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M Cuenca-García,
F B Ortega,
J R Ruiz,
M González-Gross,
I Labayen,
R Jago,
D Martínez-Gómez,
J Dallongeville,
S Bel-Serrat,
A Marcos, [......],
C Breidenassel, K Widhalm,
F Gottrand,
M Ferrari,
A Kafatos,
D Molnár,
L A Moreno,
S De Henauw,
M J Castillo,
M Sjöström
[show abstract]
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ABSTRACT: To investigate the combined influence of diet quality and physical activity on cardiovascular disease (CVD) risk factors in adolescents, adolescents (n = 1513; 12.5-17.5 years) participating in the Healthy Lifestyle in Europe by Nutrition in Adolescence study were studied. Dietary intake was registered using a 24-h recall and a diet quality index was calculated. Physical activity was assessed by accelerometry. Lifestyle groups were computed as: healthy diet and active, unhealthy diet but active, healthy diet but inactive, and unhealthy diet and inactive. CVD risk factor measurements included cardiorespiratory fitness, adiposity indicators, blood lipid profile, blood pressure, and insulin resistance. A CVD risk score was computed. The healthy diet and active group had a healthier cardiorespiratory profile, fat mass index (FMI), triglycerides, and high-density lipoprotein cholesterol (HDL-C) levels and total cholesterol (TC)/HDL-C ratio (all P ≤ 0.05). Overall, active adolescents showed higher cardiorespiratory fitness, lower FMI, TC/HDL-C ratio, and homeostasis model assessment index and healthier blood pressure than their inactive peers with either healthy or unhealthy diet (all P ≤ 0.05). Healthy diet and active group had healthier CVD risk score compared with the inactive groups (all P ≤ 0.02). Thus, a combination of healthy diet and active lifestyle is associated with decreased CVD risk in adolescents. Moreover, an active lifestyle may reduce the adverse consequences of an unhealthy diet.
Scandinavian Journal of Medicine and Science in Sports 12/2012; · 2.87 Impact Factor
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ABSTRACT: OBJECTIVE:The aim was to analyze the effectiveness of treatment concerning obesity-associated comorbidities in clinical practice.METHODS:A total of 11 681 overweight children with 6-month follow-up treated at 175 centers specialized in pediatric obesity care in Central Europe were included in this analysis (mean body mass index (BMI) 29.0±5.6 kg m(-)(2), standard deviation score body mass index (SDS-BMI) 2.48±0.54, 45% boys, age 11.4±2.8 years). The changes of weight status, blood pressure, fasting lipids and glucose, and oral glucose tolerance tests were documented by standardized prospective quality documentation software (APV).RESULTS:After follow-up of in median 1.2 (interquartile range 0.9-2.2) years, a mean reduction of -0.15 SDS-BMI was achieved. The prevalence of prehypertension (37->33%) and hypertension (17->12%) decreased, while prevalences of triglycerides >150 mg dl(-1) (22->21%), low-density-lipoprotein-cholesterol >130 mg dl(-1) (15->14%), impaired fasting glucose (6->6%) and impaired glucose tolerance (9->8%) remained stable. Drug treatment according to cutoffs recommended in European obesity guidelines were not frequently indicated (hypertension: 10%; dyslipidemia: 1%, type 2 diabetes <1%). None of the children with dyslipidemia received lipid-lowering drugs and only 1.4% of the children with hypertension were treated with antihypertensive drugs.CONCLUSIONS:Achieving sufficient weight loss to improve obesity associated comorbidities was difficult in clinical practice. Drug treatment of hypertension, dyslipidemia and type 2 diabetes was rarely performed even if it was indicated only in a minority of the overweight children. Future analyses should identify reasons for this insufficient drug treatment of comorbidities and analyze whether the benchmarking processes of APV improve medical care of childhood obesity.International Journal of Obesity advance online publication, 13 November 2012; doi:10.1038/ijo.2012.184.
