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The development of overweight and obesity during late childhood and early adolescence is one of the most critical issues in public health. Additionally, over the past few years, the consumption of protein has tended to increase in both children and adults. The present study aimed to evaluate whether the protein type, either plant- or animal-sourced, as well as the quantity consumed, could potentially have a relationship with excess body weight in children. A total of 47 primary schools were selected, and 1728 students, aged 10–12 years, were enrolled for the purposes of this study, leading to our final sample of 712. Physical measurements, such as weight and height, were measured, and children were separated into two weight status categories according to their Body Mass Index, which was obtained through the International Obesity Task Force criteria. Students' diets were assessed through a questionnaire, and total, plant- and animal-derived protein intakes were calculated. Unadjusted analysis showed a statistically significant association between body weight and plant protein. After adjustment for overall energy intake, sex, age, and exercise, there was a statistically significant negative association between plant protein and excess body weight in children (OR: 0.964, 95% CI: 0.936; 0.992), but a lack of association for animal-sourced protein (OR: 1.002, 95% CI: 0.991; 1.013). Dietary plant-derived protein seems to have a positive effect on weight status in children, independently of total energy intake and physical activity; nevertheless, additional research is required in order to elucidate the underlying mechanisms. [ABSTRACT FROM AUTHOR]

Adding extra sugars in milk and the moderating effect of sleep has yet to be investigated, setting the aim of this study. A total of 1361 school-aged children were included, aged 10–12 years old, by randomly sampling schools. Data were interview-obtained by trained personnel using a validated 17-item food frequency questionnaire, with specifics on type of milk and extra sugar additions. Analyses were stratified by average recommended hours of sleep. Predictive probability margins were obtained following necessary adjustments. Mean BMI was significantly lower, the level of SSB intake was higher, and the prevalence of adding sugars to milk four or more times per week was higher in children that slept ≥10 h. Most children (64%) consumed full fat milk, 21% had low fat, and 19.7% chocolate milk, with a significantly larger proportion of overweight or obese children consuming full fat or chocolate milk, also adding extra sugars four or more times per week (4.1% compared to 9.6%, and 12.2% compared to 39.5%, respectively). The predictive probability of being overweight or obese exponentially increased for children consuming >0.5 SSB/day while also adding sugars to their milk frequently, although this effect remained significant only for children sleeping <10 h/day. In conclusion, to accurately address the effect of SSBs on children's body weight, frequency of any type of sugar addition in milk should be accounted for, as well as average sleep hours that may further moderate the effect. [ABSTRACT FROM AUTHOR]

This study examined the association between breastfeeding, type of childbirth, and family structure with childhood obesity. During 2014–2016, 1728 Greek students attending primary schools and their parents were enrolled. Children's weight status was measured and classified according to the International Obesity Task Force criteria. A self-administered questionnaire assessing the type of childbirth, the family structure, and several perinatal and demographic characteristics was used. Factors associated with higher breastfeeding rates were the type of childbirth, high maternal educational level, and nuclear family structure. No association was found between childhood obesity and type of childbirth (p = 0.64) and family structure (p = 0.26). Although the short-term beneficial effects of breastfeeding on childhood obesity are undeniable and it is of great importance to all health professionals to promote breastfeeding, no significant long-term effects on obesity in adolescence were observed. More studies are needed in order to elucidate the role of breastfeeding in obesity status in adolescence. [ABSTRACT FROM AUTHOR]

