Fabián Vásquez

Patrón de actividad física en un grupo de preescolares obesos asistentes a jardines infantiles de JUNJI, evaluado con sensor de movimiento

Resumen es: Objetivo: Evaluar el nivel de actividad fisica de un grupo de preescolares obesos entre 3 y 5 anos asistentes a los jardines infantiles JUNJI. Metodos: E...

Balance de energía, composición corporal y actividad física en preescolares eutróficos y obesos

Objetivo: Comparar balance energetico, composicion corporal y actividad fisica en parvulos eutroficos y obesos, de 3 a 5 anos, asistentes a jardines infantiles JUNJI. Metodologia: Se compararon entre eutroficos y obesos: el gasto energetico total (GET) con agua doblemente marcada (ADM); la ingesta energetica (IE) por pesaje en jardin y registro en el hogar, mas la actividad fisica en jardin con sensor de movimiento TRITRAC. Resultados: GET fue mayor en ninos obesos (p = 0,006). IE en el jardin fue mayor para obesos de ambos sexos (p = 0,0001), IE en el hogar (semana) fue mayor en ninos obesos (p = 0,0001) y en fin de semana IE fue mayor en ninas y ninos obesos (p = 0,0001). En actividad fisica en el jardin, los ninos eutroficos tuvieron mayor actividad moderada intensa (p = 0,02). Conclusiones: El hogar condiciona una mayor ingesta energia de los ninos obesos. La actividad fisica tiende a ser sedentaria en el jardin infantil. Un proceso de intervencion educativa que busque cambiar esta situacion, debe considerar a la familia y educadores

Pilot nutrition and physical activity intervention for preschool children attending daycare centres (JUNJI); primary and secondary outcomes

INTRODUCTION A pilot intervention was conducted to promote physical activity and nutrition in public preschool education (near half a million children in Chile), in order to prevent obesity. OBJECTIVE To assess the primary (body fat) and secondary outcomes (physical activity and energy intake) of a nutrition and physical activity pilot intervention for preschool children, attending day care centres. METHODS A pilot intervention in six day care centres selected at random (n = 530), in 4-5 years old preschool children, Santiago, Chile intending to: provide nutritional and physical activity education to educators and health promotion activities for the family, which in turn, will affect the primary (body fat), and secondary outcomes (physical activity pattern and energy food intake) were measured in a representative subsample of 120 intervened and 145 controls children. RESULTS In relation to secondary outcomes monitoring, moderate-vigorous activity was duplicated in the intervention group (+5.4% and +4.7%, respectively), in both obese and eutrophic children. Energy intake decreased in 11.7% in obese and 7.5% in eutrophic children. Dietary fat intake was reduced (-11 g in obese and -8.4 g in eutrophic children). Intervened obese children reduced body fat in 1.5%, meanwhile in control obese children, body fat increased 1.3% (p < 0.01). CONCLUSIONS The pilot intervention demonstrated the feasibility to influence dietary risk factors and physical activity at the day care centres and families. Therefore, the implementation of the validated intervention program will be tested in different weather conditions, to prevent unhealthy habits in preschool children and their families.

Efecto residual del ejercicio de fuerza muscular en la prevención secundaria de la obesidad infantil

INTRODUCTION The high prevalence of the obesity in Chilean students (23,1%), necessitates the application of interventions that incorporate muscle strength exercise, as this shows great efficacy in obese children. OBJECTIVE To evaluate the residual effect of muscle strength exercise on body fat, metabolic syndrome and physical fitness in obese schoolchildren. METHODS The sample included 111 obese schoolchildren, between 8 and 13 years, of 3 schools in the city of Santiago. Early intervention (n = 60) participated in parallel intervention that included muscle strength exercise, nutrition education and psychological support for 3 months. The late intervention (n = 51) incorporated the first 3 months, only the educational intervention and psychological support, and exercise was added between 3 and 6 months. At 9 months post intervention, we evaluated the residual effect of exercise. Body fat was determined by anthropometric equations. The metabolic syndrome was diagnosed by the criteria of Cook. Physical fitness was assessed by the distance walked in six minutes test. RESULTS The body fat percentage decreased at the end of the intervention and post intervention increased with the exception of the men of early intervention. The distance traveled increased at the end of the intervention but declined in the post intervention. Metabolic syndrome, decreased at the end of the intervention increased post intervention (p < 0,05). CONCLUSION The sustainability of the exercise is essential to maintain the changes, which is checked to determine the residual effect of exercise on body fat, metabolic syndrome and physical condition.

