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Objective: To design a self-reported semi-quantitative questionnaire of frequency of food intake (QFFI) to assess the usual intake of foods and macronutrients of the academic community from the University of Antioquia (UoA). Methodology: The design of the questionnaire was done by reviewing and analyzing previous studies on food intake and the established linings for the selling of dietary products at the UoA. For selecting the foods and defining the serving size, we applied the criterion of intake pattern and the weight or size of the most frequent serving for each food, according to what has been reported in previous studies. We undertook a descriptive exploratory study with the QFFI including 154 people of the UoA. The analysis included the comprehension, applicability and comprehensiveness of the instrument for the participants, as well as the calculation of the descriptive parameters in the exploratory component. Results: A semi-quantitative QFFI compounded by 144 foods classified in 9 groups with serving sizes known by the population and 9 categories of frequencies of usual intake within the last year. The exploratory study showed differences in the pattern of intake in the population groups analyzed. Conclusion: The designed QFFI was adequate for the study population since it was easily understood and administered, and it allowed for assessing the usual intake in the community of the UoA. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To study the changes in body mass index (BMI) in a population-based cohort and their relationship with sociodemographic variables in a Mediterranean-country. METHOD: A prospective population-based cohort with 8-year follow-up. The data used derive from the Cornellà-Health-Interview Survey Follow-up (CHIS.FU). 1008 people aged > or = 20 years (females=508; males=500) were interviewed in 1994 and in 2002, providing self-reported weight and height data. The BMI was compared using the Wilcoxon test for paired data. Changes in the BMI were calculated and their relationship with sociodemographic-variables and lifestyles using multivariate Breslow-Cox regression. RESULTS: 28.1% of participants had changed from normal-BMI in 1994 to overweight in 2002 (women=25.6%; men=31.6%). 16.8% increased from overweight to obesity (women=25.8%; men=11.2%). The cumulative incidence of overweight: women=26.4%; men=34.0%. The cumulative incidence of obesity: women=29.9%; men=13.1%. The cumulative age and sex-adjusted incidence of overweight showed a significant relationship with marital-status (married: RR=2.0; 95% CI: 1.2-3.4, divorced/widowed: RR=4.0; 95% CI: 1.7-9.3) and moderate alcohol-consumption (RR=1.86; 95% CI: 1.1-3.1). We observed a decreased age-adjusted risk in the incidence of obesity for men (RR=0.49; 95% CI: 0.3-0.8). CONCLUSION: The observed changes in the increase in the incidence of obesity and overweight indicated a similar evolution in the obesity epidemic regardless of Mediterranean dietary patterns in our population. Copyright © 2010 by Elsevier Inc. [ABSTRACT FROM AUTHOR]

Objective: To analyze the consumption of critical nutrients and other sweeteners, according to the degree of food processing in the population of Antioquia., Methods: Cross-Sectional Study. The dietary intake of 4,382 participants of the Perfil Alimentario y Nutricional de Antioquia 2019 (Antioquia Food and Nutrition Profile 2019) was evaluated. Processed foods (PF) and ultra-processed products (UPP) reported by 24-hour recall were classified according to the Nova system. The Nutrient Profile Model (NPM) of the Pan American Health Organization (PAHO) was used. The amount of PF and UPP consumed with excess of critical nutrients related to chronic diseases (CD) was measured. The difference in average intake, the prevalence of excess intake, and the likelihood of inadequacy between groups with and without excess dietary content were assessed., Results: Nearly 50% of the PF and UPP consumed had excess in at least one critical nutrient. The population consumed daily one or more products with excess in free sugar (73.3%), total fat (75.2%), saturated fat (77.0%), sodium (83.9%), and/or sweeteners (36.8%). Those who consumed products with excessive amounts had a higher intake of total fat (> 5.8%); saturated fat (> 3.8%); and sodium (> 698.7 mg) in adults and adolescents, in children 5-10 years (> 659.2 mg), and in children under 5 years (> 498 mg). Those who consumed products with excessive amounts presented the greatest possibilities of dietary inadequacy., Conclusion: The population of Antioquia that consumes PF and UPP with excessive amounts of free sugars, total fat, saturated fat, sodium, and/or sweeteners presents an unbalanced diet. Reducing the consumption of these products and returning to a natural and/or minimally processed diet may be an effective strategy to achieve the nutrient intake recommendations prioritized by PAHO in the population of Antioquia.

