Impact of physical activity during pregnancy on infant neurodevelopment.

OBJECTIVES: To investigate prospectively the impact of physical activity during pregnancy on infant neurodevelopment, considering relevant confounding factors, physical activity intensity and the trimester of pregnancy in which it is performed. METHODS: Prospective follow-up study of 791 pregnant women from the first trimester of pregnancy to 40 days postpartum. Three intensity levels of physical activity were assessed in each trimester of pregnancy by the International Physical Activity Questionnaire (IPAQ). Infant neuro development was assessed at 40 days postpartum by the third edition of the Bayley Scales for Infant Development-Third Edition (BSID-III). Analysis adjusted by sociodemographics, anxiety symptoms, lifestyle habits, quality of diet, body mass index, postpartum depressive symptoms and mother-infant attachment. RESULTS: ANCOVA analysis have shown that 40 days old infants of mothers in the moderate and high PA groups in the third trimester obtained 3.2 and 3.8 points higher scores respectively in the language total scale; and 4.1 and 5.1 points higher scores respectively in the motor total scale than infants of mothers in the low PAgroup. CONCLUSION: Moderate to high intensity physical activity during pregnancy has a positive impact on infant neurodevelopment. More specific recommendations must be incorporated in international guidelines and into maternal education sessions to improve infants' neurodevelopment.

[Risk factors and prevention strategies in eating disorders]. / Factores de riesgo y estrategias de prevención en los trastornos de la conducta alimentaria.

Introduction: Scientific evidence supports an interactive model of biopsychosocial influences on the etiology of eating disorders. New genome-wide association studies suggest underlying metabolic dysregulation in anorexia nervosa. Among the psychological factors, body dissatisfaction (IC) is the most consistent predictor, mainly in females. Low self-esteem, negative affect and internalization of the ideal of thinness predict IC. Certain personality traits and other individual factors such as a high body mass index, emotional problems and some metabolic and digestive diseases, social factors such as some sporting or professional activities focused on body shape pressure, characteristics of the family environment, and social and peer group pressures to be thin, currently mediated by the use/abuse of social networks, act as risk factors for ED. Most prevention programs target adolescent girls in secondary education and young people. Interventions at an early age, in adults and in men are scarce. Successful programs focused on one or more risk factors, based on cognitive or behavioral approaches, include content on healthy eating or nutrition, media literacy, sociocultural pressures, and body acceptance or body satisfaction. They incorporate new technologies and are interactive. More research and innovative prevention programs for eating disorders in young children, adults and men are in need.

Introducción: La evidencia científica apoya un modelo interactivo de influencias biopsicosociales en la etiología de los trastornos de la conducta alimentaria (TCA). Los nuevos estudios de asociación de genoma completo sugieren una base de desregulación metabólica en la anorexia nerviosa. Entre los factores psicológicos, la insatisfacción corporal (IC) puede considerarse el predictor más consistente, principalmente en el género femenino. Baja autoestima, afecto negativo e interiorización del ideal de delgadez determinan la IC. Ciertos rasgos de personalidad y otros factores individuales como un alto índice de masa corporal, problemas emocionales y algunas enfermedades, metabólicas y digestivas, factores sociales como algunas actividades deportivas o profesionales centradas en la presión por la figura corporal, características del entorno familiar, y presiones sociales y del grupo de pares por estar delgada, mediado actualmente por el uso/abuso de las redes sociales, actúan como condicionantes de riesgo en los TCA. La mayoría de los programas de prevención se dirigen a las mujeres adolescentes en educación secundaria y jóvenes. Son escasas las intervenciones en edades tempranas, en adultos y en varones. Los programas con buenos resultados se centran en uno o más factores de riesgo, se basan en enfoques cognitivos o conductuales e incluyen contenido sobre alimentación saludable o nutrición, alfabetización mediática o presiones socioculturales y aceptación corporal o satisfacción corporal. Incorporan nuevas tecnologías y son interactivos. Se necesitan más investigación y programas de prevención de los TCA innovadores para niños pequeños, adultos y varones.

[Prevention of eating disorders in primary education]. / Prevención de los trastornos de la conducta alimentaria en educación primaria.

Introduction: Eating disorders are infrequent in school age, being predominant in the female sex. The main predictive factors at this age are similar to those of other age groups, the influence of body changes being particularly important, especially in girls. Despite preventive programs in this age group are scarce, those focused mainly on the acceptance of body image, internalization of the ideal of appearance and media literacy have shown some effectiveness. However, new research is needed to confirm the approaches with the best results.

Introducción: Los trastornos de la alimentación son poco frecuentes en las edades de la etapa escolar, siendo predominantes en el sexo femenino. Los principales factores predictivos en esta edad son similares a los de otros grupos de edad, siendo particularmente importante la influencia de los cambios corporales, sobre todo en las niñas. Aunque los programas preventivos en este grupo de edad son escasos, los centrados principalmente en la aceptación de la imagen corporal, la internalización del ideal de apariencia y la alfabetización mediática han observado cierta eficacia. No obstante, son necesarias nuevas investigaciones que confirmen los enfoques con mejores resultados.

[Characterization, epidemiology and trends of eating disorders]. / Caracterización, epidemiología y tendencias de los trastornos de la conducta alimentaria.

Introduction: Background: eating disorders are a group of conditions in which negative beliefs about food, body shape, and body weight together with behaviors such as restricted food intake, binge eating, excessive exercise, self-induced vomiting, and use of laxatives. They can become serious, affect quality of life, and lead to multiple physical and even psychiatric complications with a fatal outcome. The purpose of this chapter is to describe the characteristics, epidemiology, and trends of eating disorders with updated information based on the most recent publications. Methods: we conducted a systematic literature search in Medline, EMBASE, Cochrane, and Web of Science. The search terms were "anorexia nervosa", "bulimia nervosa", "binge eating disorders" and "epidemiology" both in titles and in abstracts. Results and conclusions: EDs generally occur in adolescents and young adults. The best characterized TCAs are anorexia nervosa (AN), bulimia nervosa (BN) and binge eating disorder (TA). Prevalence studies indicate wide differences by age group and sex, much higher in young women (NA, 0.1-2 %; BN, 0.37-2.98 %; BED, 0.62-4.45 %). The prevalence of EDs is 2.2 % (0.2-13.1 %) in Europe, 3.5 % (0.6-7.8 %) in Asia, and 4.6 % (2.0-13.5 %) in America. Comorbidity is high with psychiatric problems such as depression, anxiety, attention deficit/hyperactivity disorder, obsessive-compulsive disorder, and personality disorders.

