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Aliments; Vida saludable; Canvis Alimentos; Vida saludable; Cambios Food; Healthy life; Changes Presentació que identifica i exposa el material divulgatiu sobre la campanya "Petits canvis per menjar millor" adreçada a fomentar un estil de vida saludable a través de l'alimentació

[eng] The present thesis chapter presents the study of Millennials´ attitudinal and emotional effects on the perceptions towards advertising in social media and the consequent impact on the effectiveness of the message in that context of communication. In this sense, in the present thesis, the role of the subject´s attitudes toward advertising in social networks is determinant to measure the effectiveness of the message in social networks and then, their purchase intention or their recommendation among peers, so common for young consumers, the so- called Millennials. The term Millennials is used to define a segment of the society born between 1980 and 2000 and the world´s first generational cohort raised with the Internet (Howe & Strauss, 2009). The main contribution of the present thesis is to approach a new market segment that is globally recognized as the new young consumers. A new generation that has influenced and is being influenced by technological advances. Millennials are, with their particular perception of their own reality, game-changers in the marketing field. Millennials are special for marketers because of their economic power, specifically, because they are early adopters of technology, they influence other cohort´s consumption, they are used to share brand preferences over the social media, they want to participate and co-create advertising content and they do not rely on conventional mass communication (Laurie, et al., 2019). Millennials are unique, they are an influential consumer group as they represent a large affluent market segment (Küster et al., 2019) and whose behaviour is often discussed but not fully understood (Valentine & Powers, 2013) and research on them is still scarce (Tarabashkina et al., 2016; Küster et al., 2019). In recent years, technology has changed consumers´ lives and, also, it has changed the way companies do business and approach their marketing activities. As a matter of fact, marketers have now access to huge amount of data that might be useful for decision-making (Arenas-Gaitán et al., 2019). Technology provides a platform for personalization and immediate gratification. Millennials are more active in integrating technologies into their daily lives using mobile devices and traditional Internet. For Millennials the buying process is a time for joy and loyalty to brands, is relative for them, as they are very sensitive to electronic word-of-mouth (eWOM) advertising because it is considered more credible than traditional advertising (Moreno et al., 2017). Advertising avoidance has been one of the strongest obstacles for advertisers and marketers. Ducoffe Web Advertising Model (Ducoffe, 1996) is a well- defined theoretical framework to predict attitudes toward advertising and evaluate consumer options (Nyheim et al., 2015). The present thesis focuses, mainly, on the foundations of this model and creates a new one based on it to be tested and adjusted. The approach integrates traditional research techniques (in this case, a questionnaire) with innovative techniques (such as ones usually performed in neuromarketing studies) that could bring added value to the present work. Traditional research methods for testing and predicting advertising effectiveness depend on consumers´ willingness to describe how they feel when exposed to an advertising piece (Morin, 2011). On the other hand, advertising and marketing professionals are more and more showing their interest in new innovative techniques that help them to create effective marketing campaigns. In this sense, Neuromarketing techniques offer cutting-edge methods without requiring demanding cognitive or conscious participation, to counter the limitations of the traditional approaches (Hsu, 2017). Furthermore, neuromarketing methods are becoming more and more common not only at the academic level but also at the company level, too. Regarding the objectives pursued, there are two broad ones: I. Create a model to test advertising effectiveness on social networks oriented to highlight attitudinal and emotional variables on Millennials’ perceptions. II. The use of innovative techniques to test the proposed model And those broad objectives can be divided into two groups of objectives – general and specific ones – as follows: Regarding the general objectives, from a marketing perspective the present thesis tries: (1) to get closer to the new generations of young people (called Millennials) (Kraft &Weber, 2012); (2) to understand how companies must shape their messages to reach these new generations (Sweeney, 2006) amid the digital environment; and (3) to make an alert on the risks for the future of (somehow) unhealthy food (Rubio, 2002). Related to the specific objectives, this research tries: (1) to analyses the use of innovative techniques to know in deep how this young generation respond food messages (Küster & Vila, 2013); (2) to find the critical factors on the election and or preference of healthy food (Story et. Al., 2008); and (3) to promote the use of innovative marketing techniques to properly design food communication (Küster & Vila, 2013; Story et al., 2018), [spa] En el primero se presentan las principales características de la generación denominada comúnmente Millennials. El segundo capítulo comprende una exhaustiva reflexión sobre el marketing, sus avances a partir de la aparición de internet y profundiza en las relaciones a través de la comunicación en redes sociales. Los capítulos 3 y 4 plantan las hipótesis las preguntas de investigación. En el tercer capítulo se escogen y desarrollan tres modelos clásicos para medir la eficacia publicitaria y a partir de ellos generar uno nuevo, así como las variables moderadoras (tipo de producto y tipo de mensaje), todo ello formando parte de la columna vertebral de la tesis doctoral. En el capítulo 4 se presentan, se describen y se profundiza en las diferentes modalidades y herramientas de neuromarketing y su aplicación a las diferentes estrategias de comunicación. El capítulo 5 se centra en la metodología de carácter cuantitativo y cualitativo. Se especifican las metodologías a emplear y las características de las muestras. Desde la óptica cuantitativa, se ha seleccionado la utilización de cuestionarios y desde el punto de vista cualitativo, se realiza un estudio aplicando online eye tracking. En el capítulo 6 se exponen los resultados tanto desde el punto de vista cuantitativo como cualitativo. Y finalmente el capítulo 7 que presenta las conclusiones, las limitaciones propias de cada uno de los estudios y las implicaciones gerenciales.

[spa] INTRODUCCIÓN: La obesidad durante el embarazo es un problema de salud pública en nuestra sociedad. Las gestantes con obesidad y ganancia excesiva de peso gestacional tienen mayor riesgo de presentar complicaciones maternas y perinatales. El uso de Apps móviles y pulsera durante el embarazo puede contribuir a promover estilos de vida saludables y, por tanto, mejorar la salud materna y neonatal. OBJETIVOS: Evaluar la efectividad de una intervención digital compleja, en gestantes con obesidad, con el uso de una pulsera de actividad física y la provisión de consejos de salud y soporte virtual de una matrona a través de una APP, respecto a la ganancia ponderal gestacional, la actividad física, los hábitos alimentarios; así como analizar su impacto en los resultados maternos y perinatales. Además, se estudió la frecuencia de uso, la usabilidad y la satisfacción con las Apps móviles utilizadas por las mujeres del grupo de intervención. MÉTODOS: Se realizó un ensayo clínico paralelo aleatorizado con dos brazos 1:1 con grupo intervención (GI) y grupo control (GC). Se incluyeron 150 gestantes con obesidad preconcepcional. El grupo de intervención recibió una intervención digital compleja “Pas & Pes” que consistía en el uso de una pulsera de actividad (Mi band 2© y Mi Fit©) y la recepción de consejos de salud mediante una App, y el soporte virtual de una matrona (Hangouts©), además del control prenatal habitual. El grupo control recibió solo el control prenatal habitual. Se utilizaron las versiones validadas en español del “International Physical Activity Questionnaire Short Form”, la “System Usability Scale” y el “Cuestionario de hábitos alimentarios para pacientes con sobrepeso y obesidad”. La satisfacción se midió en una escala tipo Likert de 1 a 5 puntos. Las pruebas estadísticas fueron bilaterales y se evaluaron a un nivel α de 0,05. Los análisis se realizaron con SPSS v. 25 y SAS v. 9,4. RESULTADOS: Se analizaron un total de 137 gestantes (91,3% del total). La ganancia ponderal gestacional mediana en el grupo de intervención fue de 7,0 kg (Q1=3,8-Q3=11) frente a 9,5 kg (Q1=6-Q3=14) en el grupo control, (p=0,014). La ganancia ponderal gestacional media ajustada por semana fue de 0,5 kg/semana [intervalo de confianza (IC) del 95 %=-0,2 a -0,05] en el grupo de control y de 0,3 kg/semana (IC 95 %=0,2 a 0,4) en el grupo intervención (p=0,002). En el tiempo 1 (35-37 semanas de gestación), las mujeres del grupo de intervención tuvieron una mediana más alta de actividad física que las mujeres del grupo de control, 1.950 frente a 1.386 múltiplo de la tasa de gasto metabólico-min/semana (MET-min/sem) (p=0,007), respectivamente. En el grupo intervención la puntuación media de los hábitos alimentarios fue mayor que en el grupo control [(3,51 ± 0,37) versus (3,33 ± 0,40) puntos; (p=0,009)]. No se observaron diferencias entre los grupos de estudio en la incidencia de resultados maternos y perinatales. Respecto a la intervención digital, el 61% (36) de las gestantes utilizó la pulsera de actividad a diario y la usabilidad de la App Mi Fit© fue valorada como excelente por el 74,6% (44). Todas las mujeres del grupo de intervención utilizaban la aplicación Hangouts© al menos una vez a la semana. La media de la escala de satisfacción con la App de consejos de salud y el apoyo de la matrona virtual fue de 4,8 ± 0,6 sobre 5 puntos. CONCLUSIONES: El uso de una intervención digital compleja mostró ser efectiva en una menor ganancia ponderal gestacional, en un aumento de la actividad física y en la mejora de los hábitos alimentarios. No se hallaron diferencias en las complicaciones perinatales maternas entre ambos grupos. La satisfacción con la intervención y la usabilidad de la App fue muy elevada., [eng] BACKGROUND: Obesity during pregnancy is a public health problem in our society. Pregnant women with obesity and excessive gestational weight gain (GWG) present a higher risk of maternal and perinatal complications. The use of mobile Apps and a wristband during pregnancy may contribute to promoting healthy lifestyles and, thus, improving maternal and neonatal health. OBJECTIVE: To evaluate the effectiveness of a complex digital intervention, using a smartband and an App for health advice with virtual midwife’ counselling, on gestational weight gain, physical activity and eating habits. The secondary objectives are to assess the impact of these interventions on maternal and perinatal outcomes and identify the frequency of use, usability and satisfaction with the mobile Apps used by the women in the intervention group. METHODS: A randomized parallel clinical trial with two arms in a 1:1 ratio with intervention group (IG) and control group (CG) was conducted. 150 pregnant women with pre-pregnancy obesity were included. The intervention group received a complex digital intervention called Pas & Pes. The intervention was delivered with a smartband (Mi band 2© and Mi Fit©) linked to an App with the virtual midwife to provide personal health information (Hangouts©), and also the standard prenatal care. The control group only received standard control prenatal care. The validated Spanish versions of the International Physical Activity Questionnaire Short Form, the System Usability Scale and the Questionnaire of eating habits for patients with overweight and obesity were used. Satisfaction was measured on a 1-5 points Likert scale. Statistical tests were two-sided and evaluated at an α level of 0.05. Analyzes were performed using SPSS v. 25 and SAS v. 9.4. RESULTS: 137 (91.3% of the total) women were analyzed. The mean gestational weight gain in the intervention group was 7.0 kg (Q1=3.8-Q3=11) versus 9.5 kg (Q1=6-Q3=14) in the control group, p=0.014. The adjusted mean gestational weight gain per week was 0.5 kg/week (95% confidence interval [CI]=-0.2 to -0.05) in the control group and 0.3 kg/week (95% CI=0.2 to 0.4) in the intervention group (p= 0.002). In time 1 (35-37 gestational weeks), women in the intervention group had a higher mean physical activity than women in the control group (1,950 metabolic equivalent of tasks [METs]-min/week vs. 1,386 METs/min-week (p=0.007), respectively. The mean score for eating habits was higher in the IG than in the CG [(3.51 ± 0.37) versus (3.33 ± 0.40) points; p=0.009]. No differences were observed between the study groups in the incidence of maternal and perinatal outcomes. In the intervention group, 61% (36) of the pregnant women used the smartband daily, and 74.6% (44) evaluated the usability of the Mi Fit© App as excellent. All women in the intervention group used the Hangouts© App at least once a week. The mean of the satisfaction scale with the health counselling App and virtual midwife support was 4.8 ± 0.6/5 points. CONCLUSIONS: The use of a complex digital intervention was effective in a lower gestational weight gain, in an increase in physical activity and in the improvement of eating habits. No differences were found in maternal perinatal complications between study groups. Satisfaction with the intervention and the usability of the App was very high.

Several epidemiological studies stress the association between a diet based on high fruits and vegetables intake and a better health condition. However, elderly Europeans cannot manage the recommended fruits and vegetables consumption. This systematic review aims to explore the main factors related to fruits and vegetables consumption in elderly Europeans. We conducted literature searches on Medline, Scopus, and Web of Science from inception to May 2022. Published articles including data related to certain fruits and vegetables consumption among elderly Europeans were selected. The New Castle-Ottawa Scale and National Heart, Lung, and Blood Institute tools were used for methodological quality assessment by two authors independently. A total of 60 articles were retrieved, and data from twenty-one high-quality cross-sectional studies and five moderate-tohigh- quality cohort studies, including a total of 109,516 participants, were synthesized. Associated factors mostly analyzed were those relating to demographic and socioeconomic status, such as sex, age, marital status, educational level, and income. However, the findings show a high discrepancy. Some evidence suggests a possible positive association, while other evidence shows an inverse or no association at all. The relationship between demographic and socioeconomic factors with fruits and vegetables consumption is not at all clear. More epidemiological studies with an appropriate design and corresponding statistical methods are required., Vegetables for Better Aging: Improving The Quality Of Eating Practices Among Elderly, Bonduelle Foundation (2020–2022). Research Project I+D+I 2019, Ministry of Science and Innovation, Spain; Research Project I+D+I 2019, Cod. 10.13039/5011000011033, The Ministry of Science and Innovation, Spain

[eng] This research aims to study the effect of supplementation with docosahexaenoic acid (DHA) and antioxidants in older adults diagnosed with age-related macular degeneration or cataracts to contribute to preventive nutritional care and healthy ageing. This study involves a randomised and observed-blinded trial that included 106 patients >50 years of age with a previous diagnosis of Age-Related-Macular Degeneration (AMD) and was conducted in nine sites in Spain and Portugal between November 2014 and April 2018. We study the effect of a 2-year intervention with a nutritional supplement. Plasma samples were analysed at baseline and after 12 and 24 months to determine the fatty acid (FA) status. The omega-3 index (O3I) was additionally calculated to assess the coronary heart disease (CHD) mortality risk. Additionally, a review of another visual impairment and the effects on antioxidants was made to support the nutrition strategies as an essential factor for healthy ageing. The FA levels at baseline showed no differences between groups. However, at month 12 and 24-month follow-up, the mean changes in the polyunsaturated fatty acids (PUFAs) were statistically significantly different between the intervention and control groups except for the total omega-6 (n-6) long-chain (LC) PUFAs; thus, DHA, total omega-3 (n-3) PUFAs and total n-3 LCPUFAs showed a greater increase with the intervention than with the control treatment, with an effect size that was moderate to large. In contrast, the total n-6 PUFAs, total n-6 LCPUFAs and the ratios of n-6/n-3 PUFAs and LCPUFAs showed a greater decrease in the intervention group than in the control group. On the primary visual acuity assessment after a year, ETDRS letters had decreased with the intervention (N = 45; mean change −1.73, 95% CI −3.28 to −0.19) and in the control group (N = 48; mean change −0.10, 95% CI −2.03 to 1.83), for an estimated treatment difference between the intervention and control groups of –1.63 (95% CI –0.83 to 4.09; p = 0.192). The O3I at baseline exhibited both study groups at the second highest cardiovascular risk category (O3I >2.9 - 4.0). Nonetheless, by the 2-year intervention, the supplemented patients presented an O3I of 4.16%, reaching the second-best category of low risk for cardiovascular diseases (O3I >4.0 – 5.2), while the control group remained the same. Additionally, a review was conducted on the role of the antioxidant vitamin C in cataracts, another common eye disease to back up nutritional strategies as an essential factor in healthy ageing. While dietary intake of vitamin C might have a positive effect in cataracts, its supplementation does not show the same effect. The protective effects of vitamin C in cataracts still need to be clarified; further assessments are encouraged. The collection of analyses performed in this research allows us to confirm: 1)The link between FAs and health; 2) that DHA supplementation is promising to slow the progression of visual acuity loss in the older adult population with a previous AMD diagnosis; 3) the need to balance n-6, and n-3 proportions; 4) that DHA supplementation optimizes two markers of health, n6-n3 ratio and the O3I; 5) the antioxidant effect of vitamin C in cataracts remains unclear. Altogether, these results endorse the role of nutrition in healthy ageing decreasing the risk for NCDs, which are responsible for poor health and quality of life.

