[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.

[Motivational intervention for obesity in Primary Care using a physical activity program]. / Intervención motivacional de la obesidad en Atención Primaria mediante un programa de actividad física.

INTRODUCTION: Objective: to evaluate the effectiveness of the obesity intervention with three different approaches, one of them with a platform that promotes physical activity. Material and method: randomized, controlled, parallel clinical trial that compared 3 arms, multicenter study in overweight or obese patients with a follow-up of 12 months. The patients were randomized into three groups: Intervention in the primary care center with G1 intervention: Control group, which received the usual recommendations to lose weight following the SEEDO 2000 Consensus. G2: Motivational intervention of obesity (IMOAP) with trained nurse and small periodic work groups. G3: Motivational intervention of obesity (IMOAP) adding the use of a digital platform that allows physical activity to be recorded, monitored and at the same time favors the practice of this (iwopi). Variables were collected: weight, height, BMI, circumference of the waist, lipid parameters, blood pressure, glycosylated hemoglobin. Results: 185 patients were initially included in the study. Seventeen patients left the study. Thus, 168 patients completed the study: 47 in G1, 61 in G2 and 60 in G3. Of the population studied, 57.1% were women. observing a general average weight reduction at the end of the study of 4.37 kg, being 5.34 kg in the group 2.6.29 kg in the group 3 and 1.25 kg in the control group (G1). It was also observed that cholesterol levels in three groups were reduced. at did not reach a statistically significant value. The clinically relevant parameters were: group 1 (control) versus group 2 (IMOAP): relative risk (RR), 0.10 to 0.46; relative risk reduction (RRR), 0.54 to 0.90; absolute risk reduction (ARR), from 0.30 to 0.61; number needed to treat (NNT), 3 to 2. Group 1 versus group 3 (IMOAP-PA): RR, 0.07 to 0.30; RRR, 0.70 to 0.93; ARR, 0.61 to 0.86; NNT: 2 to 1. Group 2 versus group 3: RR, 0.54 to 0.84; RRR, 0.16 to 0.46; ARR, 0.14 to 0.43; NNT, 7 to 2. Conclusions: The digital health platform that stimulates physical activity added to an interventionist motivation in overweight or obese patients is a significant additional benefit in terms of weight loss results, reduction of BMI and lipid profile in patients affected by overweight or obesity and a more effective cost.

INTRODUCCIÓN: Objetivo: evaluar la efectividad de la intervención de la obesidad con tres enfoques diferentes, uno de ellos con una plataforma que promueve la actividad física. Material y métodos: ensayo clínico aleatorizado, controlado, paralelo que comparó 3 brazos, estudio multicéntrico en pacientes con sobrepeso u obesos con un seguimiento de 12 meses. Los pacientes fueron asignados al azar en tres grupos: Intervención en el centro de Atención Primaria con intervención G1: Grupo control, el cual recibía las recomendaciones habituales de perder peso siguiendo el Consenso SEEDO 2000 G2: Intervención motivacional de la obesidad (IMOAP) con enfermera entrenada y pequeños grupos de trabajo periódico. G3: Intervención Motivacional de la obesidad (IMOAP) añadiendo el uso de una plataforma digital que permite registrar la actividad física, Se recolectaron variables: peso, talla, IMC, circunferencia de la cintura, parámetros lipídicos, presión arterial, hemoglobina glicosilada. Resultados: 185 pacientes fueron incluidos inicialmente en el estudio. 17 pacientes abandonaron el estudio. De ese modo, 168 pacientes completaron el estudio: 47 en G1, 61 en G2 y 60 en G3. De la población estudiada, el 57,1% eran mujeres. Se observa una reducción de peso promedio general al final del estudio de 4,37 kg, siendo 5,34 kg en el grupo 2,6,29 kg en el grupo 3 y 1,25 kg en el grupo control (G1). También se observó que los niveles de colesterol en tres grupos se redujeron. El IMC mostró una reducción promedio general de -1,56, siendo -1,70 en G2, -2,26 en G3 y 0,47 en G1. Los parámetros clínicamente relevantes fueron: grupo 1 (control) versus grupo 2 (IMOAP): riesgo relativo (RR), 0,10 a 0,46; reducción del riesgo relativo (RRR), 0.54 a 0.90; reducción del riesgo absoluto (ARR), de 0.30 a 0.61; número necesario para tratar (NNT), 3 a 2. Grupo 1 versus grupo 3 (IMOAP-PA): RR, 0.07 a 0.30; RRR, 0,70 a 0,93; ARR, 0,61 a 0,86; NNT: 2 a 1. Grupo 2 versus grupo 3: RR, 0.54 a 0.84; RRR, 0,16 a 0,46; ARR, 0,14 a 0,43; NNT, 7 a 2. Conclusiones: la plataforma de salud digital que estimula actividad física agregada a una motivación intervencionista en pacientes con sobrepeso u obesidad es un beneficio adicional significativo en términos de resultados de pérdida de peso, reducción del IMC y perfil de lípidos en pacientes afectados por sobrepeso u obesidad y un costo más efectivo.

