Ibrahim Elmadfa
University of Vienna
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Annals of Nutrition and Metabolism | 2005
Agneta Yngve; Alexandra Wolf; Eric Poortvliet; Ibrahim Elmadfa; Johannes Brug; Bettina Ehrenblad; Bela Franchini; Jóhanna Haraldsdóttir; Rikke Krølner; Lea Maes; Carmen Pérez-Rodrigo; Michael Sjöström; Inga Thorsdottir; Knut-Inge Klepp
Background/Aims: An adequate fruit and vegetable intake provides essential nutrients and nutritive compounds and is considered an important part of a healthy lifestyle. No simple instrument has been available for the assessment of fruit and vegetable intake as well as its determinants in school-aged children applicable in different European countries. Within the Pro Children Project, such an instrument has been developed. This paper describes the cross-sectional survey in 11-year-olds in 9 countries. Methods: The cross-sectional survey used nationally, and in 2 countries regionally, representative samples of schools and classes. The questionnaires, including a precoded 24-hour recall component and a food frequency part, were completed in the classroom. Data were treated using common syntax files for portion sizes and for merging of vegetable types into four subgroups. Results: The results show that the fruit and vegetable intake in amounts and choice were highly diverse in the 9 participating countries. Vegetable intake was in general lower than fruit intake, boys consumed less fruit and vegetables than girls did. The highest total intake according to the 24-hour recall was found in Austria and Portugal, the lowest in Spain and Iceland. Conclusion: The fruit and vegetable intake in 11-year-old children was in all countries far from reaching population goals and food-based dietary guidelines on national and international levels.
British Journal of Nutrition | 2004
Janet Lambert; Carlo Agostoni; Ibrahim Elmadfa; Karin Hulshof; Edburga Krause; Barbara Livingstone; Piotr Socha; Daphne Pannemans; Sonia Samartín
The objective of this project was to collect and evaluate data on nutrient intake and status across Europe and to ascertain whether any trends could be identified. Surveys of dietary intake and status were collected from across Europe by literature search and personal contact with country experts. Surveys that satisfied a defined set of criteria -- published, based on individual intakes, post-1987, adequate information provided to enable its quality to be assessed, small age bands, data for sexes separated above 12 years, sample size over 25 and subjects representative of the population -- were selected for further analysis. In a small number of cases, where no other data for a country were available or where status data were given, exceptions were made. Seventy-nine surveys from 23 countries were included, and from them data on energy, protein, fats, carbohydrates, alcohol, vitamins, minerals and trace elements were collected and tabulated. Data on energy, protein, total fat and carbohydrate were given in a large number of surveys, but information was very limited for some micronutrients. No surveys gave information on fluid intake and insufficient gave data on food patterns to be of value to this project. A variety of collection methods were used, there was no consistency in the ages of children surveyed or the age cut-off points, but most surveys gave data for males and females separately at all ages. Just under half of the surveys were nationally representative and most of the remainder were regional. Only a small number of local surveys could be included. Apart from anthropometric measurements, status data were collected in only seven countries. Males had higher energy intakes than females, energy intake increased with age but levelled off in adolescent girls. Intakes of other nutrients generally related to energy intakes. Some north-south geographical trends were noted in fat and carbohydrate intakes, but these were not apparent for other nutrients. Some other trends between countries were noted, but there were also wide variations within countries. A number of validation studies have shown that misreporting is a major problem in dietary surveys of children and adolescents and so all the dietary data collected for this project should be interpreted and evaluated with caution. In addition, dietary studies rely on food composition tables for the conversion of food intake data to estimated nutrient intakes and each country uses a different set of food composition data which differ in definitions, analytical methods, units and modes of expression. This can make comparisons between countries difficult and inaccurate. Methods of measuring food intake are not standardised across Europe and intake data are generally poor, so there are uncertainties over the true nutrient intakes of children and adolescents across Europe. There are insufficient data on status to be able to be able to draw any conclusions about the nutritional quality of the diets of European children and adolescents.