Treballs Finals de Grau de Nutrició Humana i Dietètica, Facultat de Farmàcia i Ciències de l'Alimentació, Campus de l'Alimentació de Torribera, Universitat de Barcelona. Curs: 2022-2023. Tutor: Maria Grau Magaña, [cat] L’adhesió a un patró alimentari saludable i sostenible, com la Dieta Mediterrània, forma part del tractament de persones que han sofert un esdeveniment cardiovascular. Pot ajudar a la seva prompta recuperació a més de a prevenir l’aparició d’un altre episodi advers. Els objectius d’aquest treball són: (1) adaptar un protocol d’educació nutricional destinat a pacients supervivents d’un episodi cardiovascular isquèmic; (2) avaluar la usabilitat i factibilitat d’aquest programa. S’ha adaptat un protocol d’una intervenció d’educació nutricional per promoure hàbits dietètics saludables dissenyat prèviament per la Xarxa Fit4foodBcn. A continuació, s’ha realitzat aquesta intervenció a 3 pacients ingressats per infart agut de miocardi en un hospital de tercer nivell. S’han avaluat els materials utilitzats, la informació transmesa i el desenvolupament de les diferents sessions del programa a través de qüestionaris i entrevistes. D’aquestes s’extreuen suggeriments de millora i també observacions dels educadors durant les sessions. L’hospital com a emplaçament de la intervenció comporta dificultats, tal com l’estat d’ànim i de salut del pacient al moment de realitzar les sessions, però alhora és un facilitador, degut a que el pacient no s’ha de desplaçar i té temps disponible per realitzar les sessions. Els participants manifesten un nivell alt de satisfacció amb la intervenció, així com una adequada comprensibilitat i utilitat de la informació i els materials, pel qual la intervenció resulta factible de realitzar en aquest hospital., [eng] Adherence to a healthy and sustainable dietary pattern, such as the Mediterranean Diet, is part of the treatment for people who have suffered a cardiovascular event. It can faster their recovery and prevent the appearance of another adverse episode. The aims of this project are: (1) adapt a nutritional education protocol intended for patients who have survived an ischemic cardiovascular episode; (2) evaluate the usability and feasibility of this program. It has been adapted a protocol of a nutritional education intervention to promote healthy dietary habits previously designed by the Fit4foodBcn Network. Then, this intervention was performed on 3 inpatients admitted for myocardial infarction in a third-level hospital. The materials used, the information transmitted, and the development of the different sessions of the program have been evaluated through questionnaires and interviews. Suggestions for improvement including observations of the educators during the sessions are extracted. The hospital as the place of the intervention entails difficulties, such as the patient’s state of mind and health at the time of the sessions but is also a facilitator since the patient does not have to travel and has time available to carry out the sessions. The participants express a high level of satisfaction with the intervention, just as well as adequate comprehensibility and usefulness to the information and materials, which makes the program feasible to perform in this hospital.

The ingestion of excess lipids often produces the accumulation of liver fat. The modulation of diet energy partition affects this process and other metabolic responses, and oestrogens and androgens are implied in this process. Ten-week-old male and female rats were fed with either standard rat chow (SD), SD enriched with coconut oil (high-fat diet, HF), SD enriched with protein (high-protein diet, HP) or a 'cafeteria' diet (CAF) for one month. HF and CAF diets provided the same lipid-derived percentage of energy (40%), HP diet protein-energy derived was twice (40%) that of the SD. Animals were sacrificed under anaesthesia and samples of blood and liver were obtained. Hepatic lipid content showed sex-related differences: triacylglycerol accumulation tended to increase in HF and CAF fed males. Cholesterol content was higher only in the CAF males. Plasma oestradiol in HF and HP males was higher than in CAF. Circulating cholesterol inversely correlated with plasma oestradiol, which levels were proportional to lactate. These changes agreed with the differences in the expression of some enzymes related with lipid and energy metabolism, such as fatty acid synthetase or phosphoglycolate phosphatase. Oestrogen protective effects extend to males with 'normal' diets, i.e. not unbalanced by either lipid or protein, but this protection was not enough against the CAF diet. Oestradiol seems to actively modulate the liver core of 2C-3C partition of energy substrates, regulating cholesterol deposition and lactate production.

A loss of the ability to buy and prepare meals, especially in people aged 65 and over, leads to a deterioration in their optimal level of nutrition. The Index of Autonomy in Food Acquisition (IAFA) was used to identify contributing factors. This is a composite indicator for shopping and meal preparation that can be used to assess the degree of autonomous capacity observed in a specific group. Data from the European Health Survey in Spain (7167 respondents aged 65 and over) show that capacity decreased with age and that women were less affected than men, with very little difference found in levels of autonomous capacity by territory. However, in relation to different income levels, after standardizing for age and sex, no evidence was found for differences in the ability to access and prepare meals in groups that were separated by income level. This result shows the importance of standardizing when analysing food acquisition autonomy in groups of people aged 65 years and over.

BackgroundDiet is one of the most important modifiable lifestyle factors in human health and in chronic disease prevention. Thus, accurate dietary assessment is essential for reliably evaluating adherence to healthy habits.ObjectivesThe aim of this study was to identify urinary metabolites that could serve as robust biomarkers of diet quality, as assessed through the Alternative Healthy Eating Index (AHEI-2010).DesignWe set up two-center samples of 160 healthy volunteers, aged between 25 and 50, living as a couple or family, with repeated urine sampling and dietary assessment at baseline, and 6 and 12 months over a year. Urine samples were subjected to large-scale metabolomics analysis for comprehensive quantitative characterization of the food-related metabolome. Then, lasso regularized regression analysis and limma univariate analysis were applied to identify those metabolites associated with the AHEI-2010, and to investigate the reproducibility of these associations over time.ResultsSeveral polyphenol microbial metabolites were found to be positively associated with the AHEI-2010 score; urinary enterolactone glucuronide showed a reproducible association at the three study time points [false discovery rate (FDR): 0.016, 0.014, 0.016]. Furthermore, other associations were found between the AHEI-2010 and various metabolites related to the intake of coffee, red meat and fish, whereas other polyphenol phase II metabolites were associated with higher AHEI-2010 scores at one of the three time points investigated (FDR < 0.05 or β ≠ 0).ConclusionWe have demonstrated that urinary metabolites, and particularly microbiota-derived metabolites, could serve as reliable indicators of adherence to healthy dietary habits.Clinical Trail Registrationwww.ClinicalTrials.gov, Identifier: NCT03169088.

Image-based dietary records have been validated as tools to evaluate dietary intake. However, to determine meal timing, previous studies have relied primarily on image-based smartphone applications without validation. Noteworthy, the validation process is necessary to determine how accurately a test method measures meal timing compared with a reference method over the same time period. Thus, we aimed to assess the relative validity and reliability of the Remind® app as an image-based method to assess dietary intake and meal timing. For this purpose, 71 young adults (aged 20–33 years, 81.7% women) were recruited for a 3-day cross-sectional study, where they completed a 3-day image-based record using the Remind app (test method) and a 3-day handwritten food record (reference method). The relative validity of the test method versus the reference method was assessed using multiple tests including Bland–Altman, % difference, paired t-test/Wilcoxon signed-rank test, Pearson/Spearman correlation coefficients, and cross-classification. We also evaluated the reliability of the test method using an intra-class correlation (ICC) coefficient. The results showed that, compared to the reference method, the relative validity of the test method was good for assessing energy and macronutrient intake, as well as meal timing. Meanwhile, the relative validity of the test method to assess micronutrient intake was poor (p < 0.05) for some micronutrients (iron, phosphorus, potassium, zinc, vitamins B1, B2, B3, B6, C, and E, and folates) and some food groups (cereals and grains, legumes, tubers, oils, and fats). Regarding the reliability of an image-based method to assess dietary intake and meal timing, results ranged from moderate to excellent (ICC 95% confidence interval [95% CI]: 0.50–1.00) for all nutrients, food groups (except oils and fats, which had low to moderate reliability), and meal timings. Thus, the results obtained in this study provide evidence of the relative validity and reliability of image-based methods to assess dietary intake (energy, macronutrients, and most food groups) and meal timing. These results open up a new framework for chrononutrition, as these methods improve the quality of the data collected and also reduce the burden on users to accurately estimate portion size and the timing of meals.

Eating habits are learned throughout the early stages of our lives. However, it is not easy to be aware of how our food-related routine affects our healthy living. In this work, we address the unsupervised discovery of nutritional habits from egocentric photo-streams. We build a food-related behavioral pattern discovery model, which discloses nutritional routines from the activities performed throughout the days. To do so, we rely on Dynamic-Time-Warping for the evaluation of similarity among the collected days. Within this framework, we present a simple, but robust and fast novel classification pipeline that outperforms the state-of-the-art on food-related image classification with a weighted accuracy and F-score of 70% and 63%, respectively. Later, we identify days composed of nutritional activities that do not describe the habits of the person as anomalies in the daily life of the user with the Isolation Forest method. Furthermore, we show an application for the identification of food-related scenes when the camera wearer eats in isolation. Results have shown the good performance of the proposed model and its relevance to visualize the nutritional habits of individuals.

Background Cardiac rehabilitation after acute myocardial infarction permits recovery of the heart function and enables secondary prevention programs in which changes in lifestyle habits are crucial. Cardiac rehabilitation often takes place in hospitals without coordination with primary healthcare and is not focused on individual patient preferences and goals, which is the core of the motivational interview. The objective of this study was to evaluate the efficacy of a cardiac rehabilitation program with a motivational interview in patients discharged from hospital after acute myocardial infarction. Methods/design A randomized, non-pharmacological clinical trial in six primary healthcare centers in Barcelona (Spain) will assess whether a tailored cardiac rehabilitation program consisting of four motivational interviews and visits with family physicians, primary healthcare nurses and a cardiologist, coordinated with the reference hospital, results in better cardiac rehabilitation than standard care. A minimum sample of 284 participants requiring cardiac rehabilitation after acute myocardial infarction will be randomized to a cardiac rehabilitation group with a motivational interview program or to standard primary healthcare. The main outcome will be physical function measured by the six-minute walk test, and the secondary outcome will be the effectiveness of secondary prevention: a composite outcome comprising control of blood pressure, cholesterol, diabetes mellitus, smoking and body weight. Results will be evaluated at 1,3 and 6 months. Discussion This is the first clinical trial to study the impact of a new primary healthcare cardiac rehabilitation program with motivational interviews for patients discharged from hospital after myocardial infarction. Changes in lifestyles and habits after myocardial infarction are a core element of secondary prevention and require patient-centered care strategies such as motivational interviews. Therefore, this study could clarify the impact of this approach on health indicators, such as functional capacity. Trial registration ClinicalTriasl.gov NCT05285969 registered on March 18, 2022.

