Prevalencia de sobrepeso y obesidad infantil. Estudio de una cohorte en Castilla y León, España / Prevalence of overweight and obesity in child population. A study of a cohort in Castile and Leon, Spain

Introducción: Varios estudios advierten que el sobrepeso y la obesidad se han convertido en una epidemia con graves consecuencias sobre la salud de la población. El objetivo del presente estudio es estimar la prevalencia de sobrepeso y obesidad en Castilla y León en una muestra de niños a los 6, 11 y 14 años de edad, describir su evolución y su asociación con hábitos de vida y antecedentes. Metodología: Estudio observacional, de cohorte retrospectivo, realizado por los pediatras de la Red Centinela Sanitaria, que se enmarca en un proyecto conjunto con el Centro Nacional de Investigación sobre la Evolución Humana de Burgos para conocer el patrón de crecimiento y desarrollo de la población infantil de Castilla y León. En 2012 se realizó un examen de salud y una recogida retrospectiva a partir de la historia clínica en una muestra de 326 niños, de la cohorte de nacidos en 1998. Resultados: Según los criterios de la OMS, a los 14 años había un 25,3% de sobrepeso entre los niños y un 18,5% entre las niñas. En cuanto a la obesidad, esta afectaba al 8,2 y 4,8%, respectivamente. A los 11 años se produce un pico de sobrepeso en las niñas y de obesidad en los niños. El entorno urbano-no urbano, la calidad y duración del sueño, así como el índice de masa corporal (IMC) de los padres han sido algunos de los factores asociados con el peso de los niños. Discusión: En Castilla y León, como en otras poblaciones de nuestro entorno, existe un grave problema de sobrepeso y obesidad infantil. Para su control, es necesario profundizar sobre los estilos de vida y los antecedentes relacionados con el nacimiento, así como el cálculo de la velocidad de crecimiento en la edad pediátrica

Introduction: Several studies warn that overweight and obesity have become an epidemic with severe consequences in the population's health. The objetive of the present study is to estimate the prevalence of overweight and obesity in Castile and Leon in a sample of children at 6, 11 and 14 years of age, to describe its evolution and its association with life habits and antecedents. Material and methods: Observational study, retrospective cohort, performed by the pediatricians of the Health Sentinel Network. The study is part of a joint Project with the National Research Center on Human Evolution (CENIEH) in Burgos to know the pattern of growth and development of the child population of Castile and Leon. In 2012, a health examination and a retrospective collection were carried out based on the clinical history of a simple of 326 children, from the cohort was born in 1998. Results: Following the WHO references, at age 14 there was 25.3% of boys and 18.5% of girls with overweight. Obesity was estimated to affect the 8.2% and 4.8% of them respectively. At 11 years of age there was the maximum of overweight in girls and of obesity in boys. At the urban-non urban environment, quantity and quality of sleep and the parents' BMI have been some of the associated factors to weight level of the children. Discussion: In Castile and Leon, as in other populations of our environment, there is a severe problema of overweight and obesity. For their control it is necesary to deepen understanding of lifestyles and antecedents related to the birth as well as to calculate the growth rate in the pediatric age

Prevalence of overweight and obesity in child population. A study of a cohort in Castile and Leon, Spain. / Prevalencia de sobrepeso y obesidad infantil. Estudio de una cohorte en Castilla y León, España.

INTRODUCTION: Several studies warn that overweight and obesity have become an epidemic with severe consequences in the population's health. The objetive of the present study is to estimate the prevalence of overweight and obesity in Castile and Leon in a sample of children at 6, 11 and 14 years of age, to describe its evolution and its association with life habits and antecedents. MATERIAL AND METHODS: Observational study, retrospective cohort, performed by the pediatricians of the Health Sentinel Network. The study is part of a joint Project with the National Research Center on Human Evolution (CENIEH) in Burgos to know the pattern of growth and development of the child population of Castile and Leon. In 2012, a health examination and a retrospective collection were carried out based on the clinical history of a simple of 326 children, from the cohort was born in 1998. RESULTS: Following the WHO references, at age 14 there was 25.3% of boys and 18.5% of girls with overweight. Obesity was estimated to affect the 8.2% and 4.8% of them respectively. At 11 years of age there was the maximum of overweight in girls and of obesity in boys. At the urban-non urban environment, quantity and quality of sleep and the parents' BMI have been some of the associated factors to weight level of the children. DISCUSSION: In Castile and Leon, as in other populations of our environment, there is a severe problema of overweight and obesity. For their control it is necesary to deepen understanding of lifestyles and antecedents related to the birth as well as to calculate the growth rate in the pediatric age.

