Search

This work was funded by the French National Cancer Institute (grant number 2015-166). Mathilde His' work reported here was undertaken during the tenure of a postdoctoral fellowship awarded by the International Agency for Research on Cancer, financed by the Fondation ARC. The coordination of EPIC is financially supported by International Agency for Research on Cancer (IARC) and also by the Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, which has additional infrastructure support provided by the NIHR Imperial Biomedical Research Centre (BRC). The national cohorts are supported by Danish Cancer Society (Denmark); Ligue Contre le Cancer, Institut Gustave Roussy, Mutuelle Generale de l'Education Nationale, Institut National de la Sante et de la Recherche Medicale (INSERM) (France); German Cancer Aid, German Cancer Research Center (DKFZ), German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Federal Ministry of Education and Research (BMBF) (Germany); Associazione Italiana per la Ricerca sul Cancro-AIRC-Italy, Compagnia di SanPaolo and National Research Council (Italy); Dutch Ministry of Public Health, Welfare and Sports (VWS), LK Research Funds, Dutch Prevention Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF) (The Netherlands); Health Research Fund (FIS) - Instituto de Salud Carlos III (ISCIII), Regional Governments of Andalucia, Asturias, Basque Country, Murcia and Navarra, and the Catalan Institute of Oncology-ICO (Spain); Swedish Cancer Society, Swedish Research Council and County Councils of Skane and Vasterbotten (Sweden); and Cancer Research UK (14136 to EPIC-Norfolk (DOI 10.22025/2019.10.105.00004); C8221/A29017 to EPIC-Oxford), Medical Research Council (1000143, MR/N003284/1, MC-UU_12015/1 and MC_UU_00006/1 to EPIC-Norfolk; MR/M012190/1 to EPIC-Oxford) (UK). The funders were not involved in designing the study; collecting, analyzing, or interpreting the data; or writing or submitting the manuscript for publication., Background: Metabolomics is a promising molecular tool for identifying novel etiological pathways leading to cancer. In an earlier prospective study among pre- and postmenopausal women not using exogenous hormones, we observed a higher risk of breast cancer associated with higher blood concentrations of one metabolite (acetylcarnitine) and a lower risk associated with higher blood concentrations of seven others (arginine, asparagine, phosphatidylcholines (PCs) aa C36:3, ae C34:2, ae C36:2, ae C36:3, and ae C38:2). Methods: To identify determinants of these breast cancer-related metabolites, we conducted a cross-sectional analysis to identify their lifestyle and anthropometric correlates in 2358 women, who were previously included as controls in case-control studies nested within the European Prospective Investigation into Cancer and Nutrition cohort and not using exogenous hormones at blood collection. Associations of each metabolite concentration with 42 variables were assessed using linear regression models in a discovery set of 1572 participants. Significant associations were evaluated in a validation set (n = 786). Results: For the metabolites previously associated with a lower risk of breast cancer, concentrations of PCs ae C34: 2, C36:2, C36:3, and C38:2 were negatively associated with adiposity and positively associated with total and saturated fat intakes. PC ae C36:2 was also negatively associated with alcohol consumption and positively associated with two scores reflecting adherence to a healthy lifestyle. Asparagine concentration was negatively associated with adiposity. Arginine and PC aa C36:3 concentrations were not associated to any of the factors examined. For the metabolite previously associated with a higher risk of breast cancer, acetylcarnitine, a positive association with age was observed. Conclusions: These associations may indicate possible mechanisms underlying associations between lifestyle and anthropometric factors, and risk of breast cancer. Further research is needed to identify potential non-lifestyle correlates of the metabolites investigated., Institut National du Cancer (INCA) France 2015-166, International Agency for Research on Cancer - Fondation ARC, World Health Organization, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, Danish Cancer Society, Ligue Contre le Cancer (France), Institut Gustave Roussy (France), Mutuelle Generale de l'Education Nationale (France), Institut National de la Sante et de la Recherche Medicale (Inserm), Deutsche Krebshilfe, German Cancer Research Center (DKFZ) (Germany), German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE) (Germany), Federal Ministry of Education & Research (BMBF), Fondazione AIRC per la ricerca sul cancro, Compagnia di San Paolo, Consiglio Nazionale delle Ricerche (CNR), Netherlands Government, World Cancer Research Fund International (WCRF), Health Research Fund (FIS) - Instituto de Salud Carlos III (ISCIII) (Spain), Junta de Andalucia, Regional Government of Asturias (Spain), Regional Government of Basque Country (Spain), Regional Government of Murcia (Spain), Regional Government of Navarra (Spain), Catalan Institute of Oncology-ICO (Spain), Swedish Cancer Society, Swedish Research Council, County Council of Skane (Sweden), County Council of Vasterbotten (Sweden), Cancer Research UK 14136 C8221/A29017, UK Research & Innovation (UKRI), Medical Research Council UK (MRC) 1000143 MR/N003284/1 MC-UU_12015/1 MC_UU_00006/1 MR/M012190/1

Hypertension; Therapeutics; Weight management Hipertensió; Terapèutica; Gestió del pes Hipertensión; Terapéutica; Control de peso Hypertension is a common chronic medical condition. Treatment is not satisfactory in a significant proportion of patients with primary hypertension, despite the concurrent use of three or more medications with different mechanisms of action. Such treatment-resistant hypertension is a clinical challenge associated with poor prognosis and needs further investigation. The efficacy of lifestyle changes has not been established yet in patients with resistant hypertension, and educational efforts appear clinically irrelevant in patients who must achieve behavioral changes without supervision. A 6-month multidisciplinary pilot intervention enrolled 50 patients with established resistant hypertension. The aims were: (1) to examine whether intensive and supervised lifestyle changes contribute to decreasing blood pressure in this condition, and (2) to identify which components affect compliance and feasibility. The program provided intensive changes in nutrition, physical exercise, and control of sleep disturbances supervised by nutritionists, physiotherapists, and psychologists. Nurses and pharmacists followed up on adherence to the antihypertensive medication. The primary outcome was 24 h blood pressure control. Data in patients with full compliance (n = 30) indicate that lifestyle modifications in resistant hypertension significantly reduced 24 h both systolic and diastolic blood pressure (p < 0.01), body mass index (p < 0.01), medication burden (p = 0.04), improving physical fitness, and cardiovascular risk markers such as heart rate (p = 0.01) and augmentation index (p = 0.02). The adherence to the intervention was moderate, with an attrition rate of 12%. A modified version reducing visits and explorations will likely improve compliance and can be used to assess the long-term maintenance of these benefits in managing resistant hypertension by diverse healthcare providers. The program against Resistant Hypertension was supported, in part, by the Hospital Vall d’Hebron, the Menarini Foundation, and the Instituto de Salud Carlos III grant (PI21/00510) co-funded by the Fondo Europeo de Desarrollo Regional. H.C. is a recipient of a fellowship of the Department of Health of Catalonia (Government of Catalonia) “Pla Estratègic de Recerca i Innovació en Salut” (PERIS-SLT017/3501/2020).

Background This study investigated the association between xerostomia and health risk behaviours, general and oral health and quality of life. Methods A cross-sectional study involving 800 adults over 65 years of age residing in Spain using a computer-assisted telephone questionnaire. The severity of xerostomia was assessed through the Xerostomia Inventory (XI). Both univariate and adjusted multinomial logistic regression were used to determine the risk (OR) of xerostomia. Results The sample comprised of 492 females (61.5%) and 308 males, with a mean age of 73.7 ± 5.8 years. Some, 30.7% had xerostomia: 25.6% mild, 4.8% moderate and 0.3% severe, the majority being female (34.8% vs 24%; p = 0.003). The mean XI was 24.6 ± 6.3 (95% CI 19.2–24.8) for those with poor health, whereas it was 17.4 ± 6.3 (95%CI 16.1–18.6) in those reporting very good health (p p = 0.002). Logistic regression showed that the highest OR for xerostomia was observed among adults with poor general health (2.81; 95%CI 1.8–4.3; p p = 0.001). Those who needed help with household chores had 2.16 higher OR (95%CI 1.4–3.4; p = 0.001) and 1.69 (95%CI 1.1–2.7; p = 0.03) in the adjusted model. Females had a higher risk of suffering from xerostomia than males. Conclusion The strong association between xerostomia and the general and oral health status of older adults justifies the need for early assessment and regular follow-up.

There is currently no treatment for early/intermediate Age-related Macular Degeneration (AMD) but Eye Care Professionals (ECPs) are recommended to advise patients about modifiable lifestyle factors, including dietary changes, that can slow disease progression. The aim of this review was to understand advice currently given to patients with AMD by ECPs and to evaluate evidence regarding patient compliance. A systematic review was conducted of literature published in electronic databases: CINAHL, MEDLINE, PsycINFO, PyscARTICLES, EMBASE, AMED. Methods followed PRISMA guidelines (PROSPERO registration number: CRD42020223724). Twenty-four reports were eligible for inclusion, 12 focused on ECP experience, 7 on patient experience, and 6 on impact of advice (one paper reported on the ECP and patient experience). Studies reported that a substantial proportion of patients did not recall receiving lifestyle modification advice from their ECP (57.95%, range 2–95% across patient based studies). Practitioners were most likely to provide advice about nutritional supplements (80%, range 67–93% across ECP studies), and least likely about smoking (44%, range 28–71% across ECP studies), however supplements advised did not always comply with evidence-based guidelines. The main reason for patients not following lifestyle advice was lack of provision by the ECP (54.5%, range 21–94% across studies on the impact of advice). The review highlighted a need for more studies to understand patient preferences for receiving advice and research on ECP perceived barriers to advice provision. S.D. is funded by The Macular Society

Background Fetal growth restriction (FGR) affects 7–10% of all pregnancies resulting in a higher risk of perinatal morbidity and mortality, long-term disabilities, and cognitive impairment. Due to its multifactorial etiology, changes in maternal lifestyle, including suboptimal maternal diet and stress, have increasingly been associated with its prevalence. We present a protocol for the Improving Mothers for a better PrenAtal Care Trial Barcelona (IMPACT BCN), which evaluates two different maternal lifestyle strategies (improved nutrition by promoting Mediterranean diet and stress reduction program based on mindfulness techniques) on perinatal outcomes. The primary objective is to reduce the prevalence of FGR. Secondary aims are to reduce adverse perinatal outcomes and to improve neurodevelopment and cardiovascular profile in children at 2 years of age. Methods A randomized parallel, open-blind, single-center trial following a 1:1:1 ratio will select and randomize high-risk singleton pregnancies for FGR (N=1218), according to the criteria of the Royal College of Obstetricians and Gynaecologists (19.0–23.6 weeks’ gestation), into three arms: Mediterranean diet, mindfulness-based stress reduction program, and usual care without any intervention. Compliance to the interventions will be randomly tested in 30% of participants with specific biomarkers. Maternal socio-demographic, clinical data, biological samples, and lifestyle questionnaires will be collected at enrollment and at the end of the interventions (34.0–36.6 weeks’ gestation), together with a fetoplacental ultrasound and magnetic resonance. Fetoplacental biological samples and perinatal outcomes will be recorded at delivery. Postnatal follow-up is planned up to 2 years of corrected age including neurodevelopmental tests and cardiovascular assessment. Intention-to-treat and population per-protocol analysis will be performed. Discussion This is the first randomized study evaluating the impact of maternal lifestyle interventions during pregnancy on perinatal outcomes. The maternal lifestyle interventions (Mediterranean diet and mindfulness-based stress reduction program) are supported by scientific evidence, and their compliance will be evaluated with several biomarkers. Trial registration ClinicalTrials.govNCT03166332. Registered on April 19, 2017

[spa] La obesidad es una enfermedad crónica y un problema de salud pública, producido por un desequilibrio entre la ingesta y el gasto de energía. La prevalencia de la obesidad en todo el mundo se ha duplicado desde 1980, llegando a 650 millones de personas obesas en 2016, y las estimaciones futuras siguen una tendencia similar. Las principales causas de esta epidemia son las conductas alimentarias poco saludables, el aumento de los hábitos sedentarios y, lo más importante, la combinación de ambos. Aunque la obesidad está clasificada por la OMS como un factor de riesgo de enfermedades no transmisibles, su patrón de transmisión comparte rasgos comunes con las enfermedades contagiosas. Además, la obesidad sigue un patrón de agregación, que podría atribuirse en parte a la agrupación natural entre personas previamente obesas al compartir afinidades y moverse en un entorno obesogénico La Dieta Mediterránea no es solamente un tipo de dieta, es un patrón alimentario incluido en un estilo de vida donde se recogen costumbres, alimentos y formas de cocinar característicos en la zona del Mediterráneo. Todo este conjunto representa una serie de beneficios para la salud y concretamente para prevenir y combatir la obesidad. Estudios de intervención intensiva con pérdida de peso, apoyados con educación nutricional, actividad física y terapia conductual pueden ayudar a remitir la obesidad que presentan los individuos, y asimismo provocar un efecto “Halo” en su entorno más cercano y en su red social También es necesaria la validación de herramientas que nos ayuden a cuantificar la adherencia a la Dieta Mediterránea con restricción de energía y poder asociar esta adherencia con una mejoría en los parámetros de salud., [eng] Obesity is a chronic disease and a growing public health problem, caused by an imbalance between energy intake and expenditure. The prevalence of obesity worldwide has doubled since 1980, reaching 650 million obese people in 2016, and future estimates follow a similar trend. The main causes of this epidemic are unhealthy eating behaviors, the increase in sedentary habits and, most importantly, the combination of both. Although obesity is classified by the WHO as a risk factor for non-communicable diseases, its transmission pattern shares common features with contagious diseases. Obesity follows an aggregation pattern, which means that if a person suffers from obesity, their immediate environment is more likely to be obesogenic. Such aggregation could be attributed in part to natural grouping among previously obese people who share affinities. The Mediterranean Diet is not just a type of diet, it is an eating pattern included in a lifestyle where customs, foods and ways of cooking characteristic of the Mediterranean area are collected. All this set represents a series of health benefits and specifically serve to prevent and combat obesity. Intensive intervention studies with weight loss, supported by nutritional education, physical activity and behavioral therapy can help reduce the obesity that individuals present, but can also cause a “Halo” effect in their closest environment and ultimately in their social network. It is also necessary to validate tools that help us to quantify adherence to the energy- restricted Mediterranean Diet and to be able to associate this adherence with an improvement in health parameters.

