Nuestros investigadores

Silvia Carlos Chillerón

Publicaciones científicas más recientes (desde 2010)

Autores: Burgueño, E.; Carlos, Silvia; Lopez-del Burgo, C; et al.
Revista: PLOS ONE
ISSN 1932-6203  Vol. 12  Nº 12  2017  págs. e0189632
Introduction Sexual violence, an HIV determinant, is an integrated behavior in the D.R.Congo. We aimed to analyze the prevalence of forced sexual intercourse (FSI) among people receiving HIV Voluntary Counseling and Testing in a hospital in Kinshasa, and its association with socio-demographics, behaviors and HIV status. Methodology Case-control study (2010¿2012). Two-hundred and seventy-four cases with a new HIV+ test and 1,340 controls with an HIV- test were interviewed about HIV-related knowledge, attitudes and behaviors, including FSI. Results Thirty-four percent of the participants declared having had FSI (38% of women and 32% of men). Being a woman, aged 25¿49 and reporting multiple sexual partners were associated with reporting FSI. For men, being single was protective against FSI; and cohabiting, having a high socioeconomic status, and alcohol consumption increased the odds. For women, being single, divorced/separated and widow was associated with reporting FSI. A significant positive association was found between FSI and an HIV positive test. Conclusion Among our Congolese population, FSI was strongly associated with HIV infection and it was also associated with alcohol consumption and multiple sexual partnerships, other key HIV determinants. These behaviors need to be identified as potential risk factors of FSI during counseling interventions. Researchers, practitioners and decision-makers should work together to get violence prevention integrated into health, social and educational policies.
Autores: Carlos, Silvia; Lopez-del Burgo, C; Burgueño, E.; et al.
ISSN 0954-0121  Vol. 29  Nº 6  2017  págs. 772 - 781
In the Democratic Republic of Congo no previous studies have assessed the factors associated with different patterns of condom use and with multiple sexual partners, and the association between condom use simultaneously taking into account multiple sexual partnerships, and HIV infection. We carried out a prospective case¿control study. From December 2010 until June 2012, 1630 participants aged 15¿49 getting HIV Voluntary Counseling and Testing in a hospital in Kinshasa were selected. Cases were new HIV diagnosis and controls were HIV-negative participants detected along the study period. We recruited 274 cases and 1340 controls that were interviewed about HIV-related knowledge, attitudes and behaviours. Among cases there was a high prevalence of multiple lifetime and concurrent sexual partnerships (89.8% and 20.4%, respectively) and most cases never used condoms with only 1.5% using them consistently. Condom use and multiple partnerships were associated with male, single and high-educated participants. An association was found between multiple lifetime partners and `any condom use¿ (OR¿=¿2.99; 95%CI: 2.14¿4.19) but not with consistent use. Both having two or more multiple concurrent sexual partners or not using condoms were variables similarly and highly associated to HIV risk. The association found between having two or more concurrent sexual partners and HIV was slightly higher (OR¿=¿3.58, 95%CI:2.31¿5.56) than the association found between never condom use and HIV (OR¿=¿3.38, 95%CI:1.15¿9.93). We found a high prevalence of multiple lifetime sexual partners and an extremely high prevalence of inconsistent condom use, both strongly associated with HIV seropositivity. Local programmes would benefit from comprehensive interventions targeting all behavioural and sociocultural determinants.
Autores: Fresán, Ujué; Gea, Alfredo; Bes-Rastrollo, Maira; et al.
ISSN 0939-4753  Vol. 27  Nº 10  2017  págs. 874 - 880
Background and aims The relationship between juice consumption and type 2 diabetes (T2D) has not been widely evidenced. Our aims were to prospectively evaluate the associations with T2D incidence of: 1) isovolumetric substitution of a water serving/day for one of fruit juice (different types), and of fresh fruit juice for its bottled version; 2) consumption of total, fresh or bottled juice; 3) energy intake from juices. Methods and results We followed 17,518 adults without T2D at baseline. Beverage consumption was assessed at baseline through a validated food-frequency questionnaire. The outcome was T2D incidence, according to American Diabetes Association's criteria. During a median follow-up of 10.2 years, 142 incident cases of T2D were identified. In substitution models, the substitution of water for bottled juice was associated with a lower T2D incidence, and also if the replacement was done by fresh juice, or especially fresh orange juice [HR 0.75 (95% CI 0.57¿0.99), 0.65 (95% CI 0.43¿0.98) and 0.56 (95% CI 0.34¿0.92); respectively]. Each additional serving/day of bottled juice was directly associated with T2D incidence [HR 1.33 (95% CI 1.01¿1.75)]. No significant association was observed for energy coming for bottled juice [HR 1.74 (95% CI 0.94¿3.20)]. Conclusion Our results suggest that isovolumetric substitution of water or fresh juice for bottled juice was inversely associated with T2D incidence in a long-term prospective study. Thus, these substitutions could be useful to tackle the diabetes epidemic.
