What is the role of particulate matter 2.5 (PM2.5) on excess weight? A cross-sectional study in young Spanish people aged 2─14 years.

PURPOSE: To assess the relationship between particulate matter 2.5 (PM2.5) levels and the prevalence of excess weight in a representative sample of Spanish young people aged 2─14 years. METHODS: This was an ecological cross-sectional study using data from the 2017 wave of the Encuesta Nacional de Salud Española (ENSE), a nationally representative survey of the Spanish young and adult population. The final sample included 4378 young Spanish people (51.0% boys). The weight (kg) and height (cm) of the study participants were proxy-reported by parents or guardians. Excess weight was determined according to the age- and sex-criteria of the International Obesity Task Force. The PM2.5 level was calculated as the annual monitoring data indicator for 2017 among the different regions in Spain. Logistic regression models were performed to estimate the relationships between PM2.5 and weight. RESULTS: Compared to young people located in regions with low levels of PM2.5, those reporting greater odds for excess weight were found in regions with medium PM2.5 (OR = 1.23; 95% CI, 1.02-1.49) and high PM2.5 (OR = 1.35; 95% CI, 1.11-1.64) after adjusting for several sociodemographic, lifestyle and environmental covariates. CONCLUSIONS: The prevalence of excess weight in young people was positively associated with PM2.5 levels in Spain. This finding supports the hypothesis that air pollution exposure can result in excess weight in the young population, which, in turn, might lead to the development of metabolic disorders. From a socioecological perspective, a practical need to take environmental factors into consideration is important to address unhealthy weight in Spanish young people.

Physical fitness and disordered eating among adolescents: Results from the EHDLA study.

The aim of this study was to examine the association between a comprehensive spectrum of physical fitness components and disordered eating symptoms in a sample of Spanish adolescents. This cross-sectional study analysed a representative sample of 741 adolescents (55.1% girls) from the Eating Healthy and Daily Life Activities (EHDLA) study (Valle de Ricote, Region of Murcia, Spain). Objective physical fitness (i.e., cardiorespiratory fitness, upper body strength, lower body strength, speed-agility, and flexibility) was assesed by the ALPHA-FIT Test Battery for a young population. Disordered eating symptoms were assessed with the Sick, Control, One, Fat, Food (SCOFF) questionnaire. An incremental inverse association was found in participants with low cardiorespiratory fitness (OR = 2.33; 95% CI: 1.56-3.50), low handgrip strength (OR = 1.99; 95% CI: 1.33-2.97), low lower body strength (OR = 1.91; 95% CI: 1.28-2.86), low speed-agility (OR = 1.75; 95% CI: 1.17-2.62), and low global physical fitness (OR = 2.03; 95% CI: 1.37-3.01) and disordered eating symptoms, compared to participants with a high level of each of these physical fitness components. Our study provides evidence that, in Spanish adolescents, disordered eating symptoms are inversely associated with a comprehensive set of physical fitness components. Hence, it could be relevant to promote physical fitness, e.g., by a multifactorial approach, since it seems to be related to lower disordered eating symptoms in adolescents.

[Assessment of the eating habit in the health-related lifestyle among Spanish adults from 22 to 72 years of age]. / Valoración del hábito de alimentación en el estilo de vida saludable adquirido en adultos españoles de 22 a 72 años de edad.

Introduction: Introduction: eating habits are one of the main predictors of health within a person lifestyle. The assessment of these habits will be essential to confirm health-related habits and orientate behaviors of risk for health. Objectives: to assess the eating habits within the health-related lifestyle among Spanish adults from 22 to 72 years of age. Methods: the Health-Related Lifestyle Assessment Scale (E-VEVSA) was applied to a sample of 788 subjects between the ages of 22 and 72. This scale is made up of 52 items and structured in seven dimensions, among which the healthy eating habit was evaluated, which explained a variance of 8.67 % of the total scale (66.87 %) and a Cronbach's alpha of 0.794 for a total alpha of 0.894. Results: sixteen percent of the adults surveyed have healthy eating habits, 68.3 % tend towards health and 15.7 % are unhealthy. Pearson's 2 tests show a positive and significant association of women with healthy eating habits and a significant improvement with age. The inferential data (Student's t-tests and one-factor ANOVA) confirm these differences according to gender and age. Conclusions: it is necessary to promote preventive programs to improve eating habits in the adult population, especially in the 15.7 % that have an unhealthy level of nutrition in their lifestyle.

Introducción: Introducción: los hábitos de alimentación constituyen uno de los factores predictores de salud principales dentro de los estilos de vida adquiridos. La evaluación de dichos hábitos va a ser fundamental para poder reafirmar las conductas saludables y reorientar aquellos hábitos que supongan un riesgo. Objetivos: evaluar el hábito de alimentación dentro del estilo de vida saludable adquirido en adultos españoles de 22 a 72 años de edad. Métodos: a una muestra de 788 sujetos de edades comprendidas entre los 22 y los 72 años de edad se aplicó la Escala de Valoración del Estilo de Vida Saludable Adquirido (E-VEVSA), formada por 52 ítems y estructurada en siete dimensiones, entre las cuales se evaluó el hábito de alimentación saludable, que explicó una varianza de 8,67 % sobre el total de la escala (66,87 %) y un alfa de Cronbach de 0,794 para un alfa total de 0,894. Resultados: el 16 % de los adultos encuestados posee hábitos de alimentación saludables; el 68,3 %, tendente hacia la salud; y el 15,7 %, poco saludables. Las pruebas de 2 de Pearson muestran una asociación positiva y significativa de las mujeres con hábitos saludables de alimentación y una mejora significativa con el transcurso de la edad. Los datos inferenciales (pruebas t de Student y ANOVA de un factor) confirman estas diferencias en función del sexo y la edad. Conclusiones: es necesario promover programas preventivos para la mejora de los hábitos de alimentación en la población adulta, sobre todo, en el 15,7 % que posee un nivel poco saludable de la alimentación en su estilo de vida.

