The double burden of malnutrition and gross motor development in infants: A cross-sectional study.

OBJECTIVE: The objective of the present work was to study the relationship between the double burden of malnutrition and gross motor development in infants. METHOD: ology: Sample included 5900 infants under 24 months of age, participants of the ENSANUT-ECU study. To evaluate nutritional status, we calculated z-scores for body mass index/age (BAZ) and height/age (HAZ). Six gross motor milestones were considered: sitting without-support, crawling, standing and walking with-support, standing and walking without-support. Data was analysed using logistic regression models in R. RESULTS: Independently form age, sex and other socio-economic factors, the probability of achieving three gross motor milestones was significantly lower among chronically undernourished infants compared to their peers: sitting without-support, crawling, and walking without-support. Compared to no malnourished infants the probability of sitting without-support at six months was 10% lower for chronically undernourished infants (0.70, 95%CI [0.64-0.75]; 0.60, 95%CI [0.52-0.67]; respectively). The probability of crawling at eight months and walking without-support at 12 months were also significantly lower among chronically undernourished infants (0.62, 95%CI [0.58-0.67]); 0.25, 95%CI [0.20-0.30]; respectively) in comparison to no malnourished infants (0.67, 95%CI [0.63-0.72]); 0.29, 95%CI [0.25-0.34]; respectively). Obesity/overweight was not associated with the achievement of gross motor milestones, except for sitting without-support. Chronically undernourished infants with low or high BMI/age were generally delayed in the achievement of gross motor milestones than their peers. CONCLUSIONS: Chronic undernutrition is related to delayed gross motor development. Public health measures are needed to be implemented to prevent the double burden of malnutrition and its detrimental effects on infant development.

Stress and Diet Quality Among Ecuadorian Adults During the COVID-19 Pandemic. A Cross-Sectional Study.

Background: Stress has been associated with food habits. Stress changes eating patterns and the salience and consumption of hyperpalatable foods. During the lock-down due to the COVID-19 pandemic, stress was very common. Objective: We investigated the association between stress and diet quality in Ecuadorian adults during the COVID-19 pandemic. Design: A cross-sectional study. Setting: Data was collected using a self-administered online survey. Stress was measured using the Perceived Stress Scale (PSS-14), and diet quality was evaluated using the Global Diet Index (GDI). A linear regression model with restrictive cubic splines was used to investigate the association between stress and diet quality. Participants: Participants were recruited by convenience sampling, including a total of 2602 individuals. Most participants were female (68.57%) and had university education (78.52%), with a median age of 25 (IQR: 25, 37). Results: Stress was reported by 26.06% of participants. The majority of individuals (75.79%) reported having a diet that needed changes or an unhealthy diet. Independently from biological sex, age, level of education, people/room ratio, economic allowance, and expenses for food, stress was statistically significantly associated with diet quality (p = 0.035). The association between stress and diet quality was inverse and non-linear; higher stress levels were associated with poorer diet quality. The consumption of palatable foods was not statistically significant associated with stress. Conclusions: Stress is associated with poorer diet quality. Public health measures to improve the mental health and lifestyle of the population are needed during the lock-down of the pandemic.

Propiedades psicométricas de la escala de tácticas de conflictos modificada. Aplicación en el contexto de los adolescentes ecuatorianos / Psychometric properties of the modified conflict tactics scale. Application in the Ecuadorian adolescent context

El estudio de la violencia en el noviazgo adolescente tiene relevancia para la Salud Pública, dado su carácter predictivo y el impacto social de esta variable en la convivencia de la población adulta. Las escalas de valoración de violencia en el noviazgo requieren ser validadas para asegurar la fiabilidad y la certeza de sus resultados. Objetivo: Analizar las propiedades psicométricas de la escala de tácticas de conflicto modificada M-CTS en el contexto de la violencia en el noviazgo de adolescentes ecuatorianos. Materiales y métodos: Se trata de un estudio de validación mediante análisis factorial confirmatorio y análisis de variables lingüísticas y culturales, con muestreo al probabilístico (n=1249) con edades comprendidas entre 13 y 19 años, que cumplieron los requisitos de tener o haber tenido una relación de noviazgo. Resultados: Fueron modificadas culturalmente 6 preguntas y fue verificada la estructura de 4 factores del cuestionario (argumentación, violencia psicológica, física leve y física severa). Se encontró una baja fiabilidad para el ítem argumentación perpetrador (0,26) y victimización (0,26) y buena fiabilidad para violencia física grave para los dos perfiles (0,80 y 0,76). Conclusiones principales: La adaptación cultural del M-CTS ofreció una validez adecuada para los diferentes tipos de violencia en población adolescente ecuatoriana permitiendo comparar las prevalencias encontradas con otros países que usaron este instrumento basado en las mismas perspectivas teóricas y metodológicas. (AU)

