Lajos Biró

Prevalence of underweight, overweight and obesity on the basis of body mass index and body fat percentage in Hungarian schoolchildren: representative survey in metropolitan elementary schools.

Backgrounds/Aims: The incidence of obesity is increasing dramatically not only among adults, but also in children. The purpose of the survey was to assess the age- and gender-specific anthropometric data of children between the ages of 7 and 14 years who attended elementary schools in Budapest. Methods: A cross-sectional study was performed in 2005. Altogether 1,928 students (1,002 boys and 926 girls) were recruited from the schools. The representative sampling sites were selected randomly. Height and waist circumference were measured, other data were analyzed by an 8-polar bioelectrical impedance procedure. Statistical analysis was carried out using SPSS 11 for windows. Results: On the basis of body mass index (BMI), prevalence of underweight, overweight and obesity were 5.1, 18.1 and 7.4% for boys and 6.8, 19.6 and 6.3% for girls, respectively. On the basis of body fat percentage (%BF), prevalence of obesity was 17.9% for boys and 12.8% for girls. Forty nine percent of boys and 28% of girls categorized as overweight by BMI were obese according to their %BF. The difference in waist circumference between individuals categorized by BMI as normal and obese was 24.7 cm for boys and 20.5 cm for girls. Between those categorized as non-obese and obese by %BF, the difference was 17.3 cm for boys and 16.4 cm for girls. Normal and overweight boys and girls with high %BF had significantly higher waist circumferences than their counterparts with normal %BF. This means that many obese children may escape detection as obese, if classified as overweight on the basis of BMI alone. Conclusion: Results appear to underline that in addition to BMI, the determination of the %BF and waist circumference is important in epidemiological studies to identify obese subjects.

Dietary Habits of School Children: Representative Survey in Metropolitan Elementary Schools – Part Two

Background/Aims: The aim of this study was to investigate the eating habits and the nutrient intake of 11- to 14-year-old school children as part of a representative nutrition and health survey in primary schools in Budapest. Methods: A food frequency questionnaire of 875 school children, aged from 11 to 14 (449 boys and 426 girls), was recorded and evaluated. Energy and nutrient intake of 235 children (124 boys and 111 girls) was calculated in parallel by 3-day dietary record. Results: The average energy intake (MJ) was appropriate (boys: 10.40 ± 1.89; girls: 9.18 ± 1.50); protein and fat intake was somewhat higher than the Hungarian recommended dietary allowances. Sodium intake was alarmingly high. The intake of calcium and vitamin D was inadequate. The intakes of zinc, chromium, retinol, folate for both genders, and iron in the case of girls were insufficient. The daily consumption of milk and dairy products was deficient, that of vegetables and fresh fruits was rather low, while the frequency of consumption of sugar-sweetened beverages, chips, sticks and fast foods was high. Conclusions: Nutrition intervention programs should be launched among Hungarian school children.

Protein status in pancreatitis--transthyretin is a sensitive biomarker of malnutrition in acute and chronic pancreatitis.

Abstract Malnutrition may develop in acute pancreatitis (AP), accompanied by hypermetabolism and high nutritional requirements, and in chronic pancreatitis (CP). We measured the incidence of protein malnutrition in AP and CP by comparing different serum biomarkers of protein metabolism and inflammation. Thirty-five patients with acute (27 moderate, 8 severe), and 35 with chronic, pancreatitis were enrolled in the study. Serum transthyretin, albumin, transferrin and C-reactive protein (CRP) concentrations were measured in AP at admission, after 1 and 2 weeks of jejunal feeding, and in patients with CP at follow-up. In AP, at admission the transthyretin level was low in 74%, transferrin in 48%, and albumin in 29% of patients. In severe pancreatitis, transthyretin levels were significantly lower than in moderate forms (7.5±2.43 vs. 14.39±6.8 mg/dl, p<0.005). Transthyretin levels increased significantly after 2 weeks of jejunal feeding (p<0.05). In CP, transthyretin levels were decreased in 37%, transferrin in 27%, and albumin in 12% of patients. We found significantly lower transthyretin levels in alcohol-related CP than in other forms (18.5±8.3 vs. 30.2±5.7, p<0.01). Transthyretin correlated positively with albumin and transferrin and negatively with CRP. Transthyretin seems to be a sensitive biomarker of protein status and metabolic stress. Monitoring nutritional status through measurement of serum proteins is important for optimal treatment of AP and CP.

