Efectividad de las intervenciones de estilos de vida en la obesidad infantil; revisión sistemática con metaanálisis: lectura crítica DARE

CRD summaryThe authors concluded that lifestyle interventions incorporating dietary, exercise and/or behavioural therapy components were effective in treating childhood obesity under various conditions at least up to one year. This was a generally well-conducted review but variations in intervention durations, settings and components precluded identification of the format likely to work best in practice and in the long-term.Resumen CRDLos autores concluyeron que las intervenciones sobre estilos de vida que incorporan componentes como dieta, ejercicio físico y/o terapia comportamental eran eficaces en el tratamiento de la obesidad infantil bajo varias condiciones, al menos hasta un año. Esta fue una revisión en general bien realizada, sin embargo la variación en la duración de las intervenciones, las características y los componentes de las mismas impidieron la identificación del posible formato que funcione mejor en la práctica y a largo plazo

Consumo de alimentos, composición corporal y rendimiento físico en hombres y mujeres jóvenes judadores de fútbol

Introduction: Few studies have analysed the nutritional habits, body composition and physical condition of young soccer players among different categories and further differentiating between males and females. Therefore, the aim was to analyze differences in food consumption habits, body composition parameters and physical performance among young soccer players. Material and Methods: A cross-sectional study was performed during the 2019-2020 competitive season. Forty-eight soccer players (16-18 years) were classified by age and sex into three groups: under 16 and under 18 years males (U16 and U18), and under 16 years females (U16 female). Food habits, anthropometry, body composition and physical performance variables were collected. A one-way analysis of variance (ANOVA) with least significant difference post hoc comparison (Bonferroni correction) was used. Results: We found that U16 females consumed lower pork and bread and higher mollusk and shellfish than males (p<0.05). U16 males consumed less fruits (p<0.05) and more olive oil (p<0.05) than U16 females and had lower muscle mass in lower limbs than U18 male (p<0.05, ES=0.80-0.96); males showed higher muscle mass in lower limbs (p<0.01, ES=1.80-2.59) and lower %fat than females (p<0.01, ES=1.73); and U18 males presented higher weight than females (p<0.01, ES=1.64). U18 males showed better performances (p<0.05-0.01, ES=0.90-1.38) in maximal sprint trials (40-m length), counter movements jumps (CMJ) and CMJ with dominant leg, maximal bilateral horizontal jumps (HJ), HJ with dominant and non-dominant leg than U16 males. Males showed better results in linear straight sprint test (LSST, p<0.05; ES=1.66-5.16), change of direction ability (CODA, p<0.05; ES=2.82-5.46) and jumping (p<0.05; ES=1.60-4.12) performances. Conclusion: In conclusion, sex- and age- specific differences were detected in the healthier dietary practices and body composition parameter in youth of soccer players. Also, better physical performances were found as age increases, except for CODA, and males exhibited higher performances in LSST, CODA and jumping than females.Introducción: Pocos estudios han sido encontrados donde se analicen los hábitos nutricionales, la composición corporal y la condición física de jóvenes futbolistas entre diferentes categorías y diferenciando entre chicos y chicas. Por tanto, el objetivo fue analizar las diferencias en los hábitos de consumo de alimentos, los parámetros de composición corporal y el rendimiento físico en jóvenes futbolistas. Material y métodos: Se realizó un estudio transversal durante la temporada competitiva 2019-2020. Cuarenta y ocho futbolistas (16-18 años) fueron clasificados por edad y sexo en tres grupos: menores de 16 y menores de 18 años masculinos (U16 y U18), y menores de 16 años féminas (U16 femenino). Se recogieron variables de hábitos alimentarios, antropometría, composición corporal y rendimiento físico. Se utilizó un análisis de varianza de (ANOVA) de un factor con post hoc de Bonferroni. Resultados: Observamos que las chicas U16 consumieron menos carne de cerdo y pan y más moluscos y mariscos que los chicos (p<0,05). Los chicos U16 consumieron menos frutas (p<0,05) y más aceite de oliva (p<0,05) que las chicas U16 y tuvieron menor masa muscular en miembros inferiores que los chicos U18 (p <0,05, ES=0,80-0,96); los chicos mostraron mayor masa muscular en miembros inferiores (p <0,01, ES=1,80-2,59) y menor porcentaje de grasa que las chicas (p<0,01, ES=1,73); y los chicos U18 presentaron mayor peso que las chicas (p<0,01, ES=1,64). Los chicos U18 mostraron mejores rendimientos (p<0,05-0,01, ES=0,90-1,38) en pruebas de sprint máximo (40 m de longitud), salto en contramovimiento (CMJ) y CMJ con pierna dominante, saltos horizontales bilaterales máximos (HJ), HJ con pierna dominante y no dominante que los chicos U16. Los chicos mostraron mejores resultados en los esprints (LSST, p<0,05; ES=1,66-5,16), el cambio de dirección (CODA, p<0,05; ES = 2,82-5,46) y los saltos (p<0,05; ES=1,60-4,12). Conclusión: En conclusión, se observaron diferencias por sexo y edad en las prácticas dietéticas y los parámetros de composición corporal en los jóvenes futbolistas. Además, mejor rendimiento físico a medida que aumentaba la edad, excepto para el CODA. Los chicos exhibieron mejores rendimientos en LSST, CODA y saltos que las chicas

