Towards an ethical and legal framework in archeogenomics: A local case in the Atlantic coast of central Patagonia.

Ethical discussions around ancient DNA (aDNA) research predate the technological breakthroughs that led to the accelerated generation of ancient genomic data, revealing a long-due need to address these aspects in the field. Given the diverse conflicts that genomics has raised towards the communities associated with the Non-living Human Ancestors under study, it has been suggested that the ethical and legal implications of genetically studying present-day and ancient human populations should be considered case-by-case. Nevertheless, the discussions have focused on US and European perspectives. To contribute from a local and Latin American position to the problem, we present the history of consensus and disagreement of the relationships between scientists and Indigenous communities of the Atlantic coast of the central Argentinian Patagonia. We describe how these relationships resulted in the approval of a groundbreaking provincial law that acknowledges the Indigenous community's right to be involved in decision-making concerning their Ancestors. In addition, we emphasize how these established relationships allowed the development of aDNA studies. With this background, we address the main ethical concerns of genomic studies of Ancestors identified in the reference literature and commit to applying some of the recommendations suggested in those ethical guidelines. Then, we reflect on possible negative consequences of ongoing research and propose some suggestions based on personal experiences that will contribute to moving the ethical field towards a more contextualized science with a local perspective.

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)

Dimorfismo sexual del crecimiento y de la composición corporal en la población infanto-juvenil de Puerto Madryn (Chubut, Argentina) / Sexual dimorphism of growth and body composition in the child-youth population of Puerto Madryn (Chubut, Argentina)

Introducción: Analizar la composición corporal es fundamental en la valoración del estado nutricional del individuo. Consiste en cuantificar los componentes corporales y su variabilidad durante el crecimiento y entre sexos. Considerando el vacío de información en esta temática, el objetivo del presente trabajo fue analizar el dimorfismo sexual de la composición corporal durante el crecimiento en función del estado nutricional evaluado a través del índice de masa corporal en una muestra de escolares argentinos. Material y métodos: Se realizó un estudio antropométrico transversal, con varones y mujeres, de entre 6-14 años, asistentes a escuelas de Puerto Madryn. El estado nutricional se determinó según la IOTF, diferenciando delgadez, sobrepeso, obesidad y normonutrición. En cuanto a la composición corporal, se analizó la distribución adiposa, las masas grasa y libre de grasa y del índice de robustez esquelética. Se realizaron comparaciones gráficas empleando diferencias porcentuales entre medias (DPM%).para analizar variaciones en el crecimiento y la composición corporal de los malnutridos. Resultados: La muestra incluyó 2732 escolares (56,5%presentaba normonutrición, 2,9% delgadez, 26,0% sobrepeso y 14,6% obesidad). En base a la edad decimal cada participante fue asignado al grupo etario de prepúberes (48,4%) y púberes (51,6%). El análisis del dimorfismo sexual mostró diferencias significativas entre sexos en prepúberes normonutridos, con sobrepeso y obesos, mientras que entre los púberes éstas se hallaron en todos los casos. Las DPM% fueron positivas para normonutridos-delgados; en tanto que para normonutridos-sobrepeso y normonutridos-obesos fueron negativas. (AU)

Introduction: Analysis of body composition is essential in assessing nutritional status of the individual. It consists of quantifying the body components and their variability during growth and between sexes. Considering the lack information on this topic, the objective of this work was to analyzed the sexual dimorphism of body composition during growth as a function of the nutritional sta-tus evaluated through the body mass index in a sample of Argentinean school children. Material and methods: A cross-sectional anthropometric study was carried out, with males and females, aged 6-14 years, attending schools in Puerto Madryn. Nutritional status was determined according to the IOTF, differentiating thinness, overweight, obesity and normonutrition. Regarding body composition, adipose distribution, fat and fat-free masses and Frame Index were analyzed. Graphical comparisons were made using percentage differences between means (PDM%) to analyze variations in growth and body composition of the malnourished. Results: The sample included 2732 schoolchildren (56.5% presented normal nutrition, 2.9% thinness, 26.0% overweight and 14.6% obesity). Based on decimal age, each participant was assigned to prepubertal (48.4%) and pubertal (51.6%) age group. Analysis of sexual dimorphism showed significant differences between sexes in normalnourished, overweight and obese prepubescent, while these were found in all cases among pubertal subjects. PDM% were positive for normalnourished-thin; while for normalnourished-overweight and normalnourished-obese they were negative. (AU)

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.

