Prevalence of obesity and related factors in schoolchildren aged 3 to 4 years.

OBJECTIVE: To describe the prevalence of obesity and analyse possible differences in it according to sociodemographic characteristics, diet, physical activity, screen use and family perception of the weight and dietary habits of schoolchildren aged 3 to 4 years in Barcelona. METHODS: We conducted a cross-sectional study in a representative sample of schools selected based on the socioeconomic status (SES) of the corresponding neighbourhood and school ownership. We selected 101 schools in Barcelona and recruited pupils aged 3 to 4 years during the 2016-17 academic year (n = 2936 children). Anthropometric measurements were taken in each participant. Family members completed a questionnaire on eating habits, physical activity, sleeping hours, screen use and the family's perception of the child's weight and diet. The primary variable was the body mass index (BMI) for age and sex, subsequently categorised as normal weight, overweight or obese. RESULTS: Approximately 7.0% of girls and 7.1% of boys aged 3 to 4 years presented obesity. The prevalence of obesity (8.3%) was higher in neighbourhoods of lower SES compared to those of higher SES (5.2%; p = .004). Parents of children with obesity reported that the child had some excess weight or excess weight in 46.9% of cases, 3.9% indicated the child's weight was appropriate and 0.9% that the child was a little underweight or underweight (p < .001). DISCUSSION: The prevalence of obesity in children aged 3 to 4 years is high. There are social and geographical inequalities, and obesity was more prevalent in areas of lower SES. A large percentage of the families of children with obesity do not consider that the child's weight is excessive.

Predictors of adherence to follow-up and treatment success in childhood obesity.

INTRODUCTION: Management of childhood obesity, based upon behavioural, physical activity and dietary guidance, usually achieves limited success and is hindered by a high attrition rate. The identification of potential predictors of either weight loss or early weight management attrition could help develop personalised management plans in order to improve patient outcomes. PATIENTS AND METHODS: We conducted a retrospective study in a cohort of 1300 patients with obesity managed in speciality clinics for up to 5 years with outpatient conservative treatment. We studied the family background and personal characteristics (demographic, behavioural, psychosocial, anthropometric and metabolic) of patients who dropped out before completing the first year of the programme and patients who achieved significant weight loss, with a separate analysis of patients who achieved substantial reductions in weight compared to the rest of the cohort. RESULTS: The mean age of the patients in the cohort was 10.46 years (SD, 3.48) the mean BMI z-score 4.01 (SD, 1.49); 52.8% of the patients were male, 53.3% were prepubertal, 75.8% were Caucasian and 19% Latin. We found a higher proportion of Latinla ethnicity and compulsive eating in the group of patients with early attrition from the weight management follow-up. In the group of patients with substantial weight loss, a greater proportion were male, there was a higher frequency of dietary intake control at home and obesity was more severe, and the latter factor was consistently observed in patients who achieved substantial weight loss at any point of the follow-up. CONCLUSIONS: Some family and personal characteristics in childhood obesity are associated with an increased risk of early withdrawal from follow-up or a greater probability of successful outcomes; however, the predictive value of these variables is limited.

Asociación del índice de masa corporal con la insatisfacción corporal en escolares / Association of body mass index with body dissatisfaction in schoolchildren

Introducción: La malnutrición por exceso causa sobrepeso y obesidad, siendo un problema de salud pública, que se ha presentado en los primeros años de vida. Investigaciones realizadas han informado la existencia de insatisfacción corporal relacionada con el peso, debido a los estándares de belleza establecidos en la sociedad. Objetivo: asociar el índice de masa corporal con la insatisfacción corporal y percepción de la imagen corporal de los escolares. Materiales y métodos: estudio transversal con 610 escolares. El estado nutricional se clasificó según el puntaje z del IMC. Para determinar la insatisfacción corporal y la percepción de la imagen corporal, se aplicó una escala de imagen corporal infantil de siete fotografías, con un valor del 1 al 7 de acuerdo con el tamaño creciente, y el rango final del IMC. Se calculó la diferencia entre la figura que los participantes consideraron ideal y la forma corporal percibida. Resultados: el 47,3% presentaron sobrepeso y obesidad. La insatisfacción corporal fue mayor en las niñas con sobrepeso y obesidad (p = 0,013). El IMC correlacionó con la insatisfacción corporal (rho(608) = 0,480; p < 0,001) y la percepción de la imagen corporal (rho(608) = 0,433; p < 0,001). Conclusiones: El IMC se relacionó positivamente con la insatisfacción corporal y la percepción de la imagen corporal; esto podría elevar el riesgo de presentar trastornos alimentarios, contribuir al mantenimiento del exceso de peso corporal, al no percibirse con exceso de peso, es menos probable que realicen acciones para controlarlo(AU)

Introduction: Excessive malnutrition causes overweight and obesity, being a public health problem, which has occurred in the first years of life. Research has reported the existence of body dissatisfaction related to weight, due to beauty standards established in society. Objective: to associate the BMI with body dissatisfaction and body image perception of schoolchildren. Materials and methods: cross-sectional study of 610 schoolchildren. Nutritional status was classified according to the BMI z score. To determine body dissatisfaction and body image perception, a child body image scale of seven photographs was applied, with a value of 1 to 7 according to the increasing size, and the final range of the BMI. The difference between the figure that participants considered ideal, and the perceived body shape was calculated. Results: 47.3% were overweight and obese. Body dissatisfaction was higher in overweight and obese girls (p = 0.013). BMI correlated with body dissatisfaction (rho(608) = 0.480; p < 0.001) and body image perception (rho(608) = 0.433; p < 0.001). Conclusions: BMI was positively related to body dissatisfaction and body image perception; this could increase the risk of developing eating disorders, contribute to the maintenance of excess body weight, as it is not perceived with excess weight, are less likely to take actions to control it(AU)

Abordaje de la obesidad infantil. Comparativa entre comunidades autónomas / Approach to Childhood Obesity in Spain. A comparison among autonomies