[Phisical activity practice according to adherence to the Mediterranean diet, alcohol consumption and motivation in adolescents]. / Práctica de actividad física según adherencia a la dieta mediterránea, consumo de alcohol y motivación en adolescentes.

INTRODUCTION: Introduction: the study during adolescence of adherence to the Mediterranean diet, alcohol consumption, weight status as well as the practice of physical activity is fundamental to promote healthy habits conducive to a better quality of life in adulthood. Objectives: to know the adherence to the Mediterranean diet (DM) in the adolescent population, the weight status, the consumption of alcohol and the practice of physical activity (AF); and to analyze if in the studied sample there is an association between the motivation towards the realization of physical and sports practice and sex, age, body mass index (BMI), DM, the consumption of alcohol and the practice of FA. Methods: transversal descriptive study of 648 adolescents aged between 12 and 16 years. Adherence to the Mediterranean diet was analyzed with the KIDMED test; alcohol consumption, with the alcohol consumption scale; physical activity, with the IPAQ-A; and physical-sport motivation, with the CSAPPA scale. Results: according to the results, 17.6% of school children are overweight, 73.4% have high adherence to DM, and most do not consume or make moderate alcohol consumption and practice vigorous intensity AF within the recommended ranges. Men have a higher BMI (20.86 vs 20.67) and practice more days per week vigorous AF than women (3.16 vs 2.45). Schoolchildren who enjoy more the practice of AF have a better diet, spend more time doing AF and consume less alcohol. Conclusion: adolescents who do more physical activity have greater adherence to the Mediterranean diet, reduce alcohol consumption, have better weight status and increase physical-sports motivation.

INTRODUCCIÓN: Introducción: el estudio durante la adolescencia de la adherencia a la dieta mediterránea (DM), el consumo de alcohol, el estatus ponderal así como la práctica de actividad física (AF) es fundamental para fomentar hábitos saludables conducentes a una mejor calidad de vida en la edad adulta. Objetivos: el objetivo del presente estudio es conocer en población adolescente la adherencia a la dieta mediterránea, el estatus ponderal, el consumo de alcohol y la práctica de actividad física, así como analizar si en la muestra estudiada existe asociación entre la motivación hacia la realización de práctica física-deportiva y el sexo, la edad, el índice de masa corporal (IMC), la DM, el alcohol y la práctica de AF. Métodos: estudio descriptivo transversal de 648 adolescentes con edades comprendidas entre 12 y 16 años. Se analizó la adhesión a la dieta mediterránea con el test KIDMED, el consumo de alcohol con la escala de consumo de alcohol, la actividad física con el IPAQ-A y la motivación física-deportiva con la escala CSAPPA. Resultados: el 17,6% de los escolares presenta sobrepeso, el 73,4% tiene una alta adherencia a la DM, la mayoría no consume o hace un consumo moderado de alcohol y practica AF de intensidad vigorosa dentro de los rangos recomendados. Los varones tienen mayor IMC (20,86 vs. 20,67) y practican más días a la semana AF vigorosa que las mujeres (3,16 vs. 2,45). Los escolares que disfrutan más con la práctica de AF tienen una mejor alimentación, destinan más tiempo a hacer AF y consumen menos alcohol. Conclusión: los adolescentes que hacen más actividad física presentan mayor adherencia a la dieta mediterránea, reducen el consumo de alcohol, tienen mejor estatus ponderal e incrementan la motivación física-deportiva.

