Distribución de sobrepeso, obesidad y conocimiento de complicaciones de los mismos en la población de policías (Estudio realizado en el Comando Departamental de Orden y Seguridad) / Distribution of overweight, obesity and knowledge of complications of the same in the population of police (Study realised in the Departmental Commando of Order and Security)

En las últimas décadas el aumento del porcentaje del sobrepeso y la obesidad se debe principalmente a cambios importantes en la alimentación, el patrón de actividad física y otros factores de índole sociocultural que se asocian a un aumento de la morbilidad y una disminución en la esperanza de vida. Los policías se han constituido en una población de riesgo al adquirir sobrepeso y obesidad ya que cambian sus hábitos de alimentación, el patrón de actividad física y otros de factor sociocultural. El presente trabajo tiene la finalidad de conocer la distribución de sobrepeso y obesidad, y conocimientos de complicaciones de los mismos, por parte de los policías del Comando Departamental de Orden y Seguridad, en octubre del 2007.Para este estudio se elaboró un cuestionario que fue llenado por 115 policías de la institución mencionada. Se pudo evidenciar sobrepeso en un 47 % y obesidad en un 12,1 % de los policías. Tienen conocimiento de las complicaciones del sobrepeso y la obesidad, como ser: la presión alta, ataque al corazón, enfermedades de las articulaciones, alteraciones pulmonares y bajo rendimiento físico en el trabajo; pero, poco conocimiento del cáncer como complicación del sobrepeso y obesidad.

Overweight and obesity in a rural Amerindian population in Oaxaca, Southern Mexico, 1968-2000.

The purpose of this study was to evaluate secular change in the prevalence of overweight and obesity in a rural Zapotec Indian community in southern Mexico between 1968 and 2000. Cross-sectional surveys of children 6-13 years, adolescents 13-17 years, and adults 19 years of age and older resident in a rural community in Oaxaca were conducted in 1968/1971, 1978, and 2000. Individuals present in the 1968, 1978, and 2000 surveys provided a small longitudinal component. Height and weight were measured; the BMI was calculated. International criteria for overweight and obesity were used. Overweight and obesity were virtually absent in school children 6-13 years in 1968 and 1978 and in adolescents in 1978. Small proportions of children (boys, 5%; girls, 8%) and adolescents (boys, 3%; girls, 15%) were overweight in 2000; two children (1%) and no adolescents were obese. Among adults, 7% of males and 19% of females were overweight and <1% of males and 4% of females were obese in 1971/1978, but 46% of males and 47% of females were overweight; and 5% of males and 14% of females were obese in 2000. The trends for children, adolescents, and adults were confirmed in the longitudinal subsamples. In conclusion, overweight and obesity are not presently a major problem in children and adolescents in this rural Zapotec community. Overweight, in particular, and to a lesser extent obesity have increased in prevalence among adults since the late 1970s. The results suggest adulthood as a critical period for onset of overweight and obesity in this sample.

Body mass index and the prevalence of metabolic syndrome among children and adolescents in two Mexican populations.

PURPOSE: To report the prevalence of metabolic syndrome (MS) among children and adolescents living in central Mexico, and its association with body mass index (BMI). METHODS: In a sample of 1366 subjects from 7 to 24-years-old, a self-administered questionnaire was used to determined demographic characteristics. The definition of pediatric MS was determined using analogous criteria to Adult Treatment Panel III (ATPIII) as > or = 3 of the following: concentration of triglycerides > or = 100 mg/dL, HDL cholesterol < 45 mg/dL for males and < 50 mg/dL for females, waist circumference > or = 75th percentile (sex specific), glucose concentration > or = 110 to < 126 mg/dL, and systolic or diastolic blood pressure > or = 90th percentile (age, height, and sex specific). RESULTS: Most of the sample was in the 10-14- (32.4%) and the 15-19-year (35.4%) age groups, mostly females (57%), and 31% of this young sample was overweight (mean BMI = 21.6 kg/m2). About 1 in every 5 participants had full criteria for MS (19.2%, 95% confidence interval [CI]: 16.4-22.1 among females, and 20.2%, 95% CI: 17.1-23.7 among males), and only 1 in every 10 was free of any MS component. The most common component was a low HDL level, observed in 85.4% of the sample. Unfavorable fat distribution, as indicated by a large waist circumference, was present in 27.9% of the sample. About 66% of those 10-14-year-olds with a large BMI were positive for MS. CONCLUSIONS: MS and overweight are major problems for youth in Mexico. Immediate and comprehensive actions at home and schools are needed if Mexico wants to avoid the heavy burden that this disorder will have for its population in the near future.

