dietary acid load may have beneficial effects on SUA.- Published
- 2020
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6. Alcohol consumption and cardiorespiratory fitness in five population-based studies.
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Baumeister SE, Finger JD, Gläser S, Dörr M, Markus MR, Ewert R, Felix SB, Grabe HJ, Bahls M, Mensink GB, Völzke H, Piontek K, and Leitzmann MF
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- Adolescent, Adult, Aged, Aged, 80 and over, Alcohol Drinking adverse effects, Alcohol Drinking epidemiology, Binge Drinking diagnosis, Binge Drinking epidemiology, Cross-Sectional Studies, Exercise Test, Female, Germany epidemiology, Health Status, Humans, Male, Middle Aged, Nutrition Surveys, Oxygen Consumption, Risk Assessment, Risk Factors, Self Report, United States epidemiology, Young Adult, Alcohol Drinking physiopathology, Binge Drinking physiopathology, Cardiorespiratory Fitness
- Abstract
Background Poor cardiorespiratory fitness is a risk factor for cardiovascular morbidity. Alcohol consumption contributes substantially to the burden of disease, but its association with cardiorespiratory fitness is not well described. We examined associations between average alcohol consumption, heavy episodic drinking and cardiorespiratory fitness. Design The design of this study was as a cross-sectional population-based random sample. Methods We analysed data from five independent population-based studies (Study of Health in Pomerania (2008-2012); German Health Interview and Examination Survey (2008-2011); US National Health and Nutrition Examination Survey (NHANES) 1999-2000; NHANES 2001-2002; NHANES 2003-2004) including 7358 men and women aged 20-85 years, free of lung disease or asthma. Cardiorespiratory fitness, quantified by peak oxygen uptake, was assessed using exercise testing. Information regarding average alcohol consumption (ethanol in grams per day (g/d)) and heavy episodic drinking (5+ or 6+ drinks/occasion) was obtained from self-reports. Fractional polynomial regression models were used to determine the best-fitting dose-response relationship. Results Average alcohol consumption displayed an inverted U-type relation with peak oxygen uptake ( p-value<0.0001), after adjustment for age, sex, education, smoking and physical activity. Compared to individuals consuming 10 g/d (moderate consumption), current abstainers and individuals consuming 50 and 60 g/d had significantly lower peak oxygen uptake values (ml/kg/min) (β coefficients = -1.90, β = -0.06, β = -0.31, respectively). Heavy episodic drinking was not associated with peak oxygen uptake. Conclusions Across multiple adult population-based samples, moderate drinkers displayed better fitness than current abstainers and individuals with higher average alcohol consumption.
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- 2018
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7. Diet-independent relevance of serum uric acid for blood pressure in a representative population sample.
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Krupp D, Esche J, Mensink GB, Neuhauser HK, and Remer T
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- Adolescent, Adult, Aged, Cross-Sectional Studies, Dose-Response Relationship, Drug, Female, Germany epidemiology, Humans, Hypertension complications, Hypertension epidemiology, Hypertension physiopathology, Hyperuricemia epidemiology, Male, Middle Aged, Prevalence, Risk Factors, Young Adult, Blood Pressure physiology, Diet adverse effects, Hypertension blood, Hyperuricemia complications, Uric Acid blood
- Abstract
A direct relationship between serum uric acid and blood pressure (BP) has been reported, but the possible confounding impact of diet on this association is unclear. The authors performed a cross-sectional analysis in the representative German Health Interview and Examination Survey for Adults (n=6788, aged 18-79 years). In adjusted regression models considering dietary factors, each 1-mg/dL higher uric acid value was associated with a 1.10-mm Hg (P=.0002) and a 0.60-mm Hg (P=.04) higher systolic BP among participants younger than 50 years and participants 50 years and older, respectively. For diastolic BP, uric acid was a significant predictor (β=0.71 mm Hg, P=.0001) among participants younger than 50 years and for participants 50 years and older without antihypertensive treatment. Adjusted odds ratios of hypertension for participants with hyperuricemia were broadly similar in younger (odds ratio, 1.71; P=.02) and older (odds ratio, 1.81; P=.0003) participants. Uric acid is a significant predictor of systolic BP and hypertension prevalence in the general adult population in Germany independently of several known dietary BP influences., (©2017 Wiley Periodicals, Inc.)
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- 2017
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8. Vitamin D and mortality: Individual participant data meta-analysis of standardized 25-hydroxyvitamin D in 26916 individuals from a European consortium.
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Gaksch M, Jorde R, Grimnes G, Joakimsen R, Schirmer H, Wilsgaard T, Mathiesen EB, Njølstad I, Løchen ML, März W, Kleber ME, Tomaschitz A, Grübler M, Eiriksdottir G, Gudmundsson EF, Harris TB, Cotch MF, Aspelund T, Gudnason V, Rutters F, Beulens JW, van 't Riet E, Nijpels G, Dekker JM, Grove-Laugesen D, Rejnmark L, Busch MA, Mensink GB, Scheidt-Nave C, Thamm M, Swart KM, Brouwer IA, Lips P, van Schoor NM, Sempos CT, Durazo-Arvizu RA, Škrabáková Z, Dowling KG, Cashman KD, Kiely M, and Pilz S
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- Aged, Europe, Female, Humans, Male, Middle Aged, Prospective Studies, Reference Standards, Survival Rate, Vitamin D administration & dosage, Vitamin D standards, Vitamin D Deficiency prevention & control, Vitamin D analogs & derivatives, Vitamin D Deficiency mortality
- Abstract
Background: Vitamin D deficiency may be a risk factor for mortality but previous meta-analyses lacked standardization of laboratory methods for 25-hydroxyvitamin D (25[OH]D) concentrations and used aggregate data instead of individual participant data (IPD). We therefore performed an IPD meta-analysis on the association between standardized serum 25(OH)D and mortality., Methods: In a European consortium of eight prospective studies, including seven general population cohorts, we used the Vitamin D Standardization Program (VDSP) protocols to standardize 25(OH)D data. Meta-analyses using a one step procedure on IPD were performed to study associations of 25(OH)D with all-cause mortality as the primary outcome, and with cardiovascular and cancer mortality as secondary outcomes. This meta-analysis is registered at ClinicalTrials.gov, number NCT02438488., Findings: We analysed 26916 study participants (median age 61.6 years, 58% females) with a median 25(OH)D concentration of 53.8 nmol/L. During a median follow-up time of 10.5 years, 6802 persons died. Compared to participants with 25(OH)D concentrations of 75 to 99.99 nmol/L, the adjusted hazard ratios (with 95% confidence interval) for mortality in the 25(OH)D groups with 40 to 49.99, 30 to 39.99, and <30 nmol/L were 1.15 (1.00-1.29), 1.33 (1.16-1.51), and 1.67 (1.44-1.89), respectively. We observed similar results for cardiovascular mortality, but there was no significant linear association between 25(OH)D and cancer mortality. There was also no significantly increased mortality risk at high 25(OH)D levels up to 125 nmol/L., Interpretation: In the first IPD meta-analysis using standardized measurements of 25(OH)D we observed an association between low 25(OH)D and increased risk of all-cause mortality. It is of public health interest to evaluate whether treatment of vitamin D deficiency prevents premature deaths.
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- 2017
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9. Metabolic Health in Relation to Body Size: Changes in Prevalence over Time between 1997-99 and 2008-11 in Germany.
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Truthmann J, Mensink GB, Bosy-Westphal A, Scheidt-Nave C, and Schienkiewitz A
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- Adolescent, Adult, Age Factors, Aged, Female, Follow-Up Studies, Germany epidemiology, Humans, Male, Middle Aged, Obesity epidemiology, Retrospective Studies, Sex Factors, Body Size, Obesity pathology, Obesity physiopathology
- Abstract
Objective: The study examined potential changes in the proportion of metabolic health according to body size categories over time and across strata of sex and age, varying definitions of metabolic health., Methods: We analysed data from national health interview and examination surveys 1997-99 and 2008-11 for adults aged 18-79 years (GNHIES98: N = 6,565; DEGS1: 6,860). Metabolic health as defined by ATPIII criteria was examined across body mass index categories. The Plourde and Karelis criteria were applied in relation to abdominal obesity., Results: Proportions of adults with metabolic health by body size categories were largely stable over time, except for an increasing proportion of metabolically healthy persons with pre-obesity and metabolically healthy women without abdominal obesity. In both surveys proportions of adults meeting ATPIII criteria ranged from approximately 30% among men and women with obesity, to about two thirds of those with pre-obesity to about 93% among those with normal weight. According to Plourde and Karelis criteria proportions ranged from almost 30% among men and women without abdominal obesity to less than 10% among those with abdominal obesity. Proportions were consistently higher among younger than older age groups and less consistently higher among women than men., Conclusions: Proportions of adults with metabolic health by body size categories were largely stable over time, except for an increasing proportion of metabolically healthy women without abdominal obesity. There is no evidence that metabolic health among adults with obesity increased in Germany over a period of ten years., Competing Interests: The authors have declared that no competing interests exist.
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- 2016
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10. Validation of the German Diabetes Risk Score among the general adult population: findings from the German Health Interview and Examination Surveys.
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Paprott R, Mühlenbruch K, Mensink GB, Thiele S, Schulze MB, Scheidt-Nave C, and Heidemann C
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Objective: To evaluate the German Diabetes Risk Score (GDRS) among the general adult German population for prediction of incident type 2 diabetes and detection of prevalent undiagnosed diabetes., Methods: The longitudinal sample for prediction of incident diagnosed type 2 diabetes included 3625 persons who participated both in the examination survey in 1997-1999 and the examination survey in 2008-2011. Incident diagnosed type 2 diabetes was defined as first-time physician diagnosis or antidiabetic medication during 5 years of follow-up excluding potential incident type 1 and gestational diabetes. The cross-sectional sample for detection of prevalent undiagnosed diabetes included 6048 participants without diagnosed diabetes of the examination survey in 2008-2011. Prevalent undiagnosed diabetes was defined as glycated haemoglobin ≥6.5% (48 mmol/mol). We assessed discrimination as area under the receiver operating characteristic curve (ROC-AUC (95% CI)) and calibration through calibration plots., Results: In longitudinal analyses, 82 subjects with incident diagnosed type 2 diabetes were identified after 5 years of follow-up. For prediction of incident diagnosed diabetes, the GDRS yielded an ROC-AUC of 0.87 (0.83 to 0.90). Calibration plots indicated excellent prediction for low diabetes risk and overestimation for intermediate and high diabetes risk. When considering the entire follow-up period of 11.9 years (ROC-AUC: 0.84 (0.82 to 0.86)) and including incident undiagnosed diabetes (ROC-AUC: 0.81 (0.78 to 0.84)), discrimination decreased somewhat. A previously simplified paper version of the GDRS yielded a similar predictive ability (ROC-AUC: 0.86 (0.82 to 0.89)). In cross-sectional analyses, 128 subjects with undiagnosed diabetes were identified. For detection of prevalent undiagnosed diabetes, the ROC-AUC was 0.84 (0.81 to 0.86). Again, the simplified version yielded a similar result (ROC-AUC: 0.83 (0.80 to 0.86))., Conclusions: The GDRS might be applied for public health monitoring of diabetes risk in the German adult population. Future research needs to evaluate whether the GDRS is useful to improve diabetes risk awareness and prevention among the general population., Competing Interests: Conflicts of Interest: None declared.
