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Medrano Echeverría, María

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Medrano Echeverría

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María

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Ciencias de la Salud

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0000-0001-7048-642X

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811505

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Now showing 1 - 10 of 30
  • PublicationOpen Access
    Walkability and socio-economic status in relation to walking, playing and sports practice in a representative Spanish sample of youth: the PASOS study
    (Public Library of Science, 2024) Aznar, Susana; Jiménez-Zazo, Fabio; Romero-Blanco, Cristina; Gómez, Santiago F.; Homs, Clara; Wärnberg, Julia; Medrano Echeverría, María; Gusi, Narcís; González Gross, Marcela; Marín-Cascales, Elena; González Valeiro, Miguel A.; Serra-Majem, Lluis; Terrados, Nicolás; Tur, Josep A.; Segú, Marta; Lassale, Camille; Colom, Antoni; Labayen Goñi, Idoia; Sánchez-Gómez, Jesús; Alcaraz, Pedro E.; Sevilla-Sánchez, Marta; Zapico, Augusto G.; Herrera-Ramos, Estefanía; Pulgar, Susana; Bibilonii, Maria del Mar; Sistac-Sorigué, Clara; Schröder, Helmut; Molina-García, Javier; Ciencias de la Salud; Osasun Zientziak; Institute on Innovation and Sustainable Development in Food Chain - ISFOOD
    Purpose Physical activity (PA) provides multiple health-related benefits in children and adolescents, however, at present, the majority of young people are insufficiently physically active. The aim of this study was to evaluate if neighborhood walkability and/or socio-economic status (SES) could affect the practice of walking, play outdoors and sports practice in a representative sample of Spanish children and adolescents. Methods A sample of 4092 youth (aged 8-16 years old) from 245 primary and secondary schools in 121 localities from each of the 17 Spanish autonomous communities participated in the study. Walk Score was used to evaluate walkability of the neighborhood and household income was used as an indicator of SES. A 7-item self-reported validated questionnaire, was used to assess PA levels, and in a subsample of 10% of the participants, randomly selected from the entire sample, PA was objectively measured by accelerometers. Results Youth from more walkable areas reported more minutes walking per day compared with those from less walkable neighborhoods (51.4 vs 48.8 minutes, respectively). The lowest average minutes spent in playing outdoors was found among participants from low-SES and low-walkable neighborhoods. Neighborhood SES influenced on the participation in team sports during the weekend, being this participation higher in high SES neighborhoods. Conclusion Providing high walkable environments seems a good strategy to promote PA regardless SES levels. It seems that improving the walkability is a key component to partially overcome the SES inequalities, especially in urban areas with low SES. High-SES environments can offer better sports facilities and more organized physical activities than low-SES ones.
  • PublicationOpen Access
    Nutritional status and physical performance using handgrip and SPPB tests in hospitalized older adults
    (Elsevier, 2021) Amasene, María; Besga, Ariadna; Medrano Echeverría, María; Urquiza, Miriam; Rodríguez Larrad, Ana; Tobalina, Ignacio; Barroso, Julia; Irazusta, Jon; Labayen Goñi, Idoia; Institute on Innovation and Sustainable Development in Food Chain - ISFOOD
    Background & aims: Malnutrition and poor physical performance are highly prevalent within hospitalized older adults, and both have in common the loss of muscle mass. Likewise, there is growing interest in identifying markers of physical performance, other than just measuring muscle mass, that might be useful for managing malnutrition. This study aimed to (i) characterize the physical condition of hospitalized older adults in comparison to previously published reference percentile values of same age adults and (ii) to examine the association between the nutritional status and physical performance of older inpatients. Methods: A total of 604 inpatients (age 84.3 ± 6.8 years, 50.3% women) participated in this cross-sectional study. Patients were assessed for nutritional status (Mini Nutritional Assessment-Short Form (MNA-SF)) and physical performance (handgrip strength and the Short Physical Performance Battery (SPPB)). Results: During hospitalization, 65.7% of the inpatients were at risk of malnutrition or malnourished. More than a half of the older inpatients were unfit (≤P25) for handgrip strength (52.0%) and SPPB total score (86.3%) as well as for two of its subtests, gait speed (86.7%) and 5 times sit-to-stand (91.1%) tests. Patients' nutritional status was significantly associated with better physical performance within all tests (all p < 0.001), as their nutritional status improved so did their physical performance (all p for trend <0.001). Hence, being at risk of malnutrition or malnourished significantly increased the likelihood for being classified as unfit according to handgrip strength (OR: 1.466, 95% CI: 1.045–2.056), SPPB total score (OR: 2.553, 95% CI: 1.592–4.094) and 4-m walking test (OR: 4.049, 95% CI: 2.469–6.640) (all p < 0.05), and as frail (OR: 4.675, 95% CI: 2.812–7.772) according to the SPPB frailty threshold (p < 0.001). Conclusions: This study reinforces the use of handgrip strength and SPPB, as well as its subtests (gait speed and 5 times sit-to-stand tests), in hospitalized older adults as alternative measures of muscle mass for malnutrition management. Hence, it seems that risk of malnutrition or malnutrition assessed by MNA-SF might help to predict poor physical performance in older inpatients.
