Antonis Zampelas - Academia.edu (original) (raw)

Papers by Antonis Zampelas

Children

Adding extra sugars in milk and the moderating effect of sleep has yet to be investigated, settin... more Adding extra sugars in milk and the moderating effect of sleep has yet to be investigated, setting the aim of this study. A total of 1361 school-aged children were included, aged 10–12 years old, by randomly sampling schools. Data were interview-obtained by trained personnel using a validated 17-item food frequency questionnaire, with specifics on type of milk and extra sugar additions. Analyses were stratified by average recommended hours of sleep. Predictive probability margins were obtained following necessary adjustments. Mean BMI was significantly lower, the level of SSB intake was higher, and the prevalence of adding sugars to milk four or more times per week was higher in children that slept ≥10 h. Most children (64%) consumed full fat milk, 21% had low fat, and 19.7% chocolate milk, with a significantly larger proportion of overweight or obese children consuming full fat or chocolate milk, also adding extra sugars four or more times per week (4.1% compared to 9.6%, and 12.2%...

Children

The coronavirus (COVID-19) pandemic and the measures taken by most countries to curb virus transm... more The coronavirus (COVID-19) pandemic and the measures taken by most countries to curb virus transmission, such as social distancing, distance learning, population, home confinement and disruption of all organized activities, has affected children and adolescents worldwide. The aim of this review was to assess the role of diet and lifestyle changes due to COVID-19 measures on body weight/composition and cardiometabolic risk factors in children and adolescents. An electronic search was conducted in PUBMED, COCHRANE, Google Scholar and SCOPUS databases up to 31 October 2021. 15 eligible studies were identified. According to the studies included in the analysis, COVID-19 measures seem to have had a negative impact on the diets and lifestyles of children and adolescents, with a consequent increase in body weight and central fat accumulation. On the other hand, the parental presence and control resulted in better glycaemic control in children with diabetes mellitus (DM) Type 1, but the eff...

Nutrients

Childhood overweight and obesity prevalence has risen dramatically in the past decades, and famil... more Childhood overweight and obesity prevalence has risen dramatically in the past decades, and family-based interventions may be an effective method to improve children’s eating behaviors. This study aimed to evaluate the effectiveness of three different family-based interventions: group-based, individual-based, or by website approach. Parents and school aged overweight or obese children, 8–12 years of age, were eligible for the study. A total of 115 children were randomly allocated in one of the three interventions, and 91 completed the study (79% compliance); Group 1 (n = 36) received group-based interventions by various experts; Group 2 (n = 30) had interpersonal family meetings with a dietitian; and Group 3 (n = 25) received training through a specifically developed website. Anthropometric, dietary, physical activity, and screen time outcomes were measured at baseline and at the end of the study. Within-group comparisons indicated significant improvement in body weight, body mass i...

All drinks hydrate and most also provide nutrients and energy. Our objective was to evaluate the ... more All drinks hydrate and most also provide nutrients and energy. Our objective was to evaluate the contribution of drinks to total energy intake in summer and winter. Data were obtained using the Water Balance Questionnaire (WBQ) from a sample of the general population in Athens, Greece (n = 984), 473 individuals (42 ± 18 years) in summer and 511 individuals (38 ± 20 years) in winter stratified by sex and age. The WBQ embeds a semi-quantitative food frequency questionnaire of 58 foods and the Short International Physical Activity Questionnaire. Data were analyzed for the contribution of drinks to total energy intake. In winter, total energy intake was 2082 ± 892 kcal/day; energy intake from drinks was 479 ± 286 kcal/day and energy expenditure 1860 ± 390 kcal/day. In summer, total energy intake was 1890 ± 894 kcal/day, energy intake from drinks 492 ± 499 kcal/day and energy expenditure 1830 ± 491 kcal/day. Energy intake from drinks in summer was higher than in winter (p < 0.001) and in men higher than in women in both seasons (p < 0.001 in summer, p = 0.02 in winter). Coffee, coffee drinks, milk, chocolate milk and alcoholic drinks contributed approximately 75% of energy from drinks. Fruit juice and sugar-sweetened drinks, including soft drinks and fruit juice based drinks, were consumed less frequently contributing up to 25% of drink energy intake. Drinks contribute approximately 1/4 of total energy intake depending on the energy content of the drink and frequency of consumption. Coffee, dairy and alcoholic drinks were the main energy contributors.

