Comparison of anthropometric measurements of adiposity in relation to cancer risk: a systematic review of prospective studies.

PURPOSE: In epidemiology, the relationship between increased adiposity and cancer risk has long been recognized. However, whether the association is the same for measures of abdominal or whole body adiposity is unclear. The aim of this systematic review is to compare cancer risk, associated with body mass index (BMI), an indicator of whole body adiposity, with indicators of abdominal adiposity in studies in which these indicators have been directly measured. METHODS: We conducted a systematic search from 1974 (EMBASE) and 1988 (PubMed) to September 2015 with keywords related to adiposity and cancer. Included studies were limited to cohort studies reporting directly measured anthropometry and performing mutually adjusted analyses. RESULTS: Thirteen articles were identified, with two reporting on breast cancer, three on colorectal cancer, three on endometrial cancer, two on gastro-oesophageal cancer, two on renal cancer, one on ovarian cancer, one on bladder cancer, one on liver and biliary tract cancer and one on leukaemia. Evidence suggests that abdominal adiposity is a stronger predictor than whole body adiposity for gastro-oesophageal, leukaemia and liver and biliary tract cancer in men and women and for renal cancer in women. Abdominal adiposity was a stronger predictor for bladder and colorectal cancer in women, while only BMI was a predictor in men. In contrast, BMI appears to be a stronger predictor for ovarian cancer. For breast and endometrial cancer, both measures were predictors for cancer risk in postmenopausal women. CONCLUSIONS: Only few studies used mutually adjusted and measured anthropometric indicators when studying adiposity-cancer associations. Further research investigating cancer risk and adiposity should include more accurate non-invasive indicators of body fat deposition and focus on the understudied cancer types, namely leukaemia, ovarian, bladder and liver and biliary tract cancer.

Effects of clustering of multiple lifestyle-related behaviors on blood pressure in adolescents from two observational studies.

BACKGROUD: Several lifestyle-related behaviors are associated with cardiovascular health outcomes in adolescents. To examine the associations between clustered lifestyle-related behaviors and blood pressure (BP) levels in adolescents. METHODS: Participants were recruited by multistage random cluster in two cross-sectional studies; one conducted in 2006 and 2007 in ten cities from nine European countries: Athens and Heraklion in Greece, Dortmund in Germany, Ghent in Belgium, Lille in France, Pécs in Hungary, Rome in Italy, Stockholm in Sweden, Vienna in Austria, and Zaragoza in Spain; and another conducted in 2007 one city in Brazil (Maringá/PR). Systolic BP (SBP) and diastolic BP (DBP) (outcomes) and clustered behaviors (weekly consumption of fruits and vegetables, weekly consumption of sugar-sweetened beverages, sleep duration, screen time and physical activity) were analyzed. RESULTS: The Healthy Eating cluster was negatively associated with DBP in European girls, ß=-2.46 (-4.62; -0.30), and with SBP in Brazilian boys, ß=-2.79 (-3.10; -0.15). Furthermore, the Unhealthy Eating cluster was associated with increased SBP in European girls, ß=4.54 (1.29; 7.79), and in Brazilian boys, ß=4.10 (0.80; 7.40). CONCLUSION: The Healthy Eating cluster was associated with lower blood pressure, whereas the Unhealthy Eating cluster was associated with increased SBP in adolescents.

Correlates of dietary energy misreporting among European adolescents: the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study.

This study examined the correlates of dietary energy under-reporting (UR) and over-reporting (OV) in European adolescents. Two self-administered computerised 24-h dietary recalls and physical activity data using accelerometry were collected from 1512 adolescents aged 12·5-17·5 years from eight European countries. Objective measurements of height and weight were obtained. BMI was categorised according to Cole/International Obesity Task Force (IOTF) cut-off points. Diet-related attitudes were assessed via self-administered questionnaires. Reported energy intake (EI) was compared with predicted total energy expenditure to identify UR and OV using individual physical activity objective measures. Associations between misreporting and covariates were examined by multilevel logistic regression analyses. Among all, 33·3 % of the adolescents were UR and 15·6 % were OV when considering mean EI. Overweight (OR 3·25; 95 % CI 2·01, 5·27) and obese (OR 4·31; 95 % CI 1·92, 9·65) adolescents had higher odds for UR, whereas underweight individuals were more likely to over-report (OR 1·67; 95 % CI 1·01, 2·76). Being content with their own figures (OR 0·61; 95 % CI 0·41, 0·89) decreased the odds for UR, whereas frequently skipping breakfast (OR 2·14; 95 % CI 1·53, 2·99) was linked with higher odds for UR. Those being worried about gaining weight (OR 0·55; 95 % CI 0·33, 0·92) were less likely to OV. Weight status and psychosocial weight-related factors were found to be the major correlates of misreporting. Misreporting may reflect socially desirable answers and low ability to report own dietary intakes, but also may reflect real under-eating in an attempt to lose weight or real over-eating to reflect higher intakes due to growth spurts. Factors influencing misreporting should be identified in youths to clarify or better understand diet-disease associations.

