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.

Percentiles de peso, talla e índice de masa corporal de escolares de Mendoza. Comparación con la referencia de la Organización Mundial de la Salud / Body mass index, weight, and height percentiles in school-aged children from Mendoza. A comparison with the WHO reference

Introducción. La Organización Mundial de la Salud (OMS) recomienda el uso de tablas de referencia para monitorear el crecimiento y estado nutricional de niños, niñas y adolescentes. El peso corporal, la talla y el índice de masa corporal (IMC) son las variables más utilizadas. El presente trabajo tiene como objetivos estimar los percentiles de peso, talla e IMC de escolares (2009-2011) residentes en el departamento San Rafael (Mendoza) y compararlos con la referencia internacional de la Organización Mundial de la Salud, a fin de establecer su pertinencia para la evaluación del crecimiento y estado nutricional de dicha población. Población y métodos. Se realizó un estudio antropométrico transversal en 3448 escolares de entre 4,00 y 13,49 años de edad. Se utilizó el programa LMS ChartMarker Pro para calcular los valores percentilares de peso/edad, talla/edad e IMC/edad, por sexo y edad, y se compararon con las curvas de la OMS. Además, se calcularon diferencias porcentuales (D%) para estimar las diferencias y su significación estadística mediante prueba de Wilcoxon. Resultados. La población de San Rafael mostró, en varones y mujeres, valores percentilares superiores de peso e IMC (D% ≈7 % y 9 %, respectivamente), y menores de talla (D% ≈0,8 %) que los de la OMS (p <0,05). Conclusión. Las diferencias encontradas alertan sobre el empleo de la referencia OMS en la población escolar de San Rafael, ya que sobreestimaría las prevalencias de sobrepeso, obesidad y desnutrición crónica, y subestimaría la de desnutrición aguda y global. Esta situación resalta la importancia de contar con una referencia local.

Introduction. The World Health Organization (WHO) recommends the use of reference tables to monitor the growth pattern and nutritional status of children and adolescents. Body mass index (BMI), weight, and height are the most commonly used variables. The objective of this study was to estimate the BMI, weight, and height percentiles for school-aged children (2009-2011) living in the department of San Rafael (Mendoza) and compare them to the international World Health Organization reference to establish their relevance for the evaluation of the growth pattern and nutritional status of this population. Population and methods. A cross-sectional anthropometric study was conducted in 3448 school-aged children aged 4.00 to 13.49 years. The LMS ChartMarker Pro software was used to estimate the BMI- for-age, weight-for-age, and height-for-age percentiles, by sex and age, and they were compared with the WHO curves. Besides, percentage differences (%D) were calculated to estimate the differences and their statistical significance using the Wilcoxon test. Results. The population of boys and girls in San Rafael showed higher weight and BMI (%D ≈ 7% and 9%, respectively) percentiles, and lower height (%D ≈ 0.8%) values than WHO reference (p < 0.05). Conclusion. The differences found warn about the use of the WHO reference in the school-aged population of San Rafael since it would overestimate the prevalence of overweight, obesity, and chronic malnutrition and underestimate the prevalence of acute and global malnutrition. This situation highlights the importance of having a local reference resource

Body mass index, weight, and height percentiles in school-aged children from Mendoza. A comparison with the WHO reference. / Percentiles de peso, talla e índice de masa corporal de escolares de Mendoza. Comparación con la referencia de la Organización Mundial de la Salud.