Nutrients, 2021

The aim of the Nutrients Special Issue “Implications of Nutrition Education, for Health, Behavior... more The aim of the Nutrients Special Issue “Implications of Nutrition Education, for Health, Behavior, and Lifestyle” is to publish original research articles and reviews that report the design and implementation of nutrition education intervention programs and their effectiveness in terms of lifestyle, health, and wellbeing [...]

Risk factors established at young ages may set the stage for later cardiovascular disease (CVD). ... more Risk factors established at young ages may set the stage for later cardiovascular disease (CVD). Elevated total homocysteine (tHcy) in blood is an emerging risk factor for CVD, yet few studies have been conducted in children, especially in the Mediterranean. We described plasma tHcy concentrations in a group of healthy Greek children and examined its relation with physiologic, metabolic, and genetic variables. Fasting blood samples were collected from 186 students, 11.6 0.4 years old, and tHcy, folate, vitamin B-12, and routine biochemistry variables in plasma were measured. The methylenetetrahydrolate reductase (MTHFR) C677T genotype was determined and anthropometric and dietary data were obtained. The distribution of tHcy was positively skewed with a median of 7.9 mol/L (mean: 8.2 2.3 mol/L; range: 4.4–22.2 mol/L). tHcy was inversely related to plasma folate (r 0.34, P 0.0001), vitamin B-12 (r 0.20, P 0.008), and glucose (r 0.15, P 0.045). An interaction between the MTHFR genotype...

Submitted by Eιρήνη Κοτσίκου (eirhnhkot@ekt.gr) on 2016-04-20T10:52:03Z No. of bitstreams: 1 Abst... more Submitted by Eιρήνη Κοτσίκου (eirhnhkot@ekt.gr) on 2016-04-20T10:52:03Z No. of bitstreams: 1 Abstract Farajian_ICOfinal_0.pdf: 59351 bytes, checksum: 90a7afb55099a19d8358658315a5f3e1 (MD5)

Nutrients, 2021

Consumption of unbranded olive oil obtained in bulk has previously been reported to be very high ... more Consumption of unbranded olive oil obtained in bulk has previously been reported to be very high in Greece, underlining the need to investigate knowledge regarding its health attributes and storage practices, two areas that can affect oil quality. This study aimed to investigate Greek consumers’ use and choice of olive oil, their knowledge about its quality, as well as domestic storage practices of olive oil. A cross-sectional survey was conducted in a representative sample of 857 Greek households that consume olive oil, using a previously validated questionnaire. Most participating households use olive oil produced by themselves or by their extended family or friends (60.3%), and only 27.4% purchase branded olive oil, while 57% reported using extra virgin olive oil (EVOO). Only 38.4% of the respondents reported optimal domestic storage practices to maintain olive oil quality, with a significant greater percentage of non-producers group compared to olive oil producers. In all areas ...

Journal of Human Nutrition and Dietetics, 2021

BACKGROUND The present study aimed to assess micronutrient intake among Greek adults and to ident... more BACKGROUND The present study aimed to assess micronutrient intake among Greek adults and to identify the main food sources that contribute to it. METHODS Food consumption data from 2389 participants in the Hellenic National Nutrition and Health Survey (HNNHS), collected with 24-h recalls, was used to calculate micronutrient intakes. Usual nutrient intake was estimated according to the National Cancer Institute method. Nutrient adequacy was estimated using the estimated average requirement (EAR) cut-point method, when available, or adequate intake otherwise. The probability approach was used to determine iron intake adequacy in females of reproductive age. Food group contribution for each nutrient assessed was derived to identify their main food sources. RESULTS Almost all individuals had vitamin D intake below EAR, whereas vitamins A, E, K and C, as well as potassium intake, were also insufficient in a considerable percentage of the population (>70% in most age groups). Calcium intake was substantially below the EAR for females aged >50 years and males >70 years; the same for magnesium in males >70 years. Furthermore, 50% of females, including those of reproductive age, had intake of folate below EAR. More than 50% of the population (to 79%) exceeded the upper tolerable limit for sodium (2300 mg day-1 ). Food contribution analysis revealed that most vitamins were derived from low-quality foods (i.e. fast-food). CONCLUSIONS A significant proportion of adults residing in Greece have low nutrient intake and poor food selections. These results provide guidance to public health policy makers for developing strategies to improve the dietary quality in Greece.

