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1.
Allergy ; 78(9): 2456-2466, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-37496192

RESUMO

BACKGROUND: Conflicting results have been obtained when analyzing the relationship between complementary feeding (CF) practices and allergic diseases in childhood. This study aims to further explore the association between allergic diseases in early childhood (10.1016/j.jaci.2012.02.036) and the age at CF introduction (10.1016/S0140-6736(15)00149-X), food diversity in the first year of life (10.1016/j.ijporl.2019.109759) and the delayed introduction of major allergenic foods. METHODS: This analysis focused on 6662 children from the French nationwide ELFE cohort. Data on feeding practices were collected monthly from 3 to 10 months old. Their age at CF introduction was calculated alongside a diversity score, and the number of major allergenic foods (out of eggs, fish, wheat, and dairy products) not introduced at 8 and 10 months. Their associations with parent-reported allergy-related health events between 1 and 5.5 years were assessed using logistic regressions adjusted for confounding factors. A sensitivity analysis excluding early allergic cases (occurring between 2 months and 1 or 2 years) was conducted. RESULTS: Late CF (>6 months) was related to a higher risk of food allergy (OR [95% CI] = 1.35 [1.02; 1.78]), a low diversity score at 8 months to a higher risk of asthma (OR [95% CI] = 1.22 [1.01; 1.48]), and two allergenic foods or more not being introduced at 10 months to a higher risk of rhinoconjunctivitis (OR [95% CI] = 1.20 [1.00; 1.44]) and food allergy (OR [95% CI] = 2.46 [1.77; 3.42]). Only this last association remained significant after the exclusion of early cases. CONCLUSION: The delayed introduction of major allergenic foods is related to a higher risk of food allergy, which supports the updated guidelines for allergy prevention.


Assuntos
Asma , Comportamento Alimentar , Hipersensibilidade Alimentar , Pré-Escolar , Humanos , Asma/complicações , Asma/imunologia , Ovos , Hipersensibilidade Alimentar/etiologia , Hipersensibilidade Alimentar/complicações , Fenômenos Fisiológicos da Nutrição do Lactente/imunologia , Lactente
2.
Int J Obes (Lond) ; 42(9): 1671-1679, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-30120430

RESUMO

BACKGROUND/OBJECTIVES: Studies in high-income countries show that despite the positive association of weight with socioeconomic position at birth, an inverse socioeconomic gradient in overweight (OW) appears later in childhood. The objectives were to understand the natural history of socioeconomic inequalities in weight, height and body mass index (BMI), by investigating their associations with maternal educational level between birth and 5 years, separately in boys and girls. SUBJECTS/METHODS: A published work of growth modelling between birth and 5 years allowed us to calculate predicted weight, height and BMI at 1 month, 6 months, 1, 3 and 5 years for 1735 children from the French EDEN mother-child cohort. Associations between maternal education and predicted measures of body size were analysed with marginal linear and logistic models, stratified by sex. RESULTS: In girls, despite a positive association between maternal education and birthweight, an inverse socioeconomic gradient was observed as early as 1 month for BMI. Girls whose mothers had low education levels were shorter on the whole than their counterparts with better-educated mothers, despite their similar weights. In boys, no socioeconomic gradient in BMI was observed at any age, including birth, but positive associations were found as early as 1 month for both weight and height. CONCLUSIONS: The emergence of an inverse socioeconomic gradient in BMI and OW apparently results from a complex pattern of socioeconomic inequalities in weight and height from 1 month onwards. The very start of life thus appears to be an important window of opportunity for addressing socioeconomic inequalities in growth.


Assuntos
Estatura/fisiologia , Índice de Massa Corporal , Peso Corporal/fisiologia , Desenvolvimento Infantil , Sobrepeso/epidemiologia , Pré-Escolar , Feminino , França/epidemiologia , Humanos , Lactente , Recém-Nascido , Masculino , Mães/estatística & dados numéricos , Fatores Socioeconômicos
3.
Food Chem Toxicol ; 111: 310-328, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29138022

RESUMO

Pregnant women and their unborn child are exposed to a large number of substances during pregnancy. Some of these substances may cross the placenta, resulting in exposure of the foetus. There is growing evidence that certain substances could interact to produce a mixture effect. It is therefore essential to identify the main mixtures mothers are exposed to. This study aimed to identify the major mixtures French pregnant women included in EDEN and ELFE cohorts were exposed to, on the basis of the 441 substances analysed in the second French total diet study. Exposure systems and the composition of substances were identified from co-exposures using sparse non-negative matrix under-approximation to generate the main mixtures. Individuals were clustered to define clusters with similar co-exposure profiles. Six clusters associated with eight mixtures were identified. For example in ELFE, cluster 2 comprising 10% of the population was characterised by mixtures "Pest-1" mainly contains pesticides and "TE-F-PAH″ contains trace elements, furans and polycyclic aromatic hydrocarbons. Five other clusters were also described with their associated mixtures. Similar results were observed for EDEN. This study helps to prioritise mixtures for which it is crucial to investigate possible toxicological effects and to recommend epidemiological studies concerning health effects.


