Nutrition in the health policy context of Catalonia. Introduction.
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Dietary Fats↗
Biomedical subjects
L Salleras
Publications and source records attributed to L Salleras.
Changing patterns of fat consumption in Spain.
Trends of fat and fat-containing food consumption in Spain are analysed; information was obtained from data collected at two different levels: household and individual. Three major household budget surveys conducted by the National Institute of Statistics in 1964, 1980-1981, and 1990-1991 show the trends of food and fat consumption in Spain; we can observe a decrease in cereals, potatoes and pulses and an increase in dairy products and meat, similar to that observed in other countries. According to these studies, the consumption of fat and saturated fat and the other vegetable oils have increased, while olive oil intake has decreased. Food and fat consumption in Spain presents a large variation between the Spanish regions. Six individual dietary studies conducted among adult free-living populations are reviewed; intakes of fat ranged from 90 to 110 g/person/day, and percentage of total energy from saturated fat from 12 to 15%. The rise in fat intake in Spain urges dietary interventions.
Adult↗
Changes in diet and mortality from selected cancers in southern Mediterranean countries, 1960-1989.
Mortality trends of breast, colorectal, ovarian and prostate cancer in Spain, Italy, Greece, Yugoslavia, and England and Wales are presented. Figures are discussed with regard to patterns of consumption of fat-containing foods in these countries. An increase of all cancer site mortality is shown in southern European countries, whereas in England and Wales a decrease in ovarian and colorectal cancer among women is observed. Consumption of milk, meat and animal fat products increased in all Mediterranean countries but decreased in England and Wales. Some differences regarding cancer mortality and food consumption patterns among southern European countries are pointed out. This markedly divergent fat consumption pattern between northern and southern Europe appears to antedate and be associated with their substantial differences in ovarian and colorectal cancer mortality trends, and to a lesser extent with breast cancer.
Adult↗
[Smoking epidemiology among students and youngsters in Catalonia].
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Adolescent↗
[Lipid distribution in the adult population of Catalonia].
BACKGROUND: High concentrations of total and LDL-cholesterol and low concentrations of HDL-cholesterol are related to morbidity and mortality due to cardiovascular diseases. In this study, lipid concentration, prevalence of hypercholesterolemia and the association between hypercholesterolemia and other cardiovascular risk factors was investigated in a random sample of adult population of Catalonia (Spain). METHODS: A random sample of adult population of Catalonia aged 16 or more years was obtained. The sample was of 314 individuals, 156 men and 158 women. Serum total cholesterol, LDL-cholesterol, HDL-cholesterol and triglyceride concentrations were determined. Other cardiovascular risk factors were investigated: hypertension, smoking, body mass index, history of diabetes, and history of coronary heart disease. RESULTS: Total and LDL-cholesterol levels were similar in both sexes, with a mean of 211 mg/dl for the first 140 mg/dl for the latter. In contrast, triglyceride levels were higher in men (95 mg/dl) than in women (70 mg/dl), and HDL-cholesterol levels were higher in women (60 mg/dl) than in men (51 mg/dl) (p < 0.001). Total cholesterol, LDL-cholesterol and triglycerides concentration increased with age in both sexes. Total cholesterol values were > or = 240 mg/dl in 25% of men and 24% of women. Individuals with hypercholesterolemia had a higher prevalence of hypertension, obesity and diabetes was than normocholesterolemic individuals. The odds ratio was 3.68 for hypertension, 1.89 for obesity and 1.99 for diabetes. The adjusted odds ratio was statistically significant for hypertension (OR adj. = 2.77). CONCLUSION: The distribution of lipid values observed in the adult population of Catalonia was similar to that observed in other Mediterranean populations.
Adolescent↗
[Efficiency of prevaccination screening of anti-HBc in the anti-hepatitis B vaccination programs].
