Mother's smoking habits affects IL10 methylation but not asthma in Ecuadorian children.

There is no evidence evaluating the IL10 epigenetic upregulation among mestizo children in a high-altitude Andean city in Latin America. OBJECTIVE: To identify polymorphisms and methylation profiles in the IL10 gene associated with asthma in children aged 5 to 11. METHODS: A case-control study was conducted with asthmatic and non-asthmatic children aged 5 to 11 years in Cuenca-Ecuador. Data on allergic diseases and risk factors were collected through a questionnaire for parents. Atopy was measured by skin prick test (SPT) to relevant aeroallergens. Three IL10 single nucleotide polymorphisms were evaluated in all participants, and methylation analysis was performed in 54 participants. Association between risk factors, allergic diseases and genetic factors were estimated using multivariate logistic regression. RESULTS: The results of polymorphisms showed no differences between cases and controls when comparing the SNPs rs3024495, rs3024496, rs1800896 allelic and genotypic frequencies. In the methylation analysis, no differences in the IL10 methylation profile were found between cases and controls; however, the multivariate analysis showed an association between the mother's smoking habits and the IL10 methylation profile. CONCLUSION: Smoking habit could be essential as an environmental exposure factor in regulating gene expression in children with asthma.

Unhealthy food consumption among Ecuadorian children: A cross-sectional study in the context of the school food regulation / Consumo de alimentos poco saludables en niños ecuatorianos: estudio transversal en el contexto del reglamento de alimentación escolar

Introduction. The intake of energy-dense unhealthy food at school could influence the overall energy intake of children. Objective: To characterize the patterns of buying a snack at school and to analyze the association of these patterns with the source of the school snack (brought from home or bought at school) and screen time. Materials and methods: A cross-sectional study was conducted from October 2018 until May 2019 among school children (9 to 12-year-olds) from Cuenca-Ecuador. Intake of energy-dense unhealthy food groups, the source of the school snack, and screen time were assessed using questionnaires. Multiple correspondence analysis was used to identify intake patterns of unhealthy food groups, and logistic regression to assess the association between intake of energy-dense unhealthy food groups (FG) with the school snack source. Results: Among 1,028 children recruited 63%, 42%, 30% and 22% of the children reported consuming sweets/confiture, savory snacks, fast food, and pastry products, respectively, at least two days per week. Around 39% of the children were classified as "Frequent consumers of energy-dense unhealthy FG". Buying the snack at school was associated with a more frequent intake of sweets/confiture (OR=1.56, CI 95% =1.05-2.32) and fast food (OR=2.01, CI 95% =1.15-3.50) during the week, as well as with being classified in the "frequent consumer of energy-dense unhealthy FG" (OR=1.99, 95% CI=1.40-2.82). Conclusions: Ecuadorian children still consume prohibited unhealthy foods at school. These results reinforce the importance of evaluating, monitoring, and adapting strategies to promote a balanced diet(AU)

Introducción. La ingesta de alimentos poco saludables con alto contenido energético en la escuela podría influir en la ingesta energética total de los niños. Objetivo: Caracterizar los patrones de compra de snacks en el colegio y analizar la asociación de estos patrones con la procedencia del snack escolar (de la casa o comprada en el colegio) y el tiempo de pantalla. Materiales y métodos: Se realizó un estudio transversal (octubre 2018-mayo 2019) en escolares (9-12 años) Cuenca- Ecuador. La ingesta de grupos de alimentos (FG) no saludables altos en energía, la fuente del snack escolar y el tiempo de pantalla se evaluaron mediante cuestionarios. Se utilizó análisis de correspondencias múltiples para identificar patrones de ingesta de FG poco saludables y la regresión logística para evaluar asociación entre la ingesta FG no saludables con la fuente del snack escolar. Resultados: En 1.028 niños 63%, 42%, 30% y 22% declararon consumir dulces/golosinas, aperitivos salados, comida rápida y productos de pastelería, respectivamente, al menos dos/días/ semana. Un 39% fueron clasificados como "Consumidores frecuentes de FG poco saludables de alta densidad energética". La compra de los snacks en el colegio se asoció con una ingesta más frecuente de dulces/golosinas (OR=1,56; IC95%=1,05-2,32) y comida rápida (OR=2,01; IC95%=1,15-3,50) durante la semana y con la clasificación en el grupo" consumidores frecuentes de FG poco saludables de alta densidad energética" (OR=1,99; IC95%=1,40- 2,82). Conclusiones: Los niños ecuatorianos aún consumen alimentos no saludables prohibidos en la escuela. Estos resultados refuerzan la importancia de evaluar, monitorear y adaptar estrategias para promover una dieta balanceada(AU)

