Patterns of Change in Dietary Habits and Physical Activity during Lockdown in Spain Due to the COVID-19 Pandemic.

BACKGROUND: Lockdown due to COVID-19 influenced food habits and lifestyles with potential negative health impact. This study aims to identify patterns of change in eating habits and physical activity during COVID-19 lockdown in Spain and to identify associations with sociodemographic factors and usual habits. METHODS: This cross-sectional study included 1155 adults recruited online to answer a 10-section questionnaire. The protocol assessed usual diet by means of a semi-quantitative food frequency questionnaire, usual physical activity (PA) and supplement use, dietary changes, sedentary time, PA, exposure to sunlight, sleep quality, and smoking during confinement. Patterns of dietary change were identified by factor analysis. Factor scores were included in cluster analysis together with change in PA. RESULTS: Six patterns of dietary change were identified that together with PA changes during lockdown defined three clusters of lifestyle change: a cluster less active, a more active cluster, and a third cluster as active as usual. People who were usually less active were more likely to be classified in the cluster that increased physical activity in confinement. Scores of the Healthy Mediterranean-Style dietary pattern were higher in this group. Conclusions: Different patterns of change in lifestyles in confinement suggest the need to tailor support and advice to different population groups.

Association between a comprehensive smoking ban and hospitalization for acute myocardial infarction: An observational study in the Autonomous Community of Valencia, Spain.

OBJECTIVE: To assess the association between a comprehensive smoking ban and hospitalization rates for acute myocardial infarction (AMI). METHODS: An observational study was conducted to assess changes in hospital admission rates for AMI in the Autonomous Community of Valencia, Spain (population 5 million), during the period 1995-2013. Law 28/2005 prohibited smoking in all enclosed spaces (public and private), and Law 42/2010 extended the ban to bars and restaurants as well as children's playgrounds and access areas of schools and hospitals. Data on hospital admissions were obtained from the Hospital Discharge Database (CMBD) of the Autonomous Community. Annual hospital admission rates per 100000 population for AMI (ICD-9-CM code 410) for men and women were calculated. RESULTS: Adjusted hospital admission rates per 100000 population for AMI decreased markedly from 141.1 in 2005 to 119.2 in 2007, with a further reduction to 102.9 in 2013. Reductions in hospital admission were recorded in both men and women, but the downward trends were stronger in women. CONCLUSION: The Spanish comprehensive smoking ban was associated with a marked reduction in the adjusted rate of hospital admissions due to AMI in the Autonomous Community of Valencia. This decrease in the number of persons requiring in-patient care due to AMI is important from both a health care and a societal perspective.

[Nutrition and gastronomy in the region of Valencia]. / Nutrición y gastronomía en la Comunitat Valenciana.

INTRODUCTION: Objectives: to analyze the historical development of the Valencian dietary model, establish the relationship between gastronomy and nutrition and explore the role that reclaiming and adapting culinary and gastronomic traditions could play in the promotion of healthy eating. Methods: literature search and content analysis of studies on the subjects under study. Results: traditional Valencian cuisine is characterized by its variety and diversity at local and regional level; however, the extensive use of vegetables in its dishes and recipes renders it unique and was a crucial aspect of the Valencian population's successful food and nutrition transition in the 1960s. Westernization of the Valencian diet and loss of the heritage of the Mediterranean diet in the late 20th century led to a deterioration in the population's nutritional status and the emergence of problems such as overweight and obesity. Faced with this scenario, the modern cuisine spearheaded by the food sector in the Region of Valencia offers an opportunity to reverse this situation, reclaim the region's gastronomic heritage through dialogue between tradition and innovation and help restore healthier eating habits. Conclusions: the culinary grammar of traditional Valencian gastronomy can improve the population's nutrition by providing a healthy, attractive and tasty diet, besides offering a sustainable alternative for production and consumption through its commitment to regional produce.