International journal of obesity (2005) 11/2012; · 4.34 Impact Factor
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[show abstract]
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ABSTRACT: Hypercholesterinämie (FH) ist eine autosomal vererbte Lipoproteinstoffwechselerkrankung, die durch erhöhte Gesamt- und LDL(„low
density lipoprotein“)-Cholesterin-Werte im Plasma gekennzeichnet ist. Ziel dieser Erhebung mittels eines standardisierten
Fragebogens war es, zu eruieren, ob und wie in österreichischen Krankenhäusern, die mit einer eigenen Kinderabteilung ausgestattet
sind, Kinder und Jugendliche mit FH betreut werden. 34% der 41 Leiter/-innen gaben an, an ihren Abteilungen Kinder und Jugendliche
mit FH zu behandeln. In diesen 14 Krankenhäusern werden zur Diagnostik der FH verschiedenste Kriterien herangezogen, auch
die Therapiemaßnahmen werden unterschiedlich umgesetzt. Im vorliegenden Beitrag werden die unterschiedlichen Diagnoseschemata
und Therapiemaßnahmen diskutiert.
Familial hypercholesterolemia (FH) is an autosomal inherited disorder of lipoprotein characterized by markedly elevated plasma
concentrations of low density lipoprotein and total cholesterol, typically well above the 95th percentile for age and gender.
The aim was to investigate, using a standardized questionnaire, whether and how children and adolescents are diagnosed and
treated for this condition in Austrian hospitals. Thirty-four percent of 41 departments indicated that they treat children
and adolescents with FH. In these 14 hospitals, different criteria are used for diagnosis, and treatment also differs. In
the following article, the different diagnosis patterns and therapeutic measures are discussed.
Monatsschrift Kinderheilkunde 04/2012; 157(5):467-472. · 0.27 Impact Factor
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S. De Henauw,
F. Gottrand,
I. De Bourdeaudhuij,
M. Gonzalez-Gross,
C. Leclercq,
A. Kafatos,
D. Molnar,
A. Marcos,
M. Castillo,
J. Dallongeville,
C. C. Gilbert,
P. Bergman, K. Widhalm,
Y. Manios,
C. Breidenassel,
M. Kersting,
L. A. Moreno,
on behalf of the HELENA Study Group
[show abstract]
[hide abstract]
ABSTRACT: The HELENA Project—Healthy Lifestyle in Europe by Nutrition in Adolescence—is a European, collaborative research project financed by the EU Sixth Framework Programme in the area of nutrition-related
adolescent health. The basic objective of the HELENA project is to obtain reliable and comparable data from a random sample
of European adolescents (boys and girls aged 13–16years) on a broad battery of relevant nutrition and health-related parameters:
dietary intake, food choices and preferences, anthropometry, serum indicators of lipid metabolism and glucose metabolism,
vitamin and mineral status, immunological markers, physical activity, fitness and genetic markers. The HELENA project is conceived
as a scientific construction with four complementary sub-studies that are elaborated through 14 well-defined work packages.
Sub-studies are focused, respectively, on “a cross-sectional description of lifestyles and indicators of nutritional status
(HELENA-CSS)”, “a lifestyle education intervention programme (HELENA-LSEI), “a metabolic study with cross-over design (HELENA-COMS)”
and a “study on behaviour, food preferences and food development” (HELENA-BEFO). The project unites 20 research centres from
10 European countries. In addition, the consortium comprises five SMEs (small and medium-sized enterprises) that are actively
involved in the research activities. The core of the HELENA project study material is an overall European cohort of 3,000
adolescents, equally recruited in ten cities from nine countries. Standardization of methods among partners is a key issue
in the project and is obtained through the development of standard protocols, training sessions, validation sub-studies and
pilot projects. Health-related problems have a tendency to evolve in cycles, with ever new problems emerging in ever new contexts
that call for appropriate and tailored actions. The HELENA project is expected to offer essential elements for use in the
overall machinery of required public health nutrition cycles. It is of the greatest importance for its results to prove useful
that it can communicate with other initiatives on the level of science and society.
