Socioeconomic and gender inequalities in childhood obesity in Spain.

INTRODUCTION: Childhood obesity is inversely associated with household socioeconomic status in high-income countries. Our aim was to explore the association between childhood weight status and household socioeconomic status in Spain in relation to family characteristics, perceptions and lifestyle habits and the school environment. METHODS: We performed a descriptive analysis of child weight status according to family socioeconomic factors and mediating variables based on data from the ALADINO 2019 study in a sample of 16,665 schoolchildren representative of the population aged 6-9 years in Spain. RESULTS: The prevalence of childhood obesity in households with low socioeconomic status (26.8% boys; 20.4% girls) was, in both sexes, twice as high as in those with higher socioeconomic status (12.1% boys; 8.7% girls). Unhealthy eating habits, sedentary lifestyles (mainly in girls) and the presence of screens in the bedroom (more prevalent in boys) were more frequent in school-aged children from low-income households. On the other hand, in the most disadvantaged households, a history of breastfeeding and physical activity (especially in girls) were less frequent. Similarly, schools attended by children from low-income households were less likely to have their own kitchens and indoor gymnasiums or offer sports activities. CONCLUSION: A lower household socioeconomic status was associated with poorer dietary and physical activity habits and certain characteristics of the family and school environments that mediate the inverse association between household socioeconomic status and the prevalence of childhood obesity. Girls were less physically active and reported more sedentary lifestyles, while boys had greater access to screens. Interventions to combat childhood obesity should address the identified inequalities.

Weight status in the 6 to 9 year-old school population in Spain: Results of the ALADINO 2015 study.

INTRODUCTION: Overweight and obesity in childhood and adolescence has grown alarmingly in the last twenty years or so in many countries of Europe, including Spain. This study presents the prevalences of overweight and obesity in 6-9 year-old schoolchildren in 2015, and their associated characteristics. METHODOLOGY: ALADINO (Its initials in Spanish for Diet, physical activity, child development and obesity) is a cross-sectional study of a representative sample of 6-9 year-old schoolchildren in Spain, in line with the Childhood Obesity Surveillance Initiative (COSI) of the World Health Organisation (WHO). The height and weight of the participants, defining the weight status according to WHO standards, and a questionnaire was given to the parents on lifestyle and sociodemographic characteristics. RESULTS: Anthropometric measurements were taken on 10,899 schoolchildren for 168 primary education centres. Excess weight was observed in 41.3% (95% CI: 40.0-42.6), overweight in 23.2% (95% CI: 22.1-24.3) and obesity in 18.1% (95% CI: 17.2-19.1), with obesity being more prevalent in boys, overweight in girls. The prevalence of abdominal obesity was 23.2% (95% CI: 21.8-24.6). The prevalence of overweight and obesity increased with age. Excess weight decreased by 3.2% compared to 2011, mainly due to the decrease in overweight in boys, while that of obesity remained stable. Excess weight was more prevalent in schoolchildren from families with a lower socioeconomic level. CONCLUSIONS: The prevalence of excess weight in 6-9 year-old schoolchildren in Spain has decreased by 3.2% since 2011, due to the decrease in overweight, whilst obesity remained stable. Action must be taken in the obesogenic environment, by promoting healthy eating habits and physical activity, bearing in mind the inequalities in health.

[Role of breakfast and its quality in the health of children and adolescents in Spain]. / Papel del desayuno y su calidad en la salud de los niños y adolescentes en España.

INTRODUCTION: Eating breakfast is a healthy habit that should be encouraged since childhood. When it provides nutritional quality, it is an important daily meal. The consumption of dairy products, cereals, and fruits at breakfast is associated with healthier dietary patterns, with a beneficial impact on the overall quality of the diet. In Spain, as in many other countries, the proportion of children who eat breakfast daily is very high, decreasing somewhat in adolescence. However, the quality of breakfast leaves room for improvement, with a low proportion of children/adolescents with high nutritional quality breakfasts. Children/adolescents who eat breakfast regularly have a higher intake of various nutrients (especially vitamins and minerals) than those who do not eat breakfast. Although the evidence is not entirely conclusive, numerous studies have shown various benefits when comparing the population that eats breakfast regularly versus those who do not, such as cardiometabolic risk parameters (obesity, diabetes, blood pressure and lipid profile) and cognitive functions. Breakfast should be included in healthy eating plans, since it allows incorporating foods that are difficult to consume in other meals and may contribute to reducing the risk of developing cardiometabolic diseases. In order to promote the intake of a healthy breakfast, it is essential to act on the sociodemographic and cultural factors that influence compliance and quality, such as age, nutritional education (mainly parents and children/adolescents, but also other family members, school mates, friends...), carrying it out as a family, adapting it to the tastes of each population and balancing quality and costs.

