Browsing by Author "Wijnhoven, Trudy M.A."
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- Prevalence of overweight and obesity among Portuguese children (6-8 years old) using three definition criteria: COSI PORTUGAL, 2008Publication . Rito, Ana; Wijnhoven, Trudy M.A.; Rutter, Harry; Carvalho, Maria Ana; Paixão, Eleonora; Ramos, Carlos; Cláudio, Débora; Espanca, Rosa; Sancho, Teresa; Cerqueira, Zélia; Carvalho, Rita; Faria, Carmo; Feliciano, Elsa; Breda, JoãoIntroduction: Previous studies places Portugal among the five countries with the highest prevalence of childhood obesity in Europe. This paper describes the prevalence of thinness, overweight and obesity in Portuguese children of 6-8 years of age, based on the first data collection from COSI Portugal, which took place during the 2007/2008 school year. Methods: Semi-longitudinal design with repeated cross-sectional national representative samples. Specific prevalence of overweight (including obesity) and obesity was determined using three different diagnostic criteria. Across the seven geographic regions 3765 children were enrolled from 181 schools with 50.3% of boys. Results: Using the IOTF reference the prevalences of thinness, overweight and obesity were 4.8%, 28.1%, and 8.9% respectively; using the CDC reference they were 2.1%, 32.2%, and 14.6%; and according to the WHO reference they were 1.0%, 37.9%, and 15.3%. Univariate analysis showed a higher risk of obesity in older children, in boys and in the Azores region. The islands of Madeira and the Azores were the regions with the highest prevalence of overweight at 39.4% and 46.6% respectively, and Algarve was the one with the lowest (21.4%). Conclusion:. These findings demonstrate the need for urgent action in Portugal, and provide policy makers with comprehensive and detailed information to assist with this.
- WHO European Childhood Obesity Surveillance Initiative: associations between sleep duration, screen time and food consumption frequenciesPublication . Börnhorst, Claudia; Wijnhoven, Trudy M.A.; Kunešová, Marie; Yngve, Agneta; Rito, Ana I.; Lissner, Lauren; Duleva, Vesselka; Petrauskiene, Ausra; Breda, JoãoBACKGROUND: Both sleep duration and screen time have been suggested to affect children's diet, although in different directions and presumably through different pathways. The present cross-sectional study aimed to simultaneously investigate the associations between sleep duration, screen time and food consumption frequencies in children. METHODS: The analysis was based on 10 453 children aged 6-9 years from five European countries that participated in the World Health Organization European Childhood Obesity Surveillance Initiative. Logistic multilevel models were used to assess associations of parent-reported screen time as well as sleep duration (exposure variables) with consumption frequencies of 16 food items (outcome variables). All models were adjusted for age, sex, outdoor play time, maximum educational level of parents and sleep duration or screen time, depending on the exposure under investigation. RESULTS: One additional hour of screen time was associated with increased consumption frequencies of 'soft drinks containing sugar' (1.28 [1.19;1.39]; odds ratio and 99% confidence interval), 'diet/light soft drinks' (1.21 [1.14;1.29]), 'flavoured milk' (1.18 [1.08;1.28]), 'candy bars or chocolate' (1.31 [1.22;1.40]), 'biscuits, cakes, doughnuts or pies' (1.22 [1.14;1.30]), 'potato chips (crisps), corn chips, popcorn or peanuts' (1.32 [1.20;1.45]), 'pizza, French fries (chips), hamburgers'(1.30 [1.18;1.43]) and with a reduced consumption frequency of 'vegetables (excluding potatoes)' (0.89 [0.83;0.95]) and 'fresh fruits' (0.91 [0.86;0.97]). Conversely, one additional hour of sleep duration was found to be associated with increased consumption frequencies of 'fresh fruits' (1.11 [1.04;1.18]) and 'vegetables (excluding potatoes)' (1.14 [1.07;1.23]). CONCLUSION: The results suggest a potential relation between high screen time exposure and increased consumption frequencies of foods high in fat, free sugar or salt whereas long sleep duration may favourably be related to children's food choices. Both screen time and sleep duration are modifiable behaviours that may be tackled in childhood obesity prevention efforts.
