RESUMO
OBJECTIVES: We conducted a study of the food environment and nutritional status among women and children living on a Galapagos Island. Anthropometric and body silhouette data give insight into body size perceptions for women and their young children. We frame our findings in the context of the nutrition transition. METHODS: A convenience sample was recruited via word-of-mouth for in-depth interviews and assessments of household food security, dietary intake, anthropometrics, and body image. Interviews took place in 2011 on San Cristobal Island, one of four inhabited islands in the Galapagos archipelago. Twenty women with children between the ages of one and six participated, all permanent residents of San Cristobal Island. RESULTS: Most women (60%) reported limited availability of fresh produce due to an unreliable food supply shipped from mainland Ecuador. Despite reported food insecurity in our sample (55%), more than half of the children (55%) experienced high dietary diversity measured by 24 h recall. Women tended to report less dietary diversity than their children, which may be linked to a stated desire to be thinner. Eighty percent of children were classified as normal weight, while 75% of women were overweight or obese. Conclusions for Practice: Results provide an initial survey of the food landscape on one Galapagos Island. By combining qualitative interviews with indicators of nutritional status, the narrative data allow an interpretation of issues of food security, dietary intakes, dietary diversity, and body size. This study forms the basis for a larger examination of these issues in the Galapagos islands.
Assuntos
Imagem Corporal , Abastecimento de Alimentos , Estado Nutricional , Adulto , Tamanho Corporal , Pré-Escolar , Dieta , Equador , Feminino , Abastecimento de Alimentos/estatística & dados numéricos , Humanos , Entrevistas como Assunto , Masculino , Pesquisa QualitativaRESUMO
RESUMEN Objetivo:inferir el modelo probabilístico que represente a nivel estatal las discrepancias entre percepción y aspiración de la población mexicana en cuanto a su figura, a través de las denominadas siluetas de Stunkard, Sorenson y Schulsinger. Metodología: con muestras representativas a nivel estatal provenientes de la Encuesta Nacional de Salud y Nutrición (ENSANUT) 2012, se estimaron discrepancias entre distintos Índices de Masa Corporal (IMC): el medido y el autoreportado. Se utilizaron pruebas de bondad de ajuste y, con modelos ajustados de normalidad estadística, se calcularon probabilidades. Se aplicaron clusters jerárquicos a variables vinculadas con las discrepancias para identificar similitudes entre las muestras de los estados. Resultados: con la prueba Kolmogorov-Smirnov (KS), la Anderson-Darling (AD) y la Ji cuadrada (χ2) con una significancia del 1%, se ajustaron las discrepancias por sexo y estados, y en su mayoría se obtuvo una distribución normal. Se realizaron algunas estimaciones de probabilidades y se aplicó la regla empírica, con lo que se dimensionó la magnitud del posible conocimiento del IMC medido y de la satisfacción existente. Se identificaron grupos de estados que comparten similitudes en sus poblaciones en relación a variables estimadas. Conclusiones: se constató una percepción equivoca y una aspiración sistemática, permeadas de heterogeneidad ante un escenario de obesidad y sobrepeso que posee la mayor parte de la población mexicana.
ABSTRACT: Objective: to infer the probabilistic model of the discrepancy between how Mexicans perceive and aspire to be in their figure through the so-called Stunkard, Sorenson and Schulsinger silhouettes at state level. Methodology: we estimate discrepancies between different Body Mass Indexes (BMI): the measured and the auto reported. Then state samples are employed coming from the Mexican National Health and Nutrition Survey (ENSANUT) 2012. Goodness-of-fit tests are used, and, with adjusted normal models, specific probabilities are calculated. Some variables linked to discrepancies are taken into account for applying hierarchical clusters to identify similarities between states. Results: the Kolmogorov-Smirnov (KS), Anderson-Darling (AD) and Chi-square (χ2) tests were employed to model discrepancies by sex and state. The Normal distribution was recognized as appropriate. Some estimates of probabilities are made and the Empirical Rule is applied, which measures the magnitude of the possible knowing of the real BMI and the existing satisfaction. We identify groups of states that share similarities in their populations in relation to estimated variables. Conclusions: there is an erroneous perception and a systematic aspiration, permeated by heterogeneity in the face of a scenario of obesity or overweight in most mexicans.
