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Introduction: Understanding the underlying factors that influence the approach to overweight and obesity in children is basic to best support families searching a solution to this important public health problem. Objective: To assess attitudes and feelings of paediatric staff in addressing overweight and childhood obesity to parents, exploring perceived barriers and facilitators, for an effective care. Participants and method: Qualitative study by means of individual semi-structured questionnaires of paediatric staff (paediatricians and paediatrician nurses; n = 57; 68% female) of primary health care centres and hospitals in Mallorca. Thematic analysis was done. Results: Three themes emerged from the data: “Parents’ attitude in childhood obesity” (sub-themes “The conscience of parents”, “The parents ask for help”), “Paediatric staff and childhood obesity” (sub-themes “Approaching to the problem: The interview with parents”, “Looking together for the solution”), and “System barriers” (sub-themes “Improving teamwork and health policy”, “Family participation in addressing childhood obesity”). Conclusions: Paediatric staffs know how to treat childhood obesity, but demand training on motivation. Effectivity on therapy of childhood obesity will be obtained after parents/carers recognize the problem and establish a trustful relationship with paediatric staff. The health system is still a barrier to the activity of paediatric personnel. Resumen: Introducción: Comprender los factores que influyen en el tratamiento del sobrepeso y la obesidad infantil es crucial para ofrecer el mejor apoyo a las familias y solucionar este grave problema de salud pública. Objetivo: Describir las actitudes y sentimientos del personal de pediatría al tratar con los padres el sobrepeso y la obesidad de sus hijos, explorando los facilitadores y las barreras percibidas, a fin de realizar una atención efectiva. Sujetos y método: Estudio cualitativo por cuestionarios individuales semiestructurados de personal pediátrico (pediatras y enfermeras pediatras; n = 57; 68% mujeres) de centros de atención primaria y hospitales de la isla de Mallorca, sobre las que se aplicó un análisis temático. Resultados: Se identificaron 3 temas: “La actitud de los padres en la obesidad infantil” (subtemas “La conciencia de los padres”, “Los padres piden ayuda”), “El personal pediátrico y la obesidad infantil” (subtemas “Aproximación al problema: La entrevista con los padres”, “Buscando juntos la solución”) y “Barreras del Sistema” (subtemas “Mejorar el trabajo en equipo y la política de salud”, “Participación familiar al abordar y estudiar la obesidad infantile”). Conclusiones: El personal pediátrico sabe tratar la obesidad infantil, pero demanda entrenamiento en motivación. La terapia de la obesidad infantil será efectiva cuando los padres/cuidadores reconocen el problema y establecen confianza con los equipos pediátricos. El sistema de salud aún es una barrera a la actividad del personal pediátrico.

Background: It has been pointed out that moderate to vigorous exercise improves metabolic syndrome (MetS) criteria; however, studies on functional fitness in subjects with MetS are scarce. Aim: This study aimed to assess functional fitness abilities in MetS and non-MetS subjects. Methods: Cross-sectional study. Participants living in the Balearic Islands (n = 477, 52% men, 55–80 years old) with MetS (n = 333) and without MetS (n = 144). Anthropometric, socioeconomic and lifestyle characteristics were measured, and blood samples were collected. Functional fitness tests included: one leg balance, standing and sitting handgrip, 30-s chair stand, arm curl, chair sit-and-reach, back scratch, 8-foot time up-and-go, 30-m walk, and 6-min walk tests. A Functional Fitness Score was created from tests that measured agility and dynamic balance, static balance, lower-and-upper body strength, lower-and-upper body flexibility, aerobic endurance, and speed. Results: All functional fitness tests were lower in MetS subjects, except for back scratch and standing handgrip test. After adjusting for possible confounders (sex, age, civil status, education level, leisure-time physical activity) MetS subjects were more likely to be below average for a sex and age specific cut-off value of one leg balance (Odds Ratio, OR: 2.37; 95% Confidence Interval, CI: 1.25–4.48), chair stand (OR: 2.30; 95% CI: 1.26–3.20), arm curl (OR: 3.43; 95% CI:1.90–6.26), back scratch (OR: 3.49; 95% CI: 2.31–5.91), 8-foot up-&-go (OR: 13.03; 95% CI: 6.66–25.55), 30-m walk (OR: 8.10; 95% CI: 4.33–15.57) and 6-min walk test (OR: 3.28; 95% CI: 1.76–6.52), whereas they were more likely to be above average for sitting handgrip test (OR:1.69; 95% CI:1.21–2.95). Functional Fitness Score was lower in MetS subjects (5.44 ± 2.40 vs. 7.04 ± 1.72, p < 0.001), independently of sex and age. Conclusion: MetS participants showed lower functional fitness abilities and lower Functional Fitness Score than non-MetS peers, independently of sex, age, body mass index and waist circumference, showing lower ability to perform everyday activities safely and independently.

