Bilateral asymmetry in arm anthropometric measurements according to laterality and nutritional status in children and adolescents from 6 to 12 years old.

OBJECTIVE: To compare and correlate anthropometric measurements of the left arm versus the right arm and to establish their relation to laterality, sex, and nutritional status in children and adolescents from 6 to 12 years of age. METHODS: A cross-sectional study included 605 children and adolescents (285 males; 320 females), with a middle socioeconomic status, that attended an urban elementary school. Anthropometric measurements were taken in both arms, along with height and weight, to assess nutritional status. Self-reported hand preference was recorded. RESULTS: A total of 49.3% were females and 93% of the subjects were right-handed (n = 563). The mean comparison of right arm and left arm measurements and areas, according to laterality, showed differences in arm fat measurements, with higher values in the right arm. However, the mean difference in triceps skinfold and upper arm measurements between the right arm and left arm was smaller than the technical error of measurement. Significant differences were observed between arm measurements and areas. Upper arm and total upper arm areas of both arms had the highest regression coefficients, with an adjusted R2 of .98, whereas the arm fat index had the lowest (adjusted R2 of .88). Adjusting the previous differences between the right arm and left arm by age, sex, BMI, and laterality produced similar results. CONCLUSIONS: Statistical but not clinically significant differences were found between some measurements and areas of both arms, discretely modified in models adjusted for age and BMI, so the measurements can be made on either arm.

Cultural Sensitivity and Global Pharmacy Engagement in Latin America: Argentina, Brazil, Ecuador, Guatemala, and Mexico.

To establish and maintain successful global pharmaceutical and health care partnerships, pharmacists, pharmacy educators, and students should first learn more about the political, cultural, economic and health care dynamics that affect all of the parties involved in these arrangements. This paper explores Latin America within the context of transnational pharmacy and health-based engagement, including pharmacy-related concepts, health care and cultural considerations, behavioral health perspectives, and common misconceptions. Expert knowledge and experience were used to support and corroborate the existing literature about cultural dynamics of health. Recommendations are provided for how schools and colleges of pharmacy can enhance engagement in culturally sensitive partnerships within Latin America. Health-based profiles of Argentina, Brazil, Ecuador, Guatemala, and Mexico are presented to serve as models for establishing, enhancing, and maintaining partnerships across Latin America.

[Decreased anthropometric indicators of adiposity in school children as an indicator of the nutritional transition in Mexico]. / Disminución en los indicadores antropométricos de adiposidad en niños escolares como indicador de la transición nutricia en México.

BACKGROUND: The aim of this paper was to estimate the adiposity trend in children from a public elementary school in Guadalajara, Mexico, between 2007 and 2011. METHODS: Comparative study of two samples taken transversely in 1432 schoolchildren aged 6-12 years. Z-score of BMI and anthropometric indicators of arm adiposity (triceps skinfold, fat area and arm fat index) were calculated. Reference standards of the 2007-WHO and Frisancho were used. Analysis: Chi-square and Student t test. RESULTS: Adiposity decreased significantly in children with normal weight (arm fat area Z-score -0.3 SD) overweight and obesity (arm fat area and index -0.4 and -0.3 z-scores respectively). An increase in the prevalence of subjects with normal weight and thinness and a decrease of overweight (4.6, -2.0 and -2.9 percentage points respectively) was observed. Obesity prevalence remained unchanged. CONCLUSIONS: Decrease of adiposity in overweight and obese children, reduction in the prevalence of thinness and overweight and the increase in the proportion of subjects with normal weight was observed during the study period. These data probably reflect the nutritional transition in Mexico.

Introducción: el objetivo de este estudio fue estimar la tendencia de la adiposidad de alumnos de una escuela primaria pública entre 2007 y 2011. Métodos: estudio comparativo de dos muestras obtenidas transversalmente en 1432 escolares de 6 a 12 años de edad. Se calculó la puntuación z del índice de masa corporal y de indicadores antropométricos de adiposidad (pliegue cutáneo tricipital, área grasa e índice de grasa del brazo). Se utilizaron los patrones de referencia de la OMS-2007 y de Frisancho. El análisis se llevó a cabo con Chi cuadrada y t de Student. Resultados: la adiposidad disminuyó significativamente tanto en niños con peso normal (z área grasa del brazo -0.3) como en los que tenían sobrepeso y obesidad (z área grasa del brazo -0.4 y -0.3, respectivamente). Se observó un incremento en la prevalencia de niños con peso normal (4.6 puntos porcentuales), así como disminución de casos con delgadez y sobrepeso (-2.0 y -2.9 puntos porcentuales, respectivamente). La prevalencia de obesidad no se modificó. Conclusiones: se identificó disminución de la adiposidad en niños con sobrepeso y obesidad, disminución en la prevalencia de delgadez y sobrepeso, así como aumento en la proporción de sujetos con peso normal. Estas observaciones probablemente reflejan la transición nutricia en México.

