Georgia Kourlaba

Dietary quality indices and human health: A review

Indices are composite tools aiming to measure and quantify a variety of clinical conditions, behaviors, attitudes and beliefs that are difficult to be measured quantitatively and accurately. In this review, the methodology used to develop dietary indices and their relationship with health determinants and outcomes is discussed. In brief, the already proposed indices are adequate tools concerning the evaluation of diet quality, but they have shown moderate predictive ability in relation to chronic diseases and health determinants. The aforementioned weaknesses could be attributed to: inappropriate selection of the components (i.e., number or content of dietary information), selection of small number of cut-off points for each component and/or equal contribution of all index items to the calculation of the total score. Nevertheless, dietary indices are important tools to evaluate not only the diet quality, but also the relationship between dietary habits and several health outcomes.

Factors associated with television viewing time in toddlers and preschoolers in Greece: the GENESIS study

BACKGROUND The aim of this work was to describe the television (TV) viewing time of preschoolers and to examine factors that may be associated with it. METHODS A representative sample of 2374 Greek children aged 1-5 years was examined (GENESIS study). Several anthropometric, socio-demographic and lifestyle characteristics were recorded. RESULTS The mean value of childrens TV viewing time was 1.32 h/day. Twenty six percent of participants spent > or =2 h/day in TV viewing. The percentage of children whose TV viewing time was longer than 2 h/day was higher in children aged 3-5 years (32.2%) than in those aged 1-2 years (11.1%). Multiple logistic regression revealed that the time parents spent viewing TV and the region of residence were significantly associated with childs TV viewing time among children aged 3-5 years. Among children aged 1-2 years, the maternal educational status, the region of residence and the maternal TV viewing time were found to be related to childs TV viewing time. CONCLUSIONS The current findings suggest that almost one third of Greek preschoolers exceed the limit of 2 h/day TV viewing and that parental TV viewing time may be the most important determinant of childrens TV viewing time.

Effect of Cementless Acetabular Component Orientation, Position, and Containment in Total Hip Arthroplasty for Congenital Hip Disease

We evaluated the effect of the inclination angle, position, and containment of 53 cementless cups inserted in patients with congenital hip disease (CHD), after a minimum of 10 years of follow-up. The polyethylene wear rate was significantly greater when the cup was placed in more than 45° inclination (P=.045) or if the cup was placed lateral to the teardrop position by more than 25 mm (P=.001). Aseptic loosening of the femoral component was significantly greater when the cup was placed more than 25 mm superiorly to the teardrop (P=.049). Cup placement of more than 25 mm lateral to the teardrop affected significantly periacetabular osteolysis (P=.032). In CHD cases, it is preferable to avoid excessive vertical inclination, lateral, and superior placement of cementless cups in an attempt to obtain better containment.

Treatment of alcohol dependence with low-dose topiramate: an open-label controlled study

BackgroundGABAergic anticonvulsants have been recommended for the treatment of alcohol dependence and the prevention of relapse. Several studies have demonstrated topiramates efficacy in improving drinking behaviour and maintaining abstinence. The objective of the present open-label controlled study was to assess efficacy and tolerability of low-dose topiramate as adjunctive treatment in alcohol dependence during the immediate post-detoxification period and during a 16-week follow-up period after alcohol withdrawal.MethodsFollowing a 7-10 day inpatient alcohol detoxification protocol, 90 patients were assigned to receive either topiramate (up to 75 mg per day) in addition to psychotherapeutic treatment (n = 30) or psychotherapy alone (n = 60). Symptoms of depression and anxiety, as well as craving, were monitored for 4-6 weeks immediately following detoxification on an inpatient basis. Thereafter, both groups were followed as outpatients at a weekly basis for another 4 months in order to monitor their course and abstinence from alcohol.ResultsA marked improvement in depressive (p < 0.01), anxiety (p < 0.01), and obsessive-compulsive drinking symptoms (p < 0.01) was observed over the consecutive assessments in both study groups. However, individuals on topiramate fared better than controls (p < 0.01) during inpatient treatment. Moreover, during the 4-month follow up period, relapse rate was lower among patients who received topiramate (66.7%) compared to those who received no adjunctive treatment (85.5%), (p = 0.043). Time to relapse in the topiramate augmentation group was significantly longer compared to the control group (log rank test, p = 0.008). Thus, median duration of abstinence was 4 weeks for the non-medicated group whereas it reached 10 weeks for the topiramate group. No serious side effects of topiramate were recorded throughout the study.ConclusionsLow-dose topiramate as an adjunct to psychotherapeutic treatment is well tolerated and effective in reducing alcohol craving, as well as symptoms of depression and anxiety, present during the early phase of alcohol withdrawal. Furthermore, topiramate considerably helps to abstain from drinking during the first 16-week post-detoxification period.

The J-shape association of alcohol consumption on blood pressure levels, in elderly people from Mediterranean Islands (MEDIS epidemiological study).

The J-shape association of alcohol consumption on blood pressure levels, in elderly people from Mediterranean Islands (MEDIS epidemiological study)

Development of a diet index for older adults and its relation to cardiovascular disease risk factors: the Elderly Dietary Index.

