Comparative Study of Staphylococcus epidermidis Virulence Profiles in an animal Model of Endophthalmitis

Introduction: Gram-positive staphylococci are responsible for over 90% of cases of postoperative infectious endophthalmitis, with Staphylococcus epidermidis accounting for approximately 70% of isolated microorganisms. Objective: To evaluate the relationship between S. epidermidis virulence and severity of endophthalmitis in an animal model. Methodology: New Zealand albino rabbits were divided into two groups and administered 100 colony-forming units of S. epidermidis strains. In the virulent group, four rabbits received a multi-antibiotic resistant, mecA, ica, and atlE gene carrying S. epidermidis strain, from a patient´s conjuntival microbiota and three a biofilm-forming S. epidermidis ATCC 35984. In the non-virulent group, five rabbits were inoculated with a strain sensitive to all tested antibiotics and lacking mecA, ica, and atlE genes, also from a patient and three rabbits received the non-producer biofilm S. epidermidis ATCC 29122. Clinical and ultrasound examinations were conducted every three hours until endophthalmitis symptoms appeared, followed by daily clinical assessments. Histological evaluations were performed 15 days post-inoculation. Results: The less virulent group displayed milder inflammation and reduced intraocular damage in comparison to the more virulent group based on clinical and ultrasound observations. Nevertheless, histopathological analysis revealed similar inflammation in all groups, 15 days post-inoculation. Discussion: Less virulent S. epidermidis strains induced less severe inflammation as observed through clinical and ultrasound assessments. However, long-term histopathological assessments showed effects comparable to those seen with the more virulent strain.

Introducción: Gram-positive staphylococci are responsible for over 90% of cases of postoperative infectious endophthalmitis, with Staphylococcus epidermidis accounting for approximately 70% of isolated microorganisms. Objetivo: Evualuar la relación entre la virulencia de S. epidermidis y la gravedad de la endoftalmitis en un modelo animal. Metodología: Se dividieron conejos albinos de Nueva Zelanda en dos grupos y se les administraron 100 unidades formadoras de colonias de cepas de S. epidermidis. En el grupo virulento, cuatro conejos recibieron una cepa multirresistente de S. epidermidis portadora de gen mecA, ica y atlE, de la microbiota conjuntival de un paciente y tres conejos la cepa S. epidermidis ATCC 35984 formadora de biopelículas. En el grupo no-virulento, se inocularon cinco conejos con una cepa sensible a todos los antibióticos probados y que carecía de los genes mecA, ica y atlE, también de un paciente y tres conejos recibieron la cepa S. epidermidis ATCC 29122 no productora de biopelícula. Se realizaron exámenes clínicos y ecográficos cada tres horas hasta la aparición de síntomas de endoftalmitis, seguido de evaluaciones clínicas diarias. Las evaluaciones histológicas se realizaron 15 días después de la inoculación. Resultados: El grupo menos virulento mostró una inflamación más leve y un daño intraocular reducido en comparación con el grupo más virulento según observaciones clínicas y ecográficas. Sin embargo, el análisis histopatológico reveló una inflamación similar en todos los grupos, 15 días después de la inoculación. Discusión: Las cepas de S. epidermidis menos virulentas indujeron una inflamación menos grave, como se observó mediante evaluaciones clínicas y ecográficas. Sin embargo, las evaluaciones histopatológicas a largo plazo mostraron efectos comparables a los observados con la cepa más virulenta.

Parents' perceived barriers to active commuting to school. Comparative study between Spanish and Ecuadorian cities.

Parents´ perceptions can influence their children´s mode of commuting to school. In this sense, the purposes of this study were to compare parental barriers towards active commuting to school (ACS) between Ecuadorian and Spanish children, and to analyze the associations between those barriers and the children's mode of commuting. Descriptive and comparative analyses were performed using Chi-square and T-student test. Associations were analyzed by several logistic regression models. Results showed that road safety is the main barrier for ACS, and that all the barriers are perceived as higher by Ecuadorian parents (p<0.001). It was also found that Ecuadorian children were less likely to be active when parents perceive greater total barriers (OR=0.15, CI=0.06, 0.40). Public policies should focus on reducing the parental barriers in order to increase ACS, specifically those related to road safety.

Fitness and fatness in children and adolescents: investigating their role in the association between physical activity and cardiometabolic health.

