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Dietary habits and nutritional status in adolescents in Central and Eastern Europe
Abstract
The overall situation as regards dietary intake and nutritional status in the countries of Central and Eastern Europe has varied considerably during previous decades; however, after the political, social and economic changes during the nineties these differences have increased further, especially in the areas with low GDP and war, and in the regions affected by radionuclides etc. No systematic surveillance systems in representative samples of adolescents were in effect at the beginning of the nineties in Central and Eastern Europe. There exists relatively more data on nutritional status characterized by body mass index (BMI) and skinfold thickness measurements. Food intake has mainly been followed in smaller samples of adolescents, and or in special groups (athletes, obese, vegetarians, allergies, Romanies, pupils of special schools etc.). In the countries and/or areas with sufficient GDP and income the food intake has most often been too abundant when considering the real needs of the growing organism, especially from the point of view of energy output. The composition of the diet is not adequate, i.e. too much protein, fats, sugar etc. This situation is similar to that in Western countries, USA etc. On the other hand? adolescents in Central and Eastern Europe consume too few vegetables, fruit and milk products in their diet (i.e, low intakes of Ca, fibre and vitamin C), which is less apparent in Western countries. This is mainly due to bad eating habits and nutritional traditions in the families, but also due to the changes of the prices of the mentioned foodstuffs after political and economic changes in this part of the world. Certain nutritional deficiencies were also shown as factors increasing the health risks from the Chernobyl disaster, mainly in the Ukraine, Belorussia and certain parts of Poland.
... Relative to nutrient intake, following the transition from a centralized to market economy, agricultural and economic reforms and development began to rapidly unfold in most of these countries. As would be expected, some countries are reporting a generalized inadequate intake of foods and diet (Parizkova, 2000). However, most countries appear to be experiencing greater food security with an overall increase in food intake since 1990 (Dofkova et al., 2001; Kowrygo et al., 1999; Parizkova, 2000). ...
... As would be expected, some countries are reporting a generalized inadequate intake of foods and diet (Parizkova, 2000). However, most countries appear to be experiencing greater food security with an overall increase in food intake since 1990 (Dofkova et al., 2001; Kowrygo et al., 1999; Parizkova, 2000). Bulgaria is unique among former COMECON countries for several reasons. ...
... When we consider countries that have experienced similar changes as Bulgaria, the general trend varies depending upon the nutritional status prior to economic growth immediately following the transition. For example, a survey of adolescents in various countries of Central and Eastern Europe found that those from countries with a higher GDP consumed diets of poor quality (high in fat and sugar, low in fruit and vegetables) compared to those from countries with a lower GDP (Parizkova, 2000). In Hungary, immediately following the transition, the intake of animal fats and protein remained higher than nutritional recommendations, while the intake of micronutrients bordered on deficiencies (Biro et al., 1996). ...
Major economic transitions typically entail changes in the availability of and purchasing power for different types of foods leading to long-term changes in the composition of the diet. Bulgaria, a former Eastern Bloc country, underwent a difficult and protracted transition from a centralized to market economy with acute economic crises and a much slower recovery of income levels than in Poland, the Czech Republic, and Hungary. Using annual data from the Bulgarian National Household Survey, we study changes in the reported consumption of major foods (excluding alcoholic drinks) and their constituent macronutrients from 1985 to 2002, examining also the differences in dietary patterns between the period prior to and following the transition. The consumption of most major food items decreased, resulting in a fall in per capita energy consumption of 429 kcal/day (1.80 MJ/d), following the economic transition of 1991. As expected, the consumption of foods that were more expensive per unit of energy decreased greater than cheaper foods, -34% for animal products and -19% for visible fats, but only -10% for carbohydrates. These changes are related to the changes in income and market prices as well as the general negative trend in economic growth and hyperinflation in the mid-1990s. Thus, Bulgaria experienced a decrease in food consumption without significant changes in the dietary pattern following the economic transition of 1991. The fact that part of this decline may be attributed to continued economic challenges suggests that future transitions in the diet may be expected as economic development proceeds.
... The contribution of protein to energy intake in our study was similar to that reported in Greek and Italian adolescents, lower than that of Spanish peers (male: 17.2%, female: 17.8%) [42], but higher than adolescents in review studies of Western, Central and Eastern European countries434445. In addition, total protein intake was reported to be slightly lower in Italian peers (male: 99 g/d, female: 82 g/d) [46], Spanish males (male: 105 g/d, female: 86 g/d) [42], and Western European adolescents [43,45]. ...
... Obese HELENA participants consumed more total protein than non-obese participants. Evidence from other European studies indicate higher contribution of animal sources [44,47] to total protein and lower from plant protein consumptions [45] , which might point to a relationship between increasing prevalence of OB in European adolescents. Our results suggest that increasing total protein intakes may be inversely associated with adolescents' BF%, which can be explained by plant protein intakes being significantly inversely associated with BMI z-score and BF%, after adjustment for fat intake, PA and confounding factors. ...
Background: Overweight, obesity and its concomitant diseases are increasingly becoming serious epidemic health problems, especially in children and adolescents. Distribution of protein intakes and its relation with obesity is well established in adults, though little is known in adolescents.
Objectives: To evaluate total protein intakes (animal and plant) in European adolescents stratified by gender and age, and to investigate their associations with obesity indicators (anthropometry and biomarkers).
Methods: In total, 1804 randomly selected adolescents aged 12.5-17.5 y (47% of males) completed two repeated non-consecutive computerised 24-h dietary recalls. Body composition, and blood biomarkers were investigated to check the associations with protein intakes by mixed linear models.
Results: Mean total protein intake was 96 g/d (59% derived from animal protein) and met the international recommendations. Total, animal and vegetable protein intakes were significantly lower in females and total and vegetable protein intakes in younger participants (12.5-14.9 y). Protein intake was significantly lower in underweight subjects and highest in obese subjects. However, after adjustment for body weight, total protein intake was lowest in obese subjects, and highest in under-weight subjects.
Furthermore, body fat % (BF%), significantly decreased with increasing protein intake. Findings of the mixed linear models showed that animal and vegetable protein intakes were inversely associated with BF%, while animal protein positively with serum leptin and vegetable protein with glucose levels,. However, E% from animal and vegetable proteins were inversely associated with VLDL-C and serum leptin levels, respectively.
Conclusions: European adolescents had sufficient total protein intake in comparison with the recommendations. Although a positive association was found between total protein intake and increasing BMI categories, a negative association was found with BF%.
... Differences among the rural and urban food cognition , and dietary and physical activity patterns are due to different lifestyles [3]. Overall dietary intake and anthropometric status in Central and Eastern Europe, after the political, social and economic changes during the 1990s has varied considerably , especially in the war torn areas [4] . The liberation of occupied Croatian territories ended the war in the country in 1995. ...
... Energy intake under 100 % RDA has also been reported in Swiss teenagers [27]. The high protein intake as observed in this study, especially in the urban area, is often reported [4]. High protein intake can have adverse affect: increase in renal excretion of calcium [28]. ...
Background:
Post-war socio-economic changes in Croatia probably affected dietary habits, and dietary data about schoolchildren after the war are missing.
