BACKGROUND: Visceral adipose tissue is associated with increased risk for cardiovascular disease risk factors and morbidity from cardiovascular diseases. Waist measurement and waist-to-height ratio (WHtR) have been used as proxy measures of visceral adipose tissue, mainly in adults. OBJECTIVE: To validate body mass index (BMI), waist circumference and WHtR as predictors for the presence of cardiovascular disease risk factors in children of Greek-Cypriot origin. SUBJECTS AND METHODS: A total of 1037 boys and 950 girls with mean age 11.4 AE 0.4 y were evaluated. Dependent variables for the study were total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholestrol (HDL-C), lowdensity lipoprotein cholesterol (LDL-C), and systolic (SBP) and diastolic (DBP) blood pressure. RESULTS: When children were divided into two groups according to the 75th percentile for BMI, waist circumference and WHtR, all dependent variables had higher mean values in the highest percentile groups in WHtR groups and almost all variables in BMI and waist circumference groups. Adjusted odds ratios for predicting pathological values of cardiovascular disease risk factors were slightly higher for the highest WHtR group for predicting lipid and lipoprotein pathological values and for the highest BMI groups in predicting high blood pressure measurement. Using stepwise multiple regression analysis to explain the variance of the dependent variables, waist circumference was the most signi®cant predictor for all variables both for boys and girls, whereas BMI had the lowest predictive value for the detection of cardiovascular disease risk factors. CONCLUSION: Waist circumference and WHtR are better predictors of cardiovascular disease risk factors in children than BMI. Further studies are necessary to determine the cutoff points for these indices for an accurate prediction of risk factors.

1,11 on behalf of the IDEFICS consortium INTRODUCTION:To characterise the nutritional status in children with obesity or wasting conditions, European anthropometric reference values for body composition measures beyond the body mass index (BMI) are needed. Differentiated assessment of body composition in children has long been hampered by the lack of appropriate references. OBJECTIVES: The aim of our study is to provide percentiles for body composition indices in normal weight European children, based on the IDEFICS cohort (Identification and prevention of Dietary-and lifestyle-induced health Effects in Children and infantS). METHODS: Overall 18 745 2.0-10.9-year-old children from eight countries participated in the study. Children classified as overweight/obese or underweight according to IOTF (N = 5915) were excluded from the analysis. Anthropometric measurements (BMI (N = 12 830); triceps, subscapular, fat mass and fat mass index (N = 11 845-11 901); biceps, suprailiac skinfolds, sum of skinfolds calculated from skinfold thicknesses (N = 8129-8205), neck circumference (N = 12 241); waist circumference and waist-to-height ratio (N = 12 381)) were analysed stratified by sex and smoothed 1st, 3rd, 10th, 25th, 50th, 75th, 90th, 97th and 99th percentile curves were calculated using GAMLSS. RESULTS: Percentile values of the most important anthropometric measures related to the degree of adiposity are depicted for European girls and boys. Age-and sex-specific differences were investigated for all measures. As an example, the 50th and 99th percentile values of waist circumference ranged from 50.7-59.2 cm and from 51.3-58.7 cm in 4.5-to < 5.0-year-old girls and boys, respectively, to 60.6-74.5 cm in girls and to 59.9-76.7 cm in boys at the age of 10.5-10.9 years. CONCLUSION: The presented percentile curves may aid a differentiated assessment of total and abdominal adiposity in European children.

Early television exposure has been associated with various health outcomes including childhood obesity. This paper describes associations between patterns of television viewing, on one hand, and diet, taste preference and weight status, on the other, in European preschoolers and schoolchildren. The IDEFICS baseline survey was conducted at examination centers in Italy, Estonia, Cyprus, Belgium, Sweden, Germany, Hungary, and Spain. 15,144 children aged 2–9 completed the basic protocol, including anthropometry and parental questionnaires on their diets and television habits. A subsample of 1,696 schoolchildren underwent further sensory testing for fat and sweet taste preferences. Three dichotomous indicators described: children’s habitual television exposure time; television viewing during meals; and having televisions in their bedrooms. Based on these variables we investigated television habits in relation to overweight (IOTF) and usual consumption of foods high in fat and sugar. A possible role of taste preference in the latter association was tested in the sensory subgroup. All television indicators were significantly associated with increased risk of overweight, with odds ratios ranging from 1.21 to 1.30, in fully adjusted models. Children’s propensities to consume high-fat and high-sugar foods were positively and, in most analyses, monotonically associated with high-risk television behaviors. The associations between television and diet propensities were not explained by preference for added fat or sugar in test foods. To summarize, in addition to being more overweight, children with high-risk television behaviors may, independent of objectively measured taste preferences for fat and sugar, passively overconsume higher-fat and particularly higher-sugar diets.

Abstract:The aim of this study was to determine whether an association exists between children's and parental dietary patterns (DP), and whether the number of shared meals or soft drink availability during meals strengthens this association. In 2013/2014 the I.Family study cross-sectionally assessed the dietary intakes of families from eight European countries using 24-h dietary recalls. Usual energy and food intakes from six-to 16-year-old children and their parents were estimated based on the NCI Method. A total of 1662 child-mother and 789 child-father dyads were included; DP were derived using cluster analysis. We investigated the association between children's and parental DP and whether the number of shared meals or soft drink availability moderated this association using mixed effects logistic regression models.

Exploring changes in children's diet over time and the relationship between these changes and socio-economic status (SES) may help to understand the impact of social inequalities on dietary patterns. The aim of the present study was to describe dietary patterns by applying a cluster analysis to 9301 children participating in the baseline (2 -9 years old) and follow-up (4-11 years old) surveys of the Identification and Prevention of Dietary-and Lifestyle-induced Health Effects in Children and Infants Study, and to describe the cluster memberships of these children over time and their association with SES. We applied the K-means clustering algorithm based on the similarities between the relative frequencies of consumption of forty-two food items. The following three consistent clusters were obtained at baseline and follow-up: processed (higher frequency of consumption of snacks and fast food); sweet (higher frequency of consumption of sweet foods and sweetened drinks); healthy (higher frequency of consumption of fruits, vegetables and wholemeal products). Children with higher-educated mothers and fathers and the highest household income were more likely to be allocated to the healthy cluster at baseline and follow-up and less likely to be allocated to the sweet cluster. Migrants were more likely to be allocated to the processed cluster at baseline and follow-up. Applying the cluster analysis to derive dietary patterns at the two time points allowed us to identify groups of children from a lower socio-economic background presenting persistently unhealthier dietary profiles. This finding reflects the need for healthy eating interventions specifically targeting children from lower socio-economic backgrounds.