Publications by authors named "Lauren Lissner"

201 Publications

Improving cardiorespiratory fitness protects against inflammation in children: the IDEFICS study.

Pediatr Res 2021 Apr 9. Epub 2021 Apr 9.

GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain.

Background: Muscular and cardiorespiratory fitness (MF and CRF) have been related to inflammation. Thus, the aim of this study was to assess the relationship between fitness and high-sensitivity C-reactive protein (hs-CRP) in European children both in the cross-sectional and longitudinal analysis.

Methods: Three hundred and fifty-seven children (46.2% males) aged 2-9 years with hs-CRP measured, data from MF and CRF, diet quality, objectively measured physical activity (PA) and screen time at baseline and follow-up after 2 years were included. Body mass index z-score (zBMI), waist circumference (WC) and fat mass index (FMI) were assessed. MF and CRF were also dichotomized as follows: low-medium quartiles (Q1-Q3) and highest quartile (Q4).

Results: At follow-up, children with the highest CRF (Q4) showed a lower probability of having high hs-CRP. In the longitudinal analysis, children who improved their CRF over time showed a significantly lower probability (p < 0.05) of being in the highest hs-CRP category at follow-up, independently of the body composition index considered: odds ratio (OR) = 0.22 for zBMI, OR = 0.17 for WC, and OR = 0.21 for FMI.

Conclusions: Improving CRF during childhood reduces the odds of an inflammatory profile, independently of body composition and lifestyle behaviours. These highlight the importance of enhancing fitness, especially CRF, to avoid an inflammatory state in children.

Impact: Improvements in the cardiorespiratory profile during childhood could reverse an unfavourable inflammatory status. There is a longitudinal and inverse association between CRF and inflammation in children. This is the first longitudinal study assessing the relationship between fitness and inflammation during childhood that takes also into account the lifestyle behaviours. Results from the present study suggest a protective role of fitness already in childhood. Efforts to improve fitness in children should be aimed at as inflammation could trigger future cardiovascular disease.
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http://dx.doi.org/10.1038/s41390-021-01471-0DOI Listing
April 2021

Polygenic risk for obesity and its interaction with lifestyle and sociodemographic factors in European children and adolescents.

Int J Obes (Lond) 2021 Mar 22. Epub 2021 Mar 22.

Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany.

Background: Childhood obesity is a complex multifaceted condition, which is influenced by genetics, environmental factors, and their interaction. However, these interactions have mainly been studied in twin studies and evidence from population-based cohorts is limited. Here, we analyze the interaction of an obesity-related genome-wide polygenic risk score (PRS) with sociodemographic and lifestyle factors for BMI and waist circumference (WC) in European children and adolescents.

Methods: The analyses are based on 8609 repeated observations from 3098 participants aged 2-16 years from the IDEFICS/I.Family cohort. A genome-wide polygenic risk score (PRS) was calculated using summary statistics from independent genome-wide association studies of BMI. Associations were estimated using generalized linear mixed models adjusted for sex, age, region of residence, parental education, dietary intake, relatedness, and population stratification.

Results: The PRS was associated with BMI (beta estimate [95% confidence interval (95%-CI)] = 0.33 [0.30, 0.37], r = 0.11, p value = 7.9 × 10) and WC (beta [95%-CI] = 0.36 [0.32, 0.40], r = 0.09, p value = 1.8 × 10). We observed significant interactions with demographic and lifestyle factors for BMI as well as WC. Children from Southern Europe showed increased genetic liability to obesity (BMI: beta [95%-CI] = 0.40 [0.34, 0.45]) in comparison to children from central Europe (beta [95%-CI] = 0.29 [0.23, 0.34]), p-interaction = 0.0066). Children of parents with a low level of education showed an increased genetic liability to obesity (BMI: beta [95%-CI] = 0.48 [0.38, 0.59]) in comparison to children of parents with a high level of education (beta [95%-CI] = 0.30 [0.26, 0.34]), p-interaction = 0.0012). Furthermore, the genetic liability to obesity was attenuated by a higher intake of fiber (BMI: beta [95%-CI] interaction = -0.02 [-0.04,-0.01]) and shorter screen times (beta [95%-CI] interaction = 0.02 [0.00, 0.03]).

Conclusions: Our results highlight that a healthy childhood environment might partly offset a genetic predisposition to obesity during childhood and adolescence.
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http://dx.doi.org/10.1038/s41366-021-00795-5DOI Listing
March 2021

Preventable fractions of cancer incidence attributable to 7-years weight gain in the Norwegian Women and Cancer (NOWAC) study.

Sci Rep 2021 Feb 15;11(1):3800. Epub 2021 Feb 15.

Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, P.O. Box 6050 Langnes, 9037, Tromsø, Norway.

There is a lack of tangible measures for directed public health action to halt the increase in weight and cancer. We estimated the fraction and preventable cases of all and major body fatness-related cancers attributable to 7-years weight gain (≥ 2 kg). We assessed validated self-reported anthropometrics from 44,114 women aged 34-49 years at the enrolment in 1991-1992 and from a second questionnaire in 1998, with follow-up through December 31, 2015. Over 18 years, 3216 body fatness-related cancers and 2041 deaths were reported. Nearly 70% of women experienced weight gain and the average weight change was 4 kg. We observed a substantial proportional impact of weight gain on pancreatic cancer with a population attributable fraction (PAF) of 41.8% (95% CI 8.1-63.1) and a high absolute impact on postmenopausal breast cancer with 4403 preventable cases (95% CI 1064-7299) and a PAF of 16.8% (95% CI 4.1-27.8), and colorectal cancer with 3857 preventable cases (95% CI 1313-5990) and a PAF of 22.6% (95% CI 7.7-35.1). Avoiding weight gain over seven years in middle adulthood could have prevented a considerable proportion of the cancer burden and thousands of cancer cases in women in Norway.
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http://dx.doi.org/10.1038/s41598-021-83027-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7884841PMC
February 2021

Digital Media Use in Association with Sensory Taste Preferences in European Children and Adolescents-Results from the I.Family Study.

Foods 2021 Feb 9;10(2). Epub 2021 Feb 9.

Leibniz Institute for Prevention Research and Epidemiology-BIPS, 28359 Bremen, Germany.

Digital media (DM) influences children's food choice. We aim to investigate associations between DM use and taste preferences (TP) for sweet, fatty, bitter, and salty in European children and adolescents. Individuals aged 6-17 years (N = 7094) providing cross-sectional data for DM use: television (TV), computer/game console (PC), smartphone and internet, were included. Children (6 to <12 years) and adolescents (≥12 years) completed a Food and Beverage Preference Questionnaire; scores were calculated for sweet, fatty, salty and bitter preference and categorized (high vs. low). Logistic regression was used to calculate odds ratios as association measures between DM exposure and TP. On average, individuals used media for 2.4 h/day (SD = 1.7). Increasing exposures to DM were associated positively with sweet, fatty and salty TP, while inversely with bitter preference. In female adolescents, DM exposure for >2 h/day was associated with sweet (OR = 1.27, 95% CI = 1.02-1.57) and fatty preference (OR = 1.37; 95% CI = 1.10-1.70). Internet exposure was inversely associated with bitter preference, notably in male adolescents (OR = 0.65, 95% CI = 0.50-0.84), but positively associated with salty preference (OR = 1.29, 95% CI = 1.02-1.64). DM exposure was associated with sweet, fatty, salty and bitter TP in children and adolescents, serving as the basis for future longitudinal studies to shed light on the underlying mechanism by which DM exposure may determine eating habits.
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http://dx.doi.org/10.3390/foods10020377DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7916161PMC
February 2021

Weight Status and BMI-Related Traits in Adolescent Friendship Groups and Role of Sociodemographic Factors: The European IDEFICS/I.Family Cohort.

