Prevalence of stunting and associated factors among public primary school pupils of Bahir Dar city, Ethiopia: School-based cross-sectional study.

BACKGROUND: Stunting is a well-established child-health indicator of chronic malnutrition, which reliably gives a picture of the past nutritional history and the prevailing environmental and socioeconomic circumstances. OBJECTIVE: To investigate the prevalence of stunting and associated factors among public primary school children of the Bahir Dar city. METHOD: A cross-sectional study was carried out from March to June 2019. Data were coded and entered into the Epi-Data and exported to SPSS version 23 software. The pupil was stunted if the height- for-age was ≤ -2 SDs from the median growth standards according to the WHO. A descriptive summary was computed using frequency, percent, mean, median and standard deviation. A simple logistic regression model was fitted to identify associated factors between the independent variables and the dependent variable at a 95% confidence interval (CI) and p-value <0.05. RESULTS: 370 primary school pupils were included in the study with the mean age of 10.15 (± 2.23 SD) years. 51.6% of the pupils were females. The total prevalence of stunting was 15.13% (95%CI; 11%, 19%). The burden of stunting was higher in the age group of 11 years and older. Pupil's age older than 11 years (AOR = 15. 6; 95%CI; 3.31, 73.45; p-value < 0. 001) and male sex (AOR = 7. 07; 95%CI: 2.51, 19.89; p-value < 0. 0002) were significantly associated with stunting. CONCLUSION: The prevalence of stunting was relatively lower than the regional estimated stunting level. Older age and male sex were significantly associated with stunting.

Folate and Cobalamin Serum Levels in Healthy Children and Adolescents and Their Association with Age, Sex, BMI and Socioeconomic Status.

This study proposes age- and sex-specific percentiles for serum cobalamin and folate, and analyzes the effects of sex, age, body mass index (BMI), and socioeconomic status (SES) on cobalamin and folate concentrations in healthy children and adolescents. In total, 4478 serum samples provided by healthy participants (2 months-18.0 years) in the LIFE (Leipzig Research Centre for Civilization Diseases) Child population-based cohort study between 2011 and 2015 were analyzed by electrochemiluminescence immunoassay (ECLIA). Continuous age-and sex-related percentiles (2.5th, 10th, 50th, 90th, 97.5th) were estimated, applying Cole's LMS method. In both sexes, folate concentrations decreased continuously with age, whereas cobalamin concentration peaked between three and seven years of age and declined thereafter. Female sex was associated with higher concentrations of both vitamins in 13- to 18-year-olds and with higher folate levels in one- to five-year-olds. BMI was inversely correlated with concentrations of both vitamins, whilst SES positively affected folate but not cobalamin concentrations. To conclude, in the assessment of cobalamin and folate status, the age- and sex-dependent dynamic of the respective serum concentrations must be considered. While BMI is a determinant of both vitamin concentrations, SES is only associated with folate concentrations.

Relación entre adiposidad corporal y aptitud aeróbica en adolecentes de la Isla de Santiago (Cabo Verde) / Relationship between body fat and aerobic fitness in adolescents from the Island of Santiago (Cape Verde)

INTRODUCCIÓN: El exceso de adiposidad corporal, generalmente se considera como un factor negativo en el rendimiento de la salud. El objetivo del trabajo fue comparar los niveles de adiposidad corporal y aptitud aeróbica con estudios referenciales y verificar la relación entre adiposidad corporal con la aptitud aeróbica de adolescentes. MÉTODOS: Se efectuó un estudio descriptivo comparativo-correlacional. Fueron estudiados 113 adolescentes con un rango de edad entre 12,0 a 16,9 años (89 hombres y 113 mujeres). Se evaluó el peso, la estatura, circunferencia de la cintura CC y la aptitud aeróbica AE por medio de la prueba de la Milla. Se calculó el Índice de Masa Corporal IMC y VO2max (ml/kg/min). RESULTADOS: En los hombres, los valores del IMC son inferiores desde -11.60 a -13.50kg/m2, en la CC desde -9,80 a -15,90cm En las mujeres, el IMC es inferior desde -3.90 a -5.20 kg/m2 y en la CC desde -2,40 a -5,40cm. En la AE, el VO2max fue superior a la referencia, en hombres los valores oscilan entre 4,20 a 9,50 ml/kg/min y en mujeres oscilaron desde 3,90 a 5,60ml/kg/min. Las correlaciones entre IMC y CC con VO2max en hombres son de (r= -0,62 a -0,58; p < 0,001) y en mujeres fue de (r= -0,83 a -0,81; p < 0,001). CONCLUSIÓN: Los parámetros de adiposidad corporal fueron inferiores y los niveles de aptitud aeróbica fueron superiores en comparación con sus respectivas referencias. Además, se observó correlación negativa entre ambas variables