Introduction. The World Health Organization (WHO) recommends the use of reference tables to monitor the growth pattern and nutritional status of children and adolescents. Body mass index (BMI), weight, and height are the most commonly used variables. The objective of this study was to estimate the BMI, weight, and height percentiles for school-aged children (2009-2011) living in the department of San Rafael (Mendoza) and compare them to the international World Health Organization reference to establish their relevance for the evaluation of the growth pattern and nutritional status of this population. Population and methods. A cross-sectional anthropometric study was conducted in 3448 school-aged children aged 4.00 to 13.49 years. The LMS ChartMarker Pro software was used to estimate the BMIfor-age, weight-for-age, and height-for-age percentiles, by sex and age, and they were compared with the WHO curves. Besides, percentage differences (%D) were calculated to estimate the differences and their statistical significance using the Wilcoxon test. Results. The population of boys and girls in San Rafael showed higher weight and BMI (%D ≈ 7% and 9%, respectively) percentiles, and lower height (%D ≈ 0.8%) values than WHO reference (p < 0.05). Conclusion. The differences found warn about the use of the WHO reference in the school-aged population of San Rafael since it would overestimate the prevalence of overweight, obesity, and chronic malnutrition and underestimate the prevalence of acute and global malnutrition. This situation highlights the importance of having a local reference resource.

Introducción. La Organización Mundial de la Salud (OMS) recomienda el uso de tablas de referencia para monitorear el crecimiento y estado nutricional de niños, niñas y adolescentes. El peso corporal, la talla y el índice de masa corporal (IMC) son las variables más utilizadas. El presente trabajo tiene como objetivos estimar los percentiles de peso, talla e IMC de escolares (2009-2011) residentes en el departamento San Rafael (Mendoza) y compararlos con la referencia internacional de la Organización Mundial de la Salud, a fin de establecer su pertinencia para la evaluación del crecimiento y estado nutricional de dicha población. Población y métodos. Se realizó un estudio antropométrico transversal en 3448 escolares de entre 4,00 y 13,49 años de edad. Se utilizó el programa LMS ChartMarker Pro para calcular los valores percentilares de peso/edad, talla/edad e IMC/edad, por sexo y edad, y se compararon con las curvas de la OMS. Además, se calcularon diferencias porcentuales (D%) para estimar las diferencias y su significación estadística mediante prueba de Wilcoxon. Resultados. La población de San Rafael mostró, en varones y mujeres, valores percentilares superiores de peso e IMC (D% ≈7 % y 9 %, respectivamente), y menores de talla (D% ≈0,8 %) que los de la OMS (p <0,05). Conclusión. Las diferencias encontradas alertan sobre el empleo de la referencia OMS en la población escolar de San Rafael, ya que sobreestimaría las prevalencias de sobrepeso, obesidad y desnutrición crónica, y subestimaría la de desnutrición aguda y global. Esta situación resalta la importancia de contar con una referencia local.

Changes in the prevalence of undernutrition, overweight and obesity in children and adolescents from Buenos Aires, Mendoza, and Misiones provinces (Argentina) over the last two decades.

OBJECTIVES: The aim of this study was to determine changes in the prevalence of undernutrition, overweight and obesity in Argentine children and adolescents over the last two decades, and analyze their relationship with family socioeconomic conditions. METHODS: We compared data in two cross-sectional studies (C) of schoolchildren (n: 4971) aged 4 to 13 years from three provinces: Buenos Aires, Mendoza and Misiones. C1 was carried out between 2005 and 2009 and C2 between 2010 and 2019. Anthropometric (body weight, height, triceps and subscapular skinfolds) and socioeconomic data of both studies were obtained in the same schools by the same investigators, using a similar methodology. The prevalence of nutritional status and the frequency of family socioeconomic conditions were calculated by province and C. Data were analyzed by chi square test, categorical principal component analysis and generalized linear model. RESULTS: The prevalence of undernutrition decreased in C2 in Buenos Aires and Misiones and remained constant in Mendoza. At the same time, the prevalence of overweight and obesity increased in the three provinces, around 13% in Buenos Aires and 9% in Mendoza and Misiones. Similarly, fat mass increased in C2. Undernutrition was associated with inadequate family socioeconomic conditions only in C1. CONCLUSIONS: This 14-year follow-up study shows a decreasing trend in the prevalence of undernutrition and an increasing trend in the prevalence of overweight, obesity, and fat mass in the child and adolescent population of Argentina. Also, a marked deterioration in family socioeconomic conditions was found, but its relationship with the changes in nutritional status remains to be elucidated.

