i.family powerpoint template

Determinants of eating behaviour in
European children, adolescents and their parents
Study design and main objectives
Wolfgang Ahrens,
University Bremen and
Leibniz Institute for Prevention Research and Epidemiology – BIPS
- on behalf of the I.Family consortium -
I.Family briefing
Coordinator: Wolfgang Ahrens (D)
Deputy coordinators: Alfonso Siani (I), Iris Pigeot (D)
Call: FP7-KBBE-2010-4
Funding scheme: CP-IP Large-scale integrating project
Grant requested : 9 mill. €
Duration: 60 months, started in March 2012
No. of partners: 17 (incl. 1 SME)
Participating countries: Cyprus, Belgium, Denmark, Estonia, Germany,
Finland, Hungary, Italy, Spain, Sweden, The Netherlands, United Kingdom
Full title: Determinants of eating behaviour in European children,
adolescents and their parents
Aim: make significant contribution to
reduce burden of nutrition-related diseases
 Understand interplay between barriers and main
drivers of a healthy food choice
• Focus on individual and his/ her family
• Assess dynamic nature of causal factors over time and
during transition into adolescence
• Unique opportunity: follow-up of the IDEFICS cohort (16.000
EU children 2-10 years in 2007) + extension to family
members
 Develop and disseminate strategies to induce
changes towards a healthy behaviour in consumers
Longitudinal design of I.Family
and concatenation with IDEFICS
IDEFICS study
Dietary
behavior
5
Food patterns: principal
component analysis
Explained
variance
Dietary pattern
Components
Snacking
Sandwiches (including hamburgers, hotdogs, and
kebabs); butter or margarine on bread; snacks,
savoury pastries, fritters; snacks, chocolate, candy
bars; white bread, white rolls, crisp-bread
10%
Sweet & fat
Chocolate- or nut-based spreads; biscuits cakes,
pastries, and puddings; sweets/candy; fried meats;
soft drinks
6%
Fruits & wholemeal
Raw vegetables; wholemeal bread; cooked
vegetables; fresh fruit no added sugar; plain milk
(not sweetened); porridge, muesli (not sweetened)
5%
Proteines & water
Fish fresh, not fried; water; fried fish, fish-fingers;
eggs, fried, scrambled, fresh meat, not fried; pasta,
noodles, rice
4%
6
Pala V et al. Dietary patterns and overweight in children: a follow-up study on the
European IDEFICS multicentre cohort. Eur J Epidemiol 2013 (submitted)
Risk of of increased BMI z-score
(20+%) over two years of follow-up
by food pattern
Dietary pattern
Snacking
Sweet & fat
Veg. & wholemeal
Protein & water
Tertile
Adj. OR
95% CI
middle
0.94
(0.85-1.05)
high
0.99
(0.87-1.12)
middle
1.13
(1.01-1.25)
high
1.17
(1.04-1.32)
middle
0.93
(0.83-1.04)
high
0.88
(0.78-0.99)
middle
0.94
(0.84-1.05)
high
1.06
(0.94-1.20)
(reference = low)
Odd ratios (OR) with 95% confidence intervals from mixed effects logistic regression with country as
“random effect”; adjusted for sex, age, hours of physical activity/week (continuous), country specific
income (low, low/medium, medium, medium/high and high)
7
Pala V et al. Dietary patterns and overweight in children: a follow-up study on the
European IDEFICS multicentre cohort. Eur J Epidemiol 2013 (submitted)
Sensory
taste preferences
8
Odds ratios for overweight/obesity by
taste preferences
 1,833 school children
(6-9 years)
 Paired forced choice tests
 Preference for added
 sugar, apple flavour in
apple juice (not in Cyprus)
 monosodiumglutamate
(MSG), salt, fat in cracker
Preference



9
Adjusted for country, age and sex
No statistical interaction between fat and sugar preference
Reference category= preference for the non-added alternative
Lanfer A et al. Taste preferences in assocation with dietary habits and weight status in
European children: results from the IDEFICS study. IJO 36 (1); 2012: 27 - 34
The built environment
10
Development of a moveability index
 Which characteristics of the built environment influence
physical
activity
Bikeways
andgreen
footpaths
Playgrounds,
levels in the home environment of children?
allow children
to travel to
spaces
and sports
City border
School catchment area
Primary school
Kindergarden
Land use
Misc.
