[Exploring Needs, Motivations, and Limitations Towards Healthy Eating and Digital Resources: A Qualitative Study in a Mexican Primary Education Setting]. / Exploración de necesidades, motivaciones y limitaciones en relación con la alimentación saludable y recursos digitales: un estudio cualitativo en un entorno de educación primaria en México.

OBJECTIVE: To explore the needs, motivations, and limitations related to healthy eating and digital materials, as well as to identify patterns for their design as a strategy aimed at Mexican families. DESIGN: A qualitative observational study of the phenomenon through focus group sessions. LOCATION: A public primary education center in the city of Querétaro, Mexico. PARTICIPANTS: Children aged 9 to 11 years and parents, mothers, or caregivers with children in primary education. METHOD: Twelve sessions were conducted with three groups of students and two sessions with parents, mothers, or caregivers using an interview guide. Various digital materials, developed based on social cognitive theory, were presented during the sessions. The sessions were recorded with the participants' or their guardians' prior consent and transcribed for analysis. Coding was performed for key points of analysis, and information saturation was confirmed. RESULTS: Students expressed motivation towards digital material that promotes play and experimentation, especially within the family context. The main perceived barrier was the caregivers' resistance to change. Parents expressed motivation and a need for explanatory material on diseases, with economic and time-related barriers. CONCLUSIONS: Digital material based on social cognitive theory, designed to improve nutrition, can be an effective strategy in nutritional education if it considers the circumstances of the target population. It is advisable to include affective and behavioral elements to achieve meaningful learning within households.

Prevalence of overweight and obesity in school-age children.

INTRODUCTION: Childhood obesity is a public health challenge. Between 1999 and 2012, the prevalence in Mexico of overweight and obesity in schoolchildren went from 25.5 to 32 %. OBJECTIVE: To report current prevalence of overweight and obesity in schoolchildren from the municipality of Durango, Mexico. METHOD: Cross-sectional survey conducted between January 2017 and December 2018. A total of 24,600 children aged between six and 11 years from 138 schools of the municipality of Durango were included. The body mass index reference values established by the World Health Organization were used to determine the presence of overweight and obesity. RESULTS: The prevalence of overweight was 19.7 %, of obesity, 16 %, and of overweight and obesity combined, 35.7 %. In the six-year-old group, a prevalence of overweight-obesity of 25.4 % was found, and in the 11-year-old group, 41.1 %. CONCLUSIONS: The prevalence of overweight-obesity in children aged from 6 to 11 years in the municipality of Durango is higher than those reported in the national survey by states in 2012 and in the 2016 national survey; a trend towards an increase with age was observed.

INTRODUCCIÓN: La obesidad infantil es un reto de salud pública. Entre 1999 y 2012, en México la prevalencia de sobrepeso y obesidad (SO) en niños escolares pasó de 25.5 a 32 %. OBJETIVO: Reportar la prevalencia actual de SO en niños escolares del municipio de Durango, México. MÉTODO: Encuesta transversal realizada entre enero de 2017 y diciembre de 2018. Se incluyeron 24 600 niños de seis a 11 años, de 138 escuelas del municipio de Durango. Se utilizaron los valores de referencia del índice de masa corporal establecidos por la Organización Mundial de la Salud para determinar la presencia de SO. RESULTADOS: La prevalencia de sobrepeso fue de 19.7 %, la de obesidad de 16 % y la de SO de 35.7 %. En el grupo de seis años se encontró una prevalencia de SO de 25.4 % y en el de 11 años, de 41.1 %. CONCLUSIONES: La prevalencia de SO en niños de seis a 11 años del municipio de Durango es más elevada que la reportada en la encuesta nacional por entidad federativa en 2012 y la nacional en 2016; se observó tendencia al incremento en la prevalencia conforme aumenta la edad.

[Prevalence of hypovitaminosis D and associated factors in Spanish population of school children and adolescents]. / Prevalencia de hipovitaminosis D y factores asociados en la edad infantojuvenil.

OBJECTIVE: To analyse the prevalence of hypovitaminosisD and associated factors in school children and adolescents living in a region of northern Spain. DESIGN: Cross-sectional study (convenience sampling). SETTING: Primary Health Care. PARTICIPANTS: A total of 602 Caucasian individuals (aged 3.1 to 15.4years) were included in the study. MAIN MEASUREMENTS: Prevalence of hypovitaminosisD were calculated (dependent variable). HypovitaminosisD is defined according to the US Endocrine Society criteria: deficiency (calcidiol <20ng/mL), insufficiency (calcidiol: 20-29ng/mL), and sufficiency (calcidiol ≥30ng/mL). Gender, age, body mass index, residence, and season of the year were recorded (independent variables), and their association with hypovitaminosisD was analysed by multiple regression. RESULTS: The prevalence of hypovitaminosisD was 60.4% (insufficiency: 44.6%; deficiency: 15.8%). Multivariate analysis showed that factors associated to hypovitaminosisD were being female (OR: 1.6; 95%CI: 1.1-2.3), pubertal age (OR: 1.8; 95%CI: 1.2-2.6), autumn (OR: 9.5; 95%CI: 4.8-18.7), winter (OR: 8.8; 95%CI: 4.5-17.5) and spring time (OR: 13.2; 95%CI: 6.4-27.5), living in urban areas (OR:1.6; CI95%: 1.1-2.2), and severe obesity (OR: 4.4; 95%CI: 1.9-10.3). CONCLUSIONS: There is a high prevalence of hypovitaminosisD in juvenile populations. being female, pubertal age, autumn, winter and spring seasons, severe obesity, and living in urban areas are factors associated to hypovitaminosisD. Consideration should be given to the administration of vitamin supplements and/or the increase in the ingestion of natural vitaminD dietary sources.

