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Introduction: Background: this study aimed to assess how the COVID-19 lockdown (March to June 2020) affected children's sleep quality, physical activity, screen time, and nutrition. Material and methods: the survey consisted of 479 children from the SENDO project, a pediatric cohort in Spain, aged 4-5 years. The BEAR questionnaire was used to evaluate sleep quality. Hierarchical models with two-level clustering were used to account for intra-cluster correlation between siblings, and the difference regression method was used to study the association between changes in screen consumption and physical activity and changes in sleep quality. Results: the results showed an increase in the consumption of homemade pastries and snacks. Sleep quality worsened significantly during confinement, with a mean score on the BEAR scale of 0.52 before, 1.43 during, and 1.07 after confinement. Although sleep quality improved significantly after the end of confinement, it remained worse than before. The average daily screen time increased from 1.13 hours before confinement to 2.65 hours during confinement. Physical activity decreased during confinement, with the mean number of hours per day decreasing from 1.27 to 0.79. Children who spent more time on screens during confinement had worse sleep quality, as indicated by their higher scores on the BEAR scale. We used the difference regression method to identify a statistically significant association between the increased screen time for leisure hours and the worsening of children's sleep quality during confinement. Conclusion: we observed a significant relationship between confinement and reduced sleep quality. Although the end of the lockdown led to a slight improvement, the average BEAR scale score remained higher post-confinement, suggesting that the consequences of the lockdown may persist over time.

Introduction: Objective: to analyze the validity of self-reported somatometry data through a self-reported online questionnaire. Method: the SENDO project (Follow-up of Children for Optimal Development) is a prospective, dynamic pediatric cohort. Participants are recruited when they are between 4 and 6 years old, and followed annually through an online questionnaire. In a subsample of 82 participants, we compared the anthropometric information reported in the baseline questionnaire with the direct measurements collected by the investigating staff. To do this, we calculated the intraclass correlation index (ICC) and the Bland-Altman coefficient. Results: the ICC was 0.96 (95 % confidence interval [CI]: 0.94-0.98 for weight; 0.95 (95 % CI: 0.92-0.96) for height; 0.75 (95 % CI: 0.64-0.86) for waist circumference; and 0.84 (95 % CI: 0.76-0.89) for hip circumference. In relation to the indices calculated from these measurements, we found an ICC of 0.84 (95 % CI: 0.77-0.90) for body mass index; 0.46 (95 % CI: 0.27-0.62) for waist-hip ratio; and 0.59 (95 % CI: 0.43-0.72) for waist-height index. The Bland-Altman index ranged from 3.7 % for weight to 8.5 % for body mass index. Conclusions: we found a high correlation and concordance between the data collected in the physical exam and those reported by the parents. Our results indicate that the anthropometric measures provided by parents, especially those with which they are most familiar, are valid and can be used in epidemiological research.

Introduction: Introduction: the preschool stage is a critical period for teaching and modeling healthy habits to positively influence children's health and wellbeing throughout their lifetime. Objectives: to evaluate the association between parental attitudes towards their offspring's dietary habits in Spanish children aged 4 to 7 years participating in the Follow-up of Children for Optimal Development (SENDO) project. Methods: we defined an index to measure information on parental attitudes towards their offspring's diet (0 to 8 points), and another one to measure children's actual dietary habits (0 to 19 points). A higher score meant healthier attitudes and healthier habits, respectively. Information was collected through an online questionnaire completed by parents. We calculated crude and multivariable-adjusted odds ratios (OR) and 95 % confidence intervals (CI) for children's healthy dietary habits associated with parental scores in the parental attitudes index. Generalized estimation equations (GEE) were used to account for intra-cluster correlation between siblings. Results: a total of 423 preschoolers (52.3 % boys, mean age 5.3 years) were included in the analyses. Half of the children (51 %) reported unhealthy dietary habits, whereas 56 % of parents reported high adherence to the healthy eating index. Compared to those in the lowest category, the children whose parents were in the highest category in the parental attitudes index showed significantly higher odds of having healthy dietary habits (OR: 2.91; 95 % CI: 1.30-6.53, p for trend = 0.004). Conclusions: our results support a direct association between parental attitudes and their offspring's dietary habits, suggesting that public health interventions aimed at improving children's dietary habits should shift from the individual- to a family-based approach.