Journal of Public Health 04/2012; 15(3):187-197. · 2.06 Impact Factor
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I Labayen,
F B Ortega,
L A Moreno,
M Gonzalez-Gross,
D Jimenez-Pavon,
D Martínez-Gómez,
C Breidenassel,
A Marcos,
D Molnar,
Y Manios,
M Plada,
A Kafatos,
S De Henauw,
B Mauro,
M Zaccaria, K Widhalm,
F Gottrand,
M J Castillo,
M Sjöström,
J R Ruiz
[show abstract]
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ABSTRACT: We examined whether physical activity (PA) influences the association between birth weight and serum leptin in adolescents. The study comprised a total of 538 adolescents (315 girls), aged 12.5-17.49 years, born at term (≥37 weeks of gestation). We measured serum leptin levels and time engaged in moderate-vigorous PA (MVPA) by accelerometry. There was an interaction effect between birth weight and meeting the PA recommendations (60 min/day MVPA) on leptin levels in girls (P = 0.023) but not in boys (P = 0.809). Birth weight was negatively associated with leptin levels in girls not meeting the PA recommendations (i.e. more than 60 min/day of MVPA) (β = -0.096, P = 0.009), whereas no significant association was observed in those meeting the PA recommendations (β = -0.061, P = 0.433). In conclusion, meeting the PA recommendations may attenuate the negative effect of low birth weight on serum leptin levels in European female adolescents.
Nutrition, metabolism, and cardiovascular diseases: NMCD 03/2012; · 3.52 Impact Factor
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A Spinneker,
S Egert,
M González-Gross,
C Breidenassel,
U Albers,
B Stoffel-Wagner,
I Huybrechts,
Y Manios,
E Venneria,
D Molnar, K Widhalm,
L Moreno,
P Stehle
[show abstract]
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ABSTRACT: To provide a detailed lipid profile of a European adolescent population considering age, gender, biological maturity, body mass index (BMI), fat mass (FM) and percentage body fat (BF).
Within Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA), a cross-sectional study was conducted to determine fasting serum concentrations of lipids, lipoproteins and apolipoproteins in 1076 adolescents aged 12.5-17.49 years from ten European centres.
All serum lipid concentrations were significantly higher in girls than in boys. In boys, age was negatively correlated with high-density lipoprotein (HDL)-cholesterol and total cholesterol (TC), and positively associated with triacylglycerides (TAG) (P < 0.01) whereas no significant associations were observed in girls. Biological maturity was negatively associated with TC, HDL-, low-density lipoprotein (LDL)- and non-HDL cholesterol in boys (all P<0.05) and negatively correlated with HDL-cholesterol in girls (P<0.05). BMI, FM and BF were significantly correlated with HDL-cholesterol, LDL-cholesterol, non-HDL cholesterol, apolipoprotein (apo) A1, apoB and TAG in both boys and girls.
The lipid profile in adolescents is strongly determined by gender. Biological maturity, FM and percentage BF contribute to the variance in lipid concentrations and should be considered in future evaluations of lipid status.
European journal of clinical nutrition 01/2012; 66(6):727-35. · 3.07 Impact Factor
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J Valtueña,
L Gracia-Marco,
G Vicente-Rodríguez,
M González-Gross,
I Huybrechts,
J P Rey-López,
T Mouratidou,
I Sioen,
M I Mesana,
A E Díaz Martínez, K Widhalm,
L A Moreno
[show abstract]
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ABSTRACT: The effects of vitamin D concentrations on bone mineral content in adolescents are still unclear. Vitamin D and physical activity (PA) may interact to determine bone mineral content (BMC) in two possible directions; 25(OH)D sufficiency levels improve BMC only in active adolescents, or PA increases BMC in individuals with replete vitamin D levels.
The effects of suboptimal 25-hydroxycholecalciferol (25(OH)D) concentrations on BMC in adolescents are still unclear. The main aim of this study was to evaluate the influence of 25(OH)D on BMC in adolescents, considering the effect of body composition, sex, age, Tanner stage, season, calcium and vitamin D intakes, physical fitness and PA.
Serum 25(OH)D concentrations, anthropometric measurements, dual energy X-ray absorptiometry measurements, calcium and vitamin D intakes, PA and physical fitness were obtained in 100 Spanish adolescents (47 males), aged 12.5-17.5 years, within the framework of the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study. Relations were examined using ANCOVA and regression analyses including BMC as dependent variable.
Linear regression of BMC suggested that 25(OH)D concentrations independently influenced total and leg BMC after controlling for age, sex, lean mass, seasonality and calcium intake (B = 0.328, p < 0.05, and B = 0.221, p < 0.05, respectively) in the physically active group. No significant influence of 25(OH)D concentrations on BMC was observed in the inactive group. Significant effect was shown between the interaction of 25(OH)D and PA on BMC for the total body and legs (both p < 0.05).
