[Adherence to the Mediterranean diet and eating behaviour in Spanish schoolchildren]. / Adhesión a la dieta mediterránea y conducta alimentaria en escolares españoles.

Introduction: Introduction: eating behaviors may modulate or influence diet quality and the degree of adherence to the Mediterranean diet in children and adolescents. Aims: to investigate the association between diet quality and eating behavior in a group of Spanish schoolchildren. Methods: descriptive cross-sectional study of 283 Spain schoolchildren aged six to 16. Each subject was assessed using the KIDMED questionnaire for adherence to the Mediterranean diet and the Children's Eating Behaviour Questionnaire (CEBQ) questionnaire to assess eating behavior. Results: of the sample, 12.80 % had low adherence to the Mediterranean diet, 59.80 % had poor adherence, 59.80 % could be improved, and 27.40 % had high adherence. When relating eating behavior to dietary quality, it was found that, generally, schoolchildren with greater enjoyment of food and less demand for food have double the adherence to the Mediterranean diet due to almost twice the consumption of vegetables, nuts, and fish, and a lower intake of low-quality processed foods (sweets). The response to satiety and the speed of ingestion also played an important role in food choices. Conclusions: eating behaviors may play an essential role in the quality of school children's diets highlighting the enjoyment and acceptance or rejection of food. Given the bidirectional nature of the effects between eating behaviors and diet quality, the joint analysis may be the basis for future research with the aim of a better nutritional approach from the earliest ages.

Introducción: Introducción: las conductas alimentarias pueden modular o influir en la calidad de la dieta y el grado de adherencia a la dieta mediterránea de niños y adolescentes. Objetivos: investigar la asociación entre la calidad de la dieta y el comportamiento alimentario en un grupo de escolares españoles. Métodos: se trata de un estudio transversal descriptivo en una muestra de 283 escolares españoles de seis a 16 años. Cada sujeto fue evaluado mediante el cuestionario KIDMED de adherencia a la dieta mediterránea y el cuestionario Children's Eating Behaviour Questionnaire (CEBQ) para evaluar el comportamiento alimentario. Resultados: un 12,80 % de la muestra presentó baja adherencia a la dieta mediterránea; un 59,80 %, adherencia mejorable; y un 27,40 %, adherencia alta. Al relacionar las conductas alimentarias con la calidad dietética, los escolares con mayor disfrute por los alimentos y menos exigencia con la comida presentan el doble de adherencia a la dieta mediterránea, por un consumo de casi el doble de vegetales, frutos secos o pescado, así como menor ingesta de procesados de baja calidad (golosinas y dulces). La respuesta a la saciedad y la velocidad de ingesta también tuvieron un papel importante en las elecciones alimentarias. Conclusiones: las conductas alimentarias pueden tener un importante papel en la calidad de la dieta de los escolares, destacando el disfrute y la aceptación o rechazo por los alimentos. Dada la naturaleza bidireccional de los efectos entre las conductas alimentarias y la calidad de la dieta, el análisis conjunto puede ser la base de futuras investigaciones con el objetivo de un mejor abordaje nutricional desde las edades más tempranas.

Composite indexes of anthropometric failure in children under 5 years of age in Argentina: Comparative analysis among regions: 2019-2020.

OBJECTIVES: Composite Index of Anthropometric Failure (CIAF) and Extended CIAF (ECIAF) allow for the identification of simultaneous presence of two or more types of malnutrition. The objective of this study was to analyze anthropometric failure in Argentinean children under 5 years old, taking into consideration regional and socioeconomic perspectives. MATERIALS AND METHODS: Data from the National Survey of Children and Adolescents MICS 2019-2020 were used, which included 5473 children under 5 years old of both sexes residing in the six regions of Argentina. CIAF and ECIAF excludes children not in anthropometric failure (group A) and was calculated from a percentage of children included in malnutrition categories B: wasting only; C: wasting and underweight; D: wasting, stunting, and underweight; E: stunting and underweight; F: stunting only; Y: underweight only; G: only weight excess; and H: stunting and weight excess. The data were analyzed according to region and wealth quintile. RESULTS: In children aged 0-2.99 years, CIAF was 12.5% and ECIAF was 27.7%, with boys being more affected. In children aged 3-4.99 years, the rates were 9.7% and 22.3%, respectively, with girls showing a higher prevalence. The highest ECIAF was recorded in the Patagonia region (31.3%), while the highest ECIAF was observed in the poorest quintile. DISCUSSION: The presence of double burden of malnutrition has been observed across all regions and household income levels. Additionally, overweight has shown a higher intensity in economically prosperous regions and households, while stunting has been more prevalent in economically disadvantaged areas.

Concordance between methods of estimating body fat in pediatric and adolescent age.

