Physical activity practice and sports preferences in a group of Spanish schoolchildren depending on sex and parental care: a gender perspective.

BACKGROUND: Physical activity plays an important role in the maintenance of health, and it is especially important during childhood. However, the lack of information about differences in physical activity practice and sports preferences of children considering gender differences can result in non-effective policies that enhance inequalities between sexes. The aim of this study is to identify the sports preferences of Spanish schoolchildren and their physical activity practice behaviors depending on their sex and their parental care, analyzing the possible differences from a gender perspective. METHOD: Three hundred sixty-four Spanish schoolchildren (179 girls, 185 boys) participated in this cross-sectional study. A daily physical activity questionnaire was used to evaluate physical activity level (PAL), moderate-to-vigorous physical activity (MVPA) and sports preferences and a socio-health questionnaire were used to collect data about parental care. Statistical analysis was performed using SPSS and applying Student's T-test for normal variables, Mann-Whitney U-test for non-parametrical variables, and chi-square (χ2) test for categorical variables. Subsequently, odds ratios were used to analyze associations between the physical activity practice of the children and parental care. RESULTS: PAL and time spent in MVPA was significantly lower for girls compared to boys (1.44 ± 0.07 vs. 1.46 ± 0.07, p < 0.001 and 0.74 ± 0.40 h/day vs. 0.90 ± 0.45 h/day; p < 0.001, respectively). Dancing, rhythmic gymnastics, skating, and water sports were practiced more by girls, while football, wrestling sports, handball, and racket sports were practiced more by boys (p < 0.05). Children cared for by their fathers had higher odds for physical activity practice (OR = 1.995 (1.202-3.310), p = 0.008). CONCLUSION: Physical activity among girls was less frequent and less intense. Girls opted for individual sports with artistic connotations, while boys often practiced more team contact sports. Furthermore, children are more physically actives when their father is in charge of them.

Adequacy of usual macronutrient intake and macronutrient distribution in children and adolescents in Spain: A National Dietary Survey on the Child and Adolescent Population, ENALIA 2013-2014.

OBJECTIVES: To describe the nutritional profile and assess the National Dietary Survey on the Child and Adolescent Population project in Spain (ENALIA) regarding usual total energy and macronutrient intake. METHODS: A cross-sectional nationally representative sample of 1862 children and adolescents (age 6 months to 17) was surveyed between 2013 and 2014 following European methodology recommendations. Dietary information was collected using two methods, dietary records (for children from age 6 months to 9 years) and 24-h dietary recall (participants age 10 and older). Usual intake was estimated by correcting for within-person intake variance using the Iowa State University (ISU) method. A probability analysis was used to assess compliance with dietary reference intakes in the target population. RESULTS: Protein consumption in the age 1-3 group as a percentage of total energy exceeded the upper limit of the Acceptable Macronutrient Distribution Range (AMDR) by 4.7% for boys and 12.1% for girls. 42.9% of girls age 4-8 were under the lower limit of the AMDR for carbohydrates. 43.4% of boys and 46.9% of girls between 4 and 17 exceeded the AMDR in total fat intake, saturated fatty acids (SFAs) accounting for 12.3% of total energy. CONCLUSIONS: The results suggest that Spanish children and adolescents could improve macronutrient distribution by reducing fat and increasing carbohydrate intake across all age groups, and decreasing protein intake, especially in young children.

ß-Carotene Concentration and Its Association with Inflammatory Biomarkers in Spanish Schoolchildren.

AIM: To examine the correlation between inflammatory biomarkers and plasma ß-carotene levels in children. METHODS: A total of 564 Spanish schoolchildren aged 9-12 were observed and studied. Plasma ß-carotene levels were assessed by HPLC. A ß-carotene level <4.83 µg/dL (0.09 µmol/L) was considered deficient. Plasma tumour necrosis factor-α (TNF-α) and interleukin-6 (IL-6) were measured by immunoenzyme assays. Serum high-sensitivity C-reactive protein (hs-CRP) was tested by immunonephelometry. RESULTS: Subjects who were ß-carotene-deficient (23.1% of the studied children) had higher IL-6 levels than subjects with normal ß-carotene concentrations. The log-IL-6 and log-hs-CRP concentrations, but not the log-TNF-α level, were strongly and inversely related to the plasma log-ß-carotene level (taking into account log-age, energy intake, log-triglycerides, gender, log-body mass index, log-ß-carotene intake, energy from lipids and cholesterol as covariables). When the 3 inflammatory biomarkers were introduced into the regression model along with the corresponding covariables, only the log-IL-6 level was related to the plasma log-ß-carotene level (ß = -0.505 ± 0.078; p < 0.001). CONCLUSIONS: Inflammatory status, in particular IL-6 levels, appears to be negatively associated with plasma ß-carotene levels in schoolchildren.