Vitamin D and PA may interact to determine BMC. 25(OH)D sufficiency levels improve bone mass only in active adolescents, or PA has a positive influence on BMC in individuals with replete vitamin D levels.
Osteoporosis International 01/2012; 23(8):2227-37. · 4.58 Impact Factor
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K J Duffey,
I Huybrechts,
T Mouratidou,
L Libuda,
M Kersting,
T De Vriendt,
F Gottrand, K Widhalm,
J Dallongeville,
L Hallström,
M González-Gross,
S De Henauw,
L A Moreno,
B M Popkin
[show abstract]
[hide abstract]
ABSTRACT: Our objective was to describe the fluid and energy consumption of beverages in a large sample of European adolescents.
We used data from 2741 European adolescents residing in 8 countries participating in the Healthy Lifestyle in Europe by Nutrition in Adolescence Cross-Sectional Study (HELENA-CSS). We averaged two 24-h recalls, collected using the HELENA-dietary assessment tool. By gender and age subgroup (12.5-14.9 years and 15-17.5 years), we examined per capita and per consumer fluid (milliliters (ml)) and energy (kilojoules (kJ)) intake from beverages and percentage consuming 10 different beverage groups.
Mean beverage consumption was 1611 ml/day in boys and 1316 ml/day in girls. Energy intake from beverages was about 1966 kJ/day and 1289 kJ/day in European boys and girls, respectively, with sugar-sweetened beverages (SSBs) (carbonated and non-carbonated beverages, including soft drinks, fruit drinks and powders/concentrates) contributing to daily energy intake more than other groups of beverages. Boys and older adolescents consumed the most amount of per capita total energy from beverages. Among all age and gender subgroups, SSBs, sweetened milk (including chocolate milk and flavored yogurt drinks all with added sugar), low-fat milk and fruit juice provided the highest amount of per capita energy. Water was consumed by the largest percentage of adolescents followed by SSBs, fruit juice and sweetened milk. Among consumers, water provided the greatest fluid intake and sweetened milk accounted for the largest amount of energy intake followed by SSBs. Patterns of energy intake from each beverage varied between countries.
European adolescents consume an average of 1455 ml/day of beverages, with the largest proportion of consumers and the largest fluid amount coming from water. Beverages provide 1609 kJ/day, of which 30.4%, 20.7% and 18.1% comes from SSBs, sweetened milk and fruit juice, respectively.
European journal of clinical nutrition 09/2011; 66(2):244-52. · 3.07 Impact Factor
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M Ferrari,
L Mistura,
E Patterson,
M Sjöström,
L E Díaz,
P Stehle,
M Gonzalez-Gross,
M Kersting, K Widhalm,
D Molnár,
F Gottrand,
S De Henauw,
Y Manios,
A Kafatos,
L A Moreno,
C Leclercq
[show abstract]
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ABSTRACT: To assess the iron status among European adolescents through selected biochemical parameters in a cross-sectional study performed in 10 European cities.
Iron status was defined utilising biochemical indicators. Iron depletion was defined as low serum ferritin (SF<15 μg/l). Iron deficiency (ID) was defined as high-soluble transferrin receptor (sTfR>8.5 mg/l) plus iron depletion. Iron deficiency anaemia (IDA) was defined as ID with haemoglobin (Hb) below the WHO cutoff for age and sex: 12.0 g/dl for girls and for boys aged 12.5-14.99 years and 13.0 g/dl for boys aged ≥15 years. Enzyme linked immunosorbent assay was used as analytical method for SF, sTfR and C-reactive protein (CRP). Subjects with indication of inflammation (CRP >5 mg/l) were excluded from the analyses. A total of 940 adolescents aged 12.5-17.49 years (438 boys and 502 girls) were involved.
The percentage of iron depletion was 17.6%, significantly higher in girls (21.0%) compared with boys (13.8%). The overall percentage of ID and IDA was 4.7 and 1.3%, respectively, with no significant differences between boys and girls. A correlation was observed between log (SF) and Hb (r = 0.36, P < 0.01), and between log (sTfR) and mean corpuscular haemoglobin (r = -0.30, P < 0.01). Iron body stores were estimated on the basis of log (sTfR/SF). A higher percentage of negative values of body iron was recorded in girls (16.5%) with respect to boys (8.3%), and body iron values tended to increase with age in boys, whereas the values remained stable in girls.