To verify the role of the combination of fitness and fatness in the relationship between physical activity (PA) and cardiometabolic risk in children and adolescents. This is a cross-sectional study performed with 2786 children and adolescents (6 to 17 years). Fitness was determined by the cardiorespiratory fitness (CRF) six-minute walking and running test. Waist circumference (WC) was considered a fatness indicator. A selfreported questionnaire was used to determine PA practice, whereas the clustered cardiometabolic risk score (cMetS) was calculated by summing z-scores of triglycerides, total cholesterol/HDL-C ratio, systolic blood pressure, glucose, and WC. Considering the combination of CRF (fitness) and WC (fatness), the following phenotypes were created: Fit/Unfat, Fit/Fat, Unfit/Unfat and Unfit/Fat. Moderation analyses were tested using linear regression models. Significant interactions were found between PA and Unfit/Fat category (ß = -0.001; p = 0.001) only for adolescents. The interaction observed in the Unfit/Fat phenotype indicated that adolescents who practise PA for 330 minutes per week presented lower cMetS compared to those who do not practise or practise for 60 minutes respectively. The combination of fitness and fatness moderates the relationship between PA and cardiometabolic risk, suggesting that adolescents, particularly those who are less fit and present high adiposity, should be encouraged to engage in regular PA to improve their metabolic health.

The added effect of non-pharmaceutical interventions and lifestyle behaviors on vaccine effectiveness against severe COVID-19 in Chile: A matched case-double control study.

BACKGROUND: World Health Organization approved vaccines have demonstrated relatively high protection against moderate to severe COVID-19. Prospective vaccine effectiveness (VE) designs with first-hand data and population-based controls are nevertheless rare. Neighborhood compared to hospitalized controls, may differ in compliance to non-pharmacuetical interventions (NPI) compliance, which may influence VE results in real-world settings. We aimed to determine VE against COVID-19 intensive-care-unit (ICU) admission using hospital and community-matched controls in a prospective design. METHODS: We conducted a multicenter, observational study of matched cases and controls (1:3) in adults ≧18 years of age from May to July 2021. For each case, a hospital control and two community controls were matched by age, gender, and hospital admission date or neighborhood of residence. Conditional logistic regression models were built, including interaction terms between NPIs, lifestyle behaviors, and vaccination status; the model's ß coefficients represent the added effect these terms had on COVID-19 VE. RESULTS: Cases and controls differed in several factors including education level, obesity prevalence, and behaviors such as compliance with routine vaccinations, use of facemasks, and routine handwashing. VE was 98·2% for full primary vaccination and 85·6% for partial vaccination when compared to community controls, and somewhat lower, albeit not significantly, compared to hospital controls. A significant added effect to vaccination in reducing COVID-19 ICU admission was regular facemask use and VE was higher among individuals non-compliant with the national vaccine program, and/or tonroutine medical visits during the prior year. CONCLUSION: VE against COVID-19 ICU admission in this stringent prospective case-double control study reached 98% two weeks after full primary vaccination, confirming the high effectiveness provided by earlier studies. Face mask use and hand washing were independent protective factors, the former adding additional benefit to VE. VE was significantly higher in subjects with increased risk behaviors.

From pregnancy to breastfeeding: adequate maternal body mass index is essential to prevent a high body mass index in your children.

OBJECTIVES: To verify the associations between prenatal and perinatal factors with offspring body mass index (BMI) and the moderator role of maternal BMI in this relationship. METHODS: Cross-sectional study developed with 1,562 children and adolescents aged between 6 and 17 years, as well as their mothers, from southern Brazil. The prenatal and perinatal factors, weight, and height for the calculation of maternal BMI were self-reported. For the calculation of BMI, weight and height of the child/adolescent were measured on an anthropometric scale with a coupled stadiometer. Linear regression models were used for the moderation analysis. All analyzes were adjusted for the mother's and child's age, sex, sexual maturation, skin color/race, and educational level. RESULTS: cesarean as type of delivery (ß=0.66; 95% CI=0.22 1.04; p=0.002) and pregnancy complications (ß=0.60; 95% CI=0.15 1.04; p=0.002) were positively associated with offspring BMI. Schoolchildren who were breastfed for 4-6 months showed -0.56 kg/m2 of BMI (95% CI=-1.06-0.06; p=0.02). Birth weight was also associated with BMI, with low weight being inversely (ß=-0.59; 95% CI=-1.03-0.15; p=0.008), while overweight was positively related (ß=0.84; 95% CI=0.08 1.60; p=0.02). The moderation analysis indicated a positive interaction between the mother's BMI and cesarean, pregnancy complications, and smoking with the offspring's BMI. On the other hand, there was an inverse association between breastfeeding from 7 to 12 months and the offspring BMI, only in mothers with high BMI. CONCLUSIONS: Adequate maternal BMI is essential to prevent a high BMI in their children, especially when considering the influence of prenatal and perinatal risk factors.

