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Introduction: Los TCA configuran un grupo de problemas de salud en los que la insatisfacción con la imagen corporal se combina con alteraciones en la conducta alimentaria, baja autoestima, problemas de perfeccionismo, depresión o ansiedad social, entre otros. Estos trastornos pueden ser graves y acompañarse de serias complicaciones y comorbilidades. Se presentan generalmente en adolescentes y adultos jóvenes y los mejor caracterizados son la anorexia nerviosa (AN), la bulimia nerviosa (BN) y el trastorno por atracón (TA). Analizando los programas de prevención de estos trastornos, se observa que en su mayor parte se dirigen a mujeres adolescentes en educación secundaria y jóvenes. Son escasas las intervenciones en edades tempranas, en adultos y en varones. Los programas con buenos resultados se han centrado en uno o más factores de riesgo, se basan en enfoques cognitivos o conductuales e incluyen contenidos sobre alimentación saludable o nutrición, alfabetización mediática o presiones socioculturales y aceptación corporal o satisfacción corporal. Muchos de ellos, incorporan nuevas tecnologías y son interactivos. Se necesita más investigación y programas de prevención de TCA innovadores dirigidos a niños pequeños, adultos y varones.

Introduction and Objectives: Obesity is a significant public health problem associated with an increased risk of cardiovascular risk factors (CVRF). The aim of this study was to determine the prevalence of overweight and abdominal obesity (AO) in the Spanish population aged ≥ 3 years and to analyze the influence of sociodemographic and lifestyle factors and their association with CVRF., Methods: The sample was drawn from the ENPE study (n=6800). The study protocol included individual anthropometric measurements, sociodemographic factors, food intake (food frequency questionnaire), physical activity, lifestyles, and health problems., Results: The estimated overall prevalence of obesity (22.0%; 95%CI, 21.0-23.0) and AO (64.7%; 95%CI, 63.5-65.8) was higher in men, in persons aged ≥ 65 years, and in those with a lower socioeconomic level or from southern regions. Lifestyle pattern was significantly associated with obesity and AO (P=.011), which were less likely in people with an active lifestyle pattern (P <.0001). Obesity (OR, 1.85; 95%CI, 1.24-2.78) and AO (OR, 2.16; 95%CI, 1.1-4.24) were positively associated with CVRF. Clustering of CVRF with obesity and/or AO was higher in women (12.6%; 95%CI, 11.4-13.9) and in persons aged ≥ 65 years (32.7%; 95%CI, 30.0-35.4)., Conclusions: The prevalence of obesity and AO in the Spanish population is high; it is higher in men, increases with age, and is inversely related to socioeconomic status. A lifestyle pattern combining a higher level of physical activity, moderate sedentariness and a Mediterranean dietary pattern is associated with a lower probability of obesity, AO, and CVRF., (Copyright © 2020 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.)

Background and Objectives: To assess the prevalence of obesity and abdominal obesity (AO) in the Spanish population aged ≥65 years, to analyse the influence of selected sociodemographic factors and association with risk factors., Methods: The sample comes from the ENPE study, a cross-sectional study of a representative sample of the non-institutionalized population (2014-2015). This analysis refers to the population ≥65 years (n=1,233). Trained observers performed anthropometric measurements at participants' homes following standard international protocols. Obesity was defined as body mass index (BMI) ≥30; AO waist>102cm men; >88cm women., Results: Estimated prevalence of obesity in adults ≥65 years was high, higher in women (40.1% [95% CI 36.4-43.8]) than in men (32.5% [95% CI 28.5-36.8]). The prevalence of AO was also higher in women (69.9% [95% CI 66.4-73.1]) than in men (40.7% [95% CI 36.5-44.8]), and estimates were even higher when defining AO by waist-hip ratio or waist-height ratio. Of those classified as AO, 39.8% have a BMI between 25-29. Obesity and AO are higher in the South region compared to East, North-East and Central regions and showed inverse association with educational level. Obesity and AO were associated with increased probability of hypercholesterolaemia and high blood pressure, sarcopenic obesity, and diabetes., Conclusion: The prevalence of obesity and AO in adults aged ≥65 years is high, higher in women, in people of lower educational level and in the South region compared to East, North-East and Central regions. The high prevalence of OA is especially worrying due to its association with cardiovascular and metabolic complications and poorer quality of life., (Copyright © 2020 Elsevier España, S.L.U. All rights reserved.)

