array:23 [
  "pii" => "S2341287917300285"
  "issn" => "23412879"
  "doi" => "10.1016/j.anpede.2016.12.001"
  "estado" => "S300"
  "fechaPublicacion" => "2017-04-01"
  "aid" => "2196"
  "copyright" => "Asociación Española de Pediatría"
  "copyrightAnyo" => "2016"
  "documento" => "article"
  "crossmark" => 1
  "subdocumento" => "sco"
  "cita" => "An Pediatr (Barc). 2017;86:173-5"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:2 [
    "total" => 2516
    "formatos" => array:3 [
      "EPUB" => 254
      "HTML" => 1558
      "PDF" => 704
    ]
  ]
  "Traduccion" => array:1 [
    "es" => array:18 [
      "pii" => "S1695403316303411"
      "issn" => "16954033"
      "doi" => "10.1016/j.anpedi.2016.12.004"
      "estado" => "S300"
      "fechaPublicacion" => "2017-04-01"
      "aid" => "2196"
      "documento" => "article"
      "crossmark" => 1
      "subdocumento" => "sco"
      "cita" => "An Pediatr (Barc). 2017;86:173-5"
      "abierto" => array:3 [
        "ES" => false
        "ES2" => false
        "LATM" => false
      ]
      "gratuito" => false
      "lecturas" => array:2 [
        "total" => 12752
        "formatos" => array:3 [
          "EPUB" => 270
          "HTML" => 10137
          "PDF" => 2345
        ]
      ]
      "es" => array:10 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">EDITORIAL</span>"
        "titulo" => "Obesidad infantil&#58; &#191;prevenci&#243;n o tratamiento&#63;"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "173"
            "paginaFinal" => "175"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Childhood obesity&#58; Prevention or treatment&#63;"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Juan J&#46; D&#237;az Mart&#237;n"
            "autores" => array:1 [
              0 => array:2 [
                "nombre" => "Juan J&#46;"
                "apellidos" => "D&#237;az Mart&#237;n"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S2341287917300285"
          "doi" => "10.1016/j.anpede.2016.12.001"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => false
            "ES2" => false
            "LATM" => false
          ]
          "gratuito" => false
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287917300285?idApp=UINPBA00005H"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403316303411?idApp=UINPBA00005H"
      "url" => "/16954033/0000008600000004/v1_201703250037/S1695403316303411/v1_201703250037/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S2341287917300224"
    "issn" => "23412879"
    "doi" => "10.1016/j.anpede.2015.10.027"
    "estado" => "S300"
    "fechaPublicacion" => "2017-04-01"
    "aid" => "1999"
    "copyright" => "Asociaci&#243;n Espa&#241;ola de Pediatr&#237;a"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "fla"
    "cita" => "An Pediatr &#40;Barc&#41;. 2017;86:176-81"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 2028
      "formatos" => array:3 [
        "EPUB" => 222
        "HTML" => 1338
        "PDF" => 468
      ]
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>"
      "titulo" => "High incidence of type 1 diabetes in the immigrant population of Osona and Baix Camp"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "176"
          "paginaFinal" => "181"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Alta incidencia de diabetes tipo 1 en poblaci&#243;n magreb&#237; de Osona y Baix Camp"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0010"
          "etiqueta" => "Figure 2"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr2.jpeg"
              "Alto" => 1439
              "Ancho" => 1624
              "Tamanyo" => 114015
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Evolution of the incidence rate of type 1 diabetes mellitus in the populations aged 0&#8211;4 years and 5&#8211;18 years in Osona and Baix Camp between 2001 and 2012&#46; The incidence rate is expressed as number of cases per 100<span class="elsevierStyleHsp" style=""></span>000 inhabitants per year&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Meritxell Torrab&#237;as-Rodas, Albert Feliu-Rovira, Ines Porcar-Cardona, Jacint Altimiras-Roset"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "Meritxell"
              "apellidos" => "Torrab&#237;as-Rodas"
            ]
            1 => array:2 [
              "nombre" => "Albert"
              "apellidos" => "Feliu-Rovira"
            ]
            2 => array:2 [
              "nombre" => "Ines"
              "apellidos" => "Porcar-Cardona"
            ]
            3 => array:2 [
              "nombre" => "Jacint"
              "apellidos" => "Altimiras-Roset"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S1695403315004105"
        "doi" => "10.1016/j.anpedi.2015.10.013"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => false
          "ES2" => false
          "LATM" => false
        ]
        "gratuito" => false
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403315004105?idApp=UINPBA00005H"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287917300224?idApp=UINPBA00005H"
    "url" => "/23412879/0000008600000004/v1_201703250056/S2341287917300224/v1_201703250056/en/main.assets"
  ]
  "en" => array:12 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Editorial</span>"
    "titulo" => "Childhood obesity&#58; Prevention or treatment&#63;"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "173"
        "paginaFinal" => "175"
      ]
    ]
    "autores" => array:1 [
      0 => array:3 [
        "autoresLista" => "Juan J&#46; D&#237;az Mart&#237;n"
        "autores" => array:1 [
          0 => array:3 [
            "nombre" => "Juan J&#46;"
            "apellidos" => "D&#237;az Mart&#237;n"
            "email" => array:1 [
              0 => "Juanjo&#46;diazmartin&#64;gmail&#46;com"
            ]
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:2 [
