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      Regular family breakfast was associated with children's overweight and parental education: Results from the ENERGY cross-sectional study

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          This study aims to assess (i) the prevalence of having regular family breakfast, lunch, dinner (i.e. 5–7 days/week together with their family) among 10–12 year olds in Europe, (ii) the association between family meals and child weight status, and (iii) potential differences in having family meals according to country of residence, gender, ethnicity and parental levels of education.


          7716 children (mean age: 11.5 ± 0.7 years, 52% girls) in eight European countries (Belgium, Greece, Hungary, The Netherlands, Norway, Slovenia, Spain, Switzerland) participated in a cross-sectional school-based survey in 2010. Data on family meals were self-reported by the parents and children's height and weight were objectively measured to determine overweight status. Binary regression analyses assessed the associations of having regular family meals (adjusted for potential confounders) with children's overweight/obesity and to assess potential differences in having family meals according to gender, ethnicity and parental education, in the total sample and for each country respectively.


          The prevalence of regular family meals was 35%, 37% and 76% for breakfast, lunch and dinner respectively. Having regular family breakfast, but not lunch or dinner, was inversely associated with overweight (OR = 0.78 (95% CI 0.67–0.91)). Children of higher educated parents were more likely to have regular family breakfast (1.63 (95% CI 1.42–1.86)) and less likely to have regular family lunch (0.72 (95% CI 0.63–0.82)) compared to children of lower educated parents.


          This study showed that having regular family breakfast – but not other family meals- was inversely associated with children's weight status.


          • Having regular family breakfast, but not other family meals, was inversely associated with children's overweight.
          • Having regular family breakfast was associated with high parental education.
          • Having regular family lunch was inversely associated with high parental education.

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          Worldwide trends in childhood overweight and obesity.

          Obesity has become a global epidemic but our understanding of the problem in children is limited due to lack of comparable representative data from different countries, and varying criteria for defining obesity. This paper summarises the available information on recent trends in child overweight and obesity prevalence. PubMed was searched for data relating to trends over time, in papers published between January 1980 and October 2005. Additional studies identified by citations in retrieved papers and by consultation with experts were included. Data for trends over time were found for school-age populations in 25 countries and for pre-school populations in 42 countries. Using these reports, and data collected for the World Health Organization's Burden of Disease Program, we estimated the global prevalence of overweight and obesity among school-age children for 2006 and likely prevalence levels for 2010. The prevalence of childhood overweight has increased in almost all countries for which data are available. Exceptions are found among school-age children in Russia and to some extent Poland during the 1990s. Exceptions are also found among infant and pre-school children in some lower-income countries. Obesity and overweight has increased more dramatically in economically developed countries and in urbanized populations. There is a growing global childhood obesity epidemic, with a large variation in secular trends across countries. Effective programs and policies are needed at global, regional and national levels to limit the problem among children.
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            Evidence that the prevalence of childhood overweight is plateauing: data from nine countries.

            Until quite recently, there has been a widespread belief in the popular media and scientific literature that the prevalence of childhood obesity is rapidly increasing. However, high quality evidence has emerged from several countries suggesting that the rise in the prevalence has slowed appreciably, or even plateaued. This review brings together such data from nine countries (Australia, China, England, France, Netherlands, New Zealand, Sweden, Switzerland and USA), with data from 467,294 children aged 2-19 years. The mean unweighted rate of change in prevalence of overweight and obesity was +0.00 (0.49)% per year across all age ×sex groups and all countries between 1995 and 2008. For overweight alone, the figure was +0.01 (0.56)%, and for obesity alone -0.01 (0.24)%. Rates of change differed by sex, age, socioeconomic status and ethnicity. While the prevalence of overweight and obesity appears to be stabilizing at different levels in different countries, it remains high, and a significant public health issue. Possible reasons for the apparent flattening are hypothesised.
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              Environmental influences on energy balance-related behaviors: A dual-process view

              Background Studies on the impact of the 'obesogenic' environment have often used non-theoretical approaches. In this journal's debate and in other papers authors have argued the necessity of formulating conceptual models for differentiating the causal role of environmental influences on behavior. Discussion The present paper aims to contribute to the debate by presenting a dual-process view on the environment – behavior relationship. This view is conceptualized in the EnRG framework (Environmental Research framework for weight Gain prevention). In the framework, behavior is postulated to be the result of a simultaneous influence of conscious and unconscious processes. Environmental influences are hypothesized to influence behavior both indirectly and directly. The indirect causal mechanism reflects the mediating role of behavior-specific cognitions in the influence of the environment on behavior. A direct influence reflects the automatic, unconscious, influence of the environment on behavior. Specific personal and behavioral factors are postulated to moderate the causal path (i.e., inducing either the automatic or the cognitively mediated environment – behavior relation). In addition, the EnRG framework applies an energy balance-approach, stimulating the integrated study of determinants of diet and physical activity. Conclusion The application of a dual-process view may guide research towards causal mechanisms linking specific environmental features with energy balance-related behaviors in distinct populations. The present paper is hoped to contribute to the evolution of a paradigm that may help to disentangle the role of 'obesogenic' environmental factors.

                Author and article information

                Prev Med
                Prev Med
                Preventive Medicine
                Academic Press
                1 October 2016
                October 2016
                : 91
                : 197-203
                [a ]Department of Public Health, Sport and Nutrition, University of Agder, Postboks 422, N-4604 Kristiansand, Norway
                [b ]EMGO Institute for Health and Care Research, VU University Medical Center, Postbus 7057, 1007 MB Amsterdam, The Netherlands
                [c ]Department of Epidemiology and Biostatistics, VU University Medical Center, Postbus 7057, 1007 MB Amsterdam, The Netherlands
                [d ]Department of Public Health, Ghent University, De Pintelaan 185, 4K3, 9000 Ghent, Belgium
                [e ]Department of Nutrition and Dietetics, School of Health Science & Education, Harokopio University, 70, El Venizelou Ave, 17671, Kallithea, Athens, Greece
                [f ]Department of Paediatrics, Medical Faculty, University of Pécs, 48-as tér 1, 7622 Pécs, Hungary
                [g ]Institute for Medical Information Processing, Biometrics and Epidemiology, German Centre for Vertigo and Balance Disorders, Ludwig Maximilian University, Munich, Germany
                [h ]Slovenian Heart Foundation, Postboks 1000, Ljubljana, Slovenia
                [i ]GENUD (Growth, Exercise, Nutrition and Development) Research Group, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón), Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERObn), University of Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Spain
                [j ]Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Socinstrasse 57, 4051 Basel, Switzerland
                [k ]University of Basel, Basel, Switzerland
                Author notes
                [* ]Corresponding author. froydis.n.vik@
                © 2016 The Authors

                This is an open access article under the CC BY-NC-ND license (



                europe, weight status, family meals, breakfast, children, cross-sectional


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