Intervenções não farmacológicas no manejo da obesidade infantil: uma overview / Non-pharmacological interventions in the management of childhood obesity: an overview / Intervenciones no farmacológicas en el tratamiento de la obesidad infantil: una visión general

Objetivo: Analisar na literatura científica a efetividade das intervenções não farmacológicas para o manejo da obesidade infantil. Método: Trata-se de uma revisão sistemática do tipo overview. As bases científicas para coleta de dados foram: Cinahl, Cochrane, Lilacs, Medline, Scopus, Scielo e Science direct, e todo o processo de seleção foi feito por pares e avaliado pelo teste Kappa. A análise dos estudos utilizou os instrumentos: AMSTAR para avaliação da qualidade metodológica, Robis 2.0 para avaliação do risco de viés, e o Sistema Grade para classificar nível de evidência. Resultado: 17 estudos foram considerados elegíveis, e avaliação das evidências demonstrou que as intervenções não farmacológicas são efetivas para o manejo da obesidade infantil, sendo classificadas pelo Sistema Grade com alto e moderado nível de evidência. Essas intervenções são caracterizadas como: comportamentais, educacional, familiar, nutricional e tecnológica e são capazes de promover mudanças no Índice de Massa Corporal e estilo de vida. Conclusão: As intervenções não farmacológicas são capazes de promover mudanças positivas quanto ao comportamento alimentar e manejo da obesidade, entretanto os resultados não são imediatos.

Objective: To analyze the effectiveness of non-pharmacological interventions for the management of childhood obesity in the scientific literature. Method: This is a systematic review of the overview type. The scientific databases for data collection were: Cinahl, Cochrane, Lilacs, Medline, Scopus, Scielo and Science direct, and the entire selection process was done by pairs and evaluated by Kappa test. The analysis of the studies used the instruments: AMSTAR to assess methodological quality, Robis 2.0 to assess risk of bias, and the Grade System to rank level of evidence. Results: 17 studies were considered eligible, and evaluation of the evidence showed that non- pharmacological interventions are effective for the management of childhood obesity, being classified by the Grade System with high and moderate level of evidence. These interventions are characterized as: behavioral, educational, family, nutritional, and technological, and are able to promote changes in Body Mass Index and lifestyle. Conclusion: Non-pharmacological interventions are able to promote positive changes in eating behavior and obesity management, but the results are not immediate.

Objetivo: Analizar la efectividad de las intervenciones no farmacológicas para el manejo de la obesidad infantil en la literatura científica. Método: Se trata de una revisión sistemática de tipo panorámica. Las bases de datos científicas para la recogida de datos fueron: Cinahl, Cochrane, Lilacs, Medline, Scopus, Scielo y Science direct, y todo el proceso de selección se realizó por parejas y se evaluó mediante el test de Kappa. En el análisis de los estudios se utilizaron los instrumentos AMSTAR para evaluar la calidad metodológica, Robis 2.0 para evaluar el riesgo de sesgo y el Grade System para clasificar el nivel de evidencia. Resultados: Se consideraron elegibles 17 estudios, y la evaluación de la evidencia mostró que las intervenciones no farmacológicas son efectivas para el manejo de la obesidad infantil, siendo clasificadas por el Sistema Grade con nivel de evidencia alto y moderado. Estas intervenciones se caracterizan por ser: conductuales, educativas, familiares, nutricionales y tecnológicas, y son capaces de promover cambios en el Índice de Masa Corporal y en el estilo de vida. Conclusiones: Las intervenciones no farmacológicas son capaces de promover cambios positivos en la conducta alimentaria y en el manejo de la obesidad, pero los resultados no son inmediatos.

Habitos de sueño, alimentacion y uso de dispositivos tecnológicos durante la pandemia por covid-19 en población infantil Argentina / Eating, sleeping and screen exposure habits during the covid-19 pandemic in Argentinean children

Introducción: El estilo de vida de niños/as se afectó por la pandemia por Covid-19. Objetivos: Identificar conductas de sueño-vigilia, uso de la tecnología, comensalidad, participación en la compra y elaboración de las comidas y su valor nutricional. Materiales y métodos: Se realizó una encuesta a niñas/os de 6 a 12 años de La Pampa, Argentina. El estudio fue descriptivo, observacional y transversal. Resultados: de las 348 encuestas recabadas, 80% hacían las principales comidas en su casa y el 17% participó de la elaboración de las comidas, cocinando pizzas, purés, pastas, guisos, empanadas; preparaciones con hidratos de carbono complejos y grasas. Durante la noche, 43% optó por comer frutas y 24,7% galletitas y golosinas. 73,3% manifestó mirar televisión mientras come. 38,8% pasaba entre 3-4 horas con dispositivos tecnológicos. 33,5% comía galletitas, snacks, cereales, papas fritas, golosinas, sándwiches y jugos mientras usaba la tecnología. 82,5% dormía 8-10 horas diarias y 37,4% reportó dormir más horas que en pre- pandemia. 52% utilizaba pantallas antes de dormirse, del 31% que les costaba dormirse, 52% seguía usando dispositivos y del 11% ingería alimentos. Conclusiones: Se observaron hábitos de picoteos, ingestas de bajo valor nutricional, modificaciones en las horas de sueño y el uso de la tecnología. La infancia podría beneficiarse de la educación sobre rutinas de higiene tecnológica que permitan la distribución más eficaz del sueño, los horarios de comidas, el comer asociado a pantallas y el tiempo de juego y de actividad física

Introduction: The lifestyle of children was affected by the Covid-19 pandemic. Objectives: Identify sleep-wake behaviours, use of technology, participation in the purchase, preparation and sharing of meals and understand their nutritional value. Materials and Methods: A descriptive, observational and cross-sectional study was performed in children from 6 to 12 years old from La Pampa, Argentina Results: 348 were recruited, 80% ate the main meals at home and 17% participated in the preparation of meals, cooking pizzas, mash potatoes, pastas, stews, empanadas, which include food with complex carbohydrates and fats. Post dinner, 43 % chose to eat fruit and 24.7 % biscuits and sweets. 73.3% watched television while eating. 38.8 % spent between 3-4 hours with technological devices. 33.5 % ate cookies, snacks, cereals, chips, sweets, sandwiches, and drank juices while using technology. 82.5 % slept 8-10 hours a day and 37.4% reported sleeping more hours than pre-pandemic. 52% used screens before falling asleep, of the 31% who found it difficult to fall asleep, 52% continued to use devices and 11% ate food. Conclusions: snacking, food intake with low nutritional value, changes in sleeping and waking-up times, and excessive screen exposure were observed. Children could benefit from more education with regards to technological hygiene routines and the subsequent benefits of efficient sleep, meal times, food selection, playtime, and physical activity

Etiquetado nutricional de alimentos procesados (semáforo nutri-cional) y su relación con factores socioeconómicos, culturales, demográficos y publicitarios, según padres de niños entre 5-11 años de dos colegios de Quito / Nutritional labeling of processed foods (nutritional stoplight) and its relationship with socioeconomic, cultural, demographic and advertising factors, according to parents of children between 5-11 years of age from two schools in Quito