- WHO European Childhood Obesity Surveillance Initiative: health-risk behaviours on nutrition and physical activity in 6-9-year-old schoolchildrenPublication . Wijnhoven, Trudy M.A.; van Raaij, Joop M.A.; Yngve, Agneta; Sjöberg, Agneta; Kunešová, Marie; Duleva, Vesselka; Petrauskiene, Ausra; Rito, Ana I.; Breda, JoãoObjective: To assess to what extent eight behavioural health risks related to breakfast and food consumption and five behavioural health risks related to physical activity, screen time and sleep duration are present among schoolchildren, and to examine whether health-risk behaviours are associated with obesity. Design: Cross-sectional design as part of the WHO European Childhood Obesity Surveillance Initiative (school year 2007/2008). Children’s behavioural data were reported by their parents and children’s weight and height measured by trained fieldworkers. Descriptive statistics and logistic regression analyses were performed. Setting: Primary schools in Bulgaria, Lithuania, Portugal and Sweden; paediatric clinics in the Czech Republic. Subjects: Nationally representative samples of 6–9-year-olds (n 15 643). Results: All thirteen risk behaviours differed statistically significantly across countries. Highest prevalence estimates of risk behaviours were observed in Bulgaria and lowest in Sweden. Not having breakfast daily and spending screen time ≥2 h/d were clearly positively associated with obesity. The same was true for eating ‘foods like pizza, French fries, hamburgers, sausages or meat pies’ >3 d/week and playing outside <1 h/d. Surprisingly, other individual unhealthy eating or less favourable physical activity behaviours showed either no or significant negative associations with obesity. A combination of multiple less favourable physical activity behaviours showed positive associations with obesity, whereas multiple unhealthy eating behaviours combined did not lead to higher odds of obesity. Conclusions: Despite a categorization based on international health recommendations, individual associations of the thirteen health-risk behaviours with obesity were not consistent, whereas presence of multiple physical activity-related risk behaviours was clearly associated with higher odds of obesity.
- WHO European Childhood Obesity Surveillance Initiative: Impact of Type of Clothing Worn during Anthropometric Measurements and Timing of the Survey on Weight and Body Mass Index Outcome Measures in 6–9-Year-Old ChildrenPublication . Wijnhoven, Trudy M.A.; van Raaij, Joop M.A.; Spinelli, Angela; Yngve, Agneta; Lissner, Lauren; Spiroski, Igor; Farrugia Sant'Angelo, Victoria; Pérez-Farinós, Napoleón; Martos, Éva; Heinen, Mirjam; Kunešová, Marie; Rito, Ana I.; Hovengen, Ragnhild; Starc, Gregor; Duleva, Vesselka; Pudule, Iveta; Petrauskiene, Ausra; Braeckevelt, Lien; Hassapidou, Maria; Breda, João; van 't Veer, PieterBackground. The World Health Organization European Childhood Obesity Surveillance Initiative (COSI) conducted examinations in 6–9-year-old children from 16 countries in the first two rounds of data collection. Allowing participating countries to adhere to their local legal requirements or adapt to other circumstances required developing a flexible protocol for anthropometric procedures. Objectives. (1) Review intercountry variation in types of clothing worn by children during weight and height measurements, clothes weight adjustments applied, timing of the survey, and duration of data collection; (2) assess the impact of the observed variation in these practices on the children’s weight or body mass index (BMI) outcome measures. Results. The relative difference between countries’ unadjusted and clothes-adjusted prevalence estimates for overweight was 0.3–11.5%; this figure was 1.4–33.3% for BMI-for-age Z-score values. Monthly fluctuations in mean BMI-for-age Z-score values did not show a systematic seasonal effect. The majority of the monthly BMI-for-age Z-score values did not differ statistically within a country; only 1–3 monthly values were statistically different within some countries. Conclusions. The findings of the present study suggest that the built-in flexibility in the COSI protocol concerning the data collection practices addressed in the paper can be kept and thus do not necessitate a revision of the COSI protocol.