Konstantinos Gkiouras

Food insecurity and Mediterranean diet adherence among Greek university students

AIMnTo assess Mediterranean diet (MD) adherence and food insecurity (FI) among university students in Greece.nnnMETHODS AND RESULTSnA non-probability sample of 236 students was recruited from Athens and Thessaloniki during 2016. FI was assessed with the Household Food Insecurity Access Scale and MD adherence with the MEDAS questionnaire. Mean MEDAS score of the sample was 6.4xa0±xa01.9, with women demonstrating greater MD adherence compared to men (pxa0=xa00.016) and Dietetics students exhibiting increased score compared to the rest (pxa0≤xa00.001). A low proportion of participants were food-secure (17.8%), 45.3% were severely food-insecure, 22.0% experienced moderate FI and the remaining 14.8% had low FI. Participants studying in the city they grew up exhibited lower FI compared to those studying in other cities (pxa0=xa00.009), while, additionally, a trend was noted for increased FI among students with an unemployed family member (pxa0=xa00.05). Students working night shifts had lower MD adherence and increased FI compared to the rest (pxa0=xa00.004 and pxa0=xa00.003, respectively). The same pattern was observed among participants who smoked (pxa0=xa00.003 for MD adherence and pxa0=xa00.009 for FI, respectively). Multivariate regression analyses did not reveal any connections between FI categories, waist circumference or BMI, but showed an inverse relationship between severe FI and MD adherence.nnnCONCLUSIONSnThe majority of the surveyed university students from Greece demonstrate some degree of FI, with a great proportion being severely food-insecure. Increased FI is inversely associated with MD adherence.

Malnutrition surveillance among refugee children living in reception centres in Greece: a pilot study

BackgroundnThe health of asylum seekers is of cardinal importance for the future health of Europe. The aim of the present cross-sectional study was to assess malnutrition prevalence among refugee children living in reception areas in northern Greece.nnnMethodsnA total of 192 refugee children (1-18 y old), inhabitants of the refugee reception centres in Drama and Kavala, were evaluated for acute and chronic malnutrition according to the WHO growth standards and charts.nnnResultsnIn the total sample, 13.0% of the participants had at least one form of malnutrition, the prevalence of underweight was 7.8% and stunting affected 7.3% of the children. Moreover, a greater proportion of adolescent girls from the Drama centre (38.5%) demonstrated at least one form of malnutrition compared with the children in Kavala (p=0.046). Girls demonstrated an increased prevalence of malnutrition compared with boys, while children <5 y of age appeared more vulnerable.nnnConclusionsnThe present data underscore the necessity for malnutrition screening among refugees in order to have an early assessment of their nutritional status and address the direct and root causes of this substantial problem.

Food insecurity increases the risk of malnutrition among community-dwelling older adults

OBJECTIVESnTo assess the prevalence of malnutrition and food insecurity (uncertainty, or limited ability to acquire acceptable foods through socially acceptable ways), among non-hospitalised, non-institutionalised, community-dwelling older adults, and to identify possible dietary, socioeconomic and health factors associated with them.nnnSTUDY DESIGNnCross-sectional, with 207 older adult participants inhabitants of Thessaloniki and Kavala, Greece. A medical diagnosis was not a criterion for exclusion from participation.nnnMAIN OUTCOME MEASURESnMalnutrition risk (combined categories of at risk of malnutrition and malnourished by the Mini-Nutritional Assessment tool) and food insecurity (assessed by the Household Food Insecurity Access Scale).nnnRESULTSnParticipants had a mean age of 72.4u2009±u20098.5 years; 43.5% were male and 56.5% female. The prevalence of malnutrition was 5.3%, and 48.3% were at risk of malnutrition. The group of participants assessed as being at risk of malnutrition were significantly older, smoked, had a lower body mass index and a smaller waist circumference, reported single partnership status, and exhibited reduced appetite. Some degree of food insecurity was apparent in 69% of the participants. Food insecurity was associated with lack of higher education, reduced monthly income and low adherence to the Mediterranean diet. Additionally, food insecurity as compared with food security increased the risk of malnutrition (OR 2.63, 95% CI 1.21-5.75; pu2009=u20090.015) in the multivariate analysis.nnnCONCLUSIONSnGiven the financial difficulties experienced by the Greek older adult population over the last decade, a large proportion of them are at risk of malnutrition and experience some degree of food insecurity. With the two conditions being interrelated, early identification and management of both malnutrition and food insecurity are essential for public health and healthy ageing.

