La clase de Educación Física como referencia para identificar actividades vigorosas con acelerometría en niños de 8 y 9 años

The World Health Organization recommends that children and adolescents incorporate vigorous intensity activities but does not define how much vigorous physical activity (VPA) is necessary or what should be the duration of the activity sessions. Objective: To define the proportion of VPA in the most active physical education classes (PEC) to identify vigorous intensity physical activity sessions (i.e., activities). Methods: The PEC of 490 children (8-9 years old) were evaluated using accelerometry. The health-enhancing PEC were identified through the VPA performed and the weight status of the children. The 66.7 percentile of the VPA performed in the PEC by the children was calculated. Results: The average proportion of VPA of the health-enhancing PEC, and that performed by the most active schoolchildren (66.7 percentile) in the total PEC, show similar results. In boys, a VPA proportion of 16.3% and 16.1% was observed, respectively, and in girls 12.0% and 12.8%. Conclusion: The use of bouts of ≥60 minutes with ≥16.7% and 12.5% of VPA in boys and girls, respectively, is proposed to identify vigorous activity sessions with accelerometry.La Organización Mundial de la Salud recomienda que los niños y adolescentes incorporen actividades de intensidad vigorosa, pero no define cuánta actividad física vigorosa (VPA) es necesaria ni cuál debe ser la duración de las sesiones de actividad. Objetivo: Definir la proporción de VPA en las clases de educación física (CEF) más activas para identificar sesiones de actividad física (es decir, actividades) de intensidad vigorosa. Métodos: Se evaluaron mediante accelerometría las CEF de 490 escolares (8-9 años). Se identificaron las CEF consideradas saludablemente activas a través de la VPA realizada y el estado ponderal de los escolares. Se calculó el percentil 66,7 de la VPA realizada en las CEF por los escolares. Resultados: La proporción de VPA media de las CEF saludablemente activas, y la realizada por los escolares más activos (percentil 66,7) en el total de CEF, muestran resultados similares. En los niños se observó una proporción de VPA de 16,3% y 16,1%, y en las niñas del 12,0% y 12,8%, respectivamente. Conclusión: Se propone el uso de bouts de ≥60 minutos con ≥16,7% y 12,5% de VPA en niños y en niñas, respectivamente, para identificar sesiones de actividades vigorosas con acelerometría

Relación entre las horas de sueño y la frecuencia de consumo de alimentos en niños y niñas en Andalucía en 2015

Introducción: La frecuencia de consumo de alimentos y bebidas en los niños depende de diferentes patrones de comportamiento. Objetivos:Evaluar el efecto de la duración del sueño de los niños sobre la frecuencia de consumo de alimentos, y describir las frecuencias de consumo según su estado ponderal y el nivel de educación familiar. Método: Se estudiaron 2721 niños y niñas de 6 a 9 años del Estudio ALADINO 2015 en Andalucía. Se recogieron el número de horas de sueño y la frecuencia semanal de consumo de 24 grupos de alimentos. Se calculó el estado ponderal mediante el índice de masa corporal, con los estándares de crecimiento de la OMS, se recogió el nivel educativo de los padres y madres. Las frecuencias medias de consumo de alimentos se calcularon según la duración del sueño (mayor o menor que la media diaria). Se ajustaron modelos de regresión logística para evaluar las asociaciones independientes de las horas de sueño sobre las frecuencias de consumo de alimentos (variables resultado), ajustando por edad, sexo, nivel de educación de los padres, estado ponderal y disponibilidad de medios de ocio pasivo en la habitación. Resultados: Dormir suficiente número de horas se asocia con mayor probabilidad de consumir fruta (OR:1,23;IC95%:1,06-1,42) y verdura (OR:1,19;IC95%:1,01-1,40), y menor probabilidad de consumir refrescos azucarados (OR:0,80;IC95%:0,67-0,97), zumos con azúcar (OR:0,79;IC95%:0,64-0,99), snacks salados (OR:0,46;IC95%:0,33-0,65), chocolates o caramelos (OR:0,71;IC95%:0,55-0,92), y galletas y bollos (OR:0,70;IC95%:0,58-0,84). El consumo de frutas y verduras medio semanal es mayor en niños sin sobrepeso y en hijos de padres con mayor nivel educativo. Conclusiones: Una duración de sueño adecuada está asociada con mayor consumo de frutas y verduras, y menos alimentos con alta densidad de energía. Mejorar la higiene del sueño es fundamental para mejorar los hábitos alimentarios, y especialmente en niños con sobrepeso, y de menor nivel educativoUniversidad de Málaga. Campus de Excelencia Internacional Andalucía Tech

Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults

Background Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. Methods We used data from 3663 population-based studies with 222 million participants that measured height and weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children and adolescents (age 5–19 years), from 1990 to 2022 for 200 countries and territories. For adults, we report the individual and combined prevalence of underweight (BMI <18·5 kg/m2) and obesity (BMI ≥30 kg/m2). For schoolaged children and adolescents, we report thinness (BMI <2 SD below the median of the WHO growth reference) and obesity (BMI >2 SD above the median). Findings From 1990 to 2022, the combined prevalence of underweight and obesity in adults decreased in 11 countries (6%) for women and 17 (9%) for men with a posterior probability of at least 0·80 that the observed changes were true decreases. The combined prevalence increased in 162 countries (81%) for women and 140 countries (70%) for men with a posterior probability of at least 0·80. In 2022, the combined prevalence of underweight and obesity was highest in island nations in the Caribbean and Polynesia and Micronesia, and countries in the Middle East and north Africa. Obesity prevalence was higher than underweight with posterior probability of at least 0·80 in 177 countries (89%) for women and 145 (73%) for men in 2022, whereas the converse was true in 16 countries (8%) for women, and 39 (20%) for men. From 1990 to 2022, the combined prevalence of thinness and obesity decreased among girls in five countries (3%) and among boys in 15 countries (8%) with a posterior probability of at least 0·80, and increased among girls in 140 countries (70%) and boys in 137 countries (69%) with a posterior probability of at least 0·80. The countries with highest combined prevalence of thinness and obesity in school-aged children and adolescents in 2022 were in Polynesia and Micronesia and the Caribbean for both sexes, and Chile and Qatar for boys. Combined prevalence was also high in some countries in south Asia, such as India and Pakistan, where thinness remained prevalent despite having declined. In 2022, obesity in school-aged children and adolescents was more prevalent than thinness with a posterior probability of at least 0·80 among girls in 133 countries (67%) and boys in 125 countries (63%), whereas the converse was true in 35 countries (18%) and 42 countries (21%), respectively. In almost all countries for both adults and school-aged children and adolescents, the increases in double burden were driven by increases in obesity, and decreases in double burden by declining underweight or thinness. Interpretation The combined burden of underweight and obesity has increased in most countries, driven by an increase in obesity, while underweight and thinness remain prevalent in south Asia and parts of Africa. A healthy nutrition transition that enhances access to nutritious foods is needed to address the remaining burden of underweight while curbing and reversing the increase in obesit

Accelerometry-assessed daily physical activity and compliance with recommendations in Spanish children: importance of physical education classes and vigorous intensity

