Alejandro Estrada

Validación de escala de la seguridad alimentaria doméstica en Antioquia, Colombia

Objective. To adapt and validate in households of Antioquia, Colombia, a food security scale previously applied in households of Caracas, Venezuela. Material and Methods. The study was carried out in 44 municipalities in the department of Antioquia, Colombia, in 2003 and 2004, with a randomly selected sample of 1 624 rural and urban households with children under 10 years of age, representative for family units located in the department of Antioquia. The sample was selected using a confidence interval of 95% and an error of 3%. Household food security scale previously used by Paulina Lorenzana in Venezuela were validated for this survey. Internal consistency of the scale was determined using the Spearman correlation coefficient and Cronbach’s Alpha coefficient. Construct validity was established through principal components analysis for categorical data. Prinqual procedure and Rasch modeling were used to define the components and items in the scale. Results. Factor analysis showed two components: 1) variables related to “food insecurity without hunger”, which is explained in 95%; 2) variables related to “food insecurity with hunger”, which is explained in 89.4%. Cronbach’s Alpha coefficients for “food insecurity without hunger” and “food insecurity with hunger” were 0.95 and 0.89, respectively. When analyzed using Rasch modeling, all items showed infit values within a range of 0.8 and 1.2. The scale correlated significantly (p<0.000) with food availability, begging, children’s labor, household size,

Variations in the Prevalence of Metabolic Syndrome in Adolescents According to Different Criteria Used for Diagnosis: Which Definition Should Be Chosen for This Age Group?

BACKGROUND Despite the increasing prevalence of metabolic syndrome in adolescents, there is no consensus for its diagnosis. METHODS A cross-sectional study was conducted to compare the prevalence of metabolic syndrome in adolescents by different definitions, evaluate their concordance, and suggest which definition to apply in this population. A total of 851 adolescents between 10 and 18 years of age were evaluated. Anthropometric (weight, height, waist circumference), biochemical (glucose, lipid profile), and blood pressure data were taken. The prevalence of metabolic syndrome was determined by the definitions of the International Diabetes Federation (IDF) and four published studies by Cook et al., de Ferranti et al., Agudelo et al., and Ford et al. Concordance was determined according to the kappa index. RESULTS The prevalence of metabolic syndrome was 0.9%, 3.8%, 4.1%, 10.5%, and 11.4%, according to the IDF, Cook et al., Ford et al., Agudelo et al., and de Ferranti et al. definitions, respectively. The most prevalent components were hypertriglyceridemia and low high-density lipoprotein cholesterol, whereas the least prevalent components were abdominal obesity and hyperglycemia. The highest concordance was found between the definitions by Cook et al. and Ford et al. (kappa=0.92), whereas the greatest discordance was between the de Ferranti et al. and IDF definitions (kappa=0.14). CONCLUSIONS Metabolic syndrome and its components were conditions present in the adolescents of this study. In this population, with a high prevalence of dyslipidemia and a lower prevalence of abdominal obesity and hyperglycemia, the recommendation to diagnose metabolic syndrome would be that used by Ford et al.

Estado nutricional de niños de Antioquia, Colombia, según dos sistemas de referencia

OBJETIVOS: Comparar indicadores antropometricos y nutricionales en un grupo de ninos de Antioquia, Colombia, segun las referencias de la Organizacion Mundial de la Salud (OMS) y del Centro Nacional de Estadisticas de la Salud (NCHS) de los Estados Unidos de America. METODOS: Se realizo un estudio descriptivo trasversal en una muestra representativa y aleatoria compuesta por 2 290 ninos que participaban en el programa de complementacion alimentaria MANA en Antioquia, Colombia. Se comparo el percentil 50 (P50) del peso y la longitud/estatura, el estado nutricional (peso para la edad, longitud/estatura para la edad y peso para la longitud/estatura) y los promedios del indice Z segun los valores de referencia de la OMS y el NCHS. Se utilizaron la prueba pareada de la t de Student y la prueba de la ji al cuadrado, con sus intervalos de confianza de 95% (IC95%). RESULTADOS: La prevalencia de desnutricion global fue significativamente menor segun las referencias de la OMS (5,3%; IC95%: 4,42 a 6,30) que con las del NCHS (7,6%; IC95%: 6,56 a 8,78; P = 0,0014). La desnutricion cronica fue mayor con los estandares de la OMS (17,6%; IC95%: 16,03 a 19,19) que con los del NCHS (12,8%; IC95%: 11,46 a 14,25; P < 0,001) y la desnutricion aguda fue similar con ambas referencias (2,0%; IC95%: 1,49 a 2,69 frente a 2,3%; IC95%: 1,71 a 2,99, respectivamente; P = 0,477). La prevalencia de sobrepeso con los estandares de la OMS (3,8%; IC95%: 3,07 a 4,69) fue mayor que con las del NCHS (2,3%; IC95%: 1,75 a 3,04; P = 0,0035). CONCLUSIONES: Al emplear las referencias de la OMS se evidencian mejor el sobrepeso y la desnutricion cronica que con las del NCHS; ademas se reducen los valores de prevalencia de desnutricion global a partir de los 6 meses de edad y aumenta la prevalencia general de desnutricion cronica. Las nuevas normas constituyen una herramienta apropiada para evaluar el crecimiento lineal y establecer valores mas objetivos de la prevalencia de malnutricion. En el departamento de Antioquia se deben disenar politicas en salud, alimentacion y nutricion que permitan mejorar el estado nutricional de sus ninos.

