Decrease in the prevalence of hypertension in Spanish schoolchildren from 2010 to 2017: Cuenca Study.

AIMS: To examine the secular trends in blood pressure measurements and normal or high blood pressure classification among Spanish schoolchildren from 2010 to 2017, to analyze the persistence in the blood pressure category reported in 2017 compared with 2013 in those children born in 2007-08 and to compare in this cohort the prevalence of high blood pressure using both definitions, the 2004 and 2017 guidelines. METHODS AND RESULTS: The data for the prevalence/trend analysis were obtained from cross-sectional analyses conducted in 2010, 2013, and 2017 of 2709 schoolchildren aged 4-6 and 8-11 years from 22 schools in the province of Cuenca, Spain. The data for the longitudinal analysis were obtained from cross-sectional analyses of measurements gathered in 2013 and 2017 in the same cohort of children (n = 275). The prevalence of normal blood pressure increased by 5.4% in children aged 4-6 years from 2013 to 2017 and by 2.2% in children aged 8-11 from 2010 to 2017. This increase was mainly driven by a decrease in the children classified in any stage of hypertension by 4.2% and 2.3% in each age range, respectively. In the same birth cohort, there was an increase of 7.6% in normal blood pressure prevalence. CONCLUSION: The high blood pressure prevalence in Spanish children has clearly decreased over the last decade, but is still important to detect this condition to design specific school-based interventions and the evaluation of children classified as hypertensive who might need medical supervision and treatment.

Periarticular injection and hamstring block versus placebo for pain control in anterior cruciate ligament reconstruction: A randomized controlled trial.

PURPOSE: To study the effectiveness of periarticular infiltration (PI), including the proximal donor site vs. placebo in anterior cruciate ligament (ACL) reconstruction. METHOD: A total of 44 patients were randomized in two groups assigned to receive PI or placebo. The perioperative protocol was the same for both groups. The principal outcome was pain measured at 8 and 24 h by a visual analog scale (VAS). The pain was registered in the knee and the proximal donor site. Pain scores were also assessed to determine whether the VAS improvement would reach the threshold values reported for the minimal clinically significant difference. The secondary outcome was the need for opioid rescue medication. RESULTS: Patients receiving PI exhibited lower pain values in the knee at 8 h (mean PI 35.00 ± 5.76 vs. placebo 60.23 ± 4.52 p = 0.01) and at 24 h (mean PI 37.23 ± 5.62 vs. placebo 55.55 ± 3.41 p = 0.008). These results were above the threshold for clinical significance. No improvements were found in proximal donor site pain and consumption of opioid rescue medication. Complications were comparable between the two groups. CONCLUSION: PI significantly reduced pain in the knee vs. placebo after ACL reconstruction with hamstring autograft at 8 and 24 h after surgery. The instillation of part of the mixture in the proximal hamstring stump did not result in any improvement LEVEL OF EVIDENCE I: Level I, randomized controlled trial.

Alternatives to continuous positive airway pressure treatment in sleep apnoeas and hypopnoeas syndrome related to myofunctional and postural reeducation therapy: protocol for a systematic review.

INTRODUCTION: The main treatment for sleep apnoeas and hypopnoeas syndrome (SAHS) is continuous positive airway pressure (CPAP). However, patients sometimes do not adhere to the treatment protocol. Supplementary and complementary therapies have appeared as alternatives. Some of the therapies which are especially important are those related to myofunctional (MFT) and postural therapy (PT), as all of them are non-invasive, and their application is simpler than that of CPAP. We aim to present a protocol for a systematic review and meta-analysis for investigating new SAHS treatments, including the protocols and frequency of use and the effects they have on patient signs, symptoms and quality of life. METHODS AND ANALYSIS: The literature search will be conducted using the Cochrane, Web of Science, Medline (via PubMed) and Scopus databases, from January 2020 to December 2020. All types of studies written in English and Spanish that investigate the use of alternative SAHS treatments related to MFT, or more importantly, the combination of MFT and PRT, will be selected. To evaluate their quality, the Critical Appraisal Checklist for Analytical Cross-Sectional will be applied. The primary factor valued in the studies will be the inclusion of MFT and PT reeducation in the treatment. Subgroup analyses will be carried out evaluating the specific type of treatments chosen and the improvements or deteriorations in the level of health and quality of life in the patients. Finally, several patient-related outcomes, namely sleep quality, quality of life and sleep Apnoeas and Hypoapnoeas Index, will be examined. ETHICS AND DISSEMINATION: In this case, ethical approval is not necessary. The data used in the review will be exclusively obtained from published studies, implying there are no privacy concerns. The information obtained will be relevant to understand if the new treatments applied in SAHS are effective, and if postural and MFT therapy used together can be considered an appropriate approach to treat this disease.The results will be published in a peer-reviewed journal.

