[Prevalence of metabolic syndrome in people 20 years old and more. Peru, 2005]. / Prevalencia del síndrome metabólico en personas a partir de 20 años de edad: Perú, 2005.

BACKGROUND: Cardiovascular diseases are the leading causes of mortality in Peruvian population. Metabolic syndrome contributes to this problem. This study aims to determine the prevalence metabolic syndrome (MS) in Peruvian adults. METHODS: 4053 representative Peruvian adults were evaluated, 2037 women and 2016 men older than 20 years old. Data from socioeconomically issues, clinical and laboratory exam were registered. Blood samples for biochemical analysis were taken from fasted subjects. The economical conditions of subjects were characterized by the unmet basic needs (UBN) method. Worldwide definition from the International diabetes federation (IDF) was considered to determine MS. RESULTS: The components of the MS on evaluated population was: 65.6% of abdominal obesity, 54.2% of decreased C-HDL, 30% of elevated triglycerides, 19.1% of arterial hypertension and 8% of hyperglycemias. Women show higher prevalence of abdominal obesity (81%, IC95%:77.6 - 85.3) compared with men (48.5%, IC95%: 44.5 - 52.5). The prevalence of MS was 25.8%, being 34.3% in women which is higher (p <0.05) than 16.6% in men. CONCLUSION: Abdominal obesity was more prevalent on Peruvian population. The risk of MS on Peruvian population increases gradually with age and decreases while poverty is accentuated.

Development and Validation of a Simple Risk Score for Undiagnosed Type 2 Diabetes in a Resource-Constrained Setting.

Objective. To develop and validate a risk score for detecting cases of undiagnosed diabetes in a resource-constrained country. Methods. Two population-based studies in Peruvian population aged ≥35 years were used in the analysis: the ENINBSC survey (n = 2,472) and the CRONICAS Cohort Study (n = 2,945). Fasting plasma glucose ≥7.0 mmol/L was used to diagnose diabetes in both studies. Coefficients for risk score were derived from the ENINBSC data and then the performance was validated using both baseline and follow-up data of the CRONICAS Cohort Study. Results. The prevalence of undiagnosed diabetes was 2.0% in the ENINBSC survey and 2.9% in the CRONICAS Cohort Study. Predictors of undiagnosed diabetes were age, diabetes in first-degree relatives, and waist circumference. Score values ranged from 0 to 4, with an optimal cutoff ≥2 and had a moderate performance when applied in the CRONICAS baseline data (AUC = 0.68; 95% CI: 0.62-0.73; sensitivity 70%; specificity 59%). When predicting incident cases, the AUC was 0.66 (95% CI: 0.61-0.71), with a sensitivity of 69% and specificity of 59%. Conclusions. A simple nonblood based risk score based on age, diabetes in first-degree relatives, and waist circumference can be used as a simple screening tool for undiagnosed and incident cases of diabetes in Peru.

[Iodine concentration in urine and salt consumption in women between 12 to 49 years of age in Peru]. / Concentraciones de yodo en orina y en sal de consumo en mujeres entre 12 a 49 años del Perú.

OBJECTIVES: To determine the concentrations of iodine in urine and salt intake in women between 12-49 years of age in Peru. MATERIALS AND METHODS: An observational and cross-sectional study was performed. During 2012 and 2013, the study included women aged between 12-49 years living in Peruvian households selected through a probabilistic, stratified and multistage sample. The determination of iodine in urine was performed based on the Sandell-Kolthoff reaction spectrophotometry. The qualitative evaluation of iodine salt was performed by Yoditest and the quantitative by volumetric analysis. Processing was performed using complex samples with weights. Medians, interquartile range and percentiles were obtained. RESULTS: The median urinary iodine levels in the participants was 250.4 ug/L. The regions with elevated median urinary iodine levels were: Moquegua (389.3 ug/L); Tacna (320.5 ug/L); Madre de Dios (319.8 ug/L), and Ucayali (306.0 ug/L); while Puno (192.9 ug/L); Piura (188.1 ug/L) and Tumbes (180.5 ug/L) had medians within ranges recommended by the WHO. The median urinary iodine in pregnant women was 274.6 ug/L (IQR: 283 ug/L).82.5% of the samples had iodine salt ≥30 ppm and 1.9% had values of 0 ppm. CONCLUSIONS: The median urinary iodine in Peruvian women is higher than recommended by the WHO and the majority of the samples had adequate iodine concentrations according to WHO recommendations.

[Prevalence of anemia and associated factors in elderly residing in peruvian households]. / Prevalencia de anemia y factores asociados en adultos mayores peruanos.

