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ORIGINAL ARTICLE
The role of fatness on physical fitness in adolescents with and
without Down syndrome: The UP&DOWN study
R Izquierdo-Gomez
1
, D Martínez-Gómez
1
, B Fernhall
2
, A Sanz
1
and ÓL Veiga
1
on behalf of the UP&DOWN study group
3
BACKGROUND/OBJECTIVES: Adolescents with Down syndrome (DS) exhibit higher levels of fatness and low levels of physical
fitness compared with those without DS. In adolescents without DS, fatness is tightly associated with physical fitness, but this
association is unclear in adolescents with DS. The aim of this study was to examine the association between several markers of
fatness and physical fitness in a relative large sample of adolescents with and without DS.
SUBJECTS/METHODS: A total of 111 adolescents with DS (41 females) aged 11–20 years participated in this cross-sectional study.
We also included a sex-matched control group (ratio 1:2) of 222 adolescents without DS aged 12–18 years, participating in the
UP&DOWN Study. The Assessing Level of Physical Activity (ALPHA) health-related fitness test battery for adolescents was used to
assess fatness and physical fitness.
RESULTS: Our results show that fatness is not associated with low levels of physical fitness in adolescents with DS (that is, 3 of the
16 analyses identified differences in physical fitness variables by groups of fatness). In contrast, fatness, as expected, is associated
with levels of physical fitness in adolescents without DS (that is, 13 of the 16 analyses identified differences in physical fitness
variables by groups of fatness).
CONCLUSIONS: The present finding contributes to new knowledge by suggesting that the role of fatness on physical fitness is
different in adolescents with and without DS, and consequently, the poor levels of physical fitness in adolescents with DS may be
due to the syndrome rather than the high prevalence of obesity from this population.
International Journal of Obesity advance online publication, 15 September 2015; doi:10.1038/ijo.2015.164
INTRODUCTION
Pediatric obesity is a major health problem worldwide,
1
but it
is even more common in individuals with intellectual disabilities
than in the general population, especially in those with
Down syndrome (DS).
2
Adolescents with DS exhibit higher levels
of fatness caused by several factors that involves genetic
and exogenous factors such as the decrease in resting metabolic
rate, hypothyroidism, small stature and so on.
3
Although it is less
well-known, adolescents with DS also exhibits exceptionally
poor levels of physical fitness compared with individuals with
and without intellectual disabilities.
4,5
Because in the general
population, fatness is tightly related to low physical fitness
6–8
at these ages, it could explain this feature in population with
DS. However, it is unclear whether the role of fatness on
physical fitness levels is similar in adolescents with and
without DS.
Only one previous study examined the association between
fatness and physical fitness in adolescents with DS,
9
but limited to
single markers of fatness (that is, body mass index) and fitness
(that is, VO
2peak
). Importantly, more markers of fatness and other
components of physical fitness such as muscular and motor
fitness could provide additional health-related information.
10–13
Therefore, the aim of this study was to examine the association
between markers of overall and abdominal fatness (that is, body
mass index, skinfolds, waist circumference and waist-to-height
ratio) and some components of physical fitness (that is,
cardiorespiratory, muscular and motor fitness) in a relative large
sample of adolescents with and without DS.
MATERIALS AND METHODS
Study design and participants
This study was part of the UP&DOWN study (Follow UP school
children AND adolescents with DS: psycho-environmental and
genetic determinants of physical activity and its impact on physical
fitness, cardiovascular diseases, inflammatory biomarkers and
mental health). Details about design have been presented elsewhere.
14
A total of 111 adolescents with DS (41 females) aged 11–20 years
participated in this cross-sectional study. We also included a sex-matched
control group (ratio 1:2) of 222 adolescents without DS aged from 12
to 18 years. The control group was randomly selected from 673
adolescents belonging to the same study with information on
cardiorespiratory fitness scored in laps.
