Objective and Subjective Appetite Assessment in Patients with Gynecological Cancer: A Pre- and Post-Operative Pilot Study.

Although appetite and its disorders have been implicated in disease progression and outcomes, ghrelin concentrations, an objective appetite measure, are rarely assessed in patients with gynecological malignancies. The present study aimed to assess changes in post-operative versus pre-operative appetite levels in patients with gynecological cancers scheduled for tumor removal surgery (N = 53). Acylated ghrelin concentrations were assessed as an objective appetite proxy, whereas the Council of Nutrition appetite questionnaire (CNAQ) was employed as a subjective appetite measure. Ghrelin concentrations were increased post-operatively (median: 12.1 pg/mL, IQR: 0.67 to 23.5, p-value = 0.001) but the perceived appetite of patients (CNAQ) remained unchanged (median: -1, IQR: -3 to 1). Tumor removal surgery decreased all anthropometric indices (body weight, body mass index, waist and hips circumferences, triceps skinfolds, body fat, fat mass and fat mass index, p-value ≤ 0.001 for all) and doubled the risk of malnutrition among patients. No difference was recorded in the change in participants' objective and subjective appetite when they were classified according to the tumor type. No correlation was observed between ghrelin concentrations and CNAQ score pre-operatively (Spearman's rho correlation coefficient = -0.181, p-value = 0.298) or post-operatively (Spearman's rho correlation coefficient = 0.071, p-value = 0.684). The observed post-operative rise in ghrelin concentrations is associated with body weight loss and consists of a possible defense mechanism of the human body, aiming to prolong survival.

Growth, the Mediterranean diet and the buying power of adolescents in Greece.

Background The aim of the present cross-sectional study was to evaluate associations between pocket money, Mediterranean diet (MD) adherence and growth among Greek adolescents. Methods A total of 319 (157 boys and 162 girls) Greek adolescents, aged 10-18 years participated in the study. Pocket money was recorded, MD adherence was assessed with the KIDMED score and growth was evaluated using the World Health Organization (WHO) growth charts. Results Participants receiving pocket money exceeding 6.0€ daily demonstrated increased fast-food consumption and breakfast skipping. Overall, a negative relationship was revealed between pocket money and obesity. However, lower allowance receivers were less likely to be obese, consume fruit per day and more likely to consume breakfast and sweets, compared to average pocket money receivers. Increased MD adherence was associated with a lower risk of overweight and as expected, unhealthy eating habits were observed among obese adolescents. Conclusions Interrelationships tend to exist between MD adherence, pocket money and growth among adolescents.

Similar Mediterranean diet adherence but greater central adiposity is observed among Greek diaspora adolescents living in Istanbul, compared to Athens.

OBJECTIVE: The aim of this case-control study was to compare Mediterranean diet (MD) adherence and anthropometry between Greek diaspora adolescents living in Istanbul and Greek adolescents, inhabitants of Athens. DESIGN: A total of 206 adolescents (103 from each site), aged 10.0-19.0 years old, all of Greek origin, were recruited from schools in Athens and minority schools in Istanbul, for the present case-control study. Participants at each site were age and sex-matched. Anthropometric measurements were performed, and diet adherence was assessed with the KIDMED score. RESULTS: Breakfast skipping, decreased dairy and increased commercially baked good/pastries consumption for breakfast, fast-food intake and consumption of several sweets each day was more prevalent in Istanbul, but, on the other hand, students from Athens reported eating fewer fruit, vegetables and nuts. The adoption of unhealthy eating habits in each site was counterbalanced by a more 'healthy' dietary element, resulting in an overall similar MD adherence between both sites. Additionally, although weight status was indifferent between the two cities, higher rates of abdominal obesity were recorded in Istanbul, when the weight-to-height ratio was used for diagnosis. CONCLUSIONS: Differences in several domains of the KIDMED score were recorded among cities, possibly as results of food availability and prices. However, MD adherence and weight status appeared similar, indicating that the dietary transition and acculturation experienced by the remnants is actually very slow and minimal during the 93 years since population exchange.

