Nutrición, inflamación y riesgo metabólico en niños y adolescentes europeos

El estudio de los factores de riesgo cardio-metabólicos es importante para intentar prevenir enfermedades futuras. Estos factores de riesgo aparecen cada vez a edades más tempranas como en la adolescencia, o incluso en la infancia, y parecen estar asociados con algunos estilos de vida como la alimentación. Se ha observado que la la inflamación crónica de bajo grado se relaciona con factores de riesgo cardio-metabólicos. Por lo tanto, el estudio del estado inflamatorio en niños y adolescentes es necesario para evaluar esta relación desde sus orígenes y, de esta manera, poder entender sus mecanismos de aparición. Es por ello que el objetivo general de esta Tesis Doctoral es evaluar la relación entre la inflamación, valorada mediante una serie de marcadores inflamatorios, la ingesta y las alteraciones cardio-metabólicas asociadas con la obesidad en niños y adolescentes europeos. Esta memoria se ha realizado por compendio de publicaciones, incluyendo seis artículos.La presente Tesis Doctoral se ha llevado a cabo teniendo en cuenta los resultados de dos grandes estudios europeos: el estudio IDEFICS (Identification and Prevention of Dietary- and Lifestyle- induced Health Effects in Children and Infants) y el estudio HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence). En el estudio IDEFICS se obtuvo información de más de 16.000 niños, con edades comprendidas entre 2 y 9 años, procedentes de ocho países europeos (Italia, Estonia, Chipre, Bélgica, Suecia, Alemania, Hungría y España). La medida incial se realizó durante el curso 2007-2008. Estos niños fueron re-evaluados dos años después del incio del estudio. Se seleccionaron sujetos de este estudio para valorar la asociación entre la dieta y la proteína C-reactiva de alta sensibilidad (PCR-hs), como marcador de inflamación. En el primer artículo se valoró la asociación entre los ácidos grasos, medidos en sangre total, y la inflamación. Los ácidos grasos son componentes de la dieta que se relacionan con el estado inflamatorio, especialmente en el caso de los ácidos grasos de cadena larga. Se observó que los acidos grasos omega-6 (suma de omega 6 y ácido linoleico) se asociaron con valores bajos de PCR-hs, en chicos, y con valores altos de PCR-hs en chicas (ácido araquidónico, suma de omega 6 altamente insaturados y relación acido araquidónico/linoleico). En el segundo artículo se observó una asociación clara entre la frecuencia de consumo de algunos alimentos y la PCR-hs. Específicamente, la elevada frecuencia de consumo de vegetales se relacionaba inversamente con la inflamación mientras que otros tipos de alimentos, como las bebidas azucaradas o la mayonesa, se relacionaban directamente con la inflamación.En el tercer artículo, tres tipos de patrones dietéticos fueron identificados y mantenidos a lo largo del seguimiento: el patrón ”saludable”, el patrón de “proteína animal y carbohidratos refinados” y el patrón “dulces y alimentos procesados”. En el análisis transversal, realizado al final del seguimiento, se observó que aquellos niños incluidos en el patrón ”dulces y alimentos procesados” mostraban una mayor probabilidad de tener la PCR-hs elevada, en comparación con aquellos asignados a un patrón ”saludable”. De igual manera, se observó que aquellos incluidos en un patrón de “dulces y alimentos procesados” mantenido en el tiempo, es decir, desde la valoración inicial hasta la medida de seguimiento, mostraban mayor probabilidad de tener valores más elevados de la PCR-hs, en comparación con los incluidos en un patrón saludable en las dos valoraciones. En el estudio HELENA, realizado entre 2006 y 2007, se valoraron más de 3.000 adolescentes de 10 ciudades europeas: Atenas, Heraklion, Dortmund, Gante, Lille, Pecs, Roma, Estocolmo, Viena y Zaragoza. Las edades de los adolescentes participantes estaban entre 12,5 y 17,5 años. Con datos de este estudio, se valoraron las asociaciones entre el riesgo cardio-metabólico y la inflamación en la adolescencia. La American Heart Asociation (AHA) ha propuesto un índice de salud cardiovascular ideal (ISCI) que incluye cuatro comportamientos y tres factores saludables. Los criterios relacionados con los comportamientos son: no haber fumado, ser físicamente activo, tener un IMC normal y tener una alimentación saludable, mientras que los factores saludables incluidos son valores normales de: tensión arterial, colesterol total y glucosa. Mediante el uso de este índice se valoró la relación entre la salud cardiovascular y la inflamación, la cual fue medida mediante un índice inflamatorio y, a su vez, mediante los biomarcadores que componían el citado índice individualmente: PCR, el factor C3 y C4 del complemento, leptina y el recuento de glóbulos blancos. En este cuarto artículo, se observó que puntuaciones superiores del índice de salud cardiovascular se relacionaban inversamente con los valores del índice inflamatorio y, además, con algunos de sus componentes individualmente. En el quinto artículo, se observó que la composición corporal juega un papel importante en la relación entre la resistencia a la insulina y la inflamación, medida con varios marcadores inflamatorios. La asociación entre la resistencia a la insulina y el factor C3 del complemento fue especialmente relevante para aquellos adolescentes con mayores niveles de adiposidad. Finalmente, en el último artículo, se valoró la asociación entre la salud metabólica y varios marcadores inflamatorios seleccionados, teniendo en cuenta la presencia o no de sobrepeso/obesidad. La existencia de sobrepeso/obesidad y un estatus metabólico alterado se asocia con marcadores inflamatorios, siendo la PCR, C3 y C4 los marcadores más relacionados con esta condición. C3 y C4 se asociaron consistentemente con la salud cardio-metabólica.En resumen, los resultados de esta Tesis Doctoral confirman la existencia de una asociación entre alimentación y PCR-hs desde la infancia y, a su vez, que los marcadores de riesgo cardio-metabólico están presentes desde la adolescencia y se asocian con distintos marcadores inflamatorios, en esta etapa de la vida. Estos resultados ponen de manifiesto la importancia del desarrollo de estrategias de prevención precoz, teniendo en cuenta la promoción de estilos de vida saludables, para evitar el desarrollo de los factores de riesgo cardio-metabólico y la aparición de un estado inflamatorio crónico de bajo grado, asociado a los mismos.<br /

