Breastfeeding-Related Practices in Rural Ethiopia: Colostrum Avoidance.

The practices of colostrum avoidance and prelacteal feeding, which are common in many developing countries, including Ethiopia, are firmly rooted in ancient traditions. The main objective of this work is to identify the prevalence of colostrum avoidance and study its associated factors among mothers of children aged less than 2 years old in the Oromia region of Ethiopia. A cross-sectional study on the practice of colostrum avoidance/prelacteal feeding was conducted in a rural community with 114 mothers of children under 2 years old. Our results reflected that colostrum avoidance and prelacteal feeding were practiced by 56.1% of mothers. The percentage of women who started breastfeeding in the first hour after birth, as recommended by the WHO, was 2.6%. Of the women who practiced colostrum avoidance, 67.2% gave birth at home, and 65.6% were attended by relatives. The likelihood of avoiding colostrum increases in mothers who have a lower educational level, who did not receive health care at the time of delivery, who think that colostrum is dirty and dangerous and who did not receive information about breastfeeding from healthcare professionals. The knowledge emanating from this work may be useful in designing new breastfeeding education programs and/or interventions in Ethiopia and other developing countries.

Athletic Burnout and Its Association with Diet in Children and Adolescents.

Children today are constantly exposed to several risk factors and high levels of stress that can impact their mental, emotional, and physical health, which can trigger burnout. The objective of this study was to determine the prevalence and frequency of burnout in young amateur athletes and to study the role of the Mediterranean diet on burnout risk. An observational, cross-sectional, and descriptive study of 183 basketball players between 8 and 15 years old was carried out. Adherence to the Mediterranean diet was assessed using the KIDMED questionnaire and the risk of burnout was assessed with the Athlete Burnout Questionnaire. Medians, minimums and maximum values for quantitative variables and absolute frequencies and percentages for qualitative variables were obtained. The results show a higher percentage of burnout among girls. The children who meet the established threshold for burnout spend more time watching television. Participants with better adherence to the Mediterranean diet have lower burnout values in both genders and those with a higher risk of burnout have a worse adherence to the Mediterranean diet. Therefore, it is important to implement a balanced diet appropriate to the individual needs of the athlete.

The Impact of Moringa oleifera Supplementation on Anemia and other Variables during Pregnancy and Breastfeeding: A Narrative Review.

Moringa is a plant commonly used for its medical properties. However, studies have shown contradictory results. The aim of this review is to evaluate the possible association between the use of Moringa during pregnancy and breastfeeding in relation to the health status of both the mother and the baby. A search of the PubMed and EMBASE databases on the literature published during the period 2018-2023 was conducted up until March 2023. The population/exposure/comparison/outcome (PECO) approach was used to select studies on pregnant women, mother-child pairs, and the use of Moringa. Out of the 85 studies initially identified, 67 were excluded, leaving 18 for full-text evaluation. After assessment, 12 were finally included in the review. In the articles included in this work, Moringa is administered during pregnancy or in the postnatal period in the form of leaf powder (MOLP), as a leaf extract (MLE), as an ingredient associated with other supplements or in preparations. It appears to influence several variables during pregnancy and in the postnatal period such as the mother's haematochemical profile, milk production, the child's socio-personal development and the incidence of morbidity during the first 6 months of life. None of the studies analysed reported contraindications to the use of the supplement during pregnancy and lactation.

Prevalence of Depression and Fish Consumption among First Year Spanish University Students: UniHcos Project.