14
The group with DS was recruited
from special education schools, associations and foundations for
people with intellectual disabilities from the regions of Madrid and Toledo
(Spain). The sex-matched adolescents without DS were recruited
from schools in Madrid (Spain). All participants with DS met two
specific inclusion criteria: having an intelligence quotient over 35 and
not having any physical disabilities impacting physical activity.
Data collection took place between October 2011 to December 2012.
Parents, adolescents and institution supervisors were informed
about the study characteristics. Written informed consent was obtained
from all participants and their parents or guardians before the
data collection in adolescents with and without DS. The study protocols
were approved by the Ethics Committee of the Hospital Puerta de
1
Department of Physical Education, Sport and Human Movement, Autonomous University of Madrid, Madrid, Spain and
2
Department of Kinesiology and Nutrition, University of
Illinois, Chicago, IL, USA. Correspondence: Dr ÓL Veiga, Departamento de Educación Física, Deporte y Motricidad Humana, Universidad Autónoma de Madrid, Ctra. de Colmenar
Km. 15, Madrid 28049, Spain.
E-mail: oscar.veiga@uam.es
3
See Appendix.
Received 1 May 2015; revised 7 July 2015; accepted 3 August 2015; accepted article preview online 21 August 2015
International Journal of Obesity (2015), 1–6
© 2015 Macmillan Publishers Limited All rights reserved 0307-0565/15
www.nature.com/ijo
Hierro (Madrid, Spain) and the Bioethics Committee of the
National Research Council (Madrid, Spain).
Markers of fatness
Fatness was assessed following standardized procedures using anthropo-
metric techniques.
15
All fatness measures were performed twice and the
averages were recorded.
16
Weight and height were measured with participants having bare feet
and wearing light clothing. Weight was recorded to the nearest 0.1 kg
using an electronic scale (model SECA 701, Hamburg, Germany) and height
was measured to the nearest 1 mm using a telescopic height-measuring
instrument (model SECA 220). Body mass index was calculated by weight
divided by squared height (kg m
−2
). The gender- and age-specific cutoffs
according to the International Obesity Task Force
17,18
were used to
classified adolescents into ‘normal-weight’or ‘overweight-obesity’cate-
gories. Skinfold thickness was measured on the non-dominant side of the
body to the nearest 0.1 mm with a Holtain caliper at the triceps and
subscapular sites. Body fat percentage was calculated from triceps and
subscapular skinfold thicknesses using the Slaughter equations.
19
These
equations accurately predict body fat by theses skinfolds in both
populations.
20,21
Adolescents with normal-fat and over-fat were classified
according to the age- and sex-specific cutoffs proposed by FITNESGRAM.
22
Waist circumference was measured over unclothed abdomen at the
narrowest point between the costal margin and iliac crest with a non-
elastic tape (SECA 200; SECA) to the nearest 0.1 cm. Waist-to-height ratio
was calculated dividing the waist circumference by the participant’s
height. Values of waist circumference ⩾75th percentile by sex and age,
and waist-to-height ratio ⩾0.50 indicated adolescents ‘at risk’for higher
obesity-related cardiovascular diseases.
23,24
Components of physical fitness
Physical fitness was measured following the ALPHA and health-related
fitness test battery for youth.
15,25
The ALPHA health-related fitness test
showed a good reliability in adolescents with DS using some non-
significant adaptations (for example, adolescents were guided and helped
by instructors when necessary).
16
All fitness tests showed an intra-class
correlation value from 0.64 to 0.92.
16
In addition, all assessment were
explained and performed with the instructor and adolescents together for
an easy understanding of all the tests before the final testing.
Muscular fitness was assessed using the handgrip strength and the
standing long jump tests. A hand dynamometer with an adjustable grip
(TKK 5101 Grip D, Takey, Tokyo Japan) was used to assess handgrip
strength. The grip-span of the dynamometer was adjusted according to
the hand size of the youth.
