Adolescents In Europe Research Articles

Paediatric palliative care professionals congregate in Rome

International Journal of Palliative NursingVol. 19, No. 1 Conference ReportPaediatric palliative care professionals congregate in RomeJ Downing, S Fowler-Kerry, S BoucherJ DowningSearch for more papers by this author, S Fowler-KerrySearch for more papers by this author, S BoucherSearch for more papers by this authorJ Downing; S Fowler-Kerry; S BoucherPublished Online:28 Sep 2013https://doi.org/10.12968/ijpn.2013.19.1.47AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Downing J, Birtar D, Chambers L, Drake R, Gelb B, Kiman R (2012) Children’s palliative care: a global concern. Int J Palliat Nurs 18(3): 109–14 Link, Google ScholarFoley K (2012) Palliative care as a children’s right. Minerva Pediatr 64(6 Suppl 1): 3 Google ScholarInternational Children’s Palliative Care Network (2011) ICPCN charter of rights for life limited and life threatened children. http://bit.ly/10ay4LG (accessed 16 January 2013) Google ScholarKnapp C, Woodworth L, Wright M et al. (2011) Pediatric palliative care provision around the world: a systematic review. Pediatr Blood Cancer 57(3): 361–8 Crossref, Medline, Google ScholarLynch T, Benini F, Kreicbergs U et al. (2012) Mapping of palliative care services for infants, children and adolescents in Europe. Minerva Pediatr 64(6 Suppl 1): 33 Medline, Google Scholar FiguresReferencesRelatedDetails 1 January 2013Volume 19Issue 1ISSN (print): 1357-6321ISSN (online): 2052-286X Metrics History Published online 28 September 2013 Published in print 1 January 2013 Information© MA Healthcare LimitedPDF download

2577 – Prevalence of risk behaviours and psychopathology among european youth

During the transition from childhood to adulthood, adolescents establish patterns of behaviour and make lifestyle choices that affect both their current and future health. Most health indicators are socially patterned in adolescence and track into adulthood, with higher risks of adverse outcomes. Given the importance of this transitional period, it is essential to systematically monitor and assess the health and well-being of adolescents and young adults, and evaluate the nation’s efforts to improve the health of young people. Saving and Empowering Young Lives in Europe (SEYLE) aims at promoting mental health among adolescents in European schools. The SEYLE project was performed during January 2009 - December 2011, and comprised a consortium of 12 European countries: Austria, Estonia, France, Germany, Hungary, Ireland, Israel, Italy, Romania, Slovenia and Spain , with Sweden as the coordinating centre. One of its main objectives is to gather information on health and well-being in European adolescents. SEYLE generated a large epidemiological database containing information regarding sociodemographics, risk factors, lifestyles, and the mental health of adolescents in Europe. The database contains information regarding 366 variables for 12,395 cases, for a total of over 4.5 million observations. Prevalence regarding psychopathology, such as depressive and anxiety symptoms, hyperactivity, suicidal ideation and behaviour and lifestyles such as substance abuse, including alcohol, smoking and illegal drugs; sleep, nutrition and physical activity, and Internet use is available and will be described during this presentation.

3038 – Characteristics of non-suicidal self-injury and suicide attempts among adolescents in europe: results from the european research consortium seyle

