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González-Gil EM, Santabárbara J, Ruiz JR, Bel-Serrat S, Huybrechts I, Pedrero-Chamizo R, de la O A, Gottrand F, Kafatos A, Widhalm K, Manios Y, Molnar D, De Henauw S, Plada M, Ferrari M, Palacios Le Blé G, Siani A, González-Gross M, Gómez-Martínez S, Marcos A, Moreno Aznar LA. Ideal cardiovascular health and inflammation in European adolescents: The HELENA study. Nutr Metab Cardiovasc Dis 2017; 27:447-455. [PMID: 28416098 DOI: 10.1016/j.numecd.2016.12.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2016] [Revised: 12/13/2016] [Accepted: 12/14/2016] [Indexed: 11/21/2022]
Abstract
BACKGROUND AND AIMS Inflammation plays a key role in atherosclerosis and this process seems to appear in childhood. The ideal cardiovascular health index (ICHI) has been inversely related to atherosclerotic plaque in adults. However, evidence regarding inflammation and ICHI in adolescents is scarce. The aim is to assess the association between ICHI and inflammation in European adolescents. METHODS AND RESULTS As many as 543 adolescents (251 boys and 292 girls) from the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study, a cross-sectional multi-center study including 9 European countries, were measured. C-reactive protein (CRP), complement factors C3 and C4, leptin and white blood cell counts were used to compute an inflammatory score. Multilevel linear models and multilevel logistic regression were used to assess the association between ICHI and inflammation controlling by covariates. Higher ICHI was associated with a lower inflammatory score, as well as with several individual components, both in boys and girls (p < 0.01). In addition, adolescents with at least 4 ideal components of the ICHI had significantly lower inflammatory score and lower levels of the study biomarkers, except CRP. Finally, the multilevel logistic regression showed that for every unit increase in the ICHI, the probability of having an inflammatory profile decreased by 28.1% in girls. CONCLUSION Results from this study suggest that a better ICHI is associated with a lower inflammatory profile already in adolescence. Improving these health behaviors, and health factors included in the ICHI, could play an important role in CVD prevention.
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Affiliation(s)
- E M González-Gil
- GENUD "Growth, Exercise, NUtrition and Development" Research Group, Faculty of Health Sciences, Universidad de Zaragoza, Spain; Instituto Agroalimentario de Aragón (IA2), Spain; Instituto de Investigación Sanitaria Aragón (IIS Aragón), Spain; Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Spain.
| | - J Santabárbara
- Department of Preventive Medicine and Public Health, University of Zaragoza, Zaragoza, Spain
| | - J R Ruiz
- PROmoting FITness and Health through physical activity research group (PROFIT), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - S Bel-Serrat
- GENUD "Growth, Exercise, NUtrition and Development" Research Group, Faculty of Health Sciences, Universidad de Zaragoza, Spain
| | - I Huybrechts
- International Agency for Research on Cancer (IARC), Lyon, France; Department of Public Health, Ghent University, Ghent, Belgium
| | - R Pedrero-Chamizo
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Spain; ImFine Research Group, Facultad de Ciencias de la Actividad Física y del Deporte-INEF, Universidad Politécnica de Madrid, Madrid, Spain
| | - A de la O
- Department of Medical Physiology, School of Medicine, University of Granada, Granada, Spain
| | - F Gottrand
- Univ Lille 2, INSERM U995, CHU, Lille, France
| | - A Kafatos
- Preventive Medicine and Nutrition Unit, School of Medicine, University of Crete, Crete, Greece
| | - K Widhalm
- Department of Pediatrics, Division of Clinical Nutrition, Medical University of Vienna, Vienna, Austria
| | - Y Manios
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - D Molnar
- Department of Pediatrics, University of Pecs, Pecs, Hungary
| | - S De Henauw
- Department of Public Health, Ghent University, Ghent, Belgium
| | - M Plada
- Preventive Medicine and Nutrition Unit, School of Medicine, University of Crete, Crete, Greece
| | - M Ferrari
- Research Center for Food and Nutrition, Council for Agricultural Research and Economics, Rome, Italy
| | - G Palacios Le Blé
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Spain; ImFine Research Group, Facultad de Ciencias de la Actividad Física y del Deporte-INEF, Universidad Politécnica de Madrid, Madrid, Spain
| | - A Siani
- Unit of Epidemiology and Population Genetics, Institute of Food Sciences, National Research Council, Avellino, Italy
| | - M González-Gross
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Spain; ImFine Research Group, Facultad de Ciencias de la Actividad Física y del Deporte-INEF, Universidad Politécnica de Madrid, Madrid, Spain
| | - S Gómez-Martínez
