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Background Short peripheral catheters (SPC) insertion technique has a high failure rate, one of the reasons why the ultrasound (US)-guided method has been proposed as a valid alternative to traditional technique in SPC insertion. This umbrella review aims to synthesize the available evidence comparing the US-guided method with the traditional method on SPC insertion in terms of effectiveness, safety and patient satisfaction. Methods An umbrella review addressing the comparison between US-guided versus traditional method for SPC insertion in which only systematic reviews of all comparative study designs were eligible was carried out. Previous systematic reviews and meta-analyses were systematically searched in MEDLINE, EMBASE, Web of Science and Cochrane Library. Methodological quality was assessed with AMSTAR-2 tool. The quality of evidence per association was assessed using the GRADE criteria and was stablished as high, moderate, low and very low. Results Twelve systematic reviews with a range of 75–1860 patients were included. Moderate certainty evidence supports the positive effect of US-guided method on first-attempt success rate and number of attempts. There is moderate certainty evidence that US-guided method does not reduce the time spent in SPC insertion. Low certainty evidence supports that US-guided method improves both overall success rates and patient satisfaction. Emergency department was the main hospital department where these findings were reported. Conclusions The best current evidence indicates that US-guided method for SPC insertion is postulated as a valid alternative for both adult and pediatric population, especially in patients with difficult venous access and in hospital departments where optimal vascular access in the shortest time possible is critical. Trial registration PROSPERO: CRD42021290824.

AimTo investigate the prognostic value of time range metrics, as measured by continuous glucose monitoring, with respect to the development of type 2 diabetes (T2D).Research design and methodsA total of 499 persons without diabetes from the general population were followed-up for 5 years. Time range metrics were measured at the start and medical records were checked over the period study.ResultsTwenty-two subjects (8.3 per 1,000 person-years) developed T2D. After adjusting for age, gender, family history of diabetes, body mass index and glycated hemoglobin concentration, multivariate analysis revealed 'time above range' (TAR, i.e., with a plasma glucose concentration of >140 mg/dL) to be significantly associated with a greater risk (OR = 1.06, CI 1.01–1.11) of developing diabetes (AUC = 0.94, Brier = 0.035).ConclusionsTime above range provides additional information to that offered by glycated hemoglobin to identify patients at a higher risk of developing type 2 diabetes in a population-based study.

(1) Background: Heart failure (HF) with preserved ejection fraction (HFpEF) accounts for approximately 50% of all patients with HF. In the absence of pharmacological treatments that have been successful in reducing mortality or morbidity in this pathology, physical exercise is recognized as an important adjunct in the treatment of HF. Therefore, the objective of this study is to compare the efficacy of combined training and high intensity interval training (HIIT) on exercise capacity, diastolic function, endothelial function, and arterial stiffness in participants with HFpEF. (2) Methods: The ExIC-FEp study will be a single-blind, 3-arm, randomized clinical trial (RCT) conducted at the Health and Social Research Center of the University of Castilla-La Mancha. Participants with HFpEF will be randomly assigned (1:1:1) to the combined exercise, HIIT or control group to evaluate the efficacy of physical exercise programs on exercise capacity, diastolic function, endothelial function, and arterial stiffness. All participants will be examined at baseline, at three months and at six months. (3) Results: The findings of this study will be published in a peer-reviewed journal. (4) Conclusions: This RCT will represent a significant advance in the available scientific evidence on the efficacy of physical exercise in the treatment of HFpEF.