Assuntos
Humanos , Masculino , Feminino , Adulto , Autoimagem , Imagem Corporal , Índice de Massa Corporal , Antropometria , Inquéritos Nutricionais , Sobrepeso , México , ObesidadeRESUMO
Introduction Little specific information has been published about the health of people who live in the Galapagos Islands. As part of determining the status of the nutrition transition that may be occurring in the islands mothers of young children in the Galapagos perceptions of their child's body size and therefore health status was evaluated along with actual body size. Methods This paper presents data collected as part of a pilot study that used a mixed methods approach to identify and describe health and nutrition issues for mother-child pairs on Isla Isabela in Galapagos, Ecuador. It includes participant anthropometric assessment and self-perception of body size using silhouettes for themselves and one of their children along with open-ended questions to elicit further understanding of body size perceptions. Twenty mothers of children greater than 6 months of age but less than 6 years of age were interviewed. Results The women preferred a smaller body size for themselves but a larger body size for their children. Findings of different body size combinations between mothers and children in the same household demonstrated that the island is undergoing or may be post the nutrition transition. Discussion This dual burden of body weights (especially overweight or obese mothers) in the same household with underweight, normal and overweight or obese children and the potential nutrition related chronic disease burden in the future will require more educational resources and innovative health services than are currently available for the people of the Galapagos.
Assuntos
Tamanho Corporal , Conhecimentos, Atitudes e Prática em Saúde , Mães/psicologia , Obesidade/etnologia , Percepção de Peso , Adulto , Índice de Massa Corporal , Peso Corporal , Criança , Pré-Escolar , Características Culturais , Equador/epidemiologia , Feminino , Humanos , Entrevistas como Assunto , Mães/estatística & dados numéricos , Obesidade/epidemiologia , Obesidade/psicologia , Sobrepeso/etnologia , Pobreza , Pesquisa Qualitativa , Fatores Socioeconômicos , Adulto JovemRESUMO
Introducción. En México, el sobrepeso y la obesidad se han convertido en un problema de salud pública. Para diagnosticar estas enfermedades por lo regular se recurre a indicadores antropométricos. Sin embargo, en algunas situaciones o lugares no se dispone del equipo que se requiere para medir las dimensiones antropométricas. El objetivo de este estudio fue validar la utilización de siluetas corporales para evaluar el estado de nutrición en escolares y adolescentes mexicanos de zonas urbanas. Métodos. Se realizó un estudio transversal con sujetos de 6 a 18 años de edad de la Ciudad de México (n =1862). Fueron validadas 2 tipos de siluetas corporales (Stunkard y KEDS) tomando como estándar el índice de masa corporal para edad estimado a partir del peso y la talla medidos. Se utilizó la metodología de la curva ROC (receiver operating characteristic) para evaluar la exactitud de los diagnósticos derivados de las siluetas, estimándose el área bajo la curva (ABC) y el mejor punto de corte (MPC) para cada tipo de silueta. Resultados. La mayor exactitud para diagnosticar obesidad se obtuvo con la evaluación realizada por las entrevistadoras utilizando las siluetas de Stunkard (ABC =0.94), con las cuales se puede considerar que existe obesidad cuando las personas se ubican de la silueta V en adelante. Conclusiones. Cuando no se dispone de recursos para medir el peso y la estatura, es posible utilizar las siluetas de Stunkard para tener una aproximación al estado de nutrición de escolares y adolescentes.
Background. In México, overweight and obesity have become a public health problem. Anthropometric measurements are generally used to diagnose these illnesses. However, in some situations or places there is no equipment available to measure these anthropometric indicators. The aim of the present study is to validate the body silhouette to assess the nutritional status of school-age children and adolescents. Methods. A cross-sectional study was carried out with 6- to 18-year-old subjects from México City (n =1862). Two types of body silhouettes (Stunkard and KEDS) were validated. Body mass index for age estimated by mean height and weight was used as standard. To assess the accuracy of the diagnosis with the body silhouette, ROC curve (receiver operating characteristic) method was used. The area under the curve (AUC) and optimal cut-off (OC) were estimated. Results. The most accurate assessment for diagnosing obesity was obtained by the interviewers who used the Stunkard silhouettes (AUC = 0.94). The fifth silhouette was the OC. Conclusions. When necessary equipment for measuring weight and height are unavailable, the Stunkard silhouettes can be used as a proxy indicator of the nutritional status of school-age children and adolescents.