Sleep-disordered breathing and the metabolic syndrome in overweight and obese children and adolescents.

OBJECTIVE: To assess whether sleep-disordered breathing (SDB) is a risk factor of the metabolic syndrome (MS) in children and adolescents who are overweight and to examine whether the severity of SDB was independently associated with glucose intolerance, insulin resistance, and/or dyslipidemia. STUDY DESIGN: Consecutive subjects who were overweight or obese underwent polysomnography, fasting blood sample, and oral glucose tolerance test (for calculation of area under the curve [AUC]). SDB was defined as a respiratory disturbance index > or = 2. MS was present when > or = 3 of these factors were present: waist circumference > or = 90th percentile; fasting glucose level > or = 110 mg/dL; triglyceride level > or = 110 mg/dL; high-density lipoprotein cholesterol level < or = 40 mg/dL; blood pressure > or = 90th percentile. RESULTS: A total of 104 subjects were included in the study (44% boys; 58% prepubertal; mean age, 11.1 +/- 2.6 years; 69% obese). Mean SaO2 (odds ratio, 0.54) and SaO2nadir (odds ratio, 0.89) were independent, significant predictors of the presence of MS. Multiple regression showed significant associations between SaO2nadir and high-density lipoprotein cholesterol level, mean SaO2 and both AUC glucose and triglyceride levels, and between the percentage of total sleep time with SaO2 > or = 95% and cholesterol level, while controlling for adiposity and sex, puberty, or both. CONCLUSION: This study supports the hypothesis of an interaction between SDB and metabolic abnormalities, independent of estimates of body fat distribution, in children and adolescents who are overweight and obese.

Association of serum concentrations of retinol and carotenoids with overweight in children and adolescents.

OBJECTIVE: A study was conducted to verify the association between serum concentrations of retinol and carotenoids with overweight in children and adolescents. METHODS: In total 471 children (7-9.9 y of age) and adolescents (10-17 y of age), living in a poor region of the city of Rio de Janeiro, Brazil, were assessed. Serum concentrations of retinol and carotenoids were assessed by high-performance liquid chromatography, and cutoffs for inadequacy of retinol and carotenoids were <30 and <40 microg/dL, respectively. Overweight was defined by the sex- and age-specific body mass index cutoffs recommended by World Health Organization. The logistic regression model was used to test the association of overweight, gender, and age range with low serum concentrations of retinol and carotenoids. RESULTS: Prevalences were 10% for low serum concentration of retinol, 55.8% for carotenoids, and 15.3% for overweight. Retinol inadequacy was significantly higher in adolescents (12.6%) than in children (6.8%). The average of carotenoids was significantly lower in overweight subjects (30.40 +/- 16.74 versus 43.06 +/- 25.26 microg/dL, P = 0.001). Overweight children and adolescents presented a greater chance of a decrease in serum concentrations of carotenoids (odds ratio 2.51, 95% confidence interval 1.43-4.39) when compared with non-overweight subjects. CONCLUSION: An important prevalence of vitamin A deficiency was found. Overweight children, as much as adolescents, may have a greater chance of presenting low concentrations of carotenoids and, hence, a lower antioxidant defense.

Prolactin inhibition in dams during lactation programs for overweight and leptin resistance in adult offspring.

