Design and Content Validation using Expert Opinions of an Instrument Assessing the Lifestyle of Adults: The 'PONTE A 100' Questionnaire

Lifestyle, a major determinant of health status, comprises a number of habits and behaviours that form a part of daily life. People with healthy lifestyles have a better quality of life, suffer less disease, and have a longer life expectancy. This work reports the design and content validation of a questionnaire-the 'PONTE A 100' questionnaire-assessing the lifestyle of adults. This collects information across five dimensions-'Eating Habits', 'Physical Activity', 'Smoking and use of Alcohol and other Drugs', 'Emotional Wellbeing', and 'Safety and Non-intentional Injuries'-via the answering of a total 33 items. Psychometric validation of the instrument's content was obtained via expert opinions. This was performed by two rounds of assessment and involved 34 experts representing different health science disciplines (mean experience, 27.4 ± 9.4 years). At the end of each round, adjustments were made according to their recommendations. Agreement between the experts was examined using the Aiken V test. A final V value of 0.95 (95% CI, 0.90-1.00) was obtained for the questionnaire as a whole, highlighting the validity of its content. The questionnaire would therefore appear to be an appropriate instrument for assessing the lifestyle of adults.

Household food insecurity and its association with overweight and obesity in children aged 2 to 14 years

BACKGROUND

The objective was to estimate the prevalence of household food insecurity (HFI) depending on sociodemographic factors and its association with lifestyle habits and childhood overweight and obesity.

METHODS

Data was collected from 1,938 children aged 2 to 14 years who participated in the "Study about Malnutrition" of the Community of Madrid. Weight and height were obtained through physical examination. Body mass index was calculated as weight/height² (kg/m²) and the criteria of the WHO were used for determining conditions of overweight and obesity. The participants' parents answered a structured questionnaire about their diet, lifestyle (physical activity and screen time), and food insecurity. The diet quality was assessed with the Healthy Eating Index in Spain and food insecurity, defined as the lack of consistent access to sufficient food for a healthy life, was measured via three screening questions and the Household Food Insecurity Access Scale (HFIAS). Odds Ratios (ORs) and Relative Risk Ratios (RRRs) were estimated using logistic regression models and adjusted for confounding variables.

RESULTS

The overall prevalence of HFI was 7.7% (95% CI: 6.6‒9.0), with lower values in children 2 to 4 years old (5.7%, 95% CI: 4.0‒8.1) and significantly higher values in households with low family purchasing power [37.3%; OR: 8.99 (95% CI: 5.5‒14.6)]. A higher prevalence of overweight (33.1%) and obesity (28.4%) was observed in children from families with HFI, who presented a lower quality diet and longer screen time compared to those from food-secure households (21.0% and 11.5%, respectively). The RRR of children in families with HFI relative to those from food-secure households was 2.41 (95% CI: 1.5‒4.0) for overweight and 1.99 (95% CI: 1.2‒3.4) for obesity.

CONCLUSION

The prevalence of HFI was high in the paediatric population, especially in households with low family purchasing power. HFI was associated with lower diet quality and higher prevalence of childhood overweight and obesity. Our results suggest the need for paediatric services to detect at-risk households at an early stage to avoid this dual burden of child malnutrition.

Methodology for the estimation of use of tobacco, alcohol and other drugs

The objective of this article is to revise the methods used for the assessment of the use of tobacco, alcohol and other drugs. Analysing the advantages of using one method or the other, as well as the most frequent methodological difficulties and problems in medication and classification of each one of these indicators. The main sources of information available from European, National and Madrid Autonomous Community levels have been consulted to estimate the most relevant aspects of these forms of substance abuse.

Quality of life, dependency and mental health scales of interest to nutritional studies in the population

Quality of life, dependency and mental health are multidimensional constructs that cannot be observed directly yet can be deduced in an indirect manner through indicators or profiles generated from questionnaires. These questionnaires are based on the validity of information transmitted by the respondents about perceptions, feelings and attitudes. For this reason, the information is difficult to contrast with and translate to a measuring system. The use of questionnaires or rapid quality of life and mental health evaluation scales involve a process directed towards an early identification of specific problems so as to establish medical treatment. This work will review the most commonly used scales or questionnaires in determining these variables and their relationship with the nutritional status of the population.

Chinchón declaration; decalogue on low- and no-calorie sweeteners (LNCS)

Multidisciplinary experts in the areas of nutrition and health met in Chinchón, Madrid, on November 25-26, 2013 under the auspices of the Fundación para la Investigación Nutricional (Nutrition Research Foundation) and with the collaboration of the Madrid Regional Government's Health Ministry, the International Sweeteners Association and the Carlos III Health Institute CIBER of Physiopathology of Obesity and Nutrition. They analyzed the current status of scientific knowledge on low- and no-calorie sweeteners (LNCS) and developed a consensus Decalogue on their use; this constitutes the Chinchón Declaration. Sweeteners, including sugar, represent a subject of undeniable interest and are currently a popular topic, although areas relating to their safety and benefits remain unknown to segments of academia and the general public. The nature of LNCS makes them vulnerable to biased and even contradictory information. They are food additives that are broadly used as sugar substitutes to sweeten foods, medicines and food supplements when non-nutritional or non-caloric alternatives are needed. The Chinchón Decalogue is the outcome of a meeting for reflection and consensus by a group of experts with backgrounds in different scientific disciplines (toxicology, clinical nutrition, community nutrition, physiology, food science, public health, pediatrics, endocrinology and nutrition, nursing, pharmaceutical care and food legislation). The Decalogue includes different aspects of LNCS related to regulation, use, benefits and safety. In general, benefits of LNCS have been traditionally neglected in comparison with the tendency for emphasising unexisting or unproven possible risks. The need to strengthen research on LNCS in Spain was emphasized, as well as the need to educate both professionals and the public.

[Trans fatty acid content in foods marketed in the community of Madrid(Spain)]

INTRODUCTION

As a consequence of the scientific evidence which show that the high consumption of trans fatty acids is a risk factor of certain illnesses, sanitary authorities recommend less than 1% intake of trans fatty acids of the total energy intake. Moreover, the European Commission must present, by December 2014, a report about the presence of trans fatty acids in the aliments as well as in the diet of the European Union population. Thus, this study can provide useful information to reach this objective.

OBJECTIVES

To determine trans fatty acid presence in some types of foods in the Community of Madrid.

METHODS

170 samples of different foods commonly consumed by children and adolescents were selected and analized. All foods had been purchased in big shopping centers in the Community of Madrid during february of 2010. Results are shown as the percentage of each fatty acid compared to the total amount of fat in the aliment.

RESULTS

Only 33 products (19.4%) showed the presence of trans fatty acids over the method detection limit (≥ 0.1g per 100g). The highest levels were found in dairy products, with an average content of 0,4%. DISCUSIÓN/CONCLUSIONES: The trans fatty acid content of the analyzed foods can be considered low, compared with the amount reported by other authors in food products marketed in Spain and other countries in the past few years. Further studies should be undertaken to control nutrition security and diet quality of fat intake in the Spanish population, particularly among children and adolescents.