Dietary habits among 177091 Greek schoolchildren by age, sex, weight status, region, and living area. A cross-sectional study.

BACKGROUND: This study aimed to investigate the dietary habits, from early childhood to adolescence, among participants from all regions of the country and living areas (rural/urban) and to assess potential associations between dietary habits and obesity, in both sexes. METHODS: Population data were derived from a cross-sectional, health survey on a representative sample of 177091 children aged 6 to 18 years. Dietary habits were considered via a self-completed questionnaire (KIDMED index). Trained investigators assessed anthropometric data. RESULTS: KIDMED scores were 6.7±2.4 and 6.8±2.3 for boys and girls, respectively, while a percentage of almost 10% of the total study population had insufficient dietary habits. Dietary habits peaked around age 11 and then gradually worsened until the end of adolescence, among both sexes, with an annual trend equal to -0.28±0.02 (p<0.001), for boys and 0.31±0.03, (p<0.001), for girls. Overweight/obese schoolchildren presented higher percentages in all unhealthy dietary habits (e.g. skipping breakfast, going often to a fast-food restaurant, and consuming a lot of sweets) than normal-weight ones (all p-values<0.001). Dietary habits did not noteworthy differ by area of living, i.e. urban versus rural, of participants, in both sexes. Also, no noticeable differences in the values of the KIDMED index were found among all regions of Greece, with the highest values in Attica and Crete, in both sexes. CONCLUSIONS: As Greek schoolchildren do not fully adopt the traditional cardio-protective Mediterranean diet, it could be helpful to provide certain recommendations, especially for adolescents, to decrease the risk for future adverse health consequences.

European fitness landscape for children and adolescents: updated reference values, fitness maps and country rankings based on nearly 8 million test results from 34 countries gathered by the FitBack network.

OBJECTIVES: (1) To develop reference values for health-related fitness in European children and adolescents aged 6-18 years that are the foundation for the web-based, open-access and multilanguage fitness platform (FitBack); (2) to provide comparisons across European countries. METHODS: This study builds on a previous large fitness reference study in European youth by (1) widening the age demographic, (2) identifying the most recent and representative country-level data and (3) including national data from existing fitness surveillance and monitoring systems. We used the Assessing Levels of PHysical Activity and fitness at population level (ALPHA) test battery as it comprises tests with the highest test-retest reliability, criterion/construct validity and health-related predictive validity: the 20 m shuttle run (cardiorespiratory fitness); handgrip strength and standing long jump (muscular strength); and body height, body mass, body mass index and waist circumference (anthropometry). Percentile values were obtained using the generalised additive models for location, scale and shape method. RESULTS: A total of 7 966 693 test results from 34 countries (106 datasets) were used to develop sex-specific and age-specific percentile values. In addition, country-level rankings based on mean percentiles are provided for each fitness test, as well as an overall fitness ranking. Finally, an interactive fitness platform, including individual and group reporting and European fitness maps, is provided and freely available online (www.fitbackeurope.eu). CONCLUSION: This study discusses the major implications of fitness assessment in youth from health, educational and sport perspectives, and how the FitBack reference values and interactive web-based platform contribute to it. Fitness testing can be conducted in school and/or sport settings, and the interpreted results be integrated in the healthcare systems across Europe.

Adherence to the Mediterranean Diet and Successful aging in Greeks living in Greece and abroad: the epidemiological Mediterranean Islands Study (MEDIS).

