Relationship between lipid profile, anthropometric indicators, and appetite-regulating hormones in infants according to type of feeding / Relación entre perfil lipídico, indicadores antropométricos y hormonas reguladoras del apetito en lactantes según tipo de alimentación

Background: infants receiving full breastfeeding (FBF) regulate their appetites differently from those receiving human milk substitutes (HMS). In addition, early exposure to the dietary cholesterol in human milk could lead to better cholesterol regulation in later stages of life. Therefore, the purpose was to compare lipid profiles in 4-month-old infants and to correlate lipid profile with anthropometric indicators and appetite-regulating hormones according to the type of feeding. Methods: this was a cross-sectional and correlational study, which included 145 mother-infant dyads according to the type of feeding; 64 received FBF, 47 partial breastfeeding (PBF), and 34 HMS. The complete lipid profile, total ghrelin, leptin, peptide YY, and glucagon-like peptide type 1 were measured. Z-scores for weight/age, length/age, weight/length, triceps (TSF) and subscapular folds (SSF) and body mass index for age were also obtained. Results: there were significant differences in triglycerides and LDL cholesterol according to the type of feeding. In the HMS group, an inverse relationship was observed between ghrelin and triglycerides (p = 0.038), ghrelin and total cholesterol (TC) (p = 0.026), and peptide YY and HDL cholesterol (p = 0.017). In the PBF group, a direct relationship was observed between length/age (z) and triglycerides (p = 0.001) and between subscapular folds and TC (p = 0.049). In infants receiving HMS, a direct correlation was observed between weight/age (z) and TC (p = 0.045) and between length/age (z) and LDL cholesterol (p = 0.010). Conclusion: these findings show a relationship between growth, energy reserve, lipid profile, and modulation of appetite-regulating hormones according to the type of feeding they received. (AU)

Introducción: los lactantes que reciben lactancia materna completa (LMC) regulan su apetito de manera diferente a los que reciben sucedáneos de la leche humana (SLH). Además, la exposición temprana al colesterol en la leche humana conduciría a mejor regulación del colesterol en etapas posteriores de la vida. El propósito fue de comparar el perfil lípidos en lactantes de cuatro meses y correlacionarlo con indicadores antropométricos y hormonas reguladoras del apetito según el tipo de alimentación. Métodos: en un estudio transversal y correlacional se incluyeron 145 díadas madre-lactante según el tipo de alimentación; 64 recibieron LMC, 47 lactancia materna parcial (LMP) y 34 SLH. Se midió el perfil lipídico, grelina total, leptina, péptido YY y péptido tipo 1 similar al glucagón. Se obtuvieron puntajes Z para peso/edad, longitud/edad, peso/longitud, pliegue cutáneo tricipital y subescapular e índice de masa corporal para la edad. Resultados: hubo diferencias significativas en triglicéridos y colesterol LDL según el tipo de alimentación. En el grupo HMS se observó una relación inversa entre grelina y triglicéridos (p = 0,038), grelina y colesterol total (TC) (p = 0,026), y péptido YY y colesterol HDL (p = 0,017). En el grupo PBF hubo relación directa entre longitud/edad (z) y triglicéridos (p = 0,001) y entre pliegues subescapulares y CT (p = 0,049). En los lactantes que recibieron HMS, se observó una correlación directa entre peso/edad (z) y CT (p = 0,045) y entre longitud/edad (z) y colesterol LDL (p = 0,010). Conclusión: los hallazgos muestran una relación entre perfil lipídico, crecimiento, reserva energética y modulación de las hormonas reguladoras del apetito según el tipo de alimentación. (AU)

Relationship between lipid profile, anthropometric indicators, and appetite-regulating hormones in infants according to type of feeding.

Introduction: Background: infants receiving full breastfeeding (FBF) regulate their appetites differently from those receiving human milk substitutes (HMS). In addition, early exposure to the dietary cholesterol in human milk could lead to better cholesterol regulation in later stages of life. Therefore, the purpose was to compare lipid profiles in 4-month-old infants and to correlate lipid profile with anthropometric indicators and appetite-regulating hormones according to the type of feeding. Methods: this was a cross-sectional and correlational study, which included 145 mother-infant dyads according to the type of feeding; 64 received FBF, 47 partial breastfeeding (PBF), and 34 HMS. The complete lipid profile, total ghrelin, leptin, peptide YY, and glucagon-like peptide type 1 were measured. Z-scores for weight/age, length/age, weight/length, triceps (TSF) and subscapular folds (SSF) and body mass index for age were also obtained. Results: there were significant differences in triglycerides and LDL cholesterol according to the type of feeding. In the HMS group, an inverse relationship was observed between ghrelin and triglycerides (p = 0.038), ghrelin and total cholesterol (TC) (p = 0.026), and peptide YY and HDL cholesterol (p = 0.017). In the PBF group, a direct relationship was observed between length/age (z) and triglycerides (p = 0.001) and between subscapular folds and TC (p = 0.049). In infants receiving HMS, a direct correlation was observed between weight/age (z) and TC (p = 0.045) and between length/age (z) and LDL cholesterol (p = 0.010). Conclusion: these findings show a relationship between growth, energy reserve, lipid profile, and modulation of appetite-regulating hormones according to the type of feeding they received.