Assuntos
Dieta , Exposição Ambiental/estatística & dados numéricos , Poluentes Ambientais/administração & dosagem , Contaminação de Alimentos/análise , Praguicidas , Oligoelementos , Adulto , Estudos de Coortes , Misturas Complexas , Poluentes Ambientais/toxicidade , Feminino , França , Furanos , Humanos , Resíduos de Praguicidas/análise , Hidrocarbonetos Policíclicos Aromáticos , Gravidez
4.
J Dev Orig Health Dis ; 9(6): 632-641, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30720417

RESUMO

Experimental data have suggested that some contaminants in the environment may increase the risk of obesity. Infants can be exposed to chemicals either prenatally, by trans-placental passage of chemicals, or postnatally by their own diet and by other external pathways (air inhalation, dust, hand-to-mouth exposure) after birth. To provide a review of epidemiological evidence on the association between prenatal exposure to chemicals and prenatal and postnatal growth, we present the literature from systematic review articles and international meta-analyses, when available, or recent research articles when summarizing articles were not available. The most studied contaminants in this field were persistent organic pollutants (e.g. organochlorinated pesticides, polychlorinated biphenyls), non-persistent pollutants (e.g. phthalates, bisphenol A), toxic heavy metals (i.e. cadmium, lead and mercury), arsenic, mycotoxins and acrylamide. Mounting evidence suggests that child's growth may be associated with prenatal or postnatal exposures to environmental contaminants. Improving exposure assessment and studying the contaminants as mixtures should allow to gain knowledge about the environmental determinants of growth and obesity.


Assuntos
Exposição Ambiental/efeitos adversos , Poluentes Ambientais/efeitos adversos , Obesidade/epidemiologia , Efeitos Tardios da Exposição Pré-Natal/epidemiologia , Desenvolvimento Infantil/efeitos dos fármacos , Desenvolvimento Infantil/fisiologia , Feminino , Humanos , Lactente , Fenômenos Fisiológicos da Nutrição do Lactente/efeitos dos fármacos , Fenômenos Fisiológicos da Nutrição do Lactente/fisiologia , Exposição Materna/efeitos adversos , Troca Materno-Fetal/efeitos dos fármacos , Troca Materno-Fetal/fisiologia , Metanálise como Assunto , Obesidade/etiologia , Obesidade/prevenção & controle , Gravidez , Efeitos Tardios da Exposição Pré-Natal/etiologia , Efeitos Tardios da Exposição Pré-Natal/prevenção & controle , Revisões Sistemáticas como Assunto
5.
Pediatr Obes ; 12 Suppl 1: 94-101, 2017 08.
Artigo em Inglês | MEDLINE | ID: mdl-28299906

RESUMO

OBJECTIVES: As early-life feeding experiences may influence later health, we aimed to examine relations between feeding patterns over the first year of life and child's growth in the first 5 years of life. METHODS: Our analysis included 1022 children from the EDEN mother-child cohort. Three feeding patterns were previously identified, i.e. 'Later dairy products introduction and use of ready-prepared baby foods' (pattern-1), 'Long breastfeeding, later main meal food introduction and use of home-made foods' (pattern-2) and 'Use of ready-prepared adult foods' (pattern-3). Associations between the feeding patterns and growth [weight, height and body mass index {BMI}] were analysed by multivariable linear regressions. Anthropometric changes were assessed by the final value adjusted for the initial value. RESULTS: Even though infant feeding patterns were not related to anthropometric measurements at 1, 3 and 5 years, high scores on pattern-1 were associated with higher 1-3 years weight and height changes. High scores on pattern-2 were related to lower 0-1 year weight and height changes, higher 1-5 years weight and height changes but not to BMI changes, after controlling for a wide range of potential confounding variables including parental BMI. Scores on pattern-3 were not significantly related to growth. Additional adjustment for breastfeeding duration reduced the strength of the associations between pattern-2 and growth but not those between pattern-1 and height growth. CONCLUSION: Our findings emphasize the relevance of considering infant feeding patterns including breastfeeding duration, age of complementary foods introduction as well as type of foods used when examining effects of early infant feeding practices on later health. © 2017 World Obesity Federation.