The study of adolescent dating violence is relevant for Public Health, given its predictive nature and the social impact of this variable on the coexistence of the adult population. Dating violence rating scales need to be validated to ensure the reliability and certainty of their results. Objective: To analyze the psychometric properties of the modified M-CTS conflict tactics scale in the context of dating violence among Ecuadorian adolescents. Materials and methods: This is a validation study through confirmatory factor analysis and analysis of linguistic and cultural variables, with probabilistic sampling (n = 1249) with ages between 12-20 years, who met the requirements of having or having had a dating relationship. Results: 6 questions were culturally modified, and the 4-factor structure of the questionnaire was verified (argumentation, psychological violence, mild physical and severe physical). Low reliability was found for the perpetrator argument (0.26) and victimization (026) items and good reliability for severe physical violence for both profiles (0.80 and 0.76). Main conclusions: The cultural adaptation of the M-CTS offered adequate validity for the diverse types of violence in the Ecuadorian adolescent population, allowing to compare the prevalence found in other countries that used this instrument based on the same theoretical and methodological perspectives. (AU)

Anthropometry, dietetic habits and sleepiness in Ecuadorian adults

The reduction of hours of sleep affects the physical and mental health of people. Having unhealthy sleep habits are associated with a greater occurrence of daytime sleepiness, which in turn has been related to poorer nutritional status. The objective of this study was to relate food intake, anthropometric measurements, and daytime sleepiness in Ecuadorian adults. Non-experimental, cross-sectional study, the sample included 400 men and women between 18 and 65 years of age, who attended an outpatient consultation of general medicine, family medicine, and traumatology services of a public hospital in Quito-Ecuador. Anthropometric and body composition measurements were measured using tetrapolar bio-impedance, following the recommendations of the International Society for the Advancement of Anthropometry (ISAK). Caloric intake was measured using a 24-hour recall and for daytime sleepiness (DS) the Epworth questionnaire was used. Statistical analyzes were performed using R. From the sample 56.5% presented DS, which affected women more frequently compared to men (p < 0.05). Differences were found between body measurements and dietary intake between groups of people with and without DS. Caloric intake, waist circumference, percentage of fat mass were higher in people with DS (p < 0.05), while muscle mass was higher in subjects without DS (p <0.05). No differences were found concerning visceral fat. We conclude that SD is related to less healthy values in terms of dietary intake and anthropometric measures(AU)

La reducción de las horas de sueño afecta la salud física y mental de las personas. Tener hábitos de sueño poco saludables se asocia a una mayor ocurrencia de somnolencia diurna, lo que a su vez se ha relacionado con un peor Estado Nutricional. El objetivo de este estudio fue relacionar la ingesta de alimentos, las medidas antropométricas y la somnolencia diurna en adultos ecuatorianos. Estudio no experimental, transversal n=400 hombres y mujeres entre 18 y 65 años, que acudieron a consulta externa de los servicios de medicina general, medicina familiar y traumatología de un hospital público de Quito, Ecuador tomado como referencia. Se tomaron medidas antropométricas siguiendo las recomendaciones de la Sociedad Internacional para el Avance de la Antropometría (ISAK) y de composición corporal a través de la bioimpedancia tetrapolar. La ingesta calórica se midió mediante un recordatorio de 24 horas y para somnolencia diurna (SD)se utilizó el cuestionario de Epworth. Los análisis estadísticos se realizaron utilizando el software R. 56,5% de la muestra presenta SD, que afectó con mayor frecuencia a las mujeres en comparación con los hombres (p <0,05). Se encontraron diferencias entre las medidas corporales y la ingesta dietética entre grupos de personas con SD y sin ella. La ingesta calórica, la circunferencia de la cintura, el porcentaje de masa grasa fue mayor en personas con SD (p <0.05), mientras que la masa muscular fue mayor en sujetos sin SD (p <0.05). No se encontraron diferencias en relación con la grasa visceral. Concluimos que SD está relacionada con valores menos saludables en cuanto a ingesta dietética y medidas antropométricas(AU)

Interaction Between Nutrition and Metabolism.

Diet plays a fundamental role in the nutritional status, in the homeostasis and in the capacity of an individual to adapt to the environment. A proper or an inadequate nutrition has an impact on the persistence, remission and incidence of various conditions, including the infectious diseases. Consequently, nutrition has a crucial importance on survival rates and health recovery of individuals or even populations around the globe. The synergistic relationship between nutritional needs and infectious processes has been demonstrated conclusively in diverse studies. This chapter will discuss the most important nutrients, their most common natural dietary sources, the different digestive processes for each one as well as the absorption, transport, storage, excretion and function of each of the nutrients within the organism. We also go through some concepts on the interaction between nutrition and the immune system, as well as examples on the influence of nutrition or specific nutrients on some infectious diseases, and their influence on the gene expression.