Background: Information about the reliability and validity of questionnaires in low- and middle-income countries remains scarce. Objective: To test the reliability and predictive validity of a food and beverage marketing/advertising questionnaire for South American children and adolescents. Methods: A sample of 330 children (3-10 years old) and 215 adolescents (11-18 years old) was included from seven South American cities: Buenos Aires, Lima, Medellín, Montevideo, Santiago, Sao Paulo, and Teresina. The questionnaire consisted of seven questions about food and beverage marketing/advertising and decision influence. We assessed the reliability using temporal stability (2-week interval) and internal consistency. We assessed the predictive validity based on the risk of excess weight. Results: In children, reliability agreement from κ coefficients ranged from 63.7% to 86.3%, and Cronbach's α (internal consistency estimate) ranged from 0.14 to 0.75. In adolescents, the reliability agreement ranged from 78.9% to 85.7%, and Cronbach's α ranged from 0.14 to 0.76. Exploratory factor analysis revealed two factors for both age groups. The predictive probabilities for excess weight ranged from 22.3% to 61.1% in children and from 24.9% to 64.1% in adolescents. Conclusions: The screen/marketing media questionnaire is a reliable and valid measure for the pediatric population from low- and middle-income countries. This subjective tool provides a feasible screening measure for the influence of advertising on children and adolescents at risk of overweight and obesity.

Aims: To develop and validate risk scores for predicting abdominal obesity in South American children and adolescents based on extrinsic and intrinsic variables., Methods: Children (n = 358) and adolescents (n = 369) from seven South American cities from the South American Youth Cardiovascular and Environmental (SAYCARE) Study. The primary outcome was abdominal obesity. Potential predictors were based on sociodemographic, maternal, environmental, and behavioural factors and nutritional status. In multilevel logistic models, associated variables were tested to build the scores, which were internally validated., Results: We identified 120 children and 98 adolescents who were abdominally obese. We found at least five variables associated with the outcome in children with unacceptable predictive capacity. However, in adolescents, we found that biological sex, age, maternal body mass index (BMI), active commuting by bike, soft drink consumption (for risk score A), and weight (for score B) can predict abdominal obesity. Both scores, A and B, showed acceptable performance in the ROC curve [areas under curve: 0.70 (95% CI: 0.56-0.82) and 0.95 (95% CI: 0.89-1.00), respectively]., Conclusion: The SAYCARE risk scores present accurate, individualised estimates for identifying adolescents who are at risk of developing abdominal obesity. However, these have not been externally validated., Competing Interests: Declaration of competing interest The authors declare no conflict of interest., (Copyright © 2021 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.)

The present study aimed to assess the associations of the stages of Fe deficiency (Fe deficiency without anaemia (ID) and Fe-deficiency anaemia (IDA)) and anaemia with metabolic syndrome (MetS) in Ecuadorian women. A cross-sectional study was conducted in 5894 women aged 20-59 years, based on data from the 2012 Ecuadorian National Health and Nutrition Survey. The sample was stratified by age. A χ 2 test was used to assess the possible associations of ID, IDA and anaemia with MetS. The prevalence ratio (PR) for each stage of Fe deficiency and anaemia was estimated considering women without MetS as a reference. The total prevalence of MetS, ID, IDA and anaemia was 32⋅3 % (se 0⋅6), 6⋅2 % (se 0⋅3), 7⋅1 % (se 0⋅3) and 5⋅0 % (se 0⋅3), respectively. In women aged 20-29, 30-39 and 40-49 years, MetS was associated with a lower prevalence of ID (PR (95 % CI; P -value)): 0⋅17 (0⋅06, 0⋅46; P < 0⋅001), 0⋅69 (0⋅48, 0⋅99; P = 0⋅044) and 0⋅44 (0⋅29, 0⋅67; P < 0⋅001), respectively. In women aged 50-59 years, MetS was associated with IDA and anaemia (PR (95 % CI; P -value)): 0⋅12 (0⋅02, 0⋅96; P = 0⋅026) and 0⋅22 (0⋅07, 0⋅64; P = 0⋅002), respectively. In conclusion, Ecuadorian women of reproductive age with MetS have a lower prevalence of ID compared with those without MetS. Furthermore, the MetS and IDA coexist at the population level. These findings require an analysis from a dietary pattern approach, which could provide key elements for developing public policies that simultaneously address all forms of malnutrition., (© The Author(s) 2021.)

