Introduction: Schizophrenic patients are more likely to develop metabolic syndrome (MetS) than the general population. Although the exact reasons for higher MetS prevalence are not yet been fully determined, poor dietary habits may contribute to its development. This study aims to examine the effects of a 3-month nutrition intervention on dietary habits and weight change in hospitalized schizophrenic patients with MetS.

Materials and Methods: Seventy-nine hospitalized schizophrenic patients with MetS (aged 18–67) were enrolled in a 3-month randomized controlled trial. Sixty-seven of initially enrolled patients (84.8%) completed the intervention. Participants were randomly assigned to an intervention group (IG; n = 33) or a control group (CG; n = 34). The IG followed the DASH diet (-400 kcal/day when compared to regular hospital diet), the CG continued being on a regular hospital diet (2200–2400 kcal/day), while both groups participated in a nutrition educational program (4 lectures about the development of healthier eating habits). Prior and after the intervention, body weight (BW) was measured and dietary habits were assessed using the nutrition section of Dlugosch & Krieger's General Health Behaviour Questionnaire. Participants also kept a diary of food individually purchased.

Results: Nutrition intervention positively modulated the dietary habits and BW of both groups. After 3 months, in the IG, the consumption of white bread (p < 0.001), pastries (p < 0.001), cured meat products (p < 0.001), sweets (p = 0.003), and carbonated soft drinks (p = 0.009) significantly decreased, while the consumption of whole-wheat bread (p < 0.001), fruits (p < 0.001), nuts (p < 0.001), and vegetables (p < 0.001) significantly increased, when compared to the baseline data. Simultaneously, in the CG, the identified modifications mainly referred to a decreased consumption of snacks (p = 0.042) and fast food (p = 0.005), together with an increased consumption of low-fat milk and dairy products (p = 0.019) and vegetables (p = 0.003). Furthermore, results have shown that, compared to the CG, IG significantly improved dietary habits by decreasing the consumption frequency of white bread (p < 0.001), cured meat products (p < 0.001), and sweets (p = 0.043), while at the same time significantly increasing the consumption frequency of whole-wheat bread (p < 0.001), low-fat milk and dairy products (p < 0.001), fruits (p < 0.001), nuts (p < 0.001), and vegetables (p < 0.001). After 3 months, BW significantly decreased in IG (p < 0.001) and CG (p = 0.018), but with no significant difference between respective groups (p = 0.943).

Discussion: The findings suggest that this type of a 3-month nutrition intervention could be a valuable tool for an improvement of dietary habits and potentially an add-on therapy to reduce the MetS prevalence and the overall cardiovascular risk in schizophrenic patients.

The associations between grains and carbohydrate intake and type 2 diabetes mellitus are controversial. This study aimed to evaluate the relationship between grains, carbohydrate intakes and the risk of type 2 diabetes mellitus in China.

This was a 1:2 (sex/age) matched case-control study, participants were adults. Cases were diabetics diagnosed within 3 months and the controls were without disorder of glucose metabolism. Face-to-face interviews were conducted to collect information on their socio-demographic characteristics, lifestyle factors, and dietary intakes using structured questionnaires. Grains were divided into whole, refined and common grain, and the carbohydrate intake was also calculated. The study participants were divided into quartiles (Q1 (lowest), Q2, Q3, and Q4) by food and nutrients intakes separately. Multivariable conditional logistic regression was used to explore the association of foods and nutrients with type 2 diabetes mellitus after adjusting for potential confounders. Trend test were performed by treating quartiles variables as continuous variables.