[Nutritional status in children with intellectual disabilities based on anthropometric profile]. / Perfil antropométrico en función del estado nutricional de niños con discapacidad intelectual.

INTRODUCTION: Anthropometric variables such as weight, height and body length in children and adolescents with and without intellectual disabilities should be studied in connection with nutritional status, physical growth and biological maturation. OBJECTIVE: a) to analyze the anthropometric profile based on nutritional status, b) to determine the prevalence of overweight and short stature c) to propose equations for predicting height from anthropometric variables. METHODS: A total of 49 children and adolescents with intellectual disabilities, and from a special education school were studied (30 boys and 19 girls). Weight, height, trunk-cephalic height, forearm and foot length were evaluated. The calculation of nutritional status resulted in the establishment of nutritional categories: underweight, normal and overweight. RESULTS: The anthropometric profile of males varies significantly when classified according to nutritional categories (P<.05); however no variations were observed in the girls (P>.05). Also, high values of overweight prevalence were observed in both genders (43% of boys and 26% of girls). Variables such as age, weight, length of the forearm in females, and foot length in males are good predictors of height (R(2) = 91-94% males and R(2) = 87% females). CONCLUSIONS: A high percentage of overweight cases were observed; therefore, rigorous control and monitoring of nutritional status are suggested. The proposed regression equations could be an option in schools to easily and simply predict height.

Impact of periodic selective mebendazole treatment on soil-transmitted helminth infections in Cuban schoolchildren.

OBJECTIVE: To evaluate the impact of periodic selective treatment with 500 mg mebendazole on soil-transmitted helminth (STH) infections in Cuban schoolchildren. METHODS: We followed up a cohort of 268 STH-positive schoolchildren, aged 5-14 years at baseline, at six-month intervals for two years and a final follow-up after three years. Kato-Katz stool examination was used to detect infections with Ascaris lumbricoides, Trichuris trichiura and hookworm. Common risk factors related to STHs were assessed by parental questionnaire. RESULTS: A significant reduction in the number of STH infections was obtained after three years with the highest reduction for T. trichiura (87.8%) and the lowest for hookworm (57.9%). After six months, cure rates (CRs) were 76.9% for A. lumbricoides, 67.4% for T. trichiura and 44.4% for hookworm. After two treatment rounds, more than 75% of all STH-positive children at baseline were cured, but with important differences between STH species (95.2% for A. lumbricoides, 80.5% for T. trichiura and 76.5% for hookworm). At the end of the study, these cumulative CRs were almost 100% for all three STHs. Risk factors for STHs were sex, sanitary disposal and habit of playing in the soil. CONCLUSIONS: Our results indicate that periodic selective treatment with 500 mg mebendazole is effective in reducing the number of STH infections in Cuban schoolchildren. Although important differences were found between helminth species, two rounds of treatment appeared sufficient to obtain substantial reductions.

[Do socioeconomic determinants influence school menus?] / ¿Influyen los determinantes socioeconómicos en la oferta de los menús escolares?

Introduction: Introduction: the components of school menus is an important area in health strategies. Objectives: the aim of this study was to analyse differences in adherence to recommended food frequencies and other characteristics of school meals in educational centres according to the type of school and neighbourhood income. Method: schools in the city of Barcelona with a lunch service were offered a three-year review. In the three academic years, 341 schools participated: 175 were public and 165 were private. To identify any differences, the Pearson Chi-squared test or Fisher exact test were used, as appropriate. Statistical analyses were performed with the STATA SE/15 programme. Results: no statistically significant differences were found by the socioeconomic level of the school neighbourhood. Private and subsidised schools showed lower adherence to recommendations on pasta (11.1 %), red and processed meat (24.7 %), total meat (7.4 %) and fresh fruit (12.1 %), and lower use of the recommended cooking oil (13.1 %). In contrast, public schools showed lower adherence to the recommended type of frying oil (16.9 %). Conclusions: in private and subsidised schools, improvements should be recommended on the frequency of intake of certain foods. Future studies should examine the causes of lower adherence to certain recommendations in these centres.

