Clustering Health Behaviors in Mexican Adolescents: The HELENA-MEX Study.

Purpose: The prevalence of excess weight within the adolescent population is rapidly increasing in Mexico, especially in areas with lower socioeconomic status. The present study aimed to identify lifestyle clustered patterns in adolescents and analyze the associations among these clusters and body composition. Method: A final sample of n=259 participants (13 to 17 years old, 58.7% girls), residents in rural and urban areas, were included. Hierarchical and k-means clusters analyses included moderate to vigorous physical activity (MVPA), cardiorespiratory fitness (CRF), handgrip strength, screen time, sleep time, and diet. The associations between cluster membership and body composition were analyzed through general linear models (ANCOVA), including sex, age, place of residence, and socioeconomic status as covariates. Results: Three different clusters were identified: Cluster 1, [Unhealthy] (low values in all lifestyle patterns), Cluster 2, [Low Physical Fitness] (low values in CRF and handgrip strength) and Cluster 3, [High Physical Activity and CRF] (highest values in CRF, handgrip strength and MVPA). Clusters 2 and 3 showed high values in screen time and industrialized food consumption. There were no differences in sleep between the 3 Clusters. ANCOVA analysis revealed that participants belonging to Cluster 3 showed significantly lower adiposity and a higher Fat Free Mass compared with the other two clusters (p < 0.05). Conclusion: Our findings suggest that a lifestyle characterized by high levels of physical activity and physical fitness and low consumption of industrialized food may be protective against the problem of obesity, which could be helpful to develop interventions to reduce excess weight in Mexican adolescents.

Perceived Quality of Life Is Related to a Healthy Lifestyle and Related Outcomes in Spanish Children and Adolescents: The Physical Activity, Sedentarism, and Obesity in Spanish Study.

BACKGROUND: Maintaining a healthy lifestyle is crucial for safeguarding the well-being and quality of life perception, appropriate growth, and development of children and adolescents, while also mitigating the risk of future adult-onset diseases. OBJECTIVE: To assess associations between perceived quality of life and healthy lifestyle and related outcomes in Spanish children and adolescents. METHODS: Cross-sectional analysis of 8-16-year-old children and adolescents (n = 3534) were included in the nationwide study of Physical Activity, Sedentarism, and Obesity in Spanish Youth (PASOS). Data were collected through (1) questionnaires on health-related quality of life (HRQoL), healthy lifestyle outcomes (dietary intake, physical fitness, sleep, and screen time), and (2) anthropometric measurements for weight status assessment. Data were analysed by logistic regression, using the health-related quality of life (HRQoL) as the grouping variable. RESULTS: Participants with a lower HRQoL were those with a lower adherence to the MedDiet and lower achievement of the recommended daily intake of fruit and vegetables. They were also less likely to follow the recommendations for screen time and sleep (with the exception of the weekend) compared to participants with a higher HRQoL. Participants with a lower HRQoL showed a lower healthy weight status and poorer physical fitness than those with a higher HRQoL. CONCLUSIONS: Healthy eating habits, healthy weight status (normal weight), appropriate sleep time, physical fitness, and limited screen time play a crucial role in the perceived quality of life in children and adolescents.

Global Alliance for the Promotion of Physical Activity: the Hamburg Declaration.

Non-communicable diseases (NCDs), including coronary heart disease, stroke, hypertension, type 2 diabetes, dementia, depression and cancers, are on the rise worldwide and are often associated with a lack of physical activity (PA). Globally, the levels of PA among individuals are below WHO recommendations. A lack of PA can increase morbidity and mortality, worsen the quality of life and increase the economic burden on individuals and society. In response to this trend, numerous organisations came together under one umbrella in Hamburg, Germany, in April 2021 and signed the 'Hamburg Declaration'. This represented an international commitment to take all necessary actions to increase PA and improve the health of individuals to entire communities. Individuals and organisations are working together as the 'Global Alliance for the Promotion of Physical Activity' to drive long-term individual and population-wide behaviour change by collaborating with all stakeholders in the community: active hospitals, physical activity specialists, community services and healthcare providers, all achieving sustainable health goals for their patients/clients. The 'Hamburg Declaration' calls on national and international policymakers to take concrete action to promote daily PA and exercise at a population level and in healthcare settings.

Are Physical Activity and Sedentary Screen Time Levels Associated With Food Consumption in European Adolescents? The HELENA Study.

