Additional file 2. Monthly cola light drink purchases per capita in Madrid (A) and Barcelona (B) ... more Additional file 2. Monthly cola light drink purchases per capita in Madrid (A) and Barcelona (B) before the tax from January 2013 to Abril 2017. The figures show the evolution in Spanish Food Purchases Panel sample (N = 12,000) of sugary cola light drink (untaxed beverage), from January 2013 to Abril 2017 (before the tax), in Barcelona (A) and Madrid (B). We can not reject the common trend null hypothesis, as the t-test for regression time coefficients difference with homogenous variances gives a p value of 0.87.
Additional file 1. Monthly cola drink purchases per capita in Madrid (A) and Barcelona (B) before... more Additional file 1. Monthly cola drink purchases per capita in Madrid (A) and Barcelona (B) before the tax from January 2013 to Abril 2017. The figures show the evolution in Spanish Food Purchases Panel sample (N = 12,000) of sugary cola drink (taxed beverage), from January 2013 to Abril 2017 (before the tax), in Barcelona (A) and Madrid (B). We can not reject the common trend null hypothesis, as the t-test for regression time coefficients difference with homogenous variances gives a p value of 0.97.
To analyse marketing techniques used in television advertisements of food and drinks (AFDs) direc... more To analyse marketing techniques used in television advertisements of food and drinks (AFDs) directed to children, and their nutritional quality. This is a cross-sectional study of television AFDs directed to children in Spain over 7 days in 2012. Primary appeal, persuasive and nutritional marketing techniques, and links to Internet were registered. The foods were classified according to their nutritional quality using an international codification system and the UK nutrient profile model. Frequency of AFDs using marketing techniques and percentages for unhealthy products were calculated. Taste and fun were the main primary appeals used. Persuasive and nutritional marketing techniques and links to Internet were used in 61%, 68.5% and 65.2% of AFDs, respectively. These techniques were more common during weekdays, enhanced protection time slots and on channels with particular appeal to children. More than two-thirds of AFDs using these techniques were for unhealthy products, reaching 9...
Background Sugar-sweetened beverage consumption is contributing to the obesity epidemic. On 28 Ma... more Background Sugar-sweetened beverage consumption is contributing to the obesity epidemic. On 28 March 2017, Catalonia enacted a law levying an excise tax on sugar-sweetened beverages for public health reasons. The purpose of this study is to assess the impact of the tax on the consumption of sugar-sweetened beverages in Catalonia (Spain). Methods Before-and-after study to assess changes in the prevalence of consumption of sugar-sweetened beverages among 1929 persons aged 12 to 40 years residing in low-income neighbourhoods of Barcelona (intervention) and Madrid (control). Beverage consumption frequency was ascertained via a validated questionnaire administered during the month prior to the tax’s introduction (May 2017) and again at 1 year after it had come into force. The effect of the tax was obtained using Poisson regression models with robust variance weighted using propensity scores. Results While the prevalence of regular consumers of taxed beverages fell by 39% in Barcelona as ...
To evaluate the association of alcohol intake with the risk of breast cancer in post-menopausal w... more To evaluate the association of alcohol intake with the risk of breast cancer in post-menopausal women, we analyzed the data from an international case-control study conducted in five European countries (FRG, Switzerland, Northern Ireland, the Netherlands and Spain). Information on alcohol intake was available in 315 cases and 364 controls. Medians for the tertiles of alcohol intake among current drinkers were 1.7, 6.0, and 20.0 g/day. Adjusted relative risks (and 95% confidence intervals) of breast cancer for each tertile of intake in current drinkers, compared to never drinkers, were 1.00 (0.60-1.67), 1.01 (0.60-1.73), and 1.18 (0.69-2.03). The adjusted relative risk for ex-drinkers was 1.73 (1.07-2.79). Among both current drinkers and ex-drinkers, the relative risk was higher for those with body mass index above the median compared to those with body mass index below the median. These results do not support a dose-response effect of alcohol on breast cancer risk, although consumpt...
