Valores del índice cintura/cadera en población escolar de Bogotá, Colombia: Estudio

Objetivo: Determinar los valores del índice cintura/cadera (ICC) en una población escolar de Bogotá, Colombia, pertenecientes al estudio FUPRECOL. Métodos: Estudio descriptivo y transversal, realizado en 3.005 niños y 2.916 adolescentes de entre 9 y 17,9 años de edad, pertenecientes a 24 instituciones educativas oficiales de Bogotá, Colombia. Se tomaron medidas de peso, talla, circunferencia de cintura, circunferencia de cadera. El estado de maduración sexual se recogió por auto-reporte. Se calcularon los percentiles (P3, P10, P25, P50, P75, P90 y P97) según sexo y edad y se realizó una comparación entre los valores del ICC observados con estándares internacionales. Resultados: De la población general (n=5.921), el 57,0% eran mujeres (promedio de edad 12,7 ± 2,3 años). En todas las edades el ICC fue mayor en los varones que en las mujeres, observándose un descenso en la media de los valores obtenidos desde los 9 hasta los 17,9 años. En varones, los valores del ICC mayores del P90 (asociados a riesgo cardiovascular) estuvieron en el rango 0,87 y 0,93 y en las mujeres entre 0,85 y 0,89. Al comparar los resultados de este estudio, por grupos de edad y sexo, con trabajos internacionales de niños y adolescentes de Europa, Suramérica, Asia y África, se observa que los valores del ICC fueron menores en este estudio en ambos sexos, con excepción de los escolares originarios de Grecia y Venezuela. Conclusiones: Se presentan percentiles del ICC según edad y sexo que podrán ser usados de referencia en la evaluación del estado nutricional y en la predicción del riesgo cardiovascular desde edades tempranas en población de Bogotá, Colombia.

Índice de adiposidad corporal como predictor de obesidad y de síndrome metabólico en adultos de Bogotá, Colombia

Recientemente, Bergman et al. desarrollaron el índice de adiposidad corporal (IAC), como un marcador de obesidad por exceso de grasa corporal en la práctica clínica. En este estudio se evaluó la validez del IAC como marcador de obesidad por exceso de adiposidad, además de examinar la capacidad predictiva del IAC con componentes e índices metabólicos asociados al SM en adultos de Bogotá, Colombia.

Percentiles de circunferencia de cintura en escolares de Bogotá, Colombia Estudio FUPRECOL

Objetivo: Determinar la distribución por percentiles de la circunferencia de cintura en una población escolar de Bogotá, Colombia, pertenecientes al estudio FUPRECOL. Métodos: Estudio transversal, realizado en 3.005 niños y 2.916 adolescentes de entre 9 y 17,9 años de edad, de Bogotá, Colombia. Se tomaron medidas de peso, talla, circunferencia de cintura, circunferencia de cadera y estado de maduración sexual por auto-reporte. Se calcularon los percentiles (P3, P10, P25, P50, P75, P90 y P97) y curvas centiles según sexo y edad. Se realizó una comparación entre los valores de la circunferencia de cintura observados con estándares internacionales. Resultados: De la población general (n=5.921), el 57,0% eran chicas (promedio de edad 12,7±2,3 años). En la mayoría de los grupos etáreos la circunferencia de cintura de las chicas fue inferior a la de los chicos. El aumento entre el P50-P97 de la circunferencia de cintura , por edad, fue mínimo de 15,7 cm en chicos de 9-9.9 años y de 16,0 cm en las chicas de 11-11.9 años. Al comparar los resultados de este estudio, por grupos de edad y sexo, con trabajos internacionales de niños y adolescentes, el P50 fue inferior al reportado en Perú e Inglaterra a excepción de los trabajos de la India, Venezuela (Mérida), Estados Unidos y España. Conclusiones: Se presentan percentiles de la circunferencia de cintura según edad y sexo que podrán ser usados de referencia en la evaluación del estado nutricional y en la predicción del riesgo cardiovascular desde edades tempranas.

