Search

Adolescence is a crucial life stage that can lead to excess weight and body dissatisfaction. Social inequalities in these issues may have been exacerbated by the COVID-19 pandemic. We aimed to analyze the presence of socioeconomic inequalities and their changes in these inequalities stratified by sex in 13- to 19-year-olds in a large Mediterranean city (Barcelona, Spain). Cross-sectional population-based study. We used data from the 2016 and 2021 editions of the FRESC survey, which is a representative citywide survey that captures various aspects of adolescent health. Excess weight was determined by objective body mass index measurements. Body dissatisfaction was defined as the discrepancy between perceived and desired body shape. Socioeconomic status was divided into five pseudo-quintiles by using the Family Affluence Scale. We calculated the corresponding prevalence estimates and fitted robust Poisson regression models to estimate both simple and complex measures of inequality, including relative and absolute differences between the two survey years. The overall prevalence of excess weight increased from 25.3% [23.9–26.6] to 29.8% [28.2–31.4] between 2016 and 2021. Similarly, body dissatisfaction increased from 44.2% [42.6–45.8] to 60.4% [58.7–62]. Socioeconomic inequalities in excess weight significantly increased in girls (adjusted ratio of the relative index of inequalities = 1.72 [1.08; 2.74] but not in boys. No significant changes were detected in body dissatisfaction in either girls or boys. Our findings highlight the presence of a sex-specific change in socioeconomic inequalities in adolescent well-being regarding excess weight and body dissatisfaction. These results underscore the need for local public policies to improve social equity in adolescent health. [ABSTRACT FROM AUTHOR]

Background/Objectives: This study investigated the impact of the FLUYE school-based intervention on children's lifestyle behaviors, Mediterranean diet adherence, and emotional well-being in Spain. The objective was to promote healthy habits through nutrition education, physical activity, and emotional support within the school environment, with a focus on addressing the needs of both normal-weight and overweight/obese children. Methods: A total of 552 children aged 3 to 12 years participated in the study, with data collected at baseline (T0) and follow-up (T1). The intervention was designed to integrate health education into the school curriculum, emphasizing the development of personal competencies in diet, physical activity, and emotional well-being. The analysis included changes in dietary habits, screen time, physical activity, and psychosocial outcomes, with comparisons made between the normal-weight and overweight/obese groups. Results: Significant improvements were observed in water consumption and reductions in sugar-sweetened beverage intake across both weight groups. However, an increase in screen time, particularly among normal-weight children, highlighted ongoing challenges in reducing sedentary behavior. Adherence to the Mediterranean diet improved more significantly in the overweight/obese group, suggesting the program's effectiveness in promoting healthier eating patterns among at-risk children. Emotional well-being and self-esteem also saw significant enhancements, with children reporting increased feelings of pride and positivity post-intervention. Conclusions: The FLUYE program effectively improved various aspects of children's lifestyle behaviors, particularly in dietary habits and emotional well-being. These findings underscore the importance of comprehensive, school-based interventions that address both physical and psychosocial aspects of health, especially for children at higher risk for obesity. [ABSTRACT FROM AUTHOR]

Summary: Objective: This study tried to examine the association between the frequency of family meals and excess weight using large and representative samples of children and adolescents from 43 countries. Methods: This cross‐sectional study used data from the Health Behaviour in School‐aged Children (HBSC), which included nationally representative samples of children and adolescents aged 10–17 years, involving a total of 155 451 participants (mean age = 13.6 years; standard deviation [SD] = 1.6; 51.4% girls). Family meal frequency was gauged through the following question: 'How frequently do you and your family typically share meals?' The possible responses were: 'never', 'less often', 'approximately once a week', 'most days' and 'every day'. The body weight and height of the participants were self‐reported and utilized to calculate body mass index (BMI). Subsequently, BMI z‐scores were computed based on the International Obesity Task Force criteria, and the prevalence of excess weight was defined as +1.31 SD for boys and + 1.24 SD for girls, with obesity defined as +2.29 SD for boys and + 2.19 SD for girls. Generalized linear mixed models were conducted to examine the associations between the frequency of family meals and excess weight or obesity. Results: The lowest predicted probabilities of having excess weight and obesity were observed for those participants who had family meals every day (excess weight: 34.4%, 95% confidence interval [CI] 31.4%–37.5%; obesity: 10.8%, 95% CI 9.0%–13.0%). Conclusions: A higher frequency of family meals is associated with lower odds of having excess weight and obesity in children and adolescents. [ABSTRACT FROM AUTHOR]

Background: This study aimed to analyze the relationship between socioeconomic status (SES), poverty rate, and the prevalence of overweight/obesity or obesity in children and adolescents aged 2–14. Methods: Parents or guardians reported the weight and height of participants, used to calculate body mass index (BMI) and BMI z-scores according to the International Obesity Task Force standards. Participants were categorized into "overweight/obesity" and "no overweight/obesity" and further into "obesity" and "no obesity". The rate of poverty rate was determined using data from the National Statistics Institute of Spain, defining it as the percentage of people with income below 60% of the national median. SES was based on the head of household's occupation and categorized into low, medium, and high levels. Results: Adjusted multilevel models showed participants with medium or high SES had lower odds of overweight/obesity compared to those with low SES (medium SES: odds ratio [OR]: 0.63, 95% confidence interval [CI]: 0.54–0.73; high SES: OR: 0.59, 95% CI: 0.49–0.70). Participants in the high-poverty group had higher odds of having overweight/obesity (OR: 1.40, 95% CI: 1.13–1.74) compared to the low-poverty group. Conclusions: The study highlights significant socioeconomic disparities in childhood overweight/obesity, emphasizing the potential impact of SES and poverty on health outcomes in Spanish children and adolescents. [ABSTRACT FROM AUTHOR]

Background: Fear of fat is a relevant variable in initiating weight regulation behaviors in adolescents. However, little is known about the experiential and behavioral change processes that mediate the choice between healthy and unhealthy weight regulation behaviors in this population. Method: The general objective was to examine the predictive role of fear of fat on weight-related behaviors (healthy and unhealthy weight control behaviors) through the mediation of experiential and behavioral change processes (consciousness raising, counterconditioning, helping relationships, reinforcement management, self-liberation, self-reevaluation, stimulus control, substance use) in 838 adolescents aged 15–19 years from Mexico and Spain using parallel mediation analysis. Additionally, the study examined the correlations between the variables with regard to gender and country, as well as the differences in the use of processes of change across stages of change through the use of a multivariate analysis of variance. The Spanish version of the Fear of Fat, Stages of Change, Processes of Change, and Weight-Related Behaviors scales were used. Results: The mediation analysis showed that fear of fat predicted healthy weight control behaviors through consciousness raising, self-liberation, and stimulus control. On the other hand, fear of fat predicted unhealthy weight control behaviors through counterconditioning, stimulus control, and the use of weight loss substances. Intervening to reduce fear of fat may be a way to modify the processes of change used by adolescents to regulate their weight. Conclusions: The results of this study indicate that adolescents may initiate weight control behaviors as a result of fear of fat. This process is mediated by experiential and behavioral processes that influence weight regulation. [ABSTRACT FROM AUTHOR]

Food neophobia has been defined as the reluctance to try new foods. Food neophobia is common in children and older people, but until now, scarce research has been carried out on food neophobia in the adult population. The aim of this study was to assess the most usual food neophobias in Spanish adults with overweight and obesity by sex, and their association with sociodemographic factors and the most prevalent chronic diseases. A cross-sectional observational study was carried out on adults (mean age of 43.5 ± 13.7 years old; n = 590; 50% female) with overweight or obesity. Their anthropometrics, adherence to the Mediterranean diet, age, educational level, economic level, smoking and sleeping habits, physical activity, chronic diseases, and food neophobias were assessed. The highest food neophobias in Spanish adults with overweight or obesity were directed toward vegetables, meat, fish, pulses, game meat, and fruits, mostly among females, with differences between sexes. Phobias of the soft texture of foods were also observed, without differences between sexes. Age, educational level, sleeping habits, and physical activity were directly related, and economical level and smoking were inversely related to food neophobia, mainly to healthy foods, and more obvious in males than in females. There were associations between body mass index (BMI) and chronic diseases and food neophobia. Adherence to the adaption of healthy and sustainable diets is low within food neophobics, increasing the risk of diet-related chronic diseases. [ABSTRACT FROM AUTHOR]

