Slow gait speed is associated with dynapenic obesity in Mexican ambulatory older adults.

An increased risk of slow gait speed (GS) has been reported among older adults with decreased muscle strength, coupled with a concomitant increase in body fat known as dynapenic obesity (DO); however, these two conditions together have rarely been studied. The objective of this study was to determine the association between GS and DO in older Mexican ambulatory adults. A cross-sectional study was conducted; body fat percentage, and muscle strength and GS using EWGSOP criteria, were measured in 126 older ambulatory Mexican adults, with a mean age of 71 years old. The association was evaluated using controlled logistic regression models. Among ambulatory older adults with slow GS, the risk of DO was 3.4 times higher than among those without, controlling for age and sex (p<0.01). In conclusion, slow GS in ambulatory older adults can be a useful indicator for the early identification of DO.

Comorbidities associated with maternal mortality from COVID-19 in Mexico.

INTRODUCTION: In Mexico, there is a syndemic in pregnant women, where the epidemic of obesity and chronic diseases coexists with that of coronavirus disease 2019 (COVID-19), which has been associated with a higher risk of maternal mortality. OBJECTIVE: To evaluate the association of comorbidities during pregnancy with maternal mortality from COVID-19 in Mexico. MATERIAL AND METHODS: SISVER COVID-19 databases and epidemiological surveillance reports on maternal mortality were used. Multivariate logistic regression models were used to evaluate the association of comorbidities with maternal deaths from COVID-19. RESULTS: A total of 29,416 pregnant women were evaluated, out of which 39% were positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2); the risk of maternal mortality was 3.24 times higher (p < 0.01) for positive in comparison with negative women. COVID-19 is the leading cause of maternal death since July 2020 and explains more than 50% of total deaths in 2021. Chronic kidney disease (odds ratio [OR]: 4.11; p < 0.01) and diabetes (OR: 2.53; p < 0.01) were the two main comorbidities that were positively associated with maternal death from COVID-19. CONCLUSION: Comorbidities during pregnancy that are possibly associated with an increase in the inflammatory response and an alteration of the immune response increase the risk of maternal death from COVID-19 in Mexican pregnant women.

INTRODUCCIÓN: En México existe una sindemia en las mujeres gestantes, donde coexiste la epidemia de obesidad y enfermedades crónicas con la de enfermedad por coronavirus 2019 (COVID-19), lo que se ha asociado con un mayor riesgo de mortalidad. OBJETIVO: Evaluar la asociación de las comorbilidades en la mortalidad materna por COVID-19 en México. MATERIAL Y MÉTODOS: Se utilizaron las bases de datos de COVID-19 del SISVER y los reportes de vigilancia epidemiológica de muertes maternas. Se utilizaron modelos de regresión logística multivariante para evaluar la asociación de las comorbilidades durante la gestación con mortalidad materna por COVID-19. RESULTADOS: Se evaluaron 29,416 mujeres embarazadas, el 39% fueron positivas para coronavirus 2 del síndrome respiratorio agudo grave, el riesgo de mortalidad materna fue 3.24 veces mayor (p < 0.01) para las mujeres positivas en comparación con las negativas. La COVID-19 es la primera causa de muerte materna desde julio del 2020 y explica más del 50% del total de muertes en el 2021. La enfermedad renal crónica (razón de momios [RM]: 4.11; p < 0.01) y la diabetes (RM: 2.53; p < 0.01) fueron las dos principales comorbilidades asociadas positivamente a la mortalidad materna por COVID-19. CONCLUSIÓN: Las comorbilidades durante el embarazo posiblemente asociadas con un incremento de la respuesta inflamatoria y alteración de la respuesta inmunitaria incrementan el riesgo de muerte materna por COVID-19 en mujeres gestantes mexicanas.

Blood toxic metals and hemoglobin levels in Mexican children.

Metal toxicity can cause hematologic abnormalities and hemolysis. To evaluate the relationship of anemia with metal contamination in children, the following elements were quantified in dry blood: silicon, chromium, lead, titanium, vanadium, nickel, arsenic, manganese, and cadmium. A total of 88 samples of anemic children and 208 of non-anemic children aged 6-12 years were analyzed. Lead (35.1%), chromium (24.3%), vanadium (24.3%), nickel (45.6%), and silicon (48.6%) were identified in the samples, with titanium only detected in anemic children. The average level of arsenic was higher in anemic than non-anemic children (0.041 ± 0.11 wt% vs 0.014 ± 0.05 wt%, p < 0.05) and correlated with the concentration of hemoglobin (r = -0.441, p < 0.01). In conclusion, heavy metals, which confer a health risk, were detected in the dry blood of the children evaluated, and the levels of arsenic and titanium were found to be related to anemia.

