Efecto del ejercicio y reposo postintervención sobre variables de riesgo cardiovascular en grupo de escolares / Effect of exercise and a post-intervention rest in cardiovacular risk variables in schoolars / Efeitos de exercicios e do repouso pos-operatorio sobre variaveis de risco cardiovascular em grupo de escolares

Objetivo: determinar el efecto de un programa de ejercicio seguido de un periodo de reposo post-intervención en marcadores de riesgo cardiovascular de un grupo de escolares de un Colegio de Cali-Colombia. Materiales y métodos: estudio experimental en el que se incluyeron 26 escolares con edades entre 10 y 13 años. Estos se sometieron a un período (4 meses) de intervención con ejercicio seguido de un periodo de reposo. Cambios en: glucosa y perfil lipídico; variables antropométricas; y parámetros de capacidad física, fueron evaluados. Resultados: los niños mostraron mayores valores de porcentaje (%) grasa corporal, cHDL, VO2max, carga y lactato al finalizar la intervención con ejercicio, e incremento significante en el valor de glicemia, IMC y % grasa corporal respecto al final del periodo de reposo post-intervención. En las niñas solo se observó incremento en la mediana de la carga luego de intervención con ejercicio. En el periodo de reposo post-intervención el IMC, porcentaje de grasa corporal y glicemia fueron más altos, y el valor de carga menor en comparación con el final de la intervención con ejercicio. Conclusiones: los niños presentaron mejor respuesta al ejercicio en variables relacionadas con riesgo cardiovascular, y este hallazgo podría estar influenciado por actividad física espontanea en los varones. En la mayoría de variables se observaron cambios negativos tras el periodo de reposo post-intervención. Para el conocimiento de los autores, este ensayo representa una primera exploración del efecto de un periodo sedentario tras un programa de ejercicio en el perfil cardiovascular de un grupo de escolares.

Objective: to determine the effect of an exercise program followed by a rest period post-intervention on cardiovascular risk markers in a group of children of Cali-Colombia school. Materials: experimental study which included 26 children aged 10-13 years old. These were subjected to a exercise intervention period (4 months) followed by a rest period. Changes in: glucose and lipid profile, anthropometric variables, and parameters of physical capacity, were evaluated. Results:boys showed higher values of body fat percentage, cHDL, VO2max, load and lactate at the end of the exercise intervention, and significant increase in the value of blood glucose, BMI and body fat percentage at the end of the post-intervention rest period. In girls only was observed an increase in load median after exercise intervention. In the post-intervention rest period BMI, body fat percentage and blood glucose were higher and the load value was lower compared to the end of the exercise intervention. Conclusions: boys had a better response to exercise in variables related to cardiovascular risk, and this finding could be influenced by spontaneous physical activity in men. In most of the variables, negative changes were observed after the post-intervention rest period. To the author’s knowledge, this paper represents a first exploration of the effect of a sedentary period after an exercise program on the cardiovascular profile of a schoolchildren group.

Objetivo: determinar o efeito de um programa de exercícios seguidos por um período de pós-intervenção nos marcadores de risco cardiovascular em um grupo de resto escolares de Cali Colombia.Materiais: estudo experimental em que 26 alunos foram incluídos com idades entre 10 e 13 anos. Estes foram submetidos a um período (4 meses ), seguido intervenção de exercício com um período de descanso. Mudanças: glicose e do perfil lipídico; variáveis antropométricas ; e foram avaliados parâmetros de capacidade física Resultado: as crianças apresentaram maior percentagem (%) de gordura corporal, o cHDL, VO2max, de carga e de lactato no final da intervenção de exercício, e aumento significativo na quantidade de glicose, imce % de gordura corporal em comparação com o fim de período de descanso pós-intervenção. Em raparigas foi observado aumento apenas no meio de carga, após a intervenção do exercício. No período de descanso pós-intervenção imc, percentual de gordura e de glicose no sangue foram maiores e menor valor de carga em relação ao final da intervenção de exercícios.Conclusões: as crianças apresentaram melhor resposta ao exercício em variáveis relacionadas ao risco cardiovascular, e este achado poderia ser influenciada pela atividade física espontânea em homens. Na maioria das variáveis foram observadas variações negativas depois do período de descanso pós-intervenção. Para o conhecimento dos autores , este estudo representa a primeira análise do efeito de um período sedentário após um programa de exercício no perfil cardiovascular de um grupo de crianças em idade escolar

Association of self-reported familial history of cardiometabolic disease with metabolic syndrome in apparently healthy urban Colombian men.

OBJECTIVES: Evidence about the relationship between familial history (FH) of cardiometabolic disease (CMD) and metabolic syndrome (MetS) in Latin American populations is scarce. The aim of this study was to evaluate the relationship of FH of CMD and of dyslipidemia and obesity with MetS in healthy men. METHODS: One-hundred-twenty one individuals were recruited. Waist circumference and blood pressure were measured by a trained researcher using standard techniques. Glycemia and lipid profile were determined by colorimetric assays. A survey to record personal data and family antecedents in siblings, aunts/uncles, parents, and grandparents was conducted by trained interviewers. RESULTS: Individuals having three or more familial antecedents were associated with high triglycerides level even after adjusting by age, sedentarism, fat and carbohydrates intake, and alcohol consumption. After adjusting for the same variables, FH of dyslipidemia and hypertension was also associated with high triglycerides levels and elevated waist circumference, respectively. The FH of stroke was associated with high blood pressure after adjusting for the rest of familial antecedents, and with MetS in all adjustment models. DISCUSSION: the findings of association of this study together with the previous reports are evidence of the importance of hereditary component as independent predictor of cardiovascular risk factors and its clustering, as well as of possible specific association patterns between FH of CMD and MetS depending on evaluated population in terms of ethnic groups and geographic region. Further studies are required in other populations, as well as exploration of genetic markers of CMD regarding to MetS.