            "entidad" => "Secci&#243;n de Gastroenterolog&#237;a y Nutrici&#243;n&#44; &#193;rea de Gesti&#243;n Cl&#237;nica de Pediatr&#237;a&#44; Hospital Universitario Central de Asturias&#44; Oviedo&#44; Asturias&#44; Spain"
            "identificador" => "aff0005"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Obesidad infantil&#58; &#191;prevenci&#243;n o tratamiento&#63;"
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Childhood obesity is unquestionably one of the major health problems confronting the developed world&#44; and it has been termed a global XXI century epidemic by the World Health Organisation&#46; While the aetiology of this disease is multifactorial and includes genetic and environmental causes&#44; we can broadly state that the excess fat that defines it fundamentally arises from an imbalance in energy intake and expenditure&#46; Numerous authors have highlighted that there is an obesogenic environment in our society characterised by the availability of foods rich in calories&#44; refined sugars&#44; saturated fats and salt at all times of day&#44; and the emergence of sedentary leisure habits&#44; with several hours a day spent in the use of televisions&#44; console videogames&#44; smart phones&#44; etc&#46;&#44; and a considerable decline in the hours children engage in physical activity&#44; be it play or sports&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Although the concept of obesity is well understood by all&#44; its appropriate diagnosis continues to be a subject of debate&#46; Obesity corresponds to excess body fat&#44; so its correct diagnosis requires some marker or anthropometric measure that can be used to assess body fat accurately and be available to all paediatricians in everyday practise&#46; It is possible to measure total fat mass directly with great accuracy&#44; but the methods employed for this purpose are only within reach of a few research facilities&#46; This is why&#44; for all its drawbacks&#44; the body mass index &#40;BMI&#41; has been adopted as the preferred method to define overweight and obesity&#46; Whereas BMI values of 25 and 30<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span> are unanimously accepted as the cut-off points for overweight and obesity in adults&#44; the situation is quite different in paediatrics&#46; The very nature of the child as a growing being whose body composition changes as years go by precludes the determination of a single value for each age-and-sex range&#46; It is on this point that disagreements arise as to which is the appropriate standard for comparison&#46; Nevertheless&#44; the definition based on <span class="elsevierStyleItalic">z</span>-scores seems to be prevailing in recent years&#44; so that overweight is defined as a BMI <span class="elsevierStyleItalic">z</span>-score equal or greater than &#43;1 and obesity as a BMI <span class="elsevierStyleItalic">z</span>-score equal or greater than &#43;2&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">The seriousness of childhood obesity does not stem from its increasingly frequent association with the development of comorbidities in the paediatric age group &#40;diabetes mellitus&#44; hypertension&#44; fatty liver disease&#44; etc&#46;&#41;&#44; but from the fact that obese children are at high risk of becoming obese adults&#44; which carries an increased risk of mortality&#46; A recent study conducted in Jewish adolescents showed a significant association between a high BMI in adolescence and increased cardiovascular and all-cause mortality in adulthood&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">1</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">The increasing trend in the prevalence of childhood obesity is generalised across the developed world&#44; and is particularly marked in countries like the United States of America&#44; where the prevalence has tripled in the past few decades&#46; In Europe&#44; childhood obesity is a particularly serious problem in southern countries&#44; including Spain&#46; This trend&#44; however&#44; seems to have reversed in recent years&#46; The findings of the ALADINO study&#44; which have been presented recently and are awaiting publication&#44; show a significant decrease in the prevalence of obesity and overweight in Spanish children&#46; A previous study conducted in a sample of public schools in Oviedo with a twenty-year followup had similar results&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">2</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">The treatment of childhood obesity may include pharmacological and nonpharmacological measures&#44; and some cases in adolescents may even require surgery&#46; Chief among the nonpharmacological measures are changes in diet and lifestyle habits&#44; with an increase in hours spent in physical activity and a decrease in the time spent in sedentary activities&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">In the current issue of <span class="elsevierStyleSmallCaps">Anales de Pediatr&#237;a</span>&#44; Rajmil et al&#46; present the results of a systematic literature review that included a total of 48 studies in the paediatric age group with the purpose of evaluating the efficacy of different clinical interventions in childhood obesity&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">3</span></a> The review excluded studies on the management of obesity that used any type of pharmacological and&#47;or surgical interventions or preventive strategies&#46; The authors concluded that despite the heterogeneity of the interventions&#44; those that proved most efficacious in achieving a reduction of BMI in study participants were multicomponent interventions that combined changes in diet&#44; physical activity