Autores: Eguaras, S.; Bes-Rastrollo, Maira; Ruiz-Canela, Miguel; et al.
ISSN 0007-1145  Vol. 117  Nº 10  2017  págs. 1478 - 1485
It is likely that the Mediterranean diet (MedDiet) may mitigate the adverse effects of obesity on the incidence of type 2 diabetes mellitus (T2DM). We assessed this hypothesis in a cohort of 18 225 participants initially free of diabetes (mean age: 38 years, 61 % women). A validated semi-quantitative 136-item FFQ was used to assess dietary intake and to build a 0-9 score of adherence to MedDiet. After a median of 9·5-year follow-up, 136 incident cases of T2DM were confirmed during 173 591 person-years follow-up. When MedDiet adherence was low (¿4 points), the multivariable-adjusted hazard ratios (HR) were 4·07 (95 % CI 1·58, 10·50) for participants with BMI 25-29·99 kg/m2 and 17·70 (95 % CI 6·29, 49·78) kg/m2 for participants with BMI¿30 kg/m2, (v.4 points), these multivariable-adjusted HR were 3·13 (95 % CI 1·63, 6·01) and 10·70 (95 % CI 4·98, 22·99) for BMI 25-30 and ¿30 kg/m2, respectively. The P value for the interaction was statistically significant (P=0·002). When we assessed both variables (BMI and MedDiet) as continuous, the P value for their interaction product-term was marginally significant (P=0·051) in fully adjusted models. This effect modification was not explained by weight changes during follow-up. Our results suggest that the MedDiet may attenuate the adverse effects of obesity on the risk of T2DM.
Autores: Andrade, L.; Zazpe I; Santiago, Susana; et al.
ISSN 0731-5724  Vol. 36  Nº 5  2017  págs. 319 - 329
OBJECTIVE: The objective of this study was to assess the within-subject longitudinal changes in self-perceived healthy eating attitudes after 10 years of follow-up and to identify predictors of long-term changes in a middle-aged adult cohort. METHODS: Four thousand five hundred seventy-two participants completed a validated food frequency questionnaire (FFQ) at baseline and after 10 years of follow-up. The FFQ was expanded with a brief 10-item questionnaire about eating attitudes with 2 possible answers: yes or no. A baseline score and a 10-year score were calculated with these 10 items (range from 0 to 10). Participants were categorized into 3 groups according to this score. Linear and logistic regressions were used to examine changes at follow-up and associations between baseline characteristics and improvement in the score. RESULTS: After 10 years of follow-up, a statistically significant favorable change (p < 0.001) was achieved in all questions about eating attitudes, particularly in these items: "Do you try to eat less sweets and pastries?" (12%), "Do you try to eat less meat?" (11.1%), and "Do you try to reduce your fat intake?" (10%). Being female (odds ratio [OR] = 1.19, 95% confidence interval [CI], 1.02-1.39), being 35-50 or ¿ 50 years old (OR = 1.24, 95% CI, 1.07-1.44 and OR = 1.74, 95% CI, 1.38-2.18, respectively), a high level of physical activity (OR for third vs first tertile = 1.20, 95% CI, 1.02-1.41), and a higher Mediterranean diet score (OR for second and third tertiles = 1.18, 95% CI, 1.01-1.37 and OR = 1.26, 95% CI, 1.04-1.52, respectively) were associated with a higher probability of improving the eating attitudes score, while a low body mass index (BMI; OR = 0.71, 95% CI, 0.51-1.00) and snacking between meals (OR = 0.84, 95% CI, 0.73-0.97) were associated with a lower probability of improving their score. CONCLUSIONS: The eating attitudes of the participants in the Seguimiento Universidad de Navarra (SUN) cohort became more favorable after 10 years of follow-up. Certain sociodemographic or clinical variables may predict a positive change.
Autores: Osorio, A; Lopez-del Burgo, C; Carlos, Silvia; et al.
ISSN 1664-1078  Vol. 8  Nº 1298  2017  págs. 1-8
This cross-sectional study assesses the association between age of sexual initiation during adolescence and a selection of well-being outcomes regarding that first relationship. High-school adolescents from El Salvador (2,686) and from Peru (3,399) replied to a paper-pencil questionnaire. Those who were sexually initiated replied to several questions regarding their age at sexual initiation, condom use, satisfaction and reasons/circumstances for that sexual relationship. Approximately 19% of participants were sexually initiated (n=1,179). After retaining participants with valid responses and with sexual initiation ages between 13 and 17, the final sample for this paper consisted of 996 sexually initiated participants (526 Salvadorians and 470 Peruvians). Multiple logistic regression analyses showed that those who initiated sex at earlier ages had worse outcomes compared to those who initiated at older ages. Specifically, they had lower odds of having used a condom, of having good memories of that experience and of having had that first relationship because they were in love. Conversely, they had higher odds of having had that first sexual relationship as a result of peer pressure, because of partner pressure, or as a consequence of different forms of impaired autonomy. Results show that sex at earlier ages is associated with worse adolescent health and well-being outcomes.
