Accelerometry-assessed daily physical activity and compliance with recommendations in Spanish children: importance of physical education classes and vigorous intensity.

Background: Physical activity (PA) is associated with numerous health benefits. Vigorous PA (VPA) may have a greater impact on public health than lower-intensity PA. The incorporation of a specific recommendation on VPA could complement and improve existing recommendations for average daily moderate-vigorous PA (MVPA). Physical education classes could have a positive impact on children's adherence to average daily physical activity recommendations. The aim was to investigate the association between MVPA and VPA in children, as well as adherence to recommendations, and obesity and the presence of physical education classes. Methods: A cross-sectional study of physical activity was conducted in a sample of 8 and 9-year-old children in Andalusia (Spain). GENEActiv accelerometers were used, placed on the non-dominant wrist for at least eight consecutive days (24-h protocol). School days with and without physical education class, and weekend days were defined. ROC curves were used to calculate the threshold associated with obesity for average daily MVPA and VPA for recommendations. Results: A total of 360 schoolchildren were included in the analyses (184 girls). An average of 7.7 (SD 1.4) valid days per participant were evaluated, with 19.9 (SD 10.5) and 11.4 (SD 5.1) minutes of VPA performed by boys and girls respectively. 25.8% of the participants were classified with central obesity. The optimal threshold determined with ROC analysis was 12.5 and 9.5 minutes of average daily VPA for boys and girls, respectively (RecVPA), and 75 minutes of average daily MVPA for both sexes (RecMVPA). The RecVPA showed stronger association with obesity. On school days with physical education class, compared to days without this class, children showed increased VPA and MVPA engagement and better compliance with recommendations, with smaller differences in adherence according to sex or obesity. Conclusions: On days with physical education class, more physical activity was accumulated at all intensities and greater adherence to the recommendations than on days without this class. VPA had a stronger correlation with the absence of obesity than lower-intensity activity. It was also observed that boys were physically more active and had higher adherence to the recommendations than girls.

Adherence to the WHO recommendation of three weekly days of vigorous intensity activities in children: an accelerometry study of vigorous physical activity bouts.

Background: The World Health Organization (WHO) recommends that children and adolescents incorporate vigorous intensity activities (VIAs) at least three days a week. This recommendation has not been sufficiently studied using objective methods, such as accelerometry. Physical education classes and extracurricular sports activities are optimal opportunities for compliance with this recommendation. Objective: To identify VIAs through bouts of vigorous physical activity (VPA-Bouts) evaluated with accelerometry and, with this, to know the compliance with the recommendation on VIAs. Methods: A cross-sectional study of the habitual physical activity of 353 children (8-9 years old) was carried out using accelerometry and participation in organized extracurricular sports activities was asked through a questionnaire. School days with and without physical education class, weekends, and the average weekly day were identified, as well as school time and out-of-school time. A VPA-Bout was defined as an interval of at least 60 minutes with a proportion of VPA of at least 16.7% in boys and 12.5% in girls (10.0 and 7.5 minutes/hour of VPA, respectively). Results: The average daily time in organized extracurricular sports activities declared by questionnaire and the average daily duration of the VPA-Bouts evaluated with accelerometers in the extracurricular period was 21.3 (SD 19.8) and 23.9 (SD 31.2) minutes, respectively, in boys, whereas, in girls it was 20.2 (SD 17.4) and 11.0 (SD 16.9) minutes, respectively. In school time including a physical education class, there was a higher proportion of VPA-Bouts than without these classes (with: 28.6%, without: 2.1%, p < 0.001). Children who reported at least three weekly hours of organized extracurricular sports activities accumulated a higher proportion of school afternoons with VPA-Bouts than those with fewer weekly hours of this type of activities (≥3 hours/week: 27.5%, <3 hours/week: 9.3%, p < 0.001). On the weekend, boys who reported at least three weekly hours of organized extracurricular sports activities performed more VPA-Bouts than those participating in less weekly hours, while in girls no significant differences were observed (weekend; boys, ≥3 hours/week: 26.0%, <3 hours/week: 9.0%, p < 0.001; girls: 8.3%, 8.0%, p = 0.917). Compliance with the recommendation to incorporate VIAs at least three days a week was 23.8%. Children who reported at least three weekly hours of extracurricular sports activities achieved higher compliance than those who reported fewer extracurricular activities (≥3 hours/week: 35.1%, <3 hours/week: 12.7%, p < 0.001). Additionally, boys showed higher compliance rates than girls (boys: 32.9%, girls: 15.3%, p < 0.001). Conclusion: One in every four children met the WHO recommendation to incorporate VIAs at least three days a week, as evaluated by accelerometry. Physical education classes and extracurricular organized sports activities contributed to compliance with this recommendation.

Association between Asthma and Lower Levels of Physical Activity: Results of a Population-Based Case-Control Study in Spain.

