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BACKGROUND: Levels of physical activity and variation in physical activity and sedentary time by place and person in European children and adolescents are largely unknown. The objective of the study was to assess the variations in objectively measured physical activity and sedentary time in children and adolescents across Europe. METHODS: Six databases were systematically searched to identify pan-European and national data sets on physical activity and sedentary time assessed by the same accelerometer in children (2 to 9.9¿years) and adolescents (=10 to 18¿years). We harmonized individual-level data by reprocessing hip-worn raw accelerometer data files from 30 different studies conducted between 1997 and 2014, representing 47, 497 individuals (2-18¿years) from 18 different European countries. RESULTS: Overall, a maximum of 29% (95% CI: 25, 33) of children and 29% (95% CI: 25, 32) of adolescents were categorized as sufficiently physically active. We observed substantial country- and region-specific differences in physical activity and sedentary time, with lower physical activity levels and prevalence estimates in Southern European countries. Boys were more active and less sedentary in all age-categories. The onset of age-related lowering or leveling-off of physical activity and increase in sedentary time seems to become apparent at around 6 to 7¿years of age. CONCLUSIONS: Two third of European children and adolescents are not sufficiently active. Our findings suggest substantial gender-, country- and region-specific differences in physical activity. These results should encourage policymakers, governments, and local and national stakeholders to take action to facilitate an increase in the physical activity levels of young people across Europe.

Objectives To analyze independently in men and women the incidence rate of and risk factors for hip fracture in a southern European population. Illiteracy, dementia, clinically significant depression and disability were factors to receive special emphasis. Study design A community sample of 4803 individuals aged over 55 years was assessed in a two-phase case-finding study in Zaragoza, Spain, and was followed up for 16 years. Medical history and psychiatric history were collected with standardized instruments, including the History and Aetiology Schedule, the Geriatric Mental State (GMS) scale, and a Risk Factors Questionnaire. Operational criteria were used to define covariates, including diagnostic criteria for both dementia and depression. The statistical analysis included calculations of incidence rate, IR; women/men incidence rate ratio (IRR); and Hazard Ratios (HR) in multivariate Cox proportional hazards regression models. Main outcome measures Cases of hip fracture (International Classification of Diseases, WHO) identified in the treating hospitals, validated by blinded researchers. Results Hip fractures were more frequent among women than men (IRR = 3.1). Illiteracy (HR = 1.55) and depression (HR = 1.44) increased the risk in women, and smoking (HR = 2.13) and disability in basic activities of daily living (HR = 3.14) increased the risk in men. Dementia was associated with an increased risk in an univariate analysis, but the association disappeared (power = 85% in men, 95% in women) when disability was included in the multivariate models. Conclusions The IR of hip fractures was three times higher among women. Illiteracy and clinically significant depression among women and active smoking and disability (HR = 3.14) among men independently increased the risk, but dementia did not.

Introduction and objective: The aim of the present study was to conduct a systematic review over the previous 15 years of the scientific studies that have been published with the objective of increasing the levels of physical activity, improve health and reduce the prevalence of overweight and obesity in school children between ranging between the ages of 5 to 10 years.\ud Material and methods: 28 studies were found: 2 systematic reviews, 2 articles describing on the methodological processes and 24 articles on intervention. You can distinguish two types of interventions: on the one hand those interventions focused on increasing the levels of physical activity, and on other hand those interventions that also introduce some educational and nutrition assessment.\ud Results: The analysis of the results shows that 47.3% of the interventions evaluated BMI and observed significant improvements, 44.4% of the programs that assessed body composition have also seen significant improvements, 40% of the interventions that evaluated the waist-to-hip index observed improvements and 50% of the interventions that evaluated the sum of folds noted also significant improvements. In relation to bettering the physical condition of the subjects, it was shown that 45% of the intervention that assessed the cardiovascular endurance found significant improvements and in 66.6% of the procedures that evaluated the effects on strength have also seen significant improvements. Finally, changes in eating habits or increased knowledge of food and nutrition was observed at 66.6%.

