Background/Objectives: The rising prevalence of overweight and obesity reflects a trend towards worsening eating habits and reduced physical activity, with significant implications for public health and life expectancy. This pilot survey aimed to evaluate weight status, food habits and lifestyle in primary school children from under-researched rural areas of the Lazio region, Italy. Methods: A total of 182 children aged 6-10 years from the municipalities of Monte Romano and Tolfa were enrolled. Body Mass Index (BMI), calculated from measured weight and height, was classified by IOTF and WHO definitions. Food habits, socioeconomic factors and lifestyle were evaluated by a standard questionnaire, and adherence to the Mediterranean diet (MD) was assessed by the KIDMED test. Results: Data showed a high prevalence of overweight, including obesity (33.3%), based on IOTF criteria, with slightly higher rates in boys than girls (38.3% vs. 26.9%). According to the WHO definition, the rate of overweight/obesity was 39.5% with significant differences between males and females (46% vs. 30.8%). Only 19.9% of children had high adherence to MD (67.3% moderate, 12.9% low), and 29.5% of the sample did not eat breakfast every day. In addition, 25.4% met international physical activity recommendations, while around 40% exceeded the recommended screen time on weekend days, and 19.3% did not sleep the recommended hours. Conclusions: Preliminary data show high rates of excess weight, poor diet quality and unhealthy lifestyles. Extending the sampling to other municipalities in the study area will help validate these findings and provide deeper insights to inform targeted intervention strategies.

Objective: The aim of this study was to investigate the consumption frequency of foods rich in dietary fibre; in relation to gender, ponderal status and physical activity, in a sample of Italian adults.Material and Methods: A cross-sectional online survey was conducted; from November 2021 to June 2022, on 300 subjects by a questionnaire on sociodemographic characteristics, lifestyle behaviours and consumption frequency of dietary fibre-rich foods.Results: The consumption frequency of dietary fibre is higher in females than in males. A higher percentage of obese people never or rarely consumed foods rich in dietary fibre. In regards to the consumption of whole-meal biscuits/whole-meal rusks/whole grains, it was observed that a higher percentage of overweight subjects ate them every day, more so than those who were obese, of normal-underweight and in overweight females; with the difference being significant (52.6% vs 16.7% and 32.6%; p-value=0.0366). The same trend was observed for fruit and vegetable consumption; wherein, 11.1% of overweight participants consumed 5 or more servings per day of fruit and vegetables. In contrast, only 7.9% of normal-underweight and 3.6% of obese behave according to WHO recommendations. In overweight females, this difference was significant (12.8% vs 8.3% and 8.3%; p-value=0.0103). A significant (p-value<0.05) higher consumption of dietary fibre was observed in physically active people than in physical inactive people, while no significant differences existed between those who exercise for at least 150 minutes/week and those who exercise less than 150minutes.Conclusion: Dietary fibre consumption was moderately associated with gender and weight status and significantly associated with physical activity.

Background: The efficacy and safety of recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF) hydrogel in adults with deep partial-thickness burns have been confirmed. However, the clinical safety and efficacy analysis of rhGM-CSF in pediatrics is lacking, and the results are questionable. Therefore, a meta-analysis was conducted to evaluate the efficacy and safety of rhGM-CSF hydrogel in children with second- or third-degree burn injury to provide evidence-based medicine for clinical application. Methods: Articles on rhGM-CSF hydrogel for the treatment of pediatric burn wounds were retrieved from PubMed, Embase, WOS, Cochrane Central Registry of Controlled Trials, Chinese Biomedical Literature Database (CBM), China Science and Technology Journal Database (CSTJ), China National Knowledge Infrastructure (CNKI) and Wanfang from the inception of the databases to March 2024. Two reviewers screened articles and extracted the following data: general characteristics, intervention and treatment course, outcome measure. The meta-analysis was conducted using Revman 5.4 software. Results: Eight reports (336 patients: experimental 175, control 161) were ultimately included in the meta- analysis, which showed that the experimental group (rhGM-CSF hydrogel +/- other therapy) was superior to the control group (treatments without rhGM-CSF hydrogel) in terms of the wound healing rates at day 7 [mean difference (MD) =13.63, 95% confidence interval (CI): 7.25 to 20.00, P<0.001], day 14 (MD =15.59, 95% CI: 12.50 to 18.69, P<0.001), and day 21 (MD =7.47, 95% CI: 7.36 to 7.58, P<0.001), and the wound healing time (MD =-3.10, 95% CI: -3.50 to -2.71, P<0.001), and the differences were statistically significant. For the risks of bias, one study had a "high risk" in allocation sequence concealment, and the others were classified as "low risk" and "unclear risk". Conclusions: rhGM-CSF hydrogel is significantly effective in improving the wound healing rate and shortening the wound healing time in children with second- or third-degree burns.

