Bone mineral density and body composition in normal weight, overweight and obese children.

BACKGROUND: There is a possibility that excess body fat affects bone mass gain and may compromise skeletal health in obese children. The purpose of the study was to identify the relationship between bone mineral density (BMD) and body composition in normal weight, overweight and obese children. METHODS: This was a cross-sectional study of 6- to 11-year-old children who attended the hospital's outpatient clinic. They were apparently healthy and had no history of prematurity, low birth weight, or chronic diseases. Body mass index (BMI) was used to identify subjects as normal weight, overweight or obese. BMD and body composition were assessed by dual energy X-ray absorptiometry. The BMD values (total and lumbar spine) were compared between normal weight, overweight and obese children. Correlation coefficients were calculated, and multivariate models were performed. RESULTS: Forty-nine children were included: 16 with normal weight, 15 that were overweight and 18 with obesity; the mean age was 8.4 ± 1.7 years. All the participants had a normal BMD (> - 2 SD). BMD was higher in obese children and had a positive correlation with total and trunk lean mass in the three study groups (p < 0.001). In obese children, an inverse correlation of lumbar spine BMD (Z score) with total and trunk fat mass (p < 0.05) was identified. In the multivariate models (with the whole group), the total lean mass was the only significant variable that explained BMD variability. CONCLUSIONS: BMD in obese children was higher than that in normal weight children, which is explained by their greater lean mass and not by excess body fat. In obese children, a higher fat mass was related to a lower lumbar spine BMD. Lean mass had a direct correlation with BMD in the three study groups and was the most important predictor of BMD, reflecting the importance of strengthening the muscular system through performing physical activity and practicing a healthy lifestyle.

Volviéndonos mejores: necesidad de acción inmediata ante el reto de la obesidad. Una postura de profesionales de la salud.

La creciente epidemia de obesidad ha sido uno de los retos más importantes de salud pública en México durante los últimos años. Con apoyo de la Federación Mundial de Obesidad, en 2021 formamos un grupo de profesionales para identificar y resumir las acciones prioritarias en las que puede enfocarse nuestro país para hacer frente a esta epidemia. Al proceso de desarrollo y discusión de este grupo se sumaron más de 1 000 profesionales de la salud para retomar recomendaciones de documentos y guías de alto nivel previamente publicados. En conmemoración del Día Mundial de la Obesidad, en este 2022 se presenta esta postura como insumo para el desarrollo de acciones en el ámbito profesional y de los diferentes sectores, en la que se incluyen 10 recomendaciones de acción, desde la perspectiva poblacional hasta la atención individualizada, y se enfatiza en la importancia de la participación social, de las intervenciones integrales con visión centrada en la persona y de la sostenibilidad planetaria, además de mejorar la educación y las campañas de difusión, propiciar un ambiente promotor de entornos activos y blindar de conflictos de interés los esfuerzos de prevención y control. La postura hace un llamado para abordar la obesidad de manera seria, con base en la evidencia científica, oportuna e integral, con enfoque de curso de vida, de forma ética y sensible, y sin perpetuar las barreras del estigma de peso en la sociedad.

Examining the validity and consistency of the Adult Eating Behaviour Questionnaire-Español (AEBQ-Esp) and its relationship to BMI in a Mexican population.

PURPOSE: Appetitive traits in adults and their associations with weight can be measured using the Adult Eating Behaviour Questionnaire (AEBQ). The aim of this study was to confirm the factor structure of the Spanish AEBQ (AEBQ-Esp) in a Mexican sample and explore associations between the eight traits with body mass index (BMI). METHOD: A sample of 1023 adults, mean age of 36.8 ± 12.8 years, was recruited from Guadalajara, Mexico. Researchers weighed and measured participants, and they completed the AEBQ-Esp either online or in paper format and reported sociodemographic data. To test two alternative factor structures (eight factors including Hunger; seven factors excluding Hunger), confirmatory factor analysis (CFA) was used. Internal reliability was assessed using Cronbach's alpha; test-retest reliability was assessed using intra-class correlation coefficients. Multivariate linear regressions were used to test for associations between the AEBQ subscales and BMI, adjusted for age, sex, format of AEBQ responses, education, marital and employment status. RESULTS: A seven-factor structure was the best model fit using CFA, excluding the Hunger subscale but similar to the original AEBQ. Internal reliability was good for all subscales (Cronbach's α = 0.70-0.86), and the intra-class correlation coefficient (0.70-0.91) reflected good test-retest reliability. In the fully adjusted models, Satiety Responsiveness [ß = - 0.61; (- 1.01, - 0.21)] and Slowness in Eating [ß = - 0.70; (- 1.01, - 0.39)] were negatively associated with BMI, and Emotional Over-Eating [ß = 0.94; (0.62, 1.27)] was positively associated with BMI. CONCLUSIONS: The AEBQ-Esp (excluding Hunger) appears to be a valid and reliable psychometric questionnaire for measuring appetitive traits in a Mexican Spanish-speaking population. Some traits appear to be associated with BMI in adulthood and warrant further exploration. LEVEL OF EVIDENCE: Level III evidence obtained from well-designed cohort or case-control analytic studies. Although this was just an observational study, it was well designed and provided new evidence.

