Can Food and Beverage Advertising Questionnaire Predict Overweight and Obesity in Children and Adolescents from Low- and Middle-Income Countries?

Background: Information about the reliability and validity of questionnaires in low- and middle-income countries remains scarce. Objective: To test the reliability and predictive validity of a food and beverage marketing/advertising questionnaire for South American children and adolescents. Methods: A sample of 330 children (3-10 years old) and 215 adolescents (11-18 years old) was included from seven South American cities: Buenos Aires, Lima, Medellín, Montevideo, Santiago, Sao Paulo, and Teresina. The questionnaire consisted of seven questions about food and beverage marketing/advertising and decision influence. We assessed the reliability using temporal stability (2-week interval) and internal consistency. We assessed the predictive validity based on the risk of excess weight. Results: In children, reliability agreement from κ coefficients ranged from 63.7% to 86.3%, and Cronbach's α (internal consistency estimate) ranged from 0.14 to 0.75. In adolescents, the reliability agreement ranged from 78.9% to 85.7%, and Cronbach's α ranged from 0.14 to 0.76. Exploratory factor analysis revealed two factors for both age groups. The predictive probabilities for excess weight ranged from 22.3% to 61.1% in children and from 24.9% to 64.1% in adolescents. Conclusions: The screen/marketing media questionnaire is a reliable and valid measure for the pediatric population from low- and middle-income countries. This subjective tool provides a feasible screening measure for the influence of advertising on children and adolescents at risk of overweight and obesity.

Which blood cutoff value should be used for vitamin A deficiency in children aged 3-10 years? A systematic review.

CONTEXT: Blood cutoff values for vitamin A deficiency in children aged 3-10 years have not been addressed in the literature. OBJECTIVE: To identify blood retinol concentrations for determining severe vitamin A deficiency in children aged 3-10 years. DATA SOURCES: The MEDLINE, Web of Science, Embase, and Scopus databases were searched. DATA EXTRACTION: Two reviewers independently extracted article data and assessed quality. DATA ANALYSIS: The hierarchical summary receiver operating characteristic models were applied for the diagnostic accuracy meta-analysis. This review is registered at PROSPERO (identifier: CRD42020149367). RESULTS: A total of 15 articles met the eligibility criteria, and 9 were included in the diagnostic accuracy meta-analysis. The summary estimates (95%CI) were: Sensitivity, 0.39 (0.20-0.62); specificity, 0.79 (0.65-0.88); positive likelihood ratio, 1.85 (1.33-2.57); and negative likelihood ratio, 0.77 (0.60-0.99). The area under the curve of the overall analysis was 0.68 (95%CI 0.63-0.72). CONCLUSIONS: Blood retinol concentrations have low diagnostic accuracy for severe vitamin A deficiency in children aged 3-10 years. Therefore, there is unclear evidence about the preferable cutoff point for determining severe vitamin A deficiency in children in this age group.

Relative validity of FFQ to assess food items, energy, macronutrient and micronutrient intake in children and adolescents: a systematic review with meta-analysis.

FFQ are one of the most widely used tools of research into nutritional epidemiology, and many studies have been conducted in several countries using this dietary assessment method. The present study aimed to evaluate the relative validity of FFQ, in comparison with other methods, in assessing dietary intake of children and adolescents, through a systematic review. Four electronic databases (Embase, PubMed, Scopus and Web of Science) found sixty-seven articles, which met the inclusion criteria (healthy children and adolescents from 3 to 18 years of age; journal articles written in English, Spanish and Portuguese between 1988 and March 2019; results showing the comparison between the FFQ with other methods of assessment of dietary intake). The articles were analysed by two independent reviewers. A meta-analysis was conducted using correlation coefficients as estimate effects between the FFQ and the reference standard method. Subgroup analysis and meta-regression were performed to identify the probable source of heterogeneity. In fifty-five of the sixty-seven studies, a single dietary assessment method was used to evaluate the FFQ; nine combined the two methods and three used three reference methods. The most widely used reference method was the 24-h recall, followed by the food record. The overall relative validity of the FFQ to estimate energy, macronutrient, certain micronutrient and certain food item intakes in children and adolescents may be considered weak. The study protocol was registered in PROSPERO under number CRD42016038706.

Risk score for failed trial of vaginal birth after a previous cesarean section including data of labor course.

AIM: There is much discussion about the advantages and disadvantages of a trial of labor after cesarean (TOLAC). Some data suggest the greater the likelihood of success, the lower the risks of TOLAC. Our goal was to identify clinical and demographic variables associated with a failed TOLAC, available at admission for spontaneous labor and until 3 h later, with the aim of building two scores for risk of failed TOLAC. METHODS: This is a nested case-control study with live births to women with one previous cesarean, in a public Brazilian teaching hospital. Preterm, induction, noncephalic presentations, twins, fetal malformations were excluded. Cases were failed TOLAC, and controls, the successful TOLAC. It was accessed the association of the cases with 20 variables (P < 0.05). Associated variables were tested in multivariate analysis to build the scores, which were internally validated. RESULTS: We included 260 TOLAC, 42 cases and 218 controls. We found 11 variables associated with failed TOLAC. In the score to be applied at admission, we included hypertension, fundal height, previous vaginal birth and dilatation at admission. In the second score hypertension, fundal height at admission, membrane status and difference in dilatation 3 h after admission. Both scores presented good performance in the receiver-operator curve (areas under curve: 0.73 and 0.84, respectively). Both scores were translated into nomograms for clinical use. CONCLUSION: Two scores were built for risk of failed TOLAC, to be applied at admission and 3 h later. We believe that choosing the more favorable cases makes risks of TOLAC lower.

Validity and reliability of sleep time questionnaires in children and adolescents: A systematic review and meta-analysis.

Sleep duration has been associated with several health outcomes in children and adolescents. As an extensive number of questionnaires are currently used to investigate sleep schedule or sleep time, we performed a systematic review of criterion validation of sleep time questionnaires for children and adolescents, considering accelerometers as the reference method. We found a strong correlation between questionnaires and accelerometers for weeknights and a moderate correlation for weekend nights. When considering only studies performing a reliability assessment of the used questionnaires, a significant increase in the correlations for both weeknights and weekend nights was observed. In conclusion, moderate to strong criterion validity of sleep time questionnaires was observed; however, the reliability assessment of the questionnaires showed strong validation performance.