Background Physical activity (PA) is associated with numerous health benefits. Vigorous PA (VPA) may have a greater impact on public health than lower-intensity PA. The incorporation of a specific recommendation on VPA could complement and improve existing recommendations for average daily moderate-vigorous PA (MVPA). Physical education classes could have a positive impact on children’s adherence to average daily physical activity recommendations. The aim was to investigate the association between MVPA and VPA in children, as well as adherence to recommendations, and obesity and the presence of physical education classes. Methods A cross-sectional study of physical activity was conducted in a sample of 8 and 9-year-old children in Andalusia (Spain). GENEActiv accelerometers were used, placed on the non-dominant wrist for at least eight consecutive days (24-h protocol). School days with and without physical education class, and weekend days were defined. ROC curves were used to calculate the threshold associated with obesity for average daily MVPA and VPA for recommendations. Results A total of 360 schoolchildren were included in the analyses (184 girls). An average of 7.7 (SD 1.4) valid days per participant were evaluated, with 19.9 (SD 10.5) and 11.4 (SD 5.1) minutes of VPA performed by boys and girls respectively. 25.8% of the participants were classified with central obesity. The optimal threshold determined with ROC analysis was 12.5 and 9.5 minutes of average daily VPA for boys and girls, respectively (RecVPA), and 75 minutes of average daily MVPA for both sexes (RecMVPA). The RecVPA showed stronger association with obesity. On school days with physical education class, compared to days without this class, children showed increased VPA and MVPA engagement and better compliance with recommendations, with smaller differences in adherence according to sex or obesity. Conclusions On days with physical education class, more physical activity was accumulated at all intensities and greater adherence to the recommendations than on days without this class. VPA had a stronger correlation with the absence of obesity than lower-intensity activity. It was also observed that boys were physically more active and had higher adherence to the recommendations than girls

Adherence to the WHO recommendation of three weekly days of vigorous intensity activities in children: an accelerometry study of vigorous physical activity bouts

Background The World Health Organization (WHO) recommends that children and adolescents incorporate vigorous intensity activities (VIAs) at least three days a week. This recommendation has not been sufficiently studied using objective methods, such as accelerometry. Physical education classes and extracurricular sports activities are optimal opportunities for compliance with this recommendation. Objective To identify VIAs through bouts of vigorous physical activity (VPA-Bouts) evaluated with accelerometry and, with this, to know the compliance with the recommendation on VIAs. Methods A cross-sectional study of the habitual physical activity of 353 children (8–9 years old) was carried out using accelerometry and participation in organized extracurricular sports activities was asked through a questionnaire. School days with and without physical education class, weekends, and the average weekly day were identified, as well as school time and out-of-school time. A VPA-Bout was defined as an interval of at least 60 minutes with a proportion of VPA of at least 16.7% in boys and 12.5% in girls (10.0 and 7.5 minutes/hour of VPA, respectively). Results The average daily time in organized extracurricular sports activities declared by questionnaire and the average daily duration of the VPA-Bouts evaluated with accelerometers in the extracurricular period was 21.3 (SD 19.8) and 23.9 (SD 31.2) minutes, respectively, in boys, whereas, in girls it was 20.2 (SD 17.4) and 11.0 (SD 16.9) minutes, respectively. In school time including a physical education class, there was a higher proportion of VPA-Bouts than without these classes (with: 28.6%, without: 2.1%, p < 0.001). Children who reported at least three weekly hours of organized extracurricular sports activities accumulated a higher proportion of school afternoons with VPA-Bouts than those with fewer weekly hours of this type of activities (≥3 hours/week: 27.5%, <3 hours/week: 9.3%, p < 0.001). On the weekend, boys who reported at least three weekly hours of organized extracurricular sports activities performed more VPA-Bouts than those participating in less weekly hours, while in girls no significant differences were observed (weekend; boys, ≥3 hours/week: 26.0%, <3 hours/week: 9.0%, p < 0.001; girls: 8.3%, 8.0%, p = 0.917). Compliance with the recommendation to incorporate VIAs at least three days a week was 23.8%. Children who reported at least three weekly hours of extracurricular sports activities achieved higher compliance than those who reported fewer extracurricular activities (≥3 hours/week: 35.1%, <3 hours/week: 12.7%, p < 0.001). Additionally, boys showed higher compliance rates than girls (boys: 32.9%, girls: 15.3%, p < 0.001). Conclusion One in every four children met the WHO recommendation to incorporate VIAs at least three days a week, as evaluated by accelerometry. Physical education classes and extracurricular organized sports activities contributed to compliance with this recommendation