(1) Background: Our aim was to determine changes in the prevalence of physical activity (PA) in adults with asthma between 2014 and 2020 in Spain, investigate sex differences and the effect of other variables on adherence to PA, and compare the prevalence of PA between individuals with and without asthma. (2) Methods: This study was a cross-sectional, population-based, matched, case-control study using European Health Interview Surveys for Spain (EHISS) for 2014 and 2020. (3) Results: We identified 1262 and 1103 patients with asthma in the 2014 and 2020 EHISS, respectively. The prevalence of PA remained stable (57.2% vs. 55.7%, respectively), while the percentage of persons who reported walking continuously for at least 2 days a week increased from 73.9% to 82.2% (p < 0.001). Male sex, younger age, better self-rated health, and lower body mass index (BMI) were significantly associated with greater PA. From 2014 to 2020, the number of walking days ≥2 increased by 64% (OR1.64 95%CI 1.34-2.00). Asthma was associated with less PA (OR0.87 95%CI 0.47-0.72) and a lower number of walking days ≥2 (OR0.84 95%0.72-0.97). (4) Conclusions: Walking frequency improved over time among people with asthma. Differences in PA were detected by age, sex, self-rated health status, and BMI. Asthma was associated with less LTPA and a lower number of walking days ≥2.

Prevalence and Factors Related to Physical Activity in Spanish Adults with Obesity and Overweight: Analysis of the European Health Surveys for the Years 2014 and 2020.

(1) Background: To analyze the prevalence of physical activity (PA) according to the presence of overweight or obesity and other sociodemographic factors in the Spanish adult population. (2) Methods: Cross-sectional study using the European Health Interview Surveys for Spain from 2014 and 2020. (3) Results: In overweight and obese people, the percentage of those who reported not performing any type of PA remained constant between 2014 and 2020, while a statistically significant increase was observed in the percentage of people who walked for 10 min a day and exercised at least 2 days a week. The probability of being obese with respect to normal weight was higher in individuals who reported not engaging in PA during leisure time (OR 1.42; 95% CI 1.31-1.53), those who did not walk 10 min a day at least 2 days a week (OR 1.25; 95% CI 1.15-1.35), and those who did not exercise at least 2 days a week (OR 1.42; 95% CI 1.32-1.53). The probability of being overweight was higher in individuals who reported not performing PA during leisure time (OR 1.07; 95% CI 1.02-1.15) and in those who did not exercise at least 2 days per week (OR 1.15; 95% CI 1.09-1.22). (4) Conclusions: Small increases in PA have been observed in both overweight and obese individuals from 2014 to 2020.

COVID-19 and Cognitive Decline in Older Adults with High-Cardiovascular Risk: A Post Hoc Analysis.

Cognitive decline has been reported as a short-term sequela in patients hospitalized for coronavirus disease-19 (COVID-19). Whether COVID-19 is associated with late cognitive impairment in older free-living individuals with high cardiovascular risk, a group at greater risk of cognitive decline, is unknown. We determined this association of COVID-19 through a longitudinal evaluation of post-COVID-19 cognitive performance and impairment as post hoc analysis in 5,179 older adults (48% female) with mean (SD) age 68.5 (5.0) years, body mass index 31.7 (3.7) kg/m2, harboring ≥ 3 criteria for metabolic syndrome (e.g., hypertension, hyperlipidemia, hyperglycemia etc.) enrolled in PREDIMED-Plus trial. Pre- and post-COVID-19 cognitive performance was ascertained from scheduled assessments conducted using a battery of neuropsychological tests, including 5 domains: Global Cognitive Function, General Cognitive Function, Execution Function, Verbal Fluency and Attention domains, which were standardized for the cohort. Cognitive impairment was defined as the bottom 10 percentile of the sample. Multivariable linear and logistic regression models assessed the association of COVID-19 with cognitive decline and impairment, respectively. After a mean 50-week follow-up, no significant associations were observed between COVID-19 status and post-COVID-19 scores of all tapped neuropsychological domains, except Global Cognitive Function (GCF). When fully adjusted, COVID-19 was marginally associated with higher (better) post-pandemic GCF score (ßadj (95% CI): 0.06 (0.00, 0.13) p=.05). However, the odds for post-COVID-19 cognitive impairment in GCF domain were not associated with the disease (ORadj (95% CI): 0.90 (0.53, 1.51) p=.68). In the PREDIMED-Plus cohort, COVID-19 status and cognitive impairment determined 50 weeks post-infection showed no association in older adults at high cardiovascular risk. This suggests that cognitive changes observed shortly after COVID-19 revert over time. However, cautious interpretation is warranted as these data were obtained within the framework of a clinical trial encouraging a healthy lifestyle.

Situación ponderal de la población escolar de 6 a 9 años en España: resultados del estudio ALADINO 2015 / Weight status in the 6 to 9 year-old school population in Spain: Results of the ALADINO 2015 Study

