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.
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.
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).
Our results highlight that a healthy childhood environment might partly offset a genetic predisposition to obesity during childhood and adolescence.
Background
Previous research has shown that diet is associated with low‐grade systemic inflammation among adults. However, no study has yet been conducted to explore the association between ...inflammatory potential of diet and low‐grade systemic inflammation among adolescents whose dietary behavior may be different from adults.
Methods and Results
We examine the predictive ability of 24‐h recall‐derived dietary inflammatory index (DII) scores on inflammation among 532 European adolescents in the HELENA cross‐sectional study. The DII is a literature‐derived dietary index developed to predict inflammation. The DII was calculated per 1000 calories and was tested against C‐reactive protein, ILs‐1,2,4,10, TNF‐α, ICAM, vascular cell adhesion molecule (VCAM), and IFN‐γ. All inflammatory markers had nonnormal distributions and therefore were log transformed. Analyses were performed using multivariable linear regression, adjusting for age, sex, city, BMI, smoking, and physical activity. Pro‐inflammatory diet (higher DII scores) was associated with increased levels of various inflammatory markers: TNF‐α, IL‐1, 2, IFN‐γ, and vascular cell adhesion molecule (bDIIt3vs1 = 0.13, 95% CI: 0.001, 0.25; 0.13, 95% CI 0.001, 0.25; 0.40, 95% CI: 0.03, 0.77; 0.53, 95% CI: 0.05, 1.01; 0.07, 95% CI: 0.01, 0.13, respectively).
Conclusion
These results reinforce the fact that diet, as a whole, plays an important role in modifying inflammation in adolescents.
Previous research has shown that diet is associated with low‐grade systemic inflammation among adults. However, no study has yet been conducted to explore the association between inflammatory potential of diet and low‐grade systemic inflammation among adolescents whose dietary behavior may be different from adults. A pro‐inflammatory diet as evidenced by higher DII scores is associated with increased levels of various inflammatory markers in the healthy lifestyle in europe by nutrition in adolescents (HELENA) cross‐sectional study.
Background: Despite growing evidence for food-based dietary patterns' potential to reduce cardiovascular disease risk, knowledge about the amounts of food associated with the greatest change in risk ...of specific cardiovascular outcomes and about the quality of meta-evidence is limited. Therefore, the aim of this meta-analysis was to synthesize the knowledge about the relation between intake of 12 major food groups (whole grains, refined grains, vegetables, fruits, nuts, legumes, eggs, dairy, fish, red meat, processed meat, and sugar-sweetened beverages SSB) and the risk of coronary heart disease (CHD), stroke and heart failure (HF).
Methods: We conducted a systematic search in PubMed and Embase up to March 2017 for prospective studies. Summary risk ratios (RRs) and 95% confidence intervals (95% CI) were estimated using a random effects model for highest versus lowest intake categories, as well as for linear and non-linear relationships.
Results: Overall, 123 reports were included in the meta-analyses. An inverse association was present for whole grains (RR
CHD
: 0.95 (95% CI: 0.92-0.98), RR
HF
: 0.96 (0.95-0.97)), vegetables and fruits (RR
CHD
: 0.97 (0.96-0.99), and 0.94 (0.90-0.97); RR
stroke
: 0.92 (0.86-0.98), and 0.90 (0.84-0.97)), nuts (RR
CHD
: 0.67 (0.43-1.05)), and fish consumption (RR
CHD
: 0.88 (0.79-0.99), RR
stroke
: 0.86 (0.75-0.99), and RR
HF
: 0.80 (0.67-0.95)), while a positive association was present for egg (RR
HF
: 1.16 (1.03-1.31)), red meat (RR
CHD
: 1.15 (1.08-1.23), RR
stroke
: 1.12 (1.06-1.17), RR
HF
: 1.08 (1.02-1.14)), processed meat (RR
CHD
: 1.27 (1.09-1.49), RR
stroke
: 1.17 (1.02-1.34), RR
HF
: 1.12 (1.05-1.19)), and SSB consumption (RR
CHD
: 1.17 (1.11-1.23), RR
stroke
: 1.07 (1.02-1.12), RR
HF
: 1.08 (1.05-1.12)) in the linear dose-response meta-analysis. There were clear indications for non-linear dose-response relationships between whole grains, fruits, nuts, dairy, and red meat and CHD.