One of the current main public health problems is the prevalence of obesity in children. Unhealthy lifestyle behaviors such as poor dietary habits, high sedentary screen time (SST), and low levels of physical activity (PA) have a strong tendency to track from childhood into adulthood. The aim of this manuscript is to assess the association between meeting or not meeting the PA and SST recommendations and the consumption of different food groups.Data were obtained from a sample of European adolescents from the multicenter cross-sectional HELENA study. In all, 1448 adolescents from 8 cities were included. PA was objectively measured by accelerometry and dietary intake by 24-hour dietary records. Adolescents were grouped according to PA and SST recommendations.In both sexes, intake of savory snacks was higher in those groups who did not meet any of the recommendations (p < 0.05). For males, those who met both recommendations were more likely to drink/eat milk, yogurt, and water (p < 0.05). Those not meeting recommendations were more likely to drink sugar-sweetened beverages (p < 0.05). For females, those not meeting recommendations were less likely to eat fruits and vegetables and more likely to have a higher intake of fats and oils (p < 0.05).Those adolescents meeting PA and SST recommendations had a higher intake of healthy foods, like fruit and vegetables and dairy products. However, the negative relationship unhealthier food and SST is stronger in males independently of PA. More studies assessing the combined effect of both PA and SST regarding dietary habits in children and adolescents are needed.

The medium-term consequences of a COVID-19 lockdown on lifestyle among Spanish older people with hypertension, pulmonary disease, cardiovascular disease, musculoskeletal disease, depression, and cancer.

OBJECTIVES: This study investigated the associations of chronic diseases with changes in lifestyle and health behaviours in older people following the coronavirus disease 2019 (COVID-19) lockdown in Spain and compared the differences in changes over time. METHODS: 1,092 participants (80.3±5.6 years; 66.5% female) from 2 Spanish cohorts were included. Telephone-based questionnaires were conducted to evaluate lifestyle and health risk behaviours at the end of lockdown and 7 months post-lockdown. Participants were classified as having physician-diagnosed chronic diseases based on self-reported data. Cox proportional models adjusted for major confounders were used. RESULTS: Compared to those without the corresponding chronic diseases, older people with hypertension were less likely to report increased alcohol consumption (hazard ratio [HR], 0.73; 95% confidence interval [CI], 0.55 to 0.99). Pulmonary diseases were associated with lower risks of increased sedentary time (HR, 0.58; 95% CI, 0.39 to 0.86) and worsened sleep quality (HR, 0.56; 95% CI, 0.36 to 0.87), while cardiovascular diseases were associated with a lower risk of decreased sedentary time (HR, 0.58; 95% CI, 0.38 to 0.88). Depression was linked to a higher likelihood of improved diet quality (HR, 1.53; 95% CI, 1.00 to 2.36). Cancer pacients were less likely to have worsened sleep quality (HR, 0.44; 95% CI, 0.22 to 0.89) but more likely to have reduced their frequency of social contact (HR, 2.05; 95% CI, 1.05 to 3.99). CONCLUSIONS: Older people with chronic diseases showed beneficial changes in lifestyle and health risk behaviours after the COVID-19 lockdown. In particular, older people with hypertension, pulmonary disease, and cancer tended to make beneficial lifestyle and health behaviour changes. However, older people with cardiovascular disease and depression engaged in more health risk behaviours.

Interplay of physical activity and genetic variants of the endothelial lipase on cardiovascular disease risk factors.

BACKGROUND: The aim of this study was to investigate the association of endothelial lipase gene (LIPG) polymorphisms with cardiovascular disease (CVD) risk factors in adolescents and their interaction with physical activity. METHODS: Six polymorphisms of LIPG were genotyped in 1057 European adolescents (12-18 years old) enrolled in the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) Study. CVD risk factors related to lipid profile, blood pressure, adiposity and glucose regulation were recorded. Physical activity was objectively measured by accelerometry. RESULTS: The major C allele of rs2000813, the minor T allele of rs2276269 and the minor G allele of rs9951026 were associated with lower levels of several CVD risk factors related to lipid profile. We also found a significant association of the TTACA LIPG haplotype (rs2000812, rs2000813, rs8093249, rs2276269 and rs9951026) with higher concentrations of low-density cholesterol and apolipoprotein B. Finally, the interaction between physical activity and the polymorphisms rs2000813, rs2276269 and rs9951026 had a significant influence on several CVD risk factors. CONCLUSIONS: LIPG polymorphisms were significantly associated with CVD risk factors in European adolescents. Interestingly, alleles of these polymorphisms were associated with a better cardiovascular profile in physically active adolescents only. High physical activity may reduce the development of CVD, modulating its genetic risk. IMPACT: Using gene-phenotype and gene × environment analyses, we detected associations between the endothelial lipase gene and cardiovascular risk factors, along with interactions with physical activity. This study shows that physical activity may modulate the influence of LIPG gene on cardiovascular risk in adolescents. These results bring insights into the mechanisms by which physical activity positively influences CVD in adolescents.