Introducción: Introducción: la oferta de menús escolares es un área relevante en las estrategias de salud. Objetivos: analizar las diferencias en el cumplimiento de las frecuencias recomendadas de alimentos y otras características del comedor escolar en los centros educativos según su titularidad y la renta del barrio. Métodos: se ofreció la revisión trienal a los centros escolares de la ciudad de Barcelona que disponían de servicio de comedor. En los tres cursos académicos, participaron 341 centros: 175 públicos y 165 de titularidad privada. Para observar si existían diferencias, se utilizó la prueba de Pearson Chi-cuadrado o el test exacto de Fisher según el caso. Los análisis se realizaron con el programa estadístico STATA SE/15. Resultados: no se encontraron diferencias significativas según el nivel socioeconómico del barrio del centro educativo. Los centros educativos privados y concertados presentaban un menor cumplimiento en la pasta (11,1 %), las carnes rojas y procesadas (24,7 %), la carne total (7,4 %) y la fruta fresca (12,1 %), así como un menor uso del aceite recomendado para cocinar (13,1 %). Por el contrario, en los centros educativos públicos se observaba un menor cumplimiento en la recomendación del tipo de aceite para freír (16,9 %). Conclusiones: en los centros privados y concertados es necesario recomendar mejoras en la adecuación de las raciones. Se debería indagar en las causas que pueden explicar esta menor adecuación en varios aspectos como en el cumplimiento de las adecuaciones en estos centros.

[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.

[Food quality in pre-school and school children in Chile during the COVID-19 pandemic]. / Calidad de la alimentación en preescolares y escolares en Chile durante la pandemia de COVID-19.

Introduction: Introduction: the COVID-19 pandemic can affect the quality of food and nutrition of preschoolers and schoolchildren through an increase in food insecurity of families, by measures such as confinement and closure of educational establishments, which affects the daily structure, feeding schedules, and quality of food. Objectives: analyze the overall food quality of preschool and school children in Chile during the COVID-19 pandemic. Methods: five hundred and fifty-one schoolchildren (22.5 % boys and 77.5 % girls) from five Chilean cities distributed in northern, central, and southern macro zones participated in a convenience sampling. The Global Food Quality Index was applied. The data were analyzed in the IBM SPSSV24 statistical program. Differences in proportions were analyzed employing crossed tables. Results: schoolchildren from rural areas presented lower eating quality than their urban peers (p = .005). Schoolchildren who eat with the whole family had better indicators of eating quality than those who ate alone (p = .002). In nine out of 12 dietary components, evaluated females present higher compliance with dietary recommendations. Conclusions: further research is needed on changes in dietary intake and dietary quality of children and their families during the pandemic. This will allow us to analyze the impact of the pandemic on eating behavior and its possible consequences.

Introducción: Introducción: La pandemia por COVID-19 puede afectar en la calidad de la alimentación y la nutrición de preescolares y escolares a través de un incremento de la inseguridad alimentaria de las familias, por medidas como el confinamiento y cierre de establecimientos educacionales, lo que afecta la estructura diaria, horarios de alimentación y calidad de la alimentación. Objetivo: analizar la calidad global de la alimentación de preescolares y escolares en Chile durante la pandemia de COVID-19. Métodos: en un muestreo por conveniencia participaron 551 escolares (22,5 % niños y 77,5 % niñas) de cinco ciudades de Chile distribuidas en macrozonas norte, centro y sur. Se aplicó el índice de calidad global de la alimentación. Los datos fueron analizados en el programa estadístico IBM SPSSV24. Se analizaron diferencias de proporciones a través de tablas cruzadas. Resultados: escolares de zonas rurales presentaron menor calidad de la alimentación que pares de zonas urbanas (p = ,005). Escolares que comen con toda la familia presentan mejores indicadores de calidad de la alimentación que aquellos que lo hacen solos (p = ,002). En nueve de 12 componentes de la alimentación evaluados, las mujeres presentan mayor cumplimiento de recomendaciones alimentarias. Conclusiones: se requieren más investigaciones sobre los cambios de ingesta dietética y calidad de la alimentación de los niños y niñas y sus familias durante la pandemia. Esto permitirá analizar el impacto de la pandemia en la conducta alimentaria y sus posibles consecuencias.

Effect of school reopening on pediatric morbidity and mortality during the third epidemiological wave of COVID-19 in a Mexican state.

BACKGROUND: Determining the effect of reopening schools on pediatric SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infection rates increased the need to share the experience of governments in many geographic regions for better future decision-making in similar health emergencies. METHODS: Through a prospective study based on a population-based cohort, students from 18,988 schools in the State of Mexico who began returning to school were followed. Daily sanitation filters were implemented in each school and district liaisons were informed on a daily basis through a negative network. Identified cases were confirmed by reverse transcriptase-polymerase chain reaction. Simple case frequencies, percentages, and incidences of COVID-19 were estimated. State incidences were compared with the national incidence. RESULTS: A total of 3,586 cases were confirmed; 2,048 (57.1%) were children. Twenty-four (0.6%) were hospitalized for moderate to severe COVID-19; nine (37.5%) died, and only one was a schoolchild. From week 36, an average infection rate of 0.36 was observed. The highest infection rate in schoolchildren was observed in epidemiologic week 40 (1.01); from this week on, a decrease in the number of cases was observed until week 50. CONCLUSIONS: The use of non-pharmaceutical interventions has more advantages than limitations, as long as the strategies are homogeneous and properly implemented to ensure adequate control of infections.

