Decline in pubertal timing and its relationship with excess weight. A study of the secular trend in age at menarche in girls from La Plata district (Buenos Aires, Argentina).

OBJECTIVE: To provide information on the secular trend in age at menarche (AgM) in Argentinean girls in relation to excess weight (EW) and body adiposity. METHODS: Two cohorts (C) (C1, 2005-2007 and C2, 2015-2019) of children aged 8-14 years from La Plata district were studied using identical methodological criteria. Each participating child was asked about menarche (M) status: M presence (MP) or absence (MA). The AgM was estimated using the status quo method and logistic regression analysis. Body weight, height, and tricipital and subscapular skinfolds were collected to estimate EW (overweight + obesity) according to WHO criteria, and body adiposity (sum of skinfolds, SSK = [tricipital + subscapular]). The prevalence of EW by C was estimated and compared using the Chi-square test. The MP probability in relation to age, C, and EW was analyzed by applying logistic regression. Parents completed a questionnaire to assess family socioeconomic conditions. Data were compared using the Chi-square test. RESULTS: Differences in MP prevalence between C were significant (C1: 21.1% vs. C2: 28.7%). Median AgM was 12.81 years in C1 and 12.22 in C2. The prevalence of EW was higher in C2 (35.3%) than in C1 (24.6%). The probability of MP was higher in C2 than in C1 and children with EW. Both BMI and SSK showed inter-cohort increases. Socioeconomic conditions were substantially deteriorated between C. CONCLUSION: In an obesogenic context marked by the significant increase in body adiposity and EW, M prevalence exhibited a positive secular trend and AgM reduced by nearly seven months between the cohorts studied.

Comparison of frame index reference percentiles in Argentine and European boys and girls.

INTRODUCTION: The frame index (FI), based on measurements of elbow breadth and height, is the body frame size parameter most frequently used in child and adolescent populations to assess skeletal robustness. In 2018, the first FI reference percentiles were elaborated with data of boys and girls aged 0-18 years from different European populations. In Argentina, the FI reference values were published in 2022. OBJECTIVE: The present study aims to compare the Argentine (AR) and European (EU) FI reference percentiles to evaluate possible variation in bone robustness between populations. METHODS: The values of the 3rd, 50th and 97th percentiles of the AR and EU FI references for boys and girls aged 4-14 years were compared using the Wilcoxon test (p < .05). Percentage differences between means (PDM) were calculated to analyze the magnitude of the differences between both references. The R 3.2.0 program was used to plot the percentile curves. RESULTS: The FI reference values were lower in AR than in EU in both the 3rd and the 50th percentiles, regardless of sex and age. Conversely, the AR reference values of the 97th percentile were higher than the EU values at most ages. CONCLUSIONS: The comparison of the AR and EU FI references showed similar age and sex growth patterns. However, differences in percentile values between populations were observed, highlighting the importance of having local references for the evaluation of skeletal robustness.

Referencias de índice de masa corporal. Precisión diagnóstica con área grasa braquial en escolares argentinos / Body mass index references. Diagnostic accuracy with the upper-arm fat area in Argentine schoolchildren

El índice de masa corporal (IMC) es una eficaz herramienta para detectar la sobrecarga ponderal en niños y adolescentes, asociado a la adiposidad corporal. Objetivo. Analizar la concordancia, sensibilidad y especificidad de tres referencias internacionales de IMC/edad (OMS, IOTF y CDC) para diagnosticar el exceso ponderal y conocer su precisión diagnóstica para identificar el exceso de adiposidad con relación al área grasa braquial (AGB) en población infanto juvenil de Argentina. Materiales y métodos. Se realizó un estudio multicéntrico, descriptivo-comparativo y transversal entre 2003 y 2008, en 22.658 niños y adolescentes argentinos de 4 a 13 años de edad. A partir del peso, talla, circunferencia del brazo y pliegue tricipital, se calcularon IMC y AGB. Se analizó la concordancia, sensibilidad y especificidad de referencias de IMC/edad (OMS, CDC, IOTF) y la precisión diagnóstica (curvas ROC) para identificar exceso de adiposidad, a partir del AGB, así como el punto de corte óptimo (PCO). Resultados. Las tres referencias tuvieron buena concordancia. La mayor sensibilidad correspondió a OMS y la mayor especificidad a IOTF. El área bajo la curva (ABC) fue mayor en Z-IMC/IOTF en varones y en Z-IMC/OMS en mujeres. Los PCO mostraron discrepancias, siendo mayores con OMS. Conclusión. Las tres referencias muestran similar precisión diagnóstica para detectar alta reserva calórica, con puntos de corte óptimo para las puntuaciones Z-IMC menores a 2 Z scores. Esto resulta relevante para la identificación de exceso de adiposidad en poblaciones, en relación con la implementación de políticas públicas de prevención de enfermedades crónicas no transmisibles(AU)

The body mass index (BMI) is an effective tool to detect weight overload in children and adolescents, associated with body adiposity. Objective. To analyze the concordance, sensitivity and specificity of three international BMI/age references (WHO, IOTF and CDC) to diagnose excess weight and to know their diagnostic accuracy to identify excess adiposity in relation to the brachial fat area (BFA) in Argentine child-youth population. Materials and methods. A multicenter, descriptive- comparative and cross-sectional study was carried out between 2003 and 2008 in 22.658 Argentine children and adolescents between aged 4 to 13 years. From the weight, height, arm circumference and tricipital fold, BMI and BFA were calculated. The concordance, sensitivity, and specificity of BMI / age references (WHO, IOTF, CDC,) were analyzed and the diagnostic precision (ROC curves) to identify excess adiposity, from the BFA, as well as the optimal cut-off point (OCP). Results. The three references had good agreement, the highest sensitivity corresponded to WHO and the highest specificity to IOTF. The area under the curve (AUC) was greater in Z-BMI/IOTF in men and in Z-BMI/WHO in women. The OCPs showed discrepancies, being higher with WHO. Conclusion. The three references show similar diagnostic accuracy to detect high caloric reserve, but with cut-off points for Z-BMI scores less than 2 Z scores. This is relevant for the identification of excess adiposity in populations in relation to the implementation of public policies for the prevention of chronic non-communicable diseases(AU)

Magnitude and spatial distribution of food and nutrition security during the COVID-19 pandemic in Tucumán (Argentina).