Abriendo la puertazul: al lado del menor en situación de adversidad en salud

YesCon la acción de apertura de la PuertAzul, esta publicación se centra en abrir el debate, la discusión, a través de lo que opinan los involucrados en el proceso de atención de una persona menor que vive una situación de adversidad, relacionada con la salud

Llamando a la puerta azul. Al lado del menor en situación de adversidad en salud

Contiene: Llamando a la puertazul. Al lado del menor en situación de adversidad en salud (173 p.); Anexo 1. Así se realizó (45 p.); Anexo 2. Relación de biográficos (32 p.); Anexo 3. Instrumentos para la recuperación (19 p.); Anexo 4. Recomendaciones operativas en cuidados paliativos a menores (14 p.); Recopilar y resaltar (32 p.). Publicado en la página de la Consejería de Salud: www.juntadeandalucia.es/salud (Consejería de Salud / Ciudadanía / Participar. Subvenciones / 'Al Lado' con... / 'Al Lado' del Menor en situación de alta adversidad en salud)I. Un proyecto para estar al lado de menores en situación de adversidad en salud. II. Partiendo de las necesidades. III. Estrategias transversales. IV. Itinerario de atención compartida, como instrumento de seguimiento y mejora. V. Teniendo en cuenta el grado de adversidad. VI. Alta adversidad y cuidados paliativos en el menor. 1. Sobre el concepto, las oportunidades y los escenarios de los cuidados paliativos en las personas menores. 2. Necesidades del menor en situación terminal y su familia. 3. Los últimos días. 4. La atención al dueloYes'Al lado del menor en situación de adversidad en Salud' pretende, desde un modelo basado en la cooperación, estar “al lado” en el proceso de recuperación de menores afectados por una enfermedad y de sus familias, en colaboración entre los servicios de salud y las asociaciones

General and abdominal adiposity and hypertension in eight world regions: a pooled analysis of 837 population-based studies with 7·5 million participants

International audienceSummaryBackground Adiposity can be measured using BMI (which is based on weight and height) as well as indices of abdominal adiposity. We examined the association between BMI and waist-to-height ratio (WHtR) within and across populations of different world regions and quantified how well these two metrics discriminate between people with and without hypertension.MethodsWe used data from studies carried out from 1990 to 2023 on BMI, WHtR and hypertension in people aged 20–64 years in representative samples of the general population in eight world regions. We graphically compared the regional distributions of BMI and WHtR, and calculated Pearson’s correlation coefficients between BMI and WHtR within each region. We used mixed-effects linear regression to estimate the extent to which WHtR varies across regions at the same BMI. We graphically examined the prevalence of hypertension and the distribution of people who have hypertension both in relation to BMI and WHtR, and we assessed how closely BMI and WHtR discriminate between participants with and without hypertension using C-statistic and net reclassification improvement (NRI).FindingsThe correlation between BMI and WHtR ranged from 0·76 to 0·89 within different regions. After adjusting for age and BMI, mean WHtR was highest in south Asia for both sexes, followed by Latin America and the Caribbean and the region of central Asia, Middle East and north Africa. Mean WHtR was lowest in central and eastern Europe for both sexes, in the high-income western region for women, and in Oceania for men. Conversely, to achieve an equivalent WHtR, the BMI of the population of south Asia would need to be, on average, 2·79 kg/m² (95% CI 2·31–3·28) lower for women and 1·28 kg/m² (1·02–1·54) lower for men than in the high-income western region. In every region, hypertension prevalence increased with both BMI and WHtR. Models with either of these two adiposity metrics had virtually identical C-statistics and NRIs for every region and sex, with C-statistics ranging from 0·72 to 0·81 and NRIs ranging from 0·34 to 0·57 in different region and sex combinations. When both BMI and WHtR were used, performance improved only slightly compared with using either adiposity measure alone.InterpretationBMI can distinguish young and middle-aged adults with higher versus lower amounts of abdominal adiposity with moderate-to-high accuracy, and both BMI and WHtR distinguish people with or without hypertension. However, at the same BMI level, people in south Asia, Latin America and the Caribbean, and the region of central Asia, Middle East and north Africa, have higher WHtR than in the other regions

