[Strategies for the prevention and non-pharmacological treatment of obesity. Models of care]. / Estrategias para la prevención y el tratamiento no farmacológico de la obesidad. Modelos de atención.

The prevalence of obesity has increased in recent years worldwide. In this context, strategies for management obesity in primary care are essential. The first step in the treatment of obesity are lifestyle intervention programs. The three pillars of these programs, ideally of high intensity (high frequency of visits), are dietary intervention, exercise and behavioral therapy. There is no universal model of care for patients with obesity, but it must take into account key aspects, such as facilitating the access and adherence of the patient and a multidisciplinary and coordinated care among professionals at different levels of healthcare. The components of the model of care and its format should be defined according to the resources available and the characteristics of the population to be treated.

[ROWING AGAINST THE CURRENT]. / REMANDO A CONTRACORRIENTE.

At Lalonde we know that the determinants that most influence the health of the population are lifestyle, genetics and the environment. Health represents only 10% and is the determinant that consumes the most resources. It has been shown that a salutogenic approach focused on the social determinants of health and the support of public policies to improve the environment are more efficient in the long term than medicine focused on hospitals, technology and super-specialization. Primary Care (PC) that has an approach centered on the person and families with a community vision, is the ideal level to provide health care, and to influence lifestyles. However it is not invested in PC. In this article we review the socioeconomic and political factors that globally influence the lack of interest in the development of PC.

[PAPPS expert group. Lifestyle recommendations]. / Grupo de expertos del PAPPS. Recomendaciones sobre el estilo de vida.

Primary and secondary health determinants explain a large part of the morbidity and mortality observed in primary care. The recommendations of the Program of Preventive Activities and Health Promotion (PAPPS) of the semFyC are presented, for the promotion of a healthy lifestyle through intervention methodology and preventive actions in tobacco consumption, alcohol consumption, healthy eating, physical activity in free time and prevention of traffic accidents and child restraint systems. The most common clinical prevention guidelines are outlined. The recommendations are updated, new aspects are pointed out, such as the definition of low-risk alcohol consumption, and the bibliography is updated. For the main recommendations, specific tables are included that show the quality of the evidence and the strength of the recommendation.

[Differential impact and heterogeneous needs. A peer-led training program for improving chronic patients' health status and health behaviors]. / Impacto diferencial, necesidades heterogéneas. La formación entre iguales para mejorar la salud y los hábitos de vida de los pacientes crónicos.

OBJECTIVE: To measure the impact of the peer-led training for chronic patients on their health status and behaviors. DESIGN: Descriptive, transversal pretest and posttest quantitative approach. PLACEMENT: Andalusia. PARTICIPANTS: Nine hundred sixty-four patients with Diabetes, fibromyalgia and heart failure, trained at the School of Patients between 2013 and 2015. INTERVENTIONS: Peer-training intervention for self-efficacy for chronic patients. MAIN MEASUREMENT: Self-reported health status, activity limitation, diet and physical activity. Statistical analysis included descriptive and bivariate statistics, correlation coefficient and net gains for paired variables. RESULTS: Health status improved after the training, with less limitations and better diet and physical activity, with significant differences by sex, chronic illness, education level and marriage status. Improvement areas where identified for the training strategy, with special attention on the needs of more vulnerable groups (women, people with less education level). CONCLUSIONS: The peer training had a positive impact, with differences depending on social profiles. 1-year and 2-years posttest measurements are needed and a qualitative study is required in order to better evaluate the peer-led strategy and to adapt it to participants' needs and expectations.

[Study of obesity in a rural children population and its relationship with anthropometric variables]. / Estudio de la obesidad en una población infantil rural y su relación con variables antropométricas.