Background: Metabolic syndrome (MS) and its components increase the risk of a number of chronic diseases. Evidence regarding its prevalence among health professionals, particularly in Latin America, is limited. The purpose of this study was to assess the overall prevalence of MS and its components among health professionals and students from five Latin American countries. Methods: A cross-sectional multicenter study entitled LATIN America METabolic Syndrome (LATINMETS) was conducted on five groups of apparently healthy volunteer subjects. Sociodemographic factors, lifestyle variables (smoking and physical activity), anthropometric measurements (weight, height, and waist circumference), standard biochemical analyses [triglycerides, glucose, and high-density lipoprotein cholesterol (HDL-C)], and blood pressure measurements were assessed. MS was diagnosed based on internationally harmonized criteria. Associations between MS components and sociodemographic, lifestyle, and anthropometric variables were analyzed using multivariate logistic regression. Results: A total of 1,032 volunteers ( n  = 316-Mexico, n  = 285-Colombia, n  = 223-Brazil, n  = 132-Paraguay, and n  = 76-Argentina) were recruited. The majority of them were women (71.9%), students (55.4%), and younger than 28 years (67.2%). The overall prevalence of age-standardized MS was 15.5% (23.1% men and 12.2% women). The majority (59.3%) presented at least one MS component, mainly abdominal obesity (29.7%) and low HDL-C levels (27.5%). After adjusting for age and sex, MS and its components were positively associated with being overweight or obese. Conclusions: MS prevalence in this study was similar to that generally found among young populations in Latin-American countries. More than half of the sample had at least one MS component, suggesting that preventive measures and treatments aimed at achieving low-risk health status are essential in this population.

Objective: The purpose of this study was to analyse the reliability and validity of a semi-quantitative FFQ to assess food group consumption in South American children and adolescents., Design: The SAYCARE (South American Youth/Child cARdiovascular and Environmental) study is an observational, multicentre, feasibility study performed in a sample of 3- to 18-year-old children and adolescents attending private and public schools from six South American countries. Participants answered the FFQ twice with a two-week interval and three 24-h dietary recalls. Intraclass and Spearman's correlations, weighted Cohen's kappa (κw), percentage of agreement and energy-adjusted Pearson's correlation coefficients were calculated., Setting: Seven cities in South America (Buenos Aires, Lima, Medelin, Montevideo, Santiago, Sao Paulo and Teresina)., Subjects: A sample of 200 children and 244 adolescents for reliability analyses and 252 children and 244 adolescents for validity analyses were included., Results: Depending on the food group, for children and adolescents, reliability analyses resulted in Spearman's coefficients from 0·47 to 0·73, intraclass correlation coefficients from 0·66 to 0·99, κw coefficients from 0·35 to 0·63, and percentage of agreement between 72·75 and 83·52 %. In the same way, validity analyses resulted in Spearman's coefficients from 0·17 to 0·37, energy-adjusted Pearson's coefficients from 0·17 to 0·61, κw coefficients from 0·09 to 0·24, and percentages of agreement between 45·79 and 67·06 %., Conclusion: The SAYCARE FFQ achieved reasonable reliability and slight-moderate validity for almost all food groups intakes. Accordingly, it can be used for the purpose of ranking the intake of individuals within a population.

Restricting children's exposures to marketing of unhealthy foods and beverages is a global obesity prevention priority. Monitoring marketing exposures supports informed policymaking. This study presents a global overview of children's television advertising exposure to healthy and unhealthy products. Twenty-two countries contributed data, captured between 2008 and 2017. Advertisements were coded for the nature of foods and beverages, using the 2015 World Health Organization (WHO) Europe Nutrient Profile Model (should be permitted/not-permitted to be advertised). Peak viewing times were defined as the top five hour timeslots for children. On average, there were four times more advertisements for foods/beverages that should not be permitted than for permitted foods/beverages. The frequency of food/beverages advertisements that should not be permitted per hour was higher during peak viewing times compared with other times (P < 0.001). During peak viewing times, food and beverage advertisements that should not be permitted were higher in countries with industry self-regulatory programmes for responsible advertising compared with countries with no policies. Globally, children are exposed to a large volume of television advertisements for unhealthy foods and beverages, despite the implementation of food industry programmes. Governments should enact regulation to protect children from television advertising of unhealthy products that undermine their health., (© 2019 The Authors. Obesity Reviews published by John Wiley & Sons Ltd on behalf of World Obesity.)