INTRODUCCIÓN: Objetivos: analizar la evolución histórica que ha experimentado el modelo alimentario valenciano, la relación que cabe establecer entre gastronomía y nutrición y el papel que pueden jugar la recuperación y la adaptación de las tradiciones culinarias y gastronómicas en la promoción de una alimentación saludable. Metodología: búsqueda bibliográfica de trabajos que se han ocupado de los temas objeto de estudio y análisis de sus contenidos. Resultados: la cocina tradicional valenciana se caracteriza por su heterogeneidad y su diversidad comarcal y local, pero la base vegetal de sus platos y recetas le otorga una idiosincrasia gastronómica propia, que resultó clave para completar, en la década de los sesenta, la transición alimentaria y nutricional de la población valenciana. La occidentalización de los regímenes alimentarios de los valencianos y la pérdida de los referentes patrimoniales de la dieta mediterránea que tuvo lugar en las últimas décadas del siglo xx conllevaron un deterioro de su estado nutricional y la emergencia de problemas como el sobrepeso y la obesidad. Frente a semejante panorama, la actualidad y el protagonismo alcanzando por el sector de la gastronomía en la Comunitat Valenciana puede ofrecer una oportunidad para revertir esta situación y, desde el diálogo entre la tradición y la innovación, poner en valor un patrimonio gastronómico que ayude a recuperar hábitos alimentarios más saludables. Conclusiones: la gramática culinaria de la gastronomía valenciana tradicional puede mejorar la forma de nutrirnos al aportar una alimentación saludable, atractiva y sabrosa, además de ofrecer, por su compromiso con el territorio, una alternativa sostenible de producción y consumo.

[Evaluation of school menu food balance in the Autonomous Community of Valencia (Spain) by means of a questionnaire]. / Evaluación del equilibrio alimentario de los menús escolares de la Comunidad Valenciana (España) mediante un cuestionario.

OBJECTIVE: To evaluate school menu food balance in the Autonomous Community of Valencia (Spain) by means of a questionnaire. METHOD: Observational cross-section study. For convenience it shows of 255 monthly school menus (20 days each). INDEPENDENT VARIABLES: size of the city the school is in, province, location (coast vs. inland), ownership (public vs. private), design of the menu (company vs. school) and month (May vs. October). The 17-item EQ-MEs questionnaire was used as a tool to measure balance. Differences in the balance of the menus and the average of monthly servings were compared, taking into account the different levels of the independent variables. RESULTS: The average of the balance index obtained was 9.19 points (range: 0-17). Approximately 78.4% of menus were designed by companies. Approximately 60.4% were classified as suitable and 0.8% as balanced. The menus designed by companies obtained a higher score (9.49) than those designed by schools (8.13). Menus in Castellón (10.35) achieved a higher score than those in Alicante (9.43) and Valencia (8.86). Only 3.1% of the studied menus met serving recommendations in terms of meat, 37.6% met pulses serving recommendations, 49.4% met fish serving recommendations and 37% met fruit serving recommendations. CONCLUSION: With the EQ-MEs questionnaire, most of the menus offered in the Autonomous Community of Valencia are suitable for children. To improve them, they should reduce fried potato, rice, pasta, meat, fried food and dairy product servings, while increasing pulses, fish, oily fish and fruit servings.

Fiabilidad de un cuestionario para evaluar el equilibrio alimentario de menús escolares / Reliability of a questionnaire to evaluate the food balance of school menus

Una adecuada planificación del menú escolar puede servir como estrategia en la prevención de la obesidad infantil y las enfermedades crónicas no transmisibles. El objetivo del estudio fue aportar evidencias de fiabilidad de un cuestionario capaz de evaluar el equilibrio alimentario (cualitativo) de menús escolares. El cuestionario estudiado constaba de 17 ítems referidos a grupos de alimentos, técnicas culinarias y la combinación de los platos para su uso en la evaluación de la oferta alimentaria en comedores escolares (cuestionario EQ-MEs). Para la fiabilidad se analizó la reproducibilidad (coeficiente de correlación intraclase y de Pearson), tanto el grado de acuerdo intraobservador como entre dos observadores, de una muestra de 255 planificaciones mensuales de menús para 20 días ofrecidos en la Comunitat Valenciana (España). Se completó el estudio con el análisis gráfico de Bland-Altman. La asociación intraobservador mostró un coeficiente de correlación intraclase entre 0,940 y 1, y de Pearson entre 0,900 y 0,990. La comparativa interobservadores reflejó una asociación con valores entre 0,771 y 0,980 para el coeficiente de correlación intraclase (excepto para el ítem combinación de platos con 0,516), y entre 0,895 y 0,845 para el de Pearson (excepto para el ítem combinación de platos con 0,350). El análisis gráfico de Bland-Altman mostró también las altas asociaciones encontradas. En conclusión, el cuestionario EQ-MEs es un instrumento fiable para evaluar el equilibrio de menús escolares, de fácil utilización y que permite clasificarlos(AU)

