¿Sabemos lo que bebemos? La importancia del etiquetado de las bebidas alcohólicas

Artículo publicado en The Conversation España el día 03/04/2023.El consumo de alcohol es uno de los factores que contribuye con más peso a la carga de enfermedad, tanto a nivel mundial como en nuestro entorno. Por ejemplo, es responsable del 5,7 % de la mortalidad total en los países de Europa occidental y del 5,3 % en la región de Latinoamérica y del Caribe. En España, el número medio anual de muertes atribuibles al alcohol durante el periodo 2010-2017 en personas mayores de 14 años fue de 15 489, lo que representa un 4 % de la mortalidad general. Además, se trata de una mortalidad prematura, ya que uno de cada dos fallecimientos se produce en personas menores de 75 años.N

Cómo conseguir una generación libre de humo de tabaco

Artículo de divulgación publicado en The Conversation España, el día 09/04/2023.El impacto que tiene el consumo de tabaco en la salud es devastador. Cada año, más de 8 millones de personas fallecen en el mundo a causa del tabaco, y alrededor de 1,2 millones son consecuencia de la exposición al humo de tabaco en no fumadores.N

Clustering of unhealthy lifestyle behaviors, self-rated health and disability

The main objective was to identify sociodemographic characteristics of the population at risk for a greater clustering of unhealthy behaviors and to evaluate the association of such clustering with self-rated health status and disability. Data come from the 2017 Spanish National Health Survey with a sample of 21,947 participants of 15 years of age or older. Based on tobacco consumption, risk drinking, unbalanced diet, sedentarism, and body mass index <18.5/≥25 we created two indicators of risk factor clustering: 1) Number of unhealthy behaviors (0-5); and 2) Unhealthy lifestyle index (score: 0-15). Self-rated health was dichotomized into "optimal" and "suboptimal," and disability was classified as "no disability," "mild," and "severe" based on the Global Activity Limitation Index (GALI). We estimated prevalence ratios (PR) adjusted for covariates using generalized linear models using the clustering count variable, and dose-response curves using the unhealthy lifestyle index. Most participants (77.4%) reported 2 or more risk factors, with men, middle-age individuals, and those with low socioeconomic status being more likely to do so. Compared to those with 0-1 risk factors, the PR for suboptimal health was 1.26 (95% CI:1.18-1.34) for those reporting 2-3 factors, reaching 1.43 (95% CI:1.31-1.55) for 4-5 factors. The PR for severe activity limitation was 1.66 (95% CI:1.35-2.03) for those reporting 2-3 factors and 2.06 (95% CI:1.59-2.67) for 4-5 factors. The prevalence of both health indicators increased in a non-linear fashion as the unhealthy lifestyle index score increased, increasing rapidly up to 5 points, slowing down between 5 and 10 points, and plateauing afterwards.This work was supported by the Institute of Health Carlos III, Ministry of Science and Innovation [grant number PI19CIII/00021.N

Rural-urban gradients and all-cause, cardiovascular and cancer mortality in Spain using individual data

The literature reporting on rural-urban health status disparities remains inconclusive. We analyzed data from a longitudinal population-based study using individual observations. Our results show that the risks of all-cause and cancer mortality are greater in large cities than in other municipalities, with no clear urban-rural gradient. Not differences were found among territories in cardiovascular mortality.This work was supported by the Institute of Health Carlos III (ISCIII), Ministry of Science and Innovation [grant number PI19CIII/00021 and FI17CIII/00003].S

Estimations of smoking-attributable mortality in Spain at a regional level: comparison of two methods

Purpose: To estimate and discuss smoking-attributable mortality (SAM) for the 17 regions in Spain among the population aged ≥35 years in 2017, using two methods. Methods: A descriptive analysis of SAM was conducted using two methods, the prevalence-independent method (PIM) and the prevalence-dependent method (PDM). Observed mortality was obtained from the National Institute of Statistics; smoking prevalence from three National Health Surveys; lung cancer mortality rates from the Cancer Prevention Study-II; and relative risks from five US cohorts. SAM and percentages of change were estimated for each region overall, by sex, age and cause of death. Results: In 2017, tobacco caused 56,203 deaths in Spain applying the PIM. Using the PDM the number of deaths was 4.4% (95% CI: 3.4-5.5) lower (53,825 deaths). Except in four regions, the PIM estimated a higher overall SAM and the maximum percentage of change was 18.6%. Overall percentages of change were higher for women (15.7% 95% CI: 12.6-19.0) and for cardiovascular diseases-diabetes mellitus (13.8%; 95% CI: 11.5-16.2). Conclusions: At the national level, both methods estimate similar figures for SAM. However, the difference in estimates appears at the subnational level. Differences were higher in subgroups with lower smoking prevalence and for causes of death with periods of induction shorter than those for lung cancer.This paper forms part of the research conducting to the PhD degree of Julia Rey-Brandariz, who has received a FPU fellowship (reference number FPU20/00926), from the Ministry of Universities of Spain. This study has been funded by Instituto de Salud Carlos III (ISCIII) through the project “PI19/00288″ and co-funded by the European Union.S

