Ana M. Veses

Sedentarismo, adiposidad y factores de riesgo cardiovascular en adolescentes. Estudio AFINOS

Introduccion y objetivos Examinar las asociaciones entre sedentarismo medido de forma objetiva y los factores de riesgo cardiovascular (RC). Un objetivo secundario fue evaluar el grado de asociacion entre adiposidad general y abdominal con factores de RC. Metodos Doscientos diez adolescentes, de 13-17 anos, participaron en este estudio transversal. Se midio la suma de seis pliegues (sum6), perimetro de cintura (PC), presion arterial sistolica (PAS) y diastolica (PAD), glucosa, colesterol total (CT), trigliceridos (TG), colesterol de las lipoproteinas de alta (cHDL) y baja densidad (cLDL) y apolipoproteinas A-1 y B-100. Se calculo un indice de RC (IRC) usando presion arterial media (PAM), TG, cHDL y glucosa. El sedentarismo se valoro con acelerometro durante 7 dias. Se dividio a los participantes en terciles de sedentarismo y en niveles de baja-alta adiposidad general (sum6) y abdominal (PC). Resultados Los adolescentes con niveles altos de sedentarismo tuvieron valores menos favorables de PAS, TG, glucosa e IRC. Los adolescentes con mayor nivel de adiposidad general mostraron diferencias significativas en cinco de once factores analizados (PAD, cLDL, CT, apolipoproteina B-100 e IRC), mientras que los adolescentes con mas adiposidad abdominal tuvieron diferencias en ocho factores (PAS, PAM, cHDL, cLDL, TG, CT, apolipoproteina B-100 e IRC). Los adolescentes con mayor adiposidad general y abdominal y con niveles altos de sedentarismo mostraron un IRC menos favorable. Conclusiones El sedentarismo esta asociado con factores de RC en adolescentes, especialmente en los adolescentes obesos. La adiposidad abdominal parece ser mas importante en el desarrollo de factores de RC que la adiposidad general.

Sedentary Behavior, Adiposity, and Cardiovascular Risk Factors in Adolescents. The AFINOS Study

INTRODUCTION AND OBJECTIVES To investigate the association between objective measures of sedentary behavior and cardiovascular risk factors (CRFs) in adolescents. A secondary aim was to evaluate the degree of association between overall and abdominal adiposity and CRFs. METHODS This cross-sectional study involved 210 adolescents aged 13-17 years. Measurements were made of the sum of the skinfold thicknesses at six locations (sum6), waist circumference (WC), systolic (SBP) and diastolic blood pressure (DBP), glucose, total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and apolipoproteins A-1 and B-100. A CRF score was calculated from the mean arterial pressure (MAP) and TG, HDL-C and glucose levels. Sedentary behavior was assessed over 7 days using an accelerometer. Participants were divided into tertiles according to sedentary behavior and into low and high levels of overall (sum6) and abdominal (WC) adiposity. RESULTS Adolescents with a high level of sedentary behavior had less favorable SBP, TG and glucose levels and CRF scores. Adolescents with a high level of overall adiposity demonstrated significant differences in five of the 11 variables analyzed (i.e. DBP, LDL-C, TC, apolipoprotein B-100 and CRF score), while adolescents with a high level of abdominal adiposity had differences in eight (i.e. SBP, MAP, HDL-C, LDL-C, TG, TC, apolipoprotein B-100 and CRF score). Adolescents with high levels of both overall and abdominal adiposity and sedentary behavior had the least favorable CRF scores. CONCLUSIONS Sedentary behavior was associated with CRFs in adolescents, especially in obese adolescents. Abdominal adiposity seemed to play a more significant role in the development of CRFs than overall adiposity.

Potential health benefits of moderate alcohol consumption: current perspectives in research

The benefits of moderate amounts of alcohol for a better health and longer life expectancy compared with abstinence have been suggested by the findings of numerous studies. However, controversies have emerged regarding the influence of confounding factors and the systematic errors that might have been inadvertently disregarded in the early studies. This review includes a description of the findings of those research studies published in the last 5 years on the effects of moderate alcohol consumption on all-cause mortality, CVD and inflammation, the immune system, insulin sensitivity, non-alcoholic fatty liver disease (NAFLD) and cancer. Promising evidences exist from both animal studies and human clinical trials regarding intermediate end-points of CHD and insulin sensitivity, such as HDL, adiponectin or fibrinogen. However, controversies and inconsistent findings exist regarding many of these diseases and related functions and biomarkers. Further research and human randomised-controlled trials with adequate standardisation of the study conditions are necessary in order to draw a comparison between studies, establish the causal effect of moderate alcohol intake on disease protection and reach consensus on the circumstances that allow the recommendation of moderate alcohol habitual intakes as a strategy for health maintenance.