Obes Facts 2021 22;14(1):121-130. Epub 2020 Dec 22.

School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

Background: During adolescence, health behaviors and weight status are increasingly influenced by friendship and peer networks. This paper examines resemblances in weight-related characteristics and how they differ by sociodemographic factors.

Methods: Over 3,000 friendships were reported by 1,603 adolescents, aged 11-16 years, who participated in the school-based I.Family study in 6 European countries. Each "source child" named 1-10 friends for whom standardized weight-related traits were available in the same survey. The mean value of the friends' traits weighted by time spent together was calculated, and related to the source child's trait. Country, age and sex of the source child, parental education, and immigrant background were considered for confounding and moderation.

Results: Source children's z-scores of body fat percent and BMI were positively associated with their friends' characteristics, in particular if they had highly educated parents. Positive associations were also found regarding the frequency of fast-food consumption, impulsivity, screen time, preference for sugar-sweetened foods, and hours spent in sports clubs, in increasing order of effect size. Additionally, correlations were observed between friends' cognitive and school functioning and being bullied. No associations were seen for a preference for high-fat foods, weight concerns, and health-related quality of life. Finally, parental education and immigrant background were associated between friends in all countries except Sweden, where no associations were observed.

Conclusion: Adolescent friends shared a number of weight-related characteristics. For weight measures per se, positive associations with friends' characteristics were only observed in adolescents with high parental education. Associations regarding energy-balance behaviors and indicators of school-related well-being did not differ by parental education. Parental education and immigrant background correlated positively in friends in most countries showing that social aggregation is already occurring in adolescence. The wide spectrum of friendship associations in weight-related traits and behaviors suggests that health promotion initiatives in adolescents should be directed towards peer groups in both school-related and leisure-time environments. ISRCTN Registry: Pan-European IDEFICS/I.Family children cohort (ID ISRCTN62310987; https://doi.org/10.1186/ISRCTN62310987).
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http://dx.doi.org/10.1159/000512356DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7983617PMC
December 2020

The Incidence of Intestinal Gastric Cancer among Resettlers in Germany-Do Resettlers Remain at an Elevated Risk in Comparison to the General Population?

Int J Environ Res Public Health 2020 12 9;17(24). Epub 2020 Dec 9.

Heidelberg Institute of Global Health, University Hospital Heidelberg, 69120 Heidelberg, Germany.

Objective: Previous studies have shown that the incidence of gastric cancer (GC), and particularly intestinal GC, is higher among resettlers from the former Soviet Union (FSU) than in the general German population. Our aim was to investigate if the higher risk remains over time.

Methods: GC cases between 1994 and 2013, in a cohort of 32,972 resettlers, were identified by the respective federal cancer registry. Age-standardized rates (ASRs) and standardized incidence ratios (SIRs) were analyzed in comparison to the general population for GC subtypes according to the Laurén classification. Additionally, the cohort was pooled with data from a second resettler cohort from Saarland to investigate time trends using negative binomial regression.

Results: The incidence of intestinal GC was elevated among resettlers in comparison to the general population (SIR (men) 1.64, 95% CI: 1.09-2.37; SIR (women) 1.91, 95% CI: 1.15-2.98). The analysis with the pooled data confirmed an elevated SIR, which was stable over time.

Conclusion: Resettlers' higher risk of developing intestinal GC does not attenuate towards the incidence in the general German population. Dietary and lifestyle patterns might amplify the risk of GC, and we believe that further investigation of risk behaviors is needed to better understand the development of disease pattern among migrants.
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http://dx.doi.org/10.3390/ijerph17249215DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7763658PMC
December 2020

Secular trends in diet-related greenhouse gas emission estimates since 2000 - a shift towards sustainable diets in Sweden.

Public Health Nutr 2020 Oct 16:1-6. Epub 2020 Oct 16.

University of Gothenburg, School of Public Health and Community Medicine, Institute of Medicine, Gothenburg, Sweden.

Objective: This study examines secular changes in diet-related greenhouse gas emissions (GHGE) in younger and older Swedish adults, since the turn of this century.

Design: Two cross-sectional health examination surveys were conducted in 2001-2004 (T1) and 2014-2018 (T2). At both times, an eighty-six-item FFQ was embedded in the survey. From the food frequencies and age-standardised portion sizes, GHGE estimates (kg CO2e/year) were calculated. GHGE was modelled as a function of time period and covariates, for five distinct age groups.

Setting: The municipality of Gothenburg, in western Sweden.

Participants: Women and men aged 25-34, 35-44, 45-54, 55-64 and 65-75 years were randomly selected from the population registry and recruited for examinations. After exclusion of participants with incomplete dietary data, the analytic sample consisted of 2569 individuals at T1 and 2119 at T2.

Results: Lower dietary GHGE scores were observed at T2 compared with T1, in each age group, adjusting for sex, BMI and education. The largest differences in GHGE were observed in the youngest age group (approximately 30 % reduction). Decreasing trends in GHGE from animal-based foods were observed at all ages and were accompanied by smaller increases from plant-based sources in younger groups only. At all ages, GHGE from discretionary foods decreased, and prevalence of overweight remained stable.

Conclusions: Optimal dietary trends should support both human health and planetary health. Our results suggest that Swedish adults have moved in this direction, e.g. through less intake of red meat products and stable weight status.
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http://dx.doi.org/10.1017/S1368980020004073DOI Listing
October 2020

The role of lifestyle and non-modifiable risk factors in the development of metabolic disturbances from childhood to adolescence.

Int J Obes (Lond) 2020 11 17;44(11):2236-2245. Epub 2020 Sep 17.

Leibniz Institute for Prevention Research and Epidemiology-BIPS, 28359, Bremen, Germany.

Background: The study aimed to identify the effects of lifestyle, C-reactive protein (CRP) and non-modifiable risk factors on metabolic disturbances in the transition from childhood to adolescence.

Methods: In 3889 children of the IDEFICS/I.Family cohort, latent transition analysis was applied to estimate probabilities of metabolic disturbances based on waist circumference, blood pressure, blood glucose, and lipids assessed at baseline and at 2- and 6-year follow-ups. Multivariate mixed-effects models were used to assess the age-dependent associations of lifestyle, non-modifiable risk factors and CRP, with the transformed probabilities of showing abdominal obesity, hypertension, dyslipidemia, or several metabolic disturbances (reference: being metabolically healthy).