To ensure adequate iron stores, specific attention should be given to girls at European level to ensure that their dietary intake of iron is adequate.
European journal of clinical nutrition 01/2011; 65(3):340-9. · 3.07 Impact Factor
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ABSTRACT: Nonalcoholic fatty liver disease (NAFLD) is the most common cause of pediatric liver disease. Its prevalence is related to the growing epidemic in childhood obesity during the past decades. At present, NAFLD and nonalcoholic steatohepatitis (NASH) are increasingly recognized worldwide. In spite of alarming trend in the epidemiology in pediatric field and growing risk of end stage liver disease, there is no significant advance in its diagnosis and treatment.
To provide a detailed review for diagnosis and management of NAFLD and NASH.
By using Pubmed to find review articles and relevant research.
The prevalence ranges from at least 3% in children overall to about 50% in obese children. The noninvasive biomarkers can be used to identify NAFLD/NASH patients. Diagnostic criteria based on biochemical and immunological indicators in the high-risk group of children could prevent about half of cases from receiving an invasive test. The pharmacological and surgical interventions have shown a growing role in pediatric NAFLD. Novel treatment modalities, such as probiotics, have hardly been studied.
Early diagnosis by using noninvasive screening methods in high-risk groups is the most effective strategy against the NAFLD. The biology of early growth and development, including hepatic metabolism, may hold the key to pediatric NAFLD. Prevention of overweight children and childhood obesity is undoubtedly the best strategy for treating NAFLD.
International journal of obesity (2005) 10/2010; 34(10):1451-67. · 4.34 Impact Factor
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V España-Romero,
F B Ortega,
J R Ruiz,
E G Artero,
D Martínez-Gómez,
G Vicente-Rodriguez,
D Moliner-Urdiales,
L Gracia-Marco,
D Ciarapica, K Widhalm,
M J Castillo Garzon,
M Sjöstrom,
L A Moreno
[show abstract]
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ABSTRACT: We examined the role of cardiorespiratory fitness (CRF) on the association between physical activity (PA) and abdominal fat content in adolescents. Abdominal fat content was measured by waist circumference, waist-to-height ratio and dual energy X-ray absorptiometry (DXA) at 3 regions (R1, R2, and R3). PA and CRF were assessed by accelerometry and the 20 m-shuttle run test, respectively. Vigorous PA was inversely associated with waist circumference and waist-to-height ratio (β from -0.149 to -0.197; p<0.05). In both CRF groups (i. e., low and high), vigorous and moderate-to-vigorous PA (also average PA in the low CRF group) were inversely associated with abdominal fat (i. e., R1, R2 and R3; β from -0.146 to -0.244; p<0.05). This association did not differ according to CRF group (P for interaction >0.05), yet the percentage of variance in abdominal fat content, when assessed by DXA, explained by PA was slightly higher in adolescents with low CRF (3-8%) compared to those with high CRF (2-4%). The findings indicate that there is not a clear interaction effect of CRF in the association between PA and abdominal fat in adolescents, yet slightly stronger association was observed in the low fit group.
International Journal of Sports Medicine 10/2010; 31(10):679-82. · 2.43 Impact Factor
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L Gracia-Marco,
G Vicente-Rodríguez,
J Valtueña,
J P Rey-López,
A E Díaz Martínez,
M I Mesana, K Widhalm,
J R Ruiz,
M González-Gross,
M J Castillo,
L A Moreno
[show abstract]
[hide abstract]
ABSTRACT: The assessment of bone mineral content (BMC) and density (BMD) status in children and adolescents is important for health and the prevention of diseases. Bone metabolic activity could provide early information on bone mass development. Our aim was to describe bone mass and metabolism markers according to age and Tanner stage in adolescents.
Spanish adolescents (n = 345; 168 males and 177 females) aged 12.5-17.5 years participated in this cross-sectional study. Body composition variables were measured by dual-energy X-ray absorptiometry. Serum osteocalcin (n = 101), aminoterminal propeptide of type I procollagen (n = 92) and β-isomerized C-telopeptides (β-CTX, n = 65) and urine samples (β-CTX; n = 237) were analyzed by electrochemiluminescence immunoassay.