Introducción: El etiquetado nutricional es una herramienta gráfica para notificar al consumidor sobre las propiedades nutricionales de un alimento lo que facilita su selección. El objetivo del presente estudio fue determinar la influencia del etiquetado nutricional y los factores socioeconómicos, culturales, demográficos, publicitarios en la selección de alimentos en un grupo de padres de niños entre 5-11 años en dos unidades educativas públicas y privadas de Quito. Métodos: Con diseño mixto, cuantitativo- transversal y cualitativa interpretativa se analizó una muestra de opiniones de 240 padres en las Unidades Educativas (UE) Nueva Aurora (Privada) y 235 padres en la UE Julio María Matovelle (Pública) de Quito. Se realizaron tres grupos focales, grabados y transcriptos de forma textual y se aplicó un cuestionario. El paquete esta-dístico usado fue SPSS v24.0. Resultados: Hubo mayor consumo de alimentos procesados en la UE Privada n=79/240 (32.9%). Selección por fácil preparación (39.2% UE Privada y 46.4% UE Pública). El 54.2 % y 57 % de los padres ven publicidad en la televisión. El conocimiento del etiquetado fue superior en la UE privada (94.9%; n=223). Asociación entre edad [OR: 2.3; IC 95%: 1.08-5.04] instrucción [OR: 3.95; IC 95%: 2.12-7.37], exposición a la publicidad [OR: 0.62; IC 95%: 0.36-1.05] y conocimientos (P<0.05). La actitud se asoció con el nivel de instrucción [OR: 2.57; IC 95%: 1.62-4.09] e ingresos (P<0.05). Análisis cualitativo: grado de conocimiento y publicidad elevados, con un impacto importante en la selección de los alimentos. Conclusiones: El conocimiento sobre el etiquetado nutricional fue elevado; pero no fue el principal factor para seleccionar alimentos. El tiempo de preparación y el sabor fueron más importantes que las especificaciones nutricionales

Introduction: Nutrition labeling is a graphic tool to notify consumers about the nutritional properties of a food, which facilitates their selection. The objective of this study was to determine the influence of nutri-tional labeling and socioeconomic, cultural, demographic, and advertising factors on food selection in a group of parents of children between 5-11 years old in two public and private educational units in Quito. Methods: With a mixed, quantitative-transversal and qualitative interpretative design, a sample of opin-ions of 240 parents in the Educational Units (EU) Nueva Aurora (Fiscal) and 235 parents in the EU Julio María Matovelle (Private) of Quito was analyzed. Three focus groups were carried out, recorded and transcribed textually, and a questionnaire was administered. The statistical package used was SPSS v24.0. Results: There was a higher consumption of processed foods in the private EU n = 79/240 (32.9%). Selection for easy preparation (39.2% Private EU and 46.4% Public EU). 54.2% and 57% of parents see advertising on television. Knowledge of labeling was higher in the private EU (94.9%; n = 223). Association between age [OR: 2.3; 95% CI: 1.08-5.04] instruction [OR: 3.95; 95% CI: 2.12-7.37], exposure to advertising [OR: 0.62; 95% CI: 0.36-1.05] and knowledge (P <0.05). Attitude was associated with educational level [OR: 2.57; 95% CI: 1.62-4.09] and admissions (P <0.05). Qualitative analysis: high degree of knowledge and publicity, with a significant impact on food selection. Conclusions: Knowledge about nutritional labeling was high, but it was not the main factor in selecting food. Prep time and flavor were more important than nutritional specifications.

Alimentação e obesidade de crianças na fase pré-escolar: significados atribuídos pelos pais / Children's food and obesity in the pre-school phase: meanings assigned by parents / Alimentos y obesidad de los niños en la fase preescolar: significados por los padres

Objetivos: Avaliar a percepção dos pais de crianças com sobrepeso ou obesidade, em relação à qualidade da alimentação dos seus filhos, na fase pré-escolar. Método: Estudo descritivo e qualitativo, realizado por meio de entrevistas semi-estruturadas, com pais de crianças com sobrepeso ou obesas matriculadas em um Centro Municipal de Educação Infantil (CEMEI) e cadastrado nas Estratégias de Saúde da Família (ESF's) do município de Divinópolis-MG. Resultados: Em relação à caracterização dos pais, todos eram do sexo feminino. A faixa etária alternou entre 22 a 45 anos. A partir da análise dos dados, as categorias elencadas foram: Alimentação inadequada; Tecnologia e sedentarismo; A subestimação do sobre peso; Prevenção e tratamento da obesidade infantil nas ESF. Conclusão: Identificou-se a necessidade de um melhor preparo por parte dos profissionais de saúde em relação a correta nutrição das crianças e também um envolvimento entre esses profissionais, os pais e a escola.(AU)

Objectives: To evaluate the perception of parents of overweight or obese children, in relation to the quality of their children's food, in the preschool phase. Method: Descriptive and qualitative study, carried out through semi-structured interviews, with parents of overweight or obese children enrolled in a Municipal Center for Early Childhood Education (CEMEI) and registered in the Family Health Strategies (ESF's) in the municipality of Divinópolis -MG. Results: Regarding the characterization of the parents, all were female. The age group alternated between 22 to 45 years. From the data analysis, the categories listed were: Inadequate food; Technology and sedentary lifestyle; The underestimation of overweight; Prevention and treatment of childhood obesity in the FHS. Conclusion: There was a need for better preparation by health professionals in relation to the correct nutrition of children and also an involvement between these professionals, parents and the school.(AU)

Objetivos: Evaluar la percepción de los padres de niños con sobrepeso u obesidad, en relación a la calidad de la alimentación de sus hijos, en la etapa preescolar. Método: Estudio descriptivo y cualitativo, realizado a través de entrevistas semiestructuradas, con padres de niños con sobrepeso u obesidad inscritos en un Centro Municipal de Educación Infantil (CEMEI) y registrados en las Estrategias de Salud de la Familia (ESF's) del municipio de Divinópolis. -MG. Resultados: En cuanto a la caracterización de los padres, todos fueron del sexo femenino. El grupo de edad alternaba entre 22 y 45 años. Del análisis de datos, las categorías enumeradas fueron: Alimentos inadecuados; Tecnología y estilo de vida sedentario; La subestimación del sobrepeso; Prevención y tratamiento de la obesidad infantil en la ESF. Conclusión: Se identificó la necesidad de una mejor preparación por parte de los profesionales de la salud en relación a la correcta nutrición de los niños y también una participación entre estos profesionales, los padres y la escuela.(AU)

Association between breastfeeding and overweight/obesity in schoolchildren aged 7-14 years / Associação entre aleitamento materno e sobrepeso/obesidade em escolares de 7-14 anos

ABSTRACT Objective: To evaluate the prevalence of breastfeeding (BF) and the association between occurrence/duration of BF and overweight/obesity in schoolchildren aged 7-14 years. Methods: This is a cross-sectional study, conducted in 2012-2013, on schoolchildren aged 7-14 years from Florianópolis, Santa Catarina, Southern Brazil. Weight and height were measured according to procedures of the World Health Organization. Breastfeeding and sociodemographic data were obtained from a questionnaire responded by parents/guardians. BF was categorized as a dichotomous variable (yes/no) and according to duration (months). Nutritional status was evaluated according to the Z score of the body mass index per age for sex and it was categorized into two groups: normal weight (<Z score+1) and overweight/obesity (≥Z score+1). The adjusted analysis was performed by logistic regression in two age strata (age groups of 7-10 and 11-14 years). Results: 6.6% of schoolchildren had never breastfed; 16.8% had been breastfed for ≤3 months; 16.7%, for 4-6 months; and 59.9%, for ≥7 months. No statistically significant differences were found in the occurrence and duration of BF between the age groups. The prevalence of overweight/obesity was 34.2%. For age groups (7-10 and 11-14 years), the prevalence of overweight/obesity was 36.7% and 29.8%, respectively. Chance of overweight/obesity for the age group of 7-10 years was lower among schoolchildren who were breastfed (OR=0.54; 95%CI 0.33-0.88), when compared with those who never breastfed. When categorized, the chance of overweight/obesity in the age group of 7-10 years was lower for duration of BF ≤3 months (OR=0.41; 95%CI 0.20-0.83), and 4-6 months (OR=0.48; 95%CI 0.28-0.82) when compared with children who never breastfed. Conclusions: BF for at least six months was associated with a lower chance of overweight/obesity for schoolchildren aged 7-10 years. No association was found for schoolchildren aged 11-14 years.