Síndrome de Intestino Irritable en personal de enfermería de un Hospital de Cuenca-Ecuador / Irritable Bowel Syndrome in nursing staff at a hospital in Cuenca-Ecuador

INTRODUCCIÓN: El síndrome de intestino irritable (SII) es un trastorno funcional digestivo frecuente en personal de salud, con importantes repercusiones en la calidad de vida, en el trabajo, en el sistema de salud y la sociedad. El objetivo del presente estudio fue determinar la frecuencia de reporte del SII y sus subtipos en los historiales médicos del personal de enfermería de un hospital en Cuenca - Ecuador. MATERIALES Y MÉTODOS: Estudio descriptivo, transversal, en una muestra aleatoria de trabajadores del área de enfermería del José Carrasco Arteaga de Cuenca-Ecuador, entre junio 2017-abril 2018. De acuerdo con los criterios de Roma III, se valoraron los historiales médicos de los trabajadores para determinar la frecuencia de SII y sus subtipos. Finalmente, se describieron los factores sociodemográficos, laborales y psicológicos del personal de enfermería. RESULTADOS: Fueron evaluados los historiales médicos de 214 miembros del personal de enfermería (media de edad: 38.7±10.4 años, sexo: 95.3% de mujeres). Se encontró diagnóstico de SII en el 7.0% (15/214) del personal evaluado, siendo los subtipos indeterminado (7/15) y mixto (4/15) los más frecuentes. El 20% del personal del área de enfermería con SII tenía trastornos mentales (ansiedad, depresión y/o distimia) y el mismo porcentaje trabajaban por turnos CONCLUSIÓN: Los resultados obtenidos permiten evidenciar que el SII reportado en historiales médicos de personal de enfermería, en la ciudad de Cuenca-Ecuador, es menor a lo esperado (7%). Los subtipos de SII más frecuentes fueron el subtipo indeterminado, seguido del subtipo mixto.

BACKGROUND: Irritable bowel syndrome (IBS) is a common functional-digestive disorder in health personnel, with significant repercussions on life quality, work, healthcare system and society. The aim of this study was to determine the frequency of reported IBS and its subtypes in the nursing staffs' medical records of a public hospital, in Cuenca - Ecuador. METHODOLOGY: A cross-sectional, descriptive study, with a randomized sample of nursing workers of Hospital Jose Carrasco Arteaga, Cuenca- Ecuador; between June 2017 and April 2018. According to Rome III criteria, medical records were assessed looking for IBS diagnosis and the subtype. Finally, sociodemographic, occupational and psychological factors among the nursing staff was also described. RESULTS: Two-hundred and fourteen medical records were evaluated (average age: 38.7 ± 10.4 years, 95.3% women). A diagnosis of IBS was found in 7.0% (15/214) of the personnel evaluated. The most frequent IBS subtypes were undetermined (46.7%, 7/15) and mixed (26.7%, 4/15). Twenty percent of the nursing staff with IBS, had mental disorders diagnosis (anxiety, depression and/or dysthymia), the same percent worked shifts. CONCLUSION: The diagnosis of IBS reported in the nursing staff medical records, in Cuenca- Ecuador was lower than expected (7%). The most frequent IBS subtypes were undetermined subtype, followed by mixed subtype.

Food allergy, airborne allergies, and allergic sensitisation among adolescents living in two disparate socioeconomic regions in Ecuador: A cross-sectional study.

