What is the role of particulate matter 2.5 (PM2.5) on excess weight? A cross-sectional study in young Spanish people aged 2─14 years.

PURPOSE: To assess the relationship between particulate matter 2.5 (PM2.5) levels and the prevalence of excess weight in a representative sample of Spanish young people aged 2─14 years. METHODS: This was an ecological cross-sectional study using data from the 2017 wave of the Encuesta Nacional de Salud Española (ENSE), a nationally representative survey of the Spanish young and adult population. The final sample included 4378 young Spanish people (51.0% boys). The weight (kg) and height (cm) of the study participants were proxy-reported by parents or guardians. Excess weight was determined according to the age- and sex-criteria of the International Obesity Task Force. The PM2.5 level was calculated as the annual monitoring data indicator for 2017 among the different regions in Spain. Logistic regression models were performed to estimate the relationships between PM2.5 and weight. RESULTS: Compared to young people located in regions with low levels of PM2.5, those reporting greater odds for excess weight were found in regions with medium PM2.5 (OR = 1.23; 95% CI, 1.02-1.49) and high PM2.5 (OR = 1.35; 95% CI, 1.11-1.64) after adjusting for several sociodemographic, lifestyle and environmental covariates. CONCLUSIONS: The prevalence of excess weight in young people was positively associated with PM2.5 levels in Spain. This finding supports the hypothesis that air pollution exposure can result in excess weight in the young population, which, in turn, might lead to the development of metabolic disorders. From a socioecological perspective, a practical need to take environmental factors into consideration is important to address unhealthy weight in Spanish young people.

Physical fitness and disordered eating among adolescents: Results from the EHDLA study.

The aim of this study was to examine the association between a comprehensive spectrum of physical fitness components and disordered eating symptoms in a sample of Spanish adolescents. This cross-sectional study analysed a representative sample of 741 adolescents (55.1% girls) from the Eating Healthy and Daily Life Activities (EHDLA) study (Valle de Ricote, Region of Murcia, Spain). Objective physical fitness (i.e., cardiorespiratory fitness, upper body strength, lower body strength, speed-agility, and flexibility) was assesed by the ALPHA-FIT Test Battery for a young population. Disordered eating symptoms were assessed with the Sick, Control, One, Fat, Food (SCOFF) questionnaire. An incremental inverse association was found in participants with low cardiorespiratory fitness (OR = 2.33; 95% CI: 1.56-3.50), low handgrip strength (OR = 1.99; 95% CI: 1.33-2.97), low lower body strength (OR = 1.91; 95% CI: 1.28-2.86), low speed-agility (OR = 1.75; 95% CI: 1.17-2.62), and low global physical fitness (OR = 2.03; 95% CI: 1.37-3.01) and disordered eating symptoms, compared to participants with a high level of each of these physical fitness components. Our study provides evidence that, in Spanish adolescents, disordered eating symptoms are inversely associated with a comprehensive set of physical fitness components. Hence, it could be relevant to promote physical fitness, e.g., by a multifactorial approach, since it seems to be related to lower disordered eating symptoms in adolescents.

[Assessment of the eating habit in the health-related lifestyle among Spanish adults from 22 to 72 years of age]. / Valoración del hábito de alimentación en el estilo de vida saludable adquirido en adultos españoles de 22 a 72 años de edad.

Introduction: Introduction: eating habits are one of the main predictors of health within a person lifestyle. The assessment of these habits will be essential to confirm health-related habits and orientate behaviors of risk for health. Objectives: to assess the eating habits within the health-related lifestyle among Spanish adults from 22 to 72 years of age. Methods: the Health-Related Lifestyle Assessment Scale (E-VEVSA) was applied to a sample of 788 subjects between the ages of 22 and 72. This scale is made up of 52 items and structured in seven dimensions, among which the healthy eating habit was evaluated, which explained a variance of 8.67 % of the total scale (66.87 %) and a Cronbach's alpha of 0.794 for a total alpha of 0.894. Results: sixteen percent of the adults surveyed have healthy eating habits, 68.3 % tend towards health and 15.7 % are unhealthy. Pearson's 2 tests show a positive and significant association of women with healthy eating habits and a significant improvement with age. The inferential data (Student's t-tests and one-factor ANOVA) confirm these differences according to gender and age. Conclusions: it is necessary to promote preventive programs to improve eating habits in the adult population, especially in the 15.7 % that have an unhealthy level of nutrition in their lifestyle.