Antioxidant status in a group of institutionalised elderly people with chronic obstructive pulmonary disease.

Chronic obstructive pulmonary disease (COPD) is one of the most important and prevalent diseases suffered by the elderly. Evidence exists that its onset and severity might be conditioned by antioxidant status. The aim of the present study was to investigate the relationship between antioxidant status and COPD in institutionalised elderly people. In all, 183 elderly people aged >65 years (twenty-one had COPD and 160 healthy controls) were studied. The subjects' diets were investigated via the use of precise individual weighing for 7 d. Body weight, height, and biceps and triceps skinfold thickness were measured, and body fat (kg) and BMI (kg/m2) were calculated. Serum retinol, α-tocopherol, ß-carotene and vitamin C levels were determined. Subjects with COPD ate less fruits than healthy controls (117 (sd 52) v. 192 (sd 161) g/d), their coverage of the recommended intake of vitamin C was smaller (150 (sd 45) v. 191 (sd 88) %; note that both exceeded 100 %) and their diets had a lower antioxidant capacity (6558 (sd 2381) v. 9328 (sd 5367) mmol trolox equivalent/d). Those with COPD had lower serum vitamin C and α-tocopherol concentrations than healthy controls (32·4 (sd 15·3) v. 41·5 (sd 14·8) µmol/l and 12·1 (sd 3·2) v. 13·9 (sd 2·8) µmol/l, respectively). In addition, subjects with α-tocopherol <14·1µmol/l (50th percentile) were at 6·43 times greater risk of having COPD than those subjects with ≥14·1µmol/l (OR 6·43; 95 % CI 1·17, 35·24; P<0·05), taking sex, age, use of tobacco, body fat and vitamin E intake as covariables. Subjects with COPD had diets of poorer antioxidant quality, especially with respect to vitamins C and E, compared with healthy controls.

High-Protein Processed Foods: Impact on Diet, Nutritional Status, and Possible Effects on Health.

Proteins are macronutrients with multiple health benefits, but excessive consumption can negatively affect health. This study aimed to evaluate the characteristics of a sample of high-protein processed foods (HPPFs), describe how their consumption affects dietary balance, and acquire knowledge of the consumption patterns of these products in a Spanish population. A sample of HPPFs available in supermarkets and on websites was collected. The contribution to recommended protein intakes was calculated using national and international references and considering the single consumption of the HPPFs and the product plus 150 g of meat. Furthermore, an online survey was conducted among a convenience sample. A total of 36 enriched protein products were evaluated. The percentage of proteins in these products ranges from 10 to 88%. The contribution of the protein recommended intake was within a range of 87.4-306.6% and 66.4-232.8% (women and men, respectively), only considering the additional proteins from 150 g of meat. One hundred thirty-nine participants completed the survey; 67.6% affirmed that they had consumed HPPFs, and half consumed them without following any consumption control. Since these products are accessible to everyone in supermarkets and protein intake is generally higher than the recommended limits, regulating the mass sale of HPPFs is essential to ensure they do not lead to protein overconsumption.

Omega 3 and omega 6 fatty acids intake and dietary sources in a representative sample of Spanish adults.