BACKGROUND: The convenience of carrying out pre-vaccination screening of VHB markers depends on the relative costs of screening and vaccination and also on the prevalence of susceptible subjects in each group of the population. The aim of the present work was to analyse the efficiency of pre-vaccination screening of antiHBc in Catalonia in 1991. METHODS: The per-unit cost of screening was calculated at 1366 ptas. The formula applied was: cost per-unit of screening + (1-X) x the cost per-unit of vaccination of anti-HBc (-) = cost of vaccinating the group. "X" being the threshold of prevalence of markers below which screening cases to be efficient. This prevalence is compared with those expected in the groups of the population to be vaccinated. RESULTS: By applying the above-mention ned formula and taking into account costs in time and travel of the people to be vaccinated, a prevalence threshold of 23% is obtained. This prevalence is much higher than that found in adolescents and students of medicine and nursing, similar to that found in health professionals and lower than that of other risk groups. CONCLUSIONS: Systematic screening of anti-HBc is only recommended in groups of the population where a prevalence higher than 20-25% can be expected. Below this threshold vaccination without previous study of markers is more efficient. This enormously simplifies the strategies of universal vaccination of children, adolescents or both.
Carrier State↗
[Retrospective evaluation of the effectiveness of the BCG vaccine campaign in newborns of Barcelona].
BACKGROUND: The aim of this study was to know the efficacy of the BCG vaccination campaign of the newborns of Barcelona carried out during the period from 1966-1974. METHODS: To achieve this aim an epidemiologic investigation was undertaken by an observational analytical study of paired cases and controls. Two hundred and fifty randomly selected cases were studied between 1978-1988 from between 4-21 years of age during the study period. The cases were paired with 750 controls (1:3) with identical conditions and age, sex and place of residence. Statistical analysis of data was performed by the specific methods for this type of study. RESULTS: The estimated gross odds ratio was 0.68; the interval of confidence 95% and 0.51-0.91 (p < 0.025). The efficacy of this vaccination campaign was estimated as weak at 32%, in the age group and investigation time being greater in males and diminished with time. The percentage of new cases of tuberculosis potentially prevented by this campaign was calculated at 13%. CONCLUSIONS: The weak efficacy of the BCG vaccination campaign may be attributed not only to the unforeseen effects of this vaccine but also to the deficient operative aspects of the campaign itself.
Age Factors↗
[Comparative study of human cutaneous sensitivity to 2 and 5 international units of the PPD RT 23 tuberculin with Tween 80].
BACKGROUND: The aim of this study was to know whether the human reaction to the Mantoux test with 5 UT of PPD RT 23 is similar to that achieved with the same test but with 2 UT of the same substance. METHODS: A simultaneous double Mantoux test was used at doses of 2 UT and another of 5 UT of the same trade mark of tuberculin PPD RT 23 with Tween 80 in 2,575 individuals. The subjects were distributed into two different groups of different ages, taking into consideration the possible presence of BCG vaccination. RESULTS: The doses of 5 UT produced a greater number of tuberculin positive individuals and a greater diameter of induration of reaction than that of the doses of 2 UT in both groups and with significant statistical differences. One hundred ninety-six (7%) subjects were tuberculin positive with 5 UT and negative with 2 UT. CONCLUSIONS: The reactions produced by the Mantoux test with 5 and 5 UT PPD RT were different since the two doses are not bioequivalent.
Adolescent↗
[A change in the epidemiologic pattern of hepatitis A in Spain].
BACKGROUND: Seroepidemiologic studies carried out in different countries show that the prevalence of markers for infection by hepatitis A (HVA) is progressively decreasing in relation with improvement in the level of health care. The prevalence of anti-HVA in Catalunya and the factors related with infection by HVA were studied in order to obtain bases for designing prevention strategies adequate for the epidemiology of this infection. METHODS: Anti-HVA was determined by a method of enzyme immunoassay in a randomized sample of the general population in Catalunya. Investigation of the influence of socio/demographic variables in the prevalence of HVA infection was carried out. RESULTS: The global prevalence of anti-HVA was of 36%. In the population from 6 to 14 years of age it was of 13% and that of those over the age of 15 it was 86%. The prevalence of anti-HVA increases with age and is related with the social level of the families, the level of education and the place of birth. The incidence was higher in children of the lowest social class, in adults with the least education and in those born outside Catalunya. These factors constituted independent risk factors of HVA infection. CONCLUSIONS: The present study confirms the association between HVA infection and socio-economic factors and demonstrates that the infection is not commonly found in infancy, an increase in the number of susceptible adults is foreseeable.
