Transiciones de la obesidad infantil y factores de riesgo cardiometabólico

Incluye PDF de la presentación y vídeo del seminario.El Estudio ELOIN estima las prevalencias de sobrepeso y obesidad en la población infantil de los 4 hasta los 14 años de edad, los factores de riesgo y sus posibles efectos adversos en la salud infantil. En España la prevalencia de exceso de peso infantil (sobrepeso+obesidad) se sitúa en torno al 30-35%, con una prevalencia de obesidad entre el 10-15%.N

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

AUDITORIA EM ENFERMAGEM: IMPLANTAÇÃO E DESENVOLVIMENTO NO HOSPITAL UNIVERSITÁRIO DA UNIVERSIDADE DE SÃO PAULO

The study reports an experience carried aut by the Departamento de Assistência de Enfermagem do Hospital Universitário da USP, the implantation and development of the retrospective auditory process for the evaluation of their activities as an instrument for control and maintenance of the quality of nursing care given the community. It describes the various steps, instruments and reports used, as well as the use of the auditory's findings for reviewing the assistential and educational programs deve~ loped by the department.O trabalho relata a experiência do Departamento de Assistência de Enfermagem do Hospital Universitário da USP, da implantação e desenvolvimento do processo de auditoria retrospectiva para avaliação de suas atividades, como instrumento de controle e manutenção da qualidade da assistência de enfermagem prestada à comunidade. Descreve as várias etapas, instrumentos e relatórios utilizados, assim como o emprego dos resultados da auditoria para revisão dos programas assistenciais e educacionais desenvolvidos peto Departamento

Association between biomarkers of iron status and cardiometabolic risk in Spanish children aged 9-10 years. The ELOIN study

The relationship between iron metabolism and cardiometabolic risk factors has been scarcely studied in children, and the results are controversial. The objective of this study was to evaluate the association between iron parameters and lipid, glycemic and blood pressure alterations in the pediatric population. This was a cross-sectional study of 1954 children between 9 and 10 years of age in Madrid (Spain), participants in a longitudinal study of childhood obesity. Iron metabolism parameters, i.e., serum iron (Is), ferritin (Fs), transferrin (Tf) and transferrin saturation (STf) and lipid, glycemic and blood pressure profiles were evaluated. Odds ratios (ORs) were estimated using logistic regression models adjusted for sociodemographic characteristics, diet, physical activity, C-reactive protein and body mass index. Compared with the participants in the low Is and STf tertiles, those in the upper tertiles had a lower risk of low HDL-Chol (OR: 0.34; 95%CI: 0.17; 0.67) and OR: 0.44 (95%CI: 0.23; 0.84), respectively, and children in the upper Fs tertile had an OR of 2.07 (95%CI: 1.16; 3.68) for low HDL-Chol. Children in the highest Is and STf tertiles had a lower risk of prediabetes [OR: 0.63 (95%CI: 0.41; 0.97) and OR: 0.53 (95%CI: 0.34; 0.82)] and insulin resistance (IR) (OR: 0.37; 95%CI: 0.22; 0.64), and those in the upper Tf tertile had a higher risk of IR (OR: 1.90; 95%CI: 1.16; 3.12). An increased risk of hypertension was found only in children in the upper Fs tertile (OR: 1.46; 95%CI: 1.01; 2.13). Conclusions: Biomarkers of iron metabolism are associated with cardiometabolic alterations in the pediatric population, with a variable direction and magnitude depending on the indicators used. What is known: • Iron metabolism is related to important cardiometabolic alterations such as metabolic syndrome and its components. • Association between biomarkers of iron status and cardiometabolic risk have been less explored in children. What is new: • Biomarkers of iron metabolism are associated with cardiometabolic alterations in the pediatric population. • Iron parameters in the pediatric population could be of great help to detect and prevent cardiometabolic abnormalities early.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

