Pregnancy outcomes and the use of two standards to assess adequacy of maternal body mass index in early gestation.

The maternal weight gain chart proposed by Rosso and Mardones (RM) was subsequently modified by Atalah et al. (AEA). Both charts are widely used in Latin America. The purpose of this study was to compare birth length (BL) and birth weight (BW) outcomes of both charts. A prospective study of pregnant women and their offspring's was performed in Santiago, Chile. From a total sample of 27,613 pregnant women a sub-sample of 11,465 term healthy singleton pregnant women was selected for additional analyses. κ statistics was used to study the degree of agreement of both charts in the diagnosis of maternal nutritional status. Obese and underweight women were classified using both standards at the beginning of pregnancy and compared in terms of BL4250 g proportions. Sensitivity and specificity values of at risk newborns, whose categories were considered as gold standard, were obtained for obese and underweight women of each chart. There was a moderate agreement in the nutritional classification of these charts. Proportions of BL4250 g were similar at each nutritional category; however, absolute figures for at risk newborns were much higher in the RM underweight and obese women. The RM chart showed higher sensitivity values than the AEA chart. The higher sensitivity of the RM chart would support its use for prevention purposes. This chart is advisable for Latin American countries and also for most developing countries.

Detection of markers of cardiovascular and renal risk in Cuba: Isle of Youth Study (ISYS).

UNLABELLED: Chronic vascular diseases constitute a growing global health problem. OBJECTIVES: To (a) determine marker positivity for renovascular damage in the total adult population of the Isle of Youth, Cuba; (b) describe marker association with common risk factors for renal and related chronic vascular conditions, and (c) identify best predictors of renovascular damage. METHODS: Previous informed consent was obtained, the population studied was 55,646, and subjects were aged ≥20 years. Blood pressure, weight and height were measured and a questionnaire applied. Urine markers for renovascular damage (hematuria, proteinuria and microalbuminuria) were also determined. RESULTS: Positive markers were detected in 21.3%: hematuria (12.6%), microalbuminuria (6.8%), proteinuria (0.9%), and proteinuria + hematuria (0.9%). Risk factors were highly prevalent: 15.1% were aged ≥60 years; 32.3% overweight, 13.9% obese, and 25.1% smokers. Prevalence of high blood pressure (30%), diabetes mellitus (5.4%) and cardiovascular disease (5%) was also high, while cerebrovascular disease registered 0.9%. Markers were more prevalent in older people and in those suffering from diabetes mellitus, high blood pressure, cardiovascular and cerebrovascular disease, overweight or obesity. Risk factor regression tree analysis identified hypertension as the best predictor of renovascular damage. CONCLUSIONS: Adult population-wide screening revealed hidden morbidity and permitted better risk stratification. Results serve to inform community-based multidisciplinary and intersectoral disease prevention and management.

Trends in infant mortality inequalities in the Americas: 1955-1995.

STUDY OBJECTIVE: s: To describe overall and income related trends in infant mortality inequalities in the Region of the Americas from 1955 to 1995. DESIGN: Infant mortality rates (IMRs) were computed and their trends assessed by ordinary least squares. Overall trends in IMR inequalities among countries were analysed by comparing 10 year period IMRs, Gini coefficients, and Lorenz curves. Income related trends in IMR inequalities were assessed using 10 year period IMR ratios between the highest and the lowest quintiles of the per capita gross national product (GNP) distributions (adjusted for purchasing power). SETTING: Aggregated country data were used for all countries with over 200 thousand inhabitants (33 geopolitical units). The 10 year period midpoint IMR estimates used for the 1955-1995 time series were those published by the United Nations in 1997. MAIN RESULTS: IMRs decreased from 90.34 to 31.31 per 1000 live births between 1955 and 1995 at an average of 15.3 every 10 years. In contrast, Lorenz curves and Gini coefficients were similar for the five 10 year periods. After grouping by adjusted GNP distribution, a similar decreasing trend of IMR was observed in all groups. The rate ratio between the group at the lowest quintile and that at the highest quintile ranged from 4 to 5. The analysis of variance for repeated observations showed that there is a significant reduction in the IMR (F=130.18; p<0.01), that trends did not differ significantly among groups (F=1.16; p=0.32), and that they were approximately linear (F=155.83; p<0.01). CONCLUSIONS: Despite a sizable reduction in the infant mortality, whether or not income related, levels of IMR inequality among countries have remained almost constant between 1955 and 1995 in the Region of the Americas. Further analysis and focused interventions are needed to tackle the challenges of reducing these persistent mortality inequalities.