Early atherosclerotic lesions and post-mortem serum cholesterol level in a group of Colombian children / Lesiones ateroscleróticas tempranas y nivel de colesterol post mórtem en un grupo de niños colombianos

Introduction: Atherosclerosis is an asymptomatic chronic disease, which begins at early age and is difficult to detect during this stage. Prospective studies suggest a causal relationship between total serum cholesterol levels during childhood and early adolescence and the development of cardiovascular diseases in adulthood. Objective: The aim of this study was to evaluate the prevalence of early atherosclerotic lesions in the aorta artery of children and its relationship with post-mortem serum cholesterol levels. Material and methods: Post-mortem samples of blood and aorta were taken from 43 subjects aged less than 17 years old. Histopathological analysis (intimal thickening and inflammatory infiltrates) of the thoracic aorta and measurement of total serum cholesterol were performed. Results: The analysis showed thickening of the intima and lymphocyte infiltrates in 93% of children, and macrophage infiltrates in 79.1% of cases. A relationship between the highest terciles of total serum cholesterol levels and the presence of multiple lesions in the aorta wall was found (P<0.05). Conclusion: This group of children had a high prevalence of early inflammatory atherosclerotic lesions positively related with serum cholesterol levels. To our knowledge this study represents the first report of a relationship between post-mortem total serum cholesterol levels and pathological findings of macrophages and lymphocytes infiltrates in the aorta wall.

Introducción. La aterosclerosis es una enfermedad crónica asintomática que se inicia a edad temprana y es de difícil detección en esta etapa. Los estudios prospectivos sugieren una relación causal entre el nivel de colesterol sérico total en la niñez y la adolescencia, y el desarrollo de enfermedades cardiovasculares en la adultez. Objetivo. El objetivo de este estudio fue evaluar, post mórtem, la prevalencia de lesiones ateroscleróticas tempranas en la arteria aorta de niños y su relación con los niveles de colesterol. Materiales y métodos. Se tomaron muestras de sangre y de aorta de 43 sujetos con edades menores de 17 años. Se hizo el análisis histopatológico (engrosamiento de la íntima e infiltrado inflamatorio) de la aorta torácica y la medición de colesterol en suero. Resultados. El análisis mostró engrosamiento de la íntima e infiltrado linfocitario en 93 % de los niños, e infiltrado de macrófagos en 79,1 %. Se encontró relación entre los terciles superiores de colesterol sérico y la presencia de múltiples lesiones en la pared de la aorta (p<0,05). Conclusión. Este grupo de niños presentó una alta prevalencia de lesiones ateroscleróticas inflamatorias tempranas relacionada positivamente con niveles de colesterol sérico. Para nuestro conocimiento, este estudio representa el primer reporte de la relación entre el colesterol sérico y los hallazgos histopatológicos de infiltrado de macrófagos y linfocitos en la pared de la aorta, post mórtem.

Early atherosclerotic lesions and post-mortem serum cholesterol level in a group of Colombian children.

INTRODUCTION: Atherosclerosis is an asymptomatic chronic disease, which begins at early age and is difficult to detect during this stage. Prospective studies suggest a causal relationship between total serum cholesterol levels during childhood and early adolescence and the development of cardiovascular diseases in adulthood. OBJECTIVE: The aim of this study was to evaluate the prevalence of early atherosclerotic lesions in the aorta artery of children and its relationship with post-mortem serum cholesterol levels. MATERIAL AND METHODS: Post-mortem samples of blood and aorta were taken from 43 subjects aged less than 17 years old. Histopathological analysis (intimal thickening and inflammatory infiltrates) of the thoracic aorta and measurement of total serum cholesterol were performed. RESULTS: The analysis showed thickening of the intima and lymphocyte infiltrates in 93% of children, and macrophage infiltrates in 79.1% of cases. A relationship between the highest terciles of total serum cholesterol levels and the presence of multiple lesions in the aorta wall was found ( P <0.05). CONCLUSION: This group of children had a high prevalence of early inflammatory atherosclerotic lesions positively related with serum cholesterol levels. To our knowledge this study represents the first report of a relationship between post-mortem total serum cholesterol levels and pathological findings of macrophages and lymphocytes infiltrates in the aorta wall.