and lifestyle&#46; Furthermore&#44; these interventions were more likely to succeed the greater the degree of family involvement and when they were initiated at early ages&#46; These results are consistent with the findings of a recent Cochrane review in children aged up to 6 years&#44; although the effect size was small&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">4</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">Studies have been published that demonstrate the efficacy of these interventions when they are implemented in primary care settings and applying the principles of motivational interviewing&#46; Motivational interviewing is a patient-centred communication style used extensively in behaviour modification&#46; Its purpose is to establish a common ground for patient and clinician&#44; who then form a dynamic team in which the patient is the most important member&#46; In the specific case of childhood obesity&#44; motivational interviewing must necessarily involve the family&#46; This approach is based on empathy&#44; avoids &#8220;labelling&#8221; and assigning blame to the patient&#44; and works on accepting ambivalent feelings&#44; identifying resistance to change&#44; and ultimately generating self-motivating affirmations that can foster positive change&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Difficulties in adhering to treatment and in the long-term maintenance of results have been widely reported in relation to the management of obese paediatric patients&#46; Thus&#44; prevention may be a more effective approach to the problem&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Starting with the research of Osmond and Barker&#44;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">5</span></a> the scientific community has produced a growing body of evidence on the existence of &#8220;foetal programming&#8221; by which certain physiological events that take place in the early stages of life between conception and age 2 years &#40;the so-called first thousand days of life&#41; produce permanent changes in metabolism that somehow promote the subsequent development of various cardiovascular risk factors and diseases&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">An adequate control of diet that guarantees optimal weight gain during pregnancy&#44; maintenance of exclusive breastfeeding until age 6 months&#44; the gradual introduction of solid foods in a balanced diet without excessive consumption of animal protein and with adequate intake of fruits&#44; vegetables&#44; and whole grains and few simple carbohydrates&#44; the structured monitoring of weight and height gain in children in primary care&#44; and educating parents in how to promote healthy lifestyle habits in children&#44; emphasising active over sedentary leisure activities&#44; are some of the elements that research has shown ought to be implemented in strategies for the prevention of childhood obesity&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">A Cochrane review on interventions for preventing obesity in children identified the following strategies as having beneficial effects<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">6</span></a>&#58; a school curriculum that includes healthy eating&#44; physical activity and body image&#59; increased sessions for physical activity and the development of fundamental movement skills throughout the school week&#59; improvements in nutritional quality of the food supply in schools&#59; environments and cultural practices that support children eating healthier foods and being active throughout each day&#59; support for teachers and other staff to implement health promotion strategies and activities&#59; parent support and home activities that encourage children to be more active&#44; eat more nutritious foods and spend less time in screen based activities&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Last of all&#44; the aforementioned review in this issue<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">3</span></a> highlighted the lack of clear criteria for referral from primary to specialty care&#46; This is a problem that should be addressed on an urgent basis&#46; Although we have managed to slightly reduce the prevalence of obesity in our children&#44; there is a significant number of children that have severe obesity or associated comorbidities&#46; The management of these patients requires a more aggressive and multidisciplinary approach&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">In short&#44; childhood obesity continues to be a problem for society and a considerable challenge for paediatricians&#46; It is our collective duty to bring the number of children that develop obesity to a minimum &#40;primordial prevention&#41;&#44; which calls for the implementation of appropriate preventive measures from the early stages of life&#46; Another common goal should be to prevent the progression of children with overweight to obesity &#40;primary prevention&#41;&#44; and to keep obese children from becoming obese adults &#40;secondary prevention&#41;&#44; which would require&#58; &#40;1&#41; clear criteria for the diagnosis of obesity and overweight&#59; &#40;2&#41; development of adequate motivational interviewing skills in professionals in charge of the management and followup of obese patients&#59; &#40;3&#41; standardisation of and agreement on the management of obesity in primary care settings&#59; &#40;4&#41; establishment of clear criteria for referral to specialty care&#44; and &#40;5&#41; creation in hospitals of units specialised in obesity for the intensive treatment of the most serious cases&#46;</p></span>"
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Mart&#237;n JJ&#46; Obesidad infantil&#58; &#191;prevenci&#243;n o tratamiento&#63; An Pediatr &#40;Barc&#41;&#46; 2017&#59;86&#58;173&#8211;175&#46;</p>"