Fitness vs Fatness as Determinants of Survival in Noninstitutionalized Older Adults: The EXERNET Multicenter Study.

BACKGROUND: Physical fitness and body composition are important health indicators; nevertheless, their combined pattern interrelationships and their association with mortality are poorly investigated. METHODS: This longitudinal study is part of the Spanish EXERNET-Elder project. Person-months of follow-up were calculated from the interview date, performed between June 2008 and November 2009, until the date of death or censoring on March 2018 (whichever came first). In order to be included, participants had to fulfill the following criteria: (a) be older than 65 years, (b) live independently at home, (c) not suffer dementia and/or cancer, and (d) have a body mass index above 18.5. Body fat and weight were assessed by a bioelectrical impedance analyzer. Fitness was measured with the Senior Fitness and the one-leg static balance tests. The Spanish Death Index was consulted for the death's identification. Cluster analysis was performed to identify Fat-Fit patterns and traditional cut-points and percentiles to create the Fat-Fit groups. Cox proportional hazards regression models were used to calculate the hazard ratios (HRs) of death in clustered Fat-Fit patterns and in traditional Fat-Fit groups. RESULTS: A total of 2299 older adults (76.8% of women) were included with a baseline mean age of 71.9 ± 5.2 years. A total of 196 deaths (8.7% of the sample) were identified during the 8 years of follow-up. Four clustered Fat-Fit patterns (Low fat-Fit, Medium fat-Fit, High fat-Unfit, and Low fat-Unfit) and 9 traditional Fat-Fit groups emerged. Using the Low fat-Fit pattern as the reference, significantly increased mortality was noted in High fat-Unfit (HR: 1.68, CI: 1.06-2.66) and Low fat-Unfit (HR: 2.01, CI: 1.28-3.16) groups. All the traditional Fit groups showed lower mortality risk when compared to the reference group (obese-unfit group). CONCLUSION: Physical fitness is a determinant factor in terms of survival in community-dwelling older adults, independently of adiposity levels.

Is Energy Expenditure or Physical Activity Considered When Energy Intake Is Measured? A Scoping Review 1975-2015.

The health-transitions humans have delivered during the 20th Century associated with the nutrition is that from undernutrition to obesity, which perseveres in the current years of the 21st Century. Energy intake (EI) is a contributing factor and therefore a fascination in nutritional sciences. However, energy expenditure (EE) has not been usually considered as a conjoint factor. Thus, this study aimed to review if studies on adults consider data on dietary intake, specifically EI, and included data on EE and physical activity (PA). A search of MEDLINE from 1975 to December 2015 was managed. Our scoping review consisted of keywords related to EI, dietary allowances, and nutritional requirements. From 2229 acknowledged articles, 698 articles were finally taken fulfilling inclusion and quality criteria. A total of 2,081,824 adults (53.7% females) were involved, and most studies had been conducted in EEUU (241), Canada (42), Australia (30), Japan (32), and Brazil (14). In Europe, apart from UK (64), the Netherlands (31) and France (26) led the classification, followed by Sweden (18), Denmark (17), and France (26). Mediterranean countries are represented with 27 studies. A total of 76.4% did not include EE and 93.1% did not include PA. Only 23.6% of the studies contained both EI and EE. A large methodological diversity was perceived, with more than 14 different methods regarding EI, and more than 10 for EE. PA was only analyzed in scarce articles, and scarcely considered for interpretation of data and conclusions. Moreover, PA was often measured by subjective questionnaires. Dietary surveys show a large diversity regarding methodology, which makes comparability of studies difficult. EE and PA are missing in around 80% of studies or are not included in the interpretation of results. Conclusions regarding EI or diet adequacy in adults should not be taken without analyzing EE and PA.

Fat-Fit Patterns, Drug Consumption, and Polypharmacy in Older Adults: The EXERNET Multi-Center Study.