Objective: To assess the reliability and validity of body weight (BW) and body image (BI) perception reported by parents (in children) and by adolescents in a South American population., Design: Cross-sectional study. BW perception was evaluated by the question, 'Do you think you/your child are/is: severely wasted, wasted, normal weight, overweight, obese?' BI perception was evaluated using the Gardner scale. To evaluate reliability, BW and BI perceptions were reported twice, two weeks apart. To evaluate validity, the BW and BI perceptions were compared with WHO BMI Z-scores. Kappa and Kendall's tau-c coefficients were obtained., Setting: Public and private schools and high schools from six countries of South America (Argentina, Peru, Colombia, Uruguay, Chile, Brazil).ParticipantsChildren aged 3-10 years (n 635) and adolescents aged 11-17 years (n 400)., Results: Reliability of BW perception was fair in children's parents (κ=0·337) and substantial in adolescents (κ=0·709). Validity of BW perception was slight in children's parents (κ=0·176) and fair in adolescents (κ=0·268). When evaluating BI, most children were perceived by parents as having lower weight. Reliability of BI perception was slight in children's parents (κ=0·124) and moderate in adolescents (κ=0·599). Validity of BI perception was poor in children's parents (κ=-0·018) and slight in adolescents (κ=0·023)., Conclusions: Reliability of BW and BI perceptions was higher in adolescents than in children's parents. Validity of BW perception was good among the parents of the children and adolescents with underweight and normal weight.

Background: While dietary patterns (DPs) enable the combination of foods that make up a person's habitual diet to be known, little is known about the DPs of health sector professionals. The objective of this study was to describe the DPs of healthcare students and professionals and assess their association with sociodemographic, lifestyle, anthropometric and biochemical characteristics., Methods: Cross-sectional design. A sample (n = 319) of healthcare students and professionals in apparent good health who studied or worked at the University of Guadalajara (Mexico) was selected. A semiquantitative food intake frequency questionnaire validated on a Mexican population was administered. Questions covering sociodemographic factors, smoking habits and physical activity were asked. Weight, height, waist circumference, blood pressure, triglycerides, glucose, HDL-cholesterol, LDL-cholesterol and total cholesterol were also measured. DPs were generated from a principal components analysis of 25 food groups, and associations were analyzed using logistic regression adjusted for age and sex., Results: The majority of participants were younger than 29 years (84%), women (71.2%) and students (59.6%). Three DPs were identified: "Traditional Westernized", "Healthy" and "Animal protein and alcoholic beverages". After adjustment, the "Traditional Westernized" DP was positively associated with being younger than 22 years (OR: 2.15; 95%CI: 1.1-4.1); the "Healthy" DP was positively associated with having a daily energy expenditure from physical activity greater than 605 kcal (OR: 4.19; 95%CI: 2.3-7.5), and it was negatively associated with being younger than 22 years (OR: 0.48; 95%CI: 0.2-0.9); and the "Animal protein and alcoholic beverages" DP was positively associated with being male (OR: 3.07; 95%CI: 1.8-5.1) and a smoker (OR: 2.77; 95%CI: 1.2-6.3). No association was found between DPs and anthropometric and biochemical characteristics., Conclusions: Among the participants evaluated, healthy DP was associated with being physically active while unhealthy DPs were associated with being younger than 22 years, male and a smoker. These data suggest that being knowledgeable about health does not ensure that individuals will engage in healthy behaviors. As is the case among the general population, training and individual efforts aimed at achieving healthy behaviors must be reinforced by initiatives undertaken by social groups, social institutions, the community at large as well as political and business leaders.

Objective: This study aimed to describe the development of a food frequency questionnaire (FFQ) to assess dietary intake in South American children and adolescents., Methods: A total of 345 children (aged 3-10 years) and 357 adolescents (aged 11-17 years) were included for analysis. The FFQ was designed to be self-administered and to assess dietary intake over the past 3 months. It was developed in Spanish and translated into Portuguese. Multiple approaches were considered to compile the food list, and 11 food groups were included. A food photo booklet was produced as supporting material., Results: The FFQ items maintained a common core list among centers (47 items) and country-specific foods. The FFQ for Buenos Aires and Lima had a total of 63 items; there were 55 items for the FFQ in Medelin, 60 items for Montevideo, 58 items for Santiago, 67 items for Sao Paulo, and 68 items for Teresina. Alcohol was also incorporated in the adolescents' FFQ., Conclusions: We developed a semiquantitative, culturally adapted FFQ to assess dietary intake in children and adolescents in South America. It has an optimal size allowing its completion in a high proportion of the population; therefore, it can be used in epidemiological studies with South American children and adolescents., (© 2018 The Obesity Society.)

Objective: The purpose of this paper is to introduce the overarching study design of the South American Youth/Child Cardiovascular and Environmental (SAYCARE) study, which is an observational multicenter feasibility study held in seven South American cities: Buenos Aires (Argentina), Lima (Peru), Medellin (Colombia), Montevideo (Uruguay), Santiago (Chile), and São Paulo and Teresina (Brazil). Children and adolescents (3-17 years of age) were studied., Methods: The data management systems, quality assurance monitoring activities, standardized operating procedure manuals, and training and study management are addressed in this paper. Various quality controls to ensure the collection of valid and reliable data are also discussed., Results and Conclusions: Data were obtained from 237 preschoolers and schoolchildren and 258 adolescents during the validation phase measurements. The results of the SAYCARE study are expected to provide higher accuracy in the assessment of cardiovascular disease risk factors, including eating behaviors, body composition, physical activity, sedentary behaviors, lipid profiles and cardiovascular health biomarkers, oral health, social conditions, environmental factors and home environment, and their determinants in children and adolescents from ages 3 to 17 in seven South American cities., (© 2018 The Obesity Society.)