Results: Higher maternal body mass index, familial hypertension as well as higher CRP z-score increased the risk for all four metabolic outcomes while low/medium parental education increased the risk of abdominal obesity and of showing several metabolic disturbances. Out of the lifestyle factors, the number of media in the bedroom, membership in a sports club, and well-being were associated with some of the outcomes. For instance, having at least one media in the bedroom increased the risk for showing several metabolic disturbances where the odds ratio (OR) markedly increased with age (1.30 [95% confidence interval 1.18; 1.43] at age 8; 1.18 [1.14; 1.23] for interaction with age; i.e., resulting in an OR of 1.30 × 1.18 = 1.53 at age 9 and so forth). Further, entering puberty at an early age was strongly associated with the risk of abdominal obesity (2.43 [1.60; 3.69] at age 8; 0.75 [0.69; 0.81] for interaction with age) and the risk of showing several metabolic disturbances (2.46 [1.53; 3.96] at age 8; 0.71 [0.65; 0.77] for interaction with age).

Conclusions: Various factors influence the metabolic risk of children revealing the need for multifactorial interventions. Specifically, removing media from children's bedroom as well as membership in a sports club seem to be promising targets for prevention.
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http://dx.doi.org/10.1038/s41366-020-00671-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7577850PMC
November 2020

Periodic Revisions of the International Choices Criteria: Process and Results.

Nutrients 2020 Sep 11;12(9). Epub 2020 Sep 11.

Department of Nutrition and Health HAS University of Applied Sciences, 5200 MA's-Hertogenbosch, The Netherlands.

Unhealthy diets contribute to an increased risk of non-communicable diseases, which are the leading causes of deaths worldwide. Nutrition policies such as front-of-pack labeling have been developed and implemented globally in different countries to stimulate healthier diets. The Choices Programme, including the International Choices criteria, is an established tool to support the implementation of such policies. The Choices criteria were developed to define the healthier choices per product group, taking saturated fatty acids, trans fatty acids, sodium, sugars, energy, and fiber into account. To keep these criteria updated, they are periodically revised by an independent international scientific committee. This paper explains the most important changes resulting from revisions between 2010 and 2016 and describes the process of the latest revision, resulting in the International Choices criteria version 2019. Revisions were based on national and international nutrition and dietary recommendations, large food composition databases, and stakeholders' feedback. Other nutrient profiling systems served as benchmarks. The product group classification was adapted and new criteria were determined in order to enhance global applicability and form a credible, intuitively logical system for users. These newly developed criteria will serve as an international standard for healthier products and provide a guiding framework for food and nutrition policies.
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http://dx.doi.org/10.3390/nu12092774DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7551836PMC
September 2020

Cholesterol and triglyceride levels in midlife and risk of heart failure in women, a longitudinal study: the prospective population study of women in Gothenburg.

BMJ Open 2020 06 4;10(6):e036709. Epub 2020 Jun 4.

Primary Health Care, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Goteborg, Sweden.

Objective: To examine the association between triglycerides and cholesterol serum values and risk of developing heart failure in women.

Design: Longitudinal observational study of four cohorts 50-year-old women examined in 1968-1969, 1980-1981, 1992-1993 and 2004-2005, and followed until 2012. S-triglycerides and s-cholesterol were measured at baseline and heart failure morbidity and mortality data collected from 1980 to 2012.

Setting: Prospective population study Gothenburg, Sweden. Primary care.

Participants: 1143 women 50 year old without history of heart failure or myocardial infarction.

Main Outcome Measure: Association among s-triglycerides, s-cholesterol and heart failure expressed as HR for heart failure, adjusted for smoking, body mass index (BMI), physical activity and age.

Results: For 50-year-old women examined in 1968-1969, there was an independent association between level of s-triglycerides and heart failure and a significantly higher risk of developing heart failure (HR 1.8; CI 1.16 to 2.80, for each increment of 1.0 mmol/L in s-triglycerides), adjusted for smoking, BMI, physical activity and age. There was no significant association between s-cholesterol and risk of heart failure (HR 0.9; CI 0.77 to 1.15). In the cohorts of 50-year-old women examined in 1980 and 1992, there were no significant associations between neither s-triglycerides or s-cholesterol and the risk of heart failure. In the pooled analyses of the cohorts examined in 1968, 1980 and 1992, a significantly increased risk of heart failure was found (HR 1.49; CI 1.10 to 2.03) for s-triglycerides independently, but not for s-cholesterol. None of the 50-year-old women examined in 2004-2005 developed heart failure by 2012 and were excluded from further analyses.

Conclusions: High levels of s-triglycerides but not s-cholesterol may be a risk marker for later development of heart failure in 50-year-old women.
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http://dx.doi.org/10.1136/bmjopen-2019-036709DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7279659PMC
June 2020

Like me, like you - relative importance of peers and siblings on children's fast food consumption and screen time but not sports club participation depends on age.

Int J Behav Nutr Phys Act 2020 04 15;17(1):50. Epub 2020 Apr 15.

Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstrasse 30, D-28359, Bremen, Germany.

Background: Lifestyle interventions to prevent paediatric obesity often target family and peer settings; their success is likely to depend on the influence that peers and families exert on children's lifestyle behaviors at different developmental stages.

Objective: First, to determine whether children's lifestyle behavior more closely resembles their peers' or siblings' behaviors. Secondly, to investigate longitudinally whether children's behavioral change is predicted by that of their peers or their siblings as they grow older.

Methods: The European prospective IDEFICS/I.Family cohort (baseline survey: 2007/2008, first follow-up: 2009/2010, and second follow-up: 2013/2014) aims at investigating risk factors for overweight and related behaviors during childhood and adolescence. The present investigation includes 2694 observations of children and their siblings aged 2 to 18 years. Peers were defined as same-sex, same-age children in the same community and identified from the full cohort. The longitudinal analysis (mean follow-up time: 3.7 years) includes 525 sibling pairs. Children's lifestyle behaviors including fast food consumption (frequency/week), screen time (hours/week) and sports club participation (hours/week) were assessed by questionnaire. Data were analyzed using multilevel linear models.

Results: Children's lifestyle behavior was associated with the respective behavior of their peers and sibling for all 3 behaviors. For fast food consumption, the peer resemblance was more than 6-fold higher than the sibling resemblance and the peer resemblance surpassed the sibling resemblance by the age of 9-10 years. The similarities with peers for fast food consumption and screen time steadily increased, while the similarities with siblings steadily decreased with increasing age of the children (P < 0.001). In contrast, the relative importance of peers and siblings on sports club duration did not vary by the age of the children. Longitudinal results showed that children's changes in fast food consumption were more strongly associated with those in their peer group than their sibling, in particular if the age gap between siblings was large.

Conclusion: In conclusion, our results support the implementation of multi-setting interventions for improving lifestyle behaviors in children. Our findings might also guide future intervention studies in the choice of timing and setting in which interventions are likely to be most effective. From the ages of 9-10 years onwards, family- or home-based interventions targeting children's fast food intake and screen time behavior may become less effective than school- or community-based interventions aimed at peer groups.
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http://dx.doi.org/10.1186/s12966-020-00953-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7160987PMC
April 2020

A cross-sectional study of obesogenic behaviours and family rules according to family structure in European children.

