Cristina Bouzas - Academia.edu (original) (raw)

Papers by Cristina Bouzas

Research paper thumbnail of Dietary Patterns, Foods, and Nutrients to Ameliorate Non-Alcoholic Fatty Liver Disease: A Scoping Review

Research paper thumbnail of Adherence to a Mediterranean Diet Pattern, Physical Activity, and Physical Self-Concept in Spanish Older Adults

Research paper thumbnail of Intrahepatic Fat Content and COVID-19 Lockdown in Adults with NAFLD and Metabolic Syndrome

Research paper thumbnail of Adherence to Mediterranean Diet and NAFLD in Patients with Metabolic Syndrome: The FLIPAN Study

Research paper thumbnail of Metabolic syndrome criteria and severity and carbon dioxide (CO2) emissions in an adult population

Globalization and Health, Jul 13, 2023

Research paper thumbnail of The Relationship between Social Media Use and Body Image in Lebanese University Students

Nutrients

Well-being is not only defined as being physically healthy; multiple factors can affect a person’... more Well-being is not only defined as being physically healthy; multiple factors can affect a person’s well-being. Social media is strongly correlated with the body dissatisfaction of an individual. High exposure to lean and toned body shapes has created new standards and “idealized” body types. The aim of this article was to assess the relationship between social media and body image among university students in Lebanon. Data were obtained from 292 university students (median age: 22 years), selected from different Lebanese regions by using convenience sampling. Demographic data, social media addiction, body satisfaction, levels of physical activity, eating behaviors, and ultimate well-being were expressed as median and interquartile range. People who relied more on social media were younger than those who did not. Individuals addicted to social media had higher odds of having moderate and marked body image concerns. A significant association was found between social media addiction an...

Research paper thumbnail of Independent and Joined Association between Socioeconomic Indicators and Pediatric Obesity in Spain: The PASOS Study

Nutrients

Childhood obesity is a public health problem worldwide. An important determinant of child and ado... more 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....

Research paper thumbnail of Carbon dioxide (CO2) emissions and adherence to Mediterranean diet in an adult population: the Mediterranean diet index as a pollution level index

Environmental Health

Background Research related to sustainable diets is is highly relevant to provide better understa... more Background Research related to sustainable diets is is highly relevant to provide better understanding of the impact of dietary intake on the health and the environment. Aim To assess the association between the adherence to an energy-restricted Mediterranean diet and the amount of CO2 emitted in an older adult population. Design and population Using a cross-sectional design, the association between the adherence to an energy-reduced Mediterranean Diet (erMedDiet) score and dietary CO2 emissions in 6646 participants was assessed. Methods Food intake and adherence to the erMedDiet was assessed using validated food frequency questionnaire and 17-item Mediterranean questionnaire. Sociodemographic characteristics were documented. Environmental impact was calculated through greenhouse gas emissions estimations, specifically CO2 emissions of each participant diet per day, using a European database. Participants were distributed in quartiles according to their estimated CO2 emissions expre...

Research paper thumbnail of Intrahepatic Fat Content and COVID-19 Lockdown in Adults with NAFLD and Metabolic Syndrome

Nutrients

Background: COVID-19 lockdowns had a significant impact on people’s health, triggering levels of ... more Background: COVID-19 lockdowns had a significant impact on people’s health, triggering levels of anxiety, perceived stress, and changes in food and nutritional status. Objectives: To assess the changes in dietary habits, metabolic syndrome (MetS) and liver parameters before and after the COVID-19 lockdown according to changes in intrahepatic fat content in adults with non-alcoholic fatty liver disease (NAFLD) and MetS. Design: Pre- and post-lockdown observation of the COVID-19 lockdown on fifty-nine 40–60-year-old participants with MetS and NAFLD, in a parallel group, randomised experiment intended to treat NAFLD. Methods: Anthropometrics, liver and MetS biochemical parameters, intrahepatic fat content by abdominal magnetic resonance imaging, and dietary assessment using a validated 148-item Food Frequency Questionnaire were collected pre-COVID-19 lockdown and post-lockdown. Results: COVID-19 lockdown led to negative changes in the liver of patients with NAFLD and MetS, with weight ...

