RESUMEN
(1) Background: Guatemala is the Latin American country with the highest prevalence of childhood stunting. Short height can bias the diagnosis of wasting when using the weight-for-height indicator. The aim of this study was to evaluate the diagnostic concordance of the anthropometric indicators of wasting and the relationship between wasting and stunting in children from highly vulnerable communities in Guatemala. (2) Methods: The sample consisted of 13,031 anthropometric records of children under five years of age (49.5% girls, average age of 27.9 months), including weight, height, and mid-upper arm circumference (MUAC), collected in March-August 2019. The proportions of stunting, underweight, and wasting, assessed by three different indicators, as well as their concurrence through the Composite Index of Anthropometric Failure were calculated. (3) Results: Stunting affected 73% of the sample, and 74.2% showed anthropometric failure. Wasting varied by indicator (weight-for-height: 2.8%; MUAC: 4.4%; MUAC-for-age: 10.6%). Concordance between MUAC and weight-for-height was very low (Kappa: 0.310; sensitivity: 40.9%). MUAC identified more wasted children in the stunted group (53.6% vs. 26.5%), while the opposite occurred in the non-stunted group (34.8% vs. 46.7%). (4) Conclusion: The presence of stunting affected the diagnosis of wasting, and both indicators should be included as diagnostic criteria for screening campaigns and in the treatment of moderate to acute wasting in vulnerable populations affected by multiple forms of undernutrition.
Asunto(s)
Desnutrición , Salud Pública , Estatura , Caquexia , Niño , Preescolar , Femenino , Trastornos del Crecimiento/diagnóstico , Trastornos del Crecimiento/epidemiología , Trastornos del Crecimiento/etiología , Guatemala/epidemiología , Humanos , Lactante , Masculino , Desnutrición/diagnóstico , Desnutrición/epidemiologíaRESUMEN
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.
Asunto(s)
Adiposidad , Brazo/anatomía & histología , Músculo Esquelético/anatomía & histología , Adolescente , Antropometría , Argentina , Niño , Preescolar , Femenino , Humanos , Masculino , Obesidad/diagnóstico , Sobrepeso/diagnóstico , Caracteres Sexuales , Grosor de los Pliegues Cutáneos , Factores Socioeconómicos , Estados UnidosRESUMEN
OBJECTIVE: The Tarahumara ethnic group is composed of indigenous people from the Sierra Madre Occidental of Mexico. Conditions of isolation and poverty compel them to migrate to the city in search of better opportunities. This work aims to explore the influence of migration on the growth and nutritional status of Tarahumara schoolchildren. METHODS: One hundred Tarahumara students were analyzed (50 rural with a mean age of 9.78 ± 1.25 years; 50 urban aged 10.0 ± 1.04 years), comparing anthropometric indicators and body composition (T-Student, U-Mann-Whitney Tests). RESULTS: Twenty percent of rural girls and 35% of rural boys showed stunted growth compared to only 9% of the urban girls (no stunted growth among urban boys). Migrants showed greater body size, skinfold thickness, and fat percentage. Weight excess, understood as an increase in the prevalence of overweight and obesity, was detected in 17.8% of urban boys and 13.6% of urban girls compared to 10.0% of boys and 3.3% of girls of the rural series. CONCLUSION: Migration reduces stunting and increases adiposity.
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Trastornos del Crecimiento/epidemiología , Estado Nutricional , Obesidad/epidemiología , Sobrepeso/epidemiología , Migrantes , Adolescente , Antropometría , Composición Corporal , Niño , Femenino , Trastornos del Crecimiento/etiología , Humanos , Indígenas Norteamericanos/estadística & datos numéricos , Masculino , México/epidemiología , Obesidad/etiología , Sobrepeso/etiología , Prevalencia , Población Rural , Población UrbanaRESUMEN
OBJECTIVES: To analyze the effect of altitude on weight and prematurity at birth in the Province of Catamarca (Argentina), between the years 1994 and 2003. METHODS: Records of 22,628 newborns were collected from the vital statistics of the census of Catamarca. Weight was recategorized to include low birth weight (<2,500 g), and gestational age was divided into births that had occurred before or after 37 weeks (preterm or at term births). Altitude was also recategorized (<1,500 m, 1,500-2,000 m, and > 2,000 m). Nonparametric statistical tests were performed. RESULTS: Differences were found in birth weight between sexes and in the incidence of low birth weight depending on altitude. This pattern changed according to gestational age, because those sexual differences were nonexistent or lower in preterm neonates with certain advantages for females. Moreover, it was found that the effects of hypoxia were not reflected in birth weight until later stages of intrauterine development. CONCLUSIONS: To be female appears to be a benefit under conditions of prematurity and high altitude. The increased incidence of prematurity due to altitude increase may reflect an adaptive advantage of preterm birth under these conditions.