Health-related lifestyle assessment among Spanish adults from 22 to 72 years. / Valoración del estilo de vida saludable adquirido en adultos españoles de 22 a 72 años de edad.

OBJECTIVE: The objective of this paper has focused on assessing the level of health-related lifestyle acquired in Spanish adults in the Spanish cities of Albacete and Murcia, and analyzing the existing differences according to sex and age. MATERIAL AND METHODS: On a sample of 788 subjects aged between 22 and 72, the Health-related Lifestyle Assessment Scale was applied, consisting of 52 items and structured in 7 dimensions that explained a total variance of 66.87% and a Cronbach's alpha of 0.894. RESULTS: A percentage of 12 of the adults surveyed have a healthy lifestyle, 53% show a trend to health and 35% poor or unhealthy. Pearson's χ2 tests show a positive and significant association of women with health and a trend of significant improvement in lifestyle with age. The inferential data (t-Student tests and one-factor ANOVA) confirm these differences according to gender and age. CONCLUSIONS: It is necessary to promote preventive programs to improve health in the habits of the population, especially in the 35% that show a poor or unhealthy level of lifestyle.

[Evolution of the diet and physical activity of university students after the COVID-19 pandemic]. / Evolución de la dieta y la actividad física de los estudiantes universitarios tras la pandemia de COVID-19.

Introduction: Objective: to assess the evolution of adherence to Mediterranean diet and level of physical activity of university students of Health Sciences in Castilla-La Mancha during the COVID-19 lockdown and one year afterwards. Methods: a cross-sectional observational study using questionnaires on adherence to the Mediterranean diet and level of physical activity. A total of 893 students enrolled in Health Sciences degrees at the University of Castilla la Mancha participated, 575 in the first survey (during the lockdown) and 318 in the second (one year later). By sex, 672 women and 221 men (in the first survey 77.7 % were women and 22.3 % men while in the second survey these were 70.8 % and 29.2 %, respectively). Adherence to the Mediterranean diet was assessed with the Mediterranean Diet Adherence Screener (MEDAS) questionnaire and the modified Prevention with Mediterranean Diet (PREDIMED) questionnaire. The level of physical activity was assessed with the Rapid Assessment of Physical Activity Scale (RAPA). Results: one year after the COVID-19 confinement, consumption of olive oil has almost tripled. Daily fruit consumption has also doubled. Similarly, the consumption of wine and alcoholic beverages has doubled. Conversely, there was a reduction in the consumption of butter and margarine, as well as of carbonated drinks and sweetened beverages. Likewise, the percentage of university students with high adherence to the Mediterranean diet increased significantly (from 26 % to 34.3 %). Regarding physical activity level, there was a significant increase in the percentage of university students who engaged in light, moderate and even intense physical activity on an irregular basis. This increase was not found in the case of muscular strength and flexibility training activities. Conclusion: the results of the study indicate that, although the levels of adherence to the Mediterranean diet and physical activity have improved after the COVID-19 confinement, adherence to Mediterranean diet and physical activity level among the university population analyzed is still low. It is necessary to implement strategies for the achievement or maintenance of a healthy lifestyle in this population.

Introducción: Objetivo: valorar la evolución de la adherencia a la dieta mediterránea y el nivel de actividad física de los estudiantes universitarios de Ciencias de la Salud de Castilla-La Mancha durante la pandemia de COVID-19 y un año después de la misma. Método: estudio observacional transversal mediante cuestionarios sobre la adherencia a la dieta mediterránea y el nivel de actividad física. Participaron 893 alumnos matriculados en grados de Ciencias de la Salud de la Universidad de Castilla-La Mancha, 575 en la primera encuesta (durante la pandemia) y 318 en la segunda (un año después). Por sexos, 672 mujeres y 221 hombres (en la primera encuesta, el 77,7 % eran mujeres y el 22,3 % hombres, mientras que en la segunda lo eran el 70,8 % y 29,2 %, respectivamente). La adherencia a la dieta mediterránea se valoró con el cuestionario Mediterranean Diet Adherence Screener (MEDAS) y el cuestionario de Prevención con Dieta Mediterránea (PREDIMED), modificado. El nivel de actividad física se valoró con el cuestionario Rapid Assessment of Physical Activity Scale (RAPA). Resultados: tras un año desde el confinamiento por la COVID-19, el consumo de aceite de oliva casi se ha triplicado. Se ha duplicado también el consumo de frutas diario. De igual modo, se ha duplicado el consumo de vino y bebidas alcohólicas. Por el contrario, se encontró una reducción del consumo de mantequilla y margarina, al igual que de bebidas carbonatadas y azucaradas. Asimismo, aumentó significativamente el porcentaje de estudiantes universitarios con adherencia alta a la dieta mediterránea (del 26 % al 34,3 %). En cuanto al nivel de actividad física, ha aumentado significativamente el porcentaje de estudiantes universitarios que realizan actividad fisica ligera, moderada e incluso intensa de forma irregular. Este aumento no se ha encontrado en el caso de las actividades de fuerza muscular y flexibilidad. Conclusión: los resultados del estudio nos indican que, aunque los niveles de adherencia a la dieta mediterránea y de actividad física han mejorado tras el confinamiento por la COVID-19, la adherencia a la dieta mediterránea y el nivel de actividad física de la población universitaria analizada siguen siendo bajos. Es necesario aplicar estrategias para la consecución o mantenimiento de un estilo de vida saludable en dicha población.

