Regular consumption of flavonoids may reduce the risk for CVD. However, the effects of individual flavonoids, for example, quercetin, remain unclear. The present study was undertaken to examine the effects of quercetin supplementation on blood pressure, lipid metabolism, markers of oxidative stress, inflammation, and body composition in an at-risk population of ninety-three overweight or obese subjects aged 25-65 years with metabolic syndrome traits. Subjects were randomised to receive 150 mg quercetin/d in a double-blinded, placebo-controlled cross-over trial with 6-week treatment periods separated by a 5-week washout period. Mean fasting plasma quercetin concentrations increased from 71 to 269 nmol/l (P,0·001) during quercetin treatment. In contrast to placebo, quercetin decreased systolic blood pressure (SBP) by 2·6 mmHg (P,0·01) in the entire study group, by 2·9 mmHg (P,0·01) in the subgroup of hypertensive subjects and by 3·7 mmHg (P,0·001) in the subgroup of younger adults aged 25 -50 years. Quercetin decreased serum HDL-cholesterol concentrations (P,0·001), while total cholesterol, TAG and the LDL:HDL-cholesterol and TAG:HDL-cholesterol ratios were unaltered. Quercetin significantly decreased plasma concentrations of atherogenic oxidised LDL, but did not affect TNF-a and C-reactive protein when compared with placebo. Quercetin supplementation had no effects on nutritional status. Blood parameters of liver and kidney function, haematology and serum electrolytes did not reveal any adverse effects of quercetin. In conclusion, quercetin reduced SBP and plasma oxidised LDL concentrations in overweight subjects with a high-CVD risk phenotype. Our findings provide further evidence that quercetin may provide protection against CVD.Quercetin: Blood pressure: Inflammation: Oxidised LDL: CVD Flavonoids in general and quercetin in particular have been associated with a decreased risk for CVD (1) . Furthermore, there was a trend towards a reduction in the incidence of type 2 diabetes mellitus at higher quercetin intakes (2) . In Western populations, the primary dietary sources of quercetin are tea, red wine, fruits and vegetables (3,4) . Quercetin is one of the major flavonoids, ubiquitously distributed in (edible) plants, and one of the most potent antioxidants of plant origin (1) . Numerous biological effects of quercetin, including antioxidant, anti-inflammatory, anti-thrombotic and vasodilatory actions, have been described in vitro (1) . However, quercetin intervention trials in human subjects have so far shown inconclusive and even conflicting results (5) . Quercetin supplementation increased plasma antioxidant capacity, ex vivo resistance of LDL to oxidation and resistance of lymphocyte DNA to strand breakage, but decreased urinary 8-hydroxy-2 0 -deoxyguanosine concentrations (5) . Other human studies, however, failed to confirm effects on these biomarkers (5) . A recent meta-analysis of 133 controlled flavonoid trials (6) suggested that there may be clinically relevant effects of some flavonoids or flavonoid-ri...