Introducción: Introducción: los trastornos de la conducta alimentaria (TCA) son un grupo de afecciones en las cuales las creencias negativas sobre la comida, la forma del cuerpo y el peso corporal se acompañan de conductas que incluyen restricción de la ingesta, atracones, realización excesiva de ejercicio, provocación del vómito y uso de laxantes. Pueden llegar a ser graves, repercutir sobre la calidad de vida y conducir a múltiples complicaciones físicas y psiquiátricas, incluso con desenlace fatal. El propósito de este artículo es describir las características, la epidemiología y las tendencias de los TCA con información actualizada a partir de las publicaciones más recientes. Métodos: se ha realizado una búsqueda sistemática de la literatura en Medline, EMBASE, Cochrane y Web of Science. Los términos de búsqueda fueron "anorexia nervosa", "bulimia nervosa", "binge eating disorders" and "epidemiology" en título y resumen. Resultados y conclusiones: los TCA se presentan generalmente en adolescentes y adultos jóvenes. Los mejor caracterizados son la anorexia nerviosa (AN), la bulimia nerviosa (BN) y el trastorno por atracón (TA). Los estudios de prevalencia indican amplias diferencias en función del grupo de edad y el sexo, muy superior en las mujeres jóvenes (AN: 0,1-2 %; BN: 0,37-2,98 %; TA: 0,62-4,45 %). La prevalencia de los TCA es del 2,2 % (0,2-13,1 %) en Europa, del 3,5 % (0,6-7,8 %) en Asia y del 4,6 % (2,0-13,5 %) en América. La comorbilidad es elevada con problemas psiquiátricos como la depresión, la ansiedad, el déficit de atención e hiperactividad, el trastorno obsesivo-compulsivo y los trastornos de personalidad.

Platos olvidados o de consumo ocasional en la gastronomía española: Cataluña / Forgotten dishes or occasional consumption in Spanish gastronomy: Catalonia

La gastronomía de Cataluña forma parte de la dieta mediterránea. Posee una gran personalidad muy marcada por su geografía. Incluye una gran variedad de productos del mar, de la montaña y de la huerta. A lo largo de los siglos, las diferentes culturas que han pasado por ese territorio han dejado su marca y los países vecinos también han aportado algunas características. Una amplia variedad de verduras, carnes, pescados, legumbres, quesos, pasta, arroz, y frutos secos, junto con el aceite de oliva y los aromas de hierbas aromáticas y especias configuran un amplio abanico de ingredientes diversos vinculados al territorio y a las tradiciones a lo largo de de la historia. (AU)

The gastronomy of Catalonia is part of the Mediterranean diet. It has a great personality influenced by geography. A wide variety of products from the sea, the mountains, and the garden. Over the centuries, the different cultures that passed through the territory left their mark; the neighboring countries contributed somecharacteristics as well. A wide variety of vegetables, meat, fish, legumes, cheeses, pasta, rice, and nuts, together with olive oil and aromas of aromatic herbs and spices make up a widerange of diverse ingredients linked to the territory and traditions throughout history. (AU)

Prevención de los trastornos de la conducta alimentaria en educación primaria / Prevention of eating disorders in primary education

Los trastornos de la alimentación son poco frecuentes en las edades de la etapa escolar, siendo predominantes en el sexo femenino. Los principales factores predictivos en esta edad son similares a los de otros grupos de edad, siendo particularmente importante la influencia de los cambios corporales, sobre todo en las niñas. Aunque los programas preventivos en este grupo de edad son escasos, los centrados principalmente en la aceptación de la imagen corporal, la internalización del ideal de apariencia y la alfabetización mediática han observado cierta eficacia. No obstante, son necesarias nuevas investigaciones que confirmen los enfoques con mejores resultados (AU)

Eating disorders are infrequent in school age, being predominant in the female sex. The main predictive factors at this age are similar to those of other age groups, the influence of body changes being particularly important, especially in girls. Despite preventive programs in this age group are scarce, those focused mainly on the acceptance of body image, internalization of the ideal of appearance and media literacy have shown some effectiveness. However, new research is needed to confirm the approaches with the best results (AU)

Vitamin D deficiency in primary health care users at risk in Spain.