Annals of Nutrition and Metabolism | 2005
Knut-Inge Klepp; Carmen Pérez-Rodrigo; Ilse De Bourdeaudhuij; Pernille Due; Ibrahim Elmadfa; Jóhanna Haraldsdóttir; Jürgen S. König; M Sjöström; Inga Thorsdottir; Maria Daniel Vaz de Almeida; Agneta Yngve; Johannes Brug
Background/Aims: The Pro Children Project was designed to assess fruit and vegetable consumption in European schoolchildren and their parents, as well as determinants of the children’s consumption patterns. A second objective was to develop and test strategies, applicable across Europe, for promoting consumption of fruits and vegetables among schoolchildren and their parents. In this paper, the rationale, theoretical background, overall design and implementation of the project is presented. Methods: Surveys of national, representative samples of 11-year-old schoolchildren and their parents were conducted in 9 countries, i.e. in Austria, Belgium, Denmark, Iceland, the Netherlands, Norway, Portugal, Spain and Sweden. Comprehensive school-based educational programmes have been developed and tested in three settings, i.e. in Spain, the Netherlands and in Norway. A precoded 24-hour recall form combined with a set of food frequency questions assessing regular intake were used to assess fruit and vegetable consumption. Determinants were assessed employing a comprehensive theoretical framework including personal, social and environmental factors related to fruit and vegetable consumption. The intervention programmes have been tested employing a group-randomized trial design where schools have been randomly allocated to an intervention arm and a delayed intervention arm. Surveys among all participating children and their parents were conducted prior to the initiation of the intervention, immediately after the end of the intervention and at the end of the subsequent school year. Conclusion: The project is expected to provide new information of great importance for improving our understanding of consumption patterns of fruits and vegetables and for guiding future efforts to promote increased consumption patterns across Europe.
Nutrition | 2009
Hans-Konrad Biesalski; Lars O. Dragsted; Ibrahim Elmadfa; Rolf Grossklaus; Michael Müller; Dieter Schrenk; Paul Walter; Peter Weber
Biomarkers and their role in evaluating efficacy and safety were the topic of the 23rd Hohenheim Consensus Meeting at the University of Hohenheim in Stuttgart. Scientists who had published and reviewed scientific and regulatory papers on the topic were invited, among them basic researchers, toxicologists, clinicians, and nutritionists. The participants were presented with 11 questions (in bold font), which were discussed and answered (in italic font) at the workshop, with the aim of summarizing the current state of knowledge on the subject. The explicatory text accompanying the short answers was produced and agreed on after the conference and was backed up by corresponding references.
Annals of Nutrition and Metabolism | 2005
Jóhanna Haraldsdóttir; Inga Thorsdottir; Maria Daniel Vaz de Almeida; Lea Maes; Carmen Perez Rodrigo; Ibrahim Elmadfa; Lene Frost Andersen
Background/Aims: Validity and reproducibility were evaluated of a new questionnaire to assess fruit and vegetable intakes in 11- to 12-year-old children. Methods: The precoded teacher-assisted self-administered questionnaire included two sections: a 24-hour recall part and a food frequency part. Validity was tested in 4 countries (Denmark, Iceland, Norway, Portugal; n = 43–60 per country) using a 1-day weighed food record and 7-day food records as reference methods. Test-retest (7–12 days apart) reproducibility was assessed in 6 countries (Belgium, Denmark, Iceland, Norway, Portugal, Spain; n = 60–74 per country). Results: Spearman rank correlations for fruit and vegetable intake according to the frequency part and the 7-day food record ranged between r = 0.40–0.53. Between 25–50% were classified into the same quartile and 70–88% into the same or adjacent quartile. Test-retest Spearman rank correlations for the food frequency part were r = 0.47–0.84. Three countries showed no significant difference between fruit intake as assessed with the 24-hour recall part and the 1-day weighed food record, and 2 countries showed no significant difference for vegetables. In the other countries, the 24-hour recall part resulted in substantially higher mean intake levels. Conclusion: Validity and reproducibility as to ranking of subjects were regarded to be satisfactory in all countries. Group mean intake, based on the original 24-hour part, was valid for fruit in 3 countries and for vegetables in 2 countries, and this part was subsequently adjusted to avoid overestimation, before the questionnaire was used in the Pro Children study.
