Trends in hospitalisation for urinary tract infection in adults aged 18-65 by sex in Spain: 2000 to 2015.

OBJECTIVE: To analyse trends in urinary tract infection (UTIs) hospitalisation among patients adults 18-65 aged in Spain from 2000-2015. METHODS: Retrospective observational study using the Spanish Hospitalisation Minimum Data Set (CMBD), with codifications by the International Classification of Diseases (ICD-9). Variables: Type of UTIs (pyelonephritis, prostatitis, cystitis and non-specific-UTIs), sex, age (in 5 categories: 18-49 and 50-64 years in men, and 18-44, 45-55 and 56-64 years in women), comorbidity, length of stay, costs and mortality associated with admission. The incidence of hospitalisation was studied according to sex, age group and type of UTIs per 100,000. Trends were identified using Joinpoint regression. RESULTS: From 2000-2015, we found 259,804 hospitalisations for UTIs (51.6% pyelonephritis, 7.5% prostatitis, 0.6% cystitis and 40.3% non-specific UTIs). Pyelonephritis predominated in women and non-specific UTIs in men. The hospital stay and the average cost (2,160 EUR (IQR 1,7872,540 were greater in men. Overall mortality (0.4%) was greater in non-specific UTIs. More women were admitted (rates of 79.4 to 81.7) than in men (30.2 to 41). The greatest increase was found in men aged 50-64 years (from 59.3 to 87). In the Joinpoint analysis, the incidence of pyelonephritis increased in women [AAPC 2.5(CI 95% 1.6;3.4)], and non-specific UTIs decreased [AAPC -2.2(CI 95% -3.3;-1.2)]. Pyelonephritis decreased in men [AAPC -0.5 (CI 95% -1.5;0.5)] and non-specific UTIs increased [AAPC 2.3 (CI 95% 1.9;2.6)] and prostatitis increased [AAPC 2.6 (CI 95% 1.4;3.7)]. CONCLUSIONS: The urinary infection-related hospitalisation rate in adults in Spain increased during the period 2000-2015. Pyelonephritis predominated in women and non-specific UTIs in men. The highest hospitalisation rates occurred in the women but the greatest increase was found in men aged 65-74. The lenght of stay and cost were higher in men.

Adherencia a la dieta mediterránea y su asociación con factores sociodemográficos y antropométricos en adolescentes de Madrid / Adherence to mediterranean diet and its associated factors in adolescents from Madrid

FUNDAMENTOS: La dieta poco saludable es el principal factor que contribuye a la obesidad infantil. El objetivo de este estudio fue evaluar la adherencia a la dieta mediterránea en una muestra de adolescentes y analizar los factores asociados a la misma. MÉTODOS: Se realizó una encuesta transversal a 573 adolescentes de entre 11 y 14 años en Madrid en 2018. Se recogieron variables mediante un cuestionario. La adherencia a la dieta mediterránea se midió con el índiceKIDMED. Las características asociadas a una alta adherencia se analizaron mediante razones de prevalencia (RP) obtenidas con regresión de Poisson de varianza robusta. RESULTADOS: El 64,3% de los participantes presentaron un nivel de adherencia medio a la dieta mediterránea. La alta adherencia fue menos frecuente en adolescentes mujeres (17% [RP=0,63; p=0,02]), cuyas madres no habían superado los estudios primarios (16,3% [RP=0,58; p=0,07]), que dormían menos de 8,5 horas al día (16,8% [RP=0,54; p<0,01]) o que usaban el móvil más de 2,6 horas al día (12,2% [RP=0,56; p=0,02]). CONCLUSIONES: La adherencia a la dieta mediterránea es inferior a la óptima en cuatro de cada cinco adolescentes, y resulta menor en adolescentes mujeres, cuyas madres no superaron los estudios primarios o que dedicaban más tiempo al móvil y menos a dormir. Nuestros resultados apuntan a la importancia de atender a los hábitos de sueño y a reducir el uso de pantallas para mejorar la adherencia a la dieta mediterránea en adolescentes.(AU)