Relationship between exclusive breastfeeding and brain-derived neurotrophic factor in children.

OBJECTIVE: A positive relationship between breastfeeding and brain-derived neurotrophic factor (BDNF) in infants has been suggested due to the presence of BDNF in human milk. This study aimed to determine the relationship between exclusive breastfeeding and BDNF serum levels in Spanish schoolchildren. METHODS: A cross-sectional analysis including 202 schoolchildren, aged eight to 11 years, from Cuenca, Spain, was conducted. Information on sociodemographic and anthropometric variables, sexual maturation, birth weight and exclusive breastfeeding ('no exclusive breastfeeding', and exclusive breastfeeding for ≤6 and >6 months), and BDNF serum levels using an ELISA method were obtained. Covariance analyses (ANCOVA) were conducted to examine the relationship between serological BDNF and exclusive breastfeeding after controlling for potential confounders. RESULTS: ANCOVA models showed no significant differences in BDNF levels between children who were exclusively breastfed for more than six months versus those who were not (p > 0.05). No significant differences were observed by age group (eight to nine years versus 10 to 11 years; p > 0.05). Additionally, no clear negative trend in BDNF serum levels according to sexual maturation categories was found (p > 0.05). CONCLUSION: These findings suggest that exclusive breastfeeding does not have a significant positive association on BDNF from eight to 11 years, since children who were exclusively breastfed did not have significantly higher BDNF levels than those who were not exclusively breastfed. Likewise, BDNF levels were not found to be negatively affected by hormonal development. Future research should examine the influence of exclusive breastfeeding on BDNF over the different developmental stages.

The accuracy of toe brachial index and ankle brachial index in the diagnosis of lower limb peripheral arterial disease: A systematic review and meta-analysis.

BACKGROUND AND AIMS: We aimed to compare the diagnostic accuracy of ankle brachial index (ABI) and toe brachial index (TBI) for peripheral arterial disease (PAD) in a wide spectrum of PAD populations and reference standard tests, and to examine variables influencing heterogeneity in the estimates. METHODS: Systematic searches in EMBASE, MEDLINE, Web of Science and the Cochrane Library databases were performed, from inception to January 2020. Hierarchical summary receiver operating characteristic curves (HSROC) were used to summarize the pooled test performance. RESULTS: Thirty five (patient-level: 1318 patients, limb-level: 5637 limbs) and nine studies (patient-level: 294 patients, limb-level: 826 limbs) were included in ABI and TBI meta-analyses, respectively. The QUADAS-2 tool identified many studies with high risk of bias, especially in the "patient selection" domain. Pooled estimates for ABI in detecting 50% or greater stenosis were sensitivity = 61% (95% CI: 55-69), specificity = 92% (95% CI: 89-95) and dOR = 16.5 (95% CI: 11.5-23.6). Similarly, TBI yielded sensitivity = 81% (95% CI: 70-94), specificity = 77% (95% CI: 66-90) and dOR = 13.1 (95% CI: 7.0-24.8). In a direct comparison of seven studies jointly analyzing ABI and TBI, TBI showed better overall diagnostic accuracy (16.4 vs 11.0 in dOR) at the expense of sensitivity (82% vs 52%), while specificity (77% vs 94%) performed worse in TBI than ABI. Heterogeneity was large in sensitivity for ABI, with variables as different reference standard tests, smoking habit and PAD prevalence accounting for such variability. Similarly, gender, different index test cut-offs and sample size influenced the heterogeneity in TBI specificity. CONCLUSIONS: Though ABI and TBI showed similar diagnostic performance to diagnose PAD, TBI showed far better sensitivity than ABI, especially in "challenging populations", as those exhibiting calcification.

Obesity and thinness prevalence trends in Spanish schoolchildren: are they two convergent epidemics?