BACKGROUND Policies restricting access to sugary drinks and unhealthy foods in the school environ... more BACKGROUND Policies restricting access to sugary drinks and unhealthy foods in the school environment are associated with healthier consumption patterns. In 2010, Spain approved a Consensus Document regarding Food at Schools with nutritional criteria to improve the nutritional profile of foods and drinks served at schools. The objective of this study was to describe the frequency of food and drink vending machines at secondary schools in Madrid, the products offered at them and their nutritional profile. METHODS Cross-sectional study of a random sample of 330 secondary schools in Madrid in 2014-2015. The characteristics of the schools and the existence of vending machines were recorded through the internet and by telephone interview. The products offered in a representative sample of 6 vending machines were identified by in situ inspection, and its nutritional composition was taken from its labeling. Finally, the nutritional profile of each product was analyzed with the United Kingd...
We describe the magnitude and trends of obesity in Spain and of its main determinants, associated... more We describe the magnitude and trends of obesity in Spain and of its main determinants, associated both with the increase in energy intake and the reduction of energy expenditure. Such determinants include factors from the individual subjects and from their environment. We also present the main features of the strategy for the Nutrition, Physical Activity, and the Prevention of Obesity, fostered by the Ministry of Health, as well as plans and activities carried out by the Regional Governments, to control this health disorder. We conclude that effective and sustained implementation of these activities is badly needed. It should be made along with the monitoring of obesity and its determinants in the general population. Research in this field should also be strengthened because social determinants of obesity are not known in depth, and the effectiveness of many of the interventions proposed by the national and regional initiatives is not well established yet. Moreover, in the next futu...
BACKGROUND Inguinal hernia uncomplicated in patients aged over 17 years, diagnosis-related group ... more BACKGROUND Inguinal hernia uncomplicated in patients aged over 17 years, diagnosis-related group (DRG) 162, generates a substantial number of hospital stays due its high frequency in our country. These stays may not be necessary, and present an important temporal and geographical variability. MATERIAL AND METHODS We have analyzed a total of 612 days of stay belonging to the 124 admissions codified as DRG 162 during the first quarter of 1993 and 1994, using the "Appropriateness Evaluation Protocol". RESULTS The overall mean stay of the DRG 162 was 5.0 days (2.3 days of inadequate stay and 2.7 days of clinically necessary stay). The mean stay in 1993, 5.6 days, was higher than the mean stay in 1994, 4.1 days (p = 0.006). The percentage of inappropriate admission was higher in 1993 than in 1994 (33.8% versus 18.9%; p = 0.06). Similarly, the percentage of inappropriate stay was higher in 1993 than in 1994 (46.9% versus 41.9%; p = 0.06). The more frequent reasons of inappropria...
Este libro es fruto de una revision y actualizacion ampliadas de los manuales docentes de «Nutric... more Este libro es fruto de una revision y actualizacion ampliadas de los manuales docentes de «Nutricion en Salud Publica» y «La alimentacion y el consumidor», editados en 2007 y 2013 respectivamente por la Escuela Nacional de Sanidad del Instituto de Salud Carlos III.
We present the adaptation for Spain of the updated European Cardiovascular Prevention Guidelines.... more We present the adaptation for Spain of the updated European Cardiovascular Prevention Guidelines. In this update, greater stress is laid on the population approach, and especially on the promotion of physical activity and healthy diet through dietary, leisure and active transport policies in Spain. To estimate vascular risk, note should be made of the importance of recalibrating the tables used, by adapting them to population shifts in the prevalence of risk factors and incidence of vascular diseases, with particular attention to the role of chronic kidney disease. At an individual level, the key element is personalised support for changes in behaviour, adherence to medication in high-risk individuals and patients with vascular disease, the fostering of physical activity, and cessation of smoking habit. Furthermore, recent clinical trials with PCSK9 inhibitors are reviewed, along with the need to simplify pharmacological treatment of arterial hypertension to improve control and adhe...
La influencia de la propaganda es mas danina en la infancia y la adolescencia por tratarse de una... more La influencia de la propaganda es mas danina en la infancia y la adolescencia por tratarse de una poblacion vulnerable. la autorregulacion de los medios no esta dando resultado.