INTRODUCCIÓN: La determinación del efecto de reabrir las escuelas sobre las tasas de infección pediátrica por SARS-CoV-2 (síndrome respiratorio agudo grave coronavirus 2) incrementó la necesidad de trasmitir la experiencia de los gobiernos de muchas regiones geográficas para mejores decisiones futuras en emergencias sanitarias similares. MÉTODOS: Mediante un estudio prospectivo basado en una cohorte poblacional se dio seguimiento a los alumnos de 18,988 escuelas del Estado de México que iniciaron con el regreso a clases. Se implementaron filtros sanitarios diarios en cada escuela y cotidianamente se informaban a los enlaces jurisdiccionales a través de una red negativa. Los casos identificados eran confirmados a través de RT-PCR (reacción en cadena de la polimerasa con transcriptasa inversa). Se estimaron frecuencias simples de casos, porcentajes e incidencias de COVID-19. Las incidencias del estado se compararon con la incidencia nacional. RESULTADOS: Un total de 3,586 casos fueron confirmados; 2,048 (57.1%) correspondieron a niños. Veinticuatro (0.6%) fueron hospitalizados por COVID-19 moderado a grave; nueve (37.5%) fallecieron, y solamente una correspondió a un escolar. A partir de la semana 36 se observó una tasa promedio de infecciones de 0.36. En la semana epidemiológica 40 se observó la mayor tasa de infección en escolares (1.01); a partir de esta semana se observa un declive de los casos hasta la semana 50. CONCLUSIONES: La implementación de intervenciones no farmacéuticas tiene más ventajas que limitaciones, siempre y cuando las estrategias sean homogéneas y correctamente ejecutadas, lo que asegurará un adecuado control en los contagios.

RCParvulari training: A basic life support training methodology applied to 5-year-old students: Effectiveness in a cluster-randomized clinical trail.

INTRODUCTION: Basic life support training in school age is a topical issue because, with adequate training, any person can help save a life. METHODS: Cluster clinical trial with data collection through an ad hoc self-administered, semi-structured questionnaire. The target population encompassed the students aged 4-6 years enrolled in 49 educational centres. The centres were randomly allocated to the intervention or control group. The intervention group was trained with the RCParvulari® methodology, consisting of theoretical and practical training on the first link of the chain of survival. The control group only received theoretical training. We evaluated participants before and immediately after the intervention and between 3 and 12 months post intervention by means of the questionnaire. We assessed the acquisition and retention over time of the knowledge and skills covered in the training compared to previous trainings in both groups. RESULTS: A total of 1327 schoolchildren (79% of the target population) participated. The level of knowledge acquired immediately after training and after 3-12 months compared to baseline was significantly better (P < .001) in the intervention group than in the control group, both in early recognition and contacting of emergency services (112) and in remembering the "mouth-nose-eyes" mnemonic. CONCLUSIONS: The RCParvulari® methodology significantly contributed to an improved ability to recognize a possible medical emergency, start the chain of survival by alerting an adult and call the 112 emergency number in students in the last year of preschool education.

Intergenerational associations of adverse and positive maternal childhood experiences with young children's psychosocial well-being.

Background: Maternal adverse childhood experiences (ACEs) are believed to have negative consequences on offspring health. However, positive childhood experiences (PCEs) may be concurrent with ACEs, and little is known about how ACEs and PCEs transmit intergenerationally in the context of each other.Objective: To explore the independent effect of maternal ACEs and PCEs on offspring psychosocial well-being and how ACEs and PCEs are intergenerationally transmitted in their context.Method: Data were 2587 mother-child dyads in Anhui provinces of China. Mothers retrospectively reported their ACEs and PCEs, as well as provided demographic characteristics and their children's psychosocial well-being. Logistic regression models were performed to explore the associations of maternal ACEs and PCEs with offspring psychosocial well-being.Results: Separate unadjusted logistic regression models showed that children with mothers reported high ACEs scores were more likely to have psychosocial challenges (total difficulties and prosocial problems), while children whose mothers reported high PCEs scores were less likely to have psychosocial challenges. When we added maternal ACEs and PCEs to a same model, we found that PCEs slightly neutralised the negative effects of ACEs on offspring's total difficulties and prosocial problems. When stratified by sample, mothers with high PCE scores and higher maternal ACEs were related with a higher risk of offspring total difficulties; mothers with low levels of ACEs and high PCEs tend to report a lower risk of offspring total difficulties.Conclusions: Results suggest that PCEs are positively and intergenerationally transmitted. Results suggest that PCEs are positively and intergenerationally transmitted. More programme should be provided to increase maternal PCEs. When preventing the intergenerational transmission of ACEs, specific interventions should be provided to mothers with different levels of PCEs.

Positive childhood experiences positively transmit intergenerationally.Stronger relationship between maternal ACEs and risk of offspring total difficulties was observed among mothers with above-average positive childhood experiences scores.A stronger relationship between maternal PCEs and fewer offspring total difficulties was observed among mothers with low adverse maternal childhood experiences scores.

[Prevention of eating disorders in primary education]. / Prevención de los trastornos de la conducta alimentaria en educación primaria.

Introduction: Eating disorders are infrequent in school age, being predominant in the female sex. The main predictive factors at this age are similar to those of other age groups, the influence of body changes being particularly important, especially in girls. Despite preventive programs in this age group are scarce, those focused mainly on the acceptance of body image, internalization of the ideal of appearance and media literacy have shown some effectiveness. However, new research is needed to confirm the approaches with the best results.