Age Factors↗
[The prevalence of tetanus antibodies in the adult population of Catalonia].
BACKGROUND: The aim of this study was to know the immune state of the adult population of Catalonia (Spain) versus tetanus. METHODS: The prevalence of antitetanic antibodies was determined in a representative sample (n = 604) of this population group (greater than or equal to 15 years). The technique used as that of passive hemagglutination reaction. The field work was carried out during 1989. RESULTS: 37.7% of the males and 15.7% of the females (p less than 0.001) presented titres of protector antibodies (greater than or equal to 0.01 Ul/ml) versus tetanus. The prevalence of antibodies was higher in youths of either sex and progressively descended with age. No statistically significant association was found upon performance of multivariate analysis between the sociodemographic variables (place of birth, level of education, residence, social class) and the prevalence of antibodies. CONCLUSIONS: The results of this study demonstrate that antitetanic vaccination currently being undertaken is not sufficient to insure adequate protection during adult life thus potentiating the need for the vaccination of adults in Catalonia.
Adult↗
[Epidemiology of arterial hypertension in the adult population of Cataluña].
BACKGROUND: The arterial hypertension is one of the most prevalent cardiovascular diseases. In this study the epidemiology of hypertension was investigated in a random sample of the adult population of Catalonia (Spain). METHODS: It was obtained a random sample (n = 704) of the adult population of Catalonia aged 15 or more years. The blood pressure was measured and hypertension was defined as a systolic blood pressure (SBP) equal or greater to 160 and/or a diastolic blood pressure (DBP) equal or greater to 95 mmHg. The borderline hypertension was defined as a SBP of 140-159 and/or a DBP of 90-95 mmHg. It was studied the association between hypertension and the following cardiovascular risk factors: hypercholesterolemia, obesity, diabetes and smoking. The study was carried out in 1989. RESULTS: The prevalence of hypertension observed was of 20%. The prevalence increased to 28% when the individuals with borderline hypertension were included. 87 of 144 detected hypertensives (58%) were known hypertensives, 67 (46.5%) received antihypertensive medication, and 30 (21%) were treated and had their blood pressures under control. Individuals with hypertension or borderline hypertension had a greater prevalence of hypercholesterolemia, obesity and diabetes, and a lower prevalence of smoking than normotensive persons. The odds ratio (hypertensive vs. normotensive persons) was of 3.68 for hypercholesterolemia, 3.26 for obesity, 3.81 for diabetes, and 0.40 for smoking. Nevertheless, the adjusted odds ratio was only statistically significant for the hypercholesterolemia (OR adj = 2.74). CONCLUSIONS: Arterial hypertension is one of the most important public health problems in Catalonia. The percentage of detected, treated and controlled hypertensives should be increased in the following years.
Adolescent↗
Prevalence of hepatitis B markers in the population of Catalonia (Spain). Rationale for universal vaccination of adolescents.
The prevalence of hepatitis B markers was determined in a representative sample of the general population of Catalonia (Spain). HBsAg was found in 0.5% of children (less than 15 years of age) and in 1.7% of adults (more than 15 years of age), and anti HBs in 1.6% and 18%, respectively. Age-specific prevalence for both markers showed a low risk for hepatitis B before puberty, and a progressive rise since adolescence, suggesting that perinatal transmission and horizontal transmission in children are relatively uncommon in Spain. Prevalence of hepatitis B markers was significantly higher among subjects with low education level, residing in an urban area and born outside Catalonia, but in the stratified analysis, a statistical significant difference was only maintained in the prevalence of HBV markers between those who live in urban and rural areas, and between those who were born outside Catalonia and in Catalonia. These data may be used as a basis for a strategy of hepatitis B prevention in Spain which include universal vaccination of adolescents, passive-active immunization of newborns to HBsAg positive mothers and vaccination of susceptible adults subjects from high-risk groups.
Adolescent↗
Infant mortality, per capita income, and adult illiteracy: an ecological approach.
