Salud y nutrición del niño indígena chileno (Mapuche) / The health and nutrition of indigenous children in Chile (Mapuche) / Saúde e nutrição da criança indígena chilena (Mapuche)

El objetivo de este trabajo fue realizar una revisión de la situación de salud y nutrición del niño indígena chileno, específicamente del Mapuche, en lo publicado en las bases de datos de referencias bibliográficas y en investigaciones específicas que tienen base poblacional. Para este trabajo se buscó lo publicado en PubMed, LILACS, organismos nacionales e internacionales, durante los últimos 15 años. Desde el 2006 hasta el 2015 la proporción de pobres era mayor en los indígenas, con disminución de la brecha de 16% el 2006 a 7,7% el 2015 (p < 0,001). En la primera década de este siglo la mortalidad infantil en los niños indígenas tenía una tasa de 17,1/1.000 nacidos vivos, mientras en los no indígenas era de de 8,8/1.000 y, en el seguimiento de cinco años, la brecha se mantuvo (p < 0,001). Los recién nacidos con peso < 2,500g el año 2000 no superaban el 6% (5,6% en no indígenas y 5,2% en los indígenas). La talla baja al ingreso a la escuela era 8,4% en los escolares indígenas y 3,1% en los no indígenas, disminuyendo a 3,7 en los indígenas y 2,6% en los no indígenas el 2004, la obesidad en cambio aumentó más en los indígenas, llegando a 24,2 y 25,3% en los no indígenas (p < 0,001). La menarquia se presentó cuatro meses más tarde en las indígenas (12,7 años) y el índice de masa corporal, circunferencia de cintura y el porcentaje de grasa, fueron significativamente mayores en las indígenas en el momento de la telarquia, así como la frecuencia de exceso de peso (55% vs. 42% en las no indígenas). Los niños Mapuche presentan una condición de salud y nutrición favorable, comparada con los indígenas de otros países del continente, sin embargo, aun existe una brecha adversa -comparada con los no indígenas-, en que la desigualdad desfavorece al niño indígena y esta debe ser reconocida y corregida.

The aim of this study was to conduct a review of the health and nutritional status of Chilean indigenous children, specifically Mapuche children, as published in the literature and specific population-based studies. The searches were conducted in PubMed and LILACS in the last 15 years. From 2006 to 2015, the poverty rate was higher in the indigenous population, with a decrease in the gap from 16% in 2006 to 7.7% in 2015 (p < 0.001). In the first decade of this century, infant mortality in indigenous children was 17.1/1,000 live births, while in non-indigenous children it was 8.8/1,000, and the gap was maintained in the five-year follow-up (p < 0.001). Newborns with birthweight < 2,500g in the year 2000 did not reach 6% (5.6% in non-indigenous and 5.2% in indigenous children). Low height at first school enrollment was 8.4% in indigenous schoolchildren and 3.1% in non-indigenous children, decreasing to 3.7% in indigenous children and 2.6% in non-indigenous children in 2004, while obesity increased more in indigenous children, reaching 24.2% in indigenous and 25.3% in non-indigenous children (p < 0.001). Menarche appeared four months later on average in indigenous girls (12.7 years), and body mass index, waist circumference, and fat mass were significantly greater in indigenous girls at the time of thelarche, as was the overweight rate (55%, vs. 42% in non-indigenous). Mapuche children show favorable health and nutritional status compared to indigenous children elsewhere in Latin America, but there is still an adverse gap compared to non-indigenous Chilean children. This inequality affecting indigenous Chilean children should be acknowledged and corrected.