INTRODUCTION: Excess body fat is generally considered to be a negative factor in physical performance. OBJECTIVE: To compare the levels of body fat and aerobic fitness with reference studies and to verify the relationship between body fat and aerobic fitness in adolescents. MATERIAL AND METHODS: A descriptive comparative-correlational study was carried out. A total of 113 adolescents were studied, ranging in age from 12.0 to 16.9 years old (89 malesand 113 females). Weight, height, CC waist circumference and aerobic fitness (AA) were evaluated by means of the Mile test. Body Mass Index (BMI) and VO2max (ml/kg/min-1) were calculated. RESULTS: In men, BMI values are lower from -11.60 to -13.50kg/m2, in the CC from -9.80 to -15.90cm. In women, BMIis lower from -3.90 to -5.20 kg/m2 and in the CC from -2.40 to-5.40cm. In the AA, the VO2max was higher than the reference, in men the values ranged from 4.20 to 9.50 ml/kg/min and in women they ranged from 3.90 to 5.60 ml/kg/min. Correlations between BMI and CC with VO2max in men were negative (r= -0.62 to -0.58; p < 0.001) and in women it was (r= -0.83to -0.81; p < 0.001). It was verified that adolescents classified as overweight presented lower values of AA in relation to normopause and underweight. This indicates that adolescents should reflect acceptable adiposity values, not only to adequately maintain their nutritional status, but also to improve their cardiorespiratory capacity. CONCLUSION: Body adiposity parameters were lower and EC levels were higher compared to their respective references. Furthermore, it was observed that EC is inversely associated with body fat indicators in adolescents of both sexes

Impact of Strategies for Preventing Obesity and Risk Factors for Eating Disorders among Adolescents: A Systematic Review.

An effective behavior change program is the first line of prevention for youth obesity. However, effectiveness in prevention of adolescent obesity requires several approaches, with special attention paid to disordered eating behaviors and psychological support, among other environmental factors. The aim of this systematic review is to compare the impact of two types of obesity prevention programs, inclusive of behavior change components, on weight outcomes. "Energy-balance" studies are aimed at reducing calories from high-energy sources and increasing physical activity (PA) levels, while "shared risk factors for obesity and eating disorders" focus on reducing disordered eating behaviors to promote a positive food and eating relationship. A systematic search of ProQuest, PubMed, PsycInfo, SciELO, and Web of Science identified 8825 articles. Thirty-five studies were included in the review, of which 20 regarded "energy-balance" and 15 "shared risk factors for obesity and eating disorders". "Energy-balance" studies were unable to support maintenance weight status, diet, and PA. "Shared risk factors for obesity and eating disorders" programs also did not result in significant differences in weight status over time. However, the majority of "shared risk factors for obesity and eating disorders" studies demonstrated reduced body dissatisfaction, dieting, and weight-control behaviors. Research is needed to examine how a shared risk factor approach can address both obesity and eating disorders.

Dietary Patterns of Adolescents from the Chilean Growth and Obesity Cohort Study Indicate Poor Dietary Quality.

Diet during adolescence can have lasting effects on nutritional status, health, and development. We hypothesized that dietary patterns with low-quality nutrition are associated with overweightness. We collected data for 882 Chilean adolescents from the Growth and Obesity Cohort Study (mean age: 12 years). Dietary intake was assessed through 24-h recalls and weight status data were obtained during clinical visits. Dietary patterns were obtained through exploratory factor analysis. Multiple logistic regression models were used to examine cross-sectional associations between dietary patterns and overweight (BMI z-score ≥ 1SD). Four dietary patterns were identified: "Breakfast/Light dinner", "Natural foods", "Western", and "Snacking". "Breakfast/Light dinner", "Western", and "Snacking" patterns provided higher energy and excess nutrients (sodium, saturated fat, and added sugar). Moreover, adolescents with higher adherence to "Western" or " Snacking" patterns (third tertile) had higher odds of being classified as overweight (OR = 1.67; 95%CI: 1.103-2.522 and OR = 1.86; 95%CI: 1.235-2.792, respectively) than those with lower adherence (first tertile). "Natural foods" pattern was also associated with overweightness (OR = 1.83; 95%CI: 1.219-2.754). These dietary patterns were associated with overconsumption of nutrients of public health concern. Three of the four main dietary patterns were associated with overweightness. These results highlight the need of prioritizing adolescents on obesity prevention strategies.