Introduction Non-suicidal self-injury (NSSI) is an increasing phenomenon among adolescents. So far, comparable data on prevalence and psychosocial correlates are still rare due to different definitions, study samples, and measures. Aims To investigate the prevalence and associated psychosocial factors of occasional and repetitive non-suicidal self-injury (NSSI) and its relationship to suicide attempts in a representative adolescent samples from eleven European countries. Methods Cross sectional assessment of adolescents was performed within the European Union funded project, Saving and Empowering Young Lives in Europe (SEYLE), which was conducted in eleven European countries. The representative sample comprised 12,068 adolescents (F/M: 6,717/5,351; mean age: 14.9±0.89) recruited from randomly selected schools. Frequency of NSSI was assessed by a modified version of the Deliberate Self-Harm Inventory (DSHI) and the Paykel Suicide Scale. Additionally, a broad range of demographic, social and psychological factors was assessed. Results Overall lifetime prevalence of NSSI was 27.6%; 19.7% reported occasional NSSI and 7.8% repetitive NSSI. Lifetime prevalence ranged from 17.1% to 38.6% across countries. Suicidality, anxiety and depression had the highest odds ratios for both occasional and repetitive NSSI. Conclusions Results suggest high lifetime prevalence of NSSI in European adolescents, with significant country differences. A strong association of NSSI with both psychopathology and risk-behaviours, including family-related neglect and peer-related rejection/victimization could be found. These results, combined with the observed gender and country differences, support the need for a multidimensional approach to better understand the development of NSSI and facilitate culturally adapted prevention/intervention.

Progress on child safety action in Europe: the results of the 2012 child safety country profiles

BackgroundDespite injury reductions and safety improvements over the last 30 years, injury remains a leading cause of death and disability for children and adolescents in Europe. As part of the...

Prevalence of pathological internet use among adolescents in Europe: demographic and social factors

To investigate the prevalence of pathological internet use (PIU) and maladaptive internet use (MIU) among adolescents in 11 European countries in relation to demographic, social factors and internet accessibility. Cross-sectional survey. The 7th Framework European Union (EU) funded project, Saving and Empowering Young Lives in Europe (SEYLE), is a randomized controlled trial (RCT) evaluating interventions for risk behaviours among adolescents in Austria, Estonia, France, Germany, Hungary, Ireland, Israel, Italy, Romania, Slovenia and Spain, with Sweden serving as the coordinating centre. A total of 11 956 adolescents (female/male: 6731/5225; mean age: 14.9 ± 0.89) recruited from randomly selected schools within the 11 study sites. Internet users were classified by gender into three categories: adaptive, maladaptive and pathological, based on their score in the Young Diagnostic Questionnaire for Internet Addiction (YDQ). The overall prevalence of PIU was 4.4%; it was higher among males than females (5.2% versus 3.8%) and differed between countries (χ(2) = 309.98; d.f. = 20; P < 0.001). PIU correlated significantly with mean hours online and male gender. The highest-ranked online activities were watching videos, frequenting chatrooms and social networking; significantly higher rates of playing single-user games were found in males and social networking in females. Living in metropolitan areas was associated with PIU. Students not living with a biological parent, low parental involvement and parental unemployment showed the highest relative risks of both MIU and PIU. Across a range of countries in Europe, using the Young Diagnostic Questionnaire for Internet Addiction yields a prevalence of 'pathological internet use' of 4.4% among adolescents, but varies by country and gender; adolescents lacking emotional and psychological support are at highest risk.

