Manual para la capacitación de actores sociales. Compromiso 1: "Mejora del estado nutricional y de salud de los gestantes y niños hasta los 12 meses de edad para la prevención de la anemia" / Manual for the training of social actors. Commitment 1: "Improvement of the nutritional and health status of pregnant women and children up to 12 months of age for the prevention of anemia"

El presente manual, ofrece al facilitador, y/o personal de salud, una metodología y orientaciones para seguir fortaleciendo las capacidades, habilidades y destrezas de los actores sociales, en el uso del rotafolio en los temas priorizados, para el desarrollo de visitas domiciliarias con calidad, logrando en los padres de familia o gestantes, una cultura de cuidado y protección para sus niñas y niños hasta 12 meses de edad, con énfasis en la prevención de la anemia

Manual de autoaprendizaje para el actor social del compromiso 1: "Mejora del estado nutricional y de salud de las gestantes y niños hasta los 12 meses de edad para la prevención de anemia" / Self-learning manual for the social actor of Commitment 1: "Improvement of the nutritional and health status of pregnant women and children up to 12 months of age for the prevention of anemia"

El presente manual contiene el desarrollo de temas sobre el Desarrollo Infantil Temprano saludable como un derecho de las niñas y niños; el actor social y su papel en el cuidado infantil, la prevención y reducción de la anemia; la visita domiciliaria y las sesiones temáticas para desarrollar durante la visita a los niños hasta los 12 meses de edad o a las gestantes; las que deberás revisar y aprender, para así motivar y persuadir a la madre, padre o cuidador de la niña o niño o a la gestante a mejorar las prácticas de cuidado

Application of Global Leadership Initiative on Malnutrition criteria in patients with liver cirrhosis / 中华医学杂志(英文版)

BACKGROUND@#The Global Leadership Initiative on Malnutrition (GLIM) criteria were published to build a global consensus on nutritional diagnosis. Reduced muscle mass is a phenotypic criterion with strong evidence to support its inclusion in the GLIM consensus criteria. However, there is no consensus regarding how to accurately measure and define reduced muscle mass in clinical settings. This study aimed to investigate the optimal reference values of skeletal muscle mass index for diagnosing sarcopenia and GLIM-defined malnutrition, as well as the prevalence of GLIM-defined malnutrition in hospitalized cirrhotic patients.@*METHODS@#This retrospective study was conducted on 1002 adult patients with liver cirrhosis between January 1, 2018, and February 28, 2022, at Beijing You-An Hospital, Capital Medical University. Adult patients with a clinical diagnosis of liver cirrhosis and who underwent an abdominal computed tomography (CT) examination during hospitalization were included in the study. These patients were randomly divided into a modeling group (cohort 1, 667 patients) and a validation group (cohort 2, 335 patients). In cohort 1, optimal cut-off values of skeletal muscle index at the third lumbar skeletal muscle index (L3-SMI) were determined using receiver operating characteristic analyses against in-hospital mortality in different gender groups. Next, patients in cohort 2 were screened for nutritional risk using the Nutritional Risk Screening 2002 (NRS-2002), and malnutrition was diagnosed by GLIM criteria. Additionally, the reference values of reduced muscle mass in GLIM criteria were derived from the L3-SMI values from cohort 1. Multivariate logistic regression analysis was used to analyze the association between GLIM-defined malnutrition and clinical outcomes.@*RESULTS@#The optimal cut-off values of L3-SMI were 39.50 cm 2 /m 2 for male patients and 33.06 cm 2 /m 2 for female patients. Based on the cut-off values, 31.63% (68/215) of the male patients and 23.3% (28/120) of the female patients had CT-determined sarcopenia in cohort 2. The prevalence of GLIM-defined malnutrition in cirrhotic patients was 34.3% (115/335) and GLIM-defined malnutrition was an independent risk factor for in-hospital mortality in patients with liver cirrhosis ( Wald = 6.347, P  = 0.012).@*CONCLUSIONS@#This study provided reference values for skeletal muscle mass index and the prevalence of GLIM-defined malnutrition in hospitalized patients with liver cirrhosis. These reference values will contribute to applying the GLIM criteria in cirrhotic patients.

Food (in) security and nutritional dietary quality In Brazil / Insegurança alimentar e nutricional e qualidade da dieta no Brasil

ABSTRACT Objective Verify association between the perception of food insecurity and the diet quality of the Brazilian population, applying The Brazilian Food Insecurity Scale and the Brazilian Healthy Eating Index Revised. Methods Cross-sectional study using data from the Householder Budget Survey collected in 2017/18 with two 24-hour recalls. A multinomial regression model was used with Odds Ratio and a 95% confidence interval, with the final model being the insertion of variables according to the theoretical model of hierarchy adopted. Results A total of 57,920 households were analyzed, and of these, 39.22% lived with some degree of Food Insecurity. There was a significant difference between female heads of the household, mixed race and black race, households with adults and children and living in rural regions as the three levels of AI [Food insecure] (p=<0.001), with a greater chance of food insecurity in these households. The average Brazilian Healthy Eating Index Revised for the 46,152 individuals was 54.23 points for those who were not food insecure, and 54.11 points for those who experienced severe food insecurity. Conclusion It is concluded that there is an association between the perception of food insecurity and the nutritional quality of the diet of the Brazilian population, which can lead to malnutrition and obesity.