BACKGROUND:The aim of this cross-sectional study was to explore the personal values system of an Italian adolescent sample and examine the interrelations of their values with some variables characterizing their lifestyles.METHODS:A representative sample of 365 adolescents (56.2% females), 15-16 years old from the randomly selected second classes of public/private upper secondary schools of an Italian model region was investigated. The lifestyle of adolescents was explored through a 37-items structured, self-administered questionnaire. Ponderal status was evaluated from measured weight and height. The adherence to the Mediterranean Diet of the sample was determined by the KIDMED Test. The adolescents completed the 21-item Portrait Values Questionnaire, which assesses respondents' endorsement of the ten basic human values.RESULTS:The results suggest that variables related to their eating habits may be associated with their basic values. Some not healthy eating habits, such as eating while "watching TV"/using PC"/ "studying," were negatively related to tradition, conformity, and security values. The adolescents with both moderate and strong alcohol use, and with smoking habits also showed the highest percentage of low adherence to the Mediterranean Diet.CONCLUSIONS:Our findings might provide some useful information to support the development of more effective and targeted health promotion interventions approaches tailored for this age group.

Quinoa's (Chenopodium quinoa Willd.) status has been recently raised from staple food crop confined to its region of origin to a globally recognized commercial food crop, widely traded in the international market. Claims on food labels may attract consumers who can therefore purchase products with nutrition, allergy/intolerance, or social and ethical claims in an effort to make healthier and more sustainable food choices. The aim of this work was (i) to investigate the nutritional quality of quinoa food products available to the Italian consumer over the e-commerce market, as emerged from nutrition labelling, and (ii) to inquire about the occurrence of nutrition, allergy and intolerance, and social and ethical claims on the packaging. To this aim, a cross-sectional survey of quinoa food products available in the Italian market was conducted. It emerged that several quinoa product categories are available and grains and pasta are the major ones. Nutrition claims are generally displayed in combination with gluten-free and social/ethical claims. Based on the nutrition facts, a higher proportion of products are eligible for nutrition claims. The comparison between the gluten-free labelled and gluten-containing quinoa products showed limited differences in the nutritional quality.