Aims of the study:
The aim of the study was to compare current nutrient intakes and dietary behavior between urban and rural schoolchildren in Croatia.
Methods:
A completely quantified Food Frequency Questionnaire was used. Subjects were 315 urban and 163 rural schoolchildren. Mean age was 12.5 and 12.6 years in the urban and rural area, respectively.
Results:
Consumption of fast food, soft drinks and alcohol was more prevalent and more linked with dietary behavior in the urban than in the rural area. In both living areas protein intake was excessive (in the urban area 38.1% of subjects and in the rural 36.2% of subjects had protein intake higher than 200% RDA). Under 75% RDA/DRI in both living areas was observed for vitamin D, folate, calcium and selenium. Micronutrient intakes negatively correlated with age in both living areas, but were more pronounced in the urban area.
Conclusion:
The urban sample had more adequate energy and nutrient intakes which is consistent with prewar findings.
... European countries are traditionally known to have regional dietary patterns driven by climate, geography and cultural differences [7,8]. Nevertheless, modern industrialized European societies are undergoing dietary shifts towards a more-common Western style diet and are losing regional dietary characteristics [7,91011121314. These shifts are particularly pronounced in adolescents and young adults, and are most noticeable in Nordic and Mediterranean countries [12,13,15]. ...
... Even though globalization processes are acting at every level of the modern human food web separating people from their local resources (e.g., homogenization and industrialization of farming practices, large-scale distribution of food products and raw materials), here we have shown that regional dietary signatures are reflected in the tissues of consumers. Despite homogenization trends already detected in Europe [7,11121314, isotopic data of modern human hair from Western Europe support the existence of dietary heterogeneity, which has characterized European observations for many years [7,8,69]. While isotope data cannot fully resolve whether these patterns reflect consumers eating different locally produced foods or eating the same food items produced with local resources (glocal food), they capture a geographically structured heterogeneous diet among the sampled countries. ...
Although the globalization of food production is often assumed to result in a homogenization of consumption patterns with a convergence towards a Western style diet, the resources used to make global food products may still be locally produced (glocalization). Stable isotope ratios of human hair can quantify the extent to which residents of industrialized nations have converged on a standardized diet or whether there is persistent heterogeneity and glocalization among countries as a result of different dietary patterns and the use of local food products. Here we report isotopic differences among carbon, nitrogen and sulfur isotope ratios of human hair collected in thirteen Western European countries and in the USA. European hair samples had significantly lower δ(13)C values (-22.7 to -18.3‰), and significantly higher δ(15)N (7.8 to 10.3‰) and δ(34)S (4.8 to 8.3‰) values than samples from the USA (δ(13)C: -21.9 to -15.0‰, δ(15)N: 6.7 to 9.9‰, δ(34)S: -1.2 to 9.9‰). Within Europe, we detected differences in hair δ(13)C and δ(34)S values among countries and covariation of isotope ratios with latitude and longitude. This geographic structuring of isotopic data suggests heterogeneity in the food resources used by citizens of industrialized nations and supports the presence of different dietary patterns within Western Europe despite globalization trends. Here we showed the potential of stable isotope analysis as a population-wide tool for dietary screening, particularly as a complement of dietary surveys, that can provide additional information on assimilated macronutrients and independent verification of data obtained by those self-reporting instruments.
... This high carbohydrate intake was due to the intake of a carbohydrate-rich porridge (maize), a staple food in this population (Pretorius, Wright & Jerling, 2005). For most children from Africa and Central and Eastern Europe the sources of carbohydrate are primarily bread and bread products and starchy indigenous foods such as porridge, while the intake of fruit, vegetables, milk and dairy products are low (Parizkova, 2000; Abebe, Stoecker, Hinds & Gates, 2006; Steyn, Maunder, Labadarios & Nel, 2006). Therefore, although the daily carbohydrate intake may be high, the micronutrient density of these carbohydrates may be low (e.g. ...
... Therefore, although the daily carbohydrate intake may be high, the micronutrient density of these carbohydrates may be low (e.g. niacin, iron and vitamin A), placing these children and young athletes at risk of various micronutrient deficiencies (Parizkova, 2000; Mamabolo, Steyn & Alberts, 2006). Until more research is available, it is advised that young athletes consume at least 50% of their energy from carbohydrate, if daily energy intakes are sufficient (Petrie et al., 2004). ...
This article (the first of two parts) presents a review of the energy, macronutrients and micronutrients needs of young athletes in the light of optimal growth and performance. Maintaining a positive energy balance is an important nutritional objective for young elite athletes to ensure normal growth and development. The degree of catch-up growth following a negative energy balance will depend on the time and magnitude of the preceding negative energy balance. Energy needs can be calculated from various formulas or usual energy intake can be adapted to achieve individualized need e.g. weight gain, loss, or maintenance. Growth should be monitored using growth charts and body composition can be assessed with skin folds or body fat percentages. Anthropometric measurements should be limited to twice yearly and too much emphasis on an ideal body weight is discouraged. Young athletes should consume a diet moderate to high (±50%) daily energy intake (TE)) in micronutrient dense carbohydrate-rich foods, 12-15% TE of protein-rich foods and ±30% TE from healthy dietary fats. Iron and calcium are most likely to be low in the diets of young elite athletes. A daily iron intake of 8.0 mg in children 9-13 years and 11-15 mg for adolescent males and females, respectively are recommended. Children 9-13 years and adolescents should ingest 1300 mg calcium per day which can be achieved by having ∼3 milk and/or dairy servings per day.
... Differences among the rural and urban food cognition, and dietary and physical activity patterns are due to different lifestyles (Ruel et al., 1999, Woodward et al., 2000 Schneider, 2000; Kirby et al., 1995). Overall dietary intake and anthropometric status in Central and Eastern Europe, after the political, social and economic changes during the 1990s has varied considerably, especially in the war tom areas (Parizkova, 2000). The liberation of occupied Croatian territories ended the war in the country in 1995. ...
... High protein intake can have some adverse affects: increase in renal excretion of calcium, and in children consuming a high protein diet, the age of adiposity rebound is significantly earlier (Allen et al., 1979; Ziegler et al., 2000). High protein intake is often reported and our previous research also showed high daily protein intake in Croatian children and adolescents (Parizkova, 2000;). Observed fat intake could be regarded as high and unbalanced, but not when we consider that dairy products were present in high amount in the breakfasts of the observed population. ...
The aim of this study was to report breakfast food patterns among the rural and urban Croatian schoolchildren in the post-war socioeconomic changes. A quantitative Food Frequency Questionnaire was used. Subjects were 7-18 year old schoolchildren (815 from urban and 375 from rural areas). The average energy intake was 27.5 and 23.0% of the Recommended Dietary Allowance (RDA) in the urban and rural area respectively. Urban subjects tend to choose healthier options when older, while the rural subjects displayed the opposite (significantly correlated age with energy intake (% RDA) and dietary fibre intake (% of 'age + 5' rule). The same applied to age versus iron intake (urban positive, rural negative correlation). Breakfasts providing 20-30% RDA for energy and more than 300 mg of calcium were consumed by 20.7 and 32.4% of the urban and rural subjects respectively. Cereal products and milk and dairy products were the major breakfast constituents everywhere. Meat and its products, and eggs seem to be uncommon breakfast foods. The urban subjects had a more adequate energy intake at breakfast, but better food choices were observed among rural subjects.