This study aimed to assess and compare the impact of COVID-19 pandemic lockdowns on the oral health attitudes, dietary habits and access to dental care of Portuguese and Spanish children. A cross-sectional observational study involving caregivers of 3–17-year-old children who had cohabited during a COVID-19 pandemic lockdown in Spain and Portugal was conducted. Caregivers completed an online anonymous questionnaire. Aiming groups comparison, chi-square test was used for qualitative variables. 770 surveys were obtained. Significant changes in the children’s routine were higher in Portugal (p < 0.001). Both countries showed a large percentage of children who had between 2–3 snacks between meals (p < 0.001) and a higher consumption of snacks was particularly noticed among Spanish children with untreated dental caries during the lockdown (p = 0.003). Most caregivers reported children’s oral hygiene habits did not suffer noteworthy alterations (p = 0.417), although parental supervision of toothbrushing was associated with dental attendance during the lockdown. The majority of the sample had no dental attendance during confinement. Confinement appears to have not markedly affected the oral health status and habits of the majority of these children, although an important impact of some demographic and behavioral factors upon dietary and oral care/habits was detected. info:eu-repo/semantics/publishedVersion

Food addiction is characterized by a loss of behavioral control over food intake and is associated with obesity and other eating disorders. The mechanisms underlying this behavioral disorder are largely unknown. We aimed to investigate the changes in miRNA expression promoted by food addiction in animals and humans and their involvement in the mechanisms underlying the behavioral hallmarks of this disorder. We found sharp similitudes between miRNA signatures in the medial prefrontal cortex (mPFC) of our animal cohort and circulating miRNA levels in our human cohort, which allowed us to identify several miRNAs of potential interest in the development of this disorder. Tough decoy (TuD) inhibition of miRNA-29c-3p in the mouse mPFC promoted persistence of the response and enhanced vulnerability to developing food addiction, whereas miRNA-665-3p inhibition promoted compulsion-like behavior and also enhanced food addiction vulnerability. In contrast, we found that miRNA-137-3p inhibition in the mPFC did not lead to the development of food addiction. Therefore, miRNA-29c-3p and miRNA-665-3p could be acting as protective factors with regard to food addiction. We believe the elucidation of these epigenetic mechanisms will lead to advances toward identifying innovative biomarkers and possible future interventions for food addiction and related disorders based on the strategies now available to modify miRNA activity and expression. This work was supported by the Spanish “Ministerio de Ciencia e Innovación (MICIN), Agencia Estatal de Investigación (AEI)” (PID2020-120029GB-I00/MICIN/AEI/10.13039/501100011033, RD21/0009/0019, to RM; SAF2015-68341-R, RTI2018-100968-B-100, and PID2021-1277760B-100, to BC; and SAF2017-84060-R-AEI/FEDER-UE, to LD); the “Generalitat de Catalunya, AGAUR” (2017 SGR-669, to RM; 2017 SGR-734, to JMFR; 2017-SGR-738, to BC); the “ICREA-Acadèmia” (2020, to RM, 2021, to BC, and 2022, to JMFR); the “European Commission-DG Research” (PainFact, H2020-SC1-2019-2-RTD-848099, QSPain Relief, H2020-SC1-2019-2-RTD-848068, to RM; CoCA, H2020-667302, and Eat2beNICE, H2020-728018, to BC); the Spanish “Instituto de Salud Carlos III, RETICS-RTA” (RD16/0017/0020, to RM; FIS PI15/01934, PI18/01022, PI21/01361, to JMFR); the Spanish “Ministerio de Sanidad, Servicios Sociales e Igualdad, Plan Nacional Sobre Drogas” (PNSD- 2021I076, to RM; PNSD-2019I006, to EMG; PNSD-2017I050, to BC; PNSD-2020I042, to NFC); the “Fundació La Marató-TV3” (2016/20-30, to EMG); the European Regional Development Fund (project no. 01.2.2-LMT-K-718-03-0099) under a grant agreement with the Research Council of Lithuania (LMTLT), to AB; and the Project ThinkGut (EFA345/19), 65% co-financed by the European Regional Development Fund (ERDF) through the Interreg V-A Spain-France-Andorra programme (POCTEFA 2014-2020)

Treballs Finals de Grau Antropologia Social i Cultural, Facultat de Geografia i Història, Universitat de Barcelona, Curs: 2021-2022, Tutor: Aníbal Garcia Arregui, Aquest article té per objectiu analitzar de quina manera el gluten ha alterat la interacció entre persones, aliments i medi ambient i poder així traçar vincles entre casos particulars i fenòmens ecològics globals des d’una perspectiva corporal. El gluten ha esdevingut, en les últimes dècades, un element molt popularitzat per les problemàtiques que provoca al sistema digestiu. Cada vegada més persones en pateixen les conseqüències i opten per modificar les seves pràctiques alimentàries. Aquesta etnografia mostra com són de rellevants els motius biomèdics, però en destaca també la importància dels factors ambientals i l’experiència personal com a elements clau que contribueixen a la significació de riscos que suposen els aliments amb gluten. A partir d’una investigació qualitativa, s’observen les vivències corporals i emocionals de l’experiència de sis persones que han apartat el gluten de la seva dieta i s’exposen els canvis que es donen en els hàbits alimentaris. La recerca de la pròpia la salut mostra un preocupació per la incorporació (embodiment) d'elements de les ecologies alimentaries industrials, com el gluten, i es materialitza en una alimentació basada en productes naturals, rebutjant els productes processats.

Un erratum d'aquest article s'ha publicat a Int J Behav Nutr Phys Act. 2022 Nov 23;19(1):140. DOI: 10.1186/s12966-022-01373-2 Background: Few studies have analyzed the associations between impulsivity and dietary patterns. Some of them have shown a cross-sectional inverse relationship between impulsivity and healthy diet scores, whereas others reported a positive association with unhealthy dietary assessments. We aimed to examine longitudinal associations of impulsivity trait with adherence to healthy and unhealthy dietary patterns in older participants at high risk of cardiovascular disease over 3 years of follow-up. Methods: A 3-year prospective cohort analysis within the PREDIMED-Plus-Cognition study conducted in 4 PREDIMED-Plus study centers was performed. The PREDIMED-Plus study aimed to test the beneficial effect of a lifestyle intervention on the primary prevention of cardiovascular disease. The participants with overweight or obesity and metabolic syndrome included in the present study (n = 462; mean age of 65.3 years; 51.5% female) completed both the UPPS-P Impulsive Behavior Scale (range: 0-236 points) and the 143-item Food Frequency Questionnaire at baseline, 1-year and 3-years of follow-up. Ten diet scores assessing healthy and unhealthy dietary patterns were evaluated. Linear mixed models were performed adjusting by several confounders to study the longitudinal associations between impulsivity trait and adherence to dietary pattern scores over 3 years of follow-up (also assessing interactions by sex, age, and intervention group). Results: Impulsivity were negatively associated with adherence to the Healthy Plant-Based [β = -0.92 (95%CI -1.67, -0.16)], Mediterranean [β = -0.43 (95%CI -0.79, -0.07)], Energy-Restricted Mediterranean [β = -0.76 (95%CI -1.16, -0.37)], Alternative Healthy Eating Index [β = -0.88 (95%CI -1.52, -0.23)], Portfolio [β = -0.57 (95%CI -0.91, -0.22)], and DASH [β = -0.50 (95%CI -0.79, -0.22)] diet scores over 3 years of follow-up, whereas impulsivity was positively related with adherence to the unhealthy Western diet [β = 1.59 (95%CI 0.59, 2.58)] over time. An interaction by intervention group was found, with those participants in the intervention group with high impulsivity levels having lower adherence to several healthy dietary patterns. Conclusions: Heightened impulsivity was longitudinally associated with lower adherence to healthy dietary patterns and higher adherence to the Western diet over 3 years of follow-up. Furthermore, nutritional intervention programs should consider impulsivity as a relevant factor for the intervention success. Trial registration: Name of registry: Effect of an energy-restricted Mediterranean diet, physical activity and behavioral intervention on the primary prevention of cardiovascular disease. Trial registration number: ISRCTN 89,898,870. Date of registration: 05/28/2014. This work was supported by the official Spanish Institutions for funding scientific biomedical research, CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN) and Instituto de Salud Carlos III (ISCIII), through the Fondo de Investigación para la Salud (FIS), which is co-funded by the European Regional Development Fund (six coordinated FIS projects leaded by JS-S, including the following projects: PI13/00673, PI13/00492, PI13/00272, PI13/01123, PI13/00462, PI13/00233, PI13/02184, PI13/00728, PI13/01090, PI13/01056, PI14/01722, PI14/00636, PI14/00618, PI14/00696, PI14/01206, PI14/01919, PI14/00853, PI14/01374, PI14/00972, PI14/00728, PI14/01471, PI16/00473, PI16/00662, PI16/01873, PI16/01094, PI16/00501, PI16/00533, PI16/00381, PI16/00366, PI16/01522, PI16/01120, PI17/00764, PI17/01183, PI17/00855, PI17/01347, PI17/00525, PI17/01827, PI17/00532, PI17/00215, PI17/01441, PI17/00508, PI17/01732, PI17/00926, PI19/00957, PI19/00386, PI19/00309, PI19/01032, PI19/00576, PI19/00017, PI19/01226, PI19/00781, PI19/01560, PI19/01332, PI20/01802, PI20/00138, PI20/01532, PI20/00456, PI20/00339, PI20/00557, PI20/00886, PI20/01158); the Especial Action Project entitled: Implementación y evaluación de una intervención intensiva sobre la actividad física Cohorte PREDIMED-Plus grant to JS-S; the Recercaixa (number 2013ACUP00194) grant to JS-S; grants from the Consejería de Salud de la Junta de Andalucía (PI0458/2013, PS0358/2016, PI0137/2018); the PROMETEO/2017/017 and PROMETEO 21/2021 grants from the Generalitat Valenciana, and the grant PID2019-108858RB-I00 funded by AEI 10.13039/501100011033 and by “ERDF A way of making Europe” to DC; the SEMERGEN grant; None of the funding sources took part in the design, collection, analysis, interpretation of the data, or writing the report, or in the decision to submit the manuscript for publication. We thank CERCA Programme/Generalitat de Catalunya for institutional support and partial support was also provided by SLT006/17/00246, funded by the Department of Health of the Generalitat de Catalunya by the calls “Acció instrumental de programes de recerca orientats en l’àmbit de la recerca i la innovació en salut” and “Pla estratègic de recerca i innovació en salut (PERIS)”. This research was also partially funded by EU-H2020 Grants (Eat2beNICE/ H2020-SFS-2016–2, Ref 728018; and PRIME/ H2020-SC1-BHC-2018–2020, Ref: 847879). CG-M receives a predoctoral grant from the University of Rovira i Virgili (2020PMF-PIPF-37); JS-S, senior author of this paper, is partially supported by ICREA under the ICREA Academia program. SKN is supported by a postdoctoral fellowship from the Canadian Institutes of Health Research (CIHR, MFE-171207). JJ holds the Miguel Servet-II contract (CPII19/00015) awarded by the Instituto de Salud Carlos III (co-funded by the European Social Fund “Investing in your future”).

Treballs Finals de Grau d'Infermeria, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Curs: 2021-2022, Tutor: Montserrat Solà Pola, Introducció: Aquest treball final de grau consisteix en el procés de creació i aplicació d’una intervenció infermera en dos Instituts d’Educació Secundària Obligatòria (ESO) d’Esplugues de Llobregat. Ha estat dissenyat d’acord amb les necessitats detectades per part dels professionals de salut i adaptat a les diferents característiques dels adolescents de la zona. Els dos grans eixos de la intervenció han estat l’alimentació saludable i els Trastorns de Conducta Alimentària (TCA). S’ha dut a terme mitjançant la modalitat d’Aprenentatge i Servei (ApS) dins del marc del Programa Salut i Escola (PSiE). Objectiu: Dissenyar i aplicar una intervenció educativa adreçada als adolescents de 3r i 4t d’ESO de l’Escola Utmar i l’Institut Joanot Martorell d’Esplugues de Llobregat, basada en la promoció d’hàbits d’alimentació saludable i en el desenvolupament de capacitats i recursos personals en referència als TCA. Metodologia: S’elabora una intervenció educativa seguint el model de planificació d’Educació per la Salut (EpS), el qual s’aplicarà en l’àmbit escolar i en horari lectiu, a través d’una sessió de dues hores per cada grup classe. Avaluació: Es detecta una manca d’instruments per avaluar la intervenció, però, tot i aquest dèficit, s’assoleixen, en gran mesura, els objectius específics plantejats.

L’obesitat pot comportar complicacions en l’estat de salut, el rendiment acadèmic i la qualitat de vida. Seguir una conducta alimentària saludable de manera continuada en el temps i assolir nivells adequats d’activitat física (AF), han sigut informats com a aparents protectors i esdevenen components cabdals per al correcte desenvolupament físic i mental dels infants. El present estudi pretén conèixer els hàbits alimentaris, la pràctica d’AF i l’ estat ponderal en infants de 3 a 8 anys del municipi de Sant Boi de Llobregat. Es tracta d’un estudi transversal realitzat dins el marc de l’estudi SantBoiSà liderat per la Gasol Foundation i amb la col·laboració de l’ajuntament de Sant Boi de Llobregat. La mostra ha estat composta per 789 alumnes de P3 fins a 3r de primària, matriculats en alguna de les escoles públiques o concertades de Sant Boi de Llobregat. La qualitat de la dieta s’ha registrat mitjançant l’índex validat KIDMED i el nivell d’AF es va avaluar mitjançant el qüestionari d’AF per a nens Physical Activity Unified – 7 items Screener (PAU-7S) adaptat per a la població de 3 a 8 anys. S’observa en la mostra estudiada bona adherència a la DM, però una alta prevalença d’inactivitat física, així com un percentatge elevat d’infants amb excés ponderal. S’evidencia la necessitat de promoure estratègies d’adquisició d’hàbits saludables, incloent els hàbits alimentaris i la pràctica d’AF, que s’ajustin a les necessitats i preferències dels infants. Obesity can lead to complications in health status, academic performance and quality of life. Following a healthy eating behaviour continuously over time and achieving adequate levels of physical activity (PA) have been reported as apparent protectors and are key components for the correct physical and mental development of children. The present study aims to determine the dietary habits, the practice of PA and the weight status in children aged 3 to 8 years in the municipality of Sant Boi de Llobregat. This is a crosssectional study carried out as part of the SantBoiSà study led by the Gasol Foundation in collaboration with the Sant Boi de Llobregat Town Council. The sample consisted of 789 pupils from P3 to 3rd year of primary school, enrolled in one of the public or statesubsidised schools in Sant Boi de Llobregat. The quality of the diet was recorded using the validated KIDMED index and the level of PA was assessed using the PA questionnaire for children Physical Activity Unified - 7 items Screener (PAU-7S) adapted for the population aged 3 to 8 years. The sample studied showed good adherence to the MD, but a high prevalence of physical inactivity, as well as a high percentage of overweight children. There is a clear need to promote strategies for the acquisition of healthy habits, including dietary habits and the practice of PA, which are adjusted to the needs and preferences of the children. La obesidad puede comportar complicaciones en el estado de salud, el rendimiento académico y la calidad de vida. Seguir una conducta alimentaria saludable de manera continuada en el tiempo y lograr niveles adecuados de actividad física (AF), han sido informados como aparentes protectores y acontecen componentes capitales para el correcto desarrollo físico y mental de los niños. El presente estudio pretende conocer los hábitos alimentarios, la práctica de AF y el estado ponderal en niños de 3 a 8 años del municipio de Sant Boi de Llobregat. Se trata de un estudio transversal realizado dentro del marco del estudio SantBoiSà liderato por la Gasol Foundation y con la colaboración del ayuntamiento de Sant Boi de Llobregat. La muestra ha sido compuesta por 789 alumnos de P3 hasta 3.º de primaria, matriculados en alguna de las escuelas públicas o concertadas de Sant Boi de Llobregat. La calidad de la dieta se ha registrado mediante el índice validado KIDMED y el nivel de AF se evaluó mediante el cuestionario de AF para niños Physical Activity Unified – 7 items Screener (PAU-7S) adaptado para la población de 3 a 8 años. Se observa en la muestra estudiada buena adherencia a la DM, pero una alta prevalencia de inactividad física, así como un porcentaje elevado de niños con exceso ponderal. Se evidencia la necesidad de promover estrategias de adquisición de hábitos saludables, incluyendo los hábitos alimentarios y la práctica de AF, que se ajusten a las necesidades y preferencias de los niños.