Physical activity as a mediator of the association of body mass index change with anxiety/depression symptoms in Brazilian adults during COVID-19.

BACKGROUND: the COVID-19 pandemic has impacted people's behaviors and mental health around the world. AIM: to verify the mediating role of physical activity (PA) level in the relationship between body mass index (BMI) and anxiety and depression symptoms. METHODS: this is a cross-sectional study with Brazilian adults aged ≥ 18 years (n = 2,000, 59.6 % women) selected by the nonprobabilistic snowball method through digital means of communication (WhatsApp®, Telegram®, Facebook®, Twitter®, e-mails). Linear regression models were fitted for PA level mediation analyses in the relationship between BMI and anxiety/depression symptoms. RESULTS: significant differences were found between the active/not overweight group and the other three groups (active/overweight, insufficiently active/not overweight and insufficiently active/overweight [p < 0.001]) for anxiety/depression after adjusting for age, gender, chronic diseases, alcohol consumption, and smoking. When testing the mediating role of daily PA in the association between BMI and anxiety/depression symptoms, BMI was negatively associated with daily PA in the first regression equation (p < 0.001); in the second, BMI was positively related to anxiety/depression symptoms (p < 0.001); and in the third, daily PA showed an inverse relationship with anxiety/depression symptoms (p < 0.001), and although BMI remained negatively associated with anxiety/depression symptoms, these associations maintained their statistical significance. CONCLUSIONS: the results suggest that the effect of BMI on anxiety and depression was partially mediated by daily PA.

Overall proportion of orthorexia nervosa symptoms: A systematic review and meta-analysis including 30 476 individuals from 18 countries.

Background: To date, no previous meta-analysis has determined the overall proportion of orthorexia nervosa symptoms on a global scale. The aim of the present study was 2-fold: first, to establish the overall proportion of orthorexia nervosa symptoms on a global scale, assessed with the ORTO-15 questionnaire; and second, to determine the role of sex, type of population, mean age, body mass index, and the temporal trend in relation to orthorexia nervosa symptoms. Methods: Four databases were searched (PubMed, Scopus, Web of Science, and Cochrane Database of Systematic Reviews) with date limits from January 2005 to June 2023. Studies assessing the proportion of orthorexia nervosa assessed using the ORTO-15 questionnaire with a cutoff of <35 or <40 points were included in this review. Results: The overall proportion of orthorexia nervosa symptoms (using the cutoff <35 points) was 27.5% (95% confidence interval (CI) = 23.5-31.6, I2 = 97.0%). In addition, no significant differences were observed between females (34.6%, 95% CI = 29.5-39.8, I2 = 96.1%) and males (32.1%, 95% CI = 26.5-38.1, I2 = 93.1%). According to the type of population, the highest overall proportion was found in people focused on sports performance or body composition (34.5%, 95% CI = 23.1-47.0, I2 = 98.0%). Notwithstanding, caution should be exercised in interpreting this result, as reverse causality could be a potential pitfall in this relationship. Conclusions: We found that approximately three out of 10 study participants showed orthorexia nervosa symptoms according to the ORTO-15 tool. This overall proportion was higher in those participants who were athletes or fitness practitioners. Over the years, the proportion of orthorexia nervosa symptoms seems to be increasing. These high percentages and their increase are worrisome from a public health perspective and highlight the need to develop psychometric instruments to aid in clinical diagnosis and treatment efficacy. Registration: PROSPERO (CRD42022350873).

Research on Diet and Human Health.

One of the major public health challenges is the global burden and threat of noncommunicable diseases (NCDs) [...].

Breakfast and psychosocial behavioural problems in young population: The role of status, place, and habits.