Introduction: Introduction: currently, it is important to determine whether food frequency questionnaires (FFQ) are valid tools to collect information on usual diet in children. Objective: we evaluated the reproducibility and validity of the semi-quantitative FFQ used in a Spanish cohort of children aged 4-7 years. Methods: to explore its reproducibility, parents filled a 138-item FFQ at baseline (FFQ-0) and then one year later (FFQ-1). To explore its validity, the FFQ-1 was compared with four weighed 3-day dietary records (DRs) that were used as standard of reference. To estimate associations we calculated deattenuated Pearson's correlation coefficients to correct for season-to-season variability, and the Bland-Altman index. We also calculated the weighted kappa index and assessed participant's gross misclassification across quintiles. We analyzed data from 67 (for reproducibility) and 37 (for validity) children aged 4-7 years old, recruited by the pilot study of the SENDO project. Results: regarding reproducibility, we found mean Bland-Altman indexes of 0-10.45 % for nutrients and 1.49 %-10.45 % for foods. The adjusted r ranged between 0.29 and 0.71, and between 0.27 and 0.74 for nutrients and foods, respectively. Regarding validity, we found mean Bland-Altman indexes of 0 %-16.22 % and 0 %-10.81 % for nutrients and for food groups, respectively. The deattenuated r ranged between 0.38 and 0.81 for nutrients, and between 0.53 and 0.68 for foods. The weighted kappa index for agreement across quintiles ranged from 54.1 to 85.1 for nutrients, and from 55.4 to 78.4 for food groups. Conclusions: our results showed acceptable levels of both reproducibility and validity, and that the ad-hoc developed FFQ is a valid tool for assessing usual diet in Spanish preschoolers.

Introduction: Introduction: Navarra is a Community that presents a great geographical and climatic variety, which results in a wide food supply. Objectives: to review the typical gastronomy of Navarra, as well as the available evidence on dietary patterns, nutritional profile and health indicators of Navarra population. Results: Navarra has 7 Protected Designations of Origin and 6 Protected Geographical Indications. Its gastronomic identity is mainly associated with vegetables, lamb, veal and local sausages, which is reflected in dietary patterns. Comparatively, Navarra population consumes more vegetables and fresh fruits, but also has a frequent and excessive intake of meat (especially red) and sausages. The studies available on nutritional profile show high intakes of proteins and fats in the adult population, and inadequacy in some micronutrients in children. In the national context, Navarra has lower rates of overweight, obesity and sedentariness in the adult population, and there is a downward trend in the prevalence of childhood obesity. Conclusions: the food and gastronomic offer of Navarra is varied and with a great prominence of vegetables, although dietary patterns can be improved. To achieve a healthy and sustainable diet, it is essential to promote culinary knowledge and skills from an early age.

Introduction: The high prevalence of obesity among Spanish children and adolescents has become an important public health problem., Objective: To assess the association between dietary macronutrient intake and obesity in a case-control study of children and adolescents (aged 5.5 to 18.8) from Navarra., Methods: Cases were 178 obese children (body mass index > 97th percentile), from Navarra. Controls were individually matched by sex and age. Anthropometric data were collected by trained personal using standardized procedures. Personal interviews were performed to collect previously validated semiquantitative food frequency questionnaires (FFQs). From these FFQs we calculated the intake of macronutrients (carbohydrates, proteins and fats) and types of fatty acids. Energy-adjusted macronutrient intake was divided into quintiles. Conditional logistic regression was used and confounder factors were taken into account., Results: The macronutrient composition of the diet was similar between cases and controls, except for polyunsaturated fatty acids (PUFA) intake, which was significantly inversely associated with obesity (p for trend < 0.01), with adjusted odds ratio = 0.34 (95% CI: 0.15 to 0.77) for the fifth versus the first quintile., Conclusions: An inverse and significant association between PUFA intake and obesity was found in this case-control study., (Copyright © AULA MEDICA EDICIONES 2013. Published by AULA MEDICA. All rights reserved.)