Research paper thumbnail of Adherence to Mediterranean Diet and NAFLD in Patients with Metabolic Syndrome: The FLIPAN Study

Nutrients

Unhealthy diet is an important factor in the progression of non-alcoholic fatty liver disease (NA... more Unhealthy diet is an important factor in the progression of non-alcoholic fatty liver disease (NAFLD). Previous studies showed the benefits of a Mediterranean diet (MedDiet) on Metabolic syndrome (MetS), type 2 diabetes mellitus (T2DM), and cardiovascular diseases, which usually have a pathophysiological relationship with NAFLD. To assess the effect of adherence to a MedDiet on NAFLD in MetS patients after lifestyle intervention, this multicentre (Mallorca and Navarra, Spain) prospective randomized trial, with personalized nutritional intervention based on a customized MedDiet, coupled with physical activity promotion was performed to prevent, and reverse NAFLD among patients with MetS. The current analysis included 138 patients aged 40 to 60 years old, Body Mass Index (BMI) 27–40 kg/m2, diagnosed with NAFLD using MRI, and MetS according to the International Diabetes Federation (IDF). A validated food frequency questionnaire was used to assess dietary intake. Adherence to Mediterran...

Research paper thumbnail of Desired weight loss and its association with health, health behaviors and perceptions in an adult population with weight excess: One-year follow-up

Frontiers in Nutrition

BackgroundMetabolic syndrome (MetS) worsens quality of life and increases mortality. Dissatisfact... more BackgroundMetabolic syndrome (MetS) worsens quality of life and increases mortality. Dissatisfaction with weight in patients with MetS may modify the effect of lifestyle interventions to achieve changes in health-related behaviors.ObjectiveTo assess 1-year changes in cardiovascular risk scores, self-perceived general health and health-related behaviors according to observed changes in desired weight loss during the first year of intervention in a large cardiovascular prevention trial.DesignProspective analysis of the PREDIMED-PLUS trial, including 5,499 adults (55–75 years old) with overweight or obesity at baseline.MethodsThe desired weight loss was the difference between ideal and measured weight. Tertiles of change in desired weight loss (1 year vs. baseline) were defined by the following cut-off points: ≥0.0 kg (T1, n = 1,638); 0.0 to −4.0 kg (T2, n = 1,903); ≤−4.0 kg (T3, n = 1,958). A food frequency questionnaire assessed diet and the Minnesota-REGICOR questionnaire assessed p...

Research paper thumbnail of Impact of Physical Activity Differences Due to COVID-19 Pandemic Lockdown on Non-Alcoholic Fatty Liver Parameters in Adults with Metabolic Syndrome

Nutrients

Background: A Mediterranean lifestyle with a Mediterranean diet and regular physical activity (PA... more Background: A Mediterranean lifestyle with a Mediterranean diet and regular physical activity (PA) improves metabolic syndrome (MetS) characteristics and non-alcoholic fatty liver disease (NAFLD). The COVID-19 pandemic stopped healthy habits and increased NAFLD progression. Objectives: To assess how PA differences due to COVID-19 lockdown affected NAFLD parameters in adults with MetS. Design: Longitudinal 2-year analysis of data obtained between COVID-19 pre- and post-lockdown in a parallel-group randomized trial (n = 57, aged 40–60 years old, with MetS and NAFLD). Methods: NAFLD status and related parameters were assessed by magnetic resonance imaging (MRI), blood collection analysis and related indexes. PA and fitness status were assessed by an Alpha-Fit test battery, accelerometers, validated Minnesota questionnaire and functional fitness score. During lockdown, study personnel telephoned patients to motivate them. Participants were grouped according to PA levels. Results: The lo...