- Immunonutrition Group, Institute of Food Science, Technology and Nutrition. (ICTAN), Spanish National Research Council (CSIC), Madrid, Spain
| | - A Marcos
- Immunonutrition Group, Institute of Food Science, Technology and Nutrition. (ICTAN), Spanish National Research Council (CSIC), Madrid, Spain
| | - L A Moreno Aznar
- GENUD "Growth, Exercise, NUtrition and Development" Research Group, Faculty of Health Sciences, Universidad de Zaragoza, Spain; Instituto Agroalimentario de Aragón (IA2), Spain; Instituto de Investigación Sanitaria Aragón (IIS Aragón), Spain; Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Spain
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Ayerza Casas A, Rodríguez Martínez G, Samper Villagrasa MP, Murillo Arnal P, Alvarez Sauras ML, Moreno Aznar LA, Olivares López JL. [Nutritional characteristics of newborns of overweight and obese mothers]. An Pediatr (Barc) 2011; 75:175-81. [PMID: 21514908 DOI: 10.1016/j.anpedi.2011.03.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2010] [Revised: 02/09/2011] [Accepted: 03/07/2011] [Indexed: 10/17/2022] Open
Abstract
INTRODUCTION Maternal nutritional status is an important factor of adequate intrauterine growth and neonatal weight. The aim of this study is to evaluate the relationship between pre-gestational BMI (Body Mass Index) and breastfeeding duration, as well as infant anthropometric measurements during their first six months of life. MATERIALS AND METHODS Anthropometric measurements and the type of feeding were evaluated in a representative sample of 1,547 newborns from our population during 2009, according to their maternal BMI, and also in a sub-cohort of 759 infants followed up to 6 months of life. RESULTS A total of 72.9% of women had a normal weight, 18.7% were overweight and 8.4% obese. Women with a BMI ≥ 25 kg/m(2) had lower weight gain during pregnancy (P < .001), lower socioeconomic and cultural level (P < .001), and their infants had higher weight at delivery (P=.003) and at 6 months of life, with no differences in body length. Newborn weight increased in relation to maternal BMI, but over 35 kg/m(2) it decreased progressively (P < .001). Breastfeeding prevalence in obese women was 58.5% at hospital postpartum discharge, and 8.6% at six months of life; as opposed to 70.8% and 13.9%, respectively in women with normal BMI. CONCLUSIONS In our sample, maternal obesity is associated with a low socioeconomic and cultural level, higher infant weight at delivery and at 6 months of life, and less prevalence of exclusive breastfeeding; all of them nutritional risk factors in the short and long term.
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Affiliation(s)
- A Ayerza Casas
- Departamento de Pediatría, Radiología y Medicina Física, Universidad de Zaragoza, Hospital Clínico Universitario Lozano Blesa, España.
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Tomás Aznar C, Moreno Aznar LA, Germán Bes C, Alcalá Nalváiz T, Andrés Esteban E. [Dependence and necessities of non-covered services for the elderly in a health sector of Zaragoza]. Rev Esp Salud Publica 2002; 76:215-26. [PMID: 12092468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Abstract
BACKGROUND Dependency to carry out the activities of daily living (ADL) and home care needs of older adults depend upon factors which are not well understood. Caregiving is mainly provided by the family. The aim of this study is to estimate the prevalence of ADL dependence and associated factors among older adults and to identify associated factors with unmet home care needs in people over age 75 in Zaragoza (Spain). METHOD A cross-sectional study was conducted on a representative sample of the community dwelling population over age, 75 in one Health Care District in Saragossa in 1998 (n = 351). Data were collected during a personal interview. ADL dependency was assessed by the Katz index. Home care needs were assessed using prevalent norms for desired frequency of care. Sources of informal care, socio-demographic characteristics, self-rated health and depression (Yesavage Geriatric Depression Scale) were considered independent variables. Logistic regression was used to identify factors associated with both ADL dependency and unmet home care needs. RESULTS Prevalence of ADL dependence is 37.3%. The variables predicting ADL dependence are the perception of poor health, depression, being a female and being over 85 years of age. The prevalence of unmet care needs among ADL dependent individuals is 22.1%. Sources of help are limited to the families. Being a woman and living alone are the stronger risk factors for unmet needs. CONCLUSIONS A high percentage of older adults are dependent. Informal support is insufficient and confined to the family. The social and health care system in Spain should provide to the family, emotional, financial and social support and special care for disabled people living alone and with limited material resources.