O objetivo deste trabalho foi realizar una revisão da situação da saúde e nutrição da criança indígena chilena, especificamente da Mapuche, nas publicações relacionadas em bases de dados de referências bibliográficas e em pesquisas específicas que têm base populacional. A pesquisa foi realizada em publicações relacionadas: PubMed, LILACS, organismos nacionais e internacionais, nos últimos 15 anos. Desde 2006 até 2015 a proporção de pobres era maior nos indígenas, com diminuição de uma diferença de 16% em 2006 a 7,7% em 2015 (p < 0.001). Na primeira década de este século a mortalidade infantil nas crianças indígenas teve una taxa de 17,1/1.000 nascidas vivas, enquanto nos não indígenas era de 8,8/1.000 e, em um acompanhamento de cinco anos, a diferença se manteve (p < 0,001). Os recém-nascidos com peso < 2.500g no ano de 2000 não superavam 6% (5,6% em não indígenas e 5,2% nos indígenas). A baixa estatura ao momento do ingresso na escola era 8,4% nos escolares indígenas e 3,1% nos não indígenas, diminuindo a 3,7 nos indígenas e 2,6% nos não indígenas em 2004, a obesidade pelo contrário teve um aumento maior nos indígenas, chegando a 24,2 e 25,3% nos não indígenas (p < 0,001). A menarca ocorreu quatro meses mais tarde nas indígenas (12,7 anos) e o índice de massa corporal, circunferência da cintura e a porcentagem da gordura, foram significativamente maiores nas indígenas no período da telarca, à semelhança da frequência do sobrepeso (55% vs. 42% nas não indígenas). As crianças Mapuche apresentam uma condição de saúde e nutrição favorável, comparada com os indígenas de outros países do continente, no entanto, ainda existe uma brecha adversa - comparada com os não indígenas - , onde a desigualdade desfavorece a criança indígena e por isso deve ser reconhecida e corrigida.

Brechas de desigualdad en salud en niños migrantes versus locales en Chile / Health inequality gap in inmigrant versus local children in Chile

Resumen Introducción: Los niños y jóvenes migrantes internacionales enfrentan diferentes retos en salud en comparación con la población local, en particular si se enfrentan a ambientes inseguros o a condi ciones sociales adversas. Este estudio busca identificar brechas existentes en resultados de salud de la niñez entre población migrante internacional y chilena. Métodos: Este estudio analiza tres fuentes de información: (i)Nacer en Chile: Datos de consulta antenatal recolectados de los registros electrónicos de las mujeres usuarias del programa Chile Crece Contigo, de todos los centros de salud familiar (CESFAM) de administración municipal de la comuna de Recoleta el año 2012; (ii)Crecer en Chile: Datos de encuesta poblacional "Caracterización Socioeconómica Nacional" CASEN 2013 y (iii)En-fermar en Chile: Datos de todos los egresos hospitalarios de 2012, proporcionada por el departamento de estadística e información en salud (DEIS) del Ministerio de Salud. Resultados: (i) Nacer en Chile: Hay mayor proporción de inmigrantes con riesgo biopsicosocial (62,3% vs 50,1% en chilenas) y con ingreso tardío al programa (63,1% vs 33,4%). Hay menos cesáreas en inmigrantes que en chilenas (24,2% vs 33,6%). (ii) Crecer en Chile: Existe una mayor proporción de niños migrantes fuera del sistema escolar y una mayor proporción en pobreza multidimensional (40% vs 23,2%). (iii) Enfermar en Chile: En migrantes entre 7-14 años es más frecuente egresar hospitalariamente por traumatismos/ otras causas externas (23,6% vs 16,7% en chilenos). Conclusiones: Este estudio entrega nueva evi dencia sobre necesidades urgentes de salud de nuestros niños en Chile. Este es un imperativo ético, legal y moral, independiente de la condición migratoria.

Abstract Introduction: Children and young international migrants face different health challenges compa red with the local population, particularly if they live in insecure environments or adverse social conditions. This study seeks to identify gaps in health outcomes of children between immigrant and local population in Chile. Methods: This study analyses data from three sources: (i) Born in Chile: Electronic records of antenatal visits from all municipal antenatal clinics of Recoleta in 2012; (ii) Growing up in Chile: Population survey "National Socioeconomic Characterization" (CASEN) from 2013 and (iii) Getting sick in Chile: Data of all hospital discharges in 2012, provided by the department of statistics and health information (DEIS) of the Ministry of Health. Results: (I) Born in Chile: Im migrants more frequently have psychosocial risk (62.3% vs 50.1% in Chileans) and enter later into the program (63.1% vs 33.4% enter later than 14 weeks of pregnancy). All birth outcomes were better among immigrants (e.g. caesarean sections rates: 24.2% immigrants vs % Chileans). (ii) Growing up in Chile: A higher proportion of migrant children is outside the school system and lives in multidi mensional poverty (40% immigrants vs 23.2% Chileans). (iii) Getting sick in Chile: Injuries and other external causes were more frequent cause of hospitalisation among migrants (23.6%) than the local population (16.7%) aged between 7 and 14 years. Conclusions: Addressing the needs of the children in Chile, regardless of their immigration status, is an ethical, legal and moral imperative.