The World Health Organization estimates that one fifth of university students have experienced major depressive disorder at some point in their lives. Nutrition may be one of the modifiable factors that influence the development of depression. Specifically, low omega-3 fatty acid and vitamin D levels, both nutrients found in high quantities in fish, have been linked to depressive disorders. The main objective of this study was to evaluate the prevalence of depression among young Spanish university students, in addition to the pattern of fish consumption among students and the possible relationship between fish consumption and the presence of depression. Data were collected retrospectively from a nationally representative sample of 11,485 Spanish university students aged 18 years or older in 11 Spanish universities, from 2012 to 2022. The respondents were analyzed according to frequency of consumption and compliance with weekly recommendations for fish intake and the presence of depression. Regression models were also performed to determine students' odds of depression as a function of compliance with recommendations according to selected sociodemographic variables. The prevalence of depression was 10.5%; it was more prevalent in women, older students and in those with both high and low BMIs. In addition, it was also more prevalent in those that lived outside the family home, with roommates and those who were employed. Sixty-seven percent of the students met the fish intake recommendations. The most common frequency of fish consumption was 1-2 times/week (44.2%), and the least frequent was 2.3% daily fish consumption. Students from northern universities were more likely to consume fish (68.4%) than those from southern universities (66.4%). Non-consumption of fish was found to increase the risk of depression (ORa = 1.45 (1.28-1.64); AF = 31.0% (21.9-39.0)), but it was the student's own conditions that had the greatest influence on the development of the disorder. In summary, a lower consumption of fish seems to be associated with a higher incidence of depression in Spanish university students; however, other social factors of the student may influence the development of the disorder, and all of this should be taken into account for the development of prevention strategies.

Risk of Gestational Diabetes Due to Maternal and Partner Smoking.

Pregnant women are among the most vulnerable to environmental exposure to tobacco smoke (EET); which has been linked to problems in the mothers' health; one of the most frequent is gestational diabetes (GD). For this reason, there are specific interventions and prevention strategies designed to reduce this exposure risk. However, currently, they are mostly aimed only at aiding the pregnant women with smoking cessation during pregnancy and do not assess or address the risk from passive exposure due to partner smoking. The aim of this work is to study the exposure to EET of pregnant women considering active and passive smoking and to evaluate its effect on the development of GD. This is an observational case-control study within a retrospective cohort of pregnant women. Information on smoking habits was obtained from both personal interviews and recorded medical history. In total, 16.2% of mothers and 28.3% of partners declared having been active smokers during pregnancy; 36.5% of the women presented EET during pregnancy when both active and passive smoking were considered. After adjustments, the association with the EET and GD of the mother was (aOR 1.10 95% CI: 0.64-1.92); for the EET of the partner, it was (aOR 1.66 95% CI: 1.01-2.77); for both partners, it was (aOR 1.82 95% CI: 1.15-2.89), adjusted by the mother's age and body mass index. There is a lack of education regarding the effects of passive exposure to tobacco smoke. It is essential that pregnant women and their partners are educated on the risks of active and passive smoking; this could improve the effectiveness of other GD prevention strategies.

Systematic review of prenatal exposure to endocrine disrupting chemicals and autism spectrum disorder in offspring.

LAY ABSTRACT: Autism spectrum disorders comprise a complex group with many subtypes of behaviorally defined neurodevelopmental abnormalities in two core areas: deficits in social communication and fixated, restricted, repetitive, or stereotyped behaviors and interests each with potential unique risk factors and characteristics. The underlying mechanisms and the possible causes of autism spectrum disorder remain elusive and while increased prevalence is undoubtable, it is unclear if it is a reflection of diagnostic improvement or emerging risk factors such as endocrine disrupting chemicals. Epidemiological studies, which are used to study the relation between endocrine disrupting chemicals and autism spectrum disorder, can have inherent methodological challenges that limit the quality and strength of their findings. The objective of this work is to systematically review the treatment of these challenges and assess the quality and strength of the findings in the currently available literature. The overall quality and strength were "moderate" and "limited," respectively. Risk of bias due to the exclusion of potential confounding factors and the lack of accuracy of exposure assessment methods were the most prevalent. The omnipresence of endocrine disrupting chemicals and the biological plausibility of the association between prenatal exposure and later development of autism spectrum disorder highlight the need to carry out well-designed epidemiological studies that overcome the methodological challenges observed in the currently available literature in order to be able to inform public policy to prevent exposure to these potentially harmful chemicals and aid in the establishment of predictor variables to facilitate early diagnosis of autism spectrum disorder and improve long-term outcomes.

Perinatal and Obstetric Predictors for Autism Spectrum Disorder.