26
The adolescents squeezed the dynamometer
gradually for at least 2 s alternatively with both hands and the elbow in full
extension. Adolescents with DS performed the test in sitting position and
adolescents without disabilities in standing position.
16
The test was
performed twice and the highest score in kilograms for each hand was
recorded, and the average score of the left and right hand was calculated.
Standing long jump test was performed from starting position behind a
line standing with feet approximately shoulder’s width apart. Adolescents
had to jump as far as possible, landing with feet together. The test was
completed twice and the longer distance was recorded in centimeters.
27
Motor fitness was assessed using the 4 × 10m shuttle-run test of speed-
of-movement, agility and coordination. The adolescents were required to
run back and forth between two parallel lines 10-m apart. They were asked
to run as fast as possible from the starting line to the other line and they
should pick up (the first time) or exchange (second and third time) a
sponge that has earlier been placed behind the lines. The test was
performed twice and the fastest time was recorded in seconds.
27
Because
lower the score, the better the performance, it was multiplied by −1 and a
higher score indicates better motor fitness.
Cardiorespiratory fitness was assessed by the 20-m shuttle-run test. The
adolescents were required to run between two lines 20-m apart, while
keeping pace with a pre-recorded audio CD. The initial speed was
8.5 km h
−1
, which was increased by 0.5 km h
−1
each minute (1 min = one
stage). The adolescents were instructed to run in a straight line, to pivot on
completing a shuttle (20-m), and to pace themselves in accordance with
the audio signals. The test was finished when the adolescent failed to
reach the end lines concurrent with the audio signals on two consecutive
occasions.
27
The final score was the number of laps completed in both
adolescents with and without DS owing to the low aerobic capacity of
adolescents with DS.
28
Statistical analysis
Descriptive characteristics are presented as means (s.d.). We initially
analyzed differences between groups (adolescents with DS vs adolescents
without DS) unadjusted by one-way analysis of variance, and then, we
performed one-way analysis of covariance controlling for age. Pearson
correlations were used to examine the relationships between markers of
fatness and components of physical fitness within each group
of adolescents with and without DS, controlling for sex and age. Analysis
of covariance was also used to examine differences in levels of physical
fitness by fatness categories in each population group, controlling for sex
and age. Data were analyzed using SPSS statistical software (version 20.0,
Chicago, IL, USA) for Macintosh. The level of significance was set at 0.05 for
all analyses.
RESULTS
Table 1 shows the descriptive characteristics of the study samples.
Overall, adolescents with DS were older and smaller than
Table 1. Descriptive characteristics of study sample
Down syndrome Non-Down syndrome P
1
P
2
nn
Age (years) 111 15.77 ±2.45 222 14.07 ±1.60 o0.001 o0.001
Weight (kg) 111 52.20 ±11.92 222 55.76 ±12.50 0.016 o0.001
Height (cm) 111 147.66 ±9.43 222 161.96 ±9.41 o0.001 o0.001
Fatness
Body mass index (kg m
−2
) 111 23.76 ±4.11 222 21.08 ±3.48 o0.001 o0.001
Waist circumference (cm) 111 73.42 ±9.37 222 68.88 ±7.56 o0.001 0.047
Waist-to-height ratio 111 0.50±0.06 222 0.43 ±0.41 o0.001 o0.001
Triceps skinfold (mm) 107 23.61 ±8.93 222 13.79 ±6.48 o0.001 o0.001
Subscapular skinfold (mm) 107 20.58 ±9.81 222 11.74 ±6.19 o0.001 o0.001
Body fat (%) 106 34.20 ±12.79 222 20.95 ±9.49 o0.001 o0.001
Fitness
Handgrip strength (kg) 109 15.87 ±6.58 222 26.99 ±7.63 o0.001 o0.001
Standing long jump (cm) 109 73.06 ±37.79 222 163.09 ±31.62 o0.001 o0.001
Motor fitness (sec × −1) 109 −19.48 ±4.71 222 −11.97 ±1.05 o0.001 o0.001
Cardiorespiratory fitness (laps) 109 8.00 ±5.83 222 49.83 ±23.92 o0.001 o0.001
Data are mean ±s.d. P
1
=unadjusted. P
2
=age-adjusted. Statistically significant values are shown in bold (Po0.05).