Introducción: Los trastornos de la alimentación son poco frecuentes en las edades de la etapa escolar, siendo predominantes en el sexo femenino. Los principales factores predictivos en esta edad son similares a los de otros grupos de edad, siendo particularmente importante la influencia de los cambios corporales, sobre todo en las niñas. Aunque los programas preventivos en este grupo de edad son escasos, los centrados principalmente en la aceptación de la imagen corporal, la internalización del ideal de apariencia y la alfabetización mediática han observado cierta eficacia. No obstante, son necesarias nuevas investigaciones que confirmen los enfoques con mejores resultados.

[Lower grip strength values are associated with increased levels of adiposity and excess weight: a cross-sectional study]. / Menores valores de fuerza de prensión manual se asocian a incremento de los niveles de adiposidad y exceso de peso: un estudio transversal.

Introduction: Objective: physical fitness (particularly the muscular strength component) is one of the most powerful markers of health. However, few studies have described the relationship of the higher adiposity phenotype with muscular strength in Latino schoolchildren. The aim of the present study was to determine the association between levels of handgrip strength (HGS) with different anthropometric markers. The central hypothesis of this study was that lower HGS values are associated with a higher adiposity phenotype in a sample of schoolchildren and adolescents. Research methods and procedures: a descriptive cross-sectional study was carried out in 6 public schools in Bogotá, Colombia, with a final sample of 430 participants (55.8 % women) between 9 and 17.9 years of age. Handgrip strength (HGS) was assessed with a handheld dynamometer, and normalized as HGS per body mass (i.e., [grip strength in kg)/(body mass in kg]). Tertiles of normalized HGS were obtained separately for both sexes and high HGS was defined as higher tertile (T3). Waist-to-height ratio, body mass index, and skinfold thickness were measured as adiposity parameters. Results: the mean (SD) age of participants was 13.2 (1.4) years. Significant inverse correlations were found between normalized HGS, waist-to-height ratio, body mass index, and skinfold thickness (range, r = -0.40 to -0.61; p < 0.001). Regardless of sex, participants with low HGS (below the first tertile) had the highest values of waist-to-height ratio, body mass index, and skinfold thickness after adjusting for age. Conclusion: muscular strength was inversely associated with a higher adiposity phenotype. HGS could have protective potential for increased levels of adiposity excess. The evaluation of muscular fitness at an early age will allow the implementation of future cardiovascular and metabolic risk prevention programs.

Introducción: Objetivo: la condición física ­especialmente la fuerza muscular­ es uno de los predictores más relevantes del estado de salud de un individuo. No obstante, son poco los estudios que han descrito la relación del fenotipo de exceso de adiposidad con el componente muscular en escolares latinos. El objetivo del presente estudio fue determinar la asociación entre los niveles de fuerza de prensión (FP) manual con diferentes marcadores de adiposidad. Nuestra hipótesis de trabajo fue demostrar si los menores valores de FP se asocian con un fenotipo de exceso de adiposidad en una muestra de niños y adolescentes escolarizados. Métodos y procedimientos de investigación: estudio transversal realizado en 430 escolares (55,8 % mujeres) entre los 9 y 17,9 años, pertenecientes a 6 instituciones educativas oficiales de Bogotá, Colombia. Se midió la FP por dinamometría manual como indicador de fuerza muscular y se categorizó en tertiles (T) de fuerza, siendo el tertil (T3) la posición con mejor desempeño muscular. La relación cintura/estatura, el índice de masa corporal y los pliegues cutáneos se midieron como parámetros de adiposidad. Resultados: la edad media de los evaluados fue 13,2 ± 1,4 años. Se observaron correlaciones inversas y estadísticamente significativas entre la FP ajustada al peso y los parámetros antropométricos incluidos en este estudio (rango: r = -0,40 a -0,61; p < 0,001). Esta misma relación se observó tras ajustar la edad como covariable en los escolares con mejor desempeño muscular (T3), independientemente del sexo. Conclusión: basados en los resultados obtenidos en el presente trabajo, los escolares con altos niveles de FP (T3) presentaron menores niveles de adiposidad. Esto permite que los escolares con mejores valores de FP puedan contrarrestar los efectos negativos del exceso de adiposidad. La evaluación de la fuerza muscular en edades tempranas permitirá implementar programas de prevención de riesgo cardiovascular y metabólico en el futuro.

Is the physical fitness of schoolchildren dependent on their physical activity levels and nutritional status? The experience from Serbia.

Introduction: Introduction: based on the presumed relationship between physical activity and physical fitness, it seems reasonable to expect that being active would result in sufficient fitness levels. However, the relationship between physical activity and fitness is not so plausible and needs deeper exploration. Objectives: we conducted a study aimed at exploring: a) the potential variation in physical activity level by gender and school grade; and b) the effect of physical activity level, gender, and nutritional status on physical fitness test results. Methods: a total of 2795 males and 2614 females participated in the study (11-14 years). Their physical fitness was assessed by measuring anthropometric status, muscular fitness, endurance, flexibility, agility, and cardiorespiratory fitness, while their physical activity was assessed using the Physical Activity Questionnaire (PAQ-A). Results: a higher percentage of boys were highly active, while a higher percentage of girls were scarcely active (χ2 [2, n = 5017] = 151.4, p < 0.01). Decline in physical activity with age was higher in girls than in boys (χ2 [6, n = 5409] = 90.4, p < 0.01). MANOVA revealed a significant effect of gender (V = 0.009, F [6, 3669] = 5.29, p < 0.01), nutritional status (V = 0.193, F [12, 7340] = 65.16, p < 0.01) and physical activity levels (V = 0.043, F [12, 7340] = 13.60, p < 0.01) on tests outcomes. Conclusions: our study has shown that activity level in Serbian schoolchildren declines with age and is affected by nutritional status. Nutritional status represents a significant factor confounding physical fitness scores, regardless of activity levels.