The objective is to identify obstetric and perinatal factors that could be significant predictors of ASD and may lead to early detection and intervention. A population-based case-control study including 128 children diagnosed with ASD and 311 controls was conducted. Information was collected through self-reported questionnaires. The factors retained as significant predictors for ASD in the final adjusted hierarchical logistic regression model were cesarean section and male gender. The study revealed a higher incidence of cesarean sections and male gender in children with ASD in comparison to unaffected children confirming the results of previous studies. Children born by cesarean section, especially males, should be more closely monitored for the presence of ASD traits for early diagnosis and intervention.

Maternal profile according to Mediterranean diet adherence and small for gestational age and preterm newborn outcomes.

OBJECTIVE: The objective was to evaluate maternal Mediterranean diet (MD) pattern adherence during pregnancy and its association with small for gestational age (SGA) and preterm birth. A secondary objective of the current study was to describe the sociodemographic, lifestyle and obstetric profile of the mothers studied as well as the most relevant paternal and newborn characteristics. DESIGN: The current study is a two-phase retrospective population-based study of maternal dietary habits during pregnancy and their effect on newborn size and prematurity. The descriptive first phase examined maternal dietary habits during pregnancy along with the maternal sociodemographic, lifestyle and obstetric profile in a cross-sectional period study. In the second phase, newborn outcomes were evaluated in a nested case-control study. Adherence to MD during pregnancy was measured with the Spanish version of Kidmed index. SETTING: Obstetrics ward of the La Fe Hospital in Valencia. PARTICIPANTS: All mother-child pairs admitted after delivery during a 12-month period starting from January 2018 were assessed for eligibility. A total of 1118 provided complete outcome data after signing informed consent. RESULTS: 14·5 % met the criteria of poor adherence (PA); 34·8 %, medium adherence (MA); and 50·7 %, optimal adherence (OA). Medium adherence to MD was associated in the adjusted scenarios with a higher risk of giving birth to a preterm newborn. No association was found between MD adherence and SGA. CONCLUSIONS: Early intervention programmes geared towards pregnant women, where women were aided in reaching OA to MD, might reduce the risk of preterm newborn.

Maternal Physical Activity During Pregnancy and the Effect on the Mother and Newborn: A Systematic Review.

BACKGROUND: The practice of physical exercise during pregnancy has benefits for both the mother and baby. Currently, there is scientific evidence that supports the inclusion of a monitored physical activity program in the daily activities of pregnant women. The objective of this study is to provide an overview of the current status of the association between physical activity during pregnancy and the effects on the mother and the newborn. METHODS: A systematic review of the literature, assessing each study using the Scottish Intercollegiate Guidelines Network, from different databases PubMed, Embase, or ScienceDirect, on the association between maternal physical activity and its effects on the mother and the newborn published from 2010 until 2018 was conducted. RESULTS: About 25 studies were identified and divided into categories according to the health problems affecting the mother or newborn. It was found that 8% of all the studies received a grade B, 68% obtained a grade C, and the remaining 24% obtained less than a grade C. Improved cardiovascular function, decreased risk of gestational diabetes mellitus, hypertension, and the limitation of weight gain are among the benefits to the mother with lower percentage of body fat, increased gestational age, and potentially improved neurodevelopment as benefits for the child. CONCLUSIONS: The realization of physical activity during pregnancy is supported by most of the studies reviewed. However, given the vulnerability of the studied populations, more studies on the association between physical activity and pregnancy are necessary.

Effect of Breast Cancer Treatment on Dietary Vitamin Intake Levels.

Breast cancer is the most common tumor among women, representing the second cause of cancer deaths in women. Treatment with chemotherapy negatively interferes with nutritional status. The intake of vitamins before, during and after treatment in a pilot cohort of women with non-invasive breast cancer (type I, II) treated at the Valencian Institute of Oncology (IVO) is evaluated. A 3-day anthropometric and nutritional assessment was performed using the DIAL program. Nutritional intake is compared with the values of Estimated Average Requirements (EAR) and Dietary Reference Intake (DRI) provided by the United States Department of Agriculture (USDA) and the European Food Safety Authority (EFSA). There is an overall decrease in vitamin intake during treatment which worsens at the end of said treatment. The decrease is significant in the case of vitamins B2 (p = 0.006), B3 (p = 0.042), B5 (p = 0.001), and B8 (p = 0.021). The relative risk during and after treatment increases with respect to the reference timeframe, before treatment. Deficit risks are statistically significant in the case of vitamins B5 (p = 0.001), B8 (p = 0.001) and B12 (p = 0.001). Decreased vitamin intake during treatment suggests a negative change in the patients' dietary behaviors during this time. Nutritional intervention and support may be beneficial to optimize overall dietary intake and maintain compliance with EAR and DRI for patients during a time in which adequate nutrition is important.