Background: The influence of food advertising on food preferences and consumption could also contribute to the socio-economic inequalities among Spanish children in terms of eating habits and childhood obesity. Although the main food advertising channel targeted at children in Spain is television, available studies estimate exposure indirectly by combining content data with audience data. The aim of this study was therefore to describe the frequency of exposure to television advertising of unhealthy foods and drinks, measured directly, among Spanish children and adolescents, and analyse its socio-economic inequalities. Methods: Observational study of television advertising impacts in a sample of 1590 children aged 4 to 16 years drawn from a consumer panel representative of the Spanish population in this age group, over the course of a full week of broadcasting in February 2022. The sample was obtained through stratified random sampling by Autonomous Region, with quotas being set by reference to socio-demographic variables. Exposure was measured with an audiometer, and the nutrient content of the food and drink advertised was analysed using the nutrient profile of the WHO Regional Office for Europe. We used the Chi-squared test to analyse possible differences in advertising coverage by socio-economic level. Results: The participants saw a weekly mean of 82.4 food and drink commercials, 67.4 of which were for unhealthy products (81.8%), mostly outside the child-protection time slot. On average, low-social class participants received 94.4% more impacts from unhealthy food and drink advertising than did high-class participants (99.9 vs. 51.4 respectively). The mean advertising coverage of unhealthy foods and drinks was 71.6% higher in low-class than in high-class participants (10.9% vs. 18.7%; p = 0.01). Conclusion: Spanish children and adolescents received an average of 10 impacts per day from television spots for unhealthy foods and drinks. The exposure of low-class children is double that of high-class children, a finding compatible with the high prevalence of childhood obesity in Spain and the related socio-economic inequalities. To protect Spanish minors from the harmful effects of food advertising and reduce the related social health inequalities would require the implementation of a 24:00 watershed for unhealthy food advertising on television. [ABSTRACT FROM AUTHOR]

The background of this study is to examine the associations of individual and combined early morning patterns (i.e., active commuting to school, physical activity before school, having breakfast and good sleep) with white matter microstructure (WMM) and, whether the associated white mater microstructure outcomes were related to mental health outcomes in children with overweight or obesity. 103 children with overweight or obesity (10.0 ± 1.1 years old, 42 girls) from the ActiveBrains project participated in this cross-sectional study. Early morning patterns and mental health indicators (i.e., self-esteem, optimism, positive and negative affect, stress, depression and anxiety) were self-reported by the children using validated questionnaires. WMM was assessed by magnetic resonance imaging using diffusion tensor imaging. When examined independently, early morning patterns were not related with WMM (all P > 0.05). However, the combination of early morning patterns was related with WMM (P < 0.05). Specifically, physically active early morning patterns (i.e., active commuting to school and physical activity before school) were associated with global fractional anisotropy (FA) (β = 0.298, P = 0.013) and global radial diffusivity (RD) (β = − 0.272, P = 0.021), as well as with tract-specific FA (β = 0.314, P = 0.004) and RD (β = − 0.234, P = 0.032) in the superior longitudinal fasciculus (SLF). Furthermore, combined physically active early morning pattern-associated global (i.e., FA and RD) and tract-specific (i.e., FA and RD in the SLF) WMM indicators were positively associated with happiness (β absolute value range from 0.252 to 0.298, all P < 0.05). A combination of physically active early morning patterns may positively relate to white matter microstructure in children with overweight or obesity, and, in turn, happiness. [ABSTRACT FROM AUTHOR]

Considered the epidemic of the 21st century by the WHO, obesity is a global problem that is on the rise and will continue to increase in the coming years. Spain and Andalusia, in particular, are no exception to this pathology, which has tripled since the 1970s, representing a public health challenge. The aim of this study is to analyse the socioeconomic determinants of this pathology, with special emphasis on answering the question of what has a greater influence on overweight, education level, or income. For this purpose, we have used the European Survey of Health in Spain (ESHS-2020), a microdata base, with a total of 22,072 valid individual observations (of which 2,820 belong to the Andalusian population). Results we obtain in our estimations of qualitative response models reveal that, although both income and educational attainment could be effective in the fight against overweight, the social gradient of this health problem is greater with respect to educational attainment. Additionally, there are many other variables and other factors related to the individual's overweight (mental health, subjective state of health, oral health, among others) which are much less explored and which must be considered in health policies to combat this disease. [ABSTRACT FROM AUTHOR]

Bone mass progressively increases to peak during childhood and adolescence, which determines future bone health. Bone formation–resorption processes are assessed using bone markers. However, studies on the impact of obesity on bone turnover markers at this age are limited, and results are inconsistent. The objective of this study was to examine the potential impact of overweight/obesity on bone metabolism. A study was performed to compare parameters of bone metabolism in 45 girls and boys with normal weight (controls) and in a group of 612 girls and boys with overweight/obesity (cases) from the Exergames study (University of Zaragoza). Ages ranged from 8 to 12 years. Higher values of phosphorus and IGFBP-3 were observed in children with overweight/obesity, as compared to children with normal weight, (p=0.042) and (p=0.042), respectively. BAP, osteocalcin, magnesium, vitamin D and IGF-I concentrations were lower in the group with overweight/obesity, whereas calcium concentrations were higher in this group, although differences were not statistically significant. A negative correlation was found (r=−0.193) (p=0.049) between BAP and BMI. Although differences did not reach statistical significance, BAP and osteocalcin concentrations were lower in children with overweight/obesity. This added to the negative correlation found between BAP and MIC may demonstrate that overweight/obesity may negatively affect bone health already at a young age. [ABSTRACT FROM AUTHOR]

Summary: Objective: To estimate national and provincial prevalence of obesity and excess weight in the child and adolescent population in Spain by sex and sociodemographic characteristics, and to explore sources of inequalities in their distribution, and their geographical patterns. Methods: ENE‐COVID is a nationwide representative seroepidemiological survey (68 287 participants) stratified by province and municipality size (April–June 2020). Participants answered a questionnaire which collected self‐reported weight and height, that allowed estimating crude and model‐based standardized prevalences of obesity and excess weight in the 10 543 child and adolescent participants aged 2–17 years. Results: Crude prevalences (WHO growth reference) were higher in boys than in girls (obesity: 13.4% vs. 7.9%; excess weight: 33.7% vs. 26.0%; severe obesity: 2.9% vs. 1.2%). These prevalences varied with age, increased with the presence of any adult with excess weight in the household, while they decreased with higher adult educational and census tract average income levels. Obesity by province ranged 1.8%–30.5% in boys and 0%–17.6% in girls; excess weight ranged 15.2%–49.9% in boys and 10.8%–40.8% in girls. The lowest prevalences of obesity and excess weight were found in provinces in the northern half of Spain. Sociodemographic characteristics only partially explained the observed geographical variability (33.6% obesity; 44.2% excess weight). Conclusions: Childhood and adolescent obesity and excess weight are highly prevalent in Spain, with relevant sex, sociodemographic and geographical differences. The geographic variability explained by sociodemographic variables indicates that there are other potentially modifiable factors on which to focus interventions at different geographic levels to fight this problem. [ABSTRACT FROM AUTHOR]

Purpose: To compare the strength of associations between different indices of cardiorespiratory fitness (CRF) and brain health outcomes in children with overweight/obesity. Methods: Participants were 100 children aged 8–11 years. CRF was assessed using treadmill exercise test (peak oxygen uptake [V̇O2peak], treadmill time, and V̇O2 at ventilatory threshold) and 20‐metre shuttle run test (20mSRT, laps, running speed, estimated V̇O2peak using the equations by Léger et al., Mahar et al., and Matsuzaka et al.). Intelligence, executive functions, and academic performance were assessed using validated methods. Total gray matter and hippocampal volumes were assessed using structural MRI. Results: V̇O2peak/body mass (β = 0.18, 95% CI = 0.01–0.35) and treadmill time (β = 0.18–0.21, 95% CI = 0.01–0.39) were positively associated with gray matter volume. 20mSRT laps were positively associated with executive functions (β = 0.255, 95% CI = 0.089–0.421) and academic performance (β = 0.199–0.255, 95% CI = 0.006–0.421), and the running speed was positively associated with executive functions (β = 0.203, 95% CI = 0.039–0.367). Estimated V̇O2peak/Léger et al. was positively associated with intelligence, executive functions, academic performance, and gray matter volume (β = 0.205–0.282, 95% CI = 0.013–0.500). Estimated V̇O2peak/Mahar et al. and V̇O2peak/Matsuzaka et al. (speed) were positively associated with executive functions (β = 0.204–0.256, 95% CI = 0.031–0.436). Conclusion: Although V̇O2peak is considered the gold standard indicator of CRF in children, peak performance (laps or running speed) and estimated V̇O2peak/Léger et al. derived from 20mSRT had stronger and more consistent associations with brain health outcomes than other indices of CRF in children with overweight/obesity. [ABSTRACT FROM AUTHOR]