INTRODUCTION: Background and objectives: despite long hours of sunlight in Spain, vitamin D deficiency has been rising of late. We aimed to describe vitamin D deficiency and insufficiency in at-risk patients in La Rioja, a region in northern Spain. Methods: a retrospective, cross-sectional study involving 21,490 patients (74.3 % women) aged 14-105 years, who were primary health care (PHC) users in La Rioja, with an available 25-hidroxyvitamin D (25(OH)D) test result corresponding to the first request from January 2013 to October 2015. Vitamin D deficiency, insufficiency, and sufficiency were defined as 25(OH)D levels < 12 ng/mL, 12-20 ng/mL, and ≥ 20 ng/mL, respectively. Hypovitaminosis D was defined considering 2 cut-off points for 25(OH)D: < 20 ng/mL and < 30 ng/mL. Results: mean 25(OH)D levels were 18.3 (SD, 11.6) ng/mL in the whole sample, being lower in men than in women (17.6 vs 18.5 ng/mL, p < 0.001). Significantly higher 25(OH)D levels were found in the groups with 55-59, 60-64, 65-69, and 70-74 years of age (range, 19.4-20.4 ng/mL), and lower levels were found in the groups with 80-85 years and older (16.7 and 14.5 ng/mL), as compared to other groups. Two thirds of the population were vitamin D-deficient (< 12 ng/mL, 30.9 %) or insufficient (12-20 ng/mL, 32.8 %), and only 32.8 % of patients were found to be vitamin D-sufficient (> 20 ng/ml). Hypovitaminosis D rate was higher (89.7 %) when the 25(OH)D cut-off point was set at < 30 ng/mL. A higher hypovitaminosis D rate (< 20 ng/mL) was found in men (67.1 %) vs women (62.6 %) (p < 0.001), and it was more prevalent in patients over 75 years (72.6 %). The prevalence of hypovitaminosis D followed a seasonal pattern ranging from 51.8 % to 76.5 %; the lowest 25(OH)D levels were found in winter, and the highest in summer, with levels above 20 ng/mL in all age groups except for patients over 75 years (17.7 ng/mL). Patients over 75 years exhibited high rates of deficiency or insufficiency across all seasons of the year. Conclusions: in La Rioja, Spain, hypovitaminosis D was highly prevalent among PHC users, and especially in older age groups and during the winter months.

INTRODUCCIÓN: Justificación y objetivos: a pesar de las largas horas de exposición solar en España, la deficiencia de vitamina D ha ido en aumento. Nuestro objetivo fue describir la deficiencia e insuficiencia de vitamina D en pacientes de riesgo en La Rioja, España. Métodos: estudio transversal retrospectivo en el que participaron 21.490 pacientes (74,3 % mujeres), usuarios de Atención Primaria (APS) en La Rioja, con resultado de prueba de 25-hidroxivitamina D (25(OH) D) disponible, correspondiente a las solicitudes efectuadas entre enero de 2013 y octubre de 2015. La deficiencia, insuficiencia y suficiencia de vitamina D se definieron como niveles de 25(OH)D < 12 ng/mL, = 12-20 ng/mL y ≥ 20 ng/mL, respectivamente. La hipovitaminosis D se definió considerando 2 puntos de corte de 25(OH)D: < 20 ng/mL y < 30 ng/mL. Resultados: los valores medios de 25(OH)D fueron de 18,3 (DE: 11,6) ng/mL en toda la muestra, siendo menores en los hombres que en las mujeres (17,6 vs. 18,5 ng/mL, p < 0,001). Se encontraron niveles de 25(OH)D significativamente más altos en los grupos de 55-59, 60-64, 65-69 y 70-74 años (rango, 19,4-20,4 ng/mL), y más bajos en los grupos de 80-85 años y mayores (16,7 y 14,5 ng/mL) en comparación con otros grupos. Dos tercios de la población presentaban deficiencia de vitamina D (< 12 ng/mL, 30,9 %) o insuficiencia (12-20 ng/mL, 32,8 %), y solo el 32,8 % de los pacientes presentaban niveles suficientes de vitamina D (> 20 ng/mL). La hipovitaminosis D fue mayor (89,7 %) cuando el punto de corte de 25(OH)D se estableció en < 30 ng/mL. Se encontró una mayor tasa de hipovitaminosis D (< 20 ng/mL) en los hombres (67,1 %) que en las mujeres (62,6 %) (p < 0,001), y dicha hipovitaminosis fue más prevalente en los pacientes mayores de 75 años (72,6 %). La prevalencia de la hipovitaminosis D siguió un patrón estacional que varió del 51,8 % al 76,5 %. Los niveles más bajos de 25(OH)D se encontraron en invierno y los más altos en verano, con niveles por encima de 20 ng/mL en todos los grupos de edad excepto en los pacientes mayores de 75 años (17,7 ng/mL). Los pacientes mayores de 75 años presentaron altas tasas de deficiencia o insuficiencia durante todas las estaciones del año. Conclusiones: en La Rioja, España, la hipovitaminosis D fue altamente prevalente entre los usuarios de APS y, especialmente, en los grupos de mayor edad y durante los meses de invierno.

Are there anthropometric and body composition differences between children with autism spectrum disorder and children with typical development? Analysis by age and spectrum severity in a school population.

LAY ABSTRACT: This study makes a comparison between the growth status of pre-school and school-age children with autism spectrum disorder and typical development children. Pre-schoolers with autism spectrum disorder were taller than children with typical development. School-age children with autism spectrum disorder were more overweight/obese, had more body fat and a greater waist circumference and waist/height ratio than children with typical development. The presence of autism spectrum disorder and internalizing problems was associated with cardiovascular risk in school-age children.

Estado nutricional de escolares peruanos según nivel socioeconómico. Proyecto INCOS / Nutritional status of Peruvian schoolchildren by socioeconomic level. INCOS Project

FUNDAMENTOS: El aporte alimentario desequilibrado provoca malnutrición, siendo un grave problema de salud pública. El objetivo fue valorar el consumo alimentario de los escolares de una región Andina de Perú, comparando dos poblaciones con características socioeconómicas distintas: una rural en pobreza extrema con Programa Nacional de Alimentación Escolar (PNAE) y otra urbana en transición nutricional sin PNAE. MÉTODOS: Estudio transversal que incluyeron 432 escolares. Se valoraron medidas antropométricas y consumo alimentario mediante recuerdo de 24 horas y cuestionario de frecuencia alimentaria. Se calculó el Índice Ponderal (IP) (Z-score IMC/Edad-OMS) y la adecuación al consumo aconsejado. RESULTADOS: La zona en pobreza extrema, con 4,7% de delgadez y 8,8% de exceso de peso, consume más pescado (18,3 g/día vs 7,78 g/día), lácteos (593,5 g/día vs 176,8 g/día), cereales (150,8 g/día vs 134,8 g/día), tubérculos (147,4 g/día vs 57,9 g/día) y legumbres (50,3 g/día vs 14,9 g/día) y menos carne (14,4 g/día vs 64,9 g/día), huevos (9,5 g/día vs 26,3 g/día), frutas (9,6 g/día vs 95,9 g/día) grasas (20,2 g/día vs 34,2 g/día) y alimentos superfluos (18,7 g/día vs 124,7 g/día) (p˂0,001) que la zona en transición nutricional, que presenta 21,8% de delgadez y 20,7% de exceso de peso. CONCLUSIONES: Mayoritariamente los escolares de la zona en pobreza extrema presentan normopeso y un patrón alimentario cercano al modelo saludable, relacionado con el PNAE, mientras la otra zona presenta características de la transición nutricional

