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Introduction: There is controversy about the adequacy of calcium intake to that recommended in Spanish schoolchildren. Some studies indicate that the intake is inadequate in a variable percentage of children, while others insist on the danger of an excessive intake in a huge percentage of this population. Aim: To assess calcium intake and food sources of this nutrient in a representative sample of Spanish children and to judge the adequacy of its contribution to the coverage of recommended intakes. Methods: 903 schoolchildren (7 to 11 years) from 10 Spanish provinces (Tarragona, Caceres, Burgos, Guadalajara, Valencia, Salamanca, Cordoba, Vizcaya, Lugo and Madrid) were studied. They constituted a representative sample of the Spanish schoolchildren population. The energy and nutrient intake was determined using a 'Food record questionnaire' for 3 days, including a Sunday. Calcium intake was compared with the recommended intakes (RI) for the mineral. Weight and height were recorded and body mass index (BMI) calculated. Results: In the studied group (55.3% girls and 44.7% of children), 30.7% had an excess body weight (23.3% overweight and 7.4% obesity). Calcium intake was 859.9 ± 249.2 mg / day (79.5% of the recommendations). 76.7% of children had intakes below 100% of those recommended and 40.1% below of 67% of RI. The ratios calcium/phosphorus (0.74 ± 0.21) and calcium/protein (10.1 ± 2.8) and the index of nutritional quality for calcium (0.78 ± 0.29) were lower than recommended in 91.6%, 99.8% and 81.1% of children, respectively. Dietary calcium came from dairy products (64.7%), dietetic products and infant formulae (7.6%), cereals (7.3%), vegetables (3.5%), fruits (3.4%), pre-cooked meals (3.3%), meats (2.8%), fishes (2.8%) and pulses (2.2%), with no differences by gender. Conclusion: Calcium intake was lower than recommended in 76.7% of the children and 40.1% had insufficient intake (< 67% of RI). Having in mind that the main calcium source was dairy products (64.7%), increase consumption of this food group is recommended, especially in the 37.1% of children who did not reach the 2 recommended servings per day. [ABSTRACT FROM AUTHOR]

Zn plays a key role in the synthesis and action of insulin. The aim of the present work was to determine whether a poorer Zn status was associated with insulin resistance in a group of 357 Spanish schoolchildren. Zn intake was determined by using a 3 d food record (i.e. Sunday to Tuesday). The body weight, height and waist and hip circumferences of all subjects were recorded and fasting plasma glucose, insulin and Zn concentrations were determined. Insulin resistance was determined using the homoeostasis model assessment (HOMA) marker. Children (11·5 %) with Zn deficiency (serum Zn concentration < 10·7 [mu]mol/l) had higher HOMA values than those with a more satisfactory Zn status (1·73 (sd 0·93)) compared with 1·38 (sd 0·90; P < 0·05). An inverse correlation was found between the HOMA value and the serum Zn concentration (r - 0·149, P < 0·05). The risk of having a greater insulin resistance value (HOMA greater than the 75th percentile) increased with age (OR 1·438; 95 % CI 1·021, 2·027) and BMI (OR 1·448; 95 % CI 1·294, 1·619) and decreased as Zn serum levels increased (OR 0·908; 95 % CI 0·835, 0·987; P < 0·001). Moreover, an inverse relationship was observed between HOMA values and Zn dietary density (r - 0·122), and the Zn intakes of male children with a HOMA value of >3·16 made a significantly smaller contribution to the coverage of those recommended (59·7 (sd 14·7) %) than observed in children with lower HOMA values (73·6 (sd 18·2) %; P < 0·05). Taking into account that Zn intake was below than that recommended in 89·4 % of the children, it would appear that increasing the intake of Zn could improve the health and nutritional status of these children, and thus contribute to diminish problems of insulin resistance. [ABSTRACT FROM AUTHOR]

Introduction: A high percentage of the population initiate or keep diets to lose weight independently of suffering or not overweight/obesity. Nevertheless, exists a great unknowledge on the more convenient guidelines to achieve this aim. Objective: To analyze weight perception and types of behavior to control the corporal weight in Spanish adults in order to be able to start the campaigns most adapted to provide a correct nutritional information to the population. Methods: 2,168 subjects (18 +/- 50 years) of 5 Spanish provinces were studied. Anthropometric and information about the worry about corporal weight data was obtained. Results: 65.6% of subjects declare a desire to lose weight and 44.9% have followed diets with this purpose in some moment (especially in female population). 63.9% of subjects increase physical activity to control weight, 23.9% consumes dietetic products or medicinal herbs and 48.0% compensate the excesses when they try to lose weight. Sweets (24.5%), fats (15.4%), pastries (11.4%) and bread (11.4%) are avoided and fruits and vegetables consumption is increased (specially by women) when try to lose weight. Conclusions: Weight loss practices use to be inadequate due to the desire to lose weight quickly and to the unknowledge about the most adecuate diet to achieve this aim. It is necessary to avoid this type of practices and to improve the knowledge on nutrition in the population. [ABSTRACT FROM AUTHOR]

Hydration status plays a key role in healthy ageing, and it is potentially affected by several factors, including drug consumption. However, research on this issue to date is scarce, especially in highly vulnerable groups, such as the elderly. We aimed to study the relationship linking hydration status, analysed by means of a validated questionnaire, 24 h urine analysis, body composition assessment, and drug consumption in a sample of old adults. A total of 144 elders were included in the study. Cardiovascular drug consumption was significantly associated with a lower water intake in men ( β = -0.282, p = 0.029). Moreover, urinary analysis revealed that total drug intake as well as the consumption of diuretics and cardiovascular drugs were associated with poorer hydration status, whereas genito-urinary drugs were associated with an opposite effect, and these results were confirmed in terms of body composition. Hence, total drug consumption ( β = -0.205), diuretic ( β = -0.408), cardiovascular ( β = -0.297), and genito-urinary drugs ( β = 0.298) were significantly associated ( p < 0.05) with total body water. The obtained results confirmed the impact of chronic treatment with certain drugs on hydration status. Nutritional interventions may be of great interest in certain population groups in order to prevent complications due to altered hydration status.