Fatness and physical fitness in Down syndrome
R Izquierdo-Gomez et al
2
International Journal of Obesity (2015) 1 –6 © 2015 Macmillan Publishers Limited
adolescents without DS (all Po0.001). Also, adolescents with DS
had higher levels of fatness and poorer scores in physical fitness
tests than adolescents without DS (all Po0.001).
Table 2 shows correlations between fatness and physical fitness
variables in adolescents with and without DS. In adolescents with
DS, values above the diagonal showed that waist circumference,
subscapular skinfold and body fat % variables were inversely
correlated with standing long jump test (r=−0.214, −0.247 and
−0.217, all Po0.05, respectively). In adolescents without DS,
values below the diagonal showed that body mass index and
waist circumference were correlated with all physical fitness
variables (ranging r=−0.189 to 0.339, all Po0.05). Waist-to-height
ratio, skinfold thickness and body fat were correlated with
standing long jump, motor fitness and cardiorespiratory fitness
variables (ranging r= −0.352 to −0.528, all Po0.05).
Table 3 shows differences in physical fitness according to
overall fatness categories in adolescents with and without DS.
There were only significant differences in motor fitness by body
fat categories in adolescents with DS, after adjusting for sex and
age (P= 0.048). In adolescents without DS, differences in standing
long jump, motor fitness and cardiorespiratory fitness were
significant by groups of both body mass index and body fat
categories (all Po0.001).
Table 4 shows differences in physical fitness according to
abdominal body fat categories in adolescents with and without
DS. In adolescents with DS, there were only significant differences
in standing long jump and motor fitness tests (P= 0.002 and 0.026,
respectively) by waist-to-height ratio categories. In contrast, there
were significant differences in all physical fitness variables by
groups of both waist circumference and waist-to-height circum-
ference in adolescents without DS (Po0.001), with the exception
of handgrip strength by groups of waist-to-height ratio (P= 0.865).
DISCUSSION
This study examined the association between several markers of
fatness and components of physical fitness in a relatively large
sample of adolescents with and without DS. The main findings of
this study show that fatness is not associated with low levels of
physical fitness in adolescents with DS (that is, 3 of the 16 analyses
identified differences in physical fitness variables by groups of
fatness). In contrast, fatness as expected is associated with levels
of physical fitness in adolescents without DS (that is, 13 of the 16
analyses identified differences in physical fitness variables by
groups of fatness). The present finding contributes to new
knowledge by suggesting that the role of fatness on physical
fitness is different in adolescents with and without DS, and
consequently, the poor levels of physical fitness in adolescents
with DS may be due to the syndrome rather than the high
prevalence of obesity from this population.
This study used several markers of fatness in adolescents with
and without DS to examine the role of fatness on physical fitness
levels. Thus, body mass index and skinfolds-derived body fat were
used as marker of overall fatness, and waist circumference and
waist-to-height ratio as marker of abdominal fatness. Although
many studies have reported higher prevalence of obesity and
poor physical fitness in populations with DS,
29,30
there are no prior
studies that examined the association between several markers of
fatness and components of physical fitness in this population.
Contradictory results, however, have been reported in indivi-
duals with intellectual disabilities, which included people with DS.