Adherence to certain dietary patterns influences obesity status in both children and adults. Weight perception influences dietary habits. The aim of this study was to examine children's dietary habits and obesity status, in relation to weight perception. One thousand seven hundred Greek students enrolled in this study during 2014-2016. Children's characteristics were assessed through validated questionnaires, and weight status was classified according to the criteria of the International Obesity Task Force. Dietary patterns were assessed through exploratory factor analysis. Overall, 52.2% of children characterized themselves as normal weight, 34.5% as low weight, and 13.3% as overweight/obese; 52.5% of children were in accordance with their actual weight status, with girls being more likely to overestimate their weight. Children followed three dietary patterns, i.e., starchy and protein foods, unhealthy/high-fat foods, and healthy foods. Children who followed the healthy dietary pattern and had accurate weight perception (in accordance with their actual weight), had lower odds of being overweight/obese (p < 0.001). Accurate weight perception in conjunction with healthy dietary habits may play a determinant role in the prevention of obesity. From a public health perspective, early identification of children's weight misperception along with healthy dietary habit promotion shape a crucial role in childhood obesity confrontation. [ABSTRACT FROM AUTHOR]

Background: Overweight and obesity during childhood consist two of the most important public health issues in the 21st century. Consumption of high-fat processed food has been increased alarmingly.Objective: To examine the association between parental ultra-processed, high-fat products' consumption and childhood overweight/obesity.Methods: A cross-sectional survey, conducted among 422 children, aged 10-12 years, and their parents, during school years 2014-16. Parental and child data were collected through self-administered, anonymous and validated questionnaires. Among others, high-fat ultra-processed food consumption was also recorded. Children's weight status was based on gender- and age-specific tables derived from the International Obesity Task Force body mass index (BMI) cut-offs.Results: The prevalence of obesity in the reference population was 2.9%, whereas the prevalence of overweight was 19.3%. A strong correlation was observed between children's and their parents' BMI status (P < 0.001). Multi-adjusted data analysis revealed no association between parental intake of ultra-processed, high-fat products and children overweight/obesity. Similarly, when the data analysis accounted for family income and physical activity status of the children, the aforementioned results remained insignificant.Conclusion: Despite the fact that parents' specific dietary habits seem not to affect their children's weight status, public health programs should consider parental nutrition education and mobilization as a preventive measure for childhood overweight/obesity. [ABSTRACT FROM AUTHOR]

BACKGROUND: Children's dietary behaviors seem tract into adulthood and as a result preventing strategies to establish healthy behaviors from early stages of life are needed. Nutrition knowledge is essential for behavioral change. OBJECTIVE: To examine whether the status of parental health related to their children's nutrition literacy level through their perceptions mainly of healthy eating attitudes METHODS: A cross-sectional survey was conducted in Greece among 1,728 schoolchildren aged 10–12 years old. The sample was collected in the school setting during the school years of 2014–2016. Children completed anonymously a self-administered questionnaire about their knowledge and perceptions of a healthy diet while their parents completed another suitable questionnaire about family health status. RESULTS: Paternal BMI status and hypertension were inversely associated with the level of nutrition literacy of their children by b = –0.043 (95%CI: (–0.082, –0.003; p = 0.036) and by b = –0.600 (95%CI: –1.181, –0.019; p = 0.043), respectively. Parental health status, specifically, paternal diabetes and maternal dyslipidemia were associated with children's higher level of nutrition literacy by b = 0.729 (95%CI: 0.002, 1.456; p = 0.049) and by b = 0.730 (95%CI: 0.086, 1.374; p = 0.026), respectively. CONCLUSIONS: Parental health status partially affects, either negatively or positively, the level of nutrition literacy of their children. This impact depends on whether parents follow nutritional recommendations to improve their health. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate whether dietary fibres intake is associated with childhood obesity. From 2014 to 2016, a sample of 1728 Greek boys and girls students, 10-12 years and their parents were enrolled in the study. Dietary fibres intake was assessed through food questionnaires and child's body mass status was defined according to the International Obesity Task Force (IOTF)'s criteria. Prevalence of combined overweight/obesity was 26.7%, with boys having significantly higher prevalence than girls (31.5 versus 24.7%, p < 0.001). Logistic regression analysis, after various adjustments were made, revealed no association between dietary fibres intake and obesity/overweight (Odds Ratio = 0.76; 95% CI 0.48, 1.19). The lack of an association between dietary fibres intake and overweight/obesity status among pre-adolescents could be attributed to various reasons such as, methodological issues reflecting the study's design, the measurement of exposure or due to true absence of a relationship. Nevertheless, fibres consumption should not be prevented, but, promoted under the context of a balanced diet, because of their numerous pleiotropic health effects. [ABSTRACT FROM AUTHOR]