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:6 [
            0 => array:3 [
              "identificador" => "bib0035"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Body-mass index in 2&#46;3 million adolescents and cardiovascular death in adulthood"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "G&#46; Twig"
                            1 => "G&#46; Yaniv"
                            2 => "H&#46; Levine"
                            3 => "A&#46; Leiba"
                            4 => "N&#46; Goldberger"
                            5 => "E&#46; Derazne"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJMoa1503840"
                      "Revista" => array:6 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "2016"
                        "volumen" => "374"
                        "paginaInicial" => "2430"
                        "paginaFinal" => "2440"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27074389"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Obesidad en Oviedo&#58; prevalencia y tendencias temporales de 1992 a 2012"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "R&#46; Llada Su&#225;rez"
                            1 => "L&#46; del Fresno Marqu&#233;s"
                            2 => "J&#46;J&#46; D&#237;az Mart&#237;n"
                            3 => "S&#46; M&#225;laga Guerrero"
                            4 => "C&#46; Rey Gal&#225;n"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "An Pediatr &#40;Barc&#41;"
                        "fecha" => "2015"
                        "volumen" => "82"
                        "paginaInicial" => "363"
                        "paginaFinal" => "365"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0045"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Intervenciones cl&#237;nicas en sobrepeso y obesidad&#58; revisi&#243;n sistem&#225;tica de la literatura 2009&#8211;2014"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "L&#46; Rajmil"
                            1 => "J&#46; Beld"
                            2 => "R&#46; Clofent"
                            3 => "C&#46; Cabezas"
                            4 => "C&#46; Castell"
                            5 => "M&#46; Espallargues"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "An Pediatr &#40;Barc&#41;"
                        "fecha" => "2017"
                        "volumen" => "86"
                        "paginaInicial" => "197"
                        "paginaFinal" => "212"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0050"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:3 [
                  "comentario" => "Art&#46; N&#46;&#176; CD012105"
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Diet&#44; physical activity&#44; and behavioural interventions for the treatment of overweight or obesity in preschool children up to the age of 6 years"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;L&#46; Colquitt"
                            1 => "E&#46; Loveman"
                            2 => "C&#46; O&#8217;Malley"
                            3 => "L&#46;B&#46; Azevedo"
                            4 => "E&#46; Mead"
                            5 => "L&#46; Al-Khudairy"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:2 [
                        "tituloSerie" => "Cochrane Database Syst Rev"
                        "fecha" => "2016"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0055"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Weight in infancy and death from ischaemic heart disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "D&#46;J&#46; Barker"
                            1 => "P&#46;D&#46; Winter"
                            2 => "C&#46; Osmond"
                            3 => "B&#46; Margetts"
                            4 => "S&#46;J&#46; Simmonds"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S2215-0366(15)00182-0"
                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet"
                        "fecha" => "1989"
                        "volumen" => "2"
                        "paginaInicial" => "577"
                        "paginaFinal" => "580"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26303538"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0060"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Interventions for preventing obesity in children"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "E&#46; Waters"
                            1 => "A&#46; de Silva-Sanigorski"
                            2 => "B&#46;J&#46; Hall"
                            3 => "T&#46; Brown"
                            4 => "K&#46;J&#46; Campbell"
                            5 => "Y&#46; Gao"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Cochrane Database Syst Rev"
                        "fecha" => "2011"
                        "volumen" => "12"
                        "paginaInicial" => "CD001871"
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/23412879/0000008600000004/v1_201703250056/S2341287917300285/v1_201703250056/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "25501"
    "tipo" => "SECCION"
    "es" => array:2 [
      "titulo" => "Editorial"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "es"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/23412879/0000008600000004/v1_201703250056/S2341287917300285/v1_201703250056/en/main.pdf?idApp=UINPBA00005H&text.app=https://analesdepediatria.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287917300285?idApp=UINPBA00005H"
]
Share
Journal Information

Statistics

Follow this link to access the full text of the article

Editorial
Childhood obesity: Prevention or treatment?
Obesidad infantil: ¿prevención o tratamiento?