Mediation role of residential density on the association between perceived environmental factors and active commuting to school in Brazilian adolescents.

The objective of this study was to verify whether residential density and connectivity between streets are mediators on the association between perceived environmental factors and active commuting to school (ACS) in Brazilian adolescents. This is a cross-sectional study with a random sample of 1,130 adolescents (52.7% girls) aged between 14 to 20 years, from Porto Alegre, Rio Grande do Sul State, Brazil. Adolescents' self-reported their usual mode of commuting to and from school using a questionnaire and the perceived environmental attributes by Neighborhood Environment Walkability Scale for Youth (NEWS-Y). Residential density and connectivity between streets were measured by gographic information systems (GIS), within 1km road network buffers around the participant's residential address. Regression models were fitted according to mediation analyses procedures. The results showed that residential density is a mediator on the association between ACS and perceived environmental factors, including land-use mix diversity (IE = 0.114; 95%CI: 0.130, 0.311; 32% mediation), neighborhood recreation facilities (IE = 0.064; 95%CI: 0.034, 0.105; 15% mediation), and access to services (IE = 0.045; 95%CI: 0.006, 0.104; 14% mediation). Connectivity between streets did not correlate with ACS, thus it was not tested in the mediation model. In conclusion, residential density is a mediator on the relationship between perceived environmental factors and ACS.

Retinopatía del prematuro: resultados de un programa de prevención, detección y tratamiento

RESUMEN Introducción: La Retinopatía del Prematuro (ROP) es una de las principales causas de ceguera prevenibles en la infancia. La Fundación Visión implementa; el Programa de Prevención, Detección y Tratamiento en el año 2015. Objetivos: Describir los resultados de implementación y los resultados alcanzados por un programa de ROP en su accesibilidad, efectividad y calidad de atención. Materiales y Métodos: Estudio descriptivo, ambispectivo, de casos consecutivos de recién nacidos prematuros con criterios de evaluación; de una población evaluada en el año 2009 y del 2015 al 2019. Resultados: Las unidades neonatales incluidas aumentaron de 3 a 7; cubriendo Asunción, área Central, Caaguazú y Alto Paraná. De los registros se constato que la cobertura aumento de 36% en el año 2009 a 97% en el 2019. Desde que se instaló el programa; en el primer año la proporción del número de evaluaciones aumento entre el 28 y el 216%; y los resultados globales de julio 2015 a diciembre 2019 fueron: número totales de pacientes con criterio: 2397 pacientes; número totales de pacientes evaluados: 2080 (86,8%), número de pacientes con ROP: 416/2080 pacientes (20%), número de pacientes con ROP que requirieron tratamiento: 76/416 pacientes (18,2%), proporción global de ROP grave con tratamiento: 76/2080 pacientes (3,4%). Conclusiones: El programa a través de un equipo multidisplinario y la inovación con telemedicina logró aumentar la proporción de cobertura y la disminución de los casos graves que requirieron tratamiento.

ABSTRACT Introduction: Retinopathy of Prematurity (ROP) is one of the main preventable causes of blindness in childhood. The Vision Foundation implemented the Prevention, Detection and Treatment Program in 2015. Objective: To describe the implementation results and the outcomes achieved by a ROP program regarding its accessibility, effectiveness and quality of care. Materials and Methods: This was a descriptive and ambispective study of consecutive cases of premature newborns with criteria for evaluation, of a population evaluated in the year 2009 and from 2015 to 2019. Results: The participating neonatal units increased from 3 to 7; covering Asunción, the Central, Caaguazú and Alto Paraná Departments. From the records, it was found that program coverage increased from 36% in 2009 to 97% in 2019. Since the beginning of the program, during the first year the proportion of the number of evaluations increased between 28 and 218%; the global results from July 2015 to December 2019 were: total number of patients with criteria: 2397 patients; total number of patients evaluated: 2,080 (88%), number of patients with ROP: 416/2080 patients (20 %), number of patients with ROP requiring treatment: 76/416 patients (18.3%), overall proportion of severe ROP with treatment: 76/2080 patients (3.4%). Conclusions: The program, using a multidisciplinary team and the innovation of telemedicine, managed to increase the proportion of coverage and the reduction of serious cases that require treatment.