Assuntos
Antropometria/métodos , Desenvolvimento Infantil/fisiologia , Comportamento Alimentar/fisiologia , Adulto , Aleitamento Materno , Criança , Pré-Escolar , Estudos de Coortes , Feminino , Humanos , Lactente , Masculino , Pais , Estudos Prospectivos
6.
Int J Obes (Lond) ; 41(1): 38-45, 2017 01.
Artigo em Inglês | MEDLINE | ID: mdl-27528250

RESUMO

BACKGROUND/OBJECTIVES: Sedentary behavior, physical activity and dietary behavior are formed early during childhood and tend to remain relatively stable into later life. No longitudinal studies have assessed the independent influence of these three energy balance-related behaviors during toddlerhood on later adiposity. We aimed to analyze the associations between TV/DVD watching time, outdoor play time and dietary patterns at the age of 2 years and child adiposity at the age of 5 years, in boys and girls separately. SUBJECTS/METHODS: This study included 883 children from the French EDEN mother-child cohort. TV/DVD watching time, outdoor play time and dietary intakes were reported by parents in questionnaires when the child was aged 2 years. Two dietary patterns, labeled 'Guidelines' and 'Processed, fast foods', were identified in a previous study. The percentage of body fat (%BF) based on bioelectrical impedance analysis and body mass index were measured at the age of 5 years. RESULTS: In boys, TV/DVD watching time at the age of 2 years was positively associated with %BF at the age of 5 years (ß=0.50 (95% confidence interval: 0.001, 1.00) for those boys with ⩾60 min per day of TV/DVD watching time vs those with ⩽15 min per day, P-value for trend 0.05). In girls, outdoor play was inversely associated with %BF (ß=-0.96 (95% confidence interval: -1.60, -0.32) for those in the highest tertile of outdoor play time vs those in the lowest tertile, P=0.001). Overall, at the age of 2 years, dietary patterns were associated with both TV/DVD watching time and outdoor play time, but no significant and independent association was observed between dietary patterns and later adiposity. CONCLUSION: This study shows longitudinal and gender-differentiated relations between both TV/DVD watching time and outdoor play time in toddlerhood and later adiposity, whereas evidence for a relation between dietary patterns and subsequent fat development was less conclusive. Early childhood-by the age of 2 years-should be targeted as a critical time for promoting healthy energy balance-related behaviors.


Assuntos
Adiposidade/fisiologia , Ingestão de Energia/fisiologia , Metabolismo Energético/fisiologia , Mães , Adulto , Índice de Massa Corporal , Pré-Escolar , Dieta/efeitos adversos , Exercício Físico , Feminino , França/epidemiologia , Conhecimentos, Atitudes e Prática em Saúde , Inquéritos Epidemiológicos , Humanos , Masculino , Mães/psicologia , Mães/estatística & dados numéricos , Sobrepeso/epidemiologia , Sobrepeso/fisiopatologia , Obesidade Infantil/epidemiologia , Obesidade Infantil/fisiopatologia , Estudos Prospectivos , Comportamento Sedentário , Inquéritos e Questionários , Televisão
7.
Eur J Clin Nutr ; 71(2): 219-226, 2017 02.
Artigo em Inglês | MEDLINE | ID: mdl-27901039

RESUMO

BACKGROUND/OBJECTIVES: Few studies have examined the factors explaining the variability in fat and carbohydrate intake during infancy. We aimed to describe infants' fat and carbohydrate intake and analyse the associations with infant and maternal characteristics and feeding practices. SUBJECTS/METHODS: This study included 1275 infants aged 8 months from the French EDEN mother-child cohort. Carbohydrate intake, fat intake, added fat (vegetable oils and animal fats) and added sugar (honey, white sugar, brown sugar, jam and sweetened beverages) consumption were calculated at 8 and 12 months. Associations between these variables and infant and maternal characteristics as well as maternal dietary patterns during pregnancy, breast-feeding duration and age at complementary feeding introduction were analysed using multivariable linear and logistic regressions. RESULTS: Less than 5% of non-breast-fed infants reached the recommendation of consuming at least 40% of total energy from fat, whereas more than 95% of them reached 45% of energy from carbohydrates. Overall, infant and maternal characteristics and maternal diet during pregnancy were marginally associated with both carbohydrate/added sugar and fat/added fat intake. Nevertheless, age at complementary feeding introduction was associated with all outcomes. CONCLUSIONS: Our results suggest that only a small proportion of non-breast-fed infants at 8 and 12 months reached the recommendations for fat intake, whereas a majority of them reached the recommendations for carbohydrate intake. As subgroups of infants with a higher risk of inadequate diet were not identified, the present results call for an improved dissemination of information regarding infant-specific dietary fat needs in the entire population.