Presión arterial por edad, género, talla y estrato socioeconómico en población escolarizada de Cali, Colombia / Blood pressure by age, gender, height, and socioeconomic level in school populations in Cali, Colombia

Introducción: La presión arterial (PA) es un signo vital y su registro en los niños y adolescentes es fundamental.Los estudios han mostrado que la hipertensión arterial en la edad pediátrica puede llevar a enfermedadescardiovasculares del adulto que son la primera causa de muerte en muchos países y en Colombia. El objetivo de esteartículo es mostrar los datos de PA en una población escolar de 7 a 18 años, de la ciudad de Cali, Colombia.Métodos: Se realizó un estudio descriptivo transversal en Cali, Colombia, para evaluar factores de riesgo de enfermedades crónicas no transmisibles en una población escolarizada que incluyó antropometría, bioquímica sanguínea, capacidad física de trabajo, salud oral y dieta; además, dos pediatras hicieron un examen físico completo con toma de presión arterial (PA). Para la toma de PA se utilizó método auscultatorio en posición sentada con el brazalete adecuado de acuerdo con los estándares; se tomó y registró la PA en los dos brazos. Se reportaron los datos de PA de esta población escolarizada, su relación con edad, género, talla, estrato socioeconómico, ingesta de sal e índicede masa corporal (IMC). Resultados: Se evaluaron 2,807 escolares de diferentes instituciones educativas del área urbana de Cali. El 92.2% de la población escolar evaluada presentó PA normal inferior a percentil 90%, 3.8% presentó PA entre percentiles 90% a 95% o prehipertensión y 3.2% es hipertenso con tensión arterial superior al percentil 95% para edad, géneroy percentil de talla. La PA sistólica y diastólica aumenta con la edad, la talla y en los varones los valores son ligeramente más altos. No se encontraron diferencias significativas de tensión sistólica y diastólica por estrato socioeconómico. No hubo diferencias entre la tensión en brazo derecho y brazo izquierdo. A mayor ingesta de sodio en la dieta y mayorIMC, mayores los niveles de PA sistólica.

[Percentile values for physical condition for Cali, Colombian children and adolescents]. / Percentiles de condición física de niños y adolescentes de Santiago de Cali, Colombia.

INTRODUCTION: Baseline data for physical condition are not available for adolescents in Cali, Colombia. OBJECTIVE: This study aimed to develop representative age- and sex- specific percentile baseline data for physical condition (mL.kg-1.min-¹) for urban adolescents aged 10-16 years. Materials and methods. The sample (n=1,773) consisted of 865 males and 908 females from the cross-sectional population survey, the IFRECNTEC Study (Identification of Risk Factors of Non-Transmissible Adult Chronic Diseases in School-age Populations in the City of de Cali), for whom the data for physical condition were recorded. Smoothed age- and sex- specific 5th, 25th, 50th, 75th, 90th and 95th centile values where derived using least mean squares regression analysis. RESULTS: Percentile-based reference data for physical condition were presented for adolescent Colombian boys and girls for the first time. In males, the p50 of the PWC-170 (VO2max) ranged 49-43, and in females 52-40. A decreasing trend (~10%) in the p50 was seen in both sexes over 16 years of age. In general, more heterogeneity was present among males than females in terms of physical aptitude through VO2max test. CONCLUSION: The results established a baseline level of physical condition in adolescents that can be interpreted as an indicator of future cardiovascular health. They also recommend that the physical condition of Colombian adolescents must be improved to protect against cardiovascular disease in adulthood.

Inverse correlation between serum calcium and copper levels in male urban Colombian preschool children: relationships with anthropometry and age.

Copper and calcium are essential for human growth and development. The present study was conducted to evaluate the relationship between calcium and copper levels, as well as their relationship to age and anthropometry in 180 preschool children ages 2-5 years old. Serum copper levels were inversely correlated with age (r = -0.184, P = 0.032) and height (r = -0.175, P = 0.043) in the whole group and with height for age Z score only in male children (r = -0.291, P = 0.016). The correlation with age is not maintained when it is analyzed for gender. Serum calcium values in the total group were inversely correlated with weight (r = -0.153, P = 0.044) and weight for height Z score (r = -0.246, P = 0.001). No differences were found for gender in the levels of both metals. A negative relationship between serum calcium and copper was found only in male children (r = -0.339, P = 0.005). Studies are required in other populations and experimental designs that can explain an inverse relationship between serum calcium and copper levels.

Percentiles de condición física de niños y adolescentes de Santiago de Cali, Colombia / Percentile values for physical condition for Cali, Colombian children and adolescents

Introducción. Muchos estudios han mostrado la relación entre la condición física durante la infancia y adolescencia y el riesgo cardiovascular en la edad adulta. Objetivos. Determinar los valores por edad y sexo de la condición física de niños y adolescentes de 10 a 16 años de Cali, Colombia. Materiales y métodos. Se llevó a cabo un estudio descriptivo en 1.773 niños y adolescentes de ambos sexos, 865 niños y 908 niñas, pertenecientes al estudio Identificación de factores de riesgo de enfermedades crónicas no transmisibles del adulto en la población escolarizada de 10 a 16 años en el Municipio de Cali, Colombia (IFRECNTEC), a quienes se les determinó la condición física con la prueba de capacidad física de trabajo a una frecuencia cardiaca de 170 por minuto (Physical Working Capacity, the workload at a heart rate of 170 bpm, PWC170), como marcador del volumen máximo de oxígeno (VO2máx). Se calcularon los valores percentiles (5, 25, 50, 75, 90 y 95) con el método de los mínimos cuadrados (Least Mean Squares, LMS) por curvas centiles que representan la asimetría, la mediana y la viariabilidad, utilizando el paquete estadístico Growth Analyzer®. Resultados. Se presentan los datos percentiles de la condición física en menores de 10 a 16 años, por primera vez en esta población. En los de sexo masculino, el percentil 50 medido con la prueba de PWC170 (VO2máx) se situó entre 49 y 43 ml/kg por minuto, y en las de sexo femenino, entre 52 y 40 ml/kg por minuto. Por otro lado, hay una tendencia a la disminución (~10 %) en el percentil 50, en adolescentes de ambos sexos de 16 años de edad por VO2máx estimado. En general, en el sexo masculino hay más heterogeneidad que en el femenino, en términos de condición física mediante el VO2máx. Conclusión. Los resultados obtenidos en el presente estudio permiten evaluar e interpretar correctamente la condición física de niños y adolescentes de 10 a 16 años. También, indican que la condición física de este grupo de edad en Colombia, se debe mejorar para ayudar a protegerlos contra las enfermedades cardiovasculares en la edad adulta.

