Consumption of free sugars and excess weight in infants. A longitudinal study

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Estudio longitudinal" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1839 "Ancho" => 2344 "Tamanyo" => 191691 ] ] "descripcion" => array:1 [ "en" => "Percentage of total energy contributed by free sugars (FSs) and natural sugars at age 12 months by weight status at age 30 months." ] ] ] "textoCompleto" => "IntroductionObesity is a chronic disease that may manifest from the first years of life.<a class="elsevierStyleCrossRef" href="#bib0205">1</a> The increase in the prevalence of overweight and obesity in the paediatric age group<a class="elsevierStyleCrossRefs" href="#bib0210">2,3</a> continues to be a significant social and public health problem, and this is a worldwide trend.<a class="elsevierStyleCrossRef" href="#bib0220">4</a> Specifically, the global prevalence of excess weight in children aged 0–5 years was 4.2% in 1990 compared to 6.7% in 2010, and the World Health Organization (WHO) has estimated that it will reach 9% by 2020.<a class="elsevierStyleCrossRef" href="#bib0225">5</a> Obesity in childhood and adolescence is associated with an increased risk of type 2 diabetes, hypertension, coronary disease and metabolic syndrome in adulthood, in addition to its negative impact on physical and psychosocial wellbeing.<a class="elsevierStyleCrossRefs" href="#bib0230">6,7</a>Dietary practices in the first year have been identified as an important factor that may lead to excess body fat in childhood.<a class="elsevierStyleCrossRef" href="#bib0240">8</a> During this critical period in which substantial changes occur in the diet, an excessive energy intake, an imbalance in macronutrient composition and nutrient deficiencies or overconsumption may contribute to the development of poor dietary habits that may be associated with metabolic changes and increase the risk of obesity.<a class="elsevierStyleCrossRef" href="#bib0245">9</a> In recent years, the increased consumption of free sugars (FSs) has attracted considerable interest, as it is associated with obesity, especially in children and adolescents.<a class="elsevierStyleCrossRef" href="#bib0250">10</a> This increase is associated with a poorer nutritional value of the diet. In this context, the WHO has recommended limiting the intake of FSs (added sugars [ASs] and sugars naturally present in fruit juices and fruit juice concentrates) to no more than 10% of the total energy intake to prevent obesity and associated diseases, and specified that restricting the intake of FSs to less than 5% of the total energy could have additional health benefits, especially in relation to dental caries.<a class="elsevierStyleCrossRef" href="#bib0255">11</a> The results from prospective studies analysing the intake of free and added sugars in relation to the body composition of children have been contradictory.<a class="elsevierStyleCrossRefs" href="#bib0260">12–15</a> These studies have been conducted in children aged 9 months to 9 years in Europe, the United States and Africa. The meta-analysis published by Te Morenga et al. provided evidence that a high intake of FSs, ASs or sugary beverages is a determinant of body weight and of an association between a high sugar intake and diseases like hypertension, dyslipidaemia and insulin resistance in both childhood and adulthood.<a class="elsevierStyleCrossRef" href="#bib0280">16</a> On the other hand, the meta-analysis by Forshee et al. estimated an associated risk that neared zero.<a class="elsevierStyleCrossRef" href="#bib0285">17</a>Few studies have assessed the role of a high consumption of FSs in infancy in the increase in obesity. For this reason, the aim of our study was to analyse the association between the intake of FSs at age 12 months and the probability of excess weight at age 30 months in a group of healthy children in Spain.Materials and methodsDesignWe conducted a longitudinal study of children, with the followup extending from birth to age 30 months.SampleWe selected 81 healthy newborns from the population included in the DeFensas study<a class="elsevierStyleCrossRef" href="#bib0290">18</a> for who data were available on the main clinical, nutritional and anthropometric variables at ages 12 months and 30 months.The study was approved by the Ethics Board of the Hospital Universitario Sant Joan de Reus (Tarragona, Spain).The sample size required to detect differences in weight status at 30 months in children that consumed more than 10% of the total energy in the form of free sugars at 12 months (39.1% and 60.9%) was 42 patients per group for a risk of alpha error of 0.05 and a beta error of less than 0.2 in two-tailed tests (calculated with GRANMO version 7.12, Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain).Measurements and data collectionPrenatal and delivery records were available for all children under study. <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> summarises these data along with the anthropometric measures at ages 12 and 30 months. We also collected data on the medical history, nutrition and anthropometric measurements obtained by paediatricians and dieticians using a standardised protocol.<elsevierMultimedia ident="tbl0005"></elsevierMultimedia>Medical historyWe retrieved data on sociodemographic variables, and maternal and newborn health at the time of birth. We classified socioeconomic status into 3 categories (low, middle, high) using the four-factor index proposed by Hollingshead.<a class="elsevierStyleCrossRef" href="#bib0295">19</a> We collected data for the following obstetric and perinatal variables: newborn sex (male/female), gestational age, type of delivery, infant nutrition (breastfeeding or formula feeding) and 10-min Apgar score. We documented maternal use of tobacco during pregnancy using a questionnaire specifically designed for the purpose. We also recorded all medical problems and all vaccines administered to the child during the followup.Anthropometric variablesWe recorded the child's weight and length/height at birth and ages 12 months and 30 months. At birth and 12 months, the weight was measured with a SECA digital scale accurate to 5g (Vogel & Halke GmbH & Co, Hamburg, Germany), and length with an infantometer accurate to 0.1cm (PE-RILB-STND). The head circumference was measured with a flexible measuring tape accurate to 1mm. At 30 months, the weight and height were measured with a combined digital scale and stadiometer (SECA 764). We calculated the z-scores for child growth indicators such as weight-for-age at birth, weight-for-length at 12 months and weight-for-height at 30 months using the LMS method.<a class="elsevierStyleCrossRefs" href="#bib0300">20,21</a> The z-score corresponds to the number of standard deviations from the mean, with values ranging from −3 to +3 SDs. Based on weight-for-age at birth, weight-for-length at 12 months and weight-for-height at 30 months, we classified children as having underweight (−3≤z<−1), normal weight (−1<z≤+1), overweight (+1<z≤+2) or obesity (z>+2) (WHO<a class="elsevierStyleCrossRef" href="#bib0305">21</a>). We also defined a weight status dichotomous variable with the following categories: no excess weight (underweight or normal weight) and excess weight (overweight or obesity).Infant nutritionWe obtained a 24-h dietary recall at 12 months through standardised interviews with parents held by 2 trained dieticians. All the quantities of food and drink consumed were expressed in grams/person/day. To calculate nutrient intake, we used the REGAL (Répertoire général des Aliments) food composition table<a class="elsevierStyleCrossRef" href="#bib0310">22</a> supplemented with the Mataix Verdú Spanish food composition table.<a class="elsevierStyleCrossRef" href="#bib0315">23</a> We calculated the percent of the total energy intake contributed by the different macronutrients.The recall documented all breastmilk, artificial formula and cow's milk feedings. We estimated the volume of breastmilk based on the age of the infant (600mL/day at 6 months).<a class="elsevierStyleCrossRef" href="#bib0320">24</a> We calculated the intake of formula taking into account that 4.7g of powder formula are usually added to every 30mL of water. We obtained the data for calculation of the composition of breastmilk from the Tratado de nutrición edited by Gil.<a class="elsevierStyleCrossRef" href="#bib0325">25</a>We created 2 categories to classify simple carbohydrates: natural sugars contained in whole fruits, vegetables, milk and cereals (rice, bread, pasta, flour), and free sugars contained in sweetened dairy desserts, sugary drinks (fresh and processed juices, soft drinks), sweetened cereals (sweetened breakfast cereals, biscuits, baked goods) and chocolate, sugar and honey.We calculated the percent of the total energy intake contributed by free sugars. This calculation allowed us to define the standard threshold proposed by the WHO,<a class="elsevierStyleCrossRef" href="#bib0255">11</a> which recommends that FSs should contribute less than 10% of the total energy.Statistical analysisWe present the results as percentages, means and standard deviations.We used the Student's t test to compare means and the chi square test to compare categorical variables.To analyse the association between the percentage of the total energy contributed by FSs at 12 months and the presence of excess weight at 30 months, we fitted a logistic regression model. The dependent variable was weight-for-height at 30 months, which was a dichotomous variable with the following categories: 0 (absence of excess weight) and 1 (presence of excess weight). The independent variable was the percent energy from FSs at 12 months, and the logistic regression was performed selecting the ENTER method and adjusting for the following confounders: percent energy contributed by natural sugars (%), starches (%), proteins (%) and lipids (%), fibre intake (g) and energy intake (kcal) at 12 months, birth weight status (0: no excess weight; 1: excess weight), mode of infant feeding through 6 months (0: formula; 1: exclusive/mixed breastfeeding), sex (0: female, 1: male) and socioeconomic status (0: low; 1: middle/high).We defined statistical significance as a P-value of less than 0.05 in any of the tests. The statistical analysis was performed with the software SPSS for Windows, version 20.0.Results<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> presents the characteristics of the mother and of the child at birth and ages 12 and 30 months. The sample included 81 children, of who 44.6% were male. A total of 84.2% of infants were exclusively breastfeed as newborns. Excess weight was identified in 31.2% of the sample at age 12 months and 39.5% of the sample at 30 months.Children with excess weight at 30 months had consumed a higher percentage of the total energy in the form FSs at 12 months compared to the group of children without excess weight at 30 months (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>). Of all children with excess weight, 60.9% consumed more than 10% of the total energy in the form of FSs, compared to 39.1% in the group without excess weight. Overall, 40.4% of children were consuming FSs in excess of the 10% of the total energy intake recommended by the WHO. <a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a> shows the percent of the total energy contributed by free and natural sugars at 12 months by weight status at 30 months. We found a significantly greater absolute intake of FSs in children with excess weight compared to children without excess weight at 30 months (P=.030). The excessive intake of FSs resulted from a greater consumption of sugary drinks, sweetened breakfast cereals, biscuits, baked goods, chocolate, sugar and honey.<elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia><a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a> presents the results of the logistic regression analysis of the association of macronutrient intake at 12 months and the risk of excess weight at 30 months. Consumption of FSs at 12 months was associated with an increased probability of excess weight at 30 months (OR=1.136; P=.008). Male sex was also associated with an increased risk of excess weight (OR=5.348; P=.045).<elsevierMultimedia ident="tbl0015"></elsevierMultimedia>DiscussionOur study analysed the association between the excessive contribution of FSs to the total dietary energy intake at 12 months and the presence of excess weight at 30 months. We found an intake of FSs in infants that vastly exceeded the threshold of 10% of the total energy recommended by the WHO.<a class="elsevierStyleCrossRef" href="#bib0255">11</a> Several studies have described this association in adolescents and adults, but the data on young children are scarce.We carried out our study in the city of Reus (Tarragona, Spain). Most children belonged to families of middle-to-high socioeconomic status. The protocol for measurement of anthropometric variables, dietary assessment and the performance of interviews and administration of questionnaires was standardised for implementation by all professionals involved in the study with the aim of minimising interrater variability in data collection.Our results show that a high percentage of children had excess weight at age 12 months (31.2%), and that this percentage increased even more by 30 months (39.5%), which was consistent with the findings of a nationwide study conducted recently in Spain.<a class="elsevierStyleCrossRef" href="#bib0220">4</a> This high prevalence in young children has been associated with a high consumption of high-energy processed foods rich in fats, sugars and protein and a low consumption of fruits and vegetables, a low household socioeconomic level, sedentary lifestyles and sleep deprivation.<a class="elsevierStyleCrossRef" href="#bib0330">26</a>The WHO recommends restricting the consumption of FSs to less than 10% of the total energy intake in the general population. However, there is disagreement as to whether fruit juices are included in the FS definition.<a class="elsevierStyleCrossRef" href="#bib0255">11</a> In our analysis, we included juice in the sugars applied to the WHO threshold, since the consumption of fruit juices has been associated with a lower degree of energy compensation compared to consumption of fruit in solid form, thus promoting the overconsumption of energy and underconsumption of fibre.<a class="elsevierStyleCrossRef" href="#bib0335">27</a> However, other authors consider that there is insufficient evidence to confirm an association of fruit juice with overweight and obesity like the one that exists between excess weight and other sugary beverages.<a class="elsevierStyleCrossRef" href="#bib0340">28</a>In our study, we observed that a high percentage of infants consumed more than the 10% of the total energy recommended by the WHO in the form of HFs, and that this percentage increased with age. The study conducted in Italy by Sette et al. in a cohort of 3323 children and adults found a higher intake of soluble carbohydrates (25%) in the 0–2.9 years age group.