Introducción: Introducción: los hábitos de alimentación constituyen uno de los factores predictores de salud principales dentro de los estilos de vida adquiridos. La evaluación de dichos hábitos va a ser fundamental para poder reafirmar las conductas saludables y reorientar aquellos hábitos que supongan un riesgo. Objetivos: evaluar el hábito de alimentación dentro del estilo de vida saludable adquirido en adultos españoles de 22 a 72 años de edad. Métodos: a una muestra de 788 sujetos de edades comprendidas entre los 22 y los 72 años de edad se aplicó la Escala de Valoración del Estilo de Vida Saludable Adquirido (E-VEVSA), formada por 52 ítems y estructurada en siete dimensiones, entre las cuales se evaluó el hábito de alimentación saludable, que explicó una varianza de 8,67 % sobre el total de la escala (66,87 %) y un alfa de Cronbach de 0,794 para un alfa total de 0,894. Resultados: el 16 % de los adultos encuestados posee hábitos de alimentación saludables; el 68,3 %, tendente hacia la salud; y el 15,7 %, poco saludables. Las pruebas de 2 de Pearson muestran una asociación positiva y significativa de las mujeres con hábitos saludables de alimentación y una mejora significativa con el transcurso de la edad. Los datos inferenciales (pruebas t de Student y ANOVA de un factor) confirman estas diferencias en función del sexo y la edad. Conclusiones: es necesario promover programas preventivos para la mejora de los hábitos de alimentación en la población adulta, sobre todo, en el 15,7 % que posee un nivel poco saludable de la alimentación en su estilo de vida.

Physical activity as a mediator of the association of body mass index change with anxiety/depression symptoms in Brazilian adults during COVID-19.

BACKGROUND: the COVID-19 pandemic has impacted people's behaviors and mental health around the world. AIM: to verify the mediating role of physical activity (PA) level in the relationship between body mass index (BMI) and anxiety and depression symptoms. METHODS: this is a cross-sectional study with Brazilian adults aged ≥ 18 years (n = 2,000, 59.6 % women) selected by the nonprobabilistic snowball method through digital means of communication (WhatsApp®, Telegram®, Facebook®, Twitter®, e-mails). Linear regression models were fitted for PA level mediation analyses in the relationship between BMI and anxiety/depression symptoms. RESULTS: significant differences were found between the active/not overweight group and the other three groups (active/overweight, insufficiently active/not overweight and insufficiently active/overweight [p < 0.001]) for anxiety/depression after adjusting for age, gender, chronic diseases, alcohol consumption, and smoking. When testing the mediating role of daily PA in the association between BMI and anxiety/depression symptoms, BMI was negatively associated with daily PA in the first regression equation (p < 0.001); in the second, BMI was positively related to anxiety/depression symptoms (p < 0.001); and in the third, daily PA showed an inverse relationship with anxiety/depression symptoms (p < 0.001), and although BMI remained negatively associated with anxiety/depression symptoms, these associations maintained their statistical significance. CONCLUSIONS: the results suggest that the effect of BMI on anxiety and depression was partially mediated by daily PA.

[Evolution of the diet and physical activity of university students after the COVID-19 pandemic]. / Evolución de la dieta y la actividad física de los estudiantes universitarios tras la pandemia de COVID-19.

