Comparative analysis of anthropometric indicators for diagnosing obesity and predicting cardiometabolic risk in Mexican adolescents.

Introduction: Introduction: obesity is a cardiometabolic risk (CMR) factor in adolescents. It represents a public health problem that requires simple diagnostic strategies based on the determination of anthropometric indicators (AIs) such as body mass index (BMI), waist circumference (WC), conicity index (CONI), waist-to-height ratio (WHtR), and body fat percentage (BFP). The purpose of the current contribution was to analyze the utility of the aforementioned AIs for evaluating obesity as a CMR factor in Mexican adolescents. Materials and methods: the design of the study is descriptive and cross-sectional. Nutritional status was established by using various AIs and as a CMR factor under the criteria of WHtR. Participating in the present investigation were 2,000 adolescents from 15 to 17 years of age, of which 1,079 (53.9 %) were female and 921 (46.1 %) were male. All were high school students in Tuxtla Gutiérrez, Chiapas, Mexico. Results and conclusion: the prevalence of obesity was influenced by gender. With the WHtR and BFP, male students exhibited a greater prevalence of obesity, while with the BMI and CONI, the percentage of obesity was similar between the two genders. BMI was significantly correlated with BFP, WC and WHtR, and was one of the AIs with the greatest area under the curve, showing a good capacity to predict cardiometabolic risk. BMI is a simple and adequate tool for diagnosing obesity and predicting CMR in adolescents.

Introducción: Introducción: la obesidad es un factor de riesgo cardiometabolico (RCM) en los adolescentes y representa un problema de salud pública que requiere estrategias diagnosticas sencillas, basadas en la determinación de indicadores antropométricos (IA) como el índice de masa corporal (IMC), la circunferencia de la cintura (CC), el índice de conicidad (ICONI), el índice de cintura-talla (ICT) y el porcentaje de grasa corporal (PGC). El propósito del presente estudio fue analizar la utilidad de diversos IA (IMC, CC, ICONI, ICT y PGC) para evaluar la obesidad como factor de RCM en adolescentes mexicanos. Materiales y métodos: el diseño del estudio fue descriptivo y transversal. Se analizó el estado nutricional mediante varios IA y el factor de RCM bajo los criterios del ICT. Este estudio fue conducido en 2000 adolescentes de entre 15 y 17 años, de los cuales 1079 (53,9 %) eran mujeres y 921 (46,1 %) varones, todos ellos estudiantes de nivel medio superior de Tuxtla Gutiérrez, Chiapas, México. Resultados y conclusión: la prevalencia de la obesidad estuvo influenciada por el género: los varones presentaron una mayor prevalencia de obesidad con ICT y PGC, mientras que con IMC e ICONI, el porcentaje de obesidad fue similar entre ambos géneros. El IMC se correlacionó significativamente con el PGC, la CC y el ICT, y fue uno de los IA con mayor área bajo la curva, mostrando una buena capacidad para predecir el RCM. El IMC representa una herramienta sencilla y adecuada para el diagnóstico de obesidad y predecir el RCM en adolescentes.

Association of anthropometric indicators to evaluate nutritional status and cardiometabolic risk in Mexican teenagers.

INTRODUCTION: Introduction: anthropometric indicators (AIs) such as waist circumference (WC), body mass index (BMI), waist/hip index (WHpI), waist/height index (WHtI) and body fat percentage (BFP) are useful tools for the diagnosis of nutritional status (NS) in adolescents. Each of these parameters has advantages and disadvantages. The purpose of the present study was to analyze the association of these AIs (WC, BMI, WHpI, WHtI, and BFP) to evaluate nutritional status and estimate the cardiometabolic risk (CMR) in Mexican adolescents. Material and method: in a cross-sectional descriptive study, the NS was analyzed through various AIs and CMR with the WHtI criteria. Nine hundred and seventeen adolescents between 15 and 17 years old participated in the study, of whom 488 (52.9%) were female and 429 (47.1%) male, all students of middle school in Tuxtla Gutiérrez, Chiapas, Mexico. Results and conclusion: women presented a higher prevalence of obesity according to most indicators. The WHtI was the parameter that detected the highest prevalence of obesity (31%), correlating with the BMI and the BFP. Moreover, there was evidence of a significant relation between NS (assessed by all the anthropometric indicators) and CMR. The WHtI could be considered as an adequate tool for the diagnosis of obesity associated with CMR in adolescents.