Research paper thumbnail of Adherence to a Mediterranean Diet Pattern, Physical Activity, and Physical Self-Concept in Spanish Older Adults

Nutrients

Background: The aging world population is accelerating rapidly. Physical self-concept (PSC) is on... more Background: The aging world population is accelerating rapidly. Physical self-concept (PSC) is one of the psychosocial factors with the greatest influence on an individual’s well-being and health. The traditional Mediterranean dietary pattern (MDP) is considered one of the healthiest dietary models, as it is nutritionally complete and easy to follow. Objective: To assess the adherence to MDP and its association with the practice of physical activity (PA) and PSC levels in the older adult Spanish population. Methods: A cross-sectional study was conducted on a representative sample of Spanish older adults (n = 342; older than 55 years old). Their PSC was assessed using a previously validated PSC questionnaire. Adherence to an MDP was assessed using a validated Mediterranean Diet Adherence Screener questionnaire. Their PA was measured using the Spanish version of the Rapid Assessment of Physical Activity Questionnaire. Data on age, sex, hypertension, cholesterol or diabetes suffered in...

Research paper thumbnail of Health-Related Quality of Life in Spanish Schoolchildren and Its Association with the Fitness Status and Adherence to the Mediterranean Diet

Nutrients

Background: Health-related quality of life (HRQoL) allows knowing the subject’s feelings in distr... more Background: Health-related quality of life (HRQoL) allows knowing the subject’s feelings in distress and well-being, as well as perception of current and future health. Objective: To assess associations between health-related quality of life, fitness status, and adherence to the Mediterranean diet in Spanish children and adolescents. Methods: A cross-sectional study was carried out in a sample of 305 (47.2% women) children and adolescents aged between 8 and 16 years, in the primary and secondary schools of the province of Ávila (central Spain) (NCT05380674). Subjects were classified according to their quality of life: group 1 (highest quality of life) > group 2 (medium quality of life) > group 3 (lowest quality of life). Results: More participants in group 1 showed higher adherence to Mediterranean diet (70.8%) than other groups (group 2: 55.0%; group 3: 43.4%). It was less likely to find optimal levels of muscle strength as quality of life decreased (OR; 95% CI: group 2: 0.53...

Research paper thumbnail of Explaining the complex impact of the Covid-19 pandemic on children with overweight and obesity: a comparative ecological analysis of parents’ perceptions in three countries

BMC Public Health

Background The Covid-19 pandemic has changed children’s eating and physical activity behaviours. ... more Background The Covid-19 pandemic has changed children’s eating and physical activity behaviours. These changes have been positive for some households and negative for others, revealing health inequalities that have ramifications for childhood obesity. This study investigates the pandemic’s impact on families of children aged 2–6 years with overweight or obesity. Methods Drawing on interviews conducted as part of a randomised controlled trial (RCT) for childhood obesity, thematic analysis was used to examine how parents of pre-schoolers perceived changes in their eating, screentime and physical activity behaviours between the first and second waves of Covid-19. Parents (n = 70, representing 68 families) were interviewed twice during a period of 6 months in three countries with markedly different pandemic policies – Sweden, Romania, and Spain. The analysis is informed by Bronfenbrenner’s ecological systems theory, which embeds home- and school-based influences within societal and poli...

Research paper thumbnail of Association between Functional Fitness and Health-Related Quality of Life in the Balearic Islands’ Old Adults with Metabolic Syndrome

Nutrients

Research assessing the relationship between functional fitness (FF) and health-related quality of... more Research assessing the relationship between functional fitness (FF) and health-related quality of life (HRQoL) is still scarce. The objective of this research is to assess the association between FF and HRQoL in older adults with metabolic syndrome (MetS) from Balearic Islands (Spain). The design is a cross-sectional, descriptive, and comparative study involving 209 participants (42.2% women). The sociodemographic data and medical history of the participants were collected. Physical activity was evaluated using the Spanish version of the Rapid Assessment of Physical Activity Questionnaire. Anthropometrics and blood pressure were measured. Glucose, total cholesterol, high-density lipoprotein cholesterol, and triglyceride plasma levels were measured. A battery of functional fitness tests was applied. HRQoL was measured with the Spanish version of the SF-36 questionnaire. Adherence to the Mediterranean dietary pattern was assessed. In older subjects with MetS, a higher FF score and, wi...

