Open 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.
Open Access
Determinants of adherence to the mediterranean diet in Spanish children and adolescents: the PASOS Study
(MDPI, 2022) Bibiloni, María del Mar; Gallardo Alfaro, Laura; Gómez, Santiago F.; Wärnberg, Julia; Osés Recalde, Maddi; González Gross, Marcela; Gusi, Narcís; Aznar, Susana; Marín-Cascales, Elena; González Valeiro, Miguel A.; Serra-Majem, Lluis; Terrados, Nicolás; Segú, Marta; Lassale, Camille; Homs, Clara; Benavente-Marín, Juan C.; Labayen Goñi, Idoia; Zapico, Augusto G.; Sánchez-Gómez, Jesús; Jiménez-Zazo, Fabio; Alcaraz, Pedro E.; Sevilla-Sánchez, Marta; Herrera-Ramos, Estefanía; Pulgar, Susana; Sistac-Sorigué, Clara; Schröder, Helmut; Bouzas, Cristina; Tur, Josep A.; Osasun Zientziak; Institute on Innovation and Sustainable Development in Food Chain - ISFOOD; Ciencias de la Salud
A progressive shift away from traditional healthy dietary patterns, such as the Mediterranean diet (MedDiet), has been observed in recent decades. The aim of this study was to assess determinants of optimal adherence to the MedDiet in Spanish children and adolescents. A cross-sectional analysis was included in the PASOS nationwide representative study in Spain. Participants were 3607 children and adolescents; 8–16 years old. Primary and secondary outcome measures of weight and height were measured. Adherence to the MedDiet, physical activity, and sedentary behavior in children and adolescents, as well as parental physical activity and dietary habits, were assessed. Optimal adherence to the MedDiet was observed in 45.5% of primary school students and 34.8% of secondary school students (OR: 0.65; 95%CI: 0.56–0.75). Optimal adherence to the MedDiet was higher in children/adolescents meeting daily recommended moderate and vigorous physical activity (OR: 2.39, 95%CI: 1.97–2.89) and in those meeting daily recommended screen time on week-days (OR: 2.05, 95%CI: 1.77–2.38) and weekends (OR: 1.76, 95%CI: 1.48–2.10). Participants with optimal adherence to the MedDiet were more likely to have mothers with a high-level education and high-tercile of SDQS, mothers who never smoked or were former smokers, and mothers who met the recommended physical activity and screen time. It can be concluded that a low prevalence of optimal adherence to the MedDiet was found among current Spanish children and adolescents. Optimal adherence to the MedDiet was associated with reaching the recommendations on physical activity and screen time, with the highest maternal educational level, and healthier maternal life-styles.
Open Access
Trends in adherence to the mediterranean diet in spanish children and adolescents across two decades
(MDPI, 2023) Herrera-Ramos, Estefanía; Tomaino, Laura; Sánchez Villegas, María Almudena; Ribas-Barba, Lourdes; Gómez, Santiago F.; Wärnberg, Julia; Osés Recalde, Maddi; González Gross, Marcela; Gusi, Narcís; Aznar, Susana; Marín-Cascales, Elena; González Valeiro, Miguel A.; Terrados, Nicolás; Tur, Josep A.; Segú, Marta; Fitó, Montserrat; Homs, Clara; Benavente-Marín, Juan C.; Labayen Goñi, Idoia; Zapico, Augusto G.; Sánchez-Gómez, Jesús; Jiménez-Zazo, Fabio; Alcaraz, Pedro E.; Sevilla-Sánchez, Marta; Pulgar, Susana; Bouzas, Cristina; Sistac-Sorigué, Clara; Schröder, Helmut; Serra-Majem, Lluis; Institute on Innovation and Sustainable Development in Food Chain - ISFOOD
