Breastfeeding during the first 6 months of life, adiposity rebound and overweight/obesity at 8 years of age.

BACKGROUND: The question of whether breastfeeding protects the child from obesity is a still debated issue; however, the relationship between early adiposity rebound and higher risk of obesity is well known. This study was aimed at evaluating whether breastfeeding (without formula supplement) during the first 6 months of life delays the time of adiposity rebound and consequently reduces the rates of obesity at the age of 8. METHODS: This retrospective cohort study included 1812 children born in Gran Canaria in 2004, with follow-up until they were 8 years of age. Anthropometrical data had been taken during routine visits to the doctor and were extracted from medical record databases. Only children with breastfeeding for the first 6 months of life (173 children) and children without breastfeeding (192 children) were included. Children with mixed feeding and children whose data were not available were excluded. RESULTS: No body mass index (BMI) differences were found between children with breastfeeding (17.7) or without breastfeeding (17.3) during the first 6 months of life. The percentages of children with normal weight, overweight and obesity were similar in both groups, as well as the age of adiposity rebound breastfeeding 3.61 years; formula 3.64 years). Early adiposity rebound was associated with increased BMI at the age of 8, both in male and female children. CONCLUSIONS: Breastfeeding during the first 6 months of life was not demonstrated to delay the age of the adiposity rebound, in our study.

Effect of Zinc Intake on Growth in Infants: A Meta-analysis.

A systematic review and meta-analysis of available randomized controlled trials (RCTs) was conducted to evaluate the effect of zinc (Zn) intake on growth in infants. Out of 5500 studies identified through electronic searches and reference lists, 19 RCTs were selected after applying the exclusion/inclusion criteria. The influence of Zn intake on growth was considered in the overall meta-analysis. Other variables were also taken into account as possible effect modifiers: doses of Zn intake, intervention duration, nutritional status, and risk of bias. From each select growth study, final measures of weight, length, mid upper arm circumference (MUAC), head circumference, weight for age z-score (WAZ), length for age z-score (LAZ), and weight for length z-score (WLZ) were assessed. Pooled ß and 95% confidence interval (CI) were calculated. Additionally, we carried out a sensitivity analysis. Zn intake was not associated with weight, length, MUAC, head circumference, and LAZ in the pooled analyses. However, Zn intake had a positive and statistically effect on WAZ (ß = 0.06; 95%CI 0.02 to 0.10) and WLZ (ß = 0.05; 95%CI 0.01 to 0.08). The dose-response relationship between Zn intake and these parameters indicated that a doubling of Zn intake increased WAZ and WLZ by approximately 4%. Substantial heterogeneity was present only in length analyses (I(2) = 45%; p = 0.03). Zn intake was positively associated with length values at short time (four to 20 weeks) (ß = 0.01; CI 95% 0 to 0.02) and at medium doses of Zn (4.1 to 8 mg/day) (ß = 0.003; CI 95% 0 to 0.01). Nevertheless, the effect magnitude was small. Our results indicate that Zn intake increases growth parameters of infants. Nonetheless, interpretation of these results should be carefully considered.

Dietary total antioxidant capacity and mortality in the PREDIMED study.

PURPOSE: The aim of the present study was to assess the association between the dietary total antioxidant capacity, the dietary intake of different antioxidants and mortality in a Mediterranean population at high cardiovascular disease risk. METHODS: A total of 7,447 subjects from the PREDIMED study (multicenter, parallel group, randomized controlled clinical trial), were analyzed treating data as an observational cohort. Different antioxidant vitamin intake and total dietary antioxidant capacity were calculated from a validated 137-item food frequency questionnaire at baseline and updated yearly. Deaths were ascertained through contact with families and general practitioners, review of medical records and consultation of the National Death Index. Cox regression models were fitted to assess the relationship between dietary total antioxidant capacity and mortality. Dietary total antioxidant capacity was estimated using ferric-reducing antioxidant power assays. RESULTS: A total of 319 deaths were recorded after a median follow-up of 4.3 years. Subjects belonging to the upper quintile of antioxidant capacity were younger, ex-smokers, with high educational level, and more active and had higher alcohol intake. Multivariable-adjusted models revealed no statistically significant difference between total dietary antioxidant capacity and mortality (Q5 vs. Q1 ref HR 0.85; 95% CI 0.60-1.20) neither for the intake of all the vitamins studied. CONCLUSIONS: No statistically significant association was found between antioxidant capacity and total mortality in elderly subjects at high cardiovascular risk.