Proper school menu planning can serve as a strategy in the prevention of childhood obesity and chronic noncommunicable diseases. The aim of the study was to provide reliable evidence of a questionnaire that allows to evaluate the food balance of school menus. There was studied the reliability of a questionnaire of 17 articles referred to groups of food, culinary technologies and the combination of the plates for his use in the evaluation of the food offer in school dining rooms (questionnaire EQ-MEs). For the reliability there was analyzed the reproducibility (intraclass correlation coefficient and of Pearson), so much degree of agreement intra-observer as between two observers, of a sample of 255 monthly plannings of menus for 20 days offered in the Valencian Community (Spain). The study was completed with the Bland-Altman graphical analysis. The association test-retest showed an intraclass correlation coefficient between 0.940 and 1, and of Pearson between 0.900 and 0.990. Comparative inter-observers it reflected an association with values between 0.771 and 0.980 for the intraclass correlation coefficient (except for the article combination of plates with 0.516), and between 0.895 and 0.845 for that of Pearson (except for the article combination of plates with 0.350). Bland-Altman's graphical analysis showed also the high opposing associations. In conclusion, the EQ-MEs questionnaire is a reliable instrument to evaluate the balance of school menus, easy to use and classifying them(AU)

Differences between the prevalence of obesity and weight exceded estimated according to reported or direct measurement in adult people of Valencian Region / Diferencias entre la prevalencia de obesidad y exceso de peso estimadas con datos declarados o por medición directa en adultos de la Comunidad Valenciana.

Introduction: The assessment of obesity in health surveys includes the study of the physical characteristics of human body. Anthropometrical dates can be obtained by measurement or by interview. According the method that we were used we can estimate different values for frequencies of this problem. Objectives: Measure the discrepancies of the frequency of obesity and overweight estimated with data of height and weight obtained by interview respect to those measured in a population survey. Methods: Cross-sectional survey of a sample of 1,153 adult subjects, where height and weight data reported and measured were compared by Pearson correlation. It was estimated the prevalence of obesity and overweight by two methods and we calculated the Kappa's index, the sensitivity and specifi city for to define the predictive capacity of reported data. Results: The values of weight, height and BMI by declared and measured data presented a correlation of 0.96, 0.93 and 0.91, respectively. The prevalence of obesity was 16.4% with declared data and 23.3% for measured data (kappa = 0.68), sensitivity 63.2% and specifi city 97.9%. The prevalence of excess of weight was 51.4% with declared data and 61.1% for measured data (kappa = 0.73), sensitivity 81.3% and specificity 95.3%. These differences were statistically signifi cant. Conclusions: There is an underestimation of the prevalence of obesity and excess of weight in populations when anthropometric data were used but in good agreement and specificity was found when measured data are used.

Introducción: la evaluación de la obesidad en las encuestas de salud contempla el estudio de las características corporales por medición o por declaración. Según el método utilizado puede producirse una estimación diferente de la frecuencia de este problema. Objetivos: medir las discrepancias en las estimaciones de prevalencia de obesidad y exceso de peso realizadas con datos declarados con respecto a los medidos en una encuesta poblacional. Métodos: estudio transversal de una muestra de 1.153 sujetos adultos donde se compararon los datos de peso y talla declarados y medidos mediante la correlación de Pearson (r). Se calcularon las prevalencias de obesidad y exceso de peso según ambos métodos y se obtuvo el índice kappa, la sensibilidad y la especificidad para estimar la capacidad predictiva de los datos declarados. Resultados: los valores de peso, talla e IMC declarados y medidos presentaron una correlación de 0,96, 0,93 y 0,91, respectivamente. La prevalencia de obesidad declarada fue 16,4% y la medida 23,3% (kappa = 0,68), sensibilidad 63,2% y especificidad 97,9%. La prevalencia de exceso de peso declarada fue 51,4% y por medición 61,1% (kappa = 0,73), sensibilidad 81,3% y especificidad 95,3%. Las diferencias observadas fueron estadísticamente significativas. Conclusiones: existe una subestimación de las prevalencias de obesidad y de exceso de peso en poblaciones cuando se usan datos antropométricos declarados, pero una buena concordancia y especificidad con las estimaciones realizadas con datos medidos.