Background and objective: The percentage of fat (%BF), essential data in the health or nutrition field, can be estimated by different methods. This work compares the %BF values obtained by anthropometry, Near Infrared Interactance (NIR), and Bioimpedance Analysis (BIA), in childhood and adolescence. Material and Methods: The sample consisted of 1015 schoolchildren aged 9 to 16 years. Height, weight, and four adipose folds were measured: tricipital, bicipital, subscapular, and suprailiac. The %BF by anthropometry was calculated using a specific formula based on body density (BD). A tetrapolar analyzer was used for the BIA calculation. The optical density in the biceps was measured for the one observed by NIR. Results: The high correlation and determination coefficients show that the relationship between %BF by anthropometry, BIA, or NIR is very strong, mainly between the first two. The intraclass correlation coefficient (ICC) results between Anthropometry and BIA show an almost perfect agreement. Its graphical contrast attests that the correlation is higher in the male sex. In general, the agreement between Anthropometry and BIA is higher than between Anthropometry and NIR. Conclusions: The three techniques used to measure %BF show high concordance. All ICC values between pairs of methods are above 0.90. The comparison of %BF by anthropometry with BIA or NIR shows that the affinity is higher in intermediate adiposity percentages than in extreme ones. This trend occurs in both sexes and age groups.

Sobrepeso y obesidad en escolares de la Región de Magallanes y Antártica Chilena, Chile, (2009 ­ 2019), y comparación de dos metodologías para el diagnóstico / Overweight and obesity in schoolchildren in the Magallanes and Chilean Antarctica Region, Chile, (2009 - 2019), and comparison of two methodologies for diagnosis

Introducción. En Chile la prevalencia de obesidad total en población escolar alcanza al 31% y la obesidad severa al 10,8%. La Región de Magallanes y Antártica Chilena, es una de las más afectadas por esta epidemia. El diagnóstico nutricional confiable y una intervención oportuna pueden evitar que los niños enfermen y deterioren su calidad de vida. Objetivo: Analizar la tendencia del estado nutricional de escolares de la Región de Magallanes, según datos reportados por la Junta Nacional de Auxilio Escolar y Becas, JUNAEB, entre 2009-2019 y comparar resultados del año 2010 con un estudio propio. Materiales y métodos. Se analizó el estado nutricional de 71.334 escolares de la Región de Magallanes y Antártica Chilena por nivel educacional y variables demográficas, según información de JUNAEB. Luego se compararon los resultados de escolares de 1º básico del año 2010, obtenidos a través de dos metodologías: fuente secundaria, Encuesta JUNAEB, y fuente primaria, estudio antropométrico realizado en la misma región y año. Resultados. Según datos de JUNAEB el exceso ponderal se incrementó en escolares de la región en 4,4 % entre 2009 y 2019, el grupo más afectado fue 1º básico. En el año 2010 la prevalencia de obesidad para escolares de 1º básico según JUNAEB fue 21,8% y según estudio regional propio fue 25,7%. Conclusiones. La malnutrición por exceso afecta al 53,8% de los escolares de la Región de Magallanes y podría ser mayor, considerando que la información censal podría estar subestimando el sobrepeso y obesidad. Es urgente intervenir para evitar perpetuar esta epidemia(AU)

Introduction. In Chile the prevalence of total obesity in school population reaches 31% and severe obesity 10.8%. The Magallanes and Chilean Antarctica Region is one of the most affected by this epidemic. Reliable nutritional diagnosis and timely intervention can prevent children from getting sick and deteriorating their quality of life. Objective. To analyze the trend of nutritional status of schoolchildren in the Magallanes Region, according to data reported by the National Board of School Aid and Scholarships, JUNAEB between 2009-2019 and compare results from 2010 with our own study. Materials and methods. The nutritional status of 71,334 schoolchildren in the Magallanes Region and Chilean Antarctica was analyzed by educational level and demographic variables, according to information from JUNAEB. Then, the results of schoolchildren in 1st grade in 2010 were compared, obtained through two methods: secondary source, JUNAEB survey, and primary source, anthropometric study carried out in the same region and year. Results. According to JUNAEB data, overweight increased in school children in the region by 4.4% between 2009 and 2019, the most affected group was 1st grade. In 2010 the prevalence of obesity for 1st grade schoolchildren according to JUNAEB was 21.8% and according to our own regional study it was 25.7%. Conclusions. Excess malnutrition affects 53.8% of school children in the Magallanes Region and could be higher, considering that census information could be underestimating overweight and obesity. It is urgent to intervene to avoid perpetuating this epidemic(AU)

Fatigue, Work Overload, and Sleepiness in a Sample of Spanish Commercial Airline Pilots.

