The mild chronic inflammatory state associated with obesity may be an important link between adip... more The mild chronic inflammatory state associated with obesity may be an important link between adiposity and insulin resistance (IR). In a sample of 137 overweight and obese Chilean adolescents, we assessed associations between high-sensitivity C-reactive protein (hs-CRP), IR and adiposity; explored sex differences; and evaluated whether hs-CRP mediated the relationship between adiposity and IR. Positive relationships between hs-CRP, IR and 2 measures of adiposity were found. Hs-CRP was associated with waist circumference (WC) in boys and fat mass index (FMI) in girls. Using path analysis, we found that hs-CRP mediated the relationship between adiposity (WC and FMI) and the homeostatic model assessment of insulin resistance (HOMA-IR) (p < 0.05) in both sexes. Our novel finding is that inflammation statistically mediated the well described link between increased adiposity and IR.
The objective of the study was to assess a nutrition education and physical activity intervention... more The objective of the study was to assess a nutrition education and physical activity intervention to decrease obesity changing food habits and increasing physical activity in low socioeconomic women. Four groups were selected and followed-up during six months: one was intervened with food education and physical activity (group A); another with food education (group B); a third with physical activity (group C), and a control group. Three nutrition education workshops were carried out with community leaders and nutritionists, and three times per week physical activity sessions were performed. Anthropometric measurements and food and physical activity surveys were carried out before and after the intervention. Obesity increased in group A, but decreased 10% in the other two intervened groups (B and C), and total fatty mass decreased in group B. In the control group, obesity did not change but total fatty mass increased. Attendance to physical activity sessions was poor, with negative r...
Because the results of the nutritional status released by Chilean institutions which collect anth... more Because the results of the nutritional status released by Chilean institutions which collect anthropometric data on their population under control, show different increments in the prevalence of obesity between preschoolers and children in 1st grade, we decided to verify the real magnitude of this increase. This study is based on a longitudinal investigation which began in 2006 and included 1100, three-year old children, which we evaluated when they were 4, 5 and 6 y. The nutritional status was determined according to BMI Z and WHO References 2006/2007. The information was also used to determine the concordance between the anthropometric data collected on first graders by teachers from public schools in 2009 (JUNAEB data set) and the same children assessed in parallel by INTA (INTA data set). The sample included 474, six-year olds. No differences were found between the average BMI Z and HAZ of the two data sets, and the degree of concordance between the BMI Z's was good (rho = 0...
The purpose of this study was to incorporate nutrition education in Chilean primary schools. The ... more The purpose of this study was to incorporate nutrition education in Chilean primary schools. The baseline information included nutritional status, food consumption and physical activity of 1701 children from 3rd to 7th grade in ten urban and rural schools. Main results showed a high prevalence of obesity (15.4%) and overweight (19.6%), low consumption of vegetables, fruits, and dairy products, high intake of snacks and a low level of physical activity, especially in girls. Because the Ministry of Education does not allow the incorporation of new programs into the curriculum, the educational strategy was based on the development of a text book, a teacher's guide, five practical guides for students from third to eighth grade and a CD-Rom. These materials were validated by 36 teachers in six schools through an educational intervention. Teachers and students considered the educational materials useful, motivational and easy to understand. This program is being implemented in 57 scho...
To determine the attitude towards marketing of food and beverages a sample of 1,048 school childr... more To determine the attitude towards marketing of food and beverages a sample of 1,048 school children ages 8 to 13 from three cities of Chile (north, center and south of the country) were interviewed. The instrument applied was a validated questionnaire used in previous studies. A descriptive analysis of the variables was performed and differences were determined by region, socioeconomic level (SEL) and gender using Chi2 test. Differences per SEL were higher in Santiago. A greater proportion of school children of medium-low SEL watched more than 2 hours of TV during weekdays and weekends (p < 0.001). The proportion of children that liked food and beverage commercials was greater in medium-low SEL in Santiago (66%) (p < 0.001), as opposed to 26 to 35% in the medium high SEL. A high percentage indicated that they liked promotional campaigns of foods at supermarkets, on the streets, shopping centers and on the Internet. The preferred commercials were those for beverages, chocolates...
Potentially productive years of life lost (PPYLL) is an impact measure that illustrates the lost ... more Potentially productive years of life lost (PPYLL) is an impact measure that illustrates the lost that a society suffers as a consequence of deaths of young people or premature deaths. To study the evolution of PPYLL in adults in the periods 1994-1996 and 1999-2001, according to sex, income quintiles and main diagnostic groups in the communities of Metropolitan Santiago. Ecological study analyzing the population of Metropolitan Santiago, that represents 36% of the national population. A total of 87,969 deaths in people aged 20 to 79 years were analyzed. There is a greater amount of PPYLL among the poorest quintiles and men represent the higher number of PPYLL. In the different analyzed periods, all quintiles experienced a reduction in PPYLL. According to diagnosis, endocrine diseases experienced the greater decrease between periods, followed by respiratory disease. Noteworthy was the increase of PPYLL due to infectious diseases. PPYLL due to digestive diseases was 2.3 higher in the p...
