Descriptive data
In total 2,499 high-risk parents (88.8% mothers/stepmothers, mean age 40.05 ± 5.47 years) and 2,506 children (51.1% girls, mean age 8.12 ± 1.01 years) provided data on EBRB-Questionnaire at baseline. Parents’ FINDRISC-score ranged between 0 and 22 points, with an average of 9.63 ± 4.56 points. Furthermore, the highest FINDRISC-score within the family ranged between 9 and 24 points, with an average of 12.41 ± 2.94 points. Families were assigned to the high-risk group based the FINDRISC-score of the mother (41.7%), the father (35.3%) or both (22.8%). Descriptive data across all countries, and separately for the six countries can be found in Table 1.
Besides, the correlations were investigated between parents’ lifestyle behaviours and their FINDRISC-score (correlation coefficient ranged between 0.037 and 0.098), and between children’s lifestyle behaviours and the highest FINDRISC-score within the family (correlation coefficients ranged between 0.009 and 0.079]. The correlation coefficients can be found in Additional File 1.
Table 1
Descriptive data of the study sample: Children and parents from high-risk families in the Feel4Diabetes-study
Children |
| Belgium N = 420 | Finland N = 354 | Spain N = 569 | Greece N = 494 | Bulgaria N = 408 | Hungary N = 261 | All countries N = 2,506 |
Mean age (SD) in years | 8.02 (0.93) | 8.70 (0.95) | 7.84 (0.96) | 7.76 (0.89) | 8.25 (0.93) | 8.65 (1.03) | 8.12 (1.01) |
% girls | 48.1 | 53.4 | 49.9 | 51.0 | 50.4 | 56.3 | 51.1 |
% Overweight/obese (> 25 kg/m²) | 21.1 | 26.6 | 30.5 | 38.1 | 25.1 | 34.6 | 29.4 |
% low family SES % medium family SES % high family SES | 35.6 30.1 34.2 | 27.1 31.1 41.8 | 5.7 28.4 65.9 | 55.9 26.7 17.4 | 18.6 33.7 47.8 | 67.2 18.9 13.9 | 32.8 28.6 38.6 |
Highest FINDRISC score within the family Mean (SD) Range [min-max] | 11.9 (2.68) [9–22] | 12.58 (2.85) [9–21] | 12.05 (2.87) [9–22] | 12.76 (3.05) [9–22] | 12.47 (3.13) [9–24] | 13.02 (2.90) [9–22] | 12.41 (2.94) [9–24] |
Parents |
| Belgium N = 420 | Finland N = 354 | Spain N = 568 | Greece N = 594 | Bulgaria N = 404 | Hungary N = 259 | All countries N = 2,449 |
Mean age (SD) in years | 38.73 (5.50) | 40.11 (5.19) | 41.51 (5.13) | 41.18 (5.04) | 39.25 (4.50) | 37.60 (6.40) | 40.05 (5.47) |
% mother/stepmother | 86.1 | 87.3 | 86.3 | 90.0 | 94.7 | 89.0 | 88.8 |
% overweight/obese (> 25 kg/m²) | 61.6 | 84.3 | 72.4 | 66.2 | 51.8 | 83.9 | 66.4 |
% low individual SES | 43.1 | 30.9 | 7.8 | 64.1 | 24.1 | 71.3 | 38.0 |
Parents’ FINDRISC-score mean (SD) Range [min-max] % of parents with FINDRISC-score < 9 points | 9.65 (4.22) [0–21] 32.1 | 10.70 (4.30) [0–21] 22.1 | 9.64 (4.40) [0–22] 32.1 | 10.14 (4.46) [0–22] 31.0 | 7.62 (4.89) [0–21] 51.3 | 10.26 (4.51) [0–20] 28.0 | 9.63 (4.56) [0–22] 33.1 |
Self-reported lifestyle behaviours across and between the participating countries
Moderate-to-vigorous physical activity
Descriptive data (means and standard deviations) of moderate-to-vigorous physical activity in parents and children can be found in Table 2. Furthermore, within the table, differences between the countries were indicated (p-values).