Introducción: Introducción: los lactantes que reciben lactancia materna completa (LMC) regulan su apetito de manera diferente a los que reciben sucedáneos de la leche humana (SLH). Además, la exposición temprana al colesterol en la leche humana conduciría a mejor regulación del colesterol en etapas posteriores de la vida. El propósito fue de comparar el perfil lípidos en lactantes de cuatro meses y correlacionarlo con indicadores antropométricos y hormonas reguladoras del apetito según el tipo de alimentación. Métodos: en un estudio transversal y correlacional se incluyeron 145 díadas madre-lactante según el tipo de alimentación; 64 recibieron LMC, 47 lactancia materna parcial (LMP) y 34 SLH. Se midió el perfil lipídico, grelina total , leptina , péptido YY y péptido tipo 1 similar al glucagón. Se obtuvieron puntajes Z para peso/edad, longitud/edad, peso/longitud, pliegue cutáneo tricipital y subescapular e índice de masa corporal para la edad. Resultados: hubo diferencias significativas en triglicéridos y colesterol LDL según el tipo de alimentación. En el grupo HMS se observó una relación inversa entre grelina y triglicéridos (p = 0,038), grelina y colesterol total (TC) (p = 0,026), y péptido YY y colesterol HDL (p = 0,017). En el grupo PBF hubo relación directa entre longitud/edad (z) y triglicéridos (p = 0,001) y entre pliegues subescapulares y CT (p = 0,049). En los lactantes que recibieron HMS, se observó una correlación directa entre peso/edad (z) y CT (p = 0,045) y entre longitud/edad (z) y colesterol LDL (p = 0,010). Conclusión: los hallazgos muestran una relación entre perfil lipídico, crecimiento, reserva energética y modulación de las hormonas reguladoras del apetito según el tipo de alimentación.

Differences in Polyamine Content between Human Milk and Infant Formulas.

Human milk is the gold standard for nutrition during the first months of life, but when breastfeeding is not possible, it may be replaced by infant formulas, either partially or totally. Polyamines, which play an important role in intestinal maturation and the development of the immune system, are found both in human milk and infant formulas, the first exogenous source of these compounds for the newborn. The aim of this study was to evaluate the occurrence and evolution of polyamines in human milk during the first semester of lactation and to compare the polyamine content with that of infant formulas. In total, 30 samples of human milk provided by six mothers during the first five months of lactation as well as 15 different types of infant formulas were analyzed using UHPLC-FL. Polyamines were detected in all human milk samples but with great variation among mothers. Spermidine and spermine levels tended to decrease during the lactation period, while putrescine remained practically unchanged. Considerable differences were observed in the polyamine contents and profiles between human milk and infant formulas, with concentrations being up to 30 times lower in the latter. The predominant polyamines in human milk were spermidine and spermine, and putrescine in infant formulas.

Influence of Breastfeeding Factors on Polyamine Content in Human Milk.

The polyamine content of human breast milk, which is the first exogenous source of polyamines for the newborn, can be affected by several factors associated with the mother, the infant, or breastfeeding itself. The aim of this study was to evaluate the influence of different breastfeeding factors on the polyamines found in human milk. For this study, a cohort of 83 mothers was considered for up to 4 months, and a subgroup of 33 mothers were followed during the first six months of breastfeeding. Two breast milk samples were collected at each sampling point (foremilk and hindmilk) and the polyamine content was determined by UHPLC-FL. Polyamine levels varied considerably between the mothers and tended to decrease over time. Putrescine was the minor polyamine, whereas spermidine and spermine contents were very similar. The concentrations of the three polyamines were significantly higher in hindmilk than foremilk (p < 0.001). Spermidine and spermine levels decreased significantly through the lactation progress (p < 0.05). Finally, slightly higher levels of polyamines were observed in the milk of mothers providing partial, rather than full, breastfeeding, although the differences were not significant. The polyamine content in human milk was found to change during a single feed (foremilk versus hindmilk) and as lactation progressed, mainly in response to the specific circumstances of the newborn.

Occurrence of Polyamines in Foods and the Influence of Cooking Processes.

Dietary polyamines are involved in different aspects of human health and play an important role in the prevention of certain chronic conditions such as cardiovascular diseases and diabetes. Different polyamines can be found in all foods in variable amounts. Moreover, several culinary practices have been reported to modify the content and profile of these bioactive compounds in food although experimental data are still scarce and even contradictory. Therefore, the aim of this study was to evaluate the occurrence of polyamines in a large range of foods and to assess the effect of different cooking processes on the polyamine content of a few of them. The highest level of polyamines was found in wheat germ (440.6 mg/kg). Among foods of a plant origin, high levels of total polyamines over 90 mg/kg were determined in mushrooms, green peppers, peas, citrus fruit, broad beans and tempeh with spermidine being predominant (ranging from 54 to 109 mg/kg). In foods of an animal origin, the highest levels of polyamines, above all putrescine (42-130 mg/kg), were found in raw milk, hard and blue cheeses and in dry-fermented sausages. Regarding the influence of different domestic cooking processes, polyamine levels in food were reduced by up to 64% by boiling and grilling but remained practically unmodified by microwave and sous-vide cooking.

Influence of the Type of Breastfeeding and Human Milk Polyamines on Infant Anthropometric Parameters.

Feeding choices in the early months of life are key determinants of growth during infancy. Polyamines participate in cell proliferation and differentiation, and it has also been suggested that polyamine metabolism plays a role in adipogenesis. As the main exogenous source of polyamines in the infant is human milk, the aim of this work was to study if the type of breastfeeding received and the polyamine intake from human milk has an influence on infant anthropometric parameters. A cohort of 78 full-term healthy newborns was followed up until 4 months of age; 55 were fully and 23 partially breastfed. Anthropometric measurements were taken at 2 and 4 months, when human milk samples were also collected for analysis of polyamine content by UHPLC-FL. Fully breastfed infants had a better anthropometric profile than those partially breastfed (p < 0.05). Furthermore, polyamine intake in partially breastfed infants was significantly lower compared to those fully breastfed. However, only two of the 15 anthropometric indicators evaluated (triceps skinfold and mean upper arm circumference) showed a significant inverse association with polyamine content in human milk and intake (p < 0.05). Infant growth and body composition differ according to the type of breastfeeding received. Based on the weak associations between polyamines and anthropometric indicators, it is not possible to conclude the influence of polyamines in infant growth and body composition.

Full Breastfeeding Modifies Anthropometric and Body Composition Indicators in Nursing Mothers.