Mediation role of residential density on the association between perceived environmental factors and active commuting to school in Brazilian adolescents / O papel de mediação da densidade residencial na associação entre fatores ambientais percebidos e deslocamento ativo à escola em adolescentes brasileiros / El papel mediador de la densidad poblacional en la asociación entre los factores ambientales percibidos y el desplazamiento activo a la escuela en adolescentes brasileños

Abstract: The objective of this study was to verify whether residential density and connectivity between streets are mediators on the association between perceived environmental factors and active commuting to school (ACS) in Brazilian adolescents. This is a cross-sectional study with a random sample of 1,130 adolescents (52.7% girls) aged between 14 to 20 years, from Porto Alegre, Rio Grande do Sul State, Brazil. Adolescents' self-reported their usual mode of commuting to and from school using a questionnaire and the perceived environmental attributes by Neighborhood Environment Walkability Scale for Youth (NEWS-Y). Residential density and connectivity between streets were measured by gographic information systems (GIS), within 1km road network buffers around the participant's residential address. Regression models were fitted according to mediation analyses procedures. The results showed that residential density is a mediator on the association between ACS and perceived environmental factors, including land-use mix diversity (IE = 0.114; 95%CI: 0.130, 0.311; 32% mediation), neighborhood recreation facilities (IE = 0.064; 95%CI: 0.034, 0.105; 15% mediation), and access to services (IE = 0.045; 95%CI: 0.006, 0.104; 14% mediation). Connectivity between streets did not correlate with ACS, thus it was not tested in the mediation model. In conclusion, residential density is a mediator on the relationship between perceived environmental factors and ACS.

Resumo: O estudo teve como objetivo verificar se a densidade residencial e a conectividade entre ruas são mediadores da associação entre fatores ambientais percebidos e deslocamento ativo casa-escola (DAE) em adolescentes brasileiros. Foi um estudo transversal com uma amostra randomizada de 1.130 adolescentes (52,7% do sexo feminino) entre 14 e 20 anos de idade, de Porto Alegre, Rio Grande do Sul, Brasil. Os adolescentes informaram seu modo de deslocamento casa-escola (ida e volta) através de um questionário, além dos atributos ambientais percebidos, de acordo com a Neighborhood Environment Walkability Scale for Youth (NEWS-Y). A densidade residencial e a conectividade entre ruas foram medidas por sistemas de informação geográfica (SIG), dentro de um raio de 1km da rede viária em torno do endereço residencial do participante. Foram ajustados modelos de regressão de acordo com os procedimentos para análises de mediação. Os resultados mostraram que a densidade residencial é um mediador da associação entre os fatores ambientais percebidos e o DAE, inclusive a diversidade do uso do solo (EI = 0,114; IC95%: 0,130, 0,311; 32% de mediação), infraestrutura para atividades de lazer na vizinhança (EI = 0,064; IC95%: 0,034, 0,105; 15% de mediação) e acesso a serviços (EI = 0,045; IC95%: 0,006, 0,104; 14% de mediação). A conectividade entre ruas não mostrou correlação com DAE, portanto não foi testado no modelo de mediação. Conclui-se que a densidade residencial é um mediador da relação entre fatores ambientais percebidos e DAE.

Resumen: El objetivo fue verificar si la densidad poblacional y la conectividad entre calles son mediadores en la asociación entre los factores ambientales percibidos y el desplazamiento activo a la escuela (DAE) en adolescentes brasileños. Se trata de un estudio transversal, con una muestra aleatoria de 1.130 adolescentes (52,7% chicas), con una edad comprendida entre los 14 y los 20 años de edad, de Porto Alegre, Río Grande do Sul, Brasil. Los adolescentes autoinformaron su modo habitual de desplazamiento "a" y "desde" la escuela, usando un cuestionario y las características ambientales percibidas mediante el Neighborhood Environment Walkability Scale for Youth (NEWS-Y). La densidad poblacional y conectividad entre las calles se midieron mediante los sistemas de información geográfica (GIS), dentro de una red vial delimitada por un radio de 1km alrededor de la dirección residencial del participante. Los modelos de regresión se ajustaron según los procedimientos para el análisis de mediación. Los resultados mostraron que la densidad poblacional es un a mediador en la asociación entre los factores ambientales percibidos y la DAE, incluyendo el uso del suelo para diversos fines (EI = 0,114; IC95%: 0,130, 0,311; 32% mediación), instalaciones recreativas en el barrio (EI = 0,064; IC95%: 0,034, 0,105; 15% mediación), y acceso a los servicios (EI = 0,045; IC95%: 0,006, 0,104; 14% mediación). Conectividad entre calles que no mostraron correlación con DAE, por consiguiente, no fue probado en el modelo de mediación. En conclusión, la densidad poblacional es un mediador en la relación entre los factores ambientales percibidos con DAE.