Background: Whether older immigrant populations from the Mediterranean region, continue to follow the MD long after they immigrated is not known. Aim: Compare adherence to the MD and successful aging levels between Greeks living in Greece (GG) and Greeks living abroad (GA). Methods: Anthropometrical, clinical, psychological, sociodemographic, dietary and lifestyle parameters were assessed in a cross-sectional manner in a sample of 252 GG and 252 GA. Mediterranean Diet Score (MedDietScore range 0-55) was used to assess adherence to the MD. Successful aging was evaluated with the validated successful aging index (SAI range 0-10). Results: GA presented higher adherence to MD (p < 0.001); they were consuming significantly more cereals, legumes, vegetables, and fruits compared to GG. GG consumed significantly more dairy (3.8 ± 2.9 vs. 1.9 ± 2.2, p < 0.001) and potatoes (2.4 ± 1.6 vs. 1.9 ± 1.5, p < 0.001) compared to GA. Meat (p = 0.27), poultry (p = 0.72), fish (p = 0.68), olive oil (p = 0.16) and alcohol consumption (p = 0.05) were comparable between the two groups (all p's > 0.05). MedDietScore was positively associated with SAI among both groups after adjusting for possible confounders (0.041 ± 0.014, p = 0.003 GG and 0.153 ± 0.035, p < 0.001 GA). Also, legumes, cereals, fruits and vegetables were found to be beneficial for successful aging. Conclusion: Adherence to the MD is associated with higher levels of successful aging among people of the same genetic background living in different environments. However, traditional dietary habits are gradually abandoned in their native countries, when, at the same time, are considered cultural heritage and preserved accordingly among immigrants.

A Modified Mediterranean Diet Improves Fasting and Postprandial Glucoregulation in Adults with Overweight and Obesity: A Pilot Study.

The ideal lifestyle intervention to battle both obesity and diabetes is currently unknown. The aim of this pilot uncontrolled intervention trial was to assess the effect of a modified Mediterranean diet (MedDiet) on weight loss and glucoregulation among overweight/obese adults. Eleven men and women with overweight/obesity, aged 37 ± 12 years, participated in a free-living intervention until 10% weight loss was achieved. Participants followed an individualized MedDiet high in monounsaturated fat and protein with decreased carbohydrate and saturated fat contents. Physical activity and dietary intake were monitored with pedometers and food records, respectively. Upon weight loss achievement, anthropometric measurements, blood metabolic profiles and individual responses to oral glucose and mixed-meal tests were evaluated pre- and post-intervention. The results showed significant ameliorations in body fat, waist circumference and leptin levels (p < 0.01), with concomitant increases in adiponectin-leptin ratios (p < 0.001). Glucoregulation was significantly improved according to glucose and insulin responses, homeostatic model assessment of insulin resistance indices and postprandial insulin sensitivity indices (p < 0.05). In conclusion, the modified Mediterranean diet may induce significant improvements in body composition, adipocytokine profile and glucose metabolism in overweight/obese individuals. Notably, ameliorated glycemia and increased insulin sensitivity may be retained even at postprandial level, irrespective of the meal consumed.

Recommended dairy intake is associated with healthy dietary habits, better physical fitness, less obesity and a healthier lifestyle profile in school age children.

This study aimed to identify the association of recommended dairy intake with several dietary habits, obesity, physical fitness (PF), physical activity (PA), screen time and sleep. Population data were derived from a health survey on a representative sample of 177 091 children aged 8-17 years. Dairy intake and dietary habits were evaluated using questionnaires (KIDMED index). Participants were characterised as 'dairy products consumers' based on whether they met current recommendations for milk or dairy consumption (e.g. if they consumed two yogurts and/or 40 g cheese and a cup of milk daily). Participants who did not consume the above-mentioned quantities were characterised as 'non-consumers.' Anthropometric and PF data were obtained by trained investigators. PA status, screen time and sleeping habits were assessed through self-completed questionnaires. Boys and girls consuming recommended dairy products were 25 % (95 % CI: 0·71, 0·79) and 43 % (95 % CI: 0·51, 0·64) less likely to have low performances in cardiorespiratory fitness tests, Participants from both sexes classified as dairy products consumers had lower odds of central obesity by 10 % (95 % CI: 0·86, 0·95), as compared with non-consumers. Moreover, recommended dairy products consumers had lower odds for insufficient sleep by 8 % (95 % CI: 0·89, 0·96) in boys and 14 % (95 % CI: 0·83-0·90) in girls, for inadequate PA levels by 15 % (95 % CI: 0·77, 0·93) in boys and 16 % (95 % CI: 0·76, 0·90) in girls and for increased screen time by 11 % (95 % CI: 0·83, 0·95) in boys and 9 % (95 % CI: 0·85, 0·97) in girls than no-consumers. In conclusion, recommended dairy intake is associated with less obesity, better PF and a healthier lifestyle profile.