Neck circumference as an indicator of elevated central adiposity in children.

OBJECTIVE: We aimed to study the correlation between neck circumference (NC) and anthropometric adiposity indicators, and to determine cut-off points of NC for both sexes to identify elevated central adiposity in schoolchildren in western Mexico. DESIGN: Cross-sectional study. SETTING: Rural settings in western México.ParticipantsChildren from a convenience sample of six schools in Acatlán, Jalisco, Mexico (n 1802). RESULTS: NC showed a strong positive correlation with all anthropometric adiposity indicators in both sexes, which were notably higher in boys regardless of age. Noteworthy, waist circumference displayed the highest significant correlation when analysed by both age and sex. As age increased, NC cut-off points to identify elevated central adiposity ranged from 25·7 to 30·1 cm for girls and from 27·5 to 31·7 cm for boys. CONCLUSIONS: NC could be used as a simple, inexpensive and non-invasive indicator for central obesity assessment in Mexican schoolchildren.

Frequency and Risk Factors of Kidney Alterations in Children and Adolescents who Are Overweight and Obese in a Primary Health-care Setting.

OBJECTIVE: Obesity is clearly associated to kidney disease in adult population; however, there is scarce evidence in children and adolescents. The aim was to compare frequency of renal damage according to the presence of overweight-obesity in children and adolescents, as well as to compare nutritional and biochemical risk factors, according to the presence of kidney alterations. METHODS: Cross-sectional study; 172 children and adolescents, 6-16 years old, without malnutrition, diabetes mellitus, hypertension and independent comorbid conditions associated to obesity or kidney disease, as well as transitory causes of microalbuminuria (MA) from a Primary Health-Care Unit were included. Clinical, biochemical, anthropometric and dietetic evaluations were measured in all subjects; subsequently they were classified as normal weight, overweight and obesity groups according to sex- and age-adjusted body mass index (BMI). Glomerular filtration rate (GFR, estimated by Schwartz equation) and albuminuria (albumin/creatinine ratio) were determined. Presence of kidney alterations was measured as decreased GFR (<90 mL/min/1.73m2), hyperfiltration (>170 mL/min/1.73m2) and MA (30-300 mg/g). RESULTS: Compared with controls, subjects with overweight-obesity had significantly (P<.05) abdominal obesity (0 vs 69%), hypertension (19 vs 26%), hypertriglyceridemia (11 vs 47%), high low-density lipoprotein cholesterol (2 vs 8%) and low high-density lipoprotein cholesterol (HDL-cholesterol; 2 vs 28%), hyperuricemia (11 vs 28%) and hyperinsulinemia (8 vs 70%). Hyperfiltration and MA were present in 5 and 4 subjects with overweight/obesity, respectively, whereas decreased GFR was present in only 1 subject with obesity. Normal weight subjects had no kidney alterations. In multivariate analysis, kidney alterations were significantly predicted by higher BMI and lower HDL-cholesterol. CONCLUSIONS: Kidney alterations were observed only in subjects with overweight (3.6%) and obesity (9.9%), who additionally, displayed cardiometabolic and kidney disease risk factors more frequently than normal weight subjects.

Factors Associated With Anthropometric Indicators of Nutritional Status in Children With Chronic Kidney Disease Undergoing Peritoneal Dialysis, Hemodialysis, and After Kidney Transplant.