... w krajach śródziemnomorskich dominują kwasy jednonienasycone , które dostarczają przeciętnie 17 -19 % energii, z kwasów nasyconych pochodzi ok. 13 % energii, a z wielonienasyconych 5 -7 %. W żywieniu młodzieży zamieszkującej w państwach Europy środkowo–wschodniej przeważają kwasy nasycone, a ogólne spożycie tłuszczu przekracza zalecane normy [1, 14]. ...
The objective of this study was to assess the dietary intake level of: total fats, saturated, monounsatu- rated, and polyunsaturated fatty acids, and cholesterol by the 16 to 18 year old high school students. The content of fats in average food rations of school students was 33.8 % of the total energy intake. The content levels of saturated (SFA) and monounsaturated (MUFA) fatty acids were close to the recommended levels (11.1 and 13.7 % of the energy value of food ration), whereas the content levels of poly-unsaturated acids from n-3 group, especially of docosahexanoic acid (DHA) and eicosapentaenoic acid (EPA), were too low (4.9 %). At the same time, it was found that the ratio of n-6 to n-3 acids was correct (∼5 : 1). Thus, it would be reasonable to increase the consumption of fish and fish products.
... Naproti tomu se v souboru z Plzně jeví relativně bezproblémová skupina mléka a mléčných výrobků. Českého prostředí, respektive střední a východní Evropy, se týká i práce Pařízkové, publikovaná v zahraničí [6]. Autorka zde dochází k závěru, že některé obligátní problémy složení stravy, jako příliš mnoho proteinů, tuků, cukrů atd., jsou u nás podobné jako v USA a západní Evropě . ...
The study objective: The described research was performed within the ELSPAC project, which aims to study in a longitudinal manner a wide variety of child growth determinants, mainly environmental, family, life-style and social factors. The goal of this part is to give basic descriptive nutritional characteristics, especially which concern the nutrition structure based on data acquired from the ELSPAC study sample at the age of eleven. Methods: The data was acquired by administering standard ELSPAC questionnaires to participating families in Brno. The nutrition information was obtained from a questionnaire about the child filled by the mother. Altogether 2151 complete reports were elaborated. Results: The main foodstuff groups consumption assessment based on average frequency has shown a low frequency of cereals, vegetables and fruits while consumption was high in the milk, meat and "other" groups. A closer look on the group inner structure has shown in some cases very unfavorable representation, for example a dominant ratio of smoked and processed meats in the meat group or similarly the ratio of biscuits and wafers in the cereal group. The consumption frequency distribution in the sample has then shown further significant shortcomings, for example only 24% of children have fresh vegetables daily and 34% 1-2 times a week at a maximum. Daily fruit consumption is reported only in 50% of children. 58% take milk and dairy products (not including curds and cheeses) daily, and curd and cheeses 39%. But 14% take milk and dairy products 1-2 times a week at a maximum and 19% curd and cheeses 1-2 times a week at a maximum. Conclusions: The results have pointed out significant shortcomings in the main foodstuff group representation when some report insufficient consumption while others too high. The importance of nutrition in childhood for health in adulthood is emphasized. The study has also shown the importance of evaluation type, for example average frequencies versus their distribution in the study sample.
... w krajach śródziemnomorskich dominują kwasy jednonienasycone , które dostarczają przeciętnie 17 -19 % energii, z kwasów nasyconych pochodzi ok. 13 % energii, a z wielonienasyconych 5 -7 %. W żywieniu młodzieży zamieszkującej w państwach Europy środkowo–wschodniej przeważają kwasy nasycone, a ogólne spożycie tłuszczu przekracza zalecane normy [1, 14]. ...
... In Germany, Norway, Belgium, Central and Eastern Europe adolescents were found to consume too low amounts of vegetables .18,19,20,21 In a national representative study, which was part of a larger Slovenian project on iodine supply and endemic goitre,22,23 we investigated dietary habits of Slovenian adolescents aged 15–16 years (n = 2,813).24,25,26,27 ...
lactation, infancy and childhood I-133 PreglednI članek/reVIew Vegetarian diets in pregnancy, lactation, infancy and childhood Vegetarijanska prehrana v času nosečnosti, dojenja, dojenčka in otroka Abstract Strict vegetarian diet with avoidance of all foods of animal origin poses a risk of deficiency of sev-eral nutrients: iron, zinc, calcium, iodine, vita-min B12, B2, A, D, n-3 long chain polyunsaturated fatty acids, particularly docosahexaenoic acid (DHA, C22: 6n-3), proteins and energy. Guide-lines of the European Society for Paediatric Gas-troenterology, Hepatology, and Nutrition (ESP-GHAN) and the Slovenian guidelines dissuade from strict vegetarian or vegan diet for children. However, in the majority of adolescents across Europe, including in Slovenia, markedly too low intake of vegetables is reported. The manuscript presents the benefits of plant-based foods in the prevention of obesity in children and adoles-cents. Other benefits of sufficient intake of plant-based foods include the prevention of cardio-vascular diseases with the Mediterranean diet. While warning against very strict vegetarian diet in infancy, specially in children, adolescents, and pregnant and lactating women it is very impor-tant to promote plant-foods in the diet of om-nivorous children and adolescents; this should become an important public health strategy. Izvleček Stroga vegetarijanska prehrana z izogibanjem vseh živil živalskega izvora pomeni tveganje za pomanjkanje več hranil: železa, cinka, kalcija, joda, vitaminov B12, B2, A, D, n-3 dolgoverižnih večkrat nenasičenih maščobnih kislin, zlasti dokozaheksaenojske kisline (DHA, C22: 6n-3), beljakovin in energije. Smernice Evropskega združenja za pediatrično gastroenterologijo, he-patologijo in prehrano (ESPGHAN) in slovenske smernice odsvetujejo strogo vegetarijansko ali vegansko prehrano za otroke. Večina mlado-stnikov v Evropi, tudi v Sloveniji, uživa občutno prenizke količine zelenjave. Članek predstavlja prednosti živil rastlinskega izvora za prepreče-vanje debelosti pri otrocih in mladostnikih. Prav tako so predstavljene druge zdravstvene predno-sti zadostnega vnosa rastlinski živil, zlasti prepre-čuje bolezni srca in ožilja na t. i. primeru sredo-zemske prehrane. Medtem ko je pomembno, da se odsvetuje zelo stroga vegetarijanska prehrana za dojenčke, otroke in mladostnike, nosečnice in doječe matere, je prav tako pomembno spodbu-janje uživanja rastlinskih živil v t. i. vsejedi pre-hrani otrok in mladostnikov, ki bi morala postati pomemben del strategije javnega zdravja.
... Long-term observations show that many obese children grow up to be obese adults, with an increased risk of metabolic diseases, such as e.g. diet-controlled diabetes, cardio-vascular diseases, arterial hypertension, or disorders in the clotting system [9]. In recent years a trend is also observed in the nutrition of teenagers to decrease the energy value of food rations in relation to the fashion to maintain a slim figure and a growing interest in slimming diets [14, 15]. ...