The university stage is a critical developmental period for young adults, where lifestyles can determine future health. A cross-sectional study including 481 college students was conducted, with the following objectives: 1) to examine the prevalence of risk of developing eating disorders in college students, 2) to assess differences in obesity and physical fitness in those with and without risk of eating disorders, and 3) to determine whether cardiorespiratory fitness, muscular fitness or fat mass were associated with the risk of eating disorders. We measured fat mass percentage (by densitometry), risk of feeding or eating disorders (by SCOFF questionnaire), cardiorespiratory fitness levels and a muscular fitness index. The prevalence of risk of eating disorders in women (32.4%) was higher than in men (17.4%) (p

Objectives: To examine differences in cognition parameters by birth weight categories and to analyze whether the relationships between birth weight and cognitive functions are mediated by cardiorespiratory fitness (CRF) in schoolchildren. Methods: A cross-sectional study using a sample of 664 school children from the MOVI-Kids study. Variables: i) cognitive function measured by the Battery of General and Differential Aptitudes (BADyG); ii) birth weight, reported by parents; and iii) CRF (20-m shuttle run test). ANCOVA models were estimated to assess differences in cognitive function categories across birth weight and CRF categories. Mediation analysis was conducted with Hayes' PROCESS macro. Results: CRF is a full mediator of the association between birth weight with the verbal and numerical factors, and general intelligence; and is a partial mediator when logical reasoning and the spatial factor were the dependent variables. The available data suggest that, in schoolchildren, the influence of birth weight on cognitive function is mediated by CRF. Conclusions: These findings highlight that children with lower birth weight values and lower fitness levels should be target subgroups to improve children's cognition, in which long-life physical activity interventions at early ages are a priority.

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 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.

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. © 2020 the Author(s). Published by Wolters Kluwer Health, Inc.

High blood pressure levels are among the most important cardiovascular disease risk factors and are influenced by physical fitness and body composition. However, the degree to which obesity may attenuate or modify the beneficial effects of physical fitness on blood pressure levels in young adults is uncertain. Thus, the aim of this study was to analyze whether body composition is a mediator between cardiorespiratory fitness (CRF) and blood pressure levels in young adults. This work was a cross-sectional study involving first-year college students (n=386) at the University Campus of Cuenca (Spain). We measured weight, height, waist circumference, fat mass percentage (by densitometry), systolic and diastolic blood pressure and CRF levels (by a 20 m shuttle run test). Partial correlation coefficients were estimated to examine the relationships among adiposity variables, CRF and blood pressure variables, controlling for age and sex. ANCOVA models were conducted to explore differences in blood pressure levels across adiposity and CRF categories. Hayes’s PROCESS macro was used for the simple mediation analysis. The indirect effect and Sobel test were significant (P

Cross-sectional study aimed to analyse differences in cognitive performance across fitness components categories (cardiorespiratory fitness [CRF], speed-agility and muscular fitness [MF]) and weight status in children, and to determine whether physical fitness mediates the association between body mass index (BMI) and cognitive performance. Fitness components and BMI were measured using standard procedures in 630 children aged 5-to-7 years from the provinces of Cuenca and Ciudad Real, Spain. BADyG was used to assess cognitive performance. We used ANCOVA models to test mean differences in cognition scores by BMI and fitness categories. Hayes's PROCESS macro was used for mediation analyses. Children with normal weight scored better in spatial factor and general intelligence than their overweight/obese peers (

Background: Evidence supports the relationship between pre-pregnancy body mass index (BMI) and gestational diabetes mellitus (GDM). However, the association between interpregnancy weight change (IPWC) and GDM in the subsequent pregnancy has been studied less. The purpose of this study was to conduct a systematic review and meta-analysis to synthesize evidence on the association between IPWC and GDM in the subsequent pregnancy. Methods: MEDLINE, EMBASE, Cochrane Library and Web of Science were searched from inception through 16 September 2019. The most adjusted relative risk (RR) or odds ratios (OR) and their corresponding 95% confidence intervals (CIs) reported by studies included were used. The ‘no weight change’ category defined by each study was used as the reference category. Findings: 13 articles were included in this systematic review and meta-analyses with a total sample of 529.080 women. The analyses showed higher risk of GDM in the subsequent pregnancy among women with interpregnancy weigh gain (OR = 1.56; 95% CI: 1.30-1.83; I2 = 82.30%; p =

ObjectiveTo test a physical activity intervention (MOVI-KIDS) on obesity indicators, physical fitness and blood pressure (BP) in children.MethodsA 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.ResultsThere 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; pConclusionMOVI-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 numberNCT01971840; Post-results.