Association between childhood obesity, cognitive development, physical fitness and social-emotional wellbeing in a transitional economy.

BACKGROUND: It has been suggested that obese children have lower cognitive function, demonstrate poorer physical performance and are more susceptible to social-emotional problems. AIMS: To describe associations between human physical growth, cognitive development, physical fitness and social-emotional characteristics of obese and non-obese children and to verify the predictors of intellectual coefficient by socioeconomic status (SES). SUBJECTS AND METHODS: A sample of 107 non-obese (N-Ob) children [-1 z-score body mass index (BMI) ≤1 z-score] and 108 obese (Ob) children [2 z-score ≤BMI ≤5 z-score] from a larger cohort was evaluated. Intellectual coefficient (IQ), social-emotional wellbeing (SEW), 6-minute walk test (6MWT) and SES (mid-low, low and very low) were assessed. RESULTS: Ob children were taller, heavier and present more height for age and BMI than N-Ob children (p < 0.001). A significant correlation between IQ and SEW (r = 0.14), 6MWT and BMI z-score (r = -0.18) and 6MWT and SEW (r = 0.15) was found. Multiple regression analysis revealed that BMI z-score had a negative impact on IQ in the mid-low SES sub-group and that SEW had a positive effect on IQ in the very-low SES sub-group. CONCLUSIONS: In Chilean pre-school children from low-income families cognitive ability varied according to SES.

Impact of memory bias in the dietary estimation of older adults measured through a food frequency questionnaire and weighed food records: A cross-sectional study in older adults and primary caregivers.

Introduction: Introduction: changes in cognitive performance and memory of older adults (OA) can interfere in their reporting their diet. Objective: to evaluate the impact of memory bias in dietary estimation between OA and their primary caregivers (PC) through the food frequency questionnaire (FFQ) for Mexican OA and weighed food records (WFR). Methods: the present analysis uses the estimated dietary information based on the response provided by 51 older adults (OA) and their primary caregivers (PC) from the validation study of the FFQ for Mexicans OA was conducted during lockdowns for COVID-19. The personnel who applied FFQ and WFR were trained with standardized instruments and procedures. The Wilcoxon test was used to compare the intake per day of the foods and food groups, the Spearman correlation coefficient was used to evaluate the grams of intake per day of the food groups, and kappa coefficient was used to compare the level of food items and food groups between OA and PC. Results: in 11 of 14 food groups, no significant differences were observed between the amounts of intake reported by OA and PC. In the groups of dairy products, fruits, vegetables, and legumes, moderate agreement was observed (κ = 0.63 to 0.79), and in the rest of the groups was strong to perfect (κ ≥ 0.80). Correlation of the amount of intake between OA and PC was high in all food groups (r ≥ 0.87). Conclusion: the high correlation and high agreement between the amounts and frequencies of the food groups consumed as reported by the older adults and primary caregivers indicate that the information from both respondents is reliable.

Introducción: Introducción: los cambios cognitivos y la memoria que presentan los adultos mayores (AM) pueden interferir al momento de reportar los alimentos de su dieta. Objetivo: evaluar el impacto del sesgo de memoria en la estimación de la dieta entre AM y sus cuidadores principales (CP) a través del cuestionario de frecuencia de alimentos (CFA) para AM mexicanos y el registro de peso de alimentos (RPA). Métodos: el presente análisis utiliza la información dietética estimada con base en la respuesta proporcionada por 51 adultos mayores (AM) y sus cuidadores principales (CP) del estudio de validación del CFA para AM mexicanos que se realizó durante el confinamiento por COVID-19. El personal que aplicó CFA y RPA fue capacitado con instrumentos y procedimientos estandarizados. Se utilizó prueba de Wilcoxon para comparar la ingesta por día de los alimentos y grupos de alimentos, el coeficiente de correlación de Spearman para evaluar los gramos de ingesta por día de los grupos de alimentos y el coeficiente kappa para comparar el nivel de alimentos y grupos de alimentos entre AM y CP. Resultados: en 11 de 14 grupos de alimentos no se observaron diferencias significativas entre las cantidades de ingesta reportadas por AM y CP. En los grupos de lácteos, frutas, verduras y legumbres se observó concordancia moderada (κ = 0,63 a 0,79), y en el resto de los grupos fue de fuerte a perfecta (κ ≥ 0,80). La correlación de la cantidad de ingesta entre AM y CP fue alta en todos los grupos de alimentos (r ≥ 0,87). Conclusión: La alta correlación y la alta concordancia entre las cantidades y frecuencias de los grupos de alimentos consumidos según lo informado por los adultos mayores y los cuidadores principales indican que la información de ambos encuestados es confiable.