Background Cardiac rehabilitation after acute myocardial infarction permits recovery of the heart function and enables secondary prevention programs in which changes in lifestyle habits are crucial. Cardiac rehabilitation often takes place in hospitals without coordination with primary healthcare and is not focused on individual patient preferences and goals, which is the core of the motivational interview. The objective of this study was to evaluate the efficacy of a cardiac rehabilitation program with a motivational interview in patients discharged from hospital after acute myocardial infarction. Methods/design A randomized, non-pharmacological clinical trial in six primary healthcare centers in Barcelona (Spain) will assess whether a tailored cardiac rehabilitation program consisting of four motivational interviews and visits with family physicians, primary healthcare nurses and a cardiologist, coordinated with the reference hospital, results in better cardiac rehabilitation than standard care. A minimum sample of 284 participants requiring cardiac rehabilitation after acute myocardial infarction will be randomized to a cardiac rehabilitation group with a motivational interview program or to standard primary healthcare. The main outcome will be physical function measured by the six-minute walk test, and the secondary outcome will be the effectiveness of secondary prevention: a composite outcome comprising control of blood pressure, cholesterol, diabetes mellitus, smoking and body weight. Results will be evaluated at 1,3 and 6 months. Discussion This is the first clinical trial to study the impact of a new primary healthcare cardiac rehabilitation program with motivational interviews for patients discharged from hospital after myocardial infarction. Changes in lifestyles and habits after myocardial infarction are a core element of secondary prevention and require patient-centered care strategies such as motivational interviews. Therefore, this study could clarify the impact of this approach on health indicators, such as functional capacity. Trial registration ClinicalTriasl.gov NCT05285969 registered on March 18, 2022.

Background: Nutrition and lifestyle have been long established as risk factors for colorectal cancer (CRC). Modifiable lifestyle behaviours bear potential to minimize long-term CRC risk; however, translation of lifestyle information into individualized CRC risk assessment has not been implemented. Lifestyle-based risk models may aid the identification of high-risk individuals, guide referral to screening and motivate behaviour change. We therefore developed and validated a lifestyle-based CRC risk prediction algorithm in an asymptomatic European population. Methods: The model was based on data from 255,482 participants in the European Prospective Investigation into Cancer and Nutrition (EPIC) study aged 19 to 70 years who were free of cancer at study baseline (1992–2000) and were followed up to 31 September 2010. The model was validated in a sample comprising 74,403 participants selected among five EPIC centres. Over a median follow-up time of 15 years, there were 3645 and 981 colorectal cancer cases in the derivation and validation samples, respectively. Variable selection algorithms in Cox proportional hazard regression and random survival forest (RSF) were used to identify the best predictors among plausible predictor variables. Measures of discrimination and calibration were calculated in derivation and validation samples. To facilitate model communication, a nomogram and a web-based application were developed. Results: The final selection model included age, waist circumference, height, smoking, alcohol consumption, physical activity, vegetables, dairy products, processed meat, and sugar and confectionary. The risk score demonstrated good discrimination overall and in sex-specific models. Harrell’s C-index was 0.710 in the derivation cohort and 0.714 in the validation cohort. The model was well calibrated and showed strong agreement between predicted and observed risk. Random survival forest analysis suggested high model robustness. Beyond age, lifestyle data led to improved model performance overall (continuous net reclassification improvement = 0.307 (95% CI 0.264–0.352)), and especially for young individuals below 45 years (continuous net reclassification improvement = 0.364 (95% CI 0.084–0.575)). Conclusions: LiFeCRC score based on age and lifestyle data accurately identifies individuals at risk for incident colorectal cancer in European populations and could contribute to improved prevention through motivating lifestyle change at an individual level., German Research Foundation (DFG) AL 1784/3-1, European Commission European Commission Joint Research Centre, International Agency for Research on Cancer, Danish Cancer Society, Ligue Contre le Cancer (France), Institut Gustave Roussy (France), Mutuelle Generale de l'Education Nationale (France), Institut National de la Sante et de la Recherche Medicale (Inserm), Deutsche Krebshilfe, Deutsches Krebsforschungszentrum (DKFZ) (Germany), Federal Ministry of Education & Research (BMBF), Hellenic Health Foundation (Greece), Associazione Italiana per la Ricerca sul Cancro (AIRC), Consiglio Nazionale delle Ricerche (CNR), Netherlands Government, World Cancer Research Fund International (WCRF), Instituto de Salud Carlos III PI13/00061 PI13/01162, Junta de Andalucia, Regional Government of Asturias (Spain), Regional Government of Basque Country (Spain), Regional Government of Murcia (Spain) 6236, Regional Government of Navarra (Spain), Regional Government of Catalonia (Catalan Institute of Oncology -ICO-IDIBELL) (Spain), Swedish Cancer Society, Swedish Research Council, County Council of Skane (Sweden), County Council of Vasterbotten (Sweden), Cancer Research UK C864/A14136 C8221/A19170, UK Research & Innovation (UKRI) Medical Research Council UK (MRC) MR/N003284/1 MC-UU_12015/1 MR/M012190/1, Projekt DEAL

Objective: To evaluate the effect of Non-alcoholic fatty liver disease (NAFLD) status in the impact of lifestyle over Health-related quality of life (HRQoL) in patients with metabolic syndrome (MetS). Methods: Baseline and 1 year follow up data from the PREDIMED-plus cohort (men and women, 55-75 years old with overweight/obesity and MetS) were studied. Adherence to an energy-restricted Mediterranean Diet (er-MeDiet) and Physical Activity (PA) were assessed with a validated screeners. Hepatic steatosis index (HSI) was implemented to evaluate NAFLD while the SF-36 questionnaire provided HRQoL evaluation. Statistical analyses were performed to evaluate the influence of baseline NAFLD on HRQoL as affected by lifestyle during 1 year of follow up. Results: Data from 5205 patients with mean age of 65 years and a 48% of female participants. Adjusted linear multivariate mixed regression models showed that patients with lower probability of NAFLD (HSI < 36 points) were more responsive to er-MeDiet (b 0.64 vs b 0.05 per er-MeDiet adherence point, p< 0.01) and PA (b 0.05 vs b 0.01 per MET-h/week, p = 0.001) than those with high probability for NAFLD in terms Physical SF- 36 summary in the 1 year follow up. 10 points of er-MeDiet adherence and 50 MET-h/ week were thresholds for a beneficial effect of lifestyle on HRQoL physical domain in patients with lower probability of NAFLD. Conclusion: The evaluation of NAFLD by the HSI index in patients with MetS might identify subjects with different prospective sensitivity to lifestyle changes in terms of physical HRQoL (http://www.isrctn.com/ISRCTN89898870)., CIBER Fisiopatologia de la Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III (ISCIII) through the Fondo de Investigacion para la Salud (FIS), European Commission PI13/00673 PI13/00492 PI13/00272 PI13/01123 PI13/00462 PI13/00233 PI13/02184 PI13/00728 PI13/01090 PI13/01056 PI14/01722 PI14/00636 PI14/00618 PI14/00696 PI14/01206 PI14/01919 PI14/00853 PI14/01374 PI14/00972 PI14/00728 PI14/01471 PI16/00473 PI16/00662 PI16/01873 PI16/01094 PI16/00501 PI16/00533 PI16/00381 PI16/00366 PI16/01522 PI16/01120 PI17/00764 PI17/01183 PI17/00855 PI17/01347 PI17/00525 PI17/01827 PI17/00532 PI17/00215 PI17/01441 PI17/00508 PI17/01732 PI17/00926 PI19/00957 PI19/00386 PI19/00309 PI19/01032 PI19/00576 PI19/00017 PI19/01226 PI19/00781 PI19/01560 PI19/01332 PI20/01802 PI20/00138 PI20/01532 PI20/00456 PI20/00339 PI20/00557 PI20/00886 PI20/01158, Special Action Project "Implementacion y evaluacion de una intervencion intensiva sobre la actividad fisica Cohorte PREDIMED-Plus", La Caixa Foundation 2013ACUP00194, Junta de Andalucia PI0458/2013 PS0358/2016 PI0137/2018, SEMERGEN grant, Department of Health of the Government of Navarra 61/201, Fundacio La Marato de TV 201630.10, European Research Council (ERC) European Commission 340918, Ministerio de Ciencia e Investigacion RTI2018-095569-B-I00 PCI2018-093009 35/2011