OBJECTIVE: The objective of the study was to demonstrate that there are differences in the factors associated with anthropometric indicators of nutritional status, with particular emphasis on arm indicators, in children with end-stage kidney disease undergoing peritoneal dialysis (PD), hemodialysis (HD), and after kidney transplant (KT). METHODS: An analytical cross-sectional study of consecutive cases included 130 children and adolescents with end-stage kidney disease undergoing substitutive treatment: 49 patients who underwent KT, 33 undergoing PD, and 47 undergoing HD. Socioeconomic data were obtained from all the 3 groups; anthropometric indicators of nutritional status were calculated. Student's t-test and analysis of variance were used for parametric variables. Chi-square test, Mann-Whitney U test, Kruskal-Wallis test, and odds ratio (OR) were used for nonparametric variables. RESULTS: The number of parents living as couples was higher for patients who underwent KT (OR = 3.5 [95% confidence interval {CI} 1.34-9.0]) and undergoing PD (OR = 3.0 [95% CI 1.06-8.8]) than those undergoing HD. The number of mothers who worked outside the home was higher for patients who underwent KT and undergoing PD than the mothers of patients undergoing HD (OR = 13.7 [95% CI: 4.56-41.05]; OR = 15.4 [CI 95% 4.8-49], respectively). Family income was higher for patients who underwent KT and undergoing PD (P = .019, P = .093, respectively). More than 40% of patients in all the 3 groups had growth impairment. Body mass index, mid-upper arm circumference, tricipital and subscapular skinfolds, total arm area, and arm fat area were affected in HD and PD groups (9 to 40%), while of the patients who underwent KT, 36.7% were overweight or obese. More than 50% of patients who underwent KT and undergoing HD and PD had involvement in the arm muscular area. CONCLUSIONS: Socioeconomic conditions are more influential for children in the HD program. The nutritional status of children after KT improves; however, not all anthropometric indicators are fully recovered. Children after KT are up to 9 times more likely to be overweight or obese.

Dietary Intake, Nutritional Status, and Body Composition in Children With End-Stage Kidney Disease on Hemodialysis or Peritoneal Dialysis.

OBJECTIVE(S): This study aimed to demonstrate that dietary intake, anthropometric indicators, and body composition in children with end-stage kidney disease differs between those on peritoneal dialysis (PD) and those on hemodialysis (HD). METHODS: This was a cross-sectional and consecutive study that included 55 children and adolescents with end-stage kidney disease who were undergoing replacement therapy (22 PD patients and 33 HD patients). Two 24-hour dietary recall surveys were conducted for each patient. Anthropometric, biochemical, and body composition indicators were estimated. A Student's t-test and a Mann-Whitney U test were used for the parametric variables, whereas association tests were estimated for the nonparametric variables (i.e., χ2, Fisher exact test, and odds ratio). Regression models were designed to predict dietary intake on anthropometric and body composition indicators. RESULTS: The mid-upper arm circumference was greater on the patients undergoing HD than on the PD patients (odds ratio = 15.8 [95% confidence interval (CI): 2.9, 85.1], P < .001); the arm muscular area was greater in the HD patients than in the PD patients (P = .07). Children on PD had significantly greater creatinine concentration (8.4 ± 3.0 mg/dL vs. 4.6 ± 1.2 mg/dL, P < .001), urea (101 ± 27 mg/dL vs. 50 ± 17 mg/dL, P < .001), and glucose (87 ± 14.4 mg/dL vs. 77 ± 10.2 mg/dL, P = .003). Children on PD had lower lipid intake (31.2 ± 15.8 vs. 40.9 ± 19.1 g/day, P = .032), lower percentage of adequacy of vitamin C (128 ± 66 vs. 146 ± 70, P = .046), and lower sodium (62 ± 43 vs. 79 ± 42, P = .044) than children on HD. Dietary intake predicted 40% to 80% of the variability in the nutritional status in children on PD and 28% to 60% in children on HD. CONCLUSIONS: Nutritional status is affected in most patients on dialysis treatment, which differs significantly among those who are undergoing PD or HD.

[Considerations on family dynamics and the malnutrition syndrome in Mexican children]. / Consideraciones sobre la dinámica familiar y el síndrome de la mala nutrición en niños mexicanos.

Since the early 1990s we noted that family dysfunction was more common in children with severe primary malnutrition than in children admitted to the hospital without malnutrition. Defects on feeding habits during the first year of life, especially early weaning and inadequate complementary feeding were more common in dysfunctional families. We also observed that chronic malnutrition in preschool children, and overweight and obesity in schoolchildren were more common in children from dysfunctional families. Once the association between dysfunctional family dynamics and obesity in schoolchildren was demonstrated, it was observed that low education of fathers and mothers increased twofold the possibility of family dysfunction: OR: 2.06; 95% CI: 1.37-3.10 and OR: 2.47; 95% CI: 1.57-3.89, respectively. In addition, the low-income and the lower purchasing power of foods were associated to family dysfunction (p<0.05). A remaining task is to explore how to assess family dysfunction in composite, extended, single-parent families where there exist other persons vulnerable to the different entities of malnutrition syndrome and indeed depend on adults for their care, food and nutrition.

[Body composition and lipidic profile in women's during the third trimester of pregnancy]. / Composición corporal y perfil de lípidos en mujeres en el tercer trimestre del embarazo.