RESUMO Objetivo Verificar a associação entre a percepção de insegurança alimentar e a qualidade da dieta da população brasileira, aplicando a Escala Brasileira de Insegurança Alimentar e o Índice de Qualidade da Dieta Revisado a partir de dois recordatórios de 24 horas. Métodos Estudo transversal que utilizou dados da Pesquisa de Orçamentos Familiares de 2017-2018. Utilizou-se o modelo de regressão multinomial com Odds Ratio e intervalo de confiança de 95%, sendo o modelo final com inserção das variáveis de acordo com o modelo teórico de hierarquia adotado. Resultados Foram analisados 57.920 domicílios, e destes, 39,22% viviam com algum grau de Insegurança Alimentar. Verificou-se diferença significativa entre pessoas do sexo feminino como chefe do domicílio, raça pardo e preto, domicílios com adultos e crianças e residir na região rural como os três níveis de Insegurança Alimentar (p=<0,001), havendo uma maior chance de insegurança alimentar nesses domicílios. A média do Índice de Qualidade da Dieta Revisado para os 46.152 indivíduos foi de 54.23 pontos para os que não apresentavam insegurança alimentar, e 54.11 pontos para aqueles que vivenciaram insegurança alimentar grave. Conclusão Conclui-se que existe associação entre a percepção de insegurança alimentar e a qualidade nutricional da dieta da população brasileira, o que pode levar à desnutrição e obesidade.

Dietary total antioxidant capacity, cardiovascular risk, and anthropometric obesity indices in hemodialysis patients: A case-control study / Capacidade antioxidante total da dieta, risco cardiovascular e índices antropométricos de obesidade em pacientes em hemodiálise: um estudo de caso-controle

ABSTRACT Objective: Oxidative stress is triggered by malnutrition and antioxidant losses due to dialysis in hemodialysis patients and thus, oxidative stress increases the risk of mortality in patients with cardiovascular disease and obesity. The study aims to determine differences in cardiovascular risk scores and obesity indices between hemodialysis and control groups and to examine the relationship between the tertiles of dietary total antioxidant capacity with cardiovascular risk, and obesity in hemodialysis and control groups. Methods: This is a cross-sectional case-control study involving hemodialysis patients (n=46) and healthy individuals (n=46). Participants' general characteristics were obtained via a questionnaire, and the Framingham Risk Score was calculated. The dietary total antioxidant capacity was calculated using two methods based on a seven-day food record. Obesity indices, such as Basal Metabolism Index and Body Shape Index, were calculated using anthropometric measurements. Results: The mean age of the participants was 51.1±10.4 years. In the hemodialysis group, obesity indices including body weight, Basal Metabolism Index, waist circumference, fat mass index, and fat-free mass index were lower, while Framingham Risk Score values ​​were higher than the control group (p<0.05). Energy-adjusted dietary total antioksidant capacity values were lower ​​in hemodialysis group, and most patients were in the low tertiles of Trolox equivalent antioxidant capacity, total radical-trapping antioxidant parameter, ferric reducing-antioxidant power and vitamin C equivalent antioxidant capacity (p<0.05). Conclusion: Providing hemodialysis patients with a healthy diet can increase the dietary total antioxidant capacity, and potentially reduce cardiovascular risk, and obesity indices.

RESUMO Objetivo: O estresse oxidativo é desencadeado pela desnutrição e perdas de antioxidantes devido à diálise em pacientes em hemodiálise, portanto, o estresse oxidativo aumenta o risco de mortalidade em pacientes com doenças cardiovasculares e obesidade. O estudo visa determinar as diferenças nos escores de risco cardiovascular e índices de obesidade entre os grupos de hemodiálise e controle, bem como examinar a relação entre os tercis da capacidade antioxidante total da dieta e o risco cardiovascular e obesidade nos grupos de hemodiálise e controle. Métodos: Este é um estudo transversal de caso-controle envolvendo pacientes em hemodiálise (n=46) e indivíduos saudáveis (n=46). As características gerais dos participantes foram obtidas por meio de um questionário, e o Escore de Risco de Framingham foi calculado. A capacidade antioxidante total da dieta foi calculada utilizando dois métodos baseados em um registro alimentar de sete dias. Índices de obesidade como o Índice de Metabolismo Basal e o Índice de Forma Corporal, foram calculados por meio de medidas antropométricas. Resultados: A média de idade dos participantes foi de 51.1±10.4 anos. No grupo de hemodiálise, os índices de obesidade, incluindo peso corporal, Índice de Metabolismo Basal, circunferência da cintura, índice de massa gorda e índice de massa livre de gordura, foram menores, enquanto os valores do Escore de Risco de Framingham foram maiores do que no grupo controle (p<0.05). Os valores de dTAC ajustados pela energia foram menores no grupo de foram hemodiálise, e a maioria dos pacientes estava nos tercis mais baixos de Capacidade antioxidante equivalente ao Trolox, parâmetro antioxidante total de captura de radicais, poder antioxidante redutor férrico e capacidade antioxidante equivalente à vitamina C (p <0.05). Conclusão: Fornecer aos pacientes em hemodiálise uma dieta saudável pode aumentar a capacidade antioxidante total da dieta, reduzindo potencialmente o risco cardiovascular e os índices de obesidade.

Prédicteurs de mortalité précoce en cours d'hospitalisation des enfants malnutris aigus sévères de 0-59 mois au CHU Sourou Sanou, Bobo-Dioulasso / Predictors of early mortality during hospitalization of severe acute malnourished children aged 0-59 months at CHU Sourô Sanou, Bobo-Dioulasso

Objectifs : étudier les facteurs de risque de mortalité des enfants malnutris aigus sévères (MAS) dans les 72 premières heures d'hospitalisation. Méthode : Nous avons mené une étude rétrospective sur des données d'enfants MAS de 0-59 mois, hospitalisés du 1er juin 2016 au 31 mai 2019 au CHUSourô Sanou (CHUSS) de Bobo-Dioulasso. Une régression logistiquea été réalisée pour déterminer les facteurs de risque de décès. Les variables avec un odds ratio (OR) >1, et p 3s [OR :3.55, 95%IC: 1.50-8.27], le sepsis [OR : 3.39, 95%IC: 1.33-8.50], étaient les facteurs de risque prédictifs de mortalité. Conclusion : Une formation et supervision continue du personnel soignant sur la prise en charge des urgences pédiatriques, l'utilisation du protocole OMS de prise en charge de la MAS, la disponibilité de kits d'urgence pourraient améliorer la prise en charge des MAS. Mots clés : Mortalité, précoce, MAS, BoboDioulasso