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- 2016
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11. Association between vitamin D and depressive symptoms varies by season: Results from the German Health Interview and Examination Survey for Adults (DEGS1).
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Rabenberg M, Harisch C, Rieckmann N, Buttery AK, Mensink GB, and Busch MA
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- Adult, Aged, Cross-Sectional Studies, Depression diagnosis, Depressive Disorder, Major blood, Female, Humans, Logistic Models, Male, Middle Aged, Risk Assessment, Vitamin D blood, Young Adult, Depression blood, Seasons, Vitamin D analogs & derivatives, Vitamin D Deficiency blood
- Abstract
Background: Findings from epidemiological studies regarding seasonal variations in the association between vitamin D status and depression are inconsistent., Methods: Cross-sectional analysis of data from 6331 participants aged 18-79 years in the nationwide representative German Health Interview and Examination Survey for Adults 2008-2011 (DEGS1). Associations between 25-hydroxy-vitamin-D (25(OH)D) serum levels in quartiles and current depressive symptoms as measured by the Patient Health Questionnaire depression module (PHQ-9) and defined as severity of depressive symptoms (PHQ-9 score, range 0-27 points) and elevated depressive symptoms (PHQ-9 score ≥10 points) were analysed using multivariable linear and logistic regression adjusted for sociodemographic, biological and lifestyle factors. Analyses were stratified by summertime (May to October) and wintertime (November to April) because of evidence for interaction with season (p≤0.01)., Results: In crude analyses, vitamin D status was inversely associated with both depression outcomes in summertime but not in wintertime. After adjustment for potential confounders, a significant association with severity of depressive symptoms remained in summer, with 0.73 point lower PHQ-9 scores in the highest versus lowest quartile. The association between 25(OH)D quartiles and elevated depressive symptoms in summertime was less strong and no longer significant in fully adjusted models., Limitations: Participants with severe depression may be underrepresented in DEGS1. Residual confounding cannot be excluded., Conclusion: 25(OH)D serum levels were inversely associated with current depressive symptoms in summer but not in wintertime. The fact that the association is stronger in summertime suggests that vitamin D deficiency may be a consequence rather than a cause of depression., (Copyright © 2016 Elsevier B.V. All rights reserved.)
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- 2016
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12. Time Trends in Cardiometabolic Risk Factors in Adults.
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Finger JD, Busch MA, Du Y, Heidemann C, Knopf H, Kuhnert R, Lampert T, Mensink GB, Neuhauser HK, Rosario AS, Scheidt-Nave C, Schienkiewitz A, Truthmann J, and Kurth BM
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- Adult, Aged, Female, Germany, Humans, Hypertension, Male, Middle Aged, Prevalence, Reference Values, Risk Factors, Blood Glucose, Blood Pressure, Cardiovascular Diseases epidemiology, Cholesterol blood
- Abstract
Background: Data from three representative health examination surveys in Germany were analyzed to examine secular trends in the prevalence and magnitude of cardiometabolic risk factors., Methods: The target variables were the following cardiometabolic risk factors: lack of exercise, smoking, obesity, systolic blood pressure, total cholesterol, serum glucose, self-reported high blood pressure, hyperlipidemia, and diabetes, and the use of antihypertensive, cholesterol-lowering, and antidiabetic drugs. 9347 data sets from men and 10 068 from women were analyzed. The calculated means and prevalences were standardized to the age structure of the German population as of 31 December 2010 and compared across the three time periods of the surveys: 1990-1992, 1997-1999, and 2008-11., Results: Over the entire period of observation (1990-2011), the mean systolic blood pressure fell from 137 to 128 mmHg in men and from 132 to 120 mmHg in women; the mean serum glucose concentration fell from 5.6 to 5.3 mmol/L in men and from 5.4 to 5.0 mmol/l in women; and the mean total cholesterol level fell from 6.2 to 5.3 mmol/L in both sexes. In men, smoking and lack of exercise became less common. On the other hand, the prevalence of use of antidiabetic, cholesterol-lowering, and antihypertensive drugs rose over the same time period, as did that of self-reported diabetes. The first of the three surveys (1990-1992) revealed differences between persons residing in the former East and West Germany in most of the health variables studied; these differences became less marked over time, up to the last survey in 2008-2011., Conclusion: The cardiometabolic risk profile of the German adult population as a whole improved over a period of 20 years. Further in-depth analyses are now planned.
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- 2016
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13. Vitamin D deficiency in Europe: pandemic?
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Cashman KD, Dowling KG, Škrabáková Z, Gonzalez-Gross M, Valtueña J, De Henauw S, Moreno L, Damsgaard CT, Michaelsen KF, Mølgaard C, Jorde R, Grimnes G, Moschonis G, Mavrogianni C, Manios Y, Thamm M, Mensink GB, Rabenberg M, Busch MA, Cox L, Meadows S, Goldberg G, Prentice A, Dekker JM, Nijpels G, Pilz S, Swart KM, van Schoor NM, Lips P, Eiriksdottir G, Gudnason V, Cotch MF, Koskinen S, Lamberg-Allardt C, Durazo-Arvizu RA, Sempos CT, and Kiely M
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Child, Child, Preschool, Chromatography, Liquid, Databases, Factual, Europe epidemiology, Female, Humans, Infant, Male, Middle Aged, Nutrition Surveys, Nutritional Status, Prevalence, Seasons, Tandem Mass Spectrometry, Vitamin D blood, Vitamin D Deficiency blood, Vitamin D Deficiency ethnology, Young Adult, Pandemics, Vitamin D analogs & derivatives, Vitamin D Deficiency epidemiology
- Abstract
Background: Vitamin D deficiency has been described as being pandemic, but serum 25-hydroxyvitamin D [25(OH)D] distribution data for the European Union are of very variable quality. The NIH-led international Vitamin D Standardization Program (VDSP) has developed protocols for standardizing existing 25(OH)D values from national health/nutrition surveys., Objective: This study applied VDSP protocols to serum 25(OH)D data from representative childhood/teenage and adult/older adult European populations, representing a sizable geographical footprint, to better quantify the prevalence of vitamin D deficiency in Europe., Design: The VDSP protocols were applied in 14 population studies [reanalysis of subsets of serum 25(OH)D in 11 studies and complete analysis of all samples from 3 studies that had not previously measured it] by using certified liquid chromatography-tandem mass spectrometry on biobanked sera. These data were combined with standardized serum 25(OH)D data from 4 previously standardized studies (for a total n= 55,844). Prevalence estimates of vitamin D deficiency [using various serum 25(OH)D thresholds] were generated on the basis of standardized 25(OH)D data., Results: An overall pooled estimate, irrespective of age group, ethnic mix, and latitude of study populations, showed that 13.0% of the 55,844 European individuals had serum 25(OH)D concentrations <30 nmol/L on average in the year, with 17.7% and 8.3% in those sampled during the extended winter (October-March) and summer (April-November) periods, respectively. According to an alternate suggested definition of vitamin D deficiency (<50 nmol/L), the prevalence was 40.4%. Dark-skinned ethnic subgroups had much higher (3- to 71-fold) prevalence of serum 25(OH)D <30 nmol/L than did white populations., Conclusions: Vitamin D deficiency is evident throughout the European population at prevalence rates that are concerning and that require action from a public health perspective. What direction these strategies take will depend on European policy but should aim to ensure vitamin D intakes that are protective against vitamin D deficiency in the majority of the European population., (© 2016 American Society for Nutrition.)
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- 2016
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14. Changes in mean serum lipids among adults in Germany: results from National Health Surveys 1997-99 and 2008-11.
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Truthmann J, Schienkiewitz A, Busch MA, Mensink GB, Du Y, Bosy-Westphal A, Knopf H, and Scheidt-Nave C
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- Adolescent, Adult, Aged, Cardiovascular Diseases prevention & control, Cholesterol blood, Cholesterol, HDL blood, Female, Germany, Health Surveys, Humans, Life Style, Male, Middle Aged, Sex Factors, Triglycerides blood, Young Adult, Lipids blood
- Abstract
Background: Monitoring of serum lipid concentrations at the population level is an important public health tool to describe progress in cardiovascular disease risk control and prevention. Using data from two nationally representative health surveys of adults 18-79 years, this study identified changes in mean serum total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TG) in relation to changes in potential determinants of serum lipids between 1997-99 and 2008-11 in Germany., Methods: Sex-specific multivariable linear regression analyses were performed with serum lipids as dependent variables and survey wave as independent variable and adjusted for the following covariables: age, fasting duration, educational status, lifestyle, and use of medication., Results: Mean TC declined between the two survey periods by 13 % (5.97 mmol/l vs. 5.19 mmol/l) among men and by 12 % (6.03 mmol/l vs. 5.30 mmol/l) among women. Geometric mean TG decreased by 14 % (1.66 mmol/l vs. 1.42 mmol/l) among men and by 8 % (1.20 mmol/l vs. 1.10 mmol/l) among women. Mean HDL-C remained unchanged among men (1.29 mmol/l vs. 1.27 mmol/l), but decreased by 5 % among women (1.66 mmol/l vs. 1.58 mmol/l). Sports activity and coffee consumption increased, while smoking and high alcohol consumption decreased only in men. Processed food consumption increased and wholegrain bread consumption decreased in both sexes, and obesity increased among men. The use of lipid-lowering medication, in particular statins nearly doubled over time in both sexes. Among women, hormonal contraceptive use increased and postmenopausal hormone therapy halved over time. The changes in lipid levels between surveys remained significant after adjusting for covariables., Conclusion: Serum TC and TG considerably declined over one decade in Germany, which can be partly explained by increased use of lipid-lowering medication and improved lifestyle among men. The decline in serum lipids among women, however, remains unexplained.
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- 2016
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15. Changes in body weight and obesity status in German adults: results of seven population-based prospective studies.
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Haftenberger M, Mensink GB, Herzog B, Kluttig A, Greiser KH, Merz B, Nöthlings U, Schlesinger S, Vogt S, Thorand B, Peters A, Ittermann T, Völzke H, Schipf S, Neamat-Allah J, Kühn T, Kaaks R, Boeing H, Bachlechner U, Scheidt-Nave C, and Schienkiewitz A
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Body Mass Index, Female, Follow-Up Studies, Germany, Humans, Linear Models, Longitudinal Studies, Male, Meta-Analysis as Topic, Middle Aged, Prevalence, Prospective Studies, Risk Factors, Young Adult, Body Weight, Obesity epidemiology
- Abstract
Background/objectives: The objective of this study was to quantify body weight changes in German adult populations during the past decades., Subjects/methods: Longitudinal analysis of seven cohort studies covering different age ranges between 18 and 83 years. Baseline examinations were between 1994 and 2007 and follow-up durations between 4.0 and 11.9 years. For each study, mean change in body weight per year and 10-year change in body mass index (BMI) classification were analyzed. For the middle age group of 45-64 years, meta-analysis was conducted to obtain an overall estimate for Germany., Results: Among men weight gain was highest in the youngest participants and decreased with advancing age. Among women weight gain was on a stable high level among those younger than 45 years and decreased at older age. Within 10 years, 30-40% of middle-aged participants with normal baseline weight became pre-obese or obese and 20-25% of those with pre-obesity at baseline became obese, whereas >80% of persons who were obese at baseline remained obese over time. The estimated average weight change in adults aged 45-64 years was 0.25 (95% confidence interval (CI): 0.18-0.33) kg/year among men and 0.24 (0.17-0.30) kg/year among women., Conclusions: We could observe a moderate weight gain over the past years in German middle-aged populations of 0.25 kg/year. Obesity prevention needs to be targeted to specific subgroups in the population, especially to younger adults, who seem to be most vulnerable for gaining weight. Obesity intervention needs to be improved, as the majority of obese adults remained obese over time.