Objective. The aim of the study was to analyze the relationship between moderate-to-vigorous physical activity (MVPA) and insulin resistance (IR) in Spanish adults and to examine whether this relationship is mediated by abdominal obesity (waist circumference —WC). Methods. The cross-sectional study included 1162 healthy subjects belonging to the EVIDENT study (mean age 55.0±13.3 years; 61.8%women) from six different Spanish provinces. Moderate-to-vigorous physical activiity (MVPA) was measured objectively over 7 days using Actigraph accelerometers, collecting data in 60-second epochs, and retaining respondents with ≥4 valid days for the analysis. The homeostasis model of assessment (HOMA-IR) was used to determine IR, and its individual components – fasting glucose and insulin – were determined using standard protocols. Linear regressionmodelswere fitted according to Baron and Kenny's procedures for mediation analysis. Results. Fasting insulin and HOMA-IR levels were significantly worse in adults who spent fewer minutes in MVPA (first quartile ≤ 30.1 and 22.7 min/day in men and women, respectively) after adjusting for age, sex, smoking habits, drinking habits, accelerometer wear time, sedentary time, and Mediterranean diet adherence. However,when WC was added to the ANCOVA models as a covariate, the effects disappeared.Mediation analysis reported that WC acts as a fullmediator in the relationship between MVPA and IR (HOMA-IR and fasting insulin). Conclusion. These findings show that WC plays a pivotal role in the relationship between MVPA and IR, and therefore highlights that decreasing abdominal obesity might be considered as an intermediate outcome for evaluating interventions aimed at preventing diabetes mellitus., The Evident Group

CONTEXT: The effects of school-based physical activity (PA) programs on different cardiometabolic risk factors and the most appropriate features of PA programs to achieve maximum effectiveness are unclear. OBJECTIVE: To provide a comprehensive synthesis of the effectiveness of school-based PA interventions on cardiometabolic risk factors in children. DATA SOURCES: We identified studies from database inception to February 22, 2018. STUDY SELECTION: We selected studies that were focused on examining the effect of school-based PA interventions on cardiometabolic risk factors in children. DATA EXTRACTION: Random-effects models were used to calculate the pooled effect size (ES) for the included cardiometabolic risk factors (waist circumference [WC], triglycerides, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, systolic blood pressure and diastolic blood pressure (DBP), and fasting insulin and glucose). RESULTS: Nineteen randomized controlled trials (which included 11 988 children aged 3–12 years) were included in the meta-analysis. School-based PA programs were associated with a significant small improvement in WC (ES = −0.14; 95% confidence interval [CI]: −0.22 to −0.07; P < .001), DBP (ES = −0.21; 95% CI: −0.42 to −0.01; P = .040), and fasting insulin (ES = −0.12; 95% CI: −0.20 to −0.04; P = .003). LIMITATIONS: Authors of few studies described the implementation conditions of their interventions in detail, and compliance rates were lacking in most studies. In addition, results by sex were provided in a small number of studies. CONCLUSIONS: School-based PA interventions improve some cardiometabolic risk factors in children, such as WC, DBP, and fasting insulin.