Treballs Finals de Grau en Estadística UB-UPC, Facultat d'Economia i Empresa (UB) i Facultat de Matemàtiques i Estadística (UPC), Curs: 2021-2022, Tutor: Manuela Alcañiz Zanón, La importància de mantenir una dieta saludable i la seva relació amb la salut mental ha evolucionat a l'alça durant els últims anys i per això professionals de la salut demanden investigacions al respecte. Per donar resposta al col·lectiu sanitari, aquest estudi es centra en una anàlisi exhaustiva que pretén descriure les característiques sociodemogràfiques, de salut i d’estil de vida de la població adulta catalana segons els seus hàbits alimentaris, determinar quins factors de risc s'associen al benestar mental i quantificar la relació existent entre els hàbits alimentaris i la salut mental segons els factors de risc seleccionats. Previ a l’anàlisi estadística, s’inclou un ampli marc teòric que, entre altres aspectes, conté una sèrie d’evidències que constaten la relació entre aquests dos factors i detallen quines característiques de la població es traslladen en un canvi de magnitud d’aquesta associació. A més, també s’introdueix informació sobre els instruments que s’utilitzen per mesurar aquestes dues variables: la Warwick-Edinburgh Mental Well-being Scale (WEMWBS) I el Mediterranean Diet Adherence Screener (MEDAS).

On 11 March 2020, coronavirus disease 2019 (COVID-19) was declared a pandemic by the World Health Organization (WHO) and, up to 18:37 a.m. on 9 December 2021, it has produced 268,440,530 cases and 5,299,511 deaths. This disease, in some patients, included pneumonia and shortness of breath, being transmitted through droplets and aerosols. To date, there is no scientific literature to justify transmission directly from foods. In this review, we applied the precautionary principle for the home and the food industry using the known “Five Keys to Safer Food” manual developed by the World Health Organization (WHO) and extended punctually in its core information from five keys, in the light of new COVID-19 evidence, to guarantee a possible food safety tool.

Background: Diabesity is a growing problem internationally. Taking into account the importance of physical activity and diet in its prevention and treatment, the objective of this study was to delve into the impact of healthy habits on diabesity. Methods: A descriptive, cross-sectional study was carried out in 386,924 Spanish adult workers. Obesity was determined according to eleven different formulas. Life habits were also valued; sociodemographic variables; and educational level; as well as analytical and clinical variables such as blood pressure and blood glucose levels. The association between the different variables was performed using the chi-square and the Student’s t-tests when the samples were independent. A multivariate analysis was performed using the multinomial logistic regression test by calculating the odds ratio and a 95% confidence interval. The Hosmer–Lemeshow goodness-of-fit test was also performed. Results: The overall prevalence of diabesity ranged between 0.3% (95% CI 0.3–0.4) when obesity was assessed according to the abdominal volume index and 8.3% (95% CI 8.2–8.4) when evaluated according to the CUN-BAE (Clínica Universitaria de Navarra Body Adiposity Estimator) formula. The prevalence of diabesity was also higher in workers with a non-heart-healthy diet and in those who did not exercise regularly. Conclusions: The most disadvantaged socioeconomic classes are those with the highest prevalence of diabesity. It is important to prioritise prevention in populations and communities with the most unfavourable social and environmental conditions to reduce the burden of diabesity.

LThis work was supported by the official Spanish Institutions for funding scientific biomedical research, CIBER Fisiopatologia de la Obesidad y Nutricion (CIBEROBN) and Instituto de Salud Carlos III (ISCIII), through the Fondo de Investigacion para la Salud (FIS), which is co-funded by the European Regional Development Fund (six coordinated FIS projects leaded by JS-S and JVi, including the following projects: PI13/00673, PI13/00492, PI13/00272, PI13/01123, PI13/00462, PI13/00233, PI13/02184, PI13/00728, PI13/01090, PI13/01056, PI14/01722, PI14/00636, PI14/00618, PI14/00696, PI14/01206, PI14/01919, PI14/00853, PI14/01374, PI14/00972, PI14/00728, PI14/01471, PI16/00473, PI16/00662, PI16/01873, PI16/01094, PI16/00501, PI16/00533, PI16/00381, PI16/00366, PI16/01522, PI16/01120, PI17/00764, PI17/01183, PI17/00855, PI17/01347, PI17/00525, PI17/01827, PI17/00532, PI17/00215, PI17/01441, PI17/00508, PI17/01732, PI17/00926, PI19/00957, PI19/00386, PI19/00309, PI19/01032, PI19/00576, PI19/00017, PI19/01226, PI19/00781, PI19/01560, PI19/01332, PI20/01802, PI20/00138, PI20/01532, PI20/00456, PI20/00339, PI20/00557, PI20/00886, PI20/01158); the Especial Action Project entitled: Implementacion y evaluacion de una intervencion intensiva sobre la actividad fisica Cohorte PREDIMED-Plus grant to JS-S; the European Research Council (Advanced Research Grant 2014-2019; agreement #340918) granted to MAM-G.; the Recercaixa (number 2013ACUP00194) grant to JS-S; grants from the Consejeria de Salud de la Junta de Andalucia (PI0458/2013, PS0358/2016, PI0137/2018); the PROMETEO/2017/017 grant from the Generalitat Valenciana; the SEMERGEN grant; None of the funding sources took part in the design, collection, analysis, interpretation of the data, or writing the report, or in the decision to submit the manuscript for publication., Purpose We explored the cross-sectional association between the adherence to three different provegetarian (PVG) food patterns defined as general (gPVG), healthful (hPVG) and unhealthful (uPVG), and the cardiometabolic risk in adults with metabolic syndrome (MetS) of the PREDIMED-Plus randomized intervention study. Methods We performed a cross-sectional analysis of baseline data from 6439 participants of the PREDIMED-Plus randomized intervention study. The gPVG food pattern was built by positively scoring plant foods (vegetables/fruits/legumes/ grains/potatoes/nuts/olive oil) and negatively scoring, animal foods (meat and meat products/animal fats/eggs/fish and seafood/dairy products). The hPVG and uPVG were generated from the gPVG by adding four new food groups (tea and coffee/ fruit juices/sugar-sweetened beverages/sweets and desserts), splitting grains and potatoes and scoring them differently. Multivariable-adjusted robust linear regression using MM-type estimator was used to assess the association between PVG food patterns and the standardized Metabolic Syndrome score (MetS z-score), a composed index that has been previously used to ascertain the cardiometabolic risk, adjusting for potential confounders. Results A higher adherence to the gPVG and hPVG was associated with lower cardiometabolic risk in multivariable models. The regression coefficients for 5th vs. 1st quintile were − 0.16 (95% CI: − 0.33 to 0.01) for gPVG (p trend: 0.015), and − 0.23 (95% CI: − 0.41 to − 0.05) for hPVG (p trend: 0.016). In contrast, a higher adherence to the uPVG was associated with higher cardiometabolic risk, 0.21 (95% CI: 0.04 to 0.38) (p trend: 0.019). Conclusion Higher adherence to gPVG and hPVG food patterns was generally associated with lower cardiovascular risk, whereas higher adherence to uPVG was associated to higher cardiovascular risk., official Spanish Institutions, CIBER Fisiopatologia de la Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III (ISCIII), through the Fondo de Investigacion para la Salud (FIS), European Commission PI13/00673 PI13/00492 PI13/00272 PI13/01123 PI13/00462 PI13/00233 PI13/02184 PI13/00728 PI13/01090 PI13/01056 PI14/01722 PI14/00636 PI14/00618 PI14/00696 PI14/01206 PI14/01919 PI14/00853 PI14/01374, The European Regional Development Fund PI14/00972 PI14/00728 PI14/01471 PI16/00473 PI16/00662 PI16/01873 PI16/01094 PI16/00501 PI16/00533 PI16/00381 PI16/00366 PI16/01522 PI16/01120 PI17/00764 PI17/01183 PI17/00855 PI17/01347 PI17/00525 PI17/01827 PI17/00532 PI17/00215, European Commission PI17/01441 PI17/00508 PI17/01732 PI17/00926 PI19/00957 PI19/00386 PI19/00309 PI19/01032 PI19/00576 PI19/00017 PI19/01226 PI19/00781 PI19/01560 PI19/01332 PI20/01802 PI20/00138 PI20/01532 PI20/00456 PI20/00339 PI20/00557 PI20/00886 PI20/01158, Especial Action Project entitled: Implementacion y evaluacion de una intervencion intensiva sobre la actividad fisica Cohorte PREDIMED-Plus grant, European Research Council (ERC), European Commission 340918, La Caixa Foundation 2013ACUP00194, Junta de Andalucia PI0458/2013 PS0358/2016 PI0137/2018, Generalitat Valenciana European Commission PROMETEO/2017/017, SEMERGEN grant

According to the food addiction (FA) model, the consumption of certain types of food could be potentially addictive and can lead to changes in intake regulation. We aimed to describe metabolic parameters, dietary characteristics, and affective and neurocognitive vulnerabilities of individuals with and without FA, and to explore its influences on weight loss progression. The sample included 448 adults (55-75 years) with overweight/obesity and metabolic syndrome from the PREDIMED-Plus cognition sub-study. Cognitive and psychopathological assessments, as well as dietary, biochemical, and metabolic measurements, were assessed at baseline. Weight progression was evaluated after a 3-year follow up. The presence of FA was associated with higher depressive symptomatology, neurocognitive decline, low quality of life, high body mass index (BMI), and high waist circumference, but not with metabolic comorbidities. No differences were observed in the dietary characteristics except for the saturated and monounsaturated fatty acids consumption. After three years, the presence of FA at baseline resulted in a significantly higher weight regain. FA is associated with worse psychological and neurocognitive state and higher weight regain in adults with metabolic syndrome. This condition could be an indicator of bad prognosis in the search for a successful weight loss process. We thank CERCA Programme/Generalitat de Catalunya for institutional support and partial support was also provided by SLT006/17/00246, funded by the Department of Health of the Generalitat de Catalunya by the calls “Acció instrumental de programes de recerca orientats en l’àmbit de la recerca i la innovació en salut” and “Pla estratègic de recerca i innovació en salut (PERIS)”. This research was also partially funded by EU-H2020 Grants (Eat2beNICE/ H2020-SFS-2016-2; Ref 728018; and PRIME/ H2020-SC1-BHC-2018-2020; Ref: 847879). IP-G receives a grant from the Spanish Ministry of Education, Culture and Sports (FPU 17/01925). C.G.-M. receives a predoctoral grant from the University of Rovira i Virgili (2020PMF-PIPF-37); J.S-S. is partially supported by ICREA under the ICREA Academia program.

Unhealthy dietary patterns, based on ultra-processed and hyper-calorie foods, a low fruit and vegetable consumption and a sedentary lifestyle, leads to a weight gain which represents a risk factor in the development of non-communicable diseases. Overweight is currently a priority problem for the health system and Spain is one of the countries with a higher prevalence of infant and adolescent overweight. Food, among others, is one of the key factors associated to this situation. Diets based on traidtional mediterranean patterns have been appreciated by public health experts, representing a prevention factor for the health at long-term. Traditional Mediterranean diet is recommended for different population groups, infants and adolescents among them. In this context, recommendations are based on dividing the daily calories in 4 or 5 meals (breakfast, mid-morning snack, lunch, mid-afternoon snack and dinner) and being the main meals of plant origin. Although there are initiatives to sensitize and inform about the importance of healthy food during childhood, it still exists dietary patterns, specially in the mid-afternoon snack, that doesn¿t support a good health state, neither in short or long term. The main objective of this study is to evaluate the nutritional quality of the midafternoon snack of children aged between 3 and 12 years old, in the city of Barcelona and his adherence in the MD. Results show that most of the infants have the habit of having the mid-afternoon snack daily, but they¿re not having a healthy snack even if they have a good adherence to the MD. This results shows that mid-afternoon snack has a big scope for improvement and the most careless meal in this population group. This research has made possible the design of a healthy mid-afternoon snack model, based on official recommendations and based on social, cultural and environmental circumstances of the studied population. This document intends to become a useful tool for future promotion of healthy mid-afternoon snack consumption. Els patrons dietètics no saludables, basats en aliments ultraprocessats i hipercalòrics, un baix consum de fruites i verdures i dur un estil de vida sedentari, condueix a l'increment de pes, que representa un factor de risc en el desenvolupament de Malalties No Transmissibles. Actualment, l'excés de pes és un problema prioritari de salut pública i Espanya és un dels països europeus amb major prevalença d'obesitat infantil i juvenil. L'alimentació, entre d'altres, és un dels principals factors associats a aquesta situació. Les dietes basades en els patrons mediterranis tradicionals han estat positivament valorades pels experts en salut pública, ja que representen un factor de prevenció per a la salut a llarg termini. La dieta Mediterrània tradicional es recomana per a diferents grups de població, entre ells els infants i adolescents. En aquest context, les recomanacions es basen a repartir les calories diàries en 4 o 5 àpats moderats (esmorzar, desdejuni, dinar, berenar i sopar) i que els aliments principals siguin d'origen vegetal. Tot i que es duen a terme iniciatives per sensibilitzar i informar sobre la importància de l'alimentació saludable durant la infància, avui dia encara existeixen patrons alimentaris, especialment presents en el berenar, que no afavoreixen el bon estat de salut, ni a curt ni a llarg termini. En aquest estudi s'ha plantejat com a objectiu principal estudiar la qualitat nutricional del berenar de nens i nenes de 3 a 12 anys de la ciutat de Barcelona i la seva adhesió a la DM. Els resultats confirmen que la majoria dels infants tenen l'hàbit de berenar cada dia, però no consumeixen berenars saludables i en canvi sí que presenten una bona adhesió a la DM. Aquestes dades situen el berenar com un àpat amb un gran marge de millora i el més descurat de la dieta d'aquest grup de població. Aquesta investigació ha permès també dissenyar un model del berenar saludable basat en les recomanacions oficials i adaptat a les circumstàncies socials, culturals i ambientals de la població d'estudi. Aquest document de recomanacions pretén convertir-se en una eina d'utilitat per a futures accions de promoció del consum de berenars saludables. Los patrones dietéticos no saludables, basados en alimentos ultra procesados y hipercalóricos, un bajo consumo de frutas y verduras y llevar un estilo de vida sedentario, conduce al incremento de peso, que representa un factor de riesgo en el desarrollo de Enfermedades No Transmisibles. Actualmente, el exceso de peso es un problema prioritario de salud pública y España es uno de los países europeos con mayor prevalencia de obesidad infantil y juvenil. La alimentación, entre otros, es uno de los principales factores asociados a esta situación. Las dietas basadas en los patrones mediterráneos tradicionales han sido positivamente valoradas por los expertos en salud pública, puesto que representan un factor de prevención para la salud a largo plazo. La dieta Mediterráneo tradicional se recomienda para diferentes grupos de población, entre ellos los niños y adolescentes. En este contexto, las recomendaciones se basan a repartir las calorías diarias en 4 o 5 comidas moderadas (almorzar, desayuno, comer, merendar y cenar) y que los alimentos principales sean de origen vegetal. A pesar de que se llevan a cabo iniciativas para sensibilizar e informar sobre la importancia de la alimentación saludable durante la infancia, hoy en día todavía existen patrones alimentarios, especialmente presentes en la merienda, que no favorecen el buen estado de salud, ni a corto ni a largo plazo. En este estudio se ha planteado como objetivo principal estudiar la calidad nutricional de la merienda de niños y niñas de 3 a 12 años de la ciudad de Barcelona y su adhesión a la DM. Los resultados confirman que la mayoría de los niños tienen el hábito de merienda cada día, pero no consumen meriendas saludables y en cambio sí que presentan una buena adhesión a la DM. Estos datos sitúan la merienda como una comida con un gran margen de mejora y el más descuidado de la dieta de este grupo de población. Esta investigación ha permitido también diseñar un modelo de la merienda saludable basada en las recomendaciones oficiales y adaptado a las circunstancias sociales, culturales y ambientales de la población de estudio. Este documento de recomendaciones pretende convertirse en una herramienta de utilidad para futuras acciones de promoción del consumo de meriendas saludables.