Mediterranean diet, weight status and physical activity in schoolchildren of the Region of Murcia. / Dieta mediterránea, estado de peso y actividad física en escolares de la Región de Murcia.

INTRODUCTION: Childhood and adolescence are key stages to promote a healthy lifestyle. OBJECTIVE: To analyze the relationship between weight status, physical activity and the Mediterranean diet in schoolchildren in the Region of Murcia. METHODS: Cross-sectional descriptive study with 520 schoolchildren aged 8-17 years. The weight status was calculated through the body mass index. The Mediterranean diet was found through the KIDMED questionnaire and physical activity was estimated using the IPAQ-C and IPAQ-A questionnaires. RESULTS: The Mediterranean diet is not significantly associated with sex (P<.537) or weight status (P<.417) but it maintains a relationship of dependence with age (P<.010) and the level of physical activity (P<.000). Schoolchildren in normal weight and assets have a greater follow-up to the Mediterranean diet than their overweight and sedentary peers (P<.000). CONCLUSION: The Fat but fit phenomenon applied to the Mediterranean diet is confirmed.

Quality care in the management of heart failure in a health area. / Calidad asistencial en el manejo de la insuficiencia cardiaca en una zona básica de salud.

OBJECTIVE: To analyse the heart failure situation in a health area, as well quality criteria. METHOD: Cross-sectional observational study of patients diagnosed with heart failure by collecting data from their clinical history in the «Turriano¼ computer program. The variables analysed were, comorbidities, control of cardiovascular risk factors, treatments, number of chronic diseases, and admissions. The level of adherence to drugs in relation to heart failure by determining the ratio between the percentage of prescribed drugs and drugs withdrawn from pharmacy is also analysed using the Turriano prescription program. The study consisted of an improvement cycle or evaluative cycle, following the methodology proposed by Palmer to evaluate the quality of ambulatory care. RESULTS: A total of 161 patients were included, with a mean age of 81.24 years, and 54.6% were women. Almost all of them (95%) had disease associated high blood pressure, including diabetes 42.2%, dyslipidaemia 8.9%, obesity 49.1%, and cancer 13.7% Some type of heart disease was diagnosed in 62.2% of patients with 29.2% ischaemic heart disease, 46.6% cardiac arrhythmias, and 20.5% valve diseases. More than 60% had between 4 and 6 concomitant diseases. An acceptable control is observed as regards the cardiovascular risk factors. Diuretic treatment was taken by 70%, with 32% and 35% taking angiotensin converting enzyme inhibitors and angiotensin II receptor antagonists. More than 20% have had 1-2 admissions in the last year, with cardiac decompensation being the main cause. There was 16% mortality. CONCLUSIONS: Patients with heart failure have a significant number of chronic concomitant diseases, although there is an acceptable cardiovascular risk factors control. There are quality criteria that can be improved.

Review and analysis of physical exercise at hormonal and brain level, and its influence on appetite. / Revisión y análisis del ejercicio físico a nivel hormonal, cerebral y su influencia en el apetito.

Due to the currently growing rate of obesity, it is important to maintain good control of food intake. The main purpose of the present study is to determine the influence of physical exercise on appetite, changes in hormone concentrations, and changes in certain neuronal regions. To achieve this, a literature search was conducted using different data bases. The results show how exercise produces changes in the appetite perception, in the amount of energy intake, and in different weight-control related hormones, as well as in specific neuronal responses. In conclusion, it can be shown that exercise leads to changes in appetite, hunger, and energy intake. In addition, exercise decreases the ghrelin levels and increases concentrations of leptin. Likewise, it is shown how physical exercise alters the responses of certain neuronal regions after visualizing specific food elements decreasing so the appetite or the intake of them.