The aim of this study was to examine whether breakfast status, place and habits are associated with psychosocial behavioural problems in a nationally representative sample of young people aged 4-14 years residing in Spain. This study analysed secondary data from the Spanish National Health Survey (2017), including 3,772 Spanish children and adolescents. Breakfast status, place, and habits were assessed by ad hoc questions answered by parents/guardians. The Strengths and Difficulties Questionnaire (SDQ) parents' version form was applied to evaluate the psychosocial health of their children. Skipping breakfast and eating breakfast out of home were linked to greater odds of psychosocial behavioural problems (skipping breakfast: OR = 3.29; CI 95%, 1.47-7.35; breakfast out of home: OR = 2.06; CI 95%, 1.27-3.33) than eating breakfast at home. Similarly, not consuming coffee, milk, tea, chocolate, cocoa, yogurt, etc., for breakfast was related to greater odds of psychosocial behavioural problems (OR = 1.76; CI 95%, 1.21-2.55). This association was also found for those who did not eat bread, toast, cereals, pastries, etc., for breakfast (OR = 1.31; CI 95%, 1.01-1.73). Conversely, not consuming eggs, cheese, ham, etc., was associated with lower odds of psychosocial behavioural problems (OR = 0.56; CI 95%, 0.38-0.83). Our results show that eating breakfast (specifically at home) and breakfast habits related to the intake of certain food/beverages groups were associated with higher or lower odds of psychosocial behavioural problems.

Physical activity and its association with Mediterranean diet patterns among Spanish university students.

Introduction: Objective: the aim of the present study was to assess the level of physical activity and its association with Mediterranean dietary patterns in university students of health sciences at Universidad de Castilla-La Mancha (Spain). Method: a cross-sectional study was performed through an online survey. The final sample consisted of 555 university students (78.2 % females). Adherence to Mediterranean diet was assessed using the 14-item Mediterranean Diet Adherence Screener (MEDAS). To measure physical activity, the Rapid Assessment of Physical Activity Scale (RAPA) questionnaire was used. Results: according to physical activity, 2.5 % of the participants were considered active and 35.1 % did both strength and flexibility activities. A greater association was seen between intake of fruits (OR = 1.95; 95 % CI, 1.25-3.04), pulses (OR = 1.51; 95 % CI, 1.00-3.20), and nuts (OR = 1.99; 95 % CI, 1.33-2.99) in those considered sufficiently active. Similarly, we found a significant relationship between the intake of fruits (OR = 2.28; 95 % CI, 1.49-3.47), pulses (OR = 1.41; 95 % CI, 1.00-2.08), nuts (OR = 1.96; 95 % CI, 1.34-2.86), and fish/seafood (OR = 1.67; 95 % CI, 1.15-2.43) in those who engaged in both strength and flexibility activities. Conclusion: this study suggests that consumption of certain Mediterranean foods was associated with higher levels of physical activity in a sample of Spanish university students.

Introducción: Objetivo: el objetivo del presente estudio fue evaluar el nivel de actividad física y su asociación con la dieta mediterránea en estudiantes universitarios de ciencias de la salud de la Universidad de Castilla-La Mancha (España). Método: se realizó un estudio transversal a través de una encuesta online. La muestra final estuvo formada por 555 estudiantes universitarios (78,2 % mujeres). La adherencia a la dieta mediterránea se evaluó mediante el evaluador de adherencia a la dieta mediterránea de 14 ítems (MEDAS). Para medir la actividad física se utilizó el cuestionario Rapid Assessment of Physical Activity Scale (RAPA). Resultados: de acuerdo con la actividad física, el 2,5 % de los participantes se consideraron activos y el 35,1 % realizaban actividades tanto de fuerza como de flexibilidad. Se observó una mayor asociación entre la ingesta de frutas (OR = 1,95; IC 95 %, 1,25-3,04), legumbres (OR = 1,51; IC 95 %, 1,00-3,20) y frutos secos (OR = 1,99; IC 95 %, 1,33-2,99) en aquellos considerados suficientemente activos. Asimismo, encontramos una relación significativa entre la ingesta de frutas (OR = 2,28; IC 95 %, 1,49-3,47), legumbres (OR = 1,41; IC 95 %, 1,00-2,08), frutos secos (OR = 1,96; IC 95 %, 1,34-2,86) y pescado/marisco (OR = 1,67; IC 95 %, 1,15-2,43), en aquellos que participaron en actividades de fuerza y flexibilidad. Conclusión: este estudio sugiere que el consumo de determinados alimentos mediterráneos se asocia a mayores niveles de actividad física en la muestra de universitarios españoles analizada.

[Perception of loneliness, happiness, and health, and quality of diet. The moderator role of weight status]. / Percepción de soledad, felicidad y salud, y calidad de la dieta. El rol moderador del estado ponderal.

INTRODUCTION: Aim: to determine the relationship between perceived loneliness, happiness, and health, and quality of diet, observing the moderator role of weight status in elementary school children during the state of alarm decreed for COVID-19. Methods: a descriptive, cross-sectional study in a sample of 116 Spanish schoolchildren. The perception of loneliness, happiness, and health was assessed using three items of the Health Behavior in School-aged Children questionnaire. The quality of their Mediterranean diet was assessed using the Mediterranean Diet Quality Index quetsionnaire for children and adolescents. Anthropometric variables were collected through a self-reported questionnaire, and for the calculation of body mass index the Quetelet index (kg/m2) was used. Results: the descriptive analysis showed no differences in the perception of loneliness, happiness, or health, quality of diet, or anthropometric variables (p > 0.005), except for weight (p < 0.005), according to sex. The inferential analysis showed that higher values in quality of diet are correlated with higher scores in perceived happiness and health (p < 0.005). In turn, the linear regression test showed an association between quality of diet and perception of happiness after the model was adjusted for normal weight (R2 = 0.382; p < 0.005). Likewise, it showed a significant association between quality of diet and perception of health after the model was adjusted for overweight schoolchildren (R2 = 0.455; p < 0.005). Conclusion: the association between perceived health and happiness with quality of diet seems to be moderated by weight status.