Delphi method to identify education material on healthy food for teachers, school-age children an... more Delphi method to identify education material on healthy food for teachers, school-age children and their parents. Delphi method applied to get expert consensus about healthy food topics to include in educational materials for preschool and school-age children, their parents and teachers is described. The questionnaire was developed with the results of surveys and focus groups in children, parents and teachers made previously. The questionnaire was mailed to 54 experts in nutrition, education and communication in a first round. The results were analyzed and forwarded in a second round with the subjects without consensus. The cycle was completed by a validation conducted with teachers and parents and were prioritized by audiovisual educational materials on the writings, favoring participatory activities such as cooking workshops, games, activities over the passive (information at parent meetings, delivery of educational materials and conferences of experts). There was consensus on edu...
realizada por el Ministerio de Salud de Chile en los años 2009-2010, mostraron que la prevalencia... more realizada por el Ministerio de Salud de Chile en los años 2009-2010, mostraron que la prevalencia de obesidad alcanzaba al 20,5% y el sobrepeso al 45,3% en los hombres mayores de 15 años, en los que además se observaron altos niveles de sedentarismo (84%). A esto se sumaban prevalencias de hipertensión arterial del 28,7%, diabetes (8,4%), colesterol elevado (39%), colesterol HDL bajo 40 mg/dL (37,6%) y triglicéridos elevados (35,6%) (1). Una de las estrategias para abordar la prevalencia de enfermedades crónicas no transmisibles (ENT) propuesta por la Organización Mundial de la Salud (OMS) ha sido la promoción de salud en los lugares de trabajo, para benefi ciar a los trabajadores y generar impactos positivos en las empresas (2,3). Intervenciones que propician la alimentación adecuada y la práctica regular de actividad física en trabajadores se han asociado al incremento de hasta 20% en los niveles de productividad y reducción del ausentismo laboral (4-10). Goetzel y cols. ( ) proponen seis elementos caracterís-
En las últimas décadas, los profundos cambios experimentados en la alimentación y los estilos de ... more En las últimas décadas, los profundos cambios experimentados en la alimentación y los estilos de vida de la población, se han traducido en un significativo aumento en la prevalencia de obesidad y enfermedades no transmisibles asociadas a ella, como la hipertensión, la diabetes, las enfermedades cardiovasculares y algunos tipos de cáncer (1). Esto ha llevado a la Organización Mundial de la Salud (OMS) a proponer una estrategia mundial orientada a su prevención y control (2).
To assess the impact of a nutrition education program for teachers in the nutritional status, foo... more To assess the impact of a nutrition education program for teachers in the nutritional status, food knowledge and food consumption of their pre basic and basic students, and in the controls. A nutrition education intervention was conducted in pre basic and basic teachers in a school year, with a pre-post evaluation of their students, compared with a control group. Subjects were 817 students (389 men and 428 women) from pre kindergarten to the second grade. The 465 students of the intervened group were distributed in two schools (Liceo 1 = 283; Liceo 2 = 182) and 352 in the control school. The nutrition intervention consisted in 9 interactive workshops for teachers with the utilization of Information and Communication Technologies (ICT). The pre post evaluation consisted in a nutritional status assessment, and a food and nutrition survey with questions related with food knowledge and food consumption, at the beginning and at the end of the school year. There were no significant differ...
Association between body mass index (bmi) and height from birth to 5 years in Chilean preschool c... more Association between body mass index (bmi) and height from birth to 5 years in Chilean preschool children Background: It has been shown that excess weight gain during childhood is associated with a greater risk of obesity; this relationship may be mediated by growth in height. Aim: To quantify the associations between z scores for body mass index (BMIZ) and height for age (HAZ) from birth to 5 years of age and to assess how this association varies according to age and adiposity. Material and Methods: Weight and height were recorded at 11 occasions from birth on a cohort of 1089 Chilean five year-old children with a birth weight > 2500 g. BMI, BMIZ, HAZ and prevalence of obesity were calculated. We determined the cross-sectional association between BMIZ and HAZ for the total sample and by 3 BMI Z categories, using Pearson correlation. We determined the probability of obesity according to four HAZ categories. Results: Obesity increased continuously reaching approximately 16% at 5 years. Stunting was virtually nonexistent. No association between BMIZ and HAZ was observed at birth, while at 1 and 2 months, leaner infants had lower stature. No association between these parameters was observed between 6-24 months, while after 3 years, a clear relationship was observed. Conclusions: The probability of a preschool child of being obese is less than 10% with a HAZ is < 0. Nevertheless, children with heights above the median (even within the normal range) have an increased risk of obesity, especially after 3 y of age. Between 0-5 years, the relationship between weight and height varies by age and adiposity. (Rev Med Chile 2011; 139: 606-612).
