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Table 1 Published manuscripts from DEDIPAC Thematic Area 1

From: Determinants of diet and physical activity (DEDIPAC): a summary of findings

Authors

Subject/independent variable

Behaviour/dependent variable

Age group

Study design

Countries

Main conclusions

Surveillance systems

 Bel-Serrat et al. [6]

Surveillance systems

Dietary, physical activity and sedentary behaviour

Across the life course

Inventory

Cross-European

“Many on-going activities were identified at the national level focussing on adults, but fewer surveillance systems involving vulnerable groups such as infants and pre-school children. Assessment of sedentary and dietary behaviours should be more frequently considered. There is a need for harmonisation of surveillance methodologies, indicators and target populations for between-country and over time comparisons. This inventory will serve to feed future discussions within the DEDIPAC-JPI major framework on how to optimize design and identify priorities within surveillance.”

Assessment methods

 Riordan et al. [7]

Assessment methods

Intake of sugar-sweetened beverages

Across the life course

SLR

Cross-European

“The current review highlights the need for instruments to use an agreed definition of sugar-sweetened beverages. Methods that were tested for validity and used in pan-European populations encompassing a range of countries were identified. These methods should be considered for use by future studies focused on evaluating consumption of sugar-sweetened beverages.”

 Riordan et al. [8]

Assessment methods

Intake of fruits and vegetables

Across the life course

SLR

Cross-European

“The current review indicates that an agreed classification of fruits and vegetables is needed in order to standardise intake data more effectively between European countries. Validated methods used in pan-European populations encompassing a range of European regions were identified. These methods should be considered for use by future studies focused on evaluating intake of fruits and vegetables.”

 Gebremariam et al. [9]

Assessment methods

Availability and accessibility of food

Youth (≤18y)

SLR

International

“The review identified several measures of food availability or accessibility among youth with satisfactory evidence of reliability and/or validity. Findings indicate a need for more studies including measures of accessibility and addressing its conceptualization. More testing of some of the identified measures in different population groups is also warranted, as is the development of more measures of food availability and accessibility in the broader environment such as the neighbourhood food environment.”

Population levels

 Loyen et al. [10]

Variation in population levels

Physical activity

Adults (≥18y)

SLR

Cross-European

“The included studies showed substantial variation in the assessment methods, reported outcome variables and, consequently, the presented physical activity levels. Because of this, absolute population levels of physical activity in European adults are currently unknown. However, when ranking countries, Ireland, Italy, Malta, Portugal and Spain generally appear to be among the less active countries. Objective data of adults across Europe is currently limited. These findings highlight the need for standardisation of the measurement methods, as well as cross-European monitoring of physical activity levels.”

 Loyen et al. [11]

Variation in population levels

Sedentary time

Adults (≥18y)

SLR

Cross-European

“One third of European countries were not included in any of the studies. Objective measures of European adults are currently limited, and most studies used single-item self-reported questions without assessing sedentary behaviour types or domains. Findings varied substantially between studies, meaning that population levels of sedentary time in European adults are currently unknown. In general, people living in northern Europe countries appear to report more sedentary time than southern Europeans. The findings of this review highlight the need for standardisation of the measurement methods and the added value of cross-European surveillance of sedentary behaviour.”

 Van Hecke et al. [12]

Variation in population levels

Physical activity

Youth (<18y)

SLR

Cross-European

“Reported levels of physical activity and prevalence of compliance to physical activity recommendations in youth showed large variation across European countries. This may reflect true variation in physical activity as well as variation in assessment methods and reported outcome variables. Standardization across Europe, of methods to assess physical activity in youth and reported outcome variables is warranted, preferably moving towards a pan-European surveillance system combining objective and self-report methods.”

 Verloigne et al. [13]

Variation in population levels

Sedentary time

Youth (<18y)

SLR

Cross-European

“A substantial number of published studies report on levels of sedentary time in children and adolescents across European countries, but there was a large variation in assessment methods. Questionnaires (child specific) were used most often, but they mostly measured specific screen-based activities and did not assess total sedentary time. There is a need for harmonisation and standardisation of objective and subjective methods to assess sedentary time in children and adolescents to enable comparison across countries.”

Secondary data analysis

 Steene-Johannessen et al. [14]

Agreement between self-report and objective measurements

Meeting the physical activity recommendations

Adults (≥18y)

Secondary, CS

DK, FR, DE, GR, IT, NL, NO, SP, SW, UK

“The modest agreement between self-reported and objectively measured physical activity suggests that population levels of physical activity derived from self-report should be interpreted cautiously. Implementation of objective measures in large-scale cohort studies and surveillance systems is recommended.”

 Loyen et al. [20]

Accelerometer pooling

Physical activity and sedentary time

Adults (≥18y)

Secondary, pooled, CS

England, Norway, Portugal, Sweden

“We found high levels of sedentary time and physical inactivity in four European countries. Older people and obese people were most likely to display these behaviours and thus deserve special attention in interventions and policy planning. In order to monitor these behaviours, accelerometer-based cross-European surveillance is recommended.”