El propósito de nuestro estudio piloto fue medir de forma objetiva la AF saludable de la población infantil a lo largo de una semana e identificar cuanta de la misma se realizaba dentro del tiempo dedicado al recreo escolar. La muestra estaba compuesta por 36 niños de 11 a 12 años de una escuela de la provincia de Toledo en España. El instrumento utilizado fue el acelerómetro. La mayoría de los niños y niñas no cumplían las recomendaciones de AF saludable. En relación a la cantidad de AF saludable realizada en los recreos durante la semana, ésta presentó un peso importante, The purpose of our pilot study was to measure objectively the amount of moderate to vigorous PA (MVPA) children engaged over a week and to identify how much of it was carried out during recess time. The sample comprised 36 children aged 11 to 12 from a school in the province of Toledo in Spain. PA was measured with the accelerometer GT1M. Most of the children did not meet the PA recommendations for health. In relation to the amount of MVPA achieved during recess time, our study suggests that recess time represents an important load of the total amount of children’s MVPA registered per day

Since the beginning of mankind, man has sought ways to promote and preserve health as well as to prevent disease. Hydration, physical activity and exercise are key factors for enhancing human health. However, either a little dose of them or an excess can be harmful for health maintenance at any age. Water is an essential nutrient for human body and a major key to survival has been to prevent dehydration. However, there is still a general controversy regarding the necessary amount to drink water or other beverages to properly get an adequate level of hydration. In addition, up to now the tools used to measure hydration are controversial. To this end, there are several important groups of variables to take into account such as water balance, hydration biomarkers and total body water. A combination of methods will be the most preferred tool to find out any risk or situation of dehydration at any age range. On the other hand, physical activity and exercise are being demonstrated to promote health, avoiding or reducing health problems, vascular and inflammatory disea ses and helping weight management. Therefore, physical activity is also being used as a pill within a therapy to promote health and reduce risk diseases, but as in the case of drugs, dose, intensity, frequency, duration and precautions have to be evaluated and taken into account in order to get the maximum effectiveness and success of a treatment. On the other hand, sedentariness is the opposite concept to physical activity that has been recently recognized as an important factor of lifestyle involved in the obesogenic environment and consequently in the risk of the non-communicable diseases. In view of the literature consulted and taking into account the expertise of the authors, in this review a Decalogue of global recommendations is included to achieve an adequate hydration and physical activity status to avoid overweight/obesity consequences., Desde los comienzos del género humano, el hombre ha buscado el modo de promover y preservar la salud, así como prevenir la enfermedad. La hidratación, la actividad física y el ejercicio son factores clave para mejorar la salud. Sin embargo, estos factores en dosis excesivamente bajas o en exceso pueden ser perjudiciales para el mantenimiento de la salud a cualquier edad. El agua es un nutriente esencial para el organismo y un factor clave para la supervivencia y la prevención de la deshidratación. Sin embargo, hay todavía una controversia general en cuanto a la cantidad necesaria de ingesta de agua u otros líquidos con objeto de conseguir un nivel adecuado de hidratación. Además, hasta la fecha no hay consenso sobre las herramientas a utilizar para medir la hidratación. Con este fin, hay varios grupos importantes de variables a tener en cuenta, como el equilibrio de agua, biomarcadores de hidratación y el agua total corporal. Se prefiere en general una combinación de métodos para evaluar riesgo de situaciones de deshidratación en cualquier franja etaria. Por otro lado, se ha demostrado que la actividad física y el ejercicio promueven la salud, evitando o reduciendo la susceptibilidad a enfermedades de tipo vascular o inflamatorio, así como para ayudar en el manejo del peso. Por todo ello, la actividad física está siendo utilizada también a modo de “píldora” en terapias para promover la salud y reducir el riesgo de enfermedad. Como en el caso de los medicamentos, hay que evaluar la dosis, intensidad, frecuencia, duración y tener en cuenta las precauciones necesarias para conseguir la máxima eficacia y el mayor éxito del tratamiento. Por el contrario, el sedentarismo es el concepto opuesto a la actividad física y se ha reconocido recientemente como un factor importante de estilo de vida implicado en el ámbito obesogénico y en consecuencia en el riesgo de las enfermedades no transmisibles. Teniendo en cuenta la bibliografía consultada y la experiencia de los autores, en esta revisión se concluye con unas recomendaciones a modo de decálogo dirigido a la población general para conseguir un estatus de hidratación y actividad física adecuados con el fin de evitar las consecuencias del sobrepeso y la obesidad.

