Search Results (70)

Background/Objectives: Even with solid proof of its benefits for cardiovascular health and metabolism, adherence to the Mediterranean Diet (MD) in Spain has noticeably declined in recent years. The socioeconomic changes occurring in recent decades have prompted shifts in cooking habits and in how food is socially experienced, particularly among children and adolescents. The MD is more than just food: it is a cultural tradition and a lifestyle, rich in food and cooking skills, and food wisdom passed down over generations. When these practices fade, it affects both health and the environment, making them vital components in strengthening support for food knowledge, cooking abilities, and a healthier lifestyle. Considering these shifting dietary patterns and the growing need for targeted educational strategies, the present study aimed to investigate the association between cooking skills, MD-related health literacy, and adherence to the Mediterranean Diet across different developmental stages: childhood, adolescence, and adulthood in a sample of the Spanish population. Additionally, a secondary objective was to identify potential critical windows for intervention based on the strength of these associations. Methods: This cross-sectional study included 832 Spanish participants grouped by age: children and early adolescents (n = 408), older adolescents (n = 136), and adults (n = 288). Cooking skills were assessed using CooC11 for children and FCSk for older groups. Adults also completed Lit_MEDiet to assess MD-related health literacy. Adherence was measured with KIDMED (children/adolescents) and MEDAS (adults). Spearman correlations and standardized linear regressions were used. All statistical tests were two-sided, and statistical significance was set at p < 0.05. Results: In children, no significant association was found between cooking skills (CooC11) and KIDMED scores (β = 0.008; p = 0.875). Among adolescents, a strong positive association emerged between FCSk and KIDMED (β = 0.313; p < 0.001; ρ = 0.371), indicating a large, standardized effect and suggesting that this stage is particularly sensitive to food skills. In adults (18+), both food and cooking skills (FCSk) (β = 0.189; p = 0.001) and MD-related health literacy (Lit_MEDiet) (β = 0.187; p = 0.004) were moderately associated with MEDAS scores. Conclusions: These findings suggest that mid-adolescence could represent a favourable developmental window where food skills may hold potential to influence positive dietary behaviours. Regarding adults, the results indicate that combining practical and educational components appears to beneficial for dietary quality. Overall, this study supports the relevance of age-tailored public health strategies to potentially enhance long-term adherence to the Mediterranean Diet. Full article

Background: Childhood growth hormone deficiency (GHD) and idiopathic short stature (ISS) are endocrine disorders characterized by impaired linear growth due to insufficient or ineffective growth hormone (GH) activity. While daily recombinant human GH (rhGH) therapy effectively restores growth, treatment adherence remains suboptimal owing to the burden of daily injections. Long-acting formulations such as pegylated recombinant human GH (PEG-rhGH) have been developed to improve convenience and compliance while maintaining therapeutic efficacy. This systematic review and meta-analysis aimed to evaluate the comparative effectiveness and safety of once-weekly PEG-rhGH versus daily rhGH and to assess dose–response outcomes between higher- and lower-dose PEG-rhGH regimens in pediatric GHD and ISS. Methods: This study followed PRISMA 2020 guidelines. Comprehensive searches were conducted in PubMed, Web of Science, and Scopus from inception to September 2025 using MeSH terms and free-text keywords for “PEGylated recombinant human growth hormone,” “long-acting growth hormone,” and “growth hormone deficiency.” Eligible studies included randomized controlled trials (RCTs) and cohort studies evaluating PEG-rhGH in children (≤18 years) with GHD or ISS, comparing either once-weekly PEG-rhGH with daily rhGH or different PEG-rhGH doses. Data extraction included study design, participant characteristics, intervention details, and key outcomes (height SDS, height velocity, IGF-1 SDS). Meta-analysis was conducted using Review Manager with a random-effects model, and heterogeneity was quantified using the I² statistic. Results: Eight studies, comprising 2549 children, met the inclusion criteria. Once-weekly PEG-rhGH demonstrated comparable short-term growth outcomes to daily rhGH at 6 and 12 months, with modest but significant superiority in height SDS (MD = 0.10, 95% CI 0.01–0.19) and height velocity (MD = 0.74 cm/year, 95% CI 0.42–1.05) by 24 months. IGF-1 SDS did not differ significantly at 6 or 12 months. In dose comparisons, 0.2 mg/kg/week PEG-rhGH produced substantially greater gains in height SDS and IGF-1 SDS than 0.1 mg/kg/week, with a time-dependent increase in the magnitude of the effect. Safety analyses revealed no increase in adverse or serious adverse events with PEG-rhGH compared to daily rhGH; reactions were generally mild and transient. Conclusions: Once-weekly PEG-rhGH is as effective as daily rhGH for promoting growth in pediatric GHD and ISS, with possible long-term advantages in growth outcomes and similar safety. The higher PEG-rhGH dose (0.2 mg/kg/week) appears to optimize efficacy without compromising tolerability. Weekly administration may enhance adherence and quality of life, supporting PEG-rhGH as a viable alternative to daily GH therapy. Full article