[Increased height in obese schoolchildren versus healthy weight schoolchildren]. / Crecimiento acelerado en escolares obesos frente a escolares con peso saludable.

BACKGROUND: There are few articles that document the association between growth and obesity. The objective of this study was to compare height between obese schoolchildren and healthy weight schoolchildren. METHODS: Cross-sectional study performed in 369 healthy weight schoolchildren and 162 obese schoolchildren of an elementary school; 49.4 % were females. Subjects were classified by body mass index percentiles in healthy weight (5-84), and obese (> 95), and grouped by gender and one-year class intervals. It was used Mann-Whitney U test for statistical analysis. RESULTS: In all class intervals, height was higher in obese schoolgirls when we compared them with healthy weight schoolgirls; we did not identify an increasing or decreasing trend related to age. No height difference was observed in 6 and 7 years old obese/healthy weight schoolboys; however, from 8 to 11 years, height increased progressively in obese schoolchildren with a difference of 8.8 cm at the age of 10. CONCLUSIONS: The association of obesity with periods of accelerated growth suggests the existence of phenotypic variants related to metabolic and hormonal factors. Significant higher height values were identified in obese schoolchildren when they were compared with their healthy weight peers.

IBTRODUCCIÓN: la asociación entre crecimiento y obesidad ha sido poco estudiada en la población de escolares obesos mexicanos. El objetivo de este estudio fue comparar la talla para la edad entre escolares obesos y con peso saludable. MÉTODOS: estudio transversal realizado en 369 escolares con peso saludable y 162 obesos en una escuela primaria; 49.4 % era de sexo femenino. Se utilizó la clasificación percentilar del Índice de masa corporal: peso saludable: del percentil 5 al 84, obesidad: valor > percentil 95; se agruparon por sexo e intervalos de clase de un año. El análisis estadístico se hizo con U de Mann-Whitney. RESULTADOS: en las niñas obesas la talla fue mayor a la del grupo con peso saludable en todos los intervalos de clase sin que se identificara una tendencia de incremento o decremento en relación con la edad. En los niños no se observaron diferencias de talla en los 6 y 7 años; sin embargo, de los 8 a los 11 años la talla se incrementó en forma progresiva en los obesos, con diferencia máxima de 8.8 cm a los 10 años. CONCLUSIÓN: la asociación de obesidad con periodos de crecimiento acelerado sugiere la existencia de variantes fenotípicas relacionadas con factores metabólicos y hormonales. Se identificaron valores de talla que fueron significativamente mayores en los niños con obesidad al ser comparados con sus pares con peso saludable.

[Model for predicting childhood obesity from diet and physical activity]. / Modelo de predicción de obesidad en niños a partir de variables dietéticas y actividad física.

BACKGROUND: If obesity results from the interaction of variables that involve the subject and his environment, the alternatives to face the problem could be very diverse. The objective of this study was to seek for the best predictive model of childhood obesity from energy ingestion, dietary habits and physical activity. METHODS: Case control study of 99 obese and 100 healthy weight children (Center for Diseases Control criteria). Energy ingestion was estimated by means of a 24-hour recall, dietary and physical activity habits by validated questionnaires. A logistic regression analysis was made. RESULTS: Variables independently associated to obesity were higher energy ingestion; lower frequency in mealtimes; having the afternoon lunch outside home; higher frequency of consumption of fat, junk food and sweetened beverages; lower time of moderate physical activity at school and at home; and increased time for homework and watching TV. The variables included in the regression model were energy intake; frequency of ingestion of fat, junk foods and sweetened beverages; and physical activity at home and at school. CONCLUSION: The diversity of associated variables underlines the complexity and multi-causal condition of obesity.

INTRODUCCIÓN: si la obesidad es el resultado de variables que involucran al sujeto y a su entorno, las alternativas para abordar el problema pueden ser diversas. El objetivo fue mostrar el mejor modelo de predicción de obesidad en escolares a partir de la ingesta de energía, hábitos de alimentación y actividad física. MÉTODOS: estudio de casos y controles en 99 escolares obesos y 100 con peso saludable (criterio del Centro de Control de Enfermedades). La ingestión de energía se estimó por medio de dos recordatorios de 24 horas; los hábitos de alimentación y de actividad física, con instrumentos validados. El análisis se hizo con regresión logística. RESULTADOS: las variables asociadas a obesidad en forma independiente fueron mayor ingestión de energía; menor frecuencia en los tiempos de comida; colación vespertina fuera del hogar; mayor frecuencia de consumo de grasas, productos chatarra y bebidas endulzadas; menor tiempo de actividad física moderada en la escuela y en su casa, mayor tiempo en la realización de la tarea escolar y frente al televisor. Las variables incluidas en el modelo de regresión logística fueron: ingestión de energía, frecuencia de consumo de productos chatarra y bebidas endulzadas, y tiempo de actividad física moderada en la escuela y en casa. CONCLUSIÓN: la diversidad de variables asociadas identificadas muestra la complejidad y el carácter multifactorial de la obesidad.