Confiabilidad intraobservador de mediciones antropométricas en niños y adolescentes sudamericanos: Estudio SAYCARE

ABSTRACT: The South American Youth/Child Cardiovascular and Environmental (SAYCARE) feasibility study aims to develop valid and reliable indicators to investigate health-related behavior and nutritional status in children and adolescents. Anthropometric measurements are one of the evaluated indicators in the study. The accuracy of the anthropometric data is very important and relies in the quality of the measurements. Objective: to describe the intra-observer reliability of ten anthropometric measurements: weight, height, circumferences (neck, arm, waist, hip) and skinfolds (triceps, subscapular, biceps and suprailiac) of children and adolescents from six South American cities: Lima, Medellin, Montevideo, Santiago, San Pablo and Teresina. Methods: prior to the study, fieldworkers from the seven centers participated in central training to ensure the application of standardized pro- cedures in the anthropometric measurements. Intra-observer precision, technical error of measurement (TEM) and coefficient of reliability (R) were estimated for each measurement. Results: reliability of weight and height was above 99% in almost all cities. TEM for skinfold thickness was below 1.4 mm in children and 2.13 mm in adolescents, while reliability was above 95% in most of the skinfold measurements. TEM for circumferences was below 1.8 cm in children and 0.64 cm in adolescents, while reliability was above 99% in almost all circumferences. Conclusions: reliability of the anthropometric measurements in this study was high. In comparison with similar European or American studies, the reliability of the measurements taken in our study was, in most cases, similar or even higher.RESUMEN: El estudio piloto South American Youth/Child cARdiovascular and Environmental (SAYCARE) tiene como objetivo desarrollar indicadores válidos y confiables para investigar el estado nutricional y las conductas vinculadas a la salud en niños y adolescentes. Uno de estos indicadores son las mediciones antropométricas. La precisión de los datos antropométricos es muy importante y se basa en la calidad con que se toman las mediciones. Objetivos: describir la confiabilidad intraobservador de diez mediciones antropométricas: peso, talla, circunferencias (cuello, brazo, cintura, cadera) y pliegues (trÍceps, subscapular, bÍceps y suprailIaco) de niños y adolescentes de seis ciudades de Sudamérica: Lima, Medellín, Montevideo, Santiago, San Pablo and Teresina. Métodos: previo al estudio, los trabajadores de campo de los seis centros participaron de un entrenamiento centralizado, para asegurar la aplicación de procedimientos estandarizados en la toma de las mediciones antropométricas. Para determinar la precisión intraobservador, se estimó el error técnico de medición (TEM) y el coeficiente de confiabilidad (R) para cada medición. Resultados: la confiabilidad de las medidas de peso y la talla estuvo por encima del 99% en casi todas las ciudades. El TEM para el grosor de los pliegues estuvo debajo de 1,4 mm en los niños y de 2,13 mm en los adolescentes, mientras que la confiabilidad fue superior al 95% en la mayoría de las mediciones de los pliegues. El TEM para las circunferencias estuvo por debajo de 1,8 cm en los niños y de 0,64 cm en los adolescentes, mientras que la confiabilidad fue superior al 99% en casi todas las circunferencias. Conclusiones: la confiabilidad de las mediciones antropométricas en este estudio fue alta. Comparada con estudios similares realizados en Europa y Estados Unidos, la confiabilidad de las medidas tomadas en nuestro estudio es, en la mayoría de los casos, similar o aún más elevada

Il6 gene promoter polymorphism (-174G/C) influences the association between fat mass and cardiovascular risk factors