Autores: Albertos, Aranzazu ; Osorio, A; Lopez-del Burgo, C; et al.
ISSN 0140-1971  Vol. 53  2016  págs. 231 - 236
In this paper we study whether parental knowledge of adolescents' activities varies according to socio-demographic variables, and we analyze the possible association between parental knowledge patterns and certain risk behaviors among adolescents. A cross-sectional study was performed with representative samples of high-school students in Peru and El Salvador. A questionnaire assessed risk behaviors, as well as possible determinants, including parental knowledge. The questionnaire was answered by 6208 adolescents. We observed that the greater the degree of knowledge, the lower the frequency of risk behaviors among youth. The degree of knowledge was inversely associated with children's age, and we observed that being female was associated with a greater degree of parental knowledge. The study shows that parents' supervision criteria might be influenced by gender stereotypes, which would have a harmful effect on young males, as the lower degree of knowledge puts them at higher odds of risk behaviors.
Autores: Lopez-del Burgo, C; Osorio, A; Carlos, Silvia; et al.
ISSN 0188-5022  Vol. 27  Nº 3  2016  págs. 375-388
Autores: Carlos, Silvia; Osorio, A; Calatrava, María; et al.
ISSN 2296-2565  Vol. 4  2016  págs. 28
Introduction: Sexually transmitted infections and unplanned pregnancies affect adolescent sexual health and are serious public health concerns. They result from sexual intercourse in adolescence, which is usually associated with multiple partners, unprotected sex, and condom misuse. This behavior is related to socio-ecological factors that influence lifestyles. The YOURLIFE project aims to find out what young people think and feel about relationships, love, and sexuality, and to assess the associations between these thoughts and attitudes, adolescents' social factors, and sexual health. Materials and Equipment: An international school-based study with a cross-sectional and optional subsequent longitudinal design. Three online questionnaires designed for adolescents aged 13/14, 15/16, and 17/18, respectively, will be used. A matching coding system will allow longitudinal follow-up when adolescents reply to follow-up surveys. Questionnaires will include questions related to sociodemographic data; information/communication technologies; leisure time; parental supervision; influences of parents/friends; information sources; messages perceived; and sexuality-related knowledge, attitudes, and opinions. The second and third questionnaires for participants aged 15/16 and 17/18 will also contain variables concerning sexual behavior. Schools will be able to use their results to tailor educational approaches targeting the needs of their students. Multivariate analyses will be performed using the larger international dataset. Expected Impact Of the Study On Public Health: The YOURLIFE project will collect comprehensive information about the socio-ecological determinants of the sexual risk-taking of schooled adolescents worldwide. Effective preventive programs could be subsequently designed and tailored to the specific determinants of adolescents from different schools and settings, and also, when analyzed globally, to public health professionals.
Autores: Zazpe I; Santiago, Susana; Gea, Alfredo; et al.
ISSN 0939-4753  Vol. 26  Nº 11  2016  págs. 1048 - 1058
BACKGROUND AND AIMS: Beyond the quantity of carbohydrate intake, further research is needed to know the relevance of carbohydrate quality following operational indices. No previous longitudinal study has assessed the association between an index for quality of dietary carbohydrate intake and the risk of cardiovascular disease (CVD). Here, we examined the association between a carbohydrate quality index (CQI) and the risk of CVD. METHODS AND RESULTS: We used a validated semi-quantitative 136-item food-frequency questionnaire (FFQ) in a prospective follow-up study of 17,424 middle-aged adults from Spain. The CQI was defined by four criteria: dietary fiber intake, glycemic index, whole-grain/total-grain carbohydrate ratio, and solid/total carbohydrate ratio. We observed 129 incident cases of CVD during 10.1 y of median follow-up. An inverse association for CQI was found (hazard ratio = 0.44, 95% confidence interval (CI): 0.25-0.78 for the highest versus the lowest tertile, p for trend = 0.008). Participants in the highest tertile of the whole-grain/total-grain carbohydrate ratio had 47% lower risk of CVD (95% CI: 0.33-0.85, p for trend = 0.008). Participants with higher baseline CQI and higher baseline energy from carbohydrates had the lowest risk of CVD. CONCLUSION: In this Mediterranean cohort, a better quality of dietary carbohydrates measured by the CQI, showed a significant inverse association with the incidence of CVD. Specially, a higher proportion of carbohydrates from whole grains was strongly inversely associated with CVD. "Heart-healthy" diets should be focused not only on carbohydrate quantity but also on a multidimensional assessment of the type and quality of carbohydrates.
