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The aim of this review was to estimate the prevalence of overweight and obesity among European children aged 2–7 years from 2006 to 2016 and to analyze these estimations by gender, country, and food group consumption. We searched CINAHL, EMBASE, MEDLINE, and Web of Science databases from their inception until 27 February 2019 including cross-sectional studies and baseline measurements of cohort studies with overweight and obesity defined according to the International Obesity Task Force criteria. Both the inverse-variance fixed-effects method and the DerSimonian and Laird random effects method were used to determinate pooled prevalence estimates and their respective 95% confidence intervals (CIs). A total of 32 studies (n = 197,755 children) with data from 27 European countries were included. Overall, the pooled prevalence estimates of overweight/obesity in European children (aged 2–7 years) during the period 2006–2016 was 17.9% (95% CI: 15.8–20.0), and the pooled prevalence estimate of obesity was 5.3% (95% CI: 4.5–6.1). Southern European countries showed the highest prevalence of excess weight. Additional measures to address the obesity epidemic in early life should be established, especially in European countries where the prevalence of excess weight is very high.

BackgroundThis study examined the association between key components of physical fitness with inhibition and cognitive flexibility in preschoolers.MethodsThis was a cross-sectional study of 362 Spanish preschoolers. The key components of physical fitness and executive functioning were measured.ResultsThe partial correlation controlling for body mass index and family socioeconomic status showed that inhibition was positively related to cardiorespiratory fitness. No association was found between muscular strength (i.e., standing long jump and dynamometry) and speed/agility with inhibition or between physical fitness components and cognitive flexibility. The inhibition mean scores were significantly higher in preschoolers with higher cardiorespiratory than in their peers who were in lower categories, after adjustments were made for confounders. Additionally, the results showed that cardiorespiratory fitness was a significant predictor of inhibition, but for cognitive flexibility, age was the only significant predictor.ConclusionsOur data suggest that cardiorespiratory fitness is associated with inhibition in preschoolers. Likewise, our results also suggest that cognitive flexibility is an executive function that is more dependent on changes associated with age at this development stage. These findings are important for supporting initiatives that aimed at stimulating healthy brain development, and promote the improvement of cardiorespiratory fitness at early ages.

The aims of this study were to assess the association of adherence to the Mediterranean diet (MD) with physical fitness and body composition in Spanish university students and to determine the ability to predict the MD adherence of each Mediterranean Diet Adherence Screener (MEDAS) item. A cross-sectional study was performed involving 310 first-year university students. Adherence to the MD was evaluated with MEDAS-14 items. Anthropometric variables, body composition, and physical fitness were assessed. Muscle strength was determined based on handgrip strength and the standing long jump test. Cardiorespiratory fitness (CRF) was measured using the Course–Navette test. Only 24% of the university students had good adherence to the MD. The ANCOVA models showed a significant difference between participants with high adherence to the MD and those with medium and low adherence in CRF (p = 0.017) and dynamometry (p = 0.005). Logistic binary regression showed that consuming >2 vegetables/day (OR = 20.1; CI: 10.1–30.1; p < 0.001), using olive oil (OR = 10.6; CI: 1.4–19.8; p = 0.021), consuming <3 commercial sweets/week (OR = 10.1; IC: 5.1–19.7; p < 0.001), and consuming ≥3 fruits/day (OR = 8.8; CI: 4.9–15.7; p < 0.001) were the items most associated with high adherence to the MD. In conclusion, a high level of adherence to the MD is associated with high-level muscular fitness and CRF in Spanish university students.

PurposeThis study aimed at providing prevalence trend estimates of underweight among children and adolescents in Europe from 2000 to 2017.MethodsMEDLINE, Web of Science, Scopus and CINAHL were searched from their inception up to March 2020. Moreover, searches were conducted on health institutions’ websites to identify studies not published in scientific journals. Underweight was defined according to the body mass index (BMI) cut-offs proposed by the International Obesity Task Force (IOTF) and the World Health Organization (WHO) definition criteria. The Mantel–Haenszel method was used to compute the pooled prevalence estimates whenever there was no evidence of heterogeneity; otherwise, the DerSimonian and Laird random-effects method was used. Subgroup analyses by sex, age range (2–13 and 14–18 years old), study year (2000–2006 and 2007–2017), country and European region were conducted.ResultsA total of 49 studies with data from 323,420 children and adolescents aged 2 to 18 years, from 26 countries were included. From 2000 to 2017, according to the IOTF criteria, the prevalence of underweight showed an increasing trend in Eastern, Northern and Southern Europe, where the underweight prevalence ranged from 9.1 to 12.0%, from 4.1 to 6.8%, and from 5.8 to 6.7%, respectively. In Western Europe, the prevalence of underweight tended to decrease, from 14.0 to 11.8%. No significant differences were found by sex or age range.ConclusionThe prevalence of underweight is considerable (overall, around 8–9%), particularly in Eastern Europe, and follows a slight upward trend during the past decade.Systematic review registrationPROSPERO CRD42017056924.

