Percentiles of body mass index and waist circumference for Costa Rican children and adolescents / Percentiles de índice de masa corporal y circunferencia de la cintura en niños y adolescentes de Costa Rica

Introduction: body mass index (BMI) and waist circumference (WC) are anthropometric indicators used to define overweight/obesity and to predict the risk of cardiovascular disease, respectively, in adolescents and children. Objectives: to describe and provide estimations of BMI and WC distribution according to percentiles in a sample of Costa Rican students, and to test group differences at the 50th percentile with the international references by the National Center for Health Statistics of the united States of America in 2012, 2016 and 2021. Material and methods: a cross-sectional and descriptive study was carried out with 2,684 students from 7 to 17 years of age in 64 educational centers of Costa Rica. The weight of the students was determined with a Tanita model SC-331 S, and height was measured with a SECA stadiometer, model 217, to estimate BMI. To determine abdominal circumference a measuring tape was used. All procedures were approved by the INCIENSA Scientific Ethics Committee. The statistical analysis of the data was made with the SPSS 22.0 package. Results: the first percentile distribution of BMI and WC is provided. According to BMI, 16.3 % of the student population had obesity and 26.2 % had overweight. WC values increased over the years and some significant differences were found between genders. The BMI and WC curves of Costa Rican children showed patterns similar to the three international references they were compared to. Conclusions: obesity has become the main nutritional problem in Costa Rica. The BMI and WC trend graphs proposed in this study are a useful public health tool to monitor the overweight/obesity epidemic. (AU)

Introducción: el índice de masa corporal (IMC) y la circunferencia de la cintura (CC) son indicadores antropométricos utilizados para definir el sobrepeso/la obesidad y para predecir el riesgo de enfermedad cardiovascular, respectivamente, en la población infanto-juvenil. Objetivo: describir y proporcionar estimaciones de la distribución del IMC y la CC según percentiles en una muestra de estudiantes de Costa Rica y probar las diferencias de grupo en el percentil 50 con las referencias internacionales del Centro Nacional de Referencia de Estadísticas de Salud de los Estados unidos de América de 2012, 2016 y 2021. Materiales y métodos: estudio transversal y descriptivo realizado con 2684 estudiantes de 7 a 17 años de edad de 64 centros educativos de Costa Rica. El peso de los estudiantes se determinó con un equipo Tanita modelo SC-331 S y la talla se midió con un estadiómetro marca SECA, modelo 217, para estimar el IMC. Para determinar la circunferencia abdominal se usó una cinta métrica. Todos los procedimientos fueron aprobados por el Comité Ético Científico del INCIENSA. El análisis estadístico de los datos se realizó con el paquete informático SPSS 22.0. Resultados: se proporciona la primera distribución percentilar del IMC y de la CC. De acuerdo con el IMC, el 16,3 % de la población estudiantil presentó obesidad y el 26,2 % sobrepeso. Los valores de CC aumentan con los años y, al compararlos por sexos, se encontraron algunas diferencias significativas. Las curvas costarricenses para el IMC y la CC mostraron patrones similares a los de las tres referencias internacionales utilizadas para comparar. Conclusiones: la obesidad se ha convertido en el principal problema nutricional en Costa Rica. Las gráficas de tendencias del IMC y de la CC expuestas en el presente estudio son una herramienta útil para la salud pública con el fin de monitorear la epidemia de sobrepeso/obesidad. (AU)

Percentiles of body mass index and waist circumference for Costa Rican children and adolescents.