Tanto en Chile, como en otros países, el exceso de peso presenta una prevalencia alta y creciente... more Tanto en Chile, como en otros países, el exceso de peso presenta una prevalencia alta y creciente desde los primeros años de vida. A modo de ejemplo se observa un aumento de obesidad en escolares de primero básico de 17,3% en el año 2004 a 19,4% en el 2006 (1), teniendo en Chile una meta de llegar a 12% para el año 2010. Según el Estudio "Carga de Enfermedad y Carga Atribuible" (2), las enfermedades no transmisibles constituyen el 84% de los años de vida perdidos ajustados por discapacidad. El consumo de alcohol, el exceso de peso y la hipertensión, son los principales factores de riesgo atribuibles a los años de vida perdidos por discapacidad. Según la última encuesta de salud de la población chilena (año 2003) realizada en 3619 adultos mayores de 17 años 50% de la población tiene riesgo alto o muy alto
Background: The homeostasis assessment model for insulin resistance (HOMA-IR) estimates insulin r... more Background: The homeostasis assessment model for insulin resistance (HOMA-IR) estimates insulin resistance using basal insulin and glucose values and has a good concordance with values obtained with the euglycemic clamp. However it has a high variability that depends on environmental, genetic and physiologic factors. Therefore it is imperative to establish normal HOMA values in different populations. Aim: To report HOMA-IR values in Chilean elderly subjects and to determine the best cutoff point to diagnose insulin resistance. Material and methods: Cross sectional study of 1003 subjects older than 60 years of whom 803 (71% women) did not have diabetes. In 154 subjects, an oral glucose tolerance test was also performed. Insulin resistance (IR) was defined as the HOMA value corresponding to percentile 75 of subjects without over or underweight. The behavior of HOMA-IR in metabolic syndrome was studied and receiver operating curves (ROC) were calculated, using glucose intolerance defined as a blood glucose over 140 mg/dl and hyperinsulinemia, defined as a serum insulin over 60 µU/ml, two hours after the glucose load. Results: Median HOMA-IR values were 1.7. Percentile 75 in subjects without obesity or underweight was 2.57. The area under the ROC curve, when comparing HOMA-IR with glucose intolerance and hyperinsulinemia, was 0.8 (95% confidence values 0.72-0.87), with HOMA-IR values ranging from 2.04 to 2.33. Conclusions: HOMA-IR is a useful method to determine insulin resistance in epidemiological studies. The HOMA-IR cutoff point for insulin resistance defined in this population was 2.6 (Rev Méd Chile 2009; 137: 1409-16).
Background: Functional limitations limit the independence and jeopardize the quality of life of e... more Background: Functional limitations limit the independence and jeopardize the quality of life of elderly subjects. Aim: To assess the association between anthropometric measures and body composition with functional limitations in communityliving older people. Material and Methods: Cross-sectional survey of 377 people ≥65 years old (238 women), randomly selected from the SABE/Chile project. Complete anthropometric measurements were done. Handgrip muscle strength was measured using dynamometers. Body composition was determined using Dual-Energy X-Ray Absorptiometry. Functional limitations were assessed using self reported and observed activities. Results: Body mass index was strongly associated with fat mass (men r =0.87; women r =0.91) and with lean mass (men r =0.55; women r =0.62). Males had significantly greater lean mass (48.9 kg vs 34.9 kg), and bone mass than females (2.6 kg vs 1.8 kg) and women had higher fat mass than men (26.3 kg vs 22.9 kg). The prevalence of functional limitations was high, affecting more women than men (63.7% vs 37.5%, p <0.01). Functional limitations were associated with lower handgrip strength in both sexes. In the multiple regression models, with functional limitations as dependent variable and anthropometric measures as contributing variables, only hand grip strength had a significant association (negative) with functional limitation in both genders. Age was also a significant risk factor for functional limitations among women. Conclusions: Hand grip strength was strongly and inversely associated with functional limitations. Handgrip dynamometry is an easy, cheap and low time-consuming indicator for the assessment of functional limitations and the evaluation of geriatric interventions aimed to improve functional ability (Rev Méd Chile 2007; 135: 846-54).