GOALS: To know the prevalence of obesity in primary and secondary school students, and to evaluate the diagnostic accuracy of anthropometric variables for its detection. DESIGN: Cross-sectional study. LOCATION: Rural area of Córdoba. In the year 2014. PARTICIPANTS: Student population. A stratified sampling was performed according to age, gender and educational centers. A total of 323 students from 6 to 16 years were included in the study, all parents had signed informed consent. MAIN MEASUREMENTS: The prevalence of obesity was determined and sociodemographic, anthropometric, physical condition and dietary predictor variables were collected. A binary logistic regression was performed determining crude and adjusted Odds Ratio (OR) values, ROC curves were obtained and cut-off values were determined, calculating the sensitivity, specificity and Youden index. RESULTS: The prevalence of overweight and obesity was 26.2% and 22.3%, respectively. Only 15.2% of school children had an optimal Mediterranean diet. The waist-height ratio (WtHR) was the predictive variable with the highest adjusted OR 7.1 (4.3-11.6) and the largest area under the curve 0.954 (0.928-0.979), from a global cut-off value to discriminate obesity of 0.507. This gave a sensitivity of 90% and specificity of 87.2%. CONCLUSIONS: The high prevalence of obesity, the low-medium adherence to the Mediterranean diet and the low physical fitness make this population a priority target for the prevention of future cardiovascular events. The WtHR has been the best anthropometric predictor of obesity, recommending its use for the diagnosis of obesity in children at the expense of body mass index.

[Counseling and preventive action in elderly population in hospitals and residences in Spain]. / Consejo y prevención a pacientes mayores en hospitales y residencias geriátricas en España.

OBJECTIVE: To establish the profile of elderly patients, and to assess current preventive actions in hospitals, geriatric residences, and different health-care centres in Spain. DESIGN: Cross-sectional descriptive study, based on a questionnaire to be answered by doctors who treat the elderly population in Spain (2013). SETTING: Health-care centres from different regions of Spain. PARTICIPANTS: A total of 420 practitioners from hospitals, residences and other community centres, with data from 840 geriatric clinics. MAIN MEASUREMENTS: Main outcome variables are: dependence, reason for assistance, comorbidity, professional consultation, and life style recommendations. Association factor, type of institution where patients have been attended. Analysis of prevalence and association using Chi-squared test. OUTCOMES: Two-thirds (66.7%) of the study population were shown to be dependent, with a higher percentage among women than men: 68.9% vs. 62.4% (P=.055). It was also found that among the population aged 85 or more, 88.6% of the women and 85.2% of the men suffered comorbidity. In spite of these results, only 6.6% of the patients suffering comorbidity received additional advice concerning healthy-lifestyle. A large majority (79.6%) of the patients treated in hospitals received advice concerning healthy lifestyle, while 59.62% of those treated in nursing homes received it (P<.001). CONCLUSIONS: It was observed that there is a lack of preventive action related to health promotion among the elderly, with differences between hospitals and geriatric residences. This suggests that it is time to put forward new specialised programs addressed to health professionals, in order to reinforce health promotion attitudes and preventive interventions in gerontology clinical practice.

[Healthy eating and self-perception of health]. / Alimentación saludable y autopercepción de salud.

OBJECTIVES: The aim is to determine whether there is an association between perceived health status, healthy eating and other lifestyles in people over 50 years old. DESIGN: Cross-sectional study. SETTING: 8 Basic Health Zones from the Health Area of Albacete. PARTICIPANTS: A total of 781 subjects, randomly selected by simple random sampling. MAIN MEASUREMENTS: variables: self-rated quality of life (EuroQol 5D), dietary habits (questionnaire on frequency of food consumption), physical activity (IPAQ questionnaire), toxic habits, health problems (International Classification of Primary Care) and sociodemographic characteristics. RESULTS: The mean age was 61.4 years (SD: 6.6) and the proportion of women was 60.1%. On a scale of 0-100 the mean score in the perceived health status was 74.0 (SD: 15.2). This score had a weak correlation with the number of healthy eating criteria (r=0.078; P=.03). A linear trend (P=.001) was observed between exercise intensity and better self-rated health. The score was lower in smokers (70.9±15.6 vs 74.9±15.1 SD; P=.004). In the multiple regression, the number of healthy eating criteria remained an association with the score on perceived health status (P=.04), after adjusting the model for sociodemographic characteristics, number of health problems, and toxic habits. CONCLUSIONS: In people over 50years of age the level of self-rated health is associated with the fulfilment of the criteria of a healthy diet, which is independent of other health habits and main sociodemographic variables.