Obesidade adolescente, composição corporal e aptidão física

RESUMO: A principal razão que me levou a escolher este estágio e esta intervenção, foi o facto de gostar muito de trabalhar com jovens. Esse gosto, aliado à paixão que tenho pelo exercício e saúde, trouxe-me para um projecto que visa alterar e promover estilos de vida saudáveis em jovens obesos com idades entre os 12 e os 16 anos de idade. O estágio teve a duração de 10 meses, de Outubro de 2010 a Julho de 2011. Começamos com a definição dos protocolos a implementar e das tarefas a realizar. A primeira dessas tarefas, centrava-se no recrutamento da amostra que pretendíamos para desenvolver o estudo. Paralelamente ao projecto TOP, colaborámos também nas consultas de obesidade pediátrica no Hospital de Santa Maria, o que nos permitiu recrutar jovens que iam às consultas e incluí-los no projecto TOP. Após termos efectuado o recrutamento, começámos com as aulas práticas e teóricas. Essas aulas ocorriam na Universidade Lusófona, todos os sábados, das 10 às 12 horas. Eram sempre da nossa responsabilidade as aulas práticas, e as teóricas quando se falava de exercício. Nas aulas práticas realizavam-se circuitos, jogos tradicionais, jogos colectivos, e jogos que promovessem a competição saudável e a inter-ajuda, visto que ali todos os participantes tinham um objectivo comum. Durante o ano foram realizadas duas colónias de férias, onde organizámos outro tipo de actividades, nomeadamente mini-golf e caminhadas na zona do Jamor. Tanto as colónias de férias, como as avaliações eram da nossa inteira responsabilidade, desde a preparação, à execução e realização das mesmas. De referir que, tendo em conta os resutados obtidos, os participantes que melhoraram na sua capacidade cardiovascular apresentaram igualmente melhoras ao nível da composição corporal, nomeadamente com a diminuição do perímetro da anca e do perímetro acima das cristas ilíacas. Importa ainda referir que ocorreram melhorias significativas (p <0,05) ao nível da composição corporal, no que se refere ao perímetro da meia distância entre a grelha costal e as cristas ilíacas, no teste da flexibilidade dos membros inferiores e na força média. Os objectivos do estágio centravam-se em adquirir competências no que diz respeito a conhecer as características da população alvo tanto das consultas como do programa TOP, saber aplicar as recomendações internacionais de actividade física para adolescentes obesos, ser capaz de adaptar a prescrição de exercício às diferentes necessidades dos adolescentes, planear e colocar em prática os planos de aula da componente física do TOP, conduzir de forma autónoma uma consulta de avaliação e aconselhamento físico, interagir em contexto clínico com especialidades de outras áreas de intervenção, planear e implementar a calendarização das sessões teórico-práticas do Projecto TOP, saber colaborar com uma equipa multidisciplinar num ambiente clínico e colaborar na intervenção e elaboração de um projecto científico. Os resultados obtidos demonstram que uma replicação futura deste projecto, tendo em conta sempre limitações que possam ocorrer, por exemplo, ao nível dos protocolos e testes, pode melhorar a qualidade de vida do adolescente, com vista a um futuro adulto mais saudável.ABSTRACT: The main reason that made me decide on this internship is the fact that I enjoy working with young people. This, combined with the passion I have for exercising and health, led me to a project aiming at changing lifestyles by promoting a healthy lifestyle among obese young people aged between 12 and 16 years old. The internship lasted for 10 months, from October 2010 to July 2011. We started with the definition of protocols to implement and carry out the POT project (Pediatric Obesity Treatment). The first task focused on the recruitment of the sample we needed to conduct the study for this project. Along with the POT project, we‟ve also collaborated in clinical pediatric obesity surgery in Santa Maria Hospital, which allowed us to recruit young people who came to surgery and include them in the sample. After having carried out the recruitment, we started with the practical and theoretical lessons. These lessons took place at the Universidade Lusófona de Humanidades e Tecnologias (ULHT) every month on Saturdays from 10 to 12. It was always our responsibility to prepare and present both the physical lessons and the theoretical ones concerning advice on everyday exercising. During practical lessons, circuits, traditional games and team games were held in order to promote a healthy competition and mutual help, since all the participants had a common goal. During the year there were two holiday camps, where we did many more activities, including mini-golf and walking in the area of Jamor. In those camps, all activities and evaluation sessions were our responsibility. By analysing the results we came to the conclusion that the participants who improved their cardiovascular capacity also improved their body composition, particularly with the reduction of the hip circumference and the circumference above the iliac crests. It should also be noted that significant improvements (p <0.05) in terms of body composition occurred namely concerning the circumference of the half distance between the rib cage and the iliac crests, the test of lower limbs flexibility and average strength. The objectives of the internship were to develop the ability to understand the characteristics of the adolescents in the POT project, know how to apply international recommendations for physical activity for obese adolescents, being able to individualize the exercise prescription for the different needs of adolescents, plan and implement physical and theorical lessons, conduct an independent surgery with a physical evaluation and counseling, interact in the context of other clinical speciality areas, plan and implement the scheduling of theoretical-practical sessions, learn how to collaborate with a multidisciplinary team in a clinical setting, intervene and collaborate in the development of a scientific project. The results show that a future replication of this project, always taking into account constraints that may occur, for example, the ones concerning the protocols, the testing, can improve the quality of life of adolescents aiming to a healthier adult life.

