Lifestyle Clusters of Diet Quality, Sleep, and Screen Time and Associations with Weight Status in Children from Madrid City: ENPIMAD Study.

BACKGROUND: Childhood overweight and obesity is a global concern and has increased in Spain over the last decades. Combinations of lifestyle behaviors (i.e., diet, sleep, and sedentarism) are highly related to weight status. Therefore, this study aimed to identify lifestyle patterns among children from Madrid City, and analyze associations with the prevalence of overweight, obesity, and abdominal obesity, considering socio-economic factors. METHODS: A cross-sectional analysis was conducted on 4545 children from the ENPIMAD study with data on diet, sleep, anthropometric, and socio-economic variables. K-means cluster analysis was used to identify lifestyle clusters, and logistic regressions were used to examine the associations between socio-economic indicators and cluster membership, and between clusters and weight status. RESULTS: Findings show three lifestyle clusters (healthy, mixed, and unhealthy), with boys and older children more represented in the unhealthy cluster. Food insecurity and low socio-economic status were associated with unhealthier clusters in boys and girls. Children in unhealthier clusters were more likely to have obesity and abdominal obesity. However, these associations disappeared in girls after controlling for food insecurity. CONCLUSION: These results provide insight into the combination of behaviors and socio-economic factors associated with childhood obesity that may aid in the design of future interventions.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

[Weight status in the 6- to 9-year-old school population in Spain: results of the ALADINO 2019 Study]. / Situación ponderal de la población escolar de 6 a 9 años en España: resultados del estudio ALADINO 2019.

INTRODUCTION: Introduction: childhood obesity is a public health problem whose prevalence has grown steadily in recent decades. Objective: to describe the weight status of schoolchildren aged 6 to 9 years in Spain in 2019, and their associated factors. Methods: ALADINO is a cross-sectional study in schoolchildren aged 6 to 9 years, representative of the Spanish population, and aligned with the Child Obesity Surveillance Initative of the WHO Regional Office for Europe. Participants' weight, height, and abdominal circumference were measured, defining weight status according to different standards (WHO, IOTF, and Orbegozo). A questionnaire on lifestyle and socio-demographic characteristics was administered to parents. Results: a total of 16,665 schoolchildren from 276 schools were measured. Excess weight was observed in 40.6 %: 23.3 % overweight and 17.3 % obesity, with obesity being more prevalent in boys and overweight in girls, both increasing with age. The prevalence of abdominal obesity was 22.6 %. Excess weight decreased by 3.9 percentage points since 2011, mainly due to overweight in boys. Obesity remained stable. Excess weight was more prevalent in schoolchildren with less healthy eating and physical activity habits, and in families with a lower socioeconomic status. Conclusions: the prevalence of excess weight is high, although it has declined since 2011 and remains stable since 2015 among schoolchildren aged 6-9 years in Spain, this reduction being mainly due to a decrease in overweight in children. It is necessary to continue promoting healthy habits from the earliest stages of life, thus reducing health inequalities.

INTRODUCCIÓN: Introducción: la obesidad infantil es un problema de salud pública cuya prevalencia no ha dejado de crecer en las últimas décadas. Objetivo: describir la situación ponderal de los escolares de 6 a 9 años en España en 2019, y sus factores asociados. Métodos: ALADINO es un estudio transversal en escolares de 6 a 9 años, representativo de la población española, aplicando la metodología de la Child Obesity Surveillance Initative de la Oficina Regional para Europa de la OMS. Se midieron el peso, la talla y el perímetro abdominal de los participantes, definiendo la situación ponderal según diferentes estándares (OMS, IOTF y Orbegozo). Se pasó a los progenitores un cuestionario sobre estilo de vida y características sociodemográficas. Resultados: se midieron 16.665 escolares de 276 colegios. El 40,6 % presentaban exceso de peso ­23,3 % sobrepeso y 17,3 % obesidad­, siendo la obesidad más prevalente en los niños y el sobrepeso en las niñas, y aumentando ambos con la edad. La prevalencia de la obesidad abdominal era del 22,6 %. El exceso de peso disminuyó 3,9 puntos porcentuales desde 2011, principalmente el sobrepeso de los niños. La obesidad permaneció estable. El exceso de peso fue más prevalente en los escolares con hábitos menos saludables de alimentación y actividad física, y en las familias con menor nivel socioeconómico. Conclusiones: la prevalencia del exceso de peso es elevada, aunque ha descendido desde 2011 y permanece estable desde 2015 entre los escolares de 6 a 9 años en España, debiéndose esta reducción fundamentalmente al descenso del sobrepeso en los niños. Es necesario seguir fomentando hábitos saludables desde las etapas más tempranas, reduciendo las desigualdades en salud.