RESUMO Objetivo: Investigar prevalência e duração de aleitamento materno (AM) e sua associação com sobrepeso/obesidade em escolares de 7-14 anos. Métodos: Estudo transversal, realizado em 2012-2013, com escolares de 7-14 anos de Florianópolis, Santa Catarina. Peso e altura foram mensurados segundo preconizado pela Organização Mundial da Saúde (OMS). Dados sociodemográficos e sobre AM foram obtidos por questionários enviados aos responsáveis/cuidadores. A variável amamentação foi analisada como dicotômica (sim/não) e por duração (em meses). O perfil antropométrico foi avaliado por escore Z do índice de massa corporal (IMC) para a idade, segundo sexo, categorizado em: normal (<escore Z+1) e sobrepreso/obesidade (≥escore Z+1). Análises ajustadas foram realizadas (regressão logística) em dois estratos etários (7-10 e 11-14 anos). Resultados: 6,6% dos escolares nunca tinham sido amamentados, 16,8% foram amamentados por ≤3 meses, 16,7% por 4-6 meses e 59,9% por ≥7 meses. Não houve diferença estatística de ocorrência/duração de AM entre os grupos etários. A prevalência de sobrepeso/obesidade foi 34,2%. Nos grupos etários (7-10 e 11-14 anos), a prevalência foi 36,7% e 29,8%, respectivamente. A chance de sobrepeso/obesidade nos escolares de 7-10 anos foi menor entre aqueles que tinham sido amamentados (OR=0,54; IC95% 0,33-0,88), comparando com os nunca amamentados. Quando categorizada, a chance de ter sobrepeso/obesidade nos escolares de 7-10 anos foi menor quando a duração do AM foi ≤3 meses (OR=0,41; IC95% 0,20-0,83) e 4-6 meses (OR=0,48; IC95% 0,28-0,82), em comparação à ausência de AM. Conclusões: AM por pelo menos seis meses foi associado com menor chance de sobrepeso/obesidade para escolares de 7-10 anos. Não foi observada associação para o grupo 11-14 anos.

Transtorno do espectro autista: uma revisão sistemática sobre aspectos nutricionais e eixo intestino-cérebro / Autism spectrum disorder: a systematic review about nutritional aspects and gut-brain axis

O número de indivíduos diagnosticados com o transtorno do espectro autista (TEA) registrou aumento evidente na última década. Os principais sintomas, apresentados pelo portador, são neurológicos e digestórios, estando às intervenções nutricionais dentre as terapêuticas mais promissoras para amenizar a sintomatologia clínica. Assim, objetivou-se revisar sistematicamente os estudos sobre distúrbios alimentares e do trato gastrointestinal apresentado pelo indivíduo portador do TEA, a fim de compreender como o comportamento alimentar influência na etiopatogênese e manifestações clínicas da doença, com foco no eixo intestinocérebro. Para isso realizou-se uma revisão sistemática, seguindo as diretrizes PRISMA. A partir de uma busca estruturada e abrangente em bases de dados eletrônicas, 23 estudos foram recuperados e incluídos na revisão. Os critérios de inclusão definiam ser artigos originais relacionando o TEA com alterações nutricionais e/ou com o eixo intestino-cérebro. Após análise da composição da microbiota intestinal, os estudos mostraram um quadro de desequilíbrio. Foram encontradas, também, alterações na barreira de muco e permeabilidade intestinal e alterações em proteínas envolvidas na digestão e absorção de alimentos. Dietas restritivas e a modulação da microbiota, com uso de probióticos e de antibióticos específicos, são apresentadas como estratégias terapêuticas adjuvantes promissoras. Conclui-se que o eixo intestino-cérebro está envolvido tanto na etiologia, quanto nas manifestações clínicas do TEA. Porém, não sendo certo se alterações intestinais são causa ou consequência das alterações neurológicas. Até o presente momento, a comunidade científica não tem conclusões suficientes para indicar o uso de dietas restritivas, e uso de probióticos e de antibióticos como terapêutica para o TEA.

The number of individuals diagnosed with autism spectrum disorder (ASD) had an evident increase in the last decade. The primary symptoms exhibited amongst these patients were mostly digestive and neurological disorders; with nutritional interventions being one of the most promising therapies to assuage this clinical symptomology. As such, following the PRISMA guidelines, we systematically reviewed the research studies apropos of the ASD patients manifesting said digestive disorders, to comprehend how dietary behavior can influence the etiopathogenesis and clinical manifestations of the disease, with primary focus on the gut-brain axis. From a comprehensive and structured search through electronic databases, 23 studies were retrieved and admitted in this review. The inclusion criteria defined that there be original articles consociating ASD with nutritional disorders and/or with the gut-brain axis. These studies analyzed the composition of the intestinal flora of diagnosed patients, subsequently discerning cases of varying imbalances. Alterations in the gene expression of the proteins involved in the digestion and absorption of food, the mucous barrier and the intestinal permeability were described. Accordingly, restrictive diets and the modulation of the microbiota by administering specific anti- & probiotics were initially identified as promissory therapies. In conclusion, the gut-brain axis was observed to be a determinant factor in both the etiology and clinical symptomology of ASD - though it is still debatable the correlation of intestinal alterations with neurological changes. At present, there is no concrete scientific proof accrediting to restrictive diets and the use of specific anti- & probiotics, as successful treatments for ASD.