Introducción: El sobrepeso y la obesidad en la infancia y en la adolescencia han crecido alarmantemente en las últimas décadas en muchos países de Europa, incluido España. Este estudio presenta las prevalencias de sobrepeso y obesidad en escolares de 6 a 9 años en 2015 y sus características asociadas. Metodología: ALADINO es un estudio transversal de una muestra representativa de escolares de 6 a 9 años en España, alineado con la iniciativa COSI de la OMS. Se talló y pesó a los participantes, definiendo la situación ponderal según los estándares de la OMS, y se pasó un cuestionario a los progenitores sobre el estilo de vida y las características sociodemográficas. Resultados: Se tomaron medidas antropométricas a 10.899 escolares de 168 centros de educación primaria. El 41,3% (IC 95%: 40,0-42,6) presentaba exceso de peso, el 23,2% sobrepeso (IC 95%: 22,1-24,3) y el 18,1% obesidad (IC 95%: 17,2-19,1), siendo la obesidad más prevalente en niños y el sobrepeso en niñas. La prevalencia de obesidad abdominal era del 23,2% (IC 95%: 21,8-24,6). La prevalencia de sobrepeso y obesidad aumentaba con la edad. El exceso de peso disminuyó un 3,2% respecto a 2011, principalmente por la disminución del sobrepeso en niños, mientras que la obesidad permaneció estable. El exceso de peso era más prevalente en los escolares de familias con menor nivel socioeconómico. Conclusiones: La prevalencia de exceso de peso entre los escolares de 6 a 9 años en España ha disminuido un 3,2% desde 2011 por la disminución del sobrepeso, mientras que la obesidad permanece estable. Se debe intervenir en el entorno obesogénico, promocionando hábitos alimentarios saludables y la actividad física, incidiendo en las desigualdades en salud. (AU)

Introduction: Overweight and obesity in childhood and adolescence has grown alarmingly in the last twenty years or so in many countries of Europe, including Spain. This study presents the prevalences of overweight and obesity in 6 to 9 year-old schoolchildren in 2015, and their associated characteristics. Methodology: ALADINO (Its initials in Spanish for Diet, physical activity, child development and obesity) is a cross-sectional study of a representative sample of 6 to 9 year-old schoolchildren in Spain, in line with the Childhood Obesity Surveillance Initiative (COSI) of the World Health Organisation (WHO). The height and weight of the participants, defining the weight status according to WHO standards, and a questionnaire was given to the parents on lifestyle and sociodemographic characteristics. Results: Anthropometric measurements were taken on 10,899 schoolchildren for 168 primary education centres. Excess weight was observed in 41.3% (95% CI: 40.0-42.6), overweight in 23.2% (95% CI: 22.1-24.3) and obesity in 18.1% (95% CI: 17.2-19.1), with obesity being more prevalent in boys, overweight in girls. The prevalence of abdominal obesity was 23.2% (95% CI: 21.8-24.6). The prevalence of overweight and obesity increased with age. Excess weight decreased by 3.2% compared to 2011, mainly due to the decrease in overweight in boys, while that of obesity remained stable. Excess weight was more prevalent in schoolchildren from families with a lower socioeconomic level. Conclusions: The prevalence of excess weight in 6 to 9 year-old schoolchildren in Spain has decreased by 3.2% since 2011, due to the decrease in overweight, whilst obesity remained stable. Action must be taken in the obesogenic environment, by promoting healthy eating habits and physical activity, bearing in mind the inequalities in health. (AU)

National trends in utilization and in-hospital outcomes of surgical aortic valve replacements in spain, 2001-2015

Abstract Objective: The aims of this study were to examine the incidence and in-hospital outcomes of surgical aortic valve replacement (SAVR) and to identify factors associated with in-hospital mortality (IHM) among patients according to the type of implanted valve used in SAVR. Methods: We performed a retrospective study using the Spanish National Hospital Discharge Database, 2001-2015. We included patients who had SAVR listed as a procedure in their discharge report. Results: We identified 86,578 patients who underwent SAVR (52.78% mechanical and 47.22% bioprosthetic). Incidence of SAVR coding increased significantly from 11.95 cases per 100,000 inhabitants in 2001 to 17.92 in 2015 (P<0.001). Age and comorbidities increased over time (P<0.001). There was a significant increase in the frequency of concomitant coronary artery bypass grafting (CABG) and in the use of pacemaker implantation. The use of mechanical SAVR decreased and the use of bioprosthetic valves increased over time. IHM decreased over time (from 8.13% in 2001-05 to 5.39% in 2011-15). Patients who underwent mechanical SAVR had higher IHM than those who underwent bioprosthetic SAVR (7.44% vs. 6%; P<0.05). Higher IHM rates were associated with advanced age, female sex, comorbidities, concomitant CABG, and the use of mechanical SAVR (OR 1.67; 95% CI 1.57-1.77). Conclusion: The number of SAVRs performed in Spain has increased since 2001. The use of mechanical SAVR has decreased and the use of bioprosthetic valves has increased over time. IHM has decreased over time for both types of valves and despite a concomitant increase in age and comorbidities of patients during the same period.

Prevalence of childhood overweight/obesity in Spain 1993-2011 and associated risk factors in 2011 Prevalencia de sobrepeso y obesidad infa / Prevalencia de sobrepeso y obesidad infantil en España (1993-2011) y factores asociados en 2011

Introduction: Childhood obesity is a recognized public health problem. The present work reports the changing prevalence of childhood overweight/obesity in Spanish boys and girls over the period 1993-2011, and examines the risk factors apparent in 2011. Methods: Children with a body mass index (BMI) of ≥ 25 were deemed overweight, and those with a BMI of ≥ 30 were deemed obese. Overweight and obesity was consistently more common among boys than among girls. Results: The prevalence of overweight and obesity in Spain increased over the study period. Conclusions: According to the 2011 data, children who undertook no physical activity, or whose parents/guardians had a low level of education, showed the highest prevalence of obesity (AU)