Esteatosis hepática no alcohólica y factores de riesgo cardiovascular en atención primaria / Nonalcoholic Steatohepatitis and Cardiovascular Risk Factors in Primary Care

Varias circunstancias motivan el creciente interés por la esteatosis hepática no alcohólica (EHNA): la elevada prevalencia de la enfermedad en el mundo occidental, su capacidad de progresión a formas histológicas más agresivas y su asociación con enfermedades que incrementan el riesgo cardiovascular. Objetivo: analizar la relación de la esteatosis hepática no alcohólica con los factores de riesgo cardiovascular en pacientes con criterios de síndrome metabólico. Método: fue realizado un estudio descriptivo transversal con una muestra de 100 pacientes, con 2 o más factores de riesgo cardiovascular, con nula o baja ingesta de alcohol, que acudían a consulta de atención primaria. A los seleccionados se les solicitó analítica completa e interconsulta para ecografía de abdomen completo. Se evaluó si tenían esteatosis hepática; en caso de ser afirmativo, se estratificaba en 3 grados. Se recogieron las siguientes variables tanto cualitativas (sexo, antecedentes personales y familiares de diabetes, hipertensión arterial, dislipidemia, entre otros) y cuantitativas (edad, peso, talla, índice de masa corporal, tratamiento farmacológico, cifras de distintos parámetros analíticos, cifras de tensión arterial y perímetro abdominal). Resultados: participaron 100 pacientes, 56% de los cuales eran mujeres, con una edad media de 61,84 DE ± 9,5 años. Del total de sujetos del estudio, el 23 % no tenía esteatosis hepática no alcohólica; un 29% tenía esteatosis hepática leve; otro 29%, esteatosis hepática moderada; y el 19% restante, esteatosis hepática severa. En los hombres, el 82% presentó esteatosis hepática. De las mujeres, el 28,57% no presentó hígado graso. Un 22% tenía sobrepeso y un 38% de los pacientes eran obesos. Solo un 22% y un 18% tenían alteradas las cifras tensionales sistólica y diastólica, respectivamente. El 60% tenía una glucemia basal alterada. En cuanto a los parámetros lipídicos, el 36% tenía hipertrigliceridemia; el 41%, hipercolesterolemia, con un 65% de colesterol LDL alto y un 16% de colesterol HDL bajo. El 83% de los pacientes tenía 2 o más criterios de síndrome metabólico. Conclusiones: hay una estrecha relación entre la aparición de esteatosis hepática no alcohólica y los factores de riesgo cardiovascular en pacientes con síndrome metabólico, por lo que se recomienda que, ante la aparición de estos, se analice el hígado.

Several factors motivate the growing interest in this disease. They include the high prevalence of the disease in the Western world, its ability to progress to more aggressive histological forms, and its association with diseases that increase cardiovascular risk. Objective: The objective of this study was to analyze the relationship of nonalcoholic steatohepatitis (NASH) with cardiovascular risk factors in patients with criteria for metabolic syndrome. Method: This is a descriptive cross-sectional study of 100 patients who had two or more cardiovascular risk factors, who did not consume alcohol or consumed only small amounts of alcohol, and who came to the primary care clinic. The patients selected underwent complete analyses including abdominal ultrasound. They were evaluated for hepatic steatosis, and, if they tested positive, it was stratified into three degrees. Among the qualitative variables used were sex, personal and family history of diabetes, hypertension, dyslipidemia, and the quantitative variables included age, weight, height, body mass index, pharmacological treatment, numbers of different analytical parameters, blood pressure and abdominal perimeter.Results: There were 100 patients, 56% of whom were women. Patients’ mean age was 61.84 SD +/- 9.5 years. Of the total number of subjects in the study, 23% did not have NASH, 29% had mild hepatic steatosis, 29% had moderate hepatic steatosis and 19% had severe hepatic steatosis. Of the men in the study, 82% had hepatic steatosis. Of the women, 28.57% did not have fatty livers. 22% were overweight and 38% obese. Only 22% had altered the systolic blood pressure and and 18% had altered diastolic blood pressure. 60% had altered basal glycemia. 36% had hypertriglyceremia, 41% had hypercholesterolemia including 65% with high LDL cholesterol and 16% with low HDL cholesterol. 83% of the patients had two or more criteria for metabolic syndrome.Conclusions: There is a close relationship between the occurrence of NASH and cardiovascular risk factors in patients with metabolic syndrome, and it is advisable that the liver be analyzed.