Commercial aviation pilots are an occupational group that work in particular conditions, with frequent schedule changes, shift work, unfavorable environmental conditions, etc. These circumstances can lead to fatigue, work overload (WO), and daytime sleepiness, factors that can affect their health and safety. This study aimed to assess the prevalence and the association between these parameters in a sample of Spanish commercial airline pilots. The Raw TLX, Fatigue Severity Scale, and the Epworth Sleepiness Scale questionnaires were administered in a sample of 283 participants. The relationships of the total scores between all the questionnaires were studied by the chi-square test and the risk scores (odds ratio) were calculated. Different models using multiple linear regression were carried out to evaluate the effects of WO, fatigue, and daytime sleepiness, among the total scores, age, and flight hours. Additionally, the internal consistency of each questionnaire was estimated. A total of 28.2% presented WO above the 75th percentile, with mental and temporal demand the dimensions with the greatest weight. A total of 18% of pilots presented fatigue, 15.8% moderate sleepiness, and 3.9% severe sleepiness. We observed an association among WO, fatigue, and daytime sleepiness, important factors related to pilot health and aviation safety.

Eating Behavior and Obesity in a Sample of Spanish Schoolchildren.

From the point of view of prevention, it is convenient to explore the association between eating behavior and the obese phenotype during school and adolescent age. The aim of the present study was to identify eating behavior patterns associated with nutritional status in Spanish schoolchildren. A cross-sectional study of 283 boys and girls (aged 6 to 16 years) was carried out. The sample was evaluated anthropometrically by Body Mass Index (BMI), waist-to-height ratio (WHtR) and body fat percentage (%BF). Eating behavior was analyzed using the CEBQ "Children's Eating Behavior Questionnaire". The subscales of the CEBQ were significantly associated with BMI, WHtR and %BF. Pro-intake subscales (enjoyment of food, food responsiveness, emotional overeating, desire for drinks) were positively related to excess weight by BMI (ß = 0.812 to 0.869; p = 0.002 to <0.001), abdominal obesity (ß = 0.543-0.640; p = 0.02 to <0.009) and high adiposity (ß = 0.508 to 0.595; p = 0.037 to 0.01). Anti-intake subscales (satiety responsiveness, slowness in eating, food fussiness) were negatively related to BMI (ß = -0.661 to -0.719; p = 0.009 to 0.006) and % BF (ß = -0.17 to -0.46; p = 0.042 to p = 0.016).

Genetic risk score for common obesity and anthropometry in Spanish schoolchildren.

IntroductionCommon or non-syndromic obesity is a complex polygenic trait conditioned by biallelic or single-base polymorphisms called SNPs (Single-Nucleotide Polymorphisms) that present an additive effect and act synergistically. Most genotype-obese phenotype association studies include body mass index (BMI) or waist-to-height ratio (WtHR), and very few introduce a broad anthropometric profile. ObjectiveTo verify whether a genetic risk score (GRS) developed from 10 SNPs is associated with the obesity phenotype assessed from anthropometric measures indicative of excess weight, adiposity and fat distribution. Material and methodsA series of 438 Spanish schoolchildren (6-16 years old) were evaluated anthropometrically (weight, height, waist circumference, skinfold thickness, BMI, WtHR, body fat percentage [%BF]). Ten SNPs were genotyped from saliva samples, generating a GRS for obesity, establishing genotype-phenotype association. ResultsSchoolchildren categorised as obese by BMI, ICT and %BF had higher GRS than their non-obese peers. The prevalence of overweight and adiposity was higher in subjects with a GRS above the median. Similarly, between 11 and 16 years of age, all anthropometric variables presented higher averages. ConclusionsGRS estimated from the 10 SNPs can be a diagnostic tool for the potential risk of obesity in Spanish schoolchildren and could be useful from the preventive perspective.

Atherogenic Risk, Anthropometry, Diet and Physical Activity in a Sample of Spanish Commercial Airline Pilots.

Cardiovascular accidents are the most disabling event for pilots, causing complicated situations during flight and the withdrawal of license. The study aims to assess the modifiable risk factors and the atherogenic index of plasma (AIP) associated with anthropometric, physiometabolic and lifestyle profiles in a sample of Spanish aviation pilots. Data from pilots' clinical and professional history, anthropometric and bioelectrical impedance assessments of nutritional status, and diet and physical activity questionnaires. The sample comprised 304 men pilots. Up to 53.6% showed excess weight, of which 6.4% were obese, 64.3% presented high relative adiposity and 64.6% showed abdominal obesity. Regarding the physiometabolic profile, 10.0% had hypertension, 42.6% hypercholesterolemia, 9.4% high LDL and 10.6% low HDL, 9.4% hyperglycemia and 8.1% hypertriglyceridemia. The adherence to the Mediterranean diet (MedDiet) was high in 29.7% and low in 14.7%. Most of the sample showed a good physical activity level. The AIP risk increased with higher obesity indicators and LDL cholesterol levels. There was an inverse relationship between the MedDiet adherence and vigorous physical activity and the risk of atherogenicity. Elevated rates of overweight, abdominal obesity and hypercholesterolemia were found, contributing to the atherogenic risk of plasma (AIP). This parameter was significantly associated with all anthropometric indicators and LDL cholesterol. Prevention plans on reducing excess fat and blood cholesterol levels are recommended to reduce cardiovascular risk in Spanish aviation pilots and ensure flight safety.