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- 2016
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16. Changes in Waist Circumference among German Adults over Time - Compiling Results of Seven Prospective Cohort Studies.
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Haftenberger M, Mensink GB, Vogt S, Thorand B, Peters A, Herzog B, Hartwig S, Greiser KH, Ittermann T, Schipf S, Völzke H, Merz B, Nöthlings U, Koch M, Neamat-Allah J, Katzke V, Kaaks R, Boeing H, Bachlechner U, Scheidt-Nave C, and Schienkiewitz A
- Subjects
- Body Mass Index, Female, Follow-Up Studies, Germany, Humans, Longitudinal Studies, Male, Middle Aged, Obesity, Abdominal etiology, Prospective Studies, Risk Factors, Sex Distribution, Sex Factors, Time Factors, Aging, Obesity, Abdominal pathology, Waist Circumference
- Abstract
Aim: This study aims to quantify longitudinal changes in waist circumference (WC) among adults aged 45-64 years in Germany., Methods: Data of 15,444 men and 17,207 women from one nationwide and six regional prospective German cohort studies were analyzed. The sex-specific mean change in WC per year of follow-up was assessed for each study separately. Findings from the cohort-by-cohort analysis were combined by applying meta-analytic methods. Progression to central obesity (WC ≥ 102 cm in men and ≥ 88 cm in women) within a standardized period of 10 years was described for each study., Results: The estimated mean change in WC per year of follow-up for all cohorts combined was 0.53 (95% confidence interval 0.29-0.76) cm/year for men and 0.63 (0.48-0.77) cm/year for women, but varied between the included studies. Within 10 years, about 20% of individuals with low WC (<94 cm in men; <80 cm in women) and about 50% of individuals with intermediate WC (94-102 cm in men; 80-88 cm in women) progressed to central obesity., Conclusion: The increase in mean WC with aging along with a profound increase of central adiposity is obviously and may have several adverse health effects. Obesity prevention programs should also focus on abdominal obesity., (© 2016 The Author(s) Published by S. Karger GmbH, Freiburg.)
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- 2016
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17. Dietary intake and food sources of choline in European populations.
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Vennemann FB, Ioannidou S, Valsta LM, Dumas C, Ocké MC, Mensink GB, Lindtner O, Virtanen SM, Tlustos C, D'Addezio L, Mattison I, Dubuisson C, Siksna I, and Héraud F
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- Adolescent, Adult, Aged, Aged, 80 and over, Child, Child, Preschool, Choline analysis, Europe, Female, Humans, Infant, Male, Middle Aged, Nutrition Policy, Young Adult, Choline administration & dosage, Diet, Food Analysis
- Abstract
Choline is an important nutrient for humans. Choline intake of the European population was assessed considering the European Food Safety Authority European Comprehensive Food Consumption Database and the United States Department of Agriculture Nutrient Database. Average choline intake ranges were 151-210 mg/d among toddlers (1 to ≤3 years old), 177-304 mg/d among other children (3 to ≤10 years old), 244-373 mg/d among adolescents (10 to ≤18 years old), 291-468 mg/d among adults (18 to ≤65 years old), 284-450 mg/d among elderly people (65 to ≤75 years old) and 269-444 mg/d among very elderly people (≥75 years old). The intakes were higher among males compared with females, mainly due to larger quantities of food consumed per day. In most of the population groups considered, the average choline intake was below the adequate intake (AI) set by the Institute of Medicine in the USA. The main food groups contributing to choline intake were meat, milk, grain, egg and their derived products, composite dishes and fish. The main limitations of this study are related to the absence of choline composition data of foods consumed by the European population and the subsequent assumption made to assess their intake levels. Given the definition of AI, no conclusion on the adequacy of choline intake can be drawn for most European population groups. Such results improve the knowledge on choline intake in Europe that could be further refined by the collection of choline composition data for foods as consumed in Europe.
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- 2015
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18. Development of the European Health Interview Survey - Physical Activity Questionnaire (EHIS-PAQ) to monitor physical activity in the European Union.
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Finger JD, Tafforeau J, Gisle L, Oja L, Ziese T, Thelen J, Mensink GB, and Lange C
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Background: A domain-specific physical activity questionnaire (EHIS-PAQ) was developed in the framework of the second wave of the European Health Interview Survey (EHIS). This article presents the EHIS-PAQ and describes its development and evaluation processes., Methods: Research institutes from Belgium, Estonia and Germany participated in the Improvement of the EHIS (ImpEHIS) Grant project issued by Eurostat. The instrument development process comprised a non-systematic literature review and a systematic HIS/HES database search for physical activity survey questions. The developed EHIS-PAQ proposal was reviewed by survey experts. Cognitive testing of the EHIS-PAQ was conducted in Estonia and Germany. The EHIS-PAQ was further tested in a pilot survey in Belgium, Estonia and Germany in different modes of data collection, face-to-face paper and pencil interview (PAPI) and computer assisted telephone interview (CATI)., Results: The EHIS-PAQ is a rather pragmatic tool aiming to evaluate how far the population is physically active in specific public health relevant settings. It assesses work-related, transport-related and leisure-time physical activity in a typical week. Cognitive testing revealed that the EHIS-PAQ worked as intended. The pilot testing showed the feasibility of using the EHIS-PAQ in an international health interview survey setting in Europe. It will be implemented in all 28 European Union Member States via European Union implementing regulation in the period between 2013 and 2015. This will be a first opportunity to get comparable data on domain-specific physical activity in all 28 EU MS and to publish indicators at the EU level., Conclusions: The EHIS-PAQ is a short, domain-specific PA questionnaire based on PA questions which have been used in large-scale health interview surveys before. It was designed by considering the respondents' perspective in answering PA questions.
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- 2015
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19. [Fruit and vegetable consumption by children and adolescents in Germany: Results of KiGGS wave 1].
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Borrmann A and Mensink GB
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- Adolescent, Adolescent Health statistics & numerical data, Age Distribution, Child, Child Health statistics & numerical data, Child, Preschool, Educational Status, Female, Germany epidemiology, Humans, Male, Sex Distribution, Social Class, Diet statistics & numerical data, Diet Surveys, Food Preferences, Fruit, Vegetables
- Abstract
Background: A high fruit and vegetable intake contributes to a healthy diet, which is very important for the development of children and adolescents., Objectives: With data from the first follow-up survey of the Child and Adolescent Health Surveys (KiGGS wave 1) the fruit and vegetable intake and its association with determinants are analyzed., Methods: Via telephone interviews the average numbers of portions of fruits and vegetables consumed by 9,950 girls and boys aged 3-17 years were assessed. In addition, the proportion of persons achieving five portions of fruits and vegetables per day was calculated. The number of portions was analyzed in association with social status, parent's educational level, media consumption, and other determinants via multiple linear regression models., Results: Only 12.2 % of girls and 9.4 % of boys consume the recommended five portions of fruits and vegetables per day. 38.6 % of girls and 33.5 % of boys consume at least three portions per day. On average, girls consume 2.7 and boys 2.4 portions of fruits and vegetables per day. Younger participants consume significantly more portions of fruits than older participants. The percentage of persons consuming five or at least three portions per day increases significantly with higher socioeconomic status, higher parent's educational level, and lower media consumption. Furthermore, children who conduct sport outside of school, those who are physically active every day, and boys living in central Germany consume significantly more portions of fruit and vegetables., Conclusion: Most children and adolescents do not consume enough fruits and particularly vegetables. The consumption differs considerably according to socio-demographic background and lifestyle factors, which should be considered in promotional campaigns.
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- 2015
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20. Modifiable cardiovascular risk factors in adults aged 40-79 years in Germany with and without prior coronary heart disease or stroke.
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Truthmann J, Busch MA, Scheidt-Nave C, Mensink GB, Gößwald A, Endres M, and Neuhauser H
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- Adult, Aged, Alcohol Drinking epidemiology, Blood Pressure, Cholesterol blood, Coronary Disease epidemiology, Cross-Sectional Studies, Diet, Female, Germany epidemiology, Humans, Male, Middle Aged, Obesity epidemiology, Prevalence, Risk Factors, Smoking epidemiology, Stroke epidemiology, White People, Cardiovascular Diseases epidemiology, Health Behavior, Life Style
- Abstract
Background: Control of modifiable cardiovascular disease (CVD) risk factors has substantially reduced CVD mortality, but risk factor levels in populations may change and need continuous monitoring. This study aims to provide current estimates of the prevalence of these risk factors in Germany according to sex and history of coronary heart disease (CHD) or stroke., Methods: The analyses were based on data from the German Health Interview and Examination Survey for Adults (DEGS1; age 40-79 years, n = 5101), which is a cross-sectional population-based examination survey. CVD risk factors were defined according to recommendations in the European Guidelines on Cardiovascular Disease Prevention in Clinical Practice 2012., Results: The mean age was 57 years and 52% were female; 493 participants had prior CHD and 163 participants a prior stroke. The overall prevalence of behavioural risk factors ranged from 17.9% for high risk alcohol consumption to 90% for low vegetable intake. Blood pressure ≥ 140/90 mmHg was found in 21% and 69% had total cholesterol ≥ 5.0 mmol/l. Only 16% met the targets for five behavioural factors combined (smoking, physical activity, fruit intake, alcohol intake and obesity), 13% of those with and 16% of those without CHD or stroke. The prevalences of most behavioural risk factors were higher among men compared to women., Conclusions: There is a high prevention potential from modifiable cardiovascular risk factors in the general population aged 40-79 years in Germany and among those with prior CHD or stroke. Risk factors are often co-occurring, are interrelated and require combined educational, behavioral, medical and policy approaches.
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- 2015
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21. Vitamin D status among adults in Germany--results from the German Health Interview and Examination Survey for Adults (DEGS1).