Introduction: Introduction: body mass index (BMI) and waist circumference (WC) are anthropometric indicators used to define overweight/obesity and to predict the risk of cardiovascular disease, respectively, in adolescents and children. Objectives: to describe and provide estimations of BMI and WC distribution according to percentiles in a sample of Costa Rican students, and to test group differences at the 50th percentile with the international references by the National Center for Health Statistics of the United States of America in 2012, 2016 and 2021. Material and methods: a cross-sectional and descriptive study was carried out with 2,684 students from 7 to 17 years of age in 64 educational centers of Costa Rica. The weight of the students was determined with a Tanita model SC-331 S, and height was measured with a SECA stadiometer, model 217, to estimate BMI. To determine abdominal circumference a measuring tape was used. All procedures were approved by the INCIENSA Scientific Ethics Committee. The statistical analysis of the data was made with the SPSS 22.0 package. Results: the first percentile distribution of BMI and WC is provided. According to BMI, 16.3 % of the student population had obesity and 26.2 % had overweight. WC values increased over the years and some significant differences were found between genders. The BMI and WC curves of Costa Rican children showed patterns similar to the three international references they were compared to. Conclusions: obesity has become the main nutritional problem in Costa Rica. The BMI and WC trend graphs proposed in this study are a useful public health tool to monitor the overweight/obesity epidemic.

Introducción: Introducción: el índice de masa corporal (IMC) y la circunferencia de la cintura (CC) son indicadores antropométricos utilizados para definir el sobrepeso/la obesidad y para predecir el riesgo de enfermedad cardiovascular, respectivamente, en la población infanto-juvenil. Objetivo: describir y proporcionar estimaciones de la distribución del IMC y la CC según percentiles en una muestra de estudiantes de Costa Rica y probar las diferencias de grupo en el percentil 50 con las referencias internacionales del Centro Nacional de Referencia de Estadísticas de Salud de los Estados Unidos de América de 2012, 2016 y 2021. Materiales y métodos: estudio transversal y descriptivo realizado con 2684 estudiantes de 7 a 17 años de edad de 64 centros educativos de Costa Rica. El peso de los estudiantes se determinó con un equipo Tanita modelo SC-331 S y la talla se midió con un estadiómetro marca SECA, modelo 217, para estimar el IMC. Para determinar la circunferencia abdominal se usó una cinta métrica. Todos los procedimientos fueron aprobados por el Comité Ético Científico del INCIENSA. El análisis estadístico de los datos se realizó con el paquete informático SPSS 22.0. Resultados: se proporciona la primera distribución percentilar del IMC y de la CC. De acuerdo con el IMC, el 16,3 % de la población estudiantil presentó obesidad y el 26,2 % sobrepeso. Los valores de CC aumentan con los años y, al compararlos por sexos, se encontraron algunas diferencias significativas. Las curvas costarricenses para el IMC y la CC mostraron patrones similares a los de las tres referencias internacionales utilizadas para comparar. Conclusiones: la obesidad se ha convertido en el principal problema nutricional en Costa Rica. Las gráficas de tendencias del IMC y de la CC expuestas en el presente estudio son una herramienta útil para la salud pública con el fin de monitorear la epidemia de sobrepeso/obesidad.

Estimation of Sodium Availability and Food Sources from 2018 to 2019 and Its Trends during the 2004-2019 Period in Costa Rica.

Sodium availability and food sources in 2018−2019 were estimated and trends analyzed for 15 years (2004−2019) in Costa Rica. Food purchase records from the National Household Income and Expenditure Survey (ENIGH) 2018−2019 were converted to energy and sodium using food composition tables measuring "apparent consumption". Foods were classified by sodium content. ENIGH is a probabilistic, stratified, two-stage and replicated national survey, carried out regularly by the national statistics institution. Results from the 2004−2005 and 2012−2013 ENIGHs came from previous analysis. Differences between periods were determined through descriptive and inferential statistics. The available sodium adjusted to 2000 kcal/person/day was 3.40, 3.86, and 3.84 g/person/day (g/p/d) for periods 2004−2005, 2013−2014, and 2018−2019, respectively. In this last period, this was 3.94 urban and 3.60 g/p/d rural (p < 0.05), with a non-linear increase with income. During 2004−2019 sodium from salt and salt-based condiments increased from 69.5 to 75.5%; the contribution of common salt increased, from 60.2 to 64.8% and condiments without added salt from 9.3 to 10.7%. From 2012−2013 to 2018−2019, processed and ultra-processed foods with added sodium intake increased from 14.2 to 16.9% and decreased in prepared meals (7.2 to 2.8%). Costa Rica has been successful in reducing salt/sodium available for consumption; after a 12% increase of salt consumption between 2004−2005 and 2012−2013, to a level almost twice as high as recommended, it has stabilized in the last period.