OBJECTIVES: To estimate the prevalence of anemia and associated factors in elderly residing in Peruvian households. MATERIALS AND METHODS: the study deals with a cross-sectional design and was conducted in 2011. The sample was probabilistic, stratified and multistage independent in department of Peru. The required sample housing was 5792, we included 2172 elderly. We asked informed consent of all elderly. The anemia was defined as hemoglobin <13.0 g / dL in men and <12.0 g / dL in women, hemoglobin was adjusted for altitude. The anthropometric measurements were performed according to methodology MINSA/INS. The Nutritional status was assessed by body mass index. The classification of nutritional status: underweight (BMI≤23,0) (BMI>23 to <28), overweight (BMI≥28 to <32.0) and obesity (BMI≥32). Statistical analysis was performed using complex samples and adjusted by the weighting factor. We Calculated means, proportions. The chi-square and regression logistic. RESULTS: The mean hemoglobin was 13.4 ± 1.6 g / dL. The prevalence of anemia was 23,3% (mild anemia 17.1%, moderate: severe 5,7% and 0,5%). The age 70 to 79 years (OR 1.5; CI 95%:1.1; 2.0),> 80 years (OR 2.1; CI 95%: 1.4; 3.0) and thinness (OR 1.7; CI 95%: 1.2, 2.3) associated with anemia. Ayacucho, Ancash, Lambayeque and Apurimac were the departments with the highest prevalence of anemia. CONCLUSIONS: Approximately one quarter of elderly were anemic, being more prevalent in the illiterate, rural and poor. Older age and thinness are associated with anemia in elderly Peruvians.

[Overweight, obesity and chronic mal nutrition in 6 to 9 year-old children in Peru, 2009-2010]. / Sobrepeso, obesidad y desnutrición crónica en niños de 6 a 9 años en Perú, 2009-2010.

OBJECTIVES: To determine the prevalence of overweight, obesity and chronic malnutrition in 6- to 9-year-old children in Peru. MATERIALS AND METHODS: A cross-cutting study based on the 2009-2010 National Household Survey. The size/age ratio was analyzed with references of the National Center for Health Statistic (NCSH) and the World Health Organization (WHO), considering less than two standard deviations for chronic malnutrition (CM); and the Must and WHO reference tables to measure the body mass index with 85 to 95 percentile values for overweight and above 95 for obesity. RESULTS: With Must as reference, overweight was 12.1% and obesity 9.4%, and according to WHO overweight and obesity were 10.2 and 11.3% respectively. The prevalence of CM according to NCSH and WHO is 15.4 and 17.8% respectively. The highest prevalence of CM is in the north (25.2%), center (22.9%) and south of (19%) the Highland, while obesity is more present in the south coast (28%), Metropolitan Lima (22.8%) and the central Coast (22.5%). Of all the children with CM, 6.5% has overweight and 1.2% obesity. CONCLUSIONS: CM is decreasing because size averages have improved, however obesity has doubled. The presence of CM and obesity in children aged 6 to 9 years old in different regions of Peru poses a challenge in the planning of food and nutrition policies.

A 'polypill' aimed at preventing cardiovascular disease could prove highly cost-effective for use in Latin America.

We evaluated the cost-effectiveness of administering a daily "polypill" consisting of three antihypertensive drugs, a statin, and aspirin to prevent cardiovascular disease among high-risk patients in Latin America. We found that the lifetime risk of cardiovascular disease could be reduced by 15 percent in women and by 21 percent in men if the polypill were used by people with a risk of cardiovascular disease equal to or greater than 15 percent over ten years. Attaining this goal would require treating 26 percent of the population at a cost of $34-$36 per quality-adjusted life-year. Offering the polypill to women at high risk and to men age fifty-five or older would be the best approach and would yield acceptable incremental cost-effectiveness ratios. The polypill would be very cost-effective even in the country with the lowest gross national income in our study. However, policy makers must weigh the value of intervention with the polypill against other interventions, as well as their country's willingness and ability to pay for the intervention.

[Evolution of chronic malnutrition in children under five in Peru]. / Evolución de la desnutrición crónica en menores de cinco años en el Perú

Child chronic malnutrition is one of the main problems of Public Health in Peru, according to WHO's reference values, national prevalence is 19.5% in children under five. Child chronic malnutrition has a negative impact on people throughout their lives, limits the development of society and hinders poverty eradication. To attain the goal of reducing chronic malnutrition in children to 10% by 2016, the Peruvian government will continue to strengthen, mainly, the efficient use of economic resources, the assessment of interventions, the implementation of investigations that help define causal relations and provide information for the design of public policies, health capacity building and the articulation of different government levels. This article goes over the main interventions implemented in the country.

[Overweight and obesity: prevalence and determining social factors of overweight in the Peruvian population (2009-2010)]. / Sobrepeso y obesidad: prevalencia y determinantes sociales del exceso de peso en la población Peruana (2009-2010).

OBJECTIVES: Estimate the prevalence of overweight, obesity and the determining social factors of overweight in the Peruvian population. MATERIALS AND METHODS: A cross-cut study was conducted which included family members from homes in the sample of the National Household Survey, 2009-2010. Stratified random and multistage sampling was used. The sample included 69 526 members; the anthropometric measurements were done based on the international methodology. To evaluate overweight and obesity, weight-for-height (children <5 years), BMI for age (children and teenagers from 5 to 19 years old), and BMI for adults were used. An analysis of complex samples was made in SPSS and the weighting factor was adjusted. Descriptive statistics and logistic regression were calculated with a 95% confidence interval. RESULTS: Overweight and obesity were higher in young adults (62.3%) and lower in children <5 years old (8.2%). The determining social factors for overweight according to age group were: not being poor (child <5 years old, children 5-9 years old, teenagers and the elderly), living in urban areas (child <5 years old, teenagers, young adults, adults and the elderly) and being a woman (children 5-9 years old, adults and the elderly). CONCLUSIONS: Overweight and obesity are indeed a public health issue in Peru. Not being poor and living in urban areas are determining social factors of overweight among Peruvian people.