Background/Objectives: Childhood obesity and nutritional inequalities remain major public health challenges, particularly in socioeconomically disadvantaged settings. In Spain, these disparities are reflected in unequal access to healthy food and differing health outcomes among the young population. This study aimed to explore how social vulnerability influences dietary patterns, body composition, and food insecurity among children and adolescents, with a particular focus on sex differences. Methods: A descriptive cross-sectional study was conducted with 280 participants aged 6 to 15 years old, recruited from urban areas across Spain. Two groups were evaluated, a socioeconomically vulnerable group (VG) (n = 175) and a non-vulnerable group (NVG) (n = 105), classified according to socioeconomic and social established criteria. Validated tools were used to assess diet quality, adherence to the Mediterranean Diet (MD), consumption of ultra-processed foods (UPF), and household food insecurity. Anthropometric measurements were also collected, and body mass index (BMI) was calculated using both national and international reference standards. Results: Vulnerable children and adolescents showed higher prevalence of food insecurity, less favorable body composition indicators, and lower global dietary quality, characterized by lower adherence to the MD and higher consumption of UPF. Multivariate analysis confirmed that socioeconomic vulnerability was significantly associated with female sex, higher BMI, lower adherence to the MD, and greater consumption of UPF. Conclusions: Our findings highlight a concerning pattern of health and nutritional inequality among children and adolescents based on socioeconomic status. There is a clear and urgent need for effective public health strategies with an equity focus that promote healthy and affordable eating habits from early life, especially in the most disadvantaged environments and targeted by gender. Full article

Acute lymphoblastic leukemia (ALL) is the most common cancer in childhood; 30–50% of its cases are caused by the BCR-ABL1 fusion gene as a driver oncogene. In this research work, a study of the cytotoxic properties of phthalimido-1,3-thiazole derivatives against the BCR-ABL protein PDB ID: 4WA9 was carried out using a combination of different computational chemistry methods, including a molecular docking/dynamics study and ADM-T evaluation. Six top hits were identified based on their free energy scores, namely 4WA9-L21, 4WA9-L20, 4WA9-L22, 4WA9-L19, 4WA9-L18 and 4WA9-L18, which demonstrated better binding affinity (from −8.36 to −9.29 kcal/mol). Furthermore, MD studies support the molecular docking results and validate the stability of the studied complexes under physiological conditions. These results confirm that the hits selected are verifiable inhibitors of the BCR-ABL protein, implying a good correlation between in silico and in vitro studies. Moreover, in silico ADME-TOX studies were used to predict the pharmacokinetic, pharmacodynamics, and toxicological properties of the studied hits. These findings support the future role of phthalimido-1,3-thiazole derivatives against the ALL disease and may help to find a new therapeutic combination of drugs to treat relapsed acute lymphoblastic leukemia and improve overall survival. Full article