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

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

AGREEing on Guidelines for Nutrition Management of Adult Severe Burn Patients

BACKGROUNDnSevere burns are associated with a plethora of profound metabolic, immunologic, and physiologic responses, demanding prompt and adequate management. The objective of the present study was to review, compare, and critically appraise medical nutrition therapy guidelines for adult patients with severe burns, and produce salient points for the future update of relevant guidelines.nnnMETHODSnA total of 8 clinical practice guidelines developed by the American Burn Association (ABA), the European Burn Association (EBA), the European Society for Parenteral and Enteral Nutrition (ESPEN), the Midlands National Health Service, the Society for Critical Care Medicine (SCCM)/American Society for Parenteral and Enteral Nutrition (ASPEN), the Spanish Society of Intensive Care Medicine and Coronary Units and Spanish Society of Parenteral and Enteral Nutrition, the Indian Association for Parenteral and Enteral Nutrition (IAPEN), and the International Society for Burn Injury regarding medical nutrition therapy in burn patients was independently reviewed by a team of 4 multidisciplinary researchers using the Appraisal of Guidelines for Research & Evaluation (AGREE II) instrument.nnnRESULTSnFrom the appraised guidelines, the SCCM/ASPEN guidelines received the greatest scoring in the majority of AGREE domains compared with ABA, EBA, and IAPEN, which obtained the lowest scores. On the other hand, the ESPEN guidelines provided the majority of information concerning nutrition support and medical nutrition therapy.nnnCONCLUSIONnOur study identified gaps in most nutrition guidelines and emphasized methodologic issues that could improve the quality of future guidelines concerning nutrition support among adult severe burn patients.

Edmonton obesity staging system among pediatric patients: a validation and obesogenic risk factor analysis

PurposeThe Edmonton Obesity Staging System for Pediatrics (EOSS-P) is a useful tool, delineating different obesity severity tiers associated with distinct treatment barriers. The aim of the study was to apply the EOSS-P on a Greek pediatric cohort and assess risk factors associated with each stage, compared to normal weight controls.MethodsA total of 361 children (2–14xa0years old), outpatients of an Athenian hospital, participated in this case–control study by forming two groups: the obese (nxa0=xa0203) and the normoweight controls (nxa0=xa0158). Anthropometry, blood pressure, blood and biochemical markers, comorbidities and obesogenic lifestyle parameters were recorded and the EOSS-P was applied. Validation of EOSS-P stages was conducted by juxtaposing them with IOTF-defined weight status. Obesogenic risk factors’ analysis was conducted by constructing gender-and-age-adjusted (GA) and multivariate logistic models.ResultsThe majority of obese children were stratified at stage 1 (46.0%), 17.0% were on stage 0, and 37.0% on stage 2. The validation analysis revealed that EOSS-P stages greater than 0 were associated with diastolic blood pressure and levels of glucose, cholesterol, LDL and ALT. Reduced obesity odds were observed among children playing outdoors and increased odds for every screen time hour, both in the GA and in the multivariate analyses (all Pxa0<xa00.05). Although participation in sportsxa0>xa02 times/week was associated with reduced obesity odds in the GA analysis (ORxa0=xa00.57, 95% CIxa0=xa00.33–0.98, P linearxa0=xa00.047), it lost its significance in the multivariate analysis (P linearxa0=xa00.145). Analogous results were recorded in the analyses of the abovementioned physical activity risk factors for the EOSS-P stages. Linear relationships were observed for fast-food consumption and IOTF-defined obesity and higher than 0 EOSS-P stages. Parental obesity status was associated with all EOSS-P stages and IOTF-defined obesity status.ConclusionsFew outpatients were healthy obese (stage 0), while the majority exhibited several comorbidities. Since each obesity tier entails different impacts to disease management, the study herein highlights modifiable factors facilitating descend to lower stages, and provides insight for designing tailored approaches tackling the high national pediatric obesity rates.

Food addiction, orthorexia, and food-related stress among dietetics students

PurposeHealth sciences, and in particular Nutrition and Dietetics students, have been shown to exhibit an increased prevalence of disordered eating. The aim of the present cross-sectional study was to evaluate other specified feeding and eating disorders (OSFEDs), including stress-related eating, food addiction, and orthorexia, in relation to the dietary intake, among nutrition/dietetics students.MethodsA total of 176 undergraduate students from a Department of Nutrition and Dietetics, in Greece, participated in the study. Dietary intake was recorded, and the prevalence of Eating and Appraisal Due to Emotion and Stress (EADES), food addiction (with the modified Yale Food Addition scale mYFAS), and orthorexia were assessed. Chi-square and t tests were performed between sexes, orthorexic and non-orthorexic students, as well as between food-addicted and non-addicted participants. Multiple linear regression analysis assessed relationships between energy intake, BMI or waist circumference, and the food-related psychometric scales.ResultsAmong participating students, 4.5% had food addiction and 68.2% demonstrated orthorexia. No differences were observed between men and women, concerning the prevalence of food addiction and orthorexia, the sum of mYFAS symptoms, or individual EADES factors. Orthorexic students exhibited increased BMI, reduced energy, and saturated fat intake. In addition, orthorexic men consumed more vegetables. Multiple linear regression analysis revealed that orthorexic behavior was associated with increased BMI, waist circumference and energy intake. Lower BMI was associated with increasing ability to cope with emotion-and-stress-related eating and increasing appraisal of ability and resources to cope with emotions and stress. Emotion-and-stress-related eating was negatively associated with BMI. Appraisal of ability and resources to cope with emotions and stress was associated with the energy intake. Finally, age was positively correlated with the appraisal of outside stressors/influences, indicating increased ability to cope with outside stressors among older students.ConclusionsThe study shows that despite the suggested interventions, the problem of OSFEDs among nutrition and dietetics students is still valid. Regular screening, counseling, and education is needed to reduce its prevalence.Level of evidenceLevelxa0V, cross-sectionalxa0descriptive study.