Introduction. Baseline data for physical condition are not available for adolescents in Cali, Colombia. Objective. This study aimed to develop representative age- and sex- specific percentile baseline data for physical condition (mL•kg -1 •min -1 ) for urban adolescents aged 10-16 years. Materials and methods. The sample (n=1,773) consisted of 865 males and 908 females from the crosssectional population survey, the IFRECNTEC Study (Identification of Risk Factors of Non-Transmissible Adult Chronic Diseases in School-age Populations in the City of de Cali), for whom the data for physical condition were recorded. Smoothed age- and sex- specific 5th, 25th, 50th, 75th, 90th and 95th centile values where derived using least mean squares regression analysis. Results. Percentile-based reference data for physical condition were presented for adolescent Colombian boys and girls for the first time. In males, the p50 of the PWC-170 (VO2 max) ranged 49- 43, and in females 52-40. A decreasing trend (~10%) in the p50 was seen in both sexes over 16 years of age. In general, more heterogeneity was present among males than females in terms of physical aptitude through VO2max test. Conclusion. The results established a baseline level of physical condition in adolescents that can be interpreted as an indicator of future cardiovascular health. They also recommend that the physical condition of Colombian adolescents must be improved to protect against cardiovascular disease in adulthood.

[Lack of relationship of physical activity level with cardiovascular risk factors and metabolic syndrome in apparently healthy men]. / Falta de relación entre el nivel de actividad física con marcadores de riesgo cardiovascular y síndrome metabólico en hombres aparentemente sanos.

BACKGROUND: The World Health Report 2002 estimated that sedentary is one of the main 10 causes of morbidity and mortality and the proportion of people whose health is at risk due to sedentary life is approximately 60%. OBJECTIVE: To assess the relationship of the physical activity level with cardiovascular risk factors and metabolic syndrome in 61 healthy men. METHODS: The short version of the International Physical Activity Questionnaire (IPAQ) recommended by the World Health Organization was used as a valid measure to estimate two categories of physical activity, such as: low level (insufficient and sedentary) and vigorous level (moderate and very active). Cardiovascular risk factors and metabolic syndrome were defined according to criteria of the National Cholesterol Education Program of the United States and International Diabetes Federation respectively. Serum levels of C-reactive protein and ferritin were also measured, and insulin sensitivity was estimated by the Homeostatic Model Assessment-Insulin Resistance (HOMA-IR). RESULTS: Mean age of study population was 47.1 ± 6.9 years. 17 participants (28%) had metabolic syndrome. There were no differences between the categories of low and vigorous level physical activity, or relationship with total physical activity (MET × week). No association was seen between low levels of physical activity and metabolic syndrome criteria. CONCLUSIONS: The high prevalence of physical inactivity found in study participants using the IPAQ questionnaire was not associated to cardiovascular risk factors and metabolic syndrome.

Falta de relación entre el nivel de actividad física con marcadores de riesgo cardiovascular y síndrome metabólico en hombres aparentemente sanos / Lack of relationship of physical activity level with cardiovascular risk factors and metabolic syndrome in apparently healthy men

Antecedentes El Informe Mundial de la Salud de 2002 estimó que el sedentarismo es una de las principales diez causas de morbilidad y mortalidad y la proporción de las personas cuya salud está en riesgo debido a la vida sedentaria es de aproximadamente 60%.ObjetivoEvaluar la relación de el nivel de actividad física con factores de riesgo cardiovascular y el síndrome metabólico en 61 hombres sanos. Métodos La versión corta del cuestionario de la International Physical Activity Questionnaire (IPAQ), recomendado por la Organización Mundial de la Salud, fue utilizado como una medida válida para estimar dos categorías de actividad física, como son: nivel bajo (insuficiente y sedentarios) y nivel vigoroso (moderado y muy activa). Factores de riesgo cardiovascular y síndrome metabólico se definió de acuerdo con los criterios del National Cholesterol Education Program de los Estados Unidos y el International Diabetes Federation, respectivamente. Los niveles séricos de proteína C-reactiva y la ferritina también fueron medidos, y la sensibilidad a la insulina se calculó mediante la evaluación del modelo de la resistencia a la insulina (HOMA-IR).Resultados La media de edad de la población de estudio fue de 47.1±6.9 años. 17 participantes (28%) tuvieron síndrome metabólico. No hubo diferencias entre las categorías de actividad física nivel bajo y nivel vigoroso, o la relación con la actividad física total (MET×semana). No se observó asociación entre los niveles bajos de actividad física y los criterios de síndrome metabólico. Conclusiones La alta prevalencia de inactividad física en los participantes del estudio con el cuestionario IPAQ no se asoció a factores de riesgo cardiovascular y síndrome metabólico (AU)