To assess the effectiveness of insulin glargine 300 ui/ml (Gla-300) compared with insulin glargine 100 ui/ml (Gla-100) on reducing nocturnal hypoglycemia and improving glycemic control in type 1 and type 2 diabetes patients. We systematically searched in Medline, Embase, Web of Science, and Cochrane Central Register of Controlled Trials until July 4th, 2018. This study was registered with PROSPERO (CRD42017080134). We included randomized clinical trials comparing Gla-300 versus Gla-100 reporting the rate ratio or number of events of nocturnal hypoglycemia and HbA1c levels percentage or mmol/mol−1. The main outcome was the incidence rate ratio (RR) of nocturnal hypoglycemia events. The heterogeneity of results across studies was assessed using the I2 statistic. Fixed- and random-effect models were used to estimate pooled RRs. Nine studies were included in the meta-analysis, including 3977 adult patients. Compared with Gla-100, the use of Gla-300 reduced confirmed nocturnal hypoglycemia [RR = 0.81 (0.69, 0.95)] and clinically significant nocturnal hypoglycemia [RR = 0.75 (0.63, 0.91)]. Reductions in clinically significant nocturnal hypoglycemia events [RR = 0.64 (0.42, 0.97)] in type 1 diabetes patients were found. A small decrease in HbA1c levels in favor of Gla-300 in the pooled sample was identified [ES = − 0.08 (95% CI − 0.14, − 0.01)]. The best current evidence indicates that Gla-300 reduces the incidence of nocturnal hypoglycemia with slight improvements in glycemic control compared with Gla-100 in both type 1 and type 2 diabetes adult patients.

Aim To evaluate whether an informative intervention by nursing professionals through Short Message Service (SMS) improved patients’ family members’ satisfaction with the intensive care experience. Methods/design This was an exploratory, two-armed, randomised, non-pharmacological, prospective study. The intervention consisted of providing information to the contact persons of patients admitted to the ICU of the University Hospital La Princesa (Madrid, Spain) through SMS based on the patient’s nursing assessment. Nursing diagnoses established by NANDA and based on the Virginia Henderson model were used as a reference. The main result was the satisfaction levels of the contacts of patients admitted to the intensive care unit, which was evaluated with the Critical Care Family Needs Inventory. Results The total score on the Critical Care Family Needs Inventory was significantly better in the intervention group (16.6 ± 3.3 vs. 19.1 ± 4.7; p = 0.012) compared with the control group. All participants included in the intervention considered it useful to some degree. Even when the contact person received negative information, there was no demand for information outside established hours, which was included as a possible adverse effect of the intervention. Conclusion Support in the form of additional nursing information implied an increase in the satisfaction of the needs perceived by the contact persons of patients admitted to the intensive care unit, together with a better perception of the quality of intensive care unit care and a reassuring and beneficial effect.

Introduction This study examined the impact of a multicomponent physical activity (PA) intervention (MOVI-KIDS) on improving cognition in schoolchildren. This paper also analyzed the mediator role of motor fitness between MOVI-KIDS and cognition. Methods Propensity score analysis of data from a cluster randomized controlled trial (MOVI-KIDS study). This analysis including 240 5-7 years old children from nine schools in the provinces of Cuenca and Ciudad Real, Spain. MOVI-KIDS program consisted of: (a) three weekly after-school sessions of recreational non-competitive PA lasting 60 minutes during one academic year, (b) educational materials for parents and teachers, and (c) school playground modifications. Changes in cognition (logical reasoning, verbal factor, numerical factor, spatial factor, and general intelligence) were measured. A propensity score cross-cluster matching procedure and mediation analysis (Hayes's PROCESS macro) were conducted. Results All cognitive variables pre-post mean changes were significantly higher (P ≤ 0.05) in children from intervention schools than those from control schools (effect size ranged from 0.33 to 1.48). The effect of the intervention on the spatial factor and general intelligence was partially mediated by motor fitness (indirect effect = 0.92, 95% CI: 0.36; 1.65; and indirect effect = 1.21, 95% CI: 0.06; 2.62, respectively). Conclusions This study shows that a one-school-year multicomponent intervention consisting of a recreational non-competitive PA program, educational materials for parents and teachers, and school playground modifications improved the cognition of first-grade children. Further, our results suggest that the effect of the intervention on cognition was mediated by changes in motor fitness.