Determinants of cognitive development of low SES children in Chile: a post-transitional country with rising childhood obesity rates.

Studies conducted in developing countries have noted associations between concurrent stunting, social-emotional problems and poor cognitive ability in young children. However, the relative contribution of these variables in Latin America is likely changing as undernutrition rates decline and prevalence of childhood obesity rises. We conducted a cross-sectional study of 106 normal-weight and 109 obese preschool children to compare the relative contribution of early nutrition, sociodemographic factors and psychosocial variables on cognitive development in normal-weight and obese preschool children in Chile. The study variables were categorized as: (1) socio-demographic (age, sex, birth order and socioeconomic) (2) early nutrition (maternal height, birth weight, birth length and height at 5 years) (3) psychosocial factors (maternal depression, social-emotional wellbeing and home space sufficiency). In order to assess determinants of cognitive development at 4-5 years we measured intelligence quotient (IQ); variability in normal children was mostly explained by socio-demographic characteristics (r(2) = 0.26), while in obese children early nutritional factors had a significant effect (r(2) = 0.12) beyond socio-demographic factors (r(2) = 0.19). Normal-weight children, who were first born, of slightly better SES and height Z score >1, had an IQ ≥ 6 points greater than their counterparts (p < 0.05). Obese children who were first born with birth weight >4,000 g and low risk of socio-emotional problems had on average ≥5 IQ points greater than their peers (p < 0.05). We conclude that in Chile, a post-transitional country, IQ variability of normal children was mostly explained by socio-demographic characteristics; while in obese children, early nutrition also played a significant role.

[Factors associated with nutritional status of iodine in Mexican preschool children]. / Factores asociados al estado nutricional de yodo en preescolares del estado de Hidalgo, México.

BACKGROUND: Iodine deficiency is a public health problem in many developing countries where pregnant women and children are the more susceptible populations. OBJECTIVE: To evaluate the association of iodine nutritional status with the weather, availability of iodine in salt, and degree of social exclusion in preschool children of the state of Hidalgo, Mexico. METHODS: Cross-sectional study in 1,333 children < 5 years; in these, urinary iodine and iodine in the salt was measured, and annual average of humidity, type of location and degree of social marginalization in the localities where they lived was recorded. RESULTS: 24.5% of children evaluated had < 100 µg/l of urinary iodine excretion, and 28.6% of salt samples contained < 20 ppm of iodine; iodine urine average of wet weather children was lower (209.09 ± 6.8 µg/l) than in dry climates (274.7 ± 5.86 µg/l; p < 0.05); the iodine content of salt in children living communities with high levels of marginalization was less than with low marginalization (23.5 ± 1.2 and 32.9 ± 2.7 ppm, respectively; p < 0.01). CONCLUSIONS: The humidity and the degree of social marginalization of the locations were associated with lower iodine content of salt and urinary iodine in children evaluated.

Impact of a retrograded starch ingredient obtained from Negro Jamapa beans (Phaseolus vulgaris L. Negro Jamapa) on glucose metabolism and oxidative stress in induced diabetic lab rats model.

A retrograded starch ingredient obtained from Negro Jampa beans (Phaseolus vulgaris L. Negro Jamapa), applying a debranching process (18 U/g for 12 h) and retrogradation (2 °C for 3 days), was evaluated as a potential functional ingredient to improve glucose homeostasis in a diabetic animal model. The obtained ingredient was reduced in rapid digestible starch amount compared to its related isolated native starch (34.1 % and 53.6 %, respectively) and resistant (33.4 % and 22.3 %, respectively). Therefore, a reduced total digestibility was determined for the obtained ingredient compared to native starch (51.5 % and 79 %, respectively). As consequence, diabetic animals fed with functional ingredient replacement (30 %) showed a lower and attenuated postprandial glucose levels, reducing the hyperglycaemic condition, compared with the non-treated animals (r2 = 0.9775; p ≤ 0.05), reducing the glucose serum levels 73 % compared (17.21 vs 23.6 mmol/L, respectively). Also, significant improvement on weight gain (49.75 ± 34.1 g) compared to non-treated (18.14 ± 45.52 g), as well as lower insulin resistance index and improved oxidative stress status was determined for the treated group. These results highlight the potential of retrograded starch obtained from Negro Jamapa beans as a functional ingredient focus on the improvement of the glucose homeostasis and diabetic condition.