Reproducibility and Validity of a Food Frequency Questionnaire for Dietary Assessment in Adolescents in a Self-Reported Way.

Tools to assess diet in a reliable and efficient way are needed, particularly in children and adolescents. In this study, we assess the reproducibility and validity of a semiquantitative food frequency questionnaire (FFQ) among adolescents in Spain. We analyzed data of 51 male adolescents aged 15-17 years from a prospective birth cohort study. Participants answered the FFQ twice in a self-administered way over a 12-month period. Reproducibility was assessed by comparing nutrient and food intakes from the FFQs, and validity by comparing nutrient intakes from the average of two FFQs and the average of two 24-Hour Dietary Recalls obtained in the period. Pearson correlation coefficients were calculated. The average of reproducibility correlation coefficients for food group intakes was 0.33, with the highest correlation for vegetable intake (r = 0.81); and the average for nutrient intake was 0.32, with the highest coefficients for α- and ß-carotene (r = 0.65). Validity correlation coefficients ranged from 0.07 for carbohydrates to 0.53 for dietary fiber. The average of the validity correlation coefficients was r = 0.32. This study suggests that our FFQ may be a useful tool for assessing dietary intake of most nutrient and food groups among Spanish male adolescents in a self-administered way, despite reproducibility and, particularly validity, being low for some nutrients and food groups.

The longitudinal relationship between dietary intake, physical activity and muscle strength among adolescents.

The longitudinal relationship between muscle strength, dietary intake and physical activity among adolescents is not well understood. We investigated the trend and longitudinal effects of dietary intakes and physical activity scores on muscle strength in adolescents. This prospective cohort study consisted of 436 adolescents (134 males; 302 females) aged 13 years at baseline (2012) who were followed up at the ages of 15 (2014) and 17 (2016) years, respectively. We measured muscle strength using a calibrated hand dynamometer, estimated dietary intake with a 7-d dietary history and physical activity scores with a validated physical activity questionnaire for older children. A generalised estimating equation was used to examine the effect of dietary intakes and physical activity on muscle strength changes. The analysis was performed separately by sex. The muscle strength for males and females had increased within the 5-year period. The dietary intakes (energy and macronutrients) also increased initially but plateaued after the age of 15 years for both sexes. Females recorded a significant declining trend in physical activity scores compared with males as they grew older. A significant positive longitudinal relationship was found between protein (ß = 0·035; P = 0·016), carbohydrate intake (ß = 0·002; P = 0·013) and muscle strength among males. However, no longitudinal relationship was found between dietary intake, physical activity and muscle strength among females. Higher protein and carbohydrate intake among males was associated with higher muscle strength but was not observed in females. Nutrition and physical activity focusing on strength building are required in early adolescence and need to be tailored to males and females accordingly.

Systems Nutrology of Adolescents with Divergence between Measured and Perceived Weight Uncovers a Distinctive Profile Defined by Inverse Relationships of Food Consumption.

Changes in food consumption, physical inactivity, and other lifestyle habits are potential causes of the obesity epidemic. Paradoxically, the media promotes idealization of a leaner body appearance. Under these circumstances, self-perception of weight by adolescents may be affected. Here, we performed a cross-sectional study, between June and December 2009, to evaluate the interaction between anthropometric status, perceived body weight, and food consumption profiles in 1496 adolescents from public schools in Salvador, Brazil. Data on socio-epidemiological information, anthropometric status, and dietary patterns were analyzed using multidimensional statistical approaches adapted from systems biology. There were dissimilarities between anthropometric status and perception of body weight related to sex. Four dietary patterns were identified based on the food intake profile in the study participants. The distinct dietary patterns were not influenced by divergence between measured and perceived weight. Moreover, network analysis revealed that overestimation of body weight was characterized by a selectivity in ingestion of food groups that resulted in appearance of inverse correlations of consumption. Thus, misperception of body weight is associated with inverse correlations of consumption of certain food groups. These findings may aid individualized nutritional interventions in adolescents who overestimate body weight.

Low-carbohydrate interventions for adolescent obesity: Nutritional adequacy and guidance for clinical practice.