Introducción: Introducción: basado en la presumible relación entre la actividad física y la condición física, parece razonable esperar que ser activo físicamente resulte en niveles suficientes de condición física. Sin embargo, la relación entre la actividad física y la forma física no es tan plausible y necesita una exploración más profunda. Objetivos: realizamos un estudio con el objetivo de explorar: a) la variación potencial en el nivel de actividad física en función del género y el grado escolar; y b) el efecto del nivel de actividad física, el género y el estado nutricional en el resultado de las pruebas de condición física. Métodos: un total de 2795 hombres y 2614 mujeres participaron en el estudio (11-14 años). Su condición física se evaluó midiendo el estado antropométrico, la aptitud muscular, la resistencia, la flexibilidad, la agilidad y la aptitud cardiorrespiratoria, mientras que la actividad física se evaluó mediante el Cuestionario de Actividad Física (PAQ-A). Resultados: un mayor porcentaje de niños eran muy activos, mientras que un mayor porcentaje de niñas eran poco activas (χ2 [2, n = 5017] = 151,4, p < 0,01). La disminución de la actividad física con el incremento de la edad fue mayor en las niñas que en los niños (χ2 [6, n = 5409] = 90,4, p < 0,01). El MANOVA reveló un efecto significativo del género (V = 0.009, F [6, 3669] = 5.29, p < 0.01), el estado nutricional (V = 0.193, F [12, 7340] = 65.16, p < 0.01) y los niveles de actividad física (V = 0.043, F [12, 7340] = 13.60, p < 0.01) en los resultados de las pruebas. Conclusiones: nuestro estudio ha demostrado que el nivel de actividad física en los escolares serbios disminuye con la edad y se ve afectado por el estado nutricional. El estado nutricional representa un factor significativo que confunde las puntuaciones de condición física, independientemente de los niveles de actividad.

Mala nutrición en población escolar mexicana: factores geográficos y escolares asociados.

OBJETIVOS: Determinar prevalencias de mala nutrición [sobrepeso u obesidad (Sp+O) y talla baja (TB)] en población mexicana de 6 a 12 años de edad de nivel básico de primaria, y su asociación con características geográficas (ámbito, marginación y región del país), y de la escuela (tipo, turno y grado). MÉTODOS: Con información de 10 528 676 escolares, se estimaron prevalencias (e I.C. 95%), a nivel nacional y por características de interés, y su asociación mediante modelos de regresión logística. RESULTADOS: La prevalencia nacional de Sp+O fue 34.4%, 36.5% en ámbito urbano y 40.2% en escuelas privadas. La prevalencia nacional de TB fue 8.7%; en área rural, 13.7% y 28.8% en escuelas tipo indígenas. El Sp+O y la TB se asociaron significativamente con características geográficas y de escuelas. CONCLUSIONES: Existe una polarización nutricional en el contexto escolar del país. Es importante continuar con sistemas de monitoreo y vigilancia nutricional.

Association of physical activity, muscular strength, and obesity indicators with self-concept in Chilean children.

Introduction: Objectives: the present study examined the association of physical activity, muscular strength, and obesity indicators with self-concept in Chilean children. Methods: this cross-sectional study included 1078 Chilean children (mean age: 9.1 years [standard deviation: 1.1]; 598 boys). Physical activity was evaluated using the Physical Activity Questionnaire for Older Children. Upper and lower limb strength was evaluated using a digital dynamometer and standing long jump performance, respectively. The general strength index was calculated based on z-score values. Obesity indicators used were height, weight, body mass index, and body fat. The self-concept test was used to determine the academic, social, emotional, family, physical self-concept dimensions and total self-concept of children. Results: the mean total self-concept was 3.3 (standard deviation: 0.5). Physical activity was associated with academic (ß: 0.32; p = 0.03), social (ß: 0.24; p = 0.04), family (ß: 0.13; p = 0.01), physical (ß: 0.46; p = 0.01) self-concept dimensions and total self-concept (ß: 0.22; p = 0.01), regardless of sex and age. Upper limb strength and general strength index were negatively associated with academic self-concept dimensions (ß: -0.02; p = 0.01 and ß: -0.13; p = 0.02) and total self-concept (ß: -0.04; p = 0.01). Body weight and body mass index were negatively associated with academic (ß: -0.01; p = 0.01 and ß: -0.01; p = 0.02) and physical self-concept dimensions (ß: -0.03; p = 0.03). Conclusions: these findings suggest that physical activity is positively related with self-concept. Thus, physical activity and self-percept must be considered as an essential social cognitive perspective to provide suitable mental health in children.

