Metabolic syndrome in young adults from two socioeconomic Latin American settings.

BACKGROUND AND AIM: Since little information on the metabolic syndrome (MS) is available in Latin America, the aim of this study was to explore whether and to what extent differing socioeconomic conditions influence the prevalence of MS and its associated factors among young adults from two towns in Latin America: semi-rural Limache (L), Chile, and urban Ribeirão Preto (RP), Brazil. METHODS AND RESULTS: A cross-sectional study based on two independent investigations of 22- to 28 year-old subjects using a common methodology. The prevalence of MS (according to the US National Cholesterol Education Program) and its risk factors (smoking habit, alcohol and caloric intake, obesity, physical activity and socioeconomic conditions) were assessed. The prevalence of MS was 10% in L and in RP men, but was lower (4.8%) in RP women. Hyperglycemia was very low (0.8% in L and 1.1% in RP), while the prevalence of low HDL cholesterol levels was high (66.7% and 42.2%, respectively). Intermediate prevalences of hypertriglyceridemia (17.9% and 12.9%), elevated blood pressure (15.5% and 23.1%) and abdominal obesity (19.3% versus 12.7%) were detected. RP subjects had a higher educational level and more qualified jobs, came from smaller families, and a higher proportion were car owners. In L, the smoking habit was more frequent, subjects had higher excess weight and caloric intake, and lower levels of physical activity. CONCLUSIONS: Metabolic changes possibly leading to cardiovascular diseases in later life were present in both populations at an early age, but were higher in the rural and less developed county. Our findings point to the existence of a cultural, educational and socioeconomic phenomenon that possibly influences the prevalence of the diagnostic components of MS through differences in lifestyles.

Size at birth and lipoprotein concentrations in adulthood: two prospective studies in Latin American cities.

BACKGROUND: The relationship between birth weight and plasma lipoproteins is inconsistent. AIMS: To assess the association between birth weight and (1) body mass index (BMI) at birth and (2) lipoproteins in young adults, and also to explore the possible effect of current obesity as a possible effect modifier. METHODS: Two prospective studies based on representative samples of subjects born in the 1970s were carried out in Ribeirão Preto, Brazil (n=2063) and Limache, Chile (n=999). The surveys were carried out between 2001 and 2004. RESULTS: Mean birth weights were 3267 g and 3177 g and mean adult BMIs were 24.3 kg/m2 and 25.8 kg/m2 in the Brazilian and Chilean samples, respectively. Total adult cholesterol was 4.57 mmol/l in Chileans, 0.26 mmol/l higher than in Brazilians (p<0.001). The main finding was an interaction between adult obesity (BMI 30 or over) and birth weight and also BMI at birth and low-density lipoprotein (LDL) and total cholesterol. A birth-weight increment of 1 kg was associated with a decrease in total cholesterol (-0.374 mmol/l, 95% CI -0.567 to -0.181) and LDL (-0.304 mmol/l (-0.479 to -0.129) in obese participants only. These associations persisted after allowing for gestational age in a smaller sample. This finding was consistent in separate analyses in the Brazilian and Chilean samples. No associations were found in relation to high-density lipoprotein and triglyceride concentrations. CONCLUSION: The results suggest that those who were of low birth weight and are obese are more likely to have high cholesterol and LDL concentrations. Thus preventing obesity may be especially rewarding in subjects with a low birth weight.

Is malnutrition associated with crowding in permanent dentition?

Evidence suggests that energy-protein malnutrition is associated with impaired growth and development of facial bones. The objective of this study was to investigate the association between nutritional status and reduced space for dental eruption (crowding) in permanent dentition. A cross-sectional study with probabilistic sampling design was used. We evaluated 2,060 students aged 12 to 15 years enrolled in schools in the northeast of Brazil. Crowding was defined according to World Health Organization (WHO) as misalignment of teeth due to lack of space for them to erupt in the correct position. Nutritional status was evaluated by means of body mass index and height-for-age, using the WHO's reference curves. Parents and adolescents responded to a questionnaire about demographic, socioeconomic, biological and behavioral characteristics. The associations were estimated by odds ratio (OR) in multivariate logistic regression analysis (alpha = 0.05). Confounding and effect-modification were taken into account. An association between low height-for-age (z-score < -1SD) and crowding was only observed in adolescents with a prolonged history of mouth breathing (OR = 3.1). No association was observed between underweight and crowding. Malnutrition is related to crowding in permanent dentition among mouth-breathing adolescents. Policy actions aimed at reducing low height-for-age and unhealthy oral habits are strongly recommended. However, further studies are needed to increase the consistency of these findings and improve understanding of the subject.