Una experiencia transformadora: cuando el kiosco escolar se convierte en una herramienta para garantizar el consumo de alimentos de mejor perfil nutricional / A transforming experience: when the school kiosk becomes a tool to guarantee the food consumption of best nutritional profile

El objetivo del presente proyecto fue implementar un kiosco escolar saludable para brindar en el recreo alimentos con mejor perfil nutricional y promover la elección de éstos a través de un sistema de rotulado y estrategias de marketing y publicidad. Se realizó acuerdo con directivos y personal del kiosco, se evaluó características del kiosco como infraestructura y perfil nutricional de alimentos disponibles. Se efectuaron modificaciones edilicias y temporales para promover la comensalidad. Se perfilaron los alimentos con el sistema de la Agencia Británica de Alimentos y se clasificaron en diferentes grupos teniendo en cuenta el sistema francés NutriScore como recurso para ampliar la oferta. Se rotularon con una puntuación similar a la escala de calificación utilizada en el ámbito escolar, del 2 al 10. La mayor puntuación se asignó a los alimentos con mejor perfil nutricional (PN). Como estrategia de publicidad y promoción de consumo de alimentos de mejor PN se asignó un premio al grado y a la docente que juntaron la mayor cantidad de puntos. Además, se incentivó la elección de determinados alimentos con "bonustrack" y carteles explicativos de sus beneficios. Se logró implementar un kiosco escolar saludable cumpliendo requisitos del Ministerio de Salud como garantizar libre acceso a agua potable, ofrecer alimentos y bebidas en envases que contengan el tamaño adecuado, ofrecer al menos tres productos aptos para niños con enfermedad celíaca, eliminar la publicidad en la escuela de alimentos y bebidas de menor perfil nutricional, exhibir los alimentos de mejor perfil nutricional en primer plano de manera que atraigan la atención de los niños, difundir mensajes que promuevan el consumo de alimentos saludables. El entusiasmo manifestado por la comunidad educativa alienta a pensar que la intervención es prometedora y se podrán obtener resultados satisfactorios(AU)

The objective of this project was to implement a healthy school kiosk to offer during break time foods with a better nutritional profile and promote their choice through a system of labeling and marketing, as well as advertising strategies. An agreement was made with head teachers and the kiosk´s staff, and characteristics of the kiosk such as infrastructure and nutritional profile of available foods were evaluated. Building and temporary modifications were made to promote commensality. Foods were profiled using the British Food Agency system and classified into different groups taking into account the French NutriScore system as a resource to expand the offer. They were labeled with a score similar to the rating scale used in the school setting, from 2 to 10. The highest score was assigned to the foods with the best nutritional profile (NP). As an advertising strategy and promotion of food consumption with the best NP, a prize was given to the form and teacher who collected the highest amount of points. In addition, the choice of certain foods with "bonustrack" and posters explaining their benefits was encouraged. It was possible to implement a healthy school kiosk meeting the requirements of the Ministry of Health such as guaranteeing free access to drinking water, offering food and drinks in containers with the right size, offering at least three products suitable for celiac children, eliminating advertising at school of food and drinks with a lower nutritional profile, displaying the best nutritional profile foods in the forefront as a means of catching the children´s attention, spreading messages that promote the consumption of healthy foods. The enthusiasm expressed by the educational community encourages to think that the intervention is promising and satisfactory results can be obtained(AU)

Nutritional composition and acceptance of cake elaborated with beauregard potato biofortified with carotenoids / Composição nutricional e aceitação de bolo elaborado com batata beauregard biofortificada com carotenoides

Beauregard biofortified sweet potato is a tuberous root with a high content of carotenoids whose consumption can bring beneficial effects on human health related to the biological actions of these substances. The objectives of this study were to evaluate the acceptance of cake made with sweet potato biofortified with carotenoids by school children enrolled in a school of the municipal education network of the city of Teresina PI. The sweet cake containing biofortified potato (Beauregard) (PC) was compared with standard sweet wheat flour (WC) cake formulation. The PC and WC products and the Beauregard potato were analyzed for centesimal composition (moisture, ashes, proteins, lipids and carbohydrates) and total carotenoid content. Acceptance of PC was assessed by means of an acceptance test with a hedonic scale of five points applied to 100 children from 08 to 10 years of age. The evaluation of the centesimal composition showed protein content corresponding to 2.1% in WC and 3.57% in PC, and of lipids of 5.16% in WC and 8.95% inPC. Regarding the moisture content, WC presented 32.5% and PC 38.44%. The content of fixed minerals (ash) found in formulations was 1.9% and 1.26%, respectively, in WC and PC. The carotenoid content (µg of ß-carotene.g-1) was significantly higher (p <0.05) in the biofortified potato (3,200.01 ± 0.02) and in the PC formulations (3,666.17 ± 2.55) and WC (3,066.53 ± 1.88) for common sweet potatoes (2.200,23 ± 1.63). In the five-point facial hedonistic acceptance test, the formulation containing biofortified potato (PC) obtained a significantly higher score (p <0.05) (4.24 ± 0.93) when compared to the WC formulation (3.75 ± 1.19). The biofortified potato and the cake containing the biofortified potato presented some characteristics related to the centesimal composition similar to those found in WC and the content of carotenoids in PC larger than those of WC. Because sweet cake is a food product, generally well accepted by children and adults, PC's greateracceptance of WC suggests its promising potential for consumption by the population.

A batata-doce Beauregard biofortificada é uma raiz tuberosa com alto teor de carotenoides, cujo consumo pode trazer efeitos benéficos na saúde humana relacionados com as ações biológicas dessassubstâncias. Os objetivos deste estudo foram avaliar a aceitação de bolo elaborado com batata doce biofortificada com carotenoides por crianças em idade escolar matriculados em uma escola da rede municipal de ensino da cidade de Teresina PI. O bolo doce contendo batata biofortificada (Beauregard) (BB) foi comparado com formulação padrão de bolo doce de farinha de trigo (BT). Os produtos BB e BT e a batata Beauregard foram analisados quanto à composição centesimal (umidade, cinzas, proteínas, lipídeos e carboidratos) e conteúdo de carotenóides totais. A aceitação do BB foi avaliada por meio de teste de aceitação com escala hedônica facial de cinco pontos aplicado em 100 crianças de 08 a 10 anos de idade. A avaliação da composição centesimal mostrou conteúdo protéico correspondendo 2,1% no BT e 3,57% no BB, e de lipídiosde 5,16% no BT e 8,95% no BB. Em relação ao teor de umidade, o BT apresentou 32,5% e BB 38,44%. O teor de minerais fixos (cinzas) encontrado nas formulações foi de 1,9% e 1,26%, respectivamente, no BT e BB. O conteúdo de carotenoides (µ g de ß-caroteno.g-1) foi significativamente maior (p<0,05) na batata biofortificada (3.200,01 ± 0,02) e nas formulações BB (3.666,17 ± 2,55) e BT (3.066,53 ± 1,88) em relação à Figure 1. Acceptance rate of Beauregard potato and wheat cake formulations.. batata doce comum (2.200,00 ± 1,63). No teste de aceitação escala hedonica facial de cinco pontos a formulação contendo batata biofortificada (BB) obteve nota significativamente maior (p<0,05) (4,24± 0,93) quando comparada com a formulação BT (3,75± 1,19). A batata biofortificada e o bolo contendo a batata biofortificada apresentaram algumas características relacionadas à composição centesimal semelhantes àquelas encontradas no BT e conteúdo de carotenoides no BB maiores que os do BT. Por ser o bolo doce um produto alimentício, de modo geral, bem aceito por crianças e adultos, a maior aceitação do BB em relação ao BT sugere seu potencial promissor para consumo pela população.

Competencias de la enfermera en instituciones educativas: una mirada desde los gestores educativos / Competências da enfermeira nas instituições educacionais: uma visão dos gestores da educação / Competencies of the nurse in educational institutions: a look from educational managers

Resumen OBJETIVO Describir y analizar los atributos de las competencias de la enfermera en el cuidado de los escolares vista por los gestores de instituciones educativas. MÉTODO Estudio cualitativo descriptivo-exploratorio. Siete directores de instituciones educativas de Trujillo (Perú) participaron en una entrevista no estructurada, durante el primer semestre del año 2016 y se utilizó el análisis de discurso oral. RESULTADOS Categorías empíricas: La enfermera en la promoción de la salud de la comunidad educativa; La enfermera en la prevención de la enfermedad en la comunidad educativa; La enfermera escolar articulando salud-educación en el cotidiano de vida de los escolares. CONSIDERACIONES FINALES El estudio contribuye al sustento conceptual de las competencias de la enfermera escolar para la acción intersectorial salud-educación y el establecimiento de políticas de promoción de salud de los escolares dentro las instituciones educativas.