The European Paediatric Association affiliation with The Journal

The Journal is pleased to announce an affiliation with the European Paediatric Association (EPA). The EPA is an association established in 1976 for practicing general pediatricians in the 40+ national pediatric societies it represents, along with individual members. EPA strives “to provide general pediatricians with the tools and resources they need to improve the quality of care for their young patients.” The Journal seeks “to inform immediate care decisions, deepen knowledge, and advance further scientific discovery to improve the quality of care and the health of infants, children, and adolescents.” Therefore, the mission and objectives of the EPA and The Journal are aligned. Because of the global scope of The Journal, members of EPA will have access to research pertaining to European countries, as well as the broader worldwide scope of investigation and practice to enhance child health. In a new section of The Journal, “European Paediatric Association Pages,” the EPA will publish member announcements, organizational changes, and new initiatives that also may be of interest to the general readership of The Journal. In this issue of The Journal, the first pieces published in this section include an introduction from the president of the EPA, Andreas Konstantopoulos, MD, which provides background information about the EPA and what readers can expect to see in these pages in future issues, as well as a historical piece about the EPA's growth and development by Ehrich et al. The Journal welcomes the members of the EPA as readers, and encourages all readers to find out more about EPA (http://www.epa-unepsa.org/). Article page 373▶ Article page 374▶ The European Paediatric Association Partners with The Journal of Pediatrics to Make Original Research Available to Our MembersThe Journal of PediatricsVol. 161Issue 2PreviewThe European Paediatric Association (EPA) is pleased to announce a new partnership with The Journal of Pediatrics. We are proud to have established an affiliation with this prominent journal, which is published monthly by Elsevier. The Journal's mission is: “Through a rigorous process of evaluation and peer review, The Journal of Pediatrics strives to publish pediatric research of the highest value for a diverse audience of pediatric healthcare professionals... The Journal seeks to inform immediate care decisions, deepen knowledge, and advance further scientific discovery to improve the quality of care and the health of infants, children, and adolescents” ( http://www.jpeds.com/content/missionstatement ). Full-Text PDF Thirty-Six Years of the European Paediatric Association–Union of National European Paediatric Societies and Associations (EPA-UNEPSA)The Journal of PediatricsVol. 161Issue 2PreviewManaging the health care of infants, children, and adolescents in Europe requires balancing clinical aims, research findings, and socioeconomic goals within an international environment characterized by cultural and economic complexity and large disparity in availability, affordability, and accessibility of pediatric care. Since 1976, the European Paediatric Association (EPA), formerly Union of National European Paediatric Societies and Associations (UNEPSA), has been trying to establish this balance, involving almost two generations of European pediatricians. Full-Text PDF

P-598 - Prevalence of pathological internet use among adolescents in Europe: demographic and health-related risk factors

Aims To investigate the prevalence of pathological Internet use (PIU) among adolescents in eleven European countries in relation to demographic and health-related risk factors and Internet accessibility using homogenous methodology. Design Cross-sectional analysis. Setting The 7th Framework European Union funded project, Saving and Empowering Young Lives in Europe (SEYLE), is a Randomized Controlled Trial (RCT) evaluating preventive interventions for risk-behaviors among adolescents in Austria, Estonia, France, Germany, Hungary, Ireland, Israel, Italy, Romania, Slovenia and Spain with Sweden as the coordinating site. Participants 11,956 adolescents (F/M: 6731/5225; mean age: 14.9 ± 0.89) recruited from randomly selected schools within the eleven study sites. Measurements Internet users were classified by gender into three categories: adaptive, maladaptive and pathological, based on the Young Diagnostic Questionnaire for Internet Addiction (YDQ). Findings The overall prevalence of PIU was 4.4%. The rate was higher among males than females (5.2% vs. 3.8%). Students not living with a biological parent or relative had the highest risk for both maladaptive and pathological Internet use. Low-parental involvement and parental unemployment showed high relative risk for both maladaptive and pathological Internet use. PIU significantly correlated with the average number of hours spent online. No correlation was found between national levels of Internet accessibility and pathological Internet use. Conclusion Prevalence of PIU varied by gender. Youth in households without a biological parent and/or low level of parental involvement had the most significant health-related factors associated with PIU. National levels of Internet accessibility were not a risk factor for either maladaptive or pathological Internet use.

PMH22 Economic Burden of Attention Deficit Hyperactivity Disorder in Children and Adolescents in Europe