A suplementação com extracto de "Ascophyllum nodosum" está associada às modificações antropométricas registadas em mulheres com excesso de peso e obesos durante um ensaio aleatorizado de restrição energética

Uma formulação oral sob a forma de cápsulas contendo um extrato de Ascophyllum nodosum, foi testada em mulheres com execesso de peso e obesas (n=42) numa dieta hipocalórica. A vinte e um indivíduos foi atribuído, para além da dieta hipocalórica, o extrato de algas castanhas comestíveis, enquanto que outros 21 indivíduos seguiram apenas a dieta hipocalórica. Após 8 semanas de suplementação, foi observada no grupo que recebeu o extrato de algas castanhas comestíveis uma diminuição nas médias de: perda de peso, índice de massa coporal e perímetro da anca. O consumo de extrato de Ascophyllum nodosum, durante a restrição energética ao longo de 8 semanas, mudou a antropometria nestas mulheres com excesso de peso e obesas.

Arterial compliance, blood pressure, plasma leptin, and plasma lipids in women are improved with weight reduction equally with a meat-based diet and a plant-based diet

Obesity, strongly associated with the risk for coronary heart disease (CHD), is becoming increasingly prevalent. This study was designed to establish first whether systemic arterial compliance (SAC), an index of arterial function, is improved with weight loss and second, whether cardiovascular risk factors that improve with weight loss are reduced equally with lean meat or with an equivalent amount of plant protein in the diet. Thirty-six women, mostly overweight or obess, aged 40 ± 9 years, were allocated nonrandomly to a 16-week parallel-design trial of two equienergetic diets designed to lead to weight loss, with one arm of the study emphasizing red meat and the other soybeans as the major protein source. Body weight, waist and hip circumference, and plasma lipids, glucose, insulin, and leptin levels were measured, and SAC was calculated from ultrasound measurement of aortic flow velocity and aortic root driving pressure. Subjects lost weight (9% of body weight in 16 weeks) and showed decreased plasma total and low-density lipoprotein (LDL) cholesterol (12% and 14%, P < .0001, respectively), triacylglycerol (17%, P < .05), and leptin (24%, P < .01) concentrations. However, lipoprotein(a) [Lp(a)] levels did not change significantly. Mean arterial pressure (MAP) decreased 7% and SAC increased 28% (P < .001 for both). However, only the decrease in arterial pressure correlated significantly with the reduction in the waist to hip ratio (WHR), and the improvement in SAC correlated inversely with the blood pressure reduction (P < .001 for both). Further, weight loss and the metabolic benefits of weight loss occurred equally with the meat-based and plant-based diets. We conclude that moderate weight loss in women leads to a substantial reduction in the cardiovascular risk, including SAC.

Bipolar disorder and adiposity : a study using whole body dual energy X-ray absorptiometry scans

Objective: Previous research has demonstrated a relationship between adiposity and bipolar disorder, although data are derived predominantly from patient samples and use indirect methods of assessing adiposity. This study investigated the association between bipolar disorder and several indices of adiposity, including body fat mass as measured by dual energy X-ray absorptiometry (DXA), in a community-based sample.