Antioxidants and Oxidative Stress in Children: Influence of Puberty and Metabolically Unhealthy Status

Oxidative stress could help explain the relationship between childhood obesity and a metabolically unhealthy (MU) status. Moreover, puberty could also influence this relationship, since it entails physiological cardiometabolic changes. We aimed to evaluate plasma antioxidants and oxidative stress biomarkers in MU and metabolically healthy (MH) prepubertal and pubertal children and their associations with pro-inflammatory and endothelial damage biomarkers, taking puberty into account. A total of 1444 Spanish children aged 3–17 years (48.9% males, 66% prepubertal, 47.1% with obesity) were recruited. Blood pressure, anthropometric and biochemical parameters were measured, and children were categorized as having a MU or MH status according to risk factors. Retinol, carotenes, tocopherols, total antioxidant capacity (TAC), oxidized low-density lipoprotein and selected pro-inflammatory and endothelial damage biomarkers were analyzed. General linear models adjusted for age, sex, recruitment center and body mass index, partial correlations and stepwise linear regressions were performed. Lower carotenes and tocopherols levels were found in MU than in MH children. Plasma TAC was lower in prepubertal and higher in pubertal children with obesity compared to normal-weight children. Antioxidants and oxidative stress biomarkers showed novel associations with several pro-inflammatory and endothelial damage biomarkers, with pubertal differences, supporting the importance of considering both the antioxidant and oxidative stress status and puberty in the prevention of metabolic diseases in childhood.Plan Nacional de Investigacion Cientifica, Desarrollo e Innovacion Tecnologica (I + D + I), Instituto de Salud Carlos III-Health Research Funding (FONDOS FEDER) PI051968 PI11/01425 PI1102042 PI11/02059 PI16/01301 PI16/012 PI1600871CIBEROBN Network CB12/03/30038 CB15/00131 CB15/0004

Energy dense salty food consumption frequency is associated with diastolic hypertension in Spanish children