Introduction and Objectives: The aim of this study was to assess the prevalence of excess weight and abdominal obesity (AO), based on individual anthropometric measurements, according to various criteria in the Spanish population aged 3 to 24 years and to analyze their distribution by age and sex., Methods: We analyzed data from the ENPE study. This analysis included the population aged 3 to 24 years (n=1601). Anthropometric measurements were taken in participants' homes by trained observers following standardized international protocols. We defined overweight and obesity according to the International Obesity Task Force, World Health Organization, and Orbegozo 2011 criteria, and AO according to a waist-to-height index ≥ 0.5, Taylor criteria, and the 90th percentile of Orbegozo 2011., Results: The prevalence of excess weight (overweight+obesity) exceeded 30% with all the criteria used. The prevalence of excess overweight (International Obesity Task Force) was estimated at 34.1% (95%CI, 31.8-36.4) and obesity at 10.3% (95%CI, 8.9-11.9). The estimated prevalence of AO (waist-to-height index ≥ 0.5) was 31.2% (95%CI, 29.0-33.5), and 20.9% (95%CI, 18.1-22.1) satisfied all 3 criteria. A total of 16% (95%CI, 13.8-17.8) were overweight and had concomitant AO., Conclusions: The prevalence of overweight, obesity and AO in the Spanish population aged 3 to 24 years old is high and is higher in men than in women. When distinct criteria were used, the prevalence of AO was approximately 30%. Among persons classified as obese by the 3 criteria, 71.6% were also classified as having AO according to distinct cutoffs., (Copyright © 2019 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.)

Introduction: For centuries the traditional ingredients of food patterns in Basque Country were millet, chestnuts, cabbage, beans, lentils, fish, pork and beef especially, as well as a variety of fruits such as apples, pears and grapes. Later, the potato replaced chestnuts, corn replaced millet and beans replaced broad beans. In addition, tomatoes and peppers added to the vegetable repertoire. Cocoa also found great acceptance from the eighteenth century and the consumption of cider, especially among seamen, played a very important role in the prevention of scurvy. During the nineteenth century, the rise of industrialization led to important social changes and in food habits. The great romantic travelers and their stories contributed to the diffusion of uses and customs, among others, those related to culinary preparations and eating habits. Later, the growing interest in thermal baths also attracted visitors from France, Germany, Italy or Great Britain to the Basque Country, sometimes accompanied by their chefs and servants, who brought with them their own culinary practices to the Basque kitchens and restaurants. From 1977 and inspired by the Nouvelle cuisine, the new Basque cuisine emerged led by great chefs such as Juan Marí Arzak and Pedro Subijana, who soon brought together a large group that has led the current Basque cuisine to internationally recognized excellence. The new tendencies coexist with the cult to traditions and to specific forms of conviviality around the food: txokos and gastronomic societies; pintxos, pintxopote and cider houses.

Internet and the new technologies have changed the way of obtaining information of all kinds; also, information related to food and health. The sources of information and content generators have multiplied Doctors followed by other health professionals are the professional's citizens trust most to consults their doubts regarding health, food and nutrition, but the internet and social networks are increasingly used. The information on food, nutrition and health available on the net comes from very different sources and areas; from scientific journals, academic institutions, health organizations, scientific societies, professional, consumer or other kind of associations, companies from an array of sector who offer information and sell their products, or individuals with different profiles, who may or may not be qualified and present personal opinions, either independent or interested. The fact that when searching the internet for health issues citizens can access together with contrasted sources, other sites which publish information of uncertain quality has worried competent bodies and health professionals. A number of initiatives have been promoted to develop systems that allow the identification of websites that offer trusted quality health content, useful for patients and consumers. It is necessary that qualified health professionals contribute to the dissemination of quality information, easy to understand, in the internet and facilitate access to reliable information sources through directories. Citizens-active patients- active consumers need trusted information a reach in order to adopt informed decisions related to food consumption, own care or that of their families as well as to be able to participate in community actions.