BACKGROUND: The objective of this study was to analyse the secular trends in body composition variables and weight status among Spanish schoolchildren from 1992 to 2017, and to examine the persistence in the same weight status category from 2013 to 2017 of the birth cohort in 2007-08. METHODS: The data for the prevalence/trend analysis were taken from cross-sectional analyses conducted in 1992 (n = 308), 1996 (n = 307), 1998 (n = 275), 2004 (n = 1119), 2010 (n = 912), 2013 (n = 352) and 2017 (n = 275) using similar procedure methods among schoolchildren (aged 4-6 y and 8-11 years) from 22 public schools in the province of Cuenca, Spain. The data for the longitudinal analysis were obtained from cross-sectional analyses of measurements gathered in 2013 and 2017 in the same cohort of children (n = 275) born in 2007 and 2008. Weight, height, body fat percentage (by electronic bioimpedance) and waist circumference were measured by trained personnel. Weight status was defined according to the BMI cut-offs proposed by the International obesity task force (IOTF) criteria. RESULTS: In schoolchildren, the overall prevalence of thinness increased from 5.9% in 1992 to 14.5% in 2017, P < 0.001. Whereas, the overall prevalence of obesity/overweight remained relatively steady between the same time period (from 25.2% to 26.9%), P = 0.599. In relation to the longitudinal analyses, we observed that 70.9% of schoolchildren in 2017 remained in the same weight status category as in 2013. CONCLUSIONS: The child obesity epidemic in Spain has remained relatively stable over the last two decades. However, the prevalence of thinness shows a worrying upward trend.

Barriers and Facilitators Perceived by Spanish Experts Concerning Nursing Research: A Delphi Study.

The identification of research priorities in line with current health needs and nursing competencies is a priority. Nevertheless, barriers and facilitators perceived by nurses to performing nursing research have scarcely been investigated. The main aim of this study was to explore the situation in nursing research in Spain, as perceived by Spanish experts. A Delphi study technique in two phases was applied using an online survey tool. A panel of 20 nursing experts in nursing, teaching and management positions participated. The strengths highlighted were the possibility of reaching the PhD level, the possibility of receiving continuous training in research methodology, and access to scientific knowledge through the Internet. The weaknesses identified were the lack of Spanish nursing journals in which to publish the research results, the lack of funding in nursing care research, and the lack of connection between the healthcare institutions and the university. According to the experts, elements that could enhance leadership in research are the creation of nursing research units in hospitals, the economic recognition of nurses with PhDs, and considering research work as part of their daily tasks in clinical settings. The idea of being subordinated to physicians still remains in nurses' ways of thinking.

The effectiveness of high-intensity interval training on body composition, cardiorespiratory fitness, and cardiovascular risk factors in children: A protocol for a systematic review.

BACKGROUND: No previous systematic review has examined the effect of high-intensity interval training (HIIT) interventions on body composition, cardiometabolic risk factors and cardiorespiratory fitness (CRF) in healthy schoolchildren from 5 to 12 years old. METHODS: This study will be conducted by following the guideline of the preferred reporting items for systematic review and meta-analysis protocols. An electronic search in MEDLINE (via PubMed), EMBASE (via Scopus), SPORTDiscus, Cochrane Library and Web of Science databases of all dates from inception will be conducted. We will include randomized controlled trials aimed to assess the effectiveness of HIIT to improve cardiometabolic risk factors, body composition, and CRF in children. Two authors will perform the study selection and data collection; disagreements will be solved by a third reviewer. The methodological quality of studies will be assessed by the Cochrane Collaboration's tool for assessing risk of bias (RoB2). Data analysis and synthesis will be performed by Comprehensive Meta-analysis Software and StataSE software, version 15. CONCLUSION: The results should be disseminated through publication in a peer-reviewed journal. Since the data used in systematic reviews of this type will be extracted exclusively from published studies, approval form and ethics committee will not be required.

Predictive Ability of Waist Circumference and Waist-to-Height Ratio for Cardiometabolic Risk Screening among Spanish Children.

An excess of fat mass has been associated with adverse cardiometabolic risk factors. Different anthropometric measures have been proposed as alternative non-invasive measures for obesity-related cardiometabolic risk. To evaluate the magnitude of association between waist circumference (WC) and waist-to-height ratio (WtHR) with cardiometabolic risk factors and metabolic syndrome and to determine the WtHR cutoff associated with a more favorable cardiometabolic risk profile in Spanish children, data were taken from a cross-sectional survey conducted in 2010 among 848 schoolchildren aged 8-11 years from 20 public schools in the province of Cuenca (Spain). Anthropometric variables, glucose, insulin, triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), systolic (SBP) and diastolic blood pressure (DBP) and metabolic syndrome (MetS) were also analyzed. WtHR and WC had a good accuracy for TG, insulin, and MetS. The diagnostic odds ratio ranged from 2.95 to 9.07 for WtHR and from 5.30 to 27.40 for WC. The main result of the present study suggests that both WtHR and WC could be used as a screening tool to identify children with cardiometabolic abnormalities.