[Anthropometric characteristics of obese women before and after weight reduction]. / Características antropométricas de mujeres obesas antes y después de un tratamiento reductor.

Anthropometric changes in 53 premenopausal obese women, 25-45 year-old, after an obesity treatment, were analyzed. Before and immediately after treatment, midarm, abdomen, waist, hip, midthigh and midcalf circumferences, as well as tricipital, bicipital, suprailiac, subscapular, abdominal and calf skinfold thickness were measured. The later averaged over percentil 75th. All final measurements, except midcalf circumference, abdomen/waist and hip/midthigh indexes, were significantly lowers as compared with the initial values. Body weight decreased on average 8.9 kg, and skinfold thickness mean fell below the 75th percentile. Percentage body fat decreased 18.3%, and body mass index 11%. Initial principal component analysis results, exhibited three chief characteristics of obesity: general adiposity; trunk vs. extremity fatness, and upper vs. lower fatness. Body fat distribution pattern and body composition were modified as a result of the treatment. Therefore, the morbidity risk associated with them, was substantially reduced.

Body mass index at different ages and its association with height at age 14 and with the whole growing process.

The relevance of the association of the body mass index (BMI) at 1,4,6, and 12 years of age with the growing process and its capacity for predicting height at age 14 was investigated in a sample of 354 adolescents (182 boys and 172 girls). Regression analysis showed that body bulk at various ages, as expressed by the BMI is closely related with the height attained at age 14, and longitudinal principal components analysis suggested that it is also associated with the whole growing process. The way in which BMI affects height could be related with the stage of sexual development, which seems to play an intermediate role in the pathway linking body bulk and height.

The relationship of birthweight with height at 14 and with the growing process.

The association of birthweight with length at 12 mo and with height at different ages was assessed in a sample of 260 healthy adolescents (130 boys and 130 girls). The longitudinal study included measures on body weight and height at 4, 6, 12, and 14 yr of age. Birthweight is highly correlated with stature at 14 years, particularly in male adolescents. Longitudinal principal components analysis (LPCA) showed that it is also correlated with the growing process. There is also strong evidence that birthweight can be a good predictor of the onset of the pubertal maturation process.

[Influence of breast feeding on nutritional development of infants with persistent diarrhea]. / Influencia de la lactancia materna en la evolución nutricional del lactante con diarrea persistente.

The evolution of some nutritional anthropometric indicators was studied in a 115 breast-feeding infants (52 received breast-feeding during the first four months of life (120 days) exclusively and 63 mixed feeding). Breast feeding infants showed sustained weight increment during the four weeks of evolution. The multivariate repeated measures analysis performed, proved significant changes during evolution's time in all studied indicator in lineal form, as well as interaction between type of feeding and indicators evolution except the subescapular fat fold. Author concluded that it should be reinforced the breast-feeding practice promotion as an effective way for the nutritional recovery of breast-feeding infants with persistent diarrhoea.

Influencia de la lactancia materna en la evolucion nutricional del lactante con diarrea persistente / Influence of breast feeding on nutritional development of infants with persistent diarrhea

La evolución de algunos indicadores antropométricos del estado nutricional fue estudiada en 115 lactantes de los cuales 52 recibieron lactancia materna exclusivamente durante los 4 primeros meses de vida (120 días) y 63 lactancia mixta. Los lactantes alimentados con leche materna mostraron incremento sostenido del peso durante las 4 semanas de evolución. El análisis de observaciones repetidas practicado evidenció cambios significativos en el tiempo de evolución de forma lineal en todos los indicadores estudiados, al igual que la interacción entre el tipo de lactancia y evolución de los indicadores con excepción del plieque subescapular. Los autores concluyeron que debe insistirse en la promoción de la lactancia materna como vía efectiva para la recuperación nutricional del lactante con diarrea persistente

Influencia de la lactancia materna en la evolución nutricional del lactante con diarrea persistente. / [Influence of breast feeding on nutritional development of infants with persistent diarrhea]

The evolution of some nutritional anthropometric indicators was studied in a 115 breast-feeding infants (52 received breast-feeding during the first four months of life (120 days) exclusively and 63 mixed feeding). Breast feeding infants showed sustained weight increment during the four weeks of evolution. The multivariate repeated measures analysis performed, proved significant changes during evolutions time in all studied indicator in lineal form, as well as interaction between type of feeding and indicators evolution except the subescapular fat fold. Author concluded that it should be reinforced the breast-feeding practice promotion as an effective way for the nutritional recovery of breast-feeding infants with persistent diarrhoea.