Background: It has been observed that breastfeeding mobilizes the deposits of fat that accumulate during pregnancy and promotes weight loss through energy expenditure. The purpose of this study was to demonstrate that full breastfeeding (FBF) reduces anthropometric and body composition indicators in women between the 8th and the 16th week postpartum. Methods: In a nonrandom cohort study, 170 mothers at the Hospital Civil de Guadalajara, Guadalajara, México, were enrolled: FBF 74, partial breastfeeding (PBF) 57, and human milk substitutes (HMS) 39. Anthropometric indicators and body composition were measured at the 8th and 16th week postpartum. We performed analysis of variance to compare body composition according to the type of feeding and paired Student's t-test to compare the changes from the 8th to 16th week postpartum. Results: We found that FBF mothers had a trend to lower arm fat area and triceps skinfold than PBF and HMS mothers at 8 and 16 weeks postpartum. We observed a decrease in weight (p = 0.004), weight/age index (p = 0.003), body mass index (p = 0.003), hip circumference (p = 0.037), and lean mass (p = 0.003) from 8 to 16 weeks postpartum in mothers who offered FBF. The mid-upper arm circumference, the arm total area, and their z-score increased in the three feeding groups. Conclusions: Our results show that FBF mothers had some lower adiposity from 8 to 16 weeks postpartum compared with the result observed among PBF mothers and those who utilized HMS.

Appetite-regulating hormones and anthropometric indicators of infants according to the type of feeding.

It has been accepted that satiety- and appetite-stimulating hormones play a role in the regulation of food intake and body composition during and after the lactation stage. Therefore, the purpose was to demonstrate that serum appetite-regulating hormones in infants differ according to anthropometric indicators and type of feeding. In a nonrandom cohort study, 169 mother-newborn dyads whose pregnancy and birth were attended at the Hospital Civil de Guadalajara were enrolled. According to the type of feeding, infants were classified as full breastfeeding (FBF), partial breastfeeding (PBF), and infants receiving human milk substitutes (HMS). Serum concentrations of ghrelin (pg/ml), leptin (ng/ml), peptide YY (pg/ml), and glucagon-like peptide-1 (GLP-1) (pM) were measured. Anthropometric measurements including weight, length, cephalic, arm circumference, tricipital, and subscapular skinfolds were obtained. Weight/age, weight/height, height/age, and BMI Z-score indexes were estimated. We performed one-way ANOVA, unpaired Student's t test, post hoc Tukey test, and Pearson correlation tests. The ANOVA comparison of the three feeding types showed significant differences in most anthropometric indicators (z-scores), especially between infants receiving FBF versus HMS and particularly on indicators of adiposity; no differences were observed in length and cephalic circumference z-scores at 8th and 16th weeks. Further, significant correlations were found between most of the adiposity indicators with ghrelin, leptin, and GLP-1, especially in infants who received FBF. There were differences in anthropometric and body composition parameters among infants receiving FBF, PBF, and HMS. There were significant correlations between body composition indicators with ghrelin, leptin, and GLP-1 mainly in infants receiving FBF.

Concentration of ghrelin and leptin in serum and human milk in nursing mothers according to the type of feeding / Concentración de grelina y leptina en suero y leche humana en madres lactantes según el tipo de alimentación

Objective: we assessed the relationship between serum and human foremilk and hindmilk concentrations of ghrelin and leptin in nursing mothers according to the type of feeding. Methods: this cohort design was carried out on 131 mother-newborn dyads admitted to a physiological puerperium ward. The independent variables were the type of feeding, full breastfeeding (FBF, 56.5%) and partial breastfeeding (PBF, 43.5%). The dependent variables were the concentration of total ghrelin (pg/ml) and leptin (ng/ml) in serum, foremilk and hindmilk at eight and 16 weeks. Fasting blood samples were obtained from the nursing mothers at four months for serum assays. Unpaired Student's t-test, Mann-Whitney U test, Pearson's correlation tests, coefficient of determination and linear regression were used. Results: the concentration of ghrelin and leptin in hindmilk was higher than that of foremilk in both groups at eight and 16 weeks. The concentration of ghrelin and leptin was higher in serum than in foremilk in both groups. These values showed a direct and significant linear correlation with the exception of ghrelin in the FBF group. The serum concentration of leptin in mothers explained 32% of the variance of its concentration in foremilk in the FBF and 13% in the PBF groups. Conclusion: the hindmilk/foremilk gradient suggests an intake regulating mechanism during the fed. The concentration of ghrelin and leptin was higher in the serum than in foremilk and its correlation and determination coefficients could suggest plasma-milk transfer in addition to synthesis regulation by the mammary gland, adipose tissue or other organs

Objetivo: evaluar la relación entre la concentración de suero y la leche materna y la concentración de grelina y leptina en leche materna en madres lactantes según el tipo de alimentación. Métodos: diseño de cohorte realizado en 131 diadas madre-lactante que ingresaron en una sala de puerperio fisiológico. Variables independientes: tipo de alimentación, lactancia materna completa (LMC, 56,5%) y lactancia materna parcial (LMP, 43,5%). Variables dependientes: concentración sérica de grelina total (pg/ml) y leptina (ng/ml), leche humana pre-tetada y pos-tetada a las ocho y 16 semanas. Se utilizaron pruebas no pareadas t de Student, U de Mann-Whitney, correlación de Pearson, coeficiente de determinación y regresión linear. Resultados: la concentración de grelina y leptina en leche humana pre-tetada fue mayor que en leche humana pos-tetada en ambos grupos a las ocho y 16 semanas. La concentración de grelina y leptina fue mayor en suero que en leche humana en ambos grupos; estos valores mostraron una correlación lineal directa y significativa con la excepción de la grelina en el grupo de LMC. La concentración sérica de leptina en las madres explicó el 32% de la varianza de su concentración en leche humana en LMC y el 13% en madres en LMP. Conclusión: el gradiente de leche humana pre-tetada/pos-tetada sugiere un mecanismo de regulación e ingestión de leche. La concentración de grelina y leptina fue mayor en suero que en leche humana y los coeficientes de determinación sugieren una transferencia de suero-leche, además de una regulación de la síntesis por la glándula mamaria, el tejido adiposo u otros órganos

Concentration of ghrelin and leptin in serum and human milk in nursing mothers according to the type of feeding.