[Awareness, Treatment and Control of Hypertension in Population Aged 16 to 90 Years Old in the Valencia Region, Spain, 2010]. / Conocimiento, tratamiento y control de la hipertensión arterial por las personas de 16 a 90 años de edad participantes en la Encuesta de Nutrición de la Comunitat Valenciana de 2010.

OBJECTIVE: Hypertension is an important risk factor in terms of mortality attributable and the main modifiable cardiovascular risk factor. The aim of the study is to estimate the degree of awareness, treatment and control of hypertension in population of Valencia Region and identify predictors that explain the lack of proper control. METHODS: Cross-sectional population-based study in 413 men and 415 women between 16 and 90 years participants in Nutrition Survey of Valencia held in 2010. Automatic sphygmomanometer was used for taking blood pressure. Hypertension was defined according to the criteria of 2007 European Society of Hypertension and the European Society of Cardiology. Data on knowledge and treatment were obtained by survey. Predictors for awareness, treatment and control of hypertension were estimated by logistic regression models. RESULTS: The prevalence of hypertension estimated for the study population was 38.2% (95% CI: 34.9%-41.5%). 51.4% (95% CI: 45.9%-57.0%) of the hypertensive population, knew his condition. 88.8% of them (95% CI: 83.9%-93.6%) were receiving drug therapy and of these, 45.1% (95% CI: 36.9%-53.3%) maintained blood pressure controlled. CONCLUSIONS: Since the last survey in Valencia Region, the degree of awareness of hypertension has not improved although an increase in those treated with antihypertensive drugs is observed.

[Prevalence of Hypertension and Associated Factors in Population Aged 16 to 90 Years Old in Valencia Region, Spain]. / Prevalencia de hipertensión arterial y factores asociados en población de 16 a 90 años de edad en la Comunidad Valenciana.

OBJECTIVE: Hypertension is one of the main risk factor in terms of attributable mortality and the most common modifiable cardiovascular risk factor. The aim of the study was to estimate the prevalence of hypertension in population more than fifteen years of Valencia region and describe the strength of association between specific factors and the presence of hypertension. METHODS: Cross-sectional population-based study in 413 men and 415 women between 16 and 90 years participants in Nutrition Survey of Valencia held in 2010. Data were collected through household survey and blood pressure was measured using an automated sphygmomanometer. Hypertension was defined according to criteria established in 2007 by the European Society of Hypertension and the European Society of Cardiology. Strength of association between hypertension and associated factors was measured by binary logistic regression for demographic explanatory variables, family history, lifestyle, anthropometric variables and others. RESULTS: The prevalence of hypertension estimated for Valencia region was 38,2% [95% CI 34,9 to 41,5]; 40,7% in men [95% CI 35,0 to 45,5] and 35,7% in women [95% CI 31,1 to 40,3]. Remained as associated variables with hypertension: age [45-64 years OR 4.3, IC 95% 2.1-8.8; 65 or more years, OR 15.5, IC 95% 7.2-33.2], body mass index [overweight OR 2.1 95% CI 1.3 to 3.2; obesity OR 5.3, 95% CI 3.3 to 8.5] and diabetes [OR 2.4, 95% CI 1.2-4.8]. CONCLUSIONS: More than a third of the study population suffers from hypertension. Its risk increases with age. Overweight and diabetes mellitus double the likelihood of developing hypertension.

OBJETIVO: La hipertensión es un importante factor de riesgo en términos de mortalidad atribuible y como factor de riesgo cardiovascular modificable. El objetivo del estudio fue estimar la prevalencia de hipertensión arterial en población mayor de quince años de la Comunitat Valenciana y describir su asociación con determinados factores etiológicos. METODOS: Estudio transversal de base poblacional en 413 hombres y 415 mujeres de 16 a 90 años de edad participantes en la Encuesta de Nutrición de la Comunitat Valenciana realizada en 2010. La información se obtuvo mediante encuesta a domicilio y medida de la presión arterial utilizando esfigmomanómetro automático. Para la definición de hipertensión arterial se siguió el criterio establecido en 2007 por la Sociedad Europea de Hipertensión Arterial y la Sociedad Europea de Cardiología. La asociación entre factores asociados e hipertensión medida mediante regresión logística binaria para variables explicativas sociodemográficas, antecedentes, estilos de vida, variables antropométricas y otras. RESULTADOS: La prevalencia de hipertensión estimada para la Comunidad Valenciana fue de 38,2% [IC95% 34,9-41,5]; 40,7% en hombres [IC95%35,0-45,5] y 35,7% en mujeres [IC95% 31,1-40,3]. La edad [45-64 años OR: 4,3, IC 95% 2,1-8,8; 65 o más años, OR 15,5, IC 95% 7,2-33,2)], la categoría ponderal [sobrepeso OR 2,1 IC95% 1,3-3,2; obesidad OR 5,3, IC95% 3,3-8,5] y padecer diabetes [OR 2,4, IC95% 1,2-4,8] se constituyeron como variables asociadas con hipertensión. CONCLUSIONES: Más de un tercio de la población estudiada padece hipertensión. La probabilidad de presentarla aumenta con la edad. El sobrepeso así como la diabetes mellitus duplican la probabilidad de padecerla.