Objectives: to study risk factors for mortality in SAM children within the first 72 hours of hospitalization. Methods: We conducted a retrospective study on data from 0-59-month-old SAM children hospitalized from June 1th, 2016, to May 31th, 2019, at CHUSourô Sanou of Bobo-Dioulasso. A logistic regression was performed to determine risk factors for death. Variables with odds ratio (OR) > 1, and p 3seconds [OR :3.55, 95%IC: 1.50-8.27], sepsis[OR :3.39, 95%IC: 1.33-8.50]were the risk factors predictive of mortality. Conclusion: Training and ongoing supervision of healthcare staff in the management of paediatric emergencies, the use of the WHO SAM management protocol and the availability of emergency kits could improve SAM management

Seguridad alimentaria, subalimentación y canasta alimentaría en el contexto de las políticas públicas en Venezuela. Período2017-2022 / Food security, undernourishment and food basket in thecontext of public policies in Venezuela. Period 2017-2022

El presente estudio tiene como objetivo analizarla relación entre los indicadores de seguridad alimentaria,subalimentación y costo de la canasta alimentaria en el contextode las políticas públicas en materia alimentaria en Venezuela,durante el periodo comprendido entre 2017 y 2022. Para ello, sellevó a cabo un análisis exhaustivo de los datos disponibles sobrela seguridad alimentaria en Venezuela, incluyendo informaciónsobre la subalimentación, y el costo de la canasta alimentaria.Asimismo, se analizaron las políticas públicas implementadas enel país en materia alimentaria durante el periodo de estudio, conel fin de entender su impacto en los indicadores de seguridadalimentaria. Ninguna de las asociaciones estudiadas resultó sersignificativa a nivel estadístico (p>0,05), por lo que, aunqueteóricamente existe una relación entre estos indicadores en elperíodo estudiado, el carácter multidimensional prevalece y hacecompleja la posibilidad de comparaciones. Se identificaron laspolíticas públicas que requieren mejoras o ajustes para proteger laseguridad alimentaria del venezolano. Estos resultados obtenidospodrán ser de utilidad para los responsables de la toma dedecisiones en el país, así como para los investigadores yprofesionales interesados en el tema de la seguridad alimentariay la nutrición

EL objective of this study is to analyzethe relationship between the indicators of food security,undernourishment and the cost of the food basket in thecontext of public policies on food in Venezuela, during theperiod between 2017 and 2022. For this, an exhaustive analysisof the available data on food security in Venezuela wascarried out, including information on undernourishment, andthe cost of the food basket. Likewise, the public policiesimplemented in the country regarding food during the studyperiod were analyzed, in order to understand their impacton food security indicators. None of the associations studiedturned out to be statistically significant (p>0.05), therefore,although theoretically there is a relationship between theseindicators in the period studied, the multidimensional natureprevails and makes comparability complex. Public policies that require improvements or adjustments to protect Venezuelanfood security were identified. These results obtained may beuseful for those responsible for decision-making in the country,as well as for researchers and professionals interested in thesubject of food security and nutrition.

Canasta alimentaria normativa: perspectivas actuales e implicaciones para la salud pública en Venezuela / Normative Food Basket current perspectives and implications for public health in Venezuela

La Canasta Alimentaria Normativa (CAN) es un instrumento estratégico de planificación y seguimiento, que impacta el ámbito económico (fijación del salario mínimo SM y del umbral de la pobreza relativa), la seguridad alimentaria y la salud pública. El objetivo fue describir la evolución histórica de la CAN en Venezuela, contrastando su valoración económica respecto al SM durante el período 1990 ­ 2023. Tipo de estudio: Descriptivo. Se empleó la CAN del Instituto Nacional de Estadísticas/Instituto Nacional de Nutrición (INE/INN) y su comparación con la canasta del Centro de Documentación y Análisis Social de la Federación Venezolana de Maestros(CENDAS ­ FVM). Los valores mensuales de la CAN y del SM se recalcularon a dólares USA, de acuerdo a la tasa de cambio oficial. No se incluyó evaluación de la estructura interna, ni sus expresiones en términos de aporte de energía y nutrientes. Resultados: Desde 1990 hasta el año 2015, se requirieron entre1,0 y 1,8 SM y entre 0,6 y 1,7 Ingresos Mínimos Legales (IML)para acceder a la CAN. Para el año 2023 se requirieron hasta 78,3SM y 51,6 IML. El valor promedio de la canasta del CENDAS-FVM fue superior al valor de la CAN INE/INN, en una proporción de 1,7: 1. Conclusiones: la CAN resultó sensible en identificar los cambios y tendencias de su estimación económica, en el ambiente inflacionario venezolano. El uso de sus resultados está sujeta a cierto grado de discrecionalidad política. El costo de la CAN, expresa una contracción del poder de compra de los hogares venezolanos con potenciales impactos sobre la nutrición y la salud física y mental a corto y largo plazo.

