Changes in eating behaviours and physical activity among primary schoolchildren aged 7-12 during the pandemic in the light of qualitative and quantitative research - Junior-Edu-Zywienie (JEZ) Project.

INTRODUCTION AND OBJECTIVE: The COVID-19 pandemic had many direct and indirect effects, including lifestyle changes in all subpopulations, including children and adolescents. The aim of the study was to identify: 1) attitudes of students aged 7-12 years and their parents towards food, nutrition, and physical activity; 2) changes in the consumption of basic food products during the COVID-19 pandemic. MATERIAL AND METHODS: A qualitative survey was conducted among students and their parents using the Focus Group Interview method, as well as quantitative research among parents and schoolchildren aged 10-12 years. RESULTS: During the pandemic, changes were demonstrated in the eating habits of primary schoolchildren which were both positive and negative. Positive changes include a greater number of meals and their regularity, especially in relation to meals prepared at home, and a greater consumption of mainly fruit, and to a lesser extent vegetables and whole grain products. Among the negative changes observed were an increased consumption of salty snacks and sweets, including those prepared at home. Moreover, limiting physical activity during isolation may have resulted, as a long-term effect, in excessive body weight and obesity-related non-communicable diseases in children and adolescence, and later in adulthood. CONCLUSIONS: There is a need to develop post-pandemic support strategies addressed to both schoolchildren and their parents regarding adequate eating behaviours and physical activity.

Dietary Antioxidants May Support Cosmetic Treatment in Patients with Rosacea.

Rosacea is a chronic skin disease that significantly reduces the quality of life (QoL) of patients. The aim of this study was to assess whether dietary antioxidants can support the effect of cosmetic treatment in improving the QoL of patients with rosacea. Basic data about participants (N = 160) were collected using a self-reported survey. QoL was assessed using the standardized Dermatology Life Quality Index (DLQI) questionnaire. An interventional cosmetic treatment was performed using cavitation peeling and sonophoresis with a commercial capillary repair serum. The study was registered as a clinical trial (NCT06271135). To assess antioxidant diet quality, for the first time, a new dietary antioxidant quality index (DAQI) was developed, which consisted of 12 items: dietary total antioxidant capacity, dietary polyphenols, phytosterols, lignans, vitamin C, vitamin E, ß-carotene, zinc, iron, copper, manganese and selenium. It was found that the highest tertiles of DAQI diminished the odds about 40-45% of the moderate, large and extremely large effect of rosacea on QoL and about 8-11% of the occurrence of rosacea symptoms compared with the lowest tertile. This study showed that rosacea has a negative impact on QoL, but a comprehensive approach to treatment, including antioxidant cosmetic treatment and dietary antioxidants, can improve the QoL of patients with rosacea.

Breastmilk mineral composition among well-educated mothers from Central Poland - Associations with maternal dietary intake, dietary patterns and infant psychomotor development.

BACKGROUND: Maternal dietary habits could affect breastmilk mineral composition, which may influence infant development. Mineral dietary intake or supplementation slightly affects its breastmilk concentration. However, the intake of selected food groups or dietary patterns that reflect diet complexity could have a greater impact. Hence, the aim of the study was to assess breastmilk mineral composition at one, three, and six months of lactation among mothers living in urban area of Central Poland, as well as the evaluate maternal dietary determinants and associations with infant anthropometric and psychomotor development. METHODS: The study was conducted among 43 healthy and exclusively breastfeeding mothers. In the first, third, and sixth months of lactation, we collected breastmilk samples and assessed the concentration of Ca, P, Zn, Fe, Se, Ni, As, Pb, and Cd using the ICP-MS method. Maternal dietary habits were evaluated by a food frequency questionnaire in the first month of lactation, whereas in the third and sixth by the three-day food record. Based on the collected data adherence to the Polish-adapted Mediterranean (Pl-aMED; 1 month) and the DASH diet (Mellen's Index; 3 and 6 months) was assessed. In the third and sixth months of lactation infant anthropometric parameters and the sixth month of lactation psychomotor development were evaluated. RESULTS: Breastmilk Se, Ni, As, Pb, and Cd levels were under the LOQ in all the breastmilk samples at all study visits. Median breastmilk mineral concentrations of Ca, P, Zn, and Fe in the first, third, and sixth months of lactation varied from 381.9 to 332.7 mg/L, 161.6 to 139.1 mg/L, 2.2 to 0.8 mg/L, and 0.26 to 0.17 mg/L, respectively. Maternal dietary intake and supplementation did not affect breastmilk Ca, P, Zn, and Fe. Pl-aMED scores were associated with breastmilk Ca (ß = 0.489, 95% CI 0.180 - 0.799, p = 0.003) and Zn (ß = 0.499, 95% CI 0.199 - 0.798, p = 0.002) in the first month of lactation, whereas no association with the DASH diet were observed in the third and sixth month of lactation. Breastmilk Fe in the third month was associated with infant motor development (ß = 0.420, 95% CI 0.113 - 0.727, p = 0.009) in the sixth month of life, but no other associations with anthropometric or psychomotor development were observed. Moreover, we estimated that few infants meet their adequate intake (AI) requirements for P, Zn, and Fe. CONCLUSION: Our study showed that maternal adherence to Pl-aMED is a significant predictor of breastmilk Ca and Zn in the first month of lactation, which may be especially important considering that more than 75% of infants had inadequate Zn intake. Moreover, we found that breastmilk Fe positively influenced infant motor development, despite the majority of infants having inadequate intake. On the other hand, no infant had deficiency symptoms, which emphasizes the necessity to evaluate of AI norms for infants.