Int J Behav Nutr Phys Act 2020 03 5;17(1):32. Epub 2020 Mar 5.

Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.

Background: There has been an increase in children growing up in non-traditional families, such as single-parent and blended families. Children from such families have a higher prevalence of obesity and poorer health outcomes, but research on the relationship with obesogenic behaviours is limited.

Objectives: Therefore, the aim of this study was to investigate whether there are associations between family structures and obesogenic behaviours and related family rules in European children and adolescents.

Methods: The sample included 7664 children (mean age ± SD: 10.9 ± 2.9) from 4923 families who were participants of the multi-centre I.Family study (2013/2014) conducted in 8 European countries. Family structure was assessed by a detailed interview on kinship and household. Obesogenic behaviours (screen time, sleep duration, consumption of sugar-sweetened beverages (SSBs)) and family rules (rules for computer and television, bedtime routine, availability of SSBs during meals) were determined by standardized questionnaires. Multilevel mixed-effects linear and logistic regression models were used to model the associations of family structure with obesogenic behaviours and family rules. Sex, age, parental education level, number of children and adults in the household and BMI z-score were covariates in the models. Two-parent biological families were set as the reference category.

Results: Children from single-parent families were less likely to have family rules regarding screen time (OR: 0.62, 95% CI: 0.40-0.94, p = 0.026) with higher reported hours of screen time per week (β = 2.70 h/week, 95% CI: 1.39-4.00, p < 0.001). The frequency of weekly SSB consumption differed by family structure in a sex-specific manner: girls from single-parent (β = 3.19 frequency/week, 95% CI: 0.91-5.47, p = 0.006) and boys from blended/adoptive families (β = 3.01 frequency/week, 95% CI: 0.99-5.03, p = 0.004) consumed more SSBs. Sleep duration, bedtime routines and availability of SSBs during meals did not differ between children from these family structures. Parental education did not modify any of these associations.

Conclusions: Parents in non-traditional family structures appear to experience more difficulties in restricting screen time and the intake of SSBs in their children than parents in traditional two-parent family structures. Our findings therefore suggest that additional support and effective strategies for parents in non-traditional families may help to reduce obesogenic behaviours in children from such family types.
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http://dx.doi.org/10.1186/s12966-020-00939-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7059256PMC
March 2020

Impact of changes in physical activity or BMI on risk of heart failure in women - the prospective population study of women in Gothenburg.

Scand J Prim Health Care 2020 Mar 31;38(1):56-65. Epub 2020 Jan 31.

Primary Health Care, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

To longitudinally evaluate the impact of change in physical activity or change in body mass index (BMI) over time on the risk of developing heart failure (HF) in women without a previous diagnosis of HF. Longitudinal, observational, prospective study of women in Gothenburg, Sweden. Data on BMI and level of physical activity were collected from examinations 1968-1992 and hospital diagnoses and mortality data were ascertained from 1980 to 2012. Data were obtained from 1749 women included in the Prospective Population Study of Women in Gothenburg. Hazard ratio (HR) for HF was calculated, using a Cox regression model. Women with stable high physical activity during 1968-1980 and 1980-1992 reduced their risk of subsequent HF compared to the non-active women (for 1968-1980 HR 0.66, 95% Confidence Interval (CI) 0.44-0.99 and for 1980-1992 HR 0.47, 95% CI 0.29-0.74). Women with increasing levels of physical activity during 1980-1992 reduced their risk of HF compared to the non-active women (HR 0.40, 95% CI 0.22-0.72). Increase in BMI from overweight to obesity during 1968-1980 predicted increased risk of developing HF (HR 1.93, 95% CI 1.18-3.14). Reduced risk of future HF in healthy women may be achieved by remaining physically active from young middle age and throughout life or by increasing the level of physical activity. This is particularly important for sedentary women in middle age. The role of physical activity in preventing the development of obesity must be taken into account.Key pointsA sedentary lifestyle and obesity are risk factors for developing heart failure (HF) in women.The risk of developing HF may be reduced by increasing the level of activity in sedentary middle-aged women.For younger women, avoiding obesity is most important to reduce the risk of later HF.Primary care has a key role in guiding women towards the most effective lifestyle changes to prevent development of HF.
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http://dx.doi.org/10.1080/02813432.2020.1717083DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7054912PMC
March 2020

Regular versus episodic drinking in Swedish women: Reporting of regular drinking may be less biased by social desirability.

Alcohol 2020 08 9;86:57-63. Epub 2020 Jan 9.

School of Public Health and Community Medicine, Section for Epidemiology and Social Medicine (EPSO), Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Box 453, SE-405 30, Gothenburg, Sweden.

Aim: To describe the personality and social characteristics associated with regular and episodic alcohol consumption in a Swedish cohort of women.

Methods: 406 women aged 38 and 50 who participated in the Population Study of Women in Gothenburg in 2004-2005 with complete data on the key variables are included. Regular alcohol use was based on frequencies of alcoholic beverage consumption, reported to examining physicians. Regular drinking was defined as those consuming wine, beer, or spirits at least twice weekly. Episodic drinking was defined as consumption of six drinks or more on a single occasion at least once during the last year. Personality traits were studied using the self-administered 57-item Eysenck Personality Inventory, which includes a 'lie scale' measuring the tendency toward social desirability, a 'neuroticism scale', and an 'extraversion scale'. Logistic regression was used to estimate odds ratios (OR) for regular and episodic drinking, respectively, in relation to standardized (SD) personality scores and selected social characteristics.

Results: 49% of the women reported episodic drinking, while 58% reported regular drinking, and 34% reported both. Women with a higher tendency toward socially desirable responses were less likely to report episodic drinking (odds ratio [OR] = 0.67, 95% confidence interval [CI] = 0.53-0.84) per standard deviation (SD), a trait that was not associated with regular drinking.

Conclusions: The strong inverse association between the propensity to lie scale with episodic but not regular drinking suggests that episodic drinking is subject to greater social desirability and under-reporting biases than regular drinking. Our findings indicate that this type of problem drinking may be missed in medical examinations, which limits the ability of health professionals to intervene.
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http://dx.doi.org/10.1016/j.alcohol.2020.01.004DOI Listing
August 2020

Time trends in nutrient intake and dietary patterns among five birth cohorts of 70-year-olds examined 1971-2016: results from the Gothenburg H70 birth cohort studies, Sweden.

Nutr J 2019 11 6;18(1):66. Epub 2019 Nov 6.

Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health (AgeCap) at the University of Gothenburg, Gothenburg, Sweden.

Background: Nutrition is a key factor in healthy ageing but there are still gaps in knowledge about risk- and protective factors linking diet and healthy ageing. The aim of this study was to investigate time trends in dietary patterns and nutrient intake in an older population, in order to increase the understanding of whether dietary recommendations are followed and if nutrient needs are met.