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Rabenberg M, Scheidt-Nave C, Busch MA, Rieckmann N, Hintzpeter B, and Mensink GB
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- Adolescent, Adult, Age Factors, Aged, Body Mass Index, Dietary Supplements, Female, Germany epidemiology, Health Surveys, Humans, Linear Models, Male, Middle Aged, Multivariate Analysis, Regression Analysis, Residence Characteristics, Sex Factors, Socioeconomic Factors, Vitamin D blood, Young Adult, Seasons, Vitamin D analogs & derivatives, Vitamin D Deficiency epidemiology
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Background: In 1998, more than half of the adult population in Germany had serum 25-hydroxy-vitamin-D [25(OH)D] levels below the common threshold of 50 nmol/l. Since then, there has been a lot of attention for vitamin D in the scientific community, the media and the general population and serum 25(OH)D levels may have increased as a consequence. With data from the 'German Health Interview and Examination Survey for Adults' (DEGS1) the current situation of vitamin D status can be analysed., Methods: DEGS1, a national health survey among adults in Germany conducted by the Robert Koch Institute between 2008 and 2011, included 6,995 persons with available serum 25(OH)D levels. We calculated the proportion of participants with serum 25(OH)D levels <30 nmol/l, 30- < 50 nmol/l and > =50 nmol/l overall and according to age, season and latitude of residence as well as percentiles of serum 25(OH)D according to month of examination. Determinants of vitamin D status were analysed with multiple linear regression models., Results: Mean serum 25(OH)D level was 45.6 nmol/l with no significant sex differences (p = 0.47). 61.6% of the participants had serum 25(OH)D levels <50 nmol/l, 30.2% had levels <30 nmol/l. During summer, half of the participants had levels > =50 nmol/l, during winter time, 25% of the participants had levels <30 nmol/l. A significant latitudinal gradient was observed in autumn for men and in winter for women. In multiple linear regression analyses, examination during winter time, residing in northern latitude, non-use of vitamin D supplements, low sport activity, high Body Mass Index (BMI) and high media consumption were independently and significantly associated with lower serum 25(OH)D levels in both sexes. In addition, among women, significant associations with lower 25(OH)D levels were observed for older age and lower socio-economic status, among men, for low vitamin D intake and more residential traffic., Conclusions: Serum 25(OH)D levels below the threshold of 50 nmol/l are still common among adults in Germany, especially during winter and spring and in higher latitudes. Potentially modifiable factors of poorer vitamin D status are higher BMI, lack of sport activity and high media use.
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- 2015
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22. Dietary behaviour and parental socioeconomic position among adolescents: the German Health Interview and Examination Survey for Children and Adolescents 2003-2006 (KiGGS).
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Finger JD, Varnaccia G, Tylleskär T, Lampert T, and Mensink GB
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- Adolescent, Child, Cross-Sectional Studies, Ethnicity, Female, Fruit, Germany, Humans, Income, Male, Nutrition Surveys methods, Occupations, Odds Ratio, Socioeconomic Factors, Surveys and Questionnaires, Vegetables, Adolescent Behavior, Diet methods, Health Behavior, Interviews as Topic methods, Nutrition Surveys statistics & numerical data, Parents
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Background: The positive association between parental socioeconomic position (PSEP) and health among adolescents may be partly explained by dietary behaviour. We investigated the associations between fruit intake, vegetable intake, energy-dense food intake, the Healthy Nutrition Score for Kids and Youth (HuSKY) and parental education in a nationwide, cluster-randomized sample of adolescents in Germany., Methods: The German Health Interview and Examination Survey for Children and Adolescents 2003-2006 (KiGGS) included 17,641 individuals aged 0-17 years and their parents. Complete information on relevant variables was available for 6359 individuals in the 11-17 age group. The associations between nutrition indicators and parental education were analysed separately for boys and girls, using multivariate logistic regression analysis. Odds ratios (ORs) adjusted for age, region, income, occupation, physical activity and weight status related variables, were calculated for the associations between parental education and nutrition indicators., Results: After full adjustment, higher parental education level was associated with lower energy-dense food intake - with an OR of 1.3 (95 % CI 1.0-1.7) for boys with secondary educated parents and 1.8 (1.4-2.3) for boys with tertiary educated parents compared to boys with primary educated parents; the corresponding ORs for girls were 1.2 (0.9-1.5) and 1.6 (1.2-2.2). Higher parental education was associated with higher fruit intake - with an OR of 1.3 (1.0-1.7) for boys with secondary educated parents and 2.0 (1.5-2.7) for boys with tertiary educated parents compared to boys with primary educated parents; the corresponding ORs for girls were 1.0 (0.8-1.4) and 1.5 (1.0-2.1). Among boys and girls with tertiary educated parents compared to those with primary educated parents an OR of 1.3 (CI boys: 1.0-1.7, CI girls: 1.0-1.6) was observed for high vegetable intake. Among boys with tertiary educated parents compared to boys with primary educated parents an OR of 1.6 (1.2-2.2) was observed for a high HuSKY; the corresponding OR for girls was 1.5 (1.1-1.9)., Conclusions: A high PSEP is associated with consumption of less energy-dense food, more fruits and vegetables and more favourable overall dietary behaviour. Preferably school-based interventions are needed to promote healthy dietary behaviour among German adolescents and a special effort is needed to reach adolescents from low-PSEP families.
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- 2015
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23. Healthy behaviours and mental health: findings from the German Health Update (GEDA).
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Buttery AK, Mensink GB, and Busch MA
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- Adult, Cross-Sectional Studies, Female, Germany epidemiology, Humans, Life Style, Male, Middle Aged, Prevalence, Risk Factors, Health Behavior, Health Surveys statistics & numerical data, Mental Disorders epidemiology
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Background: Health risk behaviours such as smoking, physical inactivity and poor diet are independently associated with depression. However, there is a paucity of data examining associations between combined healthy behaviours and mental distress and depression., Methods: Using cross-sectional data from a nationwide population-based sample of adults in Germany [German Health Update (GEDA) 2009 and 2010 telephone surveys; n = 21 940 women, n = 17 061 men], we examined associations between five healthy behaviours and frequent mental distress (FMD) and self-reported diagnosed depression in the past 12 months. Healthy behaviours included non-smoking, low-risk alcohol drinking, regular sport, maintaining normal weight and healthy fruit and vegetable consumption. Multiple logistic regression analyses adjusted for potential confounders examined associations between the combined number of healthy behaviours and FMD and self-reported diagnosed depression., Results: FMD was reported by 13.6 and 8.0% and diagnosed depression in the last 12 months by 8.3 and 4.7% of women and men, respectively. At least four of five assessed healthy behaviours were reported by 29.1% of women and 17.8% of men. Compared with those with less than two healthy behaviours, women and men with at least four behaviours were about half as likely to report FMD [odds ratio (OR) 0.53, 95% confidence interval (CI) 0.44-0.64, and OR 0.52, 95% CI 0.41-0.66, respectively) and women with at least four behaviours were less likely to report diagnosed depression (OR 0.76, 95% CI 0.61-0.95)., Conclusion: A higher number of healthy behaviours are associated with a lower prevalence of FMD for both women and men and of self-reported diagnosed depression in women., (© The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.)
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- 2015
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24. Physical activity, aerobic fitness and parental socio-economic position among adolescents: the German Health Interview and Examination Survey for Children and Adolescents 2003-2006 (KiGGS).
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Finger JD, Mensink GB, Banzer W, Lampert T, and Tylleskär T
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- Adolescent, Body Mass Index, Child, Cross-Sectional Studies, Energy Metabolism, Female, Germany, Health Promotion, Humans, Leisure Activities, Logistic Models, Male, Multivariate Analysis, Odds Ratio, Parents, Social Support, Socioeconomic Factors, Surveys and Questionnaires, Health Surveys, Motor Activity, Physical Fitness
- Abstract
Background: The positive association between parental socio-economic position (PSEP) and health among adolescents may be partly explained by physical activity behaviour. We investigated the associations between physical activity, aerobic fitness and PSEP in a population based sample of German adolescents., Methods: 5,251 participants, aged 11-17 years, in the German Health Interview and Examination Survey for Children and Adolescents 2003-2006 (KiGGS) underwent a sub-maximal cycle ergometer test and completed a questionnaire obtaining information on physical activity and media use. The associations between physical activity, media use, aerobic fitness and PSEP were analysed with multivariate logistic regression models for boys and girls separately. Odds ratios (ORs) of PSEP (education, occupation and income) on the outcomes were calculated adjusted for age, region, and other influencing factors., Results: Parental education was more strongly associated with the outcome variables than parental occupation and income. After adjusting for age and region, a higher parental education level was associated with better aerobic fitness - with an OR of 1.5 (95% CI 1.2-1.9) for girls whose parents had secondary education and 1.9 (1.4-2.5) for girls whose parents had tertiary education compared to girls whose parents had primary education. The corresponding ORs for boys were 1.3 (1.0-1.6) and 1.6 (1.2-2.1), respectively. Higher parental education level was associated with lower media use: an OR of 2.1 (1.5-3.0) for girls whose parents had secondary education and 2.7 (1.8-4.1) for girls whose parents had primary education compared to girls whose parents had tertiary education. The corresponding ORs for boys were 1.5 (1.2-1.9) and 1.9 (1.5-2.5), respectively. Higher parental education level was associated with a higher physical activity level only among girls: an OR of 1.3 (1.0-1.6) for girls whose parents had secondary education and 1.2 (0.9-1.5) for girls whose parents had tertiary education compared to girls whose parents had primary education. The corresponding ORs for boys were 0.9 (0.8-1.2) and 0.8 (0.6-1.0), respectively., Conclusions: Adolescents of parents with low SEP showed a lower level of aerobic fitness and higher levels of media use than adolescents of parents with higher SEP. Health-promotion interventions need to reach adolescents of parents with low PSEP and stimulate physical activity.
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- 2014
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25. Dietary behaviour and socioeconomic position: the role of physical activity patterns.
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Finger JD, Tylleskär T, Lampert T, and Mensink GB
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- Adolescent, Adult, Aged, Alcohol Drinking psychology, Feeding Behavior physiology, Female, Germany, Health Surveys, Humans, Logistic Models, Male, Middle Aged, Odds Ratio, Socioeconomic Factors, Diet psychology, Feeding Behavior psychology, Motor Activity
- Abstract
Background: The positive association between education level and health outcomes can be partly explained by dietary behaviour. We investigated the associations between education and several indices of food intake and potential influencing factors, placing special emphasis on physical-activity patterns, using a representative sample of the German adult population., Methods: The German National Health Interview and Examination Survey 1998 (GNHIES98) involved 7,124 participants aged between 18 and 79. Complete information on the exposure (education) and outcome (nutrition) variables was available for 6,767 persons. The associations between 'education' and indices of 'sugar-rich food', 'fat-rich food', 'fruit-and-vegetable' and 'alcohol' intake were analysed separately for men and women using multivariate logistic regression analysis. Odds ratios (OR) of education level on nutrition outcomes were calculated and adjusted for age, region (former East/West Germany), occupation, income and other influencing factors such as physical activity indicators., Results: Men and women with only a primary education had a more frequent intake of sugar-rich and fat-rich foods and a less frequent intake of fruit and vegetables and alcohol than people with a tertiary education. 'Physical work activity' partly explained the associations between education and sugar-rich food intake. The interference with physical work activity was stronger among men than women. No significant associations between education and energy-dense food intake were observed in the retirement-age group of persons aged 65+ and among persons with low energy expenditure., Conclusions: In Germany, adults with a low level of education report that they consume energy-dense foods more frequently - and fruit and vegetables and alcohol less frequently - than adults with a high education level. High levels of physical work activity among adults with a low education level may partly explain why they consume more energy-dense foods.