Doble carga de malnutrición y nivel de bienestar socio-ambiental de escolares de la Patagonia argentina(Puerto Madryn, Chubut) / Double burden of malnutrition and socio-environmental well-being in schoolchildren from Argentinian Patagonia (Puerto Madryn, Chubut)

INTRODUCCIÓN: La doble carga de la malnutrición constituye un desafío para la salud pública y una problemática creciente en Latinoamérica y el Caribe. El análisis poblacional de Puerto Madryn resulta interesante visto que esta ciudad registró desde 1970 el mayor crecimiento demográfico de Argentina. No obstante, la reducción en el nivel de industrialización podría haber repercutido en el bienestar de los habitantes. OBJETIVO: Evaluar la asociación entre el estado nutricional y el nivel de bienestar socio-ambiental de escolares, de 6 a 14 años de edad, residentes en Puerto Madryn (Chubut, Argentina). MÉTODOS: Se relevaron peso y talla en 2799 escolares y se empleó la referencia de la Organización Mundial de la Salud para determinar: desnutrición, sobrepeso y obesidad. Las prevalencias entre grupos y sexos fueron comparadas por Chi2. El nivel de bienestar de las familias se indagó mediante encuestas que fueron procesadas por Análisis de Compo nentes Principales categórico (ACP-cat). RESULTADOS: El ACP-cat diferenció dos grupos: uno con mayor (MaB) y otro menor (MeB) bienestar socio-ambiental. El MaB se caracterizó por presentar viviendas con paredes de ladrillos y pisos revestidos, acceso a servicios públicos, cobertura de salud por obra social o prepaga y padres con trabajo formal. El MeB en cambio, presentó viviendas con paredes de chapa y/o madera, pisos de cemento o tierra, hacinamiento, asistencia a hospitales públicos y padres con trabajo informal. Se observó presencia de desnutrición (2,6%) y exceso de peso (46,9%). La prevalencia de sobrepeso fue mayor que la de obesidad (25.7% vs.21.3%). La desnutrición crónica y el sobrepeso fueron 2,1% y 3,6% superiores en los escolares con MeB. CONCLUSIÓN: La población escolar de Puerto Madryn presenta doble carga de malnutrición, característica de un estadio avanzado de transición nutricional. Las mayores prevalencias de desnutrición crónica y sobrepeso se asocian a menores condiciones socio-ambientales. La obesidad en cambio, se presenta independientemente del nivel de bienestar socio-ambiental

INTRODUCTION: The double burden of malnutrition constitutes a challenge for public health and an increasing problem in Latin America and the Caribbean. The population analysis of Puerto Madryn is interesting given that this city recorded since 1970 the highest demographic growth in Argentina. However, the reduction in the level of industrialization could have had an impact on the well-being of the inhabitants. OBJECTIVE: To determine the association between nutritional status and socio-environmental well-being in 6-14 year-old schoolchildren from Puerto Madryn, Chubut, Argentina. METHODS: Weight and height were assessed in 2799 schoolchildren and the World Health Organization reference was used to determine: malnutrition, overweight and obesity. Prevalence between groups and sexes were compared with Chi-square. Family well-being was surveyed with questionnaires and analyzed with categorical Principal Component Analysis (cat-PCA). RESULTS: The cat-PCA differentiated two groups of well-being: major (MA) and minor (MI). The MA group was characterized by the presence of houses with brick walls and coated floors, accessibility to public services, health insurance (medical insurance at the expense of the employer or paid by the person) and parents with formal employment. In the MI group, houses had zinc-metal or wood walls, concrete or earthen floors, households were overcrowded, health care was provided by the assistance public hospitals and parents had informal employment. The prevalence of malnutrition was 2.6% and that of excess weight was 46.9%. The prevalence of overweight was higher than that of obesity (25.7% vs.21.3%). Stunting and overweight were 2.1% and 3.6% higher in schoolchildren from the MI group. CONCLUSION: The schoolchildren population from Puerto Madryn presents double burden of malnutrition, characteristic of an advanced stage of nutritional transition. The higher prevalence of stunting and overweight are associated with lower socio-environmental conditions. Nevertheless, obesity occurs independently of these conditions socio-environmental well-being

