Mediation of parental educational level on fruit and vegetable intake among schoolchildren in ten European countries.

OBJECTIVE: To examine which factors act as mediators between parental educational level and children's fruit and vegetable (F&V) intake in ten European countries. DESIGN: Cross-sectional data were collected in ten European countries participating in the PRO GREENS project (2009). Schoolchildren completed a validated FFQ about their daily F&V intake and filled in a questionnaire about availability of F&V at home, parental facilitation of F&V intake, knowledge of recommendations about F&V intake, self-efficacy to eat F&V and liking for F&V. Parental educational level was determined from a questionnaire given to parents. The associations were examined with multilevel mediation analyses. SETTING: Schools in Bulgaria, Finland, Germany, Greece, Iceland, the Netherlands, Norway, Portugal, Slovenia and Sweden. SUBJECTS: Eleven-year-old children (n 8159, response rate 72%) and their parents. RESULTS: In five of the ten countries, children with higher educated parents were more likely to report eating fruits daily. This association was mainly mediated by knowledge but self-efficacy, liking, availability and facilitation also acted as mediators in some countries. Parents' education was positively associated with their children's daily vegetable intake in seven countries, with knowledge and availability being the strongest mediators and self-efficacy and liking acting as mediators to some degree. CONCLUSIONS: Parental educational level correlated positively with children's daily F&V intake in most countries and the pattern of mediation varied among the participating countries. Future intervention studies that endeavour to decrease the educational-level differences in F&V intake should take into account country-specific features in the relevant determinants of F&V intake.

Metabolic syndrome, adipokines and ghrelin in overweight and obese schoolchildren: results of a 1-year lifestyle intervention programme.

The aim of this study was to evaluate the effect of a lifestyle intervention programme (nutrition and exercise counselling) on metabolic syndrome (MS) components, adipokines (leptin, adiponectin) and ghrelin levels in overweight children. A total of 61 overweight children aged 7-9 years (≥ 85th body mass index (BMI) percentile; 27 boys/34 girls) were randomly assigned and completed a 1-year individual (IT) or group-based treatment (GT). Anthropometric and biochemical parameters were assessed at baseline, at 6 months and at 1 year. Twenty-two normal weight children (<85th BMI percentile; 7-9 years old; 13 boys/nine girls) were also evaluated at baseline. Insulin resistance (IR) was determined by the homeostasis model assessment of IR (HOMA-IR). Overweight children presented significantly higher blood pressure, triglycerides, apolipoprotein B, insulin, HOMA-IR, leptin, C-reactive protein and homocysteine levels, while apolipoprotein A-I was significantly lower. At baseline, MS was present in ten overweight children, of which only five maintained it at 1 year. Leptin and ghrelin levels were associated with IR and MS components. MS was predicted by apolipoprotein A-I, insulin and pre-puberty. The lifestyle intervention led to a significant improvement in standard deviation score of BMI, waist circumference/height ratio and lipid profile. Changes in insulin, HOMA-IR, leptin and adiponectin were not significant. Ghrelin behaved differently between IT and GT. The GT intervention seems to be more successful, with a decrease in BMI Z-score and an improvement of metabolic parameters. In conclusion, overweight children have multiple risk factors associated with MS. A lifestyle intervention programme seems to be an effective mean for reducing obesity and MS components and improving adipokines concentrations.

[Validation of a questionnaire to evaluate alcohol related behaviours in excessive drinkers]. / Validação de um instrumento de avaliação da ingestão de bebidas alcoólicas e de etanol por consumidores excessivos.

UNLABELLED: The excessive consumption of alcohol and alcoholic drinks is an habit with high socioeconomic costs and a strong impact on health that requires research aiming at establishing adequate political options concerning trends, observed behaviours and consumption. OBJECTIVES: To validate an instrument to evaluate the consumption of the different kinds of alcoholic drinks and alcohol-related behaviours; to assess the determinants of alcoholic drinks consumption. TYPE OF STUDY: Validation study of an instrument to assess alcohol-related behaviours. PLACE: Coimbra. POPULATION: Excessive alcohol consumers. METHODS: Cross-sectional study based on a questionnaire and biochemical markers assessment, aiming to validate an instrument to evaluate alcohol consumption and alcohol-related behaviours. RESULTS: A correlation between age at first contact with alcohol and the beginning of the regular consumption(r = 0,72; p < 0,001) was found. Alcohol consumption in the last 12 months correlated with - % CDT (r = 0,54; p < 0,001) and with γ-GT (r = 0,47; p < 0,001). CONCLUSIONS: The validity of the instrument developed to evaluate alcohol-related behaviours is acceptable and therefore it may be used to establish hierarchy between levels of alcohol consumption defined by categories of ingestion and negative consequences.

The Women's Health Initiative. What is on trial: nutrition and chronic disease? Or misinterpreted science, media havoc and the sound of silence from peers?

The first results of the Women's Health Initiative dietary intervention trial were published in the USA in February. This is a colossal intervention designed to see if diets lower in fat and higher in fruits, vegetables and grains than is usual in high-income countries reduce the incidence of breast cancer, colorectal cancer, heart disease and other chronic diseases, in women aged 50-79 years. As interpreted by US government media releases, the results were unimpressive. As interpreted by a global media blitz, the results indicate that food and nutrition has little or nothing to do with health and disease. But the trial was in key respects not reaching its aims, was methodologically controversial, and in any case has not produced the reported null results. What should the public health nutrition profession do about such messes?