[Prevalence of cardiometabolic risk in a national sample of Costa Rican youth using the waist-height anthropometric indicator]. / Prevalencia de riesgo cardiometabólico en una muestra nacional de jóvenes costarricenses utilizando el indicador antropométrico cintura-estatura.

Central obesity is known as an indicator of cardiometabolic risk, but better anthropometric measures than Body Mass Index (BMI) are needed to detect it. Waist-to-height ratio (WHtR) is an indicator of central adiposity and a strong predictor of cardiometabolic risk. OBJECTIVE: To determine the pre valence of cardiometabolic risk in a representative sample of Costa Rican children and adolescents. PATIENTS AND METHOD: Cross-sectional and descriptive study carried out with 2,684 students from 64 educational centers in Costa Rica. Validated questionnaires were applied to the students and their weight, height, and waist circumference were determined. Weight and body fat percentage of the students were determined with a Tanita model SC-331 S (without column). Height was measured with a SECA stadiometer model 217. The abdominal circumference was estimated using a tape mea sure. BMI and WHtR were calculated for each participant. The behavior of the indicator WHtR was analyzed with logistic regression models. All procedures were approved by the Ethics Committee of INCIENSA. RESULTS: There was a strong and positive correlation between waist circumference and BMI (r = 0.748, p < 0.001, 56% of shared variance), and a positive and moderate correlation between WHtR and BMI (r = 0.611, p < 0.01, 37% of shared variance). CONCLUSIONS: A third part of the stu dent population of elementary, middle, and high schools (31.8%) is at cardiovascular and metabolic risk.

[Breastfeeding duration, mixed feeding and health risk in Costa Rican children and adolescents]. / Duración de la lactancia materna, alimentación combinada y riesgo para la salud en jóvenes costarricenses.

OBJECTIVE: to analyze the associations between breastfeeding duration and mixed feeding (breast milk and formula) with obesity, cardiometabolic risk (WHtR), body fat, and dietary and physical activity risk behaviors in children and adolescents. SUBJECTS AND METHOD: cross-sectional study carried out with 1,467 students in Costa Rica. An interview was conducted with parents and children to gather information on socioeconomic status, education, dietary and physical activity risk behaviors of the youth, including breastfeeding duration and mixed feeding. Body mass index, waist circumference, and body fat were assessed by bioelectrical impedance analysis and cardiometabolic risk was mea sured with the waist-to-height ratio (WHtR ≥ 0.5) by trained personnel. Descriptive statistics and logistic regression models were applied. RESULTS: the average age was 11.4 ± 2.6 years and 50.9% were male. 55.5% of the population was middle class; 60% were sedentary, and 16% presented obesity. Around 20% were breastfed without the introduction of formula before 6 months, 13% were never breastfed, and more than 60% were breastfed for ≥ 6 months. Those children who were fed only with breast milk or in combination with formula for ≥ 6 months presented a lower percentage of obesity than those who received formula feeding only (60.8 vs 39.2; p < 0.005). Children with cardiometa bolic risk (WHtR ≥ 0.50), unhealthy diet, sedentary lifestyle, and who were fed only with formula are at higher risk of developing obesity (OR = 18.8, 95% CI 13.2-26.0). CONCLUSIONS: these results are consistent with other studies and reinforce the evident protection of breastfeeding against the development of obesity.