British Journal of Nutrition | 2010
Haleh Sadrzadeh-Yeganeh; Ibrahim Elmadfa; Abolghasem Djazayery; Mahmoud Jalali; Ramin Heshmat; Maryam Chamary
Many studies have been done on the hypocholesterolaemic effect of probiotic yoghurt. The results, however, are not conclusive. The aim of the present study was to test the effect of probiotic and conventional yoghurt on the lipid profile in women. In a randomised trial, ninety female volunteers aged 19-49 years were assigned to three groups. Subjects consumed daily 300 g probiotic yoghurt containing Lactobacillus acidophilus La5 and Bifidobacterium lactis Bb12 or 300 g conventional yoghurt or no yoghurt for 6 weeks. Fasting blood samples, 3 d dietary records and anthropometric measurements were collected at baseline (T1), end of week 3 (T2) and end of week 6 (T3). Lipid profile parameters were determined by enzymic methods. Results showed no significant difference in lipid profile within any group throughout the study. Comparing mean differences (T1 - T3) among the three groups showed: no difference in TAG and LDL-cholesterol, a decrease in cholesterol in both conventional (P < 0.05) and probiotic yoghurt groups (P < 0.005) compared with the control group, a decrease in total:HDL-cholesterol ratio for conventional (P < 0.05) and probiotic yoghurt groups (P < 0.001) compared with the control group, and an increase in HDL-cholesterol in the probiotic yoghurt group (P < 0.05) compared with the control group. Positive changes in lipid profile were observed in both yoghurt groups. Any added effect, therefore, is due to the consumption of fermented milk products.
Annals of Nutrition and Metabolism | 2005
Camilla Sandvik; Ilse De Bourdeaudhuij; Pernille Due; Johannes Brug; Marianne Wind; Elling Bere; Carmen Pérez-Rodrigo; Alexandra Wolf; Ibrahim Elmadfa; Inga Thorsdottir; Maria Daniel Vaz de Almeida; Agneta Yngve; Knut-Inge Klepp
Background/Aims: Children in Europe are consuming less fruit and vegetables than recommended. Knowledge about the potential determinants of fruit and vegetable intake is vital to understand discrepancies in intake and to guide interventions. The aim of the present study was to assess personal, social and environmental factors regarding fruit and vegetable intake among 11- to 12-year-old children in Europe. Methods: A cross-sectional survey was undertaken, with nationally or regionally representative samples of in total 13,305 children (mean age 11.4 years) from nine European countries. Pupils in the classroom completed a self-administered questionnaire measuring fruit and vegetable intake and personal, social and environmental factors during one school lesson. Age-adjusted covariance analyses were carried out by gender, for the full sample and for each country separately. Proportions responding positively to the constructs are presented. Results: Overall, European children held a positive attitude towards fruit and vegetable intake. For some constructs, large between-country differences were found. Children had a more positive attitude towards fruit than towards vegetables, and girls were on average more positive than boys. The children perceived their social environment as supportive towards fruit and vegetable intake. They reported good to very good availability of fruit and vegetables at home. However, availability at school and during leisure time activities seemed to be low, both for fruit and for vegetables. Conclusion: A large majority of the children reported positively to the personal and social factors regarding fruit and vegetable intake. As regards availability of fruit and vegetables at school and leisure time, and accessibility of fruit and vegetables at home, there is room for improvement.
Annals of Nutrition and Metabolism | 2001
Anna S. Olafsdottir; Karl-Heinz Wagner; Inga Thorsdottir; Ibrahim Elmadfa
Background/Aims: To investigate lactating mothers’ intake of fat-soluble vitamins in free-living subjects and to what extent cod liver oil supplementation influences the maternal intake in a population with common intake of cod liver oil. The impact of maternal diet on the concentration of fat-soluble vitamins in human milk was studied. Methods: Dietary intake of 77 lactating women was investigated by 24-hour diet recalls and breast-milk samples were taken at the same occasions. Breast milk samples were analyzed for fat-soluble vitamins. Results: The median intakes were 927 µg/day for vitamin A, 5.5 mg/day for vitamin E and 3.3 µg/day for vitamin D. Maternal vitamin A, E and D intakes were higher when the diet was supplemented with cod liver oil. Icelandic breast milk was found to have high contents of vitamin A and E. Only vitamin D was too low in breast milk to meet the recommended intake for infants. Retinylpalmitate in relation to lipids correlated with maternal vitamin A intake (r = 0.23, p < 0.05). The group with cod liver oil supplementation had significantly lower levels of γ-tocopherol in breast milk (p < 0.01), whereas the supplementation did not affect other fat-soluble vitamins. Conclusion: The recommended intake of fat-soluble vitamins for lactating women can more easily be met with a cod liver oil supplementation than diet alone. Only vitamin D in human milk cannot meet the recommended intakes for infants, with normal breastfeeding. There is a relationship between the content of vitamins A and E in human milk and the maternal diet.