Research paper thumbnail of Adopting a High-Polyphenolic Diet Is Associated with an Improved Glucose Profile: Prospective Analysis within the PREDIMED-Plus Trial

Antioxidants, 2022

Previous studies suggested that dietary polyphenols could reduce the incidence and complications ... more Previous studies suggested that dietary polyphenols could reduce the incidence and complications of type-2 diabetes (T2D); although the evidence is still limited and inconsistent. This work analyzes whether changing to a diet with a higher polyphenolic content is associated with an improved glucose profile. At baseline, and at 1 year of follow-up visits, 5921 participants (mean age 65.0 ± 4.9, 48.2% women) who had overweight/obesity and metabolic syndrome filled out a validated 143-item semi-quantitative food frequency questionnaire (FFQ), from which polyphenol intakes were calculated. Energy-adjusted total polyphenols and subclasses were categorized in tertiles of changes. Linear mixed-effect models with random intercepts (the recruitment centers) were used to assess associations between changes in polyphenol subclasses intake and 1-year plasma glucose or glycosylated hemoglobin (HbA1c) levels. Increments in total polyphenol intake and some classes were inversely associated with be...

Research paper thumbnail of Combined Body Mass Index and Waist-to-Height Ratio and Its Association with Lifestyle and Health Factors among Spanish Children: The PASOS Study

Nutrients, 2022

Background and Aims: The World Health Organization recommended simultaneous measurement of body m... more Background and Aims: The World Health Organization recommended simultaneous measurement of body mass index (BMI) and waist circumference (WC) and suggested joint use to predict disease risks. The aim of this study was to assess the prevalence of BMI and waist-to-height ratio (WHtR) categories among Spanish children and adolescents, as well as their associations with several lifestyle factors. Methods: Cross-sectional analysis of 8–16-year-old children and adolescents (n = 3772) were included in the PASOS nationwide representative study. Children/adolescents and their mothers/female caregivers answered a questionnaire on lifestyle and health factors. Child/adolescent anthropometrics were measured. Four combined BMI-WHtR disease risk categories were built. Results: A third of participants showed combined BMI-WHtR categories with high disease risk (12.3% ‘increased risk’, 9.7% ‘high risk’, 14.3% ‘very high risk’). Participants in the ‘very high risk’ group were less likely to be female...

Research paper thumbnail of Paediatric teams in front of childhood obesity: A qualitative study within the STOP project

Anales de Pediatría (English Edition), 2021

Research paper thumbnail of Dietary Quality Changes According to the Preceding Maximum Weight: A Longitudinal Analysis in the PREDIMED-Plus Randomized Trial

Nutrients, 2020

One-year dietary quality change according to the preceding maximum weight in a lifestyle interven... more One-year dietary quality change according to the preceding maximum weight in a lifestyle intervention program (PREDIMED-Plus trial, 55–75-year-old overweight or obese adults; n = 5695) was assessed. A validated food frequency questionnaire was used to assess dietary intake. A total of 3 groups were made according to the difference between baseline measured weight and lifetime maximum reported weight: (a) participants entering the study at their maximum weight, (b) moderate weight loss maintainers (WLM), and (c) large WLM. Data were analyzed by General Linear Model. All participants improved average lifestyle. Participants entering the study at their maximum weight were the most susceptible to improve significantly their dietary quality, assessed by adherence to Mediterranean diet, DII and both healthful and unhealthful provegetarian patterns. People at maximum weight are the most benefitted in the short term by a weight management program. Long term weight loss efforts may also redu...