Maternal malnutrition during lactation reduces prolactin (PRL) and milk production, alters milk composition, and programs the body weight of the offspring. Our study aimed to evaluate the long-term effects of maternal hypoprolactinemia at the end of lactation on food ingestion, body weight, amount of retroperitoneal white adipose tissue (RPWAT), leptinemia, and anorectic leptin effect in the adult offspring. Lactating rats were treated with bromocriptine (BRO), a PRL inhibitor, 1 mg twice a day, or saline (C - control) for the last 3 days of lactation. The body weight and food intake were monitored, and after sacrifice at 180 days, the RPWAT was weighted. In a second experiment, the anorectic leptin effect was tested on 180-day-old animals. Adult offspring whose mothers were BRO-treated showed higher body weight (10%), higher amount of RPWAT (2 x 3 times), higher total body fat (+39%), and hyperleptinemia (2 x 9 times) when compared with C, although food intake did not alter. After injection of leptin, the food ingestion at 2, 4 and 6 h was unaffected in BRO animals, confirming a resistance to the anorectic effect of leptin. Since the maternal PRL inhibition during lactation programs, a higher body weight with no alteration of food ingestion, we suggest a hypometabolic state. The leptin anorectic resistance can be due to the hyperleptinemia. We suggest that PRL changes during lactation can regulate body weight during adulthood.

Anthropometric measures and nutritional status in a healthy elderly population.

BACKGROUND: Anthropometric evaluation is an essential feature of geriatric nutritional evaluation for determining malnutrition, being overweight, obesity, muscular mass loss, fat mass gain and adipose tissue redistribution. Anthropometric indicators are used to evaluate the prognosis of chronic and acute diseases, and to guide medical intervention in the elderly. We evaluated anthropometric measurements and nutritional status as they relate to age and gender in healthy elderly people. METHODS: The study analyzed data from the national survey "Health needs and health service use by older-than-60-year-old beneficiaries of the Mexican Institute of Social Security (IMSS)". The present study included only individuals who reported no chronic disease in the last 20 years and had no hospital admission in the two months prior to the survey. Anthropometric measurements included weight, height, body mass index (BMI), body circumference (arm, waist, hip and calf), waist to hip ratio (WHR), elbow amplitude and knee-heel length. RESULTS: Application of the inclusion criteria resulted in a study population elderly of 1,968, representing 12.2% of the original number in the national survey in urban areas beneficiaries of the IMSS. The study population comprised 870 women and 1,098 men, with a mean age of 68.6 years. The average weights were 62.7 kg for women and 70.3 kg for men (p < 0.05), and the mean heights were 1.52 m for women and 1.63 m for men (p < 0.05). Age related changes in anthropometric values were identified. BMI values indicated that 62.3% of the population was overweight, and 73.6% of women and 16.5% of men had high fat tissue distribution. CONCLUSION: Our findings suggest that applying the BMI thresholds that identify being overweight in the general adult population may lead to an overestimation in the number of overweight elderly Similar problems appear to exist when assessing waist circumference and WHR values. Prospective studies are required to determine the associations between health and BMI, waist circumference and WHR in the elderly.

Overweight induced by high-fat diet delays rat cutaneous wound healing.

Prolonged wound healing is a complication that contributes to morbidity and mortality. Overweight people regularly undergo surgery and trauma, and often develop chronic wounds, but the effects of the adipose tissue excess on cutaneous wound healing are not well understood. This study tested the hypothesis that overweight induced by a high-fat diet impairs rat cutaneous wound healing. Male Wistar rats were fed with either a high-fat or a standard (control) diet. After 15 weeks, an excisional lesion was done and the animals were killed 21 d later. Wound contraction and re-epithelialization, blood pressure, glucose and retroperitoneal fat were evaluated. After killing, lesion and adjacent normal skin were formol-fixed and paraffin-embedded. Inflammatory infiltrate, myofibroblasts, collagen fibres and cellular proliferation were analysed and blood vessels were evaluated using stereological methods. There was no difference in blood pressure and glucose, but retroperitoneal fat increased in the high-fat diet group. Animals fed with the high-fat diet presented delayed wound contraction and re-epithelialization. It was found that 21 d after wounding, overweight induced by a high-fat diet increased the inflammatory infiltrate and delayed myofibroblastic differentiation, collagen deposition, epithelial and connective tissue cell proliferation, and angiogenesis. These findings support the hypothesis that a high-fat diet exerts negative effects on rat cutaneous wound healing, due mainly to the prolongation of the inflammatory phase.