BACKGROUND: Childhood obesity is associated with many lifestyle factors. The aim of the present study was to evaluate the relationship between overweight/obesity and abdominal obesity and several lifestyle factors in a sample of Italian adolescents. METHODS: A representative cluster sample of 15-16-year-old adolescents in secondary school in the Lazio region (Italy) was recruited. Body weight, height and waist circumference were measured. Ponderal status was assessed by the IOTF and WHO definitions. Waist-to-height ratio (WtHR) cut-off of 0.5 was used to classify subjects with the highest cardiometabolic risk. Selected dietary habits and lifestyle characteristics were assessed by questionnaires. RESULTS: Three hundred sixty-nine adolescents (162 males and 207 females) were studied. Prevalence of overweight/ obesity was 23.3%, according to the IOTF criteria with a higher percentage of males than females (30.2% vs. 17.9%; P=0.031), and 26% according to WHO references with significant differences between males and females (respectively, 33.9% vs. 19.8%; P=0.002). The WtHR=0.5 was observed in 12.7% of the total sample with a higher percentage in males than in females (16% vs. 10.1%). Males reported an increased likelihood of being overweight or obese, as well as of having a WtHR=0.5 (aOR 2.76 and 2.18, respectively). Adolescents that had breakfast regularly everyday were less likely to be overweight/obese and to have a WtHR=0.5 (aOR 0.52 and 0.49, respectively). CONCLUSIONS: These results showed a high prevalence of overweight/obesity in the sample, and food habits and lifestyle not in accordance with recommendations, especially regarding breakfast. A Surveillance System of Italian adolescents should also be implemented through anthropometric measurement data to monitor the effectiveness of the policies to counteract obesity.

Objective: Menopause is the period when significant changes occur in women and influence their life quality. The aim of this study was to investigate lifestyle behaviours and dietary habits in an Italian sample of pre-menopausal and postmenopausal women. Materials and Methods: A cross-sectional online survey was conducted May to July 2021 by online platforms. A total of 250 women (130 pre-menopausal and 120 post-menopausal) completed a self-reported questionnaire, comprising questions on demographic characteristics, anthropometrics data, lifestyle behaviours and dietary habits. Results: Overweight/obesity prevalence was 22.4% with higher values of post-menopausal than pre-menopausal women (25.9% vs 19.2%). Pre-menopausal women were slightly more physically active (67.7% vs 65.8), but with significantly lower percentages when exercised for 60+ minutes (36.2% vs 54.7%; p=0.0130). As to sedentary activities, higher and significant percentage of pre-menopausal women was found compared to post-menopausal women (89.2% vs 67.5%; p <0.0001). Regarding the dietary habit of having breakfast regularly, a significantly higher percentage of post-menopausal than pre-menopausal women (90.0% vs 80.0%) emerged. Multiple logistic regression model showed that smoking, physical activity and sleep duration affected significantly the ponderal status, whereas age, marital status, alcohol consumption, breakfast habit, and sweet consumption were not significant. Conclusions: Not many differences in lifestyle and eating habits exist between pre-menopausal and post-menopausal women. The only significant differences relate to physical activity duration, sedentary behaviours and breakfast habit in favor of post-menopausal women. However, the prevalence of overweight/obesity was particularly linked to lifestyle behaviors such as smoking, sleep and physical activity in all participating women. Key words: Premenopausal women, postmenopausal women, lifestyle behaviours, dietary habits, overweight/obese.

In March 2020 Italy went into lockdown due to COVID-19 pandemic and children changed rapidly their lifestyles with possible negative effects on their health status. An online survey collected data on eating habits, physical activity, perception/behaviour of 1027 Italian 2-11 years children during lockdown. The chi-square test was applied to test differences in proportions. Results showed a tendency of eating behaviour to worsen as children age and by areas. Only 32.3% of the children had high adherence to Mediterranean Diet, with better scores in 2-5 years children. 78.1% of the children stopped their habitual physical activity, with higher percentage among 6-11 and in Northern children; only 51.8% maintained some activities at home, playing mainly movement games/sports. Children spent more time on devices, missed school and friends, being more bored and less creative. This framework highlights the growing need for strategies to preserve children's health in this and future pandemics.