Summary: Background and Objectives: Research on the relationship between body mass index (BMI) and strain values in children and adolescents is limited. Our aim was to analyse the relationship between BMI and strain values of both ventricles and left atrium in children and adolescents. Methods: Both ventricles and left atrial strain values were compared among different BMI categories in children and adolescents from a town in the South of Spain. Results: Of the 198 subjects, aged 6–17 years, 53% were of normal weight, 26% were overweight and 21% had obesity. Lower absolute values of left ventricular global longitudinal strain (25.9 ± 2.0% vs. 26.9 ± 2.2%, p = 0.002) and right ventricular free wall longitudinal strain (29.5 ± 4.2% vs. 30.8 ± 4.5%, p = 0.04) were found in subjects with obesity and overweight versus subjects with normal weight. A lower right ventricular four‐chamber longitudinal strain was also observed in males with obesity and overweight (24.8 ± 3.3% vs. 26.4 ± 3.6%, p = 0.03). Statistically significant negative correlations of BMI were found for all ventricular, but not atrial, strain values in univariate analysis. This association turned non‐significant for right ventricular four‐chamber longitudinal strain in multivariate analysis. Conclusions: Utilizing this new strain software, children and adolescents with high BMI were associated with significantly lower values for left and right ventricular free wall longitudinal strain, without impact in left atrial strain. [ABSTRACT FROM AUTHOR]

Daytime napping, a habit widely adopted globally, has an unclear association with obesity. In this study, we executed a meta-analysis to explore the relationship between daytime napping and obesity. We conducted a comprehensive search of the PubMed, Embase, Cochrane Library, Scopus, PsycINFO, and Web of Science databases for pertinent articles published up to April 2023. Random-effects models were utilized to calculate odds ratios (ORs) with 95% confidence intervals (CIs), and we assessed the heterogeneity of the included studies using the I2 statistic. To explore potential sources of heterogeneity, subgroup analyses were performed. The methodological quality of the studies was evaluated using the Newcastle–Ottawa Scale (NOS), and funnel plots were employed to detect any publication bias. Sensitivity analyses were conducted by sequentially omitting each study. We conducted a meta-analysis of twelve studies that included one each from the UK and Spain, five from the USA, and five from China, totalling 170,134 participants, to probe the association between napping and obesity. The pooled analysis suggested a higher risk of obesity in individuals who nap (OR: 1.22 [1.10–1.35], p < 0.001, I2 = 87%) compared to non-nappers. The meta-analysis results revealed variations in the summary ORs for studies conducted in China, Spain, the USA, and the UK. The ORs for China, Spain, the USA, and the UK were 1.05 (95% CI 0.90–1.23), 9.36 (95% CI 4.74–18.45), 1.27 (95% CI 1.10–1.47), and 1.39 (95% CI 1.32–1.47), respectively. A subgroup analysis based on age within the American population disclosed that napping in both adults and children heightened obesity incidence. A subgroup analysis based on nap duration found a significant rise in obesity occurrence when nap duration exceeded one hour, but no clear relationship emerged when nap duration was less than 1 h. In a subgroup analysis based on the definition of obesity, napping did not demonstrate a significant relationship with obesity when diagnostic criteria set obesity at a BMI of 25 or above. However, when the criteria were set at a BMI of 28 or 30 or more, napping significantly increased obesity risk. Our meta-analysis indicates a positive association between daytime napping and the risk of obesity. However, given the limited number of included studies, potential confounding factors might not have been fully addressed. Future well-designed prospective studies are required to further investigate this relationship. Large-scale studies are necessary to confirm our findings and elucidate the underlying mechanisms that drive these associations and causation. [ABSTRACT FROM AUTHOR]

Background: The databases of children's anthropometric parameters are often outdated, rarely representative and are not always available at an international level. Objectives: To present children's anthropometric parameters in six European countries that contributed to the Feel4Diabetes project and find country-specific differences. Design/Setting: The Feel4Diabetes study was performed between 2016 and 2018, targeting children in Belgium, Bulgaria, Finland, Greece, Hungary and Spain. The current study presents data from the baseline and the yearly follow-up anthropometric measurements. Subjects: In total, 20,832 measurements of children (48.7% boys) between 6 and 10 years of age were conducted. Main outcome measure: weight, height, BMI. Results: Belgian boys had the lowest body weight and height, while Greek boys had the highest body weight, and Finnish had the highest body height. The highest proportion of overweight (percentile above 85%) and obese boys (percentile above 95%) was in Greece, followed by Hungarian, Spanish, Bulgarian and Finnish boys. In contrast, Belgian boys had the lowest ratio in both categories. Among girls, Greece had the highest; Belgium had the lowest body weight; Finland was the highest in all age categories. The ratio in the overweight range was the highest in Greece, followed by Spanish, Bulgarian and Hungarian girls, who were second in the obese category. Finnish girls had lower and Belgian girls had the lowest ratio in both BMI categories. All the detailed data are presented in tables, and the trends are figures. Conclusions: Our study presents fresh and comparable anthropometric data of children between 6 and 10 years of age in six European countries, supporting the need for appropriate obesity prevention. [ABSTRACT FROM AUTHOR]

There is now a wealth of research on obesity both from biomedical and socially critical perspectives. However, less research has focused on the lived experiences of young children and particularly those who are perceived as 'sedentary'. This paper critically examines the issue of obesity as related to children's experiences of physical (in)activity, via a focus on the circulation of socio-cultural and economic discourses in the context of Spain. We report on data obtained from interviews with 13 children identified as 'sedentary'. Data were analysed using thematic content analysis and based on the analysis a collective story was constructed to represent and give voice to the children's experiences. The collective story sketches a day in the life of 'Diego' to indirectly reveal the limitations associated with assuming that sport and school physical education (PE) are pragmatic 'answers' to the presumed issue of childhood obesity. In our analysis we draw on Foucauldian notions of bio-power and governmentality to highlight how neoliberal and capitalist logics shape and constrain children's experiences and opportunities. By presenting a narrative that delves into the various domains of these children's lives, their families, friends, peers and lifestyles, we argue there is still a need to reformulate and rethink how we understand childhood wellbeing and the role of PE. We conclude by suggesting that the conflation of PE with sport and health can subtly undermine some children's views of self. [ABSTRACT FROM AUTHOR]

Purpose: We aimed to characterize the distribution of energy and macronutrient intakes across eating occasions (EO) in European children from preschool to school age. Methods: Data from 3-day weighed food records were collected from children at ages 3, 4, 5, 6 and 8 years from Belgium, Germany, Italy, Poland and Spain. Food intakes were assigned to EO based on country-specific daytimes for breakfast, lunch, supper and snacks (morning, afternoon). The average energy and nutrient intakes were expressed as percentage of total energy intake (%E). Nutrients were additionally expressed as percentage per EO (%EEO). Foods were assigned to food groups; variation in intake was calculated via coefficient of variation (CV). We analyzed age trends in diurnal intake using mixed-effects beta regression. Results: The 740 healthy children included in the analysis consumed the largest proportion of daily energy at lunch (31%E ± 8, M ± SD) and supper (26%E ± 8), followed by breakfast (19%E ± 7) and snacks [afternoon (16%E ± 8); morning (8%E ± 7)], with the most variable intake at morning snack (CV = 0.9). The nutrient composition at lunch and supper was highest for fat (36 ± 9%ELunch; 39 ± 11%ESupper) and protein (18 ± 5%ELunch; 18 ± 6%ESupper) and at breakfast and snacks for carbohydrates (54 ± 12%EBreakfast; 62 ± 12%ESnacks). High-sugar content foods were consumed in relatively large proportions at breakfast and snacks. Food intakes varied significantly with age, with lower snack intakes at later ages (p < 0.001). Conclusion: Possibly unhealthy EOs with high-fat intakes and high-sugar-content foods were observed. Changes in nutrient composition of EOs may be beneficial for health. Trial registry: ClinicalTrials.gov: NCT00338689; 19/June/2006. [ABSTRACT FROM AUTHOR]