Low-carbohydrate dietary patterns are re-emerging as a popular method of weight reduction. However, their nutritional adequacy to meet the needs of growing adolescents should be considered. This study aimed to design theoretical low-carbohydrate meal plans for clinical use in the management of adolescent obesity and assess nutritional adequacy. Meal plans were created for three levels of carbohydrate restriction (≤30, ≤50 and ≤120 g/day) without energy, protein or total fat restriction. Nutrient analysis was conducted using the FoodWorks Australia Ltd software (databases: AUSNUT 2013, AusBrands 2017, AusFoods 2017, NUTTAB 2010, New Zealand FOODfiles 2016), and compared with Australian Nutrient Reference Values for male and female adolescents aged 14 to 18 years. All low-carbohydrate meal plans met the Recommended Dietary Intake, Adequate Intake or Estimated Average Requirements for most micronutrients at an energy intake of 6.3 to 7.2 MJ/day (1510-1730 kcal/day). The proportion of energy from saturated fat exceeded recommendations across all models (11.3%-17.1%). Dietary manipulation was required to minimize saturated fat and reach micronutrient adequacy, particularly for calcium in males and females, and iron for females. In practice, this may be challenging considering individual lifestyle and preferences. Therefore, the use of low-carbohydrate diets with adolescents should be monitored by a trained professional to ensure nutritional adequacy.

Vitamin D Supplementation and Blood Pressure in Children and Adolescents: A Systematic Review and Meta-Analysis.

Suboptimal vitamin D status is associated with elevated blood pressure (BP) in children and adolescents. Whether vitamin D supplementation reduces BP remains unclear. To systematically review whether vitamin D supplementation reduces BP in children and adolescents, we conducted a literature review according to the PRISMA statement. We included vitamin-D supplementation human interventions studies that reported on BP as an outcome. We searched PUBMED, MEDLINE, CINAHL, EMBASE, the Cochrane Library, and the clinical trials website. We also hand searched the references of the included articles and previous reviews of vitamin D therapy. No language or time restrictions were applied. We extracted data on population characteristics, baseline and endline vitamin D and BP values, and assessed the risk of bias of the included studies. We performed a narrative review of the findings, conducted a meta-analysis when possible, and performed sensitivity analyses to test the robustness of our results. We assessed the overall quality of the evidence produced in the meta-analysis. We included eight studies in our review and five studies in the meta-analysis, none of which included hypertensive only participants. The risk of bias was variable. In non-randomized studies, no effect of vitamin D supplementation was seen on systolic BP (SBP) (mean difference: 0.39 (95% confidence interval (CI): -0.9; 1.68) mmHg; p = 0.55; I2 = 0%). Only a significant decrease in diastolic BP (DBP) (mean difference: -1.87 (95% CI: -3.02; -0.72) mmHg; p = 0.001; I2 = 0%) was noted. Both analyses had a low quality of evidence. In randomized controlled trials (RCTs), no effect was noted on SBP (mean difference: -2.04 (95% CI: -5.12; 1.04) mmHg; p = 0.19; I2 = 71%) nor DBP (mean difference: 0.01 (95% CI: -1.09; 1.12) mmHg; p = 0.98; I2 = 0%). The final quality of evidence ranged between low and moderate. Sensitivity analyses did not affect the results. Vitamin D supplementation was found to be ineffective in lowering SBP and DBP in children and adolescents.

Iodine Status of Brazilian School-Age Children: A National Cross-Sectional Survey.

Salt iodization is the main public health policy to prevent and control iodine deficiency disorders. The National Salt Iodization Impact Assessment Survey (PNAISAL) was conducted to measure iodine concentration among Brazilian schoolchildren. A survey including 6-14-year-old schoolchildren from public and private schools from all 26 Brazilian states and the Federal District was carried out in the biennia 2008-2009 and 2013-2014. Municipalities, schools, and students were randomly selected. Students were interviewed at school using a standard questionnaire, which included the collection of demographic, educational, weight, height, and 10 mL non-fasting urine collection information. The analyses were weighted according to the population of students per federative unit. The median urinary iodine concentration (MUIC) for the entire sample by region, federative unit per school, and student characteristics, was described from the cutoff points defined by the World Health Organization (severe disability: <20 µg/L, moderate: 20-49 µg/L, mild: 50-99 µg/L, adequate: 100-199 µg/L, more than adequate: 200-299 µg/L, and excessive: >300 µg/L). In total, 18,864 students (95.9% of the total) from 818 schools in 477 municipalities from all federative units were included in this study. Almost 70% were brown skin color, nine-years-old or older, studied in urban schools, and were enrolled in elementary school. The prevalence of overweight/obesity, as measured by body mass index (BMI) for age, was about twice as high compared to nutritional deficits (17.3% versus 9.6%). The MUIC arrived at 276.7 µg/L (25th percentile = 175.5 µg/L and 75th percentile = 399.71 µg/L). In Brazil as a whole, the prevalence of mild, moderate, and severe deficit was 6.9%, 2.6%, and 0.6%, respectively. About one-fifth of the students (20.7%) had adequate iodine concentration, while 24.9% and 44.2% had more than adequate or excessive concentration, respectively. The prevalence of iodine deficits was significantly higher among younger female students from municipal public schools living in rural areas with the lowest BMI. The median urine iodine concentration showed that Brazilian students have an adequate nutritional intake, with a significant proportion of them evidencing overconsumption of this micronutrient.