Resumo OBJETIVO Descrever e analisar os atributos das competências da enfermeira escolar no cuidado escolares a partir da perspectiva dos gestores de instituições de ensino. MÉTODO Estudo qualitativo descritivo-exploratório: Sete diretores de instituições de ensino em Trujillo (Peru), participaram em uma entrevista no estruturada e se utilizou a análise de depoimentos orais. RESULTADOS Os resultados reportam as categorias empíricas: a enfermeira na promoção da saúde da comunidade educativa; a enfermeira na prevenção de doenças da comunidade educativa; A enfermeira escolar articulando a saúde e a educação no cotidiano do escolar. CONSIDERAÇÕES FINAIS O estudo contribui ao marco conceitual das competências da enfermeira escolar para a ação inter setorial em saúde-educação e para o estabelecimento de políticas na promoção da saúde dos escolares no interior das instituições educativas.

Abstract OBJECTIVE Describe and analyze the attributes of the nurse competencies in caring of students since the manager look of educational institutions. METHOD Qualitative descriptive-exploratory study. Seven principals of educational institutions of Trujillo (Peru) participates in a non-structured interview during the first semester of 2016 and the analysis of oral discourse was used. RESULTS Empirical categories: The nurse in the promotion of educational community health; The nurse in the prevention of the educational community illness; The student nurse articulating health - education in the everyday life of students. FINAL CONSIDERATIONS This study contributes to the conceptual support of the competencies of the student nurse for the intersectoral health - education action and the setting-up of health with students in the educational institutions.

Factores asociados con la anemia en niños menores de tres años en Perú: análisis de la Encuesta Demográfica y de Salud Familiar, 2007-2013 / Factors associated with anemia in children under three years of age in Perú: analysis of the Encuesta Demográfica y de Salud Familiar, ENDES, 2007-2013

Introducción. A pesar de la disminución de la pobreza en Perú, la prevalencia de la anemia infantil en el país continúa siendo alta. Objetivo. Determinar los factores sociodemográficos y las características del cuidado materno-infantil asociadas con la anemia en niños de seis a 35 meses de edad en Perú. Materiales y métodos. Se hizo un estudio observacional que incluyó los datos sobre hemoglobina sanguínea registrados en la Encuesta Demográfica y de Salud Familiar (ENDES), 2007-2013, en niños entre los seis y los 35 meses de edad. Mediante un análisis multivariado de regresión logística, se identificaron los factores asociados con la anemia, definida como una hemoglobina corregida por altitud, menor de 11 mg/dl. Resultados. La prevalencia de anemia fue alta (47,9 %). Se identificaron doce factores asociados con la anemia: factores sociodemográficos como vivir fuera de Lima y Callao; en un hogar con bajo nivel socioeconómico; tener una madre adolescente y con bajo nivel educativo; ser de sexo masculino con edad menor de 24 meses y antecedentes de fiebre reciente, y factores relacionados con el cuidado materno-infantil como la falta de control prenatal en el primer trimestre, la falta de suplemento de hierro durante el embarazo o administrado durante un periodo breve, parto en el domicilio, diagnóstico de anemia en la madre en el momento de la encuesta y ausencia de tratamiento antiparasitario preventivo en el niño. Conclusiones. La ENDES proporcionó información valiosa sobre los factores asociados con la anemia en niños de seis a 35 meses, cuyo conocimiento debe mejorar la cobertura y la efectividad de prácticas adecuadas de cuidado materno-infantil.

Introduction: Despite the reduction of poverty in Perú, the prevalence of anemia in the country remains high. Objective: To identify socio-demographic, child and maternal-child care factors associated with anemia in children between 6 and 35 months in Perú. Materials and methods: We conducted an analytical and descriptive study that included registered data from the national survey on demography and family health, 2007-2013, on children between 6 and 35 months old, including the measurement of blood hemoglobin. Anemia was confirmed by hemoglobin-altitude corrected values below 11 mg/dl. We used multivariate logistic regression models to assess potential associated factors for anemia. Results: Anemia prevalence was high (47.9%). Twelve factors were independently associated with anemia in children: Socio-demographic factors such as living outside Lima and Callao, in a low socioeconomic household, and having an adolescent mother with low education level; child-related factors as being male, younger than 24 months of age, and having fever in the previous two weeks, and maternal-child care factors such as lack of prenatal control in the first trimester of pregnancy, lack or short period of iron supplementation during pregnancy, house delivery, anemia detection at the moment of the survey, and lack of intestinal anti-parasite preventive treatment in the child. Conclusions: The analysis of survey data provided valuable information about factors associated with anemia in children between 6 and 35 months, which can be used to increase the coverage and effectiveness of maternal-child care practices.

Primaquina y recurrencias de malaria por Plasmodium vivax. Metanálisis de estudios clínicos controlados / Primaquine and relapses of Plasmodium vivax. Meta analysis of controlled clinical trials

ANTECEDENTES: La primaquina (PQ) se usa contra recurrencias del paludismo vivax (RPV), pero se desconocen varios aspectos posológicos, como la dosis total (DT) eficaz en determinado número de días. OBJETIVO: Comparar regímenes de PQ contra RPV en estudios clínicos controlados (ECC) aleatorios o no aleatorios. METODOLOGÍA: Metanálisis. Se buscó información hasta el 31 de diciembre de 2012 en Lilacs, SciELO, PubMed (Medline), Cochrane Library, Cochrane Infectious Diseases Group, Embase. Se usaron estudios experimentales o ECC, siempre con grupo control concurrente. Se incluyeron estudios con o sin asignación aleatoria, "close label" o "open label", con tratamiento supervisado o no supervisado No se exigió que el estudio estableciera diferencia entre recaída y reinfección mediante pruebas moleculares. Se aplicaron criterios de inclusión y exclusión a los artículos y satisfacer los de inclusión constituyó calidad adecuada para dejarlos en el metanálisis. RESULTADOS: Se completaron 23 ECC, que reunieron los criterios de selección. Evaluamos 4 esquemas de dosis total (DT) dada en determinados días (DT mg número de días): 210 14 = 210 mg en 14 días; 210 7 = 210 mg en 7 días; 45 a 150 mg en 3 a 10 días; 0 (no PQ). La ausencia de PQ llevó a la recurrencia de 34,48% frente a 19,66% con PQ 210 14 (diferencia significativa); 210 14 mostró eficacia igual a la de 210 7. Cada esquema 210 7 y 210 14 es mejor estadísticamente que 45 a 150. CONCLUSIONES: El uso de PQ es necesario para reducir las recurrencias y la DT 210 mg dada en 7 ó en 14 días es la que mejor eficacia tiene pero se requieren más estudios con el esquema 210 7. .