[Importance of nutrition for immune defense. The role of milk and its natural components]. / Importancia de la nutrición en la defensa inmunitaria. Papel de la leche y sus componentes naturales.

INTRODUCTION: The immune system is a complex and integrated system whose main function is to protect the body from external aggression by microorganisms, allergens, or toxic agents. Different studies show that maintaining optimal amounts of different nutrients in the body is essential to ensure the synthesis of different factors related to the immune system. Most interesting nutrients and bioactive compounds include: vitamins A, B6, B12, C, D, E, folic acid (B9) and biotin (B7); minerals such as zinc, iron, selenium, magnesium and copper; proteins (lactoferrin) and bioactive peptides; omega-3 fatty acids; and other nutrients and bioactive compounds such as fiber, polyphenols, carotenoids, probiotics, etc. Following a varied and balanced diet, including the servings recommended by food guides for each food group, is essential to achieve nutrient requirements. Food groups to which special attention should be paid are: fruits and vegetables (because of their high content in micronutrients and antioxidant compounds), fatty fish (because it contains omega-3 fatty acids), and dairy products (because this group contains a large number of nutrients). In particular, milk-especially enriched milk-contains many of the nutrients mentioned above. Moreover, their daily consumption, within a balanced diet, can help significantly cover their nutrient reference values. Finally, it is important to consider kind of milks as a good dietary alternative to increase the intake of some important nutrients for the proper functioning of the immune system, most especially some of them such as vitamin D, since a large percentage of the population have nutritional deficiencies.

INTRODUCCIÓN: El sistema inmunitario es un sistema complejo e integrado cuya función principal es proteger al organismo de agresiones externas provocadas por microorganismos, alergenos o agentes tóxicos. Diferentes estudios ponen de manifiesto que el mantenimiento de las cantidades óptimas de diferentes nutrientes es esencial para garantizar la síntesis de diferentes factores y mediadores de este sistema. Entre los nutrientes y compuestos bioactivos con mayor interés destacan: las vitaminas A, B6, B12, C, D, E, ácido fólico (B9) y biotina (B7); minerales como el zinc, hierro, selenio, magnesio y cobre; proteínas (lactoferrina) y péptidos bioactivos; ácidos grasos omega-3, y otros nutrientes y compuestos bioactivos como fibra, polifenoles, carotenoides, probióticos, etc. El seguimiento de una dieta variada y equilibrada que incluya las raciones recomendadas por las guías alimentarias para cada grupo de alimentos es fundamental para alcanzar los requerimientos de estos nutrientes. Y entre los grupos de alimentos a los que se debe prestar especial atención están: las frutas y verduras (por su alto contenido en micronutrientes y compuestos antioxidantes), los pescados azules (por contener omega-3) y los lácteos (por ser alimentos con gran cantidad de nutrientes). En concreto, la leche, especialmente enriquecida, contiene muchos de los nutrientes anteriormente mencionados y su consumo diario, dentro de una dieta equilibrada, puede contribuir a cubrir cantidades importantes de sus valores de referencia. Por último, es importante considerar las leches enriquecidas como una buena alternativa dietética para aumentar la ingesta de muchos nutrientes importantes para el buen funcionamiento del sistema inmune y, en especial, de algunos de ellos, como la vitamina D, en los que un gran porcentaje de la población presenta deficiencias nutricionales.

[Involvement of egg antioxidant components in macular protection and vision improvement]. / Implicación de los componentes antioxidantes del huevo en la protección macular y la mejora de la visión.