Impact of Bean Consumption on Nutritional Outcomes amongst Adolescents.

Brazilian adolescents have undergone a noteworthy nutritional epidemiological transition. There is an increase in the prevalence of overweight and high consumption of ultra-processed foods in parallel with patterns of traditional meals that include beans. This study analyzed associations between bean consumption in the diet of adolescents and nutrition outcomes. Multiple regression analysis showed a significant reduction in body mass index (BMI), body fat percentage (%BF) and LDL-cholesterol (LDL-c) values among those with bean consumption equal to or greater than five times a week. Adolescents who had lunch outside the home and those who did not have the habit of having lunch showed a significantly higher BMI. There was an increase in the %BF among married adolescents and those who did not have lunch. There was a reduction of LDL-c among those with intermediate per capita income and those who consumed processed juice less than 5 times a week, and an increase among those who did not have breakfast. There were significant interactions between sexual maturation, energy consumption, physical activity and energy consumption. Thus, in the context of this study, the presence of beans in the diet, at frequencies equal to or greater than five times a week, can be considered a proxy for healthy eating.

Association between the Degree of Processing of Consumed Foods and Sleep Quality in Adolescents.

The aim of this study was to evaluate the association between food consumption by the degree of processing and sleep quality in adolescents from São Luís, Maranhão, Brazil. A cross-sectional study with 2499 adolescents (aged 18 to 19 years) was developed. Exposure variables included energy contributions of food groups stratified by the NOVA classification: fresh or minimally processed foods (FMPF), processed foods (PF), and ultra-processed foods (UPF), categorized into quartiles. The outcome variable was sleep quality assessed with the Pittsburgh Sleep Quality Index. Associations between these variables were estimated by Poisson regression, with robust estimation of variance. Most of the adolescents had poor sleep quality (57.1%). There were associations between FMPF in the third (57.1%-66.0% of total calories; prevalence ratio PR = 0.88; 95% CI: 0.80, 0.97) and fourth quartile (66.1%-95.8% of total calories; PR = 0.87; 95% CI: 0.78, 0.96) and lower prevalence of poor sleep quality. The fourth quartile of UPF (44.3%-81.8% of total calories; PR = 1.14; 95% CI: 1.03, 1.27) was associated with a higher prevalence of poor sleep quality. Higher intake of FMPF is a protective factor for poor sleep quality, whereas higher UPF consumption is a risk factor for poor sleep quality.

Relative validation of the adapted Mediterranean Diet Score for Adolescents by comparison with nutritional biomarkers and nutrient and food intakes: the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study.

OBJECTIVE: To investigate whether adherence to the adapted Mediterranean Diet Score for Adolescents (MDS_A) and the adapted Mediterranean Diet Quality Index for Adolescents (KIDMED_A) is associated with better food/nutrient intakes and nutritional biomarkers. DESIGN: The Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study is a cross-sectional study aiming to obtain comparable data on a variety of nutritional and health-related parameters in European adolescents aged 12·5-17·5 years. SETTING: Nine European countries. PARTICIPANTS: European adolescents (n 2330) recruited to the HELENA study. Dietary intake was obtained with 24 h dietary recalls, an FFQ and a Food Choices and Preferences questionnaire. MDS_A was calculated as a categorical variable using cut-offs (MDS_A), as a continuous variable (zMDS_A) and with energy adjustments (zEnMDS_A). The KIDMED_A score was also calculated. RESULTS: Multilevel linear regression analysis showed positive associations for zMDS_A and KIDMED_A with serum levels of vitamin D, vitamin C, plasma folate, holo-transcobalamin, ß-carotene and n-3 fatty acids, while negative associations were observed with trans-fatty acid serum levels. For categorical indices, blood biomarkers showed few significant results. zMDS_A and KIDMED_A showed positive associations with vegetables and fruits intake, and negative associations with energy-dense and low-nutritious foods. zMDS_A and KIDMED_A were positively associated with all macronutrients, vitamins and minerals (all P < 0·0001), except with monosaccharides and PUFA for KIDMED_A and cholesterol for both indices (P < 0·05). CONCLUSIONS: zMDS_A and KIDMED_A have shown the strongest associations with the dietary indicators and biomarkers that have been associated with the Mediterranean diet before, and are therefore considered the most appropriate and valid Mediterranean diet scores for European adolescents.

