Maria del Mar Bibiloni

Dietary sources of omega 3 fatty acids: public health risks and benefits

Omega 3 fatty acids can be obtained from several sources, and should be added to the daily diet to enjoy a good health and to prevent many diseases. Worldwide, general population use omega-3 fatty acid supplements and enriched foods to get and maintain adequate amounts of these fatty acids. The aim of this paper was to review main scientific evidence regarding the public health risks and benefits of the dietary sources of omega-3 fatty acids. A systematic literature search was performed, and one hundred and forty-five articles were included in the results for their methodological quality. The literature described benefits and risks of algal, fish oil, plant, enriched dairy products, animal-derived food, krill oil, and seal oil omega-3 fatty acids.

Prevalence of Overweight and Obesity in Adolescents: A Systematic Review

Objective. To review the extant literature on the prevalence of overweight and obesity in adolescents (10–19 years old) of both sexes. Design. The search was carried out using Medline and Scopus considering articles published from the establishment of the databanks until June 7, 2012. Data on the prevalence of children being overweight and obese from the International Obesity Task Force (IOTF) website was also reviewed. Only original articles and one National Health Report were considered. Forty studies met the inclusion criteria. Results. Twenty-five of these studies were nationally representative, and ten countries were represented only by regional data. Conclusions. The prevalence of overweight and obesity among adolescents worldwide is high, and obesity is higher among boys. The IOTF criterion is the most frequently used method to classify adolescents as overweighed or obese in public health research.

Adherence to the Mediterranean dietary pattern among Balearic Islands adolescents

The aim of the present work was to assess the prevalence of the Mediterranean dietary pattern (MDP) in Balearic Islands adolescents, and socio-demographic and lifestyle factors that might determine adherence to the MDP. A cross-sectional nutritional survey was carried out in the Balearic Islands between 2007 and 2008. A random sample (n 1231) of the adolescent population (12-17 years old) was interviewed. Dietary questionnaires and a general questionnaire incorporating questions related to socio-economic status, parental education level and lifestyle factors were used. Dietary habits were assessed by means of two 24 h recalls and a quantitative FFQ. Adherence to the MDP was defined according to a score constructed considering the consumption of nine MDP characteristic components: high MUFA:SFA ratio, moderate ethanol consumption, high legumes, cereals and roots, fruits, vegetables and fish consumption, and low consumption of meat and milk. Then, socio-demographic, lifestyle and health status variables that could determine a higher or ower adherence were assessed. The mean adherence was 57.9 (sd 8.9) % and the median adherence was 57.3 %. Half of the Balearic Islands adolescents (50.5 %) showed an adherence to the MDP comprised between 52.7 and 62.8 %. By multivariate analyses, a high maternal level of education, increased physical activity, reduced alcohol intake and abstinence from smoking were independent associations of better adherence to the MDP. The promotion of not only the MDP but also the Mediterranean lifestyle, including greater physical activity, should be reinforced among the Balearic younger generations.

Proposal for a Breakfast Quality Index (BQI) for children and adolescents

OBJECTIVEnTo propose and apply an instrument to assess the breakfast quality of children and adolescents in the Mediterranean area.nnnDESIGNnRandomized, cross-sectional survey of breakfast consumption using a validated semi-quantitative FFQ administered at school by trained dietitians between Tuesday and Friday. A Breakfast Quality Index (BQI) score was developed, assigning a positive value to the consumption of cereals, fruit, vegetables, dairy products, MUFA, Ca and compliance with energy recommendations, and to the absence of SFA and trans-rich fats. Data were analysed by Students t test and ANOVA.nnnSETTINGnSchools in Granada and Balearic Islands (Spain).nnnSUBJECTSnAll schoolchildren (n 4332) aged 8-17 years at randomly selected and representative schools between 2006 and 2008, stratified by age and sex.nnnRESULTSnBreakfast was not consumed by 6·5 % of participants. BQI score was highest for children aged 7-9 years and decreased with age (P = 0·001). Females scored higher in all age groups. The lowest score was in males aged 14-17 years and the highest in females aged 7-9 years (P = 0·006).nnnCONCLUSIONSnThe proposed BQI appears useful to estimate the breakfast quality of schoolchildren and to form a basis for nutrition education.

