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INTRODUCTION AND OBJECTIVES: Information on trends in physical activity is very scarce in Mediterranean countries, which have the highest sedentariness in Europe. This study describes recent trends in leisure time physical activity (LTPA) and at work in the Madrid region. METHODS: The data were taken from representative annual surveys of population aged 18-64 years, between 1995-2008, 28,084 people participated. We calculated total energy, quantified in metabolic equivalent (MET-1 h per week), spent on LTPA and on light LTPA (<3 MET), moderate LTPA (3-6 MET) and vigorous LTPA (>6 MET). The annual change in LTPA was estimated by linear regression, and occupational activity by logistic regression, adjusting for age, gender and educational level. RESULTS: The total amount of LTPA in MET-1 h per week declined by 19.8% (P<.001) between 1995-2008; for both genders, all age groups and educational levels, except for those with the lowest level of education. The adjusted annual change in MET-1 h per week was: -0.21 (P<.001) for total LTPA; -0.1 (P<.001) for light; -0.08 (P<.001) for moderate; and -0.03 (P=.192) for vigorous. This decline is reflected by a shift to the left of the LTPA distribution in the population. Occupational physical inactivity has increased in the general population (odds ratio for annual change=1.01; 95% confidence interval, 1-1.02); specially in women, young and middle aged, and intermediate educational level. CONCLUSIONS: There has been a decline in LTPA, mainly in light and moderate activities, accompanied by greater occupational physical inactivity. This could have contributed to the increase in obesity in the Community of Madrid between 1995-2008.

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Introducción y objetivos. La información sobre tendencias en actividad física es muy escasa en países mediterráneos, los de mayor sedentarismo en Europa. Se presentan tendencias recientes en actividad física en tiempo libre (AFTL) y laboral en la región de Madrid. Métodos. Datos procedentes de encuestas anuales representativas de población de 18-64 años entre 1995 y 2008, con la participación de 28.084 personas. Se calculó el consumo de energía en equivalentes metabólicos (MET-1 h/semana) en AFTL total y en ligeras (< 3 MET), moderadas (3-6 MET) y vigorosas (> 6 MET). El cambio anual en AFTL se estimó mediante regresión lineal y en la actividad laboral, mediante regresión logística, ajustando por edad, sexo y nivel de estudios. Resultados. El consumo de MET-1 h/semana en AFTL descendió un 19,8% (p<0,001) entre 1995 y 2008 en ambos sexos, todas las edades y niveles educativos, excepto en personas con estudios más bajos. El cambio anual ajustado en MET-1 h/semana fue –0,21 (p<0,001) para AFTL total, –0,1 (p<0,001) para ligeras, –0,08 (p<0,001) para moderadas y –0,03 (p=0,192) para vigorosas. Este descenso se manifiesta en un desplazamiento a la izquierda de la distribución de AFTL en la población. La inactividad física laboral aumentó en población general (odds ratio de cambio anual=1,01; intervalo de confianza del 95%, 1-1,02), especialmente en mujeres, edades jóvenes e intermedias y con nivel medio de estudios. Conclusiones. Se ha producido un descenso en AFTL, principalmente en actividades ligeras y moderadas, acompañado de una mayor inactividad laboral. Ello puede haber contribuido al aumento de obesidad en la Comunidad de Madrid de 1995 a 2008 (AU)

Introduction and objectives: Information on trends in physical activity is very scarce in Mediterranean countries, which have the highest sedentariness in Europe. This study describes recent trends in leisure time physical activity (LTPA) and at work in the Madrid region. Methods: The data were taken from representative annual surveys of population aged 18-64 years, between 1995-2008, 28,084 people participated. We calculated total energy, quantified in metabolic equivalent (MET-1 h per week), spent on LTPA and on light LTPA (<3 MET), moderate LTPA (3-6 MET) and vigorous LTPA (>6 MET). The annual change in LTPA was estimated by linear regression, and occupational activity by logistic regression, adjusting for age, gender and educational level. Results: The total amount of LTPA in MET-1 h per week declined by 19.8% (P < .001) between 1995-2008; for both genders, all age groups and educational levels, except for those with the lowest level of education. The adjusted annual change in MET-1 h per week was: –0.21 (P < .001) for total LTPA; –0.1 (P < .001) for light; –0.08 (P < .001) for moderate; and –0.03 (P = .192) for vigorous. This decline is reflected by a shift to the left of the LTPA distribution in the population. Occupational physical inactivity has increased in the general population (odds ratio for annual change = 1.01; 95% confidence interval, 1-1.02); specially in women, young and middle aged, and intermediate educational level. Conclusions: There has been a decline in LTPA, mainly in light and moderate activities, accompanied by greater occupational physical inactivity. This could have contributed to the increase in obesity in the Community of Madrid between 1995-2008 (AU)