Vitamin B12 deficiency causes neurologic and psychiatric disease, especially in older adults. Sub... more Vitamin B12 deficiency causes neurologic and psychiatric disease, especially in older adults. Subacute combined degeneration is characterized by damage to the posterior and lateral spinal cord affecting the corticospinal tract. To test corticospinal tract projections using motor evoked potentials (MEPs) by transcranial magnetic stimulation (TMS) in asymptomatic older adults with low vitamin B12 (B12) levels. Cross-sectional study of 53 healthy older adults (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;70 years). MEPs were recorded in the abductor pollicis brevis and tibialis anterior muscles, at rest and during slight tonic contraction. Central motor conduction time (CMCT) was derived from the latency of MEPs and peripheral motor conduction time (PMCT). Neurophysiological variables were analyzed statistically according to B12 status. Median age was 74.3 ± 3.6 years (58.5% women). Twenty-six out of the 53 subjects had low vitamin B12 levels (B12 &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 221 pmol/l). MEPs were recorded for all subjects in upper and lower extremities. There were no significant differences in either latency or amplitude of MEPs and CMCT between low and normal B12 groups. There was a significant PMCT delay in the lower extremities in the low B12 group (p = 0.014). No subclinical abnormality of the corticospinal tract is detected in asymptomatic B12-deficient older adults. The peripheral nervous system appears to be more vulnerable to damage attributable to this…
Transcranial magnetic stimulation (TMS) is a non-invasive, safe, and painless method for evaluati... more Transcranial magnetic stimulation (TMS) is a non-invasive, safe, and painless method for evaluating the corticospinal pathway. The population of older adults is growing, along with the prevalence of neurological diseases common to this group. Latency and amplitude of motor evoked potentials (MEPs) vary among healthy subjects and no reference normal values for MEPs in healthy older adults are available. To create a reference value for MEPs by TMS for healthy older adults. Descriptive study in 36 healthy 70-year-old and older subjects. A 90-mm circular coil Magstim® magnetic stimulator was applied over Cz and Fz. Recording was done in the abductor pollicis brevis and tibialis anterior muscles, at rest and during sustained tonic contraction. Central motor conduction time (CMCT) was derived from MEP latency and peripheral motor conduction time (PMCT). Values were related to age, gender, standing height, and knee height. Mean age was 73.3 ± 2.4 years (58% female). In the upper extremity, average MEP latency was 23.3 ± 1.9 ms at rest and 19.9 ± 1.9 ms during tonic contraction. In the lower extremity, average MEP latency was 30.6 ± 2.5 ms at rest and 27.2 ± 2.3 ms during tonic contraction. There was a significant correlation between MEP latency and standing height, greater in the lower extremities. Female gender appeared as an independent factor determining lower MEP latency, but not CMCT, in upper and lower extremities. We have provided clinically useful reference values for MEPs by TMS in healthy adults older than 70 years of age. As in the younger population, standing height is important in defining normal MEPs. The difference between genders might be due to the lower height of women.
Objective: We analyzed trends in height and BMI and their interaction in 6-year-old Chilean child... more Objective: We analyzed trends in height and BMI and their interaction in 6-year-old Chilean children over the last 15 years. We calculated height for age z-score (HAZ), BMI z-score, prevalence of obesity, underweight, and stunting from cross-sectional national school-based annual population surveys in 1987, 1990, 1993, 1996, 2000, and 2002. Using mixed model analysis, we determined the risk of obesity according to height over time as odds ratios (ORs) and 95% confidence interval and the potential influence of height and year of study on BMI z-score. Results: Over the study period, height increased by 2.8 cm in boys and 2.6 cm in girls, whereas stunting declined from 5% to 2% in both. Tallness increased by ϳ2%, BMI z-score increased from ϩ0.3 to ϩ0.65 in boys and to ϩ0.62 in girls, and HAZ increased from Ϫ0.47 in boys and Ϫ0.45 in girls to 0 in 2002. Underweight declined from 4% to 3%, whereas obesity rose from 5% to ϳ14%. The probability of obesity among tall children was significantly greater than that for normal height children (OR, 2.3 to 3.5). The lowest obesity risk was observed between Ϫ2 and Ϫ1 HAZ. The OR for obesity in the stunted relative to normal height children was variable, ranging from 1.23 to 0.65, whereas it was significant and consistently positive (1.1 to 1.7) for boys and girls when it was compared with the lowest obesity risk according to height. Discussion: Tallness is significantly associated with increased obesity risk in children, while stunting is also associated, but to a lesser degree.
In Chile, childhood obesity rates are high. The purpose of this article is to compare BMI growth ... more In Chile, childhood obesity rates are high. The purpose of this article is to compare BMI growth characteristics of normal (N), overweight (OW), and obese (OB) 5‐year olds from 0 to 5 years and explore the influence of some prenatal factors on these patterns of growth. The study was done on a retrospective cohort of 1,089 5‐year olds with birth weight >2,500 g. Weight and height were obtained from records at nine occasions (0–36 months); at 52 and 60 months, we measured them. At 60 months, children were classified as N, OW, and OB. At each age, BMI and z‐score of BMI (BMI Z) differences were compared among groups. The influence of birth weight, pre‐pregnancy BMI, and prenatal variables (weight gain, smoking, and presence of diabetes and preeclampsia) on BMI Z differences between N and OB was also explored. Adiposity rebound (AR) was not observed for the N, although for the OW, it occurred ∼52 months and for the OB at ∼24 months. BMI Z differences between N and OB were significant...