Background/Objectives: This study investigates determinants of sleep duration and its impact on nutritional status, resting energy expenditure (REE), cardiometabolic risk factors and hormones in children/adolescents. Subjects/Methods: In 207 girls and 207 boys (13.0±3.4 (6.1-19.9) years) body mass index standard deviation score (BMI SDS), waist circumference (WC) z-score, body composition (air-displacement plethysmography), REE (ventilated hood system; n ¼ 312) and cardiometabolic risk factors/hormones (n ¼ 250) were assessed. Greater than 90th percentile of BMI/WC references was defined as overweight/overwaist. Sleep duration, media consumption (TV watching/computer use), physical activity, dietary habits, parental BMI, socio-economic status and early infancy were assessed by questionnaire. Short sleep was defined as o10 h per day for children o10 years and otherwise o9 h per day. Results: Total 15.9% participants were overweight, mean sleep duration was 8.9±1.3 h per day. Age explained most variance in sleep (girls: 57.0%; boys: 41.2%) besides a high nutrition quality score (girls: 0.9%) and a low media consumption (boys: 1.3%). Sleep was inversely associated with BMI SDS/WC z-score (girls: r ¼ À0.17/À0.19, Po0.05; boys: r ¼ À0.21/À0.20, Po0.01), which was strengthened after adjusting for confounders. Short vs long sleep was associated with 5.5-/2.3-fold higher risks for obesity/overwaist (girls). After adjusting for age, REE (adjusted for fat-free mass) was positively associated with sleep in boys (r ¼ 0.16, Po0.05). Independently of age and WC z-score, short sleep was associated with lower adiponectin levels in boys (11.7 vs 14.4 mg/ml, Po0.05); leptin levels were inversely related to sleep in girls (r ¼ À0.23, Po0.05). Homoeostasis model assessment-insulin resistance (r ¼ À0.20, Po0.05) and insulin levels (r ¼ À0.20, Po0.05) were associated with sleep (girls), which depended on WC z-score. Conclusions: Age mostly determined sleep. Short sleep was related to a higher BMI SDS/WC z-score (girls/boys), a lower REE (boys), higher leptin (girls) and lower adiponectin levels (boys).

The present data suggest that active commuting to school per se does not affect FM or BMI until considering distance to school. Increasing walking or cycling distance results in decreasing FM. However, the everyday need to get to and from school may enhance adolescents' overall PA.

Enhancing health literacy is a keystone in health promotion. Yet, most studies on health literacy are limited to functional literacy levels. Furthermore, little evidence is available from children. Based on Nutbeam's outcome model for health promotion, this study aims (i) to elaborate a set of short scales to measure important health literacy domains in children and (ii) to analyse their associations among each other, with health behaviour as an intermediate health outcome, subjective health, social status and gender. The sample comprised 852 school children in fifth grade, aged 9-13 years, in Western Pomerania, Germany. Items were taken from the child's questionnaire to form short scales for health-related knowledge, attitudes, communication and behaviour. The internal consistencies of the communication and attitude scales were 0.73 and 0.57, respectively. Unidimensional scalability of the knowledge and behaviour scales was supported by item response models. Associations between health scales were modest. In regression analyses, social status and gender predicted only health knowledge and communication but not health behaviours, attitudes and self-efficacy. Health knowledge was not associated with any other scale. Our results suggest that targeting one specific component of health literacy in children is likely to exert only small effects on health status and health behaviour.

Research Methods and Procedures:Within a cluster-sampled quasi-randomized controlled trial, 1764 children at 6 and 10 years of age were assessed between 1996 and 2005 in 32 primary schools in Kiel, North Germany. Six nutrition units followed by 20-minute running games were performed within the first year at school. Prevalence, incidence, and remission of overweight were main outcome measures. Results: The 4-year change in BMI was ϩ11.6%, with increases in prevalence of overweight and obesity from 5.2% to 11.1% and 3.9% to 5.1%, respectively. Cumulative 4-year incidence of overweight and obesity was 9.2% and 3.1%, respectively. Intervention had no effect on mean BMI. The effect on prevalence was significant in children from families with high socioeconomic status [odds ratio (OR), 0.35; 95% confidence interval (CI), 0.14 to 0.91] and marginally significant in children of normal-weight mothers (OR, 0.57; 95% CI, 0.33 to 1.00). Cumulative 4-year incidence of overweight was lower only in intervention children from families with high socioeconomic status (OR, 0.26; 95% CI, 0.07 to 0.87). Remission of overweight was most pronounced in children of normal-weight mothers (OR, 5.43; 95% CI, 1.28 to 23.01). Prevalence of underweight was unchanged. The intervention had minor but favorable effects on lifestyle. Discussion: A school-based health promotion has sustainable effects on remission and incidence of overweight; it was most pronounced in children of normal-weight mothers and children from families with high socioeconomic status. There was no effect on obesity. The data argue in favor of additional measures of prevention.