This comprehensive review was conducted to report existing evidence from published studies evaluating the economic burden of attention deficit hyperactivity disorder (ADHD) in children and adolescents in Europe. A systematic search of electronic literature databases (EMBASE and MEDLINE), was conducted from January 2001 to June 2011 to identify economic studies on ADHD in children and adolescents in Europe. All economic studies in English language, regardless of design and intervention were included. Eligibility of trials was assessed by two reviewers with any discrepancy reconciled by a third, independent reviewer. A total of 591 citations were retrieved out of which eight met pre-defined inclusion criteria. Five studies were cost-analyses while three were cost-effectiveness analyses. In Germany, the total direct costs for ADHD were €158 million in 2002 which increased to €287 million in 2006 with inpatient treatment costs comprising approximately 40% of the total direct costs in 2006 (Wehmeier 2009). Other contributors to total direct costs included hospitalisations, special health-care services, comorbidities, and physician visits (Ridder 2006). The total projected costs of ADHD in Germany during 2012 are estimated to be €311 million (Schlander 2007). The mean annual direct medical costs of ADHD patients with psychiatric comorbidities were €5908 compared to €974 for ADHD alone in the The Netherlands (Roijen 2007). The cost-effectiveness studies retrieved primarily focused on atomoxetine (ATX) and methylphenidate (MPH). ATX was found to be more cost-effective than MPH in the UK (ICER of £15 224 per QALY gained) (Cottrell 2008) as well as in Spain (ICER of €34 308 per QALY gained) (Hong 2009). ADHD is associated with substantial fiscal burden in Europe. Since 2002, a trend of increase in direct costs has been observed which may be due to increasing demand for healthcare services, and presence of comorbidities.

Age assessment of young asylum seekers

During 2009, 15,100 unaccompanied children sought asylum in Europe. Many of them came from 'failed states' like Somalia and Afghanistan where official documents with exact birth dates are rarely issued. This has led to requests to health care professionals in many countries to assist migration authorities in determining whether a young asylum seeker is a child or an adult. Many different methods are currently employed in Europe for this purpose by dentists, paediatricians, radiographers and social workers, but no currently available method has been demonstrated to have the accuracy needed to be of real use in this decision. Unclear guidelines and arbitrary practices may lead to alarming shortcomings in the protection of this high-risk group of children and adolescents in Europe. Medical participation, as well as non-participation, in these dubious decisions raises a number of ethical questions. To improve care for young asylum seekers with undetermined age, we suggest better legal procedures for the determination of age and a more flexible approach to chronological age.

Awareness and knowledge of sexually transmitted diseases (STDs) among school-going adolescents in Europe: a systematic review of published literature.

BackgroundSexually transmitted diseases (STDs) are a major health problem affecting mostly young people, not only in developing, but also in developed countries.We conducted this systematic review to determine awareness and knowledge of school-going male and female adolescents in Europe of STDs and if possible, how they perceive their own risk of contracting an STD. Results of this review can help point out areas where STD risk communication for adolescents needs to be improved.MethodsUsing various combinations of the terms "STD", "HIV", "HPV", "Chlamydia", "Syphilis", "Gonorrhoea", "herpes", "hepatitis B", "knowledge", "awareness", and "adolescents", we searched for literature published in the PubMed database from 01.01.1990 up to 31.12.2010. Studies were selected if they reported on the awareness and/or knowledge of one or more STD among school-attending adolescents in a European country and were published in English or German. Reference lists of selected publications were screened for further publications of interest. Information from included studies was systematically extracted and evaluated.ResultsA total of 15 studies were included in the review. All were cross-sectional surveys conducted among school-attending adolescents aged 13 to 20 years. Generally, awareness and knowledge varied among the adolescents depending on gender.Six STDs were focussed on in the studies included in the review, with awareness and knowledge being assessed in depth mainly for HIV/AIDS and HPV, and to some extent for chlamydia. For syphilis, gonorrhoea and herpes only awareness was assessed. Awareness was generally high for HIV/AIDS (above 90%) and low for HPV (range 5.4%-66%). Despite knowing that use of condoms helps protect against contracting an STD, some adolescents still regard condoms primarily as an interim method of contraception before using the pill.ConclusionIn general, the studies reported low levels of awareness and knowledge of sexually transmitted diseases, with the exception of HIV/AIDS. Although, as shown by some of the findings on condom use, knowledge does not always translate into behaviour change, adolescents' sex education is important for STD prevention, and the school setting plays an important role. Beyond HIV/AIDS, attention should be paid to infections such as chlamydia, gonorrhoea and syphilis.