BACKGROUND: Physical fitness levels and the amount of accumulated adipose tissue (fatness) relate to current and future individuals' heath status. Nevertheless, the interrelationships of their combined patterns with polypharmacy and the types of medications consumed have not been sufficiently investigated. METHODS: This cross-sectional study was carried out in six Spanish regions between 2008 and 2009 with a sample of older community-dwelling adults (≥65 years old) without dementia or cancer. Fitness was measured with one-leg balance and senior fitness tests, as well as by measuring weight and fat mass with a bioelectrical impedance analyzer. Polypharmacy was defined as the use of five or more medications. An analysis of variance was performed for comparisons between the physical fitness and fatness patterns and the medication consumed. RESULTS: A total of 1709 elders were included in the study (72.1 ± 5.2 years). The two unfit patterns were those with the highest drug consumption. The High-Fat-Unfit pattern was the one that had the most significant consumption and had the highest percentage of polymedicated subjects. The Low-Fat-Fit pattern had a significantly lower percentage of people that did not consume any medications. The highest percentages of drug consumption in 7 of the 10 groups that were included were concentrated in the two unfit patterns. CONCLUSIONS: This study highlights the importance of fitness in older adults, as it is at least as important as the avoidance of accumulation of excess fat with respect to the consumption of a smaller number of medicines.

Validity, reliability, and calibration of the physical activity unit 7 item screener (PAU-7S) at population scale.

BACKGROUND: Validation of self-reported tools, such as physical activity (PA) questionnaires, is crucial. The aim of this study was to determine test-retest reliability, internal consistency, and the concurrent, construct, and predictive validity of the short semi-quantitative Physical Activity Unit 7 item Screener (PAU-7S), using accelerometry as the reference measurement. The effect of linear calibration on PAU-7S validity was tested. METHODS: A randomized sample of 321 healthy children aged 8-16 years (149 boys, 172 girls) from the nationwide representative PASOS study completed the PAU-7S before and after wearing an accelerometer for at least 7 consecutive days. Weight, height, and waist circumference were measured. Cronbach alpha was calculated for internal consistency. Test-retest reliability was determined by intra-class correlation (ICC). Concurrent validity was assessed by ICC and Spearman correlation coefficient between moderate to vigorous PA (MVPA) derived by the PAU-7S and by accelerometer. Concordance between both methods was analyzed by absolute agreement, weighted kappa, and Bland-Altman statistics. Multiple linear regression models were fitted for construct validity and predictive validity was determined by leave-one-out cross-validation. RESULTS: The PAU-7S overestimated MVPA by 18%, compared to accelerometers (106.5 ± 77.0 vs 95.2 ± 33.2 min/day, respectively). A Cronbach alpha of 0.76 showed an acceptable internal consistency of the PAU-7S. Test-retest reliability was good (ICC 0.71 p < 0.001). Spearman correlation and ICC coefficients of MVPA derived by the PAU-7S and accelerometers increased from 0.31 to 0.62 and 0.20 to 0.62, respectively, after calibration of the PAU-7S. Between-methods concordance improved from a weighted kappa of 0.24 to 0.50 after calibration. A slight reduction in ICC, from 0.62 to 0.60, yielded good predictive validity. Multiple linear regression models showed an inverse association of MVPA with standardized body mass index (ß - 0.162; p < 0.077) and waist to height ratio (ß - 0.010; p < 0.014). All validity dimensions were somewhat stronger in boys compared to girls. CONCLUSION: The PAU-7S shows a good test-retest reliability and acceptable internal consistency. All dimensions of validity increased from poor/fair to moderate/good after calibration. The PAU-7S is a valid instrument for measuring MVPA in children and adolescents. TRIAL REGISTRATION: Trial registration number ISRCTN34251612 .

Relative sit-to-stand power: aging trajectories, functionally relevant cut-off points, and normative data in a large European cohort.