Plasma Carotenoids and Polyphenols and Their Association with MetS: The Need for Nutritional Interventions.

Metabolic syndrome (MetS) is characterized by increased pro-oxidative stress and a chronic inflammation state and their consequent alterations. Several studies have highlighted the protective effect of carotenoids and polyphenols in MetS patients. This study aimed to evaluate the plasma level of selected carotenoids and polyphenols and to determine their relationship with MetS severity, MetS components, and inflammatory markers in Polish adults with metabolic disorders. It was designed as a cross-sectional study. The final study group comprised 275 adults, including 158 women and 117 men. Data were collected on the frequency of consumption of selected food groups. Anthropometric measurements and blood samples were taken to determine the concentration of carotenoids, polyphenols, and indicators (parameters) of metabolic disorders. Plasma concentrations of selected carotenoids and polyphenols were low in adults with MetS. The highest concentrations of carotenoids and polyphenols in the blood were observed for lutein and phenolic acids (including gallic and p-coumaric acids). Nevertheless, a correlation was found between the individual bioactive compounds and MetS components. In terms of the lipid profile, our study showed that the plasma of the selected carotenoids and polyphenols positively correlated with HDL cholesterol (zeaxanthin; total carotenoids), LDL cholesterol (chlorogenic acid), triglycerides (lycopene), and the total cholesterol (kaempferol). We found that the level of CRP as a marker of inflammation negatively correlated with the concentration of zeaxanthin. In our study group, no relationship was found between the dietary antioxidant intensity and the variables studied, which may be attributed to the low frequency of consumption of the sources of bioactive compounds, such as carotenoids and polyphenols, but also to the metabolic disorders. Further research is needed to determine whether these associations are causally related to the metabolic syndrome or are a result of the pathologies of the syndrome or improper diet with a low intake of vegetables and fruit.

Nutrition-Related Knowledge, Diet Quality, Lifestyle, and Body Composition of 7-12-Years-Old Polish Students: Study Protocol of National Educational Project Junior-Edu-Zywienie (JEZ).

Increasing students' nutrition knowledge is an important goal of school education which may improve their lifestyle and consequently reduce the incidence of non-communicable chronic diseases, including obesity. This research aimed at assessing the dietary habits, nutrition-related knowledge and attitudes, and nutritional status of Polish students aged 7-12 years. Additional objectives included recognizing nutrition-related knowledge among their parents and teachers as well as the school food and nutrition environment. The final goal was to develop a nutrition education program. This study protocol presents a general and detailed approach for realizing the above-mentioned issues, including conducting quantitative and qualitative research. The study was designed as cross-sectional, covering primary school students from all over Poland, including rural, town, and metropolitan areas. Data on eating habits, lifestyle, nutrition-related knowledge, and attitudes were collected with questionnaires. Measurements of body weight, height, waist and hip circumferences, and handgrip strength were performed in accordance with the International Standards for Anthropometric Assessment (ISAK) recommendations. Body composition was assessed with bioelectrical impedance analysis. Ultimately, 2218 schools from all 16 voivodeships in Poland registered for the project. In total, quantitative data were collected among 27,295 students, 17,070 parents, and 2616 teachers. Anthropometric measurements were taken among 18,521 students. The results allow us to develop a multifaceted educational program based on knowledge and adapted to the perception of students. Our research may contribute to the identification of subpopulations of children and adolescents at risk of excessive body weight and define the predictors of obesity risk in Poland.