INTRODUCTION: Objective: we assessed the relationship between serum and human foremilk and hindmilk concentrations of ghrelin and leptin in nursing mothers according to the type of feeding. Methods: this cohort design was carried out on 131 mother-newborn dyads admitted to a physiological puerperium ward. The independent variables were the type of feeding, full breastfeeding (FBF, 56.5%) and partial breastfeeding (PBF, 43.5%). The dependent variables were the concentration of total ghrelin (pg/ml) and leptin (ng/ml) in serum, foremilk and hindmilk at eight and 16 weeks. Fasting blood samples were obtained from the nursing mothers at four months for serum assays. Unpaired Student's t-test, Mann-Whitney U test, Pearson's correlation tests, coefficient of determination and linear regression were used. Results: the concentration of ghrelin and leptin in hindmilk was higher than that of foremilk in both groups at eight and 16 weeks. The concentration of ghrelin and leptin was higher in serum than in foremilk in both groups. These values showed a direct and significant linear correlation with the exception of ghrelin in the FBF group. The serum concentration of leptin in mothers explained 32% of the variance of its concentration in foremilk in the FBF and 13% in the PBF groups. Conclusion: the hindmilk/foremilk gradient suggests an intake regulating mechanism during the fed. The concentration of ghrelin and leptin was higher in the serum than in foremilk and its correlation and determination coefficients could suggest plasma-milk transfer in addition to synthesis regulation by the mammary gland, adipose tissue or other organs.

INTRODUCCIÓN: Objetivo: evaluar la relación entre la concentración de suero y la leche materna y la concentración de grelina y leptina en leche materna en madres lactantes según el tipo de alimentación. Métodos: diseño de cohorte realizado en 131 diadas madre-lactante que ingresaron en una sala de puerperio fisiológico. Variables independientes: tipo de alimentación, lactancia materna completa (LMC, 56,5%) y lactancia materna parcial (LMP, 43,5%). Variables dependientes: concentración sérica de grelina total (pg/ml) y leptina (ng/ml), leche humana pre-tetada y pos-tetada a las ocho y 16 semanas. Se utilizaron pruebas no pareadas t de Student, U de Mann-Whitney, correlación de Pearson, coeficiente de determinación y regresión linear. Resultados: la concentración de grelina y leptina en leche humana pre-tetada fue mayor que en leche humana pos-tetada en ambos grupos a las ocho y 16 semanas. La concentración de grelina y leptina fue mayor en suero que en leche humana en ambos grupos; estos valores mostraron una correlación lineal directa y significativa con la excepción de la grelina en el grupo de LMC. La concentración sérica de leptina en las madres explicó el 32% de la varianza de su concentración en leche humana en LMC y el 13% en madres en LMP. Conclusión: el gradiente de leche humana pre-tetada/pos-tetada sugiere un mecanismo de regulación e ingestión de leche. La concentración de grelina y leptina fue mayor en suero que en leche humana y los coeficientes de determinación sugieren una transferencia de suero-leche, además de una regulación de la síntesis por la glándula mamaria, el tejido adiposo u otros órganos.

Polyamines in Food.

The polyamines spermine, spermidine, and putrescine are involved in various biological processes, notably in cell proliferation and differentiation, and also have antioxidant properties. Dietary polyamines have important implications in human health, mainly in the intestinal maturation and in the differentiation and development of immune system. The antioxidant and anti-inflammatory effect of polyamine can also play an important role in the prevention of chronic diseases such as cardiovascular diseases. In addition to endogenous synthesis, food is an important source of polyamines. Although there are no recommendations for polyamine daily intake, it is known that in stages of rapid cell growth (i.e., in the neonatal period), polyamine requirements are high. Additionally, de novo synthesis of polyamines tends to decrease with age, which is why their dietary sources acquire a greater importance in an aging population. Polyamine daily intake differs among to the available estimations, probably due to different dietary patterns and methodologies of data collection. Polyamines can be found in all types of foods in a wide range of concentrations. Spermidine and spermine are naturally present in food whereas putrescine could also have a microbial origin. The main polyamine in plant-based products is spermidine, whereas spermine content is generally higher in animal-derived foods. This article reviews the main implications of polyamines for human health, as well as their content in food and breast milk and infant formula. In addition, the estimated levels of polyamines intake in different populations are provided.

Is there gender discrimination in full breastfeeding in Mexico? / ¿Existe discriminación de género en la lactancia materna completa en México?

Objective: differences have been shown between males and females in terms of the prevalence of malnutrition in different parts of the world, which point to discrimination against females, including with respect to full breastfeeding. Therefore, the objective was to show that exclusive breastfeeding is less common for females in a population of medium-low and low socioeconomic strata. Methods: this was a cross-sectional analysis of a sample of 170 mother-infant dyads according to type of feeding (74 full breastfeeding, 57 partial breastfeeding and 39 human milk substitutes) at the Nuevo Hospital Civil de Guadalajara. Dependent variables according to type of feeding: full breastfeeding (exclusive and/or predominant), partial breastfeeding, and human milk substitutes. Independent variables: demographic data, schooling, occupation of mothers and/or parents, and family income. Kruskal-Wallis, Mann-Whitney U and Chi-square tests and odds ratio were used. Results: the probability of full breastfeeding was 3.8 times lower in females than in males. In a non-significant way, the likelihood of full breastfeeding was lower than that of partial breastfeeding, and full breastfeeding was lower than the combination of partial breastfeeding and human milk substitutes in females. Full breastfeeding and partial breastfeeding were lower than human milk substitutes, and partial breastfeeding was lower than human milk substitutes in females. Conclusion: there is a differentiated character in the privilege of full breastfeeding; it is four times lower in females than in males