Introducción: la obesidad infantil es un problema de salud pública a nivel mundial. El objetivo de este trabajo es describir la evolución de la prevalencia de sobrepeso/obesidad infantil en niños y niñas durante el periodo 1993-2011 y analizar cuáles son los factores de riesgo asociados, utilizando la Encuesta Nacional de Salud (ENS) de 2011. Métodos: los niños con índice de masa corporal (IMC) ≥ 25 se consideraron con sobrepeso y aquellos con IMC ≥ 30, como obesos. Se hizo uso de la ENS desde 1993 a 2011. Resultados: la prevalencia de sobrepeso y obesidad en España aumentó durante el periodo de estudio. La prevalencia de sobrepeso y obesidad fue más elevada en niños que en niñas. Conclusiones: según los datos de 2011, los niños que no realizaban ningún tipo de actividad física o cuyos padres tenían un nivel de educación bajo mostraron la mayor prevalencia de obesidad (AU)

Differences in the prevalence of diagnosis of overweight-obesity in Spanish children according to the diagnostic criteria set used / Diferencias en la prevalencia del diagnóstico de sobrepeso-obesidad en los niños españoles según el tipo de criterio utilizado

Objective: To examine relevant differences in the prevalence of overweight and obesity in children aged 2-15 years according to different sets of criteria (Orbegozo Foundation, International Obesity Task Force and World Health Organization), and how their use affects the trends in obesity recorded for both sexes between 1995 and 2011 in Spain. Method: Cross-sectional study, a population between 2 and 15 years. Three diagnosis criteria of overweight and obesity were be used. Results: The boys according to the three criteria, showed higher values of overweight and obesity compared to the girls. The lowest levels of overweight and obesity were observed using the Orbegozo tables. Discussion: The prevalence of overweight and obesity varies significantly according to the criteria used to define overweight and obesity. The percentiles of the Foundation Orbegozo gave the lowest estimates and the standards of growth of the World Health Organization were higher

Objetivo: Evaluar si existen diferencias relevantes entre los valores de prevalencia de sobrepeso y obesidad infantil en función de los tipos de criterios utilizados (Fundación Orbegozo, International Obesity Task Force, Organización Mundial de la Salud), y el modo en que su uso afecta a las tendencias sobre obesidad registradas para ambos sexos en España entre 2005 y 2011. Método: Estudio transversal, en una población de entre 2 y 15 años de edad. Se usaron tres criterios diagnósticos de sobrepeso y obesidad. Resultados: Los niños, según los tres criterios utilizados, presentaron valores superiores de sobrepeso y obesidad en comparación con las niñas. Las cifras más bajas de sobrepeso y obesidad se observaron al emplear las tablas de Orbegozo. Discusión: Las prevalencias de sobrepeso y obesidad varían de manera significativa según los criterios utilizados para definir sobrepeso y obesidad. Los percentiles de la Fundación Orbegozo proporcionan las estimaciones más bajas, y los estándares de crecimiento de la Organización Mundial de la Salud las más altas

Salt content in bread in Spain, 2014 / Cantidad de sal en el pan en España, 2014

Introduction: excess salt intake is associated to the risk of cardiovascular diseases. Bread is one of the foods that contributes the most salt to the diet in Spain. It is important to monitor the salt content of bread. Objective: to quantify the amount of salt in bread in Spain in 2014, and to compare it to the amount of salt in 2008.Methods: this cross-sectional study was conducted in Spain in 2014, and 1,137 loaves of bread (three types: barra, a Spanish style, similar in shape to a baguette; baguettes and whole meal) were purchased at bakeries with and without on-site workrooms and at supermarkets in all of Spain’s autonomous communities. Salt content (g/100 g bread) was estimated by determining total sodium. In one subsample, mean salt content was estimated by determining chlorides; it was compared to previous data of 2008 salt content (chloride determination).Results: the mean salt content was 2.08 g/100 g (SD: 0.32) with a minimum value of 0.30 and a maximum of 3.33. The mean salt content was similar in barraand baguette-type breads (2.09 g/100 g) and somewhat lower in wholemeal. The mean salt was 2.07 g/100 g in breads made with fresh dough and 2.12 g/100 g in breads made with frozen dough. The mean salt content (chlorides) was 1.64 g/100 g (SD: 0.42) in 2014 and 1.63 g/100 g (SD: 0.37) in 2008. This was not a significant difference (p = 0.428).Conclusions: the amount of salt in common bread in Spain remains stable from 2008

Introducción: el consumo excesivo de sal está relacionado con un mayor riesgo de enfermedades cardiovasculares. El pan es uno de los mayores contribuyentes a la ingesta de sal en España y es importante evaluar su contenido en sal. Objetivo: cuantificar la cantidad de sal en el pan en España en 2014 y compararla con la cantidad de sal que contenía en 2008. Métodos: este es un estudio transversal realizado en 2014. Se adquirieron 1.137 piezas de pan (barra o similar, baguette y pan integral) en panaderías con y sin obrador y en supermercados de todas las comunidades autónomas de España. El contenido de sal (g/100g de pan) se analizó mediante la determinación de sodio total. En una submuestra se estimó el contenido de sal mediante determinación de cloruros y se comparó con el contenido de sal con datos previos de 2008 (cloruros). Resultados: el contenido medio de sal fue 2,08 g/100 g (DE: 0,32), con un mínimo de 0,30 y un máximo de 3,33. El contenido medio de sal fue similar en barras y baguettes (2,09) y más bajo en pan integral. La media de sal fue de 2,07 g/100 g en pan elaborado con masa fresca y 2,12 g/100 g en pan de masa congelada. El contenido medio de sal medido mediante cloruros fue 1,64 g/100 g (DE: 0,42). La media de sal en resultados previos de 2008 era 1,63 g/100 g (DE: 0,37). La diferencia no fue significativa (p = 0,428). Conclusiones: la cantidad de sal en España permanece estable en los diferentes tipos de pan desde 2008