Assuntos
Dieta/métodos , Carboidratos da Dieta/análise , Gorduras na Dieta/análise , Ingestão de Energia , Fenômenos Fisiológicos da Nutrição Materna , Adulto , Aleitamento Materno , Estudos de Coortes , Ingestão de Alimentos/fisiologia , Comportamento Alimentar/fisiologia , Feminino , Humanos , Lactente , Fenômenos Fisiológicos da Nutrição do Lactente/fisiologia , Recomendações Nutricionais
8.
Br J Nutr ; 114(5): 763-71, 2015 Sep 14.
Artigo em Inglês | MEDLINE | ID: mdl-26195187

RESUMO

Problematic eating behaviours during early childhood could be mediators of poor dietary habits. This study aims to prospectively relate early eating behaviours with fruit and vegetable (F&V) intake and a healthy diet variety score of children aged between 4 and 5 years. Eating behaviours were assessed in three European birth cohorts (Generation XXI from Portugal, ALSPAC from the UK and EDEN from France) at 4-6, 12-15, 24 and 48-54 months of age, based on the child's feeding difficulties, mother's perception of child's poor eating (eating small quantities at each meal, not eating enough or needing to be stimulated to eat), food refusal and difficulties in the establishment of daily food routines. Daily servings of F&V (>1 v. ≤1 serving/d, except in Generation XXI: >3 v. ≤3) and the Healthy Plate Variety Score (categorised by the median score of each sample) were calculated using FFQ. Associations were tested by logistic regressions adjusted for maternal age, education, smoking during pregnancy, any breast-feeding and the child's z-score BMI at 4-5 years of age. Children with more feeding difficulties, poor eating, food refusal/neophobia and difficulties in establishing a daily routine at 12-15, 24 and 48-54 months of age had in general lower F&V intake at 4-5 years of age. The association with vegetables was slightly stronger than with fruits. These early feeding problems were also inversely associated with the variety score at 4-5 years of age, particularly when eating behaviours were reported after 12-15 months of age. A better understanding of these early feeding difficulties may help define strategies to increase the dietary quality in children.


Assuntos
Comportamento Infantil , Dieta , Ingestão de Alimentos , Comportamento Alimentar , Transtornos de Alimentação na Infância , Preferências Alimentares , Comportamento do Lactente , Adulto , Índice de Massa Corporal , Aleitamento Materno , Pré-Escolar , Dieta/normas , Ingestão de Energia , Transtornos de Alimentação na Infância/complicações , Feminino , França , Frutas , Humanos , Lactente , Masculino , Personalidade , Portugal , Estudos Prospectivos , Inquéritos e Questionários , Reino Unido , Verduras , Adulto Jovem
9.
Eur J Clin Nutr ; 69(4): 455-61, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25424603

RESUMO

BACKGROUND/OBJECTIVES: Diets high in saturated and trans fat and low in unsaturated fat may increase type 2 diabetes (T2D) risk, but studies on foods high in fat per unit weight are sparse. We assessed whether the intake of vegetable oil, butter, margarine, nuts and seeds and cakes and cookies is related to incident T2D. SUBJECTS/METHODS: A case-cohort study was conducted, nested within eight countries of the European Prospective Investigation into Cancer (EPIC), with 12,403 incident T2D cases and a subcohort of 16,835 people, identified from a cohort of 340,234 people. Diet was assessed at baseline (1991-1999) by country-specific questionnaires. Country-specific hazard ratios (HRs) across four categories of fatty foods (nonconsumers and tertiles among consumers) were combined with random-effects meta-analysis. RESULTS: After adjustment not including body mass index (BMI), nonconsumers of butter, nuts and seeds and cakes and cookies were at higher T2D risk compared with the middle tertile of consumption. Among consumers, cakes and cookies were inversely related to T2D (HRs across increasing tertiles 1.14, 1.00 and 0.92, respectively; P-trend <0.0001). All these associations attenuated upon adjustment for BMI, except the higher risk of nonconsumers of cakes and cookies (HR 1.57). Higher consumption of margarine became positively associated after BMI adjustment (HRs across increasing consumption tertiles: 0.93, 1.00 and 1.12; P-trend 0.03). Within consumers, vegetable oil, butter and nuts and seeds were unrelated to T2D. CONCLUSIONS: Fatty foods were generally not associated with T2D, apart from weak positive association for margarine. The higher risk among nonconsumers of cakes and cookies needs further explanation.