<a class="elsevierStyleCrossRef" href="#bib0345">29</a> This percentage may correspond to free sugars, although the term “soluble carbohydrates” was not clearly defined. The Diet and Nutrition Survey of Infants and Young Children aged 4–18 of the Department of Health and Food standards in the United Kingdom also found evidence of a higher-than-recommended consumption of ASs.<a class="elsevierStyleCrossRefs" href="#bib0350">30,31</a> This intake pattern in which free and added sugars contribute more than 10% of the total energy has been associated with obesity and chronic diseases.<a class="elsevierStyleCrossRefs" href="#bib0245">9–11,16,32</a> There is considerable variability in the terminology used to refer to sugars. Alles et al. analysed different studies on nutrient intake in Europe and highlighted the diversity of the terminology used.<a class="elsevierStyleCrossRef" href="#bib0245">9</a> Hur et al. measured the consumption of sugar-sweetened beverages and included natural fruit juices in this category.<a class="elsevierStyleCrossRef" href="#bib0250">10</a>Our results show that consumption of FSs at age 12 months is associated with a 12% increase in the prevalence of excess weight at 30 months. Most studies conducted in adults or children have compared the consumption of sugar-sweetened beverages to the increase in obesity, and very few have considered the total intake of FSs.<a class="elsevierStyleCrossRef" href="#bib0280">16</a> While the total intake of FSs and/or ASs has been associated with excess weight in adults, few studies in children have found an association between their intake and excess weight, as most of them have focused solely on sugar-sweetened beverages.<a class="elsevierStyleCrossRefs" href="#bib0285">17,32,33</a> Only 2 studies have found an association with the risk of excess weight in children,<a class="elsevierStyleCrossRefs" href="#bib0220">4,15</a> while others have not found an association.<a class="elsevierStyleCrossRefs" href="#bib0265">13,34–36</a> In agreement with our findings, in the Turku Coronary Risk Factor Intervention Project, children with a high intake of FSs between ages 13 months and 9 years had greater body weights in the first year of followup, while between ages 4 and 9 years their body mass index (BMI) was lower compared to children with an average to low consumption of FSs.<a class="elsevierStyleCrossRef" href="#bib0270">14</a> Maunder et al. found a greater proportion of excess weight in children aged 4–8 years that consumed more ASs.<a class="elsevierStyleCrossRef" href="#bib0275">15</a> In contrast, other prospective studies conducted in children in Germany and Hispanic children and youth in the United States did not find an association with changes in BMI,<a class="elsevierStyleCrossRefs" href="#bib0265">13,34,36</a> although the study by Davis et al. did analyse the consumption of ASs and sugary beverages.<a class="elsevierStyleCrossRef" href="#bib0380">36</a> The intake of all other macronutrients conformed to the nutritional guidelines established by the WHO.<a class="elsevierStyleCrossRef" href="#bib0385">37</a>Many of the foods marketed for infants or young children are rich in free or added sugars and tend to be introduced in the diet at an early stage, so that in addition to increasing the risk of future obesity, they may predispose individuals to develop a taste preference for sweet foods in the future.<a class="elsevierStyleCrossRefs" href="#bib0360">32,38</a> Although the WHO recommends reducing the intake of FSs in children and not introducing sugar in the diet of young children until age 1 year, European legislation and Commission Directive 2006/125/EC or the Spanish Royal Decree 490/1998 allow a higher-than-recommended proportion of sugar (20% of the total energy from ASs) in foods marketed to young children.<a class="elsevierStyleCrossRef" href="#bib0395">39</a> Elliot and Conlon found that most of these foods contravene nutritional recommendations, and some vastly exceed the recommended sugar content.<a class="elsevierStyleCrossRef" href="#bib0400">40</a>This excessive consumption of both free and added sugars at early ages should be restricted, as it not only contributes to excess weight, but also predisposes individuals to the development of caries, type 2 diabetes, hypertension, insulin resistance and dyslipidaemia,<a class="elsevierStyleCrossRef" href="#bib0280">16</a> and to consumption of a poorer diet overall, as these foods do not contribute essential nutrients. Thus, nutrition in this stage of life should be evaluated to increase adherence to nutritional recommendations for this age group with the aim of achieving an optimal nutritional status in the short as well as the long term. The establishment of a single, standardised nomenclature for sugars would also be helpful, resolving the confusion that exists to date.There are limitations to our study, such as its small sample size. Nevertheless, our study contributes longitudinal data on an age group for which there is little evidence in the current literature. We consider that our results clearly reflect the excessive consumption of FSs in this age group, although further studies with larger samples are required to confirm the association under study. Another limitation is that we had no methodological means to make adjustments to determine the role of fresh vs processed fruit juices due to the current controversy regarding the inclusion of these foods in the FS definition. At any rate, in our study we applied the criterion defined by the WHO. Yet another was that we were unable to assess the weight of mothers in the study, although we took into account other important confounders described in the previous literature that may have an impact on excess weight in young children.ConclusionOur study contributes new data on the association between free sugar intake at age 12 months and excess weight at 30 months. At 12 months, 40.4% of infants had a FS intake that exceeded the threshold recommended by the WHO. This excessive intake at 12 months was associated with a greater probability of having excess weight at age 30 months, which means that excessive consumption of FSs have deleterious effects even in early childhood. However, our results should be confirmed by further research in young children.Conflicts of interestThe authors have no conflicts of interest to declare." "textoCompletoSecciones" => array:1 [ "secciones" => array:12 [ 0 => array:3 [ "identificador" => "xres1157867" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Materials and methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1085018" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres1157866" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Material y métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec1085019" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:3 [ "identificador" => "sec0010" "titulo" => "Materials and methods" "secciones" => array:7 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Design" ] 1 => array:2 [ "identificador" => "sec0020" "titulo" => "Sample" ] 2 => array:2 [ "identificador" => "sec0025" "titulo" => "Measurements and data collection" ] 3 => array:2 [ "identificador" => "sec0030" "titulo" => "Medical history" ] 4 => array:2 [ "identificador" => "sec0035" "titulo" => "Anthropometric variables" ] 5 => array:2 [ "identificador" => "sec0040" "titulo" => "Infant nutrition" ] 6 => array:2 [ "identificador" => "sec0045" "titulo" => "Statistical analysis" ] ] ] 6 => array:2 [ "identificador" => "sec0050" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "sec0055" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0060" "titulo" => "Conclusion" ] 9 => array:2 [ "identificador" => "sec0065" "titulo" => "Conflicts of interest" ] 10 => array:2 [ "identificador" => "xack395068" "titulo" => "Acknowledgments" ] 11 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2018-01-23" "fechaAceptado" => "2018-03-28" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1085018" "palabras" => array:5 [ 0 => "Infants" 1 => "Free sugars" 2 => "Childhood obesity" 3 => "Infant feeding" 4 => "World Health Organisation" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec1085019" "palabras" => array:5 [ 0 => "Lactantes" 1 => "Azúcares libres" 2 => "Obesidad infantil" 3 => "Alimentación infantil" 4 => "Organización Mundial de la Salud" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "IntroductionThe consumption of free sugars has been related to excess weight, with the WHO recommending an intake of <10% of total energy. The aim of this study is to assess the association between the consumption of free sugars at 12 months and the risk of excess weight at 30 months in healthy children. Materials and methodsA longitudinal study was conducted on 81 children followed-up from birth to 30 months. A record was made of the clinical history and anthropometry, at birth, and at 12 and 30 months. Weight status was classified as with or without excess weight, according to WHO values. At 12 months, the intake of energy and nutrients was analysed by differentiating the intake of free and natural sugars. Multivariate analyses adjusted for the main confounding variables were performed. ResultsFree sugars were consumed by 40.4% of the 12-month-old children, being higher than that recommended, and being significantly higher in children with excess weight at 30 months (60.9%). The higher intake of free sugars at 12 months is associated with an increased risk of excess weight at 30 months (OR: 1.130, 95% CI: 1.032–1.238). ConclusionsThe consumption of free sugars is much higher than that recommended in 12-month-old infants. This high intake could be a risk factor for excess weight, even at early ages." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Materials and methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "IntroducciónEl consumo de azúcares libres se ha relacionado con el exceso de peso, recomendando la OMS una ingesta <10% de la energía total. El objetivo fue valorar la asociación entre el consumo de azúcares libres a los 12 meses y el riesgo de exceso de peso a los 30 meses en niños sanos. Material y métodosEstudio longitudinal en 81 niños seguidos desde el nacimiento hasta los 30 meses. Se registró: historia clínica y antropometría al nacer, a los 12 y 30 meses. Se clasificó el estado ponderal en con y sin exceso de peso, según los valores de la OMS. A los 12 meses se analizó la ingesta de energía y nutrientes diferenciando la ingesta de azúcares libres y azúcares naturales. Se realizaron análisis multivariantes ajustados por las principales variables confusoras. ResultadosUn 40,4% de los niños de 12 meses realizaron ingestas de azúcares libres superiores a las recomendadas, siendo significativamente mayores en los niños con exceso de peso a los 30 meses (60,9%). La mayor ingesta de azúcares libres a los 12 meses se asocia a un mayor riesgo de exceso de peso a los 30 meses (OR: 1,136; IC 95%: 1,033-1,248). ConclusionesLos lactantes de 12 meses realizan una ingesta de azúcares libres muy superior a la recomendada. Esta ingesta elevada podría ser un factor de riesgo de exceso de peso ya en edades tempranas." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Material y métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Please cite this article as: Jardí C, Aranda N, Bedmar C, Ribot B, Elias I, Aparicio E, et al. Ingesta de azúcares libres y exceso de peso en edades tempranas. Estudio longitudinal. An Pediatr (Barc). 2019;90:165–172." ] ] "multimedia" => array:4 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1839 "Ancho" => 2344 "Tamanyo" => 191691 ] ] "descripcion" => array:1 [ "en" => "Percentage of total energy contributed by free sugars (FSs) and natural sugars at age 12 months by weight status at age 30 months." ] ] 1 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:3 [ "leyenda" => "Values expressed as mean (standard deviation) or percentage (absolute frequency)." "tablatextoimagen" => array:2 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top">Mothers</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Maternal age in years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">32.3 (4.4) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top">Socioeconomic status (%)</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Bajo \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">8.9 (7) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Medio \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">46.8 (38) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Alto \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">44.3 (36) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Smokers (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">16.5 (13) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top">Type of delivery (%)</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Normal vaginal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">67.1 (56) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Forceps \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">8.2 (7) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Caesarean \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">21.9 (18) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Primiparous (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">58.1 (47) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Gestational age in weeks \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">39.6 (1.2) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top">Newborn</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Male sex (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">44.6 (36) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top">Breastfeeding (%)</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">0 months \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">84.2 (48) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">6 months \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">33.3 (19) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">12 months \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5.4 (3) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">10-min APGAR \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">10 (0.1) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Weight (kg) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3.3 (1.2) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Length (cm) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">50.1 (1.9) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1977038.png" ] ] 1 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">12 months \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">30 months \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " colspan="3" align="left" valign="top">Anthropometric values</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Weight (kg) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">10.1 (1.