Diminishing benefits of urban living for children and adolescents’ growth and development

Optimal growth and development in childhood and adolescence is crucial for lifelong health and well-being1–6. Here we used data from 2,325 population-based studies, with measurements of height and weight from 71 million participants, to report the height and body-mass index (BMI) of children and adolescents aged 5–19 years on the basis of rural and urban place of residence in 200 countries and territories from 1990 to 2020. In 1990, children and adolescents residing in cities were taller than their rural counterparts in all but a few high-income countries. By 2020, the urban height advantage became smaller in most countries, and in many high-income western countries it reversed into a small urban-based disadvantage. The exception was for boys in most countries in sub-Saharan Africa and in some countries in Oceania, south Asia and the region of central Asia, Middle East and north Africa. In these countries, successive cohorts of boys from rural places either did not gain height or possibly became shorter, and hence fell further behind their urban peers. The difference between the age-standardized mean BMI of children in urban and rural areas was <1.1 kg m–2 in the vast majority of countries. Within this small range, BMI increased slightly more in cities than in rural areas, except in south Asia, sub-Saharan Africa and some countries in central and eastern Europe. Our results show that in much of the world, the growth and developmental advantages of living in cities have diminished in the twenty-first century, whereas in much of sub-Saharan Africa they have amplified

Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults

Background: Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. Methods: We used data from 3663 population-based studies with 222 million participants that measured height and weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children and adolescents (age 5-19 years), from 1990 to 2022 for 200 countries and territories. For adults, we report the individual and combined prevalence of underweight (BMI &lt;18·5 kg/m2) and obesity (BMI ≥30 kg/m2). For school-aged children and adolescents, we report thinness (BMI &lt;2 SD below the median of the WHO growth reference) and obesity (BMI &gt;2 SD above the median). Findings: From 1990 to 2022, the combined prevalence of underweight and obesity in adults decreased in 11 countries (6%) for women and 17 (9%) for men with a posterior probability of at least 0·80 that the observed changes were true decreases. The combined prevalence increased in 162 countries (81%) for women and 140 countries (70%) for men with a posterior probability of at least 0·80. In 2022, the combined prevalence of underweight and obesity was highest in island nations in the Caribbean and Polynesia and Micronesia, and countries in the Middle East and north Africa. Obesity prevalence was higher than underweight with posterior probability of at least 0·80 in 177 countries (89%) for women and 145 (73%) for men in 2022, whereas the converse was true in 16 countries (8%) for women, and 39 (20%) for men. From 1990 to 2022, the combined prevalence of thinness and obesity decreased among girls in five countries (3%) and among boys in 15 countries (8%) with a posterior probability of at least 0·80, and increased among girls in 140 countries (70%) and boys in 137 countries (69%) with a posterior probability of at least 0·80. The countries with highest combined prevalence of thinness and obesity in school-aged children and adolescents in 2022 were in Polynesia and Micronesia and the Caribbean for both sexes, and Chile and Qatar for boys. Combined prevalence was also high in some countries in south Asia, such as India and Pakistan, where thinness remained prevalent despite having declined. In 2022, obesity in school-aged children and adolescents was more prevalent than thinness with a posterior probability of at least 0·80 among girls in 133 countries (67%) and boys in 125 countries (63%), whereas the converse was true in 35 countries (18%) and 42 countries (21%), respectively. In almost all countries for both adults and school-aged children and adolescents, the increases in double burden were driven by increases in obesity, and decreases in double burden by declining underweight or thinness. Interpretation: The combined burden of underweight and obesity has increased in most countries, driven by an increase in obesity, while underweight and thinness remain prevalent in south Asia and parts of Africa. A healthy nutrition transition that enhances access to nutritious foods is needed to address the remaining burden of underweight while curbing and reversing the increase in obesity. Funding: UK Medical Research Council, UK Research and Innovation (Research England), UK Research and Innovation (Innovate UK), and European Union