The present study analyzes the intake of omega 3 (n-3 PUFAs) and omega 6 (n-6 PUFAs) and dietary sources in a representative sample of Spanish adults. For this purpose 418 adults (18 - 60 y), from 15 Spanish provinces were studied. The intake of energy and nutrients [specifically, the n-3 polyunsaturated fatty acids (PUFAs,) α-linolenic acid (ALA), eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA); and the n-6 PUFA, linoleic acid (LA)] was determined using a 24-hour recall questionnaire for two days. The Multiple Source Method (MSM) was used to estimate participants’ usual fatty acid intake. The total n-3 PUFAs intake was 1.8 ± 0.60 g/day (ALA: 1.3 ± 0.32, EPA: 0.16 ± 0.14, and DHA: 0.33 ± 0.21 g/day) and n-6 PUFA intake was 11.0 ± 2.7 g/day (LA: 10.8 ± 2.7 g/day). A high proportion of participants did not meet their nutrient intake goals for total n-3 PUFAs (84.7 %), ALA (45.0 %), and EPA plus DHA (62.9 %). The main food sources for ALA were oil, dairy products, and meat; for EPA fish; for DHA, fish, eggs, and meat; and for LA, oils, meat, and cereals. Therefore, an increase in the intake of foods rich in n-3 PUFAs or the use of supplements with n-3 PUFAs might help to improve the n-3 PUFA intake.

[Nutritional factors related to insulin resistance in children and adolescents]. / Factores nutricionales relacionados con la resistencia a la insulina en escolares y adolescentes.

Introduction: Insulin resistance is described as a defect in the binding of insulin to its receptor and is associated with several diseases, including obesity and type 2 diabetes. Insulin resistance has been linked to vitamin and mineral deficiencies, especially those involved in oxidative stress. The Mediterranean diet, a diet based on the Healthy Eating Index or the Dietary Approaches to Stop Hypertension (DASH) diet are dietary patterns that have been associated with a lower risk of developing insulin resistance in children. Therefore, a diet rich in antioxidant vitamins and minerals, fiber, calcium, and polyunsaturated fatty acids and low in free sugars, sodium and saturated fatty acids may decrease the risk of insulin resistance in this age group. In addition, other nutritional factors, such as avoiding fast food, eating dinner with the family, not eating while watching TV or eating a sufficient and healthy breakfast on a regular basis seem to be associated with a lower risk of insulin resistance. Therefore, it is important to establish balanced daily eating habits to prevent and treat insulin resistance in schoolchildren and adolescents.

Introducción: La resistencia a la insulina se explica como un defecto en la unión de la insulina con su receptor y está asociada con numerosas enfermedades, como la obesidad o la diabetes tipo 2, entre otras. La resistencia a la insulina se ha relacionado con la deficiencia de vitaminas y minerales, especialmente de aquellos involucrados en el estrés oxidativo. La dieta mediterránea, una dieta basada en el Healthy Eating Index o la dieta Dietary Approaches to Stop Hypertension (DASH) son patrones dietéticos que se han asociado con un menor riesgo de presentar resistencia a la insulina en edad infantil. Por tanto, una dieta rica en vitaminas y minerales antioxidantes, fibra, calcio y ácidos grasos poliinsaturados y baja en azucares libres, sodio y ácidos grasos saturados puede disminuir el riesgo de presentar resistencia a la insulina en este grupo de edad. Además, otros factores nutricionales, como evitar la comida rápida, cenar en familia, no comer mientras se ve la televisión o el consumo regular de un desayuno suficiente y saludable son hábitos que parecen estar relacionados con menor riesgo de presentar resistencia a la insulina. Por tanto, es importante establecer hábitos alimentarios diarios equilibrados para prevenir y tratar la resistencia a la insulina en escolares y adolescentes.

[Cardiometabolic effects of intermittent fasting in women]. / Efectos cardiometabólicos del ayuno intermitente en la mujer.

Introduction: Intermittent fasting is a dietary pattern characterized by alternating periods of total or partial fasting and ad libitum food consumption. During prolonged fasting, the body uses the ketone bodies formed from lipolysis of body fat, which also leads to some metabolic modifications with positive effects on health. In this sense, nocturnal intermittent fasting could contribute to properly synchronize the circadian system making the physiological, hormonal, energetic and metabolic processes work correctly and keeping to the individual in homeostasis. Thus, according to the results of different studies, intermittent fasting, in the short-medium term, seems to improve body composition, as well as the values of several cardiometabolic parameters such as insulin and HOMA-IR index, among others. These effects have been observed in both pre- and postmenopausal women (no differences have been found between both states) and are similar to those found in interventions with caloric restriction diets.