Assuntos
Diabetes Mellitus Tipo 2/epidemiologia , Dieta , Gorduras na Dieta/administração & dosagem , Adulto , Índice de Massa Corporal , Manteiga , Estudos de Casos e Controles , Ingestão de Energia , Metabolismo Energético , Europa (Continente)/epidemiologia , Feminino , Seguimentos , Humanos , Incidência , Estilo de Vida , Masculino , Margarina , Rememoração Mental , Avaliação Nutricional , Nozes , Óleos de Plantas , Modelos de Riscos Proporcionais , Estudos Prospectivos , Fatores de Risco , Inquéritos e Questionários
10.
Eur J Clin Nutr ; 67(6): 631-7, 2013 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-23299715

RESUMO

BACKGROUND/OBJECTIVES: Early eating patterns and behaviors can determine later eating habits and food preferences and they have been related to the development of childhood overweight and obesity. We aimed to identify patterns of feeding in the first year of life and to examine their associations with family characteristics. SUBJECTS/METHODS: Our analysis included 1004 infants from the EDEN mother-child cohort. Feeding practices were assessed through maternal self-report at birth, 4, 8 and 12 months. Principal component analysis was applied to derive patterns from breastfeeding duration, age at complementary food (CF) introduction and type of food used at 1 year. Associations between patterns and family characteristics were analyzed by linear regressions. RESULTS: The main source of variability in infant feeding was characterized by a pattern labeled 'late CF introduction and use of ready-prepared baby foods'. Older, more educated, primiparous women with high monthly income ranked high on this pattern. The second pattern, labeled 'longer breastfeeding, late CF introduction and use of home-made foods' was the closest to infant feeding guidelines. Mothers ranking high on this pattern were older and more educated. The third pattern, labeled 'use of adults' foods' suggests a less age-specific diet for the infants. Mothers ranking high on this pattern were often younger and multiparous. Recruitment center was related to all patterns. CONCLUSIONS: Not only maternal education level and age, but also parity and region are important contributors to the variability in patterns. Further studies are needed to describe associations between these patterns and infant growth and later food preferences.


Assuntos
Características da Família , Comportamento Alimentar , Fenômenos Fisiológicos da Nutrição do Lactente , Comportamento Materno , Adulto , Fatores Etários , Aleitamento Materno , Estudos de Coortes , Escolaridade , Feminino , França , Humanos , Alimentos Infantis , Recém-Nascido , Estudos Longitudinais , Masculino , Paridade , Análise de Componente Principal , Estudos Prospectivos , Autorrelato
11.
Diabetologia ; 56(1): 47-59, 2013 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-22983636

RESUMO

AIMS/HYPOTHESIS: A diet rich in meat has been reported to contribute to the risk of type 2 diabetes. The present study aims to investigate the association between meat consumption and incident type 2 diabetes in the EPIC-InterAct study, a large prospective case-cohort study nested within the European Prospective Investigation into Cancer and Nutrition (EPIC) study. METHODS: During 11.7 years of follow-up, 12,403 incident cases of type 2 diabetes were identified among 340,234 adults from eight European countries. A centre-stratified random subsample of 16,835 individuals was selected in order to perform a case-cohort design. Prentice-weighted Cox regression analyses were used to estimate HR and 95% CI for incident diabetes according to meat consumption. RESULTS: Overall, multivariate analyses showed significant positive associations with incident type 2 diabetes for increasing consumption of total meat (50 g increments: HR 1.08; 95% CI 1.05, 1.12), red meat (HR 1.08; 95% CI 1.03, 1.13) and processed meat (HR 1.12; 95% CI 1.05, 1.19), and a borderline positive association with meat iron intake. Effect modifications by sex and class of BMI were observed. In men, the results of the overall analyses were confirmed. In women, the association with total and red meat persisted, although attenuated, while an association with poultry consumption also emerged (HR 1.20; 95% CI 1.07, 1.34). These associations were not evident among obese participants. CONCLUSIONS/INTERPRETATION: This prospective study confirms a positive association between high consumption of total and red meat and incident type 2 diabetes in a large cohort of European adults.