The purpose of this study was the estimation nutritive value of diets and nutritional status in 182 adolescents aged 12-15 years from region Wielkopolska. Nutritive value of diets were assessed by weekly recall method. Nutritional status was measured by means of anthropometrics index, body composition (FM-fat mass, FFM-fat free mass-BIA method). Diets of adolescents were not correct in the respect of minerals and vitamins. Body weight and FM value were significantly correlated with the energy value of the daily food ration and the share of energy from fat. The BMI value in the analyzed population of youngsters was significantly correlated with contents of carbohydrates and fat in daily food rations. In all population we observed high percent girls and boys with malnutrition also overweight.
... Similar results have been reported elsewhere (Karamanos et al., 2002; Tur et al., 2004; Garcia-Closas et al., 2006). This suggests that staple foods still make important contributions to the diet in these countries, although dietary patterns are observed to be changing, with a move away from traditional to commercial foods, particularly among younger generations (Cruz, 2000; Parizkova, 2000). In contrast, (variants of) the so-called 'Western' dietary patterns, characterized by a diet rich in (saturated) fats, red meat, sugary desserts and refined grains and low in fresh fruits and vegetables, poultry and/or fish, were clearly established in Nordic and central European countries, with relatively modest contributions to total energy intake from highly processed staple foods (21–29%) and non-processed foods. ...
To describe the contribution of highly processed foods to total diet, nutrient intakes and patterns among 27 redefined centres in the 10 countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC).
Single 24-hour dietary recalls were collected from 36,034 individuals (aged 35-74 years) using a standardized computerized interview programme (EPIC-SOFT). Centre-specific mean food intakes (g/day) were computed according to their degree of food processing (that is, highly, moderately and non-processed foods) using a specifically designed classification system. The contribution (%) of highly processed foods to the centre mean intakes of diet and 26 nutrients (including energy) was estimated using a standardized nutrient database (ENDB). The effect of different possible confounders was also investigated.
Highly processed foods were an important source of the nutrients considered, contributing between 61% (Spain) and 78-79% (the Netherlands and Germany) of mean energy intakes. Only two nutrients, beta-carotene (34-46%) and vitamin C (28-36%), had a contribution from highly processed foods below 50% in Nordic countries, in Germany, the Netherlands and the United Kingdom, whereas for the other nutrients, the contribution varied from 50 to 91% (excluding alcohol). In southern countries (Greece, Spain, Italy and France), the overall contribution of highly processed foods to nutrient intakes was lower and consisted largely of staple or basic foods (for example, bread, pasta/rice, milk, vegetable oils), whereas highly processed foods such as crisp bread, breakfast cereals, margarine and other commercial foods contributed more in Nordic and central European centres.
Highly industrially processed foods dominate diets and nutrient patterns in Nordic and central European countries. The greater variations observed within southern countries may reflect both a larger contribution of non/moderately processed staple foods along with a move from traditional to more industrialized dietary patterns.
... Improper nutrition is related not only to habits and traditions, but also changes in the prices of foodstuffs being a direct result of political and economic in recent years. Common nutritional errors increase the risk of certain diseases, particularly among the populations of Ukraine, Belarus and Central Poland exposed to the consequences of the nuclear disaster in Chernobyl [Parizkova 2000]. A noticeable feature of the nutritional pattern of adolescent and adult females in the U.S. is the deficiency calcium, folic acid, vitamin B 6, vitamin B 12, and vitamin C [Arab et al. 2003]. ...
This paper attempts to find out if the education of female students of a secondary school of catering has had any effect on the improvement of their diets. The research shows that the diets of first-grade students provides the recommended dietary allowance for energy and nutrients to a greater, yet still insufficient extent than the diets of higher grade students. The results of the statistical analysis showed, that among 23, only in a few causes of nutrients, differences between percentage of recommended intake were significant. The consumption of energy, water-soluble vitamins and minerals, mainly calcium, copper and magnesium has been insufficient to satisfy the recommended dietary allowances. The intake of fat-soluble vitamins (A and E) has been sufficient or even higher than the recommended dietary allowance while that of sodium several times exceeded the low normal range in the case of all female students under study.
... ng health status, and concludes that " ... the health situation in (parts of ) the former communist bloc is dire " . The adverse trends have been reported across a wide range of health problems. For example, Stegmayr et al (2000) note there has been a widening gap in stroke mortality between Russia and Sweden since the break-up of the Soviet Union. Parízková (2000) examined trends in the former Soviet states with respect to adolescent nutritional status. He observes that the changes of the early 1990s led to an increase in differences, both between countries and within them. The underlying factors have included greater civil unrest, a widening of incomes, and large fluctuations in the price and av ...
Mongolia is a poor country that lost 30% of its GDP when the Soviet Bloc collapsed in 1990. Its health care system had the typical weaknesses of centrally planned economies--quantity rather than quality, excessive medical specialisation, dominance of the hospital sector, weak policy and management capabilities, little community participation in decision making, and so on. This paper describes Mongolia's attempts to resolve these problems through a radical program of reform that began in 1998. There have been significant successes in spite of almost overwhelming difficulties, and this may be a consequence of the strong sense of community that has been present for five hundred years and re-emerged intact at the end of 70 years of Soviet dominance. We argue, however, that good design and skillful implementation of the reform program may have made a contribution. Its notable features have included the use of a comprehensive and integrated model rather than piecemeal reform, the generation of political support for change through social marketing campaigns, a team approach using local and international experts, and co-ordination of international donor activities. Some of these features may be relevant to other transitional and developing countries.
... In recent years there has been a lively interest in the literature in determining the physical, physiological, and psychological attributes that may be helpful in the early identification of talented soccer players (Reilly et al., 2000; Williams and Reilly, 2000). However, there is little information on the nutritional status and food habits of adolescent soccer players (Boisseau et al., 2002; Leblanc et al., 2002; Rico-Sanz et al., 1998), as is true for male adolescent athletes in general (Berning et al., 1991; Parizková, 2000). It is well known that proper nutrition and regular physical activity during adolescence are crucial for optimal growth and development, as well as for promoting good health in the short and long term. ...
The aim of this study was to assess the food habits and nutritional status of high level adolescent soccer players (N = 33; ages 14-16 yrs) living in their home environment. Body composition (height, mass, skinfolds), biochemical and hematological parameters, performance in soccer-specific tests (sprinting, jumping, intermittent endurance), and dietary intake (weighed food intake method) and related behaviors (nutrient supplement use, daily activity profile) were assessed. Daily energy expenditure and energy intake were 12.5 MJ and 12.6 MJ, respectively. Protein (16% of energy intake; 1.9 g/kg of body mass), lipid (38%), and cholesterol (385 mg) intake were above recommendations, while carbohydrates (45%) were below. The food intake of these adolescents was based on cereals and derivates; meat, fish, and eggs; milk and dairy products; biscuits and confectionery; and oil, butter and margarine, which provided 78% of total energy intake, 85% of proteins, 64% of carbohydrates, 90% of lipids, and 47% of fiber. Although diet provided sufficient iron, 48% of individuals showed iron deficiency without anemia. Based on these results, a well designed nutrition intervention would be advisable for optimizing performance, and especially for promoting healthy eating habits in adolescent soccer players.