Introducción: El ayuno intermitente es un patrón dietético caracterizado por la alternancia de periodos de ayuno, totales o parciales, y de consumo de alimentos ad libitum. Durante el ayuno prolongado, el organismo utiliza los cuerpos cetónicos que se forman a partir de la lipolisis de la grasa del organismo, lo que también da lugar a algunas modificaciones metabólicas con efectos positivos para la salud. En este sentido, el ayuno intermitente nocturno podría contribuir a sincronizar adecuadamente el sistema circadiano, haciendo que los procesos fisiológicos, hormonales, energéticos y metabólicos funcionen correctamente y mantengan al individuo en homeostasis. Así, de acuerdo con los resultados de diferentes estudios, el ayuno intermitente, a corto-medio plazo, parece mejorar la composición corporal, así como los valores de diversos parámetros cardiometabólicos como la insulina y el índice HOMA-IR, entre otros. Estos efectos se han observado tanto en mujeres premenopáusicas como postmenopáusicas, sin hallar diferencias entre ambos estados y son similares a los encontrados con intervenciones con dietas con restricción calórica.

Adherence to 24-h movement guidelines in Spanish schoolchildren and its association with insulin resistance: a cross-sectional study.

Introduction: Being more active, being less sedentary, and sleeping enough are associated with adequate body weight and adiposity in children. However, few researchers have analyzed these different lifestyle behaviors and the adherence to 24 h movement guidelines with respect to insulin resistance (IR) at school age. Therefore, we aimed to analyse the association between the adherence to 24 h movement guidelines (physical activity, sedentary time, sleep) and IR in Spanish schoolchildren. Methods: A cross-sectional study of 839 children (8-13 years, 51.1% girls) were studied. Anthropometric, biochemical, and lifestyle behavioral data were collected. IR was defined as HOMA-IR>3.16. Compliance with the 24 h movement guidelines were defined as ≥60 min/day of moderate and/or vigorous physical activity, < 120 min/day of screen time, and 9-11 h/day of sleep time. Associations between adherence to the 24 h movement guidelines and IR were performed by multivariate logistic regression analyses. Results: The IR in our sample was 5.0%, being higher in girls. Compliance with physical activity or screen time, but not with sleep recommendations, was associated with lower fasting glucose, fasting insulin, and HOMA-IR values. A low adherence to 24 h movement guidelines was associated with a higher risk of IR (odds ratio (95% CI): 2.150 [1.089-4.247]), especially in girls (odds ratio (95% CI): 2.800 [1.180-6.645]). Conclusion: Higher physical activity levels and lower screen times were associated with a lower risk of IR in schoolchildren, underlining the importance of adhering to as many healthy lifestyle recommendations as possible.

Breakfast Quality and Insulin Resistance in Spanish Schoolchildren: A Cross-Sectional Study.

Background: Breakfast has traditionally been considered one of the most important meals of the day; however, there is little evidence for the influence of breakfast quality and insulin resistance (IR). This study aimed to assess the quality of breakfast in a group of schoolchildren, and its association with IR. Methods: A cross-sectional study with 852 children (8−13 years) was carried out. Fasting plasma glucose, insulin and anthropometric parameters were measured. A three-day dietary record was used to assess their diet and to calculate the Breakfast Quality Index (BQI). The sample was divided into tertiles according to the BQI (tertile 3: better breakfast quality). The homeostatic model was used to assess insulin resistance (HOMA-IR), and IR was defined as HOMA-IR > 3.16. Results: The prevalence of IR was 5.2%. The mean BQI score was 4.50 ± 1.25, and boys had lower scores than girls. Children in the BQI tertile 3 had a better global diet quality. In boys, being in the BQI tertile 3 was associated with a lower risk of IR (OR [95% CI]: 0.10 [0.01−0.77], p < 0.05). Conclusions: A higher-quality breakfast was associated with better overall diet quality and a lower risk of IR, especially in boys.

[Impact of egg consumption on the nutritional status of young adults]. / Impacto del consumo de huevo en la situación nutricional de jóvenes adultos.

Introduction: Young adults move from adolescence into adulthood, and they face physical, social and personal changes that can affect their health. Regarding their nutritional needs, their energy requirements are lower than during adolescence, but they may need the same or higher amounts of other essential nutrients, such as folate, vitamin C, vitamin D, calcium, and iron. Furthermore, their increasingly sedentary lifestyle has led to a high prevalence of overweight and obesity in this group. However, despite being a vulnerable stage to nutritional problems, not enough attention has been paid to it from this point of view. In this context, eggs stand out as a food of great nutritional value for young adults, as they are an excellent source of protein, vitamins, and minerals. In addition, eggs are a nutritionally dense food, which makes them particularly useful in weight control and in situations with low energy requirements but high demands for other nutrients. Moderate egg consumption as part of a balanced diet helps to follow a healthy diet in this population group, contributing to improve their current and future health.