Dietary-Physical Activity Patterns in the Health Context of Older Polish Adults: The 'ABC of Healthy Eating' Project.

The study aimed to analyze the dietary-physical activity patterns (D-PAPs) in the health context of Polish people aged 60+ years. A total of 418 respondents across Poland were recruited; however, the final analysis included 361 women and men aged 60-89 years old. D-PAPs were derived using a principal component analysis (PCA); input variables were the frequency of consumption of 10 food groups and physical activity. Finally, three D-PAPs were identified: 'Pro-healthy eating and more-active', 'Sweets, fried foods and sweetened beverages', and 'Juices, fish and sweetened beverages'. We developed the Functional Limitations Score (FLS) using the Mini Nutritional Assessment (MNA®). A logistic regression was applied to verify the association between the D-PAPs and health-condition outcomes. Older adults were more likely to adhere to the upper tertile of the 'Pro-healthy eating and more-active' pattern, with good/better self-reported health status in comparison with their peers (OR = 1.86) or with good/very good self-assessed appetite (OR = 2.56), while this was less likely for older adults with malnutrition risk (OR = 0.37) or with a decrease in food intake (OR = 0.46). Subjects with a decrease in food intake (OR = 0.43), who declared a recent weight loss (OR = 0.49), or older adults in the upper tertile of the FLS (OR = 0.34) were less likely to adhere to the upper tertile of the 'Sweets, fried foods and sweetened beverages' pattern. The decrease in food intake due to a loss of appetite or chewing or swallowing difficulties was inversely associated with the 'Pro-healthy eating and more-active' pattern characterized by a relatively high frequency of consumption of vegetables, fruit, water, dairy, and grains and a high physical activity. In the interest of the good nutritional status and health of older adults, special attention should be paid to removing limitations in meal consumption, including improved appetite.

Sustainability of a Multi-Component Education Program (ABC of Healthy Eating) after Three Months and Nine Months: The Socioeconomic Context in Improving Nutrition Knowledge in Polish Teenagers.

The study aimed to evaluate the sustainability of a multi-component education (ABC-HEat) program related to healthy nutrition and lifestyle after three months and nine months and to assess the socioeconomic context in improving teenage nutrition knowledge. The study was designed as a clustered, controlled, education-based intervention. A sample was chosen and allocated into either an educated group (under intervention) or a control group (outside of intervention). The study covered 464 11-12-year-old students (educated/control 319/145). In the educated group, data were collected three times: before education, after three months and after nine months to measure the short- and the long-term effects of education, respectively. In the control group, data were collected in parallel. Changes in nutrition knowledge score (NKS, points) by sex, residence, family affluence scale (FAS) were the main outcome measures. The increase in the NKS was significantly higher in the educated group than in the control group-three months after education on average by 1.4 to 2.7 points (all p < 0.001) in the total sample and all subgroups, and nine months after education in rural residents by 2.2 points (p < 0.001) and in the total sample by 0.4 (p < 0.05). In the educated group, the chance of no increase in the NKS was higher in urban than rural residents after three months and nine months (adjusted odds ratios [OR] and 95% Confidence Intervals [95% CI]: 3.63, 1.80-7.31 and 2.99, 1.60-5.59, respectively, both p < 0.001) using the increase in the NKS by ≥4 points as a reference. The multi-component education program improved the nutrition knowledge of teenagers in the short term regardless of socioeconomic variables, but in the long term this effect was visible only in rural residents. It suggests that a special path of nutrition education addressed to urban teens may be required.

Perceived Nutrition and Health Concerns: Do They Protect against Unhealthy Dietary Patterns in Polish Adults?