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">14.4 (1.6) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Height (cm) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">75.9 (3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">92.8 (4.1) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="3" align="left" valign="top">Weight status (%)<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Underweight \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5.2 (5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">9.9 (7) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Normal weight \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">63.6 (52) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">50.6 (42) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Overweight \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">19.5 (15) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">27.2 (22) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Obesity \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">11.7 (9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">12.3 (10) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1977037.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "a" "nota" => "The values used to determine weight status were the weight-for-length at 12 months and the weight-for-height at 30 months." ] ] ] "descripcion" => array:1 [ "en" => "General characteristics of mothers and children." ] ] 2 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at2" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:3 [ "leyenda" => "Values expressed as mean and standard deviation (SD)." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Weight status at 12 months</th><th class="td" title="table-head " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Weight status at 30 months</th></tr><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">No excess weight Mean (SD) n=57 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Excess weight Mean (SD) n=24 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">P \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">No excess weight Mean (SD) n=49 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Excess weight Mean (SD) n=32 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">P \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " colspan="7" align="left" valign="top">Intake at 12 months</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Exclusive/mixed breastfeeding at 6 months (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">69.2 (55) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">30.8 (27) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.435 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">54.5 (44) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">47.8 (37) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.489 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Energies (kcal) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1056.5 (233.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1057.3 (189.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.990 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1089.5 (234.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1053.6 (215.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.484 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Protein (g) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">32.6 (10.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">36.6 (12.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.240 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">34.8 (12.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">34 (10.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.288 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Carbohydrates (g) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">137.3 (31.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">134.5 (20.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.716 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">137.7 (29.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">138.3 (29.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.863 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Starches (g) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">26.8 (21.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">27.1 (17.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.956 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">29 (19.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">28.8 (24) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.782 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Natural sugars<a class="elsevierStyleCrossRef" href="#tblfn0010">a</a> (g) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">24.4 (7.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">23.0 (7.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.531 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">24.9 (7.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">23.3 (7.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.574 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Free sugars<a class="elsevierStyleCrossRef" href="#tblfn0015">b</a> (g) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">29.3 (30.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">31.6 (31.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.286 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">28.8 (31.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">33.8 (32.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.646 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Lipids (g) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">41.2 (11.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">41.3 (13.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.866 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">43.1 (11.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">40.5 (12.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.423 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Fibre (g) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">11.3 (7.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">10.7 (3.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.991 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">11.8 (7.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">10.3 (2.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.347 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="7" align="left" valign="top"></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="7" align="left" valign="top">Energy from macronutrients</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Protein (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">12.9 (2.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">13.6 (2.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.298 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">13.6 (2.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">12.7 (2.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.224 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Carbohydrates (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">52.1 (5.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">51.6 (6.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.762 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5.8 (4.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">52.9 (7.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.279 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Starches (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">9.5 (6.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">10.1 (5.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.764 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.1 (6.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.3 (6.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.263 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Natural sugars<a class="elsevierStyleCrossRef" href="#tblfn0010">a</a> (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6.8 (2.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6.3 (2.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.555 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6.4 (2.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6.8 (2.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.711 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Free sugars<a class="elsevierStyleCrossRef" href="#tblfn0015">b</a> (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7.9 (7.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">10.3 (8.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.092 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7.3 (7.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">11.9 (1.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.030 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Lipids (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">34.9 (4.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">34.7 (5.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.866 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">35.3 (4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">34.4 (5.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.500 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="7" align="left" valign="top"></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="4" align="left" valign="top">Percentage of children with >10% of total energy intake from free sugars by weight status at age 30 months (%)</td><td class="td" title="table-entry " align="char" valign="top">39.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">60.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.032 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1977036.png" ] ] ] "notaPie" => array:2 [ 0 => array:3 [ "identificador" => "tblfn0010" "etiqueta" => "a" "nota" => "Sugars from fruits, vegetables, milk and cereals." ] 1 => array:3 [ "identificador" => "tblfn0015" "etiqueta" => "b" "nota" => "Monosaccharides and disaccharides added to foods and beverages and sugars naturally present in honey, syrups, fruit juices and fruit juice concentrates." ] ] ] "descripcion" => array:1 [ "en" => "Energy and macronutrient intake at age 12 months by weight status at age 30 months." ] ] 3 => array:8 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at3" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "Multivariate logistic regression. Odds ratio adjusted for intake of free sugars, natural sugars, starches, protein, fibre, lipids, weight-for-age z-score at 0 months (0: no excess weight; 1: excess weight), mode of feeding at 6 months (0: formula feeding; 1: exclusive/mixed breastfeeding), sex (0: female; 1: male), and socioeconomic status (0: low; 1: middle/high)." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Dependent variable \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Independent variable \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Adjusted OR \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">95% CI \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">P \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " rowspan="11" align="left" valign="top">Weight-for-height at 30 months (without vs with excess weight)</td><td class="td" title="table-entry " align="left" valign="top">Free sugars 12 months (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.136 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.033–1.248 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.008 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Natural sugars 12 months (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.139 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.815–1.592 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.445 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Starches 12 months (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.101 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.964–1.257 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.154 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Protein 12 months (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.770 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.548–1.082 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.132 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Lipids 12 months (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.013 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.854–1.202 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.879 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Fibre 12 months (g) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.903 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.779–1.047 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.176 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Energy 12 months (kcal) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.998 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.994–1.003 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.420 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Weight-for-age z-score 0 month (0: no excess weight; 1: excess weight) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5.370 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.574–50.236 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.141 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Mode of feeding at 6 months (0: FF; 1: EBF/MBF) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.669 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.118–3.776 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.649 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Sex (0: female; 1: male) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5.348 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.036–27.605 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.045 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Socioeconomic status (0: low; 1: middle/high) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.700 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.128–22.560 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.688 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1977039.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Association between macronutrient intake at age 12 months and other variables and the risk of having developed excess weight by 30 months." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:40 [ 0 => array:3 [ "identificador" => "bib0205" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Diet, growth, and obesity development throughout childhood in the Avon Longitudinal Study of Parents and Children" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "P.M. 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Original Article