... In the past, many European countries have carried out dietary surveys among adolescents, which provide valuable information of use in local nutrition policy and practice. However, the comparability of these local efforts across countries is questionable due to differences in sampling, methodology and measurement instruments used (Cruz, 2000; Parizkova, 2000; Rolland-Cachera et al. 2000; Samuelson, 2000). The standardised methodology of the HBSC study, elaborated with a view to consistency and comparability across participating countries and across successive surveys , therefore, provides a unique opportunity to allow between-country comparisons and trend analyses. ...
The present study describes food habits in adolescents in thirty-five countries and regions (European countries/regions, Israel, Canada and the USA), based on the food-frequency questions from the cross-sectional Health Behaviour in School-aged Children survey of the year 2001-2. A total of 162,305 pupils of 11, 13 or 15 years of age completed an anonymous standardised questionnaire on health and lifestyle factors during one school hour. Large differences in food habits between countries were found: the consumption frequency of fruit varied from on average 2.8 to 5 d/week, the consumption of vegetables varied from on average 2.4 to 5.5 d/week, the consumption of soft drinks varied from 2.1 to 5 d/week and sweet consumption from 2.6 to 5 d/week. Methodological problems in comparing between countries are discussed. Nonetheless, the results indicate a need for national and international health promotion programmes to improve adolescents' food habits.
The purpose of this study is to analyze the differences of food habits and food preferences between lower and higher grade students through the survey of elementary school students in Daejeon four elementary schools located in Jung-Gu and Seo-Gu in Daejeon are selected for this survey randomly and the completion of the questionnaires are according to grade. 1. Practical Analysis of Food Habits: For regular meals, the highest number of subjects skipped breakfast. It is being found that the girl students (81.61%) consumed more cooked rice than the boys (78.85%) and more boys (13.10%) ate bread or milk more than the girls (9.20%). The most important thing for the lower grades students (34.20%) when consuming is the nutritious foods, while the higher grades students (49.67%) consumed the set meals. During consumption, the highest number of the subjects watched TV or read books from time to time. More higher grades students (38.98%) preferred spicy and salty foods than the lower grades (22.09%). 2. Food Preferences: Between rice and noodles, most subjects preferred cooked rice (81.38%), Jajangmyeon (80.80%), Ramyeon (79.43%), and disliked bean-mixed rice (28.39%). For soups, Most students enjoy the Deokkguk. Majority of the subjects prefer meat and fried or steamed foods, and also grilled and pan-fried dishes. For the pan-roasted and fried dishes, most subjects did not enjoy the rhizome fry and sweet-pumpkin fry methods, and for vegetables, they did not like wild vegetable and seasoned cucumber (40.57%) The higher grades students enjoy the vegetables and salads more than the lower grades students. For Kimchi varieties, it is found that subjects like the cabbage Kimchi (69.66%) the most. There is little difference in food preference between the lower and higher grade students, but the rankings of food preferences are different according to various grades.
The incidence of inflammatory bowel disease (IBD) is increasing in Eastern Europe possibly due to changes in environmental factors towards a more "westernised" standard of living. The aim of this study was to investigate differences in exposure to environmental factors prior to diagnosis in Eastern and Western European IBD patients.
The EpiCom cohort is a population-based, prospective inception cohort of 1560 unselected IBD patients from 31 European countries covering a background population of 10.1million. At the time of diagnosis patients were asked to complete an 87-item questionnaire concerning environmental factors.
A total of 1182 patients (76%) answered the questionnaire, 444 (38%) had Crohn's disease (CD), 627 (53%) ulcerative colitis (UC), and 111 (9%) IBD unclassified. No geographic differences regarding smoking status, caffeine intake, use of oral contraceptives, or number of first-degree relatives with IBD were found. Sugar intake was higher in CD and UC patients from Eastern Europe than in Western Europe while fibre intake was lower (p<0.01). Daily consumption of fast food as well as appendectomy before the age of 20 was more frequent in Eastern European than in Western European UC patients (p<0.01). Eastern European CD and UC patients had received more vaccinations and experienced fewer childhood infections than Western European patients (p<0.01).
In this European population-based inception cohort of unselected IBD patients, Eastern and Western European patients differed in environmental factors prior to diagnosis. Eastern European patients exhibited higher occurrences of suspected risk factors for IBD included in the Western lifestyle.
Objective: To compare micronutrient intakes and status in Central and Eastern Europe (CEE) with those in other European countries and with reference values. Design: Review of the micronutrient intake/status data from open access and grey literature sources from CEE. Setting: Micronutrients studied were folate, iodine, Fe, vitamin B 12 and Zn (for intake and status) and Ca, Cu, Se, vitamin C and vitamin D (for intake). Intake data were based on validated dietary assessment methods; mean intakes were compared with average nutrient requirements set by the Nordic countries or the US Institute of Medicine. Nutritional status was assessed using the status biomarkers and cutoff levels recommended primarily by the WHO. Subjects: For all population groups in CEE, the mean intake and mean/median status levels were compared between countries and regions: CEE, Scandinavia, Western Europe and Mediterranean. Results: Mean micronutrient intakes of adults in the CEE region were in the same range as those from other European regions, with exception of Ca (lower in CEE). CEE children and adolescents had poorer iodine status, and intakes of Ca, folate and vitamin D were below the reference values. Conclusions: CEE countries are lacking comparable studies on micronutrient intake/ status across all age ranges, especially in children. Available evidence showed no differences in micronutrient intake/status in CEE populations in comparison with other European regions, except for Ca intake in adults and iodine and Fe status in children. The identified knowledge gaps urge further research on micronutrient intake/status of CEE populations to make a basis for evidence-based nutrition policy.
Several risk factors of diet-related diseases are present in the nutrition of the Hungarian population. The aim of the study was to investigate the health status and the association of the daily consumption of fruits and vegetables as indicators of healthy diet with sociodemographic factors, health behaviours in the south-eastern part of Hungary. In 2002, a cross-sectional study based on interviewer-administered questionnaires was conducted in the south-eastern part of Hungary. The sample comprised of 3419 people, aged between 15 and 75, with about 40 persons from each practice. The results demonstrated that fruit and vegetable consumption of the studied population were determined by certain demographical, economical and lifestyle factors, and were also associated with self-assessed health and health status. Altering the habits of nutrition is an integral part of health intervention programs. Success rate may, however, be largely reduced by the social and economic background of the habits in question.
Objective:
To compare micronutrient intakes and status in Central and Eastern Europe (CEE) with those in other European countries and with reference values.
Design:
Review of the micronutrient intake/status data from open access and grey literature sources from CEE.
Setting:
Micronutrients studied were folate, iodine, Fe, vitamin B12 and Zn (for intake and status) and Ca, Cu, Se, vitamin C and vitamin D (for intake). Intake data were based on validated dietary assessment methods; mean intakes were compared with average nutrient requirements set by the Nordic countries or the US Institute of Medicine. Nutritional status was assessed using the status biomarkers and cut-off levels recommended primarily by the WHO.
Subjects:
For all population groups in CEE, the mean intake and mean/median status levels were compared between countries and regions: CEE, Scandinavia, Western Europe and Mediterranean.
