Global Proportion of Disordered Eating in Children and Adolescents: A Systematic Review and Meta-analysis.

Importance: The 5-item Sick, Control, One, Fat, Food (SCOFF) questionnaire is the most widely used screening measure for eating disorders. However, no previous systematic review and meta-analysis determined the proportion of disordered eating among children and adolescents. Objective: To establish the proportion among children and adolescents of disordered eating as assessed with the SCOFF tool. Data Sources: Four databases were systematically searched (PubMed, Scopus, Web of Science, and the Cochrane Library) with date limits from January 1999 to November 2022. Study Selection: Studies were required to meet the following criteria: (1) participants: studies of community samples of children and adolescents aged 6 to 18 years and (2) outcome: disordered eating assessed by the SCOFF questionnaire. The exclusion criteria included (1) studies conducted with young people who had a diagnosis of physical or mental disorders; (2) studies that were published before 1999 because the SCOFF questionnaire was designed in that year; (3) studies in which data were collected during COVID-19 because they could introduce selection bias; (4) studies based on data from the same surveys/studies to avoid duplication; and (5) systematic reviews and/or meta-analyses and qualitative and case studies. Data Extraction and Synthesis: A systematic review and meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline. Main Outcomes and Measures: Proportion of disordered eating among children and adolescents assessed with the SCOFF tool. Results: Thirty-two studies, including 63 181 participants, from 16 countries were included in this systematic review and meta-analysis. The overall proportion of children and adolescents with disordered eating was 22.36% (95% CI, 18.84%-26.09%; P < .001; n = 63 181) (I2 = 98.58%). Girls were significantly more likely to report disordered eating (30.03%; 95% CI, 25.61%-34.65%; n = 27 548) than boys (16.98%; 95% CI, 13.46%-20.81%; n = 26 170) (P < .001). Disordered eating became more elevated with increasing age (B, 0.03; 95% CI, 0-0.06; P = .049) and body mass index (B, 0.03; 95% CI, 0.01-0.05; P < .001). Conclusions and Relevance: In this systematic review and meta-analysis, the available evidence from 32 studies comprising large samples from 16 countries showed that 22% of children and adolescents showed disordered eating according to the SCOFF tool. Proportion of disordered eating was further elevated among girls, as well as with increasing age and body mass index. These high figures are concerning from a public health perspective and highlight the need to implement strategies for preventing eating disorders.

Economic Migrants and Clinical Course of SARS-CoV-2 Infection: A Follow-Up Study.

Objective: To analyze whether social deprivation and economic migrant (EM) status influence the risk of being hospitalized with COVID-19. Methods: This was a retrospective follow-up study including all patients older than 18 years attending the Daroca Health Center in Madrid, Spain, diagnosed with COVID-19 during September 2020. Data on EM status and other sociodemographic, lifestyle and comorbidities that could affect the clinical course of the infection were obtained from electronic medical records. Results: Of the 796 patients positive for COVID-19, 44 (5.53%) were hospitalized. No significant differences were observed between those who were hospitalized and those who were not in the mean of social deprivation index or socioeconomic status, but EM status was associated with the risk of being hospitalized (p = 0.028). Logistic regression models showed that years of age (OR = 1.07; 95% CI: 1.04-1.10), EM status (OR = 5.72; 95% CI: 2.56-12.63) and hypertension (OR = 2.22; 95% CI: 1.01-4.85) were the only predictors of hospitalization. Conclusion: Our data support that EM status, rather than economic deprivation, is the socioeconomic factor associated with the probability of hospital admission for COVID-19 in Madrid, Spain.

Anxiety-Induced Sleep Disturbance and Associated Lifestyle Behaviors According to Sex in Argentine Adolescents.

Purpose: The aim of the current study was twofold: first, to determine the prevalence of anxiety-induced sleep disturbances among Argentine adolescents according to sex, and second, to identify the association between these sleep disturbances and lifestyle behaviors in this population. Methods: This is a cross-sectional study with data from the Global School-based Student Health Survey (GSHS) in Argentina (2018). A total of 32,393 adolescents (aged 12-17 years; 53.4% girls) were included in the final analysis. Anxiety-induced sleep disturbances were assessed with the question "During the past 12 months, how often have you been so worried about something that you could not sleep at night?" Results: The prevalence of anxiety-induced sleep disturbances was higher in girls (17.4%) than in boys (7.9%) (p < 0.001). In boys, results indicated that those who used marijuana (cannabis) (odds ratio [OR] = 1.46, 95% confidence interval [CI] 1.08-1.98), used amphetamine or methamphetamine (OR = 2.19, 95% CI 1.28-3.77), walked or biked to or from school (OR = 1.53, 95% CI 1.19-1.96), and spent 3 h or more in sedentary behaviors (OR = 1.35, 95% CI 1.05-1.74) were more likely to report anxiety-induced sleep disturbances. In girls, those who ate from a fast-food restaurant (OR = 1.24, 95% CI 1.05-1.47), consumed alcoholic beverages (OR = 1.45, 95% CI 1.19-1.75), smoked cigarettes (OR = 2.09, 95%CI 1.05-4.14), consumed any tobacco product (OR = 1.47, 95% CI 1.19-1.82), used amphetamine or methamphetamine (OR = 2.08, 95% CI 1.33-3.26), and those who spent 3 h or more in sedentary behaviors (OR = 1.32, 95% CI 1.11-1.57) were more likely to report frequent anxiety-induced sleep disturbances. Conclusion: In conclusion, considerable sex differences were observed with respect to the prevalence of anxiety-related sleep disturbances and associated lifestyle aspects.