Objective: This paper aimed to test the reliability of two questionnaires in studies involving children and adolescents (aged 3-18 years) in seven South American cities. One assesses socioeconomic status (SES) and the other measures environmental factors., Methods: The SES questionnaire was composed of 14 questions, which included the presence of several consumer goods, domestic services, family income, parental education level, and current parental occupation status. The environmental questionnaire was composed of 15 questions to measure the social and infrastructure characteristics of the area of residence. Parents or guardians completed the questionnaires on behalf of their children. Adolescents answered the questions themselves for environmental factors, while those related to SES factors were answered by their parents or guardians. We analyzed the reliability of the questionnaires through kappa coefficient determination. Multilevel linear regression models were applied to calculate the correlation between the total household scores, the household income, and parents' education level., Results: The environmental questionnaire showed good reproducibility in both age groups (k = 0.132-0.612 in children and k = 0.392-0.746 in adolescents). The SES questionnaire showed strong reliability in both age groups for all indicators (k = 0.52-1.00 in children and k = 0.296-0.964 in adolescents)., Conclusions: Our multiple indicator questionnaires focused on environmental factors and SES in pediatric health surveys provided useful and easily applicable additional indicators to measure these important determinants of cardiovascular health., (© 2018 The Obesity Society.)

Increased plasma free fatty acids (FFAs) are associated with cardiometabolic risk factors in adults with abdominal obesity (AO). However, this association remains controversial in children. This study analyzed plasma FFA concentration in children with and without AO. Twenty-nine children classified with AO were matched by age and sex with 29 non-obese individuals. Blood samples were collected after fasting for 10-12 h. Plasma concentration of glucose, insulin, triglycerides, total cholesterol, low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) were determined by automatized methods. FFAs were analyzed by gas chromatography. Children with and without AO had similar age (7.1 ± 2.6 vs. 7.2 ± 2.7 years; p > 0.05) but obese children showed higher ( p < 0.05) body mass index (BMI) (+4.3 kg/m²), systolic blood pressure (+5.1 mmHg), and insulin (+27.8 pmol/L). There were no significant differences in plasma total FFA concentration between groups (1.02 ± 0.61 vs. 0.89 ± 0.37 mmol/L; p > 0.05). However, children with AO had higher palmitoleic acid (0.94 vs. 0.70 wt %; p < 0.05) and dihomo-gamma linoleic acid (DHGL) (2.76 vs. 2.07 wt %; p < 0.05). Palmitoleic and DHGL acids correlated ( p < 0.05) with BMI ( r = 0.397; r = 0.296, respectively) and with waist circumference ( r = 0.380; r = 0.276, respectively). Palmitoleic acid correlated positively with systolic blood pressure ( r = 0.386; p < 0.05) and negatively with HDL-C (-0.572; p < 0.01). In summary, children with AO have higher plasmatic concentrations of free palmitoleic and DHGL fatty acids, which correlate with cardiometabolic risk factors., Competing Interests: The authors declare no conflict of interest.

Birth weight is a high impact factor in populations with high rates of immigration. This study establishes differences in birth weight (BW) and related factors among full-term newborn (NB) infants born to native and immigrant women living in Spain during 2007-2008. All NBs from Spanish mothers and mothers from the five nationalities with the highest birth rates in Spain (Morocco, Romania, Ecuador, Bolivia, and Colombia) according to the Statistical Bulletin of Births in Spain were included. BW was classified as low BW (LBW; <2,500 g), underweight (UW; 2,500-2,999 g), adequate weight (3,000-3,999 g), and macrosomia (≥4,000 g). The characteristics associated with a higher likelihood of LBW were Spanish mother, lower training level (OR = 1.3), more children (OR = 1.8), age ≤19 years (OR = 1.2) or ≥40 years (OR = 1.3), and female NB. The probability of macrosomia was higher in Bolivian mothers (OR = 3.0) with more children (OR = 1.7) and male NBs (OR = 2.0). The NBs of Spanish mothers have a higher likelihood of LBW and the lowest odds for macrosomía compared with immigrants from the other countries.