Adherence to the Mediterranean diet and quality of life in the SUN Project.

BACKGROUND/OBJECTIVES: Mediterranean diet has been related with reduced morbidity and better well-being. The aim of this study was to assess whether the adherence to the Mediterranean diet were associated with mental and physical health related to quality of life. SUBJECTS/METHODS: This analysis included 11 015 participants with 4 years of follow-up in the SUN Project (a multipurpose cohort study based on university graduates from Spain). A validated 136-item food frequency questionnaire was used to assess the adherence to the Mediterranean diet at baseline, according to a nine-point score, presented in four categories (low, low-moderate, moderate-high and high). Health-related quality of life (HRQL) was measured after 4 years of follow-up with the Spanish version of the SF-36 Health Survey. Generalized Linear Models were fitted to assess adjusted mean scores, the regression coefficients (ß) and their 95% confidence intervals (95% CIs) for the SF-36 domains according to categories of adherence to Mediterranean diet. RESULTS: Multivariate-adjusted models revealed a significant direct association between adherence to Mediterranean diet and all the physical and most mental health domains (vitality, social functioning and role emotional). Vitality (ß=0.50, 95% CI=0.32-0.68) and general health (ß=0.45, 95% CI=0.26-0.62) showed the highest coefficients. Mean values for physical functioning, role physical, bodily pain, general health and vitality domains were significantly better with increasing adherence to the Mediterranean diet. Those having improved their initial high diet scores have better scores in physical functioning, general health and vitality. CONCLUSIONS: Adherence to the Mediterranean diet seems to be a factor importantly associated with a better HRQL.

[Application of multivariate analysis to the serum mineral and trace element content on differentiation of healthy subjects]. / Aplicación de análisis multivariado para la diferenciación de individuos sanos según su contenido sérico de minerales.

OBJECTIVE: Serum concentrations of Na, K, Ca, Mg, Fe, Cu, Zn, Se, Mn and P were determined in apparently health individuals representing of the population of the Canary Islands. Multivariate analysis was applied on the data matrix in order to differentiate the individuals according several criteria such as gender, age, island and province of residence, smoking and drinking habits and physical exercise. SUBJECTS AND METHODS: 395 serum samples (187 men and 208 women) were analyzed mean age of 38.4 +/- 20.0 years. Individuals data about age, gender, weight, height, alcohol consumption, smoking habits and physical exercise were recorded using standardized questionnaires. The determination of minerals was carried out by flame emission spectrometry (Na and K) and atomic absorption spectrometry with flame air/acetylene (Ca, Mg, Fe, Cu, Zn), hybride generation (Se) and graphite furnace (Mn). The P was determined by a colorimetric method. RESULTS: The sex and age of individuals influenced on the serum concentrations of some minerals, Cu and Fe, and P and Se, respectively. The island of residence influenced the mean concentrations of the most the minerals analysed. The smoking and drinking habits do not seem to influence the mean contents of the minerals in an important manner. Physical exercise had significant influence on the P, Cu and Mn concentrations in serum. The water for consumption influenced on the serum concentrations of the electrolytes and Ca and Mg, but it did not affect the concentrations of the trace elements. Applying discriminant analysis the individuals lower 18 years were reasonably well differentiated (89% of the individuals correctly classified) from the rest of individuals. A tendency for differentiation of individuals according to the island of residence was also observed. CONCLUSIONS: A low differentiation of the individuals according to the sex, province or island or residence and habits or life style was observed after application of multivariate analysis techniques. However, the adults were reasonably differentiated from the children and adolescent, and the inhabitants of Lanzarote and La Palma tend to separate from the rest of the individuals of their province.