Udgivelsesdato: 1-11

Objetivos: Determinar aquellos factores pronósticos que mejor puedan prever el resultado de una intervención nutricional vía enteral y evaluar la calidad asistencial de una unidad de nutrición. Ámbito y sujetos: Pacientes que precisaron nutrición enteral en régimen de ingreso hospitalario, en un centro de 3.er nivel. Intervenciones: Estudio observacional, prospectivo, en el que se incluyeron 160 pacientes mediante muestreo consecutivo, durante un período de seguimiento de 6 meses. Se determinó: patología de base, grado de incapacidad, valoración nutricional, tipo de nutrición enteral, complicaciones, cuidados de enfermería y evolución clínica de los pacientes. Resultados: Se diagnosticó desnutrición calórica y protéica graves en el 48,4 y 52,9% de los pacientes; el grado de estrés fue moderado en el 52,2% y grave en el 36,5%. En el 88,2% de los pacientes la variación de los parámetros protéicos fueron de igual o mejor, con un incremento en las concentraciones de albúmina de 0,26 g/dl y prealbúmina de 2,4 mg/dl (p < 0,05). El análisis multivariante, ajustado por la albúmina plasmática al ingreso mostró que, además de este parámetro bioquímico, el grado de estrés grave, el nivel de consciencia disminuido, y el empeoramiento en la variación protéica durante el ingreso, son factores pronósticos independientes de mortalidad en el transcurso de una intervención nutricional enteral en el paciente hospitalizado (p < 0,05). Conclusiones: El nivel de consciencia, grado de desnutrición calórica, grado de estrés, concentraciones de albúmina plasmática y la variación de los parámetros proteicos durante el soporte nutricional, son factores pronósticos independientes del resultado de una inter-vención nutricional. El desarrollo de sistemas de monitorización global de la actividad y calidad asistencial de las Unidades de Nutrición, son básicos para mejorar la eficiencia del soporte nutricional vía enteral en el ámbito intrahospitalario, avanzar en el cuidado de los pacientes y favorecer el desarrollo de la terapia nutricional. Objective: To determine the prognostic factors that may best for see the outcome of an enteral nutritional intervention and to assess the assistance quality of a nutrition unit. Setting and subjects: Patients that required enteral nutrition during hospital admission at a third level center. Interventions: observational prospective study in which 160 patients were included by means of consecutive sampling, for a 6-months follow-up period. Underlying pathology, disability degree, nutritional assessment, type of enteral nutrition, complications, nursing care, and clinical course of patients were determined. Results: severe caloric and protein hyponutrition was diagnosed in 48.4 and 52.9% of patients; stress degree was moderate in 52.2% and severe in 36.5%. In 88.2% of patients variation of protein parameters was unchanged or improved, with a 0.26 g/dL increase in albumin levels and 2.4 m/dL in prealbumin (p < 0.05). Multivariate analysis adjusted for plasma albumin at admission showed that besides this biochemical parameter, a severe stress degree, a decreased alertness level, and worsening of protein variation during admission are independent prognostic mortality factors during an enteral nutritional intervention in the hospitalized patient (p < 0.05). Conclusions: alertness level, degree of caloric hyponutrition, stress degree, plasma albumin levels, and variation of protein parameters during nutritional support are independent prognostic factors for the nutritional intervention outcomes. The development of global monitoring systems of assistance activity and quality of Nutrition Units is paramount in order to improve the efficiency of enteral nutritional support at the hospital setting, to advance in patients care and promote the development of nutritional therapy.

Objetivos: Determinar aquellos factores pronósticos que mejor puedan prever el resultado de una intervención nutricional vía enteral y evaluar la calidad asistencial de una unidad de nutrición. Ámbito y sujetos: Pacientes que precisaron nutrición enteral en régimen de ingreso hospitalario, en un centro de 3.er nivel. Intervenciones: Estudio observacional, prospectivo, en el que se incluyeron 160 pacientes mediante muestreo consecutivo, durante un período de seguimiento de 6 meses. Se determinó: patología de base, grado de incapacidad, valoración nutricional, tipo de nutrición enteral, complicaciones, cuidados de enfermería y evolución clínica de los pacientes. Resultados: Se diagnosticó desnutrición calórica y protéica graves en el 48,4 y 52,9% de los pacientes; el grado de estrés fue moderado en el 52,2% y grave en el 36,5%. En el 88,2% de los pacientes la variación de los parámetros protéicos fueron de igual o mejor, con un incremento en las concentraciones de albúmina de 0,26 g/dl y prealbúmina de 2,4 mg/dl (p < 0,05). El análisis multivariante, ajustado por la albúmina plasmática al ingreso mostró que, además de este parámetro bioquímico, el grado de estrés grave, el nivel de consciencia disminuido, y el empeoramiento en la variación protéica durante el ingreso, son factores pronósticos independientes de mortalidad en el transcurso de una intervención nutricional enteral en el paciente hospitalizado (p < 0,05). Conclusiones: El nivel de consciencia, grado de desnutrición calórica, grado de estrés, concentraciones de albúmina plasmática y la variación de los parámetros proteicos durante el soporte nutricional, son factores pronósticos independientes del resultado de una inter-vención nutricional. El desarrollo de sistemas de monitorización global de la actividad y calidad asistencial de las Unidades de Nutrición, son básicos para mejorar la eficiencia del soporte nutricional vía enteral en el ámbito intrahospitalario, avanzar en el cuidado de los pacientes y favorecer el desarrollo de la terapia nutricional.