Trans-fatty acid content of food products in Spain in 2015 / Contenido de ácidos grasos trans en los alimentos en España en 2015

Objective: To ascertain the content of trans-fatty acids (TFA) in food products in Spain in 2015 and assess trends in TFA content since 2010. Methods: We analysed the fat content of 277 food products purchased in Spanish supermarkets in 2015 and calculated both the total fat and TFA content and the proportion of TFA to total fats. The results obtained in 2015 were compared to those yielded by a similar study in 2010. Results: In 2015, the majority of food products studied had a TFA content of less than 0.2g/100g product, and a TFA/total fat ratio of less than 2%. No significant increases were found compared to 2010. Food groups with a higher TFA content were dairy products of possible natural origin. Conclusions: TFA content in Spain is low and has significantly fallen since 2010 (AU)

Objetivo: Conocer el contenido de ácidos grasos trans en los alimentos en España en 2015 y evaluar la tendencia desde 2010. Métodos: Se analizó la composición grasa de 277 alimentos adquiridos en supermercados en España en 2015. Se calcularon el contenido en ácidos grasos trans y en grasas totales, y el porcentaje de ácidos grasos trans respecto de la grasa total. Se compararon los resultados con los de un estudio similar realizado en 2010. Resultados: En 2015 la mayoría de los alimentos estudiados tenían menos de 0,2g de ácidos grasostrans por 100g de producto, y menos del 2% de ácidos grasos trans respecto a las grasas totales. No se hallaron aumentos significativos desde 2010. Los grupos con contenidos más altos de ácidos grasos trans eran derivados lácteos, con posible origen natural. Conclusiones: El contenido de ácidos grasos trans en España es bajo y se ha reducido significativamente desde 2010 (AU)

Nuestra experiencia en el Comité Editorial de GACETA SANITARIA. Sobre todo, muchas gracias / Our experience in the Editorial Board of GACETA SANITARIA. Especially, thank you

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Gaceta Sanitaria en 2015 / Gaceta Sanitaria in 2015

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Contenido de ácidos grasos trans en los alimentos en España / Content of trans fatty acids in food products in Spain

Introducción: los ácidos grasos trans están asociados con problemas de salud, como enfermedad coronaria o diabetes. Objetivos: conocer la cantidad de ácidos grasos trans en los alimentos en España, y el porcentaje que representan con respecto al total de los ácidos grasos. Métodos: se estudió el contenido en ácidos grasos de 443 alimentos adquiridos en España en el año 2010, y clasificados en grupos. Determinación analítica de grasas en los productos mediante cromatografía de gases. Se calcularon estimadores de tendencia central y dispersión de la cantidad de ácidos grasos trans en cada grupo (g de ácidos grasos trans/100 g de producto). Se calculó el porcentaje de ácidos grasos trans con respecto a la grasa total en cada grupo. Resultados: los productos se agruparon en 42 grupos. En todos, salvo uno, la mediana de ácidos grasos trans fue inferior a 0,55 g/100 g de producto. El 83 % de los grupos tienen menos del 2 % de ácidos grasos trans con respecto a las grasas totales, y el 71 %, menos del 1 %. Discusión: el contenido de AGT en los alimentos en España es bajo y no representa actualmente un problema de salud pública (AU)

Background: trans fatty acids are associated to several health disorders, as ischemic heart disease or diabetes mellitus. Objectives: to assess the content of trans fatty acids in products in Spain, and the percentage of trans fatty acids respecting total fatty acids. Methods: 443 food products were acquired in Spain, and they were classified into groups. The content in fatty acids was analyzed using gas chromatography. Estimates of central tendency and variability of the content of trans fatty acids in each food group were computed (in g of trans fatty acids/100 g of product). The percentage of trans fatty acids respecting total fatty acids was calculated in each group. Results: 443 products were grouped into 42 groups. Median of trans fatty acids was less than 0.55 g / 100 g of product in all groups except one. 83 % of groups had less than 2 % of trans fatty acids, and 71 % of groups had less than 1 %. Discussion: the content of trans fatty acids in Spain is low, and it currently doesn’t play a public health problem (AU)

Gaceta Sanitaria en 2014 / Gaceta Sanitaria in 2014

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Sugar-sweetened soft drink frequency and associated factors in Spanish schoolchildren / Frecuencia de consumo de refrescos azucarados y factores asociados en escolares españoles