Fundamentos: la obesidad infantil representa un grave problema de salud pública y, dado su carácter multifactorial y sus consecuencias, resulta necesario llevar a cabo un abordaje eficaz. El sistema de autonomías español, con competencias delegadas, podría acentuar la desigualdad en su abordaje. El objetivo del estudio fue conocer la existencia o no de dichas desigualdades. Métodos: se llevó a cabo un estudio transversal descriptivo, entre los meses de febrero-abril de 2022, en el que se comparó el abordaje de la obesidad infantil entre las diecisiete comunidades y dos ciudades autónomas, mediante el análisis de los siguientes indicadores: personal de pediatría; enfermería pediátrica; personal de nutrición y su reconocimiento legal; existencia de planes integrales; y gasto sanitario para obesidad infantil. La búsqueda de información se realizó mediante revisión bibliográfica y solicitud de acceso a información pública a las correspondientes consejerías autonómicas. Hubo cálculo de ratios de pediatras y enfermeros por 1.000 habitantes y gasto sanitario por habitante. Resultados: se observó que a nivel nacional los pediatras poseen una ratio acorde a las recomendaciones internacionales (1,21), no así enfermería general y pediátrica (con una ratio de 0,65, que equivale a aproximadamente 1.544 habitantes por cada enfermera), ni el personal de nutrición. Entre comunidades autónomas se apreciaron grandes variaciones para las tres categorías. Los planes integrales de abordaje se encontraron desactualizados o, directamente, ausentes, al igual que el análisis periódico del gasto derivado de la obesidad.Conclusiones: el abordaje de la obesidad infantil parece variar de forma considerable entre autonomías según los indicadores analizados. Por ello, sería recomendable encauzar todos los esfuerzos en homogenizarlo, para mejorar la calidad asistencial e igualar las oportunidades de prevención y tratamiento en todo el ámbito nacional.(au)

Background: childhood obesity represents a serious public health problem and given its multifactorial nature and its con-sequences; it is necessary to carry out an effective approach. The spanish system of autonomies, with delegated powers, could accentuate inequality in its approach. The objective of the study was to know the existence or not of these inequalities. Methods: a descriptive cross-sectional study was carried out between the months of february-april 2022, in which the approach to childhood obesity was compared among the seventeen communities and two autonomous cities, through the analysis of the following indicators: pediatric staff, pediatric nursing, nutrition personnel and their legal recognition, the existence of comprehensive plans and health expenditure on childhood obesity. The search for information has been carried out through a bibliographic review and a request for access to public information to the corresponding regional councils. It were performed ratios of paediatricians and nurses per 1,000 inhabitants and health expenditure per inhabitant were calculated.results: it was observed that in spain paediatricians have a ratio according to international recommendations (1.21), but not ge-neral and paediatric nursing (with a ratio of 0.65, which is equivalent to approximately 1,544 inhabitants for each nurse), and nutrition professionals. Among autonomies there were large variations for the three categories. Comprehensive plans were outdated or absent altogether, as well as the periodic analysis of obesity expenditure. Conclusions: the approach to childhood obesity seems to vary considerably among autonomies according to the analysed indicators. Thus, it would be advisable to lead all efforts to homogenize it, to improve care quality and prevention and treatment choices in all national regions.(AU)

Índice de riesgo de obesidad infantil (IROBIC) para áreas administrativas pequeñas en Chile / Childhood obesity risk index (IROBIC) for small administrative areas in Chile

Introducción: a pesar de la alta prevalencia de la obesidad infantil (OI) globalmente, no existen índices compuestos para estimar los aspectos territoriales asociados al riesgo de OI. Objetivo: elaborar un índice de riesgo de OI (IROBIC) para unidades administrativas pequeñas (comunas) de Chile Métodos: se utilizaron datos de 2019 de fuentes públicas con información de menores de 10 años de todas las comunas de las 2 regiones más grandes. El IROBIC incluye 16 indicadores estandarizados por comuna y agrupados en cuatro dimensiones, determinadas por análisis de componentes principales (salud, socio económica, entornos comunal y educacional). Se determinó el IROBIC mediante una media geométrica ponderada y posteriormente se calcularon las diferencias entre las 10 y 5 comunas con mayores y menores IROBIC y de cada dimensión, con el coeficiente de disparidad Resultados: aun cuando los mayores IROBIC se obtuvieran en comunas más vulnerables, su valor total y el de cada dimensión, mostraron que es posible amortiguar los efectos de la desigualdad sobre la OI. Las 10 y 5 comunas con mayor IROBIC presentan un riesgo, 2,41 y 4,05 veces mayor que las de menor valor, respectivamente. Conclusiones: el IROBIC puede monitorear el riesgo de OI —y factores asociados— desde una perspectiva territorial. (AU)

Introduction: although the prevalence of childhood obesity (CO) is high globally, there are no composite indices to estimate territorial aspects associated with its risk Objective: to develop an obesity risk index (IROBIC) for small administrative units, called “comunas” in Chile Methods: we used 2019 data from public sources on children under 10 years living in “comunas” of the two largest regions. IROBIC includes 16 indicators standardized for each “comuna” and grouped together into four domains, determined by principal component analysis (health, socio-economic, built-in and educational environments). IROBIC was calculated as a weighted geometric mean. Differences in obesity risk between the 10 and 5 “comunas” with the highest and lowest IROBIC and of each domain, were calculated with the disparity ratio. Results: in spite of the poorest “comunas” having the highest IROBIC, when its value and that for each domain were considered, we observed that the effect of inequality could be mitigated. The 10 and 5 “comunas” with the highest IROBIC have a 2.41 and 4.05 higher risk of CO compared to those with the lowest values Conclusions: IROBIC is a useful tool for monitoring the risk of CO and its factors from a territorial perspective. (AU)