BACKGROUND: The unbalanced food intake causes malnutrition remains a serious public health problem. The objective was to assess the food consumption of schoolchildren in an Andean region of Peru, comparing two areas with very different socioeconomic status: a rural one in extreme poverty with a National Program for School Feeding (NPSF) and another urban in nutritional transition without NPSF. METHODS: Cross-sectional study. 432 schoolchildren. Anthropometric measures and food consumption were evaluated by 24-hour recall and food frequency questionnaire. The Ponderal Index (PI) (Z-score BMI/Age-WHO) and the advised consumption adequacy were calculated. RESULTS: The extreme poverty area, with 4.7% of thinness and 8.8% of excess weight, consumes more fish (18.3 g/day vs 7.8 g/day), dairy products (593.5 g/day vs 176.8 g/day), cereals (150.8 g/day vs 134.8 g/day), tubers (147.4 g/day vs 57.9 g/day) and legumes (50.3 g/day vs 14.9 g/day); and less meat (14.4 g/day vs 64,9 g/day), eggs (9.5 g/day vs 26.3 g/day), fruits (9.6 g/day vs 95.9 g/day), visible fats (20.2 g/day vs 34.2 g/day) and superfluous foods (18.7 g/day vs 124.7 g/day) (p˂0.001) than the nutritional transition area, which presents 21.8% thinness and 20.7% of excess-weight. CONCLUSIONS: Mostly of the schoolchildren in the extreme poverty area present normal weight and a food pattern close to the healthy model, related to the NSFP, while the nutritional transition area presents characteristics of the nutritional transition

[Validation of a short food frequency questionnaire in small children]. / Validación de un cuestionario corto de frecuencia de consumo alimentario en niños pequeños.

INTRODUCTION: Introduction: validated food frequency questionnaires in children are scarce, mostly long, and only provide data about food consumption. Objectives: the aim of this study was to evaluate the reproducibility and validity of a short food frequency questionnaire that estimates energy, nutritional intake, and the frequency of food consumption in children aged between 3 and 6 years. Material and methods: in 49 children (57% boys), the reproducibility and validity of a frequency questionnaire with 41 items was assessed using Spearman's and intraclass correlations, both adjusted and not adjusted for energy. A 6-day record was used as a reference method. Results: reproducibility was high in food groups with correlations > 0.70 for most of them and between 0.5 and 0.7 for meat, fish, potatoes, sweets/soft drinks, and oil. For energy and nutrients correlations were > 0.9 and > 0.7, respectively. Validity was strong to moderate for foods with correlations > 0.7 (dairy and milk) and between 0.4 and 0.7 (sausages, eggs, yogur/cheese, vegetables and oil), and for nutrients with correlations > 0.5 (lipids, AGS, AGP, phosphorus, calcium, vitamin E and vitamin C) and between 0.3 and 0.5 (energy, starches, fiber, MUFA, cholesterol, sodium, magnesium, potassium, retinol, riboflavin, niacin, pantothenic acid, vitamin B6 and folates). All correlations were significant and increased after they had been adjusted for energy. Conclusions: the short food frequency questionnaire for children between 3 and 6 years old has high reproducibility and good validity with results that are as good as those of long food frequency questionnaires.

INTRODUCCIÓN: Introducción: los cuestionarios de frecuencia de consumo alimentario validados en la edad infantil son escasos, principalmente largos y solo aportan datos del consumo alimentario. Objetivos: nuestro objetivo fue evaluar la reproducibilidad y validez de un cuestionario de frecuencia corto que estimara la frecuencia del consumo de alimentos y la ingesta energética y nutricional en edades de 3 a 6 años. Material y métodos: en 49 niños y niñas (57% varones) se valoró la reproducibilidad y la validez de un cuestionario de frecuencia de 41 ítems mediante los coeficientes de correlación de Spearman e intraclase, ajustados y sin ajustar por la energía. Se usó como método de referencia un registro alimentario de 6 días. Resultados: se obtuvo una reproducibilidad elevada en los alimentos con correlaciones > 0,70 para la mayoría de alimentos, y entre 0,5 y 0,7 para carnes, pescados, patatas, dulces-refrescos y aceite; para la energía y los nutrientes, las correlaciones fueron > 0,9 y > 0,7, respectivamente. Se obtuvo una validez fuerte o moderada en los alimentos, con correlaciones > 0,7 para lácteos y leche, y entre 0,4 y 0,7 para embutidos, huevos, yogur/queso, verduras y aceite, y en los nutrientes, con correlaciones > 0,5 para lípidos, AGS, AGP, fósforo, calcio, vitamina E y vitamina C, y entre 0,3 y 0,5 para energía, almidones, fibra, AGMI, colesterol, sodio, magnesio, potasio, retinol, rivoflabina, niacina, ácido pantoténico, vitamina B6 y folatos. Las correlaciones fueron significativas y se incrementaron al ajustar la energía. Conclusiones: el cuestionario de frecuencia de consumo alimentario corto para niños de 3-6 años de edad resultó tener una reproducibilidad elevada y buena validez, con resultados tan buenos como los de un cuestionario largo.

A clinical trial to evaluate the effect of the Mediterranean diet on smokers lung function.