Distribuição centrípeta da gordura corporal, sobrepeso e aptidão cardiorrespiratória: associação com sensibilidade insulínica e alterações metabólicas / Centripetal distribution of body fat, overweight and cardiorespiratory fitness: association with insulin sensitivity and metabolic alterations / Centripetal distribution of body fat, overweight and cardiorespiratory fitness: association with insulin sensitivity and metabolic alterations

O objetivo do presente estudo foi investigar associações entre a distribuição centrípeta da gordura corporal e lipídios-lipoproteínas séricos, pressão arterial e índice Homa-IR de resistência insulínica, mediante ajuste estatístico de indicadores quanto ao sobrepeso e à aptidão cardiorrespiratória. Foram analisados 89 voluntários (44 homens e 45 mulheres). A distribuição centrípeta da gordura foi analisada através de circunferência da cintura (CC) e o sobrepeso pelo índice de massa corporal (IMC). A aptidão cardiorrespiratória foi acompanhada pelo VO2máx estimado por teste de caminhada. Após ajuste pelos valores de IMC verificamos coeficientes de correlação significativos entre CC e níveis de pressão arterial e ApoB em homens, e entre CC e índice Homa-IR e triglicerídios em mulheres. Após ajuste pelos valores de VO2máx observamos correlações significativas entre CC e ApoB e índice Homa-IR em homens, e entre CC e índice Homa-IR em mulheres. Conclui-se que, dependendo do sexo, a quantidade e a distribuição da gordura corporal podem apresentar ações distintas na resistência insulínica e nas disfunções associadas. A aptidão cardiorrespiratória per se parece não contribuir na minimização da associação entre a distribuição centrípeta da gordura e o índice Homa-IR; porém, apresenta considerável impacto na associação entre a distribuição centrípeta da gordura e o metabolismo lipídico e os níveis de pressão arterial, sobretudo nos homens.

The purpose of this paper was to investigate associations between the centripetal distribution of the body fat and serum lipid-lipoproteins, blood pressure and the index Homa-IR of insulin resistance, adjusting for indicators of overweight and cardiorespiratory fitness. Eighty-nine voluntaries were analyzed (44 men and 45 women). The centripetal distribution of the body fat was analyzed through waist circumference (CC) and the overweight by the body mass index (BMI). The cardiorespiratory fitness was followed by the estimate VO2max by test of walking. After adjusted for BMI values were found significant coefficient of correlation between CC and levels of blood pressure and ApoB in men, and between CC and index Homa-IR and triglycerides in women. After adjusted for VO2max values were verified significant correlations between CC and ApoB and index Homa-IR in men, and between CC and index Homa-IR in women. In conclusion, depending on the sex, the quantity and distribution of the body fat can present different actions in the insulin resistance and associated dysfunctions. The cardiorespiratory fitness per se seems not to contribute on the minimization of the association between the centripetal distribution of the body fat and the index Homa-IR; but presents a considerable impact on the association between the centripetal distribution of the body fat and the lipid metabolism and the levels of blood pressure, mainly in men.

Is there a lag globally in overweight trends for children compared with adults?

OBJECTIVE: To determine relative trends in prevalence for overweight for adults compared with children across high-income countries (Australia, United Kingdom, and United States), middle-income countries (Brazil and Russia), and low-income countries (China and Indonesia). RESEARCH METHODS AND PROCEDURES: Extant nationally representative survey data from 1971 to the present are used. Prevalence of overweight for adults > or =18.0 years of age and children 6.0 to 17.9 years of age were used. Absolute and relative annual rates of change in prevalence of overweight in children and adults were the key outcomes. RESULTS: Absolute rates of increase in overweight were higher among adults than among children in all studied countries except Australia. However, relative rates of increase in overweight indicate faster increases in overweight among children in Brazil, China, and the three high-income countries. As a result, the relative excess of overweight among adults, seen initially in all countries, increased in Indonesia and Russia, but it decreased in Australia, Brazil, China, United Kingdom, and United States. In Brazil, time trends indicate an acceleration in the annual rate of change in overweight for children and a deceleration for adults, whereas in the United States, the increase in overweight shows acceleration for both children and adults. DISCUSSION: In absolute terms, overweight increased faster among children than adults only in Australia; however, the relative gap between children and adults is closing in four additional countries, Brazil, China, the United Kingdom, and the United States.