Introducción: Los adultos jóvenes, en su paso desde la adolescencia hacia la vida adulta, deben afrontar cambios físicos, sociales y personales que pueden afectar a su salud. Sus requerimientos energéticos son menores que durante la adolescencia, pero pueden necesitar la misma cantidad o mayor de otros nutrientes esenciales, como folatos, vitamina C, vitamina D, calcio y hierro. Además, su estilo de vida cada vez más sedentario ha llevado a una alta prevalencia de sobrepeso y obesidad en este grupo. Sin embargo, a pesar de ser una etapa sensible a los problemas nutricionales, no se le ha prestado suficiente atención desde este punto de vista. En este contexto, el huevo destaca como un alimento de gran valor nutricional para los adultos jóvenes, dado que es una excelente fuente de proteínas, vitaminas y minerales. Además, el huevo es un alimento de alta densidad nutricional, lo que lo hace especialmente útil en el control de peso y en situaciones de bajas necesidades energéticas pero altas con respecto a otros nutrientes. El consumo de huevo en cantidades moderadas y como parte de una dieta equilibrada ayuda a seguir una dieta saludable en este grupo de población, lo que contribuye a mejorar su salud actual y futura.

[Nutritional problems in cis and trans women]. / Problemática nutricional de mujeres cis y trans.

Introduction: Women deserve special attention due to the different requirements they have in comparison with men. In the same way, transgender women need individualized attention. Transgender women are at greater risk of suffering heart attacks or ischemic accidents, among other diseases, and are also at greater risk of developing eating disorders, poorer weight control and poorer perception of their image. Hormone therapy for gender reaffirmation in trans women modifies their body composition, and may also increase the risk of suffering from some pathologies. The nutritional needs of cisgender women are different from those of men, and trans women also have special needs, which may depend on whether or not they follow hormone therapy. Dietary studies, although scarce, suggest that transgender women have poor dietary habits and lifestyle. It is necessary to deepen the study of the nutritional situation of the female group, considering its diversity, and to develop standards and references appropriate to each case that allow better attention to the needs of these groups.

Introducción: El colectivo femenino merece una especial atención debido a los diferentes requerimientos que tienen en comparación con el colectivo masculino. De la misma manera, se necesita atender de manera individualizada al colectivo transgénero. En concreto, las mujeres trans tienen más riesgo de sufrir infartos o accidentes isquémicos, entre otras enfermedades, y también tienen mayor riesgo de desarrollar trastornos del comportamiento alimentario y peor control de peso y percepción de su imagen. La terapia hormonal de reafirmación de género en mujeres trans modifica su composición corporal y también puede aumentar el riesgo de padecer algunas patologías. Las necesidades nutricionales de las mujeres cisgénero son diferentes a las de los varones, y también tienen necesidades especiales las mujeres trans, que pueden depender del seguimiento o no de un tratamiento hormonal. Los estudios dietéticos, aunque escasos, sugieren que las mujeres transgénero tienen unos hábitos dietéticos y un estilo de vida menos saludables. Es necesario profundizar en el estudio de la situación nutricional del colectivo femenino, atendiendo a la diversidad del mismo, y desarrollar estándares y referencias adecuadas a cada caso que permitan una mejor atención de las necesidades de estos colectivos.

Association between Mineral Intake and Cognition Evaluated by Montreal Cognitive Assessment (MoCA): A Cross-Sectional Study.