OBJECTIVE: To describe the magnitude and spatial distribution of household food and nutrition security (FNS) during the COVID-19 pandemic in Tucumán (Argentina) and identify factors associated with food insecurity. METHODS: During April and May 2020 a cross-sectional quantitative study was performed. Data from 3915 households were analyzed. The study of FNS was performed with the Latin American and Caribbean Scale for Food Security. To identify associated factors, bivariate and multivariate logistic regression models were applied. RESULTS: Household food insecurity affected 55.9% of the sample (mild: 39.3%, moderate: 10.8%, severe: 5.8%). Analyzing the spatial distribution, the eastern area showed the highest food insecurity prevalence, followed by the south and west areas. Logistic regression analysis showed that household food insecurity varied according to household size, presence of children, socioeconomic status, and health area of residence. CONCLUSIONS: Household size, presence of children, socioeconomic status and public health area of residence were associated to household food insecurity. The perception of hunger was higher in larger households, in those with low and medium socioeconomic status and in households located in the southern area of the province.

Estado nutricional y asistencia alimentaria en escolares urbanos de Tucumán, Argentina / Nutritional status and food assistance in urban school children from Tucuman, Argentina

Fundamentos: Este trabajo se propuso avanzar en el conocimiento de la situación nutricional infantil en Rio Chico, Tucumán, Argentina. Los objetivos fueron analizar el estado nutricional de la población escolar urbana e identificar factores asociados tales como la edad, el sexo, el nivel socioeconómico(NSE) y la asistencia alimentaria escolar (AAE). Asimismo, interesó valorar el perfil calórico de la AAE brindada. Métodos: El estudio fue cuantitativo y transverso e incluyó1605 niños y niñas de 6 a 12 años. Se calcularon prevalencias de estado nutricional adecuado, desnutrición, sobrepeso, obesidad y obesidad abdominal. Mediante pruebas de regresión logística se determinaron factores asociados a la malnutrición(edad, sexo, NSE y AAE). Se analizó el perfil calórico y porcentaje de adecuación de la AAE. Resultados: La posibilidad de presentar obesidad y obesidad abdominal fue mayor en las mujeres, en los escolares de NSE medio y en aquellos que no percibían AAE. El perfil calórico dela AAE evidenció desbalance en el aporte de macronutrientes. Conclusiones: Se evidenció un perfil de transición nutricional con predominancia de sobrepeso y obesidad en relación a la desnutrición. (AU)

Background: The purpose of this study was to providenew evidence of the nutritional situation of children fromRio Chico, Tucuman, Argentina. The objectives were toanalyze the nutritional status of urban school children andidentify associated factors such as age, sex, socioeconomic status (SES) and school food assistance (SFA). It also interested assess the energy profile of SFA provided in public institutions. Methods: The study was quantitative and cross-sectional and included 1605 boys and girls aged 6 to 12. Prevalence of adequate nutritional status, undernutrition, overweight, obesity and abdominal obesity were calculated. Using logistic regression tests, factors associated with malnutrition(age, sex, SES and SFA) were determined. The caloric profile and the percentage of adequacy of the SFA were analyzed. Results: The possibility of presenting obesity and abdominal obesity was higher in women, in school children with a medium SES and in those who did not receive SFA. The caloric profile of the SFA showed an imbalance in macronutrients contributions. Conclusions: A nutritional transition profile with a predominance of overweight and obesity in relation to undernutrition was evidenced. (AU)

Body composition in relation to nutritional status and socio-environmental conditions in schoolchildren living in the urban periphery of La Plata, Argentina

The aim of this study was to evaluate body composition in relation to nutritional status and socio-environmental conditions of residence in schoolchildren living in the urban periphery of La Plata, Argentina. Weight, height, arm circumference and tricipital and subscapular skinfolds were measured in 3,284 schoolchildren aged 4-12 years in the period 2014-2017. The National Health and Nutrition Examination Survey (NHANES) III reference was used to assess nutritional status, identifying the following categories: normal, underweight, stunting, wasting, overweight and obesity. Body composition was evaluated based on upper arm muscle area (UMA) and upper arm fat area (UFA). Deficit and excess UMA and UFA were also calculated. Central fat distribution was determined with the subscapular-tricipital index. Socio-environmental characteristics were surveyed using a structured questionnaire. The prevalence of nutritional status and body composition indicators were compared by sex using Chi square test. Socio-environmental data were analyzed using categorical Principal Component Analysis, discriminating into more favorable and unfavorable conditions. Nutritional status results were as follows: normal, 64.5%; stunting, 3.4%; underweight, 0.0%; wasting, 0.1%; overweight, 15.6% and obesity 16.4%. The nutritional status of children worsened as the socio-environmental condition of their families became more precarious. Long-term socio-environmental stress manifested as decreased muscle tissue in normal, stunted, overweight and obese children. The current results evidence the strong impact of poverty on child growth and development and at the same time enforce the need for continuous monitoring of children with hidden malnutrition(AU)