INTRODUCCIÓN: Objetivo: determinar la relación existente entre la percepción de soledad, felicidad y salud, y la calidad de la dieta, observando el rol moderador del estado ponderal en escolares de primaria durante el estado de alarma decretado por la COVID-19. Métodos: estudio descriptivo transversal de una muestra de 116 escolares españoles. Las percepciones de soledad, felicidad y salud se valoraron mediante tres ítems del cuestionario Health Behavior in School-aged Children. La calidad de la dieta mediterránea se valoró a través del cuestionario Índice de calidad de la dieta mediterránea en niños y adolescentes. Las variables antropométricas se recogieron a través de un cuestionario autoinformado y para el cálculo del índice de masa corporal se empleó el índice de Quetelet (kg/m2). Resultados: el análisis descriptivo no mostró diferencias en la percepción de soledad, felicidad y salud, la calidad de la dieta, y las variables antropométricas (p > 0,005), a excepción del peso (p < 0,005), según el sexo. El análisis inferencial mostró que los valores más elevados en la calidad de la dieta se correlacionan con valores más altos en la percepción de felicidad y de salud (p < 0,005). Por su parte, la prueba de la regresión lineal mostró asociación entre la calidad de la dieta y la percepción de felicidad tras ajustarse el modelo al normopeso (R2 = 0,382; p < 0,005). Asimismo, mostró una asociación significativa entre la calidad de la dieta y la percepción de salud tras ajustarse el modelo a los escolares con sobrepeso (R2 = 0,455; p < 0,005). Conclusión: la asociación entre la percepción de salud y de felicidad con la calidad de la dieta parece estar moderada por el estado del peso.

Dietary Patterns, Adherence to the Food-Based Dietary Guidelines, and Ultra-Processed Consumption During the COVID-19 Lockdown in a Sample of Spanish Young Population.

Purpose: The aim of this study was to explore the dietary patterns, adherence to Food-Based Dietary Guidelines, and the ultra-processed consumption during the COVID-19 lockdown among a Spanish young population aged 3-17 years. Methods: Parents/legal guardians of preschoolers, children, and adolescents aged 3-17 years were enrolled through social networks. The eating habits were assessed by a Food Propensity Questionnaire applied in the ENALIA (Encuesta Nacional de Alimentación en la población Infantil y Adolescente) Spanish survey, which aims to collect food intake information and other data about eating habits on children and adolescents (0-18 years old). Participants were dichotomized following the Food-Based Dietary Guidelines for the Spanish young population offered by the Spanish Society of Community Nutrition. The ultra-processed food score was determined following the principles established in the NOVA classification. Results: Data from 604 children and adolescents were included. An association between age group and the recommendations of snacks (p = 0.002), fruits (p = 0.010), and diaries (p < 0.001) was found. Adolescents showed a lower mean compliance with these guidelines than children (p = 0.004) and preschoolers (p < 0.001). Similarly, children reported lower Food-Based Dietary Guidelines than preschoolers (p = 0.015). Regarding ultra-processed consumption, it was also observed a higher intake in adolescents than in children (p = 0.037), as well as in preschoolers (p < 0.001). Conclusions: The associations that were found highlight the low proportion of the young population (especially adolescents) meeting the Food-Based Dietary Guidelines and the high consumption of ultra-processed foods during COVID-19 lockdown.

[Assessment of adherence to the Mediterranean diet in university Health Sciences students and its relationship with level of physical activity]. / Valoración de la adherencia a la dieta mediterránea en estudiantes universitarios de Ciencias de la Salud y su relación con el nivel de actividad física.

INTRODUCTION: Objective: to assess the degree of adherence to the Mediterranean diet and the practice of physical activity in university Health Sciences students in Castile-La Mancha. Methods: this was a cross-sectional, observational study by means of a dietary and physical activity survey. The sample consisted of 575 university students (77.7 % women). An initial data collection survey was developed using the Google Forms platform (https://www.google.com/forms/about/). Adherence to the Mediterranean diet was assessed with the Mediterranean Diet Adherence Screener (MEDAS) questionnaire and the modified Prevention with Mediterranean Diet (PREDIMED) questionnaire. The Rapid Assessment of Physical Activity Scale (RAPA) questionnaire was used to measure physical activity. Results: we found a 58.3 % adherence to Mediterranean diet among Health Sciences students, with 38.6 % of average adherence, and 5.0 % of poor adherence, with a low consumption of fruits with no gender differences, and a high consumption of red or processed meat and butter or cream with significant differences between women and men. There is also a high consumption of carbonated beverages (more frequent in women). Likewise, a high percentage of students (22.5 %) do practically no physical activity. As for physical exercise, it is always higher in men, with significant differences (p > 0.05). Conclusion: this study suggests that the sample of university Health Sciences students in Castile-La Mancha shows an acceptable adherence to the Mediterranean diet and insufficient levels of physical activity.