Our study enrolled 384 type 2 diabetes mellitus patients (males 162, females 222) and 768 controls (males 324, females 444). Multivariable conditional logistic regression analysis(Ver. 21.0; PSS Inc.,Chicago,IL,USA) showed that moderate amount intake of total cereals was inversely associated with type 2 diabetes mellitus. The adjusted OR of the second quartile (Q2, 223g/d) and the third quartile (Q3, 255g/d) were 0.60(95%CI:0.38–0.93) and 0.51(95%CI:0.33–0.79), respectively, compared with the lowest quartile (Q1, 165g/d), but this inverse association was not found in the highest quartile (Q4, 307g/d) and the OR was 0.74(95%CI:0.47–1.15). There was significant negative association between whole grains intake and type 2 diabetes mellitus with the OR of the highest intake 0.48(95%CI:0.31–0.77) compared with the lowest intake(Ptrend = 0.001).No association was found between refined grains intake intake and type 2 diabetes mellitus, and neither did common grain intake. Higher carbohydrate intake may have a beneficial effect on type 2 diabetes mellitus. The best effect was found in the second quartile intake (Q2, 264g/d), with an adjusted OR of 0.56 (95%CI:0.37–0.84) compared with the lowest quartile intake (Q1, 220g/d).The OR of Q3 (285g/d) and Q4 (334g/d) were 0.69 (95%CI:0.48–1.00) and 0.66 (95CI:0.44–1.00) respectively(Ptrend p = 0.017).

Moderate amount of total cereals intake may benefit to type 2 diabetes mellitus, however, much lower and higher intake can increase the risk. Higher intake of whole grains was associated with a lower risk of type 2 diabetes mellitus. Carbohydrate intake was negative associated with type 2 diabetes mellitus.

According to diabetes care standards nutrition therapy should be an integral part of diabetes management, and all individuals with diabetes should be referred to a registered dietitian for nutrition therapy at—or soon after—diagnosis and for ongoing follow-up. There is limited international data that indicate that a large percentage of people with diabetes have not received structured diabetes education and have not visited a dietitian. The aim of this study was to assess the involvement of dietitians in diabetes care in Greece.

All adult diabetic patients admitted to a secondary care general hospital in Greece during 30 consecutive days were included in the study. Patients admitted in the ICU, CICU, day clinics and hemodialysis patients were excluded. Data were obtained by personal interviews using a 40 item questionnaire which included 10 questions regarding number of visits to dietitians for diabetes management, whether patients were referred by their doctors or sought dietary advice by their own, reasons for visiting a dietitian, goal achievement and patient satisfaction.

In total 124 patients (68 males and 56 females) with diabetes were admitted to the hospital during the study period (4 type 1, 114 type 2 and 6 pregnancy diabetes). Data were obtained from 3 (22.8 ± 6 yrs, 26.1 ± 5.7kg/m2,8.3 ± 5.9 yrs with diabetes),105 (76.6 ± 11.3 yrs, 28.0 ± 5.3 kg/m2, 12.8 ± 9.3 yrs with diabetes), and 5 (32.6 ± 4.4 yrs, 28.5 ± 4.0 kg/m2) patients with type 1, type 2 and pregnancy diabetes respectively. Two out of 3 type 1 diabetes and 1 out of 5 patients with pregnancy diabetes interviewed reported to have been referred to a dietitian by their doctor. Only 5.7% (6 patients) of type 2 diabetes patients reported to have been referred to a dietitian by their doctor and another 5.7% have visited a dietitian on their own initiative. Five out of 6 referrals were at diabetes diagnosis. The number of encounters with a dietitian ranged from 1 to 24 with patients seeking to loose weight having the greater number of encounters. Of type 2 diabetes patients 94.3% did not receive lifestyle advice before commencing diabetes medication whereas 25% did not receive any dietary advice by any health professional even after starting medication.

In our cohort the majority of diabetes patients had not received dietary counseling by a dietitian, whereas about one fourth of type 2 diabetes patients had not received any dietary advice.

Globally, over 1.97 billion adults and 338 million children and adolescents are living with overweight and obesity, increasing the risk of numerous co-morbidities, including at least 12 cancers(1). WCRF/AICR conducted a literature review of diet and physical activity as determinants of weight gain, overweight and obesity in adults and children. We also introduce a novel evidence-based policy framework for promoting physical activity, and linked database, currently in development as part of the EU-funded CO-CREATE project on child and adolescent obesity prevention.