 How can we assess these characteristics?
Recreational
Agricultural
Industrial
Residential
Commercial
Destinations
Sports facility
Sports hall
Playgrounds
Green space
Infrastructure
Footpath
Bikeway
Bus stop
Intersection
Scale 1:20,000
11
school by
facilities
arebike or by
foot.
opportunities
for
(Sallis et al.,activity
2009)
physical
in
Land use describes the
leisure
time. describe
Intersections
level
of urbanity
which
(Black
and Macinko,
the street
network.
influences
the2008) A
high amount of
infrastructure
as well as
intersections
the
availabilitywithin
of an
area produces
destinations
for different
physical
and short ways to
activity.
destinations in the
(Frank et al., 2005)
home environment.
(Frank et al., 2005)
Development of a moveability index
 Geostatistical Measures:


Availability of urban characteristics
Kernel density
 Moveability Index:
 Mean z-scores of measures of
urban characteristics
 Pilot study (317 children):
positive association with PA
(AVG CPM)
Buck C et al. Development and application of a moveability index to quantify possibilities for
physical activity in the built environment of children. Health & Place 17; 2011: 1191-1201
12
Physical activity assessed
by accelerometry
13
Duration of MVPA across Europe
(60 sec. interval, Evenson)
100%
90%
80%
70%
<= 30 min
60%
30- <= 60 min
60+ min
50%
40%
30%
20%
10%
0%
ITA
CYP
HUN
BEL
EST
ESP
GER
SWE
All
N=7,451 (46.0%) wearing of accelerometer over 3 consecutive days for at least 6 hours each
14
Odds ratio for OW/obesity by
duration of MVPA
Duration of MVPA
(accelerometry, Evenson,
60 sec. epoch)
OW/obese
N (%)
Thin/normal
N (%)
OR§
95% CI
(ref.)
60+ min./day
165
(11.1)
939 (15.7)
1.0
30-<=60 min./day
642
(43.1)
2,777 (46.6)
1.26
1.04
1.53
<=30 min./day
682
(45.8)
2,246 (37.7)
1.56
1.29
1.90
Missing
1,698
(-)
7,071
1.32
1.09
1.58
§Hierarchical
15
(-)
model, adjusted for country (random effects), age and sex
Sedentary
behaviour
16
TV consumption & OW/obesity
– prevalence odds ratios –
Duration of TV consumption (TV60)
Regularly eat meals while watching TV (EatTV)
Odds ratios (OR) and 95% confidence intervals (CI) adjusted for sex, age, parental education, country (all)
17
Lissner et al. Television habits in relation to overweight, diet and taste preferences in
European children – the IDEFICS study. Eur J Epidemiol 27, 2012.
Sleep duration
18
Odds ratios for overweight by
sleep duration
< 11h and >10h
< 10h and >9h
<9h
Pre-school
1.0 (0.7; 1.3)
1.1 (0.8; 1.5)
1.2 (0.9; 1.8)
School
1.4 (1.1; 2.0)
1.7 (1.3; 2.4)
3.0 (2.2; 4.4)
All
1.1 (0.9; 1.4)
1.3 (1.1; 1.7)
1.9 (1.6; 2.5)
(Ref. >11 h; OR, 95% CI; adj. for sex, age, parental education, screen time, country)
Hense
S et al. Sleep duration and overweight in European children: is the association modified by
19
geographic region. SLEEP 2011; 34: 885-890
Intervention: 6 key messages
Physical
activity
Nutrition
Daily water
Reduce TV-viewing
Spend more time
together
Family time
Daily PA
5/day
Safe bicycle lanes
Outdoor playing
Adequate sleep duration
1hr
MVPA/day
20
High wellbeing score
Stress
<1/day
 Less soft drinks
Daily fruit &
vegetables
<1hr/day
<2hr/day
>10hr/day
>11hr/day
Adherence to the 6 IDEFICS key
messages
No. of key messages adhered to
1%
0%
6%
14%
17%
31%
31%
21
Kovacz E et al. (2012) – unpublished –
0
1
2
3
4
5
6
OR for OW/obesity by number of
key messages adhered to at T0
Number of
key messages
(optimal cut-offs)
adhered to #
Prevalence of
adherence (%)
Odds ratio (95% CI)
0
12.5
Reference
1
30.5
0.48 (0.37-0.62)
2
33.7
0.33 (0.26-0.43)
3
18.6
0.17 (0.12-0.24)
4
4.7
0.09 (0.04-0.20)
# excluding F&V consumption and sugar sweetened drinks
22
Kovacz E et al. (2012) – unpublished –
Longitudinal design of I.Family
and concatenation with IDEFICS
IDEFICS study