Background: The World Health Report 2002 estimated that sedentary is one of the main 10causes of morbidity and mortality and the proportion of people whose health is at risk due to sedentary life is approximately 60%.Objective: To assess the relationship of the physical activity level with cardiovascular riskfactors and metabolic syndrome in 61 healthy men. Methods: The short version of the International Physical Activity Questionnaire (IPAQ) recommended by the World Health Organization was used as a valid measure to estimate two categories of physical activity, such as: low level (insufficient and sedentary) and vigorous level (moderate and very active). Cardiovascular risk factors and metabolic syndrome we redefined according to criteria of the National Cholesterol Education Program of the United States and International Diabetes Federation respectively. Serum levels of C-reactive protein and ferritin were also measured, and insulin sensitivity was estimated by the Homeostatic ModelAssessment-Insulin Resistance (HOMA-IR).Results: Mean age of study population was 47.1±6.9 years. 17 participants (28%) had metabolic syndrome. There were no differences between the categories of low and vigorous level physical activity, or relationship with total physical activity (MET week). No association was seen between low levels of physical activity and metabolic syndrome criteria. Conclusions: The high prevalence of physical inactivity found in study participants using the IPAQ questionnaire was not associated to cardiovascular risk factors and metabolic syndrome (AU)

Centile values for anthropometric variables in Colombian adolescents.

BACKGROUND AND OBJECTIVE: Reference data for anthropometric parameters are not available for adolescents in Cali (Colombia). This study aimed to develop representative age- and sex-specific percentiles for anthropometric indicators [fat percentage, body mass index (BMI), and waist circumference] in urban adolescents aged 10-16 years in Cali. METHODS: The sample (n=1,773) consisted of 865 boys and 908 girls from the descriptive, cross-sectional population-based IFRECNTEC study (Identification of Risk Factors for Non-communicable Chronic Diseases in Adulthood in a Population aged 6 to 18 years old attending School in the Municipality of Cali, Colombia). Data on anthropometric variables were recorded. Smoothed age- and sex- specific 5(th), 25(th), 50(th), 75(th), 90(th) and 95(th) centiles were derived using the least mean squares (LMS) regression method. RESULTS: In most ages, anthropometric indicators were higher for girls than for boys. The BMI p50 ranged from 16.8 to 19.9kg/m² in boys and from 16.7 to 21.1kg/m² in girls. Fat percentage in boys in the p50 varied from ≈12% at the ages of 10 and 11 years to ≈13% at the age of 16 years; for girls, these percentages varied from ≈13% in the earliest ages to ≈16% in older ages. Waist circumference was lower in girls than in boys in most ages. CONCLUSION: The results of this study could be used to identify adolescents with an elevated risk of developing obesity, dyslipidemia, hypertension and cardiovascular disorders in adulthood, to plan and implement preventive policies, and to study temporal trends. The introduction of centile values will help to classify adolescents from Cali and compare their anthropometric indicators with those of a reference population.

Centile values for anthropometric variables in Colombian adolescents

Background and objective Reference data for anthropometric parameters are not available for adolescents in Cali (Colombia). This study aimed to develop representative age- and sex-specific percentiles for anthropometric indicators [fat percentage, body mass index (BMI), and waist circumference] in urban adolescents aged 10–16 years in Cali. Methods The sample (n=1,773) consisted of 865 boys and 908 girls from the descriptive, cross-sectional population-based IFRECNTEC study (Identification of Risk Factors for Non-communicable Chronic Diseases in Adulthood in a Population aged 6 to 18 years old attending School in the Municipality of Cali, Colombia). Data on anthropometric variables were recorded. Smoothed age- and sex- specific 5th, 25th, 50th, 75th, 90th and 95th centiles were derived using the least mean squares (LMS) regression method. Results In most ages, anthropometric indicators were higher for girls than for boys. The BMI p50 ranged from 16.8 to 19.9kg/m2 in boys and from 16.7 to 21.1kg/m2 in girls. Fat percentage in boys in the p50 varied from (..) (AU)

Antecedentes y objetivos No existen indicadores antropométricos para los adolescentes de Cali, en Colombia. Este estudio tuvo como objetivo establecer percentiles antropométricos según edad y sexo para los indicadores: porcentaje de grasa, índice de masa corporal (IMC), y perímetro de la cintura en adolescentes escolarizados y con edades comprendidas entre los 10 y los 16 años. Métodos Estudio descriptivo de corte transversal con 1.773 niños y adolescentes de ambos géneros (n=865 chicos y n=908 chicas) pertenecientes al estudio IFRECNTEC (Identificación de Factores de Riesgo de Enfermedades Crónicas No Transmisibles del Adulto en la Población Escolarizada de 6 a 18 años en el Municipio de Cali, Colombia). Se calcularon los valores percentiles p5, p25, p50, p75, p90 y p95 de los indicadores antropométricos a partir de la regresión de los mínimos cuadrados promedio (LMS) según edad y sexo. Resultados En la mayoría de las edades, los indicadores antropométricos de (..) (AU)

Percentiles de presión arterial de niños y adolescentes de Santiago de Cali-Colombia / Blood pressure centiles for Santiago de Cali-Colombian children and adolescents