[Consensus on the detection and management of prediabetes. Consensus and Clinical Guidelines Working Group of the Spanish Diabetes Society]. / Consenso sobre la detección y el manejo de la prediabetes. Grupo de Trabajo de Consensos y Guías Clínicas de la Sociedad Española de Diabetes.

In Spain, according to the Di@bet.es study, 13.8% of the adult population suffers from diabetes and 14.8% from some form of prediabetes (impaired glucose tolerance, impaired fasting glucose or both). Since early detection of prediabetes can facilitate the implementation of therapeutic measures to prevent its progression to diabetes, we believe that preventive strategies in primary care and specialized clinical settings should be agreed. Screening for diabetes and prediabetes using a specific questionnaire (FINDRISC) and/or the measurement of fasting plasma glucose in high risk patients leads to detecting patients at risk of developing diabetes and it is necessary to consider how they should be managed. The intervention in lifestyle can reduce the progression to diabetes and reverse a prediabetic state to normal and is a cost-effective intervention. Some drugs, such as metformin, have also been shown effective in reducing the progression to diabetes but are not superior to non-pharmacological interventions. Finally, an improvement in some cardiovascular risk factors has been observed although there is no strong evidence supporting the effectiveness of screening in terms of morbility and mortality. The Consensus and Clinical Guidelines Working Group of the Spanish Diabetes Society has issued some recommendations that have been agreed by the Sociedad Española de Endocrinología y Nutrición, Sociedad Española de Endocrinología Pediátrica, Sociedad Española de Farmacia Comunitaria, Sociedad Española de Medicina Familiar y Comunitaria, Sociedad Española de Médicos Generales, Sociedad Española de Médicos de Atención Primaria, Sociedad Española de Medicina Interna, Asociación de Enfermería Comunitaria and Red de Grupos de Estudio de la Diabetes en Atención Primaria.

[Physical activity in adult working population: results from the European National Health Survey for Spain (2009)]. / Actividad física en población adulta trabajadora española: resultados de la Encuesta Europea de Salud en España (2009).

OBJECTIVES: 1) To describe physical activity in the Spanish adult working population aged 16-70 years in 2009, and 2) to describe the prevalence of physical activity according to socio-demographic features, self-perceived health status, co-morbidity, and lifestyle habits. DESIGN: An epidemiological population based descriptive study was conducted using individual data taken from the European Health Survey for Spain. SETTING: Community. PARTICIPANTS: The number of subjects aged 16-70 years included in the study was 10,928 (5,628 women and 5,300 men). INTERVENTIONS: None. MAIN VARIABLES: Physical activity and intensity were assessed from questions included in the interview-survey. An analysis was performed on the socio-demographic characteristics and self-rated physical and mental health, using multivariate logistic regression models. RESULTS: Not having a partner (OR 1.44; P<.001), have university studies (OR 1.62; P<.001), non-smoker (OR 1.50; P<.001), and taking medications (OR 1.22; P<.5) were a predictor of intense physical activity in men. The first 3 factors are equal for intense activity in women. In contrast, obesity (OR 0.58; P<.001), and 36-50 years (OR 0.68; P<.001) were factors related to low activity in men. Aged between 36-50 years (OR 1.26; P<.01), suffering≥2 co-morbid conditions (OR 1.30; P<.001), and non-smoker (OR 1.17; P<.5) were also associated with higher probability of reporting moderate physical activity in women. The positive mental health was significant for physical activity in both sexes (OR 1.01; P<.5). CONCLUSIONS: This study identified several factors that appear to influence physical activity in the Spanish adult working population, with potential implications for healthcare providers.

[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.

[Development and validation of the food quality score in ELSA-Brasil]. / Desarrollo y validación de la puntuación de calidad alimentaria en el ELSA-Brasil.