Table 2
Lifestyle behaviours for parents and children from high-risk families across six European countries.
| Belgium | Finland | Spain | Greece | Bulgaria | Hungary | All countries | P-value |
Moderate-to-vigorous physical activity |
CHILDREN |
Days per week ≥ 60 minutes per day (SD) | 4.96 (0.08) | 5.76 (0.09) | 5.19 (0.08) | 4.73 (0.08) | 5.17 (0.08) | 5.78 (0.11) | 5.20 (0.04) | < 0.001 |
Meeting guidelines (%) | 27.7 | 40.3 | 31.2 | 17.1 | 27.6 | 43.3 | 29.7 | < 0.001 |
PARENTS |
Days per week ≥ 60 minutes (mean ± SD) | 4.10 (0.12) | 4.32 (0.12) | 3.37 (0.10) | 3.36 (0.11) | 3.69 (0.12) | 5.04 (0.15) | 3.85 (0.05) | < 0.001 |
Meeting guidelines (%) | 48.0 | 49.3 | 37.7 | 37.0 | 38.1 | 65.2 | 43.7 | < 0.001 |
Sedentary time |
Screen-time in CHILDREN |
Minutes per day mean (SD) | 108.80 (3.24) | 113.60 (3.52) | 88.63 (2.91) | 106.22 (2.93) | 118.52 (3.25) | 125.74 (4.11) | 108.09 (1.36) | < 0.001 |
Meeting guidelines (%) | 61.8 | 62.6 | 74.6 | 67.7 | 58.5 | 54.9 | 64.5 | < 0.001 |
Sitting time during weekdays in PARENTS |
Hours per day mean (SD) | 5.91 (0.22) | 5.44 (0.26) | 4.95 (0.19) | 4.66 (0.18) | 4.96 (0.19) | 5.29 (0.29) | 5.13 (0.09) | < 0.001 |
Drinking water |
CHILDREN |
Glasses per day | 2.92 (0.09) | 2.36 (0.09) | 4.67 (0.08) | 4.54 (0.08) | 4.21 (0.08) | 4.27 (0.10) | 3.90 (0.04) | < 0.001 |
Meeting guidelines (%) | 17.7 | 12.9 | 55.1 | 51.1 | 44.8 | 51.7 | 39.8 | < 0.001 |
PARENTS |
Glasses per day | 3.76 (0.10) | 4.34 (0.10) | 5.00 (0.09) | 4.60 (0.09) | 4.73 (0.10) | 4.71 (0.13) | 4.55 (0.04) | < 0.001 |
Meeting guidelines (%) | 41.0 | 50.4 | 67.2 | 58.5 | 60.0 | 65.3 | 57.3 | < 0.001 |
Fruit and vegetable consumption |
CHILDREN |
Portions per day | 2.58 (0.08) | 2.46 (0.09) | 2.60 (0.7) | 1.95 (0.08) | 2.78 (0.08) | 2.15 (0.11) | 2.43 (0.04) | < 0.001 |
Meeting guidelines (%) | 8.0 | 11.2 | 10.1 | 6.9 | 11.9 | 8.9 | 9.4 | 0.03 |
PARENTS |
Portions per day | 2.76 (0.09) | 3.04 (0.10) | 2.81 (0.08) | 2.03 (0.09) | 2.96 (0.09) | 2.00 (0.12) | 2.62 (0.04) | < 0.001 |
Meeting guidelines (%) | 14.9 | 17.7 | 15.8 | 7.7 | 14.1 | 10.9 | 13.5 | < 0.001 |
Consumption of soft drinks or juices containing sugar |
CHILDREN |
Glasses per day | 0.51 (0.05) | 0.33 (0.05) | 0.32 (0.04) | 0.13 (0.04) | 0.30 (0.04) | 1.16 (0.06) | 0.40 (0.02) | < 0.001 |
PARENTS |
Glasses per day | 0.52 (0.05) | 0.17 (0.05) | 0.25 (0.04) | 0.14 (0.04) | 0.29 (0.05) | 1.07 (0.06) | 0.35 (0.02) | < 0.001 |
Consumption of sweets |
CHILDREN |
Portions per day | 1.13 (0.04) | 0.36 (0.05) | 0.73 (0.04) | 0.72 (0.04) | 0.84 (0.04) | 1.37 (0.05) | 0.83 (0.02) | < 0.001 |
PARENTS |
Portions per day | 0.99 (0.04) | 0.48 (0.05) | 0.64 (0.04) | 0.53 (0.04) | 0.67 (0.04) | 1.10 (0.06) | 0.70 (0.02) | < 0.001 |
Consumption of salty snacks, fast food |
CHILDREN |
Portions per day | 0.30 (0.04) | 0.12 (0.04) | INVALID | 0.19 (0.04) | 0.45 (0.04) | 0.97 (0.05) | 0.36 (0.02) | < 0.001 |
PARENTS |
Portions per day | 0.24 (0.03) | 0.10 (0.03) | 0.21 (0.03) | 0.12 (0.03) | 0.29 (0.03) | 0.61 (0.04) | 0.24 (0.01) | < 0.001 |
Breakfast consumption |
CHILDREN |
Days per week | 6.39 (0.07) | 6.80 (0.07) | 6.86 (0.06) | 6.44 (0.06) | 6.53 (0.06) | 6.41 (0.08) | 6.58 (0.03) | < 0.001 |
Meeting guidelines (%) | 82.5 | 92.4 | 95.9 | 82.9 | 83.1 | 82.3 | 86.9 | < 0.001 |