OBJECTIVE: To demonstrate the behavior of body composition and lipid profile in pregnant women during the third trimester and who attended a Regional hospital Tepatitlán, Jalisco, Mexico. METHODS: In an observational study, transversal, analytic 36 apparently healthy pregnant women were included with gestational age between 33 to <42 weeks. Anthropometric measurements, body composition and lipid profile were obtained. Student t test, Mann Whitney, chi square, Pearson and Spearman correlation for data analysis were used. RESULTS: 11 participants were overweight and 8 obese. Significant association between higher concentrations of triglycerides and TG / HDL-c index and pre-gestational BMI (p = 0.039 and p = 0.032 respectively) were found. Concentration greater than 200 mg / dL triglycerides are associated with an increased interpregnancy period of 3 years (p = 0.012). There was a significant correlation between abdominal deliveries with anthropometric indicators, pre-gestational weight, pre-gestational BMI and current BMI. CONCLUSION: There is a direct correlation between body composition and lipid profile with age and the incidence of cesarean section. It is necessary to establish a more precise reference criterion for both the longitudinal track for every pregnant woman and for purposes of parametric comparison.

Neck Circumference and Its Relation with Body Fat Percentage in Children 5-10 Years Old.

BACKGROUND: Neck circumference (NC) has been proposed as an indicator of upper trunk adiposity and a potential indicator of metabolic risk. The objective was to evaluate NC and its correlation with body fat percentage (BF%) and other indicators of adiposity in children with normal weight, overweight, and obesity. METHODS: In a cross-sectional study, 112 children 5 to 10 years of age were included in the outpatient clinic from a public hospital. Measures of weight and height to calculate BMI (kg/m2), NC, mid-upper arm circumference, waist circumference, and tricipital skinfold thickness. Body composition measurements were performed using an electrical bioimpedance device (BIA). The relationship between anthropometric variables and BF% obtained by BIA was determined using Spearman correlation tests. Multivariate models were constructed with BF% as the dependent variable and anthropometric parameters as independent. RESULTS: In the entire group, there was a direct correlation between NC and BF% (r = 0.50, p < 0.001), but lost statistical significance in the case of normal weight. The relationship maintained its significance in subjects from the overweight and obesity groups. In multivariate models, BMI exhibited the highest correlation with BF%, followed by waist circumference and mid-upper arm circumference; for NC, the R2 value was 0.30 (p < 0.001). CONCLUSIONS: Neck circumference is useful in the screening of population groups with the advantage of not requiring any specialized instruments for its measurement other than a tape measure. BMI and waist circumference were the best indicators of general and central adiposity, respectively.

[Calcium intake and adiposity in adolescents aged 12-16 years in Guadalajara, Mexico]. / Ingestión de calcio y adiposidad en adolescentes de 12 a 16 años en Guadalajara, México.

The purpose was to evaluate the association between calcium (Ca) intake and adiposity in adolescents. A cross-sectional study of 125 adolescents 12 to 16 years. Ca intake was evaluated by 24-hour recall dietary surveys and food frequency consumption. Adiposity was measured by anthropometric methods and bioelectrical impedance (BIA). The association between Ca intake and adiposity was identified by simple correlation and multivariate models adjusted to energy consumption, age, sex and menarche. Mean age of adolescents was 13.5 +/- 0.8 years. A negative correlation was identified between Ca intake and anthropometric indicators weight, skinfolds, body mass index, fat mass and percentage of fat (the latter two by BIA and only in women). Multivariate analysis, including energy consumption showed no association between Ca intake and adiposity. In conclusion, Ca consumption does not associate with adiposity in adolescents; multivariate models showed that energy intake and menarche are the variables that show a higher association with adiposity at this stage of life.

[Early introduction of potentially allergenic foods in pediatric patients under six months of age]. / Introducción temprana de alimentos potencialmente alergénicos en pacientes pediátricos menores de seis meses de edad.

OBJECTIVE: To review the available evidence on the early introduction of allergenic foods and the possible protection in the development of food allergy in later stages. METHODS: An exploratory review of randomized clinical trials whose study population included infants less than 6 months of age at enrollment with or without a diagnosis of food allergy was conducted. For the purposes of this review, eggs, peanuts, and wheat were included as potentially allergenic foods. The following databases were consulted: Medline, EBSCO, OVID, Science Direct and JSTOR (Journal Storage), Scielo, LILACS, Redalyc and Imbiomed from August to December 2021. RESULTS: 429 articles were identified, 412 were excluded, and the final analysis included 9 studies that met the inclusion criteria. Six trials correspond to allergy to eggs, two to peanuts and one to wheat. The age of introduction differs in all trials. The earliest exposure was at 3.5 months and the latest at 5.5 months. The reduction in the risk of developing food allergy occurred in children at risk of allergy. Adverse reactions were common, particularly with the introduction of egg. CONCLUSIONS: We found no evidence that early introduction (< 6 months of age) of allergenic foods reduces the risk of developing food allergy in infants without risk factors.