BACKGROUND: Primaquine (PQ) is used against relapses of vivax malaria (RVM) but several aspects about dosage are unknown, as the total effective dose (TD) in a number of days. OBJECTIVE: To compare PQ regimens against RVM in randomized or non randomized controlled clinical trials (CCTs). METHODOLOGY: Meta analysis. Information was sought until 31 December, 2012 in Lilacs, SciELO, PubMed (Medline), Cochrane Library, Cochrane Infectious Diseases Group, Embase. Experimental studies or CCT were used, always with concurrent control group. No matter whether or not the design was randomized, close label, supervised. It is not required that the study established difference between relapse and reinfection by molecular evidence. Inclusion and exclusion criteria for articles were applied and meet the inclusion criteria constituted adequate quality to be left in the meta analysis. RESULTS: 23 ECC with or without random allocation of treatment met the selection criteria. Include four schemes of TD (TD mg number of days): 210 14 = 210 mg in 14 days; 210 7 = 210 mg in 7 days, 45 to 150 mg in 3 to 10 days, 0 (not PQ). If PQ is absent, recurrences occurr 34.48% versus 19.66% with PQ 210 14 (significant difference), 210 14 showed effectiveness equal to that of 210 7. Treatments 210 7 and 210 14 were statistically better than 45 to 150 effectiveness. CONCLUSIONS: The use of PQ is necessary to reduce recurrences and TD 210 mg given at 7 or 14 days is which is more effective but more studies are required to treatment 210 7. .

Desarrollo de tolerancia oral en niños con alergia a la proteína de leche de vaca: seguimiento de 10 años / Oral tolerance development in children with allergy to cow's milk protein: follow-up of 10 years

Se estima que niños alérgicos desarrollen tolerancia oral durante los primeros años de vida con una dieta de eliminación de lácteos. Determinar el tiempo de desarrollo de tolerancia oral a la proteína de leche de vaca, características clínicas y laboratorio. Estudio prospectivo, seguimiento durante 10 años, de niños con alergia a proteína de leche de vaca. Se indicó dieta de eliminación por 4 semanas con posterior reto. Se solicitó IgE total y específica. Se registro edad y tiempo de dieta al confirmarse la tolerancia. 81 niños, 33/81(40,74%) femeninos y 48/81(59,25%) masculinos, edad promedio de diagnóstico 6,22 meses(rango <1-42). Alergia no mediada IgE 32/81 (39,50%) y alergia mediada IgE 49/81 (60,49%); IgE específica para leche de vaca positivo en 55/81 (67,90%). Diagnóstico por respuesta positiva a la dieta de eliminación en 62/81 (76,54%) y con reto en 19/81 (23,45%). Desarrollaron tolerancia después de 12-18m con dieta, 21/32 (65,62%) con alergia no IgE a los 1,6 años y 23/49 (46,93%) con alergia IgE a los 2,13 años. Los niños restantes toleraron entre 19-24m, a los 2,35 y 2,80 años para la alergia no IgE e IgE respectivamente. Después de 36m, continuaron sin tolerar 5 niños entre ambos grupos con progreso a alergia alimentaria múltiple. El diagnóstico de alergia puede basarse en la respuesta positiva a la dieta de eliminación de lácteos, el reto es necesario en casos inciertos y la tolerancia se alcanza a una edad más temprana en niños con alergia no mediada IgE

It is estimated that allergic children develop oral tolerance in the early years of life with a dairy elimination diet. To determine the time development of oral tolerance to cow's milk protein, clinical and laboratory. A prospective study followed for 10 years, children allergic to cow's milk protein. He said elimination diet for 4 weeks after challenge. Was requested total IgE and specific. Age and time was recorded to confirm diet tolerance. 81 children, 33/81 (40.74%) were female and 48/81 (59.25%) male, average age at diagnosis 6.22 months (range <1-42). IgE-mediated allergy is not 32/81 (39.50%) and IgE-mediated allergy 49/81 (60.49%) specific IgE to cow's milk positive in 55/81 (67.90%). Diagnosis by positive response to the elimination diet in 62/81 (76.54%) and challenge in 19/81 (23.45%). Tolerance developed after 12-18m with diet, 21/32 (65.62%) with non-IgE allergy to 1.6 years and 23/49 (46.93%) with IgE allergy to 2.13 years. The remaining children tolerated between 19-24m, to the 2.35 and 2.80 years for non-IgE allergy and IgE, respectively. After 36m, continued without tolerating 5 children between the two groups with multiple food allergy progress. The diagnosis of allergy can be based on positive response to milk elimination diet, the challenge is necessary in uncertain cases and tolerance is reached at an earlier age in children with IgE mediated allergy is not

Consumo alimentar entre crianças brasileiras com idade de 6 a 59 meses / Food consumption Brazilian children by 6 to 59 months of age

O objetivo foi avaliar o consumo alimentar em crianças brasileiras de 6-59 meses de idade, por região e zona de residência. Trata-se de estudo descritivo transversal com 4.322 crianças investigadas na Pesquisa Nacional de Demografia e Saúde (2006/2007). Observou-se baixo consumo diário de verduras (12,7%), legumes (21,8%), carnes (24,6%) e elevado consumo de refrigerantes (40,5%), alimentos fritos (39,4%), salgadinhos (39,4%), doces (37,8%), na frequência de uma a três vezes na semana. Comparando-se as regiões, as crianças residentes no Sul, Sudeste e Centro-oeste consumiram com mais frequência arroz, pão, batata, feijão, verdura de folha, legumes e carne, mas também consumiram, mais frequentemente, alimentos não recomendados para a idade, como doces e refrigerantes. Crianças da zona rural apresentaram menor consumo dos alimentos recomendados para a idade e, também, dos não recomendados, quando comparadas às crianças da zona urbana. O consumo alimentar evidenciado neste estudo não está de acordo com recomendações de alimentação saudável para crianças.

The aim of this study was to assess food consumption in Brazilian children 6 to 59 months of age by region of the country and area of residence. This was a descriptive cross-sectional study of 4,322 children in the National Demographic and Health Survey (2006-2007). The data showed low daily consumption of leafy vegetables (12.7%), vegetables (21.8%), and meat (24.6%) and high consumption (1-3 times a week) of soft drinks (40.5%), fried foods (39.4%), salty snacks (39.4%), and sweets (37.8%). Comparing the regions of Brazil, children in the South, Southeast, and Central-West consumed more rice, bread, potatoes, beans, greens, vegetables, and meat, but they also ate more foods not recommended for their age, like sweets and soft drinks (soda). Rural children showed lower consumption of foods recommended for their age and also those not recommended for their age, as compared to their urban counterparts. According to this study, food consumption in these young children fails to meet the recommendations for healthy eating in this age bracket.