The Normative Food Basket (NFB) represents astrategic planning and monitoring instrument, which impactsthe economic sphere (setting of the minimum wage (MW) andthe relative poverty threshold), food security and public health.The objective was to describe the historical evolution of the NFB in Venezuela, contrasting its economic valuation with respect to the MW during the period 1990 ­ 2023. Type of study: Descriptive. The NFB of the National Institute of Statistics/National Institute of Nutrition (NIS/NIN) was used and itscomparison with the basket of the Center for Documentationand Social Analysis of the Venezuelan Federation of Teachers (CENDAS ­ FVM). The monthly values of the NFB and theMW were recalculated into dollars (US$), according to theofficial exchange rate. No evaluation of the internal structurewas included, nor its expressions in terms of energy and nutrientcontribution. Results: From 1990 to 2015, between 1.0 and1.8 MW and between 0.6 and 1.7 Minimum Legal Income(MLI) were required to access the NFB. By 2023, up to 78.3MW and 51.6 MLI were required. The average value of the CENDAS-FVM basket was higher than the value of the NFBNIS/NIN, in a proportion of 1.7: 1. Conclusions: As a statistical operation, the NFB was sensitive in identifying changes andtrends in its estimate economic, in the Venezuelan inflationaryenvironment. The use of its results is subject to a certain degree ofpolitical discretion. The cost of CAN expresses a contraction inthe purchasing power of Venezuelan households with potentialimpacts on nutrition and physical/mental health in the shortand long term.

ANÁLISIS DE LA ADECUACIÓN DEL APORTE NUTRICIONAL A LA META CALÓRICA Y PROTEICA EN PACIENTES CON NUTRICIÓN ENTERAL EXCLUSIVA INTERNADOS EN UN HOSPITAL PÚBLICO PEDIÁTRICO DE ALTA COMPLEJIDAD / ANALYSIS OF ADEQUACY OF THE NUTRITIONAL CONTRIBUTION TO THE CALORIE GOAL AND PROTEIN IN PATIENTS WITH ENTERAL NUTRITION EXCLUSIVE BOARDING SCHOOLS IN A PUBLIC HOSPITAL PEDIATRIC HIGH COMPLEXITY

La malnutrición en los pacientes hospitalizados representa un importante problema sanitario asociado a una mayor tasa de complicaciones con un incremento de la morbimortalidad

Malnutrition in hospitalized patients represents a significant health problem associated with an increased rate of complications and higher morbidity and mortality

Sarcopenia and risk of malnutrition as risk factors for complications from COVID-19 / Sarcopenia e risco de desnutrição como fatores de risco para complicações da COVID-19

Purpose: This study aimed to associate nutritional and sarcopenia risk with clinical outcomes in elderly patients with COVID-19. Methods: This is a longitudinal retrospective cohort study. Hospitalized elderly individuals diagnosed with COVID-19 were included in the study. Nutritional risk was assessed using the Malnutrition Universal Screening Tool (MUST), and Sarcopenia risk was assessed using the SARC-F. Associations were assessed through multivariable logistic models. Results: In total, 127 patients (mean age: 71.25 ±8.06 years) were followed up until the clinical outcome. Sarcopenia risk was diagnosed in 63.8% of the sample, whereas nutritional risk was observed in 72%. Hospitalization in the intensive care unit (ICU) was required in 48.8% of the sample, 38.6% required mechanical ventilation, and 32.3% died. Elderly individuals with sarcopenia risk were more likely to be hospitalized in ICUs (OR: 5.62; 95%CI: 2.2-14.3), require mechanical ventilation (OR: 4.0; 95% CI: 1.5-10.2), and die (OR: 5.06; 95% CI: 1.7-14.2). The risk of malnutrition assessed through MUST was an important risk factor for death (OR = 30.15; 95% CI: 3.6-245.8; p<0.01). Conclusion: Sarcopenia risk was a risk factor for death, hospitalization in ICU, and mechanical ventilation, while nutritional risk was a risk factor for death (AU).

Objetivo: Este estudo teve como objetivo associar o risco nutricional e de sarcopenia com desfechos clínicos em pacientes idosos com COVID-19. Métodos: Trata-se de um estudo de coorte retrospectivo longitudinal. Idosos hospitalizados com diagnóstico de COVID-19 foram incluídos no estudo. O risco nutricional foi avaliado usando o Malnutrition Universal Screening Tool (MUST) e o risco de sarcopenia foi avaliado usando o SARC-F. As associações foram avaliadas por modelos logísticos multivariados. Resultados: No total, 127 pacientes (média de idade: 71,25 ±8,06 anos) foram acompanhados até o desfecho clínico. Risco de sarcopenia foi diagnosticado em 63,8% da amostra, enquanto risco nutricional foi observado em 72% deles. Além disso, 48,8% da amostra necessitou de internação em unidade de terapia intensiva (UTI), 38,6% necessitaram ventilação mecânica e 32,3% foram a óbito. Idosos com risco de sarcopenia tiveram maior chance de internação em UTI (OR: 5,62; IC 95%: 2,2-14,3), necessidade de ventilação mecânica (OR: 4,0; IC 95%: 1,5-10,2) e óbito (OR: 5,06; IC 95%: 1,7-14,2). O risco de desnutrição avaliado pelo MUST foi um importante fator de risco para óbito (OR = 30,15; IC 95%: 3,6-245,8; p<0,01). Conclusão: O risco de sarcopenia foi fator de risco para óbito, internação em UTI e ventilação mecânica, enquanto o risco nutricional foi fator de risco para óbito (AU).