Non-communicable diseases (cardiovascular diseases, cancer, chronic respiratory diseases, diabetes, etc.) are the leading cause of death worldwide, accounting for 71 % of global deaths. The risk factors for all of them are closely linked to lifestyle and in particular to diet. For this reason, public health policies in European Union countries, in line with World Health Organization (WHO) recommendations, include in their priority measures actions aimed at promoting healthier food environments. One of these measures are policies for the reformulation of processed foods to reduce critical nutrients: salt, saturated fats, trans fats and added sugars. In Spain, as part of the NAOS Strategy, food reformulation measures have been implemented since 2008. Of all of them, the Plan de Colaboración para la Mejora de la Composición de Alimentos y Bebidas y otras Medidas 2020 stands out, which has led to a reduction in the content of salt, sugar, saturated and total fat in foods belonging to 57 subcategories marketed by the main food manufacturing and marketing companies from 2016 to 2021. Despite this, to date no population-based study has been conducted to test the impact of the measure on the diet of the Spanish population. The present article, by way of example, shows results of the theoretical estimation of total sugar intake in the pre-reformulation period (2016) and post-reformulation period (2024) based on the consumption of beverages in Spain. Data highlight that reformulation policies could have positive effects that need to be evaluated in representative studies of the Spanish population assessing the overall diet, in order to solidly confirm their positive effects on the population's diet.

More and more functions related to vitamin D and more pathologies related to its deficiency are known. The deficiency that exists in vitamin D is known at all ages, sexes and throughout the world. But beyond the existing deficiencies in each population group, in this article we intend to analyze how the nutritional situation of this vitamin in pregnant women and during lactation can have influence on the future health of their offspring.

Interest in the relationship between diet and cognitive function has increased in recent years. In this sense, eggs contain many essential nutrients that are also beneficial for cognitive function. Several studies have shown that moderate egg consumption not only does not increase cardiovascular risk but is positively associated with better cognitive performance and a lower risk of dementia. Egg protein is particularly rich in tryptophan, which is a precursor to serotonin, the neurotransmitter involved in mood, and melatonin, the hormone that regulates the sleep-wake cycle. Consumption of tryptophan-rich egg hydrolysates has been associated with improved attention and reduced feelings of sadness or depression. Egg choline is needed for the synthesis of acetylcholine, the neurotransmitter involved in memory and learning, and also for the synthesis of phosphatidylcholine, the intake of which has been linked to better mental function and a lower risk of dementia in adults. Choline intake during pregnancy reduces the risk of neural tube defects and is associated with better offspring development. And lutein and zeaxanthin, which are particularly concentrated in the nervous system, are associated with better visual function and cognitive development in the offspring and also in the elderly. All this evidence confirms the importance of including eggs in a balanced diet to prevent cognitive decline and improve cognitive health throughout life.

Yogurt has been valued very positively for centuries, but the concern for food sustainability and the fact that it is a food of animal origin has raised doubts about the consumption that may be convenient. The objective of this work is to deepen the topic and establish recommendations for the population. From the nutritional point of view, yogurt is a valuable food, for its high content, quality and bioavailability of its nutrients, in a low energy content, its components together with probiotic microorganisms are provided in a matrix that helps achieve greater nutritional and health benefit. Regular consumption of yogurt has been linked to cardiovascular protection, against diabetes, excess weight, cancer, bone health. Thinking about environmental sustainability, yogurt production is not particularly dangerous, as the kg of CO2 eq (greenhouse gases) associated with their production are the lowest obtained compared to other animal foods and even lower than those associated with the production of some plant foods and the supply of nutrients per 1000 kcal, per 100 g, or per euro is one of the highest available. There is the possibility to further improve sustainability with improvements in animal feed, packaging, transport, etc. Considering this evidence, the daily consumption of yogurt / fermented milk should be included in the food guidelines, not only as one more milk option, but specifying a specific consumption such as a ration / day, this pattern can be useful from the nutritional point of view and for the improvement of public health.

Background: Childhood overweight and obesity is a global concern and has increased in Spain over the last decades. Combinations of lifestyle behaviors (i.e., diet, sleep, and sedentarism) are highly related to weight status. Therefore, this study aimed to identify lifestyle patterns among children from Madrid City, and analyze associations with the prevalence of overweight, obesity, and abdominal obesity, considering socio-economic factors., Methods: A cross-sectional analysis was conducted on 4545 children from the ENPIMAD study with data on diet, sleep, anthropometric, and socio-economic variables. K-means cluster analysis was used to identify lifestyle clusters, and logistic regressions were used to examine the associations between socio-economic indicators and cluster membership, and between clusters and weight status., Results: Findings show three lifestyle clusters (healthy, mixed, and unhealthy), with boys and older children more represented in the unhealthy cluster. Food insecurity and low socio-economic status were associated with unhealthier clusters in boys and girls. Children in unhealthier clusters were more likely to have obesity and abdominal obesity. However, these associations disappeared in girls after controlling for food insecurity., Conclusion: These results provide insight into the combination of behaviors and socio-economic factors associated with childhood obesity that may aid in the design of future interventions.