The mild chronic inflammatory state associated with obesity may be an important link between adip... more The mild chronic inflammatory state associated with obesity may be an important link between adiposity and insulin resistance (IR). In a sample of 137 overweight and obese Chilean adolescents, we assessed associations between high-sensitivity C-reactive protein (hs-CRP), IR and adiposity; explored sex differences; and evaluated whether hs-CRP mediated the relationship between adiposity and IR. Positive relationships between hs-CRP, IR and 2 measures of adiposity were found. Hs-CRP was associated with waist circumference (WC) in boys and fat mass index (FMI) in girls. Using path analysis, we found that hs-CRP mediated the relationship between adiposity (WC and FMI) and the homeostatic model assessment of insulin resistance (HOMA-IR) (p < 0.05) in both sexes. Our novel finding is that inflammation statistically mediated the well described link between increased adiposity and IR.
The objective of the study was to assess a nutrition education and physical activity intervention... more The objective of the study was to assess a nutrition education and physical activity intervention to decrease obesity changing food habits and increasing physical activity in low socioeconomic women. Four groups were selected and followed-up during six months: one was intervened with food education and physical activity (group A); another with food education (group B); a third with physical activity (group C), and a control group. Three nutrition education workshops were carried out with community leaders and nutritionists, and three times per week physical activity sessions were performed. Anthropometric measurements and food and physical activity surveys were carried out before and after the intervention. Obesity increased in group A, but decreased 10% in the other two intervened groups (B and C), and total fatty mass decreased in group B. In the control group, obesity did not change but total fatty mass increased. Attendance to physical activity sessions was poor, with negative r...
Because the results of the nutritional status released by Chilean institutions which collect anth... more Because the results of the nutritional status released by Chilean institutions which collect anthropometric data on their population under control, show different increments in the prevalence of obesity between preschoolers and children in 1st grade, we decided to verify the real magnitude of this increase. This study is based on a longitudinal investigation which began in 2006 and included 1100, three-year old children, which we evaluated when they were 4, 5 and 6 y. The nutritional status was determined according to BMI Z and WHO References 2006/2007. The information was also used to determine the concordance between the anthropometric data collected on first graders by teachers from public schools in 2009 (JUNAEB data set) and the same children assessed in parallel by INTA (INTA data set). The sample included 474, six-year olds. No differences were found between the average BMI Z and HAZ of the two data sets, and the degree of concordance between the BMI Z's was good (rho = 0...
The purpose of this study was to incorporate nutrition education in Chilean primary schools. The ... more The purpose of this study was to incorporate nutrition education in Chilean primary schools. The baseline information included nutritional status, food consumption and physical activity of 1701 children from 3rd to 7th grade in ten urban and rural schools. Main results showed a high prevalence of obesity (15.4%) and overweight (19.6%), low consumption of vegetables, fruits, and dairy products, high intake of snacks and a low level of physical activity, especially in girls. Because the Ministry of Education does not allow the incorporation of new programs into the curriculum, the educational strategy was based on the development of a text book, a teacher's guide, five practical guides for students from third to eighth grade and a CD-Rom. These materials were validated by 36 teachers in six schools through an educational intervention. Teachers and students considered the educational materials useful, motivational and easy to understand. This program is being implemented in 57 scho...
To determine the attitude towards marketing of food and beverages a sample of 1,048 school childr... more To determine the attitude towards marketing of food and beverages a sample of 1,048 school children ages 8 to 13 from three cities of Chile (north, center and south of the country) were interviewed. The instrument applied was a validated questionnaire used in previous studies. A descriptive analysis of the variables was performed and differences were determined by region, socioeconomic level (SEL) and gender using Chi2 test. Differences per SEL were higher in Santiago. A greater proportion of school children of medium-low SEL watched more than 2 hours of TV during weekdays and weekends (p < 0.001). The proportion of children that liked food and beverage commercials was greater in medium-low SEL in Santiago (66%) (p < 0.001), as opposed to 26 to 35% in the medium high SEL. A high percentage indicated that they liked promotional campaigns of foods at supermarkets, on the streets, shopping centers and on the Internet. The preferred commercials were those for beverages, chocolates...
Potentially productive years of life lost (PPYLL) is an impact measure that illustrates the lost ... more Potentially productive years of life lost (PPYLL) is an impact measure that illustrates the lost that a society suffers as a consequence of deaths of young people or premature deaths. To study the evolution of PPYLL in adults in the periods 1994-1996 and 1999-2001, according to sex, income quintiles and main diagnostic groups in the communities of Metropolitan Santiago. Ecological study analyzing the population of Metropolitan Santiago, that represents 36% of the national population. A total of 87,969 deaths in people aged 20 to 79 years were analyzed. There is a greater amount of PPYLL among the poorest quintiles and men represent the higher number of PPYLL. In the different analyzed periods, all quintiles experienced a reduction in PPYLL. According to diagnosis, endocrine diseases experienced the greater decrease between periods, followed by respiratory disease. Noteworthy was the increase of PPYLL due to infectious diseases. PPYLL due to digestive diseases was 2.3 higher in the p...