Methods: Cross-sectional data was derived from five samples of 70-year-olds examined 1971-72, 1981-83, 1992-93, 2000-02 and 2014-16 from the Gothenburg H70 birth cohort studies in Sweden. A total of 2246 individuals (56% women) participated. Dietary intake was determined by the diet history method, which is an interview including questions on usual frequencies and portion sizes of food intake during the preceding three months. Recommended values of nutrient intake and determinants of healthful dietary patterns were based on the Nordic Nutrition Recommendations 2012. Statistical analyses were performed using general linear models, student's t-test and chi-square test, stratified by sex.

Results: The intake of fruits and vegetables, fish and seafood, whole grain products and nuts and seeds increased during the study period (p < 0.0001), among both sexes. However, there was also an increase in alcohol intake (p < 0.0001), especially from wine and beer, and in 2014-16 more than 30% had an alcohol intake above recommendations. Protein intake increased (p < 0.0001 for women and p = 0.0004 for men), and 48% of the women and 37% of the men had a protein intake above recommended 1.2 g/kg body weight and day in 2014-16. The proportion of participants at risk of inadequate intake of vitamins C, D and folate decreased during the study period, among both sexes (p < 0.0001). However, vitamin D intake from diet was still below average requirement level of 7.5 μg/day for 49% of the women and 32% of the men in 2014-16.

Conclusions: Dietary patterns have changed among 70-year-olds during the past five decades, with an increase in healthful foods and a higher nutrient density in later born birth cohorts. However, the intake of alcohol increased, especially among women. Results from this study can be useful as a basis for dietary guidelines and used for prevention strategies involving older adults in population-based and health care settings.
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http://dx.doi.org/10.1186/s12937-019-0493-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6836447PMC
November 2019

Body mass index in women aged 18 to 45 and subsequent risk of heart failure.

Eur J Prev Cardiol 2020 07 5;27(11):1165-1174. Epub 2019 Nov 5.

Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

Background: The incidence of heart failure (HF) is decreasing in older ages, but increasing rates have been observed among younger persons in Sweden. Therefore, we investigated the relationship between risk of hospitalization for HF and body mass index (BMI).

Methods: This was a prospective registry-based cohort study. We included 1,374,031 women aged 18-45 years (mean age 27.9 years) who gave birth during 1982-2014, and were registered in the Medical Birth Register. Information on hospitalization because of HF was collected through linkage to the National Inpatient Register.

Results: Compared to women with a BMI of 20-<22.5 kg/m, women with a BMI of 22.5-<25.0 had a hazard ratio (HR) of 1.24 (95% confidence interval (CI), 1.10-1.39) for HF after adjustment for age, year, parity, baseline disorders, smoking, and education. The HR (95% CI) increased to 1.56 (1.36-1.78), 2.39 (2.05-2.78), 2.82 (2.43-3.28), and 4.51 (3.63-5.61) in women with a BMI of 25-<27.5, 27.5-<30, 30-<35, and ≥35 kg/m, respectively. The multiple-adjusted HRs (95% CI) associated with risk of HF per one-unit increase in BMI in women with a BMI ≥ 22.5 kg/m ranged from 1.01 (0.97-1.06) for HF related to valvular disease to 1.14 (1.12-1.15) for coronary heart disease, diabetes, or hypertension.

Conclusion: Increasing body weight was strongly associated with the risk of early HF in women. Compared with lean women, the risk for HF started to increase at high-normal BMI levels, and was nearly five-fold in women with a BMI ≥ 35 kg/m.
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http://dx.doi.org/10.1177/2047487319882510DOI Listing
July 2020

Relationship between perception of emotional home atmosphere and fruit and vegetable consumption in European adolescents: results from the I.Family survey.

Public Health Nutr 2020 01 13;23(1):53-62. Epub 2019 Aug 13.

Section for Epidemiology and Social Medicine (EPSO), The Sahlgrenska Academy, University of Gothenburg, Box 453, Gothenburg SE-405 30, Sweden.

Objective: Consumption of fruits and vegetables (F&V) among adolescents falls below recommendations in many Western countries. The impact of social and emotional aspects of family life on adolescent dietary behaviour may contribute to this, yet remains under-investigated. The present study examines the association between adolescents' perceptions of emotional home atmosphere (EHA) and their F&V consumption frequency.

Design: An FFQ was used to assess F&V consumption frequency. EHA was assessed by an eight-item measure with three subscales: perceived home warmth, strictness and relational tension. EHA subscales were used as binary variables: a score equal to or above the median value was considered as a higher perception, while a score below the median was considered as a lower perception of the EHA in question. Country differences in meeting the European 5-a-day recommendations were described. Further, the association between EHA and F&V consumption frequency was investigated using multiple linear regression.

Setting: Regional examination centres in eight European countries.

Participants: Adolescents (n 3196) aged 12-18 years.

Results: The mean F&V consumption frequency was 3·27 (sd 2·84) times/d. Only 16·1 % of boys and 18 % of girls in our study sample met the recommendation of five F&V daily. After controlling for age, sex, education level of the parents and country of origin, perceived home warmth was associated with a 16 (95 % CI 9, 22) % higher F&V consumption frequency (P < 0·001).

Conclusions: F&V consumption frequency was suboptimal in the survey areas. Interventions targeting perceived warmth as a component of EHA could potentially have a positive effect on adolescents' dietary behaviour.
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http://dx.doi.org/10.1017/S1368980019002234DOI Listing
January 2020

Reexamination of Accelerometer Calibration with Energy Expenditure as Criterion: VO Instead of MET for Age-Equivalent Physical Activity Intensity.

Sensors (Basel) 2019 Aug 1;19(15). Epub 2019 Aug 1.

Center for Health and Performance, Department of Food and Nutrition, and Sport Science, University of Gothenburg, 40530 Gothenburg, Sweden.

Accelerometer calibration for physical activity (PA) intensity is commonly performed using Metabolic Equivalent of Task (MET) as criterion. However, MET is not an age-equivalent measure of PA intensity, which limits the use of MET-calibrated accelerometers for age-related PA investigations. We investigated calibration using VO (VO - VO; mL⋅min⋅kg) as criterion compared to MET (VO/VO) and the effect on assessment of free-living PA in children, adolescents and adults. Oxygen consumption and hip/thigh accelerometer data were collected during rest, stand and treadmill walk and run. Equivalent speed (Speed) was used as indicator of the absolute speed (Speed) performed with the same effort in individuals of different body size/age. The results showed that VO was higher in younger age-groups for Speed, but was similar in the three age-groups for Speed. MET was lower in younger age-groups for both Speed and Speed. The same VO-values respective MET-values were applied to all age-groups to develop accelerometer PA intensity cut-points. Free-living moderate-and-vigorous PA was 216, 115, 74 and 71 min/d in children, adolescents, younger and older adults with VO-calibration, but 140, 83, 74 and 41 min/d with MET-calibration, respectively. In conclusion, VO calibration of accelerometers may provide age-equivalent measures of PA intensity/effort for more accurate age-related investigations of PA in epidemiological research.
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http://dx.doi.org/10.3390/s19153377DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6695745PMC
August 2019

Association between variants of neuromedin U gene and taste thresholds and food preferences in European children: Results from the IDEFICS study.