[Hemoglobin levels in pregnant women seen in health care centers of the Peruvian Ministry of Health, 2011]. / Niveles de hemoglobina en gestantes atendidas en establecimientos del Ministerio de Salud del Perú, 2011.

OBJECTIVES: Determine hemoglobin levels and prevalence of anemia in pregnant women seen in health care centers of the Ministry of Health at national level. MATERIALS AND METHODS: Cross-cut study where the database of the Information System on the Nutritional Health of Children under 5 and Pregnant Women (SIEN) were analyzed. 287 691 records of pregnant women examined at the health care centers of the Peruvian Ministry of Health in 2011 were included, hemoglobin levels corrected by height, age, gestational age, altitude and prevalence of anemia (light, moderate and serious) were analyzed. Descriptive statistics and the chi-square method were used. RESULTS: Nationwide prevalence of anemia in pregnant women was 28.0%, with mild anemia being at 25.1%, moderate anemia at 2.6% and severe anemia at 0.2%. Hemoglobin levels are higher in older and younger women during the first months of pregnancy, prevalence of anemia decreases with altitude. Furthermore, prevalence is higher in the Highland regions. Huancavelica was the region with higher prevalence of anemia (53.6%), followed by Puno with 51.0%. CONCLUSIONS: Hemoglobin levels get higher as the mother gets older, and they go down in keeping with the gestation trimester and altitude. Huancavelica has the highest prevalence of anemia in pregnant women.

[Prevalence of overwight and obesity among children under five years in Peru 2007-2010]. / Prevalencia de sobrepeso y obesidad en niños menores de cinco años en el Perú 2007-2010.

OBJECTIVES: To estimate the prevalence of overweight and obesity in children under five in Peru in the years 2007-2010 and to describe according to geographical areas, poverty levels, maternal education, breastfeeding, child age, sex and birth weight. MATERIALS AND METHODS: continuous (repeated cross-sectional) multistage, random sampling survey from the universe of children under five-years and pregnant women living in Peru, divided into five geographical areas. RESULTS: Out of 3,669 children, 50.3% were males (Lima N=680, Remaining Coast N=763, Urban Sierra N=719, Rural Sierra N=699, Jungle N=808) having their weight and height measured according to international standards. The national prevalence of overweight and obesity was 6.9%, with Metropolitan Lima (10.1%) as the highest and in the Jungle (2.6%) as the lowest. Age, sex, geographical area and birth weight were identified as risk factors through multiple logistic regression. CONCLUSIONS: overweight and obesity are higher in Lima, during the first year of age and when birth weight is more than 2.5 Kg.

La circunferencia de la cintura en adolescentes del Perú / Waist circumference of adolescents in Peru

Introducción. La circunferencia de la cintura es una medida antropométrica importantísima en el estudio de la obesidad, pero no existe unapoblación de referencia nacional. Objetivo. Poner a disposición una referencia percentilar suavizada y mostrar algunas característicasen relación a una serie de variables estudiadas. Diseño. Estudio descriptivo, observacional, transversal. Participantes. Adolescentes.Intervenciones. En 8 236 adolescentes de 14 a 19 años se midió la circunferencia de la cintura. Principales medidas de resultados.Promedios, desviación estándar y prevalencias de riesgo cardiovascular. Resultados. Se presenta una referencia nacional de valoresde circunferencia de la cintura y se toma el valor correspondiente al 90 percentilo como nivel de corte para identificar a los adolescentescon riesgo cardiovascular. Del total de la población estudiada, el 12% presentaba riesgo. Los que mostraban mayor riesgo fueron losdel género masculino (12,1%), los que vivían en áreas urbanas (15,9%), en los dominios de Costa Sur (27,1%) y Lima Metropolitana(19,9%), en ciudades por debajo de los 1 000 msnm (15,4%), los obesos (94,8%) y los considerados no pobres (14,7%). A excepcióndel género, las demás variables presentaron una asociación significativamente estadística con la circunferencia de la cintura.Conclusiones. El riesgo cardiovascular ya estuvo presente a una edad temprana, lo que obliga a tomar las medidas correspondientes parasu tratamient.