BACKGROUND: Mineral intake may protect against cognitive impairment (CI) and all-cause dementia, which affects a large number of adults worldwide. The aim of this study was to investigate the association between mineral intake and Montreal Cognitive Assessment (MoCA), which is a sensitive and specific test. METHODS: In total, 201 adults were included in a cross-sectional study. They completed a three-day dietary record to estimate their average daily intake of minerals. Contributions to dietary reference intakes (DRIs) were also calculated. The participants were divided into tertiles according to their mineral intake. CI classifications were determined via the MoCA (score < 26). Apolipoprotein E (APOE) genotyping was carried out, and the patients' anthropometric measurements and physical activity, health and personal data were collected. RESULTS: The prevalence of CI in this selective sample was 54.2% (34.3% females and 19.9% males). In women, being in the third tertiles of iron and manganese intake was associated with lower odds of having CI (OR [95% CI]: 0.32 [0.11 ± 0.93]; 0.33 [0.12 ± 0.93], p < 0.05). No significant differences were observed for any of the nutrients studied in men. CONCLUSIONS: These findings suggest that a low mineral intake, especially low iron and manganese intake in women, is associated with a worse cognition as assessed by MoCA.

[Recommended egg intake in children: past, present, and future]. / Recomendaciones de consumo de huevo en población infantil: pasado, presente y futuro.

Introduction: The consumption of high nutritional quality foods is a key for proper growth and development during childhood. This work aimed to review and analyse the current recommended egg intake in children by different national organisations. Likewise, it intended to standardise a procedure to propose new recommendations for this food. A search of available national online guidelines or recommendations was performed. The Healthy Eating Guide of the Spanish Society of Community Nutrition (SENC), 2018 and the energy requirements of the European Food Safety Authority (2017) for children and adolescents were contemplated, considering a contribution of 15 % of energy as proteins to propose the new recommended egg intake. Two scenarios according to the level of physical activity and three age groups were considered. Based on the current data and evidence, we believe that egg intake recommendations should be reassessed, proposing broader recommendations, especially for children over 13 years old with average energy requirements as well as children over seven years old who perform high physical activity or are in a brief period of growth. It will contribute to breaking down old myths associated with egg consumption and promote the development of coordinated and updated recommendations.

Introducción: Durante la edad infantil, el consumo de alimentos de alta calidad nutricional es clave para un adecuado crecimiento y desarrollo. Este trabajo se desarrolló con el objetivo de revisar y de analizar la frecuencia y la cantidad de consumo de huevo actualmente aconsejado por diferentes organismos en el ámbito nacional. Asimismo, se buscó estandarizar un procedimiento para proponer unas nuevas recomendaciones de consumo de este alimento. Para ello, se realizó una búsqueda digital de las guías o recomendaciones nacionales disponibles. Para proponer la nueva recomendación se trabajó con las frecuencias y con las raciones de los alimentos clasificados por grupos de la Guía de la alimentación saludable de la Sociedad Española de Nutrición Comunitaria (SENC), 2018, y con los requerimientos de energía para niños y niñas y adolescentes propuestos por la European Food Safety Authority de 2017, considerando un aporte del 15 % de la energía en forma de proteínas. Se contemplaron dos escenarios de acuerdo al nivel de actividad física y se hizo una clasificación en tres grupos de edad. Con base en los datos y en la evidencia actual, consideramos que las recomendaciones de consumo de huevo deben ser reevaluadas para proponer unas recomendaciones más amplias, especialmente para niños mayores de 13 años con requerimientos medios de energía y niños mayores de 7 años que realicen una actividad física elevada o que se encuentren en un periodo de rápido empuje puberal. Esto contribuirá a derribar viejos mitos asociados a este alimento con tanto potencial para la población infantil y adolescente y al desarrollo de unas recomendaciones más coordinadas y revisadas.

Association of Healthy Eating Index-2015 and Dietary Approaches to Stop Hypertension Patterns with Insulin Resistance in Schoolchildren.

Background: Diet quality patterns are associated with a lower incidence of insulin resistance (IR) in adults. The aim of this study was to investigate the association between two diet quality indices and IR in schoolchildren and to identify the best diet quality index associated with a lower risk of IR. Methods: A total of 854 schoolchildren (8−13 years) were included in a cross-sectional study, who completed a three-day dietary record to assess their diet. Fasting plasma glucose and insulin were also measured, and anthropometric data were collected. Healthy Eating Index-2015 (HEI-2015), Dietary Approaches to Stop Hypertension (DASH), and adjusted DASH (aDASH) were calculated as diet quality indices. The homeostasis model assessment of insulin resistance (HOMA-IR) was used, and IR was defined as HOMA-IR > 3.16. Results: The prevalence of IR was 5.5%, and it was higher in girls. The mean HEI-2015 and DASH scores were 59.3 and 23.4, respectively, and boys scored lower in both indices. In girls, having a HEI-2015 score above the 33rd percentile was associated with a lower risk of IR (odds ratio [95% CI]: 0.43 [0.19−0.96], p = 0.020). Conclusion: Greater adherence to a healthy dietary pattern, as assessed by a higher HEI-2015 score, was associated with a lower risk of IR in schoolchildren, especially in girls.