Birth Weight was Favorably Associated With Physical Fitness in Childhood After Adjustment for Several Perinatal Factors.

BACKGROUND: The purpose was to examine the potential associations of birth weight and infant growth with physical fitness (PF) components in childhood. METHOD: A random sample of 5125 dyads of children aged 8-9 years and their mothers were evaluated. Telephone interviews were carried out with the use of a standardized questionnaire for the collection of maternal lifestyle factors. Mothers were asked to provide information contained in their medical booklets and pregnancy ultrasound records. Data from 5 PF tests were used to assess cardiorespiratory fitness, speed, and body strength. Linear regression analysis was applied to assess the associations between birth weight and infant growth with PF test performances and logistic regression analysis to evaluate the associations of normal weight versus low birth weight and normal versus accelerated infant growth with PF tests performance categories (low vs high/average). RESULTS: Birth weight was favorably associated with cardiorespiratory fitness (b = 0.12 stage increase per SD increase in birth weight, P = .047), lower body strength (b = 1.07, P = .037), upper body strength (b = 0.10, P = .038), and speed (b = -0.04, P = .001), and infant growth was associated with upper body strength (b = 0.21 cm increase per SD increase in infant weight gain, P < .001) after adjusting for children's body mass index and several perinatal factors. Low birth weight children had 35% increased odds for low performances in PF tests compared with their normal birth weight counterparts. CONCLUSION: Low birth weight negatively affects childhood PF, and hence, it could play an unfavorable role in the future health of the offspring.

The Association of Dietary Habits and Lifestyle Characteristics with Successful Aging among Older Greek Origin Individuals Living in France, Canada, and Greece: The Epidemiological Mediterranean Islands Study (MEDIS).

The aim of the present work was to investigate the association of dietary habits and lifestyle characteristics with successful aging among native Greeks and Greeks of Diaspora (Canada and France). During 2005-2019, 2,434 Greek men and women, living in Greece, in France, and in Canada, over 65 years of age were enrolled voluntarily in the study. Anthropometric, clinical and socio-demographic characteristics, dietary habits, and lifestyle parameters were derived through standard procedures, while successful aging was evaluated using the validated Successful Aging Index (SAI, range 0-10). The SAI of the overall sample was 2.8 ± 1.4. Greeks of Diaspora had higher SAI levels compared to their counterparts in Greece (p's < .001). However, there was no difference between Greeks of Canada and these of France (p > .05). Actually, Greeks of Diaspora had almost 1.9 units higher SAI compared to native Greeks (p < .001). Work and financial status, dietary and lifestyle behaviors (i.e., physical activity, smoking habits), and several clinical characteristics (i.e., history of hypertension and hypercholesterolemia) were statistically different between the three groups (all p's < .05). Greeks of Diaspora had higher SAI levels, probably because of their healthier lifestyle practices, which mainly depend on their traditions and cultural background of their homelands and living conditions in the host countries.

Successful aging and lifestyle comparison of Greeks living in Greece and abroad: the epidemiological Mediterranean Islands Study (MEDIS).

OBJECTIVES: Comparing lifestyle and successful aging between Greeks living in Greece (GG) and Greeks living abroad (GA) using a multidimensional model of successful aging including both biomedical and non-medical components. METHODS: Anthropometric, clinical, psychological, socio-demographic, dietary and lifestyle parameters were assessed in a random sample of 252 GG and 252 GA. Successful aging was evaluated using the validated successful aging index (SAI range 0-10). RESULTS: GA had better financial and educational status and scored higher in all social activity parameters (p's < 0.05). GA were more likely to be physically active (p < 0.001), had higher adherence to the Mediterranean diet (p < 0.001) and were less likely to be smoking (p = 0.008). Depression was more evident among GG compared to GA (p < 0.001). GA was aging significantly more successfully than GG (p < 0.001). Men irrespective of location were aging significantly more successfully than women (p < 0.05). CONCLUSION: Place of residence and personal choices significantly affect the level of healthy aging among people with similar genetic backgrounds.

Human brown fat, adiposity, and cardiometabolic health: New pieces to the puzzle.

Brown adipose tissue (BAT) is an emerging target against obesity and its related metabolic diseases. Wibmer et al.1 recently reported that human BAT is associated with a healthier fat distribution and improved cardiometabolic health independent of adiposity and fat distribution.