OBJECTIVO: Revisar la evidencia disponible acerca de la introducción temprana de alimentos alergénicos y la posible protección en la aparición de alergia alimentaria en etapas posteriores. MÉTODOS: Se realizó una revisión exploratoria de ensayos clínicos aleatorizados, cuya población de estudio incluyera lactantes menores de 6 meses al momento del reclutamiento con o sin diagnóstico de alergia alimentaria. Se incluyeron como alimentos potencialmente alergénicos el huevo, cacahuate y trigo. Se consultaron las bases de datos: Medline, EBSCO, OVID, Science Direct y JSTOR (Journal Storage), Scielo, LILACS, Redalyc e Imbiomed del mes de agosto a diciembre de 2021. RESULTADOS: Se identificaron 429 artículos, se excluyeron 412 y el análisis final incluyó 9 estudios que cumplieron con los criterios de inclusión. Seis ensayos corresponden a alergia al huevo, dos al cacahuate y uno a trigo. La edad de introducción difiere en todos los ensayos. La exposición más temprana fue a los 3.5 y la más tardía a los 5.5 meses. La reducción del riesgo de alergia alimentaria se presentó en niños con riesgo de alergia. Las reacciones adversas fueron comunes, particularmente con la introducción de huevo. CONCLUSIONES: No existe evidencia que la introducción temprana (< 6 meses de edad) de alimentos alergénicos reduzca el riesgo de alergia alimentaria en lactantes sin factores de riesgo.

Conventional office blood pressure measurements and unattended automated office blood pressure compared with home self-measurement and 24-h ambulatory blood pressure monitoring.

OBJECTIVE: To assess whether automated office blood pressure (BP) (AOBP) measurement is a better method for measuring BP in the office than conventional techniques and an alternative to out-of-office BP measurements: home-self BP (HSBP) or ambulatory BP monitoring (ABPM). METHODS: We conducted a cross-sectional study of 74 patients and compared AOBP with the conventional technique using a mercury sphygmomanometer and with both out-to-office BP measurements: HSBP of 7 days (three measurements in the morning, afternoon, and night) and daytime ABPM. In addition, we compared BP values obtained using HSBP and ABPM to determine their level of agreement. We used ANOVA to compare means, Bland-Altman, and intraclass correlation coefficients (ICC) for concordance. RESULTS: BP values obtained by the two office methods were similar: conventional 147.2/85.0 mmHg and AOBP 146.0/85.5 mmHg ( P > 0.05) with good agreement (ICC 0.85). The mean SBP differences between AOBP and HSBP ( P < 0.001) and between AOBP and ABPM ( P < 0.001) were 8.6/13.0 mmHg with limits of agreement of -21.2 to 38.5 and -18.4 to 44.3 mmHg, respectively. The average SBP values obtained by HSBP were 4.3 mmHg higher than those obtained by ABPM ( P < 0.01). CONCLUSION: Our study showed good agreement and concordance between the two office methods as well between the two out-to-office methods, although there was a significant difference in the mean SBP between the HSBP and ABPM. Moreover, AOBP was not comparable to either HSBP or ABPM; therefore, the estimation of out-to-office BP using AOBP is not supported.

Relationship between lipid profile, anthropometric indicators, and appetite-regulating hormones in infants according to type of feeding.

Introduction: Background: infants receiving full breastfeeding (FBF) regulate their appetites differently from those receiving human milk substitutes (HMS). In addition, early exposure to the dietary cholesterol in human milk could lead to better cholesterol regulation in later stages of life. Therefore, the purpose was to compare lipid profiles in 4-month-old infants and to correlate lipid profile with anthropometric indicators and appetite-regulating hormones according to the type of feeding. Methods: this was a cross-sectional and correlational study, which included 145 mother-infant dyads according to the type of feeding; 64 received FBF, 47 partial breastfeeding (PBF), and 34 HMS. The complete lipid profile, total ghrelin, leptin, peptide YY, and glucagon-like peptide type 1 were measured. Z-scores for weight/age, length/age, weight/length, triceps (TSF) and subscapular folds (SSF) and body mass index for age were also obtained. Results: there were significant differences in triglycerides and LDL cholesterol according to the type of feeding. In the HMS group, an inverse relationship was observed between ghrelin and triglycerides (p = 0.038), ghrelin and total cholesterol (TC) (p = 0.026), and peptide YY and HDL cholesterol (p = 0.017). In the PBF group, a direct relationship was observed between length/age (z) and triglycerides (p = 0.001) and between subscapular folds and TC (p = 0.049). In infants receiving HMS, a direct correlation was observed between weight/age (z) and TC (p = 0.045) and between length/age (z) and LDL cholesterol (p = 0.010). Conclusion: these findings show a relationship between growth, energy reserve, lipid profile, and modulation of appetite-regulating hormones according to the type of feeding they received.