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- 2013
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26. Mapping low intake of micronutrients across Europe.
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Mensink GB, Fletcher R, Gurinovic M, Huybrechts I, Lafay L, Serra-Majem L, Szponar L, Tetens I, Verkaik-Kloosterman J, Baka A, and Stephen AM
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- Adolescent, Adult, Child, Child, Preschool, Energy Intake, Europe, Female, Humans, Infant, Male, Middle Aged, Nutritional Requirements, Nutritional Status, Risk, Vitamin D metabolism, Young Adult, Diet, Diet Surveys, Micronutrients
- Abstract
Achieving an understanding of the extent of micronutrient adequacy across Europe is a major challenge. The main objective of the present study was to collect and evaluate the prevalence of low micronutrient intakes of different European countries by comparing recent nationally representative dietary survey data from Belgium, Denmark, France, Germany, The Netherlands, Poland, Spain and the United Kingdom. Dietary intake information was evaluated for intakes of Ca, Cu, I, Fe, Mg, K, Se, Zn and the vitamins A, B₁, B₂, B₆, B₁₂, C, D, E and folate. The mean and 5th percentile of the intake distributions were estimated for these countries, for a number of defined sex and age groups. The percentages of those with intakes below the lower reference nutrient intake and the estimated average requirement were calculated. Reference intakes were derived from the UK and Nordic Nutrition Recommendations. The impact of dietary supplement intake as well as inclusion of apparently low energy reporters on the estimates was evaluated. Except for vitamin D, the present study suggests that the current intakes of vitamins from foods lead to low risk of low intakes in all age and sex groups. For current minerals, the study suggests that the risk of low intakes is likely to appear more often in specific age groups. In spite of the limitations of the data, the present study provides valuable new information about micronutrient intakes across Europe and the likelihood of inadequacy country by country.
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- 2013
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27. Distal and proximal factors of health behaviors and their associations with health in children and adolescents.
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Lämmle L, Woll A, Mensink GB, and Bös K
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- Adolescent, Child, Emigration and Immigration, Feeding Behavior, Female, Germany, Health Status, Humans, Male, Motivation, Motor Activity, Physical Fitness, Quality of Life, Rural Population, Sedentary Behavior, Social Class, Urban Population, Adolescent Behavior, Child Behavior, Health Behavior, Models, Theoretical
- Abstract
Objective: The aim of the present paper was to analyze factors affecting distal and proximal health behavior within a biopsychosocial model for examining their interactions and associations with respect to health., Methods: Path analysis was based on the nationwide, cross-sectional German Health Interview and Examination Survey for Children and Adolescents (2003 to 2006). The data was collected from 4,529 participants with an average age of 9.45 years (SD = 4.01). Socio-demographic data, psychosocial factors and health behavior were assessed via questionnaire. Participants also underwent physical fitness tests and a medical examination., Results: Over the five levels of the model analyzed with socioeconomic status, immigration background, and rural-urban differences on the first level; physical activity of relatives and peers, intrinsic motivation, and quality of life on the second level; eating patterns, sedentary behavior, and physical activity on the third level; physical fitness and objective health on the fourth level; and health complaints and subjective health on the fifth level; direct, moderation, and mediation effects could be shown., Conclusions: Several distal and proximal factors are needed to take account of the multivariate complexity of health: e.g., immigration background affected health behaviors only indirectly and the effect of physical activity on objective health was mediated by physical fitness.
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- 2013
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28. [Fruit and vegetable intake in Germany: results of the German Health Interview and Examination Survey for Adults (DEGS1)].
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Mensink GB, Truthmann J, Rabenberg M, Heidemann C, Haftenberger M, Schienkiewitz A, and Richter A
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- Adolescent, Adult, Age Distribution, Aged, Female, Germany epidemiology, Humans, Male, Middle Aged, Sex Distribution, Social Class, Survival Analysis, Survival Rate, Young Adult, Eating physiology, Fruit, Health Status, Health Surveys statistics & numerical data, Interviews as Topic methods, Vegetables
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Until now, the recommendations of the German Nutrition Society on fruit and vegetable intake have not been reached by the majority of the population. In the first wave of the"German Health Interview and Examination Survey for Adults" (DEGS1), which was conducted from 2008 to 2011, food consumption was determined with a validated food frequency questionnaire in a representative random sample of the 18-79-year-old residential population in Germany (n=7116). The number of portions of fruit and vegetables consumed on average every day and the number of persons meeting the recommended five portions of fruit and vegetables per day were calculated. On average, women consume 3.1 and men 2.4 portions of fruit and vegetables per day. 15 % of women and 7 % of men reach the recommended quantity of five portions per day. Fruit intake increases in both men and women up to the age of 60- 69 years. 39 % of women and 25 % of men consume at least three portions of fruit and vegetables every day. The proportion of men and women who consume at least three portions every day tends to increase with rising social status. Although the intake of fruit has increased slightly compared to previous surveys, the percentage of persons who consume five portions of fruit and vegetables per day is still very low. An English full-text version of this article is available at SpringerLink as supplemental.
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- 2013
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29. [Physical activity: results of the German Health Interview and Examination Survey for Adults (DEGS1)].
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Krug S, Jordan S, Mensink GB, Müters S, Finger J, and Lampert T
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- Adolescent, Adult, Age Distribution, Aged, Female, Germany epidemiology, Humans, Male, Middle Aged, Sex Distribution, Social Class, Young Adult, Activities of Daily Living, Health Status, Health Surveys statistics & numerical data, Interviews as Topic methods, Motor Activity physiology, Sports physiology, Sports statistics & numerical data
- Abstract
Regular physical activity can have a positive effect on health at any age. Today's lifestyles, however, can often be characterised as sedentary. Therefore, the promotion of physical activity and sports has become an integral part of public health measures. The representative data of adults aged 18 to 79 years in Germany obtained from the "German Health Interview and Examination Survey for Adults" (DEGS1) provide an overview of self-estimated current physical activity behaviour. The results show that one third of the adult population claims to pay close attention to reaching a sufficient level of physical activity and one fourth participates in sports for at least 2 h/week on a regular basis. Thus, the percentage of adults regularly engaged in sports has increased compared to the previous "German National Health Interview and Examination Survey 1998". Still, four out of five adults do not achieve at least 2.5 h/week of moderate-intensity physical activity as recommended by the World Health Organisation. Consequently, future individual-level and population-level interventions should focus on target group-specific measures while continuing to promote regular physical activity in all segments of the population. An English full-text version of this article is available at SpringerLink as supplemental.
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- 2013
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30. [Overweight and obesity in Germany: results of the German Health Interview and Examination Survey for Adults (DEGS1)].
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Mensink GB, Schienkiewitz A, Haftenberger M, Lampert T, Ziese T, and Scheidt-Nave C
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- Adolescent, Adult, Age Distribution, Aged, Female, Germany epidemiology, Humans, Male, Middle Aged, Obesity diagnosis, Obesity drug therapy, Prevalence, Risk Assessment, Sex Distribution, Social Class, Survival Analysis, Survival Rate, Young Adult, Health Status, Health Surveys statistics & numerical data, Interviews as Topic methods, Obesity mortality
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The increase in overweight and obesity is a worldwide health problem. The first wave of the "German Health Interview and Examination Survey for Adults" (DEGS1), conducted from 2008 through 2011, provides current data about overweight and obesity among adults in Germany. Within DEGS1, a representative sample of the 18- to 79-year-old population was interviewed with regard to health relevant issues and physically examined (n = 7,116). From measurements of body height and weight, the body mass index (BMI) was calculated, which was used to define overweight (BMI ≥ 25 kg/m(2)) and obesity (BMI ≥ 30 kg/m(2)). Results are stratified for gender, age group, socioeconomic status and region and compared with results from the German National Health Interview and Examination Survey 1998 (GNHIES98) and the National Examination Surveys 1990/92. According to DEGS1, 67.1% of men and 53.0% of women are overweight. The prevalence of overweight has not changed compared to GNHIES98. The prevalence of obesity, however, has risen substantially, especially among men: in GNHIES98, 18.9% of men and 22.5% of women were obese, in DEGS1, these figures were 23.3% and 23.9%, respectively. The increase in obesity occurred especially among young adults. An English full-text version of this article is available at SpringerLink as supplemental.
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- 2013
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31. A cluster-analytic approach towards multidimensional health-related behaviors in adolescents: the MoMo-Study.
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Spengler S, Mess F, Mewes N, Mensink GB, and Woll A
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- Adolescent, Child, Cluster Analysis, Female, Germany epidemiology, Health Surveys, Humans, Male, Socioeconomic Factors, Adolescent Behavior psychology, Computers statistics & numerical data, Feeding Behavior, Motor Activity, Overweight epidemiology, Television statistics & numerical data, Video Games
- Abstract
Background: Although knowledge on single health-related behaviors and their association with health parameters is available, research on multiple health-related behaviors is needed to understand the interactions among these behaviors. The aims of the study were (a) to identify typical health-related behavior patterns in German adolescents focusing on physical activity, media use and dietary behavior; (b) to describe the socio-demographic correlates of the identified clusters and (c) to study their association with overweight., Methods: Within the framework of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) and the "Motorik-Modul" (MoMo), 1,643 German adolescents (11-17 years) completed a questionnaire assessing the amount and type of weekly physical activity in sports clubs and during leisure time, weekly use of television, computer and console games and the frequency and amount of food consumption. From this data the three indices 'physical activity', 'media use' and 'healthy nutrition' were derived and included in a cluster analysis conducted with Ward's Method and K-means analysis. Chi-square tests were performed to identify socio-demographic correlates of the clusters as well as their association with overweight., Results: Four stable clusters representing typical health-related behavior patterns were identified: Cluster 1 (16.2%)--high scores in physical activity index and average scores in media use index and healthy nutrition index; cluster 2 (34.6%)--high healthy nutrition score and below average scores in the other two indices; cluster 3 (18.4%)--low physical activity score, low healthy nutrition score and very high media use score; cluster 4 (30.5%)--below average scores on all three indices. Boys were overrepresented in the clusters 1 and 3, and the relative number of adolescents with low socio-economic status as well as overweight was significantly higher than average in cluster 3., Conclusions: Meaningful and stable clusters of health-related behavior were identified. These results confirm findings of another youth study hence supporting the assumption that these clusters represent typical behavior patterns of adolescents. These results are particularly relevant for the characterization of target groups for primary prevention of lifestyle diseases.
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- 2012
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32. Physical activity patterns and socioeconomic position: the German National Health Interview and Examination Survey 1998 (GNHIES98).
