Weekday and Weekend Differences in Eating Habits, Physical Activity and Screen Time Behavior among a Sample of Primary School Children: The "Seven Days for My Health" Project.

BACKGROUND: Healthy eating and active lifestyle habits are essential for a child's development, wellbeing, and health. School setting and family environment play a crucial role in shaping these habits and this could be reflected in different behavior patterns during weekdays and weekends. METHODS: We investigated primary school children's lifestyle habits through a cross-sectional analysis of 428 Italian primary school children, with a mean age of 8.99 years (±1.43). Data were collected from May to June 2017 using a weekly diary to assess children's lifestyles. RESULTS: Children who eat their morning snack and lunch at school three or more times during the weekdays were 5.47 times more likely (95% CI 3.02, 10.2) to consume adequate snacks and 7.79 times more likely (95% CI 4.43, 14.5) to have adequate meals than those who did not. CONCLUSION: Consumption of vegetables, lunch, and snacks are significantly more adequate during the weekdays as compared to the weekends. Physical activity levels did not differ between weekdays and weekends. Moreover, children spent more time engaged in physical activities than in front of a screen during both the weekdays and the weekends. The present results are good indicators of the importance of the school canteen in defining correct eating habits. Family-based and school-based interventions could represent valuable integrative strategies for promoting a healthy lifestyle in children.

Children's and Families' Determinants of Health-Related Behaviors in an Italian Primary School Sample: The "Seven Days for My Health" Project.

Childhood obesity is an established health problem, and there is a growing need for health promotion interventions focused on healthy behaviors in collaboration with parents and schools. The Mediterranean diet (MD) could help to tackle obesity, but it is essential to maintain a good level of physical activity (PA) and limit time spent in sedentary activities (ST). To explore family determinants, adherence to the MD and PA levels as potential predictors of a child's health-related behaviors, we performed a cross-sectional analysis of 368 Italian primary school children with a mean age of 8.95 years (SD = 1.43). Data were collected from May to June 2017 using a weekly diary, an interactive tool to assess the child's and parents' lifestyle. The child's degree of adherence to the MD was calculated using the KIDMED index. Adherence to the MD was high, medium and poor in 5.2%, 62.5% and 32.3% of children, respectively. Higher maternal educational level was positively associated with children's MD and PA (p < 0.05) and negatively correlated to ST. Maternal fruit and vegetable consumption was positively related to the MD and negatively related to ST (p < 0.05). Maternal PA was positively associated with the MD (p < 0.001). Paternal PA, and fruit and vegetable consumption, were positively associated with children's PA (p < 0.05). Our results underline the need for future studies, mainly focused on school-based and family-based interventions, to promote healthy lifestyles and nutritional habits.

Motivational Interviewing Adapted to Group Setting for the Treatment of Relapse in the Behavioral Therapy of Obesity. A Clinical Audit.

Motivational interviewing (MI) is devised to change unhealthy behaviors by increasing motivation. We adapted MI to a group format for the treatment of relapse during the behavioral treatment of obesity and performed a clinical audit to evaluate its effectiveness in stopping weight regain. The program was structured in seven weekly sessions, plus a 6-month follow-up. Patients (n = 86) completed a questionnaire on motivation to change in both healthy diet and physical activity, and a self-reported measurement of calorie intake and physical activity at baseline, at program end and at 6-month follow-up. The attendance to the program was high, with only 13 patients (15%) not completing the program and 24% not attending the 6-month follow-up. By the end of follow up, the prevalence of patients in either precontemplation or contemplation was reduced from over 60% at enrollment to approximately 20%, whereas the sum of patients in action or maintenance stages was increased from 9.5% in healthy diet and 14% in physical activity to 39.7% and 41.3%, respectively. These changes translated into significant behavioral changes (mean calorie intake, -13%; total physical activity, +125%; sedentary time, -8%) and finally into reduced body weight ( -3%). We conclude that MI programs adapted for groups may be used to stop relapse in individuals following a behavioral intervention for obesity.

[The control system in the food industry in Italy: warranting the health of consumers and businesses]. / Il sistema dei controlli della filiera alimentare in Italia: garanzia della salute dei consumatori e delle imprese.