Perceptions of food environments in the school and at home during Covid-19: An online cross-sectional study of parents, teachers and experts from Latin America.

BACKGROUND: The high prevalence of overweight and obesity in children from Latin America (LA) have been related to obesogenic food environments. Besides, the negative effects of the Covid-19 pandemic should also be considered. The objective of this research was to describe and compare the perceptions of parents, teachers, and experts in LA of food environments at home and school that favor healthy habits in schoolchildren in pre Covid-19 stage and during the pandemic. METHODS: This study used a survey self-reporting regarding conditions at home and the school favoring healthy habits, for three profiles: parents, primary school teachers, and experts. A fisher exact test was used to establish the difference between the response categories between countries and profiles. Logistic regression models were used to determine the probability of response in the levels of importance adjusted for sex and nationality. RESULTS: Information from 954 questionnaires was reported: 48.4% experts, 32.0% teachers, and 19.6% parents. There were differences in the perception of food environments at school between profiles (p<0.001). In multivariate logistic regression models, experts and teachers were 20% more likely to give greater importance to elements of the food environment at school compared to parents (p<0.001). CONCLUSIONS: Our findings showed that parents were less likely to perceive important elements of the school food environment compared to experts and teachers. Interventions are required to improve healthy eating environments that consider children's interpersonal mediators.

[Association between body mass index (BMI) and height from birth to 5 years in Chilean preschool children]. / Asociación entre el índice de masa corporal y la talla desde el nacimiento hasta los 5 años en preescolares chilenos.

BACKGROUND: It has been shown that excess weight gain during childhood is associated with a greater risk of obesity; this relationship may be mediated by growth in height. AIM: To quantify the associations between z scores for body mass index (BMIZ) and height for age (HAZ) from birth to 5 years of age and to assess how this association varies according to age and adiposity. MATERIAL AND METHODS: Weight and height were recorded at 11 occasions from birth on a cohort of 1089 Chilean five year-old children with a birth weight > 2500 g. BMI, BMIZ, HAZ and prevalence of obesity were calculated. We determined the cross-sectional association between BMIZ and HAZ for the total sample and by 3 BMI Z categories, using Pearson correlation. We determined the probability of obesity according to four HAZ categories. RESULTS: Obesity increased continuously reaching approximately 16% at 5 years. Stunting was virtually nonexistent. No association between BMIZ and HAZ was observed at birth, while at 1 and 2 months, leaner infants had lower stature. No association between these parameters was observed between 6-24 months, while after 3 years, a clear relationship was observed. CONCLUSIONS: The probability of a preschool child of being obese is less than 10% with a HAZ is < 0. Nevertheless, children with heights above the median (even within the normal range) have an increased risk of obesity, especially after 3 y of age. Between 0-5 years, the relationship between weight and height varies by age and adiposity.

[Relation of total cholesterol in serum tocopherols, probabilistic study in Mexican children]. / Relación del colesterol total con la concentración sérica de tocoferoles, un estudio probabilístico en preescolares mexicanos.

Epidemiological studies have shown the effect of nutritional status of tocopherols and development of cardiovascular diseases that now are more frequent during early years of life. In this work we evaluated the association between the total cholesterol and serum levels of tocopherols in a population of Mexican children in whom we measured the oxidant status and antioxidant capacity (December 2003). In 1155 children (12-59 months) residents of urban and rural locations we quantified in serum alpha-tocopherol, gamma-tocopherol and total cholesterol; the antioxidant capacity and oxidative status were evaluated with the production of TBARS. Children with serum cholesterol < 170 mg/dL had an average of 472.5 +/- 179.6 microg/dL tocopherol in serum and > or = 240 mg/dL cholesterol recorded an average of 577.3 +/- 200.8 microg/dL. However, when tocopherols were expressed in relation to total cholesterol (micromol/mmol) found that children with < 170 mg/dL had the highest ratios (3.06 +/-1.19) which places them in an adequate nutritional status of tocopherol, unlike the group with > or = 240 mg/dL of cholesterol in whom the relationship was low (1.93 +/- 0.69). There were no differences in serum antioxidant capacity, but if in the production of TBARS for children with > or = 200 mg/dL cholesterol. In preschools the increases in total cholesterol limits the availability of serum tocopherol for circulating lipids, this condition over time could determine the early development of vascular injury mediated by oxidative stress.

