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)
Modelo de prevención de enfermedades crónicas (Cecchini M et al. Lancet 2010; 376: 1775-1784) Luis A. Moreno Aznar GENUD Research Group lmoreno@unizar.es Universidad de Zaragoza
Procesos que influyen en la prevalencia de obesidad (Kumanyika SK et al. Circulation 2008; 118: 428-464)
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
------ 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
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
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
ActiGraph GT1M 1.8 cm 3.8 cm 3.8 cm
Example of Output 8000 Hard 7000 6000 5000 Moderate ACTIVITY 4000 3000 2000 Light 1000 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 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
Example of Output 12000 Very Hard 10000 Hard 8000 ACTIVITY 6000 Moderate 4000 2000 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
Percentage compliance to MVPA recommendations: lowest part: 0 30 min, middle part: 30 60 min, upper part: over 60 min (Konstabel K et al. Int J Obes 2014; 38: S135-S143)
Actividad física moderada intensa Boys Girls (Ruiz J et al. Am J Epidemiol 2011; 15: 173-184) Healthy Lifestyle in EUROPE by Nutrition in Adolescence - FP6 EU funded study
Tiempo actividades sedentarias Boys Girls (Ruiz J et al. Am J Epidemiol 2011; 15: 173-184) Healthy Lifestyle in EUROPE by Nutrition in Adolescence - FP6 EU funded study
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: 1126-1135) Healthy Lifestyle in EUROPE by Nutrition in Adolescence - FP6 EU funded study
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. 2004 Morris et al. 1953
Sedentarismo vs actividad física Sedentary behaviours vs meeting PA recommendations Sedentary behaviours absence of moderate to vigorous physical activity (Pate et al. 2008)
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
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: 244-250)
Total screen time in European children (Santaliestra-Pasías A et al. Publ Health Nutr 2014; 17: 2295-2306)
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
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
Sedentarism and obesity Healthy Lifestyle in EUROPE by Nutrition in Adolescence - FP6 EU funded study
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: 242-251) Healthy Lifestyle in EUROPE by Nutrition in Adolescence - FP6 EU funded study
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: 242-251) Healthy Lifestyle in EUROPE by Nutrition in Adolescence - FP6 EU funded study
SSB and sedentary behaviors Sugar sweetened beverages intake (ml) according to sedentary behaviors in male adolescents TV week days 340.0 (12.61) TV weekend 340.1 (16.15) Computer week days 350.7 (11.60) Computer weekend 344.6 (13.58) Internet week days 358.3 (11.4) Internet weekend 344.3 (12.30) < 2 hours 2 4 hours 433.6 (20.98) 375.4 (16.76) 433.0 (27.94) 353.6 (21.4) 419.7 (33.4) 428.9 (24.85) (Santaliestra-Pasías A et al. Arch Pediatr Adolesc Med 2012; 166: 1010-1020) Healthy Lifestyle in EUROPE by Nutrition in Adolescence - FP6 EU funded study > 4 hours P 509.1 (45.68) 453.0 (26.58) 590.4 (51.75) 514.4 (27.7) 593.5 (51.1) 518.5 (37.52) < 0.05 < 0.05 < 0.05 < 0.05 < 0.05 < 0.05
SSB and sedentary behaviors Sugar sweetened beverages intake (ml) according to sedentary behaviors in female adolescents TV week days 197.9 (7.53) TV weekend 196.4 (9.42) Computer week days 208.5 (6.56) Computer weekend 205.5 (6.93) Internet week days 204.7 (6.96) Internet weekend 200.6 (7.63) < 2 hours 2 4 hours 239.0 (12.31) 215.2 (9.60) 297.6 (2.48) 257.3 (18.17) 259.2 (17.03) 231.1 (13.95) Healthy Lifestyle in EUROPE by Nutrition in Adolescence - FP6 EU funded study > 4 hours P 323.8 (26.65) 262.2 (16.40) 275.2 (46.75) 270.4 (26.68) 278.7 (30.39) 284.6 (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: 1010-1020)
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: 300-308)
Standardised mean difference in change in physical activity between intervention and control groups for each included study (Metcalf B et al. BMJ 2012; 93: 4606-4615)
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
HELENA-LSEI (De Bourdeaudhuij I, et al. J Adolesc Health 2010; 46: 458-466) Healthy Lifestyle in EUROPE by Nutrition in Adolescence - FP6 EU funded study
HELENA-LSEI MVPA (min/week) CSS sample (n=494) Total sample F=3.79** 650 600 550 500 control Intervention 450 400 baseline 1-month 3-months 400 MVPA (min/week) CSS sample inactive adolescents (n=233) F=1.52(ns) 350 300 250 control intervention 200 150 baseline 1-month 3-months (De Bourdeaudhuij I, et al. J Adolesc Health 2010; 46: 458-466) Healthy Lifestyle in EUROPE by Nutrition in Adolescence - FP6 EU funded study
(Martínez-Vizcaino V, et al. Int J Obes 2008; 32: 12-22)
(Martínez-Vizcaino V, et al. Int J Obes 2008; 32: 12-22)
Evolution of excess BMI during the trial period and at the post-trial follow-up (Simón C et al. Int J Obes 2014; 38: 936-943) Luis A. Moreno Aznar GENUD Research Group lmoreno@unizar.es Universidad de Zaragoza
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: 936-943) Luis A. Moreno Aznar GENUD Research Group lmoreno@unizar.es Universidad de Zaragoza
Effect size on body mass index reduction by sedentary behaviour intervention type (Liao Y et al. Obes Rev 2014; 15: 159-168) Luis A. Moreno Aznar GENUD Research Group lmoreno@unizar.es Universidad de Zaragoza
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: 732-737)
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
Pirámide de actividad física en niños y adolescentes Luis A. Moreno Aznar GENUD Research Group lmoreno@unizar.es Universidad de Zaragoza
Una nueva perspectiva de las nuevas tecnologías Luis A. Moreno Aznar GENUD Research Group lmoreno@unizar.es Universidad de Zaragoza