Lineamientos para la atención integral de niñas y niños menores de diez años con desnutrición severa / Guidelines for the comprehensive care of children under ten years of age with severe malnutrition

Actualmente, 1 de cada 6 niños tiene desnutrición crónica, condición que genera consecuencias preocupantes en el neurodesarrollo y que limitan el progreso del país. En la actualidad la información estadística se enfoca en los primeros 5 años de vida, pero es fundamental realizar intervenciones oportunas en las niñas y niños menores de diez años, ya que en esta etapa se establecen las bases para las funciones cerebrales superiores como la memoria, el lenguaje, el razonamiento lógico, la percepción espacial, la discriminación visual y auditiva. El Sistema Nacional Integrado de Salud, suma esfuerzos para orientar al clínico sobre el abordaje integral de la desnutrición severa, basados en evidencia científica actualizada, siendo vital brindar cuidados cariñosos, intervención oportuna del personal de salud, la familia y comunidad, para evitar o disminuir secuelas o complicaciones

Currently, 1 in 6 children suffer from chronic malnutrition, a condition that has worrying consequences for neurodevelopment and limits the country's progress. Currently the statistical information is focused on the first 5 years of life, but it is essential to make timely interventions in girls and boys under the age of ten, since at this stage the foundations are established for higher brain functions such as memory, language, logical reasoning, spatial perception, visual and auditory discrimination. The National Integrated Health System is working to guide clinicians on the comprehensive approach to severe malnutrition, based on up-to-date scientific evidence, and it is vital to provide loving care and timely intervention by health personnel, family and community, to prevent or reduce sequelae or complications

Sobrepeso y obesidad en escolares de la Región de Magallanes y Antártica Chilena, Chile, (2009 ­ 2019), y comparación de dos metodologías para el diagnóstico / Overweight and obesity in schoolchildren in the Magallanes and Chilean Antarctica Region, Chile, (2009 - 2019), and comparison of two methodologies for diagnosis

Introducción. En Chile la prevalencia de obesidad total en población escolar alcanza al 31% y la obesidad severa al 10,8%. La Región de Magallanes y Antártica Chilena, es una de las más afectadas por esta epidemia. El diagnóstico nutricional confiable y una intervención oportuna pueden evitar que los niños enfermen y deterioren su calidad de vida. Objetivo: Analizar la tendencia del estado nutricional de escolares de la Región de Magallanes, según datos reportados por la Junta Nacional de Auxilio Escolar y Becas, JUNAEB, entre 2009-2019 y comparar resultados del año 2010 con un estudio propio. Materiales y métodos. Se analizó el estado nutricional de 71.334 escolares de la Región de Magallanes y Antártica Chilena por nivel educacional y variables demográficas, según información de JUNAEB. Luego se compararon los resultados de escolares de 1º básico del año 2010, obtenidos a través de dos metodologías: fuente secundaria, Encuesta JUNAEB, y fuente primaria, estudio antropométrico realizado en la misma región y año. Resultados. Según datos de JUNAEB el exceso ponderal se incrementó en escolares de la región en 4,4 % entre 2009 y 2019, el grupo más afectado fue 1º básico. En el año 2010 la prevalencia de obesidad para escolares de 1º básico según JUNAEB fue 21,8% y según estudio regional propio fue 25,7%. Conclusiones. La malnutrición por exceso afecta al 53,8% de los escolares de la Región de Magallanes y podría ser mayor, considerando que la información censal podría estar subestimando el sobrepeso y obesidad. Es urgente intervenir para evitar perpetuar esta epidemia(AU)

Introduction. In Chile the prevalence of total obesity in school population reaches 31% and severe obesity 10.8%. The Magallanes and Chilean Antarctica Region is one of the most affected by this epidemic. Reliable nutritional diagnosis and timely intervention can prevent children from getting sick and deteriorating their quality of life. Objective. To analyze the trend of nutritional status of schoolchildren in the Magallanes Region, according to data reported by the National Board of School Aid and Scholarships, JUNAEB between 2009-2019 and compare results from 2010 with our own study. Materials and methods. The nutritional status of 71,334 schoolchildren in the Magallanes Region and Chilean Antarctica was analyzed by educational level and demographic variables, according to information from JUNAEB. Then, the results of schoolchildren in 1st grade in 2010 were compared, obtained through two methods: secondary source, JUNAEB survey, and primary source, anthropometric study carried out in the same region and year. Results. According to JUNAEB data, overweight increased in school children in the region by 4.4% between 2009 and 2019, the most affected group was 1st grade. In 2010 the prevalence of obesity for 1st grade schoolchildren according to JUNAEB was 21.8% and according to our own regional study it was 25.7%. Conclusions. Excess malnutrition affects 53.8% of school children in the Magallanes Region and could be higher, considering that census information could be underestimating overweight and obesity. It is urgent to intervene to avoid perpetuating this epidemic(AU)

Estado nutricio de niños del noroeste de México pre y post pandemia por COVID-19 / Nutritional status of children in northwest Mexico pre and post COVID-19 pandemic

Introducción. Mundialmente se observaron consecuencias negativas en la salud por el aislamiento social durante la pandemia de COVID-19; el sobrepeso y la obesidad mostraron tendencias crecientes. Objetivo. Analizar los cambios en el sobrepeso, obesidad y alimentación de escolares del noroeste de México antes y después del aislamiento por COVID-19. Materiales y métodos. Se colectaron y analizaron el peso, talla y circunferencia de cintura de escolares del noroeste de México pre y post pandemia por COVID 19 (n=479 y n=820). Además, se analizaron los cambios en la alimentación en una submuestra de 203 y 179 escolares pre y post pandemia, respectivamente. Resultados. La edad promedio de los escolares en 2019 fue 8,9 ±1,75 y en el 2022 de 9,1 ± 1,54 años. Se observó un aumento de 6,2 puntos porcentuales en la prevalencia de sobrepeso y obesidad y diferencias en la distribución de las categorías del estado nutricio (p=0,049) entre los dos periodos. También, se observaron cambios en la adiposidad central con un aumento de 3 centímetros en la circunferencia de cintura (p=0,001; 62,6 y 65,6 cm). El índice de alimentación saludable (IAS) mostró una alimentación poco saludable durante los dos periodos. Conclusiones. El aumento en las prevalencias de sobrepeso y obesidad, así como de obesidad central durante la emergencia epidemiológica, indicaron un deterioro del estado nutricio de los escolares, que coincide con los reportes en poblaciones a nivel mundial y en Latinoamérica; los resultados resultan preocupantes dada la problemática antes de la emergencia(AU)