La hipertensió arterial és una malaltia crònica no transmissible amb una alta incidència a nivell mundial, que afecta 9 de cada 100 colombians, sent una de les malalties circulatòries de més prevalença. Controlar la pressió arterial és fonamental, per disminuir el risc de malalties cardiocervell vasculars, renals, entre d’altres. Això es fa amb l’adherència del pacient al tractament farmacològic i no farmacològic. No obstant això, la disminució de l’adherència ha cobrat especial interès, i és considerat un problema de salut pública, per les implicacions que té sobre el control i la prevenció de les malalties. Són diversos els factors que poden incidir en l’adherència terapèutica, la qual requereix un acord conjunt professional de la salut/equip de salut – pacient. Les creences del pacient enfront de la malaltia, els medicaments, les recomanacions, així com la disposició a modificar el seu estil de vida, són claus en l’estudi i la comprensió dels factors que incideixen en l’adherència. Objectiu: Establir l’índex o el grau d’adherència al tractament farmacològic i no farmacològic per al maneig de la hipertensió arterial i la seva relació amb l’estil de vida i creences en pacients del règim subsidiat al Districte de Barranquilla - Colòmbia. Participants i mètodes: es va realitzar un estudi descriptiu, analític de tall transversal, mitjançant l’aplicació de dos qüestionaris colombians el CAT-HTA de Varela i el qüestionari d’avaluació de l’adherència versió 3 de Bonilla, els quals van permetre avaluar els factors que influïen en l’adherència als tractaments farmacològics i no farmacològics, així com l’adherència global o índex de compliment i l’estil de vida i creences en salut. La mostra de l’estudi va estar conformada per 400 individus, que pertanyen a un marc mostral de 3748 pacients d’un programa de risc cardiovascular del règim subsidiat a Barranquilla Colòmbia, on el 76% dels participants van ser del sexe femení, amb una edat mitjana de 63.52 anys, i un temps devolució de 9.59 anys de mitjana. A les dades recollides se’ls va realitzar una anàlisi univariada i bivariada amb el programari STATGRAPHIC Centurió 18 i l’estadística R. El qual va incloure anàlisi estadística descriptiva i inferencial amb comprovació d’hipòtesis utilitzant el Chi quadrat, la prova t-student, la prova t la correcció de Welch, ANOVA i Kruskal Wallis. També realitzo un model de regressió logística i càlcul de l’Ods Ratio. Resultats: El grau d’adherència global als tractaments farmacològics i no farmacològics segons Varela va ser del 32% i segons Bonilla, l’índex d’adherència es va distribuir 55% en avantatge d’adherència, 32% en risc de no adherència i 13% no era adherent. No es va evidenciar significància estadística entre les característiques sociodemogràfiques i el grau d’adherència. Amb relació a les dimensions de l’adherència és idèntic que les relacionades amb factors socioeconòmics i del proveïdor, sistemes i equips de salut presentaven mitjanes inferiors als grups de risc d’adherència i no adherent. Els estils de vida i les creences tenen un impacte protector en aquells pacients que segueixen les recomanacions, contribuint a complir l’adherència farmacològica i no farmacològica. Discussió i conclusió: l’índex o grau d’adherència a la població d’estudi no van ser òptims. Els estils de vida i les creences en salut poden influir en l’índex o l’adherència global al tractament farmacològic i no farmacològic dels pacients amb HTA. La comprensió i el maneig d’aquestes variables per part del personal de salut pot ajudar a enfortir els programes de seguiment, abordant primerencament els dubtes i les inquietuds que els tractaments puguin generar en els pacients hipertensos. La hipertensión arterial es una enfermedad crónica no trasmisible con una alta incidencia a nivel mundial, que afecta a 9 de cada 100 colombianos, siendo una de las enfermedades circulatorias de mayor prevalencia. Controlar la presión arterial es fundamental, para disminuir el riesgo de enfermedades cardio cerebro vasculares, renales, entre otras. Esto se logra con la adherencia del paciente al tratamiento farmacológico y no farmacológico. Sin embargo, la disminución de la adherencia ha cobrado especial interés, siendo considerado un problema de salud pública, por las implicaciones que tiene sobre el control y prevención de las enfermedades. Son diversos los factores que pueden incidir en la adherencia terapéutica, la cual requiere un acuerdo conjunto profesional de la salud/equipo de salud - paciente. Las creencias del paciente frente a la enfermedad, los medicamentos, las recomendaciones, asi como, la disposición a modificar su estilo de vida, son claves en el estudio y comprensión de los factores que inciden en la adherencia. Objetivo: Establecer el índice o grado de adherencia al tratamiento farmacológico y no farmacológico para el manejo de la hipertensión arterial y su relación con el estilo de vida y creencias en pacientes del régimen subsidiado en el Distrito de Barranquilla - Colombia. Participantes y métodos: se realizó un estudio descriptivo, analítico de corte transversal, a través de la aplicación de dos cuestionarios colombianos el CAT-HTA de Varela y el cuestionario de evaluación de la adherencia versión 3 de Bonilla, los cuales permitieron evaluar los factores que influían en la adherencia a los tratamientos farmacológicos y no farmacológicos, asi como, la adherencia global o índice de cumplimiento y el estilo de vida y creencias en salud. La muestra del estudio estuvo conformada por 400 individuos, pertenecientes a un marco muestral de 3748 pacientes de un programa de riesgo cardiovascular del régimen subsidiado en Barranquilla Colombia, donde el 76% de los participantes fueron del sexo femenino, con una edad promedio de 63.52 años, y un tiempo de evolución de 9.59 años en promedio. A los datos recolectados se les realizo un análisis univariado y bivariado con el software STATGRAPHIC Centurión 18 y el estadístico R. El cual incluyó análisis estadístico descriptivo e inferencial con comprobación de hipótesis utilizando el Chi cuadrado, la prueba t-student, la prueba t con la corrección de Welch, ANOVA y Kruskal Wallis. También realizo un modelo de regresión logística y cálculo del Odds Ratio. Resultados: El grado de adherencia global a los tratamientos farmacológicos y no farmacológicos según Varela fue del 32% y según Bonilla el índice de adherencia se distribuyó 55% en ventaja de adherencia, 32% en riesgo de no adherencia y 13% no era adherente. No se evidencio significancia estadística entre las características sociodemográficas y el grado de adherencia. Con relación a las dimensiones de la adherencia se idéntico que la relacionadas con factores socioeconómicos y del proveedor, sistemas y equipos de salud presentaban promedios inferiores en los grupos de en riesgo de adherencia y no adherente. Los estilos de vida y las creencias tienen un impacto protector en aquellos pacientes que siguen las recomendaciones, contribuyendo a cumplir con la adherencia farmacológica y no farmacológica. Discusión y conclusión: el índice o grado de adherencia en la poblacion de estudio no fueron óptimos. Los estilos de vida y las creencias en salud pueden influir en el índice o adherencia global al tratamiento farmacológico y no farmacológico de los pacientes con HTA. La comprensión y el manejo de estas variables por parte del personal de salud, puede ayudar a fortalecer los programas de seguimiento, abordando tempranamente las dudas e inquietudes que los tratamientos puedan generar en los pacientes hipertensos. Arterial hypertension is a chronic non-communicable disease with a high incidence worldwide, affecting 9 out of 100 Colombians, being one of the most prevalent circulatory diseases. Controlling blood pressure is essential to reduce the risk of cardiovascular, cerebrovascular, renal diseases, among others. This is achieved with the patient’s adherence to pharmacological and non-pharmacological treatment. However, the decrease in adherence has gained special interest, being considered a public health problem, due to the implications it has on the control and prevention of diseases. There are several factors that can influence therapeutic adherence, which requires a joint agreement between the health professional/health team and the patient. The patient’s beliefs about the disease, the medications, the recommendations, as well as the willingness to modify their lifestyle, are key in the study and understanding of the factors that affect adherence. Objective: To establish the index or degree of adherence to pharmacological and non-pharmacological treatment for the management of arterial hypertension and its relationship with lifestyle and beliefs in patients of the subsidized regimen in the District of Barranquilla - Colombia. Participants and methods: the study was descriptive analytical cross-sectional, with the application of two Colombian questionnaires, the CAT-HTA of Varela and the adherence evaluation questionnaire version 3 of Bonilla, which allowed evaluating the factors that influenced adherence to pharmacological and non-pharmacological treatments, as well as global adherence or compliance index and the lifestyle and health beliefs of the study sample, which consisted of 400 individuals, belonging to a sample frame of 3748 patients of a program of cardiovascular risk of the subsidized regimen in Barranquilla Colombia, where 76% of the participants were female, with an average age of 63.52 years, and an average evolution time of 9.59 years. A univariate and bivariate analysis was performed on the collected data with the STATGRAPHIC Centurion 18 software and the R statistic. This included descriptive and inferential statistical analysis with hypothesis testing using the Chi square, the t-student test, the t test with Welch’s correction, ANOVA and Kruskal Wallis. I also perform a logistic regression model and calculation of the Odds Ratio. Results: respect to adherence to pharmacological and non-pharmacological treatments, it was found that according to Varela, the global adherence was 32% and according to Bonilla, the adherence index was distributed 55% in advantage of adherence, 32% in risk of non-adherence and 13% were non-adherent. No statistical significance was found between the sociodemographic characteristics and the degree of adherence. In relation to the dimensions of adherence, it was identical to that related to socioeconomic and provider factors, health systems and equipment presented lower averages in the groups at risk of adherence and non-adherent. Lifestyles and beliefs have a protective impact on those patients who follow the recommendations, contributing to adherence compliance pharmacological and non-pharmacological. Discussion and conclusion: the index or degree of adherence in the study population was not optimal, lifestyles and health beliefs can influence the rate or level of adherence to pharmacological and non-pharmacological treatment of patients with hypertension. The understanding and management of these variables by health personnel can help strengthen follow-up programs, early addressing doubts and concerns that treatments may generate in hypertensive patients. Universitat Autònoma de Barcelona. Programa de Doctorat en Metodologia de la Recerca Biomèdica i Salut Pública

In recent years, supported by new scientific evidence, the conceptualization of cognitive reserve (CR) has been progressively enriched and now encompasses not only cognitive stimulating activities or educational level, but also lifestyle activities, such as leisure physical activity and socialization. In this context, there is increasing interest in understanding the role of psychological factors in brain health and cognitive functioning. In a previous study, we have found that these factors mediated the relationship between CR and self-reported cognitive functioning. In this study, we have confirmed an association between two important constructs included in the psychological wellbeing and salutogenic models, “purpose in life” and “sense of coherence,” CR, as assessed using a questionnaire, and cognitive functioning, as evaluated using a comprehensive neuropsychological battery. Results from 888 middle-aged healthy participants from the Barcelona Brain Health Initiative indicate that both sense of coherence (SoC) and CR were positively associated with verbal memory, reasoning and attention, working memory, and global cognition. Moreover, the relation between CR and cognitive functioning in the different domains is partially mediated by SoC. When we controlled for brain integrity, introducing into the model neurofilament light chain measures, the mediator role of SoC was confirmed for reasoning and attention and global cognition. However, purpose in life was not associated with cognitive functioning. These results reveal the central role of the SoC construct, which mediates the association between classic CR estimates and cognitive functions, potentially representing a modifiable target for interventions that aim to promote brain health.

COPPADIS Study Group., [Background] Identifying modifiable risk factors for cognitive impairment in the early stages of Parkinson’s disease (PD) and estimating their impact on cognitive status may help prevent dementia (PDD) and the design of cognitive trials., [Methods] Using a standard approach for the assessment of global cognition in PD and controlling for the effects of age, education and disease duration, we explored the associations between cognitive status, comorbidities, metabolic variables and lifestyle variables in 533 PD participants from the COPPADIS study., [Results] Among the overall sample, 21% of participants were classified as PD-MCI (n = 114) and 4% as PDD (n = 26). The prevalence of hypertension, diabetes and dyslipidemia was significantly higher in cognitively impaired patients while no between-group differences were found for smoking, alcohol intake or use of supplementary vitamins. Better cognitive scores were significantly associated with regular physical exercise (p, [Conclusions] We extend previous findings regarding the positive and negative influence of various comorbidities and lifestyle factors on cognitive status in early PD patients, and reinforce the need to identify and treat potentially modifiable variables with the intention of exploring the possible improvement of the global cognitive status of patients with PD., Fundación Curemos el Parkinson (https://curemoselparkinson.org/) covered the expenses derived from hiring a CRO and from carrying out complementary tests.

This is a post-peer-review, pre-copyedit version of an article published in the European Journal of Epidemiology. The final authenticated version is available online at: https://doi.org/10.1007/s10654-019-00559-6. Pancreatic cancer (PC) is a highly fatal cancer with currently limited opportunities for early detection and effective treatment. Modifiable factors may offer pathways for primary prevention. In this study, the association between the Healthy Lifestyle Index (HLI) and PC risk was examined. Within the European Prospective Investigation into Cancer and Nutrition cohort, 1113 incident PC (57% women) were diagnosed from 400,577 participants followed-up for 15 years (median). HLI scores combined smoking, alcohol intake, dietary exposure, physical activity and, in turn, overall and central adiposity using BMI (HLIBMI) and waist-to-hip ratio (WHR, HLIWHR), respectively. High values of HLI indicate adherence to healthy behaviors. Cox proportional hazard models with age as primary time variable were used to estimate PC hazard ratios (HR) and 95% confidence intervals (CI). Sensitivity analyses were performed by excluding, in turn, each factor from the HLI score. Population attributable fractions (PAF) were estimated assuming participants’ shift to healthier lifestyles. The HRs for a one-standard deviation increment of HLIBMI and HLIWHR were 0.84 (95% CI: 0.79, 0.89; ptrend = 4.3e−09) and 0.77 (0.72, 0.82; ptrend = 1.7e−15), respectively. Exclusions of smoking from HLIWHR resulted in HRs of 0.88 (0.82, 0.94; ptrend = 4.9e−04). The overall PAF estimate was 19% (95% CI: 11%, 26%), and 14% (6%, 21%) when smoking was removed from the score. Adherence to a healthy lifestyle was inversely associated with PC risk, beyond the beneficial role of smoking avoidance. Public health measures targeting compliance with healthy lifestyles may have an impact on PC incidence.

Promotion of health allows to put into practice theoretical foundations that can improve health behaviors of the population, for which it is necessary to develop a health promoting lifestyle. A positive approach to generate health in young adults is to promote the salutogenic approach to health by encouraging the use of resources the person has and developing a sense of coherence. The main objective of this paper is to identify a health promoting lifestyle and its relationship with the sense of coherence in young adult university students in Sonora, Mexico. Materials and methods: descriptive, correlational study with 300 undergraduate students. Prior informed consent, a sociodemographic data card, the Life Style Questionnaire II and the Sense of Coherence-13 Scale were applied. Results: young adults showed enough general health promoting lifestyle (51.0%), with a higher incidence in women (52.1%). Health sciences students (55.2%) obtained an insufficient health promoting lifestyle and there was statistically significant difference by career. The general sense of coherence was high (52.0%), being predominant in men (58.0%) and in health sciences students (57.2%); there was no statistically significant difference according to gender and careers. It was evidenced that a sufficient health promoting lifestyle fosters the development of a high sense of coherence. Conclusions: it is essential to establish programs for the development of life skills to ensure better health and well-being of future generations of young adults by promoting the development of a sense of coherence La promoción de la salud permite poner en práctica fundamentos teóricos que pueden mejorar las conductas en salud de la población, para lo cual es necesario desarrollar un estilo de vida promotor de salud. Un enfoque positivo para generar salud en los adultos jóvenes es promover el enfoque salutogénico al incentivar el uso de recursos con los cuales cuenta la persona y desarrollar un sentido de coherencia. El objetivo del presente artículo es identificar el estilo de vida promotor de salud y su relación con el sentido de coherencia en adultos jóvenes universitarios en Sonora, México. Materiales y métodos: estudio descriptivo, correlacional en 300 estudiantes de carreras de pregrado. Previo consentimiento informado se aplicó cédula de datos sociodemográficos, el Cuestionario Estilo de Vida II y la Escala Sentido de Coherencia-13. Resultados: los adultos jóvenes mostraron estilo de vida promotor de salud general suficiente (51.0%), mayor incidencia en mujeres (52.1%). Los estudiantes de ciencias de la salud (55.2%) tuvieron un estilo de vida promotor de salud insuficiente, hubo diferencia estadísticamente significativa por carrera. El sentido de coherencia general fue alto (52.0%), predominó en hombres (58.0%) y estudiantes de ciencias de la salud (57.2%), no hubo diferencia estadísticamente significativa según sexo y carreras. Se evidenció que un estilo de vida promotor de salud suficiente promueve el desarrollo de un sentido de coherencia alto. Conclusiones: es imprescindible establecer programas para el desarrollo de habilidades para la vida al asegurar mejor salud y bienestar de las futuras generaciones de adultos jóvenes al promover el desarrollo del sentido de coherencia A promoção da saúde permite pôr em prática fundamentos teóricos que podem melhorar as condutas em Saúde da população, para o qual é necessário desenvolver um estilo de vida para melhorar a saúde. Um enfoque positivo para gerar saúde nos adultos jovens é promover o enfoque salutogênese ao incentivar o uso de recursos com os quais conta a pessoa e desenvolver um sentido de coerência. O objetivo do presente artigo é identificar o estilo de vida promotor de Saúde e sua relação com o sentido de coerência em adultos jovens universitários em Sonora, México. Materiais e métodos: estudo descritivo, correlacional em 300 estudantes de carreiras universitárias. Prévio consentimento informado se aplicou cédula de dados sócio demográficos, o Questionário Estilo de Vida II e a Escada Sentido de Coerencia-13. Resultados: os adultos jovens amostraram estilo de vida promotor de saúde geral suficiente (51.0%), maior incidência em mulheres (52.1%). Os estudantes de ciências da saúde (55.2%) tiveram um estilo de vida promotor de saúde insuficiente, houve diferença estatisticamente significativa por corrida. O sentido de coerência geral foi ato (52.0%), predominou em homens (58.0%) e estudantes de ciências da saúde (57.2%), não houve diferença estatisticamente significativa segundo sexo e carreiras. Evidenciou-se que um estilo de vida promotor de saúde suficiente promove o desenvolvimento dum sentido de coerência alto. Conclusões: é imprescindível estabelecer programas para o desenvolvimento de habilidades para a vida ao assegurar melhor saúde e bem-estar das futuras gerações de adultos jovens ao promover o desenvolvimento do sentido de coerência