Introducción: Objetivos: el presente estudio examinó la asociación de indicadores de actividad física, fuerza muscular y obesidad con el autoconcepto en niños chilenos. Métodos: este estudio transversal incluyó a 1078 niños chilenos (edad media: 9,1 años [desviación estándar: 1,1]; 598 niños). La actividad física se evaluó mediante el Physical Activity Questionnaire for Older Children. La fuerza de los miembros superiores e inferiores se evaluó utilizando un dinamómetro digital y el rendimiento en salto de longitud de pie. El índice de fuerza general se calculó en base a los valores de z-score. Los indicadores de obesidad utilizados fueron altura, peso, índice de masa corporal y grasa corporal. Se utilizó el test de autoconcepto para determinar las dimensiones académicas, social, emocional, familiar, físico y autoconcepto total. Resultados: la muestra total presento un autoconcepto promedio de 3,3 (desviación estándar: 0,5). La actividad física se asocio con autoconcepto académico (ß: 0,32; p = 0,03), social (ß: 0,24; p = 0,04), familiar (ß: 0,13; p = 0,01), físico (ß: 0,46; p = 0,01) y total (ß: 0,22; p = 0,01). La fuerza muscular de miembros superiores y el índice general de fuerza se asociaran negativamente con al autoconcepto académico (ß: -0,02; p = 0,01 y ß: -0,13; p = 0,02) y total (ß: -0,04; p = 0,01). Mientras que el peso corporal e índice de masa corporal se asociaron negativamente con autoconcepto académico (ß: -0,01; p = 0,01 y ß: -0,01; p = 0,02) y físico (ß: -0,03; p = 0,03). Conclusiones: estos hallazgos sugieren que la actividad física se relaciona positivamente con el autoconcepto. Así, la actividad física y la autopercepción deben ser consideradas como una perspectiva cognitiva social imprescindible para proporcionar una adecuada salud mental en los niños.

[Psychocardiological intervention in the cardiovascular rehabilitation of school children with congenital heart disease: A systematic review]. / La intervención psicocardiológica en la rehabilitación cardiovascular de niños escolares con cardiopatías congénitas: una revisión sistemática.

OBJECTIVE: A systematic review is presented with the objective of determining whether school children with congenital heart disease participate in psychological interventions in the cardiovascular rehabilitation process. METHOD: Guided review by the PRISMA method was carried out in the databases: Dialnet, Pub Med, Redalyc, Science Direct, Scielo, Google Academic of articles published in English, Portuguese and Spanish. The inclusion criteria are: rehabilitative interventions that contain actions for the management of psychological factors. 23 reports were evaluated for eligibility, only 1 was chosen through the data tabulation method. RESULTS: It was evidenced that these programs for children with heart disease are scarce, they focus on physical activity, neglecting socio-psychological variables. It is proposed to implement standardized intervention actions with congenital cardiovascular patients and their families from psychocardiology according to their needs.

Learning to resuscitate at school. Study in 8-12 year-old schoolchildren.

OBJECTIVE: To quantitatively assess the learning capacity of school children aged between 8-12 years in basic life support (theory and practice) after a feasible school training programme. MATERIAL AND METHODS: Quasi-experimental study with a convenience sample of 567 pupils in 3rd and 5th year of Primary Education, and first year of Compulsory Secondary Education, from 3 public schools in Galicia. They received 2h (one theoretical and another practical) of basic life support training by their Physical Education teachers, as part of the school program. The children were evaluated by a theoretical test and a practical skill test that measured the quality of chest compressions, and assessed the performance of the basic life support sequence. RESULTS: The level of knowledge increased with respect to the baseline, and was higher in the higher grades (P < .001). The complete basic life support sequence was carried out by 16.5% of pupils in the 3rd year of Primary Education, 54.4% of pupils in the 5th year of Primary Education, and 28.5% of pupils in the 1st year of Secondary Education (P = .030). The following compression quality parameters improved significantly with age: continuity of compressions (P < .001), percentage of compressions performed at correct depth (P = .002), and median depth (P < .001), while the percentage of compressions with correct decompression decreased significantly (P < .001). CONCLUSIONS: Although their anthropometric characteristics may not allow them to achieve the ideal quality of this manoeuvre, a 2h theoretical and practical training programme, taught by Physical Education teachers, helps to improve the ability of children younger than 13 years old to recognise the emergency, start the chain of survival, and initiate chest compressions.

[Childhood obesity in Spain and associated factors]. / Obesidad en la población infantil en España y factores asociados.

INTRODUCTION: Childhood obesity is an important public health problem, also in Spain. The ALADINO study, in the context of the COSI strategy of the WHO European office, monitors the weight status of Spanish schoolchildren aged 6 to 9 years, and analyzes the associated factors. Data from the 2019 wave indicate that 23.3 % of schoolchildren are overweight, and 17.3 % are obese. A high percentage of schoolchildren eat breakfast regularly, although breakfast quality can be improved. The frequency of consumption of fruits and vegetables is low, even lower than that of other countries participating in the COSI strategy. In terms of lifestyle, more than 70 % of schoolchildren are active, although this percentage is lower than the European average. Screen exposure time is also shorter than in other countries, but this habit may be improved in a high percentage of schoolchildren. There is a lower percentage of schoolchildren with obesity who have breakfast or are active compared to those of normal weight, while they are more sedentary, spend fewer hours sleeping, and are more likely to have a TV or electronic devices in their room. It is a priority to promote access to healthier diets and the promotion of more active and less sedentary lifestyles, both in the family and at school, from an early age.