Children, 2021

Sugar intake has been associated with increased prevalence of childhood overweight/obesity; howev... more Sugar intake has been associated with increased prevalence of childhood overweight/obesity; however, results remain controversial. The aim of this study was to examine the probability of overweight/obesity with higher sugar intakes, accounting for other dietary intakes. Data from 1165 children and adolescents aged ≥2–18 years (66.8% males) enrolled in the Hellenic National Nutrition and Health Survey (HNNHS) were used; specifically, 781 children aged 2–11 years and 384 adolescents 12–18 years. Total and added sugar intake were assessed using two 24 h recalls (24 hR). Foods were categorized into specific food groups to evaluate the main foods contributing to intakes. A significant proportion of children (18.7%) and adolescents (24.5%) exceeded the recommended cut-off of 10% of total energy intake from added sugars. Sweets (29.8%) and processed/refined grains and cereals (19.1%) were the main sources of added sugars in both age groups, while in adolescents, the third main contributor ...

Nature, 2020

High blood cholesterol is typically considered a feature of wealthy western countries1,2. However... more High blood cholesterol is typically considered a feature of wealthy western countries1,2. However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world3 and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health4,5. However, the trends of HDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low- and middle-income countries, especially in east and southeast Asia, an...

Nutrients, 2021

Gravieras are ‘gruyere’ type hard cheeses with a variety of different products and the second hig... more Gravieras are ‘gruyere’ type hard cheeses with a variety of different products and the second highest consumption in Greece. In this study, we present a dietary intake assessment and a nutritional characterization of pre-packed graviera products sold in the Greek market using Nutri-Score Front of Pack Label (FoPL). The nutrient contents of 92 pre-packed graviera products were combined with daily individual consumption data extracted from the Hellenic National Nutrition Health Survey (n = 93), attempting to evaluate the contribution of graviera’s consumption to the Greek diet. The analysis of nutrients’ intake as a Reference Intake (RI) percentage ranked saturated fat first on the nutrients’ intake list, with RI percentage ranging from 36.1 to 109.2% for the 95th percentile of consumption. The respective % RI for energy, total fat, carbohydrates, sugars, proteins and salt ranged from 12.7–20.7%, 21.6–50.4%, 0–3.1%, 0–6.1%, 37–57.1% and 6.3–42%. Nutri-Score classified 1% of the produc...

eLife, 2021

From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesit... more From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory ...

Nutrients, 2020

Background: Food propensity questionnaires (FPQs) are means of dietary assessment in nutritional ... more Background: Food propensity questionnaires (FPQs) are means of dietary assessment in nutritional epidemiology, which provide valuable information for long term intakes and food group consumption. These tools, however, may be subjected to misreporting and need to be validated against standard quantitative methods. Aim: The aim of this study was to examine the validity of the qualitative FPQ developed to assess the dietary habits of the general population in Greece during the Hellenic National Nutrition and Health Survey (HNNHS) and to assess the population’s intake of specific food groups in relation to guidelines. Methods: Validation analysis was based on 3796 [1543 men (42.82%) and 2253 women (57.18%)] participants of the HNNHS in relation to two interviewer-administered 24 h recalls (24 hR). Participants were asked to report the frequency of their dietary intake, using the FPQ provided. Correlations and significance between methods were assessed via Spearman correlation and a Two-...

The Lancet, 2020

Background Comparable global data on health and nutrition of school-aged children and adolescents... more Background Comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents. Methods For this pooled analysis, we used a database of cardiometabolic risk factors collated by the Non-Communicable Disease Risk Factor Collaboration. We applied a Bayesian hierarchical model to estimate trends from 1985 to 2019 in mean height and mean BMI in 1-year age groups for ages 5-19 years. The model allowed for non-linear changes over time in mean height and mean BMI and for non-linear changes with age of children and adolescents, including periods of rapid growth during adolescence. Findings We pooled data from 2181 population-based studies, with measurements of height and weight in 65 million participants in 200 countries and territories. In 2019, we estimated a difference of 20 cm or higher in mean height of 19-year-old adolescents between countries with the tallest populations (the

Nutrients, 2020

Hypertension is a major risk of cardiovascular diseases. This study’s aim was to examine associat... more Hypertension is a major risk of cardiovascular diseases. This study’s aim was to examine associations between hypertension and a priori known lifestyle risk factors, including weight status and Mediterranean diet adherence. The study included a representative sample of the adult population (N = 3775 (40.8% males)), from the Hellenic National Nutrition and Health Survey (HNNHS), which took place from September 2013 to May 2015. Demographic and anthropometric data were collected using validated questionnaires, and blood pressure (BP) measurements were performed for the two main metropolitan areas (N = 1040; 41.1%). Hypertension diagnosis was according to the International Classification of Diseases (ICD-10) guidelines. Weighted proportions, extended Mantel–Haenszel (M–H) analyses, and multiple logistic regressions (for the survey data) were performed. Mean systolic BP (SBP) and diastolic BP (DBP) were 118.6 mmHg and 72.2 mmHg respectively, with both values being higher in males compar...