Introduction: Hypertension (HTN), atherogenic dyslipidemia, an increased glycemia in a fasting state, and abdominal obesity (AO), constitute a cluster of risk factors for cardiovascular disease named metabolic syndrome (MS)., Objective: To analyze the prevalence and distribution of MS and its components in healthcare personnel from the University of Antioquia., Methodology: Cross-sectional study conducted between 2010 and 2011. The collected data included anthropometrical, biochemical, socio-demographic, and lifestyle variables. The MS was diagnosed using the harmonized IDF/AHA definition. Descriptive and analytical statistical analyses were performed, including χ2 tests, and a = 0.05., Results: 285 volunteers (29.1% men) with ages between 20 and 61 years were included. 31.6% of participants were overweight with a Body Mass Index higher than 25 kg/m2 (BMI). AO (29.8%) and HTN (29.8%) were the most frequent components of MS. Global prevalence of MS was 17.5% (95%CI: 13.1; 22). There was a lower presence of MS among women (OR 0.328; 95%CI: 0.175; 0.614; p < 0.05), and a positive gradient with age and income. Likewise, the prevalence of MS was higher among smokers and those who are overweight (p < 0.05). After adjusting for age, MS was associated with sex (OR 0.348; 95%CI: 0.178; 0.680) and being overweight (OR 14.592; 95%CI: 6.343; 33.570)., Conclusion: The most frequently observed components of MS in the studied sample were AO and HTN. BMI, sex, and socio-economic status are important independent risk factors associated with MS., (Copyright © AULA MEDICA EDICIONES 2013. Published by AULA MEDICA. All rights reserved.)

Objective: To analyze the political agenda on diabetes in Spain under democracy by considering the frequency and content of initiatives in the Spanish parliament., Methods: A systematic search of parliamentary interventions (1979-2010) reported on the Spanish Congress of Deputies' web page was carried out using the key word "diabetes". A descriptive study of the frequency of interventions was performed, followed by a content analysis, according to the priorities of the World Health Organization (WHO), the International Diabetes Federation and the Spanish Diabetes Federation. Other study variables were the year of presentation, legislature, type of initiative and whether a political decision was taken (yes/no)., Results: There were 59 interventions: 22% were related to the first international initiatives and 44.1% took place in the last two legislatures in response to the WHO's program Diabetes Action Now. A total of 32.2% of the initiatives addressed educational and social programs, while 23.7% addressed access to resources and health services. Most initiatives (74.6%) consisted of parliamentary questions to the government, which only required a response. Of the 15 initiatives requiring a decision to be taken, only eight were approved., Conclusions: Spanish legislators aim to comply with international standards. Nevertheless, political decision-making has sometimes been slow. Importantly, most of the political responsibilities related to health have been transferred to the autonomous regions. The updated National Diabetes Strategy in Spain will need to strengthen public health policies according to established international priorities. Monitoring parliamentary interventions has proven to be a valid tool for evaluating patterns of political debate and decisions on diabetes., (Copyright © 2011 SESPAS. Published by Elsevier Espana. All rights reserved.)

The objectives of this study were to evaluate self-reporting of weight, height, and waist circumference, and to compare that perception with the real measurements in college students of the MESPYN cohort--Medellin, Salud Pública y Nutrición--from the University of Antioquia (UdeA), Colombia. A cross-sectional study was conducted starting with the first measurement of the MESPYN Cohort 2009-2010. The sample included volunteer students from different academic areas. Self-perception of weight, height, and waist circumference were recorded before the real measurements were performed. Intraclass correlation coefficients (ICC) were calculated for all the variables, and an alpha of 0.05 was used. The concordance between real measurements and self-referred values was evaluated with the Bland and Altman method. 424 volunteer students were included. The average real weight (kg) in males was 67.4 +/- 10.4 and self-reported: 67.0 +/- 11.0; in females the real value was 55.7 +/- 10.1 and self-reported: 55.0 +/- 9.0. The average real height (m) in males was 1.73 +/- 6.1 and self-reported: 1.73 +/- 6.0; in females the real value was 1.60 +/- 5.9 and self-reported: 1.61 +/- 6.0. In males, the average real waist circumference (cm) was 76.6 +/- 8.0 and self-reported: 75.0 +/- 14.0; in females the real value was 69.9 +/- 8.0 and self-reported: 70.0 +/- 9.0. Weight ICC: 0.956, 95% CI (0.95; 0.97), (p < 0.01); height ICC: 0.953, 95%IC (0.91; 0.97), (p < 0.01), and waist circumference ICC: 0.593, 95% IC (0.55; 0.65), (p < 0.01). In conclusion, anthropometric nutritional evaluation of UdeA students can be performed with self-reported data for weight and height, but the evaluation of abdominal obesity requires direct measurement of waist circumference.

