Práctica de la lactancia materna y factores asociados entre mujeres jóvenes y adultas en el Municipio de Envigado, Antioquia-Colombia / Breastfeeding practices and associated factors among young and adult women in the Municipality of Envigado, Antioquia-Colombia

Introducción. La lactancia materna (LM) tiene retosdesde la preparación, nacimiento, primera hora de vida(PHV), protección de madres en hospital, apoyo de asesoras y familiares. La LM exclusiva en Colombia es 36,1% (1 mes)y en municipio Envigado alcanzó 3,1 meses, en 2015. Objetivo. Comparar la práctica de LM y factores asociadosa planificación de gestación, inicio, tipo y duración total de LMen madres jóvenes (MJ) y adultas (MA) del Municipio deEnvigado, Departamento Antioquia, Colombia. Material y métodos: Estudio cuantitativo, observacional,con muestreo probabilístico. De un universo de 3540 nacidos,se seleccionó 288 madres lactantes. Variables asociadas aservicios de salud, prácticas y tiempos de LM fueron estudia-das. Para análisis de datos se utilizó SPSSv22. Estudio apro-bado por comité de ética de la Universidad CES. Resultados: La entrega del bebé a la madre inmediata oPHV (83%), favorece la LM precoz (74%). La LM exclusiva(4,6 meses) y la total (12,6 meses) fueron similares en MJ(<27 años) y MA (≥27 años). En MJ tener al bebé hospitali-zado (p=0,00), el número de hijos (p=0,04) y un embarazoplanificado (p=0,02) predicen la LM en PHV, exclusiva y total En MA, tener al menor hospitalizado (p=0,01), la ocupación ylas asesorías predicen la LM en PHV, exclusiva y total. El prin-cipal predictor de LM exclusiva (p=0,02) y total (p=0,01) esla asesoría en LM. Discusión: La asesoría en LM es la principal estrategia deapoyo, promoción y mantenimiento de la LM, lo que se reflejaen las elevadas prevalencias de esta práctica esencial. Conclusiones: La asesoría en LM desde la gestación es elprincipal factor que predice la práctica de la LM exclusiva y to-tal. La hospitalización del neonato en periodo postparto y tipo de parto influyen significativamente en el contacto piela piel y la LM en PHV del bebé.(AU)

Introduction: Breastfeeding (BF) has challenges frompreparation, birth, first hour of life (FHL), protection of moth-ers in hospital, support from counselors and relatives.Exclusive BF in Colombia is 36.1% (1 month) and in Envigadomunicipality reached 3.1 months, in 2015. Objective: Compare the practice of BF and factors associ-ated with planning of gestation, onset, type and total durationof BF in young mothers (YW) and adults (AW) of theMunicipality of Envigado, Antioquia Department, Colombia. Material and methods: Quantitative, observational study,with probability sampling. From a universe of 3,540 new-borns, 288 lactating mothers were selected. Variables associ-ated with health services, practices and times of BF werestudied. SPSSv22 was used for data analysis. Study approvedby the ethics committee of the CES University. Results: Delivery of the baby to the immediate mother orFHL (83%), favors early BF (74%). Exclusive BF (4.6 months)and total BF (12.6 months) were similar in YW (<27 years)and AW (≥27 years). In YW, having the baby hospitalized (p= 0.00), the number of children (p = 0.04) and a plannedpregnancy (p = 0.02) predict BF in FHL, exclusive and totalBF. In AW, having the minor hospitalized (p = 0.01), occupa-tion and counseling predict BF in FHL, exclusive and total. Themain predictor of exclusive (p = 0.02) and total (p = 0.01) BFis BF counseling. Discussion. BF counseling is the main strategy for thesupport, promotion and maintenance of BF, which is reflectedin the high prevalences of this essential practice. Conclusions: Advice on BF from pregnancy is the mainfactor that predicts the practice of exclusive and total BF. Thehospitalization of the neonate in the postpartum period andtype of delivery significantly influences skin-to-skin contactand BF in the first hour of life.(AU)

Food insecurity and the double burden of malnutrition in Colombian rural households.

OBJECTIVE: This study aimed to examine in Colombian rural households the association between different severity levels of household food insecurity and the presence of the double burden of malnutrition (SCOWT), defined as the coexistence of a stunted child under 5 years of age and an overweight or obese (OWOB) mother. DESIGN: A secondary data analysis was conducted using cross-sectional data from the Colombian National Nutritional Survey (ENSIN) 2015. Household food insecurity status was assessed by using the Latin-American and Caribbean Food Security Scale (ELCSA). The household SCOWT status (child stunting and OWOB mother) was determined using anthropometric data from a mother and her child. SETTING: Rural Colombia. PARTICIPANTS: Totally, 2·350 mother-child pairs living in the same household. RESULTS: Sixty-two per cent of the households were food-insecure and SCOWT was present in 7·8 % of the households. Moderate (OR: 2·39, 95 % CI (1·36, 4·21)) and severe (OR: 1·86, 95 % CI (1·10, 3·15)) food insecurity was associated with SCOWT in an unadjusted logistic regression. Only moderate food insecurity remained significantly associated with SCOWT in a multivariate logistic regression (adjusted OR: 2·41, 95 % CI (1·24, 4·68)). CONCLUSIONS: Colombian rural areas are not exempt from the worldwide concern of increasing OWOB rates while stunting is still persistent. These results highlight the need of implementing double-duty rural actions targeting the most vulnerable households to SCOWT, particularly in terms of overcoming food insecurity beyond hunger satisfaction to prevent all forms of malnutrition.