INTRODUCCIÓN: Introducción: los indicadores antropométricos (IA) como la circunferencia de cintura (CC), el índice de masa corporal (IMC), el índice cintura/cadera (ICC), el índice cintura/talla (ICT) y el porcentaje de grasa corporal (PGC) son herramientas útiles para el diagnóstico del estado nutricional (EN) en los adolescentes. Sin embargo, cada uno de estos IA presentan ventajas y desventajas. El propósito del presente estudio fue analizar la asociación de los IA (IMC, CC, ICC, ICT y PGC) para evaluar el EN y estimar el riesgo cardiometabólico (RCM) en adolescentes mexicanos. Material y método: el diseño del estudio fue descriptivo transversal. Se analizó el EN a través de diversos IA y el RCM bajo los criterios de ICT. Este estudio fue conducido en 917 adolescentes de entre 15 y 17 años, de los cuales 488 (52,9%) eran mujeres y 429 (47,1%) varones, todos estudiantes de nivel medio superior de Tuxtla Gutiérrez, Chiapas, México. Resultados y conclusión: las mujeres presentaron mayor prevalencia de obesidad con la mayoría de los IA utilizados. El ICT fue el IA que detectó mayor prevalencia de obesidad (31%), correlacionándose con el IMC y el PGC. Además, se evidenció una asociación significativa entre el EN valorado por todos los IA y el RCM. El ICT podría ser considerado como una herramienta adecuada para el diagnóstico de obesidad asociada a RCM en adolescentes.

[Evaluation of the nutritional status of children under 5 years of age: concordance between anthropometric indices in the indigenous population of Chiapas (Mexico)]. / Evaluación del estado nutricional en menores de 5 años: concordancia entre índices antropométricos en población indígena de Chiapas (México).

INTRODUCTION: Nutritional status is determined through various methods, including anthropometry. In children under 5 years of age indeces as weight/age (w/a), height/age (h/a), weight/height (w/h) and body mass index (BMI) are used. The purpose of this article is to analyze and compare the ability of different anthropometric indeces to identify children from marginalized communities in Chiapas (Mexico) with nutritional problems. OBJECTIVE: To analyze the correlation among the different anthropometric indeces to determine the nutritional status of children under 5 years of age in poor rural areas with a background of short stature. METHODS: Cross-sectional study in 1,160 children under 5 years of age in 13 high poverty communities in three regions of Chiapas. The variables studied were age, sex, weight and height. Nutritional status was determined through the indeces w/a, h/a, w/h and BMI. Field staff in charge of taking measurements of weight and height were trained and standardized. Kappa coefficients for agreement between the indeces were calculated. RESULTS: No correlation between BMI and w/a and h/a was found. The prevalence of malnutrition according to h/a was 64.8%. Only high concordance (0.726) between BMI and w/h was found. BMI showed a low prevalence of malnutrition and a higher prevalence of overweight and obesity rates. CONCLUSIONS: For a reliable and accurate diagnosis in individuals with a background of chronic malnutrition, it is recommended to use the four indeces together. Doing so it will reduce the risk of underestimating or overestimating nutritional status and will focus actions toward addressing and improving the health and nutrition of children living under extreme poverty conditions.

