https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(12)60646-1.pdf

Global physical activity levels: surveillance progress, pitfalls, and prospects

https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(11)60813-1.pdf

The global obesity pandemic: shaped by global drivers and local environments

Guidelines and Expert Consensus Documents summarize and evaluate all currently available evidence on a particular issue with the aim to assist physicians in selecting the best management strategies for a typical patient, suffering from a given condition, taking into account the impact on outcome, as well as the risk–benefit ratio of particular diagnostic or therapeutic means. Guidelines are not substitutes for textbooks. The legal implications of medical guidelines have been discussed previously.

A great number of Guidelines and Expert Consensus Documents have been issued in recent years by the European Society of Cardiology (ESC) as well as by other societies and organizations. Because of the impact on clinical practice, quality criteria for development of guidelines have been established in order to make all decisions transparent to the user. The recommendations for formulating and issuing ESC Guidelines and Expert Consensus Documents can be found on the ESC web site (http://www.escardio.org/knowledge/guidelines/rules).

In brief, experts in the field are selected and undertake a comprehensive review of the published evidence for management and/or prevention of a given condition. A critical evaluation of diagnostic and therapeutic procedures is performed, including assessment of the risk–benefit ratio. Estimates of expected health outcomes for larger societies are included, where data exist. The level of evidence and the strength of recommendation of particular treatment options are weighed and graded according to predefined scales, as outlined in the tables below.

The experts of the writing panels have provided disclosure statements of all relationships they may have which might be perceived as real or potential sources of conflicts of interest. These disclosure forms are kept on file at the European Heart House, headquarters of the ESC. Any changes in conflict of interest that arise during the writing period must be notified to the ESC. The Task Force report was entirely …

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European guidelines on cardiovascular disease prevention in clinical practice (version 2012) : the fifth joint task force of the European society of cardiology and other societies on cardiovascular disease prevention in clinical practice (constituted by representatives of nine societies and by invited experts).

The prevalence of obesity is rapidly increasing globally. Epidemiological studies have associated obesity with a range of cancer types, although the mechanisms by which obesity induces or promotes tumorigenesis vary by cancer site. These include insulin resistance and resultant chronic hyperinsulinaemia, increased bioavailability of steroid hormones and localized inflammation. Gaining a better understanding of the relationship between obesity and cancer can provide new insight into mechanisms of cancer pathogenesis.

/pdf/overweight-obesity-and-cancer-epidemiological-evidence-and-3aap682afc.pdf

Overweight, obesity and cancer: epidemiological evidence and proposed mechanisms

https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(12)60735-1.pdf

Correlates of physical activity: why are some people physically active and others not?

An expert report aiming to design strategies in promoting healthy diets and physical activity behaviours was published a year ago by the United Nations Food and Agriculture Organization (FAO) and t...

/pdf/global-strategy-on-diet-physical-activity-and-health-4160j4c0b8.pdf

Global strategy on diet, physical activity and health

Physical Status: The Use and Interpretation of Anthropometry. WHO Technical Report Series

Objective: To give an overview of the dietary habits among adolescents in the Nordic countries and to present results from studies showing the relationship between dietary habits and other lifestyle factors, nutritional status and socio-economic conditions Design: A number of nutritional studies among adolescents performed during recent decades using recalls, dietary records and food frequency questionnaire Setting: Denmark, Finland, Norway and Sweden Subjects: Adolescents aged 13–18 y Results: Food habits are characterized by an irregular meal pattern; many adolescents skip breakfast and also the school lunch, whereas most of them have dinner However, snacking and light meals are very common, contributing 25–35% of the daily energy intake Smoking is linked to their dietary habits as well as socio-economic conditions Dietary intakes of vitamins and minerals are adequate for normal health and growth Dietary calcium intake is high, whereas the intake of fibre, vitamin D, zinc and selenium and, in girls, iron is below the Nordic recommendations Relatively low prevalence figures of iron deficiency were found Many studies show a decrease over time in physical activity The time spent in sedentary activities, such as television and video watching and computer games has increased during recent decades Conclusion: Overweight and obesity are becoming more prevalent in all the Nordic countries, even though the prevalence figures are far below those in the USA On the other hand, dieting girls are common, which might be a factor behind their irregular meal pattern and food choice In a perspective, overweight and diseases attributable to obesity will be an immense challenge in the coming decades for both the individuals and the society as well European Journal of Clinical Nutrition (2000) 54, Suppl 1, S21–S28

Dietary habits and nutritional status in adolescents over Europe. An overview of current studies in the Nordic countries.