In epidemiological and clinical studies, the most common nutritional tool to assess dietary flavonol intake is the food frequency questionnaire (FFQ), which needs to contain a detailed list of plant-based foods and be previously validated. Our study aimed to assess the accuracy of dietary flavonol (quercetin, kaempferol, and isorhamnetin) intake from a food frequency questionnaire (FFQ) compared to fasting plasma flavonol concentrations, as biomarkers of exposure, in breast cancer patients. In a consecutive case series, newly diagnosed patients with breast cancer (n = 140) were recruited at Nour-Nejat Hospital, Tabriz, Iran. Flavonol intake was assessed using a validated FFQ. Plasma flavonol concentrations were measured using high-performance liquid chromatography-ultraviolet detection. The accuracy of dietary status was evaluated using a receiver operating characteristic (ROC) and area under the ROC curve (AUC). Dietary status was shown in dichotomous using ROC-cutoff point. The plasma concentrations of quercetin were moderately correlated with dietary intake of quercetin (Spearman's correlation coefficient (rs) = 0.188, P < .05; rpartial= 0.330, P < .01) and plasma concentrations of isorhamnetin (rs = 0.337, P < .001). A linear correlation between dietary levels and plasma concentrations of kaempferol was attained (rpartial = 0.240, P < .05). Using a ROC-cutoff of 61.9 nmol/L for plasma quercetin (test reference), we were able to differentiate between lower and higher consumers of quercetin with an AUCROC-based reference =0.65 (P < .01, sensitivity = 61.8%, and specificity = 60.0%). Using a plasma kaempferol concentration of 60.1 nmol/L (ROC-cutoff), it was possible to detect significant differences between higher and lower intakes of kaempferol (AUCROC-based reference = 0.64, P < .05). The correlations and diagnostic performance with plasma concentrations could present a significant accuracy rate (validity), which seems acceptable for a nutritional questionnaire (FFQ) to assess intakes intake levels of quercetin and kaempferol. An improvement in the accuracy of the flavonol exposure can provide more precise relationship with health outcomes, which may increase their clinical significance.

Hay cada vez más una tendencia hacia una forma de vida sedentaria y poco saludable y es un tema que preocupa en la actualidad ya que van evolucionando las patologías a lo largo de las etapas educativas por las que pasan los alumnos/as si no se tratan. Por ello, el objetivo principal de este Trabajo Fin de Grado es que el alumnado adquiera hábitos alimentarios saludables, además de fomentar la actividad física, la hidratación y horas de sueño adecuadas, ya que según la literatura científica se fundamentan en la infancia y adolescencia. Para conseguir este objetivo se realizó un cuestionario pre para determinar los hábitos saludables y práctica de actividad física del alumnado de 5º de Primaria del Colegio Claret Valencia Benimaclet. Tras observar las respuestas se propuso unas actividades planteadas como una Unidad Didáctica (U.D.) “Somos lo que comemos” para fortalecer las nociones saludables y finalmente se volvió a pasar un cuestionario post para ver que cambios hubo. Una vez recopilado los datos se analizaron y se obtuvieron unos porcentajes, en los cuales se apreciaban una mejora de hábitos saludables, de hidratación y horas de sueño recomendadas siendo esta propuesta un refuerzo para promover una vida saludable a través de la actividad física. Hi ha cada vegada més una tendència cap a una forma de vida sedentària i poc saludable i és un tema que preocupa en l'actualitat ja que van evolucionant les patologies al llarg de les etapes educatives per les que passen els alumnes si no es tracten. Per això, l'objectiu principal d'este Treball Fi de Grau és que l'alumnat adquirisca hàbits alimentaris saludables, a més de fomentar l'activitat física, la hidratació i hores de son adequades, ja que segons la literatura científica es fonamenten en la infància i adolescència. Per a aconseguir aquest objectiu es va realitzar un qüestionari pre per a determinar els hàbits saludables i pràctica d’activitat física de l'alumnat de 5t de Primària del Col·legi Claret València Benimaclet. Després d'observar les respostes es va proposar unes activitats plantejades com una Unitat Didàctica (U.D.) “Som el que mengem”; per a enfortir les nocions saludables i finalment es va tornar a passar un qüestionari post per a veure que canvis va haver-hi. Una vegada recopilat les dades es van analitzar i es van obtindre uns percentatges, en els quals s'apreciaven una millora d'hàbits saludables, d’hidratació i hores de son recomanades sent esta proposta un reforç per a promoure una vida saludable a través de l'activitat física. There is more and more a trend towards a sedentary and unhealthy way of life and it is an issue that worries today since pathologies evolve throughout the educational stages that students go through if they are not treated. Therefore, the main objective of this Final Degree Project is for the student to acquire healthy eating habits, in addition to promoting physical activity, hydration and adequate hours of sleep, since according to the scientific literature they are based on childhood and adolescence. In order to achieve this objective, a questionnaire was carried out before looking at the healthy habits and physical activity practice of the 5th grade primary school student of the Claret Valencia Benimaclet School. After observing the answers, some activities were proposed as a Didactic Unit (U.D.) "We are what we eat" to strengthen healthy notions and finally a post questionnaire was passed to see what changes there were. Once the data had been collected, they were analyzed and percentages were obtained, in which an improvement in healthy habits, hydration and recommended hours of sleep was appreciated, this proposal being a reinforcement to promote a healthy life through physical activity. Educación

Since the World Health Organization (WHO) declared Covid-19 a global pandemic, the number of cases and deaths has risen rapidly, forcing countries around the world to confine their population in order to control the virus's spread. In this study, changes in dietary habits and lifestyle during the Covid-19 lockdown from March to June 2020 have been evaluated in a specific Spanish population with an academic knowledge of food sciences. An online questionnaire, which covered sociodemographic data, dietary habits, food-related behaviours and lifestyle was distributed among professionals and students in the field of food sciences. During the lockdown, this population reported a significant increase in the consumption of fruits, vegetables, legumes, eggs, fish, and yogurt, along with a decrease in the intake of alcoholic beverages. Nevertheless, there was also an increase in the consumption of salty snacks, chocolate and homemade pastries. Poor sleep quality and increased working hours and sitting time were also reported. Overall, the studied population showed trends towards healthier dietary habits during the Covid-19 lockdown in comparison with the general population.

Se ha detectado una sobre información respecto a los Trastornos de la Conducta Alimentaria vinculados a la población adolescente que enmascara los riesgos y problemas reales que puedan tener personas adultas con este tipo de enfermedades. El presente Trabajo de Fin de Grado tiene como objetivo la creación de un vídeo educacional, basado en los hábitos de salud sobre todo alimenticios que tienen las mujeres de edad media, el cual provoque un cambio en sus comportamientos de manera física y mental. La metodología se ha centrado en la búsqueda bibliográfica a través de bases de datos, principalmente Medline y Scielo, de las cuales se ha extraído escasa información debido a la poca investigación respecto a las personas adultas y sus conductas alimentarias en relación con los Trastornos de la Conducta Alimentaria. Para completar y contrastar la información obtenida se ha diseñado una encuesta que nos permite observar y detectar los patrones que más se repiten en la población diana respecto a unos hábitos no saludables, que pueden desencadenar factores de riesgo para los TCA. Por último, gracias a la metodología se ha llegado a la conclusión de que es necesaria la implementación de la herramienta creada para la educación de la población diana respecto a las conductas alimentarias y enseñar y dar visibilidad a los trastornos de la conducta alimentaria y sus consecuencias. PALABRAS CLAVE: trastornos de la conducta alimentaria (TCA), hábitos alimenticios, mujeres. An over-information has been detected regarding Eating Disorders linked to the adolescent population that masks the risks and real problems thar adults with this type of disease may have. The purpose of this Final Degree Project is the creation of an educational video based on health habits, in detail dietary habits, of middle-aged women that it makes a change in their mental and physical behavior. The methodology has focused on the bibliographic search through databases, mainly Medline and Scielo, from which little information has been extracted due to the little research regarding adults and their eating behaviors in relation to Disorders of the Eating behavior. To complete and contrast the information obtained, a survey has been designed that allows us to observe and detect the patterns that are most repeated in the target population regarding unhealthy habits, which can trigger risk factors for eating disorders. Finally, thanks to the methodology, it has been concluded that it is necessary to implement the tool created for the education of the target population regarding eating behaviors and to teach and give visibility to eating disorders and their consequences. KEY WORDS: eating disorders, dietary habits, women Grau en Infermeria

Treballs Finals de Grau de Nutrició Humana i Dietètica, Facultat de Farmàcia i Ciències de l'Alimentació, Campus de l'Alimentació de Torribera, Universitat de Barcelona. Curs: 2020-2021. Tutor: Joana Relat Pardo, [eng] Coffee is part of the daily habits of millions of people globally. Given this significant consumption, it is important that the dietary guidelines reflect what effects this consumption may have on people's health. This review aims to examine the latest evidence regarding coffee consumption, consumers’ perception of possible coffee health benefits, and the current recommendations given in Food-Based Dietary Guidelines (FBDG) to assess whether these are up to date and therefore, if coffee consumption should be encouraged in public health guidelines. Studies were obtained though the search in different databases. Selection criteria were broad for the introductory studies but stricter for those referring to health impact, concretely to a 5 year prior to the writing of this script and mainly selected meta-analyses, reviews, and systematic reviews and, where sensible, cohort studies. Coffee is a culturally ingrained drink with potential health benefits but is, generally, negatively viewed in FBDG. Recent research on coffee has not translated into new FBDG recommendations for the general population. A better understanding of the long-term effects of coffee, the consumers’ behavior or the cultural impact of coffee could be useful to further support in favor or against a future update of public health dietary guidelines., [cat] Prendre cafè forma part dels hàbits diaris de milions de persones arreu del món. Tenint en compte la rellevància d’aquest consum, és important que les guies alimentàries reflecteixin quins efectes pot tenir aquest consum en la salut de les persones. Aquesta revisió té com a objectiu examinar les últimes evidències sobre el consum de cafè, la percepció dels consumidors sobre possibles beneficis derivats del consum de cafè i les recomanacions actuals en les guies alimentàries per avaluar si aquestes estan actualitzades i, per tant, esbrinar si s’hauria de promoure el consum de cafè a través de guies de salut pública. Els estudis obtinguts es van trobar mitjançant la cerca en diferents bases de dades. Els criteris de selecció van ser amplis per als estudis introductoris, però més estrictes per a aquells que es referien a l’impacte en la salut, concretament a cinc anys abans de l’escriptura d’aquest treball i, principalment, es van seleccionar meta-anàlisis, revisions i revisions sistemàtiques i, en casos determinats, estudis de cohorts. El cafè és una beguda arrelada culturalment amb possibles beneficis per a la salut, però, en general, les guies alimentàries mostren una visió més aviat negativa sobre el seu consum. L’evidència científica més recent sobre el cafè no s’ha traduït en noves recomanacions per a la població general. Una millor comprensió dels efectes a llarg termini del consum de cafè, del comportament dels consumidors o de l’impacte cultural del cafè pot ser útil per donar encara més suport, a favor o en contra, d’una futura actualització de les guies alimentàries.