Objective: The 2019 coronavirus disease (COVID-19) is a global public health emergency resulting in lockdowns, associated food habits and lifestyle changes and constraint public health delivery. The aim of this study was to investigate the impact of the COVID-19 induced lockdown in Italy on lifestyle behaviours among physically active population adults. Materials and Methods: A cross-sectional online survey was conducted from April to June 2020 on 175 subjects (48.6% males and 18–66 age range) by a structured questionnaire to collect information on demographic characteristics, anthropometric data, lifestyle factors and dietary habits. Results: It merged that 40% of the sample gained weight (≈1kg) with no significant differences between genders. Alcohol consumption and physical activity practice and duration significantly decreased during lockdown, while physical activity frequency, sedentary activities, sleep times, daily breakfast habits and consumption of sweets significantly increased. A multiple logistic regression model showed that education level, nutritional status, frequency of physical activity, eating between meals, and sweet consumption had a significant effect on weight gain during COVID-19. Conclusions: Lockdown had a bi-directional impact (both positive and negative) on lifestyle changes, because more time was spent at home. These results need to be confirmed with further longitudinal studies among a larger population sample to better understand the lasting effects of this pandemic on lifestyle behaviors and their changes. Key words: Covid-19, lifestyle behaviour, lockdown, pandemic, physical activity.

Burns are a serious injury and one of the leading causes of trauma in children, particularly in the first five years of life. Because of a marked hypermetabolism immediately or early after burn and protection from infections, nutritional support has been recognised as one of the most critical aspects of medical burns care in terms of mere nutrition for these patients. Resting energy expenditure (REE) has a curvilinear increasing trend according to the total burned surface area (TBSA), and indirect calorimetry is considered the most accurate method to evaluate the energy output of burned patients. Protein need in burned children is generally agreed to be higher than recommended dietary allowance and intake thereof should range around 1.5–3.0 g/kg/die. Carbohydrate intake should be 55–60% of total energy intake (TEI), whereas lipids should be lower than 35% of TEI. As regards micronutrients intake, children suffering from major burns should receive vitamin supplementation in the form of a multivitamin, in addition to vitamin C, vitamin A and zinc sulfate to ensure adequate wound healing. Enteral nutrition is the first line of nutritional care for a burned patient, and it should be started right away. To resolve patient hypermetabolism, a sufficient amount of calories must be given. It is also important to increase protein intake as long as wound healing is satisfactory. When enteral nutrition is contraindicated or not feasible, parenteral nutrition is used.

Background: The purpose of the present study was to examine and compare physical activity (PA) in an Italian sample of adolescents, measured by a self-reported questionnaire and accelerometer.

Objective: Neurological disorders are increasing, because of demographic and epidemiologic changes occurring in both developed and developing countries. This study was aimed at examining and clustering lifestyle factors in an Italian sample of neurological outpatients. Material and Methods: A total of 153 subjects were recruited from the ambulatory Unit Operative Complex of neurology, of S. Eugenio Hospital in Rome. This study was conducted from January, 2017 to May, 2019. Body Mass Index (general obesity) and Waist Circumference (abdominal obesity) were used as outcome measures. Lifestyle behaviours were assessed via questionnaires. Results: The percentage of overweight/obesity was74.0% (77.0% in males and 70.0% in females); whereas, the percentage of subjects with abdominal obesity (67.0%) was significantly higher in females than in males (76.0% vs 60.0%, p-value= 0.038). Also, among patients suffering from neurological diseases there was a significant prevalence of: (i) males, (ii) subjects with low education levels, iii) elderly adults (aged over 75), and iv) people having a significantly lower percentage of appropriate hours of sleep. Three clusters were identified for males and four for females, according to lifestyles. The ‘unhealthy habits’ cluster, dominant among males (38.4%), was characterized by high prevalence of overweight/obese, and abdominal obese subjects; high prevalence of wine and alcoholic beverages consumers, high prevalence of inactive subjects; especially in females and high prevalence of neurological diseases among males.Conclusion: The clusters were identified according to lifestyles, and the main, important findings showed a high prevalence of unhealthy lifestyle clustering was dominant among male, elderly people with neurological diseases.

