Association Between Health-Related Quality of Life, Obesity, Fitness, and Sleep Quality in Young Adults: The Cuenca Adult Study.

OBJECTIVE: The objectives of this study were to examine in university students: (a) the mean differences in the HRQoL among fat mass percentage, cardiorespiratory fitness (CRF) and sleep quality categories; and (b) the independent associations among fat mass percentage, CRF, and sleep quality with HRQoL. PARTICIPANTS: 376 students, 18-30 years old, from the University of Castilla-La Mancha in Cuenca, Spain (during 2009-2010). METHOD: Cross-sectional study measuring % fat mass (DXA), CRF (20-m shuttle run test), sleep quality (Pittsburgh Sleep Quality Index), and HRQoL (SF-12 questionnaire). RESULTS: The mean in Mental Component Summary (MCS) in men (p = .029) was lower in students in upper quartiles of % fat mass than in peers in other categories of % fat mass. Among men, MCS was significantly lower among those in the lowest quartile of CRF (p = .015), and among women, Physical Component Summary (PCS) was significantly lower among those in the lowest quartile of CRF (p = .047). MCS dimension of the HRQoL was lower in both men (p = .001) and women (p < .001) in upper quartiles of sleep quality. Multiple linear regression models showed that in men, CRF was associated with MCS (ß = 0.25, p = .031), and sleep quality was associated with PCS (ß = -0.24, p = .027) and MCS (ß = -0.38, p < .001). In women, CRF was associated with PCS (ß = 0.17, p = .018) and sleep quality with MCS (ß= -0.44, p < .001). CONCLUSIONS: Finally, our findings suggest that, regardless of adiposity and fitness, having good sleep habits may positively influence the quality of life in young adults.

Associations between Dairy Intake, Body Composition, and Cardiometabolic Risk Factors in Spanish Schoolchildren: The Cuenca Study.

Full-fat dairy has been traditionally associated with obesity and cardiovascular disease (CVD); however, recent evidence shows that the amount of dairy intake might have a beneficial effect over these pathologies, regardless of their fat content. The aim of this study was to examine the association between the intake of dairy products (including milk with different fat contents) with both adiposity and serum lipid concentration, adjusted by cardiorespiratory fitness (CRF), in Spanish schoolchildren. A cross-sectional study of 1088 children, aged 8 to 11 years, was conducted in which anthropometric variables (body mass index (BMI), waist circumference (WC), fat mass percentage (FM%) and fat mass index (FMI)), blood lipid profile, and dairy intake (using a food frequency questionnaire), and CRF (through a 20-m shuttle run test) were measured. Results showed that children with lower BMI, WC, FM%, and FMI had higher whole-fat milk intake and lower skimmed and semi-skimmed milk intake than children with higher BMI, WC, FM%, and FMI. Children with normal levels of triglycerides and high density lipoproteins (HLD) cholesterol consumed more whole-fat milk and less reduced-fat milk than children with dyslipidemic patterns. These relationships persisted after adjustment for CRF. Our findings suggest that full-fat milk intake should be promoted in children without obesity or high cardiometabolic risk.

Cardiorespiratory Fitness as a Mediator of the Influence of Diet on Obesity in Children.

The association between diet and obesity has been widely studied and it continues to be controversial; however, the extent to which cardiorespiratory fitness (CRF) acts as a confounder or mediator in this relation has not been analyzed. The aim of this study is to examine if the relation between diet and obesity is mediated by CRF. In this cross-sectional study, fat mass (by electronic bioimpedance) was measured in 320 schoolchildren, aged 9-11 years. Diet was measured through two computerised 24-h dietary recalls and CRF was assessed by the 20-m shuttle run test. Simple mediation analyses were fitted. CRF acts as a partial mediator in the negative relationship between dietary factors (energy intake/weight, carbohydrate intake/weight, protein intake/weight, and fat intake/weight) and fat mass. The percentage of mediation ranged from 24.3 to 33.2%. Thus, Spanish schoolchildren with higher levels of energy and macronutrients intake had lower adiposity levels, especially when they had good levels of CRF.

The relationship between socioeconomic status and beverage consumption in children: The Cuenca Study.

