Ljubljana, Slovenia
Ljubljana, Slovenia

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Brug J.,VU University Amsterdam | Van Stralen M.M.,VU University Amsterdam | M. ChinAPaw M.J.,VU University Amsterdam | De Bourdeaudhuij I.,Ghent University | And 10 more authors.
Pediatric Obesity | Year: 2012

Objective: The aim of this study was to explore differences in weight status and energy balance behaviours according to ethnic background among adolescents across Europe. Methods: A school-based survey among 10-12-year-old adolescents was conducted in seven European countries. Weight, height and waist circumference were measured; engagement in physical activity, sedentary and dietary behaviour, and sleep duration was assessed by child and parent-report. A distinction between native and non-native ethnic background was based on language spoken at home, and the parents' country of birth. Analyses were conducted with and without adjustment for parental education. Results: With valid data on both indicators of ethnic background for 5149 adolescents, 7307 adolescents (52% girls; 11.6 ± 0.7 years) participated. Significantly higher prevalence of overweight, obesity, body mass index and waist circumference were observed among non-native compared with native adolescents. Non-native adolescents had less favourable behavioural patterns (sugary drinks, breakfast skipping, sport, TV and computer time, hours of sleep) with the exception of active transport to school. Similar patterns were observed for both indicators of ethnicity, and in most of the separate countries; however, in Greece, weight status indicators were better among non-native adolescents. After adjustment for parental education, most differences remained significant according to country of origin of the parents, but not according to language spoken at home. Conclusion: Adolescents of native ethnicity of the country of residence have, in general, more favourable weight status indicators and energy balance-related behaviours than adolescents of non-native ethnicity across Europe. © 2012 The Authors.


Lien N.,University of Oslo | Van Stralen M.M.,University Medical Center | Androutsos O.,Harokopio University | Bere E.,University of Agder | And 7 more authors.
Health and Place | Year: 2014

The school is an important setting for promoting healthy eating especially at the transition from childhood to adolescence. This study contributes to the literature by describing practices within physical, political and sociocultural aspects of the school nutrition environment in seven countries across Europe based on questionnaires to the school management, and exploring their associations with soft drink consumption reported on questionnaires by 10-12 year olds. Several of the commonly self-reported practices could be supportive of a healthy diet (time to eat, access to water, restriction on marketing), but some practices were underutilized (i.e. discussion with stakeholders, healthy foods at events). Only a few associations of practices with the pupils' soft drink consumption were found. © 2014 Elsevier Ltd.


Van Lippevelde W.,Ghent University | te Velde S.J.,VU University Amsterdam | Verloigne M.,Ghent University | De Bourdeaudhuij I.,Ghent University | And 9 more authors.
Appetite | Year: 2013

The aim of this study is to investigate associations of family-related factors with children's fruit drink/juice and soft drink consumption. A cross-sectional survey among 10- to 12-year-old children and their parents in eight European countries was conducted to gather this data. Key variables of interest were children's self-reported fruit drink/juice and soft drink intake per day (outcome) and family-related factors (based on parents' report) related to these two behaviors (modeling, automaticity, availability, monitoring, permissiveness, negotiating, communicating health beliefs, avoid negative modeling, self-efficacy, rewarding, and family consumption). 7915 Children (52% girls; mean age. =11.7 ± 0.8. years) and 6512 parents (83% women; mean age. =41.4 ± 5.3. years) completed the questionnaire. Multilevel regression analyses were used to examine the aforementioned associations. Three of the 11 family-related factors (modeling, availability, and family consumption) were positively associated with children's fruit drink/juice and soft drink intake. Additionally, three family-related factors (permissiveness, monitoring, and self-efficacy) were solely associated with soft drink intake and one family-related factor (communicating health beliefs) was related to fruit drink/juice intake. Future interventions targeting children's fruit drink/juice and soft drink intake should focus on the home environment, parents and their practices, especially on parents' fruit drink/juice and soft drink intake and availability of these beverages at home. © 2012 Elsevier Ltd.