Objetivo: Determinar los valores percentiles de presión arterial de niños y adolescentes de 10 a 16 años de Santiago de Cali-Colombia. Materiales y Métodos: Estudio descriptivo de corte transversal en 1773 niños y adolescentes de ambos géneros (n=865 hombres y n=908 mujeres) pertenecientes al estudio IFRECNTEC (Identificación de Factores de Riesgo de Enfermedades Crónicas No Transmisibles del Adulto en la Población Escolarizada de 6 a 18 años en el Municipio de Cali, Colombia). Se calcularon los valores percentiles a partir de la regresión de los mínimos cuadrados (Least Mean Squares) según edad y sexo p5, p25, p50, p75, p90 y p95 de la presión arterial. Resultados: La presión arterial por sexo fue similar en la infancia, aumentando progresivamente con la edad y con mayor rapidez durante la pubertad. La presión sistólica y diastólica fue mayor en los adolescentes hombres que en las mujeres. Discusión y Conclusiones: La presentación de valores percentiles permite clasificar la presión arterial de niños y adolescentes de Cali-Colombia y comparar con sus contemporáneos. La presión arterial alta para la edad debería definirse en percentiles por encima del p95 y la presión arterial alta y normal podría definirse entre el p90 y p95...

Aim. To determine age- and sex- specific centile values of Blood pressure for urban Santiago de Cali-Colombia children and adolescents aged 10–16 years. Material and Methods. The sample (n=1773) consisted of 865 boys and 908 girls from the crosssectional population survey, IFRECNTEC Study (Identificación de Factores de Riesgo de Enfermedades Crónicas No Transmisibles del Adulto en la Población Escolarizada de 6 a 18 años en el Municipio de Cali, Colombia) for whom the data for Blood pressure was recorded. Smoothed age- and sex- specific 5th, 25th, 50th, 75th, 90th and 95th Centile values where derived using Least Mean Squares regression. Results. Blood pressure in both sexes was similar in childhood, rising progressively with age and more rapidly during puberty. Systolic and Diastolic pressure rose faster and was appreciably higher in men than in adolescents women. Discussion and Conclusion. These centiles increase our knowledge of blood pressure data in contemporary Colombian children and young people. High blood pressure for age should be defi ned as blood pressure above the 95th centile, and high-normal blood pressure for age as blood pressure between the 90th and 95th centiles...

Impacto de un depósito de residuos sólidos en el crecimiento físico infantil / Impact of a waste disposal site on children physical growth

Antecedentes: Varios estudios epidemiológicos han mostrado un aumento en el riesgo de presentar problemas de salud entre las personas que habitan cerca a los rellenos sanitarios. En este estudio se evaluó el impacto de un depósito municipal de residuos sólidos en el crecimiento de los niños entre 0 y 3 años de edad. Materiales y métodos: Los niños expuestos se seleccionaron en sitios con alta probabilidad de exposición a los agentes provenientes del depósito por dispersión aérea. Se seleccionó un grupo control cuya distancia y ubicación hacía poco probable que estuviera expuesto a dichos agentes. Se obtuvieron medidas antropométricas a la captación y en dos visitas de seguimiento, con intervalos de 3 meses. Se obtuvieron los puntajes estandarizados de Z del peso para la talla (PT) y talla para la edad (TE). demßs, se realizaron cuestionarios acerca de condiciones socio-económicas y morbilidad en la captación y en las visitas de seguimiento. Resultados: Los ni±os expuestos tuvieron en promedio 0.16 desviaciones estandar (DE) menos en el PT al compararlo con el grupo control (intervalo de confianza 95% [IC]: -0.34, 0.01). Entre los que habían habitado >50% de sus vidas en el area de estudio, se observó un menor valor de TE (-0.12) asociado con la exposición. Los datos también sugirieron un mayor efecto de la exposición en el PT entre los niños que presentaron síntomas respiratorios durante el seguimiento en comparación con los ni±os que permanecieron asintomaticos (p=0.08).Conclusiones: La exposición al depósito de residuos sólidos se asoció con un menor valor en los índices de crecimiento pondo-estatural.

Background: Several epidemiological studies have shown an increased risk of health problems among population living close to landfills. We evaluated the impact of a municipal solid waste disposal site on childrenÆs growth between 0-3 years of age. Methods: Children were selected in sites likely to receive dispersion of air compounds from the waste disposal site and also in a control area, in Cali, Colombia, in 2005. Anthropometric measures were obtained at enrollment and in two follow-up visits at 3 months intervals to obtain standardized z scores of weight for height (WHZ) and height for age (HAZ). In addition, questionnaires including information of socio-economical conditions and morbidity were applied at enrolment and during follow-up visits.Results: Children exposed had on average 0.16 less standard deviations (SD) in WHZ scores when compared to control group (95% Confidence Interval [CI]: -0.34, 0.01). Among those who have lived >50% of their life in the study area, a significantly lower HAZ score was observed (-0.12) associated with exposure. Our data also suggest a larger effect of exposure to the waste disposal site in WHZ among children with symptoms of respiratory disease than among asymptomatic children (p=0.08).Conclusions: Exposure to this waste disposal site was found associated with lower childrenÆs growth indexes.

[Association of risk factors for non transmissible chronic diseases with insuline sensitivity, in young adults in the city of Cali, Colombia]. / Relación entre los factores de riesgo de enfermedades crónicas no transmisibles y la sensibilidad a la insulina en adultos jóvenes de 18 a 39 años de la ciudad de Cali-Colombia.

