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      Planes de prevención de enfermedades crónicas no transmisibles en niños y adolescentes Translated title: Plans for the prevention of noncommunicable chronic diseases in children and adolescents

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          Abstract

          Resumen Introducción: los planes de prevención de enfermedades no transmisibles en niños y adolescentes ocupan un gran espacio en el marco de la investigación en ciencias de la salud. Material y métodos: se ha realizado una revisión sistemática en las principales bases de datos como son PubMed, WOS y Cochrane. Son numerosos los trabajos previos que han analizado el diseño, secuencia y efectos en diferentes poblaciones. Resultados: los resultados de esta revisión mostraron que el mayor número de estudios fueron llevados a cabo por el sistema sanitario estatal en relación o aplicación con el sistema educativo estatal. Se analizaron 11 revisiones en cuestión ocupándose, cinco de ellas, de alimentación o nutrición y tres de estas de sobrepeso, obesidad y actividad física, siendo los temas más estudiados. Discusión: el análisis pormenorizado de la literatura científica sobre este tema mostró características comunes en los estudios referentes al método de implantación, análisis de los resultados y tiempo de intervención. Se requiere un mayor esfuerzo desde la administración en el diseño e implantación de planes multidisciplinares de intervención.

          Translated abstract

          Abstract Introduction: plans for the prevention of noncommunicable diseases in children and adolescents constitute an important area in the health care research field. Material and methods: we conducted a systematic review of evidence obtained from major databases such as PubMed, WoS and the Cochrane Library. Many studies have analysed the design, implementation and outcomes of strategies in different segments of the population. Results: the review of the literature showed that most studies were developed by the public health system and related to or implemented through the public school system. We analysed 11 systematic reviews, of which 5 focused on diet and nutrition and 3 on overweight, obesity and physical activity, which were the most frequently topics. Discussion: the detailed analysis of the literature on this subject revealed commonalities in the studies in terms of the implementation of the preventive strategies, the analysis of outcomes and the duration of the interventions. Further efforts must be devoted by government authorities to the design and implementation of multidisciplinary prevention strategies.

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          Most cited references42

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          The prevalence and incidence of coronary heart disease is significantly increased in periodontitis: a meta-analysis.

          Previous studies have shown conflicting results as to whether periodontitis (PD) is associated with increased risk of coronary heart disease (CHD). The aim of the current study was to evaluate whether such an association exists. A systematic review of the literature revealed 5 prospective cohort studies (follow-up >6 years), 5 case-control studies, and 5 cross-sectional studies that were eligible for meta-analysis. Individual studies were adjusted for confounding factors such as age, sex, diabetes mellitus, and smoking. The 3 study categories were analyzed separately. Heterogeneity of the studies was assessed by Cochran Q test. The studies were homogeneous; therefore, the Mantel-Haenszel fixed-effect model was used to compute common relative risk and odds ratio (OR). Meta-analysis of the 5 prospective cohort studies (86092 patients) indicated that individuals with PD had a 1.14 times higher risk of developing CHD than the controls (relative risk 1.14, 95% CI 1.074-1.213, P < .001). The case-control studies (1423 patients) showed an even greater risk of developing CHD (OR 2.22, 95% CI 1.59-3.117, P < .001). The prevalence of CHD in the cross-sectional studies (17724 patients) was significantly greater among individuals with PD than in those without PD (OR 1.59, 95% CI 1.329-1.907, P < .001). When the relationship between number of teeth and incidence of CHD was analyzed, cohort studies showed 1.24 times increased risk (95% CI 1.14-1.36, P < .0001) of development of CHD in patients with <10 teeth. This meta-analysis indicates that both the prevalence and incidence of CHD are significantly increased in PD. Therefore, PD may be a risk factor for CHD. Prospective studies are required to prove this assumption and evaluate risk reduction with the treatment of PD.
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            Structural responses to the obesity and non‐communicable diseases epidemic: Update on the Chilean law of food labelling and advertising

            Chile approved the law of food labelling and advertising in 2012; this law aims to address the obesity epidemic, particularly in children. The implementation details were published in 2015, and the law was implemented finally in 2016, as described in the current article. Regulated foods were defined based on a specially developed nutrient profiling, which considered natural foods as gold standard. For liquid foods, amounts of energy, sugars, saturated fats, and sodium in 100 mL of cow's milk were used as cut-offs. For solid foods, values within the 90th - 99th percentile range for energy and critical nutrients were selected as cut-off within a list of natural foods. A stop sign stating "High in " was chosen as warning label for packaged regulated foods. Regulated foods were also forbidden to be sold or offered for free at kiosks, cafeterias, and feeding programme at schools and nurseries. Besides, regulated foods cannot be promoted to children under 14 years. A staggered implementation of the regulation was decided, with nutrients cut-offs becoming increasingly stricter over a 3-year period. These regulatory efforts are in the right direction but will have to be sustained and complemented with other actions to achieve their ultimate impact of halting the obesity epidemic.
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              Cardiovascular Health Promotion in Children: Challenges and Opportunities for 2020 and Beyond: A Scientific Statement From the American Heart Association.

              This document provides a pediatric-focused companion to "Defining and Setting National Goals for Cardiovascular Health Promotion and Disease Reduction: The American Heart Association's Strategic Impact Goal Through 2020 and Beyond," focused on cardiovascular health promotion and disease reduction in adults and children. The principles detailed in the document reflect the American Heart Association's new dynamic and proactive goal to promote cardiovascular health throughout the life course. The primary focus is on adult cardiovascular health and disease prevention, but critical to achievement of this goal is maintenance of ideal cardiovascular health from birth through childhood to young adulthood and beyond. Emphasis is placed on the fundamental principles and metrics that define cardiovascular health in children for the clinical or research setting, and a balanced and critical appraisal of the strengths and weaknesses of the cardiovascular health construct in children and adolescents is provided. Specifically, this document discusses 2 important factors: the promotion of ideal cardiovascular health in all children and the improvement of cardiovascular health metric scores in children currently classified as having poor or intermediate cardiovascular health. Other topics include the current status of cardiovascular health in US children, opportunities for the refinement of health metrics, improvement of health metric scores, and possibilities for promoting ideal cardiovascular health. Importantly, concerns about the suitability of using single thresholds to identify elevated cardiovascular risk throughout the childhood years and the limits of our current knowledge are noted, and suggestions for future directions and research are provided.
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                Author and article information

                Journal
                pap
                Pediatría Atención Primaria
                Rev Pediatr Aten Primaria
                Asociación Española de Pediatría de Atención Primaria (Madrid, Madrid, Spain )
                1139-7632
                June 2021
                : 23
                : 90
                : 143-153
                Affiliations
                [2] Madrid Madrid orgnameUniversidad Autónoma de Madrid orgdiv1Facultad de Formación del Profesorado Spain
                [1] Madrid orgnameColegio de Educación Especial ATEMPACE España
                Article
                S1139-76322021000200006 S1139-7632(21)02309000006
                afd6411e-9e45-41c2-87b5-a3e7a0cae6f5

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

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                Figures: 0, Tables: 0, Equations: 0, References: 42, Pages: 11
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                SciELO Spain

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                Adolescents,Prevention,Non-communicable diseases,Children,Prevención,Niños,Enfermedades no transmisibles,Adolescentes

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