The aim of this study was to assess the association between physical fitness (PF) and energy and nutrient intake in Spanish older adults. Three hundred and twenty-four participants (59.9% females, aged over 55 years) performed a battery of four validated PF tests and participants were divided into three: low, medium, and high PF. Dietary intake was assessed by two non-consecutive 24 h dietary recalls. Energy and nutrient intake was calculated using the ALIMENTA software. Energy expenditure (EE) was calculated using a validated questionnaire. Median energy intake (EI) was 2135, 1999, and 2111 kcal/day in the low, medium, and high PF in males, respectively. In females, the median EI was 1576, 1564, and 1625 kcal/day in the low, medium, and high PF groups. There were significant and positive associations between participants in the high PF group and intake of phosphorous, selenium, vitamin B6, C, D, E, niacin, and folates (all p

Introduction and objectives The ankle-brachial index (ABI) is an indicator of peripheral artery disease (PAD). The aim of this study was to assess the association between PAD, measured with the ABI, and cognitive function in persons with overweight or obesity and metabolic syndrome . Methods Cross-sectional study conducted with baseline data from the PREDIMED-Plus study, which included 4898 participants (after exclusion of those without ABI measurements) aged between 55 and 75 years, and with overweight or obesity and metabolic syndrome. At the baseline assessment, we measured the ABI with a standardized protocol and assessed the presence of other cardiovascular risk factors (eg, diabetes, dyslipidemia , hypertension). Cognitive function was evaluated using several tests validated for the Spanish population (mini-mental state examination [MMSE], phonological and semantic verbal fluency test, WAIS-III working memory index [WMI], parts A and B of the trail making test (TMT), and clock drawing test). Generalized linear models were used to assess the association between the ABI and cognitive function. Results Among the participants, 3.4% had PAD defined as ABI ≤ 0.9, and 3.3% had arterial calcification defined as ABI ≥ 1.4. PAD was associated with age, systolic blood pressure and obesity indicators, while arterial calcification was also associated with obesity and diabetes. No significant associations were observed between cognitive function and ABI or PAD. Conclusions In our sample, the presence of PAD increased with age, blood pressure, and obesity. No significant association was observed between ABI, PAD, or cognitive function.

Reactive oxygen species (ROS) such as hydrogen peroxide (H2O2) can exert opposed effects depending on the dosage: low levels can be involved in signalling and adaptive processes, while higher levels can exert deleterious effects in cells and tissues. Our aim was to emulate a chronic ex vivo oxidative stress situation through a 2 h exposure of immune cells to sustained H2O2 produced by glucose oxidase (GOX), at high or low production rate, in order to determine dissimilar responses of peripheral blood mononuclear cells (PBMCs) and neutrophils on ROS and cytokine production, and mitochondrial dynamics-related proteins, pro/anti-inflammatory and anti-oxidant gene expression. Immune cells were obtained from subjects with metabolic syndrome. H2O2 at low concentrations can trigger a transient anti-inflammatory adiponectin secretion and reduced gene expression of toll-like receptors (TLRs) in PBMCs but may act as a stimulator of proinflammatory genes (IL6, IL8) and mitochondrial dynamics-related proteins (Mtf2, NRF2, Tfam). H2O2 at a high concentration enhances the expression of pro-inflammatory genes (TLR2 and IL1) and diminishes the expression of mitochondrial dynamics-related proteins (Mtf1, Tfam) and antioxidant enzymes (Cu/Zn SOD) in PBMCs. The GOX treatments produce dissimilar changes in immune cells: Neutrophils were more resistant to H2O2 effects and exhibited a more constant response in terms of gene expression than PBMCs. We observe emerging roles of H2O2 in mitochondrial dynamics and redox and inflammation processes in immune cells., The PREDIMED-Plus trial was supported by the official funding agency for biomedical research of the Spanish government, Institute of Health Carlos III (ISCIII) through the Fondo de Investigacion para la Salud (FIS), which is co-funded by the European Regional Development Fund (Projects 14/00636 and 17/01827, Red Predimed-RETIC RD06/0045/1004, and CIBEROBN CB12/03/30038), Grant of support to research groups no. 35/2011, AAEE01/2017, and AAEE26/2017 (Balearic Islands Gov.), and EU Cost ACTION CA16112.