Consumption of free sugars and excess weight in infants. A longitudinal study

Ingesta de azúcares libres y exceso de peso en edades tempranas. Estudio longitudinal

Cristina Jardí, Núria Aranda, Cristina Bedmar, Blanca Ribot, Irene Elias, Estefania Aparicio, Victoria Arija

Corresponding author

victoria.arija@urv.cat

Corresponding author.

, Grupo investigador DeFensas

Grupo de Investigación en Nutrición y Salud Mental (NUTRISAM), Institut d’Investigació Sanitària Pere Virgili (IISPV), Universitat Rovira i Virgili, Reus, Tarragona, Spain

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          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Percentage of total energy contributed by free sugars &#40;FSs&#41; and natural sugars at age 12 months by weight status at age 30 months&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Obesity is a chronic disease that may manifest from the first years of life&#46;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">1</span></a> The increase in the prevalence of overweight and obesity in the paediatric age group<a class="elsevierStyleCrossRefs" href="#bib0210"><span class="elsevierStyleSup">2&#44;3</span></a> continues to be a significant social and public health problem&#44; and this is a worldwide trend&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">4</span></a> Specifically&#44; the global prevalence of excess weight in children aged 0&#8211;5 years was 4&#46;2&#37; in 1990 compared to 6&#46;7&#37; in 2010&#44; and the World Health Organization &#40;WHO&#41; has estimated that it will reach 9&#37; by 2020&#46;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">5</span></a> Obesity in childhood and adolescence is associated with an increased risk of type 2 diabetes&#44; hypertension&#44; coronary disease and metabolic syndrome in adulthood&#44; in addition to its negative impact on physical and psychosocial wellbeing&#46;<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">6&#44;7</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Dietary practices in the first year have been identified as an important factor that may lead to excess body fat in childhood&#46;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">8</span></a> During this critical period in which substantial changes occur in the diet&#44; an excessive energy intake&#44; an imbalance in macronutrient composition and nutrient deficiencies or overconsumption may contribute to the development of poor dietary habits that may be associated with metabolic changes and increase the risk of obesity&#46;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">9</span></a> In recent years&#44; the increased consumption of free sugars &#40;FSs&#41; has attracted considerable interest&#44; as it is associated with obesity&#44; especially in children and adolescents&#46;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">10</span></a> This increase is associated with a poorer nutritional value of the diet&#46; In this context&#44; the WHO has recommended limiting the intake of FSs &#40;added sugars &#91;ASs&#93; and sugars naturally present in fruit juices and fruit juice concentrates&#41; to no more than 10&#37; of the total energy intake to prevent obesity and associated diseases&#44; and specified that restricting the intake of FSs to less than 5&#37; of the total energy could have additional health benefits&#44; especially in relation to dental caries&#46;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">11</span></a> The results from prospective studies analysing the intake of free and added sugars in relation to the body composition of children have been contradictory&#46;<a class="elsevierStyleCrossRefs" href="#bib0260"><span class="elsevierStyleSup">12&#8211;15</span></a> These studies have been conducted in children aged 9 months to 9 years in Europe&#44; the United States and Africa&#46; The meta-analysis published by Te Morenga et al&#46; provided evidence that a high intake of FSs&#44; ASs or sugary beverages is a determinant of body weight and of an association between a high sugar intake and diseases like hypertension&#44; dyslipidaemia and insulin resistance in both childhood and adulthood&#46;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">16</span></a> On the other hand&#44; the meta-analysis by Forshee et al&#46; estimated an associated risk that neared zero&#46;<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">17</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Few studies have assessed the role of a high consumption of FSs in infancy in the increase in obesity&#46; For this reason&#44; the aim of our study was to analyse the association between the intake of FSs at age 12 months and the probability of excess weight at age 30 months in a group of healthy children in Spain&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Materials and methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Design</span><p id="par0020" class="elsevierStylePara elsevierViewall">We conducted a longitudinal study of children&#44; with the followup extending from birth to age 30 months&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Sample</span><p id="par0025" class="elsevierStylePara elsevierViewall">We selected 81 healthy newborns from the population included in the DeFensas study<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">18</span></a> for who data were available on the main clinical&#44; nutritional and anthropometric variables at ages 12 months and 30 months&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">The study was approved by the Ethics Board of the Hospital Universitario Sant Joan de Reus &#40;Tarragona&#44; Spain&#41;&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">The sample size required to detect differences in weight status at 30 months in children that consumed more than 10&#37; of the total energy in the form of free sugars at 12 months &#40;39&#46;1&#37; and 60&#46;9&#37;&#41; was 42 patients per group for a risk of alpha error of 0&#46;05 and a beta error of less than 0&#46;2 in two-tailed tests &#40;calculated with GRANMO version 7&#46;12&#44; Institut Hospital del Mar d&#8217;Investigacions M&#232;diques&#44; Barcelona&#44; Spain&#41;&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Measurements and data collection</span><p id="par0040" class="elsevierStylePara elsevierViewall">Prenatal and delivery records were available for all children under study&#46; <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> summarises these data along with the anthropometric measures at ages 12 and 30 months&#46; We also collected data on the medical history&#44; nutrition and anthropometric measurements obtained by paediatricians and dieticians using a standardised protocol&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Medical history</span><p id="par0045" class="elsevierStylePara elsevierViewall">We retrieved data on sociodemographic variables&#44; and maternal and newborn health at the time of birth&#46; We classified socioeconomic status into 3 categories &#40;low&#44; middle&#44; high&#41; using the four-factor index proposed by Hollingshead&#46;<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">19</span></a> We collected data for the following obstetric and perinatal variables&#58; newborn sex &#40;male&#47;female&#41;&#44; gestational age&#44; type of delivery&#44; infant nutrition &#40;breastfeeding or formula feeding&#41; and 10-min Apgar score&#46; We documented maternal use of tobacco during pregnancy using a questionnaire specifically designed for the purpose&#46; We also recorded all medical problems and all vaccines administered to the child during the followup&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Anthropometric variables</span><p id="par0050" class="elsevierStylePara elsevierViewall">We recorded the child&#39;s weight and length&#47;height at birth and ages 12 months and 30 months&#46; At birth and 12 months&#44; the weight was measured with a SECA digital scale accurate to 5<span class="elsevierStyleHsp" style=""></span>g &#40;Vogel &#38; Halke GmbH &#38; Co&#44; Hamburg&#44; Germany&#41;&#44; and length with an infantometer accurate to 0&#46;1<span class="elsevierStyleHsp" style=""></span>cm &#40;PE-RILB-STND&#41;&#46; The head circumference was measured with a flexible measuring tape accurate to 1<span class="elsevierStyleHsp" style=""></span>mm&#46; At 30 months&#44; the weight and height were measured with a combined digital scale and stadiometer &#40;SECA 764&#41;&#46; We calculated the <span class="elsevierStyleItalic">z</span>-scores for child growth indicators such as weight-for-age at birth&#44; weight-for-length at 12 months and weight-for-height at 30 months using the LMS method&#46;<a class="elsevierStyleCrossRefs" href="#bib0300"><span class="elsevierStyleSup">20&#44;21</span></a> The <span class="elsevierStyleItalic">z</span>-score corresponds to the number of standard deviations from the mean&#44; with values ranging from &#8722;3 to &#43;3 SDs&#46; Based on weight-for-age at birth&#44; weight-for-length at 12 months and weight-for-height at 30 months&#44; we classified children as having underweight &#40;&#8722;3<span class="elsevierStyleHsp" style=""></span>&#8804;<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">z</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#8722;1&#41;&#44; normal weight &#40;&#8722;1<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">z</span><span class="elsevierStyleHsp" style=""></span>&#8804;<span class="elsevierStyleHsp" style=""></span>&#43;1&#41;&#44; overweight &#40;&#43;1<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">z</span><span class="elsevierStyleHsp" style=""></span>&#8804;<span class="elsevierStyleHsp" style=""></span>&#43;2&#41; or obesity &#40;<span class="elsevierStyleItalic">z</span><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>&#43;2&#41; &#40;WHO<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">21</span></a>&#41;&#46; We also defined a weight status dichotomous variable with the following categories&#58; no excess weight &#40;underweight or normal weight&#41; and excess weight &#40;overweight or obesity&#41;&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Infant nutrition</span><p id="par0055" class="elsevierStylePara elsevierViewall">We obtained a 24-h dietary recall at 12 months through standardised interviews with parents held by 2 trained dieticians&#46; All the quantities of food and drink consumed were expressed in grams&#47;person&#47;day&#46; To calculate nutrient intake&#44; we used the REGAL &#40;<span class="elsevierStyleItalic">R&#233;pertoire g&#233;n&#233;ral des Aliments</span>&#41; food composition table<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">22</span></a> supplemented with the Mataix Verd&#250; Spanish food composition table&#46;<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">23</span></a> We calculated the percent of the total energy intake contributed by the different macronutrients&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">The recall documented all breastmilk&#44; artificial formula and cow&#39;s milk feedings&#46; We estimated the volume of breastmilk based on the age of the infant &#40;600<span class="elsevierStyleHsp" style=""></span>mL&#47;day at 6 months&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">24</span></a> We calculated the intake of formula taking into account that 4&#46;7<span class="elsevierStyleHsp" style=""></span>g of powder formula are usually added to every 30<span class="elsevierStyleHsp" style=""></span>mL of water&#46; We obtained the data for calculation of the composition of breastmilk from the <span class="elsevierStyleItalic">Tratado de nutrici&#243;n</span> edited by Gil&#46;<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">25</span></a></p><p id="par0065" class="elsevierStylePara elsevierViewall">We created 2 categories to classify simple carbohydrates&#58; <span class="elsevierStyleItalic">natural sugars</span> contained in whole fruits&#44; vegetables&#44; milk and cereals &#40;rice&#44; bread&#44; pasta&#44; flour&#41;&#44; and <span class="elsevierStyleItalic">free sugars</span> contained in sweetened dairy desserts&#44; sugary drinks &#40;fresh and processed juices&#44; soft drinks&#41;&#44; sweetened cereals &#40;sweetened breakfast cereals&#44; biscuits&#44; baked goods&#41; and chocolate&#44; sugar and honey&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">We calculated the percent of the total energy intake contributed by free sugars&#46; This calculation allowed us to define the standard threshold proposed by the WHO&#44;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">11</span></a> which recommends that FSs should contribute less than 10&#37; of the total energy&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Statistical analysis</span><p id="par0075" class="elsevierStylePara elsevierViewall">We present the results as percentages&#44; means and standard