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.

Adherence to the Mediterranean Diet and Health-Related Quality of Life during the COVID-19 Lockdown: A Cross-Sectional Study including Preschoolers, Children, and Adolescents from Brazil and Spain.

Scientific literature has suggested positive associations between the Mediterranean diet (MD) and the health-related quality of life (HRQoL) in young populations. However, to our knowledge, this relationship is unexplored during a situation of social isolation (i.e., lockdown). The objective of the current study is to examine the relationship between the MD and HRQoL during the COVID-19 lockdown among preschoolers, children, and adolescents from Brazil and Spain. This cross-sectional study includes a sample of 1099 three- to seventeen-year-old participants (47.6% girls) who were recruited via social networks. The HRQoL was assessed with the EQ-5D-Y. The Quality Index for Children and Teenagers (KIDMED) questionnaire was applied to evaluate the relationship between the MD and HRQoL. The highest prevalence of reported problems was found for worried, sad, or unhappy participants (39.8%). Furthermore, the lowest proportion of HRQoL problems was observed for "mobility" (2.5%). The proportion of high adherence to the MD was 44.3%. Participants with greater MD adherence reported higher HRQoL mean scores when compared with those who did not adhere to the MD (83.7 ± 0.6 vs. 85.6 ± 0.7, respectively; p < 0.05). Adherence to the MD and especially daily fruit intake were related to higher HRQoL during the COVID-19 lockdown among Brazilian and Spanish young people aged three to seventeen years.

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.

Influence of the confinement that occurred in Spain due to the SARS-CoV-2 virus outbreak on adherence to the Mediterranean diet

Introduction The Mediterranean diet (MDiet), reduces morbidity and mortality. The lockdown that took place in Spain between the months of March and May 2020 may have led to behavioural changes. The aim of the present study was to assess adherence to the MDiet at the end of the lockdown period and to compare it with the situation prior to it. Methods Data were obtained by means of two online questionnaires, one at the beginning of lockdown and the other at the end, completed by adults from the Spanish population, who responded anonymously and voluntarily. The assessment of adherence to the MDiet was carried out using two questionnaires: Mediterranean Diet Adherence Screener (MEDAS) and modified PREDIMED, which contained 14 questions each. Other variables included were: age, gender, body mass index (BMI), Autonomous Community of origin, home living conditions, and level of studies achieved. At the end of the lockdown period, the comparison was made using the Student t statistic and the McNemar test. Results A total of 207 people (137 women) participated, with a mean age 51.3 ± 12.4 years, age range: 20-83 years. After lockdown, BMI remained unchanged (initial 24.55 ± 3.7 kg/m2 and final 24.57 ± 3.7 kg/m2, p = .752), as well as fish consumption (initial 51.2%) and 60.9% at the end, p = .003) mainly due to the women and adherence to the Mdiet. The mean total score of MEDAS increased with 10.6 ± 2.0 at the beginning, and 10.57 ± 2.0 at the end;p = .001). This also occurred with the modified PREDIMED (9.47 ± 2.1 at the beginning and 9.93 ± 2.1 at the end, p < .001). Similarly, the proportion of participants that had a score classified as high at the beginning increased at the end of lockdown: from 80.7% initially in MEDAS to 87.9% at the end, p = .021, and from 68.6% initially in modified PREDIMED to 75.8% at the end, p = .037. Conclusions In the study sample, during lockdown there were no changes in BMI, but there were increases in fish consumption and adherence to the MDiet. Resumen Introducción La dieta mediterránea (DMed) reduce la morbimortalidad. El confinamiento ocurrido en España entre los meses de marzo y mayo de 2020 podría generar cambios conductuales, entre ellos la adherencia a la DMed. El objetivo del presente estudio ha sido valorar la citada adherencia al concluir dicho confinamiento y compararla con la situación previa al mismo. Métodos Los datos se obtuvieron mediante dos cuestionarios en línea uno al comienzo del confinamiento y otro al final, en personas adultas procedentes de población española, las cuales respondieron de forma anónima y voluntaria. La valoración de la adherencia a la DMed se realizó a través de dos cuestionarios: Mediterranean Diet Adherence Screener (MEDAS) y PREDIMED modificado, los cuales contenían 14 cuestiones cada uno. Otras variables incluidas fueron: edad, género, índice de masa corporal (IMC), Comunidad Autónoma de procedencia, tipo de convivencia en domicilio y nivel de estudios alcanzado. Al concluir el confinamiento la comparación entre los cambios se realizó con el estadístico t de Student y la prueba de McNemar. Resultados Participaron 207 personas (137 mujeres), edad media de 51,3 ± 12,4 años, intervalo de edad: 20-83 años. Transcurrido el confinamiento el IMC permaneció sin cambios (24,55 ± 3,7 kg/m2 inicial y 24,57 ± 3,7 kg/m2 final, p = 0,752), y sí el consumo de pescado (51,2% inicial y 60,9% al final, p = 0,003) a expensas fundamentalmente de las mujeres y la adherencia a la DMed, aumentando la puntuación total por término medio tanto en MEDAS (10,6 ± 2,0) al inicio y 10,57 ± 2,0 al final;p = 0,001) como en PREDIMED modificado (9,47 ± 2,1 al inicio y 9,93 ± 2,1 al final, p < 0,001). Igualmente, la proporción de los participantes que tenían una puntuación clasificada como alta al principio, aumentó al final del confinamiento: de 80,7% inicial en MEDAS a 87,9% al final, p = 0,021 y de 68,6% inicial en PREDIMED modificado a 75,8% al final, p = 0,037. Conclusiones En la muestra de nuestro estudio, durante el confinamiento no se apreciaron cambios en el IMC, y sí aumentos en el consumo de pescado y en la adherencia a la DMed.