Treballs Finals de Grau de Nutrició Humana i Dietètica, Facultat de Farmàcia i Ciències de l'Alimentació, Campus de l'Alimentació de Torribera, Universitat de Barcelona. Curs: 2020-2021. Tutor: Laura Isabel Arranz, [cat] La dismenorrea primària té un gran impacte en la salut de les dones, disminueix la seva qualitat de vida, provocant alteracions a nivell físic, mental i social. El seu tractament convencional es basa en fàrmacs antiinflamatoris no esteroides o anticonceptius hormonals, però degut als seus efectes adversos, cada vegada hi ha més interès en un tractament natural. L’objectiu d’aquest treball és conèixer el paper de la dieta i de l’estil de vida, en la dismenorrea primària. S’ha realitzat una recerca bibliogràfica amb les bases de dades Pubmed i Scopus, prioritzant els estudis de més evidència científica i més actualitat. També, amb la web de disseny gràfic CANVA, s’ha fet una guia per a persones amb dismenorrea primària. L’evidència apunta que una dieta poc saludable augmenta el risc de patir dolor durant la menstruació, en canvi, que una dieta sana i equilibrada té efectes beneficiosos en la dismenorrea primària. A més, s’ha vist que certs nutrients com la vitamina D i E, el calci, l’omega-3, el magnesi i el zinc poden ser beneficiosos i arribar a substituir el tractament tradicional. Altrament, la falta d’exercici físic, l’insomni i la manca de tractament psicològic, són factors de l’estil de vida que empitjoren el dolor durant la menstruació. Tot i això, cal realitzar més estudis per tenir informació més sòlida i poder fer afirmacions i recomanacions amb seguretat sobre aquest tema. Paraules clau: dismenorrea primària, dolor, menstruació, dieta, nutrients, estil de vida., [eng] Primary dysmenorrhea has a great impact on women's health, decreases their quality of life, causing alterations at a physical, mental and social level. Conventional treatment is based on non-steroidal anti-inflammatory drugs or hormonal contraceptives, but due to its adverse effects, there is an increasing interest in a natural treatment. The purpose of this work is to know the role of diet and lifestyle in primary dysmenorrhea. Bibliographic research has been done with the Pubmed and Scopus databases, prioritizing studies by higher scientific evidence and current. Moreover, with the graphic design website CANVA, a guide has been prepared for people with primary dysmenorrhea. The evidence suggests that an unhealthy diet increases the risk of suffering pain during menstruation, however, that a healthy and balanced diet has beneficial effects on primary dysmenorrhea. In addition, it has been seen those certain nutrients such as vitamin D and E, calcium, omega-3, magnesium and zinc can be beneficial and even replace traditional treatment. Otherwise, lack of physical exercise, insomnia and lack of psychological treatment are lifestyle factors that worsen pain during menstruation. However, more studies need to be carried out to have stronger information and to be able to make statements and recommendations safely on this topic. Key words: primary dysmenorrhea, pain, menstruation, diet, nutrients, lifestyle.

Chronic lymphocytic leukemia (CLL) is the most common leukemia in adults in Western countries. Its etiology is largely unknown but increasing incidence rates observed worldwide suggest that lifestyle and environmental factors such as diet might play a role in the development of CLL. Hence, we hypothesized that the consumption of ultra-processed food and drinks (UPF) might be associated with CLL. Data from a Spanish population-based case-control study (MCC-Spain study) including 230 CLL cases (recruited within three years of diagnosis) and 1634 population-based controls were used. The usual diet during the previous year was collected through a validated food frequency questionnaire and food and drink consumption was categorized using the NOVA classification scheme. Logistic regression models adjusted for potential confounders were used. Overall, no association was reported between the consumption of UPF and CLL cases (OR per each 10% increase of the relative contribution of UPF to total dietary intake = 1.09 (95% CI: 0.94; 1.25)), independently of the Rai stage at diagnosis. However, when analyses were restricted to cases diagnosed within, Spanish Ministry of Economy and Competitiveness Carlos III Institute of Health, FEDER funds/European Regional Development Fund (ERDF) (grants PI17/01280, PI11/01810, PI14/01219, PI11/02213, PI09/1662, PI15/00966, PI18/00909, RCESP C03/09, RTICESP C03/10, RTIC RD06/0020/0095, RD12/0036/0056, Rio Hortega CM13/00232, Juan de la Cierva de Incorporacion IJCI-2016-29502 and SV-09-CLINIC-1), Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP, Spain), Agència de Gestió d’Ajuts Universitaris i de Recerca (AGAUR), CERCA Programme/Generalitat de Catalunya for institutional support(2017SGR1085), European Regional Development FundERDF/FEDER, Spanish Ministerio de Economía y Competitividad (MINECO), ISCIII-Sub-Directorate General for Evaluation and the European Regional Development Fund (FEDER-”Una manera de Hacer Europa”) and CIBERONC., Spanish Ministry of Science and Innovation through the “Centro de Excelencia Severo Ochoa 2019–2023” Program (CEX2018-000806-S), Generalitat de Catalunya - CERCA Program

(1) Background: Most common hereditary cancers in Europe have been associated with lifestyle behaviors, and people affected are lacking follow up care. However, access to education programmes to increase knowledge on cancer and genetics and promote healthy lifestyle behaviors in people at high risk of cancer is scarce. This affects the quality of care of people with a hereditary risk of cancer. This study aimed to reach a multidisciplinary consensus on topics and competencies and competencies that cancer nurses need in relation to cancer, genetics, and health promotion. (2) Methods: A two-round online Delphi study was undertaken. Experts in cancer and genetics were asked to assess the relevance of eighteen items and to suggest additional terms. Consensus was defined as an overall agreement of at least 75%. (3) Results: A total of 74 multiprofessional experts from all around the world participated in this study including healthcare professionals working in genetics (39%), researchers in cancer and genetics (31%) and healthcare professionals with cancer patients (30%). Thirteen additional items were proposed. A total of thirty-one items reached consensus. (4) Conclusions: This multidisciplinary consensus study provide the essential elements to build an educational programme to increase cancer nurses’ skills to support the complex care of people living with a higher risk of cancer including addressing lifestyle behaviors. All professionals highlighted the importance of cancer nurses increasing their skills in cancer and genetics.

Background: In addition to traditional cardiovascular (CV) risk factors, antiretroviral therapy, lifestyle, and human immunodeficiency virus (HIV)-related factors may contribute to future CV events in persons with HIV (PWH). Methods: Among participants in the global REPRIEVE randomized trial, we characterized demographics and HIV characteristics relative to ACC/AHA pooled cohort equations (PCE) for atherosclerotic CV disease predicted risk and CV health evaluated by Life's Simple 7 (LS7; includes smoking, diet, physical activity, body mass index, blood pressure, total cholesterol, and glucose). Results: Among 7382 REPRIEVE participants (31% women, 45% Black), the median PCE risk score was 4.5% (lower and upper quartiles Q1, Q3: 2.2, 7.2); 29% had a PCE score

Trabajo de orientación profesional. El exceso de peso en la infancia y la adolescencia es un problema que requiere atención urgente. España se sitúa como el décimo país con más sobrepeso infantil entre los países de la Organización para la Cooperación y el Desarrollo Económicos (OCDE) y la Unión Europea (UE) (2). Los niños están creciendo en un entorno cada vez más conectado mediante el uso de pantallas. A través de ellas proliferan estímulos visuales y auditivos con potencial de incitar al consumo de alimentos poco saludables, promover formas sedentarias de ocio, fomentar el aislamiento social, y en general contribuir a la epidemia de obesidad. Los estudios consultados indican que a pesar de las medidas aún hay mucho que hacer para revertir la tendencia actual. Por ello se llevó a cabo un análisis de la realidad utilizando como instrumento de medida un cuestionario dirigido a jóvenes de 15 y 16 años residentes en Cardedeu. Los resultados de este análisis confirmaron la necesidad de desarrollar un programa para promover estilos de vida saludable en este segmento de población. La propuesta detallada en el presente trabajo consiste en un taller extraescolar titulado Cuinen Junts a impartir durante el año lectivo 2021-2022. La metodología aplicada en el desarrollo de la propuesta cuenta con el enfoque enfermero y la aplicación del modelo de enfermería de Dorothea Orem. Con ello se busca obtener resultados tales como la promoción de buenos hábitos de alimentación, el impulso del ocio activo, y el aprendizaje de conductas saludables ante el uso de pantallas. Excess weight in childhood and adolescence is a problem that requires urgent attention. Spain ranks as the tenth country with the most overweight among children among the countries of the Organization for Economic Cooperation and Development (OECD) and the European Union (EU) (2). Children are growing up in an increasingly connected environment through the use of screens. Through them, visual and auditory stimuli proliferate with the potential to incite the consumption of unhealthy foods, promote sedentary forms of leisure, promote social isolation, and in general contribute to the obesity epidemic. The studies consulted indicate that despite the measures, there is still much to do to reverse the current trend. For this reason, a reality analysis was carried out using a questionnaire aimed at 15 and 16-year-olds residing in Cardedeu as a measurement instrument. The results of this analysis confirmed the need to develop a program to promote healthy lifestyles in this segment of the population. The proposal detailed in this work consists of an extracurricular workshop titled Cuinen Junts to be taught during the 2021-2022 school year. The methodology applied in the development of the proposal has the nursing approach and the application of Dorothea Orem's nursing model. This seeks to obtain results such as the promotion of good eating habits, the promotion of active leisure, and the learning of healthy behaviors when using screens. Descripció del recurs: juny 2021 DDEUIT

An individual’s chronotype, defined as the preference for rest and activity at different times of the day, is linked to several physiological and psychological outcomes. Research on environmental determinants of chronotype has focussed mostly on geographic location, whereas other socioenvironmental determinants have been neglected. We aimed to investigate the association between other previously unrecognized socioenvironmental factors and chronotypes in adolescents. We analysed data of 1916 Bengali adolescents (aged between 13–14 years, 47% girls). Chronotype was determined by the reduced morningness–eveningness questionnaire (rMEQ), and socioenvironmental factors were identified through a structured questionnaire. Associations were analysed using multinomial logistic regression models. Our findings demonstrated that living in urban areas, the presence of a smoker at home, and higher parental education were associated with a higher evening activity (eveningness), while the use of biomass cooking media (compared to liquefied petroleum gas) and assisting parents in farming were associated with higher morningness in adolescents. This is the first study to identify the association between previously unrecognized socioenvironmental factors and chronotypes delineating the interaction between environment and sleep in adolescents and might help the parents to understand the importance of a proper sleep-activity rhythm of their kids through a comprehensive understanding of their surrounding environment and other factors.

Evidence has identified unhealthy lifestyle behaviors as the main contributors to obesity in children, so it is essential to identify factors that could influence children's lifestyles. The objective of the present study was to analyze the association of baseline maternal educational level with child's physical activity, screen time, and dietary habits at follow-up. This community-based cohort study was carried out between 2012 and 2014 and included 1405 children aged 8 to 10 years old. Maternal educational level was used as an indicator of child's socioeconomic status. Physical activity, screen time, and dietary habits were assessed by validated questionnaires. The odds of having commercially baked goods for breakfast [OR 1.47 (95% CI 1.03 to 2.10)], going more than once a week to a fast-food restaurant [OR 1.64 (95% CI 1.20 to 2.26)], and taking sweets and candys several times a day [OR 3.23 (95% CI 2.14 to 4.87) were significantly higher among children whose mothers had a lower educational level compared to their peers whose mothers had a higher level. These associations held for taking sweets and candy several times a day after additional adjustment for the corresponding dietary behavior at baseline. Maternal educational level was inversely associated (p < 0.001) with child's screen time at follow up and being in the lowest maternal educational category was associated with an increased odds of surpassing the maximum recommended time of screen time of 120 min per day (OR (95% CI) 1.43 (1.07 to 1.90), p = 0.016). Maternal education is a predictor for unhealthy dietary habits and high screen time in children. This work was supported by a grant from Instituto de Salud Carlos III FEDER, (PI11/01900).Centro de Investigación Biomédica en Red Epidemiologia y Salud Publica (CIBERESP) is an initiativeof the Instituto de Salud Carlos III (ISCIII) of Spain, which is financed by the European RegionalDevelopment Fund (ERDF), “A way to make Europe”/“Investing in your future” (CB06/03). Itis supported by the official funding agency for biomedical research of the Spanish government,ISCIII, Spain.