Introduction: Objective: to assess the evolution of adherence to Mediterranean diet and level of physical activity of university students of Health Sciences in Castilla-La Mancha during the COVID-19 lockdown and one year afterwards. Methods: a cross-sectional observational study using questionnaires on adherence to the Mediterranean diet and level of physical activity. A total of 893 students enrolled in Health Sciences degrees at the University of Castilla la Mancha participated, 575 in the first survey (during the lockdown) and 318 in the second (one year later). By sex, 672 women and 221 men (in the first survey 77.7 % were women and 22.3 % men while in the second survey these were 70.8 % and 29.2 %, respectively). Adherence to the Mediterranean diet was assessed with the Mediterranean Diet Adherence Screener (MEDAS) questionnaire and the modified Prevention with Mediterranean Diet (PREDIMED) questionnaire. The level of physical activity was assessed with the Rapid Assessment of Physical Activity Scale (RAPA). Results: one year after the COVID-19 confinement, consumption of olive oil has almost tripled. Daily fruit consumption has also doubled. Similarly, the consumption of wine and alcoholic beverages has doubled. Conversely, there was a reduction in the consumption of butter and margarine, as well as of carbonated drinks and sweetened beverages. Likewise, the percentage of university students with high adherence to the Mediterranean diet increased significantly (from 26 % to 34.3 %). Regarding physical activity level, there was a significant increase in the percentage of university students who engaged in light, moderate and even intense physical activity on an irregular basis. This increase was not found in the case of muscular strength and flexibility training activities. Conclusion: the results of the study indicate that, although the levels of adherence to the Mediterranean diet and physical activity have improved after the COVID-19 confinement, adherence to Mediterranean diet and physical activity level among the university population analyzed is still low. It is necessary to implement strategies for the achievement or maintenance of a healthy lifestyle in this population.

Introducción: Objetivo: valorar la evolución de la adherencia a la dieta mediterránea y el nivel de actividad física de los estudiantes universitarios de Ciencias de la Salud de Castilla-La Mancha durante la pandemia de COVID-19 y un año después de la misma. Método: estudio observacional transversal mediante cuestionarios sobre la adherencia a la dieta mediterránea y el nivel de actividad física. Participaron 893 alumnos matriculados en grados de Ciencias de la Salud de la Universidad de Castilla-La Mancha, 575 en la primera encuesta (durante la pandemia) y 318 en la segunda (un año después). Por sexos, 672 mujeres y 221 hombres (en la primera encuesta, el 77,7 % eran mujeres y el 22,3 % hombres, mientras que en la segunda lo eran el 70,8 % y 29,2 %, respectivamente). La adherencia a la dieta mediterránea se valoró con el cuestionario Mediterranean Diet Adherence Screener (MEDAS) y el cuestionario de Prevención con Dieta Mediterránea (PREDIMED), modificado. El nivel de actividad física se valoró con el cuestionario Rapid Assessment of Physical Activity Scale (RAPA). Resultados: tras un año desde el confinamiento por la COVID-19, el consumo de aceite de oliva casi se ha triplicado. Se ha duplicado también el consumo de frutas diario. De igual modo, se ha duplicado el consumo de vino y bebidas alcohólicas. Por el contrario, se encontró una reducción del consumo de mantequilla y margarina, al igual que de bebidas carbonatadas y azucaradas. Asimismo, aumentó significativamente el porcentaje de estudiantes universitarios con adherencia alta a la dieta mediterránea (del 26 % al 34,3 %). En cuanto al nivel de actividad física, ha aumentado significativamente el porcentaje de estudiantes universitarios que realizan actividad fisica ligera, moderada e incluso intensa de forma irregular. Este aumento no se ha encontrado en el caso de las actividades de fuerza muscular y flexibilidad. Conclusión: los resultados del estudio nos indican que, aunque los niveles de adherencia a la dieta mediterránea y de actividad física han mejorado tras el confinamiento por la COVID-19, la adherencia a la dieta mediterránea y el nivel de actividad física de la población universitaria analizada siguen siendo bajos. Es necesario aplicar estrategias para la consecución o mantenimiento de un estilo de vida saludable en dicha población.