Referencias de índice de masa corporal. Precisión diagnóstica con área grasa braquial en escolares argentinos / Body mass index references. Diagnostic accuracy with the upper-arm fat area in Argentine schoolchildren

El índice de masa corporal (IMC) es una eficaz herramienta para detectar la sobrecarga ponderal en niños y adolescentes, asociado a la adiposidad corporal. Objetivo. Analizar la concordancia, sensibilidad y especificidad de tres referencias internacionales de IMC/edad (OMS, IOTF y CDC) para diagnosticar el exceso ponderal y conocer su precisión diagnóstica para identificar el exceso de adiposidad con relación al área grasa braquial (AGB) en población infanto juvenil de Argentina. Materiales y métodos. Se realizó un estudio multicéntrico, descriptivo-comparativo y transversal entre 2003 y 2008, en 22.658 niños y adolescentes argentinos de 4 a 13 años de edad. A partir del peso, talla, circunferencia del brazo y pliegue tricipital, se calcularon IMC y AGB. Se analizó la concordancia, sensibilidad y especificidad de referencias de IMC/edad (OMS, CDC, IOTF) y la precisión diagnóstica (curvas ROC) para identificar exceso de adiposidad, a partir del AGB, así como el punto de corte óptimo (PCO). Resultados. Las tres referencias tuvieron buena concordancia. La mayor sensibilidad correspondió a OMS y la mayor especificidad a IOTF. El área bajo la curva (ABC) fue mayor en Z-IMC/IOTF en varones y en Z-IMC/OMS en mujeres. Los PCO mostraron discrepancias, siendo mayores con OMS. Conclusión. Las tres referencias muestran similar precisión diagnóstica para detectar alta reserva calórica, con puntos de corte óptimo para las puntuaciones Z-IMC menores a 2 Z scores. Esto resulta relevante para la identificación de exceso de adiposidad en poblaciones, en relación con la implementación de políticas públicas de prevención de enfermedades crónicas no transmisibles(AU)

The body mass index (BMI) is an effective tool to detect weight overload in children and adolescents, associated with body adiposity. Objective. To analyze the concordance, sensitivity and specificity of three international BMI/age references (WHO, IOTF and CDC) to diagnose excess weight and to know their diagnostic accuracy to identify excess adiposity in relation to the brachial fat area (BFA) in Argentine child-youth population. Materials and methods. A multicenter, descriptive- comparative and cross-sectional study was carried out between 2003 and 2008 in 22.658 Argentine children and adolescents between aged 4 to 13 years. From the weight, height, arm circumference and tricipital fold, BMI and BFA were calculated. The concordance, sensitivity, and specificity of BMI / age references (WHO, IOTF, CDC,) were analyzed and the diagnostic precision (ROC curves) to identify excess adiposity, from the BFA, as well as the optimal cut-off point (OCP). Results. The three references had good agreement, the highest sensitivity corresponded to WHO and the highest specificity to IOTF. The area under the curve (AUC) was greater in Z-BMI/IOTF in men and in Z-BMI/WHO in women. The OCPs showed discrepancies, being higher with WHO. Conclusion. The three references show similar diagnostic accuracy to detect high caloric reserve, but with cut-off points for Z-BMI scores less than 2 Z scores. This is relevant for the identification of excess adiposity in populations in relation to the implementation of public policies for the prevention of chronic non-communicable diseases(AU)

Growth patterns of normo-nourished Afghan, Haitian and Congolese children aged 6-59 months: A comparative study.

OBJECTIVES: International growth charts have been used in the past decades to identify atypical growth and diagnose the nutritional status of individuals. The aim of this study was to construct and compare growth patterns of normo-nourished children between 6-59 months from Afghanistan, Haiti, and the Democratic Republic of the Congo, to assess if it would be worth developing growth charts at a national level. METHODS: We used an international sample of 46 466 subjects (53.7% female; 46.3% male) from the aforementioned regions. To create the growth charts, we used different statistical methodologies: the Lambda-Mu-Sigma (LMS), LMSP, and LMST models, and regression models based on fractional polynomials. The LMSP models were the ones that fitted our data best and were therefore the ones used to make comparisons between countries using percentiles (3rd, 50th, and 97th). RESULTS: We found that Haitian children were both, taller and heavier than their Afghan and Congolese equals of the same ages. Moreover, differences were bigger in the highest percentiles (i.e., 97th percentile). These differences might be the result of the influence that genetics and diverse social and environmental contexts have on growth rates. CONCLUSIONS: Using the same international reference standards for all populations could result in the overestimation or underestimation of the proportion of malnourished children. In light of our results, we recommend the future development of national and regional growth charts to provide health workers with more precise tools to evaluate the nutritional status in the child population.

Waist circumference percentiles for Hispanic-American children and comparison with other international references.