Analysis of covariance showed that females had higher values for BMC and BMD in most of the regions. Both males and females had a significant decrease in bone markers while sexual maturation increases (all p < 0.05). Males had an increased bone turnover compared to females (all p < 0.05, except for urine β-CTX in Tanner ≤IV).
Our results support the evidence of dimorphic site-specific bone accretion between sexes and show an increased bone turnover in males, suggesting higher metabolic activity.
Hormone Research in Paediatrics 01/2010; 74(5):339-50.
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L Béghin,
M Castera,
Y Manios,
C C Gilbert,
M Kersting,
S De Henauw,
A Kafatos,
F Gottrand,
D Molnar,
M Sjöström,
C Leclercq, K Widhalm,
M I Mesana,
L A Moreno,
C Libersa
[show abstract]
[hide abstract]
ABSTRACT: Research involving humans is regulated by regulatory authorities through their specific requirements and controls. The Healthy Life Style in Europe by Nutrition in Adolescence Cross-Sectional Study (HELENA-CSS) is a multicenter biomedical research study of adolescents in several representative European cities, which requires satisfying medico-regulatory requirements including Independent Ethics Committee (IEC) approval and agreement by the national or local regulatory authorities. To achieve a high level of quality assurance relating to ethical issues, we followed the good clinical practices (GCP) described at the International Conference on Harmonisation (ICH), which we adapted to the national and local situations of each of the 11 participating cities in 10 European countries.
The main objective of the HELENA-CSS is to evaluate reliable and comparable data of nutritional habits and lifestyle in a representative sample of European adolescents. The aim of this paper is to present the methods relating to the ethical and regulatory issues of this study and to describe the current state of the medico-regulatory requirements involved in conducting this kind of study in each country.
Following the GCP-ICH guidelines, a protocol describing the HELENA-CSS was written and approved by all partners. In the pilot study, a case report form adapted to the study objectives and its manual of operation was constructed and used by all partners. All information letters to adolescents and their parents and consent forms were first written in English, then translated into the local language, and adapted to each local situation. All documents were then checked centrally for any deviation and corrected if required. An operation manual relating to ethical issues and other medico-regulatory requirements was also developed. This paper presents the current status of the medico-regulatory requirements from each HELENA-CSS participant country.Results:Before the beginning of the study, most centers had satisfied the medico-regulatory requirements of IEC approval and agreement with other national or local regulatory authorities/organizations. For a few centers, some problems were detected and corrective actions were taken to improve missing information to reach a high level of quality assurance of ethical issues.
The GCP-ICH guidelines about nontherapeutic biomedical research are interpreted and applied differently across Europe. This study shows that high-quality nontherapeutic biomedical research can address the ethical issues included in the GCP-ICH regulations and can be harmonized among the HELENA European partners.
International journal of obesity (2005) 12/2008; 32 Suppl 5:S12-8. · 4.34 Impact Factor
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L A Moreno,
S De Henauw,
M González-Gross,
M Kersting,
D Molnár,
F Gottrand,
L Barrios,
M Sjöström,
Y Manios,
C C Gilbert,
C Leclercq, K Widhalm,
A Kafatos,
A Marcos
[show abstract]
[hide abstract]
ABSTRACT: To provide an overview of the Healthy Lifestyle in Europe by Nutrition in Adolescence Cross-Sectional Study (HELENA-CSS) design, with particular attention to its quality control procedures. Other important methodological aspects are described in detail throughout this supplement.
Description of the HELENA-CSS sampling and recruitment approaches, standardization and harmonization processes, data collection and analysis strategies and quality control activities.
The HELENA-CSS is a multi-centre collaborative study conducted in European adolescents located in urban settings. The data management systems, quality assurance monitoring activities, standardized manuals of operating procedures and training and study management are addressed in this paper. Various quality controls to ensure collection of valid and reliable data will be discussed in this supplement, as well as quantitative estimates of measurement error.
The great advantage of the HELENA-CSS is the strict standardization of the fieldwork and the blood analyses, which precludes to a great extent the kind of immeasurable confounding bias that often interferes when comparing results from isolated studies.