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Finger JD, Tylleskär T, Lampert T, and Mensink GB
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- Adolescent, Adult, Aged, Cross-Sectional Studies, Educational Status, Female, Germany, Health Surveys, Humans, Income statistics & numerical data, Leisure Activities psychology, Male, Middle Aged, Occupations statistics & numerical data, Sedentary Behavior, Young Adult, Health Behavior, Motor Activity, Social Class
- Abstract
Background: We investigated the associations between education and leisure-time, occupational, sedentary and total physical-activity levels based on data from the German National Health Interview and Examination Survey 1998 (GNHIES98). The roles of income level, occupational status and other mediating variables for these associations were also examined., Methods: The total study sample of the GNHIES98 comprised 7,124 participants between the ages of 18 and 79. Complete information was available for 6,800 persons on leisure-time, sedentary and total physical-activity outcomes and for 3,809 persons in regular employment on occupational activity outcomes. The associations between educational level and physical activity (occupational, sedentary, leisure-time and total physical activity) were analysed separately for men and women using multivariate logistic regression analysis. Odds ratios (OR) of educational level on physical-activity outcomes were calculated and adjusted for age, region, occupation, income and other mediating variables., Results: After adjusting for age and region, a higher education level was associated with more leisure-time activity - with an OR of 1.6 (95% CI, 1.3-2.0) for men with secondary education and 2.1 (1.7-2.7) for men with tertiary education compared to men with primary education. The corresponding ORs for women were 1.3 (1.1-1.6) and 1.7 (1.2-2.4), respectively. Higher education was associated with a lower level of vigorous work activity: an OR of 6.9 (4.6-10.3) for men with secondary education and 18.6 (12.0-27.3) for men with primary education compared to men with tertiary education. The corresponding ORs for women were 2.8 (2.0-4.0) and 5.8 (4.0-8.5), respectively. Higher education was also associated with a lower level of total activity: an OR of 2.9 (2.2-3.8) for men with secondary education and 4.3 (3.3-5.6) for men with tertiary education compared to men with primary education. The corresponding ORs for women were 1.6 (1.2-2.0) and 1.6 (1.2-2.1), respectively., Conclusions: In Germany adults with a lower level of education are more physically active, both at work and overall, compared to adults with a higher education level, although they are less physically active in their leisure time. Higher work-related activity levels among adults with lower education may explain why they are less active in their leisure time.
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- 2012
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33. Association of breastfeeding and exposure to maternal smoking during pregnancy with children's general health status later in childhood.
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Du Y, Ellert U, Lampert T, Mensink GB, and Schlaud M
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- Adolescent, Child, Child, Preschool, Cross-Sectional Studies, Female, Germany epidemiology, Health Promotion, Humans, Logistic Models, Male, Maternal Behavior, Pregnancy, Smoking Cessation, Socioeconomic Factors, Breast Feeding, Health Status, Prenatal Exposure Delayed Effects, Smoking adverse effects, Tobacco Smoke Pollution adverse effects
- Abstract
Background: Maternal smoking during pregnancy is associated with a variety of risks on fetal health, whereas breastfeeding may protect infants from infections in the early postpartum period. Little has been reported regarding their associations with children's general health later in childhood., Subjects and Methods: Parent-rated children's general health status was investigated among 14,836 children and adolescents 3-17 years old who participated in the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) in 2003-2006. Data on breastfeeding and maternal smoking during pregnancy were collected by parent-administered questionnaires. SPSS complex samples logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs)., Results: Exclusive breastfeeding and non-exposure to maternal smoking during pregnancy were associated with better health status overall among all children in the KiGGS (both p<0.001). After adjusting for potential confounding factors including other prior and current exposures, exclusive breastfeeding over 6 months remained significant overall among all children (OR 1.21, 95% CI 1.05-1.38) and in the age groups 7-10 years (OR 1.27, 95% CI 1.01-1.60) and 11-17 years (OR 1.23, 95% CI 1.01-1.50), while non-exposure to maternal smoking during pregnancy remained significant in the age group 11-17 years only (OR 1.49, 95% CI 1.06-2.10)., Conclusions: Exclusive breastfeeding and non-exposure to maternal smoking during pregnancy may be associated with better children's general health status later in childhood, particularly when children reach adolescence. Further studies are required to elucidate these possible and biologically plausible associations. Health professionals should take opportunities to promote breastfeeding and cessation of smoking among (expectant) mothers for a healthy future of their children.
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- 2012
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34. Associations of dietary indices with biomarkers of dietary exposure and cardiovascular status among adolescents in Germany.
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Truthmann J, Richter A, Thiele S, Drescher L, Roosen J, and Mensink GB
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Background: Adolescence is an important life stage for the development of dietary preferences and health behaviour. Longitudinal studies indicated that cardiovascular status in adolescence predicts cardiovascular risk marker values in adulthood. Several diet quality indices for adolescents have been developed in the past, but literature concerning associations between indices and biomarkers of dietary exposure and cardiovascular status is rather sparse. Hence, the aim of this study was to analyse associations of dietary indices with biomarkers of dietary exposure and cardiovascular status., Methods: For the present analysis, data from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS 2003-2006) were used. The analysis included 5,198 adolescents, aged 12 to 17 years. The Healthy Food Diversity Index (HFD), the Healthy Nutrition Score for Kids and Youth (HuSKY), the Indicator Food Index (IFI) and a simple fruit/vegetable intake index were derived from food frequency questionnaire information to indicate a healthy diet. Adjusted mean values for homocysteine, uric acid, CRP, total cholesterol, HDL-C, ferritin, HbA1c, folate, vitamin B12 and BMI were calculated using complex-samples general linear models for quintiles of the different indices. Furthermore, the agreement in ranking between the different indices was calculated by weighted kappa. All statistical analyses were conducted for boys and girls separately, and were adjusted for potential confounders., Results: Folate was positively associated with the HFD, the HuSKY, and fruit/vegetable intake for both boys and girls and with IFI for boys. Among girls, positive associations were seen between vitamin B12 and the IFI and between diastolic blood pressure and the IFI as well as fruit/vegetable intake. A negative association was found between homocysteine and the HFD, the HuSKY, and the IFI for both boys and girls and with fruit/vegetable intake for boys. Among boys, uric acid and HbA1c were negatively and prevalence of obesity positively associated with the IFI., Conclusions: Overall, the indices, even the simpler ones, seem to have a similar general capability in predicting biomarkers of dietary exposure. To predict risk of cardiovascular disease dietary indices may have to be more specific.
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- 2012
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35. German health interview and examination survey for adults (DEGS) - design, objectives and implementation of the first data collection wave.
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Scheidt-Nave C, Kamtsiuris P, Gößwald A, Hölling H, Lange M, Busch MA, Dahm S, Dölle R, Ellert U, Fuchs J, Hapke U, Heidemann C, Knopf H, Laussmann D, Mensink GB, Neuhauser H, Richter A, Sass AC, Rosario AS, Stolzenberg H, Thamm M, and Kurth BM
- Subjects
- Adolescent, Adult, Aged, Chronic Disease epidemiology, Female, Germany epidemiology, Humans, Male, Middle Aged, Population Surveillance, Young Adult, Health Status Indicators, Health Surveys, Research Design
- Abstract
Background: The German Health Interview and Examination Survey for Adults (DEGS) is part of the recently established national health monitoring conducted by the Robert Koch Institute. DEGS combines a nationally representative periodic health survey and a longitudinal study based on follow-up of survey participants. Funding is provided by the German Ministry of Health and supplemented for specific research topics from other sources., Methods/design: The first DEGS wave of data collection (DEGS1) extended from November 2008 to December 2011. Overall, 8152 men and women participated. Of these, 3959 persons already participated in the German National Health Interview and Examination Survey 1998 (GNHIES98) at which time they were 18-79 years of age. Another 4193 persons 18-79 years of age were recruited for DEGS1 in 2008-2011 based on two-stage stratified random sampling from local population registries. Health data and context variables were collected using standardized computer assisted personal interviews, self-administered questionnaires, and standardized measurements and tests. In order to keep survey results representative for the population aged 18-79 years, results will be weighted by survey-specific weighting factors considering sampling and drop-out probabilities as well as deviations between the design-weighted net sample and German population statistics 2010., Discussion: DEGS aims to establish a nationally representative data base on health of adults in Germany. This health data platform will be used for continuous health reporting and health care research. The results will help to support health policy planning and evaluation. Repeated cross-sectional surveys will permit analyses of time trends in morbidity, functional capacity levels, disability, and health risks and resources. Follow-up of study participants will provide the opportunity to study trajectories of health and disability. A special focus lies on chronic diseases including asthma, allergies, cardiovascular conditions, diabetes mellitus, and musculoskeletal diseases. Other core topics include vaccine-preventable diseases and immunization status, nutritional deficiencies, health in older age, and the association between health-related behavior and mental health.
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- 2012
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36. Comorbidity of overweight and obesity in a nationally representative sample of German adults aged 18-79 years.
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Schienkiewitz A, Mensink GB, and Scheidt-Nave C
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- Adolescent, Adult, Aged, Comorbidity, Cross-Sectional Studies, Female, Germany epidemiology, Humans, Male, Middle Aged, Risk Factors, Young Adult, Obesity epidemiology, Overweight epidemiology
- Abstract
Background: Overweight has increased in many countries over the past 20 years and excessive body weight is an established risk factor for adverse health outcomes and chronic diseases. This study aimed to determine comorbidity associated with overweight and obesity in a nationally representative sample of German adults., Methods: In the German National Health Interview and Examination Survey 1998 standardized measures of body weight, height and waist circumference (WC) were obtained for 7,124 men and women 18 to 79 years of age. Information on pre-existing health conditions, health-related behaviors, and sociodemographic characteristics was collected using physician-administered computer-assisted interviews and self-administered questionnaires. World Health Organization (WHO) cut-off criteria were applied to define overweight (BMI 25.0-29.9 kg/m2) and obesity (BMI ≥30.0 kg/m2) and abdominal obesity (men: WC ≥102 cm; women: WC ≥88 cm)., Results: The crude prevalence of persons with cardiometabolic risk factors, diabetes mellitus, cardiovascular disease (CVD), gall bladder disease, and osteoarthritis showed a significant stepwise increase from the lowest to the highest BMI category in both sexes. In multiple logistic regression models adjusting for age, social status, and smoking, significant associations with overweight and obesity persisted for cardiometabolic risk factors and osteoarthritis. For example, obese persons had a three- to fourfold higher chance of having any cardiometabolic risk factor compared to normal weight persons (odds ratio (OR) = 4.07, 95% CI: 3.16-5.25 for men; OR = 3.40 (2.60-4.46) for women). Only in women, overweight and obesity as well as abdominal obesity, independent of BMI category, were significantly and consistently associated with diabetes (overweight: OR = 1.85 (1.03-3.30); obesity: OR = 2.94 (1.63-5.31); abdominal obesity: OR = 1.44 (1.08-1.92) and gall bladder disease (overweight: OR = 1.65 (1.22-2.25); obesity: OR = 3.06 (2.26-4.14); abdominal obesity: OR = 1.73 (1.25-2.39))., Conclusion: Current estimates of disease burden underline the public health importance and clinical relevance related to overweight and obesity and needs to take into account comorbidity aspects.
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- 2012
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37. Dietary patterns of adolescents in Germany--associations with nutrient intake and other health related lifestyle characteristics.