Total Sugar Intake and Macro and Micronutrients in Children Aged 6-8 Years: The ANIVA Study.

The objective of this study was to study the association between total sugar intake (TSI) levels of children aged 6-8 years old, nutrient intake and anthropometry. Food and beverage intakes were collected by a prospective three-day recall questionnaire. The 2237 children were distributed into three groups according to TSI percentiles. Mean TSI was 93.77 ± 25.72 g/day, 22%-25% of total caloric intake, with boys presenting an intake of 96.24 ± 24.34 g/day and girls 91.38 ± 26.78 g/day. Greater TSI was associated with higher body fat, parental education, energy intake, nutrients/1000 kcal, and lower weight z-scores, BMI z-scores, waist circumferences, and hip circumferences. Weight, height, and waist circumference had the highest R2 while body fat had the lowest. The percentage of total energy derived (%E) from protein decreased as the %E from TSI increased, while the opposite was true for carbohydrates and saccharides, while for fiber intake, the medium groups presented the highest intake/1000 kcal. For the remaining macronutrients studied, intake/1000 kcal decreased when the %E from TSI increased. Calcium, iodine, magnesium, vitamin B2, folate, and vitamin C intake increased as the %E from TSI increased, while the opposite was true for vitamin B12. Fiber, ω-6 PUFA, iodine, folate, vitamin D, and vitamin E intakes were insufficient across most of the sample. TSI levels in children were identified to exceed adult recommendations. It is not clear what the effect of up to an average of 21% of energy coming from total sugars has on childhood obesity and further research is needed in the pediatric population, however, opportunities exist to improve sugar intake patterns.

Alteraciones del metabolismo glucídico durante el embarazo. Efectos sobre la madre y el recién nacido / Alterations of carbohydrate metabolism during pregnancy. Effects on the mother and new born infant

INTRODUCCIÓN: La diabetes gestacional es la enfermedad que con mayor frecuencia origina alteraciones médicas en el embarazo. El objetivo de este estudio es valorar la relación entre la presencia de alteraciones en el metabolismo de los hidratos de carbono durante el embarazo y el riesgo de presentar resultados obstétricos adversos en la madre y el feto. PACIENTES Y MÉTODO: Se realizó un estudio observacional en 799 mujeres que acababan de dar a luz. Se analizaron las características clínicas y obstétricas de las pacientes, así como los datos relacionados con la gestación y el parto, incluyendo el estado del recién nacido. Se evaluó la información con relación a las alteraciones en el metabolismo de los hidratos de carbono. RESULTADOS Y DISCUSIÓN: Para las mujeres con diabetes gestacional encontramos un riesgo de 2,64 veces mayor de pérdida de bienestar fetal y 3,14 veces mayor de requerir hospitalización durante el embarazo. Para las gestantes con intolerancia a los hidratos de carbono encontramos un riesgo de 2,61 veces mayor de requerir episiotomía en el parto vaginal, 7,54 veces mayor de encontrar pérdida del bienestar fetal y 2,06 veces mayor de requerir hospitalización. El grupo de intolerancia a los hidratos de carbono se comportó de forma similar al de la diabetes. CONCLUSIONES: El grupo de intolerancia a los hidratos de carbono es un grupo poco estudiado y se han encontrado alteraciones obstétricas significativas frente al grupo control y similares a las del grupo de diabetes gestacional