High blood pressure (BP) is a risk factor for cardiovascular disease and sodium consumption is related to high BP. Moreover, sugar-sweetened beverages (SSB) and the Dietary Approach to Stop Hypertension (DASH) influence BP. For this reason, we investigated whether: 1) children with risk of elevated BP had a higher consumption frequency (CF) of energy-dense salty foods (EDSF), high-sugary foods (HSF) and SSB or a low DASH score; and 2) children with a higher CF of EDSF showed a worse anthropometric and metabolic profile. Anthropometry, BP and general biochemical parameters were measured in 687 Spanish children (5-16 years) with normal or excess weight. A food frequency questionnaire was used to calculate EDSF, HSF and SSB consumption, and modified DASH score. Results showed that sex and pubertal stage influenced modified DASH score. Diastolic hypertension was associated to higher CF of EDSF in the whole sample and to higher CF of SSB in pubertal children, both independently of nutritional status. In addition, CF of EDSF was positively associated with CF of HSF and SSB and inversely associated with modified DASH score. Targeted policies and intervention programs, specific for different age ranges, should be established that aim to reduce salt consumption from snacks and processed foods, which could reduce HSF and SSB consumption as well

Relationship between Physical Activity, Oxidative Stress, and Total Plasma Antioxidant Capacity in Spanish Children from the GENOBOX Study

The World Health Organization has recommended performing at least 60 min a day of moderate-to-vigorous physical activity (MVPA) and reducing sedentarism in children and adolescents to offer significant health benefits and mitigate health risks. Physical fitness and sports practice seem to improve oxidative stress (OS) status during childhood. However, to our knowledge, there are no data regarding the influence of objectively-measured physical activity (PA) and sedentarism on OS status in children and adolescents. The present study aimed to evaluate the influence of moderate and vigorous PA and sedentarism on OS and plasma total antioxidant capacity (TAC) in a selected Spanish population of 216 children and adolescents from the GENOBOX study. PA (light, moderate, and vigorous) and sedentarism (i.e., sedentary time (ST)) were measured by accelerometry. A Physical Activity-Sedentarism Score (PASS) was developed integrating moderate and vigorous PA and ST levels. Urinary 8-hydroxy-20-deoxyguanosine (8-OHdG) and isoprostane F2 (F2-IsoPs), as markers of OS, were determined by ELISA; and TAC was estimated by colorimetry using an antioxidant kit. A higher PASS was associated with lower plasma TAC and urinary 8-OHdG and F2-IsoPs, showing a better redox profile. Reduced OS markers (8-OHdG and F2-IsoPs) in children with higher PASS may diminish the need of maintaining high concentrations of antioxidants in plasma during rest to achieve redox homeostasis.Plan Nacional de Investigación Científica, Desarrollo e Innovación Tecnológica (I + D + I), Instituto de Salud Carlos III-Health Research Funding (FONDOS FEDER) PI11/02042 PI11/02059 PI11/01425 PI16/00871 PI16/01301 PI16/01205RETIC (Redes temáticas de investigación cooperativa) Red SAMID RD12/0026/0015Instituto de Salud Carlos III European Commission IFI17/00048Research Plan of the Vice-Rectorate of Research and Transfer of the University of Granada, Spai

Association of Diet, Physical Activity Guidelines and Cardiometabolic Risk Markers in Children

The aim was to identify different dietary and physical activity (PA) patterns in 5- to 14-year-old children with a high prevalence of overweight and obesity using cluster analysis based on their adherence to the Spanish Society of Community Nutrition dietary guidelines and levels of PA, and to determine their associations with age, sex, body composition, and cardiometabolic risk markers. In 549 children, hierarchical cluster analysis was used to identify subgroups with similar adherence to dietary recommendations and level of PA. Three clusters were identified: Cluster 1, with the lowest level of vigorous PA and adherence to dietary recommendations; Cluster 2, with the lowest levels of moderate and vigorous PA and the highest adherence to dietary recommendations; and Cluster 3, with the highest level of PA, especially vigorous PA and a medium level adherence to dietary recommendations. Cluster 3 had lower total body fat and higher lean body mass percentages than Cluster 2. Cluster 2 had lower high-density lipoprotein cholesterol and higher low-density lipoprotein cholesterol levels than Cluster 1. The results from our study suggest that it is important to consider adherence to PA recommendations together with adherence to dietary guidelines to understand patterns of obesogenic habits in pediatric populations with high prevalence of overweight and obesity.Plan Nacional de Investigación Científica, Desarrollo e Innovación Tecnológica (I + D + I), Instituto de Salud Carlos III-Health Research Funding (FONDOS FEDER) (PI05/1968, PI11/01425, PI11/02042, PI11/02059, PI16/01301, PI16/01205 and PI1600871)CIBEROBN Network (CB15/00131, CB15/00043)Plan Propio de la Universidad de Granada with a Sabatical Program 2020–202

ANGPTL-4 is Associated with Obesity and Lipid Profile in Children and Adolescents