[cat] El món està patint des de finals del segle XX una epidèmia causada per hàbits pocs saludables de nutrició i d’activitat física, relacionats amb un determinat estil de vida propi d’aquesta època. Aquest fet està portant a milions de persones a tenir excés de pes i obesitat. S’ha convertit en un problema de salut mundial, que primer es va iniciar al primer món, per després passar al segon món o països en procés de desenvolupament. L’obesitat, conseqüència d’una alimentació hipercalòrica i no saludable és una malaltia crònica, que porta associada una sèrie de complicacions perilloses com són riscos cardiovasculars, hipertensió, colesterol, diabetis, alteracions de la son, depressió, baixa autoestima, etc. De manera paral·lela, els governs i les administracions sanitàries han començat a reaccionar com a conseqüència de les dades preocupants dels últims estudis. En aquest sentit, les fundacions relacionades amb el món de la salut (esportives, alimentàries) han començat a dur a terme programes de prevenció en hàbits saludables en el col·lectiu de nens/es davant la necessitat d’actuació. El present estudi valora l’eficàcia d’un programa de salut mitjançant la seva avaluació. Aquest programa detecta la prevalença de sobrepès i d’obesitat infantil i, estableix vies per a la seva prevenció als centres educatius, mitjançant l’aplicació d’una proposta pedagògica. El programa s’adreça a alumnes de 3 a 12 anys d’escoles de Barcelona i, més en concret, a aquells alumnes amb sobrepès i obesitat, que participen dintre del programa de salut mitjançant la realització d’una proposta pedagògica de prevenció, amb sessions dintre de l’escola i, amb activitats en família els caps de setmana. L’objectiu proposat és avaluar la implementació d’un programa de prevenció del sobrepès i obesitat infantil i, d’intervenció en la promoció d’hàbits saludables en alimentació i activitat física en horari no lectiu, en el context escolar. La recollida de dades, es fa al principi del curs escolar, per tal d’analitzar i valorar el punt de partida de l’alumnat a l’inici de la implementació del programa de salut. L’avaluació valora l’eficàcia del programa de salut i, així poder elaborar propostes que incideixen en la millora del programa, la seva consolidació en els cursos següents i, com a referència per a futurs programes de salut. Es potencien hàbits alimentaris i d’activitat física saludables, des d’un context pedagògic, amb la implicació tant de les escoles com de les famílies. La present investigació s’emmarca dins de la metodologia d’investigació avaluativa en educació, que té per objectiu la profunditat i la comprensió dels fenòmens. Es considera la realitat (Buscà, 2005) com un tot dinàmic i global, assumeix una via inductiva i utilitza estratègies que permeten l’obtenció de dades referides a la particularitat de les situacions. Per tant, és un estudi amb un enfocament metodològic essencialment qualitatiu, tot i que integrant dues estratègies qualitatives (l’entrevista i l’anàlisi documental) i dues quantitatives (la presa de dades antropomètriques i el qüestionari). L’enfocament d’investigació d’aquesta metodologia es caracteritza per ser holístic, inductiu i idiogràfic, és a dir, que s’interessa per la comprensió global de les situacions i de les persones. En els quatre instruments s’analitzen les variables de les tres dimensions de la recerca: disseny del programa de salut, implantació i resultats. Els resultats obtinguts són interpretats en dos nivells d’anàlisi de la informació. En el primer, es recopila i interpreta la informació de cada un dels quatre instruments de forma separada, realitzant una reflexió de cada una de les dimensions amb les seves variables. En el segon nivell es realitza una triangulació de dades a partir de les semblances i diferències en els resultats obtinguts en els quatre instruments, buscant respondre l’objectiu principal de la recerca. Els resultats de la recerca mostren gairebé 1/3 dels nens/es amb un pes no saludable, principalment sobrepès i obesitat. La majoria dels nens/es desconeixen que és un esmorzar saludable i quins aliments són perjudicials (grasses saturades i en excés, ensucrats, etc.). Això ens indica que hi ha una feina molt important a fer pel que fa a l’educació en alimentació. Pel que fa a l’activitat física, les dades mostren un excés d’hores d’inactivitat física. I aquesta és una dada molt preocupant: la meitat de la població infantil passa unes tres hores diàries davant d’una pantalla. Això té unes conseqüències de salut, pel sedentarisme que comporta i, pels aliments hipercalòrics que solen acompanyar aquestes estones. El programa es valora positivament en quant a l’anàlisi que es fa dels hàbits de salut en els nens/es i, que referma que s’ha de seguir treballant en programes de prevenció. Cal millorar la coordinació entre els agents participants en el programa de salut i empoderar-los per tal que siguin el motor del programa. Hi ha unanimitat entre els agents participants al programa de salut que s’avalua a la present recerca que, la coordinació regular entre ells, i la col·laboració amb l’Administració (Sanitat) és imprescindible perquè tingui èxit. I l’escola és el context ideal i el referent principal dels nens/es en quant a la pràctica d’activitat física ja que la majoria realitza les activitats extraescolars a la pròpia escola. Però l’escola també s’està convertint en un referent educatiu en quant a l’alimentació ja que hi ha un percentatge menor de nens/es amb excés de pes entre els que es queden a dinar a l’escola. Per tant, no només es treballa l’alimentació i l’activitat física com a continguts curriculars teòrics, sinó també a la pràctica. Tampoc hem de perdre de vista la família com a primer entorn educatiu i model principal dels nens/es, [spa] El mundo está sufriendo, desde finales del siglo XX una epidemia caudada por hábitos poco saludables de nutrición y de actividad física, relacionados con un determinado estilo de vida propio de esta época. Este hecho está llevando a millones de personas a tener exceso de peso y obesidad. Se ha convertido en un problema de salud mundial, que primero se inició en el primer mundo, para después pasar al segundo mundo o a países en proceso de desarrollo. La obesidad, consecuencia de una alimentación hipercalórica y no saludable es una enfermedad crónica, que lleva asociada una serie complicaciones peligrosas como son riesgos cardiovasculares, hipertensión, colesterol, diabetes, alteraciones del sueño, depresión, baja autoestima, etc. De manera paralela, los gobiernos y las administraciones sanitarias han comenzado a reaccionar como consecuencia de los datos preocupantes de los últimos estudios. En este sentido, las fundaciones relacionadas con el mundo de la salud (deportivas, alimentarias) han comenzado a llevar a cabo programas de prevención en hábitos saludables en el colectivo de niños y niñas ante la necesidad de actuación El presente estudio valora la eficacia de un programa de salud mediante su evaluación. Este programa detecta la prevalencia de sobrepeso y de obesidad infantil y, establece vías para su prevención en los centros educativos, mediante la aplicación de una propuesta pedagógica. El programa se dirige a alumnos de 3 a 12 años de escuelas de Barcelona y, más en concreto, a aquellos alumnos con sobrepeso y obesidad, que participan dentro del programa de salud mediante la realización de una propuesta pedagógica de prevención, con sesiones dentro de la escuela y, con actividades en familia los fines de semana. El objetivo propuesto es evaluar la implementación de un programa de prevención del sobrepeso y la obesidad infantil y, la intervención en la promoción de hábitos saludables en alimentación y actividad física en horario no lectivo, en el contexto escolar. La recogida de datos se hace a principio del curso escolar, para así poder analizar y valorar el punto de partida del alumnado al inicio de la implantación del programa de salud. La evaluación valora la eficacia del plan de salud y, así poder elaborar propuestas que inciden en la mejora del programa, su consolidación en los cursos siguientes y, como referencia para futuros programas de salud. Se potencian hábitos alimentarios y de actividad física saludables, desde un contexto pedagógico, con la implicación tanto de las escuelas como de las familias. La presente investigación se enmarca en la metodología de investigación evaluativa en educación, que tiene por objetivo profundizar y comprender los fenómenos. Se considera la realidad (Buscà, 2005) como un todo dinámico y global, asumiendo una vía inductiva y utilizando estrategias que permiten la obtención de datos referido a la particularidad de las situaciones. Por tanto, es un estudio con un enfoque metodológico esencialmente cualitativo, aunque integrando dos estrategias cualitativas (la entrevista y el análisis documental) y dos cuantitativas (la toma de datos antropométricos y el cuestionario). El enfoque de investigación de esta metodología se caracteriza por ser holístico, inductivo e idiográfico, es decir, que se interesa por la comprensión global de las situaciones y de las personas. En los cuatro instrumentos se analizan las variables de las tres dimensiones de la investigación: el diseño del plan de salud, la implementación del plan de salud y los resultados. Los resultados obtenidos son interpretados en dos niveles de análisis de la información. En el primero, se recopila e interpreta la información de cada uno de los cuatro instrumentos de forma separada, realizando una reflexión de cada una de las dimensiones con sus variables. En el segundo nivel se realiza un cruce de datos a partir a partir de las semejanzas y diferencias en los cuatro instrumentos, buscando responder el objetivo principal de la investigación. Los resultados de la investigación muestran casi 1/3 de los niños/as con un peso no saludable, principalmente sobrepeso y obesidad. La mayoría de los niños/as desconocen que es un desayuno saludable y qué alimentos son perjudiciales (grasas saturadas y en exceso, azucarados, etc.). Esto nos indica que hay un trabajo muy importante a hacer en relación con la educación en alimentación. Por lo que respecta a la actividad física, los datos muestran un exceso de horas de inactividad física. Y este es un dato muy preocupante: la mitad de la población infantil pasa unas tres horas diaria delante de una pantalla. Esto tiene unas consecuencias de salud, por el sedentarismo que comporta y por los alimentos hipercalóricos que suelen acompañar estos espacios de tiempo. El programa de salud se valora positivamente en cuanto al análisis que se hace de los hábitos de salud en los niños/as y que reafirma que se ha de seguir trabajando en programas de prevención. Hace falta mejorar la coordinación entre los agentes participantes en el plan de salud y empoderarlos para que sean el motor del programa. Hay unanimidad entre los agentes participantes en el programa de salud que se evalúa en la presente investigación, que la coordinación regular entre ellos y la colaboración con la Administración (Sanidad) es imprescindible para que el plan de salud tenga éxito. Y la escuela es el contexto ideal y el referente principal de los niños/as en cuanto a la práctica de actividad física, ya que la mayoría realiza las actividades extraescolares en la propia escuela. Pero la escuela también se está convirtiendo en un referente educativo en cuanto a la alimentación, ya que hay un porcentaje menor de niños/as con exceso de peso entre los que se quedan a comer en el colegio. Por lo tanto, no sólo se trabaja la alimentación y la actividad física como contenidos curriculares teóricos, sino que también se lleva a la práctica. Tampoco hemos de perder de vista a la familia como primer entorno educativo y modelo principal de los niños/as., [eng] Since the end of the 20th century the world has been suffering from an epidemic caused by unhealthy habits of nutrition and physical activity, related to a certain lifestyle characteristic of this era. This fact is leading millions of people to become overweight and obese. It has become a global health problem, which first started in the first world, and then moved to the second world or developing countries. Obesity, a consequence of a hypercaloric and unhealthy diet, is a chronic disease, which carries with it a series of dangerous complications such as cardiovascular risks, hypertension, cholesterol, diabetes, sleep disorders, depression, low self-esteem, etc. At the same time, governments and health administrations have begun to react to the worrying data from recent studies. In this sense, the foundations related to the world of health (sports, food) have begun to carry out prevention programs in healthy habits in the group of children in view of the need to act. This study assesses the effectiveness of a health project by evaluating it. This program detects the prevalence of overweight and obesity in children and, establishes ways for its prevention in the educational centers, through the application of a pedagogical proposal. The plan is aimed at students from 3 to 12 years of age in schools in Barcelona and, more specifically, at those students who are overweight and obese, who participate in the health project by carrying out a pedagogical proposal of prevention, with sessions inside the school, and with family activities at weekends. The proposed objective is to evaluate the implementation of a program for the prevention of overweight and obesity in children, and an intervention in the promotion of healthy eating habits and physical activity during non-teaching hours, in the school context. Data is collected at the beginning of the school year, to analyze and evaluate the starting point of the students at the beginning of the implementation of the health program. The evaluation assesses the effectiveness of the health plan, so that proposals can be drawn up for improving the project, consolidating it in next courses and as a reference for future health plans. Healthy eating and physical activity habits are promoted, from an educational context, with the involvement of both schools and families. This research is part of the evaluation research methodology in education, which aims at the depth and understanding of the phenomena. Reality is considered (Buscà, 2005) as a dynamic and global whole, it assumes an inductive path and uses strategies that allow obtaining data referred to the particularity of the situations. Therefore, it is a study with an essentially qualitative methodological approach, integrating two qualitative strategies (the interview and the documentary analysis) and two quantitative strategies (collecting anthropometric data and the questionnaire). The research approach of this methodology is characterized by being holistic, inductive and ideographic, that is, it is interested in the global understanding of situations and people. The four instruments analyse the variables of the three dimensions of research: design of the health plan, implementation of the health plan and results. The results obtained are interpreted at two levels of information analysis. In the first one, the information of each one of the four instruments is collected and interpreted separately, making a reflection of each one of the dimensions with its variables. In the second level a data cross is made from the similarities and differences in the results obtained in the four instruments, seeking to respond to the main objective of the research. Research results show almost 1/3 of children are at an unhealthy weight, mainly overweight and obese. Most children do not know what a healthy breakfast is and foods are harmful (saturated and excess fats, sugars, etc.). This indicates to us that there is very important work to be done in terms of food education. With regard to physical activity, the data show an excess of hours of physical inactivity. And this is a very worrying fact: half of the child population spends about three hours a day in front of a screen. This has some health consequences, because of the sedentary lifestyle it entails, and because of the high- calorie foods that usually accompany these passive leisure times. The program is positively evaluated in terms of the analysis of children's health habits, which reaffirms the need to continue working on prevention plans. There is a need to improve coordination among the actors involved in the health plan and empower them to be the driving force behind the program. There is unanimity among the agents participating in the health plan being evaluated in this research, that regular coordination among them, and collaboration with the Administration (Health) is essential for it to be successful. And the school is the ideal context and the main reference for children to practice physical activity since most of them do the extra-curricular activities in the school itself. But the school is also becoming an educational and health reference in terms of nutrition as there is a lower percentage of overweight children among those who stay to eat at school. Therefore, not only is food and physical activity worked on as theoretical curricular content, but also in practice. But we must not lose sight of the family as the first educational environment and main model for children.

Purpose It is difficult to change dietary habits and maintain them in the long run, particularly in elderly people. We aimed to assess whether adherence to the Mediterranean diet (MedDiet) and cardiovascular risk factor were similar in the middle-aged and oldest participants in the PREDIMED study. Methods We analyzed participants belonging to the first and fourth quartiles of age (Q1 and Q4, respectively) to compare between-group differences in adherence to the nutritional intervention and cardiovascular risk factor (CRF) control during a 3-year follow-up. All participants underwent yearly clinical, nutritional, and laboratory assessments during the following. Results A total of 2278 patients were included (1091 and 1187 in Q1 and Q4, respectively). At baseline, mean ages were 59.6 ± 2.1 years in Q1 and 74.2 ± 2.6 years in Q4. In Q4, there were more women, greater prevalence of hypertension and diabetes, and lower obesity and smoking rates than the younger cohort (P ≤ 0.001, all). Adherence to the MedDiet was similar in Q1 and Q4 at baseline (mean 8.7 of 14 points for both) and improved significantly (P Conclusion The youngest and oldest participants showed improved dietary habits and CRFs to a similar extent after 3 years’ intervention. Therefore, it is never too late to improve dietary habits and ameliorate CRF in high-risk individuals, even those of advanced age. Registration The trial is registered in the London-based Current Controlled Trials Registry (ISRCTN number 35739639).

