Background: Parental weight status is a key predictor of childhood obesity. However, limited evidence exists on how longitudinal changes in parental BMI influence children's weight trajectories, particularly in families at elevated risk for type 2 diabetes. Objectives: To investigate children's body mass index‐for‐age z ‐score (BMIz) changes over a 2‐year period, associated with independent and cumulative changes in parents' BMI. Methods: In the Feel4Diabetes study, data from 12 280 children (age: 8.2 ± 1.0 years) and their parents were analysed to assess changes in child BMI‐for‐age z ‐scores over 2 years in relation to parental BMI changes. Analyses were adjusted for study design and baseline socio‐demographic factors and were conducted in both the total sample (all‐families) and high‐risk for type 2 diabetes families (HR‐families). Results: In the all‐families dataset, a 1 kg/m ² independent decrease in maternal and paternal BMI was associated with a −0.037 (−0.041, −0.033) and −0.027 (−0.031, −0.023) change in child's BMIz [mean (95% CI)]. The joint parental effect was stronger [−0.32 (−0.36, −0.28)], particularly in HR‐families [−0.34 (−0.42, −0.26)]. Conclusions: Parental BMI reductions, especially when both parents are involved, contribute to favourable BMI changes in children. The changes were more pronounced in HR‐families, underscoring the need for interventions targeting the whole family in populations at elevated risk for type 2 diabetes.

Background: While the importance of folic acid supplementation during pregnancy in the prevention of neural tube defects in offspring is well established, its potential role in pediatric asthma development remains unclear, with limited evidence to date. Objective: To identify perinatal and environmental factors that modify the association between maternal folic acid intake and pre-adolescent asthma. Methods: Cross-sectional analysis of the Healthy Growth Study that consisted of 2332 pre-adolescents (mean age 11 years; asthma n = 451); 50% boys attending elementary schools in Greece. Questionnaires were used to collect data on sociodemographic, perinatal, and environmental characteristics as well as asthma prevalence and maternal folic acid supplementation during pregnancy (trimesters 1, 2, and 3). Logistic regression models explored the association between maternal folic acid supplementation and pre-adolescent asthma, accounting for perinatal and environmental exposures. Results: Adjusted regression models showed that maternal folic acid supplementation during the third trimester was associated with 34% increased odds of pre-adolescent asthma. Stratified analyses per perinatal and environmental factors revealed significantly higher asthma odds with folic acid supplementation during the second and third trimesters among pre-adolescents born < 37 weeks; non-smoking mothers; in pre-adolescents attending schools of low socioeconomic level; and in neighborhoods having less traffic and more parks. Contrastingly, in appropriate for gestational age (AGA), an infant’s first-trimester supplementation increased asthma odds. Conclusions: Maternal folic acid supplementation, particularly in later trimesters, was modestly associated with increased odds of pre-adolescent asthma, modified by perinatal and environmental factors. Future research should explore whether continued folic acid supplementation beyond the first trimester carries differential risks or benefits in asthma.

Background While the importance of folic acid supplementation during pregnancy in the prevention of neural tube defects in offspring is well-established, its potential role in pediatric asthma development remains unclear, with limited evidence to date. Aim To identify perinatal and environmental factors that modify the association between maternal folic acid intake and pre-adolescent asthma. Methods Cross-sectional analysis of the Healthy Growth Study that consisted of 2332 preadolescents (mean age 11 years, asthma n = 451), 50% boys attending elementary schools in Greece. Questionnaires were used to collect data on sociodemographic, perinatal, and environmental characteristics, asthma prevalence and maternal folic acid supplementation during pregnancy (trimesters 1, 2, and 3). Logistic regression models explored the association between maternal folic acid supplementation and preadolescent asthma accounting for perinatal and environmental exposures. Results Adjusted regression models showed that maternal folic acid supplementation during the 3rd-trimester was associated with 34% increased odds of pre-adolescent asthma. Stratified analyses per perinatal and environmental factors revealed significantly higher asthma odds with folic acid supplementation during 2nd- and 3rd-trimesters among pre-adolescents born < 37 weeks, non-smoking mothers, in pre-adolescents attending schools of low socio-economic level, in neighborhoods having less traffic and more parks. Contrastingly, in appropriate for gestational age (AGA), infant’s 1st -trimester supplementation increased asthma odds. Conclusions Maternal folic acid supplementation, particularly in later trimesters, was modestly associated with increased odds of pre-adolescent asthma, modified by perinatal and environmental factors. Future research should explore whether continued folic acid supplementation beyond the 1st-trimester carries differential risks or benefits in asthma.

Background: Family‐based interventions offer a promising solution to the pressing global health concern of childhood obesity by addressing the interconnected behaviours of parents and children. Nevertheless, limited evidence identifies which families benefit most when outcomes are evaluated at the parent–child dyad level. Aim: To identify which parent–child dyads experienced clinically meaningful improvements in weight status over 1‐ and 2‐year periods within the Feel4Diabetes study, a school‐ and community‐based intervention targeting European families at risk for Type 2 diabetes. Methods: Data were drawn from 2402 high‐risk families across six European countries. For participants with overweight/obesity, improvement meant ≥ 5% parental weight loss and a ≥ 0.15‐unit child BMI‐ z reduction. Multiple logistic regression models identified socio‐demographic and contextual predictors of dyadic improvement. Results: After 2 years, 5.3% of families achieved improvements in both parent and child. Significant predictors of dyadic success included intervention group participation [OR = 2.56 (95% CI: 1.31–5.03)] and residing in high‐income countries under austerity measures [OR = 2.44 (1.00–6.02)]. Girls were more likely to improve than boys, while full‐time maternal employment was associated with lower odds of dyadic improvement. Conclusions: Sustained benefits were observed in a subset of families, highlighting the need for tailored, context‐sensitive family‐centred obesity prevention strategies.

Τo develop a revised version of the FINDRISC tailored to improve the identification of individuals at high risk for type 2 diabetes (T2D) across diverse populations. The revised-FINDRISC was developed using pooled harmonized baseline data from the multinational Feel4Diabetes (NCT02393872; N = 3526) and DigiCare4You (NCT05648383; N = 2156) studies. Validation utilized data from the 20-year ATTICA cohort study in Greece. Original FINDRISC components were analyzed using Fisher's Linear Discriminant Analysis followed by supervised stepwise logistic regression to identify significant T2D cross-sectional predictors. The revised-FINDRISC was developed by re-scoring or excluding original items and incorporating new predictors, generating an integer-based score to enhance usability. The revised-FINDRISC significantly improved accuracy in identifying current T2D risk over the original, with an overall AUC of 0.911(95%CI: 0.901,0.922) versus 0.832(0.815,0.846). When stratified by country economic classification, the revised score outperformed the original across all groups: LMICs: 0.881(0.864,0.898) vs. 0.815(0.793,0.837), South European-HICs: 0.891(0.867,0.916) vs. 0.839(0.811,0.869), and North European-HICs: 0.921(0.872,0.971) vs. 0.844(0.742,0.949). A clinical threshold score of 13/24 in the revised-FINDRISC offers optimal sensitivity and specificity for identifying individuals at risk of T2D. Enhanced with demographic, socio-economic, and clinical factors, the revised-FINDRISC potentially represents a substantive advancement in T2D screening, supporting early detection and targeted prevention.