Angiopoietin-like protein 4 (ANGPTL-4) regulates lipidic metabolism and affects energy homeostasis. However, its function in children with obesity remains unknown. We investigated plasma ANGPTL-4 levels in children and its relationship with body mass index (BMI) and different lipidic parameters such as free fatty acids (FFA). Plasma ANGPTL-4 levels were analyzed in two different cohorts. In the first cohort (n = 150, age 3–17 years), which included children with normal weight or obesity, we performed a cross-sectional study. In the second cohort, which included only children with obesity (n = 20, age 5–18 years) followed up for two years after an intervention for weight loss, in which we performed a longitudinal study measuring ANGPTL-4 before and after BMI-loss. In the cross-sectional study, circulating ANGPTL-4 levels were lower in children with obesity than in those with normal weight. Moreover, ANGPTL-4 presented a negative correlation with BMI, waist circumference, weight, insulin, homeostasis model assessment of insulin resistance index (HOMA index), triglycerides, and leptin, and a positive correlation with FFA and vitamin-D. In the longitudinal study, the percent change in plasma ANGPTL-4 was correlated with the percent change in FFA, total-cholesterol and high-density lipoprotein cholesterol. This study reveals a significant association of ANGPTL-4 with pediatric obesity and plasma lipid profileThis research was funded by INSTITUTO DE SALUD CARLOS III cofounded by FEDER, grants number PI18/00998, PI15/01272, PI11/02042, PI16/01301, and PI16/00871, and FUNDACIÓN MUTUA MADRILEÑAS

Exogenous aralar/slc25a12 can replace citrin/slc25a13 as malate aspartate shuttle component in liver

The deficiency of CITRIN, the liver mitochondrial aspartate–glutamate carrier (AGC), is the cause of four human clinical phenotypes, neonatal intrahepatic cholestasis caused by CITRIN deficiency (NICCD), silent period, failure to thrive and dyslipidemia caused by CITRIN deficiency (FTTDCD), and citrullinemia type II (CTLN2). Clinical symptoms can be traced back to disruption of the malate-aspartate shuttle due to the lack of citrin. A potential therapy for this condition is the expression of aralar, the AGC present in brain, to replace citrin. To explore this possibility we have first verified that the NADH/NAD+ ratio increases in hepatocytes from citrin(−/−) mice, and then found that exogenous aralar expression reversed the increase in NADH/NAD+ observed in these cells. Liver mitochondria from citrin (−/−) mice expressing liver specific transgenic aralar had a small (~ 4–6 nmoles x mg prot−1 x min−1) but consistent increase in malate aspartate shuttle (MAS) activity over that of citrin(−/−) mice. These results support the functional replacement between AGCs in the liver. To explore the significance of AGC replacement in human therapy we studied the relative levels of citrin and aralar in mouse and human liver through absolute quantification proteomics. We report that mouse liver has relatively high aralar levels (citrin/aralar molar ratio of 7.8), whereas human liver is virtually devoid of aralar (CITRIN/ARALAR ratio of 397). This large difference in endogenous aralar levels partly explains the high residual MAS activity in liver of citrin(−/−) mice and why they fail to recapitulate the human disease, but supports the benefit of increasing aralar expression to improve the redox balance capacity of human liver, as an effective therapy for CITRIN deficienc

Risk factors associated with methicillin-resistant Staphylococcus aureus skin and soft tissue infections in hospitalized patients in Colombia

Q2Q160-66Pacientes hospitalizadosObjectives: Methicillin-resistant Staphylococcus aureus (MRSA) skin and soft tissue infections (SSTIs) represent a major clinical problem in Colombia. The aim of this study was to evaluate the risk factors associated with MRSA SSTI in Colombia. Methods: A multicenter cohort study with nested case–control design was performed. Patients with an SSTI with at least 48 h of inpatient care were included. Patients with an MRSA SSTI were considered the case group and patients with either a non-MRSA SSTI or with an Methicillin-susceptible S. aureus (MSSA) SSTI were the control groups. A multivariate logistic regression approach was used to evaluate risk factors associated with MRSA SSTI with two different statistical models. Results: A total 1134 patients were included. Cultures were positive for 498 patients, of which 52% (n = 259) were Staphylococcus aureus. MRSA was confirmed in 68.3% of the S. aureus cultures. In the first model, independent risk factors for MRSA SSTI were identified as the presence of abscess (P<0.0001), cellulitis (P = 0.0007), age 18–44 years (P = 0.001), and previous outpatient treatment in the previous index visit (P = 0.003); surgical site infection was a protective factor (P = 0.008). In the second model, the main risk factor found was previous outpatient treatment in the previous index visit (P = 0.013). Conclusions: Community-acquired SSTIs in Colombia are commonly caused by MRSA. Therefore, clinicians should consider MRSA when designing the initial empirical treatment for purulent SSTI in Colombia, although there seems to be low awareness of this fact

