Papel de la actividad física en niños y adolescentes en la prevención de las enfermedades crónicas relacionadas con la nutrición

Transcripción

1 Papel de la actividad física en niños y adolescentes en la prevención de las enfermedades crónicas relacionadas con la nutrición Luis A. Moreno Grupo GENUD, Universidad de Zaragoza (España)

2 Modelo de prevención de enfermedades crónicas (Cecchini M et al. Lancet 2010; 376: ) Luis A. Moreno Aznar GENUD Research Group lmoreno@unizar.es Universidad de Zaragoza

3 Procesos que influyen en la prevalencia de obesidad (Kumanyika SK et al. Circulation 2008; 118: )

4 HELENA-CSS Actividad física Intensidad Actividad física vida diaria >95% Actividad física para mejora de la salud <5% Actividad física para mejorar el fitness <1% Duración Frecuencia Continuidad Healthy Lifestyle in EUROPE by Nutrition in Adolescence - FP6 EU funded study

5 Precisión HELENA-CSS Métodos de valoración de la actividad física Calorimetría en habitación Agua marcada con 2 isotopos Calorimetría indirecta FC y sensores movimiento FC Sensores movimiento Cuestionarios Factibilidad Healthy Lifestyle in EUROPE by Nutrition in Adolescence - FP6 EU funded study

6 International Physical Activity Questionnaire Developed for adults Surveillance Walking, moderate and vigorous intensity (min/week) Includes 4 domains (work, transport, domestic, leisure) Interview or self-report format Last 7 days recall Healthy Lifestyle in EUROPE by Nutrition in Adolescents - FP6 EU-funded study

7 HELENA-CSS Ventajas de los acelerómetros Individuos de cualquier sexo, edad, tamaño y capacidad se pueden valorar de la misma manera El procedimiento es sencillo Se puede valorar la actividad y la inactividad No hay que realizar traducciones, no influye el nivel socioeconómico ni las tradiciones culturales locales Se pueden hacer comparaciones entre países Bajo costo Healthy Lifestyle in EUROPE by Nutrition in Adolescence - FP6 EU funded study

8 ActiGraph GT1M 1.8 cm 3.8 cm 3.8 cm

9 Example of Output 8000 Hard Moderate ACTIVITY Light :00 AM 1:00 AM 2:00 AM 3:00 AM 4:00 AM 5:00 AM 6:00 AM 7:00 AM 8:00 AM 9:00 AM 10:00 AM 11:00 AM 12:00 PM TIME 1:00 PM 2:00 PM 3:00 PM 4:00 PM 5:00 PM 6:00 PM 7:00 PM 8:00 PM 9:00 PM 10:00 PM 11:00 PM

10 Example of Output Very Hard Hard 8000 ACTIVITY 6000 Moderate Light 0 12:00 AM 1:00 AM 2:00 AM 3:00 AM 4:00 AM 5:00 AM 6:00 AM 7:00 AM 8:00 AM 9:00 AM 10:00 AM 11:00 AM 12:00 PM 1:00 PM 2:00 PM 3:00 PM 4:00 PM 5:00 PM 6:00 PM 7:00 PM 8:00 PM 9:00 PM 10:00 PM 11:00 PM TIME

11 Percentage compliance to MVPA recommendations: lowest part: 0 30 min, middle part: min, upper part: over 60 min (Konstabel K et al. Int J Obes 2014; 38: S135-S143)

12 Actividad física moderada intensa Boys Girls (Ruiz J et al. Am J Epidemiol 2011; 15: ) Healthy Lifestyle in EUROPE by Nutrition in Adolescence - FP6 EU funded study

13 Tiempo actividades sedentarias Boys Girls (Ruiz J et al. Am J Epidemiol 2011; 15: ) Healthy Lifestyle in EUROPE by Nutrition in Adolescence - FP6 EU funded study

14 Actividad física y grasa total y abdominal % grasa (DXA) Grasa abdominal (R1 R2) % grasa (BodPod) Suma 4 pliegues Grasa abdominal (R3) Cintura (Moliner-Urdiales D et al. Int J Obes (London) 2009; 33: ) Healthy Lifestyle in EUROPE by Nutrition in Adolescence - FP6 EU funded study

15 Sedentarismo vs actividad física Health recommendations should also include sedentary PA Health recommendations based on the accumulation of moderate to vigorous PA Hamilton et al Morris et al. 1953

16 Sedentarismo vs actividad física Sedentary behaviours vs meeting PA recommendations Sedentary behaviours absence of moderate to vigorous physical activity (Pate et al. 2008)

17 Sedentary behaviours assessment Direct observation Video recording Questionnaires Diaries Parental reporting (Rey-López JP et al. In: Epidemiology of obesity in children and adolescents. Moreno LA; Pigeot I, Ahrens W (Eds.). New York: Springer, 2011) Luis A. Moreno Aznar GENUD Research Group lmoreno@unizar.es Universidad de Zaragoza

18 Television viewing habits: percentage who watch 4 h or more, 2 4 h and 2 h or less per day and average TV viewing time per day by country (Vereecken C et al. Publ Health Nutr 2006; 9: )

19 Total screen time in European children (Santaliestra-Pasías A et al. Publ Health Nutr 2014; 17: )

20 Sedentarism Proportion of adolescents having TV, computer and consoles at home and their bedrooms (Rey-López JP et al. Prev Med 2010; 51: 50-55) Healthy Lifestyle in EUROPE by Nutrition in Adolescence - FP6 EU funded study