Comparison of different approaches to calculate nutrient intakes based upon 24-h recall data derived from a multicenter study in European adolescents.

PURPOSE: The European "Healthy Lifestyle in Europe by Nutrition in Adolescence" (HELENA) project evaluated two different approaches to harmonize the matching procedures between 24-h recall data and food composition databases. In the first approach, the 24-h recall data were linked to the local/national food composition databases using standardized procedures, while in the second approach, the 24-h recall data were linked to the German BLS database which includes a larger food list. The aim of this paper was to compare the intakes of energy and eight nutrient components calculated via both approaches. METHODS: Two non-consecutive 24-h recalls were performed in 1268 adolescents. Energy, carbohydrates, proteins, fat, fiber, water, alcohol, calcium and vitamin C were calculated via the two approaches at individual level. Paired samples t test and Pearson's correlations were used to compare the mean intakes of energy and the eight mentioned nutrients and to investigate the possible associations between the two approaches. RESULTS: Small but significant differences were found between the intakes of energy and the eight food components when comparing both approaches. Very strong and strong correlations (0.70-0.95) were found between both methods for all nutrients. CONCLUSION: The dietary intakes obtained via the two different linking procedures are highly correlated for energy and the eight nutrients under study.

Assessing Fat Mass of Adolescent Swimmers Using Anthropometric Equations: A DXA Validation Study.

PURPOSE: The aim of the present study was to determine which of the published anthropometric equations is the most appropriate to estimate body-fat percentage (BF%) in adolescent swimmers. METHOD: Eighty-eight swimmers (45 boys, 43 girls) participated in this study. Following the recommendations of the International Society of the Advancement of Kinanthropometry, biceps, triceps, subscapular, iliac-crest, supraspinale, front-thigh, and medial calf skinfold thicknesses were measured. Waist, hip, midthigh, calf, relaxed arm, and arm flexed and tensed girths were also registered. BF% was measured with dual-energy X-ray absorptiometry (DXA) to obtain the reference value. Existing anthropometric equations were applied, and BF% results obtained from anthropometric equations were compared to DXA BF% results with the modified Bland-Altman. RESULTS: The Flavel, Durnin-Rahaman-Siri, and Durnin-Rahaman-Brozek were the only equations that did not demonstrate statistically significant differences when compared with DXA. CONCLUSION: The present study showed that the best anthropometric equation from existing literature to estimate BF% in swimmers is that proposed by Durnin-Rahaman (independently of applying the Siri or Brozek equation).

VALIDITY OF A FOOD-FREQUENCY QUESTIONNAIRE FOR ESTIMATING CALCIUM INTAKE IN ADOLESCENT SWIMMERS.

INTRODUCTION: accurate estimates of the intake of specific nutrients such as calcium (Ca) are crucial to correctly rank or classify subjects in the distribution of intakes. Therefore, we aimed to estimate the relative validity of a food frequency questionnaire (FFQ) for measuring Ca intake in two different groups of healthy adolescents, a normoactive control group and a physically active group of swimmers with 2 non-consecutive 24h recalls (2 x 24HR) collected as the reference method. METHODS: Pearson correlations, agreement between the 24HR and the FFQ at an individual level and questionnaire's ability to assign individuals to the same quartile of intake as the 24HR were calculated. RESULTS: mean daily Ca intakes were 564.6 mg (SD 232.0) and 895.9 mg (SD 343.1) for the 2 x 24HR and FFQ respectively in controls (P < 0.001); and 731.9 mg (SD 299.8) and 979.8 mg (SD 408.5) for the 2 x 24HR and FFQ respectively in swimmers (P < 0.001). Pearson correlations were 0.52 for controls and 0.47 for swimmers after correcting for intra-variability. Cross-classification analysis indicated that 73.7% of controls and 63.1% of swimmers were classified correctly or in the adjacent category. Also, the 89% of the control group and 79% of swimmers were classified correctly with the FFQ according to the dietary reference intake (DRI) of 1300 mg/d. CONCLUSIONS: for both groups, the FFQ tended to overestimate Ca intake, however it demonstrated fairly good ability to classify subjects into extremes of Ca intake and identified adolescents having Ca intakes lower than the dietary reference intake.