Food intake of European adolescents in the light of different food-based dietary guidelines: results of the HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) Study

Since inadequate food consumption patterns during adolescence are not only linked with the occurrence of obesity in youth but also with the subsequent risk of developing diseases in adulthood, the establishment and maintenance of a healthy diet early in life is of great public health importance. Therefore, the aim of the present study was to describe and evaluate the food consumption of a well-characterized sample of European adolescents against food-based dietary guidelines for the first time. The HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) Study is a cross-sectional study, whose main objective was to obtain comparable data on a variety of nutritional and health-related parameters in adolescents aged 12·5-17·5 years. Ten cities in Europe. The initial sample consisted of more than 3000 European adolescents. Among these, 1593 adolescents (54 % female) had sufficient and plausible dietary data on energy and food intakes from two 24 h recalls using the HELENA-DIAT software. Food intake of adolescents in Europe is not optimal compared with the two food-based dietary guidelines, Optimized Mixed Diet and Food Guide Pyramid, examined in this study. Adolescents eat half of the recommended amount of fruit and vegetables and less than two-thirds of the recommended amount of milk (and milk products), but consume much more meat (and meat products), fats and sweets than recommended. However, median total energy intake may be estimated to be nearly in line with the recommendations. The results urge the need to improve the dietary habits of adolescents in order to maintain health in later life.

Adolescents’ self‐reported suicide attempts, self‐harm thoughts and their correlates across 17 European countries

Suicide is a leading cause of death among adolescents in Europe. Self-harm thoughts and behaviours are documented precursors of completed suicide. It is therefore of great importance to investigate the prevalence of suicide thoughts and attempts and their correlates, with the aim of preventing this major life-threatening public health problem. This study provides cross-national European data on self-reported suicidal thoughts and attempts among adolescents. Data were obtained from 45,806 high school students aged 15-16 years from 17 countries that participated in the European School Survey Project on Alcohol and Other Drugs (ESPAD) 2007 school survey. The standardised methods of the ESPAD survey ensure comparability across countries. Students completed an anonymous questionnaire in their classrooms. The prevalences of suicidal thoughts and attempts are reported as well as their sociodemographic and psychosocial correlates identified in logistic regression. The median prevalence of any lifetime self-reported suicide attempt was 10.5% across the participating countries (range 4.1%-23.5%). The median of frequent self-harm thoughts (at least five times) was 7.4% (range 2.1%-15.3%). Suicidal behaviour and thoughts had significant associations with gender, substance use, family integrity and socioeconomic status. Countries with higher prevalence of substance use tended to have a weaker association between substance use and self-reported suicide attempts. Although self-reported self-harm thoughts and suicide attempts vary in prevalence within Europe, there are common correlates across countries. These have an important impact on understanding the phenomenon of suicide among young people and in guiding prevention.

350 INVITED 4 Years Later – the Impact of the European Pediatric Medicine Regulation on Children and Adolescents in Europe

350 INVITED 4 Years Later – the Impact of the European Pediatric Medicine Regulation on Children and Adolescents in Europe

Vitamin D status among adolescents in Europe: the Healthy Lifestyle in Europe by Nutrition in Adolescence study