The aim of the study was to explore the associations between perceived health and nutrition concerns, sociodemographic characteristics and unhealthy dietary patterns in a representative group of Polish adults. The data were collected in 2017 through a cross-sectional quantitative survey under the National Health Program 2016-2020. Logistic regression models were used to analyze the data. It was found that higher health concerns decreased the chances of adhering to upper tertiles of "Fast food & alcohol" and "Refined food & sweetened beverages" dietary patterns (DPs), thus displaying less frequent consumption of such foods. No relationship was found between health concerns and adhering to the "Fat food" and "Butter" DPs. Nutrition concerns increased the likelihood of frequent consumption of foods from "Fast food & alcohol" DP. Women were less likely to adhere to unhealthy eating patterns than men, while older people were less likely to often consume fast food, alcohol, or refined food and sweetened beverages. Findings of this study showed that concerns about health or nutrition were differently associated with dietary patterns and consumption of unhealthy foods. These relationships should be considered when developing interventions to address health-related lifestyle changes. However, further research is needed to identify cause-effect relationships between these variables.

Activity-Inactivity Patterns, Screen Time, and Physical Activity: The Association with Overweight, Central Obesity and Muscle Strength in Polish Teenagers. Report from the ABC of Healthy Eating Study.

Today, the time spent actively is increasingly being replaced by screen-based media, although in some teenagers, a high level of physical activity (PA) and longer time spent in front of a screen (screen time, ST) may coexist as a mixed behavioral pattern. This study aimed to examine the association of the pattern created as activity (low/high ST with high PA) and inactivity patterns (low/high ST with low PA) with overweight, central obesity, and muscle strength in Polish teenagers taking into consideration socioeconomic and demographic factors. Cross-sectional data were collected from elementary school children (n = 1567), aged 11-13 years. Height, weight, waist circumference, and handgrip strength were measured. Body mass index (BMI) was calculated as the overweight measure, and the waist-to-height ratio (WHtR) was calculated as the central obesity measure. Data on ST, PA, socioeconomic status, demographics, and nutrition knowledge were collected by a questionnaire. Activity-inactivity patterns were defined by an a priori approach. Multivariate logistic regression modelling was applied. The most active pattern (lowST-highPA) was found in 17% of the total sample. Teenagers with the most inactive pattern (highST-lowPA) had over four times higher chance of general overweight. No association between WHtR ≥0.5 and highST-highPA pattern was found. Higher muscle strength (>1 SD) was associated only with high physical activity. Urban residence or lower socioeconomic status increased adherence to the most inactive pattern. From a public health perspective, implementing interventions promoting active patterns in 11-13-year-old teenagers is important for obesity prevention and enhanced physical fitness, especially in girls, teenagers living in urban areas, and from families with lower socio-economic status.

Dissatisfaction with Body Weight among Polish Adolescents Is Related to Unhealthy Dietary Behaviors.

The aims of the study were to determine the socio-demographic factors that may affect body weight dissatisfaction and to analyze the relationship between eating habits and dissatisfaction with body weight among a national random sample of Polish adolescents aged 13-19 years. Data on gender, age, level of education, body weight status, screen time, body weight satisfaction and selected nutritional behaviors were collected using a questionnaire. Body mass status was assessed based on weight and height measurements. A total of 14,044 students from 207 schools participated in the study. A significant effect of gender, age, level of education, body weight status and screen time status on the participants' dissatisfaction with the body weight was observed. The greater prevalence of body weight satisfaction was observed among boys, younger subjects, secondary school students, adolescents with normal body weight status and those with screen time up to 2 h. Whereas girls, older study participants (17-19 years old), overweight/obese adolescents and subjects with screen time over 4 h were more often dissatisfied with body weight. Furthermore, it has been shown that participants dissatisfied with their body weight less often met dietary recommendations. These findings can help dietitians, nutritionists and healthcare professionals to provide age-specific and gender-specific nutrition strategies to promote healthy lifestyle among school-going adolescents.

Reduced Screen Time is Associated with Healthy Dietary Behaviors but Not Body Weight Status among Polish Adolescents. Report from the Wise Nutrition-Healthy Generation Project.

Screen time (ST) not only affects physical activity but can also be associated with dietary behaviors. Both of these factors determine the health and development of adolescents. The aims of the study were: 1. to analyze the relationship between ST and nutritional behaviors among adolescents; 2. to examine this association in relation to body weight status. Data on the ST duration and nutritional behaviors were collected using a questionnaire. Body mass status was assessed based on weight and height measurements. A total of 14,044 students aged 13-19 years old from 207 schools participated in the study. A significant relationship between ST and gender, age and type of school was observed, but not body weight status. The average ST duration increased with age (from 2.6 h among 13 years old to 3.2 h among 19 years old), and was significantly higher among boys in all age categories (2.7 h vs. 2.5 h in the youngest age group, and 3.5 h vs. 3.0 h in the oldest age group, respectively). The chance for meeting the recommendation for ST in a group of girls (regardless of age) was almost 50% higher compared to boys. Meeting ST recommendation (≤2 h) was associated with a greater odds ratio for favorable nutritional behaviors in the whole group, with exception of drinking milk or milk beverages, and significantly reduced the odds ratio of adverse dietary behaviors (drinking sweet beverages, consumption of sweets and fast food) in the whole group and by gender. More research is needed to clarify the possible cause-and-effect relationships between ST and dietary behaviors.