PERCEPCIÓN DE LA OBESIDAD INFANTIL EN POBLACIÓN ESTUDIANTIL Y SU IMPACTO PSICOLÓGICO Y ACADÉMICO / PERCEPTION OF CHILDHOOD OBESITY IN THE STUDENT POPULATION AND ITS PSYCHOLOGICAL AND ACADEMIC IMPACT

Introducción: La obesidad infantil se define como la acumulación corporal excesiva de grasa en niños tiene gran importancia en salud pública por su asociación con múltiples patologías crónicas, así como por repercusión a nivel psicosocial y académico. Objetivos: Describir los conocimientos, percepción e impacto de la obesidad infantil, el estado nutricional y alimenticio en la población estudiantil en un municipio de Colombia. Metodología: Se realizó un estudio observacional, descriptivo, de corte transversal entre mayo y junio del 2023, que incluye población estudiantil de entre 4 y 17 años, a quienes se aplicó una encuesta. Resultados: Se realizaron 100 encuestas, el 13.58% de los encuestados presentaba sobrepeso y el 3.70% obesidad. La obesidad fue más prevalente en niñas 2.47%, que en niños 1.23%; el sobrepeso más prevalente en niños 8.64%, que en niñas 4.94%. El 75.79% consumen harinas, el 17.89% dulces, 21.05% bebidas azucaradas y el 6.32% comidas rápidas diariamente. El 84.21% conocían el término "obesidad infantil", el 45.26% refirieron que el rendimiento académico en personas obesas cambia por sentimientos de rechazo mientras que 41.05% refieren que se debe a la alteración de estado de ánimo. El 14.74% de los encuestados refirió sentirse culpable si presentaban ingestas altas de comida, el 10.53% manifestó haber sido víctima de burlas o insultos por su peso. Conclusiones: Los patrones de alimentación reportados por los encuestados reflejan el contexto cultural de Colombia, donde una de las principales fuentes de alimentación son los carbohidratos. Los niños conocen acerca de la obesidad y sus principales formas de prevención; a su vez, perciben cambios en la esfera social y académica de quienes padecen obesidad, y cómo ello limita su correcta participación y goce en actividades propias de la edad lo que puede ser factor de riesgo para desarrollar diversas patologías futuras

Introduction: Childhood obesity is defined as the excessive accumulation of body fat in children. It has great public health importance due to its association with multiple non-transmissible diseases, as well as its repercussions at the psychosocial and academic levels. Objectives: To describe the knowledge, perception and impact of childhood obesity, nutritional and dietary status in a student population in a Colombia`s municipality. Methodology: An observational, descriptive, and cross-sectional was conducted between May and June 2023, which included a student population between 4 and 17 years old, to whom a survey was applied. Results: 100 surveys were made, 13.58% of the children were overweight and 3.70% were obese. Obesity was more prevalent in girls 2.47% than in boys 1.23%; overweight was more prevalent in boys 8.64%, than in girls 4.94%. 75.79% consumed cereals, 17.89% consumed candies, 21.05% consumed sugary beverages, and 6.32% consumed fast food daily. 84.21% knew the term "childhood obesity," 45.26% referred that academic performance in obese people changes due to feelings of rejection while 41.05% referred that it is due to altered mood. Of those surveyed, 14.74% reported feeling guilty if they had a high food intake, 10.53% reported having been the victim of ridicule or insults due to their weight

[Application of WHO 2015 nutritional profile model for the reduction of added sugars in children's dairy]. / Aplicación del modelo de perfiles nutricionales OMS 2015 para la reducción de azúcares añadidos en lácteos infantiles.

Introduction: In the last 20 years we have doubled obesity rates. In Spain, 67 % of the population does not have an adequate weight and 40 % of the child population suffers from obesity or overweight. This leads to serious diseases. To avoid this, a national plan to fight obesity is required, with prevention and therapeutic strategies so as not to continue increasing these data in 2030. Among the factors that cause childhood obesity are poor eating habits as well as a lack of physical activity and excessive use of screens. In addition, there is a significant social gap. Childhood obesity especially affects families with lower purchasing power (54 %) who do not have access to a healthy diet or the necessary tools or knowledge to promote health to their sons and daughters through food. The World Health Organization (WHO) Regional Office for Europe developed a nutrient profile model in 2015, specifically for the purpose of restricting the marketing of foods aimed at children. This model is considered by the scientific community as a reference tool when it comes to establish policies and improvements in favor of public health, in order to provide families with access to food with a better profile and nutritional value.

Introducción: En los últimos 20 años hemos duplicado las tasas de obesidad. Un 67 % de la población no tiene un peso adecuado y el 40 % de la población infantil sufre obesidad o sobrepeso en España. Esto deriva en graves enfermedades. Para evitarlo, es necesario un plan nacional de lucha contra la obesidad, con estrategias de prevención y terapéuticas para no seguir incrementando estos datos en 2030. Entre los factores causantes de la obesidad infantil se encuentran los malos hábitos de alimentación, además de la falta de actividad física y un uso excesivo de pantallas. Además, existe una brecha social importante. La obesidad infantil afecta especialmente a familias con menor poder adquisitivo (el 54 %), que no tienen acceso a una alimentación saludable ni las herramientas necesarias o el conocimiento para promover la salud a sus hijos e hijas a través de la alimentación. La Oficina Regional de la Organización Mundial de la Salud (OMS) para Europa desarrolló un modelo de perfil de nutrientes en 2015, específicamente a efectos de restringir la comercialización de alimentos dirigida a los niños, un modelo que se plantea desde la comunidad científica como una herramienta de referencia a la hora de establecer políticas y mejoras en pro de la salud pública, con el fin de facilitar a las familias el acceso a alimentos con un mejor perfil y valor nutricional.

[Impact of attend to day care associated with healthy weight in infants and preschoolers]. / Impacto del cuidado infantil en guarderías asociado con peso saludable en lactantes y preescolares.