Effectiveness of a school-based physical activity intervention on adiposity, fitness and blood pressure: MOVI-KIDS study.

OBJECTIVE: To test a physical activity intervention (MOVI-KIDS) on obesity indicators, physical fitness and blood pressure (BP) in children. METHODS: A crossover randomised cluster trial was conducted, which comprised 1434 children (4-7 years old) from 21 schools in the provinces of Cuenca and Ciudad Real in the Castilla-La Mancha region of Spain. The intervention consisted of three 60 min sessions/week on weekdays between October 2013 and May 2014. Changes in anthropometric variables, physical fitness and BP parameters were measured. The analyses used were mixed regression models to adjust for baseline covariates under cluster randomisation. RESULTS: There was no significant improvement in overweight/obesity with the intervention compared with the control group in both sexes. Further, the intervention did not alter other adiposity indicators or BP parameters. Improvements in cardiorespiratory fitness were seen in girls (1.19; 95% CI 0.31 to 2.08; p=0.008), but not in boys. Finally, there was an improvement in velocity/agility in both girls (-2.51 s; 95% CI -3.98 to -1.05; p=0.001) and boys (-2.35 s; 95% CI -3.71 to -0.98; p=0.001), and in muscular strength in both girls (0.66; 95% CI 0.03 to 1.28; p=0.038) and boys (1.26; 95% CI 0.03 to 1.28; p<0.001). CONCLUSION: MOVI-KIDS was not successful in reducing the adiposity and maintained BP levels at previous healthy values in children. The intervention, however, showed significant improvements in cardiorespiratory fitness in girls, and muscular strength and velocity/agility in boys and girls. TRIAL REGISTRATION NUMBER: NCT01971840; Post-results.

Prevalence of high blood pressure and association with obesity in Spanish schoolchildren aged 4-6 years old.

BACKGROUND: The prevalence of high blood pressure in children is increasing worldwide, largely, but not entirely, driven by the concurrent childhood obesity epidemic. The aims of this study were to examine the prevalence of prehypertension and hypertension in 4-to-6-year-old Spanish schoolchildren, and to evaluate the association between different blood pressure (BP) components with different adiposity indicators. METHODS: Cross-sectional study including a sample of 1.604 schoolchildren aged 4-to-6-years belonging to 21 schools from the provinces of Ciudad Real and Cuenca, Spain. We measured height, weight, body mass index (BMI), fat mass percentage (%FM), triceps skinfold thickness (TST), waist circumference (WC), systolic and diastolic BP, mean arterial pressure and pulse pressure. RESULTS: The estimates of prevalence of prehypertension and hypertension were 12.3% and 18.2%, respectively. In both sexes, adiposity indicators were positively and significantly associated with all BP components (p<0.001), thus schoolchildren in the higher adiposity categories had significantly higher BP levels (p<0.001). CONCLUSIONS: Our results show a high prevalence of high blood pressure in Spanish children. Moreover, high levels of adiposity are associated with high blood pressure in early childhood, which support that it could be related to cardiovascular risk later in life.

Trends in cardiometabolic parameters among Spanish children from 2006 to 2010: The Cuenca study.

OBJECTIVE: The aim of this study was to examine the trends in cardiometabolic risk factors among schoolchildren in Cuenca, Spain, from 2006 to 2010. METHODS: Data were taken from two cross-sectional surveys conducted in 2006 and 2010 among schoolchildren aged 8-12 years from 20 public schools in the province of Cuenca. The final sample consisted of 2148 participants with measured anthropometric variables, biochemical assessment, and blood pressure. RESULTS: We observed an increase in mean serum total cholesterol (8.5 mg/dL and 10.7 mg/dL), LDL-cholesterol (13.7 mg/dL and 17.3 md/dL), triglycerides (3.6 mg/dL and 2.6 md/dL), fasting insulin (1.2 µU/mL and 0.3 µU/mL) and HOMA-IR (0.2 and 0.02) and a decrease in mean serum HDL-cholesterol (4.4 mg/dL and 5.7 mg/dL), systolic blood pressure (3.8 mmHg and 5.4 mmHg) and diastolic blood pressure (0.8 mmHg and 2.0 mmHg) in both sexes. In girls, mean arterial pressure (3.2 mmHg) also decreased in this period. In addition, we found an increase in the prevalence of adverse total cholesterol concentration (≥200 mg/dL) (7.8% and 8.9%), HDL-cholesterol concentration (<40 mg/dL) (1.9% in boys and 3.5% in girls) and LDL cholesterol concentration (≥130mg/dL) (4.8% and 5.8%) in boys and girls, respectively. CONCLUSIONS: There has been a worsening of the lipid profile in schoolchildren from Cuenca, independent of weight status and age.