INTRODUCCIÓN: Objetivo: valorar el grado de adherencia a la dieta mediterránea y la práctica de actividad física en estudiantes universitarios de Ciencias de la Salud de Castilla-La Mancha. Método: estudio observacional transversal mediante encuesta alimentaria y de actividad física. La muestra contó con 575 estudiantes universitarios (77,7 % de mujeres). Se desarrolló una encuesta de recogida de datos inicial mediante la plataforma Google Forms (https://www.google.com/forms/about/). La adherencia a la dieta mediterránea se valoró con el cuestionario Mediterranean Diet Adherence Screener (MEDAS) y el cuestionario PREvención con DIeta MEDiterránea (PREDIMED), modificado. Para medir la actividad física se utilizó el cuestionario Rapid Assessment of Physical Activity Scale (RAPA), que valora la actividad física desempeñada. Resultados: se encontró en los estudiantes de Ciencias de la Salud una adherencia a la dieta mediterránea del 58,3 %, siendo la adherencia media del 38,6 % y la mala adherencia del 5,0 %, observándose un bajo consumo de frutas sin diferencias de sexo, un alto consumo de carne roja o procesada y de mantequillas o natas, con diferencias significativas entre mujeres y hombres. También hay un consumo alto de bebidas carbonatadas (más frecuente en mujeres). Asimismo, un porcentaje alto de estudiantes (22,5 % del total) no hace prácticamente ninguna actividad física. En cuanto al ejercicio físico, siempre es mayor entre los hombres, con diferencias significativas (p > 0,05). Conclusión: este estudio sugiere que la muestra de estudiantes universitarios de Ciencias de la Salud de Castilla-La Mancha presenta una aceptable adherencia a la dieta mediterránea y unos niveles de actividad física insuficientes.

Cardiorespiratory Fitness as Mediator of the Relationship of Recreational Screen Time on Mediterranean Diet Score in Schoolchildren.

BACKGROUND: Studies have reported the association between cardiorespiratory fitness and higher adherence to the Mediterranean diet as well as lower recreational screen time. Similarly, higher screen time has been negatively linked to a lower adherence to the Mediterranean diet. However, the mediator effect of cardiorespiratory fitness on the influence of screen time on adherence to the Mediterranean diet is still unknown. The aim of this study was two-fold: first, to assess the combined association of recreational screen time and cardiorespiratory fitness with adherence to Mediterranean diet among Spanish schoolchildren, and second, to elucidate whether the association between recreational screen time and adherence to the Mediterranean diet is mediated by cardiorespiratory fitness. METHODS: A descriptive and cross-sectional study was conducted. A total of 370 schoolchildren aged 6-13 years from six schools in the Region of Murcia (Spain) were included. RESULTS: The mediation analysis showed that once screen time and cardiorespiratory fitness were included together in the model, cardiorespiratory fitness was positively linked to adherence to the Mediterranean diet (p = 0.020) and although screen time remained negatively related to adherence to the Mediterranean diet, this association was slightly attenuated (indirect effect = -0.027; 95% CI = (-0.080, -0.002)). CONCLUSIONS: This research supports that cardiorespiratory fitness may reduce the negative association between screen time and Mediterranean dietary patterns.

Sociodemographic Correlates of Obesity among Spanish Schoolchildren: A Cross-Sectional Study.

Some studies have been conducted in order to assess the association between weight status (assessed by body mass index) and socio-demographic factors. Nevertheless, only a few of them have indicated these associations by other anthropometric parameters (e.g., skinfolds). The aim of this study was to determine, compare, and examine the influence of age, sex, type of the schooling, per capita income, area of residence, and immigrant status on obesity parameters in schoolchildren aged 6-13 from the Region of Murcia. A cross-sectional study was carried out in six different Primary schools of the Region of Murcia (Spain). A total sample of 370 children (166 girls) aged 6-13 (8.7 ± 1.8) were selected. In order to determine participants' body composition, body mass index, waist circumference, waist-to-height ratio, and skinfold measurements were calculated. Higher associations of excess of weight (OR = 1.96; 95%CI = 1.19-3.20) and abdominal obesity (OR = 3.12; 95CI% = 1.49-6.94) were shown in the case of children from public schools. A greater association of high trunk fat mass was found in children from municipalities with high per capita income (OR = 3.20; 95%CI = 1.05-9.77). Therefore, lower association of having an inadequate %BF was found in the participants aged 6-9 (OR = 0.38; 95%CI = 0.24-0.54), and immigrant students (OR = 2.63; 95%CI = 1.69-4.10). Our study suggested that overweight/obesity among schoolchildren in the Region of Murcia is higher than the overall prevalence of Spain. The results of the adjusted analyses showed that age, type of schooling, per capita income, and immigrant status were associated with obesity parameters.