Carga ácida potencial renal de la dieta en niños de 2 a 6 años / Potential renal acid load in children from 2 to 6 years of age

El consumo proteico excesivo incrementa la producción endógena de ácido, lo que puede conducir a acidosis metabólica, pérdida de masa ósea, hipercalciuria, urolitiasis, retardo del crecimiento y sarcopenia, entre otros. Estimar y analizar la Carga Ácida Potencial Renal (CAPR) de la dieta en niños de 2 a 6 años. Estudio descriptivo y transversal, que incluyó 52 niños de la consulta de niños sanos del Instituto de Previsión y Asistencia Social del Ministerio del Poder Popular para la Educación, estado Miranda. Las principales variables estudiadas fueron: (1) consumo de macronutrientes, y patrón alimentario evaluado mediante recordatorio de 24 horas (R24h) y cuestionario de frecuencia de consumo (CFC). El R24H permitió determinar adecuación nutricional y el CFC la calidad de la dieta y factores de protección y riesgo dietético para una mayor carga ácida de la dieta. El consumo de nutrientes se comparó con recomendaciones nacionales e internacionales; (2) la CAPR según el método de Remer y Manz. Para el análisis estadístico se utilizó el programa SPSS, v17.0. El consumo de proteínas estuvo elevado en 46,15% de los niños. Los alimentos con mayor desbalance fueron: carnes y lácteos por consumo excesivo, frutas y hortalizas por consumo deficiente. La CAPR fue positiva en 96,2% de los niños y se correlacionó positivamente (p<0,05) con el consumo de energía, proteínas, grasas, carnes y lácteos. La dieta de los niños estudiados se caracterizó por su excesiva carga ácida con el consecuente riesgo para la generación de ácidosis sistémica y sus consecuencias metabólicas

High protein intake increases endogenous acid production, which may lead to metabolic acidosis, decrease in bone and muscle mass, hipercalciuria and urolithiasis, among other disorders. Estimate and analyze the Potential Renal Acid Load (PRAL) of the diet in children from two to six years of age. The study is descriptive, cross-sectional and correlational wich included fifty two children who assisted to an ambulatory well child clinic in Carrizales, Miranda State, Venezuela. The main variables studied were: (1) Macronutrient food intake and diet pattern which was assessed by a 24 hour recall (24hR) and a food frequency questionnaire (FFQ). The 24hR allowed to evaluate nutritional adequacy and the FFQ, the diet quality, as well as diet protection and risk factors. Nutrient intake was compared with national and international recommendations; (2) PRAL was determined according to Remer and Manz. Statistical analysis was performed by means of the SPSS, v17.0 software. Protein intake was high in 46,15% of the children. Food groups with the highest unbalance were meat and dairy products for excessive intake and fruits and vegetables for defective intake, both of which represent risk factors for acid production. PRAL was positive in 92% of the children and was positively correlated (p<0.05) with intake of energy, proteins, fat and with the food groups of meat and dairy. The diet of the studied children was characterized by an excessive acid load with the risk for the generation of systemic acidosis and its metabolic consequences

Efecto del tiempo y temperatura de almacenamiento a corto plazo sobre el contenido de las proteínas en leche humana / Effects of short term storage time and temperature on the protein content of human milk

La leche materna constituye el alimento ideal para el recién nacido y el lactante en forma exclusiva hasta los 6 meses de edad; y hasta los 2 años con alimentos complementarios. El destete precoz es de causa multifactorial: falta de control prenatal, desconocimiento de los beneficios de la leche materna, hipogalactia, prácticas hospitalarias inadecuadas, publicidad de alimentos infantiles, incorporación de la madre al trabajo y como desconocimiento sobre la extracción y preservación de la leche humana. El objetivo del presente trabajo es evaluar el efecto del tiempo y temperatura de almacenamiento a corto plazo, sobre el contenido de proteínas en la leche humana madura de madres que asistieron a la consulta del Hospital “Dr. Jorge Lizárraga”, Valencia, Estado Carabobo, Venezuela. Investigación experimental, correlacional, cuantitativa y aplicada. Fueron analizadas 20 muestras de leche, de mujeres sanas, con amamantamiento en forma exclusiva, obtenidas por extracción manual. Cada una de ellas se separó en 2 la alícuotas: 1. Para analizar en fresco, 2 tras almacenamiento a 15˚C durante 24 horas. La determinación de proteínas se realiz según las normas industriales Covenin. La concentración de proteínas fue de 1,53 gr/dl en leche recién extraída y 1,50 gr/dl en leche almacenada a 15 ˚C por 24 horas. No hubo diferencia significativa entre los valores de proteínas en leche materna recién extraída y almacenada. En la leche humana almacenada a 15 ˚C durante 24 horas, las concentraciones de las proteínas no se modifican comparándola con la leche recién extraída

Maternal milk is the ideal food for newborns and infants, on an exclusive basis, up to six months and together with complementary food, up to two years of age. The early weaning could have multifactorial causes: lack of prenatal control, unawareness of the benefits of breastfeeding, hypogalactia, inappropriate hospital practices, advertising of infant foods, return of the mother to work, unawareness regarding milk extraction and preservation. The objective of this investigation is to evaluate the effect of storage time and temperature within a short term on how it affects the protein content in mature milk of mothers who attended medical consulting at Hospital Dr. Jorge Lizarraga. This is an experimental, correlational, cuantitative and applied investigation. Twenty milk samples were analyzed from healthy women with exclusive breastfeeding, obtained through manual extraction. Each of these samples was separated in 2 aliquots: 1. To be analyzed at once. 2. To be analyzed after being stored at 15°C for 24 hours. Determination of proteins was performed according to the industrial norms of Covenin. The concentration of proteins was of 1,53 gr/dl in recently extracted milk and 1,50 gr/dl in milk stored at 15°C for 24 hours. There was no significant difference between the values of proteins found in the recently extracted maternal milk and the one that had been stored

Alimentación y estado nutricional de los niños en zonas palúdicas de Antioquia (Colombia) / Food and nutritional status among children of endemic malaria zones of Antioquia (Colombia)

Introducción: Malaria, parasitosis intestinales y desnutrición interactúan en los habitantes de zonas palúdicas, en particular en niños. Objetivo: Medir el estado nutricional de niños (4-10 años) con malaria y algunos aspectos del consumo alimentario familiar en dos zonas maláricas del departamento de Antioquia. Metodología: Estudio transversal en niños que consultaron por paludismo. Diseño muestral aleatorio. Resultados: A) Consumo alimentario familiar: 74% obtenían regularmente alimentos de criar animales menores, huerta casera o ambos; 17% recibían regularmente alimentos, dinero o ambos; consumo de alimentos fuentes de vitamina A (veces/semana): carnes-vísceras animales 1, leche y huevos 2-3 cada uno, frutas con provitamina A. Satisfacción alimentaria de requerimientos nutricionales familiares de fuentes de vitamina A: 55% (grado bajo-medio). B) Estado nutricional infantil: Riesgo de desnutrición: 52% crónica, 15% aguda; parásitos intestinales patógenos 80%; promedio de hemoglobina pretratamiento 10.3 gr/dL (6.39 mmol/L) y al día 30 en 11.8 gr/dL (7.32 mmol/L); promedio de retinol pretratamiento de 19.1 µg/dL (0.67 µmol/L) y al día 30 31.2 µg/dL (1.09 µmol/L). Conclusiones: La desnutrición crónica amenaza a ≥50% de los niños; esa frecuencia es 3-4 veces la encontrada en Colombia. No hubo asociación estadísticamente significativa entre estado nutricional y las variables asociadas a obtención-consumo alimentario. Quizás esta ausencia de relación se deba a que las variables usadas para medir estas condiciones no sean adecuadas o se hayan medido de manera inapropiada.