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)

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)

Decrease of external skeletal robustness (Frame Index) between two cohorts of school children living in Puerto Madryn, Argentina at the beginning of the 21st century.

Background: It has been shown that modern life style with reduced physical activity can lead to lower bone accumulation. Also a decline trend in external skeletal robustness in children and young adolescents, measured by the Frame Index (FI), seems to have a parallel trend with the increase in overweight and obesity. Based on these findings we estimate that likely, the FI should be changed after a decade in the Argentinean population as well as in others population of the world. Thereby, the aim of the present study was to describe, using the FI, the pattern of external skeletal robustness in school children aged 6-14 years from two cohorts of Argentina (Puerto Madryn, Chubut) and to compare them with the European reference (Czech Republic, Germany, Poland and Russia). Methods: Elbow breadth and height of Puerto Madryn school children were collected in two cross-sectional studies conducted between 2001-2006 (cohort 1 = C1) and 2014-2016 (cohort 2 = C2). Percentiles (P) values, for males and females, from C1 and C2 were calculated combining the LMS-method and its extension. A t-test has been used to compare, by age and sex, the FI values between the Argentinean cohorts and the European reference (ER). Then, in order to know the percentage of the variation of the percentiles values between cohorts, as well as with ER, percent differences between means (PDM%) were employed. Results: FI from Argentinean cohorts differed significantly from ER. Even more, C2 was not only smaller than ER, but also than C1. In males, C1-C2 showed significant differences at 6-8, 11 and 12 years and in females at all ages. Then, respect to ER each Argentinean cohort showed significant differences in males of C1 at 6, 12-14 years and in females at 6 and 11-14 years; and of C2, in both sexes, from 6 to 14 years. The PDM% values for elbow breadth of male were negative in ER-C1 in all percentiles analyzed; in ER-C2 positive (P3 and P50) and negative (P97) and C1-C2 recorded positive values. In females, elbow breadth showed negative values for ER-C1 (P50 and P97), and positive for the remaining values. Finally, height registered, in both sexes, negative values in ER-C1 (except P97 in females), ER-C2 and C1-C2. Conclusions: After ten years of the first study carried on in Puerto Madryn, school children show a negative trend in the external skeletal robustness. Additionally, the children of both Argentinean cohorts have lower values compared to the European reference, and mainly the actual cohort. This situation would be explained, in part, by the progressive increase over time of overweight and obesity as consequence, among others, of the change in the quantity and/or quality of the food that children have access to and with the physical activity they do at school and outside.

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.

Menarca y estado nutricional en niñas del periurbano de la ciudad de La Plata, Argentina / Menarche and nutritional status in peri-urban girls of La Plata city, Argentina

La menarca constituye un hito madurativo importante. A escala mundial ocurre, en promedio, a los 12,5 años y está sujeta a factores genéticos y/o ambientales. El objetivo fue analizar, en niñas residentes en la periferia urbana de La Plata: a) la edad mediana de menarca y b) si el estado nutricional y la distribución adiposa influyen en la edad de ocurrencia de menarca. Se evaluaron, durante los ciclos 2014-2017, en 657 niñas de 10-14 años: presencia(P)/ausencia(A) de menarca, peso, talla y pliegues subcutáneos tricipital y subescapular. Se determinaron: edad mediana de menarca (EM) según método status quo y regresión logística; estado nutricional -desnutrición, exceso ponderal y normonutrición- empleando como referencia y puntos de corte a la OMS; y distribución de adiposidad según índice subescapular/tricipital, considerando valores >1 indicativos de adiposidad centralizada. Se calcularon en general y por estado nutricional la EM y las prevalencias de ocurrencia comparándose mediante Chi2. La menarca estuvo presente en el 44,10% de las niñas con EM de 12,13 años. Alrededor del 54% de las niñas se mantuvo dentro de los límites normales (P: 41,20%; EM: 12,28 años) y el 45,70% estaban desnutridas; de estas 4,90% mostraron desnutrición debido a la baja estatura (P: 25,00%; MS: 13,40 años) y 40,80% tenían exceso de peso (P: 50,40%; MS: 11,78 años). El 32,72% de las niñas tenían adiposidad centralizada (P: 59,10%; EM: 11,79 años). Los resultados permiten concluir que el estado nutricional influye en la edad mediana de ocurrencia de la menarca, la cual es mayor en las niñas desnutridas y menor en las niñas con exceso ponderal. La disposición centralizada de la adiposidad favorece la presencia de menarca(AU)