Metabolic Syndrome and Its Associated Factors in Older Adults: A Secondary Analysis of SABE Colombia in 2015.

Background: Understanding the metabolic syndrome (MetS) prevalence at the national level is important to develop effective programs and strategies to prevent and control MetS. This study aimed to analyze the prevalence of MetS according to gender and aging stage, and its association with potential factors in older individuals ≥60 years of age in Colombia. Methods: The data for this study came from a secondary cross-sectional, nationally representative SABE study Survey on Health, Well-Being, and Aging in Colombia, 2015. A total of 1637 participants (60.7% women, 70.5 ± 7.9 years) from 86 Colombian municipalities participated. A structured questionnaire was used to collect data on socio-demography, lifestyle, and self-report medical conditions. Measurements included anthropometric (weight, waist circumference, body mass index), sarcopenia "proxy" status (calf circumference) handgrip strength levels, high-density lipoprotein cholesterol, triglycerides, fasting glucose, and blood pressure. Univariate and multiple regression models were established as part of the main analysis. Results: Using the harmonized Joint Scientific Statement criteria, MetS was present in 54.9% of the study population, with a higher prevalence among females than males (59.8% vs. 47.3%). Individuals who were cigarette smokers (odds ratio [OR] = 1.5; 95% confidence interval [CI] = 1.0-2.4; P = 0.034), female gender (OR = 1.3; 95% CI = 1.0-1.8; P = 0.020), and sarcopenia "proxy" (OR = 1.6; 95% CI = 1.0-2.5; P = 0.026) were more likely to have a higher prevalence estimate of MetS, after controlling for relevant covariates. Conclusions: Overall prevalence of MetS among older adults in Colombia is high. Smoking, female gender, and sarcopenia "proxy" status are associated with MetS. These results suggested that MetS is still a serious public burden in Colombia, and screening for promotion of healthy lifestyle and nutrition counseling should be offered routinely in old age.

Active Commuting to University and its Association with Sociodemographic Factors and Physical Activity Levels in Chilean Students.

Background and Objectives: Active commuting to and from university (ACU) could be a strategy to increase physical activity levels (PA) and promote health in young university students. We aimed to a) examine the patterns of commuting to university in Chilean students; b) the association between the mode of commuting to and from university and socio-demographic factors and PA-levels. Materials and Methods: A total of 496 university students (21.6 ± 2.4 years old) from two universities from Valparaíso (central coast of Chile) participated in this study. Personal data, home address, socio-economic status, PA, and the usual mode of commuting to and from the university were self-reported by a questionnaire. The commute distances were objectively measured using Google-Maps-software. Associations were examined using binary logistic regressions. Results: The main mode of commuting was by bus (to university: 55.2% vs. from university: 59.3%; p < 0.001). The least used mode was cycling (1.4% to and from university). Students living >5-km from university were less active commuters than those living in closer distances: (2-5 km, odds ratio (OR): 4.424, 95% and 95% confidence intervals (CI): 2.443-8.011, p < 0.001; 2 km, OR: 143.052, 95% CI: 55.154-371.030, p < 0.001). Students with low PA-levels were less active commuters than those with medium (OR: 1.446; 95% CI: 0.864-2.421; p = 0.160) or higher levels (OR: 1.880; 95% CI: 1.880-1.094; p = 0.022). Students who lived between 2 and 5 km, presented a significant association to be active commuters when they showed medium PA-levels (OR: 5.244, 95% CI: 1.358-20.246; p = 0.016). Conclusions: Chilean university students from Valparaíso are mainly passive commuters using public transport as the main mode of commuting to and from university; longer distances from home to the university are associated with low PA levels. ACU in distances between 2-5 km (mainly walking) could contribute to having medium PA-levels in Chilean university students. Thus, promoting the ACU walking to and from the university in such distances could be an effective strategy to increase the overall PA levels in Chilean university students.

Associations between active commuting to school, sleep duration, and breakfast consumption in Ecuadorian young people.