Public Health Nutrition, 2020

Objective:To assess the usual dietary intake of twenty micronutrients and to identify their food ... more Objective:To assess the usual dietary intake of twenty micronutrients and to identify their food sources in a representative sample of Greek children and adolescents.Design:Cross-sectional data from the Hellenic National Nutrition and Health Survey (HNNHS). Vitamin and mineral intakes were estimated from two 24 h dietary recalls by sex and age groups. Estimates were calculated using the National Research Council method and the statistical software package Stata13 to account for within- and between-person variations. The prevalence of nutrients’ inadequacy among sample was estimated using the estimated average requirement (EAR) cut-point method. The contribution of food groups to nutrient intake was estimated to identify micronutrients food sources.Setting:Greece.Participants:Children and adolescents aged 1–19 years (n 577) who provided sufficient and plausible 24-h recalls.Results:A substantial percentage of children and adolescents had insufficient intakes of numerous micronutrient...

Foods, 2020

Feta cheese, a protected designation of origin (PDO) food, is one of the most important Mediterra... more Feta cheese, a protected designation of origin (PDO) food, is one of the most important Mediterranean food products. Although it is the cheese with the highest consumption in Greece, the nutritional characteristics of products available in the market, as well as their contribution to the Greek diet, have not been evaluated in detail. In the present study, the basic nutritional content of 81 prepacked feta cheese products available in the Greek market were recorded based on their labels. This was combined with consumption data to provide an overall picture of feta cheese’s contribution to the Greek diet. The nutrient contents per 100 g ranged as follows. Energy: 221–343 kcal, total fat: 20–29 g, saturated fat: 12.8–20.3 g, carbohydrates: 0–3.1 g, sugars: 0–3 g, proteins: 13.1–21.0 g and salt: 1.2–5.1 g. The median feta daily individual consumption was found to be 39 g, ranging from 20 g to 100 g (fifth and 95th percentiles, respectively). The nutritional intake analysis as a percenta...

Hellenic Journal of Cardiology, 2019

This is a PDF file of an article that has undergone enhancements after acceptance, such as the ad... more This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

Nutrition Today, 2019

Background: Many studies derive dietary information from child self-reported Food Frequency Quest... more Background: Many studies derive dietary information from child self-reported Food Frequency Questionnaires (FFQs). This may be subjected to misreporting, especially among overweight and obese children. Aim: The aim of this study was to examine the validity of data acquired from child-reported dietary intake using a semiquantitative FFQ developed for assessing dietary habits of overweight and obese children in Greece, using parental 3-day food records of child intakes. Methods: Validation analysis was based on 106 (from total 115) children (41% boys and 59% girls). Children were asked to report the frequency of their dietary intake, using the FFQ provided. Parents were asked to keep a 3-day food record for their children's intake. Correlations and significance between methods were assessed via Spearman correlation coefficient and Wilcoxon nonparametric pairwise comparisons, respectively. Agreement between the FFQ and the 3-day record was performed using Bland-Altman method. Results: Significant correlations, ranging from 0.32 to 1 (all P G .05), were observed between food consumption reported in the FFQ and recorded in the 3-day dietary record. High correlation was found for fruits (Q = 0.988), vegetables (Q = 0.985), dairy (Q = 0.702), meat (Q = 0.958), fish (Q = 0.841), starchy foods (Q = 0.793), sweets (Q = 1), and beverages (Q = 0.978). Medium correlation was observed only between the consumption of legumes (Q = 0.329). No significant differences were found between reported FFQ and 3-day dietary record for most food groups and beverages examined. Mean intake agreement was ranged from 90.6% to 98.1% (Bland-Altman). Conclusions: The FFQ used appears to be a valid tool for investigating dietary intake of food among overweight and obese children. Nutr Today. 2019;54(4):151Y158