Fernandez-Alvira J.M.,University of Zaragoza | De Bourdeaudhuij I.,Ghent University | Singh A.S.,VU University Amsterdam | Vik F.N.,University of Agder | And 5 more authors.
International Journal of Behavioral Nutrition and Physical Activity | Year: 2013

Background: Recent research and literature reviews show that, among schoolchildren, some specific energy balance-related behaviors (EBRBs) are relevant for overweight and obesity prevention. It is also well known that the prevalence of overweight and obesity is considerably higher among schoolchildren from lower socio-economic backgrounds. This study examines whether sugared drinks intake, physical activity, screen time and usual sleep duration cluster in reliable and meaningful ways among European children, and whether the identified clusters could be characterized by parental education. Methods: The cross-sectional study comprised a total of 5284 children (46% male), from seven European countries participating in the ENERGY-project (" EuropeaN Energy balance Research to prevent excessive weight Gain among Youth"). Information on sugared drinks intake, physical activity, screen time and usual sleep duration was obtained using validated self-report questionnaires. Based on these behaviors, gender-specific cluster analysis was performed. Associations with parental education were identified using chi-square tests and odds ratios. Results: Five meaningful and stable clusters were found for both genders. The cluster with high physical activity level showed the highest proportion of participants with highly educated parents, while clusters with high sugared drinks consumption, high screen time and low sleep duration were more prevalent in the group with lower educated parents. Odds ratio showed that children with lower educated parents were less likely to be allocated in the active cluster and more likely to be allocated in the low activity/sedentary pattern cluster. Conclusions: Children with lower educated parents seemed to be more likely to present unhealthier EBRBs clustering, mainly characterized by their self-reported time spent on physical activity and screen viewing. Therefore, special focus should be given to lower educated parents and their children in order to develop effective primary prevention strategies. © 2013 Fernández-Alvira et al.; licensee BioMed Central Ltd.


Cameron A.J.,Deakin University | Cameron A.J.,VU University Amsterdam | Van Stralen M.M.,VU University Amsterdam | Brug J.,VU University Amsterdam | And 9 more authors.
Pediatric Obesity | Year: 2013

Aims: A television in the bedroom is associated with measures of adiposity. We aimed to test if this association is mediated by any of (i) time spent watching television, (ii) sleep duration, (iii) physical activity level or (iv) consumption of soft drinks. Method: Data were from 7234 boys and girls aged 10-12 years in European countries involved in the EuropeaN Energy balance Research to prevent excessive weight Gain among Youth project (Belgium, Greece, Hungary, the Netherlands, Norway, Slovenia and Spain). Waist circumference, height and weight were measured. The presence of a bedroom television, television viewing time, sleep duration, physical activity time and soft drink consumption were assessed by standardized questionnaires. Results: Almost 40% of schoolchildren had a bedroom television, with the highest percentage among Hungarian children (65%) and lowest for Belgian, Slovenian and Spanish children (all 28%). A television in the bedroom was positively associated with time spent watching television, soft drink consumption and overweight and obesity (all p < 0.001). The relationship between a television in the bedroom and measures of body size was partly mediated by total television viewing time (proportion mediated for waist circumference 8.9%; for body mass index 8.3%) but not sleep duration, physical activity time or soft drink consumption. Conclusion: The strong association between a television in the bedroom and adiposity was at least partially mediated by television viewing time. The large proportion of European schoolchildren with a television in their bedroom is of concern. Parents should be aware of the potential consequences when placing a television in a child's bedroom and children should limit viewing time. © 2012 International Association for the Study of Obesity.