Medición y experiencias de inseguridad alimentaria, hambre y estrategias de afrontamiento en niños y adolescentes de 6 a 17 años en Medellín, Colombia / Measurement and experiences of food insecurity, hunger and coping strategies inchildren and adolescents from 6 to 17 years old in Medellín, Colombia

FUNDAMENTOS: La consecución alimentaria en términos de disponibilidad, acceso, consumo (cantidad y calidad), utilización biológica e inocuidad adecuada representa la seguridad alimentaria y nutricional. Los instrumentos para medir esta problemática en menores de edad no han sido estudiados en Colombia. El objetivo del trabajo es explorar y medir experiencias de inseguridad alimentaria-nutricional y hambre (INSAN) y estrategias de afrontamiento (EA) en niños y adolescentes de 6 a 17 años de Medellín, Colombia. MÉTODOS: Estudio mixto, donde se realizaron entrevistas a niños entre 6 y 17 años en Medellín. Se aplicó dos instrumentos para medir la INSAN y EA. El análisis cualitativo fue manual y el cuantitativo por medio de SPSSV.21. RESULTADOS: Un 6,7% de los niños presenta INSAN severa, 23,3% moderada y 63,3% leve. Las experiencias de INSAN fueron relatadas por los menores reflejando escasez de alimentos, episodios de hambre y estrategias de afrontamiento como: fiar, prestar y darse cuenta del sacrificio de sus padres. CONCLUSIONES: Las experiencias de inseguridad alimentaria expresadas por los niños evidencian sentimientos de preocupación e insatisfacción por la falta de alimentos y menor calidad en su alimentación. Los ítems que miden la INSAN y EA en general fueron comprendidos por los niños, aunque se requieren estudios a mayor escala

BACKGROUND: Food achievement in terms of availability, access, consumption (quantity and quality), biological use and adequate safety represents food and nutritional security. Instruments to measure this problem in minors have not been studied in Colombia. The objective of the work is to explore and measure experiences of food-nutritional insecurity and hunger (INSAN) and coping strategies (EA) in children and adolescents from 6 to 17 years of age in Medellín, Colombia. METHODS: Mixed study, where interviews were conducted with children between 6 and 17 years old in Medellín. Two instruments were applied to measure INSAN and EA. The qualitative analysis was manual and the quantitative through SPSSV.21. RESULTS: 6.7% of children have severe INSAN, 23.3% moderate and 63.3% mild. The experiences of INSAN were related by the minors, reflecting food shortages, hunger episodes and coping strategies such as: trusting, lending and realizing the sacrifice of their parents. CONCLUSIONS: The experiences of food insecurity expressed by the children show feelings of concern and dissatisfaction for the lack of food and less quality in their diet. Items measured by INSAN and EA were generally understood by children, although larger scale studies are required

Las horas pantalla se asocian al consumo de alimentos de elevada densidad calórica, sobrepeso, obesidad y sedentarismo en niños venezolanos / Screen time is associated with consumption of high energy dense foods, overweight, obesity and sedentary children in Venezuela

Fundamento: Un elevado número de horas en contacto con pantallas de televisión o electrónicas representan parte de un ambiente obesogénico, debido al estrecho contacto con publicidad de alimentos no saludables, consumo de comidas rápidas y sedentarismo. Este trabajo evalúa la asociación entre las horas pantalla, el consumo de alimentos, el estado nutricional y la actividad física en niños venezolanos. Métodos: Estudio descriptivo y transversal, con una muestra no probabilística de 8.073 sujetos de 7 a 14 años en escuelas de Venezuela. Los datos se analizaron mediante estadística descriptiva de comparación entre variables y regresión logística simple entre las horas pantalla y variables asociadas. Resultados: 86% de los niños pasan 2 o menos horas frente a las pantallas. Aquellos que destinan mayor número de horas pantalla poseen mayor consumo de alimentos con alta densidad energética (ej. galletas), mayor índice de masa corporal, área grasa y menos actividad física (p < 0,05). Conclusiones: Las horas pantalla que invierten los niños es un condicionante de la malnutrición por exceso en los niños estudiados. Es necesario el diseño y aplicación de políticas públicas para el control de esta problemática y así reducir el riesgo de padecer enfermedades crónicas no transmisibles en la vida adulta (AU)