Autores: Carlos, Silvia; Martínez, Miguel Ángel;
ISSN 0007-1145  Vol. 113  Nº Supl. 2  2015  págs. S36 - S48
Overweight/obesity, CVD and type 2 diabetes are strongly associated with nutritional habits. High consumption of fried foods might increase the risk of these disorders. However, it is not clear whether the use of vegetables oils for cooking increases the risk of chronic diseases. We systematically searched for published studies that assessed the association between vegetable oil consumption including fried food consumption and the risk of overweight/obesity or weight gain, T2DM or the metabolic syndrome, and CVD or hypertension in the following databases: PubMed; Web of Science; Google Scholar. Keywords such as `fried food¿ or `vegetable oil¿ or `frying¿ or `frying oils¿ or `dietary fats¿ and `weight gain¿ or `overweight¿ or `obesity¿ or `CHD¿ or `CVD¿ or `type 2 diabetes¿ or `metabolic syndrome¿ were used in the primary search. Additional published reports were obtained through other sources. A total of twenty-three publications were included based on specific selection criteria. Based on the results of the studies included in the present systematic review, we conclude that (1) the myth that frying foods is generally associated with a higher risk of CVD is not supported by the available evidence; (2) virgin olive oil significantly reduces the risk of CVD clinical events, based on the results of a large randomised trial that included as part of the intervention the recommendation to use high amounts of virgin olive oil, also for frying foods; and (3) high consumption of fried foods is probably related to a higher risk of weight gain, though the type of oil may perhaps modify this association.
Autores: Carlos, Silvia; Martínez, Miguel Ángel; Burgueño, E.; et al.
ISSN 1368-4973  Vol. 91  Nº 5  2015  págs. 334 - 337
Objectives To evaluate the prevalence of HIV-related misconceptions in an outpatient centre of Kinshasa (Democratic Republic of Congo) and analyse the association between these beliefs and HIV infection. Methods A case-control study was carried out from December 2010 until June 2012. We assessed 1630 participants aged 15-49 attending a primary outpatient centre in Kinshasa: 762 HIV Voluntary Counselling and Testing attendees and 868 blood donors. A 59-item questionnaire about knowledge, attitudes and practice was administered during a face-to-face interview, followed by an HIV test. Cases and controls were respondents with a newly diagnosed HIV-positive or HIV-negative test, respectively. Unconditional logistic regression was used to analyse the association between misconceptions and HIV seropositivity. Results 274 cases and 1340 controls were recruited. Cases were more likely than controls to have a low socioeconomic status, no education, to be divorced/separated or widowed. An association was found between the following variables and HIV seropositivity: having a poor HIV knowledge (adjusted OR=2.79; 95% CI 1.43 to 5.45), not knowing a virus is the cause of AIDS (adjusted OR=2.03; 95% CI 1.38 to 2.98) and reporting more than three HIV-transmission-related misconceptions (adjusted OR=3.30; 95% CI 1.64 to 6.64), such as thinking an HIV-positive person cannot look healthy and that HIV is transmitted by sorcery, God's punishment, a kiss on the mouth, mosquitoes, coughs/sneezes or undercooked food. Conclusions Despite having access to healthcare services, there are still many people in Kinshasa that have HIV-related misconceptions that increase their HIV risk. Our findings underscore the need for a culturally adapted and gender-orientated basic HIV information into Congolese HIV prevention programmes.
Autores: Osorio, A; Lopez-del Burgo, C; Ruiz-Canela, Miguel; et al.
Revista: BMJ OPEN
ISSN 2044-6055  Vol. 5  Nº 4  2015  págs. e007826
OBJECTIVES: This study intends to evaluate whether the belief that condoms are 100% effective in protecting against HIV infection is associated with sexual risk behaviours among youth. METHODS: A cross-sectional study was performed in representative samples of high-school students in the Philippines, El Salvador and Peru. Participants completed a self-administered questionnaire. Students were asked about the risk of HIV transmission if one has sex using condoms. They were also asked to indicate whether they had ever had sexual relations and whether they used a condom in their first sexual relation. The sample was composed of 8994 students, aged 13-18. RESULTS: One out of seven adolescents believed condoms are 100% effective (safe-sex believers). Those adolescents were 82% more likely to have had sex than those without such belief, after adjusting for confounders (OR=1.82; 95% CI 1.51 to 2.21). On the contrary, no association was found between risk perception and condom use. Subgroup and sensitivity analyses produced similar results. CONCLUSIONS: This is, to the best of our knowledge, the first study conducted specifically to evaluate this phenomenon and that has used the same questionnaire and the same data collection protocol in three different developing countries from Asia, Central and South America. These results reasonably suggest that there could be an association between safe sex beliefs and sexual initiation. Longitudinal studies are needed to better understand this possible association as it could influence how to better promote sexual health.
Autores: Martínez, Miguel Ángel; Ruiz-Canela, Miguel; et al.