Delphi method to identify education material on healthy food for teachers, school-age children an... more Delphi method to identify education material on healthy food for teachers, school-age children and their parents. Delphi method applied to get expert consensus about healthy food topics to include in educational materials for preschool and school-age children, their parents and teachers is described. The questionnaire was developed with the results of surveys and focus groups in children, parents and teachers made previously. The questionnaire was mailed to 54 experts in nutrition, education and communication in a first round. The results were analyzed and forwarded in a second round with the subjects without consensus. The cycle was completed by a validation conducted with teachers and parents and were prioritized by audiovisual educational materials on the writings, favoring participatory activities such as cooking workshops, games, activities over the passive (information at parent meetings, delivery of educational materials and conferences of experts). There was consensus on edu...
realizada por el Ministerio de Salud de Chile en los años 2009-2010, mostraron que la prevalencia... more realizada por el Ministerio de Salud de Chile en los años 2009-2010, mostraron que la prevalencia de obesidad alcanzaba al 20,5% y el sobrepeso al 45,3% en los hombres mayores de 15 años, en los que además se observaron altos niveles de sedentarismo (84%). A esto se sumaban prevalencias de hipertensión arterial del 28,7%, diabetes (8,4%), colesterol elevado (39%), colesterol HDL bajo 40 mg/dL (37,6%) y triglicéridos elevados (35,6%) (1). Una de las estrategias para abordar la prevalencia de enfermedades crónicas no transmisibles (ENT) propuesta por la Organización Mundial de la Salud (OMS) ha sido la promoción de salud en los lugares de trabajo, para benefi ciar a los trabajadores y generar impactos positivos en las empresas (2,3). Intervenciones que propician la alimentación adecuada y la práctica regular de actividad física en trabajadores se han asociado al incremento de hasta 20% en los niveles de productividad y reducción del ausentismo laboral (4-10). Goetzel y cols. ( ) proponen seis elementos caracterís-
En las últimas décadas, los profundos cambios experimentados en la alimentación y los estilos de ... more En las últimas décadas, los profundos cambios experimentados en la alimentación y los estilos de vida de la población, se han traducido en un significativo aumento en la prevalencia de obesidad y enfermedades no transmisibles asociadas a ella, como la hipertensión, la diabetes, las enfermedades cardiovasculares y algunos tipos de cáncer (1). Esto ha llevado a la Organización Mundial de la Salud (OMS) a proponer una estrategia mundial orientada a su prevención y control (2).
To assess the impact of a nutrition education program for teachers in the nutritional status, foo... more To assess the impact of a nutrition education program for teachers in the nutritional status, food knowledge and food consumption of their pre basic and basic students, and in the controls. A nutrition education intervention was conducted in pre basic and basic teachers in a school year, with a pre-post evaluation of their students, compared with a control group. Subjects were 817 students (389 men and 428 women) from pre kindergarten to the second grade. The 465 students of the intervened group were distributed in two schools (Liceo 1 = 283; Liceo 2 = 182) and 352 in the control school. The nutrition intervention consisted in 9 interactive workshops for teachers with the utilization of Information and Communication Technologies (ICT). The pre post evaluation consisted in a nutritional status assessment, and a food and nutrition survey with questions related with food knowledge and food consumption, at the beginning and at the end of the school year. There were no significant differ...
Association between body mass index (bmi) and height from birth to 5 years in Chilean preschool c... more Association between body mass index (bmi) and height from birth to 5 years in Chilean preschool children Background: It has been shown that excess weight gain during childhood is associated with a greater risk of obesity; this relationship may be mediated by growth in height. Aim: To quantify the associations between z scores for body mass index (BMIZ) and height for age (HAZ) from birth to 5 years of age and to assess how this association varies according to age and adiposity. Material and Methods: Weight and height were recorded at 11 occasions from birth on a cohort of 1089 Chilean five year-old children with a birth weight > 2500 g. BMI, BMIZ, HAZ and prevalence of obesity were calculated. We determined the cross-sectional association between BMIZ and HAZ for the total sample and by 3 BMI Z categories, using Pearson correlation. We determined the probability of obesity according to four HAZ categories. Results: Obesity increased continuously reaching approximately 16% at 5 years. Stunting was virtually nonexistent. No association between BMIZ and HAZ was observed at birth, while at 1 and 2 months, leaner infants had lower stature. No association between these parameters was observed between 6-24 months, while after 3 years, a clear relationship was observed. Conclusions: The probability of a preschool child of being obese is less than 10% with a HAZ is < 0. Nevertheless, children with heights above the median (even within the normal range) have an increased risk of obesity, especially after 3 y of age. Between 0-5 years, the relationship between weight and height varies by age and adiposity. (Rev Med Chile 2011; 139: 606-612).