Assuntos
Diabetes Mellitus Tipo 2/etiologia , Dieta/efeitos adversos , Carne/efeitos adversos , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Estudos de Coortes , Estudos Transversais , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/etnologia , Dieta/etnologia , Europa (Continente)/epidemiologia , Feminino , Seguimentos , Humanos , Incidência , Ferro da Dieta/administração & dosagem , Ferro da Dieta/efeitos adversos , Masculino , Carne/análise , Produtos da Carne/efeitos adversos , Produtos da Carne/análise , Pessoa de Meia-Idade , Estudos Prospectivos , Risco , Caracteres Sexuais , Adulto Jovem
12.
Diabetologia ; 56(1): 60-9, 2013 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-23052052

RESUMO

AIMS/HYPOTHESIS: Although a family history of type 2 diabetes is a strong risk factor for the disease, the factors mediating this excess risk are poorly understood. In the InterAct case-cohort study, we investigated the association between a family history of diabetes among different family members and the incidence of type 2 diabetes, as well as the extent to which genetic, anthropometric and lifestyle risk factors mediated this association. METHODS: A total of 13,869 individuals (including 6,168 incident cases of type 2 diabetes) had family history data available, and 6,887 individuals had complete data on all mediators. Country-specific Prentice-weighted Cox models were fitted within country, and HRs were combined using random effects meta-analysis. Lifestyle and anthropometric measurements were performed at baseline, and a genetic risk score comprising 35 polymorphisms associated with type 2 diabetes was created. RESULTS: A family history of type 2 diabetes was associated with a higher incidence of the condition (HR 2.72, 95% CI 2.48, 2.99). Adjustment for established risk factors including BMI and waist circumference only modestly attenuated this association (HR 2.44, 95% CI 2.03, 2.95); the genetic score alone explained only 2% of the family history-associated risk of type 2 diabetes. The greatest risk of type 2 diabetes was observed in those with a biparental history of type 2 diabetes (HR 5.14, 95% CI 3.74, 7.07) and those whose parents had been diagnosed with diabetes at a younger age (<50 years; HR 4.69, 95% CI 3.35, 6.58), an effect largely confined to a maternal family history. CONCLUSIONS/INTERPRETATION: Prominent lifestyle, anthropometric and genetic risk factors explained only a marginal proportion of the excess risk associated with family history, highlighting the fact that family history remains a strong, independent and easily assessed risk factor for type 2 diabetes. Discovering factors that will explain the association of family history with type 2 diabetes risk will provide important insight into the aetiology of type 2 diabetes.


Assuntos
Diabetes Mellitus Tipo 2/epidemiologia , Saúde da Família , Estilo de Vida , Atividade Motora , Adulto , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Estudos de Casos e Controles , Estudos de Coortes , Estudos Transversais , Diabetes Mellitus Tipo 2/etnologia , Diabetes Mellitus Tipo 2/etiologia , Diabetes Mellitus Tipo 2/genética , Europa (Continente)/epidemiologia , Saúde da Família/etnologia , Feminino , Seguimentos , Predisposição Genética para Doença , Humanos , Incidência , Estilo de Vida/etnologia , Masculino , Pessoa de Meia-Idade , Mães , Fatores de Risco , Circunferência da Cintura , Adulto Jovem
13.
Eur J Clin Nutr ; 66(10): 1082-92, 2012 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-22854878

RESUMO

Fruit and vegetable intake (FVI) may reduce the risk of type 2 diabetes (T2D), but the epidemiological evidence is inconclusive. The aim of this study is to examine the prospective association of FVI with T2D and conduct an updated meta-analysis. In the European Prospective Investigation into Cancer-InterAct (EPIC-InterAct) prospective case-cohort study nested within eight European countries, a representative sample of 16,154 participants and 12,403 incident cases of T2D were identified from 340,234 individuals with 3.99 million person-years of follow-up. For the meta-analysis we identified prospective studies on FVI and T2D risk by systematic searches of MEDLINE and EMBASE until April 2011. In EPIC-InterAct, estimated FVI by dietary questionnaires varied more than twofold between countries. In adjusted analyses the hazard ratio (95% confidence interval) comparing the highest with lowest quartile of reported intake was 0.90 (0.80-1.01) for FVI; 0.89 (0.76-1.04) for fruit and 0.94 (0.84-1.05) for vegetables. Among FV subtypes, only root vegetables were inversely associated with diabetes 0.87 (0.77-0.99). In meta-analysis using pooled data from five studies including EPIC-InterAct, comparing the highest with lowest category for FVI was associated with a lower relative risk of diabetes (0.93 (0.87-1.00)). Fruit or vegetables separately were not associated with diabetes. Among FV subtypes, only green leafy vegetable (GLV) intake (relative risk: 0.84 (0.74-0.94)) was inversely associated with diabetes. Subtypes of vegetables, such as root vegetables or GLVs may be beneficial for the prevention of diabetes, while total FVI may exert a weaker overall effect.