INTRODUCTION: Gestational diabetes is the pathology that most frequently causes medical alterations in pregnancy. The objective of this study was to assess the relationship between the presence of alterations in the metabolism of carbohydrates during pregnancy and the risk of adverse obstetric outcomes in mother and foetus. PATIENTS AND METHOD: An observational study was conducted on 799 women who had just given birth. The clinical and obstetric characteristics of the patients, as well as the data related to pregnancy and delivery, including the state of the new born infant were analysed. The information was evaluated in relation to the alterations in carbohydrate metabolism. RESULTS AND DISCUSSION: For women with gestational diabetes a 2.64 times greater risk of loss of foetal well-being and 3.14 times greater risk of requiring hospitalization during pregnancy were found. For pregnant women with carbohydrate intolerance, a 2.61 times higher risk of requiring episiotomy in vaginal delivery, a 7.54 times greater risk of finding loss of foetal well-being, and a 2.06 times greater risk of requiring hospitalization were found. The group with carbohydrate intolerance behaved similarly to that with diabetes. CONCLUSIONS: The group with intolerance to carbohydrates is a little studied group and significant obstetric alterations were found compared to the control group and similar to those of the gestational diabetes group

Alterations of carbohydrate metabolism during pregnancy. Effects on the mother and new born infant. / Alteraciones del metabolismo glucídico durante el embarazo. Efectos sobre la madre y el recién nacido.

INTRODUCTION: Gestational diabetes is the pathology that most frequently causes medical alterations in pregnancy. The objective of this study was to assess the relationship between the presence of alterations in the metabolism of carbohydrates during pregnancy and the risk of adverse obstetric outcomes in mother and foetus. PATIENTS AND METHOD: An observational study was conducted on 799 women who had just given birth. The clinical and obstetric characteristics of the patients, as well as the data related to pregnancy and delivery, including the state of the new born infant were analysed. The information was evaluated in relation to the alterations in carbohydrate metabolism. RESULTS AND DISCUSSION: For women with gestational diabetes a 2.64 times greater risk of loss of foetal well-being and 3.14 times greater risk of requiring hospitalization during pregnancy were found. For pregnant women with carbohydrate intolerance, a 2.61 times higher risk of requiring episiotomy in vaginal delivery, a 7.54 times greater risk of finding loss of foetal well-being, and a 2.06 times greater risk of requiring hospitalization were found. The group with carbohydrate intolerance behaved similarly to that with diabetes. CONCLUSIONS: The group with intolerance to carbohydrates is a little studied group and significant obstetric alterations were found compared to the control group and similar to those of the gestational diabetes group.

Particulate Matter Exposure and Attention-Deficit/Hyperactivity Disorder in Children: A Systematic Review of Epidemiological Studies.

Attention-deficit/hyperactivity disorder (ADHD) is the most common cognitive and behavioural disorder affecting children, with a worldwide-pooled prevalence of around 5%. Exposure to particulate matter (PM) air pollution is suspected to be associated with autism spectrum disorders and recent studies have investigated the relationship between PM exposure and ADHD. In the absence of any synthesis of the relevant literature on this topic, this systematic review of epidemiological studies aimed to investigate the relationship between the exposure of children to PM and ADHD and identify gaps in our current knowledge. In December 2018, we searched the PubMed and EMBASE databases. We only included epidemiological studies carried out on children without any age limit, measuring PM exposure and health outcomes related to ADHD. We assessed the quality of the articles and the risk of bias for each included article using the Newcastle-Ottawa Scale and the Office of Health Assessment and Translation (OHAT) approach, respectively. The keyword search yielded 774 results. Twelve studies with a total number of 181,144 children met our inclusion criteria, of which 10 were prospective cohort studies and 2 were cross-sectional studies. We subsequently classified the selected articles as high or good quality studies. A total of 9 out of the 12 studies reported a positive association between PM exposure to outdoor air pollution and behavioral problems related to attention. Despite these results, we found a significant degree of heterogeneity among the study designs. Furthermore, 11 studies were judged to be at a probably high risk of bias in the exposure assessment. In conclusion, we opine that further high quality studies are still needed in order to clarify the association between PM exposure and ADHD diagnosis.

Actigraphic Sleep and Dietary Macronutrient Intake in Children Aged 6-9 Years Old: A Pilot Study.

