Ultra-Processed Food vs. Fruit and Vegetable Consumption before and during the COVID-19 Pandemic among Greek and Swedish Students.

BACKGROUND: The COVID-19 pandemic has impacted children's lifestyles, including dietary behaviors. Of particular concern among these behaviors is the heightened prevalence of ultra-processed food (UPF) consumption, which has been linked to the development of obesity and related non-communicable diseases. The present study examines the changes in (1) UPF and (2) vegetable and/or fruit consumption among school-aged children in Greece and Sweden before and during the COVID-19 pandemic. METHODS: The analyzed dataset consisted of main meal pictures (breakfast, lunch, and dinner) captured by 226 Greek students (94 before the pandemic and 132 during the pandemic) and 421 Swedish students (293 before and 128 during the pandemic), aged 9-18, who voluntarily reported their meals using a mobile application. The meal pictures were collected over four-month periods over two consecutive years; namely, between the 20th of August and the 20th of December in 2019 (before the COVID-19 outbreak) and the same period in 2020 (during the COVID-19 outbreak). The collected pictures were annotated manually by a trained nutritionist. A chi-square test was performed to evaluate the differences in proportions before versus during the pandemic. RESULTS: In total, 10,770 pictures were collected, including 6474 pictures from before the pandemic and 4296 pictures collected during the pandemic. Out of those, 86 pictures were excluded due to poor image quality, and 10,684 pictures were included in the final analyses (4267 pictures from Greece and 6417 pictures from Sweden). The proportion of UPF significantly decreased during vs. before the pandemic in both populations (50% vs. 46%, p = 0.010 in Greece, and 71% vs. 66%, p < 0.001 in Sweden), while the proportion of vegetables and/or fruits significantly increased in both cases (28% vs. 35%, p < 0.001 in Greece, and 38% vs. 42%, p = 0.019 in Sweden). There was a proportional increase in meal pictures containing UPF among boys in both countries. In Greece, both genders showed an increase in vegetables and/or fruits, whereas, in Sweden, the increase in fruit and/or vegetable consumption was solely observed among boys. CONCLUSIONS: The proportion of UPF in the Greek and Swedish students' main meals decreased during the COVID-19 pandemic vs. before the pandemic, while the proportion of main meals with vegetables and/or fruits increased.

[The profile of reading and cognitive skills of children with a history of specific developmental language disorder].

The present study aimed to investigate the profile of reading and cognitive skills of primary school' students with a history of specific developmental language disorder during preschool years. The sample comprised 247 children referred for assessment of their reading difficulties to the University Child Psychiatry Department, at the "Aghia Sophia" Children's Hospital, Athens, Greece. The study was retrospective utilizing medical records from where the following information was drawn: demographic data, presence of a diagnosis of a specific developmental language disorder, results of Reading Test-A and WISC-III. Among the 247 children with normal intelligence IQ>80 (mean age: 10.5 years, 61.5% boys) included in the study, 226 (92.5%) were identified as having significant reading difficulties in at least one of the four subtests of the Reading-A Test (≤ 30 percentile); 72% performed poorly in reading fluency, 67.1% in decoding familiar and pseudowords, 52.8% in reading comprehension and 49.8% in morphosyntax subtest. When comparing children with severe reading difficulties (≤ 10 percentile on the Reading Test A) with a history of specific developmental language disorder (N=110) and no relevant history (N=116), the findings indicated that a significantly higher proportion of children with a history of specific language disorder had severe difficulty in morphosyntax (χ2=21.94, p<0.001) and reading comprehension subtests (χ2=8.89, p <0,001) than those with no history. In terms of the cognitive profile of children with severe reading difficulties, the results showed that a significantly higher proportion of children with a history of developmental language disorder than those with no history had low performance (<7TB) on all WISC-III subtests, however the difference between the two groups was found to be statistically significant on three subtests: "Vocabulary" (p=0.014), Arithmetic (p=0.006), and "Information" (p=0.005). Multiple linear stepwise regression analysis showed that lower levels of the verbal IQ (ß=-0.121, p=0.042) and positive history of developmental language disorder during preschool years (ß=0.537, p<0.001) were independently related to the severity of reading disability. In conclusion, the findings of the present study highlight the importance of early detection of language deficits during the preschool years and timely speech and language therapy intervention.

Fast Eating Is Associated with Increased BMI among High-School Students.

Fast self-reported eating rate (SRER) has been associated with increased adiposity in children and adults. No studies have been conducted among high-school students, and SRER has not been validated vs. objective eating rate (OBER) in such populations. The objectives were to investigate (among high-school student populations) the association between OBER and BMI z-scores (BMIz), the validity of SRER vs. OBER, and potential differences in BMIz between SRER categories. Three studies were conducted. Study 1 included 116 Swedish students (mean ± SD age: 16.5 ± 0.8, 59% females) who were eating school lunch. Food intake and meal duration were objectively recorded, and OBER was calculated. Additionally, students provided SRER. Study 2 included students (n = 50, mean ± SD age: 16.7 ± 0.6, 58% females) from Study 1 who ate another objectively recorded school lunch. Study 3 included 1832 high-school students (mean ± SD age: 15.8 ± 0.9, 51% females) from Sweden (n = 748) and Greece (n = 1084) who provided SRER. In Study 1, students with BMIz ≥ 0 had faster OBER vs. students with BMIz < 0 (mean difference: +7.7 g/min or +27%, p = 0.012), while students with fast SRER had higher OBER vs. students with slow SRER (mean difference: +13.7 g/min or +56%, p = 0.001). However, there was "minimal" agreement between SRER and OBER categories (κ = 0.31, p < 0.001). In Study 2, OBER during lunch 1 had a "large" correlation with OBER during lunch 2 (r = 0.75, p < 0.001). In Study 3, fast SRER students had higher BMIz vs. slow SRER students (mean difference: 0.37, p < 0.001). Similar observations were found among both Swedish and Greek students. For the first time in high-school students, we confirm the association between fast eating and increased adiposity. Our validation analysis suggests that SRER could be used as a proxy for OBER in studies with large sample sizes on a group level. With smaller samples, OBER should be used instead. To assess eating rate on an individual level, OBER can be used while SRER should be avoided.

BigO: A public health decision support system for measuring obesogenic behaviors of children in relation to their local environment.

Obesity is a complex disease and its prevalence depends on multiple factors related to the local socioeconomic, cultural and urban context of individuals. Many obesity prevention strategies and policies, however, are horizontal measures that do not depend on context-specific evidence. In this paper we present an overview of BigO (http://bigoprogram.eu), a system designed to collect objective behavioral data from children and adolescent populations as well as their environment in order to support public health authorities in formulating effective, context-specific policies and interventions addressing childhood obesity. We present an overview of the data acquisition, indicator extraction, data exploration and analysis components of the BigO system, as well as an account of its preliminary pilot application in 33 schools and 2 clinics in four European countries, involving over 4,200 participants.