International journal of obesity (2005) 12/2008; 32 Suppl 5:S4-11. · 4.34 Impact Factor
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L A Moreno,
M González-Gross,
M Kersting,
D Molnár,
S de Henauw,
L Beghin,
M Sjöström,
M Hagströmer,
Y Manios,
C C Gilbert,
F B Ortega,
J Dallongeville,
D Arcella,
J Wärnberg,
M Hallberg,
H Fredriksson,
L Maes, K Widhalm,
A G Kafatos,
A Marcos
[show abstract]
[hide abstract]
ABSTRACT: To identify the main knowledge gaps and to propose research lines that will be developed within the European Union-funded 'Healthy Lifestyle in Europe by Nutrition in Adolescence' (HELENA) project, concerning the nutritional status, physical fitness and physical activity of adolescents in Europe.
Review of the currently existing literature.
The main gaps identified were: lack of harmonised and comparable data on food intake; lack of understanding regarding the role of eating attitudes, food choices and food preferences; lack of harmonised and comparable data on levels and patterns of physical activity and physical fitness; lack of comparable data about obesity prevalence and body composition; lack of comparable data about micronutrient and immunological status; and lack of effective intervention methodologies for healthier lifestyles.
The HELENA Study Group should develop, test and describe harmonised and state-of-the-art methods to assess the nutritional status and lifestyle of adolescents across Europe; develop and evaluate an intervention on eating habits and physical activity; and develop and test new healthy food products attractive for European adolescents.
Public Health Nutrition 04/2008; 11(3):288-99. · 2.17 Impact Factor
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[show abstract]
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ABSTRACT: The dramatically increasing prevalence of obesity, especially among children, has become a major public health problem in Europe. In reaction to this alarming trend, a series of initiatives and actions has been launched in recent years. As the potential impact of these activities is widely unknown so far, we underline the need for adequate evaluation of these measures. The aim of this paper is to report the latest developments in the fight against obesity at different political levels across Europe, with special attention to the major results of the recent World Health Organization European Ministerial Conference on Counteracting Obesity. In accordance with the main principles of the European Charter on Counteracting Obesity adopted at the meeting, immediate action should be taken now by implementing the few available schemes with proven effectiveness. Finally, given the lack of appropriate evaluation, we consider it particularly important to establish national research centres to collect country-specific data that are to be evaluated together by a central European administration department. Based on the results of such a comprehensive data pool, concrete strategies could be developed for future policy building.
Obesity Reviews 02/2008; 9(1):76-82. · 7.04 Impact Factor
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[show abstract]
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ABSTRACT: The diagnostic criteria of the metabolic syndrome (MS) have been applied in studies of obese adults to estimate the metabolic risk-associated with obesity, even though no general consensus exists concerning its definition and clinical value. We reviewed the current literature on the MS, focusing on those studies that used the MS diagnostic criteria to analyze children, and we observed extreme heterogeneity for the sets of variables and cutoff values chosen.
To discuss concerns regarding the use of the existing definition of the MS (as defined in adults) in children and adolescents, analyzing the scientific evidence needed to detect a clustering of cardiovascular risk-factors. Finally, we propose a new methodological approach for estimating metabolic risk-factor clustering in children and adolescents.
Major concerns were the lack of information on the background derived from a child's family and personal history; the lack of consensus on insulin levels, lipid parameters, markers of inflammation or steato-hepatitis; the lack of an additive relevant effect of the MS definition to obesity per se. We propose the adoption of 10 evidence-based items from which to quantify metabolic risk-factor clustering, collected in a multilevel Metabolic Individual Risk-factor And CLustering Estimation (MIRACLE) approach, and thus avoiding the use of the current MS term in children.
Pediatricians should consider a novel and specific approach to assessing children/adolescents and should not simply derive or adapt definitions from adults. Evaluation of insulin and lipid levels should be included only when specific references for the relation of age, gender, pubertal status and ethnic origin to health risk become available. This new approach could be useful for improving the overall quality of patient evaluation and for optimizing the use of the limited resources available facing to the obesity epidemic.
International Journal of Obesity 05/2007; 31(4):591-600. · 4.69 Impact Factor
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[show abstract]
[hide abstract]
ABSTRACT: One major problem of using hypercholesterolaemia alone as a primary criterion for diagnosing familial hypercholesterolaemia (FH) is that 15-40% of relatives may be misdiagnosed because plasma lipid levels in FH heterozygotes overlap with those in the general population.