Conclusion: An optimal intake of whole grains, vegetables, fruits, nuts, legumes, dairy, fish, red and processed meat, eggs and SSB showed an important lower risk of CHD, stroke, and HF.
•Studies in children showed that green space is important for cognitive development.•Attention and behaviour was assessed among 596 Flemish adolescents.•High-resolution green space was subdivided ...based on vegetation height.•Residential green space higher than 3 m is positively associated with attention.
Previous studies suggested that green space is beneficial for the cognitive development in children. However, evidence in adolescents is limited. Therefore, we aim to investigate green space exposure in association with attention and behaviour in adolescents.
This study includes 596 Flemish adolescents between 13 and 17 years old. Attention was assessed with Stroop Test (selective attention) and Continuous Performance Test (sustained and selective attention). Behaviour was determined based on the Strengths and Difficulties Questionnaire. Green space was estimated in several radius distances around their current residence and school based on high-resolution land cover data. Multilevel regression analyses were used adjusting for participant’s age, sex, education level of the mother, and area deprivation index.
Surrounding green space in a 2000 m radius is associated with a faster reaction time in adolescents. An IQR (13%) increment in total green space within 2000 m of the residence and school combined, is associated with a 32.7 ms (95% CI: −58.9 to −6.5; p = 0.02) and a 7.28 ms (95% CI: −11.7 to −2.8; p = 0.001) shorter mean reaction time between the presentation of a stimulus and the response based on the Stroop Test and the Continuous Performance Test. Subdividing green space based on vegetation height, shows that green space higher than 3 m is associated with a faster reaction time of the Continuous Performance Test (−6.50 ms; 95% CI: −10.9 to −2.2; p = 0.004), while low green is not. We did not find an association between green space and behavioural development in adolescents.
Our study shows that green space, especially trees, surrounding the residence and school combined is associated with better sustained and selected attention in adolescents. These findings indicate that the availability of green is important for adolescents that are growing up in a rapidly urbanizing world.
Following a request from the European Commission, the Panel on Nutrition, Novel Foods and Food Allergens (NDA) revised its 2009 Opinion on the appropriate age for introduction of complementary ...feeding of infants. This age has been evaluated considering the effects on health outcomes, nutritional aspects and infant development, and depends on the individual's characteristics and development. As long as foods have an age‐appropriate texture, are nutritionally appropriate and prepared following good hygiene practices, there is no convincing evidence that at any age investigated in the included studies (< 1 to < 6 months), the introduction of complementary foods (CFs) is associated with adverse health effects or benefits (except for infants at risk of iron depletion). For nutritional reasons, the majority of infants need CFs from around 6 months of age. Infants at risk of iron depletion (exclusively breastfed infants born to mothers with low iron status, or with early umbilical cord clamping (< 1 min after birth), or born preterm, or born small‐for‐gestational age or with high growth velocity) may benefit from earlier introduction of CFs that are a source of iron. The earliest developmental skills relevant for consuming pureed CFs can be observed between 3 and 4 months of age. Skills for consuming finger foods can be observed in some infants at 4 months, but more commonly at 5–7 months. The fact that an infant may be ready from a neurodevelopmental perspective to progress to a more diversified diet before 6 months of age does not imply that there is a need to introduce CFs. There is no reason to postpone the introduction of potentially allergenic foods (egg, cereals, fish and peanut) to a later age than that of other CFs as far as the risk of developing atopic diseases is concerned. Regarding the risk of coeliac disease, gluten can be introduced with other CFs.