Timperio A.F.,Deakin University | van Stralen M.M.,VU University Amsterdam | Brug J.,VU University Amsterdam | Bere E.,University of Agder | And 8 more authors.
International Journal of Behavioral Nutrition and Physical Activity | Year: 2013

Background: Sport participation makes an important contribution to children's overall physical activity. Understanding influences on sports participation is important and the family environment is considered key, however few studies have explored the mechanisms by which the family environment influences children's sport participation. The purpose of this study was to examine whether attitude, perceived behavioural control, health belief and enjoyment mediate associations between the family environment and 10-12 year-old children's sports participation.Methods: Children aged 10-12 years ( = 7234) and one of their parents (n = 6002) were recruited from 175 schools in seven European countries in 2010. Children self-reported their weekly duration of sports participation, physical activity equipment items at home and the four potential mediator variables. Parents responded to items on financial, logistic and emotional support, reinforcement, modelling and co-participation in physical activity. Cross-sectional single and multiple mediation analyses were performed for 4952 children with complete data using multi-level regression analyses.Results: Availability of equipment (OR = 1.16), financial (OR = 1.53), logistic (OR = 1.47) and emotional (OR = 1.51) support, and parental modelling (OR = 1.07) were positively associated with participation in ≥ 30mins/wk of sport. Attitude, beliefs, perceived behavioural control and enjoyment mediated and explained between 21-34% of these associations. Perceived behavioural control contributed the most to the mediated effect for each aspect of the family environment.Conclusions: Both direct (unmediated) and indirect (mediated) associations were found between most family environment variables and children's sports participation. Thus, family-based physical activity interventions that focus on enhancing the family environment to support children's sport participation are warranted. © 2013 Timperio et al.; licensee BioMed Central Ltd.


te Velde S.J.,VU University Amsterdam | ChinAPaw M.J.M.,VU University Amsterdam | De Bourdeaudhuij I.,Ghent University | Bere E.,University of Agder | And 6 more authors.
International Journal of Behavioral Nutrition and Physical Activity | Year: 2014

Background: The family, and parents in particular, are considered the most important influencers regarding children's energy-balance related behaviours (EBRBs). When children become older and gain more behavioural autonomy regarding different behaviours, the parental influences may become less important and peer influences may gain importance. Therefore the current study aims to investigate simultaneous and interactive associations of family rules, parent and friend norms and modelling with soft drink intake, TV viewing, daily breakfast consumption and sport participation among schoolchildren across Europe.Methods: A school-based cross-sectional survey in eight countries across Europe among 10-12 year old schoolchildren. Child questionnaires were used to assess EBRBs (soft drink intake, TV viewing, breakfast consumption, sport participation), and potential determinants of these behaviours as perceived by the child, including family rules, parental and friend norms and modelling. Linear and logistic regression analyses (n = 7811) were applied to study the association of parental (norms, modelling and rules) and friend influences (norm and modelling) with the EBRBs. In addition, potential moderating effects of parental influences on the associations of friend influences with the EBRBs were studied by including interaction terms.Results: Children reported more unfavourable friend norms and modelling regarding soft drink intake and TV viewing, while they reported more favourable friend and parental norms and modelling for breakfast consumption and physical activity. Perceived friend and parental norms and modelling were significantly positively associated with soft drink intake, breakfast consumption, physical activity (only modelling) and TV time. Across the different behaviours, ten significant interactions between parental and friend influencing variables were found and suggested a weaker association of friend norms and modelling when rules were in place.Conclusion: Parental and friends norm and modelling are associated with schoolchildren's energy balance-related behaviours. Having family rules or showing favourable parental modelling and norms seems to reduce the potential unfavourable associations of friends' norms and modelling with the EBRBs. © 2014 te Velde et al.; licensee BioMed Central Ltd.


Fernandez-Alvira J.M.,VU University Amsterdam | Fernandez-Alvira J.M.,University of Zaragoza | te Velde S.J.,VU University Amsterdam | De Bourdeaudhuij I.,Ghent University | And 6 more authors.
International Journal of Behavioral Nutrition and Physical Activity | Year: 2013

