Cardiometabolic risk profile among children with migrant parents and role of parental education: the IDEFICS/I.Family cohort.

BACKGROUND AND AIMS: Evidence shows that migrant children have a higher risk of developing obesity than those with native parents. We aimed to investigate the association between parental migration background and cardiometabolic health in children and adolescents in Europe. METHODS AND RESULTS: We included 8745 children aged 2-17 from the second follow-up of the European IDEFICS/I.Family cohort. Linear regression models were used to investigate the association between parental migration background (one or two migrant parent(s) vs native parents) and body mass index (BMI), metabolic syndrome (MetS) score and its individual components. Outcome variables were parametrized as age and sex-specific z-scores. We adjusted for age, sex, country, and parental education, and additionally for parental income, lifestyle including dietary factors, and maternal BMI. On average, children with two migrant parents had higher z-scores of BMI (+0.24 standard deviation (SD)) and MetS score (+0.30 SD) compared to those with native parents, whereas no significant differences were seen for children with one migrant parent. Associations were attenuated when controlling for maternal BMI and sports club activity. Parental education modified the associations with BMI and MetS z-scores such that they were more pronounced in children with low parental education. CONCLUSION: Children with two migrant parents were at higher risk for adverse cardiometabolic health compared to children with native parents, especially in families with low parental education. These associations were explained by lower physical activity and maternal body weight and encourages early intervention strategies by schools and communities.

Family structure in relation to body mass index and metabolic score in European children and adolescents.

BACKGROUND: Living in single parent and blended families or as an only child-compared to living in two-parent biological families or with siblings, respectively-is associated with a higher body mass index (BMI) in cross-sectional studies. However, longitudinal research addressing the children's BMI in this context is scarce. Further, little is known about the association between family structure and metabolic health. OBJECTIVES: This study aimed at investigating the association between both aspects of family structure with BMI and a metabolic score (MetS). METHODS: Cross-sectional data from 7804 children participating in the European multi-center I.Family study (2013/2014) and longitudinal data from 5621 children who also participated previously in the IDEFICS study (2007-2010) were used. Family structure was assessed by a detailed interview. BMI z-score and the MetS were based on measured anthropometry, blood pressure, high-density lipoprotein, blood glucose, and triglycerides. Linear regressions were performed to model associations between family structure with BMI and MetS. RESULTS: Children from single-parent families had higher BMI z-scores in the cross-sectional (ß = 0.09, 95% confidence interval [CI]: 0.001 to 0.18) and longitudinal analyses compared to those from two-parent families. Cross-sectionally, the number of siblings was associated with lower BMI z-scores (ß = -0.07, 95% CI: -0.10 to -0.03) and lower MetS (ß = -0.14, 95% CI: -0.26 to -0.01). Longitudinally, only children between baseline and follow-up had higher BMI z-scores at follow-up (ß = 0.07, 95% CI: 0.01 to 0.14) compared to stable siblings. CONCLUSION: Obesity prevention measures should focus on single-parent households and families with an only child.

Associations of Sleep Duration and Screen Time with Incidence of Overweight in European Children: The IDEFICS/I.Family Cohort.

INTRODUCTION: Over the past decades, children have been increasingly using screen devices, while at the same time their sleep duration has decreased. Both behaviors have been associated with excess weight, and it is possible they act as mutually reinforcing behaviors for weight gain. The aim of the study was to explore independent, prospective associations of screen time and sleep duration with incident overweight in a sample of European children. METHODS: Data from 4,285 children of the IDEFICS/I.Family cohort who were followed up from 2009/2010 to 2013/2014 were analyzed. Hours per day of screen time and of sleep duration were reported by parents at baseline. Logistic regression analyses were carried out in separate and mutually adjusted models controlled for sex, age, European country region, parental level of education, and baseline BMI z-scores. RESULTS: Among normal weight children at baseline (N = 3,734), separate models suggest that every hour increase in screen time and every hour decrease in sleep duration were associated with higher odds of the child becoming overweight or obese at follow-up (OR = 1.16, 95% CI: 1.02-1.32 and OR = 1.23, 95% CI: 1.05-1.43, respectively). In the mutually adjusted model, both associations were attenuated slightly ( screen time OR = 1.13, 95% CI: 0.99-1.28; sleep duration OR = 1.20, 95% CI: 1.03-1.40), being consistently somewhat stronger for sleep duration. DISCUSSION/CONCLUSION: Both screen time and sleep duration increased the incidence of overweight or obesity by 13-20%. Interventions that include an emphasis on adequate sleep and minimal screen time are needed to establish their causal role in the prevention of overweight and obesity among European children.

Digital Media Use in Association with Sensory Taste Preferences in European Children and Adolescents-Results from the I.Family Study.