Introduction. Negative health consequences due to social isolation during the COVID-19 pandemic were observed worldwide; overweight and obesity showed increasing trends. Objective. To analyze the changes in overweight, obesity and diet of schoolchildren in northwest Mexico before and after lockdown due to COVID-19. Materials and methods. Weight, height, and waist circumference of schoolchildren (n=479 pre-pandemic and n=820 post-pandemic) were collected in public schools located in medium to high marginalization neighborhoods. In the same periods dietary data was collected from a subsample of 203 and 179 schoolchildren, respectively. Results. The average age of schoolchildren in 2019 was 8,9 ±1,75 and 9,1 ± 1,54 in 2022. An increase in percentage of 6,2 was observed in the overweight plus obesity prevalence and a significant difference in the distribution of nutritional status (p=0,049) between the two periods. In addition, changes in central adiposity were observed, with an increase of 3 centimeters in waist circumference (p=0,001; 62,6 and 65,6 cm). The healthy eating index (HAI) classified the diet of schoolchildren as unhealthy during both periods. Conclusions. The increase in the prevalence of overweight and obesity, as well as central adiposity is worrying given that they were already a health problem before the COVID 19 confinement(AU)

Temporal trend in the nutritional status of children in a Brazilian metropolis in light of food and nutrition policies / Tendencia temporal en el estado nutricional de los niños en una metrópolis brasileña a la luz de las políticas de alimentación y nutrición

Introduction. Brazil's health system offers insights into addressing the double burden of malnutrition by proper population monitoring, coupled with local policies and national guidelines. Objective. To investigate the recent temporal trends in nutritional status indicators and its coverage of children aged two to five years from Campinas, a metropolis in the state of São Paulo, Brazil. Material and methods. The analysis of time series from 2018 to 2022 were conducted by accessing data from the Brazilian Food and Nutrition Surveillance System (SISVAN) due to regression analysis. Results. The number of children aged two to five in the SISVAN registry rose from 7,300 in 2018 to 11,171 in 2022, forming the study sample. In 2018, 700 were chronically undernourished, 306 underweight, and 977 overweight; by 2022, 530 showed stunting, 457 were underweight, and 1,084 overweight. Stunting prevalence declined from 9.6% (2018) to 4.7% (2022). Underweight dropped slightly from 4.2% to 4.1% over the years and overweight, consistently the highest indicator, ranged from 13.4% (2018) to 9.7% (2022). SISVAN's coverage varied between 16.6% (2018) and 26.1% (2022), the lowest at 12.3% in 2020. The trend for stunting decreased significantly (APV: -15.01; CI95% -22.64; -6.62). Adding SISVAN's coverage variable the model slightly reduced the declining stunting trend (APV: -12.12; CI95% -13.19; -11.04). Conclusions. Coordinated efforts to address nutritional challenges, from adequate population monitoring to the interaction between local policies and national guidelines, have shown positive health outcomes(AU)

Introducción. El sistema de salud de Brasil ofrece conocimientos valiosos para abordar la doble carga de malnutrición mediante el seguimiento adecuado de la población y políticas locales y nacionales. Objetivo. Investigar las tendencias temporales recientes en indicadores nutricionales y cobertura en niños de dos a cinco años en Campinas, São Paulo, Brasil. Materiales y métodos. Se analizaron datos del SISVAN de 2018 a 2022 con regresión temporal. Resultados. Niños de dos a cinco años en el SISVAN pasaron de 7,300 en 2018 a 11,171 en 2022. En 2018, 700 estaban crónicamente desnutridos, 306 con bajo peso y 977 con sobrepeso; en 2022, 530 con retraso en el crecimiento, 457 con bajo peso y 1,084 con sobrepeso. La prevalencia del retraso en el crecimiento bajó de 9,6% a 4,7%. El bajo peso disminuyó levemente del 4,2% al 4,1% y el sobrepeso osciló del 13,4% al 9,7%. La cobertura de SISVAN varió de 16.6% a 26.1%, con un mínimo de 12.3% en 2020. La tendencia del retraso en el crecimiento disminuyó significativamente (APV: -15.01; CI95% -22.64; -6.62). La inclusión de la cobertura de SISVAN redujo levemente esta tendencia (APV: -12.12; CI95% -13.19; -11.04). Conclusiones. Coordinar esfuerzos para abordar los desafíos nutricionales, desde el seguimiento de la población hasta políticas locales y nacionales, ha tenido resultados positivos para la salud(AU)

Implementación de la reformulación técnica y renovación de marcas del programa nacional de alimentación complementaria (PNAC), subprogramas básico y refuerzo, segmento 12-71 meses. Informe técnico / Implementation of the technical reformulation and rebranding of the national supplementary feeding programme (PNAC), basic and booster sub-programmes, 12-71 months segment. Technical Report

A consecuencia de los cambios demográficos, epidemiológicos y especialmente los nutricionales de la población objetivo, en los últimos años se identificó la necesidad de reformular este programa. En particular, el trabajo realizado por el grupo asesor derivó en una serie de recomendaciones de cambios y mejoras al PNAC. De ellas, en este documento se abordan las relativas al PNAC Básico y Refuerzo en el segmento 12-71 meses, las que fueron implementadas en el primer semestre de 2023 en todo el país.