BACKGROUND: Allergic diseases are under-investigated and overlooked health conditions in developing countries. We measured the prevalence of food allergy (FA), airborne allergic disease, and allergic sensitisation among adolescents living in 2 socio-demographically disparate regions in Ecuador. We investigated which risk factors are associated with these conditions. METHODS: A cross-sectional study involved 1338 students (mean age: 13 ± 0.9 years old) living in Cuenca (n = 876) and Santa Isabel (n = 462). History of allergic symptoms (noted by parents or doctor) to food, house dust mites (HDM), pollen, and pets were recorded. Sociodemographic characteristics, environmental exposures, and parental history of allergic disorders data were collected. Sensitisation to 19 food and 20 aeroallergens was measured by skin-prick testing (SPT). FA and airborne allergic diseases (to HDM, pollen, cat, or dog) were defined as a report of allergic symptoms noted by doctor, together with a positive SPT (wheal size ≥3 mm). Logistic regression models were used to identify environmental and parental factors associated with allergic conditions. RESULTS: FA was prevalent among 0.4% (95% CI 0.2%-0.9%), and food sensitisation among 19.1% of the adolescents. Shrimp was the most frequent food linked with FA and food sensitisation. Risk factors associated with FA could not be evaluated due to the low prevalence. Food sensitisation was higher among adolescents exposed to family smoking (OR 1.63, 95% CI 1.14-2.34, p = 0.008) and those with parental history of allergic disorders (OR 1.68, 95% CI 1.13-2.49, p = 0.01), but less common among adolescents owning dogs (OR 0.59, 95% CI 0.41-0.84, p = 0.003).Airborne allergic diseases were prevalent amongst 12.0% of the adolescents (95% CI: 10.4-13.9, n = 1321), with HDM as the primary allergen (11.2%). Airborne allergic diseases were less common among adolescents with more siblings (OR 0.79, 95% CI 0.65-0.96, p = 0.02) and those who lived with farm animals in the first year of life (OR 0.47, 95% CI 0.23-0.95, p = 0.04), but, most common among adolescents with a smoking family (OR 1.67, 95% CI 1.04-2.70, p = 0.03) and with a parental history of allergic disorders (OR self-perceived: 2.62, 95% CI 1.46-4.71, p = 0.001; OR diagnosed by a doctor: 4.07, 95% CI 2.44-6.80, p < 0.001). CONCLUSIONS: FA and airborne allergies are less prevalent in Ecuador than in developed regions; there is a great dissociation between the prevalence of allergic disease and allergic sensitisation. Shrimp and HDM were the most prevalent allergens. Risk factors identified in this study to be related to allergic diseases should be considered by physicians, health practitioners, and epidemiologists in Ecuador.

Estudio Transversal: Factores de Riesgo para Alergia Alimentaria en Adolescentes de Cuenca y Santa Isabel, Ecuador / Cross-Sectional Study: Risk Factors for Food Allergy in Adolescents from Cuenca and Santa Isabel, Ecuador

INTRODUCCIÓN: La alergia alimentaria en adolescentes ha sido asociada ampliamente con ciertos factores de riesgo. El objetivo de esta investigación fué determinar y comparar, entre adolescentes de Cuenca y Santa Isabel, la prevalencia de alergia alimentaria y la asociación con factores de riesgo demográficos, genéticos, medioambientales y clínicos determinados por autoreporte y test cutáneo. MÉTODO: Se realizó un estudio transversal en 1508 adolescentes de Cuenca (n=1008) y Santa Isabel (n=500) entre julio de 2013 y julio de 2014. Para determinar alergia alimentaria y sus factores de riesgo se aplicaron cuestionarios de autoreporte y de necesidades básicas insatisfechas, excepto para sensibilización a aeroalérgenos. Este factor de riesgo fue establecido por test cutáneo. Se emplearon modelos de regresión lineal para determinar las asociaciones entre alergia alimentaria y factores de riesgo. RESULTADOS: La prevalencia de alergia alimentaria (síntomas de alergia alimentaria autoreportada más test cutáneo positivo al menos a un alimento), para 1411 participantes con información completa, fue de 2.34 %; no se observó diferencias estadísticamente significativas entre las áreas de estudio (Cuenca: 2.31 % vs. Santa Isabel: 2.39 %; p: > 0.05). La rinoconjuntivitis fue el único factor de riesgo asociado con la alergia alimentaria. Los adolescentes que reportaron síntomas de rinoconjuntivitis fueron 5.4 % más propensos a presentar alergia alimentaria que reportaron (p: < 0.001). Ninguna otra interacción persistió estadísticamente significativa en el modelo de regresión lineal completo por lo que ningún resultado fue estratificado por cantón. CONCLUSIONES: La alergia alimentaria determinada por auto reporte y test cutáneo fue prevalente en los adolescentes de Cuenca y Santa Isabel. Para este grupo la rinoconjuntivitis fue el único factor de riesgo relacionado con alergia alimentaria, denotando una predisposición genética a presentar enfermedades alérgicas. La rinoconjuntivitis incrementó un 5.4 % la probabilidad de padecer alergia alimentaria para los adolescentes de las regiones estudiadas.

