2026
- AbstractURLBibTeXEndNoteDOIBibSonomyDownload1.Sousa-Pinto B, Marques-Cruz M, Vieira RJ, Duarte VH, Ávila-Oliver C, Dobrescu A, Jemioło P, Agarwal A, Bala MM, Beltran J, Bognanni A, Cruciani F, Dewidar O, Gil-Mata S, Liang C, Martinho-Dias D, Nowak C, Ocagli H, Perestrelo P, Pereira Nunes Pinto AC, Reis-Pardal J, Riera-Serra P, Rocha A, Fernández-Saénz K, Etxeandia-Ikobaltzeta I, Harrod CS, Langendam MW, Meerpohl J, Nonino F, Wiercioch W, Neumann I, Izcovich A, Minozzi S, Gartlehner G, Schünemann HJ. Artificial Intelligence-enabled GRADE: how the GRADE Working Group will use automation to rate the certainty of evidence of intervention effects. Journal of clinical epidemiology [Internet]. United States; 2026 Oct.;198:112411-. https://pubmed.ncbi.nlm.nih.gov/42413633OBJECTIVES: The Grading of Recommendations Assessment, Development and Evaluation (GRADE) Working Group is developing GRADErater (GRADE Rating Automation Through Enhanced Reasoning), an official, automated tool for evaluation of the certainty of evidence (CoE). In this article, we describe the principles and methods underlying its development and state how the GRADE Working Group (GWG) will use automation to rate the CoE of intervention effects. METHODS: We followed the GRADE methods for registering a project group on GRADE and artificial intelligence (AI). The project group established that the automated tool should be developed according to the following principles: (i) compliance with the current GRADE guidance, (ii) transparency, (iii) human oversight, (iv) implementation of decision rules, (v) ease of use, (vi) understandability, and (vii) continuous improvement. We developed a set of decision rules to appraise each domain of the CoE in pairwise and network meta-analysis. These rules were developed based on official GRADE sources and validated by GRADE experts. Based on these rules, we created a first version (https://gradeai.med.up.pt/) for GRADErater. We are now evaluating this version in terms of (i) its underlying rules and (ii) its user interface. These assessments will allow for a refinement of the rules and of the first version. The modified version will be appraised and presented to the GWG with input from internal and external interest-holders before we seek formal approval. Once launched, the automated tool will be continuously evaluated and refined by incorporating feedback from end users. We will add new features (including generative AI-based functionalities), integrate this tool with GRADEpro, and develop versions in languages other than English. CONCLUSION: This project will follow a transparent methodology to create GRADErater, an official tool endorsed by the GWG that will support humans in applying the most current GRADE methods to rate the CoE.
@article{sousapinto2026artificial,
abstract = {OBJECTIVES: The Grading of Recommendations Assessment, Development and Evaluation (GRADE) Working Group is developing GRADErater (GRADE Rating Automation Through Enhanced Reasoning), an official, automated tool for evaluation of the certainty of evidence (CoE). In this article, we describe the principles and methods underlying its development and state how the GRADE Working Group (GWG) will use automation to rate the CoE of intervention effects. METHODS: We followed the GRADE methods for registering a project group on GRADE and artificial intelligence (AI). The project group established that the automated tool should be developed according to the following principles: (i) compliance with the current GRADE guidance, (ii) transparency, (iii) human oversight, (iv) implementation of decision rules, (v) ease of use, (vi) understandability, and (vii) continuous improvement. We developed a set of decision rules to appraise each domain of the CoE in pairwise and network meta-analysis. These rules were developed based on official GRADE sources and validated by GRADE experts. Based on these rules, we created a first version (https://gradeai.med.up.pt/) for GRADErater. We are now evaluating this version in terms of (i) its underlying rules and (ii) its user interface. These assessments will allow for a refinement of the rules and of the first version. The modified version will be appraised and presented to the GWG with input from internal and external interest-holders before we seek formal approval. Once launched, the automated tool will be continuously evaluated and refined by incorporating feedback from end users. We will add new features (including generative AI-based functionalities), integrate this tool with GRADEpro, and develop versions in languages other than English. CONCLUSION: This project will follow a transparent methodology to create GRADErater, an official tool endorsed by the GWG that will support humans in applying the most current GRADE methods to rate the CoE.},
address = {United States},
author = {Sousa-Pinto, Bernardo and Marques-Cruz, Manuel and Vieira, Rafael José and Duarte, Vítor Henrique and Ávila-Oliver, Camila and Dobrescu, Andreea and Jemioło, Paweł and Agarwal, Arnav and Bala, Malgorzata M and Beltran, Jessica and Bognanni, Antonio and Cruciani, Fabio and Dewidar, Omar and Gil-Mata, Sara and Liang, Changhao and Martinho-Dias, Daniel and Nowak, Claus and Ocagli, Honoria and Perestrelo, Paula and Pereira Nunes Pinto, Ana Carolina and Reis-Pardal, Joana and Riera-Serra, Pau and Rocha, Aline and Fernández-Saénz, Karina and Etxeandia-Ikobaltzeta, Itziar and Harrod, Curtis S and Langendam, Miranda W and Meerpohl, Joerg and Nonino, Francesco and Wiercioch, Wojtek and Neumann, Ignacio and Izcovich, Ariel and Minozzi, Silvia and Gartlehner, Gerald and Schünemann, Holger J},
journal = {Journal of clinical epidemiology},
keywords = {evisap},
month = {oct},
pages = {112411--112411},
title = {Artificial Intelligence-enabled GRADE: how the GRADE Working Group will use automation to rate the certainty of evidence of intervention effects},
volume = 198,
year = 2026
}%0 Journal Article
%1 sousapinto2026artificial
%A Sousa-Pinto, Bernardo
%A Marques-Cruz, Manuel
%A Vieira, Rafael José
%A Duarte, Vítor Henrique
%A Ávila-Oliver, Camila
%A Dobrescu, Andreea
%A Jemioło, Paweł
%A Agarwal, Arnav
%A Bala, Malgorzata M
%A Beltran, Jessica
%A Bognanni, Antonio
%A Cruciani, Fabio
%A Dewidar, Omar
%A Gil-Mata, Sara
%A Liang, Changhao
%A Martinho-Dias, Daniel
%A Nowak, Claus
%A Ocagli, Honoria
%A Perestrelo, Paula
%A Pereira Nunes Pinto, Ana Carolina
%A Reis-Pardal, Joana
%A Riera-Serra, Pau
%A Rocha, Aline
%A Fernández-Saénz, Karina
%A Etxeandia-Ikobaltzeta, Itziar
%A Harrod, Curtis S
%A Langendam, Miranda W
%A Meerpohl, Joerg
%A Nonino, Francesco
%A Wiercioch, Wojtek
%A Neumann, Ignacio
%A Izcovich, Ariel
%A Minozzi, Silvia
%A Gartlehner, Gerald
%A Schünemann, Holger J
%C United States
%D 2026
%J Journal of clinical epidemiology
%P 112411--112411
%R 10.1016/j.jclinepi.2026.112411
%T Artificial Intelligence-enabled GRADE: how the GRADE Working Group will use automation to rate the certainty of evidence of intervention effects
%U https://pubmed.ncbi.nlm.nih.gov/42413633
%V 198
%X OBJECTIVES: The Grading of Recommendations Assessment, Development and Evaluation (GRADE) Working Group is developing GRADErater (GRADE Rating Automation Through Enhanced Reasoning), an official, automated tool for evaluation of the certainty of evidence (CoE). In this article, we describe the principles and methods underlying its development and state how the GRADE Working Group (GWG) will use automation to rate the CoE of intervention effects. METHODS: We followed the GRADE methods for registering a project group on GRADE and artificial intelligence (AI). The project group established that the automated tool should be developed according to the following principles: (i) compliance with the current GRADE guidance, (ii) transparency, (iii) human oversight, (iv) implementation of decision rules, (v) ease of use, (vi) understandability, and (vii) continuous improvement. We developed a set of decision rules to appraise each domain of the CoE in pairwise and network meta-analysis. These rules were developed based on official GRADE sources and validated by GRADE experts. Based on these rules, we created a first version (https://gradeai.med.up.pt/) for GRADErater. We are now evaluating this version in terms of (i) its underlying rules and (ii) its user interface. These assessments will allow for a refinement of the rules and of the first version. The modified version will be appraised and presented to the GWG with input from internal and external interest-holders before we seek formal approval. Once launched, the automated tool will be continuously evaluated and refined by incorporating feedback from end users. We will add new features (including generative AI-based functionalities), integrate this tool with GRADEpro, and develop versions in languages other than English. CONCLUSION: This project will follow a transparent methodology to create GRADErater, an official tool endorsed by the GWG that will support humans in applying the most current GRADE methods to rate the CoE. - AbstractBibTeXEndNoteDOIBibSonomyDownload1.Vicente-Herrero MT, Tárraga López PJ, Busquets-Cortés C, Rodas Cañellas L, López-González Ángel A, Ramírez-Manent JI. Educational Inequalities and Obesity: Association and Attenuation After Lifestyle Adjustment in a Cross-Sectional Working-Age Population. Medical Sciences. Basel, Switzerland; 2026 Jun.;14(3):351.BACKGROUND: Obesity is a major public health concern and shows a clear social gradient, with higher prevalence among individuals with lower socioeconomic position. Educational level is a key indicator of socioeconomic status, but the extent to which lifestyle factors explain its association with obesity remains unclear. OBJECTIVE: To examine the association between educational level and obesity in a working-age population and to evaluate how adjustment for lifestyle factors influences the magnitude of the association between educational level and obesity. METHODS: A cross-sectional study was conducted among 3108 working-age adults undergoing occupational health assessments in Spain. Educational level was categorised into three groups (higher, intermediate, and primary or none). Obesity was defined as a body mass index ≥30 kg/m2. Lifestyle variables included smoking status, physical activity assessed using the International Physical Activity Questionnaire (IPAQ-SF), and adherence to the Mediterranean diet evaluated with the MEDAS-14 score. Sequential logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (95\% CI), with progressive adjustment for demographic, behavioural, and clinical factors. RESULTS: The overall prevalence of obesity was 16.6%, with a clear gradient across educational levels (11.5\% in higher education vs. 19.8\% in primary or no education). In crude analyses, individuals with the lowest educational level had higher odds of obesity (OR 1.89; 95\% CI 1.46-2.45). Adjustment for age and sex attenuated the association (OR 1.72; 95\% CI 1.32-2.24), with further reduction after inclusion of lifestyle factors (OR 1.63; 95\% CI 1.24-2.13). In the fully adjusted model, the association remained statistically significant (OR 1.61; 95\% CI 1.18-2.21), indicating that adjustment for lifestyle factors attenuated the association between educational level and obesity, although the association remained statistically significant. CONCLUSIONS: Lower educational level is associated with a higher risk of obesity. Adjustment for lifestyle factors attenuated this association, although a statistically significant relationship remained. These findings support the role of education as a fundamental determinant of health and highlight the need for strategies addressing broader social and structural determinants of obesity.
@article{vicente-herrero_educational_2026,
abstract = {BACKGROUND: Obesity is a major public health concern and shows a clear social gradient, with higher prevalence among individuals with lower socioeconomic position. Educational level is a key indicator of socioeconomic status, but the extent to which lifestyle factors explain its association with obesity remains unclear. OBJECTIVE: To examine the association between educational level and obesity in a working-age population and to evaluate how adjustment for lifestyle factors influences the magnitude of the association between educational level and obesity. METHODS: A cross-sectional study was conducted among 3108 working-age adults undergoing occupational health assessments in Spain. Educational level was categorised into three groups (higher, intermediate, and primary or none). Obesity was defined as a body mass index ≥30 kg/m2. Lifestyle variables included smoking status, physical activity assessed using the International Physical Activity Questionnaire (IPAQ-SF), and adherence to the Mediterranean diet evaluated with the MEDAS-14 score. Sequential logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (95\% CI), with progressive adjustment for demographic, behavioural, and clinical factors. RESULTS: The overall prevalence of obesity was 16.6%, with a clear gradient across educational levels (11.5\% in higher education vs. 19.8\% in primary or no education). In crude analyses, individuals with the lowest educational level had higher odds of obesity (OR 1.89; 95\% CI 1.46-2.45). Adjustment for age and sex attenuated the association (OR 1.72; 95\% CI 1.32-2.24), with further reduction after inclusion of lifestyle factors (OR 1.63; 95\% CI 1.24-2.13). In the fully adjusted model, the association remained statistically significant (OR 1.61; 95\% CI 1.18-2.21), indicating that adjustment for lifestyle factors attenuated the association between educational level and obesity, although the association remained statistically significant. CONCLUSIONS: Lower educational level is associated with a higher risk of obesity. Adjustment for lifestyle factors attenuated this association, although a statistically significant relationship remained. These findings support the role of education as a fundamental determinant of health and highlight the need for strategies addressing broader social and structural determinants of obesity.},
address = {Basel, Switzerland},
author = {Vicente-Herrero, María Teófila and Tárraga López, Pedro J. and Busquets-Cortés, Carla and Rodas Cañellas, Lluis and López-González, Ángel Arturo and Ramírez-Manent, José Ignacio},
journal = {Medical Sciences},
keywords = {grapp-caib},
month = {jun},
number = 3,
pages = 351,
title = {Educational Inequalities and Obesity: Association and Attenuation After Lifestyle Adjustment in a Cross-Sectional Working-Age Population},
volume = 14,
year = 2026
}%0 Journal Article
%1 vicente-herrero_educational_2026
%A Vicente-Herrero, María Teófila
%A Tárraga López, Pedro J.
%A Busquets-Cortés, Carla
%A Rodas Cañellas, Lluis
%A López-González, Ángel Arturo
%A Ramírez-Manent, José Ignacio
%C Basel, Switzerland
%D 2026
%J Medical Sciences
%N 3
%P 351
%R 10.3390/medsci14030351
%T Educational Inequalities and Obesity: Association and Attenuation After Lifestyle Adjustment in a Cross-Sectional Working-Age Population
%V 14
%X BACKGROUND: Obesity is a major public health concern and shows a clear social gradient, with higher prevalence among individuals with lower socioeconomic position. Educational level is a key indicator of socioeconomic status, but the extent to which lifestyle factors explain its association with obesity remains unclear. OBJECTIVE: To examine the association between educational level and obesity in a working-age population and to evaluate how adjustment for lifestyle factors influences the magnitude of the association between educational level and obesity. METHODS: A cross-sectional study was conducted among 3108 working-age adults undergoing occupational health assessments in Spain. Educational level was categorised into three groups (higher, intermediate, and primary or none). Obesity was defined as a body mass index ≥30 kg/m2. Lifestyle variables included smoking status, physical activity assessed using the International Physical Activity Questionnaire (IPAQ-SF), and adherence to the Mediterranean diet evaluated with the MEDAS-14 score. Sequential logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (95\% CI), with progressive adjustment for demographic, behavioural, and clinical factors. RESULTS: The overall prevalence of obesity was 16.6%, with a clear gradient across educational levels (11.5\% in higher education vs. 19.8\% in primary or no education). In crude analyses, individuals with the lowest educational level had higher odds of obesity (OR 1.89; 95\% CI 1.46-2.45). Adjustment for age and sex attenuated the association (OR 1.72; 95\% CI 1.32-2.24), with further reduction after inclusion of lifestyle factors (OR 1.63; 95\% CI 1.24-2.13). In the fully adjusted model, the association remained statistically significant (OR 1.61; 95\% CI 1.18-2.21), indicating that adjustment for lifestyle factors attenuated the association between educational level and obesity, although the association remained statistically significant. CONCLUSIONS: Lower educational level is associated with a higher risk of obesity. Adjustment for lifestyle factors attenuated this association, although a statistically significant relationship remained. These findings support the role of education as a fundamental determinant of health and highlight the need for strategies addressing broader social and structural determinants of obesity. - AbstractBibTeXEndNoteDOIBibSonomyDownload1.Valles JLR, López PJT, González Ángel AL, Campayo IC, Busquets-Cortés C, Ramírez-Manent JI. Insomnia as an Independent Behavioral Correlate of Estimated Type 2 Diabetes Risk: Evidence from Three Validated Risk Assessment Scales. Rambam Maimonides Medical Journal. 2026 Jul.;17(3):e0019.BACKGROUND: Sleep disturbances, particularly insomnia, are increasingly recognized as behavioral determinants of type 2 diabetes (T2DM). However, their contribution to validated diabetes risk scores beyond traditional sociodemographic and lifestyle factors remains insufficiently explored. OBJECTIVE: To examine the association between insomnia severity, sociodemographic variables, lifestyle habits, and estimated T2DM risk using three validated non-invasive risk assessment scales. METHODS: A cross-sectional study was conducted among 84,898 Spanish workers aged 18-69 years undergoing occupational health evaluations (2021-2024). Sociodemographic and behavioral data were collected through standardized questionnaires, including adherence to the Mediterranean diet (MEDAS-14), physical activity (IPAQ-SF), and smoking status. Insomnia was assessed using the Insomnia Severity Index (ISI). Diabetes risk was estimated using three validated non-invasive risk-assessment tools: the Finnish Diabetes Risk Score, the QDScore/QDiabetes, and the Trinidad Risk Assessment Questionnaire for Type 2 Diabetes Mellitus. As these instruments were developed and validated in different populations, comparisons of absolute risk categories across scales should be interpreted with caution. Multivariable logistic regression models adjusted for age, sex, social class, smoking, diet, and physical activity were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS: Severe insomnia was associated with approximately 2.1-2.6-fold higher odds of high estimated diabetes risk across all three scales in the pooled analyses, with significant trends across categories of insomnia severity (all P for trend \textless0.001). This association persisted across sex and activity strata. Adding ISI modestly improved model discrimination (ΔAUC ≈ +0.015; P≤0.003) and reclassification (continuous net reclassification improvement [NRI], 6.5\%-8.1\%). CONCLUSIONS: Insomnia severity was independently associated with higher estimated risk of T2DM beyond measured sociodemographic and lifestyle determinants. Incorporating sleep health-via brief tools such as the ISI-into diabetes risk assessment could enhance early prevention strategies in clinical and occupational settings.
@article{valles_insomnia_2026,
abstract = {BACKGROUND: Sleep disturbances, particularly insomnia, are increasingly recognized as behavioral determinants of type 2 diabetes (T2DM). However, their contribution to validated diabetes risk scores beyond traditional sociodemographic and lifestyle factors remains insufficiently explored. OBJECTIVE: To examine the association between insomnia severity, sociodemographic variables, lifestyle habits, and estimated T2DM risk using three validated non-invasive risk assessment scales. METHODS: A cross-sectional study was conducted among 84,898 Spanish workers aged 18-69 years undergoing occupational health evaluations (2021-2024). Sociodemographic and behavioral data were collected through standardized questionnaires, including adherence to the Mediterranean diet (MEDAS-14), physical activity (IPAQ-SF), and smoking status. Insomnia was assessed using the Insomnia Severity Index (ISI). Diabetes risk was estimated using three validated non-invasive risk-assessment tools: the Finnish Diabetes Risk Score, the QDScore/QDiabetes, and the Trinidad Risk Assessment Questionnaire for Type 2 Diabetes Mellitus. As these instruments were developed and validated in different populations, comparisons of absolute risk categories across scales should be interpreted with caution. Multivariable logistic regression models adjusted for age, sex, social class, smoking, diet, and physical activity were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS: Severe insomnia was associated with approximately 2.1-2.6-fold higher odds of high estimated diabetes risk across all three scales in the pooled analyses, with significant trends across categories of insomnia severity (all P for trend \textless0.001). This association persisted across sex and activity strata. Adding ISI modestly improved model discrimination (ΔAUC ≈ +0.015; P≤0.003) and reclassification (continuous net reclassification improvement [NRI], 6.5\%-8.1\%). CONCLUSIONS: Insomnia severity was independently associated with higher estimated risk of T2DM beyond measured sociodemographic and lifestyle determinants. Incorporating sleep health-via brief tools such as the ISI-into diabetes risk assessment could enhance early prevention strategies in clinical and occupational settings.},
author = {Valles, José Luis Ribes and López, Pedro Juan Tárraga and González, Ángel Arturo López and Campayo, Irene Coll and Busquets-Cortés, Carla and Ramírez-Manent, José Ignacio},
journal = {Rambam Maimonides Medical Journal},
keywords = {grapp-caib},
month = {jul},
number = 3,
pages = {e0019},
title = {Insomnia as an Independent Behavioral Correlate of Estimated Type 2 Diabetes Risk: Evidence from Three Validated Risk Assessment Scales},
volume = 17,
year = 2026
}%0 Journal Article
%1 valles_insomnia_2026
%A Valles, José Luis Ribes
%A López, Pedro Juan Tárraga
%A González, Ángel Arturo López
%A Campayo, Irene Coll
%A Busquets-Cortés, Carla
%A Ramírez-Manent, José Ignacio
%D 2026
%J Rambam Maimonides Medical Journal
%N 3
%P e0019
%R 10.5041/RMMJ.10579
%T Insomnia as an Independent Behavioral Correlate of Estimated Type 2 Diabetes Risk: Evidence from Three Validated Risk Assessment Scales
%V 17
%X BACKGROUND: Sleep disturbances, particularly insomnia, are increasingly recognized as behavioral determinants of type 2 diabetes (T2DM). However, their contribution to validated diabetes risk scores beyond traditional sociodemographic and lifestyle factors remains insufficiently explored. OBJECTIVE: To examine the association between insomnia severity, sociodemographic variables, lifestyle habits, and estimated T2DM risk using three validated non-invasive risk assessment scales. METHODS: A cross-sectional study was conducted among 84,898 Spanish workers aged 18-69 years undergoing occupational health evaluations (2021-2024). Sociodemographic and behavioral data were collected through standardized questionnaires, including adherence to the Mediterranean diet (MEDAS-14), physical activity (IPAQ-SF), and smoking status. Insomnia was assessed using the Insomnia Severity Index (ISI). Diabetes risk was estimated using three validated non-invasive risk-assessment tools: the Finnish Diabetes Risk Score, the QDScore/QDiabetes, and the Trinidad Risk Assessment Questionnaire for Type 2 Diabetes Mellitus. As these instruments were developed and validated in different populations, comparisons of absolute risk categories across scales should be interpreted with caution. Multivariable logistic regression models adjusted for age, sex, social class, smoking, diet, and physical activity were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS: Severe insomnia was associated with approximately 2.1-2.6-fold higher odds of high estimated diabetes risk across all three scales in the pooled analyses, with significant trends across categories of insomnia severity (all P for trend \textless0.001). This association persisted across sex and activity strata. Adding ISI modestly improved model discrimination (ΔAUC ≈ +0.015; P≤0.003) and reclassification (continuous net reclassification improvement [NRI], 6.5\%-8.1\%). CONCLUSIONS: Insomnia severity was independently associated with higher estimated risk of T2DM beyond measured sociodemographic and lifestyle determinants. Incorporating sleep health-via brief tools such as the ISI-into diabetes risk assessment could enhance early prevention strategies in clinical and occupational settings. - AbstractURLBibTeXEndNoteDOIBibSonomyDownload1.Thomander T, Gil-Mata S, Riera-Serra P, Vieira RJ, Ferreira A, Bognanni A, Duarte VH, Viegas H, Pereira AM, Ferreira-da Silva R, Ferreira-Cardoso H, Marques-Cruz M, Castro-Teles J, Campos-Lopes M, Ferreira AT, Lourenço-Silva N, Boechat JL, Borowiack E, Sadowska E, Costa RA, Perestrelo P, Pereira-Macedo J, Ierodiakonou D, Chu AWL, Calvi IP, Torres MI, Ribeiro RS, Chérrez-Ojeda I, Nuñez JJY, Zuberbier T, Fernandes RM, Fiocchi A, Larenas-Linnemann DE, Pham-Thi N, Papadopoulos NG, Roberts G, Valiulis A, Fonseca JA, Schünemann HJ, Giovannini M, Sousa-Pinto B, guideline panel A 2024–2025. Efficacy and safety of oral treatments for allergic rhinitis in children: A network meta-analysis. Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology [Internet]. England; 2026 Aug.;37(8):e70431-e70431. https://pubmed.ncbi.nlm.nih.gov/42596864BACKGROUND: Allergic rhinitis is the most common chronic disease in children. Information on efficacy and safety of oral allergic rhinitis treatments in children is scarce. We aimed to comprehensively evaluate the efficacy and safety of oral medications for allergic rhinitis in children. METHODS: We performed a systematic review, searching three bibliographic databases and clinicaltrials.gov for randomized controlled trials assessing the use of oral antihistamines (OAH) or leukotriene receptor antagonists (LTRA) in children (<12 years old) with seasonal or perennial allergic rhinitis. Evaluated outcomes included the Total Nasal Symptom Score (TNSS), the Total Ocular Symptom Score (TOSS), the Rhinoconjunctivitis Quality-of-Life Questionnaire (RQLQ), development of adverse or serious adverse events, and withdrawals due to adverse events. We performed network meta-analysis at both class and individual treatment levels. Certainty in the body of evidence was assessed using the GRADE approach for network meta-analysis. RESULTS: We included eight primary studies with 906 participants. Overall, OAH were more effective against placebo in improving the TNSS (mean difference (MD) = -1.60; 95%CI = -2.25 to -0.95). On the other hand, OAH+LTRA did not demonstrate additional benefit over OAH in improving the TNSS (MD = -0.15; 95% CI = -1.18 to 0.88), and there were no important differences between individual OAH. Evidence on the TOSS was not found. No significant differences in the frequency of adverse events were observed. Certainty of evidence was low or very low for most comparisons. CONCLUSIONS: Oral treatments for allergic rhinitis appear to be effective and safe in children. However, evidence is scarce and the quality of evidence is mostly low. We performed a systematic review of randomised controlled trials assessing oral medications for allergic rhinitis in children and reporting results on nasal symptoms, ocular symptoms, quality of life and adverse events. Oral antihistamines (OAH) were found to be better than placebo, and OAH + oral leukotriene receptor antagonists (OLTRA) were not found to be better than OAH. We identified trivial differences between different OAH.
@article{thomander2026efficacy,
abstract = {BACKGROUND: Allergic rhinitis is the most common chronic disease in children. Information on efficacy and safety of oral allergic rhinitis treatments in children is scarce. We aimed to comprehensively evaluate the efficacy and safety of oral medications for allergic rhinitis in children. METHODS: We performed a systematic review, searching three bibliographic databases and clinicaltrials.gov for randomized controlled trials assessing the use of oral antihistamines (OAH) or leukotriene receptor antagonists (LTRA) in children (<12 years old) with seasonal or perennial allergic rhinitis. Evaluated outcomes included the Total Nasal Symptom Score (TNSS), the Total Ocular Symptom Score (TOSS), the Rhinoconjunctivitis Quality-of-Life Questionnaire (RQLQ), development of adverse or serious adverse events, and withdrawals due to adverse events. We performed network meta-analysis at both class and individual treatment levels. Certainty in the body of evidence was assessed using the GRADE approach for network meta-analysis. RESULTS: We included eight primary studies with 906 participants. Overall, OAH were more effective against placebo in improving the TNSS (mean difference (MD) = -1.60; 95%CI = -2.25 to -0.95). On the other hand, OAH+LTRA did not demonstrate additional benefit over OAH in improving the TNSS (MD = -0.15; 95% CI = -1.18 to 0.88), and there were no important differences between individual OAH. Evidence on the TOSS was not found. No significant differences in the frequency of adverse events were observed. Certainty of evidence was low or very low for most comparisons. CONCLUSIONS: Oral treatments for allergic rhinitis appear to be effective and safe in children. However, evidence is scarce and the quality of evidence is mostly low. We performed a systematic review of randomised controlled trials assessing oral medications for allergic rhinitis in children and reporting results on nasal symptoms, ocular symptoms, quality of life and adverse events. Oral antihistamines (OAH) were found to be better than placebo, and OAH + oral leukotriene receptor antagonists (OLTRA) were not found to be better than OAH. We identified trivial differences between different OAH.},
address = {England},
author = {Thomander, Tuuli and Gil-Mata, Sara and Riera-Serra, Pau and Vieira, Rafael José and Ferreira, André and Bognanni, Antonio and Duarte, Vítor Henrique and Viegas, Hugo and Pereira, Ana Margarida and Ferreira-da Silva, Renato and Ferreira-Cardoso, Henrique and Marques-Cruz, Manuel and Castro-Teles, João and Campos-Lopes, Miguel and Ferreira, Ana Teixeira and Lourenço-Silva, Nuno and Boechat, José Laerte and Borowiack, Ewa and Sadowska, Ewelina and Costa, Raquel Albuquerque and Perestrelo, Paula and Pereira-Macedo, Juliana and Ierodiakonou, Despo and Chu, Alexandro W L and Calvi, Izabela Pera and Torres, Maria Inês and Ribeiro, Rita Silva and Chérrez-Ojeda, Ivan and Nuñez, Juan Jose Yepes and Zuberbier, Torsten and Fernandes, Ricardo M and Fiocchi, Alessandro and Larenas-Linnemann, Désirée E and Pham-Thi, Nhân and Papadopoulos, Nikolaos G and Roberts, Graham and Valiulis, Arunas and Fonseca, João A and Schünemann, Holger J and Giovannini, Mattia and Sousa-Pinto, Bernardo and guideline panel, ARIA 2024–2025},
journal = {Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology},
keywords = {evisap},
month = {aug},
number = 8,
pages = {e70431--e70431},
title = {Efficacy and safety of oral treatments for allergic rhinitis in children: A network meta-analysis},
volume = 37,
year = 2026
}%0 Journal Article
%1 thomander2026efficacy
%A Thomander, Tuuli
%A Gil-Mata, Sara
%A Riera-Serra, Pau
%A Vieira, Rafael José
%A Ferreira, André
%A Bognanni, Antonio
%A Duarte, Vítor Henrique
%A Viegas, Hugo
%A Pereira, Ana Margarida
%A Ferreira-da Silva, Renato
%A Ferreira-Cardoso, Henrique
%A Marques-Cruz, Manuel
%A Castro-Teles, João
%A Campos-Lopes, Miguel
%A Ferreira, Ana Teixeira
%A Lourenço-Silva, Nuno
%A Boechat, José Laerte
%A Borowiack, Ewa
%A Sadowska, Ewelina
%A Costa, Raquel Albuquerque
%A Perestrelo, Paula
%A Pereira-Macedo, Juliana
%A Ierodiakonou, Despo
%A Chu, Alexandro W L
%A Calvi, Izabela Pera
%A Torres, Maria Inês
%A Ribeiro, Rita Silva
%A Chérrez-Ojeda, Ivan
%A Nuñez, Juan Jose Yepes
%A Zuberbier, Torsten
%A Fernandes, Ricardo M
%A Fiocchi, Alessandro
%A Larenas-Linnemann, Désirée E
%A Pham-Thi, Nhân
%A Papadopoulos, Nikolaos G
%A Roberts, Graham
%A Valiulis, Arunas
%A Fonseca, João A
%A Schünemann, Holger J
%A Giovannini, Mattia
%A Sousa-Pinto, Bernardo
%A guideline panel, ARIA 2024–2025
%C England
%D 2026
%J Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology
%N 8
%P e70431--e70431
%R 10.1111/pai.70431
%T Efficacy and safety of oral treatments for allergic rhinitis in children: A network meta-analysis
%U https://pubmed.ncbi.nlm.nih.gov/42596864
%V 37
%X BACKGROUND: Allergic rhinitis is the most common chronic disease in children. Information on efficacy and safety of oral allergic rhinitis treatments in children is scarce. We aimed to comprehensively evaluate the efficacy and safety of oral medications for allergic rhinitis in children. METHODS: We performed a systematic review, searching three bibliographic databases and clinicaltrials.gov for randomized controlled trials assessing the use of oral antihistamines (OAH) or leukotriene receptor antagonists (LTRA) in children (<12 years old) with seasonal or perennial allergic rhinitis. Evaluated outcomes included the Total Nasal Symptom Score (TNSS), the Total Ocular Symptom Score (TOSS), the Rhinoconjunctivitis Quality-of-Life Questionnaire (RQLQ), development of adverse or serious adverse events, and withdrawals due to adverse events. We performed network meta-analysis at both class and individual treatment levels. Certainty in the body of evidence was assessed using the GRADE approach for network meta-analysis. RESULTS: We included eight primary studies with 906 participants. Overall, OAH were more effective against placebo in improving the TNSS (mean difference (MD) = -1.60; 95%CI = -2.25 to -0.95). On the other hand, OAH+LTRA did not demonstrate additional benefit over OAH in improving the TNSS (MD = -0.15; 95% CI = -1.18 to 0.88), and there were no important differences between individual OAH. Evidence on the TOSS was not found. No significant differences in the frequency of adverse events were observed. Certainty of evidence was low or very low for most comparisons. CONCLUSIONS: Oral treatments for allergic rhinitis appear to be effective and safe in children. However, evidence is scarce and the quality of evidence is mostly low. We performed a systematic review of randomised controlled trials assessing oral medications for allergic rhinitis in children and reporting results on nasal symptoms, ocular symptoms, quality of life and adverse events. Oral antihistamines (OAH) were found to be better than placebo, and OAH + oral leukotriene receptor antagonists (OLTRA) were not found to be better than OAH. We identified trivial differences between different OAH. - AbstractBibTeXEndNoteDOIBibSonomyDownload1.Ramirez Gallegos A, Tárraga López PJ, Piña Dabreu MS, Rodas Cañellas L, López-González Ángel A, Ramírez-Manent JI. Sex-Specific Misclassification of Obesity When Using Body Mass Index in Young Healthcare Professionals: A Large Cross-Sectional Study Using Multiple Adiposity Indices. Medical Sciences. Basel, Switzerland; 2026 May;14(2):234.Background: Body mass index (BMI) remains the standard tool for obesity screening; however, it does not account for body fat distribution or visceral adiposity, potentially leading to clinically relevant misclassification-particularly in young adults. Evidence on this issue in healthcare professionals is limited. Objective: To evaluate the extent of obesity misclassification when using BMI compared with alternative anthropometric and body composition indices, and to examine sex-specific associations between lifestyle factors and different adiposity phenotypes in young healthcare professionals. Methods: A large cross-sectional study was conducted in 12,874 medical residents, nursing residents, and age-matched controls (22-30 years). Obesity was defined using BMI (≥30 kg/m2), waist-to-height ratio (WtHR ≥ 0.5), Clínica Universidad de Navarra-Body Adiposity Estimator (CUN-BAE), body fat percentage, and bioimpedance-derived visceral fat. Multivariable logistic regression models adjusted for age, sex, professional group, smoking, physical activity, and Mediterranean diet adherence were fitted separately for each adiposity definition. Sex interaction terms were formally tested. Agreement between indices was assessed using Cohen's kappa. Results: Obesity prevalence varied substantially according to the index applied and was consistently higher when central or visceral adiposity measures were used. Agreement between BMI and alternative indices was only fair to moderate, with the lowest concordance observed for visceral fat (κ = 0.29; 95\% CI 0.26-0.32). Male sex was strongly associated with visceral fat-defined obesity (aOR 4.76; 95\% CI 3.82-5.92), while effect sizes were attenuated for BMI-defined obesity (aOR 1.41; 95\% CI 1.32-1.51). Significant sex interactions were detected for visceral adiposity, particularly for physical activity (p = 0.001) and smoking (p = 0.002), indicating differential lifestyle associations according to fat distribution phenotype. Conclusions: BMI substantially underestimates clinically relevant central and visceral adiposity in young healthcare professionals. Sex-specific differences were observed in the association between lifestyle behaviors and visceral fat. These findings highlight the limitations of relying exclusively on BMI for obesity screening. Incorporating waist-based or body composition-derived measures may improve early risk identification and support targeted preventive strategies.
@article{ramirez_gallegos_sex-specific_2026,
abstract = {Background: Body mass index (BMI) remains the standard tool for obesity screening; however, it does not account for body fat distribution or visceral adiposity, potentially leading to clinically relevant misclassification-particularly in young adults. Evidence on this issue in healthcare professionals is limited. Objective: To evaluate the extent of obesity misclassification when using BMI compared with alternative anthropometric and body composition indices, and to examine sex-specific associations between lifestyle factors and different adiposity phenotypes in young healthcare professionals. Methods: A large cross-sectional study was conducted in 12,874 medical residents, nursing residents, and age-matched controls (22-30 years). Obesity was defined using BMI (≥30 kg/m2), waist-to-height ratio (WtHR ≥ 0.5), Clínica Universidad de Navarra-Body Adiposity Estimator (CUN-BAE), body fat percentage, and bioimpedance-derived visceral fat. Multivariable logistic regression models adjusted for age, sex, professional group, smoking, physical activity, and Mediterranean diet adherence were fitted separately for each adiposity definition. Sex interaction terms were formally tested. Agreement between indices was assessed using Cohen's kappa. Results: Obesity prevalence varied substantially according to the index applied and was consistently higher when central or visceral adiposity measures were used. Agreement between BMI and alternative indices was only fair to moderate, with the lowest concordance observed for visceral fat (κ = 0.29; 95\% CI 0.26-0.32). Male sex was strongly associated with visceral fat-defined obesity (aOR 4.76; 95\% CI 3.82-5.92), while effect sizes were attenuated for BMI-defined obesity (aOR 1.41; 95\% CI 1.32-1.51). Significant sex interactions were detected for visceral adiposity, particularly for physical activity (p = 0.001) and smoking (p = 0.002), indicating differential lifestyle associations according to fat distribution phenotype. Conclusions: BMI substantially underestimates clinically relevant central and visceral adiposity in young healthcare professionals. Sex-specific differences were observed in the association between lifestyle behaviors and visceral fat. These findings highlight the limitations of relying exclusively on BMI for obesity screening. Incorporating waist-based or body composition-derived measures may improve early risk identification and support targeted preventive strategies.},
address = {Basel, Switzerland},
author = {Ramirez Gallegos, Alberto and Tárraga López, Pedro Juan and Piña Dabreu, Mónica Silu and Rodas Cañellas, Lluis and López-González, Ángel Arturo and Ramírez-Manent, José Ignacio},
journal = {Medical Sciences},
keywords = {grapp-caib},
month = {may},
number = 2,
pages = 234,
title = {Sex-Specific Misclassification of Obesity When Using Body Mass Index in Young Healthcare Professionals: A Large Cross-Sectional Study Using Multiple Adiposity Indices},
volume = 14,
year = 2026
}%0 Journal Article
%1 ramirez_gallegos_sex-specific_2026
%A Ramirez Gallegos, Alberto
%A Tárraga López, Pedro Juan
%A Piña Dabreu, Mónica Silu
%A Rodas Cañellas, Lluis
%A López-González, Ángel Arturo
%A Ramírez-Manent, José Ignacio
%C Basel, Switzerland
%D 2026
%J Medical Sciences
%N 2
%P 234
%R 10.3390/medsci14020234
%T Sex-Specific Misclassification of Obesity When Using Body Mass Index in Young Healthcare Professionals: A Large Cross-Sectional Study Using Multiple Adiposity Indices
%V 14
%X Background: Body mass index (BMI) remains the standard tool for obesity screening; however, it does not account for body fat distribution or visceral adiposity, potentially leading to clinically relevant misclassification-particularly in young adults. Evidence on this issue in healthcare professionals is limited. Objective: To evaluate the extent of obesity misclassification when using BMI compared with alternative anthropometric and body composition indices, and to examine sex-specific associations between lifestyle factors and different adiposity phenotypes in young healthcare professionals. Methods: A large cross-sectional study was conducted in 12,874 medical residents, nursing residents, and age-matched controls (22-30 years). Obesity was defined using BMI (≥30 kg/m2), waist-to-height ratio (WtHR ≥ 0.5), Clínica Universidad de Navarra-Body Adiposity Estimator (CUN-BAE), body fat percentage, and bioimpedance-derived visceral fat. Multivariable logistic regression models adjusted for age, sex, professional group, smoking, physical activity, and Mediterranean diet adherence were fitted separately for each adiposity definition. Sex interaction terms were formally tested. Agreement between indices was assessed using Cohen's kappa. Results: Obesity prevalence varied substantially according to the index applied and was consistently higher when central or visceral adiposity measures were used. Agreement between BMI and alternative indices was only fair to moderate, with the lowest concordance observed for visceral fat (κ = 0.29; 95\% CI 0.26-0.32). Male sex was strongly associated with visceral fat-defined obesity (aOR 4.76; 95\% CI 3.82-5.92), while effect sizes were attenuated for BMI-defined obesity (aOR 1.41; 95\% CI 1.32-1.51). Significant sex interactions were detected for visceral adiposity, particularly for physical activity (p = 0.001) and smoking (p = 0.002), indicating differential lifestyle associations according to fat distribution phenotype. Conclusions: BMI substantially underestimates clinically relevant central and visceral adiposity in young healthcare professionals. Sex-specific differences were observed in the association between lifestyle behaviors and visceral fat. These findings highlight the limitations of relying exclusively on BMI for obesity screening. Incorporating waist-based or body composition-derived measures may improve early risk identification and support targeted preventive strategies. 
AbstractBibTeXEndNoteDOIBibSonomy1.García Álvarez Ángel, Riera Serra P, Ricci-Cabello I, Morales Hernández D, Santa Cruz R, Malih N, Gonçalves-Bradley DC, Gallardo-Alfaro L, Serrano Ripoll MJ, Calafat Villalonga C, Ferrer Jaillard BA, Pinteño-Blanco M, Medina Bombardó D, Doronzo MA, Jaume Gayá S, Fiol deRoque MA. Effectiveness and safety of focused deprescribing interventions targeting specific drug classes in older adults across clinical settings: an umbrella systematic literature review. Age and Ageing. 2026 Aug.;55(8):afag243.Polypharmacy is highly prevalent among older adults and is associated with adverse outcomes. While comprehensive medication review is widely promoted to address potentially inappropriate prescribing, it is resource intensive. Focused deprescribing-defined as the targeted withdrawal or dose reduction of specific drug classes-has emerged as a potentially more scalable strategy. This umbrella review synthesised evidence on the effectiveness and safety of drug class-specific focused deprescribing interventions in older adults. We conducted an umbrella review of systematic reviews evaluating focused deprescribing interventions targeting specific pharmacological classes. MEDLINE, Embase, the Cochrane Library and Web of Science were searched from inception to March 2025. Study selection, data extraction and methodological quality assessment (AMSTAR-2) were performed independently by two reviewers. Findings were synthesised narratively by drug class and outcome domain, and overlap was assessed using the Corrected Covered Area. Twenty-seven systematic reviews were included. Most focused on psychotropics, particularly benzodiazepines, and anticholinergics, with fewer assessing antidiabetics or fall-risk increasing drugs. Reductions in medication use were most consistent for benzodiazepines and other psychotropics, especially when interventions included psychotherapy or multifaceted components. Evidence for antidiabetics suggested feasibility and safety, whereas effects on anticholinergics and fall-risk increasing drugs were limited. Clinical outcomes, including mortality, falls and cognition, were inconsistently reported and rarely improved. Most reviews were rated as critically low quality, and certainty of evidence was generally low or very low. Focused deprescribing appears feasible and generally safe for reducing selected potentially inappropriate medications in older adults; however, its clinical benefits are drug class-dependent and remain uncertain.@article{garcia_alvarez_effectiveness_2026,
abstract = {Polypharmacy is highly prevalent among older adults and is associated with adverse outcomes. While comprehensive medication review is widely promoted to address potentially inappropriate prescribing, it is resource intensive. Focused deprescribing-defined as the targeted withdrawal or dose reduction of specific drug classes-has emerged as a potentially more scalable strategy. This umbrella review synthesised evidence on the effectiveness and safety of drug class-specific focused deprescribing interventions in older adults. We conducted an umbrella review of systematic reviews evaluating focused deprescribing interventions targeting specific pharmacological classes. MEDLINE, Embase, the Cochrane Library and Web of Science were searched from inception to March 2025. Study selection, data extraction and methodological quality assessment (AMSTAR-2) were performed independently by two reviewers. Findings were synthesised narratively by drug class and outcome domain, and overlap was assessed using the Corrected Covered Area. Twenty-seven systematic reviews were included. Most focused on psychotropics, particularly benzodiazepines, and anticholinergics, with fewer assessing antidiabetics or fall-risk increasing drugs. Reductions in medication use were most consistent for benzodiazepines and other psychotropics, especially when interventions included psychotherapy or multifaceted components. Evidence for antidiabetics suggested feasibility and safety, whereas effects on anticholinergics and fall-risk increasing drugs were limited. Clinical outcomes, including mortality, falls and cognition, were inconsistently reported and rarely improved. Most reviews were rated as critically low quality, and certainty of evidence was generally low or very low. Focused deprescribing appears feasible and generally safe for reducing selected potentially inappropriate medications in older adults; however, its clinical benefits are drug class-dependent and remain uncertain.},
author = {García Álvarez, Ángel and Riera Serra, Pau and Ricci-Cabello, Ignacio and Morales Hernández, David and Santa Cruz, Roberto and Malih, Narges and Gonçalves-Bradley, Daniela C. and Gallardo-Alfaro, Laura and Serrano Ripoll, Maria Jesús and Calafat Villalonga, Catalina and Ferrer Jaillard, Bárbara Ana and Pinteño-Blanco, Manuel and Medina Bombardó, David and Doronzo, Maria Angela and Jaume Gayá, Sebastián and Fiol deRoque, Maria Antònia},
journal = {Age and Ageing},
keywords = {grapp-caib},
month = {aug},
number = 8,
pages = {afag243},
title = {Effectiveness and safety of focused deprescribing interventions targeting specific drug classes in older adults across clinical settings: an umbrella systematic literature review},
volume = 55,
year = 2026
}%0 Journal Article
%1 garcia_alvarez_effectiveness_2026
%A García Álvarez, Ángel
%A Riera Serra, Pau
%A Ricci-Cabello, Ignacio
%A Morales Hernández, David
%A Santa Cruz, Roberto
%A Malih, Narges
%A Gonçalves-Bradley, Daniela C.
%A Gallardo-Alfaro, Laura
%A Serrano Ripoll, Maria Jesús
%A Calafat Villalonga, Catalina
%A Ferrer Jaillard, Bárbara Ana
%A Pinteño-Blanco, Manuel
%A Medina Bombardó, David
%A Doronzo, Maria Angela
%A Jaume Gayá, Sebastián
%A Fiol deRoque, Maria Antònia
%D 2026
%J Age and Ageing
%N 8
%P afag243
%R 10.1093/ageing/afag243
%T Effectiveness and safety of focused deprescribing interventions targeting specific drug classes in older adults across clinical settings: an umbrella systematic literature review
%V 55
%X Polypharmacy is highly prevalent among older adults and is associated with adverse outcomes. While comprehensive medication review is widely promoted to address potentially inappropriate prescribing, it is resource intensive. Focused deprescribing-defined as the targeted withdrawal or dose reduction of specific drug classes-has emerged as a potentially more scalable strategy. This umbrella review synthesised evidence on the effectiveness and safety of drug class-specific focused deprescribing interventions in older adults. We conducted an umbrella review of systematic reviews evaluating focused deprescribing interventions targeting specific pharmacological classes. MEDLINE, Embase, the Cochrane Library and Web of Science were searched from inception to March 2025. Study selection, data extraction and methodological quality assessment (AMSTAR-2) were performed independently by two reviewers. Findings were synthesised narratively by drug class and outcome domain, and overlap was assessed using the Corrected Covered Area. Twenty-seven systematic reviews were included. Most focused on psychotropics, particularly benzodiazepines, and anticholinergics, with fewer assessing antidiabetics or fall-risk increasing drugs. Reductions in medication use were most consistent for benzodiazepines and other psychotropics, especially when interventions included psychotherapy or multifaceted components. Evidence for antidiabetics suggested feasibility and safety, whereas effects on anticholinergics and fall-risk increasing drugs were limited. Clinical outcomes, including mortality, falls and cognition, were inconsistently reported and rarely improved. Most reviews were rated as critically low quality, and certainty of evidence was generally low or very low. Focused deprescribing appears feasible and generally safe for reducing selected potentially inappropriate medications in older adults; however, its clinical benefits are drug class-dependent and remain uncertain.-
AbstractURLBibTeXEndNoteDOIBibSonomy1.García Álvarez Ángel, Riera Serra P, Ricci-Cabello I, Morales Hernández D, Santa Cruz R, Malih N, Gonçalves-Bradley DC, Gallardo-Alfaro L, Serrano Ripoll MJ, Calafat Villalonga C, Ferrer Jaillard BA, Pinteño-Blanco M, Medina Bombardó D, Doronzo MA, Jaume Gayá S, Fiol deRoque MA. Effectiveness and safety of focused deprescribing interventions targeting specific drug classes in older adults across clinical settings: an umbrella systematic literature review. Age and ageing [Internet]. England; 2026 Aug.;55(8):afag243-. https://pubmed.ncbi.nlm.nih.gov/42607278Polypharmacy is highly prevalent among older adults and is associated with adverse outcomes. While comprehensive medication review is widely promoted to address potentially inappropriate prescribing, it is resource intensive. Focused deprescribing-defined as the targeted withdrawal or dose reduction of specific drug classes-has emerged as a potentially more scalable strategy. This umbrella review synthesised evidence on the effectiveness and safety of drug class-specific focused deprescribing interventions in older adults. We conducted an umbrella review of systematic reviews evaluating focused deprescribing interventions targeting specific pharmacological classes. MEDLINE, Embase, the Cochrane Library and Web of Science were searched from inception to March 2025. Study selection, data extraction and methodological quality assessment (AMSTAR-2) were performed independently by two reviewers. Findings were synthesised narratively by drug class and outcome domain, and overlap was assessed using the Corrected Covered Area. Twenty-seven systematic reviews were included. Most focused on psychotropics, particularly benzodiazepines, and anticholinergics, with fewer assessing antidiabetics or fall-risk increasing drugs. Reductions in medication use were most consistent for benzodiazepines and other psychotropics, especially when interventions included psychotherapy or multifaceted components. Evidence for antidiabetics suggested feasibility and safety, whereas effects on anticholinergics and fall-risk increasing drugs were limited. Clinical outcomes, including mortality, falls and cognition, were inconsistently reported and rarely improved. Most reviews were rated as critically low quality, and certainty of evidence was generally low or very low. Focused deprescribing appears feasible and generally safe for reducing selected potentially inappropriate medications in older adults; however, its clinical benefits are drug class-dependent and remain uncertain.
@article{garciaalvarez2026effectiveness,
abstract = {Polypharmacy is highly prevalent among older adults and is associated with adverse outcomes. While comprehensive medication review is widely promoted to address potentially inappropriate prescribing, it is resource intensive. Focused deprescribing-defined as the targeted withdrawal or dose reduction of specific drug classes-has emerged as a potentially more scalable strategy. This umbrella review synthesised evidence on the effectiveness and safety of drug class-specific focused deprescribing interventions in older adults. We conducted an umbrella review of systematic reviews evaluating focused deprescribing interventions targeting specific pharmacological classes. MEDLINE, Embase, the Cochrane Library and Web of Science were searched from inception to March 2025. Study selection, data extraction and methodological quality assessment (AMSTAR-2) were performed independently by two reviewers. Findings were synthesised narratively by drug class and outcome domain, and overlap was assessed using the Corrected Covered Area. Twenty-seven systematic reviews were included. Most focused on psychotropics, particularly benzodiazepines, and anticholinergics, with fewer assessing antidiabetics or fall-risk increasing drugs. Reductions in medication use were most consistent for benzodiazepines and other psychotropics, especially when interventions included psychotherapy or multifaceted components. Evidence for antidiabetics suggested feasibility and safety, whereas effects on anticholinergics and fall-risk increasing drugs were limited. Clinical outcomes, including mortality, falls and cognition, were inconsistently reported and rarely improved. Most reviews were rated as critically low quality, and certainty of evidence was generally low or very low. Focused deprescribing appears feasible and generally safe for reducing selected potentially inappropriate medications in older adults; however, its clinical benefits are drug class-dependent and remain uncertain.},
address = {England},
author = {García Álvarez, Ángel and Riera Serra, Pau and Ricci-Cabello, Ignacio and Morales Hernández, David and Santa Cruz, Roberto and Malih, Narges and Gonçalves-Bradley, Daniela C and Gallardo-Alfaro, Laura and Serrano Ripoll, Maria Jesús and Calafat Villalonga, Catalina and Ferrer Jaillard, Bárbara Ana and Pinteño-Blanco, Manuel and Medina Bombardó, David and Doronzo, Maria Angela and Jaume Gayá, Sebastián and Fiol deRoque, Maria Antònia},
journal = {Age and ageing},
keywords = {evisap},
month = {aug},
number = 8,
pages = {afag243--},
title = {Effectiveness and safety of focused deprescribing interventions targeting specific drug classes in older adults across clinical settings: an umbrella systematic literature review},
volume = 55,
year = 2026
}%0 Journal Article
%1 garciaalvarez2026effectiveness
%A García Álvarez, Ángel
%A Riera Serra, Pau
%A Ricci-Cabello, Ignacio
%A Morales Hernández, David
%A Santa Cruz, Roberto
%A Malih, Narges
%A Gonçalves-Bradley, Daniela C
%A Gallardo-Alfaro, Laura
%A Serrano Ripoll, Maria Jesús
%A Calafat Villalonga, Catalina
%A Ferrer Jaillard, Bárbara Ana
%A Pinteño-Blanco, Manuel
%A Medina Bombardó, David
%A Doronzo, Maria Angela
%A Jaume Gayá, Sebastián
%A Fiol deRoque, Maria Antònia
%C England
%D 2026
%J Age and ageing
%N 8
%P afag243--
%R 10.1093/ageing/afag243
%T Effectiveness and safety of focused deprescribing interventions targeting specific drug classes in older adults across clinical settings: an umbrella systematic literature review
%U https://pubmed.ncbi.nlm.nih.gov/42607278
%V 55
%X Polypharmacy is highly prevalent among older adults and is associated with adverse outcomes. While comprehensive medication review is widely promoted to address potentially inappropriate prescribing, it is resource intensive. Focused deprescribing-defined as the targeted withdrawal or dose reduction of specific drug classes-has emerged as a potentially more scalable strategy. This umbrella review synthesised evidence on the effectiveness and safety of drug class-specific focused deprescribing interventions in older adults. We conducted an umbrella review of systematic reviews evaluating focused deprescribing interventions targeting specific pharmacological classes. MEDLINE, Embase, the Cochrane Library and Web of Science were searched from inception to March 2025. Study selection, data extraction and methodological quality assessment (AMSTAR-2) were performed independently by two reviewers. Findings were synthesised narratively by drug class and outcome domain, and overlap was assessed using the Corrected Covered Area. Twenty-seven systematic reviews were included. Most focused on psychotropics, particularly benzodiazepines, and anticholinergics, with fewer assessing antidiabetics or fall-risk increasing drugs. Reductions in medication use were most consistent for benzodiazepines and other psychotropics, especially when interventions included psychotherapy or multifaceted components. Evidence for antidiabetics suggested feasibility and safety, whereas effects on anticholinergics and fall-risk increasing drugs were limited. Clinical outcomes, including mortality, falls and cognition, were inconsistently reported and rarely improved. Most reviews were rated as critically low quality, and certainty of evidence was generally low or very low. Focused deprescribing appears feasible and generally safe for reducing selected potentially inappropriate medications in older adults; however, its clinical benefits are drug class-dependent and remain uncertain. - AbstractBibTeXEndNoteDOIBibSonomyDownload1.Agustí Àlvar, Carrizosa-Guerri X, Casanova C, Cosio B, Crispi F, Fernández-Villar A, Garcia-Aymerich J, González-de Paz L, Gonzalez JR, Iglesias A, Izquierdo JL, Marin-Oto M, Marin JM, Novoa R, Ocaña A, Pascual S, Peralta G, Perea L, Sanz-Rubio D, Sarrat-Gonzalez D, Torrent M, Vazquez M, Velasco V, Vila M, Faner R, Group PS. The P4COPD Study: Rationale, Goals and Study Design - Prediction, Prevention, Personalized and Precision Management of COPD in Young Adults. Open Respiratory Archives. 2026;8(3):100645.INTRODUCTION: Chronic obstructive pulmonary disease (COPD) is a major public health problem. Research over the past few years has shown that COPD is the result of dynamic and cumulative gene-environment interactions starting early in life. This opens new opportunities for the Prediction, Prevention, Personalized and Precise management (P4) of COPD in young adults. The P4COPD study sought to: (1) investigate the genomic and environmental/lifestyle determinants of COPD in young adults (18-50 years); (2) contrast them with those determined in children, adolescent and older individuals; and (3) explore the feasibility and cost of implementing a P4 strategy for COPD in young adults in clinical practice. MATERIALS AND METHODS: The P4COPD study leverages from already existing cohorts (EarlyCOPD, INMA, LEVANTE, Aduheart) of young subjects (18-50 years) and de novo recruitment from primary care centers, in whom we: (1) analyzed demographic, epidemiological, clinical and physiologic information; (2) measured genetic, epigenetic and proteomic markers; (3) used analytical methods to identify endotypes, biomarkers and potential therapeutic targets associated with the presence of COPD, pre-COPD and/or low peak lung function. Results in young individuals: (4) were contrasted with healthy controls from the general population (IMPACT cohort) and COPD cohorts in older patients (BIOMEPOC, CHAIN and ECLIPSE). Besides, we (5) explored how to implement results in clinical practice; and (6) estimated its potential health cost implications. RESULTS: First results are expected in the third and fourth quarters of 2026. CONCLUSIONS: Identifying young individuals at risk of COPD, in whom to establish a P4 strategy is highly relevant to promote healthy aging.
@article{agusti_p4copd_2026,
abstract = {INTRODUCTION: Chronic obstructive pulmonary disease (COPD) is a major public health problem. Research over the past few years has shown that COPD is the result of dynamic and cumulative gene-environment interactions starting early in life. This opens new opportunities for the Prediction, Prevention, Personalized and Precise management (P4) of COPD in young adults. The P4COPD study sought to: (1) investigate the genomic and environmental/lifestyle determinants of COPD in young adults (18-50 years); (2) contrast them with those determined in children, adolescent and older individuals; and (3) explore the feasibility and cost of implementing a P4 strategy for COPD in young adults in clinical practice. MATERIALS AND METHODS: The P4COPD study leverages from already existing cohorts (EarlyCOPD, INMA, LEVANTE, Aduheart) of young subjects (18-50 years) and de novo recruitment from primary care centers, in whom we: (1) analyzed demographic, epidemiological, clinical and physiologic information; (2) measured genetic, epigenetic and proteomic markers; (3) used analytical methods to identify endotypes, biomarkers and potential therapeutic targets associated with the presence of COPD, pre-COPD and/or low peak lung function. Results in young individuals: (4) were contrasted with healthy controls from the general population (IMPACT cohort) and COPD cohorts in older patients (BIOMEPOC, CHAIN and ECLIPSE). Besides, we (5) explored how to implement results in clinical practice; and (6) estimated its potential health cost implications. RESULTS: First results are expected in the third and fourth quarters of 2026. CONCLUSIONS: Identifying young individuals at risk of COPD, in whom to establish a P4 strategy is highly relevant to promote healthy aging.},
author = {Agustí, Àlvar and Carrizosa-Guerri, Xènia and Casanova, Ciro and Cosio, Borja and Crispi, Fatima and Fernández-Villar, Alberto and Garcia-Aymerich, Judith and González-de Paz, Luis and Gonzalez, Juan R. and Iglesias, Amanda and Izquierdo, Jose Luis and Marin-Oto, Marta and Marin, Jose Maria and Novoa, Rommy and Ocaña, Andrea and Pascual, Sergi and Peralta, Gabriela and Perea, Lídia and Sanz-Rubio, David and Sarrat-Gonzalez, David and Torrent, Maties and Vazquez, Miguel and Velasco, Valle and Vila, Marc and Faner, Rosa and P4COPD Study Group},
journal = {Open Respiratory Archives},
keywords = {grapp-caib},
number = 3,
pages = 100645,
title = {The P4COPD Study: Rationale, Goals and Study Design - Prediction, Prevention, Personalized and Precision Management of COPD in Young Adults},
volume = 8,
year = 2026
}%0 Journal Article
%1 agusti_p4copd_2026
%A Agustí, Àlvar
%A Carrizosa-Guerri, Xènia
%A Casanova, Ciro
%A Cosio, Borja
%A Crispi, Fatima
%A Fernández-Villar, Alberto
%A Garcia-Aymerich, Judith
%A González-de Paz, Luis
%A Gonzalez, Juan R.
%A Iglesias, Amanda
%A Izquierdo, Jose Luis
%A Marin-Oto, Marta
%A Marin, Jose Maria
%A Novoa, Rommy
%A Ocaña, Andrea
%A Pascual, Sergi
%A Peralta, Gabriela
%A Perea, Lídia
%A Sanz-Rubio, David
%A Sarrat-Gonzalez, David
%A Torrent, Maties
%A Vazquez, Miguel
%A Velasco, Valle
%A Vila, Marc
%A Faner, Rosa
%A Group, P4COPD Study
%D 2026
%J Open Respiratory Archives
%N 3
%P 100645
%R 10.1016/j.opresp.2026.100645
%T The P4COPD Study: Rationale, Goals and Study Design - Prediction, Prevention, Personalized and Precision Management of COPD in Young Adults
%V 8
%X INTRODUCTION: Chronic obstructive pulmonary disease (COPD) is a major public health problem. Research over the past few years has shown that COPD is the result of dynamic and cumulative gene-environment interactions starting early in life. This opens new opportunities for the Prediction, Prevention, Personalized and Precise management (P4) of COPD in young adults. The P4COPD study sought to: (1) investigate the genomic and environmental/lifestyle determinants of COPD in young adults (18-50 years); (2) contrast them with those determined in children, adolescent and older individuals; and (3) explore the feasibility and cost of implementing a P4 strategy for COPD in young adults in clinical practice. MATERIALS AND METHODS: The P4COPD study leverages from already existing cohorts (EarlyCOPD, INMA, LEVANTE, Aduheart) of young subjects (18-50 years) and de novo recruitment from primary care centers, in whom we: (1) analyzed demographic, epidemiological, clinical and physiologic information; (2) measured genetic, epigenetic and proteomic markers; (3) used analytical methods to identify endotypes, biomarkers and potential therapeutic targets associated with the presence of COPD, pre-COPD and/or low peak lung function. Results in young individuals: (4) were contrasted with healthy controls from the general population (IMPACT cohort) and COPD cohorts in older patients (BIOMEPOC, CHAIN and ECLIPSE). Besides, we (5) explored how to implement results in clinical practice; and (6) estimated its potential health cost implications. RESULTS: First results are expected in the third and fourth quarters of 2026. CONCLUSIONS: Identifying young individuals at risk of COPD, in whom to establish a P4 strategy is highly relevant to promote healthy aging. -
AbstractBibTeXEndNoteDOIBibSonomy1.Sarmiento-Cruz M, Ramírez-Manent JI. [When treatment has anti-doping implications: therapeutic use exemptions in primary care]. Semergen. 2026 Jul.;52(8):102818.Therapeutic use exemptions (TUEs) allow athletes to use prohibited substances or methods when there is a justified medical indication and the criteria established by anti-doping regulations are fulfilled. Although TUEs are commonly associated with professional sport, family physicians may care for federated athletes or individuals subject to anti-doping testing at different levels of competition. In primary care, commonly prescribed treatments such as systemic glucocorticoids, β2-agonists, beta-blockers or diuretics may have regulatory implications if the substance used, dosage, route of administration, timing in relation to competition and clinical context are not adequately considered. In addition, substances of abuse, cannabinoids, and some cold remedies and decongestants may lead to unexpected adverse analytical findings. This article provides practical recommendations aimed at identifying patients at risk, using official consultation tools, adequately justifying medical indications and safely managing common situations related to TUEs in daily clinical practice. .
@article{sarmiento-cruz_when_2026,
abstract = {Therapeutic use exemptions (TUEs) allow athletes to use prohibited substances or methods when there is a justified medical indication and the criteria established by anti-doping regulations are fulfilled. Although TUEs are commonly associated with professional sport, family physicians may care for federated athletes or individuals subject to anti-doping testing at different levels of competition. In primary care, commonly prescribed treatments such as systemic glucocorticoids, β2-agonists, beta-blockers or diuretics may have regulatory implications if the substance used, dosage, route of administration, timing in relation to competition and clinical context are not adequately considered. In addition, substances of abuse, cannabinoids, and some cold remedies and decongestants may lead to unexpected adverse analytical findings. This article provides practical recommendations aimed at identifying patients at risk, using official consultation tools, adequately justifying medical indications and safely managing common situations related to TUEs in daily clinical practice. .},
author = {Sarmiento-Cruz, M. and Ramírez-Manent, J. I.},
journal = {Semergen},
keywords = {grapp-caib},
month = {jul},
number = 8,
pages = 102818,
title = {[When treatment has anti-doping implications: therapeutic use exemptions in primary care]},
volume = 52,
year = 2026
}%0 Journal Article
%1 sarmiento-cruz_when_2026
%A Sarmiento-Cruz, M.
%A Ramírez-Manent, J. I.
%D 2026
%J Semergen
%N 8
%P 102818
%R 10.1016/j.semerg.2026.102818
%T [When treatment has anti-doping implications: therapeutic use exemptions in primary care]
%V 52
%X Therapeutic use exemptions (TUEs) allow athletes to use prohibited substances or methods when there is a justified medical indication and the criteria established by anti-doping regulations are fulfilled. Although TUEs are commonly associated with professional sport, family physicians may care for federated athletes or individuals subject to anti-doping testing at different levels of competition. In primary care, commonly prescribed treatments such as systemic glucocorticoids, β2-agonists, beta-blockers or diuretics may have regulatory implications if the substance used, dosage, route of administration, timing in relation to competition and clinical context are not adequately considered. In addition, substances of abuse, cannabinoids, and some cold remedies and decongestants may lead to unexpected adverse analytical findings. This article provides practical recommendations aimed at identifying patients at risk, using official consultation tools, adequately justifying medical indications and safely managing common situations related to TUEs in daily clinical practice. . - AbstractBibTeXEndNoteDOIBibSonomyDownload1.Ramírez Gallegos A, Tárraga López PJ, Piña Dabreu MS, Rodas Cañellas L, López-González Ángel A, Ramírez-Manent JI. Normal-Weight Obesity and Hidden Cardiometabolic Risk in Young Adults: Implications Beyond BMI-Based Classification. Medical Sciences. Basel, Switzerland; 2026 Jun.;14(3):354.BACKGROUND: BMI is widely used for obesity classification, yet it does not adequately reflect adiposity distribution and related metabolic risk. Normal-weight obesity (NWO), defined as excess adiposity despite normal BMI, has emerged as a clinically relevant phenotype associated with increased cardiometabolic risk. However, its prevalence and implications in young populations remain insufficiently characterized. OBJECTIVE: To evaluate the prevalence of normal-weight obesity and its association with cardiometabolic risk markers in a cohort of young adults undergoing occupational health assessments. METHODS: A cross-sectional study was conducted in 12,874 adults aged 22-30 years undergoing routine occupational health assessments. NWO was defined using a strict criterion (normal BMI with a waist-to-height ratio ≥ 0.5) and an expanded definition including additional adiposity markers derived from body fat percentage and visceral fat estimates. Anthropometric, adiposity-related, biochemical, and lifestyle data were collected using standardized protocols. Multivariable logistic regression models adjusted for age and sex were used to assess associations between NWO and cardiometabolic risk markers. RESULTS: Among individuals with normal BMI (n = 9290), the prevalence of NWO was 1.79% (n = 166) using the strict definition and 2.30% (n = 214) with the expanded definition. Compared with metabolically healthy normal-weight individuals, those with NWO exhibited higher triglycerides, fasting glucose, and atherogenic lipid indices, along with lower HDL cholesterol (all p \textless 0.05). In multivariable analyses, NWO was independently associated with elevated triglycerides (OR 4.99; 95\% CI 2.90-8.58), an unfavorable triglyceride-to-HDL ratio (OR 7.44; 95\% CI 5.19-10.65), and impaired fasting glucose (OR 3.87; 95\% CI 2.19-6.82). Associations were consistent across sensitivity and sex-stratified analyses. CONCLUSIONS: Normal-weight obesity is present in a measurable proportion of young adults and is associated with an unfavorable cardiometabolic profile despite normal BMI. The triglyceride-to-HDL ratio was consistently associated with normal-weight obesity and showed marked differences across adiposity-defined phenotypes. These findings highlight the limitations of BMI-based classification alone and suggest that additional anthropometric and metabolic markers may help identify individuals with less favorable cardiometabolic characteristics.
@article{ramirez_gallegos_normal-weight_2026,
abstract = {BACKGROUND: BMI is widely used for obesity classification, yet it does not adequately reflect adiposity distribution and related metabolic risk. Normal-weight obesity (NWO), defined as excess adiposity despite normal BMI, has emerged as a clinically relevant phenotype associated with increased cardiometabolic risk. However, its prevalence and implications in young populations remain insufficiently characterized. OBJECTIVE: To evaluate the prevalence of normal-weight obesity and its association with cardiometabolic risk markers in a cohort of young adults undergoing occupational health assessments. METHODS: A cross-sectional study was conducted in 12,874 adults aged 22-30 years undergoing routine occupational health assessments. NWO was defined using a strict criterion (normal BMI with a waist-to-height ratio ≥ 0.5) and an expanded definition including additional adiposity markers derived from body fat percentage and visceral fat estimates. Anthropometric, adiposity-related, biochemical, and lifestyle data were collected using standardized protocols. Multivariable logistic regression models adjusted for age and sex were used to assess associations between NWO and cardiometabolic risk markers. RESULTS: Among individuals with normal BMI (n = 9290), the prevalence of NWO was 1.79% (n = 166) using the strict definition and 2.30% (n = 214) with the expanded definition. Compared with metabolically healthy normal-weight individuals, those with NWO exhibited higher triglycerides, fasting glucose, and atherogenic lipid indices, along with lower HDL cholesterol (all p \textless 0.05). In multivariable analyses, NWO was independently associated with elevated triglycerides (OR 4.99; 95\% CI 2.90-8.58), an unfavorable triglyceride-to-HDL ratio (OR 7.44; 95\% CI 5.19-10.65), and impaired fasting glucose (OR 3.87; 95\% CI 2.19-6.82). Associations were consistent across sensitivity and sex-stratified analyses. CONCLUSIONS: Normal-weight obesity is present in a measurable proportion of young adults and is associated with an unfavorable cardiometabolic profile despite normal BMI. The triglyceride-to-HDL ratio was consistently associated with normal-weight obesity and showed marked differences across adiposity-defined phenotypes. These findings highlight the limitations of BMI-based classification alone and suggest that additional anthropometric and metabolic markers may help identify individuals with less favorable cardiometabolic characteristics.},
address = {Basel, Switzerland},
author = {Ramírez Gallegos, Alberto and Tárraga López, Pedro Juan and Piña Dabreu, Mónica Silu and Rodas Cañellas, Lluis and López-González, Ángel Arturo and Ramírez-Manent, José Ignacio},
journal = {Medical Sciences},
keywords = {grapp-caib},
month = {jun},
number = 3,
pages = 354,
title = {Normal-Weight Obesity and Hidden Cardiometabolic Risk in Young Adults: Implications Beyond BMI-Based Classification},
volume = 14,
year = 2026
}%0 Journal Article
%1 ramirez_gallegos_normal-weight_2026
%A Ramírez Gallegos, Alberto
%A Tárraga López, Pedro Juan
%A Piña Dabreu, Mónica Silu
%A Rodas Cañellas, Lluis
%A López-González, Ángel Arturo
%A Ramírez-Manent, José Ignacio
%C Basel, Switzerland
%D 2026
%J Medical Sciences
%N 3
%P 354
%R 10.3390/medsci14030354
%T Normal-Weight Obesity and Hidden Cardiometabolic Risk in Young Adults: Implications Beyond BMI-Based Classification
%V 14
%X BACKGROUND: BMI is widely used for obesity classification, yet it does not adequately reflect adiposity distribution and related metabolic risk. Normal-weight obesity (NWO), defined as excess adiposity despite normal BMI, has emerged as a clinically relevant phenotype associated with increased cardiometabolic risk. However, its prevalence and implications in young populations remain insufficiently characterized. OBJECTIVE: To evaluate the prevalence of normal-weight obesity and its association with cardiometabolic risk markers in a cohort of young adults undergoing occupational health assessments. METHODS: A cross-sectional study was conducted in 12,874 adults aged 22-30 years undergoing routine occupational health assessments. NWO was defined using a strict criterion (normal BMI with a waist-to-height ratio ≥ 0.5) and an expanded definition including additional adiposity markers derived from body fat percentage and visceral fat estimates. Anthropometric, adiposity-related, biochemical, and lifestyle data were collected using standardized protocols. Multivariable logistic regression models adjusted for age and sex were used to assess associations between NWO and cardiometabolic risk markers. RESULTS: Among individuals with normal BMI (n = 9290), the prevalence of NWO was 1.79% (n = 166) using the strict definition and 2.30% (n = 214) with the expanded definition. Compared with metabolically healthy normal-weight individuals, those with NWO exhibited higher triglycerides, fasting glucose, and atherogenic lipid indices, along with lower HDL cholesterol (all p \textless 0.05). In multivariable analyses, NWO was independently associated with elevated triglycerides (OR 4.99; 95\% CI 2.90-8.58), an unfavorable triglyceride-to-HDL ratio (OR 7.44; 95\% CI 5.19-10.65), and impaired fasting glucose (OR 3.87; 95\% CI 2.19-6.82). Associations were consistent across sensitivity and sex-stratified analyses. CONCLUSIONS: Normal-weight obesity is present in a measurable proportion of young adults and is associated with an unfavorable cardiometabolic profile despite normal BMI. The triglyceride-to-HDL ratio was consistently associated with normal-weight obesity and showed marked differences across adiposity-defined phenotypes. These findings highlight the limitations of BMI-based classification alone and suggest that additional anthropometric and metabolic markers may help identify individuals with less favorable cardiometabolic characteristics. - AbstractBibTeXEndNoteDOIBibSonomyDownload1.Vicente-Herrero MT, López González Ángel A, Tárraga López PJ, Busquets-Cortés C, Rodas Cañellas L, Ramírez Manent JI. Obesity as a Potential Explanatory Factor in the Association Between Socioeconomic Position and Multidimensional Cardiometabolic Risk. Medical Sciences. Basel, Switzerland; 2026 Jul.;14(3):382.BACKGROUND: Cardiometabolic diseases are strongly socially patterned, with individuals of lower socioeconomic position experiencing a disproportionate burden of metabolic disorders. Obesity has been proposed as a potential explanatory factor that may partly account for the association between social disadvantage and adverse cardiometabolic profiles. This study aimed to evaluate whether obesity may partly explain the observed associations between socioeconomic position and multiple cardiometabolic outcomes. METHODS: A cross-sectional study was conducted in 3108 working-age adults undergoing occupational health examinations in the Balearic Islands, Spain. Socioeconomic position was assessed using educational attainment and occupational category. Cardiometabolic outcomes included obesity, FLI-defined probable steatotic liver disease (FLI ≥ 60), insulin resistance, atherogenic risk, and metabolic syndrome. Multivariable logistic regression models with sequential adjustment were performed. Additional models evaluated attenuation after inclusion of obesity. Mediation analyses were conducted using bootstrapping methods. RESULTS: A clear socioeconomic gradient was observed across all cardiometabolic outcomes, with higher prevalence among individuals with lower educational attainment (p for trend \textless 0.001). In fully adjusted models, lower educational level remained significantly associated with obesity (OR 1.61; 95\% CI 1.18-2.21), whereas associations with the remaining cardiometabolic outcomes were substantially attenuated after adjustment. Inclusion of obesity reduced effect estimates for FLI-defined probable steatotic liver disease (FLI ≥ 60), insulin resistance, atherogenic risk, and metabolic syndrome by approximately 53-72%. Exploratory mediation analyses suggested that obesity was associated with approximately 28% attenuation of the association with estimated steatotic liver disease risk and 8% attenuation of the association with insulin resistance. CONCLUSIONS: Socioeconomic inequalities in cardiometabolic risk were evident across multiple metabolic domains. Obesity was associated with substantial attenuation of several downstream cardiometabolic associations and may represent an important explanatory factor associated with the observed socioeconomic differences in metabolic health, particularly for estimated steatotic liver disease risk. However, the magnitude of these associations varied across outcomes, and the cross-sectional design precludes causal interpretation. These findings support the importance of addressing obesity within its broader social context as a potential strategy to reduce metabolic health inequalities among employed working-age adults.
@article{vicente-herrero_obesity_2026,
abstract = {BACKGROUND: Cardiometabolic diseases are strongly socially patterned, with individuals of lower socioeconomic position experiencing a disproportionate burden of metabolic disorders. Obesity has been proposed as a potential explanatory factor that may partly account for the association between social disadvantage and adverse cardiometabolic profiles. This study aimed to evaluate whether obesity may partly explain the observed associations between socioeconomic position and multiple cardiometabolic outcomes. METHODS: A cross-sectional study was conducted in 3108 working-age adults undergoing occupational health examinations in the Balearic Islands, Spain. Socioeconomic position was assessed using educational attainment and occupational category. Cardiometabolic outcomes included obesity, FLI-defined probable steatotic liver disease (FLI ≥ 60), insulin resistance, atherogenic risk, and metabolic syndrome. Multivariable logistic regression models with sequential adjustment were performed. Additional models evaluated attenuation after inclusion of obesity. Mediation analyses were conducted using bootstrapping methods. RESULTS: A clear socioeconomic gradient was observed across all cardiometabolic outcomes, with higher prevalence among individuals with lower educational attainment (p for trend \textless 0.001). In fully adjusted models, lower educational level remained significantly associated with obesity (OR 1.61; 95\% CI 1.18-2.21), whereas associations with the remaining cardiometabolic outcomes were substantially attenuated after adjustment. Inclusion of obesity reduced effect estimates for FLI-defined probable steatotic liver disease (FLI ≥ 60), insulin resistance, atherogenic risk, and metabolic syndrome by approximately 53-72%. Exploratory mediation analyses suggested that obesity was associated with approximately 28% attenuation of the association with estimated steatotic liver disease risk and 8% attenuation of the association with insulin resistance. CONCLUSIONS: Socioeconomic inequalities in cardiometabolic risk were evident across multiple metabolic domains. Obesity was associated with substantial attenuation of several downstream cardiometabolic associations and may represent an important explanatory factor associated with the observed socioeconomic differences in metabolic health, particularly for estimated steatotic liver disease risk. However, the magnitude of these associations varied across outcomes, and the cross-sectional design precludes causal interpretation. These findings support the importance of addressing obesity within its broader social context as a potential strategy to reduce metabolic health inequalities among employed working-age adults.},
address = {Basel, Switzerland},
author = {Vicente-Herrero, María Teófila and López González, Ángel Arturo and Tárraga López, Pedro J. and Busquets-Cortés, Carla and Rodas Cañellas, Lluis and Ramírez Manent, José Ignacio},
journal = {Medical Sciences},
keywords = {grapp-caib},
month = {jul},
number = 3,
pages = 382,
title = {Obesity as a Potential Explanatory Factor in the Association Between Socioeconomic Position and Multidimensional Cardiometabolic Risk},
volume = 14,
year = 2026
}%0 Journal Article
%1 vicente-herrero_obesity_2026
%A Vicente-Herrero, María Teófila
%A López González, Ángel Arturo
%A Tárraga López, Pedro J.
%A Busquets-Cortés, Carla
%A Rodas Cañellas, Lluis
%A Ramírez Manent, José Ignacio
%C Basel, Switzerland
%D 2026
%J Medical Sciences
%N 3
%P 382
%R 10.3390/medsci14030382
%T Obesity as a Potential Explanatory Factor in the Association Between Socioeconomic Position and Multidimensional Cardiometabolic Risk
%V 14
%X BACKGROUND: Cardiometabolic diseases are strongly socially patterned, with individuals of lower socioeconomic position experiencing a disproportionate burden of metabolic disorders. Obesity has been proposed as a potential explanatory factor that may partly account for the association between social disadvantage and adverse cardiometabolic profiles. This study aimed to evaluate whether obesity may partly explain the observed associations between socioeconomic position and multiple cardiometabolic outcomes. METHODS: A cross-sectional study was conducted in 3108 working-age adults undergoing occupational health examinations in the Balearic Islands, Spain. Socioeconomic position was assessed using educational attainment and occupational category. Cardiometabolic outcomes included obesity, FLI-defined probable steatotic liver disease (FLI ≥ 60), insulin resistance, atherogenic risk, and metabolic syndrome. Multivariable logistic regression models with sequential adjustment were performed. Additional models evaluated attenuation after inclusion of obesity. Mediation analyses were conducted using bootstrapping methods. RESULTS: A clear socioeconomic gradient was observed across all cardiometabolic outcomes, with higher prevalence among individuals with lower educational attainment (p for trend \textless 0.001). In fully adjusted models, lower educational level remained significantly associated with obesity (OR 1.61; 95\% CI 1.18-2.21), whereas associations with the remaining cardiometabolic outcomes were substantially attenuated after adjustment. Inclusion of obesity reduced effect estimates for FLI-defined probable steatotic liver disease (FLI ≥ 60), insulin resistance, atherogenic risk, and metabolic syndrome by approximately 53-72%. Exploratory mediation analyses suggested that obesity was associated with approximately 28% attenuation of the association with estimated steatotic liver disease risk and 8% attenuation of the association with insulin resistance. CONCLUSIONS: Socioeconomic inequalities in cardiometabolic risk were evident across multiple metabolic domains. Obesity was associated with substantial attenuation of several downstream cardiometabolic associations and may represent an important explanatory factor associated with the observed socioeconomic differences in metabolic health, particularly for estimated steatotic liver disease risk. However, the magnitude of these associations varied across outcomes, and the cross-sectional design precludes causal interpretation. These findings support the importance of addressing obesity within its broader social context as a potential strategy to reduce metabolic health inequalities among employed working-age adults. -
AbstractBibTeXEndNoteDOIBibSonomy1.Jansana MDM, López PJT, Miquel JJG, López-González Ángel A, Sbert PR, Busquets-Cortés C, Ramírez-Manent JI. Determinants of obesity: The role of sociodemographic factors, health behaviors, and quality of life in Spanish workers. Obesity Research & Clinical Practice. 2026 May;:S1871-403X(26)00039.BACKGROUND: Obesity remains a major global health challenge with profound clinical, psychosocial, and economic consequences. Although body mass index (BMI) is widely used, alternative adiposity indices such as waist-to-height ratio (WtHR), Clínica Universidad de Navarra-Body Adiposity Estimator (CUN-BAE), and the Metabolic Score for Visceral Fat (METS-VF) may offer superior insights into central adiposity and cardiometabolic risk. Furthermore, the relationship between obesity and health-related quality of life (HRQoL) remains insufficiently explored in occupational settings, where lifestyle, socioeconomic, and psychosocial factors converge. METHODS: We conducted a cross-sectional study of 100,014 Spanish workers (18-69 years) who underwent standardized occupational health assessments between 2021 and 2023. Anthropometric and biochemical data were collected to calculate BMI, WtHR, CUN-BAE, and METS-VF. Sociodemographic characteristics, lifestyle habits (smoking, physical activity, and Mediterranean diet adherence), and HRQoL (12-Item Short Form Health Survey, SF-12) were also recorded. Logistic regression models were used to evaluate associations between obesity indices and sociodemographic, behavioral, and HRQoL variables, adjusting for potential confounders. RESULTS: Obesity prevalence varied markedly depending on the index employed, ranging from 17.2% with BMI to over 30% with CUN-BAE and METS-VF. Across all measures, older age, male sex, lower social class, smoking, physical inactivity, and poor adherence to the Mediterranean diet were significantly associated with higher odds of obesity. Importantly, workers with lower SF-12 physical and mental component scores consistently showed greater obesity risk, even after adjustment. These findings confirm the bidirectional interplay between excess adiposity and diminished quality of life. CONCLUSIONS: In this large occupational cohort, obesity was strongly associated with adverse sociodemographic profiles, unhealthy lifestyles, and impaired HRQoL. Our results highlight the limitations of BMI alone and underscore the value of alternative adiposity indices in public health surveillance. Integrating HRQoL assessment into obesity prevention and workplace health programs may enhance early detection, risk stratification, and the design of holistic interventions targeting both physical and psychosocial well-being.
@article{jansana_determinants_2026,
abstract = {BACKGROUND: Obesity remains a major global health challenge with profound clinical, psychosocial, and economic consequences. Although body mass index (BMI) is widely used, alternative adiposity indices such as waist-to-height ratio (WtHR), Clínica Universidad de Navarra-Body Adiposity Estimator (CUN-BAE), and the Metabolic Score for Visceral Fat (METS-VF) may offer superior insights into central adiposity and cardiometabolic risk. Furthermore, the relationship between obesity and health-related quality of life (HRQoL) remains insufficiently explored in occupational settings, where lifestyle, socioeconomic, and psychosocial factors converge. METHODS: We conducted a cross-sectional study of 100,014 Spanish workers (18-69 years) who underwent standardized occupational health assessments between 2021 and 2023. Anthropometric and biochemical data were collected to calculate BMI, WtHR, CUN-BAE, and METS-VF. Sociodemographic characteristics, lifestyle habits (smoking, physical activity, and Mediterranean diet adherence), and HRQoL (12-Item Short Form Health Survey, SF-12) were also recorded. Logistic regression models were used to evaluate associations between obesity indices and sociodemographic, behavioral, and HRQoL variables, adjusting for potential confounders. RESULTS: Obesity prevalence varied markedly depending on the index employed, ranging from 17.2% with BMI to over 30% with CUN-BAE and METS-VF. Across all measures, older age, male sex, lower social class, smoking, physical inactivity, and poor adherence to the Mediterranean diet were significantly associated with higher odds of obesity. Importantly, workers with lower SF-12 physical and mental component scores consistently showed greater obesity risk, even after adjustment. These findings confirm the bidirectional interplay between excess adiposity and diminished quality of life. CONCLUSIONS: In this large occupational cohort, obesity was strongly associated with adverse sociodemographic profiles, unhealthy lifestyles, and impaired HRQoL. Our results highlight the limitations of BMI alone and underscore the value of alternative adiposity indices in public health surveillance. Integrating HRQoL assessment into obesity prevention and workplace health programs may enhance early detection, risk stratification, and the design of holistic interventions targeting both physical and psychosocial well-being.},
author = {Jansana, María Dolores Marzoa and López, Pedro Juan Tárraga and Miquel, Juan José Guarro and López-González, Ángel Arturo and Sbert, Pere Riutord and Busquets-Cortés, Carla and Ramírez-Manent, José Ignacio},
journal = {Obesity Research & Clinical Practice},
keywords = {grapp-caib},
month = {may},
pages = {S1871--403X(26)00039--6},
title = {Determinants of obesity: The role of sociodemographic factors, health behaviors, and quality of life in Spanish workers},
year = 2026
}%0 Journal Article
%1 jansana_determinants_2026
%A Jansana, María Dolores Marzoa
%A López, Pedro Juan Tárraga
%A Miquel, Juan José Guarro
%A López-González, Ángel Arturo
%A Sbert, Pere Riutord
%A Busquets-Cortés, Carla
%A Ramírez-Manent, José Ignacio
%D 2026
%J Obesity Research & Clinical Practice
%P S1871--403X(26)00039--6
%R 10.1016/j.orcp.2026.04.005
%T Determinants of obesity: The role of sociodemographic factors, health behaviors, and quality of life in Spanish workers
%X BACKGROUND: Obesity remains a major global health challenge with profound clinical, psychosocial, and economic consequences. Although body mass index (BMI) is widely used, alternative adiposity indices such as waist-to-height ratio (WtHR), Clínica Universidad de Navarra-Body Adiposity Estimator (CUN-BAE), and the Metabolic Score for Visceral Fat (METS-VF) may offer superior insights into central adiposity and cardiometabolic risk. Furthermore, the relationship between obesity and health-related quality of life (HRQoL) remains insufficiently explored in occupational settings, where lifestyle, socioeconomic, and psychosocial factors converge. METHODS: We conducted a cross-sectional study of 100,014 Spanish workers (18-69 years) who underwent standardized occupational health assessments between 2021 and 2023. Anthropometric and biochemical data were collected to calculate BMI, WtHR, CUN-BAE, and METS-VF. Sociodemographic characteristics, lifestyle habits (smoking, physical activity, and Mediterranean diet adherence), and HRQoL (12-Item Short Form Health Survey, SF-12) were also recorded. Logistic regression models were used to evaluate associations between obesity indices and sociodemographic, behavioral, and HRQoL variables, adjusting for potential confounders. RESULTS: Obesity prevalence varied markedly depending on the index employed, ranging from 17.2% with BMI to over 30% with CUN-BAE and METS-VF. Across all measures, older age, male sex, lower social class, smoking, physical inactivity, and poor adherence to the Mediterranean diet were significantly associated with higher odds of obesity. Importantly, workers with lower SF-12 physical and mental component scores consistently showed greater obesity risk, even after adjustment. These findings confirm the bidirectional interplay between excess adiposity and diminished quality of life. CONCLUSIONS: In this large occupational cohort, obesity was strongly associated with adverse sociodemographic profiles, unhealthy lifestyles, and impaired HRQoL. Our results highlight the limitations of BMI alone and underscore the value of alternative adiposity indices in public health surveillance. Integrating HRQoL assessment into obesity prevention and workplace health programs may enhance early detection, risk stratification, and the design of holistic interventions targeting both physical and psychosocial well-being. - AbstractBibTeXEndNoteDOIBibSonomyDownload1.Sarmiento Cruz M, Tárraga López PJ, Piña Dabreu MS, Rodas Cañellas L, López-González Ángel A, Ramírez-Manent JI. Behavioral Procrastination and Heart Age Acceleration in a Large Occupational Cohort. Journal of Clinical Medicine. 2026 Jul.;15(13):5190.Background: Behavioral procrastination has been increasingly recognized as a maladaptive self-regulatory pattern associated with unhealthy lifestyle behaviors, psychological stress, and adverse cardiometabolic profiles. However, its relationship with accelerated cardiovascular aging remains poorly understood. This study aimed to evaluate the association between behavioral procrastination and heart age acceleration in a large occupational cohort of Spanish workers. Methods: A multicenter cross-sectional study was conducted including 92,184 actively employed Spanish workers undergoing routine occupational health examinations between 2021 and 2024. Behavioral procrastination was assessed using the Pure Procrastination Scale-9 (PPS-9). Estimated heart age and heart age acceleration were calculated using a cardiovascular risk-factor-based algorithm. Multivariable linear and logistic regression analyses were performed to evaluate associations between procrastination score, continuous heart age acceleration, and accelerated cardiovascular aging phenotypes after adjustment for demographic, lifestyle, anthropometric, and cardiometabolic variables. Restricted cubic spline analyses and sex-stratified analyses were additionally conducted. Results: Higher procrastination levels were associated with progressively worse cardiometabolic and cardiovascular aging profiles. Mean heart age acceleration increased from -3.1 ± 6.0 years in participants with very low procrastination to 14.0 ± 6.4 years in those with very high/chronic procrastination (p \textless 0.001). The prevalence of accelerated cardiovascular aging (\textgreater0 years) increased from 27.2% to 94.2% across increasing procrastination categories, whereas severe accelerated cardiovascular aging (≥10 years) increased from 1.7% to 75.6% (both p \textless 0.001). In fully adjusted multivariable analyses, each 5-point increase in PPS-9 score was associated with a 0.50-year increase in heart age acceleration (B = 0.50; 95\% CI 0.48-0.52; p \textless 0.001). Participants with very high/chronic procrastination exhibited significantly higher odds of accelerated cardiovascular aging (OR 1.89; 95\% CI 1.65-2.18) and severe accelerated cardiovascular aging (OR 2.51; 95\% CI 2.16-2.92). Associations were significantly stronger among women (p-interaction \textless 0.001). Findings remained robust in sensitivity analyses excluding participants with diabetes mellitus. Conclusions: Behavioral procrastination was associated with higher estimated heart age acceleration and less favorable cardiovascular aging profiles in this large occupational cohort. Higher procrastination severity was consistently related to greater estimated heart age acceleration and a higher prevalence of cardiovascular aging phenotypes, even after extensive multivariable adjustment. These findings indicate that higher procrastination levels were associated with less favorable cardiovascular aging profiles beyond traditional biomedical risk factors. However, given the cross-sectional design, no conclusions regarding causality or temporality can be drawn.