Children

Adding extra sugars in milk and the moderating effect of sleep has yet to be investigated, settin... more Adding extra sugars in milk and the moderating effect of sleep has yet to be investigated, setting the aim of this study. A total of 1361 school-aged children were included, aged 10–12 years old, by randomly sampling schools. Data were interview-obtained by trained personnel using a validated 17-item food frequency questionnaire, with specifics on type of milk and extra sugar additions. Analyses were stratified by average recommended hours of sleep. Predictive probability margins were obtained following necessary adjustments. Mean BMI was significantly lower, the level of SSB intake was higher, and the prevalence of adding sugars to milk four or more times per week was higher in children that slept ≥10 h. Most children (64%) consumed full fat milk, 21% had low fat, and 19.7% chocolate milk, with a significantly larger proportion of overweight or obese children consuming full fat or chocolate milk, also adding extra sugars four or more times per week (4.1% compared to 9.6%, and 12.2%...

Children

The coronavirus (COVID-19) pandemic and the measures taken by most countries to curb virus transm... more The coronavirus (COVID-19) pandemic and the measures taken by most countries to curb virus transmission, such as social distancing, distance learning, population, home confinement and disruption of all organized activities, has affected children and adolescents worldwide. The aim of this review was to assess the role of diet and lifestyle changes due to COVID-19 measures on body weight/composition and cardiometabolic risk factors in children and adolescents. An electronic search was conducted in PUBMED, COCHRANE, Google Scholar and SCOPUS databases up to 31 October 2021. 15 eligible studies were identified. According to the studies included in the analysis, COVID-19 measures seem to have had a negative impact on the diets and lifestyles of children and adolescents, with a consequent increase in body weight and central fat accumulation. On the other hand, the parental presence and control resulted in better glycaemic control in children with diabetes mellitus (DM) Type 1, but the eff...

Nutrients

Childhood overweight and obesity prevalence has risen dramatically in the past decades, and famil... more Childhood overweight and obesity prevalence has risen dramatically in the past decades, and family-based interventions may be an effective method to improve children’s eating behaviors. This study aimed to evaluate the effectiveness of three different family-based interventions: group-based, individual-based, or by website approach. Parents and school aged overweight or obese children, 8–12 years of age, were eligible for the study. A total of 115 children were randomly allocated in one of the three interventions, and 91 completed the study (79% compliance); Group 1 (n = 36) received group-based interventions by various experts; Group 2 (n = 30) had interpersonal family meetings with a dietitian; and Group 3 (n = 25) received training through a specifically developed website. Anthropometric, dietary, physical activity, and screen time outcomes were measured at baseline and at the end of the study. Within-group comparisons indicated significant improvement in body weight, body mass i...

All drinks hydrate and most also provide nutrients and energy. Our objective was to evaluate the ... more All drinks hydrate and most also provide nutrients and energy. Our objective was to evaluate the contribution of drinks to total energy intake in summer and winter. Data were obtained using the Water Balance Questionnaire (WBQ) from a sample of the general population in Athens, Greece (n = 984), 473 individuals (42 ± 18 years) in summer and 511 individuals (38 ± 20 years) in winter stratified by sex and age. The WBQ embeds a semi-quantitative food frequency questionnaire of 58 foods and the Short International Physical Activity Questionnaire. Data were analyzed for the contribution of drinks to total energy intake. In winter, total energy intake was 2082 ± 892 kcal/day; energy intake from drinks was 479 ± 286 kcal/day and energy expenditure 1860 ± 390 kcal/day. In summer, total energy intake was 1890 ± 894 kcal/day, energy intake from drinks 492 ± 499 kcal/day and energy expenditure 1830 ± 491 kcal/day. Energy intake from drinks in summer was higher than in winter (p < 0.001) and in men higher than in women in both seasons (p < 0.001 in summer, p = 0.02 in winter). Coffee, coffee drinks, milk, chocolate milk and alcoholic drinks contributed approximately 75% of energy from drinks. Fruit juice and sugar-sweetened drinks, including soft drinks and fruit juice based drinks, were consumed less frequently contributing up to 25% of drink energy intake. Drinks contribute approximately 1/4 of total energy intake depending on the energy content of the drink and frequency of consumption. Coffee, dairy and alcoholic drinks were the main energy contributors.