INTRODUCCIÓN: Desayunar es un hábito saludable que debe fomentarse desde la infancia. Cuando aporta calidad nutricional, supone una comida diaria importante. El consumo de lácteos, cereales y frutas en el desayuno se asocia a patrones dietéticos más saludables, con un impacto beneficioso en la calidad global de la dieta. En España, como en muchos otros países, la proporción de niños que desayunan a diario es muy alta, descendiendo algo en la adolescencia. Sin embargo, la calidad del desayuno tiene margen de mejora, con una baja proporción de niños/adolescentes con desayunos de alta calidad nutricional. Los niños/adolescentes que desayunan habitualmente presentan una mayor ingesta de varios nutrientes (especialmente vitaminas y minerales) que los que no desayunan. Aunque las evidencias no son totalmente concluyentes, numerosos estudios han mostrado varios beneficios cuando se compara la población que desayuna habitualmente frente a la que no lo hace, tanto en los parámetros de riesgo cardiometabólico (obesidad, diabetes, tensión arterial y perfil lipídico) como en las funciones cognitivas. El desayuno debe incluirse en los planes de alimentación saludable pues permite incorporar alimentos que son difíciles de consumir en otras comidas y puede contribuir a reducir el riesgo de desarrollar enfermedades cardiometabólicas. Para promover la ingesta de desayunos saludables es imprescindible actuar sobre los factores sociodemográficos y culturales que influyen en su cumplimiento y en su calidad, como son la edad, la educación nutricional (principalmente padres y niños/adolescentes, pero también otros familiares, la escuela, las amistades...), realizarlo en familia, adaptarlo a los gustos de cada población y equilibrar calidad y costes.

[Nutrition in the prevention and control of osteoporosis]. / Nutrición en la prevención y el control de la osteoporosis.

INTRODUCTION: Objective: although osteoporosis develops in advanced stages of life, it must be prevented and stopped from the pediatric age, acting on modifiable factors, especially diet and lifestyle. The objective of this work is to review the latest evidence on nutritional improvements that can help in the prevention and control of the disease. Methods: bibliographic search related to the topic. Results: it is advisable to avoid energy restrictions, especially in postmenopausal women and particularly if they have osteopenia/osteoporosis since, in relation to these pathologies, excess weight may be preferable, rather than underweight. Protein intake higher than the recommended one is beneficial for the bone, provided that the calcium intake is adequate. Excessive intake of sugar and saturated fat should be avoided, but attempts should be made to achieve the nutritional goals set for ω-3 polyunsaturated fatty acids and fiber. It is important to monitor vitamin D status and calcium intake, which is inadequate in high percentages of individuals, as well as improving the contribution of vitamins K, C and group B, and also magnesium, potassium, iron, zinc, copper, fluorine, manganese, silicon and boron, and avoiding the excessive contribution of phosphorus and sodium. Conclusions: osteoporosis is an underdiagnosed pathology and of increasing prevalence. Due to its high morbidity and mortality, prevention is important and, from a nutritional point of view, it is convenient to bring the diet closer to the theoretical ideal. In general, increasing the consumption of dairy products, fish, vegetables and fruits, as well as reducing the consumption of salt, during childhood and throughout life, seems convenient for the bone improvement of most of the population.

INTRODUCCIÓN: Introducción y objetivos: la osteoporosis, aunque se manifiesta en etapas avanzadas de la vida, se debe prevenir y frenar desde la edad pediátrica, actuando sobre los factores modificables, especialmente la alimentación y el estilo de vida. El objetivo del presente trabajo es revisar las últimas evidencias sobre las mejoras nutricionales que pueden ayudar en la prevención y el control de la enfermedad. Métodos: búsqueda bibliográfica en relación con el tema. Resultados: conviene evitar las restricciones energéticas, especialmente en mujeres posmenopáusicas, sobre todo si tienen osteopenia/osteoporosis dado que, en relación con estas patologías, puede ser preferible un exceso de peso frente a un peso insuficiente. Una ingesta proteica superior a la recomendada es beneficiosa para el hueso siempre que la ingesta de calcio sea adecuada. Se debe evitar una ingesta excesiva de azúcar y de grasa saturada, pero se deben intentar alcanzar los objetivos nutricionales marcados para los ácidos grasos poliinsaturados ω-3 y la fibra. Es importante vigilar la situación en vitamina D y la ingesta de calcio, que es inadecuada en elevados porcentajes de individuos. También conviene mejorar el aporte de vitaminas K, C y del grupo B, así como de magnesio, potasio, hierro, zinc, cobre, flúor, manganeso, silicio y boro, y evitar el aporte excesivo de fósforo y sodio. Conclusiones: la osteoporosis es una patología infradiagnosticada y de prevalencia creciente. Por su elevada morbilidad y mortalidad es importante la prevención y desde el punto de vista nutricional conviene aproximar la dieta al ideal teórico. En general, el incremento en el consumo de lácteos, pescado, verduras, hortalizas y frutas, así como la reducción del consumo de sal, durante la infancia y a lo largo de la vida parecen convenientes para la mejora ósea de la mayor parte de la población.