INTRODUCTION: Waist circumference (WC) constitutes an indirect measurement of central obesity in children and adolescents. OBJECTIVE: To provide percentiles of WC for Hispanic-American children and adolescents, and compare them with other international references. MATERIALS AND METHODS: The sample comprised 13 289 healthy children between 6 and 18 years coming from public schools of middle and low socioeconomic levels in different parts of Argentina, Cuba, Spain, Mexico, and Venezuela. The LMS method to calculate WC percentiles was applied. Sex and age differences were assessed using Student's t test and ANOVA (SPSS v.21.0). Comparisons were established with references from the United States, Colombia, India, China, Australia, Kuwait, Germany, Tunisia, Greece, and Portugal. RESULTS: WC increases with age in both sexes. Boys show higher WC in P3, P50, and P97. Comparison of 50th and 90th percentiles among populations from diverse sociocultural and geographical contexts shows high variability, not all justified by the measurement method. DISCUSSION AND CONCLUSIONS: Specific WC percentiles for sex and age, and P90 cut-off points are provided; these values are potentially useful to assess central obesity in Hispanic-American adolescent children.

[Assessment of nutritional status, and habits and food preferences in a child-youth population (7 to 16 years) of the Community of Madrid]. / Valoración del estado nutricional y de hábitos y preferencias alimentarias en una población infanto-juvenil (7 a 16 años) de la Comunidad de Madrid.

INTRODUCTION: Background: the prevalence of overweight and obesity in childhood and adolescence in Spain is alarming. The high consumption of processed products of low nutritional quality but high caloric density, together with sedentary lifestyle, are two of the main causes. Objective: to know the nutritional status of a population of children and adolescents, and some of their eating habits, tastes and preferences, and physical activity practice. Methods: a cross-sectional descriptive study based on an anthropometric assessment and a survey on food habits and lifestyle in 1,939 schoolchildren between seven and 16 years of school age in the Community of Madrid. Updated indexes such as the body mass index (BMI) adapted according to the Cole cut-off points and the waist-height index (CTI), which have a high correlation with infant adiposity, are used. Results: the rates of overweight and obesity are high in both children and adolescents. It should be noted that abdominal obesity according to ICT represents a greater percentage than global obesity diagnosed with BMI (overweight + total obesity according to BMI: 27.23%, and according to ICT: 35.17%). The sedentariness is high (25.12%), as well as the consumption of highly caloric products, but of low nutritional value mainly at breakfast, mid-morning and snack. Conclusions: the prevalence of overweight and obesity is high, especially at the abdominal level, probably associated with the increasing consumption of ultra-processed products and the high rates of sedentary lifestyle. The conclusion is the need to develop programs to prevent obesity and nutritional education.

INTRODUCCIÓN: Introducción: la prevalencia de sobrepeso y obesidad en la infancia y adolescencia en España es alarmante. El alto consumo de productos procesados de baja calidad nutricional pero alta densidad calórica, junto al sedentarismo, son dos de las principales causas. Objetivos: conocer la condición nutricional de una población de niños y adolescentes, y algunos de sus hábitos alimentarios, gustos y preferencias y práctica de actividad física. Métodos: estudio descriptivo transversal basado en una valoración antropométrica y encuesta sobre hábitos alimentarios y estilo de vida a 1.939 escolares de entre siete y 16 años de centros escolares de la Comunidad de Madrid. Se emplean índices actualizados como el índice de masa corporal (IMC) adaptado según los puntos de corte de cole y el índice cintura-talla (ICT), que presentan alta correlación con la adiposidad infantil. Resultados: las tasas de sobrepeso y obesidad son elevadas tanto en población infantil como adolescente. Cabe destacar que la obesidad abdominal según ICT representa un mayor porcentaje que la obesidad global diagnosticada con el IMC (sobrepeso + obesidad total según IMC: 27,23%; y según ICT: 35,17%). El sedentarismo es elevado (25,12%), así como el consumo de productos altamente calóricos pero de bajo valor nutricional tanto en desayuno como en media mañana y merienda. Conclusión: la prevalencia de sobrepeso y obesidad es elevada, sobre todo a nivel abdominal, probablemente asociada al creciente consumo de productos ultraprocesados y a las altas tasas de sedentarismo. Se concluye la necesidad de desarrollar programas de prevención de obesidad y educación nutricional.

SUBSCAPULAR AND TRICEPS SKINFOLDS REFERENCE VALUES OF HISPANIC AMERICAN CHILDREN AND ADOLESCENTS AND THEIR COMPARISON WITH THE REFERENCE OF CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC).

