Objective: To assess the impact of a physical activity program on obesity in primary school children. Design: Cluster-randomized controlled trial with 10 intervention and 10 control schools. Participants: A total of 1044 children, mean age 9.4 years (s.d. ¼ 0.7) at baseline, of the Province of Cuenca, Spain. Intervention: Recreational, non-competitive physical activity program conducted after school hours on school premises. The program consisted of three 90-min sessions per week, for 24 weeks. Main outcome measures: Body mass index (BMI), triceps skin-fold thickness (TST) and percentage body fat. Secondary measures were blood lipids and blood pressure. Measurements were made at the beginning (September 2004) and at the end of the program (June 2005). Since schools rather than children were randomized, mixed regression models were used to adjust for individual-level covariates under cluster randomization. Results: There were no differences in BMI between the intervention and control groups. Compared with controls, intervention children showed a decrease in TST in both boys (À1.14 mm; 95% confidence interval (CI) À1.71 to À057; Po0.001) and girls (À1.55 mm; 95% CI À2.38 to À0.73; Po0.001), as well as a reduction in the percentage of body fat in girls (À0.58%; 95% CI À1.04 to À0.11; P ¼ 0.02). Furthermore, the intervention boys exhibited a decrease in apolipoprotein (apo) B levels (À4.59; 95% CI À8.81 to À0.37; P ¼ 0.03) and an increase in apo A-I levels (13.57; Po0.001). Blood lipid results in girls were very similar. No changes in total cholesterol, triglycerides or blood pressure were associated with the intervention in either sex, except for an increase in diastolic blood pressure (1.55 mm Hg; 95% CI 0.19-2.91; P ¼ 0.03) in the intervention versus control boys. Conclusion: An after-school program of recreational physical activity reduced adiposity, increased apo A-I and decreased apo B in primary school children.

OBJECTIVEWe used confirmatory factor analysis to test whether a single factor might explain the clustering of the metabolic syndrome (MS) components in children.RESEARCH DESIGN AND METHODSWe studied 1,020 children aged 10–13 years from 20 schools in Cuenca, Spain. The single-factor model included: waist circumference (WC), fasting insulin, triglyceride to HDL cholesterol ratio (Triglyl/HDL-C), and mean arterial pressure (MAP). The standardized scores of the four variables in the model were used to develop a continuous MS index.RESULTSFactor loadings were 0.67 for WC, 0.68 for fasting insulin, 0.57 for Triglyl/HDL-C, and 0.37 for MAP. The single-factor model also showed a good fit to the data. As compared with Adult Treatment Panel III criteria, the MS index showed strong validity in the diagnosis of MS (area under the receiver operating characteristic curve = 0.98, 95% CI 0.96–0.99).CONCLUSIONSA single underlying factor has acceptable validity to represent MS in children.

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Background: In developed countries, there is abundant information on the epidemic of childhood obesity, but only a few studies on trends in the dual burden of body weight (overweight and thinness). Objective: To examine trends in overweight and thinness among 9-10-year-old Spanish children in the last decade. Methods: Data were taken from cross-sectional studies on schoolchildren in Cuenca (Spain), conducted in 1992, 1996, 1998 and 2004 with similar methods. Weight and height were measured by trained personnel with standardized procedures. Overweight (including obesity) and thinness were defined according with the International Obesity Taskforce BMI cut-offs. Results: The overall prevalence of overweight increased from 24?4 % in 1992 to 30?9 % in 2004 (P 5 0?07), rising from 21?2 % in 1992 to 32?0 % in 2004 (P 5 0?03) among boys and from 27?7 % to 29?8 % (P 5 0?67) among girls. The overall prevalence of thinness was 2?7 % in 1992 and 9?2 % in 2004 (P , 0?001); in the same period, thinness prevalence rose from 1?9 % to 9?0 % (P 5 0?10) among boys and from 3?7 % to 9?5 % (P , 0?01) among girls. Conclusions: The dual burden of body weight has increased among children in Cuenca in the last decade. Population-based policies addressing childhood obesity, which is the most frequent problem, should not increase the risk of thinness.

Objective: To examine the trends in BMI and adiposity among schoolchildren from Cuenca, Spain, during 2004Spain, during -2010. Design: Two methodologically comparable surveys were carried out in 2004 and 2010. Setting: Primary schools in Cuenca, a province in the middle of Spain. Subjects: All schoolchildren aged 8-11 years, belonging to 4th and 5th grades from twenty schools in the Province of Cuenca, were invited to participate in both cross-sectional studies. Weight, height and body fat percentage (BF%) from bioelectrical impedance were measured with standardized procedures. Results: The study included 550 boys and 539 girls in 2004, and 569 boys and 531 girls in 2010. In 2010, 8?1 % of children were underweight, 25?9 % overweight and 9?5 % obese. From 2004 to 2010, the prevalence of overweight rose from 21?6 % to 28?0 % (P 5 0?004) and BF % increased from 22?6 % to 24?0 % (P 5 0?001) among boys. No change was observed in overweight and BF % in girls, or in underweight and obesity in either sex. In boys, most of the distribution of BMI and BF % shifted to the right; in contrast, among girls no substantial change was apparent in the distribution of BMI and BF %. Conclusions: From 2004 to 2010 the prevalence of overweight and adiposity has continued to increase among boys. However, the obesity epidemic may have levelled off in girls. Given that the prevalence of childhood excess weight is still very high, the current evidence-based efforts to halt the obesity epidemic in Spain should be strengthened.

Measurement of cervical length by transvaginal ultrasonography is a better predictor of success in labor induction with both topical prostaglandin and oxytocin.

%BF from BIA is more strongly associated than either BMI or TST with most of the blood lipid fractions in schoolchildren aged 8-11 years.

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