@article{sarmiento_cruz_behavioral_2026,
abstract = {Background: Behavioral procrastination has been increasingly recognized as a maladaptive self-regulatory pattern associated with unhealthy lifestyle behaviors, psychological stress, and adverse cardiometabolic profiles. However, its relationship with accelerated cardiovascular aging remains poorly understood. This study aimed to evaluate the association between behavioral procrastination and heart age acceleration in a large occupational cohort of Spanish workers. Methods: A multicenter cross-sectional study was conducted including 92,184 actively employed Spanish workers undergoing routine occupational health examinations between 2021 and 2024. Behavioral procrastination was assessed using the Pure Procrastination Scale-9 (PPS-9). Estimated heart age and heart age acceleration were calculated using a cardiovascular risk-factor-based algorithm. Multivariable linear and logistic regression analyses were performed to evaluate associations between procrastination score, continuous heart age acceleration, and accelerated cardiovascular aging phenotypes after adjustment for demographic, lifestyle, anthropometric, and cardiometabolic variables. Restricted cubic spline analyses and sex-stratified analyses were additionally conducted. Results: Higher procrastination levels were associated with progressively worse cardiometabolic and cardiovascular aging profiles. Mean heart age acceleration increased from -3.1 ± 6.0 years in participants with very low procrastination to 14.0 ± 6.4 years in those with very high/chronic procrastination (p \textless 0.001). The prevalence of accelerated cardiovascular aging (\textgreater0 years) increased from 27.2% to 94.2% across increasing procrastination categories, whereas severe accelerated cardiovascular aging (≥10 years) increased from 1.7% to 75.6% (both p \textless 0.001). In fully adjusted multivariable analyses, each 5-point increase in PPS-9 score was associated with a 0.50-year increase in heart age acceleration (B = 0.50; 95\% CI 0.48-0.52; p \textless 0.001). Participants with very high/chronic procrastination exhibited significantly higher odds of accelerated cardiovascular aging (OR 1.89; 95\% CI 1.65-2.18) and severe accelerated cardiovascular aging (OR 2.51; 95\% CI 2.16-2.92). Associations were significantly stronger among women (p-interaction \textless 0.001). Findings remained robust in sensitivity analyses excluding participants with diabetes mellitus. Conclusions: Behavioral procrastination was associated with higher estimated heart age acceleration and less favorable cardiovascular aging profiles in this large occupational cohort. Higher procrastination severity was consistently related to greater estimated heart age acceleration and a higher prevalence of cardiovascular aging phenotypes, even after extensive multivariable adjustment. These findings indicate that higher procrastination levels were associated with less favorable cardiovascular aging profiles beyond traditional biomedical risk factors. However, given the cross-sectional design, no conclusions regarding causality or temporality can be drawn.},
author = {Sarmiento Cruz, Manuel and Tárraga López, Pedro Juan and Piña Dabreu, Mónica Silu and Rodas Cañellas, Lluis and López-González, Ángel Arturo and Ramírez-Manent, José Ignacio},
journal = {Journal of Clinical Medicine},
keywords = {grapp-caib},
month = {jul},
number = 13,
pages = 5190,
title = {Behavioral Procrastination and Heart Age Acceleration in a Large Occupational Cohort},
volume = 15,
year = 2026
}%0 Journal Article
%1 sarmiento_cruz_behavioral_2026
%A Sarmiento Cruz, Manuel
%A Tárraga López, Pedro Juan
%A Piña Dabreu, Mónica Silu
%A Rodas Cañellas, Lluis
%A López-González, Ángel Arturo
%A Ramírez-Manent, José Ignacio
%D 2026
%J Journal of Clinical Medicine
%N 13
%P 5190
%R 10.3390/jcm15135190
%T Behavioral Procrastination and Heart Age Acceleration in a Large Occupational Cohort
%V 15
%X Background: Behavioral procrastination has been increasingly recognized as a maladaptive self-regulatory pattern associated with unhealthy lifestyle behaviors, psychological stress, and adverse cardiometabolic profiles. However, its relationship with accelerated cardiovascular aging remains poorly understood. This study aimed to evaluate the association between behavioral procrastination and heart age acceleration in a large occupational cohort of Spanish workers. Methods: A multicenter cross-sectional study was conducted including 92,184 actively employed Spanish workers undergoing routine occupational health examinations between 2021 and 2024. Behavioral procrastination was assessed using the Pure Procrastination Scale-9 (PPS-9). Estimated heart age and heart age acceleration were calculated using a cardiovascular risk-factor-based algorithm. Multivariable linear and logistic regression analyses were performed to evaluate associations between procrastination score, continuous heart age acceleration, and accelerated cardiovascular aging phenotypes after adjustment for demographic, lifestyle, anthropometric, and cardiometabolic variables. Restricted cubic spline analyses and sex-stratified analyses were additionally conducted. Results: Higher procrastination levels were associated with progressively worse cardiometabolic and cardiovascular aging profiles. Mean heart age acceleration increased from -3.1 ± 6.0 years in participants with very low procrastination to 14.0 ± 6.4 years in those with very high/chronic procrastination (p \textless 0.001). The prevalence of accelerated cardiovascular aging (\textgreater0 years) increased from 27.2% to 94.2% across increasing procrastination categories, whereas severe accelerated cardiovascular aging (≥10 years) increased from 1.7% to 75.6% (both p \textless 0.001). In fully adjusted multivariable analyses, each 5-point increase in PPS-9 score was associated with a 0.50-year increase in heart age acceleration (B = 0.50; 95\% CI 0.48-0.52; p \textless 0.001). Participants with very high/chronic procrastination exhibited significantly higher odds of accelerated cardiovascular aging (OR 1.89; 95\% CI 1.65-2.18) and severe accelerated cardiovascular aging (OR 2.51; 95\% CI 2.16-2.92). Associations were significantly stronger among women (p-interaction \textless 0.001). Findings remained robust in sensitivity analyses excluding participants with diabetes mellitus. Conclusions: Behavioral procrastination was associated with higher estimated heart age acceleration and less favorable cardiovascular aging profiles in this large occupational cohort. Higher procrastination severity was consistently related to greater estimated heart age acceleration and a higher prevalence of cardiovascular aging phenotypes, even after extensive multivariable adjustment. These findings indicate that higher procrastination levels were associated with less favorable cardiovascular aging profiles beyond traditional biomedical risk factors. However, given the cross-sectional design, no conclusions regarding causality or temporality can be drawn. -
AbstractBibTeXEndNoteDOIBibSonomy1.Jansana MDM, López PJT, Miquel JJG, López-González Ángel A, Sbert PR, Busquets-Cortés C, Ramírez-Manent JI. Determinants of obesity: The role of sociodemographic factors, health behaviors, and quality of life in Spanish workers. Obesity Research & Clinical Practice. 2026;20(3):185-93.BACKGROUND: Obesity remains a major global health challenge with profound clinical, psychosocial, and economic consequences. Although body mass index (BMI) is widely used, alternative adiposity indices such as waist-to-height ratio (WtHR), Clínica Universidad de Navarra-Body Adiposity Estimator (CUN-BAE), and the Metabolic Score for Visceral Fat (METS-VF) may offer superior insights into central adiposity and cardiometabolic risk. Furthermore, the relationship between obesity and health-related quality of life (HRQoL) remains insufficiently explored in occupational settings, where lifestyle, socioeconomic, and psychosocial factors converge. METHODS: We conducted a cross-sectional study of 100,014 Spanish workers (18-69 years) who underwent standardized occupational health assessments between 2021 and 2023. Anthropometric and biochemical data were collected to calculate BMI, WtHR, CUN-BAE, and METS-VF. Sociodemographic characteristics, lifestyle habits (smoking, physical activity, and Mediterranean diet adherence), and HRQoL (12-Item Short Form Health Survey, SF-12) were also recorded. Logistic regression models were used to evaluate associations between obesity indices and sociodemographic, behavioral, and HRQoL variables, adjusting for potential confounders. RESULTS: Obesity prevalence varied markedly depending on the index employed, ranging from 17.2% with BMI to over 30% with CUN-BAE and METS-VF. Across all measures, older age, male sex, lower social class, smoking, physical inactivity, and poor adherence to the Mediterranean diet were significantly associated with higher odds of obesity. Importantly, workers with lower SF-12 physical and mental component scores consistently showed greater obesity risk, even after adjustment. These findings confirm the bidirectional interplay between excess adiposity and diminished quality of life. CONCLUSIONS: In this large occupational cohort, obesity was strongly associated with adverse sociodemographic profiles, unhealthy lifestyles, and impaired HRQoL. Our results highlight the limitations of BMI alone and underscore the value of alternative adiposity indices in public health surveillance. Integrating HRQoL assessment into obesity prevention and workplace health programs may enhance early detection, risk stratification, and the design of holistic interventions targeting both physical and psychosocial well-being.
@article{jansana_determinants_2026,
abstract = {BACKGROUND: Obesity remains a major global health challenge with profound clinical, psychosocial, and economic consequences. Although body mass index (BMI) is widely used, alternative adiposity indices such as waist-to-height ratio (WtHR), Clínica Universidad de Navarra-Body Adiposity Estimator (CUN-BAE), and the Metabolic Score for Visceral Fat (METS-VF) may offer superior insights into central adiposity and cardiometabolic risk. Furthermore, the relationship between obesity and health-related quality of life (HRQoL) remains insufficiently explored in occupational settings, where lifestyle, socioeconomic, and psychosocial factors converge. METHODS: We conducted a cross-sectional study of 100,014 Spanish workers (18-69 years) who underwent standardized occupational health assessments between 2021 and 2023. Anthropometric and biochemical data were collected to calculate BMI, WtHR, CUN-BAE, and METS-VF. Sociodemographic characteristics, lifestyle habits (smoking, physical activity, and Mediterranean diet adherence), and HRQoL (12-Item Short Form Health Survey, SF-12) were also recorded. Logistic regression models were used to evaluate associations between obesity indices and sociodemographic, behavioral, and HRQoL variables, adjusting for potential confounders. RESULTS: Obesity prevalence varied markedly depending on the index employed, ranging from 17.2% with BMI to over 30% with CUN-BAE and METS-VF. Across all measures, older age, male sex, lower social class, smoking, physical inactivity, and poor adherence to the Mediterranean diet were significantly associated with higher odds of obesity. Importantly, workers with lower SF-12 physical and mental component scores consistently showed greater obesity risk, even after adjustment. These findings confirm the bidirectional interplay between excess adiposity and diminished quality of life. CONCLUSIONS: In this large occupational cohort, obesity was strongly associated with adverse sociodemographic profiles, unhealthy lifestyles, and impaired HRQoL. Our results highlight the limitations of BMI alone and underscore the value of alternative adiposity indices in public health surveillance. Integrating HRQoL assessment into obesity prevention and workplace health programs may enhance early detection, risk stratification, and the design of holistic interventions targeting both physical and psychosocial well-being.},
author = {Jansana, María Dolores Marzoa and López, Pedro Juan Tárraga and Miquel, Juan José Guarro and López-González, Ángel Arturo and Sbert, Pere Riutord and Busquets-Cortés, Carla and Ramírez-Manent, José Ignacio},
journal = {Obesity Research & Clinical Practice},
keywords = {grapp-caib},
number = 3,
pages = {185--193},
title = {Determinants of obesity: The role of sociodemographic factors, health behaviors, and quality of life in Spanish workers},
volume = 20,
year = 2026
}%0 Journal Article
%1 jansana_determinants_2026
%A Jansana, María Dolores Marzoa
%A López, Pedro Juan Tárraga
%A Miquel, Juan José Guarro
%A López-González, Ángel Arturo
%A Sbert, Pere Riutord
%A Busquets-Cortés, Carla
%A Ramírez-Manent, José Ignacio
%D 2026
%J Obesity Research & Clinical Practice
%N 3
%P 185--193
%R 10.1016/j.orcp.2026.04.005
%T Determinants of obesity: The role of sociodemographic factors, health behaviors, and quality of life in Spanish workers
%V 20
%X BACKGROUND: Obesity remains a major global health challenge with profound clinical, psychosocial, and economic consequences. Although body mass index (BMI) is widely used, alternative adiposity indices such as waist-to-height ratio (WtHR), Clínica Universidad de Navarra-Body Adiposity Estimator (CUN-BAE), and the Metabolic Score for Visceral Fat (METS-VF) may offer superior insights into central adiposity and cardiometabolic risk. Furthermore, the relationship between obesity and health-related quality of life (HRQoL) remains insufficiently explored in occupational settings, where lifestyle, socioeconomic, and psychosocial factors converge. METHODS: We conducted a cross-sectional study of 100,014 Spanish workers (18-69 years) who underwent standardized occupational health assessments between 2021 and 2023. Anthropometric and biochemical data were collected to calculate BMI, WtHR, CUN-BAE, and METS-VF. Sociodemographic characteristics, lifestyle habits (smoking, physical activity, and Mediterranean diet adherence), and HRQoL (12-Item Short Form Health Survey, SF-12) were also recorded. Logistic regression models were used to evaluate associations between obesity indices and sociodemographic, behavioral, and HRQoL variables, adjusting for potential confounders. RESULTS: Obesity prevalence varied markedly depending on the index employed, ranging from 17.2% with BMI to over 30% with CUN-BAE and METS-VF. Across all measures, older age, male sex, lower social class, smoking, physical inactivity, and poor adherence to the Mediterranean diet were significantly associated with higher odds of obesity. Importantly, workers with lower SF-12 physical and mental component scores consistently showed greater obesity risk, even after adjustment. These findings confirm the bidirectional interplay between excess adiposity and diminished quality of life. CONCLUSIONS: In this large occupational cohort, obesity was strongly associated with adverse sociodemographic profiles, unhealthy lifestyles, and impaired HRQoL. Our results highlight the limitations of BMI alone and underscore the value of alternative adiposity indices in public health surveillance. Integrating HRQoL assessment into obesity prevention and workplace health programs may enhance early detection, risk stratification, and the design of holistic interventions targeting both physical and psychosocial well-being. - AbstractURLBibTeXEndNoteDOIBibSonomyDownload1.Leiva A, Gallardo Alfaro L, Bejarano F, Sempere E, Soler A, Huguet A, Llarena M, Lekue I, Campabadal Prats C, Salom C, Solaz RB, Socias Cañellas C, Gonzalez A, Campins GM, Vanrell A, Rovira M, Ponsa Mir G, Vicens-Caldentey C. Study protocol for a hybrid I randomised clinical trial to evaluate an audit and feedback and a pharmacist-led intervention to reduce potentially inappropriate medications in older adults: the AIM study. BMJ Open [Internet]. 2026 May;16(5):e104877. https://pmc.ncbi.nlm.nih.gov/articles/PMC13158599/Introduction Potentially inappropriate prescriptions (PIPs) in older adults, such as long-term use of benzodiazepines, proton pump inhibitors without indication or antipsychotics in dementia, are associated with adverse events and increased healthcare utilisation. Despite clinical guidelines discouraging their use, PIPs remain frequent in primary care. An audit and feedback (A\&F) intervention of PIPs to general practitioners (GPs), led by pharmacists, may reduce the prescription of PIPs in primary care. Methods and analysis A two-arm, pragmatic, controlled trial will be conducted to evaluate the effectiveness of an A&F-based intervention and a pharmacist-led intervention to reduce the proportion of patients aged ≥65 years receiving inappropriate prescriptions. A total of 170 participating GPs, 85 per group, are required. GPs will be randomised into intervention or control groups (1:1). The intervention includes feedback reports, pharmacist-led academic detailing and access to online training modules. The primary outcome is the proportion of older adults receiving at least one PIP at 12 months as well as the total number of PIPs. A random effects Tobit regression model, censored at 0 and 100, will be used to estimate between-group differences adjusted for baseline prescribing. Subgroup analyses will explore heterogeneity of effect by baseline prescribing level and healthcare region. Implementation outcomes, including reach, fidelity, engagement and maintenance, will be evaluated using the Reach, Effectiveness, Adoption, Implementation and Maintenance framework, combining quantitative and qualitative data. Ethics and dissemination Ethical approval was obtained by the Balearic Island Committee Ethics (IB5219/23PI). Study findings, including primary and secondary outcomes and qualitative implementation results, will be disseminated through peer-reviewed publications and stakeholder reports. Trial registration number ISRCTN14449434.
@article{leiva_study_2026,
abstract = {Introduction Potentially inappropriate prescriptions (PIPs) in older adults, such as long-term use of benzodiazepines, proton pump inhibitors without indication or antipsychotics in dementia, are associated with adverse events and increased healthcare utilisation. Despite clinical guidelines discouraging their use, PIPs remain frequent in primary care. An audit and feedback (A\&F) intervention of PIPs to general practitioners (GPs), led by pharmacists, may reduce the prescription of PIPs in primary care. Methods and analysis A two-arm, pragmatic, controlled trial will be conducted to evaluate the effectiveness of an A&F-based intervention and a pharmacist-led intervention to reduce the proportion of patients aged ≥65 years receiving inappropriate prescriptions. A total of 170 participating GPs, 85 per group, are required. GPs will be randomised into intervention or control groups (1:1). The intervention includes feedback reports, pharmacist-led academic detailing and access to online training modules. The primary outcome is the proportion of older adults receiving at least one PIP at 12 months as well as the total number of PIPs. A random effects Tobit regression model, censored at 0 and 100, will be used to estimate between-group differences adjusted for baseline prescribing. Subgroup analyses will explore heterogeneity of effect by baseline prescribing level and healthcare region. Implementation outcomes, including reach, fidelity, engagement and maintenance, will be evaluated using the Reach, Effectiveness, Adoption, Implementation and Maintenance framework, combining quantitative and qualitative data. Ethics and dissemination Ethical approval was obtained by the Balearic Island Committee Ethics (IB5219/23PI). Study findings, including primary and secondary outcomes and qualitative implementation results, will be disseminated through peer-reviewed publications and stakeholder reports. Trial registration number ISRCTN14449434.},
author = {Leiva, Alfonso and Gallardo Alfaro, Laura and Bejarano, Ferran and Sempere, Ermengol and Soler, Aina and Huguet, Aina and Llarena, Marta and Lekue, Itxasne and Campabadal Prats, Cecília and Salom, Clara and Solaz, Rocío Broseta and Socias Cañellas, Catalina and Gonzalez, Agusti and Campins, Guillem Marc and Vanrell, Ana and Rovira, Marta and Ponsa Mir, Georgina and Vicens-Caldentey, Caterina},
journal = {BMJ Open},
keywords = {grapp-caib},
month = {may},
number = 5,
pages = {e104877},
title = {Study protocol for a hybrid I randomised clinical trial to evaluate an audit and feedback and a pharmacist-led intervention to reduce potentially inappropriate medications in older adults: the AIM study},
volume = 16,
year = 2026
}%0 Journal Article
%1 leiva_study_2026
%A Leiva, Alfonso
%A Gallardo Alfaro, Laura
%A Bejarano, Ferran
%A Sempere, Ermengol
%A Soler, Aina
%A Huguet, Aina
%A Llarena, Marta
%A Lekue, Itxasne
%A Campabadal Prats, Cecília
%A Salom, Clara
%A Solaz, Rocío Broseta
%A Socias Cañellas, Catalina
%A Gonzalez, Agusti
%A Campins, Guillem Marc
%A Vanrell, Ana
%A Rovira, Marta
%A Ponsa Mir, Georgina
%A Vicens-Caldentey, Caterina
%D 2026
%J BMJ Open
%N 5
%P e104877
%R 10.1136/bmjopen-2025-104877
%T Study protocol for a hybrid I randomised clinical trial to evaluate an audit and feedback and a pharmacist-led intervention to reduce potentially inappropriate medications in older adults: the AIM study
%U https://pmc.ncbi.nlm.nih.gov/articles/PMC13158599/
%V 16
%X Introduction Potentially inappropriate prescriptions (PIPs) in older adults, such as long-term use of benzodiazepines, proton pump inhibitors without indication or antipsychotics in dementia, are associated with adverse events and increased healthcare utilisation. Despite clinical guidelines discouraging their use, PIPs remain frequent in primary care. An audit and feedback (A\&F) intervention of PIPs to general practitioners (GPs), led by pharmacists, may reduce the prescription of PIPs in primary care. Methods and analysis A two-arm, pragmatic, controlled trial will be conducted to evaluate the effectiveness of an A&F-based intervention and a pharmacist-led intervention to reduce the proportion of patients aged ≥65 years receiving inappropriate prescriptions. A total of 170 participating GPs, 85 per group, are required. GPs will be randomised into intervention or control groups (1:1). The intervention includes feedback reports, pharmacist-led academic detailing and access to online training modules. The primary outcome is the proportion of older adults receiving at least one PIP at 12 months as well as the total number of PIPs. A random effects Tobit regression model, censored at 0 and 100, will be used to estimate between-group differences adjusted for baseline prescribing. Subgroup analyses will explore heterogeneity of effect by baseline prescribing level and healthcare region. Implementation outcomes, including reach, fidelity, engagement and maintenance, will be evaluated using the Reach, Effectiveness, Adoption, Implementation and Maintenance framework, combining quantitative and qualitative data. Ethics and dissemination Ethical approval was obtained by the Balearic Island Committee Ethics (IB5219/23PI). Study findings, including primary and secondary outcomes and qualitative implementation results, will be disseminated through peer-reviewed publications and stakeholder reports. Trial registration number ISRCTN14449434. - AbstractURLBibTeXEndNoteDOIBibSonomyDownload1.Gervilla-García E, García-Pazo P, Guillén-Solà M, Leguizamo F, Ricci-Cabello I, Serrano-Ripoll MJ, Bennasar-Veny M, Fiol deRoque MA, Angullo-Martínez E, Zamanillo-Campos R. Stakeholder Perspectives on Implementing DiabeText: Exploring Barriers and Facilitators for a Personalized Diabetes Self-Management SMS Intervention in Spain. Diabetology [Internet]. Multidisciplinary Digital Publishing Institute; 2026 Jan.;7(1):17. https://www.mdpi.com/2673-4540/7/1/17Background/Objectives: Mobile health (mHealth) interventions can enhance chronic disease management, but their integration into public healthcare systems remains complex. DiabeText is the first SMS-based intervention in Spain delivering personalized diabetes self-management support using electronic health record data. This study explored perceived barriers and facilitators to the implementation of DiabeText in the Spanish public health context from the perspective of key stakeholders. Methods: A qualitative study was conducted using semi-structured interviews with 14 purposively selected stakeholders involved in digital health, diabetes care, data protection, and healthcare management across several Spanish regions. Interviews were thematically analyzed using Braun and Clarke’s approach and guided by the Implementation Research Logic Model. Results: Participants reported several barriers, including concerns regarding data protection, uncertainty about long-term sustainability, insufficient training and engagement of healthcare professionals and low digital literacy among certain patient groups. Facilitators included favorable institutional momentum for digital innovation, funding availability, perceived clinical utility and scalability of DiabeText, and growing patient familiarity with digital tools. Recommended strategies included integration into existing healthcare systems and workflows, professional training and use of familiar communication platforms. Conclusions: Effective implementation of DiabeText requires addressing regulatory, organizational, and equity-related barriers while leveraging institutional support and readiness for innovation. Early involvement of healthcare professionals, robust data governance, and investment in digital literacy are essential to ensure sustainable and equitable adoption. These findings provide actionable insights to support the integration of mHealth tools into chronic disease care in Spain and similar settings.
@article{gervilla-garcia_stakeholder_2026,
abstract = {Background/Objectives: Mobile health (mHealth) interventions can enhance chronic disease management, but their integration into public healthcare systems remains complex. DiabeText is the first SMS-based intervention in Spain delivering personalized diabetes self-management support using electronic health record data. This study explored perceived barriers and facilitators to the implementation of DiabeText in the Spanish public health context from the perspective of key stakeholders. Methods: A qualitative study was conducted using semi-structured interviews with 14 purposively selected stakeholders involved in digital health, diabetes care, data protection, and healthcare management across several Spanish regions. Interviews were thematically analyzed using Braun and Clarke’s approach and guided by the Implementation Research Logic Model. Results: Participants reported several barriers, including concerns regarding data protection, uncertainty about long-term sustainability, insufficient training and engagement of healthcare professionals and low digital literacy among certain patient groups. Facilitators included favorable institutional momentum for digital innovation, funding availability, perceived clinical utility and scalability of DiabeText, and growing patient familiarity with digital tools. Recommended strategies included integration into existing healthcare systems and workflows, professional training and use of familiar communication platforms. Conclusions: Effective implementation of DiabeText requires addressing regulatory, organizational, and equity-related barriers while leveraging institutional support and readiness for innovation. Early involvement of healthcare professionals, robust data governance, and investment in digital literacy are essential to ensure sustainable and equitable adoption. These findings provide actionable insights to support the integration of mHealth tools into chronic disease care in Spain and similar settings.},
author = {Gervilla-García, Elena and García-Pazo, Patricia and Guillén-Solà, Mireia and Leguizamo, Federico and Ricci-Cabello, Ignacio and Serrano-Ripoll, María Jesús and Bennasar-Veny, Miquel and Fiol deRoque, Maria Antònia and Angullo-Martínez, Escarlata and Zamanillo-Campos, Rocío},
journal = {Diabetology},
keywords = {grapp-caib},
month = {jan},
number = 1,
pages = 17,
publisher = {Multidisciplinary Digital Publishing Institute},
title = {Stakeholder Perspectives on Implementing DiabeText: Exploring Barriers and Facilitators for a Personalized Diabetes Self-Management SMS Intervention in Spain},
volume = 7,
year = 2026
}%0 Journal Article
%1 gervilla-garcia_stakeholder_2026
%A Gervilla-García, Elena
%A García-Pazo, Patricia
%A Guillén-Solà, Mireia
%A Leguizamo, Federico
%A Ricci-Cabello, Ignacio
%A Serrano-Ripoll, María Jesús
%A Bennasar-Veny, Miquel
%A Fiol deRoque, Maria Antònia
%A Angullo-Martínez, Escarlata
%A Zamanillo-Campos, Rocío
%D 2026
%I Multidisciplinary Digital Publishing Institute
%J Diabetology
%N 1
%P 17
%R 10.3390/diabetology7010017
%T Stakeholder Perspectives on Implementing DiabeText: Exploring Barriers and Facilitators for a Personalized Diabetes Self-Management SMS Intervention in Spain
%U https://www.mdpi.com/2673-4540/7/1/17
%V 7
%X Background/Objectives: Mobile health (mHealth) interventions can enhance chronic disease management, but their integration into public healthcare systems remains complex. DiabeText is the first SMS-based intervention in Spain delivering personalized diabetes self-management support using electronic health record data. This study explored perceived barriers and facilitators to the implementation of DiabeText in the Spanish public health context from the perspective of key stakeholders. Methods: A qualitative study was conducted using semi-structured interviews with 14 purposively selected stakeholders involved in digital health, diabetes care, data protection, and healthcare management across several Spanish regions. Interviews were thematically analyzed using Braun and Clarke’s approach and guided by the Implementation Research Logic Model. Results: Participants reported several barriers, including concerns regarding data protection, uncertainty about long-term sustainability, insufficient training and engagement of healthcare professionals and low digital literacy among certain patient groups. Facilitators included favorable institutional momentum for digital innovation, funding availability, perceived clinical utility and scalability of DiabeText, and growing patient familiarity with digital tools. Recommended strategies included integration into existing healthcare systems and workflows, professional training and use of familiar communication platforms. Conclusions: Effective implementation of DiabeText requires addressing regulatory, organizational, and equity-related barriers while leveraging institutional support and readiness for innovation. Early involvement of healthcare professionals, robust data governance, and investment in digital literacy are essential to ensure sustainable and equitable adoption. These findings provide actionable insights to support the integration of mHealth tools into chronic disease care in Spain and similar settings. - AbstractURLBibTeXEndNoteDOIBibSonomyDownload1.Venter C, Beltran J, Bracchiglione J, Fernández-Sáenz FK, Riera P, Solà I, Akdis C, Arasi S, Canani RB, Fleischer D, Eguíluz-Gracia I, Hourihane J, Lunjani N, Meyer R, Roberts G, Roth-Walter F, Santos AF, Skypala I, Smith PK, Sokolowska M, Torres MJ, Vassilopoulou E, Vlieg-Boerstra B, Walter J, Alonso-Coello P, O’Mahony L. Immunonutrition in Early Life: The Role of Complementary Feeding, Dietary Patterns, and Nutritional Exposures on the Health of Young Children-An EAACI Scoping Review. Allergy [Internet]. Denmark; 2026 Jul.;:10.1111/all.70429-. https://pubmed.ncbi.nlm.nih.gov/42400030BACKGROUND: Immunonutrition examines how diet influences immune development. Complementary feeding represents a critical window for long-term health. We aimed to map evidence linking complementary feeding to immune outcomes, allergy, infection, and growth in infants and toddlers (≤ 3 years). We conducted a scoping review and evidence-gap mapping, following PRISMA-ScR. MEDLINE and Epistemonikos were searched from inception to November 2024. Concepts included diet diversity/patterns, feeding practices/models, and timing of allergen introduction, timing of complementary feeding, macronutrients, micronutrients, foods, supplementation, and ultra-processed foods. We included systematic reviews and recent primary studies meeting criteria. RESULTS: From 13,512 records screened, 108 systematic reviews were included, comprising 99 randomized controlled trials, 41 cohorts, 22 case-control, and 14 cross-sectional studies. Most reviews addressed nutrient intake, supplementation, or timing of allergen introduction, while fewer reviews explored diet diversity, foods, or ultra-processed food intake. Responsive complementary feeding was consistently associated with healthier growth and lower obesity risk, whereas restrictive practices showed adverse effects. Greater diet diversity was linked to reduced asthma and food allergy risk, though eczema findings were inconsistent. Western-style diets high in processed foods, fat, sugar, and meat correlated with higher allergy risk, while home-prepared diets were protective. Micronutrient supplementation (iron, zinc, vitamin D) reduced infection and anemia risk but had mixed effects on allergy. Early allergen introduction reduced food allergy incidence. CONCLUSIONS: Complementary feeding research now extends beyond calorie counting, macronutrients, and early allergen introduction to dietary patterns and early life nutrition that supports the microbiome. Evidence supports dietary diversity, timely food allergen introduction, and responsive feeding, while discouraging restrictive practices and ultra-processed foods. Future work should harmonize definitions and investigate plant-based diets, advanced glycation end products, and processed food exposures.
@article{venter2026immunonutrition,
abstract = {BACKGROUND: Immunonutrition examines how diet influences immune development. Complementary feeding represents a critical window for long-term health. We aimed to map evidence linking complementary feeding to immune outcomes, allergy, infection, and growth in infants and toddlers (≤ 3 years). We conducted a scoping review and evidence-gap mapping, following PRISMA-ScR. MEDLINE and Epistemonikos were searched from inception to November 2024. Concepts included diet diversity/patterns, feeding practices/models, and timing of allergen introduction, timing of complementary feeding, macronutrients, micronutrients, foods, supplementation, and ultra-processed foods. We included systematic reviews and recent primary studies meeting criteria. RESULTS: From 13,512 records screened, 108 systematic reviews were included, comprising 99 randomized controlled trials, 41 cohorts, 22 case-control, and 14 cross-sectional studies. Most reviews addressed nutrient intake, supplementation, or timing of allergen introduction, while fewer reviews explored diet diversity, foods, or ultra-processed food intake. Responsive complementary feeding was consistently associated with healthier growth and lower obesity risk, whereas restrictive practices showed adverse effects. Greater diet diversity was linked to reduced asthma and food allergy risk, though eczema findings were inconsistent. Western-style diets high in processed foods, fat, sugar, and meat correlated with higher allergy risk, while home-prepared diets were protective. Micronutrient supplementation (iron, zinc, vitamin D) reduced infection and anemia risk but had mixed effects on allergy. Early allergen introduction reduced food allergy incidence. CONCLUSIONS: Complementary feeding research now extends beyond calorie counting, macronutrients, and early allergen introduction to dietary patterns and early life nutrition that supports the microbiome. Evidence supports dietary diversity, timely food allergen introduction, and responsive feeding, while discouraging restrictive practices and ultra-processed foods. Future work should harmonize definitions and investigate plant-based diets, advanced glycation end products, and processed food exposures.},
address = {Denmark},
author = {Venter, Carina and Beltran, Jessica and Bracchiglione, Javier and Fernández-Sáenz, Fiorella Karina and Riera, Pau and Solà, Ivan and Akdis, Cezmi and Arasi, Stefania and Canani, Roberto Berni and Fleischer, David and Eguíluz-Gracia, Ibon and Hourihane, Jonathan and Lunjani, Nonhlanhla and Meyer, Rosan and Roberts, Graham and Roth-Walter, Franziska and Santos, Alexandra F and Skypala, Isabel and Smith, Peter K and Sokolowska, Milena and Torres, Maria J and Vassilopoulou, Emilia and Vlieg-Boerstra, Berber and Walter, Jens and Alonso-Coello, Pablo and O'Mahony, Liam},
journal = {Allergy},
keywords = {evisap},
month = {jul},
pages = {10.1111/all.70429--},
title = {Immunonutrition in Early Life: The Role of Complementary Feeding, Dietary Patterns, and Nutritional Exposures on the Health of Young Children-An EAACI Scoping Review},
year = 2026
}%0 Journal Article
%1 venter2026immunonutrition
%A Venter, Carina
%A Beltran, Jessica
%A Bracchiglione, Javier
%A Fernández-Sáenz, Fiorella Karina
%A Riera, Pau
%A Solà, Ivan
%A Akdis, Cezmi
%A Arasi, Stefania
%A Canani, Roberto Berni
%A Fleischer, David
%A Eguíluz-Gracia, Ibon
%A Hourihane, Jonathan
%A Lunjani, Nonhlanhla
%A Meyer, Rosan
%A Roberts, Graham
%A Roth-Walter, Franziska
%A Santos, Alexandra F
%A Skypala, Isabel
%A Smith, Peter K
%A Sokolowska, Milena
%A Torres, Maria J
%A Vassilopoulou, Emilia
%A Vlieg-Boerstra, Berber
%A Walter, Jens
%A Alonso-Coello, Pablo
%A O'Mahony, Liam
%C Denmark
%D 2026
%J Allergy
%P 10.1111/all.70429--
%R 10.1111/all.70429
%T Immunonutrition in Early Life: The Role of Complementary Feeding, Dietary Patterns, and Nutritional Exposures on the Health of Young Children-An EAACI Scoping Review
%U https://pubmed.ncbi.nlm.nih.gov/42400030
%X BACKGROUND: Immunonutrition examines how diet influences immune development. Complementary feeding represents a critical window for long-term health. We aimed to map evidence linking complementary feeding to immune outcomes, allergy, infection, and growth in infants and toddlers (≤ 3 years). We conducted a scoping review and evidence-gap mapping, following PRISMA-ScR. MEDLINE and Epistemonikos were searched from inception to November 2024. Concepts included diet diversity/patterns, feeding practices/models, and timing of allergen introduction, timing of complementary feeding, macronutrients, micronutrients, foods, supplementation, and ultra-processed foods. We included systematic reviews and recent primary studies meeting criteria. RESULTS: From 13,512 records screened, 108 systematic reviews were included, comprising 99 randomized controlled trials, 41 cohorts, 22 case-control, and 14 cross-sectional studies. Most reviews addressed nutrient intake, supplementation, or timing of allergen introduction, while fewer reviews explored diet diversity, foods, or ultra-processed food intake. Responsive complementary feeding was consistently associated with healthier growth and lower obesity risk, whereas restrictive practices showed adverse effects. Greater diet diversity was linked to reduced asthma and food allergy risk, though eczema findings were inconsistent. Western-style diets high in processed foods, fat, sugar, and meat correlated with higher allergy risk, while home-prepared diets were protective. Micronutrient supplementation (iron, zinc, vitamin D) reduced infection and anemia risk but had mixed effects on allergy. Early allergen introduction reduced food allergy incidence. CONCLUSIONS: Complementary feeding research now extends beyond calorie counting, macronutrients, and early allergen introduction to dietary patterns and early life nutrition that supports the microbiome. Evidence supports dietary diversity, timely food allergen introduction, and responsive feeding, while discouraging restrictive practices and ultra-processed foods. Future work should harmonize definitions and investigate plant-based diets, advanced glycation end products, and processed food exposures. -
AbstractURLBibTeXEndNoteDOIBibSonomy1.Sousa-Pinto B, Marques-Cruz M, Vieira RJ, Duarte VH, Ávila-Oliver C, Dobrescu A, Jemioło P, Agarwal A, Bala MM, Beltran J, Bognanni A, Cruciani F, Dewidar O, Gil-Mata S, Liang C, Martinho-Dias D, Nowak C, Ocagli H, Perestrelo P, Pereira Nunes Pinto AC, Reis-Pardal J, Riera-Serra P, Rocha A, Fernández-Saénz K, Etxeandia-Ikobaltzeta I, Harrod CS, Langendam MW, Meerpohl J, Nonino F, Wiercioch W, Neumann I, Izcovich A, Minozzi S, Gartlehner G, Schünemann HJ. AI-enabled GRADE: How the GRADE Working Group will use automation to rate the certainty of evidence of intervention effects. Journal of clinical epidemiology [Internet]. United States; 2026 Jul.;:112411-. https://pubmed.ncbi.nlm.nih.gov/42413633OBJECTIVE: The Grading of Recommendations Assessment, Development and Evaluation (GRADE) Working Group is developing GRADErater (GRADE Rating Automation Through Enhanced Reasoning), an official, automated tool for evaluation of the certainty of the evidence (CoE). In this article we describe the principles and methods underlying its development and state how the GRADE Working Group will use automation to rate the CoE of intervention effects. PRINCIPLES AND METHODS: We followed the GRADE methods for registering a project group on GRADE and AI. The project group established that the automated tool should be developed according to the following principles: (i) compliance with current GRADE guidance, (ii) transparency, (iii) human oversight, (iv) implementation of decision rules, (v) ease of use, (vi) understandability, and (vii) continuous improvement. We developed a set of decision rules to appraise each domain of the CoE in pairwise and network meta-analysis. These rules were developed based on official GRADE sources and validated by a GRADE experts. Based on these rules, we created a first version (https://gradeai.med.up.pt/) for GRADErater. We are now evaluating this version in terms of (i) its underlying rules, and (ii) its user interface. These assessments will allow for a refinement of the rules and of the first version. The modified version will be appraised and presented to the GRADE Working Group with input from internal and external interest-holders before we seek formal approval. Once launched, the automated tool will be continuously evaluated and refined by incorporating feedback from end-users. We will add new features (including generative AI-based functionalities), integrate this tool with GRADEpro, and develop versions in languages other than English. CONCLUSION: This project will follow a transparent methodology to create GRADErater, an official tool endorsed by the GRADE Working Group that will support humans in applying the most current GRADE methods to rate the CoE.
@article{sousapinto2026aienabled,
abstract = {OBJECTIVE: The Grading of Recommendations Assessment, Development and Evaluation (GRADE) Working Group is developing GRADErater (GRADE Rating Automation Through Enhanced Reasoning), an official, automated tool for evaluation of the certainty of the evidence (CoE). In this article we describe the principles and methods underlying its development and state how the GRADE Working Group will use automation to rate the CoE of intervention effects. PRINCIPLES AND METHODS: We followed the GRADE methods for registering a project group on GRADE and AI. The project group established that the automated tool should be developed according to the following principles: (i) compliance with current GRADE guidance, (ii) transparency, (iii) human oversight, (iv) implementation of decision rules, (v) ease of use, (vi) understandability, and (vii) continuous improvement. We developed a set of decision rules to appraise each domain of the CoE in pairwise and network meta-analysis. These rules were developed based on official GRADE sources and validated by a GRADE experts. Based on these rules, we created a first version (https://gradeai.med.up.pt/) for GRADErater. We are now evaluating this version in terms of (i) its underlying rules, and (ii) its user interface. These assessments will allow for a refinement of the rules and of the first version. The modified version will be appraised and presented to the GRADE Working Group with input from internal and external interest-holders before we seek formal approval. Once launched, the automated tool will be continuously evaluated and refined by incorporating feedback from end-users. We will add new features (including generative AI-based functionalities), integrate this tool with GRADEpro, and develop versions in languages other than English. CONCLUSION: This project will follow a transparent methodology to create GRADErater, an official tool endorsed by the GRADE Working Group that will support humans in applying the most current GRADE methods to rate the CoE.},
address = {United States},
author = {Sousa-Pinto, Bernardo and Marques-Cruz, Manuel and Vieira, Rafael José and Duarte, Vìtor Henrique and Ávila-Oliver, Camila and Dobrescu, Andreea and Jemioło, Paweł and Agarwal, Arnav and Bala, Malgorzata M and Beltran, Jessica and Bognanni, Antonio and Cruciani, Fabio and Dewidar, Omar and Gil-Mata, Sara and Liang, Changhao and Martinho-Dias, Daniel and Nowak, Claus and Ocagli, Honoria and Perestrelo, Paula and Pereira Nunes Pinto, Ana Carolina and Reis-Pardal, Joana and Riera-Serra, Pau and Rocha, Aline and Fernández-Saénz, Karina and Etxeandia-Ikobaltzeta, Itziar and Harrod, Curtis S and Langendam, Miranda W and Meerpohl, Joerg and Nonino, Francesco and Wiercioch, Wojtek and Neumann, Ignacio and Izcovich, Ariel and Minozzi, Silvia and Gartlehner, Gerald and Schünemann, Holger J},
journal = {Journal of clinical epidemiology},
keywords = {evisap},
month = {jul},
pages = {112411--112411},
title = {AI-enabled GRADE: How the GRADE Working Group will use automation to rate the certainty of evidence of intervention effects},
year = 2026
}%0 Journal Article
%1 sousapinto2026aienabled
%A Sousa-Pinto, Bernardo
%A Marques-Cruz, Manuel
%A Vieira, Rafael José
%A Duarte, Vìtor Henrique
%A Ávila-Oliver, Camila
%A Dobrescu, Andreea
%A Jemioło, Paweł
%A Agarwal, Arnav
%A Bala, Malgorzata M
%A Beltran, Jessica
%A Bognanni, Antonio
%A Cruciani, Fabio
%A Dewidar, Omar
%A Gil-Mata, Sara
%A Liang, Changhao
%A Martinho-Dias, Daniel
%A Nowak, Claus
%A Ocagli, Honoria
%A Perestrelo, Paula
%A Pereira Nunes Pinto, Ana Carolina
%A Reis-Pardal, Joana
%A Riera-Serra, Pau
%A Rocha, Aline
%A Fernández-Saénz, Karina
%A Etxeandia-Ikobaltzeta, Itziar
%A Harrod, Curtis S
%A Langendam, Miranda W
%A Meerpohl, Joerg
%A Nonino, Francesco
%A Wiercioch, Wojtek
%A Neumann, Ignacio
%A Izcovich, Ariel
%A Minozzi, Silvia
%A Gartlehner, Gerald
%A Schünemann, Holger J
%C United States
%D 2026
%J Journal of clinical epidemiology
%P 112411--112411
%R 10.1016/j.jclinepi.2026.112411
%T AI-enabled GRADE: How the GRADE Working Group will use automation to rate the certainty of evidence of intervention effects
%U https://pubmed.ncbi.nlm.nih.gov/42413633
%X OBJECTIVE: The Grading of Recommendations Assessment, Development and Evaluation (GRADE) Working Group is developing GRADErater (GRADE Rating Automation Through Enhanced Reasoning), an official, automated tool for evaluation of the certainty of the evidence (CoE). In this article we describe the principles and methods underlying its development and state how the GRADE Working Group will use automation to rate the CoE of intervention effects. PRINCIPLES AND METHODS: We followed the GRADE methods for registering a project group on GRADE and AI. The project group established that the automated tool should be developed according to the following principles: (i) compliance with current GRADE guidance, (ii) transparency, (iii) human oversight, (iv) implementation of decision rules, (v) ease of use, (vi) understandability, and (vii) continuous improvement. We developed a set of decision rules to appraise each domain of the CoE in pairwise and network meta-analysis. These rules were developed based on official GRADE sources and validated by a GRADE experts. Based on these rules, we created a first version (https://gradeai.med.up.pt/) for GRADErater. We are now evaluating this version in terms of (i) its underlying rules, and (ii) its user interface. These assessments will allow for a refinement of the rules and of the first version. The modified version will be appraised and presented to the GRADE Working Group with input from internal and external interest-holders before we seek formal approval. Once launched, the automated tool will be continuously evaluated and refined by incorporating feedback from end-users. We will add new features (including generative AI-based functionalities), integrate this tool with GRADEpro, and develop versions in languages other than English. CONCLUSION: This project will follow a transparent methodology to create GRADErater, an official tool endorsed by the GRADE Working Group that will support humans in applying the most current GRADE methods to rate the CoE. - AbstractBibTeXEndNoteDOIBibSonomyDownload1.Maier L, Sun Y, Kronberg J, Abner E, Team EBR, Coley K, Marenholz I, Weiss S, Foraita R, Karramass T, Mykkänen J, Hernandez-Pacheco N, Wang CA, Kitaba NT, Pechlivanis S, Bouzigon E, Tingskov Pedersen C-E, Schoos A-MM, Curtin JA, Kress S, Hernangomez-Laderas A, Foppiano F, Ashley S, Batini C, Bryant L, Homuth G, Gieger C, Gilles S, Lyytikäinen L-P, Rovio S, Pahkala K, Vernet R, Valenta R, Llop S, Torrent M, Böck A, Tang MLK, Schmidt-Weber CB, Metspalu A, Esko T, Sprikkelman AB, John C, Lee Y-A, Beyer K, Völzke H, Pigeot I, Traidl-Hoffmann C, Duijts L, Lu H, Raitakari OT, Lehtimäki T, Kähönen M, Thio CHL, Melén E, Pennell CE, Holloway JW, von Mutius E, Siroux V, Bønnelykke K, Custovic A, Simpson A, Schikowski T, Bilbao JR, Schaub B, Peters R, Kersten ETG, Vonk JM, Thiering E, Peters A, Koppelman GH, Standl M. Meta-analysis of genome-wide association studies of food allergy and IgE sensitization. The Journal of Allergy and Clinical Immunology. 2026 Jul.;158(1):194-208.BACKGROUND: Food allergy (FA) arises from a complex interplay between an individual's genetic predisposition and environmental factors, and its prevalence is increasing. Genome-wide association studies to date have been hindered by small sample sizes and varying FA definitions. OBJECTIVE: We sought to identify novel FA risk loci by conducting a genome-wide association study meta-analysis in children and adults by using a multiphenotype approach to ensure a good trade-off between sufficient sample size and valid FA definitions. METHODS: Analyses were conducted separately in children and adults on the basis of the following FA phenotypes: self-report, doctor diagnosis, food-specific sensitization, and doctor diagnosis plus food-specific sensitization. A meta-analysis was performed of genome-wide association studies from up to 16 cohorts of people of European ancestry including 229,426 adults and 14,234 children. Models were adjusted for sex, age, principal components, and, if applicable, further study-specific confounders. Sensitivity models were additionally adjusted for hay fever. Replication was conducted in additional external cohorts and a validation in oral food challenge-defined FA cases. RESULTS: Thirty-seven single nucleotide polymorphisms met suggestive significance (P \textless 1 × 10-6), with two reaching genome-wide significance: rs116936231 (FGL1) in adult doctor-diagnosed FA plus food-specific sensitization phenotype (stable after additional hay fever adjustment) and rs8022829 (AKAP6-NPAS3), which was significant only in the hay fever-adjusted model in adults. However, neither variant was validated. Further, we identified 3 single nucleotide polymorphisms previously reported for FA and atopic disease. CONCLUSION: This study identified 37 single nucleotide polymorphisms suggestively associated with FA and demonstrated genetic differences across phenotypes. It highlights the need for a unified FA definition and sheds light on FA's shared genetic architecture with allergies.
@article{maier_meta-analysis_2026,
abstract = {BACKGROUND: Food allergy (FA) arises from a complex interplay between an individual's genetic predisposition and environmental factors, and its prevalence is increasing. Genome-wide association studies to date have been hindered by small sample sizes and varying FA definitions. OBJECTIVE: We sought to identify novel FA risk loci by conducting a genome-wide association study meta-analysis in children and adults by using a multiphenotype approach to ensure a good trade-off between sufficient sample size and valid FA definitions. METHODS: Analyses were conducted separately in children and adults on the basis of the following FA phenotypes: self-report, doctor diagnosis, food-specific sensitization, and doctor diagnosis plus food-specific sensitization. A meta-analysis was performed of genome-wide association studies from up to 16 cohorts of people of European ancestry including 229,426 adults and 14,234 children. Models were adjusted for sex, age, principal components, and, if applicable, further study-specific confounders. Sensitivity models were additionally adjusted for hay fever. Replication was conducted in additional external cohorts and a validation in oral food challenge-defined FA cases. RESULTS: Thirty-seven single nucleotide polymorphisms met suggestive significance (P \textless 1 × 10-6), with two reaching genome-wide significance: rs116936231 (FGL1) in adult doctor-diagnosed FA plus food-specific sensitization phenotype (stable after additional hay fever adjustment) and rs8022829 (AKAP6-NPAS3), which was significant only in the hay fever-adjusted model in adults. However, neither variant was validated. Further, we identified 3 single nucleotide polymorphisms previously reported for FA and atopic disease. CONCLUSION: This study identified 37 single nucleotide polymorphisms suggestively associated with FA and demonstrated genetic differences across phenotypes. It highlights the need for a unified FA definition and sheds light on FA's shared genetic architecture with allergies.},
author = {Maier, Lisa and Sun, Yidan and Kronberg, Jaanika and Abner, Erik and Estonian Biobank Research Team and Coley, Kayesha and Marenholz, Ingo and Weiss, Stefan and Foraita, Ronja and Karramass, Tarik and Mykkänen, Juha and Hernandez-Pacheco, Natalia and Wang, Carol A. and Kitaba, Negusse T. and Pechlivanis, Sonali and Bouzigon, Emmanuelle and Tingskov Pedersen, Casper-Emil and Schoos, Ann-Marie M. and Curtin, John A. and Kress, Sara and Hernangomez-Laderas, Alba and Foppiano, Francesco and Ashley, Sarah and Batini, Chiara and Bryant, Luke and Homuth, Georg and Gieger, Christian and Gilles, Stefanie and Lyytikäinen, Leo-Pekka and Rovio, Suvi and Pahkala, Katja and Vernet, Raphaël and Valenta, Rudolf and Llop, Sabrina and Torrent, Maties and Böck, Andreas and Tang, Mimi L. K. and Schmidt-Weber, Carsten B. and Metspalu, Andres and Esko, Tõnu and Sprikkelman, Aline B. and John, Catherine and Lee, Young-Ae and Beyer, Kirsten and Völzke, Henry and Pigeot, Iris and Traidl-Hoffmann, Claudia and Duijts, Liesbeth and Lu, Haojie and Raitakari, Olli T. and Lehtimäki, Terho and Kähönen, Mika and Thio, Chris H. L. and Melén, Erik and Pennell, Craig E. and Holloway, John W. and von Mutius, Erika and Siroux, Valérie and Bønnelykke, Klaus and Custovic, Adnan and Simpson, Angela and Schikowski, Tamara and Bilbao, Jose Ramon and Schaub, Bianca and Peters, Rachel and Kersten, Elin T. G. and Vonk, Judith M. and Thiering, Elisabeth and Peters, Annette and Koppelman, Gerard H. and Standl, Marie},
journal = {The Journal of Allergy and Clinical Immunology},
keywords = {grapp-caib},
month = {jul},
number = 1,
pages = {194--208},
title = {Meta-analysis of genome-wide association studies of food allergy and IgE sensitization},
volume = 158,
year = 2026
}%0 Journal Article
%1 maier_meta-analysis_2026
%A Maier, Lisa
%A Sun, Yidan
%A Kronberg, Jaanika
%A Abner, Erik
%A Team, Estonian Biobank Research
%A Coley, Kayesha
%A Marenholz, Ingo
%A Weiss, Stefan
%A Foraita, Ronja
%A Karramass, Tarik
%A Mykkänen, Juha
%A Hernandez-Pacheco, Natalia
%A Wang, Carol A.
%A Kitaba, Negusse T.
%A Pechlivanis, Sonali
%A Bouzigon, Emmanuelle
%A Tingskov Pedersen, Casper-Emil
%A Schoos, Ann-Marie M.
%A Curtin, John A.
%A Kress, Sara
%A Hernangomez-Laderas, Alba
%A Foppiano, Francesco
%A Ashley, Sarah
%A Batini, Chiara
%A Bryant, Luke
%A Homuth, Georg
%A Gieger, Christian
%A Gilles, Stefanie
%A Lyytikäinen, Leo-Pekka
%A Rovio, Suvi
%A Pahkala, Katja
%A Vernet, Raphaël
%A Valenta, Rudolf
%A Llop, Sabrina
%A Torrent, Maties
%A Böck, Andreas
%A Tang, Mimi L. K.
%A Schmidt-Weber, Carsten B.
%A Metspalu, Andres
%A Esko, Tõnu
%A Sprikkelman, Aline B.
%A John, Catherine
%A Lee, Young-Ae
%A Beyer, Kirsten
%A Völzke, Henry
%A Pigeot, Iris
%A Traidl-Hoffmann, Claudia
%A Duijts, Liesbeth
%A Lu, Haojie
%A Raitakari, Olli T.
%A Lehtimäki, Terho
%A Kähönen, Mika
%A Thio, Chris H. L.
%A Melén, Erik
%A Pennell, Craig E.
%A Holloway, John W.
%A von Mutius, Erika
%A Siroux, Valérie
%A Bønnelykke, Klaus
%A Custovic, Adnan
%A Simpson, Angela
%A Schikowski, Tamara
%A Bilbao, Jose Ramon
%A Schaub, Bianca
%A Peters, Rachel
%A Kersten, Elin T. G.
%A Vonk, Judith M.
%A Thiering, Elisabeth
%A Peters, Annette
%A Koppelman, Gerard H.
%A Standl, Marie
%D 2026
%J The Journal of Allergy and Clinical Immunology
%N 1
%P 194--208
%R 10.1016/j.jaci.2026.02.012
%T Meta-analysis of genome-wide association studies of food allergy and IgE sensitization
%V 158
%X BACKGROUND: Food allergy (FA) arises from a complex interplay between an individual's genetic predisposition and environmental factors, and its prevalence is increasing. Genome-wide association studies to date have been hindered by small sample sizes and varying FA definitions. OBJECTIVE: We sought to identify novel FA risk loci by conducting a genome-wide association study meta-analysis in children and adults by using a multiphenotype approach to ensure a good trade-off between sufficient sample size and valid FA definitions. METHODS: Analyses were conducted separately in children and adults on the basis of the following FA phenotypes: self-report, doctor diagnosis, food-specific sensitization, and doctor diagnosis plus food-specific sensitization. A meta-analysis was performed of genome-wide association studies from up to 16 cohorts of people of European ancestry including 229,426 adults and 14,234 children. Models were adjusted for sex, age, principal components, and, if applicable, further study-specific confounders. Sensitivity models were additionally adjusted for hay fever. Replication was conducted in additional external cohorts and a validation in oral food challenge-defined FA cases. RESULTS: Thirty-seven single nucleotide polymorphisms met suggestive significance (P \textless 1 × 10-6), with two reaching genome-wide significance: rs116936231 (FGL1) in adult doctor-diagnosed FA plus food-specific sensitization phenotype (stable after additional hay fever adjustment) and rs8022829 (AKAP6-NPAS3), which was significant only in the hay fever-adjusted model in adults. However, neither variant was validated. Further, we identified 3 single nucleotide polymorphisms previously reported for FA and atopic disease. CONCLUSION: This study identified 37 single nucleotide polymorphisms suggestively associated with FA and demonstrated genetic differences across phenotypes. It highlights the need for a unified FA definition and sheds light on FA's shared genetic architecture with allergies. - AbstractBibTeXEndNoteDOIBibSonomyDownload1.Marcilla-Toribio I, Martinez-Andres M, Gómez-Gómez I, Miranda-de la Maza M, Sierra-Martínez L, Repiso-Gento I, Castro-Rivero AB, Méndez-López F, Bulilete O, Fernández-Domínguez MJ, Martí-Lluch R, Ramos R, Zacarías-Pons L, Notario-Pacheco B. Accessibility to urban parks and resilience among adults in Spain: gender inequalities from the DESVELA study. BMC public health. 2026 Jun.;.INTRODUCTION: While associations between greenness and mental health have been studied, resilience, understood as the ability to adapt positively to stress and adversity, has received less attention. This study examined the relationship between the distance to the nearest park and resilience, considering potential gender differences. METHODS: A cross-sectional study was conducted among 3,852 Spanish adults assigned to Primary Healthcare centers of nine autonomous communities. Resilience was assessed using the Connor-Davidson Resilience Scale. Unadjusted and adjusted differences in resilience and distance to the nearest park were assessed using Analysis of Variance, Analysis of Covariance, and multiple linear regression models in the total sample and stratified by sex. The covariates considered in this study were age, education, monthly income, marital status, perceived social support, and mental health. Sex was included as a covariate in analyses of the total sample. This study finally comprised 2,922 individuals, 52.0% women. The mean age of the participants was 53.6 years ± 10.9 SD. RESULTS: Participants living farther from parks (\textgreater 700 m) showed significantly lower resilience than those in the close (\textless 300 m; mean difference = 0.59, 95\% CI: 0.06, 1.11, p = 0.028) and medium (300 m-700 m; mean difference = 0.82, 95\% CI: 0.28, 1.35, p = 0.003) subgroups. Greater distance to the nearest park was inversely associated with resilience in the total sample (β = -0.040, 95\% CI: -0.075, -0.003, p = 0.030). Stratified analyses revealed this association was significant among men (β = -0.060, 95\% CI: -0.110, -0.009, p = 0.020), but not among women (β = -0.018, 95\% CI: -0.068, 0.030, p = 0.463). CONCLUSIONS: Greater residential distance to the nearest park was associated with lower resilience in adults, especially in men. These findings highlight the potential importance of urban green space accessibility for promoting mental well-being, underscoring the need to consider gender in public health research and interventions.
@article{marcilla-toribio_accessibility_2026,
abstract = {INTRODUCTION: While associations between greenness and mental health have been studied, resilience, understood as the ability to adapt positively to stress and adversity, has received less attention. This study examined the relationship between the distance to the nearest park and resilience, considering potential gender differences. METHODS: A cross-sectional study was conducted among 3,852 Spanish adults assigned to Primary Healthcare centers of nine autonomous communities. Resilience was assessed using the Connor-Davidson Resilience Scale. Unadjusted and adjusted differences in resilience and distance to the nearest park were assessed using Analysis of Variance, Analysis of Covariance, and multiple linear regression models in the total sample and stratified by sex. The covariates considered in this study were age, education, monthly income, marital status, perceived social support, and mental health. Sex was included as a covariate in analyses of the total sample. This study finally comprised 2,922 individuals, 52.0% women. The mean age of the participants was 53.6 years ± 10.9 SD. RESULTS: Participants living farther from parks (\textgreater 700 m) showed significantly lower resilience than those in the close (\textless 300 m; mean difference = 0.59, 95\% CI: 0.06, 1.11, p = 0.028) and medium (300 m-700 m; mean difference = 0.82, 95\% CI: 0.28, 1.35, p = 0.003) subgroups. Greater distance to the nearest park was inversely associated with resilience in the total sample (β = -0.040, 95\% CI: -0.075, -0.003, p = 0.030). Stratified analyses revealed this association was significant among men (β = -0.060, 95\% CI: -0.110, -0.009, p = 0.020), but not among women (β = -0.018, 95\% CI: -0.068, 0.030, p = 0.463). CONCLUSIONS: Greater residential distance to the nearest park was associated with lower resilience in adults, especially in men. These findings highlight the potential importance of urban green space accessibility for promoting mental well-being, underscoring the need to consider gender in public health research and interventions.},
author = {Marcilla-Toribio, Irene and Martinez-Andres, Maria and Gómez-Gómez, Irene and Miranda-de la Maza, Mónica and Sierra-Martínez, Leticia and Repiso-Gento, Irene and Castro-Rivero, Ana Belén and Méndez-López, Fátima and Bulilete, Oana and Fernández-Domínguez, María José and Martí-Lluch, Ruth and Ramos, Rafel and Zacarías-Pons, Lluís and Notario-Pacheco, Blanca},
journal = {BMC public health},
keywords = {grapp-caib},
month = {jun},
title = {Accessibility to urban parks and resilience among adults in Spain: gender inequalities from the DESVELA study},
year = 2026
}%0 Journal Article
%1 marcilla-toribio_accessibility_2026
%A Marcilla-Toribio, Irene
%A Martinez-Andres, Maria
%A Gómez-Gómez, Irene
%A Miranda-de la Maza, Mónica
%A Sierra-Martínez, Leticia
%A Repiso-Gento, Irene
%A Castro-Rivero, Ana Belén
%A Méndez-López, Fátima
%A Bulilete, Oana
%A Fernández-Domínguez, María José
%A Martí-Lluch, Ruth
%A Ramos, Rafel
%A Zacarías-Pons, Lluís
%A Notario-Pacheco, Blanca
%D 2026
%J BMC public health
%R 10.1186/s12889-026-27985-y
%T Accessibility to urban parks and resilience among adults in Spain: gender inequalities from the DESVELA study
%X INTRODUCTION: While associations between greenness and mental health have been studied, resilience, understood as the ability to adapt positively to stress and adversity, has received less attention. This study examined the relationship between the distance to the nearest park and resilience, considering potential gender differences. METHODS: A cross-sectional study was conducted among 3,852 Spanish adults assigned to Primary Healthcare centers of nine autonomous communities. Resilience was assessed using the Connor-Davidson Resilience Scale. Unadjusted and adjusted differences in resilience and distance to the nearest park were assessed using Analysis of Variance, Analysis of Covariance, and multiple linear regression models in the total sample and stratified by sex. The covariates considered in this study were age, education, monthly income, marital status, perceived social support, and mental health. Sex was included as a covariate in analyses of the total sample. This study finally comprised 2,922 individuals, 52.0% women. The mean age of the participants was 53.6 years ± 10.9 SD. RESULTS: Participants living farther from parks (\textgreater 700 m) showed significantly lower resilience than those in the close (\textless 300 m; mean difference = 0.59, 95\% CI: 0.06, 1.11, p = 0.028) and medium (300 m-700 m; mean difference = 0.82, 95\% CI: 0.28, 1.35, p = 0.003) subgroups. Greater distance to the nearest park was inversely associated with resilience in the total sample (β = -0.040, 95\% CI: -0.075, -0.003, p = 0.030). Stratified analyses revealed this association was significant among men (β = -0.060, 95\% CI: -0.110, -0.009, p = 0.020), but not among women (β = -0.018, 95\% CI: -0.068, 0.030, p = 0.463). CONCLUSIONS: Greater residential distance to the nearest park was associated with lower resilience in adults, especially in men. These findings highlight the potential importance of urban green space accessibility for promoting mental well-being, underscoring the need to consider gender in public health research and interventions. - AbstractBibTeXEndNoteDOIBibSonomyDownload1.Vicente-Herrero MT, Tárraga López PJ, Busquets-Cortés C, Rodas Cañellas L, López González Ángel A, Ramírez-Manent JI. Sex Differences in the Socioeconomic Gradient of Latent Cardiometabolic Phenotypes in a Working-Age Population from the Balearic Islands (Spain): A Population-Based Analysis. Metabolites. 2026 Jun.;16(6):422.BACKGROUND: Cardiometabolic diseases are shaped by complex interactions between biological and social determinants. While socioeconomic inequalities in cardiometabolic risk are well established, less is known about how these inequalities are distributed across multidimensional cardiometabolic phenotypes and whether they differ by sex. OBJECTIVE: We aimed to examine sex differences in the socioeconomic gradient of cardiometabolic phenotypes using latent class analysis in a working-age population. METHODS: A cross-sectional study was conducted in 3108 adults aged 18-65 years undergoing occupational health assessments in the Balearic Islands (Spain). Educational level was used as an indicator of socioeconomic position. Cardiometabolic risk was assessed using obesity, insulin resistance (METS-IR), metabolic dysfunction-associated steatotic liver disease (FLI), atherogenic index of plasma, and metabolic syndrome. Latent class analysis was applied to identify cardiometabolic phenotypes. Multinomial logistic regression models stratified by sex and interaction analyses were used to assess associations between educational level and class membership. Tests for linear trend and predicted probabilities were also estimated. RESULTS: Four cardiometabolic phenotypes were identified: low-risk (40.8\%), obesity-dominant (24.1\%), dysmetabolic (19.3\%), and high-risk multimorbid (15.8\%). A clear socioeconomic gradient was observed, with lower educational attainment associated with a higher likelihood of belonging to adverse cardiometabolic profiles. This gradient was stronger among women. For the high-risk multimorbid class, the relative risk ratio comparing low vs. high educational level was 1.82 (95\% CI 1.34-2.46) in men and 2.47 (95\% CI 1.68-3.64) in women (p for interaction = 0.012). A significant linear trend across educational levels was observed in both sexes (p for trend \textless 0.001). Predicted probabilities further confirmed a steeper increase in high-risk profiles among women with lower educational attainment. CONCLUSIONS: Cardiometabolic risk is structured into distinct phenotypic profiles that are socially patterned. Socioeconomic inequalities are strongly associated with adverse cardiometabolic phenotypes, with a more pronounced gradient among women. These findings highlight the need for gender-sensitive strategies addressing social determinants to reduce cardiometabolic health inequalities.
@article{vicente-herrero_sex_2026,
abstract = {BACKGROUND: Cardiometabolic diseases are shaped by complex interactions between biological and social determinants. While socioeconomic inequalities in cardiometabolic risk are well established, less is known about how these inequalities are distributed across multidimensional cardiometabolic phenotypes and whether they differ by sex. OBJECTIVE: We aimed to examine sex differences in the socioeconomic gradient of cardiometabolic phenotypes using latent class analysis in a working-age population. METHODS: A cross-sectional study was conducted in 3108 adults aged 18-65 years undergoing occupational health assessments in the Balearic Islands (Spain). Educational level was used as an indicator of socioeconomic position. Cardiometabolic risk was assessed using obesity, insulin resistance (METS-IR), metabolic dysfunction-associated steatotic liver disease (FLI), atherogenic index of plasma, and metabolic syndrome. Latent class analysis was applied to identify cardiometabolic phenotypes. Multinomial logistic regression models stratified by sex and interaction analyses were used to assess associations between educational level and class membership. Tests for linear trend and predicted probabilities were also estimated. RESULTS: Four cardiometabolic phenotypes were identified: low-risk (40.8\%), obesity-dominant (24.1\%), dysmetabolic (19.3\%), and high-risk multimorbid (15.8\%). A clear socioeconomic gradient was observed, with lower educational attainment associated with a higher likelihood of belonging to adverse cardiometabolic profiles. This gradient was stronger among women. For the high-risk multimorbid class, the relative risk ratio comparing low vs. high educational level was 1.82 (95\% CI 1.34-2.46) in men and 2.47 (95\% CI 1.68-3.64) in women (p for interaction = 0.012). A significant linear trend across educational levels was observed in both sexes (p for trend \textless 0.001). Predicted probabilities further confirmed a steeper increase in high-risk profiles among women with lower educational attainment. CONCLUSIONS: Cardiometabolic risk is structured into distinct phenotypic profiles that are socially patterned. Socioeconomic inequalities are strongly associated with adverse cardiometabolic phenotypes, with a more pronounced gradient among women. These findings highlight the need for gender-sensitive strategies addressing social determinants to reduce cardiometabolic health inequalities.},
author = {Vicente-Herrero, María Teófila and Tárraga López, Pedro J. and Busquets-Cortés, Carla and Rodas Cañellas, Lluis and López González, Ángel Arturo and Ramírez-Manent, José Ignacio},
journal = {Metabolites},
keywords = {grapp-caib},
month = {jun},
number = 6,
pages = 422,
title = {Sex Differences in the Socioeconomic Gradient of Latent Cardiometabolic Phenotypes in a Working-Age Population from the Balearic Islands (Spain): A Population-Based Analysis},
volume = 16,
year = 2026
}%0 Journal Article
%1 vicente-herrero_sex_2026
%A Vicente-Herrero, María Teófila
%A Tárraga López, Pedro J.
%A Busquets-Cortés, Carla
%A Rodas Cañellas, Lluis
%A López González, Ángel Arturo
%A Ramírez-Manent, José Ignacio
%D 2026
%J Metabolites
%N 6
%P 422
%R 10.3390/metabo16060422
%T Sex Differences in the Socioeconomic Gradient of Latent Cardiometabolic Phenotypes in a Working-Age Population from the Balearic Islands (Spain): A Population-Based Analysis
%V 16
%X BACKGROUND: Cardiometabolic diseases are shaped by complex interactions between biological and social determinants. While socioeconomic inequalities in cardiometabolic risk are well established, less is known about how these inequalities are distributed across multidimensional cardiometabolic phenotypes and whether they differ by sex. OBJECTIVE: We aimed to examine sex differences in the socioeconomic gradient of cardiometabolic phenotypes using latent class analysis in a working-age population. METHODS: A cross-sectional study was conducted in 3108 adults aged 18-65 years undergoing occupational health assessments in the Balearic Islands (Spain). Educational level was used as an indicator of socioeconomic position. Cardiometabolic risk was assessed using obesity, insulin resistance (METS-IR), metabolic dysfunction-associated steatotic liver disease (FLI), atherogenic index of plasma, and metabolic syndrome. Latent class analysis was applied to identify cardiometabolic phenotypes. Multinomial logistic regression models stratified by sex and interaction analyses were used to assess associations between educational level and class membership. Tests for linear trend and predicted probabilities were also estimated. RESULTS: Four cardiometabolic phenotypes were identified: low-risk (40.8\%), obesity-dominant (24.1\%), dysmetabolic (19.3\%), and high-risk multimorbid (15.8\%). A clear socioeconomic gradient was observed, with lower educational attainment associated with a higher likelihood of belonging to adverse cardiometabolic profiles. This gradient was stronger among women. For the high-risk multimorbid class, the relative risk ratio comparing low vs. high educational level was 1.82 (95\% CI 1.34-2.46) in men and 2.47 (95\% CI 1.68-3.64) in women (p for interaction = 0.012). A significant linear trend across educational levels was observed in both sexes (p for trend \textless 0.001). Predicted probabilities further confirmed a steeper increase in high-risk profiles among women with lower educational attainment. CONCLUSIONS: Cardiometabolic risk is structured into distinct phenotypic profiles that are socially patterned. Socioeconomic inequalities are strongly associated with adverse cardiometabolic phenotypes, with a more pronounced gradient among women. These findings highlight the need for gender-sensitive strategies addressing social determinants to reduce cardiometabolic health inequalities. - AbstractBibTeXEndNoteDOIBibSonomyDownload1.Ramírez-Gallegos A, Tárraga López PJ, Ramírez Manent JI, Del Amo Ríos A, Coll-Campayo I, García-Samuelson M, López González Ángel A. Insulin resistance risk in domestic workers: a sex-specific assessment using TyG, METS-IR, and SPISE indices in a large Mediterranean cohort. Nutricion Hospitalaria. 2026 Feb.;.INTRODUCTION: insulin resistance is a key contributor to cardiometabolic diseases, yet it remains understudied among domestic workers. This study evaluates the usefulness of the TyG, METS-IR, and SPISE indices as non-invasive tools to estimate insulin resistance risk in this population. BACKGROUND: insulin resistance (IR) is a major precursor of type 2 diabetes and cardiovascular disease, yet its prevalence and associated factors remain underexplored in informal labor sectors. This study aimed to evaluate the prevalence of elevated IR scores using validated non-invasive indices (TyG, METS-IR, and SPISE) and their association with sociodemographic and lifestyle variables in a large cohort of Spanish female domestic workers. METHODS: a cross-sectional analysis was conducted using health examination data from 6,321 adult female domestic workers in Spain. IR was assessed using three surrogate indices: the triglyceride-glucose index (TyG), the metabolic score for insulin resistance (METS-IR), and the single-point insulin sensitivity estimator (SPISE). Participants were classified into quartiles based on each index. Associations with age, smoking status, physical activity (IPAQ-SF), and adherence to the Mediterranean diet were evaluated using logistic regression models adjusted for potential confounders. RESULTS: a high proportion of participants were in the highest-risk quartile for TyG (25.3 \%), METS-IR (24.9 \%), and the lowest-risk quartile for SPISE (26.8 \%). Older age, smoking, low physical activity, and low Mediterranean diet adherence were significantly associated with unfavorable IR profiles across all three indices. Multivariate logistic regression showed that physical inactivity was strongly associated with high TyG (OR = 3.12), high METS-IR (OR = 3.28), and low SPISE (OR = 4.07) scores. The prevalence of high IR scores increased with age and was notably higher among smokers and individuals with poor dietary habits. CONCLUSIONS: this study reveals a concerning prevalence of elevated insulin resistance among female domestic workers in Spain and identifies modifiable lifestyle factors associated with metabolic risk. The use of simple, cost-effective indices such as TyG, METS-IR, and SPISE offers a valuable opportunity for early identification of cardiometabolic risk in underserved labour populations. Targeted interventions promoting physical activity, dietary improvement, and smoking cessation are urgently needed to reduce long-term health disparities in this occupational group.
@article{ramirez-gallegos_insulin_2026,
abstract = {INTRODUCTION: insulin resistance is a key contributor to cardiometabolic diseases, yet it remains understudied among domestic workers. This study evaluates the usefulness of the TyG, METS-IR, and SPISE indices as non-invasive tools to estimate insulin resistance risk in this population. BACKGROUND: insulin resistance (IR) is a major precursor of type 2 diabetes and cardiovascular disease, yet its prevalence and associated factors remain underexplored in informal labor sectors. This study aimed to evaluate the prevalence of elevated IR scores using validated non-invasive indices (TyG, METS-IR, and SPISE) and their association with sociodemographic and lifestyle variables in a large cohort of Spanish female domestic workers. METHODS: a cross-sectional analysis was conducted using health examination data from 6,321 adult female domestic workers in Spain. IR was assessed using three surrogate indices: the triglyceride-glucose index (TyG), the metabolic score for insulin resistance (METS-IR), and the single-point insulin sensitivity estimator (SPISE). Participants were classified into quartiles based on each index. Associations with age, smoking status, physical activity (IPAQ-SF), and adherence to the Mediterranean diet were evaluated using logistic regression models adjusted for potential confounders. RESULTS: a high proportion of participants were in the highest-risk quartile for TyG (25.3 \%), METS-IR (24.9 \%), and the lowest-risk quartile for SPISE (26.8 \%). Older age, smoking, low physical activity, and low Mediterranean diet adherence were significantly associated with unfavorable IR profiles across all three indices. Multivariate logistic regression showed that physical inactivity was strongly associated with high TyG (OR = 3.12), high METS-IR (OR = 3.28), and low SPISE (OR = 4.07) scores. The prevalence of high IR scores increased with age and was notably higher among smokers and individuals with poor dietary habits. CONCLUSIONS: this study reveals a concerning prevalence of elevated insulin resistance among female domestic workers in Spain and identifies modifiable lifestyle factors associated with metabolic risk. The use of simple, cost-effective indices such as TyG, METS-IR, and SPISE offers a valuable opportunity for early identification of cardiometabolic risk in underserved labour populations. Targeted interventions promoting physical activity, dietary improvement, and smoking cessation are urgently needed to reduce long-term health disparities in this occupational group.},
author = {Ramírez-Gallegos, Alberto and Tárraga López, Pedro Juan and Ramírez Manent, José Ignacio and Del Amo Ríos, Andrea and Coll-Campayo, Irene and García-Samuelson, Miguel and López González, Ángel Arturo},
journal = {Nutricion Hospitalaria},
keywords = {grapp-caib},
month = {feb},
title = {Insulin resistance risk in domestic workers: a sex-specific assessment using TyG, METS-IR, and SPISE indices in a large Mediterranean cohort},
year = 2026
}%0 Journal Article
%1 ramirez-gallegos_insulin_2026
%A Ramírez-Gallegos, Alberto
%A Tárraga López, Pedro Juan
%A Ramírez Manent, José Ignacio
%A Del Amo Ríos, Andrea
%A Coll-Campayo, Irene
%A García-Samuelson, Miguel
%A López González, Ángel Arturo
%D 2026
%J Nutricion Hospitalaria
%R 10.20960/nh.06313
%T Insulin resistance risk in domestic workers: a sex-specific assessment using TyG, METS-IR, and SPISE indices in a large Mediterranean cohort
%X INTRODUCTION: insulin resistance is a key contributor to cardiometabolic diseases, yet it remains understudied among domestic workers. This study evaluates the usefulness of the TyG, METS-IR, and SPISE indices as non-invasive tools to estimate insulin resistance risk in this population. BACKGROUND: insulin resistance (IR) is a major precursor of type 2 diabetes and cardiovascular disease, yet its prevalence and associated factors remain underexplored in informal labor sectors. This study aimed to evaluate the prevalence of elevated IR scores using validated non-invasive indices (TyG, METS-IR, and SPISE) and their association with sociodemographic and lifestyle variables in a large cohort of Spanish female domestic workers. METHODS: a cross-sectional analysis was conducted using health examination data from 6,321 adult female domestic workers in Spain. IR was assessed using three surrogate indices: the triglyceride-glucose index (TyG), the metabolic score for insulin resistance (METS-IR), and the single-point insulin sensitivity estimator (SPISE). Participants were classified into quartiles based on each index. Associations with age, smoking status, physical activity (IPAQ-SF), and adherence to the Mediterranean diet were evaluated using logistic regression models adjusted for potential confounders. RESULTS: a high proportion of participants were in the highest-risk quartile for TyG (25.3 \%), METS-IR (24.9 \%), and the lowest-risk quartile for SPISE (26.8 \%). Older age, smoking, low physical activity, and low Mediterranean diet adherence were significantly associated with unfavorable IR profiles across all three indices. Multivariate logistic regression showed that physical inactivity was strongly associated with high TyG (OR = 3.12), high METS-IR (OR = 3.28), and low SPISE (OR = 4.07) scores. The prevalence of high IR scores increased with age and was notably higher among smokers and individuals with poor dietary habits. CONCLUSIONS: this study reveals a concerning prevalence of elevated insulin resistance among female domestic workers in Spain and identifies modifiable lifestyle factors associated with metabolic risk. The use of simple, cost-effective indices such as TyG, METS-IR, and SPISE offers a valuable opportunity for early identification of cardiometabolic risk in underserved labour populations. Targeted interventions promoting physical activity, dietary improvement, and smoking cessation are urgently needed to reduce long-term health disparities in this occupational group. - AbstractBibTeXEndNoteDOIBibSonomyDownload1.Riera-Serra P, Serrano-Ripoll MJ, Fiol deRoque MA, García-Pazo P, Bennasar-Veny M, Yánez-Juan A, Leiva-Rus A, Ginard-Puigserver M, García-Toro M, Sitges C, Balle M, Gervilla E, Gonzalez-Garcia X, García-Buades ME, Blanes MW, Zamanillo-Campos R, Andreu-Rodrigo P, Ricci-Cabello I. Evaluation of the effectiveness of SOM-RIU, a multifaceted, school-based, suicide prevention intervention targeted to Spanish adolescents: study protocol for a cluster-randomised controlled trial. BMC psychiatry. 2026 Jan.;26(1):56.BACKGROUND: Adolescent suicide is a major public health concern and the third leading cause of death among young people worldwide. Schools are widely recognized as effective settings for universal mental health promotion and suicide prevention. This study aims to evaluate the effectiveness of SOM-RIU, a multifaceted school-based intervention involving pupils and gatekeepers (teachers and parents) in preventing suicidal behaviour and promoting adolescent mental health. METHODS: We will conduct a six-month, two-arm, cluster-randomised controlled trial. We will recruit 2,280 pupils from 114 classrooms in 38 secondary schools across the Balearic Islands (Spain). Eligible pupils will be aged 12–16 and enrolled in the 2nd and 3rd years of compulsory secondary education. Schools will be randomly assigned (1:1) to either the intervention or control group. Schools in the intervention group will implement the SOM-RIU programme, which includes four weekly psychoeducational sessions for pupils, delivered by trained educational psychologists. These sessions focus on mental health literacy, emotional regulation, suicide risk detection and management, and help-seeking strategies. In parallel, gatekeepers (teachers and parents) will receive a digital educational co-intervention consisting in four multimedia modules to strengthen their role in suicide prevention. Schools in the control group will receive a minimal intervention consisting of educational posters on mental health and suicide prevention displayed within school premises. The primary outcome will be suicidal ideation (Paykel Suicide Scale). Secondary outcomes will include suicide attempts, depression symptoms, well-being, self-harm, substance use, internet addiction, bullying, and cognitive disconnection. Teachers and parents will report on suicide-related knowledge, self-efficacy, and student referrals. Data will be collected at baseline and six-month follow-up. Analyses will be conducted using generalized linear mixed models to account for clustering, and multiple imputation will be used for missing data. A qualitative process evaluation will explore implementation, acceptability, and perceived impact of the intervention, while also examining contextual factors and potential mechanisms of action that may have influenced the outcomes. DISCUSSION: This trial will generate evidence on the effectiveness of multifaceted, school-based suicide prevention interventions for adolescents. If effective, the SOM-RIU programme could serve as a practical model for enhancing mental health support within educational settings in Spain. TRIAL REGISTRATION: NCT06996054 (clinicaltrials.gov). Registration date: 2025-05-30. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12888-025-07570-0.
@article{riera-serra_evaluation_2026,
abstract = {BACKGROUND: Adolescent suicide is a major public health concern and the third leading cause of death among young people worldwide. Schools are widely recognized as effective settings for universal mental health promotion and suicide prevention. This study aims to evaluate the effectiveness of SOM-RIU, a multifaceted school-based intervention involving pupils and gatekeepers (teachers and parents) in preventing suicidal behaviour and promoting adolescent mental health. METHODS: We will conduct a six-month, two-arm, cluster-randomised controlled trial. We will recruit 2,280 pupils from 114 classrooms in 38 secondary schools across the Balearic Islands (Spain). Eligible pupils will be aged 12–16 and enrolled in the 2nd and 3rd years of compulsory secondary education. Schools will be randomly assigned (1:1) to either the intervention or control group. Schools in the intervention group will implement the SOM-RIU programme, which includes four weekly psychoeducational sessions for pupils, delivered by trained educational psychologists. These sessions focus on mental health literacy, emotional regulation, suicide risk detection and management, and help-seeking strategies. In parallel, gatekeepers (teachers and parents) will receive a digital educational co-intervention consisting in four multimedia modules to strengthen their role in suicide prevention. Schools in the control group will receive a minimal intervention consisting of educational posters on mental health and suicide prevention displayed within school premises. The primary outcome will be suicidal ideation (Paykel Suicide Scale). Secondary outcomes will include suicide attempts, depression symptoms, well-being, self-harm, substance use, internet addiction, bullying, and cognitive disconnection. Teachers and parents will report on suicide-related knowledge, self-efficacy, and student referrals. Data will be collected at baseline and six-month follow-up. Analyses will be conducted using generalized linear mixed models to account for clustering, and multiple imputation will be used for missing data. A qualitative process evaluation will explore implementation, acceptability, and perceived impact of the intervention, while also examining contextual factors and potential mechanisms of action that may have influenced the outcomes. DISCUSSION: This trial will generate evidence on the effectiveness of multifaceted, school-based suicide prevention interventions for adolescents. If effective, the SOM-RIU programme could serve as a practical model for enhancing mental health support within educational settings in Spain. TRIAL REGISTRATION: NCT06996054 (clinicaltrials.gov). Registration date: 2025-05-30. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12888-025-07570-0.},
author = {Riera-Serra, Pau and Serrano-Ripoll, Maria Jesús and Fiol deRoque, Maria Antònia and García-Pazo, Patricia and Bennasar-Veny, Miquel and Yánez-Juan, Aina and Leiva-Rus, Alfonso and Ginard-Puigserver, Miquel and García-Toro, Mauro and Sitges, Carolina and Balle, Maria and Gervilla, Elena and Gonzalez-Garcia, Xandra and García-Buades, M. Esther and Blanes, Maria Wei and Zamanillo-Campos, Rocío and Andreu-Rodrigo, Pilar and Ricci-Cabello, Ignacio},
journal = {BMC psychiatry},
keywords = {grapp-caib},
month = {jan},
number = 1,
pages = 56,
title = {Evaluation of the effectiveness of SOM-RIU, a multifaceted, school-based, suicide prevention intervention targeted to Spanish adolescents: study protocol for a cluster-randomised controlled trial},
volume = 26,
year = 2026
}%0 Journal Article
%1 riera-serra_evaluation_2026
%A Riera-Serra, Pau
%A Serrano-Ripoll, Maria Jesús
%A Fiol deRoque, Maria Antònia
%A García-Pazo, Patricia
%A Bennasar-Veny, Miquel
%A Yánez-Juan, Aina
%A Leiva-Rus, Alfonso
%A Ginard-Puigserver, Miquel
%A García-Toro, Mauro
%A Sitges, Carolina
%A Balle, Maria
%A Gervilla, Elena
%A Gonzalez-Garcia, Xandra
%A García-Buades, M. Esther
%A Blanes, Maria Wei
%A Zamanillo-Campos, Rocío
%A Andreu-Rodrigo, Pilar
%A Ricci-Cabello, Ignacio
%D 2026
%J BMC psychiatry
%N 1
%P 56
%R 10.1186/s12888-025-07570-0
%T Evaluation of the effectiveness of SOM-RIU, a multifaceted, school-based, suicide prevention intervention targeted to Spanish adolescents: study protocol for a cluster-randomised controlled trial
%V 26
%X BACKGROUND: Adolescent suicide is a major public health concern and the third leading cause of death among young people worldwide. Schools are widely recognized as effective settings for universal mental health promotion and suicide prevention. This study aims to evaluate the effectiveness of SOM-RIU, a multifaceted school-based intervention involving pupils and gatekeepers (teachers and parents) in preventing suicidal behaviour and promoting adolescent mental health. METHODS: We will conduct a six-month, two-arm, cluster-randomised controlled trial. We will recruit 2,280 pupils from 114 classrooms in 38 secondary schools across the Balearic Islands (Spain). Eligible pupils will be aged 12–16 and enrolled in the 2nd and 3rd years of compulsory secondary education. Schools will be randomly assigned (1:1) to either the intervention or control group. Schools in the intervention group will implement the SOM-RIU programme, which includes four weekly psychoeducational sessions for pupils, delivered by trained educational psychologists. These sessions focus on mental health literacy, emotional regulation, suicide risk detection and management, and help-seeking strategies. In parallel, gatekeepers (teachers and parents) will receive a digital educational co-intervention consisting in four multimedia modules to strengthen their role in suicide prevention. Schools in the control group will receive a minimal intervention consisting of educational posters on mental health and suicide prevention displayed within school premises. The primary outcome will be suicidal ideation (Paykel Suicide Scale). Secondary outcomes will include suicide attempts, depression symptoms, well-being, self-harm, substance use, internet addiction, bullying, and cognitive disconnection. Teachers and parents will report on suicide-related knowledge, self-efficacy, and student referrals. Data will be collected at baseline and six-month follow-up. Analyses will be conducted using generalized linear mixed models to account for clustering, and multiple imputation will be used for missing data. A qualitative process evaluation will explore implementation, acceptability, and perceived impact of the intervention, while also examining contextual factors and potential mechanisms of action that may have influenced the outcomes. DISCUSSION: This trial will generate evidence on the effectiveness of multifaceted, school-based suicide prevention interventions for adolescents. If effective, the SOM-RIU programme could serve as a practical model for enhancing mental health support within educational settings in Spain. TRIAL REGISTRATION: NCT06996054 (clinicaltrials.gov). Registration date: 2025-05-30. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12888-025-07570-0. - AbstractBibTeXEndNoteDOIBibSonomyDownload1.Vidal-Thomàs MC, Ripoll Amengual J, Cacereño Jiménez MB, Sempere Andrés P, Urbina Sampedro E, March Llull S. Qualitative evaluation of a community intervention in educational centres: Opinion of the professionals involved. Anales Del Sistema Sanitario De Navarra. 2026 Apr.;49(1):e1150.BACKGROUND: Consulta Joven is a community intervention developed in primary care to address adolescents´ health needs. It offers open health consultations in secondary schools within a context of trust and confidentiality and is complemented by additional health promotion activities. This study explores the perceptions of professionals involved in the programme regarding challenges and key elements influencing its implementation. METHODS: A qualitative, descriptive-interpretive approach study was conducted in primary care in Mallorca (Spain) in 2017. Participants were recruited by Consulta Joven coordinators using purposive theoretical sampling. Three focus groups were conducted with ten nurses, four physicians, and six teachers. Two researchers independently coded transcripts using a general inductive approach. Categories were developed through content analysis and refined through team discussion. RESULTS: Four categories emerged: Perceived value and usefulness of Consulta Joven, Barriers to implementation, Key elements for programme development, and Proposals for improvement. Participants described Consulta Joven as an effective strategy to reach adolescents, promote healthy behaviours, and identify health problems before they seek medical care. Trust and confidentiality are highlighted as essential for its success, along with intersectoral collaboration with community stakeholders. Conclusions, Professionals perceive Consulta Joven as a useful intervention to adolescent health promotion. Strengthening institutional support and collaboration between the health and education sectors, and introducing the programme at earlier educational stages, may enhance its preventive impact.