Background and Objective: Childhood obesity has reached epidemic proportions and relative rates have risen mostly in developing countries. As studies suggest that obesity can influence also pediatric burn population, the aim of this review is to investigate available literature on the effect of obesity in pediatric burn patients. Methods: Papers published from 1972 to 2019, in English language, and related to the topic of effect of obesity on pediatric burn patients were selected. Literature search was made on Medline, PubMed and Scopus databases. Relevant articles were then reviewed. Key Content and Findings: A total of nine papers fulfilled the inclusion criteria. Current literature suggests that childhood obesity does affect secondary outcomes of pediatric burn patients. Conclusions: However, additional research is required so that the effect that pediatric obesity can have on burn injuries is more clearly outlined, and treatments useful to limit the gap between outcomes of obese and normal weight children.

Objective: The aim of this study was to identify dietary patterns (DPs) in European adolescents and to examine the association between perceptions of healthy eating and the obtained DPs. Method: A multinational cross-sectional study was carried out in adolescents aged 12.5 to 17.5?years and 2,027 (44.9% males) were considered for analysis. A self-reported questionnaire with information on food choices and preferences, including perceptions of healthy eating, and two 24-hour dietary recalls were used. Principal component analysis was used to obtain sex-specific DPs, and linear analyses of covariance were used to compare DPs according to perceptions of healthy eating. Results: Three and four DPs for boys and girls were obtained. In boys and girls, there were significant associations between some perceptions about healthy food and the Breakfast-DP (p?<?0.05). In boys, Breakfast-DP and Healthy Beverage-DP were associated with the perception of the own diet as healthy (p?<?0.05). Healthy Beverage-DP was associated with those disliking fruits and vegetables (p?<?0.05). Girls considering the own diet as healthy were associated with Mediterranean-DP, Breakfast-DP, and Unhealthy Beverage and Meat-DP (p?<?0.05). The perception of snacking as a necessary part of a healthy diet was associated with Breakfast-DP in both genders (p?<?0.05). Conclusions: In European adolescents, perceptions of healthy eating were mainly associated with a DP characterized by foods consumed at breakfast. Future studies should further explore these findings in order to implement health promotion programs to improve healthy eating habits in adolescents.

To delineate the clustering of energy balance-related behaviors in adolescents and investigate whether these behaviors are associated with the household socioeconomic status and parental education level.

Background/Objectives: Data regarding the validity of self-reported weight and height in adolescents to calculate Body Mass Index (BMI) and determine the prevalence of obesity are conflicting. The aim of the study was to evaluate the validity of self-reported weight and height in the assessment of overweight/obesity prevalence in a sample of Italian adolescents. Subject/Methods: A representative cluster sample of 369 adolescents of the second class of secondary schools in the Lazio region was investigated. Weight and height were both self-reported and measured. BMI was calculated from both self-reported and measured values. Data were analysed using Paired-sample t-test, Student’s t test, Bland-Altman plots and Kappa Cohen’s statistics. Results: The adolescents ‘self-reported weights were underestimated; their heights were overestimated, and their resultant BMI was underestimated. The mean differences were 0.3±3.7 kg (95% CI -0.68 to 0.08; p 0.116) for weight, 1.2±2.9 cm (95% CI 0.89 to 1.48; p 0.000) for height and 0.4±1.5 kg/m2 (95% CI -0.58 to -0.27; p 0.000) for BMI. The prevalence of overweight/obesity was 18.9% based on self-reported data (24.0% for males and 15.0% for females) and 23.3% by measured data (30.2% for males and 17.9% for females). Conclusion: Self-reported weight and height, very useful to simplify large-scale investigations, should be used with caution in Italian adolescents, because they could lead to erroneous estimating rates of overweight and obesity in this population. Correspondence to: Myriam Galfo, MSc, research field, Council for Agricultural Research and Economics (CREA) Research Center for Food and Nutrition Via Ardeatina 546, 00178 Rome, Italy; E-mail: myriam.galfo@crea.gov.it

