Variations in estimates of underweight, stunting, wasting, overweight and obesity in children from Argentina comparing three growth charts.

OBJECTIVE: To compare estimates of underweight, stunting, wasting, overweight and obesity based on three growth charts. DESIGN: Cross-sectional study to estimate weight-for-age, length/height-for-age and weight-for-height comparing the 2006 WHO Child Growth Standards ('the WHO standards'), the 1977 National Center for Health Statistics (NCHS) international growth reference ('the NCHS reference') and the 1987 Argentine Pediatric Society Committee of Growth and Development reference ('the APS reference'). Cut-off points were defined as mean values ±2 s d. Epi-Info software version 6·0 (Centers for Disease Control and Prevention) was used for statistical evaluations (χ 2, P ≤ 0·05). SETTING: Greater La Plata conurbation, Buenos Aires, Argentina. SUBJECTS: A total of 2644 healthy, full-term children from 0 to 5 years of age. RESULTS: Prevalence of underweight was higher with the WHO standards than with the other references up to the first 6 months. For the rest of the ages, prevalence was lower with the WHO standards. Stunting prevalence was higher with the WHO standards at all ages. Prevalence of wasting was higher with the WHO standards compared with the NCHS reference up to the first 6 months and lower at 2-5 years of age. Overweight and obesity prevalences were higher with the WHO standards at all ages. CONCLUSIONS: The new WHO standards appear to be a solid and reliable tool for diagnosis and treatment of nutritional diseases, also being the only one built with infants fed according to WHO recommendations. Therefore, our results support the decision of the National Ministry of Health about the utilization of the new WHO standards to monitor the nutritional status of Argentinean children aged less than 5 years.

[Comparison between references of the overweight and obesity prevalence, through the Body Mass Index, in Argentinean children]. / Comparación entre referencias de las prevalencias de sobrepeso y obesidad, estimadas a través del Indice de Masa Corporal, en niños de Argentina.

The evaluation of child nutritional status is highly dependent on the growth charts used. The aim of this study was to compare different references assessing overweight and obesity in children population, through the Body Mass Index. A total of 737 healthy children born at term, aged 2-5 years, were included (cross-sectional study). The participation was voluntary and consent. Body Mass Index (kg/m2) was estimated. The measurements techniques were based on national guidelines. We compared three references: (1) Centers for Disease Control and Prevention (CDC) (> Pc85: overweight; > Pc95: obesity; (2) International Obesity Task Force (IOTF) (sex-age-specific body mass index cut-offs); (3) World Health Organization (WHO) (+2 standard deviation: overweight; +3: obesity). The Epi Info 6.0 software was used to the statistical evaluation (chi2, p < or = .05%). The prevalence of overweight was 1.1 and 2.33 times higher in CDC application respect to the IOTF and the WHO references respectively. The prevalence of overweight was 2.1 times higher in IOTF application respect to the WHO references (p = .00001). The prevalence of obesity was 5.4 and 23.9 times higher in CDC application respect to the IOTF and the WHO references respectively. The prevalence of obesity was 4.4 times higher in IOTF application respect to the WHO references (p = .0000001). The prevalence of overweight and obesity, calculated through the BMI, differs substantially according to the reference and cut-off points used. In the absence of even a single criterion, each of the references should be used with care.

Protein-energy malnutrition contributes to increased structural chromosomal alteration frequencies in Argentinean children.