Efectividad de la administración de hierro en forma semanal y diaria para la prevención de anemia por deficiencia de hierro en lactantes / Effectiveness of weekly and daily iron administration for the prevention of iron deficiency anemia in infants

Introducción. La deficiencia de hierro (DH) es la carencia nutricional más prevalente y la principal causa de anemia en lactantes. Existe consenso en la suplementación diaria con hierro como estrategia de prevención; también se demostró que la suplementación semanal es eficaz, pero la evidencia en lactantes es escasa. El objetivo fue comparar la efectividad de la administración diaria de hierro frente a la semanal para la prevención de la anemia por DH del lactante. Población y métodos. Ensayo clínico controlado y aleatorizado. Lactantes atendidos en un centro de salud público, sin anemia a los 3 meses de edad, aleatorizados en tres grupos: suplementación diaria (1 mg/kg/día), semanal (4 mg/kg/semana) o sin suplementación (grupo control con lactancia materna exclusiva [LME]). Se evaluó anemia y DH a los 3 y 6 meses. Se registró grado de adherencia y efectos adversos. Los datos se analizaron con el software R versión 4.0.3. Resultados. Participaron 227 lactantes. A los 6 meses el grupo de lactantes con LME sin suplementación (control) presentó prevalencias de DH y anemia por DH (ADH) mayores que los grupos intervenidos (diario y semanal). DH: 40,5 % vs. 13,5 % y 16,7 % (p = 0,002); ADH: 33,3 % vs. 7,8 % y 10 % (p < 0,001). No hubo diferencias entre los grupos diario y semanal. Tampoco hubo diferencias en el porcentaje de alta adherencia a la suplementación (50,6 % diaria vs. 57,1 % semanal), ni en los efectos adversos. Conclusiones. No se hallaron diferencias significativas en la efectividad entre la administración diaria y semanal para la prevención de ADH del lactante.

Introduction. Iron deficiency (ID) is the most prevalent nutritional deficiency and the main cause of anemia in infants. There is consensus on daily iron supplementation as a preventive strategy; and weekly iron supplementation has also been shown to be effective, but evidence in infants is scarce. The objective of this study was to compare the effectiveness of daily versus weekly iron administration for the prevention of ID anemia (IDA) in infants. Population and methods. Randomized, controlled clinical trial. Infants seen at a public health center, without anemia at 3 months of age, were randomized into 3 groups: daily supplementation (1 mg/kg/ day), weekly supplementation (4 mg/kg/week), or no supplementation (control group with exclusive breastfeeding [EB]). Anemia and ID were assessed at 3 and 6 months old. Adherence and adverse events were recorded. Data were analyzed using the R software, version 4.0.3. Results. A total of 227 infants participated. At 6 months, the group of infants with EB without supplementation(control) had a higher prevalence of ID and IDA than the intervention groups (daily and weekly). ID: 40.5% versus 13.5% and 16.7% (p = 0.002); IDA: 33.3% versus 7.8% and 10% (p < 0.001). There were no differences between the daily and weekly supplementation groups. There were also no differences in the percentage of high adherence to supplementation (50.6% daily versus 57.1% weekly) or adverse events. Conclusions. No significant differences in effectiveness were observed between daily and weekly administration for the prevention of infant IDA.

Percentiles de peso, talla e índice de masa corporal de escolares de Mendoza. Comparación con la referencia de la Organización Mundial de la Salud / Body mass index, weight, and height percentiles in school-aged children from Mendoza. A comparison with the WHO reference

Introducción. La Organización Mundial de la Salud (OMS) recomienda el uso de tablas de referencia para monitorear el crecimiento y estado nutricional de niños, niñas y adolescentes. El peso corporal, la talla y el índice de masa corporal (IMC) son las variables más utilizadas. El presente trabajo tiene como objetivos estimar los percentiles de peso, talla e IMC de escolares (2009-2011) residentes en el departamento San Rafael (Mendoza) y compararlos con la referencia internacional de la Organización Mundial de la Salud, a fin de establecer su pertinencia para la evaluación del crecimiento y estado nutricional de dicha población. Población y métodos. Se realizó un estudio antropométrico transversal en 3448 escolares de entre 4,00 y 13,49 años de edad. Se utilizó el programa LMS ChartMarker Pro para calcular los valores percentilares de peso/edad, talla/edad e IMC/edad, por sexo y edad, y se compararon con las curvas de la OMS. Además, se calcularon diferencias porcentuales (D%) para estimar las diferencias y su significación estadística mediante prueba de Wilcoxon. Resultados. La población de San Rafael mostró, en varones y mujeres, valores percentilares superiores de peso e IMC (D% ≈7 % y 9 %, respectivamente), y menores de talla (D% ≈0,8 %) que los de la OMS (p <0,05). Conclusión. Las diferencias encontradas alertan sobre el empleo de la referencia OMS en la población escolar de San Rafael, ya que sobreestimaría las prevalencias de sobrepeso, obesidad y desnutrición crónica, y subestimaría la de desnutrición aguda y global. Esta situación resalta la importancia de contar con una referencia local.

Introduction. The World Health Organization (WHO) recommends the use of reference tables to monitor the growth pattern and nutritional status of children and adolescents. Body mass index (BMI), weight, and height are the most commonly used variables. The objective of this study was to estimate the BMI, weight, and height percentiles for school-aged children (2009-2011) living in the department of San Rafael (Mendoza) and compare them to the international World Health Organization reference to establish their relevance for the evaluation of the growth pattern and nutritional status of this population. Population and methods. A cross-sectional anthropometric study was conducted in 3448 school-aged children aged 4.00 to 13.49 years. The LMS ChartMarker Pro software was used to estimate the BMI- for-age, weight-for-age, and height-for-age percentiles, by sex and age, and they were compared with the WHO curves. Besides, percentage differences (%D) were calculated to estimate the differences and their statistical significance using the Wilcoxon test. Results. The population of boys and girls in San Rafael showed higher weight and BMI (%D ≈ 7% and 9%, respectively) percentiles, and lower height (%D ≈ 0.8%) values than WHO reference (p < 0.05). Conclusion. The differences found warn about the use of the WHO reference in the school-aged population of San Rafael since it would overestimate the prevalence of overweight, obesity, and chronic malnutrition and underestimate the prevalence of acute and global malnutrition. This situation highlights the importance of having a local reference resource