@article{vidal-thomas_qualitative_2026,
abstract = {BACKGROUND: Consulta Joven is a community intervention developed in primary care to address adolescents´ health needs. It offers open health consultations in secondary schools within a context of trust and confidentiality and is complemented by additional health promotion activities. This study explores the perceptions of professionals involved in the programme regarding challenges and key elements influencing its implementation. METHODS: A qualitative, descriptive-interpretive approach study was conducted in primary care in Mallorca (Spain) in 2017. Participants were recruited by Consulta Joven coordinators using purposive theoretical sampling. Three focus groups were conducted with ten nurses, four physicians, and six teachers. Two researchers independently coded transcripts using a general inductive approach. Categories were developed through content analysis and refined through team discussion. RESULTS: Four categories emerged: Perceived value and usefulness of Consulta Joven, Barriers to implementation, Key elements for programme development, and Proposals for improvement. Participants described Consulta Joven as an effective strategy to reach adolescents, promote healthy behaviours, and identify health problems before they seek medical care. Trust and confidentiality are highlighted as essential for its success, along with intersectoral collaboration with community stakeholders. Conclusions, Professionals perceive Consulta Joven as a useful intervention to adolescent health promotion. Strengthening institutional support and collaboration between the health and education sectors, and introducing the programme at earlier educational stages, may enhance its preventive impact.},
author = {Vidal-Thomàs, Maria Clara and Ripoll Amengual, Joana and Cacereño Jiménez, Maria Belén and Sempere Andrés, Pau and Urbina Sampedro, Elisa and March Llull, Sebastiá},
journal = {Anales Del Sistema Sanitario De Navarra},
keywords = {grapp-caib},
month = {apr},
number = 1,
pages = {e1150},
title = {Qualitative evaluation of a community intervention in educational centres: Opinion of the professionals involved},
volume = 49,
year = 2026
}%0 Journal Article
%1 vidal-thomas_qualitative_2026
%A Vidal-Thomàs, Maria Clara
%A Ripoll Amengual, Joana
%A Cacereño Jiménez, Maria Belén
%A Sempere Andrés, Pau
%A Urbina Sampedro, Elisa
%A March Llull, Sebastiá
%D 2026
%J Anales Del Sistema Sanitario De Navarra
%N 1
%P e1150
%R 10.23938/ASSN.1150
%T Qualitative evaluation of a community intervention in educational centres: Opinion of the professionals involved
%V 49
%X BACKGROUND: Consulta Joven is a community intervention developed in primary care to address adolescents´ health needs. It offers open health consultations in secondary schools within a context of trust and confidentiality and is complemented by additional health promotion activities. This study explores the perceptions of professionals involved in the programme regarding challenges and key elements influencing its implementation. METHODS: A qualitative, descriptive-interpretive approach study was conducted in primary care in Mallorca (Spain) in 2017. Participants were recruited by Consulta Joven coordinators using purposive theoretical sampling. Three focus groups were conducted with ten nurses, four physicians, and six teachers. Two researchers independently coded transcripts using a general inductive approach. Categories were developed through content analysis and refined through team discussion. RESULTS: Four categories emerged: Perceived value and usefulness of Consulta Joven, Barriers to implementation, Key elements for programme development, and Proposals for improvement. Participants described Consulta Joven as an effective strategy to reach adolescents, promote healthy behaviours, and identify health problems before they seek medical care. Trust and confidentiality are highlighted as essential for its success, along with intersectoral collaboration with community stakeholders. Conclusions, Professionals perceive Consulta Joven as a useful intervention to adolescent health promotion. Strengthening institutional support and collaboration between the health and education sectors, and introducing the programme at earlier educational stages, may enhance its preventive impact. - AbstractBibTeXEndNoteDOIBibSonomyDownload1.Sepúlveda LG, López PJT, Vicente-Herrero MT, Cañellas LR, González Ángel AL, Ramírez-Manent JI. Work engagement and its association with obesity and lifestyle factors in a large working population: a sex-stratified analysis. AIMS public health. 2026;13(1):306-2.BACKGROUND: Work engagement, defined as a positive, fulfilling psychological state characterized by vigor, dedication, and absorption, has been proposed as a potential protective factor for cardiometabolic health. However, its relationship with obesity-particularly visceral adiposity-remains poorly understood. This study aimed to examine the association between work engagement and different adiposity indicators and to explore the mediating role of lifestyle behaviors in a large sample of Spanish workers. METHODS: A cross-sectional analysis was conducted among employees attending occupational health evaluations between 2021 and 2022. After applying inclusion and exclusion criteria, 111,612 participants (60.1\% men) were included. Work engagement was assessed using the Utrecht Work Engagement Scale (UWES-9) and categorized into very high, high, moderate, and low levels. Obesity and adiposity were evaluated through BMI, waist-to-height ratio (WtHR), CUN-BAE, and METS-VF. Logistic regression models estimated odds ratios (OR) and 95% confidence intervals (CI) for obesity outcomes across engagement levels, with progressive adjustment for sociodemographic and lifestyle covariates. Mediation analyses evaluated the indirect effects of physical activity, Mediterranean diet adherence, and smoking. RESULTS: Lower engagement levels were independently associated with higher odds of adiposity across all indices, particularly visceral fat (METS-VF). Participants with low engagement had an adjusted OR = 2.59 (95\% CI 2.34-2.85) for high METS-VF compared with those with very high engagement (p-trend \textless 0.001). Approximately 40% of this association was mediated by lifestyle factors, mainly physical activity. The results remained robust across sensitivity analyses, including nonlinear modeling, imputation, and cluster adjustment. CONCLUSIONS: Lower work engagement is strongly associated with increased visceral adiposity among Spanish workers, partly through behavioral mechanisms. Enhancing engagement may represent an effective psychosocial strategy to improve both psychological well-being and metabolic health in occupational settings.
@article{sepulveda_work_2026,
abstract = {BACKGROUND: Work engagement, defined as a positive, fulfilling psychological state characterized by vigor, dedication, and absorption, has been proposed as a potential protective factor for cardiometabolic health. However, its relationship with obesity-particularly visceral adiposity-remains poorly understood. This study aimed to examine the association between work engagement and different adiposity indicators and to explore the mediating role of lifestyle behaviors in a large sample of Spanish workers. METHODS: A cross-sectional analysis was conducted among employees attending occupational health evaluations between 2021 and 2022. After applying inclusion and exclusion criteria, 111,612 participants (60.1\% men) were included. Work engagement was assessed using the Utrecht Work Engagement Scale (UWES-9) and categorized into very high, high, moderate, and low levels. Obesity and adiposity were evaluated through BMI, waist-to-height ratio (WtHR), CUN-BAE, and METS-VF. Logistic regression models estimated odds ratios (OR) and 95% confidence intervals (CI) for obesity outcomes across engagement levels, with progressive adjustment for sociodemographic and lifestyle covariates. Mediation analyses evaluated the indirect effects of physical activity, Mediterranean diet adherence, and smoking. RESULTS: Lower engagement levels were independently associated with higher odds of adiposity across all indices, particularly visceral fat (METS-VF). Participants with low engagement had an adjusted OR = 2.59 (95\% CI 2.34-2.85) for high METS-VF compared with those with very high engagement (p-trend \textless 0.001). Approximately 40% of this association was mediated by lifestyle factors, mainly physical activity. The results remained robust across sensitivity analyses, including nonlinear modeling, imputation, and cluster adjustment. CONCLUSIONS: Lower work engagement is strongly associated with increased visceral adiposity among Spanish workers, partly through behavioral mechanisms. Enhancing engagement may represent an effective psychosocial strategy to improve both psychological well-being and metabolic health in occupational settings.},
author = {Sepúlveda, Lucía Garrido and López, Pedro Juan Tárraga and Vicente-Herrero, María Teófila and Cañellas, Lluis Rodas and González, Ángel Arturo López and Ramírez-Manent, José Ignacio},
journal = {AIMS public health},
keywords = {grapp-caib},
number = 1,
pages = {306--326},
title = {Work engagement and its association with obesity and lifestyle factors in a large working population: a sex-stratified analysis},
volume = 13,
year = 2026
}%0 Journal Article
%1 sepulveda_work_2026
%A Sepúlveda, Lucía Garrido
%A López, Pedro Juan Tárraga
%A Vicente-Herrero, María Teófila
%A Cañellas, Lluis Rodas
%A González, Ángel Arturo López
%A Ramírez-Manent, José Ignacio
%D 2026
%J AIMS public health
%N 1
%P 306--326
%R 10.3934/publichealth.2026017
%T Work engagement and its association with obesity and lifestyle factors in a large working population: a sex-stratified analysis
%V 13
%X BACKGROUND: Work engagement, defined as a positive, fulfilling psychological state characterized by vigor, dedication, and absorption, has been proposed as a potential protective factor for cardiometabolic health. However, its relationship with obesity-particularly visceral adiposity-remains poorly understood. This study aimed to examine the association between work engagement and different adiposity indicators and to explore the mediating role of lifestyle behaviors in a large sample of Spanish workers. METHODS: A cross-sectional analysis was conducted among employees attending occupational health evaluations between 2021 and 2022. After applying inclusion and exclusion criteria, 111,612 participants (60.1\% men) were included. Work engagement was assessed using the Utrecht Work Engagement Scale (UWES-9) and categorized into very high, high, moderate, and low levels. Obesity and adiposity were evaluated through BMI, waist-to-height ratio (WtHR), CUN-BAE, and METS-VF. Logistic regression models estimated odds ratios (OR) and 95% confidence intervals (CI) for obesity outcomes across engagement levels, with progressive adjustment for sociodemographic and lifestyle covariates. Mediation analyses evaluated the indirect effects of physical activity, Mediterranean diet adherence, and smoking. RESULTS: Lower engagement levels were independently associated with higher odds of adiposity across all indices, particularly visceral fat (METS-VF). Participants with low engagement had an adjusted OR = 2.59 (95\% CI 2.34-2.85) for high METS-VF compared with those with very high engagement (p-trend \textless 0.001). Approximately 40% of this association was mediated by lifestyle factors, mainly physical activity. The results remained robust across sensitivity analyses, including nonlinear modeling, imputation, and cluster adjustment. CONCLUSIONS: Lower work engagement is strongly associated with increased visceral adiposity among Spanish workers, partly through behavioral mechanisms. Enhancing engagement may represent an effective psychosocial strategy to improve both psychological well-being and metabolic health in occupational settings. -
AbstractBibTeXEndNoteDOIBibSonomy1.García Samuelsson M, Tárraga López PJ, López González Ángel A, Busquets-Cortés C, Obrador de Hevia J, Ramírez Manent JI. Lipid profile and atherogenic risk in metabolically healthy and unhealthy obese individuals: A cohort analysis by sex and sociodemographic factors. Clinica E Investigacion En Arteriosclerosis: Publicacion Oficial De La Sociedad Espanola De Arteriosclerosis. 2026;38(3):500840.OBJECTIVE: To analyze lipid profiles and sociodemographic factors associated with atherogenic risk in obese workers classified as metabolically healthy (MHO) or unhealthy (MNHO). METHODS: Cross-sectional study of 68,884 obese workers. Atherogenic lipid indices (total cholesterol/HDL-c, LDL-c/HDL-c, triglycerides/HDL-c) and prevalence of atherogenic dyslipidemia were assessed. Multinomial logistic regression identified factors linked to lipid risk. RESULTS: MNHO individuals exhibited significantly higher atherogenic indices across sexes and diagnostic criteria. Atherogenic dyslipidemia and lipid triad were more prevalent in MNHO. Male sex, older age, lower educational level, lower social class, physical inactivity, low adherence to the Mediterranean diet, and smoking were associated with higher lipid risk. CONCLUSION: Although MHO individuals show a more favorable lipid profile than MNHO, this advantage weakens with less stringent definitions. Sociodemographic and lifestyle factors strongly modulate atherogenic risk.
@article{garcia_samuelsson_lipid_2026,
abstract = {OBJECTIVE: To analyze lipid profiles and sociodemographic factors associated with atherogenic risk in obese workers classified as metabolically healthy (MHO) or unhealthy (MNHO). METHODS: Cross-sectional study of 68,884 obese workers. Atherogenic lipid indices (total cholesterol/HDL-c, LDL-c/HDL-c, triglycerides/HDL-c) and prevalence of atherogenic dyslipidemia were assessed. Multinomial logistic regression identified factors linked to lipid risk. RESULTS: MNHO individuals exhibited significantly higher atherogenic indices across sexes and diagnostic criteria. Atherogenic dyslipidemia and lipid triad were more prevalent in MNHO. Male sex, older age, lower educational level, lower social class, physical inactivity, low adherence to the Mediterranean diet, and smoking were associated with higher lipid risk. CONCLUSION: Although MHO individuals show a more favorable lipid profile than MNHO, this advantage weakens with less stringent definitions. Sociodemographic and lifestyle factors strongly modulate atherogenic risk.},
author = {García Samuelsson, Miguel and Tárraga López, Pedro Juan and López González, Ángel Arturo and Busquets-Cortés, Carla and Obrador de Hevia, Joan and Ramírez Manent, José Ignacio},
journal = {Clinica E Investigacion En Arteriosclerosis: Publicacion Oficial De La Sociedad Espanola De Arteriosclerosis},
keywords = {grapp-caib},
number = 3,
pages = 500840,
title = {Lipid profile and atherogenic risk in metabolically healthy and unhealthy obese individuals: A cohort analysis by sex and sociodemographic factors},
volume = 38,
year = 2026
}%0 Journal Article
%1 garcia_samuelsson_lipid_2026
%A García Samuelsson, Miguel
%A Tárraga López, Pedro Juan
%A López González, Ángel Arturo
%A Busquets-Cortés, Carla
%A Obrador de Hevia, Joan
%A Ramírez Manent, José Ignacio
%D 2026
%J Clinica E Investigacion En Arteriosclerosis: Publicacion Oficial De La Sociedad Espanola De Arteriosclerosis
%N 3
%P 500840
%R 10.1016/j.arteri.2025.500840
%T Lipid profile and atherogenic risk in metabolically healthy and unhealthy obese individuals: A cohort analysis by sex and sociodemographic factors
%V 38
%X OBJECTIVE: To analyze lipid profiles and sociodemographic factors associated with atherogenic risk in obese workers classified as metabolically healthy (MHO) or unhealthy (MNHO). METHODS: Cross-sectional study of 68,884 obese workers. Atherogenic lipid indices (total cholesterol/HDL-c, LDL-c/HDL-c, triglycerides/HDL-c) and prevalence of atherogenic dyslipidemia were assessed. Multinomial logistic regression identified factors linked to lipid risk. RESULTS: MNHO individuals exhibited significantly higher atherogenic indices across sexes and diagnostic criteria. Atherogenic dyslipidemia and lipid triad were more prevalent in MNHO. Male sex, older age, lower educational level, lower social class, physical inactivity, low adherence to the Mediterranean diet, and smoking were associated with higher lipid risk. CONCLUSION: Although MHO individuals show a more favorable lipid profile than MNHO, this advantage weakens with less stringent definitions. Sociodemographic and lifestyle factors strongly modulate atherogenic risk. -
AbstractBibTeXEndNoteDOIBibSonomy1.Tárraga Marcos PJ, López-González Ángel A, Martínez-Almoyna Rifá E, Paublini Oliveira H, Martorell Sánchez C, Tárraga López PJ, Ramírez-Manent JI. Atherogenic risk in 44,939 Spanish healthcare workers: Associated variables. Clinica E Investigacion En Arteriosclerosis: Publicacion Oficial De La Sociedad Espanola De Arteriosclerosis. 2026;38(1):500821.The article evaluates the atherogenic risk in 44,939 Spanish healthcare professionals by identifying the variables associated with this risk. It explains atherogenesis as the key pathological process in the development of cardiovascular diseases, characterized by the formation of atherosclerotic plaques resulting from atherogenic dyslipidemia. To quantify this risk, lipid indices (total cholesterol/HDL-c, LDL-c/HDL-c, and triglycerides/HDL-c ratios) were analyzed and related to factors such as age, sex, professional category, smoking, physical activity, and adherence to the Mediterranean diet. The results indicate that increasing age, male sex, smoking, and the lack of physical activity or adherence to a healthy diet are associated with higher atherogenic risk values. Furthermore, the study discusses its strengths (such as the large sample size and rigorous methodological design) and limitations, emphasizing the importance of comprehensive interventions and public health policies for the prevention and management of cardiovascular disease.
@article{tarraga_marcos_atherogenic_2026,
abstract = {The article evaluates the atherogenic risk in 44,939 Spanish healthcare professionals by identifying the variables associated with this risk. It explains atherogenesis as the key pathological process in the development of cardiovascular diseases, characterized by the formation of atherosclerotic plaques resulting from atherogenic dyslipidemia. To quantify this risk, lipid indices (total cholesterol/HDL-c, LDL-c/HDL-c, and triglycerides/HDL-c ratios) were analyzed and related to factors such as age, sex, professional category, smoking, physical activity, and adherence to the Mediterranean diet. The results indicate that increasing age, male sex, smoking, and the lack of physical activity or adherence to a healthy diet are associated with higher atherogenic risk values. Furthermore, the study discusses its strengths (such as the large sample size and rigorous methodological design) and limitations, emphasizing the importance of comprehensive interventions and public health policies for the prevention and management of cardiovascular disease.},
author = {Tárraga Marcos, Pedro Javier and López-González, Ángel Arturo and Martínez-Almoyna Rifá, Emilio and Paublini Oliveira, Hernán and Martorell Sánchez, Cristina and Tárraga López, Pedro Juan and Ramírez-Manent, José Ignacio},
journal = {Clinica E Investigacion En Arteriosclerosis: Publicacion Oficial De La Sociedad Espanola De Arteriosclerosis},
keywords = {grapp-caib},
number = 1,
pages = 500821,
title = {Atherogenic risk in 44,939 Spanish healthcare workers: Associated variables},
volume = 38,
year = 2026
}%0 Journal Article
%1 tarraga_marcos_atherogenic_2026
%A Tárraga Marcos, Pedro Javier
%A López-González, Ángel Arturo
%A Martínez-Almoyna Rifá, Emilio
%A Paublini Oliveira, Hernán
%A Martorell Sánchez, Cristina
%A Tárraga López, Pedro Juan
%A Ramírez-Manent, José Ignacio
%D 2026
%J Clinica E Investigacion En Arteriosclerosis: Publicacion Oficial De La Sociedad Espanola De Arteriosclerosis
%N 1
%P 500821
%R 10.1016/j.arteri.2025.500821
%T Atherogenic risk in 44,939 Spanish healthcare workers: Associated variables
%V 38
%X The article evaluates the atherogenic risk in 44,939 Spanish healthcare professionals by identifying the variables associated with this risk. It explains atherogenesis as the key pathological process in the development of cardiovascular diseases, characterized by the formation of atherosclerotic plaques resulting from atherogenic dyslipidemia. To quantify this risk, lipid indices (total cholesterol/HDL-c, LDL-c/HDL-c, and triglycerides/HDL-c ratios) were analyzed and related to factors such as age, sex, professional category, smoking, physical activity, and adherence to the Mediterranean diet. The results indicate that increasing age, male sex, smoking, and the lack of physical activity or adherence to a healthy diet are associated with higher atherogenic risk values. Furthermore, the study discusses its strengths (such as the large sample size and rigorous methodological design) and limitations, emphasizing the importance of comprehensive interventions and public health policies for the prevention and management of cardiovascular disease. -
AbstractBibTeXEndNoteDOIBibSonomy1.Llor C, Monfà R, Garcia-Sangenís A, Leiva A, Marín-Cañada J, Sánchez-Calavera MA, Moragas A, Aguilar-Sánchez M, Troncoso-Mariño A, Rodríguez-Barrientos R, Molero JM, Ouchi D, Miranda-Jiménez C, Fernández-García S, Morros R. Clinical and bacteriological effectiveness of three different short-course antibiotic regimens and single-dose fosfomycin for uncomplicated lower urinary tract infections in women (SCOUT): a pragmatic, multicentre, open-label, randomised clinical trial. Lancet. 2026 Apr.;407(10539):1603-1.BACKGROUND: Most guidelines recommend nitrofurantoin, fosfomycin, and sometimes pivmecillinam for uncomplicated urinary tract infections (UTIs), but direct comparisons between these antibiotics are needed. This study evaluated the effectiveness and safety of a single dose of fosfomycin compared with two doses of fosfomycin and short-course regimens of nitrofurantoin and pivmecillinam in women with UTI symptoms. METHODS: This phase 4, pragmatic, multicentre, parallel-group, open-label, randomised clinical trial was conducted in Spanish primary care centres from 2022 to 2024. Women aged 18 years or older with at least one UTI-specific symptom (dysuria, urinary urgency, urinary frequency, or suprapubic tenderness) and a positive urine dipstick test for either nitrites or leukocyte esterase were randomly assigned (1:1:1:1) to one of four treatments: a single 3 g dose of fosfomycin, two 3 g doses of fosfomycin, nitrofurantoin (100 mg three times per day for 5 days), or pivmecillinam (400 mg three times per day for 3 days). Doctors and patients were not masked to group assignment. The primary outcome was the proportion of patients with clinical resolution (defined as the disappearance of all infection symptoms) at day 7. This trial is registered with ClinicalTrials.gov (NCT04959331) and EudraCT (2021-001332-26) and is completed. FINDINGS: Of the 804 patients assessed for eligibility between April 4, 2022 and Nov 14, 2024, 768 patients were randomly allocated (191 to the single-dose fosfomycin group, 194 to the two-dose fosfomycin group, 190 to the nitrofurantoin group, and 193 to the pivmecillinam group). Patients had a median age of 48 years (IQR 34-63). Race and ethnicity data were not collected. Among the 720 women with available data included in the primary analysis, single-dose fosfomycin had the lowest proportion of clinical resolution (109 [59\%] of 185 patients), while nitrofurantoin had the highest (128 [74\%] of 172 patients; difference 15·5 percentage points [95\% CI 5·9 to 25·1] vs single-dose fosfomycin; p=0·0168), followed by pivmecillinam (127 [70\%] of 182; difference 10·9 percentage points [1·1 to 20·6]; p=0·2352) and the two-dose fosfomycin group (122 [67\%] of 181; difference 8·5 percentage points [-1·4 to 18·3]; p=0·6935). Adverse events occurred in 38 (19·9\% [95\% CI 14·9 to 26·1) of 191 patients who received single-dose fosfomycin, 51 (26·3\% [20·6 to 32·9]) of 194 who received two-dose fosfomycin, 51 (26·8\% [21·0 to 33·6]) of 190 who received nitrofurantoin, and 41 (21·2\% [16·1 to 27·5]) of 193 who received pivmecillinam. Most adverse events were mild and self-limiting, primarily gastrointestinal. Four serious adverse events occurred, of which one was related to the study treatment (one case of pyelonephritis in the pivmecillinam group). INTERPRETATION: Nitrofurantoin was the most effective treatment and single-dose fosfomycin the least effective treatment for UTIs. Adverse events were mild. The role of fosfomycin as a first-line antibiotic for uncomplicated UTI should be re-evaluated. FUNDING: Carlos III Institute of Health, Spanish Ministry of Science and Innovation, and European Regional Development Fund.
@article{llor_clinical_2026,
abstract = {BACKGROUND: Most guidelines recommend nitrofurantoin, fosfomycin, and sometimes pivmecillinam for uncomplicated urinary tract infections (UTIs), but direct comparisons between these antibiotics are needed. This study evaluated the effectiveness and safety of a single dose of fosfomycin compared with two doses of fosfomycin and short-course regimens of nitrofurantoin and pivmecillinam in women with UTI symptoms. METHODS: This phase 4, pragmatic, multicentre, parallel-group, open-label, randomised clinical trial was conducted in Spanish primary care centres from 2022 to 2024. Women aged 18 years or older with at least one UTI-specific symptom (dysuria, urinary urgency, urinary frequency, or suprapubic tenderness) and a positive urine dipstick test for either nitrites or leukocyte esterase were randomly assigned (1:1:1:1) to one of four treatments: a single 3 g dose of fosfomycin, two 3 g doses of fosfomycin, nitrofurantoin (100 mg three times per day for 5 days), or pivmecillinam (400 mg three times per day for 3 days). Doctors and patients were not masked to group assignment. The primary outcome was the proportion of patients with clinical resolution (defined as the disappearance of all infection symptoms) at day 7. This trial is registered with ClinicalTrials.gov (NCT04959331) and EudraCT (2021-001332-26) and is completed. FINDINGS: Of the 804 patients assessed for eligibility between April 4, 2022 and Nov 14, 2024, 768 patients were randomly allocated (191 to the single-dose fosfomycin group, 194 to the two-dose fosfomycin group, 190 to the nitrofurantoin group, and 193 to the pivmecillinam group). Patients had a median age of 48 years (IQR 34-63). Race and ethnicity data were not collected. Among the 720 women with available data included in the primary analysis, single-dose fosfomycin had the lowest proportion of clinical resolution (109 [59\%] of 185 patients), while nitrofurantoin had the highest (128 [74\%] of 172 patients; difference 15·5 percentage points [95\% CI 5·9 to 25·1] vs single-dose fosfomycin; p=0·0168), followed by pivmecillinam (127 [70\%] of 182; difference 10·9 percentage points [1·1 to 20·6]; p=0·2352) and the two-dose fosfomycin group (122 [67\%] of 181; difference 8·5 percentage points [-1·4 to 18·3]; p=0·6935). Adverse events occurred in 38 (19·9\% [95\% CI 14·9 to 26·1) of 191 patients who received single-dose fosfomycin, 51 (26·3\% [20·6 to 32·9]) of 194 who received two-dose fosfomycin, 51 (26·8\% [21·0 to 33·6]) of 190 who received nitrofurantoin, and 41 (21·2\% [16·1 to 27·5]) of 193 who received pivmecillinam. Most adverse events were mild and self-limiting, primarily gastrointestinal. Four serious adverse events occurred, of which one was related to the study treatment (one case of pyelonephritis in the pivmecillinam group). INTERPRETATION: Nitrofurantoin was the most effective treatment and single-dose fosfomycin the least effective treatment for UTIs. Adverse events were mild. The role of fosfomycin as a first-line antibiotic for uncomplicated UTI should be re-evaluated. FUNDING: Carlos III Institute of Health, Spanish Ministry of Science and Innovation, and European Regional Development Fund.},
author = {Llor, Carl and Monfà, Ramon and Garcia-Sangenís, Ana and Leiva, Alfonso and Marín-Cañada, Jaime and Sánchez-Calavera, María Antonia and Moragas, Ana and Aguilar-Sánchez, Mercedes and Troncoso-Mariño, Amelia and Rodríguez-Barrientos, Ricardo and Molero, José M. and Ouchi, Dan and Miranda-Jiménez, Cristina and Fernández-García, Silvia and Morros, Rosa},
journal = {Lancet},
keywords = {grapp-caib},
month = {apr},
number = 10539,
pages = {1603--1613},
title = {Clinical and bacteriological effectiveness of three different short-course antibiotic regimens and single-dose fosfomycin for uncomplicated lower urinary tract infections in women (SCOUT): a pragmatic, multicentre, open-label, randomised clinical trial},
volume = 407,
year = 2026
}%0 Journal Article
%1 llor_clinical_2026
%A Llor, Carl
%A Monfà, Ramon
%A Garcia-Sangenís, Ana
%A Leiva, Alfonso
%A Marín-Cañada, Jaime
%A Sánchez-Calavera, María Antonia
%A Moragas, Ana
%A Aguilar-Sánchez, Mercedes
%A Troncoso-Mariño, Amelia
%A Rodríguez-Barrientos, Ricardo
%A Molero, José M.
%A Ouchi, Dan
%A Miranda-Jiménez, Cristina
%A Fernández-García, Silvia
%A Morros, Rosa
%D 2026
%J Lancet
%N 10539
%P 1603--1613
%R 10.1016/S0140-6736(25)02171-3
%T Clinical and bacteriological effectiveness of three different short-course antibiotic regimens and single-dose fosfomycin for uncomplicated lower urinary tract infections in women (SCOUT): a pragmatic, multicentre, open-label, randomised clinical trial
%V 407
%X BACKGROUND: Most guidelines recommend nitrofurantoin, fosfomycin, and sometimes pivmecillinam for uncomplicated urinary tract infections (UTIs), but direct comparisons between these antibiotics are needed. This study evaluated the effectiveness and safety of a single dose of fosfomycin compared with two doses of fosfomycin and short-course regimens of nitrofurantoin and pivmecillinam in women with UTI symptoms. METHODS: This phase 4, pragmatic, multicentre, parallel-group, open-label, randomised clinical trial was conducted in Spanish primary care centres from 2022 to 2024. Women aged 18 years or older with at least one UTI-specific symptom (dysuria, urinary urgency, urinary frequency, or suprapubic tenderness) and a positive urine dipstick test for either nitrites or leukocyte esterase were randomly assigned (1:1:1:1) to one of four treatments: a single 3 g dose of fosfomycin, two 3 g doses of fosfomycin, nitrofurantoin (100 mg three times per day for 5 days), or pivmecillinam (400 mg three times per day for 3 days). Doctors and patients were not masked to group assignment. The primary outcome was the proportion of patients with clinical resolution (defined as the disappearance of all infection symptoms) at day 7. This trial is registered with ClinicalTrials.gov (NCT04959331) and EudraCT (2021-001332-26) and is completed. FINDINGS: Of the 804 patients assessed for eligibility between April 4, 2022 and Nov 14, 2024, 768 patients were randomly allocated (191 to the single-dose fosfomycin group, 194 to the two-dose fosfomycin group, 190 to the nitrofurantoin group, and 193 to the pivmecillinam group). Patients had a median age of 48 years (IQR 34-63). Race and ethnicity data were not collected. Among the 720 women with available data included in the primary analysis, single-dose fosfomycin had the lowest proportion of clinical resolution (109 [59\%] of 185 patients), while nitrofurantoin had the highest (128 [74\%] of 172 patients; difference 15·5 percentage points [95\% CI 5·9 to 25·1] vs single-dose fosfomycin; p=0·0168), followed by pivmecillinam (127 [70\%] of 182; difference 10·9 percentage points [1·1 to 20·6]; p=0·2352) and the two-dose fosfomycin group (122 [67\%] of 181; difference 8·5 percentage points [-1·4 to 18·3]; p=0·6935). Adverse events occurred in 38 (19·9\% [95\% CI 14·9 to 26·1) of 191 patients who received single-dose fosfomycin, 51 (26·3\% [20·6 to 32·9]) of 194 who received two-dose fosfomycin, 51 (26·8\% [21·0 to 33·6]) of 190 who received nitrofurantoin, and 41 (21·2\% [16·1 to 27·5]) of 193 who received pivmecillinam. Most adverse events were mild and self-limiting, primarily gastrointestinal. Four serious adverse events occurred, of which one was related to the study treatment (one case of pyelonephritis in the pivmecillinam group). INTERPRETATION: Nitrofurantoin was the most effective treatment and single-dose fosfomycin the least effective treatment for UTIs. Adverse events were mild. The role of fosfomycin as a first-line antibiotic for uncomplicated UTI should be re-evaluated. FUNDING: Carlos III Institute of Health, Spanish Ministry of Science and Innovation, and European Regional Development Fund. - AbstractBibTeXEndNoteDOIBibSonomyDownload1.López-González Ángel A, Tárraga López PJ, Piña Dabreu MS, Rodas Cañellas L, Busquets-Cortés C, Ramírez-Manent JI. Waist-to-Height Ratio as a Simple Anthropometric Marker for Identifying Individuals at High Risk of MASLD: A Large Population-Based Analysis Using the Fatty Liver Index. Metabolites. 2026 Apr.;16(4):246.BACKGROUND: Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common chronic liver disease worldwide and represents a major component of the global burden of metabolic disorders. Simple anthropometric markers capable of identifying individuals at increased risk of hepatic steatosis are of considerable interest for population-level screening. METHODS: In this cross-sectional population-based study, we evaluated the performance of waist-to-height ratio (WtHR) for identifying individuals with a high Fatty Liver Index (FLI ≥ 60), a widely used surrogate marker of hepatic steatosis. The study included 146,318 adult participants with available anthropometric and biochemical data. Discriminatory performance was assessed using receiver operating characteristic (ROC) curve analysis. Optimal WtHR thresholds were determined using the Youden index. Associations between WtHR and high FLI were evaluated using age-adjusted logistic regression models. Non-linear relationships were explored using restricted cubic spline models. Additional analyses included a comparison with body mass index (BMI) and waist circumference, decision curve analysis, and subgroup analyses across age and BMI strata. RESULTS: The prevalence of high FLI in the study population was 18.1%. WtHR demonstrated excellent discriminatory performance, with area under the ROC curve (AUC) values of 0.908 (95\% CI 0.906-0.910) in men and 0.972 (95\% CI 0.971-0.974) in women. Optimal WtHR thresholds for identifying individuals with high FLI were 0.52 in men and 0.53 in women. Each 0.01 increase in WtHR was strongly associated with higher odds of high FLI (OR 1.56 in men and 1.69 in women). Restricted cubic spline analysis demonstrated a non-linear relationship, with a marked increase in predicted probability of high FLI above WtHR values of approximately 0.50-0.52. WtHR showed discriminatory performance comparable to BMI and waist circumference and maintained strong associations with high FLI across age groups and BMI categories. CONCLUSIONS: Waist-to-height ratio is a simple anthropometric marker strongly associated with a high Fatty Liver Index in a large population-based cohort. Given its simplicity, low cost, and ease of calculation, WtHR may represent a practical screening indicator for identifying individuals at increased risk of MASLD-related phenotypes in both clinical practice and population health strategies.
@article{lopez-gonzalez_waist--height_2026,
abstract = {BACKGROUND: Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common chronic liver disease worldwide and represents a major component of the global burden of metabolic disorders. Simple anthropometric markers capable of identifying individuals at increased risk of hepatic steatosis are of considerable interest for population-level screening. METHODS: In this cross-sectional population-based study, we evaluated the performance of waist-to-height ratio (WtHR) for identifying individuals with a high Fatty Liver Index (FLI ≥ 60), a widely used surrogate marker of hepatic steatosis. The study included 146,318 adult participants with available anthropometric and biochemical data. Discriminatory performance was assessed using receiver operating characteristic (ROC) curve analysis. Optimal WtHR thresholds were determined using the Youden index. Associations between WtHR and high FLI were evaluated using age-adjusted logistic regression models. Non-linear relationships were explored using restricted cubic spline models. Additional analyses included a comparison with body mass index (BMI) and waist circumference, decision curve analysis, and subgroup analyses across age and BMI strata. RESULTS: The prevalence of high FLI in the study population was 18.1%. WtHR demonstrated excellent discriminatory performance, with area under the ROC curve (AUC) values of 0.908 (95\% CI 0.906-0.910) in men and 0.972 (95\% CI 0.971-0.974) in women. Optimal WtHR thresholds for identifying individuals with high FLI were 0.52 in men and 0.53 in women. Each 0.01 increase in WtHR was strongly associated with higher odds of high FLI (OR 1.56 in men and 1.69 in women). Restricted cubic spline analysis demonstrated a non-linear relationship, with a marked increase in predicted probability of high FLI above WtHR values of approximately 0.50-0.52. WtHR showed discriminatory performance comparable to BMI and waist circumference and maintained strong associations with high FLI across age groups and BMI categories. CONCLUSIONS: Waist-to-height ratio is a simple anthropometric marker strongly associated with a high Fatty Liver Index in a large population-based cohort. Given its simplicity, low cost, and ease of calculation, WtHR may represent a practical screening indicator for identifying individuals at increased risk of MASLD-related phenotypes in both clinical practice and population health strategies.},
author = {López-González, Ángel Arturo and Tárraga López, Pedro Juan and Piña Dabreu, Mónica Silu and Rodas Cañellas, Lluis and Busquets-Cortés, Carla and Ramírez-Manent, José Ignacio},
journal = {Metabolites},
keywords = {grapp-caib},
month = {apr},
number = 4,
pages = 246,
title = {Waist-to-Height Ratio as a Simple Anthropometric Marker for Identifying Individuals at High Risk of MASLD: A Large Population-Based Analysis Using the Fatty Liver Index},
volume = 16,
year = 2026
}%0 Journal Article
%1 lopez-gonzalez_waist--height_2026
%A López-González, Ángel Arturo
%A Tárraga López, Pedro Juan
%A Piña Dabreu, Mónica Silu
%A Rodas Cañellas, Lluis
%A Busquets-Cortés, Carla
%A Ramírez-Manent, José Ignacio
%D 2026
%J Metabolites
%N 4
%P 246
%R 10.3390/metabo16040246
%T Waist-to-Height Ratio as a Simple Anthropometric Marker for Identifying Individuals at High Risk of MASLD: A Large Population-Based Analysis Using the Fatty Liver Index
%V 16
%X BACKGROUND: Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common chronic liver disease worldwide and represents a major component of the global burden of metabolic disorders. Simple anthropometric markers capable of identifying individuals at increased risk of hepatic steatosis are of considerable interest for population-level screening. METHODS: In this cross-sectional population-based study, we evaluated the performance of waist-to-height ratio (WtHR) for identifying individuals with a high Fatty Liver Index (FLI ≥ 60), a widely used surrogate marker of hepatic steatosis. The study included 146,318 adult participants with available anthropometric and biochemical data. Discriminatory performance was assessed using receiver operating characteristic (ROC) curve analysis. Optimal WtHR thresholds were determined using the Youden index. Associations between WtHR and high FLI were evaluated using age-adjusted logistic regression models. Non-linear relationships were explored using restricted cubic spline models. Additional analyses included a comparison with body mass index (BMI) and waist circumference, decision curve analysis, and subgroup analyses across age and BMI strata. RESULTS: The prevalence of high FLI in the study population was 18.1%. WtHR demonstrated excellent discriminatory performance, with area under the ROC curve (AUC) values of 0.908 (95\% CI 0.906-0.910) in men and 0.972 (95\% CI 0.971-0.974) in women. Optimal WtHR thresholds for identifying individuals with high FLI were 0.52 in men and 0.53 in women. Each 0.01 increase in WtHR was strongly associated with higher odds of high FLI (OR 1.56 in men and 1.69 in women). Restricted cubic spline analysis demonstrated a non-linear relationship, with a marked increase in predicted probability of high FLI above WtHR values of approximately 0.50-0.52. WtHR showed discriminatory performance comparable to BMI and waist circumference and maintained strong associations with high FLI across age groups and BMI categories. CONCLUSIONS: Waist-to-height ratio is a simple anthropometric marker strongly associated with a high Fatty Liver Index in a large population-based cohort. Given its simplicity, low cost, and ease of calculation, WtHR may represent a practical screening indicator for identifying individuals at increased risk of MASLD-related phenotypes in both clinical practice and population health strategies. -
AbstractBibTeXEndNoteDOIBibSonomy1.Egea Sancho M, Ramírez-Manent JI, López PJT, Coll Campayo I, Vicente-Herrero MT, López-González Ángel A. Associations of sociodemographic factors, healthy habits, and weight stigma with non-alcoholic fatty liver disease risk in obese workers: Findings from a large occupational cohort. Gastroenterologia Y Hepatologia. 2026 Jan.;49(1):502560.BACKGROUND: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a growing global health concern, particularly among individuals with obesity. While metabolic and behavioral risk factors have been well described, the role of psychosocial determinants, such as weight stigma, remains underexplored. OBJECTIVES: To assess the association between sociodemographic variables, healthy lifestyle behaviors, and internalized weight stigma with MASLD risk in a large cohort of obese workers across Spain. PATIENTS AND METHODS: This cross-sectional study analyzed data from 26,816 obese employees who underwent occupational health screenings between January 2021 and December 2024. MASLD risk was assessed using three validated indices: the Fatty Liver Index (FLI), Hepatic Steatosis Index (HSI), and Lipid Accumulation Product (LAP). Sociodemographic characteristics, adherence to the Mediterranean diet, physical activity, smoking status, and weight stigma (assessed by the Weight Bias Internalization Scale) were evaluated. Multivariable logistic regression models were used to estimate associations. RESULTS: Weight stigma was significantly associated with higher risk of MASLD across all three indices, independent of age, sex, social class, and health behaviors. Participants with internalized weight stigma were 1.6-2.3times more likely to present with high-risk scores. Sociodemographic disparities and unhealthy lifestyle factors also contributed to elevated MASLD risk. CONCLUSIONS: Beyond metabolic and behavioral determinants, internalized weight stigma emerges as a strong independent factor associated with MASLD risk. These findings underscore the importance of incorporating psychosocial components into liver disease prevention strategies in occupational settings.
@article{egea_sancho_associations_2026,
abstract = {BACKGROUND: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a growing global health concern, particularly among individuals with obesity. While metabolic and behavioral risk factors have been well described, the role of psychosocial determinants, such as weight stigma, remains underexplored. OBJECTIVES: To assess the association between sociodemographic variables, healthy lifestyle behaviors, and internalized weight stigma with MASLD risk in a large cohort of obese workers across Spain. PATIENTS AND METHODS: This cross-sectional study analyzed data from 26,816 obese employees who underwent occupational health screenings between January 2021 and December 2024. MASLD risk was assessed using three validated indices: the Fatty Liver Index (FLI), Hepatic Steatosis Index (HSI), and Lipid Accumulation Product (LAP). Sociodemographic characteristics, adherence to the Mediterranean diet, physical activity, smoking status, and weight stigma (assessed by the Weight Bias Internalization Scale) were evaluated. Multivariable logistic regression models were used to estimate associations. RESULTS: Weight stigma was significantly associated with higher risk of MASLD across all three indices, independent of age, sex, social class, and health behaviors. Participants with internalized weight stigma were 1.6-2.3times more likely to present with high-risk scores. Sociodemographic disparities and unhealthy lifestyle factors also contributed to elevated MASLD risk. CONCLUSIONS: Beyond metabolic and behavioral determinants, internalized weight stigma emerges as a strong independent factor associated with MASLD risk. These findings underscore the importance of incorporating psychosocial components into liver disease prevention strategies in occupational settings.},
author = {Egea Sancho, Mónica and Ramírez-Manent, José Ignacio and López, Pedro Juan Tárraga and Coll Campayo, Irene and Vicente-Herrero, María Teófila and López-González, Ángel Arturo},
journal = {Gastroenterologia Y Hepatologia},
keywords = {grapp-caib},
month = {jan},
number = 1,
pages = 502560,
title = {Associations of sociodemographic factors, healthy habits, and weight stigma with non-alcoholic fatty liver disease risk in obese workers: Findings from a large occupational cohort},
volume = 49,
year = 2026
}%0 Journal Article
%1 egea_sancho_associations_2026
%A Egea Sancho, Mónica
%A Ramírez-Manent, José Ignacio
%A López, Pedro Juan Tárraga
%A Coll Campayo, Irene
%A Vicente-Herrero, María Teófila
%A López-González, Ángel Arturo
%D 2026
%J Gastroenterologia Y Hepatologia
%N 1
%P 502560
%R 10.1016/j.gastrohep.2025.502560
%T Associations of sociodemographic factors, healthy habits, and weight stigma with non-alcoholic fatty liver disease risk in obese workers: Findings from a large occupational cohort
%V 49
%X BACKGROUND: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a growing global health concern, particularly among individuals with obesity. While metabolic and behavioral risk factors have been well described, the role of psychosocial determinants, such as weight stigma, remains underexplored. OBJECTIVES: To assess the association between sociodemographic variables, healthy lifestyle behaviors, and internalized weight stigma with MASLD risk in a large cohort of obese workers across Spain. PATIENTS AND METHODS: This cross-sectional study analyzed data from 26,816 obese employees who underwent occupational health screenings between January 2021 and December 2024. MASLD risk was assessed using three validated indices: the Fatty Liver Index (FLI), Hepatic Steatosis Index (HSI), and Lipid Accumulation Product (LAP). Sociodemographic characteristics, adherence to the Mediterranean diet, physical activity, smoking status, and weight stigma (assessed by the Weight Bias Internalization Scale) were evaluated. Multivariable logistic regression models were used to estimate associations. RESULTS: Weight stigma was significantly associated with higher risk of MASLD across all three indices, independent of age, sex, social class, and health behaviors. Participants with internalized weight stigma were 1.6-2.3times more likely to present with high-risk scores. Sociodemographic disparities and unhealthy lifestyle factors also contributed to elevated MASLD risk. CONCLUSIONS: Beyond metabolic and behavioral determinants, internalized weight stigma emerges as a strong independent factor associated with MASLD risk. These findings underscore the importance of incorporating psychosocial components into liver disease prevention strategies in occupational settings. - AbstractBibTeXEndNoteDOIBibSonomyDownload1.García Pertegaz P, Tárraga López PJ, Coll Campayo I, Busquets-Cortés C, López-González Ángel A, Ramírez-Manent JI. Purpose in Life and Estimated Type 2 Diabetes Risk: Cross-Sectional Associations Across Three Validated Risk Scores in 93,077 Spanish Working Adults. Medical Sciences. 2026 Feb.;14(1):113.Background: Psychosocial well-being has been increasingly recognized as a relevant factor in cardiometabolic health; however, evidence linking Purpose in Life with type 2 diabetes risk across validated prediction tools remains limited. This study examined the association between Purpose in Life and estimated diabetes risk using three established risk scores. Methods: A cross-sectional analysis was performed in 93,077 Spanish working adults aged 18-69 years participating in routine occupational health assessments. Purpose in Life was measured with the 10-item Purpose in Life scale and categorized into high, moderate, and low levels. Estimated type 2 diabetes risk was evaluated using QDScore, FINDRISC, and CANRISK. Multivariable logistic regression models were applied to calculate odds ratios (ORs) and 95% confidence intervals (CIs), adjusting for age, sex, occupational social class, smoking status, dietary pattern, physical activity, and body mass index. Results: Lower levels of Purpose in Life were consistently associated with greater likelihood of high estimated diabetes risk across all three instruments. Compared with participants reporting high Purpose in Life, those with low Purpose in Life showed increased odds of high-risk classification for QDScore (OR 2.38; 95\% CI 2.19-2.57), FINDRISC (OR 2.49; 95\% CI 2.08-2.89), and CANRISK (OR 2.79; 95\% CI 2.50-3.09). Clear dose-response patterns were observed across Purpose in Life categories, and associations were similar in men and women as well as across lifestyle strata. Conclusions: Reduced Purpose in Life is strongly associated with higher estimated type 2 diabetes risk across multiple validated screening tools. Although causal direction cannot be inferred from this cross-sectional design, these findings suggest that psychosocial dimensions may provide complementary information for cardiometabolic risk assessment and prevention strategies.
@article{garcia_pertegaz_purpose_2026,
abstract = {Background: Psychosocial well-being has been increasingly recognized as a relevant factor in cardiometabolic health; however, evidence linking Purpose in Life with type 2 diabetes risk across validated prediction tools remains limited. This study examined the association between Purpose in Life and estimated diabetes risk using three established risk scores. Methods: A cross-sectional analysis was performed in 93,077 Spanish working adults aged 18-69 years participating in routine occupational health assessments. Purpose in Life was measured with the 10-item Purpose in Life scale and categorized into high, moderate, and low levels. Estimated type 2 diabetes risk was evaluated using QDScore, FINDRISC, and CANRISK. Multivariable logistic regression models were applied to calculate odds ratios (ORs) and 95% confidence intervals (CIs), adjusting for age, sex, occupational social class, smoking status, dietary pattern, physical activity, and body mass index. Results: Lower levels of Purpose in Life were consistently associated with greater likelihood of high estimated diabetes risk across all three instruments. Compared with participants reporting high Purpose in Life, those with low Purpose in Life showed increased odds of high-risk classification for QDScore (OR 2.38; 95\% CI 2.19-2.57), FINDRISC (OR 2.49; 95\% CI 2.08-2.89), and CANRISK (OR 2.79; 95\% CI 2.50-3.09). Clear dose-response patterns were observed across Purpose in Life categories, and associations were similar in men and women as well as across lifestyle strata. Conclusions: Reduced Purpose in Life is strongly associated with higher estimated type 2 diabetes risk across multiple validated screening tools. Although causal direction cannot be inferred from this cross-sectional design, these findings suggest that psychosocial dimensions may provide complementary information for cardiometabolic risk assessment and prevention strategies.},
author = {García Pertegaz, Pilar and Tárraga López, Pedro Juan and Coll Campayo, Irene and Busquets-Cortés, Carla and López-González, Ángel Arturo and Ramírez-Manent, José Ignacio},
journal = {Medical Sciences},
keywords = {grapp-caib},
month = {feb},
number = 1,
pages = 113,
title = {Purpose in Life and Estimated Type 2 Diabetes Risk: Cross-Sectional Associations Across Three Validated Risk Scores in 93,077 Spanish Working Adults},
volume = 14,
year = 2026
}%0 Journal Article
%1 garcia_pertegaz_purpose_2026
%A García Pertegaz, Pilar
%A Tárraga López, Pedro Juan
%A Coll Campayo, Irene
%A Busquets-Cortés, Carla
%A López-González, Ángel Arturo
%A Ramírez-Manent, José Ignacio
%D 2026
%J Medical Sciences
%N 1
%P 113
%R 10.3390/medsci14010113
%T Purpose in Life and Estimated Type 2 Diabetes Risk: Cross-Sectional Associations Across Three Validated Risk Scores in 93,077 Spanish Working Adults
%V 14
%X Background: Psychosocial well-being has been increasingly recognized as a relevant factor in cardiometabolic health; however, evidence linking Purpose in Life with type 2 diabetes risk across validated prediction tools remains limited. This study examined the association between Purpose in Life and estimated diabetes risk using three established risk scores. Methods: A cross-sectional analysis was performed in 93,077 Spanish working adults aged 18-69 years participating in routine occupational health assessments. Purpose in Life was measured with the 10-item Purpose in Life scale and categorized into high, moderate, and low levels. Estimated type 2 diabetes risk was evaluated using QDScore, FINDRISC, and CANRISK. Multivariable logistic regression models were applied to calculate odds ratios (ORs) and 95% confidence intervals (CIs), adjusting for age, sex, occupational social class, smoking status, dietary pattern, physical activity, and body mass index. Results: Lower levels of Purpose in Life were consistently associated with greater likelihood of high estimated diabetes risk across all three instruments. Compared with participants reporting high Purpose in Life, those with low Purpose in Life showed increased odds of high-risk classification for QDScore (OR 2.38; 95\% CI 2.19-2.57), FINDRISC (OR 2.49; 95\% CI 2.08-2.89), and CANRISK (OR 2.79; 95\% CI 2.50-3.09). Clear dose-response patterns were observed across Purpose in Life categories, and associations were similar in men and women as well as across lifestyle strata. Conclusions: Reduced Purpose in Life is strongly associated with higher estimated type 2 diabetes risk across multiple validated screening tools. Although causal direction cannot be inferred from this cross-sectional design, these findings suggest that psychosocial dimensions may provide complementary information for cardiometabolic risk assessment and prevention strategies. -
AbstractBibTeXEndNoteDOIBibSonomy1.Marina Arroyo M, Ramírez Gallegos I, López-González Ángel A, Busquets-Cortés C, Obrador de Hevia J, Tárraga López PJ, Ramírez-Manent JI. Diagnostic accuracy of non-invasive fatty liver indexes and their association with ECORE-BF scale in a cohort of 386,924 Spanish workers. Gastroenterologia Y Hepatologia. 2026 Jan.;:502656.OBJECTIVE: To evaluate the diagnostic accuracy of five non-invasive fatty liver indices and their association with obesity in a large cohort of Spanish workers, stratified by sex. PATIENTS AND METHODS: A cross-sectional analysis was conducted on 386,924 workers (232,814 men and 154,110 women) who underwent routine occupational health assessments between 2009 and 2019. Anthropometric, clinical, and biochemical parameters were collected following standardized procedures. Physical activity and adherence to the Mediterranean diet were assessed using validated IPAQ and PREDIMED questionnaires. Diagnostic performance was evaluated using ROC curves and area under the curve (AUC) values for each fatty liver index. RESULTS: All indices showed significant sex-based differences. FLI and LAP presented the highest AUC values for identifying obesity in both sexes (FLI: AUC 0.907 in men and 0.972 in women; LAP: AUC 0.836 in men and 0.878 in women). FLI also demonstrated the strongest association with higher obesity prevalence across tertiles. ZJU showed good performance, whereas HSI and FLD exhibited lower accuracy, particularly among men. Lifestyle factors and education level influenced index values, with sedentary behavior, low adherence to the Mediterranean diet, and lower educational attainment associated with worse index performance. CONCLUSIONS: FLI and LAP are the most accurate non-invasive indices for identifying obesity-associated fatty liver in this large Spanish working population. Their performance varies by sex and is influenced by sociodemographic and lifestyle factors. These findings support the relevance of FLI and LAP for large-scale screening and highlight the importance of integrating lifestyle assessments into occupational health evaluations. .
@article{marina_arroyo_diagnostic_2026,
abstract = {OBJECTIVE: To evaluate the diagnostic accuracy of five non-invasive fatty liver indices and their association with obesity in a large cohort of Spanish workers, stratified by sex. PATIENTS AND METHODS: A cross-sectional analysis was conducted on 386,924 workers (232,814 men and 154,110 women) who underwent routine occupational health assessments between 2009 and 2019. Anthropometric, clinical, and biochemical parameters were collected following standardized procedures. Physical activity and adherence to the Mediterranean diet were assessed using validated IPAQ and PREDIMED questionnaires. Diagnostic performance was evaluated using ROC curves and area under the curve (AUC) values for each fatty liver index. RESULTS: All indices showed significant sex-based differences. FLI and LAP presented the highest AUC values for identifying obesity in both sexes (FLI: AUC 0.907 in men and 0.972 in women; LAP: AUC 0.836 in men and 0.878 in women). FLI also demonstrated the strongest association with higher obesity prevalence across tertiles. ZJU showed good performance, whereas HSI and FLD exhibited lower accuracy, particularly among men. Lifestyle factors and education level influenced index values, with sedentary behavior, low adherence to the Mediterranean diet, and lower educational attainment associated with worse index performance. CONCLUSIONS: FLI and LAP are the most accurate non-invasive indices for identifying obesity-associated fatty liver in this large Spanish working population. Their performance varies by sex and is influenced by sociodemographic and lifestyle factors. These findings support the relevance of FLI and LAP for large-scale screening and highlight the importance of integrating lifestyle assessments into occupational health evaluations. .},
author = {Marina Arroyo, Marta and Ramírez Gallegos, Ignacio and López-González, Ángel Arturo and Busquets-Cortés, Carla and Obrador de Hevia, Joan and Tárraga López, Pedro Juan and Ramírez-Manent, José Ignacio},
journal = {Gastroenterologia Y Hepatologia},
keywords = {grapp-caib},
month = {jan},
pages = 502656,
title = {Diagnostic accuracy of non-invasive fatty liver indexes and their association with ECORE-BF scale in a cohort of 386,924 Spanish workers},
year = 2026
}%0 Journal Article
%1 marina_arroyo_diagnostic_2026
%A Marina Arroyo, Marta
%A Ramírez Gallegos, Ignacio
%A López-González, Ángel Arturo
%A Busquets-Cortés, Carla
%A Obrador de Hevia, Joan
%A Tárraga López, Pedro Juan
%A Ramírez-Manent, José Ignacio
%D 2026
%J Gastroenterologia Y Hepatologia
%P 502656
%R 10.1016/j.gastrohep.2026.502656
%T Diagnostic accuracy of non-invasive fatty liver indexes and their association with ECORE-BF scale in a cohort of 386,924 Spanish workers
%X OBJECTIVE: To evaluate the diagnostic accuracy of five non-invasive fatty liver indices and their association with obesity in a large cohort of Spanish workers, stratified by sex. PATIENTS AND METHODS: A cross-sectional analysis was conducted on 386,924 workers (232,814 men and 154,110 women) who underwent routine occupational health assessments between 2009 and 2019. Anthropometric, clinical, and biochemical parameters were collected following standardized procedures. Physical activity and adherence to the Mediterranean diet were assessed using validated IPAQ and PREDIMED questionnaires. Diagnostic performance was evaluated using ROC curves and area under the curve (AUC) values for each fatty liver index. RESULTS: All indices showed significant sex-based differences. FLI and LAP presented the highest AUC values for identifying obesity in both sexes (FLI: AUC 0.907 in men and 0.972 in women; LAP: AUC 0.836 in men and 0.878 in women). FLI also demonstrated the strongest association with higher obesity prevalence across tertiles. ZJU showed good performance, whereas HSI and FLD exhibited lower accuracy, particularly among men. Lifestyle factors and education level influenced index values, with sedentary behavior, low adherence to the Mediterranean diet, and lower educational attainment associated with worse index performance. CONCLUSIONS: FLI and LAP are the most accurate non-invasive indices for identifying obesity-associated fatty liver in this large Spanish working population. Their performance varies by sex and is influenced by sociodemographic and lifestyle factors. These findings support the relevance of FLI and LAP for large-scale screening and highlight the importance of integrating lifestyle assessments into occupational health evaluations. . - AbstractURLBibTeXEndNoteDOIBibSonomyDownload1.Vieira RJ, Gil-Mata S, Ferreira A, Riera-Serra P, Bognanni A, Duarte VH, Viegas H, Pereira AM, Ferreira-da Silva R, Ferreira-Cardoso H, Marques-Cruz M, Castro-Teles J, Campos-Lopes M, Teixeira-Ferreira A, Lourenço-Silva N, Boechat JL, Borowiack E, Sadowska E, Costa RA, Perestrelo P, Pereira MS, Pereira-Macedo J, Ierodiakonou D, Chu AWL, Calvi IP, Torres MI, Silva Ribeiro RA, Thomander T, Valiulis A, Cherrez-Ojeda I, Bedbrook A, Klimek L, Yepes Nuñez JJ, Zuberbier T, Fonseca JA, Schünemann HJ, Bousquet J, Sousa-Pinto B, Panel A 2024- 2025 G. Efficacy and Safety of Oral Antihistamines for Allergic Rhinitis: Network Meta-Analysis. The journal of allergy and clinical immunology. In practice [Internet]. United States; 2026 May;14(5):1175-83. https://pubmed.ncbi.nlm.nih.gov/41707943BACKGROUND: Oral H1-antihistamines (OAHs) are among the most frequently used medications for the treatment of allergic rhinitis (AR). OBJECTIVE: To perform a systematic review and network meta-analysis comparing the efficacy and safety of individual OAHs in patients with AR. METHODS: We searched 4 electronic bibliographic databases and 3 clinical trial databases for randomized controlled trials assessing adults with perennial or seasonal AR, and comparing (1) OAH versus placebo or (2) different individual OAHs. We performed a network meta-analysis on the Total Nasal Symptom Score, Total Ocular Symptom Score, Rhinoconjunctivitis Quality-of-Life Questionnaire, development of adverse events, and withdrawals due to adverse events. Certainty of evidence for comparisons involving the most clinically relevant second-generation OAHs was assessed using Grading of Recommendations, Assessment and Evaluation approach to network meta-analysis. RESULTS: We included 74 randomized controlled trials (21 on perennial AR and 53 on seasonal AR). Cetirizine, ebastine, bilastine, and rupatadine were among the individual medications associated with the highest efficacy for improving nasal symptoms. For other efficacy outcomes, the most efficacious interventions varied. A similar frequency of adverse events was observed among different individual second-generation OAHs, with serious adverse events being rare. For most comparisons, the certainty of evidence was rated as "low" or "very low," indicating substantial uncertainty regarding the treatment effects. CONCLUSIONS: Although some OAHs seem to be more efficacious than others, most of the differences between individual second-generation medications are trivial or small. In addition, we did not find any relevant differences in the safety profiles of second-generation OAHs.
@article{vieira2026efficacy,
abstract = {BACKGROUND: Oral H1-antihistamines (OAHs) are among the most frequently used medications for the treatment of allergic rhinitis (AR). OBJECTIVE: To perform a systematic review and network meta-analysis comparing the efficacy and safety of individual OAHs in patients with AR. METHODS: We searched 4 electronic bibliographic databases and 3 clinical trial databases for randomized controlled trials assessing adults with perennial or seasonal AR, and comparing (1) OAH versus placebo or (2) different individual OAHs. We performed a network meta-analysis on the Total Nasal Symptom Score, Total Ocular Symptom Score, Rhinoconjunctivitis Quality-of-Life Questionnaire, development of adverse events, and withdrawals due to adverse events. Certainty of evidence for comparisons involving the most clinically relevant second-generation OAHs was assessed using Grading of Recommendations, Assessment and Evaluation approach to network meta-analysis. RESULTS: We included 74 randomized controlled trials (21 on perennial AR and 53 on seasonal AR). Cetirizine, ebastine, bilastine, and rupatadine were among the individual medications associated with the highest efficacy for improving nasal symptoms. For other efficacy outcomes, the most efficacious interventions varied. A similar frequency of adverse events was observed among different individual second-generation OAHs, with serious adverse events being rare. For most comparisons, the certainty of evidence was rated as "low" or "very low," indicating substantial uncertainty regarding the treatment effects. CONCLUSIONS: Although some OAHs seem to be more efficacious than others, most of the differences between individual second-generation medications are trivial or small. In addition, we did not find any relevant differences in the safety profiles of second-generation OAHs.},
address = {United States},
author = {Vieira, Rafael José and Gil-Mata, Sara and Ferreira, André and Riera-Serra, Pau and Bognanni, Antonio and Duarte, Vítor Henrique and Viegas, Hugo and Pereira, Ana Margarida and Ferreira-da Silva, Renato and Ferreira-Cardoso, Henrique and Marques-Cruz, Manuel and Castro-Teles, João and Campos-Lopes, Miguel and Teixeira-Ferreira, Ana and Lourenço-Silva, Nuno and Boechat, José Laerte and Borowiack, Ewa and Sadowska, Ewelina and Costa, Raquel Albuquerque and Perestrelo, Paula and Pereira, Marta Soares and Pereira-Macedo, Juliana and Ierodiakonou, Despo and Chu, Alexandro W L and Calvi, Izabela Pera and Torres, Maria Inês and Silva Ribeiro, Rita A and Thomander, Tuuli and Valiulis, Arunas and Cherrez-Ojeda, Ivan and Bedbrook, Anna and Klimek, Ludger and Yepes Nuñez, Juan Jose and Zuberbier, Torsten and Fonseca, João A and Schünemann, Holger J and Bousquet, Jean and Sousa-Pinto, Bernardo and Panel, ARIA 2024-2025 Guideline},
journal = {The journal of allergy and clinical immunology. In practice},
keywords = {evisap},
month = {may},
number = 5,
pages = {1175--1183},
title = {Efficacy and Safety of Oral Antihistamines for Allergic Rhinitis: Network Meta-Analysis},
volume = 14,
year = 2026
}%0 Journal Article
%1 vieira2026efficacy
%A Vieira, Rafael José
%A Gil-Mata, Sara
%A Ferreira, André
%A Riera-Serra, Pau
%A Bognanni, Antonio
%A Duarte, Vítor Henrique
%A Viegas, Hugo
%A Pereira, Ana Margarida
%A Ferreira-da Silva, Renato
%A Ferreira-Cardoso, Henrique
%A Marques-Cruz, Manuel
%A Castro-Teles, João
%A Campos-Lopes, Miguel
%A Teixeira-Ferreira, Ana
%A Lourenço-Silva, Nuno
%A Boechat, José Laerte
%A Borowiack, Ewa
%A Sadowska, Ewelina
%A Costa, Raquel Albuquerque
%A Perestrelo, Paula
%A Pereira, Marta Soares
%A Pereira-Macedo, Juliana
%A Ierodiakonou, Despo
%A Chu, Alexandro W L
%A Calvi, Izabela Pera
%A Torres, Maria Inês
%A Silva Ribeiro, Rita A
%A Thomander, Tuuli
%A Valiulis, Arunas
%A Cherrez-Ojeda, Ivan
%A Bedbrook, Anna
%A Klimek, Ludger
%A Yepes Nuñez, Juan Jose
%A Zuberbier, Torsten
%A Fonseca, João A
%A Schünemann, Holger J
%A Bousquet, Jean
%A Sousa-Pinto, Bernardo
%A Panel, ARIA 2024-2025 Guideline
%C United States
%D 2026
%J The journal of allergy and clinical immunology. In practice
%N 5
%P 1175--1183
%R 10.1016/j.jaip.2025.12.034
%T Efficacy and Safety of Oral Antihistamines for Allergic Rhinitis: Network Meta-Analysis
%U https://pubmed.ncbi.nlm.nih.gov/41707943
%V 14
%X BACKGROUND: Oral H1-antihistamines (OAHs) are among the most frequently used medications for the treatment of allergic rhinitis (AR). OBJECTIVE: To perform a systematic review and network meta-analysis comparing the efficacy and safety of individual OAHs in patients with AR. METHODS: We searched 4 electronic bibliographic databases and 3 clinical trial databases for randomized controlled trials assessing adults with perennial or seasonal AR, and comparing (1) OAH versus placebo or (2) different individual OAHs. We performed a network meta-analysis on the Total Nasal Symptom Score, Total Ocular Symptom Score, Rhinoconjunctivitis Quality-of-Life Questionnaire, development of adverse events, and withdrawals due to adverse events. Certainty of evidence for comparisons involving the most clinically relevant second-generation OAHs was assessed using Grading of Recommendations, Assessment and Evaluation approach to network meta-analysis. RESULTS: We included 74 randomized controlled trials (21 on perennial AR and 53 on seasonal AR). Cetirizine, ebastine, bilastine, and rupatadine were among the individual medications associated with the highest efficacy for improving nasal symptoms. For other efficacy outcomes, the most efficacious interventions varied. A similar frequency of adverse events was observed among different individual second-generation OAHs, with serious adverse events being rare. For most comparisons, the certainty of evidence was rated as "low" or "very low," indicating substantial uncertainty regarding the treatment effects. CONCLUSIONS: Although some OAHs seem to be more efficacious than others, most of the differences between individual second-generation medications are trivial or small. In addition, we did not find any relevant differences in the safety profiles of second-generation OAHs. -
AbstractBibTeXEndNoteDOIBibSonomy1.Fernández-Figares Vicioso MP, Vicente-Herrero MT, Ramírez Gallegos A, Ramírez-Manent JI, Tárraga López PJ, Del Barrio Fernández JL, López-González Á A. [Association between sociodemographic factors and health habits and the risk of MASLD assessed by FLI, HSI, and LAP in Spanish workers from the commerce and industry sectors]. Semergen. 2026;52(1):102671.INTRODUCTION: Metabolic dysfunction-associated steatotic liver disease (MASLD) has become a growing public health concern. Identifying associated sociodemographic and lifestyle factors is essential for implementing effective preventive strategies. OBJECTIVE: To analyze the association between sociodemographic variables (age, sex, educational level, and employment sector), health habits (physical activity, adherence to the Mediterranean diet, and smoking), and the risk of MASLD assessed through three non-invasive indexes: Fatty Liver Index (FLI), Hepatic Steatosis Index (HSI), and Lipid Accumulation Product (LAP), in a large cohort of Spanish workers from the commerce and industry sectors. METHODS: A cross-sectional study involving 56,856 workers (34,448 men and 22,408 women). FLI, HSI, and LAP were calculated, and their associations with the independent variables were analyzed using descriptive statistics, group comparisons, and multinomial logistic regression. RESULTS: High MASLD risk was significantly associated with male sex, older age, lower education, employment in the industrial sector, physical inactivity, poor adherence to the Mediterranean diet, and smoking (all p\textless0.001). Physical inactivity and a non-Mediterranean diet showed the strongest associations with elevated scores in FLI, HSI, and LAP. CONCLUSIONS: Preventive interventions should prioritize high-risk subgroups. The combined use of FLI, HSI, and LAP allows accurate identification of MASLD risk in occupational settings.
@article{fernandez-figares_vicioso_association_2026,
abstract = {INTRODUCTION: Metabolic dysfunction-associated steatotic liver disease (MASLD) has become a growing public health concern. Identifying associated sociodemographic and lifestyle factors is essential for implementing effective preventive strategies. OBJECTIVE: To analyze the association between sociodemographic variables (age, sex, educational level, and employment sector), health habits (physical activity, adherence to the Mediterranean diet, and smoking), and the risk of MASLD assessed through three non-invasive indexes: Fatty Liver Index (FLI), Hepatic Steatosis Index (HSI), and Lipid Accumulation Product (LAP), in a large cohort of Spanish workers from the commerce and industry sectors. METHODS: A cross-sectional study involving 56,856 workers (34,448 men and 22,408 women). FLI, HSI, and LAP were calculated, and their associations with the independent variables were analyzed using descriptive statistics, group comparisons, and multinomial logistic regression. RESULTS: High MASLD risk was significantly associated with male sex, older age, lower education, employment in the industrial sector, physical inactivity, poor adherence to the Mediterranean diet, and smoking (all p\textless0.001). Physical inactivity and a non-Mediterranean diet showed the strongest associations with elevated scores in FLI, HSI, and LAP. CONCLUSIONS: Preventive interventions should prioritize high-risk subgroups. The combined use of FLI, HSI, and LAP allows accurate identification of MASLD risk in occupational settings.},
author = {Fernández-Figares Vicioso, M. P. and Vicente-Herrero, M. T. and Ramírez Gallegos, A. and Ramírez-Manent, J. I. and Tárraga López, P. J. and Del Barrio Fernández, J. L. and López-González, Á A.},
journal = {Semergen},
keywords = {grapp-caib},
number = 1,
pages = 102671,
title = {[Association between sociodemographic factors and health habits and the risk of MASLD assessed by FLI, HSI, and LAP in Spanish workers from the commerce and industry sectors]},
volume = 52,
year = 2026
}%0 Journal Article
%1 fernandez-figares_vicioso_association_2026
%A Fernández-Figares Vicioso, M. P.
%A Vicente-Herrero, M. T.
%A Ramírez Gallegos, A.
%A Ramírez-Manent, J. I.
%A Tárraga López, P. J.
%A Del Barrio Fernández, J. L.
%A López-González, Á A.
%D 2026
%J Semergen
%N 1
%P 102671
%R 10.1016/j.semerg.2025.102671
%T [Association between sociodemographic factors and health habits and the risk of MASLD assessed by FLI, HSI, and LAP in Spanish workers from the commerce and industry sectors]
%V 52
%X INTRODUCTION: Metabolic dysfunction-associated steatotic liver disease (MASLD) has become a growing public health concern. Identifying associated sociodemographic and lifestyle factors is essential for implementing effective preventive strategies. OBJECTIVE: To analyze the association between sociodemographic variables (age, sex, educational level, and employment sector), health habits (physical activity, adherence to the Mediterranean diet, and smoking), and the risk of MASLD assessed through three non-invasive indexes: Fatty Liver Index (FLI), Hepatic Steatosis Index (HSI), and Lipid Accumulation Product (LAP), in a large cohort of Spanish workers from the commerce and industry sectors. METHODS: A cross-sectional study involving 56,856 workers (34,448 men and 22,408 women). FLI, HSI, and LAP were calculated, and their associations with the independent variables were analyzed using descriptive statistics, group comparisons, and multinomial logistic regression. RESULTS: High MASLD risk was significantly associated with male sex, older age, lower education, employment in the industrial sector, physical inactivity, poor adherence to the Mediterranean diet, and smoking (all p\textless0.001). Physical inactivity and a non-Mediterranean diet showed the strongest associations with elevated scores in FLI, HSI, and LAP. CONCLUSIONS: Preventive interventions should prioritize high-risk subgroups. The combined use of FLI, HSI, and LAP allows accurate identification of MASLD risk in occupational settings. -
AbstractBibTeXEndNoteDOIBibSonomy1.Ramírez-Gallegos I, Tárraga López PJ, Marina Arroyo M, López-González Á A, Coll Campayo I, Busquets-Cortés C, Ramírez-Manent JI. Metabolic age as a marker of cardiometabolic risk: Relationships with metabolic syndrome, hypertriglyceridemic waist, and hypertensive waist phenotypes in a large occupational cohort. Semergen. 2026 Feb.;52(4):102725.BACKGROUND: Metabolic age (MA) has been proposed as an integrative, clinically intuitive indicator of physiological aging that may capture clustered cardiometabolic risk better than single traits. OBJECTIVE: We examined the association and discriminative performance of MA with metabolic syndrome (MetS) defined by NCEP ATP III, IDF, and Joint Interim Statement (JIS) criteria, and with the hypertriglyceridemic waist (HTGW) and hypertensive waist (HTAW) phenotypes, in a large occupational cohort. METHODS: Cross-sectional analytic study of Spanish workers attending routine occupational health examinations (January-June 2022). A total of 8590 employees (4104 men; 4486 women), aged 18-69 years, with standardized anthropometry, blood pressure, and fasting laboratory testing were included. MA was obtained via multifrequency bioelectrical impedance analysis; high MA was defined as MA ≥chronological age. Negative MA values (metabolic age lower than chronological age) indicate a metabolically younger or healthier profile, while positive values reflect accelerated metabolic aging and higher cardiometabolic risk. Five multivariable logistic models estimated adjusted odds ratios (ORs, 95\% CI) for high MA across the five phenotypes; covariates included sex, age group, social class, smoking, physical activity, and Mediterranean diet adherence. Sex-stratified ROC analyses assessed discrimination (AUC); optimal thresholds were derived using Youden's index. RESULTS: High MA showed strong, independent associations with all phenotypes: MetS NCEP ATP III, OR 8.01 (95\% CI 6.79-9.24); MetS IDF, OR 10.96 (9.23-12.80); MetS JIS, OR 7.94 (6.78-9.10); HTGW, OR 7.44 (6.10-8.79); HTAW, OR 13.97 (11.82-16.13). Behavioral and socioeconomic gradients were coherent across models (e.g., physical inactivity OR range 3.99-4.60; low Mediterranean diet adherence 2.38-2.61; smoking 1.17-1.23; lower social class III 2.27-2.42; men vs women 1.07-1.18). Sex-specific ROC analyses indicated good discrimination: AUCs (women/men) were 0.836/0.825 (NCEP ATP III), 0.835/0.833 (IDF), 0.819/0.807 (JIS), 0.813/0.849 (HTGW), and 0.827/0.865 (HTAW). Optimal MA cut-offs (difference MA-chronological age) ranged from -2 to +2 years across phenotypes and sex, yielding balanced sensitivity (∼75-82\%) and specificity (∼75-77\%). CONCLUSIONS: In a large occupational cohort, MA - derived from bioimpedance - was strongly and consistently associated with MetS (across three definitions) and with HTGW and HTAW, and it discriminated these phenotypes with AUCs ∼0.81-0.87. MA appears to be a feasible, low-burden metric that complements waist-based screening to prioritize preventive actions in workplace health programs. Longitudinal and interventional studies are warranted to confirm temporal relationships, refine MA thresholds by sex and age, and quantify incremental prognostic value beyond established risk indices.
@article{ramirez-gallegos_metabolic_2026,
abstract = {BACKGROUND: Metabolic age (MA) has been proposed as an integrative, clinically intuitive indicator of physiological aging that may capture clustered cardiometabolic risk better than single traits. OBJECTIVE: We examined the association and discriminative performance of MA with metabolic syndrome (MetS) defined by NCEP ATP III, IDF, and Joint Interim Statement (JIS) criteria, and with the hypertriglyceridemic waist (HTGW) and hypertensive waist (HTAW) phenotypes, in a large occupational cohort. METHODS: Cross-sectional analytic study of Spanish workers attending routine occupational health examinations (January-June 2022). A total of 8590 employees (4104 men; 4486 women), aged 18-69 years, with standardized anthropometry, blood pressure, and fasting laboratory testing were included. MA was obtained via multifrequency bioelectrical impedance analysis; high MA was defined as MA ≥chronological age. Negative MA values (metabolic age lower than chronological age) indicate a metabolically younger or healthier profile, while positive values reflect accelerated metabolic aging and higher cardiometabolic risk. Five multivariable logistic models estimated adjusted odds ratios (ORs, 95\% CI) for high MA across the five phenotypes; covariates included sex, age group, social class, smoking, physical activity, and Mediterranean diet adherence. Sex-stratified ROC analyses assessed discrimination (AUC); optimal thresholds were derived using Youden's index. RESULTS: High MA showed strong, independent associations with all phenotypes: MetS NCEP ATP III, OR 8.01 (95\% CI 6.79-9.24); MetS IDF, OR 10.96 (9.23-12.80); MetS JIS, OR 7.94 (6.78-9.10); HTGW, OR 7.44 (6.10-8.79); HTAW, OR 13.97 (11.82-16.13). Behavioral and socioeconomic gradients were coherent across models (e.g., physical inactivity OR range 3.99-4.60; low Mediterranean diet adherence 2.38-2.61; smoking 1.17-1.23; lower social class III 2.27-2.42; men vs women 1.07-1.18). Sex-specific ROC analyses indicated good discrimination: AUCs (women/men) were 0.836/0.825 (NCEP ATP III), 0.835/0.833 (IDF), 0.819/0.807 (JIS), 0.813/0.849 (HTGW), and 0.827/0.865 (HTAW). Optimal MA cut-offs (difference MA-chronological age) ranged from -2 to +2 years across phenotypes and sex, yielding balanced sensitivity (∼75-82\%) and specificity (∼75-77\%). CONCLUSIONS: In a large occupational cohort, MA - derived from bioimpedance - was strongly and consistently associated with MetS (across three definitions) and with HTGW and HTAW, and it discriminated these phenotypes with AUCs ∼0.81-0.87. MA appears to be a feasible, low-burden metric that complements waist-based screening to prioritize preventive actions in workplace health programs. Longitudinal and interventional studies are warranted to confirm temporal relationships, refine MA thresholds by sex and age, and quantify incremental prognostic value beyond established risk indices.},
author = {Ramírez-Gallegos, I. and Tárraga López, P. J. and Marina Arroyo, M. and López-González, Á A. and Coll Campayo, I. and Busquets-Cortés, C. and Ramírez-Manent, J. I.},
journal = {Semergen},
keywords = {grapp-caib},
month = {feb},
number = 4,
pages = 102725,
title = {Metabolic age as a marker of cardiometabolic risk: Relationships with metabolic syndrome, hypertriglyceridemic waist, and hypertensive waist phenotypes in a large occupational cohort},
volume = 52,
year = 2026
}%0 Journal Article
%1 ramirez-gallegos_metabolic_2026
%A Ramírez-Gallegos, I.
%A Tárraga López, P. J.
%A Marina Arroyo, M.
%A López-González, Á A.
%A Coll Campayo, I.
%A Busquets-Cortés, C.
%A Ramírez-Manent, J. I.
%D 2026
%J Semergen
%N 4
%P 102725
%R 10.1016/j.semerg.2026.102725
%T Metabolic age as a marker of cardiometabolic risk: Relationships with metabolic syndrome, hypertriglyceridemic waist, and hypertensive waist phenotypes in a large occupational cohort
%V 52
%X BACKGROUND: Metabolic age (MA) has been proposed as an integrative, clinically intuitive indicator of physiological aging that may capture clustered cardiometabolic risk better than single traits. OBJECTIVE: We examined the association and discriminative performance of MA with metabolic syndrome (MetS) defined by NCEP ATP III, IDF, and Joint Interim Statement (JIS) criteria, and with the hypertriglyceridemic waist (HTGW) and hypertensive waist (HTAW) phenotypes, in a large occupational cohort. METHODS: Cross-sectional analytic study of Spanish workers attending routine occupational health examinations (January-June 2022). A total of 8590 employees (4104 men; 4486 women), aged 18-69 years, with standardized anthropometry, blood pressure, and fasting laboratory testing were included. MA was obtained via multifrequency bioelectrical impedance analysis; high MA was defined as MA ≥chronological age. Negative MA values (metabolic age lower than chronological age) indicate a metabolically younger or healthier profile, while positive values reflect accelerated metabolic aging and higher cardiometabolic risk. Five multivariable logistic models estimated adjusted odds ratios (ORs, 95\% CI) for high MA across the five phenotypes; covariates included sex, age group, social class, smoking, physical activity, and Mediterranean diet adherence. Sex-stratified ROC analyses assessed discrimination (AUC); optimal thresholds were derived using Youden's index. RESULTS: High MA showed strong, independent associations with all phenotypes: MetS NCEP ATP III, OR 8.01 (95\% CI 6.79-9.24); MetS IDF, OR 10.96 (9.23-12.80); MetS JIS, OR 7.94 (6.78-9.10); HTGW, OR 7.44 (6.10-8.79); HTAW, OR 13.97 (11.82-16.13). Behavioral and socioeconomic gradients were coherent across models (e.g., physical inactivity OR range 3.99-4.60; low Mediterranean diet adherence 2.38-2.61; smoking 1.17-1.23; lower social class III 2.27-2.42; men vs women 1.07-1.18). Sex-specific ROC analyses indicated good discrimination: AUCs (women/men) were 0.836/0.825 (NCEP ATP III), 0.835/0.833 (IDF), 0.819/0.807 (JIS), 0.813/0.849 (HTGW), and 0.827/0.865 (HTAW). Optimal MA cut-offs (difference MA-chronological age) ranged from -2 to +2 years across phenotypes and sex, yielding balanced sensitivity (∼75-82\%) and specificity (∼75-77\%). CONCLUSIONS: In a large occupational cohort, MA - derived from bioimpedance - was strongly and consistently associated with MetS (across three definitions) and with HTGW and HTAW, and it discriminated these phenotypes with AUCs ∼0.81-0.87. MA appears to be a feasible, low-burden metric that complements waist-based screening to prioritize preventive actions in workplace health programs. Longitudinal and interventional studies are warranted to confirm temporal relationships, refine MA thresholds by sex and age, and quantify incremental prognostic value beyond established risk indices. - AbstractBibTeXEndNoteDOIBibSonomyDownload1.Oliva-Fanlo B, Esteva M, Ramírez-Manent JI, Albaladejo-Dávalos A, Corcoll-Reixach J, Gadea-Ruiz MC, Morán-Bayón Álvaro, Bulilete O. Lung ultrasound performed by primary care physicians as a predictive and diagnostic tool in COVID-19 patients. NPJ primary care respiratory medicine. 2026 Apr.;.To assess the value of abnormal findings of lung POCUS performed by PCPs in patients with SARS-CoV-2 virus infection in predicting hospitalisations, intensive care admissions, and mortality. Additionally, this study aims to assess the validity of lung POCUS performed by PCPs for COVID-19 pneumonia diagnosis. This prospective observational study, conducted in Mallorca and Salamanca, Spain, during 2021, assessed 624 consecutive adult patients with confirmed SARS-CoV-2 infection and worsening symptoms. Eight PCPs with 5-hour standardized training performed 12-zone lung POCUS. POCUS was considered positive if pleural abnormalities with ≥3 B-lines, subpleural consolidation, or lobar consolidation were present. Patients were followed for 30 days to confirm pneumonia diagnosis via chest X-ray or CT scan. Multivariate models using Poisson regression were performed to identify independent predictors for hospitalization and ICU admission/death. Abnormal POCUS findings were observed in 58.8% of patients, of whom 50.3% presented pleural abnormalities with 3 or more B-lines in at least one scanned area, 27.6% subpleural consolidations, and 3.4% lobar consolidations. Patients with positive POCUS were referred to the hospital more frequently (72.4\% vs. 22.8\%; OR = 8.83). Abnormal lung POCUS was independently associated with an increased risk of hospitalization (RR 1.34; 95\% CI 1.07-1.67), along with age textgreater50 years, SpO2 textless95%, hypertension, and diabetes. POCUS was not independently associated with the composite outcome of ICU admission or death (RR 1.27; 95\% CI 0.62-2.61). For the diagnosis of COVID-19 pneumonia, overall POCUS sensitivity was 68.3%, specificity 43.6%, positive predictive value 78.7%, and negative predictive value 31.1%. Lung POCUS performed by PCPs is a valuable independent predictor for hospitalization in COVID-19 patients within community settings. While its incremental prognostic benefit over simple clinical variables is modest and its diagnostic accuracy for pneumonia is limited compared to conventional imaging, it could remain as a useful tool for risk stratification in resource-limited environments or home-based care. These findings support its use in resource-limited environments and highlight the need for standardised scanning protocols and training.
@article{oliva-fanlo_lung_2026,
abstract = {To assess the value of abnormal findings of lung POCUS performed by PCPs in patients with SARS-CoV-2 virus infection in predicting hospitalisations, intensive care admissions, and mortality. Additionally, this study aims to assess the validity of lung POCUS performed by PCPs for COVID-19 pneumonia diagnosis. This prospective observational study, conducted in Mallorca and Salamanca, Spain, during 2021, assessed 624 consecutive adult patients with confirmed SARS-CoV-2 infection and worsening symptoms. Eight PCPs with 5-hour standardized training performed 12-zone lung POCUS. POCUS was considered positive if pleural abnormalities with ≥3 B-lines, subpleural consolidation, or lobar consolidation were present. Patients were followed for 30 days to confirm pneumonia diagnosis via chest X-ray or CT scan. Multivariate models using Poisson regression were performed to identify independent predictors for hospitalization and ICU admission/death. Abnormal POCUS findings were observed in 58.8% of patients, of whom 50.3% presented pleural abnormalities with 3 or more B-lines in at least one scanned area, 27.6% subpleural consolidations, and 3.4% lobar consolidations. Patients with positive POCUS were referred to the hospital more frequently (72.4\% vs. 22.8\%; OR = 8.83). Abnormal lung POCUS was independently associated with an increased risk of hospitalization (RR 1.34; 95\% CI 1.07-1.67), along with age textgreater50 years, SpO2 textless95%, hypertension, and diabetes. POCUS was not independently associated with the composite outcome of ICU admission or death (RR 1.27; 95\% CI 0.62-2.61). For the diagnosis of COVID-19 pneumonia, overall POCUS sensitivity was 68.3%, specificity 43.6%, positive predictive value 78.7%, and negative predictive value 31.1%. Lung POCUS performed by PCPs is a valuable independent predictor for hospitalization in COVID-19 patients within community settings. While its incremental prognostic benefit over simple clinical variables is modest and its diagnostic accuracy for pneumonia is limited compared to conventional imaging, it could remain as a useful tool for risk stratification in resource-limited environments or home-based care. These findings support its use in resource-limited environments and highlight the need for standardised scanning protocols and training.},
author = {Oliva-Fanlo, Bernardino and Esteva, Magdalena and Ramírez-Manent, José Ignacio and Albaladejo-Dávalos, Antonio and Corcoll-Reixach, Josep and Gadea-Ruiz, Mª Cristina and Morán-Bayón, Álvaro and Bulilete, Oana},
journal = {NPJ primary care respiratory medicine},
keywords = {grapp-caib},
month = {apr},
title = {Lung ultrasound performed by primary care physicians as a predictive and diagnostic tool in COVID-19 patients},
year = 2026
}%0 Journal Article
%1 oliva-fanlo_lung_2026
%A Oliva-Fanlo, Bernardino
%A Esteva, Magdalena
%A Ramírez-Manent, José Ignacio
%A Albaladejo-Dávalos, Antonio
%A Corcoll-Reixach, Josep
%A Gadea-Ruiz, Mª Cristina
%A Morán-Bayón, Álvaro
%A Bulilete, Oana
%D 2026
%J NPJ primary care respiratory medicine
%R 10.1038/s41533-026-00515-4
%T Lung ultrasound performed by primary care physicians as a predictive and diagnostic tool in COVID-19 patients
%X To assess the value of abnormal findings of lung POCUS performed by PCPs in patients with SARS-CoV-2 virus infection in predicting hospitalisations, intensive care admissions, and mortality. Additionally, this study aims to assess the validity of lung POCUS performed by PCPs for COVID-19 pneumonia diagnosis. This prospective observational study, conducted in Mallorca and Salamanca, Spain, during 2021, assessed 624 consecutive adult patients with confirmed SARS-CoV-2 infection and worsening symptoms. Eight PCPs with 5-hour standardized training performed 12-zone lung POCUS. POCUS was considered positive if pleural abnormalities with ≥3 B-lines, subpleural consolidation, or lobar consolidation were present. Patients were followed for 30 days to confirm pneumonia diagnosis via chest X-ray or CT scan. Multivariate models using Poisson regression were performed to identify independent predictors for hospitalization and ICU admission/death. Abnormal POCUS findings were observed in 58.8% of patients, of whom 50.3% presented pleural abnormalities with 3 or more B-lines in at least one scanned area, 27.6% subpleural consolidations, and 3.4% lobar consolidations. Patients with positive POCUS were referred to the hospital more frequently (72.4\% vs. 22.8\%; OR = 8.83). Abnormal lung POCUS was independently associated with an increased risk of hospitalization (RR 1.34; 95\% CI 1.07-1.67), along with age textgreater50 years, SpO2 textless95%, hypertension, and diabetes. POCUS was not independently associated with the composite outcome of ICU admission or death (RR 1.27; 95\% CI 0.62-2.61). For the diagnosis of COVID-19 pneumonia, overall POCUS sensitivity was 68.3%, specificity 43.6%, positive predictive value 78.7%, and negative predictive value 31.1%. Lung POCUS performed by PCPs is a valuable independent predictor for hospitalization in COVID-19 patients within community settings. While its incremental prognostic benefit over simple clinical variables is modest and its diagnostic accuracy for pneumonia is limited compared to conventional imaging, it could remain as a useful tool for risk stratification in resource-limited environments or home-based care. These findings support its use in resource-limited environments and highlight the need for standardised scanning protocols and training. - AbstractBibTeXEndNoteDOIBibSonomyDownload1.Riutord P, Tarraga PJ, Lopez-Gonzalez AA, Coll-Campayo I, Busquets C, Ramirez-Manent JI. Interplay of Lifestyle Social Determinants and Isolation in the Risk of Metabolic Syndrome Among Spanish Workers. Cureus. 2026 Jan.;18(1):e101624.BACKGROUND: Metabolic syndrome (MetS) is a cluster of cardiometabolic abnormalities linked to cardiovascular disease and type 2 diabetes mellitus. While lifestyle and sociodemographic determinants are well established, the role of social isolation in MetS is less explored. METHODS: A nationwide cross-sectional study included 117,298 Spanish workers from multiple occupational sectors (2021-2024). MetS was defined using National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP) III, International Diabetes Federation (IDF), and Joint Interim Statement (JIS) criteria. Sociodemographic, lifestyle, and psychosocial variables were assessed with standardized questionnaires, including the ENRICHD Social Support Instrument. Logistic regression estimated associations with MetS prevalence. RESULTS: MetS prevalence was 28.7% (NCEP ATP III), 32.1% (IDF), and 33.5% (JIS). Men had consistently higher prevalence than women (p\textless0.001). Prevalence rose with age, exceeding 40% in workers ≥55 years. Low socioeconomic status was linked to a higher prevalence (p\textless0.001). Lifestyle factors were strongly associated: physical inactivity doubled the odds of MetS (OR≈2.0); poor Mediterranean diet adherence and smoking increased risk, while regular activity and high dietary adherence were protective (all p\textless0.001). Low social support independently increased the odds of MetS across all definitions, even after adjustment. CONCLUSIONS: In this large cohort, MetS was highly prevalent and strongly influenced by lifestyle, sociodemographic, and psychosocial factors. Social isolation emerged as an independent determinant, underscoring the need for workplace strategies integrating lifestyle promotion with social support.