Juan J. Díaz Martín
Sección de Gastroenterología y Nutrición, Área de Gestión Clínica de Pediatría, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
Read
7496
Times
was read the article
2544
Total PDF
4952
Total HTML
Share statistics
 array:23 [
  "pii" => "S2341287917300285"
  "issn" => "23412879"
  "doi" => "10.1016/j.anpede.2016.12.001"
  "estado" => "S300"
  "fechaPublicacion" => "2017-04-01"
  "aid" => "2196"
  "copyright" => "Asociaci&#243;n Espa&#241;ola de Pediatr&#237;a"
  "copyrightAnyo" => "2016"
  "documento" => "article"
  "crossmark" => 1
  "subdocumento" => "sco"
  "cita" => "An Pediatr &#40;Barc&#41;. 2017;86:173-5"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:2 [
    "total" => 2516
    "formatos" => array:3 [
      "EPUB" => 254
      "HTML" => 1558
      "PDF" => 704
    ]
  ]
  "Traduccion" => array:1 [
    "es" => array:18 [
      "pii" => "S1695403316303411"
      "issn" => "16954033"
      "doi" => "10.1016/j.anpedi.2016.12.004"
      "estado" => "S300"
      "fechaPublicacion" => "2017-04-01"
      "aid" => "2196"
      "documento" => "article"
      "crossmark" => 1
      "subdocumento" => "sco"
      "cita" => "An Pediatr &#40;Barc&#41;. 2017;86:173-5"
      "abierto" => array:3 [
        "ES" => false
        "ES2" => false
        "LATM" => false
      ]
      "gratuito" => false
      "lecturas" => array:2 [
        "total" => 12752
        "formatos" => array:3 [
          "EPUB" => 270
          "HTML" => 10137
          "PDF" => 2345
        ]
      ]
      "es" => array:10 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">EDITORIAL</span>"
        "titulo" => "Obesidad infantil&#58; &#191;prevenci&#243;n o tratamiento&#63;"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "173"
            "paginaFinal" => "175"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Childhood obesity&#58; Prevention or treatment&#63;"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Juan J&#46; D&#237;az Mart&#237;n"
            "autores" => array:1 [
              0 => array:2 [
                "nombre" => "Juan J&#46;"
                "apellidos" => "D&#237;az Mart&#237;n"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S2341287917300285"
          "doi" => "10.1016/j.anpede.2016.12.001"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => false
            "ES2" => false
            "LATM" => false
          ]
          "gratuito" => false
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287917300285?idApp=UINPBA00005H"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403316303411?idApp=UINPBA00005H"
      "url" => "/16954033/0000008600000004/v1_201703250037/S1695403316303411/v1_201703250037/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S2341287917300224"
    "issn" => "23412879"
    "doi" => "10.1016/j.anpede.2015.10.027"
    "estado" => "S300"
    "fechaPublicacion" => "2017-04-01"
    "aid" => "1999"
    "copyright" => "Asociaci&#243;n Espa&#241;ola de Pediatr&#237;a"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "fla"
    "cita" => "An Pediatr &#40;Barc&#41;. 2017;86:176-81"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 2028
      "formatos" => array:3 [
        "EPUB" => 222
        "HTML" => 1338
        "PDF" => 468
      ]
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>"
      "titulo" => "High incidence of type 1 diabetes in the immigrant population of Osona and Baix Camp"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "176"
          "paginaFinal" => "181"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Alta incidencia de diabetes tipo 1 en poblaci&#243;n magreb&#237; de Osona y Baix Camp"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0010"
          "etiqueta" => "Figure 2"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr2.jpeg"
              "Alto" => 1439
              "Ancho" => 1624
              "Tamanyo" => 114015
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Evolution of the incidence rate of type 1 diabetes mellitus in the populations aged 0&#8211;4 years and 5&#8211;18 years in Osona and Baix Camp between 2001 and 2012&#46; The incidence rate is expressed as number of cases per 100<span class="elsevierStyleHsp" style=""></span>000 inhabitants per year&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Meritxell Torrab&#237;as-Rodas, Albert Feliu-Rovira, Ines Porcar-Cardona, Jacint Altimiras-Roset"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "Meritxell"
              "apellidos" => "Torrab&#237;as-Rodas"
            ]
            1 => array:2 [
              "nombre" => "Albert"
              "apellidos" => "Feliu-Rovira"
            ]
            2 => array:2 [
              "nombre" => "Ines"
              "apellidos" => "Porcar-Cardona"
            ]
            3 => array:2 [
              "nombre" => "Jacint"
              "apellidos" => "Altimiras-Roset"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S1695403315004105"
        "doi" => "10.1016/j.anpedi.2015.10.013"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => false
          "ES2" => false
          "LATM" => false
        ]
        "gratuito" => false
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403315004105?idApp=UINPBA00005H"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287917300224?idApp=UINPBA00005H"
    "url" => "/23412879/0000008600000004/v1_201703250056/S2341287917300224/v1_201703250056/en/main.assets"
  ]
  "en" => array:12 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Editorial</span>"
    "titulo" => "Childhood obesity&#58; Prevention or treatment&#63;"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "173"
        "paginaFinal" => "175"
      ]
    ]
    "autores" => array:1 [
      0 => array:3 [
        "autoresLista" => "Juan J&#46; D&#237;az Mart&#237;n"
        "autores" => array:1 [
          0 => array:3 [
            "nombre" => "Juan J&#46;"
            "apellidos" => "D&#237;az Mart&#237;n"
            "email" => array:1 [
              0 => "Juanjo&#46;diazmartin&#64;gmail&#46;com"
            ]
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:2 [
            "entidad" => "Secci&#243;n de Gastroenterolog&#237;a y Nutrici&#243;n&#44; &#193;rea de Gesti&#243;n Cl&#237;nica de Pediatr&#237;a&#44; Hospital Universitario Central de Asturias&#44; Oviedo&#44; Asturias&#44; Spain"