INTRODUCTION: the assessment of the skinfold thickness is an objective measure of adiposity. Therefore, it is a useful tool for nutritional diagnosis and prevention of metabolic risk associated with excess fat in chilhood and adolescence. OBJECTIVE: to provide percentiles of subscapular and triceps skinfolds for Hispanic American schoolchildren and compare them with those published by the Centers for Disease Control and Prevention (CDC) from United States, that it have been commonly used as a reference in most of these countries. METHODS: subscapular and triceps skinfolds were measured in 9.973 schoolchildren 4-19 aged from Spain, Argentina, Cuba, Venezuela and Mexico with Holtain caliper with 0.2 mm accuracy. Percentiles were obtained with the LMS statistical method and were presented in tables divided in stages of 6 months and in curves graphics. The difference between Hispanic American and CDC mean values were provided for P3, P50 and P97 in mm and also were graphically represented. RESULTS: skinfolds measurements obviously increased with age in both sexes but, in boys, this increase is much more marked in highest percentiles between 8 and 13 years; this maximum is reached earlier than what occurs in CDC reference. In both sexes, all percentiles analized in Hispanic American schoolchildren were higher than the CDC reference except P97 up to 10 or 13 years that was notably smaller. CONCLUSIONS: the skinfolds percentiles of Hispanic American children and adolescents differ from CDC that are usually used as reference. The values of subscapular and triceps skinfolds provided in this study, could be applied to populations of a similar ethnic background, especially in comparative studies of body composition.

Introducción: la evaluacion del grosor de los pliegues subcutáneos es una medida objetiva de la adiposidad. Es por tanto una herramienta útil para el diagnóstico nutricional y la prevención del riesgo metabólico asociado al exceso de grasa en la infancia y adolescencia. Objetivo: proporcionar valores percentilares de los pliegues adiposos subcutáneos subescapular y tricipital para escolares hispanoamericanos y compararlos con los valores publicados por los Centros para el Control y Prevención de Enfermedades (CDC) de los Estados Unidos, que comunmente se emplean como referencia en estos países. Métodos: se midió el pliegue subescapular y tricipital en 9.973 escolares entre 4 y 19 años procedentes de España, Argentina, Cuba, Venezuela y México con un calibre Holtain de 0,2 mm de precisión. Los percentiles fueron calculados mediante el método estadístico LMS y presentados en tablas divididas en intervalos de seis meses y en gráficos de curvas. La diferencia entre los valores medios hispanoamericanos y los valores del CDC se muestran para el P3, P50 y P97 en mm, y también gráficamente. Resultados: las medidas de los pliegues subcutáneos se incrementan obviamente con la edad pero, en niños, este incremento es mucho más marcado en los percentiles superiores entre los 8 y 13 años; este máximo es alcanzado antes que en la referencia del CDC. En ambos sexos, todos los percentiles analizados fueron superiores en los escolares hispanoamericanos, exceptuando el P97 por encima de los 10 o 13 años, donde resultó notablemente inferior. Conclusiones: los percentiles de pliegues adiposos de los niños y adolescentes hispanoamericanos difieren de la referencia del CDC. Los valores del pliegie subescapular y tricipital proporcionados en este estudio podrían ser aplicados en poblaciones de similar origen étnico, especialmente en estudios comparativos de la composición corporal.

ASSESSMENT OF SOMATIC MATURATION OF VENEZUELAN ADOLESCENTS.

INTRODUCTION: beginning of adolescence comprises important physical modifications, which affects growth and changes in body composition, therefore it is important to consider maturation assessment. OBJECTIVE: to develop a non-invasive method to assess maturity status in Venezuelan adolescents from peak height velocity (PHV) by means of anthropometric variables in a cross-sectional sample. METHODS: data comprised 681 Venezuelan adolescents 9 up to 18 years of age. Mirwald equation was applied to derived PHV. Regression analysis was used in order to build a model for Venezuelan sample as well as, ROC curves to assess sensitivity and specificity of anthropometric variables. RESULTS: the predictive equations for both sexes, exhibited a high determination coefficient (< 0.99) and a minimal estimation error (0.06). Mean decimal age at categories of PHV obtained by both equations: criterion and model, were very similar (13.27 vs. 13.39) for boys, and (11.62 vs. 11.77) for girls. Bland-Altman plot showed a tight concordance between the two equations and all anthropometric indices, exhibited high area under the curve > 0.75, specially sitting height. DISCUSSION AND CONCLUSION: in Venezuela, there is little work based on longitudinal studies of the maturation status. Giving the difficult faced in the longitudinal studies recent works have been used cross-sectional methodology in the assessment of the somatic maturation, both in non athletic and athletic populations. This study provides predicting equations for the assessment of the somatic maturation adjusted to Venezuelan population developed from Mirwald equation, which may be used to aid in evaluation of nutritional and general health, as well as, a reduction of risks associated with miss-classification for chronological age.