Childhood obesity is one of the main public health concerns in Europe. The aim was to identify possible risk factors associated with overweight/obesity in Spanish preschool and school-age children. The sample (1075 (50.7% girls) children aged 3 to 12) is part of the project 'Alimentando el Cambio' whose objective is to promote healthy lifestyles in schools. Child height and weight were measured, and parents filled out questionnaires related to the children's lifestyle. There was a positive and significant association between sweetened beverage consumption and body mass index (BMI) z-score in both sexes and age groups. There was a negative and significant association between BMI z-score and dairy products in girls of both age groups. There was also a protective effect of regular nut consumption on overweight/obesity in girls 6–12 y. Night-time sleep during weekdays showed a negative association with BMI z-score for older boys and girls. A positive and significant association was found between total screen time and BMI z-score during weekdays. Regarding emotional well-being and self-esteem, having girls 6–12 y laughing and feeling happy and good about themselves in the last week was a protective factor against overweight/obesity. Childhood obesity prevention efforts may benefit from targeting these key risk factors. [ABSTRACT FROM AUTHOR]

Numerous investigations show the need to intervene with school children and young students in order to mitigate socio-educational difficulties such as social conflict, and public health problems such as sedentary lifestyles and childhood obesity. This study seeks to explain the rationale and protocol of an educational programme called "ACTIVE VALUES" as an intervention strategy for the reduction of sedentary lifestyles and the promotion of education in values in schools. The present research used a mixed methods approach with a quasi-experimental design of repeated measures (pre-test and post-test), with a non-randomised control group (CG) and an experimental group (EG). The sample was composed of approximately 250 students and 30 teachers from different autonomous communities in Spain, divided into EG and CG. The EG implemented a teaching methodology based on the incorporation of Active Breaks (AB) into the structure of the Teaching Personal and Social Responsibility (TPSR) model, during one academic year, while the CG used conventional teaching based on the direct instruction teaching technique. A specific two-stage professional development procedure was followed: (1) initial training and (2) continuing professional development (CPD). The fidelity of the programme was checked by observational analysis of the sessions which were analysed by two observers with expertise in educational research and active methodologies. Currently, "ACTIVE VALUES" is the first study that examines the effectiveness of an educational programme that integrates into the teaching methodology, elements that foster education in values and promote healthy lifestyle habits through physical-sports activity within the classroom. [ABSTRACT FROM AUTHOR]

Summary: Background: Recent studies have associated several microRNAs (miRNAs) with childhood obesity and energy homeostasis, suggesting that an individual miRNA profile could be used as an early predictor to estimate the response to weight loss interventions in the design of precision nutrition. Objective: To investigate associations between the expression of circulating adiposity‐related miRNAs and the response to a weight loss intervention. Methods: A total of 51 Spanish girls (age 7–16 years) with abdominal obesity underwent 8 weeks of a multidisciplinary intervention for weight loss. Participants were stratified into two groups in accordance with changes in body mass index (BMI) standard deviation score: low‐responders (LR) and high‐responders (HR). The expression of 39 circulating miRNAs (c‐miRNAs) was evaluated in plasma of all subjects before the intervention. Results: Six miRNAs were differentially expressed between LR and HR. However, after adjustment for Tanner stage, the association was maintained only for miR‐126‐3p and miR‐221‐3p with a higher expression in HR group compared to LR group. After the intervention, miR‐221‐3p expression decreased in all subjects with a significant difference in the change within groups. However, changes in miR‐126‐3p levels were not significant. The expression of miR‐221‐3p was positively correlated with body weight, BMI and waist circumference, and negatively correlated with quantitative insulin sensitivity check index. Conclusions: Bioinformatic analysis evidenced that miR‐221‐3p participates in several obesity‐related pathways, and more interestingly, this miRNA targets several candidate genes to childhood obesity according to DisGeNet database. Thus, miR‐221‐3p could be used for predicting the response to a multidisciplinary intervention for weight loss in young girls. [ABSTRACT FROM AUTHOR]

Obesity bias is one of the main psychosocial consequences experienced by people who are overweight and people with obesity. Therefore, its study, especially during childhood, has become an emerging objective. The aim of this study is to examine obesity bias in children in the school setting. In total, 171 primary school students (Mean age: 10.68; SD: 0.63) from a school in Madrid (Spain) filled out a survey in which they indicated whether they would choose a classmate with obesity with whom they would carry out academic, social, and leisure activities. The rejection ratios of peers with obesity and other personal characteristics such as gender, nationality, or ethnicity were compared. The results indicate that more than half of the participants would not choose a partner with obesity to carry out any of the three activities suggested, and that obesity was the personal characteristic that elicited the highest rate of rejection, especially among females. The possible explanations for these findings are discussed, as well as why the school setting should be a nonaggressive but protective environment for children with obesity. [ABSTRACT FROM AUTHOR]

The increase in children obesity worldwide has been of particular concern in recent decades. Environmental factors have been proposed as contributors to obesity, and there is a growing concern over obesogens, environmental chemicals with potential obesity‐related endocrine‐disrupting properties. In this regard, bisphenol A (BPA) and its analogues are suspected to have obesogenic properties. Current document report on the activities of the fellow, undertaken during the fourth, 2020–2021 cycle of the EU‐FORA programme at the University of Granada, Institute of Nutrition and Food Science, in Spain. The work programme offered by the hosting site was related to the extrapolation of bisphenols exposure following the determination of these compounds in food frequently consumed by children and in their biological samples. The fellow has participated in the recruitment of the study population in the health centres. In addition, she has participated in the collection of the children biological samples, anthropometric measurements and dietary surveys and in the optimisation of the laboratory methodology for the extraction of bisphenols in biological samples. All these activities also provided the fellow an opportunity to develop her data science related skills, which will benefit her professional development. In addition, the fellow gained an overview of various topics related to food safety risk assessment by attending the EU‐FORA dedicated training modules. [ABSTRACT FROM AUTHOR]

This article analyses and compares preventive models for obesity in Spain, Argentina and Brazil through an examination of the respective measures adopted to counter it in those countries. Based on a qualitative study of the main actions carried out since 2004, the aim is to delineate the conceptual framework and reflect on the reasons for their relative effectiveness. The results show that in contexts where prevalence has increased rapidly, sociocultural causes acquire greater explanatory power as opposed to biological and/or behavioral factors. These models premise worsening diets and sedentary lifestyles as being the main culprits, and assume that contemporary societies generate obesogenic and toxic environments. The international health bodies have developed specific strategies to control and prevent obesity based on this diagnosis, and these have been supported by member states such as Spain, Argentina and Brazil. Although the measures reflect certain particularities, they conform to a common pattern organized from platforms promoting so-called "healthy lifestyles" and articulated mainly around the twin axes of a balanced diet and regular physical exercise. The discussion suggests that the excessive emphasis on individual responsibility and the underplaying of the role of food as a complex practice, as well as changing structural factors and the differential distribution of this disease, might largely explain the limited impact of these strategies. [ABSTRACT FROM AUTHOR]

The first article presents a web application called ObMetrics that evaluates obesity and metabolic health in children. The second article reports on the registry of home enteral nutrition in Spain, with a prevalence of 99.04 patients per million inhabitants. The article also presents three studies on the use of nasogastric tubes and gastrostomies in pediatric patients, the incidence of catheter-related bloodstream infections, and the association of phase angle with clinical variables in patients with amyotrophic lateral sclerosis. The third article analyzes the effect of the probiotic Limosilactobacillus fermentum CECT5716 in an experimental model of cancer associated with colitis, showing beneficial effects on tumor development. The second article presents a study on the nutritional status of older patients, finding that almost half were at risk of malnutrition. The third article refers to a study on dietary adherence, functionality, and quality of life in patients with cystic fibrosis, finding that the majority complied with dietary recommendations and that those on modulator treatment had a better quality of life. [Extracted from the article]