Efecto del cambio climático en el periodo de crecimiento en Guanajuato

El incremento de la temperatura y la modificación de los patrones de distribución de la lluvia son dos de los efectos más ampliamente documentados del cambio climático global. Los impactos que tales cambios están provocando en los procesos de producción agrícola constituyen una de las principales amenazas para la producción de alimentos, sobre todo bajo condiciones de temporal. El presente estudio pretende evidenciar los cambios que han tenido lugar en la disponibilidad de humedad para los cultivos y que son atribuibles al cambio climático en el estado de Guanajuato. El análisis consistió en estimar el periodo de crecimiento por disponibilidad de humedad (PC) a partir de las series históricas diarias de clima de 58 estaciones del Servicio Meteorológico Nacional. Las series históricas se dividieron en dos periodos: el primero de 1960 a 1979 y el segundo de 1980 a 2017. En el periodo de 1960-1979, el inicio del PC, calculado al 80 % de probabilidad acumulativa, ocurrió el día 193 (día juliano), el cual corresponde al 11 de julio; mientras que en el periodo 1980-2017 se presentó hasta el día 211, que corresponde al 30 de julio. En lo que se refiere a la duración del PC, calculada al 80 % de probabilidad de excedencia, se observa una reducción, al pasar de 110 días en el periodo 1960-1979 a solo 75 días en el periodo 1980-2017. De continuar estas tendencias, la superficie agrícola susceptible de ser cultivada bajo condiciones de temporal en el estado se reducirá drásticamente en pocos años

Impact of the "Tobacco control law" on exposure to environmental tobacco smoke in Spain

<p>Abstract</p> <p>Background</p> <p>The initial evaluations of the introduction of legislation that regulates smoking in enclosed public places in European countries, describe an important effect in the control of exposure to environmental tobacco smoke. However, the evidence is still limited. The objective of this study is to estimate the short-term effects of the comprehensive "Tobacco control law" introduced in Spain on January 2006, which includes a total ban of smoking in workplaces and a partial limitation of smoking in bars and restaurants.</p> <p>Methods</p> <p>Cross-sectional, population-based study. The self-reported exposure to environmental tobacco smoke at home, at work, in bars and restaurants of the population aged 18 to 64 years in the Madrid Region during a period prior to the law (October and November 2005; n = 1750) was compared to that of the period immediately after the law came into force (January-July 2006; n = 1252). Adjusted odds ratios (OR) were calculated using logistic regression models.</p> <p>Results</p> <p>Passive exposure to tobacco smoke at home has hardly changed. However, at indoor workplaces there has been a considerable reduction: after the law came into force the OR for daily exposure > 0–3 hours versus non-exposure was 0.11 (95% CI: 0.07 to 0.17) and for more than 3 hours, 0.12 (95% CI: 0.09 to 0.18). For fairly high exposure in bars and restaurants versus non-exposure, the OR in the former was 0.30 (95% CI: 0.20 to 0.44) and in the latter was 0.24 (95% CI: 0.18 to 0.32); for very high exposure versus non-exposure they were 0.16 (95% CI: 0.10 to 0.24) and 0.11 (95% CI: 0.07 to 0.19), respectively. These results were similar for the smoking and non-smoking populations.</p> <p>Conclusion</p> <p>A considerable reduction in exposure to environmental tobacco smoke in the workplace and, to a lesser extent, in bars and restaurants, is related to the implementation of the "Tobacco control law". Although only initial figures, these results already demonstrate the effectiveness of strategies that establish control measures to guarantee smoke-free places.</p

Plastic pollution transcends marine protected area boundaries in the eastern tropical and south-eastern Pacific

This is the final version. Available on open access from Elsevier via the DOI in this recordData availability: Our dataset is fully available within the Supplementary Information.The Eastern Tropical and South-Eastern Pacific region is of global biodiversity importance. At COP26, the governments of Costa Rica, Panama, Colombia, and Ecuador committed to the expansion of existing MPAs to create a new Mega MPA, safeguarding the Eastern Tropical Pacific Marine Corridor. It offers a profound step forward in conservation efforts but is not specifically designed to protect against the more diffuse anthropogenic threats, such as plastic pollution. We combine published data with our own unpublished records to assess the abundance and distribution of plastic pollution in the region. Macro- and microplastic concentrations varied markedly and were not significantly different when comparing areas inside and outside existing MPA boundaries. These findings highlight the diffuse and complex nature of plastic pollution and its ubiquitous presence across MPA boundaries. Understanding the sources and drivers of plastic pollution in the region is key to developing effective solutions.UK Global Challenges Resource Fund (GCRF)Galapagos Conservation Trus