The aims of the present study were twofold: to determine the association between adherence to the Mediterranean diet (MedDiet) and psychological problems and to assess the relationship between different food groups of the MedDiet and different patterns of psychosocial health problems in a sample of Spanish adolescents from the Valle de Ricote (Region of Murcia, Spain). This cross-sectional study included a representative sample of 700 adolescents (57% girls) between 12 and 17 years of age. Adherence to the MedDiet was assessed by the Mediterranean Diet Quality Index for Children and Teenagers (KIDMED). Psychosocial health problems were measured by the 25-item self-report version of the Strengths and Difficulties Questionnaire (SDQ). ANCOVA models were used to test the mean differences in psychosocial health problems (SDQ subscales) by adherence to MedDiet categories (low, medium, and high). Multiple linear regression was used to determine the association between different food groups of the MedDiet and psychosocial health problems. Adolescents with low adherence to the MedDiet had significantly higher scores in SDQ total difficulties, conduct problems, and hyperactivity problems and lower scores in pro-social behavior (p < 0.05) than their peers with medium and high adherence to the MedDiet. In relation to specific MedDiet food groups, fruit, nut, and legume intake were associated with higher psychosocial health. However, sweets, skipping breakfast, or high consumption of pasta or rice (≥5 weeks) were associated to higher psychosocial health problems. Our results show that adolescents with higher adherence to the MedDiet could benefit from greater psychosocial health. Individually, some patterns of MedDiet, such as fruit, nut, and legume intake, may reduce psychosocial health problems. These cross-sectional results should be confirmed in longitudinal and intervention studies.

PurposeThe aim of this study was to examine the relationship between nut consumption and academic performance in Spanish adolescents and to explore the role of sociodemographic, anthropometric, and lifestyle covariates on this association. MethodsA cross-sectional study was carried out using a food frequency questionnaire for estimating nut consumption in the number of 20–30 g servings per week, and academic performance data were obtained from school records. Analyses of covariance were adjusted for sociodemographic, anthropometric and lifestyle covariates, including total energy intake.ResultsAmong the 846 adolescents included in the analyses (55.3% girls, age range from 12 to 17 years), the mean ± standard deviation consumption of nuts was 2.7 ± 2.8 servings per week, while the mean of all school grades recorded was 6.5 ± 2.0. Furthermore, compared to no consumption, the consumption of ≥ 3 nut servings per week was consistently associated with higher grades in language (p for trend = 0.005), combination of language and math (p for trend = 0.026), grade point average (p for trend = 0.039), and combination of all school records (p for trend = 0.046). These associations were observed regardless of all covariates considered, although sex and socioeconomic level played a significant role in the completely adjusted models.ConclusionNut consumption is associated with higher academic performance in a representative sample of Spanish adolescents. These cross-sectional results should be confirmed in longitudinal and intervention studies.

Background The 10-item Connor-Davidson Resilience Scale (10-item CD-RISC) is an instrument for measuring resilience that has shown good psychometric properties in its original version in English. The aim of this study was to evaluate the validity and reliability of the Spanish version of the 10-item CD-RISC in young adults and to verify whether it is structured in a single dimension as in the original English version. Findings Cross-sectional observational study including 681 university students ranging in age from 18 to 30 years. The number of latent factors in the 10 items of the scale was analyzed by exploratory factor analysis. Confirmatory factor analysis was used to verify whether a single factor underlies the 10 items of the scale as in the original version in English. The convergent validity was analyzed by testing whether the mean of the scores of the mental component of SF-12 (MCS) and the quality of sleep as measured with the Pittsburgh Sleep Index (PSQI) were higher in subjects with better levels of resilience. The internal consistency of the 10-item CD-RISC was estimated using the Cronbach α test and test-retest reliability was estimated with the intraclass correlation coefficient. The Cronbach α coefficient was 0.85 and the test-retest intraclass correlation coefficient was 0.71. The mean MCS score and the level of quality of sleep in both men and women were significantly worse in subjects with lower resilience scores. Conclusions The Spanish version of the 10-item CD-RISC showed good psychometric properties in young adults and thus can be used as a reliable and valid instrument for measuring resilience. Our study confirmed that a single factor underlies the resilience construct, as was the case of the original scale in English.