INTRODUCCIÓN: La obesidad infantil es un problema de salud pública importante, también en España. El estudio ALADINO, en el contexto de la estrategia COSI de la Oficina Europea de la OMS, monitoriza la situación ponderal de los escolares españoles de 6 a 9 años y analiza los factores asociados al padecimiento de sobrepeso y obesidad. Los datos de la oleada de 2019 indican que un 23,3 % de los escolares tienen sobrepeso y un 17,3 % tienen obesidad. Un porcentaje elevado de escolares desayuna habitualmente, aunque la calidad de esta comida es muy mejorable. Se constata que la frecuencia de consumo de frutas y verduras es baja e inferior a la de otros países participantes en la estrategia COSI. En cuanto al estilo de vida, más del 70 % de los escolares son activos, aunque este porcentaje es inferior a la media europea. También es menor el tiempo de exposición a pantallas que en otros países, aunque mejorable en un porcentaje elevado de escolares. Hay un menor porcentaje de escolares con obesidad que desayunan o son activos en comparación con los que tiene peso normal, mientras que son más sedentarios, dedican menos horas a dormir, y disponen con mayor probabilidad de TV o dispositivos electrónicos en su habitación. Es prioritario favorecer el acceso a dietas más saludables y la promoción de estilos de vida más activos y menos sedentarios, tanto en el entorno familiar como en el escolar, desde edades tempranas.

The social and psychological health of children is associated with Mediterranean diet adherence items, cardiorespiratory fitness, and lifestyle.

INTRODUCTION: Background: Mediterranean diet (MD) adherence, physical activity (PA) patterns, and physical fitness are associated with physical, social, and psychological health in children. Objective: the purpose of this study was to determine the association of items of MD adherence, fitness components, and lifestyle with psychological and social health in Chilean schoolchildren. Material and methods: this cross-sectional study included 615 schoolchildren, both girls (n = 271, 11.7 ± 1.00 years old) and boys (n = 344, 11.8 ± 1.1 years old). Anthropometric parameters, fitness components, lifestyle, health-related quality of life (HRQoL), and self-esteem were measured. Results: HRQoL showed an association with cardiorespiratory fitness (ß: 0.12, p < 0.001) and PA (ß: 0.32, p = 0.023). Self-esteem was inversely associated with screen time (ß: -1.35, p < 0.001). Moreover, social health presented a positive association with PA after school (ß: 0.06, p = 0.037). In relation to MD adherence items, HRQoL was linked to the items "Takes a fruit or fruit juice every day" (ß: 1.93, p = 0.004) and "Consumes fresh or cooked vegetables ˃ 1 time/day" (ß: 1.12, p = 0.018). Self-esteem was associated to "Consumes a dairy product ˃ 1 time/day" (ß: 3.30, p = 0.030). Social health was inversely related to "Eats at a fast food restaurant ≥ 1 time/week" (ß: -0.26, p = 0.003) and positively to "Consumes pasta or rice almost every day" (ß: 0.35, p = 0.049). Conclusion: MD adherence items, fitness, and lifestyle were linked to psychological and social health, therefore it is necessary to develop preventive strategies for schoolchildren to change in a positive way these modifiable lifestyle behaviors.

INTRODUCCIÓN: Antecedentes: la adherencia a la dieta mediterránea (DM), los patrones de actividad física (AF) y la condición física están asociados a la salud física, social y psicológica de los niños. Objetivo: el propósito de este estudio fue determinar la asociación entre ítems de adherencia a la DM, componentes de la condición física y el estilo de vida con la salud psicológica y social de los escolares chilenos. Material y métodos: este estudio transversal incluyó a 615 escolares, niñas (n = 271, 11,7 ± 1,00 años) y niños (n = 344, 11,8 ± 1,1 años). Se midieron parámetros antropométricos, componentes de la condición física, estilo de vida, calidad de vida relacionada con la salud (CVRS) y autoestima. Resultados: la CVRS mostró asociación con la capacidad cardiorrespiratoria (ß: 0,12, p < 0,001) y la PA (ß: 0,32, p = 0,023). La autoestima, por su parte, se relacionó de manera inversa con el tiempo frente a la pantalla (ß: -1,35, p < 0,001). Además, la salud social presentó una asociación positiva con la AF después de la escuela (ß: 0,06, p = 0,037). En relación a los ítems de adherencia a la DM, la CVRS se vinculó a los ítems "Toma una fruta o jugo de fruta todos los días" (ß: 1,93, p = 0,004) y "Consume verduras frescas o cocidas ˃ 1 vez/día" (ß: 1,12, p = 0,018). La autoestima se asoció a "Consume un producto lácteo ˃ 1 vez/día" (ß: 3,30, p = 0,030). La salud social se vinculó inversamente con "Come en un restaurante de comida rápida ≥ 1 vez/semana" (ß: -0,26, p = 0,003) y positivamente con "Consume pasta o arroz casi todos los días" (ß: 0,35, p = 0,049). Conclusión: los ítems de adherencia a la DM, la condición física y el estilo de vida se relacionaron con la salud psicológica y social de los escolares, por lo que es necesario desarrollar estrategias preventivas para modificar de manera positiva estas conductas de estilo de vida modificables.