The aim of this study was to analyze the mediation role of cardiorespiratory fitness and waist circumference in the association between muscular strength and cardiometabolic risk. A cross-sectional study involved first-year college students (n = 370) from a Spanish public university was performed. We measured weight, height, waist circumference, blood pressure, biochemical variables, maximum handgrip strength assessment, and cardiorespiratory fitness. We calculated handgrip dynamometry/weight and a previously validated cardiometabolic risk index. Analysis of covariance models was conducted to test differences in cardiometabolic risk values across muscular strength, cardiorespiratory fitness, and waist circumference categories, controlling for confounders. Hayes' PROCESS macro was used for the multiple mediation analysis. The relationship between muscular strength and cardiometabolic risk did not remain significant (c' = 1.76 [1.4]; P > .05) in a multiple serial bootstrapped mediation model including cardiorespiratory fitness and waist circumference as mediators when controlling for age and sex. According to the indirect effect, the significant paths in the model mediating this relationship between muscular strength and cardiometabolic risk index were as follows: muscular strength → waist circumference → cardiometabolic risk index (-4.899; 95% CI: -6.690; -3.450) and muscular strength → cardiorespiratory fitness → waist circumference → cardiometabolic risk index (-0.720; 95% CI: -1.316; -0.360). Both cardiorespiratory fitness and waist circumference mediate the association between muscular strength and cardiometabolic risk in young adults. Thus, our results place cardiorespiratory fitness and waist circumference as the main targets of physical activity programmes aimed at preventing cardiometabolic diseases.

Aims and objectives To provide evidence about whether intravenous metoclopramide continuous infusion is associated with fewer extrapyramidal side effects than bolus infusion. Background Many studies have described the effects produced by the administration of metoclopramide, as a continuous intravenous infusion or intravenous bolus directly, but there is a lack of consensus about the best administration of this drug to minimise extrapyramidal side effects. Design A meta-analysis was conducted. Methods The search data base was conducted in: Cochrane Library, PubMed, Web of Knowledge and Scopus, to collect randomised controlled trials examining the association between extrapyramidal side effects and intravenous metoclopramide continuous or bolus infusion. Meta-analyses were conducted for the eligible randomised controlled trials by Comprehensive Meta-Analysis. Risk difference and 95% CIs were calculated with the Cochran's Q-statistic, and heterogeneity was assessed with the I2 test. Results Eleven randomised controlled trials were included. Meta-analysis showed that continuous intravenous infusion of metoclopramide produced less extrapyramidal side effects (8%; 95% CI, 5–11%; p

To analyze the independent relationship between the risk of eating disorders and bone health and to examine whether this relationship is mediated by body composition and cardiorespiratory fitness (CRF). In this cross-sectional study, bone-related variables, lean mass, fat mass (by DXA), risk of eating disorders (SCOFF questionnaire), height, weight, waist circumference and CRF were measured in 487 university students aged 18–30 years from the University of Castilla-La Mancha, Spain. ANCOVA models were estimated to test mean differences in bone mass categorized by body composition, CRF or risk of eating disorders. Subsequently, linear regression models were fitted according to Baron and Kenny’s procedures for mediation analysis. The marginal estimated mean ± SE values of total body bone mineral density for the categories “no risk of eating disorders” and “risk of eating disorders” were 1.239 ± 0.126

This report aims to analyse the independent association of lean mass and muscle fitness with bone mineral content (BMC) and bone mineral density (BMD), and to examine whether the relationship between muscle fitness and bone health is mediated by lean mass. Body composition (by dual energy X-ray absorptiometry (DXA)), muscle fitness, physical activity, age and height were measured in 132 schoolchildren (62 boys, aged 8-11 years). Analysis of covariance tested differences in bone-related variables by lean mass and muscle fitness, controlling for different sets of confounders. Linear regression models fitted for mediation analyses examined whether the association between muscle fitness and bone mass was mediated by lean mass. Children with good performance in handgrip and standing long jump had better and worse bone health, respectively. These differences disappeared after controlling for lean mass. Children with high lean mass had higher values in all bone-related variables. In addition, the relationship between muscle fitness and bone mass was fully mediated by lean mass. In conclusion, the relationship between upper-limbs muscle fitness and bone health seems to be dependent on lean mass but not on muscle fitness. Schoolchildren with high lean mass have more BMC and BMD in all regions. Lean mass mediates the association between muscle fitness and bone mass.