Introducción: la adolescencia es un período de cambios en la composición corporal, los cuales deben ser considerados en la evaluación del estado de maduración somática. Objetivos: desarrollar un método no invasivo para evaluar el estado de maduración en una muestra transversal de adolescentes venezolanos, a partir del punto de máxima velocidad de crecimiento (PHV), mediante medidas antropométricas. Métodos: la muestra comprende 681 adolescentes venezolanos entre 9 y 18 años. Se aplicó la ecuación de Mirwald para estimar el PHV. De igual manera se efectuó un análisis de regresión para construir el modelo de la muestra venezolana y se aplicaron curvas ROC para evaluar la sensibilidad y especificidad de las variables antropométricas. Resultados: las ecuaciones predictivas para uno y otro sexo mostraron un elevado coeficiente de determinación (< 0,99) y un mínimo error de estimación (0,06). La edad media decimal a la que se alcanza el punto de PHV obtenido por ambas ecuaciones: criterio y modelo, fueron similares para chicos (13,27 vs. 13,39) y para chicas (11,62 vs. 11,77). El test de Bland-Altman mostró una elevada concordancia entre ambas ecuaciones y todos los indicadores antropométricos mostraron un área bajo la curva > 0,75, en especial la talla sentado. Discusion y conclusiones: dada la dificultad de realizar estudios longitudinales, se han utilizado muestras transversales para estimar la maduración somática en diferentes poblaciones. El presente trabajo proporciona ecuaciones predictivas para este propósito, ajustadas a la población venezolana y desarrolladas a partir de la fórmula de Mirwald. Las mismas pueden ser usadas como ayuda en la evaluación nutricional y de salud en general, así como en la disminución de los riesgos asociados con la clasificación errónea de la edad cronológica.

[Weight-for-age percentile curves for the population of Catamarca province (Argentina)]. / Curvas percentilares de peso al nacimiento por edad gestacional para la población de la provincia de Catamarca (Argentina).

INTRODUCTION: The assessment of fetal development and birth weight is a priority in the field of nutritional epidemiology and public health. Nowadays, the World Health Organization (WHO) does not have specific birth weight curves for the distinct gestational weeks considering that socio-economic, ecological and ethnic characteristics of the different human groups are found influencing their own growth patterns. OBJECTIVE: This research develops centile curves for weight by gestational age concerning to resident populations in the province of Catamarca. METHODS: In order to process data, SPSS statistical program was used, as well as LMS Chart Maker pro program for the subsequent performing of centile curves. The sample ascended to a total of 22,576 childbirths between 1994 and 2003. DISCUSSION AND CONCLUSION: In the future, these curves make possible a better assessment of intrauterine development and birth weight in this region of Northwest of Argentina.

Introducción: La evaluación del desarrollo fetal y del peso al nacimiento es un objetivo prioritario en el ámbito de la epidemiología nutricional y de la salud pública. En la actualidad, la Organización Mundial de la Salud (OMS) no dispone de curvas específicas de peso al nacimiento para las distintas semanas gestacionales al considerar que las características socioeconómicas, ecológicas y étnicas de los distintos grupos humanos influyen en sus propios patrones de crecimiento. Objetivo: La presente investigación desarrolla las curvas percentilares de peso por edad gestacional para las poblaciones residentes en la provincia de Catamarca. Métodos: El procesamiento de los datos se llevó a cabo con el programa SPSS y para la posterior realización de las curvas percentilares se utilizó el programa LMS Chart Maker pro, a partir de un total de 22.576 nacimientos ocurridos entre 1994 y 2003. Discusión y conclusiones: Dichas curvas posibilitarán en el futuro una mejor valoración del desarrollo intrauterino y del peso de los recién nacidos en esta región del Noroeste de Argentina.

[Determining factors in body mass index of Spanish schoolchildren based on the National Health Surveys]. / Factores determinantes del índice de masa corporal en escolares españoles a partir de las Encuestas Nacionales de Salud.

INTRODUCTION: Spanish National Health Surveys do not establish synergistic relations between variables. The purpose of this study was to perform a deeper historical analysis of body mass index (BMI) and its relation to other parameters included in the questionnaire for children. MATERIAL AND METHODS: Data from interviews conducted (between 1987 and 2006) to parents and guardians of schoolchildren aged 9-15 years were analyzed. Height and weight reported by parents were selected and used to calculate BMI. Subjects were stratified by age, gender, time spent sleeping and watching television and, finally, frequency of physical activity. The historical trend of BMI and its dependence on the above factors were analyzed using ANOVA tests. RESULTS AND CONCLUSIONS: Significant weight and height increases were seen, which were more marked in boys aged 12 to 15 years. Influence of physical activity on BMI was shown, but decreased (P<.001) as exercise time increased. By contrast, BMI increased (P<.001) as time spent watching television increased. On the other hand, the role of sleep as modulator of body size was confirmed, since schoolchildren aged 9-11 years who slept over 9h had lower BMIs (P<.001). In subjects aged 12 to 15, BMI decreased (P<.001) from 6h of sleep.