Introduction: Waist circumference is an important anthropometric measure in the study of obesity, but there is no reference from a national population. Objective: To present a smoothed reference percentile and to show some characteristics of variables studied. Design: Descriptive, observational, cross-sectional study. Participants: Teenagers. Interventions: Waist circumference was measured in 8 236 adolescents aged 14 to 19 years old. Main outcome measures: Averages, standard deviation and prevalence of cardiovascular risk. Results: A national reference of waist circumference values is presented and the value corresponding to the 90 percentile is taken as cutoff level to identify adolescents with cardiovascular risk. Of the population studied, 12 per cent were at risk. Those presenting higher risk were the male adolescents (12.1 per cent), those living in urban areas (15.9 per cent), in the Southern Coast (27.1 per cent), in Metropolitan Lima (19.9 per cent), and in cities below 1 000 m (15.4 per cent); obese adolescents (94.8 per cent) and those considered non-poor (14.7 per cent). With the exception of gender, other variables presented statistically significant association with waist circumference. Conclusions: The cardiovascular risk appeared already present at an early age, making it necessary to take appropriate management measures.

Concentraciones de yodo en orina y en sal de consumo en mujeres entre 12 a 49 años del Perú / Iodine concentration in urine and salt consumption in women between 12 to 49 years of age in Peru

Objetivos. Determinar las concentraciones de yodo en orina y sal de consumo en mujeres entre 12 a 49 años en Perú. Materiales y métodos. Se realizó un estudio observacional y transversal. Durante el 2012 y 2013, se incluyó mujeres entre 12 a 49 años residentes en los hogares peruanos seleccionadas mediante un muestreo probabilístico, estratificado y multietápico. La determinación de yodo en orina se realizó por espectrofotometría basada en la reacción de Sandell-Kolthoff. La evaluación cualitativa de yodo en sal se realizó por yoditest y la cuantitativa por volumetría. El procesamiento se realizó mediante muestras complejas con ponderaciones. Se obtuvo medianas, rango intercuartílico y percentiles. Resultados. La mediana de yoduria en las participantes fue 250,4 ug/L; los departamentos con medianas de yoduria elevadas fueron: Moquegua (389,3 ug/L); Tacna (320,5 ug/L); Madre de Dios (319,8 ug/L), y Ucayali (306,0 ug/L); mientras que Puno (192,9 ug/L); Piura (188,1 ug/L) y Tumbes (180,5 ug/L) tuvieron medianas dentro de lo recomendado por la OMS. La mediana de yoduria en gestantes fue 274,6 ug/L (RIQ: 283 ug/L). El 82,5% de las muestras de sal tuvieron yodo ≥30 ppm y 1,9% tuvo valores de 0 ppm. Conclusiones. La mediana de yoduria en las mujeres peruanas está por encima de lo recomendado por la OMS y la mayoría de las muestras de sal tuvieron concentraciones adecuadas de yodo según la OMS.

Objectives. To determine the concentrations of iodine in urine and salt intake in women between 12-49 years of age in Peru. Materials and methods. An observational and cross-sectional study was performed. During 2012 and 2013, the study included women aged between 12-49 years living in Peruvian households selected through a probabilistic, stratified and multistage sample. The determination of iodine in urine was performed based on the Sandell-Kolthoff reaction spectrophotometry. The qualitative evaluation of iodine salt was performed by Yoditest and the quantitative by volumetric analysis. Processing was performed using complex samples with weights. Medians, interquartile range and percentiles were obtained. Results. The median urinary iodine levels in the participants was 250.4 ug/L. The regions with elevated median urinary iodine levels were: Moquegua (389.3 ug/L); Tacna (320.5 ug/L); Madre de Dios (319.8 ug/L), and Ucayali (306.0 ug/L); while Puno (192.9 ug/L); Piura (188.1 ug/L) and Tumbes (180.5 ug/L) had medians within ranges recommended by the WHO. The median urinary iodine in pregnant women was 274.6 ug/L (IQR: 283 ug/L).82.5% of the samples had iodine salt ≥30 ppm and 1.9% had values of 0 ppm. Conclusions. The median urinary iodine in Peruvian women is higher than recommended by the WHO and the majority of the samples had adequate iodine concentrations according to WHO recommendations.

Prevalencia de anemia y factores asociados en adultos mayores peruanos / Prevalence of anemia and associated factors in elderly residing in peruvian households

Determinar la prevalencia de anemia y factores asociados en los adultos mayores del Perú. Materiales y métodos. Se realizó un estudio transversal durante el año 2011. El muestreo fue probabilístico, estratificado y multietápico. La muestra de viviendas fue 5792 y se incluyó 2172 adultos mayores. Se definió anemia como hemoglobina <13,0 g/ dL en hombres y <12,0 g/dL en mujeres. El estado nutricional se evaluó mediante el IMC clasificándose como delgadez (IMC≤23,0), normal (IMC>23 a <28), sobrepeso (IMC≥28 a <32,0) y obesidad (IMC≥32). El análisis estadístico se realizó por muestras complejas y se ajustó por factor de ponderación. Se calcularon las medias, proporciones, chi cuadrado y regresión logística. Resultados. El promedio de hemoglobina fue 13,4 ±1,6 g/dL. La prevalencia de anemia fue 23,3% (Leve: 17,1%; moderada: 5,7% y severa: 0,5%). La edad de 70 a 79 años (OR 1,5; IC 95%: 1,1-2,0), >80 años (OR 2,1; IC 95%: 1,4-3,0) y la delgadez (OR 1,7; IC 95%:1,2-2,3) se asociaron con la anemia. Los departamentos con mayor prevalencia de anemia fueron Ayacucho (57,6%), Ancash (40,1%), Lambayeque (37,7%) y Apurímac (36,9%). Conclusiones. Aproximadamente la cuarta parte de los adultos mayores tuvieron anemia, siendo más predominante en los analfabetos, procedentes de áreas rurales y pobres. La mayor edad y la delgadez se asocian con la presencia de anemia en los adultos mayores peruanos...