A lo largo de las últimas décadas, la mayoría de las sociedades europeas se han transforma­do en multiculturales, debido a la inmigración laboral y al surgimiento de nuevos estilos de vida vinculados a la intensificación de la comunicación intercultural y a la movilidad geográfica, como consecuencia de las tecnologías globalizadoras. Este proceso ha dado como resultado no sólo los conflictos sociales entre poblaciones culturalmente divididas, sino también el diálogo y la hibridación transcultural. El artículo intenta abrir paso hacia el estudio más exhaustivo de este fenómeno, introduciendo en la temática unas reflexiones sobre la dimensión estructural-objetiva del fenómeno para preparar futuras investigaciones de carácter cualitativo sobre la dimensión interactivo-subjetiva. Basándose en datos esta­dísticos, el artículo analiza el aumento significativo de las parejas mixtas en España y en Andalucía durante las dos últimas décadas desde una perspectiva comparativa, poniéndose en relación los procesos migratorios. En el trabajo, se consideran las parejas binacionales o biculturales como un fenómeno novedoso y un hecho social que induce a la redefinición de los estándares culturales que incluyen conflictos como la segregación, al mismo tiempo que se apunta la posibilidad de establecer comunicación intercultural e hibridación como requisitos de una necesaria reconstitución cultural de las sociedades avanzadas., During the last few decades, most European societies have become multicultural due to the increase in labour immigration and the rise of new life-styles related to the intensification of intercultural communication and geographical mobility as a result of globalising technol­ogy. This process has contributed not only to social conflicts between culturally divided populations but also to dialogue and transcultural hybridization. The article attempts to open the path toward further, more comprehensive studies of this phenomenon, focussing the subject with the help of some reflections on its structural and objective dimension in order to prepare future qualitative analysis of the subjective dimension of social interaction. Based on statistical data, this article analyzes the significant rise in the number of mixed couples in Spain and Andalusia during the last two decades from a comparative perspec­tive and related with the migration processes. It considers binational or bicultural couples as a new phenomenon and a social fact that induces the redefinition of cultural standards including conflicts and segregation, but also the chance for intercultural communication and hybridisation as the prerequisites for a necessary cultural reconstitution of advanced societies.

Nuestro proyecto final es un análisis sobre los resultados de un estudio a un grupo de estudiantes de nuestra universidad, buscar nuevas formas de canalizar sus emociones y pensamientos me-diante la meditación y tiene como objetivo principal implementar en los estudiantes un método por el cual pueden mejorar en sus notas académicas y obtener muchos otros beneficios que la meditación nos ofrece.Para realizar nuestro trabajo final diseñamos una aplicación móvil compatible con el sistema operativo de Android el cual permite realizar diferentes ejercicios, posturas y audioguías, que nosotros mismos hemos diseñado y creado, para llevar a cabo nuestra prueba de campo.De esta manera llevaremos un control de 2 grupos, el primero utilizará la aplicación y los ejer-cicios de meditación. El segundo grupo no utilizará la aplicación, de esta manera obtendremos los resultados por género, edad y frecuencia en el uso de la aplicación.Además, mediante el uso de las dos encuestas que hemos creado obtendremos los datos nece-sarios de cada alumno para realizar un correcto análisis y desarrollo en conjunto con los datos obtenidos mediante el control de la APP.Por lo tanto, utilizando y comparando los resultados obtenidos mediante la APP y las encuestas obtendremos unos resultados individuales muy precisos que nos ayudaran a realizar las conclu-siones del trabajo.

En su mayoría, las intervenciones para disminuir la prevalencia de la obesidad y promover la adopción de patrones de alimentación y hábitos saludables en población escolar, se han basado en incentivar cambios conductuales bajo el precepto de comer menos y moverse más. No obstante, esta aproximación asume que los niños y jóvenes se desenvuelven en entornos neutrales que no generan influencias en sus hábitos, dejando de lado la compresión de cómo dichos entornos pueden facilitar u obstaculizar la elección de alimentos saludables y oportunidades de movimiento¬. En este sentido, existe una necesidad de construir nuevos marcos analíticos y metodológicos que permitan el estudio e inclusión de los diferentes entornos en los análisis e intervenciones nutricionales en población en edad escolar. En este orden de ideas, el objetivo central de esta tesis fue desarrollar herramientas metodológicas para el estudio de las variables ambientales en población en edad escolar, con el fin de facilitar la compresión de la relación de los entornos con la adherencia a patrones de alimentación y estilo de vida saludables. En el primer capítulo, se parte de una aproximación descriptiva sobre los principales factores individuales y ambientales asociados a la adherencia a patrones de alimentación saludables en una población escolar, usando el estudio de la adherencia a la dieta mediterránea en la población escolar de la ciudad de Mataró, España. El análisis estadístico demostró que los factores positivamente asociados con una adherencia óptima a la dieta mediterránea fueron: (i) el nivel de educación de la madre; (ii) estar cursando la primaria; (iii) la ausencia de distracciones durante el desayuno; y por último, (iv) la actividad física regular vigorosa y ligera. Adicionalmente, sobresalió cómo la disponibilidad de dinero para comprar en la escuela/instituto presentó una asociación negativa con la probabilidad de adherencia óptima a la dieta mediterránea, lo cual se relaciona con una posible influencia de los ambientes comunitarios como factor a considerar para garantizar el éxito de las intervenciones en la población de edad escolar. En el segundo y tercer capítulo, se introdujo el Facility List Coder (FLC) una nueva herramienta basada en información geo-localizada secundaria para la evaluación automática de entornos de alimentación a nivel comunitario. El FLC es un aplicativo que realiza un inventario de establecimientos con diferentes ofertas de alimentos alrededor de un sitio de interés (escuelas, parques, entre otros), a través de una consulta espacial de las principales bases de datos espaciales accesibles (Google Maps y Open Street Maps). Dicha información es analizada y clasificada a través de una lista de categorías preestablecidas que permiten tener medidas cuantitativas sobre la calidad y tipologías de los entornos de alimentación. Después del proceso de validación se concluyó que el FLC es una herramienta de bajo costo, escalable, eficiente, fácil de usar, fiable y válida para la evaluación de entornos de alimentación comunitarios de manera automática a través de uso de información secundaria geo-referenciada. Finalmente, el capítulo 4 adapta y valida a la cultura española una nueva herramienta para evaluar el micro-entrono escolar llamada School Physical Activity and Nutrition Environment Tool (SPAN-ET), la cual permite una evaluación integral del entorno de actividad física y nutrición teniendo en cuenta aspectos físicos, situacionales y de política. Para esto, se aplicaron las directrices metodológicas para la adaptación transcultural de instrumentos de recolección de información y se aplicó un análisis de validez del contenido. La evaluación realizada por el comité de expertos concluyó que los elementos incluidos en la versión SPAN-ET en español eran relevantes para el contexto español, claros, sencillos y sin ambigüedades. Por tanto, se dispone de una nueva herramienta para la evaluación de entornos escolares en España. Como resultado de esta tesis se puede concluir que existe una necesidad global de crear marcos analíticos y metodológicos que permitan estudiar las dinámicas e interacciones de las variables ambientales (entorno de alimentación comunitario, entorno de consumo, entornos organizacionales y entorno informacional) sobre la adherencia a patrones de alimentación y estilos de vida saludables. En particular, en el entorno comunitario alrededor de las escuelas y en el micro-entorno escolar, ya que constituye la dimensión con menos investigación disponible y es el lugar donde las intervenciones podrían tener mayor impacto en la formación de hábitos saludables.

CIBERDEM (Ministerio de Economia, Industria y Competitividad-ISCIII), Ministerio de Sanidad, Servicios Sociales e Igualdad-ISCIII, Instituto de Salud Carlos III [PI14/00710, PI14/01104, PI14/00970, PI14/00874, PIE14/00031], Cuesta, M., Fuentes, M., Rubio, M., Bordiu, E., Barabash, A., Garcia De La Torre, N., Rojo-Martinez, G., Valdes, S., Soriguer, F., Vendrell, J.J., Urrutia, I.M., Ortega, E., Montanya, E., Menendez, E., Lago-Sampedro, A., Gomis, R., Goday, A., Castell, C., Badia-Guillen, R., Girbés, J., Gaztambide, S., Franch-Nadal, J., Delgado Álvarez, E., Chaves, F.J., Castano, L., Calle-Pascual, A.L.

Research has shown that the young university student must adopt and effectively develop assets in health, in order to develop a high sense of coherence, which will allow for an adaptive coping to maintain wellbeing and health, and to adopt a lifestyle that promotes health. Aim: To identify the factors that directly or indirectly affect the young university student to strengthen the sense of coherence and thus acquire a lifestyle that promotes health. Methodology: Review of original articles in Spanish and English, systematic search in databases: Virtual Health Library, Scientific online e-library and Google Scholar, use of keywords from Health Sciences Descriptors, i.e. ‘sense of coherence, students, young adults and lifestyle’. Seven original articles were analysed. Results: The sense of coherence related to the lifestyle of young adults can be negatively affected when they are single, do not work, are women, are 18-21 years old, suffer from sadness and anxiety, consume alcohol, tobacco and illicit drugs. The sense of coherence positively related to lifestyle, to general and psychological health, and it can also predict students’ quality of life. Conclusions: The sense of coherence allows to identify young university students’ health assets, with the aim to modify a lifestyle that promotes their well-being, and contributes to improve their health and quality of life

Introduction: The Interdepartamental Public Health Plan of Catalonia (2014) seeks to enforce Health in All Policies (HiAP) at the regional and local levels. Within this context, the City Council of Sant Andreu de la Barca (SAB), the Metropolitan Area of Barcelona (MAB), and the Public Health Agency of Catalonia started a Health Impact Assessment (HIA) of an urbanistic redesign of the Llobregat fluvial area in SAB, the results of which are presented in this paper. Methodology: In 2018, after a HIA screening, a prospective nonquantitative HIA was conducted. Politicians, professionals, and citizens participated in identifying potential impacts. Impacts were prioritized and linked to health determinants, scientific evidence, and potentially affected social groups. Afterwards, recommendations were formulated in order to improve the health impacts of the project. Finally, indicators were selected to evaluate HIA implementation. Results: The HIA was successfully implemented with the participation of technicians and citizens of SAB. The health impacts identified were mainly related to environmental, public safety, lifestyle, socioeconomic, and political contexts. Ten recommendations were defined to minimize the potential negative health impacts of the project, with six of them directly included and only one dismissed due to incompatibility. Conclusion: A HIA was successfully carried out in the medium-sized town of Catalonia, promoting Health in all Policies at a local level and improving health impacts of an urbanistic project.

Background. Body weight dissatisfaction is a hindrance to following a healthy lifestyle and it has been associated with weight concerns. Objectives. The aim of this study was to assess the association between the adherence to the Mediterranean lifestyle (diet and exercise) and the desired body weight loss in an adult Mediterranean population with overweight. Methods. Cross-sectional analysis in 6355 participants (3268 men; 3087 women) with metabolic syndrome and BMI (Body mass index) between 27.0 and 40.0 kg/m2 (55–75 years old) from the PREDIMED-Plus trial. Desired weight loss was the percentage of weight that participants wished to lose. It was categorized into four cut-offs of this percentage (Q1, European Research Council (ERC) 340918, Recercaixa Grant 2013ACUP00194, Junta de Andalucia PI0458/2013 PS0358/2016 PI0137/2018, Generalitat Valenciana PROMETEO/2017/017, SEMERGEN Grant, European Union (EU) European Cooperation in Science and Technology (COST) CA16112, Balearic Islands Government 35/2011, Balearic Islands Health Research Institute (IDISBA), European Union (EU) CIBEROBN CB06/03 CB12/03 PI13/00673 PI13/00492 PI13/00272 PI13/01123 PI13/00462 PI13/00233 PI13/02184 PI13/00728 PI13/01090 PI13/01056, European Commission Joint Research Centre EAT2BENICE_H2020_SFS2016, "Miguel Servet Type I" program from the ISCIII-Madrid (Spain) CP15/00028, ICREA under the ICREA Academia programme, Fernando Tarongi Bauza PhD Grant, FPU from the Ministry of Science, Innovation and Univesities FPU 18/01703, Spanish government, ISCIII, through the Fondo de Investigacion para la Salud (FIS), Especial Action Project entitled: Implementacion y evaluacion de una intervencion intensiva sobre la actividad fisica Cohorte PREDIMED-Plus grant, PI14/01722, PI14/00636, PI14/00618, PI14/00696, PI14/01206, PI14/01919, PI14/00853, PI14/01374, PI14/00972, PI14/00728, PI14/01471, PI16/00473, PI16/00662, PI16/01873, PI16/01094, PI16/00501, PI16/00533, PI16/00381, PI16/00366, PI16/01522, PI16/01120, PI17/00764, PI17/01183, PI17/00855, PI17/01347, PI17/00525, PI17/01827, PI17/00532, PI17/00215, PI17/01441, PI17/00508, PI17/01732, PI17/00926, PI19/00957, PI19/00386, PI19/00309, PI19/01032, PI19/00576, PI19/00017, PI19/01226, PI19/00781, PI19/01560, PI19/01332

Unhealthy lifestyles (LSs) (such as smoking, drinking too much alcohol, taking drugs, eating a poor diet, living a sedentary life, having high-risk sex, or sleeping poorly) are all the type of health-related behaviours that we will address in this article. Key determinants of health status such as medical care, medicine, income, or educational level are at least partially characterised by being the result of personal choice, and therefore, they are modifiable.