Introducción: estimar correctamente la ingesta de calcio es crucial para conocer cómo se distribuye nutricionalmente la ingesta calórica a lo largo del día. Por lo tanto, el objetivo del presente trabajo fue validar un cuestionario de frecuencia de consumo para calcular la ingesta de calcio, mediante dos recordatorios de 24 horas, usado como método de referencia en un grupo control de adolescentes normo-activos y un grupo de adolescentes nadadores de alta competición. Metodología: la congruencia de los cuestionarios se estudio mediante correlación de Pearson y el estudio del acuerdo entre los dos métodos a nivel individual, así como la habilidad del cuestionario para clasificar a los sujetos en el mismo cuartil que los recordatorios de 24 horas. Resultados: la ingesta media diaria de calcio del grupo control fue 564,6 mg (DE 232,0) y 895,9 mg (DE 343,1) calculada mediante el recordatorio de 24 horas y el cuestionario, respectivamente (P < 0.001); y 731,9 mg (DE 299,8) y 979,8 mg (DE 408,5) en los nadadores mediante el recordatorio de 24 horas y el cuestionario, respectivamente (P < 0.001). Las correlaciones de Pearson fueron 0,52 para el grupo control y 0,47 para los nadadores después de corregir por intravariablidad. Los análisis de clasificación indicaron que el 73,7% de los controles y el 63,1% de los nadadores fueron clasificados correctamente o en la categoría contigua. El 89% de los controles y el 79% de los nadadores fueron clasificados correctamente según estuvieran por encima o por debajo de las recomendaciones de ingesta de calcio diarias (1.300 mg). Conclusiones: para ambos grupos, el cuestionario de frecuencia de consumo tiende a sobreestimar la ingesta de calcio, sin embargo demuestra ser un buen método para clasificar tanto a los sujetos de ingestas de calcio extremas, como a los sujetos que no cumplen las recomendaciones de calcio.

Validity of a food-frequency questionnaire for estimating calcium intake in adolescent swimmers / Validación de un cuestionario de frecuencia de consumo de alimentos para estimar la ingesta de calcio en adolescentes nadadores

Introduction: accurate estimates of the intake of specific nutrients such as calcium (Ca) are crucial to correctly rank or classify subjects in the distribution of intakes. Therefore, we aimed to estimate the relative validity of a food frequency questionnaire (FFQ) for measuring Ca intake in two different groups of healthy adolescents, a normoactive control group and a physically active group of swimmers with 2 non-consecutive 24h recalls (2 x 24HR) collected as the reference method. Methods: Pearson correlations, agreement between the 24HR and the FFQ at an individual level and questionnaire’s ability to assign individuals to the same quartile of intake as the 24HR were calculated. Results: mean daily Ca intakes were 564.6 mg (SD 232.0) and 895.9 mg (SD 343.1) for the 2 x 24HR and FFQ respectively in controls (P < 0.001); and 731.9 mg (SD 299.8) and 979.8 mg (SD 408.5) for the 2 x 24HR and FFQ respectively in swimmers (P < 0.001). Pearson correlations were 0.52 for controls and 0.47 for swimmers after correcting for intra-variability. Cross-classification analysis indicated that 73.7% of controls and 63.1% of swimmers were classified correctly or in the adjacent category. Also, the 89% of the control group and 79% of swimmers were classified correctly with the FFQ according to the dietary reference intake (DRI) of 1300 mg/d. Conclusions: for both groups, the FFQ tended to overestimate Ca intake, however it demonstrated fairly good ability to classify subjects into extremes of Ca intake and identified adolescents having Ca intakes lower than the dietary reference intake (AU)

Introducción: estimar correctamente la ingesta de calcio es crucial para conocer cómo se distribuye nutricionalmente la ingesta calórica a lo largo del día. Por lo tanto, el objetivo del presente trabajo fue validar un cuestionario de frecuencia de consumo para calcular la ingesta de calcio, mediante dos recordatorios de 24 horas, usado como método de referencia en un grupo control de adolescentes normo-activos y un grupo de adolescentes nadadores de alta competición. Metodología: la congruencia de los cuestionarios se estudió mediante correlación de Pearson y el estudio del acuerdo entre los dos métodos a nivel individual, así como la habilidad del cuestionario para clasificar a los sujetos en el mismo cuartil que los recordatorios de 24 horas. Resultados: la ingesta media diaria de calcio del grupo control fue 564,6 mg (DE 232,0) y 895,9 mg (DE 343,1) calculada mediante el recordatorio de 24 horas y el cuestionario, respectivamente (P < 0.001); y 731,9 mg (DE 299,8) y 979,8 mg (DE 408,5) en los nadadores mediante el recordatorio de 24 horas y el cuestionario, respectivamente (P < 0.001). Las correlaciones de Pearson fueron 0,52 para el grupo control y 0,47 para los nadadores después de corregir por intravariablidad. Los análisis de clasificación indicaron que el 73,7% de los controles y el 63,1% de los nadadores fueron clasificados correctamente o en la categoría contigua. El 89% de los controles y el 79% de los nadadores fueron clasificados correctamente según estuvieran por encima o por debajo de las recomendaciones de ingesta de calcio diarias (1.300 mg). Conclusiones: para ambos grupos, el cuestionario de frecuencia de consumo tiende a sobreestimar la ingesta de calcio, sin embargo demuestra ser un buen método para clasificar tanto a los sujetos de ingestas de calcio extremas, como a los sujetos que no cumplen las recomendaciones de calcio (AU)