[Effects of transdermic estrogen therapy, isolated or in association with micronized progesterone, on clotting factors in overweight or normal postmenopausal women]. / Efeitos da terapia estrogênica transdérmica isolada ou associada à progesterona micronizada nos fatores de coagulação em mulheres menopausadas com e sem sobrepeso.

To evaluate HRT action over hemostasis we treated 45 postmenopausal women, divided in: Group 1 (N= 22, hysterectomized) and Group 2 (N= 23, with uterus), at the average age of 51.6 years and average BMI of 27.1 kg/m(2), with no significant difference in the base-line, with 17beta-oestradiol, 50 mcg/day, transdermic and continuous (group 1) associated to micronized progesterone 200 mg 12 days per month (group 2). The average of 2 samples of TAP, PTT, fibrinogen and platelet number was measured monthly during 3 months. For the total sample, there was a PTT shortening along treatment, from the second evaluation on (p= 0.006). Fibrinogen in Group 2 was significantly higher than in Group 1, from the second evaluation on (p= 0.0005). Patients with BMI > 25 presented a greater TAP shortening (p= 0.040) and a smaller fibrinogen drop (p= 0.033) than patients with BMI < 25. Prothrombotic effects predominated, especially in overweight women and in those who used progesterone.

[Cardiovascular health profile of an adult population from the metropolitan region of São Paulo]. / Perfil de saúde cardiovascular de uma população adulta da região metropolitana de São Paulo.

OBJECTIVE: To describe the cardiovascular health profile of an adult population from the metropolitan region of São Paulo, according to the European Society of Cardiology (ESC) criteria. METHODS: Two hundred volunteers of both sexes enrolled in the "Cardiac Evaluation" project of a general outpatient clinic were studied. Data collected included socioeconomic status, cigarette smoking, alcohol consumption, anthropometric measurements, diet, physical activity, serum lipids, blood glucose and blood pressure. Average intake of dietary cholesterol and total lipids was estimated from a 24-hour dietary recall. Physical activity level was assessed using the International Physical Activity Questionnaire (IPAQ-8) and exercise stress tests. RESULTS: Sample population composition was 61.5% female and 38.5% male, mean age 41.7 (median = 42.6) and 41.0 (median = 43.0%). Prevalence of smoking (22%) and daily alcohol consumption (14% males; no females) was low. The overweight prevalence was 47% (12% being obese), in addition to high levels of serum total cholesterol (> 190 mg/dl) in 56% and LDL-cholesterol (> 115 mg/dl) in 61%. The IPAQ-8 results showed that 6% were sedentary. CONCLUSION: The study population showed greater risk of cardiovascular diseases, according to ESC criteria, due especially to the high prevalence of overweight and hypercholesterolemia.

Efeitos da terapia estrogênica transdérmica isolada ou associada à progesterona micronizada nos fatores de coagulação em mulheres menopausadas com e sem sobrepeso / Effects of transdermic estrogen therapy, isolated or in association with micronized progesterone, on clotting factors in overweight or normal postmenopausal women

Analisamos efeitos da reposição hormonal sobre coagulação em 45 mulheres menopausadas, divididas em Grupo 1 (N= 22, histerectomizadas) e Grupo 2 (N= 23, menopausa espontânea), com idade média de 51,6 anos e IMC médio de 27,1 kg/m², sem diferenças significativas no basal. No grupo 1 usamos 17-beta estradiol, 50 mcg/dia, transdérmico contínuo. No grupo 2 foi associada progesterona micronizada 200 mg/dia cíclica por 12 dias. Avaliou-se mensalmente por 3 meses a média de 2 amostras de TAP, PTT, fibrinogênio e plaquetas. No grupo total houve encurtamento do PTT a partir da 2ª avaliação (p= 0,006). Fibrinogênio no grupo 2 sofreu menor queda no grupo 1 a partir da 2ª avaliação (p= 0,0005). As pacientes com IMC > 25 apresentaram maior encurtamento do TAP (p= 0,040) e menor queda do fibrinogênio (p= 0,033) do que as de IMC < 25. Efeitos pró-trombóticos predominaram, especialmente nas mulheres com sobrepeso e que usaram progesterona.