Results:
Mean micronutrient intakes of adults in the CEE region were in the same range as those from other European regions, with exception of Ca (lower in CEE). CEE children and adolescents had poorer iodine status, and intakes of Ca, folate and vitamin D were below the reference values.
Conclusions:
CEE countries are lacking comparable studies on micronutrient intake/status across all age ranges, especially in children. Available evidence showed no differences in micronutrient intake/status in CEE populations in comparison with other European regions, except for Ca intake in adults and iodine and Fe status in children. The identified knowledge gaps urge further research on micronutrient intake/status of CEE populations to make a basis for evidence-based nutrition policy.
The present study investigated the association between cardiorespiratory fitness (CRF) and dietary intake in European adolescents. The study comprised 1492 adolescents (770 females) from eight European cities participating in the HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) study. CRF was assessed by the 20 m shuttle run test. Adolescents were grouped into low and high CRF levels according to the FITNESSGRAM Standards. Dietary intake was self-registered by the adolescents using a computer-based tool for 24 h dietary recalls (HELENA-Dietary Assessment Tool) on two non-consecutive days. Weight and height were measured, and BMI was calculated. Higher CRF was associated with higher total energy intake in boys (P = 0·003). No association was found between CRF and macronutrient intake (as percentage of energy), yet some positive associations were found with daily intake of bread/cereals in boys and dairy products in both boys and girls (all P < 0·003), regardless of centre, age and BMI. CRF was inversely related to sweetened beverage consumption in girls. These findings were overall consistent when CRF was analysed according to the FITNESSGRAM categories (high/low CRF). A high CRF was not related to compliance with dietary recommendations, except for sweetened beverages in girls (P = 0·002). In conclusion, a high CRF is associated with a higher intake of dairy products and bread/cereals, and a lower consumption of sweetened beverages, regardless of centre, age and BMI. The present findings contribute to the understanding of the relationships between dietary factors and physiological health indicators such as CRF.
Since inadequate food consumption patterns during adolescence are not only linked with the occurrence of obesity in youth but also with the subsequent risk of developing diseases in adulthood, the establishment and maintenance of a healthy diet early in life is of great public health importance. Therefore, the aim of the present study was to describe and evaluate the food consumption of a well-characterized sample of European adolescents against food-based dietary guidelines for the first time.
The HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) Study is a cross-sectional study, whose main objective was to obtain comparable data on a variety of nutritional and health-related parameters in adolescents aged 12·5-17·5 years.
Ten cities in Europe.
The initial sample consisted of more than 3000 European adolescents. Among these, 1593 adolescents (54 % female) had sufficient and plausible dietary data on energy and food intakes from two 24 h recalls using the HELENA-DIAT software.
Food intake of adolescents in Europe is not optimal compared with the two food-based dietary guidelines, Optimized Mixed Diet and Food Guide Pyramid, examined in this study. Adolescents eat half of the recommended amount of fruit and vegetables and less than two-thirds of the recommended amount of milk (and milk products), but consume much more meat (and meat products), fats and sweets than recommended. However, median total energy intake may be estimated to be nearly in line with the recommendations.
The results urge the need to improve the dietary habits of adolescents in order to maintain health in later life.
To assess the prevalence of normal weight, overweight and obesity among 10-18-year-old Czech Republic adolescents and to assess the association between energy balance-related behaviours and overweight/obesity.
Cross-sectional data from 'The 6th Nation-wide Anthropological Survey of Children and Adolescents 2001 Czech Republic' have been used.
Height and weight were objectively measured. Data on adolescents' behaviours were assessed with self-reported questionnaires. Background variables were assessed by means of a parental questionnaire. Multi-level logistic regression analyses were conducted to assess behavioural risk factors of being overweight/obese.
Data on 31,228 adolescents aged 10-18 years were included in the present study.
The highest prevalence of being overweight or obese was found among boys and younger adolescents. Boys were more physically active, watched more television (TV) and used the computer more often than did girls. Being on a diet and skipping meals were positively associated with being overweight/obese, independent of gender. In boys (10-14 years old), inverse associations with being overweight/obese were found when being more physically active. Monitoring weight showed inverse relations with being overweight/obese in 15-18-year-old girls. Watching TV more than 7 h a week was positively associated with being overweight/obese in 15-18-year-old girls, and was found to be negatively associated in boys of the same age group.
These behaviours should be targeted when preventing overweight and obesity among Czech Republic adolescents. Studies using better measures of energy balance-related behaviours are needed.
To describe the development of a European computerized 24-h dietary recall method for adolescents, and to investigate the feasibility of self-administration (self report) by comparison with administration by a dietician (interview).
Two hundred and thirty-six adolescents (mean age 14.6 years (s.d.=1.7)) of eight European cities completed the 24-h recall (Young Adolescents Nutrition Assessment on Computer (YANA-C)) twice (once by self-report and once by interview).
A small but significant underestimate in energy (61 (s.e.=31) kcal) and fat (4.2 (s.e.=1.7) g) intake was found in the self-reports in comparison with the interviews; no significant differences were found for the intake of carbohydrates, proteins, fibre, calcium, iron and ascorbic acid. Spearman's correlations were highly significant for all nutrients and energy ranging between 0.86 and 0.91. Agreement in categorizing the respondents as consumers and non-consumers for the 29 food groups was high (kappa statistics >or=0.73). Percentage omissions were on average 3.7%; percentage intrusions: 2.0%. Spearman's correlations between both modes were high for all food groups, for the total sample (>or=0.76) as well as for the consumers only (>or=0.72). Analysing the consumer only, on an average 54% of the consumed amounts were exactly the same; nevertheless, only for one group 'rice and pasta' a significant difference in consumption was found.
Adaptation, translation and standardization of YANA-C make it possible to assess the dietary intake of adolescents in a broad international context. In general, good agreement between the administration modes was found, the latter offering significant potential for large-scale surveys where the amount of resources to gather data is limited.
The present study was designed to estimate the average food and nutrient intake in a sample of Italian students living in the District of Rome. In the school year 1999-2000 all students belonging to the first, second or third year of nine randomly selected secondary public schools were contacted for filling in a food frequency questionnaire (3982 subjects). The next year, 233 of them (125 males and 108 females), randomly extracted, participated in a detailed food survey. Food intake was assessed on the basis of 12 (four consecutive days in three different periods) 24-h dietary records. The average daily intakes of fruit (107 +/- 100 g/day), vegetables (186 +/- 74 g/day) and legumes (16 +/- 29 g/day) were lower than recommended. The percentage of energy intake from fat (39%) and that from saturated fats (12%) were high. On the other hand, the percentage of energy intake from carbohydrates was low (45%) even if that from sugar (14%) was rather high. The students' diet was characterized by low intakes of fibre (16 +/- 6 g/day) and calcium (710 +/- 247 mg/day) in both males and females. Iron intakes were lower than 12 mg/day in a very high percentage of females (80%), suggesting that iron deficiency may be present in this population group. Results indicate that the diet of these students is both unbalanced in terms of macronutrients and deficient for some micronutrients, suggesting the need for intervention.