Objectives: To validate the use of an activity diary and predicted BMR for assessment of daily total energy expenditure (TEE) and physical activity level (PAL=TEE/BMR) in adolescents. Design: TEE and PAL estimated from activity diary records kept for seven days and BMR predicted from age, gender and body weight were compared with the results of doubly labelled water (DLW) measurements and indirect calorimetry performed during the same time period. Setting: The Unit of Paediatric Physiology of the Department of Clinical Physiology, University Hospital, Uppsala, Sweden. Subjects: Fifty randomly selected 15 y old adolescents (25 boys and 25 girls). Results: The mean difference between TEE estimated in all adolescents by the activity diary and by DLW methods was +1.2%. The limits of agreement (mean difference ±2 s.d.) were −3.47 and +3.77 MJ/d, equivalent to a coefficient of variation of 15%. The mean difference between PAL assessed by activity diary records and by DLW measurements was +0.001, and the limits of agreement between the two methods were ±0.54. Conclusions: The results imply that the activity diary method provides a close estimate of TEE and PAL in population groups. Sponsorship: The Swedish Medical Research Council (Project no. 10379), Uppsala University, and the University Hospital of Uppsala.

A 7-day activity diary for assessment of daily energy expenditure validated by the doubly labelled water method in adolescents.

In 1993-94 a nutritional survey of 15-year-old adolescents was carried out in Uppsala, a university city in eastern Sweden, and in Trollhattan, an industrial town in the western part of the country. The study was the beginning of a longitudinal nutritional survey of 193 boys and 218 girls randomly selected from the official population register. The dietary methods used were a food frequency questionnaire (FFQ) and a combined estimated and weighed 7-day dietary record. According to the FFQ both boys and girls consumed cereals, butter or margarine and something from the group meat/fish/eggs every day. Milk, milk products, sweets and snacks were consumed more than once per day. Vegetables and fruit/ roots were consumed less often. There was relatively good correlation between the FFQ and the 7-day record results.



The mean daily energy intakes of the 15-year-old boys and girls were 10.2 and 8.3 M J, respectively, in Uppsala, and 9.8 and 7.4 M J in Trollhattan. The mean daily intakes of sucrose were 74 and 58 g in boys and 64 and 52 g in girls. The average daily dietary fibre intake was 1.8 g/MJ. The daily intake of energy obtained from breakfast was 18% on weekdays and 22% on weekends; 18 and 11% from prepared lunch; 24 and 30% from dinner, 21 and 14% from light meals; and 16 and 28% from snacks, in Uppsala and Trollhattan respectively. The lowest energy intake from a prepared lunch meal was noted during weekends. On both weekdays and weekends, considerable energy was obtained from light meals and snacks. However, nearly 40% of the girls and 28% of the boys had an energy intake from fat of Ylt; 30 energy %.



The mean intakes of vitamin D and selenium and, in the case of girls, iron and zinc, were below the official Swedish Nutrition Recommendations. The daily median intake of iron was 18.7 mg in boys and 14.1 mg in girls. The iron intakes varied between 6 and 35 mg per day. Low serum ferritin concentrations, defined as s-ferritin <12μg/L, were found in 7 boys (3.7%) and in 29 girls (13.9%).



Significant negative correlations were found between smoking and frequency of consumption of vegetables, roots, fruits and meat. A negative correlation was also found between smoking and the intake of energy and a number of nutrients. Socioeconomic factors seem to be less important for the food habits of teenagers than for those noted during childhood. Only frequent consumption of vegetables was positively correlated to the mothers’educational level.

Gösta Samuelson

Papers

Global strategy on diet, physical activity and health

Physical Status: The Use and Interpretation of Anthropometry. WHO Technical Report Series

Dietary habits and nutritional status in adolescents over Europe. An overview of current studies in the Nordic countries.

A 7-day activity diary for assessment of daily energy expenditure validated by the doubly labelled water method in adolescents.

Food habits and energy and nutrient intake in Swedish adolescents approaching the year 2000.