deviations&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">We used the Student&#39;s <span class="elsevierStyleItalic">t</span> test to compare means and the chi square test to compare categorical variables&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">To analyse the association between the percentage of the total energy contributed by FSs at 12 months and the presence of excess weight at 30 months&#44; we fitted a logistic regression model&#46; The dependent variable was weight-for-height at 30 months&#44; which was a dichotomous variable with the following categories&#58; 0 &#40;absence of excess weight&#41; and 1 &#40;presence of excess weight&#41;&#46; The independent variable was the percent energy from FSs at 12 months&#44; and the logistic regression was performed selecting the ENTER method and adjusting for the following confounders&#58; percent energy contributed by natural sugars &#40;&#37;&#41;&#44; starches &#40;&#37;&#41;&#44; proteins &#40;&#37;&#41; and lipids &#40;&#37;&#41;&#44; fibre intake &#40;g&#41; and energy intake &#40;kcal&#41; at 12 months&#44; birth weight status &#40;0&#58; no excess weight&#59; 1&#58; excess weight&#41;&#44; mode of infant feeding through 6 months &#40;0&#58; formula&#59; 1&#58; exclusive&#47;mixed breastfeeding&#41;&#44; sex &#40;0&#58; female&#44; 1&#58; male&#41; and socioeconomic status &#40;0&#58; low&#59; 1&#58; middle&#47;high&#41;&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">We defined statistical significance as a <span class="elsevierStyleItalic">P</span>-value of less than 0&#46;05 in any of the tests&#46; The statistical analysis was performed with the software SPSS for Windows&#44; version 20&#46;0&#46;</p></span></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Results</span><p id="par0095" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> presents the characteristics of the mother and of the child at birth and ages 12 and 30 months&#46; The sample included 81 children&#44; of who 44&#46;6&#37; were male&#46; A total of 84&#46;2&#37; of infants were exclusively breastfeed as newborns&#46; Excess weight was identified in 31&#46;2&#37; of the sample at age 12 months and 39&#46;5&#37; of the sample at 30 months&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Children with excess weight at 30 months had consumed a higher percentage of the total energy in the form FSs at 12 months compared to the group of children without excess weight at 30 months &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46; Of all children with excess weight&#44; 60&#46;9&#37; consumed more than 10&#37; of the total energy in the form of FSs&#44; compared to 39&#46;1&#37; in the group without excess weight&#46; Overall&#44; 40&#46;4&#37; of children were consuming FSs in excess of the 10&#37; of the total energy intake recommended by the WHO&#46; <a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a> shows the percent of the total energy contributed by free and natural sugars at 12 months by weight status at 30 months&#46; We found a significantly greater absolute intake of FSs in children with excess weight compared to children without excess weight at 30 months &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#46;</span>030&#41;&#46; The excessive intake of FSs resulted from a greater consumption of sugary drinks&#44; sweetened breakfast cereals&#44; biscuits&#44; baked goods&#44; chocolate&#44; sugar and honey&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0105" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a> presents the results of the logistic regression analysis of the association of macronutrient intake at 12 months and the risk of excess weight at 30 months&#46; Consumption of FSs at 12 months was associated with an increased probability of excess weight at 30 months &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46;136&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#46;</span>008&#41;&#46; Male sex was also associated with an increased risk of excess weight &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>5&#46;348&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#46;</span>045&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Discussion</span><p id="par0110" class="elsevierStylePara elsevierViewall">Our study analysed the association between the excessive contribution of FSs to the total dietary energy intake at 12 months and the presence of excess weight at 30 months&#46; We found an intake of FSs in infants that vastly exceeded the threshold of 10&#37; of the total energy recommended by the WHO&#46;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">11</span></a> Several studies have described this association in adolescents and adults&#44; but the data on young children are scarce&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">We carried out our study in the city of Reus &#40;Tarragona&#44; Spain&#41;&#46; Most children belonged to families of middle-to-high socioeconomic status&#46; The protocol for measurement of anthropometric variables&#44; dietary assessment and the performance of interviews and administration of questionnaires was standardised for implementation by all professionals involved in the study with the aim of minimising interrater variability in data collection&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Our results show that a high percentage of children had excess weight at age 12 months &#40;31&#46;2&#37;&#41;&#44; and that this percentage increased even more by 30 months &#40;39&#46;5&#37;&#41;&#44; which was consistent with the findings of a nationwide study conducted recently in Spain&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">4</span></a> This high prevalence in young children has been associated with a high consumption of high-energy processed foods rich in fats&#44; sugars and protein and a low consumption of fruits and vegetables&#44; a low household socioeconomic level&#44; sedentary lifestyles and sleep deprivation&#46;<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">26</span></a></p><p id="par0125" class="elsevierStylePara elsevierViewall">The WHO recommends restricting the consumption of FSs to less than 10&#37; of the total energy intake in the general population&#46; However&#44; there is disagreement as to whether fruit juices are included in the FS definition&#46;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">11</span></a> In our analysis&#44; we included juice in the sugars applied to the WHO threshold&#44; since the consumption of fruit juices has been associated with a lower degree of energy compensation compared to consumption of fruit in solid form&#44; thus promoting the overconsumption of energy and underconsumption of fibre&#46;<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">27</span></a> However&#44; other authors consider that there is insufficient evidence to confirm an association of fruit juice with overweight and obesity like the one that exists between excess weight and other sugary beverages&#46;<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">28</span></a></p><p id="par0130" class="elsevierStylePara elsevierViewall">In our study&#44; we observed that a high percentage of infants consumed more than the 10&#37; of the total energy recommended by the WHO in the form of HFs&#44; and that this percentage increased with age&#46; The study conducted in Italy by Sette et al&#46; in a cohort of 3323 children and adults found a higher intake of soluble carbohydrates &#40;25&#37;&#41; in the 0&#8211;2&#46;9 years age group&#46;<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">29</span></a> This percentage may correspond to free sugars&#44; although the term &#8220;soluble carbohydrates&#8221; was not clearly defined&#46; The Diet and Nutrition Survey of Infants and Young Children aged 4&#8211;18 of the Department of Health and Food standards in the United Kingdom also found evidence of a higher-than-recommended consumption of ASs&#46;<a class="elsevierStyleCrossRefs" href="#bib0350"><span class="elsevierStyleSup">30&#44;31</span></a> This intake pattern in which free and added sugars contribute more than 10&#37; of the total energy has been associated with obesity and chronic diseases&#46;<a class="elsevierStyleCrossRefs" href="#bib0245"><span class="elsevierStyleSup">9&#8211;11&#44;16&#44;32</span></a> There is considerable variability in the terminology used to refer to sugars&#46; Alles et al&#46; analysed different studies on nutrient intake in Europe and highlighted the diversity of the terminology used&#46;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">9</span></a> Hur et al&#46; measured the consumption of sugar-sweetened beverages and included natural fruit juices in this category&#46;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">10</span></a></p><p id="par0135" class="elsevierStylePara elsevierViewall">Our results show that consumption of FSs at age 12 months is associated with a 12&#37; increase in the prevalence of excess weight at 30 months&#46; Most studies conducted in adults or children have compared the consumption of sugar-sweetened beverages to the increase in obesity&#44; and very few have considered the total intake of FSs&#46;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">16</span></a> While the total intake of FSs and&#47;or ASs has been associated with excess weight in adults&#44; few studies in children have found an association between their intake and excess weight&#44; as most of them have focused solely on sugar-sweetened beverages&#46;<a class="elsevierStyleCrossRefs" href="#bib0285"><span class="elsevierStyleSup">17&#44;32&#44;33</span></a> Only 2 studies have found an association with the risk of excess weight in children&#44;<a class="elsevierStyleCrossRefs" href="#bib0220"><span class="elsevierStyleSup">4&#44;15</span></a> while others have not found an association&#46;<a class="elsevierStyleCrossRefs" href="#bib0265"><span class="elsevierStyleSup">13&#44;34&#8211;36</span></a> In agreement with our findings&#44; in the Turku Coronary Risk Factor Intervention Project&#44; children with a high intake of FSs between ages 13 months and 9 years had greater body weights in the first year of followup&#44; while between ages 4 and 9 years their body mass index &#40;BMI&#41; was lower compared to children with an average to low consumption of FSs&#46;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">14</span></a> Maunder et al&#46; found a greater proportion of excess weight in children aged 4&#8211;8 years that consumed more ASs&#46;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">15</span></a> In contrast&#44; other prospective studies conducted in children in Germany and Hispanic children and youth in the United States did not find an association with changes in BMI&#44;<a class="elsevierStyleCrossRefs" href="#bib0265"><span class="elsevierStyleSup">13&#44;34&#44;36</span></a> although the study by Davis et al&#46; did analyse the consumption of ASs and sugary beverages&#46;<a class="elsevierStyleCrossRef" href="#bib0380"><span class="elsevierStyleSup">36</span></a> The intake of all other macronutrients conformed to the nutritional guidelines established by the WHO&#46;<a class="elsevierStyleCrossRef" href="#bib0385"><span class="elsevierStyleSup">37</span></a></p><p id="par0140" class="elsevierStylePara elsevierViewall">Many of the foods marketed for infants or young children are rich in free or added sugars and tend to be introduced in the diet at an early stage&#44; so that in addition to increasing the risk of future obesity&#44; they may predispose individuals to develop a taste preference for sweet foods in the future&#46;<a class="elsevierStyleCrossRefs" href="#bib0360"><span class="elsevierStyleSup">32&#44;38</span></a> Although the WHO recommends reducing the intake of FSs in children and not introducing sugar in the diet of young children until age 1 year&#44; European legislation and Commission Directive 2006&#47;125&#47;EC or the Spanish Royal Decree 490&#47;1998 allow a higher-than-recommended proportion of sugar &#40;20&#37; of the total energy from ASs&#41; in foods marketed to young children&#46;<a class="elsevierStyleCrossRef" href="#bib0395"><span class="elsevierStyleSup">39</span></a> Elliot and Conlon found that most of these foods contravene nutritional recommendations&#44; and some vastly exceed the recommended sugar content&#46;<a class="elsevierStyleCrossRef" href="#bib0400"><span class="elsevierStyleSup">40</span></a></p><p id="par0145" class="elsevierStylePara elsevierViewall">This excessive consumption of both free and added sugars at early ages should be restricted&#44; as it not only contributes to excess weight&#44; but also predisposes individuals to the development of caries&#44; type 2 diabetes&#44; hypertension&#44; insulin resistance and dyslipidaemia&#44;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">16</span></a> and to consumption of a poorer diet overall&#44; as these foods do not contribute