Diet quality, overweight and daily monetary allowance of Greek adolescents.

Objective To investigate cross-correlates of pocket-money on diet quality and weight status of Greek adolescents. Methods A total of 172 adolescents (55.2% boys), aged between 10 and 15 years old were recruited. Body weight and height were measured, body mass index (BMI) was computed. Weight status was assessed according to the International Obesity Task Force criteria and diet quality was evaluated via the Healthy Eating Index (HEI) - 2010. Results Adolescents were allowed a mean allowance of €4.63 ± 3.66 daily. Among boys participants, BMI correlated with pocket money (r = 0.311, p ≤ 0.002) and normoweight boys received statistically less money than their overweight peers (p ≤ 0.019). In both sexes, normoweight was more prevalent in the lowest monetary quartiles. Pocket money was not associated with HEI. Among boys, moderate HEI was more prevalent in the third quartile of pocket money, significantly higher compared to all others (p ≤ 0.01 for all). For girls, the prevalence of moderate HEI declined by each ascending pocket money quartile (p ≤ 0.05 for all). Conclusion In our sample, adolescents exhibited high rates of pooled overweight including obesity. The majority of the participants followed a diet of moderate quality. Pocket money was associated with BMI only among boys. As pocket money was not associated with diet quality, it is highly possible that adolescents might choose to spend their money on items other than foods. Our study shows that pocket money should be controlled during adolescence and teenagers should be educated on spending their money on healthier food choices.

Nutritional Surveillance of Christian Orthodox Minority Adolescents in Istanbul.

Previous studies have shown that the diets of migrant populations are of poor quality; however, studies on populations remaining in one geographical region as a minority after an acute population movement are scarce. Therefore, the aim of the present study was to assess dietary intake and growth of Greek minority adolescents in Turkey. Anthropometric measurements and dietary assessment were performed in 103 Greek Orthodox students (aged 10-19 years old) of three minority schools in Istanbul. Prevalence of overweight and obesity according to the WHO growth charts was 39.8 %. Accordingly, 40 % of the sample exhibited excess body fat. Dietary intakes of protein, carbohydrate, fiber, vitamins E and D, folic acid and calcium were inadequate, while energy, total fat and iron intakes were considered adequate. Our results indicate that Greek minority adolescents living in Turkey have similar weight status compared to their counterparts in Greece, but greater body fat than Turkish coevals, while being at risk of several nutrient inadequacies.

Diabetes knowledge among Greek Type 2 Diabetes Mellitus patients / Conocimiento de la diabetes por los pacientes griegos con diabetes mellitus de tipo 2

Background & objective: Diabetes knowledge has been shown to improve glycemic control and associate with several demographic parameters. In Greece, a country with high obesity rates, disease knowledge has never been evaluated in diabetic patients. This cross sectional study aimed to assess diabetes knowledge and its associations between social and demographic parameters, among Greek type 2 diabetes mellitus (T2DM) patients. Methods One hundred fifty nine patients with T2DM were recruited from an urban and a rural clinic in Greece. Diabetes knowledge was assessed with the Brief Diabetes Knowledge Test (DKT). Basic anthropometry was performed. Data regarding glycemic control and sociodemographic characteristics were collected from the patients’ medical files. Results: Greek T2DM patients demonstrated poor disease knowledge (mean DKT score 8.3±2.2/14.0 and mean DKT as a percent of correct answers 59.6±15.8%). No differences were observed between sex, place of residence, or glycemic control, among subjects. Patients with higher education demonstrated greater diabetes knowledge. Simple obesity with concurrent central obesity or suboptimal glycemic control decreased diabetes knowledge among participants. Additionally, waist circumference was inversely correlated to diabetes knowledge. Conclusions: Based on the DKT, Greek patients exhibit poor diabetes knowledge. This study provides evidence for the need for better diabetes education in order to ameliorate disease outcome (AU)