Evidence on diet and physical activity as determinants and risk of weight gain, overweight and obesity was systematically extracted from existing reviews and a systematic search for recent meta-analyses, then collated and analysed. The WCRF Continuous Update Project Expert Panel drew conclusions about which exposures influence risk of weight gain, overweight and obesity, using pre-defined criteria that included evidence of biological plausibility.

The Panel identified strong evidence that several diet and physical activity related exposures influence the risk of weight gain, overweight and obesity in adults and children (see table 1). Separate conclusions were drawn for adults and children in relation to screen time, considered a marker of sedentary time.

However, the Panel noted that as exposures tend to cluster, physiologically interact and share common biological mechanisms, they should not be regarded as absolutely ‘singular'but an integrated concept of interrelated exposures within a pattern of lifestyle. Table 1.

Risk of weight gain, overweight and obesity

For full list of footnotes, see Energy Balance and Body Fatness report(1).

Healthy dietary patterns help prevent excess weight gain. Achieving such patterns requires attention to the broader economic, environmental and social factors that influence and constrain people's behaviour. The findings of this report support the need for evidence-based public health policy to help create health-enabling environments, particularly for children and adolescents. The WCRF International MOVING framework(2) presents a package of policies to promote physical activity, which alongside wider public health policy can help address the multiple drivers of overweight and obesity.

We monitored fluid intake in children. The hydration of children during morning school classes and on consumption of high-calorie drinks. Subclinical dehydration, expressed as urine osmolarity above 800 mmol / kg, may result in lack of concentration and less effective listening.

The population included 3,360 children aged as follows: a) 6–35 months, b) 4–6 years, c) 7–10 years d) 11–14 years. 103 children aged 10.3 ± 1 years were included in the study regarding body hydration. The evaluation looked at the intake of food and fluids consumed by children in full-day diet over a period of 3 to 5 days and recorded by the Nutridan program. Child hydration was assessed using three urine osmolarity samples taken at bedtime, in the morning and just before lunch break. The data was evaluated statistically against the reference values for nutrient intake of DACH.

The median water intake in children was 101–103% of the Dietary Reference Values (DRV). In the b, c, d groups, the median was 81% - 82%, i.e 75% of DRV. 10% of 4 to 6-year-old children had water intake below 49% of DRV, 10% of 7 to 10 year-olds less than 54% of DRV and 10% of 11 to 14-year-olds less than 50% of DRV. A study regarding school children has showed that only 70% of the children drink at breakfast. 27% of the children do not consume any fluids in the morning. The mean urine osmolarity was 724 in the morning and 738 mmol / kg just before lunch. Children who had drunk less than 250 ml of water during breakfast or less than 400 ml of water during breakfast and second breakfast had a urine osmolarity of 910 and 850 mmol / kg respectively just before lunch. In school children, the proportion of sugars received from sweetened beverages accounted for 19.1% of their total calorie intake. 10% of the children in groups c) and d) had this value higher than 28.2 and 30.4% respectively. The results based on full-day diet show that sweetened drinks account for 79% of fluids consumed by children at school, whereas only for 72% at home.

The results of our studies have identified the areas where it is necessary to provide education regarding nutrition of children, to raise awareness of the importance of fluid intake, particularly focusing on the systematic approach and the choice of appropriate beverages ensuring adequate fluid intake.

Over the life course, transitions such as parenthood are described in sociological studies as periods of change in attitudes and health practices. The presence of children has been shown to modify adult dietary practices and daily timing of eating occasions, and that the arrival of a child in the household is perceived by parents to be related to changes in their dietary behaviors. Nevertheless, no epidemiological study has evaluated the impact by a longitudinal approach. The objective of our study was to assess the effect of the birth of a first child in a household on dietary intake and weight of adults over a 7-year follow-up period.

This study was conducted in 3955 adults included in the NutriNet-Santé cohort study between 2009 and 2010. At baseline and every year, dietary intakes were assessed using 24 h records. In this sample, 185 individuals experienced the birth of a first child in their household during the 7 years of follow-up. Changes in weight, assessed by self-administered questionnaire each year, were analyzed only in women (n = 115). Repeated measures of dietary intake and weight were analysed using mixed models adjusted for sex, age, education level and energy with random effects of time and period (before and after birth of the child) to assess changes following the life event.