Unhealthy dietary habits determined during childhood may represent a risk factor to many of the chronic non-communicable diseases (NCDs) in adulthood. Mediterranean Diet (MD) adherence in children and adolescents (8–16 years) living in Spain was investigated using the KIDMED questionnaire in a comparative analysis of two cross-sectional nationwide representative studies: enKid (1998–2000, n = 1001) and PASOS (2019–2020, n = 3540). Taking into account the educational level of pupils, as well as the characteristics of the place of living, a significant association was found between a KIDMED score ≥ 8 (optimal MD adherence) and primary education as well as residency in an area of <50,000 inhabitants, while living in the southern regions was associated with non-optimal MD adherence (p < 0.001). Participants of the 2019–2020 study showed an increase in the consumption of dairy products (31.1% increase), pasta/rice (15.4% increase), olive oil (16.9% increase), and nuts (9.7% increase), as well as a decreased sweets and candies intake (12.6% reduction). In contrast, a significantly lower MD adherence was found when comparing the 2019–2020 (mean ± SE: 6.9 ± 0.04) and the 1998–2000 study (7.37 ± 0.08); p < 0.001), due to less consumption of fish (20.3% reduction), pulse (19.4% reduction), and fruits (14.9% reduction), and an increased intake of commercial goods/pastries or fast-food intake (both 19.4% increase). The lowest adherence was recorded for adolescents also in the most recent study, where 10.9% of them presented a KIDMED score ≤ 3. This study shows that eating habits are deteriorating among Spanish children and adolescents. Such findings point out the urgency of undertaking strong measures to promote the consumption of healthy, sustainable, and non-ultra-processed food, such as those available in an MD, not only at a scientific and academic level, but also at a governmental one.
Open Access
Independent and joined association between socioeconomic indicators and pediatric obesity in Spain: the PASOS study
(MDPI, 2023) Homs, Clara; Berruezo, Paula; Arcarons, Albert; Wärnberg, Julia; Osés Recalde, Maddi; González Gross, Marcela; Gusi, Narcís; Aznar, Susana; Marín-Cascales, Elena; González Valeiro, Miguel A.; Serra-Majem, Lluis; Terrados, Nicolás; Tur, Josep A.; Segú, Marta; Fitó, Montserrat; Benavente-Marín, Juan C.; Labayen Goñi, Idoia; Zapico, Augusto G.; Sánchez-Gómez, Jesús; Jiménez-Zazo, Fabio; Alcaraz, Pedro E.; Sevilla-Sánchez, Marta; Herrera-Ramos, Estefanía; Pulgar, Susana; Bouzas, Cristina; Milà, Raimon; Schröder, Helmut; Gómez, Santiago F.; Institute on Innovation and Sustainable Development in Food Chain - ISFOOD
Childhood obesity is a public health problem worldwide. An important determinant of child and adolescent obesity is socioeconomic status (SES). However, the magnitude of the impact of different SES indicators on pediatric obesity on the Spanish population scale is unclear. The aim of this study was to assess the association between three SES indicators and obesity in a nationwide, representative sample of Spanish children and adolescents. A total of 2791 boys and girls aged 8 to 16 years old were included. Their weight, height, and waist circumference were measured. SES was assessed using two parent/legal guardian self-reported indicators (educational level -University/non-University- and labor market status -Employed/Unemployed-). As a third SES indicator, the annual mean income per person was obtained from the census section where the participating schools were located (≥12.731€/<12.731€). The prevalence of obesity, severe obesity, and abdominal obesity was 11.5%, 1.4%, and 22.3%, respectively. Logistic regression models showed an inverse association of both education and labor market status with obesity, severe obesity, and abdominal obesity (all p < 0.001). Income was also inversely associated with obesity (p < 0.01) and abdominal obesity (p < 0.001). Finally, the highest composite SES category (University/Employed/≥12.731€ n = 517) showed a robust and inverse association with obesity (OR = 0.28; 95% CI: 0.16–0.48), severe obesity (OR = 0.20; 95% CI: 0.05–0.81), and abdominal obesity (OR = 0.36; 95% CI: 0.23–0.54) in comparison with the lowest composite SES category (Less than University/Unemployed/<12.731€; n = 164). No significant interaction between composite SES categories and age and gender was found. SES is strongly associated with pediatric obesity in Spain.