Proteins are macronutrients with multiple health benefits, but excessive consumption can negatively affect health. This study aimed to evaluate the characteristics of a sample of high-protein processed foods (HPPFs), describe how their consumption affects dietary balance, and acquire knowledge of the consumption patterns of these products in a Spanish population. A sample of HPPFs available in supermarkets and on websites was collected. The contribution to recommended protein intakes was calculated using national and international references and considering the single consumption of the HPPFs and the product plus 150 g of meat. Furthermore, an online survey was conducted among a convenience sample. A total of 36 enriched protein products were evaluated. The percentage of proteins in these products ranges from 10 to 88%. The contribution of the protein recommended intake was within a range of 87.4-306.6% and 66.4-232.8% (women and men, respectively), only considering the additional proteins from 150 g of meat. One hundred thirty-nine participants completed the survey; 67.6% affirmed that they had consumed HPPFs, and half consumed them without following any consumption control. Since these products are accessible to everyone in supermarkets and protein intake is generally higher than the recommended limits, regulating the mass sale of HPPFs is essential to ensure they do not lead to protein overconsumption.

Introduction: Intermittent fasting is a dietary pattern characterized by alternating periods of total or partial fasting and ad libitum food consumption. During prolonged fasting, the body uses the ketone bodies formed from lipolysis of body fat, which also leads to some metabolic modifications with positive effects on health. In this sense, nocturnal intermittent fasting could contribute to properly synchronize the circadian system making the physiological, hormonal, energetic and metabolic processes work correctly and keeping to the individual in homeostasis. Thus, according to the results of different studies, intermittent fasting, in the short-medium term, seems to improve body composition, as well as the values of several cardiometabolic parameters such as insulin and HOMA-IR index, among others. These effects have been observed in both pre- and postmenopausal women (no differences have been found between both states) and are similar to those found in interventions with caloric restriction diets.

Introduction: Insulin resistance is described as a defect in the binding of insulin to its receptor and is associated with several diseases, including obesity and type 2 diabetes. Insulin resistance has been linked to vitamin and mineral deficiencies, especially those involved in oxidative stress. The Mediterranean diet, a diet based on the Healthy Eating Index or the Dietary Approaches to Stop Hypertension (DASH) diet are dietary patterns that have been associated with a lower risk of developing insulin resistance in children. Therefore, a diet rich in antioxidant vitamins and minerals, fiber, calcium, and polyunsaturated fatty acids and low in free sugars, sodium and saturated fatty acids may decrease the risk of insulin resistance in this age group. In addition, other nutritional factors, such as avoiding fast food, eating dinner with the family, not eating while watching TV or eating a sufficient and healthy breakfast on a regular basis seem to be associated with a lower risk of insulin resistance. Therefore, it is important to establish balanced daily eating habits to prevent and treat insulin resistance in schoolchildren and adolescents.

Introduction: Young adults move from adolescence into adulthood, and they face physical, social and personal changes that can affect their health. Regarding their nutritional needs, their energy requirements are lower than during adolescence, but they may need the same or higher amounts of other essential nutrients, such as folate, vitamin C, vitamin D, calcium, and iron. Furthermore, their increasingly sedentary lifestyle has led to a high prevalence of overweight and obesity in this group. However, despite being a vulnerable stage to nutritional problems, not enough attention has been paid to it from this point of view. In this context, eggs stand out as a food of great nutritional value for young adults, as they are an excellent source of protein, vitamins, and minerals. In addition, eggs are a nutritionally dense food, which makes them particularly useful in weight control and in situations with low energy requirements but high demands for other nutrients. Moderate egg consumption as part of a balanced diet helps to follow a healthy diet in this population group, contributing to improve their current and future health.

Introduction: Women deserve special attention due to the different requirements they have in comparison with men. In the same way, transgender women need individualized attention. Transgender women are at greater risk of suffering heart attacks or ischemic accidents, among other diseases, and are also at greater risk of developing eating disorders, poorer weight control and poorer perception of their image. Hormone therapy for gender reaffirmation in trans women modifies their body composition, and may also increase the risk of suffering from some pathologies. The nutritional needs of cisgender women are different from those of men, and trans women also have special needs, which may depend on whether or not they follow hormone therapy. Dietary studies, although scarce, suggest that transgender women have poor dietary habits and lifestyle. It is necessary to deepen the study of the nutritional situation of the female group, considering its diversity, and to develop standards and references appropriate to each case that allow better attention to the needs of these groups.

Background: Mineral intake may protect against cognitive impairment (CI) and all-cause dementia, which affects a large number of adults worldwide. The aim of this study was to investigate the association between mineral intake and Montreal Cognitive Assessment (MoCA), which is a sensitive and specific test., Methods: In total, 201 adults were included in a cross-sectional study. They completed a three-day dietary record to estimate their average daily intake of minerals. Contributions to dietary reference intakes (DRIs) were also calculated. The participants were divided into tertiles according to their mineral intake. CI classifications were determined via the MoCA (score < 26). Apolipoprotein E (APOE) genotyping was carried out, and the patients' anthropometric measurements and physical activity, health and personal data were collected., Results: The prevalence of CI in this selective sample was 54.2% (34.3% females and 19.9% males). In women, being in the third tertiles of iron and manganese intake was associated with lower odds of having CI (OR [95% CI]: 0.32 [0.11 ± 0.93]; 0.33 [0.12 ± 0.93], p < 0.05). No significant differences were observed for any of the nutrients studied in men., Conclusions: These findings suggest that a low mineral intake, especially low iron and manganese intake in women, is associated with a worse cognition as assessed by MoCA.