Compliance with the 2010 Nutritional Objectives for the Spanish Population in the Balearic Islands’ Adolescents

Aims: To assess compliance with the 2010 nutritional objectives for the Spanish population in the Balearic Islands’ adolescents. Methods: A cross-sectional nutrition survey was carried out in adolescents (n = 1,231). Dietary habits were assessed by means of 2 nonconsecutive 24-hour recalls and a semiquantitative food frequency questionnaire. Differences in the percentage of compliers with the 2010 nutritional objectives and differences in food consumption patterns between genders and high or low consumers of fat, saturated fatty acids (SFA), fiber, and fruits and vegetables were analyzed. Results: None of the nutritional objectives were achieved by the Balearic Islands’ adolescents, and less than 25% of them met the dietary fiber, folate, iodine, total fat, SFA, polyunsaturated fatty acid (PUFA), total carbohydrate, and fruit and vegetable requirements. Gender differences were observed in terms of energy, nutrients, and food item consumption. Low fat/SFA and high fruit and vegetable/fiber consumers kept a diet in line with current food group pyramids and the traditional Mediterranean diet. Adolescents need to decrease their meat and increase pulse, fish, and fruit and vegetable consumption. Conclusions: The nutritional objectives for the Spanish population could be achieved through maintenance of the traditional Mediterranean diet in the Balearic Islands’ adolescents. This dietary model could be used to develop food-based dietary guidelines relevant to this population.

Weight Self-Regulation Process in Adolescence: The Relationship between Control Weight Attitudes, Behaviors, and Body Weight Status

Adolescents’ self-control weight behaviors were assessed (Nu2009=u20091961; 12–17u2009years old; 2007–2008) in the Balearic Islands, Spain. The study analyzed the relationships between body weight status, body image, and self-weight concern, and actual attempts to lose weight by restrained eating and/or increased exercising. In terms of regulatory focus theory (RFT), we considered that efforts to lose or to maintain weight (successful or failed) would be motivated either by a “promotion focus” (to show an attractive body), or a “prevention focus” (to avoid social rejection of fatness), or both. Results showed that 41% of overweight boys and 25% of obese boys stated that they had never made any attempt to lose weight, and 13 and 4% in females. Around half of overweight boys and around a quarter of obese boys stated that they were “Not at all” concerned about weight gain, and girls’ percentages decreased to 13 and 11%, respectively. By contrast, 57% of normal weight girls monitored their weight and stated that they had tried to become slim at least once. Weight self-regulation in females attempted to combine diet and exercise, while boys relied almost exclusively on exercise. Apparent lack of consciousness of body weight status among overweight boys, and more important, subsequent absence of behaviors to reduce their weight clearly challenges efforts to prevent obesity. We argue that several causes may be involved in this outcome, including unconscious, emotional (self-defense), and cognitive (dissonance) mechanisms driven by perceived social stigmatization of obesity. The active participation of social values of male and female body image (strong vs. pretty), and the existence of social habituation to overweight are suggested. A better knowledge of psychosocial mechanisms underlying adolescent weight self-control may improve obesity epidemics.

Trace element contents in toenails are related to regular physical activity in older adults.

The aim was to assess the trace element contents in toenails of older adults and its association with regular physical activity. Cross-sectional multicentre study in Spain, collecting data from a random sample of 380 participants (54% female) aged 55–80 years (men) and 60–80 years (women) with no previously documented cardiovascular disease. Physical activity performed was measured using the Minnesota Leisure-time Physical Activity Questionnaire. The 25 most inactive and 25 most active individuals for each sex were selected for this study (final sample n = 100). Anthropometric measurements were performed and toenail samples collected for calcium (Ca), chromium (Cr), iron (Fe), cobalt (Co), nickel (Ni), zinc (Zn), selenium (Se) and mercury (Hg) analysis. Significant differences between sexes were reported in Ca concentrations, women having lower concentrations than men. No differences were reported in trace element contents between active and inactive men. Active women showed higher Ca, Cr, Fe, Co, and Zn and lower Hg contents than their inactive peers (all p<0.05). Inactive women showed lower Ca and Co levels (735.0 mg/kg and 4.5 μg/kg, respectively) than inactive men (1170.0 mg/kg and 7.9 μg/kg, respectively). Active women had lower Ca and higher levels of Cr (936.0 mg/kg and 1230.0 μg/kg, respectively) than active men (1070.0 mg/kg and 522.0 μg/kg, respectively). The present data added new information on the element contents in toenails of healthy Spanish older adults. The concentration of trace elements was similar in both sexes except for Ca which were lower in women. The trace element contents in women’s toenails, but not in men, were markedly influenced by physical activity, with higher levels of Ca and Fe and lower Hg among active females.