Mitochondrial DNA copy number (mtDNAcn) is a putative biomarker of oxidative stress and biological aging. Modifiable factors, including physical activity (PA), avoidance of heavy alcohol use and smoking, and maintaining good mental health, may reduce oxidative stress and promote healthy aging. Yet, limited data exist regarding how these factors are associated with mtDNAcn or whether age, sex or race/ethnicity moderate associations. In this cross-sectional study, we selected 391 adults (183 non-Hispanic White, 110 Black and 98 Hispanic; mean = 67 years) from the VITAL-DEP (VITamin D and OmegA-3 TriaL-Depression Endpoint Prevention) ancillary to the VITAL trial. We estimated associations between lifestyle and behavioral factors (PA, alcohol consumption, cigarette smoking and depression) and log-transformed mtDNAcn using multivariable linear regression models. MtDNAcn was not correlated with chronological age; women had ~17% higher mtDNAcn compared to men. There were no significant associations between PA measures (frequency, amount or intensity) or alcohol consumption with mtDNAcn. Cigarette smoking (per 5 pack-years) was significantly associated with mtDNAcn (percent difference = -2.9% (95% confidence interval (CI) = -5.4%, -0.4%)); a large contrast was observed among heavy vs. non-smokers (≥30 vs. 0 pack-years): percent difference = -28.5% (95% CI = -44.2%, -8.3%). The estimate of mtDNAcn was suggestively different for past vs. no depression history (percent difference = -15.1% 95% CI = -30.8%, 4.1%), but this difference was not statistically significant. The association between smoking and log-mtDNAcn varied by sex and race/ethnicity; it was stronger in men and Black participants. While chance findings cannot be excluded, results from this study support associations of smoking, but not chronological age, with mtDNAcn and suggest nuanced considerations of mtDNAcn as indicative of varying oxidative stress states vs. biological aging itself.

Background: Brain health is a multi-faceted concept used to describe brain physiology, cognitive function, mental health and well-being. Diseases of the brain account for one third of the global burden of disease and are becoming more prevalent as populations age. Diet, social interaction as well as physical and cognitive activity are lifestyle factors that can potentially influence facets of brain health. Yet, there is limited knowledge about the population's awareness of brain health and willingness to change lifestyle to maintain a healthy brain. This paper introduces the Global Brain Health Survey protocol, designed to assess people's perceptions of brain health and factors influencing brain health. Methods: The Global Brain Health Survey is an anonymous online questionnaire available in 14 languages to anyone above the age of 18 years. Questions focus on (1) willingness and motivation to maintain or improve brain health, (2) interest in learning more about individual brain health using standardized tests, and (3) interest in receiving individualized support to take care of own brain health. The survey questions were developed based on results from a qualitative interview study investigating brain health perceptions among participants in brain research studies. The survey includes 28 questions and takes 15–20 min to complete. Participants provide electronically informed consent prior to participation. The current survey wave was launched on June 4, 2019 and will close on August 31, 2020. We will provide descriptive statistics of samples distributions including analyses of differences as a function of age, gender, education, country of residence, and we will examine associations between items. The European Union funded Lifebrain project leads the survey in collaboration with national brain councils in Norway, Germany, and Belgium, Brain Foundations in the Netherlands and Sweden, the National University of Ostroh Academy and the Women's Brain Project. Discussion: Results from this survey will provide new insights in peoples' views on brain health, in particular, the extent to which the adoption of positive behaviors can be encouraged. The results will contribute to the development of policy recommendations for supporting population brain health, including measures tailored to individual needs, knowledge, motivations and life situations., SCOPUS: ar.j, info:eu-repo/semantics/published

[spa] INTRODUCCIÓN: Derivado de la discapacidad que produce la enfermedad, las personas con trastorno mental grave presentan una serie de problemas específicos como alteraciones cardiovasculares y metabólicas, que tienen un importante impacto en su calidad de vida. La mejora de la Calidad de vida y bienestar personal han de ser objetivos primordiales de las intervenciones dirigidas a esta población. Factores modificables, como tabaquismo, dislipidemia, obesidad, sedentarismo, hábitos tóxicos y el tratamiento farmacológico, en especial antipsicóticos de segunda generación, incrementan el riesgo de padecer síndrome metabólico. La prevalencia de síndrome metabólico ha sido ampliamente estudiada en pacientes hospitalizados, pero los estudios en pacientes que realizan su seguimiento ambulatorio son escasos. Los servicios de Salud Mental deberían proporcionar una evaluación estándar a sus pacientes, con el fin de detectar la presencia de problemas de salud físicos. Además de la monitorización y control de la salud física, los profesionales de Salud Mental deben promover su cuidado, mediante programas que incluyan intervenciones para la realización de modificaciones en la dieta y ejercicio. Desde la consulta de enfermería de algunos centros de salud mental se evalúa el perfil cardiovascular y metabólico de estos pacientes, lo que justifica que se lleven a cabo intervenciones sobre estilos de vida. OBJETIVO: Evaluar la efectividad de un programa de promoción de la salud física en personas con trastorno mental grave y en tratamiento con fármacos antipsicóticos, llevado a cabo por la enfermera de salud mental, en el centro de salud mental de adultos de Barajas (Madrid) y el de Santa Eulalia, de Hospitalet de Llobregat (Barcelona). METODOLOGÍA: Se realizó un Ensayo clínico aleatorio, de grupos paralelos, de 6 meses de duración. La muestra estuvo compuesta por usuarios de los dos centros de salud mental mencionados, de ambos sexos, con trastorno mental grave en tratamiento con fármacos antipsicóticos, que cumplían al menos 3 de los 5 criterios de síndrome metabólico según la NCEP ATP III. Los/as participantes se distribuyeron aleatoriamente en el grupo control o en el grupo experimental. El grupo control recibió el tratamiento habitual en consulta de enfermería, en la que se informa individualmente a cada usuario de los beneficios de un estilo de vida saludable y se fomenta que se lleve a cabo. El grupo experimental realizó el programa, de 24 sesiones de duración. RESULTADOS: de los 125 usuarios que formaron la muestra, más de la mitad de los participantes (58,4%), eran fumadores activos. La prevalencia de tabaquismo fue mayor en hombres que en mujeres (66,3% en hombres vs 44,4% en mujeres, p=0,018), detectándose una alta dependencia a nicotina en el 72,2% de los participantes. La prevalencia total de síndrome metabólico 60 % (n= 75). Solo 21 participantes (16,8%) tenían pautado tratamiento previo para la tensión arterial, 22 participantes (17,6%) tenían tratamiento para la hipertrigliceridemia y 14 participantes (11,2%) para diabetes tipo 1 o 2. A los 75 participantes que cumplían los criterios de inclusión, se les invitó a participar en el ensayo clínico y aquellos que aceptaron fueron aleatorizados a cada grupo. La muestra final quedó compuesta por 61 participantes. De éstos, 32 fueron asignados al grupo control y 29 al grupo intervención o experimental. Los resultados obtenidos tras la intervención demostraron que el programa de promoción de la salud fue eficaz a la hora de disminuir el perímetro abdominal, nivel de triglicéridos y tensión arterial diastólica, resultado también eficaz en la disminución del peso corporal y el aumento del colesterol HDL, aunque no estadísticamente significativo. Además, se observó un aumento tanto de la actividad física como de la calidad de vida muy significativo en el GI tras la realización del programa. CONCLUSIONES: Los resultados alertan de la pobre salud física de las personas con trastorno mental grave en España, revelando la necesidad de evaluar su salud regularmente y realizar intervenciones que fomenten la adherencia a un estilo de vida saludable, para prevenir desórdenes cardiovasculares y metabólicos. Las enfermeras de salud mental están en una posición óptima para realizar estas funciones, dado su conocimiento tanto de salud mental como de salud física, y su proximidad con el paciente y su familia. Deben asumir el rol de coordinadoras de cuidados y vincular a los pacientes con atención primaria para la prevención y tratamiento de las alteraciones de salud. El programa de promoción de la salud física de enfermería, ha demostrado ser eficaz en la mejora de los criterios de síndrome metabólico, el aumento de la calidad de vida de los pacientes y el incremento de su actividad física, por lo que la hipótesis planteada ha quedado demostrada. Las enfermeras de salud mental, deberían seguir realizando investigaciones sobre intervenciones basadas en la modificación del estilo de vida en personas con trastornos mentales, y liderando la coordinación de cuidados entre los Centros de Salud Mental y Atención Primaria. Dado el vínculo que mantienen con los/as pacientes, las enfermeras están en una posición ideal para mejorar el acceso de los/as pacientes con trastorno mental grave a otras intervenciones que se realicen en población general., [eng] INTRODUCTION: As a consequence of the disability caused by disease, people with serious mental illness present a series of specific problems, such as cardiovascular and metabolic alterations, that have a significant impact on their quality of life. The improvement of quality of life and personal well-being must be primary objectives of interventions directed to this population. The presence of modifiable risk factors, such as smoking, dyslipidaemia, obesity, sedentary lifestyle, toxic habits and pharmacological treatment, especially second-generation antipsychotics, contribute to the development of metabolic syndrome. The prevalence of metabolic syndrome has been widely studied in hospitalized patients but not in patients who attend community mental health centers. Mental health services should provide a standard assessment to their patients to detect the presence of physical health problems. In addition to the assessment of physical health, mental health professionals should promote patients´ care, through interventions including nutritional counselling and physical activity. In many mental health centers, nurses evaluate cardiovascular and metabolic profile of these patients, which justifies the performance of lifestyle interventions. AIM: To evaluate the effectiveness of a physical health-promoting programme in people with severe mental disorder and antipsychotic treatment, carried out by the mental health nurse, in the community mental health centers of Barajas (Madrid) and Santa Eulalia (Barcelona). METHODOLOGY: This was a 6-month randomized, parallel-group, controlled trial. Participants were recruited from this two community mental health centers. They were adults, from both sexes, with serious mental illness, between 18 and 65 years old, who had at least three of the five metabolic syndrome risk factors according to the NCEP-ATP III and were taking antipsychotic medication. Participants were randomly assigned to the control or intervention group. The control group received usual nurse-care treatment. They were individually informed about the benefits of a healthy lifestyle and were encouraged to follow it. The experimental group carried out the programme, which lasted 24 sessions. RESULTS: More than half of the participants (58.4%) were active smokers. The prevalence of smoking was higher in men (66.3% of men vs. 44.4% of women, p=0.018). 72.2% of participants had high nicotine dependence. The total prevalence of metabolic syndrome in the sample studied was 60 % (n=75). Only 21 (16.8%) participants had undergone previous blood pressure treatment, 22 (17.6%) for hypertriglyceridemia and 14 (11.2%) for type 1 or 2 diabetes. Seventy- five patients who met all inclusion criteria, were invited to participate in the clinical trial. Those who agreed to participate, were randomly assigned to each group. The final sample was composed of 61 participants. 32 were assigned to the control group and 29 to the intervention or experimental group. Post-intervention results showed that the health-promoting programme was effective in reducing weight, waist circumference, fasting plasma triglycerides and diastolic blood pressure and a less significant increase in HDL cholesterol. This trial also showed improvements on physical activity and quality of life in the intervention group. CONCLUSIONS: The results of this study warn of the poor physical health of serious mental illness patients in Spain and reveal the need to evaluate patients’ health regularly and initiate interventions to promote healthy lifestyle, in order to prevent cardiovascular and metabolic risks. Mental health nurses are in an optimal position to perform these functions, due to their knowledge about physical health and mental health problems, and their proximity to patients with serious mental illness and their families. They should assume the role of patients´ care coordinators and referral to primary care for the prevention and treatment of health alterations. The health-promoting mental health nursing programme based on lifestyle modifications is effective in reducing the risk of metabolic syndrome and improving patients´ quality of life and physical activity, so the hypothesis has been demonstrated. Mental health nurses should investigate the effectiveness of other lifestyle interventions in people with mental disorders and lead the coordination of care between mental health centres and primary care. Because of their close ties to patients, nurses are uniquely positioned to improve the access of patients with serious mental illness to interventions that the general population receives as a matter of course.

El programa d’Intervenció que es presenta en aquest document és un programa destinat a potenciar l’activitat física, els hàbits alimentaris i la salut mental positiva de les persones amb obesitat.

Sustained B-cell activation is an important mechanism contributing to B-cell lymphoma (BCL). We aimed to validate four previously reported B-cell activation markers predictive of BCL risk (sCD23, sCD27, sCD30, and CXCL13) and to examine their possible mediating effects on the association between anthropometric and lifestyle factors and major BCL subtypes. Pre-diagnostic serum levels were measured for 517 BCL cases and 525 controls in a nested case–control study. The odds ratios of BCL were 6.2 in the highest versus lowest quartile for sCD23, 2.6 for sCD30, 4.2 for sCD27, and 2.6 for CXCL13. Higher levels of all markers were associated with increased risk of chronic lymphocytic leukemia (CLL), follicular lymphoma (FL), and diffuse large B-cell lymphoma (DLBCL). Following mutual adjustment for the other immune markers, sCD23 remained associated with all subtypes and CXCL13 with FL and DLBCL. The associations of sCD23 with CLL and DLBCL and CXCL13 with DLBCL persisted among cases sampled > 9 years before diagnosis. sCD23 showed a good predictive ability (area under the curve = 0.80) for CLL, in particular among older, male participants. sCD23 and CXCL13 showed a mediating effect between body mass index (positive) and DLBCL risk, while CXCL13 contributed to the association between physical activity (inverse) and DLBCL. Our data suggest a role of B-cell activation in BCL development and a mediating role of the immune system for lifestyle factors.