Background: Being overweight affects millions of infants and preschoolers in the world, affecting their quality and life expectancy. Exposure to day care centers may play an important role in preventing unhealthy weight (UW). Objective: To point out the prevalence and association of day care exposure and other factors associated with UW in infants and preschoolers. Methods: An analytical cross-sectional study was carried out. Infant population aged 6-47 months without comorbidities that compromised their nutritional status were included, and those with formal childcare different from the selected day care were excluded. Exposure to day care, and other factors (perinatal, physical activity, nutritional, and familiar) were evaluated. A z score > 1 SD was considered UW. Prevalence, odds ratios (OR), 95% confidence intervals (95%CI) and adjusted RM by low birth weight, initiation of complementary feeding, consumption of sugary drinks, daytime naps, maternal nutritional status, and family income quintile through logistic regression. Results: The overall prevalence of UW was 17.84% (95%CI: 14.93-21.16), 11.84 (95%CI: 8.54-16.14) for children exposed to day care, and 23.78% (95%CI: 19.21-29.02) in unexposed infant population, showing significant differences between both prevalences (p < 0.001). The adjusted OR for UW presentation was 0.39 (95% CI: 0.23-0.66). Conclusions: Exposure to IMSS day care has shown to be a possible protective environment against the development of a UW.

Introducción: el sobrepeso afecta a millones de lactantes y preescolares en el mundo afectando su calidad y esperanza de vida. La exposición a guarderías puede jugar un papel importante para prevenir un peso no saludable (PNS). Objetivo: indicar la prevalencia y la asociación de la exposición a guarderías y otros factores asociados con el PNS en lactantes y preescolares. Métodos: se realizó un estudio transversal analítico. Se incluyó población infantil de 6-47 meses sin comorbilidades que comprometieran su estado nutricional y se excluyeron a aquellos con un cuidado infantil formal diferente al de las guarderías seleccionadas. Se evaluó la exposición a guardería, y otros factores (perinatales, actividad física, nutricionales, y familiares). Se consideró PNS una puntuación z > 1 DE. Se obtuvieron prevalencias, razones de momios (RM), intervalos de confianza del 95% (IC95%) y RM ajustadas por edad, bajo peso al nacer, inicio de la alimentación complementaria, consumo de bebidas azucaradas, siestas diurnas, estado nutricional materno y quintil de ingreso familiar a través de regresión logística. Resultados: la prevalencia general de PNS fue de 17.84% (IC95%:14.93-21.16), 11.84 (IC95%: 8.54-16.14) para la población infantil expuesta a guarderías, y 23.78% (IC95%: 19.21-29.02) en no expuestos, mostrando diferencias significativas entre ambas prevalencias (p < 0.001). La RM ajustada para la presentación de PNS fue de 0.39 (IC95%: 0.23-0.66) para exposición a guardería. Conclusiones: la exposición a guarderías IMSS mostró ser un posible ambiente protector contra el desarrollo de un PNS.

Soluble receptor for advanced glycation end-products (sRAGE) in childhood obesity: association with gene expression of RAGE and cardiometabolic markers / Receptor soluble para productos finales de glicación avanzada (sRAGE) en la obesidad infantil:asociación con la expresión génica de RAGE y marcadores cardiometabólicos

Introduction: advanced glycation end-products (AGEs) interact with the receptor for AGEs (RAGE). Full-length RAGE is associated with intracellular signal transduction, and soluble-RAGE (sRAGE) lacks the transmembrane and cytoplasmic domains, acting as a competitive inhibitor ofAGEs-RAGE binding. sRAGE levels in healthy children are associated with cell surface expression of RAGE. However, the expression of RAGE hasnot been explored in childhood obesity.Objective: the study aim was to evaluate the sRAGE levels and the gene expression of RAGE in children and its association with cardiometabolicmarkers.Methods: this is a cross-sectional study with 6-11-year children, 20 with overweight and 20 with obesity. Anthropometric measurements includedwaist circumference (cm) (WC), neck circumference (NC), weight (kg), fat mass (%), trunk fat (kg), muscular mass (kg), height (cm), and bodymass index (BMI) (kg/m2). Blood samples following an overnight fast were collected to measure glucose (mg/dl) and lipid profile with colorimetricmethods. sRAGE was determined in serum using the enzyme-linked immunosorbent assay (ELISA). Quantitative reverse transcription (RT-qPCR)was performed to analyze RAGE transcripts in peripheral blood mononuclear cells isolated by Ficoll®-Hypaque.Results: we found higher RAGE (p = 0.0315) and lower sRAGE (p = 0.0305) levels in the obesity group. sRAGE level showed a negative correlation with RAGE (r = -0.35) and BMI (r = -0.24), and positive with HDL-cholesterol (r = 0.29). Regression analysis suggests that HDL-C andRAGE levels are predictors of sRAGE levels.Conclusions: expression of RAGE is associated with lower sRAGE levels in childhood obesity. Moreover, obese children show higher cardiometabolic risk markers, and a positively associated with sRAGE. (AU)

