Perception and knowledge of low- and no-calorie sweeteners in multidisciplinary stakeholders from Spain.

Low- and no-calorie sweeteners (LNCS) as a category are one of the most thoroughly evaluated additives, and thus their safety has been largely recognised. However, their potential risks and benefits generate great controversy and discussion within countries' food policies and public debate. The goal of this study was to evaluate the degree of knowledge and the perception of key Spanish stakeholders about the role of LNCS in diet, their safety, regulatory issues and their impact on health and wellness, as well as to complete a SWOT analysis of the Strengths, Weaknesses, Opportunities and Threats regarding this topic from their perspective. Participants (n = 45 stakeholders) completed an anonymous survey about their knowledge and perception of LNCS, their role in the diet, safety and legislation, as well as health issues and completed a SWOT analysis. Most of them agreed with aspects related to safety guarantees and authorisation procedure of LNCS; however, certain disparity in their opinion in relation to several of the topics was observed, especially regarding the possible role of LNCS in diet quality and health. Effective communication strategies to inform professionals and the general population, as well as new research that deepens our knowledge of the role of LNCS in weight management and other health outcomes seem to be urgently needed.

Association between Hydration Status and Body Composition in Healthy Adolescents from Spain.

At present, obesity and overweight are major public health concerns. Their classical determinants do not sufficiently explain the current situation and it is urgent to investigate other possible causes. In recent years, it has been suggested that water intake could have important implications for weight management. Thus, the aim of this study was to examine the effect of hydration status on body weight and composition in healthy adolescents from Spain. The study involved 372 subjects, aged 12-18 years. Water intake was assessed through the validated "hydration status questionnaire adolescent young". Anthropometric measurements were performed according to the recommendations of the International Standards for Anthropometric Assessment (ISAK) and body composition was estimated by bioelectrical impedance analysis. Water intake normalized by body weight was positively correlated with body water content (boys (B): r = 0.316, p = 0.000; girls (G): r = 0.245, p = 0.000) and inversely with body mass index (BMI) (B: r = -0.515, p = 0.000; G: r = -0.385, p =0.000) and fat body mass (B: r = -0.306, p = 0.000; G: r = -0.250, p = 0.001). Moreover, according to BMI, overweight/obese individuals consumed less water than normal weight ones. In conclusion, higher water balance and intake seems to be related with a healthier body composition. In conclusion, higher water balance and intake is associated with a healthier body composition.

Influence of Water Intake and Balance on Body Composition in Healthy Young Adults from Spain.

The increasing prevalence of overweight and obesity has become an epidemic public health problem worldwide. In the last years, several investigations have suggested that water intake and retention could have important implications for both weight management and body composition. However, there is a lack of information about this issue globally, and mainly specifically in Spain. Thus, the aim of this study was to analyze the association between hydration status and body composition in a sample of healthy Spanish adults. The study involved 358 subjects, aged 18-39 years. The recently validated "hydration status questionnaire" was used to assess their water intake, elimination, and balance. Anthropometric measurements were performed according to the recommendations of the International Standards for Anthropometric Assessment (ISAK). Body composition variables were acquired by bioelectrical impedance analysis. Differences in anthropometric and body composition variables were assessed through the ANOVA test and considered significant at p < 0.05. Fluid intake was correlated with body water content. Inverse associations between water consumption, normalized by weight, with body weight, body fat mass, and waist circumference were found. Moreover, according to water balance, significant differences in body water content in females were observed. In conclusion, higher fluid intake seems to be related with a healthier body composition. Therefore, the improvement of water intake and water balance could be useful for overweight and obesity prevention, although further studies are needed to confirm the present findings.

Validated questionnaire to assess the hydration status in a healthy adult Spanish population: a cross sectional study / Validación de un cuestionario para evaluar el estado de hidratación de una población adulta sana española: un estudio transversal

Introduction: adequate hydration status is crucial in most physiological functions; conversely, its assessment is hindered by the limited availability of research tools. Objective: to develop and validate a novel questionnaire that evaluates the hydration status of a healthy adult Spanish population. Method: a novel questionnaire was designed and validated relying on biochemical parameters related to blood, urine, and body water content. The study involved 39 healthy subjects aged between 18 and 39 years. Food and beverage consumption were assessed by the novel questionnaire and through a three-day dietary record. Physical activity was assessed using both: accelerometers and the Short International Physical Activity Questionnaire (IPAQ). Validity was determined by correlation of the aforementioned parameters with the water balance and water intake obtained by the novel questionnaire. The questionnaire was administered twice over the course of 28 days to evaluate its reliability. Results: water balance and total water intake were correlated with specific gravity, and urine color. Water intake obtained by the novel questionnaire was correlated with water intake results from the three-day dietary record. Intraclass correlation coefficient indicated moderate concordance between both recordings, and the Cronbach's alpha revealed high consistency. Finally, the Bland and Altman method indicated that the limits of agreement were acceptable to reveal the reliability of the estimated measures. Conclusions: the questionnaire designed is a new valid and reliable screening tool to estimate hydration status of adult populations in dietary and nutritional assessment