Background and Objectives: a number of environmental determinants influence children growth and development and influence the potential expression or its evolution over time. In this paper we analyse the influence of selected sociodemographic factors on overweight, body weight and height in the Spanish adult population., Methods: the analysis was conducted in a subsample (25 to 64 years of age) of the ENPE study, a cross-sectional observational study on a random population sample. Information was collected on age, gender, educational level, occupation and place of residence. Social class was coded according to occupation. Individual body weight and height were measured., Results: the prevalence of obesity is higher in men, increases with age and there is an inverse relationship with the level of education and social class. Higher prevalence rates were observed in Asturias, Galicia and in Andalusia. Short stature is more frequent in people with incomplete primary education and low social class, in contrast to high stature, which is also more frequent in the North-East and central regions. Low body weight is less frequent in people with very poor education and low social class., Conclusions: based on the unequal distribution of overweight and obesity, preventive strategies in Community Nutrition should consider improving the level of nutrition education and literacy of the population, with special emphasis on the most disadvantaged people.

Objective: The Spanish Society of Community Nutrition (SENC) designed in 1994 a food guide for the Spanish population, updated in 2001. This report presents a new updated edition based on the best scientific evidence available. Methods: From a health in all policies approach, a group of experts in nutrition and public health associated with SENC was convened to review the evidence on diet-health, nutrition intake and food consumption in the Spanish population, as well as food preparation and consumption habits, determinants and impact of diet on environmental sustainability. Existing systematic reviews, updates, reports, meta-analysis and the latest quality studies have been considered. The collaborative group contributed to draft the document and design the graphic icon, then subject of a consultation process, discussion and qualitative evaluation, particularly relevant through the Advisory Group for the SENC-December 2016 Dietary Guidelines. Results: The new recommendations and its graphical representation highlights as basic considerations the practice of physical activity, emotional balance, energy balance to maintain body weight at adequate levels, healthy cooking procedures and adequate water intake. The recommendations promote a balanced, varied and moderate diet that includes whole grains, fruits, vegetables, legumes, varying amounts of dairy and alternating consumption of fi sh, eggs and lean meats, along with the preferential use of extra virgin olive oil for cooking and seasoning. Reinforce the interest in a healthy, sympathetic, supportive, sustainable diet, based on seasonal and local products, axis for conviviality, devoting adequate time and encourage the use of nutrition labelling information. Conclusions: The analysis of the evidence available and updated information on food consumption in Spain highlights the need to strengthen and implement the recommendations contained in this document to progressively achieve a greater adherence.

Introduction and Objectives: According to the 2013 analysis of the Institute of Health Metrics, high body mass index values are the most important risk factor for disease in Spain. Consequently, we describe the prevalence of total obesity and abdominal obesity in the Spanish adult population (25-64 years) for 2014-2015., Methods: The sample was taken from the ENPE study, a cross-sectional study with a representative sample of the noninstitutionalized population (n = 6800) carried out between May 2014 and May 2015. This analysis refers to the population between age 25 and 64 years (n = 3966). The anthropometric measurements were performed by trained observers at participants' homes according to standard international protocols. Body mass index ≥ 25 was defined as overweight and ≥ 30 as obesity. Abdominal obesity was classified as waist > 102 cm in men and > 88 cm in women., Results: The estimated prevalence of overweight in the Spanish adult population (25-64 years) was 39.3% 95% confidence interval [95%CI], 35.7%-42.9%). The prevalence of general obesity was 21.6% (95%CI, 19.0%-24.2%) and, more specifically, was 22.8% (95%CI, 20.6%-25.0%) among men and 20.5% (95%CI, 18.5%-22.5%) among women, and rose with age. The prevalence of abdominal obesity was estimated at 33.4% (95%CI, 31.1%-35.7%) and was higher among women (43.3%; 95%CI, 41.1%-45.8%) than among men (23.3%; 95%CI, 20.9%-25.5%), and also rose with age., Conclusions: The prevalence of general obesity and abdominal obesity in Spain is high, although the distribution differs according to autonomous community. A comparison with earlier data reveals a considerable increase in overweight, indicating the need for routine monitoring and comprehensive initiatives., (Copyright © 2016 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.)