Influence of the confinement that occurred in Spain due to the SARS-CoV-2 virus outbreak on adherence to the Mediterranean diet. / Influencia del confinamiento ocurrido en España debido a la pandemia por el virus SARS-CoV-2 en la adherencia a la dieta mediterránea.

INTRODUCTION: The Mediterranean diet (MDiet) reduces morbidity and mortality. The lockdown that took place in Spain between the months of March and May 2020 may have led to behavioural changes. The aim of the present study was to assess adherence to the MDiet at the end of the lockdown period and to compare it with the situation prior to it. METHODS: Data were obtained by means of 2online questionnaires, one at the beginning of lockdown and the other at the end, completed by adults from the Spanish population, who responded anonymously and voluntarily. The assessment of adherence to the MDiet was carried out using 2questionnaires: Mediterranean Diet Adherence Screener (MEDAS) and modified PREDIMED, which contained 14 questions each. Other variables included were: age, gender, body mass index (BMI), autonomous community of origin, home living conditions, and level of studies achieved. At the end of the lockdown period, the comparison was made using the Student t statistic and the McNemar test. RESULTS: A total of 207 people (137 women) participated, with a mean age 51.3±12.4 years, age range: 20-83 years. After lockdown, BMI remained unchanged (initial 24.55±3.7kg/m2 and final 24.57±3.7kg/m2, P=.752), as well as fish consumption (initial 51.2%) and 60.9% at the end, P=.003), mainly due to the women, and adherence to the Mdiet. The mean total score of MEDAS increased with 10.16±2.0 at the beginning, and 10.57±2.0 at the end; P=.001). This also occurred with the modified PREDIMED (9.47±2.1 at the beginning and 9.93±2.1 at the end, P<.001). Similarly, the proportion of participants that had a score classified as high at the beginning increased at the end of lockdown: from 80.7% initially in MEDAS to 87.9% at the end (P=.021) and from 68.6% initially in modified PREDIMED to 75.8% at the end (P=.037). CONCLUSIONS: In the study sample, during lockdown there were no changes in BMI, but there were increases in fish consumption and adherence to the MDiet.

