Development and reliability of questionnaires for the assessment of diet and physical activity behaviors in a multi-country sample in Europe the Feel4Diabetes Study.

BACKGROUND: Assessment of diet and physical activity and their determinants still remains a demanding task, especially when the objective is to evaluate the efficacy of lifestyle interventions. In the context of the Feel4Diabetes study (a European community based intervention study in families with school aged children and at high risk of developing diabetes), we aimed to develop questionnaires for the assessment of food-frequency and eating behaviors, and physical activity and sedentary behaviors in both parents and school-aged children and a questionnaire for overall family's energy balance-related behaviors. METHODS: Questionnaires were developed to be used in 6 countries under standardized harmonization procedures and included questions regarding not only food intake and physical activity, but also questions of their determinants. A reliability study was conducted in 191 pairs of parents and their children (N = 191). Parents completed the questionnaires on two occasions, within a 1-2 week interval. Reliability was tested by the intra-class correlation coefficients (ICC) of test-retest. RESULTS: Most of the questions in all questionnaires had excellent reliability, assessed as an ICC of > 0.810. Mean ICCs for food-frequency and eating behaviors questionnaires were 0.838 and 0.787, and for physical activity and sedentary behaviors questionnaires were 0.734 and 0.793, in adults and children respectively. Mean ICC for overall family's energy balance-related behaviors and their determinants was 0.659. CONCLUSION: The developed questionnaires showed acceptable reliability and may be valuable tools in the assessment of children's and parents' behaviors related to diet, physical activity, sedentary behavior and overall energy balance in school- and community-based interventions.

Clustering of energy balance-related behaviours and parental education in European preschool children: the ToyBox study.

Energy balance-related behaviours (EBRB) are established in childhood and seem to persist through to adulthood. A lower parental educational level was associated with unhealthy behavioural patterns. The aim of the study is to identify clusters of EBRB and examine their association with preschool children's BMI and maternal, paternal and parental education. A subsample of the ToyBox study (n 5387) conducted in six European countries was used. Six behavioural clusters ('healthy diet and low activity', 'active', 'healthy lifestyle', 'high water and screen time; low fruits and vegetables (F&V) and physical activity (PA)', 'unhealthy lifestyle' and 'high F&V consumers') emerged. The healthiest group characterised by high water and F&V consumption and high PA z scores ('healthy lifestyle') was more prevalent among preschool children with at least one medium- or higher-educated parent and showed markedly healthier trends for all the included EBRB. In the opposite, the 'unhealthy lifestyle' cluster (characterised by high soft drinks and screen time z scores, and low water, F&V and PA z scores) was more prevalent among children with lower parental, paternal and maternal education levels. OR identified that children with lower maternal, paternal and parental education levels were less likely to be allocated in the 'healthy lifestyle' cluster and more likely to be allocated in the 'unhealthy lifestyle' cluster. The 'unhealthy lifestyle' cluster was more prevalent among children with parents in lower parental educational levels and children who were obese. Therefore, parental educational level is one of the key factors that should be considered when developing childhood obesity prevention interventions.

Presence of music while eating: Effects on energy intake, eating rate and appetite sensations.

The role of music in energy and dietary intake of humans is poorly understood. The purpose of the present laboratory study was to examine the effect of background music, its presence and its intensity, on energy intake, eating rate and appetite feelings. The study had a randomized crossover design. Twenty-six normal weight and overweight/obese men participated in random order in three trials: the control trial (no music was playing), the 60dB and the 90dB music trials, while an ad libitum lunch was consumed. Visual analogue scales for hunger, fullness/satiety, as well as desire to eat were administered to the participants. Energy intake at the ad libitum lunch did not differ between trials, even when covariates were taken into account. There were no statistically significant differences between trials on meal characteristics, such as meal duration, number of servings, number of bites eaten and on appetite indices. Future studies are needed to replicate these results and investigate the effect of different types of music and/or sound.