For example, Salaun and Berthouze-Aranda
31
compared obese
and non-obese groups with several measures of physical fitness in
87 adolescents with intellectual disability, of which 3 adolescents
had DS. The results of this study revealed that there were
significant differences among non-obese and obese groups by
body fat categories and components of physical fitness, but there
was no link between body mass index and components of
Table 2. Correlations between fatness and fitness in adolescents with and without Down syndrome
Body mass index
(kg m
−2
)
Waist
circumference (cm)
Waist-to-
height ratio
Triceps
skinfold (mm)
Subscapular
skinfold (mm)
Body fat
(%)
Handgrip
strength (kg)
Standing long
jump (cm)
Motor fitness
(sec × −1)
Cardiorespiratory
fitness (laps)
Body mass index (kg m
−2
)—0.889** 0.874** 0.670** 0.770** 0.715** 0.186 −0.104 0.050 −0.092
Waist circumference (cm) 0.820** —0.906** 0.659** 0.762** 0.710** 0.175 −0.136 −0.034 −0.108
Waist-to-height ratio 0.799** 0.898** —0.676** 0.772** 0.704** 0.026 −0.214* −0.128 −0.167
Triceps skinfold (mm) 0.750** 0.765** 0.763** —0.758** 0.901** 0.075 −0.165 −0.106 −0.151
Subscapular skinfold (mm) 0.780** 0.830** 0.831** 0.880** —0.896** 0.039 −0.247* −0.176 −0.227
Body fat (%) 0.765** 0.799** 0.805** 0.971** 0.940** —0.083 −0.217* −0.154 −0.183
Handgrip strength (kg) 0.253** 0.339** 0.061 0.047 0.105 0.049 —0.486** 0.495** 0.472**
Standing long jump (cm) −0.257** −0.189* −0.356** −0.418** −0.370** −0.426** 0.470** —0.678** 0.622**
Motor fitness (sec × −1) −0.302** −0.261** −0.352** −0.436** −0.423** −0.450** 0.312** 0.674** —0.674**
Cardiorespiratory fitness
(laps)
−0.371** −0.315** −0.368** −0.500** −0.457** −0.528** 0.125 0.413** 0.480** —
Values above the diagonal are correlation in adolescents with Down syndrome, whereas values below the diagonal are Pearson correlation in adolescents without Down syndrome, controlling for sex and age
within each population group. *Po0.05, **Po0.001 denotes statistical significance.
Fatness and physical fitness in Down syndrome
R Izquierdo-Gomez et al
3
© 2015 Macmillan Publishers Limited International Journal of Obesity (2015) 1 –6
physical fitness. Foley et al.
32
showed a significant relationship
between low levels of body fatness and high levels of health-
related physical fitness in 427 adolescents with intellectual
disabilities. In individuals with DS, only Wee et al.
9
examined the
effect of fatness on physical fitness in young people with and
without DS, but analyses were limited to body mass index and
cardiorespiratory fitness (VO
2peak
). Overall, this study found that
there was a significant main effect of weight status on physical
fitness in both young people with and without DS (n= 151 and
503, respectively). However, the results indicated that the real
impact of fatness on cardiorespiratory fitness levels was almost
exclusively observed in the group of children and adolescents
without DS.
Our results support the preliminary findings from Wee et al.
9
so
that there were no differences in cardiorespiratory fitness
according to fatness categories, while remarkable differences
were found in adolescents without DS. In addition, intervention
studies found similar findings in this population. For instance,
Li et al.
33
reported in a Systematic Reviewed that intervention
groups from studies focus on losing weight in people with DS did
not improve fatness. González-Agüero et al.
34
also found that
adolescents with DS did not change the percentage of fat after a
training period. In contrast, studies reported improvements in
some physical fitness variables as compared with control groups.
Li et al.
33
also showed that interventions based on enhancing
physical activity found improvements in muscular fitness and
balance in DS intervention groups. Similarly, in previous studies,
our group found that objectively measured physical activity was
positively associated with fitness variables independent of fatness
in adolescents with DS,
35
but physical activity was not associated
with fatness. Taken together, these and our findings suggest that
clinical interventions to build physical fitness in young people with
DS are warranted, taking into account that no beneficial changes
in fatness parameters must be expected.
A meta-analysis study in adolescents without disabilities
suggested that losing-weight intervention studies are effective
in this population.