INTRODUCCIÓN: el estado nutricional se determina a través de diferentes métodos, entre ellos el antropométrico. En niños menores de 5 años se utilizan índices como peso para la edad (P/E), talla para la edad (T/E), peso/talla (P/T) e índice de masa corporal (IMC). El propósito del presente artículo es analizar y comparar la capacidad de los distintos índices antropométricos para identificar problemas nutricionales en niños de comunidades marginadas de Chiapas, México. OBJETIVO: analizar la concordancia entre los diferentes índices antropométricos para determinar el estado nutricional de niños menores de5 años de edad en áreas rurales pobres con antecedentes de baja talla. MÉTODOS: estudio transversal en 1.160 niños menores de 5 años de edad en 13 comunidades de alta marginación de tres regiones de Chiapas. Las variables estudiadas fueron edad, sexo, peso y talla. Se determinó la prevalencia del estado nutricional a través de los índices P/E, T/E, P/T e IMC. El personal de campo que realizó las mediciones de peso y talla fue capacitado y estandarizado. Se calculó el coeficiente de Kappa para analizar la concordancia entre los índices. RESULTADOS: no se encontró concordancia entre el IMC y P/E, T/E. La prevalencia de desnutrición según T/E fue de 64,8%. Solo se encontró concordancia alta (0,726) entre IMC y peso/talla. El IMC arrojó una prevalencia baja de desnutrición y una mayor prevalencia de sobrepeso y obesidad que los índices P/E y T/E. CONCLUSIONES: para un diagnóstico confiable y preciso en la población con antecedentes de desnutrición crónica se recomienda utilizar los cuatro índices de manera conjunta. Para no subestimar ni sobreestimar su estado nutricional y focalizar las acciones de atención a la mejora del estado de salud y nutrición de los niños que viven en condiciones de pobreza extrema.

Are there changes in the nutritional status of children of Oportunidades families in rural Chiapas, Mexico? A cohort prospective study.

BACKGROUND: In Mexico, despite that the fact that several social programs have been implemented, chronic undernutrition is still a public health problem affecting 1.5 million children of <5 years. Chiapas ranks first in underweight and stunting at national level with a stunting prevalence of 31.4 % whereas for its rural population is 44.2 %. The purpose of this paper is to determine if the nutritional status of a cohort of children living in poor rural communities under Oportunidades has changed. We were interested in assessing the nutrition evolution of the children who were initially diagnosed as stunted and of those who were diagnosed as normal. Oportunidades is an anti-poverty program of the Mexican government consisting mainly in monetary transfers to the families living in alimentary poverty. METHODS: A 9-year cohort prospective study was conducted with nutritional evaluations of 222 children. Anthropometric indices were constructed from measurements of weight, height, and age of the children whose nutritional status was classified following WHO standards. RESULTS: The results showed that although these children were Oportunidades beneficiaries for 9 years and their families improved their living conditions, children still had a high prevalence of stunting (40.1 %) and 69.6 % had not recovered yet. Children who were initially diagnosed with normal nutritional status and became stunted 2 years later had a higher risk (relative risk (RR) 5.69, 2.95-10.96) of continuing stunted at school age and adolescence. CONCLUSIONS: Oportunidades has not impacted, as expected, the nutritional status of the study population. These findings pose the question: Why has not the nutritional status of children improved, although the living conditions of their families have significantly improved? This might be the result of an adaptation process achieved through a decrease of growth velocity. It is important to make efforts to watch the growth of the children during their first 3 years of age, to focus on improving the diet of women at fertile age and pay special attention to environmental conditions to break the vicious cycle of malnutrition.

[Nutritional status of two generations of brothers and sisters <5 years of age beneficiaries from opportunities living in marginalized rural communities in Chiapas, Mexico]. / ESTADO NUTRICIO DE DOS GENERACIONES DE HERMANOS(AS) < DE 5 AÑOS DE EDAD BENEFICIARIOS(AS) DE OPORTUNIDADES, EN COMUNIDADES RURALES MARGINADAS DE CHIAPAS, MÉXICO.