Introduction: Childhood obesity is inversely associated with household socioeconomic status in high-income countries. Our aim was to explore the association between childhood weight status and household socioeconomic status in Spain in relation to family characteristics, perceptions and lifestyle habits and the school environment., Methods: We performed a descriptive analysis of child weight status according to family socioeconomic factors and mediating variables based on data from the ALADINO 2019 study in a sample of 16,665 schoolchildren representative of the population aged 6-9 years in Spain., Results: The prevalence of childhood obesity in households with low socioeconomic status (26.8% boys; 20.4% girls) was, in both sexes, twice as high as in those with higher socioeconomic status (12.1% boys; 8.7% girls). Unhealthy eating habits, sedentary lifestyles (mainly in girls) and the presence of screens in the bedroom (more prevalent in boys) were more frequent in school-aged children from low-income households. On the other hand, in the most disadvantaged households, a history of breastfeeding and physical activity (especially in girls) were less frequent. Similarly, schools attended by children from low-income households were less likely to have their own kitchens and indoor gymnasiums or offer sports activities., Conclusion: A lower household socioeconomic status was associated with poorer dietary and physical activity habits and certain characteristics of the family and school environments that mediate the inverse association between household socioeconomic status and the prevalence of childhood obesity. Girls were less physically active and reported more sedentary lifestyles, while boys had greater access to screens. Interventions to combat childhood obesity should address the identified inequalities., (Copyright © 2023 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.)

Introduction: Being more active, being less sedentary, and sleeping enough are associated with adequate body weight and adiposity in children. However, few researchers have analyzed these different lifestyle behaviors and the adherence to 24 h movement guidelines with respect to insulin resistance (IR) at school age. Therefore, we aimed to analyse the association between the adherence to 24 h movement guidelines (physical activity, sedentary time, sleep) and IR in Spanish schoolchildren., Methods: A cross-sectional study of 839 children (8-13 years, 51.1% girls) were studied. Anthropometric, biochemical, and lifestyle behavioral data were collected. IR was defined as HOMA-IR>3.16. Compliance with the 24 h movement guidelines were defined as ≥60 min/day of moderate and/or vigorous physical activity, < 120 min/day of screen time, and 9-11 h/day of sleep time. Associations between adherence to the 24 h movement guidelines and IR were performed by multivariate logistic regression analyses., Results: The IR in our sample was 5.0%, being higher in girls. Compliance with physical activity or screen time, but not with sleep recommendations, was associated with lower fasting glucose, fasting insulin, and HOMA-IR values. A low adherence to 24 h movement guidelines was associated with a higher risk of IR (odds ratio (95% CI): 2.150 [1.089-4.247]), especially in girls (odds ratio (95% CI): 2.800 [1.180-6.645])., Conclusion: Higher physical activity levels and lower screen times were associated with a lower risk of IR in schoolchildren, underlining the importance of adhering to as many healthy lifestyle recommendations as possible., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Salas-González, Bermejo, González-Rodríguez, Lozano-Estevan, Ortega and López-Sobaler.)

Background: Breakfast has traditionally been considered one of the most important meals of the day; however, there is little evidence for the influence of breakfast quality and insulin resistance (IR). This study aimed to assess the quality of breakfast in a group of schoolchildren, and its association with IR. Methods: A cross-sectional study with 852 children (8−13 years) was carried out. Fasting plasma glucose, insulin and anthropometric parameters were measured. A three-day dietary record was used to assess their diet and to calculate the Breakfast Quality Index (BQI). The sample was divided into tertiles according to the BQI (tertile 3: better breakfast quality). The homeostatic model was used to assess insulin resistance (HOMA-IR), and IR was defined as HOMA-IR > 3.16. Results: The prevalence of IR was 5.2%. The mean BQI score was 4.50 ± 1.25, and boys had lower scores than girls. Children in the BQI tertile 3 had a better global diet quality. In boys, being in the BQI tertile 3 was associated with a lower risk of IR (OR [95% CI]: 0.10 [0.01−0.77], p < 0.05). Conclusions: A higher-quality breakfast was associated with better overall diet quality and a lower risk of IR, especially in boys.

Background: Diet quality patterns are associated with a lower incidence of insulin resistance (IR) in adults. The aim of this study was to investigate the association between two diet quality indices and IR in schoolchildren and to identify the best diet quality index associated with a lower risk of IR. Methods: A total of 854 schoolchildren (8−13 years) were included in a cross-sectional study, who completed a three-day dietary record to assess their diet. Fasting plasma glucose and insulin were also measured, and anthropometric data were collected. Healthy Eating Index-2015 (HEI-2015), Dietary Approaches to Stop Hypertension (DASH), and adjusted DASH (aDASH) were calculated as diet quality indices. The homeostasis model assessment of insulin resistance (HOMA-IR) was used, and IR was defined as HOMA-IR > 3.16. Results: The prevalence of IR was 5.5%, and it was higher in girls. The mean HEI-2015 and DASH scores were 59.3 and 23.4, respectively, and boys scored lower in both indices. In girls, having a HEI-2015 score above the 33rd percentile was associated with a lower risk of IR (odds ratio [95% CI]: 0.43 [0.19−0.96], p = 0.020). Conclusion: Greater adherence to a healthy dietary pattern, as assessed by a higher HEI-2015 score, was associated with a lower risk of IR in schoolchildren, especially in girls., Competing Interests: Authors declare no conflict of interest.

Introduction: Vitamin D is a key nutrient for health. Recent research has shown that it is not only necessary for the maintenance of bone health, but also for the prevention of cardiovascular diseases, insulin resistance, respiratory diseases, infections, and cancer, among others. Solar synthesis of vitamin D is usually insufficient, so it is necessary to provide enough vitamin D through the diet in order to maintain an adequate nutritional status. Studies carried out in Spain and other countries have shown that serum levels of the vitamin were usually insufficient and that average dietary intakes were well below those marked as recommended, while the main food sources of vitamin D were fatty fish, breakfast cereals, eggs, and dairy. Food sources of vitamin D are scarce, and it is naturally located in the fatty part of foods of animal origin, and in the liver and viscera. Fortifying foods that are not natural food sources of vitamin D but are regularly consumed by a significant percentage of the population, is a strategy that could help to increase vitamin D intake. In this regard, dairy products and breakfast cereals are two of the most widely used food matrices for vitamin D fortification, and their incorporation into the usual diet has proven to be an effective strategy to improve the nutritional situation of the population in vitamin D.