The relationship between protein-energy malnutrition and genetic damage has been studied in human beings and laboratory animals, but results are still conflicting. The aim of the present study was to assess the induction of structural chromosomal aberrations in peripheral blood lymphocytes of children with primary protein-energy malnutrition. A case-control study was performed. Samples were obtained from 25 primary malnourished infants (mean age, 22 months; range, 1-66 months). The control group consisted of 25 eutrophic children from the same population who were matched 1:1 by age and sex. Anthropometric and clinic evaluations were performed to assess nutritional condition. Before blood collection, we interviewed each individual's parent to complete a semi-structural survey specifying age, dietary habits, viral or bacterial diseases; previous exposure to diagnostic x-rays; and use of therapeutic drugs. After 48 hours, 100 cultured lymphocytes were analyzed per patient. Statistical analysis was performed using the Epi Dat 3.0 program (P < or = .05). The chromosomal aberration frequency was nearly 7 times higher in malnourished infants than in controls (14.61% vs 2.2%, respectively). This difference was statistically significant (P < .001) and may be explained by the occurrence of achromatic lesions, breaks, and telomeric associations. DNA damage could be attributed to several factors: severe deficiency of essential nutrients (ie zinc, iron, and vitamin A) required in the synthesis of DNA maintenance factors; deterioration of repair mechanisms allowing the persistence of an unusually high number of structural chromosomal aberrations; and/or the absence of specific factors needed to protect the cell against oxidative DNA damage.

Comparación entre referencias de las prevalencias de sobrepeso y obesidad, estimadas a través del índice de masa corporal, en niños de Argentina / Comparison between references of the overweight and obesity prevalence, through the body mass index, in Argentinean children

La evaluación de la situación nutricional de los niños, depende en gran medida de las curvas de crecimiento utilizadas. El objetivo de esta investigación es comparar las prevalencias de sobrepeso y obesidad estimadas con tres referencias internacionales en una población de niños, a través del Índice de Masa Corporal. Se incluyeron 737 niños/as nacidos de término sanos, de 2 a 5 años (estudio transversal). La Participación fue voluntaria y consentida. Se estableció el Índice de Masa Corporal (kg/m²). Las técnicas de medición se basaron en guías nacionales. Las referencias utilizadas fueron: 1. Centers for Disease Control and Prevention (CDC) (>Pc85: sobrepeso; > Pc95: obesidad); 2. International Obesity Task Force (IOTF) (valores límites sexo-edad específicos) y 3. Organización Mundial de la Salud (OMS) (+2 desvíos estándar: sobrepeso; >+3: obesidad). Los resultados fueron evaluados estadísticamente mediante el programa Epi Info 6.0 (χ², p < 0,05 por ciento). La prevalencia de niños con sobrepeso estimada con la referencia del CDC es 1,1 veces mayor que la de IOTF y 2,33 veces la de OMS y la de IOTF es 2,1 veces la de OMS (p= 0,00001). La prevalencia de niños con obesidad estimada con la referencia del CDC es 5,4 veces la de IOTF y 23,9 veces la de OMS, mientras que la de IOTF es 4,4 veces la de OMS (p= 0,0000001). Las prevalencias de sobrepeso y obesidad, difieren substancialmente de acuerdo a la referencia y valores límite utilizados. No existiendo aún un criterio único, cada una de las referencias debe utilizarse con precaución.

The evaluation of child nutritional status is highly dependent on the growth charts used. The aim of this study was to compare different references assessing overweight and obesity in children population, through the Body Mass Index. A total of 737 healthy children born at term, aged 2-5 years, were included (cross-sectional study). The participation was voluntary and consent. Body Mass Index (kg/m²) was estimated. The measurements techniques were based on national guidelines. We compared three references: (1) Centers for Disease Control and Prevention (CDC) (>Pc85: overweight; >Pc95: obesity; (2) International Obesity Task Force (IOTF) (sex-age-specific body mass index cut-offs); (3) World Health Organization (WHO) (+2 standard deviation: overweight; +3: obesity). The Epi Info 6.0 software was used to the statistical evaluation ((χ2, p≤ , 05 percent). The prevalence of overweight was 1,1 and 2,33 times higher in CDC application respect to the IOTF and the WHO references respectively. The prevalence of overweight was 2,1 times higher in IOTF application respect to the WHO references (p=, 00001). The prevalence of obesity was 5,4 and 23,9 times higher in CDC application respect to the IOTF and the WHO references respectively. The prevalence of obesity was 4,4 times higher in IOTF application respect to the WHO references (p=, 0000001). The prevalence of overweight and obesity, calculated through the BMI, differs substantially according to the reference and cut-off points used. In the absence of even a single criterion, each of the references should be used with care.