36
In fact, evidence reported that intervention
studies reduced fatness and enhanced physical fitness in
adolescents without disabilities.
37
Some studies that used
objectively physical activity by accelerometry have found
consistent results, and moderate to high levels of physical activity
were negatively associated with fatness and positively associated
with physical fitness in population without DS.
38,39
For example, in
the HELENA study, Martinez-Gomez et al.
40,41
found that levels of
objectively measured physical activity were negatively associated
with fatness variables and with cardiorespiratory fitness
Table 3. Differences in physical fitness according to body mass index and % body fat categories in adolescents with and without Down syndrome
Down syndrome Non-Down syndrome
Normal-weight/fat Overweight/over-fat PNormal weight/fat Overweight/over-fat P
nn n n
Body mass index
Handgrip strength (kg) 55 15.25 ±5.68 54 16.49 ±7.40 0.136 156 27.06 ±7.35 66 26.83 ±8.32 0.295
Standing long jump (cm) 55 79.35 ±41.01 54 66.66 ±33.38 0.116 156 168.48 ±30.48 66 150.35 ±30.82 o0.001
Motor fitness (sec × −1) 55 −19.40 ±4.74 54 −19.57 ±4.71 0.944 156 −11.76 ±0.95 66 −12.43 ±1.43 o0.001
Cardiorespiratory fitness (laps) 55 8.64 ±6.57 54 7.35 ±4.95 0.326 156 53.81 ±24.41 66 40.42 ±19.89 o0.001
Body fat
Handgrip strength (kg) 25 15.38 ±5.07 80 16.15 ±7.12 0.652 161 27.02 ±7.79 61 26.92 ±7.25 0.189
Standing long jump (cm) 25 78.68 ±36.07 80 71.71 ±38.44 0.263 161 169.91 ±30.69 61 145.08 ±26.77 o0.001
Motor fitness (sec × −1) 24 −18.07 ±2.92 80 −19.69 ±4.79 0.048 161 −11.70 ±0.93 61 −12.64 ±1.06 o0.001
Cardiorespiratory fitness (laps) 24 8.79 ±7.31 79 7.89 ±5.44 0.203 161 54.73 ±24.16 61 36.89 ±17.75 o0.001
Data are mean ±s.d. Differences within groups were adjusted for sex and age. Statistically significant values are shown in bold (Po0.05).
Table 4. Differences in physical fitness according to waist circumference and waist-to-height ratio categories in adolescents with and without Down
syndrome
Down syndrome Non-Down syndrome
Not at risk At risk PNot at risk At risk P
nn n n
Waist circumference
Handgrip strength (kg) 87 15.6 ±6.0 22 16.9 ±8.5 0.324 167 26.6 ±7.5 55 28.3 ±7.8 0.009
Standing long jump (cm) 86 74.5 ±37.9 23 67.7 ±37.8 0.476 167 166.8 ±30.0 55 151.8 ±33.9 o0.001
Motor fitness (sec × −1) 86 −19.7 ±5.0 23 −18.8 ±3.3 0.403 167 −11.8 ±0.9 55 −12.4 ±1.2 o0.001
Cardiorespiratory fitness (laps) 86 8.2 ±5.9 23 7.4 ±5.8 0.595 167 52.9 ±23.9 55 40.2 ±21.5 o0.001
Waist-to-height ratio
Handgrip strength (kg) 62 15.60 ±5.08 47 16.23 ±8.20 0.822 204 27.01 ±7.58 18 26.73 ±8.37 0.865
Standing long jump (cm) 62 81.34 ±39.62 47 62.14 ±32.51 0.002 204 164.87 ±31.03 18 142.94 ±32.21 0.001
Motor fitness (sec × −1) 62 −18.69 ±3.77 47 −20.53 ±5.58 0.026 204 −11.88 ±0.99 18 −12.85 ±1.26 o0.001
Cardiorespiratory fitness (laps) 61 8.52 ±5.92 46 7.32 ±5.69 0.120 204 51.34 ±23.86 18 32.67 ±17.22 o0.001
Data are mean ±s.d. Differences within groups were adjusted for sex and age. Statistically significant values are shown in bold (Po0.05).
