The ANIBES Study on Energy Balance in Spain: design, protocol and methodology.

Energy Balance (EB) is an important topic to understand how an imbalance in its main determinants (energy intake and consumption) may lead to inappropriate weight gain, considered to be "dynamic" and not "static". There are no studies to evaluate EB in Spain, and new technologies reveal themselves as key tools to solve common problems to precisely quantify energy consumption and expenditure at population level. The overall purpose of the ANIBES ("Anthropometry, Intake and Energy Balance") Study was to carry out an accurate updating of food and beverage intake, dietary habits/behaviour and anthropometric data of the Spanish population (9-75 years, n=2009), as well as the energy expenditure and physical activity patterns. Anthropometry measurements (weight, height, body mass index, waist circumference, % body fat, % body water) were obtained; diet was evaluated throughout a three-day dietary record (tablet device) accompanied by a 24 h-dietary recall; physical activity was quantified by questionnaire and accelerometers were also employed. Finally, information about perception and understanding of several issues related to EB was also obtained. The ANIBES study will contribute to provide valuable useful data to inform food policy planning, food based dietary guidelines development and other health oriented actions in Spain.

[Orthorexia or when a healthy diet becomes an obsession]. / Ortorexia o la obsesión por la dieta saludable.

Orthorexia is an obsessive-compulsive process characterized by extreme care for and selection of what is considered to be pure 'healthy' food. This ritual leads to a very restrictive diet and social isolation as a compensation. Orthorexics obsessively avoid foods which may contain artificial colours, flavours, preservant agents, pesticide residues or genetically modified ingredients, unhealthy fats, foods containing too much salt or too much sugar and other components. The way of preparation, kitchenware and other tools used are also part of the obsessive ritual. People with orthorexia often have a history or features in common with anorexic patients. They are very careful, detailed and tidy persons with an exagerated need for selfcare and protection. Women, adolescents and those who practice sports suchs as bodybuidling or ahthetics are the gruops at higher risk. A short test has been suggested as a screening tool and useful for early diagnosis of the disorder. Treatment of orthorexia require a multidisciplinary team involving physicians, psychoterapists and dietitians. In some cases, antiserotoninergic drugs may be required as part of the treatment.

Nutrient adequacy in Spanish children and adolescents.

The nutritional intakes of the Spanish child and adolescent population are presented, as well as the population at risk of inadequate nutrient status. A random sample of 3534 people aged 2-24 years were interviewed between 1998 and 2000. Interviews included two 24 h recalls and a general questionnaire and anthropometric evaluations for the entire sample. After excluding under-reporters (18.7 %), the final sample was 2855 individuals (1348 males and 1507 females). The average intake of energy was 9543 kJ in males and 7804 kJ in females, with important variations seen by age group. Energy intake increased with age in both sexes until 14-17 years, which also applied to almost all of the nutrients studied, with the exception of vitamin C. A decreasing trend in the percentage of energy from carbohydrates was seen in both sexes. At the low socioeconomic level, it was observed that all nutrient intakes were less favourable when compared with higher socioeconomic levels. Nutrients with associated intakes below one-third of the Spanish recommended nutrient intake (RNI) included vitamin D (42 % of the sample) and folate (10 % of females), and the percentages falling below two-thirds of the RNI corresponded to: vitamin D (97 %), vitamin A (60 %), vitamin E (54 %), folate (58 % of females), Fe (23 % of females), vitamin C (8 %), Mg (4.5 %), Ca (5 % of females) and vitamin B6 (5 % of females). Adolescents aged between 14 and 17 years was the group with the highest nutritional risk, especially among girls. Nutritional adequacy in Spanish children was, in general, adequate, although it is necessary to analyse the implications of high inadequate intakes of vitamins D, E and A, which means that the current recommended intakes should be reconsidered. It should be noted that folate levels should be doubled in the near future.