Perfil de saúde cardiovascular de uma população adulta da região metropolitana de São Paulo / Cardiovascular health profile of an adult population from the metropolitan region of São Paulo

OBJETIVO: Descrever o perfil de saúde cardiovascular de uma população adulta da região metropolitana de São Paulo, segundo critérios da Sociedade Européia de Cardiologia (SEC). MÉTODOS: Foram estudados 200 indivíduos, homens e mulheres, voluntários, participantes do projeto "Avaliação Cardiológica" de um ambulatório geral. Foram coletadas informações sobre nível socioeconômico, tabagismo, consumo de álcool, medidas antropométricas, dieta, atividade física, lipídeos séricos, glicemia e pressão arterial. A ingestão média de colesterol dietético e de lipídeos totais foi estimada a partir de recordatórios de 24 horas. Avaliou-se o nível de atividade física por meio da aplicação do Questionário Internacional de Atividade Física (IPAQ-8) e de testes de esforço. RESULTADOS: A amostra foi composta por 61,5 por cento de indivíduos do sexo feminino e 38,5 por cento, do sexo masculino, com idades médias de 41,7 anos (mediana = 42,6) e 41,0 anos (mediana = 43,0). A prevalência de tabagismo (22 por cento) e de consumo diário de álcool (14 por cento dos homens; nenhuma mulher) foi baixa. A prevalência de sobrepeso foi de 47 por cento (12 por cento de obesos), além de níveis séricos elevados de colesterol total (> 190 mg/dl) em 56 por cento dos indivíduos e de LDL-colesterol (> 115 mg/dl) em 61 por cento dos participantes. Os resultados da aplicação do IPAQ-8 mostraram 6 por cento de sedentários. CONCLUSÃO: A população de estudo apresentou maior risco de doenças cardiovasculares, segundo critérios da SEC, especialmente devido à elevada prevalência de indivíduos com sobrepeso e hipercolesterolemia.

Insulin resistance in Brazilian adolescent girls: association with overweight and metabolic disorders.

We assessed the association between insulin resistance, overweight and metabolic disorders in a probabilistic sample of 388, 12-19-year-old girls from public schools in Niterói, Rio de Janeiro State, Brazil. Insulin resistance was determined using Homeostatic Model Assessment-Insulin Resistance (HOMA-IR). Overweight and obesity were defined by the sex- and age-specific body mass index cut-offs recommended by the International Obesity Task Force. Metabolic syndrome (MS) was identified by the presence of at least three of the following factors: fasting glucose >or=100mg/dL, triglycerides >130 mg/dL, LDL-C >or=110 mg/dL, HDL-C <35 mg/dL and overweight. The combined prevalence of obesity (2.9%) and overweight was 14.2%. The average HOMA-IR level was 2.24 (95% confidence interval=1.40-3.10) in the overweight group and 1.91 (95% CI=1.32-2.50) in the non-overweight one, and MS prevalence was 20 times higher in the first group (21.4 and 0.1%). MS prevalence in the overweight group was 6.3 times higher in adolescents above the 66th percentile of HOMA-IR (55.9%) than those under the 33rd percentile (8.9%). Brazilian overweight girls with higher insulin resistance had high risk of developing MS. Therefore, prevention should occur at an early age to impair the evolution of this process.

Obesity and socioeconomic status in children of Tijuana.

