Waist circumference as a prognostic index of childhood abdominal obesity: findings in the Spanish population.

INTRODUCTION: Introduction: early detection of childhood obesity plays a crucial role in the prevention of diseases during adulthood. At present, the most commonly used screening tool for detecting overweight/obesity in children is the percentile for age of body mass index, although this rate is unable to provide information about fat distribution. An emerging marker of abdominal fat distribution is waist circumference (WC). Objective: the aim of this study was to evaluate the differences between the different diagnostic criteria available to define overweight and obesity in order to establish the optimal WC cut-off values for the Spanish children population. Methods: a cross-sectional study was carried out in 8,241 schoolchildren aged 3 to 12 years from Villanueva de la Cañada (Madrid, Spain). WC (cm), weight (kg) and height (cm) were measured according to the recommendations of the Society for the Advancement of Kineanthropometry (ISAK). The values obtained for the diagnostic criteria (Spanish Orbegozo Foundation (OF), the International Obesity Task Force (IOTF), and the World Health Organization (WHO) were compared using McNemar's test for paired proportions. The kappa coefficient (κ) was used to assess the degree of agreement of the three classifications. We analyzed the validity of body mass index (BMI) and WC using the receiver operating characteristic (ROC) curve analysis. The Youden index was used to determine cut-off values for WC that identify childhood obesity Results: overweight and obesity prevalences were calculated according to the OF, IOTF, and WHO criteria. There was a "substantial" agreement for the overweight and obesity categories between the Spanish criteria and IOTF (κ = 0.636), while agreement was "slight" between the Spanish criteria and those of WHO (κ = 0.198). The estimated cut-off WC criteria ranged from 54.5 to 88.0, varying according to sex and age. Conclusion: the proposed WC cut-off values, stated for the first time in a young Spanish population, are a simple and valid alternative as diagnostic criteria of abdominal obesity.

INTRODUCCIÓN: Introducción: la detección temprana de la obesidad durante la infancia es de vital importancia para la prevención de patologías durante la edad adulta. En la actualidad, la evaluación de la obesidad infantil se realiza principalmente utilizando el índice de masa corporal por edad percentilado, aunque este no aporta información sobre la distribución del tejido adiposo. Un marcador emergente de distribución de la grasa abdominal es la circunferencia de la cintura (CC). Objetivo: el objetivo de este trabajo fue evaluar las diferencias entre diferentes criterios diagnósticos para definir el sobrepeso y la obesidad con el fin de establecer el punto de corte óptimo de la CC en los niños españoles. Método: se llevó a cabo un estudio observacional transversal de 8241 niños/as (3-12 años) en Villanueva de la Cañada (Madrid, España). Se determinaron el peso, la talla y el perímetro de la cintura atendiendo a los criterios de la Sociedad Internacional para el Avance de la Cineantropometría (ISAK). Los valores obtenidos para los criterios diagnósticos (Fundación Orbegozo (OF), el Grupo Internacional de Obesidad (IOTF) y la Organización Mundial de la Salud (OMS)) se compararon utilizando la prueba de McNemar para proporciones emparejadas. El coeficiente kappa (κ) se utilizó para evaluar el grado de acuerdo de las tres clasificaciones. Analizamos la validez del índice de masa corporal (IMC) y el perímetro de la cintura (CC) utilizando el análisis de la curva característica operativa del receptor (ROC). El índice de Youden se utilizó para determinar los valores de corte de la CC que identifican la obesidad infantil. Resultados: se calcularon las prevalencias del sobrepeso y la obesidad de acuerdo con criterios internacionales (IOTF, OMS) y nacionales (FO). Se observó un acuerdo "substancial" para el sobrepeso y la obesidad entre el criterio diagnóstico español y el IOTF (κ = 0,636), mientras que el acuerdo fue "ligero" entre el criterio español y el de la OMS (κ = 0,198). Los puntos de corte de la CC estimados variaron de 54,5 a 88,0 cm, modificándose en función de la edad y el sexo. Conclusiones: los puntos de corte de la CC propuestos, establecidos por primera vez para niños españoles, son una alternativa simple y válida como criterio diagnóstico de obesidad abdominal.

[Healthy gastronomy education: challenges and opportunities in the institutional food service]. / Educación para una gastronomía saludable: retos y oportunidades en la alimentación institucional.