Introduction: Malaria, intestinal parasites and malnutrition interact in people of malaria areas, particularly in children. Objective: To measure the nutritional status of children (4-10 years) and household food consumption in two endemic malaria areas of Antioquia (Colombia). Methodology: Cross-sectional description in children with malaria. Random sampling design. Results: A) Household food consumption: 74% regularly got food raising small animals and/or home garden; 17% regularly receiving foods, money or both; intake of vitamin A source foods (times/week): once meat-offal, twice or three times milk or eggs; once pro-vitamin A fruits; coverage of nutritional requirements of vitamin A sources: 55% (low-medium level). B) Nutritional status of children: Malnutrition risk: 52% chronic, 47% global, 15% acute; pathogen intestinal parasites 80%; hemoglobin (g/dL): pretreatment 10.3 (6.39 mmol/L); at day 30: 11.8 (7.32 mmol/L); retinol (µg/dL): pretreatment: 19.1 (0.67 µmol/L); at day 30: 31.2 (1.09 µmol/L). Conclusions: chronic malnutrition threat to ≥ 50% of children and that frequency is 3-4 times that found in Colombia; did not found any significant association between nutritional status with the variables associated with obtaining and food consumption, or between the nutritional status with the monthly spend on food; it is possible that this lack of relationship between malnutrition expressed by anthropometric indicators and food conditions due to the variables used to measure these conditions have not been adequate or have been measured so inappropriate. [Carmona-Fonseca J. Food and nutritional status among children of endemic malaria zones of Antioquia (Colombia).

Indice de sustancia activa (AKS) distribución percentilar en edades pediátricas / Active substance index (AKS) percentile distribution in pediatric ages

Se programó conocer la distribución percentilar del índice de sustancia activa (AKS), en niños y niñas de 4 a 9 años para disponer de valores de referencia de este indicador. Se calculó en 3.634 niños eutróficos, con talla normal, sanos, de una comunidad urbana marginal, atendidos en el Centro de Atención Nutricional Infantil Antímano (CANIA) entre enero 1999 y diciembre 2007. Se excluyeron niños prematuros, con inicio de estirón puberal y patologías crónicas definidas o en estudio. El cálculo del peso graso necesario para calcular el índice AKS, se hizo con la fórmula de 2 pliegues de Dugdale y Griffiths para niños menores de 150 cm y niñas de menores de 140 cm. Las variables antropométricas fueron medidas por antropometristas estandarizadas con control de calidad cuatrimestral, aplicando las normas recomendadas Internacionalmente. Se obtuvieron los estadísticos descriptivos del índice y de las variables utilizadas en su cálculo, así como los percentiles 3, 10, 25, 50, 75, 90 y 97 del índice. Se aplicó el test de Kolmogorov-Smirnoff, Anova de una vía, Chi cuadrado, test de Tukey y correlaciones divariadas (p < 0,05). El comportamiento del índice evidenció valores mayores en el sexo masculino decrecientes con la edad tanto en los varones como en las hembras, variando la mediana de 1,28 a 1,04 en el sexo masculino y de 1,17 a 0,94 en el femenino. Se encontraron diferencias estadísticamente significativas para cada año de edad y sexo. Se dispone de valores de distribución percentilar del índice AKS para la evaluación nutricional en edades pediátricas, debiéndose validar su efectividad.

The aim of this study was to discern the percentile distribution of the Active Substance Index (AKS) in boys and girls aged 4 to 9 years in order to obtain reference values for this indicator. This index was calculated in 3,634 healthy and well-nourished children with normal stature from a poor urban community at Centro de Atención Nutricional Infantil Antímano (CANIA), within the period between January 1999 and December 2007. Children with prematurity backgrounds, pubertal growth spurts, or with chronic pathologies, whether defined or under study, were excluded. The Dugdale & Griffiths two-skinfold equation for boys and girls shorter than 150 cm and 140 cm, respectively was used to obtain the fat body mass required to estimate the AKS index. The variables were measured by standardized anthropometrics technicians, with quality control every 4 months as recommended by international standards. Descriptive statistics of the AKS index and variables used for their calculation were obtained, as well as index percentiles 3, 10, 25, 50, 75, 90, and 97. Tests applied included Kolmogorov-Smirnoff, Anova one-way, Chi Square, Tukey and bivariated correlations (p < 0.05). The AKS index behavior exhibited higher values in the boys, decreasing with age in both sexes, ranging from 1.28 to 1.04 in the boys and from 1.17 to 0.94 in the girls. Statistically significant differences were found for each age and sex. These results provide the AKS index percentile distribution values needed for nutritional assessments in pediatric ages. These values should be validated and their effectiveness should be studied.

Osmolalidad de productos y fórmulas para la terapia nutricional / Osmolality of products and formulas for nutritional therapy

Se determinó la osmolalidad de fórmulas y productos para la terapia nutricional disponibles en Venezuela. Las muestras se agruparon en fórmulas infantiles de inicio, neonatos de bajo peso, infantiles de continuación, 1 a 4 años, a base de soya, sin lactosa, antirreflujo, hipoalergénicas, dietas con nutrientes intactos basadas en leche (DNIBL), fórmulas poliméricas, semielementales, módulos calóricos y proteicos. Se utilizó un osmómetro digital de presión de vapor, analizando cinco muestras por producto, preparadas por medida y por peso, de lotes diferentes. Cuando el coeficiente de variación de las medidas de osmolalidad fue mayor a 10 por ciento, se analizaron 5 muestras adicionales. Se calcularon promedios, desviación estándar y coeficiente de variación de los valores de osmolalidad (95 por ciento confiabilidad). La osmolalidad (mmol/kg) de las fórmulas de inicio y de neonatos de bajo peso estuvieron entre 258 y 309; las de continuación: 256-390; de niños de 1 a 4 años: 343-399; a base de soya: 155-252; sin lactosa: 163-248; antirreflujo: 230-292; hipoalergénica: 220-335; DNIBL: 205-454; poliméricas: 247-588; semielementales: 238-289; módulo calórico: 89-99; y proteico: 30-60. Se encontró que generalmente las fórmulas preparadas con medidor tenían mayor osmolalidad y variabilidad que las preparadas según el peso. Algunas fórmulas de continuación, poliméricas, fórmulas para niños de 1 a 4 años y con nutrientes intactos basadas en leche tuvieron osmolalidades elevadas por lo que no deben ser administradas a lactantes, y con precaución a niños y adolescentes cuando el tracto gastrointestinal esté comprometido.

The objective was to determine the osmolality of products and formulas for nutritional therapy available in Venezuela. The samples were grouped as follows: infant formulas, premature infant, follow up, 1 to 4 years, soy based, lactose free, anti-reflux, hypoallergenic, complete beverages, polymeric formulas, semi-elemental, caloric and protein modules. A vapor pressure digital osmometer was used, analyzing five samples of each product from different lots, prepared by weigth or with scoop. When the variation coefficient of the osmolality measurements was higher than 10 percent, five additional samples were analyzed. Averages, standard deviation, and the variation coefficient of the osmolality measures (95 percent reliability) were calculated. The osmolality (mmol/kg) of infant and premature infant formulas were between 258 and 309; follow up formulas ranged between 256-390; 1 to 4 years: 343-399; soy based: 155-252; lactose free: 163-248; anti-reflux: 230-292; hypoallergenic: 220-335; complete beverages: 205-454; polymeric formulas: 247-588; semi-elemental: 238-289; caloric module: 89-99 and protein module: 30-60. We found that almost all the formulas prepared with scoop had higher osmolality and variability than the same products prepared by weight. Some follow up, polymeric, 1 to 4 years formulas and complete beverages had high osmolalities and therefore should not be administered to infants, and must be administered with caution to children and adolescents when the gastrointestinal tract is compromised.