Resilience of the Hellenic navy seals assessed by heart rate variability during cognitive tasks.

OBJECTIVES: The interaction between high physical performance under extreme conditions in military and the simultaneous control of the cognitive executive functioning has been a subject of research in literature for the past few decades. Stroop test and Heart-rate variability (HRV), have been verified valuable clinical tools for the assessment of cerebral and autonomic/ cardiovascular stress responses respectively. METHODS: Thirty-four subjects were enrolled in this study. Of them, 18 were candidates under intense preparation for their enlistment in the Hellenic Navy SEALs (HN-SEALs) and 16 were healthy controls (HC). All subjects underwent stroop tasks, along with mental state and personality examination. HRV variables in time and frequency domains recordings were acquired, during each aforementioned cognitive testing procedure. RESULTS: Our results showed that HNS's performance on both cognitive and emotion stroop tasks were equivalent to controls (p≥.054); however, HNS exhibited statistically significant lower levels of HRV in different time and frequency domain variables, compared to HC (ranged from p<.01 to p<.05). Finally, in a between group comparison of the psychometric tools, HNS had significantly higher somatization, anxiety and neuroticism than HC. CONCLUSION: In conclusion, these findings indicate that HNS display flexibility in their autonomic regulation during cognitive and emotional tasks. This characteristic is closely related to problem solving or adaptability skills. Therefore, we support that HRV measurement turns out to be an invaluable tool for both scientific and clinical insights, promising to be an index regarding the psychophysiological resilience especially in the neurovisceral integration (NVI) model.

Assessment of Resilience of the Hellenic Navy Seals by Electrodermal Activity during Cognitive Tasks.

Stress resilience plays a key role in task performance during emergencies, especially in occupations like military special forces, with a routine consisting of unexpected events. Nevertheless, reliable and applicable measurements of resilience in predicting task performance in stressful conditions are still researched. This study aimed to explore the stress response in the Hellenic Navy SEALs (HN-SEALs), using a cognitive-physiological approach. Eighteen candidates under intense preparation for their enlistment in the HN-SEALs and 16 healthy controls (HCs) underwent Stroop tests, along with mental-state and personality examination. Simultaneously, electrodermal activity (EDA) was assessed during each one of cognitive testing procedures. Compared to healthy control values, multiple components of EDA values were found decreased (p < 0.05) in the HN-SEALs group. These results were associated with an increase in resilience level in the HN-SEALs group, since a restricted sympathetic reactivity according to the reduced EDA values was observed during the stressful cognitive testing. This is the first report providing physiological measurements of the sympathetic response of HN-SEALs to a stressful situation and suggests that EDA turns out to be a simple and objective tool of sympathetic activation and it may be used as a complementary index of resilience in HN-SEALs candidates.

Endocannabinoids and Heart Rate Variability Alterations after Exposure to Prolonged Intensive Physical Exercise of the Hellenic Navy SEALs.

BACKGROUND: Recent research indicates that both endocannabinoids (eCB) and heart rate variability (HRV) are associated with stress-induced experiences. However, these underlying mechanisms are not elucidated. The present study aims to investigate whether exposure to acute and chronic stress conditions can give rise to measurable changes, both to the peripheral eCB ligands and HRV. METHODS: Thirteen candidates under intense preparation for their enlistment in the Hellenic Navy SEALs (HNS) participated in the study. All subjects underwent mental state examination, while HRV variables in time and frequency domain recordings were acquired. Furthermore, at baseline and 30 days after prolonged and intensive physical exercise, hair was collected to measure eCB ligands, such as anandamide (AEA), 2-arachidonoylglycerol (2-AG), and the N-acyl ethanolamine (NAE) molecules: palmitoylethanolamide (PEA) and oleoylethanolamide (OEA). RESULTS: Comparing basal hair concentrations of eCB ligands before and after intense physical exercise, we found that AEA, PEA, and OEA were notably increased, whereas no differences were observed regarding the ligand 2-AG. Furthermore, there were observed associations between the concentrations of peripheral eCB ligands, both at baseline and after the prolonged physical exercise and the time and frequency domains of HRV. CONCLUSIONS: These findings suggest that endocannabinoid-HRV interrelations might share a short-term, and long-term adaptability of the changes in self-regulation associated with stress. Further studies will be required to determine the validity of peripheral eCB signaling and HRV as a biomarker for different aspects of the stress response.