Introducción: un estado hídrico adecuado es crucial para la mayoría de funciones fisiológicas; sin embargo, su evaluación se encuentra obstaculizada por la escasez de herramientas de diagnóstico e investigación. Objetivos: desarrollar y validar un cuestionario que permita evaluar el estado hídrico de población española adulta sana. Métodos: un nuevo cuestionario ha sido diseñado y validado a través de parámetros bioquímicos en orina y sangre y contenido en agua corporal. El estudio incluyó finalmente a 39 sujetos sanos con edades comprendidas entre 18 y 39 años. El consumo de alimentos y bebidas se evaluó empleando el nuevo cuestionario y un diario dietéticos de tres días. La actividad física fue estimada a través de acelerometría y con el Cuestionario Internacional de Actividad Física (IPAQ). La validez se determinó analizando la correlación de los parámetros citados, con el balance y con la ingesta hídrica. El cuestionario fue administrado por duplicado, con un transcurso de 28 días entre ambas cumplimentaciones para evaluar su reproducibilidad. Resultados: el balance y la ingesta hídrica se correlacionaron con la gravedad específica y con el color de la orina. La ingesta hídrica se correlacionó con los resultados procedentes del diario dietético. Según el coeficiente de correlación intraclase, la concordancia entre ambas cumplimentaciones fue moderada y el alfa de Cronbach indicó consistencia elevada. El método Bland-Altman mostró que los límites de confianza eran aceptables para revelar la reproducibilidad de las medidas estimadas. Conclusiones: el cuestionario diseñado constituye una herramienta de cribado válida y fiable para estimar el estado hídrico de población adulta sana

Validated questionnaire to assess the hydration status in a healthy adult Spanish population: a cross sectional study.

INTRODUCTION: Introduction: adequate hydration status is crucial in most physiological functions; conversely, its assessment is hindered by the limited availability of research tools. Objective: to develop and validate a novel questionnaire that evaluates the hydration status of a healthy adult Spanish population. Method: a novel questionnaire was designed and validated relying on biochemical parameters related to blood, urine, and body water content. The study involved 39 healthy subjects aged between 18 and 39 years. Food and beverage consumption were assessed by the novel questionnaire and through a three-day dietary record. Physical activity was assessed using both: accelerometers and the Short International Physical Activity Questionnaire (IPAQ). Validity was determined by correlation of the aforementioned parameters with the water balance and water intake obtained by the novel questionnaire. The questionnaire was administered twice over the course of 28 days to evaluate its reliability. Results: water balance and total water intake were correlated with specific gravity, and urine color. Water intake obtained by the novel questionnaire was correlated with water intake results from the three-day dietary record. Intraclass correlation coefficient indicated moderate concordance between both recordings, and the Cronbach's alpha revealed high consistency. Finally, the Bland and Altman method indicated that the limits of agreement were acceptable to reveal the reliability of the estimated measures. Conclusions: the questionnaire designed is a new valid and reliable screening tool to estimate hydration status of adult populations in dietary and nutritional assessment.

INTRODUCCIÓN: Introducción: un estado hídrico adecuado es crucial para la mayoría de funciones fisiológicas; sin embargo, su evaluación se encuentra obstaculizada por la escasez de herramientas de diagnóstico e investigación. Objetivos: desarrollar y validar un cuestionario que permita evaluar el estado hídrico de población española adulta sana. Métodos: un nuevo cuestionario ha sido diseñado y validado a través de parámetros bioquímicos en orina y sangre y contenido en agua corporal. El estudio incluyó finalmente a 39 sujetos sanos con edades comprendidas entre 18 y 39 años. El consumo de alimentos y bebidas se evaluó empleando el nuevo cuestionario y un diario dietéticos de tres días. La actividad física fue estimada a través de acelerometría y con el Cuestionario Internacional de Actividad Física (IPAQ). La validez se determinó analizando la correlación de los parámetros citados, con el balance y con la ingesta hídrica. El cuestionario fue administrado por duplicado, con un transcurso de 28 días entre ambas cumplimentaciones para evaluar su reproducibilidad. Resultados: el balance y la ingesta hídrica se correlacionaron con la gravedad específica y con el color de la orina. La ingesta hídrica se correlacionó con los resultados procedentes del diario dietético. Según el coeficiente de correlación intraclase, la concordancia entre ambas cumplimentaciones fue moderada y el alfa de Cronbach indicó consistencia elevada. El método Bland-Altman mostró que los límites de confianza eran aceptables para revelar la reproducibilidad de las medidas estimadas. Conclusiones: el cuestionario diseñado constituye una herramienta de cribado válida y fiable para estimar el estado hídrico de población adulta sana.