Aplicación de análisis multivariado para la diferenciación de individuos sanos según su contenido sérico de minerales / Application of multivariate analysis to the serum mineral and trace element content on differentiation of healthy subjects

Objetivos: Se determinaron las concentraciones séricas de Na, K, Ca, Mg, Fe, Cu, Zn, Se, Mn y P en individuos aparentemente sanos representativos de la población canaria. Sobre la matriz de datos obtenidos se aplicaron técnicas de análisis multivariado con objeto de diferenciar los individuos de acuerdo con diversos criterios, tales como sexo, edad, isla, provincia de residencia, hábito de fumar o beber, ejercicio físico y consumo de agua. Sujetos y metodología: Se analizaron 395 muestras de suero (187 hombres y 208 mujeres) siendo la edad media de los individuos de 38,4 ± 20,0 años. Se recogieron datos individuales acerca de la edad, sexo, peso, talla, tipo de agua consumida, consumo de alcohol, hábito de fumar y ejercicio físico por medio de cuestionarios estandarizados. La determinación de los minerales se realizó por fotometría de llama (Na y K) y espectrofotometría de absorción atómica con llama aire/acetileno (Ca, Mg, Fe, Cu y Zn), con generación de hidruros (Se) o por cámara de grafito (Mn). El P se determinó por colorimetría. Resultados: El sexo y edad de los individuos afectaron las concentraciones séricas de algunos minerales, Cu y Fe y P y Se respectivamente. La isla de residencia afectó las concentraciones medias de la mayoría de los minerales analizados. Los hábitos de fumar y beber no parecen afectar de forma importante los contenidos medios de los minerales. La práctica de ejercicio físico influyó sobre el contenido sérico de P, Cu y Mn. El tipo de agua consumida influyó sobre el contenido sérico de los electrolitos, y elementos plásticos analizados, pero no en el de los elementos traza. Después de aplicar análisis discriminante, se observa que los individuos menores de 18 años se diferencian razonablemente bien (89% de casos correctamente clasificados) del resto. Existe una cierta tendencia a diferenciarse los individuos en base a la isla de residencia. Conclusiones: La diferenciación de los individuos mediante análisis discriminante aplicado sobre los contenidos séricos de los minerales analizados en función del sexo, provincia e isla de residencia y hábitos o estilo de vida fue baja. Sin embargo, los adultos se diferencian razonablemente de los adolescentes y niños, y los individuos residentes en Lanzarote y La Palma, tienden a separarse del resto de los individuos de su provincia (AU)

Objective: Serum concentrations of Na, K, Ca, Mg, Fe, Cu, Zn, Se, Mn and P were determined in apparently healthy individuals representing of the population of the Canary Islands. Multivariate analysis was applied on the data matrix in order to differentiate the individuals according several criteria such as gender, age, island and province of residence, smoking and drinking habits and physical exercise. Subjects and methods: 395 serum samples (187 men and 208 women) were analyzed mean age of 38.4 ± 20.0 years. Individuals data about age, gender, weight, height, alcohol consumption, smoking habits and physical exercise were recorded using standardized questionnaires. The determination of minerals was carried out by flame emission spectrometry (Na and K) and atomic absorption spectrometry with flame air/acetylene (Ca, Mg, Fe, Cu, Zn), hybride generation (Se) and graphite furnace (Mn). The P was determined by a colorimetric method. Results: The sex and age of individuals influenced on the serum concentrations of some minerals, Cu and Fe, and P and Se, respectively. The island of residence influenced the mean concentrations of the most the minerals analysed. The smoking and drinking habits do not seem to influence the mean contents of the minerals in an important manner. Physical exercise had significant influence on the P, Cu and Mn concentrations in serum. The water for consumption influenced on the serum concentrations of the electrolytes and Ca and Mg, but it did not affect the concentrations of the trace elements. Applying discriminant analysis the individuals lower 18 years were reasonably well differentiated (89% of the individuals correctly classified) from the rest of individuals. A tendency for differentiation of individuals according to the island of residence was also observed. Conclusions: A low differentiation of the individuals according to the sex, province or island or residence and habits or life style was observed after application of multivariate analysis techniques. However, the adults were reasonably differentiated from the children and adolescent, and the inhabitants of Lanzarote and La Palma tend to separate from the rest of the individuals of their province (AU)

Concentraciones de Na, K Ca y P en sueros de una muestra representativa de la población canaria / Concentrations of Na, K, Ca and P in sera from a population sample representing the canary islands