BACKGROUND: Food allergy in adolescents has been widely associated with risk factors. The aimofthis investigation was determined, among adolescents of Cuenca and Santa Isabel, the prevalence of food allergy and its association with reported risk factors determined by self-report and skin prick test. METHODS: A cross-sectional study was developed in 1508 adolescents (n = 1008) of Cuenca and Santa Isabel (n = 500), between July 2013 and July 2014. To define food allergy and risk factors of food allergy self-reported and unsatisfied basic needs questionnaires were applied. Aeroallergen sensitization was determined by skin prick test with aeroallergens. Linear regression models were applied to determine the associations between food allergy and factors risks. RESULTS: The prevalence of food allergy (self-reported allergy symptoms and positive skin prick test to at least one food), for 1411 participants with complete information was 2.34 %. Do not was observed statistically significant differences between the study areas (2.31%Cuenca vs. 2.39%in Santa Isabel; p > 0.05). Rhino-conjunctivitis was the only risk factors associated. Adolescents who self-reported rhino-conjunctivitis were 5.4 % more likely to have food allergy than adolescents who not reported it (p: < 0.001). No other statistically significant interaction persisted in the full linearregression model so result no was stratified by canton. CONCLUSIONS: Food allergy determined by skin testwas prevalentin adolescents ofCuenca and Santa Isabel. Rhinoconjunctivitis forthis group was the only risk factor associated with food allergy, denoting a genetic predisposition to develop allergic diseases. Rhinoconjunctivitis increased 5.4 % chance of developing the food allergy for adolescents in the regions studied.

Evaluación del Consumo de Macronutrientes, Sodio, Calcio y Azúcares Añadidos de Acuerdo A las Recomendaciones de la Oms en Adolescentes de 9 A 18 Años de Cuenca y Nabón / Evaluation of Macronutrient Intake, Sodium, Calcium and Added Sugars According to WHO Recommendations in Adolescents 9 to 18 Years of Cuenca and Nabon

Antecedentes: La adolescencia es un periodo de crecimiento acelerado en donde se producen una serie de cambios físicos, lo que origina una mayor demanda de necesidades nutricionales, tanto de energía como de carbohidratos, proteínas, grasas, vitaminas y minerales. Estas características condicionan la posibilidad de producirse deficiencias nutricionales en esta edad si la ingesta no es la adecuada.Objetivo: El objetivo de este estudio es evaluar el con-sumo de macronutrientes, sodio, calcio y azúcar añadido en adolescentes de Cuenca y Nabón de acuerdo a las recomendaciones establecidas por la OMS. Materiales y Método: Un estudio descriptivo transversal fue realizado desde enero 2008 hasta abril 2009 en 765 adolescentes de 8vo, 9no y 10mo de educación básica de Cuenca y Nabón (Ecuador). La recolección de la ingesta dietaria fue mediante recordatorio de 24 horas aplicado en 2 días no consecutivos. Se utilizó el Software Lucille 0.1 para el ingreso y el cálculo de la ingesta de alimentos. El análisis de los datos fue realiza-do mediante el programa estadístico STATA 12, donde se determinó el consumo diario de nutrientes ajustado para la energía total y se calculó el porcentaje de adolescentes que cumple con las recomendaciones de la OMS. resultados: La ingesta de carbohidratos (80%), grasas (76%) y proteínas (67%), en la mayoría de los adolescentes se encuentran dentro del rango recomendado por la OMS; sin embargo, en el caso del consumo de sodio y azúcar añadido, los valores de más de la mitad de los adolescentes están por encima de las recomendaciones. Así también, solo alrededor del 1% de la población estudiada cumple con los requerimientos diarios de consumo de calcio. Conclusión: Esta población de adolescentes presenta un desequilibrio en la ingesta dietética, especialmente de micronutrientes y azúcar añadido. Por lo que se ven necesarios programas de intervención en alimentación saludable y prevención de la obesidad e hipertensión sobre todo en las instituciones educativas.