Introducción: los productos finales de glicación avanzada (AGE) interactúan con el receptor de AGE (RAGE). El RAGE de longitud completaestá asociado con la transducción de señales intracelulares y el RAGE soluble (sRAGE) carece de los dominios transmembrana y citoplásmico,actuando como un inhibidor competitivo de la unión de AGE-RAGE. Los niveles de sRAGE en niños sanos están asociados con la expresión deRAGE en la superficie celular. Sin embargo, la expresión de RAGE no se ha explorado en la obesidad infantil.Objetivo: el objetivo del estudio fue evaluar los niveles de sRAGE y la expresión génica de RAGE en niños y su asociación con marcadorescardiometabólicos.Métodos: se trata de un estudio transversal con niños de seis a once años, 20 con sobrepeso y 20 con obesidad. Las medidas antropométricasincluyeron la circunferencia de la cintura (cm) (CC), la circunferencia del cuello (NC), el peso (kg), la masa grasa (%), la grasa del tronco (kg),la masa muscular (kg), la altura (cm) y el índice de masa corporal (IMC) (kg/m2). Se tomaron muestras de sangre después de una noche deayuno para medir glucosa (mg/dl) y el perfil de lípidos con métodos colorimétricos. Los sRAGE se determinaron en suero utilizando un ensayoinmunoabsorbente ligado a enzimas (ELISA). Se realizó una transcripción inversa cuantitativa (RT-qPCR) para analizar los transcritos de RAGE encélulas mononucleares de sangre periférica aisladas por Ficoll®-Hypaque.Resultados: encontramos niveles más altos de RAGE (p = 0,0315) y más bajos de sRAGE (p = 0,0305) en el grupo de obesidad. El nivel de sRAGE mostró una correlación negativa con RAGE (r = -0,35) e IMC (r = -0,24), y positiva con el colesterol HDL (r = 0,29). El análisis de regresión sugiere que los niveles de HDL-C y RAGE predicen los niveles de sRAGE.Conclusiones: la expresión de RAGE se asocia con niveles más bajos de sRAGE en la obesidad infantil. ... (AU)

Soluble receptor for advanced glycation end-products (sRAGE) in childhood obesity: association with gene expression of RAGE and cardiometabolic markers.

Introduction: Introduction: advanced glycation end-products (AGEs) interact with the receptor for AGEs (RAGE). Full-length RAGE is associated with intracellular signal transduction, and soluble-RAGE (sRAGE) lacks the transmembrane and cytoplasmic domains, acting as a competitive inhibitor of AGEs-RAGE binding. sRAGE levels in healthy children are associated with cell surface expression of RAGE. However, the expression of RAGE has not been explored in childhood obesity. Objective: the study aim was to evaluate the sRAGE levels and the gene expression of RAGE in children and its association with cardiometabolic markers. Methods: this is a cross-sectional study with 6-11-year children, 20 with overweight and 20 with obesity. Anthropometric measurements included waist circumference (cm) (WC), neck circumference (NC), weight (kg), fat mass (%), trunk fat (kg), muscular mass (kg), height (cm), and body mass index (BMI) (kg/m2). Blood samples following an overnight fast were collected to measure glucose (mg/dl) and lipid profile with colorimetric methods. sRAGE was determined in serum using the enzyme-linked immunosorbent assay (ELISA). Quantitative reverse transcription (RT-qPCR) was performed to analyze RAGE transcripts in peripheral blood mononuclear cells isolated by Ficoll®-Hypaque. Results: we found higher RAGE (p = 0.0315) and lower sRAGE (p = 0.0305) levels in the obesity group. sRAGE level showed a negative correlation with RAGE (r = -0.35) and BMI (r = -0.24), and positive with HDL-cholesterol (r = 0.29). Regression analysis suggests that HDL-C and RAGE levels are predictors of sRAGE levels. Conclusions: expression of RAGE is associated with lower sRAGE levels in childhood obesity. Moreover, obese children show higher cardiometabolic risk markers, and a positively associated with sRAGE.

Introducción: Introducción: los productos finales de glicación avanzada (AGE) interactúan con el receptor de AGE (RAGE). El RAGE de longitud completa está asociado con la transducción de señales intracelulares y el RAGE soluble (sRAGE) carece de los dominios transmembrana y citoplásmico, actuando como un inhibidor competitivo de la unión de AGE-RAGE. Los niveles de sRAGE en niños sanos están asociados con la expresión de RAGE en la superficie celular. Sin embargo, la expresión de RAGE no se ha explorado en la obesidad infantil. Objetivo: el objetivo del estudio fue evaluar los niveles de sRAGE y la expresión génica de RAGE en niños y su asociación con marcadores cardiometabólicos. Métodos: se trata de un estudio transversal con niños de seis a once años, 20 con sobrepeso y 20 con obesidad. Las medidas antropométricas incluyeron la circunferencia de la cintura (cm) (CC), la circunferencia del cuello (NC), el peso (kg), la masa grasa (%), la grasa del tronco (kg), la masa muscular (kg), la altura (cm) y el índice de masa corporal (IMC) (kg/m2). Se tomaron muestras de sangre después de una noche de ayuno para medir glucosa (mg/dl) y el perfil de lípidos con métodos colorimétricos. Los sRAGE se determinaron en suero utilizando un ensayo inmunoabsorbente ligado a enzimas (ELISA). Se realizó una transcripción inversa cuantitativa (RT-qPCR) para analizar los transcritos de RAGE en células mononucleares de sangre periférica aisladas por Ficoll®-Hypaque. Resultados: encontramos niveles más altos de RAGE (p = 0,0315) y más bajos de sRAGE (p = 0,0305) en el grupo de obesidad. El nivel de sRAGE mostró una correlación negativa con RAGE (r = -0,35) e IMC (r = -0,24), y positiva con el colesterol HDL (r = 0,29). El análisis de regresión sugiere que los niveles de HDL-C y RAGE predicen los niveles de sRAGE. Conclusiones: la expresión de RAGE se asocia con niveles más bajos de sRAGE en la obesidad infantil. Además, los niños obesos muestran marcadores de riesgo cardiometabólico más elevados y una asociación positiva con sRAGE.