Follow-up in healthy schoolchildren and in adolescents with DOWN syndrome: psycho-environmental and genetic determinants of physical activity and its impact on fitness, cardiovascular diseases, inflammatory biomarkers and mental health; the UP&DOWN Study

BackgroundAn objective diagnosis of sedentary behaviour as well as of the physical activity and fitness levels in youth and to better understand how lifestyle is associated with cardiovascular disease risk factors and other phenotypes is of clinical and public health interest, and might be informative for developing intervention studies focused on the promotion of physical activity in these population. The aim of this methodological paper is to describe the design and assessment in the UP&DOWN study.Methods/DesignThe UP&DOWN study is a multi-center follow-up design where 2225 Spanish primary and secondary schoolchildren from Cadiz and Madrid, respectively, as well as 110 Spanish adolescents with Down syndrome from Madrid and Toledo were recruited to be assessed. Nine main measurement categories are assessed: i) socio-demographic and early determinants; ii) environmental determinants; iii) physical activity and sedentary behaviour; iv) health-related fitness; v) blood pressure and resting heart rate; vi) mental health; vii) dietary patterns; viii) blood samples; and ix) genetic analysis. During the 3-yr follow-up study, socio-demographic and early determinants, and genetic analysis are only assessed in the first year. Blood sampling is assessed in the first year and the third year (2nd follow-up), and all the other measurements are assessed every year.DiscussionThe findings of the UP&DOWN study may help the Health Information Systems and policy makers to identify the target population for primary prevention and health promotion policies, and to develop and test preventive strategies. Moreover, these data will allow following the trends at population level, as well as to modify/adapt/create new evidence-based physical activity guidelines at national level. The findings will also serve as a scientific platform for interventional studies.

Association between excessive body fat and eating-disorder risk in adolescents: The AFINOS Study

BACKGROUND AND OBJECTIVE Overweight and obesity, together with eating disorders, are important public health concerns in adolescence. The aim of this study was to assess the association between excessive body fat and the risk of eating disorders. SUBJECTS AND METHOD The sample consisted of 195 adolescents (97 girls) aged 13 to 18 years. Eating-disorder risk was evaluated by applying the SCOFF questionnaire. Body mass index, sum of 6 skinfolds, waist and hip circumferences and waist-hip and waist-height ratios were used to assess body fat. RESULTS 24.7% of girls and 17.3% of boys were at risk of eating disorders, and 31.6% of boys and 21.6% of girls presented overweight (including obesity) according to Coles cut-off points. Those adolescents classified above the 85th percentile on all the anthropometric measurements, as well as overweight adolescents, were at increased risk of developing an eating disorder (OR: 2.8-4.30, all p < 0.01). CONCLUSION Regardless of the anthropometric measurements used, adolescents with excessive body fat showed a higher risk of having eating disorders than those with normal weight.

Physical fitness, overweight and the risk of eating disorders in adolescents. The AVENA and AFINOS studies

What is already known about this subject Eating disorders are among the public health issues facing adolescents. An excess of body fat has been associated with an increased risk of these disorders. The association of physical fitness with eating disorders has not yet been analysed in adolescents.

Influence of health behaviours on the incidence of infection and allergy in adolescents: the AFINOS cross-sectional study

BackgroundSome health behaviours are liable to affect the incidence of allergies and/or common infections in young people; however, the extent and ways in which these might occur are mostly unknown. This study examines the association of health behaviours related to physical activity, sedentariness, diet and sleep with allergy and infection symptoms in adolescents, and also with biological markers that might mediate disease incidence.MethodsThe study comprised a total of 2054 adolescents (50.7% girls) from the Madrid region of Spain. The incidence of infection and allergy symptoms three months prior to the study was obtained from a self-administered questionnaire. Physical and sedentary activities, height and weight, food habits and sleep duration were also self-reported and their influence on infection and allergy incidence was assessed by logistic regression analysis. Blood biomarkers (IgE, eosinophil percentage, leptin, interleukin (IL)-2, IL-4, IL-5 and IL-10) were evaluated in a subsample of 198 subjects.ResultsAdequate sleep duration (OR = 0.79, 95%CI: 0.64 to 0.97) and unhealthy weight status (overweight/obesity) (OR = 1.35, 95%CI: 1.04-1.74) were independently associated with decreased and increased allergy incidence, respectively. No significant association was observed with infection incidence. IgE and leptin differed between adolescents with and without allergy symptoms. In regression models IgE was significantly associated with inadequate sleep duration and leptin with weight status.ConclusionExcess weight and inadequate sleep duration are independently associated with the incidence of allergy symptoms in adolescents. Adequate sleep duration and weight during adolescence might be relevant for a decreased risk of suffering allergy symptoms.