essential nutrients&#46; Thus&#44; nutrition in this stage of life should be evaluated to increase adherence to nutritional recommendations for this age group with the aim of achieving an optimal nutritional status in the short as well as the long term&#46; The establishment of a single&#44; standardised nomenclature for sugars would also be helpful&#44; resolving the confusion that exists to date&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">There are limitations to our study&#44; such as its small sample size&#46; Nevertheless&#44; our study contributes longitudinal data on an age group for which there is little evidence in the current literature&#46; We consider that our results clearly reflect the excessive consumption of FSs in this age group&#44; although further studies with larger samples are required to confirm the association under study&#46; Another limitation is that we had no methodological means to make adjustments to determine the role of fresh vs processed fruit juices due to the current controversy regarding the inclusion of these foods in the FS definition&#46; At any rate&#44; in our study we applied the criterion defined by the WHO&#46; Yet another was that we were unable to assess the weight of mothers in the study&#44; although we took into account other important confounders described in the previous literature that may have an impact on excess weight in young children&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Conclusion</span><p id="par0155" class="elsevierStylePara elsevierViewall">Our study contributes new data on the association between free sugar intake at age 12 months and excess weight at 30 months&#46; At 12 months&#44; 40&#46;4&#37; of infants had a FS intake that exceeded the threshold recommended by the WHO&#46; This excessive intake at 12 months was associated with a greater probability of having excess weight at age 30 months&#44; which means that excessive consumption of FSs have deleterious effects even in early childhood&#46; However&#44; our results should be confirmed by further research in young children&#46;</p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Conflicts of interest</span><p id="par0160" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span></span>"
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    "fechaRecibido" => "2018-01-23"
    "fechaAceptado" => "2018-03-28"
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          "clase" => "keyword"
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            0 => "Infants"
            1 => "Free sugars"
            2 => "Childhood obesity"
            3 => "Infant feeding"
            4 => "World Health Organisation"
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          "palabras" => array:5 [
            0 => "Lactantes"
            1 => "Az&#250;cares libres"
            2 => "Obesidad infantil"
            3 => "Alimentaci&#243;n infantil"
            4 => "Organizaci&#243;n Mundial de la Salud"
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">The consumption of free sugars has been related to excess weight&#44; with the WHO recommending an intake of &#60;10&#37; of total energy&#46; The aim of this study is to assess the association between the consumption of free sugars at 12 months and the risk of excess weight at 30 months in healthy children&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Materials and methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A longitudinal study was conducted on 81 children followed-up from birth to 30 months&#46; A record was made of the clinical history and anthropometry&#44; at birth&#44; and at 12 and 30 months&#46; Weight status was classified as with or without excess weight&#44; according to WHO values&#46; At 12 months&#44; the intake of energy and nutrients was analysed by differentiating the intake of free and natural sugars&#46; Multivariate analyses adjusted for the main confounding variables were performed&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Free sugars were consumed by 40&#46;4&#37; of the 12-month-old children&#44; being higher than that recommended&#44; and being significantly higher in children with excess weight at 30 months &#40;60&#46;9&#37;&#41;&#46; The higher intake of free sugars at 12 months is associated with an increased risk of excess weight at 30 months &#40;OR&#58; 1&#46;130&#44; 95&#37; CI&#58; 1&#46;032&#8211;1&#46;238&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">The consumption of free sugars is much higher than that recommended in 12-month-old infants&#46; This high intake could be a risk factor for excess weight&#44; even at early ages&#46;</p></span>"
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            "titulo" => "Materials and methods"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introducci&#243;n</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">El consumo de az&#250;cares libres se ha relacionado con el exceso de peso&#44; recomendando la OMS una ingesta &#60;<span class="elsevierStyleHsp" style=""></span>10&#37; de la energ&#237;a total&#46; El objetivo fue valorar la asociaci&#243;n entre el consumo de az&#250;cares libres a los 12 meses y el riesgo de exceso de peso a los 30 meses en ni&#241;os sanos&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Material y m&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Estudio longitudinal en 81 ni&#241;os seguidos desde el nacimiento hasta los 30 meses&#46; Se registr&#243;&#58; historia cl&#237;nica y antropometr&#237;a al nacer&#44; a los 12 y 30 meses&#46; Se clasific&#243; el estado ponderal en con y sin exceso de peso&#44; seg&#250;n los valores de la OMS&#46; A los 12 meses se analiz&#243; la ingesta de energ&#237;a y nutrientes diferenciando la ingesta de az&#250;cares libres y az&#250;cares naturales&#46; Se realizaron an&#225;lisis multivariantes ajustados por las principales variables confusoras&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Un 40&#44;4&#37; de los ni&#241;os de 12 meses realizaron ingestas de az&#250;cares libres superiores a las recomendadas&#44; siendo significativamente mayores en los ni&#241;os con exceso de peso a los 30 meses &#40;60&#44;9&#37;&#41;&#46; La mayor ingesta de az&#250;cares libres a los 12 meses se asocia a un mayor riesgo de exceso de peso a los 30 meses &#40;OR&#58; 1&#44;136&#59; IC 95&#37;&#58; 1&#44;033-1&#44;248&#41;&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Los lactantes de 12 meses realizan una ingesta de az&#250;cares libres muy superior a la recomendada&#46; Esta ingesta elevada podr&#237;a ser un factor de riesgo de exceso de peso ya en edades tempranas&#46;</p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0020">Please cite this article as&#58; Jard&#237; C&#44; Aranda N&#44; Bedmar C&#44; Ribot B&#44; Elias I&#44; Aparicio E&#44; et al&#46; Ingesta de az&#250;cares libres y exceso de peso en edades tempranas&#46; Estudio longitudinal&#46; An Pediatr &#40;Barc&#41;&#46; 2019&#59;90&#58;165&#8211;172&#46;</p>"
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          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Percentage of total energy contributed by free sugars &#40;FSs&#41; and natural sugars at age 12 months by weight status at age 30 months&#46;</p>"
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                  \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic"><span class="elsevierStyleBold">Mothers</span></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Maternal age in years</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">32&#46;3 &#40;4&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Socioeconomic status &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Bajo&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Alto&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">44&#46;3 &#40;36&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Smokers &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>6 months&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33&#46;3 &#40;19&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>12 months&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#46;4 &#40;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">10-min APGAR</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10 &#40;0&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Weight &#40;kg&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#46;3 &#40;1&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Length &#40;cm&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">50&#46;1 &#40;1&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1977038.png"
              ]
            ]
            1 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">12 months&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">30 months&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="left" valign="top"><span class="elsevierStyleBold">Anthropometric values</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Weight &#40;kg&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10&#46;1 &#40;1&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14&#46;4 &#40;1&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Height &#40;cm&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">75&#46;9 &#40;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">92&#46;8 &#40;4&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Weight status &#40;&#37;&#41;</span><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Underweight&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#46;2 &#40;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9&#46;9 &#40;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Normal weight&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">63&#46;6 &#40;52&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">50&#46;6 &#40;42&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Overweight&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19&#46;5 &#40;15&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">27&#46;2 &#40;22&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Obesity&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11&#46;7 &#40;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&#46;3 &#40;10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1977037.png"
              ]
            ]
          ]
          "notaPie" => array:1 [
            0 => array:3 [
              "identificador" => "tblfn0005"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0005">The values used to determine weight status were the weight-for-length at 12 months and the weight-for-height at 30 months&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">General characteristics of mothers and children&#46;</p>"
        ]
      ]
      2 => array:8 [
        "identificador" => "tbl0010"
        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at2"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:3 [
          "leyenda" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Values expressed as mean and standard deviation &#40;SD&#41;&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Weight status at 12 months</th><th class="td" title="table-head  " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Weight status at 30 months</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">No excess weight<br>Mean &#40;SD&#41;<br><span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>57&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Excess weight<br>Mean &#40;SD&#41;<br><span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>24&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">P</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">No excess weight<br>Mean &#40;SD&#41;<br><span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>49&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Excess weight<br>Mean &#40;SD&#41;<br><span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>32&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">P</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " colspan="7" align="left" valign="top"><span class="elsevierStyleBold">Intake at 12 months</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Exclusive&#47;mixed breastfeeding at 6 months &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">69&#46;2 &#40;55&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">30&#46;8 &#40;27&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;435&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">54&#46;5 &#40;44&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">47&#46;8 &#40;37&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;489&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Energies &#40;kcal&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1056&#46;5 &#40;233&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1057&#46;3 &#40;189&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;990&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1089&#46;5 &#40;234&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1053&#46;6 &#40;215&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;484&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Protein &#40;g&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">32&#46;6 &#40;10&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">36&#46;6 &#40;12&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;240&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">34&#46;8 &#40;12&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">34 &#40;10&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;288&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Carbohydrates &#40;g&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">137&#46;3 &#40;31&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">134&#46;5 &#40;20&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;716&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">137&#46;7 &#40;29&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">138&#46;3 &#40;29&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;863&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Starches &#40;g&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">26&#46;8 &#40;21&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">27&#46;1 &#40;17&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;956&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">29 &#40;19&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">28&#46;8 &#40;24&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;782&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Natural sugars<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">a</span></a> &#40;g&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">24&#46;4 &#40;7&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">23&#46;0 &#40;7&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;531&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">24&#46;9 &#40;7&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">23&#46;3 &#40;7&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;574&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Free sugars<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">b</span></a> &#40;g&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">29&#46;3 &#40;30&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">31&#46;6 &#40;31&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;286&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">28&#46;8 &#40;31&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33&#46;8 &#40;32&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;646&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Lipids &#40;g&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">41&#46;2 &#40;11&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">41&#46;3 &#40;13&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;866&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">43&#46;1 &#40;11&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">40&#46;5 &#40;12&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;423&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Fibre &#40;g&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11&#46;3 &#40;7&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10&#46;7 &#40;3&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;991&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11&#46;8 &#40;7&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10&#46;3 &#40;2&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;347&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="7" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="7" align="left" valign="top"><span class="elsevierStyleBold">Energy from macronutrients</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Protein &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&#46;9 &#40;2&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&#46;6 &#40;2&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;298&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&#46;6 &#40;2&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&#46;7 &#40;2&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;224&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Carbohydrates &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">52&#46;1 &#40;5&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">51&#46;6 &#40;6&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;762&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#46;8 &#40;4&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">52&#46;9 &#40;7&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;279&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Starches &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9&#46;5 &#40;6&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10&#46;1 &#40;5&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;764&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;1 &#40;6&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;3 &#40;6&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;263&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Natural sugars<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">a</span></a> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#46;8 &#40;2&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#46;3 &#40;2&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;555&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#46;4 &#40;2&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#46;8 &#40;2&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;711&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Free sugars<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">b</span></a> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#46;9 &#40;7&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10&#46;3 &#40;8&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;092&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#46;3 &#40;7&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11&#46;9 &#40;1&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;030&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Lipids &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">34&#46;9 &#40;4&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">34&#46;7 &#40;5&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;866&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">35&#46;3 &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">34&#46;4 &#40;5&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;500&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="7" align="left" valign="top"><span class="elsevierStyleVsp" style="height:1.0px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top">Percentage of children with &#62;10&#37; of total energy intake from free sugars by weight status at age 30 months &#40;&#37;&#41;</td><td class="td" title="table-entry  " align="char" valign="top">39&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">60&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;032&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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            0 => array:3 [
              "identificador" => "tblfn0010"
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              "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Sugars from fruits&#44; vegetables&#44; milk and cereals&#46;</p>"
            ]
            1 => array:3 [
              "identificador" => "tblfn0015"
              "etiqueta" => "b"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0015">Monosaccharides and disaccharides added to foods and beverages and sugars naturally present in honey&#44; syrups&#44; fruit juices and fruit juice concentrates&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Energy and macronutrient intake at age 12 months by weight status at age 30 months&#46;</p>"
        ]
      ]
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        "detalles" => array:1 [
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          "leyenda" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Multivariate logistic regression&#46; Odds ratio adjusted for intake of free sugars&#44; natural sugars&#44; starches&#44; protein&#44; fibre&#44; lipids&#44; weight-for-age <span class="elsevierStyleItalic">z</span>-score at 0 months &#40;0&#58; no excess weight&#59; 1&#58; excess weight&#41;&#44; mode of feeding at 6 months &#40;0&#58; formula feeding&#59; 1&#58; exclusive&#47;mixed breastfeeding&#41;&#44; sex &#40;0&#58; female&#59; 1&#58; male&#41;&#44; and socioeconomic status &#40;0&#58; low&#59; 1&#58; middle&#47;high&#41;&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Dependent variable&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Independent variable&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Adjusted OR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">95&#37; CI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">P</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " rowspan="11" align="left" valign="top">Weight-for-height at 30 months &#40;without vs with excess weight&#41;</td><td class="td" title="table-entry  " align="left" valign="top">Free sugars 12 months &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;136&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;033&#8211;1&#46;248&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;008&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Natural sugars 12 months &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;139&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;815&#8211;1&#46;592&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;445&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Starches 12 months &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;101&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;964&#8211;1&#46;257&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;154&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Protein 12 months &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;770&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;548&#8211;1&#46;082&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;132&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Lipids 12 months &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;013&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;854&#8211;1&#46;202&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;879&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Fibre 12 months &#40;g&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;903&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;779&#8211;1&#46;047&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;176&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Energy 12 months &#40;kcal&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;998&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;994&#8211;1&#46;003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;420&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Weight-for-age <span class="elsevierStyleItalic">z</span>-score 0 month &#40;0&#58; no excess weight&#59; 1&#58; excess weight&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#46;370&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;574&#8211;50&#46;236&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;141&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Mode of feeding at 6 months &#40;0&#58; FF&#59; 1&#58; EBF&#47;MBF&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;669&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;118&#8211;3&#46;776&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;649&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Sex &#40;0&#58; female&#59; 1&#58; male&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#46;348&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;036&#8211;27&#46;605&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;045&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Socioeconomic status &#40;0&#58; low&#59; 1&#58; middle&#47;high&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;700&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;128&#8211;22&#46;560&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;688&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "en" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Association between macronutrient intake at age 12 months and other variables and the risk of having developed excess weight by 30 months&#46;</p>"
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    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:40 [
            0 => array:3 [
              "identificador" => "bib0205"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Diet&#44; growth&#44; and obesity development throughout childhood in the Avon Longitudinal Study of Parents and Children"
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Article information