BACKGROUND: Daily behaviours such as active commuting to school (ACS) could be a source of physical activity, contributing to the improvement of youth cardiovascular health, however, the relationship between ACS and other aspects of a youth's health, such as sleep duration and breakfast consumption, require further clarification. The aims of this study were therefore: 1) to analyse the prevalence of modes of commuting to school, sleep duration, and breakfast consumption by age groups and gender, and 2) to analyse the association between ACS, sleep duration recommendations, and breakfast consumption by age groups and gender. METHOD: This cross-sectional study included 732 school-aged students of low-middle socioeconomic status, categorised into children (10-12 yr), young adolescents (13-15 yr), and older adolescents (16-18 yr). Modes of commuting to/from school, sleep duration, and breakfast consumption were self-reported. Logistic regression models were fitted to examine the association between ACS, sleep duration and breakfast consumption, analysed according to age groups and gender. RESULTS: The percentage of students meeting sleep duration and daily breakfast recommendations was lowest in older adolescents, and highest in children (6.3% versus 50.8% p < 0.001, and 62.1%, versus 76.8%, p = 0.001, respectively). Young adolescents and girls who met the sleep duration recommendations were more likely to be active commuters than their counterparts (OR = 4.25; 95% CI = 1.81 to 9.92, p = 0.001 and OR = 2.89; 95%CI = 1.01 to 8.27, p = 0.04, respectively). CONCLUSION: Young adolescents (13-15 yr) and girls who met the sleep duration recommendations during school days displayed a positive association with ACS. There was no association between ACS and breakfast consumption for any of the age groups or gender. Children (10-12 yr) were those that best meet with the adequate sleep duration and breakfast consumption recommendations.

Salutogénesis de la alimentación en chile: actores involucrados y brechas detectadas / Nutritional Salutogenesis in Chile: key stakeholders and detected gaps

OBJETIVOS: Conocer los principales actores involucrados y las brechas detectadas en el proceso de aprendizaje alimentario de una población adulta urbana en Santiago de Chile. MATERIALES Y MÉTODOS: De una muestra de 100 beneficiarios de un CESFAM, se incluyó a quienes tuvieran un alto Índice de Alimentación Saludable (IAS). Se realizaron entrevistas semiestructuradas, las cuales fueron grabadas en audio, transcritas de manera textual y analizadas mediante la Teoría Fundamentada. RESULTADOS: Se entrevistó a 16 personas con IAS alto, en su mayoría mujeres. Los principales actores del proceso de aprendizaje alimentario resultan ser los padres, las experiencias adquiridas en el trabajo y la consulta con el profesional nutricionista. Se detectó una brecha de educación alimentaria entre la población general y el equipo de nutricionistas en contextos de atención primaria de salud. CONCLUSIONES: Los padres, los contextos laborales y la consulta con el nutricionista son las principales influencias en el proceso de aprendizaje alimentario. También fueron identificados tres grupos poblacionales (adolescentes femeninas, madres y niños), como poblaciones carentes de intervención nutricional de carácter educativo-preventivo por nutricionistas en el contexto de la atención primaria de salud en Chile, situación que podría perpetuar y mantener los malos hábitos de alimentación de la población general.

OBJECTIVES: To identify key stakeholders involved in the nutritional educational processes and detect gaps in this process in an urban adult population in Santiago, Chile. MATERIALS AND METHODS: From a sample of 100 individuals registered at a primary health care facility, those with a high Healthy Eating Index (HEI) were included in the study. Semi-structured interviews were conducted, which were recorded in audio, transcribed verbatim, and analyzed according to Grounded Theory. RESULTS: A total of 16 people with HEI were interviewed, who were mainly women. The main actors involved in the nutritional educational process turned out to be the individuals' parents, workplace experiences, and clinical consultations with professional nutritionists. A nutritional education gap was detected between the general population and teams of nutritionists in primary health care contexts. CONCLUSIONS: Parents, the workplace, and consultations with nutritionists are the main influences in the nutritional learning process. Three population groups (female adolescents, mothers, and children) were also identified as lacking educational and preventive interventions by nutritionists in the primary health care context in Chile; this situation could perpetuate and maintain unhealthy eating habits among the general population.

Mode of Commuting to School and Its Association with Physical Activity and Sedentary Habits in Young Ecuadorian Students.