INTRODUCTION: beverage consumption constitutes a source of children's daily energy intake. Some authors have suggested that consumption of caloric beverages is higher in children with a low socioeconomic position because families limit their spending on healthy food in order to save money. OBJECTIVE: the aim of this study was to explore the relationship between socioeconomic status and Spanish children's beverage consumption. METHODS: a cross-sectional study was conducted in a sub-sample of 182 children (74 girls) aged 9-11 from the province of Cuenca (Spain). Beverage consumption was assessed using the YANA-C assessment tool, validated for HELENA study. Data for parental socioeconomic status were gathered by using self-reported occupation and education questions answered by parents and classified according to the scale proposed by the Spanish Society of Epidemiology. RESULTS: beverage intake was higher in children belonging to a middle-status family than in those of upper socioeconomic status (p = 0.037). The energy from beverages was similar in most water intake categories, except for water from beverages (p = 0.046). Regarding other beverages categories, middle-status children had higher consumption levels. In contrast, lower status children drank more fruit juices and skimmed milk. All of these do not show statistically significant differences. CONCLUSIONS: our study did not find significant associations between beverages consumption and socioeconomic status in children. In fact, intake for most beverage categories was higher in middle-status children than in both other socioeconomic groups. Future research is needed in order to identify this complex relation between socioeconomic inequality and beverage intake behavior.

The association between water intake, body composition and cardiometabolic factors among children - The Cuenca study.

INTRODUCTION: Beverage consumption and its possible association with current obesity epidemic and metabolic syndrome is under investigation in recent years, however water intake is probably the most underestimated of all beverages and could play an important role. OBJECTIVE: The aim of this study was to examine the association between water intake, body composition and cardiometabolic factors in a sample of Spanish children. METHODS: A cross-sectional study was conducted in 366 schoolchildren (53.5% girls) aged 9-11 years from the province of Cuenca in Spain. Data of anthropometrics, body composition, cardiometabolic risk factors and ardiorespiratory fi tness variables were collected. Beverage consumption was assessed using two non-consecutive 24 h dietary recalls. RESULTS: We found an inverse association between the consumption of water (ml)/kg per weight with BMI, body fat, fat-free mass, waist circumference, insulin levels, HOMA-IR (p < 0.001), and with arterial pressure parameters, systolic (p < 0.010) and diastolic blood pressure (p < 0.028), and mean arterial pressure (p < 0.012), as well as direct associations with HDL cholesterol (p < 0.001). In ANCOVA analyses, children who drank less water (ml)/kg per weight, had higher levels of LDL cholesterol (p < 0.050) and lower levels of HDL cholesterol (p < 0.042), and overweight-obesity subjects drank less water (ml)/kg per weight than normal peers (p < 0.011). Besides, children with lower levels of HDL cholesterol and higher levels of triglycerides and blood pressure had less water intake as a beverage. Finally, children who drank less water from beverages had high levels of LDL cholesterol. CONCLUSIONS: Higher consumption of water (ml)/kg per weight was negatively associated with BMI, body fat, fat-free mass, waist circumference, insulin levels, HOMA-IR, and positively with HDL cholesterol in children independently of age, sex and cardiorespiratory fi tness. In addition, overweight-obese children drank less water (ml)/kg per weight than normoweight ones. Therefore, water consumption is associated with numerous health benefi ts and its adequate intake could contribute to prevent obesity and metabolic syndrome in childhood.

ASSOCIATIONS BETWEEN ENERGY AND FAT INTAKES WITH ADIPOSITY IN SCHOOLCHILDREN - THE CUENCA STUDY.

INTRODUCTION: the relationship between changes in energy intake (EI) over the last few decades and the trends towards of excess weight in children is still debated. OBJECTIVE: to examine the relationship between energy and macronutrient intakes with adipostity in children, controlling for cardiorespiratory fitness (CRF) as a surrogate measure of physical activity. METHOD: we conducted a cross-sectional study of 320 schoolchildren aged 9-11 years (54.5% girls). We collected data on socio-demographic variables, and measured weight, height, waist circumference (WC), and fat mass percentage by bioimpedance analysis. Fat mass index (FMI) was calculated as fat mass (kg) divided by height (m) squared, to adjust for body size. Energy (kcal) and macronutrient intake (percentages) were measured by two non-consecutive 24-h recalls (weekday and weekend day), using the Young Adolescents' Nutrition Assessment on Computer (YANA-C) software program; CRF was measured by the 20-m shuttle run test. RESULTS: boys in the 4th quartile of the WC distribution had lower fat intake (34.9%) than boys in the 1st (42.4%; p = 0.019) and 2nd quartiles (41.6%; p = 0.022). Children in the 1st quartile of the FMI distribution had higher daily EIs than children in the 4th quartile (1762.3 kcal vs. 1496.8 kcal; p = 0.023). All macronutrient intakes relative to weight were lower in children in the more adipose categories for weight status, WC and FMI (p < 0.001). CONCLUSION: adiposity was inversely related to energy and fat intakes. Excessive EI and high EI from fats not appears to be directly associated with the current obesity epidemic among schoolchildren living in Cuenca (Spain).