Objetivo: se han observado diferencias entre niñas y varones en la prevalencia de desnutrición en diferentes partes del mundo, lo que apunta a la discriminación contra las niñas, incluso con respecto a la lactancia materna completa. El objetivo fue mostrar que la lactancia completa es menos común en las niñas en una población de estratos socioeconómicos medio-bajo y bajo. Métodos: se realizó un análisis transversal de una muestra de 170 díadas madre-lactante según el tipo de alimentación (74 de lactancia completa, 57 de lactancia parcial y 39 sucedáneos de la leche humana) en el Nuevo Hospital Civil de Guadalajara. Variables dependientes según el tipo de alimentación: lactancia completa (exclusiva y/o predominante), lactancia parcial y sucedáneos de leche humana. Variables independientes: datos demográficos, escolaridad, ocupación de madres y/o padres e ingresos familiares. Se utilizaron pruebas de Kruskal-Wallis, Mann-Whitney U y Chi-cuadrado y razón de momios. Resultados: la probabilidad de lactancia materna completa fue 3,8 veces menor en niñas que en varones. De manera no significativa, la probabilidad de lactancia completa fue menor que la de lactancia parcial y la frecuencia de lactancia completa fue menor que la combinación de lactancia parcial y sucedáneos de leche humana en niñas. La frecuencia de lactancia completa y lactancia parcial fue menor que los sucedáneos de leche humana y la lactancia parcial fue menos frecuente que los sucedáneos de leche humana en niñas. Conclusión: hay un carácter diferenciado en el privilegio de ofrecer lactancia materna completa. Es cuatro veces menor en las niñas que en varones

Relationship of anthropometric indexes and indicators of body composition by arm anthropometry on hospitalized pediatric patients / Relación entre índices antropométricos e indicadores de composición corporal por antropometría de brazo en pacientes pediátricos hospitalizados

Introduction: the purpose of this study was to evaluate the relationship of arm anthropometric indicators with direct indicators of nutritional status in hospitalized pediatric patients. Methods: an analytical cross-sectional study with 760 patients hospitalized in the Pediatric Division of the Nuevo Hospital Civil de Guadalajara during 2014 was used. The anthropometric indices were weight/length, weight/height, weight/age, length/age, height/age, head circumference/age and body mass index (BMI)/age. The arm indicators were mid-upper arm circumference (MUAC), total arm area (TAA), arm muscle area (AMA), arm fat area (AFA) and fat percentage (FP). The ANOVA, Kruskall-Wallis, Mann-Whitney U and Pearson's correlation tests and also odds ratios were used to identify the probability of nutritional status impairment. Results: the prevalence of acute and chronic malnutrition was higher in infants (31% and 30%, respectively). With arm areas (TAA, AMA, AFA), the risk of deficit (≤ -2DE) was higher in infants and early preschoolers (p < 0.001). The correlation between the anthropometric indexes and the arm areas was direct and significant (p < 0.001). The BMI variability was explained in 68% by the AMA, AFA, and FP (p < 0.001); the variability of the height/age index was also explained in 34% by the AMA and AFA (p < 0.001). Conclusion: it is possible to diagnose both a chronic and acute deficit using the indirect indicators of the arm, while the body mass index only reflects an acute deficit. Therefore, arm areas would be more useful indicators in the assessment of nutritional status and the diagnosis of chronic-acute malnutrition in hospitalized pediatric patients

Introducción: el objetivo de este estudio fue evaluar la relación de los indicadores antropométricos de brazo con los indicadores directos del estado de nutrición en pacientes pediátricos hospitalizados. Métodos: se utilizó un estudio transversal analítico con 760 pacientes ingresados en la División de Pediatría del Nuevo Hospital Civil de Guadalajara durante 2014. Los índices antropométricos fueron peso/longitud, peso/altura, peso/edad, longitud/edad, altura/edad, circunferencia cefálica e IMC. Los indicadores del brazo fueron circunferencia media del brazo (CMB), área total del brazo (ATB), área muscular del brazo (AMB), área grasa del brazo (AGB) y porcentaje de grasa. Se utilizaron las pruebas de ANOVA, Kruskall-Wallis, U de Mann-Whitney, correlación de Pearson y razón de momios para identificar la probabilidad de deterioro del estado nutricional. Resultados: la prevalencia de desnutrición aguda y crónica fue mayor en lactantes (31% y 30%, respectivamente). Con las áreas del brazo (ATB, AMB, AFA), el riesgo de déficit (≤ -2 DE) fue mayor en lactantes y preescolares tempranos (p < 0,001). La correlación entre los índices antropométricos y las áreas del brazo fue directa y significativa (p < 0,001). La variabilidad del IMC fue explicada en un 68% por AMB, AGB y porcentaje de grasa (p < 0,001); la variabilidad del índice de talla/edad también fue explicada en un 34% por AMB y AGB (p < 0,001). Conclusión: es posible diagnosticar el déficit crónico y agudo utilizando los indicadores indirectos del brazo, mientras que el IMC solo refleja un déficit agudo. Las áreas de brazo serían indicadores más útiles en el diagnóstico de desnutrición crónica-aguda en pacientes pediátricos hospitalizados

Relationship of anthropometric indexes and indicators of body composition by arm anthropometry on hospitalized pediatric patients.