Antecedentes y objetivo: Se ha demostrado que el conocimiento de la diabetes mejora el control de la glucemia y se asocia con varias características demográficas. En Grecia, un país con tasas de obesidad elevadas, no se ha evaluado nunca el conocimiento de la diabetes de quienes la sufren. El objetivo de este estudio transversal es valorar el conocimiento de la diabetes y su asociación con parámetros sociales y demográficos en los pacientes griegos con diabetes mellitus tipo 2 (DMT2). Métodos: Se reclutaron a 159 pacientes con diabetes mellitus tipo 2 (DMT2) de una consulta urbana y otra rural de Grecia. El conocimiento de la diabetes se valoró mediante el Brief Diabetes Knowledge Test (DKT). Se recogieron datos antropométricos básicos. Los datos sobre el control de la glucemia y las características sociodemográficas se recogieron de los historiales médicos de los pacientes. Resultados: Los pacientes griegos con DMT2 mostraron un conocimiento deficiente de la enfermedad (puntuación DKT media de 8,3±2,2/14,0 y DKT media como porcentaje de respuestas correctas 59,6±15,8%). No se observaron diferencias entre los sujetos en función del sexo, del lugar de residencia ni del control de la glucemia. Los pacientes con mayor grado de educación mostraron mayor conocimiento de la diabetes. La obesidad simple con obesidad central o control subóptimo de la glucemia concurrente coincidía con un menor conocimiento de la diabetes por los participantes. Además, había una relación inversa entre el perímetro de la cintura y el conocimiento de la diabetes. Conclusiones: Basándose en el DKT, los pacientes griegos tienen un conocimiento deficiente de la diabetes. Este estudio demuestra la necesidad de una mejor educación sobre la diabetes para mejorar la evolución de la enfermedad (AU)

Diabetes knowledge among Greek Type 2 Diabetes Mellitus patients.

BACKGROUND & OBJECTIVE: Diabetes knowledge has been shown to improve glycemic control and associate with several demographic parameters. In Greece, a country with high obesity rates, disease knowledge has never been evaluated in diabetic patients. This cross sectional study aimed to assess diabetes knowledge and its associations between social and demographic parameters, among Greek type 2 diabetes mellitus (T2DM) patients. METHODS: One hundred fifty nine patients with T2DM were recruited from an urban and a rural clinic in Greece. Diabetes knowledge was assessed with the Brief Diabetes Knowledge Test (DKT). Basic anthropometry was performed. Data regarding glycemic control and sociodemographic characteristics were collected from the patients' medical files. RESULTS: Greek T2DM patients demonstrated poor disease knowledge (mean DKT score 8.3±2.2/14.0 and mean DKT as a percent of correct answers 59.6±15.8%). No differences were observed between sex, place of residence, or glycemic control, among subjects. Patients with higher education demonstrated greater diabetes knowledge. Simple obesity with concurrent central obesity or suboptimal glycemic control decreased diabetes knowledge among participants. Additionally, waist circumference was inversely correlated to diabetes knowledge. CONCLUSIONS: Based on the DKT, Greek patients exhibit poor diabetes knowledge. This study provides evidence for the need for better diabetes education in order to ameliorate disease outcome.

Regional differences in the prevalence of underweight, overweight and obesity among 13-year-old adolescents in Greece.

BACKGROUND AND OBJECTIVES: To assess regional differences in the weight status and abdominal obesity among 13-year-old Greek adolescents. DESIGN AND SETTING: Cross-sectional, nationwide study in Greece. PATIENTS AND METHODS: A representative sample of 4833 13-year-old adolescents (50.7% boys) was recruited throughout the nine regional districts of Greece from 2010 to 2012. Basic anthropometry measurements (weight, height, and waist circumference) were obtained. Abdominal obesity and weight status were assessed according to the International Obesity Task Force criteria. RESULTS: The majority of the sample had a healthy body weight (60.3%), 4.1% were underweight, 27.2% were overweight, and 8.5% were obese. For boys, the highest prevalence of underweight was recorded in Epirus, normal body weight on the Ionian Islands, overweight in Central Greece and Macedonia, and obesity on the Ionian Islands. Among girls, the highest underweight prevalence was on the Ionian Islands, normal body weight in Macedonia, overweight in Central Greece and Macedonia, and obesity in Crete. Abdominal obesity affected 12.9% of the sample, with the greatest prevalence among Cretan boys and Thracian girls. Additionally, residing on the Greek islands was associated with a higher prevalence of central adiposity. CONCLUSION: Greek 13-year-old adolescents who are subjected to geographical changes exhibit high obesity and abdominal obesity rates. This study provides evidence to design regionally tailored interventions that aim to tackle and prevent the disease among the nine regional districts in Greece.