Representative study for the evaluation of age- and gender-specific anthropometric parameters and blood pressure in an adolescent Hungarian population

Backgrounds/Aims: To assess the age- and gender-specific anthropometric parameters and blood pressure in Hungarian adolescents. Methods: A cross-sectional study was performed between 1997and 2000. Altogether 6,345 secondary school students (aged 15–18 years) were involved in the study. The representative sampling sites were selected randomly. In the capital city 3-stage and in the counties 4-stage stratified groups were assigned for the studies. Statistical analysis was performed using SPSS for Windows 9.0. Results: The age- and gender-specific percentile distributions are given with regard to body weight, body height, body mass index (BMI), waist circumference, waist-to-hip ratio and arterial blood pressure values. Elevated blood pressure values were found at the first recording in 14.1% of the boys and in 2.5% of the girls. Since it is well known that the arterial blood pressure (ABP) may exhibit considerable intra- individual fluctuation with time, we therefore categorized normotensive and hypertensive students on the basis of the mean ABP values calculated from data obtained during the course of the three separate consecutive measurement periods at least 2 weeks apart. After that, the incidence of high blood pressure was 7.5% in boys and 1.1% in girls. Conclusion: The age- and gender-specific cutoff values thus formed may serve as reference values to assess the risk of developing nutrition-related noninfectious diseases in the future on the basis of the present percentile distribution of BMI. The present study also provides data on the prevalence of hypertension in the 15- to 18-year-old age group.

Effects of Oligofructose Containing Diet in Obese Persons

UNLABELLED In the treatment of obesity the introduction of a low-calorie diet is a fundamental requirement. The enhancement of the fiber content of food causing satiety may contribute to the observation of dietary prescriptions. Oligofructoses belong to the group of dietary fibers. AIM To study the effects of the consumption of a low-energy diet (2,000 kcal/day) completed with Jerusalem artichoke concentrate in obese adolescents and adults. METHODS 12 obese students (6 boys and 6 girls) and 6 obese women were put on a low-calorie regimen for 12 weeks, whereas 16 obese students (10 boys and 6 girls) and 17 obese women consumed the same low-calorie diet completed with Jerusalem artichoke concentrate containing 14 g/day oligofructose. Sensation of fullness was estimated. In addition to anthropometric parameters serum biomarkers of lipid and carbohydrate metabolism and adipokines were determined. RESULTS The consumption of the low-calorie diet completed with Jerusalem artichoke concentrate resulted in a diminished sensation of hunger. Body mass index and body fat percentage decreased significantly. In girls and women, the serum levels of triglycerides were also significantly reduced and the rate of insulin resistance estimated on the basis of homeostasis model assessment was also improved. CONCLUSIONS The results of this pilot study appear to demonstrate that the Jerusalem artichoke concentrate produced by a new technology can be a promising component of future diet therapy.

Enhanced accumulation of pericardial fluid ferritin in patients with coronary artery disease.

BackgroundFerritin is a storage protein for iron that can either represent a source of iron or perform a cytoprotective action as an iron sequestrant. ObjectiveTo compare the concentrations of ferritin in pericardial fluid of patients with valvular heart disease, serving as controls, and in patients with coronary artery disease. DesignWe studied a total of 59 consecutive male patients undergoing elective heart valve replacement (group 1: n=22, mean±SD age 55±11 years) or elective coronary artery bypass grafting (group 2: n=37, mean±SD age 59±9 years). MethodsIron status indicators, total protein and albumin concentrations, and lactate dehydrogenase activities were determined in pericardial fluid and serum samples obtained from patients during surgery. ResultsPericardial fluid concentrations of ferritin in both patient populations were significantly (P <0.001) greater than the concentrations in sera: group 1, 375 (107–2030) μg/l compared with 146.5 (21–407) μg/l; group 2, 1115 (226–2500) μg/l compared with 152.0 (16–398) μg/l (median (range)), respectively. Moreover, pericardial fluid ferritin concentration was significantly (P <0.01) greater in patients undergoing coronary artery bypass grafting than in those undergoing heart valve replacement, whereas serum ferritin concentrations did not differ between the two patient populations. ConclusionsAs pericardial fluid reflects the composition of the myocardial interstitium, we suggest that ferritin released can serve as a potential source of iron in the cardiac interstitium that may promote the generation of oxygen free radicals. Conversely, we presume that induction of ferritin synthesis, representing an important mechanism by which tissue adapts to hypoxic damage, can afford myocardial cytoprotection.

Táplálkozási vizsgálat Magyarországon, 2003-2004. Mikrotápanyagok: vitaminok

The 3rd Hungarian National Nutritional Survey was carried out as a part of the National Population Health Study and the data collection was done in November/December of 2003. The survey comprised a sample of adults above 19 year of age, the dietary questionnaires of 1179 people could be evaluated. The results of energy and macro-nutrient intake were published in 2005, and the results of the mineral intake in 2007, in the Hungarian Medical Journal. This paper focuses on the intake of vitamins. For the evaluation of the results authors used the data of the two previous national surveys, data of some dietary studies of other countries, and the home and international intake recommendations. In respect of the data found in the present survey, it is a favourable trend that the intake of vitamins retinol equivalent, B1 , B6 and B12 , and niacin, as well as biotin was sufficient both in case of men and women, together with adequate vitamin E intake for men. However the intake of vitamin B2 , C, D, together with pantothenic acid and folic acid of both men and women did not meet the criteria of the Hungarian recommendations, besides the vitamin E intake of women was insufficient as well. In Hungary the intake of vitamin D, biotin, folic acid and pantothenic acid was measured at first at this National Dietary Survey. The authors vigorously stress the importance of the varied and healthy nutrition in the adequate vitamin supply of the population.