BACKGROUND: Unhealthy diet is the main contributor to childhood obesity. The aim of this study was to assess adherence to the mediterranean diet in a sample of adolescents and analyse adherence-related factors. METHODS: Cross-sectional descriptive study (June-October 2020), in a non-probabilistic sample of 473 patients with Substance Use Disorder, from the 8 Addiction Care Centers (CAD) of the Madrid City Council. Their demographic, habits and health characteristics, IgM and IgG for SARS-CoV-2, previous PCR, presence of symptoms, contact with COVID-19 cases were described, and multivariate analysis was performed using binary logistic regression. RESULTS: A total of 64.3% of participants displayed a medium level and 21.3% a high level of adherence to the mediterranean diet. High adherence was less frequent among teenage girls (17% [PR=0.63; p=0.02]), those whose mothers had not gone beyond primary school (16.3% [PR=0.58; p=0.07]), those who slept less than 8.5 h/day (16.8% [PR=0.54; p<0.01]), and those who used a mobile telephone for more than 2.6 hours per day (12.2% [PR=0.56; p=0.02]).CONCLUSIONS: Adherence to the mediterranean diet is less than optimum in four out of five adolescents, and is lower in teenage girls whose mothers had not gone beyond primary school or who devote more time to mobile telephones and less time to sleeping. Our results highlight the importance of paying attention to sleeping habits and reducing the use of screens when seeking to improve mediterranean diet adherence among adolescents.(AU)

Políticas alimentarias para prevenir la obesidad y las principales enfermedades no transmisibles en España: querer es poder / Food policies to prevent obesity and the main non-transmissible diseases in Spain: where there's a will there's a way

Introducción: En España, un tercio de los menores y dos tercios de los adultos padecen exceso de peso, una condición que genera un sobrecoste médico directo de 2000 millones de euros. El entorno alimentario obesogénico causa obesidad al promover el consumo de bebidas azucaradas y de alimentos ultraprocesados. Por ello, proponemos cinco políticas prioritarias con el PODER de revertir la epidemia de obesidad y de enfermedades no transmisibles asociadas a ella, mediante la creación de entornos alimentarios saludables. El PODER de las políticas alimentarias: P (Publicidad): regulación de la publicidad de alimentos y bebidas no saludables dirigida a menores por todos los medios y prohibición de patrocinios de congresos o eventos deportivos y avales de asociaciones científicas o profesionales de la salud. O (Oferta): promoción de una oferta 100% saludable en máquinas expendedoras de centros educativos, sanitarios y deportivos. D (Demanda): implantación de un impuesto, al menos del 20%, a las bebidas azucaradas, acompañado de subvenciones o bajadas de impuestos a alimentos saludables y disponibilidad de agua potable a coste cero en todos los centros y espacios públicos. E (Etiquetado): aplicación efectiva del Nutri-Score mediante el uso de incentivos, regulación y mecanismos de contratación pública. R (Reformulación): reformular los acuerdos de reformulación con la industria con objetivos más ambiciosos y de obligado cumplimiento. Reflexión final: Las cinco intervenciones propuestas, aplicadas con éxito en otros países, contribuirán a concienciar a la población y tendrán un impacto positivo en la salud y en la economía, por una reducción de los costes sanitarios de la obesidad y un aumento de la productividad laboral. Estas medidas deberían formar parte de una gran transformación del sistema alimentario, con políticas agroalimentarias que fomenten una producción sostenible de alimentos saludables

Introduction: In Spain, one third of all children and two-thirds of adults suffer from excess weight, a condition that generates a direct excess medical cost of 2000 million Euros. Obesogenic food environments cause obesity by promoting the consumption of sugar-sweetened beverages and ultra-processed foods. Accordingly, we propose five priority policies capable of reversing the epidemic of obesity and related non-communicable diseases through the creation of healthy food environments. The power (PODER in Spanish) of food policies: Advertising (Publicidad): regulation of unhealthy food and drink advertisements carried by all media and targeted at children, and prohibition of sponsorships of congresses, conferences or sports events and endorsements by scientific associations or health professionals. Supply (Oferta): promotion of a 100% healthy supply of goods on sale in vending machines sited at educational, health and sports centres. Demand (Demanda): levying a tax of at least 20% on sugar-sweetened beverages, accompanied by subsidies or reduced taxes on healthy foods and availability of drinking water free of charge at all public venues and areas. Labelling (Etiquetado): effective application of the Nutri-Score through the use of incentives, regulation and public-tender mechanisms. Reformulation (Reformulación): revising and redrawing reformulation agreements with the industry, setting more ambitious goals and mandatory compliance. A final thought: These five proposed interventions, all of which have been successfully applied in other countries, will serve to raise population awareness and have a positive impact on health and the economy, through reducing the health care costs of obesity and enhancing work productivity. These measures should form part of a wide-ranging transformation of the food system, with agri-food policies that foster the sustainable production of healthy foods