INTRODUCTION: Introduction: the purpose of this study was to evaluate the relationship of arm anthropometric indicators with direct indicators of nutritional status in hospitalized pediatric patients. Methods: an analytical cross-sectional study with 760 patients hospitalized in the Pediatric Division of the Nuevo Hospital Civil de Guadalajara during 2014 was used. The anthropometric indices were weight/length, weight/height, weight/age, length/age, height/age, head circumference/age and body mass index (BMI)/age. The arm indicators were mid-upper arm circumference (MUAC), total arm area (TAA), arm muscle area (AMA), arm fat area (AFA) and fat percentage (FP). The ANOVA, Kruskall-Wallis, Mann-Whitney U and Pearson's correlation tests and also odds ratios were used to identify the probability of nutritional status impairment. Results: the prevalence of acute and chronic malnutrition was higher in infants (31% and 30%, respectively). With arm areas (TAA, AMA, AFA), the risk of deficit (≤ -2DE) was higher in infants and early preschoolers (p < 0.001). The correlation between the anthropometric indexes and the arm areas was direct and significant (p < 0.001). The BMI variability was explained in 68% by the AMA, AFA, and FP (p < 0.001); the variability of the height/age index was also explained in 34% by the AMA and AFA (p < 0.001). Conclusion: it is possible to diagnose both a chronic and acute deficit using the indirect indicators of the arm, while the body mass index only reflects an acute deficit. Therefore, arm areas would be more useful indicators in the assessment of nutritional status and the diagnosis of chronic-acute malnutrition in hospitalized pediatric patients.

INTRODUCCIÓN: Introducción: el objetivo de este estudio fue evaluar la relación de los indicadores antropométricos de brazo con los indicadores directos del estado de nutrición en pacientes pediátricos hospitalizados. Métodos: se utilizó un estudio transversal analítico con 760 pacientes ingresados en la División de Pediatría del Nuevo Hospital Civil de Guadalajara durante 2014. Los índices antropométricos fueron peso/longitud, peso/altura, peso/edad, longitud/edad, altura/edad, circunferencia cefálica e IMC. Los indicadores del brazo fueron circunferencia media del brazo (CMB), área total del brazo (ATB), área muscular del brazo (AMB), área grasa del brazo (AGB) y porcentaje de grasa. Se utilizaron las pruebas de ANOVA, Kruskall-Wallis, U de Mann-Whitney, correlación de Pearson y razón de momios para identificar la probabilidad de deterioro del estado nutricional. Resultados: la prevalencia de desnutrición aguda y crónica fue mayor en lactantes (31% y 30%, respectivamente). Con las áreas del brazo (ATB, AMB, AFA), el riesgo de déficit (≤ -2 DE) fue mayor en lactantes y preescolares tempranos (p < 0,001). La correlación entre los índices antropométricos y las áreas del brazo fue directa y significativa (p < 0,001). La variabilidad del IMC fue explicada en un 68% por AMB, AGB y porcentaje de grasa (p < 0,001); la variabilidad del índice de talla/edad también fue explicada en un 34% por AMB y AGB (p < 0,001). Conclusión: es posible diagnosticar el déficit crónico y agudo utilizando los indicadores indirectos del brazo, mientras que el IMC solo refleja un déficit agudo. Las áreas de brazo serían indicadores más útiles en el diagnóstico de desnutrición crónica-aguda en pacientes pediátricos hospitalizados.

Is there gender discrimination in full breastfeeding in Mexico?

INTRODUCTION: Objective: differences have been shown between males and females in terms of the prevalence of malnutrition in different parts of the world, which point to discrimination against females, including with respect to full breastfeeding. Therefore, the objective was to show that exclusive breastfeeding is less common for females in a population of medium-low and low socioeconomic strata. Methods: this was a cross-sectional analysis of a sample of 170 mother-infant dyads according to type of feeding (74 full breastfeeding, 57 partial breastfeeding and 39 human milk substitutes) at the Nuevo Hospital Civil de Guadalajara. Dependent variables according to type of feeding: full breastfeeding (exclusive and/or predominant), partial breastfeeding, and human milk substitutes. Independent variables: demographic data, schooling, occupation of mothers and/or parents, and family income. Kruskal-Wallis, Mann-Whitney U and Chi-square tests and odds ratio were used. Results: the probability of full breastfeeding was 3.8 times lower in females than in males. In a non-significant way, the likelihood of full breastfeeding was lower than that of partial breastfeeding, and full breastfeeding was lower than the combination of partial breastfeeding and human milk substitutes in females. Full breastfeeding and partial breastfeeding were lower than human milk substitutes, and partial breastfeeding was lower than human milk substitutes in females. Conclusion: there is a differentiated character in the privilege of full breastfeeding; it is four times lower in females than in males.

INTRODUCCIÓN: Objetivo: se han observado diferencias entre niñas y varones en la prevalencia de desnutrición en diferentes partes del mundo, lo que apunta a la discriminación contra las niñas, incluso con respecto a la lactancia materna completa. El objetivo fue mostrar que la lactancia completa es menos común en las niñas en una población de estratos socioeconómicos medio-bajo y bajo. Métodos: se realizó un análisis transversal de una muestra de 170 díadas madre-lactante según el tipo de alimentación (74 de lactancia completa, 57 de lactancia parcial y 39 sucedáneos de la leche humana) en el Nuevo Hospital Civil de Guadalajara. Variables dependientes según el tipo de alimentación: lactancia completa (exclusiva y/o predominante), lactancia parcial y sucedáneos de leche humana. Variables independientes: datos demográficos, escolaridad, ocupación de madres y/o padres e ingresos familiares. Se utilizaron pruebas de Kruskal-Wallis, Mann-Whitney U y Chi-cuadrado y razón de momios. Resultados: la probabilidad de lactancia materna completa fue 3,8 veces menor en niñas que en varones. De manera no significativa, la probabilidad de lactancia completa fue menor que la de lactancia parcial y la frecuencia de lactancia completa fue menor que la combinación de lactancia parcial y sucedáneos de leche humana en niñas. La frecuencia de lactancia completa y lactancia parcial fue menor que los sucedáneos de leche humana y la lactancia parcial fue menos frecuente que los sucedáneos de leche humana en niñas. Conclusión: hay un carácter diferenciado en el privilegio de ofrecer lactancia materna completa. Es cuatro veces menor en las niñas que en varones.

Serum concentration of appetite-regulating hormones of mother-infant dyad according to the type of feeding.