The birth of a first child in the household was associated with a decrease in the score of adherence to French recommendations (PNNS score, β [95% CI] = -0.45 [-0.74; -0.16]), in intakes of fruits and vegetables, meat and processed meat, and vitamin C (respectively, β = -0.30 [-0.43; -0.17]); β = -0.20 [-0.32; -0.17]); β = -0.54 [0.88; -0.19])). The birth of a first child in the household was also associated with an increase in intakes of saturated fatty acids and sodium (respectively, β = 1.49 [0.51, 2.45]); β = 0.31 [0.20; 0.43])). The birth of a first child was associated with weight gain in women (β = 1.70 [1.07, 2.33]).

Our study has shown that the birth of a first child in the household was associated with rather unhealthy dietary changes. These results could be used to guide public health interventions by focusing on this specific life transition.

zinc is an essential micro-nutrient for growth and proper immune function. Yet there are limited data available on the prevalence of zinc deficiency among children aged 3–5 at the country level. This information will enable health planners to determine the need for zinc intervention activities and to stimulate further research into these areas.

The data on children aged 3–5 were extracted from the Chinese National Nutrition and Health Surveillance in 2013. By multi-stage stratified cluster randomly sampling method, 30 children aged 3–5 years old were selected from each region for this study from 55 counties in China to analyze serum zinc. Finally, 1472 children aged 3–5 years were included in the study. The concentration of serum zinc was determined by high resolution inductively coupled plasm mass spectrometry. High and low level quality control samples were used, measured value was (1.63 ± 0.04)mg/l and (2.80 ± 0.06)mg/l, respectively. CV of quality control samples were 1.69%~2.45%. The zinc deficiency was defined as serum zinc level < 70μg/dl with the standard of WHO.

serum zinc means of children aged 3–5 years was (95.3 ± 18.2)μg/dl and 3.9% children with zinc deficiency. serum zinc means level in urban children was (98.9 ± 17.6)μg/dl, and (91.6 ± 18.2)μg/dl in rural area. we showed that the serum zinc deficiency rate was higher in rural children (5.5%) than urban children (2.4%), and there were significant differences between these two areas. serum zinc means level in boys aged 3–5 years was (95.3 ± 18.7)μg/dl, and (95.3 ± 17.8)μg/dl in girls aged 3–5 years old. The prevalence of zinc deficiency was 1.5%, 6.6% and 1.8% in 3~,4~,5~ years old urban boys, respectively; 6.8%, 7.7% and 4.0% in rural boys, respectively. The prevalence of zinc deficiency was 2.3%, 0.8% and 1.7% in 3~,4~,5~ years old urban girls, respectively; 4.1%, 7.0% and 4.0% in rural girls, respectively. And there were differences between urban and rural areas in girls of 4~.5 years.

The zinc level of children aged 3–5 years in China has been improved compared with ten years ago, but the zinc deficiency of rural children is still lower than that of urban children, especially those aged 4 to 5 years in rural areas, so we should pay more attention to this group.

Inadequate sleep, excessive screen-use and low-levels of physical activity may lead to an increased risk of childhood obesity. Caregivers during early childhood should limit screen-time, encourage active play and establish bedtime routines to ensure adequate sleep. The benefits of such may also extend to improved attention, learning, memory, psycho-social development and other factors. There is limited data on such lifestyle behaviours in infants and children in the U.S. Therefore, this analysis describes findings from the Feeding Infants and Toddlers Study (FITS) 2016.

FITS 2016 is a national, cross-sectional survey of caregivers of children aged 0–3.9 y in the U.S. Demographic data and information on feeding practices, sleep, physical activity and screen-use were collected using a questionnaire (n = 4380). Differences in behaviours across age groups were assessed using a one-way ANOVA or chi-squared tests.