El objetivo del trabajo fue analizar la composición corporal en relación al estado nutricional y las condiciones socio-ambientales de niños residentes en la periferia urbana de La Plata, Argentina. Sobre 3284 escolares de 4 a 12 años se evaluaron peso, talla, perímetro braquial y pliegues tricipital y subescapular, durante los años 2014-2017. Se determinaron, utilizando la referencia NHANES III, las categorías de estado nutricional Normal; Bajo Peso/Edad; Baja Talla/Edad; Bajo IMC/Edad; Sobrepeso y Obesidad, y para composición corporal, se calcularon las áreas muscular y grasa (UMA y UFA) y se estimaron los déficits y excesos de tejido muscular y graso. La adiposidad centralizada fue estimada con el índice subescapular-tricipital. Las características socio-ambientales se evaluaron mediante encuesta estructurada. Las prevalencias del estado nutricional y de los indicadores de composición corporal fueron estimados y comparados por sexos, mediante pruebas de Chi2. Los datos socio-ambientales se analizaron empleando Análisis de Componentes Principales categóricos y se discriminaron dos grupos: con condiciones más favorables y con condiciones desfavorables. Los resultados indicaron: 64.5% Normal, 3.4% Baja Talla/Edad, 0.0% Bajo Peso/Edad; 0.1% Bajo IMC/Edad; 15.6% Sobrepeso; 16.4% Obesidad. El estado nutricional de los niños empeoró cuando la calidad socio-ambiental de sus familias se hizo más precaria. Debido al estrés socio-ambiental continuo, los niños tuvieron disminución del tejido muscular, incluyendo aquellos con estado nutricional Normal, Baja Talla/Edad, Sobrepeso y Obesidad. Los resultados alcanzados evidencian la impronta que deja la pobreza e impone urgentemente el monitoreo continuo de niños "con desnutrición oculta"(AU)

High Blood Pressure in Children and Adolescents from Urban Peripheral Areas of La Plata, Argentina / Presión arterial elevada en niños y adolescentes residentes en áreas periurbanas de la ciudad de La Plata, Argentina

ABSTRACT Objective: The aim of the present study was to estimate the prevalence of high blood pressure in schoolchildren aged 4-14 years from urban peripheral areas of the city of La Plata, and analyze variations in high blood pressure prevalence by sex, age, excess weight and family socioeconomic status. Materials and methods: Systolic and diastolic blood pressure, body weight and height were measured in 3,312 schoolchildren of both sexes. The prevalence of high blood pressure (HBP), overweight and obesity was calculated. Socioeconomic information was obtained through a semi-structured survey and processed by categorical principal-component analysis. The prevalence of HBP was compared with sex, age and nutritional status (chi square test) and family socioeconomic status (generalized linear model) (p< 0,05). Results: The results showed that the prevalence of HBP was 20.5% and that it varied by age, nutritional status and family socioeconomic status. Sexual differences were observed only in HBP obese schoolchildren. Conclusions: Children and adolescents living in urban peripheral areas of the city of La Plata, Argentina, presented higher HBP prevalence. While HBP prevalence was higher among overweight/obese children, those aged >8 years and those of more favorable family socioeconomic status, sex did not affect HBP development. However, when HBP was analyzed associated with nutritional status, obese boys were more likely to have HBP than girls.

RESUMEN Objetivo: Estimar la prevalencia de la presión arterial elevada (PAE) en escolares de 4 a 14 años de edad residentes en áreas periféricas de la ciudad de La Plata y analizar variaciones de acuerdo al sexo, la edad, el exceso ponderal y el nivel socioeconómico familiar. Materiales y Métodos: Se registraron los valores la presión arterial sistólica y diastólica y se relevaron el peso y la talla de 3.312 escolares de ambos sexos. Se determinaron los casos de PAE, sobrepeso y obesidad y se calcularon prevalencias por sexo y edad. La información socioeconómica familiar fue obtenida a través de una encuesta y procesada mediante análisis de componentes principales. Las prevalencias de PAE se compararon por sexo, edad, estado nutricional (pruebas de chi cuadrado) y nivel socioeconómico familiar (modelo lineal generalizado) (p< 0,05). Resultados: El 20.5% de los escolares presentó PAE, con variaciones de acuerdo a la edad, el estado nutricional y el nivel socioeconómico. Sólo se observaron diferencias sexuales en los escolares obesos. Conclusiones: Los niños y adolescentes que viven en áreas periféricas de la ciudad de La Plata presentan elevadas prevalencias de PAE. Aquellos con sobrepeso/obesidad, con edades >8 años y los provenientes de familias con nivel socioeconómico más favorable evidencian mayores prevalencias de PAE. Los varones obesos son más propensos que las mujeres obesas a presentar presión arterial elevada.

Comparative study of mid-upper arm circumference, arm muscle area and arm fat area percentiles in Argentinean and US children aged 4-14 years.

INTRODUCTION: Background: mid-upper arm circumference (MUAC), subcutaneous fat and muscle measurements are an alternative method to diagnose overweight and evaluate growth as well as protein and energy reserves. Aim: to compare MUAC, arm muscle area (AMA) and arm fat area (AFA) measurements of Argentinean boys and girls (Sa) with reference curves for US boys and girls (R). Subjects and methods: data from 22,736 school-children aged 4-14 years from six Argentinean provinces were collected. MUAC and triceps skinfold thickness were measured and the derived AMA and AFA measures were calculated. Analyses were performed with GAMLSS using the R software. Differences in mean values of Sa and R were compared in percentiles 3, 50 and 97. Results: mean values of MUAC and AMA in boys and girls were higher in R than in Sa at all ages; conversely, AFA values were lower. Conclusions: our results confirm differences in upper arm anthropometry of Argentinean school-children with respect to the US reference. The higher adipose tissue and lower skeletal muscle mass observed in Argentinean children could be partly associated with the different ethnic origin of both populations. However, differences should be interpreted in the context of an obesogenic environment, which has favored a calorie-protein imbalance.