Introducción: Introducción: los lactantes que reciben lactancia materna completa (LMC) regulan su apetito de manera diferente a los que reciben sucedáneos de la leche humana (SLH). Además, la exposición temprana al colesterol en la leche humana conduciría a mejor regulación del colesterol en etapas posteriores de la vida. El propósito fue de comparar el perfil lípidos en lactantes de cuatro meses y correlacionarlo con indicadores antropométricos y hormonas reguladoras del apetito según el tipo de alimentación. Métodos: en un estudio transversal y correlacional se incluyeron 145 díadas madre-lactante según el tipo de alimentación; 64 recibieron LMC, 47 lactancia materna parcial (LMP) y 34 SLH. Se midió el perfil lipídico, grelina total , leptina , péptido YY y péptido tipo 1 similar al glucagón. Se obtuvieron puntajes Z para peso/edad, longitud/edad, peso/longitud, pliegue cutáneo tricipital y subescapular e índice de masa corporal para la edad. Resultados: hubo diferencias significativas en triglicéridos y colesterol LDL según el tipo de alimentación. En el grupo HMS se observó una relación inversa entre grelina y triglicéridos (p = 0,038), grelina y colesterol total (TC) (p = 0,026), y péptido YY y colesterol HDL (p = 0,017). En el grupo PBF hubo relación directa entre longitud/edad (z) y triglicéridos (p = 0,001) y entre pliegues subescapulares y CT (p = 0,049). En los lactantes que recibieron HMS, se observó una correlación directa entre peso/edad (z) y CT (p = 0,045) y entre longitud/edad (z) y colesterol LDL (p = 0,010). Conclusión: los hallazgos muestran una relación entre perfil lipídico, crecimiento, reserva energética y modulación de las hormonas reguladoras del apetito según el tipo de alimentación.

[Metabolic profile and concentration of ghrelin and obestatin in children and adolescents with obesity]. / Perfil metabólico, concentración de grelina y obestatina en niños y adolescentes con obesidad.

Background: It has been pointed out that ghrelin and obestatin could have an impact on the genesis of obesity, since they estimulate and inhibit apetite and, therefore, food consumption. Objective: To compare the metabolic profile, lipid profile and the concentrations of ghrelin and obestatin in children with normal weight or obesity. Material and methods: Cross-sectional design with 97 normal weight or obese children, 6 to 18 years of age, who did not present systemic diseases. The serum concentrations of glucose, insulin, total cholesterol, triglycerides, high (HDL), low (LDL) and very low density (VLDL) lipoproteins, aspartate aminotransferase (AST), alanine aminotransferase (ALT), ghrelin and obestatin were determined. Descriptive statistics were performed. Student's t test was used to compare groups, and correlation coefficients of ghrelin and obestatin values with biochemical and anthropometric variables. A p value of ≤ 0.05 was significant. Results: 55 children with normal weight and 42 with obesity were included; mean age was 10.7 years. Triglycerides, LDL, VLDL, ALT and insulin were higher, and HDL lower in obese children (p < 0.05). Ghrelin values were higher in normal weight children (p < 0.05), and there was no difference in obestatin values. Conclusions: The lower concentration of ghrelin in obese children may indicate a negative feedback to regulate energy consumption. Children and adolescents with obesity show metabolic and lipid profile alterations that place them at risk of early development of cardiovascular risk factors.

Introducción: se ha señalado que la grelina y la obestatina podrían incidir en la génesis de la obesidad al estimular o inhibir el apetito y, por ende, el consumo de alimentos. Objetivo: comparar el perfil metabólico, el perfil de lípidos y las concentraciones de grelina y obestatina en niños con normopeso u obesidad. Material y métodos: diseño transversal con 97 niños de 6 a 18 años con normopeso u obesidad que no presentaran enfermedades sistémicas. Se determinaron las concentraciones séricas de glucosa, insulina, colesterol total, triglicéridos, lipoproteínas de colesterol de alta (HDL), baja (LDL) y muy baja densidad (VLDL), aspartato aminotransferasa (AST), alanina aminotransferasa (ALT), grelina y obestatina. Se usó estadística descriptiva. Se utilizó la prueba t de Student para comparar grupos, y coeficientes de correlación de los valores de grelina y obestatina con las variables bioquímicas y antropométricas. Un valor de p ≤ 0.05 fue significativo. Resultados: se incluyeron 55 niños con normopeso y 42 con obesidad; la edad promedio fue de 10.7 años. Los triglicéridos, LDL, VLDL, ALT y la insulina fueron superiores, y el HDL inferior en niños con obesidad (p < 0.05). Los valores de la grelina fueron superiores en niños con normopeso (p < 0.05) y no hubo diferencia en los de la obestatina. Conclusiones: la menor concentración de grelina en niños con obesidad puede indicar una retroalimentación negativa para regular el consumo de energía. Los niños y adolescentes con obesidad muestran alteraciones metabólicas y del perfil de lípidos que los ponen en riesgo de desarrollar tempranamente factores de riesgo cardiovascular.