The Italian food industry is appreciated worldwide and has undoubtedly brought economic advantages, with exports in 2017 having grown by more than six percentage points, for a volume of almost €32 billion. However, some critical issues exist that require the constant presence of Food and Nutrition Hygiene Services (SIAN) of the Local Health Authorities (LHAs) which, together with other key players, including the Veterinary Services (SV), constitute the backbone of integrated competencies for the protection and promotion of community health. In Italy, controls in the food industry are very complex, involving not only the SIAN and the Veterinary Services of the LHAs (as local competent authority for food safety), but also the Central Inspectorate against frauds, specialized "Carabinieri" Command Departments (NAS AND NAC ), State Forestry Corps, Port Authorities and "Guardia di Finanza", Border Inspection Posts (PIF), Frontier Air Transport Offices (USMAF), the Customs and Monopolies Agency, as well as, for analysis of foods samples, the National Health Institute ("Istituto Superiore di Sanità"), Public Health Laboratories and Experimental Zooprophylactic Institutes. Data published by the Italian Ministry of Health show a decreasing trend in the number of checks carried out by the LHAs, probably due to implementation of increasingly targeted controls, based on risk analysis, and by a progressive reduction of staff. We describe data up to the year 2018, obtained from the survey on the "State of the Art" of the SIAN (structures, staff, activities, etc). In view of the existing complex system of official controls, consumers have a need, often unexpressed, to receive clear information on the quality of food, the ingredients contained in food, and on recent updates regarding food and nutritional safety, in order to make more informed choices and have greater awareness of individual responsibilities for one's health. However, many preventive and health promotion activities implemented by these services remain largely unknown to citizens. The authors believe that all SIANs must take an active role in communication to consumers, so that they receive clear and science-based information, in order to promote informed choices for the protection of their health. This has become increasingly important considering the large number of information channels that do not communicate according to ethical and professional criteria.

Professional competencies in health promotion and public health: what is common and what is specific? Review of the European debate and perspectives for professional development.

According to the Nairobi Call to Action, the growth of practitioners' skills can be favoured by setting accreditation standards and by reorienting professional competencies of current and future health workers. This will make it possible to develop a critical mass of competent practitioners, foster training, and increase visibility of the professional field. Through a review of the literature, the authors offer an overview of competency-based strategies for professional development in health promotion. The main research questions discussed were as follows: Is there a shared definition of public health?; Is there a shared definition of health promotion?; Who are the main stakeholders for public health and health promotion in Europe?; What is the meaning of professional competencies in education and practice for public health and health promotion?; Is there a shared system of professional core competencies in public health and health promotion?;What is common and what is specific between the two systems of professional competencies?; Is it useful and feasible to create specific strategies of professional development for public health and health promotion? A transformative use of competencies makes it possible to inform students, professionals, employers, and political decision-makers about what is expected from a specific profession and its values.

From surveillance to development of nutritional guidelines.

In Italy, like in most parts of the world, 30% of children and almost 50% of adults are overweight. This condition is one of the causes of non-communicable diseases responsible for over two thirds of DALYs, deaths and costs for healthcare. Current surveys confirm that overweight and obesity are associated with food habits which have changed, in Italy, in the last fifty years. Fewer and fewer people have been following a Mediterranean diet, which is considered an effective diet for the prevention of many diseases. The consumption of fruit, vegetables, legumes, whole cereals, and EVO oil has decreased, while the consumption of food with high energetic density and rich in sugar, salt, and added fat has increased, especially when eating out. Schools and workplaces are the best places to promote healthy food habits and an active lifestyle. The aim is to involve families (including low-income families), educators, and catering services. This type of intervention is not new to the National Health System and has already led to improvements: however, it is still possible to improve the use of resources and coordination between social, educational, and health services bringing the community to become its own health promoter. Health operators have to be more aware of overweight as a health threat. The National Health Plan represents a commitment for Italy, the country hosting EXPO 2015, to fulfill the targets of the «Action Plan European Strategy for the Prevention and Control of Non-communicable Diseases 2012-2016¼ entrusting the Departments of Prevention with the interventions and development of a network of stakeholders.

Quality of Drinking Water Treated at Point of Use in Residential Healthcare Facilities for the Elderly.

Municipal tap water is increasingly treated at the point of use (POU) to improve the acceptability and palatability of its taste. The aim of this study was to assess the bacteriologic and nutritional characteristics of tap water treated at the point of use in residential healthcare facilities for the elderly. Two types of POU devices were used: microfiltered water dispensers (MWDs) and reverse-osmosis water dispensers (ROWDs). All samples of water entering the devices and leaving them were tested for the bacteriological parameters set by Italian regulations for drinking water and for opportunistic pathogens associated with various infections in healthcare settings; in addition, the degree of mineralization of the water was assessed. The results revealed widespread bacterial contamination in the POU treatment devices, particularly from potentially pathogenic species. As expected, the use of ROWDs led to a decrease in the saline content of the water. In conclusion, the use of POU treatment in healthcare facilities for the elderly can be considered advisable only if the devices are constantly and carefully maintained.