Introduction: miology.Introduction: nutritional epidemiology seeks to understand the relationship between food consumption and the occurrence of diseases. During the COVID-19 pandemic, the Longitudinal Study of Adult Health (ELSA-Brasil) used a reduced Food Frequency Questionnaire (FFQ) to compare diet quality between cohort stages. Objective: to develop and validate an index created using a food quality score (FQS) using the FFQ of ELSA-Brasil. Methods: a cross-sectional study carried out between August 2020 and March 2021 with 4262 participants. For each frequency of consumption of healthy and unhealthy food markers, a score was given. Validity and reliability were tested using Pearson's correlation, principal component analysis (PCA) and Cronbach's alpha. Tests were performed to verify differences between individual characteristics and FQS. Results: the PCA indicated a total variability of 42.5 %. Women and individuals with higher age, physical activity and per capita income had a higher FQS, while those who reported higher consumption of alcohol and being smokers had a lower score. Cronbach's alpha was 0.47. Conclusion: the FQS showed a satisfactory validity and reliability and was associated with socioeconomic and lifestyle data. Therefore, it is a useful tool for comparing dietary information, thus contributing to nutritional epidemiology.

Introducción: Introducción: la epidemiología nutricional busca comprender la relación entre el consumo de alimentos y la ocurrencia de enfermedades. Durante la pandemia de COVID-19, el Estudio Longitudinal de Salud del Adulto (ELSA-Brasil) utilizó un Cuestionario de Frecuencia de Alimentos (CFA) reducido para comparar la calidad de la dieta en diferentes etapas de la cohorte. Objetivo: desarrollar y validar un índice creado a partir de un score (o puntuación) de calidad alimentaria (SCA) utilizando el CFA del ELSA-Brasil. Métodos: estudio transversal realizado entre agosto de 2020 y marzo de 2021 con 4262 participantes. Para cada categoría de frecuencia de consumo de alimentos indicadores de alimentación saludable y no saludable, se otorgó una puntuación. La validez y la fiabilidad se estimaron mediante el coeficiente de correlación de Pearson, el análisis de componentes principales (ACP) y la alfa de Cronbach. Se realizaron pruebas para verificar las diferencias entre las características individuales y la SCA. Resultados: el ACP indicó una variabilidad total del 42,5 %. Las mujeres y los individuos con mayor edad, actividad física e ingreso per cápita obtuvieron un valor de SCA más alto, mientras que aquellos que reportaron un mayor consumo de alcohol y tabaquismo obtuvieron una puntuación más baja. La alfa de Cronbach fue de 0,47. Conclusión: la SCA mostró una validez y confiabilidad satisfactorias y se asoció con datos socioeconómicos y de estilo de vida. Por lo tanto, es una herramienta útil para comparar la información dietética, contribuyendo a los futuros análisis en epidemiología nutricional.

Associations of physical activity, sedentary time, and fitness with cardiovascular risk and atherosclerosis over 3 years in women with systemic lupus erythematosus.

INTRODUCTION: Cardiovascular (CV) diseases are among the main causes of death in systemic lupus erythematosus (SLE). Physical activity (PA) and fitness are potential protective factors against the progression of CV risk factors and atherosclerosis. AIM: To analyze trends over time in PA, sedentary time (ST) and physical fitness and their associations of with traditional and novel markers of CV risk and subclinical atherosclerosis in women with SLE over a 3-year follow-up period. METHODS: In this exploratory study, 77 White Hispanic women with SLE (43.3±13.8 years) with mild disease activity were followed after 3 years (n=44). HDL and LDL cholesterol (blood samples), BMI and muscle mass (stadiometer and bioimpedance device), blood pressure (BP), pulse wave velocity (PWV, Mobil-O-Graph® monitor), carotid plaques and intima-media thickness (General Electric Medical Systems, LOGQ-6 model) were assessed. PA and ST were measured using triaxial accelerometers. Physical fitness was assessed with the back-scratch, handgrip strength, 30-s chair stand, and 6-min walk, tests. RESULTS: After 3 years, LDL-c (estimated mean change [est]=13.77mg/dL) and PWV (0.13m/s) increased while diastolic BP (-2.80mmHG) decreased (all, p<0.05). In mixed models, 6-min walk test was positively associated with HDL-c (est=0.07); back scratch (est=0.33) and chair-stand (est=1.19) tests were positively associated with systolic BP (all, p<0.05). No other trends or associations over time were identified (all, p>0.05). CONCLUSIONS: PA, ST, fitness, and most studied CV risk factors remained stable over time, with only marginal changes in LDL-c, PWV, and diastolic BP. Overall, PA and ST were not longitudinally associated with CV risk factors and subclinical atherosclerosis and contradictory weak associations were found for physical fitness.