Índice, carga glicémica y fibra dietética de los alimentos y su asociación con resistencia a la insulina en adultos chilenos / Glycemic index, glycemic load and dietary fiber of foods and its association with insulin resistance in Chilean adults

El Índice y Carga Glicémica (IG y CG) categorizan los alimentos según su capacidad de incrementar la glicemia, considerando cantidad y calidad de hidratos de carbono consumidos. Diferentes estudios han postulado que una dieta con IG y CG altos y bajo consumo de fibra incrementan la glicemia e insulinemia, aunque con resultados heterogéneos.El objetivo de este estudio fue analizar la asociación entre IG, CG e ingesta de fibra y valores HOMA-IR en adultos jóvenes. En una muestra representativa de 738 personas que tenían entre 32 y 38 años, nacidos en el Hospital de Limache, Región de Valparaíso, Chile, se recogió información socioeconómica, de salud, se determinó estado nutricional, glicemia, insulina basal y HOMA, y con la encuesta de frecuencia de consumo se estimó IG, CG e ingesta de fibra. Se construyeron modelos de regresión múltiple, controlando efectos de confusión e interacción. En modelos ajustados, se observó que por cada 10 unidades que aumenta el IG y CG de la dieta en individuos con exceso de peso, aumenta el HOMA-IR en 0,31 (p=0,042) y 0,03 (p=0,012), respectivamente y por cada 10 gramos que aumenta la fibra total y soluble, disminuye el HOMA-IR en 0,10 (p=0,04) y 0,62 (p=0,034) respectivamente. En personas sin exceso de peso no hubo estos efectos. Existe una asociación directa entre el aumento de IG y CG de los alimentos y el incremento de HOMA-IR sólo en individuos con exceso de peso y una asociación inversa entre ingesta de fibra dietética total y soluble y HOMA-IR(AU)

Glycemic index, glycemic load and dietary fiber of foods and its association with insulin resistance in Chilean adults. Glycemic index and glycemic load (GI and GL) categorize foods according to their ability to increase blood sugar levels, considering quantity and quality of carbohydrates consumed. Different studies have postulated that a high GI and GL diet and low fiber intake increased glycemia and insulinemia, although with heterogeneous results. The aim of this study was to analyze the association between GI, GL and fiber intake and HOMA-IR values in young adults. In a representative sample of 738 people aged between 32 and 38 years old, born in the Limache's Hospital, Valparaiso, Chile, socioeconomic and health information, nutritional status, basal glycemia, insulin and HOMA were collected. With a food frequency questionnaire, GI, GL and fiber intake were estimated. Multiple regression models were constructed, controlling confounding and interaction effects. In adjusted models, it was found that for every 10 units that increases diet GI and GL in overweight individuals, HOMA- IR increases in 0.31 (p = 0.042) and 0.03 (p = 0.012) respectively, and for every 10 grams that increases total and soluble fiber intake, HOMA-IR reduces in 0.10 (p = 0.04) and 0.62 (p = 0.034) respectively. In people without overweight such effects were not observed. There was a direct association bet- ween increased GI and GL foods and increased HOMA-IR only in individuals with overweight and an inverse association between total and soluble fiber intake and HOMA-IR(AU)

Síndrome metabólico e inflamación en adultos: un estudio poblacional / Association of C reactive protein levels with metabolic syndrome in adults: a population-based study