To estimate the prevalence of anemia and associated factors in elderly residing in Peruvian households. Materials and methods. the study deals with a cross-sectional design and was conducted in 2011. The sample was probabilistic, stratified and multistage independent in department of Peru. The required sample housing was 5792, we included 2172 elderly. We asked informed consent of all elderly. The anemia was defined as hemoglobin <13.0 g / dL in men and <12.0 g / dL in women, hemoglobin was adjusted for altitude. The anthropometric measurements were performed according to methodology MINSA/INS. The Nutritional status was assessed by body mass index. The classification of nutritional status: underweight (BMI≤23,0) (BMI>23 to <28), overweight (BMI≥28 to <32.0) and obesity (BMI≥32). Statistical analysis was performed using complex samples and adjusted by the weighting factor. We Calculated means, proportions. The chi-square and regression logistic. Results. The mean hemoglobin was 13.4 ± 1.6 g / dL. The prevalence of anemia was 23,3% (mild anemia 17.1%, moderate: severe 5,7% and 0,5%). The age 70 to 79 years (OR 1.5; CI 95%:1.1; 2.0),> 80 years (OR 2.1; CI 95%: 1.4; 3.0) and thinness (OR 1.7; CI 95%: 1.2, 2.3) associated with anemia. Ayacucho, Ancash, Lambayeque and Apurimac were the departments with the highest prevalence of anemia. Conclusions. Approximately one quarter of elderly were anemic, being more prevalent in the illiterate, rural and poor. Older age and thinness are associated with anemia in elderly Peruvians...

Peso bajo, sobrepeso, obesidad y crecimiento en adolescentes en el Perú 2009-2010 / Low weight, overweight, obesity and growth in adolescents in Peru 2009-2010

El grupo de adolescentes representan, de alguna manera, la quinta parte de la población y no se encuentran al margen de los problemas nutricionales. Objetivos: Conocer la situación nutricional, el crecimiento y algunos factores determinantes, en adolescentes en el Perú. Diseño: Estudio descriptivo, observacional, transversal. Participantes: Adolescentes. Intervenciones: En 14 753 adolescentes de 10 a 19 años se obtuvo el peso, talla, índice de masa corporal (IMC). Se utilizó la referencia percentilar de Must y los puntajes Z de OMS. Principales medidas de resultados: Promedios y DE. Prevalencias IC 95 por ciento. OR IC 95 por ciento. Chi-cuadrado y regresión múltiple. Resultados: Se encontró prevalencias de 2,6; 5,9; 79; 9,3 y 3,2 (Must); 0,2; 1,1; 82,6; 12,5; 3,5 por ciento (OMS) de déficit, peso bajo, normal, sobrepeso y obesidad, respectivamente. Predominó el sobrepeso-obesidad en áreas urbanas, en los no pobres, en la costa, selva y Lima Metropolitana, en los que vivían por debajo de 3 000 msnm. Los factores de riesgo para el déficit-bajo peso fueron: género masculino, pobres extremos, pobres no extremos, vivir en la costa norte y sierra centro, y como factor protector los que estaban por debajo de los 1 000 msnm. Los factores de riesgo del sobrepeso-obesidad fueron el vivir en áreas urbanas, costa sur y por debajo de los 1 000 msnm, los que vivían entre los 1 000 y 2 999 msnm; y los factores de protección fueron el ser pobre extremo, el pobre no extremo, vivir en costa norte, sierra norte, sierra centro y sierra sur y selva. El 28,5 por ciento presentó retardo de crecimiento (adolescentes de 10 a 17 años). Los factores de riesgo del retardo de crecimiento fueron: vivir en áreas rurales, en la mayoría de los dominios geográficos excepto la costa sur, los niveles de pobreza (extrema y no extrema), los niveles de altitud (1 000 a 2 999 y más de 3 000 msnm). Conclusiones: El sobrepeso-obesidad es el problema de mayor magnitud en los...