ISSN 0002-9165  Vol. 102  Nº 6  2015  págs. 1554 - 1562
DESIGN: The SUN Project is a dynamic, prospective, multipurpose cohort of Spanish university graduates with an overall retention rate of 90%. The study population encompassed 8569 Spanish university graduates (mean age: 37 y) who were initially free of overweight or obesity. Self-reported weight (previously validated) was collected at baseline and updated every 2 y during the follow-up period. Fructan consumption and GOS consumption were assessed with the use of a validated semiquantitative 136-item food-frequency questionnaire and were updated after 10 y. Time-dependent Cox proportional hazards models were used to estimate HRs and 95% CIs for incident overweight and to adjust for potential confounding factors. RESULTS: During follow-up (median: 9 y), 1964 incident cases of overweight were identified. After potential confounders were adjusted for, risk of overweight was 15% lower in participants in the highest quartile of fructan consumption (¿2.3 g/d) (95% CI: 0.74, 0.97; P-trend = 0.019). Subjects in the highest quartile of GOS consumption (¿0.45 g/d) had 17% lower risk of overweight (95% CI: 0.74, 0.94; P-trend = 0.001). CONCLUSIONS: Higher prebiotic consumption was associated with lower risk of overweight in a cohort of initially normal-weight, middle-aged adults. This potential protection has been previously scarcely assessed; therefore, additional longitudinal studies are needed to confirm our results.
Autores: de Irala, Jokin; Osorio, A; Ruiz-Canela, Miguel; et al.
ISSN 1041-0236  Vol. 29  Nº 6  2014  págs. 629 - 633
The common statistical indicator "mean age of first sex" can be misinterpreted by youth to indicate that most of their peers of the same age are sexually initiated, when this is not usually the case. This can jeopardize efforts to delay sexual initiation. University students were randomly assigned to one of two versions of an anonymous survey. They were asked to estimate how common sexual initiation was at a given age upon being presented with statements with different wordings, such as the "mean age of first sex" or "proportions of youth at different ages having had sex." Their interpretations were compared using logistic regression. Students who were assigned surveys using the indicator "mean age" of sexual initiation had higher odds of overestimating the extent of sexual initiation compared to those assigned surveys using percentages as the indicator, even after adjusting for student's sex and degree. We encourage the use of the "percentage" of youth, at different ages, who are sexually initiated as a more reliable indicator.
Autores: Toledo, Estefanía Ainhoa; et al.
ISSN 0167-5273  Vol. 171  Nº 2  2014  págs. 299-301
Autores: Carlos, Silvia; de Irala, Jokin; Hanley, M.; et al.
ISSN 0143-005X  Vol. 68  Nº 9  2014  págs. 897 - 904
A dangerous distortion of priorities seems to be currently apparent in the dominant approaches to major public health problems, including cardiovascular disease, diabetes, obesity, cancer and some infectious diseases. Relevant examples suggest an apparently inappropriate tendency to prioritise technocratic, partial solutions rather than confronting their true behavioural and structural determinants. Technically oriented preventive medicine often takes excessive precedence over simpler, more sensible approaches to modify lifestyles, the environment and the social structure. Structural factors (social, cultural, financial, familiar, educational, political or ideological factors) that act as determinants of individual behaviours should be effectively addressed to confront the essential causes of the most prevalent and important health problems. Some consumer-directed commercial forces seem to be increasingly driving many aspects of the current sociocultural environment, and may eventually compromise the main pursuits of public health. Population-wide strategies are needed to create a healthy sociocultural environment and to empower individuals and make themselves resistant to these adverse environmental and structural pressures. Otherwise most public health interventions will most likely end in failures.
Autores: Gea, Alfredo; et al.
ISSN 0143-005X  Vol. 68  Nº 9  2014  págs. 834 - 841
Background Polychlorinated biphenyls (PCB) are persistent organic pollutants (POP) that are consumed because of their bioaccumulation through the food chain. Recent studies have suggested the implication of POPs in the development of metabolic diseases such as type 2 diabetes and obesity. However, this relationship is not entirely consistent, and has not been investigated in longitudinal studies. The purpose of this study was to prospectively examine the association between dietary intake of PCBs and the incidence of obesity in the Seguimiento Universidad de Navarra (SUN) Project. Methods Our study included 12¿313 participants without obesity at baseline, who were followed-up for a median of 8.1¿years. Dietary intakes of PCBs, expressed as WHO toxic equivalents, were assessed at baseline through a 136-item semiquantitative food-frequency questionnaire. The published concentration levels of PCBs measured in samples of food consumed in Spain were used to estimate intakes. Multivariable Cox regression models were fitted to estimate HRs and 95% CI for incident obesity. Results During follow-up, we observed 621 incident cases of obesity. After adjustment for total energy intake and additional adjustment for potential confounders, participants in the fifth quintile of PCBs intake were at higher risk of becoming obese (adjusted HR: 1.58; (95% CI 1.21 to 2.06)) compared to those in the first quintile. The linear trend test was statistically significant (p<0.001). Conclusions Dietary intake of PCBs as estimated using a food frequency questionnaire was associated with a higher incidence of obesity. Nevertheless, further longitudinal studies are needed to confirm our results.
Autores: Osorio, A; Carlos, Silvia; Lopez-del Burgo, C;
Revista: AIDS
ISSN 0269-9370  Vol. 28  Nº 5  2014  págs. 799 - 800
Autores: Bes-Rastrollo, Maira; Carlos, Silvia; et al.