Satiety and appetite-stimulating hormones play a role in the regulation of food intake. Breastfed infants may have a different profile of serum appetite-regulating hormones than formula-fed infants. We propose to demonstrate that the serum concentration of appetite regulatory hormones differs according to the type of feeding and that there is a correlation between the serum concentrations of these hormones in mothers and in infants at 4 months of age. In a cross-sectional analysis, 167 mother-newborn dyads at the Hospital Civil de Guadalajara were enrolled: 74 full breastfeeding (FBF), 56 partial breastfeeding (PBF), and 37 receiving human milk substitutes (HMS). Serum levels of ghrelin (pg/ml), leptin (ng/ml), peptide YY (pg/ml), and glucagon-like peptide-1 (GLP-1) (pM) were measured. We performed one-way analysis of variance, unpaired Student t test, post hoc Tukey test, and Pearson correlation. The total sample at 16 weeks postpartum included 167 dyads. The mean age was 16 ± 1 weeks. The concentrations of GLP-1 (pM) and peptide YY (pg/ml) were higher in the FBF group (42.6 and 442.9) than in the HMS group (35.2 and 401.9), respectively, p = 0.046 and p = 0.056. And, the FBF group had higher correlation coefficients of ghrelin (r = 0.411 vs. 0.165), GLP-1 (r = 0.576 vs. 0.407), and peptide YY (r = 0.218 vs. 0.067), respectively, than the HMS group. The concentrations of GLP-1 and peptide YY were higher in the FBF group when compared with the HMS group. Mother-infant dyads fed by FBF had more significant direct correlations of appetite-regulating hormones than those who received HMS.

Socio-demographic variables and underlying pathologies associated to nutritional status of hospitalized children in a secondary-tertiary level hospital.

OBJECTIVE: the purpose was to evaluate the nutritional status in hospitalized children according to their socio-demographic variables, underlying pathology and based on hospital length of stay. METHODS: seven-hundred and sixty-three hospitalized patients of the Civil Hospital of Guadalajara Dr. Juan I. Menchaca were included in a cross-sectional study. The following anthropometric indices were taken: weight/length, weight/height, weight/age, length/age, height/age, head circumference/age and BMI/age. Data of socio-demographic variables and underlying pathology were also obtained. Student's t-test, Chi-squared test, ANOVA with post-hoc tests and logistic regression were used to identify the likelihood of risk of malnutrition. RESULTS: subjects were divided according to their hospital length of stay in lower than seven days and seven days or more. At the time of admission, children with stay of seven days or more showed a greater deficit in the height/age index (OR = 1.77 [95% CI 1.16-2.7], p = 0.007), head circumference (OR = 2.68 [95% CI 1.5-4.7], p ≤ 0.001) and BMI (OR = 2.9 [95% CI 1.9-4.4], p ≤ 0.001). Males had higher risk of moderate/severe malnutrition (OR = 1.87 [95% CI 1.22-2.85], p = 0.003) and higher deficit in head circumference (OR = 1.89 [95% CI 1.06-3.37], p = 0.029). Infants with gastrointestinal and respiratory problems had higher frequency of malnutrition at the time of admission than did those with other pathologies (p < 0.001). CONCLUSION: the pathological disease at time of admission and longer hospital length of stay increased the likelihood of malnutrition in male infants and preschool-aged children. There were demographic and educational risk factors in the home environment that could influence acute and chronic malnutrition.

Socio-demographic variables and underlying pathologies associated to nutritional status of hospitalized children in a secondary-tertiary level hospital / Variables sociodemográficas y patologías asociadas al estado nutricional de niños hospitalizados en una unidad de segundo-tercer nivel

Objective: the purpose was to evaluate the nutritional status in hospitalized children according to their socio-demographic variables, underlying pathology and based on hospital length of stay. Methods: seven-hundred and sixty-three hospitalized patients of the Civil Hospital of Guadalajara Dr. Juan I. Menchaca were included in a cross-sectional study. The following anthropometric indices were taken: weight/length, weight/height, weight/age, length/age, height/age, head circumference/age and BMI/age. Data of socio-demographic variables and underlying pathology were also obtained. Student's t-test, Chi-squared test, ANOVA with post-hoc tests and logistic regression were used to identify the likelihood of risk of malnutrition. Results: subjects were divided according to their hospital length of stay in lower than seven days and seven days or more. At the time of admission, children with stay of seven days or more showed a greater deficit in the height/age index (OR = 1.77 [95% CI 1.16-2.7], p = 0.007), head circumference (OR = 2.68 [95% CI 1.5-4.7], p ≤ 0.001) and BMI (OR = 2.9 [95% CI 1.9-4.4], p ≤ 0.001). Males had higher risk of moderate/ severe malnutrition (OR = 1.87 [95% CI 1.22-2.85], p = 0.003) and higher deficit in head circumference (OR = 1.89 [95% CI 1.06-3.37], p = 0.029). Infants with gastrointestinal and respiratory problems had higher frequency of malnutrition at the time of admission than did those with other pathologies (p < 0.001). Conclusion: the pathological disease at time of admission and longer hospital length of stay increased the likelihood of malnutrition in male infants and preschool-aged children. There were demographic and educational risk factors in the home environment that could influence acute and chronic malnutrition