Open Access
Effects of time-restricted eating and resistance training on skeletal muscle tissue quantity, quality and function in postmenopausal women with overweight or obesity: a study protocol
(Elsevier, 2024-12-30) Alfaro-Magallanes, Víctor Manuel; Medrano Echeverría, María; Echarte Medina, Jon; Osés Recalde, Maddi; Izquierdo Rodríguez, Claudia; Concepción Álvarez, Mara de la Caridad; Galbete Jiménez, Arkaitz; Idoate, Fernando; Zugasti Murillo, Ana; Petrina Jáuregui, María Estrella; Goñi Gironés, María Elena; Ribelles, María Jesús; Amasene, María; Arenaza Etxeberría, Lide; Tejada Garrido, Clara Isabel; Elejalde, E.; Azcárate Jiménez, Unai Xabier; Ruiz Sarrias, Oskitz; Sayar-Beristain, Onintza; García-Ramos, Amador; Martínez Labari, Cristina; Armendáriz Brugos, Cristina; Villanueva Larre, Arantxa; Ruiz, Jonatan R.; Cabeza Laguna, Rafael; Labayen Goñi, Idoia; Ciencias de la Salud; Osasun Zientziak; Institute of Smart Cities - ISC; Ingeniería Eléctrica, Electrónica y de Comunicación; Ingeniaritza Elektrikoa, Elektronikoa eta Telekomunikazio Ingeniaritza; Estadística, Informática y Matemáticas; Estatistika, Informatika eta Matematika; Institute on Innovation and Sustainable Development in Food Chain - ISFOOD
Background & aims: time-restricted eating (TRE) shows promise for weight loss and improving menopauserelated body composition and cardiometabolic health, but its effects on skeletal muscle tissue (SMT) in postmenopausal women are unknown. This study investigates the effects of three weight loss interventions over 12 weeks on SMT quantity, quality, function, and cardiometabolic health in postmenopausal women with overweight/obesity, with effects persistence evaluated at a 12-month follow-up. Methods and results: in this randomized controlled trial, 78 postmenopausal women (50–65 years; BMI 25–40 kg/m2; sedentary lifestyle; eating window ≥12 h/day; no severe metabolic impairments) will be recruited. Participants will be randomly assigned to one of three groups for 12 weeks: TRE, TRE + resistance training, or CR + resistance training. The TRE groups will reduce their eating window to 8 h and receive nutritional advice to adhere to a Mediterranean diet. The CR group will follow a personalized hypocaloric diet (− 500 kcal/day). Resistance training groups will perform supervised resistance training 3 times/week. Primary Outcome: Change in SMT quantity measured by MRI at baseline and after 12 weeks. Secondary Outcomes: intermuscular adipose tissue (IMAT), strength, power, body weight and composition, and cardiometabolic risk factors. Conclusion: this study will illustrate the effects of TRE and TRE combined with resistance exercise compared with the currently recommended obesity-lifestyle treatment on SMT quantity, quality, function, and cardiometabolic markers. The results will offer insights into dietary strategies to combat obesity and metabolic diseases without increasing sarcopenia risk in postmenopausal women, a sparsely studied and particularly affected population.