Household Cooking and Eating out: Food Practices and Perceptions of Salt/Sodium Consumption in Costa Rica.

This research aims to study the food practices and perceptions related to excessive consumption of salt/sodium when cooking and eating outside the home in a study population representing the wide intergenerational and sociocultural diversity of Costa Rica. Key communities from around the country, cultural experts, and key informants were selected. Four qualitative research techniques were applied. Data was systematized based on the Social Ecological Model. Women are generally in charge of cooking and family food purchases. Salt is perceived as a basic ingredient, used in small amounts that can be reduced-but not eliminated-when cooking. Changes in food preparations and emotions associated with the consumption of homemade food with salt were identified. The population likes to eat out, where the establishments selected depend mainly on age group and income. Beyond cultural and geographical differences, age aspects are suggested as being the main differentiators, in terms of use of salt, seasonings, and condiments in the preparation of food at home, the recipes prepared, and the selection of establishments in which to eat out. The deeply rooted values and meanings associated with salt in food indicate that the implementation of salt reduction strategies in Costa Rica is challenging.

New Diet Quality Index for children and adolescents in Costa Rica / Nuevo Índice de Calidad de la Dieta de niños y adolescentes en Costa Rica

Introduction: there is an increasing interest in the study of total diet quality indicators through the study of food groups in certain dietary patterns. Objective: to analyze the diet of students in Costa Rica with construction of a contextualized new diet quality index. Material and methods: a cross-sectional study was performed in a population of 2,677 students from 64 educational centers. Data on habits and food intake frequency were collected through interviews and questionnaires. A new Diet Quality Index was constructed and applied, which assessed the adjustment of intake frequency for 22 food groups, corrected with five preventive dietary factors and five risk factors for chronic non-communicable diseases. Descriptive statistics were evaluated using the program SPSS, version 24.0. A p-value ? 0.05 was considered significant. Results: the population was made up of 1,259 (43%) men and 1,418 women (57%). According to the new Diet Quality Index-Costa Rica classification, 1.2% (n = 33) of participants have a healthy diet; 9.0% (n = 239) require dietary changes, and 89.8% (n = 2 395) have an unhealthy diet because of excessive intake of processed foods (rich in sodium and fat) and a low consumption of fruits and vegetables. Significant differences were found in the averages of the Diet Quality Index-Costa Rica by sex, educational level, and socioeconomic status. Conclusions: around 90% of the studied population do not comply with the recommendations issued for a healthy diet. Nutritional education should be strengthened in Costa Rican education centers

Introducción: existe un interés creciente en el estudio de los indicadores de la calidad de la dieta total a través del estudio de grupos de alimentos. Objetivo: analizar la dieta de los estudiantes de Costa Rica con la construcción de un índice de calidad de la dieta contextualizado y nuevo. Material y métodos: se realizó un estudio transversal con una población de 2677 estudiantes de 64 centros educativos. Los datos sobre hábitos y frecuencia de la ingesta de alimentos se recopilaron a través de entrevistas y cuestionarios. Se construyó y aplicó un nuevo Índice de Calidad de la Dieta, que evaluó el ajuste de la frecuencia de la ingesta de 22 grupos de alimentos corregidos con cinco factores dietéticos preventivos y cinco factores de riesgo para enfermedades crónicas no transmisibles. Se realizaron estadísticas descriptivas con el programa SPSS, versión 24.0. Se consideró significativo todo valor de p < 0,05. Resultados: la población estaba compuesta por 1259 (43 %) hombres y 1418 mujeres (57 %). De acuerdo con la nueva clasificación del Índice de Calidad de la Dieta-Costa Rica, el 1,2 % (n = 33) de los participantes tienen una dieta saludable, el 9,0 % (n = 239) requieren cambios y el 89,8 % (n = 2 395) tienen una dieta poco saludable debido a la ingesta excesiva de alimentos procesados (ricos en sodio y grasas) y al bajo consumo de frutas y vegetales. Se encontraron diferencias significativas en los promedios del Índice de Calidad de la Dieta-Costa Rica por sexo, nivel educativo y clase socioeconómica. Conclusiones: alrededor del 90 % de la población estudiada no cumple con las recomendaciones para llevar una dieta saludable. La educación nutricional debe fortalecerse en los centros educativos costarricenses