Children older than 12 months slept for an average of 9.6 (sd = 2.0) hours per night, which was significantly higher than infants (0–11.9mo) who slept for 8.9 (sd = 2.1) hours per night (P < 0.001). All children slept for approximately one hour during the day. There were no significant difference in the weekly hours spent in active play (mean = 20.8,sd = 16.5) between younger and older children, while participation in sports was higher among older versus younger children. However, time spent playing video games, watching TV videos/DVDs and using a screen was significantly higher in older versus younger children (P < 0.001). For example, infants spent 7.8 hours per week watching TV, compared to 9.4 hours in 3 year old children (P < 0.001). Approximately 65% of caregivers reported that they did not allow electronics in the bedroom, however this decreased with increasing age (P = 0.036). Consequently, 5% of infants (0–11.9mo) viewed a tablet or smartphone in their bedroom, compared to 26% of 3 year old children (P < 0.001).

Recent guidelines from the American Academy for Pediatrics (AAP) recommend that children younger than 18 months avoid use of screen media, and that children aged 2–5 should limit screen-time to one hour per day. This data from the US FITS suggests that children are exceeding these recommendations. However, the current population are meeting the AAP physical activity recommendation of minimum 60 minutes/day. Furthermore, infants and children in this population are also failing to meet the AAP sleep recommendations. Therefore, further emphasis needs to be placed on the importance of limiting screen-time and promoting physical activity and positive sleep behaviours in this young population.

Food intake behavior is implicated in many chronic health issues, including obesity. Thus, understanding the underlying factors that affect food intake is important. Several studies have associated sleep restriction to increased dietary intake and poor food choices, which can be driven by hedonic mechanisms, specially food palatability. Given that people eat for different reasons other than stress, including boredom, anxiety, sadness or joy, our aim was to study the potential association between sleep quality and the cognitive-behavioral nature of food intake (eating behaviors, EB), as well as their impact on body mass index in a population of young adults.

One thousand twenty eight young adults (78% females; 21.4 ± 4.1years) were included in a cross-sectional study. The following questionnaires were used: Pittsburg Sleep Quality Index to assess sleep quality (scores > 5 indicate poor sleep quality), the Three Factor Eating Questionnaire to assess the three dimensions of EB (emotional, uncontrolled and restraint eating) (Higher scores indicate higher EB). Additionally, height, weight, body mass index (BMI) and the level of physical activity were evaluated. Statistical analysis were performed using SPSS v24, and adjusted for confounding variables.

Sixty one percent of the studied population had a poor sleep quality, whereas no significant associations were found between poor sleep quality, gender or age. Poor sleep quality was associated with uncontrolled (p < 0.001) and emotional (p < 0.001) eating, as well as with BMI (p < 0.001). In addition, emotional eating was associated to BMI (p < 0.001). Finally, linear regression model showed that BMI is associated with poor sleep quality (p < 0.01) and emotional eating (p < 0.001).

Our findings suggest that poor sleep quality is frequent among young adults. Furthermore, poor sleep quality is associated with higher emotional and uncontrolled eating, showing that poor sleep might be associated with a higher tendency to over eat when coping to emotionally negative emotions (sadness, anger, depression, anxiety), and a high tendency to lose control over food intake itself. Finally, the association between poor sleep quality and high emotional eating can have a negative impact over BMI, even in young adults. Hence, interventions designed to improve weight status would benefit from focusing on sleep quality in order to reduce emotional and uncontrolled eating.

Understanding health behaviors, such as sleep and dietary patterns, is important for health promotion and disease prevention. College period is a complicated, difficult time to maintain healthy behaviors. In this regard, little is known about the impact of sleep and diet quality on well-being among college young adults. Hence, we aimed to study the impact of sleep and diet quality on well-being in college students.

Three hundred-twelve Mexican college students (82% females; 20.6 ± 3.4years) were included in a cross-sectional study. Participants completed the following validated questionnaires: Well-being Index to assess well-being (high scores indicate high well-being), Pittsburg Sleep Quality Index for sleep quality (scores > 5 indicate poor sleep quality), and a validate version of the Health Eating Index for Mexican population to assess diet quality (scores > 80 indicate good diet quality). BMI and physical activity were also assessed. Scores were treated as continuous variables, and statistical analysis were performed using SPSS v24 and adjusted for confounding variables.