Research paper thumbnail of Dietary Patterns, Foods, and Nutrients to Ameliorate Non-Alcoholic Fatty Liver Disease: A Scoping Review

Research paper thumbnail of Adherence to a Mediterranean Diet Pattern, Physical Activity, and Physical Self-Concept in Spanish Older Adults

Research paper thumbnail of Intrahepatic Fat Content and COVID-19 Lockdown in Adults with NAFLD and Metabolic Syndrome

Research paper thumbnail of Adherence to Mediterranean Diet and NAFLD in Patients with Metabolic Syndrome: The FLIPAN Study

Research paper thumbnail of Metabolic syndrome criteria and severity and carbon dioxide (CO2) emissions in an adult population

Globalization and Health, Jul 13, 2023

Research paper thumbnail of The Relationship between Social Media Use and Body Image in Lebanese University Students

Nutrients

Well-being is not only defined as being physically healthy; multiple factors can affect a person’... more Well-being is not only defined as being physically healthy; multiple factors can affect a person’s well-being. Social media is strongly correlated with the body dissatisfaction of an individual. High exposure to lean and toned body shapes has created new standards and “idealized” body types. The aim of this article was to assess the relationship between social media and body image among university students in Lebanon. Data were obtained from 292 university students (median age: 22 years), selected from different Lebanese regions by using convenience sampling. Demographic data, social media addiction, body satisfaction, levels of physical activity, eating behaviors, and ultimate well-being were expressed as median and interquartile range. People who relied more on social media were younger than those who did not. Individuals addicted to social media had higher odds of having moderate and marked body image concerns. A significant association was found between social media addiction an...

Research paper thumbnail of Independent and Joined Association between Socioeconomic Indicators and Pediatric Obesity in Spain: The PASOS Study

Nutrients

Childhood obesity is a public health problem worldwide. An important determinant of child and ado... more 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....

Research paper thumbnail of Carbon dioxide (CO2) emissions and adherence to Mediterranean diet in an adult population: the Mediterranean diet index as a pollution level index

Environmental Health

Background Research related to sustainable diets is is highly relevant to provide better understa... more Background Research related to sustainable diets is is highly relevant to provide better understanding of the impact of dietary intake on the health and the environment. Aim To assess the association between the adherence to an energy-restricted Mediterranean diet and the amount of CO2 emitted in an older adult population. Design and population Using a cross-sectional design, the association between the adherence to an energy-reduced Mediterranean Diet (erMedDiet) score and dietary CO2 emissions in 6646 participants was assessed. Methods Food intake and adherence to the erMedDiet was assessed using validated food frequency questionnaire and 17-item Mediterranean questionnaire. Sociodemographic characteristics were documented. Environmental impact was calculated through greenhouse gas emissions estimations, specifically CO2 emissions of each participant diet per day, using a European database. Participants were distributed in quartiles according to their estimated CO2 emissions expre...

Research paper thumbnail of Intrahepatic Fat Content and COVID-19 Lockdown in Adults with NAFLD and Metabolic Syndrome

Nutrients

Background: COVID-19 lockdowns had a significant impact on people’s health, triggering levels of ... more Background: COVID-19 lockdowns had a significant impact on people’s health, triggering levels of anxiety, perceived stress, and changes in food and nutritional status. Objectives: To assess the changes in dietary habits, metabolic syndrome (MetS) and liver parameters before and after the COVID-19 lockdown according to changes in intrahepatic fat content in adults with non-alcoholic fatty liver disease (NAFLD) and MetS. Design: Pre- and post-lockdown observation of the COVID-19 lockdown on fifty-nine 40–60-year-old participants with MetS and NAFLD, in a parallel group, randomised experiment intended to treat NAFLD. Methods: Anthropometrics, liver and MetS biochemical parameters, intrahepatic fat content by abdominal magnetic resonance imaging, and dietary assessment using a validated 148-item Food Frequency Questionnaire were collected pre-COVID-19 lockdown and post-lockdown. Results: COVID-19 lockdown led to negative changes in the liver of patients with NAFLD and MetS, with weight ...