Dietary guidelines for the Spanish population (SENC, December 2016); the new graphic icon of healthy nutrition / Guías alimentarias para la población española (SENC, diciembre 2016); la nueva pirámide de la alimentación saludable.

Objective: The Spanish Society of Community Nutrition (SENC) designed in 1994 a food guide for the Spanish population, updated in 2001. This report presents a new updated edition based on the best scientifi c evidence available. Methods: From a health in all policies approach, a group of experts in nutrition and public health associated with SENC was convened to review the evidence on diet-health, nutrition intake and food consumption in the Spanish population, as well as food preparation and consumption habits, determinants and impact of diet on environmental sustainability. Existing systematic reviews, updates, reports, meta-analysis and the latest quality studies have been considered. The collaborative group contributed to draft the document and design the graphic icon, then subject of a consultation process, discussion and qualitative evaluation, particularly relevant through the Advisory Group for the SENC-December 2016 Dietary Guidelines. Results: The new recommendations and its graphical representation highlights as basic considerations the practice of physical activity, emotional balance, energy balance to maintain body weight at adequate levels, healthy cooking procedures and adequate water intake. The recommendations promote a balanced, varied and moderate diet that includes whole grains, fruits, vegetables, legumes, varying amounts of dairy and alternating consumption of fi sh, eggs and lean meats, along with the preferential use of extra virgin olive oil for cooking and seasoning. Reinforce the interest in a healthy, sympathetic, supportive, sustainable diet, based on seasonal and local products, axis for conviviality, devoting adequate time and encourage the use of nutrition labelling information. Conclusions: The analysis of the evidence available and updated information on food consumption in Spain highlights the need to strengthen and implement the recommendations contained in this document to progressively achieve a greater adherence.

Objetivo: La Sociedad Española de Nutrición Comunitaria (SENC) planteó en 1994 una guía alimentaria para la población española, renovada en 2001. Se presenta una nueva edición actualizada basada en la mejor evidencia científica disponible. Métodos: Desde un enfoque de salud en todas las políticas se convocó un grupo de expertos en nutrición y salud pública vinculados con la SENC para revisar la evidencia sobre dieta-salud, ingesta nutricional y consumo alimentario en la población española, hábitos de preparación y consumo de alimentos, factores determinantes e impacto de la dieta en la sostenibilidad medioambiental. Se han considerado revisiones sistemáticas existentes, actualizaciones, informes, metaanálisis y estudios recientes de calidad. El grupo colaborativo contribuyó a la elaboración del documento de trabajo y diseño del icono gráfico posteriormente sometidos a consulta, discusión y evaluación cualitativa con especial relevancia a través del Grupo Consultor de las Guías SENC-diciembre 2016. Resultados: Las nuevas recomendaciones y su representación gráfica subrayan como consideraciones básicas practicar actividad física, equilibrio emocional, balance energético para mantener el peso corporal adecuado, procedimientos culinarios saludables e ingesta adecuada de agua. Las recomendaciones promueven una alimentación equilibrada, variada y moderada que incluye cereales de grano entero, frutas, verduras, legumbres, cantidades variables de lácteos y alterna el consumo de pescados, huevos y carnes magras, junto con el uso preferente de aceite de oliva virgen extra como grasa culinaria. Refuerzan el interés por una dieta saludable, solidaria, sostenible, con productos de temporada, de cercanía, eje de convivialidad, dedicando el tiempo suficiente y animan a valorar la información del etiquetado nutricional. Conclusiones: El análisis de la evidencia disponible y de la información actualizada sobre el consumo alimentario en España pone de manifiesto la necesidad de reforzar e implementar las recomendaciones recogidas en este documento para conseguir progresivamente un mayor grado de adherencia.