Objective: To test the goodness of fit of a Motivation-Ability-Opportunity model (MAO-model) to evaluate the observed variance in Mexican schoolchildren's preferences to eat fruit and daily fruit intake; also to evaluate the factorial invariance across the gender and type of population (urban and semi-urban) in which children reside., Method: A model with seven constructs was designed from a validated questionnaire to assess preferences, cognitive abilities, attitude, modelling, perceived barriers, accessibility at school, accessibility at home, and fruit intake frequency. The instrument was administered in a representative sample of 1434 schoolchildren of 5th and 6th grade of primary school in a cross-sectional and ex post fact study conducted in 2013 in six cities of the State of Chihuahua, Mexico., Results: The goodness of fit indexes was adequate for the MAO-model and explained 39% of the variance in preference to eat fruit. The structure of the model showed very good factor structure stability and the dimensions of the scale were equivalent in the different samples analyzed., Conclusions: The model analyzed with structural equation modeling showed a parsimonious model that can be used to explain the variation in fruit intake of 10 to 12 year old Mexican schoolchildren. The structure of the model was strictly invariant in the different samples analyzed and showed evidence of cross validation. Finally, implications about the modification model to fit data from scholar settings and guidelines for future research are discussed., (Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.)

Objective: To determine the test-retest reliability, the internal consistency, and the predictive validity of the constructs of the Mexican version of the Pro Children Project questionnaire (PCHP) for assessing personal and environmental factors related to fruit and vegetable intake in 10-12 year-old schoolchildren., Method: Test-retest design with a 14 days interval. A sample of 957 children completed the questionnaire with 82 items. The study was conducted at eight primary schools in 2012 in Ciudad Juarez, Chihuahua, Mexico., Results: For all fruit constructs and vegetable constructs, the test-retest reliability was moderate (intraclass correlation coefficient (ICC) > 0.60). Cronbach s alpha values were from moderate to high (range of 0.54 to 0.92) similar to those in the original study. Values for predictive validity ranged from moderate to good with Spearman correlations between 0.23 and 0.60 for personal factors and between 0.14 and 0.40 for environmental factors., Conclusions: The results of the Mexican version of the PCHP questionnaire provide a sufficient reliability and validity for assessing personal and environmental factors of fruit and vegetable intake in 10-12 year old schoolchildren. Finally, implications to administer this instrument in scholar settings and guidelines for futures studies are discussed., (Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.)

Objective: To determine content and construct validity for the Mexican version of Pro Children Project questionnaire for assessing psychosocial factors, related to fruit and vegetable intake in samples of 10-12 year-old schoolchildren., Materials and Methods: The questionnaire consisted of 87 items. It was administered to 2084 children in an instrumental study conducted in 2011 in Ciudad Juarez, Chihuahua, Mexico., Results: Kappa statistic resulted in good agreement between experts (kappa=0.69), very good agreement in children (kappa=0.93). Seven factors were obtained that explained 37.87% of the variance in fruit and 48.18% of the variance in vegetable. Cronbach's alpha values were low to moderate (range 0.55 to 0.83). An internal structure of seven first order factors was confirmed in fruits and six linked to vegetables., Conclusion: The questionnaire provides sufficient validity for assessing psychosocial factors related to fruit and vegetable intake in 10-12 year old schoolchildren. Finally, implications of the findings in the test adaptation process for assessing psychosocial factors of fruit and vegetable intake and for future research in this instrument are discussed.