ISSN 1662-4025  Vol. 6  Nº 4  2013  págs. 337 - 347
METHODS: After a median of 6.5 years of follow-up, we included 10,532 or 9,470 participants without chronic disease or obesity at baseline for analyzing the association between the incidence of obesity and nocturnal sleep duration or having siesta. Sleeping hours and siesta were assessed at baseline. Weight was recorded at baseline and every 2 years during the follow-up. The outcome was the incidence of obesity during follow-up among participants with initial BMI <30 kg/m(2). RESULTS: During follow-up we observed 446 new cases of obesity in the analysis of nocturnal sleep duration. Sleeping less than 5 h at night was associated with a higher risk of becoming obese compared to sleeping between 7 and <8 h (HR 1.94; 95% CI 1.19-3.18; p for quadratic trend = 0.06) after adjusting for potential confounders. During follow-up, we observed 396 incident cases of obesity in the analysis of siesta. Those who took a siesta for 30 min/day had a 33% lower risk of becoming obese (HR 0.67; 95% CI 0.46-0.96; p for quadratic trend = 0.13) compared to those who did not take siesta. CONCLUSION: Our results suggest that short nocturnal sleep duration could be a modifiable risk factor for obesity. It is possible that this association may be stronger among men and subjects who experienced previous weight gain. Additionally, siesta might be a novel and independent protective factor for obesity; however, confirmatory studies are needed.
Autores: Ruiz-Canela, Miguel; Lopez-del Burgo, C; Carlos, Silvia; et al.
ISSN 1472-6939  Vol. 14  Nº 2  2013 
Autores: Osorio, A; Lopez-del Burgo, C; Carlos, Silvia; et al.
ISSN 1054-139X  Vol. 50  Nº 3  2012  págs. 271 - 278
ICS Purpose Adolescents who engage in sex can be affected by a range of negative physical and psychological consequences. We intend to analyze the reasons behind first sex, regret, and the association between reasons and regret. Methods A questionnaire was implemented to 8,495 high schools students aged 14¿18 years residing in the Philippines, El Salvador, and Peru. Sexually active participants responded whether several circumstances were reasons involved in their first sexual relationship. They also responded whether they regretted having already had sexual relationships. Results More than one-third of respondents reported at least one external pressure leading to first sex, and about one-half reported at least one reason implying getting carried away by sexual arousal. More females affirmed they regret having already had sex. Logistic regression shows that reasons for first sex associated with regret were partner insistence, ¿uncontrolled situations,¿ and seeing sexual images. These reasons were associated with regret even when love was also reported as related to first sex. Conclusions Adolescent sexual experience is often motivated by pressure (such as external pressure [because most friends already had sex or because of partner insistence]) and circumstances (such as getting carried away by sexual arousal [through an ¿uncontrolled situation¿ or viewing sexual images]) that lower the control over their decisions concerning sex, rather than by mature decisions, and this ma
Autores: Ruiz-Canela, Miguel; Lopez-del Burgo, C; Carlos, Silvia; et al.
ISSN 1020-4989  Vol. 31  Nº 1  2012  págs. 54 - 61
ICS Objetivo. El objetivo de este estudio es comprobar cómo influyen en el inicio de la actividad sexual de los jóvenes salvadoreños los mensajes que reciben sobre cuestiones de sexualidad, afectividad y ocio a través de la familia, los amigos y los medios de comunicación. Métodos. Estudio transversal a partir de una muestra representativa de 2 615 estudiantes (de 13 a 19 años) de El Salvador. Se utilizó un muestreo sistemático aleatorio para seleccionar 30 colegios. Se recogieron aspectos sociodemográficos, estilos de vida y fuentes de información sobre sexualidad y amor utilizadas por los jóvenes. Resultados. La edad media de los jóvenes fue de 15 años (DE = 1,8). En total 638 (24,4%) jóvenes afirmaron haber tenido relaciones sexuales. Los siguientes factores se asociaron con una mayor probabilidad de haber tenido relaciones sexuales: percibir que los hermanos (OR = 1,8, IC 95%: 1,2¿2,7) o los amigos (OR = 1,7, IC 95%: 1,3¿2,2) apoyan que se tengan relaciones sexuales. Como factores protectores se encontraron la supervisión de los padres (OR = 0,5, IC 95%: 0,4¿0,7); recibir mensajes que apoyan la abstinencia por parte de amigos (OR = 0,7, IC 95%: 0,6¿1,0) o hermanos (OR = 0,7, IC 95%: 0,5¿0,8) y recibir mensajes favorables al matrimonio por parte de los padres (OR = 0,4, IC 95%: 0,3¿0,6). Conclusiones. Los mensajes de la familia y amigos son factores que parecen influir en el inicio de las relaciones sexuales de los jóvenes. Los programas de promoción de la salud sexual en
Autores: Lopez-del Burgo, C; T., Rafael; Osorio, A; et al.