UNLABELLED: Mexico, in recent decades, has developed several programs to eradicate the problem of infant malnutrition <5 years, primarily among those living in rural and indigenous areas. However, there is insufficient evidence on these programs' impact on child health and nutrition. OBJECTIVE: To describe the nutritional changes of two generations of brothers and sisters living in rural communities of Chiapas and who are Oportunidades beneficiaries. METHODS: Cross-sectional study. It was determined: underweight, stunting, wasting and overweight plus obesity. Older brothers and sisters were evaluated in 2002-2003, for 2010-2011 younger brothers and sisters were evaluated, both groups were <5 years of age at the time of data collection. RESULTS: Malnutrition, in its three types is a problem. 43.4% of brothers and sisters evaluated in 2010-2011 showed stunting, underweight prevalence declined from 18% to 13.2%, wasting (low weight for height) increased from 8.1% to 10.4%. Overweight and obesity increased significantly by 12 percentage points among brothers and sisters, from 24.8% in 2002-2003 to 36.8% in 2010-2011. Malnutrition among male children is lower than their brothers and sisters from the 2002-2003 generation (stunting p=<0.05), overweight and obesity was 10.9 percentage points higher than their brothers and sisters (26.4% to 37.3%). CONCLUSION: Children beneficiaries from Opportunities have not yet overcome chronic malnutrition problems. This study shows that there is not a clear impact in improving the nutritional status of the study population.

En México, en las últimas décadas se han desarrollado varios programas para erradicar el problema de la desnutrición en infantes < de 5 años, principalmente de aquellos que viven en áreas indígenas y rurales. No obstante, no existe suficiente evidencia sobre su impacto en la salud y la nutrición infantil. Objetivo: describir los cambios nutricionales de dos generaciones de hermanos(as) que han sido beneficiados por el programa Oportunidades en comunidades rurales de Chiapas. Métodos: estudio transversal. Se determinó: bajo peso, baja talla, emaciación y SP + O (Sobrepeso más Obesidad). Los hermanos(as) mayores fueron evaluados en los años 2002-2003, para el 2010-2011 se evaluaron a los hermanos( as) menores, ambos grupos eran < de 5 años de edad en el momento de conseguir la información. Resultados: la desnutrición en sus tres formas es un problema, 43,4% de los hermanos(as) evaluados(as) en 2010-2011 presentaron baja talla, la prevalencia de bajo peso disminuyó de 18% a 13,2%, la emaciación (peso bajo para la talla) aumentó de 8,1% a 10.4%. El SP + O aumentó significativamente 12 puntos porcentuales entre los hermanos(as) de 24,8% en 2002-2003 a 36,8% en 2010-2011. La desnutrición en los niños (varones) es menor que la de sus hermanos de la generación de 2002- 2003 (baja talla p =.

Evaluación nutricional y sensorial de un alimento a base de atún y soya enriquecido con vitaminas y minerales / Nutritional and sensorial evaluation of a food with tuna and soya enriched with vitamins and minerals

The objective of this research was to determine the nutritional and sensorial impact of a food with tuna and soya enriched with vitamins and minerals in pre-school children of three communities of Chiapas, Mexico. It is a study of nutritional intervention with a cohorte of six months. The nutritional state of children was determined previuos to the nurishing complement, to the half and at the end of this. The sample was conformed with the children who presented undernourishment problems; they were fed during six months. The level of acceptability of the food was determined with the children in pre-school age of the three communities. Significant evidences (p<0.05) of the high level of acceptability of the food, when comparing the obtained nutritional state at the beginning, half and at the end of the study were detected. Improvement on the health state was observed, when their severe malnutrition normalized.

El objetivo de este estudio fue determinar el impacto nutricional y sensorial de un alimento a base de atún y soya enriquecido con vitaminas y minerales en preescolares de tres comunidades de Chiapas, México. Estudio de intervención nutricional con una cohorte de seis meses. Se determinó el estado nutricional de los niños previo a la alimentación, a la mitad y al final de ésta; la muestra se conformó con los niños que presentaron problemas de desnutrición inicialmente; a los que se les complementó la alimentación durante seis meses. Se determinó el nivel de agrado del producto, con niños de las tres comunidades. Se encontraron evidencias significativas (p<0.05) de un alto nivel de agrado del alimento, al comparar el estado nutricional obtenido al inicio, a la mitad y al final del estudio, se observó mejoras en el estado salud de los niños, al pasar de desnutrición severa o grave a normal.