Data on the association between lung function and some dietary patterns have been published. However, it is not yet well known if whether the Mediterranean Diet (MD) pattern can preserve or improve lung function. Our purpose is to evaluate the effect of increased MD adherence on lung function in smokers. A multicenter, parallel, cluster-randomized, controlled clinical trial is proposed. A total of 566 active smokers (>10 packs-year), aged 25-75 years will be included, without previous respiratory disease and who sign an informed consent to participate. Twenty Primary Care Centres in Tarragona (Spain) will be randomly assigned to a control or an intervention group (1:1). All participants will receive advice to quit smoking, and the intervention group, a nutritional intervention (2 years) designed to increase MD adherence by: (1) annual visit to deliver personalized nutritional education, (2) annual telephone contact to reinforce the intervention, and (3) access to an online dietary blog. We will evaluate (annually for 2 years): pulmonary function by forced spirometry and MD adherence by a 14-item questionnaire and medical tests (oxidation, inflammation and consumption biomarkers). In a statistical analysis by intention-to-treat basis, with the individual smoker as unit of analysis, pulmonary function and MD adherence in both groups will be compared; logistic regression models will be applied to analyze their associations. We hope to observe an increased MD adherence that may prevent the deterioration of lung function in smokers without previous respiratory disease. This population may benefit from a dietary intervention, together with the recommendation of smoking cessation.

Differences in food consumption and nutritional intake between children with autism spectrum disorders and typically developing children: A meta-analysis.

Children with autism spectrum disorders show higher food selectivity, which restricts consumption of some foods and may cause nutritional deficiencies. The aims of this meta-analysis are to determine the overall differences in nutritional intake and food consumption between children with autism spectrum disorder and control (typical development) children, as well as determine the extent to which the nutritional intake and food consumption of autistic children comply with the dietary recommendations. Children with autism spectrum disorder consume less protein (standardized mean difference = -0.27, 95% confidence interval (-0.45, -0.08)), calcium (-0.56 (-0.95, -0.16)), phosphorus (-0.23 (-0.41, -0.04)), selenium (-0.29 (-0.44, -0.13)), vitamin D (-0.34 (-0.57, -0.11)), thiamine (-0.17 (-0.29, -0.05)), riboflavin (-0.25 (-0.45, -0.05)) and vitamin B12 (-0.52 (-0.95, -0.09)) and more polyunsaturated fat acid (0.27 (0.11, 0.44)) and vitamin E (0.28 (0.03, 0.54)) than controls. Autistic children also consume less omega-3 (-0.83 (-1.53, -0.16)) and more fruit (0.35 (0.12, 0.59)) and vegetables (0.35 (0.09, 0.61)) than control children; however, these results must be considered with care due to the low number of studies included in the analysis and the high heterogeneity. The results also suggest a lower intake of calcium, vitamin D and dairy and a higher intake of fruit, vegetables, protein, phosphorus, selenium, thiamine, riboflavin and vitamin B12 than recommended.

Prevalence of DSM-5 depressive disorders and comorbidity in Spanish early adolescents: Has there been an increase in the last 20 years?

The aim of the study was to investigate the current prevalence of DSM-5 Depressive Disorders (DD) among Spanish school children and compare it with data obtained 20 years ago from the same place. We assessed comorbidity, severity and sociodemographic related factors. With a double-phase design, a sample of 1514 students participated in the 1st phase and 562 students (175 at risk of depression) were assessed in the 2nd phase with the Mini-International Neuropsychiatric Interview for Kids. The estimated current prevalence of Major Depressive Disorder (MDD) was 1.6%, similar to the 1.5% found 20 years ago. A total of 3.4% were diagnosed with some form of DD (MDD or Persistent Depressive Disorder (PDD)). No significant differences between genders were found in either of the two periods studied. The rate of depressive symptoms (11.6%) was not significantly different from that of previous data (9.4%). 80% and 71.9% of the children diagnosed with MDD and PDD respectively also had an anxiety disorder. In conclusion, we have not found an increase in depression among Spanish early adolescents. However, the data on the prevalence of DD, the comorbidity, and the impairment all highlight the need to design and implement appropriate preventive interventions in schools.

Implementation of the DP-TRANSFERS project in Catalonia: A translational method to improve diabetes screening and prevention in primary care.

BACKGROUND: The DE-PLAN-CAT project (Diabetes in Europe-Prevention using lifestyle, physical activity and nutritional intervention-Catalonia) has shown that an intensive lifestyle intervention is feasible in the primary care setting and substantially reduces the incidence of diabetes among high-risk Mediterranean participants. The DP-TRANSFERS project (Diabetes Prevention-Transferring findings from European research to society) is a large-scale national programme aimed at implementing this intervention in primary care centres whenever feasible. METHODS: A multidisciplinary committee first evaluated the programme in health professionals and then participants without diabetes aged 45-75 years identified as being at risk of developing diabetes: FINDRISC (Finnish Diabetes Risk Score)>11 and/or pre-diabetes diagnosis. Implementation was supported by a 4-channel transfer approach (institutional relationships, facilitator workshops, collaborative groupware, programme website) and built upon a 3-step (screening, intervention, follow-up) real-life strategy. The 2-year lifestyle intervention included a 9-hour basic module (6 sessions) and a subsequent 15-hour continuity module (10 sessions) delivered by trained primary healthcare professionals. A 3-level (centre, professionals and participants) descriptive analysis was conducted using cluster sampling to assess results and barriers identified one year after implementation. RESULTS: The programme was started in June-2016 and evaluated in July-2017. In all, 103 centres covering all the primary care services for 1.4 million inhabitants (27.9% of all centres in Catalonia) and 506 professionals agreed to develop the programme. At the end of the first year, 83 centres (80.6%) remained active and 305 professionals (60.3%) maintained regular web-based activities. Implementation was not feasible in 20 centres (19.4%), and 5 main barriers were prioritized: lack of healthcare manager commitment; discontinuity of the initial effort; substantial increase in staff workload; shift in professional status and lack of acceptance. Overall, 1819 people were screened and 1458 (80.1%) followed the lifestyle intervention, with 1190 (81.6% or 65.4% of those screened) participating in the basic module and 912 in the continuity module (62.5% or 50.1%, respectively). CONCLUSIONS: A large-scale lifestyle intervention in primary care can be properly implemented within a reasonably short time using existing public healthcare resources. Regrettably, one fifth of the centres and more than one third of the professionals showed substantial resistance to performing these additional activities.