BACKGROUND: Although obesity has been associated with socioeconomic status among Hispanics living in the United States, little is known about whether a similar association exists among Hispanics living in Mexico, particularly among those living along the U.S.-Mexico border. OBJECTIVE: To determine the prevalence of obesity and its association with socioeconomic status in Mexican schoolchildren attending public and private schools in Tijuana, Baja California. METHODS: Anthropometric measurements and socioeconomic status were assessed in a cross-sectional study of 1172 school children, aged 6 to 13 years from 55 schools in Tijuana in 2001-2002. Underweight (body mass index [BMI] for age 5th percentile or lower), risk of overweight (BMI at 85th percentile or higher), and overweight (BMI greater than 95th percentile) were assessed using charts published by the Centers for Disease Control and Prevention. RESULTS: Abnormalities in weight were found in 46.3% of 587 boys and 43.7% of 585 girls in the study. Undernutrition was found in 3.7% of the boys and 3.8% of the girls. The general prevalence of overweight was 23.2% for boys and 21.7% for girls. Children living in low-income neighborhoods had the thickest biceps skinfolds (p<0.01), while children living in moderate-income neighborhoods and attending public schools had the thickest triceps skinfolds (p<0.001). Although boys living in high socioeconomic status neighborhoods were at decreased risk for being overweight, boys and girls attending private schools had a 75% increased risk (odds ratio, 1.75; confidence interval, 1.22-2.52) of being overweight than children attending public schools. CONCLUSIONS: Adiposity varies by type of school and neighborhood socioeconomic status. The biphasic curve in risk for being overweight associated with neighborhood socioeconomic status suggests that Mexican children living along the U.S. border may be experiencing a nutrition transition with respect to an increased risk of obesity and related chronic disease.

Breastfeeding and overweight in childhood: evidence from the Pelotas 1993 birth cohort study.

OBJECTIVES: The effect of breastfeeding duration on the prevalence of overweight and on mean weight for height z-score (WHZ) was evaluated in Brazilian children. DESIGN: Prospective population-based birth cohort study. SUBJECTS: In total, 1,273 children aged 4 years, corresponding to a follow-up rate of 87.2%. MEASUREMENTS: Three explanatory variables were studied: duration of any breastfeeding, duration of exclusive or predominant breastfeeding, and ever breastfeeding. Weight and height were measured using a digital electronic scale and a portable stadiometer. Overweight was defined as WHZ >2 using the National Center for Health Statistics reference curve. RESULTS: Overweight prevalence at the age of 4 years was 10.2% (95% CI 8.4; 11.8). The lowest prevalence (6.5%) was observed among children breastfed for >11 months. Among those breastfed for less than 3 months, the prevalence of overweight was approximately 9.5%. Mean WHZ ranged from 0.38 among children breastfed for less than 1 month to 0.62 among those breastfed for 9-11.9 months. No linear trends were detected in the association between breastfeeding and anthropometric indicators. None of the three breastfeeding variables was significantly associated with the prevalence of overweight or mean WHZ in multivariable analyses. No interactions were detected between breastfeeding and the variables sex, birth weight, socioeconomic status, skin color and pregestational in body mass index. CONCLUSION: Our results do not support the hypothesis that breastfeeding promotion would reduce overweight or obesity in this population. Existing evidence on many other benefits of breastfeeding for the mother and the child supports its continued promotion, protection and support.

Avaliação de dislipidemia e de índices antropométricos em pacientes com Diabetes Mellitus tipo 1 / Lipid profile and anthropometrical evaluation in type 1 diabetes

A intensificação do tratamento insulínico no Diabetes Mellitus tipo 1 (DM1) tem resultado na melhora do seu controle clínico e metabólico, entretanto com aumento da prevalência de sobrepeso e obesidade, o que contribuiria para um maior risco cardiovascular. O objetivo deste estudo foi avaliar os fatores demográficos, clínicos e laboratoriais associados à presença de dislipidemia em uma população de pacientes com DM1 comparada a uma população não diabética. Estudamos 72 pacientes com DM1, sendo 52,8 por cento do sexo feminino, com idade de 22,7 ± 9,6 anos e índice de massa corporal (IMC) de 21,1 ± 3,1Kg/m², e 66 pacientes não diabéticos, sendo 60,6 por cento do sexo feminino, com idade de 23,1 ± 10,9 anos e IMC de 22,1 ± 3,7Kg/m². A amostra incluía 13 crianças, sendo 6 com DM1, 47 adolescentes, sendo 23 com DM1, e 78 adultos, sendo 43 com DM1. Observamos na população adulta de pacientes com DM1 menor apoB (p< 0,01), maior índice apoA/apoB (p< 0,01) e menor sobrepeso (p= 0,04) em relação à população não diabética, não sendo encontrada diferença no perfil lipídico entre essas populações. As crianças e adolescentes diabéticas apresentaram maior prevalência de colesterol total alterado (p= 0,02 e p< 0,01, respectivamente) e LDL-colesterol alterado (p= 0,02 e p= 0,01, respectivamente) em comparação às crianças e adolescentes não DM. Concluímos que os métodos usualmente utilizados na rotina de atendimento ambulatorial de pacientes com DM1 não são capazes de identificar as alterações lipídicas que poderiam ser indicativas do maior risco cardiovascular nestes pacientes, principalmente no que diz respeito à população adulta.