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Affiliation(s)
- Concepción Tomás Aznar
- Escuela Universitaria de Ciencias de la Salud Universidad de Zaragoza C/Domingo Miral, s/n 50009 Zaragoza.
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Moreno Aznar LA, Fleta Zaragozano J, Rodríguez Martínez G, Sarría Chueca A, Bueno Sánchez M. [Body fat mass in boys and male adolescents]. An Esp Pediatr 1999; 51:629-32. [PMID: 10666896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
OBJECTIVE To describe the proportion of body fat mass, quantified from the measurement of 4 skinfold thickness, in a sample of male children of Zaragoza. METHODS In 1995, we have studied 701 males aged 6.0 to 14.9 years, from 6 schools of the province of Zaragoza. We have measured: weight, height, and biceps, triceps, subscapular and suprailiac skinfold thicknesses. Body density has been calculated from the 4 skinfold measurements, with the formulas of Sarría et al. Fat mass (%), was calculated with the Weststrate and Deurenberg's formulas. In each age group, we present mean, standard deviation and 5, 25, 50, 75 and 95th percentiles. RESULTS We present mean, standard deviation and 5, 25, 50, 75 and 95th percentiles of body fat mass (%), in each age group. Body fat mass (%) progressively increased until 10.5 years and, after, progressively decrease at least until 14.5 years. CONCLUSIONS We present data of body fat mass (%), calculated from the measurement of 4 skinfold thicknesses, obtained from a reference population in the province of Zaragoza. These data are useful as more rationale criteria in the diagnosis of obesity in children and adolescents.
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Ramo Herrero MJ, Moreno Aznar LA, Sarría Chueca A, Celma Delgado MT, Lázaro Almarza A, Giner Soria A, Bueno Sánchez M. [Effect of apolipoprotein E phenotypes on the response to dietary treatment of children with hypercholesterolemia]. An Esp Pediatr 1999; 51:262-6. [PMID: 10575749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
OBJECTIVE Our objective was to determine if apo E phenotypes have any effect on the serum lipoprotein response to dietary intervention in children with hypercholesterolemia. PATIENTS AND METHODS We have selected 76 children with total serum cholesterol levels higher than 200 mg/dL. At diagnosis, each patient met with a member of our clinic that established dietary recommendations (total and saturated fat intake: 30 and 10%, respectively, of total energy intake). At diagnosis and after 6 months of therapy we determined a lipoprotein profile. RESULTS After 6 months of therapy, there was only a significant change in children with phenotype E3/E4, with significant decreases in serum total cholesterol (from 247 +/- 43 to 231 +/- 47 mg/dL, p = 0.002), LDL-cholesterol (from 164 +/- 47 to 149 +/- 48 mg/dL, p = 0.002) and triglycerides (from 81 +/- 36 to 71 +/- 31 mg/dL, p = 0.028) concentrations. Absolute and % delta differences in serum lipoprotein concentrations before and after dietary treatment do not show significant differences between apo E phenotype groups. CONCLUSIONS In the group studied, apo E phenotypes do not determine the response to a low-fat, low-cholesterol diet in children with hypercholesterolemia. To know the factors that determine the variability in the response to dietary intervention in children with hypercholesterolemia it would be interesting to study other familial and genetic factors.
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Affiliation(s)
- M J Ramo Herrero
- Departamento de Bioquímica, Facultad de Medicina, Universidad de Zaragoza
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Moreno Aznar LA, Fleta Zaragozano J, Mur de Frenne L, Feja Solana C, Rodríguez Martínez G, Sarría Chueca A, Bueno Sánchez M. [Fat distribution in children and adolescents of both sexes]. An Esp Pediatr 1998; 49:135-9. [PMID: 9773547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/11/2023]
Abstract
OBJECTIVE The aim of this study was to describe anthropometric indexes of fat distribution in 6.0 to 14.9 year old children and to estimate the timing of differentiation of fat patterning in male and female children and adolescents. PATIENTS AND METHODS We have studied a sample of 1,360 children (701 boys and 659 girls) from Zaragoza, Spain. We have measured triceps and subscapular skinfold thicknessess and waist and hip circumferences. With these measurements, we have calculated the indexes of fat distribution including waist-to-hip circumference ratio and triceps-to-subscapular skinfold thickness ratio. We present the percentiles of these indexes. RESULTS All percentiles of the waist-to-hip ratio were higher in males than in females. Percentiles 5, 50 and 95 of the triceps-to-subscapular skinfold thickness ratio showed similar values in males and females, except that percentile 95 was higher in males than in females after 10.5 years. CONCLUSIONS The waist-to-hip ratio seems to define earlier the pattern of fat distribution in children than does the triceps-to-subscapular skinfold thickness ratio. If we take into account the waist-to-hip ratio, the pattern of fat distribution is already present in school age children.