Assuntos
Diabetes Mellitus Tipo 2/prevenção & controle , Frutas , Verduras , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/etiologia , Dieta/efeitos adversos , Europa (Continente)/epidemiologia , Medicina Baseada em Evidências , Humanos , Incidência , Folhas de Planta , Raízes de Plantas , Prevalência , Risco
14.
Diabetologia ; 55(7): 1944-52, 2012 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-22526603

RESUMO

AIMS/HYPOTHESIS: We examined the independent and combined associations of physical activity and obesity with incident type 2 diabetes in men and women. METHODS: The InterAct case-cohort study consists of 12,403 incident type 2 diabetes cases and a randomly selected subcohort of 16,154 individuals, drawn from a total cohort of 340,234 participants with 3.99 million person-years of follow-up. Physical activity was assessed by a four-category index. Obesity was measured by BMI and waist circumference (WC). Associations between physical activity, obesity and case-ascertained incident type 2 diabetes were analysed by Cox regression after adjusting for educational level, smoking status, alcohol consumption and energy intake. In combined analyses, individuals were stratified according to physical activity level, BMI and WC. RESULTS: A one-category difference in physical activity (equivalent to approximately 460 and 365 kJ/day in men and women, respectively) was independently associated with a 13% (HR 0.87, 95% CI 0.80, 0.94) and 7% (HR 0.93, 95% CI 0.89, 0.98) relative reduction in the risk of type 2 diabetes in men and women, respectively. Lower levels of physical activity were associated with an increased risk of diabetes across all strata of BMI. Comparing inactive with active individuals, the HRs were 1.44 (95% CI 1.11, 1.87) and 1.38 (95% CI 1.17, 1.62) in abdominally lean and obese inactive men, respectively, and 1.57 (95% CI 1.19, 2.07) and 1.19 (95% CI 1.01, 1.39) in abdominally lean and obese inactive women, respectively. CONCLUSIONS/INTERPRETATION: Physical activity is associated with a reduction in the risk of developing type 2 diabetes across BMI categories in men and women, as well as in abdominally lean and obese men and women.


Assuntos
Diabetes Mellitus Tipo 2/epidemiologia , Atividade Motora , Obesidade/epidemiologia , Circunferência da Cintura , Índice de Massa Corporal , Estudos de Coortes , Diabetes Mellitus Tipo 2/genética , Diabetes Mellitus Tipo 2/prevenção & controle , Europa (Continente)/epidemiologia , Feminino , Seguimentos , Predisposição Genética para Doença , Humanos , Incidência , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Obesidade/genética , Obesidade/prevenção & controle , Fatores de Risco , Inquéritos e Questionários , Circunferência da Cintura/genética
15.
Diabetologia ; 52(10): 2092-100, 2009 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-19629429

RESUMO

AIMS/HYPOTHESIS: Two US randomised trials found a lower incidence of type 2 diabetes in women treated by menopausal hormone therapy (MHT) with oral conjugated equine oestrogen combined with medroxyprogesterone acetate. The purpose of this study was to evaluate the influence of various MHTs, according to their formulation and route of administration, on new-onset diabetes in a cohort of postmenopausal French women. METHODS: The association between MHT use and new-onset diabetes was investigated by Cox regression analysis in 63,624 postmenopausal women in the prospective French cohort of the Etude Epidemiologique de Femmes de la Mutuelle Générale de l'Education Nationale (E3N). Cases of diabetes were identified through self-reporting or drug-reimbursement record linkage, and further validated. RESULTS: 1,220 new-onset diabetes cases were validated. We observed a lower risk of new-onset diabetes among women who had ever used MHT (HR 0.82 [95% CI 0.72-0.93]), compared with those who had never used MHT. Adjustment for BMI during follow-up (rather than according to baseline BMI) did not substantially modify this association. An oral route of oestrogen administration was associated with a greater decrease in diabetes risk than a cutaneous route (HR 0.68 [95% CI 0.55-0.85] vs 0.87 [95% CI 0.75-1.00], p for homogeneity = 0.028). We were not able to show significant differences between the progestagens used in combined MHT. CONCLUSIONS/INTERPRETATION: Use of MHT appeared to be associated with a lower risk of new-onset diabetes. This relationship was not mediated by changes in BMI. Further studies are needed to confirm the stronger effect of oral administration of oestrogen compared with cutaneous administration.