[Impact of vitamin D on health. Difficulties and strategies to reach the recommended intakes]. / Impacto de la vitamina D en la salud. Dificultades y estrategias para alcanzar las ingestas recomendadas.

Introduction: Vitamin D is a key nutrient for health. Recent research has shown that it is not only necessary for the maintenance of bone health, but also for the prevention of cardiovascular diseases, insulin resistance, respiratory diseases, infections, and cancer, among others. Solar synthesis of vitamin D is usually insufficient, so it is necessary to provide enough vitamin D through the diet in order to maintain an adequate nutritional status. Studies carried out in Spain and other countries have shown that serum levels of the vitamin were usually insufficient and that average dietary intakes were well below those marked as recommended, while the main food sources of vitamin D were fatty fish, breakfast cereals, eggs, and dairy. Food sources of vitamin D are scarce, and it is naturally located in the fatty part of foods of animal origin, and in the liver and viscera. Fortifying foods that are not natural food sources of vitamin D but are regularly consumed by a significant percentage of the population, is a strategy that could help to increase vitamin D intake. In this regard, dairy products and breakfast cereals are two of the most widely used food matrices for vitamin D fortification, and their incorporation into the usual diet has proven to be an effective strategy to improve the nutritional situation of the population in vitamin D.

Introducción: La vitamina D es clave en la salud y sus funciones se relacionan con el mantenimiento de la salud ósea, cardiovascular, la resistencia a la insulina, enfermedades respiratorias, infecciones y cáncer, entre otras. La síntesis solar de la vitamina D es con frecuencia insuficiente, por lo que para mantener un estatus adecuado de la vitamina es necesario que se aporten cantidades suficientes con la dieta. Los estudios realizados en España y en otros países muestran que los niveles séricos de la vitamina son con frecuencia insuficientes y que las ingestas dietéticas medias se encuentran muy por debajo de las marcadas como recomendadas. Las principales fuentes alimentarias de la vitamina D son los pescados grasos, los cereales de desayuno, los huevos y los lácteos. Las fuentes alimentarias de vitamina D son escasas y se encuentra especialmente en la parte grasa de alimentos de origen animal, en hígados y en vísceras. El enriquecimiento de alimentos que de forma natural no tienen un elevado contenido en vitamina D, pero que son consumidos habitualmente por un porcentaje significativo de la población, es una estrategia que ayuda a aumentar su ingesta. En este sentido, los lácteos y los cereales de desayuno son dos de las matrices alimentarias más utilizadas y su incorporación en la dieta habitual ha demostrado ser una estrategia eficaz para mejorar la situación nutricional de la población respecto a la vitamina D.

Estimation of salt intake by 24 h urinary sodium excretion in a representative sample of Spanish adults.

The present study reports the Na intake of a representative sample of Spanish young and middle-aged adults aged 18-60 years (n 418, 53·1 % women, selected from the capitals of fifteen provinces and the surrounding semi-urban/rural area), measured with a 24 h urinary Na excretion method. To validate the paper collection of 24 h urine, the correlation between fat-free mass determined by electrical bioimpedance (50·8 (sd 11·3) kg) and that determined via urinary creatinine excretion (51·5 (sd 18·8) kg) was calculated (r 0·633, P < 0·001). Urinary Na excretion correlated with systolic and dyastolic blood pressure data (r 0·243 and 0·153, respectively). Assuming that all urinary Na (168·0 (sd 78·6) mmol/d) comes from the diet, Na excretion would correspond with a dietary salt intake of 9·8 (sd 4·6) g/d, and it would mean that 88·2 % of the subjects had salt intakes above the recommended 5 g/d. Logistic regression analysis, adjusted for sex, age and BMI, showed male sex (OR 3·678, 95 % CI 2·336, 5·791) and increasing BMI (OR 1·069, 95 % CI 1·009, 1·132) (P < 0·001) to be associated with excreting >200 mmol/d urinary Na--a consequence of the higher salt intake in men and in participants with higher BMI. The present results help us to know the baseline salt intake in the Spanish young and middle-aged adult population, and can be used as the baseline to design policies to reduce salt consumption.