Menarche is an important maturation milestone. It normally occurs at an average age of 12.5 years and is influenced by genetic and/or environmental factors. The aim of this study was to analyze in girls residing at suburbs of La Plata city a) the median age of menarche; b) if nutritional status and fat distribution have any influence in the age of menarche. During years 2014 to 2017, 657 girls aged between 10 and 14 years(y) were surveyed, determining: presence(P)/absence(A) of menarche, weight, height, and tricipital and subscapular skinfolds. It was measured: median age of menarche (MA) according to the status quo method and logistic regression; nutritional status -undernutrition, excess weight, and normonutrition- using WHO as a reference and their cut-off points; and the distribution of adiposity through the use of subscapular/tricipital index, considering values >1 an indicative of centralized adiposity. The median age of menarche was calculated both in the general sample and by nutritional status; general and age-prevalence of menarche were compared by Chi2. Menarche was present in 44.10% of the girls with MS of 12.13 years. About 54% of the population stayed within normal limits (P: 41.20%; MS: 12.28 years) and 45.70% were malnourished; of these 4.90% showed malnutrition due to short stature (P: 25.00 %; MS: 13.40 years) and 40.80% had weight excess (P: 50.40%; MS: 11.78 years). 32.72% of the girls had centralized adiposity (P: 59.10%; MS: 11.79 years). These results allow us to conclude that nutritional status influences the median age of menarche: it is higher in undernourished girls and lower in those with weight excess. Centralized disposition of adiposity promotes the presence of menarche(AU)

Percentilos de referencia de la circunferencia y de las áreas muscular y grasa del brazo para la población infantojuvenil argentina (4-14 años) / Reference percentiles for mid-upper arm circumference, upper arm muscle and fat areas in the Argentine child and adolescent population (4-14 years old)

Introducción: La circunferencia del brazo (CB) se reconoce como buen indicador del estado nutricional. Objetivo: Estimar los percentilos de referencia para la CB y las áreas muscular (AM) y grasa (AG) del brazo en la población infantojuvenil argentina mediante el empleo del método LMS (lambda, mu, sigma, en inglés). Materiales y métodos: La muestra estuvo constituida por escolares de 4,0 a 13,9 años residentes en Jujuy, Catamarca, Misiones, Buenos Aires, Mendoza y Chubut. Las mediciones antropométricas de la CB y del pliegue tricipital se realizaron entre 2003 y 2008 siguiendo protocolos estandarizados. Se estimaron las AM, AG, se calcularon los percentilos por edad y sexo, y se compararon mediante el análisis de la varianza. Resultados: Se incluyeron 22 736 escolares (11 397 varones y 11 339 mujeres). Los valores correspondientes al percentilo 50 fueron superiores, en las mujeres, para CB y AG, y, en los varones, para AM. Las curvas de CB presentaron incrementos más marcados a partir de los 7 años en todos los percentilos, para ambos sexos. Un patrón similar se observó para AM, con valores superiores en los varones. Por último, el AG mostró aumento constante en las mujeres y estabilización en los varones a partir de los 11 años. Se observaron diferencias para la edad. Conclusiones: Los valores de percentilos, tabulados y graficados, de la CB y de las AM y AG del brazo pueden constituir una referencia local para estudios epidemiológicos y antropológicos.