[Evolution of the nutritional status of Chilean children from preschool to school age: anthropometric results according to the source of the data]. / Evolución del estado nutricional de ninos chilenos desde la etapa preescolar a la escolar: resultados antropométricos según procedencia de las mediciones.

Because the results of the nutritional status released by Chilean institutions which collect anthropometric data on their population under control, show different increments in the prevalence of obesity between preschoolers and children in 1st grade, we decided to verify the real magnitude of this increase. This study is based on a longitudinal investigation which began in 2006 and included 1100, three-year old children, which we evaluated when they were 4, 5 and 6 y. The nutritional status was determined according to BMI Z and WHO References 2006/2007. The information was also used to determine the concordance between the anthropometric data collected on first graders by teachers from public schools in 2009 (JUNAEB data set) and the same children assessed in parallel by INTA (INTA data set). The sample included 474, six-year olds. No differences were found between the average BMI Z and HAZ of the two data sets, and the degree of concordance between the BMI Z's was good (rho = 0.73), however there were differences in the nutritional status, since the prevalence of low weight was significantly greater when assessed with JUNAEB's data (9.5% vs. 3.6% ), while that for obesity was lower with INTA's data, 17.5% vs. 19.2% (not significantly different). At 4 and 5 y, obesity prevalence of the children was 13.3% and 15.7% respectively (INTA's data). Considering the observed nutritional trajectory, it is likely that the rise in obesity between 4 and 6 y of age, was 4 percentage points and not 6, as was determined with INTA's data.

Iodine nutritional status in urban and rural Mexican schoolchildren. / Estado nutricional de yodo en niños escolares mexicanos de zonas urbanas y rurales.

INTRODUCTION: Deficient or excess iodine intake has effects on human health. Assessment of the prevalence and risk factors in children can therefore support effective prevention or treatment. METHOD: A cross-sectional probabilistic study in 631 children aged 5 to 12 years in whom iodine levels were measured in urine and salt samples. Results are reported by type of location and indigenous condition. Association of these variables to urinary iodine levels was assessed using a binary logistic regression. RESULTS: Median urinary iodine level was 278.4µg/L (177.3-360.9, IQR), 13.2% of children assessed had iodine levels <100µg/L, and 41.8% had values ≥300µg/L. Indigenous schoolchildren had the greatest risk of urinary iodine levels <100µg/L (ß = 2.29, CI 1.1-4.6, p <.05), while children from urban and non-indigenous localities had a high risk of iodine levels >300µg/L (ß = 2.2, CI 1.3 -3.9, p <.01, and ß = 3.8, CI 2.2-6.5, p <.01 respectively). Median iodine level in salt was 35.9ppm (29.1-42.4 IQR), and there were no differences in iodine levels in salt by type of location or ethnicity. CONCLUSIONS: In Mexican schoolchildren living in rural and indigenous areas, iodine levels <100µg/L have not been eradicated. There was high prevalence of urinary iodine levels ≥300µg/L in schoolchildren living in urban areas which was associated to high sodium intake from processed food.

Common polymorphisms in MC4R and FTO genes are associated with BMI and metabolic indicators in Mexican children: Differences by sex and genetic ancestry.