Methods: In this study, 21 women with bipolar disorder and 523 healthy controls were drawn from an age-stratified, random, community-based sample of women (20–93 years) participating in the Geelong Osteoporosis Study. Bipolar disorder was diagnosed utilising a semi-structured clinical interview. Anthropometric measurements (weight, height, waist and hip circumference) were taken and fat mass was determined from whole body DXA scans (Lunar DPX-L).

Results: Those with bipolar disorder tended to have greater adiposity. Age-adjusted mean (95% CI) values for bipolar versus controls according to adiposity indices were weight 75.6 (68.9–82.3) versus 72.6 (71.3–74.0) kg, waist circumference 89.8 (84.1–95.6) versus 87.3 (86.1–88.5) cm, waist:hip ratio 0.85 (0.82–0.87) versus 0.84 (0.83–0.84), body mass index 27.6 (25.1–30.1) versus 27.5 (27.0–28.0) kg/m2, fat mass 31.4 (26.5–36.3) versus 28.6 (27.5–29.5) kg and %body fat 40.4 (36.9–43.9) versus 38.0 (37.3–38.7)%; all p > 0.05. Further adjustment for height, smoking, alcohol, psychotropic medication, energy intake or physical activity did not influence these patterns.

Conclusion: Although a pattern suggestive of greater adiposity among those with bipolar disorder was observed, no significant differences were detected. We cannot exclude the possibility of a type II error. Further research with a larger sample may produce more conclusive results.

Lifestyle factors fail to explain the variation in plasma leptin concentrations in women

To assess the relationship between circulating leptin concentrations, metabolic parameters, and lifestyle factors such as alcohol intake, physical activity level, smoking habits, and reproductive history, a cohort of 359 women was drawn from a population-based study conducted in Victoria, Australia. The parameters measured included body mass index (BMI); waist and hip circumference; blood pressure; and fasting glucose, insulin, triacylglycerol, cholesterol, and leptin concentrations. In addition, a self-administered questionnaire was used to assess reproductive history, physical activity level, alcohol intake, and smoking habits. Our results demonstrated that BMI, body weight, waist circumference, and hip circumference were all strongly correlated with circulating leptin concentrations in this population (r > 0.56, P < 0.001 in all cases). Waist/hip ratio, triacylglycerols, insulin, glucose, and cholesterol were also associated with leptin (P < 0.05), but there was no association between leptin and age, height, or blood pressure. When these associations were adjusted for BMI, age, glucose, and waist circumference were significantly associated with leptin. The lifestyle factors examined did not help to explain the observed variation in leptin concentrations between individuals when results were adjusted for degree of adiposity and age.

The influence of body build on estimates of body composition from anthropometric measurements in premenopausal women

Objective: To assess the influence of body build on the bias and limits of agreement for estimates of body fat obtained from anthropometric prediction equations when compared with the same data obtained by dual energy X-ray absorptiometry (DEXA).

Survey design and subjects: Ninety-one premenopausal women, aged between 20 and 54 years, were chosen to represent a range of skeletal body build (relative silting height 0.50-0.56) and body fatness [body mass index (BMI) 18-34 kg/m²]. Measurements of weight, sitting height, stature, skinfold thickness, waist, umbilical and hip circumference and total body resistance and reactance were made on all subjects by standard techniques after an overnight fast. A DEXA measurement of total body fat, fat-free soft tissue and total body bone mineral mass was also obtained within 2 weeks of the anthropometric assessment.

Results: At the group level the mean difference (bias) between DEXA and the anthropometric estimates of body fat was similar for all three anthropometric estimates ranging from 2.7 kg with impedance to 1.8 kg with skinfold thickness. The 95% limits of agreement were also similar, ranging from ±5.3 kg with body mass index to ±4.1 kg with impedance. Umbilical circumference, BMI and the amount of bone mineral expressed as a proportion of the fat-free soft-tissue mass were all significantly (P < 0.01) correlated with the level of bias between DEXA and the anthropometric estimates of body fat. This was not the case for relative sitting height or measures of body fat distribution. Regression equations which included BMI or umbilical circumference in combination with the predicted estimates of body fat essentially eliminated the association between the level of bias in predicted body fat and the level of body fatness. They also reduced the 95% limits of agreement between DEXA and the anthropometric estimates of body fat.