The prevalence of insulin resistance and risk factors for chronic diseases is not known in Colombia. The purpose of the study was of determine the association of insulin resistance and risk of chronic diseases in young, apparently healthy adults. By convenience, 97 subjects, mean age of 24 years were studied. Family and personal history, anthropometrics, lipid profile, and a short insulin tolerance test was done to each subject to identify prevalence of insulin resistance and its association with risk factors. Plasma lipids and anthropometrics were within acceptable range. Insulin sensitivity was categorized as high, border high, border low and low. Out of 97 subjects 47 had altered sensitivity. Most women (68%) were classified as border low, and most men (60%) as low. There was a difference between these two categories in waist circumference and weight. Border low and low cases had not less than 3 risk factors but the total number of factors was not different within the 4 groups. More than 50% of cases had family history of chronic diseases, sedentary life and low C-HDL. There was a negative association between insulin sensitivity and fasting Glycaemia and positive with fasting triglycerides, BMI, Waist hip ratio and weight. Results suggest a surprisingly high prevalence of risk factors in a young group associated with altered insulin sensitivity. It may be possible to identify early indicators of risk and develop appropriate strategies for prevention.

Determinantes de salud y políticas públicas: identificación de indicadores de problemas de salud y factores asociados, basada en datos disponibles / Health and public policy determinants: selection of indicators for health problems

Introducción: La planeación en salud requiere de información, que está disponible, pero que no siempre se utiliza. Aunque los sistemas de información en salud aparecieron hace más de tres décadas, las decisiones del sector se dirigen al manejo de enfermedad y no a modificar los factores que la genera. El propósito del estudio fue evaluar la utilidad de datos disponibles en los diferentes sectores, para identificar grupos de población con características similares, asociadas con problemas de salud e identificar marcadores sencillos que orienten la toma de decisiones para solucionarlos. Métodos: Estudio ecológico. Se identificaron, recolectaron y procesaron datos de instituciones públicas y privadas y de estudios recientes. La asociación y correlación entre las diferentes variables permitió identificar aquellas con capacidad para discriminar grupos de población con problemas similares. Resultados: El estrato de vivienda mostró asociación significante con la mayoría de variables y se utilizó para dividir los barrios de la ciudad en cuatro conglomerados. Los barrios pertenecientes a estratos más bajos mostraron deficiencias en vivienda y educación, mayor proporción de población menor de 18 años, promedio de edad de muerte menor, menor estatura y mayor mortalidad perinatal y por accidentes y violencia. En los barrios de nivel medio y alto, se encontraron mejores condiciones de vivienda y tumores y enfermedades crónicas no transmisibles como las principales causas de muerte. La conexión a servicios públicos fue similar en los hogares de todos los estratos, excepto el teléfono. El promedio ponderado por estrato y por barrio explica más de 80% de la varianza para la mayoría de las variables analizadas. Se propone que este indicador, disponible en forma permanente, se emplee como instrumento para planes locales de desarrollo, con validaciones periódicas a fin de evaluar su capacidad en el tiempo.

Introduction: Health planning requires information from all sectors, usually available, but not used frequently. Information systems in Health appeared more than 3 decades ago but decisions are usually taken on considerations directed to the solution of a manifestation without modification of causal factors. The purpose of this study was to evaluate the usefulness of available data to identify population groups with similar characteristics associated to health problems and to identify simple markers to serve as a basis for decisions directed to solve them. Methods: Ecological study. Data were identified, collected and collated from public institutions and from recent studies for analysis. Association and correlation among the different variables identified those with the capacity to discriminate population groups. Household socio economic stratum had a significant association with most variables and was used to divide "Barrios" in four conglomerates. Results: Lower conglomerates presented deficiencies in household and education, larger proportion of young population, lower mean death age, higher mortality caused by accidents and violence, and lower stature. Middle and higher income conglomerates had better household conditions and the principal cause of death was tumors and chronic diseases. Public services were similar for all except telephone. Weighed household stratum by neighborhood "barrio" explained more that 80% of variance for most variables. It is proposed that this marker, available and easy to obtain, the instrument to define local development plans with periodic validations to evaluate its capacity.

Effects of a new Helicobacter pylori infection on height and weight in Colombian children.

PURPOSE: The aim of the study is to investigate whether a new infection caused by Helicobacter pylori in preschool children transiently or permanently affects height and weight. METHODS: A cohort of 347 children from three day care centers was followed up for a median of 494 days. Breath tests and anthropometric measurements were performed every 2 to 4 months. The lag effect of a new infection on linear growth during a period of 8 months was analyzed by using mixed-effects models. RESULTS: One hundred five children (30.3%) became infected during the follow-up period and accumulated 92 person-years of follow-up. A significant decrease in growth velocity was observed during the first 4 months after infection. There was no height catch-up in infected children, and after 8 months, an infected child had a cumulative difference of 0.24 cm (growth velocity; 95% confidence interval, 0.22-0.26) compared with an uninfected child. Newly infected children experienced a small decrease in weight at the first visit compared with uninfected children, which became nonsignificant after the second visit without catch-up. CONCLUSIONS: This study shows a significant and nontransient effect of infection caused by H. pylori on height and weight. Potential interventions that target infected preschool children are likely to prevent growth retardation.