[Strengths and weaknesses of food and diet in the Spanish population of the 21st century]. / Fortalezas y debilidades de la alimentación en la población española del siglo XXI.

INTRODUCTION: Introduction: at present, it is precisely the Mediterranean countries whose characteristic lifestyle was recognized as a health paradigm and promoted to the rest of the world, those who are at mostly at risk, in which it becomes necessary the immediate development of strategies based on education that may contribute to the adoption of a healthier diet and lifestyle. Objectives: to review the current dietary patterns in Spain, as well as its evolution in the last years. Methods: review of the studies that have been published in relation to the subject. Results: changes in the diet and lifestyle that have been introduced in recent years in Spain have led to a gradual decreased in the consumption of cereals and derivatives, potatoes and legumes, whereas an increase in the intake of meats and meat derivatives and non-alcoholic drinks has occurred. From the nutritional point of view, these trends resulted in an increase of the proportion of total fats (mainly saturated) and proteins (highly in those of animal origin) in the diet while complex carbohydrates have experienced a decrease (accompanied by a higher consumption of total sugars, including added ones). At the same time, the Spanish society should be considered as with a sedentary behavior. These facts have as one of the main negative consequences that Spain show one of the highest prevalence rates of childhood obesity in Europe, but also in adults. Conclusions: in this context, there is a need to promote the recovery of our culture (Mediterranean diet), and to return to feed and live according to patterns that have kept us protected during generations of many diseases. In fact, it should be important to try to answer the following question: If not so many years ago we had a food model that fulfilled all the recommendations of a healthy diet, which are the main barriers at present from returning to it?

INTRODUCCIÓN: Introducción: en la actualidad, son precisamente los países mediterráneos, cuyo estilo de vida característico fue reconocido como paradigma de salud y promocionado al resto del mundo, los que se encuentran en situación de riesgo, en la que se hace necesario el desarrollo inmediato de estrategias que contribuyan a la adopción de hábitos saludables de vida. Objetivos: revisar los patrones de la dieta actual en España, así como su evolución en los últimos años. Métodos: revisión bibliográfica relacionada con el tema. Resultados: los cambios en el estilo de vida que han ido introduciéndose poco a poco en los últimos años han propiciado una progresiva disminución en el consumo de cereales y derivados, patatas y legumbres, y un aumento de la ingesta de carnes rojas y derivados. Desde el punto de vista nutricional, esta tendencia se ha traducido en un incremento de la dieta en grasa y proteínas, en detrimento de los hidratos de carbono complejos (y un incremento asociado de los azúcares totales, incluidos los añadidos). Al mismo tiempo, la población española, con independencia de la edad, muestra un comportamiento mayoritariamente sedentario. Todo lo anterior ha propiciado que España se encuentre en una situación preocupante, puesto que contamos con una de las tasas de prevalencia de obesidad infantil y juvenil más elevadas de toda Europa, fenómeno que también resulta grave en la población adulta. Conclusiones: se constata la necesidad de favorecer la recuperación de nuestra cultura alimentaria, a través de la educación, y de volver a alimentarnos y a vivir de acuerdo con unos patrones que nos han mantenido protegidos durante generaciones, tratando de responder a la siguiente pregunta: si no hace tantos años llevábamos una alimentación que cumplía con las recomendaciones de dieta saludable, ¿qué nos impide volver a ella?

Adaptation and Validation of the Hydration Status Questionnaire in a Spanish Adolescent-Young Population: A Cross Sectional Study.

The achievement of adequate hydration status is essential for mental and physical performance and for health in general, especially in children and adolescents. Nevertheless, little is known about hydration status of this population, mainly due to the limited availability of research tools; thus, the objective of the current study was to adapt and validate our hydration status questionnaire in a Spanish adolescent-young population. The questionnaire was validated against important hydration markers: urine colour, urine specific gravity, haemoglobin, haematocrit and total body water and involved 128 subjects aged between 12⁻17 years. Water intake was also estimated through a three-day dietary record and physical activity was assessed through accelerometers. Participants completed the questionnaire twice. Water balance and water intake were correlated with urine specific gravity and with total body water content. Water intake obtained by the questionnaire was correlated with results from the three-day dietary record. The intraclass correlation coefficient indicated moderate concordance between both recordings and the Cronbach's alpha revealed high consistency. The Bland and Altman method indicated that the limits of agreement were acceptable to reveal the reliability of the estimated measures. In conclusion, this is the first time that a questionnaire is valid and reliable to estimate hydration status of adolescent-young populations.