[Aerobic capacity, weight status and self-concept in schoolchildren]. / Capacidad aeróbica, estado de peso y autoconcepto en escolares de primaria.

OBJETIVES: To analyze the relationship between self-concept, aerobic capacity and weight status in schoolchildren. MATERIAL AND METHOD: Relational descriptive design in which was assessed the weight status and aerobic capacity of 256 schoolchildren among 8-11 years. Aerobic capacity (low vs high) and the body mass index (normal-weight vs overweight-obesity) were categorized using standard criteria. The self-concept was assessed through the Piers Harris self-concept scale for children. RESULTS: Schoolchildren with normal-weight and high fitness level showed better levels of conductual self-concept (P=.030), physical (P<.001), lack of anxiety (P=.048), and global self-concept (P=.002). The schoolchildren with normal-weight show higher levels of conductual self-concpt (P=.016), intellectual (P=.050), physical (P<.001), life satisfaction (P=.036), and global self-concept (P=.001). The schoolchildren with a higher fitness level showed better conductual self-concept (P=.024), physical (P=.004), lack of anxiety (P=.011), social (P=.024), and global (P=.003). CONCLUSIONS: The results of the study strengthen the importance to transmit to the educative community the knowledge of the relationship between the variables analyzed aiming to improve the schoolchildren self-concept.

[Active interventions in hypercholesteroloemia patients with high cardiovascular risk in primary care; estudio ESPROCOL]. / INTERVENCIÓN ACTIVA EN LA HIPERCOLESTEROLEMIA DE PACIENTES CON RIESGO CARDIOVASCULAR ALTO DE ATENCIÓN PRIMARIA; ESTUDIO ESPROCOL.

INTRODUCTION: Hypercholesterolemia is a major modifiable risk factors for cardiovascular disease (CVD). Its reduction reduces morbidity and mortality from ischemic heart disease and CVD in general, primary prevention and secondary prevention especially. OBJECTIVE: To determine whether a notarized and intensive clinical practice can overcome inertia and achieve the therapeutic goal (OT) LDL-C <100 mg/dL in high-risk patients attended in Primary Care (PC) in our country. METHODOLOGY: Epidemiological, prospective, multicenter study conducted in centers of different ACs By AP consecutive sampling 310 patients at high cardiovascular risk (diabetic or established CVD) previously treated with statins, which did not reach the OT included c-LDL. RESULTS: The study subjects had a mean age of 65.2 years, of which 60.32% were male. The 41.64% had a previous EVC, acute myocardial infarction (20.33%), angina (16.07%), stroke/TIA (9.19%), arthropathy (5.25%), diabetes (70.87%), hypertension (71.01%), and abdominal obesity (69.62%). The 43.57% (95% CI: 37,21; 50,08) of patients who performed the 2nd visit (241) got the OT. 62.50% (95% CI: 55.68, 68.98) of those who took the 3rd (216) got the OT. Finally, 77.56% (95% CI: 72.13, 83.08) patients who performed the last visit (205) got the OT. Throughout the study there was a reduction in LDL-C levels from 135.6 mg/dL at baseline, 107.4 mg dL in the 2nd visit, 97.3 mg/dL in the 3rd visit, up to 90.7 mg/dL at the final visit (p < 0.0001). The increase in HDL-C from baseline (50.9 mg/dL) and final (53.6 mg/dL) was also significant (p = 0.013). CONCLUSIONS: The reassessment and intensification of treatment in patients at high cardiovascular risk treated in primary care, applying the indications of the guides, achieves the OT in more than three quarters of the previously uncontrolled within half a year. These results should encourage us to overcome the therapeutic inertia in the control of CVD by early and energetic performance against hypercholesterolemia.