Incidencia, características epidemiológicas y tipos de accidentes domésticos y de ocio. Red centinela sanitaria de Castilla y León (2009) / Epidemiological characteristics and types of domestic and leisure accidents. Sentinel health network of Castilla y León (2009)

Objetivos: Estudiar la incidencia, las características epidemiológicas y tipos de accidentes domésticos y de ocio en Castilla y León durante 2009. Diseño: Estudio observacional descriptivo prospectivo de diseño muestral. Emplazamiento: Centros de salud de atención primaria de Castilla y León. Participantes: El registro de enfermería lo realizan 130 enfermeros/as seleccionados mediante análisis de conglomerados. Cubren una población del 5%. Mediciones principales: Los datos se obtuvieron mediante un formulario anónimo. Las variables estudiadas fueron sexo, edad, momento, lugar, tipo y desencadenante del accidente. Se realizó análisis descriptivo y se utilizaron los tests de x2, exacto de Fischer, x2 de tendencias y t de Student. Los intervalos de confianza se calcularon al 95%. Resultados: La incidencia acumulada anual de accidentes domésticos y de ocio fue de 2.651 casos por 100.000 habitantes, siendo ligeramente mayor el porcentaje de hombres (50,4%). Se accidentaron más los menores de 15 años y ≥ 65 años. El 49,2% de los accidentes ocurrió en horario de mañana y un 71,7% en día laborable. Un 57,1% se produjo en el hogar, un 16,8% en la vía pública y un 7,3% en centros escolares. Los tipos de accidente más comunes fueron caídas al mismo nivel (40,4%) y uso de objetos cortantes y punzantes (22,7%). Conclusiones: El accidente se produjo, fundamentalmente, en el hogar, en día laborable y como consecuencia de caídas. Los grupos de edad más afectados fueron los menores de 15 años y ≥ 65 años(AU)

Objectives: To study incidence, epidemiological characteristics and types of domestic and leisure accidents in Castilla y León during 2009. Design: A descriptive study using a prospective sample design. Emplacement: Health Primary Care Centres of Castilla y León. Participants: The Nurse Registry is made up of 130 nurses selected by conglomerates analysis. They cover 5% of the population. Principal measurements: The information was obtained by means of an anonymus form. The studied variables were sex, age, type, place, type and origin of the accident. A descriptive analysis was performed using x2, Fischer, x2 of trends and t Student tests, with 95% confidence intervals. Results: The annual cumulative incidence was 2651 cases/100000 inhabitants, ther being slightly higher percentage of men (50.4%). The ≤ 15 and ≥ 65 years age groups had more accidents. The time of day of 49.2% of the accidents was during the morning and 71.7% were on a working day. The majority (57.1%) took place in the home, 16,8% in the street, and 7.3% in schools. The most common accidents types were falls to the same level (40.4%) and use of cutting and sharp objects (22.7%). Conclusions: Most accidents took place within the home, on a working day and by falls. The most affected were the ≤ 15 and ≥ 65 years old age groups(AU)

[Epidemiological characteristics and types of domestic and leisure accidents: sentinel health network of Castilla y León (2009)]. / Incidencia, características epidemiológicas y tipos de accidentes domésticos y de ocio. Red centinela sanitaria de Castilla y León (2009).