Dietary inflammatory index® and cortical bone outcomes in healthy adolescent children.

Diet is thought to modulate inflammation. This study shows no relationships between the dietary inflammatory index (DII) and biomarkers of inflammation or bone after adjusting for covariates. Monocyte chemoattractant protein-1 was inversely associated with peripheral tibia cortical thickness and prospective childhood studies should be conducted to better understand this relationship and to determine if there are long-term consequences in adulthood. INTRODUCTION: Examine the relationships between the DII-scores and bone and biomarkers of inflammation in 290 adolescents, ages 9-13 years. METHODS: DII-scores were calculated from 3-day diet records and categorized into tertiles, low (< - 1.34), medium (- 1.34 to 1.41), and high (> 1.41) inflammation. Radius and tibia bone were assessed via peripheral quantitative computed tomography (Stratec XCT 2000) at the 66% site relative to the distal growth plate. Fasting serum was measured for tumor necrosis factor alpha (TNF-α), interleukin-6 (IL-6), vascular endothelial growth factor (VEGF), and monocyte chemoattractant protein-1 (MCP-1). The relationships between DII-scores and bone and biomarkers of inflammation were assessed using bivariate and partial correlations adjusting for sexual maturation, sex, race, muscle cross-sectional area, and height. ANOVA/ANCOVA models were used to compare DII-tertiles with dependent variables. RESULTS: DII-scores were negatively associated with tibia trabecular area (TtAr; r = - .141, P = .019), periosteal perimeter (PsPM; r = - .145, P = .016), endosteal perimeter (r = - .145, P = .016), strength strain index (SSI; r = - .129, P = .032), and radius TtAr (r = - .140, P = .020), PsPM (r = -.138, P = .027) and SSI (r = -.131, P = .036) but nullified when adjusting for covariates. Tibia PsPM was higher in the low DII group compared to the medium (P = .050) and high (P = .046) groups but nullified after controlling for covariates. DII-scores were not associated with TNF-α, VEGF, or IL-6, but were associated with MCP-1 only in the unadjusted model (r = .125, P = .042). In the adjusted model, MCP-1 was inversely associated with tibia cortical thickness (r = -.150 P = .030). CONCLUSION: The DII-scores were not related to biomarkers of inflammation or bone; however, the biomarker of inflammation, MCP-1 was negatively associated with tibia CtTh. Future prospective pediatric studies should be conducted to better understand this relationship and determine if there are long-term implications in adulthood.

Feasibility of a Family Meal Intervention to Address Nutrition, Emotional Wellbeing, and Food Insecurity of Families With Adolescents.

OBJECTIVE: To assess the feasibility of a family meal intervention to address indicators of parent and adolescent nutrition and well-being and household food security. METHODS: Nine adolescents and a parent/caregiver were recruited from a youth health clinic. Families were provided with meal plans, recipes, and ingredients for 5 meals weekly for 4 weeks. Participants completed baseline and follow-up surveys and open-ended interviews. RESULTS: Overall, fidelity to the intervention was high among families; the frequency of family meals increased by approximately 2 meals/wk. Both parent/caregivers and adolescents reported improvements to nutrition (4 of 9 increased vegetable consumption for both) and most reported improvements to mental well-being. Household food insecurity also reduced during the intervention (means of 8.2 and 0.2 at baseline and follow-up, respectively). CONCLUSIONS AND IMPLICATIONS: Providing families with meal plans, recipes, and ingredients is an acceptable way to increase weekly frequency of family meals. Future research may consider the family meal as a way to engage with families about broader concerns.

Mediterranean diet, diet quality, and bone mineral content in adolescents: the HELENA study.