Estado nutricional de los escolares de una zona rural de extrema pobreza de Ccorca, Perú. Proyecto INCOS / Nutritional status of the school children in an extremely poor rural area of Ccorca, Perú.INCOS project

La ingesta deficitaria es un factor determinante en la desnutrición infantil, un problema de salud pública frecuente en algunas zonas de Latinoamérica. Nuestro objetivo es valorar el desarrollo antropométrico, el consumo alimentario, la ingesta nutricional y su adecuación en escolares, según edad y género, de una zona rural de extrema pobreza de los Andes peruanosque ha recibido programas gubernamentales de ayuda alimentaria. Estudio descriptivo en 171 escolares de 8,9±1,67 años, 51,5% varones. El desarrollo antropométrico se valora mediante el Z-score IMC/edad, el consumo alimentario por la entrevista semiestructurada de frecuencia de consumo de alimentos y el método de Recuerdo de 24 horas, la ingesta nutricional con la tabla de composición de alimentos peruana y francesa (REGAL) y su adecuación mediante la probabilidad de ingesta inadecuada (PII). Presentan delgadez el 4,7%, sobrepeso el 8,8% y obesidad el 0,6%. El consumo alimentario y la ingesta nutricional no presentan diferencia entre géneros, ni grupos de edad (6-9 años y 10-12 años). La distribución porcentual de macronutrientes es equilibrada. La PII de energía y la mayoría de nutrientes es significativamente mayor en el grupo de 10-12 años que en el de 6-9 años.Lasvitaminas A, D, C, B3 y folatosson deficientes en ambos grupos; y el calcio, hierro, vitamina E y vitamina B1 en el de 10-12 años. En conclusión, los escolares presentan un peso adecuado en relación a su talla y edad probablemente debido a la alimentación aportada por las ayudas estatales alimentarias. Sin embargo al haber un escaso consumo de frutas, verduras y hortalizas,se refleja un riesgo nutricional de algunas vitaminas y minerales, mayor en el grupo de 10-12 años de más elevados requerimientosnutricionales(AU)

An insufficient intake contributes to child malnutrition, a common public health problem in some Latin America areas. Our objective is to assess the anthropometric development, the food consumption, the nutritional intake and its school children adequacy, according to age and gender, in anextremely poor rural area in the Peruvian Andes where governmental food assistance programs were given. Descriptive study based on 171 school children about 8,9±1,67years, 51,5% males. Anthropometrics characteristics are valuated through IBM/age Z-Score. Food consumption is assessed by semi structured interview frequency of food consumption anda 24-hour diet recall method. The nutritional intake is estimated with the Peruvian and French food composition tables. The adequacy nutritional intake is calculated by the inadequate intake probability (IIP). Evidences are about 4,7% of thinness, 8,8% overweight and 0,6% obesity. The food consumption and the nutritional intake are similar among gender and age groups (6-9 years old and 10-12 years old). There is an acceptable macronutrients distribution range. The IIP energy and most nutrients are significantly greater in the 10-12 group than in the 6-9 group. A deficient intake of vitamin A, D, C, B3, folate is observed in both groups and in Calcium, iron, vitamin E and B1 in the 10-12 group. In conclusion, students have an adequate weight for their height and age, maybe due to the state program of food aid. Nevertheless, there remains weak consumption of fruit and vegetables that is reflected in the nutritional risk of some vitamins and minerals, which is higher in the 10-12 years old group due their greater nutritional requirements(AU)

Effects of Prenatal Nicotine Exposure on Infant Language Development: A Cohort Follow Up Study.

Objectives To study the longitudinal effects of prenatal nicotine exposure on cognitive development, taking into consideration prenatal and postnatal second-hand smoke exposure. Methods A cohort follow up study was carried out. One hundred and fifty-eight pregnant women and their infants were followed during pregnancy and infant development (at 6, 12, 30 months). In each trimester of pregnancy and during postnatal follow-up, a survey was administered to obtain sociodemographic data and the details of maternal and close familial toxic habits. Obstetric and neonatal data were obtained from hospital medical records. To assess cognitive development, the Bayley Scales of Infant Development were applied at 6, 12 and 30 months; to assess language development, the MacArthur-Bates Communicative Development Inventories were applied at 12 months and the Peabody Picture Vocabulary Test at 30 months. Results After adjustment for confounding variables, the results showed that infants prenatally exposed to cigarette smoke recorded poor cognitive development scores. Language development was most consistently affected, specifically those aspects related to auditory function (vocalizations, sound discrimination, word imitation, prelinguistic vocalizations, and word and sentence comprehension). Conclusions for Practice Irrespective of prenatal, perinatal and sociodemographic data (including infant postnatal nicotine exposure), prenatal exposure to cigarette smoke and second-hand smoke affect infant cognitive development, especially language abilities.

Dietary patterns are associated with lung function among Spanish smokers without respiratory disease.