Regular physical activity prescription is a key point for healthy aging and chronic disease management and prevention. Our aim was to evaluate the antioxidant defense system and the mitochondrial status in peripheral blood mononuclear cells (PBMCs) and the level of oxidative damage in plasma in active, intermediate and inactive elderly. In total, 127 healthy men and women &gt, 55 years old participated in the study and were classified according on their level of declared physical activity. A more active lifestyle was accompanied by lower weight, fat mass and body mass index when compared to a more sedentary life-style. Active participants exhibited lower circulating PBMCs than inactive peers. Participants who reported higher levels of exercise had increased antioxidant protein levels when compared to more sedentary partakers. Carbonylated protein levels exhibited similar behavior, accompanied by a significant raise in expression of cytochrome c oxidase subunit IV in PBMCs. No significant changes were found in the activities of antioxidant enzymes and in the expression of structural (MitND5) and mitochondrial dynamic-related (PGC1&alpha, and Mitofusins1/2.) proteins. Active lifestyle and daily activities exert beneficial effects on body composition and it enhances the antioxidant defenses and oxidative metabolism capabilities in PBMCs from healthy elderly.

The aim was to assess inflammatory markers among adults and adolescents in relation to the adherence to the Mediterranean diet. A random sample (219 males and 379 females) of the Balearic Islands population (12-65 years) was anthropometrically measured and provided a blood sample to determine biomarkers of inflammation. Dietary habits were assessed and the adherence to the Mediterranean dietary pattern calculated. The prevalence of metabolic syndrome increased with age in both sexes. The adherence to the Mediterranean diet in adolescent males was 51.3% and 45.7% in adults, whereas in females 53.1% and 44.3%, respectively. In males, higher adherence to the Mediterranean diet was associated with higher levels of adiponectin and lower levels of leptin, tumor necrosis factor alpha (TNF-), plasminogen activator inhibitor 1 (PAI-1) and high-sensitivity C-reactive protein (hs-CRP) in adults, but not in young subjects. In females, higher adherence was associated with lower levels of leptin in the young group, PAI-1 in adults and hs-CRP in both groups. With increasing age in both sexes, metabolic syndrome increases, but the adherence to the Mediterranean diet decreases. Low adherence to the Mediterranean dietary pattern (MDP) is directly associated with a worse profile of plasmatic inflammation markers., Instituto de Salud Carlos III (Projects PI14/00636 and PI17/01827, Red Predimed-RETIC RD06/0045/1004, and CIBEROBN CB12/03/30038), EU-COST Action CA16112, Grant of support to research groups No. 35/2011 (Balearic Islands Gov.) and EU-FEDER funds. The funding sponsors had no role in the design of the study, in the collection, analyses or interpretation of the data; in the writing of the manuscript; nor in the decision to publish the results.

There is evidence supporting the importance of a healthy diet; however, there are few studies analyzing the seasonal variation of food intake. The present study was aimed to evaluate seasonal variation of food and energy intake in Spanish elderly also to investigate diet quality based on the Healthy Eating Index (HEI) score. From a cross-sectional study, 28 individuals (39% males) aged over 55 years volunteered for a longitudinal follow-up. Dietary assessment was evaluated through 24-h dietary recalls. Energy and nutrient intake were calculated using DIAL software. Furthermore, diet quality was measured using HEI. Data was analyzed considering the interaction of sex, age, fitness status, and body composition. Cereals intake was significantly lower in summer than in winter and autumn (both p

Comunicacion oral en el congreso "Nutrition at Key life stages: new findings, new approaches conferences".