A systematic review and meta-analysis of weight status among adolescents in Cyprus: scrutinizing the data for the years 2000-2010.

OBJECTIVE: The aim of the present study was to evaluate by pooled and sensitivity analyses all available data on adolescent overweight/obesity in Cyprus. DESIGN: A thorough literature search determined the studies to be examined using Cypriot adolescent samples aged 10-18 years old, with weight status in each sex classified according to the IOTF criteria, published between the years 2001-2011. Eight studies were retrieved, but three fulfilled the criteria for the sensitivity analyses. RESULTS: The pooled prevalence of obesity was 9.8% in boys (n = 6081). The pooled analysis classified 6.1% (n = 3886) of girls as obese, whereas a higher prevalence was observed by the sensitivity analysis 6.4% (n = 1956, p ≤ 0.001). The boys' prevalence of overweight was 19.3% and the girls' 17.1%. Between sexes, boys demonstrated a higher prevalence of obesity and overweight (p ≤ 0.001 for both). The cumulative analyses demonstrated an increase in the prevalence of overweight/obesity until the year 2005 and thereafter a plateauing in boys and a slight decrease in girls in a non-linear manner. CONCLUSION: Approximately 1/3 of adolescent boys and 1/4 of adolescent girls in Cyprus were overweight/obese during the previous decade.

Greek pregnant women demonstrate inadequate micronutrient intake despite supplement use.

BACKGROUND/AIM: Maternal diet is important in the outcome of pregnancy and the health of the children. The present cross-sectional study aimed to assess the use of dietary supplements during pregnancy and define the maternal characteristics associated with supplement use. METHODS: The diet of 100 childbearing women was recorded for three consecutive days and micronutrient supplementation was added to the dietary intake and the median values were used in the analyses. RESULTS: The majority of the participants (92%) consumed at least one supplement. Supplementation of folic acid (FA) was significantly lower during the third trimester compared to the second (p ≤ .007). Higher intake of Ca and Fe supplements was observed in the second trimester (p ≤ .001). The use of supplements contributed to an attenuated consumption of all reported micronutrients (Mg, Ca, FA, and Fe, p ≤ .001). The principal components analysis revealed that the most important factor contributing to supplementation was primiparity. CONCLUSIONS: Overall, a high prevalence of micronutrient supplementation during pregnancy was observed without ensuring adequacy in the micronutrient intake. The increased rates of supplement users might be the result of an act for balancing diet in unplanned pregnancies.

Estudio piloto de la prevalencia de obesidad materna en condados griegos seleccionados / A pilot study on the prevalence of maternal obesity in selected Greek counties

OBJETIVO: Notificar una prevalencia piloto de sobrepeso, obesidad y bajo peso maternos en condados griegos seleccionados. MÉTODOS: Para este estudio transversal se reclutó a un total de 441 mujeres adultas fértiles de maternidades de seis condados griegos. El estado ponderal pregrávido se definió de acuerdo con los puntos de corte de la OMS, y el estado ponderal grávido se diagnosticó con la tabla de ganancia de peso de Mardones y Rosso. RESULTADOS: Durante la gestación, la mayoría de las participantes (34,0%) tenían peso corporal (PC) normal. El 25,6% de la muestra tenía obesidad, el 23,8% bajo peso, y el 16,6% restante tenía sobrepeso. Globalmente, el embarazo triplicaba la prevalencia de bajo peso, aumentaba la prevalencia de obesidad (el 388,0%) y reducía el número de participantes en la categoría PC normal (p≤0,001 para todos) La mayoría de las participantes clasificadas en cada categoría de peso pregrávida permanecieron en la misma categoría de peso durante la gestación. Todas las mujeres obesas antes del embarazo siguieron siéndolo durante éste. El peso bajo fue más prevalente en Kavala (37,5%), y la obesidad fue más frecuente en Tesalónica (30,8%). Las mujeres con sobrepeso antes de la concepción tenían muchas probabilidades de presentar sobrepeso u obesidad durante el embarazo (OR: 23,8, IC: 11,1-51,0). CONCLUSIONES: Los resultados indican una prevalencia alta de sobrepeso, obesidad y bajo peso en las mujeres griegas embarazadas