Tanto en Chile, como en otros países, el exceso de peso presenta una prevalencia alta y creciente... more Tanto en Chile, como en otros países, el exceso de peso presenta una prevalencia alta y creciente desde los primeros años de vida. A modo de ejemplo se observa un aumento de obesidad en escolares de primero básico de 17,3% en el año 2004 a 19,4% en el 2006 (1), teniendo en Chile una meta de llegar a 12% para el año 2010. Según el Estudio "Carga de Enfermedad y Carga Atribuible" (2), las enfermedades no transmisibles constituyen el 84% de los años de vida perdidos ajustados por discapacidad. El consumo de alcohol, el exceso de peso y la hipertensión, son los principales factores de riesgo atribuibles a los años de vida perdidos por discapacidad. Según la última encuesta de salud de la población chilena (año 2003) realizada en 3619 adultos mayores de 17 años 50% de la población tiene riesgo alto o muy alto
Background: The homeostasis assessment model for insulin resistance (HOMA-IR) estimates insulin r... more Background: The homeostasis assessment model for insulin resistance (HOMA-IR) estimates insulin resistance using basal insulin and glucose values and has a good concordance with values obtained with the euglycemic clamp. However it has a high variability that depends on environmental, genetic and physiologic factors. Therefore it is imperative to establish normal HOMA values in different populations. Aim: To report HOMA-IR values in Chilean elderly subjects and to determine the best cutoff point to diagnose insulin resistance. Material and methods: Cross sectional study of 1003 subjects older than 60 years of whom 803 (71% women) did not have diabetes. In 154 subjects, an oral glucose tolerance test was also performed. Insulin resistance (IR) was defined as the HOMA value corresponding to percentile 75 of subjects without over or underweight. The behavior of HOMA-IR in metabolic syndrome was studied and receiver operating curves (ROC) were calculated, using glucose intolerance defined as a blood glucose over 140 mg/dl and hyperinsulinemia, defined as a serum insulin over 60 µU/ml, two hours after the glucose load. Results: Median HOMA-IR values were 1.7. Percentile 75 in subjects without obesity or underweight was 2.57. The area under the ROC curve, when comparing HOMA-IR with glucose intolerance and hyperinsulinemia, was 0.8 (95% confidence values 0.72-0.87), with HOMA-IR values ranging from 2.04 to 2.33. Conclusions: HOMA-IR is a useful method to determine insulin resistance in epidemiological studies. The HOMA-IR cutoff point for insulin resistance defined in this population was 2.6 (Rev Méd Chile 2009; 137: 1409-16).
Background: Functional limitations limit the independence and jeopardize the quality of life of e... more Background: Functional limitations limit the independence and jeopardize the quality of life of elderly subjects. Aim: To assess the association between anthropometric measures and body composition with functional limitations in communityliving older people. Material and Methods: Cross-sectional survey of 377 people ≥65 years old (238 women), randomly selected from the SABE/Chile project. Complete anthropometric measurements were done. Handgrip muscle strength was measured using dynamometers. Body composition was determined using Dual-Energy X-Ray Absorptiometry. Functional limitations were assessed using self reported and observed activities. Results: Body mass index was strongly associated with fat mass (men r =0.87; women r =0.91) and with lean mass (men r =0.55; women r =0.62). Males had significantly greater lean mass (48.9 kg vs 34.9 kg), and bone mass than females (2.6 kg vs 1.8 kg) and women had higher fat mass than men (26.3 kg vs 22.9 kg). The prevalence of functional limitations was high, affecting more women than men (63.7% vs 37.5%, p <0.01). Functional limitations were associated with lower handgrip strength in both sexes. In the multiple regression models, with functional limitations as dependent variable and anthropometric measures as contributing variables, only hand grip strength had a significant association (negative) with functional limitation in both genders. Age was also a significant risk factor for functional limitations among women. Conclusions: Hand grip strength was strongly and inversely associated with functional limitations. Handgrip dynamometry is an easy, cheap and low time-consuming indicator for the assessment of functional limitations and the evaluation of geriatric interventions aimed to improve functional ability (Rev Méd Chile 2007; 135: 846-54).