Objectives: The aim of this review is to summarize the evidence available about the association between sugar consumption, especially sucrose, and the risk of different types of cancer., Methods: A systematic review was conducted of key reports, systematic reviews, meta-analysis as well as big prospective studies published after 2007 January 1 thru 2012 December 31 about the association between sugar consumption, especially sucrose, and the risk of cancer., Results: Evidence of the association of the intake of mono and disaccharides with different types of cancer is insufficient or there is evidence of lack of association. There is only possible evidence of a positive relation between the intake of monosaccharides (fructose and glucose) and pancreatic cancer. Evidence about the association between monosaccharides intake and obesity is insufficient, as well as between the intake of sucrose or added sugars and the risk of obesity in adults and children. There is possible evidence of a positive association between glycemic index (GI) and colorectal cancer and that there is no association between GI and the risk of endometrial cancer, breast cancer and pancreas cancer., Conclusion: More research is needed. Cohort studies are especially required and randomized intervention trials would be desirable, although these are difficult in this field., (Copyright © AULA MEDICA EDICIONES 2013. Published by AULA MEDICA. All rights reserved.)

School meals contribute substantially to overall energy and nutrient intake adequacy of children, but also play an important role in the development of child food habits and the socialisation process. Evidence shows that school based environmental actions, which include changes in school meals and school food policies related to increased availability and access to healthy foods and drinks while in the school are effective to foster healthy eating practices among children. A growing number of children engage in school meals. Available information to date shows that the quality of the food on offer is not always consistent with dietary guidelines. Vegetables and fish are served less often than desirable and excess added fats are used in food preparations. Norms and regulations are very detailed regarding food safety issues and administrative management of the service, including subcontracting of catering providers and care staff. Nutrition and health promotion issues should also be included in regulations by means of nutrition recommendations for school meals along with information on food based dietary guidelines and portion sizes. School meals should be part of the educational project using a whole school approach.

A growing body of scientific and epidemiological evidence indicates that diet and health are related: diet may be a risk factor or have potential protective effects. As a consequence, the focus of nutrition research has experienced a shift towards qualitative aspects of diet which could influence chronic disease, longevity, quality of life and physical and cognitive performance, leading to the development of Community Nutrition. The main undertakings in a Community Nutrition Unit are related to the identification, assessment and monitoring of nutrition problems at the community level and to planning, design, implementation and evaluation of nutrition intervention programs. Such programs combine a number of suitable strategies in a whole population approach, a high risk approach or an approach targeted at specific population groups, and are implemented in different settings, such as the work place, schools or community organizations. Community nutrition interventions aim to gradually achieve change in eating patterns towards a healthier profile. Community Nutrition programs require the use of a combination of strategies and a working group of people from different backgrounds. Many factors influence the nutritional status of an individual or a population. In order to gain effective work output, sound understanding of these patterns and a practical surveillance system are required.

Background and Objective: Independent risk factors (smoking, hypertension, hypercholesterolemia and diabetes mellitus) are direct causes of coronary heart disease and are common in the population. Considering all independent factors together seems to be more appropriate to estimate the global risk of coronary heart disease. The objective of this paper was to estimate the global risk of coronary heart disease based on the Framingham function, adapted to the prevalence of risk factors in Spain., Subjects and Method: The prevalence of risk factors in the Spanish population was estimated based on pooled analysis of regional cross-sectional random population surveys. Prevalence estimates and incidence rate of coronary events were replaced in the Framingham equation accordingly. Risk probability for 10 years was estimated and risk tables were designed using a gradual color coding system according to an increasing risk., Results: The estimated attributable fraction (AF) for hypertension in the Spanish population was 26.7% for men and 22.9% women; that for hypercholesterolemia was 15.7% and 12.7% for men and women, respectively. Smoking was identified in the third position of the ranking order for males (AF 13.13%) and fourth for the female group (AF 3.71%). The prevalence of obesity was 13.2% for men and 17.5% for women. AF for obesity among men was 4% and it was 5% for women., Conclusions: An adaptation of the Framingham equation according to the prevalence of independent risk factors and incidence of coronary events in the Spanish population is useful to build instruments to estimate the 10-year global risk of coronary heart disease while a specific function based on a well-designed cohort study in not available in Spain.