Background: Despite remarkable progress in expanding access to childhood vaccines in the last two decades, global coverage with the third dose of the diphtheria–tetanus–pertussis-containing vaccine (DTP3) has recently plateaued, with many countries yet to meet the targets of the Immunization Agenda 2030 (IA2030). As countries cluster around the 80% coverage mark, further gains require targeted interventions for unreached populations. This analysis disaggregates children missing DTP3 into three groups—zero dose (ZD), missed DTP (MD), and drop-out (DO)—which, with DTP3, form four mutually exclusive groups, and examines which of these groups contributes most to coverage changes across countries. Methods: A total of 295 Demographic and Health Surveys from 1986 to 2023 were analyzed across 80 countries, comprising over 2.4 million children. Children were classified into mutually exclusive groups: DTP3, ZD, MD, and DO. We described trends over time and conducted decomposition analyses using a naïve approach and a structural model with isometric log-ratio transformations and causal mediation pathways. Results: Among the 2.4 million children across 80 countries, 63.8% had received DTP3, while 16.2% were DO, 8.8% were MD, and 11.2% were ZD. Countries showed important variations: some mainly reduced ZD, others reduced MD or DO, many achieved balanced progress, and a few experienced setbacks. The naïve model showed that coverage changes reflected different combinations of shifts across ZD, MD, and DO depending on context. The structural model indicated that DO had the strongest direct association with DTP3 coverage, followed by MD and ZD. Conclusions: This analysis highlights the differential contribution of intermediate groups to coverage variations over time. Understanding the association between coverage gains and shifts in ZD, MD, or DO can complement existing strategies to inform targeted planning and accelerate progress towards IA2030 equity goals. Full article

Background/Objectives: Poor dietary habits remain a significant public health concern, highlighting the need to promote healthy and sustainable eating patterns, especially in childhood and adolescence. This study assessed the eating habits of primary school children in the Tagus Lezíria region, focusing on adherence to the Mediterranean Diet (MD), recognized for its health and environmental benefits. Methods: The KIDMED index (Mediterranean Diet Quality Index for children and adolescents) was applied to 435 children, the vast majority (97.7%) aged 6–10 years. Results: The data showed that 64.6% of participants exhibited high adherence to the MD, 32.0% medium, and 3.5% low adherence. Despite these encouraging levels, several gaps were identified: 80% of the children did not meet the recommendation for regular nut consumption (≥2–3 times/week), 44% consumed legumes less than once a week, and 43% failed to eat vegetables more than once a day. Regarding demographic factors, no significant differences were observed in overall adherence categories; however, differences emerged in specific eating behaviours. For example, girls consumed more vegetables and cereals than boys, and children in rural areas consumed less dairy than those living in urban settings. Conclusions: These findings emphasize the importance of reinforcing targeted school-based educational interventions to promote healthier dietary behaviours, particularly increased consumption of fruits, vegetables, fish, pulses, and nuts. Strengthening children’s adherence to the MD from an early age may contribute to improving their health and fostering sustainable eating practices. Full article

Background/Objectives: The Mediterranean diet (MD) is well-studied for its health-promoting effects, while the factors influencing adherence in children remain an important research focus. This study examines the sociodemographic, maternal, perinatal, and lifestyle determinants associated with MD adherence among children aged 6–9 years in an effort to identify key predictors and their impact on long-term nutritional habits. Methods: This study recruited 4851 children from diverse Greek rural and urban regions. The mothers of the enrolled children completed relevant questionnaires on their children’s sociodemographics, perinatal outcomes, anthropometric parameters, breastfeeding practices, and physical activity status. The enrolled children completed the Children’s Depression Inventory (CDI) and the State–Trait Anxiety Inventory for Children—State (STAIC-S) form to assess the presence of depression and anxiety symptoms, respectively. The KIDMED score was used to assess the MD compliance of the enrolled children. Results: The outcomes demonstrated that higher maternal education and family economic status gravitated toward increased MD adherence (p = 0.0071, p ˂ 0.0001), while exclusive breastfeeding (p ˂ 0.0001) and higher physical activity levels (p = 0.0101) were strong predictive factors for MD adherence, highlighting the role of early-life interventions in shaping dietary habits. In contrast, cesarean delivery (p = 0.0173) and higher birth weight (p ˂ 0.0001) were linked to lower MD adherence, indicating potential metabolic and behavioral predispositions. Notably, higher MD adherence correlated with lower prevalence of depressive and anxiety symptoms (p ˂ 0.0001, p = 0.0001), underscoring its potential protective role in mental health. Conclusions: Our findings highlight a complex interplay between early-life and dietary behaviors, while further longitudinal studies are needed to establish causality and optimize evidence-based nutritional strategies and education for childhood health and well-being. Full article