ISSN 0010-7824  Vol. 85  Nº 1  2012  págs. 69 - 77
ICS Background: Adequate knowledge is essential for making informed decisions. We attempted to determine the level of knowledge about mechanisms of action of birth control methods in five representative samples of European women. Study Design: Randomly selected women, aged 18-49 years, completed an anonymous survey in Germany, France, the UK, Sweden and Romania (N=1137). Participants were asked about how contraceptive methods work and if providers should inform them about this issue. Multiple linear regression was used to evaluate women's characteristics associated with their knowledge of mechanisms of action. Results: The majority of women identified the unequivocal mode of action of condoms, sterilization and abortion. Fewer than 2% identified all possible mechanisms of action of hormonal contraceptives and intrauterine devices. Highly educated women correctly identified the mechanism or mechanisms of action of more methods than less educated women (beta=0.22, 95% confidence interval 0.01-0.43). Regardless of their sociodemographic characteristics and their belief about when human life begins, most women (75%) stated that the provider should inform them about possible postfertilization effects. Conclusions: European women have low knowledge about mechanisms of action of several contraceptive methods. The majority want to be informed about possible postfertilization effects. Since adequate knowledge is essential for making informed decisions, providers are encouraged to info
Autores: Martínez, Miguel Ángel; Guillén, Francisco; de Irala, Jokin; et al.
ISSN 0022-3166  Vol. 142  Nº 9  2012  págs. 1672-8
The available large prospective studies supporting an inverse association between better adherence to the Mediterranean diet and lower mortality have mainly included older adults. It is not clear whether this inverse association is also present among younger individuals at lower mortality risk. Our aim was to assess the association between adherence to the Mediterranean diet and total mortality in middle-aged adults from the Seguimiento Universidad de Navarra (SUN) Project. We followed 15,535 Spanish university graduates for a mean of 6.8 y. Their mean age was 38 ± 12 y, 59.6% were females, and all were initially free of cardiovascular disease, cancer, and diabetes. A validated FFQ was used to assess dietary habits. Adherence to the Mediterranean diet was categorized into 3 groups according to the Mediterranean Diet Score (low, 0-2 points; moderate, 3-5 points; and high, 6-9 points). The outcome variable was total mortality. Cox proportional hazards models were used to estimate HR and 95% CI. We adjusted the estimates for sex, age, years of university education, BMI, smoking, physical activity, television watching, history of depression and baseline hypertension, and hypercholesterolemia. We observed 125 deaths during 105,980 person-years of follow-up. The fully adjusted HR for moderate and high adherence were 0.58 (95% CI: 0.34, 0.99; P = 0.05) and 0.38 (95% CI: 0.21, 0.70; P = 0.002), respectively. For each 2-point increment in the Mediterranean Diet Score, the HR of death
Autores: de Irala, Jokin; Osorio, A; Carlos, Silvia; et al.
ISSN 0010-7824  Vol. 84  Nº 6  2011  págs. 558 - 564
Background: The choice of a birth control method is influenced by sociocultural and personal factors. We explored the perceived influences in women's choice of a birth control method in five European countries (Germany, France, the UK, Romania and Sweden), where contraception is widely used. Study Design: This is a cross-sectional study of 1137 randomly selected women aged 18-49 years. An anonymous, 31-item questionnaire related to birth control methods was used. Logistic regression was used to identify variables associated with partner participation in choice of a contraceptive. Results: Oral contraceptives were mainly used in Germany (54.3%), France (50.5%) and Sweden (34.6%) and condoms in the UK (29.6%) and Romania (22.9%). Sweden showed the highest use of intrauterine devices (IUD, 19%). Romania had the lowest use of contraception. Oral contraceptives and IUDs use were frequently suggested by providers instead of by women. Choosing the method with the partner was associated with age [odds ratio (OR)=0.97, 95% confidence interval (CI) 0.94-0.99], being a university graduate (OR=1.59, 95% CI 1.01-2.29), married (OR=1.52, 95% CI 1.01-2.29) and with using a method that requires partner's cooperation (OR=8.18, 95% CI 5.46-12.27). Conclusions: Hormonal contraceptives and lUDs are commonly recommended by providers rather than requested by women. Partner preferences are taken into account when his cooperation in the use of the method is needed. As fertility care is a male and female issue, there is still more room for actively involving both women and men in their choice of a birth control method.
Autores: Burgui, R.; Martínez-Baz, I.; Guevara, M.; et al.
ISSN 1080-6040  Vol. 17  Nº 8  2011  págs. 1463 - 1466
Of 233 households with laboratory-confirmed pandemic (H1N1) 2009 in Navarre, Spain, only 64% (107/166) of contacts with influenza-like illness had sought medical care. This value was lower for adults (53%, 39/74) than for children <15 years of age (74%, 68/92), as well as for those with cases secondary to another household case (58%, 64/111).
Autores: de Irala, Jokin; Osorio, A; Carlos, Silvia; et al.
ISSN 0004-0002  Vol. 40  Nº 5  2011  págs. 853 - 855
Autores: Martínez, Miguel Ángel; Carlos, Silvia; Toledo, Estefanía Ainhoa; et al.