Research paper thumbnail of Adherence to Mediterranean Diet and NAFLD in Patients with Metabolic Syndrome: The FLIPAN Study

Nutrients

Unhealthy diet is an important factor in the progression of non-alcoholic fatty liver disease (NA... more Unhealthy diet is an important factor in the progression of non-alcoholic fatty liver disease (NAFLD). Previous studies showed the benefits of a Mediterranean diet (MedDiet) on Metabolic syndrome (MetS), type 2 diabetes mellitus (T2DM), and cardiovascular diseases, which usually have a pathophysiological relationship with NAFLD. To assess the effect of adherence to a MedDiet on NAFLD in MetS patients after lifestyle intervention, this multicentre (Mallorca and Navarra, Spain) prospective randomized trial, with personalized nutritional intervention based on a customized MedDiet, coupled with physical activity promotion was performed to prevent, and reverse NAFLD among patients with MetS. The current analysis included 138 patients aged 40 to 60 years old, Body Mass Index (BMI) 27–40 kg/m2, diagnosed with NAFLD using MRI, and MetS according to the International Diabetes Federation (IDF). A validated food frequency questionnaire was used to assess dietary intake. Adherence to Mediterran...

Research paper thumbnail of Desired weight loss and its association with health, health behaviors and perceptions in an adult population with weight excess: One-year follow-up

Frontiers in Nutrition

BackgroundMetabolic syndrome (MetS) worsens quality of life and increases mortality. Dissatisfact... more BackgroundMetabolic syndrome (MetS) worsens quality of life and increases mortality. Dissatisfaction with weight in patients with MetS may modify the effect of lifestyle interventions to achieve changes in health-related behaviors.ObjectiveTo assess 1-year changes in cardiovascular risk scores, self-perceived general health and health-related behaviors according to observed changes in desired weight loss during the first year of intervention in a large cardiovascular prevention trial.DesignProspective analysis of the PREDIMED-PLUS trial, including 5,499 adults (55–75 years old) with overweight or obesity at baseline.MethodsThe desired weight loss was the difference between ideal and measured weight. Tertiles of change in desired weight loss (1 year vs. baseline) were defined by the following cut-off points: ≥0.0 kg (T1, n = 1,638); 0.0 to −4.0 kg (T2, n = 1,903); ≤−4.0 kg (T3, n = 1,958). A food frequency questionnaire assessed diet and the Minnesota-REGICOR questionnaire assessed p...

Research paper thumbnail of Impact of Physical Activity Differences Due to COVID-19 Pandemic Lockdown on Non-Alcoholic Fatty Liver Parameters in Adults with Metabolic Syndrome

Nutrients

Background: A Mediterranean lifestyle with a Mediterranean diet and regular physical activity (PA... more Background: A Mediterranean lifestyle with a Mediterranean diet and regular physical activity (PA) improves metabolic syndrome (MetS) characteristics and non-alcoholic fatty liver disease (NAFLD). The COVID-19 pandemic stopped healthy habits and increased NAFLD progression. Objectives: To assess how PA differences due to COVID-19 lockdown affected NAFLD parameters in adults with MetS. Design: Longitudinal 2-year analysis of data obtained between COVID-19 pre- and post-lockdown in a parallel-group randomized trial (n = 57, aged 40–60 years old, with MetS and NAFLD). Methods: NAFLD status and related parameters were assessed by magnetic resonance imaging (MRI), blood collection analysis and related indexes. PA and fitness status were assessed by an Alpha-Fit test battery, accelerometers, validated Minnesota questionnaire and functional fitness score. During lockdown, study personnel telephoned patients to motivate them. Participants were grouped according to PA levels. Results: The lo...