Available population data suggest that a high proportion of European children and young people eat less fruit and vegetables than desirable. School based health promotion strategies fostering healthy eating practices and regular physical activity has the potential for a major impact on health and wellbeing during childhood and later stages in life. The aim of Pro-Children project is to estimate the consumption of fruit and vegetables as well as its main determinants among 11 year old European children and their families. It also aims to develop and assess the effectiveness of a school-based intervention program to promote adequate consumption levels of fruit and vegetables among school children. In the first phase of the project, cross-sectional studies were carried out on random population samples in nine European countries. The study protocol included assessment of fruit and vegetable consumption and a questionnaire to ascertain key determinants. A school-based intervention program was designed based on the Attitude, Social Influence and Self-Efficacy model (ASE). Theoretically similar but culturally relevant interventions were designed to be tested in Norway, The Netherlands and Spain during two school years. Each intervention site follows-up 10 intervention schools implementing the program and 10 control schools. Intervention planning and design followed an intervention mapping procedure. Key behaviours and determinants to be addressed through the intervention were identified in order to develop a matrix of educational objectives. The provision of fruit and vegetables in the school is an outstanding element. Program activities include guided classroom activities, computer tailored messages for children, activities to be completed at home with the family and family targeted specific actions. Additionally, optional components for community reinforcement include mass media, school health services participation and implication of grocery stores in the project. Despite cultural and social diversity, common school-based strategies to increase fruit and vegetable consumption among children are feasible across Europe. Understanding specific situations will enhance implementation and gain support.

Cereals in diets have varied along evolution trends in food patterns. Cereals are starchy foods and are the main source of polysacharides in the diet. In Mediterranean countries, cereals have been used in different ways, though they are mainly used as refined cereals. Wheat bread is one of the most commonly used. In the average Spanish diet, considerable changes have taken place since 1961 leading to a significant decrease in percent energy from carbohydrate. At the same time, percent energy from fat has increased as web as protein intake. These changes in the nutritional pattern reflect a continuous decrease in consumption of grains and cereals, pulses and potatoes. In the last decades, consumption of pasta however has increased as web as consumption of processed bakery products and biscuits. Scientific and epidemiological evidence show that cereals should be the main source of energy in the diet, in line with the so-called Mediterranean Diet. Polysacharides should provide 50-55% energy. In order to reach that goal, cereal, legumes and potatoes should be included in the daily diet as 4-6 portions. Whole grain cereales should be preferred or food preparations combining pasta, potatoes or rice with vegetables in order to reduce the glycemic index. Processed bakery products and biscuits should be consumed in moderation.

Objective: To describe food habits of school-aged population having school meals and to evaluate perceived quality of the service., Study Design: Descriptive cross-sectional study., Setting: Community School lunchrooms in different Spanish regions., Participants: Random population sample of children and young people (3-16 year) having school meals in Spain., Measurements: The study protocol included socio-economical data, food consumption and dietary habits at the school and out of the school. Information was collected by means of two questionnaires: one completed by children at school and a second one completed by the family at home., Results: Valid response was collected from 322 children and 212 families, a response rate of 96.1% children and 63.3% of the families. 88% of the children reported daily consumption of breakfast, 45% used to have a midmorning snack, which consisted of a sandwich (29%); sweet bakery products (27%) or biscuits (15%). 45% of the 12-16-year-old old group reported eating only half of the portion served at lunch in the school, mainly due to disgusting taste or preparation (50%). In the school menus vegetables and fish were offered less frequently than other food groups. 81% of the children referred having an after-school snack in the afternoon, consisting of a sandwich (65%); bakery products (20%); bread and chocolate (20%); yoghurt or fruit (20%)., Conclusions: School meals provide a wonderful opportunity to widen the variety of foods in the daily diet of children. Recommendations about school meals should address the quality and variety of the foods served for a healthy diet and stress the educational dimension.