Objective: The objective of this study is to evaluate the intake of macronutrients, sodium, calcium and added sugar in adolescents of Cuenca and Nabón according to the recommendations established by the WHO. Materials and Method: A cross-sectional descriptive study was conducted from January 2008 to April 2009 in 765 adolescents from 8th, 9th and 10th grade basic education in Cuenca and Nabón (Ecuador). The collec-tion of dietary intake was through a reminder of 24-hours that was applied in 2 non-consecutive days. The Softwa-re Lucille 0.1 was used for the intake and calculation of ingested food. Data analysis was performed using the statistical program STATA 12, which determined the daily intake of nutrients that were adjusted for the total energy and calculated according to the percentage of adolescents that follows the WHO recommendations.rEsults: The intake of carbohydrates (80%), fats (76%) and proteins (67%) in most adolescents are within the range recommended by the WHO; however, in the case of consumption of sodium and added sugar, the values of more than half of adolescents are above re-commendations. Thus, only about 1% of the population studied meets the daily requirements of calcium con-sumption. Conclusion: This population of adolescents presents an imbalance in dietary intake, especially of micronu-trients and added sugar. Therefore, intervention pro-grams in healthy eating and prevention of obesity and hypertension are necessary especially in educational institutions.

School-based intervention on healthy behaviour among Ecuadorian adolescents: effect of a cluster-randomized controlled trial on screen-time.

BACKGROUND: Effective interventions on screen-time behaviours (television, video games and computer time) are needed to prevent non-communicable diseases in low- and middle-income countries. The present manuscript investigates the effect of a school-based health promotion intervention on screen-time behaviour among 12- to 15-year-old adolescents. We report the effect of the trial on screen-time after two stages of implementation. METHODS: We performed a cluster-randomised pair matched trial in urban schools in Cuenca-Ecuador. Participants were adolescents of grade eight and nine (mean age 12.8 ± 0.8 years, n = 1370, control group n = 684) from 20 schools (control group n = 10). The intervention included an individual and environmental component tailored to the local context and resources. The first intervention stage focused on diet, physical activity and screen-time behaviour, while the second stage focused only on diet and physical activity. Screen-time behaviours, primary outcome, were assessed at baseline, after the first (18 months) and second stage (28 months). Mixed linear models were used to analyse the data. RESULTS: After the first stage (data from n = 1224 adolescents; control group n = 608), the intervention group had a lower increase in TV-time on a week day (ß = -15.7 min; P = 0.003) and weekend day (ß = -18.9 min; P = 0.005), in total screen-time on a weekday (ß = -25.9 min; P = 0.03) and in the proportion of adolescents that did not meet the screen-time recommendation (ß = -4 percentage point; P = 0.01), compared to the control group. After the second stage (data from n = 1078 adolescents; control group n = 531), the TV-time on a weekday (ß = 13.1 min; P = 0.02), and total screen-time on a weekday (ß = 21.4 min; P = 0.03) increased more in adolescents from the intervention group. No adverse effects were reported. DISCUSSION AND CONCLUSION: A multicomponent school-based intervention was only able to mitigate the increase in adolescents' television time and total screen-time after the first stage of the intervention or in other words, when the intervention included specific components or activities that focused on reducing screen-time. After the second stage of the intervention, which only included components and activities related to improve healthy diet and physical activity and not to decrease the screen-time, the adolescents increased their screen-time again. Our findings might imply that reducing screen-time is only possible when the intervention focuses specifically on reducing screen-time. TRIAL REGISTRATION: Clinicaltrials.gov identifier NCT01004367.