INTRODUCCIÓN: Antecedentes: la medición de la circunferencia del brazo (MUAC), así como la estimación de la grasa subcutánea y muscular constituyen un método alternativo para diagnosticar el sobrepeso y evaluar el crecimiento y las reservas proteicas y energéticas. Objetivo: comparar las mediciones de MUAC, área muscular (AMA) y área grasa (AFA) del brazo de niños y niñas argentinos (Sa) con curvas de referencia para niños y niñas de Estados Unidos (R). Sujetos y métodos: se recopilaron datos de 22,736 escolares de 4 a 14 años de edad de seis provincias argentinas. Se obtuvieron medidas de MUAC y pliegue subcutáneo tricipital y se calcularon AMA y AFA. Los análisis se realizaron con GAMLSS utilizando el software R. Las diferencias en los valores medios de Sa y R se compararon para los percentiles 3, 50 y 97. Resultados: a todas las edades los valores medios de MUAC y AMA en niños y niñas fueron más altos en R que en Sa; por el contrario, los valores de AFA fueron más bajos. Conclusiones: nuestros resultados confirman la existencia de diferencias en la antropometría mesobraquial de los niños argentinos con respecto a los de la referencia. La mayor cantidad de tejido adiposo y menor de tejido muscular observada en los niños argentinos de ambos sexos puede ser parcialmente asociada con el diferente origen étnico de ambas poblaciones. Sin embargo, las diferencias podrían interpretarse en el contexto de un ambiente obesogénico, el cual habría favorecido el desbalance proteico-calórico.

Calidad de vida relacionada a la salud, sobrepeso y obesidad en contextos de fragmentación socioterritorial de la provincia de Tucumán (Argentina) / Health-related quality of life, overweight and obesity in contexts of socio-territorial fragmentation of the province of Tucumán (Argentina)

Introducción: Durante la infancia, la calidad de vida relacionada con la salud caracteriza dominios físicos, cognitivos, psicológicos y sociales considerando la capacidad de desarrollar actividades de acuerdo con la etapa de crecimiento y desarrollo. Su estudio en poblaciones infantiles con sobrepeso y obesidad contribuye a la determinación de la carga global de la enfermedad y a delinear políticas públicas. Objetivos: Describir y comparar la calidad de vida relacionada a la salud según la presencia o ausencia de sobrepeso y obesidad, en niños y niñas de 8 a 12 años, Yerba Buena (Tucumán, Argentina). Métodos: Se realizó un estudio cuantitativo transverso en 985 niños/as de escuelas públicas. Se relevó peso y talla. Se calculó el índice de masa corporal, distinguiéndose las categorías: 1) con sobrepeso, 2) con obesidad y 3) sin exceso de peso. Para el estudio de la calidad de vida relacionada con la salud se administró el cuestionario Kidscreen- 52. El análisis estadístico consideró la determinación de prevalencias, intervalos de confianza, análisis de varianza y pruebas post hoc (p<0,05). Resultados: El 34% de los escolares presentó exceso de peso (20% sobrepeso, 14% obesidad), sin diferencias sexuales. Los escolares con obesidad presentaron puntuaciones medias significativamente más bajas en las dimensiones de calidad de vida relacionada a la salud: bienestar físico, autopercepción y autonomía (p<0,01). La autopercepción de la salud de los varones se vio más perjudicada que en las mujeres. Conclusiones: El sobrepeso y, especialmente la obesidad, comprometen la calidad de vida relacionada con la salud de los escolares de Yerba Buena. Las dimensiones más perjudicadas son las relacionadas con el bienestar físico y psicosocial (autopercepción y autonomía). Las mujeres perciben mejor su salud que los varones

Introduction: During childhood, health-related quality of life characterizes physical, cognitive, psychological and social domains considering the ability to develop activities according to the stage of growth and development. Its study in child populations with excess weight and obesity contributes to the determination of the global burden of the disease and to delineate public policies.Objective: To describe and compare health-related quality of life according to the presence or absence of overweight and obesity, in children from 8 to 12 years, Yerba Buena (Tucumán, Argentina). Methods: A transverse quantitative study was carried out in 985 public school children. Weight and height were collected. The body mass index was calculated, distinguishing the categories: 1) with overweight, 2) with obesity and 3) without excess weight. For the study of the health-related quality of life, the Kidscreen-52 questionnaire was applied. The statistical analysis considered the determination of prevalences, confidence intervals, analysis of variance and post hoc tests (p <0.05). Results: 34% of schoolchildren presented excess weight (20% overweight, 14% obesity), without sexual differences. Schoolchildren with obesity presented significantly lower average scores in the dimensions of health-related quality of life: physical well-being, self-perception and autonomy (p <0.01). The self-perception of health in boys was more affected than in girls. Conclusions: Overweight and, especially obesity, compromise health-related quality of life of Yerba Buena schoolchildren. The most affected dimensions are those related to physical and psychosocial well-being (self-perception and autonomy). Girls perceive their health better than boys

[Overweight, obesity and perceived health in contexts of poverty in Tucumán, Argentina]. / Sobrepeso, obesidad y salud percibida en contextos de pobreza de Tucumán, Argentina.