Open Access
Effects of a family-based lifestyle intervention plus supervised exercise training on abdominal fat depots in children with overweight or obesity: a secondary analysis of a nonrandomized clinical trial
(American Medical Association, 2022) Cadenas-Sánchez, Cristina; Cabeza Laguna, Rafael; Idoate, Fernando; Osés Recalde, Maddi; Medrano Echeverría, María; Villanueva Larre, Arantxa; Arenaza Etxeberría, Lide; Sanz Muñoz, Aritz; Ortega, Francisco B.; Ruiz, Jonatan R.; 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
Importance Excess abdominal fat is a major determinant in the development of insulin resistance and other metabolic disorders. Increased visceral adipose tissue (VAT) seems to precede the development of insulin resistance and is therefore a prime target of childhood lifestyle interventions aimed at preventing diabetes. OBJECTIVES To examine the effect of added exercise to a family-based lifestyle intervention program designed to reduce VAT plus subcutaneous (ASAT), intermuscular (IMAAT), and pancreatic (PAT) adipose tissue in children with overweight or obesity and to explore the effect of changes in VAT on insulin resistance. DESIGN, SETTING, AND PARTICIPANTS This 2-group, parallel-design clinical trial was conducted in Vitoria-Gasteiz, Spain. A total of 116 children with overweight or obesity participated and were assigned to a 22-week family-based lifestyle program (control group [n = 57]) or the same program plus an exercise intervention (exercise group [n = 59]). Data were collected between September 1, 2014, and June 30, 2017, and imaging processing for fat depot assessments and data analysis were performed between May 1, 2019, and February 12, 2021. INTERVENTIONS The compared interventions consisted of a family-based lifestyle and psychoeducation program (two 90-minute sessions per month) and the same program plus supervised exercise (three 90-minute sessions per week). MAIN OUTCOMES AND MEASURES The primary outcome of this study was the change in VAT between baseline and 22 weeks as estimated by magnetic resonance imaging. The secondary outcomes were changes in ASAT, IMAAT, and PAT. The effect of changes in VAT area on insulin resistance was also recorded. RESULTS The 116 participants included in the analysis (62 girls [53.4%]) had a mean (SD) age of 10.6 (1.1) years, and 67 (57.8%) presented with obesity. Significantly greater reductions were recorded for the exercise group in terms of reduction in VAT (−18.1% vs −8.5% for the control group; P = .004), ASAT (−9.9% vs −3.0%; P = .001), and IMAAT (−6.0% vs −2.6%; P = .02) fat fractions compared with the control group. Changes in VAT explained 87.6% of the improvement seen in insulin resistance (β = −0.102 [95% CI, −0.230 to −0.002]). CONCLUSIONS AND RELEVANCE These findings suggest that the addition of exercise to a lifestyle intervention program substantially enhanced the positive effects on abdominal fat depots in children with overweight or obesity. In addition, the reduction in VAT seemed to largely mediate the improvement of insulin sensitivity. These results highlight the importance of including exercise as part of lifestyle therapies aimed at treating childhood obesity and preventing the development of type 2 diabetes.
Open Access
Evaluación de los requerimientos nutricionales en el paciente crítico
(2023) Osés Recalde, Maddi; Escalada Hernández, Paula; Facultad de Ciencias de la Salud; Osasun Zientzien Fakultatea
La evaluación de los requerimientos nutricionales en pacientes críticos es una tarea compleja para los profesionales de las unidades de cuidados intensivos. La desnutrición es una complicación común en estos pacientes, con una alta prevalencia en todos los hospitales. El aumento en la secreción de hormonas catabólicas sumada a los factores proinflamatorios aumentados, predisponen al paciente crítico a un alto riesgo de desnutrición. En este contexto, el aporte nutricional que reciben estos pacientes suele ser limitado y/o estar interrumpido por procedimientos clínicos específicos, agravando dicha condición. La desnutrición en el paciente crítico se ha asociado a un mayor riesgo de complicaciones y a una mayor mortalidad. La atención nutricional óptima de este tipo de pacientes requiere una determinación precisa y objetiva del gasto energético, para poder proporcionar un aporte nutricional acorde al mismo. El objetivo principal de este trabajo es identificar y valorar los métodos de evaluación de los requerimientos nutricionales en el paciente crítico. Esta revisión bibliográfica ha identificado las ecuaciones predictivas, el método de Fick y la calorimetría indirecta como los métodos más utilizados en la práctica clínica para calcular el gasto energético. Así, la literatura científica establece que determinación adecuada del gasto energético es imprescindible para realizar una pauta nutricional acorde al mismo. A su vez, a pesar de encontrar recomendaciones concretas del aporte de macronutrientes, es imprescindible individualizar la pauta nutricional de cada paciente a sus requerimientos. La correcta evaluación y monitorización de la alimentación es clave, y enfermería tiene la responsabilidad de realizarla correctamente. Se concluye que la calorimetría indirecta es la mejor metodología para determinar el gasto energético. La capacitación de las enfermeras en la valoración, control y monitorización de la ingesta ayudaría a mejorar los resultados en salud de los pacientes críticos.
Open 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.