Objetivo: el propósito fue evaluar el estado nutricio en niños hospitalizados de acuerdo a variables sociodemográficas, patología de ingreso y días de estancia hospitalaria. Métodos: en estudio transversal analítico se incluyeron 763 pacientes hospitalizados en el Hospital Civil de Guadalajara Dr. Juan I. Menchaca. Se estimaron los índices: peso/edad, longitud/edad, estatura/edad, peso/talla, IMC y circunferencia cefálica/edad. Se obtuvieron variables sociodemográficas y el diagnóstico de ingreso. Se utilizaron las pruebas t de Student, Chi-cuadrado, ANOVA y post-hoc y regresión logística para identificar la probabilidad de riesgo de mala nutrición. Resultados: los participantes se dividieron de acuerdo a la duración de la estancia hospitalaria en menor de siete días e igual o mayor a siete días. Al ingreso, los niños con estancia de siete días o mayor mostraron déficit de los índices talla/edad (RM = 1,77 [IC 95% 1,16-2,7], p = 0,007), circunferencia cefálica (RM = 2,68 [IC 95% 1,5-4,7], p ≤ 0,001) e IMC (RM = 2,9 [IC 95% 1,9-4,4], p ≤ 0,001). Los varones mostraron mayor riesgo de desnutrición moderada o grave (RM = 1,87 [IC 95% 1,22-2,85], p = 0,003) y déficit en circunferencia cefálica (RM = 1,89 [IC 95% 1,06-3,37], p = 0,029). Los lactantes con problemas gastrointestinales y respiratorios tuvieron mayor frecuencia de desnutrición al ingreso hospitalario que aquellos con otras patologías (p < 0,001). Conclusión: la patología al momento del ingreso hospitalario y la estancia más prolongada aumentaron la probabilidad de desnutrición en lactantes varones y en preescolares. Hay factores de riesgo demográfico y educacional en la familia que podrían influir en la frecuencia de desnutrición aguda y/o crónica

Risk of malnutrition of hospitalized children in a university public hospital.

OBJECTIVE: The study aimed to demonstrate that the duration of hospitalization has a significant effect on the nutritional status of children treated in a university hospital. METHODS: A longitudinal study was conducted during 2014, with a non-random sampling site concentration in children from birth to 19 years who were admitted to the hospital in the past 24 hours and who met the inclusion criteria and had signed informed consent. Upon entering, at 7 days, and at discharge, anthropometric indices, including weight/age, height/age, weight/height, BMI/age, head circumference/age, triceps and subscapular skin folds, and fat percentage, were obtained. Student's t-test, U Mann-Whitney, ANOVA, chi square, Wilcoxon, and odds ratios were used to analyze the data. RESULTS: In total, 206 patients were included: 40% infants, 25% preschoolers, 15% schoolchildren, and 20% teenagers. Infants had a significant improvement from admission to discharge in the indices weight/length (p = 0.042) and BMI (p = 0.002); adolescents showed decreased BMI from admission to discharge from the hospital (p = 0.05). Patients with longer hospitalization (more than 10 days) had an increased deficit in anthropometric indices at admission (p < 0.05). Infants had a higher risk of deficit in the BMI index and height/age than preschoolers, schoolchildren, and adolescents between admission and discharge. CONCLUSION: When the nutritional condition of a child was critical at admission, the child remained hospitalized significantly longer. Infants come under the age group most vulnerable to malnutrition and require greater monitoring of nutritional status during hospitalization.

Risk of malnutrition of hospitalized children in a university public hospital / Riesgo de desnutrición en niños hospitalizados en un hospital público universitario

Objective: The study aimed to demonstrate that the duration of hospitalization has a significant effect on the nutritional status of children treated in a university hospital. Methods: A longitudinal study was conducted during 2014, with a non-random sampling site concentration in children from birth to 19 years who were admitted to the hospital in the past 24 hours and who met the inclusion criteria and had signed informed consent. Upon entering, at 7 days, and at discharge, anthropometric indices, including weight/age, height/age, weight/height, BMI/age, head circumference/age, triceps and subscapular skin folds, and fat percentage, were obtained. Student’s t-test, U Mann-Whitney, ANOVA, chi square, Wilcoxon, and odds ratios were used to analyze the data. Results: In total, 206 patients were included: 40% infants, 25% preschoolers, 15% schoolchildren, and 20% teenagers. Infants had a significant improvement from admission to discharge in the indices weight/length (p = 0.042) and BMI (p = 0.002); adolescents showed decreased BMI from admission to discharge from the hospital (p = 0.05). Patients with longer hospitalization (more than 10 days) had an increased deficit in anthropometric indices at admission (p < 0.05). Infants had a higher risk of deficit in the BMI index and height/age than preschoolers, schoolchildren, and adolescents between admission and discharge. Conclusion: When the nutritional condition of a child was critical at admission, the child remained hospitalized significantly longer. Infants come under the age group most vulnerable to malnutrition and require greater monitoring of nutritional status during hospitalization (AU)

Objetivo: demostrar que la duración de la hospitalización tiene un efecto significativo sobre el estado nutricional de niños internados en un hospital para población general. Métodos: estudio longitudinal llevado a cabo durante 2014 en niños con edades comprendidas desde el nacimiento hasta los 19 años, ingresados en un hospital público en las últimas 24 horas. Al ingreso, a los 7 días y al alta hospitalaria se obtuvieron los índices antropométricos peso/edad, talla/edad, peso/talla, IMC/edad, circunferencia cefálica/edad, pliegues cutáneos tricipital y subescapular y el porcentaje de grasa. Para el análisis de datos se utilizaron las pruebas t de Student, U Mann-Whitney, ANOVA, Chi-cuadrado, Wilcoxon y razón de momios. Resultados: se incluyeron 206 pacientes: 40% lactantes, 25% preescolares, 15% escolares y 20% adolescentes. Los lactantes tuvieron una mejoría significativa desde el ingreso al alta en los índices peso/talla (p = 0,042) y el IMC (p = 0,002); los adolescentes mostraron una disminución del IMC desde el ingreso hasta el alta del hospital (p = 0,05). Hubo mayor déficit en los índices antropométricos al ingreso en pacientes con una hospitalización superior a 10 días (p < 0,05). Entre el ingreso y el alta, los lactantes tuvieron un riesgo mayor de déficit en el índice talla/edad y en el IMC que los niños preescolares, escolares y adolescentes. Conclusión: cuando la condición nutricia del niño fue crítica al ingreso, permaneció hospitalizado por un periodo significativamente más largo. Los lactantes fueron el grupo etario más vulnerable a la desnutrición y requieren de mayor vigilancia del estado nutricio y la alimentación durante la hospitalización (AU)