In contexts in which poverty compromises children's health and quality of life, the study of perceived health allows for the identification of aspects of quality of life affected by overweight and obesity. From this perspective, the objectives of this study were: 1) to determine the prevalence of overweight and obesity in schoolchildren aged 8-12 years living in contexts of poverty, 2) to describe and compare the perception of health of children according to the presence or absence of overweight and obesity, and 3) to identify possible factors associated with low quality of life related to health. A quantitative and cross-sectional study was conducted. The KIDSCREEN-52 questionnaire was applied and weight and height were assessed in 666 schoolchildren living in the department of Simoca (province of Tucumán), which has high percentages of structural poverty. The high prevalence of overweight (23.0%) and obesity (27.2%) affect the perception of health among children, especially in psychosocial dimensions such as moods and emotions, autonomy, social acceptance, and financial resources.

En contextos en los que la pobreza compromete la salud y la calidad de vida infantil, el estudio de la salud percibida permite identificar aspectos de la calidad de vida afectados por el sobrepeso y la obesidad. Desde esta perspectiva, los objetivos de este trabajo fueron: 1) determinar la prevalencia de sobrepeso y obesidad en escolares con edades comprendidas entre 8 y 12 años residentes en contextos de pobreza, 2) describir y comparar la percepción de la salud de niños y niñas según la presencia o ausencia de sobrepeso y obesidad, y 3) identificar eventuales factores asociados a la baja calidad de vida relacionada con la salud. Se realizó un estudio cuantitativo y transversal, en el que se aplicó el cuestionario KIDSCREEN-52 y se relevó el peso y la talla de 666 escolares residentes en el departamento de Simoca (provincia de Tucumán), el cual registra elevados porcentajes de pobreza estructural. Las altas prevalencias de sobrepeso (23,0%) y obesidad (27,2%) encontradas comprometen la percepción de la salud infantil, especialmente con relación a aspectos psicosociales, como el estado anímico, la autonomía, la aceptación social y los recursos económicos familiares.

[Comparative study of the nutritional status of children living in four counties of the province of Buenos Aires (Argentina), in the context of nutrition transition]. / Estudio comparativo del estado nutricional de niños y niñas residentes en cuatro partidos de la provincia de Buenos Aires (Argentina), en el marco de la transición nutricional.

The aim of this study was to evaluate and compare the nutritional status of child populations living in four counties of the province of Buenos Aires to observe differences related to particular environmental and socioeconomic contexts in the framework of the nutrition transition. During the school years corresponding to the 2008-2012 period, weight and height were measured and body mass index was calculated for 7,873 school children between the ages of 4 and 12 years from the counties of La Plata, Brandsen, Magdalena and Punta Indio. Information about the contexts of residence was obtained using self-administered structured surveys. About 40% of schoolchildren presented malnutrition, with a prevalence of overweight in La Plata, obesity in Punta Indio and undernutrition in Magdalena. The nutritional status of the study populations was associated with the socioenvironmental conditions of residence, indicating that these populations are at different stages of the nutrition transition process.

El objetivo fue evaluar y comparar el estado nutricional en poblaciones infanto-juveniles residentes en cuatro partidos de la provincia de Buenos Aires y observar si existen diferencias vinculadas a los contextos ambientales y socioeconómicos particulares, en el marco de la transición nutricional. Entre los ciclos lectivos 2008-2012, se relevó el peso y la talla y se calculó el índice de masa corporal de 7.873 escolares, entre 4 y 12 años de edad, residentes en los partidos de La Plata, Brandsen, Magdalena y Punta Indio. La información acerca del contexto de residencia se obtuvo mediante encuesta estructurada y autoadministrada. Alrededor del 40% de los escolares presentó malnutrición, y prevalecieron el sobrepeso en La Plata, la obesidad en Punta Indio y la desnutrición en Magdalena. El estado nutricional se vinculó con las condiciones socioambientales de residencia y dio cuenta de que estas poblaciones se ubican en distintas etapas del proceso de transición nutricional.

Estudio comparativo del estado nutricional de niños y niñas residentes en cuatro partidos de la provincia de Buenos Aires (Argentina), en el marco de la transición nutricional / Comparative study of the nutritional status of children living in four counties of the province of Buenos Aires (Argentina), in the context of nutrition transition

RESUMEN El objetivo fue evaluar y comparar el estado nutricional en poblaciones infanto-juveniles residentes en cuatro partidos de la provincia de Buenos Aires y observar si existen diferencias vinculadas a los contextos ambientales y socioeconómicos particulares, en el marco de la transición nutricional. Entre los ciclos lectivos 2008-2012, se relevó el peso y la talla y se calculó el índice de masa corporal de 7.873 escolares, entre 4 y 12 años de edad, residentes en los partidos de La Plata, Brandsen, Magdalena y Punta Indio. La información acerca del contexto de residencia se obtuvo mediante encuesta estructurada y autoadministrada. Alrededor del 40% de los escolares presentó malnutrición, y prevalecieron el sobrepeso en La Plata, la obesidad en Punta Indio y la desnutrición en Magdalena. El estado nutricional se vinculó con las condiciones socioambientales de residencia y dio cuenta de que estas poblaciones se ubican en distintas etapas del proceso de transición nutricional.