Assuntos
Diabetes Mellitus/epidemiologia , Terapia de Reposição Hormonal , Pós-Menopausa , Adulto , Idoso , Estrogênios Conjugados (USP)/uso terapêutico , Feminino , Humanos , Acetato de Medroxiprogesterona/uso terapêutico , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Ensaios Clínicos Controlados Aleatórios como Assunto , Inquéritos e Questionários
16.
Eur J Clin Nutr ; 63(2): 282-91, 2009 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-17882132

RESUMO

OBJECTIVE: Our aim was to evaluate the reproducibility of a food-frequency questionnaire (FFQ) developed in a French population, and its validity against four 24-h dietary recalls (24-HRs). METHODS: A total of 57 adults (aged 18-63), 17 adolescents (aged 14-18) and 20 children (aged 10-14) completed four 24-HRs (one per season) and two FFQs over a 1-year interval. Reproducibility of the FFQ was estimated by intraclass correlation coefficients (ICCs). The validity of FFQ was assessed by comparison with the four 24-HRs. RESULTS: For most nutrients, the first FFQ measurements gave higher mean values than the second FFQ. The ICCs for nutrients ranged from 0.39 for total protein to 0.83 for alcohol. The ICCs were higher for food items consumed daily such as milk (0.80) or sugars and confectionery (0.65), and lower for rarely eaten food such as inner organs (0.11). Nutrient intakes as assessed by FFQs were higher than those from the 24-HRs, except for alcohol. The de-attenuated Pearson's correlation coefficient for nutrients varied from 0.25 (dietary fiber) to 0.90 (alcohol), but the adjustment for energy did not improve these coefficients. When nutrient intakes were categorized into quintiles, FFQ and 24-HRs produced agreement rates (same or adjacent quintile) between 55% (for PUFA) and 95% (for alcohol), while misclassification to an extreme quintile was rare (<5%). CONCLUSION: The FFQ developed for the FLVS II Study can be used to classify adults or adolescents according to their nutrients and food intakes over a 1-year period.


Assuntos
Dieta , Inquéritos e Questionários , Adolescente , Adulto , Criança , Dieta/estatística & dados numéricos , Registros de Dieta , Inquéritos sobre Dietas , Ingestão de Energia , Feminino , França , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Adulto Jovem
17.
Eur J Clin Nutr ; 60(12): 1430-6, 2006 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-16823405

RESUMO

BACKGROUND: The description of growth patterns of the different anthropometric measurements mainly used in epidemiological studies is useful to better understand the development of obesity in children and its consequences. OBJECTIVE: Our aim was to establish growth curves of anthropometric indices in a general population of French children born during the 1980s and to compare them with the French reference curves based on children born in the 1950s. DESIGN: As part of the Fleurbaix Laventie Ville Santé Studies I and II (FLVS), 441 girls and 467 boys were examined at least twice between 1993 and 2001. Height, weight and four skinfold thicknesses were measured. Body mass index (BMI), sum of peripheral and truncal skinfolds and truncal-to-peripheral ratio were calculated. Mean growth curves from ages 5 to 17 years were assessed for these indices, calculating means and 95% confidence interval per 1 year age group and by gender. RESULTS: Trajectories with age differed importantly according to the index considered; BMI was the one with the smallest difference between genders and the most linear shape with age. From the age of 5 years and after, the FLVS children were on average taller and had a higher subcutaneous adiposity than children born 30 years earlier. Truncal-to-peripheral ratio was higher in our population; this difference became more marked with puberty in girls. DISCUSSION: This study suggests the existence of a secular trend towards a precocious accelerated growth, and a more truncal adiposity distribution, especially in girls. It is a disquieting trend considering its expected consequences on adult health.


Assuntos
Adiposidade/fisiologia , Composição Corporal/fisiologia , Crescimento , Obesidade/epidemiologia , Adolescente , Distribuição por Idade , Fatores Etários , Estatura/fisiologia , Índice de Massa Corporal , Peso Corporal/fisiologia , Criança , Pré-Escolar , Doença Crônica/epidemiologia , Feminino , França/epidemiologia , Humanos , Masculino , Valores de Referência , Fatores de Risco , Distribuição por Sexo , Dobras Cutâneas
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