The objective of this study was to examine the relationship between different sleep parameters and energy and macronutrient intake in school-aged children. A total of 203 children 6 to 9 years of age participated in this cross-sectional study. Anthropometric measurements were taken first. Diet was assessed with 3-day food logs and sleep was measured with a questionnaire on sleep quality and a wrist actigraph worn for at least 7 days. A decrease of 165.45 kcal was observed per each additional hour of sleep during the week (ß (95% CI) = -165.45 (-274.01, -56.88); p = 0.003). This relationship was also observed for fat (ß (95% CI) = -11.14 (-18.44, -3.84); p = 0.003) and protein (ß (95% CI) = -13.27 (-22.52, -4.02); p = 0.005). An increase in weekend sleep efficiencies for those under the recommended threshold of 85% also had a similar association with energy (ß (95% CI) = -847.43 (-1566.77, 128.09); p = 0.021) and carbohydrate (ß (95% CI) = -83.96 (-161.76, -6.15); p = 0.035)) intake. An increase in habitual sleep variability was related with a slight increase in protein intake (ß (95% CI) = 0.32 (0.031, 0.62); p = 0.031). Children who slept less had a higher energy intake, especially from fat and protein and those who presented inefficient sleep had a higher carbohydrate intake. Strategies to enhance sleep quality and quantity combined with dietary recommendations could help to improve energy and macronutrient intake levels in children.

Total body skeletal muscle mass and diet in children aged 6-8 years: ANIVA Study.

The objective was to assess if there was any relationship between the amount of skeletal muscle mass (SMM) in children aged 6-8 years and their nutritional intake. The Valencian Anthropometry and Child Nutrition (ANIVA) study is a cross-sectional study with children aged between 6-8 years (n = 1988) from schools in Valencia. Children were distributed into 4 groups for comparison: normal and high SMM and by sex. Anthropometric data were obtained following World Health Organization protocols. Nutritional intake was measured using a prospective 3-day food journal and the KIDMED questionnaire. Of the whole child sample, 63.9% had high SMM values. No differences were found in adherence to a Mediterranean diet or absolute energy intake. Significant differences were found in the proportion of energy intake in relation to estimated energy requirements and between nutritional intake of certain macro or micronutrients with SMM. This study provides values of SMM for children. Children's adherence to a Mediterranean diet was not related to total SMM. At the same time, the consumption of excess calories or overeating is associated with SMM, with those children overeating more having lower SMM values. The differences in the intake of the other macro- and micronutrients were not associated with children's SMM.

Supplementation with micronutrients and schistosomiasis: systematic review and meta-analysis.

Schistosomiasis is a parasitic disease caused by helminths of the genus Schistosoma with two presentations; one intestinal and another urinary; which depend on the specie of Schistosoma. One of the species that can produce intestinal schistosomiasis is Schistosoma mansoni, and the specie that produces urinary schistosomiasis is Schistosoma haematobium. Infection can be aggravated by a deficient nutritional status, which negatively impacts the immune system and increases susceptibility to infection. The main objective of this meta-analysis is to determine if a relationship exists between multimicronutrient supplementation and the reduction of infestation with Schistosoma mansoni and Schistosoma haematobium in children and adolescents. A search was conducted through a scientific literature database, and articles that complied with the pre-established requirements were retrieved. The Review Manager (Rev Man) 5.3 computer program was used for data processing and analysis was carried out with the objective of testing whether the addition of micronutrient supplementation to treatment with broad-spectrum antiparasitic anthelmintic medication has an impact on schistosomiasis infection. Of the 257 initial articles retrieved, eight were included both quantitatively and qualitatively in the meta-analysis. Supplementation reduces infestation with Schistosoma spp 1.33 times more than placebo. In individuals infested with Schistosoma, mansoni supplementation is 1.30 times more effective than placebo and for individuals infested with Schistosoma haematobium, supplementation is 1.62 times more effective than the placebo. The results show a clear relationship between supplementation and reduction of infestation. The supplementation with micronutrients decreases the presence of Schistosoma spp in children and adolescents.

[Prevalence of arterial hypertension and its association with anthropometry and diet in children (6 to 9 years old): ANIVA study]. / Prevalencia de hipertensión arterial y su asociación con antropometría y dieta en niños (de seis a nueve años): estudio ANIVA.