This study analyzed prevalence rates for excess weight in adults based on body mass index (BMI) and the association with various demographic, socioeconomic, and political variables (democracy index). An ecological design was used, including a total of 105 countries, with BMI data from 2000 to 2006. Other variables were obtained by proximity to the year of nutritional status. The study used the World Health Organization (WHO) classification for BMI. Spearman correlation coefficients and multiple logistic regression models were used. In both genders, overweight and obesity were correlated with calorie availability and the human development index (HDI) and its component variables. As for the variables related to democracy, there was an inverse correlation with weight, stronger in men than women. In conclusion, better living conditions in countries were directly associated with higher rates of excess weight in the population, with different patterns according to gender.

Background: Obesity implies costs not only for the individual but also for society. The authors explore the opinions of stakeholders on the potential of taxes or subsidies, as measures for tackling obesity in Europe., Methods: Structured interviews were conducted using Multicriteria Mapping, a computer-based, decision-support tool, with 189 interviewees drawn from 21 different stakeholder categories across nine members of the EU interviews, to appraise 20 predefined policy options aimed at reducing obesity, including 'taxing obesity-promoting foods' and 'subsidising healthy foods.' A four-step approach involved selecting options, defining criteria, scoring options quantitatively and weighting criteria to provide overall rankings of options. Interviews were recorded and transcribed to yield qualitative data., Results: Compared with other policy options appraised, taxation and subsidies were not favourably received, mainly because they were considered difficult to implement. Overall, trade unions rated both options more favourably than all other stakeholder groups. As anticipated, both options received their lowest scores from representatives of the farming, food processing and advertising industries. Nutritional/obesity advisory experts and public sector caterers gave the most positive ratings to subsidies overall. Along with public health professionals, large commercial retailers were most in favour of taxation., Conclusions: Taxation and subsidies were poorly appraised compared with other policy measures, with stakeholders expressing reservations mainly focussed on the practicalities and cost of introducing such measures. Although applying taxes/subsidies could be useful to combat obesity, the study suggests that most stakeholders still need to be convinced of their viability and acceptability when compared with other measures.

The objective of this study is to establish differentials in birth weight (BW) and related factors, in term newborns (NB) of Spanish (SP) and Colombian (CO) immigrant mothers living in Spain, between 2001-2005. Data on the NB population of SP and CO mothers was retrieved from the National Statistical Bulletin of Birth in Spain. We analysed the association with BW (Low birth weight -LBW- insufficient weight -IW- macrosomia), by the nationality of the mother; taking into account variables such as the intergenesic interval, maternal age, number of live children, maternal occupation and sex of NB. The analysis was based on frequencies and the estimation of simple and adjusted odds ratios (OR) by means of logistic regression with 95% confidence intervals (95% CI). A higher prevalence of LBW was found in SP mothers (3.4%) than in their CO counterparts (2.1%). In SP mothers a higher risk of LBW (aOR 1.89, 950% CI 1.65- 2.16) and IW (aOR 1.49, 95% CI 1.51- 1.57) was observed. In CO mothers a higher percentage of macrosomia was found (8.0%). Also, a higher percentage of LBW was observed in female new borns (SP4.1%; CO 2.7%) as well as IW (PI (SP 25.6%; CO 19.6%) (p < 0.001). Mothers aged > 40 years and having 4 or more children were associated with LBW in both nationalities. As a conclusion, NB of Colombian mothers presented a lower prevalence of LBW and IW, which could be explained by the healthy migrant effect.

Objective: To explore policy options that public health specialists (PHS) consider appropriate for combating obesity in Europe, and compare their preferences with those of other stakeholders (non-PHS)., Design: Structured interviews using multicriteria mapping, a computer-based, decision-support tool., Setting: Nine European countries., Subjects: A total of 189 stakeholders. Twenty-seven interviewees were PHS and non-PHS included food, sports and health sectors., Measurements: A four-step approach was taken, i.e. selecting options, defining criteria, scoring options quantitatively and weighting the criteria to provide overall rankings of options. Interviews were recorded and transcribed to yield qualitative data., Results: The PHS concur with other stakeholders interviewed, as all emphasised the importance of educational initiatives in combating obesity, followed by policies to improve community sports facilities, introduce mandatory food labelling and controlling food and drink advertising. Further analyses revealed several significant differences. The non-PHS from the private sector ranked institutional reforms favourably; the PHS from non-Mediterranean countries supported the option of medicines to prevent obesity; and those PHS from Mediterranean countries endorsed the use of activity monitoring devices such as pedometers. As far as appraisal criteria were concerned, PHS considered efficacy and the economic impact on the public sector to be the most important., Conclusion: There is clear consensus among PHS and other stakeholders concerning the need for a package of policy options, which suggests that European-wide implementation could be successful. However, it would be advisable to avoid more contentious policy options such as taxation until future changes in public opinion.