ABSTRACT The aim of this study was to evaluate and compare the nutritional status of child populations living in four counties of the province of Buenos Aires to observe differences related to particular environmental and socioeconomic contexts in the framework of the nutrition transition. During the school years corresponding to the 2008-2012 period, weight and height were measured and body mass index was calculated for 7,873 school children between the ages of 4 and 12 years from the counties of La Plata, Brandsen, Magdalena and Punta Indio. Information about the contexts of residence was obtained using self-administered structured surveys. About 40% of schoolchildren presented malnutrition, with a prevalence of overweight in La Plata, obesity in Punta Indio and undernutrition in Magdalena. The nutritional status of the study populations was associated with the socioenvironmental conditions of residence, indicating that these populations are at different stages of the nutrition transition process.

Desigualdades en el crecimiento infantil y la composición corporal de escolares urbanos y rurales de Tucumán (Argentina) / Inequalities in child growth and body composition of urban and rural schoolchildren from Tucumán (Argentina)

Introducción: El ámbito de residencia urbano o rural podría promover desigualdades en el crecimiento y la composición corporal infantil. Objetivos: Describir el crecimiento y la composición corporal de niños y niñas de la provincia de Tucumán (Argentina) y analizar posibles diferencias en relación con el contexto de residencia urbano-rural. Métodos: Se realizó un estudio antropométrico transversal en 1948 escolares con edades comprendidas entre 8.0 y 11.9 años, residentes en ámbitos urbanos y rurales de Yerba Buena, San Miguel de Tucumán y Simoca (Tucumán). Se midió: peso, talla, circunferencias del brazo, de la cadera y de la cintura, y pliegues subcutáneos bicipital, tricipital, subescapular y suprailíaco. Se calculó: índice de masa corporal, porcentaje de grasa corporal, masa grasa y masa libre de grasa. Se estimaron medias y desvíos estándar y se efectuaron comparaciones urbano-rurales mediante la prueba U de Mann- Whitney (p<0.05). Resultados: Los escolares rurales reportaron valores significativamente menores para la mayoría de las variables analizadas. Las diferencias urbano-rurales se observaron tanto en varones como en mujeres. Los escolares urbanos evidenciaron mayor adiposidad que sus pares rurales. Discusión: Las diferencias observadas en el crecimiento y la composición corporal de los escolares urbanos y rurales de Tucumán expresan desigualdades en las condiciones de vida. Coincidentemente con lo informado en estudios previos, los niños/as residentes en las ciudades resultan menos propensos/ as a presentar alteraciones en el crecimiento. El mayor acúmulo adiposo registrado en la población urbana puede interpretarse en el contexto global de la transición nutricional, que resulta especialmente acelerado en las ciudades. Conclusiones: El crecimiento y la composición corporal de los niños y niñas de Tucumán se manifiesta diferencialmente de acuerdo con el contexto urbano o rural de residencia

Introduction: Urban or rural context of residence may promote inequalities in children growth and body composition. Objective: The purpose of this study was to describe growth and body composition of children from the province of Tucumán (Argentina) and analyze possible differences in relation to the context of urban-rural residence. Methods: A cross-sectional anthropometric study was performed in 1948 schoolchildren between 8.0 and 11.96 years old living in urban and rural areas of Yerba Buena, San Miguel de Tucumán and Simoca (Tucumán). We measured weight, height, arm, hip and waist circumferences, and bicipital, tricipital, subscapular and suprailiac skinfolds. Body mass index, fat percentage and adipose and muscle area were assessed. Means and standard deviations were calculated, and urban-rural comparisons were made using the Mann-Whitney U test (p <0.05). Results: Significant differences between urban and rural children were found for most of the variables analyzed. Such differences were observed in both sexes. Urban schoolchildren showed more adipose accumulation than their rural peers. Discussion: The differences observed in growth and body composition of urban and rural schoolchildren from Tucumán express inequalities in their living conditions, which is in line with previous studies arguing that children living in cities are less likely to suffer growth retardation. The greater accumulation of fat in the urban population can be interpreted in the global context of nutritional transition, which is especially accelerated in cities. Conclusions: Growth and body composition in Tucumán children manifested differentially according to the urban or rural context of residence

Prácticas y representaciones en torno a la alimentación familiar en distintos ambientes socio-económicos (Villaguay, Argentina, 2010-2012)

ntecedentes:se considera que el conocimiento que guía nuestras prácticas es socialmente elaborado y compartido y que la variabilidad en las elecciones en torno a la alimentación se relaciona con la variabilidad en las condiciones de vida.Objetivo: indagar acerca de prácticas (acciones) y representaciones (ideas subyacentes) en torno a la alimentación de familias con al menos un niño/a de 3 a 6 años de edad residentes en distintos ambientes socio-económicos del departamento de Villaguay, Entre Ríos, Argentina.Metodología:en establecimientos educativos públicos de la zona urbana (Ur), periurbana (Pe) y rural (Ru) del departamento de Villaguay, padres y madres fueron invitados a desarrollar voluntariamente encuestas asistidas, obteniéndose un total de 303 encuestas (109 Ur, 133 Pe y 61 Ru). Los resultados se analizaron y compararon entre zonas mediante pruebas de Chi2.Resultados y conclusiones:el análisis de los datos evidenció diferencias para algunas prácticas y representaciones exhibiendo, además, estrecha relación con la variabilidad en las condiciones de vida. Así, por ejemplo, mientras que las familias urbanas, de más alto nivel socio-económico, elegían sus alimentos principalmente por las marcas, en las familias más carenciadas del periurbano, el precio era el factor determinante. Por último, la zona rural presentó características socio-económicas intermedias y se observó una mayor participación de toda la familia en actividades relacionadas a la alimentación. No obstante, también se detectaron ciertas uniformidades independientes de las condiciones socio-económicas, como la práctica de consumo entre comidas o la preocupación por lograr una "buena alimentación", dando cuenta de que algunos aspectos trascienden las fronteras de los subsistemas socioculturales