Active commuting to and from school (ACS) could help to increase daily physical activity levels in youth; however, this association remains unknown in Ecuadorian youth. Thus, the aims of this study were (1) to determine the patterns of commuting to and from school and (2) to analyze the associations between ACS, physical activity (PA), and sedentary habits in Ecuadorian youth. A total of 732 students (65.3% males), aged 10⁻18 years (children = 246, young adolescents = 310, older adolescents = 162) from the central region of Ecuador participated in this study. A self-report questionnaire, including the usual mode and frequency of commuting, distance from home to school (PACO-Questionnaire), and PA and sedentary habits (YAP-Questionnaire), was used. Most of the sample lived ≤2 km from school; however, they were mainly passive commuters (96%). The most common mode of commuting was by car (to school = 43.4%, from school = 31.6%; p < 0.001). Children presented significantly higher scores (0⁻4) in PA outside school and total PA compared with older adolescents (2.20 ± 0.97 vs. 1.97 ± 0.96; p = 0.013 and 2.30 ± 0.76 vs. 2.09 ± 0.74, p = 0.019, respectively), as well as the lowest scores in sedentary habits (1.51 ± 0.65, p < 0.001). PA at school and total PA were positively associated with ACS (OR 3.137; 95% CI, 1.918 to 5.131; p < 0.001, and OR 2.543; 95% CI, 1.428 to 4.527; p = 0.002, respectively). In conclusion, passive modes of transportation were the most frequently used to commute to and from school in young Ecuadorians. PA at school and total PA were positively associated with ACS. Thus, interventions at school setting could be an opportunity to improve PA levels and additionally ACS in youth from the central region of Ecuador.

Active commuting to and from university, obesity and metabolic syndrome among Colombian university students.

BACKGROUND: There is limited evidence concerning how active commuting (AC) is associated with health benefits in young. The aim of the study was to analyze the relationship between AC to and from campus (walking) and obesity and metabolic syndrome (MetS) in a sample of Colombian university students. METHODS: A total of 784 university students (78.6% women, mean age = 20.1 ± 2.6 years old) participated in the study. The exposure variable was categorized into AC (active walker to campus) and non-AC (non/infrequent active walker to campus: car, motorcycle, or bus) to and from the university on a typical day. MetS was defined in accordance with the updated harmonized criteria of the International Diabetes Federation criteria. RESULTS: The overall prevalence of MetS was 8.7%, and it was higher in non-AC than AC to campus. The percentage of AC was 65.3%. The commuting distances in this AC from/to university were 83.1%, 13.4% and 3.5% for < 2 km, 2-5 km and > 5 km, respectively. Multiple logistic regressions for predicting unhealthy profile showed that male walking commuters had a lower probability of having obesity [OR = 0.45 (CI 95% 0.25-0.93)], high blood pressure [OR = 0.26 (CI 95% 0.13-0.55)] and low HDL cholesterol [OR = 0.29 (CI 95% 0.14-0.59)] than did passive commuters. CONCLUSIONS: Our results suggest that in young adulthood, a key life-stage for the development of obesity and MetS, AC could be associated with and increasing of daily physical activity levels, thereby promoting better cardiometabolic health.

Comparación de los niveles de actividad física durante la vida universitaria / Comparison of the physical activity levels during the university life

Background: A high percentage of Chilean university students are inactive. Aim: To determine differences in physical activity (PA) levels and energy expenditure in a group of university students according to their length of stay in the university. Material and Methods: We studied 56 students aged 22 ± 2 years (29 women). They wore a triaxial accelerometer during seven days, determining steps/day, steps/min, sedentary time and PA levels. Participants also answered a PA questionnaire. Their weight and height were measured. They were divided in two groups according to the time spent at university (1-2 years and 3-5 years). Results: No significant differences in energy expenditure were observed between both groups of students. The number of steps/day and steps/ min was significantly higher in the group with 3 to 5 years in the university than their counterparts with 1-2 years. Conclusions: As the university years increase, there is a tendency to increase the time spent walking (18.3%) but without an increase in the moderate-vigorous PA.

Self-Rated Health Status and Cardiorespiratory Fitness in a Sample of Schoolchildren from Bogotá, Colombia. The FUPRECOL Study.

To evaluate the relationship between Self-Rated Health (SRH) and cardiorespiratory fitness (CRF) in a sample of children and adolescents enrolled in official schools in Bogotá, Colombia. A cross-sectional study was performed with 7402 children and adolescents between 9 and 17 years of age. Participants were asked to rate their health based on eight validated questions, addressing the participants propensity for headache, stomach-ache, backache, feeling-low, irritability/bad mood, nervousness, sleeping-difficulties, and dizziness. The choices were "rarely or never", "almost every month", "almost every week", and "more than once a week/about every day". Participants performed the international course-navette shuttle run test to estimate CRF, and cut-off points for age and gender were used to categorize the healthy/unhealthy fitness zone according to the FITNESSGRAM® criteria. Overall, 16.4% of those surveyed reported a perception of irritability/bad mood "more than once a week/about every day", followed by feeling-low and nervousness (both with 9.9%). Dizziness had the lowest prevalence with a percentage of 6.9%. Unhealthy CRF in boys increased the likelihood of headaches by 1.20 times, stomach aches by 1.31 times, feeling-low by 1.29 times, nervousness by 1.24 times, and dizziness by 1.29 times. In girls, unhealthy CRF increased the likelihood of headaches by 1.19 times, backache by 1.26 times, feeling-low by 1.28 times, irritability/bad mood by 1.17 times, sleeping-difficulties by 1.20 times, and dizziness by 1.27 times. SRH was associated with CRF in both genders. Early identification of children and adolescents with low CRF levels will permit interventions to promote healthy behaviors and prevent future diseases during adulthood.