IntroductionThe work-to-retirement transition involves a process of psychologically and behaviourally distancing oneself from the workforce that is often accompanied by other social changes. The person is confronted with new social roles, expectations, challenges and opportunities that can influence lifestyle and well-being. In the scientific literature, we find recent reports of interventions aimed at improving health and well-being in people at retirement age. However, there is still a gap of knowledge on how different interventions during retirement might improve health status. We intend to conduct a scoping review with the aim of describing interventions for improving well-being across the retirement transition.Methods and analysisThe methodological framework described by Arksey and O’Malley; the Joanna Briggs Institute guidelines as well as the Preferred Reporting Items for scoping reviews and Preferred Reporting Items for Systematic Reviews and Meta-analysis Protocols statements will be followed. Eligibility criteria comprise of: (a) all type of original studies, review articles or reports published on journals as well as grey literature; (b) describing interventions to improve the well-being in adults across their retirement transition; (c) including participants before, during and after retirement; (d) all publications must describe variables associated with participants’ physical and/or psychological and/or social well-being and/or perceived quality of life related to these; (e) no language restriction and (f) published from January 2000 to March 2019. The main findings will be summarised using a narrative descriptive synthesis approach and grouped following the population, concept and context principles. A stakeholder meeting will be held to provide feedback on the findings and to develop next steps in research and practice.Ethics and disseminationApproval from a research ethics committee is not required, as no personal information will be collected. We plan to disseminate our research findings at different levels: scientific community, clinical and social arenas, as well as to healthcare leaders and policymakers and general population. The project has been registered at Open Science Framework with the name TRANSITS: work to retirement transition project.

The Barcelona Brain Health Initiative is a longitudinal cohort study that began in 2017 and aims to understand and characterize the determinants of brain health maintenance in middle aged adults. A cohort of 4686 individuals between the ages of 40 and 65 years free from any neurological or psychiatric diseases was established, and we collected extensive demographic, socio-economic information along with measures of self-perceived health and lifestyles (general health, physical activity, cognitive activity, socialization, sleep, nutrition and vital plan). Here we report on the baseline characteristics of the participants, and the results of the one-year follow-up evaluation. Participants were mainly women, highly educated, and with better lifestyles compared with the general population. After one year 60% of participants completed the one-year follow-up, and these were older, with higher educational level and with better lifestyles in some domains. In the absence of any specific interventions to-date, these participants showed small improvements in physical activity and sleep, but decreased adherence to a Mediterranean diet. These changes were negatively associated with baseline scores, and poorer habits at baseline were predictive of an improvement in lifestyle domains. Of the 2353 participants who completed the one-year follow-up, 73 had been diagnosed with new neurological and neuropsychiatric diseases. Changes in vital plan at follow-up, as well as gender, sleep quality and sense of coherence at baseline were shown to be significant risk factors for the onset of these diagnoses. Notably, gender risk factor decreased in importance as we adjusted by sleep habits, suggesting its potential mediator effects. These findings stress the importance of healthy lifestyles in sustaining brain health, and illustrate the individual benefit that can be derived from participation in longitudinal observational studies. Modifiable lifestyles, specifically quality of sleep, may partially mediate the effect of other risk factors in the development of some neuropsychiatric conditions.

Developing tools to understand and visualize lifestyle is of high interest when addressing the improvement of habits and well-being of people. Routine, defined as the usual things that a person does daily, helps describe the individuals’ lifestyle. With this paper, we are the first ones to address the development of novel tools for automatic discovery of routine days of an individual from his/her egocentric images. In the proposed model, sequences of images are firstly characterized by semantic labels detected by pre-trained CNNs. Then, these features are organized in temporal-semantic documents to later be embedded into a topic models space. Finally, Dynamic-Time-Warping and Spectral-Clustering methods are used for final day routine/non-routine discrimination. Moreover, we introduce a new EgoRoutine-dataset, a collection of 104 egocentric days with more than 100.000 images recorded by 7 users. Results show that routine can be discovered and behavioural patterns can be observed.

(1) Background: The work-to-retirement transition involves a process of psychologically and behaviorally distancing oneself from the workforce that is often accompanied by other social changes, which can influence health and well-being. However, research on interventions targeting the work-to-retirement transition to improve health status is limited. Our objective was to summarize and describe interventions aiming to improve well-being across the retirement transition, (2) Methods: We conducted a scoping review following the methodological framework described by Arksey and O&rsquo, Malley, the Joanna Briggs Institute guidelines as well as the PRISMA-ScR statements, we systematically searched articles and gray literature to identify interventions and policies that aimed to improve well-being across the retirement transition. (3) Results: 15 publications were included, which comprised both experimental designs (n = 10) and systematic reviews (n = 5). (4) Conclusions: More research on how to promote overall well-being during the work-to-retirement transition is needed. The results of this scoping review show that most reported interventions address one single lifestyle behavior, and that relevant social determinants of health have been barely considered in their design. Future investigations need to consider vulnerable groups and country-specific structural conditions. Adopting a patient and public involvement approach will contribute to developing interventions that address the significant needs of those in the transition to retirement.

BackgroundEncouraging healthy lifestyles in children is a challenge. This project aimed to improve lifestyles of younger peers by engaging adolescent creators (ACs) to design and implement peer-led and social marketing (SM) health-promoting activities.MethodsA 10-month parallel-cluster randomised controlled school-based pilot study was performed in disadvantaged neighbourhoods in Reus (Spain) spanning two academic years (2015–2016/2016–2017). Eight primary schools (n=375 children) and four high schools (n=94ACs) were randomly placed in the intervention group. The 94 ACs (12–14 years) designed and implemented four SM activities for their younger peers (9–11 years). Eight primary schools (n=327 children) and three high schools (n=98 adolescents) served as the control group and received no intervention. Primary (physical activity and fruit consumption) and secondary outcomes (screen time, vegetables, soft drinks, sweets and fast food consumptions) were assessed with validated questionnaires at baseline and at the end of the study.ResultsAfter 10 months, fruit consumption and physical activity were maintained in the children who consumed ≥1 fruit/day and spent ≥6 hours/week physical activity. However, compared with the controls, the intervention significantly increased the physical activity of girls to 15.6 min/week, whereas the percentage of girls who consumed sweets, soft drinks and fast food decreased significantly by 8.4%, 14.5% and 5.9%, respectively. Additionally, the percentage of ≥2 hour/weekday of screen time by boys decreased significantly by 8.2%.ConclusionThe European Youth Tackling Obesity-Kids, SM and peer-led intervention, effectively increased physical activity hours/week in girls, but was not effective in improving the percentage of children who consumed the recommended fruit. Moreover, the percentages of girls who consumed sweets, soft drinks and fast food and boys screen time decreased.Trial registration numberNCT02702336; Pre-results.

The objectives of the thesis are to estimate the prevalence of pathological arterial stiffness (measured with the Cardio-Ankle Vascular Index –CAVI-) in a general Mediterranean population and in a Mediterranean intermediate cardiovascular risk population, and to assess the association of this condition with lifestyle, cardiovascular risk factors, and socioeconomic status. The prevalence of pathological CAVI was high, mainly in the intermediate cardiovascular risk population. Pathological CAVI was associated with hypertension and diabetes, and negatively associated with obesity in both populations. Regarding lifestyles, only physical activity in men from the general Mediterranean population was associated with pathological CAVI. Completion of instruction only up to primary education level was associated with pathological arterial stiffness in men from the intermediate cardiovascular risk population. To improve primary prevention of cardiovascular disease we should focus on the early detection of pathological CAVI, and on the control of diabetes and hypertension Els objectius de la tesi són calcular la prevalença de la rigidesa arterial patològica (mesurada amb el Cardio-Ankle Vascular Index -CAVI-) en una població general mediterrània i en una població mediterrània de risc entremig i avaluar l’associació d’aquesta amb estils de vida, factors de risc cardiovascular i nivell socioeconòmic. La prevalença de CAVI patològic era elevada, sobretot en la població de risc entremig, i aquest s’associà positivament a la hipertensió i la diabetis, i negativament a l’obesitat en les dues poblacions. Només l’activitat física en els homes en la població general estava relacionada amb el CAVI patològic. Cap altre estil de vida no hi estava relacionat. A més, tenir un nivell d’estudis màxim de primària també estava associat a CAVI patològic en homes de la població de risc entremig. Per prevenir les malalties cardiovasculars cal incidir en la detecció precoç del CAVI i controlar la diabetis i la hipertensió

OBJECTIVE: To explore genetic and lifestyle risk factors of MRI-defined brain infarcts (BI) in large population-based cohorts. METHODS: We performed meta-analyses of genome-wide association studies (GWAS) and examined associations of vascular risk factors and their genetic risk scores (GRS) with MRI-defined BI and a subset of BI, namely, small subcortical BI (SSBI), in 18 population-based cohorts (n = 20,949) from 5 ethnicities (3,726 with BI, 2,021 with SSBI). Top loci were followed up in 7 population-based cohorts (n = 6,862; 1,483 with BI, 630 with SBBI), and we tested associations with related phenotypes including ischemic stroke and pathologically defined BI. RESULTS: The mean prevalence was 17.7% for BI and 10.5% for SSBI, steeply rising after age 65. Two loci showed genome-wide significant association with BI: FBN2, p = 1.77 × 10-8; and LINC00539/ZDHHC20, p = 5.82 × 10-9. Both have been associated with blood pressure (BP)-related phenotypes, but did not replicate in the smaller follow-up sample or show associations with related phenotypes. Age- and sex-adjusted associations with BI and SSBI were observed for BP traits (p value for BI, p [BI] = 9.38 × 10-25; p [SSBI] = 5.23 × 10-14 for hypertension), smoking (p [BI] = 4.4 × 10-10; p [SSBI] = 1.2 × 10-4), diabetes (p [BI] = 1.7 × 10-8; p [SSBI] = 2.8 × 10-3), previous cardiovascular disease (p [BI] = 1.0 × 10-18; p [SSBI] = 2.3 × 10-7), stroke (p [BI] = 3.9 × 10-69; p [SSBI] = 3.2 × 10-24), and MRI-defined white matter hyperintensity burden (p [BI] = 1.43 × 10-157; p [SSBI] = 3.16 × 10-106), but not with body mass index or cholesterol. GRS of BP traits were associated with BI and SSBI (p ≤ 0.0022), without indication of directional pleiotropy. CONCLUSION: In this multiethnic GWAS meta-analysis, including over 20,000 population-based participants, we identified genetic risk loci for BI requiring validation once additional large datasets become available. High BP, including genetically determined, was the most significant modifiable, causal risk factor for BI.

Social determinants of health (DSS) are the circumstances in which people are born, grow, live, work, and grow old in relation to their health system. The study of DSS becomes essential for understanding social health inequalities by gender. This study analyzes the perception of health status, lifestyles and the use of health services, from the perspective of social determinants of health and the axis of inequality in Catalonia in 2006 and 2012/13. , through the comparison of the results obtained with the Health Survey of Catalonia (ESCA) The descriptive study focused on the population of Catalonia, not institutionalized and over 15 years. The research results reveal differences between the two waves likely to be in different economic contexts. The main contribution of the thesis is the analysis carried out from the perspective of gender, DSS and the axis of inequality Els determinants socials de la salut (DSS) són les circumstàncies en què les persones neixen, creixen, viuen, treballen i envelleixen, en relació amb el sistema de salut. L’estudi dels DSS es converteix en essencial per entendre las desigualtats socials en salut segons el gènere. En aquest estudi, s’analitza la percepció de l'estat de salut, els estils de vida i l'ús dels serveis sanitaris, des de la perspectiva dels determinants socials de salut i els eixos de desigualtat a Catalunya al 2006 i 2012/13, a traves de la comparació dels resultats obtinguts a l’ Enquesta de Salud de Catalunya (ESCA) L'estudi descriptiu s'ha centrat en la població de Catalunya, no institucionalitzada i major de 15 anys. Els resultats de la investigació revelen diferencies entre les dues onades probablement per trobar-se en contextos econòmics diferents. La principal aportació de la tesis es l’anàlisi realitzat des de la perspectiva de gènere, DSS i els eixos de desigualtat