Appetite 2019 11 18;142:104376. Epub 2019 Jul 18.

EPIMED Research Center, Department of Medicine and Surgery, University of Insubria, Varese, Italy; Mediterranea Cardiocentro, Napoli, Italy.

Aim: The neuropeptide neuromedin U (NMU) known for its role in appetite, feeding and energy balance could be involved in the control of food choice and taste sensitivity. We examined the association between NMU polymorphisms/haplotypes and taste thresholds and food preferences in a population of European children.

Methods: A total of 578 subjects from the IDEFICS study (mean age 7.5 ± 0.8 SD, boys 53.6%) with NMU genotype data and food preference (salty, fatty, sweet, flavour and umami food) and taste threshold (salt, fat, sweet, umami) tests available were analysed. Three single nucleotide polymorphisms (SNPs; rs6827359, T:C; rs12500837, T:C; rs9999653, C:T) of NMU gene were analyzed and five major haplotypes were inferred. The associations between genotypes and food preferences or taste thresholds were investigated (odds ratios -OR, adjusted for age, sex and country). A p < 0.05 after false discovery rate adjustment (pFDR) was considered statistically significant.

Results: The association between NMU genotypes and food preference showed two NMU SNPs associated with preference for food containing sodium glutamate (umami taste; rs6827359C, OR = 1.61, 95% confidence interval (CI):1.20-2.17; rs9999653T, OR = 1.59, 95%CI:1.18-2.13). In the haplotype analysis, the CTT haplotype showed an OR of 1.70 (95%CI:1.16-2.5) for the umami food preference, while CCT haplotype showed an OR of 1.63 (95%CI:1.11-2.40), compared to the most frequent haplotype (TTC). Carriers of CCT/CCT vs subjects with no CCT haplotype showed an OR of 4.78 (95%CI:1.86-12.30). Umami food preference was associated with low values of BMI z-score, arm circumferences, skinfolds and fat mass (pFDR<0.05). No association between NMU genetic variants and taste thresholds was found.

Conclusions: This study shows for the first time in children an association between preference for umami food and a NMU haplotype, previously found associated with low BMI values.
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http://dx.doi.org/10.1016/j.appet.2019.104376DOI Listing
November 2019

Development and body mass inversely affect children's brain activation in dorsolateral prefrontal cortex during food choice.

Neuroimage 2019 11 13;201:116016. Epub 2019 Jul 13.

Image Sciences Institute, Brain Center Rudolf Magnus, University Medical Center Utrecht, the Netherlands; Division of Human Nutrition & Health, Wageningen University & Research, Wageningen, the Netherlands.

Childhood obesity is a rising problem caused in part by unhealthy food choices. Food choices are based on a neural value signal encoded in the ventromedial prefrontal cortex, and self-control involves modulation of this signal by the dorsolateral prefrontal cortex (dlPFC). We determined the effects of development, body mass (BMI Cole score) and body mass history on the neural correlates of healthy food choice in children. 141 children (aged 10-17y) from Germany, Hungary and Sweden were scanned with fMRI while performing a food choice task. Afterwards health and taste ratings of the foods were collected. In the food choice task children were asked to consider the healthiness or tastiness of the food or to choose naturally. Overall, children made healthier choices when asked to consider healthiness. However, children who had a higher weight gain per year chose less healthy foods when considering healthiness but not when choosing naturally. Pubertal development stage correlated positively while current body mass correlated negatively with dlPFC activation when accepting foods. Pubertal development negatively and current body mass positively influenced the effect of considering healthiness on activation of brain areas involved in salience and motivation. In conclusion, children in earlier stages of pubertal development and children with a higher body weight exhibited less activation in the dlPFC, which has been implicated in self-control during food choice. Furthermore, pubertal development and body mass influenced neural responses to a health cue in areas involved in salience and motivation. Thus, these findings suggest that children in earlier stages of pubertal development, children with a higher body mass gain and children with overweight may possibly be less susceptible to healthy eating interventions that rely on self-control or that highlight health aspects of food.
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http://dx.doi.org/10.1016/j.neuroimage.2019.116016DOI Listing
November 2019

Metabolic status in children and its transitions during childhood and adolescence-the IDEFICS/I.Family study.

Int J Epidemiol 2019 10;48(5):1673-1683

Leibniz Institute for Prevention Research and Epidemiology - BIPS, Epidemiological Methods and Etiological Research, Bremen, Germany.

Background: This study aimed to investigate metabolic status in children and its transitions into adolescence.

Methods: The analysis was based on 6768 children who participated in the European IDEFICS/I.Family cohort (T0 2007/2008, T1 2009/2010 and/or T3 2013/2014; mean ages: 6.6, 8.4 and 12.0 years, respectively) and provided at least two measurements of waist circumference, blood pressure, blood glucose and lipids over time. Latent transition analysis was used to identify groups with similar metabolic status and to estimate transition probabilities.

Results: The best-fitting model identified five latent groups: (i) metabolically healthy (61.5%; probability for group membership at T0); (ii) abdominal obesity (15.9%); (iii) hypertension (7.0%); (iv) dyslipidaemia (9.0%); and (v) several metabolic syndrome (MetS) components (6.6%). The probability of metabolically healthy children at T0 remaining healthy at T1 was 86.6%; when transitioning from T1 to T3, it was 90.1%. Metabolically healthy children further had a 6.7% probability of developing abdominal obesity at T1. Children with abdominal obesity at T0 had an 18.5% probability of developing several metabolic syndrome (MetS) components at T1. The subgroup with dyslipidaemia at T0 had the highest chances of becoming metabolically healthy at T1 (32.4%) or at T3 (35.1%). Only a minor proportion of children showing several MetS components at T0 were classified as healthy at follow-up; 99.8% and 88.3% remained in the group with several disorders at T1 and T3, respectively.

Conclusions: Our study identified five distinct metabolic statuses in children and adolescents. Although lipid disturbances seem to be quite reversible, abdominal obesity is likely to be followed by further metabolic disturbances.
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http://dx.doi.org/10.1093/ije/dyz097DOI Listing
October 2019

Effects of Frequency Filtering on Intensity and Noise in Accelerometer-Based Physical Activity Measurements.

Sensors (Basel) 2019 May 11;19(9). Epub 2019 May 11.

Center for Health and Performance, Department of Food and Nutrition, and Sport Science, University of Gothenburg, SE-40530 Gothenburg, Sweden.