Background: Studies have shown that overweight and obesity conditions tend to be stable from childhood and adolescence to adulthood. Unfortunately, little is known about the evolution of abdominal obesity during childhood. The aim of this study was to evaluate the temporal variations and risk of general and abdominal obesity between 4, 6, and 9 years of age.Methods: Measurements of children in the ELOIN study taken at the three follow-ups of 4, 6, and 9 years of age were included (N = 1,902). Body mass index and waist circumference were recorded via physical examination. General obesity was determined according to the criteria of the World Health Organization (WHO) and abdominal obesity according to the cut-off points proposed by the International Diabetes Federation (IDF). Prevalence ratios (PRs) were estimated by sex and family affluence using generalized estimating equation models and relative risks (RRs) of obesity were obtained via Poisson regression.Results: The prevalence of general obesity was 5.1%, 9.1%, and 15.6% at 4, 6, and 9 years, respectively, yielding a PR of 3.05 (95%CI: 2.55-3.60) (9 years old relative to 4 years). The prevalence of abdominal obesity was 6.8%, 8.4%, 14.5% at 4, 6, and 9 years, respectively, and the PR was 2.14 (95%CI: 1.82-2.51) (9 years old relative to 4 years). An inverse correlation was observed between both general and abdominal obesity and socioeconomic status. Among participants with general or abdominal obesity at 4 years of age, 77.3% and 63.6% remained in their obesity classification at 9 years, respectively, and 3.4% and 3.5% presented general or abdominal obesity also at 6 and 9 years of age, respectively. The RRs of general and abdominal obesity at 9 years were 4.61 (95%CI: 2.76-7.72) and 4.14 (95%CI: 2.65-6.48) for children classified with obesity at 4 years of age, increased to 9.36 (95%CI: 7.72-11.35) and 9.56 (95%CI: 7.79-11.74) for children who had obesity at 6 years, and up to 10.27 (95%CI: 8.52-12.37) and 9.88 (95%CI: 8.07-12.11) for children with obesity at both 4 and 6 years, respectively.Conclusions: General and abdominal obesity begin at an early age and increase over time, showing an inverse correlation with socioeconomic status. In addition, general and abdominal obesity at 9 years are strongly associated with being classified with obesity at 4 and 6 years, so preventive interventions should be established at very early ages. [ABSTRACT FROM AUTHOR]

Background and Objective: The aim was assessing a short training for healthcare providers on patient-focused counselling to treat childhood obesity in primary care, along with dietitian-led workshops and educational materials., Methods: Randomized clustered trial conducted with paediatrician-nurse pairs (Basic Care Units [BCU]) in primary care centres from Tarragona (Spain). BCUs were randomized to intervention (MI) (motivational interview, dietitian-led education, and educational materials) or control group (SC, standard care). Participants were 8-14-year-old children with obesity, undergoing 1-11 monthly treatment visits during 1 year at primary care centres. The primary outcome was BMI z-score reduction., Results: The study included 44 clusters (23 MI). Out of 303 allocated children, 201 (n = 106 MI) completed baseline, final visits, and at least one treatment visit and were included in the analysis. BMI z-score reduction was -0.27 (±0.31) in SC, versus -0.36 (±0.35) in MI (p = 0.036). Mixed models with centres as random effects showed greater reductions in BMI in MI than SC; differences were B = -0.11 (95% CI: -0.20, -0.01, p = 0.025) for BMI z-score, and B = -2.06 (95% CI: -3.89, -0.23, p = 0.028) for BMI %. No severe adverse events related to the study were notified., Conclusion: Training primary care professionals on motivational interviewing supported by dietitians and educational materials, enhanced the efficacy of childhood obesity therapy., (© 2024 The Authors. Pediatric Obesity published by John Wiley & Sons Ltd on behalf of World Obesity Federation.)

Objective: To describe the prevalence of obesity and analyse possible differences in it according to sociodemographic characteristics, diet, physical activity, screen use and family perception of the weight and dietary habits of schoolchildren aged 3 to 4 years in Barcelona., Methods: We conducted a cross-sectional study in a representative sample of schools selected based on the socioeconomic status (SES) of the corresponding neighbourhood and school ownership. We selected 101 schools in Barcelona and recruited pupils aged 3 to 4 years during the 2016-17 academic year (n = 2936 children). Anthropometric measurements were taken in each participant. Family members completed a questionnaire on eating habits, physical activity, sleeping hours, screen use and the family's perception of the child's weight and diet. The primary variable was the body mass index (BMI) for age and sex, subsequently categorised as normal weight, overweight or obese., Results: Approximately 7.0% of girls and 7.1% of boys aged 3 to 4 years presented obesity. The prevalence of obesity (8.3%) was higher in neighbourhoods of lower SES compared to those of higher SES (5.2%; p = .004). Parents of children with obesity reported that the child had some excess weight or excess weight in 46.9% of cases, 3.9% indicated the child's weight was appropriate and 0.9% that the child was a little underweight or underweight (p < .001)., Discussion: The prevalence of obesity in children aged 3 to 4 years is high. There are social and geographical inequalities, and obesity was more prevalent in areas of lower SES. A large percentage of the families of children with obesity do not consider that the child's weight is excessive., (Copyright © 2024 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.)

Childhood obesity continues to be a priority health concern in the United States. Faith communities present a viable venue for health promotion programming. The majority of obesity prevention programming focuses on African American populations. Subsequently, insights for obesity prevention programming in Latino faith communities are lacking. This qualitative study aimed to gain insight into Latino church-going parents' perspectives on childhood obesity and faith-based obesity prevention strategies. Participants were Latino church-going parents with children ages 10–18, recruited from predominantly Latino churches in south Texas, United States. Focus groups were conducted with a total of 56 Latino participants from nine churches. Discussions were audio-taped and transcribed verbatim. Inductive content analysis was performed and assisted by NVivo. Participants were aware of the obesity facing their congregations. Parents' affirmation of the physical body being God's Temple supported the development of obesity prevention programs in faith community settings. Participants suggested integration of spiritual and physical health promotion through health sermons, Bible study, Sunday school, nutrition classes and physical activities for both children and adults. In brief, Latino church-going parents were concerned about childhood obesity and perceived the need for developing obesity prevention programs integrating both faith and health promotion. [ABSTRACT FROM AUTHOR]

Childhood obesity is a major public health concern. We wanted to evaluate the effectiveness of a multidisciplinary program based on healthy eating, exercise, cognitive-behavioral therapy, and health education to achieve weight loss and improve metabolic parameters in overweight and obese children. A randomized, controlled clinical trial with long-term follow-up (24 months) was conducted at a community care center in overweight and obese individuals aged 6–12 years. A sample of 108 children was divided into an experimental and a control group receiving a standard care program. The experimental groups received a 12-month interdisciplinary program; the results were evaluated at 4 months, the end of the intervention, and at follow-up 12 months later. Anthropometric and biological marker measurements related to metabolic alterations, dyslipidemia (based on total cholesterol), hyperglycemia, fasting glycaemia, triglycerides, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol in blood were recorded. The intervention had a significant effect (p < 0.001) in terms of decreased body mass index, skinfolds, and waist and arm circumferences. These changes were accompanied by biochemical changes underlying an improvement in metabolic parameters, such as a significant reduction in total cholesterol, low-density lipoprotein-cholesterol, triglycerides, and hyperglycemia and a significant increase in high-density lipoprotein-cholesterol. These effects were still significant for markers of excess weight or obesity in the experimental group 12 months after the end of the intervention, suggesting that an enduring change in healthy lifestyles had been maintained period. This interdisciplinary, nurse-led program helped to reduce childhood and adolescent excess weight and obesity and had long-lasting effects. [ABSTRACT FROM AUTHOR]

Background Both deviations from normal weight, namely, underweight and overweight/obese status, have been inversely associated with psychosocial health in adolescents. This study aimed to examine the relationship between psychosocial health and body mass index (BMI) among adolescents in five European countries, while assessing the effect of sociodemographic variables. Methods A cross-sectional school-based study of adolescents aged 14–17.9 years was conducted in the framework of the European Network for Adolescent Addictive Behavior survey. Self-reported questionnaires from Greece, Iceland, the Netherlands, Romania and Spain were used for the current analysis. Associations between Youth Self-Report (YSR) scales and BMI status were investigated by multiple logistic regression analysis. The effect of sociodemographic variables was also measured. Results Τhe sample consisted of 7005 adolescents aged 14–17.9 years. Borderline/clinical scores on some YSR scales were independently associated with overweight/obesity, specifically total problems (OR = 1.52, 95% CI: 1.18–1.96), internalizing (OR = 1.48, 95% CI: 1.16–1.91), externalizing (OR = 1.36, 95% CI: 1.10–1.68), social (OR = 1.67, 95% CI: 1.19–2.35) and thought problems (OR = 1.62, 95% CI: 1.20–2.20). Among subscales, overweight/obesity specifically correlated with anxiety/depression (OR = 1.83, 95% CI: 1.33–2.51), withdrawal/depression (OR = 1.58, 95% CI: 1.02–2.48) and rule-breaking behavior (OR = 1.55, 95% CI: 1.15–2.08). Underweight was associated with problems on activities (OR = 1.31, 95% CI: 1.01–1.68) and withdrawal/depression (OR = 1.95, 95% CI: 1.27–3.01). Conclusions Lower levels of psychosocial health are associated with both deviations from normal weight. These findings suggest the need for health policies that target health habits and lifestyle, as well as positive attitudes towards the body image, with respect to the different psychosocial characteristics of each body weight status category. [ABSTRACT FROM AUTHOR]