            "identificador" => "aff0005"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Obesidad infantil&#58; &#191;prevenci&#243;n o tratamiento&#63;"
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Childhood obesity is unquestionably one of the major health problems confronting the developed world&#44; and it has been termed a global XXI century epidemic by the World Health Organisation&#46; While the aetiology of this disease is multifactorial and includes genetic and environmental causes&#44; we can broadly state that the excess fat that defines it fundamentally arises from an imbalance in energy intake and expenditure&#46; Numerous authors have highlighted that there is an obesogenic environment in our society characterised by the availability of foods rich in calories&#44; refined sugars&#44; saturated fats and salt at all times of day&#44; and the emergence of sedentary leisure habits&#44; with several hours a day spent in the use of televisions&#44; console videogames&#44; smart phones&#44; etc&#46;&#44; and a considerable decline in the hours children engage in physical activity&#44; be it play or sports&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Although the concept of obesity is well understood by all&#44; its appropriate diagnosis continues to be a subject of debate&#46; Obesity corresponds to excess body fat&#44; so its correct diagnosis requires some marker or anthropometric measure that can be used to assess body fat accurately and be available to all paediatricians in everyday practise&#46; It is possible to measure total fat mass directly with great accuracy&#44; but the methods employed for this purpose are only within reach of a few research facilities&#46; This is why&#44; for all its drawbacks&#44; the body mass index &#40;BMI&#41; has been adopted as the preferred method to define overweight and obesity&#46; Whereas BMI values of 25 and 30<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span> are unanimously accepted as the cut-off points for overweight and obesity in adults&#44; the situation is quite different in paediatrics&#46; The very nature of the child as a growing being whose body composition changes as years go by precludes the determination of a single value for each age-and-sex range&#46; It is on this point that disagreements arise as to which is the appropriate standard for comparison&#46; Nevertheless&#44; the definition based on <span class="elsevierStyleItalic">z</span>-scores seems to be prevailing in recent years&#44; so that overweight is defined as a BMI <span class="elsevierStyleItalic">z</span>-score equal or greater than &#43;1 and obesity as a BMI <span class="elsevierStyleItalic">z</span>-score equal or greater than &#43;2&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">The seriousness of childhood obesity does not stem from its increasingly frequent association with the development of comorbidities in the paediatric age group &#40;diabetes mellitus&#44; hypertension&#44; fatty liver disease&#44; etc&#46;&#41;&#44; but from the fact that obese children are at high risk of becoming obese adults&#44; which carries an increased risk of mortality&#46; A recent study conducted in Jewish adolescents showed a significant association between a high BMI in adolescence and increased cardiovascular and all-cause mortality in adulthood&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">1</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">The increasing trend in the prevalence of childhood obesity is generalised across the developed world&#44; and is particularly marked in countries like the United States of America&#44; where the prevalence has tripled in the past few decades&#46; In Europe&#44; childhood obesity is a particularly serious problem in southern countries&#44; including Spain&#46; This trend&#44; however&#44; seems to have reversed in recent years&#46; The findings of the ALADINO study&#44; which have been presented recently and are awaiting publication&#44; show a significant decrease in the prevalence of obesity and overweight in Spanish children&#46; A previous study conducted in a sample of public schools in Oviedo with a twenty-year followup had similar results&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">2</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">The treatment of childhood obesity may include pharmacological and nonpharmacological measures&#44; and some cases in adolescents may even require surgery&#46; Chief among the nonpharmacological measures are changes in diet and lifestyle habits&#44; with an increase in hours spent in physical activity and a decrease in the time spent in sedentary activities&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">In the current issue of <span class="elsevierStyleSmallCaps">Anales de Pediatr&#237;a</span>&#44; Rajmil et al&#46; present the results of a systematic literature review that included a total of 48 studies in the paediatric age group with the purpose of evaluating the efficacy of different clinical interventions in childhood obesity&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">3</span></a> The review excluded studies on the management of obesity that used any type of pharmacological and&#47;or surgical interventions or preventive strategies&#46; The authors concluded that despite the heterogeneity of the interventions&#44; those that proved most efficacious in achieving a reduction of BMI in study participants were multicomponent interventions that combined changes in diet&#44; physical activity and lifestyle&#46; Furthermore&#44; these interventions were more likely to succeed the greater the degree of family involvement and when they were initiated at early ages&#46; These results are consistent with the findings of a recent Cochrane review in children aged up to 6 years&#44; although the effect size was small&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">4</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">Studies have been published that demonstrate the efficacy of these interventions when they are implemented in primary care settings and applying the principles of motivational interviewing&#46; Motivational interviewing is a patient-centred communication style used extensively in behaviour modification&#46; Its purpose is to establish a common ground for patient and clinician&#44; who then form a dynamic team in which the patient is the most important