[Dairy matrix: nutritional and sanitary benefits of the interrelation between its nutrients]. / Matriz láctea: beneficios nutricionales y sanitarios de la interrelación entre sus nutrientes.

INTRODUCTION: The effect of nutrients on health has been studied traditionally. From this point of view, milk and dairy products contribute to maintaining and improving nutritional status. Due to its high content of some nutrients such as saturated fat, among others, dairy consumption has been linked to the appearance of several diseases such as obesity or cardiovascular disease. However, food cannot be classified as good or bad based on its nutrient content. On the contrary, those interactions between nutrients and other bioactive compounds that occur in the food matrix must also be taken into account, as they can lead to different results than those expected derived from their consumption. In the case of dairy products, the scientific evidence indicates that dairy matrix could play an important role in the prevention of several non-communicable diseases.

INTRODUCCIÓN: Tradicionalmente se ha estudiado el efecto de los nutrientes en la salud. Desde este punto de vista, la leche y los derivados lácteos son alimentos que contribuyen a mantener y mejorar el estado nutricional. Por su elevado contenido en algunos nutrientes como la grasa saturada, entre otros, el consumo de lácteos se ha relacionado con la aparición de diversas enfermedades como la obesidad o la enfermedad cardiovascular. Sin embargo, los alimentos no se pueden clasificar como buenos o malos por su contenido en nutrientes, sino que también hay que tener en cuenta que en la matriz alimentaria se producen interacciones entre los nutrientes y otros compuestos bioactivos que pueden hacer que el consumo de dichos alimentos tenga resultados distintos a los esperados. En el caso de los lácteos, la evidencia científica señala que la matriz láctea podría jugar un papel importante frente a la prevención de diversas enfermedades crónicas no transmisibles.

[Importance of choline in cognitive function]. / Importancia de la colina en la función cognitiva.

INTRODUCTION: Choline is a critical nutrient for cognitive development, metabolism and liver function, and regulation of homocysteine metabolism. It is necessary for the synthesis of the neurotransmitter acetylcholine, the synthesis of betaine and that of phosphatidylcholine. In the perinatal stage, the contribution of choline is essential to guarantee optimal cognitive development and prevent neural tube defects. In adults and the elderly, choline intake has been associated with better performance in some cognitive functions and a lower incidence of dementia. Despite their important role in health, most groups of the population do not reach their adequate intake of choline, and even some groups, such as pregnant women or childbearing women, have a higher risk of having suboptimal intakes. The main dietary sources of choline are eggs, dairy and meats, so reducing or limiting the consumption of these foods negatively impacts on the intake of this nutrient. Given the need to improve the intake of this vitamin, it is necessary to increase the knowledge that the population has about this nutrient, raising awareness about the importance of choline for health, and its main food sources.

INTRODUCCIÓN: La colina es un nutriente crítico para el desarrollo cognitivo, el metabolismo y la función hepática y la regulación del metabolismo de la homocisteína. Es necesaria para la síntesis del neurotransmisor acetilcolina, la síntesis de betaína y la de fosfatidilcolina. En la etapa perinatal el aporte de colina es fundamental para garantizar el desarrollo cognitivo y prevenir defectos del tubo neural. En adultos mayores y ancianos la ingesta de colina se ha asociado a mejor rendimiento en algunas funciones cognitivas y menor incidencia de demencia. A pesar de su importante papel en la salud, la mayoría de los colectivos no alcanza sus ingestas adecuadas (IA) de colina, aunque algunos colectivos, como gestantes o mujeres en edad fértil, tienen un mayor riesgo de tener ingestas subóptimas. Las principales fuentes dietéticas de esta vitamina son los huevos, lácteos y carnes, y disminuir o limitar el consumo de estos alimentos impacta negativamente en la ingesta de este nutriente. Dada la necesidad de mejorar la ingesta de esta vitamina, es necesario mejorar el conocimiento que tiene la población sobre este nutriente, concienciándola sobre la importancia de la colina para la salud y sus principales fuentes alimentarias.

Age and APOE genotype affect the relationship between objectively measured physical activity and power in the alpha band, a marker of brain disease.

BACKGROUND: Electrophysiological studies show that reductions in power within the alpha band are associated with the Alzheimer's disease (AD) continuum. Physical activity (PA) is a protective factor that has proved to reduce AD risk and pathological brain burden. Previous research has confirmed that exercise increases power in the alpha range. However, little is known regarding whether other non-modifiable risk factors for AD, such as increased age or APOE ε4 carriage, alter the association between PA and power in the alpha band. METHODS: The relationship between PA and alpha band power was examined in a sample of 113 healthy adults using magnetoencephalography. Additionally, we explored whether ε4 carriage and age modulate this association. The correlations between alpha power and gray matter volumes and cognition were also investigated. RESULTS: We detected a parieto-occipital cluster in which PA positively correlated with alpha power. The association between PA and alpha power remained following stratification of the cohort by genotype. Younger and older adults were investigated separately, and only younger adults exhibited a positive relationship between PA and alpha power. Interestingly, when four groups were created based on age (younger-older adult) and APOE (E3/E3-E3/E4), only younger E3/E3 (least predicted risk) and older E3/E4 (greatest predicted risk) had associations between greater alpha power and higher PA. Among older E3/E4, greater alpha power in these regions was associated with improved memory and preserved brain structure. CONCLUSION: PA could protect against the slowing of brain activity that characterizes the AD continuum, where it is of benefit for all individuals, especially E3/E4 older adults.