Background: Childhood obesity is a global health concern. Early development of fundamental movement skills (FMS) and adherence to the Mediterranean diet (MD) are key modifiable factors for prevention. This study assessed the effectiveness of a multidisciplinary, school-based intervention for childhood obesity prevention. Methods: Children aged 3–5 years from a preschool in Messina, Italy, participated in a 9-month intervention integrating nutritional education and physical activity. FMS were evaluated using the MOBAK test. Anthropometric measurements and MD adherence (through the Kid-Med questionnaire) were collected. Caregivers completed an online survey reporting lifestyle changes. Results: Significant improvements were observed in FMS: object control (score 1) increased from 2.67 ± 1.78 to 4.28 ± 1.82, locomotor skills (score 2) from 4.69 ± 1.96 to 5.83, 5.83 ± 1.70, and total MOBAK score (score 3) from 7.35 ± 3.09 to 10.11± 2.94. (p < 0.001 for all). Kid-Med scores significantly improved from (3.79 ± 2.31 vs. 5.03 ± 2.69) (p = 0.0027), indicating enhanced MD adherence. Post-intervention, adherence was classified as poor (27.4%), moderate (53.2%), and optimal (19.4%). Although only a minority of parents reported lifestyle changes, over 50% noted increased fruit and vegetable intake in their children. Males showed higher FMS scores and waist circumference compared to females. Conclusions: A school-based multidisciplinary intervention significantly improved motor competence and dietary habits in preschool children. These findings underscore the importance of early, integrated strategies involving families and educators to support healthy development and prevent childhood obesity. Full article

Childhood obesity represents a public concern worldwide. Evidence indicates that fruits and vegetables (FV) consumed as part of the daily diet reduce the global burden of obesity. Indeed, FV are rich in bioactive compounds, including carotenoids, which exert health benefits as very potent natural antioxidants. Here, we compared the anthropometric characteristics and the skin carotenoid content between two schoolchildren populations from Southern and Central Italy to evaluate their dietary habits. A sample of 121 and 124 schoolchildren from primary schools in Central and Southern Italy, respectively, was recruited. All participants underwent anthropometric measurements and assessment of the adherence to the Mediterranean Diet (MD) by the KIDMED questionnaire and the skin carotenoid score by Veggie Meter^®. The mean body mass index (BMI) was significantly lower in participants from Central Italy than in those from Southern Italy. A significantly higher percentage of overweight and obesity was found in the overall sample from Southern than in Central Italy. The adherence to the MD was in the average range for both populations, with no gender-related differences. The carotenoid score was higher and negatively correlated with BMI in the schoolchildren from Central Italy. In multiple regression analyses, skin carotenoids were positively associated with the consumption of fruit in the entire sample. This study suggests the importance of increasing FV intake, particularly in Southern Italy, as a strategy for preventingof obesity during the whole lifespan. Further studies are essential to better understand the influence of skin carotenoids on different variables and their potential role as indicators of health status in children. Full article

Background: Bone mineral density (BMD) is crucial for bone health, contributing up to 50% of total bone mineral content during childhood and pre-adolescence, with the accumulation of bone mass in youth significantly impacting adult bone health. Physical activity, especially impact exercise, plays a fundamental role in strengthening bones. Objectives: The aim of this meta-analysis was to study the effects of basketball practice on BMD compared to other sports and free activity practice in children and adolescents. Methods: Observational studies were selected up to January 2024. A total of 492 articles were identified, of which 9 met the criteria for inclusion in the meta-analysis. Results: The BMD increase favored the group of basketball players in the total body (MD 0.07; CI 0.04 to 0.09; p < 0.001; I² = 93%), upper limbs (MD 0.10; CI 0.008 to 0.12; p < 0.001; I² = 96%), and lower limbs (MD 0.05; CI 0.03 to 0.07; p < 0.001; I² = 80%). Conclusions: Basketball practice in children and adolescents appears to be one of the most effective sports for enhancing BMD (total body and upper and lower limbs) compared to football, swimming, combat sports, other team sports, such as baseball and volleyball, as well as athletics and gymnastics. The high heterogeneity among studies, largely due to differences in sports, may limit the interpretation of the findings. Full article