Introduction: The consumption of high nutritional quality foods is a key for proper growth and development during childhood. This work aimed to review and analyse the current recommended egg intake in children by different national organisations. Likewise, it intended to standardise a procedure to propose new recommendations for this food. A search of available national online guidelines or recommendations was performed. The Healthy Eating Guide of the Spanish Society of Community Nutrition (SENC), 2018 and the energy requirements of the European Food Safety Authority (2017) for children and adolescents were contemplated, considering a contribution of 15 % of energy as proteins to propose the new recommended egg intake. Two scenarios according to the level of physical activity and three age groups were considered. Based on the current data and evidence, we believe that egg intake recommendations should be reassessed, proposing broader recommendations, especially for children over 13 years old with average energy requirements as well as children over seven years old who perform high physical activity or are in a brief period of growth. It will contribute to breaking down old myths associated with egg consumption and promote the development of coordinated and updated recommendations.

Background and Aims: Inflammation in overweight/obesity may condition the development of insulin resistance (IR). New markers of inflammation and systemic inflammation, such as leukocyte and platelet counts, the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR), could be used as indicators of IR. The aim of the present study was to investigate the relationship between these markers and IR in overweight/obese children., Materials and Methods: A total of 1,035 schoolchildren were studied (398 overweight/obese). Anthropometric, hematological and biochemical measurements were collected. Inflammation was considered to be present when the values of leukocytes, platelets, NLR, PLR and MLR were ≥ p 75 for each sex. IR was defined as HOMA-IR >3.16., Results: In overweight/obese schoolchildren, leukocytes were higher in both boys and girls, and platelets and NLR were higher in boys with IR than in boys with insulin sensitivity. An association between leucocytes and NLR values (≥ p 75) and IR was found in the entire population [2.911 (1.328-6.381); p = 0.008 and 2.660 (1.185-5.968); p = 0.018, respectively] and in boys [9.255 (1.896-45.168); p = 0.006 and 6.996 (1.377-35.544); p = 0.019, respectively]., Conclusion: Elevated white blood cell values and elevated NLR in overweight/obese children, and particularly in boys, could be indicators of the presence of IR in these subjects and should be considered when predicting possible complications, such as type II diabetes mellitus., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Rodríguez-Rodríguez, Salas-González, Ortega and López-Sobaler.)

Introduction: Introduction: childhood obesity is a public health problem whose prevalence has grown steadily in recent decades. Objective: to describe the weight status of schoolchildren aged 6 to 9 years in Spain in 2019, and their associated factors. Methods: ALADINO is a cross-sectional study in schoolchildren aged 6 to 9 years, representative of the Spanish population, and aligned with the Child Obesity Surveillance Initative of the WHO Regional Office for Europe. Participants' weight, height, and abdominal circumference were measured, defining weight status according to different standards (WHO, IOTF, and Orbegozo). A questionnaire on lifestyle and socio-demographic characteristics was administered to parents. Results: a total of 16,665 schoolchildren from 276 schools were measured. Excess weight was observed in 40.6 %: 23.3 % overweight and 17.3 % obesity, with obesity being more prevalent in boys and overweight in girls, both increasing with age. The prevalence of abdominal obesity was 22.6 %. Excess weight decreased by 3.9 percentage points since 2011, mainly due to overweight in boys. Obesity remained stable. Excess weight was more prevalent in schoolchildren with less healthy eating and physical activity habits, and in families with a lower socioeconomic status. Conclusions: the prevalence of excess weight is high, although it has declined since 2011 and remains stable since 2015 among schoolchildren aged 6-9 years in Spain, this reduction being mainly due to a decrease in overweight in children. It is necessary to continue promoting healthy habits from the earliest stages of life, thus reducing health inequalities.

Introduction: Childhood obesity is an important public health problem, also in Spain. The ALADINO study, in the context of the COSI strategy of the WHO European office, monitors the weight status of Spanish schoolchildren aged 6 to 9 years, and analyzes the associated factors. Data from the 2019 wave indicate that 23.3 % of schoolchildren are overweight, and 17.3 % are obese. A high percentage of schoolchildren eat breakfast regularly, although breakfast quality can be improved. The frequency of consumption of fruits and vegetables is low, even lower than that of other countries participating in the COSI strategy. In terms of lifestyle, more than 70 % of schoolchildren are active, although this percentage is lower than the European average. Screen exposure time is also shorter than in other countries, but this habit may be improved in a high percentage of schoolchildren. There is a lower percentage of schoolchildren with obesity who have breakfast or are active compared to those of normal weight, while they are more sedentary, spend fewer hours sleeping, and are more likely to have a TV or electronic devices in their room. It is a priority to promote access to healthier diets and the promotion of more active and less sedentary lifestyles, both in the family and at school, from an early age.

Introduction: The immune system is a complex and integrated system whose main function is to protect the body from external aggression by microorganisms, allergens, or toxic agents. Different studies show that maintaining optimal amounts of different nutrients in the body is essential to ensure the synthesis of different factors related to the immune system. Most interesting nutrients and bioactive compounds include: vitamins A, B6, B12, C, D, E, folic acid (B9) and biotin (B7); minerals such as zinc, iron, selenium, magnesium and copper; proteins (lactoferrin) and bioactive peptides; omega-3 fatty acids; and other nutrients and bioactive compounds such as fiber, polyphenols, carotenoids, probiotics, etc. Following a varied and balanced diet, including the servings recommended by food guides for each food group, is essential to achieve nutrient requirements. Food groups to which special attention should be paid are: fruits and vegetables (because of their high content in micronutrients and antioxidant compounds), fatty fish (because it contains omega-3 fatty acids), and dairy products (because this group contains a large number of nutrients). In particular, milk-especially enriched milk-contains many of the nutrients mentioned above. Moreover, their daily consumption, within a balanced diet, can help significantly cover their nutrient reference values. Finally, it is important to consider kind of milks as a good dietary alternative to increase the intake of some important nutrients for the proper functioning of the immune system, most especially some of them such as vitamin D, since a large percentage of the population have nutritional deficiencies.