BACKGROUND: A validated, standardized, and feasible test to assess muscle power in older adults has recently been reported: the sit-to-stand (STS) muscle power test. This investigation aimed to assess the relationship between relative STS power and age and to provide normative data, cut-off points, and minimal clinically important differences (MCID) for STS power measures in older women and men. METHODS: A total of 9320 older adults (6161 women and 3159 men) aged 60-103 years and 586 young and middle-aged adults (318 women and 268 men) aged 20-60 years were included in this cross-sectional study. Relative (normalized to body mass), allometric (normalized to height squared), and specific (normalized to legs muscle mass) muscle power values were assessed by the 30 s STS power test. Body composition was evaluated by dual energy X-ray absorptiometry and bioelectrical impedance analysis, and legs skeletal muscle index (SMI; normalized to height squared) was calculated. Habitual and maximal gait speed, timed up-and-go test, and 6 min walking distance were collected as physical performance measures, and participants were classified into two groups: well-functioning and mobility-limited older adults. RESULTS: Relative STS power was found to decrease between 30-50 years (-0.05 W·kg-1 ·year-1 ; P > 0.05), 50-80 years (-0.10 to -0.13 W·kg-1 ·year-1 ; P < 0.001), and above 80 years (-0.07 to -0.08 W·kg-1 ·year-1 ; P < 0.001). A total of 1129 older women (18%) and 510 older men (16%) presented mobility limitations. Mobility-limited older adults were older and exhibited lower relative, allometric, and specific power; higher body mass index (BMI) and legs SMI (both only in women); and lower legs SMI (only in men) than their well-functioning counterparts (all P < 0.05). Normative data and cut-off points for relative, allometric, and specific STS power and for BMI and legs SMI were reported. Low relative STS power occurred below 2.1 W·kg-1 in women (area under the curve, AUC, [95% confidence interval, CI] = 0.85 [0.84-0.87]) and below 2.6 W·kg-1 in men (AUC [95% CI] = 0.89 [0.87-0.91]). The age-adjusted odds ratios [95% CI] for mobility limitations in older women and men with low relative STS power were 10.6 [9.0-12.6] and 14.1 [10.9-18.2], respectively. MCID values for relative STS power were 0.33 W·kg-1 in women and 0.42 W·kg-1 in men. CONCLUSIONS: Relative STS power decreased significantly after the age of 50 years and was negatively and strongly associated with mobility limitations. Our study provides normative data, functionally relevant cut-off points, and MCID values for STS power for their use in daily clinical practice.

Screen Time and Parents' Education Level Are Associated with Poor Adherence to the Mediterranean Diet in Spanish Children and Adolescents: The PASOS Study.

The aim of this study is to evaluate if screen time and parents' education levels are associated with adherence to a Mediterranean dietary pattern. This cross-sectional study analyzed a representative sample of 3333 children and adolescents (8 to 16 years) included in the Physical Activity, Sedentarism, lifestyles and Obesity in Spanish youth (PASOS) study in Spain (which ran from March 2019 to February 2020). Data on screen time (television, computer, video games, and mobile phone) per day, Mediterranean diet adherence, daily moderate or vigorous physical activity, and parents' education levels were gathered using questionnaires. A descriptive study of the variables according to sex and parents' education level was performed. Logistic regression models (adjusted by sex and weight status) were fitted to evaluate the independent association between screen time and Kids' level of adherence to the Mediterranean diet (KIDMED) index, as well as some of its items. A greater amount of screen time was associated with worse adherence to the Mediterranean diet; a lower consumption of fruit, vegetables, fish, legumes, and nuts; and a greater consumption of fast food, sweets, and candies. A lower parents' education level was associated with worse adherence to the Mediterranean diet. It is necessary to promote the responsible, limited use of screen time, especially in children with parents with a lower education level.

'Fat but powerful' paradox: association of muscle power and adiposity markers with all-cause mortality in older adults from the EXERNET multicentre study.

OBJECTIVES: To assess the influence of muscle power and adiposity on all-cause mortality risk and to evaluate the 'fat but powerful' (F+P) (or 'fat but fit') paradox in older adults. METHODS: A total of 2563 older adults (65‒91 years old) from the EXERNET multicentre study were included. Adiposity (body mass index (BMI), waist circumference, body fat percentage (BF%) and fat index), allometric and relative power (sit-to-stand muscle power test) and various covariates (age, sex, hypertension, smoking status and walking and sitting times per day) were registered at baseline. All-cause mortality was recorded during a median follow-up of 8.9 years. Participants were classified into four groups: lean and powerful (L+P), F+P, lean but weak and fat and weak (F+W). Cox proportional hazard regression models and adjusted HRs were calculated. RESULTS: According to BMI and waist circumference, all-cause mortality risk was reduced in the F+P (HR=0.55 and 0.63, p=0.044 and 0.049, respectively) and L+P (HR=0.57 and 0.58, p=0.043 and 0.025, respectively) groups. According to BF%, all-cause mortality decreased in the L+P group (HR=0.53; p=0.021), and a trend for a reduction was reported in the F+P group (HR=0.57; p=0.060). According to fat index, a survival benefit was only noted in the L+P group (HR=0.50; p=0.049). Higher levels of relative power reduced all-cause mortality risk among older people (HR=0.63 and 0.53, p=0.006 and 0.011, respectively). CONCLUSION: Powerful older people exhibited a reduced 9-year all-cause mortality regardless of BMI, waist circumference and BF%. Obesity according to fat index blunted the survival benefits of being powerful.