Weight change and lifestyle modifications implemented during the COVID-19 pandemic lockdown are associated with the development of gastrointestinal symptoms.

INTRODUCTION AND AIMS: Pandemic lockdown measures are a cause of concern, regarding their negative impact on the mental health of individuals. The results of numerous studies have associated the appearance of gastrointestinal symptoms with different psychologic disorders, such as stress, depression, and anxiety, due to gut-brain axis interaction. The aim of the present study was to determine the prevalence of, and factors associated with, gastrointestinal symptom onset related to the COVID-19 pandemic lockdown and various lifestyle modifications. METHODS: An analytic, observational, and cross-sectional study was conducted on an open population that agreed to participate within the time frame of January to May 2021. RESULTS: A total of 298 subjects, 165 of whom were women (55.4%), agreed to participate and the mean patient age was 36.1 ±â€¯12.6 years. There was a significant increase in the frequency of several gastrointestinal symptoms: epigastric burning, early satiety, heartburn, regurgitation, constipation, and diarrhea. Changes in weight and modifications in lifestyle were found to be associated variables. CONCLUSIONS: The results of this study showed a significant increase in a wide variety of gastrointestinal symptoms related to lifestyle changes due to the pandemic lockdown. Weight change, supplement and multivitamin intake, and reduced physical activity were the main associated risk factors. Public healthcare systems should take a multidisciplinary approach into consideration for the care of affected individuals.

Impact of an educational intervention about healthy lifestyles in teenagers.

BACKGROUND: During the last years, lifestyle has worsened along the entire European population, causing an alarming boom-up regarding overweight and obese people. Pediatric population is also influenced in this sense, which may predispose to suffer from several diseases in adulthood. Educational interventions at early ages could be an effective strategy to face this situation. AIM: To describe the impact of an educational intervention about healthy lifestyle in adolescents. METHODS: A quasi-experimental study analyzing the knowledge of high school students, before and after a brief educational intervention based on a self-elaborated questionnaire including questions from the validated questionnaire CAPA (from Spanish, Conocimientos en Alimentación de Personas Adolescentes). RESULTS: The results of this study show a significant increase in knowledge about healthy lifestyles in the study population after the educational intervention (14.3±3.8 vs. 16.5±4.5; p<0.001). In addition, this improvement presents an asymmetric distribution according to gender (13.2±3.6 vs. 14.9±4.6; p=0.002 in men; 15.6±3 vs. 18.1±3.6; p<0.001 in women) and the type of educational center (14.17±3.6 vs. 16.48±4.17; p<0.001 in public schools and 14.86±4.15 vs. 16.54±5.32; p=0.047 in private schools). Parents' educational level was associated with improvement in knowledge about healthy lifestyles (13.44±2.9 vs. 15.67±5.37; p=0.132 at low level, 14.22±3.42 vs. 16.9±4.68; p<0.001 at medium level and 15.75±3.3 vs. 17.39±4.5; p=0.022 at high level). CONCLUSION: Educational intervention taught by primary health care professionals is a useful and efficient tool for the acquisition of nutritional and healthy lifestyle knowledge in adolescents.

Impact of a mobile application-based home care nursing program on patients' quality of life and family burden.