Introduction: Age-related macular degeneration (AMD) is an ocular pathology that occurs with excess free radicals, which damages the photoreceptors of the retina producing a disability in the pigment epithelium, which leads, in the most advanced cases, to severe and irreversible vision loss. Lutein and zeaxanthin (L & Z) intake, which are abundant pigments in the macula and have antioxidant and anti-inflammatory action, as well as a role as blue light filter, seem to have a positive effect on the prevention of AMD. These carotenoids cannot be synthesized in the body and must be ingested with the diet. Green leafy vegetables and eggs are the main sources. The former have a higher L & Z content than the latter, but their bioavailability is lower, due to the lipid matrix of the egg yolk, which improves absorption. In relation to the consumption of eggs and AMD prevention, short-term consumption has been associated with an increase in serum concentrations of L & Z, long-term consumption with an increase in the density of macular pigment, and very long- term consumption with a decrease in the risk of developing advanced and neovascular AMD. These facts highlight the advantages of consuming eggs, which should be incorporated into the usual diet in order to minimize the progression of this ocular disease.

Introduction: Zinc is an essential trace element involved in catalytic, structural, and regulatory functions, participating also in the metabolism of nutrients. Its role in insulin resistance appears to be of great importance, as it is involved in oxidative stress, the endocrine regulation of insulin, and the regulation of glucose uptake. For this reason, both intake and serum levels of zinc are inversely related to insulin resistance. Currently, zinc intake in children is low, and zinc deficiency exists in a significant proportion. Zinc can be found in meat, fish, eggs, and dairy products. Although it certainly is present in foods of plant origin, their high phytate contents generally reduce its bioavailability. For this reason, it is important to monitor intake throughout childhood, and to consider supplementation in children with insulin resistance or obesity.

Introduction: Eating breakfast is a healthy habit that should be encouraged since childhood. When it provides nutritional quality, it is an important daily meal. The consumption of dairy products, cereals, and fruits at breakfast is associated with healthier dietary patterns, with a beneficial impact on the overall quality of the diet. In Spain, as in many other countries, the proportion of children who eat breakfast daily is very high, decreasing somewhat in adolescence. However, the quality of breakfast leaves room for improvement, with a low proportion of children/adolescents with high nutritional quality breakfasts. Children/adolescents who eat breakfast regularly have a higher intake of various nutrients (especially vitamins and minerals) than those who do not eat breakfast. Although the evidence is not entirely conclusive, numerous studies have shown various benefits when comparing the population that eats breakfast regularly versus those who do not, such as cardiometabolic risk parameters (obesity, diabetes, blood pressure and lipid profile) and cognitive functions. Breakfast should be included in healthy eating plans, since it allows incorporating foods that are difficult to consume in other meals and may contribute to reducing the risk of developing cardiometabolic diseases. In order to promote the intake of a healthy breakfast, it is essential to act on the sociodemographic and cultural factors that influence compliance and quality, such as age, nutritional education (mainly parents and children/adolescents, but also other family members, school mates, friends...), carrying it out as a family, adapting it to the tastes of each population and balancing quality and costs.

Background: Lockdown due to COVID-19 influenced food habits and lifestyles with potential negative health impact. This study aims to identify patterns of change in eating habits and physical activity during COVID-19 lockdown in Spain and to identify associations with sociodemographic factors and usual habits., Methods: This cross-sectional study included 1155 adults recruited online to answer a 10-section questionnaire. The protocol assessed usual diet by means of a semi-quantitative food frequency questionnaire, usual physical activity (PA) and supplement use, dietary changes, sedentary time, PA, exposure to sunlight, sleep quality, and smoking during confinement. Patterns of dietary change were identified by factor analysis. Factor scores were included in cluster analysis together with change in PA., Results: Six patterns of dietary change were identified that together with PA changes during lockdown defined three clusters of lifestyle change: a cluster less active, a more active cluster, and a third cluster as active as usual. People who were usually less active were more likely to be classified in the cluster that increased physical activity in confinement. Scores of the Healthy Mediterranean-Style dietary pattern were higher in this group. Conclusions: Different patterns of change in lifestyles in confinement suggest the need to tailor support and advice to different population groups.

Introduction: Objective: although osteoporosis develops in advanced stages of life, it must be prevented and stopped from the pediatric age, acting on modifiable factors, especially diet and lifestyle. The objective of this work is to review the latest evidence on nutritional improvements that can help in the prevention and control of the disease. Methods: bibliographic search related to the topic. Results: it is advisable to avoid energy restrictions, especially in postmenopausal women and particularly if they have osteopenia/osteoporosis since, in relation to these pathologies, excess weight may be preferable, rather than underweight. Protein intake higher than the recommended one is beneficial for the bone, provided that the calcium intake is adequate. Excessive intake of sugar and saturated fat should be avoided, but attempts should be made to achieve the nutritional goals set for ω-3 polyunsaturated fatty acids and fiber. It is important to monitor vitamin D status and calcium intake, which is inadequate in high percentages of individuals, as well as improving the contribution of vitamins K, C and group B, and also magnesium, potassium, iron, zinc, copper, fluorine, manganese, silicon and boron, and avoiding the excessive contribution of phosphorus and sodium. Conclusions: osteoporosis is an underdiagnosed pathology and of increasing prevalence. Due to its high morbidity and mortality, prevention is important and, from a nutritional point of view, it is convenient to bring the diet closer to the theoretical ideal. In general, increasing the consumption of dairy products, fish, vegetables and fruits, as well as reducing the consumption of salt, during childhood and throughout life, seems convenient for the bone improvement of most of the population.