Dietary scores, rather than individual nutrients, allow exploring associations between overall diet and bone health. The aim of the present study was to assess the associations between the Mediterranean Diet Score for Adolescents (MDS-A) and the Diet Quality Index for Adolescents (DQI-A) and bone mineral content (BMC) among Spanish adolescents. Our results do not support an association between dietary scores or indices and BMC in adolescents. INTRODUCTION: To assess the associations between the MDS-A and a DQI-A with the BMC measured with dual-energy X-ray absorptiometry. METHODS: The MDS-A and the DQI-A were calculated in 179 Spanish adolescents, based on two 24-h dietary recalls from the HELENA cross-sectional study. The associations between the diet scores and the BMC outcomes [total body less head (TBLH), femoral neck (FN), lumbar spine (LS), and hip] were analyzed using logistic regression models adjusting for several confounders. RESULTS: Four hundred ninety-two models were included and only fruits and nuts and cereal and roots were found to provide significant ORs with regard to BMC. The risk of having low BMC reduced by 32% (OR 0.684; CI 0.473-0.988) for FN when following the ideal MDS-A, but this association lost significance when adjusting for lean mass and physical activity. For every 1-point increase in the cereal and root and the fruit and nut components, the risk of having low FN diminished by 56% (OR 0.442; CI 0.216-0.901) and by 67% (OR 0.332; CI 0.146-0.755), respectively. CONCLUSION: An overall dietary score or index is not associated with BMC in our adolescent Spanish sample.

Risk behavior patterns for chronic diseases and associated factors among adolescents / Patrones de comportamiento de riesgo para enfermedades crónicas y factores asociados entre adolescentes

Background/objective: Simultaneous engagement in risk behaviors for chronic non-communicable diseases (NCDs) might exert a synergistic effect on adolescent health. This study aimed to identify risk behavior patterns for NCDs in adolescents and analyze associated factors. Methods: Cross-sectional study conducted between 2009 and 2011, with 1,716 participants aged 10-17 years of a cohort study in Central-West Region, Brazil. Demographic, economic, anthropometric, and lifestyle characteristics were collected. Risk behaviors evaluated were alcohol consumption, tobacco experimentation, insufficient physical activity, sedentary behavior, skipping breakfast, and low diet quality. Principal component analysis was used to identify patterns of risk behaviors and multiple linear regression analysis to quantify the association between independent variables and patterns of risk behavior. Results: Three patterns of risk behaviors were identified: «legal drugs», «diet and screens», and «silent». After adjustment, legal drugs pattern showed direct association with age (β = 0.13; 95% CI = 0.09; 0.16) and inverse association with maternal education (β = -0.07; 95% CI = -0.14; -0.01). Diet and screens pattern were directly associated with female gender (β = 0.14; 95% CI = 0.04; 0.23), age (β = 0.11; 95% CI = 0.08; 0.14), and economic class (β = 0.15; 95% CI = 0.04; 0.25). Silent pattern was directly associated with maternal education (β = 0.09; 95% CI = 0.03; 0.15), being overweight (β = 0.17; 95% CI = 0.06; 0.28), and female gender (β = 0.32; 95% CI= 0.22; 0.41). Conclusions: Three risk behavior patterns were identified and the associated factors were socioeconomic status, age, and female gender (AU)

Introducción/objetivo: la participación simultánea en los comportamientos de riesgo para las enfermedades no transmisibles (ENT) podría ejercer un efecto sinérgico sobre la salud de los adolescentes. El propósito del estudio fue identificar patrones de comportamiento de riesgo para las ENT en adolescentes y analizar factores asociados. Métodos: se realizó un estudio transversal entre 2009-2011, con 1.716 participantes de entre 10 y 17 años, de un estudio de cohorte en la Región Centro-Oeste, Brasil. Se recogieron las características demográficas, económicas, antropométricas y de estilo de vida. Los comportamientos de riesgo evaluados fueron el consumo de alcohol, la experimentación con el tabaco, la actividad física insuficiente, el comportamiento sedentario, omitir el desayuno y la baja calidad de la dieta. El análisis de componentes principales se utilizó para identificar patrones de comportamientos de riesgo y el análisis de regresión lineal múltiple para cuantificar la asociación entre las variables independientes y los patrones de comportamiento de riesgo. Resultados: Se identificaron tres patrones de comportamientos de riesgo: «drogas legales», «dieta y pantallas» y «omisión». Después del ajuste, el patrón de drogas legales mostró asociación directa con la edad (β = 0,13; IC del 95% = 0,09; 0,16) e inverso con la educación materna (β = -0,07; IC del 95% = -0,14; -0,01). El patrón de dieta y pantallas se asoció directamente con el sexo femenino (β = 0,14; IC del 95% = 0,04; 0,23), la edad (β = 0,11; IC del 95% = 0,08; 0,14) y la clase económica (β = 0,15; IC del 95% = 0,04; 0,25). El patrón de omisión se relacionó directamente con la educación materna (β = 0,09; IC del 95% = 0,03; 0,15), el sobrepeso (β = 0,17; IC del 95% = 0,06; 0,28) y el sexo femenino (β = 0,32; IC del 95% = 0,22; 0,41). Conclusiones: se identificaron tres patrones de comportamiento de riesgo y los factores asociados fueron el nivel socioeconómico, la edad y el sexo femenino (AU)

Are milk and alternatives and fruit and vegetable intakes during adolescence associated with cortical and trabecular bone structure, density, and strength in adulthood?