Validación de la producción masiva de las micorrizas como alternativa agroambiental para los pequeños productores del municipio de Restrepo :informe final

Los problemas generados por el uso de la agricultura intensiva en el Piedemonte Llanero, zona de mayor desarrollo agrícola de los Llanos Orientales, ha propiciado la degradación progresiva del ambiente y la reducción de la productividad de los cultivos, por lo cual surge la necesidad de establecer estrategias viables que aportan beneficios económicos y ambientales como el uso de biofertilizantes donde las micorrizas se convierten en una importante alternativa para los sistemas de producción integrados, acompañados de prácticas sostenibles de manejo agrícola que permitan mejorar la calidad de los agroecosistemas y contribuir al logro de un desarrollo socioeconómico equitativo de los pequeños productores agrícolas del municipio de Restrepo, mediante la validación y apropiación de la tecnología de uso y producción de las micorrizas

The Research Journey as a Challenge Towards New Trends

The academic community of the department of Risaralda, in its permanent interest in evidencing the results of the research processes that are carried out from the Higher Education Institutions and as a product of the VI meeting of researchers of the department of Risaralda held in November 2021 presents its work: “The journey of research as a challenge towards new trends”, which reflects the result of the latest research and advances in different lines of knowledge in Agricultural Sciences, Health Sciences, Social Sciences and Technology and Information Sciences, which seek to solve and meet the demands of the different sectors. This work would not have been possible without the help of each of the teachers, researchers and authors who presented their articles that make up each of the chapters of the book, to them our gratitude for their commitment, dedication and commitment, since their sole purpose is to contribute from the academy and science to scientific and technological development in the search for the solution of problems and thus contribute to transform the reality of our society and communities. We also wish to extend our gratitude to the institutions of the Network that made this publication possible: UTP, UCP, UNAD, UNIREMINGTON; UNISARC, CIAF, Universidad Libre, Uniclaretiana, Fundación Universitaria Comfamiliar and UNIMINUTO, institutions that in one way or another allowed this work to become a reality, which we hope will be of interest to you.Preface............................................................................................................................7 Chapter 1. Technologies and Engineering Towards a humanization in Engineering using soft skills in training in Engineers.............................................................................................................11 Omar Iván Trejos Buriticá1, Luis Eduardo Muñoz Guerrero Innovative materials in construction: review from a bibliometric analysis....................................................................................................................27 Cristian Osorio Gómez, Daniel Aristizábal Torres, Alejandro Alzate Buitrago, Cristhian Camilo Amariles López Bibliometric review of disaster risk management: progress, trends, and challenges.........................................................................................................51 Alejandro Alzate Buitrago, Gloria Milena Molina Vinasco. Incidence of land coverage and geology, in the unstability of lands of the micro-basin of the Combia creek, Pereira, Risaralda....................................73 Alejandro Alzate Buitrago, Daniel Aristizábal Torres. Chapter 2. Arts, Humanities, and Social Sciences Training experience with teachers teaching mathematics using the inquiry methodology ...............................................................................................95 Vivian Libeth Uzuriaga López, Héctor Gerardo Sánchez Bedoya. Interpretation of the multiple representations of the fears associated to the boarding of limited visual patients in the elective I students’ written productions and low vision ...................................................................................113 Eliana Bermúdez Cardona, Ana María Agudelo Guevara, Caterine Villamarín Acosta. The relevance of local knowledge in social sciences............................................131 Alberto Antonio Berón Ospina, Isabel Cristina Castillo Quintero. Basic education students’ conceptions of conflict a view from the peace for the education....................................................................................................143 Astrid Milena Calderón Cárdenas,Carolina Aguirre Arias, Carolina Franco Ossa, Martha Cecilia Gutiérrez Giraldo, Orfa Buitrago. Comprehensive risk prevention in educational settings: an interdisciplinary and socio-educational approach ............................................................................163 