Digital media (DM) influences children's food choice. We aim to investigate associations between DM use and taste preferences (TP) for sweet, fatty, bitter, and salty in European children and adolescents. Individuals aged 6-17 years (N = 7094) providing cross-sectional data for DM use: television (TV), computer/game console (PC), smartphone and internet, were included. Children (6 to <12 years) and adolescents (≥12 years) completed a Food and Beverage Preference Questionnaire; scores were calculated for sweet, fatty, salty and bitter preference and categorized (high vs. low). Logistic regression was used to calculate odds ratios as association measures between DM exposure and TP. On average, individuals used media for 2.4 h/day (SD = 1.7). Increasing exposures to DM were associated positively with sweet, fatty and salty TP, while inversely with bitter preference. In female adolescents, DM exposure for >2 h/day was associated with sweet (OR = 1.27, 95% CI = 1.02-1.57) and fatty preference (OR = 1.37; 95% CI = 1.10-1.70). Internet exposure was inversely associated with bitter preference, notably in male adolescents (OR = 0.65, 95% CI = 0.50-0.84), but positively associated with salty preference (OR = 1.29, 95% CI = 1.02-1.64). DM exposure was associated with sweet, fatty, salty and bitter TP in children and adolescents, serving as the basis for future longitudinal studies to shed light on the underlying mechanism by which DM exposure may determine eating habits.

Like me, like you - relative importance of peers and siblings on children's fast food consumption and screen time but not sports club participation depends on age.

BACKGROUND: Lifestyle interventions to prevent paediatric obesity often target family and peer settings; their success is likely to depend on the influence that peers and families exert on children's lifestyle behaviors at different developmental stages. OBJECTIVE: First, to determine whether children's lifestyle behavior more closely resembles their peers' or siblings' behaviors. Secondly, to investigate longitudinally whether children's behavioral change is predicted by that of their peers or their siblings as they grow older. METHODS: The European prospective IDEFICS/I.Family cohort (baseline survey: 2007/2008, first follow-up: 2009/2010, and second follow-up: 2013/2014) aims at investigating risk factors for overweight and related behaviors during childhood and adolescence. The present investigation includes 2694 observations of children and their siblings aged 2 to 18 years. Peers were defined as same-sex, same-age children in the same community and identified from the full cohort. The longitudinal analysis (mean follow-up time: 3.7 years) includes 525 sibling pairs. Children's lifestyle behaviors including fast food consumption (frequency/week), screen time (hours/week) and sports club participation (hours/week) were assessed by questionnaire. Data were analyzed using multilevel linear models. RESULTS: Children's lifestyle behavior was associated with the respective behavior of their peers and sibling for all 3 behaviors. For fast food consumption, the peer resemblance was more than 6-fold higher than the sibling resemblance and the peer resemblance surpassed the sibling resemblance by the age of 9-10 years. The similarities with peers for fast food consumption and screen time steadily increased, while the similarities with siblings steadily decreased with increasing age of the children (Pinteraction < 0.001). In contrast, the relative importance of peers and siblings on sports club duration did not vary by the age of the children. Longitudinal results showed that children's changes in fast food consumption were more strongly associated with those in their peer group than their sibling, in particular if the age gap between siblings was large. CONCLUSION: In conclusion, our results support the implementation of multi-setting interventions for improving lifestyle behaviors in children. Our findings might also guide future intervention studies in the choice of timing and setting in which interventions are likely to be most effective. From the ages of 9-10 years onwards, family- or home-based interventions targeting children's fast food intake and screen time behavior may become less effective than school- or community-based interventions aimed at peer groups.

Relative Validity of a Food and Beverage Preference Questionnaire to Characterize Taste Phenotypes in Children Adolescents and Adults.

To assess the relative validity of our food and beverage preference questionnaire we investigated the association between sweet and fatty taste preference scores (assessed using a food and beverage preference questionnaire) and sweet and fatty food propensity scores (derived from a food frequency questionnaire). In I.Family, a large European multi-country cohort study, 12,207 participants from Cyprus, Estonia, Germany, Hungary, Italy, Spain and Sweden, including 5291 adults, 3082 adolescents, and 3834 children, completed a food and beverage preference questionnaire with 63 items. Cumulative preference scores for sweet and fatty taste were calculated from the single item ranking ranging from 1 to 5. The relative consumption frequency of foods classified as sweet and fatty was used to calculate the corresponding consumption propensities, a continuous variable ranging from 0 to 100. We conducted regression analyses to investigate the association between sweet and fatty taste preference scores and sweet and fatty food propensity scores, respectively, separately for adults, adolescents ≥12 years, and for children <12 years. The overall sweet taste preference score was positively associated with the sweet food consumption propensity score (ß = 2.4, 95% CI: 2.1;2.7) and the fatty taste preference score was positively associated with the fatty food consumption propensity score (ß = 2.0, 95% CI: 1.8;2.2). After stratification for age (children <12 years, adolescents ≥12 years, and adults), the effect remained significant in all age groups and was strongest in adolescents and adults. We conclude that our food and beverage preference questionnaire is a useful instrument for epidemiological studies on sensory perception and health outcomes and for the characterization of sensory taste phenotypes.