Como parte de la encuesta nutricional de Canarias (ENCA-1998) se determinaron las concentraciones séricas de Na, K, Ca y P en 395 individuos representativos de la población canaria. Las concentraciones se encuentran dentro de los intervalos de referencia descritos para población sana. Se observan diferencias entre las concentraciones medias en función de la isla de residencia. Así los individuos de Tenerife presentan natremias y calcemias superiores (p<0,05) al resto de las islas. Los individuos de La Palma tienen las mayores (p<0,05) y menores (p<0,05) concentraciones de K y Ca respectivamente, mientras que los de las islas orientales muestran las mayores (p<0,05) fosfatemias. No se detectan diferencias entre los minerales en función del sexo. La fosfatemia disminuye (p<0,05) a medida que el nivel socioeconómico es menor. Las féminas menores de 18 años presentan natremias inferiores (p<0,05) al resto y los varones de más de 35 años mayores (p<0,05) potasemias. No se encuentran diferencias importantes de caicemia en función de la edad, y los individuos menores de 18 años muestran fosfatemias (p<0,05) inferiores al resto. Se observan correlaciones altamente significativas entre Na y K y entre Ca y P lo que confirma relaciones fisiológicas existentes. El hábito de fumar no influye sobre los niveles séricos de los elementos estudiados. Los individuos que manifiestan un consumo superior a siete cervezas y a siete bebidas espirituosas por semana presentan calcemias y natremias inferiores (p<0,05) respectivamente al resto. Se detecta un aumento de la potasemia y disminución significativamente (p<0,05) de la relación Na/K con el consumo de vino. Los individuos que consumen agua del grifo presentan mayor (p<0,05) natremia y potasemia, y menor (p<0,05) calcemia y relación Na/K, que los individuos que consumen agua embotellada. La relación Ca/P disminuye de forma significativa (p<0,05) con el ejercicio físico (AU)

As part of the nutritional survey of the Canary Islands (ENCA-1998), the concentrations in serum of Na, K, Ca and P were determined in 395 individuals representing the population of the Canary Islands. The concentrations were found to be within the reference intervals described for the healthy population. Differences were observed in the mean concentrations depending on the island of residence. Thus, individuals on the island of Tenerife showed higher levels of natremia and calcaemia (p < 0.05) than those on the other islands. The islanders of La Palma have the highest (p < 0.05) and lowest (p < 0.05) concentrations of K and Ca, respectively, whereas those living on the easternmost islands have the highest levels of phosphataemia. No differences were detected in the mineral levels by sex. Phosphataemia levels fall (p < 0.05) in line with socio-economic levels. Females under the age of 18 present lower levels of natremia (p < 0.05) than others while males over the age of 35 present higher levels of kalaemia (p < 0,05). No important age-related differences were found in calcaemia and individuals under the age of 18 had lower levels of phosphataemia (p < 0.05) than the remainder. Highly significant relationships were found between Na and K and between Ca and P, thus confirming existing physiological relationships. Smoking had no effect on the serum levels of the elements under study. Those individuals reporting an intake of more than seven beers and seven shots of spirit per week presented lower levels of calcaemia and natremia than the rest (p < 0.05). With wine consumption, an increase in kalaemia and a significant reduction (p < 0.05) in the Na/K ratio were detected. Individuals drinking only tap water had higher levels (p < 0.05) of natraemia and kalaemia, with lower levels (p < 0.05) of calcaemia and the Na/K ratio than those drinking bottled water. The Ca/P ratio was significantly reduced (p < 0.05) with physical exercise (AU)

Serum selenium concentration in a representative sample of the Canarian population.