INGESTA ALIMENTARIA DE PREESCOLARES OBESOS ASISTENTES A LOS JARDINES INFANTILES DE LA JUNJI

Introduccion. El programa alimentario de JUNJI cubre 60% de los requerimientos energeticos (1985). Se estudio la ingesta total de ninos obesos, el aporte del hogar y el consumo de grasa. Metodologia. Se evaluo la ingesta durante dos dias de la semana (S)/ uno en el fin de semana (FS), por pesaje en el jardin y registro en su casa. Resultados. La ingesta energetica en S es 1738 ( 269 kcal en ninos y 1545 ( 211 kcal en ninas (similar a requerimientos 1985). La energia ingerida en FS es significativamente mayor en los ninos (2105 ( 434 kcal) y ninas (2093 ( 312 kcal). Este desbalance pare estar producido fundamentalmente por el consumo de grasa en FS, pues es mayor respecto de S, 74 ( 28 g vs 48 ( 10 g, (p<0.002). Conclusiones. Los ninos estan en balance de energia durante S, pero se produce un excedente del 25-36% en FS. Se evidencia un alto consumo de grasa en el hogar principalmente durante FS. El jardin infantil protege al nino en cuanto a su ingesta de energia, sin embargo es urgente educar a los padres en alimentacion y nutricion con respecto a la ingesta del nino en el hogar.

Energy expenditure and intake comparisons in Chilean children 4-5 years attending day-care centres

INTRODUCTION the doubly labelled water (DLW) method has an accuracy of 1% and within-subject precision of 5-8%, depending on subjects age and environments issues. Energy intake assessment is prone to errors (>15- 20%) depending in the method utilized. OBJECTIVE to quantify DLW methodology errors in four to five year olds that could affect the comparison with energy intake. METHODS energy expenditure (TEE, by DLW), was assessed during 14 days in 18 preschool children, who attended eight hours daily to day-care centres. Energy intake was determined by a combined method: food weighing during weekdays and recall after leaving the Centre (17h to sleep time) plus 24 h recall, during the weekend. Several assumptions affecting DLW total error were assessed to determine their influence in the comparison to energy intake (i.e. background variability, space ratio, proportion of water subject to fractionation, food quotient value). RESULTS the individual mean energy expenditure was 1 373 ± 177 kcal and the energy intake (1 409 ± 161 kcal). The overall difference between intake and expenditure was 42.9 kcal/day (limits of agreement + 259.1 to -112.3 kcal/day). TEE measurement error only explained a minor quantity (2.4%), between both measurements, and the observed mean isotope dilution space was 1.030 ± 0.010 confirming the value utilized in adults studies. CONCLUSIONS energy expenditure data is similar to other studies in preschool children. The small difference found between energy intake and expenditure may be attributed to the applied energy intake methodology, the homogeneous diet at care centres during the week-days and the lower DLW methodology error.

Multivariate Adaptative Regression Splines (MARS), una alternativa para el análisis de series de tiempo

Multivariate Adaptive Regression Splines (MARS) is a non-parametric modelling method that extends the linear model, incorporating nonlinearities and interactions between variables. It is a flexible tool that automates the construction of predictive models: selecting relevant variables, transforming the predictor variables, processing missing values and preventing overshooting using a self-test. It is also able to predict, taking into account structural factors that might influence the outcome variable, thereby generating hypothetical models. The end result could identify relevant cut-off points in data series. It is rarely used in health, so it is proposed as a tool for the evaluation of relevant public health indicators. For demonstrative purposes, data series regarding the mortality of children under 5 years of age in Costa Rica were used, comprising the period 1978-2008.

Comparison of body fat calculations by sex and puberty status in obese schoolchildren using two and four compartment body composition models

INTRODUCTION Determine body composition changes in adiposity can assess an individual. OBJECTIVE The objective of this study was to evaluate total body fat percentage based on two and four compartment models in obese Chilean school children, adjusting for differences in sex and puberty status. METHODS Sixty-one obese school children (33 boys and 28 girls) between 8 and 13 years of age were evaluated. Two compartment measurements of body fat percentage considered isotope dilution, plethysmography, radiographic absorptiometry and bioelectrical impedance; using the four compartment model as a benchmark. RESULTS Each method explained between 43-87% of the variance in body fat percentage in Tanner stage I and II children and between 78-96% in Tanner stage III and V children. In both groups of children methods differed significantly for stage I, with the exception of plethysmography. High R2 values were observed for girls in all Tanner stages. Each method explained between 34-92% of the variance in body fat percentage for girls in stages I and II and between 63-93% for stages III and V. In obese boys, R2 values were high for stages III and V. In girls and boys in Tanner stage III and V, the smallest differences were observed for isotopic dilution, and DXA (dual-energy X-ray absorptiometry) scan for stages I and II. CONCLUSIONS For obese boys and girls, the two compartment model with isotopic dilution and DXA had the best precision and smallest differences in determining body fat percentage compared to the benchmark.

[Dietetic supplements for weight reduction: medical and ethical dilemmas].

Obesity is an important public health problem. Dietetic supplements are commonly used by obese patients who are not aware of the effectiveness or potential harms of these products. The aim of this paper is to discuss the ethical dilemma associated with the use of these supplements. The principles of autonomy, beneficence and justice are involved. Obesity as a chronic disease, requires qualified medical care. Obese individuals should be aware of their disease and voluntarily agree to receive professional care.Obesity is an important public health problem. Dietetic supplements are commonly used by obese patients who are not aware of the effectiveness or potential harms of these products. The aim of this paper is to discuss the ethical dilemma associated with the use of these supplements. The principles of autonomy, beneficence and justice are involved. Obesity as a chronic disease, requires qualified medical care. Obese individuals should be aware of their disease and voluntarily agree to receive professional care.