Intergenerational transmission of appetite: Associations between mother-child dyads in a Mexican population.

The Child Eating Behaviour Questionnaire (CEBQ) and the Adult Eating Behaviour Questionnaire (AEBQ) measure 'food approach' [Food responsiveness (FR); Emotional overeating (EOE); Enjoyment of food (EF); Desire to Drink] and 'food avoidant' [Satiety responsiveness (SR); Emotional undereating (EUE); Food fussiness (FF); Slowness in eating (SE)] appetitive traits (ATs) in children and adults, respectively. 'Food approach' traits predispose to overweight while 'food avoidance' traits provide protection, but little is known about the relationships between parents' and their offspring's ATs. The aim was to examine the associations between maternal and child appetitive traits, using the AEBQ-Esp and CEBQ-Mex adapted for use in Mexican populations. Sociodemographic data, weights and heights of mothers and their children (aged 3-13 years), who were recruited from a teaching hospital in Guadalajara, Mexico, were measured. Mothers completed both the AEBQ-Esp and the CEBQ-Mex. The CEBQ-Mex was developed, and its reliability was tested using Cronbach's alpha and Omega, and Confirmatory Factor Analysis (CFA) was used to assess its validity. Pearson's correlation coefficients were used to assess associations between mothers' and children's Ats. The sample included 842 mother-child dyads (mother's mean age = 34.8±SD6.9 years, BMI 29.7±6.1 kg/m2; children's mean age = 8.5 ±SD2.5 years, BMIz 1.5±1.6). Internal reliability was moderate to high [Cronbach alpha = .68-.86; Omega = .71-.87] for the CEBQ-Mex and validity was confirmed for an 8-factor model through CFA [RMSEA = 0.065; CFI = 0.840, NFI = 0.805; IFI = 0.842; and χ2(df = 532) = 2939.51, p < 0.001]. All but one of the children's appetitive traits showed small to moderate, significant correlations with their mother's counterpart [FR (r = .22; p<001); EOE (r = .30; p < .001); EF (r = .15; < .001); SR (r = .16; p < .001); EUE (r = .34; p < .001) and FF (r = .14; p < .001). Only SE was not significantly associated with maternal SE (r = .01; p>.05). ATs tend to run in families, signalling the intergenerational transmission of eating behaviours. These may be useful targets for family-wide interventions to support the development and maintenance of healthy eating behaviours in childhood.

Percentile Reference Values for the Neck Circumference of Mexican Children.

Neck circumference was studied for the first time in a pediatric population in 2010. Since then, various countries have proposed cutoff values to identify overweight, obesity, and metabolic syndrome. However, no reference values have been established for the Mexican child population. The aim of this study is to provide percentile reference values for the neck circumference of Mexican schoolchildren. Only normal-weight schoolchildren aged 6-11 years were included. Percentiles and growth charts were constructed based on the "Generalized Additive Model for Location, Scale and Shape" (GAMLSS). A total of 1059 schoolchildren (52.9% female) was evaluated. Weight, height, and BMI values were higher for males; however, this difference was not statistically significant. The 50th percentile for females was 24.6 cm at six years old and 28.25 cm at 11 years old, and for males, it was 25.75 cm and 28.76 cm, respectively. Both males and females displayed a pronounced increase in neck circumference between 10 and 11 years of age. The greatest variability was found in the 11-year-old group, with an increase of 5.5 cm for males and 5.4 cm for females. This study presents the first reference values for neck circumference for a Mexican child population.

[Socioeconomic, demographic and family dysfunction related to obesity in 6 to 9 year-old children]. / Obesidad en niños de 6 a 9 años. Factores socioeconómicos, demográficos y disfunción familiar.

OBJECTIVE: To identify the association between family dysfunction and obesity in children six to nine year-old. METHODS: A case-control study that included children with obesity (cases, n = 64) with body mass index (BMI) > 95th percentile and triceps skinfold (TSF) > 90th percentile; and a control group (n = 120) with BMI < 85th percentile and TSF < 90th percentile was performed. Anthropometric measurements were made and a questionnaire assessing eight areas of family dynamics was applied. We compared the frequency of family dysfunction among cases and controls with the χ² test and its association with obesity through the odds ratio. RESULTS: The average score of the questionnaire was 80.8 ± 11.3 with no differences between groups. The categories "probably dysfunctional" and "dysfunctional" were more common in the obese group but the differences were not significant. The score of the areas "dynamics of parents as a couple" (p = 0.053) and "structure of authority in the family" (p = 0.061) was higher in the control group. CONCLUSIONS: Although no association was seen between family dysfunction and obesity, we found a tendency toward obesity in dysfunctional families.