Reproducibility of a Short-Form, Multicomponent Dietary Questionnaire to Assess Food Frequency Consumption, Nutrition Knowledge, and Lifestyle (SF-FFQ4PolishChildren) in Polish Children and Adolescents.

The aim of the study was to assess the reproducibility of a short-form, multicomponent dietary questionnaire (SF-FFQ4PolishChildren) in Polish children and adolescents. The study involved 437 children (6-10 years old) and 630 adolescents (11-15 years old) from rural and urban areas of Poland. The self-administered questionnaire was related to nutrition knowledge, dietary habits, active/sedentary lifestyle, self-reported weight and height, and socioeconomic data. The questionnaire was completed with a two-week interval-twice by parents for their children (test and retest for children), twice by adolescents themselves (adolescent's test and retest) and once by adolescents' parents (parent's test). The strength of agreement measured using the kappa statistic was interpreted as follows: 0-0.20 slight, 0.21-0.40 fair, 0.41-0.60 moderate, 0.61-0.80 good, and 0.81-1.00 excellent. Regarding the frequency of consumption of food items and meals, kappa statistics were 0.46-0.81 (the lowest: fruit/mixed fruit and vegetable juices; the highest: Energy drinks) in test-retest for children, 0.30-0.54 (fruit/mixed fruit and vegetable juices; breakfast, respectively) in adolescent's test-retest, 0.27-0.56 (the lowest: Sweets, fruit, dairy products; the highest: Breakfast) in adolescent's test and parent's test. Lower kappa statistics were found for more frequently consumed foods (juices, fruit, vegetables), higher kappa statistics were found for rarely consumed foods (energy drinks, fast food). Across study groups, kappa statistics for diet quality scores were 0.31-0.55 (pro-healthy diet index, pHDI) and 0.26-0.45 (non-healthy diet index, nHDI), for active/sedentary lifestyle items they were 0.31-0.72, for components of the Family Affluence Scale (FAS) they were 0.55-0.93, for BMI categories (based on self-reported weight and height) they were 0.64-0.67, for the nutrition knowledge (NK) of adolescents the kappa was 0.36, for the nutrition knowledge of children's parents it was 0.62. The Spearman's correlations for diet quality scores were 0.52-0.76 (pHDI) and 0.53-0.83 (nHDI), for screen time score they were 0.45-0.78, for physical activity score they were 0.51-0.77, for the FAS score they were 0.90-0.93, and for the NK score they were 0.68-0.80. The questionnaire can be recommended to evaluate dietary and lifestyle behaviors among children and adolescents.

Changes in Sedentary and Active Lifestyle, Diet Quality and Body Composition Nine Months after an Education Program in Polish Students Aged 11⁻12 Years: Report from the ABC of Healthy Eating Study.

The sustainability of education focused on improving the dietary and lifestyle behaviours of teenagers has not been extensively studied. The aim of this study was to determine the sustainability of diet-related and lifestyle-related school-based education on sedentary and active lifestyle, diet quality and body composition of Polish pre-teenagers in a medium-term follow-up study. An education-based intervention study was carried out on 464 students aged 11⁻12 years (educated/control group: 319/145). Anthropometric measurements were taken and body mass index (BMI) and waist-to-height ratios (WHtR) were calculated, both at the baseline and after nine months. Dietary data from a short-form food frequency questionnaire (SF-FFQ4PolishChildren) were collected. Two measures of lifestyle (screen time, physical activity) and two diet quality scores (pro-healthy, pHDI, and non-healthy, nHDI) were established. After nine months, in the educated group (vs. control) a significantly higher increase was found in nutrition knowledge score (mean difference of the change: 1.8 points) with a significantly higher decrease in physical activity (mean difference of the change: -0.20 points), nHDI (-2.3% points), the z-WHtR (-0.18 SD), and the z-waist circumference (-0.13 SD). Logistic regression modelling with an adjustment for confounders revealed that after nine months in the educated group (referent: control), the chance of adherence to a nutrition knowledge score of at least the median was over 2 times higher, and that of the nHDI category of at least the median was significantly lower (by 35%). In conclusion, diet-related and lifestyle-related school-based education from an almost one-year perspective can reduce central adiposity in pre-teenagers, despite a decrease in physical activity and the tendency to increase screen time. Central adiposity reduction can be attributed to the improvement of nutrition knowledge in pre-teenagers subjected to the provided education and to stopping the increase in unhealthy dietary habits.