Objectives: To assess prevailing food patterns, and its association with physical activity and fitness among Spanish older adults. Methods: Cross-sectional study in Spain, collecting data from a sample (n = 380; 54% female) aged 55-80 years (men) and 60-80 years (women) with no previously documented cardiovascular disease. Body weight, body fat and waist circumference were assessed. Physical activity performed was measured using the Minnesota Leisure-time Physical Activity Questionnaire (LTPA). Physical fitness was assessed using a validated physical fitness test battery. Food consumption was assessed by a validated semi-quantitative food-frequency questionnaire. Factor analysis identified two major dietary food patterns: Western (WDP) and Mediterranean (MDP) dietary patterns. Results: Participants in MDP's fourth quartile were classified in the second (men) and third (men and women) tertile of LTPA. After adjusting for age, body fat, waist-to-height ratio, and METs, in both sexes, a negative significant association was found between 30-s Chair stand and 6-min walking test, a positive significant association was found between 30-m Gait speed and 8-foot Time Up-and-Go (except in men) tests with WDP. The 30-m Gait speed test was negatively associated with MDP in men. Conclusions: MDP is associated with more time spent on LTPA, and this association was independent of body composition and a fast gait speed in men. WDP is associated with slower gait speed and lower body strength, agility and aerobic endurance. MDP has protective effect on healthy physical fitness, and WDP may be a contributor to frailty., Special thanks to Raquel Seco, Raquel Luzardo-Socorro and Jorge Marin for technical assistance. Funds from Institute of Health Carlos III (Projects 11/01791 and 14/00636, Red Predimed-RETIC RD06/0045/1004, and CIBEROBN CB12/03/30038), Grant of support to research groups No. 35/2011 (Balearic Islands Gov.), COST Action CA16112 and EU FEDER funds are greatly appreciated. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

with patients to be identified and targeted via an integrated care pathway mapping and elderly patient care screening service. Objective: To assess the current evidence base for clinical medication review and falls in the elderly. Methods: Pubmed database search undertaken in and to July 2014, with search terms including ‘elderly’ and ‘falls’ and ‘medicines’ followed by review of all relevant publications in English. Results: Bothmedication over-use and under-use in the elderly occur frequently and can be harmful. The STOPP START tools, validated for assessment of potentially inappropriate prescribing in the elderly, offer the possibility of provision of a structured clinical medication review to patients. Conclusions:Manydrugscommonlyusedbyolderpersonshave not been systematically studied as risk factors for falls. There is a need for more research on the impact of the STOPP START interventions on both the rates of falls and risk of falls in the elderly.

The aim was to determine the effects of a diet supplemented with 1.14 g per day of docosahexaenoic acid (DHA) for eight weeks on the plasma oxidative balance and anti-inflammatory markers after training and acute exercise. Fifteen volunteer male football players were randomly assigned to placebo or experimental and supplemented groups. Blood samples were taken under resting conditions at the beginning and after eight weeks of training under resting and post-exercise conditions. The experimental beverage increased the plasma DHA availability in non-esterified fatty acids (NEFAs) and triglyceride fatty acids (TGFAs) and increased the polyunsaturated fatty acid (PUFA) fraction of NEFAs but had no effects on the biomarkers for oxidative balance in plasma. During training, plasma protein markers of oxidative damage, the haemolysis degree and the antioxidant enzyme activities increased, but did not affect lipid oxidative damage. Training season and DHA influenced the circulating levels of prostaglandin E2 (PGE2). Acute exercise did not alter the basal levels of plasma markers for oxidative and nitrosative damage of proteins and lipids, and the antioxidant enzyme activities, although DHA-diet supplementation significantly increased the PGE2 in plasma after acute exercise. In conclusion, the training season and acute exercise, but not the DHA diet supplementation, altered the pattern of plasma oxidative damage, as the antioxidant system proved sufficient to prevent the oxidative damage induced by the acute exercise in well-trained footballers. The DHA-diet supplementation increased the prostaglandin PGE2 plasma evidencing anti-inflammatory effects of DHA to control inflammation after acute exercise.