INTRODUCTION: Introduction: recent studies warn of changes in dietary habits and an increase in overweight children as possible risk factors for early hypertension. Objectives: to know the prevalence of normotension, rehypertension and hypertension in the children studied, and to evaluate its possible association with diet and anthropometric indicators. Methods: a cross-sectional study was carried out within the Project "Anthropometry and Child Nutrition of Valencia" (ANIVA), where diet, blood pressure, and anthropometry were evaluated in 652 children between six and nine years old. The World Health Organization (WHO) criteria to identify normotensive, prehypertensive and hypertensive were applied. Results: there is a higher prevalence of normotensive (83.9%, p < 0.05). The prevalence of prehypertensive and hypertensive patients is 8.1% and 8.0%, respectively. Boys have higher levels of hypertension (8.4%), while girls have a higher prevalence of prehypertension (9.3%). In boys, significantly higher values are identified for the weight, height and hip circumference. Girls present significantly higher percentage of fat mass, bicipital fold, suprailiac fold, and heart rate. Significant correlations were found between the anthropometric indicators and blood pressure by sex, highlighting the waist circumference-blood pressure correlation in boys. Significant differences are observed between the nutrients ingested in the diet and blood pressure. Conclusions: a prevalence of hypertension of 8% in children aged 6-9 years of the province of Valencia is identified. The blood pressure values increase according to the body mass index, percentage of fat mass, waist circumference and the set of folds. A dietary pattern associated with hypertension in children is identified.

INTRODUCCIÓN: Introducción: estudios recientes alertan de cambios en los hábitos alimentarios y de un aumento del sobrepeso en niños como posibles factores de riesgo de una hipertensión temprana. Objetivos: conocer la prevalencia de normotensión, prehipertensión e hipertensión en los niños estudiados y valorar su posible asociación con la dieta e indicadores antropométricos. Métodos: se realizó un estudio transversal dentro del Proyecto "Antropometría y Nutrición Infantil de Valencia" (ANIVA), donde se valoró dieta, presión arterial y antropometría en 652 niños/as de entre seis y nueve años. Se aplicaron los criterios de la Organización Mundial de la Salud (OMS) para identificar normotensos, prehipertensos e hipertensos. Resultados: existe una mayor prevalencia de normotensos (83,9%, p < 0,05). La prevalencia de prehipertensos e hipertensos es de un 8,1% y 8,0%, respectivamente. Los niños presentan mayores niveles de hipertensión (8,4%), mientras que las niñas presentan mayor prevalencia de prehipertensión (9,3%). En los niños se identifican valores significativamente mayores en el peso, la altura y la circunferencia de cadera. Las niñas presentan significativamente mayor porcentaje de masa grasa, pliegue bicipital, pliegue suprailiaco y frecuencia cardiaca. Se encontraron correlaciones significativas entre los indicadores antropométricos y la presión arterial por sexo, destacando la correlación perímetro de cintura-presión arterial en los niños. Se observan diferencias significativas entre los nutrientes ingeridos en la dieta y la presión arterial. Conclusiones: se identifica una prevalencia de hipertensión del 8% en niños de 6-9 años de la provincia de Valencia. Los valores de presión arterial aumentan en función del índice de masa corporal, el porcentaje de masa grasa, el perímetro de cintura y el conjunto de los pliegues. Se identifica un patrón dietético asociado a la hipertensión en niños.

The Association between Lead and Attention-Deficit/Hyperactivity Disorder: A Systematic Review.

The etiology of Attention-Deficit/Hyperactivity Disorder (ADHD) is complex and multifactorial. Although the development of ADHD symptoms remains to be elucidated, in recent years, epigenetic processes have emerged as candidate mechanisms. Lead is one of the most dangerous environmental pollutants, and it is suspected to be associated with ADHD. The aim of the present study was to review the epidemiological literature currently available on the relation between lead exposure and the diagnosis of ADHD. The PubMed and EMBASE databases were searched from 1 July 2018 up to 31 July 2018. The authors included observational studies (cohort, case⁻control and cross-sectional studies) published in English carried out on children within the last 5 years, measuring lead exposure and health outcomes related to ADHD. Seventeen studies met the inclusion criteria: 5 of these studies found no association between lead exposure and ADHD whereas the remaining 12 studies showed positive associations, even though not all of them were homogeneous in terms of exposure periods considered or ADHD diagnosis. To conclude, the evidence from the studies allowed us to establish that there is an association between lead and ADHD and that even low levels of lead raise the risk. However, there is still a lack of longitudinal studies about the relationship between lead exposure and the development of ADHD. Given the potential importance for public health, further research that includes the entire potential risk factors for ADHD in children must be encouraged.