Nutraceutical functions of beta-glucans in human nutrition

Recent studies have shown that naturally occurring substances found in the food of the daily human diet are important for preventing chronic non-communicable diseases. One of them is beta-glucan, which is a natural polysaccharide, occurring in plant cell walls, mainly oats, barley and wheat. It is also present in baker's yeast cells, fungal cell walls, and some microorganisms. Beta-glucan belongs to one of the dietary fiber fractions, which are attributed a number of beneficial health properties, including the prevention and treatment of certain digestive diseases and supporting the immune system. This compound has biological activity that depends on the size, molecular weight, conformation, frequency of bonds, solubility and changes in structure. Beta-glucan reduces cholesterol and glucose concentrations in the blood, which reduces the risk of cardiovascular disease and diabetes. In addition to its effects on lipid levels and glucose metabolism, beta-glucan also exhibits antioxidant properties by scavenging reactive oxygen species, thereby reducing the risk of diseases, including atherosclerosis, cardiovascular diseases, neurodegenerative diseases, diabetes, and cancer. Immunostimulatory and antitumor effects have also been reported. The immunostimulatory activity of beta-glucan occurs as a result of its attachment to specific receptors present on the immune cell surface. Beta-glucan belongs to the group of prebiotics which stimulate the growth and activity of the desired natural intestinal microbiota, while inhibiting the growth of pathogens. It plays an important role in the proper functioning of the gastrointestinal tract and preventing inflammation as well as colon cancer. Such a number of health benefits resulting from the properties of beta-glucan may play a key role in improving health and preventing chronic non-communicable diseases, such as diabetes, hypercholesterolemia, obesity, cardiovascular diseases, and cancer.

The combined effects of alcohol and tobacco use during pregnancy on birth outcomes

Background: Exposure to alcohol and tobacco during pregnancy may lead to developmental disorders in the foetus and can also adversely impact pregnancy outcomes and the newborn's health status. Objective: Assessment of alcohol consumption and tobacco use during pregnancy as well as their impact on pregnancy outcomes and birth parameters of the newborn in a selected group of mothers with children aged ≤ 2 years. Material and methods: The study was conducted in 104 mothers with children aged ≤ 2 years living in the Mazowiecki Voivodeship. A questionnaire was used for assessing selected lifestyle parameters tobacco and alcohol use, dietary supplements use, physical activity during pregnancy, socio-demographic characteristics as well as children's birth parameters (birth weight, length, head circumference, chest circumference). Data were analyzed statistically using logistic regression analysis, Spearman's rang correlation, the Mann-Whitney U, Kruskal-Wallis, Student-t, Tukey and Chi2 tests (p≤0.05; STATISTICA 13.1 PL). Results: 22% of the participants solely smoked cigarettes, 13% solely drank alcohol while 7% smoked cigarettes and drank alcohol. Both cigarette smoking and alcohol use increased the risk of preterm birth (OR 9.6, 95% CI 2.9 ­ 31.4, p=0.00015; OR 5.3 95% CI 1.3 ­ 22.3, p=0.0199, respectively) as along with a low birth weight (OR 6.9, 95% CI 1.9 ­ 25.2, p=0.0028; OR 7.6, 95% CI 1.7 ­ 34.3, p=0.007). Cigarette smoking and alcohol use by the pregnant women also adversely impacted on children's health status (8.7 ± 1.4 vs. 9.7 ± 0.8, p=0.001 and 8.5 ± 1.9 vs. 9.6 ± 0.8, p=0.027, respectively). Simultaneous use of alcohol and cigarettes exacerbated the adverse impact of such substances on birth parameters and health status (birth weight, body length, Apgar score) as well as on pregnancy duration. Conclusions: The introduction of educational programs for high risk groups as well as prenatal obligatory consultations for mothers about the negative effects of substance use on fetus and the development of the child are warranted. Conclusions: Introducing educational programs are thus warranted for high risk groups as well as prenatal obligatory consultations for mothers about the adverse effects of such substance use on foetal and child development.