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Affiliation(s)
- L A Moreno Aznar
- Departamento de Pediatría, E.U. de Ciencias de la Salud, Universidad de Zaragoza
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Rodríguez Martínez G, Sarría Chueca A, Fleta Zaragozano J, Moreno Aznar LA, Bueno Sánchez M. [Exploration of the nutritional status and body composition]. An Esp Pediatr 1998; 48:111-5. [PMID: 9577016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Sarría Chueca A, Martín Nasarre de Letosa MT, Lomba García B, Moreno Aznar LA, Lázaro Almarza A, Bueno Sánchez M. [Lipoprotein profile determinants in children and adolescents from a lipid consultation clinic. The impact of diet, body composition and physical activity]. An Esp Pediatr 1997; 47:357-62. [PMID: 9499301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Diet, physical activity, physical fitness and body composition are factors that contribute to lipid disorders; however, we do not know whether they are relevant in children of the general population and in children with dyslipoproteinemias. PATIENTS AND METHODS We have studied all of these factors in 89 children, aged 4.0 to 20.0 years. Children were divided into two groups: 1) Normocholesterolemics (total cholesterol < 225 mg/dL) and 2) Hypercholesterolemics (total cholesterol > or = 225 mg/dL). RESULTS In normocholesterolemic children, the main determinants of total and low-density lipoprotein cholesterol were height and cholesterol intake, which explained both 50 and 32% of its variability, respectively. The main determinants of high density lipoprotein cholesterol were blood pressure after submaximal loading and fat mass, which explained 50% of the variability. In hypercholesterolemic children, fat and carbohydrate intake and physical activity explained more than 90% of the variability of total and low density lipoprotein cholesterol. Resting energy expenditure explained 40% of the variability of high density lipoprotein cholesterol. CONCLUSIONS In the treatment of children and adolescents with dyslipoproteinemias, we must emphasize not only dietary intake, but also physical activity. To increase high density lipoprotein cholesterol we must also improve physical fitness and decrease the amount of body fat mass.
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Affiliation(s)
- A Sarría Chueca
- Departamento de Pediatria, Hospital Clínico Universitario Lozano Blesa, Zaragoza
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Fleta Zaragozano J, Moreno Aznar LA, Mur de Frenne L, Bueno Lozano M, Feja Solana C, Sarría Chueca A, Bueno Sánchez M. [Assessment of the submandibular adipose skinfold for the determination of a nutritional status in children and adolescents]. An Esp Pediatr 1997; 47:258-62. [PMID: 9499277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE The aim of this study was to show the validity of a new skinfold thickness for measuring nutritional status in children. We also compare submandibular skinfold thickness with other anthropometric measures and indices. PATIENTS AND METHODS We have studied 899 boys and 837 girls between 3.0 and 15.1 years of age. All of them were healthy and from different socioeconomic statuses. We measured weight, height, obesity indices, circumferences, indices of body fat distribution and indices of body fat. Data were divided according to age and sex. We calculated the percentiles of submandibular skinfold thickness and correlations between this parameter and all other measurements were performed. The mean values of the two sexes were compared by using Student's t-test. RESULTS Submandibular skinfold is an easy and fast skinfold to measure. Its value is maximum at 10 and 11 years in girls and boys, respectively. This measurement is higher in girls than in boys at 5, 7, 10, 13 and 14 years of age (p < 0.05). There was a high correlation between this skinfold value and almost all of the measurements and indices studied, especially with the body mass index (r = 0.589), the sum of the four conventional skinfolds (r = 0.844), arm circumference (r = 0.513), arm fat area (r = 0.776) and percentage body fat (r = 0.830). CONCLUSIONS Submandibular skinfold thickness in children and adolescents shows a high correlation with body fat indices. It is for this reason that it could be used as a new measurement to assess nutritional status and obesity in children.
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Affiliation(s)
- J Fleta Zaragozano
- Departamento de Pediatría, Hospital Clínico Universitario Lozano Blesa, Escuela Universitaria de Ciencias de la Salud, Universidad de Zaragoza
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