Background: The increasing rates of childhood obesity (CO) are an ongoing problem. We focused on the adherence to the Mediterranean diet (MD), physical activity, and sleep habits of preschool children in order to investigate the relationship between lifestyle habits and health outcomes through parental perception. Methods: In the context of “EpPOI: Education to prevent CO”, we investigated physical activity (PA) and sleep hygiene using an online survey for caregivers. Parents also completed the Mediterranean Diet Quality Index for children and adolescents (Kid-Med) questionnaire. Results: A total of 5.3% of the interviewees achieved a score indicating an adequate adherence to the MD. Additionally, 50.5% of children ate sweets every day, and 80% skipped breakfast. We also found that the parents’ perceptions of their children’s PA were a predictor of MD adherence, and PA was also positively correlated with fruit consumption [p < 0.034], vegetable consumption [p < 0.015], and fish consumption [p < 0.005]. Conclusions: Parents seem to be oriented towards a healthy lifestyle, but the children’s level of adherence to the Mediterranean diet is poor. CO prevention requires a synergic effort that includes an adherence to healthy eating patterns such as the MD and a greater awareness of parents on the importance of adopting a healthy lifestyle at an early age. Full article

Background/Objectives: The measurement of axial length (AL) is important to monitor the success of interventions to slow childhood myopia, but traditional biometers are expensive for clinicians to acquire. To address this, Oculus has developed the Myopia Master (MM), which measures auto-refraction (AR), corneal curvature (CC) and AL. This study compared inter-instrument and inter-examiner measures on the MM, IOL Master 700 (Carl Zeiss Meditec, Jena, Germany) and NVisionK-5001 (Shin-Nippon, Tokyo, Japan) in myopic children. Methods: Fifty-six myopic children participated (mean age 11.93 ± 1.93 years). A first examiner obtained the following under cycloplegia: (i) AR using the NVisionK, (ii) AL and CC using the IOL Master 700 and (iii) AR, AL and CC using the MM. The latter measures were repeated by a second examiner to assess inter-examiner agreement of the MM. Mean differences (MD) and 95% limits of agreement (LoA) were calculated. Spherical equivalent refraction (SER) was calculated using AR values. Acceptable LoA for AL, SER and CC were defined as ±0.05 mm, ±0.40 D and ±0.06 mm, respectively. Results: Inter-instrument LoA between the MM and IOL Master 700 for AL and CC were acceptable (MD 0.02 mm; 95%LoA −0.02 to 0.06 mm and MD 0.025 mm, 95% LoA −0.03 to 0.08 mm, respectively). SER measures between the NVisionK-5001 and MM were not acceptable (MD −0.44 D, 95% LoA −0.91 to 0.03 D). SER values were, on average, 0.44 D more negative when using the MM. Inter-examiner measures on the MM were all acceptable (AL MD 0.00 mm; 95% LoA −0.04 to 0.04 mm; SER MD −0.01 D; 95% LoA −0.33 to 0.32 D; CC MD 0.01 mm; 95% LoA −0.03 to 0.05 mm). Conclusions: The MM demonstrated excellent inter-examiner repeatability. Inter-instrument agreement between the MM and IOL Master 700 for the AL and CC measures showed excellent agreement. The MM over-estimated myopia SER compared with the NVisionK-5001. Full article