Treballs Finals de Grau d'Infermeria, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Curs: 2020-2021, Tutor: Adhara Giner Molina, Introducció: El Baby-Led Weaning o BLW és un mètode d’alimentació complementària que permet als infants "dirigir" el procés des d'un principi. Es tracta de posar al seu abast aliments de consistència blana, tallats segons l'edat del nadó, per tal que sigui ell mateix el que agafi el menjar, sense la intervenció d'un adult. El procés ha de començar a partir dels 6 mesos de vida del nadó, quan aquest pugui seure sense suport, tenint un bon control del cap i sàpiga agafar objectes i portar-los a la boca. El paper de la infermeria pediàtrica és clau en la recomanació d’aquest mètode d’alimentació complementària. Objectiu: Esbrinar si el BLW es pot recomanar de manera inequívoca com a mètode d’alimentació complementària explorant la seva influència amb els patrons alimentaris, l’autoregulació energètica, el dèficit de ferro i l’ennuegament. Metodologia: S’ha realitzat una revisió bibliogràfica a les bases de dades PubMed, Scielo i Chinal, a partir de les quals es van extreure 12 articles científics tenint en compte els criteris d’inclusió i exclusió. A més, aplicant l'estratègia de bola de neu s’ha inclòs 1 article. Resultats: Dels 13 articles inclosos a la revisió, hi trobem 5 revisions bibliogràfiques, 5 assaigs controlats aleatoris, 1 estudi comparatiu, 1 assaig prospectiu i 1 estudi observacional. Conclusions: Des de la infermeria pediàtrica es pot recomanar de manera inequívoca el BLW com un mètode d'alimentació complementària, atès que el proporciona uns patrons alimentaris saludables i una millor autoregulació energètica. A més, tot i que hi ha una menor ingesta de ferro, aquesta no repercuteix en la salut. Tanmateix, el BLW no augmenta la incidència d’episodis d’ennuegament.

It is thought that just as hunger itself, the expectancy to eat impacts attention and cognitive control toward food stimuli, but this theory has not been extensively explored at a behavioral level. In order to study the effect of expectancy to eat on attentional and cognitive control mechanisms, 63 healthy fasting participants were presented with an affective priming spatial compatibility Simon task that included both food and object (non-food) distracters. The participants (N = 63) were randomly assigned to two groups: an “immediate expectancy” group made up of participants who expected to eat immediately after the task (N = 31; females = 21; age = 26.8 ± 9.6) and a “delayed expectancy” cohort made up of individuals who expected to eat a few hours later (N = 32; females = 21; age = 25.0 ± 8.0). Slower reaction times (RTs) toward the food and non-food distracters and a more pronounced effect on the RTs in the incompatible condition [i.e., the Simon effect (SE)] were noted in both groups. The effect of the food and non-food distracters on the RTs was more pronounced in the immediate with respect to the delayed expectancy group. The magnitude of the SE for the food and the non-food distracters was also greater in the immediate with respect to the delayed expectancy group. These results seem to indicate that when the expectancy to eat is short, the RTs are delayed, and the SE is more pronounced when food and non-food distracters are presented. Instead, when the expectancy to eat is more distant, the distracters have less of an effect on the RTs and the correspondence effect is smaller. Our results suggest that the expectancy to eat can modulate both attention orienting and cognitive control mechanisms in healthy fasting individuals when distracting details are competing with information processing during goal directed behavior.

Wu, L., and Sun, D. (2017). Adherence to Mediterranean diet and risk of developing cognitive disorders: an updated systematic review and meta-analysis of prospective cohort studies. Sci. Rep. 7:41317. doi: 10.1038/srep41317 Wu, Z., Phyo, A. Z. Z., Al-harbi, T., Woods, R. L., and Ryan, J. (2020). Distinct cognitive trajectories in late life and associated predictors and outcomes: a systematic review. J. Alzheimer’s Dis. Rep. 4, 459–478. doi: 10.3233/ADR-200232 Conflict of Interest: SKN was a volunteer member of the not-for profit group Plant Based Canada. JS-S reported receiving research support from the Instituto de Salud Carlos III, Ministerio de Educación y Ciencia, Departament de Salut Pública de la Generalitat de Catalunya, the European Commission, the United States National Institutes of Health; receiving consulting fees or travel expenses from Danone, California Walnut Commission, Eroski Foundation, Instituto Danone, Nestle, and Abbott Laboratories, receiving non-financial support from Hojiblanca, Patrimonio Comunal Olivarero, the California Walnut Commission, Almond Board of California, La Morella Nuts, Pistachio Growers, and Borges SA; serving on the board of and receiving grant support through his institution from the International Nut and Dried Foundation and the Eroski Foundation; and grants and personal fees from Instituto Danone; Serving in the Board of Danone Institute International. DC reported receiving grants from Instituto de Salud Carlos III. RE reported receiving grants from Instituto de Salud Carlos III, Fundación Dieta Meditarránea and Cerveza y Salud and olive oil for the trial from Fundación Patrimonio Comunal Olivarero and personal fees from Brewers of Europe, Fundación Cerveza y Salud, Interprofesional del Aceite de Oliva, Instituto Cervantes in Albuquerque, Milano and Tokyo, Pernod Ricard, Fundación Dieta Mediterránea (Spain), Wine and Culinary International Forum and Lilly Laboratories; non-financial support from Sociedad Española de Nutrición and Fundación Bosch y Gimpera; and grants from Uriach Laboratories. ER reports grants, personal fees, non-financial support, and others from California Walnut Commission, during the conduct of the study; grants, personal fees, non-financial support and other from Alexion; grants from Amgen and Pfizer; grants, personal fees and other from Sanofi Aventis; personal fees, non-financial support and other from Ferrer International, Danone and Merck Sharp and Dohme, personal fees and other from Amarin, outside the submitted work., This work was supported by the official Spanish Institutions for funding scientific biomedical research, CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN) and Instituto de Salud Carlos III (ISCIII), through the Fondo de Investigación para la Salud (FIS), which was co-funded by the European Regional Development Fund (six coordinated FIS projects leaded by JS-S and JV, including the following projects: PI13/00673, PI13/00492, PI13/00272, PI13/01123, PI13/00462, PI13/00233, PI13/02184, PI13/00728, PI13/01090, PI13/01056, PI14/01722, PI14/00636, PI14/00618, PI14/00696, PI14/01206, PI14/01919, PI14/00853, PI14/01374, PI14/00972, PI14/00728, PI14/01471, PI16/00473, PI16/00662, PI16/01873, PI16/01094, PI16/00501, PI16/00533, PI16/00381, PI16/00366, PI16/01522, PI16/01120, PI17/00764, PI17/01183, PI17/00855, PI17/01347, PI17/00525, PI17/01827, PI17/00532, PI17/00215, PI17/01441, PI17/00508, PI17/01732, PI17/00926, PI19/00957, PI19/00386, PI19/00309, PI19/01032, PI19/00576, PI19/00017, PI19/01226, PI19/00781, PI19/01560, PI19/01332, PI20/01802, PI20/00138, PI20/01532, PI20/00456, PI20/00339, PI20/00557, PI20/00886, and PI20/01158); the Especial Action Project entitled: Implementation y evaluación de una intervención intensiva sobre la actividad física Cohorte PREDIMED-Plus grant to JS-S; the European Research Council (Advanced Research Grant 2014–2019; agreement #340918) granted to MAM-G; the Recercaixa (number 2013ACUP00194) grant to JS-S; grants from the Consejería de Salud de la Junta de Andalucía (PI0458/2013, PS0358/2016, and PI0137/2018); the PROMETEO/2017/017 grant from the Generalitat Valenciana; the SEMERGEN grant; Juan de la Cierva-Incorporación research grant (IJC2019-042420-I) of the Spanish Ministry of Economy, Industry and Competitiveness and European Social Funds to JK. This research was also partially funded by EU-H2020 Grants [Eat2beNICE/H2020-SFS-2016-2; and the Horizon 2020 PRIME study (Prevention and Remediation of Insulin Multimorbidity in Europe); grant agreement #847879]. SKN was supported by a postdoctoral fellowship from the Canadian Institutes of Health Research (CIHR, vMFE-171207). None of the funding sources took part in the design, collection, analysis, interpretation of the data, or writing the report, or in the decision to submit the manuscript for publication., Background and Aims: Plant-forward dietary patterns have been associated with cardiometabolic health benefits, which, in turn, have been related to cognitive performance with inconsistent findings. The objective of this study was to examine the relationship between baseline adherence to three a priori dietary patterns (Mediterranean, DASH, and MIND diets) with 2-year changes in cognitive performance in older adults with overweight or obesity and high cardiovascular disease risk. Methods: A prospective cohort analysis was conducted within the PREDIMED-Plus trial, involving 6,647 men and women aged 55–75 years with overweight or obesity and metabolic syndrome. Using a validated, semiquantitative 143-item food frequency questionnaire completed at baseline, the dietary pattern adherence scores were calculated. An extensive neuropsychological test battery was administered at baseline and 2-year follow-up. Multivariable-adjusted linear regression models were used to assess associations between 2-year changes in cognitive function z-scores across tertiles of baseline adherence to the a priori dietary patterns. Results: Adherence to the Mediterranean diet at baseline was associated with 2-year changes in the general cognitive screening Mini-Mental State Examination (MMSE, β: 0.070; 95% CI: 0.014, 0.175, P-trend = 0.011), and two executive function-related assessments: the Trail Making Tests Part A (TMT-A, β: −0.054; 95% CI: −0.110, − 0.002, P-trend = 0.047) and Part B (TMT-B, β: −0.079; 95% CI: −0.134, −0.024, P-trend = 0.004). Adherence to the MIND diet was associated with the backward recall Digit Span Test assessment of working memory (DST-B, β: 0.058; 95% CI: 0.002, 0.114, P-trend = 0.045). However, higher adherence to the DASH dietary pattern was not associated with better cognitive function over a period of 2 years. Conclusion: In older Spanish individuals with overweight or obesity and at high cardiovascular disease risk, higher baseline adherence to the Mediterranean dietary pattern may be associated with better cognitive performance than lower adherence over a period of 2 years., Board of Danone Institute International, Borges SA, CIBER Fisiopatología de la Obesidad y Nutrición, Consejería de Salud de la Junta de Andalucía PI0137/2018, PI0458/2013, PROMETEO/2017/017, PS0358/2016, Danone and Merck Sharp and Dohme, Departament de Salut Pública de la Generalitat de Catalunya, EU-H2020 Eat2beNICE/H2020-SFS-2016-2, Eroski Foundation, Fondo de Investigación para la Salud, Fundación Cerveza y Salud, Fundación Dieta Meditarránea and Cerveza y Salud, Fundación Dieta Mediterránea, Fundación Patrimonio Comunal Olivarero, Instituto Danone, Nestle, and Abbott Laboratories, International Nut and Dried Foundation, Lilly Laboratories, Ministerio de Educación y Ciencia, Sociedad Española de Nutrición, Uriach Laboratories, Amgen, Pfizer, Almond Board of California, California Walnut Commission, Canadian Institutes of Health Research MFE-171207, European Commission, European Research Council 2013ACUP00194, 340918, Generalitat Valenciana IJC2019-042420-I, Instituto de Salud Carlos III, European Social Fund, Horizon 2020 847879, Fundació Bosch i Gimpera, European Regional Development Fund PI13/00233, PI13/00272, PI13/00462, PI13/00492, PI13/00673, PI13/00728, PI13/01056, PI13/01090, PI13/01123, PI13/02184, PI14/00618, PI14/00636, PI14/00696, PI14/00728, PI14/00853, PI14/00972, PI14/01206, PI14/01374, PI14/01471, PI14/01722, PI14/01919, PI16/00366, PI16/00381, PI16/00473, PI16/00501, PI16/00533, PI16/00662, PI16/01094, PI16/01120, PI16/01522, PI16/01873, PI17/00215, PI17/00508, PI17/00525, PI17/00532, PI17/00764, PI17/00855, PI17/00926, PI17/01183, PI17/01347, PI17/01441, PI17/01732, PI17/01827, PI19/00017, PI19/00309, PI19/00386, PI19/00576, PI19/00781, PI19/00957, PI19/01032, PI19/01226, PI19/01332, PI19/01560, PI20/00138, PI20/00339, PI20/00456, PI20/00557, PI20/00886, PI20/01158, PI20/01532, PI20/01802, Ministerio de Economía, Industria y Competitividad, Gobierno de España, Consejería de Salud y Familias, Junta de Andalucía, Centro de Investigación Biomédica en Red-Fisiopatología de la Obesidad y Nutrición, Grupo Ferrer Internacional, S.A

This baseline cross-sectional analysis from data acquired in a sub-sample of the PREDIMED-Plus study participants aimed to evaluate the relation between the Composite Socioeconomic Index (CSI) and lifestyle (diet and physical activity). This study involved 1512 participants (759 (52.2%) women) between 55 and 80 years with overweight/obesity and metabolic syndrome assigned to 137 primary healthcare centers in Catalonia, Spain. CSI and lifestyle (diet and physical activity) were assessed. Multiple linear regression or multinomial regression were applied to the data. Cluster analysis was performed to identify dietary patterns. The multiple linear regression model showed that a high deprivation index was related to a higher consumption of refined cereals (11.98 g/d, p-value = 0.001) and potatoes (6.68 g/d, p-value = 0.001), and to a lower consumption of fruits (−17.52 g/d, p-value = 0.036), and coffee and tea (−8.03 g/d, p-value = 0.013). Two a posteriori dietary patterns were identified by cluster analysis and labeled as “healthy” and “unhealthy”. In addition, the multinomial regression model showed that a high deprivation index was related to an unhealthy dietary pattern and low physical activity (OR 1.42 [95% CI 1.06–1.89], p-value &lt, 0.05). In conclusion, a high deprivation index was related to an unhealthy lifestyle (diet and physical activity) in PREDIMED-Plus study participants.