Nutrients, 2021

The aim of the Nutrients Special Issue “Implications of Nutrition Education, for Health, Behavior... more The aim of the Nutrients Special Issue “Implications of Nutrition Education, for Health, Behavior, and Lifestyle” is to publish original research articles and reviews that report the design and implementation of nutrition education intervention programs and their effectiveness in terms of lifestyle, health, and wellbeing [...]

Risk factors established at young ages may set the stage for later cardiovascular disease (CVD). ... more Risk factors established at young ages may set the stage for later cardiovascular disease (CVD). Elevated total homocysteine (tHcy) in blood is an emerging risk factor for CVD, yet few studies have been conducted in children, especially in the Mediterranean. We described plasma tHcy concentrations in a group of healthy Greek children and examined its relation with physiologic, metabolic, and genetic variables. Fasting blood samples were collected from 186 students, 11.6 0.4 years old, and tHcy, folate, vitamin B-12, and routine biochemistry variables in plasma were measured. The methylenetetrahydrolate reductase (MTHFR) C677T genotype was determined and anthropometric and dietary data were obtained. The distribution of tHcy was positively skewed with a median of 7.9 mol/L (mean: 8.2 2.3 mol/L; range: 4.4–22.2 mol/L). tHcy was inversely related to plasma folate (r 0.34, P 0.0001), vitamin B-12 (r 0.20, P 0.008), and glucose (r 0.15, P 0.045). An interaction between the MTHFR genotype...

Submitted by Eιρήνη Κοτσίκου (eirhnhkot@ekt.gr) on 2016-04-20T10:52:03Z No. of bitstreams: 1 Abst... more Submitted by Eιρήνη Κοτσίκου (eirhnhkot@ekt.gr) on 2016-04-20T10:52:03Z No. of bitstreams: 1 Abstract Farajian_ICOfinal_0.pdf: 59351 bytes, checksum: 90a7afb55099a19d8358658315a5f3e1 (MD5)

Nutrients, 2021

Consumption of unbranded olive oil obtained in bulk has previously been reported to be very high ... more Consumption of unbranded olive oil obtained in bulk has previously been reported to be very high in Greece, underlining the need to investigate knowledge regarding its health attributes and storage practices, two areas that can affect oil quality. This study aimed to investigate Greek consumers’ use and choice of olive oil, their knowledge about its quality, as well as domestic storage practices of olive oil. A cross-sectional survey was conducted in a representative sample of 857 Greek households that consume olive oil, using a previously validated questionnaire. Most participating households use olive oil produced by themselves or by their extended family or friends (60.3%), and only 27.4% purchase branded olive oil, while 57% reported using extra virgin olive oil (EVOO). Only 38.4% of the respondents reported optimal domestic storage practices to maintain olive oil quality, with a significant greater percentage of non-producers group compared to olive oil producers. In all areas ...

Journal of Human Nutrition and Dietetics, 2021

BACKGROUND The present study aimed to assess micronutrient intake among Greek adults and to ident... more BACKGROUND The present study aimed to assess micronutrient intake among Greek adults and to identify the main food sources that contribute to it. METHODS Food consumption data from 2389 participants in the Hellenic National Nutrition and Health Survey (HNNHS), collected with 24-h recalls, was used to calculate micronutrient intakes. Usual nutrient intake was estimated according to the National Cancer Institute method. Nutrient adequacy was estimated using the estimated average requirement (EAR) cut-point method, when available, or adequate intake otherwise. The probability approach was used to determine iron intake adequacy in females of reproductive age. Food group contribution for each nutrient assessed was derived to identify their main food sources. RESULTS Almost all individuals had vitamin D intake below EAR, whereas vitamins A, E, K and C, as well as potassium intake, were also insufficient in a considerable percentage of the population (>70% in most age groups). Calcium intake was substantially below the EAR for females aged >50 years and males >70 years; the same for magnesium in males >70 years. Furthermore, 50% of females, including those of reproductive age, had intake of folate below EAR. More than 50% of the population (to 79%) exceeded the upper tolerable limit for sodium (2300 mg day-1 ). Food contribution analysis revealed that most vitamins were derived from low-quality foods (i.e. fast-food). CONCLUSIONS A significant proportion of adults residing in Greece have low nutrient intake and poor food selections. These results provide guidance to public health policy makers for developing strategies to improve the dietary quality in Greece.