Introducción: la hipercolesterolemia es uno de los principales factores de riesgo modificables de la enfermedad cardiovascular (ECV). Su reducción disminuye la morbimortalidad por cardiopatía isquémica y ECV en general, en prevención primaria y, especialmente, en prevención secundaria. Objetivo: comprobar si una práctica clínica protocolizada e intensiva permite vencer la inercia y alcanzar el objetivo terapéutico (OT) de c-LDL < 100 mg/dL en pacientes de alto riesgo asistidos en Atención Primaria (AP) de nuestro país. Metodología: estudio epidemiológico, prospectivo, multicentrico, realizado en centros de AP de diferentes CC. AA. Mediante muestreo consecutivo se incluyeron 310 pacientes de alto riesgo cardiovascular (diabéticos o con ECV establecida), tratados previamente con estatinas, que no alcanzaban el OT de c-LDL. Resultados: los sujetos del estudio tenían una edad media de 65,2 años, de los que el 60,32 % eran varones. El 41,64 % presentaban un EVC previo, infarto agudo de miocardio (20,33 %), angina (16,07 %), ictus/AIT (9,19 %), artropatía (5,25 %), diabetes (70,87 %), hipertensión (71,01 %) y obesidad abdominal (69,62 %). El 43,57 % (IC95 %: 37,21; 50,08) de los pacientes que realizaron la segunda visita (241) consiguieron el OT. El 62,50 % (IC95 %: 55,68; 68,98) de los que realizaron la tercera (216) consiguieron el OT. Finalmente, el 77,56 % (IC95 %: 72,13; 83,08) de los pacientes que realizaron la última visita (205) consiguieron el OT. A lo largo del estudio hubo una reducción de los niveles de c-LDL desde los 135,6 mg/dL en la visita basal, 107,4 mg/dL en la segunda visita, 97,3 mg/dL en la tercera visita, hasta los 90,7 mg/dL en la visita final (p < 0,0001). El incremento de c-HDL entre la visita basal (50,9 mg/dL) y la final (53,6 mg/dL) también fue significativo (p = 0,013). Conclusiones: la reevaluación e intensificación del tratamiento en pacientes de alto riesgo cardiovascular atendidos en Atención Primaria, aplicando las indicaciones de las guías, permite alcanzar el OT en más de las tres cuartas partes de los previamente no controlados en el plazo de medio año. Estos resultados nos deben estimular a superar la inercia terapéutica en el control de la ECV mediante una actuación precoz y enérgica ante la hipercolesterolemia.

[Active interventions in hypercholesteroloemia patients with high cardivascular risk in primary care]. / INTERVENCIÓN ACTIVA EN LA HIPERCOLESTEROLEMIA DE PACIENTES CON RIESGO CARDIOVASCULAR ALTO DE ATENCIÓN PRIMARIA; ESTUDIO ESPROCOL.

INTRODUCTION: Hypercholesterolemia is a major modifiable risk factors for cardiovascular disease (CVD). Its reduction reduces morbidity and mortality from ischemic heart disease and CVD in general, primary prevention and secondary prevention especially. OBJECTIVE: To determine whether a notarized and intensive clinical practice can overcome inertia and achieve the therapeutic goal (OT) LDL-C <100 mg / dL in high-risk patients attended in Primary Care (PC) in our country. METHODOLOGY: epidemiological, prospective, multicenter study conducted in centers of different ACs By AP consecutive sampling 310 patients at high cardiovascular risk (diabetic or established CVD) previously treated with statins, which did not reach the OT included c-LDL. RESULTS: The study subjects had a mean age of 65.2 years, of which 60.32% were male. The 41.64% had a previous EVC, acute myocardial infarction (20.33%), angina (16.07%), stroke / TIA (9.19%), arthropathy (5.25%), diabetes (70 , 87%), hypertension (71.01%), and abdominal obesity (69.62%). The 43.57% (95% CI: 37,21; 50,08) of patients who performed the 2nd visit (241) got the OT. 62.50% (95% CI: 55.68, 68.98) of those who took the 3rd (216) got the OT. Finally, 77.56% (95% CI: 72.13, 83.08) patients who performed the last visit (205) got the OT. Throughout the study there was a reduction in LDL-C levels from 135.6 mg / dL at baseline, 107.4 mg / dL in the 2nd visit, 97.3 mg / dL in the 3rd visit, up to 90.7 mg / dL at the final visit (p <0.0001) The increase in HDL-C from baseline (50.9 mg / dL) and final (53.6 mg / dL) was also significant (p = 0.013). CONCLUSIONS: The reassessment and intensification of treatment in patients at high cardiovascular risk treated in primary care, applying the indications of the guides, achieves the OT in more than three quarters of the previously uncontrolled within half a year. These results should encourage us to overcome the therapeutic inertia in the control of CVD by early and energetic performance against hypercholesterolemia.