Estudio de seguimiento de la prevalencia de delgadez y sobrepeso de una cohorte de escolares de 4 a 6 años de Castilla-La Mancha.

Introducción y objetivos: los objetivos del presente estudio fueron: a) estimar la prevalencia de sobrepeso/obesidad y delgadez en escolares nacidos en 2007 y 2008 de Castilla-La Mancha, España, en los años 2013 y 2015; y b) analizar la persistencia en las mismas categorías de estatus ponderal entre 2013 y 2015 en esta cohorte de escolares.Material y métodos: estudio de seguimiento en el que se analizaron los datos antropométricos de los escolares nacidos en 2007 y 2008 en los años 2013 (4-6 años) y 2015 (6-8 años). Se invitó a participar a todos los escolares de 21 colegios de las provincias de Cuenca y Ciudad Real que cursaban tercero de Educación Infantil o primero de Educación Primaria en 2013. En todos ellos se determinaron, además de variables sociodemográficas, peso, talla y porcentaje de grasa corporal por bioimpedancia eléctrica.Resultados: la prevalencia de delgadez, sobrepeso y obesidad en la medición basal fue de 20,7%, 12% y 8,2% respectivamente. Dos años después, la prevalencia de delgadez disminuyó hasta 14,7% y la de sobrepeso y obesidad aumentó hasta 15,4% y 8,4% respectivamente. Por otro lado, el 78,8% de los escolares permanecía en 2015 en la misma categoría ponderal que en 2013.Conclusiones: el aumento en la prevalencia de sobrepeso/obesidad de los escolares parece estar remitiendo, al mismo tiempo que el incremento en la prevalencia de bajo peso ha aumentado sustancialmente. Por último, los escolares tienden a mantener el estatus ponderal previo al rebote adiposo durante la edad escolar.

Estudio de seguimiento de la prevalencia de delgadez y sobrepeso de una cohorte de escolares de 4 a 6 años de Castilla-La Mancha / Trends in underweight and excess of weight prevalence in a cohort of 4-to 6-year-old schoolchildren from Castilla-La Mancha

Introducción y objetivos: los objetivos del presente estudio fueron: a) estimar la prevalencia de sobrepeso/obesidad y delgadez en escolares nacidos en 2007 y 2008 de Castilla-La Mancha, España, en los años 2013 y 2015; y b) analizar la persistencia en las mismas categorías de estatus ponderal entre 2013 y 2015 en esta cohorte de escolares. Material y métodos: estudio de seguimiento en el que se analizaron los datos antropométricos de los escolares nacidos en 2007 y 2008 en los años 2013 (4-6 años) y 2015 (6-8 años). Se invitó a participar a todos los escolares de 21 colegios de las provincias de Cuenca y Ciudad Real que cursaban tercero de Educación Infantil o primero de Educación Primaria en 2013. En todos ellos se determinaron, además de variables sociodemográficas, peso, talla y porcentaje de grasa corporal por bioimpedancia eléctrica. Resultados: la prevalencia de delgadez, sobrepeso y obesidad en la medición basal fue de 20,7%, 12% y 8,2% respectivamente. Dos años después, la prevalencia de delgadez disminuyó hasta 14,7% y la de sobrepeso y obesidad aumentó hasta 15,4% y 8,4% respectivamente. Por otro lado, el 78,8% de los escolares permanecía en 2015 en la misma categoría ponderal que en 2013. Conclusiones: el aumento en la prevalencia de sobrepeso/obesidad de los escolares parece estar remitiendo, al mismo tiempo que el incremento en la prevalencia de bajo peso ha aumentado sustancialmente. Por último, los escolares tienden a mantener el estatus ponderal previo al rebote adiposo durante la edad escolar (AU)