OBJECTIVES: To study incidence, epidemiological characteristics and types of domestic and leisure accidents in Castilla y León during 2009. DESIGN: A descriptive study using a prospective sample design. EMPLACEMENT: Health Primary Care Centres of Castilla y León. PARTICIPANTS: The Nurse Registry is made up of 130 nurses selected by conglomerates analysis. They cover 5% of the population. PRINCIPAL MEASUREMENTS: The information was obtained by means of an anonymous form. The studied variables were sex, age, type, place, type and origin of the accident. A descriptive analysis was performed using χ(2), Fischer, χ(2) of trends and t Student tests, with 95% confidence intervals. RESULTS: The annual cumulative incidence was 2651 cases/100000 inhabitants, there being slightly higher percentage of men (50.4%). The ≤ 15 and ≥ 65 years age groups had more accidents. The time of day of 49.2% of the accidents was during the morning and 71.7% were on a working day. The majority (57.1%) took place in the home, 16,8% in the street, and 7.3% in schools. The most common accidents types were falls to the same level (40.4%) and use of cutting and sharp objects (22.7%). CONCLUSIONS: Most accidents took place within the home, on a working day and by falls. The most affected were the ≤ 15 and ≥ 65 years old age groups.

Factors associated with childhood obesity in Spain. The OBICE study: a case-control study based on sentinel networks.

OBJECTIVE: To estimate the association strength of dietary behaviour and sedentary habits in relation to childhood obesity in Spain. DESIGN: A matched case-control study was carried out using data collected by sentinel network paediatricians in general practices. SETTING: Five Spanish autonomous communities. SUBJECTS: Cases were 437 children (2-14 years old) with BMI >95th percentile according to Spanish reference tables. Controls were 751 children (2-14 years old; two paired per case) with BMI <84th percentile. Data were collected in two phases: individual (questionnaires filled in by sentinel paediatricians) and family (self-administered questionnaires filled in a family environment). Crude OR and adjusted OR (ORc and adj OR) for the given variables were calculated using a simple and multiple conditional logistic regression analysis. RESULTS: The factors with the greatest effect on obesity were family history of obesity: both parents (adj OR = 11.2), mother but not father (adj OR = 9.1), father but not mother (adj OR = 6.1), siblings (adj OR = 2.7); and eating between meals (adj OR = 2.5) and consumption of sweets and soft drinks >2 times/week (adj OR = 2.0). The highest protection effect was found for five meals per day (adj OR = 0.5), the regular consumption of breakfast (adj OR = 0.5) and for eating fruit for dessert (adj OR = 0.6). Factors related to sedentary habits did not appear as noteworthy. CONCLUSIONS: We have determined the association between certain dietary behaviour and family history with childhood obesity in several Spanish regions.

Patrón epidemiológico de la obesidad en Castilla y León y su relación con otros factores de riesgo de enfermedad cardiovascular / Obesity in Castile and Leon, Spain: epidemiology and association with other cardiovascular risk factors

Estudio transversal de la obesidad en una muestra aleatoria de 4.012 personas de edad >=≥ 15 años en Castilla y León. Se estimó la prevalencia de obesidad (índice de masa corporal ≥ 30) y de obesidad abdominal (cintura > 102cm en varones y > 88cm en mujeres) y se calculó la relación de ambos tipos de obesidad con otros factores de riesgo cardiovascular. La prevalencia de obesidad fue del 21,7% (intervalo de confianza [IC] del 95%, 20,3%-23,2%), mayor en mujeres —23,2% (IC del 95%, 20,9%-25,5%) que en varones —20,4% (IC del 95%, 18%-22,7%)—. La prevalencia de obesidad abdominal fue del 36,7% (IC del 95%, 34,6%-38,9%), mayor también en mujeres —50,1% (IC del 95%, 47%-53,1%)— que en varones —22,8% (IC del 95%, 20,3%-25,2%). Todos los factores de riesgo cardiovascular, excepto el tabaquismo, estuvieron asociados a la obesidad. El riesgo SCORE y Framingham a 10 años fue superior en obesos (AU)

A cross-sectional study of obesity in a random sample of 4012 individuals aged >=15 years in Castile and Leon, Spain, was carried out. The prevalence of obesity (i.e. a bodymass index >=30 kg/m2) and abdominal obesity (i.e. a waist circumference >102 cm in males or >88 cm in females) was determined and associations between both types of obesity and other cardiovascular risk factors were investigated. The overall prevalence of obesity was 21.7% (95% confidence interval [CI], 20.3%-23.2%): it was higher in women, at 23.2% (95% CI, 20.9%-25.5%), than in men, at 20.4% (95% CI, 18.0%-22.7%). The prevalence of abdominal obesity was 36.7% (95% CI, 34.6%-38.9%): again it was higher in women, at 50.1% (95% CI, 47%-53.1%) than inmen, at 22.8% (95% CI, 20.3%-25.2%). Associations were found between obesity and all classic cardiovascular risk factors, except smoking. The 10-year Systematic Coronary Risk Evaluation (SCORE) and Framingham risk scores were higher in obese individuals (AU)

Obesity in Castile and Leon, Spain: epidemiology and association with other cardiovascular risk factors.