Introducción: La hipercolesterolemia es uno de los principales factores de riesgo modificables de la enfermedad cardiovascular (ECV). Su reducción disminuye la morbimortalidad por cardiopatía isquémica y ECV en general, en prevención primaria y en prevención secundaria especialmente. Objetivo: Comprobar si una práctica clínica protocolizada e intensiva permite vencer la inercia y alcanzar el objetivo terapéutico (OT) de c-LDL < 100 mg/dL en pacientes de alto riesgo asistidos en Atención Primaria (AP) de nuestro país. Metodología: Estudio epidemiológico, prospectivo, multicentrico, realizado en Centros de AP de diferentes CC.AA. Mediante muestreo consecutivo se incluyeron 310 pacientes de alto riesgo cardiovascular (diabéticos o con ECV establecida), tratados previamente con estatinas, que no alcanzaban el OT de c-LDL. Resultados: Los sujetos del estudio tenían una edad media de 65,2 años, de los que el 60,32% eran varones. El 41,64% presentaba un EVC previo, infarto agudo de miocardio (20,33%), angina (16,07%), ictus/AIT (9,19%), artropatía (5,25%), diabetes (70,87%), hipertensión (71,01%), y obesidad abdominal (69,62%). El 43,57% (IC95%: 37,21; 50,08) de los pacientes que realizaron la 2a visita (241) consiguieron el OT. El 62,50% (IC95%: 55,68; 68,98) de los que realizaron la 3a (216) consiguieron el OT. Finalmente, el 77,56% (IC95%: 72,13; 83,08) de los pacientes que realizaron la última visita (205) consiguieron el OT. A lo largo del estudio hubo una reducción de los niveles de c-LDL desde los 135,6 mg/ dL en la visita basal, 107,4 mg/dL en la 2a visita, 97,3 mg/ dL en la 3a visita, hasta los 90,7 mg/dL en la visita final (p < 0,0001) El incremento de c-HDL entre la visita basal (50,9 mg/dL) y la final (53,6 mg/dL) también fue significativo (p = 0,013). Conclusiones: La reevaluación e intensificación del tratamiento en pacientes de alto riesgo cardiovascular atendidos en Atención Primaria, aplicando las indicaciones de las guías, permite alcanzar el OT en más de las tres cuartas partes de los previamente no controlados en el plazo de medio año. Estos resultados nos deben estimular a superar la inercia terapéutica en el control de la ECV mediante una actuación precoz y enérgica ante la hipercolesterolemia.

[Aerobic capacity and quality of life in school children from 8 to 12]. / Capacidad aeróbica y calidad de vida en escolares de 8 a 12 años.

Aerobic capacity is a powerful physiological indicator of the overall health status. The objective of this study was to analyse the relationship between aerobic capacity and quality of life in a sample of 298 (159 girls) school children aged 8-12 years. Aerobic capacity was tested using the Course-Navette test. Quality of life was assessed using the KIDSCREEN-10 Index scale. Males showed higher performance in the Course-Navette test and highest values of VO2max (P<.001 for both). ANOVA statistical analysis showed that the quality of life was significantly higher in school children with increased level of aerobic capacity compared to those with a low level (P=.001). Children with high aerobic capacity showed higher quality of life scores in relation to their peers with low scores (P<.001). As for the females, significant differences were found among those with high aerobic capacity level and their peers low levels (P<.031). The results of this study suggest that school children with higher level of aerobic capacity show better results in the quality of life index. Long-term intervention studies are needed to verify if an aerobic capacity development programme may upgrade the quality of life of children and adolescents.

[Relationship between body weight status and self-concept in schoolchildren]. / Relación entre el estatus de peso corporal y el autoconcepto en escolares.