New Diet Quality Index for children and adolescents in Costa Rica.

INTRODUCTION: Introduction: there is an increasing interest in the study of total diet quality indicators through the study of food groups in certain dietary patterns. Objective: to analyze the diet of students in Costa Rica with construction of a contextualized new diet quality index. Material and methods: a cross-sectional study was performed in a population of 2,677 students from 64 educational centers. Data on habits and food intake frequency were collected through interviews and questionnaires. A new Diet Quality Index was constructed and applied, which assessed the adjustment of intake frequency for 22 food groups, corrected with five preventive dietary factors and five risk factors for chronic non-communicable diseases. Descriptive statistics were evaluated using the program SPSS, version 24.0. A p-value ˂ 0.05 was considered significant. Results: the population was made up of 1,259 (43%) men and 1,418 women (57%). According to the new Diet Quality Index-Costa Rica classification, 1.2% (n = 33) of participants have a healthy diet; 9.0% (n = 239) require dietary changes, and 89.8% (n = 2 395) have an unhealthy diet because of excessive intake of processed foods (rich in sodium and fat) and a low consumption of fruits and vegetables. Significant differences were found in the averages of the Diet Quality Index-Costa Rica by sex, educational level, and socioeconomic status. Conclusions: around 90% of the studied population do not comply with the recommendations issued for a healthy diet. Nutritional education should be strengthened in Costa Rican education centers.

INTRODUCCIÓN: Introducción: existe un interés creciente en el estudio de los indicadores de la calidad de la dieta total a través del estudio de grupos de alimentos. Objetivo: analizar la dieta de los estudiantes de Costa Rica con la construcción de un índice de calidad de la dieta contextualizado y nuevo. Material y métodos: se realizó un estudio transversal con una población de 2677 estudiantes de 64 centros educativos. Los datos sobre hábitos y frecuencia de la ingesta de alimentos se recopilaron a través de entrevistas y cuestionarios. Se construyó y aplicó un nuevo Índice de Calidad de la Dieta, que evaluó el ajuste de la frecuencia de la ingesta de 22 grupos de alimentos corregidos con cinco factores dietéticos preventivos y cinco factores de riesgo para enfermedades crónicas no transmisibles. Se realizaron estadísticas descriptivas con el programa SPSS, versión 24.0. Se consideró significativo todo valor de p ˂ 0,05. Resultados: la población estaba compuesta por 1259 (43%) hombres y 1418 mujeres (57%). De acuerdo con la nueva clasificación del Índice de Calidad de la Dieta-Costa Rica, el 1,2% (n = 33) de los participantes tienen una dieta saludable, el 9,0% (n = 239) requieren cambios y el 89,8% (n = 2 395) tienen una dieta poco saludable debido a la ingesta excesiva de alimentos procesados (ricos en sodio y grasas) y al bajo consumo de frutas y vegetales. Se encontraron diferencias significativas en los promedios del Índice de Calidad de la Dieta-Costa Rica por sexo, nivel educativo y clase socioeconómica. Conclusiones: alrededor del 90% de la población estudiada no cumple con las recomendaciones para llevar una dieta saludable. La educación nutricional debe fortalecerse en los centros educativos costarricenses.

