BUSCADOR RECOLECTA

This study examined 1) the association of dietary energy density from solid (EDS) and solid plus liquids (EDSL) with adiposity and cardiometabolic risk factors (CRF) in children with overweight and obesity, 2) the effect of under-reporting on the mentioned associations, and 3) whether the association between ED, and body composition and CRF is influenced by levels of physical activity. In a cross-sectional design, 208 children with overweight and obesity (8 to 12-year- old; 111 boys) completed two non-consecutive 24-hour recalls. ED was calculated using two different approaches: EDS and EDSl- Under-reporters were determined with the Goldberg method. Body composition, anthropometry and fasting blood sample measurements were performed. Moderate-to-vigorous physical activity (MVPA) was registered with accelerometers (7-day-register). Linear regressions were performed to evaluate the association of ED with the previously mentioned variables. Neither EDS nor EDSL were associated with body composition nor CRF. However, when under-reporters were excluded, EDS was positively associated with BMI (p=.019), body fat percentage (p=.005), abdominal fat (p=.008) and fat mass index (p=.018), while EDSL was positively associated with body fat percentage (p=.008) and fat mass index (p=.026). When stratifying the group according to physical activity recommendations, the aforementioned associations were only maintained for non-compliers. Cluster analysis showed that the low-ED and high-MVPA group presented the healthiest profile for all adiposity and CRF. These findings could partly explain inconsistencies in literature, as we found that different ED calculations entail distinct results. Physical activity levels and excluding under-reporters greatly influence the associations between ED and adiposity in children with overweight and obesity.

Los objetivos principales de esta Tesis Doctoral Internacional fueron: I) examinar si la capacidad cardiorrespiratoria se relaciona con la concentración plasmática de enzimas hepáticas en adolescentes europeos independientemente de la circunferencia de cintura, y testar si tener una mayor capacidad cardiorrespiratoria está asociada con un mejor perfil de enzimas hepáticas en aquellos adolescentes con una mayor circunferencia de cintura; II) explorar la asociación de los componentes de la condición física y la actividad física con el porcentaje de grasa hepática, las concentraciones plasmáticas de enzimas hepáticas, la resistencia a la insulina y el riesgo cardiometabólico en niñas y niños con sobrepeso u obesidad; III) analizar sistemáticamente el efecto del ejercicio físico supervisado en el porcentaje de grasa hepática y en la prevalencia de esteatosis hepática en niños y adolescentes; investigar el diseño de ejercicio más apropiado en términos de tipo, intensidad, volumen y frecuencia, para el manejo de la esteatosis hepática pediátrica; y explorar si existe una asociación entre las mejorar de la capacidad cardiorrespiratoria y la fuerza muscular con la reducción del porcentaje de grasa hepática en jóvenes; IV) determinar si un programa de intervención multicomponente de 22 semanas de duración, basado en educación familiar en estilos de vida saludable y psicoeducación que incluya además ejercicio físico supervisado, es más efectivo reduciendo el porcentaje de grasa hepática que solamente el programa educativo en niñas y niños con sobrepeso u obesidad; y V) analizar la variabilidad interindividual y comparar la prevalencia de respondedores en relación con el porcentaje de grasa hepática, la adiposidad total y abdominal y las concentraciones plasmáticas de gamma-glutamil-transferasa en los niñas y niños participantes en una intervención basada en educación familiar en estilos de vida saludable y psicoeducación de 22 semanas de duración, que incluya o no ejercicio físico., The objectives of the present International Doctoral Thesis were: I) to examine whether cardiorespiratory fitness is related to liver enzymes levels in European adolescents independent of waist circumference, and to test whether having a high cardiorespiratory fitness is associated with an improved liver enzyme profile in those adolescents with a high waist circumference; II) to explore the association of physical fitness components and physical activity with percentage hepatic fat, liver enzymes levels, insulin resistance, and cardiometabolic risk in children with overweight/obesity; III) to systematically analyse the effects of supervised exercise interventions on percentage hepatic fat and hepatic steatosis prevalence in children and adolescents, to investigate the most appropriate design of exercise in terms of the type, intensity, volume and frequency, for the management of paediatric hepatic steatosis, and to explore whether exists an association of improvements in cardiorespiratory fitness and musculoskeletal
fitness with the reduction of percentage hepatic fat in youth; IV) to determine whether a 22-week multicomponent family-based lifestyle and psycho-education program plus a supervised exercise intervention, is more effective reducing percentage hepatic fat, than the lifestyle program alone in children with overweight/obesity; and V) to analyse the interindividual variability and to compare the prevalence of responders regarding percentage hepatic fat, total and abdominal adiposity, and gamma-glutamyl-transferase levels among children with overweight/obesity participating in a 22-week lifestyle intervention, with or without supervised exercise., Esta tesis se realizó con una beca-contrato 'Ayuda de Formación de Profesorado Universitario (FPU14/03329)', de los subprogramas de 'Formación y Movilidad dentro del Programa Estatal de Promoción del Talento y su Empleabilidad', del Ministerio de Educación, Cultura y Deporte. La estancia predoctoral que permitió a la investigadora optar a la mención de Tesis Doctoral Internacional se realizó gracias a la 'Ayuda de Movilidad para Estancias Breves en otros Centros Españoles y Extranjeros (EST17/00210)', para beneficiarios del subprograma de formación del profesorado universitario del Ministerio de Ciencia, Innovación y Universidades., Programa de Doctorado en Ciencias de la Salud (RD 99/2011), Osasun Zientzietako Doktoretza Programa (ED 99/2011)