Health-related lifestyle assessment among Spanish adults from 22 to 72 years. / Valoración del estilo de vida saludable adquirido en adultos españoles de 22 a 72 años de edad.

OBJECTIVE: The objective of this paper has focused on assessing the level of health-related lifestyle acquired in Spanish adults in the Spanish cities of Albacete and Murcia, and analyzing the existing differences according to sex and age. MATERIAL AND METHODS: On a sample of 788 subjects aged between 22 and 72, the Health-related Lifestyle Assessment Scale was applied, consisting of 52 items and structured in 7 dimensions that explained a total variance of 66.87% and a Cronbach's alpha of 0.894. RESULTS: A percentage of 12 of the adults surveyed have a healthy lifestyle, 53% show a trend to health and 35% poor or unhealthy. Pearson's χ2 tests show a positive and significant association of women with health and a trend of significant improvement in lifestyle with age. The inferential data (t-Student tests and one-factor ANOVA) confirm these differences according to gender and age. CONCLUSIONS: It is necessary to promote preventive programs to improve health in the habits of the population, especially in the 35% that show a poor or unhealthy level of lifestyle.

Overall proportion of orthorexia nervosa symptoms: A systematic review and meta-analysis including 30 476 individuals from 18 countries.

Background: To date, no previous meta-analysis has determined the overall proportion of orthorexia nervosa symptoms on a global scale. The aim of the present study was 2-fold: first, to establish the overall proportion of orthorexia nervosa symptoms on a global scale, assessed with the ORTO-15 questionnaire; and second, to determine the role of sex, type of population, mean age, body mass index, and the temporal trend in relation to orthorexia nervosa symptoms. Methods: Four databases were searched (PubMed, Scopus, Web of Science, and Cochrane Database of Systematic Reviews) with date limits from January 2005 to June 2023. Studies assessing the proportion of orthorexia nervosa assessed using the ORTO-15 questionnaire with a cutoff of <35 or <40 points were included in this review. Results: The overall proportion of orthorexia nervosa symptoms (using the cutoff <35 points) was 27.5% (95% confidence interval (CI) = 23.5-31.6, I2 = 97.0%). In addition, no significant differences were observed between females (34.6%, 95% CI = 29.5-39.8, I2 = 96.1%) and males (32.1%, 95% CI = 26.5-38.1, I2 = 93.1%). According to the type of population, the highest overall proportion was found in people focused on sports performance or body composition (34.5%, 95% CI = 23.1-47.0, I2 = 98.0%). Notwithstanding, caution should be exercised in interpreting this result, as reverse causality could be a potential pitfall in this relationship. Conclusions: We found that approximately three out of 10 study participants showed orthorexia nervosa symptoms according to the ORTO-15 tool. This overall proportion was higher in those participants who were athletes or fitness practitioners. Over the years, the proportion of orthorexia nervosa symptoms seems to be increasing. These high percentages and their increase are worrisome from a public health perspective and highlight the need to develop psychometric instruments to aid in clinical diagnosis and treatment efficacy. Registration: PROSPERO (CRD42022350873).

Research on Diet and Human Health.

One of the major public health challenges is the global burden and threat of noncommunicable diseases (NCDs) [...].

Breakfast and psychosocial behavioural problems in young population: The role of status, place, and habits.