ISSN: 23412879
Original language: English

DOI:10.1016/j.anpede.2018.03.011

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Year/Month	Html	Pdf	Total

2024 November	9	12	21
2024 October	61	49	110
2024 September	44	38	82
2024 August	60	58	118
2024 July	38	28	66
2024 June	36	24	60
2024 May	45	33	78
2024 April	31	28	59
2024 March	52	21	73
2024 February	29	30	59
2024 January	35	22	57
2023 December	27	19	46
2023 November	41	31	72
2023 October	29	25	54
2023 September	27	24	51
2023 August	23	22	45
2023 July	26	23	49
2023 June	26	41	67
2023 May	40	24	64
2023 April	44	24	68
2023 March	41	26	67
2023 February	56	20	76
2023 January	29	22	51
2022 December	65	28	93
2022 November	53	40	93
2022 October	97	50	147
2022 September	39	26	65
2022 August	40	48	88
2022 July	36	48	84
2022 June	29	26	55
2022 May	47	37	84
2022 April	37	29	66
2022 March	45	56	101
2022 February	32	25	57
2022 January	56	29	85
2021 December	35	41	76
2021 November	44	36	80
2021 October	48	64	112
2021 September	27	38	65
2021 August	35	38	73
2021 July	55	25	80
2021 June	34	40	74
2021 May	33	49	82
2021 April	120	80	200
2021 March	43	29	72
2021 February	42	20	62
2021 January	41	19	60
2020 December	56	25	81
2020 November	45	19	64
2020 October	42	17	59
2020 September	27	13	40
2020 August	38	6	44
2020 July	27	18	45
2020 June	29	7	36
2020 May	35	15	50
2020 April	33	13	46
2020 March	37	9	46
2020 February	43	11	54
2020 January	41	8	49
2019 December	66	15	81
2019 November	50	8	58
2019 October	39	13	52
2019 September	40	17	57
2019 August	64	21	85
2019 July	40	13	53
2019 June	65	38	103
2019 May	70	33	103
2019 April	66	44	110
2019 March	230	41	271
2019 February	36	20	56
2019 January	11	9	20

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