Composición corporal en relación al sobrepeso y a la obesidad. Un estudio en niños residentes en diferentes áreas geográficas de Argentina / Relationship between body composition and overweight/obesity. A study in children living in different geographic areas from Argentina

Introducción: En las últimas décadas se ha observado un rápido incremento del exceso de peso. Las dificultades para acceder a una alimentación adecuada, predisponen a los niños a presentar sobrepeso u obesidad y muchos de ellos resultan además anémicos o con déficit de tejido muscular. Objetivo: Analizar la composición corporal de niños con sobrepeso u obesidad, residentes en dos ciudades argentinas con diferente localización geográfica: General Alvear (Mendoza) y Puerto Madryn (Chubut). Métodos: Se realizó un estudio transversal en 5828 escolares (3048 varones y 2780 mujeres) desde los 5,0 a los 14,9 años de edad residentes en las ciudades de General Alvear (GA) y Puerto Madryn (PM). Se relevaron: peso, talla, perí- metro braquial y pliegues tricipital y subescapular y se calcularon las áreas muscular y adiposa del brazo y el Índice Subescapular/Tricipital (IST). Las prevalencias de sobrepeso (S) y obesidad (O) se estimaron utilizando NHANES III (S>P85 y ≤P95 y O>P95). El análisis de la composición corporal mesobraquial se realizó estimando déficit y exceso de tejidos adiposo (DTA, ETA) y muscular (DTM, ETM). Resultados: Las prevalencias de S y O fueron mayores en PM respecto a GA (S=13,1% vs 7,0%) y (O= 9,0% vs 4,8%). En GA se registraron los mayores porcentajes de niños con DTM y ETA mientras que en PM aquellos con ETM. En niños y niñas de ambas ciudades se encontraron valores de IST>1. No obstante, estos se manifestaron a edades más tempranas principalmente en niñas obesas. Discusión y Conclusiones: El ambiente urbano de PM y su estilo de vida, conducen a que la población infanto-juvenil presente mayor exceso de peso, como consecuencia del aumento en los tejidos adiposo y muscular. La mayor centralización adiposa en niñas puede conducir al desarrollo de enfermedades no trasmisibles. Por otra parte, aun cuando el exceso de peso es menor en GA, la condición de estos niños es también preocupante, puesto que el exceso de tejido adiposo se acompaña de déficit de tejido muscular, posiblemente como consecuencia de ingestas altamente calóricas pero proteicamente deficientes (AU)

Introduction: In the recent decades a rapid increase of excess weight has been observed. Difficulties in having access to adequate food predispose children to being overweight or obese and many of them are also anemic or have a deficit in the muscle tissue. Objective: To analyze the body composition of overweight or obese children living in two Argentinean cities with different geographical locations: General Alvear (Mendoza) and Puerto Madryn (Chubut). Methods: A cross-sectional study was carried out on 5828 schoolchildren (3048 males and 2780 females) aged from 5,0 to 14,9 living in the cities of General Alvear (GA) and Puerto Madryn (PM). Weight, height, upper arm circumference and tricipital and subscapular skinfolds were measured. Also, muscle and adipose areas of the arm and Subscapular/Tricipital Index (STI) were calculated. The prevalence of overweight (O) and obesity (Ob) were estimated using NHANES III (O> P85 and ≤P95 and Ob> P95). The analysis of body composition was performed in the arm estimating deficit and excess of adipose (DAT, EAT) and muscular tissues (DMT, EMT). Results: The O and Ob prevalence was higher in PM than in GA (O= 13.1% vs 7.0%) and (Ob= 9.0% vs 4.8%). The highest percentages of children with DMT and EAT were recorded in GA, whereas those with EMT were recorded in PM. The STI values >1 were found in boys and girls from both cities. Nevertheless, they appear at early ages mainly in obese girls. Discussion and Conclusions: The urban environment of PM and its lifestyle result in a child-juvenile population whit greater excess of weight, as a consequence of the increase in adipose and muscular tissues. The centralization of adipose tissue in girls could lead to the development of non-communicable diseases. On the other hand, even when excess of weight is lower in GA the condition of these children is as worrying, since excess of adipose tissue is accompanied by muscle tissue deficit, possibly as a consequence of highly caloric but poorly protein intakes (AU)