PARENTS |
Days per week | 5.88 (0.11) | 6.71 (0.12) | 6.45 (0.10) | 4.99 (0.10) | 4.30 (0.11) | 5.10 (0.14) | 5.60 (0.05) | < 0.001 |
Meeting guidelines (%) | 71.8 | 89.1 | 85.3 | 52.9 | 40.0 | 56.7 | 66.5 | < 0.001 |
INVALID: No valid cases because of missing question |
Children. Across the participating countries, children spent 5.20 days per week being moderate-to-vigorous physically active for at least 60 minutes per day and 29.7% of children complied with the PA guideline (being moderate-to-vigorous physically active for at least 60 minutes, 7 days per week). Significant differences exist between the countries (p < 0.001). Children from Hungary and Finland were significantly more physically active (respectively 5.78 and 5.76 days/week) compared to the other countries (p < 0.001), while children from Greece and Belgium spent the lowest number of days being at least 60 min physically active (respectively 4.73 and 4.96 days/week) (p < 0.001). Further, in Hungary and Finland a significantly higher percentage of children (respectively 43.3% and 40.3%) complied with the PA guidelines compared to the other participating countries (p < 0.01). On the other hand, the lowest number of children complied with the PA guidelines was found in Greece (17.1%; p < 0.01).
Parents. Overall, parents spent 3.85 days per week being moderate-to-vigorous physically active for at least 30 minutes per day and in total 43.7% complied with the PA guideline (being moderate-to-vigorous physically active for at least 30 minutes, 5 days per week). Significant differences exist between the participating countries (p < 0.001). Hungarian parents had the highest number of days in which they were physically active (5.04 days/week) compared to the other countries (p < 0.01). In Greece, Spain and Bulgaria, parents had the lowest number of days in which they were physically active (respectively 3.36, 3.37 and 3.69 days/week). The highest percentage of parents complying with the PA guidelines was found in Hungary (64.2%) (p < 0.01), while the lowest percentages of parents complying with the guidelines were found in Spain (37.7%), Greece (37.0%) and Bulgaria (38.1%) (p < 0.01).
Sedentary behaviour
Descriptive data (means and standard deviations) of subjectively measured sedentary behaviour in children and parents can be found in Table 2. Furthermore, within the table, differences between the countries were indicated (p-values).
Children. Children across the participating countries spent on average 108.09 minutes in front of screens and 64.5% complied with the screen-time guideline (less than 120 min/day). Significant differences exist between the countries. Spanish children spent 88.63 minutes in front of screens, which is the lowest amount of time compared to the other participating countries (p < 0.001). The highest amounts were found in Hungarian and Bulgarian children (respectively 125.74 and 118.52 min/day) (p < 0.01). The percentage of children meeting the screen-time guideline ranged between 74.6% in Spanish children and 54.9% in Hungarian children. A significantly higher number of Spanish and Greek children complied with the screen-time guideline compared to the other countries (p < 0.001).