Las creencias de la docente de educación física sobre la obesidad en la niñez de edad escolar

Trata de comprender cómo las creencias del personal docente de educación física (EF) acerca de la obesidad de los niños en edad escolar, favorecen u obstaculizan la prevención de esta condición. Se empleó el método etnográfico en una escuela urbana pública. Las técnicas de recolección de datos fueron observación, entrevistas a profundidad, grupos focales y análisis documental. Éstas permitieron recoger datos abundantes y ricos de significados, que al ser triangulados por fuentes le dieron validez a los resultados de la investigación. Hallazgos informan sobre la actividad física limitada al ámbito áulico, la obesidad como condición que dificulta la participación de los niños y niñas en EF, la exclusión de niños con obesidad en la práctica de esta asignatura, el privilegio que da la docente a los estudiantes con menos dificultad en la actividad física y su desatención a los que requieren más apoyo, y cómo sus estudiantes modelan sus creencias.

A systems approach to modeling Community-Based Environmental Monitoring: a case of participatory water quality monitoring in rural Mexico.

Community-Based Environmental Monitoring (CBM) is a social practice that makes a valuable contribution to environmental management and construction of active societies for sustainable future. However, its documentation and analysis show deficiencies that hinder contrast and comparison of processes and effects. Based on systems approach, this article presents a model of CBM to orient assessment of programs, with heuristic or practical goals. In a focal level, the model comprises three components, the social subject, the object of monitoring, and the means of action, and five processes, data management, social learning, assimilation/decision making, direct action, and linking. Emergent properties were also identified in the focal and suprafocal levels considering community self-organization, response capacity, and autonomy for environmental management. The model was applied to the assessment of a CBM program of water quality implemented in rural areas in Mexico. Attributes and variables (indicators) for components, processes, and emergent properties were selected to measure changes that emerged since the program implementation. The assessment of the first 3 years (2010-2012) detected changes that indicated movement towards the expected results, but it revealed also the need to adjust the intervention strategy and procedures. Components and processes of the model reflected relevant aspects of the CBM in real world. The component called means of action as a key element to transit "from the data to the action." The CBM model offered a conceptual framework with advantages to understand CBM as a socioecological event and to strengthen its implementation under different conditions and contexts.

Avances en la reducción del consumo de sal y sodio en Costa Rica / Advances in reducing salt and sodium intake in Costa Rica

En el presente artículo se describen los avances logrados en Costa Rica —así como los desafíos y limitaciones— en la reducción del consumo de sal. El establecimiento del Plan Nacional para la Reducción del Consumo de Sal/sodio en la Población de Costa Rica 2011–2021 se complementó con programas y proyectos multisectoriales específicos dirigidos a: 1) conocer la ingesta de sodio y el contenido de sal o sodio en los alimentos de mayor consumo; identificar los conocimientos, actitudes y comportamientos del consumidor respecto a la sal/sodio, su relación con la salud y el etiquetado nutricional; evaluar la relación costo-efectividad de las medidas dirigidas a reducir la prevalencia de hipertensión arterial; 2) implementar estrategias para disminuir el contenido de sal/sodio en los alimentos procesados y los preparados en casa; 3) promover cambios de conducta en la población para reducir el consumo de sal en la alimentación; y 4) monitorear y evaluar las acciones dirigidas a reducir el consumo de sal o sodio en la población. Para alcanzar las metas propuestas se debe lograr una exitosa coordinación interinstitucional con los actores estratégicos, negociar compromisos con la industria alimentaria y los servicios de alimentación, y mejorar la regulación de los nutrientes críticos asociados con las enfermedades crónicas no transmisibles, en los alimentos. Se espera que a partir de los avances logrados durante la ejecución del Plan Nacional, Costa Rica logre alcanzar la meta internacional de reducción del consumo de sal.