Influencia de la lactancia materna en la evolucion nutricional del lactante con diarrea persistente / Influence of breast feeding on nutritional development of infants with persistent diarrhea

La evolución de algunos indicadores antropométricos del estado nutricional fue estudiada en 115 lactantes de los cuales 52 recibieron lactancia materna exclusivamente durante los 4 primeros meses de vida (120 días) y 63 lactancia mixta. Los lactantes alimentados con leche materna mostraron incremento sostenido del peso durante las 4 semanas de evolución. El análisis de observaciones repetidas practicado evidenció cambios significativos en el tiempo de evolución de forma lineal en todos los indicadores estudiados, al igual que la interacción entre el tipo de lactancia y evolución de los indicadores con excepción del plieque subescapular. Los autores concluyeron que debe insistirse en la promoción de la lactancia materna como vía efectiva para la recuperación nutricional del lactante con diarrea persistente (AU)

Percentiles of the waist-hip ratio in Cuban scholars aged 4.5 to 20.5 years.

Values of the waist-hip ratio (WHR), expressed as percentiles and stratified by sex and age, were obtained from a simple judgment sample of 7285 schoolchildren and adolescents (3721 males and 3564 females) aged between 4.5 and 20.5 years. WHR is higher with age in males, and it changes more gradually chronologically also. The graph for males shows three relative maxima at 6, 11-12 and 15-16 years; and for females, two relative maxima at 10 and 13 years. In females, there are two sharp reductions between 10 and 13 and between 13 and 16 years of age. The changes in WHR are associated with age and sexual maturation in both sexes. We conclude that WHR might be useful in assessing body fat distribution in late childhood and adolescence.

[Subscapular/triceps index: percentile values in Cuban children and adolescents]. / Indice subescapular/tricipital: valores percentilares en niños y adolescentes cubanos.

The percentiles (3,10,25,50,75,90 and 97) of the subscapular/triceps Index (SS/TR), obtained in a sample of 7286 subjects (3721 males and 3765 females) aged 5 to 20 years, were calculated. Median values of SS/TR are generally higher in females up to the age of 13 years approximately, and show a pattern of peripheral distribution of fat during all the period of study. In males, a pattern of central distribution of fat develops starting from age fourteen and becomes more central as age increases. Values obtained were higher than those reported in the literature at all ages and in both sexes. The results reported in this paper show that SS/TR is useful for assessing changes in the pattern of fat distribution during childhood and adolescence.

Adiposity and growth: relationship of stature at fourteen years with relative body weight at different ages and several measures of adiposity and body bulk.

A non-probabilistic sample of 354 healthy adolescents (182 boys and 172 girls) with ages ranging from 13.6 to 14.5 years was studied. Measurements of mid-arm muscle, thigh and leg circumferences, triceps and subscapular skinfolds, and records of body weight and height at one, four, six and twelve years of age were available. The sexual maturation stage of all subjects was also determined. Height at fourteen years was found to be significantly associated with relative body weight at different ages in both sexes, and particularly with the relative weight at twelve months. Height is more strongly related with indicators of lean body mass than with indicators of adiposity, especially in boys. The stage of sexual development is also an important determinant of stature at fourteen years of age. The results seem to support the hypothesis that the same factors which increase fat deposition, contribute to increase lean tissues and linear growth.

Multivariate allometry as a model of morphometric harmony of four skinfolds in the newborn.

The concept of harmony in a set of anthropometric dimensions is identified with the notion of minimum variance associated with a function of several variables in those dimensions. When the chosen function is linear in the natural logarithms of the variables, the resulting model is the well-known multivariate allometry and the notion of minimum variance corresponds to the eigenvector associated with the smallest eigenvalue of the covariance matrix. This multivariate allometry model was fitted to four skinfolds in a sample of 250 newborns. The existence of a harmonic relationship among the skinfolds which is independent of weight, total body fat, body mass index, and several other maternal variables is indicated. There is, however, some evidence suggesting a possible correlation with the nutritional condition of the mother. © 1992 Wiley-Liss, Inc.