Prevalencia de hipertensión arterial y su asociación con antropometría y dieta en niños (de seis a nueve años): estudio ANIVA / Prevalence of arterial hypertension and its association with anthropometry and diet in children (6 to 9 years old): ANIVA study

Introducción: estudios recientes alertan de cambios en los hábitos alimentarios y de un aumento del sobrepeso en niños como posibles factores de riesgo de una hipertensión temprana. Objetivos: conocer la prevalencia de normotensión, prehipertensión e hipertensión en los niños estudiados y valorar su posible asociación con la dieta e indicadores antropométricos. Métodos: se realizó un estudio transversal dentro del Proyecto "Antropometría y Nutrición Infantil de Valencia" (ANIVA), donde se valoró dieta, presión arterial y antropometría en 652 niños/as de entre seis y nueve años. Se aplicaron los criterios de la Organización Mundial de la Salud (OMS) para identificar normotensos, prehipertensos e hipertensos. Resultados: existe una mayor prevalencia de normotensos (83,9%, p < 0,05). La prevalencia de prehipertensos e hipertensos es de un 8,1% y 8,0%, respectivamente. Los niños presentan mayores niveles de hipertensión (8,4%), mientras que las niñas presentan mayor prevalencia de prehipertensión (9,3%). En los niños se identifican valores significativamente mayores en el peso, la altura y la circunferencia de cadera. Las niñas presentan signifi cativamente mayor porcentaje de masa grasa, pliegue bicipital, pliegue suprailiaco y frecuencia cardiaca. Se encontraron correlaciones significativas entre los indicadores antropométricos y la presión arterial por sexo, destacando la correlación perímetro de cintura-presión arterial en los niños. Se observan diferencias significativas entre los nutrientes ingeridos en la dieta y la presión arterial. Conclusiones: se identifica una prevalencia de hipertensión del 8% en niños de 6-9 años de la provincia de Valencia. Los valores de presión arterial aumentan en función del índice de masa corporal, el porcentaje de masa grasa, el perímetro de cintura y el conjunto de los pliegues. Se identifi ca un patrón dietético asociado a la hipertensión en niños

Introduction: recent studies warn of changes in dietary habits and an increase in overweight children as possible risk factors for early hypertension. Objectives: to know the prevalence of normotension, prehypertension and hypertension in the children studied, and to evaluate its possible association with diet and anthropometric indicators. Methods: a cross-sectional study was carried out within the Project "Anthropometry and Child Nutrition of Valencia" (ANIVA), where diet, blood pressure, and anthropometry were evaluated in 652 children between six and nine years old. The World Health Organization (WHO) criteria to identify normotensive, prehypertensive and hypertensive were applied. Results: there is a higher prevalence of normotensive (83.9%, p < 0.05). The prevalence of prehypertensive and hypertensive patients is 8.1% and 8.0%, respectively. Boys have higher levels of hypertension (8.4%), while girls have a higher prevalence of prehypertension (9.3%). In boys, significantly higher values are identified for the weight, height and hip circumference. Girls present significantly higher percentage of fat mass, bicipital fold, suprailiac fold, and heart rate. Significant correlations were found between the anthropometric indicators and blood pressure by sex, highlighting the waist circumference-blood pressure correlation in boys. Significant differences are observed between the nutrients ingested in the diet and blood pressure. Conclusions: a prevalence of hypertension of 8% in children aged 6-9 years of the province of Valencia is identified. The blood pressure values increase according to the body mass index, percentage of fat mass, waist circumference and the set of folds. A dietary pattern associated with hypertension in children is identified