This publication is linked to the following EFSA Supporting Publications article: http://onlinelibrary.wiley.com/doi/10.2903/sp.efsa.2019.EN-1686/full
Objective: Psychosocial stress has been linked with an unhealthy lifestyle but the relation's direction remains unclear. Does stress induce sleeping problems, comfort food consumption, and lower ...physical activity, or do these unhealthy lifestyle factors enhance stress? This study examined the bidirectional stress-lifestyle relation in children. Method: The relation between stress and lifestyle was examined over 2 years in 312 Belgian children 5-12 years old as part of the Children's Body Composition and Stress study. Stress-related aspects were measured by questionnaires concerning negative events, negative emotions, and behavioral problems. The following lifestyle factors were assessed: physical activity (by accelerometers), sleep duration, food consumption (sweet food, fatty food, snacks, fruits and vegetables), and eating behavior (emotional, external, restrained). Bidirectional relations were examined with cross-lagged analyses. Results: Certain stress aspects increased physical activity, sweet food consumption, emotional eating, restrained eating, and external eating (βs = .140-.319). All relations were moderated by sex and age: Dietary effects were mainly in the oldest children and girls; stress increased physical activity in the youngest, whereas it tended to decrease physical activity in the oldest. One reversed direction effect was found: Maladaptive eating behaviors increased anxiety feelings. Conclusions: Relations were mainly unidirectional: Stress influenced children's lifestyle. Stress stimulated eating in the absence of hunger, which could facilitate overweight. Consequently, families should realize that stress may influence children's diet, and problem-solving coping skills should be acquired. In contrast to recent findings, stress might also stimulate physical activity in the youngest as positive stress coping style.
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.
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).
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.
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.
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.
Short sleep duration and poor sleep quality in children have been associated with concentration, problem behavior, and emotional instability, but recently also with disrupted autonomic nervous ...function, which predicts cardiovascular health. Heart rate variability (HRV) was used as noninvasive indicator of autonomic function to examine the influence of sleep.
Cross-sectional and longitudinal observational study on the effect of sleep on HRV.
Belgian children (5-11 years) of the ChiBS study in 2010 (N = 334) and 2011 (N = 293).
N/A.
Sleep duration was reported and in a subgroup sleep quality (efficiency, latency, awakenings) was measured with accelerometry. High-frequency (HF) power and autonomic balance (LF/HF) were calculated on supine 5-minute HRV measurements. Stress was measured by emotion and problem behavior questionnaires. Sleep duration and quality were used as HRV predictors in corrected cross-sectional and longitudinal regressions. Stress was tested as mediator (intermediate pathway) or moderator (interaction) in sleep-HRV associations.
In both cross-sectional and longitudinal analyses, long sleep latency could predict lower HF (parasympathetic activity), while nocturnal awakenings, sleep latency, low sleep efficiency, and low corrected sleep duration were related to higher LF/HF (sympathetic/parasympathetic balance). Parental reported sleep duration was not associated with HRV. The significances remained after correction for stress. Stress was not a mediator, but a moderator (enhancer) in the relationship between sleep quality and HRV.
Low sleep quality but not parent-reported low sleep duration leads to an unhealthier heart rate variability pattern (sympathetic over parasympathetic dominance). This stresses the importance of good sleep quality for cardiovascular health in children.
Mycotoxins are important food contaminants responsible for health effects such as cancer, nephrotoxicity, hepatotoxicity or immunosuppression. The assessment of mycotoxin exposure is often based on ...calculations combining mycotoxin occurrence data in food with population data on food consumption. Because of limitations inherent to that approach, the direct measurement of biomarkers of exposure in biological fluids has been proposed as a suitable alternative to perform an accurate mycotoxin exposure assessment at individual level. For this reason, the BIOMYCO study was designed to assess mycotoxin exposure in Belgian adults and children using urinary biomarkers of exposure. Morning urine was gathered in a representative part of the Belgian population according to a standardised study protocol, whereby 155 children (3–12 years old) and 239 adults (19–65 years old) were selected based on random cluster sampling. These urine samples were analysed for the presence of 33 potential biomarkers with focus on aflatoxins, citrinin (CIT), fumonisins, trichothecenes, ochratoxin A (OTA), zearalenone and their metabolites using two validated LC–MS/MS methods.