Body weight status has been linked to other health parameters. The aim of this study was to evaluate the relationship between body weight status and self-concept in a sample of 216 students (9.26 ± 1.26 years) from schools of the Southeast of Spain. BMI (Body-mass index) was used to evaluate the body weight status. Subjects were classified into normal weight, overweight and obesity according to international standards. The six dimensions of self-concept (intellectual, behavioral, physical, lack of anxiety, social and life satisfaction) were assessed using the Piers-Harris Self-Concept Scale. The results showed significant associations between BMI and intellectual self-concept, life satisfaction, global self-concept and physical self. Subjects categorized as overweight or obese were those who showed lower scores on the self-concept scale. Interventions focused on improving the body weight status are needed in order to achieve better self-concept levels and health among young people.

El estatus de peso corporal se ha estudiado como un elemento relacionado con distintos parámetros de salud. El objetivo del presente estudio fue evaluar la relación entre el estatus de peso corporal y el autoconcepto en una muestra de 216 escolares (9,26 ± 1,26 años) pertenecientes a colegios de Educación Primaria. Para la evaluación del estatus corporal se empleó el IMC (Índice de masa corporal), clasificando a los sujetos en normopeso, sobrepeso y obesidad de acuerdo a los parámetros internacionales. Las seis dimensiones del autoconcepto (intelectual, conductual, físico, falta de ansiedad, social y satisfacción vital) fueron evaluadas mediante la Escala de Autoconcepto de Piers-Harris. Los resultados mostraron asociaciones significativas entre el IMC y el autoconcepto intelectual, la satisfacción vital, el autoconcepto global y el autoconcepto físico. Los sujetos categorizados en sobrepeso u obesidad eran aquellos que poseían resultados inferiores en la escala de autoconcepto. Se precisan intervenciones que incidan en la mejora del estatus corporal para obtener consecuentes mejoras en los niveles de autoconcepto y de salud general entre los jóvenes.

[Nutritional status and health-related life quality in school children from the southeast of Spain]. / Estado nutricional y calidad de vida relacionada con la salud en escolares del sureste español.

INTRODUCTION AND OBJECTIVE: Analyze the level of Life Quality (LQ) in relation to nutritional status in a sample of primary school children. MATERIAL AND METHODS: Cross sectional study with 298 participants (53.35% female) of 8-12 years. LQ was assessed by the KIDSCREEN-10 questionnaire . Measures of weight and size were taken. The BMI (normal-weight, overweight and obesity) was categorized using standard criteria. To establish the relationship between the different statistical variables was performed the Kolmogorov- Smirnov test and analysis of variance. RESULTS: Nutritional status was significantly correlated with LQ (F = 5.096; p =, 007). School children with a normal- weight state showed higher LQ levels compared to those overweight (p = .015) and obese (p =, 013). CONCLUSIONS: The results show that nutritional status acts as a differentiating factor in LQ. Adopting active lifestyle behaviours that promote a healthy nutritional status not only can have benefits over health biological parameters (such as physical condition) but can also contribute to improve other LQ indicators and mental health .

Introducción y objetivo: Analizar el nivel de calidad de vida en relación al estado nutricional en una muestra de escolares de primaria. Material y método: Estudio descriptivo transversal con 298 participantes (53,35% mujeres) de 8 a 12 años. Se valoró la calidad de vida mediante el cuestionario KIDSCREEN- 10. Se midió el peso y la talla de los escolares. El índice de masa corporal (normo-peso, sobrepeso y obesidad) fue categorizado usando criterios estándar. Para establecer la relación entre las diferentes variables se realizó un análisis de varianza de un factor. Resultados: El estado nutricional se relaciona de forma significativa con la calidad de vida (F = 5,096; p = ,007). Los escolares con un estado nutricional de normo-peso mostraron índices superiores de calidad de vida con respecto a los escolares con sobrepeso (p = ,015) y obesidad (p = ,013). Conclusiones: Los resultados indican que el estado nutricional se muestra como un elemento diferenciador en el nivel de calidad de vida. La adopción de conductas de estilo de vida activo que favorezcan un estado nutricional saludable no solo puede tener beneficios sobre otros parámetros biológicos de la salud (como la condición física) sino que puede favorecer a su vez la mejora de otros indicadores de calidad de vida y salud mental.