Teenagers represent somehow a fifth of the population and are not away from nutritional problems. Objectives: To determine the nutritional status, growth and some determining factors in adolescents in Peru. Design: Descriptive, observational, transversal study. Participants: Adolescents. Interventions: Weight, height, body mass index were obtained from 14 753 adolescents 10-19 yearold. Must percentile reference and WHO Z score were used. Main outcome measures: Averages and DE, prevalence CI 95 per cent, OR IC 95 per cent, chi-square and multiple regressions were obtained. Results: Prevalence of deficit, underweight, normal, overweight and obesity found respectively were 2.6; 5.9; 79; 9.3 and 3.2 (Must); 0.2; 1.1; 82.6; 12.5; 3.5 per cent (WHO). Overweight-obesity predominated in urban areas, in non-poor areas , the coast, jungle and Metropolitan Lima,and in those lived below 3 000 masl. Risk factors for deficitunderweight were: male gender, extremely poor, non-extremely poor, living in the northern coast and central sierra; and as protective factor living below 1 000 masl. Risk factors for overweight-obesity were living in urban areas, southern coast and below 1 000 masl, and living between 1 000 and 2 999 meters; and protective factors were being extremely poor, and not extremely poor, living in the northern coast, northern sierra, central sierra, southern sierra and in the jungle. Growth retardation was found in 28.5 per cent of adolescents 10 to 17 years. Risk factors for growth retardation were living in rural areas, in most geographic domains except the southern coast, extreme and non-extreme poverty levels, altitude 1 000-2 999 and above 3 000 masl. Conclusions: Overweight-obesity was a problem of greater magnitude and confirmed its tendency to increase with time. Height attained was far from satisfactory and reflected maintenance of unsatisfied basic needs...

Estado nutricional de gestantes atendidas en servicios de salud del Ministerio de Salud, Perú 2011 / Nutritional status of pregnant women at health services of the Ministry of Health, Peru 2011

Objetivo: Determinar el estado nutricional y los par metros antropométricos de la gestante peruana atendida en los establecimientos de salud del Ministerio de Salud durante el año 2011. Métodos: Estudio retrospectivo transversal en 285 834 registros de gestantes (283 041 gestaciones únicas y 2 793 gestaciones múltiples), provenientes del Sistema de Información del Estado Nutricional (SIEN) de la Dirección Ejecutiva de Vigilancia Alimentaria y Nutricional (CENAN) del Instituto Nacional de Salud del Perú (INS). Se incluyeron registros completos, excluyéndose datos vacíos e inconsistencias. Se evaluó el estado nutricional a través del Õndice de Queletet, datos de peso, talla, tipo de gestación, región de procedencia. Se aplicó estad¡sticas descriptivas y prueba de Chi cuadrado de Barlett para determinación de homogeneidad de las varianzas. Resultados. El 0,5% (IC95% 0,1 – 0,9%) de gestantes con feto único presentó bajo peso, 46,8% (IC99% 46,5 – 47,1%) sobrepeso y 16,1% (IC95% 15,7 – 16,4%) presentó obesidad. Con respecto a la gestación múltiple un 0,4% presentó bajo peso (IC95% 0,0 – 4,1%); 47,1% presentó sobrepeso (IC95% 44,4 – 49,8%) y un 22,9% presentó obesidad (IC95% 19,6 – 26,1%). Las prevalencias más altas de bajo peso fueron en Loreto (1,1%); Piura (1,0%) y San Martín (0,9%) y de sobrepeso fueron Puno (54,1%); Huancavelica (50,7%) y Moquegua (50,2%). El peso promedio 2 fue de 55,6ñ9,1 Kg, la talla promedio fue 151,6ñ5,6 cm, siendo el IMC pregestacional promedio de 24,2ñ3,5 Kg/m . Conclusiones: En gestantes el mayor porcentaje presenta sobrepeso. Las regiones de San Martín, Tumbes y Ucayali presentaron mayor prevalencia de bajo peso, mientras que las regiones de Puno, Huancavelica y Moquegua la mayor prevalencia de sobrepeso.

Objective. To determine the nutritional and anthropometric parameters of pregnant women attended in Peruvian health facilities of the Ministry of Health in 2011. Methods. Cross-sectional, retrospective study in 285 834 records of pregnant women (283 041 singleton pregnancies and 2793 multiple gestations), from National Centre of Nutrition of National Institute of Health, Peru. Complete records were included, excluding data gaps and inconsistencies. Nutritional status was assessed through Queletet Index, data on weight, height, type of gestation and region of origin. We applied descriptive statistics and Barlett's Chi square test for determining homogeneity of variances. Results. The 0,5% (CI95% 0,1-0,9%) with singleton pregnancies presented underweight, 46,8% (CI95% 46,5-47,1%) overweight and 16,1% (CI95% 15,7-16,4%) were obese. Regarding multiple gestation, 0,4% presented low weight (CI95% 0,0-4,1%), 47,1% were overweight (CI95% 44,4-49,8%) and 22,9% were obese (CI95% 19,6-26,1%). The highest prevalences of underweight were in Loreto (1,1%), Piura (1,0%) and San Martin (0,9%), and of overweight were in Puno (54,1%), Huancavelica (50,7%) and Moquegua (50,2%). The mean weight was 55,6ñ9,1Kg, mean height was 151,6ñ5,6cm, with pre-2pregnancy BMI of 24,2ñ3,5Kg/m . Conclusions. In pregnant women the highest percentage is overweight. The regions of SanMartin, Tumbes and Ucayali had a higher prevalence of low weight, while the regions of Puno, Huancavelica and Moquegua the highest prevalence of overweight.