In objective physical activity (PA) measurements, applying wider frequency filters than the most commonly used ActiGraph (AG) filter may be beneficial when processing accelerometry data. However, the vulnerability of wider filters to noise has not been investigated previously. This study explored the effect of wider frequency filters on measurements of PA, sedentary behavior (SED), and capturing of noise. Apart from the standard AG band-pass filter (0.29-1.63 Hz), modified filters with low-pass component cutoffs at 4 Hz, 10 Hz, or removed were analyzed. Calibrations against energy expenditure were performed with lab data from children and adults to generate filter-specific intensity cut-points. Free-living accelerometer data from children and adults were processed using the different filters and intensity cut-points. There was a contribution of acceleration related to PA at frequencies up to 10 Hz. The contribution was more pronounced at moderate and vigorous PA levels, although additional acceleration also occurred at SED. The classification discrepancy between AG and the wider filters was small at SED (1-2%) but very large at the highest intensities (>90%). The present study suggests an optimal low-pass frequency filter with a cutoff at 10 Hz to include all acceleration relevant to PA with minimal effect of noise.
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http://dx.doi.org/10.3390/s19092186DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6539652PMC
May 2019

A Growing Social Divide in Body Mass Index, Strength, and Fitness of Swedish Male Conscripts.

J Adolesc Health 2019 08 23;65(2):232-238. Epub 2019 Apr 23.

Department of Public Health and Community Medicine/Primary Health Care, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

Purpose: The aim of the study was to monitor trends in socioeconomic inequalities in body mass index (BMI), cardiorespiratory fitness (CRF), and muscular strength over several decades in a population of Swedish males aged 18-19 years.

Methods: The cohort consists of 1.5 million young men attending military conscript examinations from late 1968 to 2005. Parental education was used as a marker for socioeconomic conditions in the conscripts' families of origin. Changing gradient in BMI, CRF, and muscular strength in sons of parents with higher and lower educational attainment was evaluated during four periods covering 36 years.

Results: Over the course of the obesity epidemic, BMI remained higher in conscripts with lesser (vs. higher) parental education. Moreover, the absolute difference in obesity prevalence between groups showed a continuous increase, from .6% to 3.9%, indicating growing inequalities. Regarding fitness, lower CRF was consistently associated with less parental education, but with no clear secular trend in the magnitude of the difference. Finally, social differences in muscular strength changed in direction, from lower strength among conscripts with higher parental education in the initial observation period to lower strength associated with lower parental education in the final decade studied.

Conclusions: Among Swedish conscripts entering adulthood, social gradients in BMI and obesity widened continuously between 1968 and 2005. An apparent reversal of the earlier gradient in muscular strength in young men may be related to societal trends in occupational and leisure-time physical activity over the observation period. This cohort is being continually monitored through national registries for obesity-related comorbidities in later life.
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http://dx.doi.org/10.1016/j.jadohealth.2019.02.016DOI Listing
August 2019

Differences and Similarities between Front-of-Pack Nutrition Labels in Europe: A Comparison of Functional and Visual Aspects.

Nutrients 2019 Mar 14;11(3). Epub 2019 Mar 14.

Department of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, SE-405 30 Gothenburg, Sweden.

Many different front-of-pack (FOP) nutrition labels have been introduced worldwide. To continue the debate on the most effective FOP labels for increased consumer health, full comprehension of their visual and functional features is relevant. This paper compares and provides an overview of all FOP labels currently in practice or in preparation in Europe, by means of the visually oriented Funnel Model. The Funnel Models were completed in collaboration with the respective FOP labelling initiatives. In total, six positive FOP labels, two mixed FOP labels and one negative FOP label were compared. There are multiple similarities and differences between the FOP labels, with each FOP label being characterised by a unique set of criteria and methodological approach. This Funnel Model comparison provides the knowledge to ultimately find more common ground for all stakeholders involved in the FOP labelling debate. Importantly, implementation and evaluation activities carried out by FOP labelling organisations are crucial success factors for FOP labels in practice. We conclude that more attention should be paid to methodological differences between FOP labels and recommend that the current comparison is expanded to a global level and periodically updated, as the variety of FOP labels in the global marketplace is changing constantly.
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http://dx.doi.org/10.3390/nu11030626DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6471039PMC
March 2019

Nordic populations are still getting taller - secular changes in height from the 20th to 21st century.

Acta Paediatr 2019 07 5;108(7):1311-1320. Epub 2019 Mar 5.

Department of Physiology/Endocrinology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

Aim: The study aims to investigate secular changes in adult height among Nordic reference populations during the last four decades and in parents of Swedish study participants, and to study during which growth phase(s) infancy, childhood or puberty changes in height and tempo occurred.

Methods: Length and height data were obtained from publications on populations used as current and previous national height references in Denmark, Finland, Norway and Sweden. Measurements from birth until adult height and original parental heights of participants in Swedish reference populations born 1956, 1974, and 1990 were used.

Results: Adult height has increased progressively in Nordic populations born in 1950s-1990s; for females by 6 mm/decade Norway, 4 mm; Sweden, 6 mm; Finland and Denmark, 7 mm; for males by 9 mm/decade, in Sweden, 5 mm; Finland, 7 mm; Denmark 8 mm; Norway, 15 mm. This was due to more growth during childhood despite earlier timing of mid-puberty. Heights of Swedish parents born 1920s-1960s increased 11 mm/decade for mothers, 14 mm/decade for fathers.

Conclusion: The Nordic countries comprise some of the tallest populations in the world yet continue to show a positive secular change in adult height alongside a faster tempo of growth by earlier timing of puberty, highlighting the need to regularly update national height references.
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http://dx.doi.org/10.1111/apa.14683DOI Listing
July 2019

Circulating microRNAs are associated with early childhood obesity: results of the I.Family Study.

Genes Nutr 2019 9;14. Epub 2019 Jan 9.

1Institute of Food Sciences, National Research Council, ISA-CNR, Via Roma, 64 83100 Avellino, Italy.

Background: Nearly 10 years ago, the World Health Organization reported the increasing prevalence of overweight and obesity worldwide as a challenge for public health due to the associated adverse consequences. Epidemiological studies established a firm relationship between an elevated body mass index and chronic conditions such as diabetes, dyslipidemia, hypertension, heart disease, non-alcoholic fatty liver disease, and some types of cancer. Omic studies demonstrated that microRNA (miRNA) profile changes in tissues correlate with a number of diseases, including obesity. Recent studies showed a remarkable stability of miRNAs also in blood, emphasizing their potential as theranostic agents for a variety of disorders and conditions. A number of miRNAs enriched in homeostasis of obesity and metabolic disorders have been characterized in previous researches.

Aim: This work was finalized to investigate the differential circulating miRNAs signature in early childhood obesity. Our cross-sectional study analyzed the signature of circulating miRNAs in plasma samples of normal weight ( = 159) and overweight/obese ( = 149) children and adolescents participating to the I.Family study, an EC-funded study finalized to investigate the etiology of overweight, obesity and related disorders and the determinants of food choice, lifestyle, and related health outcomes in children and adolescents of eight European countries (www.ifamilystudy.eu).

Results: Differences in miRNA signature with respect to anthropometric and biochemical variables were analyzed. A high degree of variability in levels of circulating miRNAs was identified among children from different countries, in line with recent reports supporting the hypothesis that these molecules are likewise affected by environmental and lifestyle factors. A panel of miRNAs differentially expressed in overweight/low-grade obesity children was characterized (miR-551a and miR-501-5p resulted upregulated; miR-10b-5p, miR-191-3p, miR-215-5p, and miR-874-3p resulted downregulated). ROC curves were also constructed for experimentally confirmed miRNAs. Single miRNAs generally exhibited low AUC values with the highest values for miR-874-3p and miR-501-5p which in combination provided an interesting value (AUC = 0.782). Pearson's analysis confirmed that miR-10b-5p, miR-215-5p, miR-501-5p, miR-551a, and miR-874-3p significantly correlated with BMI -score. Molecular interactions of obesity-associated miRNAs were also predicted by bioinformatics tools.