Olga María Henao Trujillo, Claudia María López Ortiz. Chapter 3. Natural and Agricultural Sciences Physicochemical characterization of three substrates used in the deep bedding system in swine .......................................................................................175 Juan Manuel Sánchez Rubio, Andrés Felipe Arias Roldan, Jesús Arturo Rincón Sanz, Jaime Andrés Betancourt Vásquez. Periodic solutions in AFM models........................................................................187 Daniel Cortés Zapata, Alexander Gutiérrez Gutiérrez. Phenology in flower and fruit of Rubus glaucus benth. Cv. Thornless in Risaralda: elements for phytosanitary management .........................................199 Shirley Palacios Castro, Andrés Alfonso Patiño Martínez, James Montoya Lerma, Ricardo Flórez, Harry Josué Pérez. Socio-economic and technical characterization of the cultivation of avocado (Persea americana) in Risaralda..............................................................217 Andrés Alfonso Patiño Martínez, Kelly Saudith Castañez Poveda, Eliana Gómez Correa. Biosecurity management in backyard systems in Santa Rosa de Cabal, Risaralda................................................................................................................227 Julia Victoria Arredondo Botero, Jaiver Estiben Ocampo Jaramillo, Juan Sebastián Mera Vallejo, Álvaro de Jesús Aranzazu Hernández. CONTENTS Physical-chemical diagnosis of soils in hillside areas with predominance of Lulo CV. La Selva production system in the department of Risaralda.............241 Adriana Patricia Restrepo Gallón, María Paula Landinez Montes, Jimena Tobón López. Digestibility of three concentrates used in canine feeding....................................271 María Fernanda Mejía Silva, Valentina Noreña Sánchez, Gastón Adolfo Castaño Jiménez. Chapter 4. Economic, Administrative, and Accounting Sciences Financial inclusion in households from socioeconomic strata 1 and 2 in the city of Pereira ..................................................................................................285 Lindy Neth Perea Mosquera, Marlen Isabel Redondo Ramírez, Angélica Viviana Morales. Internal marketing strategies as a competitive advantage for the company Mobilautos SAS de Dosquebradas........................................................................303 Inés Montoya Sánchez, Sandra Patricia Viana Bolaños, Ana María Barrera Rodríguez. Uses of tourist marketing in the tourist sector of the municipality of Belén de Umbría, Risaralda.............................................................................................319 Ana María Barrera Rodríguez, Paola Andrea Echeverri Gutiérrez, María Camila Parra Buitrago, Paola Andrea Martín Muñoz, Angy Paola Ángel Vélez, Luisa Natalia Trejos Ospina. Territorial prospective of Risaralda department (Colombia), based on the SDGS...............................................................................................................333 Juan Guillermo Gil García, Samanta Londoño Velásquez. Chapter 5. Health and Sports Sciences Performance evaluation in times of pandemic. What do medical students think?.......................................................................................................353 Samuel Eduardo Trujillo Henao, Rodolfo A. Cabrales Vega, Germán Alberto Moreno Gómez. The relevance of the therapist’s self and self-reference in the training of psychologists.....................................................................................................371 Maria Paula Marmolejo Lozano, Mireya Ospina Botero. Habits related to oral health which influence lifestyle of elder people in a wellness center for the elderly in Pereira 2020. .............................................387 Isadora Blanco Pérez, Olga Patricia Ramírez Rodríguez, Ángela María Rincón Hurtado. Analysis of the suicide trend in the Coffee Region in Colombia during the years 2012-2018 ..............................................................................................405 Germán Alberto Moreno Gómez, Jennifer Nessim Salazar, Jairo Franco Londoño, Juan Carlos Medina Osorio. Hind limb long bone fractures in canines and felines...........................................419 María Camila Cruz Vélez, Valentina Herrera Morales, Alba Nydia Restrepo Jiménez, Lina Marcela Palomino, Gabriel Rodolfo Izquierdo Bravo. Prevalence of overweight and obesity in children in the rural and urban area of Risaralda....................................................................................................439 Angela María Álvarez López, Angela Liceth Pérez Rendón, Alejandro Gómez Rodas, Luis Enrique Isaza Velásquez. Chapter 6. Architecture, Design and Advertising The artisan crafts of Risaralda, characteristics, importance, and risks within the Colombian Coffee Cultural Landscape, CCCL....................................457 Yaffa Nahir Ivette Gómez Barrera, Javier Alfonso López Morales