INTRODUCTION: the population demands a healthy gastronomy (binomial Gastronomy and Nutrition), so it must include knowledge of food and health. Health, Education and Gastronomy complement each other. The institutional food service must be healthy and at the same time pleasant. OBJECTIVES: collect activities, resources and interventions that have been carried out in various institutional food services (school lunches, nursing homes and hospitals) where knowledge about gastronomy and healthy eating has been included as a teaching method at different levels. METHODS: a review of the actions and/or materials developed to educate on healthy gastronomy from different areas of collective catering has been carried out, as well as the search for scientific articles in the PubMed, Dialnet and Google academic databases. RESULTS: the Taste Workshops are complementary and useful educational material for the teachers of Infant and Primary School Education. The menus of nursing home must have a good nutritional contribution and organoleptic quality that stimulates the well-being and socialization of the users, considering that in old age sensory losses affects the pleasure of eating. The alimentary model in the hospital is adapted mainly to the health needs of the users and must reach a gastronomic suitability that will produce well-being during the stay. CONCLUSIONS: institutional food service poses challenges in food preparation and conservation, quality and food safety, nutritional value of food and its implications for the health of populations, and from the point of view of gastronomy, since it involves a daily routine in groups of vulnerable population such as schoolchildren, hospitalized people or the elderly.

Introducción: la población demanda una gastronomía saludable (un binomio entre gastronomía y nutrición), por lo que debe incluir los conocimientos de alimentación y la salud. Salud, educación y gastronomía se complementan entre sí. La alimentación institucional debe ser saludable y, a su vez, placentera.Objetivos: recopilar actividades, recursos e intervenciones que se han llevado a cabo en diversos centros de alimentación institucional (comedores escolares, residencias y hospitales), donde se incluyen los conocimientos sobre gastronomía y alimentación saludable como método de enseñanza a diferentes niveles.Métodos: se ha realizado una revisión de las acciones y/o materiales elaborados para educar en gastronomía saludable desde distintos ámbitos de la alimentación institucional. Además, se ha realizado una búsqueda de artículos científicos en las bases de datos PubMed, Dialnet y Google académico.Resultados: los talleres del gusto son un material educativo complementario y muy útil para el profesorado de Educación Infantil y Primaria. Los menús de las instituciones geriátricas deben tener un buen aporte nutricional y una buena calidad organoléptica que estimule el bienestar y la socialización de los usuarios, ya que en la vejez se producen pérdidas sensoriales que afectan al placer de comer. El modelo alimentario en el hospital está adaptado principalmente a las necesidades de salud de los usuarios, y debe alcanzar una idoneidad gastronómica que produzca bienestar durante la estancia.Conclusiones: la alimentación institucional plantea retos en la elaboración, la conservación, la calidad y el valor nutritivo de los alimentos, así como en la seguridad alimentaria y en sus implicaciones en la salud de las poblaciones, y, desde el punto de vista gastronómico, como rutina diaria en grupos de población vulnerables (escolares, personas hospitalizadas o adultos mayores).

Fifty years of beverages consumption trends in Spanish households.

OBJECTIVES: To describe the evolution of non-alcoholic and alcoholic beverages consumption in the Spanish households from the 60's to nowadays. METHODS: This study is based on beverages and food consumption in Spanish households; the data sample consisted of consumption and distribution data, obtained from the Household Budget Survey (HBS) since 1964 to 1991 and from the Food Consumption Survey (FCS) since 2000 to 2014, in collaboration with the Spanish Nutrition Foundation (FEN). RESULTS: In 2014 the average consumption of non-alcoholic beverages was 332 g/person/day, whereas alcoholic beverages consumption represented 72.6 g/person/day. Consumption of non-alcoholic beverages has increased 721% (1964: 46 g/person/day; 1991: 96 g/person/day; 2000: 240 g/person/day and 2014: 332 g/person/day), whereas alcoholic beverages consumption has decreased roughly a 50% (1964: 145 g/person/day; 1991: 113 g/person/day; 2000: 78.4 g/person/day and 2014: 72.6 g/person/day). The most consumed alcoholic beverage in 2014 was beer (41.3 g/day), followed by wine (23.0 g/day). Regarding non-alcoholic beverages, the most consumed was water (144 g/day), followed by cola (ordinary: 30.7 g/day and diet: 20.5 g/day).According to Spanish regions, in 2014 non-alcoholic beverages were the most consumed in the islands (Balearic Islands 521 grams/person/day; Canary Islands 515 grams/person/day), as it was in the nineties (Balearic Islands 148 grams/person/day and Canary Islands 281 grams/person/day). However in 1980-81 the largest consumption of alcoholic beverages was that of Galicia, 408 g/person per day, and the lower in the Canary Islands, 63 g/person per day. In 2014, Murcia and Andalucía represented the regions with the highest consumption of alcoholic beverages. In 2014, alcoholic beverages provided roughly 1.89% of the total energy and 1.47% of sugars, whereas non-alcoholic beverages provided 3.28% of energy and 15.72% of sugars and, in 2000, alcoholic beverages contributed 2.29% of the energy and 1.47% of sugars and non-alcoholic drinks provided 3.76% of the energy and 22.7% of sugars. CONCLUSION: There have been signifi cant changes in the eating patterns at the Spanish homes, especially regarding beverages consumption, over the last five decades. In general, a higher consumption and variety for non-alcoholic drinks has occurred, especially in the islands. In parallel, a decline in alcoholic beverages consumption has been clearly observed.