Background and Objective: Obesity is a chronic disease with a complex multifactorial nature which typically begins during childhood and adolescence. It represents one of today's most critical and escalating public health concerns for this segment of the population. The lack of obesity prevalence data at national level prompted the enKid Study (1998-2000), which was designed to evaluate the food habits and nutritional status of Spanish children and youth., Subjects and Method: Cross-sectional epidemiological study of a representative sample of the Spanish population aged 2 to 24 years (n=3534). Height and weight measurements were carried out using standard procedures and equipment. Obesity and overweight were defined according to BMI values for the 97th and 85th percentiles, respectively using Spanish reference data provided by Hernández et al (1998)., Results: The prevalence of obesity in Spain is 13.9%, while the combination of overweight and obesity yields a prevalence of 26.3% (with a prevalence of overweight alone of 12.4%). Obesity is more common in males (15.6%) than in females (12%), which was also true for overweight. With regard to age, a higher prevalence is found among those aged 6 to 13 years. As for the geographic area, Canary Islands and Andalusia show the highest prevalence and the northeast region the lowest. Obesity is also more prevalent among those people with the lowest socio-economic and educational levels, and in those who omitted or consumed a poor breakfast., Conclusions: Compared to other countries, Spain shows an intermediate level of obesity in children and youth. Over the past decades, there has been an increasing trend towards overweight and obesity, which are more prevalent in males and during prepuberal ages.

Background and Objective: Although children and adolescents have special nutritional requirements due to their physical development, little is known about the concept of a healthy diet. This study shows the food consumption of the Spanish population aged 2-24 years in relation to socio-economic and geographic factors., Subjects and Method: A representative sample of the Spanish population (n = 3.534 individuals, 1.905 female and 1.629 male) was studied. Both a 24-hours recall and a general questionnaire with socio-economic, demographic and life style items were administered., Results: Most individuals consumed meals at home. The consumption of vegetables (90.4 g), cereals (181.1 g) and potatoes (69.7 g) was low, the consumption of red meat (71.6 g) and sausages (46.8 g) was high, and fish consumption was low (47.7 g). Girls had insufficient intakes of milk (280.9 g). We noticed geographical differences in food consumption which may be reflected in various health outcomes in adulthood. The familiar socioeconomic status and the educational level of the mother showed some influence on the intakes of meat, fish, fruits and vegetables, yoghurt and cheese., Conclusions: Nutritional education programs are needed to settle the observed nutritional inadequacies in the food habits of Spanish children and adolescents so that the future health of the population improves. It is also needed to reduce the inequalities linked to geographic and socio-economic factors.

Background and Objective: Obesity is a major public health problem in developed countries. It is of key importance to ascertain its magnitude and to identify main groups at risk. In this paper the prevalence of obesity in Spanish adult population aged 25-60 is estimated, based on measured height and weight., Subjects and Method: Pooled-analysis of regional cross-sectional nutrition surveys performed on representative random population samples. Randomly selected 9,885 free living subjects aged 25-60 years respondents of population nutritional surveys carried out in eight Spanish regions (Andalucía, Balearic Islands, Basque Country, Canary Islands, Catalunya, Galicia, Madrid and Valencia) between 1990 to 2000. Weight and height were measured on each individual by trained observers following standardised procedures and measuring instruments. The samples were pooled together and weighted according to the distribution of Spanish adult population aged 25-60 years. Obesity was defined as body mass index (BMI) >= 30 kg/m2. The protocol used in each survey was in accordance to the recommendations of the Spanish Society for the study of Obesity (SEEDO) to estimate the prevalence of obesity in population studies., Results: The prevalence of obesity in Spanish adult population was 14.5% (95% CI, 13.93-15.07%), significantly higher among women 15.75% (95% CI, 14.89-16.61%), than men 13,39% (95% CI, 11.84-14.94%) (*2 = 12.470; p = 0.000). Prevalence of obesity significantly increased with age in men and women. The highest rates were estimated for the age group older than 55 years, both among males and females, 21.58% (95% CI, 18.68-24.48%) and 33.9% (95% CI, 32.73-35.07%), respectively., Conclusion: Obesity is a health problem which affects an important proportion of the Spanish adult population. Considering its potential impact on Public Health, it would be required to design and implement effective strategies aimed at the early detection of subjects at risk and the provision of adequate treatment, as well as to establish suitable preventive programmes.