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OBJECTIVE: To examine the dose-response relationship between leisure time physical activity (LTPA) and self-rated health. METHODS: A survey (n=18,058) representative of the population aged 18-64years of Madrid (Spain) conducted between 2000 and 2008. A questionnaire on the frequency and duration of numerous activities was used to assess the total amount, the intensity, and the duration of LTPA. Self-rated health was classified as optimal or sub-optimal (fair/bad/very bad). Analyses were performed using logistic regression. RESULTS: Compared with no LTPA, active people in the lowest quintile for total amount of LTPA showed an odds ratio (OR) of sub-optimal health of 0.69; a linear dose-response relationship (p<0.001) was observed, with the OR gradually decreasing to 0.49 in the highest quintile of LTPA. There was an inverse gradient for LTPA intensity adjusted for energy expenditure, so that the OR of sub-optimal health was 0.69 for light LTPA, 0.60 for moderate, and 0.48 for vigorous (p linear trend <0.001). For the same duration, the frequency of optimal health increases with the intensity of LTPA. CONCLUSIONS: The total amount of LTPA shows a graded and continuous association with better self-rated health. The benefits of LTPA on self-rated health increase with the intensity of the activity.

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INTRODUCTION AND OBJECTIVES: To determine whether adults in Madrid, Spain adhere to leisure-time physical activity (LTPA) recommendations and to identify factors associated with adherence. METHODS: A telephone survey of 12,037 individuals, representative of the Madrid population aged 18-64 years, was conducted. The LTPA level was quantified in metabolic equivalent (MET) hours per week from answers to a questionnaire on the frequency and duration of LTPA. This level was compared with the recommendation to engage in at least moderate activity >or=150 min/week or vigorous activity >or=60 min/week. Factors associated with adherence to the recommendation were identified using logistic regression analysis. RESULTS: The mean LTPA level was 17.3 MET-hours/ week (95% confidence interval [CI], 16.9-17.7 MET-hours/week) and 28.8% (95% CI, 28%-29.7%) adhered to the recommendation. The recommended level was achieved more frequently in men than women (odds ratio [OR]=2.41; 95% CI, 2.20-2.64). In comparison with younger individuals, adherence decreased gradually with age until 60-64 years, when the OR was 0.20 (95% CI, 0.15-0.25). Compared with less well-educated individuals, the university-educated were more likely to meet the recommendation (OR=2.28; 95% CI, 1.82-2.87). Obese individuals achieved it less frequently (OR=0.49; 95% CI, 0.40-0.61) than normal-weight individuals. Those whose job involved low-intensity physical activity achieved it more frequently than those with sedentary occupations (OR=1.21; 95% CI, 1.10-1.34). CONCLUSIONS: The majority of adults in Madrid did not achieve the recommended LTPA level. Adherence was lower in women, older individuals, the less well-educated and the obese, while it was greater in those with a job involving low-intensity physical activity.