Introduction and objectives: The aims of this study were to: a) estimate the prevalence of overweight/obesity and thinness in a sample of schoolchildren which were born in 2007 and 2008 from Castilla-La Mancha, Spain, in the years 2013 and 2015; and b) examine the persistence, from 2013 to 2015, in the same weight status category in this cohort. Material and methods: Follow up study in which we analysed anthropometric variables in schoolchildren that were born in 2007 and 2008 during the years 2013 (4-6 years old) and 2015 (6-8 years old). We invited to participate all children belonging to third grade of pre-primary education and first grade of primary education of 21 schools from Cuenca and Ciudad Real provinces. Sociodemographic variables, weight, height and body fat percentage by electric bioimpedance were determined in all participants. Results: The prevalence of thinness, overweight and obesity at the baseline was 20.7%, 12% and 8.2%, respectively. After two years, the prevalence of thinness decreased to 14.7% and the prevalence of overweight and obesity increased to 15.4% and 8.4%, respectively. Besides, a 78.8% of schoolchildren remained at 2015 in the same weight status category that were in 2013. Conclusions: The increase in the prevalence of overweight/obesity in the Spanish schoolchildren might be levelling off; in parallel, thinness prevalence has substantially increased. Lastly, the weight status previous to adipose rebound tracks to school age (AU)

Association between parental socioeconomic status with underweight and obesity in children from two Spanish birth cohorts: a changing relationship.

BACKGROUND: Our objective was twofold: to estimate the prevalence of underweight, overweight, and obesity in two birth cohorts (1999-2000 and 2007-2008) from Castilla-La Mancha, Spain; and to examine the association between parental socioeconomic status (SES) and weight status in these two cohorts. METHODS: Cross-sectional analysis of baseline measurements was utilised in two cluster randomised trials. Using population-based samples of children from Castilla-La Mancha, Spain, 1158 children with a mean age of 9.5 years, born in the years 1999-2000 and 1588 children with a mean age of 5.3 years born in the years 2007-2008 participated. Children were classified according to the body mass index cut-offs proposed by the International Obesity Task Force criteria. An index of SES was calculated using questions regarding parental education and occupation levels. RESULTS: Prevalence of underweight was higher in the 2007-2008 birth cohort (20.5%, 95 % CI: 18.5, 22.5) than in the 1999-2000 birth cohort (8.1%, 95% CI: 6.5, 9.7), and the overweight/obesity prevalence was 20.4% (95% CI: 18.4, 22.5) and 35.5% (95% CI: 32.7, 38.3) respectively. In the lower SES stratum, in the 2007-2008 birth cohort, the prevalence of underweight and overweight/obesity was 36.7% (95% CI: 22.2, 51.2) and 16.3% (95% CI: 4.9, 27.7) respectively, and 22.2% (95% CI: 2.8, 60.0) and 55.5% (95% CI: 21.2, 86.3) in the 1999-2000 cohort. The ratio between underweight:overweight/obesity showed higher values for all SES categories in 2007-2008 cohort, but particularly in the lower SES group (0.4 in the 1999-2000 cohort and 2.2 in the 2007-2008 cohort). CONCLUSION: Underweight prevalence was lower in the cohort of children born in 1999-2000, and the prevalence of overweight and obesity was lower in the cohort of children born in 2007-2008. Furthermore, while in the 1999-2000 children's cohort underweight was more frequent amongst children from high SES families and overweight/obesity was more frequent in children from low SES families, in the 2008-2009 children's cohort the opposite was true.

[PREVALENCE OF THINNESS, OVERWEIGHT AND OBESITY AMONG 4-TO-6-YEAR-OLD SPANISH SCHOOLCHILDREN IN 2013; SITUATION IN THE EUROPEAN CONTEXT]. / PREVALENCIA DE DELGADEZ, SOBREPESO Y OBESIDAD EN ESCOLARES ESPAÑOLES DE 4-6 AÑOS EN 2013; SITUACIÓN EN EL CONTEXTO EUROPEO.