Comparison of Three Adiposity Indexes and Cutoff Values to Predict Metabolic Syndrome Among University Students.

PURPOSE: Obesity and high body fat are related to diabetes and metabolic syndrome (MetS) in all ethnic groups. Based on the International Diabetes Federation (IDF) definition of MetS, the aim of the present study was to compare body adiposity indexes (BAIs) and to assess their various cutoff values for the prediction of MetS in university students from Colombia. METHODS: A cross-sectional study was conducted on 886 volunteers (51.9% woman; age mean 21.4 years). Anthropometric characteristics (height, weight, waist circumference [WC], and hip circumference [HC]) were measured, and body composition was assessed by bioelectrical impedance analysis. MetS was defined as including ≥3 of the metabolic abnormalities (WC, high-density lipoprotein cholesterol [HDL-C], triglycerides, fasting glucose, and systolic and diastolic blood pressure [BP]) in the definition provided by the IDF. The BAIs (i.e., BAI-HC [BAI], BAI-WC [BAI-w], and [BAI-p]) were calculated from formulas taking into account, height, weight, and WC, and for the visceral adiposity indexes, a formula, including WC, HDL-C, and triglycerides, was used. RESULTS: The overall prevalence of MetS was 5.9%, higher in men than in women. The most prevalent components were low HDL-C, high triglyceride levels, WC, and BP levels. The receiver operating characteristic curves analysis showed that BAI, BAI-w, and BAI-p could be useful tools to predict MetS in this population. CONCLUSION: For women, the optimal MetS threshold was found to be 30.34 (area under curve [AUC] = 0.720-0.863), 19.10 (AUC = 0.799-0.925), and 29.68 (AUC = 0.779-0.901), for BAI, BAI-w, and BAI-p, respectively. For men, the optimal MetS threshold was found to be 27.83 (AUC = 0.726-0.873), 21.48 (AUC = 0.755-0.906), and 26.18 (AUC = 0.766-0.894), for BAI, BAI-w, and BAI-p, respectively. The three indexes can be useful tools to predict MetS according to the IDF criteria in university students from Colombia. Data on larger samples are needed.

Cycling to School and Body Composition, Physical Fitness, and Metabolic Syndrome in Children and Adolescents.

OBJECTIVE: To evaluate the association between cycling to/from school and body composition, physical fitness, and metabolic syndrome among a sample of Colombian children and adolescents. STUDY DESIGN: During the 2014-2015 school year, we examined a cross-sectional component of the Association for muscular strength with early manifestation of cardiovascular disease risk factors among Colombian children and adolescents (FUPRECOL) study. Participants included 2877 youths (54.5% girls) from Bogota, Colombia. A self-reported questionnaire was used to measure the frequency and mode of commuting to school. Four components of physical fitness were measured: (1) anthropometric (height, weight, body mass index, and waist circumference); (2) musculoskeletal (handgrip and standing long jump test); (3) motor (speed-agility test; 4 × 10-meter shuttle run); and (4) cardiorespiratory (20-m shuttle run test [20mSRT]). The prevalence of metabolic syndrome was determined by the definitions provided by the International Diabetes Federation. RESULTS: Twenty-three percent of the sample reported commuting by cycle. Active commuting boys had a likelihood of having an unhealthy 4 × 10 m value (OR, 0.72; 95% CI, 0.53-0.98; P = .038) compared with the reference group (passive commuters). Active commuting girls showed a lower likelihood of having unhealthy a 20mSRT value (OR, 0.81; 95% CI, 0.56-0.99; P = .047) and metabolic syndrome (OR, 0.61; 95% CI, 0.35-0.99; P = .048) compared with passive commuters. CONCLUSION: Regular cycling to school may to be associated with better physical fitness and a lower incidence of metabolic syndrome than passive transport, especially in girls.