Frequency of increased aminotransferases levels and associated metabolic abnormalities in obese and overweight children of an elementary school in Mexico City.

BACKGROUND: Elevated ALT is an indirect marker of NAFLD in patients with non-alcohol abuse and without other known causes of chronic hepatitis. Obesity, type 2 diabetes and some dyslipidemias are associated to this condition. The purpose of this study was to determine the frequency of increased aminotransferases and associated metabolic anomalies among overweight and obese children. METHODS: Children from an elementary school with obesity or overweight were included. Medical history and anthropometrics measurements were recorded and serum liver function tests, lipid profile, glucose and insulin levels, and HOMA index were determined. NAFLD diagnosis was considered in those children with ALT>40 U/L and AST/ALT ratio<1 after exclusion of other causes of chronic hepatitis. RESULTS: Increase ALT levels (>40 U/L) were found in 34/ 80 (42%) obese and overweight children; mean age was 9.5+/-1.1 years and mean BMI of 25.8+/-3. The metabolic abnormalities in the study group were similar, there were no differences in insulin concentration, insulin resistance determined by HOMA-IR Index, serum lipid profile and serum glucose between children with or without increased ALT. CONCLUSIONS: The frequency (42%) of elevated ALT levels in children with excess body weight in this study was greater to those reported in other pediatric populations. There were no differences among the metabolic alterations with or without increased ALT; these findings support that the principal pathogenic factor involved in the development of the hepatic injury may be located in the liver.

[Lipid profile and anthropometrical evaluation in type 1 diabetes]. / Avaliação de dislipidemia e de índices antropométricos em pacientes com Diabetes Mellitus tipo 1.

Intensive insulin therapy in patients with type 1 diabetes is resulting in a better clinic and metabolic control. On the other hand, an increase in overweight and obesity prevalence, which could contribute to a higher risk of cardiovascular disease, has been observed. The aim of our study is to analyze the demographics, clinical and laboratorial factors associated to the presence of dyslipidemia in a group of patients with type 1 diabetes compared to a non-diabetic population. We have studied 72 type 1 diabetics: 52.8% female, aged 22.7 +/- 9.6 years old, with a body mass index (BMI) of 21.1 +/- 3.1 Kg/m2 and 66 non-diabetic patients: 60.6% female, aged 23.1 +/- 10.9 years old and a BMI of 22.12 +/- 3.7 Kg/m2. The group included 13 children (6 with type 1 diabetes), 47 adolescents (23 with type 1 diabetes) and 78 adults (43 with type 1 diabetes). We have found in the adult population with type 1 diabetes a lower overweight prevalence and lower levels of apoB (p< 0.01) and a higher apoA/apoB ratio (p< 0.01) when compared to the non-diabetic population. We have not found difference in the lipid profile in adult groups. Diabetic children and adolescents had higher frequency of total cholesterol (p= 0.02 and p< 0.01, respectively) and LDL-cholesterol (p= 0.02 and p= 0.01 respectively) above the upper limit when compared to the non-diabetic group. We concluded that the conventional methods for detecting lipids alterations in outpatients with type 1 diabetes under routine care are not sufficient to identify the lipid alterations, which could be related to the higher risk of cardiovascular disease in adult population.