Introduction: Choline is a critical nutrient for cognitive development, metabolism and liver function, and regulation of homocysteine metabolism. It is necessary for the synthesis of the neurotransmitter acetylcholine, the synthesis of betaine and that of phosphatidylcholine. In the perinatal stage, the contribution of choline is essential to guarantee optimal cognitive development and prevent neural tube defects. In adults and the elderly, choline intake has been associated with better performance in some cognitive functions and a lower incidence of dementia. Despite their important role in health, most groups of the population do not reach their adequate intake of choline, and even some groups, such as pregnant women or childbearing women, have a higher risk of having suboptimal intakes. The main dietary sources of choline are eggs, dairy and meats, so reducing or limiting the consumption of these foods negatively impacts on the intake of this nutrient. Given the need to improve the intake of this vitamin, it is necessary to increase the knowledge that the population has about this nutrient, raising awareness about the importance of choline for health, and its main food sources.

Introduction: The effect of nutrients on health has been studied traditionally. From this point of view, milk and dairy products contribute to maintaining and improving nutritional status. Due to its high content of some nutrients such as saturated fat, among others, dairy consumption has been linked to the appearance of several diseases such as obesity or cardiovascular disease. However, food cannot be classified as good or bad based on its nutrient content. On the contrary, those interactions between nutrients and other bioactive compounds that occur in the food matrix must also be taken into account, as they can lead to different results than those expected derived from their consumption. In the case of dairy products, the scientific evidence indicates that dairy matrix could play an important role in the prevention of several non-communicable diseases.

The association between breakfast quality and total diet quality of children and adolescents ((1-17.9 years ( n = 1570)) from the National Dietary Survey on the Child and Adolescent Population in Spain (ENALIA) was analyzed. Dietary information was collected using two non-consecutive one-day food diaries (1-10 years old) or two 24 h dietary recalls (>10 years). Breakfast quality index (BQI) and a variant of Nutrient Rich Foods index (NRF9.3) were calculated to assess the total diet quality. Children and adolescents who had breakfast on at least one day ( n = 1561) were divided into two groups according to BQI: Worse Quality Breakfast (WQB) (BQI < 4 points (P66), n = 781) and Good Quality Breakfast (GQB) (BQI ≥ 4, n = 780). Younger children and those whose parents have university education presented higher BQI. GQB group had significantly higher intakes of micronutrients (vitamins A, D, C, B 1 , B 2 , B 6 , niacin, folate, calcium, potassium, magnesium). Fewer GQB children exceeded the Acceptable Macronutrient Distribution Range for fat and had folate and calcium intakes below their estimated average requirement. Daily NRF9.3 was 496.2 ± 54.0, being higher in GQB (503.8 ± 50.6 vs. 488.6 ± 56.2, p < 0.001). Increasing the quality of breakfast increased the possibility of having a NRF9.3 higher than P 50 (OR: 1.893, CI: 1.549-2.315, p < 0.0001). Breakfasts have room for quality improvement in a high percentage of children. A higher quality breakfast is associated with a benefit in the quality of the total diet.

Context: Some studies suggest that consumption of dairy products can aid in weight loss, while others suggest a negative effect or no effect., Objective: An overview of systematic reviews and meta-analyses was conducted to examine the effect of dairy product consumption on changes in body composition., Data Sources: PRISMA guidelines were followed to ensure transparent reporting of evidence. The MEDLINE, Embase, Cochrane Central Database of Systematic Reviews, and Web of Science databases were searched from inception to April 2018., Study Selection: Six systematic reviews and 47 associated meta-analyses (which included the results of 58 different randomized controlled trials) published in English or Spanish and reporting data on dairy intake and changes in weight, fat mass, lean mass, or waist circumference were included., Data Extraction: Two authors independently extracted the data and assessed the risk of bias using the AMSTAR2 tool., Results: Dairy consumption interventions without dietary energy restriction had no significant effects on weight, fat mass, lean mass, or waist circumference. Interventions in energy-restricted settings had significant effects on fat mass and body weight., Conclusions: Increasing total dairy intake without energy restriction in adults does not affect body composition. In the context of an energy-restricted diet, however, increased dairy intake results in lower fat mass and body weight but has no conclusive effects on waist circumference or lean mass., Systematic Review Registration: PROSPERO registration number CRD42018094672., (© The Author(s) 2020. Published by Oxford University Press on behalf of the International Life Sciences Institute. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Background: Electrophysiological studies show that reductions in power within the alpha band are associated with the Alzheimer's disease (AD) continuum. Physical activity (PA) is a protective factor that has proved to reduce AD risk and pathological brain burden. Previous research has confirmed that exercise increases power in the alpha range. However, little is known regarding whether other non-modifiable risk factors for AD, such as increased age or APOE ε4 carriage, alter the association between PA and power in the alpha band., Methods: The relationship between PA and alpha band power was examined in a sample of 113 healthy adults using magnetoencephalography. Additionally, we explored whether ε4 carriage and age modulate this association. The correlations between alpha power and gray matter volumes and cognition were also investigated., Results: We detected a parieto-occipital cluster in which PA positively correlated with alpha power. The association between PA and alpha power remained following stratification of the cohort by genotype. Younger and older adults were investigated separately, and only younger adults exhibited a positive relationship between PA and alpha power. Interestingly, when four groups were created based on age (younger-older adult) and APOE (E3/E3-E3/E4), only younger E3/E3 (least predicted risk) and older E3/E4 (greatest predicted risk) had associations between greater alpha power and higher PA. Among older E3/E4, greater alpha power in these regions was associated with improved memory and preserved brain structure., Conclusion: PA could protect against the slowing of brain activity that characterizes the AD continuum, where it is of benefit for all individuals, especially E3/E4 older adults.