Nine out of the 33 analysed mycotoxins were detected whereby deoxynivalenol (DON), OTA, CIT and their metabolites were the most frequently detected. Deoxynivalenol-15-glucuronide was the main urinary DON biomarker and was found in all urine samples in the ng/mL range. Furthermore deoxynivalenol-3-glucuronide was quantified in 91% of the urine samples collected from children and in 77% of the samples collected from adults. Deoxynivalenol was detected in 70% and 37% of the samples of children and adults respectively. For the first time deepoxy-deoxynivalenol-glucuronide was detected in children's urine (17%). In the samples collected by adults, the prevalence was 22%. Whereas all these mycotoxins contaminated the urine samples in the ng/mL range, CIT and OTA were present in much lower concentrations (pg/mL). OTA contaminated 51% and 35% of the samples collected by children and adults respectively. CIT and its metabolite were present in 72% and 6% of children's urine, whereas they contaminated 59% and 12% of adult's urine. Finally, α-zearalenol and β-zearalenol-14-glucuronide were found in respectively one and two samples from adults. The exposure to DON, OTA and CIT was compared between subgroups and urinary mycotoxin concentrations differed significantly among age and gender. Based on the urinary levels, the daily intake of DON and OTA was estimated and evaluated whereby, depending on the used method, 16–69% of the population possibly exceeded the tolerable daily intake for DON and 1% for OTA.
The BIOMYCO study is the first study whereby a multi-toxin approach was applied for mycotoxin exposure assessment in adults and children on a large-scale. Moreover, it is the first study that described the exposure to an elaborated set of mycotoxins in the Belgian population. Biomarker analysis showed a clear exposure of a broad segment of the Belgian population to DON, OTA and CIT. The risk assessment based on these data indicates a potential concern for a number of individuals whereby young children need special attention because of the relatively higher food intake per kg body weight.
•Morning urine of 394 Belgian individuals was collected according to a standardised study protocol.•Deoxynivalenol, ochratoxin A, citrinin and their metabolites were the most frequently detected.•Deoxynivalenol-15-glucuronide was the main urinary DON biomarker found.•For the first time deepoxy-deoxynivalenol-glucuronide was detected in children's urine.•Risk assessment based on urinary levels indicates a potential concern for a number of individuals.
Mitochondrial DNA (mtDNA) content and telomere length are putative aging biomarkers and are sensitive to environmental stressors, including pollutants. Our objective was to identify, from a set of ...environmental exposures, which exposure is associated with leukocyte mtDNA content and telomere length in adults. This study includes 175 adults from 50 to 65 years old from the cross-sectional Flemish Environment and Health study, of whom leukocyte telomere length and mtDNA content were determined using qPCR. The levels of exposure of seven metals, 11 organohalogens, and four perfluorinated compounds (PFHxS, PFNA, PFOA, PFOS) were measured. We performed sparse partial least-squares regression analyses followed by ordinary least-squares regression to assess the multipollutant associations. While accounting for possible confounders and coexposures, we identified that urinary cadmium (6.52%, 95% confidence interval, 1.06, 12.28), serum hexachlorobenzene (2.89%, 018, 5.68), and perfluorooctanesulfonic acid (11.38%, 5.97, 17.08) exposure were positively associated (p < 0.05) with mtDNA content, while urinary copper (−9.88%, −14.82, −4.66) and serum perfluorohexanesulfonic acid (−4.75%, −8.79, −0.54) exposure were inversely associated with mtDNA content. Urinary antimony (2.69%, 0.45, 4.99) and mercury (1.91%, 0.42, 3.43) exposure were positively associated with leukocyte telomere length, while urinary copper (−3.52%, −6.60, −0.34) and serum perfluorooctanesulfonic acid (−3.64%, −6.60, −0.60) showed an inverse association. Our findings support the hypothesis that environmental pollutants interact with molecular hallmarks of aging.
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