INTRODUCTION: Age-related macular degeneration (AMD) is an ocular pathology that occurs with excess free radicals, which damages the photoreceptors of the retina producing a disability in the pigment epithelium, which leads, in the most advanced cases, to severe and irreversible vision loss. Lutein and zeaxanthin (L & Z) intake, which are abundant pigments in the macula and have antioxidant and anti-inflammatory action, as well as a role as blue light filter, seem to have a positive effect on the prevention of AMD. These carotenoids cannot be synthesized in the body and must be ingested with the diet. Green leafy vegetables and eggs are the main sources. The former have a higher L & Z content than the latter, but their bioavailability is lower, due to the lipid matrix of the egg yolk, which improves absorption. In relation to the consumption of eggs and AMD prevention, short-term consumption has been associated with an increase in serum concentrations of L & Z, long-term consumption with an increase in the density of macular pigment, and very long- term consumption with a decrease in the risk of developing advanced and neovascular AMD. These facts highlight the advantages of consuming eggs, which should be incorporated into the usual diet in order to minimize the progression of this ocular disease.

INTRODUCCIÓN: La degeneración macular asociada a la edad (DMAE) es una patología ocular que cursa con exceso de radicales libres y que daña los fotorreceptores de la retina, produciendo incapacidad en el epitelio pigmentario, lo que lleva, en los casos más avanzados, a una pérdida de visión severa e irreversible. La ingesta de luteína y zeaxantina (L y Z), que son pigmentos muy abundantes en la mácula y presentan acción antioxidante y antiinflamatoria, así como de filtro de luz azul, parece presentar un efecto positivo en la prevención de la DMAE. Estos carotenoides no pueden ser sintetizados por el organismo y hay que ingerirlos con la dieta, siendo los vegetales de hoja verde y los huevos sus principales fuentes. Los primeros presentan un mayor contenido de L y Z que los segundos, pero su biodisponibilidad es menor debido a la matriz lipídica de la yema del huevo, que hace mejorar su absorción. Con respecto al consumo de huevo y el padecimiento de DMAE, a corto plazo se ha relacionado con un aumento de las concentraciones séricas de L y Z, a largo plazo con un aumento de la densidad del pigmento macular y a muy largo plazo con una disminución del riesgo de desarrollar DMAE avanzada y neovascular, lo que pone de manifiesto las ventajas de consumir este alimento y su recomendación para incorporarlo a la dieta habitual con el fin de minimizar la progresión de esta enfermedad ocular.

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

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

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

[Zinc and its relation to insulin resistance in children]. / El zinc y su relación con la resistencia a la insulina en los niños.

INTRODUCTION: Zinc is an essential trace element involved in catalytic, structural, and regulatory functions, participating also in the metabolism of nutrients. Its role in insulin resistance appears to be of great importance, as it is involved in oxidative stress, the endocrine regulation of insulin, and the regulation of glucose uptake. For this reason, both intake and serum levels of zinc are inversely related to insulin resistance. Currently, zinc intake in children is low, and zinc deficiency exists in a significant proportion. Zinc can be found in meat, fish, eggs, and dairy products. Although it certainly is present in foods of plant origin, their high phytate contents generally reduce its bioavailability. For this reason, it is important to monitor intake throughout childhood, and to consider supplementation in children with insulin resistance or obesity.

INTRODUCCIÓN: El zinc es un oligoelemento esencial involucrado en funciones catalíticas, estructurales y de regulación, además de participar en el metabolismo de los nutrientes. Su función en la resistencia a la insulina parece tener gran importancia, ya que tiene relación con el estrés oxidativo, la regulación endocrina de la insulina y la regulación de la captación de glucosa. Por esta razón, tanto la ingesta como los niveles séricos de zinc se relacionan inversamente con la resistencia a la insulina. A día de hoy, la ingesta de zinc es insuficiente en muchos niños y existe deficiencia de este mineral en una importante proporción. El zinc lo podemos encontrar en carnes, pescados, huevos y lácteos. Aunque es cierto que también existe en los alimentos de origen vegetal, generalmente, su alto contenido en fitatos reduce la biodisponibilidad del zinc. Por esta razón es importante vigilar la ingesta a lo largo de toda la etapa infantil y considerar la suplementación en los niños con resistencia a la insulina u obesidad.

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.