Introduction: Mid-upper arm circumference (MUAC) is widely recognized as an adequate indicator of nutritional status. Objective: To estimate the reference percentiles for MUAC, upper arm muscle area (UAMA), and upper arm fat area (UAFA) in the Argentine child and adolescent population using the LMS method (lambda, mu, sigma) Materials and methods: The sample was made up of schoolchildren aged 4.0-13.9 years living in Jujuy, Catamarca, Misiones, Buenos Aires, Mendoza, and Chubut. MUAC and tricipital skinfold anthropometric measurements were obtained between 2003 and 2008 as per standardized protocols. UAMA and UAFA were calculated, and percentiles by age and sex were estimated and compared using an analysis of variance. Results: A total of 22 736 schoolchildren (11 397 boys and 11 339 girls) were included. The 50th percentile was higher for the MUAC and UAFA among girls and for the UAMA among boys. The MUAC curves showed sharper increases as of 7 years old in all percentiles among both boys and girls. A similar pattern was observed for the UAMA, with higher values among boys. Lastly, the UAFA showed a constant increase among girls and a stabilization among boys as of 11 years old. Differences for age were observed. Conclusions: The tabulated and plotted percentiles and the MUAC, UAMA, and UAFA may be used as local references for epidemiological and anthropological studies.

Reference percentiles for mid-upper arm circumference, upper arm muscle and fat areas in the Argentine child and adolescent population (4-14 years old). / Percentilos de referencia de la circunferencia y de las áreas muscular y grasa del brazo para la población infantojuvenil argentina (4-14 años).

INTRODUCTION: Mid-upper arm circumference (MUAC) is widely recognized as an adequate indicator of nutritional status. OBJECTIVE: To estimate the reference percentiles for MUAC, upper arm muscle area (UAMA), and upper arm fat area (UAFA) in the Argentine child and adolescent population using the LMS method (lambda, mu, sigma). MATERIALS AND METHODS: The sample was made up of schoolchildren aged 4.0-13.9 years living in Jujuy, Catamarca, Misiones, Buenos Aires, Mendoza, and Chubut. MUAC and tricipital skinfold anthropometric measurements were obtained between 2003 and 2008 as per standardized protocols. UAMA and UAFA were calculated, and percentiles by age and sex were estimated and compared using an analysis of variance. RESULTS: A total of 22 736 schoolchildren (11 397 boys and 11 339 girls) were included. The 50th percentile was higher for the MUAC and UAFA among girls and for the UAMA among boys. The MUAC curves showed sharper increases as of 7 years old in all percentiles among both boys and girls. A similar pattern was observed for the UAMA, with higher values among boys. Lastly, the UAFA showed a constant increase among girls and a stabilization among boys as of 11 years old. Differences for age were observed. CONCLUSIONS: The tabulated and plotted percentiles and the MUAC, UAMA, and UAFA may be used as local references for epidemiological and anthropological studies.

Introducción: La circunferencia del brazo (CB) se reconoce como buen indicador del estado nutricional. Objetivo: Estimar los percentilos de referencia para la CB y las áreas muscular (AM) y grasa (AG) del brazo en la población infantojuvenil argentina mediante el empleo del método LMS (lambda, mu, sigma, en inglés). Materiales y métodos: La muestra estuvo constituida por escolares de 4,0 a 13,9 años residentes en Jujuy, Catamarca, Misiones, Buenos Aires, Mendoza y Chubut. Las mediciones antropométricas de la CB y del pliegue tricipital se realizaron entre 2003 y 2008 siguiendo protocolos estandarizados. Se estimaron las AM, AG, se calcularon los percentilos por edad y sexo, y se compararon mediante el análisis de la varianza. Resultados: Se incluyeron 22 736 escolares (11 397 varones y 11 339 mujeres). Los valores correspondientes al percentilo 50 fueron superiores, en las mujeres, para CB y AG, y, en los varones, para AM. Las curvas de CB presentaron incrementos más marcados a partir de los 7 años en todos los percentilos, para ambos sexos. Un patrón similar se observó para AM, con valores superiores en los varones. Por último, el AG mostró aumento constante en las mujeres y estabilización en los varones a partir de los 11 años. Se observaron diferencias para la edad. Conclusiones: Los valores de percentilos, tabulados y graficados, de la CB y de las AM y AG del brazo pueden constituir una referencia local para estudios epidemiológicos y antropológicos.