INTRODUCTION AND OBJECTIVES: both, weight excess and thinness, are related with several health disorders that could continue into adulthood. The objectives of this study were to estimate the prevalence of thinness, overweight and obesity in 4-to-6-year-old schoolchildren in the provinces of Cuenca and Ciudad Real (Spain), using both the International Obesity Task Force and the World Health Organization criteria; and to compare this prevalence with those provided for other European studies. METHODS: a cross-sectional study was performed in 1 585 schoolchildren in September 2013. Weight and height measurements were performed by previously trained nurses with standardized procedures. Weight status was defined according to the International Obesity Task Force and the World Health Organization criteria. RESULTS: when the International Obesity Task Force criteria were used prevalence of thinness, overweight and obesity was 20.51%, 11.84% and 8.58%, respectively; and 3.97%, 13.92% and 10.79% when the World Health Organization criteria were utilized. No statistically significant differences by sex or province in any category of weight status were found. The prevalence of thinness decreased as age increases. Conversely, thinness prevalence decreased and overweight/obesity prevalence was significantly higher in older schoolchildren. The prevalence of overweight in this study is similar to other Mediterranean countries. CONCLUSIONS: the prevalence of overweight seems to level off, although it remains a public health priority. The increase in the prevalence of thinness has become an emergent problem that could claim for public health interventions.

Introducción y objetivos: tanto el exceso de peso como la delgadez se relacionan con diversos problemas de salud que pueden continuar hasta la edad adulta. Los objetivos de este estudio fueron estimar la prevalencia de delgadez, sobrepeso y obesidad en escolares de 4-6 años de las provincias de Cuenca y Ciudad Real (España), mediante criterios del Grupo Internacional de Trabajo sobre Obesidad y de la Organización Mundial de la Salud, y comparar estas cifras con otros estudios europeos. Métodos: estudio observacional-transversal que incluyó a 1.585 escolares realizado en septiembre de 2013. Las mediciones de peso y talla fueron realizadas por enfermeras entrenadas y mediante procedimientos estandarizados. El estatus ponderal se definió según los criterios del Grupo Internacional de Trabajo sobre Obesidad y la Organización Mundial de la Salud. Resultados: según criterios del Grupo Internacional de Trabajo sobre Obesidad, la prevalencia de delgadez, sobrepeso y obesidad fue del 20,51%, 11,84% y 8,58%, respectivamente; y del 3,97%, 13,92% y 10,79% cuando se utilizaron los criterios de la Organización Mundial de la Salud. No se encontraron diferencias estadísticamente significativas por sexo ni provincia para ninguna categoría de estatus ponderal. Para ambos criterios, la prevalencia de delgadez fue menor a medida que aumentaba la edad, mientras que la prevalencia de sobrepeso/obesidad fue mayor. Conclusiones: la prevalencia de exceso de peso podría haber tocado techo en España, aunque continúa siendo un importante problema de salud pública. El aumento de la prevalencia de bajo peso debería ocupar un lugar relevante en las intervenciones de salud pública.

Prevalencia de delgadez, sobrepeso y obesidad en escolares españoles de 4-6 años en 2013; situación en el contexto europeo / Prevalence of thinness, overweight and obesity among 4-to-6-year-old Spanish schoolchildren in 2013; situation in the European context

Introducción y objetivos: tanto el exceso de peso como la delgadez se relacionan con diversos problemas de salud que pueden continuar hasta la edad adulta. Los objetivos de este estudio fueron estimar la prevalencia de delgadez, sobrepeso y obesidad en escolares de 4-6 años de las provincias de Cuenca y Ciudad Real (España), mediante criterios del Grupo Internacional de Trabajo sobre Obesidad y de la Organización Mundial de la Salud, y comparar estas cifras con otros estudios europeos. Métodos: estudio observacional-transversal que incluyó a 1.585 escolares realizado en septiembre de 2013. Las mediciones de peso y talla fueron realizadas por enfermeras entrenadas y mediante procedimientos estandarizados. El estatus ponderal se definió según los criterios del Grupo Internacional de Trabajo sobre Obesidad y la Organización Mundial de la Salud. Resultados: según criterios del Grupo Internacional de Trabajo sobre Obesidad, la prevalencia de delgadez, sobrepeso y obesidad fue del 20,51%, 11,84% y 8,58%, respectivamente; y del 3,97%, 13,92% y 10,79% cuando se utilizaron los criterios de la Organización Mundial de la Salud. No se encontraron diferencias estadísticamente significativas por sexo ni provincia para ninguna categoría de estatus ponderal. Para ambos criterios, la prevalencia de delgadez fue menor a medida que aumentaba la edad, mientras que la prevalencia de sobrepeso/obesidad fue mayor. Conclusiones: la prevalencia de exceso de peso podría haber tocado techo en España, aunque continúa siendo un importante problema de salud pública. El aumento de la prevalencia de bajo peso debería ocupar un lugar relevante en las intervenciones de salud pública (AU)