Sobrepeso y obesidad en escolares de la Región de Magallanes y Antártica Chilena, Chile, (2009 ­ 2019), y comparación de dos metodologías para el diagnóstico / Overweight and obesity in schoolchildren in the Magallanes and Chilean Antarctica Region, Chile, (2009 - 2019), and comparison of two methodologies for diagnosis

Introducción. En Chile la prevalencia de obesidad total en población escolar alcanza al 31% y la obesidad severa al 10,8%. La Región de Magallanes y Antártica Chilena, es una de las más afectadas por esta epidemia. El diagnóstico nutricional confiable y una intervención oportuna pueden evitar que los niños enfermen y deterioren su calidad de vida. Objetivo: Analizar la tendencia del estado nutricional de escolares de la Región de Magallanes, según datos reportados por la Junta Nacional de Auxilio Escolar y Becas, JUNAEB, entre 2009-2019 y comparar resultados del año 2010 con un estudio propio. Materiales y métodos. Se analizó el estado nutricional de 71.334 escolares de la Región de Magallanes y Antártica Chilena por nivel educacional y variables demográficas, según información de JUNAEB. Luego se compararon los resultados de escolares de 1º básico del año 2010, obtenidos a través de dos metodologías: fuente secundaria, Encuesta JUNAEB, y fuente primaria, estudio antropométrico realizado en la misma región y año. Resultados. Según datos de JUNAEB el exceso ponderal se incrementó en escolares de la región en 4,4 % entre 2009 y 2019, el grupo más afectado fue 1º básico. En el año 2010 la prevalencia de obesidad para escolares de 1º básico según JUNAEB fue 21,8% y según estudio regional propio fue 25,7%. Conclusiones. La malnutrición por exceso afecta al 53,8% de los escolares de la Región de Magallanes y podría ser mayor, considerando que la información censal podría estar subestimando el sobrepeso y obesidad. Es urgente intervenir para evitar perpetuar esta epidemia(AU)

Introduction. In Chile the prevalence of total obesity in school population reaches 31% and severe obesity 10.8%. The Magallanes and Chilean Antarctica Region is one of the most affected by this epidemic. Reliable nutritional diagnosis and timely intervention can prevent children from getting sick and deteriorating their quality of life. Objective. To analyze the trend of nutritional status of schoolchildren in the Magallanes Region, according to data reported by the National Board of School Aid and Scholarships, JUNAEB between 2009-2019 and compare results from 2010 with our own study. Materials and methods. The nutritional status of 71,334 schoolchildren in the Magallanes Region and Chilean Antarctica was analyzed by educational level and demographic variables, according to information from JUNAEB. Then, the results of schoolchildren in 1st grade in 2010 were compared, obtained through two methods: secondary source, JUNAEB survey, and primary source, anthropometric study carried out in the same region and year. Results. According to JUNAEB data, overweight increased in school children in the region by 4.4% between 2009 and 2019, the most affected group was 1st grade. In 2010 the prevalence of obesity for 1st grade schoolchildren according to JUNAEB was 21.8% and according to our own regional study it was 25.7%. Conclusions. Excess malnutrition affects 53.8% of school children in the Magallanes Region and could be higher, considering that census information could be underestimating overweight and obesity. It is urgent to intervene to avoid perpetuating this epidemic(AU)

Ultra-processed food consumption and nutritional status in Uruguayan and Brazilian children between three to five years / Consumo de alimentos ultraprocesados y estado nutricional en niños de tres a cinco años uruguayos y brasileños

Introduction. There is growing consensus globally that the consumption of ultra- processed food (UPF) can negatively affect the nutritional status of children. Objective. The present study aims to evaluate associations between the consumption of UPF and the nutritional status in a sample of Uruguayan and Brazilian preschoolers belonging to two studies: the ENDIS Study and the Pelotas 2015 Birth Cohort. Materials and methods. We conducted a cross-sectional analysis. The main outcome measure was obesity defined as BMI for age and sex ≥ +3 z-scores. The score of UPF consumption was the main exposure measured. Each positive answer of habitual intake was added up to create a UPF score ranging from zero to six or more UPF. Crude and adjusted logistic regressions were performed for the associations between UPF consumption and nutritional status in preschoolers. Results. The final sample consisted of 8,687 preschool children, 50.8% belonging to the Uruguayan study, while the remaining 49.2% belonged to the Brazilian study. Nearly 5% of the sample of young children were obese. We didn't observe a relationship between the score of UPF consumption and obesity, the odds ratio (OR) was 1.04 (95% CI, 1.00­1.09). Adjustments resulted in modest attenuation of the relationship and a lack of statistical significance. However, in children under 48 months, the score of UPF consumption was directly associated with childhood obesity. Conclusions. Results suggest that higher consumption of UPF is associated with obesity in Uruguayan and Brazilian preschool children under 4 years of age. These findings suggest that actions to reduce ultra- processed food consumption could lead to diminish obesity patterns and bring important public health benefits(AU)

Introducción. Existe creciente consenso a nivel mundial de que el consumo de alimentos ultraprocesados puede afectar negativamente el estado nutricional de los niños. Objetivo. El presente estudio tiene como objetivo evaluar asociaciones entre el consumo de ultraprocesados y el estado nutricional en una muestra de preescolares uruguayos y brasileños pertenecientes a dos estudios: el Estudio ENDIS y la Cohorte de Nacimiento de Pelotas 2015. Materiales y métodos. Se realizó un análisis transversal. La principal medida de resultado fue la obesidad definida como el IMC/edad y sexo ≥ +3 puntuaciones z. La puntuación del consumo de ultraprocesados fue la principal exposición. Cada respuesta positiva de la ingesta habitual se sumó para crear una puntuación de ultraprocesados que oscilaba entre cero y seis o más. Se realizaron regresiones logísticas crudas y ajustadas. Resultados. La muestra final estuvo constituida por 8.687 niños, de los cuales el 50,8% pertenecía al estudio uruguayo, mientras que el 49,2% restante pertenecía al estudio brasileño. Casi el 5% de la muestra de niños pequeños eran obesos. No observamos relación entre la puntuación del consumo de ultraprocesados y la obesidad, el odds ratio (OR) fue de 1,04 (IC 95%, 1,00-1,09). Los ajustes dieron lugar a modesta atenuación de la relación y falta de significación estadística. Sin embargo, en menores de 48 meses la puntuación de consumo de ultraprocesados se asoció directamente con la obesidad infantil. Conclusiones. Los resultados sugieren que un mayor consumo de ultraprocesados se asocia con obesidad en prescolares uruguayos y brasileños menores de 4 años. Estos hallazgos sugieren que las acciones para reducir el consumo de alimentos ultraprocesados podrían conducir a una disminución de los patrones de obesidad y traer importantes beneficios para la salud pública(AU)

Relationship between eating habits, sleep patterns and physical activity and the degree of obesity in children and adolescents.