We are pleased to present the European Guidelines on Cardiovascular Disease Prevention, translate... more We are pleased to present the European Guidelines on Cardiovascular Disease Prevention, translated and adapted by the Interdisciplinary Spanish Committee for Cardiovascular Disease Prevention. This guide is focused on the prevention of cardiovascular disease as a whole, recommending the SCORE model for risk assessment and placing priority on the care of patients and high-risk individuals. The objective is to prevent premature death due to CVD by means of dealing with its related risk factors in clinical practice. Hence, a maintained professional intervention is required in order to obtain an increase of physical activity and of healthy diets in patients high-risk individuals, and smoking cessation in smokers. The decision to start blood pressure treatment will depend upon the BP values, cardiovascular risk and possible damage to target organs. The treatment goal is to achieve BP < 140/90 mmHg, but among patients with diabetes, chronic kidney disease, a past history of ictus, coro...
RESUMEN Fundamento: Las politicas restrictivas del acceso a bebidas azucaradas y alimentos no sal... more RESUMEN Fundamento: Las politicas restrictivas del acceso a bebidas azucaradas y alimentos no saludables en el entorno escolar se asocian con patrones de consumo mas saludables. En 2010 se aprobo en Espana el Documento de Consenso sobre la Alimentacion en los Centros Educativos con criterios nutricionales para mejorar el perfil nutricional de los alimentos y bebidas ofertados. El objetivo de este estudio fue describir la frecuencia de maquinas expendedoras de bebidas y alimentos y perfil nutricional de sus productos en los Institutos de Ensenanza Secundaria (IES) de Madrid. Metodos: Estudio transversal sobre una muestra aleatoria de 330 IES de la Comunidad de Madrid durante el curso 2014-2015. A traves de internet y por entrevista telefonica se registraron las caracteristicas de los centros y la existencia o no de maquinas expendedoras en ellos. Los productos ofertados en una muestra representativa de 6 maquinas expendedoras se obtuvieron mediante inspeccion in situ y su composicion...
Additional file 2. Monthly cola light drink purchases per capita in Madrid (A) and Barcelona (B) ... more Additional file 2. Monthly cola light drink purchases per capita in Madrid (A) and Barcelona (B) before the tax from January 2013 to Abril 2017. The figures show the evolution in Spanish Food Purchases Panel sample (N = 12,000) of sugary cola light drink (untaxed beverage), from January 2013 to Abril 2017 (before the tax), in Barcelona (A) and Madrid (B). We can not reject the common trend null hypothesis, as the t-test for regression time coefficients difference with homogenous variances gives a p value of 0.87.
Additional file 1. Monthly cola drink purchases per capita in Madrid (A) and Barcelona (B) before... more Additional file 1. Monthly cola drink purchases per capita in Madrid (A) and Barcelona (B) before the tax from January 2013 to Abril 2017. The figures show the evolution in Spanish Food Purchases Panel sample (N = 12,000) of sugary cola drink (taxed beverage), from January 2013 to Abril 2017 (before the tax), in Barcelona (A) and Madrid (B). We can not reject the common trend null hypothesis, as the t-test for regression time coefficients difference with homogenous variances gives a p value of 0.97.
To analyse marketing techniques used in television advertisements of food and drinks (AFDs) direc... more To analyse marketing techniques used in television advertisements of food and drinks (AFDs) directed to children, and their nutritional quality. This is a cross-sectional study of television AFDs directed to children in Spain over 7 days in 2012. Primary appeal, persuasive and nutritional marketing techniques, and links to Internet were registered. The foods were classified according to their nutritional quality using an international codification system and the UK nutrient profile model. Frequency of AFDs using marketing techniques and percentages for unhealthy products were calculated. Taste and fun were the main primary appeals used. Persuasive and nutritional marketing techniques and links to Internet were used in 61%, 68.5% and 65.2% of AFDs, respectively. These techniques were more common during weekdays, enhanced protection time slots and on channels with particular appeal to children. More than two-thirds of AFDs using these techniques were for unhealthy products, reaching 9...