Táplálkozási vizsgálat Magyarországon, 2003–2004. Mikro-tápanyagok: ásványi sók

A 3. Orszagos Taplalkozasi Vizsgalatban az adatgyűjtesre 2003-ban, az eredmenyek ertekelesere 2004–2005-ben kerult sor. A 19 even feluli lakossag 1179 főből allo mintajanak energia- es tapanyagbeviteleről az Orvosi Hetilap 2005. ev 34. szamaban jelent meg beszamolo, a jelen kozlemeny a mikrotapanyagok kozul az asvanyi sok beviteleről szol. Az eredmenyeket a szerzők elsősorban a ket korabbi hazai taplalkozasi vizsgalat adataival osszehasonlitva, valamint magyar es nemzetkozi ajanlasokhoz viszonyitva ertekeltek. Az asvanyi anyagokat illetően kedvezőnek itelhető a mindket nemben megfelelő atlagos magnezium-, valamint a ferfiak eseteben az ajanlast kielegitő vas-, cink- es rezbevitel. Kedvezőtlen a mindket nemben elegtelen kalcium- es a tulzott foszforbevitel, valamint a kalcium- es foszforbevitel aranytalansaga. A kedvezőtlen eredmenyek koze tartozik a nők elegtelen vas-, cink- es rezbevitele, valamint a mindket nemben rendkivul nagy natriumbevitel. A szerzők hangsulyozzak az egeszseges taplalkozas elterjesztesenek es az elelmiszeriparral valo egyuttműkodesnek a fontossagat az asvanyianyag-hianyok megelőzese erdekeben. | In the course of the 3 rd national nutritional survey data were collected in 2003, and the paper on the energy and nutrition intake of a sample group consisting of 1179 people all aged above 19, was published in the Hungarian Medical Journal (Vol. 146, No. 34, 2005). The present paper focuses on one group of micronutrients, namely the minerals’ intake. The authors evaluated the results mainly in comparison with the data of the two previous Hungarian national surveys, and the international and national recommendations. The average magnesium intake was considered adequate in both sexes, while iron, zinc and copper intakes also met the recommended level in men. On the other hand, the insufficient calcium and the excessive phosphorus intakes, as well as the disproportionate calcium-phosphorus ratio in both sexes are unfavourable facts. The adverse results include insufficient iron, zinc and copper intake in women and the excessive sodium intake in both sexes, as well. The authors emphasize the importance of spreading the principles of healthy nutrition as well as co-operating with the food industry in order to prevent the occurrence of mineral nutrients deficiency.

Lifestyle of School Children: Representative Survey in Metropolitan Elementary Schools – Part One

Background/Aims: The prevalence of overweight and obesity among school children is increasing dramatically. Obesity is multifactorial and depends on lifestyle as well as genetic components. The purpose of the survey was to investigate the lifestyle of 7- to 14-year-old children attending elementary schools in Budapest. Methods: The research was questionnaire-based. Children were asked to answer questions about their leisure activities, physical exercise, nutritional, eating, and smoking habits. Results: Many children live a sedentary life and are dissatisfied with their body weight. One in 5 boys and 1 in 3 girls have been on a slimming diet at least once. About two-thirds of the children regularly consumed vitamin and/or mineral supplements and at the same time just over half of them knew how much fruit should be eaten daily. School children in the upper classes did not eat 5 times a day. More than 5% of the 11- to 14-year-old boys and more than 10% of the girls smoked regularly.Conclusions: According to our results, the unfavorable lifestyle of the great majority of Hungarian school children may have implications for their health during adulthood.

Assessment of Cardiovascular Risk Factors among Hungarian University Students in Budapest

Background/aims: The lack of data regarding cardiovascular risk factors among university students in Hungary prompted us to undertake a cross-sectional pilot study in students at Semmelweis University, Budapest. Methods: A total of 264 students (78 males, mean age 21.4 ± 2.6 years, and 186 females, mean age 21.2 ± 2.6 years) participated in the study. Anthropometric measures, blood pressure and serum lipid parameters were investigated. The relationship between body mass index and cardiovascular disease risk factors were analyzed. Results: The occurrence of overweight and abdominal obesity was significantly higher in the male group. The mean serum lipid values were within the acceptable range for both genders; however, in a significantly greater number of male than female students the HDL-cholesterol concentration (<1 mmol/l) was in the low range. High lipoprotein(a) values were seen in 33% of the male and 22.6% of the female students. In both groups of students the body mass index exhibited a positive correlation with waist circumference, total cholesterol, LDL-cholesterol, apolipoprotein B (p < 0.01), and systolic and diastolic blood pressure. In the female students there was an inverse correlation between body mass index and HDL-cholesterol concentrations. Conclusions: The anthropometric and lipid parameters of the student population studied were more favorable than those for an age-matched Hungarian youth population. Nevertheless, the higher occurrence of elevated blood pressure, overweight, abdominal obesity, lower HDL-cholesterol in the male group should be regarded as a warning sign, all the more since their diet was imbalanced and their knowledge in this field was incomplete. The results of our preliminary study point out the importance of teaching nutrition more efficiently, not only during university training but also at an earlier age.