Predictors of in-hospital COVID-19 mortality: A comprehensive systematic review and meta-analysis exploring differences by age, sex and health conditions.

OBJECTIVE: Risk factors for in-hospital mortality in confirmed COVID-19 patients have been summarized in numerous meta-analyses, but it is still unclear whether they vary according to the age, sex and health conditions of the studied populations. This study explored these variables as potential mortality predictors. METHODS: A systematic review was conducted by searching the MEDLINE, Scopus, and Web of Science databases of studies available through July 27, 2020. The pooled risk was estimated with the odds ratio (p-OR) or effect size (p-ES) obtained through random-effects meta-analyses. Subgroup analyses and meta-regression were applied to explore differences by age, sex and health conditions. The MOOSE guidelines were strictly followed. RESULTS: The meta-analysis included 60 studies, with a total of 51,225 patients (12,458 [24.3%] deaths) from hospitals in 13 countries. A higher in-hospital mortality risk was found for dyspnoea (p-OR = 2.5), smoking (p-OR = 1.6) and several comorbidities (p-OR range: 1.8 to 4.7) and laboratory parameters (p-ES range: 0.3 to -2.6). Age was the main source of heterogeneity, followed by sex and health condition. The following predictors were more markedly associated with mortality in studies with patients with a mean age ≤60 years: dyspnoea (p-OR = 4.3), smoking (p-OR = 2.8), kidney disease (p-OR = 3.8), hypertension (p-OR = 3.7), malignancy (p-OR = 3.7), diabetes (p-OR = 3.2), pulmonary disease (p-OR = 3.1), decreased platelet count (p-ES = -1.7), decreased haemoglobin concentration (p-ES = -0.6), increased creatinine (p-ES = 2.4), increased interleukin-6 (p-ES = 2.4) and increased cardiac troponin I (p-ES = 0.7). On the other hand, in addition to comorbidities, the most important mortality predictors in studies with older patients were albumin (p-ES = -3.1), total bilirubin (p-ES = 0.7), AST (p-ES = 1.8), ALT (p-ES = 0.4), urea nitrogen (p-ES), C-reactive protein (p-ES = 2.7), LDH (p-ES = 2.4) and ferritin (p-ES = 1.7). Obesity was associated with increased mortality only in studies with fewer chronic or critical patients (p-OR = 1.8). CONCLUSION: The prognostic effect of clinical conditions on COVID-19 mortality vary substantially according to the mean age of patients. PROSPERO REGISTRATION NUMBER: CRD42020176595.

[Teachers on temporary employment contracts reveal more frequent consumption of pre-prepared food]. / Professores com vínculo temporário apresentam maior frequência de consumo de alimentos pré-preparados.

The scope of this article is to analyze the eating behavior of schoolteachers according to the type of employment contract. Interviews were conducted at 20 public state schools in Londrina, State of Paraná, between 2012 and 2013. Of the 978 teachers interviewed, 672 (68.7%) had permanent employment contracts and 306 (31.3%) were on temporary employment contracts. High frequencies of recommended eating behaviors - consumption of fruit, vegetables and/or vegetables and removing visible fat from red meat - were observed in teachers with a permanent employment contract. On the other hand, teachers with temporary employment contracts revealed a high frequency of non-recommended eating behaviors with consumption of pre-prepared foods and packaged drinks or sodas. It was highlighted that a high frequency of consumption of pre-prepared foods was statistically associated with the type of employment contract irrespective of sociodemographic, lifestyle and health status factors.

O artigo tem por objetivo analisar as condutas alimentares de professores segundo os vínculos de trabalho. As entrevistas foram realizadas em 20 escolas da rede estadual de Londrina entre 2012 e 2013. Dos 978 professores entrevistados, 672 (68,7%) tinham vínculo efetivo e 306 (31,3%) temporário. Altas frequências de condutas alimentares recomendadas - consumo de frutas, verduras e/ou legumes e retirada da gordura visível da carne vermelha - foram observadas em professores com vínculo efetivo. Em contrapartida, professores com vínculo temporário apresentaram altas frequências de condutas alimentares não recomendadas - consumo de alimentos pré-preparados e de bebidas industrializadas ou refrigerantes. Destaca-se que o consumo em alta frequência de alimentos pré-preparados esteve estatisticamente associado ao tipo de vínculo independentemente de fatores sociodemográficos, de estilo de vida e da condição de saúde.