During the last decades, the prevalence of obesity has increased rapidly among young people. A polymorphism in the promoter region of the IL6 gene (-174G/C), has been previously reported to be involved in obesity and metabolic syndrome development. Therefore, the aim of the study was to examine whether the IL6 -174G/C polymorphism influence the association of body fat with low-grade inflammatory markers and blood lipids and lipoproteins in Spanish adolescents. 504 Spanish adolescents participating in the AVENA study were genotyped for the -174G/C polymorphism of the IL6 gene. Anthropometric and body composition measurements were taken and blood samples were collected for plasma molecules determinations. No differences between genotypes were observed in anthropometric values, body composition measurements and plasma markers concentration. Physical activity level differ between genotypes with subjects carrying the C allele of the polymorphism being significantly (p<0.05) more active than GG subjects. The association between body fat mass and plasma glucose was influenced by the -174G/C polymorphism of the IL6 gene. Subjects carrying the C allele of the mutation seem to have higher values of lipoprotein (a) and C-reactive protein as their percentage of body fat mass increase. Our results suggest that this promoter polymorphism influences the association between adiposity and some plasma markers

Total antioxidant capacity and oxidative stress after a 10-week dietary intervention program in obese children

Dietary and serum total antioxidant capacity (TAC) are considered appropriate tools for investigating the potential healthy effects of dietary antioxidants consumed in mixed diets. The aim was to analyse the impact of a dietary intervention on macronutrient intakes and to evaluate the improvement on oxidative status after weight loss (WL) by measuring dietary and serum TAC, and urinary F2-isoprostane levels as markers of oxidative stress. Forty-four overweight/obese children (mean age 11.5yr) were enrolled to undergo a 10-week WL program. They were dichotomized at the median of Body Mass Index-Standard Deviation Score (BMI-SDS) change, as high (HR) and low responders (LR) after intervention. Subjects were prescribed a fixed full-day meal diet, calculated according to their basal metabolic rate and physical activity levels. A validated food-frequency questionnaire was used to retrospectively calculate TAC and daily nutrient intake. The HR subjects were able to reduce anthropometric indices and to improve lipid and glucose profile. They also significantly diminished fat intake (p=0.013). Moreover, baseline serum TAC values did significantly predict the reduction in urinary F2 isoprostane [B= -0.236 (-0.393 to -0.078); p=0.014] in the HR group after the WL program. Notably, changes in dietary TAC after the treatment were associated with a decrease in body weight after the 10-week intervention [B=-2.815 (-5.313 to -0.318), p=0.029] in the HR group. The -SerumTAC/DietaryTAC and the -F2Isoprostane/DietaryTAC ratios revealed that the relationships between oxidative markers and antioxidants dietary intake were more favourable in the HR than in the LR group. Conclusion: Our study showed that a 10-week WL program was able to reduce adiposity indices in obese children. Moreover, after the intervention changes in dietary TAC and WL were significantly associated. Our result suggests that specific food with a high TAC content (such as fruits, vegetables and legumes) could be recommended to improve WL

Reliability and validity of an FFQ for South American children and adolescents from the SAYCARE study

Objective:The purpose of this study was to analyse the reliability and validity of a semi-quantitative FFQ to assess food group consumption in South American children and adolescents.Design:The SAYCARE (South American Youth/Child cARdiovascular and Environmental) study is an observational, multicentre, feasibility study performed in a sample of 3-to 18-year-old children and adolescents attending private and public schools from six South American countries. Participants answered the FFQ twice with a two-week interval and three 24-h dietary recalls. Intraclass and Spearman''s correlations, weighted Cohen''s kappa (¿w), percentage of agreement and energy-adjusted Pearson''s correlation coefficients were calculated.Setting:Seven cities in South America (Buenos Aires, Lima, Medelin, Montevideo, Santiago, Sao Paulo and Teresina).Subjects:A sample of 200 children and 244 adolescents for reliability analyses and 252 children and 244 adolescents for validity analyses were included.Results:Depending on the food group, for children and adolescents, reliability analyses resulted in Spearman''s coefficients from 0·47 to 0·73, intraclass correlation coefficients from 0·66 to 0·99, ¿w coefficients from 0·35 to 0·63, and percentage of agreement between 72·75 and 83·52 %. In the same way, validity analyses resulted in Spearman''s coefficients from 0·17 to 0·37, energy-adjusted Pearson''s coefficients from 0·17 to 0·61, ¿w coefficients from 0·09 to 0·24, and percentages of agreement between 45·79 and 67·06 %.Conclusion:The SAYCARE FFQ achieved reasonable reliability and slight-moderate validity for almost all food groups intakes. Accordingly, it can be used for the purpose of ranking the intake of individuals within a population

Design of the nutritional therapy for overweight and obese Spanish adolescents conducted by registered dieticians: the EVASYON study