Children, 2021

Sugar intake has been associated with increased prevalence of childhood overweight/obesity; howev... more Sugar intake has been associated with increased prevalence of childhood overweight/obesity; however, results remain controversial. The aim of this study was to examine the probability of overweight/obesity with higher sugar intakes, accounting for other dietary intakes. Data from 1165 children and adolescents aged ≥2–18 years (66.8% males) enrolled in the Hellenic National Nutrition and Health Survey (HNNHS) were used; specifically, 781 children aged 2–11 years and 384 adolescents 12–18 years. Total and added sugar intake were assessed using two 24 h recalls (24 hR). Foods were categorized into specific food groups to evaluate the main foods contributing to intakes. A significant proportion of children (18.7%) and adolescents (24.5%) exceeded the recommended cut-off of 10% of total energy intake from added sugars. Sweets (29.8%) and processed/refined grains and cereals (19.1%) were the main sources of added sugars in both age groups, while in adolescents, the third main contributor ...

Nature, 2020

High blood cholesterol is typically considered a feature of wealthy western countries1,2. However... more High blood cholesterol is typically considered a feature of wealthy western countries1,2. However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world3 and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health4,5. However, the trends of HDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low- and middle-income countries, especially in east and southeast Asia, an...

Nutrients, 2021

Gravieras are ‘gruyere’ type hard cheeses with a variety of different products and the second hig... more Gravieras are ‘gruyere’ type hard cheeses with a variety of different products and the second highest consumption in Greece. In this study, we present a dietary intake assessment and a nutritional characterization of pre-packed graviera products sold in the Greek market using Nutri-Score Front of Pack Label (FoPL). The nutrient contents of 92 pre-packed graviera products were combined with daily individual consumption data extracted from the Hellenic National Nutrition Health Survey (n = 93), attempting to evaluate the contribution of graviera’s consumption to the Greek diet. The analysis of nutrients’ intake as a Reference Intake (RI) percentage ranked saturated fat first on the nutrients’ intake list, with RI percentage ranging from 36.1 to 109.2% for the 95th percentile of consumption. The respective % RI for energy, total fat, carbohydrates, sugars, proteins and salt ranged from 12.7–20.7%, 21.6–50.4%, 0–3.1%, 0–6.1%, 37–57.1% and 6.3–42%. Nutri-Score classified 1% of the produc...

eLife, 2021

From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesit... more From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory ...

Nutrients, 2020

Background: Food propensity questionnaires (FPQs) are means of dietary assessment in nutritional ... more Background: Food propensity questionnaires (FPQs) are means of dietary assessment in nutritional epidemiology, which provide valuable information for long term intakes and food group consumption. These tools, however, may be subjected to misreporting and need to be validated against standard quantitative methods. Aim: The aim of this study was to examine the validity of the qualitative FPQ developed to assess the dietary habits of the general population in Greece during the Hellenic National Nutrition and Health Survey (HNNHS) and to assess the population’s intake of specific food groups in relation to guidelines. Methods: Validation analysis was based on 3796 [1543 men (42.82%) and 2253 women (57.18%)] participants of the HNNHS in relation to two interviewer-administered 24 h recalls (24 hR). Participants were asked to report the frequency of their dietary intake, using the FPQ provided. Correlations and significance between methods were assessed via Spearman correlation and a Two-...

The Lancet, 2020

Background Comparable global data on health and nutrition of school-aged children and adolescents... more Background Comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents. Methods For this pooled analysis, we used a database of cardiometabolic risk factors collated by the Non-Communicable Disease Risk Factor Collaboration. We applied a Bayesian hierarchical model to estimate trends from 1985 to 2019 in mean height and mean BMI in 1-year age groups for ages 5-19 years. The model allowed for non-linear changes over time in mean height and mean BMI and for non-linear changes with age of children and adolescents, including periods of rapid growth during adolescence. Findings We pooled data from 2181 population-based studies, with measurements of height and weight in 65 million participants in 200 countries and territories. In 2019, we estimated a difference of 20 cm or higher in mean height of 19-year-old adolescents between countries with the tallest populations (the

Nutrients, 2020

Hypertension is a major risk of cardiovascular diseases. This study’s aim was to examine associat... more Hypertension is a major risk of cardiovascular diseases. This study’s aim was to examine associations between hypertension and a priori known lifestyle risk factors, including weight status and Mediterranean diet adherence. The study included a representative sample of the adult population (N = 3775 (40.8% males)), from the Hellenic National Nutrition and Health Survey (HNNHS), which took place from September 2013 to May 2015. Demographic and anthropometric data were collected using validated questionnaires, and blood pressure (BP) measurements were performed for the two main metropolitan areas (N = 1040; 41.1%). Hypertension diagnosis was according to the International Classification of Diseases (ICD-10) guidelines. Weighted proportions, extended Mantel–Haenszel (M–H) analyses, and multiple logistic regressions (for the survey data) were performed. Mean systolic BP (SBP) and diastolic BP (DBP) were 118.6 mmHg and 72.2 mmHg respectively, with both values being higher in males compar...