Background: This study aimed to examine the association between breakfast consumption and childhood weight status, in relation to various socioeconomic and lifestyle factors. Methods: A cross‐sectional survey was conducted including 1,728 children aged 10–12 years and their parents, during the school years 2014–2016. Primary schools from five Greek counties (including the Athens metropolitan area) were randomly selected. Parental and child data were collected through self‐administered, anonymous questionnaires. Children's weight status was based on gender‐ and age‐specific tables derived from the International Obesity Task Force body mass index cutoffs. Logistic regression was used to determine the association between frequency and type of breakfast consumption and children's weight status. Results: The frequency of breakfast consumption was not associated with childhood overweight or obesity, even when other factors were included in the analysis like sex, age, physical activity, meals / day, family annual income, parental weight status, parental physical activity level, parental educational level and parental employment status. From the nine foods that were included only the consumption of bread or rusks and chocolate milk were found to have a negative association with childhood overweight or obesity (odds ratio: 0.51; 95% CI: 0.34, 0.79 and OR: 0.50; 95% CI: 0.28, 0.87, respectively). Conclusions: The result that frequency of breakfast consumption was not associated with children's overweight / obesity may lead to a deeper investigation of the foods consumed during breakfast. Bread or rusks and chocolate milk seemed to have a protective effect; further nutritional analysis is needed to explore the potential mechanisms of this observation. [ABSTRACT FROM AUTHOR]

Background: School environmental factors contributing to children obesity have not been thoroughly investigated. The Geographical Information System (GIS) mapping is a suitable instrument for detection of such factors outside schools. Methods: The study group consisted of 940 students in grades 7 and 10 of all secondary schools (17 schools) in the city of Lamia, Greece, during the school year 2012-2013. Data analysis included students’ BMI and spot checks within a 500m radius of each school for food shops and settings of physical activity through GIS mapping. Results: The highest values of BMI were found at the 10th grade [22.2 (±3.2) to 23.1 (±4.4)]. The lowest values of students’ BMI were found at the 10th grade of the Musical School [(19.7 (±2.8)]. The boys had a considerably higher BMI compared to the girls (p<0.001). Students from schools which were in close proximity of food shops had significantly higher BMI in comparison with students whose schools were not (p=0.022). The larger the school yard, the lower the students’ BMI values (p=0.022). Conclusions: Communities could support schools to fight students’ obesity by setting limits regarding the distance of food shops, playing fields and larger yards. [ABSTRACT FROM AUTHOR]

• Engagement in out-of-school sport activities means less likelihood of obesity. • Important role of extracurricular activities on children's weight status. • Out-of-school reading was associated with increased likelihood of obesity. Childhood obesity rates have shown a rising trend in the past years, becoming a public health challenge and threat. The aim of this study was to examine the association between extracurricular activities and weight status, among children. A survey was performed in 1728 primary school Greek students, during school years 2014–2016. Dietary and lifestyle habits, such as engagement in a variety of extracurricular activities were evaluated. The KIDMED Score was used to assess the level of adherence to the Mediterranean diet. Children's Body Mass Index (BMI) was calculated and classified as normal, overweight, or obese, according to the International Obesity Task Force (IOTF) classification. The prevalence of overweight was 21.7% and obesity 5.0%, with a greater proportion of overweight/obese boys than girls (32.4% vs. 23.3%; p < 0.001). Increased engagement on extracurricular activities, such as watching TV, reading out-of-school material and reduced participation in sports activities were associated with a higher likelihood of overweight/obesity (p < 0.05). Extracurricular physical activities can be promoted within the family environment and incentives or obstacles should be considered and addressed. [ABSTRACT FROM AUTHOR]