BACKGROUND: Mexico is experiencing an epidemic of childhood obesity and overweight, the factors that determine type 2 diabetes and cardiovascular diseases. Even though variants in genes such as MC4R, LEP, LEPR, and FTO have been associated with the risk of obesity, in Mexico the level of miscegenation is heterogeneous, so this risk must be measured as genetic ancestry. This study aimed at evaluating the association between common SNPs in FTO and MC4R genes in Mexican children with Amerindian, mestizo and predominance European ancestry. METHODS: Anthropometric data and fasting blood samples were collected from 718 unrelated Mexican school children aged 4-13 years old. Variants in the FTO, MC4R, LEP, LEPR genes and 15 ancestry informative markers (AIMs), were genotyped using allelic discrimination assays. RESULTS: High triglycerides and low cholesterol HDL were the most frequent metabolic alterations. The prevalence of minor allele frequency of polymorphism rs8050136, rs9939609, and rs3751812 in the FTO gene; and rs17782313 of MC4R gene were found to be significantly higher among Mexican children with a predominance of European ancestry (EA) compared to native Mexican children (Amerindian predominance), X2 test, p < 0.05. The FTO (rs8050136, rs9939609) and MC4R (rs17782313) genotypes also were significantly associated with obesity (BMI > 2Z) in boys (OR=1.89, P=0.04, OR=3.3, P=0.006 OR=3.11, p=0.04, respectively). Children with AA genotype (minor) of rs8050136 and rs9939609 SNPs have higher triglycerides in relation to native ancestral genotypes. CONCLUSION: Risk variants in the FTO and MC4R genes had a higher frequency in children with EA compared with Amerindian predominance children, showing that miscegenation is associated with the frequency of obesity-related genotypes.

Maternal anthropometry and feeding behavior toward preschool children: association with childhood body mass index in an observational study of Chilean families.

BACKGROUND: A better understanding of the link between eating behavior and maternal feeding practices with childhood and maternal weight status is of great interest. OBJECTIVE: To assess the association between childhood anthropometric measures with mothers' Body Mass Index (BMI) and their feeding practices toward preschool children in Chile. METHODS: 1029 children (504 boys, 4.3 +/- 0.3 years) and their mothers were selected from public nurseries located in low income neighborhoods in Santiago. Mothers' BMI, children's BMI and waist-to-height ratios were registered. Maternal feeding practices towards their children's nutritional habits were measured using an adapted version of the Child Feeding Questionnaire (CFQ). RESULTS: We found a direct correlation (p < 0.001) between children's BMI z-score and their mothers' BMI, both in boys (Spearman rho = 0.26) and girls (rho = 0.30). A direct association was also found between children's BMI z-score with scores of the subscale "concern for child's weight" (Spearman rho = 0.26 in boys and rho = 0.37 in girls; p < 0.001) and "food restriction" (rho = 0.19 in boys and rho = 0.27 in girls; p < 0.001). A reverse significant association was found between children's BMI z-score with scores of "pressure to eat" (rho = -0.30 in boys and rho = -0.36 in girls; p < 0.001). Analyses of the combined categories of childhood obesity and/or maternal obesity showed an important influence of children's weight status on CFQ scores. CONCLUSION: Mothers' BMI and children's BMI z-scores are highly correlated. We found significant associations between mothers' behaviour subscales and children's BMI z-score. It is not possible to establish a causal link between mother's CFQ scores and children's nutritional status, given the cross-sectional nature of this study and the bidirectional influences that exist between mothers and their children.

[Nutritional status of preschool children attending the Chilean National Nursery Schools Council Programs (JUNJI): assessment of the agreement among anthropometric indicators of obesity and central obesity]. / Estado nutricional de preescolares asistentes a la Junta Nacional de Jardines Infantiles de Chile: evaluación de la concordancia entre indicadores antropométricos de obesidad y obesidad central.

Historically, the anthropometric assessment of nutritional welfare programs has been targeted to assess nutritional deficiencies based on weight-to-age and height-to-age indicators. Recently, given the increase on childhood obesity, it has been also recommended the measurement of indicators of obesity (i.e., weight-to-height) and central obesity (i.e., waist circumference). However, the agreement of these indicators in preschool children is unclear. The aims of this study were: (1) assess the nutritional status of children attending the Chilean National Nursery Schools Council Program (JUNJI); (2) assess the agreement between general and central obesity anthropometric measurements in these children. In 574 girls and 580 boys, 3.0 to 5.9 years old, we measured: weight, height, waist and hip circumference, and five skinfolds. We used the WHO 2006 growth standards to estimate Z-scores. We defined general obesity as WHZ or BAZ= 2, and central obesity as waist circumference > or =90 percentile of NHANES III. The participants were on average slightly shorter but considerably heavier and obese than the reference populations. Prevalence of general obesity was close to 16% with both indicators while prevalence of central obesity reached 15%. There was good agreement among general obesity indicators and central obesity indicators (Kappa = 0.6-0.7). In summary, we found a high prevalence of obesity and central obesity among Chilean preschool children beneficiaries of a welfare program. At this age, there was a good agreement among general obesity indicators and central obesity indicators. These results suggest that waist circumferences measurements should not be incorporated to the program.