@article{riutord_interplay_2026,
abstract = {BACKGROUND: Metabolic syndrome (MetS) is a cluster of cardiometabolic abnormalities linked to cardiovascular disease and type 2 diabetes mellitus. While lifestyle and sociodemographic determinants are well established, the role of social isolation in MetS is less explored. METHODS: A nationwide cross-sectional study included 117,298 Spanish workers from multiple occupational sectors (2021-2024). MetS was defined using National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP) III, International Diabetes Federation (IDF), and Joint Interim Statement (JIS) criteria. Sociodemographic, lifestyle, and psychosocial variables were assessed with standardized questionnaires, including the ENRICHD Social Support Instrument. Logistic regression estimated associations with MetS prevalence. RESULTS: MetS prevalence was 28.7% (NCEP ATP III), 32.1% (IDF), and 33.5% (JIS). Men had consistently higher prevalence than women (p\textless0.001). Prevalence rose with age, exceeding 40% in workers ≥55 years. Low socioeconomic status was linked to a higher prevalence (p\textless0.001). Lifestyle factors were strongly associated: physical inactivity doubled the odds of MetS (OR≈2.0); poor Mediterranean diet adherence and smoking increased risk, while regular activity and high dietary adherence were protective (all p\textless0.001). Low social support independently increased the odds of MetS across all definitions, even after adjustment. CONCLUSIONS: In this large cohort, MetS was highly prevalent and strongly influenced by lifestyle, sociodemographic, and psychosocial factors. Social isolation emerged as an independent determinant, underscoring the need for workplace strategies integrating lifestyle promotion with social support.},
author = {Riutord, Pere and Tarraga, Pedro J. and Lopez-Gonzalez, Angel A. and Coll-Campayo, Irene and Busquets, Carla and Ramirez-Manent, Jose I.},
journal = {Cureus},
keywords = {grapp-caib},
month = {jan},
number = 1,
pages = {e101624},
title = {Interplay of Lifestyle Social Determinants and Isolation in the Risk of Metabolic Syndrome Among Spanish Workers},
volume = 18,
year = 2026
}%0 Journal Article
%1 riutord_interplay_2026
%A Riutord, Pere
%A Tarraga, Pedro J.
%A Lopez-Gonzalez, Angel A.
%A Coll-Campayo, Irene
%A Busquets, Carla
%A Ramirez-Manent, Jose I.
%D 2026
%J Cureus
%N 1
%P e101624
%R 10.7759/cureus.101624
%T Interplay of Lifestyle Social Determinants and Isolation in the Risk of Metabolic Syndrome Among Spanish Workers
%V 18
%X BACKGROUND: Metabolic syndrome (MetS) is a cluster of cardiometabolic abnormalities linked to cardiovascular disease and type 2 diabetes mellitus. While lifestyle and sociodemographic determinants are well established, the role of social isolation in MetS is less explored. METHODS: A nationwide cross-sectional study included 117,298 Spanish workers from multiple occupational sectors (2021-2024). MetS was defined using National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP) III, International Diabetes Federation (IDF), and Joint Interim Statement (JIS) criteria. Sociodemographic, lifestyle, and psychosocial variables were assessed with standardized questionnaires, including the ENRICHD Social Support Instrument. Logistic regression estimated associations with MetS prevalence. RESULTS: MetS prevalence was 28.7% (NCEP ATP III), 32.1% (IDF), and 33.5% (JIS). Men had consistently higher prevalence than women (p\textless0.001). Prevalence rose with age, exceeding 40% in workers ≥55 years. Low socioeconomic status was linked to a higher prevalence (p\textless0.001). Lifestyle factors were strongly associated: physical inactivity doubled the odds of MetS (OR≈2.0); poor Mediterranean diet adherence and smoking increased risk, while regular activity and high dietary adherence were protective (all p\textless0.001). Low social support independently increased the odds of MetS across all definitions, even after adjustment. CONCLUSIONS: In this large cohort, MetS was highly prevalent and strongly influenced by lifestyle, sociodemographic, and psychosocial factors. Social isolation emerged as an independent determinant, underscoring the need for workplace strategies integrating lifestyle promotion with social support. -
AbstractBibTeXEndNoteDOIBibSonomy1.Fernández-Figares Vicioso MP, Vicente-Herrero MT, Sbert PR, Ramírez-Manent JI, Tárraga Marcos PJ, Del Barrio Fernández JL, López-González Ángel A. Atherogenic Risk in Commerce and Industry Workers: Associations with Sociodemographic and Lifestyle Factors in a Large Spanish Occupational Cohort. Clinica E Investigacion En Arteriosclerosis: Publicacion Oficial De La Sociedad Espanola De Arteriosclerosis. 2026 Jan.;:500873.BACKGROUND: Atherogenic dyslipidemia (AD) and associated lipid ratios are critical markers for cardiovascular risk, yet little is known about how these markers vary by occupational sector and sociodemographic or lifestyle factors in working populations. OBJECTIVE: To evaluate the prevalence and determinants of elevated atherogenic risk according to total cholesterol/HDL-c (TC/HDL-c), LDL-c/HDL-c, triglycerides/HDL-c (TG/HDL-c), and AD in workers from the commerce and industry sectors, stratified by sex, age, education, physical activity, diet, and smoking. METHODS: This cross-sectional study included 56,856 Spanish workers (39,448 men and 17,408 women) from commerce (n=27,448) and industry (n=29,408). Sociodemographic, clinical, and lifestyle data were collected, and atherogenic risk was assessed using TC/HDL-c, LDL-c/HDL-c, TG/HDL-c ratios, and AD presence. Mean values and prevalence were compared by group, and multinomial logistic regression was used to estimate the association between risk markers and covariates. RESULTS: Workers in the industry sector showed higher mean values and prevalence of all atherogenic risk scales compared to those in commerce, particularly among men and older age groups. Male sex, older age, lower education, physical inactivity, absence of Mediterranean diet, and smoking were consistently associated with higher odds of elevated lipid ratios and AD. Notably, the absence of physical activity was strongly associated with all outcomes, with ORs ranging from 3.08 to 11.66. The industrial sector was independently associated with increased risk: TC/HDL-c (OR=1.23), LDL-c/HDL-c (OR=1.15), TG/HDL-c (OR=1.16), and AD (OR=1.19). CONCLUSIONS: Atherogenic risk profiles are less favorable among industrial workers and are significantly influenced by modifiable lifestyle factors. These findings support the need for preventive strategies tailored to the occupational context, with emphasis on promoting physical activity, smoking cessation, and healthier dietary habits, in order to reduce cardiovascular risk in these populations.
@article{fernandez-figares_vicioso_atherogenic_2026,
abstract = {BACKGROUND: Atherogenic dyslipidemia (AD) and associated lipid ratios are critical markers for cardiovascular risk, yet little is known about how these markers vary by occupational sector and sociodemographic or lifestyle factors in working populations. OBJECTIVE: To evaluate the prevalence and determinants of elevated atherogenic risk according to total cholesterol/HDL-c (TC/HDL-c), LDL-c/HDL-c, triglycerides/HDL-c (TG/HDL-c), and AD in workers from the commerce and industry sectors, stratified by sex, age, education, physical activity, diet, and smoking. METHODS: This cross-sectional study included 56,856 Spanish workers (39,448 men and 17,408 women) from commerce (n=27,448) and industry (n=29,408). Sociodemographic, clinical, and lifestyle data were collected, and atherogenic risk was assessed using TC/HDL-c, LDL-c/HDL-c, TG/HDL-c ratios, and AD presence. Mean values and prevalence were compared by group, and multinomial logistic regression was used to estimate the association between risk markers and covariates. RESULTS: Workers in the industry sector showed higher mean values and prevalence of all atherogenic risk scales compared to those in commerce, particularly among men and older age groups. Male sex, older age, lower education, physical inactivity, absence of Mediterranean diet, and smoking were consistently associated with higher odds of elevated lipid ratios and AD. Notably, the absence of physical activity was strongly associated with all outcomes, with ORs ranging from 3.08 to 11.66. The industrial sector was independently associated with increased risk: TC/HDL-c (OR=1.23), LDL-c/HDL-c (OR=1.15), TG/HDL-c (OR=1.16), and AD (OR=1.19). CONCLUSIONS: Atherogenic risk profiles are less favorable among industrial workers and are significantly influenced by modifiable lifestyle factors. These findings support the need for preventive strategies tailored to the occupational context, with emphasis on promoting physical activity, smoking cessation, and healthier dietary habits, in order to reduce cardiovascular risk in these populations.},
author = {Fernández-Figares Vicioso, María Pilar and Vicente-Herrero, María Teófila and Sbert, Pere Riutord and Ramírez-Manent, José Ignacio and Tárraga Marcos, Pedro Juan and Del Barrio Fernández, José Luis and López-González, Ángel Arturo},
journal = {Clinica E Investigacion En Arteriosclerosis: Publicacion Oficial De La Sociedad Espanola De Arteriosclerosis},
keywords = {grapp-caib},
month = {jan},
pages = 500873,
title = {Atherogenic Risk in Commerce and Industry Workers: Associations with Sociodemographic and Lifestyle Factors in a Large Spanish Occupational Cohort},
year = 2026
}%0 Journal Article
%1 fernandez-figares_vicioso_atherogenic_2026
%A Fernández-Figares Vicioso, María Pilar
%A Vicente-Herrero, María Teófila
%A Sbert, Pere Riutord
%A Ramírez-Manent, José Ignacio
%A Tárraga Marcos, Pedro Juan
%A Del Barrio Fernández, José Luis
%A López-González, Ángel Arturo
%D 2026
%J Clinica E Investigacion En Arteriosclerosis: Publicacion Oficial De La Sociedad Espanola De Arteriosclerosis
%P 500873
%R 10.1016/j.arteri.2025.500873
%T Atherogenic Risk in Commerce and Industry Workers: Associations with Sociodemographic and Lifestyle Factors in a Large Spanish Occupational Cohort
%X BACKGROUND: Atherogenic dyslipidemia (AD) and associated lipid ratios are critical markers for cardiovascular risk, yet little is known about how these markers vary by occupational sector and sociodemographic or lifestyle factors in working populations. OBJECTIVE: To evaluate the prevalence and determinants of elevated atherogenic risk according to total cholesterol/HDL-c (TC/HDL-c), LDL-c/HDL-c, triglycerides/HDL-c (TG/HDL-c), and AD in workers from the commerce and industry sectors, stratified by sex, age, education, physical activity, diet, and smoking. METHODS: This cross-sectional study included 56,856 Spanish workers (39,448 men and 17,408 women) from commerce (n=27,448) and industry (n=29,408). Sociodemographic, clinical, and lifestyle data were collected, and atherogenic risk was assessed using TC/HDL-c, LDL-c/HDL-c, TG/HDL-c ratios, and AD presence. Mean values and prevalence were compared by group, and multinomial logistic regression was used to estimate the association between risk markers and covariates. RESULTS: Workers in the industry sector showed higher mean values and prevalence of all atherogenic risk scales compared to those in commerce, particularly among men and older age groups. Male sex, older age, lower education, physical inactivity, absence of Mediterranean diet, and smoking were consistently associated with higher odds of elevated lipid ratios and AD. Notably, the absence of physical activity was strongly associated with all outcomes, with ORs ranging from 3.08 to 11.66. The industrial sector was independently associated with increased risk: TC/HDL-c (OR=1.23), LDL-c/HDL-c (OR=1.15), TG/HDL-c (OR=1.16), and AD (OR=1.19). CONCLUSIONS: Atherogenic risk profiles are less favorable among industrial workers and are significantly influenced by modifiable lifestyle factors. These findings support the need for preventive strategies tailored to the occupational context, with emphasis on promoting physical activity, smoking cessation, and healthier dietary habits, in order to reduce cardiovascular risk in these populations. -
AbstractBibTeXEndNoteDOIBibSonomy1.López-González Ángel A, Ramírez-Manent JI, Martínez-Almoyna Rifá E, Paublini Oliveira H, Martorell Sánchez C, Tárraga López PJ. Association between sociodemographic variables, lifestyle factors, and stress with lipoprotein ratio values. Clinica E Investigacion En Arteriosclerosis: Publicacion Oficial De La Sociedad Espanola De Arteriosclerosis. 2026;38(2):500803.INTRODUCTION: Atherosclerosis is a multifactorial process underlying major cardiovascular diseases (CVDs). Among the associated risk factors, lipoprotein ratios have been identified as key indicators of atherogenic risk. However, the influence of sociodemographic variables, lifestyle factors, and stress levels on lipoprotein ratios remains underexplored. OBJECTIVE: To analyze the relationship between sociodemographic variables, healthy lifestyle habits, and stress levels with lipoprotein ratios and atherogenic risk in a large cohort of Spanish workers. MATERIALS AND METHODS: A cross-sectional study was conducted in 24,244 Spanish workers. The association between age, gender, socioeconomic status, tobacco and alcohol consumption, physical activity, adherence to the Mediterranean diet, and stress levels with atherogenic risk scales, including atherogenic dyslipidemia (AD) and atherogenic índices, was evaluated. RESULTS: A significant association was found between all analyzed variables and lipoprotein ratios. The strongest associations were observed with age and gender, followed by occupational status, tobacco and alcohol consumption, physical activity, diet, and stress levels. Men exhibited a higher atherogenic risk compared to women (OR 2.36; 95\% CI 2.18-2.55). The risk increased significantly with age, peaking in the 50-69 age group (OR 5.00; 95\% CI 3.70-6.31). Manual workers had a higher prevalence of atherogenic dyslipidemia compared to non-manual workers (OR 1.35; 95\% CI 1.27-1.41). Furthermore, smoking (OR 1.84; 95\% CI 1.71-1.97) and alcohol consumption (OR 1.45; 95\% CI 1.36-1.55), physical inactivity (OR 1.90; 95\% CI 1.76-2.05), and low adherence to the Mediterranean diet (OR 1.72; 95\% CI 1.60-1.84) were associated with higher atherogenic index values. CONCLUSIONS: The presence of an adverse lipoprotein profile is strongly influenced by sociodemographic factors, lifestyle habits, and stress. Identifying these determinants may enable the implementation of preventive strategies aimed at reducing atherogenic risk and improving cardiovascular health in working populations.
@article{lopez-gonzalez_association_2026,
abstract = {INTRODUCTION: Atherosclerosis is a multifactorial process underlying major cardiovascular diseases (CVDs). Among the associated risk factors, lipoprotein ratios have been identified as key indicators of atherogenic risk. However, the influence of sociodemographic variables, lifestyle factors, and stress levels on lipoprotein ratios remains underexplored. OBJECTIVE: To analyze the relationship between sociodemographic variables, healthy lifestyle habits, and stress levels with lipoprotein ratios and atherogenic risk in a large cohort of Spanish workers. MATERIALS AND METHODS: A cross-sectional study was conducted in 24,244 Spanish workers. The association between age, gender, socioeconomic status, tobacco and alcohol consumption, physical activity, adherence to the Mediterranean diet, and stress levels with atherogenic risk scales, including atherogenic dyslipidemia (AD) and atherogenic índices, was evaluated. RESULTS: A significant association was found between all analyzed variables and lipoprotein ratios. The strongest associations were observed with age and gender, followed by occupational status, tobacco and alcohol consumption, physical activity, diet, and stress levels. Men exhibited a higher atherogenic risk compared to women (OR 2.36; 95\% CI 2.18-2.55). The risk increased significantly with age, peaking in the 50-69 age group (OR 5.00; 95\% CI 3.70-6.31). Manual workers had a higher prevalence of atherogenic dyslipidemia compared to non-manual workers (OR 1.35; 95\% CI 1.27-1.41). Furthermore, smoking (OR 1.84; 95\% CI 1.71-1.97) and alcohol consumption (OR 1.45; 95\% CI 1.36-1.55), physical inactivity (OR 1.90; 95\% CI 1.76-2.05), and low adherence to the Mediterranean diet (OR 1.72; 95\% CI 1.60-1.84) were associated with higher atherogenic index values. CONCLUSIONS: The presence of an adverse lipoprotein profile is strongly influenced by sociodemographic factors, lifestyle habits, and stress. Identifying these determinants may enable the implementation of preventive strategies aimed at reducing atherogenic risk and improving cardiovascular health in working populations.},
author = {López-González, Ángel Arturo and Ramírez-Manent, José Ignacio and Martínez-Almoyna Rifá, Emilio and Paublini Oliveira, Hernán and Martorell Sánchez, Cristina and Tárraga López, Pedro Juan},
journal = {Clinica E Investigacion En Arteriosclerosis: Publicacion Oficial De La Sociedad Espanola De Arteriosclerosis},
keywords = {grapp-caib},
number = 2,
pages = 500803,
title = {Association between sociodemographic variables, lifestyle factors, and stress with lipoprotein ratio values},
volume = 38,
year = 2026
}%0 Journal Article
%1 lopez-gonzalez_association_2026
%A López-González, Ángel Arturo
%A Ramírez-Manent, José Ignacio
%A Martínez-Almoyna Rifá, Emilio
%A Paublini Oliveira, Hernán
%A Martorell Sánchez, Cristina
%A Tárraga López, Pedro Juan
%D 2026
%J Clinica E Investigacion En Arteriosclerosis: Publicacion Oficial De La Sociedad Espanola De Arteriosclerosis
%N 2
%P 500803
%R 10.1016/j.arteri.2025.500803
%T Association between sociodemographic variables, lifestyle factors, and stress with lipoprotein ratio values
%V 38
%X INTRODUCTION: Atherosclerosis is a multifactorial process underlying major cardiovascular diseases (CVDs). Among the associated risk factors, lipoprotein ratios have been identified as key indicators of atherogenic risk. However, the influence of sociodemographic variables, lifestyle factors, and stress levels on lipoprotein ratios remains underexplored. OBJECTIVE: To analyze the relationship between sociodemographic variables, healthy lifestyle habits, and stress levels with lipoprotein ratios and atherogenic risk in a large cohort of Spanish workers. MATERIALS AND METHODS: A cross-sectional study was conducted in 24,244 Spanish workers. The association between age, gender, socioeconomic status, tobacco and alcohol consumption, physical activity, adherence to the Mediterranean diet, and stress levels with atherogenic risk scales, including atherogenic dyslipidemia (AD) and atherogenic índices, was evaluated. RESULTS: A significant association was found between all analyzed variables and lipoprotein ratios. The strongest associations were observed with age and gender, followed by occupational status, tobacco and alcohol consumption, physical activity, diet, and stress levels. Men exhibited a higher atherogenic risk compared to women (OR 2.36; 95\% CI 2.18-2.55). The risk increased significantly with age, peaking in the 50-69 age group (OR 5.00; 95\% CI 3.70-6.31). Manual workers had a higher prevalence of atherogenic dyslipidemia compared to non-manual workers (OR 1.35; 95\% CI 1.27-1.41). Furthermore, smoking (OR 1.84; 95\% CI 1.71-1.97) and alcohol consumption (OR 1.45; 95\% CI 1.36-1.55), physical inactivity (OR 1.90; 95\% CI 1.76-2.05), and low adherence to the Mediterranean diet (OR 1.72; 95\% CI 1.60-1.84) were associated with higher atherogenic index values. CONCLUSIONS: The presence of an adverse lipoprotein profile is strongly influenced by sociodemographic factors, lifestyle habits, and stress. Identifying these determinants may enable the implementation of preventive strategies aimed at reducing atherogenic risk and improving cardiovascular health in working populations. - AbstractURLBibTeXEndNoteDOIBibSonomyDownload1.Zamanillo-Campos R, Chela-Álvarez X, Mateu-Estrany EM, Colom-Rosselló M, Taltavull-Aparicio JM, Ripoll J, Serrano-Ripoll MJ, Fiol deRoque MA, Ricci-Cabello I. Experiences of using the DiabeText mobile text messaging intervention to support diabetes self-management for people living with type 2 diabetes: Post-hoc process evaluation. Digital health [Internet]. United States; 2026 Sep.;12:20552076261484739-. https://pubmed.ncbi.nlm.nih.gov/42718965OBJECTIVE: Poor adherence to prescribed treatment for people with type 2 diabetes increases the risk of complications, mortality, and associated healthcare costs. Mobile phone text-messaging interventions such as DiabeText can support diabetes self-management and improve health outcomes. This study aimed to explore patients' experiences with the DiabeText intervention and the contexts and mechanisms through which behavioral change might occur. METHODS: A post-hoc process evaluation using a mixed-methods design was conducted within primary care settings in Spain. The analysis combined a questionnaire-based study with 371 participants, aimed at rating the behavior change techniques embedded in the text messages, and a qualitative interview study with 19 participants. Quantitative data were analyzed descriptively, while qualitative data underwent thematic analysis. RESULTS: Participants reported predominantly positive experiences with the intervention, highlighting increased support, motivation, and self-care capacity. They valued the reliable and practical content as well as the user-friendly format, which were perceived as facilitating healthier lifestyle changes and supporting medication adherence. However, participants also suggested incorporating greater personalization to enhance acceptability. The mechanisms through which the intervention may foster behavioral change likely relate to the inclusion of behavior change techniques (BCTs) previously associated with positive outcomes-and which participants rated as highly helpful in supporting change. Nevertheless, further research is needed to determine the specific active ingredients that would maximize DiabeText's overall impact. CONCLUSION: DiabeText was well received by individuals with T2DM to support self-care. Introducing personalized features and messages that utilize BCTs previously associated with better outcomes could be a good starting point for better outcomes.
@article{zamanillocampos2026experiences,
abstract = {OBJECTIVE: Poor adherence to prescribed treatment for people with type 2 diabetes increases the risk of complications, mortality, and associated healthcare costs. Mobile phone text-messaging interventions such as DiabeText can support diabetes self-management and improve health outcomes. This study aimed to explore patients' experiences with the DiabeText intervention and the contexts and mechanisms through which behavioral change might occur. METHODS: A post-hoc process evaluation using a mixed-methods design was conducted within primary care settings in Spain. The analysis combined a questionnaire-based study with 371 participants, aimed at rating the behavior change techniques embedded in the text messages, and a qualitative interview study with 19 participants. Quantitative data were analyzed descriptively, while qualitative data underwent thematic analysis. RESULTS: Participants reported predominantly positive experiences with the intervention, highlighting increased support, motivation, and self-care capacity. They valued the reliable and practical content as well as the user-friendly format, which were perceived as facilitating healthier lifestyle changes and supporting medication adherence. However, participants also suggested incorporating greater personalization to enhance acceptability. The mechanisms through which the intervention may foster behavioral change likely relate to the inclusion of behavior change techniques (BCTs) previously associated with positive outcomes-and which participants rated as highly helpful in supporting change. Nevertheless, further research is needed to determine the specific active ingredients that would maximize DiabeText's overall impact. CONCLUSION: DiabeText was well received by individuals with T2DM to support self-care. Introducing personalized features and messages that utilize BCTs previously associated with better outcomes could be a good starting point for better outcomes.},
address = {United States},
author = {Zamanillo-Campos, Rocío and Chela-Álvarez, Xènia and Mateu-Estrany, Esperança Maria and Colom-Rosselló, Miquel and Taltavull-Aparicio, Joana Maria and Ripoll, Joana and Serrano-Ripoll, Maria Jesús and Fiol deRoque, Maria Antonia and Ricci-Cabello, Ignacio},
journal = {Digital health},
keywords = {evisap},
month = {sep},
pages = {20552076261484739--20552076261484739},
title = {Experiences of using the DiabeText mobile text messaging intervention to support diabetes self-management for people living with type 2 diabetes: Post-hoc process evaluation},
volume = 12,
year = 2026
}%0 Journal Article
%1 zamanillocampos2026experiences
%A Zamanillo-Campos, Rocío
%A Chela-Álvarez, Xènia
%A Mateu-Estrany, Esperança Maria
%A Colom-Rosselló, Miquel
%A Taltavull-Aparicio, Joana Maria
%A Ripoll, Joana
%A Serrano-Ripoll, Maria Jesús
%A Fiol deRoque, Maria Antonia
%A Ricci-Cabello, Ignacio
%C United States
%D 2026
%J Digital health
%P 20552076261484739--20552076261484739
%R 10.1177/20552076261484739
%T Experiences of using the DiabeText mobile text messaging intervention to support diabetes self-management for people living with type 2 diabetes: Post-hoc process evaluation
%U https://pubmed.ncbi.nlm.nih.gov/42718965
%V 12
%X OBJECTIVE: Poor adherence to prescribed treatment for people with type 2 diabetes increases the risk of complications, mortality, and associated healthcare costs. Mobile phone text-messaging interventions such as DiabeText can support diabetes self-management and improve health outcomes. This study aimed to explore patients' experiences with the DiabeText intervention and the contexts and mechanisms through which behavioral change might occur. METHODS: A post-hoc process evaluation using a mixed-methods design was conducted within primary care settings in Spain. The analysis combined a questionnaire-based study with 371 participants, aimed at rating the behavior change techniques embedded in the text messages, and a qualitative interview study with 19 participants. Quantitative data were analyzed descriptively, while qualitative data underwent thematic analysis. RESULTS: Participants reported predominantly positive experiences with the intervention, highlighting increased support, motivation, and self-care capacity. They valued the reliable and practical content as well as the user-friendly format, which were perceived as facilitating healthier lifestyle changes and supporting medication adherence. However, participants also suggested incorporating greater personalization to enhance acceptability. The mechanisms through which the intervention may foster behavioral change likely relate to the inclusion of behavior change techniques (BCTs) previously associated with positive outcomes-and which participants rated as highly helpful in supporting change. Nevertheless, further research is needed to determine the specific active ingredients that would maximize DiabeText's overall impact. CONCLUSION: DiabeText was well received by individuals with T2DM to support self-care. Introducing personalized features and messages that utilize BCTs previously associated with better outcomes could be a good starting point for better outcomes. - AbstractBibTeXEndNoteBibSonomyDownload1.Gervilla-García E, García-Pazo P, Guillén-Solà M, Leguizamo F, Ricci-Cabello I, Serrano-Ripoll MJ, Bennasar-Veny M, Fiol deRoque MA, Angullo-Martínez E, Zamanillo-Campos R. Stakeholder Perspectives on Implementing DiabeText: Exploring Barriers and Facilitators for a Personalized Diabetes Self-Management SMS Intervention in Spain. Diabetology. 2026;7:17.Background/Objectives: Mobile health (mHealth) interventions can enhance chronic disease management, but their integration into public healthcare systems remains complex. DiabeText is the first SMS-based intervention in Spain delivering personalized diabetes self-management support using electronic health record data. This study explored perceived barriers and facilitators to the implementation of DiabeText in the Spanish public health context from the perspective of key stakeholders. Methods: A qualitative study was conducted using semi-structured interviews with 14 purposively selected stakeholders involved in digital health, diabetes care, data protection, and healthcare management across several Spanish regions. Interviews were thematically analyzed using Braun and Clarke’s approach and guided by the Implementation Research Logic Model. Results: Participants reported several barriers, including concerns regarding data protection, uncertainty about long-term sustainability, insufficient training and engagement of healthcare professionals and low digital literacy among certain patient groups. Facilitators included favorable institutional momentum for digital innovation, funding availability, perceived clinical utility and scalability of DiabeText, and growing patient familiarity with digital tools. Recommended strategies included integration into existing healthcare systems and workflows, professional training and use of familiar communication platforms. Conclusions: Effective implementation of DiabeText requires addressing regulatory, organizational, and equity-related barriers while leveraging institutional support and readiness for innovation. Early involvement of healthcare professionals, robust data governance, and investment in digital literacy are essential to ensure sustainable and equitable adoption. These findings provide actionable insights to support the integration of mHealth tools into chronic disease care in Spain and similar settings.
@article{gervillagarcia2026stakeholder,
abstract = {Background/Objectives: Mobile health (mHealth) interventions can enhance chronic disease management, but their integration into public healthcare systems remains complex. DiabeText is the first SMS-based intervention in Spain delivering personalized diabetes self-management support using electronic health record data. This study explored perceived barriers and facilitators to the implementation of DiabeText in the Spanish public health context from the perspective of key stakeholders. Methods: A qualitative study was conducted using semi-structured interviews with 14 purposively selected stakeholders involved in digital health, diabetes care, data protection, and healthcare management across several Spanish regions. Interviews were thematically analyzed using Braun and Clarke’s approach and guided by the Implementation Research Logic Model. Results: Participants reported several barriers, including concerns regarding data protection, uncertainty about long-term sustainability, insufficient training and engagement of healthcare professionals and low digital literacy among certain patient groups. Facilitators included favorable institutional momentum for digital innovation, funding availability, perceived clinical utility and scalability of DiabeText, and growing patient familiarity with digital tools. Recommended strategies included integration into existing healthcare systems and workflows, professional training and use of familiar communication platforms. Conclusions: Effective implementation of DiabeText requires addressing regulatory, organizational, and equity-related barriers while leveraging institutional support and readiness for innovation. Early involvement of healthcare professionals, robust data governance, and investment in digital literacy are essential to ensure sustainable and equitable adoption. These findings provide actionable insights to support the integration of mHealth tools into chronic disease care in Spain and similar settings.},
author = {Gervilla-García, Elena and García-Pazo, Patricia and Guillén-Solà, Mireia and Leguizamo, Federico and Ricci-Cabello, Ignacio and Serrano-Ripoll, María J. and Bennasar-Veny, Miquel and Fiol deRoque, Maria A. and Angullo-Martínez, Escarlata and Zamanillo-Campos, Rocío},
booktitle = {Diabetology},
keywords = {evisap telemedicine},
pages = 17,
series = 1,
title = {Stakeholder Perspectives on Implementing DiabeText: Exploring Barriers and Facilitators for a Personalized Diabetes Self-Management SMS Intervention in Spain},
volume = 7,
year = 2026
}%0 Journal Article
%1 gervillagarcia2026stakeholder
%A Gervilla-García, Elena
%A García-Pazo, Patricia
%A Guillén-Solà, Mireia
%A Leguizamo, Federico
%A Ricci-Cabello, Ignacio
%A Serrano-Ripoll, María J.
%A Bennasar-Veny, Miquel
%A Fiol deRoque, Maria A.
%A Angullo-Martínez, Escarlata
%A Zamanillo-Campos, Rocío
%B Diabetology
%D 2026
%P 17
%T Stakeholder Perspectives on Implementing DiabeText: Exploring Barriers and Facilitators for a Personalized Diabetes Self-Management SMS Intervention in Spain
%V 7
%X Background/Objectives: Mobile health (mHealth) interventions can enhance chronic disease management, but their integration into public healthcare systems remains complex. DiabeText is the first SMS-based intervention in Spain delivering personalized diabetes self-management support using electronic health record data. This study explored perceived barriers and facilitators to the implementation of DiabeText in the Spanish public health context from the perspective of key stakeholders. Methods: A qualitative study was conducted using semi-structured interviews with 14 purposively selected stakeholders involved in digital health, diabetes care, data protection, and healthcare management across several Spanish regions. Interviews were thematically analyzed using Braun and Clarke’s approach and guided by the Implementation Research Logic Model. Results: Participants reported several barriers, including concerns regarding data protection, uncertainty about long-term sustainability, insufficient training and engagement of healthcare professionals and low digital literacy among certain patient groups. Facilitators included favorable institutional momentum for digital innovation, funding availability, perceived clinical utility and scalability of DiabeText, and growing patient familiarity with digital tools. Recommended strategies included integration into existing healthcare systems and workflows, professional training and use of familiar communication platforms. Conclusions: Effective implementation of DiabeText requires addressing regulatory, organizational, and equity-related barriers while leveraging institutional support and readiness for innovation. Early involvement of healthcare professionals, robust data governance, and investment in digital literacy are essential to ensure sustainable and equitable adoption. These findings provide actionable insights to support the integration of mHealth tools into chronic disease care in Spain and similar settings. - BibTeXEndNoteDOIBibSonomyDownload1.Vieira RJ, Gil-Mata S, Ferreira A, Riera-Serra P, Bognanni A, Duarte VH, Viegas H, Pereira AM, Ferreira-da Silva R, Ferreira-Cardoso H, Marques-Cruz M, Castro-Teles J, Campos-Lopes M, Teixeira-Ferreira A, Lourenço-Silva N, Boechat JL, Borowiack E, Sadowska E, Costa RA, Perestrelo P, Pereira MS, Pereira-Macedo J, Ierodiakonou D, Chu AWL, Calvi IP, Torres MI, Silva Ribeiro RA, Thomander T, Valiulis A, Cherrez-Ojeda I, Bedbrook A, Klimek L, Yepes Nuñez JJ, Zuberbier T, Fonseca JA, Schünemann HJ, Bousquet J, Sousa-Pinto B. Efficacy and safety of oral antihistamines for allergic rhinitis: Network meta-analysis. J Allergy Clin Immunol Pract. 2026;.
@article{RN6,
author = {Vieira, R. J. and Gil-Mata, S. and Ferreira, A. and Riera-Serra, P. and Bognanni, A. and Duarte, V. H. and Viegas, H. and Pereira, A. M. and Ferreira-da Silva, R. and Ferreira-Cardoso, H. and Marques-Cruz, M. and Castro-Teles, J. and Campos-Lopes, M. and Teixeira-Ferreira, A. and Lourenço-Silva, N. and Boechat, J. L. and Borowiack, E. and Sadowska, E. and Costa, R. A. and Perestrelo, P. and Pereira, M. S. and Pereira-Macedo, J. and Ierodiakonou, D. and Chu, A. W. L. and Calvi, I. P. and Torres, M. I. and Silva Ribeiro, R. A. and Thomander, T. and Valiulis, A. and Cherrez-Ojeda, I. and Bedbrook, A. and Klimek, L. and Yepes Nuñez, J. J. and Zuberbier, T. and Fonseca, J. A. and Schünemann, H. J. and Bousquet, J. and Sousa-Pinto, B.},
journal = {J Allergy Clin Immunol Pract},
keywords = {evisap},
title = {Efficacy and safety of oral antihistamines for allergic rhinitis: Network meta-analysis},
type = {Journal Article},
year = 2026
}%0 Journal Article
%1 RN6
%A Vieira, R. J.
%A Gil-Mata, S.
%A Ferreira, A.
%A Riera-Serra, P.
%A Bognanni, A.
%A Duarte, V. H.
%A Viegas, H.
%A Pereira, A. M.
%A Ferreira-da Silva, R.
%A Ferreira-Cardoso, H.
%A Marques-Cruz, M.
%A Castro-Teles, J.
%A Campos-Lopes, M.
%A Teixeira-Ferreira, A.
%A Lourenço-Silva, N.
%A Boechat, J. L.
%A Borowiack, E.
%A Sadowska, E.
%A Costa, R. A.
%A Perestrelo, P.
%A Pereira, M. S.
%A Pereira-Macedo, J.
%A Ierodiakonou, D.
%A Chu, A. W. L.
%A Calvi, I. P.
%A Torres, M. I.
%A Silva Ribeiro, R. A.
%A Thomander, T.
%A Valiulis, A.
%A Cherrez-Ojeda, I.
%A Bedbrook, A.
%A Klimek, L.
%A Yepes Nuñez, J. J.
%A Zuberbier, T.
%A Fonseca, J. A.
%A Schünemann, H. J.
%A Bousquet, J.
%A Sousa-Pinto, B.
%D 2026
%J J Allergy Clin Immunol Pract
%R 10.1016/j.jaip.2025.12.034
%T Efficacy and safety of oral antihistamines for allergic rhinitis: Network meta-analysis - AbstractBibTeXEndNoteDOIBibSonomyDownload1.Riera-Serra P, Serrano-Ripoll MJ, Fiol deRoque MA, García-Pazo P, Bennasar-Veny M, Yánez-Juan A, Leiva-Rus A, Ginard-Puigserver M, García-Toro M, Sitges C, Balle M, Gervilla E, Gonzalez-Garcia X, García-Buades ME, Blanes MW, Zamanillo-Campos R, Andreu-Rodrigo P, Ricci-Cabello I. Evaluation of the effectiveness of SOM-RIU, a multifaceted, school-based, suicide prevention intervention targeted to Spanish adolescents: study protocol for a cluster-randomised controlled trial. BMC Psychiatry. 2026;26(1):56.BACKGROUND: Adolescent suicide is a major public health concern and the third leading cause of death among young people worldwide. Schools are widely recognized as effective settings for universal mental health promotion and suicide prevention. This study aims to evaluate the effectiveness of SOM-RIU, a multifaceted school-based intervention involving pupils and gatekeepers (teachers and parents) in preventing suicidal behaviour and promoting adolescent mental health. METHODS: We will conduct a six-month, two-arm, cluster-randomised controlled trial. We will recruit 2,280 pupils from 114 classrooms in 38 secondary schools across the Balearic Islands (Spain). Eligible pupils will be aged 12–16 and enrolled in the 2nd and 3rd years of compulsory secondary education. Schools will be randomly assigned (1:1) to either the intervention or control group. Schools in the intervention group will implement the SOM-RIU programme, which includes four weekly psychoeducational sessions for pupils, delivered by trained educational psychologists. These sessions focus on mental health literacy, emotional regulation, suicide risk detection and management, and help-seeking strategies. In parallel, gatekeepers (teachers and parents) will receive a digital educational co-intervention consisting in four multimedia modules to strengthen their role in suicide prevention. Schools in the control group will receive a minimal intervention consisting of educational posters on mental health and suicide prevention displayed within school premises. The primary outcome will be suicidal ideation (Paykel Suicide Scale). Secondary outcomes will include suicide attempts, depression symptoms, well-being, self-harm, substance use, internet addiction, bullying, and cognitive disconnection. Teachers and parents will report on suicide-related knowledge, self-efficacy, and student referrals. Data will be collected at baseline and six-month follow-up. Analyses will be conducted using generalized linear mixed models to account for clustering, and multiple imputation will be used for missing data. A qualitative process evaluation will explore implementation, acceptability, and perceived impact of the intervention, while also examining contextual factors and potential mechanisms of action that may have influenced the outcomes. DISCUSSION: This trial will generate evidence on the effectiveness of multifaceted, school-based suicide prevention interventions for adolescents. If effective, the SOM-RIU programme could serve as a practical model for enhancing mental health support within educational settings in Spain. TRIAL REGISTRATION: NCT06996054 (clinicaltrials.gov). Registration date: 2025-05-30. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12888-025-07570-0.
@article{RN7,
abstract = {BACKGROUND: Adolescent suicide is a major public health concern and the third leading cause of death among young people worldwide. Schools are widely recognized as effective settings for universal mental health promotion and suicide prevention. This study aims to evaluate the effectiveness of SOM-RIU, a multifaceted school-based intervention involving pupils and gatekeepers (teachers and parents) in preventing suicidal behaviour and promoting adolescent mental health. METHODS: We will conduct a six-month, two-arm, cluster-randomised controlled trial. We will recruit 2,280 pupils from 114 classrooms in 38 secondary schools across the Balearic Islands (Spain). Eligible pupils will be aged 12–16 and enrolled in the 2nd and 3rd years of compulsory secondary education. Schools will be randomly assigned (1:1) to either the intervention or control group. Schools in the intervention group will implement the SOM-RIU programme, which includes four weekly psychoeducational sessions for pupils, delivered by trained educational psychologists. These sessions focus on mental health literacy, emotional regulation, suicide risk detection and management, and help-seeking strategies. In parallel, gatekeepers (teachers and parents) will receive a digital educational co-intervention consisting in four multimedia modules to strengthen their role in suicide prevention. Schools in the control group will receive a minimal intervention consisting of educational posters on mental health and suicide prevention displayed within school premises. The primary outcome will be suicidal ideation (Paykel Suicide Scale). Secondary outcomes will include suicide attempts, depression symptoms, well-being, self-harm, substance use, internet addiction, bullying, and cognitive disconnection. Teachers and parents will report on suicide-related knowledge, self-efficacy, and student referrals. Data will be collected at baseline and six-month follow-up. Analyses will be conducted using generalized linear mixed models to account for clustering, and multiple imputation will be used for missing data. A qualitative process evaluation will explore implementation, acceptability, and perceived impact of the intervention, while also examining contextual factors and potential mechanisms of action that may have influenced the outcomes. DISCUSSION: This trial will generate evidence on the effectiveness of multifaceted, school-based suicide prevention interventions for adolescents. If effective, the SOM-RIU programme could serve as a practical model for enhancing mental health support within educational settings in Spain. TRIAL REGISTRATION: NCT06996054 (clinicaltrials.gov). Registration date: 2025-05-30. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12888-025-07570-0.},
author = {Riera-Serra, P. and Serrano-Ripoll, M. J. and Fiol deRoque, M. A. and García-Pazo, P. and Bennasar-Veny, M. and Yánez-Juan, A. and Leiva-Rus, A. and Ginard-Puigserver, M. and García-Toro, M. and Sitges, C. and Balle, M. and Gervilla, E. and Gonzalez-Garcia, X. and García-Buades, M. E. and Blanes, M. W. and Zamanillo-Campos, R. and Andreu-Rodrigo, P. and Ricci-Cabello, I.},
journal = {BMC Psychiatry},
keywords = {evisap},
number = 1,
pages = 56,
title = {Evaluation of the effectiveness of SOM-RIU, a multifaceted, school-based, suicide prevention intervention targeted to Spanish adolescents: study protocol for a cluster-randomised controlled trial},
type = {Journal Article},
volume = 26,
year = 2026
}%0 Journal Article
%1 RN7
%A Riera-Serra, P.
%A Serrano-Ripoll, M. J.
%A Fiol deRoque, M. A.
%A García-Pazo, P.
%A Bennasar-Veny, M.
%A Yánez-Juan, A.
%A Leiva-Rus, A.
%A Ginard-Puigserver, M.
%A García-Toro, M.
%A Sitges, C.
%A Balle, M.
%A Gervilla, E.
%A Gonzalez-Garcia, X.
%A García-Buades, M. E.
%A Blanes, M. W.
%A Zamanillo-Campos, R.
%A Andreu-Rodrigo, P.
%A Ricci-Cabello, I.
%D 2026
%J BMC Psychiatry
%N 1
%P 56
%R 10.1186/s12888-025-07570-0
%T Evaluation of the effectiveness of SOM-RIU, a multifaceted, school-based, suicide prevention intervention targeted to Spanish adolescents: study protocol for a cluster-randomised controlled trial
%V 26
%X BACKGROUND: Adolescent suicide is a major public health concern and the third leading cause of death among young people worldwide. Schools are widely recognized as effective settings for universal mental health promotion and suicide prevention. This study aims to evaluate the effectiveness of SOM-RIU, a multifaceted school-based intervention involving pupils and gatekeepers (teachers and parents) in preventing suicidal behaviour and promoting adolescent mental health. METHODS: We will conduct a six-month, two-arm, cluster-randomised controlled trial. We will recruit 2,280 pupils from 114 classrooms in 38 secondary schools across the Balearic Islands (Spain). Eligible pupils will be aged 12–16 and enrolled in the 2nd and 3rd years of compulsory secondary education. Schools will be randomly assigned (1:1) to either the intervention or control group. Schools in the intervention group will implement the SOM-RIU programme, which includes four weekly psychoeducational sessions for pupils, delivered by trained educational psychologists. These sessions focus on mental health literacy, emotional regulation, suicide risk detection and management, and help-seeking strategies. In parallel, gatekeepers (teachers and parents) will receive a digital educational co-intervention consisting in four multimedia modules to strengthen their role in suicide prevention. Schools in the control group will receive a minimal intervention consisting of educational posters on mental health and suicide prevention displayed within school premises. The primary outcome will be suicidal ideation (Paykel Suicide Scale). Secondary outcomes will include suicide attempts, depression symptoms, well-being, self-harm, substance use, internet addiction, bullying, and cognitive disconnection. Teachers and parents will report on suicide-related knowledge, self-efficacy, and student referrals. Data will be collected at baseline and six-month follow-up. Analyses will be conducted using generalized linear mixed models to account for clustering, and multiple imputation will be used for missing data. A qualitative process evaluation will explore implementation, acceptability, and perceived impact of the intervention, while also examining contextual factors and potential mechanisms of action that may have influenced the outcomes. DISCUSSION: This trial will generate evidence on the effectiveness of multifaceted, school-based suicide prevention interventions for adolescents. If effective, the SOM-RIU programme could serve as a practical model for enhancing mental health support within educational settings in Spain. TRIAL REGISTRATION: NCT06996054 (clinicaltrials.gov). Registration date: 2025-05-30. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12888-025-07570-0. - AbstractBibTeXEndNoteDOIBibSonomyDownload1.Sarmiento Cruz M, Tárraga López PJ, Piña Dabreu MS, Rodas Cañellas L, López-González Ángel A, Ramírez-Manent JI. Clinically Relevant Discordance Between SCORE2 and REGICOR in Spanish Workers: Implications for Cardiovascular Risk Reclassification in Primary Prevention. Medical Sciences. Basel, Switzerland; 2026 Jun.;14(2):294.BACKGROUND: Cardiovascular risk prediction models are central to primary prevention strategies, yet substantial variability exists between contemporary and traditional equations used in clinical practice. In Spain, SCORE2 and REGICOR currently coexist as major cardiovascular risk assessment tools despite important methodological differences. However, evidence regarding their concordance in large occupational populations remains limited. OBJECTIVE: To evaluate the agreement between SCORE2 and REGICOR in cardiovascular risk stratification among Spanish workers and to quantify the extent of cardiovascular risk reclassification associated with SCORE2 implementation. METHODS: A multicenter cross-sectional study was conducted in 216,310 Spanish workers aged 40-64 years undergoing routine occupational health examinations between 2019 and 2024. Cardiovascular risk was estimated using SCORE2, REGICOR, ERICE, DORICA, Globorisk, and Framingham-based equations. High-risk categories were defined according to the thresholds recommended for each model. Agreement between categorical classifications was assessed using Cohen's kappa coefficient, whereas Pearson correlation coefficients were calculated for continuous risk estimates. RESULTS: SCORE2 classified 15,617 workers (7.22\%) as high cardiovascular risk, whereas REGICOR identified only 4409 individuals (2.04\%). Among workers classified as high risk by SCORE2, 14,387 (92.1\%) were not identified as high risk by REGICOR. Agreement between SCORE2 and REGICOR was slight (kappa = 0.094), indicating minimal concordance in high-risk classification. By contrast, SCORE2 demonstrated higher agreement with Framingham hard coronary events (kappa = 0.567) and Globorisk (kappa = 0.534). Correlation analyses showed strong associations between SCORE2 and several continuous cardiovascular risk estimates, including the Framingham categorical score (r = 0.768), Framingham hard coronary events (r = 0.758), and Globorisk (r = 0.739), whereas the correlation between SCORE2 and REGICOR was substantially lower (r = 0.251). These findings indicate that strong statistical correlation does not necessarily translate into clinically meaningful agreement in cardiovascular risk categorization. CONCLUSIONS: Substantial discordance exists between SCORE2 and REGICOR in the identification of high cardiovascular risk among Spanish workers. SCORE2 consistently classified a considerably larger proportion of individuals as high risk, whereas REGICOR showed limited concordance with contemporary cardiovascular prediction models. Continued reliance on REGICOR instead of SCORE2 may lead to under-identification of workers who could currently be considered candidates for intensified primary cardiovascular prevention according to contemporary European prevention strategies. Nevertheless, the present study does not establish which model provides superior prediction of future cardiovascular events, and prospective outcome-based validation studies remain necessary.
@article{sarmiento_cruz_clinically_2026,
abstract = {BACKGROUND: Cardiovascular risk prediction models are central to primary prevention strategies, yet substantial variability exists between contemporary and traditional equations used in clinical practice. In Spain, SCORE2 and REGICOR currently coexist as major cardiovascular risk assessment tools despite important methodological differences. However, evidence regarding their concordance in large occupational populations remains limited. OBJECTIVE: To evaluate the agreement between SCORE2 and REGICOR in cardiovascular risk stratification among Spanish workers and to quantify the extent of cardiovascular risk reclassification associated with SCORE2 implementation. METHODS: A multicenter cross-sectional study was conducted in 216,310 Spanish workers aged 40-64 years undergoing routine occupational health examinations between 2019 and 2024. Cardiovascular risk was estimated using SCORE2, REGICOR, ERICE, DORICA, Globorisk, and Framingham-based equations. High-risk categories were defined according to the thresholds recommended for each model. Agreement between categorical classifications was assessed using Cohen's kappa coefficient, whereas Pearson correlation coefficients were calculated for continuous risk estimates. RESULTS: SCORE2 classified 15,617 workers (7.22\%) as high cardiovascular risk, whereas REGICOR identified only 4409 individuals (2.04\%). Among workers classified as high risk by SCORE2, 14,387 (92.1\%) were not identified as high risk by REGICOR. Agreement between SCORE2 and REGICOR was slight (kappa = 0.094), indicating minimal concordance in high-risk classification. By contrast, SCORE2 demonstrated higher agreement with Framingham hard coronary events (kappa = 0.567) and Globorisk (kappa = 0.534). Correlation analyses showed strong associations between SCORE2 and several continuous cardiovascular risk estimates, including the Framingham categorical score (r = 0.768), Framingham hard coronary events (r = 0.758), and Globorisk (r = 0.739), whereas the correlation between SCORE2 and REGICOR was substantially lower (r = 0.251). These findings indicate that strong statistical correlation does not necessarily translate into clinically meaningful agreement in cardiovascular risk categorization. CONCLUSIONS: Substantial discordance exists between SCORE2 and REGICOR in the identification of high cardiovascular risk among Spanish workers. SCORE2 consistently classified a considerably larger proportion of individuals as high risk, whereas REGICOR showed limited concordance with contemporary cardiovascular prediction models. Continued reliance on REGICOR instead of SCORE2 may lead to under-identification of workers who could currently be considered candidates for intensified primary cardiovascular prevention according to contemporary European prevention strategies. Nevertheless, the present study does not establish which model provides superior prediction of future cardiovascular events, and prospective outcome-based validation studies remain necessary.},
address = {Basel, Switzerland},
author = {Sarmiento Cruz, Manuel and Tárraga López, Pedro Juan and Piña Dabreu, Mónica Silu and Rodas Cañellas, Lluis and López-González, Ángel Arturo and Ramírez-Manent, José Ignacio},
journal = {Medical Sciences},
keywords = {grapp-caib},
month = {jun},
number = 2,
pages = 294,
title = {Clinically Relevant Discordance Between SCORE2 and REGICOR in Spanish Workers: Implications for Cardiovascular Risk Reclassification in Primary Prevention},
volume = 14,
year = 2026
}%0 Journal Article
%1 sarmiento_cruz_clinically_2026
%A Sarmiento Cruz, Manuel
%A Tárraga López, Pedro Juan
%A Piña Dabreu, Mónica Silu
%A Rodas Cañellas, Lluis
%A López-González, Ángel Arturo
%A Ramírez-Manent, José Ignacio
%C Basel, Switzerland
%D 2026
%J Medical Sciences
%N 2
%P 294
%R 10.3390/medsci14020294
%T Clinically Relevant Discordance Between SCORE2 and REGICOR in Spanish Workers: Implications for Cardiovascular Risk Reclassification in Primary Prevention
%V 14
%X BACKGROUND: Cardiovascular risk prediction models are central to primary prevention strategies, yet substantial variability exists between contemporary and traditional equations used in clinical practice. In Spain, SCORE2 and REGICOR currently coexist as major cardiovascular risk assessment tools despite important methodological differences. However, evidence regarding their concordance in large occupational populations remains limited. OBJECTIVE: To evaluate the agreement between SCORE2 and REGICOR in cardiovascular risk stratification among Spanish workers and to quantify the extent of cardiovascular risk reclassification associated with SCORE2 implementation. METHODS: A multicenter cross-sectional study was conducted in 216,310 Spanish workers aged 40-64 years undergoing routine occupational health examinations between 2019 and 2024. Cardiovascular risk was estimated using SCORE2, REGICOR, ERICE, DORICA, Globorisk, and Framingham-based equations. High-risk categories were defined according to the thresholds recommended for each model. Agreement between categorical classifications was assessed using Cohen's kappa coefficient, whereas Pearson correlation coefficients were calculated for continuous risk estimates. RESULTS: SCORE2 classified 15,617 workers (7.22\%) as high cardiovascular risk, whereas REGICOR identified only 4409 individuals (2.04\%). Among workers classified as high risk by SCORE2, 14,387 (92.1\%) were not identified as high risk by REGICOR. Agreement between SCORE2 and REGICOR was slight (kappa = 0.094), indicating minimal concordance in high-risk classification. By contrast, SCORE2 demonstrated higher agreement with Framingham hard coronary events (kappa = 0.567) and Globorisk (kappa = 0.534). Correlation analyses showed strong associations between SCORE2 and several continuous cardiovascular risk estimates, including the Framingham categorical score (r = 0.768), Framingham hard coronary events (r = 0.758), and Globorisk (r = 0.739), whereas the correlation between SCORE2 and REGICOR was substantially lower (r = 0.251). These findings indicate that strong statistical correlation does not necessarily translate into clinically meaningful agreement in cardiovascular risk categorization. CONCLUSIONS: Substantial discordance exists between SCORE2 and REGICOR in the identification of high cardiovascular risk among Spanish workers. SCORE2 consistently classified a considerably larger proportion of individuals as high risk, whereas REGICOR showed limited concordance with contemporary cardiovascular prediction models. Continued reliance on REGICOR instead of SCORE2 may lead to under-identification of workers who could currently be considered candidates for intensified primary cardiovascular prevention according to contemporary European prevention strategies. Nevertheless, the present study does not establish which model provides superior prediction of future cardiovascular events, and prospective outcome-based validation studies remain necessary.
2025
- AbstractURLBibTeXEndNoteDOIBibSonomyDownload1.Munné-Barellas B, Monfà R, Llor C, Garcia-Sangenís A, Miranda-Jiménez C, Morros R, Moragas A, Alvarez-Greciano P, Leiva A, Lozano-Del Hoyo ML, Sánchez-Calavera MA, Marín-Cañada J, Sánchez-Ruano R. The Use of Antibiotics for Uncomplicated Urinary Tract Infections in Adult Women: Qualitative Findings From the SCOUT Trial. Patient preference and adherence [Internet]. 2025 Aug.;19:2673-85. https://pmc.ncbi.nlm.nih.gov/articles/PMC12410387/Background This paper focuses on women’s subjective experiences with UTIs and antibiotic use. Uncomplicated urinary tract infections (UTI) are among the most common infections treated in primary care, however, there is limited evidence regarding the experiences and their antibiotic treatment preferences. Objective The aim of this study is to gather experiences, beliefs, and attitudes regarding the use of antibiotics and the participation in the clinical trial. Methods This qualitative sub-study is part of the SCOUT project, which, through a clinical trial, aims to assess the effectiveness of four short antibiotic regimens (a single 3g dose of fosfomycin; 3g of fosfomycin for two days; 400mg of pivmecillinam for three days; and 100mg of nitrofurantoin for five days). A total of 68 semi-structured interviews were conducted in four regions of Spain (Catalonia N=19, Aragón N=19, Madrid N=15, and the Balearic Islands N=15). A purposive and theoretical sampling approach was employed. Participants were recruited after taking part in the clinical trial. Data collection took place between March and July 2024 and analysed using Thematic Analysis. Results UTI did not cause excessive concern, except in cases where the antibiotic was ineffective or when participants had experienced multiple infections in the past. Fosfomycin was the most widely recognized antibiotic, and the two-dose regimen was generally well-regarded for being easy to take while also being more effective than the single-dose treatment. Longer regimens could cause some side effects, but in certain cases, they were perceived as more effective. Participation in the clinical trial was viewed positively, as it contributed to increasing overall knowledge about UTI and the antibiotics used to treat them, as well as ensuring closer monitoring of each specific case. Conclusion This study gathers experiences related to UTI, antibiotic treatment regimens, and participation in the SCOUT clinical trial. It highlights the need to document the realities of UTI in order to improve future clinical trials.
@article{munne-barellas_use_2025,
abstract = {Background This paper focuses on women’s subjective experiences with UTIs and antibiotic use. Uncomplicated urinary tract infections (UTI) are among the most common infections treated in primary care, however, there is limited evidence regarding the experiences and their antibiotic treatment preferences. Objective The aim of this study is to gather experiences, beliefs, and attitudes regarding the use of antibiotics and the participation in the clinical trial. Methods This qualitative sub-study is part of the SCOUT project, which, through a clinical trial, aims to assess the effectiveness of four short antibiotic regimens (a single 3g dose of fosfomycin; 3g of fosfomycin for two days; 400mg of pivmecillinam for three days; and 100mg of nitrofurantoin for five days). A total of 68 semi-structured interviews were conducted in four regions of Spain (Catalonia N=19, Aragón N=19, Madrid N=15, and the Balearic Islands N=15). A purposive and theoretical sampling approach was employed. Participants were recruited after taking part in the clinical trial. Data collection took place between March and July 2024 and analysed using Thematic Analysis. Results UTI did not cause excessive concern, except in cases where the antibiotic was ineffective or when participants had experienced multiple infections in the past. Fosfomycin was the most widely recognized antibiotic, and the two-dose regimen was generally well-regarded for being easy to take while also being more effective than the single-dose treatment. Longer regimens could cause some side effects, but in certain cases, they were perceived as more effective. Participation in the clinical trial was viewed positively, as it contributed to increasing overall knowledge about UTI and the antibiotics used to treat them, as well as ensuring closer monitoring of each specific case. Conclusion This study gathers experiences related to UTI, antibiotic treatment regimens, and participation in the SCOUT clinical trial. It highlights the need to document the realities of UTI in order to improve future clinical trials.},
author = {Munné-Barellas, Berta and Monfà, Ramon and Llor, Carl and Garcia-Sangenís, Ana and Miranda-Jiménez, Cristina and Morros, Rosa and Moragas, Ana and Alvarez-Greciano, Pablo and Leiva, Alfonso and Lozano-Del Hoyo, Mª Luisa and Sánchez-Calavera, Maria Antonia and Marín-Cañada, Jaime and Sánchez-Ruano, Raquel},
journal = {Patient preference and adherence},
keywords = {grapp-caib},
month = {aug},
pages = {2673--2685},
title = {The Use of Antibiotics for Uncomplicated Urinary Tract Infections in Adult Women: Qualitative Findings From the SCOUT Trial},
volume = 19,
year = 2025
}%0 Journal Article
%1 munne-barellas_use_2025
%A Munné-Barellas, Berta
%A Monfà, Ramon
%A Llor, Carl
%A Garcia-Sangenís, Ana
%A Miranda-Jiménez, Cristina
%A Morros, Rosa
%A Moragas, Ana
%A Alvarez-Greciano, Pablo
%A Leiva, Alfonso
%A Lozano-Del Hoyo, Mª Luisa
%A Sánchez-Calavera, Maria Antonia
%A Marín-Cañada, Jaime
%A Sánchez-Ruano, Raquel
%D 2025
%J Patient preference and adherence
%P 2673--2685
%R 10.2147/PPA.S531582
%T The Use of Antibiotics for Uncomplicated Urinary Tract Infections in Adult Women: Qualitative Findings From the SCOUT Trial
%U https://pmc.ncbi.nlm.nih.gov/articles/PMC12410387/
%V 19
%X Background This paper focuses on women’s subjective experiences with UTIs and antibiotic use. Uncomplicated urinary tract infections (UTI) are among the most common infections treated in primary care, however, there is limited evidence regarding the experiences and their antibiotic treatment preferences. Objective The aim of this study is to gather experiences, beliefs, and attitudes regarding the use of antibiotics and the participation in the clinical trial. Methods This qualitative sub-study is part of the SCOUT project, which, through a clinical trial, aims to assess the effectiveness of four short antibiotic regimens (a single 3g dose of fosfomycin; 3g of fosfomycin for two days; 400mg of pivmecillinam for three days; and 100mg of nitrofurantoin for five days). A total of 68 semi-structured interviews were conducted in four regions of Spain (Catalonia N=19, Aragón N=19, Madrid N=15, and the Balearic Islands N=15). A purposive and theoretical sampling approach was employed. Participants were recruited after taking part in the clinical trial. Data collection took place between March and July 2024 and analysed using Thematic Analysis. Results UTI did not cause excessive concern, except in cases where the antibiotic was ineffective or when participants had experienced multiple infections in the past. Fosfomycin was the most widely recognized antibiotic, and the two-dose regimen was generally well-regarded for being easy to take while also being more effective than the single-dose treatment. Longer regimens could cause some side effects, but in certain cases, they were perceived as more effective. Participation in the clinical trial was viewed positively, as it contributed to increasing overall knowledge about UTI and the antibiotics used to treat them, as well as ensuring closer monitoring of each specific case. Conclusion This study gathers experiences related to UTI, antibiotic treatment regimens, and participation in the SCOUT clinical trial. It highlights the need to document the realities of UTI in order to improve future clinical trials. - AbstractURLBibTeXEndNoteDOIBibSonomyDownload1.Guarro Miguel JJ, Tárraga López PJ, Marzoa Jansana MD, López-González Ángel A, Riutord Sbert P, Busquets-Cortés C, Ramirez-Manent JI. Diagnostic Accuracy of Anthropometric and Metabolic Indicators for Predicting MASLD: Evidence from a Large Cohort of Spanish Workers Using FLI and LAP. Medical Sciences [Internet]. 2025 Sep.;13(3):160. https://www.mdpi.com/2076-3271/13/3/160Background: Metabolic-dysfunction-associated steatotic liver disease (MASLD) is a major global health concern associated with insulin resistance, metabolic syndrome, and cardiovascular morbidity. Early identification of at-risk individuals through simple, non-invasive methods is essential, particularly in working populations. Objectives: This study aimed to assess and compare the diagnostic accuracy of four widely used anthropometric and metabolic indicators—body mass index (BMI), waist-to-height ratio (WtHR), triglyceride–glucose index (TyG), and waist–triglyceride index (WTI)—in identifying individuals at risk of metabolic-dysfunction-associated steatotic liver disease (MASLD), as determined by the Fatty Liver Index (FLI) and the Lipid Accumulation Product (LAP), within a large sample of Spanish workers. Methods: A cross-sectional analysis was performed on data from 386,924 Spanish employees aged between 18 and 69 years. Standardized anthropometric and laboratory measurements were obtained as part of routine occupational medical examinations conducted from 2021 to 2023. The presence of NAFLD was inferred using two validated surrogate markers: FLI and LAP. Receiver operating characteristic (ROC) curves and area under the curve (AUC) values were used to assess the discriminatory ability of each index, stratified by sex. Results: WTI and TyG demonstrated the highest diagnostic accuracy for both FLI- and LAP-defined NAFLD, with AUC values textgreater0.95 in both sexes. WTI showed the best overall performance, followed closely by TyG. WtHR outperformed BMI but was less accurate than the metabolic indices. Sex-stratified analyses confirmed consistent patterns, with slightly higher AUCs for TyG and WTI in women. BMI consistently yielded the lowest discriminatory performance. Conclusions: WTI and TyG are superior to BMI and WtHR for non-invasive screening of MASLD in occupational settings. Their simplicity, low cost, and strong predictive value support their integration into routine workplace health surveillance. Sex-specific thresholds and prospective validation are warranted to enhance clinical application.
@article{guarro_miguel_diagnostic_2025,
abstract = {Background: Metabolic-dysfunction-associated steatotic liver disease (MASLD) is a major global health concern associated with insulin resistance, metabolic syndrome, and cardiovascular morbidity. Early identification of at-risk individuals through simple, non-invasive methods is essential, particularly in working populations. Objectives: This study aimed to assess and compare the diagnostic accuracy of four widely used anthropometric and metabolic indicators—body mass index (BMI), waist-to-height ratio (WtHR), triglyceride–glucose index (TyG), and waist–triglyceride index (WTI)—in identifying individuals at risk of metabolic-dysfunction-associated steatotic liver disease (MASLD), as determined by the Fatty Liver Index (FLI) and the Lipid Accumulation Product (LAP), within a large sample of Spanish workers. Methods: A cross-sectional analysis was performed on data from 386,924 Spanish employees aged between 18 and 69 years. Standardized anthropometric and laboratory measurements were obtained as part of routine occupational medical examinations conducted from 2021 to 2023. The presence of NAFLD was inferred using two validated surrogate markers: FLI and LAP. Receiver operating characteristic (ROC) curves and area under the curve (AUC) values were used to assess the discriminatory ability of each index, stratified by sex. Results: WTI and TyG demonstrated the highest diagnostic accuracy for both FLI- and LAP-defined NAFLD, with AUC values textgreater0.95 in both sexes. WTI showed the best overall performance, followed closely by TyG. WtHR outperformed BMI but was less accurate than the metabolic indices. Sex-stratified analyses confirmed consistent patterns, with slightly higher AUCs for TyG and WTI in women. BMI consistently yielded the lowest discriminatory performance. Conclusions: WTI and TyG are superior to BMI and WtHR for non-invasive screening of MASLD in occupational settings. Their simplicity, low cost, and strong predictive value support their integration into routine workplace health surveillance. Sex-specific thresholds and prospective validation are warranted to enhance clinical application.},
author = {Guarro Miguel, Juan José and Tárraga López, Pedro Juan and Marzoa Jansana, María Dolores and López-González, Ángel Arturo and Riutord Sbert, Pere and Busquets-Cortés, Carla and Ramirez-Manent, José Ignacio},
journal = {Medical Sciences},
keywords = {grapp-caib},
month = {sep},
number = 3,
pages = 160,
title = {Diagnostic Accuracy of Anthropometric and Metabolic Indicators for Predicting MASLD: Evidence from a Large Cohort of Spanish Workers Using FLI and LAP},
volume = 13,
year = 2025
}%0 Journal Article
%1 guarro_miguel_diagnostic_2025
%A Guarro Miguel, Juan José
%A Tárraga López, Pedro Juan
%A Marzoa Jansana, María Dolores
%A López-González, Ángel Arturo
%A Riutord Sbert, Pere
%A Busquets-Cortés, Carla
%A Ramirez-Manent, José Ignacio
%D 2025
%J Medical Sciences
%N 3
%P 160
%R 10.3390/medsci13030160
%T Diagnostic Accuracy of Anthropometric and Metabolic Indicators for Predicting MASLD: Evidence from a Large Cohort of Spanish Workers Using FLI and LAP
%U https://www.mdpi.com/2076-3271/13/3/160
%V 13
%X Background: Metabolic-dysfunction-associated steatotic liver disease (MASLD) is a major global health concern associated with insulin resistance, metabolic syndrome, and cardiovascular morbidity. Early identification of at-risk individuals through simple, non-invasive methods is essential, particularly in working populations. Objectives: This study aimed to assess and compare the diagnostic accuracy of four widely used anthropometric and metabolic indicators—body mass index (BMI), waist-to-height ratio (WtHR), triglyceride–glucose index (TyG), and waist–triglyceride index (WTI)—in identifying individuals at risk of metabolic-dysfunction-associated steatotic liver disease (MASLD), as determined by the Fatty Liver Index (FLI) and the Lipid Accumulation Product (LAP), within a large sample of Spanish workers. Methods: A cross-sectional analysis was performed on data from 386,924 Spanish employees aged between 18 and 69 years. Standardized anthropometric and laboratory measurements were obtained as part of routine occupational medical examinations conducted from 2021 to 2023. The presence of NAFLD was inferred using two validated surrogate markers: FLI and LAP. Receiver operating characteristic (ROC) curves and area under the curve (AUC) values were used to assess the discriminatory ability of each index, stratified by sex. Results: WTI and TyG demonstrated the highest diagnostic accuracy for both FLI- and LAP-defined NAFLD, with AUC values textgreater0.95 in both sexes. WTI showed the best overall performance, followed closely by TyG. WtHR outperformed BMI but was less accurate than the metabolic indices. Sex-stratified analyses confirmed consistent patterns, with slightly higher AUCs for TyG and WTI in women. BMI consistently yielded the lowest discriminatory performance. Conclusions: WTI and TyG are superior to BMI and WtHR for non-invasive screening of MASLD in occupational settings. Their simplicity, low cost, and strong predictive value support their integration into routine workplace health surveillance. Sex-specific thresholds and prospective validation are warranted to enhance clinical application. -
AbstractURLBibTeXEndNoteDOIBibSonomy1.Fernández-Figares Vicioso MP, López-González Á. A, Ramírez-Manent JI, Del Barrio Fernández JL, Tárraga López PJ, Vicente-Herreros MT. Prevalence of obesity: Comparison of commerce vs. industry sector and associated variables. Hipertensión y Riesgo Vascular [Internet]. 2025 Oct.;42(4):276-88. https://www.sciencedirect.com/science/article/pii/S1889183725000492Introduction and objectives Obesity has been considered the pandemic of the 21st century due to its high prevalence and the significant morbidity and mortality it entails. The aim of this study is to assess the prevalence of obesity in two occupational sectors and to determine the variables associated with it. Methodology This is a cross-sectional and descriptive study involving 56,856 workers from the commerce and industrial sectors. Anthropometric, clinical, analytical, and sociodemographic data were collected during medical examinations conducted between 2017 and 2019. Results The prevalence of obesity was found to be significantly higher in the industrial sector compared to the commerce sector. Factors such as age, sex, educational level, physical activity, adherence to the Mediterranean diet, and smoking showed significant associations with the four scales of excess weight evaluated. Among these, age, physical activity level, and adherence to the Mediterranean diet demonstrated the strongest associations. In the industrial sector, obesity may be related to work-related stress, prolonged shifts, and limited access to healthy food, whereas in the commerce sector, sedentary behaviour and poor dietary habits were identified as key contributing factors. Conclusions Specific strategies tailored to each occupational sector are recommended, including active breaks, the promotion of physical activity, and access to healthy foods. While the study has strengths such as its large sample size and multivariate analysis, the cross-sectional design and lack of control for certain confounding variables limit its ability to establish causality. The findings underscore the need for preventive policies adapted to workplace environments to mitigate the impact of obesity. Resumen Introducción y objetivos La obesidad se ha considerado como la pandemia del siglo xxi por su elevada prevalencia y la gran morbimortalidad que acarrea. El objetivo es valorar la prevalencia de obesidad en dos sectores laborales y determinar qué variables se asocian con ella. Metodología Estudio transversal y descriptivo en 56.856 trabajadores de los sectores comercio e industrial. Se recolectaron datos antropométricos, clínicos, analíticos y sociodemográficos durante exámenes médicos realizados entre 2017 y 2019. Resultados Se observa una prevalencia de obesidad significativamente mayor en el sector industrial en comparación con el comercio. Factores como edad, sexo, nivel educativo, actividad física, dieta mediterránea y tabaquismo presentaron asociaciones relevantes con las cuatro escalas de exceso de peso evaluadas. La edad, el nivel de actividad física y la dieta mediterránea fueron las variables con mayor asociación. En el sector industrial, la obesidad podría relacionarse con estrés laboral, turnos prolongados y acceso limitado a alimentos saludables, mientras que en el sector comercio el sedentarismo y los hábitos alimentarios inadecuados son factores destacados. Conclusiones Se recomienda desarrollar estrategias específicas para cada sector laboral, incluyendo pausas activas, promoción de actividad física y acceso a alimentos saludables. Aunque el estudio presenta fortalezas, como su amplio tamaño muestral y el análisis multivariado, el diseño transversal y la falta de control de algunas variables de confusión limitan su capacidad para establecer causalidad. Los hallazgos subrayan la necesidad de políticas preventivas adaptadas al entorno laboral para mitigar el impacto de la obesidad.
@article{fernandez-figares_vicioso_prevalence_2025,
abstract = {Introduction and objectives Obesity has been considered the pandemic of the 21st century due to its high prevalence and the significant morbidity and mortality it entails. The aim of this study is to assess the prevalence of obesity in two occupational sectors and to determine the variables associated with it. Methodology This is a cross-sectional and descriptive study involving 56,856 workers from the commerce and industrial sectors. Anthropometric, clinical, analytical, and sociodemographic data were collected during medical examinations conducted between 2017 and 2019. Results The prevalence of obesity was found to be significantly higher in the industrial sector compared to the commerce sector. Factors such as age, sex, educational level, physical activity, adherence to the Mediterranean diet, and smoking showed significant associations with the four scales of excess weight evaluated. Among these, age, physical activity level, and adherence to the Mediterranean diet demonstrated the strongest associations. In the industrial sector, obesity may be related to work-related stress, prolonged shifts, and limited access to healthy food, whereas in the commerce sector, sedentary behaviour and poor dietary habits were identified as key contributing factors. Conclusions Specific strategies tailored to each occupational sector are recommended, including active breaks, the promotion of physical activity, and access to healthy foods. While the study has strengths such as its large sample size and multivariate analysis, the cross-sectional design and lack of control for certain confounding variables limit its ability to establish causality. The findings underscore the need for preventive policies adapted to workplace environments to mitigate the impact of obesity. Resumen Introducción y objetivos La obesidad se ha considerado como la pandemia del siglo xxi por su elevada prevalencia y la gran morbimortalidad que acarrea. El objetivo es valorar la prevalencia de obesidad en dos sectores laborales y determinar qué variables se asocian con ella. Metodología Estudio transversal y descriptivo en 56.856 trabajadores de los sectores comercio e industrial. Se recolectaron datos antropométricos, clínicos, analíticos y sociodemográficos durante exámenes médicos realizados entre 2017 y 2019. Resultados Se observa una prevalencia de obesidad significativamente mayor en el sector industrial en comparación con el comercio. Factores como edad, sexo, nivel educativo, actividad física, dieta mediterránea y tabaquismo presentaron asociaciones relevantes con las cuatro escalas de exceso de peso evaluadas. La edad, el nivel de actividad física y la dieta mediterránea fueron las variables con mayor asociación. En el sector industrial, la obesidad podría relacionarse con estrés laboral, turnos prolongados y acceso limitado a alimentos saludables, mientras que en el sector comercio el sedentarismo y los hábitos alimentarios inadecuados son factores destacados. Conclusiones Se recomienda desarrollar estrategias específicas para cada sector laboral, incluyendo pausas activas, promoción de actividad física y acceso a alimentos saludables. Aunque el estudio presenta fortalezas, como su amplio tamaño muestral y el análisis multivariado, el diseño transversal y la falta de control de algunas variables de confusión limitan su capacidad para establecer causalidad. Los hallazgos subrayan la necesidad de políticas preventivas adaptadas al entorno laboral para mitigar el impacto de la obesidad.},
author = {Fernández-Figares Vicioso, M. P. and López-González, Á. A. and Ramírez-Manent, J. I. and Del Barrio Fernández, J. L. and Tárraga López, P. J. and Vicente-Herreros, M. T.},
journal = {Hipertensión y Riesgo Vascular},
keywords = {grapp-caib},
month = {oct},
number = 4,
pages = {276--288},
title = {Prevalence of obesity: Comparison of commerce vs. industry sector and associated variables},
volume = 42,
year = 2025
}%0 Journal Article
%1 fernandez-figares_vicioso_prevalence_2025
%A Fernández-Figares Vicioso, M. P.
%A López-González, Á. A.
%A Ramírez-Manent, J. I.
%A Del Barrio Fernández, J. L.
%A Tárraga López, P. J.
%A Vicente-Herreros, M. T.
%D 2025
%J Hipertensión y Riesgo Vascular
%N 4
%P 276--288
%R 10.1016/j.hipert.2025.04.002
%T Prevalence of obesity: Comparison of commerce vs. industry sector and associated variables
%U https://www.sciencedirect.com/science/article/pii/S1889183725000492
%V 42
%X Introduction and objectives Obesity has been considered the pandemic of the 21st century due to its high prevalence and the significant morbidity and mortality it entails. The aim of this study is to assess the prevalence of obesity in two occupational sectors and to determine the variables associated with it. Methodology This is a cross-sectional and descriptive study involving 56,856 workers from the commerce and industrial sectors. Anthropometric, clinical, analytical, and sociodemographic data were collected during medical examinations conducted between 2017 and 2019. Results The prevalence of obesity was found to be significantly higher in the industrial sector compared to the commerce sector. Factors such as age, sex, educational level, physical activity, adherence to the Mediterranean diet, and smoking showed significant associations with the four scales of excess weight evaluated. Among these, age, physical activity level, and adherence to the Mediterranean diet demonstrated the strongest associations. In the industrial sector, obesity may be related to work-related stress, prolonged shifts, and limited access to healthy food, whereas in the commerce sector, sedentary behaviour and poor dietary habits were identified as key contributing factors. Conclusions Specific strategies tailored to each occupational sector are recommended, including active breaks, the promotion of physical activity, and access to healthy foods. While the study has strengths such as its large sample size and multivariate analysis, the cross-sectional design and lack of control for certain confounding variables limit its ability to establish causality. The findings underscore the need for preventive policies adapted to workplace environments to mitigate the impact of obesity. Resumen Introducción y objetivos La obesidad se ha considerado como la pandemia del siglo xxi por su elevada prevalencia y la gran morbimortalidad que acarrea. El objetivo es valorar la prevalencia de obesidad en dos sectores laborales y determinar qué variables se asocian con ella. Metodología Estudio transversal y descriptivo en 56.856 trabajadores de los sectores comercio e industrial. Se recolectaron datos antropométricos, clínicos, analíticos y sociodemográficos durante exámenes médicos realizados entre 2017 y 2019. Resultados Se observa una prevalencia de obesidad significativamente mayor en el sector industrial en comparación con el comercio. Factores como edad, sexo, nivel educativo, actividad física, dieta mediterránea y tabaquismo presentaron asociaciones relevantes con las cuatro escalas de exceso de peso evaluadas. La edad, el nivel de actividad física y la dieta mediterránea fueron las variables con mayor asociación. En el sector industrial, la obesidad podría relacionarse con estrés laboral, turnos prolongados y acceso limitado a alimentos saludables, mientras que en el sector comercio el sedentarismo y los hábitos alimentarios inadecuados son factores destacados. Conclusiones Se recomienda desarrollar estrategias específicas para cada sector laboral, incluyendo pausas activas, promoción de actividad física y acceso a alimentos saludables. Aunque el estudio presenta fortalezas, como su amplio tamaño muestral y el análisis multivariado, el diseño transversal y la falta de control de algunas variables de confusión limitan su capacidad para establecer causalidad. Los hallazgos subrayan la necesidad de políticas preventivas adaptadas al entorno laboral para mitigar el impacto de la obesidad. - AbstractURLBibTeXEndNoteDOIBibSonomyDownload1.Ribes Valles JL, Tárraga López PJ, López González Ángel A, Coll Campayo I, Busquets-Cortés C, Ramírez-Manent JI. Associations of Sociodemographic Factors, Lifestyle Habits, and Insomnia Severity with Obesity Indices in Spanish Workers: Sex-Specific Differences. Medical Sciences [Internet]. 2025 Nov.;13(4):271. https://pmc.ncbi.nlm.nih.gov/articles/PMC12641970/Background: Obesity and insomnia are prevalent public health issues with shared behavioral and physiological pathways. However, their interplay remains understudied in occupational cohorts. Obesity and insomnia are prevalent public health issues with shared behavioral and physiological pathways. However, their interplay remains understudied in occupational cohorts. This study aimed to evaluate the associations of sociodemographic factors, lifestyle habits, and insomnia severity with multiple obesity indices in a large population of Spanish workers. Methods: We conducted a cross-sectional analysis of 84,898 workers (2021–2024). Data were obtained from annual occupational health assessments conducted across multiple Spanish regions between 2020 and 2024. Insomnia severity was assessed using the Insomnia Severity Index (ISI), dietary quality using the 14-item Mediterranean Diet Adherence Screener (MEDAS-14), and physical activity using the International Physical Activity Questionnaire—Short Form (IPAQ-SF). Adiposity was measured using Body Mass Index (BMI), waist-to-height ratio (WtHR), the Clínica Universidad de Navarra–Body Adiposity Estimator (CUN-BAE), and the Metabolic Score for Visceral Fat (METS-VF). Multivariable logistic regression models were used to examine associations adjusted for age, sex, education, and occupational social class. Results: Higher ISI scores were significantly and independently associated with elevated adiposity across all indices, with the strongest association observed for METS-VF (odds ratio = 1.19, 95\% CI 1.14–1.25, p \textless 0.001). Women showed higher mean CUN-BAE and METS-VF values than men (CUN-BAE: 37.4 ± 6.2 vs. 25.6 ± 6.4; p \textless 0.001; METS-VF: 5.7 ± 0.7 vs. 6.4 ± 0.6; p \textless 0.001), despite lower BMI (25.3 ± 4.8 vs. 26.8 ± 4.3; p \textless 0.001). Lower physical activity (OR = 5.70; 95\% CI 4.91–6.50), poor adherence to the Mediterranean diet (OR = 3.29; 95\% CI 2.88–3.70), smoking (OR = 1.29; 95\% CI 1.22–1.36), and lower occupational class (Class III: OR = 1.77; 95\% CI 1.56–1.97) were also significantly associated with higher obesity markers. Associations were more pronounced among women and participants with severe insomnia symptoms. Conclusions: Insomnia severity, sociodemographic disadvantage, and unhealthy behaviors (low physical activity, poor diet, smoking) were all independent correlates of general and visceral adiposity. The findings underscore the need for comprehensive workplace health programs that integrate sleep quality assessment, dietary improvement, and physical activity promotion to prevent obesity and its metabolic consequences.
@article{ribes_valles_associations_2025,
abstract = {Background: Obesity and insomnia are prevalent public health issues with shared behavioral and physiological pathways. However, their interplay remains understudied in occupational cohorts. Obesity and insomnia are prevalent public health issues with shared behavioral and physiological pathways. However, their interplay remains understudied in occupational cohorts. This study aimed to evaluate the associations of sociodemographic factors, lifestyle habits, and insomnia severity with multiple obesity indices in a large population of Spanish workers. Methods: We conducted a cross-sectional analysis of 84,898 workers (2021–2024). Data were obtained from annual occupational health assessments conducted across multiple Spanish regions between 2020 and 2024. Insomnia severity was assessed using the Insomnia Severity Index (ISI), dietary quality using the 14-item Mediterranean Diet Adherence Screener (MEDAS-14), and physical activity using the International Physical Activity Questionnaire—Short Form (IPAQ-SF). Adiposity was measured using Body Mass Index (BMI), waist-to-height ratio (WtHR), the Clínica Universidad de Navarra–Body Adiposity Estimator (CUN-BAE), and the Metabolic Score for Visceral Fat (METS-VF). Multivariable logistic regression models were used to examine associations adjusted for age, sex, education, and occupational social class. Results: Higher ISI scores were significantly and independently associated with elevated adiposity across all indices, with the strongest association observed for METS-VF (odds ratio = 1.19, 95\% CI 1.14–1.25, p \textless 0.001). Women showed higher mean CUN-BAE and METS-VF values than men (CUN-BAE: 37.4 ± 6.2 vs. 25.6 ± 6.4; p \textless 0.001; METS-VF: 5.7 ± 0.7 vs. 6.4 ± 0.6; p \textless 0.001), despite lower BMI (25.3 ± 4.8 vs. 26.8 ± 4.3; p \textless 0.001). Lower physical activity (OR = 5.70; 95\% CI 4.91–6.50), poor adherence to the Mediterranean diet (OR = 3.29; 95\% CI 2.88–3.70), smoking (OR = 1.29; 95\% CI 1.22–1.36), and lower occupational class (Class III: OR = 1.77; 95\% CI 1.56–1.97) were also significantly associated with higher obesity markers. Associations were more pronounced among women and participants with severe insomnia symptoms. Conclusions: Insomnia severity, sociodemographic disadvantage, and unhealthy behaviors (low physical activity, poor diet, smoking) were all independent correlates of general and visceral adiposity. The findings underscore the need for comprehensive workplace health programs that integrate sleep quality assessment, dietary improvement, and physical activity promotion to prevent obesity and its metabolic consequences.},
author = {Ribes Valles, José Luis and Tárraga López, Pedro Juan and López González, Ángel Arturo and Coll Campayo, Irene and Busquets-Cortés, Carla and Ramírez-Manent, José Ignacio},
journal = {Medical Sciences},
keywords = {grapp-caib},
month = {nov},
number = 4,
pages = 271,
title = {Associations of Sociodemographic Factors, Lifestyle Habits, and Insomnia Severity with Obesity Indices in Spanish Workers: Sex-Specific Differences},
volume = 13,
year = 2025
}%0 Journal Article
%1 ribes_valles_associations_2025
%A Ribes Valles, José Luis
%A Tárraga López, Pedro Juan
%A López González, Ángel Arturo
%A Coll Campayo, Irene
%A Busquets-Cortés, Carla
%A Ramírez-Manent, José Ignacio
%D 2025
%J Medical Sciences
%N 4
%P 271
%R 10.3390/medsci13040271
%T Associations of Sociodemographic Factors, Lifestyle Habits, and Insomnia Severity with Obesity Indices in Spanish Workers: Sex-Specific Differences
%U https://pmc.ncbi.nlm.nih.gov/articles/PMC12641970/
%V 13
%X Background: Obesity and insomnia are prevalent public health issues with shared behavioral and physiological pathways. However, their interplay remains understudied in occupational cohorts. Obesity and insomnia are prevalent public health issues with shared behavioral and physiological pathways. However, their interplay remains understudied in occupational cohorts. This study aimed to evaluate the associations of sociodemographic factors, lifestyle habits, and insomnia severity with multiple obesity indices in a large population of Spanish workers. Methods: We conducted a cross-sectional analysis of 84,898 workers (2021–2024). Data were obtained from annual occupational health assessments conducted across multiple Spanish regions between 2020 and 2024. Insomnia severity was assessed using the Insomnia Severity Index (ISI), dietary quality using the 14-item Mediterranean Diet Adherence Screener (MEDAS-14), and physical activity using the International Physical Activity Questionnaire—Short Form (IPAQ-SF). Adiposity was measured using Body Mass Index (BMI), waist-to-height ratio (WtHR), the Clínica Universidad de Navarra–Body Adiposity Estimator (CUN-BAE), and the Metabolic Score for Visceral Fat (METS-VF). Multivariable logistic regression models were used to examine associations adjusted for age, sex, education, and occupational social class. Results: Higher ISI scores were significantly and independently associated with elevated adiposity across all indices, with the strongest association observed for METS-VF (odds ratio = 1.19, 95\% CI 1.14–1.25, p \textless 0.001). Women showed higher mean CUN-BAE and METS-VF values than men (CUN-BAE: 37.4 ± 6.2 vs. 25.6 ± 6.4; p \textless 0.001; METS-VF: 5.7 ± 0.7 vs. 6.4 ± 0.6; p \textless 0.001), despite lower BMI (25.3 ± 4.8 vs. 26.8 ± 4.3; p \textless 0.001). Lower physical activity (OR = 5.70; 95\% CI 4.91–6.50), poor adherence to the Mediterranean diet (OR = 3.29; 95\% CI 2.88–3.70), smoking (OR = 1.29; 95\% CI 1.22–1.36), and lower occupational class (Class III: OR = 1.77; 95\% CI 1.56–1.97) were also significantly associated with higher obesity markers. Associations were more pronounced among women and participants with severe insomnia symptoms. Conclusions: Insomnia severity, sociodemographic disadvantage, and unhealthy behaviors (low physical activity, poor diet, smoking) were all independent correlates of general and visceral adiposity. The findings underscore the need for comprehensive workplace health programs that integrate sleep quality assessment, dietary improvement, and physical activity promotion to prevent obesity and its metabolic consequences. - AbstractURLBibTeXEndNoteDOIBibSonomyDownload1.Marina Arroyo M, Obrador de Hevia J, López-González Ángel A, Tárraga López PJ, Busquets-Cortés C, Ramírez-Manent JI. Comparative Accuracy of the ECORE-BF Index Versus Non-Insulin-Based Insulin Resistance Markers in over 400,000 Spanish Adults. Diabetology [Internet]. 2025 Nov.;6(11):130. https://www.mdpi.com/2673-4540/6/11/130Background: The early detection of insulin resistance (IR) is critical for the prevention of type 2 diabetes and cardiometabolic diseases. The ECORE-BF index is a simple anthropometric tool for estimating body fat percentage and overweight. However, its potential utility as a predictor of IR risk has not been previously evaluated in large populations using validated IR indices. Methods: This cross-sectional study included 418,343 Spanish workers (172,282 women and 246,061 men) who underwent occupational health evaluations. The ECORE-BF index was calculated for all participants, and its association with four validated surrogate markers of IR was analyzed: the triglyceride–glucose index (TyG), TyG-BMI, METS-IR, and SPISE. Subjects were classified into normal or high-risk IR groups based on established cut-off values. We evaluated the mean ECORE-BF values across groups, the prevalence of ECORE-BF-defined obesity, and the diagnostic performance of ECORE-BF using receiver operating characteristic (ROC) curve analysis. Results: Participants with elevated IR index values had significantly higher mean ECORE-BF scores than those with normal values (p \textless 0.001). The prevalence of ECORE-BF-defined obesity was substantially higher in all high-risk IR groups, exceeding 99% for METS-IR and SPISE in both sexes. ROC analysis demonstrated the high diagnostic accuracy of ECORE-BF in predicting elevated IR risk, with area under the curve (AUC) values ranging from 0.698 (TyG in men) to 0.992 (METS-IR in women). Sensitivity and specificity were also high, particularly for TyG-BMI, SPISE, and METS-IR, with optimal Youden indices above 0.75. Conclusions: ECORE-BF demonstrated high accuracy as a non-invasive tool for identifying individuals at increased insulin resistance risk; however, due to the cross-sectional design, predictive value for incident disease cannot be inferred. Its simplicity, cost-effectiveness, and high diagnostic accuracy support its potential utility in large-scale screening programs for early detection of metabolic risk.