www.idefics.eu
www.ifamilystudy.eu
Work programme
 To study the impact of biological, socio-behavioural, genetic and
environmental factors on dietary behaviour by comparing subjects
who developed in an unfavourable direction with those who
maintained a healthy diet
 To study brain activation, expression of genes related to food
choice, biological and genetic basis for taste thresholds, role of
sleep, sedentary time, physical activity and built environment in
subgroups with contrasting dietary profiles
 To study the prognostic value of body composition and cardiometabolic markers by linking them to diet and interacting factors
 To derive effective communication strategies to empower EU
consumers to induce favourable behaviour changes
Workflow and work packages (WPs)
WP5
Physical
Activity
Epidemiologic
Platform
Consumer
Behaviour
WP6
Family
Environment
WP6
Genetics &
Neurobehaviour
Cascade
WP7
WP9
WP2
Awareness
Dietary
Behaviour
WP8
Management
WP1
WP3
Partners
1.
Strovolos, Cyprus
2.
Ghent, Belgium
3.
Copenhagen, Denmark
4.
Tallin, Estonia
5.
Helsinki, Finland
6.
Bremen, Germany
7.
Pécs, Hungary
8.
Avellino, Italy
9.
Milan, Italy
10.
Utrecht, Netherlands
11.
Palma de Mallorca, Spain
12.
Zaragoza, Spain
13.
Gothenburg, Sweden
14.
Bristol, United Kingdom
15.
Lancaster, United Kingdom
16.
Andover, United Kingdom
FP7 Work Programme 2010
Theme 2 Food, Agriculture and Fisheries, and
Biotechnology (29 July 2009)
KBBE.2010.2.1-01: Determinants of food choice and eating habits
Call: FP7-KBBE-2010-4 The objective is to identify the main driving
factors for food choice and eating habits (including genomics and brain
functions). Research will help understanding discrepancies between
actual versus optimal dietary behaviour. It should also develop
strategies to induce behavioural changes and facilitate consumers'
choice for a healthy diet. Cross-cultural and sub-population group
differences and interactions with other life style factors such as
physical activity should also be considered taking, where applicable,
existing longitudinal studies into account. Methods for
communication and dissemination based on the developed strategies
should be set up to reach the consumers, in particular children,
adolescents, and their parents. A cross-disciplinary approach should
be encouraged. Where appropriate, gender issues should be considered.
FP7 Work Programme 2010
Theme 2 Food, Agriculture and Fisheries, and
Biotechnology (29 July 2009)
Funding scheme: Collaborative Project (large-scale integrating project). The
requested European Community contribution shall not exceed EUR
9,000,000.
Expected impact: It is expected that the results will help to better
understand (un-)healthy food choice through identification of
main determinants and triggers and to facilitate a healthy food
choice for European consumers. Methods for a better
communication and dissemination strategy in Europe that will
induce healthier lifestyles in children, adolescents, and adults.
Increased collaboration between different scientific fields and
contribution to the successful achievements of the EU Platform
on Diet, Physical Activity and Health.
Instruments
 Questionnaires (parent + child)
 Social factors, lifestyle, peers + PA
 Food preference, eating behaviour + FFQ
 Medical history
 Kinship
 24-hour dietary recall
 SACANA: web-based 24-h dietary recall
 Physical activity
 Accelerometer: 7 days
30
Examinations & Assessments
 Physical examination
 Anthropometry + blood pressure
 Bone health: ultrasonometry
 Biological markers
 Blood, saliva + urine
 Add-ons, e.g.
 Sensory taste perception
 Physical environment: moveability (GIS
+ GPS)
 Neuropsychological tests: impulsitvity
31

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