Quality of life in institutionalized elderly people of Medellín

INTRODUCTION Many factors contribute to the deteriorating quality of life of elderly people living in care institutions. Some of these problems are a consequence of few contacts with relatives and friends, and being alone with a feeling of isolation. OBJECTIVE The conditions of quality of life are explored for elderly people living in care institutions. MATERIALS AND METHODS In a cross sectional study, 276 subjects were selected from 39 long term institutions located in the city of Medellín, Colombia. The sex ratio was female: male 60:40% with a mean age of 79.2 ± 8.0. Elderly subjects with cognitive problems or not living in the institution were excluded. The World Health Organization Quality of Life of Older Adults (WHOQOL-OLD) questionnaire was applied; in additional, capacity and cognitive functional scales of Pfeffer, the anxiety scale of Goldberg, and the Geriatric Depression Scale of Yesavage were administered. Mininutritional assessment scales and complementary questionnaires about demographics, health perception, social support system were also included. The information was analyzed using the Mann Whitney U test, Kruskal Wallis test, Pearson correlation and multiple linear regression method. RESULTS Most (71%) considered themselves autonomous for undertaking daily, habitual activities. Other statistics included the following: 45.7% with depression, 33.0% with anxiety, 28.3% with functional problems, and 54.3% at risk of malnutrition. A negative quality-of-life assessment was associated with the following factors: female, diabetes, depression, anxiety and high functional capacity. A positive quality-of-life assessment was associated with individuals who voluntarily came to the institution. CONCLUSION Quality of life for elderly people living in care institutions can become deteriorated when they are not capable to do the usual activities necessary for daily living. Exacerbating factors included sex, symptoms of depression, anxiety, or perceived mistreatment by their families.

Environmental risk factors and metabolic syndrome components in overweight youngsters

INTRODUCTION The environmental risk factors such as food intake and physival activity, are determinants in the etiology of metabolic syndrome in overweight adolescents. OBJECTIVE To explore the association between environmental risk factors and components presence of metabolic syndrome in overweight youngsters in Medellín. MATERIALS AND METHODS Adolescents between the ages of 10 and 18 were selected for a cross sectional study. Body composition by anthropometry, blood pressure, lipid profile, glucose, insulin, food intake and physical activity level were assessed in the study population. RESULTS The prevalence for metabolic syndrome components of hypertriglyceridemia was 40.9%; hypertension, 20.9%; low HDLc, 15.6%; high waist circumference, 4.0%, and hyperglycemia, 0.9%; the overall prevalence of metabolic syndrome was 3.1%. There was a statistical difference (p<0.005) between the consumption of calories, simple and total carbohydrates and the presence of the components; no association was found between the level of physical activity and the presence of components (p>0.05). The logistic regression model showed a higher probability of having at least one component if the youngster was male (p=0.022), with a higher BMI (Body Mass Index)(p=0.019) and was located in the fourth simple carbohydrates consumption quartile (p=0.036). CONCLUSIONS Environmental risk factors associated with components of metabolic syndrome were the increased consumption of calories, simple and complex carbohydrates, all directly related to the BMI. In contrast, the level of physical activity, family history and personal risk factors showed no association. The metabolic syndrome only occurred in youngsters with obesity.

Examining for an association between candidate gene polymorphisms in the metabolic syndrome components on excess weight and adiposity measures in youth: a cross-sectional study

BackgroundA polymorphism in a gene may exert its effects on multiple phenotypes. The aim of this study is to explore the association of 10 metabolic syndrome candidate genes with excess weight and adiposity and evaluate the effect of perinatal and socioeconomic factors on these associations.MethodsThe anthropometry, socioeconomic and perinatal conditions and 10 polymorphisms were evaluated in 1081 young people between 10 and 18 years old. Genotypic associations were calculated using logistic and linear models adjusted by age, gender, and pubertal maturation, and a genetic risk score (GRS) was calculated by summing the number of effect alleles.ResultsWe found that AGT-rs699 and the IRS2-rs1805097 variants were significantly associated with excess weight, OR = 1.25 (CI 95% 1.01–1.54; p = 0.034); OR = 0.77 (CI 95% 0.62–0.96; p = 0.022), respectively. AGT-rs699 and FTO-rs17817449 variants were significantly and directly associated with body mass index (BMI) (p = 0.036 and p = 0.031), while IRS2-rs1805097 and UCP3-rs1800849 were significantly and negatively associated with BMI and waist circumference, correspondingly. Each additional effect allele in GRS was associated with an increase of 0.020 log(BMI) (p = 0.004). No effects from the socioeconomic and perinatal factors evaluated on the association of the candidate genes with the phenotypes were detected.ConclusionsOur observation suggests that AGT-rs699 and FTO-rs17817449 variants may contribute to the risk development of excess weight and an increase in the BMI, while IRS2-rs1805097 showed a protector effect; in addition, UCP3- rs1800849 showed a decreasing waist circumference. Socioeconomic and perinatal factors had no effect on the associations of the candidate gene.