This article describes the progress—as well as the challenges and limitations—in reducing salt intake in Costa Rica. The National Plan to Reduce Public Consumption of Salt/Sodium in Costa Rica 2011–2021 was complemented with multisectoral programs and projects specifically designed to: 1) determine sodium intake and the salt/sodium content of the most widely consumed foods; identify the consumer knowledge, attitudes, and behaviors with regard to salt/sodium, their relationship to health, and nutritional labeling; evaluate the cost-effectiveness of measures aimed at reducing the incidence of hypertension; 2) implement strategies to reduce the salt/sodium content of processed foods and foods prepared at home; 3) promote behavioral changes in the population to reduce salt in people’s diets; and 4) monitor and evaluate action geared to reducing salt/ sodium intake in the population. Meeting the proposed targets will require successful interinstitutional coordination among the strategic actors, the negotiation of commitments with the food industry and food services, and tighter regulation of critical nutrients in foods associated with chronic noncommunicable diseases. Given the progress made during the implementation of the National Plan, Costa Rica is expected to meet the international goal of reducing salt intake.

[Advances in reducing salt and sodium intake in Costa Rica]. / Avances en la reducción del consumo de sal y sodio en Costa Rica.

This article describes the progress-as well as the challenges and limitations-in reducing salt intake in Costa Rica. The National Plan to Reduce Public Consumption of Salt/Sodium in Costa Rica 2011 - 2021 was complemented with multisectoral programs and projects specifically designed to: 1) determine sodium intake and the salt/sodium content of the most widely consumed foods; identify the consumer knowledge, attitudes, and behaviors with regard to salt/sodium, their relationship to health, and nutritional labeling; evaluate the cost-effectiveness of measures aimed at reducing the incidence of hypertension; 2) implement strategies to reduce the salt/sodium content of processed foods and foods prepared at home; 3) promote behavioral changes in the population to reduce salt in people's diets; and 4) monitor and evaluate action geared to reducing salt/sodium intake in the population. Meeting the proposed targets will require successful interinstitutional coordination among the strategic actors, the negotiation of commitments with the food industry and food services, and tighter regulation of critical nutrients in foods associated with chronic noncommunicable diseases. Given the progress made during the implementation of the National Plan, Costa Rica is expected to meet the international goal of reducing salt intake.

Components of the metabolic syndrome among a sample of overweight and obese Costa Rican schoolchildren.

BACKGROUND: The term "pediatric metabolic syndrome" includes a cluster of cardiovascular risk factors such as insulin resistance, dyslipidemia (including increased triglycerides and decreased HDL cholesterol), hypertension, and obesity in children. No studies have been performed on this syndrome in a pediatric population in Costa Rica. OBJECTIVE: To establish the prevalence of metabolic syndrome and its components in 8- to 10-year-old prepuberal overweight and obese schoolchildren. METHODS: This cross-sectional survey was conducted in 214 overweight and obese boys and girls, aged 8 to 10 years, who were selected from six urban schools from San José, Costa Rica. Anthropometric measurements and determinations of blood glucose, insulin, triglycerides, total cholesterol, HDL cholesterol, and high-sensitivity C-reactive protein (hs-CRP) were performed. The homeostasis model assessment of insulin resistance (HOMA-IR) index and the Castelli index were calculated to assess insulin resistance and cardiovascular risk, respectively. Social and lifestyle variables were obtained through validated questionnaires. RESULTS: A total of 110 boys and 104 girls participated in this study; 37.9% of them were overweight and 62.1% were obese. Compared with boys, girls were more sedentary and had higher insulin levels (16.05 +/- 10.45 microIU/ mL vs. 12.72 +/- 7.63 microIU/mL, p = .008), body fat (36.5% vs. 30.9%, p < .001), and HOMA-IR indexes (3.5 +/- 2.4 vs. 2.8 +/- 1.7, p = .014) but lower HDL cholesterol (0.99 +/- 0.23 mmol/L vs. 1.08 +/- 0.27 mmol/L, p = .009). Obese children had significantly higher mean serum concentrations of insulin, hs-CRP, and triglycerides and higher insulin resistance (estimated by HOMA-IR) than overweight children, but lower mean serum levels of HDL cholesterol. The prevalence of metabolic syndrome in the study population was 5.6%. Other risk factors for developing cardiovascular disease and type 2 diabetes had high prevalence rates among the children: sedentarism (40.6%),family history of type 2 diabetes (73.3%), high LDL cholesterol levels (> or = 2.84 mmol/L) (57.0%), hyperinsulinemia (> 10.5 microIU/mL) (59.8%), insulin resistance (estimated by HOMA-IR > or = 2.4) (55.1%), and total cholesterol (> 4.39 mmol/L) (60.7%). Children with metabolic syndrome had significantly higher body mass indexes, glucose levels, and triglyceride levels and lower HDL cholesterol levels than children without metabolic syndrome. Insulin had a very strong positive correlation with HOMA-IR values (r = 0.982), and hs-CRP had a mild positive correlation with body mass index (r = 0.296) and body fat (r = 0.320). CONCLUSIONS: This study reported a prevalence of 5.6% of metabolic syndrome among a sample of Costa Rican overweight and obese prepuberal children. Lifestyle interventions focusing on weight reduction and increasing physical activities should be promoted by education and health authorities in order to avoid the early development and onset of type 2 diabetes and atherosclerosis in childhood.