Background Sugar-sweetened beverage consumption is contributing to the obesity epidemic. On 28 Ma... more Background Sugar-sweetened beverage consumption is contributing to the obesity epidemic. On 28 March 2017, Catalonia enacted a law levying an excise tax on sugar-sweetened beverages for public health reasons. The purpose of this study is to assess the impact of the tax on the consumption of sugar-sweetened beverages in Catalonia (Spain). Methods Before-and-after study to assess changes in the prevalence of consumption of sugar-sweetened beverages among 1929 persons aged 12 to 40 years residing in low-income neighbourhoods of Barcelona (intervention) and Madrid (control). Beverage consumption frequency was ascertained via a validated questionnaire administered during the month prior to the tax’s introduction (May 2017) and again at 1 year after it had come into force. The effect of the tax was obtained using Poisson regression models with robust variance weighted using propensity scores. Results While the prevalence of regular consumers of taxed beverages fell by 39% in Barcelona as ...
To evaluate the association of alcohol intake with the risk of breast cancer in post-menopausal w... more To evaluate the association of alcohol intake with the risk of breast cancer in post-menopausal women, we analyzed the data from an international case-control study conducted in five European countries (FRG, Switzerland, Northern Ireland, the Netherlands and Spain). Information on alcohol intake was available in 315 cases and 364 controls. Medians for the tertiles of alcohol intake among current drinkers were 1.7, 6.0, and 20.0 g/day. Adjusted relative risks (and 95% confidence intervals) of breast cancer for each tertile of intake in current drinkers, compared to never drinkers, were 1.00 (0.60-1.67), 1.01 (0.60-1.73), and 1.18 (0.69-2.03). The adjusted relative risk for ex-drinkers was 1.73 (1.07-2.79). Among both current drinkers and ex-drinkers, the relative risk was higher for those with body mass index above the median compared to those with body mass index below the median. These results do not support a dose-response effect of alcohol on breast cancer risk, although consumpt...
BACKGROUND Policies restricting access to sugary drinks and unhealthy foods in the school environ... more BACKGROUND Policies restricting access to sugary drinks and unhealthy foods in the school environment are associated with healthier consumption patterns. In 2010, Spain approved a Consensus Document regarding Food at Schools with nutritional criteria to improve the nutritional profile of foods and drinks served at schools. The objective of this study was to describe the frequency of food and drink vending machines at secondary schools in Madrid, the products offered at them and their nutritional profile. METHODS Cross-sectional study of a random sample of 330 secondary schools in Madrid in 2014-2015. The characteristics of the schools and the existence of vending machines were recorded through the internet and by telephone interview. The products offered in a representative sample of 6 vending machines were identified by in situ inspection, and its nutritional composition was taken from its labeling. Finally, the nutritional profile of each product was analyzed with the United Kingd...
We describe the magnitude and trends of obesity in Spain and of its main determinants, associated... more We describe the magnitude and trends of obesity in Spain and of its main determinants, associated both with the increase in energy intake and the reduction of energy expenditure. Such determinants include factors from the individual subjects and from their environment. We also present the main features of the strategy for the Nutrition, Physical Activity, and the Prevention of Obesity, fostered by the Ministry of Health, as well as plans and activities carried out by the Regional Governments, to control this health disorder. We conclude that effective and sustained implementation of these activities is badly needed. It should be made along with the monitoring of obesity and its determinants in the general population. Research in this field should also be strengthened because social determinants of obesity are not known in depth, and the effectiveness of many of the interventions proposed by the national and regional initiatives is not well established yet. Moreover, in the next futu...