Open Access
Identification of sociodemographic, biochemical and epigenetic biomarkers of hepatic steatosis in children with overweight or obesity
(2022) Osés Recalde, Maddi; Labayen Goñi, Idoia; Ciencias de la Salud; Osasun Zientziak; Gobierno de Navarra / Nafarroako Gobernua
La obesidad infantil se ha convertido en unos de los problemas más graves en materia de salud pública del siglo XXI. En las últimas dos décadas, y de forma paralela a la epidemia de la obesidad infantil, diferentes comorbilidades asociadas como las enfermedades cardiovasculares, la diabetes mellitus de tipo 2 y la enfermedad metabólica asociada al hígado graso (en inglés MAFLD; metabolic associated fatty liver disease) han aumentado su prevalencia en la población infantil. La MAFLD se ha convertido en la comorbilidad más frecuente de la obesidad infantil, siendo hoy en día a nivel mundial la primera causa de enfermedad hepática crónica en población pediátrica. La MAFLD puede progresar a esteatohepatitis y cirrosis, complicando su pronóstico y la reversibilidad de la patología. Sin embargo, su evolución asintomática, junto con la dificultad de su diagnóstico por tratarse de métodos costosos y/o invasivos (biopsia hepática y/o resonancia magnética), impiden su identificación y diagnóstico precoz. La evolución y progresión de la MAFLD pediátrica es compleja, multifactorial y no está del todo esclarecida. Ciertos polimorfismos genéticos y modificaciones epigenéticas, así como factores sociodemográficos y de estilo de vida se han relacionado con el desarrollo de esta enfermedad. Así, la identificación de los factores de riesgo de desarrollo de MAFLD, así como el estudio de biomarcadores de la enfermedad es crucial para su prevención y tratamiento temprano. En este sentido, asociaciones médicas y científicas subrayan la necesidad de desarrollar métodos de cribado útiles para la detección de la MAFLD pediátrica. Por ello, los objetivos de la presente Tesis Doctoral Internacional son: i) desarrollar un protocolo mínimamente invasivo y con alta capacidad predictiva, para la identificación de esteatosis hepática en niños/as con sobrepeso u obesidad, ii) analizar el papel de los miRNAs como biomarcadores de la obesidad infantil y de sus comorbilidades mediante un análisis sistematizado de los estudios publicados que identifican perfiles de miRNAs en la obesidad pediátrica y/o en sus comorbilidades asociadas, y iii) identificar miRNAs potencialmente marcadores de MAFLD y/o resistencia a la insulina en niños/as preadolescentes y estudiar su asociación con factores de riesgo metabólico. Para dar respuesta a estos objetivos se llevaron a cabo cuatro estudios en el contexto de tres proyectos de investigación: EFIGRO, PREDIKID y MICROKID. Las conclusiones de esta Tesis Doctoral son: i) los factores sociodemográficos y de estilos de vida como la pertenencia a una etnia minoritaria, la prematuridad, un elevado índice cintura-talla, el consumo de bebidas azucaradas, el tiempo de visualización de pantallas, y la baja capacidad cardiorrespiratoria están consistentemente asociados con la presencia de esteatosis hepática en niños/as con sobrepeso u obesidad, ii) los métodos de cribado de MAFLD pediátrica disponibles muestran una limitada precisión y aplicabilidad, iii) el índice HEPAKID es la primera herramienta de cribado basada en datos antropométricos, sociodemográficos y de estilos de vida capaz de identificar a niños/as con sobrepeso u obesidad con elevado riesgo de padecer esteatosis hepática, iv) los niveles elevados de triglicéridos (TG), HOMA-IR, alanina aminotransferasa (ALT), aspartato aminotransferasa (AST), gamma-glutamil transferasa (GGT) y ferritina en plasma, así como la presencia de alelos de riesgo de las variantes genéticas PPARGrs13081389, PPARGrs1801282, HFErs1800562 y PNLPLA3rs4823173 se asocian consistentemente con la presencia de esteatosis hepática en niños/as con sobrepeso u obesidad. Sin embargo, su capacidad predictiva es baja por lo que no son suficientes para el cribado de la MAFLD, v) el protocolo de predicción HEPAKID muestra una alta sensibilidad, especificidad y capacidad discriminatoria, así como con una mínima inversión de tiempo y de recursos económicos, para identificar la MAFLD en niños/as con sobrepeso u obesidad y que deben ser derivados a unidades especializadas para la confirmación del diagnóstico, vi) los miRNAs circulantes son biomarcadores prometedores de enfermedades asociadas a la obesidad como la MAFLD y la diabetes mellitus tipo 2. Sin embargo, no ha sido posible identificar un perfil de miRNAs concreto asociado con las comorbilidades mencionadas en niños/as con obesidad en la literatura científica actual, vii) el miRNA circulante miR-660-5p parece ser un biomarcador predictivo de la presencia de MAFLD en niños/as preadolescentes, independientemente de su peso corporal y viii) los miRNAs circulantes miR-320a, miR 142-3p, miR-190a-5p, miR-374a-5p y los de la familia let-7 podrían servir como potenciales biomarcadores de la resistencia a la insulina en población pediátrica.