21 Sedentarism Factors predicting TV use more than two hours per day in adolescents (Rey-López JP et al. Prev Med 2010; 51: 50-55) Healthy Lifestyle in EUROPE by Nutrition in Adolescence - FP6 EU funded study

22 Sedentarism and obesity Healthy Lifestyle in EUROPE by Nutrition in Adolescence - FP6 EU funded study

23 Sedentarism Proportion of cross-sectional studies with a significant relationship between sedentary behaviour and overweight (Rey-López JP et al. Nutr Metab Cardiovas Dis 2008; 18: ) Healthy Lifestyle in EUROPE by Nutrition in Adolescence - FP6 EU funded study

24 Sedentarism Proportion of longitudinal studies with a significant relationship between sedentary behaviour and overweight (Rey-López JP et al. Nutr Metab Cardiovas Dis 2008; 18: ) Healthy Lifestyle in EUROPE by Nutrition in Adolescence - FP6 EU funded study

25 SSB and sedentary behaviors Sugar sweetened beverages intake (ml) according to sedentary behaviors in male adolescents TV week days (12.61) TV weekend (16.15) Computer week days (11.60) Computer weekend (13.58) Internet week days (11.4) Internet weekend (12.30) < 2 hours 2 4 hours (20.98) (16.76) (27.94) (21.4) (33.4) (24.85) (Santaliestra-Pasías A et al. Arch Pediatr Adolesc Med 2012; 166: ) Healthy Lifestyle in EUROPE by Nutrition in Adolescence - FP6 EU funded study > 4 hours P (45.68) (26.58) (51.75) (27.7) (51.1) (37.52) < 0.05 < 0.05 < 0.05 < 0.05 < 0.05 < 0.05

26 SSB and sedentary behaviors Sugar sweetened beverages intake (ml) according to sedentary behaviors in female adolescents TV week days (7.53) TV weekend (9.42) Computer week days (6.56) Computer weekend (6.93) Internet week days (6.96) Internet weekend (7.63) < 2 hours 2 4 hours (12.31) (9.60) (2.48) (18.17) (17.03) (13.95) Healthy Lifestyle in EUROPE by Nutrition in Adolescence - FP6 EU funded study > 4 hours P (26.65) (16.40) (46.75) (26.68) (30.39) (15.53) < 0.05 < 0.05 < 0.05 < 0.05 < 0.05 < 0.05 (Santaliestra-Pasías A et al. Arch Pediatr Adolesc Med 2012; 166: )

27 Standardized regression coefficients between individual sedentary behaviours during weekdays and weekend days, and mean scores of DPs in boys and girls (Santaliestra-Pasías A et al. Eur J Clin Nutr 2014; 68: )

28 Standardised mean difference in change in physical activity between intervention and control groups for each included study (Metcalf B et al. BMJ 2012; 93: )

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30 Mensajes de salud Alimentación Actividad física Control de estrés Estimular el consumo diario de agua Estimular el consumo diario de frutas y verduras Reducir el tiempo de ver la TV Estimular la actividad física diaria Pasar mas tiempo juntos Dormir las horas adecuadas 30

31 HELENA-LSEI (De Bourdeaudhuij I, et al. J Adolesc Health 2010; 46: ) Healthy Lifestyle in EUROPE by Nutrition in Adolescence - FP6 EU funded study

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33 HELENA-LSEI MVPA (min/week) CSS sample (n=494) Total sample F=3.79** control Intervention baseline 1-month 3-months 400 MVPA (min/week) CSS sample inactive adolescents (n=233) F=1.52(ns) control intervention baseline 1-month 3-months (De Bourdeaudhuij I, et al. J Adolesc Health 2010; 46: ) Healthy Lifestyle in EUROPE by Nutrition in Adolescence - FP6 EU funded study

34 (Martínez-Vizcaino V, et al. Int J Obes 2008; 32: 12-22)

35 (Martínez-Vizcaino V, et al. Int J Obes 2008; 32: 12-22)

36 Evolution of excess BMI during the trial period and at the post-trial follow-up (Simón C et al. Int J Obes 2014; 38: ) Luis A. Moreno Aznar GENUD Research Group lmoreno@unizar.es Universidad de Zaragoza

37 The intervention tend to induce a higher decrease in excess BMI in students with high initial TV levels (>2 h per day) (Simón C et al. Int J Obes 2014; 38: ) Luis A. Moreno Aznar GENUD Research Group lmoreno@unizar.es Universidad de Zaragoza

38 Effect size on body mass index reduction by sedentary behaviour intervention type (Liao Y et al. Obes Rev 2014; 15: ) Luis A. Moreno Aznar GENUD Research Group lmoreno@unizar.es Universidad de Zaragoza

39 School-age youth should participate daily in 60 minutes or more of moderate to vigorous physical activity that is developmentally appropriate, enjoyable, and involves a variety of activities (Strong WB, et al. J Pediatr 2005; 146: )

40 Alimentación, nutrición y estilo de vida. Impacto de la actividad física sobre la salud (Moreno LA, Gracia-Marco L. An Pediatr 2012; 77:136) Luis A. Moreno Aznar GENUD Research Group lmoreno@unizar.es Universidad de Zaragoza

41 Pirámide de actividad física en niños y adolescentes Luis A. Moreno Aznar GENUD Research Group lmoreno@unizar.es Universidad de Zaragoza

42 Una nueva perspectiva de las nuevas tecnologías Luis A. Moreno Aznar GENUD Research Group Universidad de Zaragoza

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