The development of an EU-wide nutrition and physical activity expert knowledge base to support a personalised mobile application across various EU population groups.

A healthy lifestyle comprising regular physical activity and an adequate diet is imperative for the prevention of non-communicable diseases such as hypertension and some cancers. Advances in information computer technology offer the opportunity to provide personalised lifestyle advice directly to the individual through devices such as smartphones or tablets. The overall aim of the PROTEIN project (Wilson-Barnes et al., 2021) was to develop a smartphone application that could provide tailored and dynamic nutrition and physical activity advice directly to the individual in real time. However, to create this mobile health (m-health) smartphone application, a knowledge base of reference ranges for macro-/micronutrient intake, anthropometry, biochemical, physiological and sleep parameters was required to underpin the parameters of the recommender systems. Therefore, the principal aim of this emerging research paper is to describe the process by which experts in nutrition and physiology from the PROTEIN consortium collaborated to develop the nutritional and physical activity requirements, based upon existing recommendations, for 10 separate population groups living within the EU including, but not limited to healthy adults, adults with type 2 diabetes mellitus, cardiovascular disease, excess weight, obesity and iron deficiency anaemia. A secondary aim is to describe the development of a library of 24-h meal plans appropriate for the same groups and also encompassing various dietary preferences and allergies. Overall, the consortium devised an extensive nutrition and physical activity knowledge base that is pertinent to 10 separate EU user groups, is available in 7 different languages and is practically implemented via a library of culturally appropriate, 24-h meal plans.

Nutrition strategies before and during ultra-endurance event: A significant gap between science and practice.

The purpose of this study was to investigate and assess the nutritional practices of open-water swimmers, during the preparation period and the competition, as well as their implications on performance and anthropometric parameters according to their age. Twenty-four (n = 24) men open-water swimmers, twelve young (26.3 ± 4.9 years) and twelve older athletes (45.8 ± 9.7 years), participated in this study. Nutritional behavior-energy intake consumption, and anthropometric characteristics were evaluated prior to the Toroneos Gulf crossing (26 km). In addition, nutritional intakes during the race and anthropometrics after the race were also evaluated. Significant differences between the two groups were found for Toroneos Gulf crossing performance, BMI, and all variables of body composition at the preparation period (P < .05). The results involving energy consumption, in both preparation period and during the race, displayed significant differences between the two groups, while both groups exhibited significantly negative energy balances. During the race, significant differences were found also for the energy expenditure, relative energy intake, negative energy balance, relative consumption of carbohydrates per hour, and relative protein intake (P < .05). In both groups, lower intakes than the recommended were observed for macronutrient-micronutrient elements at any time point. Significant correlations were found between selected variables of body composition, nutritional intakes during the preparation period and the competition, and athletes' performance. In summary, this study provides strong evidence about the malnutrition of ultra-endurance swimmers prior and during their competition, with potential dangers for their health and performance as certain deficiencies in both macro- and micronutrient contents are present.

Exercise monitoring of young adults using a Facebook application.

Facebook, with a record 1.7+ billion monthly active users, is increasingly the platform of choice for a multitude of e-health applications. This work presents our experience in exercise monitoring using a custom-built Facebook application for activity self-reporting. A group of young adults (n = 49, age = 24 ± 7 years, body mass index (BMI) = 22.5 ± 3) took part in a 5-week pilot study, part of the NutriHeAl intervention project. Participants reported their daily exercise activities for an average of 33 ± 5 days and were also equipped with digital pedometers (Fibit Zips) for the full duration, allowing the evaluation of their activity reporting accuracy by comparing steps/min to a 'truth ceiling' value for two pre-defined exercise categories (2 + and 3+ metabolic equivalent of task (MET) intensity). We found that users not only reported their exercise consistently for an extended period of time but also achieved an average accuracy score of 71 ± 21% (82 ± 18% for 2+ MET exercises), making this novel exercise monitoring methodology a formidable tool for a modern physician's digital arsenal. In addition, the developed tools and processes can also be re-used in other e-health applications.

Short communication: Dmfs and BMI in preschool Greek children. An epidemiological study.

AIM: To investigate the relationship between dental caries (dmfs) and body mass index (BMI) categories in 3-5.5 year old children in Thessaloniki, Greece. METHODS: The study was conducted in 18 municipal day care centres and involved 361 children. The dmfs was determined on site by one calibrated examiner using disposable dental mirrors and a penlight. The height and weight of the children were measured on site by a nutritionist, who grouped them into four BMI categories, shown in the results. STATISTICS: The estimation of the relationship between the BMI and dmfs values was based on a generalized linear model (Poisson log-linear regression) while the sequential Bonferroni method was used for pair-wise comparisons between BMI categories. RESULTS: Mean dmfs values for each BMI category were: 1.02 (SD=2.41) for the underweight (n=44), 0.74 (SD=2.24) for the normal weight (n=281), 1.88 (SD=4.28) for the overweight (n=26) and 0.80 (SD=2.53) for the obese (n=10). Overweight children were found to show statistically significant differences in dmfs values compared with both children of normal weight (p<0.001) and those underweight (p=0.015). CONCLUSION: Overweight Greek pre-school children are at higher risk of dental caries.