Sobrepeso, obesidad y desnutrición crónica en niños de 6 a 9 años en Perú, 2009-2010 / Overweight, obesity and chronic mal nutrition in 6 to 9 year-old children in Peru, 2009-2010

Objetivos. Determinar la prevalencia de sobrepeso, obesidad y desnutrición crónica en niños de 6 a 9 años en Perú. Materiales y métodos . Estudio transversal utilizando la Encuesta Nacional de Hogares del 2009 al 2010. Se analizó la relación talla/edad con referencias del National Center for Health Statistic (NCSH) y de la Organización Mundial de la Salud (OMS), considerando debajo de menos dos desviaciones estándar para desnutrición crónica (DC); y las tablas de referencias de Must y de la OMS para medir el índice de masa corporal con valores percentiles entre 85 y 95 para sobrepeso y por encima del percentil 95 para obesidad. Resultados. Utilizando como referencia Must el sobrepeso fue 12,1% y la obesidad 9,4%, y de acuerdo a la OMS el sobrepeso y la obesidad fueron 10,2 y 11,3% respectivamente. La prevalencia de DC según referencias de la NCSH y OMS es 15,4 y 17,8% respectivamente. Mayor prevalencia de DC se encuentran en la sierra norte (25,2%), sierra centro (22,9%) y sierra sur (19%), mientras que la obesidad está más presente en la costa sur (28%), Lima Metropolitana (22,8%) y costa centro (22,5%). De los niños con DC el 6,5% tiene sobrepeso y 1,2% obesidad. Conclusiones. La DC está disminuyendo por cuanto los promedios de talla han mejorado, sin embargo la obesidad se ha duplicado. La presencia de DC y obesidad en niños de 6 a 9 años en diferentes regiones del Perú propone un reto en la planificación de políticas de alimentación y nutrición.

Objectives. To determine the prevalence of overweight, obesity and chronic malnutrition in 6- to 9-year-old children in Peru. Materials and methods. A cross-cutting study based on the 2009-2010 National Household Survey. The size/age ratio was analyzed with references of the National Center for Health Statistic (NCSH) and the World Health Organization (WHO), considering less than two standard deviations for chronic malnutrition (CM); and the Must and WHO reference tables to measure the body mass index with 85 to 95 percentile values for overweight and above 95 for obesity. Results. With Must as reference, overweight was 12.1% and obesity 9.4%, and according to WHO overweight and obesity were 10.2 and 11.3% respectively. The prevalence of CM according to NCSH and WHO is 15.4 and 17.8% respectively. The highest prevalence of CM is in the north (25.2%), center (22.9%) and south of (19%) the Highland, while obesity is more present in the south coast (28%), Metropolitan Lima (22.8%) and the central Coast (22.5%). Of all the children with CM, 6.5% has overweight and 1.2% obesity. Conclusions. CM is decreasing because size averages have improved, however obesity has doubled. The presence of CM and obesity in children aged 6 to 9 years old in different regions of Peru poses a challenge in the planning of food and nutrition policies.

Tendencia del sobrepeso, obesidad y exceso de peso en el Perú / Trend of overweight and obesity in Peru

Objetivo: Describir la tendencia del sobrepeso, obesidad, exceso de peso y determinantes sociales más frecuentes del exceso de peso de los miembros que residen en hogares peruanos; 2007-2011. Métodos: Se realizó un estudio transversal que incluyó a los miembros residentes en los hogares peruanos durante el periodo de estudio 2007 al 2011. Se empleó un muestreo probabilístico estratificado y multietápico. Las mediciones antropométricas se realizaron según metodología internacional propuesta por la OMS. Para evaluar el sobrepeso y la obesidad se utilizó el peso para la talla (niños 0.05). En los niños 0.05), mientras que en adolescentes y adulto mayor se mantienen para el periodo. El exceso de peso fue más frecuente en los niños<10 años, y a partir de la adolescencia en las mujeres y predominantemente en la zona urbana.

Objective: To describe the trend of overweight , obesity and frequent social determinants of overweight in members of peruvian households, 2007-2011. Methods: We performed a cross-sectional study that included all residents of peruvian homes during the study period 2007 to 2011. We used a stratified, multistage probability sampling. Anthropometric measurements were performed according to international methodology proposed by WHO. To assess overweight and obesity we used weight for height (children 0.05). In children 0.05), whereas in adolescents and older adults remain for the period. Overweight was more common in children <10 years, and from adolescence in women and predominantly in the urban area.

Evolución de la desnutrición crónica en menores de cinco años en el Perú / Evolution of chronic malnutrition in children under five in Peru

La desnutrición crónica infantil constituye uno de los principales problemas de Salud Pública en el Perú, según los valores de referencia de la OMS, la prevalencia nacional es del 19,5% en niños menores de cinco años. La desnutrición crónica infantil afecta negativamente al individuo a lo largo de su vida, limita el desarrollo de la sociedad y dificulta la erradicación de la pobreza. Para lograr la meta de reducir a 10% la desnutrición crónica infantil para el año 2016, el Gobierno peruano deberá continuar fortaleciendo principalmente el uso eficiente de recursos económicos, la evaluación de intervenciones, la realización de investigaciones que permitan definir relaciones de causalidad y brindar información para el diseño de políticas públicas, el fortalecimiento de las capacidades de recursos humanos en salud y la articulación de los diferentes niveles de Gobierno. En el artículo se revisan las principales intervenciones realizadas en el país.