Parents. Overall, parents spent on average 5.07 hours in sitting time during the day. Significant differences exist between the participating countries (p < 0.001). More specifically, Belgian parents had a significantly higher amount of sitting time (5.91 hours/day) compared to Greek (4.6 hours/day), Spanish (4.94 hours/day) and Bulgarian (4.96 hours/day) parents (p < 0.01). Furthermore, no differences exist between the other countries. No differences exist between the other countries.
Dietary behaviour
Drinking water. Descriptive data (means and standard deviations) of drinking water in children and parents can be found in Table 2. Furthermore, within the table, differences between the countries were indicated (p-values).
Children. Across the countries, children consumed on average 3.90 glasses of water per day and 39.8% complied with the guideline regarding water consumption (drinking at least 5 glasses per day). Significant differences exist between the participating countries (p < 0.001). More specifically, Spanish and Greek children consumed the highest amount of water (respectively 4.67 and 4.54 glasses/day) compared to the other countries (p < 0.01). The lowest amount of water consumption was found in children from Finland, who consumed 2.36 glasses per day (p < 0.001). The highest percentages of children meeting the guidelines regarding water consumption were found in Spain (55.1%), Greece (51.1%) and Hungary (51.7%) (p < 0.001), while only 12.9% of Finnish children and 17.7% of Belgian children complied with the guideline (p < 0.001).
Parents. Overall, parents consumed on average 4.55 glasses of water per day and 57.3% complied with the guideline regarding water consumption (drinking at least 5 glasses per day). Significant differences exist between the participating countries (p < 0.001). In Spain, Hungary and Bulgaria, parents consumed respectively 5.00, 4.71 and 4.73 glasses per day, which is significantly higher compared to the other countries (p < 0.01), while Belgian parents consumed the lowest amount of water (3.76 glasses/day) (p < 0.001). in Spain, Bulgaria and Hungary, respectively 67.2%, 60.0% and 65.3% of the parents complied with the guidelines of water consumption, which is significantly higher compared to the other countries (p < 0.01). The lowest amount of parents meeting the guideline was found in Belgium (41.0%) (p < 0.01).
Fruit and vegetable consumption. Descriptive data (means and standard deviations) of fruit and vegetable consumption in children and parents can be found in Table 2. Furthermore, within the table, differences between the countries were indicated (p-values).
Children. Across the countries, children consumed on average 2.43 portions of fruits and vegetables per day and differences were found between the countries (p < 0.001). Children in Bulgaria, Spain, Belgium and Finland consumed more fruit and vegetables compared to the other countries (p < 0.01), respectively 2.78, 2.60, 2.58 and 2.46 portions fruit and vegetables per day. Greek and Hungarian children consumed the lowest amount of fruit and vegetables per day (respectively 1.95 and 2.15 portions/day). Across the countries 9.4% of children complied with the guideline of at least 5 portions of fruit and vegetables per day. No significant differences were found between the participating countries.
Parents. Across the participating countries, parents consumed on average 2.63 portions of fruit and vegetables per day and 13.5% complied with the guideline of at least 5 portions of fruit and vegetables per day. Further, significant differences exist between the participating countries (p < 0.001). Parents from Finland, Bulgaria, Spain and Belgium consumed the highest proportions of fruit and vegetables per day (respectively 3.04, 2.96, 2.81 and 2.76 portions/day) compared to Hungarian and Greek parents who consumed respectively 2.03 and 2.00 portions of fruit and vegetables per day (p < 0.001). The percentage of parents meeting the fruit and vegetable guidelines ranged between 17.7% in Finish parents and 7.7% in Greek parents. In Greece and Hungary (10.9%), a significantly lower proportion of parents complied with guidelines compared to the other countries (p < 0.01).
Consumption of soft drinks and juices containing sugar. Descriptive data (means and standard deviations) of the consumption of soft drinks and juices containing sugar in children and parents can be found in Table 2. Furthermore, within the table, differences between the countries were indicated (p-values).
Children. Children across the participating countries consumed on average 0.40 glasses of soft drinks or juices containing sugar per day and significant differences exist between the countries. In Greece, children consumed the lowest amount of soft drinks or juices containing sugar per day (i.e. 0.13 glasses/day) (p < 0.001), while in Hungary, children consumed the highest amount of soft drinks or juices containing sugar per day (i.e. 1.16 glasses/day) (p < 0.001).