Metal distribution in coral reef complex Cayo Arcas in the Gulf of Mexico.

This study evaluated the spatial and temporal distribution of metals in the coral reef system Cayos Arcas and Triangulos in the Campeche Bank region, off the Yucatan peninsula in Mexico. No information has been generated before for the incorporation of natural and non-natural occurring metals, some of which are possibly endowed by the oil marine station Cayo Arcas. The multivariate exploratory study of the metals on the coral skeletons, showed the formation of two distinct groups. The metals that have the highest influence on the differentiation of the groups are the metals that are natural constituents of the coral skeletons, in particular Sr can explain much of the differences between the groups, and to a much lesser extent are the metals that could be indicators of pollution. This differentiation suggests that, in our case, the environment around the corals has a higher impact than the non-naturally occurring metals (and possible indicators of pollution). The two groups formed corresponded to: the coral cores influenced by open sea variables and the coral cores in the inner part of the keys which is less exposed to open sea variables. A chronological study was made to two samples that had the longest coral section and were situated in two clearly distinctive zones: an exposed surface subjected to high wave forces and another that was less exposed. Ni and Zn show an accumulation trend in both coral samples, while Ba showed an increase in incorporation around 1980 when the Cayo Arcas oil marine station was constructed.

Insulin resistance and impaired glucose tolerance in overweight and obese Costa Rican schoolchildren.

BACKGROUND: Worldwide obesity has become an unprecedented public health challenge. In addition, a notable increase in the risk of insulin resistance and type 2 diabetes mellitus has emerged. In Costa Rica, there are no epidemiological data to establish the prevalence of type 2 diabetes in the pediatric population. However, information from the Endocrinology Department of the Children's National Hospital indicates an increased number of cases in the last 2 to 3 years. OBJECTIVE: To determine the prevalence of insulin resistance and impaired glucose tolerance in overweight and obese schoolchildren. METHODS: This cross-sectional study was conducted among 214 healthy 8- to 10-year-old children from urban schools of San José, Costa Rica. Anthropometric measurements and blood determinations of glucose, insulin, proinsulin, glycosylated hemoglobin, C-peptide, and leptin were performed. Indexes were calculated to assess insulin resistance. Information on social and lifestyle variables was obtained from questionnaires, and acanthosis nigricans was certified by a physician. Statistical analysis was performed with SPSS software for Windows, version 10.0. RESULTS: The prevalence of type 2 diabetes mellitus was very low (0.5%) in the studied population. However, hyperinsulinemia and impaired glucose tolerance were present in 20.6% and 6.5% of the subjects, respectively. On the basis of the Fasting Glucose-to-Insulin Resistance Ratio (FGIR), 46.7% of the children showed insulin resistance. Girls and obese children (body mass index > or = 95th percentile) were more likely to have higher serum insulin levels and insulin resistance than boys and overweight children (BMI > or = 85th percentile). Compared with the lowest quintile, children in the highest quintile of body-fat tissue had higher insulin resistance but had similar serum concentrations of glucose, C-peptide, and proinsulin. Positive family histories of type 2 diabetes mellitus and sedentarism (73.7% and 40.7%, respectively) were highly prevalent among overweight and obese children. CONCLUSIONS: The prevalence of impaired glucose tolerance and insulin resistance in obese children indicates a worrisome trend in the incidence of type 2 diabetes in Costa Rica. Strategies for weight reduction, obesity prevention, and promotion of healthy lifestyles are necessary to prevent the onset of type 2 diabetes during childhood and adolescence.