The aim of this study was to examine whether breakfast status, place and habits are associated with psychosocial behavioural problems in a nationally representative sample of young people aged 4-14 years residing in Spain. This study analysed secondary data from the Spanish National Health Survey (2017), including 3,772 Spanish children and adolescents. Breakfast status, place, and habits were assessed by ad hoc questions answered by parents/guardians. The Strengths and Difficulties Questionnaire (SDQ) parents' version form was applied to evaluate the psychosocial health of their children. Skipping breakfast and eating breakfast out of home were linked to greater odds of psychosocial behavioural problems (skipping breakfast: OR = 3.29; CI 95%, 1.47-7.35; breakfast out of home: OR = 2.06; CI 95%, 1.27-3.33) than eating breakfast at home. Similarly, not consuming coffee, milk, tea, chocolate, cocoa, yogurt, etc., for breakfast was related to greater odds of psychosocial behavioural problems (OR = 1.76; CI 95%, 1.21-2.55). This association was also found for those who did not eat bread, toast, cereals, pastries, etc., for breakfast (OR = 1.31; CI 95%, 1.01-1.73). Conversely, not consuming eggs, cheese, ham, etc., was associated with lower odds of psychosocial behavioural problems (OR = 0.56; CI 95%, 0.38-0.83). Our results show that eating breakfast (specifically at home) and breakfast habits related to the intake of certain food/beverages groups were associated with higher or lower odds of psychosocial behavioural problems.

Physical activity and its association with Mediterranean diet patterns among Spanish university students.

Introduction: Objective: the aim of the present study was to assess the level of physical activity and its association with Mediterranean dietary patterns in university students of health sciences at Universidad de Castilla-La Mancha (Spain). Method: a cross-sectional study was performed through an online survey. The final sample consisted of 555 university students (78.2 % females). Adherence to Mediterranean diet was assessed using the 14-item Mediterranean Diet Adherence Screener (MEDAS). To measure physical activity, the Rapid Assessment of Physical Activity Scale (RAPA) questionnaire was used. Results: according to physical activity, 2.5 % of the participants were considered active and 35.1 % did both strength and flexibility activities. A greater association was seen between intake of fruits (OR = 1.95; 95 % CI, 1.25-3.04), pulses (OR = 1.51; 95 % CI, 1.00-3.20), and nuts (OR = 1.99; 95 % CI, 1.33-2.99) in those considered sufficiently active. Similarly, we found a significant relationship between the intake of fruits (OR = 2.28; 95 % CI, 1.49-3.47), pulses (OR = 1.41; 95 % CI, 1.00-2.08), nuts (OR = 1.96; 95 % CI, 1.34-2.86), and fish/seafood (OR = 1.67; 95 % CI, 1.15-2.43) in those who engaged in both strength and flexibility activities. Conclusion: this study suggests that consumption of certain Mediterranean foods was associated with higher levels of physical activity in a sample of Spanish university students.

Introducción: Objetivo: el objetivo del presente estudio fue evaluar el nivel de actividad física y su asociación con la dieta mediterránea en estudiantes universitarios de ciencias de la salud de la Universidad de Castilla-La Mancha (España). Método: se realizó un estudio transversal a través de una encuesta online. La muestra final estuvo formada por 555 estudiantes universitarios (78,2 % mujeres). La adherencia a la dieta mediterránea se evaluó mediante el evaluador de adherencia a la dieta mediterránea de 14 ítems (MEDAS). Para medir la actividad física se utilizó el cuestionario Rapid Assessment of Physical Activity Scale (RAPA). Resultados: de acuerdo con la actividad física, el 2,5 % de los participantes se consideraron activos y el 35,1 % realizaban actividades tanto de fuerza como de flexibilidad. Se observó una mayor asociación entre la ingesta de frutas (OR = 1,95; IC 95 %, 1,25-3,04), legumbres (OR = 1,51; IC 95 %, 1,00-3,20) y frutos secos (OR = 1,99; IC 95 %, 1,33-2,99) en aquellos considerados suficientemente activos. Asimismo, encontramos una relación significativa entre la ingesta de frutas (OR = 2,28; IC 95 %, 1,49-3,47), legumbres (OR = 1,41; IC 95 %, 1,00-2,08), frutos secos (OR = 1,96; IC 95 %, 1,34-2,86) y pescado/marisco (OR = 1,67; IC 95 %, 1,15-2,43), en aquellos que participaron en actividades de fuerza y flexibilidad. Conclusión: este estudio sugiere que el consumo de determinados alimentos mediterráneos se asocia a mayores niveles de actividad física en la muestra de universitarios españoles analizada.