Cross-sectional and longitudinal associations between psychosocial well-being and sleep in European children and adolescents.

Research on associations of positive mental health, in contrast to mental ill-health, with sleep duration and sleep disturbances in young populations is scarce. In particular, longitudinal studies focussing on the influence of positive mental health on sleep characteristics are lacking. Therefore, we investigated cross-sectional and longitudinal associations of psychosocial well-being with sleep duration and sleep disturbances. For the cross-sectional analysis, we used data of 3-15-year-old children and adolescents participating in the 2013/14 examination of the European IDEFICS/I.Family cohort study (N = 6,336). The longitudinal analysis was restricted to children who also participated in the 2009/10 examination (N = 3,379). Associations between a psychosocial well-being score created from 16 items of the KINDLR Health-Related Quality of Life Questionnaire covering emotional well-being, self-esteem and social relationships, an age-standardized nocturnal sleep duration z-score and two sleep disturbance indicators ("trouble getting up in the morning", "difficulties falling asleep") were estimated using linear and logistic mixed-effects models. Cross-sectionally, a higher well-being score was associated with longer sleep duration and lower odds of sleep disturbances. A positive change in the well-being score over the 4-year period was associated with longer sleep duration and lower odds of sleep disturbances at follow-up. However, there was only weak evidence that higher psychosocial well-being at baseline was associated with better sleep 4 years later. Thus, our results suggest that increases in well-being are associated with improvements in both sleep duration and sleep disturbances, but that well-being measured at one point in time does not predict sleep characteristics several years later.

Disordered eating in three different age groups in Cyprus: a comparative cross-sectional study.

OBJECTIVE: The objective of this study was to evaluate disordered eating behaviours (DEBs) in different age groups in a Cypriot non-clinical population sample. STUDY DESIGN: Comparative cross-sectional study. METHOD: A total of 1716 participants from the Cyprus component of the I.Family study completed the Eating Attitudes Test-26 (EAT-26). The EAT-26 score ≥20 was used to define participants at risk for DEBs. Participants were divided according to age: adolescence (12-18 years old), young adulthood (25-45 years old) and middle adulthood (46-60 years old). RESULTS: Mean EAT-26 total scores were higher for middle adulthood men and women compared with the two younger age groups. Young adulthood women had the highest percentage of behavioural symptoms of DEBs: binge eating (35%) and laxatives/diet pills/diuretics (12%) compared with the other age groups. Men and women in young adulthood had the highest percentage of participants with EAT-26 scores ≥20. In logistic regression analysis, age group did not prove a significant predictor of DEB risk in a model adjusting for sex, body mass index and physical activity. CONCLUSION: DEB can present at any age and was not confined to adolescence.

Familial aggregation and socio-demographic correlates of taste preferences in European children.

BACKGROUND: Studies on aggregation of taste preferences among children and their siblings as well as their parents are scarce. We investigated the familial aggregation of taste preferences as well as the effect of sex, age, country of residence and education on variation in taste preferences in the pan- European I.Family cohort. METHOD: Thirteen thousand one hundred sixty-five participants from 7 European countries, comprising 2,230 boys <12 years, 2,110 girls <12 years, 1,682 boys ≥12 years, 1,744 girls ≥12 years and 5,388 parents, completed a Food and Beverage Preference Questionnaire containing 63 food items representing the taste modalities sweet, bitter, salty and fatty. We identified food items that represent the different taste qualities using factor analysis. On the basis of preference ratings for these food and drink items, a preference score for each taste was calculated for children and parents individually. Sibling and parent-child correlations for taste preference scores were calculated. The proportion of variance in children's preference scores that could be explained by their parents' preference scores and potential correlates including sex, age and parental educational was explored. RESULTS: Mean taste preferences for sweet, salty and fatty decreased and for bitter increased with age. Taste preference scores correlated stronger between siblings than between children and parents. Children's salty preference scores could be better explained by country than by family members. Children's fatty preference scores could be better explained by family members than by country. Age explained 17% of the variance in sweet and 16% of the variance in fatty taste preference. Sex and education were not associated with taste preference scores. CONCLUSION: Taste preferences are correlated between siblings. Country could explain part of the variance of salty preference scores in children which points to a cultural influence on salt preference. Further, age also explained a relevant proportion of variance in sweet and fatty preference scores.