@article{marina_arroyo_comparative_2025,
abstract = {Background: The early detection of insulin resistance (IR) is critical for the prevention of type 2 diabetes and cardiometabolic diseases. The ECORE-BF index is a simple anthropometric tool for estimating body fat percentage and overweight. However, its potential utility as a predictor of IR risk has not been previously evaluated in large populations using validated IR indices. Methods: This cross-sectional study included 418,343 Spanish workers (172,282 women and 246,061 men) who underwent occupational health evaluations. The ECORE-BF index was calculated for all participants, and its association with four validated surrogate markers of IR was analyzed: the triglyceride–glucose index (TyG), TyG-BMI, METS-IR, and SPISE. Subjects were classified into normal or high-risk IR groups based on established cut-off values. We evaluated the mean ECORE-BF values across groups, the prevalence of ECORE-BF-defined obesity, and the diagnostic performance of ECORE-BF using receiver operating characteristic (ROC) curve analysis. Results: Participants with elevated IR index values had significantly higher mean ECORE-BF scores than those with normal values (p \textless 0.001). The prevalence of ECORE-BF-defined obesity was substantially higher in all high-risk IR groups, exceeding 99% for METS-IR and SPISE in both sexes. ROC analysis demonstrated the high diagnostic accuracy of ECORE-BF in predicting elevated IR risk, with area under the curve (AUC) values ranging from 0.698 (TyG in men) to 0.992 (METS-IR in women). Sensitivity and specificity were also high, particularly for TyG-BMI, SPISE, and METS-IR, with optimal Youden indices above 0.75. Conclusions: ECORE-BF demonstrated high accuracy as a non-invasive tool for identifying individuals at increased insulin resistance risk; however, due to the cross-sectional design, predictive value for incident disease cannot be inferred. Its simplicity, cost-effectiveness, and high diagnostic accuracy support its potential utility in large-scale screening programs for early detection of metabolic risk.},
author = {Marina Arroyo, Marta and Obrador de Hevia, Joan and López-González, Ángel Arturo and Tárraga López, Pedro J. and Busquets-Cortés, Carla and Ramírez-Manent, José Ignacio},
journal = {Diabetology},
keywords = {grapp-caib},
month = {nov},
number = 11,
pages = 130,
title = {Comparative Accuracy of the ECORE-BF Index Versus Non-Insulin-Based Insulin Resistance Markers in over 400,000 Spanish Adults},
volume = 6,
year = 2025
}%0 Journal Article
%1 marina_arroyo_comparative_2025
%A Marina Arroyo, Marta
%A Obrador de Hevia, Joan
%A López-González, Ángel Arturo
%A Tárraga López, Pedro J.
%A Busquets-Cortés, Carla
%A Ramírez-Manent, José Ignacio
%D 2025
%J Diabetology
%N 11
%P 130
%R 10.3390/diabetology6110130
%T Comparative Accuracy of the ECORE-BF Index Versus Non-Insulin-Based Insulin Resistance Markers in over 400,000 Spanish Adults
%U https://www.mdpi.com/2673-4540/6/11/130
%V 6
%X Background: The early detection of insulin resistance (IR) is critical for the prevention of type 2 diabetes and cardiometabolic diseases. The ECORE-BF index is a simple anthropometric tool for estimating body fat percentage and overweight. However, its potential utility as a predictor of IR risk has not been previously evaluated in large populations using validated IR indices. Methods: This cross-sectional study included 418,343 Spanish workers (172,282 women and 246,061 men) who underwent occupational health evaluations. The ECORE-BF index was calculated for all participants, and its association with four validated surrogate markers of IR was analyzed: the triglyceride–glucose index (TyG), TyG-BMI, METS-IR, and SPISE. Subjects were classified into normal or high-risk IR groups based on established cut-off values. We evaluated the mean ECORE-BF values across groups, the prevalence of ECORE-BF-defined obesity, and the diagnostic performance of ECORE-BF using receiver operating characteristic (ROC) curve analysis. Results: Participants with elevated IR index values had significantly higher mean ECORE-BF scores than those with normal values (p \textless 0.001). The prevalence of ECORE-BF-defined obesity was substantially higher in all high-risk IR groups, exceeding 99% for METS-IR and SPISE in both sexes. ROC analysis demonstrated the high diagnostic accuracy of ECORE-BF in predicting elevated IR risk, with area under the curve (AUC) values ranging from 0.698 (TyG in men) to 0.992 (METS-IR in women). Sensitivity and specificity were also high, particularly for TyG-BMI, SPISE, and METS-IR, with optimal Youden indices above 0.75. Conclusions: ECORE-BF demonstrated high accuracy as a non-invasive tool for identifying individuals at increased insulin resistance risk; however, due to the cross-sectional design, predictive value for incident disease cannot be inferred. Its simplicity, cost-effectiveness, and high diagnostic accuracy support its potential utility in large-scale screening programs for early detection of metabolic risk. -
AbstractBibTeXEndNoteDOIBibSonomy1.García Samuelsson M, Tárraga López PJ, López González AA, Busquets-Cortés C, Obrador de Hevia J, Ramírez Manent JI. [Metabolically healthy obesity and cardiovascular risk: Analysis of risk scores in a large population cohort]. Semergen. 2025;51(8):102580.INTRODUCTION: Metabolically healthy obesity (MHO) describes obese individuals without evident metabolic disturbances. However, its relationship with cardiovascular risk remains controversial. OBJECTIVE: To assess cardiovascular risk using different risk scores among MHO individuals compared to metabolically unhealthy obese (MUO) and normal-weight subjects in a large cohort of Spanish workers. METHODS: Cross-sectional study including 68,884 obese workers (45,498 men and 23,386 women). MHO and MUO were classified according to NCEP-ATPIII criteria. Cardiovascular risk was estimated using SCORE2, REGICOR, ERICE, DORICA, vascular age, and avoidable years of life lost. RESULTS: MHO individuals exhibited a better risk profile than MUO subjects but significantly worse than normal-weight individuals. Across all evaluated scores, MUO individuals showed the highest risk values, particularly among men. Lower educational attainment, low social class, physical inactivity, and smoking were independently associated with increased cardiovascular risk. CONCLUSIONS: Although considered intermediate risk, MHO is not a clinically benign phenotype. Targeted preventive strategies are necessary to reduce the progression toward metabolically unhealthy states in this subgroup.
@article{garcia_samuelsson_metabolically_2025,
abstract = {INTRODUCTION: Metabolically healthy obesity (MHO) describes obese individuals without evident metabolic disturbances. However, its relationship with cardiovascular risk remains controversial. OBJECTIVE: To assess cardiovascular risk using different risk scores among MHO individuals compared to metabolically unhealthy obese (MUO) and normal-weight subjects in a large cohort of Spanish workers. METHODS: Cross-sectional study including 68,884 obese workers (45,498 men and 23,386 women). MHO and MUO were classified according to NCEP-ATPIII criteria. Cardiovascular risk was estimated using SCORE2, REGICOR, ERICE, DORICA, vascular age, and avoidable years of life lost. RESULTS: MHO individuals exhibited a better risk profile than MUO subjects but significantly worse than normal-weight individuals. Across all evaluated scores, MUO individuals showed the highest risk values, particularly among men. Lower educational attainment, low social class, physical inactivity, and smoking were independently associated with increased cardiovascular risk. CONCLUSIONS: Although considered intermediate risk, MHO is not a clinically benign phenotype. Targeted preventive strategies are necessary to reduce the progression toward metabolically unhealthy states in this subgroup.},
author = {García Samuelsson, M. and Tárraga López, P. J. and López González, A. A. and Busquets-Cortés, C. and Obrador de Hevia, J. and Ramírez Manent, J. I.},
journal = {Semergen},
keywords = {grapp-caib},
number = 8,
pages = 102580,
title = {[Metabolically healthy obesity and cardiovascular risk: Analysis of risk scores in a large population cohort]},
volume = 51,
year = 2025
}%0 Journal Article
%1 garcia_samuelsson_metabolically_2025
%A García Samuelsson, M.
%A Tárraga López, P. J.
%A López González, A. A.
%A Busquets-Cortés, C.
%A Obrador de Hevia, J.
%A Ramírez Manent, J. I.
%D 2025
%J Semergen
%N 8
%P 102580
%R 10.1016/j.semerg.2025.102580
%T [Metabolically healthy obesity and cardiovascular risk: Analysis of risk scores in a large population cohort]
%V 51
%X INTRODUCTION: Metabolically healthy obesity (MHO) describes obese individuals without evident metabolic disturbances. However, its relationship with cardiovascular risk remains controversial. OBJECTIVE: To assess cardiovascular risk using different risk scores among MHO individuals compared to metabolically unhealthy obese (MUO) and normal-weight subjects in a large cohort of Spanish workers. METHODS: Cross-sectional study including 68,884 obese workers (45,498 men and 23,386 women). MHO and MUO were classified according to NCEP-ATPIII criteria. Cardiovascular risk was estimated using SCORE2, REGICOR, ERICE, DORICA, vascular age, and avoidable years of life lost. RESULTS: MHO individuals exhibited a better risk profile than MUO subjects but significantly worse than normal-weight individuals. Across all evaluated scores, MUO individuals showed the highest risk values, particularly among men. Lower educational attainment, low social class, physical inactivity, and smoking were independently associated with increased cardiovascular risk. CONCLUSIONS: Although considered intermediate risk, MHO is not a clinically benign phenotype. Targeted preventive strategies are necessary to reduce the progression toward metabolically unhealthy states in this subgroup. - AbstractURLBibTeXEndNoteDOIBibSonomyDownload1.Cameselle-Lago C, Rico-Blázquez M, Sánchez-Ruano R, Ayala A, Pascual-García M, Solé-Agustí M, Gimeno-Pi I, Echevarria-Echevarria A, González-Chordá VM, Esteban-Sepúlveda S, Pedraz-Marcos A, Company-Sancho MC, Cidoncha-Moreno M Ángeles, Vidal-Thomas MC, Taltavull-Aparicio JM, Moreno-Casbas MT. Changes in daily routines and health-related quality of life among Spanish older adults after the COVID-19 pandemic: analysis from a gender perspective. Frontiers in Public Health [Internet]. 2025 Oct.;13:1678003. https://pmc.ncbi.nlm.nih.gov/articles/PMC12554437/Aims To examine the association between perceived changes in daily routines due to the COVID-19 pandemic and health-related quality of life (HRQoL) among community-dwelling adults aged 75 and older in Spain, through a gender-stratified analysis. Design Cross-sectional, community-based, multicentre study using baseline data from the CUIDAMOS+75 cohort. Methods A total of 1,072 older adults over 75 from 11 Spanish regions were interviewed between June 2022 and June 2023. Data on SARS-CoV-2 exposure, sociodemographic and clinical characteristics and perceived changes in daily routines (basic-needs, healthcare and social routines) were collected. HRQoL was measured using the EQ-5D-5L utility index. Gender-stratified linear regression models were used to examine associations between changes in routines and HRQoL. Results Over half of the participants (52\%) reported considerable changes in their daily routines due to the pandemic, especially in social routines (48\%). Women reported more frequent changes across all routine types. Although women had lower overall HRQoL scores, changes in routines were more strongly associated with poorer HRQoL among men, particularly when healthcare routines were affected. Among women, significant associations were observed for disruptions in combined basic and social routines as well as when all three routine types were simultaneously affected. Notably, COVID-19 infection status was not associated with HRQoL after adjustment. Conclusion The COVID-19 pandemic led to substantial and persistent changes in daily routines among older adults in Spain, with gender-specific patterns in their association with HRQoL. These findings highlight the importance of incorporating a gender perspective in public health responses to health crises, particularly in strategies aimed at preserving daily routines to support autonomy and wellbeing in older populations.
@article{cameselle-lago_changes_2025,
abstract = {Aims To examine the association between perceived changes in daily routines due to the COVID-19 pandemic and health-related quality of life (HRQoL) among community-dwelling adults aged 75 and older in Spain, through a gender-stratified analysis. Design Cross-sectional, community-based, multicentre study using baseline data from the CUIDAMOS+75 cohort. Methods A total of 1,072 older adults over 75 from 11 Spanish regions were interviewed between June 2022 and June 2023. Data on SARS-CoV-2 exposure, sociodemographic and clinical characteristics and perceived changes in daily routines (basic-needs, healthcare and social routines) were collected. HRQoL was measured using the EQ-5D-5L utility index. Gender-stratified linear regression models were used to examine associations between changes in routines and HRQoL. Results Over half of the participants (52\%) reported considerable changes in their daily routines due to the pandemic, especially in social routines (48\%). Women reported more frequent changes across all routine types. Although women had lower overall HRQoL scores, changes in routines were more strongly associated with poorer HRQoL among men, particularly when healthcare routines were affected. Among women, significant associations were observed for disruptions in combined basic and social routines as well as when all three routine types were simultaneously affected. Notably, COVID-19 infection status was not associated with HRQoL after adjustment. Conclusion The COVID-19 pandemic led to substantial and persistent changes in daily routines among older adults in Spain, with gender-specific patterns in their association with HRQoL. These findings highlight the importance of incorporating a gender perspective in public health responses to health crises, particularly in strategies aimed at preserving daily routines to support autonomy and wellbeing in older populations.},
author = {Cameselle-Lago, Candela and Rico-Blázquez, Milagros and Sánchez-Ruano, Raquel and Ayala, Alba and Pascual-García, Marcos and Solé-Agustí, María and Gimeno-Pi, Iraida and Echevarria-Echevarria, Aitziber and González-Chordá, Víctor M. and Esteban-Sepúlveda, Silvia and Pedraz-Marcos, Azucena and Company-Sancho, María Consuelo and Cidoncha-Moreno, María Ángeles and Vidal-Thomas, María Clara and Taltavull-Aparicio, Joana Maria and Moreno-Casbas, María Teresa},
journal = {Frontiers in Public Health},
keywords = {grapp-caib},
month = {oct},
pages = 1678003,
title = {Changes in daily routines and health-related quality of life among Spanish older adults after the COVID-19 pandemic: analysis from a gender perspective},
volume = 13,
year = 2025
}%0 Journal Article
%1 cameselle-lago_changes_2025
%A Cameselle-Lago, Candela
%A Rico-Blázquez, Milagros
%A Sánchez-Ruano, Raquel
%A Ayala, Alba
%A Pascual-García, Marcos
%A Solé-Agustí, María
%A Gimeno-Pi, Iraida
%A Echevarria-Echevarria, Aitziber
%A González-Chordá, Víctor M.
%A Esteban-Sepúlveda, Silvia
%A Pedraz-Marcos, Azucena
%A Company-Sancho, María Consuelo
%A Cidoncha-Moreno, María Ángeles
%A Vidal-Thomas, María Clara
%A Taltavull-Aparicio, Joana Maria
%A Moreno-Casbas, María Teresa
%D 2025
%J Frontiers in Public Health
%P 1678003
%R 10.3389/fpubh.2025.1678003
%T Changes in daily routines and health-related quality of life among Spanish older adults after the COVID-19 pandemic: analysis from a gender perspective
%U https://pmc.ncbi.nlm.nih.gov/articles/PMC12554437/
%V 13
%X Aims To examine the association between perceived changes in daily routines due to the COVID-19 pandemic and health-related quality of life (HRQoL) among community-dwelling adults aged 75 and older in Spain, through a gender-stratified analysis. Design Cross-sectional, community-based, multicentre study using baseline data from the CUIDAMOS+75 cohort. Methods A total of 1,072 older adults over 75 from 11 Spanish regions were interviewed between June 2022 and June 2023. Data on SARS-CoV-2 exposure, sociodemographic and clinical characteristics and perceived changes in daily routines (basic-needs, healthcare and social routines) were collected. HRQoL was measured using the EQ-5D-5L utility index. Gender-stratified linear regression models were used to examine associations between changes in routines and HRQoL. Results Over half of the participants (52\%) reported considerable changes in their daily routines due to the pandemic, especially in social routines (48\%). Women reported more frequent changes across all routine types. Although women had lower overall HRQoL scores, changes in routines were more strongly associated with poorer HRQoL among men, particularly when healthcare routines were affected. Among women, significant associations were observed for disruptions in combined basic and social routines as well as when all three routine types were simultaneously affected. Notably, COVID-19 infection status was not associated with HRQoL after adjustment. Conclusion The COVID-19 pandemic led to substantial and persistent changes in daily routines among older adults in Spain, with gender-specific patterns in their association with HRQoL. These findings highlight the importance of incorporating a gender perspective in public health responses to health crises, particularly in strategies aimed at preserving daily routines to support autonomy and wellbeing in older populations. - AbstractURLBibTeXEndNoteDOIBibSonomyDownload1.Riutord-Sbert P, Tárraga López PJ, López-González Ángel A, Coll Campayo I, Busquets-Cortés C, Ramírez Manent JI. Obesity indices and their sociodemographic, lifestyle, and social isolation correlates in a large Spanish working population. Frontiers in Endocrinology [Internet]. 2025 Oct.;16:1695705. https://pmc.ncbi.nlm.nih.gov/articles/PMC12549272/Background Obesity is a multifactorial condition shaped by biological, behavioral, socioeconomic, and psychosocial determinants. While lifestyle correlates are well documented, the impact of social isolation on obesity in occupational settings remains insufficiently explored. This study examined associations between sociodemographic variables, health behaviors, and social isolation with multiple obesity indices in a large cohort of Spanish workers. Methods We analyzed 117298 employees across Spain (2021–2024). Obesity was defined using body mass index (BMI), waist-to-height ratio (WtHR), Clínica Universidad de Navarra–Body Adiposity Estimator (CUN-BAE), and Metabolic Score for Visceral Fat (METS-VF). Sociodemographic data, lifestyle habits, and social isolation (ENRICHD Social Support Instrument, ESSI) were obtained through standardized protocols. Multivariable logistic regression estimated adjusted odds ratios (OR) and 95% confidence intervals (CI). Results Obesity prevalence ranged from 20.4% (BMI) to 39.6% (METS-VF). Male sex (OR up to 2.11, 95\% CI 2.05–2.18), older age (OR 2.83, 95\% CI 2.71–2.96 for ≥55 years vs. \textless35), and lower social class (OR 1.62, 95\% CI 1.54–1.71) were consistently associated with obesity across all indices. Poor adherence to the Mediterranean diet and physical inactivity increased the likelihood of obesity (OR 1.35 and 1.41, respectively). Social isolation independently predicted higher obesity risk (OR 1.27, 95\% CI 1.21–1.33), even after adjusting for sociodemographic and lifestyle factors. Associations remained robust in sensitivity analyses. Conclusions Obesity in Spanish workers is strongly associated with sociodemographic disadvantage, unhealthy lifestyles, and psychosocial vulnerability. Social isolation emerged as a novel determinant, reinforcing the need for multidimensional public health strategies that integrate lifestyle promotion, reduction of socioeconomic inequalities, and enhancement of social connectedness.
@article{riutord-sbert_obesity_2025,
abstract = {Background Obesity is a multifactorial condition shaped by biological, behavioral, socioeconomic, and psychosocial determinants. While lifestyle correlates are well documented, the impact of social isolation on obesity in occupational settings remains insufficiently explored. This study examined associations between sociodemographic variables, health behaviors, and social isolation with multiple obesity indices in a large cohort of Spanish workers. Methods We analyzed 117298 employees across Spain (2021–2024). Obesity was defined using body mass index (BMI), waist-to-height ratio (WtHR), Clínica Universidad de Navarra–Body Adiposity Estimator (CUN-BAE), and Metabolic Score for Visceral Fat (METS-VF). Sociodemographic data, lifestyle habits, and social isolation (ENRICHD Social Support Instrument, ESSI) were obtained through standardized protocols. Multivariable logistic regression estimated adjusted odds ratios (OR) and 95% confidence intervals (CI). Results Obesity prevalence ranged from 20.4% (BMI) to 39.6% (METS-VF). Male sex (OR up to 2.11, 95\% CI 2.05–2.18), older age (OR 2.83, 95\% CI 2.71–2.96 for ≥55 years vs. \textless35), and lower social class (OR 1.62, 95\% CI 1.54–1.71) were consistently associated with obesity across all indices. Poor adherence to the Mediterranean diet and physical inactivity increased the likelihood of obesity (OR 1.35 and 1.41, respectively). Social isolation independently predicted higher obesity risk (OR 1.27, 95\% CI 1.21–1.33), even after adjusting for sociodemographic and lifestyle factors. Associations remained robust in sensitivity analyses. Conclusions Obesity in Spanish workers is strongly associated with sociodemographic disadvantage, unhealthy lifestyles, and psychosocial vulnerability. Social isolation emerged as a novel determinant, reinforcing the need for multidimensional public health strategies that integrate lifestyle promotion, reduction of socioeconomic inequalities, and enhancement of social connectedness.},
author = {Riutord-Sbert, Pere and Tárraga López, Pedro Juan and López-González, Ángel Arturo and Coll Campayo, Irene and Busquets-Cortés, Carla and Ramírez Manent, José Ignacio},
journal = {Frontiers in Endocrinology},
keywords = {grapp-caib},
month = {oct},
pages = 1695705,
title = {Obesity indices and their sociodemographic, lifestyle, and social isolation correlates in a large Spanish working population},
volume = 16,
year = 2025
}%0 Journal Article
%1 riutord-sbert_obesity_2025
%A Riutord-Sbert, Pere
%A Tárraga López, Pedro Juan
%A López-González, Ángel Arturo
%A Coll Campayo, Irene
%A Busquets-Cortés, Carla
%A Ramírez Manent, José Ignacio
%D 2025
%J Frontiers in Endocrinology
%P 1695705
%R 10.3389/fendo.2025.1695705
%T Obesity indices and their sociodemographic, lifestyle, and social isolation correlates in a large Spanish working population
%U https://pmc.ncbi.nlm.nih.gov/articles/PMC12549272/
%V 16
%X Background Obesity is a multifactorial condition shaped by biological, behavioral, socioeconomic, and psychosocial determinants. While lifestyle correlates are well documented, the impact of social isolation on obesity in occupational settings remains insufficiently explored. This study examined associations between sociodemographic variables, health behaviors, and social isolation with multiple obesity indices in a large cohort of Spanish workers. Methods We analyzed 117298 employees across Spain (2021–2024). Obesity was defined using body mass index (BMI), waist-to-height ratio (WtHR), Clínica Universidad de Navarra–Body Adiposity Estimator (CUN-BAE), and Metabolic Score for Visceral Fat (METS-VF). Sociodemographic data, lifestyle habits, and social isolation (ENRICHD Social Support Instrument, ESSI) were obtained through standardized protocols. Multivariable logistic regression estimated adjusted odds ratios (OR) and 95% confidence intervals (CI). Results Obesity prevalence ranged from 20.4% (BMI) to 39.6% (METS-VF). Male sex (OR up to 2.11, 95\% CI 2.05–2.18), older age (OR 2.83, 95\% CI 2.71–2.96 for ≥55 years vs. \textless35), and lower social class (OR 1.62, 95\% CI 1.54–1.71) were consistently associated with obesity across all indices. Poor adherence to the Mediterranean diet and physical inactivity increased the likelihood of obesity (OR 1.35 and 1.41, respectively). Social isolation independently predicted higher obesity risk (OR 1.27, 95\% CI 1.21–1.33), even after adjusting for sociodemographic and lifestyle factors. Associations remained robust in sensitivity analyses. Conclusions Obesity in Spanish workers is strongly associated with sociodemographic disadvantage, unhealthy lifestyles, and psychosocial vulnerability. Social isolation emerged as a novel determinant, reinforcing the need for multidimensional public health strategies that integrate lifestyle promotion, reduction of socioeconomic inequalities, and enhancement of social connectedness. - AbstractURLBibTeXEndNoteDOIBibSonomyDownload1.Mira-Martínez S, Malih N, Angullo-Martínez E, Zamanillo-Campos R, Yañez AM, Bennasar-Veny M, Gómez-Juanes R, Konieczna J, Jiménez R, Serrano-Ripoll MJ, Fiol deRoque MA, Leiva A, Galmes-Panades AM, Miralles-Xamena J, Vidal-Thomàs MC, Gómez-Cobo C, Gervilla E, Oña-Gil JI, Ricci-Cabello I. A Multifaceted Digital Intervention for the Prevention of Type 2 Diabetes Mellitus in Primary Care (PREDIABETEXT): Cluster Randomized Trial. Journal of Medical Internet Research [Internet]. 2025 Oct.;27(1):e70981. https://www.jmir.org/2025/1/e70981Background: The diabetes epidemic continues to surge worldwide, demanding urgent and innovative solutions. Digital health interventions, particularly those targeting behavior change, hold promise due to their affordability and scalability. However, research in this field remains in its early stages. Objective: This study aimed to evaluate the effectiveness of PREDIABETEXT (Prediabetes Text Message Digital Intervention for the Prevention of Type 2 Diabetes Mellitus), a digital health intervention, in reducing glycated hemoglobin (HbA1c) and in improving secondary clinical, physiological, and behavioral outcomes. Methods: We conducted a 6-month, 3-arm, pragmatic cluster randomized clinical trial. We recruited patients with prediabetes (HbA1c levels between 6\% and 6.4\% in the previous 3 months or 2 consecutive fasting plasma glucose measurements of 110-125 mg/dL) registered at primary care centers in the Balearic Islands, Spain. The PREDIABETEXT intervention consisted of 3 personalized SMS text messages per week aimed at supporting lifestyle behavior changes and online training for their primary health care professionals. A total of 58 professionals (clusters) from 16 centers participated in the study and were randomized (1:1:1) to intervention group A (patient SMS text messaging), intervention group B (patient SMS text messaging+health care professional web-based training), or the control group (usual care). Following the 6-month intervention period, we conducted individual qualitative interviews with 8 patients and 7 health care professionals to evaluate their experiences with the intervention in terms of utility, satisfaction, and implementation barriers. Results: In total, 58 health care professionals (clusters) were included, allocated to the control group (n=20, 34\%; 119/365, 32.6\% patients), intervention group A (SMS text messaging only; n=18, 31\%; 106/365, 29\% patients), and intervention group B (SMS text messaging+training; n=20, 34\%; 140/365, 38.4\% patients). The mean age of the patients was 59.79 (SD 9.75) years, and 54.5% (199/365) were female. The results of the intention-to-treat analysis at the 6-month time point showed that intervention A led to a small, nonsignificant reduction in HbA1c levels compared to the control group (β=−0.05, 95\% CI −0.21 to 0.10; P=.50), whereas intervention B showed a similar nonsignificant reduction (β=−0.04, 95\% CI −0.12 to 0.10; P=.56). No substantial differences were observed in the remaining secondary outcomes. Interviews revealed positive feedback from patients, who appreciated the intervention’s dietary messages and their frequency and practicality. Participants suggested enhancements such as increased personalization, links to recipes, and nursing follow-ups. Health care professionals valued the online training but highlighted time constraints, suggesting shorter or blended formats to improve accessibility. Conclusions: While PREDIABETEXT did not significantly improve HbA1c levels, it demonstrated potential benefits for patient engagement. Further studies involving more intensive interventions are warranted to confirm the clinical impact on diabetes prevention. Trial Registration: ClinicalTrials.gov NCT05110625; https://www.clinicaltrials.gov/study/NCT05110625
@article{mira-martinez_multifaceted_2025,
abstract = {Background: The diabetes epidemic continues to surge worldwide, demanding urgent and innovative solutions. Digital health interventions, particularly those targeting behavior change, hold promise due to their affordability and scalability. However, research in this field remains in its early stages. Objective: This study aimed to evaluate the effectiveness of PREDIABETEXT (Prediabetes Text Message Digital Intervention for the Prevention of Type 2 Diabetes Mellitus), a digital health intervention, in reducing glycated hemoglobin (HbA1c) and in improving secondary clinical, physiological, and behavioral outcomes. Methods: We conducted a 6-month, 3-arm, pragmatic cluster randomized clinical trial. We recruited patients with prediabetes (HbA1c levels between 6\% and 6.4\% in the previous 3 months or 2 consecutive fasting plasma glucose measurements of 110-125 mg/dL) registered at primary care centers in the Balearic Islands, Spain. The PREDIABETEXT intervention consisted of 3 personalized SMS text messages per week aimed at supporting lifestyle behavior changes and online training for their primary health care professionals. A total of 58 professionals (clusters) from 16 centers participated in the study and were randomized (1:1:1) to intervention group A (patient SMS text messaging), intervention group B (patient SMS text messaging+health care professional web-based training), or the control group (usual care). Following the 6-month intervention period, we conducted individual qualitative interviews with 8 patients and 7 health care professionals to evaluate their experiences with the intervention in terms of utility, satisfaction, and implementation barriers. Results: In total, 58 health care professionals (clusters) were included, allocated to the control group (n=20, 34\%; 119/365, 32.6\% patients), intervention group A (SMS text messaging only; n=18, 31\%; 106/365, 29\% patients), and intervention group B (SMS text messaging+training; n=20, 34\%; 140/365, 38.4\% patients). The mean age of the patients was 59.79 (SD 9.75) years, and 54.5% (199/365) were female. The results of the intention-to-treat analysis at the 6-month time point showed that intervention A led to a small, nonsignificant reduction in HbA1c levels compared to the control group (β=−0.05, 95\% CI −0.21 to 0.10; P=.50), whereas intervention B showed a similar nonsignificant reduction (β=−0.04, 95\% CI −0.12 to 0.10; P=.56). No substantial differences were observed in the remaining secondary outcomes. Interviews revealed positive feedback from patients, who appreciated the intervention’s dietary messages and their frequency and practicality. Participants suggested enhancements such as increased personalization, links to recipes, and nursing follow-ups. Health care professionals valued the online training but highlighted time constraints, suggesting shorter or blended formats to improve accessibility. Conclusions: While PREDIABETEXT did not significantly improve HbA1c levels, it demonstrated potential benefits for patient engagement. Further studies involving more intensive interventions are warranted to confirm the clinical impact on diabetes prevention. Trial Registration: ClinicalTrials.gov NCT05110625; https://www.clinicaltrials.gov/study/NCT05110625},
author = {Mira-Martínez, Sofía and Malih, Narges and Angullo-Martínez, Escarlata and Zamanillo-Campos, Rocío and Yañez, Aina M. and Bennasar-Veny, Miquel and Gómez-Juanes, Rocío and Konieczna, Jadwiga and Jiménez, Rafael and Serrano-Ripoll, Maria J. and Fiol deRoque, Maria Antonia and Leiva, Alfonso and Galmes-Panades, Aina M. and Miralles-Xamena, Jerónima and Vidal-Thomàs, Maria Clara and Gómez-Cobo, Cristina and Gervilla, Elena and Oña-Gil, José Iván and Ricci-Cabello, Ignacio},
journal = {Journal of Medical Internet Research},
keywords = {grapp-caib},
month = {oct},
number = 1,
pages = {e70981},
title = {A Multifaceted Digital Intervention for the Prevention of Type 2 Diabetes Mellitus in Primary Care (PREDIABETEXT): Cluster Randomized Trial},
volume = 27,
year = 2025
}%0 Journal Article
%1 mira-martinez_multifaceted_2025
%A Mira-Martínez, Sofía
%A Malih, Narges
%A Angullo-Martínez, Escarlata
%A Zamanillo-Campos, Rocío
%A Yañez, Aina M.
%A Bennasar-Veny, Miquel
%A Gómez-Juanes, Rocío
%A Konieczna, Jadwiga
%A Jiménez, Rafael
%A Serrano-Ripoll, Maria J.
%A Fiol deRoque, Maria Antonia
%A Leiva, Alfonso
%A Galmes-Panades, Aina M.
%A Miralles-Xamena, Jerónima
%A Vidal-Thomàs, Maria Clara
%A Gómez-Cobo, Cristina
%A Gervilla, Elena
%A Oña-Gil, José Iván
%A Ricci-Cabello, Ignacio
%D 2025
%J Journal of Medical Internet Research
%N 1
%P e70981
%R 10.2196/70981
%T A Multifaceted Digital Intervention for the Prevention of Type 2 Diabetes Mellitus in Primary Care (PREDIABETEXT): Cluster Randomized Trial
%U https://www.jmir.org/2025/1/e70981
%V 27
%X Background: The diabetes epidemic continues to surge worldwide, demanding urgent and innovative solutions. Digital health interventions, particularly those targeting behavior change, hold promise due to their affordability and scalability. However, research in this field remains in its early stages. Objective: This study aimed to evaluate the effectiveness of PREDIABETEXT (Prediabetes Text Message Digital Intervention for the Prevention of Type 2 Diabetes Mellitus), a digital health intervention, in reducing glycated hemoglobin (HbA1c) and in improving secondary clinical, physiological, and behavioral outcomes. Methods: We conducted a 6-month, 3-arm, pragmatic cluster randomized clinical trial. We recruited patients with prediabetes (HbA1c levels between 6\% and 6.4\% in the previous 3 months or 2 consecutive fasting plasma glucose measurements of 110-125 mg/dL) registered at primary care centers in the Balearic Islands, Spain. The PREDIABETEXT intervention consisted of 3 personalized SMS text messages per week aimed at supporting lifestyle behavior changes and online training for their primary health care professionals. A total of 58 professionals (clusters) from 16 centers participated in the study and were randomized (1:1:1) to intervention group A (patient SMS text messaging), intervention group B (patient SMS text messaging+health care professional web-based training), or the control group (usual care). Following the 6-month intervention period, we conducted individual qualitative interviews with 8 patients and 7 health care professionals to evaluate their experiences with the intervention in terms of utility, satisfaction, and implementation barriers. Results: In total, 58 health care professionals (clusters) were included, allocated to the control group (n=20, 34\%; 119/365, 32.6\% patients), intervention group A (SMS text messaging only; n=18, 31\%; 106/365, 29\% patients), and intervention group B (SMS text messaging+training; n=20, 34\%; 140/365, 38.4\% patients). The mean age of the patients was 59.79 (SD 9.75) years, and 54.5% (199/365) were female. The results of the intention-to-treat analysis at the 6-month time point showed that intervention A led to a small, nonsignificant reduction in HbA1c levels compared to the control group (β=−0.05, 95\% CI −0.21 to 0.10; P=.50), whereas intervention B showed a similar nonsignificant reduction (β=−0.04, 95\% CI −0.12 to 0.10; P=.56). No substantial differences were observed in the remaining secondary outcomes. Interviews revealed positive feedback from patients, who appreciated the intervention’s dietary messages and their frequency and practicality. Participants suggested enhancements such as increased personalization, links to recipes, and nursing follow-ups. Health care professionals valued the online training but highlighted time constraints, suggesting shorter or blended formats to improve accessibility. Conclusions: While PREDIABETEXT did not significantly improve HbA1c levels, it demonstrated potential benefits for patient engagement. Further studies involving more intensive interventions are warranted to confirm the clinical impact on diabetes prevention. Trial Registration: ClinicalTrials.gov NCT05110625; https://www.clinicaltrials.gov/study/NCT05110625 - AbstractURLBibTeXEndNoteDOIBibSonomyDownload1.Esteva M, March S, Martín-Rabadan M, Torres-Solera E, Ripoll J. Health-related quality of life and lifestyle in long-term survivors of colorectal cancer and a matched non-cancer reference group. Clinical & Translational Oncology [Internet]. 2025;27(10):3993-4002. https://pmc.ncbi.nlm.nih.gov/articles/PMC12460565/Objective To compare the long-term health status of a group of survivors of colorectal cancer (CRC) with a reference group of individuals who did not have cancer. We determined the physical, mental, and general health-related quality of life (HRQoL); overall morbidities and CRC-specific morbidities related to the delayed effects of treatment; and maintenance of a healthy lifestyle in these two groups. Methods This descriptive cross-sectional study was conducted from 2016 to 2019 in the Balearic Islands (Spain). CRC patients who were diagnosed from 2011 to 2012 and survived at least 5 years were randomly selected from the Majorca and Eivissa-Formentera cancer registries. The reference group consisted of individuals matched for gender and age who had no history of cancer. Results We examined 201 CRC survivors and 199 matched individuals without cancer. The global analysis showed that the two groups had similar scores in the physical and mental components of the Short Form 12 (SF-12) HRQoL scale and in general health status. The CRC survivors had significantly higher prevalence of general comorbidity and CRC-specific comorbidity. Multivariate analyses and calculation of odds ratios (ORs) showed that the groups had similar physical HRQoL (Model 1, OR: 1.01, 95\% CI: 0.99–1.03), mental HRQoL (Model 2, OR: 0.99, 95\% CI: 0.66–1.01), and general HRQoL (Model 3, OR: 1.67, 95\% CI: 0.39–1.13). However, the long-term CRC survivors had significantly greater ORs for an increased overall comorbidity index, number of CRC-specific comorbidity, and obesity in all three models (P \textless 0.05). Conclusions The CRC survivors and individuals without cancer had similar HRQoL, suggesting that CRC survivors do not need additional services that aim to improve HRQoL. Nonetheless, health care providers should be pro-active when caring for CRC survivors, because they are more likely to present with certain comorbidity and less likely to follow a healthy lifestyle.
@article{esteva_health-related_2025,
abstract = {Objective To compare the long-term health status of a group of survivors of colorectal cancer (CRC) with a reference group of individuals who did not have cancer. We determined the physical, mental, and general health-related quality of life (HRQoL); overall morbidities and CRC-specific morbidities related to the delayed effects of treatment; and maintenance of a healthy lifestyle in these two groups. Methods This descriptive cross-sectional study was conducted from 2016 to 2019 in the Balearic Islands (Spain). CRC patients who were diagnosed from 2011 to 2012 and survived at least 5 years were randomly selected from the Majorca and Eivissa-Formentera cancer registries. The reference group consisted of individuals matched for gender and age who had no history of cancer. Results We examined 201 CRC survivors and 199 matched individuals without cancer. The global analysis showed that the two groups had similar scores in the physical and mental components of the Short Form 12 (SF-12) HRQoL scale and in general health status. The CRC survivors had significantly higher prevalence of general comorbidity and CRC-specific comorbidity. Multivariate analyses and calculation of odds ratios (ORs) showed that the groups had similar physical HRQoL (Model 1, OR: 1.01, 95\% CI: 0.99–1.03), mental HRQoL (Model 2, OR: 0.99, 95\% CI: 0.66–1.01), and general HRQoL (Model 3, OR: 1.67, 95\% CI: 0.39–1.13). However, the long-term CRC survivors had significantly greater ORs for an increased overall comorbidity index, number of CRC-specific comorbidity, and obesity in all three models (P \textless 0.05). Conclusions The CRC survivors and individuals without cancer had similar HRQoL, suggesting that CRC survivors do not need additional services that aim to improve HRQoL. Nonetheless, health care providers should be pro-active when caring for CRC survivors, because they are more likely to present with certain comorbidity and less likely to follow a healthy lifestyle.},
author = {Esteva, Magdalena and March, Sebastià and Martín-Rabadan, María and Torres-Solera, Elena and Ripoll, Joana},
journal = {Clinical & Translational Oncology},
keywords = {grapp-caib},
number = 10,
pages = {3993--4002},
title = {Health-related quality of life and lifestyle in long-term survivors of colorectal cancer and a matched non-cancer reference group},
volume = 27,
year = 2025
}%0 Journal Article
%1 esteva_health-related_2025
%A Esteva, Magdalena
%A March, Sebastià
%A Martín-Rabadan, María
%A Torres-Solera, Elena
%A Ripoll, Joana
%D 2025
%J Clinical & Translational Oncology
%N 10
%P 3993--4002
%R 10.1007/s12094-025-03930-0
%T Health-related quality of life and lifestyle in long-term survivors of colorectal cancer and a matched non-cancer reference group
%U https://pmc.ncbi.nlm.nih.gov/articles/PMC12460565/
%V 27
%X Objective To compare the long-term health status of a group of survivors of colorectal cancer (CRC) with a reference group of individuals who did not have cancer. We determined the physical, mental, and general health-related quality of life (HRQoL); overall morbidities and CRC-specific morbidities related to the delayed effects of treatment; and maintenance of a healthy lifestyle in these two groups. Methods This descriptive cross-sectional study was conducted from 2016 to 2019 in the Balearic Islands (Spain). CRC patients who were diagnosed from 2011 to 2012 and survived at least 5 years were randomly selected from the Majorca and Eivissa-Formentera cancer registries. The reference group consisted of individuals matched for gender and age who had no history of cancer. Results We examined 201 CRC survivors and 199 matched individuals without cancer. The global analysis showed that the two groups had similar scores in the physical and mental components of the Short Form 12 (SF-12) HRQoL scale and in general health status. The CRC survivors had significantly higher prevalence of general comorbidity and CRC-specific comorbidity. Multivariate analyses and calculation of odds ratios (ORs) showed that the groups had similar physical HRQoL (Model 1, OR: 1.01, 95\% CI: 0.99–1.03), mental HRQoL (Model 2, OR: 0.99, 95\% CI: 0.66–1.01), and general HRQoL (Model 3, OR: 1.67, 95\% CI: 0.39–1.13). However, the long-term CRC survivors had significantly greater ORs for an increased overall comorbidity index, number of CRC-specific comorbidity, and obesity in all three models (P \textless 0.05). Conclusions The CRC survivors and individuals without cancer had similar HRQoL, suggesting that CRC survivors do not need additional services that aim to improve HRQoL. Nonetheless, health care providers should be pro-active when caring for CRC survivors, because they are more likely to present with certain comorbidity and less likely to follow a healthy lifestyle. - AbstractURLBibTeXEndNoteDOIBibSonomyDownload1.García Samuelsson M, Tárraga López PJ, López-González Ángel A, Busquets-Cortés C, Obrador de Hevia J, Ramírez-Manent JI. Evaluation of Type 2 Diabetes Risk in Individuals With or Without Metabolically Healthy Obesity. Biology [Internet]. 2025 May;14(6):608. https://pmc.ncbi.nlm.nih.gov/articles/PMC12189814/Not all people with obesity are equally at risk for type 2 diabetes. Some individuals, although obese, do not show the typical signs of poor metabolic health—like high blood pressure, high blood sugar, or abnormal cholesterol levels. These individuals are known as “metabolically healthy obese” (MHO). This study looked at over 68,000 Spanish workers and compared MHO individuals to those with unhealthy obesity (MNHO). Researchers used several tools to estimate the risk of developing type 2 diabetes. They found that while MHO people had a lower risk than MNHO ones, their risk was still higher than people of normal weight with good metabolic health. The study also showed that lack of physical activity, poor diet, smoking, and low education levels were linked to higher diabetes risk. In short, even if someone with obesity appears healthy now, they may still face serious health risks later. The study highlights the importance of healthy habits and shows that weight alone is not enough to determine a person’s risk for diabetes., Background: The concept of metabolically healthy obesity (MHO) has emerged as a controversial yet clinically relevant phenotype, challenging the traditional view that all obese individuals are uniformly at high metabolic risk. However, the long-term health implications of MHO, particularly its association with type 2 diabetes mellitus (T2DM), remain poorly defined. Objective: To assess the risk of T2DM in individuals with MHO compared to those with metabolically non-healthy obesity (MNHO), using multiple validated diabetes risk scales across a large population-based cohort. Methods: This cross-sectional study analyzed data from over 68,884 adults stratified by sex and BMI-defined obesity status. Metabolic health was categorized using three progressively inclusive definitions based on the number of metabolic syndrome components. Diabetes risk was estimated using Finrisk, Canrisk, TRAQ-D, Thai, Oman, and QD-score tools. Multinomial logistic regression assessed associations between MHO/MNHO phenotypes and high-risk diabetes scores, adjusting for demographic, socioeconomic, and lifestyle variables. Results: Across all definitions and scales, MNHO individuals exhibited significantly higher mean diabetes risk scores and greater prevalence of high-risk categories compared to MHO participants (p \textless 0.001). Nevertheless, MHO individuals consistently showed elevated diabetes risk relative to non-obese, metabolically healthy controls. Physical inactivity, low educational level, lower socioeconomic status, smoking, and absence of a Mediterranean diet were independently associated with higher diabetes risk. MNHO phenotype was a strong and consistent predictor of high-risk classification across all models. Conclusions: While MHO individuals present a comparatively lower risk of T2DM than their MNHO counterparts, their risk remains substantially higher than that of non-obese individuals. These findings highlight the need to refine risk stratification approaches beyond BMI alone, and to consider metabolic health status in guiding prevention strategies for T2DM.
@article{garcia_samuelsson_evaluation_2025,
abstract = {Not all people with obesity are equally at risk for type 2 diabetes. Some individuals, although obese, do not show the typical signs of poor metabolic health—like high blood pressure, high blood sugar, or abnormal cholesterol levels. These individuals are known as “metabolically healthy obese” (MHO). This study looked at over 68,000 Spanish workers and compared MHO individuals to those with unhealthy obesity (MNHO). Researchers used several tools to estimate the risk of developing type 2 diabetes. They found that while MHO people had a lower risk than MNHO ones, their risk was still higher than people of normal weight with good metabolic health. The study also showed that lack of physical activity, poor diet, smoking, and low education levels were linked to higher diabetes risk. In short, even if someone with obesity appears healthy now, they may still face serious health risks later. The study highlights the importance of healthy habits and shows that weight alone is not enough to determine a person’s risk for diabetes., Background: The concept of metabolically healthy obesity (MHO) has emerged as a controversial yet clinically relevant phenotype, challenging the traditional view that all obese individuals are uniformly at high metabolic risk. However, the long-term health implications of MHO, particularly its association with type 2 diabetes mellitus (T2DM), remain poorly defined. Objective: To assess the risk of T2DM in individuals with MHO compared to those with metabolically non-healthy obesity (MNHO), using multiple validated diabetes risk scales across a large population-based cohort. Methods: This cross-sectional study analyzed data from over 68,884 adults stratified by sex and BMI-defined obesity status. Metabolic health was categorized using three progressively inclusive definitions based on the number of metabolic syndrome components. Diabetes risk was estimated using Finrisk, Canrisk, TRAQ-D, Thai, Oman, and QD-score tools. Multinomial logistic regression assessed associations between MHO/MNHO phenotypes and high-risk diabetes scores, adjusting for demographic, socioeconomic, and lifestyle variables. Results: Across all definitions and scales, MNHO individuals exhibited significantly higher mean diabetes risk scores and greater prevalence of high-risk categories compared to MHO participants (p \textless 0.001). Nevertheless, MHO individuals consistently showed elevated diabetes risk relative to non-obese, metabolically healthy controls. Physical inactivity, low educational level, lower socioeconomic status, smoking, and absence of a Mediterranean diet were independently associated with higher diabetes risk. MNHO phenotype was a strong and consistent predictor of high-risk classification across all models. Conclusions: While MHO individuals present a comparatively lower risk of T2DM than their MNHO counterparts, their risk remains substantially higher than that of non-obese individuals. These findings highlight the need to refine risk stratification approaches beyond BMI alone, and to consider metabolic health status in guiding prevention strategies for T2DM.},
author = {García Samuelsson, Miguel and Tárraga López, Pedro Juan and López-González, Ángel Arturo and Busquets-Cortés, Carla and Obrador de Hevia, Joan and Ramírez-Manent, José Ignacio},
journal = {Biology},
keywords = {grapp-caib},
month = {may},
number = 6,
pages = 608,
title = {Evaluation of Type 2 Diabetes Risk in Individuals With or Without Metabolically Healthy Obesity},
volume = 14,
year = 2025
}%0 Journal Article
%1 garcia_samuelsson_evaluation_2025
%A García Samuelsson, Miguel
%A Tárraga López, Pedro Juan
%A López-González, Ángel Arturo
%A Busquets-Cortés, Carla
%A Obrador de Hevia, Joan
%A Ramírez-Manent, José Ignacio
%D 2025
%J Biology
%N 6
%P 608
%R 10.3390/biology14060608
%T Evaluation of Type 2 Diabetes Risk in Individuals With or Without Metabolically Healthy Obesity
%U https://pmc.ncbi.nlm.nih.gov/articles/PMC12189814/
%V 14
%X Not all people with obesity are equally at risk for type 2 diabetes. Some individuals, although obese, do not show the typical signs of poor metabolic health—like high blood pressure, high blood sugar, or abnormal cholesterol levels. These individuals are known as “metabolically healthy obese” (MHO). This study looked at over 68,000 Spanish workers and compared MHO individuals to those with unhealthy obesity (MNHO). Researchers used several tools to estimate the risk of developing type 2 diabetes. They found that while MHO people had a lower risk than MNHO ones, their risk was still higher than people of normal weight with good metabolic health. The study also showed that lack of physical activity, poor diet, smoking, and low education levels were linked to higher diabetes risk. In short, even if someone with obesity appears healthy now, they may still face serious health risks later. The study highlights the importance of healthy habits and shows that weight alone is not enough to determine a person’s risk for diabetes., Background: The concept of metabolically healthy obesity (MHO) has emerged as a controversial yet clinically relevant phenotype, challenging the traditional view that all obese individuals are uniformly at high metabolic risk. However, the long-term health implications of MHO, particularly its association with type 2 diabetes mellitus (T2DM), remain poorly defined. Objective: To assess the risk of T2DM in individuals with MHO compared to those with metabolically non-healthy obesity (MNHO), using multiple validated diabetes risk scales across a large population-based cohort. Methods: This cross-sectional study analyzed data from over 68,884 adults stratified by sex and BMI-defined obesity status. Metabolic health was categorized using three progressively inclusive definitions based on the number of metabolic syndrome components. Diabetes risk was estimated using Finrisk, Canrisk, TRAQ-D, Thai, Oman, and QD-score tools. Multinomial logistic regression assessed associations between MHO/MNHO phenotypes and high-risk diabetes scores, adjusting for demographic, socioeconomic, and lifestyle variables. Results: Across all definitions and scales, MNHO individuals exhibited significantly higher mean diabetes risk scores and greater prevalence of high-risk categories compared to MHO participants (p \textless 0.001). Nevertheless, MHO individuals consistently showed elevated diabetes risk relative to non-obese, metabolically healthy controls. Physical inactivity, low educational level, lower socioeconomic status, smoking, and absence of a Mediterranean diet were independently associated with higher diabetes risk. MNHO phenotype was a strong and consistent predictor of high-risk classification across all models. Conclusions: While MHO individuals present a comparatively lower risk of T2DM than their MNHO counterparts, their risk remains substantially higher than that of non-obese individuals. These findings highlight the need to refine risk stratification approaches beyond BMI alone, and to consider metabolic health status in guiding prevention strategies for T2DM. - AbstractURLBibTeXEndNoteDOIBibSonomyDownload1.Marzoa Jansana MD, Tárraga López PJ, Guarro Miquel JJ, López-González Ángel A, Riutord Sbert P, Busquets-Cortés C, Ramírez-Manent JI. Sociodemographic, Lifestyle, and Quality of Life Determinants of Atherogenic Risk: A Cross-Sectional Study in a Large Cohort of Spanish Workers. Journal of Clinical Medicine [Internet]. 2025 Sep.;14(19):6876. https://pmc.ncbi.nlm.nih.gov/articles/PMC12524400/Background: Atherosclerosis is a leading cause of cardiovascular morbidity and mortality worldwide. Although lipid-derived atherogenic indices are widely used for cardiovascular risk assessment, their relationship with sociodemographic factors, lifestyle behaviors, and health-related quality of life (HRQoL) in occupational populations remains insufficiently explored. This study aimed to evaluate the association between atherogenic risk, measured by total cholesterol/high-density lipoprotein cholesterol (TC/HDL-c), low-density lipoprotein cholesterol/high-density lipoprotein cholesterol (LDL-c/HDL-c), triglyceride/high-density lipoprotein cholesterol (TG/HDL-c), and atherogenic dyslipidemia (AD) and sociodemographic, lifestyle, and HRQoL variables in a large cohort of Spanish workers. Methods: We conducted a cross-sectional analysis of 100,014 Spanish workers aged 18–69 years, of whom 39.9% were women, with a mean age of 38.2 years (SD 10.2 or IQR) and 38.9 years (SD 10.3 or IQR) for men, during the health examinations carried out between 2021 and 2024. Sociodemographic variables included sex, age group, and occupational social class. Lifestyle factors comprised smoking status, adherence to the Mediterranean diet (MEDAS score), and physical activity (IPAQ categories). HRQoL was assessed using the 12-item Short Form Survey (SF-12), stratified into good vs. poor categories. Logistic regression models were applied to estimate odds ratios (OR) and 95% confidence intervals (CI) for moderate-to-high atherogenic risk across indices, adjusting for potential confounders. Results: Men exhibited a lower likelihood of moderate-to-high TC/HDL-c and LDL-c/HDL-c but a markedly higher probability of elevated TG/HDL-c and AD compared to women (OR range: 0.42–3.67, p \textless 0.001). A clear age-related gradient was observed across all indices, with participants aged 60–69 showing the highest risk (OR range: 2.28–7.84, p \textless 0.001). Lower social class, smoking, physical inactivity, poor diet, and poor SF-12 scores were significantly associated with increased atherogenic risk, with physical inactivity (OR up to 8.61) and poor diet (OR up to 4.98) emerging as the strongest predictors. Conclusions: Atherogenic risk in this large working cohort is strongly influenced by both traditional cardiovascular risk factors and HRQoL. Integrating lifestyle modification and quality-of-life improvement strategies into workplace health programs could substantially reduce the atherogenic burden. Longitudinal research is needed to confirm these associations and guide targeted interventions.
@article{marzoa_jansana_sociodemographic_2025,
abstract = {Background: Atherosclerosis is a leading cause of cardiovascular morbidity and mortality worldwide. Although lipid-derived atherogenic indices are widely used for cardiovascular risk assessment, their relationship with sociodemographic factors, lifestyle behaviors, and health-related quality of life (HRQoL) in occupational populations remains insufficiently explored. This study aimed to evaluate the association between atherogenic risk, measured by total cholesterol/high-density lipoprotein cholesterol (TC/HDL-c), low-density lipoprotein cholesterol/high-density lipoprotein cholesterol (LDL-c/HDL-c), triglyceride/high-density lipoprotein cholesterol (TG/HDL-c), and atherogenic dyslipidemia (AD) and sociodemographic, lifestyle, and HRQoL variables in a large cohort of Spanish workers. Methods: We conducted a cross-sectional analysis of 100,014 Spanish workers aged 18–69 years, of whom 39.9% were women, with a mean age of 38.2 years (SD 10.2 or IQR) and 38.9 years (SD 10.3 or IQR) for men, during the health examinations carried out between 2021 and 2024. Sociodemographic variables included sex, age group, and occupational social class. Lifestyle factors comprised smoking status, adherence to the Mediterranean diet (MEDAS score), and physical activity (IPAQ categories). HRQoL was assessed using the 12-item Short Form Survey (SF-12), stratified into good vs. poor categories. Logistic regression models were applied to estimate odds ratios (OR) and 95% confidence intervals (CI) for moderate-to-high atherogenic risk across indices, adjusting for potential confounders. Results: Men exhibited a lower likelihood of moderate-to-high TC/HDL-c and LDL-c/HDL-c but a markedly higher probability of elevated TG/HDL-c and AD compared to women (OR range: 0.42–3.67, p \textless 0.001). A clear age-related gradient was observed across all indices, with participants aged 60–69 showing the highest risk (OR range: 2.28–7.84, p \textless 0.001). Lower social class, smoking, physical inactivity, poor diet, and poor SF-12 scores were significantly associated with increased atherogenic risk, with physical inactivity (OR up to 8.61) and poor diet (OR up to 4.98) emerging as the strongest predictors. Conclusions: Atherogenic risk in this large working cohort is strongly influenced by both traditional cardiovascular risk factors and HRQoL. Integrating lifestyle modification and quality-of-life improvement strategies into workplace health programs could substantially reduce the atherogenic burden. Longitudinal research is needed to confirm these associations and guide targeted interventions.},
author = {Marzoa Jansana, María Dolores and Tárraga López, Pedro Juan and Guarro Miquel, Juan José and López-González, Ángel Arturo and Riutord Sbert, Pere and Busquets-Cortés, Carla and Ramírez-Manent, José Ignacio},
journal = {Journal of Clinical Medicine},
keywords = {grapp-caib},
month = {sep},
number = 19,
pages = 6876,
title = {Sociodemographic, Lifestyle, and Quality of Life Determinants of Atherogenic Risk: A Cross-Sectional Study in a Large Cohort of Spanish Workers},
volume = 14,
year = 2025
}%0 Journal Article
%1 marzoa_jansana_sociodemographic_2025
%A Marzoa Jansana, María Dolores
%A Tárraga López, Pedro Juan
%A Guarro Miquel, Juan José
%A López-González, Ángel Arturo
%A Riutord Sbert, Pere
%A Busquets-Cortés, Carla
%A Ramírez-Manent, José Ignacio
%D 2025
%J Journal of Clinical Medicine
%N 19
%P 6876
%R 10.3390/jcm14196876
%T Sociodemographic, Lifestyle, and Quality of Life Determinants of Atherogenic Risk: A Cross-Sectional Study in a Large Cohort of Spanish Workers
%U https://pmc.ncbi.nlm.nih.gov/articles/PMC12524400/
%V 14
%X Background: Atherosclerosis is a leading cause of cardiovascular morbidity and mortality worldwide. Although lipid-derived atherogenic indices are widely used for cardiovascular risk assessment, their relationship with sociodemographic factors, lifestyle behaviors, and health-related quality of life (HRQoL) in occupational populations remains insufficiently explored. This study aimed to evaluate the association between atherogenic risk, measured by total cholesterol/high-density lipoprotein cholesterol (TC/HDL-c), low-density lipoprotein cholesterol/high-density lipoprotein cholesterol (LDL-c/HDL-c), triglyceride/high-density lipoprotein cholesterol (TG/HDL-c), and atherogenic dyslipidemia (AD) and sociodemographic, lifestyle, and HRQoL variables in a large cohort of Spanish workers. Methods: We conducted a cross-sectional analysis of 100,014 Spanish workers aged 18–69 years, of whom 39.9% were women, with a mean age of 38.2 years (SD 10.2 or IQR) and 38.9 years (SD 10.3 or IQR) for men, during the health examinations carried out between 2021 and 2024. Sociodemographic variables included sex, age group, and occupational social class. Lifestyle factors comprised smoking status, adherence to the Mediterranean diet (MEDAS score), and physical activity (IPAQ categories). HRQoL was assessed using the 12-item Short Form Survey (SF-12), stratified into good vs. poor categories. Logistic regression models were applied to estimate odds ratios (OR) and 95% confidence intervals (CI) for moderate-to-high atherogenic risk across indices, adjusting for potential confounders. Results: Men exhibited a lower likelihood of moderate-to-high TC/HDL-c and LDL-c/HDL-c but a markedly higher probability of elevated TG/HDL-c and AD compared to women (OR range: 0.42–3.67, p \textless 0.001). A clear age-related gradient was observed across all indices, with participants aged 60–69 showing the highest risk (OR range: 2.28–7.84, p \textless 0.001). Lower social class, smoking, physical inactivity, poor diet, and poor SF-12 scores were significantly associated with increased atherogenic risk, with physical inactivity (OR up to 8.61) and poor diet (OR up to 4.98) emerging as the strongest predictors. Conclusions: Atherogenic risk in this large working cohort is strongly influenced by both traditional cardiovascular risk factors and HRQoL. Integrating lifestyle modification and quality-of-life improvement strategies into workplace health programs could substantially reduce the atherogenic burden. Longitudinal research is needed to confirm these associations and guide targeted interventions. - AbstractURLBibTeXEndNoteDOIBibSonomyDownload1.Sánchez-Recio R, Oliván-Blázquez B, Méndez-López F, Gascón-Santos S, Martí-Lluch R, Zabaleta-Del-Olmo E, Tamayo-Morales O, Maderuelo-Fernández JA, Casajuana M, López-Jiménez T, Motrico E, Gómez-Gómez I, Sánchez-Pérez Álvaro, Rodero-Cosano ML, Llobera J, Bellón JA, Moreno-Peral P, Bolíbar B, Recio-Rodríguez JI, Ramos R, Clavería A. Self-reported health and depression among EIRA cohort: a moderated mediation model of sex and perceived social support. Frontiers in Psychology [Internet]. 2025 Jun.;16:1540530. https://pmc.ncbi.nlm.nih.gov/articles/PMC12202560/Background The positive relationship between health and good perceived social support has been widely demonstrated in the scientific literature. It is known that having a good social support influences the proper maintenance of health even as a protective factor, besides being a good predictor in the recovery of health during a disease process, influencing differently men and women. Aim This project aims to study the moderating effects of perceived social support in the relationship between depression and self-perceived health according to gender, after a complex multiple-risk intervention was carried out in patients of primary health care with low social support. Methods A cluster randomized clinical trial was developed in the subgroup of patients included in phase 3 of the EIRA project. CONSORT recommendations were followed to present the results. To determine the mediating effect between social support and self-perceived health, three regression analyses were carried out using the procedure designed by Hayes through the PROCESS macro for SPSS. Results 3,062 people (54.9\% women) participated in the study. Men reported experiencing more social support and self-perceived health (p \textless 0.001) than women at the beginning of the study, but women reported higher social support at post-intervention. Moderation analyses showed that, post-intervention, those women (bsimple = −2.9867, p \textless 0.001) and males (bsimple = −1.4337, p \textless 0.001) who scored lower in depression reported higher social support. Conclusion In primary care, it is necessary to encourage intervention strategies that promote social networks as a key element of positive action aimed at maintaining and improving the population’s health, especially in adults and more specifically in women. Clinical trial registration ClinicalTrials.gov, identifier NCT03136211.
@article{sanchez-recio_self-reported_2025,
abstract = {Background The positive relationship between health and good perceived social support has been widely demonstrated in the scientific literature. It is known that having a good social support influences the proper maintenance of health even as a protective factor, besides being a good predictor in the recovery of health during a disease process, influencing differently men and women. Aim This project aims to study the moderating effects of perceived social support in the relationship between depression and self-perceived health according to gender, after a complex multiple-risk intervention was carried out in patients of primary health care with low social support. Methods A cluster randomized clinical trial was developed in the subgroup of patients included in phase 3 of the EIRA project. CONSORT recommendations were followed to present the results. To determine the mediating effect between social support and self-perceived health, three regression analyses were carried out using the procedure designed by Hayes through the PROCESS macro for SPSS. Results 3,062 people (54.9\% women) participated in the study. Men reported experiencing more social support and self-perceived health (p \textless 0.001) than women at the beginning of the study, but women reported higher social support at post-intervention. Moderation analyses showed that, post-intervention, those women (bsimple = −2.9867, p \textless 0.001) and males (bsimple = −1.4337, p \textless 0.001) who scored lower in depression reported higher social support. Conclusion In primary care, it is necessary to encourage intervention strategies that promote social networks as a key element of positive action aimed at maintaining and improving the population’s health, especially in adults and more specifically in women. Clinical trial registration ClinicalTrials.gov, identifier NCT03136211.},
author = {Sánchez-Recio, Raquel and Oliván-Blázquez, Bárbara and Méndez-López, Fátima and Gascón-Santos, Santiago and Martí-Lluch, Ruth and Zabaleta-Del-Olmo, Edurne and Tamayo-Morales, Olaya and Maderuelo-Fernández, José A. and Casajuana, Marc and López-Jiménez, Tomas and Motrico, Emma and Gómez-Gómez, Irene and Sánchez-Pérez, Álvaro and Rodero-Cosano, María Luisa and Llobera, Joan and Bellón, Juan A. and Moreno-Peral, Patricia and Bolíbar, Bonaventura and Recio-Rodríguez, José I. and Ramos, Rafel and Clavería, Ana},
journal = {Frontiers in Psychology},
keywords = {grapp-caib},
month = {jun},
pages = 1540530,
title = {Self-reported health and depression among EIRA cohort: a moderated mediation model of sex and perceived social support},
volume = 16,
year = 2025
}%0 Journal Article
%1 sanchez-recio_self-reported_2025
%A Sánchez-Recio, Raquel
%A Oliván-Blázquez, Bárbara
%A Méndez-López, Fátima
%A Gascón-Santos, Santiago
%A Martí-Lluch, Ruth
%A Zabaleta-Del-Olmo, Edurne
%A Tamayo-Morales, Olaya
%A Maderuelo-Fernández, José A.
%A Casajuana, Marc
%A López-Jiménez, Tomas
%A Motrico, Emma
%A Gómez-Gómez, Irene
%A Sánchez-Pérez, Álvaro
%A Rodero-Cosano, María Luisa
%A Llobera, Joan
%A Bellón, Juan A.
%A Moreno-Peral, Patricia
%A Bolíbar, Bonaventura
%A Recio-Rodríguez, José I.
%A Ramos, Rafel
%A Clavería, Ana
%D 2025
%J Frontiers in Psychology
%P 1540530
%R 10.3389/fpsyg.2025.1540530
%T Self-reported health and depression among EIRA cohort: a moderated mediation model of sex and perceived social support
%U https://pmc.ncbi.nlm.nih.gov/articles/PMC12202560/
%V 16
%X Background The positive relationship between health and good perceived social support has been widely demonstrated in the scientific literature. It is known that having a good social support influences the proper maintenance of health even as a protective factor, besides being a good predictor in the recovery of health during a disease process, influencing differently men and women. Aim This project aims to study the moderating effects of perceived social support in the relationship between depression and self-perceived health according to gender, after a complex multiple-risk intervention was carried out in patients of primary health care with low social support. Methods A cluster randomized clinical trial was developed in the subgroup of patients included in phase 3 of the EIRA project. CONSORT recommendations were followed to present the results. To determine the mediating effect between social support and self-perceived health, three regression analyses were carried out using the procedure designed by Hayes through the PROCESS macro for SPSS. Results 3,062 people (54.9\% women) participated in the study. Men reported experiencing more social support and self-perceived health (p \textless 0.001) than women at the beginning of the study, but women reported higher social support at post-intervention. Moderation analyses showed that, post-intervention, those women (bsimple = −2.9867, p \textless 0.001) and males (bsimple = −1.4337, p \textless 0.001) who scored lower in depression reported higher social support. Conclusion In primary care, it is necessary to encourage intervention strategies that promote social networks as a key element of positive action aimed at maintaining and improving the population’s health, especially in adults and more specifically in women. Clinical trial registration ClinicalTrials.gov, identifier NCT03136211. -
AbstractURLBibTeXEndNoteDOIBibSonomy1.Bescos R, Gallardo-Alfaro L, Ashor A, Rizzolo-Brime L, Siervo M, Casas-Agustench P. Nitrate and nitrite bioavailability in plasma and saliva: Their association with blood pressure — A systematic review and meta-analysis. Free Radical Biology and Medicine [Internet]. 2025 Jan.;226:70-83. https://www.sciencedirect.com/science/article/pii/S0891584924010335In this study, we conducted a systematic review and meta-analysis to determine plasma and salivary nitrate (NO3−) and nitrite (NO2−) concentrations under resting and fasting conditions in different type of individuals and their association with blood pressure levels. A total of 77 studies, involving 1918 individuals aged 19–74 years (males = 906; females = 1012), which measured plasma and/or salivary NO3− and NO2− using the chemiluminescence technique, were included. Mean plasma NO3− and NO2− concentrations were 33.9 μmol/L and 158.3 nmol/L, respectively. Subgroup analyses revealed lower plasma NO3− and NO2− concentrations in individuals with cardiometabolic risk (NO3−: 21.2 μmol/L; 95 \% CI, 13.4–29.0; NO2−: 122.8 nmol/L; 95 \% CI, 75.3–138.9) compared to healthy (NO3−: 33.9 μmol/L; 95 \% CI, 29.9–37.9; NO2−: 159.5 nmol/L; 95 \% CI, 131.8–187.1; P \textless 0.01) and trained individuals (NO3−: 43.0 μmol/L; 95 \% CI, 13.2–72.9; NO2−: 199.3 nmol/L; 95 \% CI, 117.6–281; P \textless 0.01). Mean salivary NO3− and NO2− concentrations were 546.2 μmol/L and 197.8 μmol/L, respectively. Salivary NO3−, but no NO2−, concentrations were higher in individuals with cardiometabolic risk (680.0 μmol/L; 95 \% CI, 510.2–849.8; P = 0.001) compared to healthy individuals (535.9 μmol/L; 95 \% CI, 384.2–687.6). A significant positive association (coefficient, 15.4 [95 \% CI, 0.255 to 30.5], P = 0.046) was observed between salivary NO3− and diastolic blood pressure (DBP). These findings suggest that the health status is positively associated with plasma NO3− and NO2− concentrations, but the circulatory levels of these anions are not associated with blood pressure. Only salivary NO3− showed a significant positive association with DBP.
@article{bescos_nitrate_2025,
abstract = {In this study, we conducted a systematic review and meta-analysis to determine plasma and salivary nitrate (NO3−) and nitrite (NO2−) concentrations under resting and fasting conditions in different type of individuals and their association with blood pressure levels. A total of 77 studies, involving 1918 individuals aged 19–74 years (males = 906; females = 1012), which measured plasma and/or salivary NO3− and NO2− using the chemiluminescence technique, were included. Mean plasma NO3− and NO2− concentrations were 33.9 μmol/L and 158.3 nmol/L, respectively. Subgroup analyses revealed lower plasma NO3− and NO2− concentrations in individuals with cardiometabolic risk (NO3−: 21.2 μmol/L; 95 \% CI, 13.4–29.0; NO2−: 122.8 nmol/L; 95 \% CI, 75.3–138.9) compared to healthy (NO3−: 33.9 μmol/L; 95 \% CI, 29.9–37.9; NO2−: 159.5 nmol/L; 95 \% CI, 131.8–187.1; P \textless 0.01) and trained individuals (NO3−: 43.0 μmol/L; 95 \% CI, 13.2–72.9; NO2−: 199.3 nmol/L; 95 \% CI, 117.6–281; P \textless 0.01). Mean salivary NO3− and NO2− concentrations were 546.2 μmol/L and 197.8 μmol/L, respectively. Salivary NO3−, but no NO2−, concentrations were higher in individuals with cardiometabolic risk (680.0 μmol/L; 95 \% CI, 510.2–849.8; P = 0.001) compared to healthy individuals (535.9 μmol/L; 95 \% CI, 384.2–687.6). A significant positive association (coefficient, 15.4 [95 \% CI, 0.255 to 30.5], P = 0.046) was observed between salivary NO3− and diastolic blood pressure (DBP). These findings suggest that the health status is positively associated with plasma NO3− and NO2− concentrations, but the circulatory levels of these anions are not associated with blood pressure. Only salivary NO3− showed a significant positive association with DBP.},
author = {Bescos, Raul and Gallardo-Alfaro, Laura and Ashor, Ammar and Rizzolo-Brime, Lucia and Siervo, Mario and Casas-Agustench, Patricia},
journal = {Free Radical Biology and Medicine},
keywords = {grapp-caib},
month = {jan},
pages = {70--83},
title = {Nitrate and nitrite bioavailability in plasma and saliva: Their association with blood pressure — A systematic review and meta-analysis},
volume = 226,
year = 2025
}%0 Journal Article
%1 bescos_nitrate_2025
%A Bescos, Raul
%A Gallardo-Alfaro, Laura
%A Ashor, Ammar
%A Rizzolo-Brime, Lucia
%A Siervo, Mario
%A Casas-Agustench, Patricia
%D 2025
%J Free Radical Biology and Medicine
%P 70--83
%R 10.1016/j.freeradbiomed.2024.11.010
%T Nitrate and nitrite bioavailability in plasma and saliva: Their association with blood pressure — A systematic review and meta-analysis
%U https://www.sciencedirect.com/science/article/pii/S0891584924010335
%V 226
%X In this study, we conducted a systematic review and meta-analysis to determine plasma and salivary nitrate (NO3−) and nitrite (NO2−) concentrations under resting and fasting conditions in different type of individuals and their association with blood pressure levels. A total of 77 studies, involving 1918 individuals aged 19–74 years (males = 906; females = 1012), which measured plasma and/or salivary NO3− and NO2− using the chemiluminescence technique, were included. Mean plasma NO3− and NO2− concentrations were 33.9 μmol/L and 158.3 nmol/L, respectively. Subgroup analyses revealed lower plasma NO3− and NO2− concentrations in individuals with cardiometabolic risk (NO3−: 21.2 μmol/L; 95 \% CI, 13.4–29.0; NO2−: 122.8 nmol/L; 95 \% CI, 75.3–138.9) compared to healthy (NO3−: 33.9 μmol/L; 95 \% CI, 29.9–37.9; NO2−: 159.5 nmol/L; 95 \% CI, 131.8–187.1; P \textless 0.01) and trained individuals (NO3−: 43.0 μmol/L; 95 \% CI, 13.2–72.9; NO2−: 199.3 nmol/L; 95 \% CI, 117.6–281; P \textless 0.01). Mean salivary NO3− and NO2− concentrations were 546.2 μmol/L and 197.8 μmol/L, respectively. Salivary NO3−, but no NO2−, concentrations were higher in individuals with cardiometabolic risk (680.0 μmol/L; 95 \% CI, 510.2–849.8; P = 0.001) compared to healthy individuals (535.9 μmol/L; 95 \% CI, 384.2–687.6). A significant positive association (coefficient, 15.4 [95 \% CI, 0.255 to 30.5], P = 0.046) was observed between salivary NO3− and diastolic blood pressure (DBP). These findings suggest that the health status is positively associated with plasma NO3− and NO2− concentrations, but the circulatory levels of these anions are not associated with blood pressure. Only salivary NO3− showed a significant positive association with DBP. - AbstractURLBibTeXEndNoteDOIBibSonomyDownload1.Marzoa Jansana MD, Tárraga López PJ, Guarro Miquel JJ, López-González Ángel A, Riutord Sbert P, Busquets-Cortés C, Ramírez-Manent JI. Sociodemographic Factors, Healthy Habits, and Quality of Life in Relation to Insulin Resistance Risk in a Large Cohort of Spanish Workers. Medical Sciences [Internet]. 2025 Aug.;13(3):122. https://pmc.ncbi.nlm.nih.gov/articles/PMC12371977/Background: Insulin resistance (IR) is a key pathogenic mechanism underlying numerous cardiometabolic disorders. While sociodemographic and lifestyle determinants of IR are well-established, their association with health-related quality of life (HRQoL) remains understudied. This study explores the relationship between IR risk, as measured by TyG, METS-IR, and SPISE-IR indices, and HRQoL in a large cohort of Spanish workers. Methods: This cross-sectional study included 100,014 Spanish workers aged 18–69 years evaluated between January 2021 and December 2023. Exclusion criteria included incomplete clinical, laboratory, or questionnaire data. IR was assessed using TyG, METS-IR, and SPISE-IR indices. HRQoL was measured using the SF-12 questionnaire. Sociodemographic factors, physical activity (IPAQ), dietary habits (MEDAS-14), and social class (based on CNAE-11 and Spanish Society of Epidemiology criteria) were also evaluated. Statistical analysis was conducted using SPSS v29.0. Results: Higher IR risk was consistently associated with older age, male sex, lower social class, current smoking, low adherence to the Mediterranean diet, and physical inactivity. Lower HRQoL scores (both physical and mental components) were significantly associated with higher IR indices, particularly with METS-IR and SPISE-IR. These associations persisted after adjusting for sociodemographic and behavioral covariates. Conclusions: This study demonstrates a robust association between insulin resistance risk and diminished health-related quality of life. The integration of validated IR indices and subjective health perception tools such as the SF-12 may enhance early identification of at-risk individuals in occupational health settings.
@article{marzoa_jansana_sociodemographic_2025,
abstract = {Background: Insulin resistance (IR) is a key pathogenic mechanism underlying numerous cardiometabolic disorders. While sociodemographic and lifestyle determinants of IR are well-established, their association with health-related quality of life (HRQoL) remains understudied. This study explores the relationship between IR risk, as measured by TyG, METS-IR, and SPISE-IR indices, and HRQoL in a large cohort of Spanish workers. Methods: This cross-sectional study included 100,014 Spanish workers aged 18–69 years evaluated between January 2021 and December 2023. Exclusion criteria included incomplete clinical, laboratory, or questionnaire data. IR was assessed using TyG, METS-IR, and SPISE-IR indices. HRQoL was measured using the SF-12 questionnaire. Sociodemographic factors, physical activity (IPAQ), dietary habits (MEDAS-14), and social class (based on CNAE-11 and Spanish Society of Epidemiology criteria) were also evaluated. Statistical analysis was conducted using SPSS v29.0. Results: Higher IR risk was consistently associated with older age, male sex, lower social class, current smoking, low adherence to the Mediterranean diet, and physical inactivity. Lower HRQoL scores (both physical and mental components) were significantly associated with higher IR indices, particularly with METS-IR and SPISE-IR. These associations persisted after adjusting for sociodemographic and behavioral covariates. Conclusions: This study demonstrates a robust association between insulin resistance risk and diminished health-related quality of life. The integration of validated IR indices and subjective health perception tools such as the SF-12 may enhance early identification of at-risk individuals in occupational health settings.},
author = {Marzoa Jansana, María Dolores and Tárraga López, Pedro Juan and Guarro Miquel, Juan José and López-González, Ángel Arturo and Riutord Sbert, Pere and Busquets-Cortés, Carla and Ramírez-Manent, José Ignacio},
journal = {Medical Sciences},
keywords = {grapp-caib},
month = {aug},
number = 3,
pages = 122,
title = {Sociodemographic Factors, Healthy Habits, and Quality of Life in Relation to Insulin Resistance Risk in a Large Cohort of Spanish Workers},
volume = 13,
year = 2025
}%0 Journal Article
%1 marzoa_jansana_sociodemographic_2025
%A Marzoa Jansana, María Dolores
%A Tárraga López, Pedro Juan
%A Guarro Miquel, Juan José
%A López-González, Ángel Arturo
%A Riutord Sbert, Pere
%A Busquets-Cortés, Carla
%A Ramírez-Manent, José Ignacio
%D 2025
%J Medical Sciences
%N 3
%P 122
%R 10.3390/medsci13030122
%T Sociodemographic Factors, Healthy Habits, and Quality of Life in Relation to Insulin Resistance Risk in a Large Cohort of Spanish Workers
%U https://pmc.ncbi.nlm.nih.gov/articles/PMC12371977/
%V 13
%X Background: Insulin resistance (IR) is a key pathogenic mechanism underlying numerous cardiometabolic disorders. While sociodemographic and lifestyle determinants of IR are well-established, their association with health-related quality of life (HRQoL) remains understudied. This study explores the relationship between IR risk, as measured by TyG, METS-IR, and SPISE-IR indices, and HRQoL in a large cohort of Spanish workers. Methods: This cross-sectional study included 100,014 Spanish workers aged 18–69 years evaluated between January 2021 and December 2023. Exclusion criteria included incomplete clinical, laboratory, or questionnaire data. IR was assessed using TyG, METS-IR, and SPISE-IR indices. HRQoL was measured using the SF-12 questionnaire. Sociodemographic factors, physical activity (IPAQ), dietary habits (MEDAS-14), and social class (based on CNAE-11 and Spanish Society of Epidemiology criteria) were also evaluated. Statistical analysis was conducted using SPSS v29.0. Results: Higher IR risk was consistently associated with older age, male sex, lower social class, current smoking, low adherence to the Mediterranean diet, and physical inactivity. Lower HRQoL scores (both physical and mental components) were significantly associated with higher IR indices, particularly with METS-IR and SPISE-IR. These associations persisted after adjusting for sociodemographic and behavioral covariates. Conclusions: This study demonstrates a robust association between insulin resistance risk and diminished health-related quality of life. The integration of validated IR indices and subjective health perception tools such as the SF-12 may enhance early identification of at-risk individuals in occupational health settings. - AbstractURLBibTeXEndNoteDOIBibSonomyDownload1.Standl M, Budu‐Aggrey A, Johnston LJ, Elias MS, Arshad SH, Bager P, Bataille V, Blakeway H, Bønnelykke K, Boomsma D, Brumpton BM, Bustamante Pineda M, Campbell A, Curtin JA, Eliasen A, Fadista JPS, Feenstra B, Gerner T, Medina‐Gomez C, Grosche S, Gutzkow KB, Halling A, Hayward C, Henderson J, Herrera‐Luis E, Holloway JW, Hottenga J, O’B Hourihane J, Hu C, Hveem K, Irizar A, Jacquemin B, Jessen L, Kress S, Kurukulaaratchy RJ, Lau S, Llop S, Løset M, Marenholz I, Mason D, McCartney DL, Melbye M, Melén E, Minica C, Murray CS, Nijsten T, Pardo LM, Pasmans S, Pennell CE, Rinnov MR, Santorelli G, Schikowski T, Sheehan D, Simpson A, Söderhäll C, Thomas LF, Thyssen JP, Torrent M, van Beijsterveldt T, Visconti A, Vonk JM, Wang CA, Xu C, Ziyab AH, Custovic A, Di Meglio P, Duijts L, Flohr C, Irvine AD, Koppelman GH, Lee Y, Reynolds NJ, Smith C, Langan SM, Paternoster L, Brown SJ. Gene–Environment Interaction Affects Risk of Atopic Eczema: Population and In Vitro Studies. Allergy [Internet]. 2025 Aug.;80(8):2201-12. https://pmc.ncbi.nlm.nih.gov/articles/PMC12368900/Atopic eczema is a complex trait resulting from multiple genetic and environmental factors. This study investigated evidence for interaction between 24 established eczema genetic risk variants and 18 environmental factors. One variant‐environmental pair showed nominally significant interaction in discovery, replication and meta‐analyses: early‐life dog exposure modulates the increased risk of rs10214237 and preliminary work suggests a mechanistic effect via IL‐7R. CCL2, C‐C motif chemokine ligand 2; chr 5, chromosome 5; CSF2, colony stimulating factor 2 (granulocyte‐macrophage); CXCL8, C‐X‐C motif chemokine ligand 8 (IL‐8); ELISA, enzyme‐linked immunosorbent assay; FLG, filaggrin; GWAS, genome‐wide association study; IL, interleukin; n, number of participants; OR, odds ratio; RT‐qPCR, reverse transcription quantitative polymerase chain reaction; TNF, tumour necrosis factor; TSLP, thymic stromal lymphopoietin.
@article{standl_geneenvironment_2025,
abstract = {Atopic eczema is a complex trait resulting from multiple genetic and environmental factors. This study investigated evidence for interaction between 24 established eczema genetic risk variants and 18 environmental factors. One variant‐environmental pair showed nominally significant interaction in discovery, replication and meta‐analyses: early‐life dog exposure modulates the increased risk of rs10214237 and preliminary work suggests a mechanistic effect via IL‐7R. CCL2, C‐C motif chemokine ligand 2; chr 5, chromosome 5; CSF2, colony stimulating factor 2 (granulocyte‐macrophage); CXCL8, C‐X‐C motif chemokine ligand 8 (IL‐8); ELISA, enzyme‐linked immunosorbent assay; FLG, filaggrin; GWAS, genome‐wide association study; IL, interleukin; n, number of participants; OR, odds ratio; RT‐qPCR, reverse transcription quantitative polymerase chain reaction; TNF, tumour necrosis factor; TSLP, thymic stromal lymphopoietin.},
author = {Standl, Marie and Budu‐Aggrey, Ashley and Johnston, Luke J. and Elias, Martina S. and Arshad, S. Hasan and Bager, Peter and Bataille, Veronique and Blakeway, Helena and Bønnelykke, Klaus and Boomsma, Dorret and Brumpton, Ben M. and Bustamante Pineda, Mariona and Campbell, Archie and Curtin, John A. and Eliasen, Anders and Fadista, João P. S. and Feenstra, Bjarke and Gerner, Trine and Medina‐Gomez, Carolina and Grosche, Sarah and Gutzkow, Kristine B. and Halling, Anne‐Sofie and Hayward, Caroline and Henderson, John and Herrera‐Luis, Esther and Holloway, John W. and Hottenga, Joukejan and O’B Hourihane, Jonathan and Hu, Chen and Hveem, Kristian and Irizar, Amaia and Jacquemin, Bénédicte and Jessen, Leon and Kress, Sara and Kurukulaaratchy, Ramesh J. and Lau, Susanne and Llop, Sabrina and Løset, Mari and Marenholz, Ingo and Mason, Dan and McCartney, Daniel L. and Melbye, Mads and Melén, Erik and Minica, Camelia and Murray, Clare S. and Nijsten, Tamar and Pardo, Luba M. and Pasmans, Suzanne and Pennell, Craig E. and Rinnov, Maria R. and Santorelli, Gillian and Schikowski, Tamara and Sheehan, Darina and Simpson, Angela and Söderhäll, Cilla and Thomas, Laurent F. and Thyssen, Jacob P. and Torrent, Maties and van Beijsterveldt, Toos and Visconti, Alessia and Vonk, Judith M. and Wang, Carol A. and Xu, Cheng‐Jian and Ziyab, Ali H. and Custovic, Adnan and Di Meglio, Paola and Duijts, Liesbeth and Flohr, Carsten and Irvine, Alan D. and Koppelman, Gerard H. and Lee, Young‐Ae and Reynolds, Nick J. and Smith, Catherine and Langan, Sinéad M. and Paternoster, Lavinia and Brown, Sara J.},
journal = {Allergy},
keywords = {grapp-caib},
month = {aug},
number = 8,
pages = {2201--2212},
title = {Gene–Environment Interaction Affects Risk of Atopic Eczema: Population and In Vitro Studies},
volume = 80,
year = 2025
}%0 Journal Article
%1 standl_geneenvironment_2025
%A Standl, Marie
%A Budu‐Aggrey, Ashley
%A Johnston, Luke J.
%A Elias, Martina S.
%A Arshad, S. Hasan
%A Bager, Peter
%A Bataille, Veronique
%A Blakeway, Helena
%A Bønnelykke, Klaus
%A Boomsma, Dorret
%A Brumpton, Ben M.
%A Bustamante Pineda, Mariona
%A Campbell, Archie
%A Curtin, John A.
%A Eliasen, Anders
%A Fadista, João P. S.
%A Feenstra, Bjarke
%A Gerner, Trine
%A Medina‐Gomez, Carolina
%A Grosche, Sarah
%A Gutzkow, Kristine B.
%A Halling, Anne‐Sofie
%A Hayward, Caroline
%A Henderson, John
%A Herrera‐Luis, Esther
%A Holloway, John W.
%A Hottenga, Joukejan
%A O’B Hourihane, Jonathan
%A Hu, Chen
%A Hveem, Kristian
%A Irizar, Amaia
%A Jacquemin, Bénédicte
%A Jessen, Leon
%A Kress, Sara
%A Kurukulaaratchy, Ramesh J.
%A Lau, Susanne
%A Llop, Sabrina
%A Løset, Mari
%A Marenholz, Ingo
%A Mason, Dan
%A McCartney, Daniel L.
%A Melbye, Mads
%A Melén, Erik
%A Minica, Camelia
%A Murray, Clare S.
%A Nijsten, Tamar
%A Pardo, Luba M.
%A Pasmans, Suzanne
%A Pennell, Craig E.
%A Rinnov, Maria R.
%A Santorelli, Gillian
%A Schikowski, Tamara
%A Sheehan, Darina
%A Simpson, Angela
%A Söderhäll, Cilla
%A Thomas, Laurent F.
%A Thyssen, Jacob P.