ackground:It is known that the knowledge that guides our practices is socially elaborated and that the variability in food choices is related to the variability in living conditions.Objetive: To inquire about practices (actions) and representations (underlying ideas) about the feeding of families with at least one child from 3 to 6 years old living in different socio-economic environments of the Villaguay district, Entre Ríos, Argentina.Methodology:In public educational establishments of the urban (Ur), periurban (Pe) and rural (Ru) areas of the department of Villaguay, parents were invited to voluntarily develop assisted surveys, obtaining a total of 303 surveys (109 Ur, 133 Pe and 61 Ru).Results and Conclusions:The analysis of the data showed differences between zones for some practices and representations, also exhibiting their close relationship with the variability of the living conditions. For example, while urban families of higher socioeconomic status chose their food primarily for brands, in the most deprived families of the periurban, price was the determining factor. Finally, the rural area had intermediate socio-economic characteristics and a greater participation of the whole family in activities related to food was observed. However, certain uniformities, independent of the socioeconomic differences, were also detected, such as the practice of eating between meals or the concern to achieve "a good food", noting that some aspects transcend the boundaries of sociocultural subsystems.

Malnutrición infantil e inseguridad alimentaria como expresión de las condiciones socio-económicas familiares en Villaguay, Argentina (2010-2012). Un enfoque biocultural()

Objetivo:Indagar a) si existen diferencias en las condiciones de vida estimadas a partir de variables socio-económicas, entre familias con niños de 3 a 6 años de edad, residentes en zonas urbana, periurbana y rural del departamento de Villaguay, Entre Ríos, Argentina; y b) en caso de haberlas, si esas diferencias se expresan en el estado nutricional infantil y en la percepción de inseguridad alimentaria en los hogares (PIAH) (en lo que respecta al acceso).Población y Métodos:El estudio fue de tipo transversal e incluyó 303 niños de 3 a 6 años de edad. Para el estudio antropométrico se tomaron peso corporal y estatura, y se empleó la referencia The Third National Health and Nutrition Examination Survey (Frisancho, 2008) para determinar los indicadores de estado nutricional. La información socio-económica se relevó mediante una encuesta semiestructurada, mientras que la PIAH se obtuvo a partir de la encuesta propuesta por la Academia para el Desarrollo Educativo. Ambas encuestas fueron completadas por los padres de los niños medidos antropométricamente.Resultados y Conclusiones:En general se observó que las poblaciones estudiadas presentaron diferencias socio- económicas en relación con el nivel educativo y empleo paterno y materno, hacinamiento crítico, cobertura de salud, entre otras; estas diferencias se expresarían en la distribución diferencial de la malnutrición infantil y de la percepción de las limitaciones que los padres manifestaron tener a una buena alimentación tanto en términos de cantidad como de calidad.

Objective:To inquire: a) if there are differences in living conditions estimated through socio-economic variables among families with 3 to 6 years old children, living in urban, peri-urban and rural areas of Villaguay department, Entre Ríos, Argentina; and b) in case there is any, whether these differences are expressed in child nutritional status and in the perception of households food insecurity (PHFI) (regarding access).Population and Methods:The study was transverse and included 303 children aged 3 to 6 years old. For the anthropometric study, we considered body weight and height, along with The Third National Health and Nutrition Examination Survey (Frisancho, 2008) reference to determine nutritional status indicators. Socioeconomic information was inquired through a semistructured survey, while the PHFI was obtained from the survey proposed by the Academy for Educational Development (AED), both filled by parents of children measured anthropometrically.Results and Conclusion:In general, it was observed that the studied populations showed socio-economic differences in relation to parental education level and employment, critical overcrowding, and health insurance, among others; these differences might be expressed in the differential distribution of children malnutrition and in the perception of the limitations that parents said to have to a good nutrition both in terms of quantity and quality.

Contexts of occurrence of child malnutrition in the district of Villaguay, Entre Ríos, Argentina. A multivariate analysis.

The analysis of nutritional status is anthropologically important to address the complex interaction of biological, social, political, economic and cultural factors. To deepen the knowledge about contexts of occurrence of child malnutrition, we analyzed nutritional status in relation to socio-environmental conditions of residence in children between three and six years from Villaguay, Entre Ríos, Argentina. We performed a cross-sectional study of 1,435 school children of both sexes. Body weight and height were measured and prevalence of low height/age (LH/A), low weight/age (LW/A), low BMI/age (LBMI/A), overweight (Ow) and obesity (Ob) was calculated using World Health Organization reference charts. Socio-environmental information was obtained through a semi-structured survey and processed by Categorical Principal Component Analysis (CatPCA). Anthropometric data showed 1.5% LW/A, 5.2% LH/A; 0.6% LBMI/A, 20.9% Ow and 10.9% Ob. CatPCA allowed us to define four groups (G1-G4) with better (G2), middle (G1) and worst (G4) urban socio-environmental conditions and one with rural characteristics (G3). G4 presented the highest LH/A prevalence and G2 the highest Ow and Ob prevalence (P<0.05). It is concluded that since the distribution of malnutrition was not even it may dependent on the context in which children grow up. Thus, the higher the socio-economic level, the higher the incidence of overweight and obesity. Conversely, at the other end of the social scale, undernutrition and increasing weight excess remained major health problems.

Secular changes in body size and body composition in schoolchildren from La Plata City (Argentina).