BACKGROUND: Diet can help preserve lung function in smokers, in addition to avoidance of smoking. The study aimed to evaluate associations between dietary patterns and lung function in smokers without respiratory disease. METHODS: This cross-sectional study analysed baseline data from randomised representative smokers without respiratory disease (n = 207, aged 35-70 years), selected from 20 primary health-care centres. Participants completed a validated semi-quantitative food-frequency questionnaire. Dietary patterns were identified by Principal Component Analysis (PCA). Impaired lung function was defined as FVC <80% and/or FEV1 < 80% of predicted value and/or FEV1/FVC <0.7. Associations were determined by logistic regression. RESULTS: Three major dietary patterns were identified. In multivariate-adjusted model, impaired lung function was associated with the Alcohol-consumption pattern (OR 4.56, 95% CI 1.58-13.18), especially in women (OR 11.47, 95% CI 2.25-58.47), and with the Westernised pattern in women (OR 5.62, 95% CI 1.17-27.02), whereas it not was associated with the Mediterranean-like pattern (OR 0.71, 95% CI 0.28-1.79). CONCLUSION: In smokers without respiratory disease, the Alcohol-consumption pattern and the Westernised pattern are associated with impaired lung function, especially in women. The Mediterranean-like pattern appears to be associated with preserved lung function because no statistical association is observed with impaired lung function. In addition to smoking cessation, modifying dietary patterns has possible clinical application to preserve lung function.

Dietary Guidelines for the Spanish population (SENC, diciembre 2016); the new graphic icon of healthy food / Guías alimentarias para la población española (SENC, diciembre 2016); la nueva pirámide de la alimentación saludable

Objective: The Spanish Society of Community Nutrition (SENC) designed in 1994 a food guide for the Spanish population, updated in 2001. This report presents a new updated edition based on the best scientific evidence available. Methods: From a health in all policies approach, a group of experts in nutrition and public health associated with SENC was convened to review the evidence on diet-health, nutrition intake and food consumption in the Spanish population, as well as food preparation and consumption habits, determinants and impact of diet on environmental sustainability. Existing systematic reviews, updates, reports, meta-analysis and the latest quality studies have been considered. The collaborative group contributed to draft the document and design the graphic icon, then subject of a consultation process, discussion and qualitative evaluation, particularly relevant through the Advisory Group for the SENC-December 2016 Dietary Guidelines. Results: The new recommendations and its graphical representation highlights as basic considerations the practice of physical activity, emotional balance, energy balance to maintain body weight at adequate levels, healthy cooking procedures and adequate water intake. The recommendations promote a balanced, varied and moderate diet that includes whole grains, fruits, vegetables, legumes, varying amounts of dairy and alternating consumption of fi sh, eggs and lean meats, along with the preferential use of extra virgin olive oil for cooking and seasoning. Reinforce the interest in a healthy, sympathetic, supportive, sustainable diet, based on seasonal and local products, axis for conviviality, devoting adequate time and encourage the use of nutrition labelling information. Conclusions: The analysis of the evidence available and updated information on food consumption in Spain highlights the need to strengthen and implement the recommendations contained in this document to progressively achieve a greater adherence.

Objetivo: La Sociedad Española de Nutrición Comunitaria (SENC) planteó en 1994 una guía alimentaria para la población española, renovada en 2001. Se presenta una nueva edición actualizada basada en la mejor evidencia científica disponible. Métodos: Desde un enfoque de salud en todas las políticas se convocó un grupo de expertos en nutrición y salud pública vinculados con la SENC para revisar la evidencia sobre dieta-salud, ingesta nutricional y consumo alimentario en la población española, hábitos de preparación y consumo de alimentos, factores determinantes e impacto de la dieta en la sostenibilidad medioambiental. Se han considerado revisiones sistemáticas existentes, actualizaciones, informes, metaanálisis y estudios recientes de calidad. El grupo colaborativo contribuyó a la elaboración del documento de trabajo y diseño del icono gráfico posteriormente sometidos a consulta, discusión y evaluación cualitativa con especial relevancia a través del Grupo Consultor de las Guías SENC-diciembre 2016. Resultados: Las nuevas recomendaciones y su representación gráfica subrayan como consideraciones básicas practicar actividad física, equilibrio emocional, balance energético para mantener el peso corporal adecuado, procedimientos culinarios saludables e ingesta adecuada de agua. Las recomendaciones promueven una alimentación equilibrada, variada y moderada que incluye cereales de grano entero, frutas, verduras, legumbres, cantidades variables de lácteos y alterna el consumo de pescados, huevos y carnes magras, junto con el uso preferente de aceite de oliva virgen extra como grasa culinaria. Refuerzan el interés por una dieta saludable, solidaria, sostenible, con productos de temporada, de cercanía, eje de convivialidad, dedicando el tiempo suficiente y animan a valorar la información del etiquetado nutricional. Conclusiones: El análisis de la evidencia disponible y de la información actualizada sobre el consumo alimentario en España pone de manifiesto la necesidad de reforzar e implementar las recomendaciones recogidas en este documento para conseguir progresivamente un mayor grado de adherencia.

Dietary guidelines for the Spanish population (SENC, December 2016); the new graphic icon of healthy nutrition / Guías alimentarias para la población española (SENC, diciembre 2016); la nueva pirámide de la alimentación saludable.

Objective: The Spanish Society of Community Nutrition (SENC) designed in 1994 a food guide for the Spanish population, updated in 2001. This report presents a new updated edition based on the best scientifi c evidence available. Methods: From a health in all policies approach, a group of experts in nutrition and public health associated with SENC was convened to review the evidence on diet-health, nutrition intake and food consumption in the Spanish population, as well as food preparation and consumption habits, determinants and impact of diet on environmental sustainability. Existing systematic reviews, updates, reports, meta-analysis and the latest quality studies have been considered. The collaborative group contributed to draft the document and design the graphic icon, then subject of a consultation process, discussion and qualitative evaluation, particularly relevant through the Advisory Group for the SENC-December 2016 Dietary Guidelines. Results: The new recommendations and its graphical representation highlights as basic considerations the practice of physical activity, emotional balance, energy balance to maintain body weight at adequate levels, healthy cooking procedures and adequate water intake. The recommendations promote a balanced, varied and moderate diet that includes whole grains, fruits, vegetables, legumes, varying amounts of dairy and alternating consumption of fi sh, eggs and lean meats, along with the preferential use of extra virgin olive oil for cooking and seasoning. Reinforce the interest in a healthy, sympathetic, supportive, sustainable diet, based on seasonal and local products, axis for conviviality, devoting adequate time and encourage the use of nutrition labelling information. Conclusions: The analysis of the evidence available and updated information on food consumption in Spain highlights the need to strengthen and implement the recommendations contained in this document to progressively achieve a greater adherence.