Endoscopic bariatric therapies (EBTs) are promising strategies for the treatment of obesity. However, there is still great variability in its effectiveness in weight loss. Thus, we investigated whether adherence to healthy lifestyle habits is a significant determinant of weight loss effectiveness among patients undergoing EBTs. Additionally, the role of eating behaviors and psychological traits in the effectiveness of weight loss was studied. A cohort of 361 participants (81.4% women; age 41.8 ± 9.5 years; BMI 37.8 ± 4.3 kg/m2) was followed for 1 year after EBT. Anthropometric parameters, adherence to healthy lifestyle habits, emotional eating, and psychological traits (anxiety and depression) were evaluated. General linear models were used to compare outcome variables according to weight loss effectiveness groups (poor vs. good weight-loss-responders). Additionally, a hierarchical linear regression model was used to determine whether adherence to healthy lifestyle habits, emotional eating, or psychological traits were significant predictors of excess weight loss (%EWL). One year after EBT, weight loss differed significantly between good and poor weight-loss-responders (67.5% EWL [95% CI: 64.2, 70.8] vs. 28.2% EWL [95% CI: 25.5, 30.9], p < 0.001). Participants who adhered to good lifestyle habits had 4.37 more odds [95% CI: 2.19, 8.88] of being good weight-loss-responders. We also observed that eating four to five meals/day and practicing muscle-strengthening activities >2 times/week were the two lifestyle habits that most significantly determined weight loss response. Furthermore, our results revealed that while adherence to healthy lifestyle habits was a significant determinant of %EWL 3, 6, and 12 months after EBT (p < 0.001), emotional eating was a significant determinant of %EWL only 3 and 6 months after the intervention (p < 0.01 and p < 0.05, respectively). Regarding psychological traits, we observed that neither anxiety nor depression were significant determinants of %EWL. Our results revealed that adherence to healthy lifestyle habits is a significant determinant for weight loss effectiveness among patients with obesity undergoing EBT. These findings highlight the importance of implementing an adequate nutritional intervention program, especially since patients who adhere to good lifestyle habits are able to achieve a weight loss that would be comparable with bariatric surgery.

En su mayoría, las intervenciones para disminuir la prevalencia de la obesidad y promover la adopción de patrones de alimentación y hábitos saludables en población escolar, se han basado en incentivar cambios conductuales bajo el precepto de comer menos y moverse más. No obstante, esta aproximación asume que los niños y jóvenes se desenvuelven en entornos neutrales que no generan influencias en sus hábitos, dejando de lado la compresión de cómo dichos entornos pueden facilitar u obstaculizar la elección de alimentos saludables y oportunidades de movimiento¬. En este sentido, existe una necesidad de construir nuevos marcos analíticos y metodológicos que permitan el estudio e inclusión de los diferentes entornos en los análisis e intervenciones nutricionales en población en edad escolar. En este orden de ideas, el objetivo central de esta tesis fue desarrollar herramientas metodológicas para el estudio de las variables ambientales en población en edad escolar, con el fin de facilitar la compresión de la relación de los entornos con la adherencia a patrones de alimentación y estilo de vida saludables. En el primer capítulo, se parte de una aproximación descriptiva sobre los principales factores individuales y ambientales asociados a la adherencia a patrones de alimentación saludables en una población escolar, usando el estudio de la adherencia a la dieta mediterránea en la población escolar de la ciudad de Mataró, España. El análisis estadístico demostró que los factores positivamente asociados con una adherencia óptima a la dieta mediterránea fueron: (i) el nivel de educación de la madre; (ii) estar cursando la primaria; (iii) la ausencia de distracciones durante el desayuno; y por último, (iv) la actividad física regular vigorosa y ligera. Adicionalmente, sobresalió cómo la disponibilidad de dinero para comprar en la escuela/instituto presentó una asociación negativa con la probabilidad de adherencia óptima a la dieta mediterránea, lo cual se relaciona con una posible influencia de los ambientes comunitarios como factor a considerar para garantizar el éxito de las intervenciones en la población de edad escolar. En el segundo y tercer capítulo, se introdujo el Facility List Coder (FLC) una nueva herramienta basada en información geo-localizada secundaria para la evaluación automática de entornos de alimentación a nivel comunitario. El FLC es un aplicativo que realiza un inventario de establecimientos con diferentes ofertas de alimentos alrededor de un sitio de interés (escuelas, parques, entre otros), a través de una consulta espacial de las principales bases de datos espaciales accesibles (Google Maps y Open Street Maps). Dicha información es analizada y clasificada a través de una lista de categorías preestablecidas que permiten tener medidas cuantitativas sobre la calidad y tipologías de los entornos de alimentación. Después del proceso de validación se concluyó que el FLC es una herramienta de bajo costo, escalable, eficiente, fácil de usar, fiable y válida para la evaluación de entornos de alimentación comunitarios de manera automática a través de uso de información secundaria geo-referenciada. Finalmente, el capítulo 4 adapta y valida a la cultura española una nueva herramienta para evaluar el micro-entrono escolar llamada School Physical Activity and Nutrition Environment Tool (SPAN-ET), la cual permite una evaluación integral del entorno de actividad física y nutrición teniendo en cuenta aspectos físicos, situacionales y de política. Para esto, se aplicaron las directrices metodológicas para la adaptación transcultural de instrumentos de recolección de información y se aplicó un análisis de validez del contenido. La evaluación realizada por el comité de expertos concluyó que los elementos incluidos en la versión SPAN-ET en español eran relevantes para el contexto español, claros, sencillos y sin ambigüedades. Por tanto, se dispone de una nueva herramienta para la evaluación de entornos escolares en España. Como resultado de esta tesis se puede concluir que existe una necesidad global de crear marcos analíticos y metodológicos que permitan estudiar las dinámicas e interacciones de las variables ambientales (entorno de alimentación comunitario, entorno de consumo, entornos organizacionales y entorno informacional) sobre la adherencia a patrones de alimentación y estilos de vida saludables. En particular, en el entorno comunitario alrededor de las escuelas y en el micro-entorno escolar, ya que constituye la dimensión con menos investigación disponible y es el lugar donde las intervenciones podrían tener mayor impacto en la formación de hábitos saludables.

Present project is concerned with the possibility to modulate the neural regulation of food intake by non-invasive stimulation of the vagus nerve. This nerve carries viscero-afferent information from the gut and other internal organs and therefore serves an important role in ingestive behavior. The electrical stimulation of the vagus nerve (VNS) is a qualified procedure in the treatment of drug-resistant epilepsy and depression. Since weight loss is a known common side effect of VNS treatment in patients with implanted devices, VNS is evaluated as a treatment of obesity. To investigate potential VNS-related changes in the cognitive processing of food-related items, 21 healthy participants were recorded in a 3-Tesla scanner in two counterbalanced sessions. Participants were presented with 72 food pictures and asked to rate how much they liked that food. Before entering the scanner subjects received a 1-h sham or verum stimulation, which was implemented transcutanously with a Cerbomed NEMOS® device. We found significant activations in core areas of the vagal afferent pathway, including left brainstem, thalamus, temporal pole, amygdala, insula, hippocampus, and supplementary motor area for the interaction between ratings (high vs low) and session (verum vs sham stimulation). Significant activations were also found for the main effect of verum compared to sham stimulation in the left inferior and superior parietal cortex. These results demonstrate an effect of tVNS on food image processing even with a preceding short stimulation period. This is a necessary prerequisite for a therapeutic application of tVNS which has to be evaluated in longer-term studies.

Aquest projecte pretén millorar els hàbits alimentaris saludables en l'alumnat de secundària, ja que en aquesta edat hi ha molts riscs de contreure malalties com l'obesitat o trastorns alimentaris (anorèxia i bulímia) , a part d'un desequilibri alimentari a causa de la falta d'hàbits. Per això es fa responsable a l'alumnat de la pròpia elecció de l'alimentació, aquesta també anirà en funció de l'activitat física que realitzi. El treball també vol conscienciar sobre com prevenir el malbaratament alimentari que hi ha actualment en la societat. Les aportacions que s'han fet per tal de poder millorar la situació, són la creació d'un full de càlcul, on hi ha confeccionat un simulador i el càlcul de dietes setmanals en funció de les calories necessàries. Per tal de poder garantir un ensenyament dirigit cap a l'alumnat s'han inclòs aquestes contribucions dins d'unes activitats que es portaran a terme dins de l'aula.

La desnutrición crónica infantil (DCI) es un grave problema de salud pública presente en países de ingresos medios y bajos. En 2019, fueron 149 millones los niños menores de cinco años en todo el mundo afectados por esta enfermedad. Un retraso lineal del crecimiento, resultado de una ingesta insuficiente de energía y nutrientes y/o repetidas infecciones, con consecuencias severas en la salud y la calidad de vida de los niños. Además, es una de las causas principales de la pobreza en los niños que se perpetua en la edad adulta y en las siguientes generaciones. Las causas de la DCI son multifactoriales y requieren un abordaje multidisciplinar, pero los programas de educación nutricional sobre nutrición y prácticas alimentarias en niños con DCI y dirigidos a sus madres, son una herramienta eficaz para reducir su tasa. Por consiguiente, se elabora un diseño de un programa de educación nutricional dirigido a las madres de niños menores de cinco años con DCI asentados en las zonas rurales de Janjanbureh (Gambia). Este programa pretende ser de utilidad para disminuir la DCI prevalente en el país con cifras respectivamente del 24,6% en todo el estado y del 35% en la zona del gobierno local de Janjanbureh (Gambia). Y, asimismo, ampliar una línea de investigación para establecer los componentes de los programas de educación nutricional efectivos para acabar con esta problemática. Si tras la implementación tiene éxito, esta intervención educativa confirmaría las características esenciales a integrar en otros programas de educación nutricional con los mismos objetivos. Childhood chronic malnutrition (CCM) is a serious public health problem present in low and middle-income countries. In 2019, 149 million children under five were affected by this disease in all over the world. It is defined as a linear growth failure, a result of an insufficient intake of energy and nutrients and/ or repeated infections, with severe consequences on children's health and their quality of life. In addition, it is one of the main causes of poverty in children, which is perpetuated in adulthood and in the following generations. The causes of CCM are multifactorial so it is required a multidisciplinary approach. In spite of this fact, nutrition education programs about children nutrition and feeding practices aimed at mothers of children with CCM, are an effective tool to reduce its rate. The purpose of this paper is a designing of a nutrition education program developed for mothers of children under the age of five with CCM and settled in rural areas of Janjanbureh (The Gambia). This program is intended to be useful in reducing the prevalence of CCM in the country, which is 24.6% state-wide and 35% along the area of the local government in Janjanbureh (The Gambia). Likewise, it is an opportunity to develop a research about the effectiveness of nutrition education components in order to end this problem. If the program results successful after it is carried out, this educational intervention would confirm the essential characteristics to be integrated into other nutritional education programs with the same aims. La desnutrició crònica infantil (DCI) és un greu problema de salut pública present en països d'ingressos mitjans i baixos. En 2019, van anar 149 milions els nens menors de cinc anys a tot el món afectats per aquesta malaltia. Un retard lineal del creixement, resultat d'una ingesta insuficient d'energia i nutrients i/o repetides infeccions, amb conseqüències severes en la salut i la qualitat de vida dels nens. A més, és una de les causes principals de la pobresa en els nens que es perpètua en l'edat adulta i en les següents generacions. Les causes de la DCI són multifactorials i requereixen un abordatge multidisciplinari, però els programes d'educació nutricional sobre nutrició i pràctiques alimentàries en nens amb DCI i dirigits a les seves mares, són una eina eficaç per a reduir la seva taxa. Per consegüent, s'elabora un disseny d'un programa d'educació nutricional dirigit a les mares de nens menors de cinc anys amb DCI assentats en les zones rurals de Janjanbureh (Gàmbia). Aquest programa pretén ser d'utilitat per a disminuir la DCI prevalent al país amb xifres respectivament del 24,6% en tot l'estat i del 35% en la zona del govern local de Janjanbureh (Gàmbia). I, així mateix, ampliar una línia de recerca per a establir els components dels programes d'educació nutricional efectius per a acabar amb aquesta problemàtica. Si després de la implementació té èxit, aquesta intervenció educativa confirmaria les característiques essencials a integrar en altres programes d'educació nutricional amb els mateixos objectius.

Treballs Finals de Grau de Nutrició Humana i Dietètica, Facultat de Farmàcia i Ciències de l'Alimentació, Campus de l'Alimentació de Torribera, Universitat de Barcelona. Curs: 2019-2020. Tutor: Toni Cunillera, [eng] Dietary restraint has been the solution for many people to lose weight or simply have it under control to cope with this obesogenic environment that we live in, full of easily approachable palatable-food advertising. However, this behavior of ruling dietary intake by what must be or must not be consumed instead of following the intrinsic signs of appetite is believed to lead to an opposite reaction of failed inhibition as a result of self control loss. Hence, not all dieters succeed in obtaining their goal. Interestingly, years of experimentation have helped to develop different assessment tools, such as experimental measures of the inhibitory pattern and the self-reported measures of dietary restraint that have helped to broaden the knowledge on this field. This way, it has been seen that some of those who are self-reported as restrained eaters vary in controlling their reaction towards food, surprisingly being those who have a more pronounced tendency for refraining from food intake the same who fail in inhibitory control. In the same line, restrained eating has been related to a more pronounced attraction to food known as attentional bias that also explains why some attempt significantly more to food consumption. Finally, based on the accumulating evidence of training inhibitory control, leads to the conclusion that such trait should be the target for treatment in order to encourage the successful and healthier performance of chronic dieters., [spa] La restricción dietética ha sido, para muchas personas, la solución para evitar ganar peso o intentar mantenerlo en este ambiente obesogénico que nos rodea, lleno de publicidad sobre productos alimenticios de alta densidad calórica que son fácilmente accesibles. Sin embargo, se ha visto que esta actitud de limitarse a comer solo lo que se debe cuando se debe, en lugar de hacer caso a las señales fisiológicas reguladoras del apetito, provoca un efecto adverso en la capacidad inhibitoria hacia la comida como resultado de una pérdida de control en algunas personas. En consecuencia, no todos los comedores restrictivos cumplen con su objetivo principal de controlar el peso. Con el paso del tiempo, los expertos han ido desarrollando una serie de herramientas capaces de medir tanto el patrón inhibitorio a través de unos métodos experimentales, como la tendencia restrictiva por medio de unos cuestionarios que han contribuido al conocimiento de este campo. Se ha visto así, que la mayoría de aquellos que se consideran comedores restrictivos son los mismos que presentan un control inhibitorio limitado. También se ha asociado esta población a una mayor atracción por la comida calificada como sesgo atencional lo que a su vez explica la tendencia incrementada de algunos hacia el consumo alimentario. Con todo ello, y dadas las evidencias que apoyan el uso de los métodos que entrenan el control inhibitorio, se podría decir que las intervenciones de tratamiento deberían insistir en él pudiendo así corroborar en una restricción alimentaria exitosa y saludable.