Research paper thumbnail of Adherence to a Mediterranean Diet Pattern, Physical Activity, and Physical Self-Concept in Spanish Older Adults

Nutrients

Background: The aging world population is accelerating rapidly. Physical self-concept (PSC) is on... more Background: The aging world population is accelerating rapidly. Physical self-concept (PSC) is one of the psychosocial factors with the greatest influence on an individual’s well-being and health. The traditional Mediterranean dietary pattern (MDP) is considered one of the healthiest dietary models, as it is nutritionally complete and easy to follow. Objective: To assess the adherence to MDP and its association with the practice of physical activity (PA) and PSC levels in the older adult Spanish population. Methods: A cross-sectional study was conducted on a representative sample of Spanish older adults (n = 342; older than 55 years old). Their PSC was assessed using a previously validated PSC questionnaire. Adherence to an MDP was assessed using a validated Mediterranean Diet Adherence Screener questionnaire. Their PA was measured using the Spanish version of the Rapid Assessment of Physical Activity Questionnaire. Data on age, sex, hypertension, cholesterol or diabetes suffered in...

Research paper thumbnail of Health-Related Quality of Life in Spanish Schoolchildren and Its Association with the Fitness Status and Adherence to the Mediterranean Diet

Nutrients

Background: Health-related quality of life (HRQoL) allows knowing the subject’s feelings in distr... more Background: Health-related quality of life (HRQoL) allows knowing the subject’s feelings in distress and well-being, as well as perception of current and future health. Objective: To assess associations between health-related quality of life, fitness status, and adherence to the Mediterranean diet in Spanish children and adolescents. Methods: A cross-sectional study was carried out in a sample of 305 (47.2% women) children and adolescents aged between 8 and 16 years, in the primary and secondary schools of the province of Ávila (central Spain) (NCT05380674). Subjects were classified according to their quality of life: group 1 (highest quality of life) > group 2 (medium quality of life) > group 3 (lowest quality of life). Results: More participants in group 1 showed higher adherence to Mediterranean diet (70.8%) than other groups (group 2: 55.0%; group 3: 43.4%). It was less likely to find optimal levels of muscle strength as quality of life decreased (OR; 95% CI: group 2: 0.53...

Research paper thumbnail of Explaining the complex impact of the Covid-19 pandemic on children with overweight and obesity: a comparative ecological analysis of parents’ perceptions in three countries

BMC Public Health

Background The Covid-19 pandemic has changed children’s eating and physical activity behaviours. ... more Background The Covid-19 pandemic has changed children’s eating and physical activity behaviours. These changes have been positive for some households and negative for others, revealing health inequalities that have ramifications for childhood obesity. This study investigates the pandemic’s impact on families of children aged 2–6 years with overweight or obesity. Methods Drawing on interviews conducted as part of a randomised controlled trial (RCT) for childhood obesity, thematic analysis was used to examine how parents of pre-schoolers perceived changes in their eating, screentime and physical activity behaviours between the first and second waves of Covid-19. Parents (n = 70, representing 68 families) were interviewed twice during a period of 6 months in three countries with markedly different pandemic policies – Sweden, Romania, and Spain. The analysis is informed by Bronfenbrenner’s ecological systems theory, which embeds home- and school-based influences within societal and poli...

Research paper thumbnail of Association between Functional Fitness and Health-Related Quality of Life in the Balearic Islands’ Old Adults with Metabolic Syndrome

Nutrients

Research assessing the relationship between functional fitness (FF) and health-related quality of... more Research assessing the relationship between functional fitness (FF) and health-related quality of life (HRQoL) is still scarce. The objective of this research is to assess the association between FF and HRQoL in older adults with metabolic syndrome (MetS) from Balearic Islands (Spain). The design is a cross-sectional, descriptive, and comparative study involving 209 participants (42.2% women). The sociodemographic data and medical history of the participants were collected. Physical activity was evaluated using the Spanish version of the Rapid Assessment of Physical Activity Questionnaire. Anthropometrics and blood pressure were measured. Glucose, total cholesterol, high-density lipoprotein cholesterol, and triglyceride plasma levels were measured. A battery of functional fitness tests was applied. HRQoL was measured with the Spanish version of the SF-36 questionnaire. Adherence to the Mediterranean dietary pattern was assessed. In older subjects with MetS, a higher FF score and, wi...

