title: Revised Healthy Lifestyle-Diet Index and associations with obesity and iron deficiency in schoolchildren: The Healthy Growth Study.
abstract: BACKGROUND
  The Healthy Lifestyle-Diet Index (HLD-index), previously developed to assess the degree of adherence to dietary and lifestyle guidelines for primary schoolchildren, was revised according to updated recommendations. Τhe association of the revised HLD-index (R-HLD-index) with obesity and iron deficiency (ID) was also examined.
  
  
  METHODS
  A representative sample of 2660 primary schoolchildren from Greece (9-13 years old) participating in the 'Healthy Growth Study' was examined. Twelve components related to dietary and lifestyle patterns were used to develop the R-HLD-index. Scores from 0 up to 4 were assigned to each one of these components, giving a total score ranging from 0 to 48. The associations between the R-HLD-index, obesity and ID were examined via logistic regression analysis.
  
  
  RESULTS
  The total score of the R-HLD-index calculated for each one of the study participants was found to range between 2 and 32 units, with higher scores being indicative of a healthier lifestyle and better diet quality. After adjusting for potential confounders, logistic regression analysis showed that an increase in the R-HLD-index score by one unit was associated with 6% lower odds for obesity. However, no significant association was observed between the R-HLD-index score and ID.
  
  
  CONCLUSIONS
  The R-HLD-index may be a useful tool for public health policy makers and healthcare professionals when assessing diet quality and lifestyle patterns of primary schoolchildren. Identification of children with lower scores in the R-HLD-index and its individual components could guide tailored made interventions targeting specific children and behaviors.
authors.affiliation: Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
authors.forename: Y
authors.initials: Y
authors.lastname: Manios
authors.forename: G
authors.initials: G
authors.lastname: Moschonis
authors.forename: C
authors.initials: C
authors.lastname: Papandreou
authors.forename: E
authors.initials: E
authors.lastname: Politidou
authors.forename: A
authors.initials: A
authors.lastname: Naoumi
authors.forename: D
authors.initials: D
authors.lastname: Peppas
authors.forename: C
authors.initials: C
authors.lastname: Mavrogianni
authors.forename: C
authors.initials: C
authors.lastname: Lionis
authors.forename: G P
authors.initials: GP
authors.lastname: Chrousos
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D002648:Child; D004032:Diet / Q000592:standards*; D005247:Feeding Behavior; D005260:Female; D006115:Greece; D006128:Growth; D006262:Health; D015438:Health Behavior; D006801:Humans; D000090463:Iron Deficiencies; D008019:Life Style; D016015:Logistic Models; D008297:Male; D018673:Nutrition Policy; D009765:Obesity / Q000209:etiology*; D012574:Schools
keywords: diet; iron deficiency; lifestyle patterns; obesity; primary schoolchildren