Vitamin B12 deficiency causes neurologic and psychiatric disease, especially in older adults. Sub... more Vitamin B12 deficiency causes neurologic and psychiatric disease, especially in older adults. Subacute combined degeneration is characterized by damage to the posterior and lateral spinal cord affecting the corticospinal tract. To test corticospinal tract projections using motor evoked potentials (MEPs) by transcranial magnetic stimulation (TMS) in asymptomatic older adults with low vitamin B12 (B12) levels. Cross-sectional study of 53 healthy older adults (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;70 years). MEPs were recorded in the abductor pollicis brevis and tibialis anterior muscles, at rest and during slight tonic contraction. Central motor conduction time (CMCT) was derived from the latency of MEPs and peripheral motor conduction time (PMCT). Neurophysiological variables were analyzed statistically according to B12 status. Median age was 74.3 ± 3.6 years (58.5% women). Twenty-six out of the 53 subjects had low vitamin B12 levels (B12 &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 221 pmol/l). MEPs were recorded for all subjects in upper and lower extremities. There were no significant differences in either latency or amplitude of MEPs and CMCT between low and normal B12 groups. There was a significant PMCT delay in the lower extremities in the low B12 group (p = 0.014). No subclinical abnormality of the corticospinal tract is detected in asymptomatic B12-deficient older adults. The peripheral nervous system appears to be more vulnerable to damage attributable to this…
Transcranial magnetic stimulation (TMS) is a non-invasive, safe, and painless method for evaluati... more Transcranial magnetic stimulation (TMS) is a non-invasive, safe, and painless method for evaluating the corticospinal pathway. The population of older adults is growing, along with the prevalence of neurological diseases common to this group. Latency and amplitude of motor evoked potentials (MEPs) vary among healthy subjects and no reference normal values for MEPs in healthy older adults are available. To create a reference value for MEPs by TMS for healthy older adults. Descriptive study in 36 healthy 70-year-old and older subjects. A 90-mm circular coil Magstim® magnetic stimulator was applied over Cz and Fz. Recording was done in the abductor pollicis brevis and tibialis anterior muscles, at rest and during sustained tonic contraction. Central motor conduction time (CMCT) was derived from MEP latency and peripheral motor conduction time (PMCT). Values were related to age, gender, standing height, and knee height. Mean age was 73.3 ± 2.4 years (58% female). In the upper extremity, average MEP latency was 23.3 ± 1.9 ms at rest and 19.9 ± 1.9 ms during tonic contraction. In the lower extremity, average MEP latency was 30.6 ± 2.5 ms at rest and 27.2 ± 2.3 ms during tonic contraction. There was a significant correlation between MEP latency and standing height, greater in the lower extremities. Female gender appeared as an independent factor determining lower MEP latency, but not CMCT, in upper and lower extremities. We have provided clinically useful reference values for MEPs by TMS in healthy adults older than 70 years of age. As in the younger population, standing height is important in defining normal MEPs. The difference between genders might be due to the lower height of women.
Objective: We analyzed trends in height and BMI and their interaction in 6-year-old Chilean child... more Objective: We analyzed trends in height and BMI and their interaction in 6-year-old Chilean children over the last 15 years. We calculated height for age z-score (HAZ), BMI z-score, prevalence of obesity, underweight, and stunting from cross-sectional national school-based annual population surveys in 1987, 1990, 1993, 1996, 2000, and 2002. Using mixed model analysis, we determined the risk of obesity according to height over time as odds ratios (ORs) and 95% confidence interval and the potential influence of height and year of study on BMI z-score. Results: Over the study period, height increased by 2.8 cm in boys and 2.6 cm in girls, whereas stunting declined from 5% to 2% in both. Tallness increased by ϳ2%, BMI z-score increased from ϩ0.3 to ϩ0.65 in boys and to ϩ0.62 in girls, and HAZ increased from Ϫ0.47 in boys and Ϫ0.45 in girls to 0 in 2002. Underweight declined from 4% to 3%, whereas obesity rose from 5% to ϳ14%. The probability of obesity among tall children was significantly greater than that for normal height children (OR, 2.3 to 3.5). The lowest obesity risk was observed between Ϫ2 and Ϫ1 HAZ. The OR for obesity in the stunted relative to normal height children was variable, ranging from 1.23 to 0.65, whereas it was significant and consistently positive (1.1 to 1.7) for boys and girls when it was compared with the lowest obesity risk according to height. Discussion: Tallness is significantly associated with increased obesity risk in children, while stunting is also associated, but to a lesser degree.
In Chile, childhood obesity rates are high. The purpose of this article is to compare BMI growth ... more In Chile, childhood obesity rates are high. The purpose of this article is to compare BMI growth characteristics of normal (N), overweight (OW), and obese (OB) 5‐year olds from 0 to 5 years and explore the influence of some prenatal factors on these patterns of growth. The study was done on a retrospective cohort of 1,089 5‐year olds with birth weight >2,500 g. Weight and height were obtained from records at nine occasions (0–36 months); at 52 and 60 months, we measured them. At 60 months, children were classified as N, OW, and OB. At each age, BMI and z‐score of BMI (BMI Z) differences were compared among groups. The influence of birth weight, pre‐pregnancy BMI, and prenatal variables (weight gain, smoking, and presence of diabetes and preeclampsia) on BMI Z differences between N and OB was also explored. Adiposity rebound (AR) was not observed for the N, although for the OW, it occurred ∼52 months and for the OB at ∼24 months. BMI Z differences between N and OB were significant...
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