Annals of Nutrition and Metabolism | 2005
Alexandra Wolf; Agneta Yngve; Ibrahim Elmadfa; Eric Poortvliet; Bettina Ehrenblad; Carmen Pérez-Rodrigo; Inga Thorsdottir; Jóhanna Haraldsdóttir; Johannes Brug; Lea Maes; Maria Daniel Vaz de Almeida; Rikke Krølner; Knut-Inge Klepp
Objective: To describe and compare fruit and vegetable intakes of mothers of 11-year-old children across Europe. Methods: Cross-sectional surveys were carried out in 9 European countries in October/November 2003. Self-administered questionnaires assessing fruit and vegetable consumption were used for data collection. The current paper presents dietary intake data obtained by a precoded 24-hour recall and a food frequency questionnaire. Results: The consumption levels of fruit and vegetables (without fruit juice) were in line with World Health Organization recommendations of ≧400 g/day for only 27% of all participating mothers. Based on both instruments, the Pro Children results showed comparatively high average fruit intake levels in Portugal, Denmark and Sweden (211, 203 and 194 g/day) and the lowest intake in Iceland (97 g/day). High vegetable intake levels were found in Portugal and Belgium (169 and 150 g/day), the lowest in Spain (88 g/day). A south-north gradient could not be observed in the Pro Children study. Conclusion: Fruit and vegetable intakes are low in mothers of 11-year-olds across Europe. Especially vegetable consumption can be regarded as marginal in most of the studied European countries. A high percentage of mothers indicated to eat fruit and vegetables less than once a day. The results have shown that national and international interventions are necessary to promote fruit and especially vegetable consumption in the European population of mothers.
Annals of Nutrition and Metabolism | 2011
Elisabeth Fabian; Sabine Töscher; Ibrahim Elmadfa; Thomas R. Pieber
Background/Aims: This study was conducted to evaluate the current use of biologically-based complementary and alternative medicine (CAM) therapies in diabetics, considering health awareness, motivation, and expectations for CAM use. Moreover, patients’ attitudes toward cinnamon preparations and the need for appropriate information from health care professionals were determined. Methods: A total of 200 patients (59% men and 41% women) with type 1 (16%) or type 2 diabetes (84%) were interviewed using a standardized, validated questionnaire; the results from 198 respondents were analyzed. Results: A third of type 1 and type 2 diabetics (women > men; p < 0.01) reported current use of biologically-based CAM supplements, and intake was significantly (r = 0.203; p < 0.05) correlated to the degree of health awareness/interest in self-care in type 2 diabetics. The use of nutritional supplements (vitamins/multivitamins and minerals), herbal medicine, and cinnamon was reported most frequently. Prevention (36%) and improved well-being/quality of life (13%) but not the positive modulation of diabetes management (4%) were given as main motivations. Eighty-three percent of type 1 diabetics (women > men; p < 0.05) and 70% of type 2 diabetics already knew about the postulated positive effect of cinnamon on blood glucose. Up to 85% reported a willingness or a probable willingness to test the effect of cinnamon on blood glucose. Among patients with type 2 diabetes the subjectively felt disease burden was found to have a significant (r = 0.235; p < 0.01) impact on the willingness to use cinnamon preparations for better diabetes management. Conclusion: This study indicates a remarkable interest in CAM remedies in the investigated group of diabetics as a strategy for active engagement in health and disease self-management. Healthcare professionals should be aware of the increasing number of patients using CAM supplements and hence incorporate these aspects into patient care in order to ensure patient satisfaction and optimize health care.