Conclusions: Using DEXA estimates of body fat as the standard of reference our results suggest that the comparability and precision of body fat estimates derived from age- and/or sex-specific anthropometric prediction equations based on skinfolds and BMI, but not impedance, can be improved by adjusting for differences in BMI and umbilical circumference respectively.

Relationship of serum leptin to total and truncal body fat

1. In this study we investigated the relationship between serum leptin levels and body fat distribution in a random sample of women of widely ranging age and body mass index. Anthropometry and dual energy X-ray absorptiometry were used to measure body fat and its distribution.

2. Leptin levels (log transformed) were not significantly correlated with age, but were significantly positively correlated (P < 0.001) with most anthropometric measures except waist-to-hip circumference ratio. The strongest correlations were with total grams of body fat and percentage body fat (r = 0.68 and 0.76 respectively, P < 0.001). When corrected for percentage body fat the partial correlation coefficients for all other measures became non-significant. The correlation with truncal body fat fell significantly from 0.66 to - 0.05 after correction, but the partial correlation with total body fat remained significant (P < 0.005) when grams of truncal fat were controlled for (r = 0.21).

3. These results indicate that the relationship of serum leptin to percentage body fat is the strongest, and that truncal body fat, although the most metabolically active, does not appear to have an independent association with serum leptin.

Cross-sectional study of 24-hour urinary electrolyte excretion and associated health outcomes in a convenience sample of Australian primary schoolchildren: the salt and other nutrients in children (SONIC) study protocol

BACKGROUND: Dietary sodium and potassium are involved in the pathogenesis of cardiovascular disease. Data exploring the cardiovascular outcomes associated with these electrolytes within Australian children is sparse. Furthermore, an objective measure of sodium and potassium intake within this group is lacking. OBJECTIVE: The primary aim of the Salt and Other Nutrient Intakes in Children ("SONIC") study was to measure sodium and potassium intakes in a sample of primary schoolchildren located in Victoria, Australia, using 24-hour urine collections. Secondary aims were to identify the dietary sources of sodium and potassium, examine the association between these electrolytes and cardiovascular risk factors, and assess children's taste preferences and saltiness perception of manufactured foods. METHODS: A cross-sectional study was conducted in a convenience sample of schoolchildren attending primary schools in Victoria, Australia. Participants completed one 24-hour urine collection, which was analyzed for sodium, potassium, and creatinine. Completeness of collections was assessed using collection time, total volume, and urinary creatinine. One 24-hour dietary recall was completed to assess dietary intake. Other data collected included blood pressure, body weight, height, waist and hip circumference. Children were also presented with high and low sodium variants of food products and asked to discriminate salt level and choose their preferred variant. Parents provided demographic information and information on use of discretionary salt. Descriptive statistics will be used to describe sodium and potassium intakes. Linear and logistic regression models with clustered robust standard errors will be used to assess the association between electrolyte intake and health outcomes (blood pressure and body mass index/BMI z-score and waist circumference) and to assess differences in taste preference and discrimination between high and low sodium foods, and correlations between preference, sodium intake, and covariates. RESULTS: A total of 780 children across 43 schools participated. The results from this study are expected at the end of 2015. CONCLUSIONS: This study will provide the first objective measure of sodium and potassium intake in Australian schoolchildren and improve our understanding of the relationship of these electrolytes to cardiovascular risk factors. Furthermore, this study will provide insight into child taste preferences and explore related factors. Given the cardiovascular implications of consuming too much sodium and too little potassium, monitoring of these nutrients during childhood is an important public health initiative.

Comparison of anthropometric measures as predictors of cancer incidence: a pooled collaborative analysis of 11 Australian cohorts