Actividad física y su repercusión en la composición corporal en adolescentes venezolanos / Physical activity and its impact on body composition in adolescents Venezuelans

La actividad física es importante para promocionar la salud de las poblaciones. Objetivo: Se estudió la repercusión de laactividad física en los indicadores y distribución de la adiposidad en 304 adolescentes (9-17 años). Las variables antropométricas se apreciaron de acuerdo a la Sociedad Internacional para el Avance de la Kinantropometría (ISAK). La actividad física (AF) se evaluó con los cuestionarios de Godin, Shepard y los hábitos de AF (montar en bicicleta y desplazarse a pie) con el de Baecke. La normalidad de los datos con la prueba Kolmogorov-Smirnov y Levene, y se aplicaron las pruebas Anova y Duncan para análisis cuantitativos y cualitativos. Se consideró significativo un valor de p<0,05. La actividad física aumentó significativamente con la edad en varones y presentó una significación marginal en mujeres, siendo las puntuaciones superiores en el primer grupo. Las diferencias entre categorías Godin (intensa, moderada y leve) fueron significativas para todos los indicadores antropométricos excepto para el índice cintura muslo en varones y la razón tronco/extremidad en mujeres. La influencia de los hábitos de AF en los indicadores antropométricos, varían de acuerdo al sexo. El test de Duncan mostró diferencias significativas entre las categorías de quienes practican“nunca/algunas veces” y “frecuentemente” en varones y mujeres, dependiendo de los índices considerados. El incremento de la AF tiene un efecto favorable en la disminución de la adiposidad total y relativa. Se destaca la importancia de estimularla a edades tempranas como factor protector de las enfermedades crónicas asociadas a la nutrición

Physical activity plays an important role influencing health. Objective: The aim of this study examined the links betweenphysical activity and indicators of adiposity and fat distribution by age, sex, and its frequency and intensity in 304 Venezuelan adolescents, ages 9-17. Anthropometric procedures employed adhere to the International Society for the Advancement ofKinanthropometry guidelines (ISAK). Physical activity by the Godin Shepard Leisure-time questionnaire, and bicycle/walking habits byBaecke questionnaire. Normality of the data was assessed by the Kolmogorof-Smirov test and the Anova variance analysis was used with Duncan test, when applicable for analysis of the quantitative and qualitative data. Significant differences were established as p<0.05. Physical activity exhibited positive changes according to age especially in boys with higher scores in this group. Significant differences for activity categories (strenuous, moderate, mild) were found for all indexes except for limb fat in boys and trunk to extremity skinfolds ratio in females. Duncan test elicited statistical significant differences between “never or sometimes” and “frequently” habitual physical activity for boys and girls depending on the indices considered. Influence of bicycle/ walking habits on anthropometric indicators vary with sex. Conclusions: Intensity of physical activity favors diminishing total and relative adiposity. Attention is called to the importance of stimulate physical activity at younger ages as a prevention factor to no communicable disease

Obesidad y circunferencia de la cintura en adolescentes madrileños / Obesity and waist circumference in teenagers in Madrid

El incremento de la obesidad infantil es marcado y prevé un futuro de trastornos relacionados, en la edad adulta de estos niños. El objetivo de este estudio es determinar la prevalencia de sobrepeso, obesidad y el exceso de grasa abdominal, en un grupo de adolescentes madrileños a partir de la valoración del Índice de Masa Corporal, la grasa corporal total y la circunferencia de la cintura. Se estudiaron 407 niños (183 niñas, 224 niños), entre 13 y 17 años de edad, alumnos de centros educativos de la Comunidad de Madrid durante el año 2005. Se realizó la evaluación antropométrica a través del peso, la estatura, la circunferencia de la cintura y los pliegues cutáneos de grasa. De acuerdo al Índice de Masa Corporal se observó que el 18,2 por ciento de los niños y el 24,1 por ciento de las niñas se clasificaron en las categorías de sobrepeso y obesidad. La circunferencia de la cintura aumentó de forma significativa con la edad en el sexo masculino, en ambos sexos cifras altas de este indicador aparecieron acompañadas de sobrepeso y obesidad, tendencia más marcada en el sexo femenino; entre las adolescentes los valores de los indicadores de adiposidad llegaron en algunas edades a superar los valores considerados de riesgo para la población adulta. La detección precoz de estos problemas constituye un elemento importante para la prevención de la morbilidad y la mortalidad de la población adulta.

The rise of infant obesity is marked and foresees a future of related disorders at the adult age of these kids. The objective of this study was to determine the prevalence of overweight, obesity and excessive abdominal fat in a group of teenagers living in Madrid, taken as a basis the assessment of the body mass index, the total body fat and the waist circumference. Four hundred and seven teenagers (183 girls, 224 boys) aged 13 to 17 years, who studied in educational centers of the Community of Madrid, were studied in 2005. The anthropometric evaluation took into account weight, size, waist circumference and skin folds. According to the Body Mass Index, it was observed that 18,2 percent of boys and 24,1 percent of girls were classified into the categories of overweight and obesity. Waist circumference significantly increased with the age in males; high values of this indicador can be seen in both sexes accompanied by overweight and obesity. The tendency is more acute in females since adiposity indicator values even exceed at some ages the risk values considered for the adult population. The early detection of these problems constitutes an important element for the prevention of morbidity and mortality in the adult population.