OBJECTIVE: To report a pilot prevalence of maternal overweight, obesity and underweight in selected Greek counties. METHODS: A total of 441 adult childbearing women were recruited from maternity clinics in 6 Greek counties for this cross-sectional study. Pre-gravid weight status was defined according to the WHO cut-offs and gravid weight status was diagnosed with the Mardones and Rosso weight gain chart. RESULTS: During gestation the majority of the participants were of normal body weight (BW) (34.0%), obesity was apparent in 25.6% of the sample, 23.8% of the participants were underweight, and the remaining 16.6% were overweight. Overall, pregnancy tripled the prevalence of underweight, increased the prevalence of obesity (by 388.0%) and decreased the number of participants in the normal BW category (p ≤ 0.001 for all). The majority of participants classified in each pre-gravid weight-category remained in the same weight category during their gestation. All the pre-gravidly obese women were also obese during pregnancy. Underweight was more prevalent in Kavala (37.5%) and obesity was more frequent in Thessaloniki (30.8%). Women who were overweight prior to conception were highly likely to be overweight/obese during pregnancy (OR: 23.8, CI: 11.1-51.0). CONCLUSIONS: The results indicate a high prevalence of overweight, obesity and underweight among pregnant women in Greece

A pilot study on the prevalence of maternal obesity in selected Greek counties.

OBJECTIVE: To report a pilot prevalence of maternal overweight, obesity and underweight in selected Greek counties. METHODS: A total of 441 adult childbearing women were recruited from maternity clinics in 6 Greek counties for this cross-sectional study. Pre-gravid weight status was defined according to the WHO cut-offs and gravid weight status was diagnosed with the Mardones and Rosso weight gain chart. RESULTS: During gestation the majority of the participants were of normal body weight (BW) (34.0%), obesity was apparent in 25.6% of the sample, 23.8% of the participants were underweight, and the remaining 16.6% were overweight. Overall, pregnancy tripled the prevalence of underweight, increased the prevalence of obesity (by 388.0%) and decreased the number of participants in the normal BW category (p≤0.001 for all). The majority of participants classified in each pre-gravid weight-category remained in the same weight category during their gestation. All the pre-gravidly obese women were also obese during pregnancy. Underweight was more prevalent in Kavala (37.5%) and obesity was more frequent in Thessaloniki (30.8%). Women who were overweight prior to conception were highly likely to be overweight/obese during pregnancy (OR: 23.8, CI: 11.1-51.0). CONCLUSIONS: The results indicate a high prevalence of overweight, obesity and underweight among pregnant women in Greece.

Ten-year obesity and overweight prevalence in Greek children: a systematic review and meta-analysis of 2001-2010 data.

OBJECTIVE: While the US today has the highest rates worldwide of obesity, Europe, and particularly Southern Europe, is catching up fast. The aim of this study was to report the prevalence of obesity in Greek children, aged 1-12 years. DESIGN: A systematic review--including all studies published in English and Greek from January 2001 until December 2010 regarding childhood obesity, using the IOTF criteria--was performed. Twenty-five out of 134 published studies were finally selected, including 219,996 boys and 210,772 girls. RESULTS: Meta-analysis revealed that 10.2% (CI 95%: 9.8-10.7%) of Greek children (1-12 years) are obese, 23.7% (CI 95%: 22.7-24.8%) are overweight and the combined prevalence of overweight and obesity is 34% (CI 95%: 32.7-35.3%). Subgroup analysis by gender showed that 11% of the boys and 9.7% of the girls were obese, while 24.1% of the boys and 23.2% of the girls were overweight. The combined prevalence of excess in body weight predominated in boys (35%), while in girls the above prevalence was 32.7%. Cumulative analysis revealed an upward trend of the phenomenon (2001-2003), followed by a stabilization (2003-2010). CONCLUSIONS: During the decade 2001-2010, 1/10 Greek children was obese and 3/10 were overweight. The implementation of policies to reverse childhood obesity is of the utmost urgency.