Open Access
Twenty-year trend in the prevalence of increased cardiometabolic risk, measured by abdominal obesity, among Spanish children and adolescents across body mass index categories
(BCM, 2024-11-05) Schröder, Helmut; Juton, Charlotte; Goran, Michael I.; Wärnberg, Julia; Osés Recalde, Maddi; González Gross, Marcela; Gusi, Narcís; Aznar, Susana; Marín-Cascales, Elena; González Valeiro, Miguel A.; Herrera-Ramos, Estefanía; Terrados, Nicolás; Tur, Josep A.; Segú, Marta; Fitó, Montserrat; Ribas-Barba, Lourdes; Bautista-Castaño, Inmaculada; Peña-Quintana, Luis; Berruezo, Paula; Benavente-Marín, Juan C.; Labayen Goñi, Idoia; Zapico, Augusto G.; Sánchez-Gómez, Jesús; Jiménez-Zazo, Fabio; Alcaraz, Pedro E.; Sevilla-Sánchez, Marta; Pulgar, Susana; Bouzas, Cristina; Serra-Majem, Lluis; Gómez, Santiago F.; Ciencias de la Salud; Osasun Zientziak; Institute on Innovation and Sustainable Development in Food Chain - ISFOOD
Background: identifying children and adolescents with cardiometabolic risk at an early stage is crucial for effective treatment and prevention. From a practical perspective, this could be accomplished by assessing the presence of abdominal obesity, which serves as a surrogate indicator of increased cardiometabolic risk and is easy to measure. However, the assessment of abdominal obesity via waist circumference has not yet become a standard procedure in pediatric healthcare. The present study aimed to analyze the secular trends in increased cardiometabolic risk, as indicated by waist circumference among Spanish children and adolescents. Methods: this study included 4861 children and adolescents aged 8 to 16 years from two nationwide representative cross-sectional surveys, the EnKid study and the PASOS study, conducted in 1998–2000 and 2019–2020, respectively. Anthropometric variables were measured in both surveys by trained personnel. Three different waist-to-height (WHtR) cutoffs were used to define abdominal obesity as criteria for cardiometabolic risk. BMI categories were defined according to the IOTF and WHO growth charts. Results: abdominal obesity [waist to height ratio (cm/cm) > 0.49] significantly increased from 40.7 to 56.1% and 93.8 to 97.2% in participants with overweight and obesity, respectively, between 1998–2000 and 2019–2020 (p < 0.05). Logistic regression analysis, adjusted for sex and age, revealed that the odds of being at increased cardiometabolic risk in 2019–2020 was 1.99 (95% CI 1.48–2.67) in participants with overweight in comparison with 1998–2000. The effect size was comparable among the three WHtR criteria for abdominal obesity or the BMI categories according to IOTF and WHO boundaries. Conclusions: the prevalence of Spanish children with increased cardiometabolic risk, identified by abdominal obesity, significantly increased among those with overweight during the last two decades. This finding underlines the need of including the measurement of waist circumference as a standard procedure in pediatric practice.