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Introducción y objetivos. Examinar en adultos de la Comunidad de Madrid la adecuación de la actividad física en tiempo libre (AFTL) a las recomendaciones e identificar factores asociados. Métodos. Encuesta telefónica a 12.037 personas, representativa de la población de 18-64 años de Madrid. La AFTL se calculó en MET-h/semana mediante un cuestionario de frecuencia y duración de AFTL. Se comparó con la recomendación de realizar actividad al menos moderada ≥ 150 min/semana, o vigorosa ≥ 60 min/semana. Los factores asociados al cumplimiento se identificaron mediante regresión logística. Resultados. La media de AFTL fue 17,3 (intervalo de confianza [IC] del 95%, 16,9-17,7) MET-h/semana y un 28,8% (IC del 95%, 28%-29,7%) alcanzó la recomendación. La AFTL recomendada fue más frecuente en varones que en mujeres (odds ratio [OR] = 2,41; IC del 95%, 2,20-2,64). Comparando con los más jóvenes, la adherencia disminuyó gradualmente con la edad hasta los 60-64 años, donde la OR fue 0,20 (IC del 95%, 0,15-0,25). Respecto a los sujetos sin estudios, los universitarios siguieron más frecuentemente la recomendación (OR = 2,28; IC del 95%, 1,82-2,87). Las personas obesas tuvieron menos probabilidad que los normopesos de realizar la AFTL recomendada (OR = 0,49; IC del 95%, 0,40-0,61). Las personas con actividad laboral de baja intensidad se adhirieron a la recomendación con más frecuencia que las de ocupación sedentaria (OR = 1,21; IC del 95%, 1,10-1,34). Conclusiones. La mayoría de los adultos de Madrid no siguió la recomendación de AFTL. La adherencia fue menor en mujeres, al aumentar la edad, con menor nivel de estudios y en obesos, mientras que fue mayor en personas con ocupaciones que requieren baja intensidad física (AU)

Introduction and objectives. To determine whether adults in Madrid, Spain adhere to leisure-time physical activity (LTPA) recommendations and to identify factors associated with adherence. Methods. A telephone survey of 12,037 individuals, representative of the Madrid population aged 18-64 years, was conducted. The LTPA level was quantified in metabolic equivalent (MET) hours per week from answers to a questionnaire on the frequency and duration of LTPA. This level was compared with the recommendation to engage in at least moderate activity ≥150 min/week or vigorous activity ≥60 min/week. Factors associated with adherence to the recommendation were identified using logistic regression analysis. Results. The mean LTPA level was 17.3 MET-hours/ week (95% confidence interval [CI], 16.9-17.7 MET-hours/week) and 28.8% (95% CI, 28%-29.7%) adhered to the recommendation. The recommended level was achieved more frequently in men than women (odds ratio [OR]=2.41; 95% CI, 2.20-2.64). In comparison with younger individuals, adherence decreased gradually with age until 60-64 years, when the OR was 0.20 (95% CI, 0.15-0.25). Compared with less well-educated individuals, the university-educated were more likely to meet the recommendation (OR=2.28; 95% CI, 1.82-2.87). Obese individuals achieved it less frequently (OR=0.49; 95% CI, 0.40-0.61) than normal-weight individuals. Those whose job involved low-intensity physical activity achieved it more frequently than those with sedentary occupations (OR=1.21; 95% CI, 1.10-1.34). Conclusions. The majority of adults in Madrid did not achieve the recommended LTPA level. Adherence was lower in women, older individuals, the less well-educated and the obese, while it was greater in those with a job involving low-intensity physical activity (AU)

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OBJECTIVE: This study was undertaken to test the hypothesis of an association between pharmacologic agents used for labor induction, in particular dinoprostone, and postpartum disseminated intravascular coagulation (DIC). STUDY DESIGN: A retrospective hospital-based case-control study. Adjusted odds ratios (AOR) were calculated by a conditional logistic regression. RESULTS: Forty valid cases of postpartum DIC were compared against 197 matched controls. Labor was induced in 17% of controls, and 56% of cases (AOR = 7.2; 95% CI: 2.1-24.6). The association was observed for both dinoprostone (AOR = 6.7; 95% CI: 1.7-26.5) and oxytocin (AOR = 8.4; 95% CI: 1.4-50.9). Other risk factors identified were as follows: a maternal age older than 34 years (AOR = 9.5; 95% CI: 2.4-37.7), complications during pregnancy (AOR = 5.5; 95% CI: 1.3-22.8), and a gestational age of over 40 weeks (AOR = 3.5; 95% CI: 1.1-11.1). Such factors were shown to also have an interaction with the induction of labor. Oxytocin augmentation showed a negative association (AOR = 0.1; 95% CI: 0.02-0.4). The absolute risk attributable to induction was estimated in 5 per 10,000 deliveries. CONCLUSION: The pharmacologic induction of labor is associated with an increased risk of postpartum DIC, regardless the substance used. Although the absolute risk seems to be quite low, the obstetricians should not neglect it, in particular for the special risk groups identified.

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