Public Health Nutrition, 2020

Objective:To assess the usual dietary intake of twenty micronutrients and to identify their food ... more Objective:To assess the usual dietary intake of twenty micronutrients and to identify their food sources in a representative sample of Greek children and adolescents.Design:Cross-sectional data from the Hellenic National Nutrition and Health Survey (HNNHS). Vitamin and mineral intakes were estimated from two 24 h dietary recalls by sex and age groups. Estimates were calculated using the National Research Council method and the statistical software package Stata13 to account for within- and between-person variations. The prevalence of nutrients’ inadequacy among sample was estimated using the estimated average requirement (EAR) cut-point method. The contribution of food groups to nutrient intake was estimated to identify micronutrients food sources.Setting:Greece.Participants:Children and adolescents aged 1–19 years (n 577) who provided sufficient and plausible 24-h recalls.Results:A substantial percentage of children and adolescents had insufficient intakes of numerous micronutrient...

Foods, 2020

Feta cheese, a protected designation of origin (PDO) food, is one of the most important Mediterra... more Feta cheese, a protected designation of origin (PDO) food, is one of the most important Mediterranean food products. Although it is the cheese with the highest consumption in Greece, the nutritional characteristics of products available in the market, as well as their contribution to the Greek diet, have not been evaluated in detail. In the present study, the basic nutritional content of 81 prepacked feta cheese products available in the Greek market were recorded based on their labels. This was combined with consumption data to provide an overall picture of feta cheese’s contribution to the Greek diet. The nutrient contents per 100 g ranged as follows. Energy: 221–343 kcal, total fat: 20–29 g, saturated fat: 12.8–20.3 g, carbohydrates: 0–3.1 g, sugars: 0–3 g, proteins: 13.1–21.0 g and salt: 1.2–5.1 g. The median feta daily individual consumption was found to be 39 g, ranging from 20 g to 100 g (fifth and 95th percentiles, respectively). The nutritional intake analysis as a percenta...

Hellenic Journal of Cardiology, 2019

This is a PDF file of an article that has undergone enhancements after acceptance, such as the ad... more This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

Nutrition Today, 2019

Background: Many studies derive dietary information from child self-reported Food Frequency Quest... more Background: Many studies derive dietary information from child self-reported Food Frequency Questionnaires (FFQs). This may be subjected to misreporting, especially among overweight and obese children. Aim: The aim of this study was to examine the validity of data acquired from child-reported dietary intake using a semiquantitative FFQ developed for assessing dietary habits of overweight and obese children in Greece, using parental 3-day food records of child intakes. Methods: Validation analysis was based on 106 (from total 115) children (41% boys and 59% girls). Children were asked to report the frequency of their dietary intake, using the FFQ provided. Parents were asked to keep a 3-day food record for their children's intake. Correlations and significance between methods were assessed via Spearman correlation coefficient and Wilcoxon nonparametric pairwise comparisons, respectively. Agreement between the FFQ and the 3-day record was performed using Bland-Altman method. Results: Significant correlations, ranging from 0.32 to 1 (all P G .05), were observed between food consumption reported in the FFQ and recorded in the 3-day dietary record. High correlation was found for fruits (Q = 0.988), vegetables (Q = 0.985), dairy (Q = 0.702), meat (Q = 0.958), fish (Q = 0.841), starchy foods (Q = 0.793), sweets (Q = 1), and beverages (Q = 0.978). Medium correlation was observed only between the consumption of legumes (Q = 0.329). No significant differences were found between reported FFQ and 3-day dietary record for most food groups and beverages examined. Mean intake agreement was ranged from 90.6% to 98.1% (Bland-Altman). Conclusions: The FFQ used appears to be a valid tool for investigating dietary intake of food among overweight and obese children. Nutr Today. 2019;54(4):151Y158