Study protocol of a population-based cohort investigating Physical Activity, Sedentarism, lifestyles and Obesity in Spanish youth: the PASOS study.

INTRODUCTION: Physical activity (PA) is essential to healthy mental and physical development in early life. However, the prevalence of physical inactivity, which is considered a key modifiable driver of childhood obesity, has reached alarming levels among European youth. There is a need to update the data for Spain, in order to establish if current measures are effective or new approaches are needed. METHODS AND ANALYSIS: We present the protocol for Physical Activity, Sedentarism, lifestyles and Obesity in Spanish youth (PASOS). This observational, nationally representative, multicentre study aims to determine the PA levels, sedentary behaviours and prevalence of physical inactivity (defined as <60 min of moderate to vigorous PA per day) in a representative sample of Spanish children and adolescents. The PASOS study has recruited a representative random sample of children and adolescents aged 8-16 years from 242 educational centres in the 17 'autonomous regions' into which Spain is divided. The aim is to include a total of 4508 youth participants and their families. Weight, height and waist circumference will be measured by standardised procedures. Adherence to the Mediterranean diet, quality of life, sleep duration, PA and sedentary behaviour are being measured by validated questionnaires. PA is measured by the Physical Activity Unit 7-item Screener. A representative subsample (10% of participants) was randomly selected to wear accelerometers for 9 days to obtain objective data on PA. Parents are asked about their educational level, time spent doing PA, diet quality, self-perceived stress, smoking habit, weight, height, their child's birth weight and if the child was breast fed. ETHICS AND DISSEMINATION: The study was approved by the Ethics Committee of the Fundació Sant Joan de Déu, Barcelona, Spain. Main findings of the study will be disseminated to the scientific community and to general public by media conferences, social media and a website. TRIAL REGISTRATION NUMBER: ISRCTN34251612.

Palm Oil on the Edge.

Internationally recognized Spanish experts in the food industry, nutrition, toxicology, sustainability, and veterinary science met in Madrid on July 2018 to develop a consensus about palm oil (PO) as a food ingredient. Their aim was to provide a useful, evidence-based point of reference about PO. Scientific evidence about the role of PO in food safety, nutrition and sustainability was analyzed. Main conclusions were: (1) RSPO foundation responded to the environmental impact of palm crops. The Amsterdam Declaration pursues the use of 100% sustainable PO in Europe by 2020. Awareness about choosing sustainable products will help to maintain local economies and environments in the producing countries; (2) evidence shows that a moderate intake of PO within a healthy diet presents no risks for health. No evidence justifies any change fat intake recommendations; (3) food industry is interested in assuring safe, sustainable and high-quality products. The use of certified sustainable PO is increasing; and (4) there is no evidence associating PO consumption and higher cancer risk, incidence or mortality in humans. Tolerable daily intake (TDI) for toxic contaminants (2-and 3-monochloropropanediols (MCPDs), glycidyl esters (GEs)) have been established by JECFA and EFSA. Consequently, the European Commission has modified the Contaminants Regulation for GEs and it is still working on 3-MCPDs'.

Cardiometabolic risk through an integrative classification combining physical activity and sedentary behavior in European adolescents: HELENA study.

PURPOSE: This study aims to compare adolescents' cardiometabolic risk score through an integrative classification of physical activity (PA), which involves the combination of moderate-to-vigorous physical activity (MVPA) and sedentary behavior (SB). METHODS: A cross-sectional study derived from the Healthy Lifestyle in Europe by Nutrition in Adolescence Cross-Sectional Study database (2006-2008) was conducted in adolescents (n = 548; boys, 47.3%; 14.7 ± 1.2 years) from 10 European cities. MVPA and SB were objectively measured using accelerometry. Adolescents were divided into 4 categories according to MVPA (meeting or not meeting the international recommendations) and the median of SB time (above or below sex- and age-specific median) as follows: High-SB & Inactive, Low-SB & Inactive, High-SB & Active, and Low-SB & Active. A clustered cardiometabolic risk score was computed using the homeostatic model assessment, systolic blood pressure, triglycerides, total cholesterol/high-density lipoprotein cholesterol, sum 4 skinfolds, and cardiorespiratory fitness (CRF). Analyses of covariance were performed to discern differences on cardiometabolic risk scores among PA categories and each health component. RESULTS: The cardiometabolic risk score was lower in adolescents meeting the MVPA recommendation and with less time spent in SB in comparison to the high-SB & Inactive group (p < 0.05). However, no difference in cardiometabolic risk score was established between High-SB or Low-SB groups in inactive adolescents. It is important to note that CRF was the only variable that showed a significant modification (higher) when children were compared from the category of physically inactive with "active" but not from high- to low-SB. CONCLUSION: Being physically active is the most significant and protective outcome in adolescents to reduce cardiometabolic risk. Lower SB does not exhibit a significant and extra beneficial difference.