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Richter A, Heidemann C, Schulze MB, Roosen J, Thiele S, and Mensink GB
- Subjects
- Adolescent, Child, Cross-Sectional Studies, Diet Surveys, Energy Intake, Female, Food statistics & numerical data, Germany, Humans, Life Style, Male, Overweight, Principal Component Analysis, Sex Factors, Socioeconomic Factors, Adolescent Behavior, Diet statistics & numerical data, Health Behavior
- Abstract
Background: The aim of this study was to identify dietary patterns among a representative sample of German adolescents and their associations with energy and nutrient intake, socioeconomic and lifestyle characteristics, and overweight status., Methods: In the analysis, data from the German Health Interview and Examination Survey for Children and Adolescents were used. The survey included a comprehensive dietary history interview conducted among 1272 adolescents aged 12 to 17 years. Dietary patterns were determined with principal component analysis (PCA) based on 48 food groups, for boys and girls separately., Results: Three dietary patterns among boys and two among girls were identified. Among boys, high adherence to the 'western' pattern was associated with higher age, lower socioeconomic status (SES), and lower physical activity level (PA). High adherence to the 'healthy' pattern among boys, but not among girls, was associated with higher SES, and higher PA. Among boys, high adherence to the 'traditional' pattern was associated with higher age. Among girls, high adherence to the 'traditional and western' pattern was associated with lower age, lower SES and more hours watching TV per day. The nutrient density of several vitamins and minerals, particularly of B-vitamins and calcium, increased with increasing scores of the 'healthy' pattern among both sexes. Conversely, with increasing scores of the 'western' pattern among boys, most nutrient densities decreased, particularly of fibre, beta-carotene, vitamin D, biotin and calcium. Among girls with higher scores of the 'traditional and western' pattern, nutrient densities of vitamin A, C, E, K and folate decreased. Among boys, high adherence to the 'traditional' pattern was correlated with higher densities of vitamin B12 and vitamin D and lower densities of fibre, magnesium and iron. No significant associations between dietary patterns and overweight were found., Conclusions: Higher scores for dietary patterns characterized by higher consumption of take away food, meat, confectionary and soft drinks ('western' and 'traditional and western') were found particularly among 16- to 17-years old boys and among adolescents with lower SES. These patterns were also associated with higher energy density, higher percent of energy from unsaturated fatty acids and lower percent of energy from carbohydrates as well as lower nutrient densities of several vitamins and minerals. Therefore, nutritional interventions should try to focus more on adolescents with lower SES and boys in general.
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- 2012
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38. [Physical and sporting activity among adults in Germany. Results from the "German Health Update 2009" survey].
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Lampert T, Mensink GB, and Müters S
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- Adolescent, Adult, Age Distribution, Aged, Aged, 80 and over, Data Collection, Female, Germany epidemiology, Humans, Male, Middle Aged, Sex Distribution, Socioeconomic Factors, Young Adult, Motor Activity, Sports statistics & numerical data
- Abstract
The study analyses the distribution of physical and sporting activity among the adult population in Germany. The data came from the "German Health Update 2009" survey, which is based on 21,262 telephone interviews conducted by the Robert Koch Institute between July 2008 and June 2009. The study shows that 56% of men aged 18 and over and 38% of women in the same age group engaged in physical activity with an intensity that made them sweat or be out of breath for at least 2.5 h/week. In addition, 64% of both men and women stated that they had actively engaged in sporting activities over the previous 3 months. Comparing 1998 and 2003, participation in sport was observed to have increased among men and women in all age groups over time. Furthermore, socio-economic differences were observed, indicating lower physical activity among higher-status groups and lower sporting activity among lower-status groups. Measures to promote physical activity and sport prove to be especially necessary for people who are not physically active (19% of men and 26% of women) or who do not engage in sport at all (36% of both men and women).
- Published
- 2012
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39. [Overview of primary prevention measures to promote physical activity in Germany].
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Jordan S, Weiss M, Krug S, and Mensink GB
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- Germany, Attitude to Health, Health Promotion methods, Health Promotion organization & administration, Motor Activity, Primary Prevention methods, Primary Prevention organization & administration
- Abstract
This article provides an overview of primary prevention measures to promote physical activity. First, health-related recommendations for physical activity are presented together with a brief description of the frequency and determinants of physical activity. Prevention measures in Germany to promote physical activity are categorized taking into account the respective level of intervention (individual, setting, population) and contextual reference (with and without relying on structural conditions). Typical preventive measures to promote physical activity will be presented along with some examples. This is followed by concluding remarks about the current state in the area of preventive measures in Germany for the promotion of physical activity.
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- 2012
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40. Relative validation of the KiGGS Food Frequency Questionnaire among adolescents in Germany.
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Truthmann J, Mensink GB, and Richter A
- Subjects
- Adolescent, Body Weight, Bread, Child, Female, Germany, Humans, Interviews as Topic, Male, Nutrition Assessment, Oryza, Self Administration, Socioeconomic Factors, Diet Surveys, Feeding Behavior, Surveys and Questionnaires standards
- Abstract
Background: The aim of this study was to determine the relative validity of the self-administered Food Frequency Questionnaire (FFQ) "What do you eat?", which was used in the German National Health Interview and Examination Survey for Children and Adolescents (KiGGS 2003-2006)., Methods: The validation was conducted in the EsKiMo Nutrition Module, a subsample of KiGGS. The study population included 1,213 adolescents aged between 12 and 17. A modified diet history interview DISHES (Dietary Interview Software for Health Examination Studies) was used as the reference method. In order to compare the food groups, the data assessed with both instruments were aggregated to 40 similar food groups. The statistical analysis included calculating and comparing Spearman's correlation coefficients, calculating the mean difference between both methods, and ranking participants (quartiles) according to food group consumption, including weighted kappa coefficients. Correlations were also evaluated for relative body weight and socioeconomic status subgroups., Results: In the total study population the Spearman correlation coefficients ranged from 0.22 for pasta/rice to 0.69 for margarine; most values were 0.50 and higher. The mean difference ranged between 1.4% for milk and 100.3% for pasta/rice. The 2.5 percentiles and 97.5 percentiles indicated a wide range of differences. Classifications in the same and adjacent quartile varied between 70.1% for pasta/rice and 90.8% for coffee. For most groups, Cohen's weighted kappa showed values between 0.21 and 0.60. Only for white bread and pasta/rice were values less than 0.20. Most of the 40 food groups showed acceptable to good correlations in all investigated subgroups concerning age, sex, body weight and socio-economic status., Conclusions: The KiGGS FFQ showed fair to moderate ranking validity except for pasta/rice and white bread. However, the ability to assess absolute intakes is limited. The correlation coefficients for most food items were similar for normal weight and overweight as well as for different socio-economic status groups. Overall, the results of the relative validity were comparable to FFQs from the current literature.
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- 2011
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41. Dietary patterns are associated with cardiometabolic risk factors in a representative study population of German adults.
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Heidemann C, Scheidt-Nave C, Richter A, and Mensink GB
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- Adolescent, Adult, Aged, Cardiovascular Diseases epidemiology, Cross-Sectional Studies, Female, Germany epidemiology, Humans, Male, Metabolic Syndrome epidemiology, Middle Aged, Nutrition Surveys, Risk Factors, Young Adult, Cardiovascular Diseases etiology, Diet adverse effects, Metabolic Syndrome etiology
- Abstract
Studies that investigated complex actual eating behaviours of the general population and their relation to cardiometabolic risk markers are sparse. We aimed to identify dietary patterns within a nationally representative sample of 4025 German adults by factor analysis based on validated dietary history interviews. Furthermore, we evaluated associations of the derived dietary patterns with abnormalities clustered within the metabolic syndrome and related metabolic markers by logistic regression models and ANCOVA. A high adherence to the 'processed foods' pattern reflected a high intake of refined grains, processed meat, red meat, high-sugar beverages, eggs, potatoes, beer, sweets and cakes, snacks and butter, whereas a high adherence to the 'health-conscious' pattern represented a high intake of vegetables, vegetable oils, legumes, fruits, fish and whole grains. For subjects in the highest compared with those in the lowest quintile of the processed foods pattern, the occurrence of abdominal obesity was 88 (95 % CI 31, 169) % higher, hypertension was 34 (95 % CI - 4, 86) % higher, hypertriacylglycerolaemia was 59 (95 % CI 11, 128 ) % higher and the metabolic syndrome was 64 (95 % CI 10, 143) % higher when adjusted for age, sex, energy intake, socio-economic status, sport activity and smoking. Furthermore, subjects in the highest quintile had statistically significantly higher uric acid concentrations and lower folate concentrations (P for trend < 0·05). In contrast, subjects in the highest quintile of the health-conscious pattern had a 30 (95 % CI 10, 46) % lower occurrence of hypertension, higher folate concentrations and lower homocysteine and fibrinogen concentrations (P for trend < 0·05). These data strengthen the findings from non-representative studies and emphasise the importance of healthy overall food patterns for preventing metabolic disturbances.
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- 2011
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42. [Monitoring and quality assurance of prevention and health promotion at the federal level].
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Jordan S, Töppich J, Hamouda O, von Rüden U, Mensink GB, Mann R, and Hölling H
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- Germany, Federal Government, Health Promotion standards, Practice Guidelines as Topic, Preventive Medicine standards, Quality Assurance, Health Care organization & administration
- Abstract
Monitoring and quality assurance are gaining in importance for the identification of needs and the effectiveness of prevention and health promotion activities. This paper presents examples of activities of monitoring and quality assurance at the federal level, carried out by the Federal Centre for Health Education and the Robert Koch Institute. Examples include the prevention issues "HIV/AIDS", "nutrition and physical activity" and "child health". They illustrate the roles of epidemiological surveillance, health monitoring, evaluation, and intervention reporting. The Robert Koch Institute and the Federal Centre for Health Education provide complementary information on health and intervention reporting at the federal level. With their reports, they provide essential information for health policy to formulate, to implement and to evaluate evidence-based national health goals and action plans.
- Published
- 2011
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43. [Which implications for obesity prevention can be offered by the KiGGS follow-up study?].
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Mensink GB, Schlack R, Kurth BM, and Hölling H
- Subjects
- Adolescent, Child, Child, Preschool, Female, Follow-Up Studies, Germany epidemiology, Humans, Infant, Infant, Newborn, Male, Prevalence, Risk Assessment, Risk Factors, Treatment Outcome, Clinical Trials as Topic statistics & numerical data, Health Status, Obesity epidemiology, Obesity prevention & control, Primary Prevention statistics & numerical data
- Abstract
From 2003-2006, the health status of 17,641 girls and boys was comprehensively assessed by interview and medical examinations in the nationwide German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Therewith, data exists for a broad spectrum of health relevant questions in childhood and adolescence, including indicators, determinants and consequences of obesity. As part of the health monitoring system of the Robert Koch Institute, KiGGS is being continued as a longitudinal study. This enables the observation of health development of children and adolescents up to adulthood as well as the detection of changes in behavior and circumstances within this population. This offers many new perspectives for analyses, whose findings may be helpful for the prevention of obesity. Current insights and future perspectives are discussed.
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- 2011
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44. Indicators of overweight and cardiovascular disease risk factors among 11- to 17-year-old boys and girls in Germany.