We investigated the impact of food group intake during adolescence on bone structure and strength during adulthood. In females, we found a beneficial effect of adolescent milk and alternatives and fruit and vegetable intake on adult radius shaft and distal tibia bone structure, respectively. No association was observed in males. INTRODUCTION: The purpose of this study was to investigate whether adolescents with high intake of milk and alternatives (M&A) or fruit and vegetables (F&V) had better adult bone structure and strength compared to those with low intake levels. METHODS: We analyzed data from 47 males and 69 females enrolled in the Pediatric Bone Mineral Accrual Study (PBMAS 1991-2011), who had one peripheral quantitative computed tomography scan at age 29 ± 2 years. We measured radius and tibia shaft total area (ToA), cortical area (CoA), cortical content (CoC), cortical density, bone strength (SSIp), and muscle area, as well as distal radius and tibia ToA, total density, trabecular area, trabecular content, trabecular density, and bone strength (BSIc). Sequential 24-h recalls were used to assess M&A and F&V intake; participants were grouped for their mean intake during adolescence (low = bottom quartile, moderate = middle quartiles, high = top quartile) and were compared using multivariate analysis of covariance while adjusting for adult height, muscle area, physical activity, energy and calcium intake and adolescent energy intake, and physical activity. RESULTS: Females with high M&A intake compared to low M&A intake group (mean 3.8 vs. 1.3 servings/day, respectively) had greater adult ToA (14 %, p < 0.05), CoA (15 %, p < 0.01), and CoC (16 %, p < 0.01) at radius shaft. Females with moderate F&V intake compared to low F&V intake group (mean 3.7 vs. 2.1 servings/day, respectively) had greater adult ToA (8.5 %, p < 0.05) at distal tibia. CONCLUSION: Higher intake of M&A or F&V during adolescence had a long-term beneficial effect on bone structure in females, an association not observed in males.

Los avatares de la ausencia las conductas de dependencia en la adolescencia / The avatars of the absence: adolescents´dependent behaviours

El autor aborda el estudio de toda una serie de conductas dependientes en la adolescencia (dependencia de drogas o alcohol, pero también de determinadas conductas alimentarias o de tentativas de suicidio reiteradas) que emergen en el momento en que se ha de producir el proceso de consolidación identitaria, con toda su vertiente psíquica y física, en que se asienta la genitalidad y se renuncia a la bisexualidad. Considera básico para que el proceso pueda darse con garantías que la relación con el objeto primario en los primeros tiempos haya permitido una adecuada superación de la separación-individuación, así como una buena sucesión de movimientos identificatorios. Cuando la citada relación es fallida, el adolescente se confronta con la clínica del vacío y las conductas de dependencia le permiten intentar retomar un control activo de la situación, siendo su objeto de dependencia más manejable, pero llevándole a dinámicas de riesgo que pueden poner en peligro su vida, pero también poner en jaque y en movimiento a todo su entorno. Tales conductas pueden aparecer como una manifestación más de trastornos psiquiátricos mayores, pero también presentarse en formas difíciles de encuadrar nosotáxicamente, siendo su particular dinámica el centro de interés del presente trabajo (AU)

The author evaluates a whole series of dependent behaviours in teenagers (drugs or alcohol dependence, but also sorne feeding conducts or repetitive autolytic attempts) which emerge in the moment where the process of self-identity consolidation takes place. This includes not only the physical but also the psychical component, that consolidates the genitality and gives up bisexuality. He considers essential for this process to be guaranteed the first relationship with the primary object, that allows a right overcome of separation-individuation, as well as a good succession of identification movements. When this relationship with the mother has failed, the adolescent has to face the emptiness clinic, and the dependent behaviours allow him or her to gain an active control of the situation. The dependency object is easier to manage, but it can lead the adolescent to risk dynamics, where he can endanger his life, but also involving all his environment. These behaviours may be considered as other manifestations of mayor psychiatnc disorders, but some other times can also be clinical forms difficult to classify. These singular situations make up the focus of the present work (AU)