Parents. Parents across the participating countries consumed on average 0.35 glasses of soft drinks or juices containing sugar per day and significant differences exist between the countries. Hungarian parents consumed a significantly higher amount of soft drinks or soft drinks containing sugar (1.07 glasses per day) compared to parents in Greece (0.14 glasses/day), Finland (0.17 glasses/day), Spain (0.25 glasses/day), Bulgaria (0.29 glasses/day) and Belgium (0.52 glasses/day) (p < 0.001).
Consumption of sweets. Descriptive data (means and standard deviations) of the consumption of sweets in children and parents can be found in Table 2. Furthermore, within the table, differences between the countries were indicated (p-values).
Children. Children across the countries consumed on average 0.83 portions of sweets per day and significant differences could be detected between the countries (p < 0.001). In Finland, children consumed a significantly lower number of sweets (0.36 portions/day) compared to the other countries (p < 0.001). The highest consumption of sweets was found in Hungary, with an average of 1.37 portions per day (p < 0.001).
Parents. Parents across the countries consumed on average 0.70 portions of sweets per day and significant differences exist between the countries (p < 0.001). Parents from Finland and Greece consumed the lowest number of sweets per day (respectively 0.48, 0.53 portions/day), while in Hungary (1.10 portions/day) and Belgium (0.99 portions/day), parents consumed the highest number of sweets per day (p < 0.001).
Consumption of salty snacks and fast food. Descriptive data (means and standard deviations) of salty snacks and fast food in children and parents can be found in Table 2. Furthermore, within the table, differences between the countries were indicated (p-values).
Children. Children across the participating countries consumed on average 0.36 portions of salty snacks/fast food per day and differences exist between the countries (p < 0.001). In Finland and Greece, children consumed the lowest number of salty snacks and fast food (respectively 0.12 and 0.19 portions/day) (p < 0.01), while in Hungary, children consumed 0.97 portions of salty snacks and fast food, which is the highest number compared to the other countries (p < 0.001). From Spanish children, no data are available, due to a question missing in the local survey.
Parents. Parents across the countries consumed on average 0.34 portions of salty snacks and fast food per day and significant differences were found between the countries (p < 0.001). Finnish and Greek parents consumed the lowest number of salty snacks and fast food (respectively 0.10 and 0.12 portions/day) compared to the other countries (p < 0.01), while the highest number, 0.61 portions per day, was found in Hungarian parents (p < 0.001)
Breakfast consumption. Descriptive data (means and standard deviations) of breakfast consumption in children and parents can be found in Table 2. Furthermore, within the table, differences between the countries were indicated (p-values).
Children. Children across the countries consumed breakfast on 6.58 days per week and in total 86.9% complied with the daily breakfast guideline (consuming breakfast, 7 days/week). Significant differences exist between the countries (p < 0.001). The highest number of days in which children consumed breakfast were found in Spain (6.86 days/week) and Finland (6.79 days/week), while the lowest numbers were found in Belgium (6.39 days/week), Greece (6.44 days/week), Hungary (6.41 days/week) and Bulgaria (6.53 days/week) (p < 0.01). The highest percentages of children complying with the daily breakfast guideline were found in Spain (95.9%) and Finland (92.4%), while the lowest percentages were found in Hungary (82.3%), Belgium (82.5%), Greece (82.9%) and Bulgaria (83.1%) (p < 0.001).
Parents. Overall, parents consumed breakfast on average 5.60 days per week and in total 66.5% of all parents complied with the guideline of daily breakfast consumption. Significant differences exist between the participating countries (p < 0.001). The highest numbers of days in which parents consumed breakfast were found in Finland (6.71 days/week) and Spain (6.45 days/week) compared to the other countries (p < 0.001). In contrast, Bulgarian parents consumed breakfast on 4.30 days per week, which was significantly lower compared to the other countries (p < 0.001). The percentages of parents meeting the breakfast guidelines were the highest in Finland (89.1%) and Spain (85.3%), while the lowest percentage was found in Bulgaria (40.0%) (p < 0.001).
A more detailed description (p-values) of lifestyle behaviours between the participating countries can be found in Additional File 2.