Background: The objective of this systematic review and meta-analysis was: (i) to examine the association between wine consumption and cardiovascular mortality, cardiovascular disease (CVD), and coronary heart disease (CHD) and (ii) to analyse whether this association could be influenced by personal and study factors, including the participants’ mean age, the percentage of female subjects, follow-up time and percentage of current smokers. Methods: In order to conduct this systematic review and meta-analysis, we searched several databases for longitudinal studies from their inception to March 2023. This study was previously registered with PROSPERO (CRD42021293568). Results: This systematic review included 25 studies, of which the meta-analysis included 22 studies. The pooled RR for the association of wine consumption and the risk of CHD using the DerSimonian and Laird approach was 0.76 (95% CIs: 0.69, 0.84), for the risk of CVD was 0.83 (95% CIs: 0.70, 0.98), and for the risk of cardiovascular mortality was 0.73 (95% CIs: 0.59, 0.90). Conclusions: This research revealed that wine consumption has an inverse relationship to cardiovascular mortality, CVD, and CHD. Age, the proportion of women in the samples, and follow-up time did not influence this association. Interpreting these findings with prudence was necessary because increasing wine intake might be harmful to individuals who are vulnerable to alcohol because of age, medication, or their pathologies.

An excess of fat mass has been associated with adverse cardiometabolic risk factors. Different anthropometric measures have been proposed as alternative non-invasive measures for obesity-related cardiometabolic risk. To evaluate the magnitude of association between waist circumference (WC) and waist-to-height ratio (WtHR) with cardiometabolic risk factors and metabolic syndrome and to determine the WtHR cutoff associated with a more favorable cardiometabolic risk profile in Spanish children, data were taken from a cross-sectional survey conducted in 2010 among 848 schoolchildren aged 8–11 years from 20 public schools in the province of Cuenca (Spain). Anthropometric variables, glucose, insulin, triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), systolic (SBP) and diastolic blood pressure (DBP) and metabolic syndrome (MetS) were also analyzed. WtHR and WC had a good accuracy for TG, insulin, and MetS. The diagnostic odds ratio ranged from 2.95 to 9.07 for WtHR and from 5.30 to 27.40 for WC. The main result of the present study suggests that both WtHR and WC could be used as a screening tool to identify children with cardiometabolic abnormalities.

Background Muscular fitness, particularly handgrip strength, is increasingly recognized as a robust marker of cardiometabolic risk (CMR) in children and adolescents. However, evidence‐based diagnostic thresholds for identifying at‐risk individuals remain scarce, particularly in children. This study aimed to (1) establish sex‐specific diagnostic thresholds for handgrip strength normalized to body weight to identify elevated CMR in children aged 8–11 years, and (2) synthesize existing evidence through a systematic review and meta‐analysis across pediatric age groups, integrating the new data with existing evidence. Methods We analyzed cross‐sectional data from 1124 Spanish children (49.7% girls) aged 8–11 years participating in the MOVI‐2 study. Normalized handgrip strength was associated with a CMR index composed of waist circumference, triglyceride‐to‐HDL ratio, mean arterial pressure and fasting insulin. Diagnostic accuracy was assessed using receiver operating characteristic curves and optimized with the Youden Index. Results from the MOVI‐2 study and other diagnostic accuracy studies were combined in a meta‐analysis for identifying the optimal threshold for normalized handgrip strength to identify elevated CMR in youth. Results In the MOVI‐2 study, thresholds were 0.38 for boys and 0.34 for girls, with area under the curve (AUC) of 0.77 (95% CI: 0.73–0.81) and 0.75 (95% CI: 0.70–0.79), respectively. The systematic review and meta‐analysis followed PRISMA‐DTA guidelines and included nine additional studies (n = 10 588). Meta‐analytic thresholds for normalized handgrip strength were 0.30 for girls and 0.39 for boys in childhood (6–12 years), and 0.36 for girls and 0.42 for boys in adolescence (13–18 years), with the highest diagnostic accuracy observed in adolescent girls (AUC = 0.80, 95% CI: 0.77–0.83; Youden Index = 0.60). Children showed greater heterogeneity, particularly in specificity. Conclusions Despite certain limitations, our findings provide clinically relevant, sex‐ and age‐specific thresholds for normalized handgrip strength to identify elevated CMR in youth. These thresholds may serve as a valuable starting point for CMR screening in both boys and girls.