Tracking and risk of abdominal and general obesity in children between 4 and 9 years of age. The Longitudinal Childhood Obesity Study (ELOIN)

Background: Studies have shown that overweight and obesity conditions tend to be stable from childhood and adolescence to adulthood. Unfortunately, little is known about the evolution of abdominal obesity during childhood. The aim of this study was to evaluate the temporal variations and risk of general and abdominal obesity between 4, 6, and 9 years of age. Methods: Measurements of children in the ELOIN study taken at the three follow-ups of 4, 6, and 9 years of age were included (N = 1,902). Body mass index and waist circumference were recorded via physical examination. General obesity was determined according to the criteria of the World Health Organization (WHO) and abdominal obesity according to the cut-off points proposed by the International Diabetes Federation (IDF). Prevalence ratios (PRs) were estimated by sex and family affluence using generalized estimating equation models and relative risks (RRs) of obesity were obtained via Poisson regression. Results: The prevalence of general obesity was 5.1%, 9.1%, and 15.6% at 4, 6, and 9 years, respectively, yielding a PR of 3.05 (95%CI: 2.55–3.60) (9 years old relative to 4 years). The prevalence of abdominal obesity was 6.8%, 8.4%, 14.5% at 4, 6, and 9 years, respectively, and the PR was 2.14 (95%CI: 1.82–2.51) (9 years old relative to 4 years). An inverse correlation was observed between both general and abdominal obesity and socioeconomic status. Among participants with general or abdominal obesity at 4 years of age, 77.3% and 63.6% remained in their obesity classification at 9 years, respectively, and 3.4% and 3.5% presented general or abdominal obesity also at 6 and 9 years of age, respectively. The RRs of general and abdominal obesity at 9 years were 4.61 (95%CI: 2.76–7.72) and 4.14 (95%CI: 2.65–6.48) for children classified with obesity at 4 years of age, increased to 9.36 (95%CI: 7.72–11.35) and 9.56 (95%CI: 7.79–11.74) for children who had obesity at 6 years, and up to 10.27 (95%CI: 8.52–12.37) and 9.88 (95%CI: 8.07–12.11) for children with obesity at both 4 and 6 years, respectively. Conclusions: General and abdominal obesity begin at an early age and increase over time, showing an inverse correlation with socioeconomic status. In addition, general and abdominal obesity at 9 years are strongly associated with being classified with obesity at 4 and 6 years, so preventive interventions should be established at very early ages.The ELOIN study was funded by the General Directorate of Public Health of the Ministry of Health of the Community of Madrid. The authors have not received financial support for the research, authorship, or publication of this article. This project received a grant for the translation and publication of this paper from the Foundation for Biosanitary Research and Innovation in Primary Care (FIIBAP).S

Changes in general and abdominal obesity in children at 4, 6 and 9 years of age and their association with other cardiometabolic risk factors

Temporary changes in childhood obesity and their association with cardiometabolic risk factors have been receiving increased attention. The objective of this study was to evaluate changes in general (GO) and abdominal (AO) obesity in children from 4 to 9 years of age and their associations with cardiometabolic risk factors at 9 years of age. This study includes 1344 children from the Longitudinal Childhood Obesity Study (ELOIN). Physical examinations performed at 4, 6 and 9 years of age and a blood sample was only taken at 9 years of age. Changes in obesity from 4 to 9 years of age were estimated using Body Mass Index and waist circumference. Participants were classified into four groups according to GO and AO: (1) stable without obesity (no obesity at all three measurements); (2) remitting obesity at 9 years (obesity at 4 and/or 6 years but not at 9 years); (3) incident or recurrent obesity at 9 years (obesity only at 9 years, at 4 and 9 years or at 6 and 9 years); and (4) stable or persistent with obesity (obesity at 4, 6 and 9 years). Dyslipidemia and dysglycemia were defined by the presence of at least one altered parameter of the lipid or glycemic profile. Odds ratios (OR) were estimated using logistic regression. Compared with children without GO at all ages, those with persistent GO had an OR of 3.66 (95% CI: 2.06-6.51) for dyslipidemia, 10.61 (95% CI: 5.69-19.79) for dysglycemia and 8.35 (95% CI: 4.55-15.30) for high blood pressure. The associations were fairly similar in the case of AO, with ORs of 3.52 (95% CI: 1.96-6.34), 17.15 (95% CI: 9.09-32.34) and 8.22 (95% CI: 4.46-15.15), respectively, when comparing persistent versus stable without AO. Children with incident obesity at 9 years presented a moderate cardiometabolic risk that was nevertheless higher compared to those stable without obesity, whereas those with remitting obesity did not show any significant associations. Conclusion: Incident, and especially, persistent obesity, is associated with an increased cardiometabolic risk. The very early prevention of obesity, with a focus on nutrition, physical activity and sedentary behaviour, as well as tracking growth from birth to age 5, should be a priority to prevent the burden of cardiometabolic disease with consequences for adulthood.The ELOIN study was funded by the General Directorate of Public Health of the Ministry of Health of the Community of Madrid. The authors have not received financial support for the research, authorship or publication of this article. This project received a grant for the translation and publication of this paper from the Foundation for Biosanitary Research and Innovation in Primary Care (FIIBAP).S