AIM: To analyze the secular changes in body size and composition of two cohorts of children from La Plata City, Argentina, with a 35-year follow-up. subjects and methods: Cohort 1 (C1) was measured in 1969-1970 and included 1772 children (889 boys, 883 girls), and Cohort 2 (C2), measured in 2004-2005, included 1059 children (542 boys, 517 girls). Both cohorts were obtained from matching geographical areas and comprised children from 4 to 12 years. Body weight (W); Height (H); Upper arm circumference (UAC); Tricipital (TS) and Subscapular skinfolds (SS) were measured, and Body Mass Index (BMI) and muscle (UMA) and fat (AFA) brachial areas were calculated. Prevalence of overweight and obesity was estimated by IOTF. To compare C1-C2 we used a generalized linear model with log-transformed variables, and chi square test. RESULTS: There were significant and positive differences between C2-C1 in W, UAC, SS, TS, and AFA. In contrast, H was not significantly different and UMA was significantly different but with negative values. The prevalence of overweight and obesity was 14.5% and 3.8% in C1, and 17.0% and 6.8% in C2. Differences between cohorts were significant for obesity. CONCLUSION: The shifts observed for soft tissues--positive trend for fat and negative for muscle area--occurring without changes in height lead us to suppose that in these three decades, La Plata's population has experienced deterioration in living conditions and important changes in their lifestyle, such as an increased consumption of energy-dense foods and sedentary habits.

Effect of intergenerational chronic undernutrition on ponderal, and linear growth.

The aim of this paper was to analyze if intergenerational undernutrition causes growth retardation in weight and body length in two generations of rats and, if so, to assess whether the delay is cumulative. Male and female rats were assigned to one of the following groups: (1) control: they were fed ad libitum and constituted the parental generation (P), and (2) undernourished generations (F1 and F2): they were fed on 75% of the control diet. Animals were weighed and X-rayed every ten days from 20 to 100 days old in order to measure total body length. Also, body mass index was calculated. Data were processed by ANOVA and LSD post hoc tests. Impairment in weight, body length, and body mass index was found in both generations; nevertheless growth retardation was greater in F2, indicating a cumulative effect of nutritional stress. Sex differences were found, since the cumulative effect of generational undernutrition was greater and earlier in males than in females. It is concluded that when the undernutrition acts with constant intensity during several generations, the growth retardation is cumulative, indicating a negative secular trend.

A comparative study on nutritional status and body composition of urban and rural schoolchildren from Brandsen district (Argentina).

The purpose of this study was to analyze whether nutritional status and body composition varies according to the environment of residence (urban or rural) of children in the Brandsen district (Argentina). Weight, height, arm circumference and tricipital and subscapular skinfolds were performed in 1368 schoolchildren aged 3 to 14. NHANES III reference was used to estimate nutritional status -underweight, stunting, wasting, overweight, and obesity- and to evaluate body composition -deficit and excess of adipose (DA, EA) and muscular (DM, EM) tissues of the arm-. Central fat distribution (CFD) was estimated using the subscapular-tricipital index. A structured questionnaire was implemented to evaluate socio-environmental characteristics. Nutritional categories based on body size and body composition were compared between urban and rural areas of residence using Chi-squared tests (χ2). The results indicated for the total sample: 1.1% underweight, 6.9% stunting, 0.4% wasting, 12.1% overweight, 9.7% obesity, 22.0% DM, 2.5% EM, 0.1% DA, 17.6% EA, and 8.5% CFD. Significant differences between urban and rural areas were found only for CFD. The socio-environmental analysis showed that while access to public services and housing quality was significantly better in the urban area, a considerable number of city households lived under deficient conditions, lacked health insurance and had low socioeconomic level. Fifty-three percent of the undernourished children had DM without urban-rural significant differences, and none of them showed DA. In the overweight plus obesity group, 62.8% presented EA, 6.4% EM, 4.7% DM, and 22.8% CFD. The highest percentages of DM and CFD were recorded in rural areas (p = 0.00). We conclude that the child population shows the "double burden" of malnutrition. The environment of residence does not promote any differentiation in the nutritional status. Nevertheless, the increment of central adiposity and, in some cases of muscle deficit in rural children, suggests a consumption of unbalanced diet.

Growth of functional cranial components in rats with intrauterine growth retardation after treatment with growth hormone.

The goal of this study was to analyse the effect of growth hormone (GH) on catch-up growth of functional facial (splanchnocranial) and neurocranial components in rats with intrauterine growth retardation (IUGR). Wistar rats were divided into the following groups: control (C), sham-operated (SH), IUGR, and IUGR + GH. IUGR was surgically induced and GH was administered between 21 and 60 days of age. Radiographs were obtained at 1, 21, 42, 63, and 84 days of age in order to measure length, width, and height of neurocranium (NL, NW, and NH) and face length, width, and height (FL, FW, and FH). Analysis of variance was performed at 1 day of age and a principal components analysis (PCA) at 84 days of age. Neurocranial and facial volumetric indexes were calculated as NVI = (3)√NL × NW × NH and FVI = (3)√FL × FW × FH, respectively, and adjusted by non-linear regression analysis. On postnatal day 1, there were significant differences between SH and IUGR (P < 0.01). Also, in both genders, final neurocranial volume was similar between SH and IUGR + GH groups, while the IUGR group had the lower value (P < 0.01). Final facial volume was similar among the three groups. In both genders, facial growth rates were SH = IUGR > IUGR + GH (P < 0.01). The first axis of the PCA exhibited size effect and the second axis showed shape effect. Reductions of placental blood flow modify cranial growth. The functional neurocranial and facial components in rats with IUGR presented different recovery strategies through modular behaviour, mainly related to modifications of growth rate as response to GH administration.