Appetitive traits in children aged 6 to 12 years: association with obesity and differences by gender.

Background: Overweight and obesity in schoolchildren are a major public health problem in Mexico. The objective of this study was to demonstrate the association of appetitive traits with the presence of obesity and identify gender differences in children attending a university hospital. Methods: A cross-sectional study was conducted on 176 children with obesity and 175 children with normal weight in the outpatient clinic of the Nuevo Hospital Civil de Guadalajara. The body mass index (BMI) of the participants was calculated. The parents completed the Children's Eating Behaviour Questionnaire to measure eight appetitive traits. The mean appetitive trait scores were compared between children with obesity and normal weight, and between genders. Statistical analysis was performed using Student's t-tests for independent samples and regression analysis between appetite traits and BMI Z-scores. Results: The mean food responsiveness score (or food onset appetitive trait) was higher in children with obesity (p < 0.001), while the mean satiety responsiveness (or food offset trait) was higher in children with normal weight (p < 0.001). Normal weight males showed higher scores for Food responsiveness, Emotional over-eating, and Desire to drink (p < 0.05). Conclusions: Children with obesity show appetitive traits that could lead to higher food consumption. Normal weight males showed appetitive traits that could represent a risk of developing obesity.

Introducción: El sobrepeso y la obesidad en niños de edad escolar se consideran un problema de salud pública en México. El objetivo de este estudio fue demostrar la asociación entre los rasgos del apetito y la presencia de obesidad, e identificar diferencias por sexo en niños que acuden a un hospital universitario. Métodos: Se realizó un estudio de diseño transversal en 176 niños con obesidad y 175 niños con normopeso, pacientes del Nuevo Hospital Civil de Guadalajara y se calculó el índice de masa corporal (IMC) de los participantes. Se aplicó el Cuestionario de Conductas Alimentarias del Niño a los padres para evaluar ocho rasgos del apetito y se comparó el promedio de la puntuación de los rasgos del apetito entre niños con obesidad y normopeso, y entre sexos. Se utilizó la prueba t de Student para muestras independientes y análisis de regresión con los rasgos del apetito y el puntaje Z del IMC. Resultados: El promedio de la puntuación de los rasgos del apetito que muestran inclinaciones positivas hacia los alimentos (proingesta) fue mayor en niños con obesidad (p < 0.001), mientras que el promedio de los que muestran inclinaciones negativas hacia los alimentos (antiingesta) fue mayor en niños con normopeso (p < 0.001). Los participantes de sexo masculino con normopeso presentaron mayor puntaje en los rasgos del apetito Respuesta a los alimentos, Sobrealimentación emocional y Deseo de beber (p < 0.05). Conclusiones: Los niños con obesidad muestran rasgos del apetito que pueden llevar a un mayor consumo de alimentos. Los participantes de sexo masculino con normopeso mostraron rasgos del apetito que podrían representar un riesgo de desarrollo de obesidad.

Appetite-regulating hormones and anthropometric indicators of infants according to the type of feeding.

It has been accepted that satiety- and appetite-stimulating hormones play a role in the regulation of food intake and body composition during and after the lactation stage. Therefore, the purpose was to demonstrate that serum appetite-regulating hormones in infants differ according to anthropometric indicators and type of feeding. In a nonrandom cohort study, 169 mother-newborn dyads whose pregnancy and birth were attended at the Hospital Civil de Guadalajara were enrolled. According to the type of feeding, infants were classified as full breastfeeding (FBF), partial breastfeeding (PBF), and infants receiving human milk substitutes (HMS). Serum concentrations of ghrelin (pg/ml), leptin (ng/ml), peptide YY (pg/ml), and glucagon-like peptide-1 (GLP-1) (pM) were measured. Anthropometric measurements including weight, length, cephalic, arm circumference, tricipital, and subscapular skinfolds were obtained. Weight/age, weight/height, height/age, and BMI Z-score indexes were estimated. We performed one-way ANOVA, unpaired Student's t test, post hoc Tukey test, and Pearson correlation tests. The ANOVA comparison of the three feeding types showed significant differences in most anthropometric indicators (z-scores), especially between infants receiving FBF versus HMS and particularly on indicators of adiposity; no differences were observed in length and cephalic circumference z-scores at 8th and 16th weeks. Further, significant correlations were found between most of the adiposity indicators with ghrelin, leptin, and GLP-1, especially in infants who received FBF. There were differences in anthropometric and body composition parameters among infants receiving FBF, PBF, and HMS. There were significant correlations between body composition indicators with ghrelin, leptin, and GLP-1 mainly in infants receiving FBF.