  • PublicationOpen Access
    Differences in specific abdominal fat depots between metabolically healthy and unhealthy children with overweight/obesity: the role of cardiorespiratory fitness
    (Wiley, 2023) Cadenas-Sánchez, Cristina; Medrano Echeverría, María; Villanueva Larre, Arantxa; Cabeza Laguna, Rafael; Idoate, Fernando; Osés Recalde, Maddi; Rodríguez Vigil, Beatriz; Álvarez de Eulate, Natalia; Alberdi Aldasoro, Nerea; Ortega, Francisco B.; Labayen Goñi, Idoia; Ciencias de la Salud; Ingeniería Eléctrica, Electrónica y de Comunicación; Institute on Innovation and Sustainable Development in Food Chain - ISFOOD; Institute of Smart Cities - ISC; Osasun Zientziak; Ingeniaritza Elektrikoa, Elektronikoaren eta Telekomunikazio Ingeniaritzaren
    Objectives: Fat depots localization has a critical role in the metabolic health status of adults. Nevertheless, whether that is also the case in children remains under- studied. Therefore, the aims of this study were: (i) to examine the differ-ences between metabolically healthy (MHO) and unhealthy (MUO) overweight/obesity phenotypes on specific abdominal fat depots, and (ii) to further explore whether cardiorespiratory fitness plays a major role in the differences between metabolic phenotypes among children with overweight/obesity. Methods: A total of 114 children with overweight/obesity (10.6 ±1.1 years, 62 girls) were included. Children were classified as MHO (n=68) or MUO. visceral (VAT), abdominal subcutaneous (ASAT), intermuscular abdominal (IMAAT), psoas, hepatic, pancreatic, and lumbar bone marrow adipose tissues were measured by magnetic resonance imaging. Cardiorespiratory fitness was assessed using the 20 m shuttle run test. Results: MHO children had lower VAT and ASAT contents and psoas fat fraction compared to MUO children (difference =12.4%– 25.8%, all p<0.035). MUO- unfit had more VAT and ASAT content than those MUO- fit and MHO- fit (difference =34.8%– 45.3%, all p<0.044). MUO- unfit shows also greater IMAAT fat fraction than those MUO- fit and MHO- fit peers (difference =16.4%– 13.9% respectively, all p≤0.001). In addition, MHO- unfit presented higher IMAAT fat fraction than MHO- fit (difference =13.4%, p<0.001). MUO- unfit presented higher psoas fat fraction than MHO- fit (difference =29.1%, p=0.008). Conclusions: VAT together with ASAT and psoas fat fraction, were lower in MHO than in MUO children. Further, we also observed that being fit, regardless of metabolic phenotype, has a protective role over the specific abdominal fat depots among children with overweight/obesity.