Effect of an Education Program on Nutrition Knowledge, Attitudes toward Nutrition, Diet Quality, Lifestyle, and Body Composition in Polish Teenagers. The ABC of Healthy Eating Project: Design, Protocol, and Methodology.

To increase teenagers' nutrition knowledge is an important target and has the potential to improve their dietary habits and lifestyle while reducing incidences of obesity-related non-communicable diseases throughout the whole lifespan. This study protocol presents the general approach and details of an assessment of nutritional knowledge, attitudes toward nutrition, diet quality, lifestyle and body composition that have been used to comprehensively evaluate the cross-behavioral patterns covering dietary and lifestyle behaviors in Polish teenagers. The study was designed in two paths as: a cross-sectional study (covering 1569 students) and an education-based intervention study (464 students) with a 9-month follow-up. We describe a short form of the food frequency questionnaire (SF-FFQ4PolishChildren) used to collect data and details of diet-related and lifestyle-related education program, which was developed and implemented by academic researchers involved in the study. We also describe details of the data development and statistical analysis, including multidimensional methods of clustering variables to identify cross-behavioral patterns covering diet and lifestyle. The results of the study will provide evidence-based support for preventive health care to promote normal growth and development of young population and reduce the risk of diet-related diseases in adulthood, by early shaping of adequate dietary and lifestyle behaviors. In the future, well-tailored education programs addressed to teenagers can be created as an important public health action, based on our results.

Determinants of the use of dietary supplements among secondary and high school students

Background: All over the world, including Poland, the sale of dietary supplements is increasing. More and more often, people including children and youths, use dietary supplements on their own initiative and without any medical indications or knowledge in this field. Objectives: Analysis of the conditions of using the dietary supplements with vitamins and minerals among secondary school and high school students in Poland. Material and methods: The study included 396 students aged 13-18 years (249 girls and 147 boys). Authors' questionnaire was used to evaluate the intake of dietary supplements. The use of cluster analysis allowed to distinguish groups of students with similar socio-demographic characteristics and the frequency of use of dietary supplements. Results: In the studied population of students three clusters were created that significantly differed in socio-demographic characteristics. In cluster 1 and 2, were mostly students who used dietary supplements (respectively, 56% of respondents and 100%). In cluster 1 there were mostly students coming from rural areas and small city, with a worse financial situation, mainly boys (56%), while cluster 2 was dominated by girls (81%) living in a big city, coming from families with a good financial situation and who were more likely to be underweight (28.8%). In cluster 3 there were mostly older students (62%), not taking dietary supplements. In comparison to cluster 2, they had lower frequency of breakfast consumption (55% vs. 69%), but higher frequency of the consumption of soft drinks, fast-food, coffee as well as salt use at the table. Conclusions: The results show that the use of dietary supplements in adolescence is a common phenomenon and slightly conditioned by eating behaviors. This unfavorable habit of common dietary supplements intake observed among students indicates the need for education on the benefits and risks of the supplements usage.

Family influences on breakfast frequency and quality among primary school pupils in Warsaw and its surrounding areas.