Asociación entre la calidad de la dieta, el estado de salud y las complicaciones diabéticas en pacientes con diabetes tipo 2 y con obesidad comórbida / Associations between diet quality, health status and diabetic complications in patients with type 2 diabetes and comorbid obesity

Objetivos Los pacientes con diabetes tipo 2 (DM2) muestran un bajo cumplimiento dietético y esto se agrava aún más con la obesidad comórbida. El objetivo de este estudio fue evaluar la calidad en la dieta de los pacientes con DM2 y obesidad comórbida en comparación con pacientes que solo padecen DM2, además de examinar la asociación entre las comorbilidades y la calidad de la dieta. Métodos La muestra consistió en 59 pacientes adultos con diabesidad (DM2 y obesidad comórbida) y 94 pacientes con solo DM2. Se registraron todas las comorbilidades y las complicaciones por diabetes, y se evaluó la calidad de la dieta con el Índice de Alimentación Saludable (IAS).Resultados La media bruta del IAS en las personas diabéticas y obesas fue del 81,9±7,1 y en aquellas que presentaban solo diabetes 80,2±6,9. Al ajustar por sexo, edad y peso, las personas con diabetes y obesidad simultánea presentaron un IAS más elevado. De las comorbilidades habituales, solo la nefropatía disminuyó el IAS. De acuerdo con el análisis de componentes principales de la muestra total, la calidad de una dieta adecuada viene explicada por las enfermedades cardiovasculares, el tabaquismo, el consumo de alcohol, la úlcera péptica, el sexo, la diabesidad y el síndrome del pie diabético. En las personas diabéticas obesas, un IAS adecuado venía explicado por el síndrome del pie diabético, el tabaquismo, consumo de alcohol y antecedentes familiares de diabetes. Conclusiones Los pacientes adultos con DM2 demostraron una calidad adecuada en su dieta. Existen diversos factores asociados con la adopción de una dieta de alta calidad entre las personas con diabetes y obesas, y aquellas con solo DM2(AU)

Objective Patients with type 2 diabetes (T2DM) demonstrate low dietary adherence and this is further aggravated with comorbid obesity. The aim of the present study was to assess diet quality in patients with T2DM and comorbid obesity compared to patients with T2DM alone and to examine the associations between comorbidities and diet quality. Methods The sample consisted of 59 adult patients with diabesity (T2DM and comorbid obesity) and 94 patients with T2DM alone. All diabetes comorbidities and complications were recorded and diet quality was assessed with the Healthy Eating Index (HEI).Results Mean raw HEI of the diabese subjects was 81.9±7.1 and the diabetic subjects was 80.2±6.9. When HEI was adjusted to the sex, age and weight status, the diabese demonstrated a higher HEI. Among comorbidities, only renal disease decreased HEI. According to the principal component analysis of the total sample, adequate diet quality was explained by cardiovascular disease, cigarette smoking, alcohol consumption, peptic ulcer, sex, diabesity and diabetic foot syndrome. In the diabese, adequate HEI was explained by diabetic foot syndrome, smoking, drinking alcohol and having a family history of diabetes. Conclusions Adult patients with T2DM demonstrate adequate diet quality. Different factors are associated with the adoption of a high quality diet between the diabese and the T2DM alone(AU)

Associations between diet quality, health status and diabetic complications in patients with type 2 diabetes and comorbid obesity.