BACKGROUND Inguinal hernia uncomplicated in patients aged over 17 years, diagnosis-related group ... more BACKGROUND Inguinal hernia uncomplicated in patients aged over 17 years, diagnosis-related group (DRG) 162, generates a substantial number of hospital stays due its high frequency in our country. These stays may not be necessary, and present an important temporal and geographical variability. MATERIAL AND METHODS We have analyzed a total of 612 days of stay belonging to the 124 admissions codified as DRG 162 during the first quarter of 1993 and 1994, using the "Appropriateness Evaluation Protocol". RESULTS The overall mean stay of the DRG 162 was 5.0 days (2.3 days of inadequate stay and 2.7 days of clinically necessary stay). The mean stay in 1993, 5.6 days, was higher than the mean stay in 1994, 4.1 days (p = 0.006). The percentage of inappropriate admission was higher in 1993 than in 1994 (33.8% versus 18.9%; p = 0.06). Similarly, the percentage of inappropriate stay was higher in 1993 than in 1994 (46.9% versus 41.9%; p = 0.06). The more frequent reasons of inappropria...
Este libro es fruto de una revision y actualizacion ampliadas de los manuales docentes de «Nutric... more Este libro es fruto de una revision y actualizacion ampliadas de los manuales docentes de «Nutricion en Salud Publica» y «La alimentacion y el consumidor», editados en 2007 y 2013 respectivamente por la Escuela Nacional de Sanidad del Instituto de Salud Carlos III.
We present the adaptation for Spain of the updated European Cardiovascular Prevention Guidelines.... more We present the adaptation for Spain of the updated European Cardiovascular Prevention Guidelines. In this update, greater stress is laid on the population approach, and especially on the promotion of physical activity and healthy diet through dietary, leisure and active transport policies in Spain. To estimate vascular risk, note should be made of the importance of recalibrating the tables used, by adapting them to population shifts in the prevalence of risk factors and incidence of vascular diseases, with particular attention to the role of chronic kidney disease. At an individual level, the key element is personalised support for changes in behaviour, adherence to medication in high-risk individuals and patients with vascular disease, the fostering of physical activity, and cessation of smoking habit. Furthermore, recent clinical trials with PCSK9 inhibitors are reviewed, along with the need to simplify pharmacological treatment of arterial hypertension to improve control and adhe...
La influencia de la propaganda es mas danina en la infancia y la adolescencia por tratarse de una... more La influencia de la propaganda es mas danina en la infancia y la adolescencia por tratarse de una poblacion vulnerable. la autorregulacion de los medios no esta dando resultado.
We are pleased to present the European Guidelines on Cardiovascular Disease Prevention, translate... more We are pleased to present the European Guidelines on Cardiovascular Disease Prevention, translated and adapted by the Interdisciplinary Spanish Committee for Cardiovascular Disease Prevention. This guide is focused on the prevention of cardiovascular disease as a whole, recommending the SCORE model for risk assessment and placing priority on the care of patients and high-risk individuals. The objective is to prevent premature death due to CVD by means of dealing with its related risk factors in clinical practice. Hence, a maintained professional intervention is required in order to obtain an increase of physical activity and of healthy diets in patients high-risk individuals, and smoking cessation in smokers. The decision to start blood pressure treatment will depend upon the BP values, cardiovascular risk and possible damage to target organs. The treatment goal is to achieve BP < 140/90 mmHg, but among patients with diabetes, chronic kidney disease, a past history of ictus, coro...
RESUMEN Fundamento: Las politicas restrictivas del acceso a bebidas azucaradas y alimentos no sal... more RESUMEN Fundamento: Las politicas restrictivas del acceso a bebidas azucaradas y alimentos no saludables en el entorno escolar se asocian con patrones de consumo mas saludables. En 2010 se aprobo en Espana el Documento de Consenso sobre la Alimentacion en los Centros Educativos con criterios nutricionales para mejorar el perfil nutricional de los alimentos y bebidas ofertados. El objetivo de este estudio fue describir la frecuencia de maquinas expendedoras de bebidas y alimentos y perfil nutricional de sus productos en los Institutos de Ensenanza Secundaria (IES) de Madrid. Metodos: Estudio transversal sobre una muestra aleatoria de 330 IES de la Comunidad de Madrid durante el curso 2014-2015. A traves de internet y por entrevista telefonica se registraron las caracteristicas de los centros y la existencia o no de maquinas expendedoras en ellos. Los productos ofertados en una muestra representativa de 6 maquinas expendedoras se obtuvieron mediante inspeccion in situ y su composicion...
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