  • PublicationOpen Access
    A sociodemographic, anthropometric and lifestyle-based prediction score for screening children with overweight and obesity for hepatic steatosis: the HEPAKID index
    (Wiley, 2021) Osés Recalde, Maddi; Medrano Echeverría, María; Galbete Jiménez, Arkaitz; Arenaza Etxeberría, Lide; Ruiz, Jonatan R.; Sánchez-Valverde, Félix; Ortega, Francisco B.; Labayen Goñi, Idoia; Ciencias de la Salud; Osasun Zientziak
    Background: Hepatic steatosis (HS) is currently the most prevalent hepatic disease in paediatric population and a major risk factor for type 2 diabetes and cardiovascular diseases. The proper identification of children with HS is therefore of great public health interest. Objective: To develop a new prediction score using anthropometric, sociodemographic and lifestyle factors to identify children with HS (the HEPAKID index). Previously published biochemical paediatric screening tools were validated in the same cohort. Methods: A total of 115 pre-adolescent children aged 8 to 12 years with overweight/obesity, recruited at hospital paediatric units were enrolled in this cross-sectional study. HS (≥5.5% hepatic fat) was assessed by magnetic resonance imaging (MRI). Anthropometric, sociodemographic and lifestyle variables were collected by validated tests/questionnaires. Results: Forty-one children had MRI-diagnosed HS (35.6%, 49% girls). These children had (P <.01) a higher waist-height ratio, a lower cardiorespiratory fitness, a younger gestational age, and consumed more sugar-sweetened beverages than their HS-free peers. Children with HS were more likely to belong to an ethnic minority (P <.01) and to spend longer viewing screens than recommended (P <.05). The addition of these variables to the multivariate logistic regression model afforded a HEPAKID index with high discriminatory capacity (area under the receiver-operating characteristic curve: 0.808, 95% CI 0.715-0.901), and score of ≥25.0 was associated with high sensitivity (82%, 95% CI 68%-96%). Biochemical biomarker-based paediatric tools for identifying HS showed only moderate discriminatory capacity and low sensitivity (5%-41%) in this cohort. Conclusions: The HEPAKID index is the first simple, non-invasive, sensitive, inexpensive and easy-to-perform screening that can identify children with overweight or obesity who have HS.
  • PublicationOpen Access
    Dietary determinants of hepatic fat content and insulin resistance in overweight/obese children: a cross-sectional analysis of the Prevention of Diabetes in Kids (PREDIKID) study
    (Cambridge University Press, 2019) Arenaza Etxeberría, Lide; Medrano Echeverría, María; Osés Recalde, Maddi; Huybrechts, Inge; Díez, Ignacio; Henriksson, Hanna; Labayen Goñi, Idoia; Institute on Innovation and Sustainable Development in Food Chain - ISFOOD
    Pediatric non-alcoholic fatty liver disease (NAFLD) has increased in parallel with childhood obesity. Dietary habits, particularly products rich in sugars, may influence both hepatic fat and insulin resistance (HOMA-IR). The aim of the study was to examine the associations of the consumption of foods (cereals, fruits and vegetables, meat/meat products, dairy products, dairy desserts/substitutes (DDS) fish/shellfish, total and added sugars), sugar-sweetened beverages (SSB) and food components (macronutrients and fiber), on hepatic fat and HOMA-IR. Dietary intake (two non-consecutive 24h-recalls), hepatic fat (magnetic resonance imaging) and HOMA-IR were assessed in 110 children (10.6-1.1 years old) with overweight/obesity. Linear regression analyses were used to examine the associations of dietary intake with hepatic fat and HOMA-IR adjusted for potential confounders (sex, age, energy intake, maternal educational level, total and abdominal adiposity and sugar intake). The results showed that there was a negative association between cereal intake and hepatic fat (-0.197, P<0.05). In contrast, both SSB consumption (=0.217; P=0.028) and sugar in SSB (=0.210, P=0.035), but not DDS or sugar in DDS or other dietary components, were positively associated with hepatic fat regardless of potential confounders including total sugar intake. In conclusion, cereal intake might decrease hepatic fat, whereas SSB consumption and its sugar content may increase the likelihood of having hepatic steatosis. Although these observations need to be confirmed using experimental evidence, these results suggest that healthy lifestyle intervention programs are needed to improve dietary habits as well as to increase the awareness of the detrimental effects of SSB consumption early in life.
  • PublicationOpen Access
    Protocol of the MOVI-ageing randomized controlled trial: a home-based e-Health intervention of cognitively demanding exercise for the improvement of cardiorespiratory fitness and cognitive function in older individuals
    (Frontiers Media, 2023) Álvarez-Bueno, Celia; Lucerón Lucas-Torres, Maribel; Ruiz-Hermosa, Abel; Sequí-Domínguez, Irene; Venegas Sanabria, Luis Carlos; Medrano Echeverría, María; Visier-Alfonso, María Eugenia; Rodríguez-Martín, Beatriz; Ciencias de la Salud; Osasun Zientziak
    Objective: To describe the protocol of the MOVI-ageing randomized controlled trial, a home-based eHealth intervention of cognitive-demanding exercise for older adults, in improving global cognitive function and basic cognitive functions, cardiorespiratory fitness, and muscle fitness. Methods: This randomized controlled trial will include participants identified in the social centers of Cuenca and Talavera de la Reina who agree to participate and provide informed consent. Adults aged 60–80 years of both genders retired regardless of the reason for retirement, who do not meet frailty criteria according to Fried criteria, and without cognitive impairment will be invited to participate. This study will be developed in two phases: (i) a 12-week randomized efficacy/feasibility trial and (ii) a large-scale implementation randomized trial phase with a 12-week follow-up following similar procedures. In addition, a qualitative study on barriers to and facilitators of the implementation of the physical exercise intervention using eHealth for older people will be conducted. Participants will have access to a platform including videos of cognitively demanding physical exercise. The participants will be remotely and off-line guided through the physical exercise intervention, and the research team will be able to check the degree of compliance with the program and its correct execution. The participants will receive feedback on their compliance with the routines and reinforcement messages. Implications: The implementations of the findings and their inclusion in guidelines may directly impact in older people’s life, and relatives, through the prevention of morbidity and the reduction of years lost to disability. These benefits may be reflected in the reduction of economic expenditure by reducing the demand for social and health care services. Ethics: The Clinical Research Ethics Committee of the ‘Virgen de la Luz’ Hospital in Cuenca approved the study protocol (registration number: 2022/PI3222). In addition, this protocol was previously registered in Clinicaltrials.gov (Number: NCT05928078).