Macronutrients contribution from beverages according to sex and age: findings from the ANIBES Study in Spain.

Methodologies and procedures used in dietary surveys have been widely developed with the aim of evaluating the nutritional status of a population. However, beverages are often either disregarded at national and international assessment of nutrients intake or poorly mentioned. Moreover, there is no standardized questionnaire developed as a research tool for the evaluation of beverages intake in the general population. Moreover, the contribution of different beverages to macronutrients intake is rarely provided. The latter in the context of a continuous expansion and innovation of the beverages market in Spain. Therefore, the main goal of the present study was to evaluate non-alcoholic and alcoholic beverages macronutrients contribution in the ANIBES study in Spain (9-75 years old).As expected, those contributed to dietary macronutrient intake mainly as total carbohydrates and sugar. The contribution to other macronutrients (proteins and lipids) by the beverage groups was of much less importance. For non-alcoholic beverages, contribution to carbohydrates was much higher in younger populations (children: 10.91 ± 9.49%, mean ± SD for boys and 9.46 ± 8.83% for girls; adolescents: 11.97 ± 11.26% for men and 13.77 ± 10.55% in women) than in adults: 9.01 ± 9.84% for men and 7.77 ± 8.73% in women. Finally, a much lower contribution was observed in the elderly: 4.22 ± 6.10% for men and 4.46 ± 6.56% for women. No sex differences, however, across all age groups were found. Results for sugar contribution showed a similar trend: children (23.14 ± 19.00% for boys and 19.77 ± 17.35% for girls); adolescents (28.13 ± 24.17% for men and 29.83 ± 21.82% in women); adults 20.42 ± 20.35% for men and 16.95 ± 17.76% in women, p ≤ 0.01; and elderly: 14.63% ± 9.97 for men and 9.33 ± 12.86% in women. The main contribution corresponded to sugared soft drinks, juices and nectars, more relevant and significant in the younger populations. As for alcoholic beverages, the contribution of macronutrients to the total diet is low for carbohydrates and sugar. The main contribution of this group, as expected, is alcohol, being higher from low alcohol content beverages, and in men vs women (p ≤ 0.001).

A new educational tool to learn about hydration: taste workshops for children.

INTRODUCTION: Nutrition education contributes to children´s understanding and practice of healthy lifestyles behaviors. Having a well hydration status is an essential topic, especially since children are a vulnerable population who are much more  prone to dehydration than adults are. The approval of the Report on the European Gastronomic Heritage: Cultural and Educational Aspects in 2014 served as starting point to work on innovative audio-visual and multimedia materials for children. The Spanish Nutrition Foundation (FEN) and the Royal Academy of Gastronomy (RAG), in collaboration with the Ministry of Education, Culture and Sport in Spain (MECD),  developed educational videos for schoolchildren to learn about food, nutrition and gastronomy, specially, the importance of being hydrated. OBJECTIVES: To develop a serial of videos for children between 3 and 9 years old with nutrition and cooking lessons to be used as educational resources in the official curricula. METHODS: Fourteen chapters related to food, nutrition, gastronomy, physical activity and hydration to be used to record videos were designed and tested. A nutritionist, a chef and two puppets were the main characters acting in the videos.  RESULTS: The chapters were assembled in nine videos that included five sections: introduction, video lesson, recipes -in case of hydration, recipes with different water content foods were recorded-, what have you learntand check your knowledge. A summary of the new educational material was officially presented at the Spain Pavilion during the Expo Milano 2015. Moreover, they are included as education  tool for teachers in the new PANGEI Programme (Food, Nutrition and Gastronomy for Infantile Education) conjointly launched by FEN, RAG and MEDC. CONCLUSION: Taste workshops are useful as innovative nutrition education tools to reinforce language, listening and motor skills as well as food and nutrition concepts, and specially, the importance of being well hydrated.