[Vitamin D deficiency in Spanish population. Importance of egg on nutritional improvement]. / Deficiencia en vitamina D de la población española. Importancia del huevo en la mejora nutricional.

INTRODUCTION: Vitamin D is an essential nutrient whose deficiency has been associated with the risk of various chronic diseases such as osteoporosis, hypertension, cardiovascular disease, diabetes, some types of cancer and even overweight and obesity. Although vitamin D can be synthesized at the skin from exposure to sunlight, this source is not always sufficient to meet the needs. For example, the use of sunscreen or the low exposition to the sunlight limits the syntheses. In fact, studies have found that at least half of the Spanish population has vitamin D deficits. Therefore, the dietary contribution is fundamental. Although there are different foods fortified in this vitamin, few products are natural source of it, as fatty fish and eggs. However, according to different studies carried out in the Spanish population, there is a low consumption of this food group. In this way, it would be advisable to promote egg consumption among the population, since this food, in addition to having many nutrients, contains a high amount of vitamin D, which contributes to avoid the appearance of deficiencies and the consequences health consequences that this implies.

INTRODUCCIÓN: La vitamina D es un nutriente esencial cuya deficiencia se ha asociado con el riesgo de aparición de diversas enfermedades crónicas, como la osteoporosis, la hipertensión arterial, la enfermedad cardiovascular, la diabetes, algunos tipos de cáncer e incluso el padecimiento de sobrepeso y obesidad. A pesar de que la vitamina D puede sintetizarse a nivel cutáneo a partir de la exposición a la luz solar, esta fuente no es siempre suficiente para cubrir las necesidades debido al uso de cremas de protección solar y a la baja exposición que se produce durante el invierno, o, como en el caso de las personas enfermas, que salen poco a la calle o se exponen poco a la luz del sol. De hecho, estudios han constatado que al menos la mitad de la población española presenta déficit de vitamina D. Por ello, el aporte dietético es fundamental. Aunque existen diferentes alimentos fortificados con esta vitamina, son pocos los productos que son una fuente natural, entre los que se encuentran los pescados grasos y los huevos. Sin embargo, de acuerdo con diferentes estudios realizados en la población española, existe un bajo consumo de este último grupo de alimentos. De esta manera, sería recomendable fomentar el consumo de huevo entre la población, ya que este alimento, además de tener numerosos nutrientes, contiene una cantidad elevada de vitamina D, lo que contribuye a evitar la aparición de deficiencias y las consecuencias negativas para la salud que ello implica.

[Role of yogurt in children's breakfast]. / Papel del yogur en el desayuno de los niños.

INTRODUCTION: Some studies link children and adolescents breakfast habits with a better quality of the diet and higher intake of nutrients in general, and lower adiposity and cardiometabolic risk, which highlights the important role of this meal. A quality breakfast should include at least three food groups: cereals, dairy and fruits. However, the most frequent breakfast of Spanish schoolchildren combines only dairy and cereals. Therefore, it would be desirable to incorporate fruit in this first meal of the day, which would also help to improve the overall low consumption of fruit by Spanish children. On the other hand, yogurt is a food of high nutritional density and its habitual consumption in children is associated with a greater intake of most nutrients, with the follow-up of more balanced diets and with a lower prevalence of overweight and obesity. Incorporating yogurt into breakfast can help to improve the intake of some of the nutrients that are insufficiently in the diet, and can be a vehicle to incorporate other foods such as fruits. The combination of these two foods in the same meal has a synergistic effect, both by complementing the nutrients of each of these foods, and by the synbiotic effect that is achieved by adding the probiotic effect of yogurt and the prebiotic fiber of the fruits.