An adequate vitamin D status is essential during childhood and adolescence, for its important role in cell growth, skeletal structure and development. It also reduces the risk of conditions such as CVD, osteoporosis, diabetes mellitus, infections and autoimmune disease. As comparable data on the European level are lacking, assessment of vitamin D concentrations was included in the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study. Fasting blood samples were obtained from a subsample of 1006 adolescents (470 males; 46·8%) with an age range of 12·5-17·5 years, selected in the ten HELENA cities in the nine European countries participating in this cross-sectional study, and analysed for 25-hydroxycholecalciferol (25(OH)D) by ELISA using EDTA plasma. As specific reference values for adolescents are missing, percentile distribution were computed by age and sex. Median 25(OH)D levels for the whole population were 57·1nmol/l (5th percentile 24·3nmol/l, 95th percentile 99·05nmol/l). Vitamin D status was classified into four groups according to international guidelines (sufficiency/optimal levels ≥75nmol/l; insufficiency 50-75nmol/l; deficiency 27·5-49·99nmol/l and severe deficiency <27·5nmol/l). About 80% of the sample had suboptimal levels (39% had insufficient, 27% deficient and 15% severely deficient levels). Vitamin D concentrations increased with age (P<0·01) and tended to decrease according to BMI. Geographical differences were also identified. Our study results indicate that vitamin D deficiency is a highly prevalent condition in European adolescents and should be a matter of concern for public health authorities.

Plasma levels of leptin and soluble leptin receptor and polymorphisms of leptin gene -18G &gt; A and leptin receptor genes K109R and Q223R, in survivors of childhood acute lymphoblastic leukemia

BackgroundApproximately 20% of children and adolescents in Europe are overweight. Survivors of pediatric acute lymphoblastic leukemia (ALL) are at increased risk of overweight and obesity. The purpose of this study was to assess leptin and leptin soluble receptor levels, as well as polymorphisms of selected genes in survivors of pediatric ALL, and the influence of chemo- and radiotherapy on development of overweight in the context of leptin regulation.MethodsEighty two patients (55% males), of median age 13.2 years (m: 4.8 years; M: 26.2 years) were included in the study. The ALL therapy was conducted according to modified Berlin-Frankfurt-Munster (BFM; n = 69) regimen or New York (n = 13) regimen. In 38% of patients cranial radiotherapy (CRT) was used in median dose of 18.2Gy (m: 14Gy; M: 24Gy). Median age at diagnosis was 4.5 (m: 1 year; M: 16.9 years) and median time from completion of ALL treatment was 3.2 years (m: 0.5 year; M: 4.3 years). Patients with BMI ≥85 percentile were classified as overweight. Correlation of plasma levels of leptin and leptin soluble receptor, and polymorphisms of leptin gene -18G > A, leptin receptor genes K109R and Q223R, and the overweight status were analyzed in relation to gender, intensity of chemotherapy (high intensity vs. standard intensity regimens) and to the use of CRT.ResultsSignificant differences of leptin levels in patients treated with and without CRT, both in the entire study group (22.2+/- 3.13 ng/ml vs. 14.9+/-1.6 ng/ml; p < 0.03) and in female patients (29.9+/-4.86 ng/ml vs. 16.9+/-2.44 ng/ml; p = 0.014), were found. Significant increase of leptin levels was also found in overweight patients compared to the non-overweight patients in the entire study group (29.2+/-2.86 ng/ml vs. 12.6+/-1.51 ng/ml; p < 0.0001), female patients (35.4+/-6.48 ng/ml vs. 18.4+/-2.5 ng/ml; p = 0.005), and male patients (25.7+/-2.37 ng/ml vs. 6.9+/-0.95 ng/ml; p < 0.0001). Negative correlation was observed for plasma levels of soluble leptin receptor and overweight status, with significant differences in overweight and non-overweight patients, both in the entire study group (18.2+/-0.75 ng/ml vs. 20.98+/-0.67 ng/ml; p = 0.017) and in male patients (18.2+/-1.03 ng/ml vs. 21.8+/- 1.11 ng/ml; p = 0.038). Significant (p < 0.05) negative correlation was found between leptin and leptin receptor levels in the entire group (correlation coefficient: 0.393) and in both gender subgroups (correlation coefficient in female patients: -0.427; in male patients: -0.396).ConclusionsThe prevalence of overweight in our cohort was higher than in general European population (31% vs 20%) and increased regardless of the use of CRT. Leptin and leptin receptor levels may be used as useful markers of high risk of becoming overweight in ALL survivors, particularly in females treated with CRT. Polymorphisms of leptin gene -18G > A and leptin receptor genes K109R and Q223R were not associated with overweight status in ALL survivors.