OBJECTIVE To develop an index that assesses the degree of adherence to nutritional recommendations for older adults (Elderly Dietary Index [EDI]) and investigate its association with risk factors related to cardiovascular disease (CVD). METHODS The EDI was constructed using 10 components (ie, questions about the consumption frequency of meat, fish, fruits, vegetables, grains, legumes, olive oil, and alcohol as well as the type of bread and dairy products) according to the Modified MyPyramid for Older Adults and select features of the traditional Mediterranean diet. Scores from 1 to 4 were assigned to all components of the index. The EDI total score had a range between 10 and 40. As a validation procedure, a sample of 668 elderly individuals without known CVD (the MEDIS Study) was used to evaluate the associations between the proposed index and various health outcomes. RESULTS The overall mean EDI score was 29.2+/-3.5. This score implies that study participants were 73% (ie, 29.2/40) adherent to the nutritional recommendations that the EDI evaluates. Regarding the conventional CVD risk factors, it was found that a 1 unit increase in the EDI score is associated with almost 10% lower odds of being obese or hypertensive or having at least one of the investigated CVD risk factors (P<0.001) after controlling for potential confounders. CONCLUSIONS The suggested EDI may be a useful tool for public health policymakers and other health care professionals to assess diet quality and health status (especially concerning the risk for developing CVD) in older adults.

Associations of several anthropometric indices with insulin resistance in children: The Children Study.

Aim: To compare the associations of several anthropometric indices (i.e. waist circumference [WC], waist‐to‐height ratio, body mass index (BMI) and waist‐to‐hip ratio) with the insulin resistance (IR) proxy measures in Greek schoolchildren.

Development of a diet–lifestyle quality index for young children and its relation to obesity: the Preschoolers Diet–Lifestyle Index

OBJECTIVE To develop an index that assesses the degree of adherence to existing diet-lifestyle recommendations for preschoolers (Preschoolers Diet-Lifestyle Index (PDL-Index)) and to investigate its association with obesity. DESIGN The PDL-Index was constructed using eleven components (i.e. questions regarding the frequency of consumption of selected foods/food groups, time spent on television watching and on moderate-to-vigorous physical activities). SETTING Scores from 0 to 4 were assigned to all components of the index. The PDL-Index total score ranged from 0 to 44. Higher values of the PDL-Index indicate greater adherence to dietary and lifestyle recommendations for preschoolers or otherwise greater adherence to healthier dietary-lifestyle patterns. SUBJECTS As a validation procedure, a sample of 2287 preschoolers from Greece (GENESIS study) was used. RESULTS The participants following healthier diet-lifestyle patterns (third tertile of PDL-Index) were less likely to be obese or overweight/obese compared to those following unhealthy diet-lifestyle patterns (first tertile of PDL-Index). It was observed that a 1/44 unit increase in the score of the PDL-Index was associated with approximately 5 % and 3 % lower odds of being obese and overweight/obese, respectively. Statistically significant results were observed after adjusting for potential confounders. CONCLUSIONS The suggested PDL-Index could help public health policy makers in identifying vulnerable population subgroups and developing cost-effective, targeted intervention actions both in family and preschool settings. In addition, health-care professionals can use the PDL-Index to evaluate diet quality, lifestyle and risk for overweight/obesity at an individual level and counsel parents accordingly.

Comparison of two methods for identifying dietary patterns associated with obesity in preschool children: the GENESIS study

Background/Objectives:The aim of this work was to identify dietary patterns based on reduced rank regression (RRR) and principal component analysis (PCA) and to evaluate the association of these patterns with the prevalence of childhood obesity.Subjects/Methods:A sample of 2317 toddlers and preschoolers from Greece (Growth, Exercise and Nutrition Epidemiological Study In preSchoolers) was used. In total, 12 food groups were used as predictors of RRR and PCA. Nutrients such as total fat, simple carbohydrate and fiber intake were used as response variables to apply RRR.Results:One factor/pattern was retained from RRR and PCA in order to ensure the comparability of the methods. The pattern derived from PCA was mainly characterized by consumption of fruits, vegetables, legumes, fish and seafood, grains and oils. This pattern explained 12.5% of the total variation in food groups. On the other hand, the pattern extracted from RRR was mainly characterized by reduced consumption of fruits, vegetables and legumes, and by increased consumption of sweets and red meat. The pattern derived from RRR explained 8.2% of the total variation in food groups. Simple and multiple logistic regression revealed that the pattern extracted from RRR is significantly associated with the prevalence of childhood obesity (OR=1.11, 95% CI: 1.00–1.28 for each unit increase of dietary pattern) as opposed to the pattern derived from PCA.Conclusions:The preferable technique to derive dietary patterns related to childhood obesity seems to be RRR compared with PCA.

Assessing children's diet quality in Crete based on Healthy Eating Index: the Children Study.

Background:This study aimed to assess childrens diet quality in Crete and the potential role of several socio-demographic factors related to it.Methods:Between October 2005 and March 2006, 481 primary school children were recruited from Crete. Dietary intake data was obtained using a combination of techniques comprising a 24 h recall and 3 food diaries. The Healthy Eating Index (HEI) was calculated summing the individual scores (0–10) assigned to 10 index components.Results:The majority of participants (84.5%) had diet that ‘needs improvement’ (HEI score: 51–80). Twelve percent of participants had ‘poor diet’ and only 3.5% of schoolchildren had ‘good diet’ (HEI score >80). The overall mean of the HEI score was 60.5. The mean values of the HEI components score ranged between 2.8 (that is, the HEI component that measures vegetables intake) and 9.9 (that is, component that expresses the variety of consumed foods). Low mean values were found in the total fat and saturated fat components (3.7 and 3.4, respectively). Moreover, the HEI score was strongly associated with dietary macronutrients and micronutrients intake.Conclusion:On the basis of the HEI score, the vast majority of children were found to have a diet that ‘needs improvement’. This indicates the increased necessity of drawing and implementing nutrition education programs targeting both children and their families and aiming to increase vegetables and fruits intake and reduce fat intake.