We estimated the prevalence of underweight, overweight and obesity of children and adolescents from Castilla-La Mancha region (Spain), applying the new International Obesity Task Force (IOTF) 2012 criteria, and analysed differences in physical fitness components in relation to weight status. The sample was 2,330 schoolchildren aged 6–17 years. We measured height and weight, calculated body mass index (BMI) and assessed physical fitness using four tests included in the EUROFIT battery. Differences in physical fitness components across BMI categories, by sex, were calculated using ANOVA models. In children aged 6–11 years, 4.9 % were underweight, 26.7 % overweight and 11.0 % obese; in adolescents aged 12–17 years, 6.4 % were underweight, 16.7 % overweight and 5.8 % obese. Overall, overweight and obesity were associated with worse physical fitness but students in the underweight category did not score worse than their normal weight counterparts on fitness tests. Conclusion: Childhood obesity in Spain remains a public health problem. Our results show low physical fitness levels in overweight/obese children and adolescents and low levels of handgrip strength in underweight adolescents compared with normal weight subjects. Exercise programmes must be tailored to the specific needs of the subjects according to the different weight status.

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.

Sleep seems to have a significant influence on the metabolic syndrome (MetS). However, results in this association are still inconsistent in children. The aim of this study was to examine the influence of sleep characteristics in the MetS (index and factors) in Spanish children. Cross-sectional study including a sample of 210 children aged 8-to-11-years belonging to 20 schools from the province of Cuenca, Spain was conducted. Cardiometabolic risk and actigraphy sleep patterns were determined and analysed using correlation coefficients, ANCOVA models and a propensity score derivation model. Overall, children in the lower time in bed category and those who went to bed later (> 23:15h) showed worse values in the cardiometabolic profile and risk index. Differences were observed when the total time in bed was below 9h 15mins. Our study shows that short sleep duration could be a risk factor for cardiometabolic risk in children, and bedtime may independently influence this risk. In addition, our data suggests that children's sleep hygiene should be incorporated in parenting educational programs.

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.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.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.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.

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

OBJECTIVE The relationship between cardiorespiratory fitness (CRF) and metabolic syndrome (MetS) is well known, although the extent to which body weight may act as a confounder or mediator in this relationship is uncertain. The aim of this study was to examine whether the association between CRF and cardiometabolic risk factors is mediated by BMI. RESEARCH DESIGN AND METHODS A cross-sectional study including 1,158 schoolchildren aged 8–11 years from the province of Cuenca, Spain, was undertaken. We measured height, weight, waist circumference (WC), blood pressure, fasting plasma lipid profile and insulin, and CRF (20-m shuttle run test). A validated cardiometabolic risk index was estimated by summing standardized z scores of WC, log triglyceride-to-HDL cholesterol ratio (TG/HDL-c), mean arterial pressure (MAP), and log fasting insulin. To assess whether the association between CRF and cardiometabolic risk was mediated by BMI, linear regression models were fitted according to Baron and Kenny procedures for mediation analysis. RESULTS In girls, BMI acts as a full mediator in the relationship between CRF and cardiometabolic risk factors, with the exception of log TG/HDL-c ratio. In boys, BMI acts as a full mediator in the relationship between CRF and both log TG/HDL-c ratio and MAP, and as a partial mediator in the relationship between CRF and cardiometabolic risk factors. CONCLUSIONS BMI mediates the association between CRF and MetS in schoolchildren. Overall, good levels of CRF are associated with lower cardiometabolic risk, particularly when accompanied by weight reduction.