Dietary Guidelines for the Spanish population (SENC, diciembre 2016); the new graphic icon of healthy food / Guías alimentarias para la población española (SENC, diciembre 2016); la nueva pirámide de la alimentación saludable

Objective: The Spanish Society of Community Nutrition (SENC) designed in 1994 a food guide for the Spanish population, updated in 2001. This report presents a new updated edition based on the best scientific evidence available. Methods: From a health in all policies approach, a group of experts in nutrition and public health associated with SENC was convened to review the evidence on diet-health, nutrition intake and food consumption in the Spanish population, as well as food preparation and consumption habits, determinants and impact of diet on environmental sustainability. Existing systematic reviews, updates, reports, meta-analysis and the latest quality studies have been considered. The collaborative group contributed to draft the document and design the graphic icon, then subject of a consultation process, discussion and qualitative evaluation, particularly relevant through the Advisory Group for the SENC-December 2016 Dietary Guidelines. Results: The new recommendations and its graphical representation highlights as basic considerations the practice of physical activity, emotional balance, energy balance to maintain body weight at adequate levels, healthy cooking procedures and adequate water intake. The recommendations promote a balanced, varied and moderate diet that includes whole grains, fruits, vegetables, legumes, varying amounts of dairy and alternating consumption of fi sh, eggs and lean meats, along with the preferential use of extra virgin olive oil for cooking and seasoning. Reinforce the interest in a healthy, sympathetic, supportive, sustainable diet, based on seasonal and local products, axis for conviviality, devoting adequate time and encourage the use of nutrition labelling information. Conclusions: The analysis of the evidence available and updated information on food consumption in Spain highlights the need to strengthen and implement the recommendations contained in this document to progressively achieve a greater adherence.

Objetivo: La Sociedad Española de Nutrición Comunitaria (SENC) planteó en 1994 una guía alimentaria para la población española, renovada en 2001. Se presenta una nueva edición actualizada basada en la mejor evidencia científica disponible. Métodos: Desde un enfoque de salud en todas las políticas se convocó un grupo de expertos en nutrición y salud pública vinculados con la SENC para revisar la evidencia sobre dieta-salud, ingesta nutricional y consumo alimentario en la población española, hábitos de preparación y consumo de alimentos, factores determinantes e impacto de la dieta en la sostenibilidad medioambiental. Se han considerado revisiones sistemáticas existentes, actualizaciones, informes, metaanálisis y estudios recientes de calidad. El grupo colaborativo contribuyó a la elaboración del documento de trabajo y diseño del icono gráfico posteriormente sometidos a consulta, discusión y evaluación cualitativa con especial relevancia a través del Grupo Consultor de las Guías SENC-diciembre 2016. Resultados: Las nuevas recomendaciones y su representación gráfica subrayan como consideraciones básicas practicar actividad física, equilibrio emocional, balance energético para mantener el peso corporal adecuado, procedimientos culinarios saludables e ingesta adecuada de agua. Las recomendaciones promueven una alimentación equilibrada, variada y moderada que incluye cereales de grano entero, frutas, verduras, legumbres, cantidades variables de lácteos y alterna el consumo de pescados, huevos y carnes magras, junto con el uso preferente de aceite de oliva virgen extra como grasa culinaria. Refuerzan el interés por una dieta saludable, solidaria, sostenible, con productos de temporada, de cercanía, eje de convivialidad, dedicando el tiempo suficiente y animan a valorar la información del etiquetado nutricional. Conclusiones: El análisis de la evidencia disponible y de la información actualizada sobre el consumo alimentario en España pone de manifiesto la necesidad de reforzar e implementar las recomendaciones recogidas en este documento para conseguir progresivamente un mayor grado de adherencia.

Factors associated with childhood obesity in Spain. The OBICE study: a case-control study based on sentinel networks.