INTRODUCCIÓN: Numerosos estudios relacionan el hábito de desayunar en niños y adolescentes con una mejor calidad de la dieta y mayor ingesta de nutrientes en general, menor adiposidad y riesgo cardiometabólico, lo que pone de relieve el importante papel de esa comida. Uno de los criterios empleados para definir un desayuno de calidad es la inclusión de, al menos, cereales, lácteos y frutas. Sin embargo, el desayuno más frecuente de los escolares españoles combina solo un lácteo y un cereal. Por lo tanto, sería deseable incorporar fruta en esta primera comida del día, lo que ayudaría, además, a mejorar el bajo consumo en general de fruta de los niños españoles. Por otro lado, el yogur es un alimento de elevada densidad nutricional y su consumo habitual en niños se asocia con una mayor ingesta de la mayoría de nutrientes, con el seguimiento de dietas más equilibradas y con menor prevalencia de sobrepeso y obesidad. Incorporar yogur al desayuno puede ayudar a mejorar la ingesta de algunos de los nutrientes que se toman de forma insuficiente en la dieta y puede servir de vehículo para incorporar otros alimentos, como las frutas. La combinación de estos dos alimentos en una misma comida tiene un efecto sinérgico, tanto al complementarse los nutrientes de cada uno de estos alimentos, como por el efecto sinbiótico que se alcanza al sumar el efecto probiótico del yogur y el prebiótico de la fibra de las frutas.

[Nutritional value of dairy products and recommended daily consumption]. / Valor nutricional de los lácteos y consumo diario aconsejado.

INTRODUCTION: Objective: messages that are given recently have encouraged to reduce the consumption of dairy products, by noting them as dispensable or even harmful in relation to certain pathologies. The objective of this present work is to review the nutritional value of this group of foods and their recommended consumption. Methods: bibliographic search related to the topic. Results: dairy products provide proteins of high biological value, vitamins and minerals, especially calcium and vitamins B2 and B12, as well as essential fatty acids, and some antioxidants, among other nutrients. Although its fat is mostly saturated (65%), it does not seem to adversely affect cardiovascular risk and may even have a slight protective effect. More than 75% of individuals have calcium intakes lower than recommended, and since more than 50% of the calcium in the diet comes from dairy products, increasing their consumption may be recommended. Moderate milk intake during pregnancy is positively associated with birth weight and length of the offspring and bone mineral content during childhood. In adults, dairy consumption it is associated with a lower risk of metabolic syndrome, coronary heart disease and myocardial infarction, colorectal and gallbladder cancer, and type 2 diabetes. Moreover in older people it is associated with a lower risk of sarcopenia and vertebral fractures. Conclusions: the population ignores what is the nutritional value of dairy products and their advisable consumption (2-4 servings / day). The latest studies support the need to have an adequate consumption in all stages of life due to its relationship with the prevention and control of chronic diseases. Dairy consumption is less than 2 servings / day in 37.1% of children and 42.3% of adults, so it would be desirable to improve this situation.

INTRODUCCIÓN: Objetivos: mensajes recientes han animado a disminuir el consumo de lácteos al señalarlos como prescindibles o incluso perjudiciales en relación a ciertas patologías. El objetivo del presente trabajo consiste en revisar el valor nutricional de este grupo de alimentos y su consumo aconsejado. Métodos: búsqueda bibliográfica relacionada con el tema. Resultados: los lácteos aportan proteínas de alto valor biológico, vitaminas y minerales, especialmente calcio y vitaminas B2 y B12, así como ácidos grasos esenciales y algunos antioxidantes, entre otros nutrientes. Aunque su grasa es mayoritariamente saturada (65%), parece no afectar adversamente al riesgo cardiovascular y puede tener incluso un ligero efecto protector. Más de un 75% de los individuos tiene ingestas de calcio inferiores a las recomendadas, y dado que más del 50% del calcio de la dieta proviene de lácteos, aumentar su consumo puede ser recomendable. La ingesta moderada de leche durante el embarazo se asocia positivamente con el peso al nacer del descendiente y con su longitud y contenido mineral óseo durante la infancia. En adultos el consumo de lácteos se asocia con menor riesgo de síndrome metabólico, enfermedad coronaria e infarto de miocardio, cáncer colorrectal y de vesícula y diabetes tipo 2; en personas mayores, se asocia a un menor riesgo de fragilidad, sarcopenia y fracturas vertebrales. Conclusiones: la población desconoce cuál es el valor nutricional de los lácteos y su consumo aconsejable (2-4 raciones/día). Los últimos estudios avalan la necesidad de tener un consumo adecuado en todas las etapas de la vida por su relación con la prevención y el control de enfermedades crónicas. El consumo de lácteos es menor de 2 raciones/día en el 37,1% de los niños y en el 42,3% de los adultos, por lo que conviene mejorar esta situación.

[Myths and fallacies in relation to the consumption of dairy products]. / Mitos y falacias en relación al consumo de productos lácteos.

INTRODUCTION: In recent years the consumption of milk has declined, which could be due to the many myths and fallacies that exist about this food and other dairy products. Affirmations such as: "cow's milk is ideal for calves not humans", "humans are the only animals that drink milk beyond infancy", "milk lead to mucus production or occurrence of asthma" or "milk increases cholesterol levels", among others, are present in many conversations of the general population. However, due to the high nutritional value of dairy products, the elimination/restriction of these foods of our diet, without the existence of circumstances that support it, can have negative repercussions for health. Therefore, it is necessary to dismantle all these myths with scientific arguments.