Lifestyle patterns and endocrine, metabolic, and immunological biomarkers in European adolescents: The HELENA study.

OBJECTIVE: To evaluate the association of lifestyle patterns related to physical activity (PA), sedentariness, and sleep with endocrine, metabolic, and immunological health biomarkers in European adolescents. METHODS: The present cross-sectional study comprised 3528 adolescents (1845 girls) (12.5-17.5 years) enrolled in the Healthy Lifestyle in Europe by Nutrition in Adolescence Study. Cluster analysis was performed by including body composition, PA by accelerometry, self-reported sedentary behaviors, and sleep duration. We also measured endocrine, metabolic, and immunological biomarkers. RESULTS: Three-cluster solutions were identified: (a) light-PA time, moderate-vigorous-PA time and sedentary time, (b) light-PA time, moderate-vigorous-PA time, sedentary time and sleep time, (c) light-PA time, moderate-vigorous-PA time, sedentary time and body composition. In addition, each cluster solution was defined as: "healthy," "medium healthy," and "unhealthy" according to the presented rating. Analysis of variance showed that overall the healthiest groups from the three clusters analyzed presented a better metabolic profile. A decision tree analysis showed that leptin had a strong association with cluster 3 in both boys and girls, high-density lipoprotein cholesterol had the strongest association with clusters 1 and 3 in boys. Cortisol had the strongest association with cluster 1. HOMA index (homeostatic model assessment) and C3 showed a strong association with cluster 3 in girls. CONCLUSIONS: Our results support the existence of different interactions between metabolic health and lifestyle patterns related to PA, sedentariness, and sleep, with some gender-specific findings. These results highlight the importance to consider multiple lifestyle-related health factors in the assessment of adolescents' health to plan favorable strategies.

Association between Physical Condition and Body Composition, Nutrient Intake, Sociodemographic Characteristics, and Lifestyle Habits in Older Spanish Adults.

In this study, we assessed physical condition and its association with body composition, nutrient intake, sociodemographic characteristics, and lifestyle habits in older Spanish adults. In this cross-sectional study, we investigated 380 individuals (54% women; men aged 55⁻80 years and women aged 60⁻80 years) with no previously documented cardiovascular disease. A general questionnaire was used, and body weight, height, fat, appendicular skeletal muscle mass, and waist circumference were assessed. Physical condition measurements included handgrip strength (HGS) and agility/dynamic balance by eight-foot time up-and-go (8-f TUG) test. The lowest maximum HGS score (kg) was found in older participants, inactive men, and men with abdominal obesity. The highest maximum 8-f TUG score (s) was found in older and inactive, low education, low income, and abdominal obesity and overfat participants; 24.5% of participants had low maximum HGS and 36.8% had a high 8-f TUG score. Sex- and/or age-adjusted odds ratio (OR) for low maximum HGS in women, older participants, overweight and overfat participants were 4.6, 2.9, 0.6 and 0.6 respectively. Sex and/or age adjusted OR for high maximum 8-f TUG in women, overweight, overfat, and abdominally obese participants were 2.4, 1.6, 1.7, and 3.4, respectively; in participants with higher education, those who earned €900 or more per month, and slightly active and active participants had OR values of 0.4, 0.4, and 0.3, respectively. Sarcopenia incidence was 0.3%; however, 4.5% of men and 19.1% of women registered low physical condition (high and low scores in 8-f TUG and HGS tests, respectively). Overall, 36.8%, 24.5%, and 0.3% of participants had high maximum 8-f TUG score, low maximum HGS, and sarcopenia, respectively. Prevalence of these low values varies according to sociodemographic and body composition variables.

[Palm oil and cardiovascular health: considerations to evaluate the literature critically]. / Aceite de palma y salud cardiovascular: consideraciones para valorar la literatura.

