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The relationship between social vulnerabilities and the effectiveness of behavioral interventions to prevent obesity in children is poorly understood. Therefore, the objective of this study is to evaluate the association between parental employment and the effectiveness of IDEFICS, a multilevel behavioral intervention aiming to prevent obesity among children (2 to 9.9 years old) in eight European countries. Data from 9,901 children and their parents was included in the analysis. We determined the Body Mass Index (BMI) z-score mean difference as the measurement of the intervention effectiveness and we calculated it as the follow-up (T1) BMI z-score mean minus baseline (T0) BMI z-score mean. Parents self-reported their employment status at T0 and T1. Children were classified, at both study times (T0 and T1), as children with employed parents (both parents employed) or as children with unemployed parents (one or both parents unemployed or receiving social assistance). We calculated unadjusted and adjusted multilevel mixed model analyses to evaluate if the employment status at T0 and the evolution of the employment status within a two-year period (from T0 to T1) predicted the BMI z-score mean difference among boys and girls. In boys, parental unemployment at T0 and throughout a two-year period (T0 to T1) predicted an increase of BMI z-score mean difference when compared to boys with employed parents (unemployment at T0: adjusted β = 0.12; p = 0.028; and unemployment from T0 to T1: adjusted β = 0.20; p = 0.031). We found no difference in the effectiveness of the IDEFICS intervention among girls with unemployed parents at T0 and from T0 to T1 when compared to girls with employed parents (unemployment at T0: adjusted β = 0.04; p = 0.337; and unemployment from T0 to T1: adjusted β = 0.10; p = 0.216, respectively). Our results suggest that the influence of parental unemployment in the IDEFICS outcome is different for boys and girls. Employment of both parents, which is related to a higher income, could contribute the families to engage healthier eating and physical activity behaviors among boys. Future multilevel interventions should include a combination of community-based and school-based components, as well as family-centered components, specifically on those families with parents out of the labor force, to address specific barriers or vulnerabilities that prevent them from improving behavior and weight status.
Metabolic syndrome (MetS) is a combination of risk factors that may be present already in childhood. MetS has been associated with inflammatory biomarkers such as high sensitivity C-reactive protein (hsCRP) in aduls. In 2014, Ahrens et al, published reference standards for a paediatric MetS score based on reference values from European children. The aim of this study is to assess longitudinally the relationship between a MetS score and hsCRP in a sample of European children.
Materials and Methods
Out of the baseline sample of the IDEFICS Study, 2913 children aged 2–9 years were included in this study. Inclusion criteria was having available data of waist circumference (WC), diastolic and systolic blood pressure (DBP, SBP), high density lipoprotein (HDL) cholesterol, triglycerides (TG), glucose and insulin, to calculate the homeostasis model assessment index (HOMA); and hs-CRP as a marker of inflammation, at baseline (T0) and two years later (T1). hs-CRP was categorized into two categories as some children had lower concentration than the detection limit of 0.02mg/dL. Student t-test and logistic regression were used to assess these associations. Logistic regression was adjusted by age, sex, body mass index (BMI), socioeconomic level and country.
Differences of mean values of the components of the MetS and the two categories of hs-CRP were observed between both time points. Mean values of SBP, DBP, WC, TG and HOMA were significantly higher in children with a higher category of hsCRP (p < 0.005). In addition, MetS score was significantly higher in those with a higher category of hs-CRP (p < 0.001) at both measurement points, T0 and T1. Finally, logistic regression between components of MetS and categories of hs-CRP, at both time points, showed significant associations (p < 0.001) for WC (OR = 1.06 at T0 and OR = 1.04 at T1) and HDL (OR = 0.98 at T0 and OR = 0.98 at T1) and the MetS score (OR = 1.07) score at T1.
The association between MetS and inflammation is already present in children. Out of the components of the MetS, WC and HDL were the ones more associated with an inflammatory state at two times points. Also the MetS score, but only at the follow-up, was associated with the hs-CRP. Therefore, in order to prevent the inflammatory state in childhood, efforts to improve the metabolic profile, specially WC and HDL, need to be made.
Introduction: Childhood obesity is rising in all countries. Dietary habits are modifiable factors which develop early in life. During growth, several factors, such as peer- influence and food availability, determine the development of food preferences and eating behaviour. Parents play also a key role model by influencing their own food intake.
Objetives: The purpose of this study was to assess the influence of parental role modelling, as predictor of fruits and vegetables intake in European pre-schoolers.
Methods: The present study included a sample of 6633 preschool children (51.9% boys) from six European centres (Belgium, Bulgaria, Germany, Greece, Poland and Spain), 3.5 to 5.5 years of age, participating in the ToyBox-study. Data on parental role modelling related with their own fruits and vegetables intake (portions/day) and children's fruits and vegetables intake (portions/day) were collected via standardized proxy-administered questionnaires. Linear regression model was used to assess this association. The adjusted model included socioeconomic status and weight status.
Results: In the unadjusted model, boys whose parents consumed fruits, showed a mean intake of 0.09 (95% CI: 0.08–0.11; p ≤ 0.001) portions of fruits more than the boys whose parents did not consume fruits. Also, girls whose parents consumed fruits, had intake of 0.10 (95% CI: 0.08–0.12; p ≤ 0.001) portions of fruits more than the girls whose parents did not consume fruits.
Moreover, boys whose parents consumed vegetables, showed a mean intake of 0.09 (95% CI: 0.07–0.11; p ≤ 0.001) portions of vegetables more than the boys whose parents did not consume vegetables. Also, girls whose parents consumed fruits, had intake of 0.11 (95% CI: 0.09–0.13; p ≤ 0.001) portions of vegetables more than the girls whose parents did not consume vegetables.
Finally, parental role related with fruits consumption explained 19.3% of fruits intake in European pre-schoolers and the 17.8% of vegetables intake in boys and 21.9% of vegetable intake in girls taking into consideration the potential effect of socioeconomic status of the family and the weight status of the children.
Conclusions: Parental role model of fruit intake has moderate effect on the pre-schooler's dietary intake. However, home environment characteristics such as family rules or availability and accessibility of foods should be considered as potential factors related to food intake in pre-schoolers.
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