Background and Objectives: Considering the link between childhood experiences with adult health and well-being, this study examined how living with a heavy drinker (HD) during childhood affected self-rated mental health (SRMH) in adulthood, while identifying risk and protective factors and assessing the prevalence within a regional context. Materials and Methods: Data (N = 11,113) were obtained from a cross-sectional DEEP SEAS survey (2021) of the general population, aged 18–64 years, in six countries (Croatia, Bosnia and Herzegovina, Slovenia, Austria, Hungary, and Italy). Results: A statistically significant difference in SRMH was found, related to the childhood experience of living with an HD (MD = −0.221, 95% CI −0.250–0.172, N = 10,886) and being negatively affected (MD = −0.216, 95% CI −0.311–0.122, N = 2978). The correlation analysis revealed that individuals who lived with an HD during childhood perceived poorer SRMH in adulthood, consistently across all observed countries. Subsequent logistic regression identified different predictors for SRMH between those who were negatively affected and those who were not. The relationship satisfaction (RAS) was the strongest predictor, significantly contributing to better SRMH, especially in the subgroup that was not negatively affected (OR 28.724, 95% CI 3.450–239.173). A high prevalence of individuals negatively affected was found, especially in Hungary (34.4%) and Croatia (26.5%). Conclusions: Growing up with someone who was a heavy drinker may have lasting negative consequences on SRMH, with a negative subjective evaluation of mental health in adulthood. Targeted public health and preventive measures are needed to protect those living with heavy drinkers. Full article

Background/Objectives: The long-term consequences of intensive treatment for Hodgkin lymphoma (HL), including metabolic syndrome (MetS) and cardiovascular diseases, but also deteriorated quality of life (QoL), are present in many survivors of childhood HL. Methods: Adolescents and young adults diagnosed with HL who continued the follow-up after successful treatment for HL were included. Anthropometric parameters, body composition, laboratory data, blood pressure values, compliance to the Mediterranean diet (MD), QoL and lifestyle habits were evaluated at the follow-up. Available data were also extracted retrospectively at the time of diagnosis. The primary objective was to determine metabolic sequelae in the early post-treatment period in adolescents treated for HL. Additionally, QoL and compliance with MD were explored, and the correlation of MetS with QoL was investigated. Results: Sixty percent of patients had at least one risk factor for metabolic syndrome, with obesity/abdominal obesity, high blood pressure and low HDL being most commonly observed, present in 66.7%, 44.4% and 44.4% of patients, respectively. The number of obese patients increased from 6.3% at the diagnosis to 31.3% at the follow-up. The majority of patients (53.3%) had low adherence to the MD. Participants had comparable quality-of-life domains to those of the healthy population at the follow-up. The physical health domain of QoL was positively correlated with compliance to the MD in young adults (r = 0.8, p = 0.032) and negatively correlated with obesity/overweight in adolescents (r = −0.85, p = 0.008). Conclusions: Healthy lifestyle choices can impact not only the metabolic health of survivors but also their quality of life, and therefore should be encouraged in these patients. Full article

Background: Mediterranean diet (MD) constitutes a commonly examined dietary model. It includes a plethora of bioactive ingredients with strong antioxidant, anti-inflammatory, antithrombotic and anticancer properties. Several substantial studies support strong evidence that MD can exert preventing actions against human morbidity and mortality, promoting human well-being and quality of life. The present study aims to evaluate whether childhood MD compliance may be associated with socio-demographic, anthropometric, and lifestyle factors in children at the age of 6–9 years. Methods: This is a cross-sectional survey on 3875 children aged 6–9 years old with their matched mothers. Qualified questionnaires were used to evaluate and collect by one-to-one interviews with trained professionals the above data. Results: Elevated MD adherence was observed only in 22.2% of the enrolled children, while 37.5% of children maintained intermediate MD adherence and 40.3% of children adopted lower MD levels. Children MD compliance was related at an independent manner with maternal education level, childhood anthropometric factors such as Body Mass Index (BMI), Waist circumference to Height ratio (WtHR), quality of life, and exclusively breastfeeding behaviors after adjusting for several possible confounders (p ˂ 0.05). Conclusions: Elevated MD adherence of children aged 6–9 years old showed a lower obesity of overweight/obesity, including abdominal obesity. A higher maternal educational status and adopting exclusively breastfeeding practices were associated with greater levels of children’s MD adherence, promoting their quality of life and well-being. Based on the present results, future prospective surveys need to be performed to evaluate if there is a causality relation concerning this topic. Full article