Background: Metabolic syndrome is highly prevalent among adults in Chile and represents a health risk. Aim: To determine the relationship between metabolic syndrome (MetS) and its components, with C reactive protein levels (CRP) as an inflammation marker. Material and Methods: The population studied consisted of 736 individuals born in a hospital from Valparaíso Region, aged between 32-38 years at the time of the study. MetS was identified according to the Adult Treatment Panel (ATP) III guidelines and inflammation was measured using ultra-sensitive CRP. This parameter was classified as normal for values from 0 to 3 mg/L, high for values from 3.01 to 10 mg/L and very high for values > 10 mg/L. Results: Median CRP was in the normal range (1.9 mg/L, interquartile range 0.7-5.2) and was higher among women than men (2.2 and 1.4 mg/L respectively, p < 0.01). Twenty seven percent of participants had MetS. One-fourth had high blood glucose values, one-third had high triglyceride levels and 28% had blood pressure values over those established as normal in MetS. Elevated waist circumference (WC) and low HDL cholesterol were found among almost 50% of participants. A relationship between MetS and high CRP was only found among men with an Odds ratio (OR) of 2.04 (95% confidence intervals (CI): 1.11-3.73). The same association was observed for high triglyceride levels with an OR of 2.02 (CI: 1.17-3.49) and high WC with an OR of 3.89 (CI: 2.06-7.36). Among women, the only relationship observed was between abdominal obesity and very high CRP with an OR of 2. 65 (CI: 1.20-5.84). Conclusions: Metabolic syndrome, high triglyceride levels, and abdominal obesity were associated with inflammation only in men.

Ingesta de bebidas azucaradas analcohólicas e índice de masa corporal en escolares chilenos / Intake of sugar-sweetened non-alcoholic beverages and body mass index: A national sample of Chilean school children

Objetivo. Estimar la asociación entre la ingesta de bebidas azucaradas analcohólicas y el índice de masa corporal (IMC) en escolares chilenos. Material y métodos. Se analizaron datos de frecuencia de consumo de alimentos en escolares de entre 6 y 18 años de edad. Se estimó la asociación entre el consumo de bebidas azucaradas y el IMC a través de modelos de regresión lineal multivariada. Resultados. El 92% (IC95%:90-94) consume bebidas azucaradas diariamente, con medianas de ingesta de 424 ml (p25-p75:212-707). En los escolares de 6 a 13 años, cada incremento de una porción diaria de gaseosas y refrescos con azúcar se asocia con 0.13 puntajes z más de IMC (IC95%:0.04-0.2;p=0.01). Conclusiones. El consumo de bebidas azucaradas en escolares chilenos es diario y alcanza medianas de ingesta cercanas a medio litro. Existe asociación entre el consumo de bebidas azucaradas y mayor IMC.

Objective. To estimate the association between the intake of sugar-sweetened non-alcoholic beverages and body mass index (BMI) in Chilean school children. Materials and methods. Food consumption frequency data were analyzed for school children aged 6 to 18. The association between consumption of sugar-sweetened beverages and BMI was estimated by multivariate lineal regression models. Results. Sugar-sweetened beverages are consumed on a daily basis by 92% (95%CI:90-94) of subjects with daily intake medians of 424 mL (p25-p75:212-707). Every extra daily portion of sugar-sweetened beverages consumed by school children aged 6 to 13 is associated with 0.13 BMI z-scores (95%CI:0.04-0.2;p=0.01). Conclusions. School children consume sugar-sweetened beverages daily with intake medians close to 0.5L. There is an association between sugar-sweetened beverage consumption and higher BMI in Chilean school children.

Consumo de frutas, verduras y presión arterial: Un estudio poblacional / Fruit and vegetable intake, and blood pressure: A population research