OBJECTIVE: This study aims to identify the effectiveness of a mobile application-based home care nursing service in improving patient quality of life and healthy lifestyle and reducing the family burden. METHODS: This study was a clinical trial with a pre- and post-test control group design. The accessible population in this study was post-discharge patients from general hospitals in West Kalimantan and East Kalimantan, Indonesia, who required home care nursing. We allocated a selected sample of 40 people to the intervention group and 40 people to the control group using a randomized block design. We gave mobile application-based home care nursing to the intervention group and community health nursing care to the control group. This study was conducted in 10 months (January-October 2022). We measure the patient quality of life, healthy lifestyle, and family burden before and 3 months after the intervention. RESULTS: There was no significant difference in the post-test quality of life between the two groups (p = 0.187), but there was a significant difference in the psychological (p = 0.014) and environmental health (p = 0.021) domain of quality of life. There was no significant difference in the post-test of a healthy lifestyle between the two groups (p = 0.083). There was a significant difference in the post-test family burden between the two groups (p = 0.015). CONCLUSION: Mobile Application-Based Home Care Nursing is effective in improving patient quality of life in the psychological and environmental health domains and reducing the family burden for post-discharge patients.

[Activities after school time and obesity in children. Influence of family and neighborhood environment]. / Actividad extraescolar y obesidad en los niños. Influencia del ámbito familiar y del vecindario.

BACKGROUND: elementary school children spend little time at the school in Mexico. The aim was to investigate the activities after school time in children and to determine the presence of overweight and obesity. METHODS: one hundred and seventy two children of both sexes were included. They belonged to the first and second grade of an official primary school from a marginalized zone. Somatometry was obtained and the type of physical practice and motifs for no practice physical activity were investigated. Descriptive statistics were applied. RESULTS: the frequency of underweight was 12.1 %, overweight 19 %, and obesity 18.5 %. Sedentary activities like watching television and playing video games were the most common registered, whereas sports were the lowest physical activity practiced, especially in girls. The parents' lack of time, low family income, and the scarcity of safe spaces where children can play and practice physical activity or sports were the most related factors. CONCLUSIONS: poverty and insecurity of the neighborhoods influence the outside activities in after school time. The high frequency of underweight, overweight and obesity in school children were associated to the lack of physical activity.

Introducción: los niños de primaria en México permanecen poco tiempo en el ámbito escolar. El objetivo de este trabajo fue conocer las características somatométricas de los escolares y sus padres e investigar las actividades extraescolares que realizan y las que les gustaría realizar y la razón por la que no lo hacen. Métodos: participaron 172 niños de uno y otro sexo, de primer y segundo año de una escuela primaria oficial de una colonia marginada. Resultados: la frecuencia de bajo peso fue de 12.1 %; de sobrepeso, de 19 % y de obesidad, de 18.5 %. Las actividades sedentarias como ver la televisión y los videojuegos fueron las más altas y las deportivas las más bajas, principalmente en las niñas. La falta de tiempo de los padres, los bajos recursos económicos de la familia y la falta de espacios seguros donde los niños puedan jugar y realizar actividades físicas y deportivas fueron los factores más importantes. Conclusiones: la pobreza y la inseguridad del barrio determinan las actividades extraescolares. La alta frecuencia de bajo peso, el sobrepeso y la obesidad en los escolares se relacionaron con la falta de actividad física.

Lifestyle and cardiometabolic risk factors in the ethnic and non-ethnic population > 15 years of age: results from the National Chilean Health Survey 2016-2017.