Background: The weight distribution of a random sample of Spanish population aged 25-60 years is described. The prevalence of obesity and overweight is estimated by sex, age group and cultural level., Subjects and Method: Weight, height and waist to hip ratio (WHR) were measured on 5,388 subjects aged 25-60 yr who participated in population Nutritional surveys carried out in four Spanish autonomous regions (Cataluña, País Vasco, Madrid and Valencia) from 1989 to 1994. They were pooled together in order to build a national random sample. The sample was classified according to body mass index (BMI) (weight in kg/height in m2). Obesity was defined as BMI > or = 30 kg/m2. The prevalence of obesity by sex, age group and cultural level was estimated. Risk values for WHR were defined as WHR > 1 for men and WHR > 0.9 for women., Results: The prevalence of obesity was 13.4%, 11.5% among men and 15.2% among women. Obesity increased with age in men and women, from 5.3% in the 25-34 yr group to 26.3% in the age group 55-60. Among those with a BMI > or = 30, 30.7% of men and 25.1% of women had also risk values for WHR. Educational level showed an inverse relationship with obesity, thus obesity was higher in less educated groups, particularly among women (p < 0.001). The geographical distribution of obesity showed a south-southeast trend, significant for males (p < 0.001)., Conclusions: Prevalence of obesity in Spain was 13.4%, higher after 45 yr of age, particularly in women and less educated groups.

Objective: To describe the prevalence of iron deficiency anaemia in the Basque Country by age group and sex and to identify the main groups at risk., Design: Cross-sectional study., Setting: Basque Country., Participants: School-aged population of Bilbao (n = 762); further education students of San Sebastian (n = 372); adult population of the Basque Country (n = 2348) and elderly population of Bilbao, institutionalized (n = 154) and free living people (n = 410). Every sample was drafted by random sampling methods., Methods: Blood samples were collected by venopunction after 10-12 h. fasting, according to the same protocol. Haematological and biochemical analytes were assessed in the reference laboratory for the Basque Country, which followed internal and external quality control programs during that period. Iron deficiency anaemia was defined according to the criteria from the Spanish Society for Parenteral and Enteral Nutrition (SENPE)., Measurements and Main Results: Prevalence of iron deficiency anaemia in school-aged children was 0.6% for boys and 0.7% for girls, with the highest rate for girls aged 12-14 years (2.3%). Men aged 25-60 years showed a prevalence rate of 0.1% and women in the same age group 2.1%. Younger women, 25-34 years, showed the highest prevalence in this age group (2.9%). Among elderly people, overall prevalence was 0.4%, although people aged 80 years and over was affected more frequently., Conclusions: The prevalence of iron deficiency anaemia in the Basque Country is low though it is relatively frequent among young women and very old people. Both population subgroups should be monitored.

Head lice infestation have become a great problem in school children, reaching epidemic proportions in some countries. An open study was conducted to determinate how widespread head lice infestation were among preschool and elementary school children in Bilbao (North of Spain). We studied 23,624 children from whole public school of the city, aged 3 years to 14 years. The results of head lice control were: total prevalence 9.39% (between 1.8% and 31.6%). We found more girls than boys become infested (1.7% 1.0). Higher infestation levels were found between third and fifth grades (9 years to 11 years). At the same time, whole social-economic levels (low, middle and upper) resulted infesting by head louse, so there is not immunity against this parasite, although higher infestations degrees were found in low levels. At last we realized that head louse infestation is usually a family condition, so that treatment should not be confined only to the school children, and it is necessary besides health-school, whole the social-help.