INTRODUCCIÓN: En los últimos años el consumo de leche ha descendido, lo que podría deberse a los numerosos mitos y falacias que circulan por distintos medios en torno a este alimento y a otros productos lácteos. Afirmaciones como "la leche de vaca es para los terneros, no para los humanos", "somos el único mamífero que sigue tomando leche en la edad adulta", "la leche produce mocos y asma" o "la leche aumenta el colesterol", entre otras, están presentes en muchas conversaciones de la población general. Sin embargo, por su elevado valor nutricional, la eliminación/restricción de estos alimentos de nuestra dieta, sin la existencia de circunstancias que las avalen, puede tener repercusiones negativas para la salud. Por ello, es necesario desmontar todos estos mitos con argumentos científicos.

[Nutrition and gastronomy in the Community of Madrid]. / Nutrición y gastronomía en la Comunidad de Madrid.

INTRODUCTION: Objectives: the nutrition and gastronomy are part of the strategies of maintenance and promotion of the health of the population. The aim of the present revision is to deep on the knowledge of the gastronomy and nutritional problems of the Community of Madrid. Methods: bibliographic search in relation to the subject. Results: the gastronomy of Madrid stands out for its great variety and abundant offer of food and dishes, which favors the possibilities of choice. The consumption of food is lower than that recommended for fruits, vegetables, whole grains, fish, eggs and dairy products and higher than recommended for meats. The Community of Madrid is one of those Autonomous Communities in Spain that consume and spent less per capita on food. Food consumption in general is lower than the national average, especially for sugars and fats and oils. There is a high intake of proteins and fats, an insufficient intake of complex carbohydrates and fiber, together with an inadequate intake of several micronutrients. The change in eating habits and the sedentary lifestyle favor the increase of the prevalence of overweight and obesity. Nevertheless, the problem of weight excess is somewhat lower in Madrid compared to other regions, perhaps because of its lower energy intake. Conclusions: the Community of Madrid is characterized by a high availability of food and a great gastronomic offer. This forces us to improve the nutritional education of the population, in order to facilitate the most appropriate selections for the improvement of health and weight control.

INTRODUCCIÓN: Objetivos: la nutrición y la gastronomía forman parte de las estrategias de mantenimiento y promoción de la salud de una población. Profundizar en el conocimiento de la gastronomía y de la problemática nutricional de la Comunidad de Madrid constituye el objeto de la presente revisión. Métodos: búsqueda bibliográfica relacionada con el tema. Resultados: la gastronomía de Madrid destaca por la gran variedad y abundante oferta de alimentos y platos, lo que favorece las posibilidades de elección. Actualmente el consumo de alimentos es inferior al aconsejado para frutas, verduras, hortalizas, cereales integrales, pescados, huevos y lácteos, y supera lo aconsejado para carnes. Madrid es una de las comunidades autónomas con menor consumo y gasto per cápita en alimentación: se consumen menos alimentos, en general, y menos azúcares y grasas y aceites, en particular, respecto a la media nacional. La ingesta de proteínas y grasas es elevada, mientras que es insuficiente el aporte de hidratos de carbono complejos, fibra y diversos micronutrientes. El cambio en los hábitos alimentarios y el creciente sedentarismo favorece el incremento en el padecimiento de sobrepeso y obesidad, aunque el problema del exceso de peso es algo menor en Madrid respecto a otras comunidades, posiblemente por la menor ingesta energética. Conclusiones: la Comunidad de Madrid tiene una elevada disponibilidad de alimentos y una gran oferta gastronómica, lo que obliga a mejorar la educación y la formación del consumidor para que sus elecciones sean las más adecuadas para su salud y control de peso.

[Assessment of beverage consumption, dietary water intake and adequacy to the recommendations of a group of Spanish schoolchildren from 7 to 12 years old]. / Evaluación del consumo de bebidas, ingesta dietética de agua y adecuación a las recomendaciones de un colectivo de escolares españoles de 7 a 12 años.

INTRODUCTION: the dietary water and the intake of beverages play a relevant role in the dietary and hydration patterns of children and few studies provide an overview of them. Objetives: to assess the dietary intake of water, its adaptation to the recommendations and its distribution throughout the day, and the average consumption of beverages by a group of Spanish schoolchildren. MATERIAL AND METHODS: a sample of 262 schoolchildren (139 boys and 123 girls) between seven and 12 years old was studied. A three-day dietary record (one day in weekend) was kept to assess beverage consumption. Dietary water intake obtained was compared to EFSA's adequate intake (AI) and other recommendations, its distribution throughout the day was studied, and personal and anthropometric date were collected too. The data were processed using DIAL and SPSS. RESULTS: the beverages consumed in greatest quantity were water as a beverage, milk and commercial juices and nectars. The average dietary water intake was 1,401 ± 432 ml/day (42% from food and 58% from beverages). Only 20.2% of schoolchildren were above the AIs. Dietary water intake was significantly higher at all intakes in the day in those schoolchildren who were above AIs. CONCLUSIONS: based on our results, 79.8% of children do not cover the AIs. For this reason it is important improve their hydration patterns. In this aspect, water as a beverage plays a key role to cover the recommendations.