Introduction: Background: lifestyle and cardiometabolic risk factors information is scarce regarding youth and adults of Latin-American ethnics. Objective: the primary aim was to describe the lifestyle and cardiometabolic risk factors for arterial hypertension (HTN) and diabetes in ethnic Latin-American groups (Mapuche and Aymara) and other non-ethnics > 15 years of age in the Chilean population. A secondary aim was to determine the association between physical activity 'intensity' with HTN and diabetes markers. Material and methods: a representative sample from the National Chilean Health Survey 2016-2017, included Mapuche (EG-Map; women n = 166, men n = 300; total n = 466), Aymara (EG-Aym; women n = 96, men n = 55; total n = 151), and a non-ethnic population group (No-EG; women n = 2057, men n = 3445; total n = 5502). The main outcomes were; systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting plasma glucose (GL), and secondary outcomes were other anthropometric, lipid profile, and lifestyle parameters. Results: GL was significantly associated with nutrition (0.9 %, p < 0.0001), tobacco and alcohol habits (0.6 %, p < 0.0001). SBP was significantly associated with nutrition (whole-grains 0.04, p = 0.001; water consumption 0.07, p < 0.0001), sleep hygiene (week 0.04, p = 0.030; on weekends -0.04, p = 0.026), and alcohol consumption (-0.06, p < 0.0001). Conclusion: in conclusion, lifestyle differences among Mapuche and Aymara ethnic groups in comparison with non-ethnic Chilean peers > 15 years are significantly associated with blood pressure and glycemia.

Introducción: Antecedentes: la información sobre estilos de vida y factores de riesgo cardiometabólico es escasa en jóvenes y adultos de etnia latinoamericana. Objetivo: el objetivo principal fue describir el estilo de vida y los factores de riesgo cardiometabólico para la hipertensión arterial (HTA) y la diabetes en grupos étnicos latinoamericanos (Mapuche y Aymara) y otros no étnicos > 15 años de la población chilena. Un objetivo secundario fue determinar la asociación de la "intensidad" de la actividad física con la HTA y los marcadores de diabetes. Material y métodos: muestra representativa de la Encuesta Nacional de Salud de Chile 2016-2017, compuesta por mapuches (EG-Map; mujeres n = 166, hombres n = 300; total n = 466), aymaras (EG-Aym; mujeres n = 96, hombres n = 55; total n = 151) y un grupo poblacional no étnico (No-GE; mujeres n = 2057, hombres n = 3445; total n = 5502). Las principales evaluaciones fueron la presión arterial sistólica (PAS), la presión arterial diastólica (PAD) y la glucosa plasmática en ayunas (GL), y los resultados secundarios fueron otros parámetros antropométricos, del perfil lipídico y del estilo de vida. Resultados: la GL se asoció significativamente a los hábitos nutricionales (0,9 %, p < 0,0001) y los hábitos de tabaco y alcohol (0,6 %, p < 0,0001). La PAS se asoció significativamente con la nutrición (cereales integrales 0,04, p = 0,001; consumo de agua 0,07, p < 0,0001), higiene del sueño (semana 0,04, p = 0,030; fines de semana -0,04, p = 0,026) y consumo de alcohol (- 0,06, p < 0,0001). Conclusión: en conclusión, las diferencias de estilo de vida entre las etnias mapuche y aymara en comparación con sus pares chilenos no étnicos mayores de 15 años se asocian significativamente con la presión arterial y la glucemia.

[Short version of the Minnesota Leisure Time Physical Activity Questionnaire for general population: MLTPAQ 9+2]. / Versión reducida del Minnesota Leisure Time Physical Activity Questionnaire para población general: MLTPAQ 9+2.

The aim of this study was to propose a short version of the Minnesota Leisure Time Physical Activity Questionnaire (MLTPAQ) to estimate the prevalence of physical inactivity. MLTPAQ was included in the Galician Risk Behavior Information System survey. Each activity was associated with an intensity code, in multiples of 1 MET, and a weekly energy expenditure of less than 1000kcal was defined as physically inactive. The prevalence of physical inactivity was calculated with the complete and short list (nine activities are performed by at least 10% of the population). The complete and short list classify physical inactivity with an agreement of 98,8%. Misclassified people do one or two more activities, so two open response items were included. This study proposes a short version (9+2 items), suitable for inclusion in a general adult population health survey.

Performance and validation of the Healthy Heart Score model for predicting 12-year cardiovascular mortality in a nationwide Mediterranean population.