The concentration of serum selenium in 395 individuals (187 males + 218 females) living in the Canary Islands, Spain was determined by hydride generation atomic absorption spectrometry. The mean selenium concentration was 74.7 +/- 25.2 microg/l ranging between 7.86 and 182.3 microg/l. Twenty-two adults (7.2% of the total) had serum selenium concentrations under 45 microg/l. It is widely accepted that below this selenium serum concentration (45 microg/l) there is an increased risk of cardiovascular disease and cancer. Our results fall within data recently published in other Spanish and European regions and are much lower than data observed in USA or seleniferous regions. The estimated Se intakes of our population were lower than the Recommended Dietary Allowances for American people. Individuals from Lanzarote had a mean Se concentration significantly higher than individuals from the other islands. This could be attributed to differences in Se content of soil and/or differences in dietary habits of the populations. Serum selenium concentration did not vary with the sex of the subjects. Individuals younger than 14 years old had a serum selenium concentration significantly lower than the rest of the individuals. No relationship with socio-economic status, educational level, smoking habits, physical exercise or beer consumption was found. However, individuals who consume wine more than three times a week showed higher selenium concentrations than individuals with lower consumption. Also, individuals with consumption above seven units of spirit drinks a week had the highest mean selenium concentration.

Tabaquismo en Gran Canaria. Consumo y actitudes en adolescentes / Tobacco smoking in adolescents in Gran Canaria, Spain. Consumption and attitudes

Objetivo: Estudiar la prevalencia y características del hábito tabáquico de los estudiantes de COU y 2.o de Bachillerato de Gran Canaria en el curso académico 1996-97.Métodos: Estudio transversal sobre una muestra de 931 alumnos obtenida por un método bietápico por conglomerados y estratificación en función del hábitat y del tipo de centro docente. La información se recogió mediante un cuestionario autoadministrado que incluía variables de identificación, características del consumo de tabaco, entorno familiar y social y factores actitudinales sobre las medidas restrictivas. Resultados: El 66,8 por ciento de los entrevistados son no fumadores y el 4 por ciento exfumadores. De los restantes, el 18,1 por ciento son fumadores habituales y el 11,1 por ciento ocasionales. La prevalencia de tabaquismo es mayor en las mujeres (p < 0,001), no difiriendo la cantidad de cigarrillos consumidos según el sexo. Se iniciaron al consumo de tabaco, en promedio, a los 15 años (ñ 1,5 años). No se aprecian diferencias significativas entre el consumo de tabaco de los padres y de los hijos, pero sí con el de los amigos o hermanos: el 87,5 por ciento de los fumadores tienen amigos que también lo son y el 42 por ciento algún hermano. Al inicio del hábito, sólo el 12 por ciento de los padres permiten fumar a sus hijos, llegando al 50 por ciento a medida que tienen más edad, siendo más permisivos con el sexo masculino. Conclusiones: La prevalencia de tabaquismo y la edad de inicio son menores en nuestra población que las observadas en otros estudios. La actuación debe centrarse en evitar la incorporación al consumo de tabaco creando un ambiente social y familiar en el que el tabaquismo sea considerado un comportamiento excepcional (AU)

[Biochemical assessment of nutritional status in the Canary Islands population (1998)]. / Evaluación bioquímica del estado nutricional de la población canaria (1998).

UNLABELLED: Nutrition surveys include information about dietary intake and nutritional status utilising clinical, biochemical and anthropometric measurements. OBJECTIVE: To evaluate the nutritional status of the Canary Island population by means of biochemical and haematological indicators METHODOLOGY: A cross-sectional study was realised in a representative subsample aged 6 to 75 years that participated in the Nutritional Survey of the Canary Islands, 1997-98 (ENCA). We determined levels of ferritin and vitamin B12 (enzyme-immunoassay), serum and erythrocytic folic acid (automated ionic catchment), retinol, tocopherol and carotenes (high performance liquid chromatography) and minerals (atomic absorption spectrometry) RESULTS: There were neither sex, age nor socio-economic differences in the reference population sample and the ENCA sample. The participation rate was 48.8%. 25% of the women had deficit levels of ferritin and the prevalence of anaemia in women over 18 years was 2.9%. 13% of the population had low erythrocyte folic acid levels, that increased with age, and 3.4% had low vitamin B12 levels, which, on the contrary, decreased with age, 15% of the population presented a deficit of alpha-tocopherol and 5.2% of retinol, being more frequent in the youngest group, and 56.4% and 41.1% exhibited low levels of beta-carotene and lycopene respectively. Among mineral and trace elements, low levels of manganese drew attention due to its heightened prevalence, and, to a lesser extent, selenium. CONCLUSIONS: In spite of the complexity of its interpretation, this data yields a precise estimation of nutritional status for certain vitamins and minerals in the Canary Island population.