Introduction and objectives: both, weight excess and thinness, are related with several health disorders that could continue into adulthood. The objectives of this study were to estimate the prevalence of thinness, overweight and obesity in 4-to-6-year-old schoolchildren in the provinces of Cuenca and Ciudad Real (Spain), using both the International Obesity Task Force and the World Health Organization criteria; and to compare this prevalence with those provided for other European studies. Methods: a cross-sectional study was performed in 1 585 schoolchildren in September 2013. Weight and height measurements were performed by previously trained nurses with standardized procedures. Weight status was defined according to the International Obesity Task Force and the World Health Organization criteria. Results: when the International Obesity Task Force criteria were used prevalence of thinness, overweight and obesity was 20.51%, 11.84% and 8.58%, respectively; and 3.97%, 13.92% and 10.79% when the World Health Organization criteria were utilized. No statistically significant differences by sex or province in any category of weight status were found. The prevalence of thinness decreased as age increases. Conversely, thinness prevalence decreased and overweight/obesity prevalence was significantly higher in older schoolchildren. The prevalence of overweight in this study is similar to other Mediterranean countries. Conclusions: the prevalence of overweight seems to level off, although it remains a public health priority. The increase in the prevalence of thinness has become an emergent problem that could claim for public health interventions (AU)

Self-reports versus parental perceptions of health-related quality of life among deaf children and adolescents.

The aim of this study was to assess the agreement between deaf children's and adolescents' self-ratings of health-related quality of life (HRQoL) and their parents' proxy reports. This observational cross-sectional study included 114 deaf 8- to 18-years-old students and proxy family members. HRQoL was measured using the KIDSCREEN-27 questionnaire, which was adapted to Spanish sign language for children, with a written version for parents. Respondents completed a self-administered paper questionnaire. Parents' and children's mean scores differences were not significant, except for the "Autonomy and Parents" and "Peers and Social Support" dimensions. Children aged 8-11 years scored higher in some domains of QoL compared to those aged 12-18 years. The level of agreement between children/adolescents' and parents/proxies' responses was acceptable, except for the dimension "Autonomy and Parents." Overall, deaf children/adolescents' self-ratings of HRQoL did not differ from their parents' proxy reports; however, differences were found in the dimensions that explored the quality of the interaction of children/adolescents and parents, the perceived level of autonomy, and social relations and support.

Rationale and methods of a randomised cross-over cluster trial to assess the effectiveness of MOVI-KIDS on preventing obesity in pre-schoolers.

BACKGROUND: Childhood obesity has become an alarming worldwide increasing public health problem. The earlier adiposity rebound occurs, the greater the risk of becoming obese during puberty and adolescence. It has been speculated about the potential influence of vigorous physical activity on modifying the age of onset of adiposity rebound. Moreover, studies aimed to evaluate the effectiveness of physical activity interventions programs on reducing adiposity and other cardiovascular risk factors in children younger than 6 years are scarce. This paper describes the rationale and methods of a study aimed to test the effectiveness of a two-years multidimensional pre-school intervention on preventing obesity and improving physical fitness during the adiposity rebound period. METHODS/DESIGN: Twenty-one schools from the provinces of Cuenca and Ciudad Real, Spain, were randomised to an intervention and a control arm. In the first academic year, children in third grade of pre-school and first grade of primary school in the intervention group received the physical activity intervention (MOVI-KIDS). After an academic year schools were crossed over to the alternative arm. According to the socio-ecological model, the intervention included children, their parents and teachers, and the school environment where MOVI-KIDS was conducted. MOVI-KIDS consisted of: i) three-h/week sessions of recreational non-competitive physical activity in after-school time; ii) educational materials to parents and teachers about physical activity benefits and sedentary lifestyle risks; and iii) modifications in the playground to promote physical activity during recess. Baseline and post-intervention outcomes are going to be measured in both arms three times, at the beginning and at the end of first academic year, and at the end of the second academic year. Primary outcomes included body mass index, waist circumference, triceps skinfold thickness, percentage of both body fat and fat-free mass, and blood pressure. Secondary end points were physical activity, fitness, and carotid intima-media thickness. DISCUSSION: This paper reports the design of a randomised cross-over cluster trial aimed at assessing the effectiveness of the multidimensional physical activity intervention (MOVI-KIDS) during two years in pre-school children. TRIAL REGISTRATION: Clinical trials.gov: NCT01971840 . (Date of registration: Initial Release: 10/07/2013; Record Verification: 23/10/2013).