Comparative study of mid-upper arm circumference, arm muscle area and arm fat area percentiles in Argentinean and US children aged 4-14 years / Estudio comparativo de los percentiles de circunferencia, área muscular y área grasa del brazo en niños argentinos y estadounidenses de 4-14 años

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

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

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

[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.

[Malnutrition and structural poverty. Comparison of two schoolchildren cohorts from Puerto Madryn, Argentina]. / Malnutrición y pobreza estructural. Comparación de dos cohortes de escolares de Puerto Madryn, Argentina.

OBJECTIVE: To assess nutritional condition in two cohorts (C) of children from households with different Unsatisfied Basic Needs (UBN) attending neighborhood schools in Puerto Madryn, Argentina. METHODS: A cross-sectional study on six to 11 year-old children attending seven neighborhood schools surveyed in the periods 2001-2006 (C1, n=2 040) and 2014-2016 (C2, n=1 696) was performed. Weight, height and body mass index were measured using the World Health Organization cut-off values for nutritional condition. Neighborhood structural poverty was determined with percent UBN from the 2001 and 2010 census. Chi2 was used to compare the prevalence of nutritional condition between C and UBN categories. RESULTS: In the seven neighborhoods analyzed, percent UBN was 0%-10% (n=3), 10%-25% (n=2) and 25%-50% (n=1), without changes in the period 2001-2010. In the remaining neighborhood, UBN increased from 25%-50% to >50%. The nutritional evaluation of children showed significant differences in the prevalence of obesity in most schools, while low height-for-age and overweight prevalence was significant only in one school. Comparison of C1 and C2 only showed significant differences in the prevalence of obesity. CONCLUSIONS: Structural poverty rates in Puerto Madryn neighborhoods were mostly unchanged; however, the nutritional condition of children was different: while the prevalence of chronic malnutrition did not change or decreased, the prevalence of obesity increased in all neighborhoods. Our findings could help to determine changes in the context of resident population and identify vulnerable groups.

OBJETIVO: Estimar el estado nutricional de dos cohortes (C) de niños concurrentes a escuelas de barrios con diferentes Necesidades Básicas Insatisfechas (NBI) de Puerto Madryn, Argentina. MÉTODOS: Investigación transversal. Se midieron peso y talla de niños de seis a 11 años asistentes a escuelas ubicadas en siete barrios. La C1 (n=2 040) fue relevada entre 2001-2006 y C2 (n=1 696) entre 2014-2016. Se calculó el Índice de Masa Corporal y se emplearon los puntos de corte de la OMS para determinar el estado nutricional. Para estimar la pobreza estructural se extrajeron, para 2001 y 2010, los porcentajes de NBI censales de cada barrio. Las prevalencias de estado nutricional entre cohortes y categorías de NBI se compararon mediante Chi2. RESULTADOS: En los siete barrios analizados, las NBI fueron: 0%-10% (n=3), 10%-25% (n=2) y 25%-50% (n=1), sin variación entre 2001-2010. En otro barrio, las NBI aumentaron de 25%-50% a >50%. Al evaluar el estado nutricional de los niños de cada escuela hubo diferencias para obesidad en la mayoría de ellas y para baja talla/edad y sobrepeso solo en una. La comparación C1-C2 indicó diferencias para obesidad. CONCLUSIONES: Los barrios de Puerto Madryn conservan, en gran parte, sus niveles de pobreza estructural. No ocurre lo mismo con el estado nutricional de los niños: mientras las prevalencias de desnutrición crónica se mantienen o descienden, las de obesidad aumentan en todos los barrios. El análisis efectuado permite evaluar transformaciones del contexto de residencia de la población e identificar grupos vulnerables.