Sixty-seven percent of our population showed a poor sleep quality and eighty-four percent needs to make changes in their diet in order to improve its quality. On the other hand, fifty-one percent of the studied population had a low well-being perception. Poor sleep quality (p < 0.001) and low diet quality (p < 0.001) associated with a lower well-being perception. In addition, poor sleep quality is associated with low diet quality (p < 0.05). Regarding food consumption, higher sweets (p < 0.001) and soft-drink (p < 0.001) intake was inversely associated with well-being scores. Likewise, high consumption of sweets (p < 0.05) and soft-drink (p < 0.05), and low fruit (p < 0.05) and cereal (p < 0.05) consumption are linked to poor sleep quality.

Our results show that half of the studied population had a low well-being, and also that poor sleep and diet quality are frequent among college students. Interestingly, the fact that poor sleep and diet quality were associated to a lower perception of well-being highlights the importance of promoting sleep hygiene and diet quality among college students as an important strategy to improve well-being and health, even in young adults. In addition, we found that higher sweets and soft-drink consumption were associated to both low well-being perception and poor sleep quality. Hence, it is important to promote healthy habits regarding eating and sleeping well, in order to improve well-being perception among college students.

339 mother and child pairs were followed up from the ROLO Kids study in the National Maternity Hospital, Dublin, Ireland. Height and weight of the mother and the child were measured, and BMI was calculated. Demographic details were collected and questionnaires asked mothers to assign their child to a weight category and to give the reason they put their child in this particular category. KAPPA analysis and student t tests were used to analyse the data.

In this cohort over 75% of the children were normal weight, 14.7% were in the overweight category, and 8.5% in the obese category. The KAPPA score for maternal-perceived category and actual weight status was 0.037 which is a low level of agreement. Mothers were more likely to underestimate their child's weight, with 28.5% underestimating the appropriate weight category for their child compared with 2.4% who overestimated. Maternal age, education, and child sex did not influence accurate weight assessments; however, mothers with a higher BMI were more likely to inaccurately assess their child's weight (P < 0.05).

Maternal perception of their child's weight status is not an accurate indication of child weight, particularly for mothers with a raised BMI. This research highlights the important role of health care providers in assessing child weight status, rather than relying on parental reports alone, in order to appropriately intervene to reduce the incidence of childhood obesity.

We studied term participants (n = 265) of the DONALD Study, with a bilateral sonographic measurement of the IMT in young adulthood (18–40 years) and data on early life factors (maternal and paternal age at child birth, birth weight (including appropriateness of birth weight- for gestational age), gestational weight gain and full breastfeeding (breastfeeding > 17weeks). Sonographic IMT measurements were performed on the left and right common carotid artery using a minimum of 4 measurements. Mean IMT values were obtained averaging the measurements from both sides, an overall average obtained from 8 and 16 measurement of both sides was used for this analysis. Information on gestation and birth were abstracted from the “Mutterpass”, maternal and paternal age at birth were inquired at study entry and breastfeeding information was assessed prospectively. Prospective association between early life factors and IMT were analyzed using multivariable linear regression models, considering age at IMT measurement, physician taking the measurement, in addition: birth year, first born status, maternal and paternal educational status, maternal overweight, presence of smokers in the household tested for potential confounding.

Mean adult IMT was 0.56mm ± 0.03, range: 0.41mm-0.78 mm. Maternal age at child birth was of prospective relevance for IMT in young adulthood, however, this association was sex specific: Increased maternal age at child birth was independently associated with an increased IMT among female offspring during young adulthood (β 0.029, SE 0.009) mm/decade, P = 0.003) only, this was not mediated by adult waist circumference. None of the remaining early life factors showed relevance for adult IMT levels among males and females in early adulthood.

This study suggests that advanced maternal age at child birth is of prospective relevance for IMT levels in younger adulthood in a healthy Western population. This association appears to be sex specific, with maternal age at child birth positively associated with IMT in females in early adulthood only.