A cross-sectional study of obesity in a random sample of 4012 individuals aged ≥ 15 years in Castile and Leon, Spain, was carried out. The prevalence of obesity (i.e. a body mass index ≥ 30 kg/m²) and abdominal obesity (i.e. a waist circumference > 102 cm in males or > 88 cm in females) was determined and associations between both types of obesity and other cardiovascular risk factors were investigated. The overall prevalence of obesity was 21.7% (95% confidence interval [CI], 20.3%-23.2%): it was higher in women, at 23.2% (95% CI, 20.9%-25.5%), than in men, at 20.4% (95% CI, 18.0%-22.7%). The prevalence of abdominal obesity was 36.7% (95% CI, 34.6%-38.9%): again it was higher in women, at 50.1% (95% CI, 47%-53.1%) than in men, at 22.8% (95% CI, 20.3%-25.2%). Associations were found between obesity and all classic cardiovascular risk factors, except smoking. The 10-year Systematic Coronary Risk Evaluation (SCORE) and Framingham risk scores were higher in obese individuals.

Guía de principios y métodos de las redes centinelas sanitarias en España / Guide to the principles and methods of health sentinel networks in Spain

Las redes centinelas sanitarias son cada vez más utilizadas en el estudio de problemas relacionados con la salud. Este documento tiene como objetivo la presentación de una guía metodológica para la instauración y desarrollo de redes centinelas sanitarias, que ha sido elaborada por gestores de las redes centinelas autonómicas a partir de los resultados obtenidos de un estudio Delphi. Los principales apartados recogidos en la guía son: definición de una red centinela sanitaria; descripción de la red –objetivos y composición–; modo de selección de los centinelas participantes; descripción de los procesos de salud adecuados para su estudio mediante esta metodología –incidencia, definición de casos, criterios de inclusión y exclusión–; descripción de la población diana; establecimiento de indicadores de calidad; periodicidad de la recogida de datos; diffusion de la información –periodicidad y métodos–, e incorporación de los participantes en los órganos de decisión a través de comisiones multidisciplinarias. La guía tiene como fin contribuir al desarrollo de redes con una metodología común en las diferentes comunidades autónomas. Asimismo, se considera de gran utilidad contar con un modelo para la implantación de nuevas redes en nuestro país. Por último, se concluye que es importante dar a conocer el concepto de red centinela sanitaria, difundir la información que generan y potenciar su uso desde la Administración (AU)

Health sentinel networks are being increasingly used in the study of health-related problems. The present article aims to provide a methodological guide – designed by regional sentinel network managers and based on the results of a Delphi study – that can be used to set up and develop a health sentinel network. The main topics in the guide are the following: definition of a health sentinel network; network description: aims and structure; methods for the selection of sentinel participants; description of health processes suitable for study through this methodology: incidence, case definition, exclusion and inclusion criteria; description of the target population: the denominator for incidence rates estimates; quality indicators; periodicity of data collection; dissemination of the information: periodicity and methods, and incorporation of the participants in the decision- making process through multidisciplinary commissions. This guide aims to contribute to the development of sentinel networks in the autonomous communities by providing a common methodology, which could be highly useful when introducing new networks in Spain. Finally, we conclude that it is important to raise awareness of the concept of health sentinel networks, disseminate the information generated, and promote its use by public health administration (AU)

Redes centinela sanitarias en España. Consenso para una guía de principios y métodos / Health sentinel networks in Spain. Consensus for a guide of principles and methods