[Changes in adherence to the Mediterranean diet observed in a Spanish population during confinement for the SARS-CoV-2 pandemic]. / Cambios observados en la adherencia a la dieta mediterránea en una población española durante el confinamiento debido a la pandemia ocasionada por el SARS-CoV-2.

INTRODUCTION: Introduction: home confinement due to the COVID-19 pandemic can influence the dietary profiles of the population, suddenly subjected to a stressful factor that implies important modifications in life habits. Among others, a restriction of mobility and a change in the way of carrying out work, going from being face-to-face to non-contact (teleworking). Objective: to know the usual dietary pattern prior to confinement, and to assess the evolution of adherence to the Mediterranean diet weekly until its conclusion. Methods: data were collected using a weekly anonymous online questionnaire that monitored adherence to the Mediterranean diet in real time in an initial sample of 490 adults from Spain. Adherence to the Mediterranean diet was assessed using the MEDAS (Mediterranean Diet Adherence Screener) and modified PREDIMED questionnaires. Results: confinement due to the COVID-19 pandemic influenced the eating habits of the participants, so that adherence to the Mediterranean diet increased at the end of the confinement period, which is of special interest, since it was based on a good initial adherence (MEDAS adherence: 10.03 ± 1.9 initial and 10.47 ± 2.1 final; p = 0.016; modified PREDIMED adherence: 9.26 ± 2.0 initial and 9.89 ± 2.1 final; p < 0.001), without observing clinically relevant changes in body composition as measured by body mass index (BMI) except in women (23.3 kg/m2 ± 2.9 initial and 23.4 kg/m2 ± 2.9 final; p < 0.001), with a slight increase in this parameter, but maintaining on average the healthy values recommended by the guidelines. Conclusions: in the studied population we observed an improvement in adherence to the Mediterranean diet without observing clinically relevant changes in BMI.

INTRODUCCIÓN: Introducción: el confinamiento domiciliario debido a la pandemia de COVID-19 puede influir en los perfiles dietéticos de la población, sometida súbitamente a un factor estresante que implica importantes modificaciones en los hábitos de vida. Entre otros, la restricción de la movilidad y el cambio en la forma de realizar el trabajo, pasando de ser presencial a no presencial (teletrabajo). Objetivo: conocer el patrón dietético habitual previo al confinamiento y valorar la evolución de la adherencia a la dieta mediterránea semanalmente hasta la conclusión del mismo. Métodos: los datos se recopilaron mediante un cuestionario anónimo semanal en línea que monitorizó la adherencia a la dieta mediterránea en tiempo real en una muestra inicial de 490 adultos de España. La adherencia a la dieta mediterránea se valoró mediante los cuestionarios MEDAS (Mediterranean Diet Adherence Screener) y PREDIMED modificado. Resultados: el confinamiento debido a la pandemia de COVID-19 influyó en los hábitos alimenticios de los participantes, de modo que la adherencia a la dieta mediterránea aumentó al concluir el período de confinamiento, lo cual tiene especial interés, ya que se partía de una buena adherencia inicial (adherencia MEDAS: 10,03 ± 1,9 inicial y 10,47 ± 2,1 final; p = 0,016; adherencia PREDIMED modificado: 9,26 ± 2,0 inicial y 9,89 ± 2,1 final; p < 0,001), sin observarse cambios clínicamente relevantes en la composición corporal valorada por el índice de masa corporal (IMC) excepto en las mujeres (23,3 kg/m2 ± 2,9 inicial y 23,4 kg/m2 ± 2,9 final; p < 0,001), con un discreto aumento de dicho parámetro pero manteniendo en promedio los valores saludables aconsejados por las guías. Conclusiones: en la población estudiada observamos una mejora de la adherencia a la dieta mediterránea sin observar cambios clínicamente relevantes en el IMC.