Research paper thumbnail of Adopting a High-Polyphenolic Diet Is Associated with an Improved Glucose Profile: Prospective Analysis within the PREDIMED-Plus Trial

Antioxidants, 2022

Previous studies suggested that dietary polyphenols could reduce the incidence and complications ... more Previous studies suggested that dietary polyphenols could reduce the incidence and complications of type-2 diabetes (T2D); although the evidence is still limited and inconsistent. This work analyzes whether changing to a diet with a higher polyphenolic content is associated with an improved glucose profile. At baseline, and at 1 year of follow-up visits, 5921 participants (mean age 65.0 ± 4.9, 48.2% women) who had overweight/obesity and metabolic syndrome filled out a validated 143-item semi-quantitative food frequency questionnaire (FFQ), from which polyphenol intakes were calculated. Energy-adjusted total polyphenols and subclasses were categorized in tertiles of changes. Linear mixed-effect models with random intercepts (the recruitment centers) were used to assess associations between changes in polyphenol subclasses intake and 1-year plasma glucose or glycosylated hemoglobin (HbA1c) levels. Increments in total polyphenol intake and some classes were inversely associated with be...

Research paper thumbnail of Combined Body Mass Index and Waist-to-Height Ratio and Its Association with Lifestyle and Health Factors among Spanish Children: The PASOS Study

Nutrients, 2022

Background and Aims: The World Health Organization recommended simultaneous measurement of body m... more Background and Aims: The World Health Organization recommended simultaneous measurement of body mass index (BMI) and waist circumference (WC) and suggested joint use to predict disease risks. The aim of this study was to assess the prevalence of BMI and waist-to-height ratio (WHtR) categories among Spanish children and adolescents, as well as their associations with several lifestyle factors. Methods: Cross-sectional analysis of 8–16-year-old children and adolescents (n = 3772) were included in the PASOS nationwide representative study. Children/adolescents and their mothers/female caregivers answered a questionnaire on lifestyle and health factors. Child/adolescent anthropometrics were measured. Four combined BMI-WHtR disease risk categories were built. Results: A third of participants showed combined BMI-WHtR categories with high disease risk (12.3% ‘increased risk’, 9.7% ‘high risk’, 14.3% ‘very high risk’). Participants in the ‘very high risk’ group were less likely to be female...

Research paper thumbnail of Paediatric teams in front of childhood obesity: A qualitative study within the STOP project

Anales de Pediatría (English Edition), 2021

Research paper thumbnail of Dietary Quality Changes According to the Preceding Maximum Weight: A Longitudinal Analysis in the PREDIMED-Plus Randomized Trial

Nutrients, 2020

One-year dietary quality change according to the preceding maximum weight in a lifestyle interven... more One-year dietary quality change according to the preceding maximum weight in a lifestyle intervention program (PREDIMED-Plus trial, 55–75-year-old overweight or obese adults; n = 5695) was assessed. A validated food frequency questionnaire was used to assess dietary intake. A total of 3 groups were made according to the difference between baseline measured weight and lifetime maximum reported weight: (a) participants entering the study at their maximum weight, (b) moderate weight loss maintainers (WLM), and (c) large WLM. Data were analyzed by General Linear Model. All participants improved average lifestyle. Participants entering the study at their maximum weight were the most susceptible to improve significantly their dietary quality, assessed by adherence to Mediterranean diet, DII and both healthful and unhealthful provegetarian patterns. People at maximum weight are the most benefitted in the short term by a weight management program. Long term weight loss efforts may also redu...