OBJECTIVE: Patients with type 2 diabetes (T2DM) demonstrate low dietary adherence and this is further aggravated with comorbid obesity. The aim of the present study was to assess diet quality in patients with T2DM and comorbid obesity compared to patients with T2DM alone and to examine the associations between comorbidities and diet quality. METHODS: The sample consisted of 59 adult patients with diabesity (T2DM and comorbid obesity) and 94 patients with T2DM alone. All diabetes comorbidities and complications were recorded and diet quality was assessed with the Healthy Eating Index (HEI). RESULTS: Mean raw HEI of the diabese subjects was 81.9±7.1 and the diabetic subjects was 80.2±6.9. When HEI was adjusted to the sex, age and weight status, the diabese demonstrated a higher HEI. Among comorbidities, only renal disease decreased HEI. According to the principal component analysis of the total sample, adequate diet quality was explained by cardiovascular disease, cigarette smoking, alcohol consumption, peptic ulcer, sex, diabesity and diabetic foot syndrome. In the diabese, adequate HEI was explained by diabetic foot syndrome, smoking, drinking alcohol and having a family history of diabetes. CONCLUSIONS: Adult patients with T2DM demonstrate adequate diet quality. Different factors are associated with the adoption of a high quality diet between the diabese and the T2DM alone.

Assessing the silent epidemic of malnutrition in Palestinian preschool children.

BACKGROUND: The nutritional status of children living under conflict is an important issue. The aim of the present study is to review all available data on malnutrition in preschool Palestinian children and provide objective results concerning the epidemic of malnutrition. METHODS: The literature for all research on the prevalence of malnutrition on Palestinian children with data collected during the period 1998-2007 was reviewed. Der Simonian-Laird Random effects model for meta-analysis was applied and cumulative analyses were performed to determine time-trends for each outcome measure (iron deficiency anemia [IDA], wasting, underweight and stunting). FINDINGS: The results showed that 39.5% of the children suffered from IDA, 2.9% from wasting, 4.7% were underweight and 10.9% stunted. The cumulative analyses showed a peak in the prevalence of IDA during 1999, followed by an irregular decrease afterward. The proportion of wasted and underweight children peaked during 2002 and 2004, respectively, both showing a gradual decline afterward. Chronic malnutrition appears to be almost similar during the decade 1998-2007, by demonstrating small, irregular oscillations. CONCLUSIONS: Although the prevalence of malnutrition among Palestinian preschool children has been improved during the studied period, it still remains high. Additionally, the results show that interventions/aid have acute effects on the health of children. FUNDING: None.

Nutrition transition and health status of Cretan women: evidence from two generations.

OBJECTIVE: Research has suggested the abandonment of the traditional Mediterranean diet (MD) by youngsters for a more Westernized regime. The present study aimed (i) to delineate differences in the consumption of traditional Cretan dishes and key nutrients in the MD between two contiguous generations of women and (ii) define how these dietary changes contribute to the morbidity of the younger generation. DESIGN: Cross-sectional. SETTING: The island of Crete, Greece. SUBJECTS: Eighty pairs of mothers and daughters, all living in their own households, were recruited from Crete. Information regarding the consumption of traditional Cretan dishes and two previous-day recalls were collected. The health status of the participants was also recorded. Simple correspondence analysis (SCA) was used to assess associations between differences in the food intake of daughters compared with their mothers and the prevalence of disease. RESULTS: The younger women showed increased intakes of rusks and meat dishes and decreased consumption of green vegetables, pulses and wine compared with their mothers. When nutrients were accounted for, only sugar consumption of the younger women surpassed the intake reported by their mothers. SCA associated hypercholesterolaemia in the daughters with increased cheese and meat intakes; allergies and respiratory problems were associated with lower cheese, fish and oil intakes; being overweight was associated with higher baked goods, oils, desserts, fish and alcohol intakes; and Fe-deficiency anaemia was associated with lower consumption of green vegetables. CONCLUSIONS: Results showed that, although a trend towards a more Westernized diet was noted in the younger women, the differences between the two generations appear to be small. Therefore, in Crete, the MD is still the primary diet regime.

Healthy Eating Index during pregnancy according to pre-gravid and gravid weight status.