[Smoking in Gran Canaria. Consumption and attitude in adolescents]. / Tabaquismo en Gran Canaria. Consumo y actitudes en adolescentes.

OBJECTIVE: To study the prevalence and characteristics of tobacco use in the last years of the high school students in Gran Canaria (Spain) enrolled in the 1996-1997 academic year. METHODS: Cross-sectional study of a sample of 931 students obtained through a two-stage method by conglomerates and stratification based on habit and type of educational institution. The information was gathered from a personal questionnaire that included identification variables, characteristics of tobacco consumption, family and social environment and attitudinal factors about restrictive measures. RESULTS: 66.8% of participants were non-smokers and 4% ex-smokers. Of the remaining, 18.1% were habitual smokers and 11.1% occasional smokers. The use of tobacco is higher in women than in men (p < 0.001) even though the quantity of tobacco consumed is the same. On the average, the consumption of tobacco begins at 15 years (+/- 1.5 years). There is not significant relation between tobacco use in parents and their children; however, there is a relation between tobacco use in those questioned and their siblings and friends: 87.5% of smokers had friends who also smoked and 42% a sibling who smoked. When those questioned started, only 12% of their parents had allowed them to smoke, reaching 50% when they were interviewed. Parents were more permissive with regard to tobacco consumption with males. CONCLUSIONS: The prevalence of tobacco use and age at starting are lower in our population than in other studies. Any action taken should concentrate on avoiding the incorporation of tobacco into daily life, creating a social and family environment where the use of tobacco is exceptional.

[Smoking. Prevalence and attitudes among health science students]. / Hábito tabáquico. Prevalencia y actitudes en estudiantes de ciencias de la salud.

OBJECTIVES: To find the prevalence of tobacco use among Health Sciences students at the University of La Laguna, its main features and their attitude to preventive programmes and the struggle against tobacco. DESIGN: A descriptive crossover study (prevalence study). SETTING AND PARTICIPANTS: The target population group was the 371 students matriculated at the two Nursing Schools and the 305 students in the first, third and sixth years at the Medicine Faculty of the University of La Laguna. MEASUREMENTS AND MAIN RESULTS: Through an anonymous and voluntary questionnaire, self-filled by 76.4% of the population-group under study, 31.1% stated they were smokers, though 7.6% only occasionally. 4.3% said they were ex-smokers and 64.6% non-smokers. There were no significant differences for gender, but smokers predominated among the oldest students, as did non-smokers among the youngest. 74.8% of smokers said they would like to give up for good, which 67.5% had attempted on some occasion. The restrictive measures on tobacco consumption and advertising were viewed positively. CONCLUSIONS: There is strong motivation to give up tobacco among this group, which generally accepts restrictive measures on tobacco consumption and advertising.

[Food habits among children in a district of the island of Gran Canaria]. / Hábitos alimentarios de la población infantil de un distrito en la isla de Gran Canaria.

OBJECTIVE: To find out the characteristics of the diet of a population-group of young children and to quantify their caloric and nutrient intake. DESIGN: A descriptive study of a crossover type by means of a questionnaire on the frequency of food consumption. Stratified random sampling. SETTING: A Primary Care Centre. PATIENTS AND OTHER PARTICIPANTS: 264 healthy children aged from 2 to 8, representative of a District. MEASUREMENTS AND MAIN RESULTS: The children studied had overall sufficient caloric intake ("calories consumed/calories recommended" index of 1 +/- 0.2), with an excess of proteins (16.6 +/- 1.8% of calories) and lipids (36.3 +/- 4% of calories, mainly of animal origin) to the detriment of carbohydrate intake (47.7 +/- 5% of the caloric intake). There was an important percentage (42%) of children whose iron intake was deficient. Only 9% of children had a poor calcium intake. The vitamin intake was adequate. CONCLUSIONS: The variability of alimentary customs between zones means that we must identify the dietetic habits of the population group (or even individuals) we are serving, especially for the paediatric age group. We propose systematic Primary Care use of questionnaires on food consumption to enable the detection and correction of nutritional dangers.