The Feel4Diabetes intervention: effectiveness on 24-hour physical behaviour composition in families at risk for diabetes development.

The Feel4Diabetes project conducted a 2-year intervention aiming to encourage healthy behaviours in families in six European countries. Within this paper, the intervention effect was evaluated after the first intervention year on 24-hour physical behaviour composition in Belgian families at risk for type 2 diabetes. Parents' and children's levels of physical activity (PA) and sedentary behaviour (SB) were objectively measured and sleep duration was self-reported. Valid data were obtained in 82 children (mean age: 8.2 ± 0.84; 50.0% boys) and 72 parents (mean age: 40.1 ± 5.5; 27.8% fathers). Data were analysed using a compositional data approach, and mixed models were used to take clustering into account. Results showed that for children, the mean baseline composition of the 24-hour day in sleep, SB, light and moderate-to-vigorous PA for the intervention group was (11 hours 18 minutes; 6 hours 33 minutes; 5 hours 02 minutes, 1 hour 08 minutes) and for the control group (11 hours 18 minutes; 6 hours 35 minutes; 5 hours 04 minutes; 1 hour 06 minutes), respectively. For parents, the mean baseline composition was for the intervention group (8 hours 12 minutes; 9 hours 36 minutes; 5 hours 43 minutes; 27 minutes) and for the control group (8 hours 00 minute; 9 hours 00 minute; 6 hours 27 minutes; 33 minutes). No significant intervention effects were found on 24-hour physical behaviour composition of either parents or children (p = 0.19 and p = 0.21, respectively). A relatively small study population and a poor attendance rate among parents could maybe explain the lack of effectiveness. More effective strategies are needed to retain vulnerable families in interventions. Furthermore, future approaches to improve the 24-hour physical behaviour composition should maybe focus more specifically on PA, SB and sleep, and involve teachers, children and parents in the design of the intervention. Trial registration: NCT02393872 in ClinicalTrials.gov.

Associations between soft-drink consumption and lifestyle patterns in overweight and obese European adults: Feel4Diabetes Study.

OBJECTIVES: The purpose of this study was to identify lifestyle patterns that are characteristic of overweight and obese European adults in the context of educational level. METHODS: This was a cross-sectional study of dietary data from 1235 men and 10 343 women. Dietary intake, educational level, and physical activity were assessed using questionnaires. A principal component analysis was used to derive lifestyle patterns, and associations with being overweight or obese (OW/OB) and waist circumference (WC) were explored by applying a multivariate logistic regression. RESULTS: Overall, 35% of women and 68% of men were OW/OB, of whom 30% and 40%, respectively, had ≤12 y of education. The principal component analysis derived 2 distinct dietary patterns (healthy vs. unhealthy). The daily intake of fruits (fresh, canned, and juice) and vegetables was found to be associated with lower odds of being OW/OB and WC in women only. In contrast, the daily intake of diet soft drinks was associated with higher odds of being OW/OB in women and men, but the daily intake of sweets was associated with higher odds of WC in women only. In both sexes, having >12 y of education was inversely associated with being OW/OB. No associations were observed for regular soft-drink intake. CONCLUSIONS: A healthy dietary pattern constituting of a daily intake of fruits and vegetables was inversely associated with being OW/OB in women. Conversely, a diet soft-drink intake was positively associated with being OW/OB in both sexes, probably because of a reduction in overall energy intake. More studies are recommended to clarify the effectiveness of diet soft-drink consumption in controlling caloric intake and as a healthier alternative to regular soft drinks and sweets.

Prevalence of Childhood Obesity by Country, Family Socio-Demographics, and Parental Obesity in Europe: The Feel4Diabetes Study.

The Feel4Diabetes study recruited 12,193 children (age: 8.20 ±1.01 years) and their parents from six European countries as part of the broader attempt to prevent type 2 diabetes. The current work collected data pre-intervention to identify the prevalence of childhood obesity by country and describe its association with socio-demographic characteristics and parental obesity status. One in four children were overweight or obese, and one in four families had at least one obese parent. Multivariate logistic regression examined the associations between childhood obesity, family socio-demographics, and parental obesity status. Children had a higher chance of being overweight or obese if they were living in "low income" countries (OR: 2.11, 95% CI: 1.62, 2.74) and countries "under economic crisis" (OR: 2.48, 95% CI: 1.89, 3.24) compared to "high-income" countries; if their fathers completed fewer than nine years of education (OR: 2.16, 95% CI: 1.54, 3.05) compared to children whose fathers had a higher level (>14 years) of education; and if one (OR: 2.46, 95% CI: 0.32, 0.62) or both of their parents (OR: 6.83, 95% CI: 5.15, 9.05) were obese. Future childhood obesity prevention-programs should target the whole family while taking into consideration the socioeconomic and weight status of parents. Future research should examine these associations in more countries and in socio-demographically diverse populations in order to facilitate the generalisability of the present study's findings.