%A Torrent, Maties
%A van Beijsterveldt, Toos
%A Visconti, Alessia
%A Vonk, Judith M.
%A Wang, Carol A.
%A Xu, Cheng‐Jian
%A Ziyab, Ali H.
%A Custovic, Adnan
%A Di Meglio, Paola
%A Duijts, Liesbeth
%A Flohr, Carsten
%A Irvine, Alan D.
%A Koppelman, Gerard H.
%A Lee, Young‐Ae
%A Reynolds, Nick J.
%A Smith, Catherine
%A Langan, Sinéad M.
%A Paternoster, Lavinia
%A Brown, Sara J.
%D 2025
%J Allergy
%N 8
%P 2201--2212
%R 10.1111/all.16605
%T Gene–Environment Interaction Affects Risk of Atopic Eczema: Population and In Vitro Studies
%U https://pmc.ncbi.nlm.nih.gov/articles/PMC12368900/
%V 80
%X Atopic eczema is a complex trait resulting from multiple genetic and environmental factors. This study investigated evidence for interaction between 24 established eczema genetic risk variants and 18 environmental factors. One variant‐environmental pair showed nominally significant interaction in discovery, replication and meta‐analyses: early‐life dog exposure modulates the increased risk of rs10214237 and preliminary work suggests a mechanistic effect via IL‐7R. CCL2, C‐C motif chemokine ligand 2; chr 5, chromosome 5; CSF2, colony stimulating factor 2 (granulocyte‐macrophage); CXCL8, C‐X‐C motif chemokine ligand 8 (IL‐8); ELISA, enzyme‐linked immunosorbent assay; FLG, filaggrin; GWAS, genome‐wide association study; IL, interleukin; n, number of participants; OR, odds ratio; RT‐qPCR, reverse transcription quantitative polymerase chain reaction; TNF, tumour necrosis factor; TSLP, thymic stromal lymphopoietin. - AbstractURLBibTeXEndNoteDOIBibSonomyDownload1.Fernández-Figares Vicioso MP, Riutord Sbert P, Ramírez-Manent JI, López-González Ángel A, del Barrio Fernández JL, Vicente Herrero MT. Association Between Sociodemographic and Lifestyle Factors and Type 2 Diabetes Risk Scores in a Large Working Population: A Comparative Study Between the Commerce and Industry Sectors. Nutrients [Internet]. 2025 Jul.;17(15):2420. https://pmc.ncbi.nlm.nih.gov/articles/PMC12348608/Background: Type 2 diabetes (T2D) is a major global health concern influenced by sociodemographic and lifestyle factors. This study compared T2D risk scores between commerce and industry sectors and assessed the associations of age, sex, education, physical activity, diet, and smoking with elevated risk. Methods: This cross-sectional study included 56,856 men and 12,872 women employed in the commerce (n = 27,448) and industry (n = 42,280) sectors across Spain. Anthropometric, clinical, and biochemical data were collected. Four validated T2D risk scores (QDscore, Finrisk, Canrisk, and TRAQ-D) were calculated. Multinomial logistic regression models estimated adjusted odds ratios (ORs) for high-risk categories by sociodemographic and lifestyle characteristics. Results: Women in the industrial sector had significantly higher age, BMI, waist circumference, and lipid levels than those in commerce; differences among men were less marked. Across all participants, higher T2D risk scores were independently associated with physical inactivity (OR up to 12.49), poor Mediterranean diet adherence (OR up to 6.62), industrial employment (OR up to 1.98), and older age. Male sex was strongly associated with high Canrisk scores (OR = 6.31; 95\% CI: 5.12–7.51). Conclusions: Employment in the industrial sector, combined with sedentary behavior and poor dietary habits, is independently associated with higher predicted T2D risk. Workplace prevention strategies should prioritize multicomponent interventions targeting modifiable risk factors, especially in high-risk subgroups such as older, less-educated, and inactive workers.
@article{fernandez-figares_vicioso_association_2025,
abstract = {Background: Type 2 diabetes (T2D) is a major global health concern influenced by sociodemographic and lifestyle factors. This study compared T2D risk scores between commerce and industry sectors and assessed the associations of age, sex, education, physical activity, diet, and smoking with elevated risk. Methods: This cross-sectional study included 56,856 men and 12,872 women employed in the commerce (n = 27,448) and industry (n = 42,280) sectors across Spain. Anthropometric, clinical, and biochemical data were collected. Four validated T2D risk scores (QDscore, Finrisk, Canrisk, and TRAQ-D) were calculated. Multinomial logistic regression models estimated adjusted odds ratios (ORs) for high-risk categories by sociodemographic and lifestyle characteristics. Results: Women in the industrial sector had significantly higher age, BMI, waist circumference, and lipid levels than those in commerce; differences among men were less marked. Across all participants, higher T2D risk scores were independently associated with physical inactivity (OR up to 12.49), poor Mediterranean diet adherence (OR up to 6.62), industrial employment (OR up to 1.98), and older age. Male sex was strongly associated with high Canrisk scores (OR = 6.31; 95\% CI: 5.12–7.51). Conclusions: Employment in the industrial sector, combined with sedentary behavior and poor dietary habits, is independently associated with higher predicted T2D risk. Workplace prevention strategies should prioritize multicomponent interventions targeting modifiable risk factors, especially in high-risk subgroups such as older, less-educated, and inactive workers.},
author = {Fernández-Figares Vicioso, María Pilar and Riutord Sbert, Pere and Ramírez-Manent, José Ignacio and López-González, Ángel Arturo and del Barrio Fernández, José Luis and Vicente Herrero, María Teófila},
journal = {Nutrients},
keywords = {grapp-caib},
month = {jul},
number = 15,
pages = 2420,
title = {Association Between Sociodemographic and Lifestyle Factors and Type 2 Diabetes Risk Scores in a Large Working Population: A Comparative Study Between the Commerce and Industry Sectors},
volume = 17,
year = 2025
}%0 Journal Article
%1 fernandez-figares_vicioso_association_2025
%A Fernández-Figares Vicioso, María Pilar
%A Riutord Sbert, Pere
%A Ramírez-Manent, José Ignacio
%A López-González, Ángel Arturo
%A del Barrio Fernández, José Luis
%A Vicente Herrero, María Teófila
%D 2025
%J Nutrients
%N 15
%P 2420
%R 10.3390/nu17152420
%T Association Between Sociodemographic and Lifestyle Factors and Type 2 Diabetes Risk Scores in a Large Working Population: A Comparative Study Between the Commerce and Industry Sectors
%U https://pmc.ncbi.nlm.nih.gov/articles/PMC12348608/
%V 17
%X Background: Type 2 diabetes (T2D) is a major global health concern influenced by sociodemographic and lifestyle factors. This study compared T2D risk scores between commerce and industry sectors and assessed the associations of age, sex, education, physical activity, diet, and smoking with elevated risk. Methods: This cross-sectional study included 56,856 men and 12,872 women employed in the commerce (n = 27,448) and industry (n = 42,280) sectors across Spain. Anthropometric, clinical, and biochemical data were collected. Four validated T2D risk scores (QDscore, Finrisk, Canrisk, and TRAQ-D) were calculated. Multinomial logistic regression models estimated adjusted odds ratios (ORs) for high-risk categories by sociodemographic and lifestyle characteristics. Results: Women in the industrial sector had significantly higher age, BMI, waist circumference, and lipid levels than those in commerce; differences among men were less marked. Across all participants, higher T2D risk scores were independently associated with physical inactivity (OR up to 12.49), poor Mediterranean diet adherence (OR up to 6.62), industrial employment (OR up to 1.98), and older age. Male sex was strongly associated with high Canrisk scores (OR = 6.31; 95\% CI: 5.12–7.51). Conclusions: Employment in the industrial sector, combined with sedentary behavior and poor dietary habits, is independently associated with higher predicted T2D risk. Workplace prevention strategies should prioritize multicomponent interventions targeting modifiable risk factors, especially in high-risk subgroups such as older, less-educated, and inactive workers. - AbstractURLBibTeXEndNoteDOIBibSonomyDownload1.Guarro Miquel JJ, Tárraga López PJ, Marzoa Jansana MD, López-González Ángel A, Riutord Sbert P, Busquets-Cortés C, Ramirez-Manent JI. Comparison of Anthropometric and Metabolic Indexes in the Diagnosis of Metabolic Syndrome: A Large-Scale Analysis of Spanish Workers. Metabolites [Internet]. 2025 Jul.;15(8):495. https://pmc.ncbi.nlm.nih.gov/articles/PMC12388431/Background: Metabolic syndrome (MS) is a major public health concern linked to an elevated risk of type 2 diabetes and cardiovascular disease. Simple, reliable screening tools are needed for early identification, especially in working populations. Objective: To compare the diagnostic accuracy of body mass index (BMI), waist-to-height ratio (WtHR), triglyceride–glucose index (TyG), and waist–triglyceride index (WTI) for detecting MS based on NCEP ATP III and IDF criteria in a large cohort of Spanish workers. Methods: This cross-sectional study analyzed data from 386,924 Spanish workers. MS was diagnosed using NCEP ATP III and IDF definitions. The four indexes were evaluated by sex using a receiver operating characteristic (ROC) curve analysis. Area under the curve (AUC), optimal cut-off points, and Youden’s index were calculated. Results: TyG and WTI had the highest AUC values in men (0.911 and 0.901, respectively) for NCEP ATP III-defined MS, while WtHR and WTI achieved the best performance in women (0.955 and 0.953, respectively). WtHR outperformed BMI in all subgroups. Optimal cut-off values were identified according to sex and the definition of MS: TyG (8.95 men, 8.51 women), WtHR (0.54 men, 0.51 women), and WTI (170.6 men, 96.5 women), supporting their practical implementation in occupational health programs. All indexes showed significant discriminatory capacity (p \textless 0.001). Conclusions: TyG, WtHR, and WTI are more effective than BMI in detecting MS among Spanish workers, with sex-specific patterns. Their ease of use and diagnostic strength support their adoption in occupational health programs for early cardiometabolic risk detection.
@article{guarro_miquel_comparison_2025,
abstract = {Background: Metabolic syndrome (MS) is a major public health concern linked to an elevated risk of type 2 diabetes and cardiovascular disease. Simple, reliable screening tools are needed for early identification, especially in working populations. Objective: To compare the diagnostic accuracy of body mass index (BMI), waist-to-height ratio (WtHR), triglyceride–glucose index (TyG), and waist–triglyceride index (WTI) for detecting MS based on NCEP ATP III and IDF criteria in a large cohort of Spanish workers. Methods: This cross-sectional study analyzed data from 386,924 Spanish workers. MS was diagnosed using NCEP ATP III and IDF definitions. The four indexes were evaluated by sex using a receiver operating characteristic (ROC) curve analysis. Area under the curve (AUC), optimal cut-off points, and Youden’s index were calculated. Results: TyG and WTI had the highest AUC values in men (0.911 and 0.901, respectively) for NCEP ATP III-defined MS, while WtHR and WTI achieved the best performance in women (0.955 and 0.953, respectively). WtHR outperformed BMI in all subgroups. Optimal cut-off values were identified according to sex and the definition of MS: TyG (8.95 men, 8.51 women), WtHR (0.54 men, 0.51 women), and WTI (170.6 men, 96.5 women), supporting their practical implementation in occupational health programs. All indexes showed significant discriminatory capacity (p \textless 0.001). Conclusions: TyG, WtHR, and WTI are more effective than BMI in detecting MS among Spanish workers, with sex-specific patterns. Their ease of use and diagnostic strength support their adoption in occupational health programs for early cardiometabolic risk detection.},
author = {Guarro Miquel, Juan José and Tárraga López, Pedro Juan and Marzoa Jansana, María Dolores and López-González, Ángel Arturo and Riutord Sbert, Pere and Busquets-Cortés, Carla and Ramirez-Manent, José Ignacio},
journal = {Metabolites},
keywords = {grapp-caib},
month = {jul},
number = 8,
pages = 495,
title = {Comparison of Anthropometric and Metabolic Indexes in the Diagnosis of Metabolic Syndrome: A Large-Scale Analysis of Spanish Workers},
volume = 15,
year = 2025
}%0 Journal Article
%1 guarro_miquel_comparison_2025
%A Guarro Miquel, Juan José
%A Tárraga López, Pedro Juan
%A Marzoa Jansana, María Dolores
%A López-González, Ángel Arturo
%A Riutord Sbert, Pere
%A Busquets-Cortés, Carla
%A Ramirez-Manent, José Ignacio
%D 2025
%J Metabolites
%N 8
%P 495
%R 10.3390/metabo15080495
%T Comparison of Anthropometric and Metabolic Indexes in the Diagnosis of Metabolic Syndrome: A Large-Scale Analysis of Spanish Workers
%U https://pmc.ncbi.nlm.nih.gov/articles/PMC12388431/
%V 15
%X Background: Metabolic syndrome (MS) is a major public health concern linked to an elevated risk of type 2 diabetes and cardiovascular disease. Simple, reliable screening tools are needed for early identification, especially in working populations. Objective: To compare the diagnostic accuracy of body mass index (BMI), waist-to-height ratio (WtHR), triglyceride–glucose index (TyG), and waist–triglyceride index (WTI) for detecting MS based on NCEP ATP III and IDF criteria in a large cohort of Spanish workers. Methods: This cross-sectional study analyzed data from 386,924 Spanish workers. MS was diagnosed using NCEP ATP III and IDF definitions. The four indexes were evaluated by sex using a receiver operating characteristic (ROC) curve analysis. Area under the curve (AUC), optimal cut-off points, and Youden’s index were calculated. Results: TyG and WTI had the highest AUC values in men (0.911 and 0.901, respectively) for NCEP ATP III-defined MS, while WtHR and WTI achieved the best performance in women (0.955 and 0.953, respectively). WtHR outperformed BMI in all subgroups. Optimal cut-off values were identified according to sex and the definition of MS: TyG (8.95 men, 8.51 women), WtHR (0.54 men, 0.51 women), and WTI (170.6 men, 96.5 women), supporting their practical implementation in occupational health programs. All indexes showed significant discriminatory capacity (p \textless 0.001). Conclusions: TyG, WtHR, and WTI are more effective than BMI in detecting MS among Spanish workers, with sex-specific patterns. Their ease of use and diagnostic strength support their adoption in occupational health programs for early cardiometabolic risk detection. - AbstractURLBibTeXEndNoteDOIBibSonomyDownload1.Soler A, Huguet A, Leiva A, Vicens C, Bejarano-Romero F, Sempere E, Izquierdo T, Parera MM, Seco R, Fages M, Medina A, Castillo-Palomares L, López-Guerrero E, Ferrer BA, Ugarriza L, Llarena M, Gallardo-Alfaro L. A pharmacist-led educational and audit & feedback strategy to reduce antibiotic prescription in primary care: the AFA study. BMC Primary Care [Internet]. 2025 Jul.;26:228. https://pmc.ncbi.nlm.nih.gov/articles/PMC12275277/Introduction The increasing emergence of bacteria resistant to antibiotic treatments has become a global public health concern and one of the leading causes of death worldwide. This growing threat demands urgent and coordinated action from health systems across the globe. A key driver of antimicrobial resistance is the inappropriate and excessive use of antibiotics, which accelerates the development of resistant strains. At the same time, the lack of new antibiotics in development exacerbates the crisis. In this context, promoting the appropriate and prudent use of antibiotics is essential to limit the emergence and spread of resistance. Methods A randomized, multicentre, parallel-group clinical trial with a hybrid type I (effectiveness-implementation) design to reduce antibiotic prescriptions in primary care. General practitioners from three regional health systems in Spain will be randomly assigned (1:1) to an intervention or active control group. The intervention includes a monthly Audit & Feedback report, pharmacist-led consultations, clinical messages, patient information sheets, and an online training module. The primary outcome is the rate of antibiotic prescriptions per 100 patient visits at 12-month follow-up. Implementation outcomes will be assessed using the RE-AIM framework. All analyses will follow the intention-to-treat principle. Ethics and dissemination The study was approved by the Balearic island, Valencia and IDIAP Jordi Gol Ethical Committee, follows the Declaration of Helsinki, Good Clinical Practice guidelines, and applicable national and European regulations concerning clinical trials and data protection. Trial registration ISRCTN11175879, registration date: 11/12/2024.
@article{soler_pharmacist-led_2025,
abstract = {Introduction The increasing emergence of bacteria resistant to antibiotic treatments has become a global public health concern and one of the leading causes of death worldwide. This growing threat demands urgent and coordinated action from health systems across the globe. A key driver of antimicrobial resistance is the inappropriate and excessive use of antibiotics, which accelerates the development of resistant strains. At the same time, the lack of new antibiotics in development exacerbates the crisis. In this context, promoting the appropriate and prudent use of antibiotics is essential to limit the emergence and spread of resistance. Methods A randomized, multicentre, parallel-group clinical trial with a hybrid type I (effectiveness-implementation) design to reduce antibiotic prescriptions in primary care. General practitioners from three regional health systems in Spain will be randomly assigned (1:1) to an intervention or active control group. The intervention includes a monthly Audit & Feedback report, pharmacist-led consultations, clinical messages, patient information sheets, and an online training module. The primary outcome is the rate of antibiotic prescriptions per 100 patient visits at 12-month follow-up. Implementation outcomes will be assessed using the RE-AIM framework. All analyses will follow the intention-to-treat principle. Ethics and dissemination The study was approved by the Balearic island, Valencia and IDIAP Jordi Gol Ethical Committee, follows the Declaration of Helsinki, Good Clinical Practice guidelines, and applicable national and European regulations concerning clinical trials and data protection. Trial registration ISRCTN11175879, registration date: 11/12/2024.},
author = {Soler, A. and Huguet, A. and Leiva, A. and Vicens, C. and Bejarano-Romero, F. and Sempere, E. and Izquierdo, T. and Parera, M. M. and Seco, R. and Fages, M. and Medina, A. and Castillo-Palomares, L. and López-Guerrero, E. and Ferrer, B. A. and Ugarriza, L. and Llarena, M. and Gallardo-Alfaro, L.},
journal = {BMC Primary Care},
keywords = {grapp-caib},
month = {jul},
pages = 228,
title = {A pharmacist-led educational and audit & feedback strategy to reduce antibiotic prescription in primary care: the AFA study},
volume = 26,
year = 2025
}%0 Journal Article
%1 soler_pharmacist-led_2025
%A Soler, A.
%A Huguet, A.
%A Leiva, A.
%A Vicens, C.
%A Bejarano-Romero, F.
%A Sempere, E.
%A Izquierdo, T.
%A Parera, M. M.
%A Seco, R.
%A Fages, M.
%A Medina, A.
%A Castillo-Palomares, L.
%A López-Guerrero, E.
%A Ferrer, B. A.
%A Ugarriza, L.
%A Llarena, M.
%A Gallardo-Alfaro, L.
%D 2025
%J BMC Primary Care
%P 228
%R 10.1186/s12875-025-02933-8
%T A pharmacist-led educational and audit & feedback strategy to reduce antibiotic prescription in primary care: the AFA study
%U https://pmc.ncbi.nlm.nih.gov/articles/PMC12275277/
%V 26
%X Introduction The increasing emergence of bacteria resistant to antibiotic treatments has become a global public health concern and one of the leading causes of death worldwide. This growing threat demands urgent and coordinated action from health systems across the globe. A key driver of antimicrobial resistance is the inappropriate and excessive use of antibiotics, which accelerates the development of resistant strains. At the same time, the lack of new antibiotics in development exacerbates the crisis. In this context, promoting the appropriate and prudent use of antibiotics is essential to limit the emergence and spread of resistance. Methods A randomized, multicentre, parallel-group clinical trial with a hybrid type I (effectiveness-implementation) design to reduce antibiotic prescriptions in primary care. General practitioners from three regional health systems in Spain will be randomly assigned (1:1) to an intervention or active control group. The intervention includes a monthly Audit & Feedback report, pharmacist-led consultations, clinical messages, patient information sheets, and an online training module. The primary outcome is the rate of antibiotic prescriptions per 100 patient visits at 12-month follow-up. Implementation outcomes will be assessed using the RE-AIM framework. All analyses will follow the intention-to-treat principle. Ethics and dissemination The study was approved by the Balearic island, Valencia and IDIAP Jordi Gol Ethical Committee, follows the Declaration of Helsinki, Good Clinical Practice guidelines, and applicable national and European regulations concerning clinical trials and data protection. Trial registration ISRCTN11175879, registration date: 11/12/2024. - AbstractURLBibTeXEndNoteDOIBibSonomyDownload1.Obrador de Hevia J, López-González Ángel A, Ramírez-Manent JI, Busquets-Cortés C, Tárraga López PJ, Riutord-Sbert P. Cross-Sectional and Longitudinal Assessment of Sociodemographic and Lifestyle Determinants of Metabolic Syndrome and Hypertriglyceridemic Waist Phenotypes in 139,634 Spanish Workers. Metabolites [Internet]. 2025 Jul.;15(7):474. https://pmc.ncbi.nlm.nih.gov/articles/PMC12298749/Objective: The objective of this study was to analyze the prevalence and key sociodemographic and lifestyle determinants of metabolic syndrome (MetS) and the hypertriglyceridemic waist (HTGW) phenotype in a large occupational cohort. Background: Metabolic syndrome (MetS) and the hypertriglyceridemic waist (HTGW) phenotype, defined as the simultaneous presence of elevated waist circumference and high triglyceride levels, are major predictors of cardiometabolic morbidity and mortality. Despite their clinical relevance, data on their distribution and determinants in large occupational populations remain limited. Methods: A cross-sectional analysis was conducted on 139,634 employed adults (56,352 women and 83,282 men) across Spain, based on standardized clinical evaluations and validated questionnaires assessing physical activity, diet, smoking, alcohol consumption, education, and occupational class. Logistic regression models were used to estimate associations with MetS and HTGW. A longitudinal subsample of 40,431 individuals was followed over a 10-year period (2009–2019) to assess trends in metabolic risk phenotypes. Results: Male sex, older age, lower educational attainment, and unhealthy lifestyle behaviors were associated with a higher prevalence of both MetS and the HTGW phenotype. Physical inactivity, low adherence to the Mediterranean diet, and alcohol consumption were significantly associated with increased risk. The HTGW phenotype proved useful in identifying high-risk individuals, with a steadily increasing prevalence over time. Conclusions: Sociodemographic disparities and modifiable lifestyle factors significantly influence the prevalence and progression of MetS and HTGW in the Spanish workforce. Preventive strategies should emphasize early workplace screening, promotion of healthy behaviors, and reduction in educational and socioeconomic inequalities to mitigate cardiometabolic risk.
@article{obrador_de_hevia_cross-sectional_2025,
abstract = {Objective: The objective of this study was to analyze the prevalence and key sociodemographic and lifestyle determinants of metabolic syndrome (MetS) and the hypertriglyceridemic waist (HTGW) phenotype in a large occupational cohort. Background: Metabolic syndrome (MetS) and the hypertriglyceridemic waist (HTGW) phenotype, defined as the simultaneous presence of elevated waist circumference and high triglyceride levels, are major predictors of cardiometabolic morbidity and mortality. Despite their clinical relevance, data on their distribution and determinants in large occupational populations remain limited. Methods: A cross-sectional analysis was conducted on 139,634 employed adults (56,352 women and 83,282 men) across Spain, based on standardized clinical evaluations and validated questionnaires assessing physical activity, diet, smoking, alcohol consumption, education, and occupational class. Logistic regression models were used to estimate associations with MetS and HTGW. A longitudinal subsample of 40,431 individuals was followed over a 10-year period (2009–2019) to assess trends in metabolic risk phenotypes. Results: Male sex, older age, lower educational attainment, and unhealthy lifestyle behaviors were associated with a higher prevalence of both MetS and the HTGW phenotype. Physical inactivity, low adherence to the Mediterranean diet, and alcohol consumption were significantly associated with increased risk. The HTGW phenotype proved useful in identifying high-risk individuals, with a steadily increasing prevalence over time. Conclusions: Sociodemographic disparities and modifiable lifestyle factors significantly influence the prevalence and progression of MetS and HTGW in the Spanish workforce. Preventive strategies should emphasize early workplace screening, promotion of healthy behaviors, and reduction in educational and socioeconomic inequalities to mitigate cardiometabolic risk.},
author = {Obrador de Hevia, Joan and López-González, Ángel Arturo and Ramírez-Manent, José Ignacio and Busquets-Cortés, Carla and Tárraga López, Pedro Juan and Riutord-Sbert, Pere},
journal = {Metabolites},
keywords = {grapp-caib},
month = {jul},
number = 7,
pages = 474,
title = {Cross-Sectional and Longitudinal Assessment of Sociodemographic and Lifestyle Determinants of Metabolic Syndrome and Hypertriglyceridemic Waist Phenotypes in 139,634 Spanish Workers},
volume = 15,
year = 2025
}%0 Journal Article
%1 obrador_de_hevia_cross-sectional_2025
%A Obrador de Hevia, Joan
%A López-González, Ángel Arturo
%A Ramírez-Manent, José Ignacio
%A Busquets-Cortés, Carla
%A Tárraga López, Pedro Juan
%A Riutord-Sbert, Pere
%D 2025
%J Metabolites
%N 7
%P 474
%R 10.3390/metabo15070474
%T Cross-Sectional and Longitudinal Assessment of Sociodemographic and Lifestyle Determinants of Metabolic Syndrome and Hypertriglyceridemic Waist Phenotypes in 139,634 Spanish Workers
%U https://pmc.ncbi.nlm.nih.gov/articles/PMC12298749/
%V 15
%X Objective: The objective of this study was to analyze the prevalence and key sociodemographic and lifestyle determinants of metabolic syndrome (MetS) and the hypertriglyceridemic waist (HTGW) phenotype in a large occupational cohort. Background: Metabolic syndrome (MetS) and the hypertriglyceridemic waist (HTGW) phenotype, defined as the simultaneous presence of elevated waist circumference and high triglyceride levels, are major predictors of cardiometabolic morbidity and mortality. Despite their clinical relevance, data on their distribution and determinants in large occupational populations remain limited. Methods: A cross-sectional analysis was conducted on 139,634 employed adults (56,352 women and 83,282 men) across Spain, based on standardized clinical evaluations and validated questionnaires assessing physical activity, diet, smoking, alcohol consumption, education, and occupational class. Logistic regression models were used to estimate associations with MetS and HTGW. A longitudinal subsample of 40,431 individuals was followed over a 10-year period (2009–2019) to assess trends in metabolic risk phenotypes. Results: Male sex, older age, lower educational attainment, and unhealthy lifestyle behaviors were associated with a higher prevalence of both MetS and the HTGW phenotype. Physical inactivity, low adherence to the Mediterranean diet, and alcohol consumption were significantly associated with increased risk. The HTGW phenotype proved useful in identifying high-risk individuals, with a steadily increasing prevalence over time. Conclusions: Sociodemographic disparities and modifiable lifestyle factors significantly influence the prevalence and progression of MetS and HTGW in the Spanish workforce. Preventive strategies should emphasize early workplace screening, promotion of healthy behaviors, and reduction in educational and socioeconomic inequalities to mitigate cardiometabolic risk. - AbstractURLBibTeXEndNoteDOIBibSonomyDownload1.Garcia-Aymerich J, de las Heras M, Carsin A-E, Accordini S, Agustí A, Bui D, Dharmage SC, Dodd JW, Eze I, Gehring U, Gislason T, Granell R, Imboden M, Íñiguez C, Jeong A, Koch S, Koppelman GH, Leynaert B, Melén E, Perret J, Probst-Hensch N, Santa-Marina L, Torrent M, Vicendese D, Vonk JM, de Vries M, Walters EH, Wang G, Wedzicha JA, Jarvis D, Faner R. General population-based lung function trajectories over the life course: an accelerated cohort study. The Lancet Respiratory Medicine [Internet]. 2025 Jul.;13(7):611-22. https://www.sciencedirect.com/science/article/pii/S2213260025000438Background Lung function is a key determinant of health, but current knowledge on lung function growth and decline over the life course is based on fragmented, potentially biased data. We aimed to empirically derive general population-based life course lung function trajectories, and to identify breakpoints and plateaus. Methods We created an accelerated cohort by pooling data from eight general population-based child and adult cohort studies from Europe and Australia. We included all participants with information on lung function, smoking status, BMI, and asthma diagnosis status from at least two visits. We used cross-classified three-level linear mixed models to derive sex-specific life course trajectories of FEV1, forced vital capacity (FVC), and FEV1/FVC ratio based on observations at ages 4–80 years, and Bayesian time-series decomposition to identify breakpoints and plateaus. We repeated sex-specific analyses with separate stratification for asthma status (never had asthma vs persistent asthma, where persistent was defined as the risk factor being present at all participant visits) and smoking status (never smoker vs persistent smoker). Findings The accelerated cohort included 30 438 participants born between 1901 and 2006 (15 703 [51·6\%] female and 14 735 [48·4\%] male; mean age 26 [SD 16] years), who provided a total of 87 666 observations (range 2–8 observations per participant). In female participants, FEV1 increased non-linearly in two phases, at a mean of 234 (95\% CI 223 to 245) mL/year until age 13 (95\% credible interval [CrI] 12 to 15) years, then at 99 (76 to 122) mL/year until a peak at age 20 (18 to 22) years, and subsequently decreased throughout the rest of adulthood (−26 [−27 to −25] mL/year). In male participants, the pattern was similar, with an increase in FEV1 of 271 (263 to 280) mL/year until age 16 (14 to 18) years, which slowed to 108 (93 to 124) mL/year until reaching a maximum at age 23 (21 to 25) years, decreasing thereafter (−38 [−39 to −37] mL/year), representing a later peak than in female participants. In female participants, FVC increased non-linearly in two phases, at 232 (95\% CI 222 to 243) mL/year until age 14 (95\% CrI 12 to 15) years, then at 77 (59 to 94) mL/year until peaking at age 20 (19 to 22) years, after which it decreased throughout the rest of adulthood (−26 [−27 to −25] mL/year). In male participants, FVC also increased in two phases, at 326 (315 to 337) mL/year until age 15 (13 to 17) years, then at 156 (144 to 168) mL/year until a peak at 23 (19 to 30) years, and subsequently declined in two phases (−22 [−29 to −14] mL/year until age 42 [38 to 50] years, then −36 [−38 to −34] mL/year thereafter). No plateau after the peak was observed for either lung function parameter in both sexes. FEV1/FVC ratio decreased throughout life from the starting age of 4 years in both sexes with some distinct patterns. Stratified analysis showed that persistent asthma (vs never had asthma) was related to an earlier FEV1 peak, lower FEV1 throughout adulthood, and lower FEV1/FVC ratio across the life course in both sexes. Persistent smoking (vs never smoking) was related to an accelerated decrease in FEV1 and FEV1/FVC ratio during adulthood in both sexes. No statistically significant plateau was observed in any lung function parameter across the strata of asthma or smoking status. Interpretation In both sexes, FEV1 and FVC increased in two phases, with a fast increase until around age 13–16 years, and then a slower increase until a peak. Neither parameter showed a plateau phase after the peak, and decreases started earlier than previously described. FEV1/FVC ratio decreased throughout life. These observations provide an essential, but previously unavailable, framework to assess and monitor lung health over the life course. Funding EU Horizon 2020, Wellcome, European Respiratory Society, AstraZeneca, Chiesi, GSK, Menarini Group, and Sanofi.
@article{garcia-aymerich_general_2025,
abstract = {Background Lung function is a key determinant of health, but current knowledge on lung function growth and decline over the life course is based on fragmented, potentially biased data. We aimed to empirically derive general population-based life course lung function trajectories, and to identify breakpoints and plateaus. Methods We created an accelerated cohort by pooling data from eight general population-based child and adult cohort studies from Europe and Australia. We included all participants with information on lung function, smoking status, BMI, and asthma diagnosis status from at least two visits. We used cross-classified three-level linear mixed models to derive sex-specific life course trajectories of FEV1, forced vital capacity (FVC), and FEV1/FVC ratio based on observations at ages 4–80 years, and Bayesian time-series decomposition to identify breakpoints and plateaus. We repeated sex-specific analyses with separate stratification for asthma status (never had asthma vs persistent asthma, where persistent was defined as the risk factor being present at all participant visits) and smoking status (never smoker vs persistent smoker). Findings The accelerated cohort included 30 438 participants born between 1901 and 2006 (15 703 [51·6\%] female and 14 735 [48·4\%] male; mean age 26 [SD 16] years), who provided a total of 87 666 observations (range 2–8 observations per participant). In female participants, FEV1 increased non-linearly in two phases, at a mean of 234 (95\% CI 223 to 245) mL/year until age 13 (95\% credible interval [CrI] 12 to 15) years, then at 99 (76 to 122) mL/year until a peak at age 20 (18 to 22) years, and subsequently decreased throughout the rest of adulthood (−26 [−27 to −25] mL/year). In male participants, the pattern was similar, with an increase in FEV1 of 271 (263 to 280) mL/year until age 16 (14 to 18) years, which slowed to 108 (93 to 124) mL/year until reaching a maximum at age 23 (21 to 25) years, decreasing thereafter (−38 [−39 to −37] mL/year), representing a later peak than in female participants. In female participants, FVC increased non-linearly in two phases, at 232 (95\% CI 222 to 243) mL/year until age 14 (95\% CrI 12 to 15) years, then at 77 (59 to 94) mL/year until peaking at age 20 (19 to 22) years, after which it decreased throughout the rest of adulthood (−26 [−27 to −25] mL/year). In male participants, FVC also increased in two phases, at 326 (315 to 337) mL/year until age 15 (13 to 17) years, then at 156 (144 to 168) mL/year until a peak at 23 (19 to 30) years, and subsequently declined in two phases (−22 [−29 to −14] mL/year until age 42 [38 to 50] years, then −36 [−38 to −34] mL/year thereafter). No plateau after the peak was observed for either lung function parameter in both sexes. FEV1/FVC ratio decreased throughout life from the starting age of 4 years in both sexes with some distinct patterns. Stratified analysis showed that persistent asthma (vs never had asthma) was related to an earlier FEV1 peak, lower FEV1 throughout adulthood, and lower FEV1/FVC ratio across the life course in both sexes. Persistent smoking (vs never smoking) was related to an accelerated decrease in FEV1 and FEV1/FVC ratio during adulthood in both sexes. No statistically significant plateau was observed in any lung function parameter across the strata of asthma or smoking status. Interpretation In both sexes, FEV1 and FVC increased in two phases, with a fast increase until around age 13–16 years, and then a slower increase until a peak. Neither parameter showed a plateau phase after the peak, and decreases started earlier than previously described. FEV1/FVC ratio decreased throughout life. These observations provide an essential, but previously unavailable, framework to assess and monitor lung health over the life course. Funding EU Horizon 2020, Wellcome, European Respiratory Society, AstraZeneca, Chiesi, GSK, Menarini Group, and Sanofi.},
author = {Garcia-Aymerich, Judith and de las Heras, Martí and Carsin, Anne-Elie and Accordini, Simone and Agustí, Alvar and Bui, Dinh and Dharmage, Shyamali C and Dodd, James W and Eze, Ikenna and Gehring, Ulrike and Gislason, Thorarinn and Granell, Raquel and Imboden, Medea and Íñiguez, Carmen and Jeong, Ayoung and Koch, Sarah and Koppelman, Gerard H and Leynaert, Bénédicte and Melén, Erik and Perret, Jennifer and Probst-Hensch, Nicole and Santa-Marina, Loreto and Torrent, Maties and Vicendese, Don and Vonk, Judith M and de Vries, Maaike and Walters, E Haydn and Wang, Gang and Wedzicha, Jadwiga A and Jarvis, Deborah and Faner, Rosa},
journal = {The Lancet Respiratory Medicine},
keywords = {grapp-caib},
month = {jul},
number = 7,
pages = {611--622},
title = {General population-based lung function trajectories over the life course: an accelerated cohort study},
volume = 13,
year = 2025
}%0 Journal Article
%1 garcia-aymerich_general_2025
%A Garcia-Aymerich, Judith
%A de las Heras, Martí
%A Carsin, Anne-Elie
%A Accordini, Simone
%A Agustí, Alvar
%A Bui, Dinh
%A Dharmage, Shyamali C
%A Dodd, James W
%A Eze, Ikenna
%A Gehring, Ulrike
%A Gislason, Thorarinn
%A Granell, Raquel
%A Imboden, Medea
%A Íñiguez, Carmen
%A Jeong, Ayoung
%A Koch, Sarah
%A Koppelman, Gerard H
%A Leynaert, Bénédicte
%A Melén, Erik
%A Perret, Jennifer
%A Probst-Hensch, Nicole
%A Santa-Marina, Loreto
%A Torrent, Maties
%A Vicendese, Don
%A Vonk, Judith M
%A de Vries, Maaike
%A Walters, E Haydn
%A Wang, Gang
%A Wedzicha, Jadwiga A
%A Jarvis, Deborah
%A Faner, Rosa
%D 2025
%J The Lancet Respiratory Medicine
%N 7
%P 611--622
%R 10.1016/S2213-2600(25)00043-8
%T General population-based lung function trajectories over the life course: an accelerated cohort study
%U https://www.sciencedirect.com/science/article/pii/S2213260025000438
%V 13
%X Background Lung function is a key determinant of health, but current knowledge on lung function growth and decline over the life course is based on fragmented, potentially biased data. We aimed to empirically derive general population-based life course lung function trajectories, and to identify breakpoints and plateaus. Methods We created an accelerated cohort by pooling data from eight general population-based child and adult cohort studies from Europe and Australia. We included all participants with information on lung function, smoking status, BMI, and asthma diagnosis status from at least two visits. We used cross-classified three-level linear mixed models to derive sex-specific life course trajectories of FEV1, forced vital capacity (FVC), and FEV1/FVC ratio based on observations at ages 4–80 years, and Bayesian time-series decomposition to identify breakpoints and plateaus. We repeated sex-specific analyses with separate stratification for asthma status (never had asthma vs persistent asthma, where persistent was defined as the risk factor being present at all participant visits) and smoking status (never smoker vs persistent smoker). Findings The accelerated cohort included 30 438 participants born between 1901 and 2006 (15 703 [51·6\%] female and 14 735 [48·4\%] male; mean age 26 [SD 16] years), who provided a total of 87 666 observations (range 2–8 observations per participant). In female participants, FEV1 increased non-linearly in two phases, at a mean of 234 (95\% CI 223 to 245) mL/year until age 13 (95\% credible interval [CrI] 12 to 15) years, then at 99 (76 to 122) mL/year until a peak at age 20 (18 to 22) years, and subsequently decreased throughout the rest of adulthood (−26 [−27 to −25] mL/year). In male participants, the pattern was similar, with an increase in FEV1 of 271 (263 to 280) mL/year until age 16 (14 to 18) years, which slowed to 108 (93 to 124) mL/year until reaching a maximum at age 23 (21 to 25) years, decreasing thereafter (−38 [−39 to −37] mL/year), representing a later peak than in female participants. In female participants, FVC increased non-linearly in two phases, at 232 (95\% CI 222 to 243) mL/year until age 14 (95\% CrI 12 to 15) years, then at 77 (59 to 94) mL/year until peaking at age 20 (19 to 22) years, after which it decreased throughout the rest of adulthood (−26 [−27 to −25] mL/year). In male participants, FVC also increased in two phases, at 326 (315 to 337) mL/year until age 15 (13 to 17) years, then at 156 (144 to 168) mL/year until a peak at 23 (19 to 30) years, and subsequently declined in two phases (−22 [−29 to −14] mL/year until age 42 [38 to 50] years, then −36 [−38 to −34] mL/year thereafter). No plateau after the peak was observed for either lung function parameter in both sexes. FEV1/FVC ratio decreased throughout life from the starting age of 4 years in both sexes with some distinct patterns. Stratified analysis showed that persistent asthma (vs never had asthma) was related to an earlier FEV1 peak, lower FEV1 throughout adulthood, and lower FEV1/FVC ratio across the life course in both sexes. Persistent smoking (vs never smoking) was related to an accelerated decrease in FEV1 and FEV1/FVC ratio during adulthood in both sexes. No statistically significant plateau was observed in any lung function parameter across the strata of asthma or smoking status. Interpretation In both sexes, FEV1 and FVC increased in two phases, with a fast increase until around age 13–16 years, and then a slower increase until a peak. Neither parameter showed a plateau phase after the peak, and decreases started earlier than previously described. FEV1/FVC ratio decreased throughout life. These observations provide an essential, but previously unavailable, framework to assess and monitor lung health over the life course. Funding EU Horizon 2020, Wellcome, European Respiratory Society, AstraZeneca, Chiesi, GSK, Menarini Group, and Sanofi. - AbstractURLBibTeXEndNoteDOIBibSonomyDownload1.Tosoratto J, Tárraga López PJ, López-González Ángel A, Obrador de Hevia J, Busquets-Cortés C, Ramírez-Manent JI. Association of Shift Work, Health Behaviors, and Socioeconomic Status with Diabesity in over 53,000 Spanish Employees. Journal of Clinical Medicine [Internet]. 2025 Aug.;14(17):5969. https://pmc.ncbi.nlm.nih.gov/articles/PMC12429148/Background: Diabesity, the coexistence of obesity and type 2 diabetes, is a major public health concern. Shift work and unhealthy lifestyle behaviors may exacerbate its prevalence, particularly in working populations. Objective: This study aims to evaluate the association between sociodemographic characteristics, health behaviors, and shift work and the prevalence of diabesity, using both BMI and the CUN-BAE estimator, in a large cohort of Spanish workers. Methods: This cross-sectional study included 53,053 workers (59.8\% men) aged 18–69 years who underwent occupational health examinations. Diabesity was defined as obesity (BMI ≥ 30 kg/m2 or high CUN-BAE) plus fasting glucose ≥ 100 mg/dL or prior diagnosis of diabetes. Adherence to the Mediterranean diet was assessed by the MEDAS questionnaire, physical activity by the IPAQ, alcohol intake by standard drink units (UBEs), and socioeconomic class by the CNAE-11 classification. Shift work was defined according to ILO criteria. Logistic regression was used to assess associations, adjusting for potential confounders. Results: Shift work was independently associated with increased odds of diabesity both in men and women. Diabesity prevalence was higher when assessed by CUN-BAE compared with BMI. Age, male sex, lower socioeconomic class, physical inactivity, smoking, poor diet adherence, and alcohol intake were all significantly associated with higher risk. The CUN-BAE index showed superior sensitivity in identifying individuals at risk. Conclusions: Shift work and unhealthy behaviors are key determinants of diabesity among Spanish workers. The use of adiposity estimators beyond BMI, such as CUN-BAE, should be encouraged in occupational health surveillance. Workplace-targeted interventions are urgently needed to address this growing metabolic burden.
@article{tosoratto_association_2025,
abstract = {Background: Diabesity, the coexistence of obesity and type 2 diabetes, is a major public health concern. Shift work and unhealthy lifestyle behaviors may exacerbate its prevalence, particularly in working populations. Objective: This study aims to evaluate the association between sociodemographic characteristics, health behaviors, and shift work and the prevalence of diabesity, using both BMI and the CUN-BAE estimator, in a large cohort of Spanish workers. Methods: This cross-sectional study included 53,053 workers (59.8\% men) aged 18–69 years who underwent occupational health examinations. Diabesity was defined as obesity (BMI ≥ 30 kg/m2 or high CUN-BAE) plus fasting glucose ≥ 100 mg/dL or prior diagnosis of diabetes. Adherence to the Mediterranean diet was assessed by the MEDAS questionnaire, physical activity by the IPAQ, alcohol intake by standard drink units (UBEs), and socioeconomic class by the CNAE-11 classification. Shift work was defined according to ILO criteria. Logistic regression was used to assess associations, adjusting for potential confounders. Results: Shift work was independently associated with increased odds of diabesity both in men and women. Diabesity prevalence was higher when assessed by CUN-BAE compared with BMI. Age, male sex, lower socioeconomic class, physical inactivity, smoking, poor diet adherence, and alcohol intake were all significantly associated with higher risk. The CUN-BAE index showed superior sensitivity in identifying individuals at risk. Conclusions: Shift work and unhealthy behaviors are key determinants of diabesity among Spanish workers. The use of adiposity estimators beyond BMI, such as CUN-BAE, should be encouraged in occupational health surveillance. Workplace-targeted interventions are urgently needed to address this growing metabolic burden.},
author = {Tosoratto, Javier and Tárraga López, Pedro Juan and López-González, Ángel Arturo and Obrador de Hevia, Joan and Busquets-Cortés, Carla and Ramírez-Manent, José Ignacio},
journal = {Journal of Clinical Medicine},
keywords = {grapp-caib},
month = {aug},
number = 17,
pages = 5969,
title = {Association of Shift Work, Health Behaviors, and Socioeconomic Status with Diabesity in over 53,000 Spanish Employees},
volume = 14,
year = 2025
}%0 Journal Article
%1 tosoratto_association_2025
%A Tosoratto, Javier
%A Tárraga López, Pedro Juan
%A López-González, Ángel Arturo
%A Obrador de Hevia, Joan
%A Busquets-Cortés, Carla
%A Ramírez-Manent, José Ignacio
%D 2025
%J Journal of Clinical Medicine
%N 17
%P 5969
%R 10.3390/jcm14175969
%T Association of Shift Work, Health Behaviors, and Socioeconomic Status with Diabesity in over 53,000 Spanish Employees
%U https://pmc.ncbi.nlm.nih.gov/articles/PMC12429148/
%V 14
%X Background: Diabesity, the coexistence of obesity and type 2 diabetes, is a major public health concern. Shift work and unhealthy lifestyle behaviors may exacerbate its prevalence, particularly in working populations. Objective: This study aims to evaluate the association between sociodemographic characteristics, health behaviors, and shift work and the prevalence of diabesity, using both BMI and the CUN-BAE estimator, in a large cohort of Spanish workers. Methods: This cross-sectional study included 53,053 workers (59.8\% men) aged 18–69 years who underwent occupational health examinations. Diabesity was defined as obesity (BMI ≥ 30 kg/m2 or high CUN-BAE) plus fasting glucose ≥ 100 mg/dL or prior diagnosis of diabetes. Adherence to the Mediterranean diet was assessed by the MEDAS questionnaire, physical activity by the IPAQ, alcohol intake by standard drink units (UBEs), and socioeconomic class by the CNAE-11 classification. Shift work was defined according to ILO criteria. Logistic regression was used to assess associations, adjusting for potential confounders. Results: Shift work was independently associated with increased odds of diabesity both in men and women. Diabesity prevalence was higher when assessed by CUN-BAE compared with BMI. Age, male sex, lower socioeconomic class, physical inactivity, smoking, poor diet adherence, and alcohol intake were all significantly associated with higher risk. The CUN-BAE index showed superior sensitivity in identifying individuals at risk. Conclusions: Shift work and unhealthy behaviors are key determinants of diabesity among Spanish workers. The use of adiposity estimators beyond BMI, such as CUN-BAE, should be encouraged in occupational health surveillance. Workplace-targeted interventions are urgently needed to address this growing metabolic burden. - AbstractURLBibTeXEndNoteDOIBibSonomyDownload1.Obrador de Hevia J, López-González Ángel A, Ramírez-Manent JI, Busquets-Cortes C, Tárraga López PJ, García Samuelsson M, Riutord-Sbert P. Atherogenic Risk and Its Association with Alcohol Consumption, Lifestyle Habits, and Sociodemographic Factors in a Population of Spanish Workers. Life [Internet]. 2025 Jun.;15(6):923. https://pmc.ncbi.nlm.nih.gov/articles/PMC12194332/Atherogenic dyslipidemia is a major contributor to cardiovascular disease, the leading cause of morbidity and mortality worldwide. While lipid abnormalities are well-established clinical risk factors, growing evidence highlights the influence of sociodemographic and lifestyle determinants on lipid profiles. However, large-scale epidemiological data addressing these associations within occupational settings remain limited. Objective: To assess the cross-sectional and longitudinal associations between atherogenic risk—measured through TC/HDL-c, LDL-c/HDL-c, TG/HDL-c ratios, and atherogenic dyslipidemia (AD)—and sociodemographic variables, health behaviors, and alcohol consumption in a large cohort of Spanish workers. Methods: A dual-phase study was conducted. The first phase was a cross-sectional analysis of 139,634 workers (83,282 men; 56,352 women) from multiple employment sectors undergoing routine occupational health assessments. The second phase was a longitudinal study of a subsample (n = 40,431) with complete data from 2009 and 2019. Clinical, anthropometric, and biochemical data were collected using standardized protocols. Lifestyle factors (smoking, physical activity, Mediterranean diet adherence, alcohol intake) and socioeconomic indicators (education, occupational class) were recorded. Multinomial logistic regression was used to determine independent associations with high-risk atherogenic profiles. Results: Higher atherogenic indices and prevalence of AD were associated with advancing age, lower educational level, lower social class, smoking, physical inactivity, poor diet quality, and alcohol consumption. Men exhibited higher TG/HDL-c and AD values, whereas women had higher TC/HDL-c and LDL-c/HDL-c. Physical inactivity showed the strongest association with TG/HDL-c (OR: 36.23; 95\% CI: 32.12–40.35) and AD (OR: 16.86; 95\% CI: 14.80–18.93). Alcohol intake also independently predicted higher TG/HDL-c (OR: 1.60) and AD (OR: 1.79). Over the decade, a general increase in atherogenic risk was observed, especially among older adults, socially disadvantaged groups, and those with unhealthy behaviors. Conclusions: Sociodemographic and lifestyle factors, particularly physical inactivity and alcohol consumption, are strongly associated with adverse atherogenic profiles in the working population. The observed rise in lipid-related cardiovascular risk over the past decade emphasizes the urgent need for workplace-based health promotion strategies targeting modifiable behaviors and structural health inequalities.
@article{obrador_de_hevia_atherogenic_2025,
abstract = {Atherogenic dyslipidemia is a major contributor to cardiovascular disease, the leading cause of morbidity and mortality worldwide. While lipid abnormalities are well-established clinical risk factors, growing evidence highlights the influence of sociodemographic and lifestyle determinants on lipid profiles. However, large-scale epidemiological data addressing these associations within occupational settings remain limited. Objective: To assess the cross-sectional and longitudinal associations between atherogenic risk—measured through TC/HDL-c, LDL-c/HDL-c, TG/HDL-c ratios, and atherogenic dyslipidemia (AD)—and sociodemographic variables, health behaviors, and alcohol consumption in a large cohort of Spanish workers. Methods: A dual-phase study was conducted. The first phase was a cross-sectional analysis of 139,634 workers (83,282 men; 56,352 women) from multiple employment sectors undergoing routine occupational health assessments. The second phase was a longitudinal study of a subsample (n = 40,431) with complete data from 2009 and 2019. Clinical, anthropometric, and biochemical data were collected using standardized protocols. Lifestyle factors (smoking, physical activity, Mediterranean diet adherence, alcohol intake) and socioeconomic indicators (education, occupational class) were recorded. Multinomial logistic regression was used to determine independent associations with high-risk atherogenic profiles. Results: Higher atherogenic indices and prevalence of AD were associated with advancing age, lower educational level, lower social class, smoking, physical inactivity, poor diet quality, and alcohol consumption. Men exhibited higher TG/HDL-c and AD values, whereas women had higher TC/HDL-c and LDL-c/HDL-c. Physical inactivity showed the strongest association with TG/HDL-c (OR: 36.23; 95\% CI: 32.12–40.35) and AD (OR: 16.86; 95\% CI: 14.80–18.93). Alcohol intake also independently predicted higher TG/HDL-c (OR: 1.60) and AD (OR: 1.79). Over the decade, a general increase in atherogenic risk was observed, especially among older adults, socially disadvantaged groups, and those with unhealthy behaviors. Conclusions: Sociodemographic and lifestyle factors, particularly physical inactivity and alcohol consumption, are strongly associated with adverse atherogenic profiles in the working population. The observed rise in lipid-related cardiovascular risk over the past decade emphasizes the urgent need for workplace-based health promotion strategies targeting modifiable behaviors and structural health inequalities.},
author = {Obrador de Hevia, Joan and López-González, Ángel Arturo and Ramírez-Manent, José Ignacio and Busquets-Cortes, Carla and Tárraga López, Pedro Juan and García Samuelsson, Miguel and Riutord-Sbert, Pere},
journal = {Life},
keywords = {grapp-caib},
month = {jun},
number = 6,
pages = 923,
title = {Atherogenic Risk and Its Association with Alcohol Consumption, Lifestyle Habits, and Sociodemographic Factors in a Population of Spanish Workers},
volume = 15,
year = 2025
}%0 Journal Article
%1 obrador_de_hevia_atherogenic_2025
%A Obrador de Hevia, Joan
%A López-González, Ángel Arturo
%A Ramírez-Manent, José Ignacio
%A Busquets-Cortes, Carla
%A Tárraga López, Pedro Juan
%A García Samuelsson, Miguel
%A Riutord-Sbert, Pere
%D 2025
%J Life
%N 6
%P 923
%R 10.3390/life15060923
%T Atherogenic Risk and Its Association with Alcohol Consumption, Lifestyle Habits, and Sociodemographic Factors in a Population of Spanish Workers
%U https://pmc.ncbi.nlm.nih.gov/articles/PMC12194332/
%V 15
%X Atherogenic dyslipidemia is a major contributor to cardiovascular disease, the leading cause of morbidity and mortality worldwide. While lipid abnormalities are well-established clinical risk factors, growing evidence highlights the influence of sociodemographic and lifestyle determinants on lipid profiles. However, large-scale epidemiological data addressing these associations within occupational settings remain limited. Objective: To assess the cross-sectional and longitudinal associations between atherogenic risk—measured through TC/HDL-c, LDL-c/HDL-c, TG/HDL-c ratios, and atherogenic dyslipidemia (AD)—and sociodemographic variables, health behaviors, and alcohol consumption in a large cohort of Spanish workers. Methods: A dual-phase study was conducted. The first phase was a cross-sectional analysis of 139,634 workers (83,282 men; 56,352 women) from multiple employment sectors undergoing routine occupational health assessments. The second phase was a longitudinal study of a subsample (n = 40,431) with complete data from 2009 and 2019. Clinical, anthropometric, and biochemical data were collected using standardized protocols. Lifestyle factors (smoking, physical activity, Mediterranean diet adherence, alcohol intake) and socioeconomic indicators (education, occupational class) were recorded. Multinomial logistic regression was used to determine independent associations with high-risk atherogenic profiles. Results: Higher atherogenic indices and prevalence of AD were associated with advancing age, lower educational level, lower social class, smoking, physical inactivity, poor diet quality, and alcohol consumption. Men exhibited higher TG/HDL-c and AD values, whereas women had higher TC/HDL-c and LDL-c/HDL-c. Physical inactivity showed the strongest association with TG/HDL-c (OR: 36.23; 95\% CI: 32.12–40.35) and AD (OR: 16.86; 95\% CI: 14.80–18.93). Alcohol intake also independently predicted higher TG/HDL-c (OR: 1.60) and AD (OR: 1.79). Over the decade, a general increase in atherogenic risk was observed, especially among older adults, socially disadvantaged groups, and those with unhealthy behaviors. Conclusions: Sociodemographic and lifestyle factors, particularly physical inactivity and alcohol consumption, are strongly associated with adverse atherogenic profiles in the working population. The observed rise in lipid-related cardiovascular risk over the past decade emphasizes the urgent need for workplace-based health promotion strategies targeting modifiable behaviors and structural health inequalities. - AbstractURLBibTeXEndNoteDOIBibSonomyDownload1.Tosoratto J, Tárraga López PJ, López-González Ángel A, Busquets-Cortés C, Obrador de Hevia J, Ramírez-Manent JI. Associations Between Shift Work and Insulin Resistance Markers in 53,053 Spanish Workers: A Sex-Stratified Cross-Sectional Analysis Using TyG, TyG-BMI, METS-IR, and SPISE-IR Indices. [Internet]. 2025 Jun.;. https://hdl.handle.net/20.500.13003/25413Background/Objective: Shift work has been increasingly associated with adverse metabolic outcomes, including insulin resistance (IR), a key contributor to cardiometabolic diseases. However, few large-scale studies have explored the association between shift work and validated IR indices across sociodemographic and lifestyle variables, stratified by sex. To investigate the relationship between shift work and four surrogate markers of insulin resistance-TyG índex, TyG-BMI, METS-IR (Metabolic score for insulin resistance), and SPISE-IR (Single-Point insulin Sensitivity estimator)-in a large Spanish working population and to assess how sociodemographic and behavioral factors modify these associations. Methods: This cross-sectional study included 53,053 employed adults (31,753 men and 21,300 women) across various regions and labor sectors in Spain. Participants were classified as shift or non-shift workers based on their work schedules. Data were collected during routine occupational health assessments and included anthropometric, clinical, biochemical, and behavioral variables. IR indices were calculated using standard formulas. Statistical analyses included t-tests, chi-square tests, and multivariable logistic regression, with stratification by sex. Results: Shift workers exhibited significantly higher levels of TyG, TyG-BMI, and METS-IR, and lower SPISE values compared to non-shift workers (all p \textless 0.001). These differences persisted after stratification by sex, age, education, and lifestyle factors. Logistic regression analyses confirmed that shift work independently predicted high IR risk across all indices, with adjusted ORs ranging from 1.49 to 1.89. Physical inactivity, low adherence to the Mediterranean diet, and alcohol consumption were the strongest modifiable predictors. Men exhibited a higher burden of IR than women across all indices. Conclusions: Shift work is independently associated with elevated insulin resistance in both men and women. These findings emphasize the importance of workplace health interventions targeting physical activity, diet, and substance use, particularly in populations engaged in non-standard work schedules.
@article{tosoratto_associations_2025,
abstract = {Background/Objective: Shift work has been increasingly associated with adverse metabolic outcomes, including insulin resistance (IR), a key contributor to cardiometabolic diseases. However, few large-scale studies have explored the association between shift work and validated IR indices across sociodemographic and lifestyle variables, stratified by sex. To investigate the relationship between shift work and four surrogate markers of insulin resistance-TyG índex, TyG-BMI, METS-IR (Metabolic score for insulin resistance), and SPISE-IR (Single-Point insulin Sensitivity estimator)-in a large Spanish working population and to assess how sociodemographic and behavioral factors modify these associations. Methods: This cross-sectional study included 53,053 employed adults (31,753 men and 21,300 women) across various regions and labor sectors in Spain. Participants were classified as shift or non-shift workers based on their work schedules. Data were collected during routine occupational health assessments and included anthropometric, clinical, biochemical, and behavioral variables. IR indices were calculated using standard formulas. Statistical analyses included t-tests, chi-square tests, and multivariable logistic regression, with stratification by sex. Results: Shift workers exhibited significantly higher levels of TyG, TyG-BMI, and METS-IR, and lower SPISE values compared to non-shift workers (all p \textless 0.001). These differences persisted after stratification by sex, age, education, and lifestyle factors. Logistic regression analyses confirmed that shift work independently predicted high IR risk across all indices, with adjusted ORs ranging from 1.49 to 1.89. Physical inactivity, low adherence to the Mediterranean diet, and alcohol consumption were the strongest modifiable predictors. Men exhibited a higher burden of IR than women across all indices. Conclusions: Shift work is independently associated with elevated insulin resistance in both men and women. These findings emphasize the importance of workplace health interventions targeting physical activity, diet, and substance use, particularly in populations engaged in non-standard work schedules.},
author = {Tosoratto, Javier and Tárraga López, Pedro Juan and López-González, Ángel Arturo and Busquets-Cortés, Carla and Obrador de Hevia, Joan and Ramírez-Manent, José Ignacio},
keywords = {grapp-caib},
month = {jun},
title = {Associations Between Shift Work and Insulin Resistance Markers in 53,053 Spanish Workers: A Sex-Stratified Cross-Sectional Analysis Using TyG, TyG-BMI, METS-IR, and SPISE-IR Indices},
year = 2025
}%0 Journal Article
%1 tosoratto_associations_2025
%A Tosoratto, Javier
%A Tárraga López, Pedro Juan
%A López-González, Ángel Arturo
%A Busquets-Cortés, Carla
%A Obrador de Hevia, Joan
%A Ramírez-Manent, José Ignacio
%D 2025
%R 10.3390/jcm14134604
%T Associations Between Shift Work and Insulin Resistance Markers in 53,053 Spanish Workers: A Sex-Stratified Cross-Sectional Analysis Using TyG, TyG-BMI, METS-IR, and SPISE-IR Indices
%U https://hdl.handle.net/20.500.13003/25413
%X Background/Objective: Shift work has been increasingly associated with adverse metabolic outcomes, including insulin resistance (IR), a key contributor to cardiometabolic diseases. However, few large-scale studies have explored the association between shift work and validated IR indices across sociodemographic and lifestyle variables, stratified by sex. To investigate the relationship between shift work and four surrogate markers of insulin resistance-TyG índex, TyG-BMI, METS-IR (Metabolic score for insulin resistance), and SPISE-IR (Single-Point insulin Sensitivity estimator)-in a large Spanish working population and to assess how sociodemographic and behavioral factors modify these associations. Methods: This cross-sectional study included 53,053 employed adults (31,753 men and 21,300 women) across various regions and labor sectors in Spain. Participants were classified as shift or non-shift workers based on their work schedules. Data were collected during routine occupational health assessments and included anthropometric, clinical, biochemical, and behavioral variables. IR indices were calculated using standard formulas. Statistical analyses included t-tests, chi-square tests, and multivariable logistic regression, with stratification by sex. Results: Shift workers exhibited significantly higher levels of TyG, TyG-BMI, and METS-IR, and lower SPISE values compared to non-shift workers (all p \textless 0.001). These differences persisted after stratification by sex, age, education, and lifestyle factors. Logistic regression analyses confirmed that shift work independently predicted high IR risk across all indices, with adjusted ORs ranging from 1.49 to 1.89. Physical inactivity, low adherence to the Mediterranean diet, and alcohol consumption were the strongest modifiable predictors. Men exhibited a higher burden of IR than women across all indices. Conclusions: Shift work is independently associated with elevated insulin resistance in both men and women. These findings emphasize the importance of workplace health interventions targeting physical activity, diet, and substance use, particularly in populations engaged in non-standard work schedules. - URLBibTeXEndNoteBibSonomyDownload1.Sánchez Rodríguez C, Chela Álvarez X, Llobera J, Terrer E, Vidal Thomas MC, Zarzosa C, Bulilete O. Evaluation of an intervention based on lifestyle modification and coping with chronic pain and stress in reducing pain in hotel housekeepers: a cluster-randomised clinical trial in primary health care. Academic Journal of Health Sciences 2025, vol. 40, n.6 pp. 66-77 [Internet]. 2025;40(6). https://ibdigital.uib.es/greenstone/library/collection/medicinaBalear/document/AJHS_Medicina_Balear_2025v40n6p066
@article{sanchez_rodriguez_evaluation_2025,
author = {Sánchez Rodríguez, Cristian and Chela Álvarez, Xenia and Llobera, Joan and Terrer, Estela and Vidal Thomas, María Clar and Zarzosa, Carmen and Bulilete, Oana},
journal = {Academic Journal of Health Sciences 2025, vol. 40, n.6 pp. 66-77},
keywords = {grapp-caib},
number = 6,
title = {Evaluation of an intervention based on lifestyle modification and coping with chronic pain and stress in reducing pain in hotel housekeepers: a cluster-randomised clinical trial in primary health care},
volume = 40,
year = 2025
}%0 Journal Article
%1 sanchez_rodriguez_evaluation_2025
%A Sánchez Rodríguez, Cristian
%A Chela Álvarez, Xenia
%A Llobera, Joan
%A Terrer, Estela
%A Vidal Thomas, María Clar
%A Zarzosa, Carmen
%A Bulilete, Oana
%D 2025
%J Academic Journal of Health Sciences 2025, vol. 40, n.6 pp. 66-77
%N 6
%T Evaluation of an intervention based on lifestyle modification and coping with chronic pain and stress in reducing pain in hotel housekeepers: a cluster-randomised clinical trial in primary health care
%U https://ibdigital.uib.es/greenstone/library/collection/medicinaBalear/document/AJHS_Medicina_Balear_2025v40n6p066
%V 40 - AbstractURLBibTeXEndNoteDOIBibSonomyDownload1.Riutord-Sbert P, Tárraga López PJ, López-González Ángel A, Coll Campayo I, Busquets-Cortés C, Ramírez Manent JI. Sociodemographic, Lifestyle, and Social Isolation Correlates of TyG, METS-IR, and SPISE-IR Scores in a Large Spanish Working Population. Medical Sciences [Internet]. 2025 Sep.;13(3):171. https://pmc.ncbi.nlm.nih.gov/articles/PMC12452687/Background: Insulin resistance (IR) is a central feature in the pathophysiology of type 2 diabetes and a major determinant of cardiovascular morbidity. While sociodemographic and lifestyle factors are established contributors, the role of social isolation as a potential determinant of IR remains underexplored in working populations. Objectives: To assess the association between sociodemographic variables, lifestyle habits, and social isolation with three validated insulin resistance indexes—Triglyceride–Glucose (TyG), Metabolic Score for Insulin Resistance (METS-IR), and Single Point Insulin Sensitivity Estimator (SPISE-IR)—in a large cohort of Spanish workers. Methods: A cross-sectional study was conducted involving 117,298 workers from occupational health centers across Spain. Sociodemographic data, lifestyle factors (Mediterranean diet adherence, physical activity, and smoking), and social support levels (ENRICHD Social Support Instrument) were recorded. Biochemical and anthropometric parameters were obtained through standardized protocols. Logistic regression models estimated the odds ratios (ORs) and 95% confidence intervals (CIs) for high IR risk across the three indexes, adjusting for potential confounders. Results: Male sex, older age, lower social class, smoking, low Mediterranean diet adherence, physical inactivity, and low social support were independently associated with higher odds of IR in all three indexes. The strongest associations were observed for physical inactivity (OR range 6.21–9.95) and low social support (OR range 1.98–3.76). Although effect sizes varied by index, patterns of association were consistent. Conclusions: Sociodemographic, lifestyle, and psychosocial factors, including social isolation, are strongly associated with insulin resistance in working populations. Integrating social support assessment into occupational health strategies may enhance early detection and prevention of IR and related cardiometabolic diseases.
@article{riutord-sbert_sociodemographic_2025,
abstract = {Background: Insulin resistance (IR) is a central feature in the pathophysiology of type 2 diabetes and a major determinant of cardiovascular morbidity. While sociodemographic and lifestyle factors are established contributors, the role of social isolation as a potential determinant of IR remains underexplored in working populations. Objectives: To assess the association between sociodemographic variables, lifestyle habits, and social isolation with three validated insulin resistance indexes—Triglyceride–Glucose (TyG), Metabolic Score for Insulin Resistance (METS-IR), and Single Point Insulin Sensitivity Estimator (SPISE-IR)—in a large cohort of Spanish workers. Methods: A cross-sectional study was conducted involving 117,298 workers from occupational health centers across Spain. Sociodemographic data, lifestyle factors (Mediterranean diet adherence, physical activity, and smoking), and social support levels (ENRICHD Social Support Instrument) were recorded. Biochemical and anthropometric parameters were obtained through standardized protocols. Logistic regression models estimated the odds ratios (ORs) and 95% confidence intervals (CIs) for high IR risk across the three indexes, adjusting for potential confounders. Results: Male sex, older age, lower social class, smoking, low Mediterranean diet adherence, physical inactivity, and low social support were independently associated with higher odds of IR in all three indexes. The strongest associations were observed for physical inactivity (OR range 6.21–9.95) and low social support (OR range 1.98–3.76). Although effect sizes varied by index, patterns of association were consistent. Conclusions: Sociodemographic, lifestyle, and psychosocial factors, including social isolation, are strongly associated with insulin resistance in working populations. Integrating social support assessment into occupational health strategies may enhance early detection and prevention of IR and related cardiometabolic diseases.},
author = {Riutord-Sbert, Pere and Tárraga López, Pedro Juan and López-González, Ángel Arturo and Coll Campayo, Irene and Busquets-Cortés, Carla and Ramírez Manent, José Ignacio},
journal = {Medical Sciences},
keywords = {grapp-caib},
month = {sep},
number = 3,
pages = 171,
title = {Sociodemographic, Lifestyle, and Social Isolation Correlates of TyG, METS-IR, and SPISE-IR Scores in a Large Spanish Working Population},
volume = 13,
year = 2025
}%0 Journal Article
%1 riutord-sbert_sociodemographic_2025
%A Riutord-Sbert, Pere
%A Tárraga López, Pedro Juan
%A López-González, Ángel Arturo
%A Coll Campayo, Irene
%A Busquets-Cortés, Carla
%A Ramírez Manent, José Ignacio
%D 2025
%J Medical Sciences
%N 3
%P 171
%R 10.3390/medsci13030171
%T Sociodemographic, Lifestyle, and Social Isolation Correlates of TyG, METS-IR, and SPISE-IR Scores in a Large Spanish Working Population
%U https://pmc.ncbi.nlm.nih.gov/articles/PMC12452687/
%V 13
%X Background: Insulin resistance (IR) is a central feature in the pathophysiology of type 2 diabetes and a major determinant of cardiovascular morbidity. While sociodemographic and lifestyle factors are established contributors, the role of social isolation as a potential determinant of IR remains underexplored in working populations. Objectives: To assess the association between sociodemographic variables, lifestyle habits, and social isolation with three validated insulin resistance indexes—Triglyceride–Glucose (TyG), Metabolic Score for Insulin Resistance (METS-IR), and Single Point Insulin Sensitivity Estimator (SPISE-IR)—in a large cohort of Spanish workers. Methods: A cross-sectional study was conducted involving 117,298 workers from occupational health centers across Spain. Sociodemographic data, lifestyle factors (Mediterranean diet adherence, physical activity, and smoking), and social support levels (ENRICHD Social Support Instrument) were recorded. Biochemical and anthropometric parameters were obtained through standardized protocols. Logistic regression models estimated the odds ratios (ORs) and 95% confidence intervals (CIs) for high IR risk across the three indexes, adjusting for potential confounders. Results: Male sex, older age, lower social class, smoking, low Mediterranean diet adherence, physical inactivity, and low social support were independently associated with higher odds of IR in all three indexes. The strongest associations were observed for physical inactivity (OR range 6.21–9.95) and low social support (OR range 1.98–3.76). Although effect sizes varied by index, patterns of association were consistent. Conclusions: Sociodemographic, lifestyle, and psychosocial factors, including social isolation, are strongly associated with insulin resistance in working populations. Integrating social support assessment into occupational health strategies may enhance early detection and prevention of IR and related cardiometabolic diseases. - AbstractURLBibTeXEndNoteDOIBibSonomyDownload1.Arregui-Gallego B, Orts-Cortés MI, Moreno-Casbas MT, Abad-Corpa E, Camacho-Bejarano R, Cidoncha-Moreno M Ángeles, Feria-Raposo I, Iruzubieta-Barragán J, Carmona M, Cristóbal-Domínguez E, Bernués-Caudillo L, Casado-Ramírez E, Recas-Martin A, Sánchez-López D, Company-Sancho MC, Rascón NL, Esteban-Sepúlveda S, Vidal-Thomàs MC, Alonso I, Muñoz-Jiménez D, Segura-Heras JV, Moncho J, Rich-Ruiz M. Factors modulating the impact of the COVID-19 pandemic on posttraumatic stress symptomatology of the Spanish healthcare workers: A cohort study. PLOS One [Internet]. 2025 Jun.;20(6):e0323777. https://pmc.ncbi.nlm.nih.gov/articles/PMC12169526/Introduction The COVID-19 pandemic generated a global health crisis that significantly impacted healthcare systems and professionals. Healthcare workers were exposed to high levels of psychological distress, including posttraumatic stress symptomatology (PTSS). Aim Analyse the evolution of PTSS among Spanish healthcare workers during the COVID-19 pandemic, and to identify associated factors. Method A multicenter prospective cohort study with a 12-month follow-up was conducted. PTSS was the primary outcome. Secondary variables included sociodemographic, occupational, psychological, and coping-related factors. Statistical analyses comprised bivariate comparisons and multivariate modelling, such as generalized linear models and linear mixed models. Results Of the 428 participants, 180 completed the 12-month follow-up. At baseline, changes in work posts, negative family-work relations, avoidant coping, burnout symptoms, and emotional intelligence were associated with PTSS levels. Linear mixed models showed a significant decrease in PTSS over the 12-month period, regardless of gender, age, household type, occupational role, contract type, job title, level of care or type of service (p \textless 0.001). The generalised linear model explained 25.5% of the variance in PTSS levels at baseline, highlighting the role of psychological and coping factors over sociodemographic or occupational characteristics. Conclusions This study highlights the need for early identification and intervention focused on psychological and coping mechanisms. Promoting emotional regulation, reducing burnout, and addressing maladaptive coping may help mitigate long-term psychological effects among healthcare workers during public health crises.
@article{arregui-gallego_factors_2025,
abstract = {Introduction The COVID-19 pandemic generated a global health crisis that significantly impacted healthcare systems and professionals. Healthcare workers were exposed to high levels of psychological distress, including posttraumatic stress symptomatology (PTSS). Aim Analyse the evolution of PTSS among Spanish healthcare workers during the COVID-19 pandemic, and to identify associated factors. Method A multicenter prospective cohort study with a 12-month follow-up was conducted. PTSS was the primary outcome. Secondary variables included sociodemographic, occupational, psychological, and coping-related factors. Statistical analyses comprised bivariate comparisons and multivariate modelling, such as generalized linear models and linear mixed models. Results Of the 428 participants, 180 completed the 12-month follow-up. At baseline, changes in work posts, negative family-work relations, avoidant coping, burnout symptoms, and emotional intelligence were associated with PTSS levels. Linear mixed models showed a significant decrease in PTSS over the 12-month period, regardless of gender, age, household type, occupational role, contract type, job title, level of care or type of service (p \textless 0.001). The generalised linear model explained 25.5% of the variance in PTSS levels at baseline, highlighting the role of psychological and coping factors over sociodemographic or occupational characteristics. Conclusions This study highlights the need for early identification and intervention focused on psychological and coping mechanisms. Promoting emotional regulation, reducing burnout, and addressing maladaptive coping may help mitigate long-term psychological effects among healthcare workers during public health crises.},
author = {Arregui-Gallego, Beatriz and Orts-Cortés, María Isabel and Moreno-Casbas, María Teresa and Abad-Corpa, Eva and Camacho-Bejarano, Rafaela and Cidoncha-Moreno, Mª Ángeles and Feria-Raposo, Isabel and Iruzubieta-Barragán, Javier and Carmona, Montserrat and Cristóbal-Domínguez, Estíbaliz and Bernués-Caudillo, Leticia and Casado-Ramírez, Elvira and Recas-Martin, Alda and Sánchez-López, Dolores and Company-Sancho, M. Consuelo and Rascón, Noelia López and Esteban-Sepúlveda, Silvia and Vidal-Thomàs, María Clara and Alonso, Isabel and Muñoz-Jiménez, Daniel and Segura-Heras, José Vicente and Moncho, Joaquín and Rich-Ruiz, Manuel},
journal = {PLOS One},
keywords = {grapp-caib},
month = {jun},
number = 6,
pages = {e0323777},
title = {Factors modulating the impact of the COVID-19 pandemic on posttraumatic stress symptomatology of the Spanish healthcare workers: A cohort study},
volume = 20,
year = 2025
}%0 Journal Article
%1 arregui-gallego_factors_2025
%A Arregui-Gallego, Beatriz
%A Orts-Cortés, María Isabel
%A Moreno-Casbas, María Teresa
%A Abad-Corpa, Eva
%A Camacho-Bejarano, Rafaela
%A Cidoncha-Moreno, Mª Ángeles
%A Feria-Raposo, Isabel
%A Iruzubieta-Barragán, Javier
%A Carmona, Montserrat
%A Cristóbal-Domínguez, Estíbaliz
%A Bernués-Caudillo, Leticia
%A Casado-Ramírez, Elvira
%A Recas-Martin, Alda
%A Sánchez-López, Dolores
%A Company-Sancho, M. Consuelo
%A Rascón, Noelia López
%A Esteban-Sepúlveda, Silvia
%A Vidal-Thomàs, María Clara
%A Alonso, Isabel
%A Muñoz-Jiménez, Daniel
%A Segura-Heras, José Vicente
%A Moncho, Joaquín
%A Rich-Ruiz, Manuel
%D 2025
%J PLOS One
%N 6
%P e0323777
%R 10.1371/journal.pone.0323777
%T Factors modulating the impact of the COVID-19 pandemic on posttraumatic stress symptomatology of the Spanish healthcare workers: A cohort study
%U https://pmc.ncbi.nlm.nih.gov/articles/PMC12169526/
%V 20
%X Introduction The COVID-19 pandemic generated a global health crisis that significantly impacted healthcare systems and professionals. Healthcare workers were exposed to high levels of psychological distress, including posttraumatic stress symptomatology (PTSS). Aim Analyse the evolution of PTSS among Spanish healthcare workers during the COVID-19 pandemic, and to identify associated factors. Method A multicenter prospective cohort study with a 12-month follow-up was conducted. PTSS was the primary outcome. Secondary variables included sociodemographic, occupational, psychological, and coping-related factors. Statistical analyses comprised bivariate comparisons and multivariate modelling, such as generalized linear models and linear mixed models. Results Of the 428 participants, 180 completed the 12-month follow-up. At baseline, changes in work posts, negative family-work relations, avoidant coping, burnout symptoms, and emotional intelligence were associated with PTSS levels. Linear mixed models showed a significant decrease in PTSS over the 12-month period, regardless of gender, age, household type, occupational role, contract type, job title, level of care or type of service (p \textless 0.001). The generalised linear model explained 25.5% of the variance in PTSS levels at baseline, highlighting the role of psychological and coping factors over sociodemographic or occupational characteristics. Conclusions This study highlights the need for early identification and intervention focused on psychological and coping mechanisms. Promoting emotional regulation, reducing burnout, and addressing maladaptive coping may help mitigate long-term psychological effects among healthcare workers during public health crises. - AbstractURLBibTeXEndNoteDOIBibSonomyDownload1.Arias-Alonso L, Barragán-Brun N, Elizondo-Alzola U, Boldu-Minguell A, Rocha-Calderón CA, Niño-de Guzmán E, Santandreu FM, Quesada-Carrasco F, Ricci-Cabello I, Gorrotxategi-Gorrotxategi PJ, de la Poza-Abad M, Mas-Dalmau G, Gibert-Agulló A, González-Lama J, Alonso-Coello P. Development and assessment of an online communication skills course to optimise antibiotic prescribing for children in primary care. BMC primary care [Internet]. England; 2025 Aug.;26(1):247-. https://pubmed.ncbi.nlm.nih.gov/40775754BACKGROUND: Antibiotic overprescription is a complex global problem that contributes to antibacterial resistance. Enhancing professionals' communication skills is one of the most promising interventions for optimising antibiotic prescription in respiratory tract infections in children. METHODS: We developed a communication skills course for primary care paediatricians, paediatric nurses and community pharmacists. We conducted: 1) A scoping review, 2) brainstorming and selection of themes, 3) design of content, 4) user testing, through a survey and semi-structured interviews. A multidisciplinary advisory group gave feedback throughout the design and development process. We conducted a descriptive analysis of the survey results, and we used a predefined analytical framework for qualitative content. RESULTS: The course comprised four modules with nineteen themes, which included communication theoretical content, clinical cases, complementary reading, videos, and a glossary. It also included a forum and webinars, after each module. Sixteen users completed several themes and a survey, and eight were interviewed. They rated a mean of 4 or higher (5-point scale), across most of the domains evaluated. The videos received the highest rating (4.81; SD = 0.39). Suggestions for improvement included incorporating a workshop, and featuring more representation of other professionals. The majority of professionals (93%) expressed interest in completing the course. CONCLUSION: We developed a comprehensive, evidence-based online communication skills training course to optimise antibiotic prescribing in paediatric primary care. Integrating key communication strategies and insights from a scoping review, the course equips healthcare professionals with practical tools to enhance shared decision-making and antimicrobial stewardship. TRIAL REGISTRATION: Not applicable.
@article{ariasalonso2025development,
abstract = {BACKGROUND: Antibiotic overprescription is a complex global problem that contributes to antibacterial resistance. Enhancing professionals' communication skills is one of the most promising interventions for optimising antibiotic prescription in respiratory tract infections in children. METHODS: We developed a communication skills course for primary care paediatricians, paediatric nurses and community pharmacists. We conducted: 1) A scoping review, 2) brainstorming and selection of themes, 3) design of content, 4) user testing, through a survey and semi-structured interviews. A multidisciplinary advisory group gave feedback throughout the design and development process. We conducted a descriptive analysis of the survey results, and we used a predefined analytical framework for qualitative content. RESULTS: The course comprised four modules with nineteen themes, which included communication theoretical content, clinical cases, complementary reading, videos, and a glossary. It also included a forum and webinars, after each module. Sixteen users completed several themes and a survey, and eight were interviewed. They rated a mean of 4 or higher (5-point scale), across most of the domains evaluated. The videos received the highest rating (4.81; SD = 0.39). Suggestions for improvement included incorporating a workshop, and featuring more representation of other professionals. The majority of professionals (93%) expressed interest in completing the course. CONCLUSION: We developed a comprehensive, evidence-based online communication skills training course to optimise antibiotic prescribing in paediatric primary care. Integrating key communication strategies and insights from a scoping review, the course equips healthcare professionals with practical tools to enhance shared decision-making and antimicrobial stewardship. TRIAL REGISTRATION: Not applicable.},
address = {England},
author = {Arias-Alonso, Lucía and Barragán-Brun, Nieves and Elizondo-Alzola, Usue and Boldu-Minguell, Andrea and Rocha-Calderón, Claudio Alfonso and Niño-de Guzmán, Ena and Santandreu, Francisca María and Quesada-Carrasco, Fermín and Ricci-Cabello, Ignacio and Gorrotxategi-Gorrotxategi, Pedro Jesús and de la Poza-Abad, Mariam and Mas-Dalmau, Gemma and Gibert-Agulló, Anna and González-Lama, Jesús and Alonso-Coello, Pablo},
journal = {BMC primary care},
keywords = {evisap},
month = {aug},
number = 1,
pages = {247--247},
title = {Development and assessment of an online communication skills course to optimise antibiotic prescribing for children in primary care},
volume = 26,
year = 2025
}%0 Journal Article
%1 ariasalonso2025development
%A Arias-Alonso, Lucía
%A Barragán-Brun, Nieves
%A Elizondo-Alzola, Usue
%A Boldu-Minguell, Andrea
%A Rocha-Calderón, Claudio Alfonso
%A Niño-de Guzmán, Ena
%A Santandreu, Francisca María
%A Quesada-Carrasco, Fermín
%A Ricci-Cabello, Ignacio
%A Gorrotxategi-Gorrotxategi, Pedro Jesús
%A de la Poza-Abad, Mariam
%A Mas-Dalmau, Gemma
%A Gibert-Agulló, Anna
%A González-Lama, Jesús
%A Alonso-Coello, Pablo
%C England
%D 2025
%J BMC primary care
%N 1
%P 247--247
%R 10.1186/s12875-025-02919-6
%T Development and assessment of an online communication skills course to optimise antibiotic prescribing for children in primary care
%U https://pubmed.ncbi.nlm.nih.gov/40775754
%V 26
%X BACKGROUND: Antibiotic overprescription is a complex global problem that contributes to antibacterial resistance. Enhancing professionals' communication skills is one of the most promising interventions for optimising antibiotic prescription in respiratory tract infections in children. METHODS: We developed a communication skills course for primary care paediatricians, paediatric nurses and community pharmacists. We conducted: 1) A scoping review, 2) brainstorming and selection of themes, 3) design of content, 4) user testing, through a survey and semi-structured interviews. A multidisciplinary advisory group gave feedback throughout the design and development process. We conducted a descriptive analysis of the survey results, and we used a predefined analytical framework for qualitative content. RESULTS: The course comprised four modules with nineteen themes, which included communication theoretical content, clinical cases, complementary reading, videos, and a glossary. It also included a forum and webinars, after each module. Sixteen users completed several themes and a survey, and eight were interviewed. They rated a mean of 4 or higher (5-point scale), across most of the domains evaluated. The videos received the highest rating (4.81; SD = 0.39). Suggestions for improvement included incorporating a workshop, and featuring more representation of other professionals. The majority of professionals (93%) expressed interest in completing the course. CONCLUSION: We developed a comprehensive, evidence-based online communication skills training course to optimise antibiotic prescribing in paediatric primary care. Integrating key communication strategies and insights from a scoping review, the course equips healthcare professionals with practical tools to enhance shared decision-making and antimicrobial stewardship. TRIAL REGISTRATION: Not applicable. - AbstractBibTeXEndNoteDOIBibSonomyDownload1.Ramírez-Gallegos I, Tárraga López PJ, Paublini Oliveira H, López-González Ángel A, Martorell Sánchez C, Martínez-Almoyna-Rifá E, Ramírez-Manent JI. Relationship Between Metabolic Age Determined by Bioimpedance and Insulin Resistance Risk Scales in Spanish Workers. Nutrients. 2025 Mar.;17(6):945.Introduction: Metabolic age (MA) is the difference between an individual's actual age and the age of their body based on physiological and biological factors. It is an indicator that reflects a person's physical and biological state, regardless of chronological age. Insulin resistance (IR) is a health disorder in which tissues exhibit a reduced response to the circulating glucose uptake stimulated by insulin. Objective: The aim of this study is to evaluate the association between MA, determined through bioelectrical impedance analysis, and the risk of IR, assessed using validated scales, in a cohort of Spanish workers. Methodology: A descriptive cross-sectional study was conducted on 8590 Spanish workers to assess the association between MA and a set of sociodemographic variables, health habits, and IR risk scales such as the Triglyceride-Glucose Index (TyG Index), Metabolic Score for Insulin Resistance (METS-IR), and Single Point Insulin Sensitivity Estimator (SPISE). Results: All analyzed variables were associated with MA values, with the strongest associations observed for IR risk scale values (OR 4.88 [95\% CI 4.12-5.65] for METS-IR, 4.42 [95\% CI 3.70-5.15] for SPISE, and 3.42 [95\% CI 2.97-3.87] for the TyG Index) and physical activity. Conclusions: Metabolic age is influenced by sociodemographic variables such as age, sex, and social class; health habits such as smoking, physical activity, and adherence to the Mediterranean diet; and by IR risk scale values.
@article{ramirez-gallegos_relationship_2025,
abstract = {Introduction: Metabolic age (MA) is the difference between an individual's actual age and the age of their body based on physiological and biological factors. It is an indicator that reflects a person's physical and biological state, regardless of chronological age. Insulin resistance (IR) is a health disorder in which tissues exhibit a reduced response to the circulating glucose uptake stimulated by insulin. Objective: The aim of this study is to evaluate the association between MA, determined through bioelectrical impedance analysis, and the risk of IR, assessed using validated scales, in a cohort of Spanish workers. Methodology: A descriptive cross-sectional study was conducted on 8590 Spanish workers to assess the association between MA and a set of sociodemographic variables, health habits, and IR risk scales such as the Triglyceride-Glucose Index (TyG Index), Metabolic Score for Insulin Resistance (METS-IR), and Single Point Insulin Sensitivity Estimator (SPISE). Results: All analyzed variables were associated with MA values, with the strongest associations observed for IR risk scale values (OR 4.88 [95\% CI 4.12-5.65] for METS-IR, 4.42 [95\% CI 3.70-5.15] for SPISE, and 3.42 [95\% CI 2.97-3.87] for the TyG Index) and physical activity. Conclusions: Metabolic age is influenced by sociodemographic variables such as age, sex, and social class; health habits such as smoking, physical activity, and adherence to the Mediterranean diet; and by IR risk scale values.},
author = {Ramírez-Gallegos, Ignacio and Tárraga López, Pedro Juan and Paublini Oliveira, Hernán and López-González, Ángel Arturo and Martorell Sánchez, Cristina and Martínez-Almoyna-Rifá, Emilio and Ramírez-Manent, José Ignacio},
journal = {Nutrients},
keywords = {grapp-caib},
month = {mar},
number = 6,
pages = 945,
title = {Relationship Between Metabolic Age Determined by Bioimpedance and Insulin Resistance Risk Scales in Spanish Workers},
volume = 17,
year = 2025
}%0 Journal Article
%1 ramirez-gallegos_relationship_2025
%A Ramírez-Gallegos, Ignacio
%A Tárraga López, Pedro Juan
%A Paublini Oliveira, Hernán
%A López-González, Ángel Arturo
%A Martorell Sánchez, Cristina
%A Martínez-Almoyna-Rifá, Emilio
%A Ramírez-Manent, José Ignacio
%D 2025
%J Nutrients
%N 6
%P 945
%R 10.3390/nu17060945
%T Relationship Between Metabolic Age Determined by Bioimpedance and Insulin Resistance Risk Scales in Spanish Workers
%V 17
%X Introduction: Metabolic age (MA) is the difference between an individual's actual age and the age of their body based on physiological and biological factors. It is an indicator that reflects a person's physical and biological state, regardless of chronological age. Insulin resistance (IR) is a health disorder in which tissues exhibit a reduced response to the circulating glucose uptake stimulated by insulin. Objective: The aim of this study is to evaluate the association between MA, determined through bioelectrical impedance analysis, and the risk of IR, assessed using validated scales, in a cohort of Spanish workers. Methodology: A descriptive cross-sectional study was conducted on 8590 Spanish workers to assess the association between MA and a set of sociodemographic variables, health habits, and IR risk scales such as the Triglyceride-Glucose Index (TyG Index), Metabolic Score for Insulin Resistance (METS-IR), and Single Point Insulin Sensitivity Estimator (SPISE). Results: All analyzed variables were associated with MA values, with the strongest associations observed for IR risk scale values (OR 4.88 [95\% CI 4.12-5.65] for METS-IR, 4.42 [95\% CI 3.70-5.15] for SPISE, and 3.42 [95\% CI 2.97-3.87] for the TyG Index) and physical activity. Conclusions: Metabolic age is influenced by sociodemographic variables such as age, sex, and social class; health habits such as smoking, physical activity, and adherence to the Mediterranean diet; and by IR risk scale values. -
AbstractURLBibTeXEndNoteDOIBibSonomy1.Marques-Cruz M, Pinto F, Vieira RJ, Bognanni A, Perestrelo P, Gil-Mata S, Duarte VH, Barbosa JP, Cardoso-Fernandes A, Martinho-Dias D, Franco-Pego F, Germini F, Arienti C, Chu AWL, Riera-Serra P, Jemioło P, Rodrigues PP, Fonseca JA, Azevedo LF, Schünemann HJ, Cruz-Correia R, Jankin S, Sousa-Pinto B. Use of artificial intelligence to support the assessment of the methodological quality of systematic reviews. Journal of clinical epidemiology [Internet]. United States; 2025 Aug.;:111944-. https://pubmed.ncbi.nlm.nih.gov/40865587INTRODUCTION: Published systematic reviews display an heterogeneous methodological quality, which can impact decision-making. Large language models (LLMs) can support and make the assessment of the methodological quality of systematic reviews more efficient, aiding in the incorporation of their evidence in guideline recommendations. We aimed to develop a LLM-based tool for supporting the assessment of the methodological quality of systematic reviews. METHODS: We assessed the performance of eight large language models (LLMs) in evaluating the methodological quality of systematic reviews. In particular, we provided 100 systematic reviews for eight LLMs (five base models and three fine-tuned models) to evaluate their methodological quality based on a 27-item validated tool (ReMarQ). The fine-tuned models had been trained with a different sample of 300 manually assessed systematic reviews. We compared the answers provided by LLMs with those independently provided by human reviewers, computing the accuracy, kappa coefficient and F1-score for this comparison. RESULTS: The best performing LLM was a fine-tuned GPT-3.5 model (mean accuracy=96.5% [95%CI=89.9-100%]; mean kappa coefficient=0.90 [95%CI=0.71-1.00]; mean F1-score=0.91 [95%CI=0.83-1.00]). This model displayed an accuracy >80% and a kappa coefficient >0.60 for all individual items. When we made this LLM assess 60 times the same set of systematic reviews, answers to 18 of 27 items were always consistent (i.e., were always the same) and only 11% of assessed systematic reviews showed inconsistency. CONCLUSION: Overall, LLMs have the potential to accurately support the assessment of the methodological quality of systematic reviews based on a validated tool comprising dichotomous items.