Background: Dietary treatment for obese adolescents should aim to ensure adequate growth and development, by reducing excessive fat mass accumulation, avoiding loss of lean body mass, improving well-being and selfesteem and preventing cyclical weight regain. The aim of this article is to describe the dietary intervention design and the methods used to evaluate nutritional knowledge and behavior in the EVASYON study (Development, implementation and evaluation of the efficacy of a therapeutic programme for overweight/obese adolescents). Methods/design: EVASYON is a multi-centre study conducted in 5 Spanish hospital settings (Granada, Madrid, Pamplona, Santander and Zaragoza), where 204 overweight/obese Spanish adolescents were treated in groups of 9 to 11 subjects over 20 visits. The study was implemented in two stages: an intensive, calorie-restricted period for the first 9 weeks, and an extensive body-weight follow-up period for the last 11 months. A moderate energy intake restriction was applied in the intensive period according to the degree of obesity, on the basis of a balanced diet supplying 50-55% of daily energy as carbohydrates; 30-35% as fats and 10-15% as proteins. In the intensive period, adolescents were prescribed both a fixed full-day meal plan for the first three weeks and a full day meal plan with different food-choices for 6 weeks. Later, adolescents received a flexible meal plan based on food exchanges for the follow-up period until the end of the trial. Data on food intake, dietary and meal-related habits and behavior were collected by means of dietary questionnaires. To analyse nutritional knowledge, adolescents were examined regarding nutrient concepts and food items for a healthy diet with the appropriate tools. Participants were given nutritional information with complementary teaching material, which was available on the EVASYON website (www.estudioevasyon.com). Discussion: The dietary intervention of the EVASYON programme with a moderate calorie restriction for a limi - ted period of time could be a good strategy in treating overweight and obese adolescents and that will be tested further. Moreover, combining fixed plan with free-choice menus may help adolescents and their families to make right decisions for every day meals

Decreased cardiotrophin-1 levels are associated with a lower risk of developing the metabolic syndrome in overweight/obese children after a weight loss program

Objective: Cardiotrophin-1 (CT-1) shares some similarities with other cytokines, and participates in the control of energy metabolism. Higher circulating levels are observed in obese humans, but little information is gathered in weight loss (WL) programs. Therefore, we aimed to investigate the association of serum CT-1 levels with metabolic variables and the risk of developing metabolic syndrome (MetS) after a WL program in overweight/obese children. Subjects and Methods: Forty-four overweight/obese children (mean age 11.5 yr; 50% males) undergoing a 10-week WL program were enrolled. Subjects were dichotomized at the median of Body Mass Index-Standard Deviation Score (BMI-SDS) change, as high and low responders after intervention. Results: CT-1 levels were significantly reduced (-48 fmol/mL, p=0.043) in the high responder group after the WL program. They had significantly lower body weight (-3.7 kg, p<0.001), body fat mass (-8%, p<0.001), BMI-SDS (-0.78, p<0.001) and waist circumference (-5.4 cm, p<0.001), and a significant improvement in lipid and glucose profiles (p<0.05). Interestingly, decreased CT-1 levels significantly predicted changes in total cholesterol (41%) and LDL-cholesterol (28%). Moreover, in our participants the lower the CT-1 levels, the higher the reduction in MetS risk components, after the 10- week intervention, (p-ANCOVA=0.040, p-trend=0.024). Conclusion: We showed, for the first time, a reduction in serum CT-1 levels after a WL program and this decrease in CT-1 was strongly associated with a reduction in cholesterol levels and in MetS risk factors in overweight/obese children. Our findings may suggest that CT-1 could be an indirect marker for the diagnosis of MetS in this population

Perfil metabólico y transcriptómico en población infantil obesa tras una intervención nutricional para la pérdida de peso

The increasing prevalence of childhood obesity makes necessary to intensify obesity treatment. A successful weight loss programme in overweight and obese children and adolescents should be accompanied by a general metabolic improvement and a reduction in several cardiovascular risk factors. The aim of this study was to evaluate the effect of a 10-week intervention program, based on a moderate calorie restriction on metabolic and oxidative stress markers and gene expression profile in peripheral blood mononuclear cells (PBMC) from obese children. For this purpose, forty-four overweight/obese children (mean age 11.5 years; 50% males) were enrolled in a 10-week weight loss programme. Subjects were dichotomized by the median of Body Mass Index-Standard Deviation Score (BMI-SDS) change as high (HR) and low responders (LR) at the end of the weight loss programme. These results suggest that a lower decrease in dietary total antioxidant capacity (TAC) after the intervention may predict a greater weight loss in obese children with a good response to the diet. Furthermore, a better serum antioxidant-oxidant balance before a weight loss treatment could predict a better weight loss response. On the other hand, we showed, for the first time, a reduction in serum cardiotrophin-1 levels after a weight loss programme and that this decrease in cardiotrophin-1 was strongly associated with lower cholesterol levels in overweight/obese children. Finally, the study confirms that PBMC gene expression changes in obese boys may help to understand the weight loss response