Efecto de la complementación con zinc en la velocidad de crecimiento en niños preescolares / Effect of zinc supplementation on growth velocity of school children

INTRODUCCIÓN: La disminución de las infecciones junto con el consumo de dietas de alta densidad calórica, explica la reducción de la prevalencia de desnutrición observada en encuestas nacionales. El consumo de 50/100 de energía proveniente de grasas y azúcares representa un riesgo de déficit de micronutrientes. OBJETIVO: Evaluar las deficiencias de zinc mediante la respuesta a su administración en la velocidad de crecimiento.MÉTODOS: Estudio doble ciego en 270 niños sanos seleccionados en 9 guarderías, con ingesta de macronutrientes adecuada, de estrato socioeconómico medio-bajo y bajo de Cali, Colombia y que se siguieron mensualmente por un período de 18 meses. Se efectuó valoración antropométrica y dieta, análisis de zinc en sangre y faneros y coprológico inicial. Se evaluó crecimiento (cm/mes) durante 9 meses al final de los cuales se dividieron aleatoriamente en 2 grupos: uno recibió complemento de vitaminas y minerales sin zinc y el otro con 12 mg/día de zinc, durante 8 meses. RESULTADOS: En la primera evaluación se encontraron menos de 2/100 de los niños por debajo de -2 desviaciones de Z de talla-edad. Se encontró un consumo alto de grasa, azúcar y proteína. Hubo un aumento en todos los niños de la media de velocidad con complemento, pero fue mayor en los que recibieron zinc. Los cambios de velocidad ajustados por población de referencia fueron significantes. Las diferencias corresponden a cambios de percentiles en un grupo de niños más que a un efecto general sobre el grupo. El OR de aumento de escore Z de talla con zinc es 1.8 (IC 95/100 1.02-3.12). No hubo diferencia de zinc en sangre o en cabello y uñas (faneros). CONCLUSIÓN: La deficiencia de otros micronutrientes además del zinc, que limitan el crecimiento puede explicar el aumento de velocidad en los dos grupos. Es probable que en niños más desprotegidos la respuesta sea mayor

Evaluación de manifestaciones tempranas de riesgo para enfermedades crónicas no transmisibles en población escolarizada de Cali-Colombia / Evaluation of early manifestations of chronic no transmitted diseases risk in school population in Cali-Colombia

Colombia presenta cambios en la estructura de población y mortalidad similares a la de la mayoría de los países de América con un nivel avanzado de transición epidemiológica. Las enfermedades crónicas son la primera causa de muerte en los municipios con alta concentración urbana. Con el objetivo de identificar en escolares factores asociados con enfermedades crónicas no transmisibles del adulto se efectuó un estudio de la población escolar de Cali estratificando por edad, sexo y estrato socioeconómico(ESE). Por muestreo aleatorio se incluyeron 2.807 escolares de 14 colegios a en quienes se midió antropometría, consumo de alimentos, presión arterial, maduración sexual, capacidad física de trabajo y bioquímica sanguínea. Las medias de talla y peso encontradas fueron inferiores a la referencia internacional y superiores a estudios previos. Por el contrario los de masa corporal fueron superiores. El pico aparente de crecimiento fue 14 años en hombres y 11 en niñas. Madurez, 12 años en mujeres y 16,9 en hombres, menarca a los 11.9 años. La capacidad física de trabajo fue superior en el ESE bajo. Se encontró un porcentaje elevado de dislipidemias, 19,5 por ciento con presión sistólica mayor o igual 120mm. y 24 por ciento con diastólica mayor o igual 70 mm. Consumo de energía y proteína adecuada pero alta en grasas y carbohidratos simples. No existen deficiencias de macronutrientes aunque sí en la ingesta de algunos minerales como calcio y hierro. Los hallazgos indican una población con consumo inadecuado, masa corporal y grasa elevada y dislipidemias, que puede representar riesgo de aumento de enfermedades crónicas en el futuro

[Evaluation of early manifestations of chronic no transmitted diseases risk in school population in Cali - Colombia]. / Evaluación de manifestaciones tempranas de riesgo para enfermedades crónicas no trasmisibles en población escolarizada de Cali - Colombia.

Similar to other countries in America, Colombia and the Department of Valle present changes in their population structure and mortality suggesting an advanced epidemiological transition status. Grouped, chronic diseases represent the principal cause of death in municipalities with high urban concentration. To identify associated factors of chronic conditions later in life, school children stratified by age, socio-economic level and gender were studied. By random sampling of 14 schools 2.807 children were examined to measure: anthropometry, work capacity, food intake, sexual maturation, blood pressure, and blood levels of glucose and lipids. Weight and height for all ages and gender were lower than international reference but higher than in previous studies. On the contrary body mass indicators were higher. Work capacity adjusted for body weight was higher in low income children. Mean age of menarche was 11,9 years. The relative peak of growth was 11 years for girls and 14 for boys. Maturity was reached at 12 years in women and 17 in men. Blood lipids were considered high and borderline high in a large proportion of the students, while 19.5% had systolic blood pressure > or = 120 mm. and 24% diastolic > or = 70. Intake of protein and energy was adequate, but diet was high in fat and sugar. There was not deficiency in macro nutrients but dietary intake of some minerals was low, specially iron and calcium. The findings indicate a population with unbalanced diet and disturbing high body mass and lipid concentration that could represent in the future an increase in the already high prevalence of chronic diseases.