Introduction: Childhood obesity is increasing alarmingly, and the consumption of sugared soft drinks (SSD) has been reported as a risk factor for weight gain and obesity in some systematic reviews. Nevertheless, the factors associated with the consumption of SSD, including activity patterns and some family factors, have not been investigated in deep in Spanish children. Objective: to analyze SSD consumption habits in Spanish children and their relationship with physical activity habits and family factors. Methods: 7,659 6-9-years-old Spanish children (3,841 boys and 3,818 girls) were selected to participate in ALADINO study. Children’s weight and height were measured, and BMI calculated. Parents answered a questionnaire about the frequency of consumption of some beverages and activity patterns of their child, parent’s weight and height, and other family aspects. Data were analyzed regarding the frequency of consumption of SSD using SPSS (v.19.0). Results: 53.5% of children never consumed SSD (Nondrinkers, ND), 36.8% consumed them 1-3 times/week and 9.6% drunk SSB more than 3 times/week (frequent drinkers, FD). Children’s BMI were similar in all groups. Nevertheless both father’s and mother’s BMI were higher in FD groups vs ND. Comparing with ND group, in FD group there were more children who skipped breakfast, spent >2 h/day watching TV or >1 h/day playing with computer games, and lived in families with a higher percentage of smoker parents, less educated mothers and fathers, and lower income. Conclusion: In this group of Spanish children the frequency of consumption of SSD is not related to their BMI, but is associated with a more sedentary pattern of activity and unhealthy habits in their families. Study founded by AESAN (AU)

Introducción: Las cifras de obesidad infantil están aumentando de forma alarmante. Algunas revisiones sistemáticas sugieren que el consumo de bebidas azucaradas es uno de los factores relacionados con el aumento de peso y riesgo de obesidad. Sin embargo, no se han estudiado suficientemente los factores relacionados con este consumo de bebidas azucaradas, como pueden ser los hábitos de actividad física y características del entorno familiar, especialmente en niños españoles. Objetivo: Analizar la frecuencia de consumo de refrescos azucarados (RA) en población escolar española y su relación con los hábitos de actividad física y características familiares. Métodos: Se han estudiado 7.659 escolares españoles de 6 a 9 años (3.841 niños y 3.818 niñas) participantes en el estudio ALADINO, a los que se midió el peso y altura y se calculó su IMC. Los padres cumplimentaron un cuestionario con preguntas sobre la frecuencia de consumo de diferentes bebidas, las actividades realizadas habitualmente por su hijo, el peso y altura de los padres y características del entorno familiar. Se analizaron los datos en función de la frecuencia de consumo de refrescos azucarados empleando el programa SPSS (v.19.0). Resultados: El 53,5% de los escolares no consume nunca RA (No consumidores, NC), el 36,8% los consume entre 1 y 3 veces por semana y el 9.6% los toma con más frecuencia (consumo frecuente, CF). El IMC de los escolares fue similar en todos los grupos. Sin embargo, el IMC de los padres y madres de niños del grupo CF fue significativamente mayor que para los del NC. En comparación con el grupo NC, en el grupo CF hay un mayor porcentaje de escolares que se saltan habitualmente el desayuno, ven más de 2 horas al día la TV o juegan más de 1 hora diaria con ordenadores o consolas, viven en familias con menores ingresos y tienen padres con menor nivel educativo o que son fumadores. Conclusión: En este grupo de escolares españoles, la frecuencia de consumo de RA no está relacionada con su IMC, pero si con un estilo de vida más sedentario y un entorno familiar menos saludable (AU)

Factores de riesgo asociados a la cirugía del adulto con cardiopatía congénita: 22 años de experiencia. ¿Quién debe intervenirlos? / Risk factors for surgery of congenital heart disease in adults: Twenty-two years of experience. Who should operate them?

Objetivo: Analizar la asociación entre mortalidad en cirugía de cardiopatías congénitas del adulto y los factores relacionados con el paciente y la intervención. Método: Estudio descriptivo de intervenciones por cirujanos con actividad habitual en cardiopatías congénitas (238), cardiopatías adquiridas (117) y residentes (108). Se evaluó la asociación de la mortalidad con el riesgo y complejidad quirúrgica, actividad habitual del cirujano, y tiempo de circulación extracorpórea y de pinzamiento aórtico, mediante modelos de regresión logística. Resultados: Se incluyeron 463 cirugías (442 con circulación extracorpórea) entre 1991 y 2012. Edad mediana de intervención: 34 años (52.8% mujeres); primera cirugía 295, reintervención 168. La puntuación mediana del Aristóteles fue 6.8, con complejidad significativamente mayor tras reestructurarse la Unidad en 2001. La mortalidad hospitalaria total fue del 3.9%. La mortalidad se asoció significativamente al número de intervenciones previas (OR: 5.02; IC 95%: 1.44-17.52), intervenciones por cirujanos de cardiopatía adquirida (OR: 3.53; IC 95%: 1.14-10.98), Aristóteles alto (OR: 1,64; IC 95%: 1.18-2.29), y tiempos prolongados de extracorpórea (OR: 1.13; IC 95%: 1.07-1.19). Conclusiones: La mortalidad en cirugía de cardiopatía congénita en adultos es baja. Las intervenciones de alta complejidad, tiempos elevados de extracorpórea y múltiples reintervenciones se asocian con mayor mortalidad. La participación de cirujanos especialistas en cardiopatías congénitas se asocia con mejores resultados.