Introducción: la relación entre los cambios en la ingesta energética en las últimas décadas y el incremento en las cifras de obesidad en niños está aún en debate. Objetivo: examinar la asociación entre la ingesta energética y de macronutrientes con diferentes medidas de adiposidad en niños, controlando por resistencia cardiorrespiratoria como una medida sustituta de la actividad física. Método: se realizó un estudio observacional sobre 320 escolares de entre 9 y 11 años (54,5% niñas). Se tomó información sobre variables sociodemográficas y se midió peso, altura, perímetro de cintura y porcentaje de masa grasa a través de bioimpedancia. El índice de masa grasa fue calculado dividiendo la masa grasa (en kg) entre la altura al cuadrado (en m), para ajustar por el tamaño corporal. La ingesta energética y el porcentaje de macronutrientes fueron medidos con dos recordatorios de 24-h en días no consecutivos (entre semana y fin de semana), empleando el software Young Adolescents' Nutrition Assessment on Computer (YANA-C); el fitness cardiorrespiratorio fue medido a través del test de 20 metros de ida y vuelta. Resultados: los niños en el cuarto cuartil de perímetro de cintura tienen una ingesta de grasas menor (34,9%) que los chicos en el primer (42,4%; p = 0,019) y segundo cuartil (41,6%; p = 0,022). Los escolares en el primer cuartil de índice de masa grasa tienen mayor ingesta energética total que los escolares del cuarto cuartil (1762,3 kcal vs. 1496,8 kcal; p = 0,023). Las ingestas de macronutrientes relativas al peso son menores en los sujetos de las categorías más altas de estatus ponderal, perímetro de cintura e índice de masa corporal (p < 0,001). Conclusión: la adiposidad está inversamente asociada con las ingestas energética y de grasas. Una excesiva ingesta energética y de grasas no parece estar directamente asociada con la actual epidemia de obesidad de los escolares de Cuenca (España).

The relationship between beverage intake and weight status in children: the Cuenca study.

INTRODUCTION: Beverage consumption is becoming more important in current research regarding its possible association with the childhood obesity epidemic. The influence of physical activity on fluid intake has been poorly studied, and cardiorespiratory fitness (CRF) may be a reliable marker for this type of assessment. The present study analysed beverage intake related to weight, adjusted by CRF, in children aged 9 to 11 years. METHODS: A cross-sectional, school-based study was conducted on 373 children, aged 9 to 11 years, from the Cuenca province in Spain. To obtain beverage consumption we averaged two 24-h recalls, collected using the YANA-C assessment tool, validated for HELENA study. CRF was assessed by the 20-m shuttle run test. RESULTS: Fluid intake was 1483.39 mL/day, and energy ascribed to fluids was 16% of total energy intake. Beverages were 40% of total sugar intake from diet. The largest amount of fluid consumed among thinness boys came from fruit juices and milk drinks. Thinner girls consumed more diet drinks and whole milk than their normal and overweight counterparts, after adjusting for age and CRF. CONCLUSIONS: Overweight-obese boys consumed less fruit juices and milk drinks and girls ingested less diet drinks and whole milk than their normal-weight counterparts. These results suggest the importance of investigating the hydration habits of children to draw reliable conclusions about the best way to hydrate in different situations to avoid adiposity increases.

Introducción: El consumo de bebidas está cobrando mayor importancia en las investigaciones actuales en relación a una posible asociación con la epidemia de obesidad infantil. La influencia de la actividad física en este consumo de fluidos ha sido escasamente estudiada y la resistencia cardiorespiratoria (RCR) puede resultar un marcador fiable para su valoración. Nuestro estudio analiza la ingesta de fluidos y su relación con el estatus ponderal ajustado por RCR en niños de 9-11 años. Métodos: Estudio transversal en el que participaron 373 niños de 9-11 años de colegios de la provincia de Cuenca (España). Para obtener la ingesta de bebidas, se realizó la media de dos recordatorios de 24 horas obtenidos mediante el programa YANA-C, validado para el estudio HELENA. La condición física cardiorrespiratoria fue evaluada a través del test de 20 metros ida y vuelta. Resultados: La ingesta media de líquidos fue de 1483,39 ml/día, y la energía proveniente de fluidos supone un 16% del aporte energético diario. Las bebidas suponen el 40% del aporte de azúcares ingeridos en la dieta. Las bebidas más consumidas en niños son los zumos naturales y las bebidas lácteas. Las niñas delgadas consumen más leches enteras y bebidas refrescantes "light" que sus homólogas con peso normal y sobrepeso-obesidad. Conclusiones: Los niños con exceso de peso consumen menos zumos naturales y bebidas lácteas, y las niñas consumen menos leches enteras y bebidas refrescantes "light" que sus compañeras en normopeso. Es de gran importancia revisar los hábitos de hidratación de los escolares para establecer conclusiones fiables sobre cuál es la mejor forma de hidratarse en diferentes situaciones para evitar ganancias ponderales.