member&#46; In the specific case of childhood obesity&#44; motivational interviewing must necessarily involve the family&#46; This approach is based on empathy&#44; avoids &#8220;labelling&#8221; and assigning blame to the patient&#44; and works on accepting ambivalent feelings&#44; identifying resistance to change&#44; and ultimately generating self-motivating affirmations that can foster positive change&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Difficulties in adhering to treatment and in the long-term maintenance of results have been widely reported in relation to the management of obese paediatric patients&#46; Thus&#44; prevention may be a more effective approach to the problem&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Starting with the research of Osmond and Barker&#44;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">5</span></a> the scientific community has produced a growing body of evidence on the existence of &#8220;foetal programming&#8221; by which certain physiological events that take place in the early stages of life between conception and age 2 years &#40;the so-called first thousand days of life&#41; produce permanent changes in metabolism that somehow promote the subsequent development of various cardiovascular risk factors and diseases&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">An adequate control of diet that guarantees optimal weight gain during pregnancy&#44; maintenance of exclusive breastfeeding until age 6 months&#44; the gradual introduction of solid foods in a balanced diet without excessive consumption of animal protein and with adequate intake of fruits&#44; vegetables&#44; and whole grains and few simple carbohydrates&#44; the structured monitoring of weight and height gain in children in primary care&#44; and educating parents in how to promote healthy lifestyle habits in children&#44; emphasising active over sedentary leisure activities&#44; are some of the elements that research has shown ought to be implemented in strategies for the prevention of childhood obesity&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">A Cochrane review on interventions for preventing obesity in children identified the following strategies as having beneficial effects<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">6</span></a>&#58; a school curriculum that includes healthy eating&#44; physical activity and body image&#59; increased sessions for physical activity and the development of fundamental movement skills throughout the school week&#59; improvements in nutritional quality of the food supply in schools&#59; environments and cultural practices that support children eating healthier foods and being active throughout each day&#59; support for teachers and other staff to implement health promotion strategies and activities&#59; parent support and home activities that encourage children to be more active&#44; eat more nutritious foods and spend less time in screen based activities&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Last of all&#44; the aforementioned review in this issue<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">3</span></a> highlighted the lack of clear criteria for referral from primary to specialty care&#46; This is a problem that should be addressed on an urgent basis&#46; Although we have managed to slightly reduce the prevalence of obesity in our children&#44; there is a significant number of children that have severe obesity or associated comorbidities&#46; The management of these patients requires a more aggressive and multidisciplinary approach&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">In short&#44; childhood obesity continues to be a problem for society and a considerable challenge for paediatricians&#46; It is our collective duty to bring the number of children that develop obesity to a minimum &#40;primordial prevention&#41;&#44; which calls for the implementation of appropriate preventive measures from the early stages of life&#46; Another common goal should be to prevent the progression of children with overweight to obesity &#40;primary prevention&#41;&#44; and to keep obese children from becoming obese adults &#40;secondary prevention&#41;&#44; which would require&#58; &#40;1&#41; clear criteria for the diagnosis of obesity and overweight&#59; &#40;2&#41; development of adequate motivational interviewing skills in professionals in charge of the management and followup of obese patients&#59; &#40;3&#41; standardisation of and agreement on the management of obesity in primary care settings&#59; &#40;4&#41; establishment of clear criteria for referral to specialty care&#44; and &#40;5&#41; creation in hospitals of units specialised in obesity for the intensive treatment of the most serious cases&#46;</p></span>"
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Mart&#237;n JJ&#46; Obesidad infantil&#58; &#191;prevenci&#243;n o tratamiento&#63; An Pediatr &#40;Barc&#41;&#46; 2017&#59;86&#58;173&#8211;175&#46;</p>"
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:6 [
            0 => array:3 [
              "identificador" => "bib0035"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Body-mass index in 2&#46;3 million adolescents and cardiovascular death in adulthood"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "G&#46; Twig"
                            1 => "G&#46; Yaniv"
                            2 => "H&#46; Levine"
                            3 => "A&#46; Leiba"
                            4 => "N&#46; Goldberger"
                            5 => "E&#46; Derazne"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJMoa1503840"
                      "Revista" => array:6 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "2016"
                        "volumen" => "374"
                        "paginaInicial" => "2430"
                        "paginaFinal" => "2440"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27074389"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Obesidad en Oviedo&#58; prevalencia y tendencias temporales de 1992 a 2012"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "R&#46; Llada Su&#225;rez"
                            1 => "L&#46; del Fresno Marqu&#233;s"
                            2 => "J&#46;J&#46; D&#237;az Mart&#237;n"
                            3 => "S&#46; M&#225;laga Guerrero"