Se ha descrito que consumir frutas y verduras disminuye la presión arterial. Sin embargo, no está clara la magnitud del efecto según la cantidad consumida. El objetivo de este estudio fue analizar la asociación entre consumo de frutas y verduras, y presión arterial. Se realizó un estudio transversal en una muestra aleatoria de 777 adultos entre 32 y 38 años de la Región de Valparaíso, Chile. Se midió presión arterial sistólica (PAS) y diastólica (PAD), y se aplicó una encuesta de tendencia de consumo cuantificada del último mes. La ingesta de frutas y verduras se dividió en tres grupos: menor a 200 g, 200 a 400 g, mayor a 400 g. Para el análisis se utilizaron modelos de regresión lineal múltiple ajustados por sexo, IMC, actividad física, nivel socioeconómico, tabaquismo e ingesta de sodio. Se observó que a medida que aumenta la ingesta de frutas y verduras disminuye la presión arterial sistólica(β=-3,37; IC 95%: -6,45 a -0,29; en consumo entre 200 y 400 g) (β=- 4,02; IC 95%: -7,06 a -0,98; en consumo mayor a 400 g), mientras que en la presión diastólica solamente se ve el efecto en los que cumplen la recomendación de la OMS de consumir más de 400 g al día (β-2,87; IC=-5,17 a -0,57). Se concluye que consumir frutas y verduras en cantidades mayores a 400 g, tiene un efecto protector en el aumento de la presión arterial tanto sistólica como diastólica.

Consuming fruits and vegetables is known to lower blood pressure. However, it is unclear how much should be consumed in order to achieve this effect. The aim of this study was to analyze the association between fruit and vegetable consumption and blood pressure. A cross-sectional study was conducted among a random sample of 777 adults between the ages of 32 and 38 from the Region of Valparaiso, Chile. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured, and a survey was carried out to quantify consumption trends over the past month. The fruit and vegetable intake was divided into three groups: less than 200 g, 200-400 g, and more than 400 g. In the analysis, multiple linear regression models were used and were adjusted for sex, BMI, physical activity, socioeconomic status, smoking, and sodium intake. It was observed that increasing intake of fruits and vegetables lowers the systolic blood pressure (β = -3.37 , 95% CI : -6.45 to -0.29; for consumption between 200 and 400 g ) (β =-4.02 , 95% CI: -7.06 to -0.98; for consumption great than 400 g), while an effect on diastolic pressure is only seen in those who meet the WHO recommendation of consuming more than 400 g per day (β -2,87, CI = -5.17 to -0.57). In conclusion, consuming fruits and vegetables in amounts larger than 400 g per day, provides a protective effect against increases in both systolic and diastolic blood pressure.

Índice cintura estatura como predictor de riesgo de hipertensión arterial en población adulta joven: ¿Es mejor indicador que la circunferencia de cintura?

El objetivo de este estudio fue estimar la asociación entre los valores de circunferencia de cintura (CC) y del índice cintura estatura (C/E) con la presión arterial (PA) y determinar cual de estos indicadores presenta la mejor asociación en una población adulta joven de una zona semi-rural de Chile. Se realizó un estudio transversal analítico en 998 personas entre 22 y 28 años nacidas en el Hospital de Limache, V Región del país quienes fueron encuestados sobre antecedentes socioeconómicos y familiares, junto con mediciones de PA y antropometría entre los años 2000 y 2003. Se realizó un modelo de regresión lineal de asociación univariada entre distintas variables de control y PA; luego se construyó un modelo entre CC y C/E con PA con ajuste por variables de control. El promedio de PA fue 114,6/72,5 mmHg (± 13,5/8,8), CC 83,9 cm (±11,3), C/E 0,52 (±0,07). La edad, sexo masculino, peso, talla y consumo de alcohol aumentaron la PA (p<0,05), la escolaridad en cambio la disminuyó (p<0,05). Se obtuvo una asociación directa entre CC y PA (β=0,27 para la PAS y 0,33 para la PAD) y entre C/E y PA (β=32,7 para PAS y 23,9 para PAD) (p<0,01). Al ajustar, esta asociación disminuye pero persiste significativa y es similar entre CC con la PA en comparación con C/E y PA (R2 0,20 y 0,37 para PAS; 0,20 y 0,36 para PAD respectivamente). En nuestra población la CC y C/E se asociaron significativamente con la PA, con una fuerza similar entre ambas.