INTRODUCCIÓN: la ingesta dietética de agua y el consumo de bebidas juegan un papel relevante en los hábitos de hidratación y alimentación de la población infantil y escasos estudios nos ofrecen una visión global de los mismos. OBJETIVOS: evaluar la ingesta dietética de agua y el consumo de bebidas, su adecuación a las recomendaciones y su distribución a lo largo del día en un colectivo de escolares españoles. MATERIAL Y MÉTODOS: se estudió una muestra de 262 escolares (123 niñas) entre siete y 12 años. Se realizó un registro dietético de tres días (uno de ellos festivo) para evaluar el consumo de bebidas. Se comparó la ingesta dietética de agua obtenida con las ingestas adecuadas (IA) marcadas por la EFSA y por otros organismos y se estudió su distribución a lo largo del día. También se procedió a recoger datos personales y antropométricos. Los datos fueron procesados mediante DIAL y SPSS. RESULTADOS: las bebidas más consumidas fueron agua de bebida, leche y zumos comerciales y néctares. La ingesta dietética media de agua fue de 1.401 ± 432 ml/día (42% aportada por alimentos y 58% por bebidas). Solo el 20,2% de los escolares superaron las IA. La ingesta dietética de agua fue significativamente superior en todos los momentos del día en aquellos escolares que superaron las IA establecidas. CONCLUSIÓN: el 79,8% de los escolares no alcanza las IA, por lo que es importante mejorar sus pautas de hidratación, jugando el agua de bebida un papel clave a la hora de alcanzar las recomendaciones.

[Introduction]. / Introducción.

En el presente suplemento de la revista Nutrición Hospitalaria se resumen las conferencias presentadas en las Quintas Jornadas UCM-ASEN (Universidad Complutense de Madrid-Asociación de Estudios Nutricionales), bajo el título "Avances en nutrición. Su impacto sanitario y social", celebradas durante los días 21 y 22 de febrero de 2018 en la Facultad de Farmacia de la Universidad Complutense de Madrid.Estas jornadas han sido una actividad promovida por el grupo de Investigación VALORNUT-UCM y han contado con el apoyo institucional de la Fundación Española de la Nutrición (FEN).

Ibero⁻American Consensus on Low- and No-Calorie Sweeteners: Safety, Nutritional Aspects and Benefits in Food and Beverages.

International scientific experts in food, nutrition, dietetics, endocrinology, physical activity, paediatrics, nursing, toxicology and public health met in Lisbon on 2⁻4 July 2017 to develop a Consensus on the use of low- and no-calorie sweeteners (LNCS) as substitutes for sugars and other caloric sweeteners. LNCS are food additives that are broadly used as sugar substitutes to sweeten foods and beverages with the addition of fewer or no calories. They are also used in medicines, health-care products, such as toothpaste, and food supplements. The goal of this Consensus was to provide a useful, evidence-based, point of reference to assist in efforts to reduce free sugars consumption in line with current international public health recommendations. Participating experts in the Lisbon Consensus analysed and evaluated the evidence in relation to the role of LNCS in food safety, their regulation and the nutritional and dietary aspects of their use in foods and beverages. The conclusions of this Consensus were: (1) LNCS are some of the most extensively evaluated dietary constituents, and their safety has been reviewed and confirmed by regulatory bodies globally including the World Health Organisation, the US Food and Drug Administration and the European Food Safety Authority; (2) Consumer education, which is based on the most robust scientific evidence and regulatory processes, on the use of products containing LNCS should be strengthened in a comprehensive and objective way; (3) The use of LNCS in weight reduction programmes that involve replacing caloric sweeteners with LNCS in the context of structured diet plans may favour sustainable weight reduction. Furthermore, their use in diabetes management programmes may contribute to a better glycaemic control in patients, albeit with modest results. LNCS also provide dental health benefits when used in place of free sugars; (4) It is proposed that foods and beverages with LNCS could be included in dietary guidelines as alternative options to products sweetened with free sugars; (5) Continued education of health professionals is required, since they are a key source of information on issues related to food and health for both the general population and patients. With this in mind, the publication of position statements and consensus documents in the academic literature are extremely desirable.

[Assessment of diet in patients with chronic kidney diseases without dialysis and relationship with the nutritional status]. / Evaluación de la dieta en pacientes con enfermedad renal crónica sin diálisis y su relación con el estado nutricional.