Fatness and physical fitness in Down syndrome
R Izquierdo-Gomez et al
4
International Journal of Obesity (2015) 1 –6 © 2015 Macmillan Publishers Limited
independently of fatness. In a subsample of this study, Moliner-
Urdiales et al.
42
found that all markers of central fat measured with
DEXA and Bodpod were negatively associated with vigorous
physical activity.
Some of the strengths of the present study are the relatively
large and heterogeneous sample of adolescents with DS, and the
use of a control group. Another strength is the complete and
standardized assessment of fatness and physical fitness compo-
nents in both populations. However, this study has several
limitations. The cross-sectional nature of this study limits the
ability to address causality. In addition, it was undertaken a
convenience sample, which limit the generalizability across
populations. The lack of standard reference values for overweight
and being at risk of obesity according to waist circumference and
body fat in adolescents with DS affect the result of this study. Our
results may not be generalizable and additional studies, mainly
intervention and prospective designs, are warranted to confirm
these findings. Finally, diet information is important, so further
studies should examine whether the role of fatness on fitness in
adolescents with DS might be influenced by dietary patterns and
physical activity.
In summary, the results of the present study show that the
association of fatness on physical fitness is different in adolescents
with and without DS. Fatness was not associated with physical
fitness components in adolescents with DS, but in adolescents
without DS, fatness remains to be a key factor of their physical
fitness levels. Because previous interventions in physical activity in
adolescents with DS improved physical fitness but not fatness and
in adolescents without DS both features are improved, future
interventions must be target-specific in adolescents with DS.
CONFLICT OF INTEREST
The authors declare no conflict of interest.
ACKNOWLEDGEMENTS
We would like to thank all adolescents with DS, parents and institution collaborators
in this study. This study was supported by the DEP 2010-21662-C04-00 grant from the
National Plan for Research, Development and Innovation (R+D+i) MICINN.
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APPENDIX
UP&DOWN group
Coordinator: Ascension Marcos. Principal Investigators: Ascension
Marcos, Oscar L. Veiga, Jose Castro-Piñero, and Fernando Bandrés.
Scientific Coordinators: David Martinez-Gomez (chair), Jonatan R.
Ruiz (co-chair), Ana Carbonell-Baeza, Sonia Gomez-Martinez,
and Catalina Santiago. Spanish National Research Council:
Ascension Marcos, Sonia Gomez-Martinez, Esther Nova, Esperanza
L. Diaz, Belén Zapatera, Ana M. Veses, Jorge R. Mujico, and
Alina Gheorghe. Autonomous University of Madrid: Oscar L. Veiga,
H. Ariel Villagra, Juan del-Campo, Carlos Cordente (UPM),
Mario Diaz, Carlos M. Tejero, Aitor Acha, Jose M. Moya,
Alberto Sanz, David Martinez-Gomez, Veronica Cabanas-Sanchez,
Gabriel Rodriguez-Romo (UPM), Rocio Izquierdo-Gomez,
Laura Garcia-Cervantes, and Irene Esteban-Cornejo. University of
Cadiz: José Castro-Piñero, Jesús Mora-Vicente, José L. González-
Montesinos, Julio Conde-Caveda, Francisco B. Ortega (UGR),
Jonatan R. Ruiz (UGR), Carmen Padilla Moledo, Ana Carbonell
Baeza, Palma Chillón (UGR), Jorge del Rosario Fernández,
Ana González Galo, Gonzalo Bellvís Guerra, Álvaro Delgado
Alfonso, Fernando Parrilla, Roque Gómez, and Juan Gavala.
Complutense University of Madrid: Fernando Bandrés, Alejandro
Lucia (UEM), Catalina Santiago (UEM), and Felix Gómez-
Gallego (UEM).
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