Conclusions: Our work showed that several circulating miRNAs are differentially represented in overweight/low-grade obesity children and adolescents. Although causal pathways cannot be firmly inferred, it is conceivable that circulating miRNAs may be new biomarkers of early childhood obesity.

Trial Registration: ISRCTN, ISRCTN62310987. Registered 23/02/2018 - Retrospectively registered.
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http://dx.doi.org/10.1186/s12263-018-0622-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6327413PMC
January 2019

Rationale for a Swedish cohort consortium.

Ups J Med Sci 2019 Jan 8;124(1):21-28. Epub 2019 Jan 8.

b Uppsala Clinical Research Center (UCR) , Uppsala , Sweden.

We herein outline the rationale for a Swedish cohort consortium, aiming to facilitate greater use of Swedish cohorts for world-class research. Coordination of all Swedish prospective population-based cohorts in a common infrastructure would enable more precise research findings and facilitate research on rare exposures and outcomes, leading to better utilization of study participants' data, better return of funders' investments, and higher benefit to patients and populations. We motivate the proposed infrastructure partly by lessons learned from a pilot study encompassing data from 21 cohorts. We envisage a standing Swedish cohort consortium that would drive development of epidemiological research methods and strengthen the Swedish as well as international epidemiological competence, community, and competitiveness.
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http://dx.doi.org/10.1080/03009734.2018.1556754DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6450580PMC
January 2019

Occupational stress is associated with major long-term weight gain in a Swedish population-based cohort.

Int Arch Occup Environ Health 2019 May 6;92(4):569-576. Epub 2018 Dec 6.

Section for Epidemiology and Social Medicine (EPSO), Department of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, P.O. Box 453, 405 30, Gothenburg, Sweden.

Purpose: Occupational stress and obesity are both increasing in prevalence, but prospective findings relating these conditions are inconsistent. We investigated if baseline as well as prolonged exposure to high job demands and low decision latitude were associated with major weight gain (≥ 10% of baseline weight) in 3872 Swedish women and men examined three times over 20 years in the population-based Västerbotten Intervention Program.

Methods: Anthropometry was measured and participants completed questionnaires on job strain, diet, and other lifestyle factors. Logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI), adjusting for confounders.

Results: Adjusting for age, baseline low decision latitude was associated with major weight gain over 10- and 20-year OR (95% CI) 1.16 (1.00-1.33) and 1.29 (1.13-1.47), respectively (both sexes combined). After adjustment for diet quality and other confounders, the effect over 20 years remained 1.30 (1.13-1.50). Sex modified the effect of prolonged exposure to high job demands over at least 10 years (interaction p = 0.02), showing that high job demands was a risk factor of major weight gain over 20 years in women [1.54 (1.14-2.07)], but not in men [0.87 (0.63-1.19)]. Neither diet nor other lifestyle factors explained these associations.

Conclusions: In conclusion, low decision latitude predicted major weight gain in women and men. In women, the results suggest an additional contribution to major weight gain from high job demands.
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http://dx.doi.org/10.1007/s00420-018-1392-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6435615PMC
May 2019

Pre-obese children's dysbiotic gut microbiome and unhealthy diets may predict the development of obesity.

Commun Biol 2018 7;1:222. Epub 2018 Dec 7.

2Leibniz Institute for Prevention Research and Epidemiology-BIPS, Achterstraße 30, 28359 Bremen, Germany.

It is widely accepted that the intestinal microbiome is connected to obesity, as key mediator of the diet impact on the host metabolic and immunological status. To investigate whether the individual gut microbiome has a potential in predicting the onset and progression of diseases, here we characterized the faecal microbiota of 70 children in a two-time point prospective study, within a four-year window. All children had normal weight at the beginning of this study, but 36 of them gained excessive weight at the subsequent check-up. Microbiome data were analysed together with the hosts' diet information, physical activity, and inflammatory parameters. We find that the gut microbiota structures were stratified into a discrete number of groups, characterized by different biodiversity that correlates with inflammatory markers and dietary habits, regardless of age, gender, and body weight. Collectively, our data underscore the importance of the microbiome-host-diet configuration as a possible predictor of obesity.
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http://dx.doi.org/10.1038/s42003-018-0221-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6286349PMC
December 2018

Socioeconomic disparities in physical activity among Swedish women and trends over time - the population study of women in Gothenburg.

Scand J Prim Health Care 2018 Dec 5;36(4):363-371. Epub 2018 Nov 5.

a Department of Public Health and Community Medicine/Primary Health Care , Institute of Medicine, Sahlgrenska Academy, University of Gothenburg , Gothenburg , Sweden.

Objective: To explore secular trends in physical activity in relation to socioeconomic position in middle-aged women, with focus on whether the social gaps have become wider, narrower, or remain unchanged.

Design: Cohort comparisons between two representative samples of women, recruited in 1980-81 and 2004-05 as a part of the Population Study of Women in Gothenburg.

Setting: Gothenburg, the second largest city of Sweden, with ≈ 450 000 inhabitants.

Subjects: Population-based cohorts of 38- and 50-year-old women, invited in 1980-81 and 2004-05 to free health examinations. The study population in 1980 was n = 477, 38- and 50-year-old women born in 1930 (n = 355) and 1942 (n = 122), and in 2004 n = 500, 38- and 50-year- old women born in 1966 (n = 207) and 1954 (n = 293).

Main Outcome Measure: Physical activity at work and leisure time. Socioeconomic position was defined based on socio-occupational group and level of education. Physical activity during work and leisure time was based on questionnaires.

Results: On average 38- and 50-year-old women were more physically active at work and leisure time in 2004-05 compared to 1980-81; odds ratio (OR) for increase over time for physical activity at work for 38-year-olds: 2.59, (95% confidence interval (CI) 1.65-4.07), and for 50-year-olds: OR 2.09 (1.52-2.88); OR for increase physical activity leisure time in 38-year-olds: 1.93 (1.25-2.98), and in 50-year-olds 2.04 (1.49-2.79). There were no significant differences between socioeconomic groups in physical activity levels changes over time.

Conclusion: Women in different socioeconomic groups improved their physical activity at work and leisure time to the same extent from 1980 to 2004, indicating that the socioeconomic gap in physical activity is neither increasing nor decreasing. Key Points   The gap in physical activity levels between socioeconomic groups seems to have remained stable for middle-aged women the last 25 years.   • However, women were more physically active in 2004 at work and during leisure time, independent of socioeconomic position, compared to 1980.   • It remains a great challenge to create structures that enable these behaviours for all social groups.
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http://dx.doi.org/10.1080/02813432.2018.1499599DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6381527PMC
December 2018