Assesment of trace elements and organic pollutants from a marine oil complex into the coral reef system of Cayo Arcas, Mexico.

Possible contaminants produced by the Petroleos Mexicanos (PEMEX) marine oil complex in the vicinity of the Cayo Arcas (Mexico) coral reef ecosystem were evaluated by analyzing sediments and sea water for hydrocarbons and metal elements. We found that the concentrations of aliphatic hydrocarbons in the sea water were generally low, with the highest values detected near the oil station; the concentration of polycyclic aromatic hydrocarbons (PAHs) was generally below the detection limit. The hydrocarbons found in the sediments seem to have a pyrogenic origin, and were probably produced by marine traffic in the study area. The total PAH concentration did not exceed the NOAA criteria, although levels of some individual PAHs did. The only metal detected in the sea water at high concentrations was nickel. The Ni/V ratio in the sediments indicates the contribution of crude oil to the system. The high content of Ni and Zn was attributed to the ballast waters from the oil tankers that load at the station's monobuoys. The presence of fine sediments that commonly originate from terrestrial ecosystems supported this assumption.

Melanoma maligno primario oral: presentación de un caso y revisión de la literatura / Primitive malignant oral melanoma: report of a case and review of the literature

Se presenta un caso de melanoma maligno primitivo bucal (MMPO)en una paciente de sexo femenino. La lesión era pigmentada con meses de evolución. Se destacan el aspecto diagnóstico, clínico, histológico y genético. Se discute la posibilidad del diangóstico precoz de las lesiones piegmentadas como los nevos de unión. Finalmente se considera la conducta terapéutica (AU)

Melanoma maligno primario oral: presentación de un caso y revisión de la literatura / Primitive malignant oral melanoma: report of a case and review of the literature

Se presenta un caso de melanoma maligno primitivo bucal (MMPO)en una paciente de sexo femenino. La lesión era pigmentada con meses de evolución. Se destacan el aspecto diagnóstico, clínico, histológico y genético. Se discute la posibilidad del diangóstico precoz de las lesiones piegmentadas como los nevos de unión. Finalmente se considera la conducta terapéutica

Biochemical indicators of nutritional status and dietary intake in Costa Rican Cabécar Indian adolescents.

The purpose of this study was to determine the blood levels of selected nutritional status indicators and the dietary intake of Costa Rican Cabécar Indians aged 10 to 16 years. The results showed that 65% of the adolescents had an adequate body mass index (BMI) for their age, and 32% had a BMI < 5th percentile. Likewise, the study revealed a high prevalence of anemia (57%), deficient serum folate levels (54%), deficient vitamin B12 levels (31%), and subclinical vitamin A deficiency (10%). Additionally, the youngsters had elevated prevalences of high triglyceride levels (77%), borderline high-density lipoprotein (HDL) cholesterol levels (46%), homocysteine levels > 10 micromol/L (29%), and homozygous mutation of methylenetetrahydrofolate reductase (MTHFR) (49%). The diet was poor, being high in saturated fat and low in polyunsaturated fat, fiber, and several micronutrients. The dietary intakes of more than 55% of the adolescents did not meet 50% of the estimated average requirements (EAR) for zinc, vitamin A, vitamin C, vitamin B12, vitamin B2, and folate. Furthermore, a high prevalence of parasitosis was found (68%). Our results show an adolescent Cabécar population with a mosaic of nutritional deficiencies and cardiovascular risk factors.