To compare health behavior patterns of adolescents in Lithuania with health behavior of adolescents in European Union (EU) in 2001/2002.
The study was carried out in conformity with the methodology of Health Behavior in School-aged Children: a World Health Organization cross-national study. Three country representative samples of schoolchildren, aged 11, 13, and 15, were surveyed in 25 EU countries and regions in 2001/2002 school year. The study instrument was a standardized questionnaire that included questions on alcohol consumption, smoking, illegal drugs use, physical activity, and other patterns of health behavior. The rate or mean values of the targeted health behavior of Lithuanian students were assessed and compared to those calculated as an average for the EU countries and regions.
We found an early onset of alcohol consumption among Lithuanian boys. Lithuanian boys and girls across all age groups reported being drunk two and more times more often than their peers from other EU member states. Lithuanian 15-year-old boys smoked more often that did their European peers, while girls smoke more rarely. The prevalence of drugs (marihuana group) use among Lithuanian students is relatively low: the prevalence of drug use among 15-year-olds in Lithuania is two times lower than the prevalence in other EU countries and regions (11.2% vs 24.5% for boys and 4.5% vs 18.3% for girls, respectively). Physical activity of Lithuanian adolescents is rather high in comparison with their EU peers, although many students watch television for > or =4 hours a day. Lithuanian students did not eat sweets often, or drank soft drinks (Coca Cola and other), and they ate fruits and had breakfast every school day. With respect to hygienic habits, approximately only one in 3 boys and every second girl brushed their teeth more than once a day.
There are health behavior differences between adolescents in Lithuania and those in other EU countries. The disparities among health behavior of young people in EU countries and regions require Lithuanian and EU health policy to develop initiatives aimed at decreasing health behavior inequalities.
Dieting, a behavioral phenomenon which is becoming more frequent among adolescents, is certainly involved in the pathogenesis of eating disorders, especially anorexia nervosa (AN), and may result in an unbalanced nutrition. Our study aimed at identifying girls with symptoms of AN and describing their diets. We assessed girls with symptoms by using the Eating Attitudes Test and considered girls with a score > or = 20 as having symptoms of AN. To evaluate their diets, a "modified" 24-hour recall was applied on three alternate days. Twenty-one percent of the 279 girls studied showed symptoms of AN. Analysis of the food intake showed that calories, calcium and iron were below the recommendations of the Standing Committee on the Specific Evaluation of Dietary Reference Intakes (DRI Committee) and the National Research Council, while protein and carbohydrate were within the recommended range and fat was above the percentage of recommended total energy intake. Compared to girls without symptoms, they had a significantly smaller intake of calories and iron, and a higher intake of protein. Findings shown in this paper point out the need for intervention in adolescents because their dieting behavior can predispose to an eating disorder.
The aim of the study was to evaluate diet quality and nutrient intakes in Croatian university students, which are missing for the past 15 years, and also to report the prevalence of overweight/obesity and underweight. The subjects were 663 students (average age 22 years), representing 0.6% of all Croatian university students. The Quantified Food Frequency Questionnaire, checked for reproducibility and validity, was used for dietary assessment. Students on average had an adequate number of daily meals and snacks, but consumption of breakfast was irregular, particularly for men. The average energy intake was 130.1% of the dietary reference intake and the protein intake was more than double the dietary reference intake in 64.3% students. Dietary fiber, iron (in females), calcium, zinc, folate, and vitamins C, A and E intake were below recommendations in both genders. Only 3.8% of females and 21.9% of males were overweight/obese (body mass index >25 kg/m(2)). Nutrient intakes significantly differed according to gender and better macronutrient but not micronutrient intakes were observed in females.
For over 20 years Poland has been one of the countries with the world's highest consumption of tobacco. In view of the widespread popularity of this addition, of particular importance becomes the problem of women becoming addicted to tobacco smoke. Therefore, the objective of this work was to develop and conduct preliminary surveys aimed at the determination of the scale of active and passive cigarette smoking among young women as well as the assessment of smoking on physical fitness. The research took a form of an anonymous questionnaire administered to 80 female secondary school graduates who were passing their entrance examinations to the University of Physical Education in Wrocław. The physical capacities were assessed on the basis of fitness tests and their results were subject to statistical analysis. One identified a significant impact of cigarette smoking on reducing the physical fitness and, in consequence, lower scores in the fitness test among smoking girls when compared to the scores of non-smoking girls (respectively 17.5+/-2.0; 21.0+/-4.5; p<0.0001). It was shown that smoking more than 10 cigarettes per day and on the fitness test day has considerably influenced their physical fitness (p<0.002; p<0.0004). Moreover, smoking women devoted less time to exercises and had a higher BMI when compared to non-smoking women.
The prevalence of obesity is increasing in transitional countries, but extensive data on some countries, such as Bulgaria, are still lacking. Therefore, the objective of the present study was to estimate the prevalence of overweight and obesity, relative to gender and income, among adults in Sofia, Bulgaria.
Cross-sectional survey to collect data on diet, health, BMI and income using a brief questionnaire on diet and income. Data were analysed using analysis of covariance to determine differences within and between income and gender groups.
Sofia, Bulgaria.
Adults living in the city of Sofia, Bulgaria.
For adults 30-60 years of age, 35.1 % were overweight and 6.2 % were obese. The proportion of overweight and obesity was higher among men than women (44.8 % v. 32.4 % and 6.0 % v. 4.7 %, respectively). With respect to income, BMI decreased as income increased. For men, BMI was highest for the lowest and highest income groups, whereas for women lower income was associated with a higher BMI.
The prevalence of overweight and obesity appears to be an emerging problem in some sectors of Bulgarian society, based on our data from the largest urban area of the country. These data provide new information on the divergence in health and disease risk in a country that is still economically challenged and may be facing the nutrition transition.
This study evaluated the iron sufficiency of the Russian diet.
Data were obtained from 24-hour dietary recalls conducted in 4 rounds (1992 through 1994) of a nationally representative longitudinal survey of 10,548 women and children. Iron bioavailability was estimated via algorithms adjusting for enhancers (heme, vitamin C) and inhibitors (tannins in tea, phytates in grains) consumed at the same meal.
Dietary iron intakes were deficient in the most vulnerable groups: young children and women of reproductive age. Poverty status was strongly associated with deficiency. After adjustment for enhancers and inhibitors, estimated bioavailable iron intakes at 3% to 4% of total iron were inadequate in all women and children.
These dietary data suggest that Russian women and children are at high risk of iron deficiency. Grain products rich in phytates, which inhibit absorption, were the major food source of iron in Russia. High intakes of tea and low consumption of vitamin C also inhibited iron bioavailability. Since changes in eating behavior could potentially double iron bioavailability, educational programs should be explored as a strategy for improving iron nutriture.
Iron status was assessed in a sample of 103 male and 282 female students aged from 15 to 18 years attending secondary schools in Budapest. Using a ferritin model, in boys the prevalence of iron depletion, iron-deficient erythropoiesis and iron-deficient anemia was 3.9, 2.9 and 1.0%, respectively. In girls these values were 9.6, 8.2 and 2.8%, respectively. Males had better eating habits than females. Data for nutrients intake connected with iron status are discussed. The authors recommend the improvement of iron status by dietary means and oppose the indiscriminate iron supplementation.