Valor diagnóstico del índice de masa corporal en comparación con impedancia bioeléctrica para identificar sobrepeso u obesidad en jóvenes adultos mexicanos / Diagnostic value of body mass index versus bioelectrical impedance analysisfor detection of overweight and obesity among Mexican young adults

Introducción: El índice de masa corporal (IMC) es am-pliamente utilizado para diagnosticar estado de nutrición;pero tiene limitaciones porque no evalúa la grasa corporal. Objetivo: Determinar el valor diagnóstico del IMC en com-paración con impedancia bioeléctrica para identificar sobre-peso y obesidad (SpyOb) en adultos jóvenes mexicanos.Material y métodos: Estudio de validación en adultos jó-venes mexicanos. Se midió talla con estadímetro SECA 215,peso y composición corporal con InBody 270 por personal en-trenado. Se realizaron comparaciones por sexo con U deMann Whitney y Chi2; y correlaciones de Spearman para IMCy porcentaje de grasa corporal total (%GCT). Se calculó sen-sibilidad (s) y especificidad (e) con curvas ROC comparandoIMC y %GCT para diagnosticar SpyOb. Análisis se realizó conStata 14 y valores p<0.05 fueron considerados significativos. Resultados: Se evaluaron 351 universitarios con medianade edad de 19 años. El 42.4% fue diagnosticado con SpyObde acuerdo al IMC, y 48.1% fue identificado en esa mismacondición mediante %GCT; con diferencias significativas porsexo sólo en el diagnóstico por %GCT. La correlación entre IMC y %GCT fue alta para la muestra en general (r=0.68) ymuy alta por sexo (r=0.85 hombres y r=0.81 mujeres). ElAUC para diagnosticar obesidad en mujeres fue de 0.90, conalta sensibilidad (100%) y alta especificidad (80.4%), y paradiagnosticar sobrepeso el AUC fue de 0.52 con baja sensibili-dad (31.5%) y especificidad regular (73.1%). El AUC paradiagnosticar obesidad en hombres fue de 0.84, con alta sen-sibilidad (80%) y alta especificidad (88.9%), y para diagnos-ticar sobrepeso el AUC fue de 0.63, con baja sensibilidad(32.5%) y alta especificidad (94.3%).Conclusiones: Se encontró alta y muy alta correlaciónentre IMC y %GCT, tanto en hombres como en mujeres. ElIMC es un indicador útil y confiable para diagnosticar obesi-dad, pero no para diagnosticar sobrepeso en jóvenes adultos mexicanos.(AU)

Background:The Body Mass Index (BMI) is widely usedfor nutritional status assessment; nevertheless, it has limita-tions due to the fact that it doesn’t evaluate the body fat.Objective: Identify the diagnostic value of the BMI versusBioelectrical Impedance to determinate overweight and obe-sity in young Mexican adults.(AU)

[Programs destined to decrease the chronic malnutrition. A review in Latin American]. / Programas destinados a disminuir la desnutrición crónica. Una revisión en América Latina.

Stunting affects 16% of children under 5 years old, in Latin America. This is a cumulative effect of poor diets and repeated episodes of infectious diseases. Our aim was to analyze the impact of nutrition programs oriented to increase food availability at the family level on the growth of under fives in Latin America. We included all evaluated and published interventions on food availability. An electronic and manual search of papers published between 1995-2005 in PUBMED, LILACS, SCIELO and international organizations, was performed. Three type of programs were identified: Conditioned Economical Transference Programs (CETP) (n= ), Complementary Feeding Programs (CFP) (n= ), and Food Security Programs (FSP) (n=). Operational deficiencies were reported, some of them being participants attrition, non acceptance of the food supplement or its dilution among other members of the family. Beneficiaries of CETP (<36 months) gained up to 1 cm while the CFP registered impact but only in the low socioeconomic children. Conversely, the (FSP) did not show the expected effects on growth. This reduced impact is understandable because in order to permit the development of the children's growth potential interventions should be directed to strike on poverty as the main mechanism of the children's hampered growth. Hence, the best results are obtained by coordinated programs that combat poverty optimizing the intervention's continuity and management and give priority to the most vulnerable groups.