BACKGROUND: Diet is one of the pillars of the treatment for patients with chronic kidney disease without dialysis (NDD-CKD). Despite this, very few studies have evaluated the diet in Spanish population. OBJECTIVE: To evaluate the diet of a group of patients with advanced CKD, comparing it with the recommendations, and its relation with nutritional status. MATERIAL AND METHODS: A cross-sectional study of 74 patients (39 men), with a mean age of 70.9 ± 13.6 years and creatinine clearance of 15.3 ± 2.1 mL/min. Biochemical, anthropometric and intake variables (3-day dietary record) were collected, comparing them with the recommendations for patients with CKD and, if they did not exist, with nutritional recommendations and objectives for the Spanish population. The nutritional status was assessed by modified criteria of protein-energy wasting (PEW). RESULTS: The mean energy intake was 23.2 ± 6.5 kcal/kg body weight/day, and the protein intake was 0.93 ± 0.2 g/kg body weight/day. Men had a higher intake of alcohol and vitamin D whereas women presented a higher intake of trans fatty acids and vitamin B1. In addition, 91.4% of patients had high intake of phosphorus and 73% of potassium. Only 2.7% showed an adequate intake of vitamin D and 21.6% of folates; 18.9% of patients presented PEW. A positive correlation was found between albumin, body mass index (BMI) and creatinine clearance. CONCLUSION: Most patients with non-dialysis CKD do not meet dietary recommendations or nutritional goals, regardless of gender and PEW status, considering renal function as a limiting factor.

Improvement in Nutritional Status in Patients With Chronic Kidney Disease-4 by a Nutrition Education Program With No Impact on Renal Function and Determined by Male Sex.

OBJECTIVE: Protein-energy wasting (PEW) is associated with increased morbidity and mortality and a rapid deterioration of kidney function in patients with chronic kidney disease (CKD). However, there is little information regarding the effect of nutrition intervention. The aims of this study were to evaluate the efficacy and safety of a nutrition education program (NEP) in patients with nondialysis dependent CKD (NDD-CKD), based on the diagnostic criteria for PEW proposed by the International Society of Renal Nutrition and Metabolism. The design of the study was a 6-month longitudinal, prospective, and interventional study. The study was conducted from March 2008 to September 2011 in the Nephrology Department of La Paz University Hospital in Madrid, Spain. SUBJECTS: A total of 160 patients with NDD-CKD started the NEP, and 128 finished it. INTERVENTION: The 6-month NEP consisted of designing an individualized diet plan based on the patient's initial nutritional status, and 4 nutrition education sessions. MAIN OUTCOME MEASURES: Changes in nutritional status (PEW) and biochemical, anthropometric and body composition parameters. RESULTS: After 6 months of intervention, potassium and inflammation levels decreased, and an improved lipid profile was found. Body mass index lowered, with increased muscle mass and a stable fat mass. Men showed increased levels of albumin and prealbumin, and women showed decreased proteinuria levels. The prevalence of PEW decreased globally (27.3%-10.9%; P = .000), but differently in men (29.5%-6.5%; P = .000) and in women (25.4%-14.9%; P = .070), 3 of the women having worsened. Kidney function was preserved, despite increased protein intake. CONCLUSION: The NEP in NDD-CKD generally improved nutritional status as measured by PEW parameters, but individual poorer results indicated the need to pay special attention to female sex and low body mass index at the start of the program.

The relationship between hours of sleep, screen time and frequency of food and drink consumption in Spain in the 2011 and 2013 ALADINO: a cross-sectional study.

BACKGROUND: The frequency of intake of food and beverages depends on a number of ill-defined behaviour patterns. The objectives of this study were to evaluate the effects of screen time and sleep duration on food consumption frequency, and to describe frequencies and types of food consumption according to BMI category and parents' level of education. METHODS: We studied 6287 and 2806 children drawn from the 2011 and 2013 cross-sectional ALADINO studies respectively. Data were collected on number of hours of sleep, screen time, and weekly frequency of consumption of 17 food groups. Weight status was measured, and information was also collected on parents' educational level. Average food consumption frequencies were calculated by reference to hours of sleep and hours of screen time, and were defined as ≥4 times or <4 times per week (once per week for soft drinks and diet soft drinks). Differences in frequency were evaluated for screen times of more and less than 2 h per day, and for sleep durations longer or shorter than the daily average. We fitted logistic regression models to evaluate the independent association between screen exposure and hours of sleep on the one hand, and food consumption frequency on the other. RESULTS: Consumption of fruit and vegetables was lower among children who had parents with no formal or only primary school education. High levels of screen time were associated with a greater frequency of consumption of energy-dense, micronutrient-poor products and a lower frequency of consumption of fruit and vegetables. Sleeping a sufficient number of hours was associated with a higher consumption of fruit and vegetables. The results for 2011 were concordant with those for 2013. CONCLUSIONS: If efforts to ensure healthier eating habits among children are to be at all successful, they should focus on promoting a sufficient amount of sleep for children, limiting the time they spend watching television and/or playing with computers or video games, and educating parents accordingly.