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Kleiser C, Schienkiewitz A, Schaffrath Rosario A, Prinz-Langenohl R, Scheidt-Nave C, and Mensink GB
- Subjects
- Adolescent, Biomarkers, Child, Female, Germany, Health Surveys, Humans, Interviews as Topic, Male, Odds Ratio, Reference Values, Risk Assessment, Risk Factors, Body Height, Body Mass Index, Cardiovascular Diseases etiology, Obesity complications, Waist Circumference
- Abstract
Objective: We analyzed the magnitude of the association between cardiovascular disease (CVD) risk factors and various measures of overweight among adolescents, to determine which indicator of overweight is most relevant for risk assessment., Methods: 5,546 boys and girls aged 11-17 years participating in the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) were studied. Overweight was assumed when different anthropometric variables exceeded age- and sex-specific 90th percentiles. Blood pressure was measured and blood samples were analyzed for serum total cholesterol, lipoproteins, high-sensitivity C-reactive protein, and glycosylated hemoglobin (HbA1c)., Results: In both sexes, overweight was significantly associated with adverse levels of CVD risk factors, except HbA1c. These associations were most pronounced for overweight as defined by waist circumference (WC), waist-to-height ratio (WHtR), or BMI. Between 11% and 37% of the overweight children exceeded the defined cut-offs for individual CVD risk factors, with age- and puberty-adjusted significant odds ratios (95% confidence interval (CI)) in comparison to normal-weight age mates ranging from 1.7 (1.0-3.0) to 6.1 (4.5-8.2)., Conclusions: The findings of this population-based survey suggest that, among adolescents, WC, WHtR, and BMI are easily applicable measures of overweight that appear to be relevant for CVD risk assessment., (Copyright © 2011 S. Karger AG, Basel.)
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- 2011
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45. Relative validation of a food frequency questionnaire for national health and nutrition monitoring.
- Author
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Haftenberger M, Heuer T, Heidemann C, Kube F, Krems C, and Mensink GB
- Subjects
- Adolescent, Adult, Aged, Eating, Female, Germany, Humans, Male, Middle Aged, Surveys and Questionnaires, Diet Surveys methods
- Abstract
Background: Validation of a food frequency questionnaire (FFQ) is important as incorrect information may lead to biased associations. Therefore the relative validity of an FFQ developed for use in the German Health Examination Survey for Adults 2008-2011 (DEGS) was examined., Methods: Cross-sectional comparisons of food consumption data from the FFQ and from two 24-hour recalls were made in a sample of 161 participants (aged 18 to 80 years) of an ongoing nationwide survey, the German National Nutrition Monitoring (NEMONIT). The data collection took place from November 2008 to April 2009., Results: Spearman rank correlations between the FFQ and the 24-hour dietary recalls ranged from 0.15 for pizza to 0.80 for tea, with two third of the correlation coefficients exceeding 0.30. All correlation coefficients were statistically significant except those for pizza and cooked vegetables. The proportion of participants classified into the same or adjacent quartile of intake assessed by both methods varied between 68% for cooked vegetables and 94% for coffee. There were no statistically significant differences in food consumption estimates between both methods for 38% of the food groups. For the other food groups, the estimates of food consumption by the FFQ were not generally higher or lower than estimates from the 24-hour dietary recalls., Conclusions: The FFQ appears to be reasonably valid in the assessment of food consumption of German adults. For some food groups, such as raw and cooked vegetables, relative risks estimates should be interpreted with caution because of the poor ranking agreement.
- Published
- 2010
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46. Food intake of young people with a migration background living in Germany.
- Author
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Kleiser C, Mensink GB, Neuhauser H, Schenk L, and Kurth BM
- Subjects
- Adolescent, Age Distribution, Child, Child, Preschool, Cross-Sectional Studies, Diet Surveys, Feeding Behavior, Female, Food Preferences, Germany, Health Surveys, Humans, Linear Models, Male, Rural Population statistics & numerical data, Russia ethnology, Sex Distribution, Socioeconomic Factors, Turkey ethnology, Urban Population statistics & numerical data, Acculturation, Diet ethnology, Diet statistics & numerical data, Emigrants and Immigrants statistics & numerical data
- Abstract
Objective: To explore the food intake of young migrants living in Germany., Design: Children and adolescents aged 0 to 17 years living in Germany, including 17.1 % with a migration background, were examined in a representative health survey. Food frequency data of 7186 boys and 6919 girls, aged 3 to 17 years, were analysed separately for Turkish, Russian Germans, other migrants and non-migrants. Daily food intake was calculated and a healthy diet score was used to allow an overall interpretation of the diet. Using stepwise linear regression, the association between migrant status and healthy diet score was analysed., Results: Turkish participants (4.8 %) consumed significantly more soft drinks, fried potatoes, chocolate cream and snacks than all other groups and significantly less meat than other migrants and non-migrants. Turkish as well as other migrants (8.8 %) ate more poultry, fish and pasta/rice, and less sausage/bacon and cooked potatoes, than Russian Germans and non-migrants. Russian Germans (3.5 %) consumed less cooked vegetables than non-migrants and other migrants. Non-migrants had a better mean dietary score than Russian Germans and other migrants. A less preferable diet score was associated with higher age, male sex, being a migrant from Russia, low or middle socio-economic status, and living in rural or provincial areas., Conclusions: The study showed considerable differences in dietary habits between young persons of different origin. This underlines the importance of focusing on ethnic groups in dietary interventions.
- Published
- 2010
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47. Intake of selected nutrients from foods, from fortification and from supplements in various European countries.
- Author
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Flynn A, Hirvonen T, Mensink GB, Ocké MC, Serra-Majem L, Stos K, Szponar L, Tetens I, Turrini A, Fletcher R, and Wildemann T
- Abstract
Background: Recent European Union regulation requires setting of maximum amount of micronutrients in dietary supplements or foods taking into account the tolerable upper intake level (ULs) established by scientific risk assessment and population reference intakes., Objective: To collect and evaluate recently available data on intakes of selected vitamins and minerals from conventional foods, food supplements and fortified foods in adults and children. Intake of calcium, copper, iodine, iron, magnesium, phosphorus, selenium, zinc, folic acid, niacin and total vitamin A/retinol, B(6), D and E was derived from nationally representative surveys in Denmark, Germany, Finland, Ireland, Italy, the Netherlands, Poland, Spain and the United Kingdom. Intake of high consumers, defined as the 95th percentile of each nutrient, was compared to the UL., Results: For most nutrients, adults and children generally consume considerably less than the UL with exceptions being retinol, zinc, iodine, copper and magnesium. The major contributor to intakes for all nutrients and in all countries is from foods in the base diet. The patterns of food supplements and voluntary fortification vary widely among countries with food supplements being responsible for the largest differences in total intakes. In the present study, for those countries with data on fortified foods, fortified foods do not significantly contribute to higher intakes for any nutrient. Total nutrient intake expressed as percentage of the UL is generally higher in children than in adults., Conclusion: The risk of excessive intakes is relatively low for the majority of nutrients with a few exceptions. Children are the most vulnerable group as they are more likely to exhibit high intakes relative to the UL. There is a need to develop improved methods for estimating intakes of micronutrients from fortified foods and food supplements in future dietary surveys.
- Published
- 2009
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48. Changes in food and nutrient intake of 6- to 17-year-old Germans between the 1980s and 2006.
- Author
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Stahl A, Vohmann C, Richter A, Heseker H, and Mensink GB
- Subjects
- Adolescent, Child, Cross-Sectional Studies, Diet Surveys, Energy Intake, Female, Food Analysis, Germany, Humans, Male, Nutritive Value, Water, Diet trends, Feeding Behavior
- Abstract
Objective: To compare the food consumption and nutrient intakes of German children and adolescents in the 1980s with present dietary habits., Design: Two cross-sectional representative surveys, the German National Food Consumption Study (Nationale Verzehrsstudie, NVS) from 1985-8 and the nutrition module 'EsKiMo' of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) from 2006, were analysed for differences in food and nutrient intakes stratified by age and sex groups., Setting: Secondary analyses of data from representative observational studies., Subjects: Children and adolescents aged 6-17 years living in Germany in the 1980s (n 2265) and in 2006 (n 2506)., Results: Food consumption was characterised by higher amounts of vegetables/pulses, fruits/nuts and beverages and less meat products/sausages, butter, fats/oils, potatoes/potato products and bread/pastries in 2006 than in 1985-8. The overall changes in food intake were reflected in improvements of macronutrient composition, increased water intake and lower energy density of the diet. Intake of most vitamins and minerals increased in relation to energy intake, but the nutrient density of the diet for vitamins B12 and D decreased. The most critical nutrients observed in NVS and EsKiMo were folate, vitamin D, vitamin A, vitamin E, Ca and Fe. In addition, dietary fibre intake was relatively low and fatty acid and carbohydrate compositions were not favourable., Conclusions: Further efforts will be necessary to improve dietary habits among children and adolescents.
- Published
- 2009
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49. [Development and implementation of health targets for children and adolescents. What contribution can the Robert Koch Institute's National Health Interview and Examination Survey for Children and Adolescents (KiGGS) make?].
- Author
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Lampert T, Mensink GB, Hölling H, Schlack R, Kleiser C, and Kurth BM
- Subjects
- Adolescent, Child, Germany, Health Planning Councils, Humans, Needs Assessment, Adolescent Health Services, Child Health Services, Health Surveys, National Health Programs, Organizational Objectives
- Abstract
Health targets are increasingly becoming a health-policy control instrument, both nationally and internationally. In the project gesundheitsziele.de, targets have been formulated for children and adolescents in Germany - currently in the areas of nutrition, exercise, and stress management. Implementing and evaluating health targets requires regularly updated, informative data that allow a comprehensive and precise description of the relevant problems and developments. The Robert Koch Institute's National Health Interview and Examination Survey for Children and Adolescents - conducted during the period from 2003 to 2006 - provides a pool of data with information on virtually all facets of health development during childhood and adolescence which can be used to determine the starting point of the health-targeting process. This article describes the data provided by the survey of the areas nutrition, exercise, and stress management and the contribution these data could make towards further developing and implementing the health targets for children and adolescents.
- Published
- 2009
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50. HuSKY: a healthy nutrition score based on food intake of children and adolescents in Germany.
- Author
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Kleiser C, Mensink GB, Scheidt-Nave C, and Kurth BM
- Subjects
- Adolescent, Age Factors, Child, Child, Preschool, Emigration and Immigration, Folic Acid blood, Germany, East, Germany, West, Health Status Indicators, Homocysteine blood, Humans, Linear Models, Male, Nutrition Surveys, Nutritional Status, Russia ethnology, Sex Factors, Socioeconomic Factors, Surveys and Questionnaires, Turkey ethnology, Eating
- Abstract
For many epidemiological questions an overall indicator of healthy nutrition can be useful. Based on the data from the FFQ of the German Health Interview and Examination Study for children and adolescents (KiGGS) we developed a healthy nutrition score based on a comparison with current recommendations for children and adolescents. We observed independent and statistically significant relationships between the nutrition score and age, sex, socio-economic status, immigration background, level of urbanisation and residence in former East v. former West Germany. Furthermore, the nutrition score was statistically significantly related to serum concentrations of homocysteine (inverse association) and folate (positive associations). The construction of a healthy nutrition score appears to be useful for several reasons. For instance, our score can be used to summarise an abundance of dietary information to a single measure, to get an overall impression of diets of individuals or groups, which can be useful to detect certain risk groups.
- Published
- 2009
- Full Text
- View/download PDF
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