Length of residence and risk of eating disorders in immigrant adolescents living in Madrid: the AFINOS study

OBJECTIVES This study was designed to compare the risk of having an eating disorder (ED) among immigrant and native adolescents living in Madrid and to determine the possible influence of length of residence (LOR) on the risk of the immigrants. METHODS A cross-sectional survey was conducted from november 2007 to february 2008 in a representative sample of adolescents aged 13 to 17 years (n = 2,077, 1,052 girls) living in the Madrid region. Data were collected using the Spanish version of the SCOFF Eating Disorders Questionnaire. Further factors considered were country of birth, LOR and several biological, sociodemographic, lifestyle and health-related variables. RESULTS According to the three logistic regression models constructed, female immigrant adolescents on the whole showed a greater ED risk (OR = 1.95; 95% CI 1.29- 2.95; p = 0.001) than native adolescents. Moreover, the likelihood of ED was higher among female immigrants living in Spain for <6 years than for Spanish native females (OR = 2.44; 95% CI 1.42-4.18; p = 0.001), while no significant differences were found when female natives were compared with female immigrants living in this country for ≥ 6 years. Similarly, no differences were observed in the ED risk recorded for male native and immigrant adolescents, both as a whole and by length of residence in Spain. CONCLUSIONS The immigrant status and the length of Spanish residence are relevant factors in regard to the ED risk in adolescents living in Madrid.

Cardiorespiratory Fitness Cutoff Points for Early Detection of Present and Future Cardiovascular Risk in Children:A 2-Year Follow-up Study

Objective: To examine the association between cardiorespiratory fitness (CRF) at baseline and cardiovascular disease (CVD) risk in 6‐ to 10‐year‐olds (cross‐sectional) and 2 years later (8‐ to 12‐year‐olds [longitudinal]) and whether changes with age in CRF are associated with CVD risk in children aged 8 to 12 years. Patients and Methods: Spanish primary schoolchildren (n=236) aged 6 to 10 years participated at baseline. Of the 23 participating primary schools, 22% (n=5) were private schools and 78% (n=18) were public schools. The dropout rate at 2‐year follow‐up was 9.7% (n=23). The 20‐m shuttle run test was used to estimate CRF. The CVD risk score was computed as the mean of 5 CVD risk factor standardized scores: sum of 2 skinfolds, systolic blood pressure, insulin/glucose, triglycerides, and total cholesterol/high‐density lipoprotein cholesterol. Results: At baseline, CRF was inversely associated with single CVD risk factors (all P<.05) and CVD risk score at baseline and follow‐up (P<.001). Cardiorespiratory fitness cutoff points of 39.0 mL/kg per minute or greater in boys and 37.5 mL/kg per minute or greater in girls are discriminative to identify CVD risk in childhood (area under the curve, >0.85; P<.001) and to predict CVD risk 2 years later (P=.004). Persistent low CRF or the decline of CRF from 6‐10 to 8‐12 years of age is associated with increased CVD risk at age 8 to 12 years (P<.001). Conclusion: During childhood, CRF is a strong predictor of CVD risk and should be monitored to identify children with potential CVD risk. Abbreviations and Acronyms: AUC = area under the curve; CRF = cardiorespiratory fitness; CVD = cardiovascular disease; HDL‐C = high‐density lipoprotein cholesterol; HOMA‐IR = homeostasis model assessment for insulin resistance; OR = odds ratio; SBP = systolic blood pressure; TC = total cholesterol; TG = triglycerides; VO2max = maximum oxygen consumption

Television viewing time and risk of eating disorders in Spanish adolescents: AVENA and AFINOS studies

Effective preventive interventions for both eating disorders and obesity in adolescence should be focused on shared risk factors. We analyzed the association between television (TV) viewing time and the risk of eating disorders, as well as the potential role of obesity in this association.