Objetivo: La Sociedad Española de Nutrición Comunitaria (SENC) planteó en 1994 una guía alimentaria para la población española, renovada en 2001. Se presenta una nueva edición actualizada basada en la mejor evidencia científica disponible. Métodos: Desde un enfoque de salud en todas las políticas se convocó un grupo de expertos en nutrición y salud pública vinculados con la SENC para revisar la evidencia sobre dieta-salud, ingesta nutricional y consumo alimentario en la población española, hábitos de preparación y consumo de alimentos, factores determinantes e impacto de la dieta en la sostenibilidad medioambiental. Se han considerado revisiones sistemáticas existentes, actualizaciones, informes, metaanálisis y estudios recientes de calidad. El grupo colaborativo contribuyó a la elaboración del documento de trabajo y diseño del icono gráfico posteriormente sometidos a consulta, discusión y evaluación cualitativa con especial relevancia a través del Grupo Consultor de las Guías SENC-diciembre 2016. Resultados: Las nuevas recomendaciones y su representación gráfica subrayan como consideraciones básicas practicar actividad física, equilibrio emocional, balance energético para mantener el peso corporal adecuado, procedimientos culinarios saludables e ingesta adecuada de agua. Las recomendaciones promueven una alimentación equilibrada, variada y moderada que incluye cereales de grano entero, frutas, verduras, legumbres, cantidades variables de lácteos y alterna el consumo de pescados, huevos y carnes magras, junto con el uso preferente de aceite de oliva virgen extra como grasa culinaria. Refuerzan el interés por una dieta saludable, solidaria, sostenible, con productos de temporada, de cercanía, eje de convivialidad, dedicando el tiempo suficiente y animan a valorar la información del etiquetado nutricional. Conclusiones: El análisis de la evidencia disponible y de la información actualizada sobre el consumo alimentario en España pone de manifiesto la necesidad de reforzar e implementar las recomendaciones recogidas en este documento para conseguir progresivamente un mayor grado de adherencia.

Guías alimentarias para la población española (SENC, diciembre 2016); la nueva pirámide de la alimentación saludable / No disponible

Objetivo: La Sociedad Española de Nutrición Comunitaria (SENC) planteó en 1994 una guía alimentaria para la población española, renovada en 2001. Se presenta una nueva edición actualizada basada en la mejor evidencia científica disponible. Métodos: Desde un enfoque de salud en todas las políticas se convocó un grupo de expertos en nutrición y salud pública vinculados con la SENC para revisar la evidencia sobre dieta-salud, ingesta nutricional y consumo alimentario en la población española, hábitos de preparación y consumo de alimentos, factores determinantes e impacto de la dieta en la sostenibilidad medioambiental. Se han considerado revisiones sistemáticas existentes, actualizaciones, informes, metaanálisis y estudios recientes de calidad. El grupo colaborativo contribuyó a la elaboración del documento de trabajo y diseño del icono gráfico posteriormente sometidos a consulta, discusión y evaluación cualitativa con especial relevancia a través del Grupo Consultor de las Guías SENC-diciembre 2016. Resultados: Las nuevas recomendaciones y su representación gráfica subrayan como consideraciones básicas practicar actividad física, equilibrio emocional, balance energético para mantener el peso corporal adecuado, procedimientos culinarios saludables e ingesta adecuada de agua. Las recomendaciones promueven una alimentación equilibrada, variada y moderada que incluye cereales de grano entero, frutas, verduras, legumbres, cantidades variables de lácteos y alterna el consumo de pescados, huevos y carnes magras, junto con el uso preferente de aceite de oliva virgen extra como grasa culinaria. Refuerzan el interés por una dieta saludable, solidaria, sostenible, con productos de temporada, de cercanía, eje de convivialidad, dedicando el tiempo suficiente y animan a valorar la información del etiquetado nutricional. Conclusiones: El análisis de la evidencia disponible y de la información actualizada sobre el consumo alimentario en España pone de manifiesto la necesidad de reforzar e implementar las recomendaciones recogidas en este documento para conseguir progresivamente un mayor grado de adherencia (AU)

Objective: The Spanish Society of Community Nutrition (SENC) designed in 1994 a food guide for the Spanish population, updated in 2001. This report presents a new updated edition based on the best scientific evidence available. Methods: From a health in all policies approach, a group of experts in nutrition and public health associated with SENC was convened to review the evidence on diet-health, nutrition intake and food consumption in the Spanish population, as well as food preparation and consumption habits, determinants and impact of diet on environmental sustainability. Existing systematic reviews, updates, reports, meta-analysis and the latest quality studies have been considered. The collaborative group contributed to draft the document and design the graphic icon, then subject of a consultation process, discussion and qualitative evaluation, particularly relevant through the Advisory Group for the SENC-December 2016 Dietary Guidelines. Results: The new recommendations and its graphical representation highlights as basic considerations the practice of physical activity, emotional balance, energy balance to maintain body weight at adequate levels, healthy cooking procedures and adequate water intake. The recommendations promote a balanced, varied and moderate diet that includes whole grains, fruits, vegetables, legumes, varying amounts of dairy and alternating consumption of fish, eggs and lean meats, along with the preferential use of extra virgin olive oil for cooking and seasoning. Reinforce the interest in a healthy, sympathetic, supportive, sustainable diet, based on seasonal and local products, axis for conviviality, devoting adequate time and encourage the use of nutrition labelling information. Conclusions: The analysis of the evidence available and updated information on food consumption in Spain highlights the need to strengthen and implement the recommendations contained in this document to progressively achieve a greater adherence (AU)