Diet quality of Mediterranean adolescents evaluated by Mediterranean adaptation of the Diet Quality Index-Internationa(DQI I):socioeconomic, anthropometric, lifestyle and body image determinants

Title: Diet quality of Mediterranean adolescents evaluated by Mediterranean adaptation of the Diet Quality Index-International (DQI-I): socioeconomic, anthropometric, lifestyle and body image determinants. nBackground: Epidemiological evidences suggest that dietary patterns in the Mediterranean countries are changing rapidly. Objective: To assess the diet quality of Mediterranean adolescents by means of the Mediterranean adaptation of the DQI-I, and its association with socioeconomic, anthropometric, lifestyle and body image characteristics. nMethods & Findings: Cross-sectional survey (n=1231; 12−17 years old) carried out in the Balearic Islands, a Mediterranean region. Diet quality was assessed by means of the DQI-I’s Mediterranean adaptation. Body composition, body image, socioeconomic factors, and physical activity were also assessed. The mean total modified DQI score was around 47.0% (standard deviation: 9.8%) of the possible score (100%). The univariate linear regression analysis showed that age and media screen time were inversely correlated with the DQI score; whereas a direct correlation with parental educational level was found. The DQI score also decreased in physically inactive adolescents and in those adolescents who wish a thicker body shape; whereas increased in those adolescents who wish a thinner body shape. The multivariate linear regression showed that age group, parental educational level, media screen time and body image dissatisfaction were the main associated variables with the DQI score. nConclusions: The assessed Mediterranean adolescents showed a poor-quality diet. Programs to promote the traditional Mediterranean dietary pattern among adolescents and their relatives, combined with active lifestyle, would likely result in a more favorable future health profile.

What is the relationship between physical fitness level and macro- and micronutrient intake in Spanish older adults?

PurposeThe aim of this study was to assess the association between physical fitness (PF) and energy and nutrient intake in Spanish older adults.MethodsThree hundred and twenty-four participants (59.9% females, aged over 55xa0years) performed a battery of four validated PF tests and participants were divided into three: low, medium, and high PF. Dietary intake was assessed by two non-consecutive 24xa0h dietary recalls. Energy and nutrient intake was calculated using the ALIMENTA software. Energy expenditure (EE) was calculated using a validated questionnaire.ResultsMedian energy intake (EI) was 2135, 1999, and 2111xa0kcal/day in the low, medium, and high PF in males, respectively. In females, the medianxa0EI was 1576, 1564, and 1625xa0kcal/day in the low, medium, and high PF groups. There were significant and positive associations between participants in the high PF group and intake of phosphorous, selenium, vitamin B6, C, D, E, niacin, and folates (all pu2009<u20090.05). However, subjects in the high PF group presented negative associations with thiamine and riboflavin intake (all pu2009<u20090.05). A total of 8.3% of participants presented inadequate intake of 11 micronutrients. PF seems to affect total nutrient intake.ConclusionsHigher protein and fat intake was observed in the high PF group compared to the other PF groups in males, although participants in the high PF group had also higher EE. However, females presented different patterns. In both sexes participants in the high PF group showed a better micronutrient intake profile than the other PF groups. There is a need to develop combined nutritional and fitness programs.

Association between blood marker analyses regarding physical fitness levels in Spanish older adults: A cross-sectional study from the PHYSMED project

Biomarkers have been postulated as essential variables to measure the effects of exercise on the human body. To investigate the relationship between physical fitness (PF) and blood biomarkers that are associated with disease risk in Spanish older adults, four hundred and twenty-nine adults (57% females) aged older than 55 years from a cross-sectional study were included. A battery of PF test was performed, and participants were divided into 3 groups: low, medium and high fitness. Blood samples were collected, and subjects were also grouped based on a particular biomarker being within its reference range. Furthermore, drug intake and dietary intake were considered for each participant. Higher concentrations out of the reference range were observed for vitamin 25(OH)D (67.9%) and total cholesterol (TC) (58.6%). Participants from the low PF group presented lower significant concentrations out of the reference range for vitamin B12 and triglycerides; however, participants in the low PF group showed higher significant concentrations out of the reference range for total homocysteine, creatinine, TC, HDL-cholesterol and LDL-cholesterol (LDL-c) than those in the high PF group (all p<0.05). Considering drugs related to blood lipid modifications, subjects who regularly consumed lipid reducers presented higher significant concentrations out of the reference range for TC and LDL-c than participants who did not take these drugs (p<0.01). Participants from the high PF group presented better blood marker profiles, namely, lower blood markers related to disease risk out of the reference range. These blood markers could be used as a routine method for considering PF groups in older adults.