Background: Screen time or been in contact with television or electronics are part of the obesogenic environment which includes factors such as the advertising of unhealthy foods, consumption of fast food and sedentarism. This study evaluates the association between screen time, food consumption, nutritional status and physical activity in Venezuelan children. Methods: Descriptive and transversal study with a non probabilistic sample of 8,073 subjects 7-14 years attending schools in Venezuela. Data were analyzed using descriptive statistics comparison between variables and simple logistic regression between the screen time and associated variables. Results: 86% of children and adolescents spend 2 hours or less in front of screens. The more screen time is associated with increased consumption high energy density foods (e.x. cookies), higher body mass index and fat area and fewer hours of physical activity (p < 0.05). Conclusions: The screen time that children invest is a predictor of overweight and obesity in children studied. We need to design and apply public policies to control this problem and reduce the risk of chronic noncommunicable diseases in adulthood (AU)

Prácticas vinculadas al consumo de sal en pacientes con enfermedad renal / Salt intake practices in patients with renal disease

Excederse en el consumo de sal es una práctica común, que conlleva a consecuencias patológicas en la población en general, más aún en el paciente renal. Un consumo elevado de este elemento se asocia con mayor riesgo de desarrollo de hipertensión, enfermedad cardiovascular y renal, patologías responsables de 60% de la morbi-mortalidad mundial. La Organización Mundial de la Salud recomienda un consumo máximo de 5g. sal/día. Esta investigación busca determinar las prácticas vinculadas al consumo de sal y estimar su consumo en pacientes con enfermedad renal, que asisten al departamento de nefrología del hospital Guanare, Portuguesa-Venezuela. Es un estudio mixto, realizado en 66 pacientes (n=36 grupos focales, n=30 entrevistas cuantitativas). Las variables estudiadas fueron: disponibilidad de sal en hogar, consumo de alimentos con elevado contenido de sodio y prácticas cualitativas vinculadas al consumo de sal. Los pacientes consumieron 12,5 (♀) y 11,3 (♂) g/día de sal, provenientes del consumo directo y alimentos procesados. Los alimentos con elevado contenido de sodio más frecuentemente consumidos fueron: leche entera en polvo, quesos llanero y blanco pasteurizado, embutidos, enlatados, bebidas gaseosas, margarina, sazonadores y salsas (mayonesa, inglesa, ajo y soya). Los pacientes no leen el etiquetado nutricional y desconocen la cantidad de sodio de alimentos procesados. Los pacientes evitan el uso de sal de mesa, pero no el consumo de alimentos procesados. El consumo de sal de los pacientes, duplica las recomendaciones internacionales y nacionales que regulan el consumo de sodio, lo que conlleva a una disminución de la expectativa y calidad de vida(AU)

Exceed salt intake is a common practice, that leads to pathological consequences in the whole population, even more in the patient with renal disease. High salt consumption has been associated with hypertension, cardiovascular and cerebrovascular disease that are responsible for 60% of worldwide morbi-mortality. The World Health Organization recommends a maximum intake of 5 g of salt/day. The aim of this study is to determine practices related with salt intake, and estimate the consumption in patients with renal disease, who attended the nephrology department in Guanare´s Hospital, Portuguesa State, Venezuela. We used a mixed-method approach in 66 patients (n=36 subjects from focus groups, n=30 who participated in quantitative interviews). The main variables studied were: availability of salt at household, intake of foods with high Sodium content, practices related with use of salt. The patients consumed 12.5 (♀) and 11.3 (♂) g/day, from salt alone and processed foods. The most consumed foods with high sodium content were: whole milk powder, white local cheese, ham, canned food, soft drinks, margarine, mayonnaise, garlic and soy sauce. Patients do not read the food label, ignore the amount of sodium in processed foods, avoid the salt on the table, but not from processed food. The salt intakes of these patients exceed more than double the international and national recommendations, and as a consequence they diminished their life expectancy and reduced their quality of life(AU)

[Dietary diversity and associated factors among beneficiaries of 77 child care centers: Central Regional, Venezuela]. / Diversidad alimentaria y factores asociados en beneficiarios de 77 multihogares de cuidado diario: región central de Venezuela.

The aim of this study was to estimate household measure diet quality, using a dietary diversity score, and its associated demographic and socio-economic factors. One hundred fifty three households representatives of the Capital District and Miranda State belonging of seventy seven day care children centers were studied. To gather data on dietary diversity, we used the food register method, collecting data on household food availability during a month. Dietary diversity at day care centers of the Capital District was 46 foods differed from that found, in Miranda State was 39 foods (p = 0.005). Likewise it differed in beneficiaries' households of the Capital District was 33 foods compared to those in Miranda State was 25 foods (p = 0.000). There were 13 and 14 foods more between day care centers and the households in both states. State (Capital District or Miranda), money spent on food per person, households size and social level were variables that explained 28.9% of dietary diversity variation in households studied. Households in the Capital District had less members, spent more money on food, and a greater proportion were non-poor compared to those in Miranda. These factors could partially explain differences in diet quality among households in the two States. Whatever perspective studied indicates that the dietary diversity had a statistically significant difference between day care centers and households in states studied. Miranda State was more deficiency than Capital District. Higher dietary diversity reflects a better quality diet at day care centers compared to households studied.