Vitamin D deficiency is an independent predictor of elevated triglycerides in Spanish school children.

PURPOSE: To determine the association between vitamin D status and the serum lipid profile in children. METHODS: The subjects of this cross-sectional study were 149 Spanish school children (8-13 years of age). The anthropometric data collected were weight and height, from which the body mass index (BMI) was calculated. Serum 25(OH)D concentrations were measured by chemiluminescent assay. Triglycerides were determined by enzyme colorimetry; total cholesterol and HDL-cholesterol were determined by the cholesterol esterase method. The LDL-cholesterol concentrations were determined mathematically. RESULTS: Compared to children with serum 25(OH)D concentrations in the fourth quartile, those in the first had higher triglyceride (86.0 ± 35.7 vs. 64.1 ± 26.7 mg/dL; p < 0.05). After adjusting for age, sex, BMI, and physical activity, the serum 25(OH)D level was found to be inversely proportional to the triglyceride (r = -0.857; p = 0.010). While age, sex, BMI, and physical activity explained 12% of the variance of the HDL-cholesterol figures, the inclusion of serum 25(OH)D allowed 23% of the variance to be explained. CONCLUSION: A low serum vitamin D levels in children is associated with high triglyceride levels.

Preliminary data on the association between waist circumference and insulin resistance in children without a previous diagnosis.

The aim of the present work was to study the association between different anthropometric parameters and insulin resistance (IR) in Spanish schoolchildren without a previous diagnosis. A total of 443 Spanish schoolchildren (9-11 years of age) were studied in this cross-sectional study. The anthropometric measurements collected were weight, height, body circumferences and skinfolds. Body mass index (BMI), waist/hip ratio, percentage body fat and fat-free body mass were determined. Overnight-fasted blood lipids, insulin and glucose levels were analysed, and estimation of IR, taking into account the homeostasis model assessment (HOMA), was calculated. The children with IR had higher serum triglycerides and insulin levels, were heavier and taller, and had a higher BMI, a larger waist circumference, a larger hip circumference, a larger waist/hip ratio and thicker bicipital and tricipital skinfolds than those who did not have IR. Age, sex, BMI and waist circumference explained 32.0% of the variance in the HOMA values; only sex, triglycerides and waist circumference independently influenced this variable. A 1-cm increase in waist circumference was associated with approximately a 3.8% increase in the mean HOMA value. The children with a waist circumference of over the p90 for their age and sex were at greater risk of showing IR as measured by the HOMA: odds ratio = 6.94 (2.01-23.91; P < 0.001). In conclusion, according to these results, waist circumference is the best anthropometric parameter associated with IR in children, and those with a waist circumference of over the p90 for their age and sex would appear to be at particular risk.

Leukocytes and Neutrophil-Lymphocyte Ratio as Indicators of Insulin Resistance in Overweight/Obese School-Children.

Background and Aims: Inflammation in overweight/obesity may condition the development of insulin resistance (IR). New markers of inflammation and systemic inflammation, such as leukocyte and platelet counts, the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR), could be used as indicators of IR. The aim of the present study was to investigate the relationship between these markers and IR in overweight/obese children. Materials and Methods: A total of 1,035 schoolchildren were studied (398 overweight/obese). Anthropometric, hematological and biochemical measurements were collected. Inflammation was considered to be present when the values of leukocytes, platelets, NLR, PLR and MLR were ≥p75 for each sex. IR was defined as HOMA-IR >3.16. Results: In overweight/obese schoolchildren, leukocytes were higher in both boys and girls, and platelets and NLR were higher in boys with IR than in boys with insulin sensitivity. An association between leucocytes and NLR values (≥p75) and IR was found in the entire population [2.911 (1.328-6.381); p = 0.008 and 2.660 (1.185-5.968); p = 0.018, respectively] and in boys [9.255 (1.896-45.168); p = 0.006 and 6.996 (1.377-35.544); p = 0.019, respectively]. Conclusion: Elevated white blood cell values and elevated NLR in overweight/obese children, and particularly in boys, could be indicators of the presence of IR in these subjects and should be considered when predicting possible complications, such as type II diabetes mellitus.