Objective: To assess the association between mortality in surgery of congenital heart disease in adults, and factors related to patients and operations. Method: Descriptive study of operations performed by specialized surgeons in congenital heart surgery (238), adult acquired surgery (117), and specialty residents (108). The association of mortality with surgical risk and complexity, specialization of surgeon, cardiopulmonary by-pass and aortic cross clamping was assessed fitting logistic regression models. Results: A total of 463 operations were included (442 with cardiopulmonary by-pass) in the study performed between 1991 and 2012. Median age at surgery: 34; 52.8% were women. First surgery: 295, reoperation: 168. Median score of Aristotle was 6.8, with significantly higher complexity since 2001, after restructuring the Unit. Overall hospital mortality was 3.9%. Mortality was significantly associated to number of previous surgeries (OR: 5.02; 95%CI: 1.44-17.52), operations by acquired heart disease surgeons (OR: 3.53; 95%CI: 1.14-10.98), higher Aristotle (OR: 1,64; 95%CI: 1.18-2.29), and high cardiopulmonary by-pass time (OR: 1.13; 95%CI: 1.07-1.19). Conclusions: Surgery of congenital heart disease in adults has been performed with low mortality. High complexity interventions, prolonged cardiopulmonary by-pass times and multiple reoperations were associated to higher mortality. Participation of cardiac surgeons specialized in congenital heart disease is associated with better outcomes.

Sodium intake may promote weight gain; results of the FANPE study in a representative sample of the adult Spanish population / La ingesta de sodio puede favorecer el incremento de peso; resultados del estudio FANPE realizado en una muestra representativa de adultos españoles

Introduction: Recent studies have indicated that diets rich in sodium may predispose to the development of obesity, either directly, or be associated with the consumption of foods that promote weight gain. Objective: The aims of this study were to analyze the association between urinary sodium and the presence of excess of weight. Additionally, the study investigated the relationships between salt intake and dietary habits, as a high salt intake may be associated with inadequate eating habits and a high incidence of obesity. Methods: This study involved 418 adults (196 men and 222 women) aged 18 to 60 years old. Weight, height and waist circumference were measured, and we calculated, BMI and waist/height ratio. Dietary intake was estimated using a «24 h recalls», for two consecutive days, and sodium content was determined from 24 h urine sample. Results: The 34.4% of the population had overweight and 13.6% had obesity. A positive association was seen between BMI and urinary sodium concentration. Urine sodium values were also positively associated with others adiposity indicators such as waist circumference and waist/height ratio. Body weight, BMI, waist circumference, and waist/height ratio were higher in the group of individuals with a urinary sodium excretion ≥ 154 mmol/l (Percentile 50) (P50). Additionally, individuals placed in this group presented a higher caloric intake and total food intake, in particular, more meat, processed food and snacks. Adjusting by energy intake, a higher sodium intake was a risk factor of being overweight or obese (OR = 1.0041, IC 95% 1.0015-1.0067, p < 0.01). Conclusions: Salt intake was associated with obesity; since people with higher sodium intake consumed more energy and presented worse eating habits. Additionally, sodium intake itself appears to be related to obesity (AU)

Introducción: Estudios recientes, han señalado que las dietas ricas en sodio podrían predisponer a la aparición de obesidad, ya sea de forma directa, o por estar asociadas con el consumo de alimentos que favorecen el aumento de peso. Objetivo: El objeto de este estudio fue analizar la asociación entre sodio urinario y presencia de sobrepeso y obesidad, en una muestra representativa de adultos españoles, así como conocer si el mayor consumo de sal, se asocia con unos peores hábitos alimentarios y con una mayor ingesta de alimentos, que puedan predisponer a la aparición de la misma. Métodos: Se ha estudiado un grupo de 418 adultos (196 hombres y 222 mujeres) de 18 a 60 años de edad. Se recogieron datos de peso, talla, circunferencia de cintura y se calculó, a partir de ellos, el IMC y el índice cintura/talla. Con el fin de conocer el consumo de alimentos, se aplicó un «Recuerdo de 24 horas» durante dos días consecutivos y se determinó el sodio en orina de 24 horas. Resultados: Un 34,4% de la población presentó sobrepeso y un 13,6% obesidad. Se observó una asociación positiva entre el IMC y la excreción urinaria de sodio. Los valores de sodio en orina también se relacionaron de forma directa con otros parámetros indicadores de adiposidad, como la circunferencia de la cintura o la relación cintura/talla. Tanto el peso, como el IMC, la circunferencia de la cintura y la relación cintura/talla, fueron mayores en el grupo con una excreción urinaria de sodio ≥ 154 mmol/l (Percentil 50) (P50). Además, las personas con una mayor eliminación urinaria de sodio presentaron una mayor ingesta calórica y un mayor consumo de alimentos totales y, en concreto, de carnes, precocinados y aperitivos. Tras ajustar por la ingesta de energía, la mayor ingesta de sodio resultó ser un factor de riesgo de tener un IMC más alto (OR = 1.0041, IC 95% 1.0015-1.0067, p < 0,01). Conclusiones: La ingesta de sal estuvo asociada con la presencia de obesidad, ya que las personas con una mayor ingesta de sodio ingirieron más energía y presentaron peores hábitos alimentarios. Sin embargo, la ingesta de sodio por sí misma, también parece estar relacionada con el padecimiento de obesidad (AU)