Background: Physical activity plays an important role in the maintenance of health, and it is especially important during childhood. However, the lack of information about differences in physical activity practice and sports preferences of children considering gender differences can result in non-effective policies that enhance inequalities between sexes. The aim of this study is to identify the sports preferences of Spanish schoolchildren and their physical activity practice behaviors depending on their sex and their parental care, analyzing the possible differences from a gender perspective., Method: Three hundred sixty-four Spanish schoolchildren (179 girls, 185 boys) participated in this cross-sectional study. A daily physical activity questionnaire was used to evaluate physical activity level (PAL), moderate-to-vigorous physical activity (MVPA) and sports preferences and a socio-health questionnaire were used to collect data about parental care. Statistical analysis was performed using SPSS and applying Student's T-test for normal variables, Mann-Whitney U-test for non-parametrical variables, and chi-square (χ2) test for categorical variables. Subsequently, odds ratios were used to analyze associations between the physical activity practice of the children and parental care., Results: PAL and time spent in MVPA was significantly lower for girls compared to boys (1.44 ± 0.07 vs. 1.46 ± 0.07, p < 0.001 and 0.74 ± 0.40 h/day vs. 0.90 ± 0.45 h/day; p < 0.001, respectively). Dancing, rhythmic gymnastics, skating, and water sports were practiced more by girls, while football, wrestling sports, handball, and racket sports were practiced more by boys (p < 0.05). Children cared for by their fathers had higher odds for physical activity practice (OR = 1.995 (1.202-3.310), p = 0.008)., Conclusion: Physical activity among girls was less frequent and less intense. Girls opted for individual sports with artistic connotations, while boys often practiced more team contact sports. Furthermore, children are more physically actives when their father is in charge of them.

Bone problems in the population begin to be establish in childhood. The present study aims to assess the usual calcium, phosphorus, magnesium, and vitamin D intakes, along with the food sources of these nutrients, in Spanish children participating in the EsNuPI (Estudio Nutricional en Población Infantil Española) study. Two 24 h dietary recalls were applied to 1448 children (1 to <10 years) divided into two sub-samples: one reference sample (RS) of the general population [ n = 707] and another sample which exclusively included children consuming enriched or fortified milks, here called "adapted milks" (AMS) [ n = 741]. Estimation of the usual intake shows that nutrient intake increased with age for all nutrients except vitamin D. Using as reference the Dietary Reference Values from the European Food Safety Authority (EFSA), calcium and magnesium intakes were found to be below the average requirement (AR) and adequate intake (AI), respectively, in a considerable percentage of children. Furthermore, phosphorus exceeded the AI in 100% of individuals and vitamin D was lower than the AI in almost all children studied. The results were very similar when considering only plausible reporters. When analyzing the food sources of the nutrients studied, milk and dairy products contributed the most to calcium, phosphorus, magnesium, and vitamin D. Other sources of calcium were cereals and vegetables; for phosphorus: meat, meat products, and cereals; for magnesium: cereals and fruits; and, for vitamin D: fish and eggs. These results highlight the desirability of improving the intake concerning these nutrients, which are involved in bone and metabolic health in children. The AMS group appeared to contribute better to the adequacy of those nutrients than the RS group, but both still need further improvement. Of special interest are the results of vitamin D intakes, which were significantly higher in the AMS group (although still below the AI), independent of age.

Background: Neuronal hyperexcitability and hypersynchrony have been described as key features of neurophysiological dysfunctions in the Alzheimer's disease (AD) continuum. Conversely, physical activity (PA) has been associated with improved brain health and reduced AD risk. However, there is controversy regarding whether AD genetic risk (in terms of APOE ε4 carriage) modulates these relationships. The utilization of multiple outcome measures within one sample may strengthen our understanding of this complex phenomenon., Method: The relationship between PA and functional connectivity (FC) was examined in a sample of 107 healthy older adults using magnetoencephalography. Additionally, we explored whether ε4 carriage modulates this association. The correlation between FC and brain structural integrity, cognition, and mood was also investigated., Results: A relationship between higher PA and decreased FC (hyposynchrony) in the left temporal lobe was observed among all individuals (across the whole sample, in ε4 carriers, and in ε4 non-carriers), but its effects manifest differently according to genetic risk. In ε4 carriers, we report an association between this region-specific FC profile and preserved brain structure (greater gray matter volumes and higher integrity of white matter tracts). In this group, decreased FC also correlated with reduced anxiety levels. In ε4 non-carriers, this profile is associated with improved cognition (working and episodic memory)., Conclusions: PA could mitigate the increase in FC (hypersynchronization) that characterizes preclinical AD, being beneficial for all individuals, especially ε4 carriers.

To reduce the sugar content of processed foods through reformulation, the first step is to determine the content of the largest sources of sugars in each country's diet. The aim of this work was to describe the sugar content in the most commonly consumed processed foods in Spain and to compare that sugar's labelling and laboratory analysis values (LVs and AVs, respectively) to confirm its adequacy. A sample of the 1173 most commonly consumed processed foods in Spain (28 groups; 77 subcategories) was collected. For each product, the total sugar content was compared according to its AV and LV. The median (25 th -75 th percentiles, interquartile range) sugar content by group was calculated for the total sample, and the groups were classified as "high sugar content" when this value was above 22.5 g/100g of product. The adequacy of the LV, according to the European Union (EU) tolerance requirements, was then evaluated, and each subcategory median was compared with the AV to determine its appropriateness via a median test for independent samples ( p < 0.05). In total, 10 out of 28 groups presented high sugar content. Moreover, 98.4% of the products met the EU tolerance ranges. Finally, only one subcategory ("cured ham") presented significant differences between the AV and LV median values (0.4 g vs. 0.1 g sugar/100g, p < 0.05). The groups of food products whose sugar content reduction could have the greatest impact on public health were identified. In addition, our study showed the high adequacy of LV with the EU labeling tolerance requirements, as well as the LV's appropriateness as a tool to implement actions aimed at reducing sugar consumption., Competing Interests: The authors declare no conflict of interest.