Las redes centinela sanitarias han estado activas en nuestro país desde la década de los años ochenta, con variados objetivos, metodología y diferente grado de desarrollo en las comunidades autónomas donde se han implantado. La necesidad de normalizar el funcionamiento y de armonizar los indicadores ha propiciado un proyecto de investigación de redes centinela sanitarias españolas, uno de cuyos objetivos es establecer una guía de principios y métodos de trabajo. Se ha procedido a realizar un estudio con el método Delphi, en el que un panel de 23 expertos ha consensuado, en 3 fases consecutivas, la definición de red centinela, los objetivos, los principios que deben regirlas y otros aspectos relacionados con la organización y funcionamiento. En conjunto se plantearon 41 cuestiones sobre la base de un primer borrador, las cuales necesitaban un 80% de consenso en una primera fase y un 70% en la segunda. Todos los expertos participaron en la primera fase, 22 en la segunda y 20 en la tercera. Se alcanzó un consenso en 36 cuestiones en la primera fase y en 4 de las 5 restantes en la segunda. En la tercera fase se dio forma definitiva al documento de la guía. El método de consenso Delphi ha resultado extremadamente útil en la resolución de discrepancias y divergencias, obteniéndose una guía válida para redes centinela. Los expertos ajenos a los sistemas centinela del panel seleccionado aportaron una visión más extensa sobre los objetivos y la aplicabilidad de las redes centinela sanitarias en España

Since the eighties, health sentinel networks have been active in our country, but with a variety of objectives, methods and different development levels in the autonomous communities. The necessity of standardising the management and harmonising the indicators has concluded in a research project on the Spanish health sentinel networks, one of whose objectives is to establish a guide for work principles and methods. A panel of 23 experts has made a study using the Delphi method to agree, in three consecutive phases, a definition of sentinel network, the objectives and the management principles and other aspects related to the organisation and functioning. Altogether, 41 questions were gathered from a previous draft which needed 80% of consensus in the first phase and 70% in the second. All the experts participated in the first phase, 22 in the second and 20 in the third. A consensus was achieved on 36 questions in the first phase and in 4 of the remaining ones in the second. In the third phase the shape of the guide document was given. The Delphi consensus method has been extremely useful in the resolution of discrepancies and divergences. The experts who were selected outside of the sentinel networks contributed with a wider vision on the objectives and applicability of the health sentinel networks in Spain

[Health sentinel networks in Spain. Consensus for a guide of principles and methods]. / Redes centinela sanitarias en España. Consenso para una guía de principios y métodos.

Since the eighties, health sentinel networks have been active in our country, but with a variety of objectives, methods and different development levels in the autonomous communities. The necessity of standardising the management and harmonising the indicators has concluded in a research project on the Spanish health sentinel networks, one of whose objectives is to establish a guide for work principles and methods. A panel of 23 experts has made a study using the Delphi method to agree, in three consecutive phases, a definition of sentinel network, the objectives and the management principles and other aspects related to the organisation and functioning. Altogether, 41 questions were gathered from a previous draft which needed 80% of consensus in the first phase and 70% in the second. All the experts participated in the first phase, 22 in the second and 20 in the third. A consensus was achieved on 36 questions in the first phase and in 4 of the remaining ones in the second. In the third phase the shape of the guide document was given. The Delphi consensus method has been extremely useful in the resolution of discrepancies and divergences. The experts who were selected outside of the sentinel networks contributed with a wider vision on the objectives and applicability of the health sentinel networks in Spain.

[Guide to the principles and methods of health sentinel networks in Spain]. / Guía de principios y métodos de las redes centinelas sanitarias en España.

Health sentinel networks are being increasingly used in the study of health-related problems. The present article aims to provide a methodological guide - designed by regional sentinel network managers and based on the results of a Delphi study - that can be used to set up and develop a health sentinel network. The main topics in the guide are the following: definition of a health sentinel network; network description: aims and structure; methods for the selection of sentinel participants; description of health processes suitable for study through this methodology: incidence, case definition, exclusion and inclusion criteria; description of the target population: the denominator for incidence rates estimates; quality indicators; periodicity of data collection; dissemination of the information: periodicity and methods, and incorporation of the participants in the decision-making process through multidisciplinary commissions. This guide aims to contribute to the development of sentinel networks in the autonomous communities by providing a common methodology, which could be highly useful when introducing new networks in Spain. Finally, we conclude that it is important to raise awareness of the concept of health sentinel networks, disseminate the information generated, and promote its use by public health administration.