GACETA SANITARIA en 2013: cambios, retos e incertidumbres / GACETA SANITARIA in 2013: changes, challenges and uncertainties

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Associated factors of obesity in Spanish representative samples / Factores asociados al padecimiento de obesidad en muestras representativas de la población española

Given the dramatic increase in the prevalence of obesity and the serious health and economic consequences, the scientific community, health professionals and health agencies are looking for the best strategies to prevent/ fight this trend. In order to plan the most appropriate intervention measures the first step is to identify the associated factors of obesity. This paper presents the results of research conducted/coordinated by our research team and promoted by the Spanish Food Safety Agency (AESAN), in the last five years. These studies were focussed on representative samples of the Spanish population, paying attention to the condition of overweight/obesity and their associated factors. The first study, FANPE ("Fuentes alimentarias de nutrientes de la población española") (2009), was centered in 418 adults (18-60 years) from 15 provinces (30 sampling points). Its aim was to analyze the dietary sources of nutrients, paying particular attention to sodium. This research showed that the risk of overweight/obesity increases with age, in people who have follow weight control diets, in ex-smokers, married people and those who slept less than 8.5 hours per day, while the risk is lower in women, people who make sport and those with an University degree. It was also found that overweight people had higher sodium intake and urine excretion. Therefore, and having in mind that 88.2% of the subjects took more than 2 g/day of sodium (the maximum recommended), it is advised to lower the sodium intake not only from the health point of view but also as a probably strategy against obesity. The study ALADINO (Estudio de Alimentación, Actividad física, Desarrollo Infantil y Obesidad- Study of the Diet, Physical Activity, Child Development and Obesity) (2010-2011) was focused on 7659 children (6-9 years) from 19 autonomous communities. We founded a higher percentage of overweight/obesity in boys than in girls, and a significant increase in the figures from the age of 7. Being overweight is more evident in offspring of parents with low educational level or low income, or if parents are smokers (especially when both parents smoke). The problem increases in those children who skip breakfast, have lunch at home (compared with having this meal at school), in those with sports facilities far from their home, those who have a personal computer, video game or TV in their room, or those who sleep less than 8 hours per day. All these factors, either by themselves or because they influence eating habits and/or activity patterns, are associated with a higher risk of being overweight, so it must be monitored and modified in a more favourable direction, within the health policies of each country, as part of strategies to halt the rise in obesity condition (AU)

Ante el espectacular incremento en la prevalencia de obesidad y dadas las graves consecuencias sanitarias y económicas que conlleva, la comunidad científica, los profesionales y organismos sanitarios están buscando las mejores estrategias para prevenir/combatir la tendencia. Para tomar medidas el primer paso es conocer los factores asociados al padecimiento de obesidad, para planificar las medidas de intervención más adecuadas. El presente trabajo presenta resultados de investigaciones realizadas/coordinadas por nuestro equipo investigador, en los últimos 5 años y promovidas por la Agencia Española de Seguridad Alimentaria (AESAN), en los que se presta atención al padecimiento de sobrepeso/obesidad y a los factores asociados, analizando muestras representativas de la población española. 
Por una parte, se presentan datos de 418 adultos (18-60 años) estudiados en 2009 en 15 provincias (30 puntos de muestreo) para analizar las "Fuentes alimentarias de nutrientes de la población española" (FANPE) con especial atención al sodio, esta investigación puso de relieve que el riesgo de padecer sobrepeso/obesidad incrementa con la edad, en las personas que han realizado dietas de control de peso, exfumadores, personas casadas y en aquellas que dormían menos de 8.5 horas diarias. Mientras que el riesgo es menor en mujeres, personas que realizan algún deporte y en aquellas con estudios universitarios. También se constató que las personas con exceso de peso tenían mayor ingesta y excreción de sodio por orina. Por ello, teniendo en cuenta que un 88,2% de los sujetos estudiados tomaba más de los 2 g/día de sodio (límite máximo aconsejado) se considera conveniente reducir la ingesta de sodio, desde el punto de vista sanitario y probablemente también como estrategia en la lucha contra la obesidad. En población infantil los datos del Estudio de Alimentación, Actividad física, Desarrollo Infantil y Obesidad (ALADINO) (2010-2011) estudiando 7.659 niños (6-9 años) de 19 CCAA, ponen de relieve un mayor padecimiento de sobrepeso/obesidad en varones, con incremento notable del problema a partir de los 7 años. También se constata que el exceso de peso es más evidente en descendientes de padres con escaso nivel de estudios y/o bajos ingresos, entre niños que no desayunan, en aquellos que comen en casa en comparación con los que comen en el colegio, cuando las instalaciones deportivas están lejos del domicilio del niño, o cuando los escolares disponen de ordenador personal, videoconsola o TV en su habitación, cuando duermen menos de 8 h/día o los padres son fumadores (especialmente si fuman ambos). Todas estas influencias, por si mismas o por condicionar los hábitos alimentarios y/o pautas de actividad del individuo se asocian con un mayor riesgo de presentar exceso de peso, por lo que deben ser vigiladas y modificadas en una dirección más favorable, dentro de las políticas sanitarias de cada país, como parte de las estrategias encaminadas a frenar el incremento en el padecimiento de obesidad (AU)