Palm oil is obtained from Elaeis guineensis, E. oleifera or the hybrid OxG palm fruits. When crude, it contains high carotenoid concentrations (responsible for the red color), tocopherols and tocotrienols, but most of them are eliminated during its refining. Palm oil main components are palmitic and oleic acids, both near 50%, but their proportion changes depending on the fraction used. Fatty acids absorption and the effect on blood lipid profile depend on the position in the triacylglycerol, especially in the sn-2 position. The location of the monounsaturated or saturated fatty acids varies depending on the type of palm oil or fraction used. We critically review the two main reviews published about palm oil, which analyze 67 publications, and several studies that are more recent. Most of the studies were performed in non-European countries where palm oil is the main culinary oil. The effect on cardiovascular risk factors depends on the fat used as counterpart. Palm oil improves lipid profile after a diet rich in trans and saturated fats, while it impairs lipid profile after a diet rich in monounsaturated and polyunsaturated fats. Relevant methodological errors have been identified, such as not differentiating between palm oil, palm kernel oil and their fractions, comparing single fatty acids with whole oils or fats, or not considering physical activity or other factors that can affect blood lipids. No studies considering palm oil as an ingredient in a Mediterranean diet context, where olive oil is the main culinary oil, were found, so extrapolation of data is currently very difficult.

El aceite de palma se obtiene de los frutos de Elaeis guineensis, E. oleifera y el cruce de ambas, OxG (híbrida). En crudo contiene gran proporción de carotenoides (responsables del color rojo), tocoferoles y tocotrienoles, pero se pierden durante su refinado. En su composición destacan los ácidos grasos palmítico y oleico, casi al 50%, aunque su proporción varía según la fracción en la que se utilizan. La absorción de los ácidos grasos y, por tanto, su efecto sobre el perfil lipídico plasmático dependen de su posición en el triglicérido, especialmente en sn-2. Según el aceite de palma o la fracción, variará dicha posición de los ácidos grasos monoinsaturados o saturados. Se revisan críticamente las dos principales revisiones publicadas en relación al aceite de palma, que incluyen un total de 67 artículos, además de otros estudios más recientes. La mayoría se realizan en países no europeos donde el aceite de palma es el principal aceite culinario. Su efecto sobre el perfil cardiovascular varía según con qué se compare, mejorándolo frente a las grasas trans y saturadas y empeorándolo frente a las grasas mono y poliinsaturadas. Hemosdetectado errores metodológicos importantes, como no diferenciar entre palma, palmiste o fracciones, comparar ácidos grasos con aceites o no considerar la actividad física y otros factores que influyen sobre el perfil lipídico. No hemos encontrado estudios realizados con aceite de palma como ingrediente de alimentos en un contexto de dieta mediterránea, donde el principal aceite culinario es el de oliva, que serían los extrapolables a nuestro entorno.

Dietary Intake and Food Sources of Niacin, Riboflavin, Thiamin and Vitamin B6 in a Representative Sample of the Spanish Population. The Anthropometry, Intake, and Energy Balance in Spain (ANIBES) Study †.

Thiamin, riboflavin, niacin, and vitamin B6 are essential micronutrients that are mainly involved in energy metabolism; they may prevent the occurrence of developmental abnormalities and chronic degenerative and neoplastic diseases. The aim was to analyze dietary intake and food sources of those four nutrients in subjects (n = 2009) aged 9⁻75 years old from the Spanish ANIBES (Anthropometry, Intake, and Energy Balance in Spain) study. Dietary data were collected by means of a validated, photo-based three-day dietary food record. Underreporting was analysed according to the European Food and Safety Authority (EFSA, Parma, Italy) protocol. Mean (max⁻min) reported intake for the whole population of thiamin was 1.17 ± 0.02 mg/day, (0.30⁻3.44 mg/day), riboflavin 1.44 ± 0.02 mg/day, (0.37⁻3.54 mg/day), niacin 29.1 ± 0.2 mg/day (6.7⁻109 mg/day), and vitamin B6 1.54 ± 0.01 mg/day (0.28⁻9.30 mg/day). The main sources of intake for thiamin, niacin, and vitamin B6 were meat and meat products, and for riboflavin were milk and dairy products. An elevated percentage of the Spanish ANIBES population meets the EFSA recommended intakes for thiamin (71.2%), riboflavin (72.0%), niacin (99.0%), and vitamin B6 (77.2%).