THAO-CHILD HEALTH PROGRAMME: COMMUNITY BASED INTERVENTION FOR HEALTHY LIFESTYLES PROMOTION TO CHILDREN AND FAMILIES: RESULTS OF A COHORT STUDY.

INTRODUCTION: childhood obesity is one of the main public health concerns. The multifactorial and multilevel causes require complex interventions such the community based interventions (CBI). Thao-Child Health Programme is a CBI implemented in Spain since 2007. GOAL: show the Thao methodology and the latest cross-sectional and longitudinal results. METHODS: longitudinal cohort study (4 years of follow- up) and cross sectional study. RESULTS: the longitudinal study found an increase of 1% in the overweight prevalence after a follow-up of 4 years of Thao-Programme implementation in 10 municipalities with 6 697 children involved. The cross-sectional study carried out with 20 636 children from 22 municipalities found a childhood overweight prevalence of 26.6%. DISCUSSION: currently a brake in the increase of childhood overweight prevalence is considered a success due to the high prevalence worldwide. More studies well methodologically performed are needed to know the efficacy of the CBI's in this field.

Introducción: la obesidad infantil es una de las principales preocupaciones de salud pública. La etiología multifactorial y multinivel requiere de intervenciones complejas como las intervenciones de base comunitaria (CBI). El Programa Thao-Salud Infantil es una CBI implementada en España desde 2007. Objetivo: mostrar la metodología Thao y los últimos resultados transversales y longitudinales. Métodos: estudio de cohortes longitudinal (4 años de seguimiento) y estudio transversal. Resultados: el estudio longitudinal encontró un incremento del 1% en la prevalencia de exceso de peso tras 4 años de implementación del Programa Thao en 10 municipios con 6.697 niños y niñas involucrados. El estudio transversal llevado a cabo con 20.636 niños y niñas de 22 municipios encontró una prevalencia de exceso de peso infantil del 26,6%. Discusión: actualmente un freno en el incremento de la prevalencia de exceso de peso infantil es considerado como un éxito debido a la alta prevalencia a nivel mundial. Son necesarios más estudios metodológicamente bien realizados para conocer la eficacia de las CBI en este campo.

Sources of information on food consumption in Spain and Europe.

Estimation of food consumption and nutrient intake is a topic of growing interest. Currently, both in Europe and in Spain, there are numerous sources of information on food consumption, that we provide information on different levels: national, household and individual, all of them are useful, but including some limitations, mainly arising from the lack of accurate data on food purchased but not consumed. The data obtained allow, among other things, meet dietary habits, explore the food quality, study the energy and nutrient intake and / or assessing exposure to food risks. Among the existing sources in Spain can highlight two surveys especially useful: the Household Budget Survey of the National Statistics Institute (INE) and Food Consumption Panel Ministry of Agriculture, Food and Environment (MAGRAMA). Both provide for many years food consumption but, lately, only in households. Both European and Spanish would be necessary to improve the usefulness of the data, standardize the type of survey used and could be comparable between them.

La estimación del consumo de alimentos y la ingesta de nutrientes es un tema de creciente interés. Actualmente, tanto en Europa como en España, existen fuentes de información sobre el consumo de alimentos, que nos ofrecen esta información a distintos niveles: nacional, familiar o individual, todas ellas son de gran utilidad, pero incluyen algunas limitaciones, principalmente derivadas de la falta de datos precisos sobre los alimentos comprados pero no consumidos. Los datos obtenidos permiten, entre otras, conocer los hábitos alimentarios, explorar la calidad de la alimentación, estudiar la ingesta de energía y nutrientes y/o evaluar la exposición a riesgos alimentarios. Entre las fuentes existentes en España se pueden resaltar dos encuestas de especial utilidad: la encuesta de presupuestos familiares del Instituto Nacional de Estadística (INE) y el panel de consumo de alimentos del Ministerio de Agricultura, Alimentación y Medio Ambiente (MAGRAMA). Ambas proporcionan desde hace bastantes años la información relativa al consumo de alimentos pero, últimamente, sólo en hogares. Tanto a nivel europeo como español sería necesario, para mejorar la utilidad de los datos, estandarizar el tipo de encuestas utilizadas, para ser comparables entre ellas.