Students Living in the Islands are Heavier and have Lower Fitness Levels Compared to their Mainland Counterparts; Results from the National Action for Children's Health (EYZHN) Program.

Few studies have examined variations in obesity by geographic location in youth and its relation with fitness levels. The present study investigated the association between geographic status (islands versus mainland), excess of body weight and fitness levels among 335.810 schoolchildren (male: 51.3%, 6-18 y, during the school year 2014-2015). Students' anthropometric parameters and fitness levels - accessed via the Euro-fit test - were measured by trained physical education teachers and evaluated according to published norms. Prevalence of overweight (23.0 Vs 21.8%) and obese (10.1 Vs 8.0%) was significantly higher for students living in the islands contrary to their mainland counterparts. A significant difference was also observed for centrally obese children (33.5 Vs 28.2%). Except for speed test .408), in all other four fitness tests, the students from the islands presented significantly lower performance (≤25th percentile of published age- and sex-specific normative values) versus their mainland counterparts. Boys and girls living in the islands had 48% and 37% increased odds of low physical fitness (as a total), respectively, compared to their mainland counterparts. Likewise, children living in islands presented increased odds of being overweight or obese by 19% and 15% in boys and girls, respectively, as compared to those living in the mainland. Increased general and abdominal adiposity have a direct negative impact on students' performance in Physical Fitness tests. Our data highlight the problem of excessive body weight that children living in rural areas, face.

The association of animal and plant protein with successful ageing: a combined analysis of MEDIS and ATTICA epidemiological studies.

OBJECTIVE: The aim of the present study was to investigate the differences between the consumption of plant-based v. animal-based protein-rich diets on successful ageing, as well as to identify the optimal combination of dietary protein intake for facilitating successful ageing in people aged >50 years. DESIGN: A combined analysis was conducted in older adults of the ATTICA and MEDIS population-based cross-sectional studies. Anthropometrical, clinical and sociodemographic characteristics, lifestyle parameters, dietary habits and level of protein intake were derived through standard procedures. Successful ageing was evaluated using the validated Successful Aging Index (SAI) composed of ten health-related social, lifestyle and clinical characteristics. SETTING: Athens area and twenty Greek islands. PARTICIPANTS: A total of 3349 Greek women and men over 50 years old. RESULTS: Participants with high consumption of plant proteins were more likely to be male, physically active, with higher daily energy intake, higher adherence to the Mediterranean diet and higher level of SAI (P < 0·001). Participants with 'Low animal & High plant' and 'High animal & High plant' protein consumption had a 6 and 7 % higher SAI score, respectively, compared with the other participants (P < 0·001). In contrast, 'Low animal & Low plant' and 'High animal & Low plant' protein intake was negatively associated with SAI as compared to the combination of all other consumption categories (P < 0·02). CONCLUSIONS: The consumption of a plant-based protein-rich diet seems to be a beneficial nutritional choice that should be promoted and encouraged to older people since it may benefit both individual's health and prolong successful ageing.

Screen time and its effect on dietary habits and lifestyle among schoolchildren.

OBJECTIVE: The aim of the study was to determine the associations between recreational screen time and dietary habits and lifestyle factors in a representative sample of schoolchildren. METHODS: Observational, cross-sectional study data were derived from 177,091 children aged 8 to 17 years participating in a health survey. Recreational screen time, physical activity (PA), and sleeping hours were assessed through self-completed questionnaires. Dietary habits were evaluated via the Mediterranean Diet Quality Index for children and adolescents (KIDMED) test. Anthropometric and physical fitness (PF) estimations were obtained by trained investigators. RESULTS: Binary logistic regression comparisons between screen time levels (e.g. < 2 vs. ≥ 2 - < 3 h/d, < 2 vs. ≥ 3 - < 4 h/d and < 2 vs. ≥ 4 h/d) and dietary habits showed that the longer the screen time the increased the odds of unhealthy dietary habits such as skipping breakfast, consuming fast food frequently, and eating sweets frequently, and the decreased the odds of healthy dietary habits such as consuming a second fruit every day, consuming fresh or cooked vegetables or/and fish regularly, in both genders, after adjusting for several covariates. Furthermore, the longer the screen time the increased the odds of total and central obesity, insufficient sleep (< 8-9 h/d), and inadequate PA, and the decreased the odds of healthy PF. CONCLUSIONS: The longer the screen time the unhealthier dietary habits and lifestyle profile among schoolchildren, after adjusting for several covariates.