Introducció: Els estils de vida són el conjunt de pautes i hàbits d'una persona que mantinguts en el temps poden comportar-se com factors de risc o de protecció depenent de la seva naturalesa. Alguns estudis demostren que determinats canvis en l'estil de vida són eficaços per millorar la salut i disminuir la càrrega de malaltia. L'augment en les noves tecnologies obre un nou camí en el tractament dels estils de vida com són el tabac i l'obesitat. Les aplicacions per a dispositius mòbils proporcionen solucions a diverses necessitats dels usuaris. No obstant això, moltes d'aquestes no són molt sofisticades i proporcionen un benefici limitat o dubtós, necessitant regular aquest mercat creixent mitjançant estudis que aportin evidència científica real sobre l'impacte en l'atenció primària. Objectius: - Analitzar l'efectivitat de les intervencions basades en la implementació d'una aplicació desenvolupada per a dispositius mòbils per reduir el pes i augmentar l'activitat física. - Dissenyar un protocol d'estudi per avaluar l'efectivitat d'una intervenció de pèrdua de pes basada en recomanacions de dieta estàndard més una aplicació de telèfon intel·ligent (app) i dispositiu portàtil, en comparació amb la intervenció dietètica basada en l'evidència estàndard sola, en pacients d'atenció primària amb edats 18 anys o més que tenen sobrepès o obesitat. - Conèixer les estratègies d'afrontament i el suport social en línia proporcionat pels usuaris d'una app per a dispositius mòbils per deixar de fumar durant el procés de deshabituació tabàquica. Metodologia: Per a la consecució del primer objectiu es va realitzar una revisió sistemàtica i una metanàlisi d'estudis rellevants identificats mitjançant una cerca a PubMed, CINAHL (the Cumulative Index to Nursing and Allied Health Literature) i Scopus des del seu inici fins a l’ agost de 2015. Dos membres de l'equip d'estudi van analitzar de forma independent els estudis per verificar els criteris d'inclusió i extreure les dades. Es van incloure tots els estudis controlats que van avaluar una intervenció amb una aplicació de telèfon mòbil mesures de salut relacionades amb el pes (és a dir, pes corporal, índex de massa corporal i/o circumferència de cintura) i/o resultats d'activitat física. Les estimacions del canvi net que comparaven el grup intervenció amb el grup control es Introducción: Los estilos de vida son el conjunto de pautas y hábitos de una persona que mantenidos en el tiempo pueden comportarse como factores de riesgo o de protección dependiendo de su naturaleza. Algunos estudios demuestran que determinados cambios en el estilo de vida son eficaces para mejorar la salud y disminuir la carga de enfermedad. El auge en las nuevas tecnologías abre un camino en el tratamiento de los estilos de vida como son el tabaco y la obesidad. Las aplicaciones para dispositivos móviles proporcionan soluciones a diversas necesidades de los usuarios. Sin embargo, muchas de éstas no son muy sofisticadas y proporcionan un beneficio limitado o dudoso, necesitando regular este mercado creciente mediante estudios que aporten evidencia científica real sobre el impacto en la atención primaria. Objetivos: -Analizar la efectividad de las intervenciones basadas en la implementación de una aplicación desarrollada para dispositivos móviles para reducir el peso y aumentar la actividad física. -Diseñar un protocolo de estudio para evaluar la efectividad de una intervención de pérdida de peso basada en recomendaciones de dieta estándar más una aplicación de teléfono inteligente (app) y dispositivo portátil, en comparación con la intervención dietética basada en la evidencia estándar sola, en pacientes de atención primaria con edades 18 años o más que tienen sobrepeso u obesidad. -Conocer las estrategias de afrontamiento y el apoyo social en línea proporcionado por los usuarios de una app para dispositivos móviles para dejar de fumar durante el proceso de deshabituación tabáquica. Metodología: Para la consecución del primer objetivo se realizó una revisión sistemática y un metanálisis de estudios relevantes identificados mediante una búsqueda en PubMed, CINAHL (the Cumulative Index to Nursing and Allied Health Literature) y Scopus desde su inicio hasta agosto de 2015. Dos miembros del equipo de estudio analizaron de forma independiente los estudios para verificar los criterios de inclusión y extraer los datos. Se incluyeron todos los estudios controlados que evaluaron una intervención con una aplicación de teléfono móvil medidas de salud relacionadas con el peso (es decir, peso corporal, índice de masa corporal y/o circunferencia de cintura) y/o resultados de actividad física. Las estimaciones del Introduction: Lifestyles are the set of guidelines and habits of a person that maintained over time can behave as risk or protection factors depending on their nature. Some studies show that certain changes in lifestyle are effective in improving health and decreasing the burden of disease. The rise of the new technologies opens a new way in the lifestyles treatment such as tobacco and obesity. Applications for mobile devices provide solutions to different user needs. However, many of these are not very sophisticated and provide a limited or dubious benefit, needing to regulate this growing market through studies that provide real scientific evidence on the impact on primary care. Goals: - Analyze the effectiveness of interventions based on the implementation of an application developed for mobile devices to reduce weight and increase physical activity. - Design a study protocol to evaluate the effectiveness of a weight loss intervention based on standard diet recommendations plus a smartphone application (app) and portable device, compared to the standardized evidence-based dietary intervention alone, in primary care patients aged 18 years or older who are overweight or obese. - Know the coping strategies and online social support provided by users of an app for mobile devices to stop smoking during the process of smoking cessation. Methodology: To achieve the first objective, a systematic review and meta-analysis of relevant studies identified through a PubMed search, CINAHL (the Cumulative Index to Nursing and Allied Health Literature) and Scopus from its inception to August 2015 were performed. Two team members analyzed the studies independently to verify the inclusion criteria and extract the data. We included all controlled studies that evaluated an intervention with a mobile phone application health measures related to weight (ie, body weight, body mass index and/or waist circumference) and/or physical activity results. The estimattions of the net change that compared the intervention group with the control group were combined in the studies that used random effects models. To achieve the second objective, a randomized, multicenter controlled clinical trial was designed in two primary care centers in the city of Tarragona. Subjects: 70 primary care patients, 18 years of age or older, with a body ma

Background Sarcopenia is a progressive age-related skeletal muscle disorder associated with increased likelihood of adverse outcomes. Muscle wasting is often accompanied by an increase in body fat, leading to 'sarcopenic obesity'. The aim of the present study was to analyse the association of lifestyle variables such as diet, dietary components, physical activity (PA), body composition, and inflammatory markers, with the risk of sarcopenic obesity. Methods A cross-sectional analysis based on baseline data from the PREDIMED-Plus study was performed. A total of 1535 participants (48% women) with overweight/obesity (body mass index: 32.5 +/- 3.3 kg/m(2); age: 65.2 +/- 4.9 years old) and metabolic syndrome were categorized according to sex-specific tertiles (T) of the sarcopenic index (SI) as assessed by dual-energy X-ray absorptiometry scanning. Anthropometrical measurements, biochemical markers, dietary intake, and PA information were collected. Linear regression analyses were carried out to evaluate the association between variables. Results Subjects in the first SI tertile were older, less physically active, showed higher frequency of abdominal obesity and diabetes, and consumed higher saturated fat and less vitamin C than subjects from the other two tertiles (all P < 0.05). Multiple adjusted linear regression models evidenced significant positive associations across tertiles of SI with adherence to the Mediterranean dietary score (P-trend < 0.05), PA (P-trend < 0.0001), and the 30 s chair stand test (P-trend < 0.0001), whereas significant negative associations were found with an inadequate vitamin C consumption (P-trend < 0.05), visceral fat and leucocyte count (all P-trend < 0.0001), and some white cell subtypes (neutrophils and monocytes), neutrophil-to-lymphocyte ratio, and platelet count (all P-trend < 0.05). When models were additionally adjusted by potential mediators (inflammatory markers, diabetes, and waist circumference), no relevant changes were observed, only dietary variables lost significance. Conclusions Diet and PA are important regulatory mediators of systemic inflammation, which is directly involved in the sarcopenic process. A healthy dietary pattern combined with exercise is a promising strategy to limit age-related sarcopenia. This work was supported by the official Spanish institutions for funding scientific biomedical research, CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn) and Instituto de Salud Carlos III (ISCIII), through the Fondo de Investigación para la Salud (FIS), co‐funded by the European Regional Development Fund (ERDF) (four coordinated FIS projects leaded by J.S.‐S. and J.V., including the following projects: PI13/00462, PI13/01090, PI13/02184, PI14/00853, PI14/00728, PI14/01919, PI16/00501, PI16/00381, PI16/01522, PI17/00525, PI17/00532, PI17/00215, and PI17/00926), and through specific grants: the Astra Zeneca Young Investigators Award in Category of Obesity and Diabetes 2017 (D.R.); Juan de la Cierva‐formación research grant (FJCI‐2015‐24058) of the Spanish Ministry of Economy, Industry and Competitiveness and European Social Funds (J.K.), the ‘FOLIUM’ programme within the FUTURMed project; and talent for the medicine within the future from the Fundación Instituto de Investigación Sanitaria Illes Balears (financed by 2017 annual plan of the sustainable tourism tax and at 50% with charge to the ESF Operational Program 2014–2020 of the Balearic Islands) (J.K.). None of the funding sources took part in the design, collection, analysis, or interpretation of the data or in the decision to submit the manuscript for publication. This work is supported by the European Research Council (Advanced Research Grant 2014–2019; agreement #340918 granted to MAM‐G).

[spa] Esta tesis presenta una investigación-formación con un grupo de personas obesas. Su objetivo es entender por qué los tratamientos para estas personas obesas no consiguen evitar la reincidencia de la obesidad ni el incremento de nuevos casos en todas las sociedades civilizadas. Para ello, hemos revisado la literatura latinoamericana y española sobre la obesidad y las recomendaciones y evidencias de la comunidad científica. Es una investigación-formación inmersa en un paradigma reflexivo/interpretativo, con el método autobiográfico desde el punto de vista de las historias de vida para la formación de adultos, con un método en dos perspectivas. Un recorte de las historias de vida, relacionado con la obesidad, en las narrativas autobiográficas elaboradas en la reflexión y la interacción, por 13 personas obesas que concordaron en participar de la intervención educativa, para la formación de un nuevo estilo de vida y la pérdida de peso corporal. Para el análisis de los datos no partimos de categorías previas o hipótesis. Buscamos una categorización primaria en la que analizamos de forma inductiva las narrativas autobiográficas y transcripciones en grupos de discusión. Las unidades de significado son interpretadas y responden a nuestro eje central de la investigación, con el abordaje en su diseño. Los resultados de la revisión de literatura distinguen que los tratamientos para las personas obesas son ineficaces porque después de dos a tres años, el 95% de las personas obesas tratadas vuelven al peso anterior, otras abandonan el tratamiento, no consiguen atender a los sistemas de salud, o, aún ignoran la obesidad y sus consecuencias. Los principales resultados del estudio apuntan: dificultades subjetivas de las personas obesas; fenómenos relacionados al surgimiento de la obesidad; fenómenos responsables por la progresión de la obesidad; génesis de la obesidad; fenómenos que contribuyen para la pérdida de peso corporal y fenómenos influyentes para el exceso de peso corporal, a partir de la experiencia y de la subjetividad de las personas obesas para la ciencia. El estudio concluye que el contexto social impulsa el desarrollo del sobrepeso y de la obesidad, especialmente, en el ambiente familiar, por la falta de educación nutricional, cultura y creencias alimentarias. Coloca en evidencia la necesidad de aprendizajes para la formación de un nuevo estilo de vida de las personas obesas a través de la educación nutricional, así como la educación emocional, para el alcance de cambios de las conductas y de los hábitos alimentarios inadecuados, pérdida del exceso de peso corporal y control de la obesidad., [eng] This thesis presents a research-training with a group of obese people. Its aim is to understand why treatments for the obese cannot prevent the recurrence of obesity nor the increase of new cases in the world. Therefore, we review the Latin American and Spanish literature on obesity and the recommendations and evidence of the scientific community. A research-training immersed in a reflective / interpretive paradigm, with the method autobiographical from the point of view of life stories for adult education, with a method from two perspectives. A clipping of life stories related to obesity in autobiographical narratives elaborated in reflection and interaction by 13 obese people who agreed to participate in the educational intervention to form a new lifestyle and loss of body weight. For the analysis of the data we do not start from previous categories or hypotheses. We seek a primary categorization by inductively analyzing autobiographical narratives and discussion groups. The units of significance are interpreted and respond to our central research theme, with the approach in its design. The results of the literature review recognize that treatments for obese people are ineffective because two to three years later, 95% of the obese treated return to their previous weight, others abandon treatment, are unable to obtain access to healthcare systems, or even ignore obesity and its consequences. The main results of the study indicate: subjective difficulties of the obese people; phenomena related to the appearance of obesity; responsible phenomena for the progression of obesity; genesis of obesity; phenomena that contribute to the loss of body weight and influential phenomena for overweight, from the experience and subjectivity of obese people to science. The study concludes that the social context drives the development of overweight and obesity, especially the family environment, for the lack of nutritional education, culture and food beliefs. It evidences the need of learning to form a new lifestyle for obese people through nutritional education and emotional education, to achieve changes in behavior and inappropriate eating habits, loss of excess body weight and control of obesity.

Background Chronic diseases are generating a major health and societal burden worldwide. Healthy lifestyles, including physical activity (PA), have proven efficacy in the prevention and treatment of many chronic conditions. But, so far, national PA surveillance systems, as well as strategies for promotion of PA, have shown low impact. We hypothesize that personalized modular PA services, aligned with healthcare, addressing the needs of a broad spectrum of individual profiles may show cost-effectiveness and sustainability. Methods The current manuscript describes the protocol for regional implementation of collaborative self-management services to promote PA in Catalonia (7.5 M habitants) during the period 2017–2019. The protocols of three implementation studies encompassing a broad spectrum of individual needs are reported. They have a quasi-experimental design. That is, a non-randomized intervention group is compared to a control group (usual care) using propensity score methods wherein age, gender and population-based health risk assessment are main matching variables. The principal innovations of the PA program are: i) Implementation of well-structured modular interventions promoting PA; ii) Information and communication technologies (ICT) to facilitate patient accessibility, support collaborative management of individual care plans and reduce costs; and iii) Assessment strategies based on the Triple Aim approach during and beyond the program deployment. Discussion The manuscript reports a precise roadmap for large scale deployment of community-based ICT-supported integrated care services to promote healthy lifestyles with high potential for comparability and transferability to other sites. Trial registration This study protocol has been registered at ClinicalTrials.org (NCT02976064). Registered November 24th, 2016. Electronic supplementary material The online version of this article (10.1186/s12913-018-3363-8) contains supplementary material, which is available to authorized users.