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.

Malnutrición y pobreza estructural. Comparación de dos cohortes de escolares de Puerto Madryn, Argentina / Malnutrition and structural poverty. Comparison of two schoolchildren cohorts from Puerto Madryn, Argentina

RESUMEN Objetivo Estimar el estado nutricional de dos cohortes (C) de niños concurrentes a escuelas de barrios con diferentes Necesidades Básicas Insatisfechas (NBI) de Puerto Madryn, Argentina. Métodos Investigación transversal. Se midieron peso y talla de niños de seis a 11 años asistentes a escuelas ubicadas en siete barrios. La C1 (n=2 040) fue relevada entre 2001-2006 y C2 (n=1 696) entre 2014-2016. Se calculó el Índice de Masa Corporal y se emplearon los puntos de corte de la OMS para determinar el estado nutricional. Para estimar la pobreza estructural se extrajeron, para 2001 y 2010, los porcentajes de NBI censales de cada barrio. Las prevalencias de estado nutricional entre cohortes y categorías de NBI se compararon mediante Chi2. Resultados En los siete barrios analizados, las NBI fueron: 0%-10% (n=3), 10%-25% (n=2) y 25%-50% (n=1), sin variación entre 2001-2010. En otro barrio, las NBI aumentaron de 25%-50% a >50%. Al evaluar el estado nutricional de los niños de cada escuela hubo diferencias para obesidad en la mayoría de ellas y para baja talla/edad y sobrepeso solo en una. La comparación C1-C2 indicó diferencias para obesidad. Conclusiones Los barrios de Puerto Madryn conservan, en gran parte, sus niveles de pobreza estructural. No ocurre lo mismo con el estado nutricional de los niños: mientras las prevalencias de desnutrición crónica se mantienen o descienden, las de obesidad aumentan en todos los barrios. El análisis efectuado permite evaluar transformaciones del contexto de residencia de la población e identificar grupos vulnerables.(AU)

ABSTRACT Objective To assess nutritional condition in two cohorts (C) of children from households with different Unsatisfied Basic Needs (UBN) attending neighborhood schools in Puerto Madryn, Argentina. Methods A cross-sectional study on six to 11 year-old children attending seven neighborhood schools surveyed in the periods 2001-2006 (C1, n=2 040) and 2014-2016 (C2, n=1 696) was performed. Weight, height and body mass index were measured using the World Health Organization cut-off values for nutritional condition. Neighborhood structural poverty was determined with percent UBN from the 2001 and 2010 census. Chi2 was used to compare the prevalence of nutritional condition between C and UBN categories. Results In the seven neighborhoods analyzed, percent UBN was 0%-10% (n=3), 10%-25% (n=2) and 25%-50% (n=1), without changes in the period 2001-2010. In the remaining neighborhood, UBN increased from 25%-50% to >50%. The nutritional evaluation of children showed significant differences in the prevalence of obesity in most schools, while low height-for-age and overweight prevalence was significant only in one school. Comparison of C1 and C2 only showed significant differences in the prevalence of obesity. Conclusions Structural poverty rates in Puerto Madryn neighborhoods were mostly unchanged; however, the nutritional condition of children was different: while the prevalence of chronic malnutrition did not change or decreased, the prevalence of obesity increased in all neighborhoods. Our findings could help to determine changes in the context of resident population and identify vulnerable groups.(AU)