Associations of Maternal Prepregnancy Body Mass Index and Gestational Weight Gain With Physical Fitness in Childhood.

PURPOSE: To investigate the potential associations of maternal prepregnancy body mass index (mppBMI) and gestational weight gain (GWG) with physical fitness in children. METHODS: A random sample of 5125 children and their mothers was evaluated. The mothers provided data contained in their medical booklets and pregnancy ultrasound records. The data from 5 physical fitness tests (eg, 20-m shuttle run, 30-m sprint, vertical jump, standing long jump, and small ball throw) were used to assess children's cardiorespiratory fitness, speed, explosive power, and lower and upper body strength, respectively. RESULTS: MppBMI was inversely associated with cardiorespiratory fitness (b = -0.02), lower body strength (b = -1.01), upper body strength (b = -0.07), and speed (b = 0.04). Also, GWG was unfavorably associated with cardiorespiratory fitness (b = -0.02), lower body strength (b = -1.12), upper body strength (b = -0.03), and speed (b = 0.03), after adjusting for sex, birth weight, and children's BMI (all P values < .05). Children of mothers with an mppBMI ≥ 25 kg/m2 and excess GWG had almost 30% and 20% increased odds for low performances in physical fitness tests than those of mothers with an mppBMI < 25 kg/m2 and adequate GWG, respectively. CONCLUSIONS: Antenatal factors such as increased mppBMI and excess GWG could play an unfavorable role in the future health of the offspring.

Exercise-Associated Hyponatremia during the Olympus Marathon Ultra-Endurance Trail Run.

Research on hyponatremia during mountain marathons is scarce. The present study aimed to investigate the prevalence of exercise-associated hyponatremia during a 44-km trail running race that reached an altitude of 2780 m (Olympus Marathon). Sixty-two runners (five women) who completed the race participated in the study (age: 34.4 ± 8.6 years; height: 1.77 ± 0.06 m; and weight: 75.3 ± 10.0 kg). Anthropometric characteristics, blood, and urine samples were collected pre- and post-race. Food and fluid intake were recorded at each checkpoint. Due to race regulations, the runners could not carry any additional food and fluids besides the ones provided at specific checkpoints. Five runners (8%) exhibited asymptomatic hyponatremia (serum sodium <135 mmol∙L-1). Serum sodium in the hyponatremic runners decreased from 138.4 ± 0.9 (pre) to 131.4 ± 5.0 mmol∙L-1 (post), p < 0.05. Plasma osmolality increased only in the eunatremic runners (pre: 290 ± 3; post: 295 ± 6 mmol∙kg-1; p < 0.05). Plasma volume decreased more in the hyponatremic compared to eunatremic runners (-4.4 ± 2.0 vs. -3.2 ± 1.4%, p < 0.05). Lastly, dietary sodium intake was lower in the hyponatremic runners compared to eunatremic (789 ± 813 vs. 906 ± 672 mg; p < 0.05). The incidence of hyponatremia among the athletes was relatively low, possibly due to race conditions.

The association between the level of adherence to the Mediterranean diet and successful aging: An analysis of the ATTICA and MEDIS (MEDiterranean Islands Study) epidemiological studies.