Background: It is well known that the prevalence of overweight and obesity is considerably higher among youth from lower socio-economic families, but there is little information about the role of some energy balance-related behaviors in the association between socio-economic status and childhood overweight and obesity. The objective of this paper was to assess the possible mediation role of energy balance-related behaviors in the association between parental education and children's body composition.Methods: Data were obtained from the cross sectional study of the " EuropeaN Energy balance Research to prevent excessive weight Gain among Youth" (ENERGY) project. 2121 boys and 2516 girls aged 10 to 12 from Belgium, Greece, Hungary, the Netherlands, Norway, Slovenia and Spain were included in the analyses. Data were obtained via questionnaires assessing obesity related dietary, physical activity and sedentary behaviors and basic anthropometric objectively measured indicators (weight, height, waist circumference). The possible mediating effect of sugared drinks intake, breakfast consumption, active transportation to school, sports participation, TV viewing, computer use and sleep duration in the association between parental education and children's body composition was explored via MacKinnon's product-of-coefficients test in single and multiple mediation models. Two different body composition indicators were included in the models, namely Body Mass Index and waist circumference.Results: The association between parental education and children's body composition was partially mediated by breakfast consumption, sports participation, TV viewing and computer use. Additionally, a suppression effect was found for sugared drinks intake. No mediation effect was found for active transportation and sleep duration. The significant mediators explained a higher proportion of the association between parental education and waist circumference compared to the association between parental education and BMI.Conclusions: Tailored overweight and obesity prevention strategies in low SES preadolescent populations should incorporate specific messages focusing on the importance of encouraging daily breakfast consumption, increasing sports participation and decreasing TV viewing and computer use. However, longitudinal research to support these findings is needed. © 2013 Fernández-Alvira et al.; licensee BioMed Central Ltd.


Jimenez-Pavon D.,University of Zaragoza | Fernandez-Alvira J.M.,University of Zaragoza | te Velde S.J.,VU University Amsterdam | Brug J.,VU University Amsterdam | And 7 more authors.
Preventive Medicine | Year: 2012

Objective: The present study sought to examine the independent associations of parental education and physical activity (PA) with children's PA across Europe. Methods: A total of 7214 children (10-12. years) were recruited from a school-based cross-sectional survey during 2010 in seven European countries. Weight and height were measured. Parental educational level (PEL) and parents' and children's PA were collected using self-reported questionnaires. Multiple linear regression models were used, comparing children's PA with PEL and PA levels. Results: PEL was directly associated with children's PA in Greek and Spanish girls (all P< 0.01) and boys' PA in Norway (all P< 0.05). Paternal education was directly associated with PA in Hungarian boys (P< 0.05). In overall, parental PA was directly associated with children's PA in more than half of the countries involved (all P< 0.05). Conclusions: Our observations suggest that PEL and parental modeling of PA are two independent factors from the home environment influencing the children's PA, but the relationships were gender- and country-specific. Further studies should be focused on intervention strategies for increasing children's PA but considering the important role of these two aspects and especially on the modification of parental modeling of PA. © 2012 Elsevier Inc.


PubMed | Swiss Tropical and Public Health Institute, Slovenian Heart Foundation, Ghent University, Ludwig Maximilians University of Munich and 4 more.
Type: | Journal: Preventive medicine | Year: 2016

This study aims to assess (i) the prevalence of having regular family breakfast, lunch, dinner (i.e. 5-7days/week together with their family) among 10-12year olds in Europe, (ii) the association between family meals and child weight status, and (iii) potential differences in having family meals according to country of residence, gender, ethnicity and parental levels of education.7716 children (mean age: 11.50.7years, 52% girls) in eight European countries (Belgium, Greece, Hungary, The Netherlands, Norway, Slovenia, Spain, Switzerland) participated in a cross-sectional school-based survey in 2010. Data on family meals were self-reported by the parents and childrens height and weight were objectively measured to determine overweight status. Binary regression analyses assessed the associations of having regular family meals (adjusted for potential confounders) with childrens overweight/obesity and to assess potential differences in having family meals according to gender, ethnicity and parental education, in the total sample and for each country respectively.The prevalence of regular family meals was 35%, 37% and 76% for breakfast, lunch and dinner respectively. Having regular family breakfast, but not lunch or dinner, was inversely associated with overweight (OR=0.78 (95% CI 0.67-0.91)). Children of higher educated parents were more likely to have regular family breakfast (1.63 (95% CI 1.42-1.86)) and less likely to have regular family lunch (0.72 (95% CI 0.63-0.82)) compared to children of lower educated parents.This study showed that having regular family breakfast - but not other family meals- was inversely associated with childrens weight status.

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