Formulación de galletas fortificadas por sustitución parcial de harina de moringa y suero lácteo / Formulation of fortified cookies by partial substitution of moringa flour and whey

El suero lácteo y la moringa poseen alto valor nutricional; sin embargo, su uso en la elaboración de productos alimenticios es una alternativa viable pero poco utilizada. Objetivo. Elaborar una galleta fortificada por sustitución parcial de harina de moringa (HM) y polvo de suero lácteo (PSL). Materiales y métodos. Durante septiembre-diciembre 2021, se desarrollaron cuatro formulaciones con sustitución parcial de harina de trigo por HM y PSL (F0=100:0:0; F1=90:5:5; F2=80:10:10; F3=70:15:15). La aceptación del producto se determinó mediante una evaluación sensorial considerando los atributos sabor, olor, color, textura y aceptación general. Se realizó el análisis químico proximal a la HM, al PSL, a la formulación de mayor aceptación y a F0. Se compararon los distintos parámetros químico proximales y de aceptación mediante una anova de una vía, seguido de una prueba de comparación de medias de Tukey (p<0,05). Resultados. Conforme se incrementa el porcentaje de sustitución de harina de trigo por HM y PSL se obtiene menor aceptación de las galletas, siendo F1 la más aceptada. F1 registró un contenido proteico de 6,90±0,04%, significativamente mayor al observado en F0. Conclusiones. La buena aceptabilidad de F1 indica que la sustitución parcial por HM y PSL no influyen en su aceptación; además, F1 mostró un enriquecimiento de proteinas, lípidos y cenizas, así como contenido adecuado de humedad y carbohidratos(AU)

Introduction. Whey and moringa have high nutritional value; however, their use in the production of food products is a viable but rarely used alternative. Objective. To make a biscuit fortified by partial substitution of moringa flour (MF) and whey powder (WP). Materials and methods. During September-December 2021, four formulations were developed with different degrees of partial substitution of wheat flour for MF and WP (F0=100:0:0; F1=90:5:5; F2=80:10:10; F3=70:15:15). The acceptance of the product was determined through a sensory evaluation considering the attributes taste, odor, color, texture and general acceptance. A proximal chemical analysis was performed on the MF, WP, the most widely accepted formulation and F0. Proximal chemical parameters and acceptance attributes were compared using a one-way anova, followed by a Tukey mean comparison test (p<0.05). Results. As the percentage of substitution of wheat flour by MF and WP increases less acceptance of the biscuits is obtained, with F1 as the most accepted formulation. F1 registered a protein content of 6.90±0.04%, significantly higher than that observed in F0. Conclusions: The good acceptability of F1 indicates that the partial substitution of wheat flour for MF and WP do not influence its acceptance; in addition, F1, showed an enrichment of protein, lipid and ash, as well as adequate moisture and carbohydrate content(AU)

Association of adductor pollicis muscle thickness and anthropometric indicators in community older adults / Associação da espessura do músculo adutor do polegar e indicadores antropométricos em idosos da comunidade

INTRODUCTION: The measurement of the adductor pollicis muscle thickness (APMT) has been investigated as an index for muscle mass and undernutrition. OBJECTIVE: However, there are few studies related to community-living older adults. METHODS: Cross-sectional study carried out with community-dwelling older adults, of both sexes. The APMT, the body mass index (BMI), arm circumference (AC), arm muscle circumference (AMC), and calf circumference (CC) were evaluated. For APMT classification, the 25th percentile value (P25 ≤9 mm) of the sample was considered to identify muscle mass deficit. Chi-square test, Pearson's correlation, and Poisson regression were performed, with a significance level of p<0.05. RESULTS: Among men, APMT showed a correlation with AC (r=0.350; p<0.01), and among women it was with BMI (r=0.337; p=0.01). There was an association between the BMI classification and the APMT percentile (p=0.020). Older adults with BMI<23 kg/m² were 1.28 times more likely to have APMT≤P25 (p=0.007) and older adults with adequate BMI were 1.23 times more likely (p=0.023). Older adults with reduced CC have a 1.18 times more chance of presenting APMT≤P25 (p=0.064). CONCLUSION: APMT has been associated with BMI in older adults, proving to be a good parameter for the assessment of malnutrition.

INTRODUÇÃO: A espessura do músculo adutor do polegar (EMAP) tem sido sugerido como um índice de massa muscular e desnutrição. OBJETIVO: Verificar a associação da EMAP com indicadores antropométricos convencionais em idosos da comunidade. MÉTODOS: Estudo transversal realizado com 159 idosos da comunidade, de ambos os sexos, com média de idade de 70,9±29,4 anos. Foram avaliados a EMAP, o índice de massa corporal (IMC), as circunferências do braço (CB), muscular do braço (CMB) e da panturrilha (CP). Para classificação da EMAP se considerou o valor do percentil 25 (P25≤9 mm) da amostra para identificar déficit de massa muscular. Teste Qui-quadrado, Correlação de Pearson e Regressão de Poisson foram realizados, sendo adotado um nível de significância de p<0,05. RESULTADOS: Entre os homens, a EMAP apresentou correlação com a CB (r=0,350; p<0,01) e entre as mulheres foi com o IMC (r=0,337; p=0,01). Houve associação entre a classificação do IMC e o percentil da EMAP (p=0,020). Os idosos com IMC<23 kg/m² tinham 1,28 vezes mais chances de possuir EMAP≤P25 (p=0,007) e idosos com IMC adequado tinham 1,23 vezes mais chance (p=0,023). Idosos com CP reduzido apresentaram 1,18 vezes mais chance de apresentar EMAP≤P25 (p=0,064). Conclusão: A EMAP apresentou associação com o IMC em idosos, demostrando ser um bom parâmetro para a avaliação da desnutrição.