Copyright of Revista Nutrición Clínica y Dietética Hospitalaria is the property of Sociedad Espanola de Dietetica y Ciencias de la Alimentacion and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Eating breakfast is a healthy habit that should be encouraged since childhood. When it provides nutritional quality, it is an important daily meal. The consumption of dairy products, cereals, and fruits at breakfast is associated with healthier dietary patterns, with a beneficial impact on the overall quality of the diet. In Spain, as in many other countries, the proportion of children who eat breakfast daily is very high, decreasing somewhat in adolescence. However, the quality of breakfast leaves room for improvement, with a low proportion of children/adolescents with high nutritional quality breakfasts. Children/adolescents who eat breakfast regularly have a higher intake of various nutrients (especially vitamins and minerals) than those who do not eat breakfast. Although the evidence is not entirely conclusive, numerous studies have shown various benefits when comparing the population that eats breakfast regularly versus those who do not, such as cardiometabolic risk parameters (obesity, diabetes, blood pressure and lipid profile) and cognitive functions. Breakfast should be included in healthy eating plans, since it allows incorporating foods that are difficult to consume in other meals and may contribute to reducing the risk of developing cardiometabolic diseases. In order to promote the intake of a healthy breakfast, it is essential to act on the sociodemographic and cultural factors that influence compliance and quality, such as age, nutritional education (mainly parents and children/adolescents, but also other family members, school mates, friends...), carrying it out as a family, adapting it to the tastes of each population and balancing quality and costs. [ABSTRACT FROM AUTHOR]

Introduction: Introduction: early detection of childhood obesity plays a crucial role in the prevention of diseases during adulthood. At present, the most commonly used screening tool for detecting overweight/obesity in children is the percentile for age of body mass index, although this rate is unable to provide information about fat distribution. An emerging marker of abdominal fat distribution is waist circumference (WC). Objective: the aim of this study was to evaluate the differences between the different diagnostic criteria available to define overweight and obesity in order to establish the optimal WC cut-off values for the Spanish children population. Methods: a cross-sectional study was carried out in 8,241 schoolchildren aged 3 to 12 years from Villanueva de la Cañada (Madrid, Spain). WC (cm), weight (kg) and height (cm) were measured according to the recommendations of the Society for the Advancement of Kineanthropometry (ISAK). The values obtained for the diagnostic criteria (Spanish Orbegozo Foundation (OF), the International Obesity Task Force (IOTF), and the World Health Organization (WHO) were compared using McNemar's test for paired proportions. The kappa coefficient (κ) was used to assess the degree of agreement of the three classifications. We analyzed the validity of body mass index (BMI) and WC using the receiver operating characteristic (ROC) curve analysis. The Youden index was used to determine cut-off values for WC that identify childhood obesity Results: overweight and obesity prevalences were calculated according to the OF, IOTF, and WHO criteria. There was a "substantial" agreement for the overweight and obesity categories between the Spanish criteria and IOTF (κ = 0.636), while agreement was "slight" between the Spanish criteria and those of WHO (κ = 0.198). The estimated cut-off WC criteria ranged from 54.5 to 88.0, varying according to sex and age. Conclusion: the proposed WC cut-off values, stated for the first time in a young Spanish population, are a simple and valid alternative as diagnostic criteria of abdominal obesity. [ABSTRACT FROM AUTHOR]

Introduction: Introduction: moderate to vigorous physical activity, limiting sedentary behaviors, and getting adequate rest are lifestyle factors that help prevent overweight and obesity. However, there are few studies that relate all of these factors to weight status, body composition, and diet quality in school children. Objective: to assess the differences in anthropometric status and diet quality in a group of Spanish schoolchildren, according to their level of adherence to the 24-hour movement guidelines. Methods: a total of 367 schoolchildren aged 7-11 years were studied. Anthropometric, dietary, and movement patterns were collected. Subsequently, they were divided into three groups based on their adherence to the extant guidelines: low adherence (BA), medium adherence (AM) and high adherence (AA). Results: only 15 % of the schoolchildren met the guidelines. The percentage of overweight was higher in the BA group than in the AM and AA groups. The BA group also had a lower fibre intake; a lower contribution to the recommendations for vitamins B6, B12 and C, selenium and magnesium; and a higher intake of saturated fatty acids. The schoolchildren who did not meet screen time recommendations had a higher odds ratio for overweight/obesity (OR = 1.92 (1.10-3.36); p = 0.022). Conclusion: schoolchildren who adhere to 2 or more movement guideline recommendations had less overweight and a diet of better nutritional quality. Non-compliance with the screen time recommendation leads to a higher risk of overweight or obesity. [ABSTRACT FROM AUTHOR]

(1) Background: We aimed to analyze the dimensionality, internal consistency, and structural validity of the Preschool Eating, Lifestyle, and Sleeping Attitudes Scale (PRELSA Scale), which is an instrument that was designed to measure obesogenic behaviors. (2) Methods: We carried out an observational study by means of an online survey. The PRELSA Scale consists of 13 dimensions and 60 items relating to the most common obesogenic behaviors and attitudes. Additionally, we obtained sociodemographic characteristics and concrete habits from the sample. We obtained the responses of 791 parents and caregivers of preschool children between 2 and 6 years of age in Andalusia (southern Spain). We analyzed dimensionality through an Exploratory Factor Analysis (EFA), consistency through Cronbach's Alpha, structural validity through a Confirmatory Factor Analysis (CFA), and measurement invariance with multigroup CFA models. (3) Results: The EFA showed a 14-dimensional structure with 48 items. The internal consistency was acceptable in all dimensions (Cronbach's Alpha range of 0.72 to 0.97). The structure was confirmed in the CFA with good fit indices (CFI and TLI > 0.9 and RMSEA < 0.05). We ensured that the scale had measurement invariance regarding education, income, and marital status. (4) Conclusions: The PRELSA Scale shows promising properties that have the potential to measure obesogenic behaviors in Spain, which could be the basis for future interventions associated with the prevention of childhood obesity in healthcare and educational settings.

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. [ABSTRACT FROM AUTHOR]

Introduction: Introduction: body mass index (BMI) does not allow to discriminate the composition of the different body compartments. The aim of this study was to develop reference values for the fat mass index (FMI) and fat-free mass index (FFMI) in healthy adolescents using anthropometric techniques in order to provide reference standards for daily clinical practice. Methods: a cross-sectional study in 1,040 healthy Caucasian adolescents (470 boys and 570 girls) aged 10.1 to 14.9 years. Weight, height, and skinfold thickness were recorded, and BMI, percentage of total body fat, FMI and FFMI, and FMI and FFMI percentiles were calculated. Results: FFMI and FMI percentiles for healthy adolescents (both sexes) categorized by age are displayed. In boys a significant increase in FFMI is observed, and both the percentage of total body fat and FMI significantly decreased. In contrast, in girls the percentage of body fat mass, FMI, and FFMI significantly increased. Except at 10 years of age, FMI was higher (p < 0.05) in girls at all ages. FFMI was higher (p < 0.05) in boys at all ages. Conclusions: reference values of FMI and FFMI would be a very useful instrument in clinical practice for the diagnosis and, especially, the analysis of body composition changes during the treatment of childhood obesity. [ABSTRACT FROM AUTHOR]