Waist: height ratio as a predictor of risk of hypertension in young adults: Is it better indicator that waist circumference?. The objective was to determine the association between values of waist circumference (WC) and waist: height ratio (W/H) with blood pressure (BP) and to estimate which of these indicators present the best association with BP in a young adult population of a semi-rural area of Chile. We performed a cross sectional study in 998 people between 22 and 28 years, born in the Limache Hospital, V Region of the country who were surveyed for socioeconomic and family background, BP and anthropometric measurements were also taken during 2000 and 2003. Linear regression model was apply between control variables and BP, then models between WC and W/H and BP were built adjusting by control variables. The mean of BP was 114,6 / 72,5 mmHg (± 13,5/8,8), WC 83,9 cm (± 11,3), W/H 0,52 (± 0,07). Age, being male, weight, height and alcohol consumption increased the BP (p < 0,05), scholarity instead decreased it (p <0,05). A direct association was observed between WC and BP (β = 0,7for SBP and 0,33 for DBP) and between W/H and BP (β = 32,75 for SBP and 23,90 for DBP) (p <0.01). These association decreases but remain significant after adjustement. There was a similar association between WC with BP compared with W/H (R2 0,20 and 0,37 for SBP; 0,20 y 0,36 for DBP respectively). In our population WC and W/H were significantly associated with BP, with a similar force between them.

Edad de menarquia y ascendencia indígena: Un estudio poblacional en Chile / Age at menarche and indigenous ancestry: A population study in Chile

Background: The age at menarche may influence decisively health and disease in women. It also indicates the beginning of the reproductive period and, as a consequence, the possibility of biological continuity for the human species. Genetic and environmental determinants define the age of menarche and can explain differences found among different populations. Aim: To determine the age at menarche among adolescents with different levels of indigenous descent (parental indigenous surnames), considering the effect of socioeconomic and demographic factors. Material and Methods: An observational study of historic cohorts of8.624 girls from the Arauca-nía Region (central-southern Chile) was carried out. Data were collected by health professionals using a previously validated questionnaire. Occurrence of menarche was estimated through survival analysis and compared between groups (according to indigenous parental surnames) adjusted for parents' income and educational level and provenance (rural/urban). Results: Estimated median age of menarche was 151 months (95% Cl: 150-151). In female with four indigenous surnames, menarche occurred two months later than girls without indigenous surnames and with two indigenous surnames (p < 0,001). In girls whose parents had lowest level of schooling, the difference increased to eight months later (p < 0,005). Conclusions: Age at menarche in the group with higher indigenous descent is later even if socio-economic conditions remain stable. Genetic factors might play an important role, however conditions of vulnerability can influence and further delay the onset of reproductive competency.

Vigilancia nutricional en escolares chilenos: validez de la información / Nutritional surveillance in Chilean schoolchildren: validity ofthe information

Background: Anthropometry is used to survey health and nutritional situation of the population. Therefore the quality of the information that is being used must be evaluated. Aim: To estímate the agreement in weight, height and nutritional status in schoolchildren, comparing measurements made by teachers in schools and a standardized and supervised team of professionals. Material and methods: Cross sectional study including 927 schoolchildren in 31 schools from 7 counties of Santiago. Schools were randomly chosen and the universe of children attending to first grade was measured. Weight, height and nutritional status collected by teachers and researches, were compared. Results: Total agreement for nutritional status reached 0.67, random-weighted Kappa was 0.40 and weighted Kappa, 0.42. Teachers tended to over diagnose under-nutrition and under diagnose overweight and obesíty measuríng 270 grams less than the qualified team (p <0.001) and 1.7 cm more in height (p <0.001), what is reflected in a difference of less than one point in body mass index (p <0.001). Discrepancies in height and body mass índex were higher in extreme valúes. Conclusions: There is a low agreement between the measurements taken by the research team and teachers. Even though there are discrepancies between measurements, high levéis of overweight and low prevalences of stunting and underweight are kept, reílecting problems with exactitude, but not bias. Corrective actions to improve the quality of information, which should include training programs for teachers, instrument maintenance, supervisión and verification system for data entry, are needed.