The ecological association of infant mortality rate (IM) with per capita income (PI) and prevalence of adult illiteracy (AI) has been studied using countries as the unit of analysis. A negative association between IM and PI in 1960 and 1982 has been observed (sample correlation coefficient [r] = -.625 and r = -.729, respectively; P less than .05). A correlation between IM and AI has been found for both men and women (r = .827 and r = .855, respectively; P less than .05). The ecological relative risks were 7.43 for men and 5.82 for women (95% confidence intervals: 5.16-10.71 and 4.36-7.75, respectively). The association of IM and PI shows a slight but not significant improvement between 1960 and 1982. AI can be considered a good predictor of IM in countries.
Bias↗
[Epidemiology of obesity among the adult population of Catalonia].
Several epidemiological studies have shown that obesity is related to the mortality from cardiovascular disease. In this study, the epidemiology of obesity and the correlation between body mass index and other cardiovascular risk factors was studied in a representative sample of the adult population of Catalonia. It was obtained a random sample (n = 704) of the adult population of Catalonia aged 15 or more years. Height and weight were measured and body mass index (BMI) was calculated (height in Kg/weight2 in m2). Obesity was defined as a BMI greater than 30, and overweight as a BMI from 25 to 30. In the first 314 participants, it was determined the concentration of total cholesterol, cholesterol-HDL and triglyceride, and it was measured the blood pressure. The correlation between BMI and other cardiovascular risk factors was analysed. The study was carried out in 1989. The mean of BMI increased with age in both sexes. BMI was significantly higher in men (26 kg/m2) than women (25 kg/m2). The prevalence of obesity was of 12% in both men and women, and the prevalence of overweight was of 48.5% in men and 38% in women. The prevalence of arterial hypertension, hypercholesterolemia and diabetes was greater individuals with obesity, with differences statistically significant for hypertension (odds ratio of 3.26). The multiple logistic regression analysis showed that the association between obesity and hypertension was not statistically significant (OR adj. = 2.09), when the effect of the other risk factors, the age and sex were controlled.(ABSTRACT TRUNCATED AT 250 WORDS)
Adolescent↗
The Barcelona Smoke-free Olympics project.
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Adolescent↗
[The schedule of systematic vaccinations in Catalonia].
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Child↗
Inclusion of laboratory test results in the surveillance of infectious diseases.
We studied certain indicators of the speed with which infectious diseases were notified and epidemiological case records carried out by public health workers for notifications with and without inclusion of laboratory test results. The notification records for brucellosis, dysentery, typhoid fever, viral hepatitis, meningococcal meningitis, and pulmonary tuberculosis in the province of Barcelona between 1982 and 1986 have been reviewed. For each disease notified the time lapse between the onset of symptoms and notification (Delay 1), between notification and implementation of the epidemiological investigation (Delay 2), and the sum of both time lapses (Delay 3) were calculated. In all diseases (with the exception of meningococcal meningitis) when significant differences in delays were noted, the longest were found in those notifications that included laboratory data in the epidemiological investigation. This means that the provision of laboratory data makes the process of notification slower (Delays 1, 2, and 3). Both notification when laboratory results are available and the inclusion of laboratory data in the epidemiological investigation, have a negative influence on the speed of the statutory notification process.
Communicable Disease Control↗
[Hepatitis B and hepatitis delta in young inmates].
The prevalence of infection by hepatitis B (HBV) and delta (HDV) viruses and presumably related variables were evaluated in a prison for young male convicts, aged 16-21 years (n = 686), 55.1% of convicts were positive for one or more VHB markers, and 7.1% were positive for HBsAg; 89.7% of these were negative for IgM anti-HBc (chronic carriers), while 36.6% were positive for HBeAg. Anti-delta antibodies were detected in 37.5% of chronic carriers. The seropositivity of HVB markers was much higher in parenteral drug abusers (PDA) as compared with non PDA (76.3% vs 26.7%, p less than 0.0000001, OR = 8.82). Among PDA, it was higher in regular users than in occasional ones (83.3% vs 62.9%, p = 0.0001, OR = 2.95) and in those who had acquired the habit at an early age (p = 0.035). The stratified analysis also showed an association of VHB infection with other variables, basically ethical and prison-related. The possibility to develop active immunization programs is evaluated.
Adolescent↗