Valoración del hábito de alimentación en el estilo de vida saludable adquirido en adultos españoles de 22 a 72 años de edad / Assessment of the eating habit in the health-related lifestyle among Spanish adults from 22 to 72 years of age

Introducción: los hábitos de alimentación constituyen uno de los factores predictores de salud principales dentro de los estilos de vida adqui-ridos. La evaluación de dichos hábitos va a ser fundamental para poder reafirmar las conductas saludables y reorientar aquellos hábitos quesupongan un riesgo.Objetivos: evaluar el hábito de alimentación dentro del estilo de vida saludable adquirido en adultos españoles de 22 a 72 años de edad.Métodos: a una muestra de 788 sujetos de edades comprendidas entre los 22 y los 72 años de edad se aplicó la Escala de Valoración delEstilo de Vida Saludable Adquirido (E-VEVSA), formada por 52 ítems y estructurada en siete dimensiones, entre las cuales se evaluó el hábitode alimentación saludable, que explicó una varianza de 8,67 % sobre el total de la escala (66,87 %) y un alfa de Cronbach de 0,794 para unalfa total de 0,894.Resultados: el 16 % de los adultos encuestados posee hábitos de alimentación saludables; el 68,3 %, tendente hacia la salud; y el 15,7 %, pocosaludables. Las pruebas de χ2 de Pearson muestran una asociación positiva y significativa de las mujeres con hábitos saludables de alimentacióny una mejora significativa con el transcurso de la edad. Los datos inferenciales (pruebas t de Student y ANOVA de un factor) confirman estasdiferencias en función del sexo y la edad.Conclusiones: es necesario promover programas preventivos para la mejora de los hábitos de alimentación en la población adulta, sobre todo,en el 15,7 % que posee un nivel poco saludable de la alimentación en su estilo de vida.(AU)

Introduction: eating habits are one of the main predictors of health within a person lifestyle. The assessment of these habits will be essentialto confirm health-related habits and orientate behaviors of risk for health.Objectives: to assess the eating habits within the health-related lifestyle among Spanish adults from 22 to 72 years of age.Methods: the Health-Related Lifestyle Assessment Scale (E-VEVSA) was applied to a sample of 788 subjects between the ages of 22 and 72.This scale is made up of 52 items and structured in seven dimensions, among which the healthy eating habit was evaluated, which explained avariance of 8.67 % of the total scale (66.87 %) and a Cronbach’s alpha of 0.794 for a total alpha of 0.894.Results: sixteen percent of the adults surveyed have healthy eating habits, 68.3 % tend towards health and 15.7 % are unhealthy. Pearson’sχ2 tests show a positive and significant association of women with healthy eating habits and a significant improvement with age. The inferentialdata (Student’s t-tests and one-factor ANOVA) confirm these differences according to gender and age.Conclusions: it is necessary to promote preventive programs to improve eating habits in the adult population, especially in the 15.7 % that havean unhealthy level of nutrition in their lifestyle.(AU)

Mediterranean diet, weight status and physical activity in schoolchildren of the Region of Murcia. / Dieta mediterránea, estado de peso y actividad física en escolares de la Región de Murcia.

INTRODUCTION: Childhood and adolescence are key stages to promote a healthy lifestyle. OBJECTIVE: To analyze the relationship between weight status, physical activity and the Mediterranean diet in schoolchildren in the Region of Murcia. METHODS: Cross-sectional descriptive study with 520 schoolchildren aged 8-17 years. The weight status was calculated through the body mass index. The Mediterranean diet was found through the KIDMED questionnaire and physical activity was estimated using the IPAQ-C and IPAQ-A questionnaires. RESULTS: The Mediterranean diet is not significantly associated with sex (P<.537) or weight status (P<.417) but it maintains a relationship of dependence with age (P<.010) and the level of physical activity (P<.000). Schoolchildren in normal weight and assets have a greater follow-up to the Mediterranean diet than their overweight and sedentary peers (P<.000). CONCLUSION: The Fat but fit phenomenon applied to the Mediterranean diet is confirmed.

Trastornos adaptativos y su manejo desde atención primaria / Adaptive disorders and their management in primary care

Introducción: El trastorno de adaptación describe una respuesta emocional y conductual desproporcionada a uno o más estresores psicosociales identificables. Existen múltiples situaciones capaces de generarnos una situación de estrés agudo. Sin embargo, uno de los requisitos necesarios para poder hablar de trastorno adaptativo es que ese o esos factores estresantes supongan un deterioro en el funcionamiento normal del individuo. Objetivos: El objetivo principal de este trabajo es analizar, mediante una revisión bibliográfica, el diagnóstico y abordaje de los trastornos adaptativos dentro del ámbito de Atención Primaria. El objetivo secundario es destacar la importancia de la detección y el tratamiento precoces, así como de la gestión multidisciplinar y la promoción de la salud mental. Resultados: Los principales factores de riesgo de los trastornos adaptativos son el desempleo, los bajos ingresos,el escaso apoyo social, las enfermedades físicas y la salud mental. La prevalencia es mayor en jóvenes,especialmente entre las mujeres, y existe un riesgo aumentado de suicidio en el subtipo de estado de ánimo depresivo. El Cuestionario Internacional de Trastornos Adaptativos es actualmente la principal herramienta diagnóstica, por establecer sus criterios diagnósticos en base a la definición teórica establecida por la CIE-11. El manejo de estos trastornos se realiza principalmente mediante terapia cognitivo-conductual. Conclusiones: Los trastornos de adaptación surgen como respuestas anormales ante ciertas situaciones estresantes. El papel de los médicos de Atención Primaria en el abordaje de este trastorno es primordial, siendo necesaria su detección y manejo precoz para disminuir los niveles de ansiedad disfuncionales que presentan los pacientes.(AU)