Central Europe comprises a heterogeneous group of some 120 million persons from 11 countries which differ greatly in food availability and preferences. The region has undergone dramatic changes in food consumption patterns and in the patterns of nutritionally related diseases. The changes in the political situation in central Europe have provided a unique natural experiment which allows the study of the effects of different eating behaviors on health within a genetically homogeneous population and an analysis of the time frame in which effects can be seen at the national level. This is in particular the case for the FRG and the GDR. Epidemics of nutritionally related disease have arisen, including cardiovascular disease, cancers of the colon and breast and obesity. These occur at very different rates in neighboring countries. Furthermore, unknown factors, probably including food-hygienic factors and methods of storage and preparation, have resulted in drastic reductions in the rates of stomach cancers in all countries. These have only recently been detected, as no systematic nutritional surveillance systems are currently in effect in Europe. Due to the chronic nature of the diseases in question, we are noticing too little, too late. Food patterns provide a realistic and sensitive predictor of disease incidence. They are timely enough to detect changes before they are reflected in a diminished health status of the population or specific risk groups. Details on the patterns of intake and secular trends, as far as they are available for individual countries, reveal that eating behavior is quite labile and subject to dramatic changes within decades. The current information status does not allow a closer examination of specific population groups, such as the behavior of children or the elderly, the intakes of pregnant or breast-feeding women, or the eating behavior of men at high risk of heart disease. The foundations of a European nutrition surveillance system need to be laid, to make possible the timely detection of high-risk-related changes in food consumption, unfavorable trends and early signs of nutritionally related epidemics. The regular, standardized assessment of eating patterns will be an important building stone in such a system.
The validity of equations for the calculation of resting metabolic rate (RMR) were studied and new predictive equations were developed.
The RMR was measured in a sample of 371 10- to 16-year-old prepubertal and postpubertal children. The study group included 193 male (116 nonobese and 77 obese) and 178 female (119 nonobese and 59 obese) subjects; for each group the RMRs predicted from five equations recommended for this age group were compared. The RMR was assessed by indirect calorimetry with a ventilated hood system for 45 minutes after an overnight fast. Body composition was estimated from skin-fold measurements.
The mean +/- SD RMR was found to be 5600 +/- 972 kJ/24 hr and 7223 +/- 1220 kJ/24 hr in nonobese and obese boys, and 5112 +/- 632 kJ/24 hr and 6665 +/- 1106 kJ/24 hr in nonobese and obese girls, respectively. All five equations applicable to 10- to 16-year-old children overestimated RMR by 7.5% to 18.1% (p < 0.001 for each equation). Stepwise regression analysis, with independent variables such as age, weight, height, and gender, allowed development of new predictive equations for the calculation of RMR in 10- to 16-year-old boys (RMR = 50.9 Weight (kg) + 25.3 Height (cm) -50.3 Age (yr) + 26.9; R2 = 0.884, p < 0.0001) and girls (RMR = 51.2 Weight (kg) + 24.5 Height (cm) - 207.5 Age (yr) + 1629.8; R2 = 0.824, p < 0.0001). These predictive equations were tested in a second, independent cohort of children (80 male and 61 female subject) and were found to give a reliable estimate of RMR in 10- to 16-year-old obese and nonobese adolescents.
The currently used predictive equations overestimate RMR in 10- to 16-year-old children. The use of the newly developed equations is recommended.
Selected indicators of nutritional status in children and adolescents assessed in 1988 and 1992 were compared in relation to changed food consumption trends caused by liberalization of food prices. In 1992, 1507 individuals aged 11-18 years were examined and the results were compared with those of children and adolescents of the same age group examined in 1988. Negative changes in food habits are probably the cause of persisting high levels of serum lipids and increasing frequency of hypoascorbinaemia.
Food intake and nutrition were studied in a representative population of 10-year-olds living in the Czech Republic (n = 339), along with biological parameters (anthropometry, cholesterol) and social factors. The weight/height body mass index was normal (average = 17 kg/m2), in spite of energy intake (about 8,000 kJ) 10% below Czech recommendations. The protein-fat-carbohydrate distribution of the diet was 11, 35 and 54%. Many children had a high level of serum cholesterol (mean 4.38 mmol/l). Finally, ingesting a healthier lunch at school than at home improved the daily ration in energy and many nutrients.
In Czechoslovakia, overweight and nutrition-associated pathologies are frequent. The body mass index (BMI) is often used in the clinical assessment of adiposity in children and adults. Its variations during growth are well documented. A cohort of 300 newborns were selected at random in Prague between 1956 and 1960. Weight and height were collected in these subjects at the ages of 3, 6, 9, and 12 months and twice a year from 1 to 20 years. Charts of longitudinal variations of the BMI were drawn for males and females. The three expected phases of BMI development were observed: initial rise until 12 months, subsequent decrease, and second augmentation (the 'adiposity rebound', 'AR') between 4 and 8 years of age. The inverse relationship between age at AR and the BMI in adulthood was confirmed: in the leanest adults, AR had happened by age 7.6 years, in the heaviest adults, age at AR was around 5 years. Many lean (44%) and fat (58%) infants developed into average-size adults. The risk of becoming a heavy adult was increased in fat infants (31%) as opposed to non-fat (22%) ones. The relative risk of fat infants to become obese adults as compared to non-fat infants is 31/22 = 1.8. Individual growth curves of children with very high or very low adult BMI values illustrate the relationships between BMI at 12 months, age at AR and adult BMI. The Czech BMI distribution was higher than a comparable French one at all percentiles after age 7 years.(ABSTRACT TRUNCATED AT 250 WORDS)
In the present study, the body composition was measured in 35 Ukrainian children, 14 boys and 21 girls, aged 8-12 years, by dual-energy X-ray absorptiometry (DEXA), anthropometry, and bioelectrical impedance. The results were compared with those obtained from a sample of the same number of Italian and Dutch children of the same sex and range of age. The Ukrainian children were slightly smaller, had a lower body weight, and had a lower body fat percentage, as measured by skinfolds, as compared with the Italian and Dutch children, as well as a lower calculated fat-free mass (FFM) by impedance. Comparison between FFM as determined by different methods in the Ukrainian children showed that all assessed values differed significantly. In particular, all methods overestimated the FFM as compared with DEXA, but the differences between DEXA and the other methods were not dependent on the level of FFM as determined by DEXA. Furthermore, the difference between predicted FFM and FFM values obtained by DEXA was correlated for skinfolds and body mass index (r = 0.77, p < 0.01), but not for body mass index and impedance, or skinfolds and impedance. The mean differences were 1.8 +/- 1.5 for body mass index, 1.0 +/- 1.4 for impedance, and 3.6 +/- 1.6 for skinfolds. Some differences in the body composition have also been found between boys and girls. The boys had higher values of lean tissue (23.3 +/- 3.1 vs. 20.7 +/- 3.3; p < 0.01) and FFM (24.5 +/- 3.3 vs. 21.8 +/- 3.5; p < 0.01) as compared with the girls and slightly higher values of bone mineral content. It should be noted, however, that the differences between different groups and different methods are always small, even when they are statistically significant.