Factores determinantes del exceso de peso en escolares: Un estudio multinivel / Determinant factors of excess of weight in school children: a multilevel study

Background: Rates of obesity reach high levels in Chile, with geographic, social and school variations. Aim: To identify factors at two levels associated with excessive weight in school children: child-family characteristics and school-neighborhood. Material and methods: Using a cross-sectional and multi-step design, seven counties with the highest prevalence of obesity were identified, and schools were randomly chosen from within the 1st, 3 and 5 quintiles of the school strata (same level of obesity prevalence). Within each school, twelve 2nd grade children were randomly chosen (n =42 schools and 504 students). Nutritional status, food intake, eating habits and physical activity were measured. Socio demographic, economic characteristics and nutritional status of the parents were assessed. Home size and facilities for children physical activities were assessed, as well as school infrastructure and management. Results: Most of the explained variance (97 percent) in the Body Mass Index (BMI) was due to individual-level factors: sedentary children behaviour (JS coefficient 1.6, standard error (SE) 0.052), maternal obesity (ß 0.94; SE 0.25), paternal obesity (ß 0.83; SE 0.28) and hours watching television (ß 0.789, SE 0.297). The same risk factors were predictive of obesity: child sedentary behaviours odds ratio (OR): 3-98, 95 percent) confidence interval (CI): 2.44-6.48, maternal obesity (OR 1.91, CI 1.21-3-02) and being woman (OR 1.75, CI 1.01-2.76). Conclusions: BMI and obesity are associated with children behaviour or biological and cultural conditions of their families and not with school characteristics.

Nivel socioeconómico y estado nutricional: un estudio en escolares / Socioeconomic level and Nutritional Status: a study in schoolchildren

La obesidad ha aumentado en años recientes en tasas que difieren según el nivel socioeconómico (NSE). El propósito de este estudio fue analizar la asociación entre NSE y estado nutricional de escolares de enseñanza básica en seis comunas con las mayores prevalencias de obesidad en Santiago, Chile. Se seleccionaron escuelas con diferentes prevalencias de obesidad en cada comuna y los escolares se escogieron aleatoriamente en cada escuela. Se evaluaron antropométricamente los escolares y a sus madres se les aplicó una encuesta sociodemográfica y del registro alimentario de 24 horas de sus hijos. Mediante la técnica de componentes principales se clasificó la muestra entre los que son de menor y mayor NSE. La prevalencia de exceso de peso fue de 51,1%, (24,7% tenía sobrepeso y 26,4% eran obesos) sin diferencias significativas entre NSE. Los de menor NSE presentaron menores valores de IMC, pliegues y circunferencia del brazo e ingesta alimentaria, sin embargo estas diferencias no fueron estadísticamente significativas. Hubo también una menor tendencia al sedentarismo en los de menor NSE, ya que usaban más lugares comunitarios [Odds Ratio (OR) 1,91; Intervalos de Confianza (IC) 1,05-3,48] y se iban y volvían al colegio caminando (OR 6,76; IC 2,75-16,67). En conclusión, aunque no hubo asociación significativa entre NSE e indicadores antropométricos e ingesta alimentaria, aunque los escolares de menor NSE tienen una tendencia a tener valores más bajos de estos índices y son más activos.

Socioeconomic level and Nutritional Status: A study in schoolchildren. Obesity increased in recent years at different rates among socioeconomic levels (SEL). The purpose of this study was to analyze the association between SEL and nutritional status in schoolchildren attending elementary schools in the six counties that show the highest prevalence of obesity in Santiago, Chile. Within the counties schools were stratified according to obesity and children were randomly selected from each school. Anthropometric assessment was performed in children whilst a socio-demographic survey and a 24 hour recall of food intake were applied to their mothers. We classified the sample according to SEL in two categories (higher and a lower vulnerability). The prevalence of excess weight was 51.1% (24.7% overweight and 26,4% obese) without significant differences among SEL. The most vulnerable group had lower values of body mass index, skinfold thickness, arm circumference and food intake however, these differences were not statistically significant. At the same time, these children were physically more active, showing higher use of community places to play [OR 1.91; 95% CI 1.05-3.48] and walked larger distances from houses to schools OR 6.6; CI 2.5-16.7). Thus, albeit non significant association was detected between SEL and anthropometric indicators nor with food intake, the highest vulnerable group showed a tendency to have lower values and more physical activity.