Asunto(s)
Altitud , Peso al Nacer , Recién Nacido de Bajo Peso , Recien Nacido Prematuro , Adaptación Biológica , Argentina , Femenino , Edad Gestacional , Humanos , Recién Nacido , MasculinoRESUMEN
BACKGROUND: Various anthropometric parameters have been proposed for defining overweight in adolescence, but few studies have evaluated their diagnostic accuracy in comparative terms, using samples from different regions. AIM: To compare the performance of anthropometric parameters in determining the excess of adiposity in Argentinian and Spanish adolescents. SUBJECTS AND METHODS: The sample is composed of 1781 Argentinian and 1350 Spanish subjects, aged 12-17 years. Excess adiposity was defined as percentage BF in the 90th percentile or higher. ROC curves established the validity of parameters to define excess adiposity. RESULTS: Descriptive statistics showed differences between the Argentinian and Spanish samples. ROC curves indicate that all the parameters analysed had, in the Spanish and Argentinian samples, a positive and elevated association with excess of adiposity. The waist-to-height ratio had the highest value of the area under ROC curve (AUC), while conicity index and waist-to-hip ratio had the lowest. CONCLUSIONS: Differences exist with respect to size and body composition between the Argentinian and Spanish samples. ROC curves reflect a general pattern of variation. Waist-to-hip ratio and conicity index are less desirable in the diagnosis of excess adiposity and the most desirable is waist-to-height ratio.
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Adiposidad , Antropometría/métodos , Composición Corporal , Tamaño Corporal , Curva ROC , Tejido Adiposo/metabolismo , Adolescente , Argentina , Femenino , Geografía , Humanos , Masculino , Caracteres Sexuales , EspañaRESUMEN
La composición corporal y la distribución de la adiposidad son indicadores útiles para el diagnóstico temprano de factores de riesgo de enfermedades cardiovasculares. Se evaluó composición corporal, distribución de adiposidad y relación con actividad física en 300 adolescentes venezolanos (2006-2007), mediante el índice de masa corporal (IMC), áreas grasa (AG) y muscular (AM), distribución tronco/extremidad y actividad física (Test Krece Plus) y técnicas multivariantes. Se encontró: IMC: déficit 6,7% y exceso 11,7%. AG: 3,3% déficit y 12,7% exceso. AM 11,3% déficit y 19% exceso, 56% presentó nivel de actividad física malo, 33% regular y 11% bueno. En los adolescentes con sobrepeso la actividad física fue mala o regular. El primer clúster agrupó individuos de 13 años, normales y actividad física regular a buena; hombres 5,5 h mujeres 2,3h. El 2do clúster agrupó el déficit, y 3ro y 4to normales y exceso. Los varones practicaron más actividad física que las niñas (6,6-3,4)-(4,1-2,3). La edad caracterizó comportamiento en los clúster y se relacionó con la distribución de grasa. El test de actividad física contribuyó muy poco en la construcción de los ejes factoriales y fue débil su asociación con composición y distribución de grasa. Los jóvenes practican poca actividad física que se asocia a una distribución central y/o periférica de la adiposidad, ambos considerados factores de riesgo negativos para la salud de los adolescentes. La poca actividad física y las alteraciones en el patrón de distribución, pueden ser factores de riesgo modificables como parte de una política de atención integral al adolescente(AU)
Body composition and fat patterning are considered as predictor tools for an early diagnosis of risk of cardiovascular diseases. A study was conducted in 300 male and female Venezuelan adolescents (2006-2007) to explore body composition, and fat patterning, related to physical activity. Subjects were categorized based on body mass index (BMI), arm fat area (AFA), arm muscle area (AMA), central and peripheral distribution of fat and physical activity by Krece Plus questionnaire. Multivariante techniques were applied. According to BMI categories 6.7% were categorized as low and 11.7% as high; AFA classified 12.7% as high and 3.3% as low. AMA found 11.3% as low and 19% as high, 56% of adolescents did not archive a moderate or good physical activity. Overweight adolescents showed poor physical activity. The first cluster grouped most of the normal subjects, average age 13 years, and moderate and intense physical activity (5.5 /2.3 hours for males and females). The second cluster depicted subjects with deficit, normal and high ones were located on the third and four clusters. Boys were more active (6.6-3.3) than girls (4.1-2.3). Age was a variable that characterized the profile of the clusters and was related to body fat distribution. The physical test was not strong enough to the conformation of the factorial axes and was weakly associated with body composition and its distribution. The youngest were more sedentary linked to centralized and peripheral body fat distribution, both components recognized as contributing factors to a number of medical conditions, even during adolescence. A poor physical activity level and impairment of fat distribution could be considered modifiable risks factors as elements of integral policies for adolescents(AU)