BACKGROUND: Diverging trends of decreasing energy intake and increasing prevalence of obesity suggest that physical inactivity and sedentary lifestyle may be one of the key determinants of the growing rates of overweightaobesity in Western populations. information about the impact of physical inactivity and sedentary lifestyles on the prevalence of obesity among the general adult population in the European Union is sparse. OBJECTIVES: To estimate the association of leisure-time sedentary and non-sedentary activities with body mass index (BMI, kgam 2 ) and with the prevalence of obesity (BMI b 30 kgam 2 ) in a sample of the 15 member states of the European Union. METHODS: Professional interviewers administered standardized in-home questionnaires to 15,239 men and women aged 15 years upwards, selected by a multi-stage strati®ed cluster sampling with quotas applied to ensure national and European representativeness. Energy expenditure during leisure time was calculated based on data on frequency of and amount of time participating in various physical activities, assigning metabolic equivalents (METS) to each activity. Sedentary lifestyle was assessed by means of self-reported hours spent sitting down during leisure time.Multiple linear regression models with BMI as the dependent variable, and logistic regression models with obesity (BMI b 30 kgam 2 ) as the outcome, were ®tted. RESULTS: Independent associations of leisure-time physical activity (inverse) and amount of time spent sitting down (direct) with BMI were found. The adjusted prevalence odds ratio (OR) for obesity was 0.52 [95% con®dence interval (CI): 0.43 ± 0.64, P`0.001] for the upper quintile of physical activity ( b 30 METS) compared with the most physically inactive quintile (`1.75 METS). A positive independent association was also evident for the time spent sitting down, with an adjusted OR 1.61(95% CI: 1.33 ± 1.95, P`0.001) for those who spent more than 35 h of their leisure time sitting down compared with those who spent less than 15 h. Conclusions: Obesity and higher body weight are strongly associated with a sedentary lifestyle and lack of physical activity in the adult population of the European Union. These results, however, need to be interpreted with caution due to the cross-sectional design. Nonetheless, they are consistent with the view that a reduction in energy expenditure during leisure time may be the main determinant of the current epidemic of obesity.

Objective: To ascertain the major dietary patterns in the cohort 'SUN' and to assess the association of several sociodemographic (including age and gender) and lifestyle variables with the adherence to these dietary patterns. Design: This study is a cross-sectional analysis of 3847 subjects (1587 men and 2260 women) belonging to a prospective cohort study based on self-reported questionnaires. A factor analysis based on 30 predefined food groups was conducted to ascertain the major dietary patterns in the cohort. Multiple regression models were fitted to assess the relationship between several sociodemographic and lifestyle variables and the adherence to these dietary patterns (measured using two scores with observed values ranging from 7 3.2 to þ 4.6 for the Western pattern and 7 3.1 to þ 5.5 for the Mediterranean pattern). Results: Two major dietary patterns were found. The first pattern was labelled as a 'Western' dietary pattern and the other as a 'Spanish-Mediterranean' dietary pattern. Younger subjects were more likely to follow a 'Western' dietary pattern; the coefficient representing the change for every 10 y increase in age was b ¼ 7 0.24 (P < 0.001) for men and b ¼ 7 0.12 (P < 0.001) for women. More physically active subjects were less likely to follow a 'Western' dietary pattern and more likely to follow a 'SpanishMediterranean' dietary pattern. Conclusions: An association between a higher level of physical activity during leisure time and adherence to a 'SpanishMediterranean' diet was apparent. However, the profile of being a young, sedentary and single male was identified as the most likely to exhibit a departure from the traditional 'Spanish-Mediterranean' diet and follow a 'Western' dietary pattern.

Objectives: To evaluate the prevalence of undernutrition among communitydwelling elderly people in Spain using the Mini Nutritional Assessment (MNA) and to analyse its distribution according to age, gender and residence region. Design: Cross-sectional study assessing the nutritional status of elderly persons through both the short form and the full version of the MNA test. Setting: Pharmacy offices across the whole country (Spain) were enrolled to recruit participants. Subjects: A total of 22 007 participants (8014 men and 13 993 women), aged $65 years, assessed during the last two months of 2005. Results: According to MNA screening, 4?3 % subjects were classified as undernourished (MNA score ,17) and 25?4 % were at risk of undernutrition (MNA score $17 to #23?5). The MNA short form correlated strongly with the full MNA version (r 5 0?85). MNA total score was significantly higher in men than in women (25?4 (SD 3?7) v. 24?6 (SD 3?9); P , 0?001) and lower in the oldest than in the youngest subjects (P , 0?001) in both genders. According to regional distribution, the best nutritional status was found in elderly from the north of Spain excluding the north-west area. Conclusions: Female gender, older age and living in the south half or northwest of the country were associated with higher rates of undernutrition among community-dwelling elderly persons in Spain.

European surveys indicate that people in the lowest category of occupation consume more fat and SF than people in the highest category.

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