OBJECTIVE: To assess differences in the Healthy Eating Index (HEI) during pregnancy with the pre-gravid and gravid weight status of women. DESIGN: Cross-sectional. SETTING: Athens, Greece. SUBJECTS: One hundred pregnant women, inhabitants of Athens. RESULTS: The mean raw HEI score of the sample was 66·9 (sd 7·6) and the mean HEI adjusted for energy intake was 66·9 (sd 0·6). No difference was recorded between the adjusted HEI and different gravidities, the embryo's sex, different income categories or education. When HEI was categorised as low, average and adequate, living in an urban residence increased the odds for demonstrating low HEI score (OR = 10·231, 95 % CI 1·300, 80·487). HEI score during pregnancy was significantly higher in participants who were either pre-gravidly underweight or of normal body weight (BW). In relation to the gestational weight status, the highest HEI scores and protein intake were shown in the underweight and of normal BW participants compared with the obese. According to the simple correspondence analysis, adequate HEI was associated with rural residence and being underweight or having normal BW during pregnancy. Low HEI was associated with overweight and obesity during pregnancy, with obesity before pregnancy and living in an urban environment. HEI was negatively correlated to the pre-conceptional and gestational BMI (r = -0·298, P ≤ 0·003 and r = -0·345, P ≤ 0·001) and to the week of gestation (r = -0·285, P ≤ 0·004). CONCLUSIONS: Overall, the HEI of the sample was mediocre. Women who were underweight or of normal BW exhibited a better diet quality compared with obese women; thus the latter consist a population in greater need for supervised nutrition and dietary counselling during pregnancy.

Diet, feeding practices, and anthropometry of children and adolescents with cerebral palsy and their siblings.

OBJECTIVE: We investigated growth and nutrition in children and adolescents with cerebral palsy (CP) in comparison with their healthy siblings. METHODS: This was a case-control, single observational investigation of 16 pairs of children with CP and their healthy siblings. Stature, weight, skinfolds, and selected circumferences were measured, and Z-scores, percentage of body fat (calipers), and body mass index were calculated. Diet and feeding practices were recorded for 3 d. RESULTS: No differences were observed in the macronutrient distribution of energy intake, with participants with CP covering 75% of their energy requirements. Subjects with CP demonstrated low vitamin A, biotin, folate, vitamin K, and copper intakes. The healthy siblings inadequately consumed vitamin E and both groups followed diets low in zinc. Iron was marginal for the CP group, but calcium was consumed adequately by all. The participants with CP demonstrated lower body weight, body mass index, percentage of body fat, weight-for-age Z-score, and triceps skinfold (P

Comparing diet composition and growth of children living in two limitary Greek islands (Samos and Corfu).

OBJECTIVE: The study aimed to assess differences in dietary intake and growth of pre-schoolers and schoolchildren living in two limitary Greek islands; Samos, situated on the eastern border, and Corfu, situated on the western border. DESIGN: Cross-sectional two-site study. METHODS: A total of 248 children aged 3-12 years from the two islands participated in the survey. Body weight and height were recorded and Z-scores were calculated. A 3 d food record was collected for each child, computer-analysed and compared with the Recommended Daily Allowances (RDA). Intakes < or =70 % of the RDA were considered inadequate. RESULTS: The prevalence of overweight in participants from Samos and Corfu was 10.7 % and 6.5 % respectively, according to the Centers for Disease Control and Prevention growth charts. In Corfu, the diet comprised 52 % carbohydrate, 34 % fat and 14 % protein, all different from the composition of the Samian diet (42 % carbohydrate, 39 % fat, 19 % protein; P < or = 0.05). Inadequacies in micronutrient intake were evident only in the diet of Samos and concerned folate and P of the pre-schoolers and biotin of the school-aged participants. The diet in Corfu was more similar to the overall Mediterranean pattern as well as that of Italian children. Growth and overweight trends in Corfu resembled the ones in Italy, whereas in Samos, similarities were identified with trends from Turkey. CONCLUSIONS: Border areas at a distance from the mainland exhibit different dietary intakes compared with rest of the country; thus when designing nutrition surveys the setting should also include such limitary areas.