Purpose: The objective of this secondary analysis is to describe the types of commercial complementary foods (CCF) consumed by infants and young children enrolled in the European Childhood Obesity Project (CHOP), to describe the contribution of CCF to dietary energy intakes and to determine factors associated with CCF use over the first 2 years of life. Methods: The CHOP trial is a multicenter intervention trial in Germany, Belgium, Italy, Poland and Spain that tested the effect of varying levels of protein in infant formula on the risk for childhood obesity. Infants were recruited from October 2002 to June 2004. Dietary data on CCF use for this secondary analysis were taken from weighted, 3-day dietary records from 1088 infants at 9 time points over the first 2 years of life. Results: Reported energy intakes from CCF during infancy (4–9 months) was significantly higher (p ≤ 0.002) amongst formula-fed children compared to breastfed children. Sweetened CCF intakes were significantly higher (p ≤ 0.009) amongst formula-fed infants. Female infants were fed significantly less CCF and infant age was strongly associated with daily CCF intakes, peaking at 9 months of age. Infants from families with middle- and high-level of education were fed significantly less quantities of CCF compared to infants with parents with lower education. Sweetened CCF were very common in Spain, Italy and Poland, with over 95% of infants and children fed CCF at 9 and 12 months of age consuming at least one sweetened CCF. At 24 months of age, 68% of the CHOP cohort were still fed CCF. Conclusions: CCF comprised a substantial part of the diets of this cohort of European infants and young children. The proportion of infants being fed sweetened CCF is concerning. More studies on the quality of commercial complementary foods in Europe are warranted, including market surveys on the saturation of the Western European market with sweetened CCF products. [ABSTRACT FROM AUTHOR]

Background: Some studies suggest that children and adolescents with intellectual disability (ID) are at elevated risk of obesity. The objective was to determine the prevalence of and factors associated with overweight and obesity among students attending special education schools in Cantabria, Spain. Methods: Cross‐sectional design. A sample of n = 220 students with intellectual disability attending seven special education schools was selected using convenience sampling. Body mass index was classified into four categories according to the International Obesity Task Force (IOTF) criteria: underweight; normal weight; overweight; obesity. Results: The prevalence of overweight/obesity was 40.9% (95% CI: 34.6–47.5). Obesity was more frequent among females (26.0%) than males (9.8%), with an OR = 3.23 (95% CI: 1.53–6.85). Participants with Down syndrome showed an increased risk of obesity compared to other conditions (p =.005). Conclusions: The prevalence of overweight/obesity among children, adolescents and young adults with intellectual disability was remarkably high, with females in general and students of both sexes with Down syndrome at particularly high risk. [ABSTRACT FROM AUTHOR]

Childhood obesity is a growing problem with a complex aetiology, for which multidisciplinary interventions are required. Our programme describes a novel structured psychosocial family‐based intervention targeting the emotional regulation in childhood obesity, using a train trip metaphor aimed at improving healthy lifestyles for the family. The aims were (a) to describe the feasibility and acceptability of this psychosocial family‐based intervention among children with overweight or obesity in primary care and (b) to examine the effectiveness of the "ENTREN‐F" programme (with family intervention) compared with the "ENTREN" programme (without family intervention) among Spanish children regarding anthropometric variables, physical activity, emotional well‐being, and family functioning. Children were randomly allocated to either ENTREN‐F programme (n = 30) or psychological intervention for children (ENTREN, n = 40), and assessments were carried out over time (T0 baseline vs. T1 post/6‐month vs. T2 6‐month follow‐up). Both parent groups expressed high levels of satisfaction with the interventions. ENTREN‐F resulted in higher adherence to treatment and was more effective in improving z–body mass index, reducing children's anxiety, and increasing family adaptability than the ENTREN programme. There were no significant changes in parents' emotional well‐being and expressed emotion. Both groups improved in the children's emotional well‐being and light physical activity. In summary, this multidisciplinary psychosocial family‐based intervention was succesful. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the association between excess weight and the demand of health services in preschool children compared with healthy weight.Methods: The data come from the Longitudinal Study of Childhood Obesity cohort (1884 4-year-old children, residing in the Madrid region, Spain) who provided information through telephone questionnaire, physical examination and electronic medical records. We defined overweight, general and abdominal obesity based on body mass index, waist circumference and waist-to-height ratio. Using mixed models of multivariable negative binomial regression we calculated the incidence rate ratio (IRR) regarding primary care (PC) doctor visits, drug prescriptions and hospital admissions by weight status at the end of the 2-year follow-up.Results: Childhood general obesity was associated with a higher demand for PC services related to psychological problems (IRR=1.53; 95% CI 1.02 to 2.28) and childhood abdominal obesity, according to waist-to-height ratio, was related to more frequent problems of the musculoskeletal system (IRR=1.27; 95% CI 1.00 to 1.62). Drugs were prescribed more frequently to children falling under all three definitions of excess weight, compared with healthy weight children. No differences in the number of hospital admissions were observed.Conclusions: The demand of health services related to early childhood obesity was small. Nevertheless, obesity was associated with a slightly greater demand for drug prescriptions and for PC doctor visits related to psychological and musculoskeletal problems. [ABSTRACT FROM AUTHOR]

Objective: Pediatric hepatic steatosis is highly prevalent and closely related to type 2 diabetes. This study aimed to determine whether the addition of supervised exercise to a family-based lifestyle and psycho-educational intervention results in greater reduction of percentage of hepatic fat (HF), adiposity, and cardiometabolic risk factors in children with overweight/obesity.Research Design and Methods: The study subjects of this nonrandomized, two-arm, parallel design clinical trial were 116 overweight/obese children (10.6 ± 1.1 years of age, 53.4% girls) living in Vitoria-Gasteiz (Spain). For 22 weeks, they followed either a lifestyle and psycho-education program (control intervention [CInt], N = 57), consisting of two family-based education sessions/month, or the same plus supervised exercise (intensive intervention [II], N = 59) focused mainly on high-intensity aerobic workouts (3 sessions/week, 90 min/session). The primary outcome was the change in percentage of HF (as measured by MRI) between baseline and the end of the intervention period. Secondary outcomes included changes in BMI, fat mass index (FMI), abdominal fat (measured by DEXA), blood pressure, triglycerides, HDL, LDL, γ-glutamyl transferase, glucose, and insulin concentrations.Results: A total of 102 children completed the trial (N = 53 and N = 49 in the CInt and II groups, respectively). Percentage of HF decreased only in the II group (-1.20 ± 0.31% vs. 0.04 ± 0.30%, II and CInt groups, respectively), regardless of baseline value and any change in adiposity (P < 0.01). BMI, FMI, abdominal fat (P ≤ 0.001), and insulin (P < 0.05) were reduced in both groups.Conclusions: Multicomponent intervention programs that include exercise training may help to reduce adiposity, insulin resistance, and hepatic steatosis in overweight/obese children. [ABSTRACT FROM AUTHOR]

Introduction: Introduction: childhood overweight and obesity have increased progressively in the last decades, especially in countries of Southern Europe. Objective: to analyze the association of overweight and obesity childhood in the city of Barcelona according to socioeconomic variables in schoolchildren in third grade primary school. Methods: transversal study. Study population: third grade primary school students in the city of Barcelona in year 2011 (n = 3,624). Body mass index was studied as the dependent variable, and sex, age, social class, parental status, origin, ownership school, neighborhood socioeconomic status of the school and district were studied as independent. Logistic regression models were analyzed, obtaining odds ratio (OR) with 95% confidence intervals (95% CI). Results: the prevalence of overweight and obesity in childhood were 24.5% and 13.8%, respectively. The variables associated with obesity were: boy (OR = 1.26; 95% CI = 1.02-1.57), low socioeconomic status (OR = 1.60; 95% CI = 1.16-2.20), single-parent family (OR = 1.35; 95% CI = 1.03-1.77), immigrant (OR = 1.68; 95% CI = 1.33-2.13) and living in one of the less favored districts of Barcelona. Conclusions: it is evident that social class, origin, family status and the district of residence play an important role in childhood obesity. [ABSTRACT FROM AUTHOR]

Obesity is considered a global epidemic of the twenty-first century by the World Health Organization (WHO). Specifically, the Canary Islands has the highest level of this disease in Europe and 40% of children in Spain are overweight or obese. This increase is a direct result of changes in the lifestyles of the population and its nutrition. Because of this, we have designed an educational program based on motor games, active videogames and virtual learning environments to improve the long-term health of children. This article presents and analyzes the results of a study on the nutritional knowledge and adherence to the Mediterranean diet of 46 obese children aged 6 to 12 years in the Canary Islands who participated in an educational program. The study design was quasi-experimental, with two groups (experimental and control). A long-term longitudinal study (3 years) was carried out. A set of evaluation instruments was used for the different phases. The results show significant improvements between the experimental and control groups in terms of their knowledge of healthy nutrition and their adherence to the Mediterranean diet. As a main conclusion, we emphasize that a gamified educational intervention program supported by ICT helps to motivate and promote improvements in the nutrition of children. [ABSTRACT FROM AUTHOR]