Introduction: Adjustment disorder describes a disproportionate emotional and behavioral response to one or more identifiable psychosocial stressors. There are multiple situations capable of generating an acute stressful situation. However, one of the requirements to be able to speak of an adaptive disorder is that the stressor(s) in question should lead to an impairment of the individual's normal functioning.Objectives: The main objective of this work is to analyze , through a literature review, the diagnosis and approach to the diagnosis and management of adaptive disorders in the Primary Care setting. The secondary objective is toemphasize the importance of early detection and treatment, as well as multidisciplinary management and mentalhealth promotion. Results: The main risk factors for adjustment disorders are unemployment, low income, low social support, physical illness, and personal history of mental health. The International Questionnaire of Adaptive Disorders is currently the principal diagnostic tool, as it establishes its diagnostic criteria based on the theoretical definition established by the ICD-11. The management of these disorders is mainly through cognitive behavioural therapy.Conclusions: Adjustment disorders arise as abnormal responses to certain stressful situations. The role of primary care physicians in dealing with this disorder is essential, and early detection and management are necessary to reduce the levels of dysfunctional anxiety that patients present.(AU)

La telemedicina en la diabetes mellitus, el nuevo camino por recorrer / Telemedicine in diabetes mellitus, the new road ahead

Introducción: La Diabetes Mellitus es una enfermedad crónica muy prevalente a nivel mundial que genera un grannúmero de procesos asistenciales y un abordaje complejo, suponiendo un importante porcentaje del gasto sanitario. Espor ello por lo que se plantea la necesidad de desarrollar un sistema que permita hacer más eficiente el manejo de estospacientes a la vez que se garantiza una asistencia continuada de calidad, resultando la telemedicina como una alternativaválida. Objetivos: Con este estudio se pretende analizar la eficacia de las intervenciones basadas en la telemedicina en elmanejo de los pacientes con Diabetes Mellitus frente a la asistencia estándar. Se compara el rendimiento de estas nuevasintervenciones en pacientes con Diabetes Mellitus tipo 1 y tipo 2, evaluando la mejoría de parámetros clínicos y analíticos,la calidad de vida y la reducción de costes gracias a su empleo. Resultados: Se realizó una revisión de los principales motores de búsqueda y bases de datos. Entre las publicacionesutilizadas se pudo encontrar una reducción significativa de los niveles de HbA1c en ambos tipos de diabetes, unincremento en el autocontrol y autoeficacia, una mejoría en la calidad de vida variable según el cuestionario y finalmente,una reducción en los costes asistenciales. Conclusión: La telemedicina se erige como una alternativa eficaz y válida a la atención habitual para estos pacientes.Es necesaria mayor investigación en el futuro para poder unificar los diferentes sistemas dando así lugar a unaherramienta universal.(AU)

Introduction: Diabetes Mellitus is a very prevalent chronic disease worldwide that generates a large number of careprocesses and a complex approach, assuming a significant percentage of health spending. That is why the need arisesto develop a system that allows for more efficient management of these patients while ensuring continuous quality care,resulting in telemedicine as a valid alternative. Objectives: This study aims to analyze the effectiveness of interventions based on telemedicine in the management ofpatients with Diabetes Mellitus compared to standard care. The performance of these new interventions in patients withtype 1 and type 2 Diabetes Mellitus is compared, evaluating the improvement of clinical and analytical parameters, qualityof life and cost reduction thanks to their use. Results: A review of the main search engines and databases was carried out. Among the publications used, it waspossible to find a significant reduction in HbA1c levels in both types of diabetes, an increase in self-control and self-efficacy, an improvement in variable quality of life according to the questionnaire, and finally, a reduction in care costs.Conclusion: Telemedicine stands as an effective and valid alternative to regular care for these patients. More researchis needed in the future to be able to unify the different systems, thus giving rise to a universal too.(AU)

[Obstructive sleep apnoea syndrome]. / Síndrome de apneas-hipopneas durante el sueño.

INTRODUCTION: Obstructive sleep apnoea (OSA) is highly prevalent in children and a major public health problem. An attempt is made to determine the clinical and polysomnographic presentation of paediatric OSA in our area. PATIENTS AND METHODS: Retrospective descriptive study of sleep tests conducted on children up to 14 years-old from 1999 to 2012 in the Sleep Unit of the University Hospital of Albacete. Age, gender, anthropometric, clinical data, indication and variables of sleep study, treatment, and outcomes were collected. RESULTS: The study included 234 children. OSA was found in 71.8%, with 42.3% moderate and 44.6% severe. The majority were male (60.7%) and the mean age 5 was years, of whom 78% were pre-school or school age. There was overweight/obesity in 44%, with 93.4% snoring, apnoea 84.5%, and 5.4% daytime sleepiness. There were 23 polysomnographies and 145 polygraphies, with a median apnoea/hypopnoea index (AHI) of 10, Sat.O2 minimum 84%, desaturation index 8, and mean sleep supine 53.65% and supine events 57.61%. Treatment was lifestyle modifications 29.2%, CPAP 6%, and surgery 42.9%. Improved snoring and/or apnoea 69.4%, and weight 32.4% of overweight/obesity children. CONCLUSIONS: Most of the studied children had a pathological AHI. Almost half were overweight/obese, and a high percentage had moderate-severe OSA. Most frequent treatment was surgery. The clinical outcome was favourable in almost 70%. Less than a third with OSA and overweight/obesity improved weight.