  • PublicationOpen Access
    Exercise prescription for the prevention and treatment of chronic diseases in primary care: protocol of the RedExAP study
    (Public Library of Science, 2024-07-05) Saz-Lara, Alicia; Martínez Hortelano, José Alberto; Medrano Echeverría, María; Luengo-González, Raquel; Garrido Miguel, Miriam; García-Sastre, Montserrat; Recio-Rodríguez, José Ignacio; Lozano-Cuesta, Daniel; Cavero-Redondo, Iván; Ciencias de la Salud; Osasun Zientziak; Institute on Innovation and Sustainable Development in Food Chain - ISFOOD
    Background. Existing evidence supports the effectiveness of exercise in preventing and treating chronic diseases, yet its integration into clinical practice remains limited. This study protocol aims to address the evidence-practice gap by exploring barriers to exercise prescription in primary care and developing a clinical practice guideline (CPG). Methods. Employing a qualitative approach, focus groups will be conducted to investigate primary care professionals’ challenges in prescribing exercise and patients’ adherence to recommendations. Phenomenological analysis will facilitate data interpretation. Data triangulation, expert analysis, and quality criteria will ensure study reliability. The CPG development process is outlined, emphasizing transdisciplinary collaboration and patient involvement. Conclusion. The RedExAP study responds to the imperative for evidence-based exercise integration in primary care. The study’s combined qualitative exploration and CPG development present the potential to improve health outcomes and cost-effectiveness. By elucidating primary care professionals’ and patients’ perspectives, the study contributes to enhancing exercise prescription adoption. The innovative transdisciplinary approach aligns with the 2030 Agenda, promoting better population health and greater social well-being, showing promise in alleviating chronic disease burdens. This study’s findings lay the groundwork for advancing evidence-based exercise interventions within primary care to transform chronic disease management.
  • PublicationOpen Access
    Validity, reliability, and calibration of the physical activity unit 7 item screener (PAU-7S) at population scale
    (BioMed Central, 2021) Schröder, Helmut; Subirana, Isaac; Wärnberg, Julia; Medrano Echeverría, María; González Gross, Marcela; Gusi, Narcís; Aznar, Susana; Alcaraz, Pedro E.; González Valeiro, Miguel A.; Serra-Majem, Lluis; Terrados, Nicolás; Tur, Josep A.; Segú, Marta; Homs, Clara; García-Álvarez, Alicia; Benavente-Marín, Juan C.; Barón-López, F. Javier; Labayen Goñi, Idoia; Zapico, Augusto G.; Sánchez-Gómez, Jesús; Jiménez-Zazo, Fabio; Marín-Cascales, Elena; Sevilla-Sánchez, Marta; Herrera-Ramos, Estefanía; Pulgar, Susana; Bibiloni, María del Mar; Sistac-Sorigué, Clara; Gómez, Santiago F.; Institute on Innovation and Sustainable Development in Food Chain - ISFOOD
    Background: Validation of self-reported tools, such as physical activity (PA) questionnaires, is crucial. The aim of this study was to determine test-retest reliability, internal consistency, and the concurrent, construct, and predictive validity of the short semi-quantitative Physical Activity Unit 7 item Screener (PAU-7S), using accelerometry as the reference measurement. The effect of linear calibration on PAU-7S validity was tested. Methods: A randomized sample of 321 healthy children aged 8–16 years (149 boys, 172 girls) from the nationwide representative PASOS study completed the PAU-7S before and after wearing an accelerometer for at least 7 consecutive days. Weight, height, and waist circumference were measured. Cronbach alpha was calculated for internal consistency. Test-retest reliability was determined by intra-class correlation (ICC). Concurrent validity was assessed by ICC and Spearman correlation coefficient between moderate to vigorous PA (MVPA) derived by the PAU-7S and by accelerometer. Concordance between both methods was analyzed by absolute agreement, weighted kappa, and Bland-Altman statistics. Multiple linear regression models were fitted for construct validity and predictive validity was determined by leave-one-out cross-validation.