@article{marquescruz2025artificial,
abstract = {INTRODUCTION: Published systematic reviews display an heterogeneous methodological quality, which can impact decision-making. Large language models (LLMs) can support and make the assessment of the methodological quality of systematic reviews more efficient, aiding in the incorporation of their evidence in guideline recommendations. We aimed to develop a LLM-based tool for supporting the assessment of the methodological quality of systematic reviews. METHODS: We assessed the performance of eight large language models (LLMs) in evaluating the methodological quality of systematic reviews. In particular, we provided 100 systematic reviews for eight LLMs (five base models and three fine-tuned models) to evaluate their methodological quality based on a 27-item validated tool (ReMarQ). The fine-tuned models had been trained with a different sample of 300 manually assessed systematic reviews. We compared the answers provided by LLMs with those independently provided by human reviewers, computing the accuracy, kappa coefficient and F1-score for this comparison. RESULTS: The best performing LLM was a fine-tuned GPT-3.5 model (mean accuracy=96.5% [95%CI=89.9-100%]; mean kappa coefficient=0.90 [95%CI=0.71-1.00]; mean F1-score=0.91 [95%CI=0.83-1.00]). This model displayed an accuracy >80% and a kappa coefficient >0.60 for all individual items. When we made this LLM assess 60 times the same set of systematic reviews, answers to 18 of 27 items were always consistent (i.e., were always the same) and only 11% of assessed systematic reviews showed inconsistency. CONCLUSION: Overall, LLMs have the potential to accurately support the assessment of the methodological quality of systematic reviews based on a validated tool comprising dichotomous items.},
address = {United States},
author = {Marques-Cruz, Manuel and Pinto, Filipe and Vieira, Rafael José and Bognanni, Antonio and Perestrelo, Paula and Gil-Mata, Sara and Duarte, Vítor Henrique and Barbosa, José Pedro and Cardoso-Fernandes, António and Martinho-Dias, Daniel and Franco-Pego, Francisco and Germini, Federico and Arienti, Chiara and Chu, Alexandro W L and Riera-Serra, Pau and Jemioło, Paweł and Rodrigues, Pedro Pereira and Fonseca, João A and Azevedo, Luís Filipe and Schünemann, Holger J and Cruz-Correia, Ricardo and Jankin, Slava and Sousa-Pinto, Bernardo},
journal = {Journal of clinical epidemiology},
keywords = {evisap},
month = {aug},
pages = {111944--111944},
title = {Use of artificial intelligence to support the assessment of the methodological quality of systematic reviews},
year = 2025
}%0 Journal Article
%1 marquescruz2025artificial
%A Marques-Cruz, Manuel
%A Pinto, Filipe
%A Vieira, Rafael José
%A Bognanni, Antonio
%A Perestrelo, Paula
%A Gil-Mata, Sara
%A Duarte, Vítor Henrique
%A Barbosa, José Pedro
%A Cardoso-Fernandes, António
%A Martinho-Dias, Daniel
%A Franco-Pego, Francisco
%A Germini, Federico
%A Arienti, Chiara
%A Chu, Alexandro W L
%A Riera-Serra, Pau
%A Jemioło, Paweł
%A Rodrigues, Pedro Pereira
%A Fonseca, João A
%A Azevedo, Luís Filipe
%A Schünemann, Holger J
%A Cruz-Correia, Ricardo
%A Jankin, Slava
%A Sousa-Pinto, Bernardo
%C United States
%D 2025
%J Journal of clinical epidemiology
%P 111944--111944
%R 10.1016/j.jclinepi.2025.111944
%T Use of artificial intelligence to support the assessment of the methodological quality of systematic reviews
%U https://pubmed.ncbi.nlm.nih.gov/40865587
%X INTRODUCTION: Published systematic reviews display an heterogeneous methodological quality, which can impact decision-making. Large language models (LLMs) can support and make the assessment of the methodological quality of systematic reviews more efficient, aiding in the incorporation of their evidence in guideline recommendations. We aimed to develop a LLM-based tool for supporting the assessment of the methodological quality of systematic reviews. METHODS: We assessed the performance of eight large language models (LLMs) in evaluating the methodological quality of systematic reviews. In particular, we provided 100 systematic reviews for eight LLMs (five base models and three fine-tuned models) to evaluate their methodological quality based on a 27-item validated tool (ReMarQ). The fine-tuned models had been trained with a different sample of 300 manually assessed systematic reviews. We compared the answers provided by LLMs with those independently provided by human reviewers, computing the accuracy, kappa coefficient and F1-score for this comparison. RESULTS: The best performing LLM was a fine-tuned GPT-3.5 model (mean accuracy=96.5% [95%CI=89.9-100%]; mean kappa coefficient=0.90 [95%CI=0.71-1.00]; mean F1-score=0.91 [95%CI=0.83-1.00]). This model displayed an accuracy >80% and a kappa coefficient >0.60 for all individual items. When we made this LLM assess 60 times the same set of systematic reviews, answers to 18 of 27 items were always consistent (i.e., were always the same) and only 11% of assessed systematic reviews showed inconsistency. CONCLUSION: Overall, LLMs have the potential to accurately support the assessment of the methodological quality of systematic reviews based on a validated tool comprising dichotomous items. -
BibTeXEndNoteBibSonomy1.Oliver LL, Peña MPA, Ricci-Cabello I. Deprescripción como estrategia de seguridad del paciente en el manejo de fármacos de tipo AINE, opioides, IBP y antiagregantes. Actualización en Medicina de Familia: AMF. 2025;21(10):606-19.
@article{RN2,
author = {Oliver, Lourdes Luzón and Peña, María Pilar Astier and Ricci-Cabello, Ignacio},
journal = {Actualización en Medicina de Familia: AMF},
keywords = {evisap},
number = 10,
pages = {606-619},
title = {Deprescripción como estrategia de seguridad del paciente en el manejo de fármacos de tipo AINE, opioides, IBP y antiagregantes},
type = {Journal Article},
volume = 21,
year = 2025
}%0 Journal Article
%1 RN2
%A Oliver, Lourdes Luzón
%A Peña, María Pilar Astier
%A Ricci-Cabello, Ignacio
%D 2025
%J Actualización en Medicina de Familia: AMF
%N 10
%P 606-619
%T Deprescripción como estrategia de seguridad del paciente en el manejo de fármacos de tipo AINE, opioides, IBP y antiagregantes
%V 21 -
BibTeXEndNoteBibSonomy1.Benejam JMC, Herrera RB, Ricci-Cabello I. Uso inadecuado y riesgo de sobrediagnóstico en las pruebas de imagen en Atención Primaria. Actualización en Medicina de Familia: AMF. 2025;21(10):578-86.
@article{RN3,
author = {Benejam, Josep Maria Coll and Herrera, Rubén Blanco and Ricci-Cabello, Ignacio},
journal = {Actualización en Medicina de Familia: AMF},
keywords = {evisap},
number = 10,
pages = {578-586},
title = {Uso inadecuado y riesgo de sobrediagnóstico en las pruebas de imagen en Atención Primaria},
type = {Journal Article},
volume = 21,
year = 2025
}%0 Journal Article
%1 RN3
%A Benejam, Josep Maria Coll
%A Herrera, Rubén Blanco
%A Ricci-Cabello, Ignacio
%D 2025
%J Actualización en Medicina de Familia: AMF
%N 10
%P 578-586
%T Uso inadecuado y riesgo de sobrediagnóstico en las pruebas de imagen en Atención Primaria
%V 21 - AbstractURLBibTeXEndNoteDOIBibSonomyDownload1.Marques-Cruz M, Pinto F, Vieira RJ, Bognanni A, Perestrelo P, Gil-Mata S, Duarte VH, Barbosa JP, Cardoso-Fernandes A, Martinho-Dias D, Franco-Pego F, Germini F, Arienti C, Chu AWL, Riera-Serra P, Jemioło P, Rodrigues PP, Fonseca JA, Azevedo LF, Schünemann HJ, Cruz-Correia R, Jankin S, Sousa-Pinto B. Use of artificial intelligence to support the assessment of the methodological quality of systematic reviews. Journal of clinical epidemiology [Internet]. United States; 2025 Nov.;187:111944-. https://pubmed.ncbi.nlm.nih.gov/40865587OBJECTIVES: Published systematic reviews display a heterogeneous methodological quality, which can impact decision-making. Large language models (LLMs) can support and make the assessment of the methodological quality of systematic reviews more efficient, aiding in the incorporation of their evidence in guideline recommendations. We aimed to develop an LLM-based tool for supporting the assessment of the methodological quality of systematic reviews. METHODS: We assessed the performance of 8 LLMs in evaluating the methodological quality of systematic reviews. In particular, we provided 100 systematic reviews for eight LLMs (five base models and three fine-tuned models) to evaluate their methodological quality based on a 27-item validated tool (Reported Methodological Quality (ReMarQ)). The fine-tuned models had been trained with a different sample of 300 manually assessed systematic reviews. We compared the answers provided by LLMs with those independently provided by human reviewers, computing the accuracy, kappa coefficient and F1-score for this comparison. RESULTS: The best performing LLM was a fine-tuned GPT-3.5 model (mean accuracy = 96.5% [95% CI = 89.9%-100%]; mean kappa coefficient = 0.90 [95% CI = 0.71-1.00]; mean F1-score = 0.91 [95% CI = 0.83-1.00]). This model displayed an accuracy >80% and a kappa coefficient >0.60 for all individual items. When we made this LLM assess 60 times the same set of systematic reviews, answers to 18 of 27 items were always consistent (ie, were always the same) and only 11% of assessed systematic reviews showed inconsistency. CONCLUSION: Overall, LLMs have the potential to accurately support the assessment of the methodological quality of systematic reviews based on a validated tool comprising dichotomous items.
@article{marquescruz2025artificial,
abstract = {OBJECTIVES: Published systematic reviews display a heterogeneous methodological quality, which can impact decision-making. Large language models (LLMs) can support and make the assessment of the methodological quality of systematic reviews more efficient, aiding in the incorporation of their evidence in guideline recommendations. We aimed to develop an LLM-based tool for supporting the assessment of the methodological quality of systematic reviews. METHODS: We assessed the performance of 8 LLMs in evaluating the methodological quality of systematic reviews. In particular, we provided 100 systematic reviews for eight LLMs (five base models and three fine-tuned models) to evaluate their methodological quality based on a 27-item validated tool (Reported Methodological Quality (ReMarQ)). The fine-tuned models had been trained with a different sample of 300 manually assessed systematic reviews. We compared the answers provided by LLMs with those independently provided by human reviewers, computing the accuracy, kappa coefficient and F1-score for this comparison. RESULTS: The best performing LLM was a fine-tuned GPT-3.5 model (mean accuracy = 96.5% [95% CI = 89.9%-100%]; mean kappa coefficient = 0.90 [95% CI = 0.71-1.00]; mean F1-score = 0.91 [95% CI = 0.83-1.00]). This model displayed an accuracy >80% and a kappa coefficient >0.60 for all individual items. When we made this LLM assess 60 times the same set of systematic reviews, answers to 18 of 27 items were always consistent (ie, were always the same) and only 11% of assessed systematic reviews showed inconsistency. CONCLUSION: Overall, LLMs have the potential to accurately support the assessment of the methodological quality of systematic reviews based on a validated tool comprising dichotomous items.},
address = {United States},
author = {Marques-Cruz, Manuel and Pinto, Filipe and Vieira, Rafael José and Bognanni, Antonio and Perestrelo, Paula and Gil-Mata, Sara and Duarte, Vítor Henrique and Barbosa, José Pedro and Cardoso-Fernandes, António and Martinho-Dias, Daniel and Franco-Pego, Francisco and Germini, Federico and Arienti, Chiara and Chu, Alexandro W L and Riera-Serra, Pau and Jemioło, Paweł and Rodrigues, Pedro Pereira and Fonseca, João A and Azevedo, Luís Filipe and Schünemann, Holger J and Cruz-Correia, Ricardo and Jankin, Slava and Sousa-Pinto, Bernardo},
journal = {Journal of clinical epidemiology},
keywords = {evisap},
month = {nov},
pages = {111944--111944},
title = {Use of artificial intelligence to support the assessment of the methodological quality of systematic reviews},
volume = 187,
year = 2025
}%0 Journal Article
%1 marquescruz2025artificial
%A Marques-Cruz, Manuel
%A Pinto, Filipe
%A Vieira, Rafael José
%A Bognanni, Antonio
%A Perestrelo, Paula
%A Gil-Mata, Sara
%A Duarte, Vítor Henrique
%A Barbosa, José Pedro
%A Cardoso-Fernandes, António
%A Martinho-Dias, Daniel
%A Franco-Pego, Francisco
%A Germini, Federico
%A Arienti, Chiara
%A Chu, Alexandro W L
%A Riera-Serra, Pau
%A Jemioło, Paweł
%A Rodrigues, Pedro Pereira
%A Fonseca, João A
%A Azevedo, Luís Filipe
%A Schünemann, Holger J
%A Cruz-Correia, Ricardo
%A Jankin, Slava
%A Sousa-Pinto, Bernardo
%C United States
%D 2025
%J Journal of clinical epidemiology
%P 111944--111944
%R 10.1016/j.jclinepi.2025.111944
%T Use of artificial intelligence to support the assessment of the methodological quality of systematic reviews
%U https://pubmed.ncbi.nlm.nih.gov/40865587
%V 187
%X OBJECTIVES: Published systematic reviews display a heterogeneous methodological quality, which can impact decision-making. Large language models (LLMs) can support and make the assessment of the methodological quality of systematic reviews more efficient, aiding in the incorporation of their evidence in guideline recommendations. We aimed to develop an LLM-based tool for supporting the assessment of the methodological quality of systematic reviews. METHODS: We assessed the performance of 8 LLMs in evaluating the methodological quality of systematic reviews. In particular, we provided 100 systematic reviews for eight LLMs (five base models and three fine-tuned models) to evaluate their methodological quality based on a 27-item validated tool (Reported Methodological Quality (ReMarQ)). The fine-tuned models had been trained with a different sample of 300 manually assessed systematic reviews. We compared the answers provided by LLMs with those independently provided by human reviewers, computing the accuracy, kappa coefficient and F1-score for this comparison. RESULTS: The best performing LLM was a fine-tuned GPT-3.5 model (mean accuracy = 96.5% [95% CI = 89.9%-100%]; mean kappa coefficient = 0.90 [95% CI = 0.71-1.00]; mean F1-score = 0.91 [95% CI = 0.83-1.00]). This model displayed an accuracy >80% and a kappa coefficient >0.60 for all individual items. When we made this LLM assess 60 times the same set of systematic reviews, answers to 18 of 27 items were always consistent (ie, were always the same) and only 11% of assessed systematic reviews showed inconsistency. CONCLUSION: Overall, LLMs have the potential to accurately support the assessment of the methodological quality of systematic reviews based on a validated tool comprising dichotomous items. - AbstractURLBibTeXEndNoteDOIBibSonomyDownload1.Mira-Martínez S, Malih N, Angullo-Martínez E, Zamanillo-Campos R, Yañez AM, Bennasar-Veny M, Gómez-Juanes R, Konieczna J, Jiménez R, Serrano-Ripoll MJ, Fiol deRoque MA, Leiva A, Galmes-Panades AM, Miralles-Xamena J, Vidal-Thomàs MC, Gómez-Cobo C, Gervilla E, Oña-Gil JI, Ricci-Cabello I. A Multifaceted Digital Intervention for the Prevention of Type 2 Diabetes Mellitus in Primary Care (PREDIABETEXT): Cluster Randomized Trial. Journal of medical Internet research [Internet]. Canada; 2025 Oct.;27:e70981-e70981. https://pubmed.ncbi.nlm.nih.gov/41067715BACKGROUND: The diabetes epidemic continues to surge worldwide, demanding urgent and innovative solutions. Digital health interventions, particularly those targeting behavior change, hold promise due to their affordability and scalability. However, research in this field remains in its early stages. OBJECTIVE: This study aimed to evaluate the effectiveness of PREDIABETEXT (Prediabetes Text Message Digital Intervention for the Prevention of Type 2 Diabetes Mellitus), a digital health intervention, in reducing glycated hemoglobin (HbA(1c)) and in improving secondary clinical, physiological, and behavioral outcomes. METHODS: We conducted a 6-month, 3-arm, pragmatic cluster randomized clinical trial. We recruited patients with prediabetes (HbA(1c) levels between 6% and 6.4% in the previous 3 months or 2 consecutive fasting plasma glucose measurements of 110-125 mg/dL) registered at primary care centers in the Balearic Islands, Spain. The PREDIABETEXT intervention consisted of 3 personalized SMS text messages per week aimed at supporting lifestyle behavior changes and online training for their primary health care professionals. A total of 58 professionals (clusters) from 16 centers participated in the study and were randomized (1:1:1) to intervention group A (patient SMS text messaging), intervention group B (patient SMS text messaging+health care professional web-based training), or the control group (usual care). Following the 6-month intervention period, we conducted individual qualitative interviews with 8 patients and 7 health care professionals to evaluate their experiences with the intervention in terms of utility, satisfaction, and implementation barriers. RESULTS: In total, 58 health care professionals (clusters) were included, allocated to the control group (n=20, 34%; 119/365, 32.6% patients), intervention group A (SMS text messaging only; n=18, 31%; 106/365, 29% patients), and intervention group B (SMS text messaging+training; n=20, 34%; 140/365, 38.4% patients). The mean age of the patients was 59.79 (SD 9.75) years, and 54.5% (199/365) were female. The results of the intention-to-treat analysis at the 6-month time point showed that intervention A led to a small, nonsignificant reduction in HbA(1c) levels compared to the control group (β=-0.05, 95% CI -0.21 to 0.10; P=.50), whereas intervention B showed a similar nonsignificant reduction (β=-0.04, 95% CI -0.12 to 0.10; P=.56). No substantial differences were observed in the remaining secondary outcomes. Interviews revealed positive feedback from patients, who appreciated the intervention's dietary messages and their frequency and practicality. Participants suggested enhancements such as increased personalization, links to recipes, and nursing follow-ups. Health care professionals valued the online training but highlighted time constraints, suggesting shorter or blended formats to improve accessibility. CONCLUSIONS: While PREDIABETEXT did not significantly improve HbA(1c) levels, it demonstrated potential benefits for patient engagement. Further studies involving more intensive interventions are warranted to confirm the clinical impact on diabetes prevention. TRIAL REGISTRATION: ClinicalTrials.gov NCT05110625; https://www.clinicaltrials.gov/study/NCT05110625. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.3390/ijerph192214706.
@article{miramartinez2025multifaceted,
abstract = {BACKGROUND: The diabetes epidemic continues to surge worldwide, demanding urgent and innovative solutions. Digital health interventions, particularly those targeting behavior change, hold promise due to their affordability and scalability. However, research in this field remains in its early stages. OBJECTIVE: This study aimed to evaluate the effectiveness of PREDIABETEXT (Prediabetes Text Message Digital Intervention for the Prevention of Type 2 Diabetes Mellitus), a digital health intervention, in reducing glycated hemoglobin (HbA(1c)) and in improving secondary clinical, physiological, and behavioral outcomes. METHODS: We conducted a 6-month, 3-arm, pragmatic cluster randomized clinical trial. We recruited patients with prediabetes (HbA(1c) levels between 6% and 6.4% in the previous 3 months or 2 consecutive fasting plasma glucose measurements of 110-125 mg/dL) registered at primary care centers in the Balearic Islands, Spain. The PREDIABETEXT intervention consisted of 3 personalized SMS text messages per week aimed at supporting lifestyle behavior changes and online training for their primary health care professionals. A total of 58 professionals (clusters) from 16 centers participated in the study and were randomized (1:1:1) to intervention group A (patient SMS text messaging), intervention group B (patient SMS text messaging+health care professional web-based training), or the control group (usual care). Following the 6-month intervention period, we conducted individual qualitative interviews with 8 patients and 7 health care professionals to evaluate their experiences with the intervention in terms of utility, satisfaction, and implementation barriers. RESULTS: In total, 58 health care professionals (clusters) were included, allocated to the control group (n=20, 34%; 119/365, 32.6% patients), intervention group A (SMS text messaging only; n=18, 31%; 106/365, 29% patients), and intervention group B (SMS text messaging+training; n=20, 34%; 140/365, 38.4% patients). The mean age of the patients was 59.79 (SD 9.75) years, and 54.5% (199/365) were female. The results of the intention-to-treat analysis at the 6-month time point showed that intervention A led to a small, nonsignificant reduction in HbA(1c) levels compared to the control group (β=-0.05, 95% CI -0.21 to 0.10; P=.50), whereas intervention B showed a similar nonsignificant reduction (β=-0.04, 95% CI -0.12 to 0.10; P=.56). No substantial differences were observed in the remaining secondary outcomes. Interviews revealed positive feedback from patients, who appreciated the intervention's dietary messages and their frequency and practicality. Participants suggested enhancements such as increased personalization, links to recipes, and nursing follow-ups. Health care professionals valued the online training but highlighted time constraints, suggesting shorter or blended formats to improve accessibility. CONCLUSIONS: While PREDIABETEXT did not significantly improve HbA(1c) levels, it demonstrated potential benefits for patient engagement. Further studies involving more intensive interventions are warranted to confirm the clinical impact on diabetes prevention. TRIAL REGISTRATION: ClinicalTrials.gov NCT05110625; https://www.clinicaltrials.gov/study/NCT05110625. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.3390/ijerph192214706.},
address = {Canada},
author = {Mira-Martínez, Sofía and Malih, Narges and Angullo-Martínez, Escarlata and Zamanillo-Campos, Rocío and Yañez, Aina M and Bennasar-Veny, Miquel and Gómez-Juanes, Rocío and Konieczna, Jadwiga and Jiménez, Rafael and Serrano-Ripoll, Maria J and Fiol deRoque, Maria Antonia and Leiva, Alfonso and Galmes-Panades, Aina M and Miralles-Xamena, Jerónima and Vidal-Thomàs, Maria Clara and Gómez-Cobo, Cristina and Gervilla, Elena and Oña-Gil, José Iván and Ricci-Cabello, Ignacio},
journal = {Journal of medical Internet research},
keywords = {evisap grapp-caib},
month = {oct},
pages = {e70981--e70981},
title = {A Multifaceted Digital Intervention for the Prevention of Type 2 Diabetes Mellitus in Primary Care (PREDIABETEXT): Cluster Randomized Trial},
volume = 27,
year = 2025
}%0 Journal Article
%1 miramartinez2025multifaceted
%A Mira-Martínez, Sofía
%A Malih, Narges
%A Angullo-Martínez, Escarlata
%A Zamanillo-Campos, Rocío
%A Yañez, Aina M
%A Bennasar-Veny, Miquel
%A Gómez-Juanes, Rocío
%A Konieczna, Jadwiga
%A Jiménez, Rafael
%A Serrano-Ripoll, Maria J
%A Fiol deRoque, Maria Antonia
%A Leiva, Alfonso
%A Galmes-Panades, Aina M
%A Miralles-Xamena, Jerónima
%A Vidal-Thomàs, Maria Clara
%A Gómez-Cobo, Cristina
%A Gervilla, Elena
%A Oña-Gil, José Iván
%A Ricci-Cabello, Ignacio
%C Canada
%D 2025
%J Journal of medical Internet research
%P e70981--e70981
%R 10.2196/70981
%T A Multifaceted Digital Intervention for the Prevention of Type 2 Diabetes Mellitus in Primary Care (PREDIABETEXT): Cluster Randomized Trial
%U https://pubmed.ncbi.nlm.nih.gov/41067715
%V 27
%X BACKGROUND: The diabetes epidemic continues to surge worldwide, demanding urgent and innovative solutions. Digital health interventions, particularly those targeting behavior change, hold promise due to their affordability and scalability. However, research in this field remains in its early stages. OBJECTIVE: This study aimed to evaluate the effectiveness of PREDIABETEXT (Prediabetes Text Message Digital Intervention for the Prevention of Type 2 Diabetes Mellitus), a digital health intervention, in reducing glycated hemoglobin (HbA(1c)) and in improving secondary clinical, physiological, and behavioral outcomes. METHODS: We conducted a 6-month, 3-arm, pragmatic cluster randomized clinical trial. We recruited patients with prediabetes (HbA(1c) levels between 6% and 6.4% in the previous 3 months or 2 consecutive fasting plasma glucose measurements of 110-125 mg/dL) registered at primary care centers in the Balearic Islands, Spain. The PREDIABETEXT intervention consisted of 3 personalized SMS text messages per week aimed at supporting lifestyle behavior changes and online training for their primary health care professionals. A total of 58 professionals (clusters) from 16 centers participated in the study and were randomized (1:1:1) to intervention group A (patient SMS text messaging), intervention group B (patient SMS text messaging+health care professional web-based training), or the control group (usual care). Following the 6-month intervention period, we conducted individual qualitative interviews with 8 patients and 7 health care professionals to evaluate their experiences with the intervention in terms of utility, satisfaction, and implementation barriers. RESULTS: In total, 58 health care professionals (clusters) were included, allocated to the control group (n=20, 34%; 119/365, 32.6% patients), intervention group A (SMS text messaging only; n=18, 31%; 106/365, 29% patients), and intervention group B (SMS text messaging+training; n=20, 34%; 140/365, 38.4% patients). The mean age of the patients was 59.79 (SD 9.75) years, and 54.5% (199/365) were female. The results of the intention-to-treat analysis at the 6-month time point showed that intervention A led to a small, nonsignificant reduction in HbA(1c) levels compared to the control group (β=-0.05, 95% CI -0.21 to 0.10; P=.50), whereas intervention B showed a similar nonsignificant reduction (β=-0.04, 95% CI -0.12 to 0.10; P=.56). No substantial differences were observed in the remaining secondary outcomes. Interviews revealed positive feedback from patients, who appreciated the intervention's dietary messages and their frequency and practicality. Participants suggested enhancements such as increased personalization, links to recipes, and nursing follow-ups. Health care professionals valued the online training but highlighted time constraints, suggesting shorter or blended formats to improve accessibility. CONCLUSIONS: While PREDIABETEXT did not significantly improve HbA(1c) levels, it demonstrated potential benefits for patient engagement. Further studies involving more intensive interventions are warranted to confirm the clinical impact on diabetes prevention. TRIAL REGISTRATION: ClinicalTrials.gov NCT05110625; https://www.clinicaltrials.gov/study/NCT05110625. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.3390/ijerph192214706. - AbstractURLBibTeXEndNoteDOIBibSonomyDownload1.Navarra-Ventura G, Coronado-Simsic V, Riera-Serra P, Castro A, García-Toro M, Roca M, Gili M. Associations between unhealthy lifestyle and depression: Cross-sectional results from the Spanish National Health Survey. Spanish journal of psychiatry and mental health [Internet]. Spain; 2025;18(3):191-8. https://pubmed.ncbi.nlm.nih.gov/38591831INTRODUCTION: Depression usually worsens lifestyle habits, but previous evidence also suggests that an unhealthy lifestyle (UL) increases the risk of depression. Many studies have analyzed the association between lifestyle and depression in several nationally representative samples, but none have done so in the Spanish adult population. Our aim was to examine the associations between UL habits and depression in Spain. MATERIALS AND METHODS: Analysis of cross-sectional data from the latest National Health Survey published in 2018 (N=23,089). Data on depression and 4 lifestyle factors (diet, physical exercise, smoking, and alcohol consumption) were used. These factors were combined into an UL index ranging from 0 (healthiest lifestyle) to 4 (unhealthiest lifestyle). The prevalence of depression at different levels of the UL index, and the association between depression and both the cumulative UL index and the 4 UL factors was analyzed using parametric and non-parametric tests. RESULTS: Sedentarism was the most prevalent UL factor, followed by unhealthy diet, smoking and high-risk alcohol consumption. Having ≥1 UL factors was associated with a higher prevalence of depression compared to having 0 UL factors (2.5% vs. ≥5.2%), regardless of the cumulative number UL factors (1, 2, 3 or 4). Being physically inactive (OR=1.6) and a smoker (OR=1.3) increased the likelihood of depression. Being a high-risk wine drinker (OR=0.26) decreased the likelihood of depression. Dietary intake was not significant. CONCLUSIONS: The prevalence of depression changes depending on several modifiable lifestyle factors. Policy makers should therefore spare no resources in promoting strategies to encourage healthy lifestyles and prevent the acquisition of UL habits.
@article{navarraventura2025associations,
abstract = {INTRODUCTION: Depression usually worsens lifestyle habits, but previous evidence also suggests that an unhealthy lifestyle (UL) increases the risk of depression. Many studies have analyzed the association between lifestyle and depression in several nationally representative samples, but none have done so in the Spanish adult population. Our aim was to examine the associations between UL habits and depression in Spain. MATERIALS AND METHODS: Analysis of cross-sectional data from the latest National Health Survey published in 2018 (N=23,089). Data on depression and 4 lifestyle factors (diet, physical exercise, smoking, and alcohol consumption) were used. These factors were combined into an UL index ranging from 0 (healthiest lifestyle) to 4 (unhealthiest lifestyle). The prevalence of depression at different levels of the UL index, and the association between depression and both the cumulative UL index and the 4 UL factors was analyzed using parametric and non-parametric tests. RESULTS: Sedentarism was the most prevalent UL factor, followed by unhealthy diet, smoking and high-risk alcohol consumption. Having ≥1 UL factors was associated with a higher prevalence of depression compared to having 0 UL factors (2.5% vs. ≥5.2%), regardless of the cumulative number UL factors (1, 2, 3 or 4). Being physically inactive (OR=1.6) and a smoker (OR=1.3) increased the likelihood of depression. Being a high-risk wine drinker (OR=0.26) decreased the likelihood of depression. Dietary intake was not significant. CONCLUSIONS: The prevalence of depression changes depending on several modifiable lifestyle factors. Policy makers should therefore spare no resources in promoting strategies to encourage healthy lifestyles and prevent the acquisition of UL habits.},
address = {Spain},
author = {Navarra-Ventura, Guillem and Coronado-Simsic, Victoria and Riera-Serra, Pau and Castro, Adoración and García-Toro, Mauro and Roca, Miquel and Gili, Margalida},
journal = {Spanish journal of psychiatry and mental health},
keywords = {evisap},
number = 3,
pages = {191--198},
title = {Associations between unhealthy lifestyle and depression: Cross-sectional results from the Spanish National Health Survey},
volume = 18,
year = 2025
}%0 Journal Article
%1 navarraventura2025associations
%A Navarra-Ventura, Guillem
%A Coronado-Simsic, Victoria
%A Riera-Serra, Pau
%A Castro, Adoración
%A García-Toro, Mauro
%A Roca, Miquel
%A Gili, Margalida
%C Spain
%D 2025
%J Spanish journal of psychiatry and mental health
%N 3
%P 191--198
%R 10.1016/j.sjpmh.2023.08.001
%T Associations between unhealthy lifestyle and depression: Cross-sectional results from the Spanish National Health Survey
%U https://pubmed.ncbi.nlm.nih.gov/38591831
%V 18
%X INTRODUCTION: Depression usually worsens lifestyle habits, but previous evidence also suggests that an unhealthy lifestyle (UL) increases the risk of depression. Many studies have analyzed the association between lifestyle and depression in several nationally representative samples, but none have done so in the Spanish adult population. Our aim was to examine the associations between UL habits and depression in Spain. MATERIALS AND METHODS: Analysis of cross-sectional data from the latest National Health Survey published in 2018 (N=23,089). Data on depression and 4 lifestyle factors (diet, physical exercise, smoking, and alcohol consumption) were used. These factors were combined into an UL index ranging from 0 (healthiest lifestyle) to 4 (unhealthiest lifestyle). The prevalence of depression at different levels of the UL index, and the association between depression and both the cumulative UL index and the 4 UL factors was analyzed using parametric and non-parametric tests. RESULTS: Sedentarism was the most prevalent UL factor, followed by unhealthy diet, smoking and high-risk alcohol consumption. Having ≥1 UL factors was associated with a higher prevalence of depression compared to having 0 UL factors (2.5% vs. ≥5.2%), regardless of the cumulative number UL factors (1, 2, 3 or 4). Being physically inactive (OR=1.6) and a smoker (OR=1.3) increased the likelihood of depression. Being a high-risk wine drinker (OR=0.26) decreased the likelihood of depression. Dietary intake was not significant. CONCLUSIONS: The prevalence of depression changes depending on several modifiable lifestyle factors. Policy makers should therefore spare no resources in promoting strategies to encourage healthy lifestyles and prevent the acquisition of UL habits. - AbstractURLBibTeXEndNoteDOIBibSonomyDownload1.Pang Y, Szuecs A, Ricci-Cabello I, Gangannagaripalli J, Goh LH, Leong FL, Zhou LF, Valderas JM. Patient and family engagement interventions in primary care patient safety: systematic review and meta-analysis of randomised controlled trials. The British journal of general practice : the journal of the Royal College of General Practitioners [Internet]. England; 2025 May;:BJGP.2024.0369-. https://pubmed.ncbi.nlm.nih.gov/40355248BACKGROUND: Engaging patients and families have been promoted as a key strategy for improving patient safety of health systems. However, evidence remains scarce on the effectiveness of this approach in primary care. AIM: To assess the combined effectiveness of primary care interventions in randomised controlled trials (RCTs) promoting patient and family engagement in patient safety. DESIGN AND SETTING: Systematic review and meta-analysis. METHODS: The review followed PRISMA and Cochrane guidelines. Five electronic databases (MEDLINE, CINAHL, Embase, Web of Science, CENTRAL) were searched from inception to 18 September 2024 with keywords in four blocks (patient and family engagement; patient safety; primary care; randomised controlled trial). Patient and family engagement levels were appraised. Where feasible and advisable, results were combined into meta-analyses. RESULTS: Of the 19 included records, 12 reported on completed RCTs. Only one intervention integrated patients/families into overall care safety (high engagement); six aimed at enhancing skills and tools (intermediate), and 12 infirmed patients/families how to engage and prompted them to do it (low). RCTs primarily targeted medication safety, with meta-analyses showing no significant effects on reducing adverse drug events (OR=0.83, 95%CI [0.70,1.08]) or improving medication appropriateness measured categorically (OR=0.92, 95%CI [0.76,1.13]) or continuously (MD=0.71, 95%CI [-0.10,1.52]). Overall risk of bias was low and certainty of evidence very low to moderate. CONCLUSION: Existing randomised controlled evidence on patient and family engagement in primary care remains inconclusive and limited in scope. Future interventions should include higher levels of engagement and address more diverse patient safety outcomes relevant for primary care.
@article{pang2025patient,
abstract = {BACKGROUND: Engaging patients and families have been promoted as a key strategy for improving patient safety of health systems. However, evidence remains scarce on the effectiveness of this approach in primary care. AIM: To assess the combined effectiveness of primary care interventions in randomised controlled trials (RCTs) promoting patient and family engagement in patient safety. DESIGN AND SETTING: Systematic review and meta-analysis. METHODS: The review followed PRISMA and Cochrane guidelines. Five electronic databases (MEDLINE, CINAHL, Embase, Web of Science, CENTRAL) were searched from inception to 18 September 2024 with keywords in four blocks (patient and family engagement; patient safety; primary care; randomised controlled trial). Patient and family engagement levels were appraised. Where feasible and advisable, results were combined into meta-analyses. RESULTS: Of the 19 included records, 12 reported on completed RCTs. Only one intervention integrated patients/families into overall care safety (high engagement); six aimed at enhancing skills and tools (intermediate), and 12 infirmed patients/families how to engage and prompted them to do it (low). RCTs primarily targeted medication safety, with meta-analyses showing no significant effects on reducing adverse drug events (OR=0.83, 95%CI [0.70,1.08]) or improving medication appropriateness measured categorically (OR=0.92, 95%CI [0.76,1.13]) or continuously (MD=0.71, 95%CI [-0.10,1.52]). Overall risk of bias was low and certainty of evidence very low to moderate. CONCLUSION: Existing randomised controlled evidence on patient and family engagement in primary care remains inconclusive and limited in scope. Future interventions should include higher levels of engagement and address more diverse patient safety outcomes relevant for primary care.},
address = {England},
author = {Pang, Yan and Szuecs, Anna and Ricci-Cabello, Ignacio and Gangannagaripalli, Jaheeda and Goh, Lay Hoon and Leong, Foon Leng and Zhou, Li Fan and Valderas, Jose Maria},
journal = {The British journal of general practice : the journal of the Royal College of General Practitioners},
keywords = {evisap},
month = {may},
pages = {BJGP.2024.0369--},
title = {Patient and family engagement interventions in primary care patient safety: systematic review and meta-analysis of randomised controlled trials},
year = 2025
}%0 Journal Article
%1 pang2025patient
%A Pang, Yan
%A Szuecs, Anna
%A Ricci-Cabello, Ignacio
%A Gangannagaripalli, Jaheeda
%A Goh, Lay Hoon
%A Leong, Foon Leng
%A Zhou, Li Fan
%A Valderas, Jose Maria
%C England
%D 2025
%J The British journal of general practice : the journal of the Royal College of General Practitioners
%P BJGP.2024.0369--
%R 10.3399/BJGP.2024.0369
%T Patient and family engagement interventions in primary care patient safety: systematic review and meta-analysis of randomised controlled trials
%U https://pubmed.ncbi.nlm.nih.gov/40355248
%X BACKGROUND: Engaging patients and families have been promoted as a key strategy for improving patient safety of health systems. However, evidence remains scarce on the effectiveness of this approach in primary care. AIM: To assess the combined effectiveness of primary care interventions in randomised controlled trials (RCTs) promoting patient and family engagement in patient safety. DESIGN AND SETTING: Systematic review and meta-analysis. METHODS: The review followed PRISMA and Cochrane guidelines. Five electronic databases (MEDLINE, CINAHL, Embase, Web of Science, CENTRAL) were searched from inception to 18 September 2024 with keywords in four blocks (patient and family engagement; patient safety; primary care; randomised controlled trial). Patient and family engagement levels were appraised. Where feasible and advisable, results were combined into meta-analyses. RESULTS: Of the 19 included records, 12 reported on completed RCTs. Only one intervention integrated patients/families into overall care safety (high engagement); six aimed at enhancing skills and tools (intermediate), and 12 infirmed patients/families how to engage and prompted them to do it (low). RCTs primarily targeted medication safety, with meta-analyses showing no significant effects on reducing adverse drug events (OR=0.83, 95%CI [0.70,1.08]) or improving medication appropriateness measured categorically (OR=0.92, 95%CI [0.76,1.13]) or continuously (MD=0.71, 95%CI [-0.10,1.52]). Overall risk of bias was low and certainty of evidence very low to moderate. CONCLUSION: Existing randomised controlled evidence on patient and family engagement in primary care remains inconclusive and limited in scope. Future interventions should include higher levels of engagement and address more diverse patient safety outcomes relevant for primary care. -
AbstractURLBibTeXEndNoteDOIBibSonomy1.Venter C, Alonso-Coello P, Beltran J, Bracchiglione J, Fernandez-Saenz K, Riera P, Solà I, Arasi S, Berni Canani R, Fleischer D, Eguíluz-Gracia I, Meyer R, Roberts G, Roth-Walter F, Santos AF, Skypala I, Smith PK, Sokolowska M, Torres MJ, Vassilopoulou E, Walter J, O’Mahony L. Protocol: Scoping review of the association between complementary feeding, growth, and immune health in infants and toddlers-An EAACI guideline paper. Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology [Internet]. England; 2025 Aug.;36(8):e70145-e70145. https://pubmed.ncbi.nlm.nih.gov/40747578The European Academy of Allergy and Clinical Immunology (EAACI) is currently developing guidelines on immunomodulation and nutrition. To inform these recommendations, a scoping review will be conducted to synthesize and map the available empirical evidence on how complementary feeding affects immune health in infants and toddlers to explore the association between complementary feeding during the first year of life and immune health outcomes in children up to 3 years of age. The scoping review will be conducted using the Preferred Reporting Items for Systematic Reviews and Meta-analysis Scoping Review Extension for scoping reviews (PRISMA-ScR) guidelines. We have developed inclusion criteria using the PCC (Population, Concept and Context) format: the population will include healthy infants; the concept refers to specific factors related to introduction of complementary feeding; and the context will focus on studies conducted in settings representative of everyday nutrition and feeding practices for infants and toddlers. Evidence sources include systematic reviews. We will search in MEDLINE and Epistemonikos. Data will be extracted using a standardized form developed in REDCap, and the findings will be synthesized narratively. Only published literature will be included in this systematic review. Therefore, no ethical approval is required. The final review paper will be published in a peer-reviewed journal. OSF registration DOI: 10.17605/OSF.IO/T5F8.
@article{venter2025protocol,
abstract = {The European Academy of Allergy and Clinical Immunology (EAACI) is currently developing guidelines on immunomodulation and nutrition. To inform these recommendations, a scoping review will be conducted to synthesize and map the available empirical evidence on how complementary feeding affects immune health in infants and toddlers to explore the association between complementary feeding during the first year of life and immune health outcomes in children up to 3 years of age. The scoping review will be conducted using the Preferred Reporting Items for Systematic Reviews and Meta-analysis Scoping Review Extension for scoping reviews (PRISMA-ScR) guidelines. We have developed inclusion criteria using the PCC (Population, Concept and Context) format: the population will include healthy infants; the concept refers to specific factors related to introduction of complementary feeding; and the context will focus on studies conducted in settings representative of everyday nutrition and feeding practices for infants and toddlers. Evidence sources include systematic reviews. We will search in MEDLINE and Epistemonikos. Data will be extracted using a standardized form developed in REDCap, and the findings will be synthesized narratively. Only published literature will be included in this systematic review. Therefore, no ethical approval is required. The final review paper will be published in a peer-reviewed journal. OSF registration DOI: 10.17605/OSF.IO/T5F8.},
address = {England},
author = {Venter, Carina and Alonso-Coello, Pablo and Beltran, Jessica and Bracchiglione, Javier and Fernandez-Saenz, Karina and Riera, Pau and Solà, Ivan and Arasi, Stefania and Berni Canani, Roberto and Fleischer, David and Eguíluz-Gracia, Ibon and Meyer, Rosan and Roberts, Graham and Roth-Walter, Franziska and Santos, Alexandra F and Skypala, Isabel and Smith, Peter K and Sokolowska, Milena and Torres, Maria J and Vassilopoulou, Emilia and Walter, Jens and O'Mahony, Liam},
journal = {Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology},
keywords = {evisap},
month = {aug},
number = 8,
pages = {e70145--e70145},
title = {Protocol: Scoping review of the association between complementary feeding, growth, and immune health in infants and toddlers-An EAACI guideline paper},
volume = 36,
year = 2025
}%0 Journal Article
%1 venter2025protocol
%A Venter, Carina
%A Alonso-Coello, Pablo
%A Beltran, Jessica
%A Bracchiglione, Javier
%A Fernandez-Saenz, Karina
%A Riera, Pau
%A Solà, Ivan
%A Arasi, Stefania
%A Berni Canani, Roberto
%A Fleischer, David
%A Eguíluz-Gracia, Ibon
%A Meyer, Rosan
%A Roberts, Graham
%A Roth-Walter, Franziska
%A Santos, Alexandra F
%A Skypala, Isabel
%A Smith, Peter K
%A Sokolowska, Milena
%A Torres, Maria J
%A Vassilopoulou, Emilia
%A Walter, Jens
%A O'Mahony, Liam
%C England
%D 2025
%J Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology
%N 8
%P e70145--e70145
%R 10.1111/pai.70145
%T Protocol: Scoping review of the association between complementary feeding, growth, and immune health in infants and toddlers-An EAACI guideline paper
%U https://pubmed.ncbi.nlm.nih.gov/40747578
%V 36
%X The European Academy of Allergy and Clinical Immunology (EAACI) is currently developing guidelines on immunomodulation and nutrition. To inform these recommendations, a scoping review will be conducted to synthesize and map the available empirical evidence on how complementary feeding affects immune health in infants and toddlers to explore the association between complementary feeding during the first year of life and immune health outcomes in children up to 3 years of age. The scoping review will be conducted using the Preferred Reporting Items for Systematic Reviews and Meta-analysis Scoping Review Extension for scoping reviews (PRISMA-ScR) guidelines. We have developed inclusion criteria using the PCC (Population, Concept and Context) format: the population will include healthy infants; the concept refers to specific factors related to introduction of complementary feeding; and the context will focus on studies conducted in settings representative of everyday nutrition and feeding practices for infants and toddlers. Evidence sources include systematic reviews. We will search in MEDLINE and Epistemonikos. Data will be extracted using a standardized form developed in REDCap, and the findings will be synthesized narratively. Only published literature will be included in this systematic review. Therefore, no ethical approval is required. The final review paper will be published in a peer-reviewed journal. OSF registration DOI: 10.17605/OSF.IO/T5F8. - AbstractURLBibTeXEndNoteDOIBibSonomyDownload1.Chaplin A, Prohens L, Wordsworth J, Obrador-Hevia A, Guillot M, Ricci-Cabello I, Romaguera D, Sesé A. Identifying the key components of a diet and lifestyle screener for people living with and beyond cancer: an e-Delphi study. BMJ open [Internet]. England; 2025 Aug.;15(8):e097084-e097084. https://pubmed.ncbi.nlm.nih.gov/40784779OBJECTIVES: There are currently no validated screeners that evaluate diet and lifestyle of people living with and beyond cancer (PLWBC). The purpose of this study was to reach a consensus among an international expert panel on the essential items to include in this type of instrument. DESIGN: A scientific committee developed the initial list of items, which were presented to an expert panel in a two-round-modified electronic Delphi. Panellists were asked to rate the adequacy, relevance and feasibility of self-reporting each item. Qualitative assessments were encouraged. SETTING: Four countries (Spain, UK, USA and Portugal). PARTICIPANTS: Experts working in a cancer-related health profession or cancer-related research were recruited. MAIN OUTCOME MEASURES: Items were initially categorised into seven domains (body composition, physical activity, diet, alcohol, smoking, sleep and psychosocial distress). A content validity index per item (CVI-i) and a scale-level CVI (S-CVI) were calculated (acceptable≥0.78). All items with a CVI-i≥0.78 were submitted to a final consensus meeting. RESULTS: A total of 108 items were proposed to the panel. In Round 1, 77 items were accepted, 10 items were excluded and 6 new items were proposed. During Round 2, 4 items were accepted and 19 were excluded. Diet and alcohol were merged into one domain. The final consensus meeting decided on 61 items categorised into six domains (S-CVI:0.94): body composition, physical activity, diet and alcohol, smoking, sleep and psychosocial distress. CONCLUSIONS: We identified the main items to be considered when developing a screener to evaluate diet and lifestyle in PLWBC in a clinical setting, and the results obtained will guide the content of the screener in the following validation study.
@article{chaplin2025identifying,
abstract = {OBJECTIVES: There are currently no validated screeners that evaluate diet and lifestyle of people living with and beyond cancer (PLWBC). The purpose of this study was to reach a consensus among an international expert panel on the essential items to include in this type of instrument. DESIGN: A scientific committee developed the initial list of items, which were presented to an expert panel in a two-round-modified electronic Delphi. Panellists were asked to rate the adequacy, relevance and feasibility of self-reporting each item. Qualitative assessments were encouraged. SETTING: Four countries (Spain, UK, USA and Portugal). PARTICIPANTS: Experts working in a cancer-related health profession or cancer-related research were recruited. MAIN OUTCOME MEASURES: Items were initially categorised into seven domains (body composition, physical activity, diet, alcohol, smoking, sleep and psychosocial distress). A content validity index per item (CVI-i) and a scale-level CVI (S-CVI) were calculated (acceptable≥0.78). All items with a CVI-i≥0.78 were submitted to a final consensus meeting. RESULTS: A total of 108 items were proposed to the panel. In Round 1, 77 items were accepted, 10 items were excluded and 6 new items were proposed. During Round 2, 4 items were accepted and 19 were excluded. Diet and alcohol were merged into one domain. The final consensus meeting decided on 61 items categorised into six domains (S-CVI:0.94): body composition, physical activity, diet and alcohol, smoking, sleep and psychosocial distress. CONCLUSIONS: We identified the main items to be considered when developing a screener to evaluate diet and lifestyle in PLWBC in a clinical setting, and the results obtained will guide the content of the screener in the following validation study.},
address = {England},
author = {Chaplin, Alice and Prohens, Lara and Wordsworth, Janna and Obrador-Hevia, Antònia and Guillot, Monica and Ricci-Cabello, Ignacio and Romaguera, Dora and Sesé, Albert},
journal = {BMJ open},
keywords = {evisap},
month = {aug},
number = 8,
pages = {e097084--e097084},
title = {Identifying the key components of a diet and lifestyle screener for people living with and beyond cancer: an e-Delphi study},
volume = 15,
year = 2025
}%0 Journal Article
%1 chaplin2025identifying
%A Chaplin, Alice
%A Prohens, Lara
%A Wordsworth, Janna
%A Obrador-Hevia, Antònia
%A Guillot, Monica
%A Ricci-Cabello, Ignacio
%A Romaguera, Dora
%A Sesé, Albert
%C England
%D 2025
%J BMJ open
%N 8
%P e097084--e097084
%R 10.1136/bmjopen-2024-097084
%T Identifying the key components of a diet and lifestyle screener for people living with and beyond cancer: an e-Delphi study
%U https://pubmed.ncbi.nlm.nih.gov/40784779
%V 15
%X OBJECTIVES: There are currently no validated screeners that evaluate diet and lifestyle of people living with and beyond cancer (PLWBC). The purpose of this study was to reach a consensus among an international expert panel on the essential items to include in this type of instrument. DESIGN: A scientific committee developed the initial list of items, which were presented to an expert panel in a two-round-modified electronic Delphi. Panellists were asked to rate the adequacy, relevance and feasibility of self-reporting each item. Qualitative assessments were encouraged. SETTING: Four countries (Spain, UK, USA and Portugal). PARTICIPANTS: Experts working in a cancer-related health profession or cancer-related research were recruited. MAIN OUTCOME MEASURES: Items were initially categorised into seven domains (body composition, physical activity, diet, alcohol, smoking, sleep and psychosocial distress). A content validity index per item (CVI-i) and a scale-level CVI (S-CVI) were calculated (acceptable≥0.78). All items with a CVI-i≥0.78 were submitted to a final consensus meeting. RESULTS: A total of 108 items were proposed to the panel. In Round 1, 77 items were accepted, 10 items were excluded and 6 new items were proposed. During Round 2, 4 items were accepted and 19 were excluded. Diet and alcohol were merged into one domain. The final consensus meeting decided on 61 items categorised into six domains (S-CVI:0.94): body composition, physical activity, diet and alcohol, smoking, sleep and psychosocial distress. CONCLUSIONS: We identified the main items to be considered when developing a screener to evaluate diet and lifestyle in PLWBC in a clinical setting, and the results obtained will guide the content of the screener in the following validation study. - AbstractURLBibTeXEndNoteDOIBibSonomyDownload1.Navarra-Ventura G, Riera-Serra P, Castro A, Montaño JJ, Roca M, Gili M. Longitudinal associations between melancholic depression and executive function in adult patients with major depressive disorder: a 12-month follow-up study. Psychiatry research [Internet]. Ireland; 2025 Jul.;351:116636-. https://pubmed.ncbi.nlm.nih.gov/40651192Major depressive disorder (MDD) is often associated with deficits in executive function, but the long-term cognitive impact of specific depressive subtypes, in particular melancholic depression (MelD), is underexplored. This is the first prospective study aimed at exploring longitudinal associations between MelD and executive function in adult patients with MDD. This is a secondary analysis using data from a larger project with assessments at baseline, 6 and 12 months. MelD was identified using an algorithm derived from a subset of eight items from the Inventory of Depressive Symptomatology-Self Rated, which provides a standardized framework for the identification of this specific depressive subtype. Executive function was assessed using the Cambridge Neuropsychological Test Automated Battery. Longitudinal associations between MelD and executive function, including a global domain, four subdomains (working memory, planning, response inhibition and decision-making), and eight individual variables used to calculate the composite scores of the five (sub)domains, were analyzed using linear mixed-effects models adjusted for demographic and clinical variables and psychomotor speed. One hundred and five patients (20.95 % MelD) were analyzed at baseline, 73 (17.81 % MelD) at 6 months, and 61 (19.67 % MelD) at 12 months. MelD, older age and female sex were significantly associated with worse performance in the global executive function domain, in the working memory subdomain, and in four individual variables within the working memory, planning and decision-making subdomains, independent of other demographic and clinical variables and psychomotor speed. The findings highlight MelD as a distinct risk factor for worse long-term executive function in adult patients with MDD.
@article{navarraventura2025longitudinal,
abstract = {Major depressive disorder (MDD) is often associated with deficits in executive function, but the long-term cognitive impact of specific depressive subtypes, in particular melancholic depression (MelD), is underexplored. This is the first prospective study aimed at exploring longitudinal associations between MelD and executive function in adult patients with MDD. This is a secondary analysis using data from a larger project with assessments at baseline, 6 and 12 months. MelD was identified using an algorithm derived from a subset of eight items from the Inventory of Depressive Symptomatology-Self Rated, which provides a standardized framework for the identification of this specific depressive subtype. Executive function was assessed using the Cambridge Neuropsychological Test Automated Battery. Longitudinal associations between MelD and executive function, including a global domain, four subdomains (working memory, planning, response inhibition and decision-making), and eight individual variables used to calculate the composite scores of the five (sub)domains, were analyzed using linear mixed-effects models adjusted for demographic and clinical variables and psychomotor speed. One hundred and five patients (20.95 % MelD) were analyzed at baseline, 73 (17.81 % MelD) at 6 months, and 61 (19.67 % MelD) at 12 months. MelD, older age and female sex were significantly associated with worse performance in the global executive function domain, in the working memory subdomain, and in four individual variables within the working memory, planning and decision-making subdomains, independent of other demographic and clinical variables and psychomotor speed. The findings highlight MelD as a distinct risk factor for worse long-term executive function in adult patients with MDD.},
address = {Ireland},
author = {Navarra-Ventura, Guillem and Riera-Serra, Pau and Castro, Adoración and Montaño, Juan José and Roca, Miquel and Gili, Margalida},
journal = {Psychiatry research},
keywords = {evisap},
month = {jul},
pages = {116636--116636},
title = {Longitudinal associations between melancholic depression and executive function in adult patients with major depressive disorder: a 12-month follow-up study},
volume = 351,
year = 2025
}%0 Journal Article
%1 navarraventura2025longitudinal
%A Navarra-Ventura, Guillem
%A Riera-Serra, Pau
%A Castro, Adoración
%A Montaño, Juan José
%A Roca, Miquel
%A Gili, Margalida
%C Ireland
%D 2025
%J Psychiatry research
%P 116636--116636
%R 10.1016/j.psychres.2025.116636
%T Longitudinal associations between melancholic depression and executive function in adult patients with major depressive disorder: a 12-month follow-up study
%U https://pubmed.ncbi.nlm.nih.gov/40651192
%V 351
%X Major depressive disorder (MDD) is often associated with deficits in executive function, but the long-term cognitive impact of specific depressive subtypes, in particular melancholic depression (MelD), is underexplored. This is the first prospective study aimed at exploring longitudinal associations between MelD and executive function in adult patients with MDD. This is a secondary analysis using data from a larger project with assessments at baseline, 6 and 12 months. MelD was identified using an algorithm derived from a subset of eight items from the Inventory of Depressive Symptomatology-Self Rated, which provides a standardized framework for the identification of this specific depressive subtype. Executive function was assessed using the Cambridge Neuropsychological Test Automated Battery. Longitudinal associations between MelD and executive function, including a global domain, four subdomains (working memory, planning, response inhibition and decision-making), and eight individual variables used to calculate the composite scores of the five (sub)domains, were analyzed using linear mixed-effects models adjusted for demographic and clinical variables and psychomotor speed. One hundred and five patients (20.95 % MelD) were analyzed at baseline, 73 (17.81 % MelD) at 6 months, and 61 (19.67 % MelD) at 12 months. MelD, older age and female sex were significantly associated with worse performance in the global executive function domain, in the working memory subdomain, and in four individual variables within the working memory, planning and decision-making subdomains, independent of other demographic and clinical variables and psychomotor speed. The findings highlight MelD as a distinct risk factor for worse long-term executive function in adult patients with MDD. - AbstractURLBibTeXEndNoteDOIBibSonomyDownload1.Ramírez-Gallegos I, Busquets-Cortes C, Paublini H, López-González Ángel A, Martínez-Almoyna-Rifá E, Tárraga López PJ, Ramírez-Manent JI. Association Between Bioimpedance-Determined Metabolic Age and MASLD Risk Scores in Spanish Workers. Metabolites [Internet]. 2025 May;15(5):343. https://pmc.ncbi.nlm.nih.gov/articles/PMC12113834/Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a prevalent liver disorder with significant metabolic implications. Metabolic age, determined through bioimpedance analysis, has emerged as a potential indicator of overall metabolic health. The objective of this study is to evaluate the association between metabolic age and MASLD risk scores in a cohort of Spanish workers. Methods: A cross-sectional study was conducted on 8590 Spanish workers who underwent annual occupational health examinations between 2019 and 2020. Metabolic age was determined using bioelectrical impedance analysis, and the Avoidable Lost Life Years (ALLY) index was calculated as the difference between their metabolic and chronological age. MASLD risk was assessed using various validated scales, including the Fatty Liver Index (FLI), Hepatic Steatosis Index (HSI), Zhejiang University Index (ZJU), Fatty Liver Disease Index (FLD), and Lipid Accumulation Product (LAP). A multinomial logistic regression analysis was performed to examine the association between metabolic age and MASLD risk scores, adjusting for sociodemographic and lifestyle variables. Results: Higher metabolic age values were observed in individuals with greater MASLD risk across all evaluated scales. The mean metabolic age was consistently lower in women compared to men, and these differences were statistically significant (p \textless 0.01). Multinomial logistic regression analysis revealed that the strongest associations with increased metabolic age were found for MASLD risk scores, physical inactivity, and poor adherence to the Mediterranean diet. ROC curve analysis demonstrated a high predictive capacity for the FLD (AUC: 0.935 in women and 0.917 in men) and FLI (AUC: 0.900 in women and 0.833 in men), with high Youden index values. Conclusions: Metabolic age is significantly associated with MASLD risk, suggesting its potential as a non-invasive biomarker for identifying individuals with a higher risk for metabolic liver disease. Lifestyle factors, including physical activity and dietary patterns, play a crucial role in modulating metabolic age, highlighting the importance of targeted interventions for MASLD prevention. Further research is warranted to validate metabolic age as a prognostic tool in MASLD risk assessment.
@article{ramirez-gallegos_association_2025,
abstract = {Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a prevalent liver disorder with significant metabolic implications. Metabolic age, determined through bioimpedance analysis, has emerged as a potential indicator of overall metabolic health. The objective of this study is to evaluate the association between metabolic age and MASLD risk scores in a cohort of Spanish workers. Methods: A cross-sectional study was conducted on 8590 Spanish workers who underwent annual occupational health examinations between 2019 and 2020. Metabolic age was determined using bioelectrical impedance analysis, and the Avoidable Lost Life Years (ALLY) index was calculated as the difference between their metabolic and chronological age. MASLD risk was assessed using various validated scales, including the Fatty Liver Index (FLI), Hepatic Steatosis Index (HSI), Zhejiang University Index (ZJU), Fatty Liver Disease Index (FLD), and Lipid Accumulation Product (LAP). A multinomial logistic regression analysis was performed to examine the association between metabolic age and MASLD risk scores, adjusting for sociodemographic and lifestyle variables. Results: Higher metabolic age values were observed in individuals with greater MASLD risk across all evaluated scales. The mean metabolic age was consistently lower in women compared to men, and these differences were statistically significant (p \textless 0.01). Multinomial logistic regression analysis revealed that the strongest associations with increased metabolic age were found for MASLD risk scores, physical inactivity, and poor adherence to the Mediterranean diet. ROC curve analysis demonstrated a high predictive capacity for the FLD (AUC: 0.935 in women and 0.917 in men) and FLI (AUC: 0.900 in women and 0.833 in men), with high Youden index values. Conclusions: Metabolic age is significantly associated with MASLD risk, suggesting its potential as a non-invasive biomarker for identifying individuals with a higher risk for metabolic liver disease. Lifestyle factors, including physical activity and dietary patterns, play a crucial role in modulating metabolic age, highlighting the importance of targeted interventions for MASLD prevention. Further research is warranted to validate metabolic age as a prognostic tool in MASLD risk assessment.},
author = {Ramírez-Gallegos, Ignacio and Busquets-Cortes, Carla and Paublini, Hernán and López-González, Ángel Arturo and Martínez-Almoyna-Rifá, Emilio and Tárraga López, Pedro Juan and Ramírez-Manent, José Ignacio},
journal = {Metabolites},
keywords = {grapp-caib},
month = {may},
number = 5,
pages = 343,
title = {Association Between Bioimpedance-Determined Metabolic Age and MASLD Risk Scores in Spanish Workers},
volume = 15,
year = 2025
}%0 Journal Article
%1 ramirez-gallegos_association_2025
%A Ramírez-Gallegos, Ignacio
%A Busquets-Cortes, Carla
%A Paublini, Hernán
%A López-González, Ángel Arturo
%A Martínez-Almoyna-Rifá, Emilio
%A Tárraga López, Pedro Juan
%A Ramírez-Manent, José Ignacio
%D 2025
%J Metabolites
%N 5
%P 343
%R 10.3390/metabo15050343
%T Association Between Bioimpedance-Determined Metabolic Age and MASLD Risk Scores in Spanish Workers
%U https://pmc.ncbi.nlm.nih.gov/articles/PMC12113834/
%V 15
%X Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a prevalent liver disorder with significant metabolic implications. Metabolic age, determined through bioimpedance analysis, has emerged as a potential indicator of overall metabolic health. The objective of this study is to evaluate the association between metabolic age and MASLD risk scores in a cohort of Spanish workers. Methods: A cross-sectional study was conducted on 8590 Spanish workers who underwent annual occupational health examinations between 2019 and 2020. Metabolic age was determined using bioelectrical impedance analysis, and the Avoidable Lost Life Years (ALLY) index was calculated as the difference between their metabolic and chronological age. MASLD risk was assessed using various validated scales, including the Fatty Liver Index (FLI), Hepatic Steatosis Index (HSI), Zhejiang University Index (ZJU), Fatty Liver Disease Index (FLD), and Lipid Accumulation Product (LAP). A multinomial logistic regression analysis was performed to examine the association between metabolic age and MASLD risk scores, adjusting for sociodemographic and lifestyle variables. Results: Higher metabolic age values were observed in individuals with greater MASLD risk across all evaluated scales. The mean metabolic age was consistently lower in women compared to men, and these differences were statistically significant (p \textless 0.01). Multinomial logistic regression analysis revealed that the strongest associations with increased metabolic age were found for MASLD risk scores, physical inactivity, and poor adherence to the Mediterranean diet. ROC curve analysis demonstrated a high predictive capacity for the FLD (AUC: 0.935 in women and 0.917 in men) and FLI (AUC: 0.900 in women and 0.833 in men), with high Youden index values. Conclusions: Metabolic age is significantly associated with MASLD risk, suggesting its potential as a non-invasive biomarker for identifying individuals with a higher risk for metabolic liver disease. Lifestyle factors, including physical activity and dietary patterns, play a crucial role in modulating metabolic age, highlighting the importance of targeted interventions for MASLD prevention. Further research is warranted to validate metabolic age as a prognostic tool in MASLD risk assessment. -
AbstractURLBibTeXEndNoteDOIBibSonomy1.Zamanillo-Campos R, Colom-Rossello M, Rodríguez-Calero MA, Martín MI, Planas T, Núñez-Jiménez C, Ramos M. Key components of effective non-pharmacological interventions for childhood obesity: a review considering social determinants of health. European journal of pediatrics [Internet]. Germany; 2025 Jun.;184(7):449-. https://pubmed.ncbi.nlm.nih.gov/40563002Childhood obesity, driven by an obesogenic environment, remains a public health priority. To review the effectiveness of non-pharmacological interventions for treating childhood obesity, with a focus on weight reduction and consideration of social determinants of health (SDOH). The review included randomized and quasi-experimental studies, published between August 2016 and December 2021, that evaluated the effectiveness of interventions aimed at reducing body weight in children aged 2 to 14 years with obesity. (PROSPERO ID: CRD42022301191). A total of 59 interventions were identified, showing wide variability in design, duration, components and settings. Most included physical activity (93%) and nutrition (81%), while fewer incorporated psychological support (46%) or digital tools (25%). Despite the diversity of approaches, 56% of the interventions were effective, particularly those implemented in healthcare or school settings, involving physical activity, and delivered by multidisciplinary teams. However, only six demonstrated sustained effects beyond 6 months. Risk of bias was high in over half of the studies, and only a small proportion (22%) reported participants' social characteristics such as family structure, race, or socioeconomic status. Importantly, very few interventions were designed or evaluated with explicit consideration of SDOH. CONCLUSION: Overall, effective interventions tended to target both children and parents, include multiple components-especially physical activity-and be delivered in accessible settings such as schools or primary care. Yet, the generalizability of findings is limited, as most studies involved children from relatively advantaged backgrounds. Future interventions should integrate SDOH in both design and evaluation to ensure equity and long-term effectiveness in diverse populations. WHAT IS KNOWN: • Childhood obesity remains a critical public health issue, heavily influenced by obesogenic environments and social determinants of health (SDOH). • Non-pharmacological interventions, particularly those incorporating physical activity and nutritional guidance, have been commonly used to address childhood obesity, though with varying degrees of success. WHAT IS NEW: • This review highlights that interventions delivered in healthcare or school settings by multidisciplinary teams, and involving both physical activity and parental engagement, show higher effectiveness in reducing childhood obesity. • The study identifies a significant gap in the integration of social determinants of health in both the design and evaluation of interventions, limiting their long-term impact and equity across diverse populations.
@article{zamanillocampos2025components,
abstract = {Childhood obesity, driven by an obesogenic environment, remains a public health priority. To review the effectiveness of non-pharmacological interventions for treating childhood obesity, with a focus on weight reduction and consideration of social determinants of health (SDOH). The review included randomized and quasi-experimental studies, published between August 2016 and December 2021, that evaluated the effectiveness of interventions aimed at reducing body weight in children aged 2 to 14 years with obesity. (PROSPERO ID: CRD42022301191). A total of 59 interventions were identified, showing wide variability in design, duration, components and settings. Most included physical activity (93%) and nutrition (81%), while fewer incorporated psychological support (46%) or digital tools (25%). Despite the diversity of approaches, 56% of the interventions were effective, particularly those implemented in healthcare or school settings, involving physical activity, and delivered by multidisciplinary teams. However, only six demonstrated sustained effects beyond 6 months. Risk of bias was high in over half of the studies, and only a small proportion (22%) reported participants' social characteristics such as family structure, race, or socioeconomic status. Importantly, very few interventions were designed or evaluated with explicit consideration of SDOH. CONCLUSION: Overall, effective interventions tended to target both children and parents, include multiple components-especially physical activity-and be delivered in accessible settings such as schools or primary care. Yet, the generalizability of findings is limited, as most studies involved children from relatively advantaged backgrounds. Future interventions should integrate SDOH in both design and evaluation to ensure equity and long-term effectiveness in diverse populations. WHAT IS KNOWN: • Childhood obesity remains a critical public health issue, heavily influenced by obesogenic environments and social determinants of health (SDOH). • Non-pharmacological interventions, particularly those incorporating physical activity and nutritional guidance, have been commonly used to address childhood obesity, though with varying degrees of success. WHAT IS NEW: • This review highlights that interventions delivered in healthcare or school settings by multidisciplinary teams, and involving both physical activity and parental engagement, show higher effectiveness in reducing childhood obesity. • The study identifies a significant gap in the integration of social determinants of health in both the design and evaluation of interventions, limiting their long-term impact and equity across diverse populations.},
address = {Germany},
author = {Zamanillo-Campos, R and Colom-Rossello, M and Rodríguez-Calero, M A and Martín, M I and Planas, T and Núñez-Jiménez, C and Ramos, M},
journal = {European journal of pediatrics},
keywords = {evisap},
month = {jun},
number = 7,
pages = {449--449},
title = {Key components of effective non-pharmacological interventions for childhood obesity: a review considering social determinants of health},
volume = 184,
year = 2025
}%0 Journal Article
%1 zamanillocampos2025components
%A Zamanillo-Campos, R
%A Colom-Rossello, M
%A Rodríguez-Calero, M A
%A Martín, M I
%A Planas, T
%A Núñez-Jiménez, C
%A Ramos, M
%C Germany
%D 2025
%J European journal of pediatrics
%N 7
%P 449--449
%R 10.1007/s00431-025-06279-2
%T Key components of effective non-pharmacological interventions for childhood obesity: a review considering social determinants of health
%U https://pubmed.ncbi.nlm.nih.gov/40563002
%V 184
%X Childhood obesity, driven by an obesogenic environment, remains a public health priority. To review the effectiveness of non-pharmacological interventions for treating childhood obesity, with a focus on weight reduction and consideration of social determinants of health (SDOH). The review included randomized and quasi-experimental studies, published between August 2016 and December 2021, that evaluated the effectiveness of interventions aimed at reducing body weight in children aged 2 to 14 years with obesity. (PROSPERO ID: CRD42022301191). A total of 59 interventions were identified, showing wide variability in design, duration, components and settings. Most included physical activity (93%) and nutrition (81%), while fewer incorporated psychological support (46%) or digital tools (25%). Despite the diversity of approaches, 56% of the interventions were effective, particularly those implemented in healthcare or school settings, involving physical activity, and delivered by multidisciplinary teams. However, only six demonstrated sustained effects beyond 6 months. Risk of bias was high in over half of the studies, and only a small proportion (22%) reported participants' social characteristics such as family structure, race, or socioeconomic status. Importantly, very few interventions were designed or evaluated with explicit consideration of SDOH. CONCLUSION: Overall, effective interventions tended to target both children and parents, include multiple components-especially physical activity-and be delivered in accessible settings such as schools or primary care. Yet, the generalizability of findings is limited, as most studies involved children from relatively advantaged backgrounds. Future interventions should integrate SDOH in both design and evaluation to ensure equity and long-term effectiveness in diverse populations. WHAT IS KNOWN: • Childhood obesity remains a critical public health issue, heavily influenced by obesogenic environments and social determinants of health (SDOH). • Non-pharmacological interventions, particularly those incorporating physical activity and nutritional guidance, have been commonly used to address childhood obesity, though with varying degrees of success. WHAT IS NEW: • This review highlights that interventions delivered in healthcare or school settings by multidisciplinary teams, and involving both physical activity and parental engagement, show higher effectiveness in reducing childhood obesity. • The study identifies a significant gap in the integration of social determinants of health in both the design and evaluation of interventions, limiting their long-term impact and equity across diverse populations. - AbstractURLBibTeXEndNoteDOIBibSonomyDownload1.Bennasar-Veny M, Abbate M, Colom-Rosselló M, Capitán-Moyano L, Hernández-Bermúdez IC, Ricci-Cabello I, Yañez AM, Fernandez ME, investigators A. Impact of an adapted diabetes prevention program in a spanish primary care setting: protocol for a type II hybrid effectiveness-implementation cluster-randomized trial (ALADIM). Implementation science : IS [Internet]. England; 2025 Jun.;20(1):27-. https://pubmed.ncbi.nlm.nih.gov/40457444BACKGROUND: Type 2 diabetes (T2D) is a global health concern affecting 10.5% of the adult population and is projected to rise significantly in the coming decades. Lifestyle modification programs, such as the Diabetes Prevention Program (DPP), can effectively reduce T2D risk among individuals with prediabetes. However, their implementation in real-world healthcare settings remains poor, particularly in Spain, where T2D prevalence is the highest in Europe. The ALADIM study aims to evaluate the effectiveness and implementation of an adapted DPP in Spanish Primary Care Centers (PCCs). The primary effectiveness outcome is weight, the co-primary implementation outcome is implementation fidelity. We will also assess the effect of DPP implementation on overall prediabetes management within the PCCs (spillover) by measuring the percentage of people with prediabetes receiving lifestyle advice. METHODS: The ALADIM trial is a hybrid type II effectiveness-implementation cluster-randomized controlled trial involving 10 PCCs of Mallorca (Balearic Islands, Spain). PCCs will be randomized to the intervention (5 PCCs) or control (5 PCCs) group in a 1:1 ratio. The intervention group will receive training and materials to implement and deliver the adapted DPP over 12 months. The control group will continue providing usual care. The DPP will be culturally adapted using the Intervention Mapping-ADAPT (IM-ADAPT) approach. The implementation strategy will be designed using Implementation Mapping. Measures of effectiveness will be assessed at the participant level at baseline, 6 and 12 months during the intervention period, and 18 months after baseline. Implementation outcomes will be assessed at the PCC level at multiple time-points throughout the study period. Spillover will be assessed at PCC level at months -1, 6 and 18. An intention-to-treat analysis will assess effectiveness and spillover effect using generalized estimating equations. Implementation outcomes will be evaluated using a mixed-methods approach. DISCUSSION: The ALADIM study has the potential to address the gap between research and practice by employing implementation science for evaluation, adaptation and implementation of an evidence-based diabetes intervention. The findings will contribute to the development of a sustainable and scalable implementation strategy for T2D prevention, with potential implications for policy and practice at regional and national levels. TRIAL REGISTRATION: ClinicalTrials.gov, NCT06871059. Registered 10 March 2025, https://clinicaltrials.gov/study/NCT06871059.
@article{bennasarveny2025impact,
abstract = {BACKGROUND: Type 2 diabetes (T2D) is a global health concern affecting 10.5% of the adult population and is projected to rise significantly in the coming decades. Lifestyle modification programs, such as the Diabetes Prevention Program (DPP), can effectively reduce T2D risk among individuals with prediabetes. However, their implementation in real-world healthcare settings remains poor, particularly in Spain, where T2D prevalence is the highest in Europe. The ALADIM study aims to evaluate the effectiveness and implementation of an adapted DPP in Spanish Primary Care Centers (PCCs). The primary effectiveness outcome is weight, the co-primary implementation outcome is implementation fidelity. We will also assess the effect of DPP implementation on overall prediabetes management within the PCCs (spillover) by measuring the percentage of people with prediabetes receiving lifestyle advice. METHODS: The ALADIM trial is a hybrid type II effectiveness-implementation cluster-randomized controlled trial involving 10 PCCs of Mallorca (Balearic Islands, Spain). PCCs will be randomized to the intervention (5 PCCs) or control (5 PCCs) group in a 1:1 ratio. The intervention group will receive training and materials to implement and deliver the adapted DPP over 12 months. The control group will continue providing usual care. The DPP will be culturally adapted using the Intervention Mapping-ADAPT (IM-ADAPT) approach. The implementation strategy will be designed using Implementation Mapping. Measures of effectiveness will be assessed at the participant level at baseline, 6 and 12 months during the intervention period, and 18 months after baseline. Implementation outcomes will be assessed at the PCC level at multiple time-points throughout the study period. Spillover will be assessed at PCC level at months -1, 6 and 18. An intention-to-treat analysis will assess effectiveness and spillover effect using generalized estimating equations. Implementation outcomes will be evaluated using a mixed-methods approach. DISCUSSION: The ALADIM study has the potential to address the gap between research and practice by employing implementation science for evaluation, adaptation and implementation of an evidence-based diabetes intervention. The findings will contribute to the development of a sustainable and scalable implementation strategy for T2D prevention, with potential implications for policy and practice at regional and national levels. TRIAL REGISTRATION: ClinicalTrials.gov, NCT06871059. Registered 10 March 2025, https://clinicaltrials.gov/study/NCT06871059.},
address = {England},
author = {Bennasar-Veny, Miquel and Abbate, Manuela and Colom-Rosselló, Miquel and Capitán-Moyano, Laura and Hernández-Bermúdez, Ivonne C and Ricci-Cabello, Ignacio and Yañez, Aina M and Fernandez, Maria E and investigators, ALADIM},
journal = {Implementation science : IS},
keywords = {evisap},
month = {jun},
number = 1,
pages = {27--27},
title = {Impact of an adapted diabetes prevention program in a spanish primary care setting: protocol for a type II hybrid effectiveness-implementation cluster-randomized trial (ALADIM)},
volume = 20,
year = 2025
}%0 Journal Article
%1 bennasarveny2025impact
%A Bennasar-Veny, Miquel
%A Abbate, Manuela
%A Colom-Rosselló, Miquel
%A Capitán-Moyano, Laura
%A Hernández-Bermúdez, Ivonne C
%A Ricci-Cabello, Ignacio
%A Yañez, Aina M
%A Fernandez, Maria E
%A investigators, ALADIM
%C England
%D 2025
%J Implementation science : IS
%N 1
%P 27--27
%R 10.1186/s13012-025-01438-3
%T Impact of an adapted diabetes prevention program in a spanish primary care setting: protocol for a type II hybrid effectiveness-implementation cluster-randomized trial (ALADIM)
%U https://pubmed.ncbi.nlm.nih.gov/40457444
%V 20
%X BACKGROUND: Type 2 diabetes (T2D) is a global health concern affecting 10.5% of the adult population and is projected to rise significantly in the coming decades. Lifestyle modification programs, such as the Diabetes Prevention Program (DPP), can effectively reduce T2D risk among individuals with prediabetes. However, their implementation in real-world healthcare settings remains poor, particularly in Spain, where T2D prevalence is the highest in Europe. The ALADIM study aims to evaluate the effectiveness and implementation of an adapted DPP in Spanish Primary Care Centers (PCCs). The primary effectiveness outcome is weight, the co-primary implementation outcome is implementation fidelity. We will also assess the effect of DPP implementation on overall prediabetes management within the PCCs (spillover) by measuring the percentage of people with prediabetes receiving lifestyle advice. METHODS: The ALADIM trial is a hybrid type II effectiveness-implementation cluster-randomized controlled trial involving 10 PCCs of Mallorca (Balearic Islands, Spain). PCCs will be randomized to the intervention (5 PCCs) or control (5 PCCs) group in a 1:1 ratio. The intervention group will receive training and materials to implement and deliver the adapted DPP over 12 months. The control group will continue providing usual care. The DPP will be culturally adapted using the Intervention Mapping-ADAPT (IM-ADAPT) approach. The implementation strategy will be designed using Implementation Mapping. Measures of effectiveness will be assessed at the participant level at baseline, 6 and 12 months during the intervention period, and 18 months after baseline. Implementation outcomes will be assessed at the PCC level at multiple time-points throughout the study period. Spillover will be assessed at PCC level at months -1, 6 and 18. An intention-to-treat analysis will assess effectiveness and spillover effect using generalized estimating equations. Implementation outcomes will be evaluated using a mixed-methods approach. DISCUSSION: The ALADIM study has the potential to address the gap between research and practice by employing implementation science for evaluation, adaptation and implementation of an evidence-based diabetes intervention. The findings will contribute to the development of a sustainable and scalable implementation strategy for T2D prevention, with potential implications for policy and practice at regional and national levels. TRIAL REGISTRATION: ClinicalTrials.gov, NCT06871059. Registered 10 March 2025, https://clinicaltrials.gov/study/NCT06871059. - AbstractURLBibTeXEndNoteDOIBibSonomyDownload1.Chaplin A, Wordsworth J, Prohens L, Obrador-Hevia A, Guillot M, Ricci-Cabello I, Sesé A, Romaguera D. Validation and pilot feasibility study of a novel screener to assess diet, lifestyle and mental health in people living with and beyond cancer: Study protocols. PloS one [Internet]. United States; 2025 Jun.;20(6):e0323671-e0323671. https://pubmed.ncbi.nlm.nih.gov/40472046BACKGROUND AND AIM: Current clinical care may not address behavioural and psychosocial elements which can influence quality of life (QoL) and recurrence risk of people living with and beyond cancer (PLWBC). There is a lack of validated tools to assess diet, lifestyle and mental health in PLWBC. We have developed a screener to identify individuals who may need further support beyond cancer recurrence. The aim is two-fold: 1) validate the screener in PLWBC; and 2) carry out a pilot feasibility study (PFS) to explore the impact of a lifestyle complex intervention (diet, physical activity and mental health components) on the QoL of PLWBC. METHODS: The study will be carried out at the University Hospital Son Espases (Spain) in PLWBC. A face validity study (n = 15) will assess construct interpretation, completion time, and acquiescence of the screener. For construct validity and reproducibility analysis (n = 100), participants will answer the screener together with validated diet, lifestyle, and mental health questionnaires for comparison. Body composition, physical activity, strength and cortisol levels will be assessed using validated instruments. All participants will answer the screener 7-10 days later for reproducibility analysis. Participants will then be randomized (1:1) to the Low Intervention (LI) or the High Intervention (HI) for the PFS study. LI will receive general advice regarding diet, lifestyle and mental health, and HI will receive individual and group sessions with specialised health professionals. Participants will be followed for three months. Primary outcomes include: 1) validity and reproducibility of the screener; and 2) feasibility of a complex intervention to improve QoL of PLWBC. Secondary outcomes include changes in screener answers and body composition. DISCUSSION: A validated screener which detects PLWBC's needs could be used in follow-up care plans. The PFS will inform on the recruitment of participants and identify potential shortfalls of the design and efficacy. TRIAL REGISTRATION: ClinicalTrials.gov NCT06582498.
@article{chaplin2025validation,
abstract = {BACKGROUND AND AIM: Current clinical care may not address behavioural and psychosocial elements which can influence quality of life (QoL) and recurrence risk of people living with and beyond cancer (PLWBC). There is a lack of validated tools to assess diet, lifestyle and mental health in PLWBC. We have developed a screener to identify individuals who may need further support beyond cancer recurrence. The aim is two-fold: 1) validate the screener in PLWBC; and 2) carry out a pilot feasibility study (PFS) to explore the impact of a lifestyle complex intervention (diet, physical activity and mental health components) on the QoL of PLWBC. METHODS: The study will be carried out at the University Hospital Son Espases (Spain) in PLWBC. A face validity study (n = 15) will assess construct interpretation, completion time, and acquiescence of the screener. For construct validity and reproducibility analysis (n = 100), participants will answer the screener together with validated diet, lifestyle, and mental health questionnaires for comparison. Body composition, physical activity, strength and cortisol levels will be assessed using validated instruments. All participants will answer the screener 7-10 days later for reproducibility analysis. Participants will then be randomized (1:1) to the Low Intervention (LI) or the High Intervention (HI) for the PFS study. LI will receive general advice regarding diet, lifestyle and mental health, and HI will receive individual and group sessions with specialised health professionals. Participants will be followed for three months. Primary outcomes include: 1) validity and reproducibility of the screener; and 2) feasibility of a complex intervention to improve QoL of PLWBC. Secondary outcomes include changes in screener answers and body composition. DISCUSSION: A validated screener which detects PLWBC's needs could be used in follow-up care plans. The PFS will inform on the recruitment of participants and identify potential shortfalls of the design and efficacy. TRIAL REGISTRATION: ClinicalTrials.gov NCT06582498.},
address = {United States},
author = {Chaplin, Alice and Wordsworth, Janna and Prohens, Lara and Obrador-Hevia, Antònia and Guillot, Monica and Ricci-Cabello, Ignacio and Sesé, Albert and Romaguera, Dora},
journal = {PloS one},
keywords = {evisap},
month = {jun},
number = 6,
pages = {e0323671--e0323671},
title = {Validation and pilot feasibility study of a novel screener to assess diet, lifestyle and mental health in people living with and beyond cancer: Study protocols},
volume = 20,
year = 2025
}%0 Journal Article
%1 chaplin2025validation
%A Chaplin, Alice
%A Wordsworth, Janna
%A Prohens, Lara
%A Obrador-Hevia, Antònia
%A Guillot, Monica
%A Ricci-Cabello, Ignacio
%A Sesé, Albert
%A Romaguera, Dora
%C United States
%D 2025
%J PloS one
%N 6
%P e0323671--e0323671
%R 10.1371/journal.pone.0323671
%T Validation and pilot feasibility study of a novel screener to assess diet, lifestyle and mental health in people living with and beyond cancer: Study protocols
%U https://pubmed.ncbi.nlm.nih.gov/40472046
%V 20
%X BACKGROUND AND AIM: Current clinical care may not address behavioural and psychosocial elements which can influence quality of life (QoL) and recurrence risk of people living with and beyond cancer (PLWBC). There is a lack of validated tools to assess diet, lifestyle and mental health in PLWBC. We have developed a screener to identify individuals who may need further support beyond cancer recurrence. The aim is two-fold: 1) validate the screener in PLWBC; and 2) carry out a pilot feasibility study (PFS) to explore the impact of a lifestyle complex intervention (diet, physical activity and mental health components) on the QoL of PLWBC. METHODS: The study will be carried out at the University Hospital Son Espases (Spain) in PLWBC. A face validity study (n = 15) will assess construct interpretation, completion time, and acquiescence of the screener. For construct validity and reproducibility analysis (n = 100), participants will answer the screener together with validated diet, lifestyle, and mental health questionnaires for comparison. Body composition, physical activity, strength and cortisol levels will be assessed using validated instruments. All participants will answer the screener 7-10 days later for reproducibility analysis. Participants will then be randomized (1:1) to the Low Intervention (LI) or the High Intervention (HI) for the PFS study. LI will receive general advice regarding diet, lifestyle and mental health, and HI will receive individual and group sessions with specialised health professionals. Participants will be followed for three months. Primary outcomes include: 1) validity and reproducibility of the screener; and 2) feasibility of a complex intervention to improve QoL of PLWBC. Secondary outcomes include changes in screener answers and body composition. DISCUSSION: A validated screener which detects PLWBC's needs could be used in follow-up care plans. The PFS will inform on the recruitment of participants and identify potential shortfalls of the design and efficacy. TRIAL REGISTRATION: ClinicalTrials.gov NCT06582498. - URLBibTeXEndNoteDOIBibSonomyDownload1.Marques-Cruz M, Perestrelo P, Chu AWL, Gil-Mata S, Riera-Serra P, Sousa-Pinto B. Comparison between two tools assessing the methodological quality of systematic reviews: ReMarQ and AMSTAR 2. Clinical and Public Health Guidelines [Internet]. 2025;2(2):e70021. https://onlinelibrary.wiley.com/doi/abs/10.1002/gin2.70021
@article{RN64,
author = {Marques-Cruz, Manuel and Perestrelo, Paula and Chu, Alexandro W. L. and Gil-Mata, Sara and Riera-Serra, Pau and Sousa-Pinto, Bernardo},
journal = {Clinical and Public Health Guidelines},
keywords = {evisap},
number = 2,
pages = {e70021},
title = {Comparison between two tools assessing the methodological quality of systematic reviews: ReMarQ and AMSTAR 2},
type = {Journal Article},
volume = 2,
year = 2025
}%0 Journal Article
%1 RN64
%A Marques-Cruz, Manuel
%A Perestrelo, Paula
%A Chu, Alexandro W. L.