Design and evaluation of a campaign to promote the consumption of vegetables and fruits in Mexican school-age children.

INTRODUCTION: In Mexican school-age children the consumption of vegetables and fruits (V&F) is less than 25% of the amount recommended by the World Health Organization. OBJECTIVES: Evaluate the effectiveness of a promotion campaign about the consumption of V&F in urban school children from Hidalgo, Mexico. METHODS: A non controlled community trial in 226 school-age children from private and public schools was conducted, we designed and distributed printed material for promoting the consumption of V&F among the school population, access to V&F was provided through planning and sales at school stores, and consumption was supervised by the teachers. RESULTS: At the end of the intervention vegetable consumption increased by 50 g and plain water in 100 mL (T-test, p < 0.05); the proportion of school-age children who identified the health benefits of the consumption of V&F increased significantly (68% initial, 87% final) and greater support from parents (61% initial, 92 final%) was achieved. CONCLUSIONS: A promotion campaign and improved access to vegetables, fruits and water in the school environment which is supported by parents and teachers can encourage healthier eating at school.

Relación de la vulnerabilidad alimentaria con el estado de nutrición y fragilidad en adultos mayores mexicanos / Relationship of food vulnerability with nutritional status and fragility in elderly Mexicans

Introducción: Envejecer implica cambios físicos, biológicos, psicosociales y económicos que predisponen al adulto mayor (AM) a vulnerabilidad alimentaria (VA) influyendo en su estado de nutrición y fragilidad, trayendo como consecuencia un alto riesgo de discapacidad, hospitalización y mortalidad. Objetivo: Determinar la relación de la vulnerabilidad alimentaria con el estado de nutrición y fragilidad en una población de adultos mayores mexicanos. Métodos: Se realizó un estudio observacional analítico en adultos de 60 años o más de ambos sexos que se encontraban institucionalizados en el Centro Gerontológico Integral de Pachuca, México; los cuales dieron su consentimiento para realizar la Escala de Vulnerabilidad Alimentaria Nutricional, el cuestionario Mini Nutritional Assessment MNA(R) y el cuestionario Frail de cribado para identificar personas frágiles. Resultados: Se incluyeron 80 AM de 60-64 años (n=19), 65-74 años (n=37) y ≥ 75 (n=24) años; encontrando proporciones de VA leve de 92.5% y VA moderada de 7.5%; y el 50% de AM se encontró con riesgo de malnutrición de acuerdo con MNA(R), y 65% se encontró con riesgo de fragilidad de acuerdo con la escala Frail. Se encontró correlación negativa entre el puntaje obtenido en MNA y puntaje de VA (r= -0.56, p <0.001), y no se encontró asociación entre VA y fragilidad (CHI2, p =0.062). Conclusión: Una mayor vulnerabilidad alimentaria se asoció con incrementó del riesgo de malnutrición en los adultos mayores, pero no se encontró relación entre vulnerabilidad alimentaria con la fragilidad. Una alta proporción de adultos mayores presentó algún indicador de fragilidad, lo que en el corto plazo podría afectar su calidad de vida

Introduction: Aging implies physical, biological, psychosocial and economic changes that predispose the elderly (AM) to food vulnerability (VA) influencing their nutritional status and fragility, resulting in a high risk of disability, hospitalization and mortality. Objective: To determine the relationship of food vulnerability with the state of nutrition and frailty in an elderly Mexican population. Methods: An analytical observational study was conducted in adults of 60 years or older of both sexes who were institutionalized in the Comprehensive Gerontological Center of Pachuca, Mexico; who gave their consent to carry out the Nutritional Food Vulnerability Scale, the Mini Nutritional Assessment MNA(R) questionnaire and the Frail screening questionnaire to identify frail people.Results: 80 AM of 60-64 years (n = 19), 65-74 years (n = 37) and ≥75 (n = 24) years were included; finding proportions of mild VA of 92.5% and moderate VA of 7.5%; and 50% of AM was at risk of malnutrition according to MNA(R), and 65% was found to be at risk of frailty according to the Frail scale. A negative correlation was found between the score obtained in MNA and the VA score (r = -0.56, p <0.001), and no association was found between VA and fragility (CHI2, p = 0.062). Conclusion: Greater food vulnerability was associated with increased risk of malnutrition in older adults, but no relationship was found between food vulnerability and frailty. A high proportion of older adults presented some indicator of frailty, which in the short term could affect their quality of life