Obesity is a risk factor for cancer. However, it is not known if general adiposity, as measured by body mass index (BMI) or central adiposity [e.g., waist circumference (WC)] have stronger associations with cancer, or which anthropometric measure best predicts cancer risk. We included 79,458 men and women from the Australian and New Zealand Diabetes and Cancer Collaboration with complete data on anthropometry [BMI, WC, Hip Circumference (HC), WHR, waist to height ratio (WtHR), A Body Shape Index (ABSI)], linked to the Australian Cancer Database. Cox proportional hazards models assessed the association between each anthropometric marker, per standard deviation and the risk of overall, colorectal, post-menopausal (PM) breast, prostate and obesity-related cancers. We assessed the discriminative ability of models using Harrell's c-statistic. All anthropometric markers were associated with overall, colorectal and obesity-related cancers. BMI, WC and HC were associated with PM breast cancer and no significant associations were seen for prostate cancer. Strongest associations were observed for WC across all outcomes, excluding PM breast cancer for which HC was strongest. WC had greater discrimination compared to BMI for overall and colorectal cancer in men and women with c-statistics ranging from 0.70 to 0.71. We show all anthropometric measures are associated with the overall, colorectal, PM breast and obesity-related cancer in men and women, but not prostate cancer. WC discriminated marginally better than BMI. However, all anthropometric measures were similarly moderately predictive of cancer risk. We do not recommend one anthropometric marker over another for assessing an individuals' risk of cancer.

Obesity in adults: an emerging problem in urban areas of Ho Chi Minh City, Vietnam

OBJECTIVE: To assess the prevalence of overweight, obesity and underweight among Vietnamese adults living in urban areas of Ho Chi Minh City (HCMC), Vietnam. DESIGN: This cross-sectional survey was conducted in the local health stations of 30 randomly selected wards, which represent all 13 urban districts of HCMC, over a period of 2 months from March to April 2004. SUBJECTS: A total of 1488 participants aged 20-60 years completed the interview, physical examination and venous blood collection. MEASUREMENTS: Anthropometric measurements of body weight, height, waist and hip circumference were taken to construct indicators of adiposity including body mass index (BMI), waist circumference, and waist-to-height and waist-to-hip ratios. Both systolic and diastolic blood pressure and biochemical indicators of cardiovascular disease and type II diabetes risk (lipid profile and fasting blood glucose) were also measured. RESULTS: The age and sex standardized prevalence of overweight and obesity using Asian specific BMI cutoffs of 23.0 and 27.5 kg/m2 was 26.2 and 6.4%, respectively. The prevalence of overweight and obesity was slightly higher in females (33.6%) than males (31.6%), and progressively increased with age. The age and sex-standardized prevalence of underweight (BMI <18.5 kg/m2) among Vietnamese adults living in HCMC was 20.4%. The prevalence was slightly higher in males (22.0%) than in females (18.9%), and there was a much higher prevalence in all underweight categories in younger women than in men but this was reversed for older men. CONCLUSION: The adult population in HCMC Vietnam is in an early 'nutrition transition' with approximately equal prevalence of low and high BMI. The prevalence of overweight and obesity of Vietnamese urban adults was lower than that reported for other east and southeast Asian countries.

Menstrual irregularity: a possible clinical marker of metabolic dysfunction in women with class III obesity

Purpose. To evaluate whether menstrual irregularity in morbidly obese women is indicative of metabolic dysfunction.Patients and Methods. Fifty-seven women with morbid obesity were evaluated. They were divided into two groups: one comprising women without menstrual dysfunctions or hirsutism (Group 1), and another obese women showing menstrual dysfunction with or without hirsutism (Group 2). The following were evaluated: age, colour, childbirth, marital status, profession, socio-economic level, education, age at menarche, body weight, height, body mass index, presence of hirsutism (Ferriman Gallwey Index), abdominal circumference, hip circumference, waist-to-hip ratio, menstrual cycle, blood pressure, presence of acanthosis nigricans, insulin resistance (IR), fasting glycaemia, total cholesterol, HDL-C, LDL-C, triglycerides, thyroid-stimulating hormone, free T4, luteinising hormone (LH), follicle-stimulating hormone, prolactin, total testosterone, dehydroepiandrosterone sulfate, insulin and the Homeostasis Model Assessment (HOMA test).Results. Clinical and epidemiological aspects did not present statistical differences. Clinical and laboratory parameters did not show statistically significant alterations; however, HOMA test values for Group 2 were significantly higher than those for Group 1.Conclusions. The presence of IR in class III obese women can cause menstrual dysfunctions such as amenorrhoea or oligomenorrhoea even in the absence of hyperandrogenism, suggesting that IR plays an important role in the ovarian mechanisms involved in the menstrual cycle control.