AIM: The aim of the present work was to evaluate the association between the level of adherence to the Mediterranean diet and successful aging, taking into consideration the overall dietary pattern, rather than individual foods, among middle-aged and older individuals. METHODS: A harmonized dataset of middle-aged and older participants (>50 years old) from the ATTICA (n = 1,128) and MEDIS (n = 2,221) population-based cross-sectional studies was used. Socio-demographic, anthropometric, clinical and lifestyle characteristics were measured in both studies and harmonized using standardized procedures. Level of adherence to the Mediterranean diet was evaluated using the MedDietScore (range 0-55, "Low" adherence <34, "High">38). Successful aging was evaluated using the validated successful aging index (SAI, range 0-10) comprising of health-related, social, lifestyle and clinical characteristics. RESULTS: Adherence to the Mediterranean diet was positively associated with SAI (b ± SE "High" vs. "Low": 1.094 ± 0.130, p < 0.001 and "Moderate" vs "Low": 0.476 ± 0.156, p = 0.003). CONCLUSION: Higher adherence to the Mediterranean diet was independently associated with a higher level of successful aging. Mediterranean diet or dietary patterns that are close to this pattern, should be actively promoted and encouraged to middle aged and older people to achieve successful aging.

Exclusive olive oil consumption was favorably associated with metabolic indices and lifestyle factors in schoolchildren.

BACKGROUND AND AIM: Olive oil consumption has been suggested to favorably impact children's health. The present study aimed to identify possible associations between exclusive olive oil consumption and metabolic indices and lifestyle factors. METHODS AND RESULTS: Cross-sectional, observational study. Population data derived from a health survey on a sample of 177 091 children aged 8-17 years. Olive oil consumption and dietary habits were evaluated using questionnaires (KIDMED index). Anthropometric and physical fitness measurements were obtained by trained investigators. Physical activity (PA) status, screen time and sleeping habits were assessed through self-completed questionnaires. Exclusive olive oil consumption decreased the odds of obesity and increased the odds of healthy cardiorespiratory fitness (CRF) by 15% (95% confidence interval (CI): 0.75-0.95) and 13% (95% CI: 1.04-1.22), respectively, after adjusting for several covariates. Moreover, exclusive olive oil consumption was associated with increased odds of having sufficient dietary habits (average/optimal adherence to the Mediterranean Diet) by almost four times (95% CI: 3.65-4.45) and decreased odds of insufficient sleep (<8-9 h/d) and increased screen time (>2 h/d) by 20% (95% CI: 0.73-0.87) and 40% (95% CI: 0.48-0.72), respectively. CONCLUSIONS: Exclusive olive oil consumption was associated with metabolic indices such as obesity and CRF and a healthy lifestyle profile. The exclusive consumption of olive oil as part of a balanced MD does seem to provide favorable health benefits and should be further promoted.

High and moderate adherence to Mediterranean lifestyle is inversely associated with overweight, general and abdominal obesity in children and adolescents: The MediLIFE-index.

Several lifestyle factors, such as diet and exercise, have been linked to pediatric obesity. However, relatively few studies have considered them simultaneously, as a pattern. To investigate the associations between students' lifestyle and overweight, general, and abdominal obesity, an a priori Mediterranean lifestyle index (ie, MediLIFE-index) was created. We hypothesized that students' characteristics and their probability to be overweight or obese would be lower towards a better adherence to a Mediterranean lifestyle pattern. This study included 174 209 students aged 6 to 18 years from all geographical regions of Greece who participated in the 2014-2015 EYZHN study. The total range of MediLIFE-index was 0-8 (higher values indicating greater adherence to the Mediterranean lifestyle). Index values were thereafter divided into three groups according to its tertiles (a) 'non-adherent'; (b) 'moderately adherent'; and (c) "highly adherent" to the Mediterranean lifestyle. The mean ±â€¯standard deviation of the MediLIFE-index was 5.1 ±â€¯1.6. Students with higher scores had lower BMI and waist circumference (all P < .001). Those who were "highly adherent" compared to those who were "non-adherent" were associated with lower likelihood of being overweight, obese or abdominal obese, by 6% (OR 0.94, 95% CI 0.92, 0.98), 30% (OR 0.70, 95% CI 0.67, 0.75) and 20% (OR 0.80, 95% CI 0.77, 0.83), respectively. The optimal discriminating value of the index for overweight was 4.5 (78% sensitivity and 80% specificity), while for obese/abdominal obese was 3.5 (82% sensitivity and 85% specificity). A useful tool was developed in order to identify children and adolescents with increased odds of being overweight, obese, or abdominal obese based on their lifestyle.