Libro:  Piédrola Gil. Medicina Preventiva y Salud Pública
2016  págs. 169 - 180
Autores: Martínez, Miguel Ángel; Carlos, Silvia; et al.
Libro:  Piédrola Gil. Medicina Preventiva y Salud Pública
2016  págs. 318 - 330
Autores: de Irala, Jokin; Carlos, Silvia; Lopez-del Burgo, C;
Libro:  Piédrola Gil. Medicina Preventiva y Salud Pública
2016  págs. 601 - 609
Autores: Carlos, Silvia; Toledo, Estefanía Ainhoa; Martínez, Miguel Ángel;
Libro:  Conceptos de salud pública y estrategias preventivas. Un manual para ciencias de la salud
2013  págs. 225 - 230
Autores: Carlos, Silvia; Reina, G; Delgado-Rodríguez, M.;
Título: Tuberculosis
Libro:  Conceptos de salud pública y estrategias preventivas. Un manual para Ciencias de la Salud
2013  págs. 201 - 208
Autores: Carlos, Silvia; Reina, G; Gea, Alfredo;
Libro:  Conceptos de salud pública y estrategias preventivas. Un manual para Ciencias de la Salud
2013  págs. 265 - 270
Autores: Reina, G; Carlos, Silvia; Gómez-Gracia, E.;
Título: Hepatitis virales
Libro:  Conceptos de salud pública y estrategias preventivas. Un manual para Ciencias de la Salud
2013  págs. 217 - 224
Autores: Alegre, Félix; Carlos, Silvia;
Libro:  Conceptos de salud pública y estrategias preventivas. Un manual para ciencias de la salud
2013  págs. 245 - 254
Autores: Reina, G; Carlos, Silvia; Castilla-Catalán, J.;
Libro:  Conceptos de salud pública y estrategias preventivas. Un manual para Ciencias de la Salud
2013  págs. 209 - 216
Autores: Reina, G; Carlos, Silvia;
Libro:  Conceptos de salud pública y estrategias preventivas. Un manual para Ciencias de la Salud
2013  págs. 259 - 264
Autores: Carlos, Silvia; Lopez-del Burgo, C; Reina, G;
Libro:  Conceptos de salud pública y estrategias preventivas. Un manual para Ciencias de la Salud
2013  págs. 193 - 200
Autores: Reina, G; Toledo, Estefanía Ainhoa; Carlos, Silvia;
Libro:  Conceptos de salud pública y estrategias preventivas. Un manual para Ciencias de la Salud
2013  págs. 177 - 184
Autores: Ruiz-Canela, Miguel; Carlos, Silvia; Bes-Rastrollo, Maira;
Libro:  Conceptos de salud pública y estrategias preventivas. Un manual para ciencias de la salud
2013  págs. 449 - 456
Autores: Carlos, Silvia; Reina, G; Castilla-Catalán, J.;
Título: Vacunas
Libro:  Conceptos de salud pública y estrategias preventivas. Un manual para Ciencias de la Salud
2013  págs. 185 - 192
Autores: Carlos, Silvia; Toledo, Estefanía Ainhoa; Martínez, Miguel Ángel;
Libro:  Compendio de salud pública
2011  págs. 279 - 284
Autores: Carlos, Silvia; Reina, G; Martínez, Miguel Ángel;
Título: Vacunas
Libro:  Compendio de salud pública
2011  págs. 327-334
Autores: Martínez, Miguel Ángel; Toledo, Estefanía Ainhoa; Carlos, Silvia;
Título: Salud del adulto
Libro:  Compendio de salud pública
2011  págs. 493 - 502
Autores: Martínez, Miguel Ángel; Carlos, Silvia; Zozaya, C.;
Libro:  Compendio de salud pública
2011  págs. 335 - 342
Autores: Carlos, Silvia; Reina, G; Núñez, Jorge María;
Libro:  Compendio de salud pública
2011  págs. 321-326
Autores: Carlos, Silvia; Lopez-del Burgo, C; Reina, G;
Libro:  Compendio de salud pública
2011  págs. 247-256
Autores: Reina, G; Carlos, Silvia; Martínez, Miguel Ángel;
Libro:  Compendio de salud pública
2011  págs. 315-320
Autores: Alegre, Félix; Carlos, Silvia;
Título: Paludismo
Libro:  Compendio de salud pública
2011  págs. 307 - 312
Autores: Martínez, Miguel Ángel; Carlos, Silvia; de Irala, Jokin;
Libro:  Compendio de salud pública
2011  págs. 5 - 16
Autores: Carlos, Silvia; Reina, G;
Título: Tuberculosis
Libro:  Compendio de salud pública
2011  págs. 257 - 264
Autores: Reina, G; Carlos, Silvia; Gómez, E.;
Título: Hepatitis virales
Libro:  Compendio de salud pública
2011  págs. 271-278
Autores: Bes-Rastrollo, Maira, (Coordinador); Carlos, Silvia, (Coordinador); et al.
Autores: Martínez, Miguel Ángel, (Editor); Carlos, Silvia, (Editor)