OBJECTIVE: To estimate the association strength of dietary behaviour and sedentary habits in relation to childhood obesity in Spain. DESIGN: A matched case-control study was carried out using data collected by sentinel network paediatricians in general practices. SETTING: Five Spanish autonomous communities. SUBJECTS: Cases were 437 children (2-14 years old) with BMI >95th percentile according to Spanish reference tables. Controls were 751 children (2-14 years old; two paired per case) with BMI <84th percentile. Data were collected in two phases: individual (questionnaires filled in by sentinel paediatricians) and family (self-administered questionnaires filled in a family environment). Crude OR and adjusted OR (ORc and adj OR) for the given variables were calculated using a simple and multiple conditional logistic regression analysis. RESULTS: The factors with the greatest effect on obesity were family history of obesity: both parents (adj OR = 11.2), mother but not father (adj OR = 9.1), father but not mother (adj OR = 6.1), siblings (adj OR = 2.7); and eating between meals (adj OR = 2.5) and consumption of sweets and soft drinks >2 times/week (adj OR = 2.0). The highest protection effect was found for five meals per day (adj OR = 0.5), the regular consumption of breakfast (adj OR = 0.5) and for eating fruit for dessert (adj OR = 0.6). Factors related to sedentary habits did not appear as noteworthy. CONCLUSIONS: We have determined the association between certain dietary behaviour and family history with childhood obesity in several Spanish regions.

[Trend in platelet antiaggregants utilization in the autonomous community of Valencia, Spain (2000-2005)]. / Tendencia en la utilización de antiagregantes en la comunidad Valenciana (2000-2005).

BACKGROUND: Platelet antiaggregants are basic drugs for preventing ischemic arterial diseases. This study is aimed at ascertaining the trend in their use in Primary Care in the Autonomous Community of Valencia during the 2000-2005 period. METHODS: Descriptive study of the use of platelet antiaggregants (ATC code: B01AC) dispensed charged to the National Health System in the Autonomous Community of Valencia in Primary Care. Data given in defined daily doses (DDD) per 1000 inhabitants per day. RESULTS: In 2005, three drugs totalled 98% of all those prescribed overall (acetyl salicylicacid (ASA) 66%, clopidogrel 23% and triflusal 9%). Oral antiaggregant use rose by 23% within the 2000-2005 period (from 29.6 to 36.5 DDD/1000 inhab./day). Clopidogrel showed a 218% increase, whilst ASA was the most used drug, with quite a stable percentage of use throughout said time period (nearing 70%). The expense generated by this group of drugs doubled, clopidogrel having been the highest-cost drug/DDD (2.14 EUROS), its use having totalled 23% of all antiaggregants yet the expense thereof having totalled 76% of the total expenditure. CONCLUSIONS: The use of antiaggregants increased in the Autonomous Community of Valencia during the time period under study. The utilization of ASA remained stable, whilst clopidogrel increased its market share despite the treatment guide recommendations and the restrictions on its use. The consumption of clopidogrel noticeably contributed to the drug spending for this group.

[Prevalence of obesity in Spain: results of the SEEDO 2000 study]. / Prevalencia de la obesidad en España: resultados del estudio SEEDO 2000.

BACKGROUND AND OBJECTIVE: Obesity is a major public health problem in developed countries. It is of key importance to ascertain its magnitude and to identify main groups at risk. In this paper the prevalence of obesity in Spanish adult population aged 25-60 is estimated, based on measured height and weight. SUBJECTS AND METHOD: Pooled-analysis of regional cross-sectional nutrition surveys performed on representative random population samples. Randomly selected 9,885 free living subjects aged 25-60 years respondents of population nutritional surveys carried out in eight Spanish regions (Andalucía, Balearic Islands, Basque Country, Canary Islands, Catalunya, Galicia, Madrid and Valencia) between 1990 to 2000. Weight and height were measured on each individual by trained observers following standardised procedures and measuring instruments. The samples were pooled together and weighted according to the distribution of Spanish adult population aged 25-60 years. Obesity was defined as body mass index (BMI) >= 30 kg/m2. The protocol used in each survey was in accordance to the recommendations of the Spanish Society for the study of Obesity (SEEDO) to estimate the prevalence of obesity in population studies. RESULTS: The prevalence of obesity in Spanish adult population was 14.5% (95% CI, 13.93-15.07%), significantly higher among women 15.75% (95% CI, 14.89-16.61%), than men 13,39% (95% CI, 11.84-14.94%) (*2 = 12.470; p = 0.000). Prevalence of obesity significantly increased with age in men and women. The highest rates were estimated for the age group older than 55 years, both among males and females, 21.58% (95% CI, 18.68-24.48%) and 33.9% (95% CI, 32.73-35.07%), respectively. CONCLUSION: Obesity is a health problem which affects an important proportion of the Spanish adult population. Considering its potential impact on Public Health, it would be required to design and implement effective strategies aimed at the early detection of subjects at risk and the provision of adequate treatment, as well as to establish suitable preventive programmes.