Policies to Increase Physical Activity in Children and Youth

The World Health Organization is encouraging countries to develop and implement policies aimed at increasing physical activity in children and adolescents. The purpose of this paper is twofold: (1) to identify the common existing international policies established to increase physical activity in children and adolescents; and (2) to examine the extent to which these policies are supported by solid scientific evidence. Existing policies as well as intervention studies for children and adolescents in Europe, America, Asia, and Oceania that were written in English and Chinese were identified via scientific databases, reference lists of articles, and existing archives and databases via non-electronic search. The policy areas found to be the most common were: (1) Physical Education in School ; (2) Physical Activity-Related Health Education ; (3) Community Environmental Support ; (4) School Environmental Support ; (5) Active Transport/Urban Design ; and (6) Mass Media/Advertising Campaigns . For these policy areas, the intervention literature was reviewed and segmented into three domains: policy research (studies examining the relationship of policies to physical activity levels in young people), effectiveness studies (multi-site physical activity interventions), and efficacy studies (single site or local physical activity interventions). Effectiveness studies provided support for policies that focus on increasing Physical Education in School , improving School Environmental Support and Active Transport/Urban Design , and launching Mass Media/Advertising Campaigns designed to increase physical activity levels in children and adolescents. The results for Physical Activity-Related Health Education and Community Environmental Support were mixed, indicating that more research is needed to determine the effectiveness of physical activity policies in those areas.

What do we know about sexual and reproductive health of adolescents in Europe?

Republished from: The European Journal of Contraception and Reproductive Health Care, 2008;13:58–70

Physiological and public health basis for assessing micronutrient requirements in children and adolescents. The EURRECA network.

This paper provides an overview of the current knowledge relating to the nutritional requirements and corresponding recommended nutrient intake values of children and adolescents for micronutrients and specificities related to these requirements in the course of childhood and adolescence in Europe. Aspects that can influence micronutrient requirements, such as physiological requirements and bioavailability of the nutrients in the organism, are discussed. The methodology used to obtain the data and also the main knowledge gaps regarding these concepts are emphasized. Methodological critical points in achieving the data and physiological aspects of children and adolescents are important in order to standardize the reference values for micronutrients among Europe for these stages of life.

Burden of injury in childhood and adolescence in Europe

BackgroundInjury is the major cause of death and suffering among children and adolescents, but awareness of the problem and political commitment for preventive actions remain unacceptably low. We have assessed...

Systematic Review Demonstrating that Breakfast Consumption Influences Body Weight Outcomes in Children and Adolescents in Europe

Skipping breakfast is common among children and adolescents. However, there is uncertainty regarding whether breakfast consumption contributes to or protects against overweight or obesity. We aimed to review the evidence on the effects of breakfast consumption on body weight outcomes in children and adolescents in Europe. The Cochrane Library, MEDLINE, and EMBASE were searched in January 2009. We identified 16 studies. All were cross-sectional or cohort trials involving more than 59,000 children/adolescents from Europe. Thirteen studies (n = 57,481) consistently showed that breakfast has a protective effect against becoming overweight or obese. One trial (n = 886) showed that this effect was significant only for boys. The effect of eating breakfast on the body mass index (BMI) was analyzed in 4 studies (n = 2897). All of these studies showed an increase in BMI in breakfast skippers. In one study (n = 1245), this effect was significant only for boys. The results of this analysis suggest that eating breakfast is associated with a reduced risk of becoming overweight or obese and a reduction in the BMI in children and adolescents in Europe. However, almost all of the data in this review were gathered from observational studies, thus, causality should not be assumed based on these findings.