General Hospital/University of Vienna, Department of Pediatrics, Outpatient lipid clinic.
As a part of the MED-PED (make early diagnosis-prevent early death) project we are currently investigating children, adolescents and their relatives who are suspected to be affected with FH in our out-patient clinic for metabolic diseases using MED-PED inclusion criteria and confirming the diagnosis by means of DNA analysis.
263 patients with premature atherosclerosis and/or hypercholesterolaemia: 116 children (mean age 11.6 +/- 4.1 years; 57 girls and 59 boys) and 147 adults (64 women, mean age 41.5 +/- 13.7 years; 83 men, mean age 42.8 +/- 10.8 years).
119 patients with mutations have been detected; 56 children with either low density lipoprotein receptor (LDLR) and/or ApoB mutations (27 girls and 29 boys; mean total cholesterol (TC) 275 +/- 71 mg/dl, triglycerides (TG) 101 +/- 57 mg/dl, high-density lipoprotein cholesterol (HDL-C) 49 +/- 12 mg/dl, low-density lipoprotein cholesterol (LDL-C) 198 +/- 67 mg/dl) and one boy with a homozygous. LDLR mutation. A further 62 adults with LDLR and/or ApoB mutations were documented; 33 women (mean age 36.9 +/- 11.1 years; mean TC 283 +/- 76 mg/dl, TG 137 +/- 78 mg/dl, HDL-C 55 +/- 17 mg/dl, LDL-C 210 +/- 67 mg/dl) and 29 men (mean age 45.0 +/- 10.6 years; mean TC 301 +/- 87 mg/dl, TG 163 +/- 112 mg/dl, HDL-C 42 +/- 12 mg/dl, LDL-C 233 +/- 83 mg/dl). In 32 of these subjects (11 children (21%), 21 adults (42%)), serum lipid levels were lower than the diagnostic MED-PED limits adopted, so that they might have been misclassified without an additional DNA analysis.
In our study, diagnosis of FH and related disorders (ApoB-100 defect) by means of conventional laboratory methods missed at least 21% in children and 42% in adults affected with LDLR and/or ApoB gene mutations. Genetic FH diagnosis provides a tool for specific diagnosis of mutation carrier status.
Journal of Inherited Metabolic Disease 05/2007; 30(2):239-47. · 3.58 Impact Factor
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ABSTRACT: In the last 15 y there has been a tremendous increase in the number of studies on pediatric obesity looking at epidemiology, health-related risks, etiology, methodology and treatment. During the early 1990s, the European Childhood Obesity Group (ECOG) was born as a group of scientists' expert in the field of pediatric obesity. ECOG this year celebrates the approach to early maturity with an excited and omni-comprehensive program developing through eight different tracks.
Comments on different 'key' papers in each of the eight tracks.
The eight tracks were (1) Nutrition requirements and food habits, (2) physical activity, (3) prevention and political actions/strategies, (4) diabetes, (5) metabolism, (6) psychology, (7) pathology, and (8) treatment with emphasis on drugs.
Looking at the overall picture of the ECOG workshop we could conclude that despite the fact that childhood obesity is a crisis facing worldwide youth, it is necessary that action to control it must be taken now. All the six relevant levels (ie, family, schools, health professionals, government, industry and media) could be involved in prevention of child and adolescent obesity.
International Journal of Obesity 10/2005; 29 Suppl 2:S1-6. · 4.69 Impact Factor
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ABSTRACT: In view of the dramatically increasing prevalence of obesity among European children and adolescents and its comorbidities, the EU and national health authorities are confronted with a major public health problem, starting in childhood. So far, little is known about policies and prevention programs that are planned and implemented in EU member states in order to combat childhood obesity epidemic. For this reason all 25 Ministries of Health have been asked to give a report on their activities in that specific field. In all, 19 ministries responded and provided information on their measures in varying detail. Taken together, it shows that most ministries are aware of that severe problem and different kind of 'National Action plans against Obesity' have been recently established. However, in most cases no detailed information about the realization and the effectiveness of these programs were given. Thus, there is an urgent need for specific actions both at national and European levels in regard to succeed in fighting childhood obesity.
International Journal of Obesity 10/2005; 29 Suppl 2:S130-5. · 4.69 Impact Factor