INTRODUCTION: Childhood obesity is an extremely prevalent pathology and, in order to be able to address it, it is necessary to understand the factors that influence on its genesis and maintenance. We hypothesise that the timing of meals and sleep, the regularity of these throughout the week and a sedentary lifestyle influence the degree of obesity. MATERIAL AND METHODS: We included children and adolescents with obesity who attended a first check-up visit at the Childhood Obesity Unit between January 2018 and February 2020. The data were obtained from a questionnaire on food (36-h intake, frequency of consumption, eating times and habits) and sleep. RESULTS: The degree of obesity was influenced to a greater extent by later meal times and the distribution of calories throughout the day (less at breakfast, more at dinner) than by the total number of calories ingested. In addition, a lower consumption of vegetables was related to a higher degree of obesity. The difference between the hours of sleep at weekends and on weekdays correlated positively with a higher degree of obesity. Finally, the anthropometric data correlated negatively with the number of hours of physical activity. Almost half of the children did not exercise after school. CONCLUSION: In the approach to childhood obesity, it is necessary to include recommendations on the regularity of meal and sleep times, as well as the distribution of calories throughout the day. Additionally, it is necessary to encourage the practice of physical exercise.

[Childhood obesity risk index (IROBIC) for small administrative areas in Chile]. / Índice de riesgo de obesidad infantil (IROBIC) para áreas administrativas pequeñas en Chile.

Introduction: Introduction: although the prevalence of childhood obesity (CO) is high globally, there are no composite indices to estimate territorial aspects associated with its risk Objective: to develop an obesity risk index (IROBIC) for small administrative units, called "comunas" in Chile Methods: we used 2019 data from public sources on children under 10 years living in "comunas" of the two largest regions. IROBIC includes 16 indicators standardized for each "comuna" and grouped together into four domains, determined by principal component analysis (health, socio-economic, built-in and educational environments). IROBIC was calculated as a weighted geometric mean. Differences in obesity risk between the 10 and 5 "comunas" with the highest and lowest IROBIC and of each domain, were calculated with the disparity ratio. Results: in spite of the poorest "comunas" having the highest IROBIC, when its value and that for each domain were considered, we observed that the effect of inequality could be mitigated. The 10 and 5 "comunas" with the highest IROBIC have a 2.41 and 4.05 higher risk of CO compared to those with the lowest values Conclusions: IROBIC is a useful tool for monitoring the risk of CO and its factors from a territorial perspective.

Introducción: Introducción: a pesar de la alta prevalencia de la obesidad infantil (OI) globalmente, no existen índices compuestos para estimar los aspectos territoriales asociados al riesgo de OI. Objetivo: elaborar un índice de riesgo de OI (IROBIC) para unidades administrativas pequeñas (comunas) de Chile Métodos: se utilizaron datos de 2019 de fuentes públicas con información de menores de 10 años de todas las comunas de las 2 regiones más grandes. El IROBIC incluye 16 indicadores estandarizados por comuna y agrupados en cuatro dimensiones, determinadas por análisis de componentes principales (salud, socio económica, entornos comunal y educacional). Se determinó el IROBIC mediante una media geométrica ponderada y posteriormente se calcularon las diferencias entre las 10 y 5 comunas con mayores y menores IROBIC y de cada dimensión, con el coeficiente de disparidad Resultados: aun cuando los mayores IROBIC se obtuvieran en comunas más vulnerables, su valor total y el de cada dimensión, mostraron que es posible amortiguar los efectos de la desigualdad sobre la OI. Las 10 y 5 comunas con mayor IROBIC presentan un riesgo, 2,41 y 4,05 veces mayor que las de menor valor, respectivamente. Conclusiones: el IROBIC puede monitorear el riesgo de OI ­y factores asociados­ desde una perspectiva territorial.

Genetic risk score for common obesity and anthropometry in Spanish schoolchildren.

IntroductionCommon or non-syndromic obesity is a complex polygenic trait conditioned by biallelic or single-base polymorphisms called SNPs (Single-Nucleotide Polymorphisms) that present an additive effect and act synergistically. Most genotype-obese phenotype association studies include body mass index (BMI) or waist-to-height ratio (WtHR), and very few introduce a broad anthropometric profile. ObjectiveTo verify whether a genetic risk score (GRS) developed from 10 SNPs is associated with the obesity phenotype assessed from anthropometric measures indicative of excess weight, adiposity and fat distribution. Material and methodsA series of 438 Spanish schoolchildren (6-16 years old) were evaluated anthropometrically (weight, height, waist circumference, skinfold thickness, BMI, WtHR, body fat percentage [%BF]). Ten SNPs were genotyped from saliva samples, generating a GRS for obesity, establishing genotype-phenotype association. ResultsSchoolchildren categorised as obese by BMI, ICT and %BF had higher GRS than their non-obese peers. The prevalence of overweight and adiposity was higher in subjects with a GRS above the median. Similarly, between 11 and 16 years of age, all anthropometric variables presented higher averages. ConclusionsGRS estimated from the 10 SNPs can be a diagnostic tool for the potential risk of obesity in Spanish schoolchildren and could be useful from the preventive perspective.