  • PublicationOpen Access
    Association of breakfast quality and energy density with cardiometabolic risk factors in overweight/obese children: role of physical activity
    (MDPI, 2018) Arenaza Etxeberría, Lide; Muñoz-Hernández, Victoria; Medrano Echeverría, María; Osés Recalde, Maddi; Amasene, María; Merchán Ramírez, Elisa; Cadenas-Sánchez, Cristina; Ortega, Francisco B.; Ruiz, Jonatan R.; Labayen Goñi, Idoia; Institute on Innovation and Sustainable Development in Food Chain - ISFOOD
    There is a general belief that having breakfast is an important healthy lifestyle factor; however, there is scarce evidence on the influence of breakfast quality and energy density on cardiometabolic risk in children, as well as on the role of physical activity in this association. The aims of this paper were (i) to examine the associations of breakfast quality and energy density from both solids and beverages with cardiometabolic risk factors, and (ii) to explore whether physical activity levels may attenuate these relationships in children with overweight/obesity from two projects carried out in the north and south of Spain. Breakfast consumption, breakfast quality index (BQI) score, BEDs/BEDb (24 h-recalls and the KIDMED questionnaire), and physical activity (PA; accelerometry) were assessed, in 203 children aged 8-12 years who were overweight or obese. We measured body composition (Dual X-ray Absorptiometry), uric acid, blood pressure, lipid profile, gamma-glutamyl-transferase (GGT), glucose, and insulin, and calculated the HOMA and metabolic syndrome z-score. The BQI score was inversely associated with serum uric acid independently of a set of relevant confounders (= -0.172, p = 0.028), but the relationship was attenuated after further controlling for total PA (p < 0.07). BEDs was positively associated with total and HDL cholesterol, and systolic blood pressure regardless of confounders (all p < 0.05), while BEDb was positively associated with HOMA in either active/inactive children (all p < 0.03). In conclusion, higher breakfast quality and lower breakfast energy density should be promoted in overweight/obesity children to improve their cardiometabolic health.
  • PublicationOpen Access
    Differences in areal bone mineral density between metabolically healthy and unhealthy overweight/obese children: the role of physical activity and cardiorespiratory fitness
    (Springer Nature, 2019) Ubago Guisado, Esther; Gracia-Marco, Luis; Medrano Echeverría, María; Cadenas-Sánchez, Cristina; Arenaza Etxeberría, Lide; Migueles, Jairo H.; Mora González, José; Tobalina, Ignacio; Escolano Margarit, María Victoria; Osés Recalde, Maddi; Martín Matillas, Miguel; Labayen Goñi, Idoia; Ortega, Francisco B.; Institute on Innovation and Sustainable Development in Food Chain - ISFOOD
    Objectives: To examine whether areal bone mineral density (aBMD) differs between metabolically healthy (MHO) and unhealthy (MUO) overweight/obese children and to examine the role of moderate-to-vigorous physical activity (MVPA) and cardiorespiratory fitness (CRF) in this association. Methods: A cross-sectional study was developed in 188 overweight/obese children (10.4 ± 1.2 years) from the ActiveBrains and EFIGRO studies. Participants were classified as MHO or MUO based on Jolliffe and Janssen’s metabolic syndrome cut-off points for triglycerides, glucose, high-density cholesterol and blood pressure. MVPA and CRF were assessed by accelerometry and the 20-m shuttle run test, respectively. Body composition was measured by dual-energy X-ray absorptiometry. Results: In model 1 (adjusted for sex, years from peak high velocity, stature and lean mass), MHO children had significantly higher aBMD in total body less head (Cohen’s d effect size, ES = 0.34), trunk (ES = 0.43) and pelvis (ES = 0.33) than MUO children. These differences were attenuated once MVPA was added to model 1 (model 2), and most of them disappeared once CRF was added to the model 1 (model 3). Conclusions: This novel research shows that MHO children have greater aBMD than their MUO peers. Furthermore, both MVPA and more importantly CRF seem to partially explain these findings.