Background: Abdominal obesity in adolescents has been identified as a risk factor for occurrence of cardiovascular and metabolic diseases. Objective: To monitor abdominal obesity in Roman adolescents through a five years-period. Method: A total of 410 adolescents aged 14.5-17.9 years, living in the city of Rome, were selected from two cross-sectional studies conducted during 2006-2007 (HELENA Study) (n=198) and 2011-2012 (ALIADO Study) (n=212). Anthropometric measurements such as weight, height and Waist Circumference (WC) were taken in both surveys using the same methodology and trained staff. Overweight and obesity were defined by both the latest IOTF (International Obesity Task Force) and WHO (World Health Organization) references, abdominal obesity as a Waist-to-Height Ratio (WtHR) ≥0.5. Smoking data were collected by questionnaire and socio-economic status was assessed using the education level of both parents. Results: A significant decrease in the mean value of WC in males (p=0.001) and of WtHR in females (p=0.002) was observed from 2006-2007 to 2011-2012. A decrease of abdominal obesity proportion was observed in female. Lower proportions of overweight and obese females were observed in 2011-12 than in 2006-07 using both criteria, IOTF and WHO. It was not found that smokers were more likely to have abdominal obesity. Conclusion: There is a decrease of abdominal obesity and a significant trend towards lower WtHR values in female adolescents from Rome (Italy). In males, despite a trend towards lower waist circumference values, the prevalence of abdominal obesity leveled- off. Keywords: Abdominal, adolescence, gender, obesity, smokers, trend.

Abstract Objective To analyse the Nutritional Knowledge Test (NKT) using Item Response Theory (ITR) analysis and to assess the construct validity of the Nutritional Knowledge Scale (NKTS) and its associations with adolescent food group consumption and nutritional biomarkers. Design Cross-sectional study. Setting Multicentre investigation conducted in ten European cities. Participants Adolescents aged 12·5–17·5 years (n 3215) who completed over 75 % of the NKT. Results Factor analysis indicated that the NKT can be analysed with a one-dimensional model. Eleven out of twenty-three items from the NKT presented adequate parameters and were selected to be included in the NKTS. Nutrition knowledge was positively associated with consumption of fruits, cereals, dairy products, pulses, meat and eggs, and fish, as well as with blood concentrations of vitamin C, β-carotene, n-3 fatty acids, holo-transcobalamin, cobalamin and folate; nutrition knowledge was negatively associated with intake of olives and avocado, alcohol and savoury snacks. Conclusions The NKTS assessed nutritional knowledge adequately and it is proposed as a new tool to investigate this subject in future studies.

AIMThis study aimed to evaluate the prevalence of overweight and obesity derived from measured data of weight and height in a cross-sectional sample of adolescents in the Italian region of Lazio and to analyse their association with different socio-demographic factors.METHODSThe study was conducted in a representative sample of 15-16-year-old adolescents recruited in secondary schools between December 2011 and May 2012. 369 adolescents were investigated. Body weight, height and waist circumference were measured. The BMI of each subject was calculated, and the prevalence of overweight and obesity was determined by age and sex using the IOTF reference values and WHO growth standards. Waist circumference/height ratio (WC/Ht) was calculated and the subjects were classified using the cut-off of 0.5: WC/Ht≥0.5 and WC/Ht<0.5. Selected socio-demographic characteristics were assessed via questionnaire.RESULTSThe percentages of overweight and obesity were high, 15.4% and 7.9%, respectively, with significant difference between males and females (19.1% vs. 12.6% for overweight and 11.1% vs. 5.3% for obese) using the IOFT reference. The ratio WC/Ht≥0.5 was observed in 12.7% of the sample (all the obese and 29.8% of the overweight subjects). Multiple logistic regression analysis indicated that gender, school municipality, mother's employment status, and family structure had a significant effect on ponderal status (overweight/obesity vs. normal weight).CONCLUSIONThese findings show a high prevalence of body weight excess associated with socio-demographic factors in the Italian sample investigated, and the need for effective public health interventions to combact obesity with particular attention to disadvantaged adolescents.