Prevalencia de sobrepeso y obesidad en Aragón y variaciones según condicionantes de salud / Prevalence of overweight and obesity in Aragón and variations according to health determinants

Introducción: La obesidad infantil constituye un grave problema de salud global en continuo aumento en todo el mundo. Muchos estudios señalan que determinados factores socioeconómicos están relacionados con el desarrollo de obesidad. El objetivo de este estudio fue analizar la prevalencia de sobrepeso y obesidad en Aragón, calculadas según los estándares de la Organización Mundial de la Salud (OMS) y estudiar su relación con factores socioeconómicos. Material y métodos: Se recopiló información sobre la totalidad de la población infantil de Aragón entre dos y 14 años y cada individuo fue clasificado como normopeso, sobrepeso u obesidad según su índice de masa corporal (IMC). Se obtuvieron las prevalencias por provincias y zonas básicas de salud (ZBS). Utilizamos el índice de privación (IP) de Aragón como marcador de la situación socioeconómica. Resultados: La muestra final estuvo constituida por 161.335 niños (51%) y niñas (49%) de dos a 14 años. La prevalencia global de sobrecarga ponderal (SP) fue de 31,1% (17,7% sobrepeso y 13,3% obesidad), siendo significativamente mayor en niños. Detectamos un porcentaje elevado (65%) de infrarregistro en la historia clínica.Se encontró una relación directa entre el IP y la prevalencia de obesidad y SP en todo Aragón, con una fuerte correlación significativa en zonas urbanas, en las que los factores socioeconómicos llegan a explicar hasta 66,4% de la obesidad y 48,9% de la SP total. Conclusiones: En Aragón, la prevalencia de obesidad y SP es elevada y está relacionada con una situación socioeconómica familiar desfavorable. (AU)

Introduction: Childhood obesity is a serious global health problem that is continuously increasing worldwide. Many studies suggest that socioeconomic factors are related to the development of obesity. The objective of our study was to analyse the prevalence of overweight and obesity in Aragón, calculated applying the World Health Organization (WHO) growth standards, and to study its association with socioeconomic factors. Material and methods: We collected data for the entire paediatric population of Aragón aged 2–14 years. We classified each child as normal weight, overweight or obese based on the body mass index. We calculated prevalences by province and basic health care zone. To analyse differences in relation to social inequalities, we used the Aragón deprivation index as an indicator of socioeconomic status. Results: The final sample consisted of 161 335 children aged 2–14 years, 51% male and 49% female. The overall prevalence of excess weight was 31.1% (17.7% overweight and 13.3% obesity) and was significantly higher in boys. We found a high frequency of under-recording in health records (65%). There was a direct association between the deprivation index and the prevalence of obesity and overweight throughout Aragón, with a significant strong correlation in urban areas, where socioeconomic factors explained up to 66.4% of obesity and 48.9% of body weight excess. Conclusions: In Aragón, the prevalence of obesity and excess weight is high and associated with low family socioeconomic status. (AU)

Prevalence of overweight and obesity in Aragón and variations according to health determinants.

INTRODUCTION: Childhood obesity is a serious global health problem that is continuously increasing worldwide. Many studies suggest that socioeconomic factors are related to the development of obesity. The objective of our study was to analyse the prevalence of overweight and obesity in Aragón, calculated applying the World Health Organization (WHO) growth standards, and to study its association with socioeconomic factors. MATERIAL AND METHODS: We collected data for the entire paediatric population of Aragón aged 2-14 years. We classified each child as normal weight, overweight or obese based on the body mass index. We calculated prevalences by province and basic health care zone. To analyse differences in relation to social inequalities, we used the Aragón deprivation index as an indicator of socioeconomic status. RESULTS: The final sample consisted of 161 335 children aged 2-14 years, 51% male and 49% female. The overall prevalence of excess weight was 31.1% (17.7% overweight and 13.3% obesity) and was significantly higher in boys. We found a high frequency of under-recording in health records (65%). There was a direct association between the deprivation index and the prevalence of obesity and overweight throughout Aragón, with a significant strong correlation in urban areas, where socioeconomic factors explained up to 66.4% of obesity and 48.9% of body weight excess. CONCLUSIONS: In Aragón, the prevalence of obesity and excess weight is high and associated with low family socioeconomic status.

Calidad de productos alimentarios anunciados por televisión antes y después del plan para mejorar su composición, 2017-2020 / Quality of food products announced on television before and after the plan to improve their composition, 2017–2020

Objetivo: Comparar la calidad nutricional de los alimentos y bebidas anunciados por televisión en España antes y después del plan para mejorar su composición. Método: Se grabaron las emisiones por televisión digital terrestre (TDT) en horario infantil de los canales más populares. Se registraron los productos anunciados en los cortes comerciales y su composición nutricional. Se comparó su distribución de frecuencias por categorías alimentarias y su adherencia al perfil nutricional de la Organización Mundial de la Salud en 2017 y 2020. Resultados: En 256 horas de emisión se identificaron 173 productos (78 en 2017 y 95 en 2020). Los más anunciados fueron los chocolates (26,9% en 2017 y 22,1% en 2020). El 76,3% de los productos anunciados eran no saludables (76,9% en 2017 y 75,8% en 2020; p = 0,86). Conclusiones: El perfil nutricional de los productos anunciados por televisión, mayoritariamente no saludables, no cambió tras la implantación del plan para mejorar su composición. Es preciso regular la publicidad alimentaria para proteger a los niños. (AU)

Objective: To compare the nutritional quality of the foods and beverages advertised on television in Spain, before and after the plan to improve their composition. Method: DTT broadcasts of the more popular channels were recorded in children's hours. Every advertised products in commercial breaks were registered and their nutritional data collected. We compared the distribution of frequencies by food categories and their adherence to the nutritional standards of the World Health Organization in 2017 and 2020. Results: In 256 h of broadcasting we identified 173 products (78 in 2017 and 95 in 2020). The most advertised products were chocolates (26.9% in 2017 and 22.1% in 2020). 76.3% of the products advertised were unhealthy (76.9% in 2017 vs. 75.8% in 2020; p = 0.86). Conclusions: The nutritional profile of the foods and drinks advertised on television, mostly unhealthy, did not change after the implementation of the plan to improve their composition. A regulation is needed to protect children from food advertising. (AU)