Metabolic indices, energy and macronutrient intake according to weight status in a rural sample of 17-year-old adolescents.

INTRODUCTION: With adolescent health a priority on the WHO agenda, research into the diet, weight status and metabolic profile of adolescents is indicated. The present study aimed to assess the diet and metabolic parameters of a rural sample of adolescents. METHODS: One hundred adolescents (17 years of age) were recruited from schools in Nea Madytos, Thessaloniki, Greece. Two previous-day food recalls were collected for each participant, and weight, height, waist circumference, serum lipids and fasting glucose levels were measured. The prevalence of underweight/overweight, central obesity, dyslipidemia and impaired fasting glucose (IFG) were calculated. RESULTS: Overweight was present in half the boys (51.2%) and one-fifth of the girls (21.3%). In the total sample 7.1% were underweight and another 7.1% were diagnosed with central obesity. Boys had an increased risk of abdominal obesity (OR:1.405, CI:0.7-2.8), IFG (OR:1.200, CI:0.3-4.9) and elevated triglycerides (OR:1.514, CI:1.0-2.4) and serum cholesterol levels (OR:1.806, CI:1.1-3.1). Central obesity increased the chances of IFG (OR:8.000, CI:1.6-39.1) and doubled the prevalence of dyslipidemia (OR:2.190, CI:0.5-9.1). Under-reporting of energy was found among overweight participants and was further verified by an inverse relationship between BMI and the ratio of energy intake to energy expenditure. Adolescents identified a dietary pattern high in fats in lieu of protein. CONCLUSIONS: Irrespectively of their weight status, teenagers consume a high fat diet; therefore, dietary counseling, as a means of preventive medicine, should be applied to all weight categories. In addition, the prevalence of obesity in a rural sample of adolescents appears to be higher compared with the whole of Greece.

Dietary intakes and food habits of adolescents in northern Greece.

The purpose of this study was to assess the dietary intakes and food habits of 582 adolescents in Northern Greece. Anthropometric data have been collected for all the participating adolescents. The prevalence of obesity as determined by both body mass index (BMI) and triceps skinfold thickness (TST) was higher for boys than for girls. Furthermore, boys had higher energy and macronutrient intakes compared to girls. Of total energy intake, 41% for boys and 43% for girls was derived from fat. Energy intake was found adequate whereas fat intake was much higher than recommended. A percentage of adolescents also had lower than recommended iron, vitamin A, folate and zinc intakes, showing an unbalanced diet.

Dietary intakes of elite female athletes in Greece.

BACKGROUND: Although there is a great interest in sports in Greece, there are very few data regarding dietary intakes and habits of Greek elite female athletes. The present study assesses the dietary intakes and the energy balance of elite female athletes of four different sports (volleyball, middle distance running, ballet dancing, and swimming) and a non-athletic control group. METHODS: Data were collected over two seasons, the training and the competitive, using 7-day weighed dietary records. Energy expenditure was calculated from 7-day activity records. Anthropometric measurements were also taken for all athletes. RESULTS: Athletes and controls had similar BMI values. Per cent body fat was lower for athletes compared with controls. Between sports, middle distance runners had the lowest per cent body fat. No significant differences were found between mean energy intake of athletes and controls. Mean energy intake was found lower than calculated energy expenditure, for all four teams. Macronutrient and micronutrient intakes of the athletes were not statistically different from those of the non-athletic control group. Mean micronutrient intakes were found above the recommended values with the exception of iron. Both athletes and controls had a high intake of vitamin C that is a characteristic of the population of the Mediterranean countries. CONCLUSIONS: Energy intakes varied between sports and between athletes of the same sport. Calculated energy expenditure was higher from the reported energy intake for most athletes. Athletes with the lowest energy intakes reported menstrual abnormalities.

Dietary vitamin E intake and plasma tocopherol levels of a group of adolescents from Spili, Crete.

Vitamin E is a very important nutrient in the human diet mainly due to its antioxidant properties. In this study an attempt was made to measure and evaluate vitamin E intake and to determine plasma tocopherol levels in a group of adolescents in Spili, Crete, Greece. It is known that Crete is an area with a high consumption of olive oil. It has been shown in this study that the mean olive oil consumption of these adolescents was 70.7 +/- 15.4 g/day. Vitamin E intake was 11.7 +/- 2.3 mg/day and olive oil provided 67% of this intake. Furthermore the vitamin E/PUFA ratio in food intake was 1.5 mg/g a value higher than reported by other investigators for populations with a high consumption of seed oils. The mean serum a-tocopherol levels in the selected 12 adolescents was 0.79 mg/dl (range 0.7-1.02).