BACKGROUND: Regular consumption of a well balanced breakfast is a pre-requisite for normal growth and child development, along with the acquisition of proper eating habits. The family environment is crucial place where children learn such patterns of behaviour that form the basis for their development. OBJECTIVES: To determine how family factors affect the regular eating of breakfast and types of foodstuffs consumed in primary school pupils, including food purchases made from vending machines and school tuck shops. MATERIALS AND METHODS: Subjects were 836 pupils (435 girls and 401 boys, aged 6 - 13) from Warsaw and the surrounding areas. Appropriate socio-demographic data and relevant eating habits were obtained from direct interviewing of the subjects by means of a custom designed questionnaire. Statistical analyses were performed by the Kohonen type cluster analysis model and Chi-square test (Chi(2)); (p≤0.05). RESULTS: Three clusters of pupils were identified by their differing socio-demographics and eating habits (eg. rates of breakfast consumption, buying from vending machines or school tuck shops). The first and third clusters were mainly pupils from two-parent families with parents proportionally spending similar times at work, where respective breakfast (87% and 91%) and second breakfast (77% and 72%) consumption rates were also similar together with food shopping rates during school time (respectively 69% and 63%). Pupils with single-parents, multi-generation families or if both parents were profession- ally active, predominated in the second cluster. These ate breakfast (73%) and second breakfast (67%) more rarely, but more frequently shopped for food at school (84%). A small number of pupils had a packed second breakfast from home, rarely ate sandwiches, fruit and/or vegetables and dairy products but ate more sweets, sweet rolls and savoury snacks. However, a large number of subjects bought sandwiches, fresh fruit and/or vegetables and fast-food at school. CONCLUSIONS: Family factors were found to affect eating habits in children and adolescents regarding how often breakfast was eaten and the type of foodstuffs consumed. High consumptions of unhealthy food items for second breakfast were also observed. Single-parent pupils, those in multi-generation families or if both parents are employed rarely brought second breakfasts from home but frequently bought food from vending machines and school tuck shops. The results of the presented findings are significant towards planning an appropriate educational campaigns and health programmes targeted at children, adolescents and their families.

α-Tocopherol, ascorbic acid, and ß-carotene protect against oxidative stress but reveal no direct influence on p53 expression in rats subjected to stress.

We hypothesized that α-tocopherol, ascorbic acid, and ß-carotene, either applied individually or in combination, would modulate redox homeostasis and affect the regulation of genes involved in DNA repair under stress conditions. To test this hypothesis, we analyzed the influence of these vitamins, either supplied individually or in combination, on the plasma lipid peroxide level and the hepatic level of 8-hydroxy-2'-deoxyguanosine in rats. We also evaluated the expression of p53 and Mdm2 protein in the intestinal epithelium, as these proteins are involved in the cellular regulation of DNA damage repair. Male Wistar rats (n = 112) were supplemented with α-tocopherol (2 mg), ascorbic acid (12 mg), and ß-carotene (1 mg), both individually and in combination, for 14 days; 32 control rats were treated with placebo. Half of the animals in each group (n = 8) were subjected to 15-minute treadmill running at 20 m/min to cause exercise-induced oxidative stress. A statistically significant reduction in lipid peroxide levels was observed in the plasma of rats subjected to exercise and given 2 or 3 of the antioxidants (P < .0001). Exercise, as well as coadministration of the antioxidants, had no significant effect on the amount of DNA damage. Downward trends in the level of p53 protein expression were observed both in exercised and nonexercised animals, especially when the studied vitamins were administered in combination. Our findings suggest that α-tocopherol, ascorbic acid, and ß-carotene, when given concurrently, have primarily antioxidant effects on lipids under stress but do not significantly affect the regulation of p53 gene expression.

Dietary, anthropometric, and lifestyle correlates of serum carotenoids in postmenopausal women.

PURPOSE: Concentration of carotenoids in the serum is a biomarker of mainly vegetable and fruit consumption. However, the levels of carotenoids in humans may decline with age and can also depend on body fat, alcohol consumption, and cigarette smoking. METHOD: Food intake and characteristics of 159 randomly chosen women aged 56-75 years were obtained by a self-administered questionnaire. Serum concentrations of carotenoids were determined by high-performance liquid chromatography. Estimation of fat mass was carried out by dual energy X-ray absorptiometry. RESULTS: The estimated total daily intake of carotenoids was 9.75 mg: α-carotene 10.6%; ß-carotene 35.6%; lutein/zeaxanthin 27.1%; ß-cryptoxanthin 4.7%; and lycopene 22.0%. We observed statistically significant positive correlations between concentrations of serum carotenoids and their estimated intakes (r = 0.11 lycopene to 0.38 ß-carotene) and fruit and vegetable intake (r = 0.15 lycopene to 0.30 ß-carotene). Concentration of serum carotenoids positively correlated with education (r = 0.17 α-carotene to 0.29 lycopene) and alcohol intake (r = 0.02 α-carotene to r = 0.25 lycopene). Inverse correlations were with the age (r = -0.18 α-carotene to -0.42 lycopene) and fat mass (r = -0.15 lycopene to -0.29 α-, ß-carotene). CONCLUSION: In this population of healthy postmenopausal women, serum concentrations of carotenoids declined with increasing age and body fat mass. The concentrations were increased among women with high vegetable and fruit consumption, moderate alcohol intake, and high level of education.