                            4 => "C&#46; Rey Gal&#225;n"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "An Pediatr &#40;Barc&#41;"
                        "fecha" => "2015"
                        "volumen" => "82"
                        "paginaInicial" => "363"
                        "paginaFinal" => "365"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0045"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Intervenciones cl&#237;nicas en sobrepeso y obesidad&#58; revisi&#243;n sistem&#225;tica de la literatura 2009&#8211;2014"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "L&#46; Rajmil"
                            1 => "J&#46; Beld"
                            2 => "R&#46; Clofent"
                            3 => "C&#46; Cabezas"
                            4 => "C&#46; Castell"
                            5 => "M&#46; Espallargues"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "An Pediatr &#40;Barc&#41;"
                        "fecha" => "2017"
                        "volumen" => "86"
                        "paginaInicial" => "197"
                        "paginaFinal" => "212"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0050"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:3 [
                  "comentario" => "Art&#46; N&#46;&#176; CD012105"
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Diet&#44; physical activity&#44; and behavioural interventions for the treatment of overweight or obesity in preschool children up to the age of 6 years"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;L&#46; Colquitt"
                            1 => "E&#46; Loveman"
                            2 => "C&#46; O&#8217;Malley"
                            3 => "L&#46;B&#46; Azevedo"
                            4 => "E&#46; Mead"
                            5 => "L&#46; Al-Khudairy"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:2 [
                        "tituloSerie" => "Cochrane Database Syst Rev"
                        "fecha" => "2016"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0055"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Weight in infancy and death from ischaemic heart disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "D&#46;J&#46; Barker"
                            1 => "P&#46;D&#46; Winter"
                            2 => "C&#46; Osmond"
                            3 => "B&#46; Margetts"
                            4 => "S&#46;J&#46; Simmonds"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S2215-0366(15)00182-0"
                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet"
                        "fecha" => "1989"
                        "volumen" => "2"
                        "paginaInicial" => "577"
                        "paginaFinal" => "580"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26303538"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0060"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Interventions for preventing obesity in children"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "E&#46; Waters"
                            1 => "A&#46; de Silva-Sanigorski"
                            2 => "B&#46;J&#46; Hall"
                            3 => "T&#46; Brown"
                            4 => "K&#46;J&#46; Campbell"
                            5 => "Y&#46; Gao"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Cochrane Database Syst Rev"
                        "fecha" => "2011"
                        "volumen" => "12"
                        "paginaInicial" => "CD001871"
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/23412879/0000008600000004/v1_201703250056/S2341287917300285/v1_201703250056/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "25501"
    "tipo" => "SECCION"
    "es" => array:2 [
      "titulo" => "Editorial"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "es"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/23412879/0000008600000004/v1_201703250056/S2341287917300285/v1_201703250056/en/main.pdf?idApp=UINPBA00005H&text.app=https://analesdepediatria.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287917300285?idApp=UINPBA00005H"
]
Article information
ISSN: 23412879
Original language: English
The statistics are updated each day
Year/Month Html Pdf Total
2024 November 9 9 18
2024 October 53 48 101
2024 September 44 28 72
2024 August 53 64 117
2024 July 38 24 62
2024 June 44 34 78
2024 May 50 30 80
2024 April 64 34 98
2024 March 33 23 56
2024 February 40 27 67
2024 January 28 24 52
2023 December 36 18 54
2023 November 27 29 56
2023 October 43 26 69
2023 September 30 22 52
2023 August 37 16 53
2023 July 29 28 57
2023 June 40 28 68
2023 May 58 26 84
2023 April 46 10 56
2023 March 59 32 91
2023 February 26 19 45
2023 January 33 14 47
2022 December 52 33 85
2022 November 63 28 91
2022 October 81 51 132
2022 September 54 37 91
2022 August 60 54 114
2022 July 51 34 85
2022 June 47 37 84
2022 May 59 35 94
2022 April 60 30 90
2022 March 71 47 118
2022 February 66 35 101
2022 January 77 42 119
2021 December 73 51 124
2021 November 74 49 123
2021 October 116 73 189
2021 September 69 31 100
2021 August 60 43 103
2021 July 114 32 146
2021 June 92 53 145
2021 May 76 49 125
2021 April 170 86 256
2021 March 114 34 148
2021 February 66 12 78
2021 January 57 17 74
2020 December 49 14 63
2020 November 69 14 83
2020 October 52 13 65
2020 September 66 32 98
2020 August 62 36 98
2020 July 53 34 87
2020 June 62 11 73
2020 May 71 22 93
2020 April 73 23 96
2020 March 49 22 71
2020 February 85 20 105
2020 January 35 11 46
2019 December 53 17 70
2019 November 91 23 114
2019 October 72 12 84
2019 September 44 106 150
2019 August 40 35 75
2019 July 75 41 116
2019 June 76 42 118
2019 May 113 44 157
2019 April 116 25 141
2019 March 69 27 96
2019 February 45 10 55
2019 January 51 29 80
2018 December 36 23 59
2018 November 55 33 88
2018 October 47 23 70
2018 September 24 14 38
2018 August 5 0 5
2018 July 2 0 2
2018 June 3 0 3
2018 May 11 0 11
2018 April 25 0 25
2018 March 33 0 33
2018 February 18 0 18
2018 January 16 0 16
2017 December 19 0 19
2017 November 21 0 21
2017 October 12 0 12
2017 September 14 0 14
2017 August 14 0 14
2017 July 15 0 15
2017 June 31 11 42
2017 May 36 13 49
2017 April 188 149 337
2017 March 14 9 23
Show all

Follow this link to access the full text of the article

Idiomas
Anales de Pediatría (English Edition)
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?