Background: Association between immigration and low birth weight (LBW) and preterm birth (PB) is an important indicator of health inequalities. The objective of this study is to analyse the differences between LBW and PB according to the mothers nationality in newborns in Spain., Methods: Data were provided from the National Statistical Bulletin of Birth of 1,878,718 newborns in the period 2001-2005. The nationality was considered the exposure variable (Spanish- Immigrant). The outcomes were LBW (< 2,500 gr and >or=37 gestational weeks) and PB (< 37 gestational weeks). Odds ratios were calculated and adjusted by possible confounders by logistic regression., Results: PB and LBW prevalence were higher in Spanish women (7.9% and 3.2% respectively). In comparison with Spanish ones, the lowest risk of PB was observed in North Africa (ORa= 0.77 CI95% 0.74-0.80). With respect to LBW, the lowest risk was found in mothers from South America (ORa=0.62 CI95% 0.59-0.65) and Eastern Europe (ORa=0.65 CI95% 0.60-0.71)., Conclusion: Results of LBW and PB were more favourable in the births of immigrant women. It could be associated with the healthy migrant effect and a low frequency of risk practices during gestation.

Aim: To explore the criteria used to assess public policy initiatives on obesity in Spain by the main stakeholders., Methods: Multicriteria mapping was performed within the framework of the European PorGrow Project "Policy options for responding to obesity" through a structured interview with 21 stakeholders, who were leaders in the public and private sectors in Spain in the area of food and physical exercise. Qualitative and quantitative information was included in the analysis. The interviewees justified their positions for or against the various policy options with criteria that were weighted by their relative importance and documented with quotations and nuggets from the interviewees' discourse., Results: We identified 93 criteria for policy selection in the 21 interviewees. The most frequent criteria and those perceived as most important were efficacy (n = 18), social benefits (n = 17) and social acceptability (n = 14). The economic impact on individuals and the public sector was not considered important by the interviewees. The economic impact on the commercial sector was not included by any of the participants. The criterion most highly valued by public sector stakeholders was societal benefits while that most valued by private sector stakeholders was efficacy., Conclusions: Spain is in the initial stages of developing public policy on obesity and, as yet, there are no winners and losers among those concerned, which may explain why economic costs seem to be relatively unimportant for the stake-holders, opening a window of opportunity for the development of regulatory policies.

This study assesses the opinions of the main Spanish stakeholders from food and physical exercise policy networks on public policy options for responding to obesity. We followed the multi-criteria mapping methodology in the framework of the European project 'Policy options in responding to obesity' (PorGrow), through a structured interview to 21 stakeholders. A four-step approach was taken: options, criteria, scoring and weighting, obtaining in this way a measure of the performance of each option which integrates qualitative and quantitative information. In an overall analysis, the more popular policy options where those grouped as educational initiatives: include food and health in the school curriculum, improve health education to the general public, improve the training of health professionals in obesity care and prevention, incentives to caterers to provide healthier menus and improve community sports facilities. Fiscal measures as subsidies and taxes had the lowest support. The criteria assessed as priorities were grouped as efficacy and societal benefits. Obesity in Spain can be approached through public policies, although the process will not be easy or immediate. The feasibility of changes requires concerned public policymakers developing long-term actions taking into account the map of prioritized options by the stakeholders.

Objective: To determine whether the famine experienced during the Spanish civil war and immediate postwar period influenced mortality from coronary heart disease (CHD) in persons born in this period, following the lines of Barker's hypothesis on fetal programming of chronic diseases in adult life., Methods: Using CHD mortality data by age and sex for 1990-2002, annual and age-adjusted rates were calculated by the direct method. Poisson regressions were used to estimate period, age and cohort effects by year of birth (1918-1957)., Results: During the study period, CHD mortality fell by a yearly average of -2.3% in both sexes and in all ages yearly. This trend was influenced by both cohort and period effects (p<0.001); an increased risk was observed for both sexes and in all ages in the deaths corresponding to persons born during the war and postwar years when the famine was most intense (1937, 1940, 1943 and 1945)., Conclusions: The results obtained by studying yearly CHD mortality are compatible with those expected by Barker's hypothesis of the effect of nutritional stress during pregnancy. In addition to its human, economic and political costs, the Spanish civil war could also have had negative consequences for the health of persons born in this period.