Childhood obesity is one of the most serious public health challenges of our times. Although an important body of experimental evidence highlights the obesogenic potential of endocrine disruptors such as bisphenol A (BPA), the epidemiological evidence remains inconclusive and limited. To assess associations between urinary BPA concentrations and several adiposity measures in peripubertal boys from the Environment and Childhood (INMA) cohort in Granada, Spain. BPA concentrations were determined in spot urine samples from 298 boys aged 9–11, and their weight, height, waist circumference, and percentage body fat mass were measured. Overweight/obesity was defined as BMI z-score ≥85th percentile and abdominal obesity as waist-to-height ratio (WHtR) ≥0.5. Associations were assessed using multivariable linear and logistic regression models. In adjusted models, each natural log-unit increase in urinary BPA concentrations was associated with higher BMI z-score (β = 0.22; 95%CI = 0.03, 0.41) and increased odds of overweight/obesity (OR = 1.46; 95%CI = 1.05, 2.05). Children with higher BPA concentrations had higher WHtR values (β = 0.007; 95%CI = −0.001, 0.015), and BPA was associated with a greater risk of abdominal obesity (OR = 1.45; 95%CI = 1.03, 2.06). No associations were found with % body fat mass. BPA may exert an obesogenic effect in peripubertal boys, potentially increasing the risk of overweight/obesity, especially abdominal obesity. However, these results should be interpreted with caution given the modest sample size and the possibilities of reverse causality and residual confounding by diet and lifestyle patterns. • We assessed associations between BPA and adiposity measures in peripubertal boys. • Urinary BPA concentrations were associated with the risk of overweight/obesity. • BPA concentrations were also associated with abdominal obesity, but not body fat mass. • BPA could exert an obesogenic effect, preferentially targeting abdominal fat. • Prepuberty constitutes a less explored critical window for BPA effects. [ABSTRACT FROM AUTHOR]

The aims of the present study were: i) to examine the associations of total accelerometer-based sedentary time (ST) and specific-domain self-reported ST (i.e., screen-based, educational-based, social-based, and other-based ST) with adiposity and physical fitness in youth; and ii) to analyse the mediation effect of physical activity (PA) on associations. This study was conducted with 415 children (9.1 ± 0.4 years) and 853 adolescents (13.6 ± 1.6 years) in Spain during 2011-2012. Total ST and PA were assessed by accelerometry. Leisure-time spent in twelve sedentary behaviours was self-reported. Adiposity and physical fitness was measured following the ALPHA battery for youth. Total accelerometer-based ST was positively associated with global adiposity score in children, and negatively associated with global physical fitness score in children and adolescents; but relationships were not independent of PA. PA mediated all associations of accelerometer-based and self-reported ST with adiposity or physical fitness in children. Conversely, screen-, educational-, social-, and other-based ST were negatively related to physical fitness in adolescents, independently of PA. These findings give an impetus to developing effective strategies for specifically promoting PA in children and for increasing PA while reducing ST in adolescents in order to produce improvements on adiposity and physical fitness. [ABSTRACT FROM AUTHOR]

Results of community-based childhood obesity intervention programs do not provide strong evidence for their effectiveness. In this study, we evaluated the effect of the Thao-Child Health Program (TCHP), a community-based, multisetting, multistrategy intervention program for healthy weight development and lifestyle choices. In four Catalan cities, a total of 2250 children aged 8 to 10 years were recruited. Two cities were randomly selected for the TCHP intervention, and two cities followed usual health care policy. Children were selected from 41 elementary schools. Weight, height, and waist circumference were measured at baseline and after a mean follow-up of 15 months. Physical activity and adherence to the Mediterranean diet were measured with validated questionnaires. Generalized estimating equations (GEE) models were fitted to determine the intervention's effect on body mass index (BMI) z-score, waist-to-height ratio, Mediterranean diet adherence, and physical activity. Fully adjusted models revealed that the intervention had no significant effect on the BMI z-score, incidence of general and abdominal obesity, Mediterranean diet adherence, and physical activity. Waist-to-height ratio was significantly lower in controls than in the intervention group at follow-up (p < 0.004).Conclusions: The TCHP did not improve weight development, diet quality, and physical activity in the short term. What is Known: • There is inconsistent evidence for the efficacy of school-based childhood obesity prevention programs. • There is little evidence on the efficacy of childhood obesity intervention programs in other settings. What is New: • This paper contributes information about the efficacy of a multisetting and multistrategy Community Based Intervention (CBI) program that uses the municipality as its unit of randomization. • This CBI had no effect on the prevention and treatment of childhood obesity in the short term. [ABSTRACT FROM AUTHOR]

The dominant approaches to public health policy on childhood obesity are based on the neoliberal emphasis of personal choice and individual responsibility. We study adolescents' (N = 81) beliefs about responsibility for childhood obesity as a public health issue, through an innovative participatory method, PlayDecide, organised in two countries: the UK and Spain. There is no evidence of a blanket rejection of individual responsibility, rather, a call for renegotiation of the values that inform adolescents' food choices. The findings suggest the need to broaden the framing of obesity-related policy to go beyond the nutritional paradigm and include other values that signal health. [ABSTRACT FROM AUTHOR]

Introduction: the recent economic and financial crisis has affected most Western countries, especially families of low socioeconomic classes. We speculate that worsening of socioeconomic condition associated with the crisis would increase obesity, mainly in disadvantaged families.Material and Methods: cross-sectional study of the 290,111 children aged three to 12 years old attending public school during the term 2014-2015 in Madrid City, by means of a stratified weighted sample randomly chosen, taking into account age (grade), city district and schools. The questionnaire included weight and height (auto-reported), dietary report (weekly frequency of intake), as well as socioeconomic variables.Results: 1,208 questionnaires were evaluated from 64 classes. Half of participants were boys; 42% were younger than five years old, 35% werebetween six and eight years old, and 23% older than eight. Undernutrition was present in 5.0%, and excess of weight (overweight + obesity) in 36.7%. Undernutrition was higher in children under the age of six (9.1%). No relationship was found between undernutrition and the characteristics of the families but was slightly higher in families where both parents were unemployed. Excess of weight was higher in children of non-Spaniard parents (44% vs 32%, p < 0.0001), as well as in those families with economic problems (41% vs 31%, p = 0.0005). Only for meat, grains and dairy, the weekly intake was close to the recommendations.Conclusions: children from lower income households were at a higher risk of being overweight compared with their peers. Participation in a school-based food aid program may reduce food insecurity for children and their families. [ABSTRACT FROM AUTHOR]

Background: Differences in obesity prevalence among vulnerable groups exist in childhood but it remains unclear whether these differences may be partly determined by socioeconomic status (SES), parental body mass index (BMI) and early life risk factors. We aimed to explore (i) longitudinal associations between belonging to a minority group and being overweight/obese at age 2, 4 and 6 and (ii) associations between accumulation of social vulnerabilities and being overweight/obese at age 6. Methods: In total, 1031 children (53.8% boys) were evaluated at birth and re-examined during a 6-year follow-up in a representative cohort of Aragon (Spain). Children from minority (vulnerable) groups included Spanish Roma/gypsies, Eastern Europeans, Latin Americans and Africans. Two more vulnerable groups were defined at baseline as children whose parents reported low occupation and education. Ethnicity, SES and parental BMI were collected via interviews. We used logistic mixed-effects models and adjusted for parental BMI, SES, mother's tobacco use, maternal weight gain, birth weight, infant weight gain and breastfeeding practices. Results: Regardless of confounders, Roma/gypsy children (OR = 4.63;[1.69-12.70]95%CI) and with Latin American background (OR = 3.04;[1.59-5.82]95%CI) were more likely to be overweight/obese at age 6 compared with non-gypsy Spanish group. Children with three vulnerabilities (OR = 2.18;[1.31-3.64]95%CI) were more likely to be overweight/obese at age 6 compared with children with no vulnerabilities. No associations were found between belonging to a minority group and overweight/obesity in children under 6. Conclusion: Interventions should target Roma/gypsy children, Latin American children and those who accumulate more vulnerabilities as they are at higher risk of being overweight/obese at age 6. [ABSTRACT FROM AUTHOR]