%A Gil-Mata, Sara
%A Riera-Serra, Pau
%A Sousa-Pinto, Bernardo
%D 2025
%J Clinical and Public Health Guidelines
%N 2
%P e70021
%R https://doi.org/10.1002/gin2.70021
%T Comparison between two tools assessing the methodological quality of systematic reviews: ReMarQ and AMSTAR 2
%U https://onlinelibrary.wiley.com/doi/abs/10.1002/gin2.70021
%V 2 - AbstractURLBibTeXEndNoteDOIBibSonomyDownload1.Obrador de Hevia J, López-González Ángel A, Ramírez-Manent JI, Paublini H, Tárraga López PJ, Martorell Sánchez C, Riutord-Sbert P. Association Between Alcohol Consumption, Other Healthy Habits and Sociodemographic Variables and the Values of Different Insulin Resistance Risk Scales in 139,634 Spanish Workers. Healthcare (Basel, Switzerland) [Internet]. Switzerland; 2025 Apr.;13(8):921. https://pubmed.ncbi.nlm.nih.gov/40281870Background: Alcohol consumption is a major public health concern, influencing metabolic health and insulin resistance (IR). While moderate alcohol intake has been associated with potential metabolic benefits, excessive consumption is linked to IR and related disorders. This study examines the association between sociodemographic variables, health habits, and IR risk using validated metabolic indices. Methods: A dual-phase study was conducted, including a cross-sectional analysis of 139,634 Spanish workers and a retrospective longitudinal follow-up of 40,431 participants (2009-2019). Data on sociodemographic factors (age, sex and socioeconomic status) and health habits (smoking, alcohol consumption, diet and physical activity) were collected through standardized occupational health assessments. IR risk was assessed using the Triglyceride-Glucose Index (TyG), Metabolic Score for Insulin Resistance (METS-IR), and Single-Point Insulin Sensitivity Estimator (SPISE-IR). Binary logistic regression was used for statistical analysis. Results: Age, male sex, lower socioeconomic status, smoking, alcohol consumption, physical inactivity and low adherence to the Mediterranean diet were significantly associated with higher IR risk across all indices (p < 0.001). Alcohol consumption exhibited a dose-dependent relationship with IR, with excessive intake significantly increasing the risk of IR. Longitudinal data revealed a worsening IR profile over time, particularly among older, low-income and physically inactive individuals. Conclusions: Sociodemographic factors and lifestyle habits strongly influence IR. Preventive strategies focused on reducing alcohol consumption, smoking cessation and promoting physical activity and dietary improvements are essential to mitigate the risk of IR, especially in vulnerable populations. Further longitudinal studies are needed to establish causal relationships and refine intervention strategies.
@article{obradordehevia2025association,
abstract = {Background: Alcohol consumption is a major public health concern, influencing metabolic health and insulin resistance (IR). While moderate alcohol intake has been associated with potential metabolic benefits, excessive consumption is linked to IR and related disorders. This study examines the association between sociodemographic variables, health habits, and IR risk using validated metabolic indices. Methods: A dual-phase study was conducted, including a cross-sectional analysis of 139,634 Spanish workers and a retrospective longitudinal follow-up of 40,431 participants (2009-2019). Data on sociodemographic factors (age, sex and socioeconomic status) and health habits (smoking, alcohol consumption, diet and physical activity) were collected through standardized occupational health assessments. IR risk was assessed using the Triglyceride-Glucose Index (TyG), Metabolic Score for Insulin Resistance (METS-IR), and Single-Point Insulin Sensitivity Estimator (SPISE-IR). Binary logistic regression was used for statistical analysis. Results: Age, male sex, lower socioeconomic status, smoking, alcohol consumption, physical inactivity and low adherence to the Mediterranean diet were significantly associated with higher IR risk across all indices (p < 0.001). Alcohol consumption exhibited a dose-dependent relationship with IR, with excessive intake significantly increasing the risk of IR. Longitudinal data revealed a worsening IR profile over time, particularly among older, low-income and physically inactive individuals. Conclusions: Sociodemographic factors and lifestyle habits strongly influence IR. Preventive strategies focused on reducing alcohol consumption, smoking cessation and promoting physical activity and dietary improvements are essential to mitigate the risk of IR, especially in vulnerable populations. Further longitudinal studies are needed to establish causal relationships and refine intervention strategies.},
address = {Switzerland},
author = {Obrador de Hevia, Joan and López-González, Ángel Arturo and Ramírez-Manent, José Ignacio and Paublini, Hernán and Tárraga López, Pedro Juan and Martorell Sánchez, Cristina and Riutord-Sbert, Pere},
journal = {Healthcare (Basel, Switzerland)},
keywords = {grapp-caib},
month = {apr},
number = 8,
pages = 921,
title = {Association Between Alcohol Consumption, Other Healthy Habits and Sociodemographic Variables and the Values of Different Insulin Resistance Risk Scales in 139,634 Spanish Workers},
volume = 13,
year = 2025
}%0 Journal Article
%1 obradordehevia2025association
%A Obrador de Hevia, Joan
%A López-González, Ángel Arturo
%A Ramírez-Manent, José Ignacio
%A Paublini, Hernán
%A Tárraga López, Pedro Juan
%A Martorell Sánchez, Cristina
%A Riutord-Sbert, Pere
%C Switzerland
%D 2025
%J Healthcare (Basel, Switzerland)
%N 8
%P 921
%R 10.3390/healthcare13080921
%T Association Between Alcohol Consumption, Other Healthy Habits and Sociodemographic Variables and the Values of Different Insulin Resistance Risk Scales in 139,634 Spanish Workers
%U https://pubmed.ncbi.nlm.nih.gov/40281870
%V 13
%X Background: Alcohol consumption is a major public health concern, influencing metabolic health and insulin resistance (IR). While moderate alcohol intake has been associated with potential metabolic benefits, excessive consumption is linked to IR and related disorders. This study examines the association between sociodemographic variables, health habits, and IR risk using validated metabolic indices. Methods: A dual-phase study was conducted, including a cross-sectional analysis of 139,634 Spanish workers and a retrospective longitudinal follow-up of 40,431 participants (2009-2019). Data on sociodemographic factors (age, sex and socioeconomic status) and health habits (smoking, alcohol consumption, diet and physical activity) were collected through standardized occupational health assessments. IR risk was assessed using the Triglyceride-Glucose Index (TyG), Metabolic Score for Insulin Resistance (METS-IR), and Single-Point Insulin Sensitivity Estimator (SPISE-IR). Binary logistic regression was used for statistical analysis. Results: Age, male sex, lower socioeconomic status, smoking, alcohol consumption, physical inactivity and low adherence to the Mediterranean diet were significantly associated with higher IR risk across all indices (p < 0.001). Alcohol consumption exhibited a dose-dependent relationship with IR, with excessive intake significantly increasing the risk of IR. Longitudinal data revealed a worsening IR profile over time, particularly among older, low-income and physically inactive individuals. Conclusions: Sociodemographic factors and lifestyle habits strongly influence IR. Preventive strategies focused on reducing alcohol consumption, smoking cessation and promoting physical activity and dietary improvements are essential to mitigate the risk of IR, especially in vulnerable populations. Further longitudinal studies are needed to establish causal relationships and refine intervention strategies. - AbstractURLBibTeXEndNoteDOIBibSonomyDownload1.Marina Arroyo M, Ramírez Gallegos I, Paublini H, López-González Ángel A, Tárraga López PJ, Martorell Sánchez C, Sastre-Alzamora T, Ramírez-Manent JI. Usefulness of the Córdoba Equation for Estimating Body Fat When Determining the Level of Risk of Developing Diabetes Type 2 or Prediabetes. Medicina (Kaunas, Lithuania) [Internet]. Switzerland; 2025 Mar.;61(4):613-. https://pubmed.ncbi.nlm.nih.gov/40282904Background and Objectives: Type 2 diabetes (T2D) and prediabetes represent major global health concerns, with obesity being a key risk factor. However, recent evidence suggests that the adipose tissue composition and distribution play a more critical role in metabolic dysfunction than the total body weight or body mass index (BMI). This study evaluates the predictive capacity of the Córdoba Equation for Estimating Body Fat (ECORE-BF) for identifying individuals at high risk of developing T2D and prediabetes. Materials and Methods: A cross-sectional study was carried out involving 418,343 Spanish workers. Body fat percentage was estimated using the ECORE-BF equation, and diabetes risk was assessed using validated predictive models, including the Finnish Diabetes Risk Score (FINDRISC), QDiabetes score (QD-score), and others. The discriminatory power of ECORE-BF in predicting T2D and prediabetes was assessed using receiver operating characteristic (ROC) curve analysis. Results: ECORE-BF showed a strong correlation with high-risk classifications across all diabetes risk scales. The area under the ROC curve (AUC) exceeded 0.95 for both men and women, demonstrating high predictive accuracy. Conclusions: Adipose tissue distribution, particularly visceral adiposity, is a central factor in metabolic dysfunction. ECORE-BF provides a cost-effective alternative for large-scale T2D and prediabetes risk assessment. Future research should explore the impact of visceral adipose tissue reduction on diabetes prevention and the integration of estimation scales into clinical and public health strategies.
@article{marinaarroyo2025usefulness,
abstract = {Background and Objectives: Type 2 diabetes (T2D) and prediabetes represent major global health concerns, with obesity being a key risk factor. However, recent evidence suggests that the adipose tissue composition and distribution play a more critical role in metabolic dysfunction than the total body weight or body mass index (BMI). This study evaluates the predictive capacity of the Córdoba Equation for Estimating Body Fat (ECORE-BF) for identifying individuals at high risk of developing T2D and prediabetes. Materials and Methods: A cross-sectional study was carried out involving 418,343 Spanish workers. Body fat percentage was estimated using the ECORE-BF equation, and diabetes risk was assessed using validated predictive models, including the Finnish Diabetes Risk Score (FINDRISC), QDiabetes score (QD-score), and others. The discriminatory power of ECORE-BF in predicting T2D and prediabetes was assessed using receiver operating characteristic (ROC) curve analysis. Results: ECORE-BF showed a strong correlation with high-risk classifications across all diabetes risk scales. The area under the ROC curve (AUC) exceeded 0.95 for both men and women, demonstrating high predictive accuracy. Conclusions: Adipose tissue distribution, particularly visceral adiposity, is a central factor in metabolic dysfunction. ECORE-BF provides a cost-effective alternative for large-scale T2D and prediabetes risk assessment. Future research should explore the impact of visceral adipose tissue reduction on diabetes prevention and the integration of estimation scales into clinical and public health strategies.},
address = {Switzerland},
author = {Marina Arroyo, Marta and Ramírez Gallegos, Ignacio and Paublini, Hernán and López-González, Ángel Arturo and Tárraga López, Pedro J and Martorell Sánchez, Cristina and Sastre-Alzamora, Tomás and Ramírez-Manent, José Ignacio},
journal = {Medicina (Kaunas, Lithuania)},
keywords = {grapp-caib},
month = {mar},
number = 4,
pages = {613--},
title = {Usefulness of the Córdoba Equation for Estimating Body Fat When Determining the Level of Risk of Developing Diabetes Type 2 or Prediabetes},
volume = 61,
year = 2025
}%0 Journal Article
%1 marinaarroyo2025usefulness
%A Marina Arroyo, Marta
%A Ramírez Gallegos, Ignacio
%A Paublini, Hernán
%A López-González, Ángel Arturo
%A Tárraga López, Pedro J
%A Martorell Sánchez, Cristina
%A Sastre-Alzamora, Tomás
%A Ramírez-Manent, José Ignacio
%C Switzerland
%D 2025
%J Medicina (Kaunas, Lithuania)
%N 4
%P 613--
%R 10.3390/medicina61040613
%T Usefulness of the Córdoba Equation for Estimating Body Fat When Determining the Level of Risk of Developing Diabetes Type 2 or Prediabetes
%U https://pubmed.ncbi.nlm.nih.gov/40282904
%V 61
%X Background and Objectives: Type 2 diabetes (T2D) and prediabetes represent major global health concerns, with obesity being a key risk factor. However, recent evidence suggests that the adipose tissue composition and distribution play a more critical role in metabolic dysfunction than the total body weight or body mass index (BMI). This study evaluates the predictive capacity of the Córdoba Equation for Estimating Body Fat (ECORE-BF) for identifying individuals at high risk of developing T2D and prediabetes. Materials and Methods: A cross-sectional study was carried out involving 418,343 Spanish workers. Body fat percentage was estimated using the ECORE-BF equation, and diabetes risk was assessed using validated predictive models, including the Finnish Diabetes Risk Score (FINDRISC), QDiabetes score (QD-score), and others. The discriminatory power of ECORE-BF in predicting T2D and prediabetes was assessed using receiver operating characteristic (ROC) curve analysis. Results: ECORE-BF showed a strong correlation with high-risk classifications across all diabetes risk scales. The area under the ROC curve (AUC) exceeded 0.95 for both men and women, demonstrating high predictive accuracy. Conclusions: Adipose tissue distribution, particularly visceral adiposity, is a central factor in metabolic dysfunction. ECORE-BF provides a cost-effective alternative for large-scale T2D and prediabetes risk assessment. Future research should explore the impact of visceral adipose tissue reduction on diabetes prevention and the integration of estimation scales into clinical and public health strategies. - AbstractURLBibTeXEndNoteDOIBibSonomyDownload1.García Samuelsson M, Tárraga López PJ, López-González Ángel A, Paublini H, Martínez-Almoyna Rifá E, Ramírez-Manent JI. Assessment of the Risk of Insulin Resistance in Workers Classified as Metabolically Healthy Obese. Nutrients [Internet]. Switzerland; 2025 Apr.;17(8):1345-. https://pubmed.ncbi.nlm.nih.gov/40284209Introduction and Objectives: Obesity constitutes a significant public health concern and is frequently linked to metabolic dysfunctions, particularly insulin resistance (IR). Nevertheless, a subset of obese individuals, referred to as metabolically healthy obese (MHO), do not exhibit overt metabolic abnormalities. The present study aims to assess the risk of developing IR among MHO workers and to explore the determinants contributing to this risk. Methods: This cross-sectional investigation utilized data from a cohort of 68,884 obese workers across multiple occupational sectors in Spain. The classification of participants as MHO was based on the number of metabolic syndrome components, in accordance with the criteria established by the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATPIII). Anthropometric, clinical, and biochemical parameters-including body mass index (BMI), waist circumference, lipid profile, glycemic levels, and blood pressure-were systematically assessed. The likelihood of developing IR was estimated through various validated risk assessment models. Results: The analysis indicates that, despite having a relatively favorable metabolic profile, individuals classified as MHO also show signs of metabolic deterioration, such as an increased risk of insulin resistance. Key risk factors such as physical inactivity, low adherence to the Mediterranean diet, and socioeconomic disparities were identified as significant contributors to the transition from the MHO phenotype to a metabolically unhealthy state. Logistic regression analyses corroborated that insufficient physical activity and suboptimal dietary habits were strongly associated with an elevated risk of IR. Conclusions: The findings underscore the dynamic and potentially transient nature of the MHO phenotype, emphasizing the necessity of proactive monitoring and early preventive strategies. Encouraging physical activity, promoting adherence to a nutritionally balanced diet, and implementing workplace health initiatives emerge as critical measures to attenuate the risk of IR and metabolic deterioration in MHO individuals. Future longitudinal studies are warranted to enhance risk stratification and to formulate tailored preventive interventions.
@article{garciasamuelsson2025assessment,
abstract = {Introduction and Objectives: Obesity constitutes a significant public health concern and is frequently linked to metabolic dysfunctions, particularly insulin resistance (IR). Nevertheless, a subset of obese individuals, referred to as metabolically healthy obese (MHO), do not exhibit overt metabolic abnormalities. The present study aims to assess the risk of developing IR among MHO workers and to explore the determinants contributing to this risk. Methods: This cross-sectional investigation utilized data from a cohort of 68,884 obese workers across multiple occupational sectors in Spain. The classification of participants as MHO was based on the number of metabolic syndrome components, in accordance with the criteria established by the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATPIII). Anthropometric, clinical, and biochemical parameters-including body mass index (BMI), waist circumference, lipid profile, glycemic levels, and blood pressure-were systematically assessed. The likelihood of developing IR was estimated through various validated risk assessment models. Results: The analysis indicates that, despite having a relatively favorable metabolic profile, individuals classified as MHO also show signs of metabolic deterioration, such as an increased risk of insulin resistance. Key risk factors such as physical inactivity, low adherence to the Mediterranean diet, and socioeconomic disparities were identified as significant contributors to the transition from the MHO phenotype to a metabolically unhealthy state. Logistic regression analyses corroborated that insufficient physical activity and suboptimal dietary habits were strongly associated with an elevated risk of IR. Conclusions: The findings underscore the dynamic and potentially transient nature of the MHO phenotype, emphasizing the necessity of proactive monitoring and early preventive strategies. Encouraging physical activity, promoting adherence to a nutritionally balanced diet, and implementing workplace health initiatives emerge as critical measures to attenuate the risk of IR and metabolic deterioration in MHO individuals. Future longitudinal studies are warranted to enhance risk stratification and to formulate tailored preventive interventions.},
address = {Switzerland},
author = {García Samuelsson, Miguel and Tárraga López, Pedro Juan and López-González, Ángel Arturo and Paublini, Hernán and Martínez-Almoyna Rifá, Emilio and Ramírez-Manent, José Ignacio},
journal = {Nutrients},
keywords = {grapp-caib},
month = {apr},
number = 8,
pages = {1345--},
title = {Assessment of the Risk of Insulin Resistance in Workers Classified as Metabolically Healthy Obese},
volume = 17,
year = 2025
}%0 Journal Article
%1 garciasamuelsson2025assessment
%A García Samuelsson, Miguel
%A Tárraga López, Pedro Juan
%A López-González, Ángel Arturo
%A Paublini, Hernán
%A Martínez-Almoyna Rifá, Emilio
%A Ramírez-Manent, José Ignacio
%C Switzerland
%D 2025
%J Nutrients
%N 8
%P 1345--
%R 10.3390/nu17081345
%T Assessment of the Risk of Insulin Resistance in Workers Classified as Metabolically Healthy Obese
%U https://pubmed.ncbi.nlm.nih.gov/40284209
%V 17
%X Introduction and Objectives: Obesity constitutes a significant public health concern and is frequently linked to metabolic dysfunctions, particularly insulin resistance (IR). Nevertheless, a subset of obese individuals, referred to as metabolically healthy obese (MHO), do not exhibit overt metabolic abnormalities. The present study aims to assess the risk of developing IR among MHO workers and to explore the determinants contributing to this risk. Methods: This cross-sectional investigation utilized data from a cohort of 68,884 obese workers across multiple occupational sectors in Spain. The classification of participants as MHO was based on the number of metabolic syndrome components, in accordance with the criteria established by the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATPIII). Anthropometric, clinical, and biochemical parameters-including body mass index (BMI), waist circumference, lipid profile, glycemic levels, and blood pressure-were systematically assessed. The likelihood of developing IR was estimated through various validated risk assessment models. Results: The analysis indicates that, despite having a relatively favorable metabolic profile, individuals classified as MHO also show signs of metabolic deterioration, such as an increased risk of insulin resistance. Key risk factors such as physical inactivity, low adherence to the Mediterranean diet, and socioeconomic disparities were identified as significant contributors to the transition from the MHO phenotype to a metabolically unhealthy state. Logistic regression analyses corroborated that insufficient physical activity and suboptimal dietary habits were strongly associated with an elevated risk of IR. Conclusions: The findings underscore the dynamic and potentially transient nature of the MHO phenotype, emphasizing the necessity of proactive monitoring and early preventive strategies. Encouraging physical activity, promoting adherence to a nutritionally balanced diet, and implementing workplace health initiatives emerge as critical measures to attenuate the risk of IR and metabolic deterioration in MHO individuals. Future longitudinal studies are warranted to enhance risk stratification and to formulate tailored preventive interventions. -
AbstractURLBibTeXEndNoteDOIBibSonomy1.Paublini H, Arturo López-González Á, Tárraga López PJ, Martínez-Almoyna Rifá E, Vallejos D, Ignacio Ramírez-Manent J. [Usefullness of different scales of overweight and obesity to predict the presence of atherogenic dyslipidemia and lipid triad in 418,343 spanish workers]. Semergen [Internet]. 2025;51(4):102428. https://europepmc.org/article/med/39693830INTRODUCTION AND OBJECTIVES: Obesity and atherogenesis are two highly prevalent pathological processes that are closely related to the increase in cardiometabolic diseases. The aim of this study is to assess the relationship between obesity and two parameters that measure the risk of atherogenesis: atherogenic dyslipidaemia (AD) and the lipid triad (TL). MATERIAL AND METHODS: Descriptive and cross-sectional study in 418,343 Spanish workers in which the possible association between AD and TL with different scales of overweight and obesity such as body mass index (BMI), waist/height index, Clínica Universitaria de Navarra Body Adiposity Estimator (CUN BAE), relative fat mass (RFM), Palafolls and Deuremberg formulas, body surface index (BSI), normalized weight-adjusted index (NWAI) and body roundness index (BRI) was assessed. RESULTS: The values of all overweight-obesity scales are higher in people with AD and LBP and the prevalence of AD and LBP increases as the values of these overweight-obesity scales increase. The overweight-obesity scales that best predict the occurrence of AD are Deuremberg and CUN BAE (AUC 0.813 and 0.811 in men and 0.810 and 0.802 in women) while for TL they are also Deuremberg and CUN BAE (AUC 0.793 and 0.786 in men and 0.802 and 0.786 in women). CONCLUSIONS: The different scales that assess excess weight, especially those that predict body fat such as the Deuremberg formula and CUN BAE, are good predictors of AD and LD.
@article{paublini_usefullness_2025,
abstract = {INTRODUCTION AND OBJECTIVES: Obesity and atherogenesis are two highly prevalent pathological processes that are closely related to the increase in cardiometabolic diseases. The aim of this study is to assess the relationship between obesity and two parameters that measure the risk of atherogenesis: atherogenic dyslipidaemia (AD) and the lipid triad (TL). MATERIAL AND METHODS: Descriptive and cross-sectional study in 418,343 Spanish workers in which the possible association between AD and TL with different scales of overweight and obesity such as body mass index (BMI), waist/height index, Clínica Universitaria de Navarra Body Adiposity Estimator (CUN BAE), relative fat mass (RFM), Palafolls and Deuremberg formulas, body surface index (BSI), normalized weight-adjusted index (NWAI) and body roundness index (BRI) was assessed. RESULTS: The values of all overweight-obesity scales are higher in people with AD and LBP and the prevalence of AD and LBP increases as the values of these overweight-obesity scales increase. The overweight-obesity scales that best predict the occurrence of AD are Deuremberg and CUN BAE (AUC 0.813 and 0.811 in men and 0.810 and 0.802 in women) while for TL they are also Deuremberg and CUN BAE (AUC 0.793 and 0.786 in men and 0.802 and 0.786 in women). CONCLUSIONS: The different scales that assess excess weight, especially those that predict body fat such as the Deuremberg formula and CUN BAE, are good predictors of AD and LD.},
author = {Paublini, H. and Arturo López-González, Á and Tárraga López, P. J. and Martínez-Almoyna Rifá, E. and Vallejos, D. and Ignacio Ramírez-Manent, J.},
journal = {Semergen},
keywords = {grapp-caib},
number = 4,
pages = 102428,
title = {[Usefullness of different scales of overweight and obesity to predict the presence of atherogenic dyslipidemia and lipid triad in 418,343 spanish workers]},
volume = 51,
year = 2025
}%0 Journal Article
%1 paublini_usefullness_2025
%A Paublini, H.
%A Arturo López-González, Á
%A Tárraga López, P. J.
%A Martínez-Almoyna Rifá, E.
%A Vallejos, D.
%A Ignacio Ramírez-Manent, J.
%D 2025
%J Semergen
%N 4
%P 102428
%R 10.1016/j.semerg.2024.102428
%T [Usefullness of different scales of overweight and obesity to predict the presence of atherogenic dyslipidemia and lipid triad in 418,343 spanish workers]
%U https://europepmc.org/article/med/39693830
%V 51
%X INTRODUCTION AND OBJECTIVES: Obesity and atherogenesis are two highly prevalent pathological processes that are closely related to the increase in cardiometabolic diseases. The aim of this study is to assess the relationship between obesity and two parameters that measure the risk of atherogenesis: atherogenic dyslipidaemia (AD) and the lipid triad (TL). MATERIAL AND METHODS: Descriptive and cross-sectional study in 418,343 Spanish workers in which the possible association between AD and TL with different scales of overweight and obesity such as body mass index (BMI), waist/height index, Clínica Universitaria de Navarra Body Adiposity Estimator (CUN BAE), relative fat mass (RFM), Palafolls and Deuremberg formulas, body surface index (BSI), normalized weight-adjusted index (NWAI) and body roundness index (BRI) was assessed. RESULTS: The values of all overweight-obesity scales are higher in people with AD and LBP and the prevalence of AD and LBP increases as the values of these overweight-obesity scales increase. The overweight-obesity scales that best predict the occurrence of AD are Deuremberg and CUN BAE (AUC 0.813 and 0.811 in men and 0.810 and 0.802 in women) while for TL they are also Deuremberg and CUN BAE (AUC 0.793 and 0.786 in men and 0.802 and 0.786 in women). CONCLUSIONS: The different scales that assess excess weight, especially those that predict body fat such as the Deuremberg formula and CUN BAE, are good predictors of AD and LD. - AbstractURLBibTeXEndNoteDOIBibSonomyDownload1.Hernáez Álvaro, Camps-Vilaró A, Polo-Alonso S, Subirana I, Ramos R, de Cid R, Rodríguez-Artalejo F, Elosua R, Chirlaque MD, Amiano P, Bermúdez-López M, Guevara M, Cinza-Sanjurjo S, Sánchez M-J, de León AC, Laclaustra M, Rojo-Martínez G, Guembe-Suescun MJ, Pérez-Gómez B, Vega-Alonso T, Torán-Monserrat P, Lora-Pablos D, Huerta JM, Valdivielso JM, Dégano IR, Félix-Redondo FJ, Gandarillas AM, Valdés S, Mundet-Tuduri X, Sánchez PL, Martín-Sánchez V, Rigo F, Alonso-Sampedro M, Moreno-Iribas C, Martín-Escudero JC, Delgado E, Grau M, Urrutia I, Ovejero D, Quintela I, Martí-Lluch R, Blay N, Banegas JR, Tizón-Marcos H, Gómez JH, Aizpurua A, Castro-Boqué E, Delfrade J, Prieto-Díaz M Ángel, Rodríguez-Barranco M, Almeida-González D, Moreno-Franco B, Oualla-Bachiri W, Sayón-Orea C, Plans-Beriso E, Lozano JE, López-Lifante VM, Cancelas-Navia P, Cabrera-Castro N, Cambray S, Zacarías-Pons L, Fernández-Bergés D, Donoso-Navarro E, Maldonado-Araque C, Franch-Nadal J, Dorado-Díaz PI, Villarín-Castro A, Frontera-Juan G, Gude F, Andueza N, Téllez-Plaza M, Ares-Blanco J, Cruz R, Ribas-Aulinas M, Barretina J, Guallar-Castillón P, Caínzos-Achirica M, Colorado-Yohar SM, Llorente A, Diaz-Tocados JM, Ardanaz E, Micó-Pérez RM, Fernandez-Martinez NF, del Cristo Rodríguez-Pérez M, Cenarro A, Calle-Pascual AL, Marrugat J. Cohort profile: the CORDELIA study (Collaborative cOhorts Reassembled Data to study mEchanisms and Longterm Incidence of chronic diseAses). European Journal of Epidemiology [Internet]. 2025;40(5):581-99. https://pmc.ncbi.nlm.nih.gov/articles/PMC12170779/The CORDELIA Study (Collaborative Cohorts Reassembled Data to Study Mechanisms and Long-term Incidence of Chronic Diseases) combines 35 Spanish population cohorts to investigate the clinical, environmental, genetic, and omics determinants of cardiovascular disease in the Southern European population. It aims to conduct the largest genome-wide association study to date on cardiovascular disease in this population, improve predictions of cardiovascular incidence using genomic and clinical data, and identify subgroups that would benefit most from targeted pharmacological and lifestyle interventions. CORDELIA includes 196,632 individuals (ages 18–84, 54\% female, 96\% born in Spain, 20\% with higher education, recruited from 1989 to 2020, with follow-up periods ranging from 5 to 30 years), with DNA samples available for 117,342 participants (60\%). Of the participants, 24% were current smokers, 43% hypertensive, 11% diabetic, 15% medicated with lipid-lowering drugs, 44% overweight, and 27% obese. If not already available, genotyping is being performed using the Axiom™ Spain Biobank array (\textasciitilde 750,000 variants, including 115,000 specific and 50,000 rare functional variants from the Spanish population). The cohort also includes incident events (coronary heart disease, stroke, heart failure, peripheral artery disease, hypertension, diabetes); date and cause of death; and harmonized data on risk factors (body mass index, waist circumference, lipid profile, blood pressure, glucose, creatinine), lifestyle (smoking, physical activity, diet, alcohol), and socioeconomic status. 99,019 participants (50\%) also provide plasma samples. CORDELIA will significantly contribute to understanding the complex interplay of risk factors contributing to cardiovascular disease and advance the fields of precision medicine and public health in Southern European individuals.
@article{hernaez_cohort_2025,
abstract = {The CORDELIA Study (Collaborative Cohorts Reassembled Data to Study Mechanisms and Long-term Incidence of Chronic Diseases) combines 35 Spanish population cohorts to investigate the clinical, environmental, genetic, and omics determinants of cardiovascular disease in the Southern European population. It aims to conduct the largest genome-wide association study to date on cardiovascular disease in this population, improve predictions of cardiovascular incidence using genomic and clinical data, and identify subgroups that would benefit most from targeted pharmacological and lifestyle interventions. CORDELIA includes 196,632 individuals (ages 18–84, 54\% female, 96\% born in Spain, 20\% with higher education, recruited from 1989 to 2020, with follow-up periods ranging from 5 to 30 years), with DNA samples available for 117,342 participants (60\%). Of the participants, 24% were current smokers, 43% hypertensive, 11% diabetic, 15% medicated with lipid-lowering drugs, 44% overweight, and 27% obese. If not already available, genotyping is being performed using the Axiom™ Spain Biobank array (\textasciitilde 750,000 variants, including 115,000 specific and 50,000 rare functional variants from the Spanish population). The cohort also includes incident events (coronary heart disease, stroke, heart failure, peripheral artery disease, hypertension, diabetes); date and cause of death; and harmonized data on risk factors (body mass index, waist circumference, lipid profile, blood pressure, glucose, creatinine), lifestyle (smoking, physical activity, diet, alcohol), and socioeconomic status. 99,019 participants (50\%) also provide plasma samples. CORDELIA will significantly contribute to understanding the complex interplay of risk factors contributing to cardiovascular disease and advance the fields of precision medicine and public health in Southern European individuals.},
author = {Hernáez, Álvaro and Camps-Vilaró, Anna and Polo-Alonso, Sara and Subirana, Isaac and Ramos, Rafel and de Cid, Rafael and Rodríguez-Artalejo, Fernando and Elosua, Roberto and Chirlaque, M. Dolores and Amiano, Pilar and Bermúdez-López, Marcelino and Guevara, Marcela and Cinza-Sanjurjo, Sergio and Sánchez, María-José and de León, Antonio Cabrera and Laclaustra, Martín and Rojo-Martínez, Gemma and Guembe-Suescun, María J. and Pérez-Gómez, Beatriz and Vega-Alonso, Tomás and Torán-Monserrat, Pere and Lora-Pablos, David and Huerta, José María and Valdivielso, José M. and Dégano, Irene R. and Félix-Redondo, Francisco J. and Gandarillas, Ana María and Valdés, Sergio and Mundet-Tuduri, Xavier and Sánchez, Pedro L. and Martín-Sánchez, Vicente and Rigo, Fernando and Alonso-Sampedro, Manuela and Moreno-Iribas, Conchi and Martín-Escudero, Juan Carlos and Delgado, Elías and Grau, Maria and Urrutia, Inés and Ovejero, Diana and Quintela, Inés and Martí-Lluch, Ruth and Blay, Natalia and Banegas, José R. and Tizón-Marcos, Helena and Gómez, Jesús Humberto and Aizpurua, Amaia and Castro-Boqué, Eva and Delfrade, Josu and Prieto-Díaz, Miguel Ángel and Rodríguez-Barranco, Miguel and Almeida-González, Delia and Moreno-Franco, Belén and Oualla-Bachiri, Wasima and Sayón-Orea, Carmen and Plans-Beriso, Elena and Lozano, José Eugenio and López-Lifante, Víctor M. and Cancelas-Navia, Pilar and Cabrera-Castro, Natalia and Cambray, Serafí and Zacarías-Pons, Lluís and Fernández-Bergés, Daniel and Donoso-Navarro, Encarnación and Maldonado-Araque, Cristina and Franch-Nadal, Josep and Dorado-Díaz, Pedro Ignacio and Villarín-Castro, Alejandro and Frontera-Juan, Guillem and Gude, Francisco and Andueza, Naroa and Téllez-Plaza, María and Ares-Blanco, Jessica and Cruz, Raquel and Ribas-Aulinas, Marc and Barretina, Jordi and Guallar-Castillón, Pilar and Caínzos-Achirica, Miguel and Colorado-Yohar, Sandra Milena and Llorente, Adrián and Diaz-Tocados, Juan Miguel and Ardanaz, Eva and Micó-Pérez, Rafael Manuel and Fernandez-Martinez, Nicolás Francisco and del Cristo Rodríguez-Pérez, María and Cenarro, Ana and Calle-Pascual, Alfonso L. and Marrugat, Jaume},
journal = {European Journal of Epidemiology},
keywords = {grapp-caib},
number = 5,
pages = {581--599},
title = {Cohort profile: the CORDELIA study (Collaborative cOhorts Reassembled Data to study mEchanisms and Longterm Incidence of chronic diseAses)},
volume = 40,
year = 2025
}%0 Journal Article
%1 hernaez_cohort_2025
%A Hernáez, Álvaro
%A Camps-Vilaró, Anna
%A Polo-Alonso, Sara
%A Subirana, Isaac
%A Ramos, Rafel
%A de Cid, Rafael
%A Rodríguez-Artalejo, Fernando
%A Elosua, Roberto
%A Chirlaque, M. Dolores
%A Amiano, Pilar
%A Bermúdez-López, Marcelino
%A Guevara, Marcela
%A Cinza-Sanjurjo, Sergio
%A Sánchez, María-José
%A de León, Antonio Cabrera
%A Laclaustra, Martín
%A Rojo-Martínez, Gemma
%A Guembe-Suescun, María J.
%A Pérez-Gómez, Beatriz
%A Vega-Alonso, Tomás
%A Torán-Monserrat, Pere
%A Lora-Pablos, David
%A Huerta, José María
%A Valdivielso, José M.
%A Dégano, Irene R.
%A Félix-Redondo, Francisco J.
%A Gandarillas, Ana María
%A Valdés, Sergio
%A Mundet-Tuduri, Xavier
%A Sánchez, Pedro L.
%A Martín-Sánchez, Vicente
%A Rigo, Fernando
%A Alonso-Sampedro, Manuela
%A Moreno-Iribas, Conchi
%A Martín-Escudero, Juan Carlos
%A Delgado, Elías
%A Grau, Maria
%A Urrutia, Inés
%A Ovejero, Diana
%A Quintela, Inés
%A Martí-Lluch, Ruth
%A Blay, Natalia
%A Banegas, José R.
%A Tizón-Marcos, Helena
%A Gómez, Jesús Humberto
%A Aizpurua, Amaia
%A Castro-Boqué, Eva
%A Delfrade, Josu
%A Prieto-Díaz, Miguel Ángel
%A Rodríguez-Barranco, Miguel
%A Almeida-González, Delia
%A Moreno-Franco, Belén
%A Oualla-Bachiri, Wasima
%A Sayón-Orea, Carmen
%A Plans-Beriso, Elena
%A Lozano, José Eugenio
%A López-Lifante, Víctor M.
%A Cancelas-Navia, Pilar
%A Cabrera-Castro, Natalia
%A Cambray, Serafí
%A Zacarías-Pons, Lluís
%A Fernández-Bergés, Daniel
%A Donoso-Navarro, Encarnación
%A Maldonado-Araque, Cristina
%A Franch-Nadal, Josep
%A Dorado-Díaz, Pedro Ignacio
%A Villarín-Castro, Alejandro
%A Frontera-Juan, Guillem
%A Gude, Francisco
%A Andueza, Naroa
%A Téllez-Plaza, María
%A Ares-Blanco, Jessica
%A Cruz, Raquel
%A Ribas-Aulinas, Marc
%A Barretina, Jordi
%A Guallar-Castillón, Pilar
%A Caínzos-Achirica, Miguel
%A Colorado-Yohar, Sandra Milena
%A Llorente, Adrián
%A Diaz-Tocados, Juan Miguel
%A Ardanaz, Eva
%A Micó-Pérez, Rafael Manuel
%A Fernandez-Martinez, Nicolás Francisco
%A del Cristo Rodríguez-Pérez, María
%A Cenarro, Ana
%A Calle-Pascual, Alfonso L.
%A Marrugat, Jaume
%D 2025
%J European Journal of Epidemiology
%N 5
%P 581--599
%R 10.1007/s10654-025-01229-6
%T Cohort profile: the CORDELIA study (Collaborative cOhorts Reassembled Data to study mEchanisms and Longterm Incidence of chronic diseAses)
%U https://pmc.ncbi.nlm.nih.gov/articles/PMC12170779/
%V 40
%X The CORDELIA Study (Collaborative Cohorts Reassembled Data to Study Mechanisms and Long-term Incidence of Chronic Diseases) combines 35 Spanish population cohorts to investigate the clinical, environmental, genetic, and omics determinants of cardiovascular disease in the Southern European population. It aims to conduct the largest genome-wide association study to date on cardiovascular disease in this population, improve predictions of cardiovascular incidence using genomic and clinical data, and identify subgroups that would benefit most from targeted pharmacological and lifestyle interventions. CORDELIA includes 196,632 individuals (ages 18–84, 54\% female, 96\% born in Spain, 20\% with higher education, recruited from 1989 to 2020, with follow-up periods ranging from 5 to 30 years), with DNA samples available for 117,342 participants (60\%). Of the participants, 24% were current smokers, 43% hypertensive, 11% diabetic, 15% medicated with lipid-lowering drugs, 44% overweight, and 27% obese. If not already available, genotyping is being performed using the Axiom™ Spain Biobank array (\textasciitilde 750,000 variants, including 115,000 specific and 50,000 rare functional variants from the Spanish population). The cohort also includes incident events (coronary heart disease, stroke, heart failure, peripheral artery disease, hypertension, diabetes); date and cause of death; and harmonized data on risk factors (body mass index, waist circumference, lipid profile, blood pressure, glucose, creatinine), lifestyle (smoking, physical activity, diet, alcohol), and socioeconomic status. 99,019 participants (50\%) also provide plasma samples. CORDELIA will significantly contribute to understanding the complex interplay of risk factors contributing to cardiovascular disease and advance the fields of precision medicine and public health in Southern European individuals. - AbstractURLBibTeXEndNoteDOIBibSonomyDownload1.Riutord-Sbert P, Tárraga López PJ, López-González Ángel A, Coll Campayo I, Busquets-Cortés C, Ramírez Manent JI. Determinants of Atherogenic Dyslipidemia and Lipid Ratios: Associations with Sociodemographic Profile, Lifestyle, and Social Isolation in Spanish Workers. Journal of Clinical Medicine [Internet]. 2025 Jan.;14(19):7039. https://www.mdpi.com/2077-0383/14/19/7039Background: Atherogenic dyslipidemia is defined by the coexistence of high triglyceride concentrations, low levels of high-density lipoprotein cholesterol (HDL-C), and an excess of small, dense particles of low-density lipoprotein cholesterol (LDL-C). This lipid profile is strongly associated with an increased burden of cardiovascular disease and represents a leading cause of global morbidity and mortality. To better capture this risk, composite lipid ratios—including total cholesterol to HDL-C (TC/HDL-C), LDL-C to HDL-C (LDL-C/HDL-C), triglycerides to HDL-C (TG/HDL-C), and the atherogenic dyslipidemia index (AD)—have emerged as robust markers of cardiometabolic health, frequently demonstrating superior predictive capacity compared with isolated lipid measures. Despite extensive evidence linking these ratios to cardiovascular disease, few large-scale studies have examined their association with sociodemographic characteristics, lifestyle behaviors, and social isolation in working populations. Methods: We conducted a cross-sectional analysis of a large occupational cohort of Spanish workers evaluated between January 2021 and December 2024. Anthropometric, biochemical, and sociodemographic data were collected through standardized clinical protocols. Indices of atherogenic risk—namely the ratios TC/HDL-C, LDL-C/HDL-C, TG/HDL-C, and the atherogenic dyslipidemia index (AD)—were derived from fasting lipid measurements. The assessment of lifestyle factors included tobacco use, physical activity evaluated through the International Physical Activity Questionnaire (IPAQ), adherence to the Mediterranean dietary pattern using the MEDAS questionnaire, and perceived social isolation measured by the Lubben Social Network Scale. Socioeconomic classification was established following the criteria proposed by the Spanish Society of Epidemiology. Logistic regression models were fitted to identify factors independently associated with moderate-to-high risk for each lipid indicator, adjusting for potential confounders. Results: A total of 117,298 workers (71,384 men and 45,914 women) were included. Men showed significantly higher odds of elevated TG/HDL-C (OR 4.22, 95\% CI 3.70–4.75) and AD (OR 2.95, 95\% CI 2.70–3.21) compared with women, whereas LDL-C/HDL-C ratios were lower (OR 0.86, 95\% CI 0.83–0.89). Advancing age was positively associated with all lipid ratios, with the highest risk observed in participants aged 60–69 years. Lower social class, smoking, physical inactivity, poor adherence to the Mediterranean diet, and low social isolation scores were consistently linked to higher atherogenic risk. Physical inactivity showed the strongest associations across all indicators, with ORs ranging from 3.54 for TC/HDL-C to 7.12 for AD. Conclusions: Atherogenic dyslipidemia and elevated lipid ratios are strongly associated with male sex, older age, lower socioeconomic status, unhealthy lifestyle behaviors, and reduced social integration among Spanish workers. These findings highlight the importance of workplace-based cardiovascular risk screening and targeted prevention strategies, particularly in high-risk subgroups. Interventions to promote physical activity, healthy dietary patterns, and social connectedness may contribute to lowering atherogenic risk in occupational settings.
@article{riutord-sbert_determinants_2025,
abstract = {Background: Atherogenic dyslipidemia is defined by the coexistence of high triglyceride concentrations, low levels of high-density lipoprotein cholesterol (HDL-C), and an excess of small, dense particles of low-density lipoprotein cholesterol (LDL-C). This lipid profile is strongly associated with an increased burden of cardiovascular disease and represents a leading cause of global morbidity and mortality. To better capture this risk, composite lipid ratios—including total cholesterol to HDL-C (TC/HDL-C), LDL-C to HDL-C (LDL-C/HDL-C), triglycerides to HDL-C (TG/HDL-C), and the atherogenic dyslipidemia index (AD)—have emerged as robust markers of cardiometabolic health, frequently demonstrating superior predictive capacity compared with isolated lipid measures. Despite extensive evidence linking these ratios to cardiovascular disease, few large-scale studies have examined their association with sociodemographic characteristics, lifestyle behaviors, and social isolation in working populations. Methods: We conducted a cross-sectional analysis of a large occupational cohort of Spanish workers evaluated between January 2021 and December 2024. Anthropometric, biochemical, and sociodemographic data were collected through standardized clinical protocols. Indices of atherogenic risk—namely the ratios TC/HDL-C, LDL-C/HDL-C, TG/HDL-C, and the atherogenic dyslipidemia index (AD)—were derived from fasting lipid measurements. The assessment of lifestyle factors included tobacco use, physical activity evaluated through the International Physical Activity Questionnaire (IPAQ), adherence to the Mediterranean dietary pattern using the MEDAS questionnaire, and perceived social isolation measured by the Lubben Social Network Scale. Socioeconomic classification was established following the criteria proposed by the Spanish Society of Epidemiology. Logistic regression models were fitted to identify factors independently associated with moderate-to-high risk for each lipid indicator, adjusting for potential confounders. Results: A total of 117,298 workers (71,384 men and 45,914 women) were included. Men showed significantly higher odds of elevated TG/HDL-C (OR 4.22, 95\% CI 3.70–4.75) and AD (OR 2.95, 95\% CI 2.70–3.21) compared with women, whereas LDL-C/HDL-C ratios were lower (OR 0.86, 95\% CI 0.83–0.89). Advancing age was positively associated with all lipid ratios, with the highest risk observed in participants aged 60–69 years. Lower social class, smoking, physical inactivity, poor adherence to the Mediterranean diet, and low social isolation scores were consistently linked to higher atherogenic risk. Physical inactivity showed the strongest associations across all indicators, with ORs ranging from 3.54 for TC/HDL-C to 7.12 for AD. Conclusions: Atherogenic dyslipidemia and elevated lipid ratios are strongly associated with male sex, older age, lower socioeconomic status, unhealthy lifestyle behaviors, and reduced social integration among Spanish workers. These findings highlight the importance of workplace-based cardiovascular risk screening and targeted prevention strategies, particularly in high-risk subgroups. Interventions to promote physical activity, healthy dietary patterns, and social connectedness may contribute to lowering atherogenic risk in occupational settings.},
author = {Riutord-Sbert, Pere and Tárraga López, Pedro Juan and López-González, Ángel Arturo and Coll Campayo, Irene and Busquets-Cortés, Carla and Ramírez Manent, José Ignacio},
journal = {Journal of Clinical Medicine},
keywords = {grapp-caib},
month = {jan},
number = 19,
pages = 7039,
title = {Determinants of Atherogenic Dyslipidemia and Lipid Ratios: Associations with Sociodemographic Profile, Lifestyle, and Social Isolation in Spanish Workers},
volume = 14,
year = 2025
}%0 Journal Article
%1 riutord-sbert_determinants_2025
%A Riutord-Sbert, Pere
%A Tárraga López, Pedro Juan
%A López-González, Ángel Arturo
%A Coll Campayo, Irene
%A Busquets-Cortés, Carla
%A Ramírez Manent, José Ignacio
%D 2025
%J Journal of Clinical Medicine
%N 19
%P 7039
%R 10.3390/jcm14197039
%T Determinants of Atherogenic Dyslipidemia and Lipid Ratios: Associations with Sociodemographic Profile, Lifestyle, and Social Isolation in Spanish Workers
%U https://www.mdpi.com/2077-0383/14/19/7039
%V 14
%X Background: Atherogenic dyslipidemia is defined by the coexistence of high triglyceride concentrations, low levels of high-density lipoprotein cholesterol (HDL-C), and an excess of small, dense particles of low-density lipoprotein cholesterol (LDL-C). This lipid profile is strongly associated with an increased burden of cardiovascular disease and represents a leading cause of global morbidity and mortality. To better capture this risk, composite lipid ratios—including total cholesterol to HDL-C (TC/HDL-C), LDL-C to HDL-C (LDL-C/HDL-C), triglycerides to HDL-C (TG/HDL-C), and the atherogenic dyslipidemia index (AD)—have emerged as robust markers of cardiometabolic health, frequently demonstrating superior predictive capacity compared with isolated lipid measures. Despite extensive evidence linking these ratios to cardiovascular disease, few large-scale studies have examined their association with sociodemographic characteristics, lifestyle behaviors, and social isolation in working populations. Methods: We conducted a cross-sectional analysis of a large occupational cohort of Spanish workers evaluated between January 2021 and December 2024. Anthropometric, biochemical, and sociodemographic data were collected through standardized clinical protocols. Indices of atherogenic risk—namely the ratios TC/HDL-C, LDL-C/HDL-C, TG/HDL-C, and the atherogenic dyslipidemia index (AD)—were derived from fasting lipid measurements. The assessment of lifestyle factors included tobacco use, physical activity evaluated through the International Physical Activity Questionnaire (IPAQ), adherence to the Mediterranean dietary pattern using the MEDAS questionnaire, and perceived social isolation measured by the Lubben Social Network Scale. Socioeconomic classification was established following the criteria proposed by the Spanish Society of Epidemiology. Logistic regression models were fitted to identify factors independently associated with moderate-to-high risk for each lipid indicator, adjusting for potential confounders. Results: A total of 117,298 workers (71,384 men and 45,914 women) were included. Men showed significantly higher odds of elevated TG/HDL-C (OR 4.22, 95\% CI 3.70–4.75) and AD (OR 2.95, 95\% CI 2.70–3.21) compared with women, whereas LDL-C/HDL-C ratios were lower (OR 0.86, 95\% CI 0.83–0.89). Advancing age was positively associated with all lipid ratios, with the highest risk observed in participants aged 60–69 years. Lower social class, smoking, physical inactivity, poor adherence to the Mediterranean diet, and low social isolation scores were consistently linked to higher atherogenic risk. Physical inactivity showed the strongest associations across all indicators, with ORs ranging from 3.54 for TC/HDL-C to 7.12 for AD. Conclusions: Atherogenic dyslipidemia and elevated lipid ratios are strongly associated with male sex, older age, lower socioeconomic status, unhealthy lifestyle behaviors, and reduced social integration among Spanish workers. These findings highlight the importance of workplace-based cardiovascular risk screening and targeted prevention strategies, particularly in high-risk subgroups. Interventions to promote physical activity, healthy dietary patterns, and social connectedness may contribute to lowering atherogenic risk in occupational settings. - AbstractURLBibTeXEndNoteDOIBibSonomyDownload1.Tosoratto J, Tárraga López PJ, López-González Ángel A, Busquets-Cortes C, Obrador de Hevia J, Ramirez-Manent JI. Associations Between Shift Work, Sociodemographic and Lifestyle Characteristics, Body Measurements, and MASLD. Life [Internet]. 2025 Jun.;15(6):961. https://www.mdpi.com/2075-1729/15/6/961Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most prevalent chronic liver disorder worldwide and is closely linked to the components of metabolic syndrome. Shift work, through its disruption of circadian rhythms and the promotion of adverse behavioral patterns, has been proposed as a potential contributor to metabolic dysfunction and liver disease, yet evidence on its association with MASLD remains limited in large, heterogeneous occupational populations. Objectives: To investigate the association between shift work and MASLD risk using multiple validated non-invasive indices in a large sample of Spanish workers, and to explore the influence of sociodemographic characteristics, lifestyle behaviors, and sex on these associations. Methods: This cross-sectional study analyzed data from 53,053 employed adults across diverse sectors in Spain, including 31,753 men and 21,300 women. The participants underwent standardized occupational health assessments between 2019 and 2020. The MASLD risk was evaluated using seven indices: fatty liver index (FLI), hepatic steatosis index (HSI), ZJU index, fatty liver disease (FLD) index, Framingham steatosis index (FSI), lipid accumulation product (LAP), and BARD score. Sociodemographic, anthropometric, clinical, biochemical, and lifestyle data were collected. Multinomial logistic regression models were used to assess independent associations between shift work and high-risk MASLD scores. Results: Shift workers exhibited significantly higher mean values and prevalence of elevated MASLD scores across all indices compared to non-shift workers, in both sexes. In men, the prevalence of high BARD scores increased from 43.5% (non-shift) to 71.5% (shift), while in women it rose from 49.9% to 85.7%. Multivariate analysis confirmed that shift work was independently associated with an increased MASLD risk, particularly for HSI (OR: 7.83; 95\% CI: 7.40–8.26) and ZJU (OR: 5.91; 95\% CI: 5.60–6.22). Male sex, older age, smoking, and blue-collar status were also consistently associated with elevated risk scores. Conclusions: Shift work is significantly associated with an increased MASLD risk, independent of sociodemographic and lifestyle factors. Women and blue-collar workers may be especially vulnerable to the hepatic consequences of circadian disruption. These findings support the inclusion of liver health screening in occupational health programs and highlight the need for targeted interventions to reduce the MASLD risk among shift-working populations. Cross-sectional design limits causality; longitudinal studies are needed to confirm temporal relationships.
@article{tosoratto_associations_2025,
abstract = {Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most prevalent chronic liver disorder worldwide and is closely linked to the components of metabolic syndrome. Shift work, through its disruption of circadian rhythms and the promotion of adverse behavioral patterns, has been proposed as a potential contributor to metabolic dysfunction and liver disease, yet evidence on its association with MASLD remains limited in large, heterogeneous occupational populations. Objectives: To investigate the association between shift work and MASLD risk using multiple validated non-invasive indices in a large sample of Spanish workers, and to explore the influence of sociodemographic characteristics, lifestyle behaviors, and sex on these associations. Methods: This cross-sectional study analyzed data from 53,053 employed adults across diverse sectors in Spain, including 31,753 men and 21,300 women. The participants underwent standardized occupational health assessments between 2019 and 2020. The MASLD risk was evaluated using seven indices: fatty liver index (FLI), hepatic steatosis index (HSI), ZJU index, fatty liver disease (FLD) index, Framingham steatosis index (FSI), lipid accumulation product (LAP), and BARD score. Sociodemographic, anthropometric, clinical, biochemical, and lifestyle data were collected. Multinomial logistic regression models were used to assess independent associations between shift work and high-risk MASLD scores. Results: Shift workers exhibited significantly higher mean values and prevalence of elevated MASLD scores across all indices compared to non-shift workers, in both sexes. In men, the prevalence of high BARD scores increased from 43.5% (non-shift) to 71.5% (shift), while in women it rose from 49.9% to 85.7%. Multivariate analysis confirmed that shift work was independently associated with an increased MASLD risk, particularly for HSI (OR: 7.83; 95\% CI: 7.40–8.26) and ZJU (OR: 5.91; 95\% CI: 5.60–6.22). Male sex, older age, smoking, and blue-collar status were also consistently associated with elevated risk scores. Conclusions: Shift work is significantly associated with an increased MASLD risk, independent of sociodemographic and lifestyle factors. Women and blue-collar workers may be especially vulnerable to the hepatic consequences of circadian disruption. These findings support the inclusion of liver health screening in occupational health programs and highlight the need for targeted interventions to reduce the MASLD risk among shift-working populations. Cross-sectional design limits causality; longitudinal studies are needed to confirm temporal relationships.},
author = {Tosoratto, Javier and Tárraga López, Pedro Juan and López-González, Ángel Arturo and Busquets-Cortes, Carla and Obrador de Hevia, Joan and Ramirez-Manent, José Ignacio},
journal = {Life},
keywords = {grapp-caib},
month = {jun},
number = 6,
pages = 961,
title = {Associations Between Shift Work, Sociodemographic and Lifestyle Characteristics, Body Measurements, and MASLD},
volume = 15,
year = 2025
}%0 Journal Article
%1 tosoratto_associations_2025
%A Tosoratto, Javier
%A Tárraga López, Pedro Juan
%A López-González, Ángel Arturo
%A Busquets-Cortes, Carla
%A Obrador de Hevia, Joan
%A Ramirez-Manent, José Ignacio
%D 2025
%J Life
%N 6
%P 961
%R 10.3390/life15060961
%T Associations Between Shift Work, Sociodemographic and Lifestyle Characteristics, Body Measurements, and MASLD
%U https://www.mdpi.com/2075-1729/15/6/961
%V 15
%X Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most prevalent chronic liver disorder worldwide and is closely linked to the components of metabolic syndrome. Shift work, through its disruption of circadian rhythms and the promotion of adverse behavioral patterns, has been proposed as a potential contributor to metabolic dysfunction and liver disease, yet evidence on its association with MASLD remains limited in large, heterogeneous occupational populations. Objectives: To investigate the association between shift work and MASLD risk using multiple validated non-invasive indices in a large sample of Spanish workers, and to explore the influence of sociodemographic characteristics, lifestyle behaviors, and sex on these associations. Methods: This cross-sectional study analyzed data from 53,053 employed adults across diverse sectors in Spain, including 31,753 men and 21,300 women. The participants underwent standardized occupational health assessments between 2019 and 2020. The MASLD risk was evaluated using seven indices: fatty liver index (FLI), hepatic steatosis index (HSI), ZJU index, fatty liver disease (FLD) index, Framingham steatosis index (FSI), lipid accumulation product (LAP), and BARD score. Sociodemographic, anthropometric, clinical, biochemical, and lifestyle data were collected. Multinomial logistic regression models were used to assess independent associations between shift work and high-risk MASLD scores. Results: Shift workers exhibited significantly higher mean values and prevalence of elevated MASLD scores across all indices compared to non-shift workers, in both sexes. In men, the prevalence of high BARD scores increased from 43.5% (non-shift) to 71.5% (shift), while in women it rose from 49.9% to 85.7%. Multivariate analysis confirmed that shift work was independently associated with an increased MASLD risk, particularly for HSI (OR: 7.83; 95\% CI: 7.40–8.26) and ZJU (OR: 5.91; 95\% CI: 5.60–6.22). Male sex, older age, smoking, and blue-collar status were also consistently associated with elevated risk scores. Conclusions: Shift work is significantly associated with an increased MASLD risk, independent of sociodemographic and lifestyle factors. Women and blue-collar workers may be especially vulnerable to the hepatic consequences of circadian disruption. These findings support the inclusion of liver health screening in occupational health programs and highlight the need for targeted interventions to reduce the MASLD risk among shift-working populations. Cross-sectional design limits causality; longitudinal studies are needed to confirm temporal relationships.
2024
- AbstractURLBibTeXEndNoteDOIBibSonomyDownload1.Navarra-Ventura G, Riera-Serra P, Roca M, Gili M, García-Toro M, Vilagut G, Alayo I, Ballester L, Blasco MJ, Castellví P, Colom J, Casajuana C, Gabilondo A, Lagares C, Almenara J, Miranda-Mendizabal A, Mortier P, Piqueras JA, Soto-Sanz V, Alonso J, study group U. Factors associated with high and low mental well-being in Spanish university students. Journal of affective disorders [Internet]. Netherlands; 2024 Jul.;356:424-35. https://pubmed.ncbi.nlm.nih.gov/38631424BACKGROUND: Previous studies conducted in various nationally representative samples of the general population show that positive mental health is related to social prosperity. However, specific studies in university populations are scarce. In this study, we set out to explore factors associated with mental well-being (MWB) in a representative sample of first-year university students in Spain. METHODS: MWB was assessed with the short version of the Warwick-Edinburgh Mental Well-Being Scale. Multinomial logistic regressions were performed to explore the association between different blocks of factors, including relational, adversity, stress, lifestyle, spiritual, health, and self-perceived health variables with high and low MWB, controlling for sociodemographic and university-related variables. RESULTS: Data from 2082 students (18.6 ± 1.2 years; 56.6 % females) were analysed. Being male, being born in a foreign country, "high" self-perceived support, and "high" self-perceived mental health increased the odds of high MWB. Growing up in the suburbs, stressful experiences, and anxiety disorders reduced the odds of high MWB. Mood and anxiety disorders increased the odds of low MWB. "Middle" self-perceived support, sleeping ≥8 h per day, and "high" self-perceived mental health reduced the odds of low MWB. LIMITATIONS: The cross-sectional design precludes establishing causal relationships. Data were collected in the 2014-15 academic year using self-reported online surveys. CONCLUSION: The factors associated with high and low MWB do not always mirror each other, so specific plans are needed to successfully address each of the two poles. Interventions and policies targeting these factors for health promotion and disease prevention would improve the MWB of university students.
@article{navarraventura2024factors,
abstract = {BACKGROUND: Previous studies conducted in various nationally representative samples of the general population show that positive mental health is related to social prosperity. However, specific studies in university populations are scarce. In this study, we set out to explore factors associated with mental well-being (MWB) in a representative sample of first-year university students in Spain. METHODS: MWB was assessed with the short version of the Warwick-Edinburgh Mental Well-Being Scale. Multinomial logistic regressions were performed to explore the association between different blocks of factors, including relational, adversity, stress, lifestyle, spiritual, health, and self-perceived health variables with high and low MWB, controlling for sociodemographic and university-related variables. RESULTS: Data from 2082 students (18.6 ± 1.2 years; 56.6 % females) were analysed. Being male, being born in a foreign country, "high" self-perceived support, and "high" self-perceived mental health increased the odds of high MWB. Growing up in the suburbs, stressful experiences, and anxiety disorders reduced the odds of high MWB. Mood and anxiety disorders increased the odds of low MWB. "Middle" self-perceived support, sleeping ≥8 h per day, and "high" self-perceived mental health reduced the odds of low MWB. LIMITATIONS: The cross-sectional design precludes establishing causal relationships. Data were collected in the 2014-15 academic year using self-reported online surveys. CONCLUSION: The factors associated with high and low MWB do not always mirror each other, so specific plans are needed to successfully address each of the two poles. Interventions and policies targeting these factors for health promotion and disease prevention would improve the MWB of university students.},
address = {Netherlands},
author = {Navarra-Ventura, Guillem and Riera-Serra, Pau and Roca, Miquel and Gili, Margalida and García-Toro, Mauro and Vilagut, Gemma and Alayo, Itxaso and Ballester, Laura and Blasco, Maria Jesús and Castellví, Pere and Colom, Joan and Casajuana, Cristina and Gabilondo, Andrea and Lagares, Carolina and Almenara, José and Miranda-Mendizabal, Andrea and Mortier, Philippe and Piqueras, José Antonio and Soto-Sanz, Victoria and Alonso, Jordi and study group, UNIVERSAL},
journal = {Journal of affective disorders},
keywords = {evisap},
month = {jul},
pages = {424--435},
title = {Factors associated with high and low mental well-being in Spanish university students},
volume = 356,
year = 2024
}%0 Journal Article
%1 navarraventura2024factors
%A Navarra-Ventura, Guillem
%A Riera-Serra, Pau
%A Roca, Miquel
%A Gili, Margalida
%A García-Toro, Mauro
%A Vilagut, Gemma
%A Alayo, Itxaso
%A Ballester, Laura
%A Blasco, Maria Jesús
%A Castellví, Pere
%A Colom, Joan
%A Casajuana, Cristina
%A Gabilondo, Andrea
%A Lagares, Carolina
%A Almenara, José
%A Miranda-Mendizabal, Andrea
%A Mortier, Philippe
%A Piqueras, José Antonio
%A Soto-Sanz, Victoria
%A Alonso, Jordi
%A study group, UNIVERSAL
%C Netherlands
%D 2024
%J Journal of affective disorders
%P 424--435
%R 10.1016/j.jad.2024.04.056
%T Factors associated with high and low mental well-being in Spanish university students
%U https://pubmed.ncbi.nlm.nih.gov/38631424
%V 356
%X BACKGROUND: Previous studies conducted in various nationally representative samples of the general population show that positive mental health is related to social prosperity. However, specific studies in university populations are scarce. In this study, we set out to explore factors associated with mental well-being (MWB) in a representative sample of first-year university students in Spain. METHODS: MWB was assessed with the short version of the Warwick-Edinburgh Mental Well-Being Scale. Multinomial logistic regressions were performed to explore the association between different blocks of factors, including relational, adversity, stress, lifestyle, spiritual, health, and self-perceived health variables with high and low MWB, controlling for sociodemographic and university-related variables. RESULTS: Data from 2082 students (18.6 ± 1.2 years; 56.6 % females) were analysed. Being male, being born in a foreign country, "high" self-perceived support, and "high" self-perceived mental health increased the odds of high MWB. Growing up in the suburbs, stressful experiences, and anxiety disorders reduced the odds of high MWB. Mood and anxiety disorders increased the odds of low MWB. "Middle" self-perceived support, sleeping ≥8 h per day, and "high" self-perceived mental health reduced the odds of low MWB. LIMITATIONS: The cross-sectional design precludes establishing causal relationships. Data were collected in the 2014-15 academic year using self-reported online surveys. CONCLUSION: The factors associated with high and low MWB do not always mirror each other, so specific plans are needed to successfully address each of the two poles. Interventions and policies targeting these factors for health promotion and disease prevention would improve the MWB of university students. - AbstractURLBibTeXEndNoteDOIBibSonomyDownload1.Roldán-Espínola L, Riera-Serra P, Roca M, García-Toro M, Coronado-Simsic V, Castro A, Navarra-Ventura G, Vilagut G, Alayo I, Ballester L, Blasco MJ, Almenara J, Cebrià AI, Echeburúa E, Gabilondo A, Lagares C, Piqueras JA, Soto-Sanz V, Mortier P, Kessler RC, Alonso J, Forteza-Rey I, Gili M. Depression and lifestyle among university students: A one-year follow-up study. The European Journal of Psychiatry [Internet]. 2024;38(3):100250. https://www.sciencedirect.com/science/article/pii/S0213616324000016Background and objectives University stage is a risk period for development of mental disorders and major depression disorder (MDD) is one of the most prevalent disorders. There is increasing evidence about the influence of lifestyle factors on depression onset and maintenance, nevertheless there is a great heterogeneity between analyzed lifestyle factors and few longitudinal studies has been carried out. The current study aims to longitudinally assess the influence of lifestyle on MDD courses among first-year university students. Methods First-onset and persistence of MDD and lifestyle trajectories are measured using baseline and 12-months follow-up online surveys. Multivariate logistic regression analyses were performed to study longitudinal risk/protective associations between lifestyle factors and MDD. Results 1,292 participants were included. Mean age of included participants at baseline was 18.5 (SD= 1.16) and 75.7 % were female. First-onset and persistence of MDD at T2 were 10.3 % and 38.9 % respectively. Maintenance of healthy sleep (Adjusted Odds Ratio (aOR) = 0.26; 95 % CI =0.12–0.58) and physical activity (aOR = 0.24; 95 % CI = 0.10–0.58) were protectively associated against MDD first-onset. Adoption of healthy levels of social support showed a protective effect against MDD persistence (aOR = 0.17; 95 % CI = 0.07–0.44). Conclusions Lifestyle should be considered in order to improve depression prevention strategies among university students. Sleep, physical activity, and social support seem to have a crucial role in the onset and persistence of depression among this population.
@article{RN65,
abstract = {Background and objectives University stage is a risk period for development of mental disorders and major depression disorder (MDD) is one of the most prevalent disorders. There is increasing evidence about the influence of lifestyle factors on depression onset and maintenance, nevertheless there is a great heterogeneity between analyzed lifestyle factors and few longitudinal studies has been carried out. The current study aims to longitudinally assess the influence of lifestyle on MDD courses among first-year university students. Methods First-onset and persistence of MDD and lifestyle trajectories are measured using baseline and 12-months follow-up online surveys. Multivariate logistic regression analyses were performed to study longitudinal risk/protective associations between lifestyle factors and MDD. Results 1,292 participants were included. Mean age of included participants at baseline was 18.5 (SD= 1.16) and 75.7 % were female. First-onset and persistence of MDD at T2 were 10.3 % and 38.9 % respectively. Maintenance of healthy sleep (Adjusted Odds Ratio (aOR) = 0.26; 95 % CI =0.12–0.58) and physical activity (aOR = 0.24; 95 % CI = 0.10–0.58) were protectively associated against MDD first-onset. Adoption of healthy levels of social support showed a protective effect against MDD persistence (aOR = 0.17; 95 % CI = 0.07–0.44). Conclusions Lifestyle should be considered in order to improve depression prevention strategies among university students. Sleep, physical activity, and social support seem to have a crucial role in the onset and persistence of depression among this population.},
author = {Roldán-Espínola, Lorenzo and Riera-Serra, Pau and Roca, Miquel and García-Toro, Mauro and Coronado-Simsic, Victoria and Castro, Adoración and Navarra-Ventura, Guillem and Vilagut, Gemma and Alayo, Itxaso and Ballester, Laura and Blasco, María Jesús and Almenara, José and Cebrià, Ana Isabel and Echeburúa, Enrique and Gabilondo, Andrea and Lagares, Carolina and Piqueras, José Antonio and Soto-Sanz, Victoria and Mortier, Philippe and Kessler, Ronald C. and Alonso, Jordi and Forteza-Rey, Inés and Gili, Margalida},
journal = {The European Journal of Psychiatry},
keywords = {evisap},
number = 3,
pages = 100250,
title = {Depression and lifestyle among university students: A one-year follow-up study},
type = {Journal Article},
volume = 38,
year = 2024
}%0 Journal Article
%1 RN65
%A Roldán-Espínola, Lorenzo
%A Riera-Serra, Pau
%A Roca, Miquel
%A García-Toro, Mauro
%A Coronado-Simsic, Victoria
%A Castro, Adoración
%A Navarra-Ventura, Guillem
%A Vilagut, Gemma
%A Alayo, Itxaso
%A Ballester, Laura
%A Blasco, María Jesús
%A Almenara, José
%A Cebrià, Ana Isabel
%A Echeburúa, Enrique
%A Gabilondo, Andrea
%A Lagares, Carolina
%A Piqueras, José Antonio
%A Soto-Sanz, Victoria
%A Mortier, Philippe
%A Kessler, Ronald C.
%A Alonso, Jordi
%A Forteza-Rey, Inés
%A Gili, Margalida
%D 2024
%J The European Journal of Psychiatry
%N 3
%P 100250
%R https://doi.org/10.1016/j.ejpsy.2024.100250
%T Depression and lifestyle among university students: A one-year follow-up study
%U https://www.sciencedirect.com/science/article/pii/S0213616324000016
%V 38
%X Background and objectives University stage is a risk period for development of mental disorders and major depression disorder (MDD) is one of the most prevalent disorders. There is increasing evidence about the influence of lifestyle factors on depression onset and maintenance, nevertheless there is a great heterogeneity between analyzed lifestyle factors and few longitudinal studies has been carried out. The current study aims to longitudinally assess the influence of lifestyle on MDD courses among first-year university students. Methods First-onset and persistence of MDD and lifestyle trajectories are measured using baseline and 12-months follow-up online surveys. Multivariate logistic regression analyses were performed to study longitudinal risk/protective associations between lifestyle factors and MDD. Results 1,292 participants were included. Mean age of included participants at baseline was 18.5 (SD= 1.16) and 75.7 % were female. First-onset and persistence of MDD at T2 were 10.3 % and 38.9 % respectively. Maintenance of healthy sleep (Adjusted Odds Ratio (aOR) = 0.26; 95 % CI =0.12–0.58) and physical activity (aOR = 0.24; 95 % CI = 0.10–0.58) were protectively associated against MDD first-onset. Adoption of healthy levels of social support showed a protective effect against MDD persistence (aOR = 0.17; 95 % CI = 0.07–0.44). Conclusions Lifestyle should be considered in order to improve depression prevention strategies among university students. Sleep, physical activity, and social support seem to have a crucial role in the onset and persistence of depression among this population.
2022
-
AbstractURLBibTeXEndNoteDOIBibSonomy1.Zamanillo-Campos R, Chaplin A, Romaguera D, Abete I, Salas-Salvadó J, Martín V, Estruch R, Vidal J, Ruiz-Canela M, Babio N, Fiol F, de Paz JA, Casas R, Olbeyra R, Martínez-González MA, García-Gavilán JF, Goday A, Fernandez-Lazaro CI, Martínez JA, Hu FB, Konieczna J. Longitudinal association of dietary carbohydrate quality with visceral fat deposition and other adiposity indicators. Clinical nutrition (Edinburgh, Scotland) [Internet]. England; 2022 Oct.;41(10):2264-7. https://pubmed.ncbi.nlm.nih.gov/36084360BACKGROUND & AIMS: The quality of dietary carbohydrates rather than total carbohydrate intake may determine the accumulation of visceral fat; however, to date, few studies have examined the impact of diet on adiposity using specific imaging techniques. Thus, the aim of this prospective study was to investigate the association between concurrent changes in carbohydrate quality index (CQI) and objectively-quantified adiposity distribution over a year. METHODS: We analyzed a cohort of 1476 participants aged 55-75 years with overweight/obesity and metabolic syndrome (MetS) from the PREDIMED-Plus randomized controlled trial. Dietary intake information was obtained at baseline, 6- and 12-months from a validated 143-item semi-quantitative food-frequency questionnaire, and CQI (range: 4 to 20) was calculated based on four dietary criteria: total dietary fibre, glycemic index, wholegrain/total grain carbohydrate ratio, and solid/total carbohydrate ratio. Overall and regional adiposity (total body fat, visceral fat and android-to-gynoid fat ratio) was quantified using dual-energy X-ray absorptiometry at all three time points. Multiple adjusted linear mixed-effects models were used to assess associations between concurrent changes in repeatedly measured CQI and adiposity over time. RESULTS: After controlling for potential confounding factors, a 3-point increment in CQI over 12-month follow-up was associated with a decrease in visceral fat (β -0.067 z-score, 95% CI -0.088; -0.046, p < 0.001), android-to-gynoid fat ratio (-0.038, -0.059; -0.017, p < 0.001), and total fat (-0.064, -0.080; -0.047, p < 0.001). Fibre intake and the ratio of wholegrain/total grain showed the strongest inverse associations with all adiposity indicators. CONCLUSIONS: In this prospective cohort of older adults with overweight/obesity and MetS, we found that improvements in dietary carbohydrate quality over a year were associated with concurrent favorable changes in visceral and overall fat deposition. These associations were mostly driven by dietary fibre and the wholegrain/total grain ratio. TRIAL REGISTRATION: The trial was registered at the International Standard Randomized. CONTROLLED TRIAL: (ISRCTN: http://www.isrctn.com/ISRCTN89898870) with number 89898870 and registration date of 24 July 2014, retrospectively registered.
@article{zamanillocampos2022longitudinal,
abstract = {BACKGROUND & AIMS: The quality of dietary carbohydrates rather than total carbohydrate intake may determine the accumulation of visceral fat; however, to date, few studies have examined the impact of diet on adiposity using specific imaging techniques. Thus, the aim of this prospective study was to investigate the association between concurrent changes in carbohydrate quality index (CQI) and objectively-quantified adiposity distribution over a year. METHODS: We analyzed a cohort of 1476 participants aged 55-75 years with overweight/obesity and metabolic syndrome (MetS) from the PREDIMED-Plus randomized controlled trial. Dietary intake information was obtained at baseline, 6- and 12-months from a validated 143-item semi-quantitative food-frequency questionnaire, and CQI (range: 4 to 20) was calculated based on four dietary criteria: total dietary fibre, glycemic index, wholegrain/total grain carbohydrate ratio, and solid/total carbohydrate ratio. Overall and regional adiposity (total body fat, visceral fat and android-to-gynoid fat ratio) was quantified using dual-energy X-ray absorptiometry at all three time points. Multiple adjusted linear mixed-effects models were used to assess associations between concurrent changes in repeatedly measured CQI and adiposity over time. RESULTS: After controlling for potential confounding factors, a 3-point increment in CQI over 12-month follow-up was associated with a decrease in visceral fat (β -0.067 z-score, 95% CI -0.088; -0.046, p < 0.001), android-to-gynoid fat ratio (-0.038, -0.059; -0.017, p < 0.001), and total fat (-0.064, -0.080; -0.047, p < 0.001). Fibre intake and the ratio of wholegrain/total grain showed the strongest inverse associations with all adiposity indicators. CONCLUSIONS: In this prospective cohort of older adults with overweight/obesity and MetS, we found that improvements in dietary carbohydrate quality over a year were associated with concurrent favorable changes in visceral and overall fat deposition. These associations were mostly driven by dietary fibre and the wholegrain/total grain ratio. TRIAL REGISTRATION: The trial was registered at the International Standard Randomized. CONTROLLED TRIAL: (ISRCTN: http://www.isrctn.com/ISRCTN89898870) with number 89898870 and registration date of 24 July 2014, retrospectively registered.},
address = {England},
author = {Zamanillo-Campos, Rocío and Chaplin, Alice and Romaguera, Dora and Abete, Itziar and Salas-Salvadó, Jordi and Martín, Vicente and Estruch, Ramón and Vidal, Josep and Ruiz-Canela, Miguel and Babio, Nancy and Fiol, Francisca and de Paz, José Antonio and Casas, Rosa and Olbeyra, Romina and Martínez-González, Miguel A and García-Gavilán, Jesús F and Goday, Albert and Fernandez-Lazaro, Cesar I and Martínez, J Alfredo and Hu, Frank B and Konieczna, Jadwiga},
journal = {Clinical nutrition (Edinburgh, Scotland)},
keywords = {evisap},
month = {oct},
number = 10,
pages = {2264--2274},
title = {Longitudinal association of dietary carbohydrate quality with visceral fat deposition and other adiposity indicators},
volume = 41,
year = 2022
}%0 Journal Article
%1 zamanillocampos2022longitudinal
%A Zamanillo-Campos, Rocío
%A Chaplin, Alice
%A Romaguera, Dora
%A Abete, Itziar
%A Salas-Salvadó, Jordi
%A Martín, Vicente
%A Estruch, Ramón
%A Vidal, Josep
%A Ruiz-Canela, Miguel
%A Babio, Nancy
%A Fiol, Francisca
%A de Paz, José Antonio
%A Casas, Rosa
%A Olbeyra, Romina
%A Martínez-González, Miguel A
%A García-Gavilán, Jesús F
%A Goday, Albert
%A Fernandez-Lazaro, Cesar I
%A Martínez, J Alfredo
%A Hu, Frank B
%A Konieczna, Jadwiga
%C England
%D 2022
%J Clinical nutrition (Edinburgh, Scotland)
%N 10
%P 2264--2274
%R 10.1016/j.clnu.2022.08.008
%T Longitudinal association of dietary carbohydrate quality with visceral fat deposition and other adiposity indicators
%U https://pubmed.ncbi.nlm.nih.gov/36084360
%V 41
%X BACKGROUND & AIMS: The quality of dietary carbohydrates rather than total carbohydrate intake may determine the accumulation of visceral fat; however, to date, few studies have examined the impact of diet on adiposity using specific imaging techniques. Thus, the aim of this prospective study was to investigate the association between concurrent changes in carbohydrate quality index (CQI) and objectively-quantified adiposity distribution over a year. METHODS: We analyzed a cohort of 1476 participants aged 55-75 years with overweight/obesity and metabolic syndrome (MetS) from the PREDIMED-Plus randomized controlled trial. Dietary intake information was obtained at baseline, 6- and 12-months from a validated 143-item semi-quantitative food-frequency questionnaire, and CQI (range: 4 to 20) was calculated based on four dietary criteria: total dietary fibre, glycemic index, wholegrain/total grain carbohydrate ratio, and solid/total carbohydrate ratio. Overall and regional adiposity (total body fat, visceral fat and android-to-gynoid fat ratio) was quantified using dual-energy X-ray absorptiometry at all three time points. Multiple adjusted linear mixed-effects models were used to assess associations between concurrent changes in repeatedly measured CQI and adiposity over time. RESULTS: After controlling for potential confounding factors, a 3-point increment in CQI over 12-month follow-up was associated with a decrease in visceral fat (β -0.067 z-score, 95% CI -0.088; -0.046, p < 0.001), android-to-gynoid fat ratio (-0.038, -0.059; -0.017, p < 0.001), and total fat (-0.064, -0.080; -0.047, p < 0.001). Fibre intake and the ratio of wholegrain/total grain showed the strongest inverse associations with all adiposity indicators. CONCLUSIONS: In this prospective cohort of older adults with overweight/obesity and MetS, we found that improvements in dietary carbohydrate quality over a year were associated with concurrent favorable changes in visceral and overall fat deposition. These associations were mostly driven by dietary fibre and the wholegrain/total grain ratio. TRIAL REGISTRATION: The trial was registered at the International Standard Randomized. CONTROLLED TRIAL: (ISRCTN: http://www.isrctn.com/ISRCTN89898870) with number 89898870 and registration date of 24 July 2014, retrospectively registered.
2021
-
AbstractURLBibTeXEndNoteDOIBibSonomy1.Zamanillo Campos R, Colomar Ferrer MT, Ruiz López RM, Sanchís Cortés MP, Urgelés Planella JR. Specific Quality of Life Assessment by the NutriQoL® Questionnaire Among Patients Receiving Home Enteral Nutrition. JPEN. Journal of parenteral and enteral nutrition [Internet]. United States; 2021 Mar.;45(3):490-8. https://pubmed.ncbi.nlm.nih.gov/32459026BACKGROUND: Home enteral nutrition (HEN), including tube feeding and oral supplementation, can improve or worsen quality of life (QoL). The specific assessment of factors affecting QoL may identify the inherent problems associated with HEN. The aim of this study was to evaluate whether the validated NutriQoL® questionnaire is useful for assessing the QoL and the factors influencing it in patients receiving HEN. METHODS: A total of 78 patients receiving HEN completed both the NutriQoL and the SF-12 questionnaires during their routine visits to nutrition service at the hospital. RESULTS: Ninety percent of patients receiving HEN had cancer, 58% received oral supplements, and 42% received tube feeding. At recruitment, the mean score ± SD of the NutriQoL was 66 ± 14, whereas that of the SF-12 was 40 ± 9. A positive correlation between NutriQoL and SF-12 scores (ρ = 0.5; P < .001) was found. Multivariate analysis showed that HEN type (oral vs tube) (odds ratio [OR], 5.6; 95% CI 2.0-15.3; P = .001) and the absence of secondary effects (OR, 3.0; 95% CI, 1.2-7.9; P = .024) were both variables explaining NutriQoL results adjusted by sex and age. The SF-12 results did not show associations with nutrition factors. On visit 2, we observed significant improvements in NutriQoL results. CONCLUSION: The NutriQoL questionnaire identifies specific problems that affect the QoL of patients receiving HEN, whereas SF-12 does not. The route of entry and the occurrence of complications influence specific QoL. NutriQoL is a useful tool to identify the factors that worsen the QoL in patients receiving HEN.
@article{zamanillocampos2021specific,
abstract = {BACKGROUND: Home enteral nutrition (HEN), including tube feeding and oral supplementation, can improve or worsen quality of life (QoL). The specific assessment of factors affecting QoL may identify the inherent problems associated with HEN. The aim of this study was to evaluate whether the validated NutriQoL® questionnaire is useful for assessing the QoL and the factors influencing it in patients receiving HEN. METHODS: A total of 78 patients receiving HEN completed both the NutriQoL and the SF-12 questionnaires during their routine visits to nutrition service at the hospital. RESULTS: Ninety percent of patients receiving HEN had cancer, 58% received oral supplements, and 42% received tube feeding. At recruitment, the mean score ± SD of the NutriQoL was 66 ± 14, whereas that of the SF-12 was 40 ± 9. A positive correlation between NutriQoL and SF-12 scores (ρ = 0.5; P < .001) was found. Multivariate analysis showed that HEN type (oral vs tube) (odds ratio [OR], 5.6; 95% CI 2.0-15.3; P = .001) and the absence of secondary effects (OR, 3.0; 95% CI, 1.2-7.9; P = .024) were both variables explaining NutriQoL results adjusted by sex and age. The SF-12 results did not show associations with nutrition factors. On visit 2, we observed significant improvements in NutriQoL results. CONCLUSION: The NutriQoL questionnaire identifies specific problems that affect the QoL of patients receiving HEN, whereas SF-12 does not. The route of entry and the occurrence of complications influence specific QoL. NutriQoL is a useful tool to identify the factors that worsen the QoL in patients receiving HEN.},
address = {United States},
author = {Zamanillo Campos, Rocío and Colomar Ferrer, María Teresa and Ruiz López, Rosa María and Sanchís Cortés, María Pilar and Urgelés Planella, Joan Ramón},
journal = {JPEN. Journal of parenteral and enteral nutrition},
keywords = {evisap},
month = {mar},
number = 3,
pages = {490--498},
title = {Specific Quality of Life Assessment by the NutriQoL® Questionnaire Among Patients Receiving Home Enteral Nutrition},
volume = 45,
year = 2021
}%0 Journal Article
%1 zamanillocampos2021specific
%A Zamanillo Campos, Rocío
%A Colomar Ferrer, María Teresa
%A Ruiz López, Rosa María
%A Sanchís Cortés, María Pilar
%A Urgelés Planella, Joan Ramón
%C United States
%D 2021
%J JPEN. Journal of parenteral and enteral nutrition
%N 3
%P 490--498
%R 10.1002/jpen.1852
%T Specific Quality of Life Assessment by the NutriQoL® Questionnaire Among Patients Receiving Home Enteral Nutrition
%U https://pubmed.ncbi.nlm.nih.gov/32459026
%V 45
%X BACKGROUND: Home enteral nutrition (HEN), including tube feeding and oral supplementation, can improve or worsen quality of life (QoL). The specific assessment of factors affecting QoL may identify the inherent problems associated with HEN. The aim of this study was to evaluate whether the validated NutriQoL® questionnaire is useful for assessing the QoL and the factors influencing it in patients receiving HEN. METHODS: A total of 78 patients receiving HEN completed both the NutriQoL and the SF-12 questionnaires during their routine visits to nutrition service at the hospital. RESULTS: Ninety percent of patients receiving HEN had cancer, 58% received oral supplements, and 42% received tube feeding. At recruitment, the mean score ± SD of the NutriQoL was 66 ± 14, whereas that of the SF-12 was 40 ± 9. A positive correlation between NutriQoL and SF-12 scores (ρ = 0.5; P < .001) was found. Multivariate analysis showed that HEN type (oral vs tube) (odds ratio [OR], 5.6; 95% CI 2.0-15.3; P = .001) and the absence of secondary effects (OR, 3.0; 95% CI, 1.2-7.9; P = .024) were both variables explaining NutriQoL results adjusted by sex and age. The SF-12 results did not show associations with nutrition factors. On visit 2, we observed significant improvements in NutriQoL results. CONCLUSION: The NutriQoL questionnaire identifies specific problems that affect the QoL of patients receiving HEN, whereas SF-12 does not. The route of entry and the occurrence of complications influence specific QoL. NutriQoL is a useful tool to identify the factors that worsen the QoL in patients receiving HEN. -
AbstractURLBibTeXEndNoteDOIBibSonomy1.Zamanillo Campos R, Rovira Boixadera L, Rendo Urteaga T. Common practices and beliefs in the preparation of complementary infant feeding in a Spanish sample: a cross-sectional study. Nutricion hospitalaria [Internet]. Spain; 2021 Oct.;38(5):919-34. https://pubmed.ncbi.nlm.nih.gov/34176276Introduction: complementary feeding together with breast milk should cover the nutritional needs of children from 6 months onwards. Thus, inadequate dietary practices can lead to poor nutritional intake. The objective of this study was to examine infant food handling and cooking in Spanish households. Methodology: a cross-sectional study was carried out using an online survey in non-institutionalized adults living in Spain who usually prepare infant food for children under 2 years of age. Results: a total of 1,944 people (37.4 ± 6 years; 65.5 % women) answered the survey. Of these, 72 % prepared mainly mashed foods and 21 % used store-bought baby cereals frequently. Zucchini (39 %), chicken (62 %), hake (64 %) and banana (44 %) were the most commonly used foods. Boiling (63 %) and freezing (59 %) were the most widely used culinary and preservation practices. An inappropriate use of salt and some unsafe foods (large fish and chard) was identified, whereas olive oil and eggs were offered below the current nutritional recommendations. Conclusion: the population surveyed preferred to use mashed foods to feed children under 2 years of age. Even though they were aware that homemade food is nutritionally better, on certain occasions they offer store-bought baby cereal. Furthermore, some inappropriate feeding practices were detected, highlighting the need to implement nutritional education policies regarding infant food preparation.
@article{zamanillocampos2021common,
abstract = {Introduction: complementary feeding together with breast milk should cover the nutritional needs of children from 6 months onwards. Thus, inadequate dietary practices can lead to poor nutritional intake. The objective of this study was to examine infant food handling and cooking in Spanish households. Methodology: a cross-sectional study was carried out using an online survey in non-institutionalized adults living in Spain who usually prepare infant food for children under 2 years of age. Results: a total of 1,944 people (37.4 ± 6 years; 65.5 % women) answered the survey. Of these, 72 % prepared mainly mashed foods and 21 % used store-bought baby cereals frequently. Zucchini (39 %), chicken (62 %), hake (64 %) and banana (44 %) were the most commonly used foods. Boiling (63 %) and freezing (59 %) were the most widely used culinary and preservation practices. An inappropriate use of salt and some unsafe foods (large fish and chard) was identified, whereas olive oil and eggs were offered below the current nutritional recommendations. Conclusion: the population surveyed preferred to use mashed foods to feed children under 2 years of age. Even though they were aware that homemade food is nutritionally better, on certain occasions they offer store-bought baby cereal. Furthermore, some inappropriate feeding practices were detected, highlighting the need to implement nutritional education policies regarding infant food preparation.},
address = {Spain},
author = {Zamanillo Campos, Rocío and Rovira Boixadera, Laia and Rendo Urteaga, Tara},
journal = {Nutricion hospitalaria},
keywords = {evisap},
month = {oct},
number = 5,
pages = {919--934},
title = {Common practices and beliefs in the preparation of complementary infant feeding in a Spanish sample: a cross-sectional study},
volume = 38,
year = 2021
}%0 Journal Article
%1 zamanillocampos2021common
%A Zamanillo Campos, Rocío
%A Rovira Boixadera, Laia
%A Rendo Urteaga, Tara
%C Spain
%D 2021
%J Nutricion hospitalaria
%N 5
%P 919--934
%R 10.20960/nh.03527
%T Common practices and beliefs in the preparation of complementary infant feeding in a Spanish sample: a cross-sectional study
%U https://pubmed.ncbi.nlm.nih.gov/34176276
%V 38
%X Introduction: complementary feeding together with breast milk should cover the nutritional needs of children from 6 months onwards. Thus, inadequate dietary practices can lead to poor nutritional intake. The objective of this study was to examine infant food handling and cooking in Spanish households. Methodology: a cross-sectional study was carried out using an online survey in non-institutionalized adults living in Spain who usually prepare infant food for children under 2 years of age. Results: a total of 1,944 people (37.4 ± 6 years; 65.5 % women) answered the survey. Of these, 72 % prepared mainly mashed foods and 21 % used store-bought baby cereals frequently. Zucchini (39 %), chicken (62 %), hake (64 %) and banana (44 %) were the most commonly used foods. Boiling (63 %) and freezing (59 %) were the most widely used culinary and preservation practices. An inappropriate use of salt and some unsafe foods (large fish and chard) was identified, whereas olive oil and eggs were offered below the current nutritional recommendations. Conclusion: the population surveyed preferred to use mashed foods to feed children under 2 years of age. Even though they were aware that homemade food is nutritionally better, on certain occasions they offer store-bought baby cereal. Furthermore, some inappropriate feeding practices were detected, highlighting the need to implement nutritional education policies regarding infant food preparation.