Child chronic malnutrition is one of the main problems of Public Health in Peru, according to WHO’s reference values, national prevalence is 19.5% in children under five. Child chronic malnutrition has a negative impact on people throughout their lives, limits the development of society and hinders poverty eradication. To attain the goal of reducing chronic malnutrition in children to 10% by 2016, the Peruvian government will continue to strengthen, mainly, the efficient use of economic resources, the assessment of interventions, the implementation of investigations that help define causal relations and provide information for the design of public policies, health capacity building and the articulation of different government levels. This article goes over the main interventions implemented in the country.

Prevalencia del síndrome metabólico en pobladores peruanos por debajo de 1 000 y por encima de los 3 000 msnm / Metabolic syndrome prevalence in Peruvians living below 1 000 and over 3 000 meters

Objetivos: Determinar y comparar la prevalencia del síndrome metabólico y de sus diferentes componentes en población adulta peruana que habita por debajo de 1 000 y por encima de 3 000 msnm. Diseño: Análisis de los datos de la Encuesta Nacional de Indicadores Nutricionales, Bioquímicos, Socioeconómicos y Culturales Relacionados a las Enfermedades Crónicas Degenerativas 2006. Institución: Instituto Nacional de Salud Centro Nacional de Alimentación y Nutrición, Ministerio de Salud, Lima, Perú. Participantes: Personas mayores de 20 años. Métodos: Se incluyó 3 384 personas mayores de 20 años, 2 425 que habitaban por debajo de 1 000 (nivel-I) y 959 por encima de los 3 000 msnm (nivel-II). El síndrome metabólico fue definido de acuerdo a los criterios del National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III). Principales medidas de resultados: Prevalencia del síndrome metabólico y sus componentes. Resultados: La prevalencia de síndrome metabólico fue significativamente mayor en el nivel-I (19,7 por ciento) que en el nivel-II (10,2 por ciento), p<0,001. En varones, la prevalencia fue 9,2 por ciento en el nivel-I y 5,1 por ciento en el nivel-II. En mujeres fue 29,9 por ciento en el nivel-I comparado con 15,2 por ciento en el nivel-II. La obesidad central (35,5 por ciento vs. 21,1 por ciento), elevación de presión arterial (20,9 por ciento vs. 15,0 por ciento), hiperglicemia (3,9 por ciento vs. 1,7 por ciento), hipertrigliceridemia (31,3 por ciento vs. 25,7 por ciento) y concentraciones bajas de HDLc (57,4 por ciento vs. 52,5 por ciento) fueron significativamente más prevalentes en el nivel-I comparado con el nivel-II (p<0,05). Los componentes del síndrome metabólico más frecuentes en los varones fueron la hipertrigliceridemia y el HDLc bajo, mientras que en las mujeres fueron la obesidad central y el HDLc disminuido. Conclusiones: El síndrome metabólico fue significativamente más prevalente en la población por debajo de los 1 000 msnm; esto podría ser resultado de la transición nutricional, demográfica y socioeconómica en esta área. Las mujeres fueron más susceptibles a los factores de riesgo cardiovascular.

Objectives: To determine and compare the prevalence of metabolic syndrome and its components in Peruvian population living below 1000 m and over 3000 m. Design: Data analysis of Encuesta Nacional de Indicadores Nutricionales, Bioquimicos, Socioeconomicos y Culturales Relacionados a las Enfermedades Cronicas Degenerativas 2006. Setting: Instituto Nacional de Salud Centro Nacional de Alimentacion y Nutricion, Ministerio de Salud, Lima, Perú. Participants: Subjects 20 year-old and above. Methods: We included 3384 participants aged 20 year-old and above, 2425 living below 1000 m (level-1) and 959 over 3000 m (level-2). Metabolic syndrome was defined according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria. Main outcome measures: Metabolic syndrome and components prevalence. Results: Prevalence of metabolic syndrome was significantly higher in level-1 (19.7 per cent) than in level-2 (10.2 per cent), p<0.001. Prevalence in males was 9.2 per cent in level-1 and 5.1 per cent in level-2, and in females 29.9 per cent in level-1 compared to 15.2 per cent in level-2. Central obesity (35.5 per cent vs. 21.1 per cent), elevated blood pressure (20.9 per cent vs. 15.0 per cent), hyperglycemia (3.9 per cent vs. 1.7 per cent), raised triglycerides (31.3 per cent vs. 25.7 per cent), and low concentrations of HDLc (57.4 per cent vs. 52.5 per cent) were significantly more prevalent in level-1 compared to level-2 (p<0.05). The most frequent components of metabolic syndrome in men were hypertriglyceridemia and low HDLc, and in women were low HDLc and central obesity. Conclusions: Metabolic syndrome was significantly more prevalent in population under 1000 m; it may be as result of the nutritional, demographic, and socioeconomic transition in this area. Women were more susceptible to cardiovascular risk factors.