INTRODUCTION AND OBJECTIVES: The Healthy Heart Score (HHS) is a lifestyle-based equation for predicting cardiovascular disease (CVD) risk and may serve as a tool in primordial prevention. However, its performance outside North American populations is unknown. This study assessed the performance of the HHS for estimating CVD mortality in the adult population of Spain. METHODS: We analyzed data from the ENRICA cohort, comprising 10 228 participants free of chronic disease and representative of the Spanish population aged ≥ 18-years, who were recruited from 2008 to 2010 and were followed up to 2020. The HHS includes body mass index, alcohol, physical activity, smoking, and a 5-component dietary score. The HHS was calculated at baseline using the sex-specific beta coefficients from the original development cohorts. Model discrimination was assessed using the Harrell c-statistic and Gonen-Heller c-statistic for survival data, and calibration was evaluated through calibration plots. RESULTS: After a median follow-up of 11.8 years, 110 CVD deaths were ascertained. The discrimination of the HHS was similar for women (Harrell c, 0.91; 95%CI, 0.87-0.95; Gonen-Heller-c, 0.85; 95%CI, 0.83-0.88) and men (Harrell c, 0.91; 95%CI, 0.88-0.94; Gonen-Heller c: 0.85; 95%CI, 0.83-0.88). After recalibration by the sex-specific baseline survival function, the calibration became optimal for: a) all deciles of predicted CVD risk except the highest decile, where HHS underestimated the risk, and b) all age groups except 70 years and older, where there was an underestimation. CONCLUSIONS: In this Spanish cohort, the HHS showed good discrimination and calibration for predicting CVD death. The performance of HHS in other European populations and its implementation in the clinical setting warrants further investigation.

The relationship between results of coronary angiography, Mediterranean-type lifestyle, type D personality, and healthy life expectancy.

AIM: The aim of this study was to determine the relationship between coronary angiography results and Mediterranean-type lifestyle and type D personality. METHODS: Mediterranean-type lifestyle index and type D personality scale were administered to 230 participants. RESULTS: In univariate analysis according to coronary angiography results, a statistically significant effect was determined between the decision for treatment with percutaneous coronary intervention (PCI) and diabetes mellitus, and total and subscale points of Mediterranean lifestyle index, and between the decision for treatment with bypass and body mass index, Mediterranean diet, physical activity, and total points. In multivariate analysis, there was determined to be an effect between the PCI and systolic pressure, and between bypass and body mass index and subscale of physical activity. When disease-free life expectancy was examined, there was seen to be a negative effect of smoking and low Mediterranean diet points for participants with PCI, and of smoking, presence of hypertension, family history, and high type D personal characteristics score for those with bypass decision. CONCLUSION: The evidence-based recommendations for a Mediterranean-type lifestyle stated in cardiovascular disease (CVD) preventative guidelines may have a positive effect on the prevention of CVD, disability-free life, and mortality.

OBJETIVO: Este estudio se llevó a cabo para determinar la relación entre los resultados la angiografía coronaria y el estilo vida mediterráneo y los rasgos personalidad tipo D. MÉTODO: El índice de estilo de vida de tipo mediterráneo y la escala de personalidad de tipo D se administraron a 230 participantes. RESULTADOS: Según el resultado angiografía coronaria, subdimensiones intervención coronaria percutánea y diabetes y estilo de vida mediterráneo y puntajes totales en análisis univariante, circunvalación, cuanto a índice masa corporal, dieta estilo mediterráneo, actividad física y puntuación total; en análisis multivariado, se encontró que la intervención coronaria percutánea se asoció con la presión arterial sistólica, circunvalación con el índice masa corporal y subdimensión actividad física. Mirando la esperanza vida libre enfermedades, el tabaquismo y la baja puntuación la dieta tipo mediterránea del participante para el que se tomó la intervención coronaria percutánea, el índice masa corporal bajo, tabaquismo, hipertensión, los antecedentes familiares y los rasgos de personalidad tipo D altos del participante con la circunvalación afectan negativamente la esperanza de vida libre enfermedades. CONCLUSIÓN: Como se indica en las pautas de prevención enfermedades cardiovasculares, el estilo vida mediterráneo puede tener efectos positivos en la prevención enfermedades cardiovasculares, discapacidad y mortalidad.